Tips for Parenting a Puppy

[Dr. Sullivan's puppy, Winnie]
Meet Winnie.

Life as a new pet parent can be challenging, and to be honest, you never really know what to expect. After losing Oskee, our dog of 14 years, last fall, I knew our family would get a new dog, but we just didn’t know when. We were not in any rush, but over the past few months, we were discussing it more and more.

This past month we adopted a puppy from a rescue in Central Illinois called Hudson’s Halfway Home. I had the privilege of working with this rescue group before moving to Chicago, and they do amazing work. Our family was lucky enough to adopt a 6-month-old puppy, and she has been a great addition to our family.

Even though I see puppies daily, it had been more than 15 years since I had a puppy at home, so I had a lot to think about before bringing Winnie into our family. Here is my list of ways you can help set a puppy up for success.

Routine


Most important is creating consistency among all family members to avoid confusion for new puppies. Having a routine that everyone follows around housetraining, feeding, basic commands, and so on will help your new dog catch on quickly.

Housetraining

When it comes to housetraining, it is very important to be proactive early on. Puppies initially will not ask to go outside to go to the bathroom. Anticipating when they may need to go and then providing a small reward once they go outside is key. Additionally, do not confuse puppies by trying to teach them both potty pads and grass early on. I always tell owners if your goal is to train to go to the bathroom outside, that should be started from Day 1. After they are puppy pad trained, they can still be trained to go outside, but it may be more challenging.

Consistent diet

Puppies commonly have intestinal parasites and are also known for eating/chewing on everything. Keeping puppies on a consistent diet will help keep their bowel movements regular and predictable. Feeding an overabundance of treats and/or human table scraps will likely lead to soft stool/diarrhea. When puppies have diarrhea, the frequency of defecation increases, so accidents inside are common, further delaying potty training. Not to mention that a poor diet could make puppies very sick. I always say avoid the human food. It is not a good habit to start at such a young age.

House safety

Be sure you puppy-proof your house and have limitations for your new puppy. I highly recommend crate training. Crates are not to be used as a source of punishment, but a place where puppies feel safe and secure. The training may take time, and you may need to sleep next to the crate initially, but once puppies realize it is their safe place, it is wonderful. Having a dog crate trained also keeps dogs safe when you are away. If crate training is not for you and your puppy, then using baby gates to create boundaries can be used similarly. In addition to boundaries, make sure all garbage cans have lids or are in cabinets. Be sure electrical cords are placed where puppies can’t chew them. Keep all cleaning products away from the puppy. Puppies love socks, so use caution to prevent your puppy from eating your socks.

Preventive care

It is very important to take your new puppy to the vet as soon as possible for an overall health check and vaccines, if needed. Typically, puppies receive vaccines at 8, 12, and 16 weeks of age. Additionally, puppies should have an intestinal parasite screen for worms (very common in puppies) and need to be started on heartworm, flea, and tick prevention as young as 6 to 8 weeks of age.

Socialization

It is very important to socialize puppies with both dogs and people. Puppies mature so quickly that it is important to start socialization very early on.

Insurance

If you are considering insurance, the best time to purchase is when you have a puppy with, hopefully, no pre-existing problems. Once a problem occurs, most companies will consider it pre-existing and insurance will not cover treatment of that problem the remainder of that pet’s life (allergies and ear infections, for example). There are many insurance companies, so to find one that’s right for you consider whether you are looking for coverage for accidents and illness or full coverage that includes wellness/preventive care.


Over the past three weeks, our family has made changes to our routines to accommodate Winnie. She is adjusting well and, luckily, our house is somewhat puppy-proof because it is somewhat kid-proof (minus all the kids’ toys).

We are crate training her, and she is doing great. She loves her crate and goes in willingly at bedtime. During the day, she prefers never to go in, but when we leave the house, she does great in her crate. When we are home, she goes outside to pee every few hours, and she can make it through the night without an accident. So overall, housetraining is going very well, though there have been a few accidents.

We are both trying to figure each other out. Since she had lived in a kennel setting for 4 months, the grass and leash walking were brand new to her. Now that she is catching on and is gaining confidence outside, she is doing well. She still does not alert us when she needs to go out, so we try to stay proactive in telling her it’s time to go “potty.” With a continued consistent routine, I’m confident we will be accident-free in a short time.

Like many of you, we are thrilled to have a new dog in our home. We love having Winnie in our family. Start early and stay consistent to set your puppy or new dog up for success.

Dr. Drew Sullivan, Medical Director

Make Room for Kitty

The spring is one of my favorite times of the year. Not only do I look forward to the beautiful weather, but I also look forward to seeing lots of adorable, newly adopted kittens. I can’t help but smile from ear to ear whenever I see them! I have been saying for months that I have kitten fever. Every day it is getting more difficult not to adopt one of my own.

Next month is the height of “kitten season.” It’s when litter after litter of kittens are born, taken to shelters and rescues, and in need of new homes. Unfortunately, there are far more pets than available homes, which further adds to pet overpopulation. American Humane celebrates Adopt-A-Cat Month each June to bring awareness to this situation and in hopes of encouraging more people to adopt cats in need of a loving home.

The pandemic has made the operations of shelters and adoptions more challenging, which makes Adopt-A-Cat Month even more important. While many people have already welcomed new four-legged family members into their families, there are still many precious and loving cats in need of a forever home. To find your forever feline, check out the websites of shelters and rescues and visit to see them in person. Be prepared to be overwhelmed by the cuteness overload, and potentially leave with multiple cats!

To help with this process, there are many resources available to help you. Many organizations provide information to guide you through this process. For example, American Humane provides literature on their website including A Cat Adoption Checklist and Introducing Cats (And Dogs) to Cats. You can also contact us if you have any questions regarding adoption. We will do whatever we can to help you find the right cat for you!

If you are unable to adopt, there are other ways to help the many pets in need. Donations (such as monetary gifts and food)can be made to local shelters and rescues. Volunteer opportunities are often available.

Adopt-A-Cat Month is almost here, so you have plenty of time to find your purrfect feline companion!

Amber Slaughter, DVM

Photo from our Instagram account.

Seizures to Shining Seizures

Oh, the nostalgia of COVID springs past. The smell of fresh crocus buds mixed with a new pandemic mask is one that evokes awakening. The freshness of April baseball overlapping with the anxiety of crowded super-spreader events, weddings, and birthday parties with only limited mortalities makes the body and brain feel young again. Socially distant first dates are in the air and all the Spring kids playing Legos together over Zoom brings back the hope squashed by the constraints of Winter kids playing Legos together over Zoom just weeks ago. The dogs and cats can feel the weather changing and with it, ramp up their dog and cat A-game. And with that, I end my introductory ramblings and segue, quite unnaturally, into a discussion regarding … your cats’ and dogs’ general neurologic behavior.

There’s This Weird Thing that Happens…

As always the bearer of angst-inducing theoretical scenarios, I would like to evoke a scene that is relayed to me often that goes like this. A dog is doing generally well. No real issues. She is eating and drinking fine, seems to be getting along with the new dog, loves to take walks, yes, there are no issues. But [hesitates for a moment], there’s this weird thing that happens every so often, I am told, and it’s probably nothing but she seems to just stare off into space every once in a while, acting like she’s not there. Then she stops, licks her leg for a few minutes, and then seems to come to and then there’s nothing wrong.

The cat version is usually something similar but often involves chasing a fly (or dust) and then twitching for a bit. I ask how long it’s been going on and often the answer is vague, like she has always done odd things like that but we thought it was just a thing, like when she goes to sleep and twitches and chases bunnies in her dreams, and sometimes whimpers… So it’s been going on for years, but it seems to be getting worse.

The Movie Version of Seizures

I think when people think of dogs and cats having seizures, they usually evoke the classic grand mal seizure like one you’d see a person have in a movie, or if you know humans with epilepsy, in real life. This big seizure in dogs and cats usually presents with them seeming off for a bit, maybe scared and hiding under the bed or in the closet for a few minutes with dilated eyes and hearts beating fast. Then the seizure will hit causing their front legs to go stiff and stick out. Their back legs paddle, their eyes can start twitching back and forth, and often they vomit, defecate, or urinate. Then comes the post-seizure time frame where they slowly come out of it and seem exhausted and not themselves for a few hours.

This would be the seizure most likely to be portrayed in the Lifetime Movie Network’s scandalous romantic thriller about a single mom/widower with a heart of gold who adopts a dog from the local church auction and then gets more than she bargained for when the dog’s neurologic activity comes between her and her rebellious daughter’s new boyfriend [screenplay pending].

Abnormal neurologic behavior is very far-ranging and sometimes we see cats and dogs act like both of the above examples and sometimes it’s even vaguer or weirder. With hopes that I am not inciting a mob of people calling with thoughts that their animals are having seizures, I will say that seizures often are retroactively understood to be seizures after they progress.

What Is a Seizure?

I’m sure you’ve heard the term “seizure,” but it’s important to know what this means. Here’s a simplified explanation: The brain is constantly activating and suppressing parts of the body through, essentially, electrical and chemical conduction. A seizure is an abnormal event where the brain is essentially not able to control its firing. It loses control of all the carefully metered out activity of the body.

Seizures can be caused by many things, and it’s important to remember that often the cause does not have to be as scary as one first assumes, especially if an animal is otherwise doing well.

Diagnosing Epilepsy

If a dog or cat is not particularly young or old, let’s just say 2 to 9 years old, the first thought is idiopathic epilepsy. This is just a way of saying, to be simpler than I like or actually have ever been, that there is no real reason or cause for the seizure.

We usually get to this diagnosis by two means. The first option is that we examine the animal and perform complete blood work to rule out metabolic and endocrine causes of seizures (like anemia, abnormal electrolytes, etc.). I usually will also focus on the heart to make sure that abnormal cardiovascular or blood pressure activity is not causing events that look like seizures. If all is normal, we monitor and see if the seizures continue while not really affecting a dog’s or cat’s life in a significant way. Sometimes we add anti-seizure medications (which are generally cheap and safe) if things are progressing. If enough time goes by and things seem controlled (with or without medications), it’s most likely epilepsy. Sometimes we have no options other than to go this direction due to limited finances or temperament of the animal.

The second option is more expensive and thorough. This would require an animal to see a boarded neurologist at a specialty hospital and most often have advanced imaging and diagnostics performed, such as an MRI and cerebral spinal fluid tap under anesthesia. I usually would have an echocardiogram of the heart performed for the reasons explained above. If there is no other cause of seizures found, we call it epilepsy, and the management is similar to option 1: monitor and start anti-seizure medications if things are getting worse.

I want to be clear, though, that seizures are serious, regardless of whether they are vague and mild or serious and dramatic. Every seizure has the potential to cause brain damage, and every seizure can be one that is life altering and even fatal. That is why doing a work-up for animals suffering from seizures is important and why we always want to rule out the other things before presuming that this is “just” epilepsy. It may not always be an emergency, but we should always see animals who are having abnormal neurologic events.

Other Causes of Seizures

And then what is it if it isn’t epilepsy? Besides being a repulsive sentence to say aloud, it also is answered by a conversation that everyone wants to avoid.

The first thing that everyone is fearful of, especially if an animal is older, is that seizures are being caused by a brain tumor. Though this is possible, there are other things about which to worry such as liver or kidney dysfunction, low blood sugar, anemia, high or low calcium, magnesium, potassium, chloride, congenital malformations of the brain, trauma, toxins, infections (viral, fungal, bacterial), diseases caused by tick bites, parasites that go to the brain, immune-mediated causes, and in some dogs we see degenerative causes that sometimes can cause our pets to act “senile.”

Unfortunately, in many cases, dogs and cats that are having seizures can be thought to have epilepsy or, at least all of the above are presumed to not be occurring. Later we discover one of these causes, like cancer, had been hiding without detection. If a cat or dog is presumed to not be suffering from all of the above and is diagnosed with epilepsy, the proper course of treatment is often, again, just to monitor or start anti-seizure medications, but if it is not working, sometimes rescue drugs like steroids are tried.

Serious But Often Very Treatable

With fear of ending on a bad note, I want to emphasize that seizures are serious, definitely scary to see, vague and can manifest in a wide-array of abnormal behavior, but often very treatable and controllable. Some dogs, though, just do weird things for no reason. My dog loses his mind whenever he sees a black bag, either on the ground or blowing in the wind, and his behavior is probably insane enough to be viewed as abnormal by most people, but he’s just crazy.

Some dogs and cats just do weird things, and this is not reason to treat your dog for a neurologic event. So let us know if you have questions and enjoy the remainder of your pandemic.

Wear your masks, read your books: https://www.bookcellarinc.com/book/9781501160349

Brett Grossman, DVM
Medical District Veterinary Clinic

Photo by Sandra Seitamaa on Unsplash

March Vaxness?

Right now with the pandemic, I don’t think a day goes by when I’m not thinking about vaccines. Granted, a big part of my job is vaccinating your furry family members to help keep them healthy and maintain their legal status, but with most of us having “Moderna/Pfizer versus Johnson & Johnson” or “one- or two-shot protocols” swirling in our head, I’m hoping to review a little bit about vaccines and their importance while I take a break from working on my NCAA bracket.

What Is a Vaccine?

I’m sure this is common knowledge at this point, but as a reminder, a vaccine is a composite of either a dead or modified-live version of a virus or bacteria that you expose the body to so the immune system to be able to quickly build a response if or when exposed to the actual virus or bacteria in the future. (We will not worry about the newer mRNA vaccines, as at this time the veterinary field does not use them.) Using a sports analogy, you can think about vaccines as giving the immune system a little practice with a disease, so it will be ready for game day.

When Do You Booster Vaccines?

In order for a vaccine to work, the immune system needs enough exposure to build up long-term immunity. That means, when the body is exposed, it not only remembers the disease, but can build a defense quickly, before the disease causes significant illness. Sometimes you need more than one practice session to master that layup; it’s the same with the immune system. Some immune systems need more practice than others. This mostly pertains to puppies and kittens: their immune systems are less developed, so they require more practice than an older more “skilled” immune system.

Why Do Some Vaccines Last Longer Than Others?

It can get a little confusing to know how long each vaccine last for. Some vaccines, such as canine and feline distemper, can provide immunity for up to 3 years in most adult pets. Others (e.g., leptospirosis and feline leukemia) need boosters every year to maintain adequate immunity. This is because the immune system is better at remembering certain diseases than others. Some people will never forget how to shoot a free throw, but it will probably take a lot more practice to maintain that hook shot.

What Vaccines Should My Pet Have?

Ultimately, you should discuss this question with your vet. Recommendations will vary based on your pet’s lifestyle and geographical location. Here is what we currently recommend for the average dog and cat that live in Chicago:

Dogs: DAPP (Distemper virus, Adenovirus, Parvovirus, and Parainfluenza virus), Leptospirosis, Bordetella, and Rabies

Cats (indoor only): FVRCP (Feline Viral Rhinotracheitis, Calicivirus, and Panleukopenia) and Rabies

When they are current on these vaccines, your dogs’ and cats’ immune systems will be ready to fight and win on the big game day.

Let’s hope our Illini are ready to do the same! I-L-L

Alyssa Kritzman, DVM

Photos by Fred Zwicky, © Board of Trustees of the University of Illinois, and Charles Deluvio on Unsplash

The Case of the Shih Tzu That Couldn’t Pee

What’s Your Diagnosis?

This is Chang Lu, a 10-year-old Shih Tzu. Chang Lu visited Medical District Veterinary Clinic in December with a history of straining to urinate, increased frequency of urination, and bloody urine.

During her exam she was trying to urinary every few minutes and was producing small, blood-tinged urine droplets each time. Initial diagnostics included urinalysis and X-rays. Her urine revealed significant bacteria and an overabundance of white blood cells. Below are her X-rays.

What is your diagnosis?

If you diagnosed Chang Lu with urinary tract infection and urinary bladder stones (urolithiasis), then you are correct. The large egg-shaped structures should not be there. Those are large urinary calculi (stones). Below I have notated the X-ray to point out various organs.

Urolithiasis (urinary bladder stones) are common in both dogs and cats. In people, most urinary stones originate in the kidneys, but in animals, more than 90% originate in the bladder, or lower urinary tract.

Urolithiasis (Urinary Bladder Stones)

Many factors, including genetic predisposition, can lead to bladder stones. Smaller breed dogs are at higher risk of developing urinary calculi (stones). Other predisposing factor include urinary tract infections, urine pH, urine mineral composition, and urine concentration.

When we see patients exhibiting the signs Chang Lu came in with (inappropriate urination, bloody urine, straining to urinate, increased frequency of urination), the most likely cause in dogs is a urinary tract infection and in cats is idiopathic (stress-induced) cystitis. In both species, however, it is important to rule out bladder stones, especially if urinary issues have been an ongoing problem for the pet.

To diagnose urinary bladder stones, veterinarians need to look inside the abdomen using X-rays and/or ultrasound. Seeing these stones is easier on X-rays than with ultrasound, and the number of stones can be more easily counted. Unfortunately, not all stones show up on X-rays, so ultrasound is needed to diagnose the non-radiopaque stones. Luckily, those that can’t be seen on X-ray are the much less common than those that can.

Treatment for Urinary Bladder Stones

Once stones have been diagnosed, treatment usually consists of a cystotomy (surgical removal of the stones) and treating the infection, if one is present. In some cases, prescription diets can be used to try to dissolve the stones. I personally have had great success with dissolution of stones in cats but very little to no success of dissolving stones with diet in dogs.

Chang Lu underwent a cystotomy, and two large stones were removed from her urinary bladder (see photo). At the time of surgery, we took a bacterial culture of her bladder, and the results showed that she had a resistant bacterial urinary tract infection. A resistant bacterial infection means the bacteria present in her bladder was resistant to most antibiotics, including the one she was initially prescribed. She was prescribed a new antibiotic in hopes the infection would be cleared.

How to Prevent Urinary Bladder Stones

Once stones have been diagnosed, it is very important to identify the type of stone to understand steps that can be taken to help prevent re-occurrence. After any cystotomy, the stones are sent to the University of Minnesota Urolith Laboratory, where the stones are evaluated. Knowing the mineral composition of the stone helps veterinarians determine the best way to prevent stones in the future. In many cases, pets are started on a long-term prescription diet to help alter their urine pH, encourage urine dilution, and limit the mineral components of the diet that lead to stone formation.

Chang Lu’s stones were determined to be 100% struvite stones, most likely secondary to her resistant bacterial infection. After she finished the course of new antibiotics, her urine was re-cultured, and the infection was completely cleared. Moving forward we will be screening her urine for infection every 3 to 6 months. She has also been switched to a prescription food designed to keep new stones from forming. Chang Lu is currently doing great and all her clinical signs have resolved.

– Dr. Drew Sullivan

Every Day Is Dental Care Day

With National Pet Dental Month beginning in February, the dental health of our patients is a main focus of our practice right now. While having dental procedures performed is key to help maintain dental health, home dental care is also an extremely important aspect of maintaining dental health in dogs and cats.

The goal of practicing home dental care is to prevent or control periodontal disease by reducing plaque and tartar buildup. In order to be most beneficial, this must be practiced long term. There are various home dental care options available and the combination of different methods is ideal.
The following are examples of home dental care options:

Brushing the Teeth

This is the most effective way to slow the progression of dental disease between dental cleanings. By brushing the teeth, formation of the film of bacteria on the teeth (known as plaque) is disrupted. Ideally the teeth should be brushed daily for the best results. Introducing your pet to brushing when they are younger is easiest for both you and your pet. Your pet will likely resist having the teeth brushed at first. Please remain patient and persistent, as it will take some time for them to get used to it.

Be sure to use a pet-safe toothpaste and avoid using human products. Toothpastes come in a variety of flavors, so hopefully you can find one that your pet will enjoy. You can also try a variety of pet toothbrushes styles until you find one that works best for your pet.

Dental Rinses

As with brushing, it may take time for your pet to adjust to the taste and having dental rinse applied. Some rinses taste better than others. Find one your pet likes. We recommend finding a rinse that contains chlorhexidine, which is one of the most effective antiseptics and helps prevent plaque formation on the teeth.

Dental Diets and Treats

Diets and treats formulated to address pets’ dental health rely on the shape or size of the kibble and the ingredients of the food to effective. The diets can be fed as the main diet and also as treats. Examples of prescription diets include Hill’s Prescription Dental t/d Dental Care, Royal Canin Dental Care, and Purina Pro Plan Veterinary Diets DH Dental Health. There are also over-the-counter diets and treats available without a prescription.

The Veterinary Oral Health Council’s (VOHC) Seal of Acceptance is awarded to home oral hygiene products that meet or exceed the VOHC standard for slowing down the accumulation of dental plaque and tartar. Check out these links to learn which products have the VOHC Seal of Acceptance:
Dogs – http://www.vohc.org/VOHCAcceptedProductsTable_Dogs.pdf
Cats – http://www.vohc.org/VOHCAcceptedProductsTable_Cats.pdf

Taking an active role in your pet’s dental care will help reduce dental disease and potentially life-threatening heart and kidney disease, which is why it is so important! Please contact us if you have any questions regarding home dental care for your pet.

Amber Slaughter, DVM

Image by Lynn Greyling from Pixabay

The ‘Why’ Behind Common Dog Vaccines

You bring your dog to the vet every year for a physical examination and vaccinations. But do you recall why your dog is receiving her shots and how her doctor has decided which ones she needs? The following is a summary of the vaccinations we offer and the diseases they prevent.

Rabies

Rabies is a virus that is contracted through the saliva (usually a bite) from an infected animal. Because rabies is always fatal and can be transmitted to humans, it is required by law that pet dogs be vaccinated. The first rabies vaccine your pet receives can be given as young as 12 weeks of age and must be re-administered one year later. Subsequent vaccines are given at either one- or three-year intervals.

DAPP, aka Distemper

This combination vaccine protects your dog from four respiratory, neurologic, and gastrointestinal viruses (distemper, adenovirus, parvovirus, and parainfluenza) that are in the environment and easy to contract through contact with an affected dog or contaminated feces. It is especially important that puppies receive this inoculation at appropriate intervals. The immune system of puppies is immature and not ready to battle these diseases. We administer this vaccine starting at 6 to 8 weeks of age, and continue every 2 to 4 weeks until your dog is at least 16 weeks of age. As your dog gets older, this vaccine will be given less frequently since his immune system is armed with antibodies to fight illness.

Leptospirosis

A bacteria found in standing water, leptospirosis is transmitted through the urine of infected rodents. A dog can contract the bacteria by drinking out of, or even walking through, a contaminated puddle. Symptoms range from mild gastrointestinal signs to liver and/or kidney failure. This potentially fatal disease is communicable to humans, so we strongly recommend all dogs receive the vaccine once a year.

There are several vaccines we give to dogs based on their lifestyles, which determines their risks.

Bordetella

Bordetella is the bacteria implicated in “kennel cough,” a respiratory illness that is easy to transmit through contact with an infected dog or through nasal or oral secretions. If your dog has contact with dogs you don’t know at a park or kennel, she should receive this vaccine. Puppies can get this vaccine as young as 6 weeks of age. It requires annual boosters.

Lyme

The Lyme disease vaccine protects dogs against the spirochete Borrelia burgdorferi, which is transmitted by ticks. Lyme disease is characterized by arthritis, lameness, fever, and rarely, a serious kidney disease. If your dog spends any time in the woods and has exposure to ticks, this vaccine is recommended. It’s worth noting that protection against ticks is an essential part of disease prevention, since Lyme is not the only disease ticks can transmit.

Canine Influenza virus

Canine flu causes fever, cough, and fatigue and can lead to life-threatening pneumonia. It’s transmitted through oral or nasal secretions or through contact with a contaminated surface. If your dog spends time around dogs you don’t know at a park or a kennel, this vaccine is an important part of disease prevention.

Vaccinations can protect your dog from contagious diseases, some of which are fatal. As your pet’s caregiver, you should understand the preventable diseases your dog is at risk for contracting. Please call our office if you have any questions about these vaccines.

Barrie Yallof, DVM

Image by Rajesh Balouria from Pixabay

The Weather Outside Is Fightful

Oh, what a typical December in a year of continual peace and normalcy.

What’s your favorite holiday memory regarding socially distanced Zoom calls with family members you haven’t seen in person for years due to splintered political realities followed by a deadly pandemic all the while keeping your 6-year-old son inside and away from his friends for 9 months and simultaneously being forced to keep an external facade of sanity and light fun in your two-holiday household while your profession, which is universally adored and undervalued at the same time, is more in demand of your time than at any other period in history?

I have so many.

So we know what usually happens here on the holiday. There is a cute blog post about keeping your dogs and cats safe, titled something like “’Tis the Wheezin’: Asthma During the Holidays.” I have written some in the past (HERE), and feel free to read. It generally can be summed up by this wise adage: “Don’t let your dog and cat eat things or get burned and remember that New Year’s Eve in Chicago generally involves people who do not have children and animals lighting off fireworks late at night to make those of us who do angry.” And don’t buy puppies, kittens, or bunnies as gifts. Instead, buy books like this inspirational tale for the animal lover in your life.

But I’m going to write about an unrelated topic: domesticated cats and the outdoors. I can imagine, even before writing this, that many people have strong feelings about this topic. My intention is not to pass judgment on anyone. I want to just give you the veterinarian perspective, and possibly give you an excuse to see photos of my fat indoor cats sitting next to holiday decorations, because that is how we indoor-cat people are generally seen and heard.

Crocodile and Penelope deign to be photographed by the tree. They are not fat. They are fluffy.

Some cats go outside. Cats go outside because some people feel that they have no choice but to let the cat out. Some people feel that it is philosophically cruel to not let the cat out, and some cats get outside by accident. All are acceptable.

I will be upfront and tell you that my two cats, Crocodile the Russian Blue mutt and Penelope the one-eyed tuxedo, do not go outside. They both try at times and have both gotten out before, but they stay inside and tolerate the complete subservience of all surrounding them.

Some of the dangers facing an outdoor cat are pretty obvious, but let’s go through them (you and I, together, like old friends who aren’t being watched):

1. Fighting with Other Cats

Cat bites and scratches are bad, cause severe infections, and can be fatal. All veterinarians have seen cats brought in with bite wounds that have become severely infected and, at worst, can puncture the abdomen, chest, eyeball, or throat and need surgical fix, hospital stays, and even euthanasia. We clean it up and give antibiotics, but it’s always concerning. This also can lead to:

2. Spread of Infectious Disease

Feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) are spread through the exchange of bodily fluids (blood, saliva, etc.). Let’s just assume that the cats outside getting into fights are mostly ones that are homeless, and that homeless cats comprise the largest population of cats carrying these viral diseases. Well, the logic chain/train follows, and you see the danger. We can vaccinate for FeLV, so if your cat does go outside, you can get this done. There is no vaccine for FIV. And no treatment for either disease.

3. Other Infectious Disease

Rabies is a classic viral hit and can be spread through other cats or wild animals (bats, skunks, foxes). Make sure your outside cat is vaccinated for rabies, not only because it is the law but also because, even though it is rare, your sweet rabid cat can kill you and your family. (Still waiting for the Hallmark Channel’s Very Special Rabies Christmas.)

Just for fun let’s add endless respiratory infections (that can pass on to the other cats in your house), feline distemper (get your cat vaccinated for that, too), and parasitic diseases such as fleas (get monthly flea protection), ticks (get monthly tick protection), ear mites, intestinal worms (have monthly dewormers given), and ringworm.

All but one of these diseases can be passed on to you, your children, your grandparents, their friends, their friends’ neighbor, your friends’ neighbors’ son’s cat, etc. You see how this works. If you have an outdoor cat, and you’re afraid to tell your veterinarian (which you shouldn’t be), you can still take all the precautions: vaccines, preventatives, etc.

4. And Even More Infectious Disease

For the lucky, cats bring home presents, such as mice, birds, rats, etc. The rodents bring diseases and other rodents. It’s endless.

5. Cats Get Hit by Cars…

… get hit by bikers, get stuck in garages, get hurt by bad people, get snagged on fences, freeze to death, etc. [Cut to unwatchable montage of more horrible things.] It happens.

My previous cat got stuck in someone’s garage. I could not find her and searched for hours around the neighborhood. I eventually heard a cat crying in a garage and called the police who, hours later, located the owner who wasn’t on premise, to open the door. That could have easily gone another way, and I will write that fan fiction novel later.

“Lost cat” signs litter my current neighborhood, and you know they aren’t lost with a hobo bag on a train. They are all either dead, or (at best) living their lives with someone else. Also please have your outdoor cats microchipped. It’s not painful and may save your cats’ lives. You can also buy GPS trackers for their collars. I am not promoting a specific brand, but they are available anywhere.

6. Overpopulation

Cats are really good at making babies, causing the population of stray cats in the city to blow up. These cats either end up being helped by people/shelters that can barely deal with the cats they have or they are left to fend for themselves on the streets to die, starve, or spread more disease.

So first, get your outdoor cat spayed or neutered. It is absolutely the best thing for them, for their health, and to keep down the population of wild cats in need. I also do not need to explain to you how a wild tom cat will treat a sweet young lady cat taking a stroll down the promenade with her uterus and ovaries. If you want to reduce the chances that your boy cat doesn’t get into a fight, well, then neuter. There are conflicting statistics, but most sources suggest that one female cat and her mate and all the subsequent offspring amounts to 11 million cats in nine years.

7. Anti-Nature

Lastly, I fear that some of you feel like the most natural thing for the world is to let your cats outside and let them live the full entirety of their existence. I get this, I really do, but also understand how much destruction to the natural environment cats do. They destroy natural foliage and other wildlife despite their good intentions. There is some very good evidence that the best thing for “nature” is to keep your cats inside, and you can find many other resources on this topic.

There are cats that do better when they go outside. I’ve had clients keep their cats inside and later see them become anxious, yowl, not eat, urinate all over the house, etc. I don’t want your cats to suffer, but if you want to make that transition, there are things we can do. It may not be the case that your cat is anxious because it can’t go outside. In fact, it may be that it has always been anxious, but you never noticed until you kept it inside. Always have us examine your cat before making any judgments. Maybe your formerly outdoor cat is suffering from something else (UTI, pain, etc.).

As always, feel free to discuss with us at any time. This wasn’t meant to be a philosophical treatise on domesticated animals’ rights, though that is generally how I fantasize spending a great deal of my off time.

Try to relax during these times and make sure you don’t feed your dogs chocolate-covered antifreeze-infused garlic balls for the holidays, or give your cats kerosene holiday lamps for Hanukkah.

I will continue to lord over Secret Santas everywhere while I fulfill my long-standing December tradition of making holiday cookies I can’t eat in a house I don’t own. 

Be safe, don’t travel, wear masks, and shop locally on-line. And Black Panther is a holiday movie.

— Brett Grossman, DVM

Is online shopping for preventives really worth it?

If you’re like my dad, you’ll spend an extra five minutes circling or waiting for that closer parking spot outside of a store. During those five minutes, someone else has parked in a spot that is farther away and is already in the store.

Buying heartworm, flea, and tick preventives online can be just that like. Sometimes going that extra mile to get what may be just a bit of a savings ends up setting you back more than you know.

Online Is Often Not Cheaper

When you look at the prices of a single dose of most preventives, online pharmacies like Chewy.com and 1800petmeds.com are less expensive. But when purchasing product to cover 6 or 12 months, we are actually less expensive.

Right now, for Nexgard, when you buy 6 doses from us, you get an additional 2 free. This is about a $50 savings. And you get 3 free doses—a $75 value—when you buy 9. For Sentinel, when you apply the rebates offered here, we are less expensive when you buy 6 or 12 doses. (These are according to prices as of November 2020.)

Sentinel Spectrum Comparison Shopping
Our prices
w/rebate
Our prices
w/rebate
Chewy.comChewy.com
Weight class6 doses12 doses6 doses12 doses
2-8 lbs$40.76$59.84$51.36$102.72
8.1-25 lbs$42.98$65.24$53.01$106.02
25.1-50 lbs$52.40$83.12$64.61$129.22
50.1-100 lbs$64.88$108.44$77.86$155.72
Nexgard Comparison Shopping
 Our  pricesOur prices Chewy.comChewy.com 
Weight class6+2 doses9+3 doses6 doses12 doses
4-10 lbs$134.70$202.05$111.49$222.98
10.1-24 lbs$136.80$205.20$114.49$228.98
24.1-60 lbs$140.88$211.32$116.49$232.98
60.1-121 lbs$142.80$214.20$118.99$237.98

Preventives Guarantees

Most preventatives have guarantees on their products. For example, if your dog is on Nexgard consistently and does end up getting fleas or Lyme, Merial will cover testing and treatment, including a home inspection of your home in case of fleas, and up to $5000 in diagnostics and treatment for Lyme disease. But this guarantee is often only honored if the products are purchased from a veterinarian. Purchasing from an online source can void the guarantee.

A Final Word

This post is not meant to discourage anyone from keeping their pets protected. We recommend year-round preventives for heartworms, fleas, and ticks for dogs. Cats that go outdoors or live with a dog in the house should also be protected.

So, if you prefer to find these products online, then we will happily approve any online request for all of your up-to-date pets. But remember: if the pricing looks too good to be true online, it often is.

Alyssa Kritzman, DVM

Aging Pets: When Is It Time to Say Goodbye?

Aging golden retriever in waning sunlight

Life with an elderly pet brings a lot of uncertainty and anxiety. We all wish for our pets to be comfortable and happy and live as long as possible, but interpreting subtle signs shown by aging pets can be challenging.

I can relate on a personal level. Our 14-year-old mixed breed dog named Oskee was diagnosed with thyroid cancer a few years ago. My wife and I did not think he would still be with us today. He has done better than expected for a dog with this diagnosis. 

Oskee has been the best dog for the past 14 years. I would never want to see him have anything but a good quality of life.

Dr. Drew Sullivan

We feel very fortunate that he is doing relatively well. Recently, however, we have been noticing changes that make us wonder if this is the beginning of the end.

Facing the Inevitable

How do you know if he is uncomfortable? Is he suffering? When the time comes, how will our children react? Will we know when it is time?

These are all questions that many clients are faced with, and now my wife and I are the ones contemplating them.

When you are faced with these or similar thoughts and questions, I recommend making a list of things your pet really enjoys. For example, Oskee enjoys going for walks, chewing bones, begging/taking food from our kids. As he has aged and his condition has declined, we have seen his enjoyment in these activities decrease. 

Some days he does not seem to have the energy or strength to go on much of a walk. Occasionally his legs slip out from under him. He also spends much more time sleeping and is not waiting by the dinner table like he used to. Noticing these changes helps us determine a “good” day from a “bad” day. 

Focus on Quality of Life

Fortunately, his good days still outnumber the bad. An anti-inflammatory pain medication seems to make him more comfortable, and he does pretty well. I recommend clients keep a journal of good and bad days. When the bad days start outnumbering the good days, the pet’s overall quality of life needs to be considered. 

For those of you with aging pets or terminally ill pets, I recommend discussing with your veterinarian what medications or therapies may help improve your pet’s overall quality of life. Unfortunately, though, most of us will be faced with a very difficult decision: when is it time to say goodbye?

It is never an easy decision. No matter how sick or old your pet is, the decision is going to be gut-wrenching and difficult. My wife and I are not looking forward to making this decision, but I owe this to Oskee when the time comes. Oskee has been the best dog for the past 14 years, and I would never want to see him have anything but a good quality of life.

Dr. Drew Sullivan