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It is always an unhappy surprise when we find a spot of urine somewhere other than the litter box or a potty pad. Especially when it’s on your pile of clothes.

Knowing your pet’s normal urine schedule can be a great help for getting to the bottom of episodes that are outside their routine. Urine changes in a cat or a dog can be caused by very mild to very severe and potentially fatal medical conditions, so it is important to address any changes quickly. 

This blog addresses various health conditions that can lead to urinary changes in cats and dogs. You’ll learn clinical signs to watch for, diagnostic tests performed to help determine the cause of these changes, possible medical or surgical treatment options, and what to expect long term. 

Urinary Tract Infection (UTI)

The urinary tract consists of the kidneys, the bladder, and the ureters (which carry urine from the kidneys to the bladder). Although a dog or cat can get an infection in any of these three regions, bladder infections are the most common.

Clinical signs may include polyuria, which means frequent urine episodes, such as going in and out of the litter box, or having multiple small streams of urine instead of one large stream. Other clinical signs range from blood in the urine, pain or discomfort when urinating, and posturing to urinate with no urine being produced to odorous urine or lethargy, indicating your pet is not feeling well or is uncomfortable.

An easy inexpensive diagnostic test that can be performed to rule in/out a UTI is a urinalysis. This is a great screening test that allows us to assess the urine for pH changes, specific gravity, crystals, bacteria, white blood cells, etc.

Although a free-catch sample (a sample collected at home) is great, a cystocentesis can be performed in the clinic to obtain a sterile sample. After an ultrasound is used to find the bladder, a sterile needle is inserted to obtain a sample externally. If bacteria are present, the patient has a UTI.

Once a UTI is confirmed, the next step is a urine culture, which means that the laboratory will grow the bacteria in the urine and let us know what antibiotic will treat the infection. Follow-up rechecks with your veterinarian are important to assure that the infection is cleared, as bacteria can become resistant to antibiotics.

Once the infection is gone, the pet’s prognosis is good. Patients with recurrent UTIs may need a long-term prescription urinary diet to keep their pH at a level that does not allow bacteria to grow. This diet will help prevent new infections.

Bladder Stones and Crystals

Stones start off as crystals in the bladder. Crystals may arise due to a variety of factors, such as pH changes and increased urine concentration. Bladder stones come in many types, including struvite, calcium oxalate, urate, cysteine, xanthine, and calcium phosphate. 

Fun Facts

1. What are the two most common types of bladder stones?
   Struvite and Calcium Oxalate
2. What type of bladder stone is commonly associated with urinary tract infections? 
   Struvite
3. Which bladder stone is hormonally dependent and more common in a male dog that has not been neutered?
   Cysteine
4. Why are Dalmatians predisposed to urate stones? (Urate stones are a type of kidney stone formed when uric acid crystals accumulate in the urinary tract.)
   Dalmatians have a gene mutation that interferes with uric acid metabolism, causing high levels of uric acid in the body, which concentrates in the urine and leads to stones. 

Clinical signs of bladder stones include straining to urinate, dribbling urine, blood in the urine, and pain/discomfort when urinating. Bladder stones can be diagnosed via ultrasound of the bladder and abdominal radiographs. If large enough, they can even be palpated manually. Keep in mind that certain types of bladder stones are not visible on radiographs, so it is important to assess the patient as a whole. 

It is always important to check a urine sample to look for an infection. Struvite stones are commonly associated with UTIs. Once the UTI is cleared, then the stone can dissolve.

If a UTI is not present or if a UTI is cleared and a stone remains, then the next step is a prescription urinary diet. The goal of the prescription diet is to change the pH of the urine to allow the stone to dissolve and prevent new stone formation. Some patients may not need to be on a prescription urinary diet long term, however, most patients will.

If the patient is on a urinary diet and the stone is not dissolving or getting smaller, then the next step is surgery. A cystotomy is a surgical procedure performed to remove the stone from the patient’s bladder. Left untreated, stones can become large enough to make urination difficult, which can lead to blockage and life-threatening situations.

Your pet should be urinating daily. A blocked cat or dog is a medical emergency. 

Kidney Disease

The kidneys help produce urine and remove toxins from the body. They also help manage hydration, blood pressure, production of red blood cells, and calcium/ phosphorus balance.

The filtration unit of the kidney is called a nephron. As a patient ages, so do the nephrons. If kidney tissue ceases to do its job of filtration, normal function cannot be maintained.

Clinical signs of kidney disease include polyuria (increased frequency of urination), polydipsia (increased water intake), decreased appetite, vomiting, and lethargy in advanced cases.

Kidney disease is diagnosed via blood screening tests along with clinical signs. Kidney disease is irreversible. Treatment depends on the stage and severity of kidney disease. The patent will likely need to be on a prescription kidney diet long term. It is important to check blood pressure, as many patients will have to be on additional medications. If left untreated, kidney disease can be fatal.

Endocrine Conditions

A few conditions related to hormones result in urinary changes in pets.

Hypothyroidism results from decreased thyroid hormone production by the thyroid gland. This condition is more common in dogs than in cats. Clinical signs include weight gain, polyuria, polydipsia, and fatigue.

Hyperthyroidism, on the other hand, is an overproduction of thyroid and is more common in cats. Clinical signs include weight loss, ravenous appetite, polyuria, and polydipsia.

Hypo/hyperthyroidism can be diagnosed via routine blood work and are both medically managed. 

Diabetes mellitus is caused by a deficiency in insulin, which is produced by the pancreas. Diabetes can be diagnosed via routine blood work, a fructosamine, along with clinical signs. Clinical signs include polyuria, polydipsia, and weight loss.

With elevated glucose levels in the bloodstream, glucose can spill into the urine in high amounts. Glucose in the urine can lead to bacteria growth leading to urinary tract infections, which are common findings in diabetic patients. 

Treatment for diabetes entails daily subcutaneous insulin injections.

Bladder Tumors

Bladder tumors, unfortunately, display similar signs to both urinary tract infections and bladder stones. These include straining to urinate, dribbling urine, blood in the urine, pain/discomfort when urinating, and abdominal pain/discomfort.

A bladder tumor may be suspected if, during a cystocentesis, the ultrasound indicates an abnormality in the bladder. If large enough, bladder tumors can also be seen on radiographs.

Treatment of a bladder tumor depends on the type of tumor and will be determined by working with a veterinary oncologist. 

As you can see, urinary changes can range from mild to severe. As veterinarians, our job is to investigate the underlying cause of your pet’s health changes. If you notice any urinary changes in your pet, please see your local veterinarian. 

— Dr. Angélica Calderón

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Cambios de Orina en Sus Mascotas

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Siempre es una gran sorpresa cuando encontramos una mancha de orina de nuestra mascota en algún lugar que no sea apropiado.

Conocer el horario normal de micción de tu mascota puede ser una gran herramienta para lidiar con cualquier episodio que se salga de su rutina habitual. Los cambios en la orina de un gato o un perro pueden ser causados  por condiciones médicas desde muy leves hasta muy graves y potencialmente fatales, por eso es importante visitar a su veterinario cuando note cambios de orina en sus mascotas.

Discutiremos varias condiciones de salud que pueden provocar cambios urinarios en gatos y perros y sus signos clínicos a monitorear, pruebas de diagnóstico realizadas para ayudar a determinar la causa de los cambios, opciones médicas o quirúrgicas (si es necesario), mantenimiento y pronóstico.

Infección del Tracto Urinario

El tracto urinario está formado por los riñones, los uréteres y la vejiga. Aunque un perro o un gato pueden contraer una infección en cualquiera de estas tres regiones, las infecciones de la vejiga son las más comunes. Algunos signos clínicos incluyen poliuria (episodios frecuentes de orina), como entrar y salir de la caja de arena o tener múltiples chorros pequeños de orina en lugar de un chorro grande. Otros signos clínicos incluyen sangre en la orina, dolor o malestar al orinar, posturas para orinar sin producir orina, orina con olor y letargo si su mascota no se siente bien o está incómoda.

Una prueba de diagnóstico sencilla y económica que se puede hacer para descartar una infección urinaria es un análisis de orina. Esto nos permite evaluar la orina en busca de cambios de pH, gravedad específica, cristales, bacterias, glóbulos blancos, etc. Aunque una muestra de orina recogida en casa es una buena opción, se puede hacer una cistocentesis en la clínica para obtener una muestra estéril. Esto se realiza mediante el uso de un ultrasonido para encontrar la vejiga; luego se utiliza una aguja estéril para obtener una muestra externa. Si hay bacterias, se confirma la presencia de una infección urinaria en el paciente. Una vez confirmada la infección urinaria, el siguiente paso es un cultivo de orina, lo que significa que el laboratorio hará crecer las bacterias en la orina y nos informará qué antibiótico tratará la infección. Los controles de seguimiento con su veterinario son importantes para asumir que la infección se ha curado, ya que las bacterias pueden volverse resistentes a los antibióticos.

Algunos pacientes con infecciones urinarias recurrentes necesitarán una dieta urinaria prescrita a largo plazo para mantener el pH en un nivel que no permita el crecimiento de bacterias, lo que ayudará a prevenir nuevas infecciones. Una vez que la infección haya desaparecido, el pronóstico es bueno.

Cálculos y Cristales en la Vejiga

Los cálculos comienzan como cristales en la vejiga y pueden deberse a diversos factores, como cambios de pH y aumento de la concentración de orina. Existen muchos tipos de cálculos en la vejiga, como los de estruvita, oxalato de calcio, urato, cisteína, xantina, fosfato de calcio, etc.

Datos curiosos

1. Cuáles son los dos tipos más comunes de cálculos en la vejiga?
   Estruvita y oxalato de calcio
2. Qué tipo de cálculo en la vejiga se asocia comúnmente con infecciones del tracto urinario?
   Estruvita
3. Qué cálculo en la vejiga depende de las hormonas y es más común en un perro macho intacto?
   Cisteína
4. Por qué los dálmatas están predispuestos a los cálculos de urato?
   Los dálmatas tienen una mutación genética que interfiere con el metabolismo del ácido úrico y causa altos niveles de ácido úrico en el cuerpo, que se concentra en la orina y produce cálculos.

Los signos clínicos incluyen esfuerzo para orinar, goteo de orina, sangre en la orina, dolor o malestar al orinar, etc. Los cálculos en la vejiga se pueden diagnosticar con ultrasonido de la vejiga y radiografías abdominales; si son lo suficientemente grandes, incluso se pueden palpar manualmente si están grandes. Hay ciertos tipos de cálculos en la vejiga que no son visibles en las radiografías, por lo que es importante evaluar a todo el paciente.

Siempre es importante analizar una muestra de orina para evaluar si hay una infección, ya que los cálculos de estruvita se asocian comúnmente con las infecciones urinarias. Una vez que se cura la infección urinaria, el cálculo puede disolverse. Si no hay una infección urinaria o si se cura y queda un cálculo, el siguiente paso es una dieta urinaria recetada. El objetivo de la dieta recetada es cambiar el pH de la orina para permitir que el cálculo se disuelva y evitar la formación de nuevos cálculos. Depende de cada paciente si necesitará seguir una dieta urinaria recetada a largo plazo, pero la mayoría de los pacientes lo harán. Si el paciente sigue una dieta urinaria y el cálculo no se disuelve o no se hace más pequeño, el siguiente paso es la cirugía. Una cistotomía es un procedimiento quirúrgico que se realiza para extraer el cálculo de la vejiga del paciente. Si no se trata, los cálculos pueden llegar a ser lo suficientemente grandes como para dificultar la micción, lo que puede provocar un bloqueo y situaciones potencialmente mortales. Su mascota debe orinar a diario. Un gato o perro bloqueado es una emergencia médica.

Enfermedad Renal

Los riñones ayudan a producir orina y a eliminar toxinas del cuerpo. También ayudan a controlar la hidratación, la presión arterial, la producción de glóbulos rojos y el equilibrio calcio/fósforo. La unidad de filtración del riñón se llama nefrona. Cuando una mascota envejece, las nefronas también envejecen. Sin tejido renal funcional no se puede mantener una función normal. Los signos clínicos de la enfermedad renal incluyen poliuria (aumento de la frecuencia de micción), polidipsia (aumento de la ingesta de agua), disminución del apetito, vómitos y letargo si está avanzado.

La enfermedad renal se diagnostica por análisis de sangre y signos clínicos. La enfermedad renal es irreversible y el tratamiento depende de la etapa de la enfermedad y de lo avanzada que esté. Es probable que el paciente deba seguir una dieta renal recetada a largo plazo. Es importante controlar la presión arterial, ya que muchos pacientes deberán tomar medicamentos adicionales. Si no se trata, la enfermedad renal puede ser mortal.

Condiciones de Endocrinas

El hipotiroidismo es el resultado de una disminución de la producción de hormona tiroidea por parte de la glándula tiroides, más común en los perros. Los signos clínicos incluyen aumento de peso, poliuria, polidipsia y fatiga. Por el contrario, el hipertiroidismo es más común en los gatos y es la sobreproducción de hormonas. Los signos clínicos incluyen pérdida de peso, apetito voraz, poliuria y polidipsia. El hipotiroidismo y el hipertiroidismo se pueden diagnosticar mediante análisis de sangre de rutina y ambos se tratan con medicamentos. Como puede ver, estas afecciones también implican cambios urinarios en una mascota.

La diabetes mellitus es causada por una deficiencia de insulina, que es producida por el páncreas. La diabetes se puede diagnosticar mediante análisis de sangre de rutina, una fructosamina, junto con los signos clínicos. Últimamente, el tratamiento implica inyecciones subcutáneas diarias de insulina. Los signos clínicos incluyen poliuria (micción excesiva), polidipsia (ingesta excesiva de agua) y pérdida de peso. Con niveles elevados de glucosa en el orine, la glucosa puede derramarse en la orina en grandes cantidades. La glucosa en la orina puede provocar el crecimiento de bacterias que provocan infecciones del tracto urinario, que son hallazgos comunes en pacientes diabéticos.

Tumores de Vejiga

Los tumores de vejiga pueden presentar síntomas similares a las infecciones del tracto urinario y a los cálculos vesicales, como esfuerzo para orinar, goteo de orina, sangre en la orina, dolor o malestar al orinar y dolor o malestar abdominal. Se puede sospechar un tumor de vejiga si se observa una anomalía en ultrasonido mientras se examina la vejiga durante una cistocentesis. Si son lo suficientemente grandes, los tumores de vejiga también se pueden ver en las radiografías. Una vez que se diagnostica un tumor de vejiga, el tratamiento se basa en el tipo de tumor. Aquí es donde el dueño de la mascota trabajará junto con un oncólogo veterinario para determinar el mejor plan de tratamiento para su mascota.

Como puede ver, los cambios urinarios pueden variar de leves a graves y nuestro trabajo como veterinario es investigar la causa subyacente de los cambios en la salud de su mascota. Si nota algún cambio urinario en su mascota, consulte a su veterinario local.

— Dr. Angélica Calderón

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With the start of the new year, you might have noticed an increase in the number of gym memberships and more people waiting in line to use the elliptical. If you’ve also noticed that your pet at home has packed on a couple of extra holiday pounds, now would be a perfect time to start considering some weight loss for your pet. Increased weight can lead to obesity, and various negative health conditions can follow.

How Do I Know If My Pet Is Overweight?

Pets are given a body condition score (BCS) to determine if they are overweight, underweight, or at an ideal body weight. BCS is determined not only by the number on the scale and physical appearance, but also fat deposits felt by your veterinarian during the exam along with amount of muscle mass. Below are charts from the Association for Pet Obesity Prevention that illustrate body condition scores for dogs and cats. Please reach out to your local veterinarian if you would like to know if your pet is overweight.

1. Ribs visible from a distance under shorthair, no palpable body fat
2. Ribs visible under shorthair, no palpable fat
3. Ribs may be visible under shorthair, no palpable fat
4. Ribs minimally visible, easy to palpate with minimal fat cover
5. Ribs not visible, easy to palpate with minimal fat covering
6. Ribs palpable under mild fat covering
7. Ribs palpable with difficulty under moderate fat covering. Mild fat deposits over lumbar area and tail base
8. Ribs palpable only with significant pressure under marked fat deposits. Moderate fat deposits over lumbar area and tail base
9. Ribs not palpable under marked fat deposits. Marked fat deposit over spine including the neck and tail base

What Are the Health Risks?

Obesity is associated with many negative health conditions. Such conditions include joint disease and osteoarthritis, heart disease, respiratory distress, decreased grooming in cats, diabetes mellitus, increased anesthetic risk, and ultimately a decreased lifespan.

Joint Disease and Osteoarthritis: Extra weight adds extra pressure and stress on joints, which can lead to early joint degeneration and decreased mobility. This, in turn, can exacerbate obesity. In a patient undergoing a weight loss journey, adding joint supplements can help strengthen joints, which may increase mobility and comfort, ultimately helping with weight loss.

Diabetes Mellitus: Extra body fat can lead to insulin resistance. Weight loss can help decrease a cat’s risk for the development of diabetes mellitus. According to a study at Cornell University College of Veterinary Medicine, obese cats are four times more likely to develop diabetes than are cats with an ideal BCS.

Heart Disease: Although fat is relatively nonvascular tissue, it still requires blood flow, which leads to an increase in circulatory volume and cardiac output, ultimately resulting in hypertension. Compared to dogs with an ideal body weight, obese dogs develop negative changes to the overall structure and function of their heart.

Why Do Pets Become Overweight?

Well, we are the culprits. Overfeeding, lack of exercise, and too many treats can lead to obesity in pets. Various endocrine diseases are associated with obesity, such as Cushing’s disease and hypOthyroidism in dogs. In cats, weight loss and low BCS are commonly associated with hypERthyroidism.

What Do I Do If My Pet Is Overweight?

Weight loss can be a hard, slow process. It takes much time and patience. When your veterinary team works with you and provides the right tools, we can achieve a healthy weight for your pet.

There are many dietary changes that can be done in order to achieve weight loss in your pet. A great start is checking out the Pet Nutrition Alliance website. When you enter your dog’s current weight and body condition score, this website calculates a calorie count for you. It is important to account for all food AND treats using this calorie count. Please reach out to your local veterinarian if you would like to know your pets BCS.

There are several over-the-counter options as well as prescription diets that can be given to your pet for weight loss. When feeding in cups, it is important to use an actual measuring cup to avoid overfeeding/underfeeding. Calories per cup can vary, so please check the back of the bag for an accurate calorie measurement of how many cups your pet should be eating. Healthy, low-calorie fruits and vegetables such as apple slices, carrots, celery, and cucumber can be used as treats. Please avoid grapes, raisins, onion, garlic, and avocados, which can be highly toxic to pets.

Exercise is a very important component in order to achieve weight loss. Therefore, adding more play time, frequent walks, and possibly even a kitty treadmill can help achieve your pet’s weight loss goals. Frequent weigh-ins are also a very important component for weight loss to track the progression of your pet’s weight.

If you suspect that your pet is overweight, please reach out to your primary care veterinarian to you can discuss the best option for your pet.

From ‘Fat Vincent’ to ‘Skinny Vinny’

In 2016, a 7-year-old obese dachshund named Vincent was surrendered to an animal shelter in Houston, Texas, after his owner died. He weighed 38 pounds. Thanks to the help of K-9 Angels Rescue, he was able to lose over half of his body weight and was renamed Skinny Vinny. He weighed in at 17 pounds after an 8-month weight-loss journey.

By Dr. Angélica Calderón

Dog image: VinnieRattolle, CC BY-SA 4.0, via Wikimedia Commons

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Propósitos de Año Nuevo para todos

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Con el comienzo del nuevo año, es posible que hayas notado un aumento en el número de membresías en gimnasios y más personas esperando en fila para usar la máquina elíptica. Ahora, si ha notado que su mascota en casa subio un par de kilos de más durante las vacaciones, entonces sería un momento perfecto para comenzar a considerar perder algo de peso; ya que el aumento de peso puede provocar obesidad y pueden producirse diversas condiciones negativas de salud.

¿Cómo puedo saber si mi mascota tiene sobrepeso?

A las mascotas se les asigna una puntuación de condición corporal (también conocida como BCS) para determinar si tienen sobrepeso, bajo peso o si tienen un peso corporal ideal. Comuníquese con su veterinario local si desea saber si su mascota tiene sobrepeso.

A continuación se muestran gráficos de la Asociación para la Prevención de la Obesidad de las Mascotas que ilustran las puntuaciones de condición corporal de perros y gatos. Comuníquese con su veterinario local si desea saber si su mascota tiene sobrepeso.

1. Costillas visibles desde lejos debajo del pelo corto, sin grasa corporal palpable
2. Costillas visibles debajo del pelo corto, sin grasa palpable
3. Las costillas pueden ser visibles debajo del pelo corto, no se palpa grasa
4. Costillas mínimamente visibles, fáciles de palpar con mínima cobertura de grasa
5. Costillas no visibles, fáciles de palpar con una cobertura mínima de grasa
6. Costillas palpables bajo una leve capa de grasa
7. Costillas palpables con dificultad bajo una cubierta grasa moderada. Depósitos leves de grasa sobre la zona lumbar y la base de la cola.
8. Costillas palpables sólo con una presión significativa bajo depósitos de grasa marcados. Depósitos moderados de grasa sobre la zona lumbar y la base de la cola.
9. Costillas no palpables bajo depósitos de grasa marcados. Depósito de grasa marcado sobre la columna, incluido el cuello y la base de la cola.

¿Cuales son los riesgos para la salud?

La obesidad está asociada con muchas condiciones de salud negativas. Dichas afecciones incluyen enfermedades como osteoartritis, enfermedades cardíacas, dificultad respiratoria, disminución del aseo en los gatos, diabetes mellitus, mayor riesgo anestésico, y en casos graves menos tiempo de vida.

Enfermedades de osteoartritis: El peso extra añade presión y estrés adicionales a las articulaciones, lo que puede provocar una degeneración temprana de los huesos y una disminución de la movilidad, lo que a su vez puede exacerbar la obesidad. En un paciente que está pasando por un proceso de pérdida de peso, agregar suplementos para los huesos puede ayudar a fortalecer los huesos, lo que puede conducir a una mayor movilidad y mayor comodidad.

Diabetes mellitus: El exceso de grasa corporal puede provocar resistencia a la insulina y la pérdida de peso puede ayudar a disminuir el riesgo de que un gato desarrolle diabetes mellitus. Según un estudio de la Facultad de Medicina Veterinaria de la Universidad de Cornell, los gatos obesos tienen cuatro veces más probabilidades de desarrollar diabetes que un gato con un BCS ideal.

Enfermedad cardíaca: Aunque la grasa es un tejido relativamente no vascular, aún requiere perfusión, lo que conduce a un aumento en el volumen circulatorio y el gasto cardíaco, lo que puede resultar en hipertensión. En comparación con los perros con un peso ideal, los perros obesos tienen varios cambios en la estructura y función general de su corazón.

¿Por qué las mascotas tienen sobrepeso?

Bueno, nosotros somos los culpables. La sobrealimentación, la falta de ejercicio y demasiados premios pueden provocar obesidad en las mascotas. Varias enfermedades endocrinas están asociadas con la obesidad, como la enfermedad de Cushing y el hipotiroidismo en perros, mientras que la pérdida de peso y un nivel bajo de BCS pueden estar asociados con el hipertiroidismo en los gatos.

¿Qué hago si mi mascota tiene sobrepeso?

La pérdida de peso puede ser un proceso lento y difícil y requiere mucho tiempo y paciencia. Somos un equipo pero con las herramientas adecuadas podemos lograr un peso saludable para tu mascota.

Hay muchos cambios en la dieta que se pueden realizar para lograr la pérdida de peso de su mascota. Un buen comienzo es visitar el sitio web de Pet Nutrition Alliance. Este sitio web le permite ingresar el peso actual de su perro junto con su puntuación de condiciones corporales. Se calcula un recuento de calorías. Es importante tener en cuenta todos los alimentos y premios utilizando este recuento de calorías.

Hay varias opciones de venta libre, así como dietas recetadas que se pueden administrar a su mascota para bajar de peso. Varias marcas de alimentos de venta libre tienen una fórmula “baja en calorías” o de “peso perfecto”. Al alimentar en tazas, es importante utilizar una taza medidora para evitar la sobrealimentación o la subalimentación. Las calorías por taza varían, así que revise la parte posterior de la bolsa de comida para obtener una medida precisa de cuánto debe comer su mascota. Se pueden utilizar frutas y verduras saludables bajas en calorías como premio. Varias opciones incluyen rodajas de manzana, zanahorias, apio y pepino. Evite las uvas, las pasas, la cebolla, el ajo y los aguacates, ya que pueden ser muy tóxicos.

El ejercicio es un componente muy importante para lograr la pérdida de peso. Por lo tanto, agregar más tiempo de juego, caminatas frecuentes y posiblemente incluso una cinta de correr para gatos puede ayudar a lograr los objetivos de pérdida de peso de su mascota. Los pesajes frecuentes también son un componente muy importante para la pérdida de peso para realizar un seguimiento de la progresión del peso de su mascota.

Si sospecha que su mascota tiene sobrepeso, comuníquese con su veterinario para que pueda analizar la mejor opción para su mascota.

De ‘Fat Vincent’ a ‘Skinny Vinny’

En 2016, un perro salchicha obeso de 7 años llamado Vincent fue entregado a un refugio de animales en Houston, Texas, después del fallecimiento de su dueño. Pesaba 38 libras. Gracias a la ayuda de K-9 Angels Rescue, pudo perder más de la mitad de su peso corporal y pasó a llamarse Skinny Vinny. Pesó 17 libras después de un viaje de pérdida de peso de 8 meses.

By Dr. Angélica Calderón

Cat image: Jami430, CC BY-SA 4.0, via Wikimedia Commons

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Fear of the Unknown, or Fear of Saying ‘I Don’t Know’?

Originally, I was planning to write this blog about the current “mystery illness” that is popping up in random places around the United States. But when I sat down to research what I could, I kept getting stuck on the word “unknown.” It made me think about all that I haven’t figured out myself yet.

“I don’t know” is a phrase that you are likely to hear from me as your pet’s veterinarian. It is a phrase that I used to be terrified of saying when I first started practicing medicine over a decade ago.

I spent a lot of time (most of my 20s) and money (over six figures) learning everything about biology, chemistry, pharmacology, virology, physiology, anatomy (of multiple species, mind you!), really any animal-related “-ology” so I could avoid that very phrase.

Why I Say ‘I Don’t Know’

Now, with years of experience in the field, I frequently say “I don’t know” because I am so acutely aware that figuring out why an animal is sick (we call this a differential diagnosis) is often much harder than just making an animal feel better (we call this empiric therapy).

There are a few reasons why this is so:

1. Answers often cost money. Even the best veterinarians can go only so far on a physical exam and asking good questions. Eventually we need test results, but this costs money—your money—and sometimes we don’t need an answer to find the treatment. We want to put your resources to the best use. If we use up the available budget to find answers, that may mean we have fewer resources to provide the care your pet needs.
2. Answers often aren’t easy. One of the worst things that has ever happened to any medical professional is the show CSI. They always find the answer in a convenient hour (or 40 minutes if you’re paying for premium streaming). This is just not reality. Yes, sometimes tests to give you a precise answer, but a lot of times testing provides information and clues. Then I use my expensive degree to put all the pieces of the puzzle together.
3. Answers often aren’t universal. This is what I mean when I say a pet “hasn’t read the textbook.” The same problem does not always manifest in the same way in every pet. (Not to put all the blame on cats, but it’s usually cats who haven’t read the textbook!) That can mean that even if we think we know what’s going on, we can get curveballs.

I know this may not instill a lot of confidence in what I and my colleagues do, but I say this because I want you to know that getting an answer isn’t my only goal. I want to help you and your pet in the best way possible. Often these goals are at odds with each other.

We Still Don’t Have an Answer

This brings me to the current “crisis” going on in veterinary medicine right now: the mystery respiratory illness that is affecting dogs. We still don’t have an answer as to what it is. It won’t be easy or cheap to figure out, but there are people working on it. As soon as we have verified information, we will let you know.

For now, we’re left with the general guidance of trying to keep your dog away from crowded canine events as much as possible (I will be boarding my own dog over the Christmas because that’s our only option), keeping them away from unhealthy dogs, and keeping up with the recommended respiratory vaccines like distemper, bordetella, and parainfluenza, and, for some dogs, influenza.

It’s hard accepting “we don’t know,” but to tell you anything more than that would be foolish. In all my years of practice, I would much rather say “I don’t know” than “I was wrong.”

—Dr. Alyssa Kritzman

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“Prevention is cheaper than treatment.” A quote that I will forever remember from Dr. Vinu, a primary care veterinarian I worked for during my undergraduate studies at the University of Illinois-Chicago.

Vaccines are very critical in cats and dogs, and the vaccine series are started at a very young age. Some vaccines even need to be boosted in order for the pet to reach adequate immunity.

There are many different vaccines in cats and dogs. Some vaccines are core vaccines, meaning that they are recommended in every patient, and some are considered lifestyle vaccines, meaning that it depends on what your pet does.

Is your dog frequently boarded at a boarding facility or often goes to grooming, where they might be surrounded by many other dogs? Does your dog go to forest preserves or on camping trips where they can be exposed to ticks? Is your cat a strictly indoor cat or an indoor/outdoor cat?

All of those are great questions that are usually asked at the beginning of your annual wellness exam. Yes, we may ask many, many questions during your pet’s wellness exam, but we are putting the puzzle pieces together to recommend the best vaccine schedule for your pet.

Rabies Vaccine in Dogs AND Cats

Having your pet vaccinated for rabies is required by law. It is recommended that the canine and feline rabies vaccine be administered at 4 months of age. However, it is sometimes given earlier in a shelter setting. The first rabies vaccine is usually a 1-year vaccine, while the following year your pet can get either the 1-year or 3-year vaccine.

Rabies is transmitted via bite wounds, usually by wildlife like skunks, bats, racoons, and foxes. The virus attaches to local muscle cells, then penetrates local nerves and ascends to the brain.

There is no reliable effective treatment for rabies. Infection usually results in death of the animal. Once clinical signs are present, death can occur within 10 days.

If your pet bites another animal or human and is not up to date on their rabies vaccine, depending on their vaccine history, they might have to be confined and observed at a veterinary facility for 10 days. If the animal shows any symptoms or there is suspicion that the pet might have rabies, their brain tissue must be submitted for sampling. This means that they must be humanely euthanized for tissue submission.

Regulations can vary by state or county, so it is important to keep up with current regulations. Visit rabiesaware.org for more information regarding regulations in your area. Ultimately, prevention consists of vaccination as well as limiting exposure to wildlife. Please visit your local veterinarian if your pet is not up to date on the rabies vaccine.

Vaccines in Dogs: Distemper (DAPP)

The second core vaccine in dogs is the distemper vaccine (DAPP). This vaccine protects against the Distemper Virus, Parvovirus, Adenovirus 1 & 2, and Parainfluenza virus. The DAPP vaccine is started at 8 weeks of age and must be boostered at least 3 times, 3 to 4 weeks apart.

This means that your puppy will get a DAPP vaccine at 8 weeks,12 weeks, and 16 weeks old. After the initial puppy series, the vaccine becomes annual. It is also available in a 3-year version, which can be the year after your puppy’s initial vaccine series.

Parvovirus is a common viruses affecting puppies. Any puppy with clinical signs consisting of vomiting and diarrhea should be tested for parvovirus. A diagnosis can be made from a fecal sample.

Intensive supportive care is needed to treat a dog that has been infected with parvovirus. Supportive care consists of hospitalization, fluid therapy, antibiotics, anti-nausea medication, anti-diarrheal medication, and monitoring blood work changes (particularly your dog’s white blood cells). Be prepared for a 5- to 7-day hospitalization as well as an expensive bill, depending on the severity of your dog’s illness.

Without treatment, this virus can be fatal. Prevention is cheaper than treatment.

Vaccines in Dogs: Leptospirosis

Although the canine Leptospirosis vaccine is not a core vaccine, it is highly recommended in areas that have a high rodent population. It can be given as early as 12 weeks of age and needs to be boostered 3 to 4 weeks after an initial dose is given. After that, it is given annually.

Dogs can become infected with this bacterium via open wounds or mucus membranes coming into contact with infected urine or infected water or soil. This bacterium can survive for weeks to months in the environment, so it is important to have your pet vaccinated if you live in an area that has a high rodent population.

Leptospirosis is zoonotic, which means that humans can get infected as well. An infection can quickly lead to organ damage and can affect the kidneys and liver. Clinical signs can be very nonspecific, and treatment consists of antibiotics and supportive care. In severe cases infection can lead to irreversible organ damage.

Vaccines in Dogs: Bordetella

The canine Bordetella vaccine covers Canine Kennel Cough. It requires no booster and is given annually, although in some cases it is recommended to be given every 6 months. It can be delivered either intranasally or subcutaneously.

Bordetella is essentially an infectious bronchitis and is spread within respiratory secretions from an infected dog. In crowded situations with many animals, for example, at a boarding or grooming facility, dogs can be more predisposed to infection due to close contact as well as poor ventilation.

Clinical signs can range from mild to severe symptoms, such as a hacking cough and pneumonia. Treatment consists of antibiotics and quarantine. Keep in mind that many boarding and grooming facilities require this vaccine.

Vaccines in Dogs: Canine Influenza Virus

The canine influenza virus (CIV) vaccine requires one additional booster given 3 to 4 weeks after the initial dose. After that, it is given annually. It can be started as early as 16 weeks old.

Clinical signs can be very similar to Bordetella and can include cough, sneezing, and nasal discharge. Outbreaks are most commonly associated with kennels where dogs are in close contact. This virus is spread via nasal secretions. It can be hard to distinguish Bordetella from CIV, so treatment consists of controlling secondary signs and treating symptomatically. That means antibiotics and cough suppressants, depending on the severity.

Vaccines in Dogs: Lyme Disease

The canine Lyme vaccine is a lifestyle vaccine for dogs that frequently go to forest preserves or camping. If you live in a highly wooded area, this vaccine is highly recommended due to tick exposure. It can be given any time after 16 weeks of age and requires one additional booster 3 to 4 weeks after the first dose. After that, it is an annual vaccine.

Lyme disease is spread via a bite from infected ticks. Lyme disease can be diagnosed with a SNAP 4DX heartworm test, which entails a blood sample from your dog. Results are obtained in no more than 8 minutes. However, a positive Lyme result does not differentiate exposure to the disease from active infection.

Clinical signs can vary and can be very nonspecific. These can include fever, fatigue, and swollen joints. Treatment consists of antibiotics and managing secondary symptoms. Don’t forget your dog’s monthly flea and tick preventatives, which can greatly reduce the chance of infection with Lyme disease.

Vaccines in Cats: FVRCP

The Feline Viral Rhinotracheitis, Calicivirus, and Panleukopenia (FVRCP) vaccine series, also called the cat distemper vaccine, should be started at 6 to 8 weeks of age. This is boostered every 3 to 4 weeks until your kitten is 16 weeks old. This vaccine is also available in a 3-year version that can be given the year after your kitten’s initial vaccine series.

Feline panleukopenia is similar to parvovirus in dogs. It is a very contagious and life-threatening infectious disease that can spread among cat colonies or cats housed with many other cats. An infected cat sheds the virus via secretions, e.g., feces, vomit, urine, saliva, and mucus membranes. Infection occurs when the virus enters through the nose or mouth.

The virus suppresses the immune system and depletes the cat’s white blood cells, leaving the infected individual immunosuppressed and vulnerable to other infectious diseases. Clinical signs can be nonspecific and include fever, vomiting, diarrhea, and lethargy.

Similar to parvovirus in dogs, treatment of a cat infected with panleukopenia consists of hospitalization, aggressive fluids therapy, antinausea and anti diarrheal medications, and supportive care.

Vaccines in Cats: Feline Leukemia Virus

If your cat is an indoor/outdoor cat, the feline leukemia vaccine is highly recommended due to socialization with other cats. This vaccine requires an additional booster 3 to 4 weeks after initial dose.

Feline leukemia virus (FLV) is spread through close social contact with saliva, blood, urine, or feces. There is no effective treatment, so treatment consists of supportive care. Prognosis after infection can be variable.

One Last Reminder

Vaccinating your dogs and cats is very important. If your pet is not up to date on vaccines or their annual wellness exam, please schedule an appointment with their primary care veterinarian to get their vaccines updated.

And remember, prevention is cheaper than treatment.

—Dr. Angelica Calderon

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Vacunas en Perros y Gatos

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La prevención es más barata que el tratamiento. Una cita que siempre recordaré del Dr. Vinu, una veterinaria con la que trabajé durante mis estudios en la UIC.

Las vacunas son muy críticas en gatos y perros y sus series se inician a una edad muy temprana, incluso algunas vacunas necesitan ser reforzadas para que la mascota alcance la inmunidad adecuada. Hay muchas vacunas diferentes en gatos y perros. Algunas vacunas son vacunas básicas, lo que significa que se recomiendan para todos los pacientes, y otras se consideran vacunas de estilo de vida, lo que significa que depende de lo que haga su mascota. Su perro se aloja con frecuencia en un centro de alojamiento o va frecuentemente a la peluquería, donde puede estar rodeado de muchos otros perros? Su perro va a reservas forestales o a viajes de campamento donde puede estar expuesto a las garrapatas? Su gato es un gato estrictamente de interior o un gato de interior/exterior? Todas esas son excelentes preguntas que generalmente se hacen al comienzo de su examen anual de bienestar. Sí, es posible que le hagamos muchas preguntas durante el examen de bienestar de su mascota, pero estamos reuniendo las piezas del rompecabezas para recomendar el mejor programa de vacunas para su mascota.

Vacuna contra la Rabia en Perros y Gatos

La ley exige que su mascota sea vacunada contra la rabia. Se recomienda que la vacuna contra la rabia canina y felina se administre a los 4 meses de edad, sin embargo, a veces se puede administrar antes en un refugio. La primera vacuna suele ser una vacuna de 1 año, sin embargo, al año siguiente, su mascota puede recibir la vacuna contra la rabia de 1 año o de 3 años.

La rabia se transmite a través de heridas por mordedura, generalmente por la vida silvestre como zorrillos, murciélagos, mapaches y zorros. El virus se adhiere a las células musculares locales y luego penetra en los nervios locales y asciende al cerebro. No existe un tratamiento eficaz y fiable para la rabia y la infección suele provocar la muerte del animal. Una vez que los signos clínicos están presentes, la muerte puede ocurrir dentro de los 10 días. Si su mascota muerde a otro animal o humano y no está al día con la vacuna contra la rabia, dependiendo de su historial de vacunas, es posible que deba ser confinado y observado en un centro veterinario durante 10 días. Si el animal muestra algún síntoma o se sospecha que la mascota pueda tener rabia, se debe enviar su tejido cerebral para la toma de muestras. Esto significa que deben ser sacrificados humanamente para la presentación de tejido. Las regulaciones pueden variar según el estado o el condado, por lo que es importante mantenerse al día con las regulaciones actuales. Puede visitar rabiesaware.org para obtener más información sobre las regulaciones en su área. En última instancia, la prevención consiste en vacunar y limitar la exposición a la vida silvestre. Visite a su veterinario local si su mascota no está al día con la vacuna contra la rabia.

Vacunas en Perros

Distemper (DAPP):

La segunda vacuna básica en perros es la vacuna contra el distemper(DAPP). Esta vacuna protege contra los virus de distemper, el parvovirus, el adenovirus 1 y 2 y el virus de la parainfluenza. La vacuna DAPP se inicia a las 8 semanas de edad y debe reforzarse al menos 3 veces, con 3-4 semanas de diferencia. Esto significa que su cachorro recibirá la vacuna DAPP a las 8, 12 y 16 semanas de edad. Después de la serie inicial de cachorros, se vuelve anual. Esta vacuna también está disponible en un año 3 que se puede administrar el año siguiente después de la serie inicial de vacunas de sus cachorros.

El parvovirus es uno de los virus más comunes que cubre esta vacuna. Cualquier cachorro con signos clínicos que consisten en vómitos y diarrea debe someterse a una prueba de parvovirus y se puede llegar a un diagnóstico con una muestra fecal. Se necesitan cuidados intensivos para tratar a un perro que ha sido infectado con parvovirus y, en última instancia, el tratamiento es de apoyo. La atención de apoyo consiste en hospitalización, terapia de fluidos, antibióticos, medicamentos contra las náuseas, medicamentos contra la diarrea y el control de los cambios en los análisis de sangre (en particular, los glóbulos blancos de su perro). Esté preparado para una hospitalización de 5 a 7 días, así como para una factura costosa, según la gravedad de los síntomas de su perro. Sin tratamiento, este virus puede ser fatal. La prevención es más barata que el tratamiento.

Leptospirosis:

Aunque la vacuna contra la leptospirosis canina no es una vacuna básica, es muy recomendable en áreas que tienen una alta población de roedores. Puede administrarse tan pronto como a las 12 semanas de edad y debe reforzarse 3 o 4 semanas después de administrar la dosis inicial. Después de eso, se da anualmente.

Los perros pueden infectarse con esta bacteria a través de heridas abiertas o membranas mucosas que entran en contacto con orina infectada o agua o tierra infectada. Esta bacteria puede sobrevivir durante semanas o meses en el medio ambiente, por lo que es importante vacunar a su mascota si vive en un área con una gran población de roedores. La leptospirosis es zoonótica, lo que significa que los humanos también pueden infectarse. Esto puede conducir rápidamente a daños en los órganos y puede afectar los riñones y el hígado. Los signos clínicos pueden ser muy inespecíficos y el tratamiento consiste en antibióticos y atención de apoyo; sin embargo, en casos graves, puede provocar daños irreversibles en los órganos.

Bordetella:

La vacuna canina Bordetella cubre la tos canina. No requiere refuerzo y se administra anualmente, sin embargo en algunos casos se recomienda administrar cada 6 meses. Hay dos formas disponibles, por vía intranasal y por vía subcutánea.

Bordetella es esencialmente una bronquitis infecciosa y se transmite dentro de las secreciones respiratorias de un perro infectado. En situaciones de hacinamiento donde hay muchos animales en una instalación, por ejemplo, alojamiento o aseo, los perros pueden estar más predispuestos a la infección debido al contacto cercano y a la mala ventilación. Los signos clínicos pueden variar desde síntomas leves a graves, como tos seca, hasta neumonía. El tratamiento consiste en antibióticos y cuarentena durante el tratamiento. Tenga en cuenta que muchas instalaciones de alojamiento y aseo requiere esta vacuna.

Virus de la influenza canina (CIV):

La vacuna contra el virus de la influenza canina requiere un refuerzo adicional administrado de 3 a 4 semanas después de la primera dosis inicial, luego de lo cual se vuelve anual. Se puede iniciar desde las 16 semanas de edad.

Los signos clínicos pueden ser muy similares a los de Bordetella y pueden incluir tos, estornudos y secreción nasal. Los brotes se asocian más comúnmente con perreras donde los perros están en contacto cercano con otros perros y este virus se transmite a través de las secreciones nasales. Puede ser difícil distinguir Bordetella de CIV, por lo que el tratamiento consiste en controlar los signos secundarios y tratar sintomáticamente. Eso significa antibióticos y supresores de la tos, según la gravedad.

Lyme:

La vacuna canina de Lyme es una vacuna de estilo de vida. Esto significa que si tu perro va con frecuencia a reservas forestales o a acampar, o si vives en una zona muy boscosa, es muy recomendable debido a la exposición a las garrapatas. Se puede administrar en cualquier momento después de las 16 semanas de edad y requiere un refuerzo adicional de 3 a 4 semanas después de la primera dosis inicial. Después de eso, es una vacuna anual.

La enfermedad de Lyme se transmite a través de una picadura de garrapatas infectadas. La enfermedad de Lyme se puede diagnosticar con una prueba de gusano del corazón SNAP 4DX, que implica una muestra de sangre para su perro. Los resultados se obtienen en no más de 7-8 minutos. Sin embargo, incluso si su perro tiene un resultado positivo de Lyme, eso no diferencia la exposición frente a la infección activa. Los signos clínicos pueden variar y pueden ser muy inespecíficos. Estos pueden incluir fiebre, fatiga, articulaciones inflamadas, etc. El tratamiento consiste en antibióticos y el control de los síntomas secundarios. No olvide los preventivos mensuales contra pulgas y garrapatas de sus perros, ya que pueden reducir en gran medida la posibilidad de infección con la enfermedad de Lyme.

Vacunas en Gatos

FVRCP:

La serie de vacunas FVRCP (moquillo felino) debe comenzar a las 6-8 semanas de edad. Esta vacuna requiere refuerzos y se refuerza cada 3-4 semanas hasta que tu gatito tenga 16 semanas. Esta vacuna también está disponible en un año 3 que se puede administrar el año siguiente después de la serie inicial de vacunas de sus gatitos.

FVRCP significa rinotraqueítis viral felina, calicivirus y panleucopenia. La panleucopenia felina es similar al parvovirus en perros. Esta es una enfermedad infecciosa muy contagiosa y potencialmente mortal que puede afectar a las colonias de gatos o a los gatos alojados con muchos otros gatos si una persona está infectada. Un gato infectado elimina el virus a través de secreciones, que incluyen heces, vómito, orina, saliva y membranas mucosas. La infección se produce cuando el virus entra por la nariz o la boca. El virus suprime el sistema inmunológico y agota los glóbulos blancos del gato, dejando al individuo infectado inmunosuprimido y vulnerable a otras enfermedades infecciosas. Los signos clínicos pueden ser inespecíficos e incluyen fiebre, vómitos, diarrea y letargo. Similar al parvovirus en perros, el tratamiento de un gato infectado con panleucopenia consiste en hospitalización, fluidoterapia agresiva, así como antináuseas, antidiarreicas y atención de apoyo.

Virus de la leucemia felina

Si su gato es un gato de interior/exterior, la vacuna contra la leucemia felina es muy recomendable debido a la socialización con otros gatos. Esta vacuna requiere un refuerzo adicional de 3 a 4 semanas después de la dosis inicial.

FeLV (virus de la leucemia felina) se propaga a través del contacto social cercano con saliva, sangre, orina, heces. No existe un tratamiento eficaz, por lo que el tratamiento consiste en cuidados de apoyo. El pronóstico después de la infección puede ser variable.

Es muy importante vacunar a sus perros y gatos. Si su mascota no está al día con las vacunas o su examen anual de bienestar, programe una cita con su veterinario de atención primaria para actualizar sus vacunas.

Y recuerda, la prevención es más barata que el tratamiento.

—Dr. Angelica Calderon

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I frequently speak with pet owners whose dog has a suspected CCL injury. Here are the most common questions these owners have.

What is a CCL (cranial cruciate ligament)?

The cranial cruciate ligament is a ligament inside the knee of dogs that provides stability of the knee when a dog runs and walks. This ligament is very similar to the anterior cruciate ligament (known as the ACL) in people. These ligaments in dogs and people have nearly identical anatomy but different names because dogs walk on four limbs and people on two. CCL ligaments are only found in dogs’ back legs.

How is an injury to this ligament diagnosed?

In most cases, dogs present to the veterinary clinic with a back leg lameness or limp. Veterinarians will examine the dog, trying to isolate the source of pain. Veterinarians use two techniques to test the stability of the knee: cranial tibial thrust and cranial drawer. If there is thrust and/or drawer present in a dog’s knee, this indicates there is a CCL injury. X-rays are often recommended to help rule out any other causes of pain or lameness, but the ligament itself cannot be seen on x-rays. There are some x-ray findings that make veterinarians suspicious of underlying CCL injury, but true diagnosis is made from physical exam and laxity in the knee joint.

How did this rupture happen?

In dogs, cranial cruciate ligament injury and/or rupture is thought to be due to degeneration of the ligament over time. Unlike people, where a traumatic injury – often sports-related – causes ACL injuries, in dogs the cause is usually degeneration, which leads to injury or even rupture through normal activity. Although a traumatic injury can cause a CCL rupture in dogs, it is less common.

What can we do to help our dog feel better?

When a dog experiences a CCL injury, anti-inflammatory pain medications and rest are recommended. Human pain medications are not safe for dogs, so be sure to consult your veterinarian to discuss appropriate medications for your dog. In addition to rest and medications, surgery is the gold standard for treatment of a CCL injury. Various surgical techniques are available, and your veterinarian will discuss the best option for your dog.

How much does surgery cost?

I recommend that owners see a board-certified surgeon for their pet’s orthopedic surgery. These veterinarians have had additional training to specialize in advanced surgical techniques. As previously mentioned, there are multiple different surgical stabilization techniques for CCL injuries. The most-performed technique in the Chicago area is the Tibial Plateau Leveling Osteotomy (TPLO). These procedures cost between $4,000 to $6,000 in Chicagoland.

Can we use a brace like in humans?

Unfortunately, braces and/or wraps are typically not beneficial in dogs. This is because dogs walk on their tiptoes, so their knee is always bent. (Try it: If you stand on your tiptoes, your knee will be bent too). We humans walk flat-footed, so our weight can transfer from our hip to heel. Since this weight transfer cannot occur in dogs, braces are ineffective.

What if surgery is not an option?

In many cases, surgery is not financially feasible, or it may not be in the best interest of the dog due to other underlying health issues. In these cases, I recommend multi-modal therapy. This includes strict rest for 4 to 8 weeks, long-term non-steroidal anti-inflammatories (NSAIDs), high-quality omega-3 supplements, and glucosamine/chondroitin supplements, along with weight loss. After the period of rest, physical therapy can be very beneficial as well.

With time, the knee will stabilize, but with the stabilization comes more arthritis formation. The body develops arthritis to try to stabilize the knee joint. Surgery on the knee reduces instability, so the body does not form as much arthritis in that joint. However, even with arthritis, dogs are able to compensate well. Many dogs do well without surgery, although the injured leg may always cause some discomfort. The dogs that typically do not do well without surgery are very large dogs that already have joint disease, such as advanced hip dysplasia.

One exception to the surgery rule is toy breed dogs and cats. We do not commonly see CCL injuries in these pets, but when we do, they typically do really well with cage rest and medications and surgery is not often needed.

What about the other leg?

Unfortunately, over 50% of dogs will rupture their other CCL within a year of the first rupture. This can be explained by the fact that both ligaments are typically degenerating at a similar rate. I like to always warn owners of this because they may be faced with the decision to pursue surgery again soon.

How can we prevent a CCL injury?

Unfortunately, there seems to be a hereditary component. We do not have a good method of determining which dogs that will have CCL injuries in their life. However, maintaining an ideal weight is key to joint health. I would also recommend considering pet insurance prior to any issues. Insurance does not cover pre-existing conditions, so don’t wait until your pet starts limping. I have seen CCL injuries in dogs as young as 6 months old, but most commonly we see them in medium to large breed, active, overweight dogs aged 2 to 6 years old.

Dr. Drew Sullivan

After two long years of this pandemic, we still do not know much about pets and SARS-CoV-2 (COVID-19), but over the last few months I have learned a lot. I am writing this blog as I am isolated in my basement with COVID-19. I am thankful for the protection I have received from vaccines as I am only experiencing very mild signs.

Transmission

We believe that transmission to pets is from contact with a positive human within the household. Transmission from pets to humans is considered extremely low. Due to the risk of transmission to pets, the CDC recommend avoiding close contact with pets if you are ill. The occurrence of severe illness in pets is rare, but transmission is possible. Pets presumed positive should remain isolated from other pets until clinical signs have resolved.

Clinical Signs

It is important to remember this is a human pandemic. We know that by comparing the large number of human cases of COVID 19 and the very few cases documented in pets.

I truly believe that most pets do not acquire the virus. If they do, they are typically asymptomatic or have very mild symptoms. The clinical signs I observed in these presumptive positive cases were upper respiratory signs: nasal congestion, sneezing, reverse sneezing, and gag-like cough. These signs were odd and did not fit with classic tracheobronchitis (canine cough). When I examined these dogs, they did not cough when I touched their neck to palpate their trachea, which is the typical response during a physical exam when the patient has classic canine cough.

We have seen patients with clinical signs suspected to be secondary to SARS-CoV-2 in the past 2 to 4 weeks.

Treatment

Unfortunately, there is no approved or documented treatment for COVID in dogs or cats, but in most cases, they do not need treatment. For those pets with more severe clinical signs, I have found that corticosteroids seem to provide the most relief. The brachycephalic breeds seem to have more nasal congestion and difficulty breathing. In these pets, I have started anti-inflammatory doses of steroids and they seem to respond well.

In a few of these cases, chronic rhinitis (irritation/swelling of the mucous membrane in the nose) and sneezing has lasted for weeks to months. Home care for pets is similar to home care for most human COVID-19 cases. The virus needs to run its course. Be sure your pets continue to eat and drink. You can also put the pets in the bathroom with the shower running; the warm humid air can be soothing for the upper airway.

Testing

SARS-CoV-2 testing is not widely available for dogs or cats, but most large veterinary laboratories are offering PCR testing. Antibody testing is not widely available at present. If you feel you dog or cat has signs of SARS-CoV-2 after exposure to an infected person, I recommend contacting your veterinarian.

If you are a client at Medical District Veterinary Clinic, feel free to reach out to me and I may be able to assist in testing as I am collaborating with Dr. Ying Fang, a virologist, at the University of Illinois College of Veterinary Medicine.

– Dr. Drew Sullivan

Rock Salt Is the Real Culprit

There comes a point at the end of every year when you can no longer just grab the leash and causally head out for a walk with your dog. (That is, unless you have a Bernese mountain dog like my brother’s dog, Ruby, who would live in the snow if she could.)

Instead, you have to determine how many layers of clothing you and your dog need to go for a walk. I’ve been doing this dance for years with Emmie. Eventually she complies, thankfully. But, just once, I wish she would remember that when we don’t put the booties on and there is salt out, she ends up crying out and her paws hurt.

As cold as our Chicago winters are, there are really only a few days in any calendar year where it is so cold you have to truly worry about a dog’s paws. The real culprit that is causing dogs to lift up their paws and look at you like they’re auditioning for an ASPCA commercial is the rock salt. I’ve definitely had to carry Emmie a few hundred feet through a heavily salted sidewalk stretch when we were caught off guard.

So here are two ways to help protect your pet’s paws, plus what to do if you forget:

Booties

Yes, they are annoying to put on. Yes, they can sometimes fall off. And yes, most dogs don’t like putting them on. But booties are by far the best way to protect your dog’s paws, and when she’s outside she’s much happier.

The key is to find a brand that fits your dog well. Put in the extra effort to measure the size of your dog’s paws for best fit and look for waterproof options, if they are in your budget.

I’m a fan of Muttluks. They have a measuring guide to help ensure the best fit. Remember: Never use a rubber band or any other band that can be constricting to hold up the booties.

Balms

These can be used to try to prevent ice balls from forming between the toes. Balms also help keep small amounts of salt from bothering their paws. The base ingredient for most of these balms is beeswax, but sometimes you can use coconut oil as well.

The most common brand I see is called Musher’s Secret, though a lot of other brands are out there. The upside is that most of these can be licked or ingested with no concerns. The downside is that they tend not to work as well as booties.

Remedies

If you are like me, sometimes you forget. (Or, TBH, are too lazy and depressed about how dark it is at 6:30 in the morning. Even after we go back to standard time, ugh! Which if any of you have a toddler like me, does not mean an extra hour of sleep!)

When you forget and your dog gets salt on her paws, rinse them off with cool water once you’re home. A warm water Epsom salt soak for 5 to 10 minutes will usually fix the problem if her paws are still irritated after everyone has warmed up from the outing. If the paws are still irritated or seem painful after a soak, give us a call.

This is a question and a discussion that I have with clients daily. And to be honest, it’s a very difficult question to answer. I am going to give you a few tips on how to pick out a food that is best suited for your dog or cat.

Life Stages

I recommend feeding a food based on the life stage of your pet. The four life stages include growth, young adult, mature adult and senior. The below picture helps illustrate the life stages of cats. Canine life stages are pretty similar, but with more variation due to the vast size difference we see in the canine species. The growth life stage is typically done by 6-12 months of age. For cats the growth phase is typically finished by 6-10 months of age and I recommend transitioning to adult food around that time. If you have a puppy or kitten it is very important for proper growth and development to feed a puppy or kitten food. In the same manner as your pet is aging feeding a senior diet is important as they have different nutrient profiles.

You may ask what about an “All Life Stages” dog or cat food. For a company to market their food as “All Life Stages” the food must meet the nutritional requirements for all life stages. Therefore, most of these foods are formulated as a puppy/kitten food because puppies and kittens have the highest nutritional requirements of the four life stages. These foods can be good foods and well balanced, but they typically have a high caloric density. Therefore, in my experience, dogs are more likely to become overweight than if they were fed some other diets.

Medical Conditions

Does your pet have any health conditions that require a special diet? Prescription diets can play a vital role in management of many health conditions, including kidney disease, diabetes, obesity, allergies, and feline lower urinary tract disease.

If your pet suffers from a medical condition, diet can manage and help many conditions, so I always recommend considering a prescription diet if you pet has one of the above conditions.

More Expensive Does Not Mean Better

Many pet food companies are great at marketing but might not be as good at formulating diets. You can always look for the Nutritional Advocacy AFFCO (Association of American Feed Control Officials) Statement on each bag or can of food. These statements will tell you if the food has been through a food trial or formulated to meet particular feeding guidelines. The ingredient list should also list all ingredients in decreasing amounts by weight.

Labels are very confusing and often misleading to consumers. For example, if I made up a food with the following labels, the variation in ingredients can be drastic.

• If the term “All” is used, then the ingredient must make up 100% of product minus preservatives and water. So, this treat would be 100% beef
• If the listed ingredient is used, then the ingredient must make up 95% of product minus water. So, this Beef Dog Chow would be 95% beef on a dry matter basis.
• If the term “dinner,” “platter,” or “recipe” is used, then the ingredient must make up only 25% of product. So, this Beef Dinner is likely only 25% beef.
• If the term “with” is used, then the ingredient must make up only 5% of product. So, this Dog Chow with Beef is likely only 5% beef.

I hope this illustration helps demonstrate how confusing pet food labels can be to both consumers and veterinarians. I recommend visiting the AAFCO website if you want to be better educated about what’s in your pet’s food.

Say No to ‘Grain Free’

Does my pet need grain-free food? The answer is NO. There little to no research showing the true benefit of grain-free food. In fact, grain-free food has been shown to cause heart disease in some dogs. The exact cause is still being researched. Visit this site for more information. https://www.fda.gov/animal-veterinary/animal-health-literacy/questions-answers-fdas-work-potential-causes-non-hereditary-dcm-dogs

What About Raw Food?

Some dogs do really well on raw food, but I do not recommend it. That’s because I see too many owners who try to feed raw but who are not feeding a balanced diet because they are solely feeding raw meat and limited other nutrients.

In the wild canines and felines will consume entire animals. Eating meat, skin, ingesta, organs, and bone makes up a balanced diet.

Raw can be balanced and can be a good diet for some animals, but there is also a public health risk with feeding these diets. This is a statement from the CDC:

“Germs like Salmonella and Listeria bacteria have been found in raw pet food, even packaged ones in stores. These germs can make your pet sick. Your family can also get sick by handling the food or by taking care of your pet.”

Centers for Disease Control and Prevention

Therefore, if there are young children or anyone who is immune-compromised in your house, I highly advise against feed raw pet foods.

Each Pet Is Different

I hope this information has been helpful and informative. I recommend discussing your pet’s daily calorie needs with your veterinarian as each pet is different, just like people. Two people that have ideal weights of 180 pounds may be able to eat very different diets to maintain their weight, and the same goes for cats and dogs. All 10-pound cats do not need the same daily calories.

The recommendations on the bag or can of food should only be a guide. Some animals may need more calories, but most will need less than the recommended amount to maintain an ideal weight. And always remember to factor in all treats and table scraps into their daily calories. Most pets are overweight these days.

—Dr. Drew Sullivan

For many people, the doctor’s office can be a scary place. So it is no surprise that many pets view going to the vet with a similar fear.

Our clinic truly believes in Fear Free practices. Our goal is to limit your pet’s stress and fear and make visits with us as pleasant as possible. There are various ways that we do this, which I would like to share with you.

Treats, Teats, and More Treats!

During your pet’s visit you will notice that we like to offer treats. We have biscuits, cheese, peanut butter – like a candy store for dogs and cats! This is not only because we think your pet is adorable and we want to spoil them, but this is also a main way we like to bond with them.

Imagine if you are at the doctor and you are anxiously waiting, and then the doctor walks in and immediately offers you your favorite treat (for me, that would be some delicious baked goods) and socializes with you. You would likely feel much calmer and connected to them. This is the equivalent of what we do with your pets.

Although we have lots of treats, if you have a dog or cat that is pickier with food, please feel free to bring whatever your pet likes best. This is not uncommon, as I have seen many patients that would eat only one food.

We encourage owners to offer treats as well during visits to help make the entire experience as positive as possible. We joke that visits go best when our patients come hungry, so you may want to consider bringing your pet to see us with an empty stomach so there is plenty of space for treats!

Getting on Their Level

We want our patients to feel comfortable, so we often will sit on the ground with them. We hope that by sitting on their level they feel less intimidated and fearful, and that they see us as their “friend.” I have noticed that when I sit on the ground and spend time in the room before even beginning my exam, my patients generally seem more at ease.

Please do not feel obligated to sit with us, but if you would like to you are totally welcome!

Limit Stress from Other Pets

Many cats never leave the home except to go to the vet. They may be stressed by traveling before they even arrive.

The smells and sounds of dogs can be very scary for them, too, which is why we recently created a separate feline waiting room and exam rooms. We use all separate supplies, have tasty treats and fun toys, and have nice feline-friendly smells. In the months since we have started using this new space, I have noticed that cats overall seem much calmer and happier. 

Dogs can be become upset from other pets as well. Some of the sweetest and most affectionate dogs that I have met do not get along well with other dogs. Being around other dogs is stressful for them. I personally have a dog-reactive dog, and while she loves people, other dogs make her highly anxious.

To reduce this anxiety, we have multiple tactics, such as choosing specific exam rooms and trying to limit time in the clinic and exam room, when other pets are a trigger for the patient. We also perform exams outside in an isolated area if needed.

Fear Free for Your Pet

Please let us know if your pet is reactive with other pets, or there are any other behavioral concerns, and we will work with you to formulate a plan for their visits.

I hope you can see how much we at Medical District Veterinary Clinic truly care about our amazing patients! We look forward to continuing to make their time with us as fun and enjoyable and fear free as possible!

Amber Slaughter, DVM

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.

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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