Sunday, November 23, 2014

Thanksgiving overindulgence: For pet owners, a different Black Friday

Thanksgiving stirs memories both warm and not-so, the latter often connected with our younger years, when we were forced to sit quietly and display impeccable table manners. Most of my own Thanksgiving recollections are quite pleasant, especially those of the seasonal flavors inextricably bound in my primitive brain.  

The day after Thanksgiving evokes its own set of images. So-called “Black Friday” makes us think of waiting in line at obscene hours (party!), great bargains, death-defying stampedes, and excitement.  For me, the thought of Black Friday calls up equally hectic but less enjoyable memories: of the many phone calls I’ve received from worried owners of dogs suffering from various degrees of indigestion.

It’s only natural that we’d want to share the glorious cuisine of the holiday with our furry friends!  How can we sit there in our gluttony, savoring Grandma’s special sage stuffing and creamy gravy, while Daisy’s imploring eyes stare at us?  It’s hard to ignore the saliva dripping from her flews while you’re enjoying a delectable piece of Mom’s sour cream pumpkin pie with whipped cream.

I implore you:  Please ignore it!  Ignore the whining, slavering, barking, head nudging, pacing — all of it! If you capitulate to clever canine manipulation, there could be a price to pay.

Even careful owners can be undone by a devious dog. The leftover scalloped potatoes (made with heavy cream and shredded Gruy√®re cheese on top!) languish on the kitchen table, and your dog quietly counter-surfs; or she silently salvages turkey bones from the garbage.  All the while, you’re in the living room eating the aforementioned pie. 

Sure, a little indigestion might be only slightly unpleasant for you both; your dog’s appetite temporarily decreases, or she has a bout of loose stool in the yard.  But most dogs are used to eating the same food at the same time every day, and deviation from that protocol can have more severe consequences.  Those usually involve a trip to our office, intestinal antibiotics, and anti-vomiting drugs, perhaps with Imodium and probiotics thrown into the mix for the inevitable diarrhea that follows (usually on your newly cleaned carpet).  Occasionally an abdominal x-ray, lab work, and fluids are necessary.
Not as common but of more concern is the possibility of pancreatitis.  In some dogs, even a single meal that is too high in fat can result in inflammation of that tiny but crucial organ.  The pancreas produces digestive enzymes; when it becomes inflamed, those caustic substances can leak out and literally digest the surrounding tissue.  It’s serious, painful and sometimes even fatal.

So how do we assuage our guilt when we’re dining like royalty and our best friend is pleading for a share of the fare?  Yes, you can resist.  Or if your dog can handle table food, simply make her a doggie version of some of your dishes.  Save some of those boiled potatoes or baked sweet potatoes before you slather them with cream cheese and butter.  Soak plain croutons in hot fat-free chicken broth.  Unembellished carrots, cooked green beans and peas are all flavorful treats that some dogs enjoy.  Add small amounts of skinless, boneless turkey white meat to any of those dishes for extra palatability.   What about dessert?  The ASPCA has published a pumpkin pie cookie recipe for dogs and cats! 

Reduce the possibility of accidents by making sure leftovers and table scraps are safely put away or stored well out of reach.
And remember: Although you might enjoy pushing back from the table engorged like a replete tick, that doesn’t mean your dog does.  Filling her stomach won’t fill her heart.  Only you can do that.  


Thursday, November 13, 2014

About those lumps and bumps

If I removed every little lump I saw on my patients, I’d be wealthy!  But I don’t, and I’m not.  The reason veterinarians don’t eliminate every single blemish is that it’s usually not necessary.

You’ve probably seen an aging pet that has hairless, warty-looking bumps on his body.  Those rather unsightly lesions are most likely sebaceous adenomas, which are benign tumors of the sebaceous glands of the skin.  Because sebaceous glands secrete oil, the adenomas might be greasy and scabby.  As long as they don’t bother the pet owner or patient, and don’t get too big, they can be left alone.

But sometimes they create problems that indicate removal:   They can bleed and create a mess on rugs and furniture. They can also be itchy and an annoyance to the pet; some dogs and cats become obsessed with licking at the adenomas, which can make them red and sore.  Occasionally they are in a location that causes pain, such as between the toes.  And often our clients are just tired of looking at them!

Skin tags, which are seldom seen on cats, are another category of ugly, lumpy things.  Once in a while, their location makes them a problem.  For example, skin tags on the elbows are subject to repeated trauma whenever the dog lies down on the floor.  Sometimes skin tags are unattractive to the dog owner.   In those cases, we remove them.  Otherwise, skin tags are perfectly harmless and may be left alone.

Another benign skin mass we commonly encounter is a sebaceous cyst.  This differs from the aforementioned sebaceous adenoma in that it’s not a tumor, but a sac full of the oily secretion of the sebaceous gland.   But like sebaceous adenomas, they can bleed, itch, and aggravate the pet, and we recommend excision in those cases. 

We eliminate these small skin bumps in two ways:  Excision or tissue ablation.  When we excise a mass, we simply cut around it using a surgical scalpel or a laser beam.  The resulting skin defect may be left open or closed with sutures.  Excision of small masses might require only a local anesthetic.   Larger lumps or those in sensitive areas, such as the feet or face, will require a general anesthetic, so we usually try to remove those when the patient needs another procedure, such as a dental prophylaxis. 

A CO2 laser also can be used to ablate small lumps; the laser beam vaporizes the lump without thermal damage to surrounding tissue.   But this is painful without using local or general anesthesia, and again, we try to coordinate the removal with other procedures.

I’ve often wished we could remove some of these small skin masses right in the exam room instead of subjecting the pet to hospitalization and general anesthesia.  With the addition of a new instrument in our practice, that wish has come true.  

Cryoprobe™ is a portable and efficient cryosurgical device for the treatment of many kinds of skin lesions in small animals. The pen-shaped hand piece freezes unwanted tissue with pinpoint accuracy by using a micro-fine jet of liquefied nitrous oxide.  After the tissue freezes, it is allowed to thaw, and then it’s frozen again.  The “freeze-thaw-freeze” cycle results in destruction of the cells.  The cool thing (no pun intended) is that the treatment causes only minor discomfort and doesn’t require a local anesthetic.  

Because geriatric dogs tend to be skin-lump factories, they will benefit the most from cryosurgery, especially if they aren’t candidates for general anesthesia.  Even small mammals and birds may have lumps that can be selectively removed by freezing.   At Vernon Hills Animal Hospital, we think that this icy-cold therapy will be an asset for many of our patients!

Sunday, November 2, 2014

Pilling your cat: A hard act to swallow

When I was a new graduate, I never hesitated to prescribe pills for my feline patients.  I would demonstrate the technique of administering a capsule or tablet, and down the hatch it would go.  Occasionally my cat clients would call and tell me that they couldn’t pill their cat.  I knew that couldn’t possibly be true: There was simply no such thing as an “unpillable cat”!  After all, I had easily popped in that medication at the appointment.

So I called it the “myth of the unpillable cat” — until a few months into my first year of practice.  Because that’s when I met such a rascal, and became more humble.

It’s one thing if clients can’t pill their cat.  They don’t have our expertise, and they are afraid of hurting their little buddy, or they’re just plain afraid of her; one little struggle or hiss, and they give up.  Veterinarians, on the other hand, know every cat trick in the book.   But even the slyest and strongest among us is no match for a truly determined feline.

First, she hears the pill bottle rattle. (Here’s a hint: Take the pill out of the bottle well ahead of time.)  Just that sound is enough to send her into the crawl space for two days.  But sometimes she’ll humor you and allow you to put her into the pilling position.  You gently scruff her or place your hand over her muzzle, and that’s when the trouble starts:  If she doesn’t lacerate your forearms with her front claws, she’ll flip her hind legs over her head and push you away with her well-armed hind paws, at the same time twisting her body into impossible positions, all of which yields her desired result:  You simply have to let go.  Think you can wrap this scoundrel in a towel like a mummy and avoid the flying fur?  Hah! The unpillable cat laughs at a stinking towel!  D.H. Lawrence said that “reason is a supple nymph, and slippery as a fish by nature.”  In my opinion, reason doesn’t hold a candle to the unpillable cat.

Then there is the sly feline who allows her people to pop the pill.  But no matter how far down her throat they push it, this creature has a true gift:  She can always regurgitate it.  I see these cats from time to time, and I’m always grudgingly impressed.  

There are alternatives to pills, of course.  There are injections, but they don’t appeal to most cat owners or to their kitties.  Liquid oral concoctions and instant-dissolving tablets are easier to administer, but the unpillable cat will have none of that: As soon as the medication hits her tongue, she turns on a fountain of foamy saliva and violently shakes her head while racing around the house.

The most promising solution is delivery of medication via a cream, applied to the inner surface of the ear, but not many medications come in that form.  And true to her nature, the hard-core unpillable cat (maybe I should rename this critter “the unmedicatable cat,” but it doesn’t slip off the tongue) has a technique to prevent that.  Her response is immediate and violent, especially if she is equipped with front claws.  

So how do we treat these kitties?  We can’t, and we don’t.  Sometimes their life depends on the very medications they reject, but forcing a cat to do something to which he is violently opposed can destroy the bond he has with his people.  Many clients have told me that they would rather forgo treatment and take the consequences than have their cat hate them.  Still, I like to get these patients into our office to check the owner’s technique. Occasionally I find they’re just going about it the wrong way; a few tweaks and all is well.  But to the steadfastly unpillable cat, I say, “I have met the devil, and it is thee!”