Spay

by | Apr 2, 2024 | Surgery/Anesthesia

Spay (Ovariohysterectomy)

By Dr. Karen Burgess

Who is it for?
Female animals

What is it?
Surgical removal of ovaries and uterus.

When is it done?
Typically performed at 6 months of age or older, shelters will often do at a much earlier age.

Why is it done?
To prevent breeding/reproduction, has also been shown to significantly decrease the incidence of breast (mammary) cancer in dogs. Risk if spayed after 2nd heat of breast cancer is 26%, if spayed after 1st heat is 8%, if spayed before 1st heat 0.5%.

How is it done?
Preanesthetic bloodwork performed, intravenous catheter placed and intraop fluids administered, monitoring performed by a registered technician and include blood pressure, EKG, blood oxygen levels, and carbon dioxide levels. The animal is sedated and then administered anesthesia via a tube in the windpipe. After surgery the pet is monitored for the remainder of the day until discharge. Pain medication is administered during the procedure and sent home with the pet. The incision may have stitches or not that would be removed in 10-14 days.

Neuter

by | Apr 2, 2024 | Surgery/Anesthesia

Neuter (Castration)

By Dr. Karen Burgess

Who is it for?
Male animals

What is it?
Surgical removal of testicles

When is it done?
6 months of age or older, shelters will often do at a much earlier age.

Why is it done?
To prevent breeding/reproduction, eliminates chances of testicular cancer, decreases benign prostatic enlargement by 80% or more, decreases testosterone levels thereby curbing the chance of leaving the yard to find the in heat female which decreases their risk of HBC and dog fights.

How is it done?
Preanesthetic bloodwork performed, intravenous catheter placed and intraop fluids administered, monitoring performed by a registered technician and include blood pressure, EKG, blood oxygen levels, and carbon dioxide levels. The animal is sedated and then administered anesthesia via a tube in the windpipe. After surgery the pet is monitored for the remainder of the day until discharge. Pain medication is administered during the procedure and sent home with the pet. The incision may have stitches or not that would be removed in 10-14 days.

Anesthesia- What you should know

by | Apr 2, 2024 | Surgery/Anesthesia

Anesthesia

What You Should Know Before a Procedure

By Dr. Karen Burgess

Anesthesia is an artificially created state of insensitivity typically created by drugs or inhalant gas that depress the nervous system. General anesthesia creates a state of unconsciousness allowing for muscle relaxation and complete lack of sensation. Local anesthesia is typically where a small area is numbed allowing for less invasive procedures while a pet is awake. For pet owners anesthesia is a situation that often evokes a feeling of fear or anxiety. Estimates indicate that only 1 out of 100,000 will have a reaction of some sort to anesthesia. While this number is small, understanding the process of anesthesia and the steps that are taken to minimize the associated risks helps to alleviate these concerns.

Trusted and trained professional team
The most important element behind a safe and successful anesthetic procedure is the team working with your pet. Having a relationship with your veterinarian and their staff, knowing that they practice up to date medical management, and understanding that their attention is dedicated exclusively to your pet while it is under general anesthesia is essential. As a pet owner you should feel that your concerns have been addressed prior to any anesthetized procedure and that there is an open line of communication between the veterinary team and yourself. Talk to your veterinarian about how they develop their protocols, what specific considerations there may be for your pet, and what additional training in anesthesia/pain management they have had. It is also important to know that all “veterinary technicians” are not the same. The title may be a certified (academically trained) technician, a degreed Animal Science major, or simply someone that was hired yesterday with no formal training. A typical anesthetic procedure at Healthy Paws Animal Hospital involves at a minimum a dedicated certified technician/degreed major and the doctor. The pet under anesthesia is the primary focus of all involved.

Physical examination, complete history, signed consent
The physical exam allows the doctor to evaluate for any issues that may impact the anesthetic episode or procedure. This should occur immediately prior to general anesthesia to ensure accuracy. Historical questions asked at admission allow a dialogue with the pet owner looking for any additional issues or concerns. Previous medical problems, current medications, and recent ingestion of food are only a few of the necessary details. An anesthesia consent form should also be completed allowing the client to understand and acknowledge that the details of the procedure, potential risks, and financial commitment are understood and agreed to by all.

Pre-anesthetic laboratory testing
Testing of the blood and at times urine allows a more detailed evaluation of a pet’s internal organs. Dehydration, kidney, liver, and electrolyte abnormalities can all negatively impact an anesthetic episode. Laboratory testing may be done the day of a procedure or within the several weeks prior. While test results should be normal, any abnormalities may cause a procedure to be postponed until addressed further. In some cases radiographs (x-rays) of the heart may also be recommended as an added precaution.

Intravenous Catheter
An intravenous catheter allows direct access to a pet’s vein and thus immediate access for necessary treatments. Typical uses for an IV catheter include administration of additional sedation, pain medication, antibiotics, or fluids. When pets are under general anesthesia maintenance of blood pressure is of utmost importance. The ability to administer large volumes of fluid quickly is essential if blood pressure problems arise. It has been shown that 1-2% of pets NOT receiving fluids during a procedure will develop kidney problems within two weeks of anesthesia. This risk is nearly zero in animals that DO receive fluids. In times of low blood pressure or an anesthetic crisis it can be very difficult to place an IV catheter thus the need for placement when the pet is still awake.

Appropriate sedation

  • Pre-emptive/intraoperative pain management, inhalant anesthesia via an endotracheal tube
  • Animals should be maintained under anesthesia via a tube placed in the mouth and down the windpipe thus allowing direct access to the lungs. An endotracheal tube allows tighter control of the depth of anesthesia and if respiratory problems develop the ability to administer oxygen and artificial respirations. This tube also seals the airway preventing any unintentional leakage of fluid from the esophagus into the airway. The gas administered via the tube is typically isoflurane mixed with oxygen and is very short acting. Thus when you turn the gas off, animals should wake up within minutes. Prior to intubation with an endotracheal tube, pets should be sedated with drugs that provide both anxiety and preemptive pain relief. Following sedation, an induction agent is given intravenously putting them in a sleep state and thus allowing the tube to be placed. It is common for five or six different drugs to be given prior to gas anesthesia with the goal being to create as smooth and safe an anesthetic episode as possible. By using very small amounts of many drugs (“cocktails”) better overall control can be achieved. Providing pain control prior to painful stimulation better controls pet’s comfort throughout the procedure. Additional pain management in the form of local nerve blocks or injectable drugs during the procedure continue the pain control process.

Continual monitoring

  • There are many ways to evaluate depth of anesthesia. Ultimately we want to administer enough gas to keep the pet asleep but not so much as to be dangerous. Complications from anesthesia are most commonly related to a pet becoming “too deep”. With appropriate monitoring, this should be almost completely avoidable. The following are recommended for the safest episode possible.
  • Licensed technician-human observation is the absolute most important monitor available. The veterinary technician is constantly monitoring the level of anesthesia and altering the amount of anesthesia being given accordingly.
  • End tidal CO2-measurement of respiratory rate and carbon dioxide levels as the breath leaves the lungs is one of the earliest indicators of poor oxygenation.
  • Blood pressure-low pressures can impact blood flow to sensitive organs (brain, kidneys).
  • Pulse oximetry-indirect evaluation of the oxygen being carried by blood cells and the heart rate.
  • EKG-visual image of heart beat and electrical waves.
  • Temperature control-the body temperature tends to fall with anesthesia leading to potentially life-threatening complications. It is imperative that a pet’s body temperature be monitored and controlled until they are completely awake and normalized.

Recovery management/postoperative pain management
Once a pet is awake the job is not done. Continued monitoring to ensure return to normal body temperature, comfort, and safety are necessary. Observation should continue until all parameters are normal and the pet is perhaps drowsy but able to move safely on its own. Comprehensive discharge instructions and discussion with the pet owner to relay expectations after discharge and resources if problems arrive should also be provided.

Vomiting, Feline & Canine

by | Apr 2, 2024 | Sick

Vomiting, Feline & Canine

Vomiting in Dogs and Cats

By Dr. Karen Burgess

Vomiting is a symptom of an underlying problem not a disease in itself and should always be cause for concern. Infections (viral, bacterial, parasites), toxins, inflammation, or disease of the intestinal tract can all lead to vomiting, and while mild cases may resolve without intervention, vomiting accompanied by diarrhea, lethargy or any other behavioral changes should be treated as a medical emergency.

One of the most common causes of vomiting is GI (intestinal) upset from a sudden change in diet, giving an unfamiliar treat, or feeding table scraps. When caused by food changes, vomiting can often be resolved at home as long as it is not severe and the pet continues to act and feel normally. Withholding water for 12 hours and food for 24 hours allows the digestive system to settle down. After 12-18 hours, small amounts (1/4 cup or less) of water can be offered every 1-2 hours. If vomiting does not recur after 12 hours of water being offered, then small amounts (depending on size of pet a teaspoon up to a ¼ cup) of a bland diet such as white rice and chicken can be offered (see recipe/schedule below) every 1-2 hours. If no further symptoms are noted after being on a bland diet for two days, then regular food can be gradually reintroduced over a three to five day time period. If vomiting persists in spite of nothing being given orally or recurs, veterinary treatment is recommended.

In order to avoid intestinal upset due to a new diet, changes in food should always take place over several days. For the first three days of a food switch, feed ¼ of the new diet and ¾ of the old food. If your pet is doing well, then feed a half new food and half old food for another three days, then ¼ old food and ¾ new food for another three days. This slow transition will help to minimize intestinal upsets and decrease the incidence of food related vomiting and diarrhea.

Although many pets regularly receive table scraps care must be taken to ensure that these are not too rich for their system. Fatty foods in particular can cause diarrhea, vomiting, and may lead to pancreatitis (a potentially life threatening inflammation of the pancreas). It is also important to remember that pets should never be given turkey, chicken, or rib bones as these can splinter into small pieces and puncture the stomach and intestines.

While the goal of treatment for vomiting is aimed at solving a specific underlying problem many times this is difficult to accomplish. Supportive or symptomatic care is often what ends up resolving the problem. If vomiting is present for less than 24 hours and there are no other signs of illness (normal energy level, no diarrhea), a conservative approach of wait and see may be successful. However, if there are any additional signs of distress or lethargy, increasing amounts of vomiting, or diarrhea a visit to the veterinarian is required.

Upon visiting the veterinarian a full history will be obtained including when symptoms began, frequency, volume, and consistency. It is helpful to bring a fresh stool sample to this visit. After a comprehensive physical exam, the following tests may be performed:

  • Fecal examination – testing for parasite infections or bacterial overgrowth
  • Blood work – evaluation of a variety of body systems (ex. kidneys, liver, hydration, red and white blood cells) to give a reading of basic health
  • X-rays – radiographs may be recommended to diagnose potential intestinal obstructions or ingested foreign bodies

Treatment of vomiting may involve a bland diet, anti-nausea medication, or antacid therapy; severe cases may require hospitalization and intravenous therapy

Chronic intermittent vomiting (lasting for three or more weeks), while less common, is also reason for a visit to your veterinarian. Keeping track of vomiting episodes on a calendar can help determine frequency. If a pet is vomiting more than once weekly, this may be indicative of underlying issues. Chronic vomiting can lead to poor digestion and absorption of nutrients, low energy levels, weight loss, and poor quality hair coat.

Food allergies and intolerances are a common cause of mild chronic vomiting. Similar to lactose intolerance in people, dogs may have or develop allergies or sensitivities to a variety of ingredients in dog food leading to chronic inflammation in the intestinal tract. Pancreatic diseases, inflammatory bowel disease, and cancer are also causes of chronic vomiting.

Whether chronic or acute, vomiting is almost always a sign of an underlying medical condition that needs to be addressed. Because vomiting in itself has the potential to be life threatening, any dog suffering from more than a short-term bout or showing signs of other medical problems should be seen by a veterinarian. In addition, because young animals are so susceptible to several potentially fatal viruses, the presence of vomiting in any puppy or kitten should be treated as a medical emergency until proven otherwise.

Bland diet recipes – 8 ounces cooked white rice (baby rice cereal for cats), 4 ounces single protein source (ex. boiled beef, boiled chicken, low fat cottage cheese). Can boil together, use lean meat, 1# food mixture daily for a 30# dog.

Sample bland diet schedule

Food Type

Volume

Frequency (adjust volume for size of dog)
Day 1 No food No food No food
Day 2 Bland 1/2 of normal caloric intake 6-8 small feedings (ex. 1/4 cup every 2-3 hours)
Day 3 Bland 3/4 of normal caloric intake 4-6 small feedings (ex. 1/2 cup every 4 hours)
Day 4 Bland Full caloric intake 4 feedings (ex. 3/4 cup every 6 hours)
Day 5 75% bland, 25% regular dog food 75% bland:25% regular food 2-4 feedings
Day 6 50% bland, 25% regular dog food 50%:50% 2-4 feedings
Day 7 25% bland, 75% regular dog food 75%:25% 2 feedings
Day 8 Regular dog food Regular amount Regular interval

Kennel Cough

by | Apr 2, 2024 | Sick

Kennel Cough

Infectious Tracheobronchitis (Kennel Cough)

By Dr. Karen Burgess

What is infectious tracheobronchitis?
Infectious tracheobronchitis is often also referred to as kennel cough. The trachea or windpipe is the major airway that divides into smaller bronchi in the lungs. Finally bronchi become bronchioles and alveoli where oxygen is ultimately exchanged with red blood cells in blood circulating through the body. A variety of bacteria and viruses (likely more than fifteen) are capable of causing inflammation in the trachea and bronchi thus leading to a typical dry hacking cough. While often described as one disease, kennel cough is actually a generalization that would be similar to a person saying they have a cold or the flu but not knowing the specific causative virus or bacteria. Kennel cough is considered highly contagious from dog to dog.

What are symptoms of kennel cough?
Kennel cough is notorious for causing a dry hacking, non-productive, or honking cough that is easily exacerbated by excitement, exercise, or pressure on the neck/trachea. Owners will often note that coughing is worse after barking or pulling on a collar. Dogs with uncomplicated kennel cough do not show signs of general illness and are typically eating, drinking, and active. Symptoms may only last for days or a mild cough may be present for weeks after infection. If a pet is acting sick in any way other than a cough the problem may be more serious than kennel cough.

How is kennel cough spread?
Kennel cough is easily spread to healthy dogs from aerosolized cough droplets originating from an infected dog. Objects such as toys and food bowls can also be methods of transmission. Symptoms can develop anywhere from two days to two weeks after exposure. Large numbers of dog in small confines with poor ventilation all contribute to risk. Dogs that have had kennel cough can technically be contagious for two to three months after exposure. Some dogs may not even show signs themselves of infection but still be able to spread the disease to other dogs.

What is the significance of a kennel cough?
Kennel cough is typically more of an inconvenience than a true medical problem. Sleep for the pet and owner may be interrupted and severe cases. Very young, very old, or immunocompromised dogs may be more prone to developing pneumonia from kennel cough. The contagious nature of kennel cough requires infected dogs to be confined even after symptom free for some time. Kennel cough is a not uncommon risk to boarding or exposing dogs to group situations.

How is kennel cough diagnosed?
Kennel cough is typically diagnosed by physical examination and review of patient history (recent exposure to other dogs, no other signs of illness). Testing for the specific bacteria or virus responsible for an infection is typically not warranted and tests available are limited. In some cases radiographs of the lungs may be recommended to help rule out other possible causes of a cough.

How is kennel cough typically treated?
Assuming no other symptoms are present, supportive care and time are often the only treatment required. Rest, avoiding irritation of the trachea (ex. using a harness), and monitoring appetite are all recommended. If the cough is such that it is keeping an owner or pet from sleeping through the night a cough suppressant may be recommended. In some cases a course of antibiotics may be recommended, although this will not help if the original problem is viral in nature.

Can kennel cough be prevented?
Vaccination for distemper, adenovirus, Bordetella, and Parainfluenza (all potential causes of kennel cough) are available. Distemper and adenovirus are core vaccinations recommended for all dogs and typically given as a puppy and adult in combination with parvovirus. Bordetella and Parainfluenza are non-core vaccinations recommended only for dogs considered at increased risk for exposure to kennel cough. Vaccination is available in both an intranasal and injectable formulation, however the intranasal is thought to be slightly more effective. Surfaces exposed to kennel cough should be disinfecte with dilute bleach.

Can a dog get kennel cough even if they are vaccinated?
It is important to note that no vaccine is 100% effective against kennel cough and that if a vaccinated pet develops the disease this does not mean that the vaccine was “bad” or a place of business where exposure occurred “dirty”. It just means that similar to the human flu vaccination, the vaccine was not effective against the particular disease strain a dog was exposed to. In some cases vaccination will not prevent the disease 100% but shorten its course or lessen the severity of symptoms. The most effective way to prevent kennel cough is to not expose a dog to any other dogs.