pet quarterly | winter 2013

FOOD ALLERGY REmEDiEsHow to identify food culprits

SEPARATIONANXIETYEase your dog’s fears

You found what?Benefits of dental X-rays

Watching your seniorpet’s water intake

Pet Care News From Your Veterinarian

WINTER 2013 | Vo lume 10, No. 1


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Pet Quarterly | Winter 2013 1

BeanNew Hope Animal HospitalDurham, N.C.

YoyoGarden Grove Animal HospitalWinter Haven, Fla.

2 You Found What? Surprising finds from

dental X-rays.

4 Never Can Say Goodbye? How to ease your dog’s distress

from separation anxiety.

7 Food Allergy Fix Elimination diets help identify

food culprits.

10 Water Warnings Increased thirst and urination

and your pet’s health.

14 Pet Tales Ways to keep your pet moving

year round and more.

I N T H I S I S S U E

WINTER 2013 | VOL. 10, NO 1


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Picture-Perfect Pets

ShadowAnimal Health CenterEast Palatka, Fla.

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IYou Found What?You might be surprised by what regular X-rays of your pet’s mouth may reveal. Veterinary dentists share their findings.

Is something lurking in your pet’s mouth that regular dental checkups might not reveal?

Dental radiographs (X-rays) are an essential part of any dental checkup, because they detect problems in your pet’s mouth that a visual examination alone won’t show. What you and your veterinarian can’t see during an exam often becomes as clear as day to your veterinarian with simple X-rays.

Just as your dentist regularly uses X-rays to check what might be happening below your gum line, veterinary dentists routinely uncover problems when they view

your pets’ X-rays. An estimated 42 percent of dental diseases are found beneath the gums—something your veterinarian may miss by examining your pet’s mouth. Research published in the American Journal of Veterinary Research found that 28 percent of dogs and 41 percent of cats had significant oral disease that was not visible.

We asked three veterinary dentists—Dr. Brett Beckman, Dr. Jan Bellows and Dr. R. Michael Peak— to share some of the discoveries they have encountered through dental X-rays. From dead teeth to retained roots and other complications, their answers might surprise you.

Dental Health

Dr. Peak

Abscessed ToothPhoto 1: When Dr. Peak examined this dog, its teeth appeared normal. He did not see problems—such as discoloration, gingivitis or fractures—during a periodontal probing. But an X-ray revealed a potentially painful condition: bone destruction at the root tips caused by dying pulp within the tooth. These signs pointed to an abscessed tooth. This pet was likely in a lot of pain without showing it. “Without the X-rays we never would have known it,” says Dr. Peak. Standard treatment is extraction or a root canal.

Feline Tooth ResorptionPhoto 2: At first glance, this cat’s teeth seem healthy.Photo 3: X-rays uncover a very different story. Dark spots on one of the cat’s canine teeth (large front teeth) and lack of a distinct root on

the X-ray indicate extensive tooth resorption. This condition involves breakdown or destruction of the tooth, a painful condition for cats that often goes undetected without X-rays. An estimated 60 percent to 70 percent of cats experience tooth resorption during their lives. In this cat’s case, the tooth was extracted, which alleviated potential discomfort.

Dead ToothPhoto 4: Can you spot the dead tooth in this Pug’s mouth? If not, you’re not alone, because the problem isn't visible without an X-ray.

Photo 5: In the X-ray, look closely at the second tooth from the right, and you will notice a wide canal down the middle of the tooth. This wider-than-normal

pulp canal shows that the tooth is dead. “This tooth could be a source of chronic infection and discomfort,” notes Dr. Peak. The tooth was extracted, alleviating the dog’s pain.

Unerupted ToothPhoto 6: This dog is missing a tooth. Photo 7: Or it is? The radiograph reveals that the tooth is actually there. This condition can be caused by a tooth that formed but never completely grew in (known as an unerupted tooth), which can cause problems over time. “This tooth has the potential to develop into a dentigerous cyst, which can be

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quite destructive to the supporting bone, predisposing it to a jaw fracture,” says Dr. Peak.

Fractured Tooth RootPhoto 8: During a visual exam, this dog’s upper front teeth appear normal.

When Dr. Peak examined the radiograph, he found a root fracture on one of the dog’s upper incisors. “If this tooth was stable and periodontally sound, it could remain,” explains Dr. Peak. “In this case it was not, and the tooth and root were extracted.”

Dr. Bellows

Dead ToothPhoto 9: This dog’s teeth appear normal. Photo 10: X-rays revealed a problem. Dr. Bellows could see an enlarged pulp chamber within one of the dog’s upper teeth. This indicated that the tissue inside the tooth had died, a potentially painful condition, so Dr. Bellows extracted the tooth.

“The dog was not showing any signs of pain,” explains Dr. Bellows. “But the affected tooth was non-vital (dead) so it most probably caused dull pain and pain when grabbing food due to pressure on the affected surrounding bone.” Dr. Bellows also found evidence of advanced periodontal disease. “If the periodontal disease was not present, the tooth could have been saved through root canal therapy,” he says.

Bad BitePhoto 11: Why are this Shih Tzu’s lower incisors misaligned? Photo 12: X-rays showed the problem. One of the dog’s deciduous (baby) teeth never grew through the gum. This may have caused two of the dog’s other teeth to grow in improperly. That, in turn, caused a large cyst, a condition that was likely painful, Dr. Bellows notes. Dr. Bellows extracted the embedded tooth, as well as three other teeth, to make this dog’s mouth pain-free.

Root ResorptionPhoto 13: A pet owner brought her cat to Dr. Bellows for a root canal to save the pet’s fractured tooth. Photo 14: When Dr. Bellows X-rayed the cat’s teeth, he found that the problems were more serious than expected. Below the cat's gum line, most of the root was resorbed. Root resorption (destruction of the tooth) made it impossible to save the tooth with a root canal, so Dr. Bellows extracted the tooth. “The tooth lacked root support and probably was painful during eating,” he notes.

Dr. Beckman

Retained RootPhoto 15: To the naked eye, it looks like this dog is missing a tooth, perhaps as a result of a fracture.Photo 16: When Dr. Beckman examined the dog’s X-rays, he discovered that part of the tooth was still there, but only below the gum line. The gum had grown over the tooth, so only the root of the tooth remained. When this happens, the pulp within the tooth often dies and causes bone destruction around the root tip, a painful condition that often goes unnoticed. With surgery, Dr. Beckman made a gum flap to expose the root and extracted the tooth to prevent further pain. n

Does Your Pet Need Radiography?Bad breath, discolored teeth, gum inflammation, discolored gums, excessive salivation, dropping food, trouble chewing and abnormal tongue movements are just some of the symptoms that could signal that your pet has a dental problem. Watch for signs and let your veterinarian know if you spot anything unusual in your pet’s mouth.

X-Ray Essentialsn X-rays are a standard part of your

pet’s preventive care. Untreated periodontal disease and other dental disease can lead to diseases in other parts of your pet’s body.

n Radiography commonly reveals deep infection that destroys bone around the tooth, as well as tooth abscesses, cysts and tumors that are not detectable without this invaluable tool.

n Pets naturally hide pain. Regular dental checkups, including X-rays, can uncover—and prevent—painful conditions.

n Start early, when your pet is 12 to 18 months old, with a full oral radiographic screen and your pet’s first professional dental cleaning.

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DDo you come home to urine or stool on the floor, couch stuffing strewn all over, carpeting pulled up and voice mails from neighbors complaining that your dog barks all day long? If so, your dog may have separation anxiety.

Q: What is separation anxiety?A: Separation anxiety is a distress response that dogs can experience when separated from familiar or favorite people, or if they are anxious about being home alone due to other fears or phobias.

Q: What are the common signs? A: Common signs include urination, defecation and

destruction while alone. Your dog may also pant, pace, whine or huddle in one spot while you are away. These signs may begin as you get ready to leave home. When you return, you may encounter exaggerated and excited greetings.

Q: Does my dog have separation anxiety?A: Your dog may be distressed even if you don’t see visible signs of destruction or elimination when you are gone. A dog’s distress may begin as you initiate your departure routine

(gathering keys, briefcase, lunch) or after you are actually gone, often within 15 minutes of departure. Many dogs with separation distress refuse to eat their food or yummy treats when alone.

Before you jump to the diagnosis of separation anxiety, however, consider other possible reasons for unwanted behaviors while your dog is home alone. Destruction of household items may indicate a lack of appropriate outlets for play and activity in your dog’s life. Indoor elimination can be due to a

never Can SaY GoodbYe?Learn how to part without pain! How to ease your dog’s distress if it is suffering from separation anxiety.

By Debra Horwitz DVm, DACVB, and Amy Pike DVm


General Wellness

1. Teach Calmness at Home. If your dog cannot be calm and away from you

when you are home, it may not be able to be calm when alone. Conversely, if your dog can relax when you are home, it may be able to relax when you are gone. Teach your dog to relax with a sit/stay or down/stay command in a designated “safe spot” (a dog bed or mat) and not to follow you anxiously from place to place. Keep initial sessions short, and always use food rewards and praise.

2. Uncouple Departure Cues from Departure. Departure cues (putting on shoes, grabbing a jacket and keys) may trigger distress.

Behavior Modification for Separation AnxietyFollow these four steps to help easy your furry friend’s fears of being alone. Key Points

DOgS CAN SUFFER FROM separation anxiety when separated from favorite people.

COMMON SIgNS INClUDE urination, defecation, destruction and refusal to eat when alone.

OTHER SIgNS INClUDE panting, pacing, whining or huddling in one spot, and exaggerated and excited greetings upon the owner’s return home.

CANINE SEPARATION ANXIETY can be treated with behavior modification and, in extreme cases, with medication.

medical problem or the inability to wait until you get home to eliminate outdoors. Barking can occur in response to interesting things a dog sees out the windows, such as the mailman, people and dogs walking by or squirrels in the yard.

Q: So how do I know if my dog actually has separation anxiety?A: The best and most reliable way to determine if your dog is experiencing symptoms of separation anxiety is to videotape your dog in your absence. New technology has made it easy—you can use a smart phone, web cam or tablet with video software. To find out what your dog does when you are gone, you must really leave. Walking out the door and waiting in your yard or next door will not work; it must be a normal, regular departure. To verify a diagnosis of separation anxiety, share your video >>


Uncouple those cues from your actual departure by occa-sionally and randomly presenting a departure cue without actually leaving the house. Choose just one cue to work on (shoes, keys or jacket). Perform the cue and then head to the sofa. Sit down for a few minutes, read a magazine and ignore your dog. After the allotted few minutes, calmly get up and put the item away. Once these signals of departure no longer reliably predict that you are leaving the house, your pet’s anxiety level around departure may diminish. Do this exercise a few times a day—not every hour, or you may increase, rather than decrease, your pet’s distress.

3. Make Departures and Returns Calm. When you must leave, associate departures with something good,

act calmly and keep your energy low-key. Leave your dog (separate multiple dogs) a food-dispensing toy stuffed with something delicious to help it focus on the food and be more relaxed as you exit. If you have progressed to the point where your dog can relax in your selected safe spot, settle your dog there with the food toy. Your exit should be quiet and calm. It

may help to pack up your necessary items and put them in your car the night before. Say a calm good-bye and leave the house. When you return, if your dog shows excitement that lasts for several minutes, try to ignore it (except for allowing your dog outside to eliminate) until your pet can sit or stand calmly for a quiet petting and greeting session.

4. Teach Your Dog to Be Alone. If the previous tools do not sufficiently diminish anxiety at departure and

while you are gone, you may need to go one step further. During the last phase of behavior modification, we work to teach the dog to be home alone using specifically designed training departures. These must be done correctly or they may not be helpful and can actually increase distress rather than diminish it. A consultation with your veterinarian or a veterinary behaviorist is your next step.

While an expert is treating your dog, it helps if your pet does not have to experience separation distress. Consider taking your pet to doggy daycare, having friends stay with your dog, hiring a dog walker or sitter and taking your pet to work.

Destruction of household items while you are away could be a sign of separation anxiety.


Did You Know?If your dog’s level of anxiety is

so high that it is unable to learn or respond to

behavior modification, your veterinarian may

decide to prescribe medication for your dog.

Currently there are two medications approved

by the U.S. Food and Drug Administration

for the treatment of separation anxiety in

dogs: Reconcile® (Elanco Animal Health) and

Clomicalm® (Novartis). Only your veterinarian

or veterinary behaviorist is qualified and

licensed to diagnose, prescribe and dispense

prescription medication. With their help, your

pet can truly learn to live a normal, happy and

fulfilled life.

Symptoms of Separation AnxietyYour dog may have separation anxiety if it:

n Urinates, defecates or destroys household items in your absence.

n Pants, paces, whines or hides regularly when you get ready to leave.

n Consistently refuses to eat food or even treats when home alone.

To find out what your dog does while you are away, videotape your dog and share the video with your veterinarian.

results with your veterinarian or a veterinary behaviorist and allow this expert to rule out possible medical conditions that may also be present.

Q: What’s the solution? A: The solution in most cases is behavior modification. The goal of this therapy is to teach your pet how to relax and how to be home alone without becoming anxious. The most common steps are: teaching calmness while you are home, uncoupling departure cues from departure, making departures and returns calm, and actually teaching your dog to be alone. (See sidebar, pg. 4-5.) n

Dr. Debra Horwitz is a diplomate of the American College of Veterinary Behaviorists.

Dr. Amy Pike is pursuing a residency in veterinary behavior under Dr. Horwitz’s mentorship.

General Wellness


JJust like humans, pets can have food allergies that are problematic and pervasive, with chronic symptoms in pets such as licking, biting and scratching. But unlike humans, our pets can’t tell us which foods seem to bring on those uncomfortable and long-lasting symptoms.

To help resolve food allergies, a veterinarian may prescribe a food trial to determine a healthy and appropriate diet for your pet. These trials help identify the offending food sources so you can eliminate them, allowing your pet to be healthy and allergy free.

Parasite Control/Dermatology

>>

Key PointsFOOD AllERgIES CAN CAUSE itchiness and digestive problems.

DIAgNOSINg A FOOD AllERgY can be difficult, because many of the symptoms are similar to the symptoms of environmental allergies and parasites.

A FOOD ElIMINATION DIET is the only way to identify which foods cause allergic reactions for the pet.

IN AN ElIMINATION DIET, all previously fed foods are removed and a new one is introduced. If the symptoms disappear, the pet will be “challenged” with the previously fed food. If symptoms return, the diagnosis is confirmed.

FooD AllERGY FIxElimination diets help identify

culprits to make your pet more

comfortable.

By Paula Andruss


Warning SignsSeveral signs may indicate that your pet might have a food allergy, which is an adverse health effect arising from a specific immune response, says Michael Canfield, DVM, who specializes in veterinary dermatology at Animal Hospital of Regency Park in New Port Richey, Fla., and Animal Emergency and Referral Center of Fort Pierce, Fla.

Classic indicators, he says, include non-seasonal itchiness involving the ears, paws, groin, armpits, neck and the area below the tail. Signs of food allergies may also include increased numbers of bowel movements per day (three or more), vomiting, diarrhea and flatulence.

The timing of the problems figures into the diagnosis as well, Canfield adds. “Food allergy signs develop at one year of age or younger in about 30 percent of food-allergic patients,” he says.

Tricky DiagnosisTo determine if your pet has a true food allergy, a veterinary dermatologist will need to fully evaluate your pet and its food. “A comprehensive medical history and dermatological examination are key in determining if food allergy should be considered,” Canfield says.

Unfortunately, many factors make food allergies difficult to diagnose, including the fact that the symptoms of food allergies are similar to those of environmental and seasonal allergies.

While there is a blood test designed to identify food allergies, experts agree it’s typically not accurate enough to make a definitive diagnosis. “The problem with blood tests for food allergies is that there’s not always a correlation between the results and what an animal may truly be allergic to,” says veterinary

dermatologist Patricia White, DVM, and owner of the Atlanta Veterinary Skin & Allergy Clinic. “You may get false negatives and false positives. For example, you may get a result that says rice is okay, but when the animal eats rice it has a reaction. And if you only go by the results of the blood test, you’ll miss that.”

The only Sure Way As a result, experts agree that the only way to conclusively diagnose and resolve a food allergy is through a food elimination diet. This type of diet helps identify which foods are causing allergy symptoms so they can be removed from the pet’s regular diet. “If food allergy is a strong consideration, then an elimination diet is the only way to know for sure,” White says.

Food elimination diets work by identifying all of the foods an animal

Many pet owners find sticking to an elimination diet challenging enough, but there are also several items that can derail the diet if your pet ingests them.

“Many people know their animal can only have one kind of food, but they think their pet

can still have rawhides, milk bones and the goo they squeeze into its

Kongs,” says Dr. Michael

Canfield of the Animal Hospital of Regency Park in New Port Richey, Fla. “But those things all have flavorings that can completely throw off the trial.”

Medications can also be problematic if they are flavored, he adds, including heartworm preventatives, oral flea controls, non-steroidal medications for pain and other medications used daily to treat various conditions.

“Many of those are now flavored, so pet owners should also make special considerations when

administering certain medications, such as looking for a non-flavored or topical

option,” he says.

DIET DISRUPTORS

Parasite Control/Dermatology

Breakthrough Allergen Diet for DogsA new breakthrough in allergen diets is poised to help more pet owners whose dogs have food allergies. Royal Canin’s Anallergenic diet is a new product created by a highly technical process that breaks down food proteins to particles so small that they reduce or even eliminate the possibility of an allergic reaction in pets.

“Pets with food allergy have a food hypersensitivity, typically an uncontrolled immune response to large ingested proteins,” explains Jeff Kellerman, DVM, MBA, scientific support manager for Royal Canin. “One significant strategy in managing those pets is to feed hydrolyzed or cleaved proteins that will not be ‘recognized’ by the immune system.”

Scientific studies of Royal Canin’s breakthrough diet are promising. The company conducted a trial at six veterinary practices in dogs suffering from food allergy, and all showed significant improvement in skin condition, with 37.5 percent of dogs’ skin conditions being completely resolved at the end of the 13-week trial.


has been eating, and then replacing them with a hypoallergenic diet that contains none of those items for a certain amount of time, usually at least eight weeks.

The type of diet prescribed can vary depending on the pet, according to White.

“Some animals are put on a home-cooked diet, some can be on a can-limited diet and some can be on a dry diet with limited ingredients,” she says.

No matter what type of food is used, the goal is to identify which food or foods are causing the problems. “The idea with an elimination trial is to eliminate all of the previously exposed ingredients for a period of time sufficient to clear the adverse responses being produced by the immune system,” Canfield says.

If the pet’s symptoms clear and an allergy is suspected, the veterinarian will then perform a “challenge” with the previously fed food to see if the problems reappear.

“If a flare occurs (worsening of itchiness, recurrence of infections), the patient is returned to the trial diet until

clinical signs resolve,” Canfield explains. “Then, and only then, can the diagnosis be confirmed.”

Experts agree that sticking to an elimination diet can be a real labor of love, difficult for both pet owner and patient. “Even if one owner or family member understands that the patient cannot have anything beyond the prescribed food, the toddler, neighbor and bank teller do not,” Canfield says. Other times, pets may ingest certain offenders without their owners even knowing it (see sidebar, pg. 8).

But ultimately, White emphasizes, despite the challenges that come with performing an elimination diet for your pet, it’s worth the trouble when it comes to relieving those troublesome symptoms. “A hypoallergenic dietary trial can be frustrating,” she says. “But at the end, you’ll help your pet get better and get it comfortable, so that its quality of life is improved.” n

Paula Andruss is Cincinnati-based writer.

OOne of my favorite pastimes has always been reading on the couch snuggled up with my dogs. I loved spending long peaceful afternoons curled up with my furry friends—until recently, when the cozy couch time seemed to lose its magic. After a few unsuccessful snuggle sessions, I realized that my Boston Terrier, BB, was frequently leaving the couch to go outside.

After a bit of detective work, I determined that BB was not only making repeated excursions outside to urinate, but also was drinking water from the base of my flowerpots. Suddenly BB’s fascination with my walk-in shower and the mysterious damp spot on the couch from last week were starting to make sense. BB was showing signs of increased thirst (polydipsia) and excessive urination (polyuria). I knew right away I needed to look into this problem further.

Warning Signs Increased thirst and urination are frequently overlooked early indicators of several important diseases. Pets with signs of increased thirst and urination typically have a total body water imbalance, where the amount of fluid lost from the body is not equal to the amount of fluid taken in.

Polydipsia is characterized by excessive water consumption. Increases in water consumption are easy to overlook in our pets,

Water WarninGSIs your pet lapping up water faster than you can fill the

bowl? Increased thirst and urination in senior pets can

be early indicators of disease.

By Juliet Gladden, DVm

Senior Wellness

Don't write off changes in your pet's drinking habits as a normal sign of aging. It could be a sign of disease.


because many of us simply fill our pet’s water bowls as needed. Sometimes pets with polydipsia will seek out inappropriate water sources such as tubs, sinks and toilets. They may also eat snow and drink from puddles, ponds or streams.

Many senior pets increase their water consumption to keep up with urinary fluid losses. Excessive urination in senior pets is typically due to polyuria, a condition characterized by the production of large volumes of urine. It is important to distinguish excess (large volume) urination (polyuria) from frequent (small volume) urination (pollakiuria) because these elimination habits often represent very different disease processes.

Don’t assume that changes in water consumption and urination habits are “normal” signs of aging. Increased thirst and excessive urination are often the first signs of several serious systemic diseases. Senior pets exhibiting these signs should be thoroughly evaluated by a veterinarian, and further diagnostic testing should be performed.

Common Causes As pets age, diseases that damage their kidneys and important endocrine organs can disrupt the delicate balancing act required to maintain appropriate body fluid levels, causing increased thirst and urination in many senior pets. These pets typically urinate more than normal and then drink more water in an attempt to replace water lost from the urinary tract.

Common causes of excessive thirst and urination in middle-aged and older cats are kidney disease, diabetes mellitus and hyperthyroidism (excessive thyroid hormone production). In dogs, major causes include kidney disease, diabetes mellitus and hyperadrenocorticism (excessive cortisol hormone production).

A number of other diseases cause increased thirst and urination in senior pets, as well, so it is important to have your veterinarian thoroughly evaluate senior pets during their exams for other signs of disease. Several medications commonly administered to senior pets—including steroids, diuretics and anti-seizure drugs—can also lead to excessive thirst and urination.

looking for CluesA urine concentration test is one of the first tests that should be performed in senior pets with signs of increased thirst and urination. Evaluation of a urine sample provides a tremendous amount of information about a pet’s overall health, and this test is relatively inexpensive. The best time to collect urine is first thing in the morning. Early-morning urine samples tend to be more concentrated because sleeping pets are less likely to drink water overnight.

If you haven’t had the pleasure (or the practice) of collecting a urine sample from your pet, I suggest you stop by your veterinarian’s office for a few quick tips that

can make the whole process a lot easier. I evaluated BB’s urine sample at the clinic with a

specific gravity test, which helps determine the relative concentration of the urine. Your veterinarian will check your pet’s urine concentration more than once to see if there is a consistent trend. Any one urine sample can be affected by your pet’s water consumption, diet and fluctuations in urine production.

Key PointsSENIOR PETS THAT URINATE IN INAPPROPRIATE lOCATIONS or stop using the litter box usually have an underlying medical problem.

TAlK TO YOUR vETERINARIAN if you notice changes in your pet’s drinking and urination habits.

EARlY DETECTION AND MANAgEMENT of kidney and endocrine diseases improves long-term outcomes.

SENIOR wEllNESS HEAlTH PANElS THAT INClUDE both urine (urinalysis) and blood tests (CBC, biochemistry panel, thyroid levels) are more likely to identify common diseases of senior pets.

>>



Senior Wellness

BB had low urine specific gravity (dilute urine). Dehydrated pets with dilute urine need further diagnostic testing, because this suggests that the kidneys are not functioning properly. Unfortunately, BB’s hydration level and low urine specific gravity indicated he had a more serious problem.

I took BB into the clinic and collected another urine sample via cystocentesis, a quick, painless procedure where urine is collected directly from the bladder using a very small needle. Although urine samples collected at home are valuable to your veterinarian when determining your pet’s ability to concentrate urine, additional urine samples need to be collected under sterile conditions by your veterinarian for further diagnostic testing.

While I was performing the cystocentesis, I used an ultrasound probe to locate BB’s bladder. The ultrasound showed that he had a normal bladder wall and helped me rule out urinary bladder stones as a cause of his frequent urination. Ultrasound-guided urine sample collection makes it easier to obtain urine from pets with very small bladders and also provides important information about the bladder wall and contents.

BB’s urinalysis results suggested an underlying endocrine disorder. I submitted a urine culture to rule

out an underlying bacterial infection of the bladder and kidneys, and I collected blood for further diagnostics testing. I submitted the blood for a cell blood count, biochemistry panel and a special endocrine test to look for a disease called hyperadrenocorticism (Cushing’s disease) that is a common cause of increased thirst and urination in senior dogs. This turned out to be BB’s problem.

Seeking TreatmentUrinary incontinence, inappropriate urination and excess urine production in senior pets can be frustrating to deal with alone. Discuss possible options for the treatment and management of urinary issues with your veterinarian.

Appropriately diagnosing and treating the underlying cause of your pet’s urinary issues can, in some cases, completely resolve your pet’s clinical signs. Early detection is key to initiating treatments that may not only slow the progression of disease but also potentially prevent the development of serious complications.

Schedule an exam with your veterinarian at the onset of these signs and ask for a senior wellness health screen that includes both urine (urinalysis) and blood tests (CBC, biochemistry panel, thyroid levels).

Condition Affects Treatment/Management

Chronic kidney disease Dogs and cats

• Diet changes and fluid support to slow disease progression

• Prescribed medications to help manage urinary incontinence

• Serial monitoring of urine samples to detect serious problems before life-threatening complications develop

Diabetes mellitus Dogs and cats

• Insulin therapy

• Serial monitoring of urine samples to detect serious problems before life-threatening complications develop

Hyperthyroidism (excessive thyroid hormone production)

Cats• Daily medication

• Radioactive iodine therapy

Hyperadrenocorticism (excessive cortisol hormone production)

Dogs • Medication that decreases cortisol levels

SlowINg THE FlowCommon causes and treatment options for increased thirst and urination in senior pets.

How Much water Is Too Much?n An average 10-pound dog should consume approximately 1 cup of water a day. If your pet appears to be consuming considerably more than 1 cup per 10 pounds of body weight, it may be experiencing increased thirst (polydipsia). Water consumption may be higher in areas with warmer climates, in pets fed food scraps and in hyperactive pets.

n Cats may consume slightly less than dogs but on average have similar water requirements. Cats can be secretive about their drinking habits and often will supplement their water supply with sources of water from sinks and unattended cups or bowls.

n Excessive urination in senior pets is typically characterized as urine production greater than about 1 cup per 10 pounds of body weight per day in dogs and cats.


Many of the common underlying diseases associated with increased thirst and urination in senior pets can be successfully managed (see sidebar, pg. 12). Behavioral and environmental modifications can also be used as potential strategies to help you and your senior pet cope with changes in your pet’s elimination habits.

Together, you and your veterinarian can identify and combat the common causes of increased thirst and urination in your pet. Early diagnosis and

management of chronic diseases helps ensure that your pet will live a longer, healthier life.

As for BB and my pile of pups on the couch, we are all, thankfully, back to contently snuggling together without the incessant interruptions. BB’s urinary issues resolved after I started his treatment for hyperadrenocorticism, restoring our cozy afternoons once again. n

Dr. Juliet Gladden is an emergency and critical care veterinarian.

DiD You KnoW?Senior pets that no longer seem

“house-broken” (urinate outside of the litter box, cry and whine at night or

“wet their beds” when sleeping) may have an underlying kidney or endocrine disorder

that can medically managed.

Pets with increased thirst may seek out water from sinks and other sources.

Rule of thumb: An average 10-lb. dog should consume about 1 cup of water per day.


Pet Tales

wintertime doesn’t always seem like a real wonderland for outdoor activity with your dog, but daily exercise is essential to maintaining your pet’s health.

n While short-haired and small dogs may need warm apparel to help brave the elements, if your dog has a thick fur coat it will likely just need a little encouragement to enjoy a cold-weather romp.

n Doggie booties aren’t just fashion accessories. If there is snow, ice and salt on the ground, walking without protection can be irritating and downright painful for your canine companion. Booties are an easy solution—if your dog tolerates them. If you find Fido is a bit bashful strutting in his new shoes, disposable latex feet protectors or even some simple petroleum jelly may be your solution.

n Change up the scenery. If your summer activity is playing Frisbee in open spaces, consider moving winter exercise sessions to a different location, such as a park or forest. The trees provide protection from the wind, and the new noises, smells and sights are sure to keep your pooch’s

mind engaged and off of the cold.n If your dog is reluctant to go on its morning winter

walk, consider bringing along treats (or even breakfast) along the way. Offering kibble while walking is a great way to get Fido excited about morning walks. This is safe to do while walking, but feeding while jogging isn’t recommended.

n Going from the cold and into the heat can cause dry, itchy skin. Purchase a humidifier for your home and towel-dry your pet as soon as it comes inside. Pay special attention to your pet’s feet, in-between the toes.

n When Fido digs in his heels and refuses to go out the door, consider staying inside. Ever tried agility classes or even some basic obedience classes? Find an indoor class in a heated building, and you may have a better-behaved dog when springtime arrives. No classes in your area? Pick up a dog trick book, play tug of war, and bring the party inside your own house. Even if all you have energy for is a movie, grab some grooming supplies and turn it into a relaxing evening for two.

Keep Moving Year Round Pet tales by Laci schaible, DVm

Pet Tales

If you’ve ever described your pet as “not fat, just fluffy,” you probably aren’t alone. Pet obesity is a growing problem in the United States. A recent study by Association of Pet Obesity Prevention found that 54 percent of our nation’s pets are overweight or obese. Another study, Banfield’s State of Pet Health 2012, found that 76 percent of dog owners and 69 percent of cat owners believe their pets are just the right weight.

Obesity in pets is more than cosmetic. Packing on too many pounds can lead to kidney disease, arthritis, diabetes, high blood pressure, breathing problems and shortened life

expectancy. Overweight pets can also rack up veterinary bills as a result of diseases caused by obesity, not to mention losing our beloved furry family members at premature ages.

The good news: You can control what your pet eats as well as its exercise level. The most important decision you make as a pet parent each day is to help keep your pet at a healthy weight. Ask your veterinarian to review your pet’s Body Condition Score with you. This score rates your pet’s weight and appearance.

Food for thought: A 15-pound cat is the equivalent of a 219-pound 5'4'' female; each excess pound on a Pomeranian is equal to 24 to 25 pounds on a 5'9'' male!

1. Brush your pet’s teeth. It’s kind of like going to the gym—the hardest part is deciding to do it. It gets much easier, and you will make progress more quickly than anticipated. Poor dental health leads to oral infections and bacteria that can travel to the heart and organs, causing major problems and even death.

2. If your pet is lacking in manners, it’s time to change that! Ask friends or your veterinarian to recommend a good trainer—one who uses positive techniques and positive reinforcement.

3. Less treats, more measured food portions. Don’t just eyeball food portions for your pets. If you aren’t sure how much food your pet should eat, don’t trust the back of the pet food bag; remember, the companies marketing the food to you want you to purchase frequently. Ask your veterinarian for the most reliable information.

4. Resolve to exercise! Take your dogs for more walks. While the idea of feline boot camp earns a big hiss, cats can be tricked into having fun and elevating their heart rates by engaging play with a laser

light or my personal favorite, the Pocket Fisherman (minus the hook of course).

5. Love your vet and want to show your appreciation? Leave a positive online review. It will not go unnoticed, and you will be on your way to VIP Client status.

6. Have fun! Take your dog to the beach or for more rides in the car; spend more time snuggling with your cat. Even if it is simply taking a few moments to pet your pets at bedtime,

they will cherish the attention, and you will find it relaxes you too.

7. Do you have financial concerns about your pet’s veterinary expenses? Many veterinarians offer payment plans, will help you apply for a line of credit for vet bills or have programs in place to assist those who are financially strapped. Putting off a visit to the veterinarian when a pet is sick not only puts the pet’s health at risk, but also has a good chance of increasing the treatment needed—and the accompanying veterinary invoice.

New Years Resolutions for Pet Parents

It’s Not All Fluff



Pet Tales

CAUTION: Federal (U.S.A.) law restricts this drug to use by or on theorder of a licensed veterinarian.INDICATIONS: For use in dogs to prevent canine heartworm diseaseby eliminating the tissue stage of heartworm larvae (Dirofilariaimmitis) for a month (30 days) after infection and for the treatment andcontrol of ascarids (Toxocara canis, Toxascaris leonina) andhookworms (Ancylostoma caninum, Uncinaria stenocephala,Ancylostoma braziliense).DOSAGE: HEARTGARD® Plus (ivermectin/pyrantel) Chewablesshould be administered orally at monthly intervals at therecommended minimum dose level of 6 mcg of ivermectin per kilogram(2.72 mcg/lb) and 5 mg of pyrantel (as pamoate salt) per kg (2.27mg/lb) of body weight. The recommended dosing schedule forprevention of canine heartworm disease and for the treatment andcontrol of ascarids and hookworms is as follows:

HEARTGARD Plus is recommended for dogs 6 weeks of age and older.For dogs over 100 lb use the appropriate combination of these chewables.ADMINISTRATION: Remove only one chewable at a time from thefoil-backed blister card. Return the card with the remaining chewablesto its box to protect the product from light. Because most dogs findHEARTGARD Plus palatable, the product can be offered to the dog byhand. Alternatively, it may be added intact to a small amount of dogfood.The chewable should be administered in a manner thatencourages the dog to chew, rather than to swallow without chewing.Chewables may be broken into pieces and fed to dogs that normallyswallow treats whole.Care should be taken that the dog consumes the complete dose, andtreated animals should be observed for a few minutes after administrationto ensure that part of the dose is not lost or rejected. If it is suspected thatany of the dose has been lost, redosing is recommended.HEARTGARD Plus should be given at monthly intervals during theperiod of the year when mosquitoes (vectors), potentially carryinginfective heartworm larvae, are active. The initial dose must be givenwithin a month (30 days) after the dog’s first exposure to mosquitoes.The final dose must be given within a month (30 days) after the dog’slast exposure to mosquitoes.When replacing another heartworm preventive product in a heartwormdisease prevention program, the first dose of HEARTGARD Plus must begiven within a month (30 days) of the last dose of the former medication. If the interval between doses exceeds a month (30 days), the efficacyof ivermectin can be reduced. Therefore, for optimal performance, thechewable must be given once a month on or about the same day ofthe month. If treatment is delayed, whether by a few days or many,immediate treatment with HEARTGARD Plus and resumption of therecommended dosing regimen will minimize the opportunity for thedevelopment of adult heartworms.Monthly treatment with HEARTGARD Plus also provides effectivetreatment and control of ascarids (T. canis, T. leonina) and hookworms(A. caninum, U. stenocephala, A. braziliense). Clients should be advisedof measures to be taken to prevent reinfection with intestinal parasites.EFFICACY: HEARTGARD Plus Chewables, given orally using therecommended dose and regimen, are effective against the tissuelarval stage of D.immitis for a month (30 days) after infection and, as aresult, prevent the development of the adult stage. HEARTGARD PlusChewables are also effective against canine ascarids (T. canis, T.leonina) and hookworms (A. caninum, U. stenocephala, A. braziliense).

ACCEPTABILITY: In acceptability and field trials, HEARTGARD PlusChewables were shown to be an acceptable oral dosage form thatwas consumed at first offering by the majority of dogs.PRECAUTIONS: All dogs should be tested for existing heartworminfection before starting treatment with HEARTGARD Plus which isnot effective against adult D. immitis. Infected dogs must be treatedto remove adult heartworms and microfilariae before initiating aprogram with HEARTGARD Plus.While some microfilariae may be killed by the ivermectin inHEARTGARD Plus at the recommended dose level, HEARTGARD Plusis not effective for microfilariae clearance. A mild hypersensitivity-type reaction, presumably due to dead or dying microfilariae andparticularly involving a transient diarrhea, has been observed inclinical trials with ivermectin alone after treatment of some dogs thathave circulating microfilariae.Keep this and all drugs out of the reach of children.In case of ingestion by humans, clients should be advised to contact aphysician immediately. Physicians may contact a Poison ControlCenter for advice concerning cases of ingestion by humans.Store at controlled room temperature of 68°F - 77°F (20°C - 25°C).Excursions between 59°F - 86°F (15°C - 30°C) are permitted. Protectproduct from light.ADVERSE REACTIONS: In clinical field trials with HEARTGARD Plus,vomiting or diarrhea within 24 hours of dosing was rarely observed(1.1% of administered doses). The following adverse reactions havebeen reported following the use of HEARTGARD: Depression/lethargy,vomiting, anorexia, diarrhea, mydriasis, ataxia, staggering,convulsions and hypersalivation.SAFETY: HEARTGARD Plus has been shown to be bioequivalent toHEARTGARD, with respect to the bioavailability of ivermectin. Thedose regimens of HEARTGARD Plus and HEARTGARD are the samewith regard to ivermectin (6 mcg/kg). Studies with ivermectin indicatethat certain dogs of the Collie breed are more sensitive to the effectsof ivermectin administered at elevated dose levels (more than 16times the target use level) than dogs of other breeds. At elevateddoses, sensitive dogs showed adverse reactions which includedmydriasis, depression, ataxia, tremors, drooling, paresis, recumbency,excitability, stupor, coma and death. HEARTGARD demonstrated nosigns of toxicity at 10 times the recommended dose (60 mcg/kg) insensitive Collies. Results of these trials and bioequivalency studies,support the safety of HEARTGARD products in dogs, including Collies,when used as recommended.HEARTGARD Plus has shown a wide margin of safety at therecommended dose level in dogs, including pregnant or breedingbitches, stud dogs and puppies aged 6 or more weeks. In clinical trials,many commonly used flea collars, dips, shampoos, anthelmintics,antibiotics, vaccines and steroid preparations have been administeredwith HEARTGARD Plus in a heartworm disease prevention program.In one trial, where some pups had parvovirus, there was a marginalreduction in efficacy against intestinal nematodes, possibly due to achange in intestinal transit time.HOW SUPPLIED: HEARTGARD Plus is available in three dosagestrengths (see DOSAGE section) for dogs of different weights. Eachstrength comes in convenient cartons of 6 and 12 chewables.For customer service, please contact Merial at 1-888-637-4251.

Color Coding 0nDog Chewables Ivermectin Pyrantel Foil-Backing

Weight Per Month Content Content and Carton

Up to 25 1 68 mcg 57 mg Blue26 - 50 1 136 mcg 114 mg Green51 - 100 1 272 mcg 227 mg Brown

CHEWABLES

®HEARTGARD and the Dog & Hand logo are registered trademarks of Merial. ®INTERCEPTOR is a registered trademarkof the Novartis Corporation. ®FLAVOR TABS is a registered trademark of Novartis AG. ©2010 Merial Limited, Duluth, GA.All rights reserved. HGD10CNPETQTRAD.

1 Of dogs showing a preference in three studies conducted by independent investigators, dogs preferred HEARTGARD®

(ivermectin) Chewables over INTERCEPTOR® (milbemycin oxime)FlavorTabs® by a margin of 37 to 1; data on file at Merial.

TrimDog Exercise Belt & weight loss System is a relatively new product that offers hope in curbing pet obesity. This weighted belt is fitted to your pet under your veterinarian’s supervision and worn during walks to increase the amount of calories your pet burns. It is not a quick fix and must be used in conjunction with an appropriate diet and exercise program. Talk to your veterinarian before starting a weight loss program for your pet.

®HEARTGARD and the Dog & Hand logo are registeredtrademarks of Merial. ©2012 Merial Limited, Duluth, GA.All rights reserved. HGD11TRCVCCOVER.

Start puppies off right with

Love.

Puppy.

Ask your veterinarian about HEARTGARD® Plus (ivermectin/pyrantel) today!

xhg171963_PetQtrly-8x10.75_rsg 5/2/12 12:48 PM Page 1

Take it Easy with PuppiesPuppies should never accompany you on jogs, no matter the season. You should not start jogging your dog until it is fully grown and its growth plates are closed. For some small breed dogs, you can begin around 10 months of age, but for large and giant breed dogs, it can take 15 months or more before they are ready for strenuous exercise. Start all canine exercise programs at a low level of intensity and work your way up.

Deep-chested dogs should avoid exercise and rough play after eating to reduce the chance of bloat, a life-threatening condition in which the stomach can twist on itself.

Spotlight on New TrendsVisit http://trimdog.blogspot.com.

®HEARTGARD and the Dog & Hand logo are registeredtrademarks of Merial. ©2012 Merial Limited, Duluth, GA.All rights reserved. HGD11TRCVCCOVER.

Start puppies off right with

Love.

Puppy.

Ask your veterinarian about HEARTGARD® Plus (ivermectin/pyrantel) today!

xhg171963_PetQtrly-8x10.75_rsg 5/2/12 12:48 PM Page 1

Spotlight on New Trends

*Data on file at Merial.†Vet-dispensed; MDI Data.

®FRONTLINE is a registered trademark of Merial. ©2011 Merial Limited, Duluth, GA. All rights reserved. FLE11CNPRINTAD.

Unleash the complete

killing force against fleas and ticks.

completekiller.com

What makes FRONTLINE® Plus complete? It annihilates the flea life cycle by killing fleas as adults, eggs, and larvae. Ticks, too. FRONTLINE Plus also keeps killing for 30 days.

Satisfaction guaranteed. That’s why it’s the #1 choice of vets for their pets*— and yours.†

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pet quarterly | winter 2013

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