Pet Peeves

Now that the snow and ice is hopefully behind us, it is time to think about spring. With our dogs and cats, two of the largest concerns we have around this time of the year are parasites and allergies.  Parasites include fleas, ticks, heartworm from mosquitoes, and intestinal parasites.  Also, as the spring buds begin to open, allergies kick into full gear.

As far as parasites, thankfully we have many ways to keep them at bay, but we must be vigilant. Probably the most concerning of the external parasites is the tick. There are four main types of ticks in this area: the brown dog tick,  American dog tick,  deer tick and the  lone star tick.  We think about the deer tick the most, as it is the common vector of Lyme disease in the northeast United States.   Check out capcvet.org website for companion animals and University of Rhode Island’s Tick Encounter web site http://www.tickencounter.org. The first website is very helpful for identifying pet risks in your area for many parasites.  The second one  is a very helpful web site that provides a tremendous amount of information on tick identification, removal, perimeter treatment and much more.

In dogs Lyme disease  usually clinically presents as swollen joints, a shifting leg lameness, fevers that come and go, a poor appetite, lethargy, and in some cases severe kidney or cardiac disease.  Many veterinarians screen for Lyme disease at the time yearly heartworm testing is done along with anaplasmosis and ehrlichiosis.  There are many effective ways to prevent this debilitating and sometimes fatal disease in dogs. There are multiple Lyme vaccinations approved for use in dogs and many effective tick control products. Most folks are familiar with the topical monthly spot -ons like Frontline  (Merial) or K9 Advantix (Bayer). However there are many other choices you should discuss with your veterinarian. They all have their pros and cons. We now have an eight month flea and tick collar and  two types of oral flea and tick  pills.  In addition to tick control, most of these products also control fleas and some also prevent heartworm.   Some also prevent gastrointestinal worms. However, no tick control and no vaccine is one hundred percent, so a watchful eye is always recommended too. Ticks like to hang out in tall grass, brush and the edge of woods. Keeping your pets out of those areas and keeping the environment mowed also helps.

In cats Lyme disease isn’t a big concern, but cats can get other tick- borne diseases such as ehrlichiosis, cytauxoonosis, and anaplasmosis. There are effective tick and flea control products for cats also. Some are topicals and one is an effective 8 month collar.

 There are also diseases spread to cats and dogs by fleas, but we will have to discuss this another day along with those annoying allergies that  cause our furry friends to lick, scratch, rub, shake their heads.  Ticks and  fleas are not only a nuisance to us and our furry friends, but a significant, and  sometimes serious, public health hazard.

 As much as we like to discuss our pet concern of the day, we would  like to hear from you.  Please feel free to e-mail us with your pet question at  drspepin.slade@gmail.com.  Depending on the number of questions we get,we will answer as many as space allows.  As always, if your pet has a specific problem that needs to be addressed, contact your veterinarian.  Usually when a problem is chronic, it is more difficult and expensive to treat, and  the success rate of treatment tends to be lower.

 Dr. Marisa Pepin Slade and Dr. Robert Slade

            Last month we discussed ticks and other parasites. This month we wanted to touch on another springtime concern: allergies. When you have to turn on the windshield wipers to clear pollen off the car its time when dogs start licking there feet, scratching their ears, rubbing their eyes and generally itch everywhere along with the occasional hotspot. In cats, many times they develop what is called milliary dermatitis. This usually presents as little scabs around their neck about the size of a millet seed.

            One of the most common allergies in dogs and cats is fleas. We are not going to discuss that today, as last month we mentioned that there are many quality products to keep these annoying critters at bay.

            Seasonal inhaled allergies, also known as atopy, is what comes into full force in the spring. There are also contact allergies that can develop on the feet or belly do to sensitivities to grass and weeds.  These sensitivities can occur year round – due to house dust, fungal organisms and grain storage mites, to name a few causes.

            Many times seasonal allergies can be addresses with oral antihistamines, topical sprays and shampoos. In severe cases, oral cortical steroids like prednisone are needed. Other long-term medications include nonsteroidal medications like cyclosporine or Apoquel (Zoetis). Never use any over the counter people allergy medicine on your pet with out talking to your veterinarian first. Many contain ingredients such as decongestants or pain relievers that are toxic to our pets.

            For chronic allergies that do not respond to antihistamines and require long term use of steroids may benefit from allergy testing. There are two types of allergy testing: intradermal where small amounts of multiple allergens are injected in the skin after the fur is clipped, and the pet’s response is noted. A Board Certified Veterinary Dermatologist usually does intradermal testing, when required. We are lucky to have several of these specialists in the area. The second type of allergy testing is serum allergy testing. Here a blood sample is taken and sent to a lab which screens antibodies against a list of allergens. The serum allergy tests have gotten very good in the past few years. Most general practice veterinarians can do serum tests.  Once the allergens are identified then hypo sensitization or allergy shots can begin. For years the only way we could hyposensitize a pet was with allergy injections. Today we have the option, in many cases, to use oral hypo sensitization where the allergy serum is administered orally twice a day. It is important if your pet requires an allergy test that you talk to your veterinarian to see how long specific allergy medications, like prednisone, need to be withheld prior to the test.

            Another common allergy is the food allergy. Today we have a plethora of grain-free diets on the market. Ironically, while pets can have allergies to grain, the usual culprit for the food allergy is the protein sources i.e. the meat! While there are serum allergy test for food allergy, the best way to identify a food allergy is an elimination food trial. Here the pet if fed a select protein or a hydrolyzed protein diet for six to eight weeks and is monitored for improvement of the clinical signs. While there are some over the counter select protein diets, the best ones are prescription diets available from your veterinarian. The over the counter diets sometimes have cross contamination with non-hypoallergenic diet that occurs during the manufacturing process.

            When a pet develops allergies, it is common that they develop secondary ear, skin or eye infections. These infections are usually due to bacteria or yeast and often require treatment too.

            As much as we like to discuss our pet concern of the day, we would like to hear from you. Please feel free to e-mail us with your pet question at drspepin.slade@gmail.com.

            As always if your pet has a specific problem that needs to be addressed contact your veterinarian. Allergies can be very uncomfortable for your pet so prompt treatment is important.

Dr. Marisa Pepin-Slade and Dr. Robert Slade are long time Carroll County residents and reside in Hampstead. They operate a housecall veterinary practice.

Just as people are living longer and longer, so are our pets. Today we see more geriatric problems than in the past. While there are many issues that can crop up as our pets age, arthritis and degenerative joint disease is probably the biggest chronic issue we have to address.

Modern veterinary medicine offers much to relieve the pain our pets feel.  Pain can present itself in many different ways. Dogs often act stiff when they get up from laying down, are lame, are hesitant to go up steps or play outside. Sometimes they cry then touched, begin to act aggressive or pant more. Cats too get arthritis but it is a little harder to pick it up in them. Sometimes they show lameness or hesitant to jump. Sometimes they cry or get grumpy.

A good history and physical exam is needed for the veterinarian to access the plan of action.  Often blood work and sometimes x-rays are needed to determine if other geriatric conditions are present.

            For dogs we have a plethora of options to help ease the pain. Many folks are familiar with Nonsteroidal anti-inflammatory drugs or NSAIDS like Rimadyl (Zoetis). There are other NSAIDS too and each offers its own advantages and disadvantages. There is also now a generic of Rimadyl which offers cost savings. When using an NSAID blood work needs to be checked periodically as these drugs can be hard on the liver and kidneys and can cause intestinal bleeding rarely.

            There are also several prescription diets your veterinarian may discuss: j/d(Hills) and JM (Purina). They offer high levels of fatty acids and antioxidants to help with arthritis. We have seen some dogs really benefit from these diets and they do not have the side effects like NSAIDS do.

            Tramadol is another drug that we often use in dogs. It is similar to codeine and helps deaden pain in our canine friends. This is now a controlled drug by the DEA but is still widely available at most veterinarians or can be called into a local pharmacy.

            Cats do not tolerate many of the pain medications we use in dogs. Cats are very sensitive to NSAIDS but some like-- meloxicam--are only approved for a one time injection or three-day oral usage—Oniar (Novartis).  This may help get your kitty over the hump from an acute injury but will not help for long-term pain relief.  A codeine like drug called buprenorphine can be given to cats for pain orally but is usually not given long term.

            Both cats and dogs can benefit from oral chondroitin/glucosamine compounds. These supplements, if they are going to help, take four to six needs to kick in and can be given long term. There are many choices out there for these supplements. Some are better than others. Be sure to ask your veterinarian which one he/she recommends!

            Lastly, Adaquan (Novartis) is an injectable joint lubricant that was originally approved in racehorses and now there is a canine approved version. Usually, this is given twice a week as an injection then every month for dogs. It is also used off-label in cats.

            Many times multiple medications are added and used together as the arthritis worsens.

            Never give any human medications like ibuprofen or acetaminophen to your pet. These drugs can very dangerous to dogs and cats. Also, many human pain relievers also contain other drugs like decongestants which can be very dangerous for dogs and cats.

            As always, if your pet has a specific problem be sure to see your veterinarian. Oftentimes much can be done to help with that arthritic pain and improve your pet’s quality of life.

            If you have a dog or cat question, we would like to hear from you. You can e- mail us at drspepin.slade@gmail.com. As space allows we will answer as many question as we can in future columns.

Dr. Marisa Pepin-Slade and Dr. Robert Slade reside in Hampstead and are long time Carroll County residents. They operate a Housecall Veterinary Practice.

           Just think what our mouth would look and smell like if we did not brush our teeth regularly. We would be pretty smelly. But that is not all --- it is unhealthy! Our pets need dental care too. Often this is one area of our pet’s health that is overlooked. The smelly breath our pets get is often due to dental plaque and tartar that is a mixture of food material and bacteria. Minerals in the saliva help harden the plaque into the tartar that adheres to the teeth.  The bacteria can lead to abscesses in the mouth and loose teeth.  Pets who have severe tartar and gingivitis( inflammation of the gums) can develop a condition called septicemia, which is bacteria flowing through the blood stream. This can cause a serious infection on the valves of the heart. It can cause infection anywhere in the body, including the liver and kidneys.

            If your dog or cat will tolerate it, their teeth can be brushed. Pet toothpaste must be used because human toothpaste contains fluoride and other ingredients that are toxic  to pets.  Since pets swallow all of the toothpaste,  it could make them ill. Daily brushing is best but anything is better than nothing. Pet toothpaste is available from most veterinarians and pet stores.  Using a finger brush is usually easier and more gentle on the gum tissue.  Brushing is more effective and acceptable to pets if it is started very early in life when they are 2 or 3 months old.  Experimenting  with different flavors of toothpaste can help.  Also, very gradually getting the pet to accept it with a lot of praise as you go is best.  You need to make it a positive experience for the pet for it to be successful.  Never risk getting bitten or scratched.  Some pets will not accept having their teeth brushed. 

            If brushing the teeth is not practical,  there are many other options.  VOHC (Veterinary Oral Health Council) is a website that is run by a group of board-certified veterinary dentists.  They put veterinary dental products through double-blind studies to test their effectiveness.  If the products pass their tests, they are added to the list.  This list is being updated often with new effective products.  Some dog products on this list include prescription dental diets, Milkbone Brushing Chews (Big Heart Pet Brands), Greenies ( The Nutro Company), Oravet Dental Hygiene Chews (Merial), dental gels, and water additives. For cats, there are prescription dental diets,  Greenies dental treats in 5 different flavors, dental gels, and water additives.  Two prescription dental diets include Purina Pro Plan DH and Hill's t/d in feline and canine formulas.

            Be sure to take your pet to the veterinarian to have a good oral exam and possibly dental  X-rays.Dental disease can also be very painful and often our pets do not tell us about their mouth pain,  but we all know how  sore we can be if we have a bad tooth!Often a sedated dental cleaning is needed once a year as a pet ages. Small breed dogs tend to get some of the worst dental disease. For pets with severe dental issues, we are lucky to have several board -certified veterinary dentists in the area.  These vets can perform root canals, complicated surgical extractions,  and other advanced procedures.  Sometimes despite our best efforts, these specialized dental procedures are needed. However, an ounce of prevention can go a long way. If your pet has not had his or her teeth checked recently by your veterinarian, set up an appointment to discuss home and in- hospital dental care. As always, we welcome your questions and comments at DrsPepin.Slade@gmail.com.

          Oh those itchy, smelly ears. Ear infections are very common in dogs and cats. There are three types of ear infections seen --- otitis externa or an outer ear infection, otitis media or a middle ear infection, and otitis interna  or an inner ear infection. Our discussion today will concentrate on otitis externa. Otitis media and interna usually present with neurological signs and/ or issues with balance.

         Most outer ear infections in dogs are caused by a yeast called Malassezia and bacteria. In cats, ear mites are more common. However, dogs can get mites and cats can get yeast and bacterial infections. Yeast infections are characterized by a waxy brown to black material with a sweet but stinky smell.  A pure bacterial infection often produces a white pus-like discharge that may not be able to be seen without an otoscopic  examination by a veterinarian. Ear mites usually present as a dry, black, flaky material in the ear. Your veterinarian can take a swab of that material and look at it under the microscope if there is any concern as to what type of infection is to be treated. In the case of a bacterial infection,  an ear culture and sensitivity may be needed for stubborn infections. Here a sample swab is obtained from the ear and sent to a laboratory in a special culture medium where they identify the type of bacteria and then test it against a variety of antibiotics to see which ones kill the infection the best.

            Ear infections can be brought on by a pet’s allergies, swimmer's ear from getting water in the ear, and other causes. Ear mites are transmissible from one pet to another, most commonly from a queen cat to her kittens.

           Animals with ear infections are very uncomfortable. They tend to scratch their ears and shake their heads. They can self-traumatize themselves and create hotspots ( localized area of skin infection), ear hematomas (ruptured blood vessels in the ear which may require surgical  repair), or even eye injuries from rubbing the head.  Fortunately, there are many good treatments for this unpleasant condition.  Before treatment it is important to be comfortable that the ear drum is still intact depending on what medication is needed.  First, it is important to clean the ears. There are many different ear cleaners available from your veterinarian and all have their advantages. Some are more mild for a very sore ear.  Some change the acidity of the ear to make the environment less hospitable to microorganisms, and some even contain anti-yeast (ketoconazole) and antibacterial agents.  For bacterial infections, an oral antibiotic may be needed. Very rarely, an oral antifungal is needed  for yeast infections.  Most often bacterial and yeast infections are treated with a combination product that contains a steroid to stop itching and reduce inflammation, an antibiotic for the bacterial component, and an  antifungal. These products are instilled in the ear usually one to two times a day depending on the product. There are several combination products now that are instilled weekly. The advantage of these is that the pet owner does not have to clean and medicate these ears every day at home for one to two weeks.  The ears can be professionally cleaned by a veterinarian or veterinary technician and the medication can be applied once weekly immediately following the cleaning. Usually two treatments are required, one week apart. Some pets are so resistant to treatment at home and that makes this newer option so much more effective for the pet and  safer for the owner.

          Ear mites are treated differently. There are topical spot-ons available from your veterinarian like Revolution (Zoetis) and Advantage Multi (Bayer). There are also a variety of medicated drops for ear mites.  So if your pet has an itchy, smelly ear,  give your veterinarian a call and set up an appointment!

Cats!  We wanted to dedicate this month’s column to our feline friends. The two primary reasons cats are given up are that they are urinating around the house or scratching up the furniture. Today we are going to discuss urinary tract disease in cats.

Spraying-- where a cat, usually a male, backs up to the wall and vertically sprays urine on the wall, is behavioral and not always due to urinary tract disease. Often this happens in male cats who have not been neutered, so neuter your cat!

Urinary tract disease is very common in cats.  Often this is referred to as FLUTD (Feline Lower Urinary Tract Disease), FUS (Feline Urologic Syndrome) or cystitis. It  is due to irritation in the bladder. These cats urinate frequent,  small amounts and often do not use the litter box. Male cats can become obstructed, which is a life-threatening emergency.  FLUTD is a multifaceted problem: Stress, Infection, Diet and Genetics are the complicating factors. Stress is a big factor. Negative cat- to- cat interaction from the introduction of a new cat, other new pets, cats seen roaming outside in their territory, loud noises and lack of privacy near their litterboxes, dirty litter boxes, litterbox hoods,  lack of enrichment, a move to a new house, house renovation, new people in the house, and the holidays  are all common causes of stress.  There are as many causes of stress as there are cats! Be sure to keep litter boxes clean, and they should be big enough so that the cat can walk in a circle in the box. Uncovered pans are preferable and there should be one more pan than there are cats in the house – what veterinary behaviorists call the number one rule.  Long under-the-bed storage boxes make great litterboxes.   An unscented scoopable litter is usually best, but changing the type of litter is not recommended if the cats are already happy with the one they are using.   If more than one cat is in the house, all of the litter pans should not be kept together because one cat may “guard” the pans. Cats are not stupid -- often they will get your attention by urinating in obvious places. The worst case we have  seen is a cat that urinated on top of the owner’s coffee pot every morning until she got the clue that something was wrong.  For cats with chronic stress,  your veterinarian may recommend trying feline anti-stress pheromones like Feliway (Ceva), nutritional supplements, or prescription drugs like fluoxetine or Prozac (Eli Lilly).   Prescription drugs usually require bloodwork before they are used.  It is important to know that drugs like Prozac may take up to thirty days to see if they will be helpful with the problem.

There are many prescription diets your veterinarian may recommend to help prevent the formation of crystals in a FLUTD cat’s urine. Generally, moist food is better than dry because it forces cats to take in more water while eating dinner, which helps flush the bladder. However,  some cats will not eat moist food and moist food is generally more expensive than dry versions.  The prescription urinary dry foods generally have ingredients that make cats drink more water from the water dish.  If crystals are seen in the urine,  your veterinarian may recommend an x-ray to be sure no bladder stones are present.   Surgery may be needed to remove them or, depending on the type of stone suspected,  they may be placed on a food such as Purina UR, which is formulated to dissolve what are called struvite stones. It does not dissolve other types of stones.

Many times cat owners put off visiting the veterinarian when their cat starts peeing around the house. The longer they have the problem, the harder it is to correct. This is a very complicated and often frustrating problem for cat owners and their veterinarians.  Early intervention is important!

The holiday season is full of excitement, fun, and, yes, a little stress for everyone in the family including our pets. If we keep a few things in mind, our pets can have a joyous holiday.  Many times when a veterinarian talks about the holidays, we go into depth about all the things we should not give our pets .   We want to discuss that,  but we also want to discuss all the ways we can include our pets in our celebration of the season. We also want to give a few gift ideas to consider for our pets.

First,  the lecture on the don’t’s---no chocolate, no coffee or tea, no grapes, no raisins, no onions, no gum or candy, no bones, no jerky treats made in China. Keep the trash away from the pets.  If you do have a concern that your pet got into something poisonous,  contact your veterinarian. You may also want to contact animal poison control. There is a $65.00 consult fee for this service, as it receives no taxpayer support. Information on the ASPCA Animal Poison Control can be found at https://www.aspca.org/pet-care/animal-poison-control.  People have different toxicities than do pets,  so contacting an animal poison control is important. If company visits, make sure they do not feed your pets things they are not supposed to or used to getting. If you need to board or set up a pet sitter, do so early because they tend to book up fast. Be sure you have checked to see what your kennel’s vaccination requirements are and have written documentation from your veterinarian. If you need to have vaccinations updated,  set up an appointment soon because rushing in the last minute just creates more holiday stress for everyone. Also, from a medical standpoint, vaccinations take days to weeks to stimulate the immune system to provide the desired disease protection. This is also a great opportunity to have your dog or cat  have a wellness check. In many cases the exam is the most important part of a veterinary appointment.  This is a time when the veterinarian listens to the heart, checks the teeth for signs of problems, checks out those new lumps you noticed, and discusses what type of wellness screening is recommended for your dog or cat and much more.

Now for the fun part, we will discuss holiday treat and gift options for our cats and dogs. Cats thrive in a stimulating environment. Cat trees are a great gift idea as our feline friends like to sit up high and keep an eye on all that is going on in and around THEIR home.  Interactive cat toys are another great idea. Cat treats like Greenies (Nutro) dental treats make good stocking stuffers. Stay away from all those highly processed treats from the big box stores and never give any raw treats. Keep in mind many freeze-dried treats are also raw treats and should be avoided for both human health and animal health reasons.

If you have a dog that likes to play ball,  watch this YouTube video: https://youtu.be/s7AOy1DbvYw.  A nice comfy dog bed is always nice, just so they do not eat it! As far as treats, consider a treat that will help with the teeth like Milk-Bone Brushing Chews (Big Heart Pet Brands) or any other treat on the Veterinary Oral Health Council web site: http://www.vohc.org/accepted_products.htm.  Lastly, consider just to give your dog a big hug and tell him or her how much you love him or her. Be careful giving your cat a big hug because sometimes they do not like that very much!

We hope all the pets out there and their parents have a great holiday and a wonderful 2016!

 Dr. Marisa Pepin-Slade and Dr. Robert Slade are longtime Hampstead residents. They operate a mobile veterinary housecall practice.

Ben Franklin once said, "An ounce of prevention is worth a pound of cure."  So true this is in the land of veterinary medicine -- with both illness and expense. Our pets provide so much for us --- joy, stress relief, comic relief, lower blood pressure, and sometimes protection from strangers.  It behooves us to make sure they live a longer quality of life.

Once to twice yearly preventive veterinary visits, vaccines based on lifestyle and environment, parasite tests and prevention, home dental care, nutrition, exercise, pet-proofing your house and yard, and pet insurance, pet savings accounts, or credit card plans are some of the most important things you can do for your pets.

 Home dental care is best started when you first obtain your pet.  If your pet is a puppy or a kitten, teaching your pet to allow you to put your fingers in its mouth gently (with caution) and with a fingerbrush (if the mouth is big enough) or guaze wrapped round your finger, is a good first step. Fingerbrushes and toothpaste are available from your veterinarian and most pet stores.  Stay away from toothpaste made in China. Don't use human toothpaste --- it is toxic to pets. The whole brushing experience must be positive for your pet and not forced or it will not work. If brushing is not possible, refer to  Veterinary Oral Health Council website http://www.vohc.org/ for many other dental products recommended by board-certified veterinary dentists. 

 Nutrition is also very important.  There are many quality pet foods on the market and homemade recipes if the owner prefers this. Never feed a raw diet as they tend to be unbalanced and often contain bacterial contamination. Any homemade diet should be made in consultation with a veterinary nutritionist. Pets have a much shorter lifespan than us and we want to achieve the maximum amount of quality life.  Talk to your veterinarian about your pet's unique dietary recommendations--not all pets are the same.

 Exercising your cats inside with laser toys, handheld feather toys, automatic toys that you start with a button for them to chase, or feeding balls that they have to roll to dispense food, are all good options. Taking your dog for a walk at least 30 minutes total per day is recommended.

 Pet-proofing a house and yard can be just as complicated as toddler proofing---sometimes moreso. There are many toxic hazards in our homes and yards that can send a pet straight to the pet E.R.  These include rodent bait, non-pet-safe de-icing salts, pesticides, antifreeze, cocoa mulch, fertilizer, many plants, over-the-counter pain relievers, vitamins, prescription drugs, tobacco, household cleaners and detergents, chocolate, coffee, tea, grapes and raisins;xylitol that is in many gums, candies, low-sugar versions of foods ; pennies, alcohol, raw yeast dough, and spoiled foods. Also, fatty  foods can sometimes cause life-threatening illness.

There are also many objects which can land your pet in the E.R. for emergency surgery.  These include tiny balls, coins, sharp objects, batteries, twist ties, hair twisties, rubberbands, tinsel, ribbon, string , dental floss, yarn, thread, hairpins, glass, jewelry, nylons, socks, plastic wrap, paper clips,  and electrical cords.

 Having pet insurance, a pet savings account, or a Care Credit account http://www.carecredit.com/vetmed/  in place for emergencies is important.  Many treatments, medications, and surgeries are available that can save pets' lives ,  but we have to have these safety nets available to make them more affordable.  Many pet insurance plans are available for monthly costs much less than the cost of a monthly cell phone plan or a monthly cable/satellite plan.  A search of pet insurance on the internet will enlighten you.  

Dr. Marisa Pepin-Slade and Dr. Robert Slade are long-time Carroll County residents and operate a mobile veterinary practice. They welcome your comments at DrsPepin.Slade@gmail.com.

             As the snow falls outside, there are a few things we need to think about with our pets. Our pets need to be kept warm. Please do not tether your dog outside. They deserve to be kept cozy just like the rest of us. If you do have an outside kennel,  be sure to have adequate dry bedding and a safe heat source. Make sure water and food is not frozen! Dogs are social animals, so be sure they continue to get their mandatory human contact.

            In addition, snow and ice creates other issues for our pets. Be careful  with deicer --even pet-safe deicer, if ingested, can cause stomach upset.  Also,  it can be drying and irritating on their paws.  Your dog's paws should be wiped off with a wet rag and dried when they come in from outside. Dog boots available at your local pet store or online can be used to protect those paws.  Antifreeze is extremely deadly to our pets. It has a sweet taste, making it appealing to them. If you car develops an antifreeze leak, clean it up and have it repaired immediately.

           Most large and mid-size dogs love to play in the snow.  We don't want  to take all their fun away, but do not let them eat snow because it is full of pollutant chemicals and can cause stomach upset. Also, running on top of deep or crusted snow can cause leg injuries, such as ACL (anterior cruciate ligament ) injuries. That is an injury that can cost several thousand dollars to fix!  Little dogs should have a place shoveled out so they can go to the bathroom. Small breed dogs should not be left outside longer that absolutely needed because they can get hypothermic. Dog sweaters can be helpful for them and they can also be really cute.  Just as a pet should not be left in the car on a hot or sunny day, they should not be left in the car on a cold day either.

             We need to think about our cats on those cold days too. Indoor cats tend to just go about their normal activity-- sleep, eat, demand attention when they want it, and so on. But outdoor and barn cats have it much harder. They too should have some place warm to go when needed. Cats sometimes seek out  warmth from a recently driven vehicle and can climb under the hood. If you have outdoor cats, it may not be a bad idea to check under the hood the before you head out in your car or truck!   Also, banging on the hood with your hands and blowing the horn before you start the engine usually gets the cats moving.  Also, they need to have extra food and water to keep themselves warm.  If you do not need to have your cats outside,  they do better off in the house or barn.

              Just because it is cold outside, do not get lax on flea and tick control.  They do not all die in the winter, they just slow down a little, which makes it a good time to hit them hard! Intestinal parasites are also still a concern in the winter. Heartworm prevention should also be continued year round for dogs and ideally cats-- ask your veterinarian about heartworm-associated feline respiratory disease. Many heartworm preventions for dogs and cats help prevent gastrointestinal parasites.

           Between the snow shoveling and dealing with the school delays for our human kids, we can, with a few extra precautions, give our furry kids a safe and warm winter too.

          Dr. Marisa Pepin-Slade and Dr.  Robert Slade are long time Hampstead residents and operate a mobile Veterinary Housecall Practice. They welcome your comments at DrsPepin.Slade@ gmail.com.

We try to write columns that are both very practical and fun. One very common problem that pet owners have to deal with is stomach upset. Yes, vomiting and diarrhea.  Not a very fun topic but important because of the discomfort and dehydration that the pet can develop and that stinky, runny mess that always seems to happen at midnight on your best carpet.

            There are many causes of stomach upset in dogs and cats and most can be prevented.  Common causes are what we call dietary indiscretion or getting into something they should not eat.  Others are bacterial.  Some are viral diseases like parvovirus, corona virus, and distemper in dogs.  Some are parasitic worms such as roundworms, hookworms, whipworms, and tapeworms.  Others are protozoan parasites like coccidia and giardia. Some of these are contagious to people, and thorough hand washing before eating or touching your mouth is of paramount importance.  Using disposable gloves to clean up accidents is wise.   Inflammatory bowel disease, irritable bowel syndrome, food intolerance, and food allergies are also sometimes problems. Rarely,  gastrointestinal cancer is also a concern -- especially lymphoma in the older cat.  Pancreatitis can cause gastrointestinal disturbances,  but we will need to dedicate an entire future column to them.  Eating fatty foods can be a trigger for pancreatitis.

            Many of the viral diseases in dogs can be prevented with annual vaccinations.  Gastrointestinal parasites are easily prevented with annual fecal exams and periodic deworming. In dogs there are two monthly heartworm preventive pills that also prevent and/or treat all the common intestinal parasites along with preventing heartworm: Interceptor Plus (Elanco) and Sentinel Spectrum (Virbac).  In cats, we have monthly Advantage Multi (Bayer) and Revolution (Zoetis) which prevent heartworm and  most of the intestinal parasites.                                                                                            Giardia is present in contaminated puddles and streams.  Humans can get this also.  Coccidia is another single-celled parasite that can cause diarrhea.  Both can be treated with different antibiotics.

            Inflammatory bowel disease is fairly common but often is a diagnosis of exclusion, which means everything else needs to be ruled out first. These conditions are seen more commonly in cats, and often the signs are the same as intestinal lymphoma in cats. An endoscopic biopsy is often the best way to try to tell them apart, but not always affordable. In these cases, often a hypoallergenic or hydrolyzed protein diet are used along with a trial of cortisone. Cortisone can also sometimes provide a temporary remission of intestinal lymphoma.

            Food intolerance and food allergy can be common in dogs and cats.  Some pets need to be placed on a bland easily digestible diet rather than a hypoallergenic diet.  Food sensitivities require feeding trials to see what type of diet works best for the pet’s gastrointestinal disturbance. True food allergies require a prescription hypoallergenic or hydrolyzed diet.

            In general,  if your pet temporarily develops diarrhea, they usually benefit from a bland     diet. This is easier in dogs rather than cats, because it is difficult to get a cat to eat a homemade bland diet, and a prescription diet is usually required.  Often for dogs, we usually use three parts cooked white rice and one part cooked 98 % lean, boneless  skinless chicken breast or 98% lean ground chicken.  Your veterinarian may have his or her own recipe for a homemade bland diet. A homemade bland diet is not a balanced diet and should not be used as a longterm diet. As always, any time your pet is sick call your veterinarian for advice, and any time you have to take your pet in for an exam for vomiting and diarrhea, bring in a stool sample if possible.

Dr. Marisa Pepin Slade and Dr. Robert Slade are long-time Carroll County Residents and operate a mobile Housecall practice. They Welcome your comments at DrsPepin.Slade@gmail.com

Now that we think the snow is behind us, it is time to think more about fleas and ticks.  Not only are fleas and ticks annoying, but they can transmit many serious diseases. 

Fleas can transmit cat scratch fever (Bartonella) to people through a bite.  Cat scratch fever can cause fever, headache, appetite loss, exhaustion, and lymph node swelling. In the western United States, fleas can transmit plague sometimes. These diseases are treatable with antibiotics, but cat scratch fever can cause serious illness for some people -- especially the immunocompromised. Fleas can also transmit Bartonella and Mycoplasma haemofelis to cats,  and Bartonella to dogs.  Dogs and cats can get anemic with these diseases and have other health problems.  Very young  puppies and kittens can also get so anemic with a serious flea infestation that they can die.

Preventing fleas is easy with our new products for flea control, but getting rid of them in your house is not as easy and much more expensive.  Fleas have developed resistance to many of the products on the market, because the tougher fleas have survived  new agents have been developed to meet the challenge. Ask your veterinarian which products he/she recommends.  These products should be used year-around.  The egg, larval, and pupal stages of the fleas just go dormant when it is too cold.  Then they are hatching and developing when the weather warms.  Also, all flea stages can survive on a warm, furry body and in your house, even in the cold weather.

Ticks can cause many diseases in dogs, cats, and people.  Some are debilitating and some are fatal.  The more common diseases in dogs around here include Lyme, many Ehrlichia  species, Anaplasmosis, Rocky Mountain Spotted Fever, Bartonella, and Babesia.  People can get all of these diseases also.  The cats can also get Bartonella, Ehrlichia, Babesia, and occasionally Cytauxzoonosis , which is fatal 50% of the time. Tickborne diseases in cats are even more difficult to diagnose, because the cats hide their illnesses so easily until it may be too late.  We tend to diagnose many more dogs with tickborne disease.

Our favorite products for fleas and ticks are Seresto collars (Bayer) for dogs and cats, Bravecto Chewable Tablets  (Merck) that lasts eight to twelve weeks, Nexgard monthly chewables for dogs. In cats, Advantage  (Bayer) and Activil (Merck) works well for fleas and  Frontline Plus (Merial) can be used for fleas and ticks.

  Removing ticks must be done without touching the tick with your bare fingers or you will expose yourself to the disease(s) the tick is carrying---sometimes multiple diseases.  You should use a hemostat or tweezers to remove the tick as close to the skin as possible, trying to remove the mouthparts too.  Sometimes the mouthparts are so tightly clamped in the skin that you cannot remove them.  Clean the area with hydrogen peroxide twice daily until the sore heals, and the mouthparts will fall out as the skin heals.  Tell your vet and ask for advice.  Do not use alcohol or petroleum jelly on the tick while it is attached to your pet, and do not burn the tick. These actions will make it more likely for the tick to release its saliva (possibly ridden with diseases) into your pet's body before you are able to remove it. Place the ticks that were attached in a dry resealable bag and label with the date, because they may come in handy later if your pet becomes ill.

We must all do what we can to prevent tick and flea bites for our pets and for ourselves. The CAPC (Companion Animal Parasite Council) http://www.capcvet.org/capc-recommendations/ticks/ and the CDC (Centers  For Disease Control) http://www.cdc.gov/ncezid/dvbd/ are excellent sources of information on flea and tickborne diseases in animals and people, respectively.

Dr Marisa Pepin Slade and Dr Robert Slade are longtime Hampstead residents and operate a mobile veterinary Housecall practice.

            End of life care is a very difficult and sad topic to discuss in regards to our pets. Unfortunately, death is as much of life as is birth. The goal of veterinary medicine is to provide the best preventive care and medical treatment as possible to provide the longest, happiest and healthiest life possible, but in the end to do everything possible to alleviate suffering. This includes hospice type care and euthanasia.

            Hospice care has grown in recent years. Many new and safer pain management tools have been developed for everything from arthritis to cancer. New palliative treatments for types of cancer that are not curable are also present.  The goal of hospice care is to give the pet and their human family some additional quality time together in the pet’s home. If the pet owner chooses to pursue hospice type care, it is important to budget for it ahead of time. As with anything, costs can add up over time.

            Deciding when to euthanize is often an agonizing decision for the loving pet owner. Here the veterinarian can be helpful by discussing the prognosis of the pet, but the ultimate decision is for the pet’s human family. Everyone involved in making the decision in the family should be on the same page here.  Some pet owners want to do absolutely everything medically possible  (or somewhere along the treatment pathway) for their beloved pet; others are concerned about not having any pain or suffering and decide to euthanize earlier. Others do not believe in euthanasia at all and want hospice care until the natural end. All these decisions are made with love and okay. Here we are not discussing euthanasia for people who just do not want their healthy pet anymore. THAT IS NOT OKAY and is irresponsible. There are many rescue groups available to help people who, for some legitimate reason, cannot keep their pet anymore.

            When the day comes to euthanize your beloved pet,  there are a few pointers to make the day go smoother for you, your family, and your pet. First, schedule an appointment. Talk to your veterinarian  to see if there is a time during appointment hours that would be best. Ideally, it is  a time when the waiting room is not packed with others waiting for their appointment. Some folks prefer to have the euthanasia done at home. There are housecall veterinarians in the area that can help here.  Again, if at all possible, make an appointment.  Often, after hour euthanasias are often referred to a local emergency hospital.  We have a very compassionate local emergency hospital in Carroll County for these emergency situations.

            Some owners want the entire family to be present for the euthanasia; others do not want to be present at all. Either way is okay. Different veterinarians have slightly different euthanasia protocols, but typically a sedative is given prior to the euthanasia solution. This protocol is designed to be as  pain-free as possible.

            After the euthanasia there are different options for the remains. Some folks take the remains home to inter them…be sure your local ordinance  or homeowners' association allows this. There is cremation available through most veterinarians. Some funeral homes offer pet cremation. There are several local pet cemeteries. The decision as to how to care for the remains should be a discussion the family has prior to the euthanasia. The loss of a pet is often devastating for the pet’s human family. With a little planning, the end of life, while sad, can also be very peaceful. There are many pet loss support hotlines through veterinary schools, pet loss books, and websites to help everyone through this rough time. Ask your veterinarian.

Dr. Marisa Pepin-Slade and Dr. Robert Slade are longtime Hampstead residents and operate a mobile Housecall practice. They welcome your comments at DrsPepin.Slade@gmail.com.

               Summer is a great time to take your dog on nice long walks through your neighborhood or local park. Cape Horn and Leister Park here in North Carroll have great walking paths. Be sure to keep your dog on a leash to prevent accidental dog fights or being hit by a car. While retractable leashes are popular, they do not provide good control over your pet and are not recommended. Stick with  a conventional chew-resistant leash and preferably a sturdy harness so it isn't easy for your dog to get loose.  Do not trust voice commands while out in public with your pup. Sometimes something as simple as seeing a squirrel will distract your dog from a voice command. The exception here is only with professionally trained working dogs. We have heard so many owners say their dog always stays in the yard or always listens to their commands --- after their dog has been hit by a car or been chewed up by another dog. Also, be sure to clean up after your dog while out in the community. Not doing so is not only rude, but spreads disease  potentially to other dogs or even people. For those who want to play with their dog off the leash, visit a dog park like the one at Bennett Cerf Park in Westminster. Check out their facebook page at https://www.facebook.com/BennettCerfDogPark/.

         Be sure your dog is current on all vaccinations and mosquito-borne conditions like heartworm, and on quality flea and tick prevention. Do not let your dog eat any mushrooms or toadstools outside because some are very toxic and some dogs will eat them without a second thought. Standard antifreeze is also deadly to pets! Antifreeze tastes sweet and animals will drink it readily. If your pet drinks antifreeze,  prompt veterinary care is critically important. If your car overheats and leaks antifreeze, be sure to clean it up ASAP. There is a variety of antifreeze that is safer for pets. Ask your mechanic if it can be used in your vehicle.

         Pets that are outside in the heat need to always have extra clean water and a place to go in the shade. Never leave a dog tethered outside. They can strangle themselves by accident and we cannot stand to hear these stories.  Dogs are social animals and crave human interaction. Never leave a pet in a car even for a few minutes.  The summer sun can make the car so hot your canine or feline friend may suffer from heat stroke.

              We do not want to forget about out kitties in the summer. Indoor cats usually tolerate summer pretty well sitting on their cat tree or the back of the couch in the AC,  looking out the window. Outdoor and barn cats are a different story. For them, current vaccines and flea/tick control are especially  important. All cats should be spayed and neutered except for ones owned by professional breeders. One unspayed female cat and her kittens can lead to over 300,000 kittens! These kittens often do not have a very happy life. They get killed by wild animals and they often die from disease or parasites. These cats also can depopulate song birds, chipmunks and other little wild critters. If they are lucky enough to end up in a shelter, they may or may not find a home and could end up being euthanized.  Try not to put cat food outside, because you  may end up with a large number of stray, feral cats and raccoons.   Your neighbors also may not like your fleet of wild cats. There are low cost spay and neuter programs to help control this problem.  Ask your veterinarian for a recommendation.

Dr Marisa Pepin-Slade and Dr Robert Slade are longtime Carroll residents. They operate a mobile veterinary housecall practice. They welcome your comments at DrsPepin.Slade@gmail.com.

Today we thought we would dedicate our column to kidney disease in cats. In general, the kidneys ( and the liver) filter toxins out of the body. When kidneys do not work correctly, kidney disease develops.  Kidney or renal disease is the number one killer of cats. Renal disease in cats is divided into two types: acute renal disease and chronic renal disease. Acute renal disease is something that comes on all of a sudden and causes an injury to the kidneys--like eating a toxic plant or getting into some people medicine or antifreeze.  Acute renal disease is treated aggressively with IV fluids, supportive care, and sometimes dialysis.  Cats can often overcome this with good care,  but there may be an injury to the kidneys  so severe that it progresses to chronic renal disease. Today we are going to concentrate on chronic renal disease.

          Chronic renal disease is kidney disease that has been there for a while. It can be the result of a bad acute injury, kidney infection, inherited conditions like cysts in the kidneys, or aging. The kidneys just become less able to do their job over time.

         Before standard bloodwork shows any changes, the cat needs to lose about 75% of its kidney function. Cats with clinical kidney disease tend to drink and urinate more, lose weight, and vomit. Signs often come on slowly. Older cats over 7 years old should have geriatric lab work done at least annually. The values of concern with kidney disease are the BUN or blood urea nitrogen, the creatine, phosphorus, and the urine sample. When the kidneys do not work right, the urea backs up in the blood and is toxic. It can cause stomach upset and even ulcers in places like the mouth. Creatine is a byproduct of muscle metabolism and is not toxic in the way urea is, but it is excreted only by the kidney.  It is a good value to monitor kidney function. In the urine, we look for signs of infection,crystals, and what is called the specific gravity. The specific gravity checks to see if the kidneys are concentrating the urine the way they are supposed to. There is a new test that is supposed to pick up renal disease earlier than the classic renal values discussed above. It is called the SDMA test and is available through Idexx reference lab. Ask you veterinarian if your kitty should have this test.

        The key to managing kidney disease is early diagnosis! Often the signs of early renal disease are subtle, hence periodic labwork on older cats is critical.  Aside from things like infections that are often treatable if picked up early, chronic kidney disease is progressive. In some cats it progresses rapidly and very slowly in others.  A cat with early renal disease treatment may start with something as simple as a prescription diet. These diets available from your veterinarian come in many flavors, aromas and textures and in canned and dry formulations. There are several prescription food companies that offer a variety of kidney diets that please almost any feline.  Often different diets need to be tried to see which one your feline friend will eat. As kidney disease progresses, other treatments, supplements, and medications are added. For example, some cats need subcutaneous fluids (fluids given under the skin) which can often be given by the kitty parents at home, medications to calm the stomach,  phosphate binders, and injections to combat anemia that can go along with kidney failure. Be sure to ask your veterinarian.

Dr Marisa Pepin Slade and Dr Robert Slade reside in Hampstead and operate a mobile Housecall practice. They welcome your comments at DrsPepin.Slade@gmail.com

Last month we discussed renal disease in cats. This month we wanted to discuss another serious but very treatable illness in older cats. Hyperthyroidism is caused by a (usually benign) tumor in the neck that produces thyroid hormone. Thyroid hormone controls the body's rate of metabolism so cats that are hyperthyroid are constantly running in "high gear." They lose weight, eat more,  drink and urinate more, develop heart murmurs, and often develop behavioral changes. The behavioral changes often manifest in meowing or crying more, often at night.  Like renal disease, hyperthyroidism is common in older cats.

             Thankfully, it is very easy to diagnose with a veterinary exam and bloodwork. On exam the veterinarian gets a good history about weight changes, appetite changes,  fluid intake and urinations, and behavioral changes. Sometimes the thyroid tumor can be felt in the kitty's neck by the veterinarian. Bloodwork is taken to check thyroid blood levels and usually a complete blood cell count, blood chemistry and urinalysis is taken. These are done to look for other conditions that commonly occur in geriatric cats. Sometimes hyperthyroid cats also have concurrent kidney disease too.

             Once diagnosed there are many good treatment options for the hyperthyroid cat. Most cats take a drug called methimazole. This medication does not cure the cat but blocks the thyroid tumors' ability to produce the excess hormone.  Methimazole is a life-long treatment. Periodic lab work is needed to monitor the cat's response to the medication and monitor for side effects. The dose needs to be adjusted over time in some cats. The most cost-effective way to dose methimazole is as a tablet. It can be administered as a pill or crushed and put on the top of moist cat food( if the cat will eat it). For cats where pills are difficult, the medication can be compounded into a flavored oral liquid or even a gel that can be applied to the cats ear. Recently, Hills developed a food called y/d to treat hyperthyroidism in cats. The food  has clinically significant iodine restriction. Iodine is a primary component of thyroid hormone.  One major concern with y/d is it must be the only food the cat eats. If the cat eats anything else, the kitty will collect iodine from the other food and the y/d will not work. A cat on y/d also needs to have labwork to monitor response to treatment.

          The gold standard for treating hyperthyroidism is I 131 treatment. This involves referral to a radiologist who, after a complete workup,  injects the kitty with a small dose of radioactive iodine. The thyroid tumor recognizes  it only as iodine, absorbs the I 131. Once absorbed the radioactive iodine destroys the tumor. This is often a cure. There are several local facilities that offer this service -- ask your veterinarian. When cats go in for radioiodine treatment, they need to remain at the radiology center for a few days for monitoring. When the radiation levels are at an appropriate safety level, they are sent home. In the past, surgery was done to remove the thyroid mass. This is not done much anymore with the advent of radio-iodine treatment which offers better success and fewer complications.

           Generally hyperthyroidism , if diagnosed before the kitty is too debilitated, has many great treatment options.  They can live many years after the diagnosis.  If they lose too much weight before the diagnosis is made, they can become very weak and debilitated.  Many owners just think their cat is aging and nothing will help them.  Talk to your veterinarian.

Dr Marisa Pepin-Slade and Dr Robert Slade are long time Hampstead residents and operate a mobile veterinary housecall practice. They welcome your comments at DrsPepin.Slade@gmail.com.

To round out our series on common illnesses in older cats, we are going to discuss diabetes in cats.  We will discuss diabetes in dogs another day. Cats get insulin-dependent diabetes. These tend to be overweight cats that have a recent history of weight loss, increased drinking and urinating.The urine can sometimes seem sticky when cleaning the litter pans, because the urine in an unregulated diabetic contains large amounts of sugar.  Normal urine contains no sugar.  When it is not diagnosed quick enough, the cats can develop ketoacidosis. This is a severe condition where the brain is affected and the lungs start to blow off excess sugar. Sometimes the breath of these cats smells like a person does when they consume alcohol. These cats can die without prompt veterinary medical care!

       Diabetes is diagnosed by analyzing blood and urine tests. The blood contains an elevated  glucose and so does the urine.  In more severe cases, the urine contains ketones. In a  cat without ketoacidosis,  insulin is usually started twice a day. The ketoacidotic cat often needs critical care and intravenous fluids until it feels better. The two most common insulins used in cats is a type called PZI or protamine-zinc insulin and Lantus ( Sanofi-Aventis) or glargine.  PZI is  available from a veterinarian under the brand name Prozinc (Boehringer Ingelheim). This insulin is less concentrated than human insulin and requires special insulin syringes ( U-40 -- 40 units of insulin per one milliliter of liquid).  The other insulin used in cats is actually a synthetic human insulin called Lantus or glargine. This is usually scripted out to a human pharmacy. Both types of insulin tend to be pretty pricey.

         Once insulin is started, frequent periodic blood glucoses need to be monitored. Your veterinarian will discuss when this needs to be done. Not only does the blood sugar need to be lowered to acceptable levels, but it cannot be lowered too much.  If the blood sugar is lowered too much,  it will cause seizures and ultimately death, if it is not addressed. The owner of a diabetic pet should always have some honey or corn sweetener that can be administered ( as directed by the attending veterinarian) by the pet owner at home in the event of an emergency. Sometimes the cat owner can be taught to monitor urine or blood glucoses at home. Monitoring pet glucoses at home ideally  requires a special glucometer made for pets. There are several, but the most common is called the AlphaTrak (Zoetis). The inner ear flap or foot pad is pierced with the lancet to get a drop of blood. Some cats tolerate this better than other cats. Sometimes special prescription diets  like Purina Proplan Veterinary DM or Hill's m/d are needed to limit the cat's intake of sugar or carbohydrates. These diets are available from the veterinarian. Once the cat's diabetes is regulated or under control, periodic blood tests are needed. Commonly a fructosamine test is done around three weeks after the insulin dose seems to be correct.  Fructosamine  is kind of like the A1C level done in people, because it shows what the blood sugar is doing over a period of several weeks. Periodic glucose curves may also be needed. Here a blood glucose level is taken multiple times throughout the day to see how it is fluctuating throughout the day. These tests will help the veterinarian determine if the insulin dose needs to be increased or decreased. Diabetic cats can often be treated very successfully,  but they require a dedicated pet owner who carefully follows the instructions provided by their veterinarian.

Dr Marisa Pepin-Slade and Dr Robert Slade are longtime Hampstead residents and operate a mobile Veterinary Housecall practice. They welcome your comments at DrsPepin.Slade@gmail.com.

              We have dedicated our last three columns to cats.  We thought it was time to give dogs a turn.  Leptospirosis is a serious bacterial disease the can cause liver and/ or kidney disease in dogs. It is also contagious from dogs to people. Dogs tend to pick it up from contaminated water or exposure to infected rodents. People can contract it from infected dogs if they have exposure to the pets urine. There are multiple subtypes of Leptospirosis called serovars.  It is rare that cats get infected and they tend to have a mild illness.

              Infected dogs can present with kidney disease, liver disease,  or both. It  often can  be overlooked because there are many other causes of liver and kidney disease.  Symptoms vary and can include fever, muscle tenderness, lethargy, vomiting, diarrhea, increased thirst, and lack of appetite.  Missing the diagnosis can be a serious oversight because, without treatment, the pet may not survive and also expose any person who comes into contact with the urine.  Screening lab work can show increases in the renal values such as blood urea nitrogen, creatinine,  and SDMA, and increased liver enzymes and also protein in the urine. There are several tests that can be perfomed to attempt to make the diagnosis. There is a DNA test called a PCR -- often run on whole blood and urine-- as well as tests that look for the dog's exposure to the organism in the form of what is called antibodies.. These are called antibody titers. Vaccination for Leptospirosis will cause a positive titer and some animals that have had an exposure in the past but not a current infection, may also have a positive titer. Therefore, a second titer needs to be done in several weeks to see if it is getting stronger, weaker or staying the same. Needless to say,  if there is a concern, treatment is usually instituted prior to the second titer! There is also an in clinic test by IDEXX Laboratories that can provide some quick information at a low cost, but this test may miss some early cases and also will show positive with vaccination. Your veterinarian will recommend what test he/ she feels is best indicated for your dog, if Leptospirosis is a concern.

          Depending on the stage of the disease,  Leptospirosis is treated with antibiotics like amoxicillin and doxycycline, along with supportive care for the associated liver or kidney disease.

          Vaccination can help prevent or reduce the severity of the clinical disease associated with Leptospirosis. In the past,  there were concerns that Leptospirosis vaccinations may cause more  adverse reactions than other vaccinations, and was not very protective. Older vaccinations only had two sub types or serovars of the organism in them. Modern Leptospirosis vaccinations do not have a higher risk of reaction than other vaccinations, and now most contain four serovars.  There are multiple manufacturers that offer a high quality vaccine. Vaccination for Leptospirosis is important for not just the rural farm or hunting dog, but also the suburban and urban dog, because exposure to rodents can happen anywhere. Ask your veterinarian if vaccination for Leptospirosis is recommended for your dog. You can also get more information on Leptospirosis from the American Veterinary Medical Association:  https://www.avma.org/public/PetCare/Pages/Leptospirosis.aspx.

           Leptospirosis can also cause serious illness in people. Your physician can discuss this with you and  there is also a wealth of information on the CDC website --   https://www.cdc.gov/leptospirosis/. This is not a disease most people have heard about, but it is nothing to fool around with.  However,  with prompt diagnosis and treatment, it can be addressed. Better yet, vaccination can mitigate infection in the first place. Talk to your veterinarian.

Dr Marisa Pepin-Slade and Dr Robert Slade are long time Hampstead residents and operate a mobile veterinary Housecall practice. They welcome your comments at DrsPepin.Slade@gmail.com.

Medical science has proven that our dogs and cats have health benefits for us.  Research shows that they lower blood pressure and cholesterol in their owners.  They help lessen the outbursts in Alzheimers' patients. They  lessen depression, anxiety, and feelings of isolation. Playing with a dog has been shown to increase serotonin and dopamine levels---feel-good chemicals from the brain.  They help students learn to read in an accepting environment. They provide comfort and help with psychological therapy for those with post traumatic stress disorder. They give you a reason to get up in the morning.  Some dogs can smell cancer in people. Some dogs and cats have saved their owners from carbon monoxide poisoning in their own homes.  Some dogs can even predict seizures in their owners and alert them before they happen. Our pets are often the first ones to greet us when we come home at night, offering their unconditional love to us like no human being can.  ( Refer to http://www.webmd.com/hypertension-high-blood-pressure/features/health-benefits-of-pets#2. )

The unconditional love of our pets is displayed in so many ways---a cold nose and a wet kiss from our family dog after a hard day at work, the constant purr of our kitties or perhaps the cat that sleeps on our pillow with us at night and wakes us up at 4 am just to remind us that we need to get up in 4 more hours to feed them. Our pets offer us the unconditional albeit sometimes demanding-- especially with cats-- love that is sometimes missing in our busy and tumultous world. We have seen pets reopen the eyes and minds of folks with dementia that only a cold nose can. We have seen them start recanting detailed stories of beloved pets of years gone by. We have seen the Afghanistan War veteran bring home a dog from each tour. These dogs offer a connection to his experiences and offer the peace and comfort only a cold nose can. We have seen college students  skip exams and fly across the country to be with the 18  year old family cat that has fallen into ill health. Through the gentle hands of the veterinarian, the cat peacefully slips from this world. Pets can help a bullied child feel loved and offer a widow guidance. We have seen churches offer blessing of the pets. We have seen parishioners not only bring their dogs and cats, but even birds and other pets. Pets have a way of offering a bond to each individual in a unique way. Pets can offer happiness and love in a special way that only they can!  But let's not forget about the working dog! Dogs guide the blind and assist our police and military. They offer comfort to the sick. They guard our homes and  businesses and herd our livestock. Yes, this season we have a lot to thank our animal friends for. Try to take a little time out of this busy holiday season to give your pet an extra hug and say thank you for all you do. Consider making a donation to a local shelter or rescue group. If money is tight,  make a donation of time if you can. If you have that strange void in your life,  consider adopting a pet. Most shelters and veterinarians can offer advice to find a pet that will fit into your lifestyle.

Dr Marisa Pepin-Slade and  Dr  Robert Slade are long time Hampstead  residents and operate a mobile veterinary House Call practice. They welcome your comments at DrsPepin.Slade@gmail.com. 

Choosing a pet food can be a confusing task. The days where you go to the supermarket and purchase “dog food” or “cat food” are over. Nowadays there is “grain-free”,”gluten -free”, organic, raw, prescription,  and others. What is  best for my pet? The best advice comes from the veterinarian who knows your pet's health status, not other people selling pet food who will sway you in multiple directions. In the old days, much of what pet food was made out of was low quality ingedients and full of fillers. Now there are much better options, but it takes a veterinarian or a veterinarian board-certified in veterinary nutrition for pets with very special needs,  to help you with these decisions. There is a lot of false information and false advertising out there, because pet food is a $ 24 billion dollar business.

When you go to purchase pet food -- start by reading the label. Start by making sure the food is AAFCO (American Association of Feed Control Officials) http://petfood.aafco.org recommended and recommended for your pet -- i.e.. puppy vs. adult, kitten vs. cat.  There is much popularity in grain-free diets recently. While a properly balanced grain- free diet is good,  it is no better than a properly balanced non-grain-free diet, unless your pet is allergic to one of the grains in the diet. As far as food allergies go, the most common are beef, chicken, dairy, and wheat.  Grain-free diets are often higher in calorie,  thus feeding amount needs to be adjusted.  The label will also help you figure out exactly what is in the diet. Some diets advertise that meat is the primary ingredient,  but a closer look at the label may show the meat as the first listed ingredient,  but after that there may be three different types of rice listed. Perhaps if all the rice was combined, it would be the first ingredient. Also, a diet may say something to make the pet owner think, for example, the diet is salmon. When the ingredients are inspected on the bag or can -- it says salmon, chicken, etc.  Something else to consider is that many of the big name companies manufacture their own food in plants owned by them. This allows them to follow quality control from beginning to end. Many of the small brand foods subcontract the manufacturer of their food, so they may not have a prudent eye on the manufacturing process as they would like.  

Raw diets are a real concern. Many have nutritional deficiencies or imbalances that can cause harm to pets. They can also spread dangerous bacteria like Salmonella and E. Coli to pets and people alike. Handling the contaminated food or cleaning up the feces in the yard can transmit the  bacteria to people. The only benefit that may exist in scientific study of the issue is a small increase in digestibility versus commercial diets. The veterinary college at Tufts has studied this issue and offers a wealth of information. Please see http://vetnutrition.tufts.edu/2016/01/raw-diets-a-healthy-choice-or-a-raw-deal/.

By-products are another area where the label can be confusing. Some diets say no by- products,  but then list things like liver on the label. Organ meat is a by-product.  By-products are not inherently bad, but it depends on which by-products the food contains.  Avoid artificial flavors and colors and artificial preservatives.

Find a veterinarian who is willing to discuss nutrition and explain the reasons for certain diets. Veterinarians also have ready access to veterinarians board-certified in nutrition who can formulate balanced home-made diets for normal pets and pets with special dietary needs.

Dr Marisa Pepin Slade and Dr Robert Slade are longtime Hampstead residents and operate a mobile house call practice. They welcome your comments at DrsPepin.Slade@gmail.com.

February is National Pet Dental Health Month. Dental disease is the most prevalent clinical disease in cats and dogs. Many pets do not get the dental care they need for optimal health.

Unlike humans, dogs and cats must be anesthetized for dental cleaning which includes cleaning under the gumline. Can you imagine Fido or Fluffy sitting in a dental chair with a bib clipped to their fur and having a dentist calmly clean their teeth with instruments that clean under their gums and outside of all of their teeth?  Do you think the most calm dog or cat would ever tolerate this?  Any dental cleaning that does not include cleaning under the gums is purely cosmetic. What hides under the gums is where the infection resides, and this infection will eventually affect the heart, kidneys, and liver if left unattended. This also happens in people with periodontal disease. Dogs and cats need periodic dental cleanings just like us. Eighty percent of dogs and cats over the age of three have dental issues.

Even though dental disease is often a silent disease until it becomes very serious, here are some symptoms you can observe:  bad breath, excessive drooling, pawing at the mouth, trouble chewing, tooth loss, red, inflamed and thickened gums, brown tartar buildup on teeth, bleeding gums, and sensitivity when chewing.

The good news is we can all do a lot to prevent dental disease and slow its progression in our pets.  The best time to start prevention is in kittenhood or puppyhood or when you first obtain your pet. Some people can slowly, gradually get their pets to accept brushing, but it must be done in a very gentle, and not a forceful way. First, you buy a pet toothpaste (not made in China) with a flavor that you think your pet will like. Also buy a fingerbrush to use. There are numerous websites on the internet that show you in video format how to brush your cat's teeth and your dog's teeth, or you can consult your veterinarian.  Brushing your pet's teeth should be done daily or at least 3 times weekly.  Plaque becomes tartar in about 48 hrs. and slowly becomes difficult to impossible to remove without professional cleaning. Plaque is a sticky biofilm consisting of bacteria. Tartar is plaque hardened by minerals from saliva. 

If brushing isn't possible, there are many other options in the veterinary world to prevent dental disease.  Many dental chews, dental treats, prescription dental diets, dental wipes, dental gels, dental water additives, and dental supplements are available. However, all are not created equal.  Effectiveness and safety matter. Ask your veterinarian and view the VOHC (Veterinary Oral Health Council) website for recommendations by board-certified veterinary dentists.  These veterinary dentists have done double-blind studies on the products listed on their website for cats and dogs.  Just because a product says it is for dental health on the package, doesn't mean it is effective and safe for longterm use.

Some of the over-the-counter products recommended by the Veterinary Oral Health Council for cats  include Science Diet Oral Care for Cats (Hill's Pet Nutrition), Feline Greenies Dental Treats (Nutro), Purina ProPlan Dental Crunch Cat Snacks (Nestle-Purina PetCare Company), and Cat::ESSENTIAL water additive and gel (Healthymouth).  Some of the products recommended by VOHC for dogs include Science Diet Oral Care for Dogs (Hill's Pet Nutrition), Purina Busy HeartyHide Chew Treats, Canine Greenies (Nutro), HealthiDent Bright Bites and Checkups Chews for Dogs, Improved Milk-Bone Brushing Chews for Dogs (Big Heart Pet Brands), VetIQ Minties Medium Dog Dental Treat (TruRx), Hill's Science Diet Canine Oral Care Chews, Pettura Oral Care Gel (Lifes2Good), and Dog::ESSENTIAL water additive and gel (Healthymouth).

Many other dental care products are available through veterinarians.  Ask your veterinarian for advice and about what they have found to work well on their own pets.

Dr Marisa Pepin-Slade and Dr Robert Slade are longtime Hampstead Residents and operate a mobile Housecall practice. They welcome your coments at DrsPepin.Slade@gmail.com.

Heartworm disease is a potentially fatal disease that occurs in both dogs and cats throughout the United States. It is transmitted by mosquito bites. Areas with standing water in hubcaps, old tires, ponds, marshes, and swamps can affect the incidence of mosquitoes and therefore increase the incidence of heartworm disease. Mosquitoes that come into our homes also affect our indoor pets.  There is now an Asian Tiger mosquito that bites even during the day, increasing the risk. Relocation of heartworm infected pets after Hurricane Katrina increased the incidence in some places. Mosquitoes can also be blown great distances by strong winds and change the incidence in certain areas. Wild animals such as coyotes, foxes, and wolves are carriers of heartworm disease.

The signs of heartworm disease in dogs and cats vary and are often very subtle or not noticeable until great damage is done inside our pets' bodies.  Some dogs and cats get lucky and live a long life with no heartworm prevention. Others get bitten by the right  (or wrong)

mosquito and pay dearly for it. Dogs have a higher incidence of heartworm disease because they are the natural hosts for heartworm. Dogs tend to show signs of a mild cough, exercise intolerance, decreased appetite, and weight loss. They can eventually develop heart failure.  Cats may have no symptoms at all before an episode of sudden death. Cats may also have coughing, wheezing, periodic vomiting, decreased appetite, weight loss, or seizures.

The good news is there is very effective heartworm prevention available in oral and topical formulations for both dogs and cats.  Prevention is the best medicine for this disease!  Even better news is that most products also protect the pet against intestinal worms at the same time.  Many intestinal worms are a human threat also.  Some of the topical products also prevent earmites and treat for various types of mites in dogs and cats.  Ask your veterinarian for advice on the best product for your cat or dog. 

Because heartworm disease can be so insidious in its early stages, testing for it first is a must! None of these preventives will get rid of heartworm disease if it is already present. It will continue to ravage the pet's body if it goes unnoticed.  Testing is done before we start the prevention (especially for dogs), unless the pet is under 6 months old. A puppy who is under 6 months old will not show positive for adult heartworms until it has been infected for 6 months.  This is because the immature worms take 6 months to mature and become adults inside the heart.  Dogs are tested with a heartworm antigen test that detects the antigen from the adult worms.  Since cats are not the natural hosts  of heartworms, they may only have immature stages of heartworm in their bodies and only sometimes have adult heartworms present in their hearts.  For this reason, the cats are tested with heartworm antigen and antibody tests. Even these tests can miss an infected cat. Unlike in the dog where a heartworm test is mandatory, oftentimes it is okay to start heartworm prevention in the cat without testing.  The antibody test will test for exposure to heartworm disease, even if there are not any heartworms currently in their bodies. When immature stages of the heartworms circulate throughout their blood vessels, it can cause HARD (heartworm-associated respiratory disease).  Even if the cats don't have live worms left in their bodies, they can suffer the after-effects of blood vessel damage and damage to their lungs. 

The treatment for dogs who get heartworm disease is expensive and does have some risk, but usually cures a dog from heartworm  disease, especially if it is detected early.  Dogs who don't get treated for heartworm can eventually develop congestive heart failure. On the other hand, there is no cure for cats. We can only treat cats for their symptoms and hope that there  wasn't major damage to the heart and lungs.

Please ask your vet for advice on the prevention of heartworm disease. It is preventable!