http://www.petmd.com/blogs/thedailyvet/rss en Why You Need a Surgeon to Perform Your Pet's Cancer Surgery http://www.petmd.com/blogs/thedailyvet/drjintile/2014/december/why-you-need-surgeon-perform-your-pets-cancer-surgery-3229







The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets. < Previous Post Dec 19, 2014 Why You Need a Surgeon to Perform Your Pet's Cancer Surgery by Dr. Joanne Intile     Share    
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Certain combinations are indelibly etched in our minds as cohesive partnerships. For example, can you think of peanut butter without contemplating jelly? I challenge you to hear the word “ying” and not think of  “yang.” If someone says “tequila,” I’m guaranteed to think of a lime. Don’t judge — I’m sure you have your own particular groupings you’d never think to separate.
 
When it comes to veterinary medicine, the specialties of oncology and surgery are an example of equally inseparable grouping.
 
At first glance, the connection between the two may not be apparent. Surgeons are often stereotyped as arrogant, cold, egocentric, and harsh. They are the “carpenters” of bodies, who willingly carve flesh and bones in an effort to impart a detached and impersonal “quick fix” to a problem.
 
Oncologists, conversely, are perceived as continuously compassionate and endlessly optimistic, possessing traits necessary to somehow deliver devastatingly harsh news while simultaneously maintaining an outlook of hope and inspiration.
 
Whether these stereotypes are true or not isn’t the important debate. What we do know is that the adage “a chance to cut is a chance to cure” is especially pertinent for oncology cases. When it comes to the majority of cancers I treat, when I’m able to recommend a patient’s tumor burden be reduced using some form of surgical excision, their survival time is likely to be significantly increased no matter the diagnosis.
 
When feasible, and medically indicated, my preference is to have tumors surgically removed before attempting to treat them with any of the other weapons I have in my treatment arsenal, such as chemotherapy or immunotherapy. Furthermore, in many cases I recommend the oncologic surgery be performed by a board certified veterinary surgeon rather than by the pet’s primary care doctor.
 
The advantages to utilizing a veterinary surgeon for complex tumor removal are innumerable. The foremost being that they possess extensive training in, and have access to the tools necessary to practice, the fundamental principles of surgical oncology (SO).
 
Some of the basic tenets of SO include (but are not limited to):
 

Careful pre-surgical planning of the removal of skin and subcutaneous tumors such that any remaining scar tissue could be potentially incorporated into a post-surgical radiation field should excision be incomplete. This includes understanding how to orient a scar such that radiation therapy can be delivered without extensive damage to healthy tissue. Poor planning can lead to disastrous outcomes for pets.


Performing a thorough exploration of the entire anatomical cavity from which an internal tumor is removed (e.g., a full abdominal exploratory surgery for cases of removal of an intestinal mass). In order to accomplish this, a surgeon must create an incision long enough to permit adequate access to the region they are examining. All too often I see a patient diagnosed with an abdominal tumor with a surgical incision only a few centimeters in length. This immediately raises concern that the veterinarian who performed the procedure was unable to adequately assess all of the anatomical structures in the abdomen and may have missed other organs that should have been biopsied.


Using a different set of surgical instruments, gowns, and gloves during closure of the skin or a body cavity following tumor removal. If these objects are not changed, it is theoretically possible to (inadvertently) physically transfer tumor cells attached to the objects' surfaces from one site in the body to another.

 
Primary care veterinarians often indicate that owners are reluctant to seek consultation with a board certified surgeon because of concern for expense. I challenge those doctors to encourage reluctant owners to consider the value of information they could obtain from meeting with a surgeon.
 
I also challenge veterinarians to disclose any limitations they may face in their ability to perform oncological surgeries (e.g., not having the resources necessary to change surgical instruments when necessary), their comfort level with the procedure in question, and to be familiar with the results of studies indicating the outcome for pets with certain tumors can be improved when a board-certified veterinary surgeon, rather than their primary care veterinarian, performs the procedure.
 
I challenge owners to think about whom they would rather have performing a complicated oncological surgery on their pet: a person who performs that particular surgery once every other month versus one that performs that surgery twice or more per week.
 
Lastly, I challenge the specialists to 1) present owners with all available options, not solely the “ideal” plan, 2) continue to train general practitioners in the proper way to approach oncological surgeries, and 3) uphold the medical and surgical standards to which they were trained in the first place.
 
Oncology and surgery go together exceptionally well. I’m fortunate to have worked alongside, and to personally know, some of the most outstanding veterinary surgeons in the field. I can’t work to the fullest of my capabilities without the help of these amazing individuals, and likewise I’d like to think they couldn’t be as successful managing their cancer cases without my input.
 
We may not mix as palatably as chocolate and peanut butter, but we’re pretty darn close in our ability to create an outcome that’s nothing short of amazing.
 
For more information on how to find a board certified veterinary surgeon near you, visit the American College of Veterinary Surgeons (ACVS)
 
For more information on the field of veterinary surgical oncology and why seeking a veterinary surgeon for your pets oncological surgery is important, visit the Veterinary Society of Surgical Oncology (VSSO)
 

Dr. Joanne Intile
 
Image: aldegonde / Shutterstock
 
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TheOldBroad Surgeons 12/19/2014 04:43pm At the very least, I'd want the person with the most experience and survival rate to do the surgery. This goes for pets AND humans.

After all, most humans don't ask their general practitioner to do surgery. How many general practitioners do surgery these days? (When I was a kid, general practitioners only did simple surgeries like tonsillectomies.)

When it comes to removing cancer, I'd want the person most skilled with doing the surgery. Reply to this comment Report abuse 1
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http://www.petmd.com/blogs/thedailyvet/drjintile/2014/december/why-you-need-surgeon-perform-your-pets-cancer-surgery-3229#comments TheDailyVet Fri, 19 Dec 2014 11:00:00 +0000 32293 at http://www.petmd.com
World's Oldest Two-Faced Cat Dies at 15 Years of Age http://www.petmd.com/blogs/thedailyvet/patrick-mahaney/2014/december/worlds-oldest-two-faced-cat-dies-15-years-age-32292







The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets. < Previous Post Next Post > Dec 18, 2014 World's Oldest Two-Faced Cat Dies at 15 Years of Age by Dr. Patrick Mahaney     Share    
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I was saddened to hear the news of a remarkable, two-faced, 15-year-old cat who recently passed away. Yet, I’m intrigued to learn more about this feline and how he lived to such an advanced age despite his physical challenges.
 
The Worcester Telegram reported the death of Frank and Louie the cat (yes, the cat is “singular”) in North Grafton, Massachusetts, at the Cummings School of Veterinary Medicine at Tufts University. The Tufts veterinarians diagnosed Frank and Louie with advanced cancer and he was humanely euthanized.
 
Why Did Frank and Louie Have Two Faces?
 
Frank and Louie was born with a congenital condition called Diprosopia, which technically means that he was a “two-faced conjoined twin (an incompletely separated conjoined twin). Louie lacked an esophagus, so the Frank side was responsible for all the eating and drinking and was the primary supporter of life.
 
According to Guinness World Records life sciences consultant Dr. Karl Shuker, “Cats such as Frank and Louie, born with two faces, suffer from a developmental abnormality known as diprosopia, in which the face widens and partially duplicates during embryogeny due to the excessive production of a specific protein called SHH.”
 
Frank and Louie attained quite the celebrity status in his time and was inducted into the Guinness Book of World Records in 2006 for being the longest surviving two-faced cat.
 
Two-faced cats are also known as Janus cats. Dr. Shuker reportedly coined the term Janus cat after the Roman god Janus, who is commonly portrayed as having two faces.
 
It’s notable that Frank and Louie was born alive, as most Diprosopus humans are stillborn. Also extraordinary is that he successfully thrived from a kitten into an adult cat, as many don’t make it past the first few hours or days of life.
 
Martha “Marty” Stevens was Frank and Louie’s owner; she became aware of him in 1999 during her employment as a veterinary nurse at Tufts when he was brought in for euthanasia back when he was just one day old. Although veterinarians warned Stevens of the likelihood that Frank and Louie wouldn’t survive longer than a few days, she persevered and “tube-fed him until he was 3 months old because I was afraid he wouldn't be able to eat.” 
 
Was Frank and Louie Able to Function Like a Normal Cat?
 
Yes, Frank and Louie was eventually able to eat and drink on his own, though only from the Frank side of the head. The Louie side lacked a mandible (lower jaw) and couldn't do the work of chewing and swallowing like Frank, so Louie had some of his teeth surgically removed. Being tube fed for three months is a long time for any cat, especially considering most kittens are only tube fed for the first few days to weeks, pending their ability to nurse from their mother (or a suitable surrogate) and to eventually consume solid foods.
 
Stevens reports Frank and Louie “grew up in a shoebox” and “went to work with me every day for the first three months of his life.” Diprosopus newborns are commonly born with cleft palate and other facial and jaw deformities that affect their ability to consume water and nutrients, which results in a failure to thrive. Tube feeding can help, but there exists the risk for potentially fatal problems like aspiration pneumonia associated with inhalation of food or liquid through the palate defect or by improper tube feeding.
 
Frank and Louie reportedly became friendly with his household companions, which included a dog, and even was tolerant of an opera-singing parrot. He enjoyed activity, including going outside for excursions and dexterously playing with toys, as seen in this Worcester Telegram YouTube video, Frank and Louie, two-faced cat.
 
Did Frank and Louie Face Health Challenges Throughout His Life?
 
Frank and Louie had two visual outer eyes and a non-functional (blind) inner eye, so there were three eyes shared by the two heads. Additionally, he had two mouths and two noses, but only one brain.
 
Frank and Louie also was neutered, as passing on his genes to a new generation of cats that could be born with similar defects isn’t a good ethical practice.
 
Yet, his development of cancer is an occurrence quite common to both cats and dogs these days. According to PetCancerAwareness.org:
 

Cancer accounts for nearly 50% of all disease-related pet deaths each year (via The Veterinary Cancer Center)


Dogs get cancer at roughly the same rate as humans (via the American Veterinary Medical Association)


Approximately 1 in 4 dogs develops a tumor of some kind during his lifetime (via the American Veterinary Medical Association)

 
Rest in peace Frank and Louie. I commend Stevens for her hard work in providing you the ability to live to such an advanced age despite the challenges nature inherently provided you.
 
 

Dr. Patrick Mahaney
 
 
Image: Frank and Louie, with owner Martha Stevens
 
 
Related Articles
 
What Does a Veterinarian Do When a Pet With a Complicated Medical History Gets Sick Again?
 
Documentary on Pet Cancer Aims to Lower Cancer Related Deaths
 
What Can Be Learned About Treating Cancer in Captive Apes?
 
A Doggy Birthday Party, Celebrities, and the CLEAR Foundation Fight Cancer with a Fundraiser
 
When Pets Complete Chemotherapy Are They Cancer-Free?
 
Unexpected Side Effects of Chemotherapy Treatment
 
Feeding Your Dog During Chemotherapy Treatment
 
Can a Veterinarian Treat His Own Pet?
 
How a Vet Diagnoses and Treats Cancer in His Own Dog
 
A Veterinarian's Experience with Treating His Dog's Cancer
 
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TheOldBroad Kudos 12/18/2014 06:17pm Kudos to Marty Stevens for seeing past the physical problems and providing Frank and Louie a quality of life.

I'll bet Frank and Louie thought he was a handsome dude and no doubt those who knew his heart agreed.

Rest in Peace Frank and Louie. Reply to this comment Report abuse 3
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http://www.petmd.com/blogs/thedailyvet/patrick-mahaney/2014/december/worlds-oldest-two-faced-cat-dies-15-years-age-32292#comments TheDailyVet Thu, 18 Dec 2014 11:00:00 +0000 32292 at http://www.petmd.com
Gifted Pets Often Become Returned Pets After Holidays http://www.petmd.com/blogs/thedailyvet/lorieahuston/2014/december/gifted-pets-often-become-returned-pets-after-holidays-3









The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets. < Previous Post Next Post > Dec 17, 2014 Gifted Pets Often Become Returned Pets After Holidays by Dr. Lorie Huston     Share    
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For better or for worse, the holidays often bring new pets into our households. Your addition may have been well-planned and thoughtfully implemented, which is always the recommended course. However, many new pets end up in our homes either as gifts or as our own impulsive purchases or adoptions.
 
While I never recommend giving a pet as an unexpected (i.e., surprise) gift, it happens. And when it does, it often places a pet into a household where it may not be all that welcome. As a result, that pet often ends up surrendered to a shelter or rescue shortly after the holidays conclude.
 
Impulsive purchases are a bit different but the result is often the same. When the addition of a pet is unplanned, new pet owners may find themselves in a position where they are financially or physically unable to care for the new pet. Or they may simply have second thoughts about having the pet in the household.
 
Whatever the reason, the period immediately following the holidays unfortunately finds a lot of puppies, kittens, dogs, cats, and other pets being surrendered to shelters and rescues. For some shelters and rescues, this happens less frequently than for others. Shelters and rescues that screen adopters carefully and prohibit the adoption of a pet as a gift for someone else are probably less likely to see as many returns, I should think (though I admit I have no statistics or studies to back up this thought). However, not all shelters have the luxury of being so discerning.
 
What happens when a pet is returned to a shelter or surrendered to a rescue after the holidays? That animal, which may have already had time to begin to bond with its new family, is now placed back into a cage. He certainly does not understand what he did to deserve to be abandoned again. He does not understand that his "new people" did not plan adequately for him or never wanted him to begin with. For that animal, the situation becomes stressful, depressing, and frightening.
 
Can these animals be re-homed a second time? Yes, many of them will adjust to another home, which hopefully will be better prepared for the arrival of the new pet. Some of these animals may still need training, especially in the case of young or adolescent puppies, which may not have received adequate house training guidance and/or socialization in their previous, short-lived home. But they can still make good pets for someone willing to take the time.
 
Many of these pets will become loving and loyal companions. That is assuming, though, that a new home can be located. Unfortunately, that is often easier said than done, and too many pets end up meeting an unpleasant end when there are no new homes for them.
 
What is the moral of the story? If you did not adopt a pet this holiday season, hopefully you already know that the holidays are perhaps not the best time of year to adopt a new pet and, likewise, hopefully you will never make the mistake of adopting a pet you are not prepared to care for.
 
If you did adopt a pet, for yourself or for someone else, and now find yourself in a position where surrendering that pet is inevitable, accept that you made a serious mistake in judgment. Learn from that mistake and vow never to repeat it. After all, it is not really you that suffers for this transgression. It is the pet that pays the ultimate price!
 
Today's post was originally published in January 2012.
 

Dr. Lorie Huston
 
 
Image: malajka / Shutterstock
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TheOldBroad Who Suffers? 12/17/2014 06:17pm Who suffers from human's poor decisions? In cases like these, it's always the critter who suffers.

If anyone is thinking of giving a pet as a gift, please please PLEASE, give a gift certificate. Let the human choose their own pet after the holidays. If not a gift certificate, maybe pet supplies.

Not to mention, most households are full of unusual activity over the holidays. Not the best time to introduce a new pet into the home. Reply to this comment Report abuse
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http://www.petmd.com/blogs/thedailyvet/lorieahuston/2014/december/gifted-pets-often-become-returned-pets-after-holidays-3#comments TheDailyVet Wed, 17 Dec 2014 11:00:00 +0000 32291 at http://www.petmd.com
The 12 Days of a Vet's Christmas http://www.petmd.com/blogs/thedailyvet/aobriendvm/2014/december/12-days-vets-christmas-32290


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http://www.petmd.com/blogs/thedailyvet/aobriendvm/2014/december/12-days-vets-christmas-32290#comments TheDailyVet Tue, 16 Dec 2014 11:00:00 +0000 32290 at http://www.petmd.com
Early Signs of Kidney Disease in Cats http://www.petmd.com/blogs/thedailyvet/dr-coates/2014/december/early-signs-kidney-disease-cats-32289









The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets. < Previous Post Next Post > Dec 15, 2014 Early Signs of Kidney Disease in Cats by Dr. Jennifer Coates     Share    
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Chronic kidney disease (CKD) is a leading cause of death in older cats. The condition is insidious because by the time a diagnosis can be made, kidney function has already declined to at least two-thirds to three-quarters of what is considered normal.
 
Initially, symptoms are quite mild, but as time goes on affected cats become dehydrated, metabolic waste products build up within the bloodstream, electrolyte abnormalities develop, blood pressure can rise to dangerous levels, and red blood cell production slows. All of this causes some combination of increased thirst and urination, urinary accidents, poor appetite, lethargy, weight loss, abnormal behavior, vomiting, diarrhea or constipation, bad breath, sores in the mouth, unsteadiness, and a ratty looking coat.
 
Stepping in with treatment when a cat is this sick is certainly helpful (many patients can be stabilized and maintained with fluid therapy, medications, and a special diet), but early diagnosis and treatment should always be our goal. What we need is an easy way to determine which cats are most likely to develop CKD.
 
A recent study looked at the health records of 1,230 cats seen by primary care veterinarians in an attempt to identify risk factors for CKD. The hope is that with increased awareness of these risk factors, veterinarians can recommend additional screening for those individuals who would most benefit from it. The study found the following:
 
Risk factors for CKD in cats included thin body condition, prior periodontal disease or cystitis [bladder infection], anesthesia or documented dehydration in the preceding year, being a neutered male (vs spayed female), and living anywhere in the United States other than the northeast.
 
The difference in the amount of weight lost between the CKD and control cats included in the study was quite remarkable. A thin body condition was noted in 66.3% of cats with CKD, and these individuals experienced a median weight loss of 10.8% in the preceding 6-12 months. In comparison, 38.4% of control cats were identified as having a thin body condition and the median weight loss during the preceding 6-12 months for this group was 2.1%.
 
The study’s authors make the point of saying that these associations “should be viewed as potential indicators for facilitating earlier recognition and diagnosis of CKD and not necessarily as evidence of a cause-effect relationship between the risk factors and CKD in cats.” For example, we don’t know whether “documented dehydration” is damaging the kidneys leading to CKD or if these cats have as-of-yet undiagnosed CKD, which results in dehydration.
 
I can see using these findings as a sort of check list during wellness exams in older cats – the more boxes that get ticked off, the greater the need for additional screening in the form of blood chemistry tests and a urinalysis. Treatment can’t cure CKD, but it can slow the progression of the disease and greatly improve quality of life, and the earlier it starts, the better.
 
Finally, I want to bring up one item that is conspicuously absent from our check list — type of diet. Many veterinarians and cat enthusiasts recommend canned food for cats, in part for its supposed protective effects on the kidneys (due to its high water content). However, this research found that “the study cats with a record of having been fed kibble were no more likely to develop CKD than those fed wet food.” This is hardly the last word on the matter, but it should ease the worries of owners who feed dry cat food.
 

Dr. Jennifer Coates
 
Reference
 
Risk factors associated with the development of chronic kidney disease in cats evaluated at primary care veterinary hospitals. Greene JP, Lefebvre SL, Wang M, Yang M, Lund EM, Polzin DJ. J Am Vet Med Assoc. 2014 Feb 1;244(3):320-7.
 
Image: Artem and Victoria Popovy / Shutterstock
 
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http://www.petmd.com/blogs/thedailyvet/dr-coates/2014/december/early-signs-kidney-disease-cats-32289#comments TheDailyVet Mon, 15 Dec 2014 11:00:00 +0000 32289 at http://www.petmd.com
Using Viruses to Treat Cancer in Pets http://www.petmd.com/blogs/thedailyvet/ken-tudor/2014/december/using-viruses-treat-cancer-pets-32279









The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets. < Previous Post Next Post > Dec 12, 2014 Using Viruses to Treat Cancer in Pets by Dr. Ken Tudor     Share    
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Surgery, radiation, and chemotherapy are the more commonly known treatments for cancer in pets. But newer technologies are opening up other possibilities. I read a recent experiment summary (abstract) describing the use of genetic modified viruses to treat various types of cancer.
 
Oncolytic Virotherapy
 
The idea of using a virus for cancer treatment or oncolytic virotherapy is not a new idea. In the 1940s scientists conducted animal studies using viruses to treat tumors. Doctors in the 1950s observed that cancer patients that were stricken with viral infections or recently vaccinated experienced improvement in their condition. It was believed that the infections or vaccinations triggered an immune response that increased the production of interferon and tumor necrosis factors, or TNFs.
 
Interferons are large molecules released by cells infected with viruses, bacteria, parasites and tumors to interfere, hence their name, with virus reproduction and to trigger responses from immune cells. Interferons activate natural killer white blood cells and large white cells called macrophages that attack and destroy the invading organisms and cancer cells. Interferon promotes the production or molecular complexes that attach to viral, bacterial, parasite, and tumor cells so they are more quickly and effectively attacked by killer white cells. TNFs causes destructive changes in cell walls and causes foreign or tumor cells to burst and die
 
Despite the potential for viral therapy of cancer in these early years, it required the present advances in technology to achieve a real possibility. Precisely, it required our present ability to genetically modify organisms like viruses and safely use them to target cancer cells. The viruses are modified to prevent their normal ability to cause disease and genetically altered to produce interferon or other anti-cancer molecules.
 
Preliminary Study in Dogs
 
The abstract that caught my attention was a small study intended to evaluate the safety and effectiveness of a new oncolytic virus. The group was made up of of seven dogs suffering from various cancers (lymphoma, malignant melanoma and multiple myeloma). The researchers used a novel virus for their study; they used a modified vesicular stomatitis virus that causes oral, udder, and hoof ulcers in cattle. Although seldom fatal, the disease causes inappetence and decreased milk or meat production [in cattle]. It can also infect horses and pigs, and rarely, sheep, goats, and llamas. Because of its effect on agricultural production, vesicular stomatitis is a diagnosis that requires mandatory reporting to federal and state animal health officials.
 
The virus was also modified to produce human or canine interferon. Three dogs received the human form and four dogs received the canine form. The abstract reported measurable improvement but did not specify the type and extent of the improvements except for the production of neutralizing antibodies within 7-10 days after viral administration. Side effects were minimal and included reversible changes in liver enzymes, fever, and urinary tract infection. Virus was not shed in the urine or saliva. These limited side effects are comparable or even fewer than those expected with radiation or chemotherapy.
 
This is a small study and rightly titled as preliminary. It has yet to be published so critical evaluation is still not available. Clearly, much more study is required for this type of treatment. What is exciting is that this is one of many new potential treatments for cancer in pets. Advanced cancer treatment in the last decade has changed how the diagnosis is now viewed. Rather than an immediate death sentence, cancer can now be better managed as a chronic disease much like kidney and heart conditions. These new treatments offer greater treatment flexibility and potentially an improved quality of life.
 

Dr. Ken Tudor
 
Source
 
A.K. Leblanc, S. Naik, G. Gaylon et al. Preliminary toxicity and efficacy of the novel oncolytic virus, VSV-IFNB-NIS, in tumor-bearing dogs. Journal of Veterinary Internal Medicine, July/August 2014; Vol. 28; No. 4: 1362. [Abstract]
 
Image: Photographee.eu / Shutterstock
 
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TheOldBroad Cool Stuff 12/12/2014 06:26pm So the body doesn't try to fight cancer cells? Is it because the body has created the cancer cells and there's no identification of cancer being an invader?) How does that work when the white cells go "on the attack?" How is it that they suddenly see cancer cells as something to destroy? Or would it not work by just increasing the white cells - one would need the modified viruses that are programmed to attack cancer cells? Reply to this comment Report abuse Dr. Ken Tudor 12/14/2014 10:18pm You ask some very good questions. The body's response to cancer is variable. That is why the survival time varies from individual to individual. Those with a more vigilant immune system will fare better. A study done about 10-15 years ago suggested that people with allergies were less likely to get cancer. It is thought that people with allergies have an overly active immune system and it attacks cancer cells more immediately. You are also correct that although cancer cells are different is some ways, they are still the body's own cells and are recognized as "self" and that limits the immune response to them in some individuals. That is what makes this research exciting. If GMO viruses can be programmed to target the differences in cancer cells it is an additional tool for treating cancer. Reply to this comment Report abuse
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http://www.petmd.com/blogs/thedailyvet/ken-tudor/2014/december/using-viruses-treat-cancer-pets-32279#comments TheDailyVet Fri, 12 Dec 2014 11:00:00 +0000 32279 at http://www.petmd.com
Finding the Causes of Cancer in Cats and Dogs http://www.petmd.com/blogs/thedailyvet/drjintile/2014/december/finding-causes-cancer-cats-and-dogs-32278









The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets. < Previous Post Next Post > Dec 11, 2014 Finding the Causes of Cancer in Cats and Dogs by Dr. Joanne Intile     Share    
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Hearing the news that your pet has been diagnosed with cancer can be both devastating and terrifying at the same time. It is natural to have many questions about exactly what the diagnosis means, what might happen to your pet as the cancer progresses, and what options you have for treating the disease.
 
One of the most common questions I am asked by owners during an initial appointment is, "What caused my pet’s cancer?" I can definitely appreciate why this is an important piece of information they would want to understand. Unfortunately, this is a very difficult question to answer accurately, as in nearly all cases cancer is typically caused by a combination of genetic and environmental influences, many of which may have occurred years before the diagnosis was made.
 
The fact that certain types of cancers occur more often in particular breeds of dogs and cats lends much evidence to the concept of a genetic cause for the disease. We do know that the genetic mutations that cause cancer can occur in the reproductive cells of male and female animals, and these mutations can be passed on to puppies and kittens, giving rise to a heritable predisposition to different types of tumors. Most cancers, however, arise from mutations that occur to genes during a dog’s or cat’s lifetime that were not present at birth. These mutations can result from internal factors, such as exposure to naturally occurring hormones, or external factors, such as environmental tobacco smoke, chemicals, or even sunlight.
 
In people we know that up to one-third of all tumors are related to environmental and lifestyle factors. In veterinary oncology, we have discovered that nutrition, hormones, viruses, and carcinogens such as smoke, pesticides, UV light, asbestos, waste incinerators, polluted sites, radioactive waste, and canned cat foods can increase the risk of cancer in pets.
 
Some examples of known causes of cancer in companion animals include:
 
Increased risk of mammary cancer in un-spayed female dogs and cats.

Dogs spayed before experiencing their first heat cycle have a 0.5% chance of developing mammary cancer during their lifetime. This increases to 8% if they are spayed after they have experienced one heat cycle, and 26% if spayed after they have experienced two heat cycles.


Cats spayed before six months of age are seven times less likely to develop mammary tumors than cats spayed after six months of age.


It is thought that the hormones that are released during heat cycles cause mutations within the mammary tissue, leading to the development of tumors.

 
There is a possible association between environmental tobacco smoke exposure and development of oral cancer in cats.

The hypothesis is that the carcinogens present in cigarette smoke will be passively deposited on the fur of the cats, and when cats groom themselves, they inadvertently ingest these particles, which can lead to tumor development within the oral cavity.

 
There is an association between Feline leukemia virus (FeLV) and Feline immunodeficiency virus (FIV) and development of lymphoma in cats.

FeLV and FIV are retroviruses that affect cats, and can cause a variety of clinical signs in infected animals. Many cats that test positive for either virus as kittens may not show any clinical signs for several years. These viruses are known to cause cancers in cats. Cats that test positive for FeLV are 60 times more likely to develop lymphoma than cats that test negative for this virus, and cats that are FIV positive are five times more likely to develop lymphoma. Cats that test positive for both viruses concurrently are 80 times more likely to develop lymphoma.

 
Studies have shown conflicting information regarding the risk of exposure to herbicides and/or pesticides and the development of cancer in pets. For example, some studies have shown an increased risk for the development of lymphoma, which is a cancer of white blood cells, while other studies have refuted the risk. Because the results are inconclusive I generally recommend that owners should strive to minimize their pets’ exposure to these chemicals and discuss any concerns they may have with their primary care veterinarian.
 
It is important to remember that it is often difficult to prove "cause and effect" when it comes to cancer. This is true for even well designed research studies designed to look at those exact parameters, so one has to be careful when researching this topic and not over interpret the available information. There are so many potential interactions between genes and environment influences that could lead to the development of a tumor, and ultimately, we may never be able to know exactly what caused the cancer in the first place.
 
Although I can appreciate why an owner would want to try and understand how it is their pet developed cancer, what I often try to have owners focus on is, now that we have the diagnosis, how we can move forward with a plan to treat it so that we can provide the best possible quality of life for as long as possible for their pet? Keeping the emphasis on the present tense is what allows owners to continue to maintain their wonderful bond with their pets during the duration of their cancer treatment and beyond.
 

Dr. Joanne Intile
 
Today's post was originally published in October 2012
 
Image: Ermolaev Alexander / Via Shutterstock
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TheOldBroad Causation 12/11/2014 07:01pm I've heard so many people want to know why so-and-so got cancer. For some reason it's important to them to know "why."

Unfortunately, we don't always know why. Sometimes it's "just because you were unlucky." No predisposition. No environmental factors. I've seen it happen.

"cats that are FIV positive are five times more likely to develop lymphoma."

My Owen is FIV+ (he came that way) so I'll definitely be on the lookout for it. So far, so good. Reply to this comment Report abuse 1 Living in Whisker City 12/12/2014 01:21pm Knowing the reason a cat has cancer is not just an exercise of curiosity. In the event that the cause of the cancer is external (rather than genetic), it is very important to ascertain the reason/cause of the cancer (if possible) if you have a multi-cat household or intend to add another cat to the household. If the cause is external and you don't eliminate it, then your other cats remain exposed to the danger. Reply to this comment Report abuse
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http://www.petmd.com/blogs/thedailyvet/drjintile/2014/december/finding-causes-cancer-cats-and-dogs-32278#comments TheDailyVet Thu, 11 Dec 2014 11:00:00 +0000 32278 at http://www.petmd.com
Does Inappropriate Urination Make Your Feline Friend a Cat From Hell? http://www.petmd.com/blogs/thedailyvet/patrick-mahaney/2014/december/does-inappropriate-urination-make-your-feline-friend









The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets. < Previous Post Next Post > Dec 10, 2014 Does Inappropriate Urination Make Your Feline Friend a Cat From Hell? by Dr. Patrick Mahaney     Share    
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Having been involved on the production side of the Animal Planet’s hit show My Cat From Hell (MCFH) for three seasons, I am now familiar with and have some expectation for the circumstances I find myself in when providing a house call for the reputed cats from Hell. Of course every circumstance is unique, as the only seeming similarities are the cats’ tendencies to be fractious (e.g., aggressive, mean, etc.) or otherwise behaviorally challenging.
 
If you've been following my petMD Daily Vet column, you've previously become familiar with some of my MCFH patients like Molly (see A Veterinarian's Perspective on Treating a Cat from Hell and Animal Planet's video, Molly’s Follow Up). The first cat I worked on this season was a 100% indoor calico (and thereby female) named Sweet Pea who was driving her owner and his roommate crazy with her habits of inappropriate urination.
 
My role was to lend some holistic veterinary medical perspective, so I examined Sweet Pea and collected blood and urine samples for diagnostic testing.
 
Before the conclusion of a primary behavior issue can be achieved, medical problems must first be ruled out. With any cat (or dog) having urinary problems, it's important to start with blood and urine testing to thoroughly evaluate kidney function. Additional diagnostics like radiographs (X-rays), ultrasound, or others may also be needed. Many inappropriately urinating cals have underlying health concerns, such as:
 

Feline Lower Urinary Tract Disease (FLUTD) — a syndrome of issues including urinary tract infection, crystals/stones, or interstitial cystitis (inflammation of the bladder resulting from a non-medical issue, such as household stress), which all ultimately produce similar clinical signs, including straining to urinate, increased frequency of urination, bloody urine, vocalizing while urinating, etc.


Osteoarthritis (DJD or degenerative joint disease) — joint inflammation leads to pain that causes discomfort while squatting to urinate, which can then motivate the cat to seek out a more comfortable location to eliminate waste (both urine and bowel movements).


Intervertebral Disc Disease (IVDD) — like DJD, decreased shock absorbing capacity in the discs that support the vertebral column (backbones) puts more stress on the spinal cord, nerves, and even the joints that hold vertebrae in place (facets), which leads to the experience of pain while urinating (or defecating).


Anal Sacculitis — when one or both of the paired anal sacs that exist just inside the right and left margins of the anus aren’t emptying properly (impaction) or are inflamed/infected, then discomfort while defecating or urinating occurs.


Renal (kidney) Failure — as the kidneys lose their capacity for filtering the blood and excreting toxins from the body, the concentrated urine results in an associated increase in urine output (also paired with increased water consumption). An increased need to urinate means a cat will visit the litter box or other preferred elimination site more frequently and will also produce larger volumes of urine.


Hyperthyroidism — one of the most common endocrine (glandular) problems affecting senior cats is hyperthyroidism, where benign nodules of thyroid tissue produce larger quantities of thyroxine (thyroid hormone). Increased levels of thyroxine in the blood causes a variety of physiologic and behavior changes, including increased water consumption and urination.


Diabetes Mellitus (DM) — like with renal failure and hyperthyroidism, diabetes mellitus leads to increased water consumption and urination. This occurs as a result of deficient insulin production to appropriately reduce blood sugar levels or resistance to insulin. Instead of appropriately moving out of the blood and into tissue via insulin, glucose is excreted through the kidneys and pulls more water out of the body. More urine produced creates the need for more water to be consumed to meet hydration levels.


Other — some cancers, toxic exposures and other conditions can make cats have the urge to urinate more frequently, larger volumes, or outside of the previous/established location for elimination.

 
Fortunately, Sweet Pea’s physical exam showed no spinal or joint pain and her anal sacs were normally expressing. Blood tests showed no evidence of kidney or liver disease, hyperthyroidism, or other detectable ailments. Additionally, her urinalysis indicated normally concentrated urine, lacking hallmarks of kidney disease such as the presence of bacteria, crystals, sugar, protein, ketones, kidney cells, or other abnormalities. More importantly, her urine culture was negative. Urine culture is the gold standard test to rule in or out bacterial a urinary tract infection because bacteria may be missed on microscopic examination when present in low numbers or if urine is very dilute.
 
Once we ruled out underlying health problems, Sweet Pea’s owner was able to attain an improved relationship between human and feline household members through the combination of environmental enrichment and medication.
 
Sweet Pea has another feline friend named Critten sharing the 100% indoor space. Critten was preventing her from having access to the litter box and causing a general increased level of stress in the household. Their less-than-friendly interactions were videotaped by the owner and are seen on the show. If I were a cat, enduring an attack from another household cat or other animal would scare me away from urinating or defecating in the litter box and force me to pick a new spot... one likely deemed inappropriate by my human caretakers.
 
By increasing Sweet Pea’s available options to urinate via multiple litter boxes in locations where she wasn’t constantly being stalked by Critten, she electively started urinating in the boxes and not in various places around the apartment. Additionally, locations where she could hide in confined spaces (under the couch, etc.) and potentially urinate were obstructed.
 
Although this bit of information was not reflected in the episode, Jackson Galaxy and I elected to start Sweet Pea on a behavior modifying medication called Buspirone (BuSpar). She was started on a bodyweight-appropriate dose for 30 days and then her dose was increased when we perceived that she needed additional relief from her household anxiety.
 
If you’ve set your DVR, the episode is titled “Godzilla Attacks,” which originally aired on 10/25/14. Sweet Pea’s follow up report can be seen on AminalPlanet.com: Will Sweet Pea Come Out of Hiding?. A brief video of the seconds where I’m featured can be found via this YouTube video: Dr. Patrick Mahaney appears on My Cat From Hell Season 5 to examine Sweet Pea
 
Do you have a “cat from Hell?” f so, what steps have you taken to evaluate the problem with your veterinarian and has the issue improved or resolved?
 

 

Dr. Patrick Mahaney
 
Image: deree / Shutterstock
 
Related:
 
Top Ten Ways to Help Your Cat Stop Peeing Outside the Litter Box
 
Urinating Outside the Litter Box and Wandering Away from Home in Cats
 

Peeing Outside the Box
 

Cats Should Not Die for Peeing on the Bed
 


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TheOldBroad Litter Boxes 12/10/2014 06:52pm You didn't mention how many boxes were in the household. There should have been at least three. (One per cat plus one)

Poor Sweet Pea! I totally agree that I would find any way possible to keep from getting attacked - especially when going potty.

I've had Cats From Hell. My Sylvia Rose (RIP) would bite anyone - including me, but still wanted to be a lap cat. That was truly challenging when it came to finding someplace for my hands.

My Winston (RIP) had a litter box problem and, yes, he was taken to the vet immediately. None of the problems you mention, but he was trying to tell me that he had the beginnings of lymphocytic lymphoma. It took five trips to the doctor, but since I was convinced that he was trying to tell me something, we kept looking. (Thank goodness.)

I've had some that are a real challenge to medicate. I've had some that are underfoot all the time. I've had some that really REALLY hate other cats. Somehow it all works out because I firmly believe that once I take them in, it's a promise to do the best I can for as long as I can. Reply to this comment Report abuse 2
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http://www.petmd.com/blogs/thedailyvet/patrick-mahaney/2014/december/does-inappropriate-urination-make-your-feline-friend#comments TheDailyVet Wed, 10 Dec 2014 11:00:00 +0000 32277 at http://www.petmd.com
Holiday Dangers for Cats and What You Can Do to Lower the Risks http://www.petmd.com/blogs/thedailyvet/lorieahuston/2014/december/holiday-dangers-cats-and-what-you-can-do-lower-risks-32









The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets. < Previous Post Next Post > Dec 09, 2014 Holiday Dangers for Cats and What You Can Do to Lower the Risks by Dr. Lorie Huston     Share    
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We all enjoy special foods, particularly over the holidays. During these weeks, our homes are often filled with chocolates, wine and other culinary masterpieces. Many of these items can be quite dangerous for our pets, both feline and canine.
 
For cats, chocolate, caffeine-containing foods and beverages, foods containing onions and/or garlic, alcohol, and raw bread dough are among the dangers.
 
Besides the wonderful foods we share over the holidays, many of us also spend a lot of time decorating our homes and decking out the halls. Although these decorations add beauty to our homes and are a traditional part of the holidays, they can also pose significant risks for your cat.
 

Lilies, Christmas roses, amaryllis, holly berries (and their leaves), and mistletoe are among the dangerous plants often used as holiday decorations. Interestingly, poinsettias (which are often maligned as being extremely toxic for pets) are really only mildly toxic and the risk to pets with this particular plant is somewhat overrated.


Ribbons, strings and other similar types of items can pose a threat for kittens and curious cats. If swallowed, these items can cause intestinal obstructions that may require surgical treatment and may even prove to be fatal for your cat.


Potpourris are often used to freshen the air and give our homes a delicious scent. However, these items can contain herbs and essential oils that can be dangerous for your cat. Be especially cautious of liquid potpourris.


Candles are another decorative hazard. Candles can not only cause burn injuries to curious cats but overturned candles can also pose a fire risk for your home.


Electrical cords can also be dangerous to a playful cat. Electrocution is a real risk for any cat that bites into a low-hanging electrical cord.


Christmas tree water can become stagnant, becoming a breeding ground for bacteria and other unhealthy organisms. It may also contain fertilizers and other preservatives designed to keep your tree fresher longer. This water may pose a disease threat to a thirsty cat who samples the water.


Glass ornaments may be knocked off trees and countertops, resulting in sharp edges that can pose a safety hazard and injure your cat.

 
Despite our best intentions and well-laid planned, accidents can still happen. It’s a good idea to keep the telephone number for your local veterinarian and closest emergency veterinary hospital on hand.
 
The ASPCA Poison Control Center can be reached at and the Pet Poison Helpline is available at 855-764-7661 (a fee is applied). Program these numbers into your telephone so they are readily available if needed. Hopefully, there will be no need to use these telephone numbers but, if needed, you’ll be glad to have them close.
 

Dr. Lorie Huston
 
Today's post was originally published in December 2012.
 
Image: Alena Haurylik / Shutterstock
 
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TheOldBroad Christmas Trees 12/09/2014 06:38pm I've always thought that Christmas trees were dangerous to kitties. I've not seen a cat yet that doesn't attempt to climb it at least once. Fluffy can be injured if the tree falls.

Back when I put up a tree, my Darlene (RIP) would try to eat the plastic needles. The last thing I needed was surgery to remove plastic tree needles from the cat, so that was the last time I erected a tree because I've always had at least one would I suspected would try the same thing. Reply to this comment Report abuse
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http://www.petmd.com/blogs/thedailyvet/lorieahuston/2014/december/holiday-dangers-cats-and-what-you-can-do-lower-risks-32#comments TheDailyVet Tue, 09 Dec 2014 11:00:00 +0000 32276 at http://www.petmd.com
Why Do Spays Cost So Much? http://www.petmd.com/blogs/thedailyvet/dr-coates/2014/december/why-do-spays-cost-so-much-32275









The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets. < Previous Post Next Post > Dec 08, 2014 Why Do Spays Cost So Much? by Dr. Jennifer Coates     Share    
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I used to work in a general veterinary practice in a wealthy part of Wyoming. Despite the fact that many of our clients arrived at the clinic driving cars worth more than my annual salary, the question “Why does a spay cost so much?” seemed to come up on a daily basis. I think the ready availability of spays through nonprofit organizations has skewed owner perception of the true cost of this surgery absent support via donations, tax-exempt status, and a focus on maximizing the number of surgeries performed.
 
It’s impossible to itemize the cost of everything that goes into a high quality dog spay, but I thought that an overview of what’s involved might provide some insight.
 

An examination by a veterinarian prior to anesthesia on the day of the surgery.


Laboratory tests prior to surgery. Exactly which tests should be run depends on your dog’s age, breed, and health history. For example, a six month old mixed breed dog who has never been sick a day in her life may only need a check of her hematocrit (red blood cell count), total blood protein level, and an Azostix (a quick and dirty check of kidney function) while a dog with an increased risk of disorders that make anesthesia and surgery riskier would require more extensive testing.


“Pre-meds.” Sedatives and pain relievers that help dogs to relax and can reduce the dose of anesthetics that are subsequently given.


Placement of an intravenous catheter after the site is shaved and prepped with antiseptics to prevent infection. Catheters allow multiple injections to be given with only one “stick,” the administration of intravenous fluids during surgery (more on why this is so important next week), and ensure access to the blood stream in case an emergency arises.


Administration of injectable anesthetics allowing the dog to be intubated (placement of a breathing tube into the trachea).


Administration of oxygen and inhalational anesthetics through the breathing tube throughout the procedure.


Shaving and multiple applications of antiseptic solutions to the surgical site to prevent infection.


The use of several monitoring devices (e.g., blood pressure, blood oxygenation, pulse and breathing rates, and temperature).


A specially designed room used only for surgery complete with all necessary equipment (oxygen delivery system, surgical lights and tables, etc.).


The use of special devices to hold the dog in the correct position and keep her warm.


Application of sterile drapes (newly sterilized ones for every surgery) that leave only a small area around the surgical site exposed.


Caps, masks, surgical hand scrub, and sterile gowns and gloves (new ones for every surgery) for the veterinarian and anyone else who might assist in the surgery.


A sterile equipment pack containing scalpel handles, needle holders, hemostats, a variety of clamps, absorbent gauze, etc. A new sterile pack should be used for every surgery.


Sterile, individually packaged scalpel blade(s).


Several different types of individually packaged, sterile absorbable sutures.


Sterile nonabsorbable sutures, tissue glue, or surgical staples to close the skin.


Close monitoring while the dog recovers from anesthesia in a warm and soft location.


Pain relievers to go home and clear instructions (both written and verbal) regarding what owners should be monitoring for during the postoperative period.


The veterinarian’s, veterinary technician’s, and support staff’s time/salaries.


Expenses to cover costs associated with the running of the veterinary practice (e.g., equipment purchases and maintenance, utilities, rent/mortgage payments, etc.)

 
Truth is, most veterinary clinics greatly undercharge for spaying dogs. They consider providing high quality spays a necessary part of patient care and are willing to take a loss on the procedure to avoid scaring clients away with the actual cost of the surgery.
 

Dr. Jennifer Coates
 
Image: Kachalkina Veronika / Shutterstock
 
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Dog Mama Spay and Dental 12/08/2014 12:29pm Same thing applies to dentals. I hear people freaking out about the quotes they get for full dental, little realizing what it entails. Reply to this comment Report abuse TheOldBroad Experience/Education 12/08/2014 06:23pm You left out the education and experience of the vet and techs. If it were easy, anyone could do it.

I feel that expertise is worth a whole lot.

Plus, there's a whole lot that goes into overhead. To get those sterile instruments, there must be an autoclave. And don't forget the front desk staff. Reply to this comment Report abuse
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Love Animals? There's An App For That http://www.petmd.com/blogs/thedailyvet/aobriendvm/2014/december/love-animals-theres-app-32246


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How Humans Can Save Pets with Blood Transfusions http://www.petmd.com/blogs/thedailyvet/ken-tudor/2014/december/how-humans-can-save-dogs-blood-transfusions-32245









The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets. < Previous Post Next Post > Dec 04, 2014 How Humans Can Save Pets with Blood Transfusions by Dr. Ken Tudor     Share    
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The ability to transfuse blood has proved to be a valuable medical procedure for saving lives, both human and animal. Blood transfusions, however, require stringent matching to avoid life-threatening reactions in blood recipients. It is uncommon for humans to donate blood to animals for these reasons. But brand new research suggests that humans can donate a blood serum protein called albumin and save the lives of their pets.
 
What's Important About Serum Protein in Blood
 
When most people think of blood they typically think of red blood cells and their important function of carrying oxygen to the cells of the body. But blood contains many other cells and chemicals that are equally important. Blood contains white blood cells and antibodies to fight off infections. Special cells and chemicals also promote clotting after injury to protect against excessive blood loss.
 
But one crucial blood protein is called albumin. Albumin is necessary in blood to act like a sponge and keep the water content of blood in the arteries and veins. Arteries and veins are not lifeless pipes. They are made of cells that are connected to each other in a cylinder to form a hose. But the joints of these cells are not water tight and can leak that water that is a major component of blood. Serum albumin creates an osmotic force that attracts water so it doesn’t leak from the blood vessels through the cell junctions.
 
Dog Diseases that Reduce Serum Albumin in Blood
 
The lack of protein intake or protein loss in animals can result in losses of serum albumin levels. Decreased levels of albumin result in water leaking from blood vessels and pooling in body cavities. Starving children have pot bellies because the lack of dietary protein leads to a decrease of serum albumin and results in leakage of water into the abdominal cavity. Puppies and kittens with parasites will have the same pot-bellied appearance because their intestinal worms are consuming all of the protein in the diet. With severe decreases in serum albumin, the chest cavity can fill with water, causing a life threating situation where the human or pet dies of drowning in their own body fluids.
 
Animals with certain intestinal diseases also experience hypoalbuminemia, as low serum albumin is called. Dogs and cats with severe inflammatory bowel disease (IBD) have a much thickened lining of the intestines due to inflammation of unknown cause. The increased thickness makes it difficult to absorb dietary protein and it goes wasted in the animal's stool. Severely affected animals can become hypoalbuminemic and begin accumulating water in their abdomen and chest cavities. Another disease called protein losing enteropathy or PLE also interferes with protein absorption and can cause the same symptoms.
 
During these episodes of hypoalbunemia, transfusions of blood serum can reverse the fluid accumulation and give veterinarians an opportunity to make dietary adjustments to manage the condition.
 
Recent Research
 
At the recent American College of Veterinary Internal Medicine in Nashville, Tennessee, veterinary researchers presented a study* where human serum albumin was transfused to dogs with IBD and PLE that were experiencing acute fluid accumulation in the abdomen and chest due to low serum albumin. They found that the transfusions were effective, safe, and had rejections rates no higher than is expected with blood or other types of transfusions.
 
This research suggests that you can now help your pet in the event of a hypoalbuminemia.
 

Dr. Ken Tudor
 
*This study has not yet been published.
 
Image: Ljiljana Jankovic / Shutterstock
 
Related Content
 

New Medical Option for Inflammatory Bowel Disease
 
Inflammatory Bowel Disease (IBD) in Cats
 
Inflammatory Bowel Disease (IBD) in Dogs
 

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TheOldBroad Serum albumin 12/04/2014 06:01pm There's no DNA or immuno-anything in serum albumin that would cause one to be concerned about a reaction?

If not, that's a most excellent thought. Hopefully you'll learn more about this and share! Reply to this comment Report abuse 1 dogaware How to get the albumin? 12/05/2014 02:26pm How would the albumin be collected from the person? I assume a veterinarian isn't allowed to draw blood from a human. The blood would also have to be processed to separate out the albumin -- who would do that? Reply to this comment Report abuse 1 Jim Dandy 12/06/2014 01:06am Fear not, if there's a need to be filled, someone will fill it. The technology must exist in order for the research to be performed to test/prove that this is possible. Now that there is another way for humans to help animals you can bet there will be manufacturers filling the need for the machinery and that means there will be people getting training/educated on this process and the operation of this equipment and taking jobs providing the service. As long as people have pets they will be willing to spend money to keep them alive and healthy, that translates into profit for manufacturers and technicians so there will be someone with the proper equipment willing to do the job as needed as soon as the process is refined enough to be practical. Reply to this comment Report abuse 1
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http://www.petmd.com/blogs/thedailyvet/ken-tudor/2014/december/how-humans-can-save-dogs-blood-transfusions-32245#comments TheDailyVet Thu, 04 Dec 2014 11:00:00 +0000 32245 at http://www.petmd.com
How Do You Answer Your Veterinarian's Questions? http://www.petmd.com/blogs/thedailyvet/drjintile/2014/december/how-do-you-answer-your-veterinarians-questions-32241







The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets. < Previous Post Next Post > Dec 03, 2014 How Do You Answer Your Veterinarian's Questions? by Dr. Joanne Intile     Share    
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The five crucial components to a veterinary visit include recording a patient's vital signs, taking a complete medical history, performing a comprehensive physical exam, recommending laboratory tests, and discussing the utility of other ancillary studies. You might be surprised to learn that the most useful of those five pieces of the diagnostic puzzle has nothing to do with fancy machines or expensive laboratory tests. 
 
Any vet worth their weight in prednisone will tell you it’s the patient’s history and current physical exam that are the most crucial contributors to answering the proverbial question of “What’s going on with Fluffy?”
 
Veterinarians are trained in the art of obtaining a thorough medical history in school, where we’re exposed to a variety of interrogation techniques during our curriculum. The most important aspect ingrained in us, above all else, is to avoid asking closed-ended questions.
 
For example, when faced with an owner who is worried about the way their pet is breathing, instead of asking “Does Fluffy pant?” which can be answered with a simple “yes” or “no” response, we should inquire “Describe Fluffy’s breathing.” The latter allows for further probing, establishment of trust between the doctor and client, and, ultimately, a more open dialogue.
 
The goal of asking open-ended questions is to allow owners to not only give as much information as possible as to what they perceive is happening to their pets, but also to empower them to feel as though they are an active participant in the process.
 
It all sounds wonderfully productive in theory. However, at least once a day I find the tactic of asking open-ended questions about as successful in helping to achieve a diagnosis as attempting to communicate anything to my husband during Sunday night football. In other words, it just doesn’t work.
 
Here are three very typical scenarios where open-ended questions literally, without fail, detonate within my exam room:
 
Scenario #1: “The Disagreeable Husband/Wife Team”
 
ME: “How is Fluffy’s breathing?”
 
HUSBAND (with a slightly blank look): “She’s breathing fine.”
 
WIFE (looks at husband with shock and horror): “Fluffy’s breathing much harder than ever before. Especially at night. Sometimes it wakes me up and I can hear this noise, like it’s coming from deep in her lungs. It’s very raspy and loud.”
 
ME (struggling): “So Fluffy breathes harder at night? Tell me a little more about this. How long have you noticed this going on?”
 
HUSBAND (with a complete blank look): “I don’t know what she is talking about. Fluffy breathes the same way she has her whole life.”
 
WIFE (shooting daggers from both eyes that are designed to shred her husband’s soul): “Well with as much attention you pay to me, I’m not surprised you haven’t noticed that Fluffy breathes so poorly. She’s been doing it ever since last Thursday, right after Dr. Intile called us with the news about her cancer.”
 
ME (continuing to struggle): “So Fluffy started showing signs of labored breathing after she was diagnosed with her tumor on her paw?”
 
WIFE (interrupting my statement and still addressing her husband in an escalating loud voice): “I can’t believe you didn’t notice her breathing! She’s practically gasping for air, while you sit there and ignore her!!!”
 
ME (hands pressing into forehead): “Moving on…”
 
 
Scenario #2: "The Strong But Silent Type”
 
ME: “How is Fluffy’s breathing?
 
SST: “Fine”
 
ME: “It says here you brought Fluffy to see your primary doctor because she was coughing? Tell me more.”
 
SST: “She does cough”
 
ME: “When did you first notice the cough?”
 
SST: “A while ago”
 
ME: “When you say ‘a while ago’ do you mean a few weeks or months? Any idea how long it’s been going on?”
 
SST (Pausing): “For a while”
 
ME (hands pressing into forehead): “Moving on…”
 
 
Scenario #3: “The Busy Mom With 3 Children Under The Age Of 4”
 
ME: “How is Fluffy’s breathing?”
 
MOM: “Declan put that down! Do not put that in your mouth! Do you know you are in a VET HOSPITAL with TONS OF GERMS?! Madison, if you don’t stop hitting your brother, you will not get any ice cream! Sophia, sit down! I’m sorry — what did you say?”
 
ME: “Wow, looks like you have your hands full! Let’s try this again. How is Fluffy’s breathing?”
 
MOM: “Fluffy pants a lot. I noticed it back in — Declan stop going through the garbage and do NOT feed that paper towel to Fluffy! Madison and Sophia stop screaming right now! Here’s mommy’s iPad. Why don’t you watch some Elmo” Turning back to me, “I’m sorry, what did you say?”
 
ME: (hands pressing into dents that are now permanently located along my forehead) “Moving on… and could I please get my stethoscope back from little Declan’s mouth?”
 
 
Despite the communication difficulties, the bottom line is that each of the aforementioned are in the exam room because they love their pets and they want the best information available to help them make a decision about how to pursue their care. But making sure the information flows freely in both directions, from owner to myself and vice versa, can be challenging, to say the least.
 
It’s an understatement to say we could all stand to benefit from working on our communication skills every day. Likewise, no one single communication style will work for every owner, despite what my mentors in vet school taught me.
 
I’ve found that when faced with any one of the situations above, I have to accept it’s just one of those times where the “rules” don’t apply, and we all simply need a break from being open-ended.
 
Instead, a closed ended-question can be just the thing to help move the consult along and help get me to the actual answer of “What’s going on with Fluffy?” so I can move along to the next appointment, and start the adventure all over again!
 
 

Dr. Joanne Intile
 
 
Image: Kachalkina Veronika / Shutterstock
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TheOldBroad Conversations 12/03/2014 07:08pm I can't imagine how difficult it must be to have a coherent conversation when there is more than one client in the exam room and the clients don't give the same responses. I've heard that doctors (both animal and human doctors) many times have to play detective to get good information and this post is a really good demonstration of exactly that!

It was, however, really entertaining. Reply to this comment Report abuse 1
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What Does a Veterinarian Do When a Pet With a Complicated Medical History Gets Sick Again? http://www.petmd.com/blogs/thedailyvet/patrick-mahaney/2014/december/what-does-veterinarian-do-when-pet-complicated-medic









The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets. < Previous Post Next Post > Dec 02, 2014 What Does a Veterinarian Do When a Pet With a Complicated Medical History Gets Sick Again? by Dr. Patrick Mahaney     Share    
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Since November’s National Pet Cancer Awareness Month is ending, this will be the last of my cancer-related posts in this column for the time being.
 
For those of you petMD readers who aren't aware, my dog Cardiff has endured three episodes of typically fatal immune mediated hemolytic anemia (IMHA) and one bout of cancer (T-cell lymphoma) in his nine years of life.
 
Having a pet that has gone through both immune mediated (“autoimmune”) disease and cancer is a challenge for any owner or its overseeing veterinarian, as there always is the concern that either or both illnesses will recur.
 
Since Cardiff finished his course of chemotherapy for lymphoma this summer, he’s been feeling energetic, eating with a normal appetite, enjoying challenging hikes at home in Los Angeles, and lakeside sprints in Massachusetts. Yet, just when we thought everything was going great, his day-to-day health started to decline this fall.
 
What is Currently Going on With Cardiff’s Health?
 
Cardiff’s latest health issue started with non-life-threatening clinical signs that wouldn’t normally cause significant concerns for the typical pet owner. Of course, Cardiff isn’t an average pooch and I’m a highly-informed pet owner, so any deviation from his normal is highly scrutinized for potential causes and outcomes.
 
Cardiff's clinical signs included:

Anorexia — decreased appetite (partial anorexia in Cardiff’s case, as we were still able to get him to eat some food)


Lameness — limping (alternating between right and front limbs in Cardiff’s case due to osteoarthritis in his toes)


Lethargy — lower energy, sleeping more, exercise intolerance, etc.

 
Partial anorexia, lameness, and lethargy were also the main clinical signs Cardiff exhibited during his most recent IMHA episode in 2009. The lameness doesn’t fit the bill for his cancer, which manifested as a tumor on a loop of small intestine that prevented food and fluid from appropriately moving in a downward direction. Due to the intestinal tumor, Cardiff was having partial anorexia, lethargy, and regurgitation of the food (seemingly undigested) he had eaten hours before. Of course, anorexia and lethargy are also consistent with lymphoma, other cancers, or a variety of other diseases (glandular problems, infection, toxicity, etc).
 
In Cardiff’s case, I was left with another challenging puzzle to solve before determining the most appropriate course of treatment.
 
How Was It Determined That Cardiff Was Having IMHA Again and Not Cancer?
 
Since the completion of his chemotherapy in July 2014, I’ve been running routine blood screening on Cardiff approximately every 30 days. The good news in working up his latest bout of illness is that his latest blood tests weren’t overly remarkable.
 
With IMHA, the red blood cell, hemoglobin (iron component of red blood cells that transports oxygen), and hematocrit (percentage of the blood made of red blood cells) levels are those values that indicate a problem when they are low. Of course, there’s a wide range of normal for these values. So, a pet may not yet be anemic (low red blood cell count) but could be having an emergence of IMHA, as not enough red blood cells have yet been destroyed to cause the red blood cell level to be low. Seeing all three tests appear within normal limits (or WNL, as we veterinarians like to say) in Cardiff’s case is a positive finding, but it doesn’t mean that the patient is normal and that there’s not a disease process occurring.
 
Another hallmark of hemolytic anemia (where a disease process destroys red blood cells) is elevated bilirubin, which causes a distinct yellow appearance to the serum (the parts of the blood not made up of red/white blood cells and platelets). When whole blood is centrifuged (spun down) in a serum separator tube, the serum rises to the top and all other blood components are displaced to the bottom of the tube. Red blood cell destruction or liver and gall bladder diseases cause elevated bilirubin, which lends a distinct, bright-yellow to orange appearance, known as icterus, to the serum. Additionally, the sclera (white of the eye), gingiva (gums), and skin of the inner ear flaps and other ares of the body having less hair can also take on a characteristic yellow appearance that we veterinarians never like to see when evaluating our patients.
 
Seeing Cardiff’s low normal red blood cell level and normal bilirubin certainly provided some sense of relief, but during his initial stages of his previous bouts of IMHA there also were no significant abnormalities. Ultimately, Cardiff’s red blood cell levels then started rapidly dropping and his bilirubin increased.
 
One hallmark of both Cardiff’s IMHA and cancer has been a reduced T4 (baseline thyroid level), which can be low-normal or low due to a phenomenon called euthyroid sick syndrome. This means that a pet isn’t hypothyroid, but there’s another disease process (infection, inflammation, immune-mediated disease, cancer, etc.) that is causing the level to falsely appear low. Further thyroid testing can differentiate among hypothyroidism and euthyroid sick syndrome. So, besides IMHA, Cardiff could be having a reemergence of lymphoma or even another cancer that was suppressing his T4.
 
The deeper diagnostic process to further evaluate Cardiff’s current issue then began. Due to his previous history of intra-abdominal cancer, Cardiff underwent chest, abdominal, and front limb radiographs (X-rays) and abdominal ultrasound (thank you Southern California Veterinary Imaging). Fortunately, none of Cardiff’s imaging showed any evidence of cancer nor other major concerns, so the highest differential diagnosis was IMHA and the treatment process began.
 
What Kind of Treatment Does Cardiff Need to Treat His IMHA?
 
Where are multiple aspects to Cardiff’s IMHA treatment, with the primary components being:
 

Immunosuppression — Drugs are used to suppress the immune system from attacking its own tissues: red blood cells in Cardiff’s case. In Cardiff’s case, I’m using Prednisone and Azathioprine (Imuran) as he’s shown a favorable response to both medications before. The ultimate goal is to taper down and discontinue the Prednisone while maintaining the non-hemolytic state with Azathioprine every 48 hrs (every other day).


Blood Transfusion — To permit body tissues to oxygenate in the face of the red blood cells being destroyed, a whole blood or red blood cell transfusion is needed. Cross-matching the donor to the recipient is essential to minimize potentially life-threatening transfusion reactions.


Management of Side Effects — Prednisone is a steroid with many side effects besides immunosuppression, including polydipsia, polyphagia, polyuria (increased water consumption, appetite, and urine output, respectively), gastrointestinal inflammation/ulceration, liver inflammation/enlargement, susceptibility to opportunistic (secondary) infections. Azathioprine is a purine analog that also helps to control the immune response and has many fewer side effects than Prednisone, but it can cause pancreatitis (inflammation of the pancreas).

 
Supporting Whole Body Health — Cardiff takes supplements and herbs to support all body systems, including:

Rx Vitamins for Pets Nutrigest (probiotic and digestive tract support)


Honest Kitchen ProBloom (dehydrated goat’s milk with probiotics and digestive enzymes)


Functional Nutriments Nutrocept (joint-supporting glucosamine and other ingredients that augment whole-body function, which is a maintenance version of the Apocaps he took during his cancer treatment)


Nordic Naturals Omega 3 Pet (fish-oil based omega 3 fatty acids that have a natural anti-inflammatory effect)


Nutramax Denamarin (milk thistle/SAMe combination to enhance the liver’s detoxifying function)


TCVM Herbal Wei Qi Booster (herbal combination that moves blood and has an anti-cancer/anti-inflammatory/anti-bacterial/anti-viral effect)


Vitamin B12 injections (for digestive and immune system support)


Iron injections and oral supplementation (iron is the basic building block of hemoglobin)

 
How Can a Pet Owner Help Prevent IMHA Development and Recurrence?
 
The management of diseases like IMHA is complicated and expensive, so the best strategy is to reduce immune system stimulation, including:
 

Avoiding stinging-insect or other hypersensitivity (“allergic”) reactions — bee stings, snake bites, exposure to environmental allergens/toxins, and consumption of certain foods all can activate the immune system and should be avoided as much as possible.


Preventing or resolving inflammation and infection — joint, skin, intestinal, and other body system inflammation and infections (periodontal disease, bacteria from fleas/ticks, etc.) can trigger an immune system response. Therefore, minimizing the presence of such immunostimulants is key to IMHA management.


Determining alternative strategies to vaccinations — Although vaccinations are important to create immunity to infectious diseases, the immunity often carries on longer than the recommended booster time. As single or multiple vaccination can cause a vaccine associated adverse event (VAAE), it’s best that owners who have a pet with an immune system disease like IMHA, cancer, or others, work with their veterinarians to determine an appropriate alternative strategy (vaccine antibody titers via VacciCheck, lifestyle modification, etc.).

 
Why Did Cardiff Have a Recurrence of IMHA?
 
In Cardiff’s case, my strongest inclination as to why his IMHA recurred was the fact that I did not start him back on the immunosuppressive drug Azathioprine. This drug was seemingly the key to keeping him from developing an over exuberant immune system for a four-year stretch from 2009-2013. During this time, Cardiff took Azathioprine at a bodyweight appropriate dose on an every 48 hour (every other day) frequency and tolerated it extremely well.
 
When Cardiff was diagnosed with lymphoma in December 2013, I elected to discontinue his Azathioprine, as immunosuppressive drugs can inhibit the surgical recovery process and he needed to heal from the surgery to remove his small intestine tumor. The extensive course of chemotherapy served also as an immunosuppressant, so providing him with Azathioprine was deemed unnecessary at the time.
 
Once he was done with his chemo, I speculated as to whether we should again start the Azathioprine. Both Cardiff’s internal medicine specialist and oncologist hadn’t previously cared for a patient having the “double whammy” of diseases like Cardiff, so they were unsure as to what was the best option for him.
 
I felt taking the watchful waiting approach seemed appropriate considering all Cardiff had been through, and for some time this approach seemed to be working. Yet, as soon as Cardiff started to again show his clinical signs of IMHA I found myself regretting the decision to not put him back on Azathioprine.
 
Needless to say, after one transfusion of red blood cells, high doses of Prednisone, daily treatment with Azathioprine, ongoing whole-food diet feedings, and the combination of immunosupportive supplements and herbs, he’s nearly back to normal. He’s gained some weight from his Prednisone, which has been drastically tapered, and recently suffered a bout of pancreatitis (either from his Azathioprine or being overindulged at a temporary caretakers house), but he’s pretty much the Cardiff of his pre-cancer days.
 
Now I just need to continue weekly blood testing, schedule a follow up abdominal ultrasound ( at three month intervals), continue to taper and discontinue his Prednisone, keep him on Azathioprine, appropriately modify his supplements and herbs, and watchfully wait.
 

Cardiff’s hematocrit tubes (pre- and post-transfusion) with ongoing icteric serum
 

Icetric serum (yellow to orange is bad!)
 

Cardiff getting a blood transfusion accompanied by his other daddy, Phil
 

Cardiff getting a blood transfusion
 
 

Dr. Patrick Mahaney
 
 
Related
 
Documentary on Pet Cancer Aims to Lower Cancer Related Deaths
 
What Can Be Learned About Treating Cancer in Captive Apes?
 
A Doggy Birthday Party, Celebrities, and the CLEAR Foundation Fight Cancer with a Fundraiser
 
When Pets Complete Chemotherapy Are They Cancer-Free?
 
Unexpected Side Effects of Chemotherapy Treatment
 
Feeding Your Dog During Chemotherapy Treatment
 
Can a Veterinarian Treat His Own Pet?
 
How a Vet Diagnoses and Treats Cancer in His Own Dog
 
A Veterinarian's Experience with Treating His Dog's Cancer
 
Image: Cardiff getting a blood transfusion
 
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TheOldBroad Cardiff 12/02/2014 06:48pm Poor little guy, having to deal with all this!

Glad to hear he's almost back to normal, though. He's so lucky to have a human that keeps a close eye and knows exactly what to look for. (And not afraid to deal with complicated treatment.)

I'm guessing that Cardiff won't be hiking in the woods any time soon.

What do you do about flea and tick medications? Surely that would make his system go haywire. Reply to this comment Report abuse
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How Dog Food Can Help Manage Pancreatitis http://www.petmd.com/blogs/thedailyvet/dr-coates/2014/december/how-dog-food-can-help-manage-pancreatitis-32174
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The Case of the Nearly Exploding Cow http://www.petmd.com/blogs/thedailyvet/aobriendvm/2014/november/case-nearly-exploding-cow-32172









The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets. < Previous Post Next Post > Nov 28, 2014 The Case of the Nearly Exploding Cow by Dr. Anna O'Brien     Share    
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I’ve written a lot in past blogs about the amazing physiology of the cow. From cud chewing to massive milk production, the bovine is an impressive feat of engineering, for sure. But, as with most biological systems, there are occasional design flaws.
 
Take the rumen. This giant fermentation vat, encompassing the majority of the bovine’s upper digestive system, is home to billions of microorganisms that break down the grass and hay the cow consumes. If you looked at a functioning rumen in cross-section, you would notice there are layers to its contents; this is called the compartmentalization of the rumen. At the bottom of the rumen is a liquid layer. This is the most-digested stuff — food that’s been sitting in there the longest, waiting to pass into the intestines. The layer on top of that is called slurry — sort of a mix between liquid and solid. This is the almost-digested stuff. On top of the slurry is the solid layer. This is the stuff just-chewed, the hay and grass, creating a mat that floats on top. Above this mat is gas, the by-product of all the fermentation going on inside.
 
Normally, the “gas cap,” as it’s called, floats happily at the top of the rumen with periodic escapes through the esophagus. Bovines burp (the medical term is eructate) a lot because of this. But what happens what that gas cap can’t escape? You get a bloated cow.
 
There are two ways a cow can bloat. One type occurs if the esophagus is physically obstructed, preventing the release of gas. The second type, called frothy bloat, occurs when the cow has consumed a lot of lush legume grass such as clover or alfalfa. The consumption of a large quantity of rich legumes creates foam in the rumen that sits on top of the gas cap. The small bubbles in this foam prevent the cow from burping and releasing gas.
 
If the gas is not released either mechanically through passing of an orogastric tube or chemically via administration of a surfactant that breaks down the froth in a way not dissimilar to soap detergent, the animal will die.
 
I have encountered bloat occasionally. One case particularly sticks out in my memory.
 
One afternoon, a client called in a panic about her daughter’s 4H show steer. She reported that he seemed bloated and wasn’t sure what to do. I came right out and found an ornery steer and a frantic and frazzled client who had just struggled to get the steer into the chute.
 
I brought out my orogastric tube and was quickly feeding it down the steer’s mouth through a metal speculum. I looked over at the client, discussing how sometimes you’ll be able to hear the gas rushing out of the tube when suddenly: POW! A wad of partly chewed cud flew out of the tube onto the shoulder of the client, followed by a huge rush of air.
 
“WOW!” I said, relieved at the instantaneous and very satisfying resolution of the problem at hand.
 
“ARGGGGG!” yelled the client in horror at the unexpected lump of grassy goo on her person.
 
I couldn’t help it. I burst out laughing. I mean, who wouldn’t, right?
 
After the initial shock subsided and the client realized her steer was back to normal, she, too, started laughing. Thank goodness for clients with a sense of humor! To add to the humorous mayhem, after complaining that this steer “had a mind of his own” and was the “most ornery steer I’ve ever dealt with,” the steer mostly dragged the client out of the chute and back to the pasture gate.
 
After making sure said steer was safely put away and the client hadn’t been yanked around too harshly, I giggled my way back to my truck. Who knew bloat could be so entertaining?
 

Dr. Anna O'Brien
 
Image: smereka / Shutterstock
 
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TheOldBroad *Chuckle* 12/01/2014 06:58pm After everyone got done laughing, is there a need to find out why the steer couldn't belch? Is there a danger of this happening again? Reply to this comment Report abuse 2
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'Rich' Ingredients on the Pet Food Label Are Worthless http://www.petmd.com/blogs/thedailyvet/ken-tudor/2014/november/rich-ingredients-pet-food-label-are-worthless-32171









The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets. < Previous Post Next Post > Nov 26, 2014 'Rich' Ingredients on the Pet Food Label Are Worthless by Dr. Ken Tudor     Share    
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The focus of the holidays always seems to center around food in some way or another. When people talk about nutrition, human or pet, the word “rich” is frequently heard. Foods will be referred to as rich in this vitamin, that mineral, or those fats.
 
Commercial pet food companies promote their diets as rich in this or that. Those who make homemade diets also like to use the word rich about their chosen ingredients. Unfortunately, we tend to use the word “rich” to mean adequate. The implication is that if a food rich in X is in the diet, in whatever amount, it represents a nutritionally adequate amount of X.
 
But rich is a comparative word, not a quantitative one. Rich only refers to a comparison to something else, generally a food that is deficient or contains miniscule amounts of the identified nutrients.
 
The concept of rich has also spawned many new pet feeding philosophies. Many dog owners are now regularly fasting their dogs 1-2 days a week. A celebrity vet is encouraging the “hybrid diet,” where dogs are fed a balanced commercial diet 5 days a week and then given any unbalanced combination of table scraps or people food for 2 days. And a popular manufacturer of raw foods advocates an “ancestral diet” that is fed as little as once a week to provide the nutrients he feels are necessary to achieve the right ancestral mix of protein and fats.
 
These various programs are predicated on the assumption that replacing foods “rich in” will make up for any deficiencies during deprivation or are capable of correcting all deficiencies that were previously present. It is a concept of “biological catch-up” that is a not supported by nutritional science. I will address the concept of biological catch-up in a separate post.
 
Rich is a Meaningless Word
 
As mentioned, rich is a comparative term and is meaningless with regards to nutrition.
 
I have had actual conversations with owners who insisted that the chicken and brown rice diet they were feeding their dog is adequate in calcium because they added kale, a food considered rich in calcium. When I point out that it takes eighteen cups of cooked kale or nineteen cups of chopped raw kale for every 1,000 calories of chicken and rice to provide the daily requirement of calcium, they are mystified.
 
If they substituted milk in the diet, another touted rich source of calcium, it would take almost 5 cups of milk and 12 cups of cottage cheese per 1,000 calories of chicken and rice for adequate calcium. It would be impossible and not even advisable to feed these amounts of kale, milk, or cottage cheese to your dog.
 
The point is, the word rich is meaningless. In science, if it isn’t measured it didn’t happen. If you don’t know the quantity and comparison of that quantity to daily requirements, you cannot assume it is adequate. Rich is not a guarantee of quantity.
 
I could repeat this exercise for almost every necessary nutrient, even mixing the ingredient choices to reduce volumes, and the results would be the same. It takes an un-consumable amount of food or a consumable amount that far exceeds caloric intake to balance a diet with foods that are “rich in...”
 
With all due respect to Dr. Oz, “rich in” means nothing.
 

Dr. Ken Tudor
 
Image: guidocava / Shutterstock
 
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TheOldBroad Agree! 11/26/2014 03:17pm What you say makes perfect sense. I am, however, horrified that some people don't feed their pets daily. And, of course, I'm equally horrified that some people are feeding their dogs/pets an unbalanced diet two days a week. (I'm sure the critters are loving it, though!)

To me, "rich in" means that something is abundant, not just adequate.

Chicken, brown rice and kale doesn't strike me as an adequate diet for any living creature. There are other vitamins and minerals necessary - not to mention the inadequate calcium you mention.

This post gives some extreme fad diets for pets and I sure hope that people aren't taking them too seriously. Sadly, there's always someone who will. Reply to this comment Report abuse 1 Purrsngrrs Variety 11/30/2014 05:59pm Pets should never be fed same thing on daily basis. They need to eat as much variety as we humans do. All nutrients are equally important in dog or [url=http://purrsngrrs.com/homemade-cat-food-cats/]cat food[/url]. I don't know much about other pets but dogs and cats should eat high protein but low carbo diets. Reply to this comment Report abuse 1 rodrussell Gratuitous Slam @Homemade 12/02/2014 05:45pm You write: "Those who make homemade diets also like to use the word rich about their chosen ingredients." --- Even when you critically analyze commercial pet foods, you still have to throw in a gratuitous slam at the homemade foods. There is a BIG difference between a major pet food manufacturer hyping its junk kibble as "rich in", and a little homemaker using the that term in a conversation over the backyard fence to her neighbor. The manufacturer is committing a nationwide fraud and the homemaker is only feeding her own pets. Reply to this comment Report abuse 3
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The Philosophy Behind Diagnosing Diseases in Pets http://www.petmd.com/blogs/thedailyvet/drjintile/2014/november/philosophy-behind-diagnosing-diseases-pets-32169









The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets. < Previous Post Next Post > Nov 25, 2014 The Philosophy Behind Diagnosing Diseases in Pets by Dr. Joanne Intile     Share    
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I have an unusual fascination with the concept of medicine as both an art and a science. Superficially, the two disciplines have little to do with each other. Where medicine is sterile, factual, statistical, and specific, art is paradoxically relaxed, fluid, and imaginative.
 
The role for creativity in the mind of a doctor is limited. We are thinkers and memorizers of minutia. Artists are thoughtful and philosophical. The proverbial war of the left brained versus the right brained prevails.
 
The ancient Greek physician Hippocrates is credited with being the first to truly separate medical science from religion and philosophy, based on his belief that disease was not a punishment inflicted by the gods but rather the product of environmental factors, diet, and living habits. For this, he is touted as being the “father of medicine.”
 
Fast-forward a thousand years and we meet a lesser known, but equally influential, ancient physician named Claudius Galenus. Galenus studied Hippocrates’s understanding of pathology but was also heavily influenced by the writings of the great Greek and Roman thinkers like Plato and Aristotle. He recognized medicine as an interdisciplinary field that was best practiced by utilizing theory, observation, and experimentation in conjunction.
 
One of Galenus’s most famous writings is the treaty entitled “That the best physician is also a philosopher,” which called for a melding of rationalist and empiric medicine sects. Galenus believed the best doctors were the best because they really thought about what they did.
 
My obsession with medical philosophy introduced me to the interesting and opposing theories called Occam’s razor and Hickam’s dictum. No, these strange sounding terms do not refer to unusual diseases but rather to two important, yet contradictory, fundamental philosophical ideals of medicine, with specifics regarding the approach to the diagnosis of disease.
 
Occam’s razor refers to the idea of “diagnostic parsimony,” which means that when diagnosing a given injury, ailment, illness, or disease, a doctor should strive to look for the fewest possible causes that will account for all the symptoms.
 
Hickam’s dictum counterbalances Occam’s razor by stating that more often it’s statistically more likely that a patient has several common diseases rather than a single, rare disease that explains a myriad of symptoms.
 
In veterinary school we learn when that we hear hoofbeats, we should look for horses, not zebras. The adage refers to more than just the sounds made by the limbs of our patients. Essentially, we’re trained to think more like Occam and base our diagnoses on the idea that “common things happen commonly.”
 
An unvaccinated puppy with vomiting, bloody diarrhea, and a fever likely has parvovirus. An older cat with vomiting, weight loss, a rough hair coat, and a lump on its throat likely has hyperthyroidism. In other words, keep it simple, explain things in the most uncomplicated way, and you will have your answer.
 
There are times, as a veterinary oncologist, when I find Occam’s razor to be a bit cumbersome. Don’t get me wrong — I’m a huge fan of giving my patients as few problems as possible, and I’m happy to leave Hickam’s mentality to my internist friends who love to come up with dozens of differential diagnoses for each and every one of a patient’s clinical signs. But I can’t ignore the innumerable instances where I’ve seen Occam’s line of thinking not only to be wrong, but also downright dangerous for my patients.
 
Perhaps the worst “Occam offense” occurs when a veterinarian concludes a pet’s most likely diagnosis is cancer based solely on demographical characteristics such as age or breed, in lieu of performing diagnostics designed to verify their suspicions.
 
I understand owners are reluctant to spend money on expensive tests when the outlook for their beloved companion may be poor, and vets are often expected to offer their professional opinion as to a diagnosis prior to having the evidence they need to be sure. This doesn’t excuse doctors from their responsibility for knowing and stating their limitations and their obligation to divulge their inability to predict an outcome off of limited information.
 
Occam’s razor also fails owners when we “blame” cancer, or anti-cancer treatments, for a pet’s adverse signs, behavior changes, or labwork alterations that actually result from a completely separate illness or condition. Cancer most commonly strikes older to geriatric pets, a population of animals predisposed to a wide variety of chronic, progressive diseases. 
 
Sometimes a cat with lymphoma isn’t eating well because it has worsening kidney disease unrelated to its cancer. Sometimes dogs have diarrhea because they’re fed a remarkable amount of table scraps and it has nothing to do with their chemotherapy.
 
I don’t think it’s an end-all-be-all West Side Story type of analogy, where a veterinarian must choose whether they’re an Occam or a Hickam. That’s an oversimplification of the point I’m trying to make.
 
The more important issue is how we need to open up some of the tunnel vision that blinds us to the bigger picture of what’s really going on with our patients. We’re obligated to treat the whole animal, and its family, with equal parts respect and knowledge. Occum’s razor isn’t an excuse for laziness or ineptitude.
 
If we sway too far towards diagnostic parsimony, we could easily miss important signs of other diseases or conditions that are unrelated to our primary concern. Likewise, it’s possible to knit pick each and every detail of a pet’s case to the point where we are blinded by the possibilities of their pathology.
 
Finally, pet owners should keep an open mind when it comes to their veterinarian’s recommendations for further testing when a definitive diagnosis has not yet been achieved. Opinions and experience account for a great deal of the art of medicine, but there’s also a tremendous amount of data garnered from the plain old science part of the discipline as well.
 
Maybe the hoofbeats are zebras more often than we think.
 
Maybe I sound a bit too philosophical for a doctor. 
 
Maybe they said the same thing about Galenus…
 

Dr. Joanne Intile
 
Image: Javier Brosch / Shutterstock
 
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TheOldBroad Philosophy 11/25/2014 06:04pm Great post! I'm a big fan of Occam, although I confess that after I Googled Occam's Razor, I found that I completely misunderstood it. I always thought it was more "the simplest solution is many times the best solution."

Luckily my vet is apparently a fan of both lines of thinking. More than once he has correctly figured out that a kitty has more than one thing going on concurrently. Reply to this comment Report abuse 1
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http://www.petmd.com/blogs/thedailyvet/drjintile/2014/november/philosophy-behind-diagnosing-diseases-pets-32169#comments TheDailyVet Tue, 25 Nov 2014 11:00:00 +0000 32169 at http://www.petmd.com
Surgical Site Infections Benefit Some Dogs with Bone Cancer http://www.petmd.com/blogs/thedailyvet/dr-coates/2014/november/surgical-site-infections-benefit-some-dogs-bone-cancer-321









The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets. < Previous Post Next Post > Nov 24, 2014 Surgical Site Infections Benefit Some Dogs with Bone Cancer by Dr. Jennifer Coates     Share    
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“Infections are bad.”
 
Now there’s a statement that seems self-evident, right? But as is always the case in veterinary medicine, exceptions to the rule exist. I know of at least one instance when a surgical site infection can be looked at as, if not exactly a good thing, at least a cloud that might very well have a silver lining.
 
Osteosarcoma is the most common type of bone cancer in dogs and usually affects a leg, although other locations are possible. The disease is most commonly diagnosed in middle-aged or older large and giant breeds of dogs. The first symptom that develops is usually a limp. Owners often think something relatively benign like arthritis is to blame, and leave the veterinary hospital heartbroken because their dog has just been diagnosed with a fatal disease.
 
Treatment for osteosarcoma is often worthwhile, however. Studies show that dogs who undergo amputation of the affected leg and no other form of treatment live, on average, another five months. When amputation isn’t possible (e.g., for pets whose other limbs are compromised by arthritis or neurological disease), limb-sparing surgery is a good, albeit expensive, alternative. Post-operative chemotherapy increases the median survival time after surgery to around one year. Radiotherapy can also play a role in treatment, either to eliminate cancerous tissue that can’t be surgically removed or simply to reduce pain.
 
I tell owners to make the decision for or against surgery and chemotherapy with that one year median survival number in mind. Of course, the very definition of “median” means that some dogs do worse and others do better. Is there something that the dogs who live longer than one year after diagnosis have in common? This is the question that a group of scientists recently tried to answer.
 
They combed through the medical records of 90 dogs with appendicular [affecting the limbs] osteosarcoma looking at a variety of parameters. Eighty-nine dogs (99%) underwent surgery, and 78 (87%) received chemotherapy. The median survival time beyond one year for these dogs was approximately 8 months (range 1 to 1,899 days). Nineteen dogs (21%) lived for more than 3 years, and 5 dogs (6%) lived for more than 3 years after diagnosis.
                                                                                                                                              
Of all the parameters the scientists evaluated that could potentially affect a dog’s survival time, the one that stood out was infection of the surgical site after limb-sparing surgery. The 20 dogs who had this complication had a median survival time after 1 year of 180 days (range 25 to 1,899 days) in comparison to the other dogs whose median survival time after 1 year was 28 days (range 8 to 282 days).
 
Two studies prior to this one had similar results, which makes one think this is a real effect, not an arbitrary finding. Veterinarians currently hypothesize that a type of “bystander effect” is at work in these cases. The immune system’s response to the infection inadvertently enhances its ability to recognize cancerous cells as a threat, thereby prolonging survival.
 
Postoperative infections aren’t all good news, of course. They increase the cost of treatment, cause discomfort for the patient, and can even shorten survival times if they don’t respond to antibiotics. So while no one is recommending that we intentionally contaminate the surgical site of a dog undergoing limb sparing surgery for osteosarcoma, if infection does develop, a small smile isn’t an irrational response.
 

Dr. Jennifer Coates
 
 
Reference
 
Evaluation of outcome and prognostic factors for dogs living greater than one year after diagnosis of osteosarcoma: 90 cases (1997-2008). Culp WT, Olea-Popelka F, Sefton J, Aldridge CF, Withrow SJ, Lafferty MH, Rebhun RB, Kent MS, Ehrhart N. J Am Vet Med Assoc. 2014 Nov 15;245(10):1141-6
 
 
Image: Jaromir Chalabala / Shutterstock
 
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TheOldBroad Fascinating! 11/24/2014 06:15pm "The immune system’s response to the infection inadvertently enhances its ability to recognize cancerous cells as a threat,"

I wonder why the immune system sees the infection as a threat, but not the cancer.

Hopefully someone is studying to find a way to stimulate the immune response without causing an infection. Perhaps there's a way to inject something into the cancer to cause the immune system to attack it. Reply to this comment Report abuse 1 Dr. Jennifer Coates 11/25/2014 10:53am "I wonder why the immune system sees the infection as a threat, but not the cancer."

Cancers have evolved multiple ways to evade detection by the immune system. Reply to this comment Report abuse
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http://www.petmd.com/blogs/thedailyvet/dr-coates/2014/november/surgical-site-infections-benefit-some-dogs-bone-cancer-321#comments TheDailyVet Mon, 24 Nov 2014 11:00:00 +0000 32168 at http://www.petmd.com
Documentary on Pet Cancer Aims to Lower Cancer Related Deaths http://www.petmd.com/blogs/thedailyvet/patrick-mahaney/2014/november/documentary-pet-cancer-aims-lower-cancer-related-dea









The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets. < Previous Post Next Post > Nov 20, 2014 Documentary on Pet Cancer Aims to Lower Cancer Related Deaths by Dr. Patrick Mahaney     Share    
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November is National Pet Cancer Awareness Month, so my PetMD Daily Vet articles are trending toward topics pertaining to cancer diagnosis and treatment.
 
The statistics about cancer in our pets are astounding and are definitely not in favor of our companion canines and felines.
 
According to PetCancerAwareness.org:
 

Cancer accounts for nearly 50% of all disease-related pet deaths each year (via The Veterinary Cancer Center)


Dogs get cancer at roughly the same rate as humans (via the American Veterinary Medical Association)


Approximately 1 in 4 dogs develops a tumor of some kind during his lifetime (via the American Veterinary Medical Association)

 
If you're not already aware, I have endured the process of putting my own pet through surgery and chemotherapy to resolve his cancer. It's been a challenging yet inspirational process that has taught me much about the integrative approach to Cardiff’s cancer care, where I combine Western (conventional) and Eastern (Chinese medicine) approaches to consider his disease and treatment from a holistic perspective (see links to Cardiff’s story and others on PetMD and Pet360 at the end of this article).
 
As a veterinarian, one of the top goals in my practice is to reduce the likelihood that my patients will be exposed to man-made and environmental toxins that could be carcinogenic (cancer-causing). Yet, sometimes you can strive to do your best in providing a non-toxic existence for your pet, but nature has another plan. Such was the case with Cardiff. 
 
I therefore felt an obligation to share my story as a pet owner and veterinarian dealing with cancer in his own canine companion through a documentary called My Friend: Changing the Journey. Terry Simmons, founder of the Canine Lymphoma Education Awareness and Research (CLEAR) Foundation, and the film’s director, Stacey-Zipfel Flannery, got me involved in the project, which was shot from early spring through summer 2014 and captured many aspects of Cardiff’s cancer treatment. The message I want to convey to other pet owners enduring the trials and tribulations of companion-animal cancer is that there’s hope out there to beat the disease.
 
Paige O’Hara, best known as the memorable voice of Bell from Disney’s Beauty and the Beast, narrated the film, which recently premiered at a fundraiser to benefit CLEAR foundation at the Vertigo Event Venue in Burbank, California. Laura Nativo, a pet-passionate professional dog trainer (CPDT-KA), pet lifestyle expert, and regular contributor to Hallmark Channel’s Home & Family, hosted the event. 
 
Two days later, Nativo and I teamed to educate the Home & Family audience about pet cancer awareness. See the full segment here: Canine Cancer Awareness Month
 
It’s important that all pet owners are mindful of the clinical signs of cancer, which may vary from subtle to obvious. On a weekly basis, I work at the Veterinary Cancer Group  (VCG) in Culver City, CA, alongside veterinary oncologists who provide cutting-edge cancer treatments for dogs, cats, and other species. VCG also educates people on early illness recognition through their 10 Warning Signs of Cancer in Dogs & Cats, which can include:
 

Persistent change in appetite and/or water intake
 



A lump that is enlarging, changing, or waxing and waning in size
 



Progressive weight loss or weight gain
 



Non-healing sore or infection, such as persistent nail bed infection
 



Abnormal odor
 



Persistent or recurring lameness
 



Chronic vomiting or diarrhea
 



Persistent or recurring cough
 



Unexplained bleeding or discharge
 



Difficulty swallowing, breathing, urinating, or defecating

 
In addition to looking for the above clinical signs, I always stress that my clients have their pets undergo a physical examination by a veterinarian at least every 12 months (more frequently with sick animals and those regularly receiving medications). The eyes and hands of veterinarians are highly trained to seek out problems that may not be apparent to the average pet owner. Additionally, thorough history-taking can identify behavioral trends (decreased appetite, lethargy, etc.) that may not seem as serious to a canine or feline caretaker, but may raise concern in the overseeing veterinarian.
 
I hope your pets stay healthy and cancer-free throughout their lives. Should the diagnosis of cancer occur in your pet, I suggest pursuing a consultation with a veterinary oncologist. These specialty-trained veterinarians have dedicated their professional livelihoods to diagnosing and treating cancer and are better resources in determining the most appropriate course of action than are general practice veterinarians, who may only occasionally treat tumors and their associated problems. Ask your regular veterinarian for a referral or you can find a veterinary oncologist in your area via the American College of Veterinary Internal Medicine (ACVIM).
 

The Hallmark Channel’s Home & Family, Mark Steines, Christina Ferrare, Laura Nativo, Cardiff, and Dr. Patrick Mahaney
 

Premiere of My Friend: Changing the Journey; with Terry Simmons, Dr. Patrick Mahaney, Stacey Zipfel-Flannery, Cardiff, Phil Hammond
 
 

Dr. Patrick Mahaney
 
 
You can follow Hallmark Channel’s Home & Family on Twitter: @HomeAndFamilyTV

 
Image: Cardiff getting treatment
 
 
Related articles:
 
What Can Be Learned About Treating Cancer in Captive Apes?
 
A Doggy Birthday Party, Celebrities, and the CLEAR Foundation Fight Cancer with a Fundraiser
 
When Pets Complete Chemotherapy Are They Cancer-Free?
 
Unexpected Side Effects of Chemotherapy Treatment
 
Feeding Your Dog During Chemotherapy Treatment
 
Can a Veterinarian Treat His Own Pet?
 
How a Vet Diagnoses and Treats Cancer in His Own Dog
 
A Veterinarian's Experience with Treating His Dog's Cancer
 
Top 5 Acupuncture Success Stories
 
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TheOldBroad Vets 11/20/2014 06:44pm "The eyes and hands of veterinarians are highly trained to seek out problems that may not be apparent to the average pet owner."

My kitties and I have definitely benefitted from frequent checkups and a great doctor.

Although the diagnosis was devastating and my Louise was only with me for another 10 days, he found her adenocarcinoma when she was asymptomatic. At the very least, it put me in a position to keep a close eye on her to see when she began to suffer so steps could be taken.

He knows the right questions to ask about behavior if he suspects something and can glean information I didn't know I had (and wouldn't have thought to mention). Reply to this comment Report abuse 2
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http://www.petmd.com/blogs/thedailyvet/patrick-mahaney/2014/november/documentary-pet-cancer-aims-lower-cancer-related-dea#comments TheDailyVet Thu, 20 Nov 2014 11:00:00 +0000 32133 at http://www.petmd.com