Pet Quarterly Spring 2014 by VetBoost

Pet Care News From Your Veterinarian ®

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SPR ING 2014 | Volum e 11, No. 2

DITCH THE ITCH

Relief for your pet’s itching and scratching

THERE’S THE RUB Treating feline osteoarthritis

Does Your Pet Have a Toothache? Generic Drugs: Lower Cost Options

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SPRING 2014 | VOL. 11, NO 2

Picture-Perfect Pets Pet Care News From Your Veterinarian

Spazz and Damian

Ocean Animal Hospital Cocoa Beach, Fla.

IN THIS ISSUE 2

Does Your Pet Have a Toothache? Five conditions that cause oral pain.

There’s the Rub 5 As cushioning cartilage thins, senior cats may get osteoarthritis. Know the signs.

Buster Boy

Collingswood Animal Hospital Port Charlotte, Fla.

Lola

Island Veterinary Hospital Key Biscayne, Fla.

Ditch the Itch 8 Relief for your pet’s itching

Coquito

Greenbriar Animal Hospital Jacksonville, Fla.

and scratching—from fungal infections to parasites.

Boka and Spurr

Going Generic Generic versions of brandname drugs provide the same ingredients at a lower cost.

14 GPetreatTales Pyrenees health profile and more.

Ollie Huber

Shelton Veterinary Clinic Interlachen, Fla.

New Hope Animal Hospital Durham, N.C.

Ivy

Animal Health Center of East Palatka Palatka, Fla.

Pet Quarterly® is an educational resource provided by your veterinary hospital. Comments are welcome at info@petquarterly.com ©Copyright 2014. All rights reserved. Pet Quarterly® magazine does not make any representations as to opinions or facts as presented. Reproduction of contents in any form is prohibited without prior written permission of the publisher. POSTMASTER: Send address changes to: Pet Quarterly, 2951 34th Street South St. Petersburg, FL 33711

Dixie, Molly, Gracie

Clay County Animal Hospital Orange Park, Fla.

Pet Quarterly | Spring 2014 1

Dental Health

REASONS

YOUR PET MIGHT HAVE A TOOTHACHE The signs can be subtle—or not noticeable at all— but your pet may still be in pain. By Sharon Hoffman, DVM, Diplomate American Veterinary Dental College

“My dog broke his tooth chewing on his cage and it is bleeding,” the caller explains. “It doesn’t seem to bother him. He’s still eating.” Pets may not show dental pain, but it is just as real for our pets as it is for us. Those of you who have experienced a broken or infected tooth can testify to the agony. A pet may not show signs of dental pain regardless of its severity. You may notice some subtle signs, but in many cases pets suffer in silence. Our pets will continue to eat, play and, in the case of service dogs, work in spite of the pain. I have seen pets with jaw fractures that still eat. There are many causes of oral and dental pain. Here’s a look at five key contenders:

A pet with dental pain may not show the signs and may still eat or play.

2 Spring 2014 | Pet Quarterly

Symptoms of Dental Disease n

Persistent bad breath Sensitivity around the mouth

Pawing at the mouth

Loss of appetite Reluctance to chew hard food or toys

Difficulty eating and chewing food

DID YOU KNOW? Periodontitis may lead to premature tooth loss.

1. Periodontal Disease

The most common source of oral pain in dogs, especially small breeds, periodontal disease is not easy to see because it occurs below the gum around the tooth root. You may, however, smell it. Your pet’s breath will smell strong and unpleasant. Odor is a sign of infection and ongoing destruction of the ligaments and bones that support the pet’s teeth. Pockets of infection form around the tooth under the gum. Some dogs will avoid chewing hard food or will swallow food whole to avoid the pain of chewing. Left untreated, periodontal disease results in ongoing pain, tooth loss and, in severe cases, broken jaws. Starting at two years of age, any small breed dog should have annual dental

X-rays performed by a veterinarian to check for periodontal disease. Prevention of periodontal disease begins with daily dental home care and an annual oral exam by your veterinarian. Once periodontal disease begins, periodontal treatment will be required for the duration of the pet’s life to provide oral comfort and maintain dental health. Periodontal treatment involves more than just a professional cleaning. The periodontal pockets must be cleaned and treated. Surgery may be needed to alleviate pain and maintain affected teeth.

Bleeding, inflamed or receded gums Plaque (often not visible unless stained)

2. Broken Teeth

Broken teeth are the result of trauma. In dogs, this may be self-induced by chewing on inappropriate chew items (nylon >> Pet Quarterly | Spring 2014 3

Dental Health bones, natural bones, cattle hooves, antlers). Or it might be caused by separation anxiety (cage and fence chewing) or dog fights. Both dogs and cats may break teeth during an accident. A broken tooth that involves the pulp causes severe pain, but the pet will still eat, play and work. Bleeding may or may not be evident, especially if the fracture is not recent. The tooth cannot heal or “seal over.” Options for fractured teeth include root canal therapy or extraction. Antibiotics will not help the tooth heal, and watching and waiting only prolongs the pain.

Malocclusion

A pet with malocclusion has teeth or jaws that are not aligned in a normal “bite.” Malocclusions can occur at any age. Some malocclusions are caused when primary teeth (baby teeth) do not fall out when they should. Other malocclusions are inherited, and others are caused by trauma to young growing jaws. Malocclusions can cause painful wounds to the mouth or teeth. To prevent a malocclusion due to persistent primary teeth (baby teeth that have not fallen out), a puppy should have an oral exam by a veterinarian every two to four weeks until all adult teeth have come in. Your veterinarian can examine for any signs of pain due to malocclusion of permanent teeth during your pup’s six-month oral exam.

4. Tooth Resorption

Tooth resorption (when painful holes develop in the tooth) is a common cause of dental pain in cats and is not uncommon in dogs. Resorption can affect any adult tooth and increases in frequency as the pet ages. 4 Spring 2014 | Pet Quarterly

Your pet may avoid chewing on a favorite toy or avoid chewing hard food. There is currently no way to prevent tooth resorption, and we don’t know its cause. Dental X-rays will reveal tooth resorption. Treatment involves surgery to remove affected teeth.

5. Stomatitis

Signs of stomatitis include redness, swelling, ulcers and pain of the gums, lips, back of the mouth and sometimes the tongue and palate. Stomatitis affects both dogs and cats.

This disease can be so painful that a pet may eat less because it associates eating with pain. In severe cases, cats will stop grooming and avoid yawning because opening the mouth widely is too painful. Hiding is a common behavior for a cat with oral pain. The pet may drool and have bad breath. Antibiotics and steroids are only temporary “fixes” for stomatitis. Surgery is needed to control this painful disease.

Taking Away the Pain Dental pain can cause a pet to “act old.” A veterinarian saw a 10-yearold German Shepherd that was being treated for arthritis with pain management. The veterinarian found a molar that had advanced periodontal disease. He extracted the molar. After a couple of days, the pet’s owner reported that her 10-year-old dog was acting like a puppy again. The pain was not due to arthritis but to a single painful tooth. Time and time again, testimonies shared about pets treated for dental or oral pain include a similar story. After being treated for stomatitis a cat picks up a toy for the very first time. Another cat “acts like a kitten again.” Sometimes we really don’t realize how much pain a pet is in until we take the pain away. n Dr. Hoffman is a Board Certified Veterinary Dental Specialist.

A fractured tooth needs a root canal or extraction. Antibiotics will not help the tooth heal.

Senior Wellness

There’s the Rub

As cushioning cartilage thins, senior cats should be examined for osteoarthritis, a common but hard-to-spot joint disease. By Stephanie Gandy Murphy, DVM

If your senior cat seems stiff in the morning, is less active, or doesn’t jump up to its favorite place anymore, it might not just be a sign of age. Most senior cats (80 to 90 percent) experience osteoarthritis (OA) to some degree. Unfortunately, OA is difficult to identify in cats. Their natural agility, small size and tendency to mask the signs of pain are all characteristics that keep them alive in the wild, but make it difficult for cat owners to recognize subtle changes in their movements. Make sure that your senior cat gets a veterinary examination to check for this painful disease, so you can take steps to ease your cat’s discomfort if needed.

Q: What is osteoarthritis? A: Osteoarthritis is a progressive, degenerative disease

involving the joints. Over time, the cartilage (a tough, elastic, fibrous connective tissue) breaks down, and bones

Key Points OSTEOARTHRITIS (OA) IS A PROGRESSIVE, degenerative disease involving the joints. AN ESTIMATED 80 PERCENT TO 90 PERCENT of senior and geriatric cats suffer from OA. SYMPTOMS INCLUDE chronic pain and reduced joint motion. OA IS NOT EASY TO RECOGNIZE in cats.

Pet Quarterly | Spring 2014 5

Senior Wellness

start rubbing together, creating friction, pain, reduced joint motion (more commonly seen in dogs than cats) and sometimes bone spurs.

Q: Who gets it? A: The disease typically affects senior cats (11 to 14 years Osteoarthritis typically affects cats aged 11 years and older.

old) and geriatric cats (15 years or older). Sometimes genetic predispositions (such as hip dysplasia) and other factors such as body weight, growth, nutrition and activity can be responsible for OA in much younger cats.

Q: What is the impact? A: Cats that suffer from OA are stiff and in pain, even

if it isn’t obvious. Prolonged pain can result in reduced quality of life, a change in your cat’s disposition, undesirable behavioral problems and other medical conditions that result from a sedentary lifestyle.

Q: How will a veterinarian examine and diagnose my cat? A: During a typical veterinary exam for OA, your

veterinarian will ask you about your cat’s behavior—how your cat moves, what it is not doing that it used to do, and any changes in behavior that you have noticed. A general physical examination will be followed by a more comprehensive orthopedic exam, which involves isolation and manipulation of each joint. Your veterinarian will then compare the exam results to those of earlier exams, looking for weight loss, muscle atrophy and pain response. Radiographs are a possibility, but it is difficult to detect indicators in cats most of the time. In some cases, your veterinarian may recommend a trial of medication to see if your cat responds in a positive way.

Seeing the Light Laser therapy can help ease the pain of osteoarthritis by reducing inflammation. If your cat is a candidate for laser therapy, your veterinarian or a trained technician will use a hand-held laser to send energy (photons) into the cat’s bodily tissues. During treatment, the cat will experience a warm, relaxing sensation. Your veterinarian will prescribe several treatment sessions, which will lead to healthier cells and tissues and may ease osteoarthritis-related pain.

6 Spring 2014 | Pet Quarterly

Normal Joint

Osteoarthritis

Signs of Feline Osteoarthritis

Muscle Bone Bursa

Synovial membrane

Because osteoarthritis often affects the same joint on both sides of the cat, for instance both the left and right front elbow, it may be difficult to notice lameness or a limp. Here are some signs to watch for in your senior cat:

Synovial fluid

Tendon

Joint capsule

Cartilage

Bone ends rub together

Thinned cartilage

In osteoarthritis, the cushioning layer of cartilage breaks down, causing pain, swelling and reduced joint motion.

Q: What are the treatment options? A: OA requires life management,

since there is no cure. Several treatment options are available, each with challenges. Analgesic drugs. Challenge: Many analgesic drugs used in other species are not licensed for use in cats. Non-steroidal anti-inflammatory Drugs (NSAIDs). Challenge: These can lead to chronic kidney disease. Nutraceuticals, such as Omega-3 fatty acids, glucosamine/chondroitin, and ASU (avocado and soybean unsaponifiables). Challenge: There is limited evidence for the effectiveness of omega-3 fatty acidâ&#x20AC;&#x201C;rich diets in managing feline OA, and further work is required. Narcotics. Challenge: These will not address inflammation and can cause hyper excitability and constipation. Also, as controlled substances, they must be closely regulated and monitored. Gabapentin. This anticonvulsant medication used for chronic pain in cats is showing great promise. Challenge: Some cats become extremely lethargic while on this medication. Physical therapy and hydrotherapy. Challenge: These can be wonderful but are not tolerated by

all feline patients. Frequent specialty visits are required. Therapy laser. This treatment with laser light that leads to healthier cells and tissues can be effective as an adjunct therapy. (See sidebar on pg. 6.)

Q: What can I do to make my cat more comfortable? A: There are several steps you can take: n

Weight loss

Muscle atrophy of the legs

Behavior changes (such as irritability or depression)

Inappropriate elimination

Loss of appetite

Reduced activity

Stiffness when cat wakes from

sleeping that seems to resolve n

Inability to jump down from areas

Unwilling or unable to jump up/

reduced height of jumping n

P oor hair coat (due to lack of grooming)

Constipation

Joint swelling

K eep your cat at a healthy weight. U se litter pans with lower sides for ease of entering and exiting. E levate your catâ&#x20AC;&#x2122;s food and water bowls. P rovide soft bedding. Foam microfiber bath mats are a great bedding option for older arthritic cats. These mats are slightly thicker than traditional bathmats, easier for a cat to lie on than some cushioned cat beds and very easy to wash. P rovide a heated cat bed. Cold, damp conditions seem to worsen clinical signs. I nstall steps for your cat to get to its favorite places. n

Dr. Stephanie Gandy Murphy is a feline veterinarian. Pet Quarterly | Spring 2014 7

Parasite Control/Dermatology

DITCH THE ITCH

Hereâ&#x20AC;&#x2122;s how your veterinarian will get to the bottom of why your pet is itchingâ&#x20AC;&#x201D; from fungal infections to parasites. By Michael Canfield, DVM, DACVD (Diplomate, American College of Veterinary Dermatology)

Allergies and parasites are top causes of itching and scratching.

8 Spring 2014 | Pet Quarterly

Is your pet is licking, biting, scratching? How about chewing, pulling hair or rubbing? The culprit could be any of hundreds of bacterial and fungal infections, parasites and immune-mediated disorders of the skin. Many itchy skin conditions look the same, but they can have very different causes. The good news is that with time and patience, your veterinarian will be able to pinpoint the problem and develop a treatment plan for your pet. Intense itchiness (a condition called pruritus) may be caused by parasites, allergies or by an underlying medical issue. With skin issues, methodical diagnostic tests are the only way to get to the root of the problem. Your veterinary team will run tests to differentiate between primary and secondary issues, so they can recommend a therapeutic plan to ease your pet’s discomfort. Here’s a look at some common causes of pruritus.

Allergies Allergies are the most common cause of itchiness. They are often compounded by secondary bacterial and yeast infections that make your pet’s itching worse. If your veterinary team suspects an allergy, they will test for: nvironmental allergies, a hypersensitivity to n E things in the environment like pollens and dust mites. lea allergy, a hypersensitivity to flea saliva that n F can cause prolonged and extreme pruritus. ood allergy, a hypersensitivity to certain foods, n F typically proteins. ontact allergies, which can occur when the skin n C comes in contact with an irritant.

Parasites These tiny terrors can be responsible for large-scale infections and itching. For example: cabies mites can live and feed in the upper layers n S of the skin, causing scratching. ertain internal parasites, such as hookworms n C and roundworms, may also manifest as an itchy skin condition. ermatophytes, infectious fungal organisms n D commonly known as ringworm, can also cause intense itching.

More Than Skin Deep Other conditions and diseases, such as hypothyroidism, can play a role in the overall health of skin and can lead to secondary skin issues. Conditions such as epitheliotropic lymphoma and mast cell tumors could be an underlying cause of a pet’s itchy and infected skin. Pets are masters at hiding pain, but painful conditions may cause them to lick excessively at certain areas, especially joints. The skin may also be a target >>

Abby before and after treatment.

Helping Abby’s Itching When Abby, a four-year-old terrier mix, came to our clinic, she was itching and scratching all over— especially on her face, feet and legs. She had scratched and rubbed her face so much that most of the hair was missing around her eyes. Her owners said she miserable. We embarked on a mission to get the dog some relief. Over a period of months, we ran a series of diagnostic tests and analyzed clues from Abby’s background and behavior. We could see potential signs of infection, such as lesions and redness. After testing skin cells under a microscope to confirm infection, we treated her with an antibiotic. We also started Abby on a drug for atopic dermatitis to give her relief in the short term. Next, we conducted a series of tests (intradermal skin testing) to pinpoint Abby’s allergies. Once we discovered that she was allergic to various grasses, trees and dust mites, we were able to treat her with immunotherapy, a series of weekly injections designed to target Abby’s specific allergies. Eventually, Abby’s owners described her as a new dog. She interacted with the family again and acted like a puppy. Abby was weaned off other drugs and has continued to do well.

Pet Quarterly | Spring 2014 9

Parasite Control/Dermatology

of autoimmune conditions, which develop when the body’s immune system attacks the body instead of protecting it. Genetics can also play a role.

Signs to Watch For

A dog with atopic dermatitis.

Treating Pruritus Skin infections benefit greatly from bathing with a medicated shampoo in conjunction with antibiotics and anti-fungals.

Oral medications may include: ntibiotics na ntifungals na n i mmunosuppressives ormone nh

supplements

arasiticides np ain np

medications

Topical treatments may include:

Regardless of the underlying cause, skin and ear conditions can be very itchy affairs for pets. Pruritus can make pets very uncomfortable— and sometimes can be painful. Itching can go on all day long, and it is often worse at night, keeping pets and their owners awake. Symptoms can include: cratching, biting, licking, n S chewing, rubbing edness (usually on the n R underside of the paws, ears, armpits, groin) andruff n D atchy hair loss n P imples n P ash n R rusts (scabs) n C lackheads n B reasiness n G arkening or lightening of n D the skin n “ Elephant skin” appearance kin growths or masses n S lcerations (holes in the skin) n U ischarge from the ears n D

Finding the Source Your veterinarian will start with a thorough physical exam and have a detailed conversation with you about your pet’s history. Because no one symptom fits in any specific category of disease, your veterinarian will discuss the need for certain diagnostics based on the exam findings.

Putting it to the Test Recommended tests may include: lea combing, a simple test n F that looks for live fleas as well as flea feces. skin scraping to detect n A mites, some of which are contagious to people. ar and skin cytology. n E Cytology involves looking at cells, bacteria and yeast in a lab. Your veterinarian will take skin and ear samples, put them on slides and examine them under a microscope to determine whether or not there is an infection present. Bacterial cultures may be collected for the laboratory, which will grow the bacteria and determine which antibiotics will kill the bacteria present. Fungal cultures may be warranted

hampoos ns ousses nm ipes nw intments no prays ns n l otions

10 Spring 2014 | Pet Quarterly

Your veterinarian may examine skin and ear samples under a microscope.

A flea combing or skin scraping may reveal fleas or mites.

if a ringworm infection is suspected. A fungal culture, which can take four to six weeks, is the best way to look for ringworm. fecal analysis to rule out n A intestinal parasites. Most of these parasites would be nearly impossible to see in your pet’s bowel movement. (Your veterinarian will look for eggs produced by intestinal parasites.) Parasites can cause allergy-like symptoms. arious blood samples n V to screen for internal diseases such as low thyroid function or increased steroid production. hen considering certain n W skin conditions, your veterinarian may recommend a biopsy to rule out certain skin diseases and skin cancer.

Treating the Itch Based on the findings, your veterinarian will work with you to formulate a treatment plan that may include topical treatments, oral medications or both.

If environmental allergies are suspected as the underlying cause, intradermal allergy testing may be recommended in order to identify allergens and institute allergenspecific immunotherapy, which is as close to a natural treatment as you can get for your pet’s allergies. Food allergy can only be diagnosed by performing a strict diet trial, so your veterinarian may recommend a specific diet to test for a food allergy. The idea is to feed a select protein and a carbohydrate that your pet has never been exposed to in the past. If your pet has a food allergy, a prescription diet may help. Flea allergy dermatitis requires strict avoidance of the offending allergen. Your veterinarian will recommend a rigorous flea control protocol for all pets in the household, including indoor cats, even if no fleas have been seen. Did you know it is actually unusual to find fleas on pets that are flea allergic? Some problems may prompt your veterinarian to refer you and your pet to a dermatologist,

internist or other specialist, who will work with your veterinarian to address your pet’s needs.

Frequent Follow-up Treating skin conditions can require frequent follow-up with your veterinarian. Allergies can flare up, medication doses may require adjustments, and new issues can develop. Be sure to administer all medications as prescribed and notify your veterinarian of any changes or problems. Discovering the source of your pet’s itchiness and treating it can be a complex, sometimes slow—but always methodical— process. Keep in contact with your veterinary team as you work together to make your furry friend more comfortable. n Dr. Michael Canfield is a boardcertified veterinary dermatologist.

See the cover reminder for an important message from your veterinarian.

Pet Quarterly | Spring 2014 11

General Wellness

GOING GENERIC Generic versions of brand-name drugs provide the same ingredients at a lower cost. By Paula Andruss

Like most people today, pet owners often look for ways to cut costs and stay on budget, without compromising their beloved animal’s well-being. In response to this need, many veterinarians are offering generic drugs to treat commonly diagnosed ailments. Humans have been turning to generic drugs for years to cost-effectively manage and treat various conditions, and now they can do the same for their furry family members.

Key Points GENERIC DRUGS ARE EQUIVALENT TO brand-name drugs but cost less. GENERICS CAN HELP stretch your veterinary budget, especially for large pets and those with chronic conditions that require larger/longer doses of the drug. YOUR VETERINARIAN CAN TELL YOU if a generic alternative is available to treat your pet’s condition.

12 Spring 2014 | Pet Quarterly

Passing on Savings Just as with humans, generic dog and cat drugs offer the same ingredients and benefits as brandname drugs, but often at a considerable cost savings. “They’re equivalent drugs, but they are less expensive,” explains Dr. Tracy Revoir, a veterinarian and manager of veterinary support at Putney Inc., a Portland, Maine-based veterinary generic pharmaceutical company. Revoir says that brand-name drugs are expensive to develop and get approved, and are often backed by large marketing campaigns, all of which contribute to their higher costs. While generic companies do bioequivalence studies to make sure their drugs are just as safe and effective, their marketing costs are lower. “That’s why generics can be offered at a lower price that’s more attractive to pet owners,” she says.

Names to Know Currently, the most common drugs available in generic form are those used to treat post-surgery pain and conditions including osteoarthritis and skin, respiratory and urinary tract infections.

n Carprofen Caplets, the generic form of the brand drug Rimadyl Caplets, is a non-steroidal antiinflammatory drug that’s commonly used to treat pain after surgery, as well as chronic discomfort caused by hip dysplasia and osteoarthritis in dogs. n Enrofloxacin Flavored Tablets, the generic counterpart to the antibiotic Baytril Taste Tabs, is available for both cats and dogs to eliminate bacteria that can cause urinary tract, respiratory tract and skin infections. n Cefpodoxime Proxetil, another antibiotic, is the generic form of Simplicef and is also used to treat skin infections in dogs. “Both Enrofloxacin and Cefpodoxime are widely used antibiotics that are safe and effective,” Revoir says.

Significant Savings The cost savings of using generic versions of these drugs can be significant, especially in large dogs that require larger doses, and for chronic conditions that require the medication to be administered for an animal’s entire life. “The generic provides a costeffective alternative,” says Revoir. To take advantage of the cost savings that generic drugs can provide, Revoir says pet owners should

not be afraid to ask their veterinarians if there is a generic equivalent available for the drug a veterinarian is prescribing, and where they might be able to get it. “People may not realize they’re available, but the majority of pet owners prefer them once they know,” she says. In fact, she says, research shows that roughly half of pet owners don’t know about generics. Of those who are aware, 26 percent prefer generics over branded drugs, and 61 percent have no preference. “Eighty-four percent of human prescriptions are filled by generics, so I think most pet owners are very comfortable with generics because they and their family members take them,” says Revoir, adding that while only 9 percent of the drugs for companion animals are available in generic form today, many more are in development, so the benefits of generics will continue to grow. “As more generic drugs become available, it will allow veterinarians to have more prescribing options and make healthcare recommendations based on what the pet needs, rather than what the pet owner can afford,” she says. “That’s good for everyone involved.” n Paula Andruss is Cincinnati-based writer.

GENERIC OPTIONS Pet diseases and other maladies that can be treated with generic drugs include: n Osteoarthritis n Post-surgical n Skin

GENERIC

pain infections n Urinary tract infections

infections n Respiratory

BRANDED

DRUG TYPE

Carprofen Caplets

Rimadyl Caplets

Anti-inflammatory

Enrofloxacin Flavored Tablets

Baytril Taste Tabs

Antibiotic

Simplicef

Antibiotic

Cefpodoxime Proxetil Common generics and their brand-name counterparts.

Pet Quarterly | Spring 2014 13

Pet Tales

Ask the Veterinarian Q: Why is my dog shaking its head and rubbing it on the ground? A: There are many reasons why a dog will shake its heads or rub it on the ground, so first and foremost, a veterinarian visit is in order. With that said, a commonly diagnosed reason for a dog to be exhibiting these symptoms is known as otitis externa, an infection or inflammation of the external ear canal. The most common signs of otitis externa are: n discharge and odor from the ear n redness of the ear n rubbing or pawing at the ear n shaking of the head. Your veterinarian will evaluate the amount of debris and exudate in the ear, look for changes in the ear canal and evaluate your pet’s eardrum. At that point, a simple test can determine if the infection is due to bacteria, yeast, mites or a combination. Puppies may have ear mites, but this is not common in healthy adult dogs. This test is noninvasive and results are ready in just a few minutes. If it is just mild inflammation, you may only have to use a soothing ear cleaner to treat it. Unless you are a pro at catching ear-infection symptoms early, otitis is often more advanced with an infection present, requiring more aggressive

Pet Tales by Laci Schaible, DVM

treatment. These results will guide your veterinarian in the proper course of treatment. In certain severe cases (especially in chronic or recurrent otitis), your veterinarian may submit an ear swab for bacterial culture. Common medications applied to the ear include cleaning and drying agents, antibiotics and antifungals to treat the infection, and sometimes anti-inflammatory medications to relieve itching and swelling. In severe cases, oral medications (steroid, antibiotic, antifungal) may also be prescribed. To keep otitis from recurring, ask your veterinarian to demonstrate how to properly clean your dog’s ears. You should also know that there are predisposing factors and underlying

causes that increase the likelihood of recurrence. Some examples include: n long floppy ears n ear canals with a small or narrow diameter n excess hair in the canal n frequent swimming n allergic skin disease, such as canine atopic dermatitis or food allergy n hormonal disorders. There are other causes for a dog to shake its head and rub it on the ground, as well. Foreign objects, tumors, systemic endocrine diseases and allergic reactions can all be factors. If your pet is exhibiting these signs, make sure to schedule an examination.

Eye Conditions to Watch For Have your senior dog’s eyes become cloudy? In middle-aged to older dogs, this is usually not due to a cataract, even though many pet owners assume it is. It’s often a result of nuclear sclerosis, a normal aging change of the lens that generally has no (or minimal) effect on vision. However, cloudiness in a dog’s eyes may be due to a number of other causes, from viruses to cataracts, and if you notice or suspect that your dog is having trouble with vision, contact your veterinarian immediately. In fact, any cloudiness is cause for a visit.

14 Spring 2014 | Pet Quarterly

Pet Tales

Breed Profile:

The Great Pyrenees Regal in appearance with a thick white coat and imposing size, this gentle giant commands attention. Because Great Pyrenees were originally bred to work independently as sheep guardians, they can be stubborn and are not the easiest breed to train. They are usually not good off-leash, because they are prone to escaping and venturing off. With their family they are gentle and affectionate, but they may be wary of strangers. Great Pyrenees have a rather long lifespan for a giant breed, sometimes living up to 10 or 12 years. Their specific health concerns are often related to their large stature and include: n Degenerative bone diseases, such as hip and elbow dysplasia nO steochondrosis, a disease of inappropriate bone growth that leads to painful lesions within the joints nP anosteitis, a condition in young, rapidly growing animals in which the superficial layer of the bone becomes painfully inflamed n Osteosarcoma, a deadly and painful bone cancer nG astric Dilatation Volvulus (bloat), a life-threatening emergency where the stomach twists on itself, compromising its blood supply nL ess common health concerns include entropion (a condition in which the lower or upper eyelids roll inwards) and heart disease.

A Pet’s Coat:

Insulation from the Heat As the mercury rises, you may consider shaving your pets to keep them more comfortable. Common sense tells us that shaving off a heavy fur coat would keep pets cooler in hot weather, but this is not actually the case. While a full coat of fur seems like it would make for a hot and stuffy ensemble, pets’ coats help them regulate their temperatures in both cold and warmer weather, similar to insulation for our houses. Unlike human hair, pet fur has different layers that are responsible for your pet’s comfort and temperature control. If you do decide to trim down your pet’s coat during the next heat wave, keep these tips in mind. n Leave it to a professional. At-home grooming attempts may result in accidental lacerations and clipper burns. In effort to save a few dollars, you may find yourself at the emergency clinic getting your pet stitched up. n Leave an inch of fur. Leaving too little fur puts your pet at risk for sunburn, and a clip too close to the skin puts your pet at risk for ingrown hairs and irritated skin. n If you are considering shaving because your dog has developed hot spots, seek help from your veterinarian. Hot spots are tender and may make your pup extra painful and protective when being groomed. >>

Great Pyrenees

Pet Quarterly | Spring 2014 15

Pet Tales

Protect Your Puppy from Parvovirus The most important thing you can do this spring for your puppy is to make sure it has all its vaccinations. Puppies are particularly susceptible to canine parvovirus, a highly contagious and often deadly virus. Transmission: Parvovirus is easily spread by direct contact with an infected dog’s feces, which can happen directly or via contaminated materials such as food dishes and toys. Clinical symptoms: The virus primarily affects the gastrointestinal tract and immune system, causing severe vomiting, profuse diarrhea (usually bloody), and extreme lethargy, fever and lack of appetite. Who it affects: While puppies are most susceptible to this ruthless virus, adults can be affected as well. Treatment and prevention: There is no effective treatment other than supportive treatment for conditions that develop in the course of the infection. Vaccination is the key to prevent this disease and protect your dog. Dogs of all ages should be vaccinated. Recommended vaccine schedule: Vaccinations typically start at six weeks of age, with boosters every three to four weeks until 16 weeks of age, followed by a one-year booster after the last dose. Speak with your veterinarian about what vaccination protocol is the best for your dog.

Puppy vaccinations for parvovirus typically start at six weeks, with boosters until 16 weeks of age.

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

Chewables Ivermectin Pyrantel Per Month Content Content

Up to 25 lb 26 to 50 lb 51 to 100 lb

1 1 1

68 mcg 136 mcg 272 mcg

57 mg 114 mg 227 mg

Color Coding 0n Foil Backing and Carton Blue Green Brown

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

ACCEPTABILITY: In acceptability and field trials, HEARTGARD Plus was shown to be an acceptable oral dosage form that was consumed at first offering by the majority of dogs. PRECAUTIONS: All dogs should be tested for existing heartworm infection before starting treatment with HEARTGARD Plus which is not effective against adult D. immitis. Infected dogs must be treated to remove adult heartworms and microfilariae before initiating a program with HEARTGARD Plus. While some microfilariae may be killed by the ivermectin in HEARTGARD Plus at the recommended dose level, HEARTGARD Plus is not effective for microfilariae clearance. A mild hypersensitivity-type reaction, presumably due to dead or dying microfilariae and particularly involving a transient diarrhea, has been observed in clinical trials with ivermectin alone after treatment of some dogs that have circulating microfilariae. Keep this and all drugs out of the reach of children. In case of ingestion by humans, clients should be advised to contact a physician immediately. Physicians may contact a Poison Control Center for advice concerning cases of ingestion by humans. Store between 68°F - 77°F (20°C - 25°C). Excursions between 59°F - 86°F (15°C - 30°C) are permitted. Protect product from light. ADVERSE REACTIONS: In clinical field trials with HEARTGARD Plus, vomiting or diarrhea within 24 hours of dosing was rarely observed (1.1% of administered doses). The following adverse reactions have been reported following the use of HEARTGARD: Depression/lethargy, vomiting, anorexia, diarrhea, mydriasis, ataxia, staggering, convulsions and hypersalivation. SAFETY: HEARTGARD Plus has been shown to be bioequivalent to HEARTGARD, with respect to the bioavailability of ivermectin. The dose regimens of HEARTGARD Plus and HEARTGARD are the same with regard to ivermectin (6 mcg/kg). Studies with ivermectin indicate that certain dogs of the Collie breed are more sensitive to the effects of ivermectin administered at elevated dose levels (more than 16 times the target use level) than dogs of other breeds. At elevated doses, sensitive dogs showed adverse reactions which included mydriasis, depression, ataxia, tremors, drooling, paresis, recumbency, excitability, stupor, coma and death. HEARTGARD demonstrated no signs of toxicity at 10 times the recommended dose (60 mcg/kg) in sensitive Collies. Results of these trials and bioequivalency studies, support the safety of HEARTGARD products in dogs, including Collies, when used as recommended. HEARTGARD Plus has shown a wide margin of safety at the recommended dose level in dogs, including pregnant or breeding bitches, stud dogs and puppies aged 6 or more weeks. In clinical trials, many commonly used flea collars, dips, shampoos, anthelmintics, antibiotics, vaccines and steroid preparations have been administered with HEARTGARD Plus in a heartworm disease prevention program. In one trial, where some pups had parvovirus, there was a marginal reduction in efficacy against intestinal nematodes, possibly due to a change in intestinal transit time. HOW SUPPLIED: HEARTGARD Plus is available in three dosage strengths (See DOSAGE section) for dogs of different weights. Each strength comes in convenient cartons of 6 and 12 chewables. For customer service, please contact Merial at 1-888-637-4251.

16 Spring 2014 | Pet Quarterly MERHRT130002 Rv2 Brief Summary 1

11/27/13 12:03 PM

ONE BITE C A N TRA NSM I T HE AR TWO R M DIS E AS E

ONE DOSE E VE RY MON TH WILL HELP PROTECT HIM

MOSQUITOES CAN TRANSMIT POTENTIALLY DEADLY HEARTWORM DISEASE TO YOUR DOG. Just one dose of HEARTGARD® Plus (ivermectin/pyrantel) a month helps prevent heartworm disease, and treats and controls the most common intestinal parasites. All in a real beef chew dogs love.

Ask your vet about HEARTGARD Plus.

heartgard.com

Important Safety Information All dogs should be tested for heartworm infection before starting a preventative program. HEARTGARD Plus is well tolerated. In rare cases digestive and neurological side effects have been reported. For more information, contact your veterinarian or visit www.heartgard.com. ® HEARTGARD and the Dog & Hand logo are registered trademarks of Merial. ©2013 Merial Limited, Duluth, GA. All rights reserved. HGD13PRAD (05/2013)

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