The Pet Quarterly | Spring 2013 by VetBoost

Pet Care News From Your Veterinarian ®

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SPR ING 2013 | Volum e 10, No. 2

Nutrition Know-How How to read a pet-food label

Stem-cell Breakthroughs

Healing options for your pet

Lumps and bumps: What to watch for Dental care for your pet’s breed and size

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Spring 2013 | VOL. 10, No 2

Picture-Perfect Pets Pet Care News From Your Veterinarian

IN THIS ISSUE Sizing Up Dental Disease 2 Size and breed can affect your pet’s dental care. Nutrition Know-How 4 Learn how to read

Dolly Jayce

The West Esplanade Veterinary Clinic Metairie, La.

Good Hands Veterinary Hospital Athens, Ga.

a pet-food label. Lumps and Bumps 8 Be on the lookout for lesions on your pet. Wookie

Midway Animal Hospital Largo, Fla.

New Leash on Life Stem-cell healing options to ease your pet’s pain. Pet Tales 1 4 Kitten and puppy tips;

Spike

McCurdy Animal Hospital Huntsville, Ala.

treating feline herpes and more.

Pet Quarterly® is an educational resource provided by your veterinary hospital. Comments are welcome at info@petquarterly.com ©Copyright 2013. 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

Sonny

Collingswood Animal Hospital Port Charlotte, Fla.

Hiway

Shelton Veterinary Clinic Interlachen, Fla.

Share your photos with other PQ readers. Email your best shot and the name and location of your veterinary hospital to PetQuarterly@yahoo.com. To be published, images should be at least 3 inches at 300 dpi. We’ll publish as many as we can.

Pet Quarterly | Spring 2013 1

Dental Health

Sizing Up Dental Disease Your petâ&#x20AC;&#x2122;s size and breed can make it susceptible to specific oral conditions. By Brett Beckman, DVM, Diplomate American Veterinary Dental College

Just as certain breeds of dogs are susceptible to certain diseases, the size and breed of your dog matters when it comes to dental care. Knowing your petâ&#x20AC;&#x2122;s risks helps you seek the proper care to keep your pet safe from oral conditions that can lead to discomfort and pain.

Preventing Periodontal Disease Periodontal disease, an infection of the gums and bone that surround and support the teeth, affects far more of our pets than all other oral diseases combined. Veterinarians know a lot about periodontal disease, because it is so common in our pets. Periodontal disease manifests differently in different sizes of pets. Small dogs tend to have more severe periodontal disease than large dogs, and they tend to develop this disease at a much earlier age. Some large breeds, especially Greyhounds, are also prone to early and severe periodontal disease. Small dogs generally have smaller jaws with relatively larger teeth than most large breed dogs, which can lead to crowding, rotation and misaligned teeth that can cause trauma to other teeth as well as gum and lip tissue. As pets age, the trauma can add up and result in periodontal disease.

Other Oral Conditions

Key Points Periodontal disease is the number-one most diagnosed disease in dogs as well as cats. Itâ&#x20AC;&#x2122;s generally more common and severe in small dogs, as well as some large breeds such as Greyhounds. To prevent and treat dental disease, pets should have their first Comprehensive Oral Health Assessment and Treatment (COHAT) at 18 months of age or sooner.

2 Spring 2013 | Pet Quarterly

n Gingival overgrowth (hyperplasia), or excess growth of gums, is more common in large breed dogs, especially Boxers (Photo 1). We also see it more frequently in Great Danes, Collies and Dalmatians. This condition often results in debris and hair collection between the gum tissue and the tooth, causing inflammation and periodontal disease. n Tooth overcrowding is more common in small breeds. Overcrowding often causes the teeth to come to rest in an abnormal position (Photo 2). This can result in injuries to other teeth or gum tissue and can also lead to periodontal disease. n Cysts occur frequently in small breed dogs, especially short-nosed breeds like Boston Terriers, Pugs and Shih Tzus. Unfortunately, these patients rarely show that there is a problem. X-rays will reveal a dark halo around a tooth (Photo 3). Teeth and bone are gradually destroyed if the cyst is not removed. n Lingually (toward the tongue) displaced canine teeth in the lower jaw more often affect large breeds such as German Shepherds and Rottweilers. A lower canine tooth will dig a hole in the hard palate, the upper canine tooth or both (Photo 4). Treatment is aimed at moving the tooth with braces or incline planes, extraction or

crown reduction with treatment of the pulp. Specialists generally treat this condition. n Eosinophilic stomatitis can produce red and inflamed areas and ulcers throughout the mouth (Photo 5). This condition affects Cavalier King Charles Spaniels and Siberian Huskies. Some pets with this condition may not show pain, even though the condition is quite painful. Treatment is frustrating and can range from steroids to extraction of adjacent teeth. n Mesioversion of the maxillary canines (lance canine) is a breed-specific predisposition of Shetland Sheepdogs (Photo 6). This condition occurs when one or both upper canine teeth come in too far forward and can cause tooth or gum trauma. The pet may be unable to completely close its mouth.

Personalized Prevention Individual breeds and breed sizes have different needs for oral care. Your veterinarian can recommend the right schedule of preventative treatment for your pet. A Comprehensive Oral Health Assessment and Treatment (COHAT) is a complete evaluation, cleaning and treatment under anesthesia. It involves full-mouth dental x-rays, periodontal probing, cleaning, polishing, diagnosis and treatment. All dogs and cats should have their first COHAT at 18 months of age or sooner. Many small breed dogs will already have advanced disease at this age that will require treatment beyond cleaning. Recommendations for a pet’s oral home care and in-hospital cleaning and evaluation frequency are also different for small and large breed dogs. Your veterinarian can recommend what’s right for your dog. Proper oral home care may include water additives, brushing, sealants and special foods and/or chews. Schedule an evaluation that may uncover hidden oral problems in your pet. Early recognition and treatment of many hereditary or congenital oral diseases may save your pet from unrecognized discomfort or pain. n Dr. Brett Beckman specializes in veterinary dentistry.

Cats Need Oral Care Too Exotic cat breeds are predisposed to a number of oral diseases, some of which are painful, including misaligned teeth, wry bite (jaw deformities) and stomatitis (severe inflammation of the gum and lip tissue).

Gingival overgrowth, or hyperplasia, in a 9-year-old Boxer.

The dark area between the two black arrows reveals a cyst in this Shih Tzu’s mouth. The cyst is a result of the small premolar tooth (white arrow) that failed to grow in.

Eosinophilic stomatitis caused these ulcers and redness in a Cavalier King Charles Spaniel.

Crowding of the incisors has resulted in tooth position changes, making periodontal disease a real issue in the future of this Shih Tzu.

A lingually (toward the tongue) displaced canine tooth in this Rottweiler mix caused a hole in the gum that is packed with hair.

The black arrow points to a lance canine tooth in this Shetland Sheepdog. The white arrow points to a baby tooth that should have already fallen out but is now interfering with the incisor and lower canine tooth. This prevents this pet from closing its mouth without discomfort.

Pet Quarterly | Spring 2013 3

General Wellness

Nutrition Know-How Are you choosing the right food for your pet? Understanding pet-food nutrition labels will help. By Laci Schaible, DVM

Perhaps you welcomed a new furry family member into your home this past holiday season, or maybe you are tackling a resolution to pay more attention to your petâ&#x20AC;&#x2122;s weight and nutrition. Whatever your motives are, learning to decipher pet-food nutrition labels is a proactive step in the right direction toward longer and healthier years for your pet.

4 Spring 2013 | Pet Quarterly

A pet-food label is a legal document regulated by the Association of American Feed Control Officials (AAFCO). There are specific rules and requirements that pet-food companies must adhere to, and this is one aspect of pet ownership where it behooves you to understand what the label is telling you. Read on for a top-notch pet-food label education. >>

Anatomy of a Label Sample Pet Food Label

Guaranteed Analysis

Guaranteed Analysis: Crude Protein ............................... (Shown as a minimum %) Crude Fat ..................................... (Shown as a minimum %) Crude Fiber ................................. (Shown as a maximum %) Moisture ..................................... (Shown as a maximum %) Other Ingredients ..............................(Vary by manufacturer) Ingredients: This listing could include such foods as chicken, chicken meal or other proteins, brown rice, corn, wheat, vegetables, vitamins and many other combinations of ingredients. Nutritional Adequacy Statement AAFCO Statement: This legally required statement tells you which testing method was used to determine nutritional adequacy. The two methods are the formulation method and the feeding trial method.

Nutritional Adequacy Statement (AAFCO Statement) A sample AAFCO statement (using the formulation method) might read: “Brand ABC Cat Food is formulated to meet the nutritional levels established by AAFCO Cat Food Profiles for maintenance of adult cats.”

Products with the “all lifestages” statement likely contain excessive levels of some nutrients necessary for the demanding lifestage of growth that can be inappropriate for adults or senior pets or even harmful to them. For example, puppies require higher levels of protein and calcium for growing muscle mass and bones, although those levels are inappropriate for other lifestages. Puppies and kittens also require more calorically dense nutrition. These high-calorie foods may be contributing to the obesity epidemic we see in our adult pets, because they are falsely advertised as nutritionally balanced for “all lifestages,” which is a misleading statement in itself.

This is the mandatory guarantee that the food contains the minimum or maximum labeled percentages of crude protein, fat, fiber and moisture. This guarantee does not indicate the exact levels of nutrients in the pet food.

Ingredients List Ingredients are vehicles that provide nutrients, while nutrients are food components that support life and are metabolically useful. For example, chicken is an ingredient that provides nutrients such as protein, fatty acids and vitamins. Ingredients on pet-food labels are listed in order of weight, starting with the heaviest. Some ingredients are “wet” or predominantly water, which means they weigh more. For example, dehydrated chicken meal packs more protein than fresh chicken, which is around 75 percent to 80 percent water. The same goes for all proteins. Don’t think that an ingredients list that begins with “chicken” has more protein or is superior to one that begins with “chicken meal.”

The feeding trial method requires feeding the product to animals and is ideal for determining nutritional adequacy and how pets will actually perform when fed brand X food.

The formulation method does not require feeding the product to an animal. Instead it requires the manufacturer to formulate the food to meet the AAFCO nutrient profiles for dogs and cats. There is one standardized set of nutrient profiles for dogs and one for cats. It is the faster and less expensive method of testing, and it is undoubtedly the inferior method.

The AAFCO statement also specifies whether the food provides complete and balanced nutrition for a specific lifestage of your pet (puppy/kitten, adult, pregnant/nursing), or if the product is designed to be nutritionally adequate for “all lifestages.”

Be sure to choose a food designed for the specific lifestage of your pet. Pets have different nutritional needs through their different lifestages, and no formulation is perfect for every pet.

Pet Quarterly | Spring 2013 5

General Wellness

Applying Your Knowledge Having a basic understanding of pet-food labels will help you discuss your pet’s diet with your veterinarian. Work closely with your veterinarian to choose the best food for your pet based on your pet’s age, breed and health. There are several questions to ask your veterinarian to help you pick the most appropriate food for your pet. While most pet parents will ask these questions at a new puppy or kitten appointment, don’t forget to ask these questions periodically throughout your pet’s life. Reviewing your pet’s diet with your veterinarian is a good habit to incorporate at each veterinary appointment, whether the appointment is for wellness or illness.

Questions to Ask Your Veterinarian n Do you have any specific food recommendation for my pet based on its lifestyle or future health risks? (For instance, large breed puppies need a uniquely balanced food that doesn’t allow them to grow at too accelerated of a pace, or they will be prone to orthopedic diseases. Large breed puppy formulas provide nutrients geared at minimizing these diseases.) n Do you see any indication for a change in diet based on my pet’s exam or lab findings? (Annual exams and lab work are great tools to track trends in your pet’s health, allowing veterinarians to pick up on illnesses earlier.) n Is my pet overweight or underweight? n At what age is my pet is considered “senior”? (Ask this as your pet ages. For example, giant breeds such as Irish Wolfhounds are considered seniors at around six years of age, while small breeds such as Toy Poodles are considered seniors in their mid to late teens. ) n Does my pet have any special skin conditions? Dental concerns? GI or urinary problems? n Does my pet have any food allergies? (Beef, dairy and wheat as common food allergies in dogs and cats.) n Does my pet have special nutritional needs or health risks?

Key Points Ingredients on a pet-food label are listed by weight, starting with the heaviest. Choose a pet food designed for the particular lifestage of your pet (puppy/kitten, adult, pregnant/nursing). Prescription pet-food diets address specific health conditions and can help pets avoid medication and surgery.

6 Spring 2013 | Pet Quarterly

Did You Know? Nutritional excesses can be as harmful as (and are more common than) nutritional deficiencies.

Prescription Diets If your pet has a condition such as kidney disease, liver problems, food allergies or obesity, dietary modification can make a significant impact on your pet’s health and well-being. There are terrific diets on the market to help prolong the lives of our pets as they develop these problems. A prescription diet is a commercially prepared food scientifically formulated to address a specific health condition. Prescription pet-food diets—also called therapeutic pet foods—are specially formulated with higher or lower levels of the specific nutrients that will make a difference in your pet’s health. Nutrient levels can be adjusted to treat or control medical conditions such as diabetes, kidney, liver or heart disease. Fiber levels, protein, phosphorus, fats, carbohydrates and other nutrients may also be higher or lower depending on your pet’s ailment or condition. For example, prescription diets for feline urinary tract disease provide antioxidants, including vitamin E and beta-carotene, which counteract oxidative stress and generate an environment to help prevent the development of bladder stones. High amounts of omega-3 fatty acids help break the inflammatory

cycle associated with bladder stones, crystals and feline idiopathic cystitis. As a result of feeding this diet to a needy feline patient, surgery to remove bladder stones can often be avoided. The diet can even prevent recurrence of bladder stones and urinary tract inflammation episodes altogether. While prescription diets are typically more costly than non-prescription formulas, when you consider the money saved by avoiding medications and surgeries, you may realize that the additional cost of the pet food is actually a small price to pay. In addition, you can increase the quality of your pet’s life. All in all, there is no “one size fits all” diet for any of our pets. By educating yourself on how to properly read pet-food nutritional labels, you are taking an active role in your pet’s health. Consult your veterinarian for guidance on selecting the best pet food. Ask your veterinarian if you are unsure which food to select or want to know how much or how often to feed your pet. The adage “you are what you eat” holds true with our canine and feline family members as well—choosing the right pet food can help your dog or cat live a longer and healthier life. n

Label Language Terms you’ll find on pet-food labels and what they mean.

Dr. Laci Schaible is a small-animal veterinarian dedicated to educating pet parents.

Work closely with your veterinarian to choose the best food for your pet based on its age, breed and health.

Term

Meaning

“100% Beef” (or Protein X) “Protein X for Dogs/Cats” “Protein X Cat/Dog Food”

95% or more of the product’s dry matter weight must be beef (or protein X).

“Dinner” “Platter” “Formula” “Recipe”

25%–94% of the product’s dry matter weight must be what the label claims.

“With” Food X

Food X must be 3%–24% of the product’s dry matter weight.

“Natural”

No ingredients have had any chemical alternations.

“Flavor”

This word is essentially meaningless. A “flavor” must be recognizable to a pet.

“Premium” “Super Premium” “Ultra Premium” “Gourmet”

There is no official definition of these terms.

“Holistic”

There is no legal definition of this term.

“Dry”

Less than 20% water.

“Semi-moist”

Between 20% and 64% water.

“Wet”

Between 65% and 78% water.

“Stew” “Gravy” “Sauce” “Broth”

More than 78% water. (This is basically expensive food in water.) Source: U.S. Food and Drug Administration http://www.fda.gov/animalveterinary/resourcesforyou/ucm047113.htm

Pet Quarterly | Spring 2013 7

Parasite Control/Dermatology

The Lowdown on

Lumps and Bumps Be on the lookout for lesions on your pet, and move swiftly if you find them. By Michael Canfield, DVM, DACVD

Check your pet each week for lumps and bumps. Early detection is key.

8 Spring 2013 | Pet Quarterly

If you find a lump or bump on your pet, what should you do? There are many possible causes for lumps and bumps, especially as your pet ages. A lump or bump can arise from trauma, inflammation, infection or benign or malignant tumors, among other causes. The clinical consequences for each can be vastly different, so work closely with your veterinarian to get any lesions checked out as soon as possible.

Home Screenings Take an active role in your pet’s care by following a set of simple rules. You see your pet much more frequently and in a more relaxed state than your veterinarian does. So think of yourself as an extension of your veterinary team by routinely screening your pet. If you establish a weekly or biweekly routine of evaluating your pet from the tip of its nose to the tip of its tail, you will increase the likelihood of detecting a lump or bump early. Check less obvious places, too, such as in the mouth, between the toes, under the tail, in the ears and on the eyelids. If you find a lump or bump, make sure to document where it is (because inevitably when you try to find it again, you can’t). A simple drawing or photo can be invaluable. As pets age, some will develop more lumps and bumps than others, and maintaining a “map” of their locations will help your veterinarian monitor and diagnose problems.

Diagnosing Lumps Next step: Schedule an appointment with your veterinarian—even if your pet is due for an exam in a few months. Your veterinarian will perform a physical examination of your pet and address your concerns. Remember that although your veterinarian may have a clinical suspicion as to the cause of a lump or bump, diagnostics may be needed to precisely identify the lesion. One of the least invasive procedures to evaluate a lump or bump is known as fine needle aspiration and cytology. During this procedure, a veterinarian uses a small needle to collect a sampling of cells. The cells are placed on glass slides, spread evenly and stained for review under a microscope. Many lumps and bumps release cells easily; >>

Fine needle aspiration and cytology revealed that this ½-inch ulcerated mass on a Great Dane puppy was a histiocytoma. Histiocytomas are benign lesions that typically resolve spontaneously.

The owner of this 6-year-old Boxer thought the dog had broken a toenail by snagging it on the carpet. A series of tests revealed that this lesion on the dog’s toe was a squamous cell carcinoma. Squamous cell carcinomas are malignant, requiring wide surgical excision as initial therapy. In this instance, the dog’s toe was removed.

Multiple lumps and bumps on this 10-year-old Boxer were diagnosed as a type of lymphoma (cancer of the lymph system) that affects the skin. Testing required fine needle aspiration and cytology, then biopsy and histopathology.

A biopsy and histopathology found that this ½-inch mass near the wrist of an older Great Dane was a histiocytic sarcoma. Histiocytic sarcomas are invasive and metastasize (spread), requiring wide surgical excision as initial therapy.

This 2-inch raised mass on the ear flap of a 3-year-old Boxer is a leproid granuloma, which is caused by a type of mycobacteria. The lesion resolved with antibacterial therapy.

This lesion on an 8-year-old Sheltie’s wrist was thought to be a wart. The lesion was removed and was not submitted for analysis. It returned. Fine needle aspiration and biopsy revealed that the lesion was a malignant melanoma. By this time, the melanoma had metastasized to the dog’s lymph node.

Pet Quarterly | Spring 2013 9

Parasite Control/Dermatology

Multiple masses on this 12-yearold cat’s ear flap and in the ear canal are ceruminous cyst adenomas, which are benign tumors of the ear canal. The masses were removed with a surgical laser.

Fine needle aspiration and cytology found that this lesion on the back of a 12-year-old Shih Tzu was a sebaceous adenoma. Sebaceous adenomas are benign tumors that are common in older patients. The lesion was treated with cryosurgery (frozen).

This lesion between the pads of a 4-year-old German Shepherd’s paw is a furuncle, which results from trauma affecting the hair follicles in the area. These are common in allergic patients. Treatment involves an allergy workup.

This lesion along a young Labrador Retriever’s lumbar region was caused by inflammation of hair follicles and rupture of hair follicles below the skin, resulting in a foreign-body reaction. Fine needle aspiration and cytology suggested this might be the cause of the lesion, but biopsy was needed for confirmation. The patient was flea allergic, not on flea control and had secondary bacterial skin infections.

for these, diagnosis is often immediate. Other cells may be too immature to reveal the tissue of origin without a biopsy. Biopsy procedures vary a bit, but basically your veterinarian will send a piece of the lesion to a laboratory for a veterinary pathologist to look at the tissue and determine its origin. Not all biopsy samples require sedation or anesthesia; your veterinarian will make that decision for you.

Addressing the Issue Once the lump or bump is sampled and a diagnosis is made, your veterinarian can guide you in forming a plan to address the lesion(s). Some lumps and bumps may resolve on their own, and some may require immediate action. Some malignant lumps and bumps can carry an excellent prognosis or outcome if they are removed aggressively and early. Other malignant tumors may require something other than surgery, such as radiation, which is becoming more readily available than in years past. The key is early treatment, but we can’t treat early if the lump or bump is not found early. You are the extra hands that your veterinary team needs to help them care for your pet. By performing your examination for lumps and bumps weekly to biweekly, you have the power to help preserve the relationship with your pet by getting any lumps and bumps that you find mapped, diagnosed and—if needed— treated as soon as possible. n Dr. Michael Canfield practices veterinary dermatology at several locations in Florida.

Mast Cell Tumors (before and after)

Fine needle aspiration and cytology determined that this 1½-inch mass near the right eye of a 9-year-old cat was mast cell tumor based. The owner delayed evaluation for more than a year because the lesion did not seem to be growing fast and the cat did not seem bothered by it. The lesion was successfully excised, but the procedure would have been much simpler and less costly if addressed earlier.

10 Spring 2013 | Pet Quarterly

See the cover for an important message from your veterinarian.

Senior Wellness

A New Leash on Life Harvesting and injecting an animal’s own stem cells may heal painful joint and ligament deterioration and restore a pet’s range of motion without the need for medication. By Paula Andruss

Doc, a 12-year-old Giant Schnauzer, was suffering deterioration of his right hip. He had trouble standing for any length of time and spent most of his day lying around. He was so uncomfortable that he had to discontinue his work as a therapy dog in a children’s hospital. Granite, an eight-year-old Chocolate Labrador, suffered from arthritis in both elbows and walked with a limp. His owners said he seemed to be in great pain. Both pets got a new lease on life when their owners and veterinarians turned to stem-cell therapy to reduce pain and regenerate tissue in their affected areas. A few months after their treatments, Granite is enjoying longer walks and Doc is able to jump up on the couch, his favorite napping spot. >>

Key Points Stem-cell therapy uses an animal’s own cells to heal and regenerate tissue. Stem cells are harvested from the pet’s fat tissue and then injected back into the affected areas. The therapy helps reduce pain, swelling and disability caused by arthritis and ligament and tendon damage. Results typically last 6 to 18 months, although some pets never need to repeat the procedure.

Pet Quarterly | Spring 2013 11

Senior Wellness

Harvesting Health

Clearing Cell Confusion Stem-cell therapy is a new technology, so it’s not uncommon for pet owners to have questions about the type of cells that are used. This type of therapy uses the animal’s own adult stem cells, which are typically found in the bone marrow and fat. Unlike embryonic stem cells, there are no ethical concerns around harvesting these cells and reintroducing them back into the patient where regeneration is needed.

These pets and others have had great results using stem-cell therapy to relieve the pain and debilitation associated with arthritis and other joint and ligament issues. For dogs and cats that are suffering, stem-cell therapy can reduce pain and inflammation, restore range of motion and spur healing that leads to a happier, healthier life.

In stem-cell therapy, a veterinarian collects fat tissue (an area rich in stem cells) from the animal while it is under general anesthesia. That tissue is then processed to further concentrate the stem cells. Once the cells are processed, the veterinarian injects them back into the animal’s affected area (under local anesthesia), where the stem cells reduce the pain and create a healing process that can regenerate tendon, ligament and joint tissues. “The animal’s own stem cells are extracted, concentrated and then put back in to treat orthopedic diseases and injuries,” explains Dr. Bob Harman, chief executive officer of Vet-Stem, a Poway, Calif.-based provider of stem-cell therapy services. A veterinary clinic may perform stem-cell processing in-house or send the tissue to an outside lab to be prepared. Either way, the process only takes a maximum of a few days to complete. For example, Harman explains, with Vet-Stem, the sample is collected at the clinic and shipped to his technicians overnight in a temperature-controlled collection kit. “We process it the next day under sterile conditions and ship it right back, so it’s 48 hours from collection to treatment,” he says. Using the Vet-Stem system, extra cells are stored for the animal, providing a sort of insurance in case there is a future need.

Easing Arthritis While the use of stem cells is being evaluated for the treatment of other conditions, today it’s primarily used in dogs and cats to treat the pain, swelling and disability that comes from chronic arthritis (especially as a result of dysplasia) or a tendon or ligament tear.

Arthritis on the Rise

+38%

Increase in prevalence of arthritis among dogs from 2006 to 2011 Source: Banfield “State of Pet Health 2012 Report”

12 Spring 2013 | Pet Quarterly

After stem-cell therapy, many dog owners say that their pets are happier and friendlier because they are not in pain.

The results of stem-cell therapy vary depending on the pet’s condition, but Harman says initial improvements can take anywhere from a week to a couple of months to appear. As the cells reduce swelling and pain, the pet will be able to move around more easily and become more active. At that point, the pet can start a rehabilitation program to continue healing and strengthening the affected area. The therapy’s positive effects typically last from 6 to 18 months, depending on the ailment, and the process can be repeated when the effects start to wear off. Harman says that some pets heal well enough from the first treatment that they never need another one. “About half of all animals need a retreatment within a year or two,” he says, noting that extra cells are stored from the original harvest for future use, so animals that do repeat the treatment don’t have to go through sample collection again.

Comparable Cost While the cost of stem-cell therapy varies depending on the animal and its affected areas, a standard fee is typically in the $2,500 to $2,800 range, an expense Harman says is covered by most pet insurance policies. Because the therapy can result in pets no longer needing regular pain medication, it can actually end up saving some pet owners money compared to what they had been spending on prescriptions.

Healthier Healing Taking medications out of the equation is especially helpful for pets with chronic conditions that might otherwise cause them to have to ingest prescription drugs for their entire lives. “One of the benefits of stem-cell therapy is that it’s not a drug; it’s the animal’s own cells,” Harman says. “It’s the most natural way of healing.” And ultimately, that healing leads not only to improved longevity for the pet, but improved quality of life as well, since chronic pain affects pets in just the same way it affects people—it makes them miserable. “It’s not just about their joints; it’s about their behavior and their happiness, and taking away the pain makes a big difference in that,” Harman says. “People tell us that their dogs got much happier and friendlier after stem-cell therapy because they weren’t in pain anymore. And when the pet is happy, the owner is happy.” n Paula Andruss is Cincinnati-based writer.

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

Pet Quarterly | Spring 2013 13

Pet Tales

Feline Herpes: It’s Not a Disease of Promiscuous Tomcats Pet Tales by Laci Schaible, DVM

If you have ever been told that your cat has herpes, don’t assume your pet has been prowling the city streets for some after-hours activities. Herpesvirus is quite common in cats, but it causes a different disease complex entirely than the herpesvirus that people can get. Chances are, your innocent feline will be exposed to feline herpesvirus type 1 (FHV-1), also known as feline viral rhinopneumonitis (FVR), at some point in its life, most likely as a kitten

when its immune system is not at its peak performance.

Stress Is a Trigger In cats, the herpesvirus typically results in eye problems, though it can trigger upper respiratory signs as well, such as sneezing and conjunctivitis. Herpes infections in cats are sporadic and are triggered by stress—adjusting to a new home, being boarded, or even their owners packing a suitcase is enough to bring on an outbreak for some cats. As far as viral infections go, feline herpesvirus is a rather contagious one. The virus is easily spread through contact with discharge from an infected cat’s eyes, mouth or nose, or simply by sharing infected litter boxes, food and water dishes. The good news is that humans and dogs are not at risk for catching feline herpes, and cats cannot catch the strains of herpes that humans carry. Herpesvirus infection is the most common cause of conjunctivitis (inflammation of the conjunctiva, or tissues lining the inner eyelids and whites of the eye) in cats. Many cats are infected with the virus and do not show any signs of clinical illness, making them carriers of this virus. Does your cat have herpesvirus? Squinting and other eye problems are often symptoms of the diseases.

14 Spring 2013 | Pet Quarterly

Luckily, in most cases, herpesvirus conjunctivitis will resolve within a couple weeks.

Symptoms: Squinting and Sneezing When it does not resolve, the most common clinical signs of the resulting conjunctivitis are squinting or closing of the eye; red, swollen tissue surrounding the eye and eyelids; eye discharge that may range from clear to yellow-greenish in color; and those pesky upper respiratory infection symptoms such as sneezing or nasal discharge. These signs often appear suddenly and are especially common after stressful situations. There is no cure for herpes and diagnosis is usually presumptive, but the therapeutic goal is to reduce the frequency and severity of recurrences. The best defense is to: minimize the chance of infection, feed a premium diet, reduce stressful situations, properly vaccinate against preventable causes and supplement the diet daily with L-lysine, an amino acid used to decrease the severity of symptoms caused by feline herpesvirus. L-lysine is an over-the-counter supplement that is available in many forms. I have found the easiest way is treats with L-lysine in them. Before starting any nutritional supplement, make sure your veterinarian first thinks herpes is probable and that your cat is a good candidate for L-lysine therapy. As with herpes in people, a little bit of prevention goes a long way, so make sure your feline socializes only with herpes-free kitties.

Pet Tales

Kittens and String: A Case for Supervised Play

Ask the Veterinarian Question: My eight-week-old Rottweiler puppy’s belly button hasn’t completely closed. I can push his skin back down to be level with his belly. It is getting tougher to push down as time goes on (like it is closing). Is this a genetic defect? The veterinarian I visited wants to do surgery at six months.

Answer:

It sounds like your pup has been diagnosed with an umbilical hernia. This is when the layer of tissue underneath the skin hasn’t closed completely. When the dog or cat stands on all fours, a bubble-like swelling can appear, because there is an opening in the muscle layers that lets air and abdominal contents into this area. This doesn’t mean that food gets in this area, but a piece of intestinal fat that is attached to the intestines can work its way into this small space. Hernias can vary in severity and can be caused by trauma, but in puppies and kittens, they are often congenital. If it is a new hernia, it may just be some fluid that has seemed into the area, but a hernia is essentially a tear in the layers of body wall. The real problem with umbilical hernias—which usually doesn’t happen too often—is when a piece of the intestine slips into the “hernia space” and twists. The blood supply to the intestines can be decreased or stopped entirely, which can quickly escalate into a serious situation. Hernias are easily diagnosed based upon palpation in most cases. A veterinarian will be able to “reduce” the hernia and verify that’s what it actually is. Hernias should be corrected surgically at the time of the neuter or spay (unless they are large, and then they should be addressed sooner). There are a few cases where X-rays should be taken if the diagnosis isn’t clear, but this is not common. Do keep an eye on the hernia and make sure it doesn’t grow until your veterinarian can repair it surgically, usually at the time of the spay or neuter. If it does get bigger, you should have your pet seen ASAP. As long as the pup or kitten with a hernia is doing well, behaving normally, and the hernia is staying the same approximate size, a hernia is not an emergency.

The idea of kittens and a ball of yarn is nothing new; kittens love string! Unsupervised string play isn’t all fun and games though, as it can lead to a dangerous surgical outcome. Kittens are notorious for eating string, and when string is ingested, it tends to scrunch the intestines together and is known as a linear foreign object. String rarely works its way out of the kitty’s intestines on its own and usually requires invasive and risky surgery. This doesn’t have to mean no string in sight for your feline’s future, but do make sure there is no string in sight when you are not in sight—that is, only allow supervised string play and always securely store the string at the end of the play session. Dr. Laci Schaible is a small-animal veterinarian dedicated to educating pet parents.

Pet Quarterly | Spring 2013 15

Pet Tales

Over-vaccination in Puppies and Kittens? I hear many clients today confused about the necessity of vaccines and the risks of over-vaccination, especially in small puppies and kittens. Just because a puppy or kitten is smaller in size does not mean that its risk to disease exposure will be any less than for a full-sized adult. You shouldn’t skip out on vaccinating these small pets, but spacing the vaccines out versus giving four vaccines at one vet visit may help reduce the chance that tiny pets will have a vaccine reaction. Ask your veterinarian about a vaccine schedule that is tailored for your individual pet.

Sneaky Sugars Food incentives are great training tools for puppies, but did you know that sugars are hiding in many treats? Sugars add unnecessary calories to our growing pets and are partly to blame for our growing pet obesity epidemic. An overweight puppy or kitten is more likely to struggle with obesity well into its adult years. To spot an unnecessary sweet calorie bomb, be on the lookout for ingredients ending in “ose”—sucrose, fructose, lactose and glucose—along with those ending in “ol”—sorbitol, mannitol and xylitol. Never give a food with xylitol to your pets, as it can be deadly.

Spring Cleaning Thrills and Pills You may know to keep your pets out of the room until all until all cleaning products have dried, but there is a far more common danger waiting to tempt our curious pets. That danger comes in the form of medicine bottles that are fun to shake, rattle and roll and are full of tasty sugar-coated treats, a.k.a. pills. Puppies and kittens in particular explore their new world with their mouths, and toxicities associated with human medication ingestion are one of the most common we see as veterinarians. Aspirin, ibuprofen, amphetamines and acetaminophen are common and dangerous medical pet poisons.

C H E WA B L E S 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) Chewables 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 Chewables Ivermectin Weight Per Month Content

Up to 25 26 - 50 51 - 100

1 1 1

68 mcg 136 mcg 272 mcg

Pyrantel Content

Color Coding 0n Foil-Backing and Carton

57 mg 114 mg 227 mg

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 prevention 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 Chewables were 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 hypersensitivitytype 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 at controlled room temperature of 68°F - 77°F (20°C - 25°C). Excursions between 59°F - 86°F (15°C - 30°C) are permitted. 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. 1 Of

dogs showing a preference in three studies conducted by independent investigators, dogs preferred HEARTGARD® (ivermectin) Chewables over INTERCEPTOR® (milbemycin oxime) FlavorTabs® by a margin of 37 to 1; data on file at Merial.

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

16 Spring 2013 | Pet Quarterly

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