Grooming: Combing and Brushing my Pet

Most of our dogs and cats need regular brushing. If you have a dog that doesn’t shed, he needs to be clipped by either you or a professional because the coat keeps getting longer. Longer coats tend to mat and can be uncomfortable for your pet. Unkempt coats can be oily and dirty; if they are uncomfortable, itching and scratching result and can lead to skin infections. 

Too many pet owners think slicker brushes are always appropriate. Slickers work well for short coated dogs and cats. But, as the coats get longer, the slicker tends to simple brush out the ends of the coat while leaving matted tangles near the skin. The mats are uncomfortable to the pet; shampooing a tangled coat can produce severe mats which must be shaved out.

If I only had one utensil for grooming my pet (dog or cat), it would be a detangling comb (a long steel comb with teeth closer at one end than the other). This works well for all but the shortest coated pets. I would regularly and carefully comb my pet from the skin out, while paying particular attention to areas where the coat is thicker or longer (such as behind the rear legs and ears).

Rubber grooming gloves work well on short coated pets. They are safe and easy on thinner pets, and pets that enjoy being petted will not object to these.

Dematting tools can be purchased to cut through thicker or matted coats on some pets but with regular attention, your dog’s coat should seldom need this type of attention. Grooming rakes used regularly help prevent the need for dematting tools. The rake has a limited number of very stout teeth that are pulled through thicker, longer coats to prevent matting.

Again, always remember to thoroughly comb out your pet before bathing. Shampooing a tangled area will produce hopeless mats that will need to be carefully trimmed out. It is safest to seek a professional groomer before attempting to trim out these mats by yourself.

My Book is available: Laughter & Tears: A Veterinarian's Memoir and Advice

This is to let my readers (and their friends) know that the book I have written  Laughter & Tears: A Veterinarian's Memoir and Advice is now available as an e-book through Amazon. In 3-4 months it will be out in paperback (and I will send another announcement). The e-book is $5.99 and the paperback should be about $12.99.

Here is the link

 to Amazon.

Amazon does include a brief description of my book, but: I'd like to share my own thoughts.

This veterinarian’s memoir is inspired by an almost forty year career that overflowed with wonderful people and their devoted pets. In this book you meet animal lovers who struggle with guilt even though it is obviously time to say goodbye to their pets. You share the anguish of those who have no idea how to select the right pet and are shocked when their choice turns out to be totally inappropriate. You read about a house call where a client has a heart attack only moments before her pet is put to sleep; you witness a Rottweiler escape from his owner and lunge at my face. I will describe the cruel and sordid picture of corporate veterinary America where monetary ambition is considered more important than the practice of quality medicine. The stories of my own pets are scattered through the book. Each is introduced with a short novelized autobiography (and a picture). You laugh out loud when my Golden Retriever, Bailey, compares road kill to the delicacies in a buffet line. But, for the most part, this is a poignant story of people and the pets they love.

The last section is an appendix with 13 valuable lessons. Included are topics ranging from selecting the right pet to why you should feed a measured amount of a quality pet food.  Suggestions for easier house training and essential obedience training are reviewed. I offer advice on how to identify the exceptional veterinarian as well as how to save money on your pet’s medications and veterinary care. More appropriate and safer vaccination protocols are examined in detail. (Are your pets still getting vaccinations every year? You need to read and understand why they should not be!) Why your pet should be neutered, ear disease, and understanding your cat are all discussed before the closing lesson on euthanasia embraces the inevitable heartbreak we face with each of our pets. If you enjoy reading about people and their pets, you’ll love this book. If you want to partner in your pet’s health care, this will be a great help.    

Please send me your comments; praise or criticism, I'd still like to hear.

Kenneth H. Cohn, DVM    

    

Pet hoarding and why it makes good pet care so difficult (and expensive)

One day I made a home visit to vaccinate a healthy dog.  When I parked in front of my client’s home, I noticed all the empty cat litter boxes stacked in her garage. I started thinking: am I sure she wanted her dog vaccinated?

Once she opened the door I had to ask if I was here to vaccinate her dog because all I could see were cats. I’d walked into her small bungalow and there were cats everywhere. 34 to be exact but that doesn’t count the 4 in her bedroom (that don’t get along with the others) or the 5 on the enclosed back porch (which are relatively new arrivals). I had to start petting them because these were very friendly cats. Each level of the cat tree was occupied; four more cats were scattered across the living room sofa. Each dining room chair was occupied by 1 or 2 felines. Everyone was happy and if I got close enough, the heads swayed my way for rubbing and caressing. No one could get enough attention.

The litter boxes were relatively clean and filled the end of the dining room. There was plenty of food left in the bowls I could see. (I’d have to give her my advice about this later.) It was kind of fun to be surrounded by all these cats that each wanted all your attention, but where was the dog?

The dog was confined in a small second bedroom. My client explained that the elderly neighbors had both gone to the hospital and left the dog behind. Now, she had found out that they weren’t coming back. But the dog was fine with the cats, and the cats weren’t afraid of the dog but she didn’t trust them together (yet?)

As we looked over the dog and talked, it looked like he was getting the short end of the stick. Yes, he had a loving home but he was confined to a small spare bedroom. Periodically he was led out to the back yard where he spent some time, but there were no walks, minimal exercise and not a lot of stimulation.

This was a very busy woman and she was doing the best she could with all these pets, but Bosco was a very nice dog, and he belonged in a new home where he would get more attention and stimulation.

The cats seemed to be doing well with the exception of one who had lost a lot of weight and was not responding well to treatment after his diagnosis of diabetes. If you read my posts on the importance of limit feeding your pets and how to treat the diabetic cat, you will understand how complicated this 43 cat household becomes. How do I know who is eating and who is not? How do I feed the most appropriate diet as well as the right amount to each cat? It can be done, but it’s not easy and is very time consuming (as if any home with 43 cats wouldn’t be time consuming). I had had a client in St. Louis who managed quite well with her 24 cats. At meal time (twice each day), each feline knew to go to his or her food bowl and wait for their particular diet. With 24 cats of various ages and needs, there were 4 different diets spread between these cats.  

Ultimately the couple got divorced but had to continue to live together because where can you move and take 12 cats?

Most of us don’t have the time, energy or finances to take care of this many cats. It’s hard to say no to each additional cat that needs a good home, but you have to be fair to yourself as well as the cats. Also, the more cats in one household the more likely behavioral problems (such as urine marking) and even fighting will result. 

As far as Bosco: There was food sitting in his bowl and he exercise was limited to visits to the back yard a few times each day. If patterns didn’t change he would continue to put on weight and ultimately suffer all the side effects of too much food and too little exercise. Unfortunately, this kind woman had a bad knee and couldn’t walk this big dog. My recommendation was to find a new home for the dog. Until that happened, I suggested feeding a precise premeasured amount of a light diet twice daily, and when possible, going out into the yard with the dog and throwing a ball for him to encourage more exercise and activity.

When can I no longer postpone the inevitable euthanasia?

Ten days ago, while my wife and I were driving our small motor-home through the Superstition Mountains in Arizona, “Debby” called to request a home visit to euthanize her 13 year old dog. She explained Sunny was having more and more trouble getting around and that she and her husband had finally agreed this was the time. He was taking Tramadol which helped some, but he was an old, arthritic dog and he had had a long, good life. I explained that I wouldn’t be back for another week and we set up an evening appointment for the day after I planned to return.  I asked Debby to leave a brief message on my home phone with her address and said I would call once we were in town. A few days later she called again. Her husband wanted to wait until after the weekend and we postponed the visit till the following Monday. I was surprised that once we returned to Tucson, there was no phone message. I thought maybe they’d changed their minds or decided not to wait so I called to check. She apologized; she thought she had called and left a message. What bothered me most about this exchange of phone calls was the obvious lack of urgency. Typically, if I am traveling and someone needs their pet put to sleep, they can’t wait a week for me to return. They simply call someone else. Something about this house call wasn’t quite right, but we set up a date and time, and I headed to her home on Monday morning.

When I’m greeted by a bunch of pets wagging their tails, I always assume (and pray) that the pet I’m here to see is not waiting at the door with everyone else, but instead, painfully confined to a comfortable bed in another part of the house. I should never have to wonder, “Am I putting to sleep one of these?” When I’m going to someone’s home to euthanize their pet, I want to walk in the door and easily recognize the pet that will be much more comfortable once I’ve done my job. He is ready to go to sleep and will appreciate this final rest.

Once Debbie had identified the biggest (and slowest) greeter as Sunny, I gently petted this old dog and tried to visually evaluate him before carefully asking, “Do you want me to first examine him and then we can talk about what we might be able to do to make him more comfortable so he can spend some more time with you? Or, have you and your husband already made up your minds that this is what you want to do?”

With no hesitation she responded. “We’ve had this big dog for 13 years and it is time. My husband said goodbye to Sunny when he left for work and for days we have been preparing ourselves for what we know needs to be done. Let’s get it over with.”

Her estimate of Sunny’s weight seemed pretty accurate and I asked when the vet had last weighed her. Most people aren’t good at guessing their pet’s weight and can’t easily weigh an 80 pound dog in their own home.

“I just guessed his weight because my son’s dog is almost as big and he was just at the vet. Sunny hasn’t been at the vet since we got him from the Humane Society.”

I innocently asked when that was. “That was when we got him 13 years ago.”

I always ask if the pet owner has seen this done before. Most have, but I still go through the procedure step by step so that they will know exactly what to expect. Debbie made it clear that she and her husband had already talked about this quite a bit and they wanted no further discussion. Once Sunny was resting comfortably on his bed, I placed a tourniquet on his leg and put him to sleep.     

Lesson: a pet needs a yearly examination. As he gets older,lab tests and other diagnostics need to be added to his workup. Proper exercise, diet and pain management can add quality years to our pets’ lives.

These previous blogs include additional information for keeping your older pet healthy:

http://kennethcohndvm.blogspot.com/2014/05/does-arthritis-always-meaneuthanasia.html
http://kennethcohndvm.blogspot.com/2014/06/limit-feeding-dogs-and-cats-to-prevent.html

Dental disease in dogs and cats: why you should brush your dog’s teeth! Part 2

The most important question pet owners fail to ask is how often do I need to brush my pet’s teeth?  For you to take the best possible care of your pet’s teeth, they need to be brushed once daily! A daily brushing will certainly reduce your pet’s frequency of professional veterinary dental cleanings, but probably will not eliminate them. Remember, under anesthetic and with the best possible lighting, your vet will see things you cannot and can perform a very thorough exam and cleaning.

If you take care of your pet’s teeth (and that means daily brushing), the gums will remain much healthier and the dental procedures will be simpler and less frequent. Almost 15 years ago I adopted a 5 year old rescue dog with very heavy tartar accumulation, but fortunately little gum disease. After a thorough dental prophylaxis, I began brushing his teeth every day. It wasn’t easy to get him used to it (he was 5 years old and no one had ever tried), but in a few weeks he was becoming much more cooperative and ultimately came to enjoy it (they love the taste of the veterinary pastes). He lived another 11 years and never needed to have his teeth cleaned again. This dog was the exception, but had I not chosen to brush his teeth every day, he would have needed to be anesthetized for professional dentals every 6 to 12 months for the rest of his life. 

Our pet’s dental health is similar to ours and once the gum tissue has become infected and receded (leaving the exposed dental roots), it will not grow back. After a thorough dental prophylaxis, this area will rapidly refill with tartar and the gum disease will continue to progress. Ultimately the involved tooth or teeth will become unstable and need to be pulled. So don’t wait to have your pet’s teeth cleaned and to begin home dental care.

The sooner you begin to practice good dental hygiene with your pet, the healthier his mouth will remain. It is important to remember that we are not simply talking about cleaner teeth. Heart and kidney disease and other serious health issues are known to be caused by untreated periodontal disease and the associated bacterial infection that floods our blood stream. And, we aren’t even talking about the pain and discomfort caused by infected gums and loosening teeth. 

Yes, your pet will need to be anesthetized to have his teeth cleaned, but with new anesthetic regimens and appropriate monitoring, this is a safe procedure. In fact, the odds of serious complications from untreated dental disease are much greater than the risks of general anesthetic for most pets. Neither you nor your vet should ignore your pet’s dental health! Don’t rely on the occasional dental prophylaxis to take care of your pet’s teeth without the benefit of home dental care. You wouldn’t stop brushing your own teeth and simply rely on your dentist to take care of your teeth and you shouldn’t take this approach with your pet! If you need more suggestions on how to brush your dog’s teeth or how to take better care of your cat’s teeth, talk to your veterinarian.

Dental disease in dogs and cats: why you should brush your dog’s teeth! Part 1

Dental disease is all too common in our pets. Every time you go to the dentist the hygienist gives you advice on how to better care for your teeth. Does your veterinarian suggest how to take the best care of your pet’s teeth?

When your pet is getting his annual exam, be sure that the mouth is opened and there is a thorough oral exam. Not only ask but take a careful look to see how your pet’s teeth look. Inquire about what you might be doing at home to help your pet maintain a healthy mouth.

The simplest suggestion is one that will help both canines and felines: limit feed dry food. Canned food tends to leave a paste residue over the surface of the teeth. Free feeding (the food is allowed to stay out all day) and nibbling throughout the day is no better for your pet’s teeth than frequent snacking is for our teeth. Every time we eat, more plaque is left on the teeth.

Dental diets and treats may help some, but not at all if your pets doesn’t chew them thoroughly, and some pets, especially cats and small dogs, may simply swallow them whole. Unfortunately, there is no substitute for brushing your dog’s teeth. (The same could be said for our cats, but while few cats will allow us to brush their teeth, almost all dogs can be trained to have their teeth brushed.) We are only talking about 1 to 2 minutes daily.

When you adopt a puppy, you should get him used to your opening his mouth and looking around. When you need to give your pet a pill, the process will be much easier; it will be possible to pull something out of his mouth if you need to, and once his adult teeth have all erupted (about 6 months of age), you can begin brushing his teeth. Until this time he will be getting used to your handling and playing with his mouth.

For most dogs a small or pediatric tooth brush works well. A used brush (with the bristles somewhat crushed) is great. Always use a veterinary tooth paste. Human paste actually contains soap and is not meant to be swallowed, and pets hate the foaming action of our tooth paste. In addition, because we live so much longer than our pets, their past can be much more abrasive (and effective) than ours.

Push the paste down into the bristles, hold your pet’s mouth closed (pets hate to have their mouth forced open), lift the cheek on one side of the mouth and brush away. You are mostly interested in brushing the surfaces of the maxillary (upper) teeth. These actually scrape off and clean the lower teeth as your pet chews. Be sure to include the last molars on each side as well as his fangs (canine teeth). Check his incisors (the smaller teeth between the canines) carefully. Many (especially large breed) dogs maintain healthy, clean incisors and they don’t appreciate your brushing them (because you are often closing you pet’s nose while you try to get to these teeth). However, some dogs (especially smaller breeds) accumulate heavy tartar and plaque between these smaller teeth and the gums become red and irritated as they recede. If a careful examination shows anything but perfect incisors and gum tissue, this area will need to be brushed also. While you are at it, check the lower incisors. In some dogs this can be a real problem area and may also need your attention. On a weekly basis I try to hold my pet’s mouth open and briefly brush the inside surfaces, but this is difficult (and often ineffective) and the inside surfaces tend to accumulate much less tartar than the outside surfaces.

We’ll continue this discussion in another week!

Part 2 of 2: Euthanasia of the Potbellied Pig

The big mastiff calmed down quickly and the couple led me to the barn to see why I was here. I retrieved my house call kit from the car and followed them between two old barns out into a fenced area that looked like it once held livestock. Other than 2 goats in an adjacent area there were no more farm animals to see now.

“We got our potbellied pig, Jimmy, for our kids about 15 years ago. He’s lost so much weight. He used to be fat and now he’s skin and bones. He can hardly walk. Our regular vet put him on some medications a while ago, but they are not helping anymore. We think it’s time.”

I first drew up a sedative and gave him an injection in the neck muscle. (Recommended in this area because the pigs have so much fat everywhere else and the injection needs to go into the muscle and not the fat.)

Euthanasia solution is best given directly into the vein and the most accessible vein in a pig is in the ear flap. Mrs. Arnez headed into her house to get me a bowl of water to wash up the area. I needed to thoroughly clean the outside of the ear and improvise a tourniquet to force the vein to stand up for me. This would be the sight of Jimmy’s injection.

He was sleeping soundly from the sedative. Once the ear was clean and the tourniquet was in place, I could still not see a vein. The next step was dousing the area with alcohol and tapping or lightly “slapping” it with your hand until the vein stood out. My worry was, what if after the sedative and the prep, I still couldn’t find a vein? Or what if I found a tiny vein but couldn’t successfully feed the needle into it?

There was no problem. The vein became obvious after the alcohol treatment. Jimmy felt nothing as I gave his injection and he peacefully went to his final rest. 

Part 1 of 2: The Brazilian Mastiff and the Potbellied Pig

Have you ever driven down a street and seen a sign: aircraft may also use this road for landing? Or seen a street sign that says: aircraft only? If you haven’t, then you haven’t driven through an air park in Tucson where homes, planes, horses and wildlife share space. When I was heading to a house call a few nights ago and saw these signs, coyotes, jackrabbits, multiple Gambel quails  and the many homes that shared their backyards with private aircraft, I knew my GPS had mislead me. I had even been forewarned by my new client. Luckily, I still had cell phone reception and could get directions. Making house calls in unfamiliar areas around Tucson, the most frustrating experience is to be lost and not have cell phone reception.

I was heading out to euthanize a potbellied pig. He was weak; he was old and had been losing weight for a long time. I hadn’t dealt with one of these guys for many years, but I had done my homework and was prepared.

It took me so long to find their home that it was getting dark by the time I arrived.  The directions weren’t easy (I have a terrible sense of direction anyway), but when I passed their barn, rusting antique tractors and horse stalls, I knew I was in the right place.

As I pulled over to park, 2 huge dogs came running over to greet me. The Great Dane was quiet and friendly. His much larger companion wasn’t happy to see visitors; he barked and snarled as foaming saliva flew all over my dust covered car (I had just driven 3 or 4 miles down a dirt road to get here).  I assumed when I saw my client walking across his driveway that he would call off his guard dog, but he paid no attention. I wasn’t getting out while this snarling giant was waiting on the other side of my car door. Finally a woman walked out the front door and she thought to call this big boy to her side.

When I felt safe enough to leave my car, the first thing I asked was, “How big is that dog? He kind of dwarfs your Great Dane, doesn’t he?”

“He’s about 225 pounds. The only thing we could get that was bigger was a steer.”

I had to agree and you’ll have to wait for the next blog to hear about the pig.

Pet Food: Should I feed an all-natural or grain-free diet?

Hardly a week goes by that I don’t hear a pet owner tell me that they have started feeding their pet a much more expensive food with no grain or an all-natural diet or a food with meat (instead of meat byproducts). The obvious question is: Are these the best foods to feed our pets and are they worth what we pay for them?

My opinion (also shared by the professional veterinary nutritionists I have spoken with) is that these foods offer no advantage to more traditional high quality diets, but we may be paying more to simply purchase some advertised ingredients. This post offers my opinion as a veterinarian who has researched and promoted careful dietary management for almost 40 years.

Let’s discuss low-end  pet foods first. Unfortunately, you get what you pay for when it comes to most pet foods. If you pay less, you are most likely getting less. Comparing labels and ingredients simply doesn’t help. To prove this point, years ago a major pet food company cooked down leather boots and then tested the product to come up with the guaranteed nutritional analysis. The results: the nutritional analysis was identical to most of the available canned pet foods, but a pet fed the cooked leather boots would have starved to death because the ingredients were not digestible. Some time ago when a new pet food was introduced by a major company, they wanted their label to have meat listed before meat byproducts (to look better  than a major competing brand). This diet contained less meat than meat byproducts, but by simply playing with the processing, they were able to list meat first. (Besides, quality meat byproducts are not necessarily an undesirable ingredient!)

When you look at the biggest pet food manufacturers such as Royal Canin, Iams-Eukanuba, and Purina, you see huge, multinational companies that can afford extensive research and feeding trials. They employ teams of professionals to formulate and evaluate their diets. These companies study the relationship between diet and disease and invest millions of dollars developing diets formulated to help control or treat many diseases. Often existing diets are reformulated and improved based on the results of these studies.

Yes, you do help pay for these studies, but you also benefit from the fact that these large companies can reduce their costs by buying large quantities of quality ingredients, and they pass this savings on to you. You are spending what is necessary to buy a diet with the very same ingredients that have been proven to keep our pets long-lived and healthy. So, what about the niche natural food diets, the no-grain diets, the diets with nothing but meat and vegetables and no byproducts?

There are pets that suffer from food responsive problems. Your veterinarian is best qualified to help you select the ideal diet for such a pet. Sometimes this may include a no-grain diet, but most often it will be a particular prescription diet that has been specially formulated to treat pets such as yours. But, when you are buying pet food, consider these facts. You have no idea who makes a store or generic brand pet food, but it’s not a major company that’s buying the highest quality ingredients or running extensive feeding trials. When you buy the niche diets, you are paying a premium for a special diet that for most pets has no advantage to the diets made by the major name-brand pet food manufactures. In fact you are paying a premium for what most professionals agree has no added value for a pet. Buy the higher quality and pricier diets from the companies you know and trust and you are investing in proven ingredients and not the marketing gimmicks that have led us to believe in the value of the all-natural and grain-free diets. Our pets have been domesticated for over 10,000 years and most thrive on high quality conventional pet foods.

(And, of course, regardless of what you feed, don’t overfeed your pet!)

    

Curing Diabetic Cats with Purina DM and Glargine Insulin

I went on a house call to put an old, debilitated dog to sleep, and as often is the case, we started talking about their other pets. They had a second dog and 2 other cats and all their pets were significantly overweight. The husband agreed there was a weight problem, but his wife didn’t want to deprive her pets. (Luckily, she had left the room as we continued our conversation.) Mr. Bedrow told me that one of his cats was diabetic, and they were giving him insulin shots every 12 hours. When I asked about special diet, feeding schedule and anything else the vet had recommended (because often with proper management, we can eliminate the need for insulin in these cats), I was quite surprised to hear that there were no other instructions. Both cats ate the same dry grocery store (name brand) food, and the food sat out all day every day.

“Did you know that most diabetic cats can be weaned off of insulin with scheduled and limited feeding of special (prescription) diets for feline diabetes and a human type of insulin. We can cure these diabetic cats."

His eyes widened as he responded, “I had no idea but I doubt we could get my wife to cooperate, but tell me more.”  

I first explained that we used to treat diabetic cats like they were little dogs. We used high fiber diets (just like we prescribed for dogs); some of the cats stabilized but none lost their need for insulin. “Then we started treating them like they were cats. We went to high protein, moderate fat with very low carb diets. After a thorough evaluation to rule out any other problems, I recommend limit feeding Purina DM (prescription diet for diabetes) diet (mix a small amount of this with the cat’s regular diet and slowly increase the new diet as you decrease the old). Your cat’s daily amount of food should be divided into at least 2 meals. If he needs to begin insulin injections (and most do), the feeding intervals are coordinated with the injections so that he is fed as the blood sugar begins to drop. Initially simply a change in diet and careful limit feeding (the goal is an ideal weight) can be attempted to “cure” the diabetes, but I wouldn’t wait longer than a week before adding insulin into the picture because the longer cats remain untreated the more likely they are to start having complications from their diabetes and the more difficult it can be to ultimately wean them off of insulin. Glargine insulin is the most effective for eliminating the need for daily injections. The bottom line is when you combine a careful feeding management (optimal diet, quantity and schedule) program with the appropriate type of insulin, most cats can be weaned off of insulin.  Work with a veterinarian who not only wants to manage your cat’s diabetes, but also wants to eliminate the need for continued insulin injections. He can even make suggestions for monitoring your cat’s sugar at home to reduce the number of office visits.

I need to stress that almost all diabetic cats (and dogs) have type 2 diabetes, and this is the result of how we feed our pets. Too many people believe that if pet food is left out, cats will not over eat. That is simply not true. In other blogs I will write about the other important reasons to limit feed our cats (and dogs).

For all you ever wanted to know about treating your cat for diabetes follow this link http://www.catinfo.org/?link=felinediabetes. I don’t necessarily agree with everything the author says (especially when she discusses appropriate diets), but she certainly provides a lot of valuable information.

Send me any questions or comments you might have!

Limit feeding dogs and cats to prevent obesity, arthritis, diabetes...

I created this blog to entertain and to educate. (And, if you enjoy the blog, you will enjoy my upcoming book LAUGHTER AND TEARS, a Veterinarian’s Memoir and Lessons.)  One of the most important and money saving tips that a veterinarian can teach is how to properly feed a pet. In other words, what exactly is limit feeding and why is it such a big deal. Too many pet owners think their pet(s) won’t overeat. They feel guilty if food is not always available. Others think they are limit feeding because once or twice daily they put food in their pet’s bowl and ultimately (maybe by the end of the evening) it is finished. But, if your pet doesn’t empty his bowl before he walks away, he is not limit-fed and he is at increased risk for obesity, arthritis, diabetes and many other serious, health issues.

I define limit feeding as first determining how much food is necessary to maintain your pet’s ideal weight and then dividing this amount into 2 daily feedings. (A pup may be fed 3 to 4 times daily but no pet should be fed once daily.) A healthy pet instinctively will eat enough to maintain or increase his weight. In other words, a limit-fed pet will empty his food bowl within minutes twice daily 7 days a week. (Dogs may take less than a minute and cats may take several minutes.)

What’s the big deal? If your pet is limit fed and one day he doesn’t finish his food, there is a problem and either you or the vet needs to determine what that problem is. If food is always available, it is never obvious when your pet’s appetite changes.  

Why else would you limit feed? I have been making house calls for almost 40 years. The most common reason I go to someone’s home is that their pet is having a hard time getting around. They are arthritic and the owner is deciding whether euthanasia is the most humane solution. Often the reason for the arthritis is chronic obesity from over feeding (and under exercising). Most pets will overeat if food is always available.
  

How do you decide how much to feed your pet? The pet food probably has feeding suggestions on the label. But, remember these recommendations are for maintaining an ideal weight. If your pet should weigh 25 pounds but weighs 35 pounds, you should look at the instructions for feeding a 25 pound dog and even this might be 25% more than your pet needs. Your veterinarian might be your best resource for feeding instructions, but the bottom line remains, your pet’s ideal daily ration will be less than he wants but enough to maintain his ideal weight. For example, if his ideal weight is 20 pounds, this may be 1 cup of a quality name brand pet food each day. Every morning I carefully measure this 1 cup. He is then given ½ in the morning and the balance in the evening. This is measured once daily because it is easier and more accurate than measuring twice daily.

Limit feed your pet (dog or cat)! You will prevent weight problems, you will be evaluating how your pet feels twice daily, and you won’t be wasting expensive pet food or cleaning up excessive poop after your pet (either in the yard or the litter box).

How can I start my pet on this limit feeding schedule? Is it even possible to change a dog or cat from a free fed schedule to a limit fed schedule?  It’s much easier than you might think and whether your pet is a dog or cat, the process is the same. Once you begin to limit feed, if your pet walks away before the bowl is empty, pick up the balance and either throw it away or add it back to the main food container. (If this is beyond an introductory period, you need to know why he didn't finish his food.) It is not added to the other meal and it is not left out. It doesn’t take long for your pet to learn that this is no longer an all day buffet. He is getting hungrier before each meal and soon (within a few days) he is eating what he needs to maintain his (current) weight. Over time you can slowly adjust the amount until he is maintaining his ideal weight.   

2 of 2: Does arthritis have to mean euthanasia?

I palpated nothing abnormal in Roscoe’s abdomen so I began to examine his legs. First I had Liz lead her pet around the yard so I could see how he did on a routine walk. His rear end was obviously weak, but I didn’t see anything more specific. When Roscoe stood up earlier for me to continue his exam, I had noticed definite weakness and difficulty in getting up. After walking a few minutes, I l had Liz stop him in front of me and I continued the examination.  Starting with his front limbs, I turned each of his feet over so that he was standing on his knuckles. With a normal placing response (evaluates neurologic function-not arthritis), he would immediately flip each foot back over to stand on the bottom.  He did this; there was no deficiency here. Please notice I am examining his front end even though I have seen no problems here yet. Every pet needs a complete exam regardless of where we think the problem is. Once we had finished our exam it was obvious that Roscoe’s discomfort was mostly in his hips. I could elicit no pain when examining any other joints.

“Have you ever heard of hip dysplasia?” I asked Liz.

“I’ve heard of it,” she responded, “but I really don’t know what it is.”

“This is most commonly diagnosed in large, older dogs but it can be seen in any size and age dog. It just causes the most obvious signs in these guys. The hip is a ball and socket joint, and in hip dysplasia (which is usually genetic) the socket isn’t as deep as it should be and as the dog ages (though this can be diagnosed in young dogs, also), the joint becomes more and more unstable. The body produces a lot of extra bone and arthritic changes as it tries to stabilize the hip but that only makes things more painful. With a younger dog, I would recommend x-rays to further evaluate the joint, but it would be difficult to get good pictures without some sedation because of the pain. At his age and with these symptoms I have no doubt about the diagnosis.”

“So what can we do to make Roscoe more comfortable? I will do anything I can to keep him around longer. I don’t care if it’s only for a month or two. I just want him to be more comfortable.”

“I would treat this the same way I would treat any joint disease in the older pet. First, we evaluate his weight and in Roscoe’s case, his weight is fine so we don’t need to make any changes there. He does belong on a diet for older dogs and there are some prescription diets for arthritis, but we’ll talk about diet later. Secondly, we need to talk about exercise. The less Roscoe moves around and the less you walk him, the more difficult it will become for him to get up and walk. We all need to keep exercising as we get older. That might begin as an easy five to ten minute walk once or twice daily. As he gets stronger we can increase that. I think walking your dog is also a quality of life issue. They just enjoy walking with us. Thirdly, he needs to be on medication for the pain. If he was much younger, I would talk about glucosamine, but at his age a non-steroidal combined with a pain medication like tramadol (a narcotic-like pain medication) tends to be very effective. Before we start these medications, we should run a blood screen to be sure we aren’t missing anything and that there are no contraindications to these medications. If he responds well, in a month we may want to repeat some basic blood tests to be sure that he is having no ill effects from the medication. Once you begin this exercise and medication regimen within a week you should be able to decide if we are helping Roscoe. Don’t try to read between the lines. If there is improvement, it should be obvious.”

After only a few days Liz called to tell me how thrilled she was with how well Roscoe was doing. He was up to two 10 minute walks each day. He was having no more trouble with the back steps; he was clearly enjoying life once again.

I had cautioned Liz that I didn’t know how much longer we could keep Roscoe comfortable and she understood. She explained that she would do anything she could to buy even a little more time with her best friend. He did quite well for close to four months and then began to slowly deteriorate again. When we met again at the cemetery, Liz and I were both thrilled with the four good months we had bought her pet. We both had tears in our eyes when we said goodbye to Roscoe one last time.

During almost 40 years of practice I have seen some dogs (and cats) respond to treatment and do well for years and I have seen others we simply could not help. More often than not, pets do well on medication, but unfortunately, it’s often hard to predict results; you just have to try. Again, this is a 3 step program that needs to be supervised by a caring veterinarian. . You have to be willing to evaluate your pet’s diet (he belongs on a quality senior diet and he needs to be weight appropriate), he needs exercise, and he needs prescription medication. Home remedies can be ineffective or even dangerous. 

1 of 2: Does arthritis mean euthanasia?

Early one evening Liz called. “Dr. Cohn, I got your number from the Tucson Pet Cemetery. I wondered if you could meet me at the cemetery and look at my dog. He’s 14 years old and I think it might be time to put him to sleep. He has a really hard time getting around. If you can’t help him, you can put him to sleep at the cemetery. I already have a burial plot. I’ve talked to the director and she has no problem with us meeting at the cemetery for this examination and possible euthanasia.

(There is a part of me that has to wonder how a dog feels about going to see the vet at the pet cemetery. I know if my wife arranged for me to meet with my physician at the mortuary I might have some second thoughts.)

At 1:00 the next afternoon I was visiting with Liz and her 85 pound shepherd mix, Roscoe. “Please tell me all about Roscoe, how long he has been like this and what your other veterinarian has suggested and anything you are doing to help him.”   

She wiped her eyes and briefly talked about her pet’s earlier and very healthy years. Then she told me why we were meeting. “I guess about two years ago I first noticed he was having more trouble getting up in the morning. It took about five minutes for the rear end to catch up with the front. But, as the day went on, he always did better and better. He’s never been much of a walker and he continued to do well on any short walks we might take, but over the last year or so we’ve stopped taking any walks. I just go out in the yard with him. Now he is having more and more trouble getting up during the day. Last week I noticed he was having a hard time going down the few steps into the back yard. Over the weekend he tripped when he was coming down the steps and cried out. That’s when I knew it was probably time. After all, he is 14 years old and he’s had a long, wonderful life. I don’t want to watch him suffer like this. I know his arthritis must be terrible!” 

“Has your current vet made any recommendations?”

With no hesitation she explained. “It’s so difficult to get him up into the car; we haven’t been to the vet for several years. I did talk to him over the phone, and he agreed that Roscoe had arthritis and maybe it was time. “

Roscoe was laying comfortably in the shade, so my exam began with him right where he was. I always start with the easiest and least painful things. The ophthalmoscope showed some increased cloudiness in his eyes caused by lentricular sclerosis which is due to the normal aging process of the lenses. This is obvious to us but not to the dog and there is no interference with his vision. In most dogs this process is not due to cataracts. The otoscopic exam showed very clean canals (common in the dry desert southwest; much less common in the humid Midwest where I saw yeast ear infections almost every day). His teeth showed early tarter but his gum tissue was still healthy. (Smaller breeds tend to accumulate tarter and suffer from associated periodontal disease at a younger age than do larger breeds probably due to the increased space in the larger breeds’ mouth.) His heart beat was slow and regular; his coat was clean and healthy in appearance. His nails needed cutting (quite common in less active aging pets (canine and feline).

Next we helped Roscoe stand and I deeply palpated his abdomen and began to evaluate him for neurologic or arthritic changes that would make it more difficult for him to get around.   

You’ll have to wait to see what I found to read about Roscoe’s destiny in the second part of this story. (You can make some guesses in the meantime.)

Buried catgut sutures create multiple abscesses along suture line

My wife and I spent a few days in Homolovi Ruin State Park (Arizona) in early May. With our small motorhome already set up in the campground, we decided to walk to the Indian ruins, but they turned out to be much farther than we had originally guessed. On the way we stopped to eat a picnic lunch and flagged down a campground host to ask how much further the ruins were. Susan graciously offered us a ride because we were still some distance away. After walking around the ruins, she offered to take us back to the campground. On both trips we shared the vehicle with her young and friendly Blue Tick Healer mix that she had rescued almost a year earlier. It had been plagued with some serious health issues but looked fine now. Only two weeks before, Jenny had undergone an exploratory surgery. Her abdomen was still clean shaven. Down the center of her belly ugly fresh blisters (abscesses) covered the incision scar. 

I asked, “So where was the exploratory surgery performed? It looks like Jenny is reacting to whatever suture material they closed her abdomen with. The surgeon will have to open the blisters and pull out the reactive suture material. By now the muscle has healed, but the ‘buried’ suture needs to be removed before the blisters will disappear.” 

She explained that the surgery had been performed in Phoenix, and she didn’t know when they could get back. “Could you do it for me?”

We’d been on the road for about 10 days and hadn’t brought any veterinary supplies with us. I explained I had nothing with me and she anxiously responded, “I probably have most of what you’ll need. I have alcohol, gauze, and even a scalpel blade. What else might you need?”

“The only other thing would be a tweezers and sharp scissors.” Before she could respond, my wife answered. She had both.

We headed to Susan’s campsite, submerged all the instruments in rubbing alcohol and while Jenny lay comfortably on a blanket covered picnic table, I scrubbed up.

In less than 15 minutes, I had made a few painless incisions through the largest blisters and removed two large knots and a few inches of what appeared to be number one cat gut (a very large and reactive – meaning the body tries to reject it -  type of suture material).

The campground host’s eyes bugged out at what I had pulled from the wounds, and I explained, “I didn’t think vets were even using this type of suture material any longer. If you use the littlest size and keep the knots small, it might be fine, but with that size suture material and those huge knots, I’m not surprised we got this kind of reaction.”  

We finished the procedure without hearing a word from our patient. Susan couldn’t thank me enough, and I have to admit, I enjoyed every minute of it.