Your Pet's Best Friend

Bruising on pets may be hard to see.

Can you see all the bruises on this cat?  What, you can't?  I guarantee you that they are there.  This cat was rescued from a situation where a big dog was chewing it and a person (I use the term loosely) was hitting it with a stick.  There are no broken bones, no obvious wounds, no apparent bleeding.  Circulation is good, so probably no internal bleeding.  Lungs sound okay with the stethoscope.  He must be un-injured, then, right?  Wrong.   He didn't want to eat, he didn't want to move.  That is, he wouldn't eat until we gave him some pain control medication.  I wouldn't call him perky at that point, but he did get up and eat.  After three days of rest (and pain medication) he was behaving pretty normally.

We are accustomed to seeing discoloration when we think of a bruise.  A visible bruise means that the tissue has been damaged enough by blunt trauma that blood vessels are leaking blood into the tissue.  This produces the lovely colors.  On a pet, the skin is usually concealed by the fur, so you just don't see that very often, even when it is there.  Sometimes the hairless belly of a dog will show a purple spot, but if the pet has a dense coat, you'd have to shave them to find the bruises.

As a teenager, one of my more foolish decisions resulted in a motorcycle crash that sent me rolling quite a ways across the pavement.  Fortunately, I did not collide with a vehicle, and I was wearing new Levis, leather jacket, boots, gloves and helmet.  I did not have any visible bruises or scrapes, but my whole body felt like one big "charley-horse".  I felt like someone had beaten me like a xylophone from one end to the other.  I was stiff and sore and hurt everytime I moved for several days, this despite having no visible injuries.

Last week I was presented with a little dog who had been bitten in the head by a big dog.  His owners couldn't understand why he was acting so sadly. He just had this small wound on top of his head.  Of course, that wound was produced by the big dog's fang punching through the scalp while the whole head was getting crunched between the jaws.  This dog did not have a lot of visible injuries, but he had received the equivalent of having your head smashed in a car door while somebody stabs your scalp with a screwdriver.  Even with pain medication, you are going to be pretty sore for a while.

Sometimes we have to use a little intuition, combined with our history, combined with my usual question, "If this were me, would I be hurting?"

Why we don't feed bones to dogs.

"Do dogs get hemorrhoids?"  That's how the phone call began late last night.  Actually they don't typically get the same problem in that area that people do. On the other hand, they can certainly have polyps in the rectum, or even rectal prolapse (turned inside out).  "Does it look like a red bump? How big is it?  Marble sized? Pea sized?" "It looks like a ribbon."  Well, she had me there.  Over-the-phone diagnosis is always tricky, but I couldn't figure the ribbon thing at all.  "He's panting and acting like he's in pain." Hey, let's go back to work tonight.

Do you remember those ads: "Here's your brain.  Here's your brain on drugs."?

Here's your butt.  Here's your butt with a jagged chunk of bone stuck in it.  Can you say, "Owie"?   Three days earlier, this dog had received a lovely bone for his Christmas Eve present.  It came from the grocery store, labelled "Pig Bone; not for human consumption".  If it's not for people, it must be for dogs.  He ate it really fast.  In a previous post, I talked about the pros and cons of chew bones.  These pictures will be added to that post. 

When the old boy ate the bone, his teeth broke it into fragments.  This one looks a lot like an arrowhead made by prehistoric man, doesn't it? One of those jagged ends was hung up in the back door.  That deal where he was acting like he was in pain?  I don't think you'd have to spend much on acting lessons for that one.  Fortunately, it wasn't hard to remove after he was sedated.  Oddly enough, he didn't want you to monkey with it while he was wide awake and feeling it.

If looking at that piece of bone doesn't make your bottom hurt, then you probably don't understand why we don't feed bones to dogs. I suspect that most of you do understand.

Too fat to scratch

Tommy and Missy are housemates.  Missy weighs 12 pounds, which is pretty big for a female cat.  Tommy weighs 21 pounds which is too big for his frame.  In fact, his size makes it difficult for him to groom himself adequately.  So, despite the fact that their environment is the same, and that they both have fleas, Tommy's flea population is exponentially higher.

Here's Tommy next to the pile of dead undercoat I combed out of him in about five minutes.  I often say that I don't care how a pet looks in a bathing suit, but when their weight begins to affect their health, that's a different story.  You think that grooming is just about looks, but when there is this much dead hair hanging around, that's not good for the skin underneath.  Plus since he can't groom, he can't do much about his flea population.

Here's a close-up of some of that wad of hair.  All the little black specks are flea-droppings (aka nasty flea poo-poo mess). The white junk is dandruff.  There are probably some flea eggs in there, too, but they are much smaller and more difficult to see. Obviously, we need some flea control here, but we also need a little help with personal hygiene, i.e. brushing this guy once or twice a week.  That's pretty do-able (compared to getting his weight down, which is frequently not so easy, and certainly can't be done as quickly).  We like Revolution for flea control on our cat patients.  It's about the same trouble and expense as other products, but it also gives you ear-mite protection, de-worming for hookworms and roundworms, and heartworm prevention.

Note to self: I need to become much more lovable if I'm going to ask people to help with my personal hygiene.

Super Puppy: How to raise the best dog you'll ever have!

Any time of year is a good time for a new puppy, but this time of year will see a larger number of new puppies getting homes. More pertinently, there will be a lot of new puppies who are suprises for their lucky new owners. That's great, except that it may mean that the new owner is not really prepared for the challenges of a new pup.  They just don't understand the "nuts and bolts" of raising a dog. The generous giver failed to include an owner's manual.  Consequently they can become frustrated when the playful puppy doesn't grow up to be the wonderful family pet they envisioned. 

There are many hurdles to be overcome in a raising a puppy, such as: control in your absence, discipline, house-training, chewing, barking, and jumping up on people.  Coincidentally, those just happen to be chapters in this little book.   Peter Vollmer is a behavior specialist, and in each of the chapters, he tells you what your dog is doing and thinking and why.  No matter what your puppy looks like on the outside, he's a wolf on the inside.  He has hard-wired instincts in his brain, and reflexes in his body.  Dr. Vollmer explains these, and, better yet, gives you a step-by-step program to USE what's already there instead of trying to over-ride nature.  You have the understanding to be a good wolf parent instead of trying to make the dog into some kind of weird, hairy, little kid.  The buttons are already in there and he teaches you how to push them.

You gain an understanding of how your dog is relating to the family as a pack, and you learn how to be the leader of the pack (as least as far as the dog is concerned).  Your puppy is looking to you for leadership, and if you don't give it, he will begin testing you to see how far he can go.  It starts out as play, true enough, but it's play that's designed to see how high he can rise in the pecking order.  There are a lot of reasons why you should be the leader instead of your dog. For one thing, you pay the bills, and for another, you look both ways before crossing the street.

These methods are so well explained, and they work so well.  I cannot say enough good about this book.  I used the first edition back in 1981 to train my Rottweiler, Anna.  At nine weeks of age, she would growl, snarl and try to bite you if you reached for her food, or tried to pick her up.  Without "Super Puppy", I would have had to get rid of her.  Using the book (plus some formal obedience training later), we completely turned her around. When our children came along later, they were able to take food from her mouth and walk off with it.  Instead of a snarl, she just gave a kind of goofy, grinning, "Okey dokey" type reaction.

Anna was a pushy pup, as many are. The methods work faster for a more cooperative dog, like our Golden Retriever, Buster.  He was a doormat, just dying to please. The body language we learned from "Super Puppy" helped us show him what we wanted.  He could find his niche faster.

Behavior problems are the number one reason dogs are relinquished to shelters.  All puppies are cute, but many need some education to stay that way.  When I worked at a shelter back in '73,  I got pretty tired of hearing "He was so cute when he was a puppy, but now we don't like him anymore."  Using the "Super Puppy" book methods between the ages of 7 and 16 weeks of age will head off most any behavior problem you can think of. 

I love this book so much that we don't mark them up to suggested retail cost.  We want people to have them.  Each section is short and concise.  Here's what your dog is doing and why.  Here's your step-by-step program to get him to do what you want to him to do.  The longest section in the book is four pages, and that's the best discussion of house-training I've ever seen anywhere.  Check out the Super Puppy website and get this book if you have a new puppy. If you know someone with a new puppy, get this book for them.  I know you can order them on-line, and we always have a stock of them here at KVC. 

These first weeks with your new puppy are the critical time in establishing your relationship with the puppy and molding his future behavior.  He can be just as happy with you as leader of the pack, and you will be a lot happier if you are the leader instead of your dog. GET THE BOOK! Read it.  Use it.

Steel shot is for waterfowl, not dogs.

Not that any kind of buckshot is that good for a dog.  This has been a heavy week for trauma.  We had a guy who was horribly lacerated by large dogs.  After removal of dead tissue, partial closure of wounds, surgical drains, four days on I.V. antibiotics and fluids, hot compresses, hand-feeding and general heavy-duty nursing care, he's doing okay.  The dog whose foot got run over with one toe mashed off -- we're still having trouble with that one.  Crushing injuries are the worst.  I think we'll save the foot, but we're not out of the woods yet.

A little bird-shot is a bit of an occupational hazard for a working retriever.  Sometimes folks are not all shooting in the same direction at the same time, and the guy bringing in the ducks gets more than he bargained for. 

Fortunately, this was from some distance.  The pattern of shot is pretty spread out and the pellets only penetrated about 1cm from their entry wounds.   With lead pellets, the body will encapsulate them and they are pretty inert.  If you leave them alone, they rarely cause any problems (provided they are not impinging on some vital structure).   It doesn't cause lead poisoning when it sits there, though it would if you ate it.  And thereby hangs the tale.

Around 1990, folks decided that those bottom-feeding waterfowl were getting way too much lead poisoning by eating shot that fell into the water (after missing its target).  Thus, it came to pass that a law was passed mandating the use of steel shot for waterfowl hunting in any federally managed wildlife area.  When the birds eat steel shot they don't get poisoned.  On the other hand, steel shot is not inert in the body.  It corrodes, and this can produce inflammation.  In fact, in 1991 a study was done comparing lead pellets to steel after surgically implanting sterilized pellets.  The lead pellets caused no problems, and the steel pellets festered and got nasty.

So, does the same thing happen when dogs actually get shot?  I've had a hard time getting an authoritative answer, but if it were a very big problem, I think you'd hear more about it.   I've got a test case going now, though.  Here are six steel pellets that I removed today.  These six were easy to get to (relatively speaking, that is -- it's more complicated than the "hot knife and a bottle of whiskey" used in many a Western movie). 

Max has one more pellet left.  If you look carefully, you might be able to see its entry wound just back of and above the surgical site at bottom left. It went deep into his cheek tissues and would have taken a lot of exploring to find (meaning: a lot of pain and damage for questionable benefit).  So, we'll just wait and see how much trouble it causes.  None, I hope.

Scouting does not "rain out".

"In a fair and distant land, where we're going to take the Scouts, it never rains a single drop unless you're camping out.  So, a-camping we will go 'til the rivers overflow, and when everything is soaking we will shoot the buffalo."

The red asterisk in the Bootheel is Kennett.  The big green and blue thing  headed east is the last of the weather system that has been drenching us with cold rain all week.  It was supposed to be gone last night, but it wasn't.  We had a big campout scheduled for today with an all-day orienteering and challenge course, followed with a zip-line ride.  It was to be the first campout for new Webelos Scouts who will soon (we hope) join the Boy Scout Troop.  The Cub Scout leaders decided that cold rain wouldn't be a great way for the boys to get initiated (or should I say baptized?).  So, instead of bailing out their tents, they just bailed out of the campout.

Bad introduction either way, unfortunately.  In Boy Scouts we schedule campouts and camporees ahead of time, and we go when the time comes. When the weather is sub-optimal, we deal with it.  No going home because it started raining.  Gear up for good or bad weather. Be prepared, and remember that a Scout is cheerful.

It wasn't a beautiful day, but that's a life lesson, too.  One of our most memorable hikes was five miles in rain and mud.  We were cold and tired and everybody who was there felt like they did something. Things don't have to be perfect to have fun.  Good thing, too, as things are seldom perfect... anywhere.

Pyometra revisited

Warning: gross pictures at the bottom

I've posted on pyometra before, and also on why you should spay your dog while she's young and healthy.   Today we had a really spectacular case, though.  This  beautiful German Shepherd is only 2 years old, and had what appeared to be a normal heat cycle three weeks ago.  Yesterday she started having a bloody discharge.

Her clotting time was normal and she had plenty of platelets, so it didn't look like a "bleeding problem", despite the blood on the floor.  White blood cell count was really high (30,000/mm3, vs 7,000 to 16,000 normal range), and red blood cells were a little low.   An ultrasound of her uterus showed it to be huge.  How huge was it?

The normal uterus, even in a big dog like this, is about the size and weight of a couple of pencils.  This baby weighed over 4&1/2 pounds.

When we opened it, yes, it was full of pus. More than two liters of pus.  Man, do I ever wish this dog had been spayed a long time ago.  Did I mention I had to do the surgery on my afternoon off? Yeah.  The upside is, she's doing great now. Prognosis is good.

Christmas spirit, in spite of myself

Every year, my wife wants the Christmas tree up on December first.  It doesn't usually happen, but that's what she shoots for.  Myself, I think that it's a mistake to start revving up the Christmas decorations and songs before Thanksgiving.  By the time Christmas arrives, you've worn it out (yes, Wal-Mart, I'm talking to YOU).   It seems to me that it would be that much more special if you waited until about a week before the holiday. 

I'm no Scrooge, I don't want to skip it.  When I was a kid, every year about the first of December, my Dad would walk in after work one day and say, "Let's skip Christmas this year."  He could be stern at times, and year after year, we took this threat seriously.  We prostrated ourselves, begging and pleading, until at last he relented.  In reality, nobody loved the holiday gathering with family more than my Dad.  He was just having a little joke at our expense.  [It is not necessary for you to remark, "Well, that explains a lot."]

This year I'm in the Christmas spirit in spite of myself.  I always look forward to Tuba Christmas.  A mass choir of tubas and euphoniums play Christmas carols.  We rehearse at SEMO for an hour, then proceed to the mall to provide lucky shoppers with a sound that is unique.  As an old band-nerd, this is one of my favorite days of the year.   What, you can't see me?

Here I am in the back, playing the baritone horn I started with in 1963.  When the music reverberated away, leaving only the usual din of the mall, I got a little shopping done, then headed home.  Later that evening, I spent an hour rehearsing for next week's gig, but this weekend still had plenty of Christmas spirit to infuse me.

Every fall for the last 25 years or so, I have enjoyed singing early choral music with my wife and friends under the direction of Jerry Mercier.  The group is called Schola Cantorum (Latin for "singing school", and I have learned a lot of music there).  One concert a year, usually around the first of December.  This year's program was all Christmas music, though you might not immediately recognize "Hodie Christus Natus Est" or "Allons Gay Bergeres".

From the Schola concert in our Presbyterian Church, I headed on to the First Baptist Church in Blytheville, Arkansas.  My friend David Ross is the Minister of Music there and he invited me down to play some tuba and shake some maracas.  They had a really nice program tonight, and he and I had our annual catching-up visit.  I got to sing the "Hallelujah Chorus", too. What, you can't see me?

If you look really closely at the bottom left of the right-hand Christmas tree, you'll see the bell of my tuba sticking up.  If you looked really close, the white is the back of my white shirt.  While I am getting balder all the time, there's still enough hair on top to keep me from being as shiny as the tuba.

After all that Christmas music, I actually found myself enjoying the Christmas decorations on the country houses as I drove home.  Christmas spirit, in spite of myself.  Get some yourself  -- it feels pretty good.

Sometimes you can be right, even when you're wrong.

Sometimes it seems that your patient's history is rigged to fool you.  Of course, you don't know that when you start the case.  At that point, everything seems so logical.

Sassy is a 7-years old Maine Coon cat.  We had her in for dental cleaning a few weeks ago.  Her pre-op blood-work was fine.  No problems noted at home other than an occasional hairball.  When we cleaned her teeth, we found that she had a bad tooth which needed to be extracted.  We removed the bum tooth and sutured the gums.   Since she had something a bit out of the ordinary, we sent home pain medication, and antibiotics.  She's a big girl (17 pounds) and not so easy to medicate, so we decided on one BIG capsule once a day, instead of a small one twice a day.  This usually works okay in a case like this.

Shortly after her dental procedures, Sassy began having vomiting troubles.  She could keep down liquids, and soft foods, but dry food came back up pronto.  I feared she might have some irritation to her esophagus from those big antibiotic capsules.  We started her on sucralfate in slurry form three times a day. Sucralfate forms a gel that will temporarily patch into small ulcers and help them heal.

She seemed to be doing better, eating better, but still had trouble with hard cat food.  I feard that she was developing a stricture (a narrow place in the esophagus, caused by the shrinkage of scar tissue in a damaged area).  When I found that she had lost a pound, I was really worried about her.  We mixed some barium into some soft food, which her owner hand-fed her.  An X-ray showed that it all got to her stomach, nothing left in the esophagus.  What she really needed was an endoscopic examination to actually look at that esophagus. 

I have a fiber-optic endoscope, but it's a bit too large to put down a cat's throat, even a 17-pound cat.  Plus, I'm not really experienced in the techniques of dilating a damaged esophagus.  I called the nearest referral specialists and discussed the case.  They agreed with my assessment, and scheduled Sassy for endoscopic examination.

Imagine their surprise to find a normal esophagus, and the pylorus (the stomach's exit valve) pretty much plugged with this gigantic hair-ball. It was hard, not soft, and hooked around into the intestine, so it didn't move much.  Soft stuff gets around it, but no hard chunks need apply.  They were able to remove it by cutting it into pieces [reassembled for the photo here] and retrieving it with the scope -- no surgery required.

Why did this vomiting not start until two days after the dental procedure?  We don't know.  If the vomiting had come out of the blue, would I have sent the cat to a specialist for endoscopy? Probably not.  If I had made the hairball-of-the-decade diagnosis here, the cat would have had exploratory surgery to remove it.

So, I felt bad that I might have caused the problem with the big antibiotic capsules, but that's not what happened, so I feel better about that.  I felt bad that I referred a case of hairball to a specialist, but having it retrieved with an endoscope was so much easier than surgery for the cat and her owner.  It was the absolute best way for the cat's problem to have been handled, so I feel better about that, too.

Despite the fact that I was on the wrong track, we did exactly what the cat needed for the best possible resolution of her problem.  So, sometimes you can be right, even when you're wrong.

Lead paint in dog toys.

This is nothing to lose sleep over.  While it is certainly true that lead is toxic and you shouldn't eat it, the potential hazards of the involved toys have been way overblown.

So, some toy tennis balls like this have lead paint in the pawprints.  How much of this would your dog have to actually eat in order to have a problem?  Here is what Sharon Gwaltney-Brant DVM, PhD, DABVT, DABT of the ASPCA Animal Poison Control Center says:

"So let's calculate a toxic dose for a 10 kg (22 pounds) dog. Assuming worst case scenario, we know that chronic toxicosis is induced at 3-30 mg/kg/day; we'll use the 3. For a 10 kg dog, that's 30 mg of lead per day times 90 days (3 month subchronic study) for a total lead dose of 2700 mg. Let's also assume that somehow the dog manages to eat 1/2 oz (15 gm, 0.015 kg) of leaded paint (at 30 ppm) off of these toys every day (unlikely there's even that much total paint on a toy, but we'll call this worst case scenario). So every day the dog is eating 0.45 mg of lead; it'll take 6000 days to get to the chronic toxic dose of 2700 mg of lead. That's 16.4 years. So, if the dog, every day, scrapes off 1/2 oz (1 tablespoon) of paint from toys/bowls whose paint contains 30 ppm of lead, the dog might finally develop lead toxicosis when it hits 16 years of age. Very very unlikely. Allowable levels for humans should be fine for dogs, especially since dogs don't live as long as we do (risk assessments for humans have to take into account our long life span). "

My brothers and I have laughed about the concerns with children's toys and lead paint.  Certainly it wouldn't be funny for children to be poisoned by eating their toys, but we had toys made out of lead. In fact, we made them ourselves, in our room, without adult supervision, when our ages were 4, 7 and 11.   First, you coat the cast-iron molds with soot by using the open flame of a candle.  Then the two halves of the mold are clamped together.  In the meantime, the lead has been heating up until it is all melted, its liquid surface shimmering like silver.

Now, while we inhale the acrid fumes, the cauldron of molten lead is tipped carefully to pour the mold full, making some shiny new lead soldiers.  Of course, sometimes we weren't as careful as we should have been.  Once some hot lead landed on my toe.  We were in our pajamas and barefoot while doing this.  I skipped briskly to the bathroom and dunked my toe in what commercials used to refer to as "the bathroom bowl".  This was screamingly funny to my little brothers, and little children often find it amusing even today.

So, you shouldn't eat lead paint, and the Chinese are bums for putting it on toys, but your dog is probably not going to get enough to hurt him... unless he helps us make lead soldiers.