Human Drugs

Dear Fellow Pet Lovers,

Though I take this up every so often, I would like to again remind you to be very careful giving “safe” human drugs to your pet for whatever reason.

Recently, I treated a dog who was  hit by a car, and the owners had already given him a certain amount of Tylenol. The owner just sort of gave an amount that seemed reasonable to him, without really knowing a dose or even whether the drug was ok. Luckliy, the dose used was not toxic and I was still able to use effective drugs on this dog despite the Tyleonol in its system.

I have on many occasions had possibly toxic doses of various drugs given by sincere owners just trying to help their pet. In most of these cases, I can deal with the toxic drug, but I am then limited on what effective drug I can use due to the toxic drug being present.

So, best bet is to avoid giving your pet any med not ordered by a DVM for this particular incident.

Remember that, even if the drug used is an OK drug in the correct dose, it may not be the one that best suits your pet’s condition, and it may then prevent use of a better drug due to drug interactions.

Remember too that many drugs used safely in people are toxic or have wildly different dosing in pets.

So, as regards drug use in your pet, avoid the do-it-yourself spirit. Since the stakes are so high, this is a time when a DVM should prescribe the correct med at the correct dose to best help your pet.

See? Something can be done about keeping pets healthy!

That is all.

Dr. John Emerson, Pet Emergency Clinic

Compounding (the problem?)

Dear Fellow Pet Lovers,

You probably know that most veterinary drugs tend to also be human drugs and that veterinarians (DVM’s) have the authority to prescribe any human drug the veterinarian feels is appropriate for any animal that is his/her patient.

In some cases, needed drugs are not available from a regular pharmacy or the concentration or form of the drug makes it unusable on animals. In such cases, a compounding pharmacy (a pharmacy which has the skills and equipment to create different forms or concentrations of drugs) can be useful to the patient.

For example, if a needed drug for a cat came only in a tablet that the cat would not take, the compounding pharmacist could make it into, say, a liquid. Pharmacies, such as this, are valuable for both veterinary medicine and for human medicine.

Of course, it is necesary that the compounding pharmacist be very skilled and meticulous. In a case several years ago, numerous horses died after being given a compounded injectable product. This tragedy resulted in tightening of the regulations concerning compounding. These tighter rules caused several compounding pharmacies to elect to not compound injectables rather than comply with the newer, stricter, rules.

Compounding pharmacies are another weapon that DVMs may use in the war against pet disease. And, like any weapon, it must be used skillfully and cautiously.

See? Something can be done about keeping pets healthy!

That is all.

Dr. John Emerson, Pet Emergency Clinic

Doc. It’s OK. He Doesn’t Bite

Dear Fellow Pet Lovers,

Whenever people find out that I am a veterinarian, many of them ask whether I have ever been bitten. I always answer in the affirmative, as almost any veterinarian would. Though that particular question can become monotonous to me, it is a good topic for today.

Aggressive dogs can be difficult and, I believe, unhappy. Recently, I had a dog that the person was “home schooling” as a police dog come in to the ER. This dog was so vicious that it was almost impossible to even inject him to sedate him. [FYI- Actual Police dogs are rarely truly vicious and are always under control]

Of course, few dogs are ever that aggressive. Usually, the bites we receive are the result of the poor dog panicing and biting in what he considers “self-defense.”

My colleague Dr. Joe Soileau used to say that the number one cause of death in dogs is euthanasia due to behavior problems. I believe that is true. So, what to do?

1- Start with a breed that is generally docile. There are very few actual advantages to an aggressive breed. (And no. It is NOT just in how you raise them. Some breeds, raised among the most loving people and situation in the world, are still just aggressive.)

2- Socialize the puppy. This does not mean you must call him “comrade.” Rather, it means to expose the pet to other pets and lots of situations early in life. This will probably result in a confident, non-biting pet. The puppy should stay with its litter at least 6 weeks and up to 12 is even better.

3- Avoid hand-raised orphans. These pets often become very squirrelly due to their lack of other members of their species to emulate. And yes, there ARE exceptions.

3- Puppy classes. Some of the big box pet stores offer these, and they are good. Some private individuals offer “private lessons.” These can be very good if you get the right trainer.

4- Train yourself in how to interact with a puppy. Slap fights with a puppy? No. Tug-a-wars with your puppy? Probably no. How you interact with your puppy is key in his later confidence as an adult. Usually confident adults do not feel they must bite.

5- Have all vaccinations and licenses in place as early as possible in case something does happen, it is a huge hassle if your pet is not legal.

Pet owners are very compassionate and kind as a group. The above tips may help you avoid being one of those owners who has to make a difficult decision about a pet due to bad pet behavior.

See? Something can be done about keeping pets healthy!

That is all.

Dr. John Emerson, Pet Emergency Clinic

TOXIC PETS

Dear Fellow Pet Lovers,

What is a toxin? One definition is a “poisonous substance capable of causing disease when present at low concentration in the body.” This seems like a pretty good definition. I also always try to remember that ANYTHING in large enough amounts can be toxic.

If you think about a usually non-toxic human drug taken by a 200 pound man that is now ingested by a 20 pound Beagle, you can see that the dose of drug per pound body weight is 10X higher in the dog. And there is the problem. At that dose, it may kill.

I have seen cases in which a 10 pound Poodle was given an ounce of alcohol at a party just “for fun.” What the alcohol provider did not realize was that this 20X higher dose of alcohol may be enough to cause severe illness or even death in the dog.

Recently, I treated 2 cases on the same day in which a dog ingested an illegal stimulent drug. In the first case, nobody knew about any single thing that the dog could have received. As a result, I needed a good bit of blood testing that I may not have needed had I known, and I also had lots of stress as this dog that had “gotten nothing” tried to seizure itself to death.  I spent far more money and effort just because the owner would not help me.

In the second case, the innocent owner had figured it out and advised us at admit. As a result, I was able to specifically treat the problem more aggressively and without lots of extra possibly unneeded testing. Both dogs, eventually did well.

So it comes down to this. If you are aware of what may be “ailing” your pet, even if it may be illegal and you may not want to admit it, ADMIT IT. We at Pet ER are not police. We need the data to help your pet. And then, once all is well again, DON’T DO IT AGAIN!!!!

Also remember to never give your pet ANY meds unless a DVM has ordered it and you KNOW FOR A FACT that the drug is OK  and and the dose. I have had pharmacists innocently give pet owners potentially deadly “advice” to use a pet-harmful drug just due to lack of knowledge.

As they say on “Hill Street Blues,” let’s be careful out there.

See? Something can be done about keeping pets healthy!

That is all.

Dr. John Emerson, Pet Emergency Clinic

Accreditation

Dear Fellow Pet Lovers,

Did you know that veterinary facilities may be accredited by certain professional groups?

Many of you have probably heard of the American Animal Hospital Association, or AAHA, which is a group attempting to raise and improve the level at which veterinary hospitals are managed and practice. Practices that voluntarily choose to become accredited have met some pretty stringent standards and stand a chance of being a very good practice. (Many outstanding practices choose to NOT go through this process and are still great.)

In the Emergency Clinic world, the AAHA accreditation does not seem to fit as well, since it is focused on regular day practices. In the Emergency Clinic world, the organization that is similar to AAHA is called the Veterinary Emergency and Critical Care Society, or VECCS.

I learned several months ago that VECCS has an accreditation program for emergency clinics that is analgous to the AAHA accreditation for day clinics. The Pet Emergency clinic has been working on earning this accreditation for the past several months.

This is to let you know that the Pet Emergency Clinic is in the final stages of VECCS accreditation and will have this action completed before the end of the year. What do you get out of the deal?

An emergency clinic that has met stringent standards of operation on an international level. I am trying to say that your emergency clinic is definitely striving to be as good and competent as any similar one on the planet.

Earning this VECCS accreditation means that your pet gets treated at a clinic that has been evaluated and certified to high standards. And you still get our fine doctors and staff as always.

We will let you know when this is completed.

See? Something CAN be done about preventing pet illness.

That is all.

Dr. John Emerson, Pet Emergency Clinic

Cough Cough Cough

Dear Fellow Pet Lovers,

Many of us who have been in veterinary for many years remember plain old “kennel cough”, in which a dog coughs as if something is caught in his throat. The cough is noisy and bothersome and usually would run its course over about 7-10 days with the dog fully recovering afterwards. A “Kennel Cough” vaccine would prevent the problem in almost every case, and this was more of a nuisance than a severe threat to life.

In recent years, the cough situation has become more complicated. It started with Canine  Influenza (flu), a disease that possibly was a mutation of the Equine Influenza. This disease initially presents with symptoms similar to Canine Cough, fooling veterinarians. But then, the pet becomes more and more ill, with some dying and some having permament lung damage.

Once this disease became significant, tests to confirm it and vaccines to prevent became available. “Flu shot” for dogs is now commonly recommended by many veterinarians. Now, there is another deadly cough appearing in certain parts of the country. As I type, the actual ‘identity” of the new bug has not been learned.

While Canine Cough, or Kennel Cough, seemed to be found all over the country, Canine Influenza and the other new cough strain seem to appear in different  “bands” of disease in different regions of the country. We have also seen these strains spread slowly from region to region.

Louisiana was Influenza free for several years, but now is beginning to have cases appear. The new unknown strain has not yet appeared in Louisiana.

What is the point of all the above?

Simple. If your dog shows any type of coughing that lasts more than an day or of he is coughing at all and seems to fele bad, do not wait. Have him seen by a DVM ASAP, since the new coughs could be far worse than just a nuisance.

See? Something CAN be done about preventing pet illness.

That is all.

Dr. John Emerson, Pet Emergency Clinic

IT’S NOT WHAT YOU THINK IT IS!

Dear Fellow Pet Lovers,

At an emergency clinic, we treat many different types of cases, from bleeding-to-death trauma patients to ingrown toenails.

And our approach to sick pets is, often necessarily, different from the approach your day veterinarian may take.

Usually, once a person has decided to take the pet to the ER, the situation is probably serious, or at least very concerning to the person. So, the ER DVM will usually be somewhat aggressive in trying to determine what the problem is, or at least determining  how dangerous the condition is. (Your home DVM, may sometimes have more of the luxury of being able to take a “wait and see” attitude more often than we can.)

So, when your pet comes to the ER, we will very often order blood testing, X rays, etc., in an attempt to get the case handled.

In some cases, especially of trauma or an unstable patient, our approach is to handle what is “killing him the fastest” rather than some of the more obvious and spactacular injuries that we see. For example, though your hit-by-car pet may have a very gaudy broken leg, we will probably be far more concerned about his overall state of shock, low blood pressure, bleeding, etc. Things such as fractures will usually be definitively handled by your home clinic, and usually are not immediately life-threatening.

I occasionally field complaints about cases in which the ER veterinarian heroically saved a critical patient, but maybe did not mention certain other injuries that would require further repair a little later. (Though the ER veterinarian had ordered the pet to the home clinic to complete the care) The owner thought something had been missed, but usually those injuries had to wait until we could be certain that the pet could survive.

If you are a football fan, you may have heard about elite football quarterbacks, such as the Saints’ Drew Brees, and how they go through a “progression” when planning to throw a pass. It may be to look for the planned receiver first, then a secondary, then a third one, etc etc, so that the play will be successful.

Similar to Drew, your ER DVM has “progressions” in attempting to save your pet’s life. First treated are the things that will kill first.

Remember this if we are treating your pet and you do not immediately see certain apparently obvious actions being taken. There is probably a reason.

Of course, you should always ask questions and attempt to understand your pet’s case the best you can. Our ER veterinarians are usually pretty good at explaining things.

See? Something CAN be done about preventing pet illness.

That is all.

Dr. John Emerson, Pet Emergency Clinic

Ha!… Ha!… Ha!… Ha!… Stayin Alive. ….Stayin Alive

Many of you remember the movie Saturday Night Fever that included the famous BeeGees disco song “Stayin Alive.”

And did you know that “Stayin Alive” can help your pet to stay alive by making CPR easier?

CPR (Coronary Pulmonary Ressussitation)  is a set of lifesaving actions taken when a heart stops. It includes “pumping” the heart at a certain speed  to try to restart it . And it just happens that the rhythm of “staying Alive” matches the rhythm of correct CPR.

Regarding CPR on your pet, here are a few bits of info….

1- There are some somewhat new standardized actions now published for pet CPR. (This has been complete in humans for many years, but in veterinary medicine, universal guidelines had never before been completed)
2- CPR for a pet (or even a person) with severe multi-organ disease is often unsuccessful, even if the heart is restarted initially.
3- CPR for an otherwise healthy pet or person who “codes” under anesthesia or in unusual situations has a far better chance of success.
4- Remember this paddles you see on every TV medical show? These are often useful on humans but not so much on pets, because the cause of heart stoppage is different.
5- A good CPR team drills and practices to try to give a pet the very best chance whenever a cardiac arrest occurs.

So, there you have it. Heart-stopping information in case a heart stops.

See? Something CAN be done about preventing pet illness.

That is all.

Dr. John Emerson, Pet Emergency Clinic

Veterinarians: “As Seen On TV.”

Dear Fellow Pet Lovers,

As a veterinarian, I am always interested in how we DVM’s are portrayed on TV. It definitely varies. From insults on MASH and Gray’s Anatomy to kinder portrayals on some other shows, I have seen a lot.

But the shows that are really hard for me to watch are ‘reality shows” featuring starring animal doctors practicing very poor quality medicine and yet are very likable. While veterinarians like “Dr. Pol” and “Dr. Jeff the Rocky Mountain Vet” are probably great guys, they seem to be trying to say that things such as sterile surgery and medical workups are not necessary. Guys such as this often point out that their cases do fine most of the time and their fees are dirt cheap, and that maybe guys who do it right, are mostly doing things right just to be able to charge more money.

FYI, and my opinion only, I cringe every time I see poor, outdated techniques being glorified on TV, as it makes all DVM’s look like quacks. (If Dr. Pol fixes cases without sterilized instruments and Dr. Jeff “cures” cases without any testing, why can’t YOU?)

As you know, pets are more a part of families now than ever before, and veterinarians are expected to practice comparible quality to our human MD colleagues. This definitely requires more and better equipment, techniques, and levels of expertise that were not much thought of even 20 years ago.

And, of course, it costs money as well.

So, appreciate your DVM if she or he is one you trust and feel good about. (And maybe find another one if you don’t.)

See? Something CAN be done about preventing pet illness.

That is all.

Dr. John Emerson, Pet Emergency Clinic

BUILD YOUR OWN DOG

Dear Fellow Pet Lovers,

Have you ever really thought about how long dog and man have worked together as partners?

Thousands of years, no doubt.

And did you ever wonder why dogs, maybe more than most other species, vary so widely in size and shape even when considering “normal” animals? It is true, a “normal” toy breed dog could naturally weigh 3 lbs, while a “normal” giant breed one may be upwards of 250. (The Spanish Mastiff is the largest breed of dog at about 225 lbs on average.)

And why are some dogs thin and svelte while others are thick and stocky?

The answer to all of this is because we as man have bred dogs to have traits that we consider desirable for whatever mission the dog is to have with us. For example, if you wanted the fastest dog, you would want one thin and with strong leg muscles (the Greyhound,) if you wanted one to guard your sheep, you would need a strong, smart, loyal type (the Collie,) and if you wanted one to sit on your lap and maybe not shed, you might breed dogs that begin to look like a Poodle.

This is all fine at least at first, but then people begin to go for certain types that have the “cool” factor but that may not exactly suit that dog’s mission. It is here where we may see a Great Dane in an apartment or a toy Maltese running free outside.

Some other examples of popular dogs that are maybe not so practical include many Bulldog breeds. Goofy, happy, and friendly, bulldogs are a joy. But many bulldogs also are cursed with severe difficulty breathing and overall poor health.

So, considering that I do not have a dog in this hunt, and in no way being “catty,” here are my tips for tis week….

-Look hard at the type of breed you will get and try to select rationally based on practical matters as much as you can.

-Select a breed that is a size that works for you and that is as healthy as possible.

-Ask lots of people, mentally place the dog into your life, and see if it will work out before you get the pet.

-If you just must have a higher-maintenance breed, consider getting pet health insurance or self insure by setting money aside every month towards health care.

-Team up with your DVM for best data on feeding, care, and overall health.

-And come the Pet Emergency Clinic anytime your pet has even a small problem out of hours.

Happy Dogging!!!!

See? Something CAN be done about preventing pet illness.

That is all.

Dr. John Emerson, Pet Emergency Clinic