pet connection

Finally, some pet-related legislation we can all get behind: a law to force antifreeze makers to add a bitter flavoring to their products is under consideration by the United States Congress. From the VIN News Service:

If enacted, H.R. 615, sponsored by Rep. Gary Ackerman, would amend the Federal Hazardous Substances Act to nationally require what already is mandatory in ten states and has been considered in a handful of others: Engine coolant must contain denatonium benzoate, the most bitter compound known, to render the sweet but toxic liquid unpalatable.

The goal of H.R. 615, or the Antifreeze Bittering Act of 2009, is to deter children and animals from drinking antifreeze. Ingesting just a tablespoon of ethylene glycol, the poisonous component in automotive antifreeze, can be lethal to a 10-pound cat. The Humane Society of the United States estimates that about 10,000 dogs and cats die from complications related to ethylene glycol toxicity each year, but other agencies guess that number to be much higher. Thousands of people are accidentally poisoned annually, states the American Association of Poison Control Centers. There also are reports of ethylene glycol-based antifreeze being used as a murder weapon.

It’s time, and past time, that lawmakers got off their butts and did this. If industry was going to do it on its own, they would have already. If the 40 states that haven’t passed it themselves were going to, ditto.

There are already some antifreezes out there made with propylene glycol, a substance that’s not as toxic as ethylene glycol. And just because something’s incredibly bitter or otherwise inedible doesn’t mean a dog won’t eat it — dogs have, as we all know, eaten some very unlikely things.

But it’s a start, and a big one.

Federal lawmakers have twice before failed to pass this law, so let’s all hope the third time is the charm.

When Dr. Becker posted yesterday about kidney disease and a cat named Puff who beat the odds to live into his second decade, my first thoughts turned to Samson, a senior kitty I adopted when he was 15.

When I took him to the veterinarian for his first check-up, she was pessimistic. He had “ten years of deferred dental work,” needed all his teeth extracted, and was in renal failure. “He has maybe a year,” she said.

Samson lived to be 18 and a half, healthy, active and loved for all of it. Even three days before he finally breathed his last, he was still purring, playing and eating.

But then a second, darker memory came to mind.

My dog Bran was 4 years old, and had never been sick a day in his life, when he was diagnosed with kidney failure.

It didn’t seem too terrible at first. He got finicky about eating one day, but the next day he was fine. The day after that he was finicky again, and then he started to vomit, so we headed for the vet. She drew some blood, gave him some fluids and medication for his stomach and sent us home until the test results came back. He didn’t seem very sick.

The test results indicated kidney failure, so we took him to a specialist in another town. He still didn’t seem very sick, but his kidney values were so bad that the specialist was extremely concerned. We hospitalized him. We did more tests. We treated what we thought he had (letpospirosis), until that was ruled out by the tests.

We dug deeper. We did more tests. He was getting sicker. I took time off from work. I slept at the vet hospital, or in my car, or in a hotel room. I tried to hand-feed him, but he just vomited, so we gave him intravenous nutrition.

He got even sicker. His kidneys got worse. We still had no diagnosis. My vet bill at that moment was over $4,000. I cashed in my savings and paid it.

My vet suggested I take him to UC Davis. I hesitated. They wouldn’t let me stay with him at the hospital, and I was at a state-of-the-art specialty practice already. I asked her, “What can they do there that you can’t do here?”

“Dialysis,” she answered bluntly.

I went. And on the way, I called my credit card company and negotiated my credit limit upward, to cover the cost of dialysis. Fortunately, the person I spoke to was a dog lover, and he put the credit increase through on the spot.

At Davis, they were not optimistic, but did offer me a little hope. Some of the worst possibilities had been ruled out, and a few of his symptoms had actually improved, even though his kidneys were clearly worse. If this was a bacterial infection of some kind, the vets told me, dialysis might keep him alive while the antibiotics cured the infection, and he might recover. It wasn’t impossible.

He was only 4 years old. I’d held him in my hands when he was born. So I told them to go ahead. They put in the dialysis catheter and took a kidney tissue sample while he was anesthetized. I borrowed $2,000 from my mother.

The next day, he went into respiratory failure, and we put him to sleep.

I’d made the last 10 days of his life miserable with tests, tubes and hospitalization. I’d spent over $10,000, more than half of it borrowed. I’d let my professional and personal lives go completely to hell while I sat next to my dog on the hospital floor, stroking his head and hoping for a miracle. If I’d known how it would end, I’d have put him to sleep the first day.

The problem is we never do know how it will end. From necessity, we do a kind of emotional and financial triage without the single most important piece of information: Will it be worth it?

For people with little or no money in the budget for veterinary care, that triage might be painful but simple. There’s no point in debating the merits of a diagnostic procedure or treatment that you can’t afford. But even if finances aren’t tight, the incredible array of technologies available in veterinary practice today can burn through the most generous pet care budget in days, and can be bewildering to pet owners.

Surgeries that were once unheard-of in veterinary medicine — such as organ transplants — are now being done on pets. Chemotherapy, arthroscopic and laser surgeries, hip replacements, MRIs and nearly every form of sophisticated medical treatment or diagnostic procedure known to human medicine is available in animal practice, too.

And while people with insurance find a big chunk of their own medical bills doesn’t come out of their own pocket, very few people have veterinary insurance for their pets. Those who do rarely find it covers intensive diagnostics or the most expensive therapies.

I wrote about this for my SFGate.com column a few years ago, and interviewed leading veterinary cardiologist Dr. Paul Pion, president and co-founder of the Veterinary Information Network.

He agreed that veterinary medicine today offers choices that can overwhelm pet owners, particularly in the area of diagnostic testing. “We can do a much better job of diagnosing things than we ever could,” he said. “Today’s veterinarian is a different vet from James Herriot, whose diagnostic methods were things like the laying on of hands, and smelling.”

But Pion doesn’t see technology as being the main source of veterinary medical miracles. “Things are being diagnosed earlier. Owners are watching them more. They’re bringing them in when something can be done. And veterinarians are detecting more. It’s not just the technology, it’s having the relationship with the vet.”

Unfortunately, as with my dog, no matter how many diagnostic tests you run, you don’t always get the answers you’re looking for. Not even on necropsy (the animal equivalent of a human autopsy) did the vets at UC Davis discover what destroyed my dog’s kidneys. When faced with uncertainty, Pion recommends that pet owners “look the vet in the eye and ask, ‘Do you believe this will make a difference? If this were your dog, what would you do?’”

Ultimately, the decision of how far to take the search for answers — and for miracles — is a personal one. Some people go too far, putting their pets through needless stress to chase a cure that is, at best, unlikely. Others give up too soon, or resist digging a little deeper for money to pay for even routine care. Most people, though, just try to walk the difficult line between the extremes and make rational, caring decisions based on their animal’s needs as well as their own.

Experienced professionals can help you evaluate the odds. Only you can decide how much you’re going to bet, or how long you’re going to play.

Photos: Christie Keith

It’s almost guaranteed: if I write about almost any pet health topic, from how to pick a good veterinarian to a story about a recalled drug, comments and email about anesthesia for pets come pouring in — along with a truckload of urban legends, dire warnings about specific drugs, second-hand horror stories and egregious mis-statements of scientific fact.

Yes, anesthesia can be risky for pets, just as it is for us. And yes, pets tend to be anesthetized more often than humans in their lifetimes. And yes, also, not all veterinary practices are equal when it comes to how well then handle anesthesia for pets.

But anesthesia techniques have improved a great deal over the last decade. So have the drugs. What you have to do as a pet owner is understand the general principles behind best anesthesia practices and find a veterinary team that uses them.

So this week, I’ve interviewed three experts and put together a roadmap to getting it right.

“Our days of performing surgery on animals with substandard anesthesia are long gone, just as our days of performing open heart surgery on babies without anesthesia belong in the dark ages,” said Dr. Julie Meadows of the UC-Davis Veterinary Medical Teaching Hospital.

Also left behind is just hoping for the best, said Dr. Kris Kruse-Elliott, medical director at AnimalScan in Redwood City and a board-certified veterinary anesthesiologist.

“We’re much better equipped to minimize anesthesia risk than in the past,” she told me. “Veterinarians in James Herriot’s day didn’t have a lot of tools to monitor anesthesia, but today, we have everything that’s available in human medicine.”

Those tools include sophisticated equipment that can monitor heart and lung function in ways that were unheard of even two decades ago; better anesthesia drugs; more knowledge about how to intervene if problems with respiration and circulation arise; and better pre-anesthetic screening procedures to identify patients that need special care when being anesthetized, such as dogs or cats with kidney, heart or liver problems.

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For planned procedures, the veterinarian will want to see your pet a day or two before for a complete physical examination, including blood tests.

When the veterinarian listens to the pet’s heart, the rhythm should be normal, and there should be no unusual sounds such as a murmur. “If the heart evaluation is normal, a veterinarian should recommend blood and urine testing, to evaluate the function of the liver and kidneys, the two organs that break down the anesthetic agents commonly used,” said Meadows.

If the pet has heart, kidney or liver problems and the need for anesthesia is critical, special precautions can be taken to make the process safer. Knowing in advance allows the veterinary team to take those precautions.

When it comes to the procedure itself, pet owners often focus primarily on what drugs will be used, but Kruse-Elliot thinks that approach is misguided.

“The questions people should be asking of their veterinarians aren’t so much what exact drugs will be used, but what is the procedure they follow?” she said. “As a specialist, I have many drugs available, while a veterinarian in general practice will have fewer. But what you want to hear is that they’ll be able to modify what they’re doing with the drugs they’re comfortable with, according to the needs of each individual patient.”

Nancy Campbell, a registered veterinary technician with special training in anesthesiology, agrees. “Almost any appropriate drug combination can be safe if the medical team knows what they’re doing,” she said. “And almost any can be dangerous if they don’t.”

The rest is here… hope you find it helpful!

Photo courtesy of the American College of Veterinary Anesthesiologists.

I was fresh out of vet school when I met Ruth. It wasn’t under the best of circumstances; she was elderly and all alone in the world except for her very senior cat Puff, and Puff wasn’t doing very well. In fact, despite three days of everything the medicine of those days could do for him, he was slipping away.

I told my wife Teresa that I dreaded breaking the news to his owner, knowing he was all she had left to live for.

If you’ve read Chicken Soup for the Cat Lover’s Soul, you know how it ended: I asked the people at my church to pray for Puff and for Ruth, and the next morning he began to recover. In fact, he made it to the ripe old age of 22.

Not every cat has an entire prayer circle pulling for him, so it’s fortunate that our ability to diagnose and treat kidney failure in cats has gotten better in recent years.

But few of these interventions make much difference if the cat’s kidneys have progressed too far into failure. As a veterinarian I can tell you that the earlier we can detect a kidney problem, the better chance we have of successfully treating or controlling it.

In order to get a jump start on kidney failure and other diseases, I’ve long recommended that owners have their cats age 6 and older undergo a battery of tests including a complete blood count, serum biochemistry panel and a urinalysis to determine if the kidneys and other body systems are functioning properly.

That early detection is critical as it allows us a period of grace before something becomes more difficult or impossible to treat, cure or control. It also prevents unnecessary pain, risk or worse. And, harkening back to a commercial of my childhood talking about routine oil changes, “You can pay me now or pay me later.” In other words, prevention and early detection can save money in the long run.

There are several tests available to get an idea of how the kidneys are functioning. Blood tests and urinalyses are familiar to most pet owners, although they typically don’t detect kidney problems until they’re quite advanced — kidneys will have lost around 66 percent of their function by the time it shows up in the urine, and around 75 percent by the time it can be detected in a blood chemistry profile.

Two other less well-known tests can detect loss of kidney function at an earlier stage. One of these is the glomerular filtration rate/Iohexol clearance test, which your veterinarian can have done through the Michigan State University.

To understand how this test works, you have to understand what it means for a kidney to “fail.” Kidneys are made of cells called “nephrons,” which filter the blood and remove wastes so they can be flushed out in the urine.

The rate at which the nephrons can flush out waste is known as the “glomerular filtration rate,” or GFR. The less efficient the nephrons are at removing waste, the more severe the kidney failure.

Iohexol is a substance used as a contrast medium for radiographic tests, and it’s excreted by the kidneys. By measuring how long it takes the cat’s kidneys to process a dose of iohexol, the lab can calculate the GFR, and get a strong indication of how well the nephrons are doing their job.

Another test is the E.R.D. Healthscreen from Heska Corporation, which looks for microscopic amounts of albumin in dog and cat urine, an indication that the kidneys are beginning to fail. This test is done in the veterinarian’s office, and is a quick and easy urine test.

It would be nice if you could walk into the veterinarian’s office with your pet, take one of these tests, and walk out with a definitive answer as to how well your pet’s kidneys are working. Unfortunately, that’s not how it works.

There are a number of causes of abnormal kidney function, including simple, treatable problems like an infection. That’s why it’s critical for older cats and dogs to have kidney function tests at regular intervals, to provide their veterinarians with a picture of how that function is changing over time.

A single test might not tell you anything, but a series of changes in kidney values are much more clinically significant. Talk with your pet’s veterinarian about which tests are most appropriate for that dog or cat, and how frequently they should be given. That’s your best bet for catching renal failure early.

This information is very important for all dog and cat owners, because kidney failure is on the rise; it’s the number two cause of death in cats.

That increase may be because our pets are living longer, and kidney failure is associated with aging. It may also be due to stresses of modern life such as toxic exposures and infectious disease. And let’s not forget the dogs and cats exposed to melamine in the 2007 pet food recall; many of those pets’ kidneys have been compromised, and their owners will need to be particularly vigilant as those animals grow older.

Kidney failure is also irreversible. Short of a kidney transplant, which costs north of $20,000, you can’t restore kidney function once it’s been destroyed. By catching kidney damage early on, by treating the underlying causes if possible and by instituting certain preventive measures such as special diets, supplements or medication, you not only will save money in the long run but much more importantly, give your pets a happier, healthier, fuller life.

Time to talk to your veterinarian!

Pet killing debate now high profile issue in Illinois: This November, Illinois voters will be going to the polls to select a new governor.  You remember the whole Rod Blagojevic mess?  Well, he was replaced by Lt. Governor Pat Quinn.  Quinn (a Democrat) is now running for election in his own right, and last week came out with a statement about who his prospective running mate might be:

“I think it’s important for our lieutenant governor to be someone who loves dogs,” Quinn said.

That might sound a little odd for a governor’s race, but The Huffington Post tells us the remark has its roots in an ongoing debate over the use of the carbon monoxide gas chamber to kill shelter pets in multiples.

In 2009, the Illinois legislature passed a bill banning the use of carbon monoxide gas chambers for the mass [killing] of dogs. At the time, Sen. [Bill] Brady voted against the bill. And recently, just days after the Feb. 2 primary [for the GOP nomination]  he introduced a new bill to re-legalize the practice.

Brady took considerable flak over the proposed legislation from the Humane Society [of the United States] and the story garnered a good deal of media coverage.

According to the Chicago Sun-Times, Brady was pretty quick to back off this porcupine:

Brady  gutted the legislation Wednesday and turned it over to another sponsor after the Humane Society of the United States condemned the measure and characterized the procedure as cruel.

“A constituent asked me to do it, and I have an obligation to represent my constituents,” Brady said.

“I was never for it, but I thought it was a subject that deserved discussion. But the politics surrounding me being the nominee created an environment that’s more attack mode than discussion mode, so we shelled the bill.”

The Sun-Times reports the “constituent” was an animal-control facility in Brady’s district, apparently one with management that believes killing pets in a cruel and terrifying way is preferable to, you know, just plain old killing them. Someone, please, get those people information on building a no-kill community. Or better yet, replace them with people who at least live in this century.

Oly the Olympic puppy: You may have seen something about a bunch of winter sports taking place in and near Vancouver over the last couple weeks.  Jordan Malone is an American short-track skater. He didn’t have a great Olympics, but he did have a best friend who got him through it all.

Uncanny canine carousel carvings: You may know Tim Racer as one of the co-founders of BADRAP. However, you might not know about Tim’s phenomenal talent in creating drop-dead gorgeous canine carousel sculptures.   Tim takes up to 700 hours getting these works of art exactly right, and has been known to fly across the country to meet his models, using the opportunity to take precise measurements with calipers.   Thanks to Susan and Gina for tipping me off to this SFGate article.

So what does “Cami Missy Diva Piglet Punky Girl” mean? I’m a sucker for psychological discussions that try to analyze tidbits about me and use those little factoids to draw broad-brush conclusions.    This one from Forbes Magazine is perfect, then.  What you name your pet gives clues as to your personality.

Your dog’s name says a lot about who you are. “The name of a dog reflects the personality and sense of humor of the owner,” says Lisa Peterson, spokeswoman for the American Kennel Club. “For example if you name your toy poodle ‘Brutus,’ that shows a sense of irony.”

Ok, so maybe I won’t learn as much as I hoped, but you should still check it out.

Funny things that veterinary clients say: PetConnection BFF Dr. Patty Khuly has a funny piece on Dolittler about great stuff uttered by her clients.  The comments yield even more, so be sure to read them too.

I always like to hear from readers, especially if you have tips, and links for interesting stories.  Give me a shout in the comments, or better yet, send me an email.

Image:  Ruff weekend on the campaign for state Sen. Bill Brady (HuffPo image).