Healthy Paws

Editor’s Note: Healthy Paws is a column sponsored and written by the owners of Clarendon Animal Care, a full-service, general practice veterinary clinic and winner of a 2017 Arlington Chamber of Commerce Best Business Award. The clinic is located 3000 10th Street N., Suite B. and can be reached at 703-997-9776.

Online, 3rd party, pet pharmacies such as 1-800-Petmeds, Allivet and many others, have become very popular over the recent years, and with good reason. They often are able to offer lower prices on many of the medications commonly prescribed by veterinarians, with the convenience of having it shipped directly to your home. It seems like a no-brainer that this would be a win-win. After all, in most cases we fill our own prescription medications at pharmacies rather than our doctors’ offices, so why should it be any different for our pets?  

It turns out the situation is not quite as straight-forward as it may seem. Most of the major pharmaceutical companies claim to not sell their products directly to these online pharmacy sources and that they cannot track their product. As such, they do not guarantee the product for its efficacy, expiration date or validity. They will guarantee safety, so long as it is not a counterfeit product. This does beg several questions:

• Where are these drugs coming from, if not from the manufacturer? In some cases, they are coming from unscrupulous veterinarians who purchase a large quantity at cost and then sell it to an online pharmacy for resale to the customer. In other cases, counterfeit product is sold. 
• What happens if my pet experiences an adverse reaction, or the product is ineffective? When many brand-name prescription medications are purchased directly from your veterinarian the manufacturer stands behind the product, guaranteeing both its safety and its efficacy for the labeled indications. As such, if there is a product failure, or an adverse reaction, the veterinarian can contact the manufacturer to report the incident and often obtain some financial compensation for the client for necessary treatments or even diagnostic tests. However, when the product is purchased through a 3rd party online pharmacy avenue, the manufacturer does not support the product because they cannot guarantee that it the product has been labeled or handled correctly, or that it actually is their product.  

Lets use heartworm prevention as an example. Heartworm disease can be very serious medically for the pet, but also very expensive to treat. If a pet has been on heartworm preventative diligently, and the veterinarian has records to indicate appropriate purchase intervals, the company will help to cover the cost of treatment.

In our area of Northern Virginia, heartworm disease is not especially endemic, but the intestinal parasites roundworms and hookworms both are. Both are on the label for treatment for many heartworm preventatives. We have, on more than one occasion, been able to report a treatment failure to the appropriate manufacturer and obtain compensation for treatment costs and follow-up testing for the client. Testing and follow up that may otherwise cost hundreds (sometimes thousands in the case of heartworm disease) of dollars.

Issues and complaints with online pet pharmacies have become frequent enough over recent years that the FDA has created a program called AWARE to educate pet owners about what to be on the look-out for when it comes to online pet pharmacies.  

• A – Ask your veterinarian
• W – Watch for red flags
• A – Always check for site Accreditation — the National Association of Board of Pharmacists has created a program to accredit veterinary pharmacies, called Veterinary-Verified Internet Pharmacy Practices Sites (Vet-VIPPS)
• R – Report problems and suspicious pharmacies
  • FDA:  http://www.fda.gov/Safety/ReportaProblem/ucm059315.htm
  • NABP:  https://nabp.pharmacy/about/
• E – Educate yourself about online pet pharmacies — for more information visit http://www.fda.gov/AnimalVeterinary

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Editor’s Note: Healthy Paws is a column sponsored and written by the owners of Clarendon Animal Care, a full-service, general practice veterinary clinic and winner of a 2017 Arlington Chamber of Commerce Best Business Award. The clinic is located 3000 10th Street N., Suite B. and can be reached at 703-997-9776.

November 13-19 has been declared World Antibiotic Week. While at first glance it might be easy to roll your eyes at this, think about how much antibiotics have done for health and medicine over the last century, and you’ll see few things are more deserving of their own week than antibiotics. Antibiotic, by definition, means “opposed to life” — specifically the life of bacteria. Antibiotic is often used interchangeably with the term antimicrobial, but antimicrobial refers more generally to all microorganisms (bacteria, viruses, fungi, protozoal organisms)

The original antibiotic, penicillin was first discovered by biologist Alexander Fleming in 1928, purified by Ernst Chain, Howard Florey and Edward Abraham in 1942, and further developed for wide-scale production by Norman Heatley. Penicillin arrived on the scene just in time to be the decisive factor in saving countless lives during World War II, and it’s difficult to overestimate the importance of antibiotics since then. However, as “bigger and better” antibiotics have been developed in the 89 years since their initial discovery, many of the bacteria they are targeting have also developed coping mechanisms or resistance to the antibiotics designed to destroy them.

Antimicrobial resistance (AMR) is the ability of a microbe (which includes bacteria, viruses and certain parasites) to prevent an antimicrobial agent from working against it. This has become an increasingly serious problem as microbes develop resistance against more and more antimicrobials and is seen with all kinds of microbes — not just bacteria. While all resistance is a concern, antibacterial resistance typically receives the most attention as bacteria account for so many of the infections seen worldwide, both in humans and animals.  

One of the ways that health care professionals, including veterinarians, determine if a bacterial infection is resistant to common bacteria is to “culture” the organism and perform sensitivity testing — in this process the organism is grown on a petri dish in a lab and various antibiotics are tested against it to see which are effective and which are ineffective at hindering growth in a lab setting. Ideally, all suspected bacterial infections would be cultured; however, from a cost, time and resources standpoint this is not often practical and often health care professionals need to make an educated guess about which antibiotic would be most appropriate for the type of infection they are treating.  

Many of the general recommendations from human medicine for decreasing the chances of resistance apply to veterinary medicine as well:

• Antibiotics should only be used when prescribed by a licensed health professional.
• The full course of antibiotics should be finished, unless otherwise directed by a health professional.
• Antibiotics should not be shared with other people or animals.
• Left-over antibiotics should not be used for similar signs down the road, unless under the direction of a health professional (and if they were used for the full course initially, there shouldn’t be any leftover regardless).

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Editor’s Note: Healthy Paws is a column sponsored and written by the owners of Clarendon Animal Care, a full-service, general practice veterinary clinic and winner of a 2017 Arlington Chamber of Commerce Best Business Award. The clinic is located 3000 10th Street N., Suite B. and can be reached at 703-997-9776.

Cats are often forgotten members of the household in terms of veterinary care, since they are by nature self-reliant and hide illness and discomfort remarkably well. According to the American Association of Feline Practitioners (AAFP), a “senior” cat is defined as a cat over 11 years of age, while a “geriatric” cat is defined as being over 15 years of age.

As age increases, cats are more prone to developing subtle changes in behavior that can help clue us into various common diseases in older kitties, such as arthritis, chronic kidney disease, hyperthyroidism, hypertension (high blood pressure) and small intestinal disease.

Chronic pain caused by osteoarthritis (degenerative joint disease) is the most common condition we diagnose that causes a chronic, negative impact on quality of life. Studies have shown that up to 90% of older cats will have changes consistent with osteoarthritis on x-rays, affecting many different joints in the spine and limbs.

Recognition of feline pain and pain management in cats has come a very long way in the last two decades. Some cats will develop visible lameness or signs of discomfort, but often the signs are much more subtle, such as:

• Hesitation before jumping.
• Relocating favored perches and sleeping areas to more accessible areas.
• If in a home with stairs, limiting themselves to one level of the home.
• Under grooming or over grooming.
• Not using the litterbox, especially to defecate.
• Reclusiveness and/or changes in temperament.

Treatment of osteoarthritis is often multimodal, meaning approached from many different angles. We generally start with omega-3 and joint supplements, as well as some prescription foods to manage the disease from a nutritional angle. Weight management is also an important part of nutritional management, as obesity creates a pro-inflammatory state in the body that can worsen disease symptoms (this is true of humans and dogs, as well!). Pain management with various drug therapies are often recommended; as well as physical therapy, cold laser therapy and acupuncture.

Osteoarthritis and common systemic diseases in cats, such as chronic kidney disease, hyperthyroidism, hypertension and gastrointestinal disease, often have an insidious onset and a nonspecific set of symptoms (weight loss, increased or decreased appetite, vomiting and/or diarrhea, increased water consumption and accidents outside the litter box, etc… ).

The non specificity of symptoms, and often coexistence of multiple diseases in a single cat, is why we recommend a blood pressure and comprehensive blood work and urinalysis profile any time a senior or geriatric cat presents with any combination of these symptoms. We may also recommend diagnostic imaging such as x-rays and abdominal ultrasound to be able to further define symptoms and come to a diagnosis. Treatment of the various common systemic diseases in older cats is also multimodal, often employing a combination of supplements, diet and drug therapies.

In the generally healthy senior or geriatric cat, the annual physical examination is a great opportunity to review the happenings of the past year with your veterinarian, and have a discussion as to the “normals” and “abnormals” of your unique kitty. We very often have findings on our examinations that are so subtle that clients have not noticed them at home, such as weight loss and painful joints. (more…)

Editor’s Note: Healthy Paws is a column sponsored and written by the owners of Clarendon Animal Care, a full-service, general practice veterinary clinic and winner of a 2017 Arlington Chamber of Commerce Best Business Award. The clinic is located 3000 10th Street N., Suite B. and can be reached at 703-997-9776.

Halloween is right around the corner, so this week we’re going to discuss… candy!  These tasty sweets can be dangerous for dogs, particularly those that contain chocolate, are sugar-free candy and those containing raisins. Although not life-threatening, ingestion of high-sugar candy can cause diarrhea by pulling water into the gastrointestinal tract and giving gut bacteria too much “food,” leading to excess growth of bacterial populations. Specific candy toxicities are discussed below:

Chocolate contains a compound called theobromine, which is related to caffeine. Dogs do not metabolize these compounds quickly, so they can experience more intense and lasting effects of these stimulants. Common signs of chocolate toxicity are anxiousness, panting, muscle twitches, rapid heart rate, and even seizures. Vomiting and diarrhea are also common and will sometimes be the only symptom in mild cases.

The weight of the dog, the amount of chocolate, and type of chocolate ingested are all factors that determine whether chocolate ingestion is toxic. As a general rule the darker the chocolate is more toxic it is (baking chocolate is far more toxic than milk chocolate), and larger amounts of any chocolate consumed by smaller dogs carries more risk of toxicity. Milk chocolate is often more concerning for the potential to cause illness and symptoms from pancreatitis, as a result of ingestion of sugar and fat, than true chocolate toxicity from theobromine.

Sugar-free candy with the sweetener xylitol is extremely dangerous to dogs. Xylitol causes large amounts of insulin release in the dog. This leads to a rapid drop in blood sugar levels which can manifest as  uncoordinated walking (ataxia), extreme lethargy and/or seizures.

Xylitol can also induce liver failure and blood clotting abnormalities. Any amount of xylitol ingested should be considered very toxic to Any size dog; if you suspect your dog has ingested this substance, you should immediately visit your veterinarian or the nearest emergency veterinary clinic  for emergency treatment, hospitalization and monitoring.

Raisins (and grapes) have the potential to cause acute kidney failure in dogs. The frustrating thing about this toxicity is that we do not know what in the grapes or raisins causes the toxicity, and there is not a widely accepted toxic dose. Raisins tend to be more concerning than grapes as they present a more “concentrated” version of the fruit. Any ingestion comes with recommendations for emergency care to induce vomiting and, preferably, 48-72 hours of IV fluids and monitoring of kidney values.

In all cases of suspected toxin ingestion, it is advised to call your veterinarian, go to an emergency veterinarian or call ASPCA Poison Control  (888) 426-4435 immediately for further direction. If it is determined a toxic dose of a candy has been ingested, seeking medical care to induce vomiting as soon as possible is the best course of action. Depending on the amount ingested, further treatments may be indicated such as: administration of activated charcoal to help absorb toxins within the gastrointestinal tract, intravenous fluids, hospitalization, and drug therapy.

We wish everyone a happy and safe Halloween — and remember to keep that candy out of reach of the pups, which means the more for you as well!

Editor’s Note: Healthy Paws is a column sponsored and written by the owners of Clarendon Animal Care, a full-service, general practice veterinary clinic and winner of a 2017 Arlington Chamber of Commerce Best Business Award. The clinic is located 3000 10th Street N., Suite B. and can be reached at 703-997-9776.

Arthritis is something that we see pretty commonly in our pet cats and dogs. Most people think of big dogs and their predisposition to getting hip dysplasia — but we’ve come to recognize that cats and every size of dog are prone to getting arthritis as they age…much like us. They are just SO much better at hiding the symptoms for so much longer than most of us wimpy humans.

When we break it down to it’s Latin & Greek roots arthritis means “inflammation of a joint.” There are two main classes of arthritis — osteoarthritis: which is a chronic use/degenerative process of a joint that develops from overuse or poor conformation of the joint; and inflammatory/immune mediated arthritis such as rheumatoid arthritis.

Inflammation, in short/brief doses is good for the body — but when uncontrolled can lead to destruction of the cartilage. In attempts to stabilize the joint and reduce pain, inflammation often leads to excess bone production along the joint edge (such as bone spurs) that actually lead to more pain and inflammation…and the cycle continues.

Symptoms of arthritis can include overt joint pain (i.e. lameness, stiffness) but also more subtle changes such as reduced activity (reluctance on walks, jumping, etc…), inappropriate elimination (many times because it is painful to posture to urinate/defecate) or changes in behavior or mood.

True diagnosis of osteoarthritis is made with x-rays — but we are often suspicious of it and may will manage accordingly based on physical exam findings and history alone. Management of arthritis involves nutrition, weight management, exercise, nutritional supplements and depending on the severity prescription pain medications.

A multi-modal approach to pain management often results is better comfort and many times less needed drug. Two of the most important things to start with are weight and exercise.  A trim/fit dog or cat is going to be able to deal with arthritis much better than an overweight/out of shape pet, as the physical stress on the joints is going to be less.

Regular, controlled exercise is also so important as it helps maintain a normal joint range of motion as well as muscle mass — which is necessary to support a joint. As our pets get older they tend to lose muscle mass and get overweight — which exacerbates any predisposition for arthritis development.

Diagnosis of other types of arthritis (such as infectious arthritis or rheumatoid arthritis) often involves a much more extensive work up with blood work, joint taps or other diagnostics, and may involve additional treatments such as antibiotics or immunosuppressive drugs.  

Arthritis, while potentially painful for our pets, can often be well-managed — if you are concerned that your pet may be suffering from arthritis, we recommend talking with your pet’s veterinarian about the best options for him/her.

Editor’s Note: Healthy Paws is a column sponsored and written by the owners of Clarendon Animal Care, a full-service, general practice veterinary clinic and winner of a 2017 Arlington Chamber of Commerce Best Business Award. The clinic is located 3000 10th Street N., Suite B. and can be reached at 703-997-9776.

We’ve discussed fleas previously, but since we’re just starting to see the first real fleas of the season figured it’s a good time to revisit these icky insects.

What exactly is a flea?

Fleas are small (~2-3mm), reddish-brown insects. They feed on the blood of mammals and birds. While they cannot fly, they have incredible jumping ability. According to the website fleascience.com, the average flea can jump about 5 inches high and 9 inches horizontally, though they can reach 8 inches high and nearly 20 inches horizontally.

What diseases can they carry?

Fleas can cause symptoms of mild itchiness to severe itching/scratching and significant secondary bacterial infections, depending both on the flea burden and the individual animal’s sensitivity to flea bites. Additionally, in young puppies and kittens, or severely infested animals, fleas can cause anemia due to blood loss.

Other parasites and diseases can also be carried or transmitted by fleas:

• The most common form of tapeworms, Diplydium caninum, are carried by fleas. Tapeworms are rarely a significant health concern but can be uncomfortable to the pet and disturbing to the owner who discovers them.
• Bartonella, the causative agent of Cat Scratch Disease, is also carried by fleas. Typical transmission is from the scratch of an infected cat (who got the disease from fleas), but there is some thought that infected fleas can transmit directly to humans via a bite.
• Plague, caused by the bacteria Yersinia pestis, can also be transmitted by fleas.

What is the lifecycle of the flea? And why does it matter?

Adult female fleas feeding on an animal can start laying eggs within hours, laying up to 50 eggs per day. Eggs develop in the environment, preferring cool dark places (like under fallen leaves — which is why we tend to see an increase in cases of flea infestations in the fall) and indoors along baseboards, carpets and crevices of furniture or floors.

Larvae then develop into pupae, typically preferring the same places as the larval stages. Finally, adults emerge from the pupal stage and start looking for a host to feed on. This whole process can take as little as a few weeks in optimal conditions. However, the larval and pupal stages can also lie dormant for months, and hatch only once they sense the environmental factors are ideal (vibrations from movement, heat and CO2 can all trigger this).

Because of the prodigious egg-laying of the adult flea, it is possible for a single adult female to quickly lead to an infestation. The environment (which can be outdoors or indoors) quickly becomes contaminated with eggs, larvae and pupae.

How do I know if my pet has fleas?

Sometimes you will actually see the flea moving along the skin under the hair coat, or even jumping from the pet as you rub their belly. A more reliable way to detect them is to look for “flea dirt,” which is digested and excreted blood. The tail area and behind the ears are two common places to see this.

However, sometimes it’s not a simple diagnosis, especially early on. Some pets are very sensitive to flea bites, and will demonstrate intense itching with only a single bite — in these cases, it may be difficult to detect the fleas.

The classic signs of a pet with fleas are intense itching or chewing around the tail base (and in general). The itch associated with fleas is often more intense than we might see with other causes of itchiness (namely, allergies). (more…)

Editor’s Note: Healthy Paws is a column sponsored and written by the owners of Clarendon Animal Care, a full-service, general practice veterinary clinic and winner of a 2017 Arlington Chamber of Commerce Best Business Award. The clinic is located 3000 10th Street N., Suite B. and can be reached at 703-997-9776.

Lets face it, our pets age.  Just like us, some maintain cognitive function and stay sharp as a razor, and others … not so much. Whether you call it dementia or cognitive dysfunction, the symptoms we see in our pets are similar to what is seen in humans with Alzheimer’s or senile dementia.

These pets can get lost in the house, become ornery, not want to do things they used to enjoy, lose house training and litter box habits, pace/vocalize or otherwise seem agitated or anxious (and often at night), just to name a few common symptoms.

Cognitive Dysfunction is relatively common in an aged pet population – though the symptoms are not “normal” signs of aging. When screening and intervention occurs earlier in the process of this syndrome, we can often improve longevity and quality of life for the pet (and often their human companion), though we cannot cure it.

It is important to realize that these symptoms can be seen with many other diseases or chronic pain (such as from arthritis). Ruling out other treatable or manageable conditions is helpful and increases our chances of keeping our aged pets comfortable.

Adequate pain management is by far the most common issue we have to address before determining if additional therapies for cognitive dysfunction are needed. Our fur family is just so good at being stoic that sometimes we don’t adequately recognize subtle signs of pain until it becomes so bad and starts to alter their behavior.

Some other diseases that can cause similar symptoms are other primary neurologic diseases (brain tumors, inflammation around the brain, etc…), kidney disease, hypertension, altered thyroid function and altered adrenal gland function. Blood testing and a comprehensive physical exam are important screening tools for some of these underlying diseases.

Once any and all underlying problems are adequately addressed, management of cognitive dysfunction generally involves dietary management (there are some newer diets that specifically help address the altered brain nutrient needs), increased antioxidant supplements, melatonin and anti-anxiety medications such as selegiline or Prozac.

Reducing outside stressors on our pets has also been shown to be beneficial. If your pet is showing symptoms of cognitive dysfunction – then it is not ideal to make major changes in their life (such as getting a new pet or changing their environment), if possible those stressors can trigger things to get much worse for them, and more quickly.

If major stressors are inevitable, then easing them into the change may be helpful. Additionally, similar to doing crossword puzzles as a human, keeping cognitive skills fresh is important for our pets as well.

Environmental enrichment and mental stimulation is really important: ways we can work on these skills are with tools like puzzle and feeder toys, climbing and agility and general maintenance of a good activity level and ongoing task and obedience training.

If you have an older pet who is experiencing disorientation, changes in their sleep/wake cycle, loss of house training, changes in social interactions, increased agitation or anxiety and/or changes in activity level – talk to your veterinarian about looking into what underlying causes might be present and ways to help support your old friend’s brain health and comfort.

Editor’s Note: Healthy Paws is a column sponsored and written by the owners of Clarendon Animal Care, a full-service, general practice veterinary clinic and winner of a 2017 Arlington Chamber of Commerce Best Business Award. The clinic is located 3000 10th Street N., Suite B. and can be reached at 703-997-9776.

Heart disease in various forms is quite common in dogs and cats.  In fact, veterinarians frequently diagnose patients with heart murmurs, arrhythmias, congestive heart failure and enlarged hearts, just to name a few.

Heart disease in pets can be due to congenital defects (such as a hole in the heart), age-related change (a thickened valve that becomes leaky), problems with the heart muscle itself, heart-worms living in the vessels around the heart or the heart itself, or even be secondary to an unrelated problem that causes changes in hormone levels or electrolytes.

It is interesting to note that, unlike people, cats and dogs rarely have high cholesterol or triglycerides as the underlying cause of their heart disease, and rarely have true “heart attacks.”

The first step in diagnosing heart disease is obtaining a full history, as often there are clinical signs that may be noted at home even before the pet comes in for a full exam.  These include:

• Elevated resting respiratory rate
• Persistent coughing and/or difficulty breathing
• Decreased exercise tolerance or energy in general
• Collapsing or fainting episodes
• Decreased appetite
• Distended abdomen

Other symptoms that may not be apparent at home, but can be picked up by your pet’s veterinarian, include:

• Irregular heartbeat / arrhythmia
• Heart murmur (the sound of turbulent blood flow through the heart)
• Lung sounds that may indicate fluid build-up in or around the lungs
• Signs of poor oxygenation such as discolored gums
• Fluid build-up in the abdomen
• Abnormal blood pressure

Because pets are very good at “hiding” their heart disease, it is not unusual that they can be seemingly asymptomatic for a long period of time and then quite quickly develop severe symptoms of heart disease such as coughing, respiratory distress, or collapsing episodes.  This is especially true in cats, as they are well-known for showing very few symptoms of heart disease until their disease is quite advanced.

If your pet is diagnosed with a heart murmur or arrhythmia on routine physical exam additional testing may be recommended.  This may include bloodwork to look for underlying metabolic or electrolyte abnormalities, chest x-rays to evaluate the shape and size of the heart and to further evaluate the lungs for evidence of fluid build-up, and/or an EKG to diagnose an abnormal rhythm.

In some cases, referral to a veterinary cardiologist may be indicated. Veterinary cardiologists have special training in diagnosing and treating heart-related conditions.

One of the most important tests they perform is an echocardiogram, or ultrasound of the heart. This allows visualization of the structure of the heart muscle and valves, as well as flow of blood through the heart. This is a specialized test not routinely performed by most family veterinarians, but provides very valuable information about the underlying cause of the symptoms and can help us more effectively manage the heart disease.

Studies have shown that pets in congestive heart failure may live up to 75 percent longer when co-managed by a veterinary cardiologist and their primary veterinarian.

We are fortunate in the Northern Virginia/D.C. metropolitan area to have one of the country’s premier veterinary cardiology groups nearby – Chesapeake Veterinary Cardiology Associates. Their website is a wealth of information for any pet parent whose furry friend has been diagnosed with heart disease.

When caught early, most heart disease conditions in our pets can be managed,and some for quite a long time. If your pet is experiencing any of the symptoms above please consult with your family veterinarian for further evaluation. If your pet has been diagnosed with a heart condition, additional resources and educational material can be found with the links below.

Additional Resources:

• Resting respiratory rate monitoring app
• CVCA Diseases & Conditions
• At-Home Monitoring of Pets with Heart Disease

Editor’s Note: Healthy Paws is a column sponsored and written by the owners of Clarendon Animal Care, a full-service, general practice veterinary clinic and winner of a 2017 Arlington Chamber of Commerce Best Business Award. The clinic is located 3000 10th Street N., Suite B. and can be reached at 703-997-9776.

Having had two cases develop acute kidney failure from this bacterial organism in the last nine months, we felt it prudent to discuss Leptospirosis: what it is, how dogs and humans can get it, and ways to prevent it.

Leptospirosis is a disease that is caused from infection with bacteria in the Leptospira family. These bacteria can cause acute kidney and/or liver damage that can lead to organ failure in many cases. It is also one of the most important zoonotic disease worldwide – meaning it is one of the most common diseases transmitted from animals to humans.

We don’t see much Leptospirosis in humans in the U.S. because we have toilets and good sanitation, but in developing countries it is a significant problem. There is also currently an outbreak of this disease in homeless human populations in New York City. The organism is carried in the urine of infected animals and can be acquired from contact with contaminated water or with the urine of an infected animal.

Late summer and early fall generally bring an increased incidence of Leptospirosis in dogs. Leptospira bacteria are most commonly transmitted in the urine of mammalian wildlife — generally rodents, raccoons, and deer.

Even though we aren’t teeming with wildlife in the Arlington and DC area, we do have plenty of a very important carrier of this organism: city rats. Because of the rodent populations in urban environments most dogs in our area are in fact at risk for contracting Leptospirosis. Interestingly enough, cats do not contract the disease.

Leptospirosis is often under-diagnosed due to the vague signs it can cause. The liver and kidneys are the most common organs to be affected by Leptospirosis, ranging from mild to life-threatening illness. The common signs dogs exhibit after contracting Leptospirosis are fever, lethargy, muscle and joint pain, vomiting, diarrhea and increased thirst or urination, much like having the flu in people.

If your pet exhibits symptoms of Leptospirosis, his or her veterinarian will generally run bloodwork and a urinalysis, as well as testing to detect an immune response in the blood or the presence of the bacteria itself in the blood and urine.  Most animals with illness consistent with Leptospirosis need to be hospitalized on intravenous fluids and antibiotics for several days, and sometimes can be left with permanent liver and kidney damage.

A vaccination against four different strains of the Leptospira bacteria is widely used and reliable for preventing and decreasing severity of disease, as well as prevention of bacterial shedding in the urine to prevent human infection.  Even though there are over 200 strains of Leptospira, the four that are included in the canine vaccine are the ones responsible for about 90 percent of infections.

After an initial series of two vaccines given three weeks apart, the vaccine is given annually. Leptospirosis is an important disease to prevent due to the risk of severe, life-threatening illness to both pets and humans. Given the prevalence of this disease in this area, the severity of the course of the disease, and the safety and efficacy of the vaccination we recommend vaccination for the majority of our canine patients.

Editor’s Note: Healthy Paws is a column sponsored and written by the owners of Clarendon Animal Care, a full-service, general practice veterinary clinic and winner of a 2017 Arlington Chamber of Commerce Best Business Award. The clinic is located 3000 10th Street N., Suite B. and can be reached at 703-997-9776.

Ever had a cat that peed on things around the house when they were “mad” or were doing it “out of spite”? Or had a male cat with frequent “UTIs” – going in and out of the box frequently to pee small amounts, sometimes with blood?

Well – this is actually a fairly common issue in cats and can present in a number of ways – and surprisingly it is rarely an infection, and it is rarely because they were “mad” or “spiteful” and most often it occurs because they were…stressed.

Feline Lower Urinary Tract Disease or FLUTD is a catch all term that we use to describe the problem – and it’s a problem that we see most commonly in middle-age, indoor only, overweight cats that get little exercise. Symptoms of FLUTD include:

• Difficult or painful urination
• Increased frequency of urination
• Crying out while urinating
• Blood in the urine
• Inappropriate urination (that is, outside of the litter box)
• Frequent licking of the genital region.

So – what causes FLUTD in cats? Well most commonly it’s “idiopathic cystitis.” Idiopathic is a fun term we use in the medical field meaning we don’t know or fully understand the mechanisms and cystitis means inflammation of the bladder wall.

Feline Idiopathic Cystitis (FIC) is a diagnosis of exclusion — meaning we need to make sure nothing else is the problem before calling it this. What do we need to make sure nothing else is going on before we can call the cat’s painful bladder and inappropriate urinary habits FIC? Well below are a list of things that can cause similar symptoms that we need to make sure are not going on before we call these symptoms FIC:

• Urinary tract infection
• Bladder stones
• Metabolic diseases (such as diabetes mellitus or hyperthyroidism)
• Pain posturing to urinate (e.g. arthritis)
• Congenital abnormalities
• Bladder masses/tumors
• Trauma to the urinary tract or spinal cord

We can rule out most of these other problems with a simple urinalysis (checking the urine for concentration, presence of blood and inflammatory cells, bacteria, crystals, etc…) and imaging of the bladder (ultrasound and/or x-rays).

In older cats, blood work is also often recommended to look for common metabolic problems as well as x-rays of their spine/joints if arthritis or orthopedic disease is suspected.

Once we’ve determined there’s nothing else going on – how do we manage something that is “idiopathic” and we don’t entirely understand? Well, what we do know about FIC is that the reasons for the bladder irritation are linked to stress, abnormal stress responses, neurogenic (or psychosomatic) stimulation of inflammation of the bladder wall and a defective bladder wall lining. Surprisingly, there is a condition in humans that is pretty similar called interstitial cystitis, also linked to stress.

Why do we need to treat this? Well: 1) it’s painful for the cat, 2) it can lead to a urethral obstruction (a life threatening situation where the cat is unable to pass any urine), 3) it’s often an indication of a stressed cat and 4) no one likes it when a cat is inappropriately urinating in their house.

Treatment in the acute phase/painful cat involves pain medications and anti-inflammatory medications. Long-term treatment often includes dietary changes (many of these are prescription diets that help protect the bladder wall lining, promote water intake and reduce crystal formation; some of these diets have supplements to reduce stress as well), increased water intake (canned foods, water fountains, etc…), and stress reduction.

Stress reduction can be managed with environmental management (more litter boxes, different substrates, changing how multiple cats or other pets in a household can interact, etc..), supplements (such as Zylkene and Feliway – to reduce stress; supplements to help with the bladder wall lining such as Dasuquin & Adequan), and in some cases prescription anti-anxiety medications.

With inappropriate urination being the number one cause for euthanasia of otherwise healthy cats – it’s really important to talk to your vet as soon as your cat starts showing any lower urinary tract problems.

While sometimes very frustrating, once the underlying problem is determined these guys can be managed and kept far more comfortable and live happy lives (and you can maintain your sanity).

Editor’s Note: Healthy Paws is a column sponsored and written by the owners of Clarendon Animal Care, a full-service, general practice veterinary clinic and winner of a 2017 Arlington Chamber of Commerce Best Business Award. The clinic is located 3000 10th Street N., Suite B. and can be reached at 703-997-9776.

Have you ever questioned what your mixed breed dog is mixed with, or if your pure-bred dog is in fact a pure breed? There are multiple DNA tests out on the market, and we decided to run a little experiment in the clinic to see how we felt the test measured up to our clinic pets.

We used the most popular test — the Wisdom Panel 4.0, which consists of a simple cheek swab. Several Clarendon Animal Care staff members swabbed their dogs and sent the swabs off the the Wisdom Panel laboratory.

Once the lab receives the swabs, they extract the DNA from the dog’s cheek cells, which is then matched up against 1,800 markers used in their tests. They then send those results to a computer, which uses an algorithm to analyze your dog’s DNA and determine what is the most likely pedigree for your dog, up to the last three generations.

In addition to looking at pedigree, the Wisdom Panel also tests for several genetic health abnormalities, such as the MDR1 genetic mutation (which leads to certain drug sensitivities in herding dogs), and can also tell you the estimated weight and color for your full grown dog.

We ultimately ended up testing seven different dogs in our office – four purebred dogs, and three mixed breeds. First we tested our LVT Sam’s Bloodhound, Gunner, who, despite us making fun of him for his tiny head, came back as 100 percent purebred Bloodhound. Our receptionist Charnita tested her Long-Haired Chihuahua, Teko, and his results were also 100% Chihuahua.

Next was Dewey, Dr. Ungerer’s purebred English Pointer. Dewey’s results showed that he was 75 percent Pointer, but one of his parents was likely mixed with a German Short-Haired Pointer — still in the Pointer family, just a slight variation. Dr. Ungerer’s reaction was, “surprised, but not after I thought about it for a bit, based on his lineage.”

We also tested Uma, a purebred Scottish Terrier who belongs to our receptionist, Ashley. Uma’s results showed that she was 75 percent Scottish Terrier, and 25 percent West Highland White Terrier, which came as a bit of a surprise to her owner.

The three mixed breeds we tested were our LVT Leslie’s dog Weebles, labeled an Affenpinscher mix, our LVT Alex’s dog Frankie, labeled a Pit Bull mix, and our Practice Manager Sara’s dog Peyton, labeled a Pointer mix.

Weebles had initially been labeled as an Affenpinscher mix, but his DNA test showed a mix of Miniature Poodle, Pug, Pekingese, Shih Tzu and Miniature Pinscher — a true mix! Frankie had generally been referred to as a Pit Bull mix, but his DNA results showed that he was 90 percent American Staffordshire Terrier, and the other 10 percent was likely an American Staffordshire mix, so not so much of a mutt after all.

The last staff pet we tested was Peyton, who was initially labeled as a Pointer mix. Her DNA results came back as being 50 percent German Short-Haired Pointer, and 50 percent American Staffordshire Terrier, which makes sense — she looks like a stocky Pointer.

We also recently had one of our clients run a Wisdom Panel test on her dog and send us the results. Her dog Parker has always been labeled as a Labrador mix. His results came back pretty well mixed, and showed that his pedigree included Labrador Retriever, Golden Retriever, as well as German Shepherd.

For the most part, we thought that this was a fun, fairly accurate tool to learn a little more about your dog. It does highlight that in general, visual breed prediction/guessing without genetic background is actually not that great, and this can become important with certain breed restrictions (and pit-bull type dogs are often the most discriminated breed – for reasons that are not based in any actual evidence) in various localities.

Studies have shown that the ability of visual identification of these breeds is quite poor, even among experts. It will be interesting if this kind of genetic testing would become admissible in legal disputes over breed restrictions.

Beyond breed testing, the really nice thing about some of these genetic tests such as the Wisdom 4.0 panel and the Embark Dog DNA Test is not just that there is breed information (because, let’s be honest – it doesn’t really matter what breed your dog is, just that you love them!) – but that in working with Washington State University (Wisdom) and Cornell University (Embark) they are able to look at certain disease risks based on genetic predisposition.

This is really cool because it may allow us to manipulate the environmental triggers (such as diet, exercise, certain medications, etc…) and screen for at-risk diseases earlier in life to prevent or mitigate illness later in life.