Next, I’d like to explain how I approach Leaky Bowel Syndrome when treating patients. The first aspect of improving an animal’s intestinal environment involves making dietary changes. Every pet has a different level of reactivity to food borne allergens, so finding out your pet’s specific food allergies may require some watchful experimentation. The idea is to eliminate potential allergens by using a limited ingredient food, or using some other diet that would create less immunologic stimulation, such as a hydrolized prescription diet. Unfortunately, while dry or canned pet food may be most convenient, the processing of nutrients from the natural source to the dry or canned form can greatly increase their allergic reactivity. With this in mind, it may be helpful for some pets to be fed homemade or raw formulas.

The second component of treating Leaky Bowel Syndrome is promoting the right environment inside the intestinal tract. This is accomplished by supplementing a pet’s meals with a source of pre-biotics—the basic energy/fuel for the normal intestinal bacteria. (These are also called probiotics.) Additionally, the use of certain digestive enzymes—such as bromelain or papain—will aid in making the whole digestive process a lot easier, consequently decreasing a pet’s intestinal inflammation, and discomfort.

The third component is adding nutrients or supplements that may provide some restorative properties to the intestinal lining. Specifically, L-Glutamine, Licorice Root, and Slippery Elm Bark are some of the supplements that have been shown to encourage intestinal lining repair. Over the last few years there has been extensive research and development on this topic, and there are a few specific supplement formulas that can simplify the management of the problem. If you suspect that your pet may have this syndrome, please contact us at the Worth Street Veterinary Center at 212-257-6900, and we will be happy to help guide you in your pet’s treatment.

Francisco Dipolo, DVM, CVA

Leaky Bowel Syndrome is a problem that develops in dogs when the animal’s intestinal wall is unable to retain bacteria inside the intestinal tract. This allows toxins and bacteria to migrate from the vascular system to other organs in the body. Some indications that your pet may have Leaky Bowel include chronic skin infections, intermittent diarrhea, lethargy, and more.

In human medicine, this syndrome has been linked to chronic fatigue and depression. However, in our pet population, the problems seem to present as some kind of food allergy that may contribute to skin irritation and bowel problems. Since the intestinal tract is the largest immunologic organ, if it’s not working well, it may profoundly affect or influence problems throughout the entire body. (In the interest of keeping this post brief, I’ll discuss food borne allergies or intolerance only, and will leave contact and other environmental allergies for a different time.)

While Leaky Bowel Syndrome is not the only cause for most of our pets’ chronic allergies and diarrheas, it can certainly intensify the problem. So, I believe that it is crucial to pay attention to this potential underlying effect in the gut, while at the same time using standard medicine to control the clinical signs and discomfort.

Thankfully, there are a few things that we can do to help improve our pet’s intestinal health. This involves the use of multiple therapies, such as dietary changes and other supplements that can improve the overall health of the intestinal tract.

Stay tuned for my next blog post on the standard treatment protocol for Leaky Bowel Syndrome.

Francisco DiPolo, DVM CVA

Doggie winter gear: Awesome, or overkill?

Although it’s been a very mild winter here in New York City, one of the most common questions I am asked is whether a dog should wear a coat. In general, most dogs don’t need coats in mild weather. With temperatures above 32 degrees Fahrenheit, dogs are able to self-regulate their body temperature very well. Exceptions may be thin, short-haired, young or toy breed dogs. Especially susceptible are Chihuahuas and Italian Greyhounds.

Even with the 32 degree Fahrenheit general rule, you still need to be mindful of your dog’s individual level of comfort. If it’s a relatively cold day and your dog is shivering, he may be cold. In addition, if your dog is used to warmer climates, he may need a coat in the colder weather until he is acclimatized to it.

This is New York City, and I understand that showing off your dog’s fashionista side may be important to you. But just as we exercise and raise our body temperatures, our dogs do too. Please remember to take off your dog’s coat or sweater when running around the dog run. They have fur coats and can overheat quickly.

Booties or no booties? 

Frankly, most dogs don’t tolerate booties well, no matter how they are constructed. They can, however, be very helpful on those icy days when every shop owner and doorman is out sprinkling salt. The salt can be extremely uncomfortable and cause a burning sensation to your dog’s paws, especially if they are already raw or irritated. If it becomes a Sumo wrestling match trying to get and keep the booties on, I recommend something like Mushers Secret, which is a wax-like bond you apply to the paws. It’s also important to wash the paws and between the toes after a walk.  You can do this with a paper towel saturated with warm water, or with unscented baby wipes.

If you have any questions regarding your dogs needs—or their attire—please don’t hesitate to call us at Worth Street Veterinary Center and we will be happy to help.

Julie Horton, DVM

What is Leptospirosis?
Leptospirosis is a bacteria called Leptospira interrogans, occurring worldwide in both domestic and wild animals. It can also be transmitted to humans. It is important, especially in regards to the vaccine, to note that there are over 200 named serovars (types) of leptospirosis.

How Is It Contracted?
It is generally spread through the infected urine of contaminated animals where it settles in water and soil. The virus can last in the environment for months. Generally, your pet becomes infected by drinking, swimming, or walking through infected water. Raccoons, skunks, squirrels, opossums, deer, rats and mice are all carriers. Cases of leptospirosis in cats are extremely rare.

Signs that Your Pet May be Infected
The most frustrating thing about leptospirosis is that signs may be vague and vary dramatically from pet to pet. Time between exposure to the bacteria and symptoms is typically five to 14 days, although it may take less or longer than 30 days for it to appear. In the early stages, dogs exhibit fever and lethargy. Symptoms may quickly progress to nausea, vomiting, diarrhea, decreased appetite, weakness, depression, joint stiffness, and muscle and abdominal pain. Your pet may exhibit none, one, or all of these symptoms. Later stages of the disease may cause increased thirst and urination (a sign of kidney disease) and even jaundice (a sign of liver disease).

How Do We Test for Leptospirosis?
To find out if your pet may be infected, we will take a blood sample to analyze antibody levels. Most labs require several days for test results to come back, so if there is a suspicion of leptospirosis, I usually recommend starting antibiotics right away.

Treating Leptospirosis
Treatment for leptospirosis should include the administration of the antibiotic doxycycline. Current recommendations by the ACVIM (American College of Veterinary Internal Medicine) recommend at least 2 weeks of medication. If your pet cannot receive oral medication due to vomiting or nausea, he should be started on an intravenous form of penicillin. Because this bacteria has a high prevalence for causing kidney failure, your pet may require intravenous fluids for several days. Prognosis is reported to be very good for those cases treated early.

What to do If Your Pet is Leptospirosis Positive
Because leptospirosis has potential transmission to humans, strict precautions should be taken when handling these animals. It can be transmitted via the urine, blood, or tissues. One should wear a gown and gloves and dispose of any waste appropriately. Your dog should not be allowed around other dogs until he is cleared of the infection.

Should You Vaccinate Your Pet?
It is most important to remember the vaccine does not provide 100% protection. Most leptospirosis vaccines administered as a single agent include four different serovars (types) of leptospirosis: grippotyphosa, pomona, icterohaemorragiae and canicola. Those vaccines that include a combination of the distemper/ parvovirus and leptospirosis usually only contain 2 types of leptospirosis. But here’s the catch: There are currently more than 200 types of leptospirosis named and probably many more unnamed. Many of the most recent outbreaks consist of serovars for which there is no vaccine.

So, which dogs should be vaccinated? Usually those that are in the “at- risk” population should receive the vaccine. The tricky part is defining who is the “at-risk” population. Typically, that may include any of the following:

• dogs living in an urban environment with a high population of rodents
• hunting dogs
• dogs off leash who frequently come into contact with stagnant pools of water or swim
• dogs who live in an area where multiple cases of leptospirosis have been reported and documented to be of the type which the vaccine covers

Why not vaccinate all dogs?
First vaccines are not benign treatments. They have been known to cause adverse reactions including hives, facial swelling, vomiting and in more severe cases anaphylaxis. Less reported (but still documented) is a correlation between vaccines and immune mediated hemolytic anemia. In general, small breed young pets (ages 1 to 3) have a higher risk of a vaccine reaction.

I believe it is important to evaluate each potential candidate for the vaccine on an individual basis. Circumstances, lifestyle, exposure risk, and vaccine reaction should all be taken into account. We are here to guide you through the decision process on whether your pet should be vaccinated and make appropriate recommendations. As always please feel free to contact us at the Worth Street Veterinary Center with any questions and we will be more than happy to clarify any concerns you have regarding this vaccine or any other pet related issue.

Julie Horton, DVM

Let’s face it, most cats hate going to the veterinarian. Just imagine, you’re going about your daily routine of sleeping in your favorite spot, lounging in the sun, grooming yourself, and occasionally having some food. All of a sudden, your reverie is interrupted as you’re briskly snatched up, shoved into a carrier, taken out into the frigid streets of Manhattan, jostled around in some moving vehicle, then brought into an office with barking dogs trying to sniff you and all sorts of troubling, unknown smells. All the while you’re wondering, Why did I have my day interrupted? I don’t like change! I don’t like noise or strangers or unfamiliar environments. Now I’m here, in this strange contraption in which I can’t see out and waiting for something, and it can’t be good…

Someone comes in the room talking to my mom and opens the box I’m in—which, incidentally, isn’t looking so bad right now. Eek, don’t take me out—I’m ok, really! An unfamiliar hand scoops me up, tries to pry open my mouth, shines a terribly bright light in my eyes, puts a cold metal thing to my chest and starts pushing on my full belly. Who does this lady think she is? I’ll give her a hiss or two and she’ll stop. Hmm, that didn’t work. I must’ve not sounded ferocious enough. I’ll show them! Big hiss, growl, another hisssssssss. Uh-oh, now here comes another stranger, and this one’s got a blanket. I try out my best ninja-cat wrestling moves, but they wrap me up with a towel over my hand. I can’t move. Exhausted, I give up. This is humiliating.

Finally, they mercifully cram me back into the dark box, there’s another bumpy ride, and I’m back at home. The ride home left just enough time for me to contemplate two things: 1) My mom has betrayed me terribly, and for that she will pay, and 2) I’m going to start my rebellion by not eating for a day or two—and maybe I’ll even pee in her bed for good measure.

The above scenario is all too typical, which is why many cat owners avoid or procrastinate taking their beloved pet to the vet. The good news is, there are many tips that can make the experience more positive for you and your cat:

• First, don’t keep the cat carrier tucked away, only to be brought out just to take your animal to the vet. You want to condition your cat to its carrier—meaning, you want him comfortable in and around it. If possible, always leave the carrier out and entice your cat to crawl in and out using a feather toy or treat. This process may take several weeks, but ultimately your cat will view the carrier as a “good” place.
• When a trip to the veterinarian is warranted, spray the carrier with Feliway (http://www.feliway.com/us) approximately 30 minutes prior to travel. Feliway mimics the feline facial pheromone used by cats to mark their territory as a safe place. By spraying Feliway in your cat’s carrier, it creates a state of security for your cat and may help him cope with the stress of a vet visit. This spray can be obtained at almost any pet store and is easily found online.
• Book your appointment at a time when your vet’s office is quiet, or ask to be placed in an exam room immediately upon arrival. Once in the room, open the carrier and allow your cat to explore. Hopefully he will eventually come out and feel more comfortable. If not, do not force him. Allow the veterinarian to do as much of the exam in the carrier as possible, then entice him out. Sometimes it helps for the owner to hold their cat during the exam.
• Upon returning home, give your pet a treat. If there is another cat at home, don’t be surprised if they both hiss or hide, as the housemate will smell the vet’s office. Spraying Feliway can decrease this sensitivity.
• Reinforcing this routine with positive rewards such as treats can help graduate each experience to a more rewarding one.

Instead of waiting for your cat to become sick, focus on preventative care and annual exams. This will help detect any problems early and allow your cat to ultimately lead a more active, healthy and longer life.

If you have any concerns or questions about your particular cat or veterinarian visit, please don’t hesitate to call us at Worth Street Veterinary Center 212-257-6900. We will help make each step easier, and hopefully, stress free.

Dr. Julie Horton

If you’re like most cat owners in New York City, your thought process regarding taking your pet to the vet probably goes something like this: My cat is eating and acting normally, and he never goes outside or is exposed to other cats so he doesn’t need vaccines. Plus, he stresses out and pees every time I put him in his carrier. I’ll just take him to the vet when he’s sick.

Does this scenario sound familiar? You’re not alone. We all obviously want the best for our furry friends, but the stress of taking a cat to the vet is typically too much to handle—for the cat and owner. Therefore I, as the veterinarian, only see your cat when he’s sick. Obviously the sick visits are necessary and important. But if we can focus on preventative care at annual exams, we can often avoid a “crisis” visit.

All cats should be seen once yearly for a physical exam, fecal test, and vaccines if necessary. There are several reasons for this. First, I am surprised time and again how many “strictly indoor” cats often come up positive for an intestinal parasite on an annual fecal exam. Some of these parasites can then be transmitted to us, especially to kids or immunocompromised individuals.

It’s also important to do annual blood work in our feline patients, particularly those six years and older. Cats are great at hiding illness and suffering in silence. Their subtle behaviors and changes are often difficult for us humans to pick up on (See Dr. DiPolo’s blog “How to Tell if Your Cat isn’t Feeling Well” from August 18th, 2011). By performing annual blood work, we can detect trends or changes in organ function via the kidney and liver enzymes. For instance, if we detect early kidney disease we may be able to help slow or prevent its progression. Sometimes simply changing the diet or adding liquid can do this. Another easy example is subtle changes in liver enzymes. While an abdominal ultrasound and potential biopsy may be needed to detect actual liver disease, we can add in nutraceuticals—such as milk thistle and antioxidants—which may help prevent further negative changes.

A simple routine physical exam can also detect subtle weight changes, potential hypertension, lack of grooming, dehydration, and dental disease, amongst other things. These changes may be so subtle that you as the owner don’t recognize them—especially when seeing them on a day-to-day basis. More specifically, trends in either weight loss or weight gain may indicate a progressive disease process. Remember, cats are EXCELLENT at hiding illness and pain. Dental disease is particularly important to detect because it can lead to more severe problems, including liver, kidney, and heart disease.

In summary, it is important for feline owners to appreciate how critical annual wellness exams are in addressing both current problems and future preventative health. So, the next and most obvious question is, How do I actually get my feline friend to the vet? Stay tuned for helpful hints to ease the stress on you and your cat in the next blog.

If you have any questions in the meantime, feel free to call me at the Worth Street Veterinary Center at 212-257-6900.

Dr. Julie Horton

Photo courtesy of healthypet.com

Because of all the news reports regarding a canine influenza outbreak in New York City, I wanted to take a minute to share my thoughts and perspective:

We have not seen a confirmed case of canine influenza at our practice thus far. However, we continue to see the same number of pets with kennel cough that we have seen throughout the rest of the year. We do not believe that there is enough evidence or cause for concern to vaccinate every pet against canine influenza. The reason for this is that this vaccine does not prevent the disease but simply alleviates the clinical signs. In addition, it is fair to assume that since influenza viruses have a very high capacity for mutation, the vaccine that was developed two to three years ago may not offer protection over time.

Still, if our clients are in need of the canine influenza vaccine for boarding kennel requirements or should they still choose/prefer to vaccinate their pet, we can absolutely provide this vaccine. For canine influenza, the protocol is that we give two vaccines two weeks apart.

Feel free to contact the Worth Street Veterinary Center with any additional questions.

Francisco Dipolo, DVM, CVA

So what—and where, exactly—are these glands? They’re a pair of sac-like glands located on either side of the anus, and they produce a very foul smelling liquid, which is usually excreted when pets defecate. Animals use this liquid scent to mark their territory —and as a sort of personal “ID card.” This is why you oftentimes see dogs sniffing each other’s rear when they say hello in greeting.

Many pets may never have anal gland issues, but others develop problems regularly. Here’s why: Anal sacs are constantly filling with a smelly liquid, and in a healthy, balanced state, it is supposed to come out with every bowel movement, thus maintaining that balance. (This emptying is facilitated by the pressure of the feces as it is passed through the rectum near the glands.) In some cases, though, the fluid starts to accumulate in the sacs because 1) the stools aren’t firm enough to express the glands, or 2) the production of liquid is excessive due to dietary imbalances or allergies. The anal fluid eventually becomes over full and impacted, causing your pet discomfort so he will scoot his rear end across the ground, often more frequently after defecating. This problem is more common in smaller breeds as well as those with high allergy predispositions.

What can be done to minimize your pet’s discomfort?

1. If you’re not sure if there’s an actual problem (i.e. you haven’t noticed your pet scooting), it’s better to leave these glands alone. Feel free to inform your vet or groomer not to express your pet’s glands unless there is an actual sign of discomfort.
2. Since some of the potential underlying causes—allergies—are related to food, changing your pet’s diet to a high quality, grain-free and limited ingredient one may be all that is needed. Some brands that fit this description include: Natural Balance Limited Ingredient Diets, Nature’s Variety, and Pinnacle.
3. Adding fiber to your pet’s diet will make the stools bulkier, and therefore more likely to empty the glands. You can accomplish this by adding psyllium husks, sweet potatoes, pumpkin or Metamucil to his food. (Consult your vet for the appropriate volume.)
4. More regular walks and exercise will increase the muscle tone of the rectum and improve the emptying mechanism. Increased exercise will also increase the frequency of defecation.

At the Worth Street Veterinary Center, we try to focus on correcting the underlying issue by making dietary and supplement changes when possible. If signs of scooting or discomfort persist, have your groomer or veterinarian manually express your pet’s glands to provide immediate relief. We do NOT advise trying this on your own.

Feel free to contact us if you have any questions regarding you pet’s anal glands.
Francisco DiPolo, DVM, CVA

“Reverse sneezing”—also known as the pharyngeal gag reflex—is when a dog makes noises that sound as if he can’t get enough air. It can be disconcerting and worrisome, even causing some owners to rush to emergency clinics in the middle of the night. So, how can you tell if your pet is reverse sneezing? Some people describe it as wheezing or gasping for air. It gets its name because it seems as if the dog is inhaling, as opposed to exhaling, sneezes.

Before you worry too much, let me explain further: Reverse sneezing is a simple condition that may last for 10 to 20 seconds, and it usually does not require any treatment. During this spasm, the dog’s neck will extend and the chest will expand as he tries harder to inhale. At times, the trachea may narrow, which may lead to a deeper honking-like sound. If you’re still uncertain what I mean, take a look at the following video for an example: http://www.youtube.com/watch?v=8xS7kAideC0&feature=related.

CAUSES

The most common cause of reverse sneezing is an irritation of the soft palate (a membrane that separates the nose from the mouth) and the throat that results in a spasm. Anything that irritates the throat can cause this spasm and subsequent sneeze. To be more specific, some causes—even seemingly innocuous ones—include: excitement, eating or drinking, exercise intolerance, pulling on a leash, nasal mites, pollen, foreign bodies caught in the throat, or any aerosolized or upper airway irritant.

But are certain breeds more prone to this condition? Yes. Brachycephalic dogs—those with flat faces, such as Pugs and Boxers—have elongated soft palates; they will sometimes suck their palate into the throat while inhaling, causing reverse sneezing. Yorkies, Chihuahuas and other small dogs are particularly prone to this behavior as well, possibly because of their throats are smaller in size.

TREATMENT

If you want to know what you can do about reverse sneezing, take heart: it rarely requires treatment. Once the sneezing stops, the spasm is over. Often, one can massage the dog’s throat to stop the spasm. It can also be effective to cover the nostrils by pinching the dog’s nose for a few seconds. This can force the animal to swallow, which clears out whatever irritant is present and should stop the sneezing.

Treatment or elimination of the underlying cause is obviously useful, but in many cases the irritant cannot be determined, or it’s difficult to eliminate. Because reverse sneezing is not a severe problem, don’t worry about leaving your dog home alone. Should the episode occur when you’re away, it will most likely end on its own and your pet should recover from it naturally.

Occasionally, though, reverse sneezing can become a chronic problem. At the Worth Street Veterinary Center, we will try to determine the cause of chronic reverse sneezing by looking into the nasal passages. If necessary, we will prescribe an anti-histamine to alleviate the discomfort. Some pets have these episodes their entire lives, while others may develop it as they age. However, in most instances the spasm is a temporary problem that goes away on its own, leaving the dog with no after-effects.

Cats are less likely to reverse sneeze than dogs are. To be sure what’s going on, owners should always have their veterinarian examine the cat in case it’s feline asthma, and not reverse sneezing.

If you have any doubts or questions about your pet’s breathing, please don’t hesitate to call the Worth Street Veterinary Center at 212-257-6900. We’d be happy to help.

Francisco DiPolo, DVM, CVA

Unlike dogs, cats have a tendency to hide their illnesses. This mechanism has evolved to make them appear less vulnerable in the wild. Unfortunately, though, this ability to conceal their discomfort makes it difficult to identify when your cat is not feeling well and you should take him to the vet. Here are some signs that your pet may have something going on internally that you should be concerned about:

1. Inappropriate elimination
Cats may urinate or defecate out of the litter box due to a variety of issues, including urinary tract infections or inflammations, renal disease, diabetes, etc. It can also be a sign of arthritic pain or difficulty getting in and out of the litter box comfortably.

2. Changes in activity
A decrease in your cat’s activity could be due to internal discomfort, illness or arthritic pain. Conversely, an increase in activity can also be related to some metabolic changes such as hyperthyroidism.

3. Changes in interaction
Cats are generally social creatures, so a change in the level of interaction with their owners or other pets can signal disease, fear, anxiety or pain.

4. Changes in food and water consumption
Most cats tend to have a very clear feeding pattern, so any consistent changes are usually due to some medical condition. We rarely see cats drinking water, so when it becomes obvious that they’re more interested in drinking it, it’s important to closely monitor how much urine they’re producing in the litter box. (Meaning, if you notice you’re cleaning your litter box more often, your pet is probably drinking more.) Changes in water in/output are often the first indication of many common diseases, including diabetes and kidney disease.

5. Changes in sleeping habits
Most cats will nap between 16 and 18 hours each day. Consistent changes from this pattern may indicate a variety of illnesses.

6. Unexplained weight loss or gain
Sudden weight changes can be signs of hyperthyroidism, diabetes, pancreatitis and many other conditions. Obesity, on the other hand, can cause an increased risk for diabetes and joint disease.

7. Changes in grooming patterns
Patches of hair loss or a greasy/matted appearance may suggest there is an underlying problem. Cats that have difficulty grooming often suffer from obesity and joint disease, while excessive grooming may indicate skin disease, anxiety and other compulsive behavior.

8. Signs of stress
Stressed cats may have difficulty socializing and may hide more, or spend more time scanning their environment. Sometimes this behavior can be related to physical diseases.

9. Changes in vocalization
An increase in vocalization can suggest hyperactivity, high blood pressure, pain or anxiety.

10. Bad breath
Bad breath is the earliest indication of dental disease. Current studies show that about 70 percent of cats over 3 years of age have gum disease or periodontitis. Gum disease is a source of inflammation and infection to the rest of the body, so it’s important to have your cat’s teeth cleaned regularly.

Now, I realize that this is a long list of warning signs and potentially very scary concerns. We are always happy to help you figure out what may (or may not) be going on with your pet, so feel free to give us a call at the Worth Street Veterinary Center at any time at 212-257-6900.

Dr. Francisco DiPolo
worthstreetvet.com