Your Pet's Best Friend

Phone lines are out of order

If I were just punching the clock, I might think how great it is not to be troubled by the phone.  What a great chance to catch up the paperwork... or play solitaire.

Unfortunately, we are all here prepared to care for our patients and no way to communicate with them. Being idle is no fun when you KNOW there's work to be done.  With our AT&T land line service dead as a hammer, our clients just think we've left for the day, or maybe we're too lazy to answer the phone.

The lines went dead yesterday afternoon.  Dr. Brigance called in a repair request on her cell-phone.  When I called to check on the status of the repair order, I found nothing.  SO, I submitted another repair request and a computer-generated voice assured me that my service would be restored by 7:00 PM Saturday evening.

Well, great.  We're here, crying in the wilderness.

After the Puppies are Born

Care of the Bitch after Whelping

 

Pregnancy and nursing puppies constitute a severe strain on the mother’s health.  Though most mothers handle the task admirably, the wise owner can take certain precautions to protect the health of both mother and puppies.  Consider these important points in post-natal care.

 

Diet: Feed a growth diet (Science Diet puppy or another good, name-brand puppy food) during the second half of pregnancy and during the nursing period.  Mom needs a lot more nutrition than she can get out of a normal size bowl of regular adult dog food.  Provide clean, fresh water at all times.

 

Activity: Ordinarily the mother will spend most of the first 3 weeks with her puppies.  Allow her to exercise as much as she desires. 

 

Bowel Movements: Due to increased food consumption and the enlarged uterus, your pet may have to relieve herself more frequently. The stools maybe a little soft for the first few days.

 

Mammary Gland Care: Check the nipples daily and clean with warm water if dried milk begins to accumulate.  Inform the doctor of any discoloration of the skin, swelling, tenderness or sores.  Trim the puppies’ nails if they are scratching the breasts.

 

Vaginal Discharge: A reddish vaginal discharge, with clotted blood, is normal for the first few days.  It normally disappears by seven days, but can go on for two weeks or longer.  The amount should be gradually getting less and less during this period.

 

Hypocalcemia: Sometimes called “milk fever” or post-partum eclampsia.  Some heavily lactating females will get a low-blood calcium while nursing their puppies.  This is most common in very small breeds.  The outward appearance begins with muscle tremors, progressing to seizures with very high fever.  This is an emergency, requiring treatment with intravenous calcium solutions.  Watch for a stiff gait, tremoring, and panting in the early stages.

 

Spaying: If you desire surgical sterilization for your pet, an appointment should be scheduled after the puppies are weaned (six to eight weeks of age), and before the next heat period.

 

 

 

Care of Newborn Puppies

 

 

During the first few weeks of the newborn’s life, the mother provides the necessities of warmth, nutrition and stimulation.  The owner’s responsibilities consist of careful observation to detect problems before they become serious.

 

Warmth: Room temperature should be at least 70 F.  The puppies should be kept off cold floors because chilling can be fatal to young puppies.

 

Nursing: A well-fed healthy puppy has a round stomach and seems content.  In the first two weeks they are either nursing or sleeping.  If the puppies are uneasy or cry frequently, there is a problem.

 

Tail Docking/Dewclaw removal: Puppies in which these procedures are done should be presented at 3 days of age.  Call for your appointment the day the puppies are born so that we can schedule your time.

 

Eyes: The puppies’ eyes open between 7 and 21 days of age, with 10 to 14 being average.  Any discharge from the eyelids is abnormal and means that we need to see them.

 

Weaning: Soon after the puppies’ eyes are open, pan feeding of milk or formula may be started.  Moistened puppy food (Science Diet Puppy food, or another good name-brand puppy food) can be added.  Use a high-sided cookie-sheet pan so that it will contain the liquid and cannot be tipped over.  They will probably just wade in it at first, so be prepared for a mess.  This will allow them to eat solid food sooner, making things easier on mom, plus helping with the weaning process.

 

Worms: The puppies should be dewormed with pyrantel pamoate at 3 weeks of age, and this should be repeated at 2-week intervals.

 

Vaccinations:  The “puppy shots” should begin at weaning, around six weeks of age.  A stool specimen from the litter should be brought at this time, as well.

 

Normal Birth in Dogs

Normal Birth in Dogs

 

Preparations for Whelping: Begin preparations for delivery of puppies before the female gives birth.  A whelping box should be provided for the mother to being sleeping in to ensure the birth of the puppies in the area you have chosen.  This box should be relatively small, with sides 6 to 8 inches high to keep the pups from crawling out of the nest.  With larger mothers, it is a good idea to build a little shelf around the inside of the walls.  It should be high enough for the puppies to be scooted under if mom lies on them, to avoid crushing the puppies.  The whelping box should be placed in a secluded yet familiar area of the home, away from the family traffic, to allow the mother solitude.  It is her instinct to hide during the birthing process.

 

Newspapers make excellent bedding because they can be changed easily, are absorbent and can be shredded by the mother as she makes her “nest”.  If such materials as old quilts, blankets, rugs or towels are used, they must be washed or replaced frequently.

 

If you want to know more precisely when delivery is near, check the rectal temperature of the mother twice daily from the 58^th day of pregnancy until labor begins.  Normal rectal temperature varies between 100.5 and 102 F.  Within 24 hours before the onset of labor, the rectal temperature drops nearly 2 degrees.

 

Labor and Delivery: Labor in the female dog can be divided into 3 stages. The second and third stages are repeated with the birth of each puppy.

 

Stage 1: During the first stage, the mother seems extremely restless and very nervous, and often seeks seclusion. She may refuse food even if offered her favorite treats. This stage may last 6 to 24 hours.  This is a good time to exercise the mother to allow her to urinate and defecate.

 

Stage 2: In the second stage, contractions and expulsion of the puppies begins. Usually a small greenish sac of fluid protrudes first form the vulva. This is followed by the puppy and its attached placenta (afterbirth).  The normal presentation of the puppy is nose first, stomach down. About one-third of all puppies, however, are born hindquarters first.  This presentation is considered normal in the dog.

 

After delivery, the mother opens the sac, cleans off the pup and  severs the umbilical cord. You may have to perform these functions for the mother (see Obstetric Care).  Make sure the sac is removed from the puppy immediately if it is unbroken during delivery.

 

Stage 3: The third stage of labor is the resting stage, which follows each delivery. Mild contractions and delivery of the afterbirth occur in this phase.  This stage usually lasts 10 to 30 minutes, but it may range from a few seconds to an hour. 

 

 

Obstetric Care

 

After a pup is delivered, remove all membranes covering the puppy, clean the face, and remove mucus from the mouth and nose.  Rub the puppy with a clean towel to dry it and to stimulate breathing and circulation.  After a few minutes of rubbing, the puppy should begin to squirm and cry loudly.

 

The umbilical cord should be tied with thread about an inch from the puppy’s body.  Then cut the cord on the other side of the knot (away from the puppy). 

 

Assisting with the Birth:

If a puppy seems to be lodged in the birth canal and the mother cannot expel it, rapid assistance is necessary.  There may not be time to call your veterinarian and drive to the hospital.

 

Grasp the puppy with a clean towel (to get a grip: these little guys are slimy and slippery), and exert steady, firm traction. Do not jerk or pull suddenly.   Don’t pull straight back, but pull down and around, as though to bring the puppy between the hind legs.  Traction may have to be applied for as long as 5 minutes.  If you cannot remove the puppy, call the veterinarian. 

 

Behavior of the Mother:

During whelping and nursing, your pet may not be her usual self. She may be very nervous and filled with a sense of protectiveness for her new family. Any aggression she may exhibit usually fades as time passes.

 

Notify the Doctor if ANY of the following occur:

1. You cannot remove a puppy lodged in the birth canal.
2. There is strong persistent labor for 30 minutes without delivery of a pup.
3. There is weak, intermittent labor for 2 hours without delivery of a pup.
4. It has been more than 4 hours since the last birth and it is probable that more puppies are still inside.
5. There is a greenish-black discharge and no labor or puppies within 3 to 4 hours.  The greenish-black color is normal, but such a discharge should be followed very soon by the delivery of the pups. It means that they are separating from mother and need to get out soon.
6. Labor has continued for 12 hours and is not yet finished.
7. The pregnancy lasts more than 65 days

 

Normal Pregnancy in Dogs

I received a question on this today, so I will post the handouts we use here at KVC.  This is the first of three.

Normal Gestation in Dogs

Gestation is the period when the young are developing in the mother’s uterus.  In dogs, gestation normally lasts 9 weeks (63 days).  However, puppies may be delivered between 58 and 68 days and the pregnancy is still considered normal.

 Diagnosis of Pregnancy:

Ultrasound examination can reliably detect pregnancy by 21 days post-conception.  Examination is scheduled at 30 days post-breeding.  While ultrasound is great for detecting pregnancy, it is not great for counting the pregnancies.  By the eighth week of pregnancy, the puppies can be seen on X-rays (when there is calcium in their bones).  This is the best way to count the number of puppies expected.

 Physical Changes:

During the first 5 weeks of pregnancy, there are few noticeable changes in the mother. After the 5^th week, you may notice weight gain, especially with large litters.  If only 1 or 2 puppies are present, the mother may gain little weight until shortly before birth.  Abdominal enlargement is generally obvious in the last 3 weeks.  The mammary glands may begin to enlarge a early as the 35^th day, but usually development is not obvious until 45 days.  Milk maybe present as early as 7 to 9 days before delivery, but usually it is not produced until 1 to 2 days before delivery.

 Behavioral Changes:

During pregnancy, the female dog may show a change in behavior, especially in the last few weeks. As the uterus enlarges with the developing puppies, your pet may become restless, seek seclusion and in the last few days, soil the house.  She may shred papers, blankets or bedding in an attempt at “nest building” in the last weeks.  During the last 2 weeks, your pet may become irritable and should avoid contact with small children.  She will need a quiet place, out of the traffic pattern to deliver her puppies. It would be good to set aside a place ahead of time and let her get accustomed to it, rather than have her crawl under the bed or into a closet when the time comes.

 

Nutrition:

Good nutrition is essential for healthy puppies and mothers.  During the first four weeks, nutritional needs don’t change much.  The mother needs to be on a good, well-balanced diet, and her regular name-brand dog food should be okay.

During the last 5 weeks, your dog’s nutritional needs nearly double.  Even if fed several small meals each day, she may not be able to eat enough of her regular dog food to satisfy these needs.  Therefore it is best to feed a good, name-brand puppy food, like Science Diet, Purina, Iams, etc. during the last half of pregnancy and during the nursing period.  The puppy food has 50% more nutrition than the same volume of adult dog food. This will do a better job of supplying the increased calories, protein, and calcium needed for the development of the puppies and for nursing.

 

Exercise:

Moderate exercise is the proper approach.  Neither forced rest nor strenuous exercise is a good idea. Short periods  of gentle play and short walks are good.

 

FurEverBrite Glow-in-the-Dark Pet Collar

I had ordered a couple of these to tie on to my dog, but I found a better alternative.

You see, most of the time, my dog Cady sleeps in her favorite spots -- spots that are a long way from the traffic pattern.  There are other times when she randomly decides to sleep between my bed and the bathroom.

This is bad, as I frequently have to make an old-man bathroom trip in the middle of the night.  Being the  middle of the night, it's dark in the bedroom and hallway.  Since I don't want to wake the wife (and I hardly ever get lost on that trip), I don't turn on the lights.  So it's dark.

Not only is it dark, I'm about half asleep.  Thus, should the dog decide to sleep in the path, there's a pretty good chance that I won't notice until I trip over her.  Maybe nothing happens, or maybe I fall and we both break a rib.

This is a better alternative:  the FurEverBrite Glow-in-the-Dark Pet Collar.  They don't cost much.  They charge up with normal room light.  They really do glow in the dark, and the glow lasts all night.  They do have that cheap plastic ambience, but they do work.  With a longer-haired dog (like mine), the collar isn't always as visible as it would be on a short-haired dog. Even so, the collar has saved me from tripping numerous times already.  I'm sold on it.

Another good use would be that dog you let out to use the bathroom before you go to bed, and the dog decides to piddle around the yard for a while instead of coming back in.  Well, the yard is dark and you have a hard time finding him when he doesn't answer your call.  What if he glowed in the dark?

After I bought one for myself (for my dog and myself, I guess), I liked it well enough that I am selling them in my office.  You can also buy them direct online.

 

Removing Painful Teeth is Worth the Trouble

I got excited this week.  I got excited because I got the opportunity to fix something that really needed fixing.  You might think that happens all the time, but you don't always see such a great opportunity to handle a painful situation in such a rapid fashion.

This is Dawson.  When his loving owner "inherited" him three years ago, she asked her regular veterinarian about what she could do to help his awful mouth odor.  Unfortunately, that doctor mis-estimated a couple of things:  the owner's commitment to caring for the pet, and how long this dog would live. 

Mama was told that Dawson was too old to anesthetize, and the other doctor periodically prescribed antibiotics to "control the infection".

We saw him on Thursday.  You could smell his mouth across the room.  He was in constant pain, whining, rubbing his mouth, and at last he was hurting badly enough to  quit eating.  "I just have to do something for him".  I felt the same way.  When I touched his mouth during the exam, he really cried.

Amazingly enough, Dawson hadn't gotten any younger in the last three years.  At fourteen, he's still "too old".  He's a little overweight, and you can hear some fine crackles (like emphysema) all over his lungs. 

The owner was happy to let me assess him for anesthetic risk factors.  His chest X-ray was actually pretty clear, no fluid in his lungs and only mild heart enlargement.  His blood chemistries were nearly normal.  His electrocardiogram was just fine.  I called the teaching hospital at the University of Missouri's veterinary college.  An anesthesiologist was happy to advise me about the best course for Dawson.

We set him up for oral surgery the next morning, and sent him home with pain medicine.  He got the best rest he'd had in weeks.

The next day Dawson was successfully anesthetized, meaning he slept through the procedure without evidence of pain, and he woke up again pretty quickly.  Having good monitoring equipment lets us know when he needs more support (which he didn't, much), and sevoflurane gas lets us adjust his anesthesia rapidly.

We removed these nasty snags and sutured up the gums.  He doesn't have a tooth in his head, but he doesn't need them to eat dog food.  He will need some additiona surgery to close up some old sockets that have been open for a long time.  For now, though, his constant pain has been relieved.  He's not too old for that.

 

The Fur-Ball Tree Returns

  At this holiday time of year, we think about giving and receiving gifts, and about helping those in need.  Kennett’s Humane Officer, Tena Petix, has been going above the call of duty in helping the animals in her care.  Dr. Everett Mobley and Dr. Carol Brigance and the team at Kennett Veterinary Clinic are helping her help again this year with “The Fur-Ball Tree”, the pet’s version of an “angel tree”. 

During the month of December, you can bring a donation for the shelter animals to Kennett Veterinary Clinic at 1704 Saint Francis Street on the west end of Kennett.  Donations can be monetary, food, treats, towels, blankets, or pet-toys.  When you bring in a donation, your name will go up on the The Fur-Ball Tree, and you will receive a $5.00 credit toward your own pet’s next examination at Kennett Veterinary Clinic.

Last year in December of 2010, clients responded by donating generously,  and nine bags of pet food, twelve blankets, eighteen towels, a bushel of toys and treats, and $315.00 in cash were soon under the tree.  We’d love to see even more this year.

So help the animals (and help your own pet) by bringing a donation to The Fur-Ball Tree at Kennett Veterinary Clinic, on Saint Francis St., on the west side of Kennett.

Diagnostic Workup Success - that almost wasn't.

This is Molly.  A few days ago she was presented for an examination.  She had been limping a little the night before and just didn't feel well.

There was no lameness when she came in, but she didn't have much mojo.  She didn't seem in any distress really, just no energy.  She also had not wanted to eat much.  There was no fever, nothing seemed swollen or out of place, and I couldn't find a sore spot anywhere.

She lives in a fenced yard, so trauma didn't seem likely, even though she shares it with another pretty big dog.   There just wasn't really anything to put your finger on, but you could tell she was unhappy.

I was about to send her home with some anti-inflammatory medicine, thinking she might have slipped and made a bad landing in the mud the night before.  Then her owner said, "You know she usually chews on everything, but she doesn't want anything today."  I asked, "Everything, as in a lot of things that aren't food?"  She replied in the affirmative.

With that piece of information, I thought of all the dogs with foreign body intestinal blockages I have seen who had no specific outward signs -- they just didn't feel good. "Let's take an X-ray of that belly. We probably won't see anything, but I'd hate to miss a ridiculously obvious foreign object."  Okay, let's do it.

The abdominal X-ray looked normal, but there was a little bit of the chest on the film, too.  When I looked at the whole film, the chest part looked "funny" (funny-strange, not funny-haha).  We took pictures of the chest.

There was what appeared to be a significant amount of fluid in the chest.  That will make you feel bad.  We tapped her chest - it was blood.  Internal bleeding will also make you feel bad.  In your chest, it will squish your lungs and eventually keep you from breathing, even if you don't go into shock first.

Even though there was no history of exposure to rat-poison, we filled her full of vitamin-K (the antidote).  That stuff makes the dog a free bleeder, and bleeding into the chest (hemothorax) is not uncommon.  Since my associate is pretty knowledgeable in Chinese medicine, we also started the herbal preparation called Yunnan Baiyao, as it helps to get the body's own clotting mechanisms into high gear.

The alternatives to rat-poison were not happy ones: a bleeding tumor, some other abnormal structure that had begun to bleed, or some other heretofore unnoticed bleeding disorder in the dog.  All of those have a terrible prognosis, not to mention that referral to a surgical specialist was not in the cards.

Thankfully, Molly has responded well to treatment and seems about normal now.   Who takes a full set of X-rays every time a patient just "doesn't feel good"?  Nobody.  A chance remark, a look at the wrong place, and we got an accidental look at the right place.  And I almost sent her home with some pain-killers.  Serendipity, it's called.

Is there a good alternative to Immiticide treatment?

Eric writes:

Thank you for all the information regarding heartworm prevention and treatment. There is a lot of misunderstanding. We are an animal welfare group who took in a dog which tested positive for heartworms. The dog has received ivermectin weekly + doxycyline daily for two weeks, paused a week, and will receive another week of doxycycline.

A few studies conclude doxycyline + ivermectin kill adult heartworm: "Results indicate that the combination of these two drugs causes adult worm death." http://www.ncbi.nlm.nih.gov/pubmed/18433753 There is also internet talk of a "slow kill" method.

Do you have any advice for animal welfare groups or others with a budget that would not involve Immiticide? There are also such frequent shortages of Immiticide, it appears to be an annual event. Thank you.

For some reason, my reply is not posting to the original blog thread, so I am publishing it here.

Hello, Eric,

The American Heartworm Society has withdrawn its endorsement of so-called "slow kill" or "soft kill".

First, while some of the worms may die with long-term (like two years)administration of ivermectin and doxycycline, you cannot be certain of clearing the dog.

Second, the dog's problems with treatment arise from dealing with the death and movement of the worms within the pulmonary arteries.  We want to keep the dog's activity restricted until the dead worms have been dissolved by the body's defenders.

It takes at least five weeks for the dead worms to be cleared from the circulation.  With the Immiticide, we know when the worms will be dying (within a week), and can watch the dog accordingly. 

If you are treating long term with other medications, you would have to keep the dog's activity restricted for years, as you have no idea when (or if) the worms will be dying and moving.

The frustration with Immiticide shortage and expense is something I feel pretty personally.  While I have an adequate supply at present, I had none for several months.

My experience with humane organizations has been that resources are limited and must be allocated where they can do the most good.

When there was no indication that Immiticide would be available, the American Heartworm Society recommended monthly ivermecin (Heartgard, Iverhart, etc.) and 10 mg/kg of doxycycline twice daily for one month.  The doxy inhibits the Wohlbachia (beneficial symbiote of the heartworm)for an additional two months after giving it for one month.  Thus, they recommended repeating this at 3-month intervals.

If I were in a shelter environment, I would follow that protocol.  This is what one would do in the month prior to starting Immiticide treatment anyway.

The adopting owner just has to realize that he/she is taking on a bigger commitment when adopting a pet with heartworms.  There isn't a quick fix.

Thanks for reading and writing.

This wound looks worse than it is.

I saw this little kitty today for a very nice lady who wanted a second opinion.  Her cat received a big wound in the left flank about six days ago.  Her regular veterinarian sutured the laceration and sent her home with antibiotics.  That seems like a good plan.

She was upset because the wound is opening up now and it just doesn't look good to her.  She was even afraid it might open up and let the cat's "guts fall out".  That would be bad, I think you'll agree.

A little questioning reveals that the kitty seems to be feeling well and eating well.  That's good.  No fever when I checked her temperature.

A closer look at the wound lets us see that while it is open, there are no pockets of fluid around it and the wound is not deep.  The exposed raw tissue looks pretty healthy.  There are a few stitches present, but many appear to be missing.  And what's that black stuff in there?

I've talked about crushing injuries time and again (here and here).  I really believe what has happened here is that the wound edges were damaged in the initial injury.  The other veterinarian sewed it together nicely, but the tissue he sewed died.  Then it started falling off (the black stuff is dead skin).  Really, for that scenario, this looks pretty good.

The owner and I discussed our options.  I could certainly have made fresh edges on the wound and scraped it out and re-sewed it.  It would look nice, and I'm pretty sure it would have healed well.

On the other hand, I'm not sure that the cat would be any more comfortable and heal any faster than if I just put a bandage on to protect the tissue from drying and other trauma.  So that's what we did.

The owner was quite convinced that the other doctor had done the worst job in the world.  She hasn't seen a gazillion wounds like I have. 

The other doctor did what was technically appropriate, but he did do a poor job in letting the owner know what to expect.  Some of these things are not going to get totally fixed on the first visit.  She could have been happy with the first doctor with a little more communication.

Don't feel bad about asking your veterinarian for more information and clarification.  They won't think you're stupid - they'll just realize that they haven't done their job of explaining as well as they need to.