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A Hookworm Invasion

We have noted over the past year or two an alarming increase in intestinal parasites in our area, and particularly in Hookworms. We're not entirely sure why this is happening. It may be due to milder winters, an increased resistance of the worms to the medications used to kill them, or maybe the higher number of pets being adopted into our state from Southern states. 
Here is a quick review of the lifestyle of this parasite:
 Hookworms live in the small intestine of the host, but unlike other parasites who consume the host's own food by absorbing it through their skin, hookworms attach to the intestinal wall with six sharp teeth, and feed on the host's blood. This is particularly detrimental to young puppies who can become anemic and die from a severe infestation. 
 The adult worms feed and mate inside the small intestines, and the resulting eggs pass into the world through feces. Once outside, the eggs undergo a transformation into infective larvae and make their way into a new host either by penetrating their skin, or more commonly by being ingested, usually through self grooming. 

Do natural and herbal always mean safe for our pets?

As the use of supplements and alternative therapies continues to rise for our pet population, it's important to consider the safety of our furry family members. While the terms "natural" and "herbal" have a reassuring sound, they are not indicators of either quality or safety in a product or service. Though the Food and Drug Administration (FDA) has recently requested public comment on the use of the term "natural," it is not currently regulated on pet food or supplement labels -- There is no official definition and there are no requirements for making this claim. In fact, there are supplements and therapies that can actually be harmful to pets. herb
Here are just a few examples of natural and/or herbal therapies that can be dangerous for pets:
  • Tea Tree Oil - Application of concentrated tea tree oil to the skin or oral exposure is considered moderately to severely toxic and may be life-threatening to pets. Symptoms include vomiting, weakness, incoordination, seizures, liver toxicity and coma in cats and dogs. Even lower concentrations can cause dermatitis in sensitive individuals. 
  • Garlic and Onion - Ingestion of these foods from the Allium family by dogs or cats can lead to vomiting, diarrhea, collapse and anemia, as well as possible increased bleeding tendencies at surgery.
  • Alpha Lipoic Acid (ALA) - Found in many supplements, ALA can cause hypoglycemia, seizures and liver toxicity in pets at higher doses.
  • Aloe - When ingested, aloe in its various forms can result in vomiting, diarrhea, lethargy and rarely tremors.
  • Ephedra / Ma Huang - Found in some weight loss products and herbal decongestants, this stimulant can cause hyperactivity, racing heart rate, fever, tremors, seizures and death from cardiovascular collapse.
  • White Willow Bark - Typically used for its possible anti-inflammatory effects, this herb contains salicylates which are particularly toxic to cats. It can also have dangerous interactions with anti-inflammatory medications and heart medications that are prescribed to pets.  
  • Pennyroyal Oil - While considered a pest / flea repellant, this oil is extremely toxic to pets if ingested and can cause vomiting, difficulty breathing, liver toxicity and death.
  • Marijuana and Cannabinoids - Ingestion of any formulation and/or inhalation of smoke from marijuana may result in hypothermia, incoordination, seizures, coma and even death. Safe dosing of marijuana and its various formulations has not been determined for cats and dogs.
Even supplements that are generally considered safe can be dangerous when over-consumed by a pet. This is particularly concerning given the number of supplements that are increasingly incorporated into appealing, flavorful treats. Joint supplements for example, when ingested in large quantities, can lead to gastrointestinal upset, liver toxicity and blood sugar regulation problems in pets.
There is also a general lack of regulation and monitoring of supplement health claims, especially for pet-specific products. The Dietary Supplement Health and Education Act of 1994 requires that product labels with claims regarding beneficial health effects also have the statement: "This product is not intended to diagnose, treat, cure, or prevent any disease." However, the FDA and American Veterinary Medical Association (AVMA) have taken the positions that this act does not apply to animals.
Supplement quality and efficacy are not closely regulated either. A label description of ingredients and dosages may vary significantly from the actual dose delivered, and there are risks of supplement contamination with potentially harmful substances. Especially with long term use, product contaminants such as heavy metals may be harmful. Ensuring that a supplement has been tested by an independent laboratory is helpful. 
Listed below are some websites that may be helpful in evaluating supplements, but keep in mind that websites can be fallible and there is variation from batch to batch in the manufacturing of any product:
  • www.fda.gov/Food/DietarySupplements: Maintained by the FDA, this site describes regulation of supplements and reporting of adverse events.
  • Quality-supplements.org: This site by the United States Pharmacopeia (USP) lists human supplements that have met independent testing requirements for quality, potency and safety. USP audits the manufacturing facilities for these supplements as well.
  • Labdoor.comLabdoor is an independent company that tests supplements through an FDA-approved laboratories for label accuracy and contaminants. 
  • Consumerlab.com: This site charges a fee for members to access their reports evaluating primarily human supplements.
Ultimately, your veterinarian can be your partner in helping you assess the need for supplements, as well as safety concerns and potential for interactions. It's important to always inform your veterinarian of all supplements your pet is taking, especially if you're having your pet evaluated for illness or prior to surgery.

Coping with Coprophagia

Is coprophagia your dog’s dirty little secret? If it is, you (and your dog) are not alone. According various estimates, 10-25% of dogs engage in intraspecies coprophagia—that is, they eat their own or other dogs’ feces.  


While in most cases, coprophagia is a behavioral problem, it can also have medical basis.  Medical causes of coprophagia include dietary deficits from inadequate intake or absorption of nutrients and increased appetite caused by different diseases or medications. Dogs receiving adequate calories and being fed diets that are “complete and balanced” according to AAFCO standards, should be receiving the nutrients they need unless they have a disease that prevents them from absorbing and retaining nutrients. Exocrine pancreatic insufficiency (EPI) is one disease in which dogs do not have the enzymes they need to properly digest their food. Despite receiving a diet that is complete and balanced, dogs with EPI will often lose weight, act hungry, and lose nutrients in voluminous stools. Dogs with severe liver disease, intestinal parasites, undertreated diabetes mellitus, and some types of gastrointestinal and kidney disease may also not be able to properly absorb and retain nutrients from their food. These deficits can leave dogs hungry and seeking calories and nutrients from nontraditional food sources (feces). Cushing’s Disease or hyperadrenocorticism can increase a dog’s appetite as can steroids or medications given to control seizures. In some cases, these dogs may eat feces as a way to satisfy their hunger.


In the majority of cases, coprophagia is a behavioral rather than a medical problem. Coprophagia is actually a normal behavior in female dogs with puppies. Good dog mothers will lick at their puppies’ rear ends to stimulate defecation and will consume puppies’ feces to keep the “nest” clean.  It is possible that dogs who aren’t cleaning up after their puppies may also engage in this cleaning behavior. Some researchers propose that eating feces may have had evolutionary benefits. Dogs are omnivores and dogs who scavenged and ate stools of carnivores may gotten some added nutrients with little energy expenditure. Since some intestinal parasites take a few days to reach an infective stage in the environment, eating fresh feces within a dog’s territory may be advantageous to help contain or prevent parasite transmission to members of the pack.


What Should You Do if Your Dog Eats Poo?


If your dog is suddenly eating its own or other dogs’ feces, it is best to consult with your veterinarian to ensure there isn’t a medical cause. A fecal parasite test may be recommended to screen for some intestinal parasites that may be a cause or consequence of your dog’s coprophagia. If any medical causes are identified, they should of course be treated. For the more common behavioral causes, the most effective treatment is behavior modification (training). The best way to prevent coprophagia is to pick up feces promptly and keep dogs on leash or well-supervised when in areas where other dogs’ feces might be present. Teaching dogs to come when called (and rewarded with an edible treat that is more high value than stool) and the commands “leave it” and “drop it” can also be helpful to prevent coprophagia.  Food additives also exist that can be given to the “victim”--the dog whose stool is being eaten--with the idea that it will make the stool distasteful to the coprophagic dog. The problem with these additives is that they aren’t always practical, nor are they very effective. The additives have to be given to the dog whose stool is being eaten (and you can’t give medication to all of the dogs at the dog park!) and have to be given with every meal for a period of time (one product recommends giving it for 20 days). During this time period, the coprophagic dog is allowed to eat feces, which will ideally be unappetizing and stop the behavior. Unfortunately, a recent survey of owners of coprophagic dogs found the overall efficacy of these additives was 0-2% in eliminating coprophagia (Hart et al. 2018).


References available upon request.

Meet Dr. Google

As a veterinarian, every day I see sick patients that have already been diagnosed by Dr. Google with a myriad of conditions.  Some appear reasonable; others, however, are way out in left field.  There was a time when I would dread the words “So I saw on the internet that Fluffy could have [Fill in the blank]”.  My attitude has evolved, however, to where I now relish the opportunity to educate and have an open discussion about that particular patient’s condition.  Moreover, as my clients have become better educated on various topics, I find the discourse between us more engaging and firmly believe this results in better care for my patients.  


I think it is important, however, to keep some things in mind when searching the web for medical information.  Here are some tips to keep in mind when searching the web for veterinary medical advice.  


1. Ensure the advice is from a knowledgeable source. Articles written by licensed veterinarians are the ideal source.  These are often supported by good science and are peer reviewed.  Veterinarians are bound to uphold professional standards and rarely disparage other veterinarians or sources of information.  Moreover, spreading of misinformation can put their license at risk.

2. Check multiple sources. Cross checking multiple quality sources will validate any information you may gather.  This attenuates the risk of falling to a lone wolf that may be spreading false information or rumors.  

3. Be aware of highly emotional articles or those that are derogatory of veterinarians or other professionals. I’m always quite suspicious of articles that will appeal solely to one’s emotional judgment or is derogatory of veterinary professionals.  These articles are not based on sound science or professional standards, and often times end up trying to sell something.  See below.

4. Be aware of sales pitches. I was once referred to a web site that was supposedly selling a “very high quality” food.  The opening article was a diatribe on how veterinarians are in cahoots with food companies to sell diets that is killing our patients.  But then it dovetailed into how much better their food was and you could buy it on their website.  And remember, if it sounds too good to be true, it is.

5. Remember, there is no scrutiny of information available on the web. Articles aren’t screened for their accuracy and validity.  It is up to us - as individuals - to validate information available to us.  Utilizing a trusted, peer-reviewed source is important in having the most accurate up to date information.

6. Keep your veterinarian in the loop. No one knows your pet like you do.  I would argue a close second is your veterinarian.  Before you try something, talk to your veterinarian.  There may be a particular issue or condition specific to your pet that may prohibit certain medications or treatment alternatives.  Keeping the line of communication with your veterinarian open and fluid is paramount to maintaining your pet’s health.  


Hopefully these tips help in keeping your pet healthy.  I’ll reiterate it again, before you try anything you learned on the web, it is important you speak with your veterinarian.  We both (you as the pet owner, me as the veterinarian) want to keep your pet as healthy and long lived as possible.

Heart Murmurs in Dogs

Say you went into the clinic for a physical exam and vaccinations and you were told your dog has a heart murmur.  What does this mean?  A heart murmur is an abnormal sound heard when listening to the heart beat.  Instead of the normal “lub dub” sound, you will hear a “woosh dub”.  The most common reason for this is a leaky heart valve (mitral valve or aortic valve) and the mitral valve which is on the left side of the heart is the most common type.  There are other reasons for a murmur besides a leaky valve:  anemia and thinner blood can create turbulence and a murmur; holes in the heart wall such as with young dogs with inherited heart defects; changes in heart shape and contractility from heart muscle diseases.  Certain breeds have a higher risk of heart murmurs such as the Cavalier King Charles Spaniel, Toy and Miniature Poodle, Schnauzer, Shih Tzu, Cocker Spaniel, and other breeds under 25 pounds adult weight - these are usually due to changes in the valve leaflets due to breed genetics and age.  (Large breeds with murmurs more often have heart muscle diseases and not valve changes, and starting a cardiac work-up is recommended and their diseases and risks will be covered in another article.).  If your dog is otherwise healthy and there is no history of coughing or exercise intolerance, it is not likely the heart murmur is causing a problem yet, so we have some time to do a work-up.  We would recommend chest x-rays to evaluate the heart size and shape and Vertebral Heart Score (VHS).  This gives us a baseline to compare with x-rays in the future.  The VHS helps us see if the heart is enlarging in response to the leaky valve, which lets us know it is time to start medications to help the heart contract better before heart failure starts. Many small breed dogs with heart murmurs develop congestive heart failure (CHF) over time, so yearly or twice a year exams and yearly x-rays are recommended.  Some dogs need to have a cardiac ultrasound (echo) and EKG and blood pressure in addition to radiographs.  Signs of CHF are coughing, breathing rate at rest >40 breaths per minute, gum or tongue color changes from pink (normal)  to violet (abnormal), and exercise intolerance.


If your dog has been coughing and you brought him into the clinic and we found a heart murmur,  we would recommend chest x-rays right away.  Radiographs will show if there is fluid in the lungs (pulmonary edema) from congestive heart failure and we will measure VHS and look for heart enlargement.  Some dogs with heart murmurs and a cough do not have congestive heart failure - they can have respiratory problems such as bronchitis, pneumonia, collapsing trachea,  kennel cough, or cancer.  Respiratory problems are treated differently than heart problems. There are good medications for dogs with CHF, including  therapy with pimobendan, enalapril, and furosemide.  An additional medication called spironolactone is added for some patients.  With CHF, recheck x-rays and exams are needed to monitor response to treatment and blood tests are done to see if kidney function is being impacted by the medications.  Staying in the hospital in an oxygen cage is necessary for patients with low oxygenation of the blood (pulse ox) along with fluid in the lungs (pulmonary edema).  An exam by a board certified cardiologist and  an echocardiogram is needed in some cases.


In summary, we recommend x-rays for all dogs with heart murmurs.  With proper monitoring and medications, our canine friends can live longer, happier lives.

Our Mission:

We provide the quality care our clients expect and their pets deserve, by relying on the expertise and
compassion of each team member.


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Westgate Pet Clinic
4345 France Avenue South
Minneapolis, MN 55410
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(612)925-6297 Fax
(612)568-1405 Pharmacy

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