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Rattlesnakes are highly adaptable venomous snakes that live thoughout the continental United States. They are members of the Crotalidae family of venomous snakes which is a subfamily of vipers. Beside rattlesnakes, this group includes water moccasins and copperheads. This group does not include coral, mamba or sea snakes which are part of the Elapidae family.

Vipers inject venom into prey through two large fangs that protrude from the upper jaw. The venom is a mix of toxins and enzymes that will immobilize the prey and destroy the tissue in the area of the bite which allows the venom to spread more quickly. It includes myotoxins, cytotoxins, neurotoxins, cardiotoxins and hemorrhagic toxins. The venom from rattlesnakes is the most toxic followed by venom from water moccasins and copperheads in that order. The snake controls how much venom is injected per strike. Young snakes tend to deliver their entire load of venom whereas mature snakes may not inject any venom at all. This is referred to as a ‘dry bite’.

Swelling, bruising and pain are the most common clinical signs of a snake bite. Dogs are often bit on the head or legs which is a good thing because the venom spreads more slowly from these areas when compared to the torso. Swelling develops quickly and may cause airway obstruction. Snake bites are very painful! Dogs will yelp, moan and cry if the affected area is touched. The venom also interferes with the victim’s ability to clot their blood. Bleeding from the nose, mouth and eyes as well as bloody urine or feces are common. If this isn’t bad enough, some rattlesnake venom contains neurotoxins. Dogs may suffer a variety of neurologic signs from difficulty walking to paralysis, seizures to coma.

The goal of treatment is to neutralize the venom with antivenom as soon as possible. Best outcomes occur when the antivenom is given within 4 hours of the bite. The antivenom is made of antibodies, either the entire IgG or fragments of IgG, given through an intravenous catheter.  Again, time is of the essence.  In addition, patients need fluid therapy to treat shock and strong pain management. Some patients may need blood transfusions if bleeding is severe. Unfortunately, even with aggressive therapy, some dogs will not make it. Pictured below is a dog who was bitten on the left side of the lip by a Western Diamondback Rattlesnake. Severe swelling was noted on the lip and neck. This dog was treated with ‘Rattler’ Antivenom. This is the only antivenon that has antibodies against the Mohave rattlesnake venom. The swelling started to recede within ten minutes of starting treatment and she made a complete recovery!

Prevention of snake bites:

  1. Snake Avoidance Training – In areas with a lot of indigenous venomous snakes, many dog training centers offer snake avoidance training. The dog is fitted with an electric (shock) collar then exposed to the snake that is either in a cage or wearing a hood to prevent a strike. When the dog smells the snake, they receive a small shock and are taken away from the snake. A few minutes later, the dog is exposed to the snake again. Most dogs, will freeze instantly and then leave the area. If they continue toward the snake, a stronger shock is administered until the dog gives up. This type of training works well for confident dogs but I do not recommend it for timid dogs.
  2. Crotalus Atrox Vaccine (Rattlesnake Vaccine) – Red Rock Biologics produces a vaccine for rattlesnake bites. Unfortunately, there is a lot of confusion surrounding this product. It is not a true vaccine that protects the pet from disease like the rabies vaccine. Instead, the crotalus atrox vaccine gives the dog more time to get treatment. The dog pictured above had the crotalus atrox vaccine a month and a half before the bite occurred. Most of the dogs I vaccinate live on ranches or go hiking and camping in remote areas where it may take hours to get treatment. Unfortunately, I have seen some bad reactions in my patients from this vaccine. Also, this vaccine stimulates antibodies against the Western Diamondback rattlesnake. Although the antibodies cross react with some other rattlesnakes but does not stimulate antibodies against the neurotoxin in Mohave rattlesnakes. Please discuss the pros and cons with a veterinarian before use.
  3. Prevent Snake Exposure – Snakes follow their noses to prey. Keep rats, mice and other rodents away from homes by making the environment less inviting. Keep citrus picked up and pet food indoors. Install snake fencing to keep reptiles out. Pictured below are some ideas to help you snake proof your yard. The first one if a gate showing the gate resting on pavers without a gap. The gate actually rubs the pavers when opened. The screen extends on both sides to cover the gaps that occur. The second image shows screen wired to a combination block and iron fence. The screen extends to the block without any gaps. The brush has been removed from both sides of the fence to make the area less hospitable for rodents and snakes. It also provides a defensible space in case of fire. Drains in the wall need to be covered with screen as well.

Source:

-Rothrock, Kari. ‘Snake Evenomation, Crotalid’. VIN Associate Database, last updated 10/26/2017.

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Lilies and cats do not mix. Easter Lilies and many other members of the lily family including day lilies, Asiatic lilies, tiger lily, stargazer lily, rubrum lily, red lily, western lily and wood lily are poisonous to cats.  Their toxic potential in other animals is not known at this time. The exact cause of toxicity is also unknown.  The toxin causes severe kidney problems (renal tubular necrosis) within two to three days of ingestion.  Therefore, I do not recommend bringing this plant into any household with cats!

All parts of the plant are poisonous with the flowers containing the most poison.  Death may result within hours in cats that eat several flowers. Even the pollen is toxic.  If your cat is exposed, bring them in for veterinary care immediately!  This is not something you can treat at home.  If you suspect toxicity, please do not delay. Unlike other animal species, lily exposure in cats causes severe kidney disease that often leads to death.

Initial clinical signs of toxicity include vomiting, lethargy and anorexia. As the toxin damages the kidneys, the affected cat becomes depressed, weak, salivates and drinks a lot of water. Some cats will lay with their head on the water bowl and drink constantly. As the kidney damage progresses, the kidneys may become unable to produce urine. Death is coming soon.

Several years ago I treated a beautiful kitten for renal disease.  The rambunctious girl jumped up on the counter to investigate the Eater Lily that adorned her home.  Some of the pollen stuck to her nose as she sniffed the flowers.  She licked it off and then left to play with more interesting toys.  Two days later, the kitten felt awful.  She refused to eat or drink.  When I examined her, I felt her kidneys bulging beneath the skin.  She screamed in pain when I touched (palpated) them.  The swollen kidneys were twice as large as normal.  Blood work confirmed what I already suspected, the kitten suffered from severe kidney disease caused by the Easter Lily.

With aggressive therapy, some of these cats do recover from the poison.  The kitten mentioned above was a terrible case of poisoning.  At the beginning of therapy, her blood urea nitrogen (BUN) and creatinine levels were off the charts.  After five days of fluid therapy, they fell back to the normal range.  She was lucky but it is best not to take chances with lilies.

More information on lily and other toxic plants can be found at the ASPCA. Here’s the link to the ASPCA poisonous and non-poisonous plant list https://www.aspca.org/pet-care/animal-poison-control/toxic-and-non-toxic-plants

Source:

-Gwaltney-Brant, Sharon. ‘Lily Toxicosis’ VIN Associate, last updated 10/10/2015.

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Electronic cigarettes (e-cigs) are toxic to dogs and cats. Beside the danger of the e-cig causing an obstruction or perforation, the liquid inside can be fatal. E-juice or e-liquid contains propylene glycol, nicotine, flavorings and either vegetable glycerin or polyethylene glycol. Propylene glycol and glycerin are usually not toxic at the low levels contained in e-cigs although it is unknown if chronic exposure may be hazardous. The bigger concern is the nicotine. As little as 20 mg can kill a small dog or cat. The concentration of nicotine contained in each e-cig varies dramatically between brands.

Clinical signs of nicotine toxicity depend upon how much nicotine the pet consumed. With ingestion of small amounts, the dogs and cats will experience vomiting, diarrhea, drooling, restlessness and panting. Ingestion of moderate amounts causes increased blood pressure and heart rate. The pets may also twitch or seizure. Pets who consumed large amounts often progress to paralysis, abnormal heart rhythms, coma and death. Nicotine is absorbed rapidly through the mucous membranes making it difficult to decontaminate the pet. Inducing vomiting to get rid of the nicotine or giving charcoal to absorb is often too late to help. Unfortunately, many dogs and cats will die even with aggressive therapy.

If you think your pet may have eaten or chewed on an e-cig or worse yet, a bottle of the e-juice, please seek emergency veterinary care immediately. Bring the e-cig and/or e-juice bottle as well. This will allow the veterinarian to determine the amount of nicotine ingested and the level of toxicity.

Source:

-Gwaltney-Brant, Sharon. ‘Electronic Cigarettes are Toxic to Pets’ Veterinary Partner, VIN.com.

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Finding the best food for pets has become a frustrating and time consuming process. With isles full of foods, people read the labels thinking that will help them identify the best one. They mistakenly think that dog and cat food can be compared by the Guaranteed Analysis (GA). Nothing could be further from the truth! Metabolizable Energy (ME) should be used instead.

The guaranteed analysis is simply a list of the percentage of fat, protein, fiber and moisture in the food. Specifically, the list includes the minimum crude protein, minimum crude fat, maximum crude fiber and maximum moisture. The term ‘crude’ means all the nutrients are included in the results whether they can be digested or not. For example, a label can say 25% minimum crude protein even though only half of it is digestible. The actual amount of useful protein is 12.5%. The opposite happens with crude fat because this value is listed as a minimum. The value on the guaranteed analysis is much lower than what is actually digested because many pet food companies add highly digestible fat to make it taste better. In my opinion, the term guaranteed analysis is more confusing than helpful. I would like to see it removed from labels and replaced by metabolizable energy.

Metabolizable Energy is a much better method for comparing diets because it only reports what is actually digested. The USDA defines it as follows: “The net energy in food or feed that is available to humans or animals by digestion and absorption, and measured as the difference between gross energy and the energy lost as being digested or indigestible.” That means that the energy lost in digesting the food through the urine, feces and combustible gases is not included. Metabolizable energy takes into account the quality of the ingredients which allows for an ‘apple to apple’ comparison. Guaranteed analysis does not.

Several years ago, I treated a miniature schnauzer for pancreatitis. This breed is prone to pancreatitis because they often have too much fat in their bloodstream. After treatment, I sent the dog home on a low fat (8% ME fat) canned diet. Three months later, the dog came back with pancreatitis again because the owner didn’t like the food I recommended. She went to a specialty pet food boutique and selected a food that was 8% minimum fat based on the guaranteed analysis. When I converted the guaranteed analysis of the food she bought to metabolizable energy, the food was actually 52% fat! The dog almost died because of the confusion caused the the label.

Guaranteed analysis results can be converted to metabolizable but the calculations are time consuming. Instead of doing it yourself, I recommend using the converter provided by BalanceIt.com. The nutrition service at the University of California-Davis, College of Veterinary Medicine created this helpful tool. Simply plug in the numbers from the guaranteed analysis listed on the label and the converter will do the rest.

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Last week I examined a dog for itching and wound up with a surprising diagnosis. This beautiful dog has a history of allergies which require constant treatment to keep her comfortable. I though she had another breakthrough of her allergies or maybe developed a secondary bacterial or fungal infection. This wasn’t the case at all. During her examination, I found little black specks all over her body that moved. She also had thick tan colored crusts on the edges of her ears, excoriations on her abdomen and generalized inflammation. This dog itched constantly. She was miserable. Examine the microscopic image of the black specks below and then answer the following questions: What parasite is this? How did this dog become infected? Is it transmissible to people?

Diagnosis: Lice

Unfortunately, my patient was suffering from pediculosis which means an infestation of lice. Lice are small parasites that are divided into two groups: 1) Chewing lice that feed on the skin (secretions, hair, fur) 2) Biting lice that pierce the skin to obtain blood. Pictured above is a biting lice.

Lice spend their entire life on their victim. The adults lay eggs (nits) on the shafts of hair. Nymphs hatch from the eggs and then begin feeding on the host. They molt three times before they become an adult capable of reproducing.

Lice are spread through close contact with an infested dog or contaminated objects like bedding. My patient started itching after going to the groomer. Most likely, the groomer transferred lice from an infected dog to my patient through their tools.

Unlike fleas, ticks and mites, lice are fairly easy to treat because they spend their entire life cycle on the dog. There are many topical treatments that work well killing the lice within a week. I recommend treating all the dogs in the household when lice are involved. I also recommend cleaning the environment including dog beds, blankets and brushes to prevent reinfection. Since most lice are species specific, the varieties found on dogs don’t infest humans and vice versa. That means that cats don’t have to be treated either unless the lice infestation is caused by a variety called Heterodoxus spriniger. I treated my patient with Vectra 3D and she is feeling much better now.

Source: Shell, Linda original author, Rothrock, Kari revision author, ‘Pediculosis’ Associate Database, VIN, last updated 6/8/2017.

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On January 21, 2018, Mary Martin, Director at Maricopa Animal Care Centers (MCACC), announced that Streptococcus equi subspecies zooepidemicus was found at their east valley shelter located at 2630 W. Rio Salado Parkway in Mesa, AZ. S. epidemicus is a serious bacterial disease that effects horses, dogs, cats and immune compromised people in rare circumstances. As of yet, there are no confirmed cases of human infection after direct contact with infected dogs. Most of the human cases occurred after consuming unpasteurized dairy products from infected cows or working with infected horses. Infected people developed pharyngitis, glomerulonephritis, meningitis and pneumonia.

S. epidemicus is a bacterium often found in the respiratory tract of horses and ruminants including goats and cows. When given the opportunity, it will invade other species. In dogs, it usually causes hemorrhagic pneumonia. Although MCACC has not declared this an outbreak, previous outbreaks at other facilities throughout the U.S. have been associated with crowded, kennel-like situations. At this time 30 dogs are showing clinical signs of illness in the Arizona facility.

Clinical signs of S. epidemicus  in dogs include:

  1. Coughing, sometimes bringing up a bloody material
  2. Nasal Discharge, sometimes bloody
  3. Anorexia
  4. Fever
  5. Bloody Urine
  6. Vomiting
  7. Labored Breathing
  8. Death

S. epidemicus is diagnosed by either culturing the bacteria or with a PCR test performed on samples taken from infected tissues. The advantage with PCR is a much faster turn around time as well as better accuracy. The advantage with culture is that antibiotic sensitivity can be performed to determine the best antibiotic for treatment. Early diagnosis and treatment with antibiotics is the key to saving effected dogs. Unfortunately, doxycycline resistance is starting to occur with S. epidemicus.

To prevent further infections, MCASS has shut down all playgroups and non-mandated services at the east location. They have held press conferences to warn local veterinarians about the disease. They are also adopting out animals for free in order to get them out of the shelter before contracting this disease. This last action step is surprising to many including me for fear of spreading the disease to dogs outside the shelter. According to the New York City Department of Health and Mental Hygiene, ‘Streptococcus equi subspecies zooepidemicus is an extremely rare pathogen in dogs and typically limited to shelter settings. Unpublished observations suggest transmission of Streptococcus equi subspecies zooepidemicus from shelter dogs to other dogs following adoption is unlikely.’

Although I understand their decision is based on the above information, I still worry that this action may end up spreading the disease. I am especially worried about animals and people with compromised immune systems including chemotherapy patients and valley fever patients. Therefore, I recommend isolating newly adopted pets from this shelter from all other animals for a least 2 weeks. Do not bring your existing pets to this shelter. Clean all equipment including bowls, leashes and combs between animals. Last, wash hands well and change clothes after visiting the shelter.  In other words, I would not adopt pets from there right now and strongly feel the facility should be quarantined until the incubation period has passed.

For a more detailed discussion of this horrible disease, watch Dr. Cynda Crawford’s presentation at the UF Maddie’s Shelter Medicine Conference 2011 on Streptococcus zooepidemicus. 

Sources:

-Slavinski, Sally. “2009 Veterinary Alert#1: Streptococcus equi subspecies zooepidemicus Identified in Shelter Dogs.” NYC Health:  NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENE, 1.12.2008.

-Tanabe, Morgan. “More than 30 dogs showing symptoms of ‘Strep Zoo’ at Maricopa County animal shleter.” ABC15news,com, posted 1.21.18.

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Keeping pets in the home during pregnancy may help prevent eczema and asthma in babies. Two studies presented at the annual meeting of the American College of Allergy, Asthma and Immunology (ACAAI) indicate that having pets, dogs in particular, in the home during pregnancy decreases the chance of children developing these immune related diseases.

In the first study, Dr. Tsou studied how children with asthma reacted to dogs. He separated the exposure into what is on the dog’s fur (like dirt from outside) versus proteins innate to the dogs themselves. The study found that exposing these urban kids (who already have dog allergies) to the protein from dogs caused asthma symptoms to occur. However, exposing the kids to the fur which contained bacteria and other environmental antigens had a protective effect that lessened the asthma symptoms.

The second study conducted by allergists Drs. Cheema and Zoratti looked at the progression of allergic disease. Infants often start with eczema then progress to food allergies then nasal allergies and finally asthma. This study found that infants exposed to dogs during pregnancy had a reduced risk of having eczema by age 2.

The bottom line for parents on whether to have dogs in their home or not depends upon the family members allergies. If a child reacts to the specific dog allergen or protein, then reducing their exposure is recommended by the ACAAI. If a child has asthma, then having a dog in the home should help based on these studies. It is important that the dog goes outside every day to bring the outdoors inside in small doses.

Sources:

-‘Dogs may protect against childhood eczema and asthma’. American College of Allergy, Asthma and Immunology, IMMUNOLOGY, Oct. 10, 2017

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The Food and Drug Administration has issued a warning for dog bone treats. From November 1, 2010 to September 12, 2017, many dogs have fallen ill after eating commercially produced dog bone treats. Unfortunately, 15 dogs died. According to their report, the treats are marketed under the names, “Ham Bones, Pork Femur Bones, Rib Bones and Smokey Knuckle Bones.” Some are smoked or baked with additional chemicals added for flavor.

According to the FDA, the clinical signs reported are:

  • Gastrointestinal obstruction (blockage requiring surgical removal)
  • Vomiting
  • Choking
  • Diarrhea
  • Damage to the mouth
  • Bleeding from the anus
  • Death

As a veterinarian, I do not recommend bones of any kind. Beside the problems listed above, I see a lot of tooth fractures from bones. The large upper premolar is often fractured when the dog chews the bone. This results in a painful infection along the roots that causes a swelling under the eye. Removal of the tooth is the only way to end the pain.

More information on the FDA warning can be found at: https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm208365.htm

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Beagles are a wonderful breed of dog known for their unique personalities. They have a zest for life that never stops.  Their antics keep their human families in stitches. Maggie, pictured below, is the perfect example enjoying an afternoon on the boat. Beagles have a keen sense of smell and an immense joy for eating that make them wonderful working dogs.  The US Customs Beagle Brigade sniffs arriving passengers for illegal food stuffs. When a fresh piece of fruit is detected, the dog sits by the unsuspecting passenger. Beagles are also being used to detect bed bugs.

Unfortunately, beagles are prone to several health problems. Some are genetic while others are caused by their lovable personalities. Name the top seven health problems in beagles then scroll down to check your answer.

Image contributed by Jim Vail

DIAGNOSIS:

  1. Obesity – The majority of beagles I treat are overweight leading to many health problems as they age. A great sense of smell coupled with an unending appetite can be a deadly combination. In the clinic, I use their appetite to my advantage by smooshing a treat onto the table. While the beagles licks it off, I can perform all kinds of treatments.
  2. Allergies (Atopic Dermatitis) – Beagles are prone to allergies that manifest as chronic ear infections, stained paws from constant licking, smelly skin from sebhorreha and infections, impacted anal glands that cause scooting and constant itching.
  3. Hypothyroidism (Low thyroid) – When I have an overweight beagle that isn’t losing weight on a diet, I recommend blood work to see how well their thyroid gland is functioning. Hypothyroidism is very common in this breed.
  4. Hyperadrenalcorticism (Cushings’ Disease) – Excess production of cortisol causes Cushings’ Disease. Affected dogs drink a lot of water, urinate a lot, have a pot-bellied appearance and skin that feels like tissue paper.
  5. Cruciate Ligament Rupture – The cruciate ligament is a tendon in the knee that provides stability. It is common for beagles to rupture this ligament while out doing their crazy activities.
  6. Eye Disease – Beagles are prone to several eye conditions including glaucoma, progressive retinal atrophy, cornea ulcers and prolapse of the gland of the third eyelid. The prolapsed gland looks like a cherry sitting in the inside corner of the eye which is why it is commonly called ‘cherry eye’.
  7. Kidney Disease – Unfortunately, many beagles develop kidney problems. That’s why I recommend annual lab work to catch it early.

The next time you see a beagle at the airport you are sure to smile (unless they sit down by your bag).

Image contributed by Jim Vail
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It is with great dismay that I read of the Trump administration’s decision to allow importation of lion and elephant trophies. Lions and elephants are classified as ‘threatened’ which means they are likely to become endangered (become extinct in all or part of their normal habitat) soon. The ban was put in place in 2014 because the populations of endangered and threatened species in Zimbabwe and Zambia are dropping due to poaching, game hunts and loss of habitat. Zimbabwe is where the beloved Cecil the lion was killed. He was lured out of a national park for a so-called “game hunter”, Walter Palmer, to kill. These countries also allow ‘lion hunting’ which means shooting confined lions who are acclimated to humans. This is not hunting as the animals do not have any chance of escape.

‘Serengeti Elephants’ taken by Kristen Nelson

The argument made by the hunting industry is that big game hunting brings money to the local communities. According to Richard Leakey of Kenya Wildlife Service, the amount of money generated by killing wildlife is minuscule compared to the millions generated by tourists coming for ecotourism. I was fortunate to go on safari in Tanzania this year. Seeing the animals living in their native habitats was amazing. Based on the number of tourists I saw on safari, I sincerely believe what Mr. Leakey is reporting. The animals are worth far more alive than dead.

On Friday, President Trump said he would halt the import of elephant “trophies” pending his personal review. Unfortunately, he did not halt the importation of lion “trophies”. The Trump family appears to be divided on this issue. Although President Trump has expressed disgust over game hunting, two of his sons have gone on big game hunts in Africa. Lara Trump, the president’s daughter-in-law, has been campaigning for several important animal issues including providing therapy dogs for veterans, saving wild horses and burros from slaughter and tighter regulation of puppy mills. Hopefully, she will take up this issue as well.

‘Ngorongoro Crater Lions’ taken by Kristen Nelson

If you care about the ethical treatment of animals and helping Zimbabwe and Zambia care for their greatest natural resource, please express your opinion to the White House, US Fish & Wildlife Service and our Interior Department. Please join me in asking President Trump to please keep the ban in place on importation of elephant and lion “trophies”. Keeping these magnificent animals alive is the right thing to do.

Sources:

– Eilperin, J & Gearan, A. ‘Trump face public and private pressure to halt elephant hunting trophy imports.’ WASHINGTON POST, 11/18/17, 6:12PM

– https://blog.humanesociety.org/wayne/2017/11/interior-department-allow-imports-elephant-lion-trophies-africa-reversing-obama-policies.html

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