Part 2: Treatment Options for Arthritis in Pets

By: Cynthia Quezada, DVM

Once your pet has been diagnosed with osteoarthritis (OA), there are several treatment options available that can help alleviate your pet’s achy joints.

Medications

Since OA is an inflammatory condition, non-steroidal anti-inflammatories (NSAIDs) are the treatment of choice for most patients suffering from OA. Examples of NSAIDs used in veterinary medicine include Rimadyl, Metacam, Deramaxx, Poodle Vaccination ShotPrevicox, Onsior, and Galliprant. Your veterinarian will most likely recommend blood work and a urinalysis to make sure that your pet is healthy before NSAIDs are prescribed. Over the counter NSAIDs labeled for use in people are not recommended for pets since most of these medications are toxic to dogs and cats. It is important to consult with your veterinarian to determine which medication is the most appropriate for your pet. Cats and some dogs can be sensitive to the side effects from NSAIDs. However, under the careful guidance of your veterinarian, NSAIDs can be safe and can significantly improve your pet’s quality of life.

Another class of drugs frequently used for the treatment of OA are opioids. While NSAIDs work directly at the sight of pain by decreasing inflammation, opioids work at the level of the central nervous system by decreasing the number of pain signals that reach the brain. This alters the patient’s perception of pain. Opioids can safely be combined with NSAIDs for added analgesic effects or they can be used on their own for those patients in which NSAIDs are contra-indicated. Examples of opiods prescribed for arthritic pain are buprenorphine (mostly prescribed for cats) and Tramadol (mostly prescribed for dogs).

Gabapentin is another class of drug that has been used for OA pain management. Gabapentin is thought to decrease the production in neurotransmitters that are involved in transmitting pain signals to the brain. It works especially well when combined with NSAIDs in cases of chronic pain.

Polysulfated glycosaminoglycans (PSGAGs) are what are known as disease modifying osteoarthritis drugs (DMOAD). PSGAGs provide building blocks needed for cartilage and joint (synovial) fluid health. They also work by inhibiting the enzymes that break down cartilage, so that joint damage is reduced. This drug is usually used as part of a multi-modal treatment plan for arthritis. It is most effective when used in the early stages of disease, before significant joint damage has occurred. It is also recommended in cases of acute joint injury/trauma. Of this class of drugs, Adequan is the only FDA approved DMOAD for use in veterinary medicine. Initial treatment of two injections per week, for 4 weeks is recommended.

Alternative Treatments

In recent years, alternative methods for the treatment of OA have become more  available
in veterinary medicine. These methods, when used as an adjunct to medical management, have shown to significantly enhance the response to OA medications and may even decrease the amount of medications needed to keep patients comfortable. Alternative methods for treating OA include physical therapy, acupuncture, and laser therapy. At our clinic we offer Companion Therapy Laser, which is a Class IV deep tissue laser. Laser therapy works by stimulating injured cells to produce more ATP, the energy needed for tissue to heal. Laser therapy is both safe and well tolerated by both dogs and cats. Visit our Laser Therapy page if you would like to learn more on how laser therapy works.

Supplements

Omega-3 fatty acids manage  inflammation within the body, especially of the skin and joints. Omega-3 fatty acids are considered an essential nutrient for cats, dogs, and people. This means that it cannot be synthesized in the body and that it must be obtained from diet. Offering a well-balanced diet, rich in omega-3 fatty acids is one way to provide your pet with this essential nutrient. Another way to ensure that your pet receives the amount needed for joint health, is to offer a daily dose of high quality omega-3 fatty acid supplements. There are several formulations available for dogs and cats. Ask your veterinarian which they recommend.

Other supplements that may be beneficial in the management of OA include glucosamine, boswellin (Indian frankincense), chondroitin, and curcumin (turmeric). It is always recommended to first consult with your veterinarian before starting any supplements for your pet.

Hemp and Cannabidiol (CBD)

The cannabis plant has been used by humans for centuries for its analgesic properties, as well as for other health benefits. Of the hundreds of molecules present in the hemp plant, cannabidiol (CBD) has received the most attention for its medicinal health benefits, including for the treatment of acute and chronic pain. Although further pharmacologic research is needed, anecdotal evidence has been promising. When choosing a CBD product for your pet, it is important that the product is standardized. This means that the exact amount of CBD is consistent per dose administered. Also, look for CBD products that have been extracted without the use of chemicals and have been derived from organic hemp.

A multi-modal approach for the treatment of arthritis usually offers the best results. At our clinic, we tailor arthritis treatment to each individual patient. Talk to your veterinarian regarding which treatment plan is best suited for your pet. Arthritis can be a very debilitating disease, but with appropriate management and early intervention we can help our pets live more comfortably.

Part 1: Arthritis in Pets

By: Cynthia Quezada, DVM

What is Osteoarthritis and What are its Causes?

This is taken of my elderly dog Cali riding in her Wagon. She had bad hips.Arthritis or Osteoarthritis (OA) is a degenerative joint disease that affects as many as 1 in 5 dogs in the United States. Although it is most common in dogs, OA also affects cats. Degenerative joint disease is defined as the break down of the cartilage within a joint that serves to protect the articular surface of the bones. This in turn creates inflammation, swelling, and pain within the joint. Primary osteoarthritis occurs through normal wear and tear of an otherwise healthy joint. It affects mostly middle-aged and geriatric patients. Secondary osteoarthritis occurs in joints that are compromised either by trauma, congenital or conformation problems and other orthopedic diseases. Some examples include: cruciate ligament injuries, hip dysplasia, elbow dysplasia and luxating patellas. These pre-existing conditions cause abnormal wear and tear of the joints and may pre-dispose patients to OA at an earlier age. Obesity is also an important risk factor in the development of degenerative joint disease. Maintaining your pets at a healthy weight is crucial in the management of this disease.

What are the Signs of Osteoarthritis?

Some pets with OA exhibit obvious signs of orthopedic pain such as limping. In other pets, OA may initially go unnoticed since clinical signs are often times vague and most owners may attribute these early signs to their pets simply “getting old”. In general dogs and cats are very good at masking pain. This makes it difficult for owners to realize that their pets may be in discomfort.  That is why it is important to be able to pick up on subtle changes in your pet’s behavior and daily routine. Symptoms that may indicate your pet is suffering from orthopedic pain include: slow or difficulty rising to a standing position, trouble jumping into the car or onto furniture, slowing down on walks, and spending more time lying down with reluctance to get up. Some pets may begin to inappropriately urinate and/or defecate in the house because it just takes too much effort for them to make it outdoors or to their litter box. This again can be misinterpreted by owners as their pets “misbehaving”. Other signs of pain include restlessness, whining, panting, pacing, aggression and insomnia.

My Dog or Cat May Have Osteoarthritis, but How Do I Know for Sure?

Since there are other medical conditions that can appear similar to OA it is important that your pet is evaluated by your veterinarian so that the correct course of treatment is initiated. Your veterinarian will begin by taking a thorough history and performing a complete physical exam. He or she may then recommend blood work and/or radiographs depending on the history and physical exam findings. Once OA has been confirmed, a medical plan that is most appropriate for your pet can be recommended.

Pain in pets can be difficult to recognize, but understanding the signs of  osteoarthritis is the first step in providing a more comfortable and healthier life for your pet. Please read our next article to learn about the treatment options available.

More Rain Means More Leptospirosis. Is Your Dog Protected?

February 2017

The beagle in wood searches for game

Due to the recent heavy rainfall in Los Angeles, and the rest of California, Leptospirosis is on the rise. Leptospirosis (Lepto) is an infection caused by a spirochete bacteria that affects wildlife, domestic animals, and humans. It is shed in the urine of infected animals and can survive for months in soil, standing water, lakes, and streams. Dogs become infected by coming into contact with contaminated water or soil. Infections can cause kidney and/or liver failure, severe muscle pains, and bleeding abnormalities.

It is recommended that dogs at risk of exposure to Lepto are vaccinated against the disease. At risk dogs are those that live in or visit rural areas, are exposed to wildlife such as rodents, raccoons, opossums and skunks, or visit forested areas to hike or camp.

West LA Veterinary Group offers Merial RECOMBITEK 4 Lepto vaccines for dogs for the safest and most complete protection. If you have any questions regarding vaccinating your dog against Lepto or if you would like to make an appointment to update his or her vaccinations, please call the clinic at (310) 478-5915. You may also email us at info@wlavg.com.

Periodontal Disease in Dogs and Cats and How to Prevent It

inspecting dog teeh with dental mirror

By: Cynthia Quezada, DVM

Did you know that the American Veterinary Medical Association has found that 80% of dogs and 70% of cats have some form of periodontal disease by the age of 3? Not only does periodontal disease cause bad breath, but it can lead to other, more significant health problems. In its advanced stages, periodontal disease can lead to oral pain, loose teeth, and damage to the kidneys, heart, and liver.

Periodontal disease occurs when plaque and tartar begin to accumulate under the gum line. This creates a biofilm for bacteria to attach and multiply. The inflammation triggered by the infection weakens and damages the surrounding connective tissue that holds the tooth in place. This tissue includes the gingiva, periodontal ligament, and the actual bone surrounding the root of the tooth. As periodontal disease advances, more of the root becomes exposed loosening the tooth. Not only is this painful, but patients with periodontal disease are also at higher risk for bacteria seeding into the blood stream which can harm other organ systems.

Fortunately, periodontal disease is preventable. Prevention starts with good and consistent at-home dental care, along with regular veterinary visits. There are several dental care options that pet owners can easily incorporate into their pet’s daily routine. Daily teeth brushing is considered the gold standard in helping keep pets’ teeth healthy. If your pet does not allow for proper teeth brushing, there are several dental chews available on the market that can also be quite effective in decreasing plaque and tartar build-up. Besides dental chews, prescription dental diets are also available, as well as oral rinses and water additives. If dental plaque and tartar are already present, a thorough dental cleaning under general anesthesia by your pet’s veterinarian may be necessary. It is important to speak to your veterinarian about which dental care options are best for your pet. Your veterinarian is also a great resource on which products are the safest and most effective to use. Another good resource is the Veterinary Oral Health Council (VOHC). Visit their website for a list of veterinary dental products that have been VOHC approved.

Regardless of which at-home dental care method you chose for your pet, it is important to start at an early age and to be consistent. This, along with professional anesthetic dental cleanings as needed, can help maintain excellent oral health in your pet.

Holiday Pet Toxins & Hazards

By: Cynthia Quezada, DVM

The holidays are a time of family, friends, sharing, giving, and joy. The holidays can also be a very stressful time especially with our busy schedules. In all the excitement and rush to greet the New Year, we may not think about potential dangers that our pets may be exposed to during this time. To help keep your pets safe during the holiday season, here are the most common toxins to be aware of.

Plants:
A cat eating poinsettia on Christmas.Toxic plants that are commonly around during this time of year include lilies, daffodils, holly berries, mistletoe, and Christmas trees. Lilies are the most toxic on the list, causing sudden kidney failure in dogs and cats if eaten. This can result in death, especially in cats. If your dog or cat ingests even a small amount of lily or daffodil plant material, it is important to take them for immediate veterinary care. Mistletoe and holly berries are considered moderately toxic. Ingestion of these plants can cause gastrointestinal upset and possibly cardiac arrhythmias if enough of the plant is eaten. The fir tree oils found in Christmas trees can also cause gastrointestinal upset, as well as excessive drooling when the needles are chewed on or swallowed.

Foods:
German Shorthaired Pointer sulks next to cookies left out for SantaXylitol is an artificial sweetener found in many “sugar free” human food items including gum, mints, candy, and other sweets. Dogs metabolize xylitol differently than humans. In dogs, xylitol triggers a large release of insulin causing a dog’s blood sugar to drop to very low levels. This drop in blood sugar (hypoglycemia) can cause lethargy, unsteadiness, vomiting, and in severe cases seizures. Grapes, raisins, and currants used in many sweets, deserts, trail mixes, bagels, grape juice, and other holiday recipes are also considered highly toxic. If ingested, these foods can cause kidney failure in dogs and cats. Even grape seed oil is considered toxic. The reason why these fruits are poisonous is not known and their toxicity does not appear to be dose dependent. In some pets a single grape can be toxic and others have to ingest many before they are affected. Macadamia nuts are another food toxic to pets in which the mechanism of toxicity is unknown. Ingestion of these nuts can cause incoordination, lethargy, vomiting, muscle tremors, hyperthermia (elevated body temperature), weakness, and tachycardia (elevated heart rate).

Other Toxins and Hazards:
The British cat lies in a tinsel with Christmas toysEthylene-glycol is another toxin potentially fatal to both dogs and cats. Ethylene glycol is not only what makes up anti-freeze, but can also be found in some imported snow globes. Spills must be cleaned up immediately as ingestion of even the smallest amount by dogs or cats can cause acute severe kidney failure. It is important to seek veterinary care immediately if exposure to ethylene glycol is suspected. Liquid potpourri is another unsuspecting danger for pets, especially cats. Contact with liquid potpourri can cause serious injuries such as chemical burns to the mouth, skin, and eyes. It is best not to have any of these oils in the house if you have pets. Other hazards that are not necessarily toxic but that can pose serious health risks are tinsel, string, and ribbon. If swallowed, they can literally “saw” right through the gastrointestinal tract. This is what is referred to as a linear foreign body. So it is best to keep these materials out of your pet’s reach.

If you have any questions or think that your pet has been exposed to any poisonous substances please call our office at (310) 478-5915. Another good resource is the ASPCA Animal Poison Control Center. Their call center is available 24 hours a day , 365 days a year at (888) 426-4435.

We hope that this information was helpful. West LA Veterinary Group wishes you and your pet a safe and joyous holiday. Happy New Year!

Pet Food Drive

west-la-pet-food-drive-1

November 2016

For the month of November we are having a Pet Food Drive to help less fortunate dogs and cats in need. All pet food collected will be donated to two local animal rescue groups: A Dog’s Life Rescue (ADLR) and Modjeska Ranch Rescue (MRR). If you are interested in participating, please drop off your pet food donation at our clinic by November 30th. We are collecting both dog and cat food for all life stages. Hill’s® Science Diet® will also be participating. For every 8 lb bag (or larger) or case of Hill’s® Prescription Diet® purchased at our clinic, they will generously donate a bag of their maintenance diet. Below is more information on where your pet food donations will go.

A Dog’s Life Rescue is a Los Angeles based, all volunteer, non-profit that has saved the lives of thousands of animals. We have worked with them closely and know first hand how devoted they are to the animals they care for. The following are just two of their amazing programs:

Not Forgotten Program – There are thousands of abandoned cats trying to survive on the streets of Los Angeles. ADLR manages several feral cat colonies which require feeding and caring for dozens of cats every single night at different locations. All cats have been spayed and neutered and ADLR provides any medical care that is needed for them.

Furry Family Assistance Fund – ADLR started this program to provide regular dog and cat food deliveries and medical care to pet guardians, who despite adoring their fur kids, cannot afford to provide for them.

west-la-pet-food-drive-2

Modjeska Ranch Rescue is a non-profit, grass-roots organization located in Silverado Canyon. Many of the animals they rescue are unable to find homes or have been abandoned due to their old age, health issues, and/or behavioral problems. As a result, MRR has opened their doors to provide a safe sanctuary for these forgotten animals. Here is some of the important work that MRR does:

-Provide shelter, medical treatment, food, and exercise for the animals under their care
-Provide a permanent home for senior and special needs animals
-Educate the public regarding animals and how to appropriately care for them
-Re-establish trust in abused animals and allow them time to heal

We are proud to be able to host a pet food drive to help support these amazing animal rescue organizations. Pet food donations are much needed and will be greatly appreciated.

1st Annual Halloween Pet Costume Contest Winners

October 2016

Thank you everyone for entering our 1st Annual Halloween Pet Costume Contest! All the costumes were adorable and it was so much fun going through all the cute pics! The winners received gift certificates to our clinic. Congratulations!

Here are our October 2016 winners:
1st Place: Alfie the Crocodile
2nd Place: Houdini as Darth Vader
3rd Place: Zoey the Girl Scoutwest-la-2

Why Vaccinating Your Pet Against Rabies is Still Important in Los Angeles County

rabies-logo

By: Cynthia Quezada, DVM

Our clinic occasionally receives calls from pet parents inquiring if the rabies vaccine is safe and if their dog or cat truly need to be vaccinated against rabies. Before addressing these questions, let’s review a few facts about rabies and the efforts implemented to help control this disease.

The last documented cases of rabies in Los Angeles County of a domestic dog was in 1966, and of a domestic cat in 1987. So why is rabies vaccination required by law for dogs and recommended for cats? Rabies is controlled through the implementation of proper vaccine protocols for pets and the close surveillance of rabies outbreaks. Before 1960, the majority of reported rabies cases in the U.S. were in domestic animals. Since 1960, most animal rabies cases in the U.S. involve wildlife. This shift in the epidemiology of the disease is due to the effectiveness of the rabies vaccine and mandatory vaccine laws. Rabies continues to be an epidemic in 150 countries world wide, with 99% of human rabies caused by dog bites.

In rare instances, the LA County Department of Public Health will grant certain dogs an exemption from receiving the rabies vaccine. These exemptions are reserved for dogs with specific medical conditions, and those with history of life threatening reactions to the rabies vaccine. Rabies vaccine exemptions are reserved for cases in which “a rabies vaccine would endanger the dog’s life” in order to preserve herd immunity. Herd immunity occurs when a critical portion of a population is immunized against a disease. This protects those individuals that have not been immunized and prevents an out-break. In order to establish herd immunity against rabies, at least 70% of dogs in a given population need to be immunized against the disease. Vaccinating your pet against rabies not only protects them as individuals, it also protects those pets that are not able to receive the vaccine.

Is the rabies vaccine for dogs and cats safe? The majority of patients do not experience any adverse reactions to the vaccine. There is no risk of developing rabies from receiving the vaccine. The most common side effects to the rabies vaccine (or any vaccine) are pain at the injection site, lethargy, inappetence and a mild fever. These are not considered life-threatening reactions and symptoms should resolve within 2 days. Some patients may develop an injection site reaction where a small, firm swelling may develop.  These generally resolve in a few weeks.  In rare instances, a patient may experience a severe allergic reaction to the vaccine. Signs of an allergic reaction are usually immediate and include vomiting, diarrhea, collapse, difficulty breathing, facial swelling and hives. Allergic reactions, although rare, can be life-threatening to pets and require immediate veterinary care.

Rabies is always a fatal disease, but is easily prevented by vaccination. Although canine rabies (rabies strain specific to dogs) has been eradicated from the U.S. due to mandatory vaccine laws, wildlife still remains a reservoir for the disease and current cases of rabies in domestic animals in the U.S. are from contact with rabid wildlife. In LA County, bats are the primary hosts for rabies.

So how can we, as pet owners, help eradicate this fatal disease? Here are 5 steps to take:

  • Make sure your pet has a current rabies vaccine
  • Avoid contact with wildlife that can transmit rabies, such as: bats, skunks, raccoons, and foxes.
  • Keep your cat indoors and supervise your dog when outdoors.
  • Report all dog, cat, and wild animal bites
  • Bat proof your home (yes, we do have bats in LA County).

If you are not sure if your pet is due for their rabies vaccine, or if you have any other questions, please call our clinic at 310-478-5915.

 

Keep Your Pets Cool and Safe During Hot Summer Days

By: Cynthia Quezada, DVM

Hot summer days can be grueling not only for us but for our pets as well. Dogs and cats are not able to cool off as efficiently as we can. If it is too hot for us, it is even hotter for our pets. Brachycephalic breeds (i.e., English Bulldogs, French Bulldogs, Pugs, Shih-Tzus, Pekingeses, Boston Terriers, Himalayans, Persians) are the most susceptible to heat stroke. Using common sense and simple precautions can help keep our pets cool and safe during the hot weather.

Plan dog walks for early in the morning and late in the evening when the day is the coolest. Avoid walking your dog on hot concrete, pebbles/rocks and asphalt as this can cause severe burns to the paw pads. If you must walk your dog on hot ground, place protective booties on his/her paws. You can find dog booties at most pet supply stores.

For indoor pets, keep the AC thermostat at a comfortable temperature. If AC is not available, make sure that your home is well ventilated. You can also provide a cooling bed for your pet. Check on-line retailers for types of cooling beds available. If your home gets too warm during the day consider boarding your pet at a well air-conditioned facility.

For outdoor pets, provide plenty of shade and cool, fresh water at all times. You can help keep your pet comfortable by adding ice cubes to their water bowl and by providing a shallow wading pool so that your pet can take a dip to cool off if needed.

Keep your pet well-groomed, brushed and matt-free. If your pet has a long coat, clipping it short will help keep him/her cooler. Don’t skimp on flea prevention. Summer is peak flea season.

Lastly, remember to NEVER leave your pet unattended in the car. Leaving your pet in a hot car for just a few minutes can be fatal.

Canine Influenza: Pet Owners’ Guide

West LA Veterinary Group now offers vaccinations against both strains of canine influenza (dog flu). Dog flu vaccines are recommended for at risk dogs that have frequent exposure to other dogs.

Canine influenza (CI, or dog flu) in the U.S. is caused by the canine influenza virus (CIV), an influenza A virus. It  is highly contagious and easily spread from infected dogs to other dogs through direct contact, nasal secretions (through barking, coughing or sneezing), contaminated objects (kennel surfaces, food and water bowls, collars and leashes), and by people moving between infected and uninfected dogs. Dogs of any breed, age, sex or health status are at risk of infection when exposed to the virus. In early 2016, a group of cats in an Indiana shelter were infected with H3N2 canine influenza (passed to them by infected dogs), and the findings suggested that cat-to-cat transmission was possible.

Unlike seasonal flu in people, canine influenza can occur year round. So far, there is no evidence that canine influenza infects people. However, it does appear that at least some strains of the disease can infect cats.

Canine influenza symptoms and diagnosis

CIV infection resembles canine infectious tracheobronchitis (“kennel cough”). The illness may be mild or severe, and infected dogs develop a persistent cough and may develop a thick nasal discharge and fever (often 104-105oF). Other signs can include lethargy, eye discharge, and reduced appetite. Some dogs may not show signs of illness, but can shed the virus and infect other dogs.

Most dogs recover within 2-3 weeks. However, secondary bacterial infections can develop, and may cause more severe illness and pneumonia. Anyone with concerns about their pet’s health, or whose pet is showing signs of canine influenza, should contact their veterinarian.

CIV can be diagnosed early in the illness (less than 3 days) by testing a nasal or throat swab. The most accurate test for CIV infection is a blood test that requires a sample taken during the first week of illness, followed by a second sample 10-14 days later.

Cats infected with H3N2 canine influenza show symptoms of upper respiratory illness, including a runny nose, congestion, malaise, lip smacking, and excessive salivation.

Transmission and prevention of canine influenza

Dogs are most contagious during the two- to four-day incubation period for the virus, when they are infected and shedding the virus in their nasal secretions but are not showing signs of illness. Almost all dogs exposed to CIV will become infected, and the majority (80%) of infected dogs develop flu-like illness. The mortality (death) rate is low (less than 10%).

The spread of CIV can be reduced by isolating ill dogs as well as those who are known to have been exposed to an infected dog and those showing signs of respiratory illness. Dogs infected with H3N2 canine influenza should be isolated for at least 21 days. Good hygiene and sanitation, including hand washing and thorough cleaning of shared items and kennels, also reduce the spread of CIV. Influenza viruses do not usually survive in the environment beyond 48 hours and are inactivated or killed by commonly used disinfectants.

There are vaccines against the H3N8 strain of canine influenza, which was first discovered in 2004 and until 2015 was the only strain of canine influenza found in the United States. However, a 2015 outbreak of canine influenza in Chicago was traced to the H3N2 strain – the  first reporting of this strain outside of Asia – and it is not known whether the H3N8 vaccine provides any protection against this strain. Used against H3N8, the vaccines may not completely prevent infection, but appear to reduce the severity and duration of the illness, as well as the length of time when an infected dog may shed the virus in its respiratory secretions and the amount of virus shed – making them less contagious to other dogs.

In November 2015, the U.S. Department of Agriculture granted a conditional license to Zoetis to market the first commercially available H3N2 canine influenza vaccine. Later that month, Merck Animal Health announced the availability of an H3N2 canine influenza vaccine, also conditionally licensed by USDA. None of the currently available H3N2 canine influenza vaccines are approved for use in cats.

The CIV vaccination is a “lifestyle” vaccination, recommended for dogs at risk of exposure due to their increased exposure to other dogs – such as boarding, attending social events with dogs present, and visiting dog parks.

SOURCE: https://www.avma.org/public/PetCare/Pages/CanineInfluenza.aspx#.V0CxG2oDIQs.facebook