Vet Blog
10/08/09
 Feline asthma is a common syndrome in cats. It causes chronic coughing and wheezing in some individuals. Others may suffer from acute asthmatic crises that cause severe respiratory distress. These crises can be fatal.
Feline asthma historically has been challenging to treat. No cure is available. The mainstay of treatment has been oral steroids, but these medications are not universally effective and have the potential for serious side effects.
Inhalable asthma medications also may be of benefit to asthmatic cats, but special equipment is required to administer these drugs. Also, many cats do not tolerate the process of receiving nebulized (inhalable) medications.
Morris Animal Foundation (MAF) is an independent organization (although it has links to Hill’s) dedicated to research that benefits animals. I am pleased that the foundation has recently initiated a feline-specific emphasis in order to make up some of the discrepancy between medical care for dogs (who always seem to get the best that veterinary medicine has to offer) and cats (the second species of veterinary medicine).
MAF recently released news that they are investigating a potential cure for feline asthma. The treatment, called rush immunotherapy, is designed to attenuate or eliminate asthmatic cats’ excessive response to items that simulate the immune system. This excessive response is the cause of asthma. Rush immunotherapy may soon be available by injection or as a treatment that is introduced into the nose.
I hope it works. You can read more about the study here.
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06/17/09
A recent article in The Economist caught my eye.
Medical technology: A new, low-cost design for an artificial heart takes its inspiration from an unusual source—the cockroach
EVOLUTION has favoured cockroaches above human beings, at least when it comes to the functioning of the heart. A cockroach’s heart will continue to beat even when one of its chambers has failed; in similar circumstances, a man will die. Now a team led by Sujoy Guha of the Indian Institute of Technology, Kharagpur, has created an artificial human heart based on a cockroach’s, which they believe will be unusually robust and affordable.
A cockroach’s heart is a tube that runs the length of its body. It has 13 chambers, linked like a string of sausages. As each chamber contracts, the blood within is pumped to a higher pressure. Each successive chamber increases the pressure. A human
or feline or canine
heart, by contrast, has four chambers. Two of these pump blood to the lungs, where it picks up oxygen, then the other two pump this oxygenated blood throughout the body. One of these four chambers—the left ventricle—contracts most strongly to pressurise the blood.
The artificial hearts developed so far have mostly mimicked human ones. The first devices, developed in the 1950s and 1960s, were large machines placed on trolleys next to the patient and attached by tubes. Modern artificial hearts are less cumbersome, but they are still rather unwieldy because they use compressed air to pump the blood and are powered by heavy batteries. They are used temporarily, usually for a few days or weeks, until a real heart is available for transplant.
Instead of trying to mimic the action of the left ventricle, Dr Guha’s design uses a multi-step approach borrowed from the cockroach. His device, made from plastic and titanium, is the same size as a human heart but with five chambers arranged like the layers of an onion. Each chamber acts in succession to increase the pressure of the blood. The contraction of each chamber is controlled by a motor driven by bulky batteries. The artificial heart is being tested on goats, with human trials scheduled for next year. If these are successful, the device could be on the market in three to five years.
The multi-step approach makes this artificial heart much cheaper to build than those that use compressed air to pump the blood. Dr Guha says it would cost $2,000-2,500.
Add in the costs of protection from liability lawsuits, and I’ll bet the new artificial heart will come in for $50,000 or so.
This article nearly inspired me to make another 30 year prediction for the record: that artificial hearts will be available for cats and dogs by 2039. But, although I am excited by advances in artificial heart technology, I am not going to make that prediction.
Instead, I predict that within 30 years stem cell technology will allow veterinarians to grow new hearts for cats and dogs from their own tissues.
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05/22/09
Another pet food recall was announced yesterday. This recall affects two types of Nutro Brand cat food. No dog foods are affected. Nutro issued a press release yesterday. Here is a quote.
This recall is due to incorrect levels of zinc and potassium in our finished product resulting from a production error by a US-based premix supplier.
Two mineral premixes were affected. One premix contained excessive levels of zinc and under-supplemented potassium. The second premix under-supplemented potassium. Both zinc and potassium are essential nutrients for cats and are added as nutritional supplements to NUTRO® dry cat food.
Based upon the limited information I have seen I am optimistic that this recall will not lead to serious illness in many cats. Zinc can be toxic in very high doses. Although I have not seen quantitative information on the amount of zinc contained in the recalled foods, it is unlikely that their zinc levels are high enough to cause problems.
Low potassium also can lead to a host of problems. However, they usually develop slowly.
In either case, I’m optimistic that switching affected cats to a nutritionally balanced diet will prevent major issues from occurring.
However, contact your veterinarian immediately if your cat has been eating a recalled food and he or she experiences lethargy, weakness, lack of appetite, vomiting, diarrhea, or any other unusual symptoms.
For more information, click here to read the entire press release.
A note about comments: emotions tend to run strong when pet food is discussed. Please keep your comments civil. Thank you in advance for not forcing me to delete your comments.
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05/19/09
 Surgery is an important tool for medical professionals. For many syndromes, surgical intervention is the only appropriate therapy. And for many vets, performing surgery is fun.
However, individuals on the other end of the scalpel rarely enjoy the experience. Surgery inevitably leads to pain. Surgical recoveries can be lengthy, uncomfortable, and fraught with the risk of complications.
In general, it is best to choose the least invasive treatment for any given syndrome. Consider a pet dog that swallows a pine cone and suffers from intestinal obstruction. If possible it is best to remove the pine cone with an endoscope (a flexible tube with a camera and various instruments that is passed through the mouth into the intestines) rather than with surgery.
Bladder stones are relatively common in dogs and cats. Historically, veterinarians have resorted to opening the bladder and removing certain types of stones surgically.
However, two articles in the May 15, 2009 issue of the Journal of the American Veterinary Medical Association (JAVMA) report on an alternative technique. A catheter containing a laser is passed into the bladder through the urethra. The laser is used to break down the stone (or stones), and the fragments are removed through the catheter.
The studies found that the new technique is as safe and effective as surgery. The technique is less painful, and recovery is more rapid. The studies only addressed bladder stones in dogs; however, similar techniques hopefully will be available soon for cats.
Unfortunately, the new procedure generally only is available through specialists (almost any vet can surgically remove bladder stones). In time, however, more veterinarians may acquire the necessary instruments to treat bladder stones less invasively.
Photo: not that type of laser. Credit: Fir0002/Flagstaffotos. License: click here.
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05/09/09
The April 25, 2009 Economist’s science and technology section contained an article that discussed a promising technique to aid in treating cancers in all species.
A DIAGNOSIS of cancer is often followed by a prescription of surgery. Before chemotherapy, before radiation, the knife is frequently the oncologist’s first line of attack. If done early and well, it has the potential to stop the disease in its tracks. Even if it does not, it is the best way for the doctor to get a feel for what he is dealing with, how extensive it is, and what to do next. But, whereas therapies and diagnostics for cancer have been evolving steadily in response to new biochemical knowledge, surgical techniques have remained surprisingly primitive.
What happens at the moment is that a surgeon roots around inside a patient, removes as much tumour as he can find, and hopes he got it all. He then sends what he has excised to a laboratory, where pathologists sample all around the outside of the extracted mass to see if it is encapsulated by healthy tissue. If it is, the whole tumour has probably been removed. If not, the surgeon must go back in, and the time-consuming process starts again.
Roger Tsien and his colleagues at the University of California, San Diego (UCSD), are trying to halt this cycle by creating a luminous map for the surgeon to follow. Dr Tsien, who shared the 2008 Nobel prize in chemistry for his work on green fluorescent protein, has found a way to make cancer cells glow. That could help surgeons see precisely what to cut out and what to leave behind.
Tumor removal surgery definitely can be harrowing business. The mainstay of tumor excision is obtaining “wide margins”. This means that the capsule of healthy tissue surrounding the tumor should be as large as possible. But tumor tissue can only be definitively diffentiated from normal tissue when it is examined under a microscope.
The technique detailed in the Economist will do nothing to address the need for microscopic evaluation to definitively determine tumor margins. However, it definitely is a step in the right direction.
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03/21/09
 Heartworm disease is potentially fatal and completely preventable. The disease is caused by a blood parasite that is spread by mosquitoes. It affects both cats and dogs, although dogs generally are at greater risk. Heartworm disease can lead to heart failure and a plethora of other problems.
DVM Newsmagazine recently reported on a new heartworm incidence study released by the American Heartworm Society. The study was not rigorously scientific, but it does provide evidence that heartworm incidence is increasing in certain areas. The notable areas in the US include the gulf coast, east coast, and northern California.
The triennial survey was distributed to more than 40,000 veterinarians last fall. Ultimately, veterinary practices from some 2,200 counties were represented . . . [a]ccording to the most recent results, the number of positive cases rose per clinic in 31 states. The reasons likely are multifactorial, including increased heartworm testing, increased client base per clinic or even climate trends.
Actual incidence of heartworm may be increasing. It’s also possible that veterinarians are detecting more cases due to increased testing. Either way, Dr. Sheldon B. Rubin, president of the American Heartworm Society, feels that heartworm disease is inexcusable.
“There is no reason a dog should have heartworm disease today. If we can get more animals on prevention, we will get the numbers of heartworm-infected animals down. It is a serious problem.”
Monthly heartworm preventatives are readily available. They have excellent safety profiles. Many of them have the added benefit of eliminating intestinal worms that may be contagious to human beings. My pal Buster gets his on the first of each month.
I recommend that you talk to your vet about protecting your pet from heartworm.
Photo: Indy contracted heartworm before he was adopted.
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02/09/09
 I’d like to thank Joel, of San Francisco, for forwarding an article to me yesterday. The article discusses adverse events associated with flea preventatives, especially those available over-the-counter.
Let me begin with two caveats. Some of the sidebar advertisements on the article are a bit loony. In my opinion this damages the credibility of the article. Loony websites have loony advertisements, and loony websites often publish loony material.
More important, before anyone gets too worked up railing against flea products, don’t forget how vile and terrible are fleas. Fleas spread tapeworms, “cat scratch disease”, and feline infectious anemia. They contribute to skin disease and autoimmune disease. Their feces contaminates houses. They spread bubonic plague. Fleas are bad, bad, bad.
Now, on to the article.
[P]yrethroid-based flea and tick treatments — from Hartz, Sergeant’s, Farnam, and Bayer — are approved for sale by the Environmental Protection Agency (EPA), and they are readily available at grocery stores, specialty pet retailers, and hardware stores. But they are also linked to thousands of reported pet poisonings, and they have stirred the ire of pet owners, the concern of veterinarians, and the attention of regulatory agencies . . . At least 1,600 pet deaths related to spot on treatments with pyrethroids were reported to the EPA over the last five years, according to an analysis of EPA pesticide incident exposure data by the Center for Public Integrity. That is about double the number of reported fatalities tied to similar treatments without pyrethroids, such as Frontline and Advantage — although these products also have critics.
I was surprised to learn that Advantage and Frontline had been linked to 800 pet deaths over the last five years. In my practice, I see major toxic reactions to the Hartz and Sargent’s products regularly. In the last ten years, I have not seen even one life-threatening reaction to Advantage or Frontline, although I realize they occur.
I would be curious to learn the rate of reactions to Advantage and Frontline relative to those for the pyrethroid-based products, rather than the absolute numbers for each product. Also, readers should remember that the number of adverse events listed for each of the products represents events that have been reported to regulatory agencies. The majority of reactions are not reported.
The article, predictably, goes on to describe several heartbreaking horror stories associated especially with use of cheap flea products. But then it delves into unexpected territory:
Another possible explanation for the number of incidents is that consumers often misuse flea and tick products, causing the sickness that pet owners later blame on the treatments, said Jennifer Windrum, a spokeswoman for Sergeant’s. “Pet owners feel incredibly guilty if they misapply it to their pet,” Windrum said. “It’s easier to blame a company.”
Whoa! This is a total cop out. All products are misused by consumers. It’s a fact of life. For a product to be truly safe, it should not consistently cause problems when it is inevitably misused.
Ultimately, the article does not offer any simple advice to pet owners who wish to avoid adverse events associated with flea preventatives. But I’ll be happy to take over that department.
Talk to your veterinarian about the risks and benefits of flea preventatives before you use them. Don’t buy the cheapest preventatives. Use the preventatives according to the manufacturer’s instructions. Don’t assume that natural preventatives are any safer than synthetics. Garlic, a common ingredient in natural products, is potentially toxic to pets.
Finally, keep things in perspective. It is tragic when a pet loses its life to an adverse reaction to any sort of product. But remember that fleas have killed far more pets than even the worst of the flea preventatives. Fleas have also killed millions of people–it is estimated that in 1400 alone fleas killed 125,000,000 residents of Europe.
Flea preventatives may not be perfectly safe, but fleas are very dangerous as well.
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02/04/09
 I have noticed that the subject of pet food has an extraordinary ability to get people riled up. Folks tend to have strong opinions about what pets should eat. I therefore could not resist publishing the following e-mail.
Dear Dr. Barchas,
I’m writing to let you know about a report on pet foods just released by Consumer Reports Health on its website ([click here]) and in the March 2009 issue of Consumer Reports. Given the focus of your Dogster/Catster blog, I thought it might be of interest to you and your readers.
For the report, Consumer Reports asked experts at seven top veterinary schools whether pet owners should be paying a lot for fancy pet food brands, what ingredients they should be looking for, what common claims on pet-food labels really mean, and more. The bottom line: there isn’t scientific evidence that pricier foods are better, or that cheap food can make pets sick. Consumers should pay more attention to the nutrient profile of the food than the price, and the health, age and lifestyle of their pets have a lot to do with what’s best.
Details about these findings – and a lot more information about pet food – can be found on the Consumer Reports Health website: [click here] . . .
Yours,
Paul Selker.
Mr. Selker attached a press release to the e-mail. I have a hunch that readers may have a few things to say about some parts of it. For instance:
Be careful when making your own pet food. Most experts said they hadn’t seen a pet get sick from inexpensive food; however, half said they had seen pets become ill from eating homemade pet food, a growing trend since the 2007 recall of some commercial pet food contaminated by melamine. Dogs and cats each require about 40 different nutrients in very specific proportions, so pet owners who insist on making their own pet food should consider enlisting a nutritionist certified by the American College of Veterinary Nutrition . . .
or
Consider your pet’s age. Age-specific food is very important for puppies, kittens, and pregnant pets, who have especially stringent nutritional needs. Foods labeled either “for growth” or “for all life stages” meet those needs. Foods “for maintenance” are for healthy adult animals only. “Senior” is a marketing term, not a nutritional term.
or
Weigh the costs and benefits of wet versus dry food. There’s no nutritional difference between wet and dry pet food, but there is a cost difference. Wet foods contain about 75 percent water, so pets need more to get the same calories, and that makes wet food more expensive per serving.
or
[Regarding interpreting claims on pet food labels:] Grain-free. Protein in the product comes from nongrain sources (perhaps for people who want pets to eat more animal protein). It’s unclear whether there’s any benefit to a diet high in animal protein.
In the interest of full disclosure, I should point out that Consumer Reports did a great deal to damage its credibility in my mind (and in the mind of basically every veterinarian in America) when it published an article on veterinary services several years back.
The article, as I remember it, recommended that people seek the cheapest possible health care for their pets. It ignored the fact that cost of care may be related to quality of care. Many vets (including me) interpreted the article as advocating that people cut corners when seeking medical care for their pets.
Given the rocky relationship between vets and Consumer Reports, I can’t blindly sign off on this most recent article. But I encourage you to read it and offer your thoughts.
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01/14/09
 Idexx laboratories is a major veterinary diagnostic corporation with veterinary-specific laboratories located in North America, Europe, and Asia. The company is an innovator in veterinary diagnostics. And, I am happy to see that Idexx has signed on to the current initiative to boost the quality of health care delivered to cats.
As I have mentioned in at least one previous post, feline health care generally receives short shrift relative to the care that canine companions receive. Vets, industries linked to veterinary medicine and cat lovers are working to change the situation and give cats their due.
As part of its work to promote feline health, Idexx has launched a new website. The site, www.kittytest.com, displays the number of cats infected with FIV, FeLV and feline heartworm in each county in the USA as reported to the laboratory.
It’s a very interesting site. I recommend that you check it out.
Photo: Red, of Texas, has been diagnosed with FIV.
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01/09/09
 A few months ago I wrote about a new antibiotic called Convenia. The medicine is available by injection and lasts for a week or longer, eliminating the need to give daily (or, in many cases, twice daily) doses of pills or liquids.
In my original post I mentioned a few reservations I had about prescribing the drug. One of my (not explicitly mentioned) reservations was that there were few independent clinical efficacy and safety studies published in peer-reviewed journals.
That is beginning to change. A study released in the January 1, 2009 Journal of the American Veterinary Medical Association (JAVMA) compared Convenia to a commonly used conventional antibiotic in cats. Here are the results.
Effectiveness of [Convenia] in the treatment of cats with abscesses and infected wounds was similar to that of [the conventional antibiotic]. There were no serious adverse events or deaths related to treatment. (J Am Vet Med Assoc 2009;234:81-87)
This study does not address the long term concerns about injection-site tumors in cats that I mentioned in the original post. But it, combined with my personal experience with the medication (which has been highly favorable), makes me feel better about using Convenia in cats who refuse to take oral medications.
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Feline asthma is a common syndrome in cats. It causes chronic coughing and wheezing in some individuals. Others may suffer from acute asthmatic crises that cause severe respiratory distress. These crises can be fatal.
You have questions. 