I haven’t defleaed my adult female cat for eight
months because she reacted the last time by
excessive scratching that went on for several
days. I am concerned she may be allergic to the
flea med. She is an indoor cat and I haven’t
seen fleas around. Should I take her for a check
up and see what the vet recommends?

Carol
Eureka CA

I spend a lot of time on this blog harping about the importance of flea prevention. Fleas carry a number of animal and human diseases (such as tapeworms and bubonic plague, respectively). In pets, fleas contribute to skin rashes, ear infections and itching anywhere on the body. They have been implicated in syndromes, such as feline asthma, that are caused by an overactive immune system.

I often see pets with skin problems and recommend flea control as the first step. I can’t count the number of times that recommendation has been met with the following comment: “But my pet doesn’t have fleas!”

In these cases I recommend flea control nonetheless, because even an occasional flea bite can trigger skin or ear problems in a sensitive individual.

But the situation is different in your case, Carol. First, you don’t mention that your cat is experiencing any skin, ear, or other problems. And you have reason to believe that she has reacted adversely to a flea preventative in the past. Such reactions are rare, but they do occur.

In your cat’s case, I don’t think flea prevention is mandatory.

However, if your cat develops any of the problems I have listed above, or if you see any fleas or their feces, it will be time for a trip to the vet to discuss alternative flea control products.

• What’s the Best Flea Preventative?
• Another good reason to use an appropriate flea preventative
• Why are all of the dogs in America suddenly itching?
• Can Dogs and Cats Take Herbal Cleansers?
• Does Pet Food Cause Health Problems?

My dog has very thin blonde hair. She now has
really dark spots on her skin (some small- some
large) and she is losing her hair. They are not
sores - just dark spots. She still acts like she
feels fine and is still very hyper. Could this be
allergies or a skin rash?

Diana
Sachse, Texas

You don’t mention your dog’s age. If she is older, I suspect that the dark spots are natural pigmentary changes. In people, these are known as liver spots.

It is quite common for dogs to develop liver spots as they mature. The are dark and irregular in shape. They do not itch or hurt, and they are harmless. In thin-coated dogs, they can be seen through the fur. In dogs with thicker coats, they may be invisible unless the hair above them is trimmed.

In people, liver spots are occasionally a precursor to skin cancer. This happens less often in dogs.

One thing that is not normal, however, is for hair to fall out above a liver spot. You mention that your dog is losing hair. Is she going bald over the areas in question?

Given your dog’s hair loss, the safest option is a trip to the vet. He or she should be able to determine whether there is anything to worry about.

• What Causes Cysts in Pets?
• Can Dogs and Cats Take Herbal Cleansers?
• Does Pet Food Cause Health Problems?
• What Causes Chronic Limping in Young Dogs?
• Study Reveals High Levels of Dangerous Chemicals in Pets’ Bodies

Last Friday was Take Your Dog to Work Day in the United States. The event is designed to showcase the benefits that workers and workplaces can derive from the presence of well-behaved pets in the office.

An article on MSN about last year’s event pointed out some of the advantages of having furry friends at work.

[M]ore companies are looking into dog-friendly policies because they improve staff morale and camaraderie and encourage employees to work longer hours. “People will stay longer if they don’t have to leave to let their dog out,” [the co-founder of dogfriendly.com] said.

As a pet lover, I agree that having a dog (or cat) at work makes the day go better. Fortunately for me, pets are quite common at veterinary hospitals!

Although dog lovers won’t need to be convinced that Take Your Dog to Work Day is a great idea, it is important to remember that some people are allergic to or afraid of dogs. Dogs that go to work should be calm, free of parasites, and well controlled.

You can click on the link in the first paragraph for more information about the event. 2009’s Take Your Dog to Work Day is only a year away!

• What Causes Cysts in Pets?
• Can Dogs and Cats Take Herbal Cleansers?
• Does Pet Food Cause Health Problems?
• What Causes Chronic Limping in Young Dogs?
• Study Reveals High Levels of Dangerous Chemicals in Pets’ Bodies

My vet recently decided not to give out
prescriptions for online pet med services. He
claims they use “old” medications which can be
harmful. I wonder if he is more interested in
making a profit for himself off the meds than
giving a break to his patients. How can an online
supplier consciously sell old meds?

S H
Chicago, IL

My vet says that ordering from a well-known internet pharmacy is a
bad idea because you don’t know what you’re
getting. Is it really a bad source to order from,
or is the vet not wanting to lose money? Thanks so
much!!

Alison
Muscatine, IA

Veterinarians and online pharmacies have had a rocky relationship from the start.

When online pharmacies first started selling medicines, many vets were worried that their already slim profit margins (even though vet care is expensive, most of what you pay your vet ends up going to his suppliers, his landlord, his employees, utility companies, the IRS, and regulatory agencies) would be reduced by the loss of income-generating drug sales.

This concern has not panned out as expected. Well-managed veterinary hospitals do not derive much income from drug sales. In the hospitals where I have worked, medications were offered to clients more for their convenience than for our profit. And this makes sense. A veterinarian’s job is to manage the health of pets, not to sell drugs.

So why is there a lingering animosity between vets and online pharmacies?

To my knowledge, none of my patients has ever received an expired or ineffective medicine from an online pharmacy. But I have had conversations with representatives from drug manufacturing companies who assure me that this does happen. They also claim that some online pharmacies unwittingly distribute counterfeit medications that have no efficacy.

In my opinion, if you order from a reputable online pharmacy the odds of receiving expired or counterfeit medicines are low. Most of the drugs that I have seen dispensed from these pharmacies are perfectly fine.

However, I still have a bone or two to pick with many of the internet pharmacies. Working with them can be very frustrating.

For instance, one internet pharmacy habitually refuses to write instructions on the drugs it dispenses. If I send a prescription to the pharmacy and indicate that the medicine should be taken twice daily, they will dispense the medicine with instructions to “take as instructed by veterinarian”. In the best case, this wastes my time–clients call me to ask how often the medicine should be given, when I have already provided that information to the pharmacy. In the worst case, it puts my patients at risk of overdose (for instance, if the client for some reason believes the medicine should be given four times daily).

Another pharmacy routinely sends faxes to my office requesting authorization for prescriptions. I promptly fax back authorizations. The next day, I often receive faxes from the pharmacy, written in a somewhat threatening tone, stating that they have not received my authorization. This confusion on the part of the pharmacy is very annoying, and it also causes me to lose confidence in their business in general. If they can’t manage their fax system, how can I expect them to dispense drugs accurately?

To give the internet pharmacies credit, I have been experiencing these sorts of problems less often over the last year. Nonetheless, I still find working with some online pharmacies to be quite inconvenient.

• No Related Post

Hi,
We have a new Boston Terrier pup (9 weeks) who
tested positive for coccidia but has no symptoms
yet. Our vet has prescribed a 7 day course of
Albon. However, some other people have told me
that she needs a 28 day treatment regimen. Do you
think that this is necessary or should I just do
the 7 day treatment and follow up with the vet
next month (we see her for vaccines then)?
Also- could my cat catch this from my puppy?
Thanks!

Beth
Stoneham, MA

Coccidia are microscopic parasites that are incredibly common in puppies and kittens. Some animals can tolerate Coccidia infestations without showing any symptoms. Others develop diarrhea. In severely afflicted young pets, profuse diarrhea can lead to dehydration, failure to grow and severe illness.

Sadly, there is no perfect treatment for Coccidia. Albon is used to arrest the reproduction of the organisms within the intestinal tract. However, in the long run it is up to the pet’s immune system to tackle and eliminate the parasites.

Because every pet’s immune system is unique, some pets need to take Albon longer than others. I have known some puppies and kittens who had to take it for a month or more before they were cured. I have known others who cleared the parasite on their own, without any medication whatsoever.

Since your puppy isn’t showing symptoms, I think it is reasonable to start with a less aggressive treatment plan. It sounds like her immune system is already fighting the Coccidia. I’d recommend that you complete the seven day course of Albon. Have her stool tested after the medicine runs out. If parasites are still present, your vet can prescribe more medicine.

If your cat is an adult, it is extremely unlikely that the parasites will spread to her. Adult animals with fully-developed immune systems almost never contract Coccidia.

• What can I do About Intractable Puppy Mange?
• Can dogs catch Parvo twice?

Vaccines are a perennially controversial subject in veterinary (and human) medicine. As I have mentioned many times on this blog, nobody knows with any true certainty how often pets should receive vaccines (although plenty of people have strong opinions about the matter).

Over the last several years, the trend in the veterinary community has been to vaccinate pets less often. But researchers are discovering new uses for vaccines that might reverse that trend.

Historically, vaccines have been used to protect individuals from communicable diseases such as parvovirus. However, a new generation of vaccines is likely to emerge in the next decade to combat an entirely different problem: cancer.

In fact, anti-cancer vaccines already exist. The vaccine for human papilloma virus is, in essence, a vaccine against cervical cancer in people. And, as I mentioned in a previous post, veterinary oncologists are using a vaccine to help treat oral melanoma in dogs.

A veritable army of researchers is exploring new ways to use vaccines to fight cancer. And the work is paying off. An article in the May 31, 2008 issue of The Economist discusses the results of clinical trials of a vaccine against a highly deadly type of brain tumor. An excerpt from the article is below.

A piece of research expected to be unveiled on June 1st by Duane Mitchell of Duke University . . . hints that glioblastomas, the most lethal form of brain tumor, may . . . be susceptible to vaccination.

There are two means by which vaccines may be used to fight cancer. The first is to vaccinate against cancer-causing viruses (this is the basis for the vaccines against cervical cancer and glioblastoma). The second is to give a vaccine that stimulates the body’s immune system to attack cancerous cells (this is how the canine melanoma vaccine works).

Cancer is a leading killer of pets and people. Vaccines may prove to be a very important tool for fighting cancer in the future.

• Does Pet Food Cause Health Problems?
• Study Reveals High Levels of Dangerous Chemicals in Pets’ Bodies
• Which Breeds Are Most Likely to Develop Cancer?
• Can Dogs and Cats Take Herbal Cleansers?
• Protect Your Pet From Three Common Poisons

My six-month-old, 3.5 pound Chihuahua is due for
spaying. I am nervous about complications. How do
I know if my vet does a good job? What is the
difference between my vet and a pet pal
rescue-spaying clinic (it is less expensive)?

Robin
St. Petersburg, FL

This is a very good question. The overwhelming majority of spays and neuters performed by veterinarians do not lead to major complications. Nonetheless, the risk of complications exists any time a pet undergoes surgery. Your desire to minimize that risk is very understandable.

Here is what I recommend: ask your vet some questions.

Surgeries performed by experienced vets generally have lower rates of complications than those performed by vets fresh out of school. Ask your vet how long she has been practicing. Ask her how many spays she has performed.

As well, surgical safety precautions vary widely among veterinary facilities. Does your vet run blood tests before surgery to ensure that your pet’s organs are functioning properly? Does she give IV fluids to help support blood pressure? Does she monitor heart rate, blood oxygenation levels, and blood pressure continuously throughout surgery? Does she provide thermal support to prevent low body temperature? Is she aggressive and proactive about treating pain? Does she use the most modern and safest forms of anesthesia?

The only way to know whether your vet does these things is to ask her. You can ask the same questions at the rescue-spaying clinic. Once you have the answers you will be able to make an informed decision that is in the best interest of your dog.

• How Should I Prepare my Pets for Spays and Neuters?
• Los Angeles Enacts Mandatory Spay and Neuter Law
• Discussion on the optimal time to spay or neuter
• What Causes Cysts in Pets?
• Can Dogs and Cats Take Herbal Cleansers?

My Cat has some stomach problems and my vet had me
put him on a probiotic pill (break open with
powder inside) and a B-12 supplement (one drop a
day). I usually mix them in his wet food that he
LOVES and I was wondering if it was ok to mix them
both together. As of now I mix the drop in his wet
and the probiotic in the dry. He inhales the wet
food, so I know he would eat it all if I put them
both in there. I just don’t know if thats a safe
thing to do.

Maggie
Brooklyn, NY

I am glad that your vet prescribed probiotics and vitamins as a first step for your cat’s problem. There are several medications that can be administered to cats with stomach issues. However (as I discussed yesterday), if the syndrome can be treated effectively by more natural means, there is no reason to medicate.

To answer your question, I see no reason why you can’t mix the vitamin B-12 and the probiotics together into the wet food. Very high concentrations of B-12 could conceivably inactivate the benign flora in the probiotics. However, if you thoroughly mix one drop of B-12 into the wet food before you add the probiotics, I sincerely doubt any problems will occur.

I have two additional points to make. First, remember that diet often plays a role in digestive problems in cats. If your cat is not already on an easily digestible diet and you have trouble managing his problems with the regimen of B-12 and probiotics, talk to your vet about switching foods.

Second, some people might get the impression from my last two posts that I am opposed to prescribing medication for my patients. That is not the case. Medications, when prescribed appropriately, can be incredibly beneficial to animals and humans. What I object to is using medications inappropriately or unnecessarily.

• Does Pet Food Cause Health Problems?
• Can Dogs and Cats Take Herbal Cleansers?
• Protect Your Cat From Five Common Hazards
• Study Reveals High Levels of Dangerous Chemicals in Pets’ Bodies
• Can Infected Teeth Cause Sneezing?

Most medicines prescribed by vets are safe. This means that they are not likely to cause serious adverse effects or toxicity.

Nonetheless, any time a pet takes a medicine there is a chance that side effects can occur, even if the side effects are not common.

Because of the risk of side effects, I try not to prescribe medications unless I have a solid reason to believe that they will help my patient. When I diagnose a condition that will resolve rapidly on its own without treatment, I prefer not to prescribe any medicine at all.

That sounds straightforward. But believe it or not, sometimes it upsets clients. Some people feel that they have wasted their time and money if they come home from the vet without some sort of medicine.

When a beloved pet is not feeling well, it is natural to want to do something about the problem. When people give medicine to their pet, they feel that they are helping their pet. However, if the medicine is not appropriate for the condition it may cause more harm than good.

Consider the following letter from a reader.

Hi, My baby Ginger just turned 8 this past
week and lately she has been coughing quite a
bit. It almost sounds croupey. She has an over-the-
counter allergy medicine that I give her and I’m
guessing she might have allergies. What do you
think I should do? (I’m planning to take her to
our vet this week, but I’d like your opinion.)

Allergies rarely cause coughing in 8-year-old dogs. Syndromes such as collapsing trachea, bronchitis, and heart disease are more likely culprits. It is unlikely that an over-the-counter allergy medicine will help much. (A trip to the vet, on the other hand, is exactly what I’d recommend.)

Over-the-counter allergy medicines (antihistamines) may cause sedation, agitation, or upset stomach. What’s more, they have been linked to some scary side effects in people. A number of studies have correlated the use of antihistamines (many of which fall into a class of medications known as anticholinergics) with cognitive decline (dementia) in elderly people. For an article that describes these effects in more detail, click here (warning: the article is somewhat technical in nature).

Some experts now recommend that people with familial histories of Alzheimer’s disease avoid over-the-counter antihistamines.

Animals do not suffer from Alzheimer’s disease per se. However, cognitive dysfunction and dementia appear to be common in elderly cats and dogs.

No link has yet been made between antihistamines and cognitive dysfunction in pets. Nonetheless, the brains and bodies of our pets are very similar to our own. In time a correlation may (or may not) be discovered.

Antihistamines have many valid uses in veterinary medicine. However, unless a pet has been diagnosed with a condition for which antihistamines are the appropriate treatment, I see no reason to give them.

• Can Dogs and Cats Take Herbal Cleansers?
• Does Pet Food Cause Health Problems?
• Protect Your Cat From Five Common Hazards
• Study Reveals High Levels of Dangerous Chemicals in Pets’ Bodies
• Protect Your Pet From Three Common Poisons

Hello Dr. B.,

Amy
Chico, CA

I definitely think that the smoke in the air could have affected Justin’s tolerance for exercise.

On days when air quality is poor, health authorities recommend that people (especially older people and people with asthma) stay indoors. And, they recommend against intense exercise, because pollution can cause irritation to the lungs.

Cats and dogs have lungs that are even more sensitive to environmental contamination than ours. Because of this, I think there is an extremely good chance that the smoky air affected Justin’s breathing and adversely impacted his ability to play fetch. I would recommend that you and he avoid strenuous activity until air quality improves.

I have two additional points to make. First, be glad you live in a town like Chico, where air quality usually is good (even if it’s not so great now). I was recently in Guatemala, where emissions controls are nonexistent. Cars, buses, and tuk-tuks all belch huge plumes of black smoke everywhere they go. I easily became winded climbing small hills.

Second, remember there is a small chance that the air quality is not the only problem causing Justin’s inability to exercise. If he continues to seem weak once the smoke has cleared, have a veterinarian look at him to assess his heart, lungs, and other organs.

• Reflections on the Ancient Origins of the Chuckit!
• What Causes Cysts in Pets?
• Can Dogs and Cats Take Herbal Cleansers?
• Does Pet Food Cause Health Problems?
• What Causes Chronic Limping in Young Dogs?