Vet Blog
10/12/09
 The other day I was at Costco. En route to the checkout line I passed an enormous display of plants for sale. The display consisted entirely of sago palms. (This article discusses cycad sago palms, not true sago palms.)
As I walked to the checkout line I thought to myself that there were enough plants in the display to kill half of the dogs and cats in San Francisco.
Sago palms are beautiful and common house plants. Sadly, few people realize that they are deadly.
Every part of the common sago palm is toxic. The plants are palatable to cats and dogs. Both may suffer liver failure after ingesting the plant. Remarkably few people realize this, and countless loving pet owners unknowingly place their animals at risk by keeping these attractive plants in their homes or gardens.
 Today I saw a cat who was in serious trouble. He was in the prime of life. He was an indoor-only cat. He appeared to be in perfect health. Unfortunately, his face was covered in lily pollen. A conversation with the owner confirmed my worst fears. The cat had chewed on stargazer lilies.
Stargazer lilies are staples of many bouquets. They are beautiful. They also are deadly. Cats especially are at risk. Lilies, especially stargazer lilies, may cause irreversible kidney failure in pets.
If you have pets, please don’t allow these two deadly beauties into your house. Nothing good can come of it.
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08/31/09
 Dear Dr. Barchas,
I read your article via dogster.com on why pets get sick when owners go on vacation. [Note: the questioner is not referring to the article published a few days ago. I originally covered the subject last year. Click here to read the article to which the questioner refers.]
I recently experienced the loss of my 13-year-old dog when I left for a business trip. Just before my trip, I took precaution by paying a visit to our vet. One week into my trip, I learned that my dog was admitted to the hospital with a kidney failure. It took me 29 hours to travel back home but I did get to spend the last hours with my dog.
Even though my dog’s mind seemed fully alert when he saw me, the vet saw a poor prognosis since his kidney condition hadn’t improved with hospitalization.
Just as a dog is impacted by an owner’s absence, do you believe an owner’s presence could cause recovery that goes against all odds? I wonder if my dog would be around had I had never left for the trip. I wish I had come across your article before my trip…maybe then I wouldn’t be dealing with the sadness and guilt of having lost my dog.
Heather
San Francisco
Your trip did not cause your dog’s illness. Staying home would not have prevented it. There is no reason to feel guilty.
Kidney failure generally develops slowly. This is especially true in 13-year-old animals. This means that your dog almost certainly had kidney failure for months before your trip.
Animals’ bodies naturally hide disease–from owners, from veterinarians, and from the animals themselves. Chronic diseases like kidney failure develop slowly. As the syndrome progresses, the affected animal’s body adapts to the condition. No outward symptoms occur. Without blood and urine tests, there is no way for any person to know that anything is wrong. Significantly, during this time the animal does not appear to feel sick.
Over time the condition progresses, and the body continues to adapt. This proceeds until a breaking point is reached. At some point, the disease reaches the point that the body no longer can tolerate it. Sometimes this happens for no obvious reason. Some times, stress such as hot weather, a bout of diarrhea, or the absence of the owner tips the balance.
When this point is reached, animals tend to get very sick very suddenly. An apparently healthy animal falls ill very quickly. But in fact the animal has been sick for a long time.
Your trip did not cause your dog’s illness. The illness was already there. Your trip was the last straw in a process that was inevitable.
You mention that your pet’s condition improved noticeably when you returned home to visit him. This is part of what is so amazingly about pets. They experience genuine joy at the sight of their loved ones. The joy makes them feel better.
In many cases, they feel better only temporarily. It is true that the presence of loved ones leads to a desire to get well, and a desire to get well helps with recovery (this is one of the reasons why therapy animals are used in hospitals — they motivate patients to get well). But with a very serious medical condition the pathology may be so advanced that getting well is not possible, no matter how motivated the patient. Although I don’t know the details of your dog’s situation, advanced kidney failure is one of the most relentless medical problems an animal can face.
I am very sorry for your loss.
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07/22/09
 I have a cat (Charlie) who has chronic kidney failure and his blood counts have gone down especially his red blood cells. He is now taking erythropoietin and is on his second vial.
How long has this med been around for kitties? Does it just help the red blood cells or can it help the kidney failure numbers (BUN, creatinine, etc.) get better?
Karin
Phoenixville, PA
Erythropoietin, also known as Epo or Epogen, has gained significant notoriety in recent years because it can be used as a performance enhancing drug by athletes. However, Epo has many legitimate medical uses. Among those uses is treating anemia in cats with kidney disease.
Healthy kidneys secrete erythropoietin, which is a hormone, as part of their natural function. Erythropoietin stimulates the bone marrow to make red blood cells.
Cats with kidney disease produce significantly less Epo. They therefore develop anemia. Cats are treated with synthetic Epo in order to reverse the anemia. The treatment has been available for over a decade.
(Some athletes take Epo in order to build up excessive red blood cells. This is a type of blood doping.)
In cats with kidney failure, Epo may lead to increased strength and appetite. However, it does nothing to treat the underlying kidney disease. Blood test results related to kidney disease, such as BUN, creatinine, and urine specific gravity will not be affected by Epo.
The Epo used in cats is human erythopoietin, which is slightly different from the feline version of the hormone. Epo therefore has the potential (in very rare cases) to cause serious complications in cats. However, in markedly anemic individuals the benefits greatly exceed the risks.
Photo: Danilo Di Luca does not have chronic renal failure. From telegraph.co.uk.
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03/09/09
 The Arizona Game and Fish Department has published a web page offering more details about the final day of Macho B’s life. Macho B was the USA’s only known wild jaguar. A tracking collar was placed on him after he was captured by Arizona Game and Fish officials in February. The big cat quickly fell ill. He was re-captured and euthanized approximately two weeks later.
A few days ago I posted about the incident, and speculated that Macho B’s initial capture may have hastened his death, but was not likely to have been the cause of it.
Here are some quotes from the Arizona Game and Fish website, along with my comments. As with my last post, a moderate amount of speculation is included in my comments.
“During the necropsy [animal autopsy], we didn’t find anything out of the ordinary for a cat of Macho B’s advanced age,” said Dr. Rice, a veterinarian and executive vice president at the Phoenix Zoo. “But, given the extremely small size of his bladder despite aggressive intravenous fluid therapy, it was apparent that his kidneys were shutting down. I expect the histopathology reports to show that this animal had been experiencing kidney failure for awhile. Kidney failure is more a matter of weeks or months, not days.”
Intravenous fluids treat kidney failure by helping the kidneys to flush toxins out of the bloodstream and into the urine. If Macho B’s bladder failed to fill, this implies that the condition of his kidneys was grave. In my experience, few cats survive if they fail to produce urine despite aggressive intravenous fluid therapy.
This implies that euthanasia may have been the kindest choice for Macho B in the situation (although I would not want to be responsible for making such a decision in the case of a national treasure such as Macho B).
There are few therapies for cases of kidney failure that do not respond to intravenous fluids. One option, dialysis, is not feasible in a wild animal. Another option, combining fluids with medications (furosemide and dopamine) that increase urine output and theoretically increase kidney blood flow, is commonly used in humans and dogs. However, this combination therapy has not been proven effective in any species, let alone jaguars. Dialysis and combination therapy are merely symptomatic treatments. They do little to treat the underlying kidney disease; that would require a kidney transplant, which is not possible at this time in jaguars.
I agree with Dr. Rice that Macho B’s kidney disease was most likely pre-existing. However, any attempt to guess how long Macho B would have lived had he not been captured would require an extreme amount of speculation.
Veterinarians indicated that Macho B showed no physical signs of illness that could have been detected by the biologists that originally collared him after he was unintentionally captured during a mountain lion and bear study. Diagnosis of kidney failure depends on running blood tests to analyze the blood urea nitrogen (BUN) and creatinine levels, which are the two most important indicators of kidney function.
Blood tests run Monday upon arrival at the zoo showed Macho B’s BUN was greater than 180, but an exact level could not be determined because the maximum reading on the diagnostic equipment was 180. The upper limit of a normal BUN level is 30. The cat’s creatinine level was 15.2 with the normal range being .3 to 2.1.
It is true that cats with mild or moderate kidney disease can appear completely normal upon physical examination. The cat could have appeared completely normal when he was first captured, even if he was suffering from kidney disease.
I am a bit disappointed that the exact level of Macho B’s BUN was not reported. Although the machine used could not read values greater than 180, samples can be diluted to obtain exact values. If the technicians running the tests were not comfortable performing this procedure, the samples could have been sent to a reference laboratory for more precise results.
That said, any BUN greater than 180 is extreme. Likewise, a creatinine of 15.2 often indicates a hopeless situation.
Arizona Game and Fish Department biologists had hoped to learn more from blood samples taken at the original capture, but the samples were deemed to be inadequate for testing. The blood samples were collected for use in DNA analysis in accordance with the capture protocol developed by leading jaguar experts. They were not intended to determine the health or condition of the animal at the time of the collaring, which would have required a different blood handling process.
After this incident, I’m confident that leading jaguar experts will change the protocol. DNA analysis requires a few drops of blood. Samples for blood chemistry analyses (which test, among many things, kidney function) require approximately three cubic centimeters–a very small amount of blood from such a large cat. Both samples are straightforward to obtain. As long as a jaguar is anesthetized, there is no reason not to obtain a slightly larger sample of blood. I’ll bet the Arizona Game and Fish officials are regretting their decision not to collect a comprehensive blood sample from Macho B at his initial capture. If nothing else the sample could have proved that his kidneys were already compromised, saving the officials from some of the painful scrutiny they are dealing with now.
The jaguar’s initial capture was guided by protocols developed in case a jaguar was inadvertently captured in the course of other wildlife management activities. The plan, which was created in consultation with leading jaguar experts, includes a protocol for capture, sedation and handling.
This quote makes an important point. I have been involved in wild cat captures. Such procedures are complex, harrowing, and prone to complications. They are not to be undertaken lightly.
No self respecting biologist would capture a jaguar without doing his homework. All of the information I have seen indicates that the people who captured Macho B performed their due diligence. They planned carefully. Their protocols were well thought out. Things went badly. That isn’t necessarily their fault. I am not convinced that anything was done wrong.
The loss of Macho B is heartbreaking. But I personally don’t feel that finger pointing is appropriate.
Photo: Macho B in happier days. Courtesy of Arizona Department of Game and Fish
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03/05/09
 I was saddened by an article that appeared on Livescience recently. The USA’s only known wild jaguar has died.
A rare jaguar captured and collared in Arizona two weeks ago was euthanized after falling ill, state game officials said.
The jaguar was the only one spotted in the United States in more than a decade. Officials captured the cat Feb. 18 as part of a program to study bears and mountain lions. A procedure had previously been put in place to attach a satellite collar to any such fortuitously captured jaguar, so wildlife experts could monitor its movements to learn more about the extremely rare creatures.
The jaguar stopped moving, however.
Biologists found the male jaguar, brought it to a zoo, and he was put down that day. Officials say the cat, named Macho B, suffered kidney failure, common among old cats.
Macho B was first spotted by automatic trail cameras in 1996 when he was about age 2 or 3. He was thought to be 15 or 16 – relatively old for jaguars – when he was euthanized.
The article continues:
The cat had dropped from 118 pounds at the time of his capture last month to just 99.5 pounds Monday . . . [a] necropsy (animal autopsy) will be performed to learn more about the jaguar’s condition and to possibly provide clues to how long the animal had been sick.
In a statement released yesterday, officials did not say whether . . . they might or might not have contributed the animal’s demise.
The Arizona officials may be keeping mum about their role in Macho B’s death, but I will weigh in. What follows is speculation based on my experiences working with big cats in California and Botswana.
To work with a jaguar safely, the cat must be anesthetized. Chemical restraint (as anesthesia is often called by wildlife experts) of a wild cat generally involves loading drugs into a syringe dart and firing the dart at the cat.
All anesthetic agents have the potential to trigger low blood pressure. Low blood pressure can damage the kidneys. This especially true of kidneys that are already compromised by pre-existing disease. Veterinarians generally prefer to run blood tests on patients before anesthesia so that the kidneys and other organs can be assessed. Obviously, it is not possible to run blood tests on a wild jaguar before darting him.
I suspect that Macho B, like many elderly cats, was suffering from kidney disease before he was captured by Arizona officials. The anesthetic procedure stressed his already weak kidneys and pushed them over the edge, causing his health to fail rapidly.
I should stress that I do not believe that the officials who captured Macho B caused his death. The kidney disease was going to catch up with the jaguar eventually. However, I do believe that Macho B’s death was accelerated by the procedure.
Finally, I am in no way convinced that the Arizona officials did anything wrong. Everything I have read indicates that their capture strategy and techniques were well thought out and executed (although it is not clear whether Macho B’s advanced age was considered when the decision was made to capture him).
The people who captured Macho B certainly were animal lovers. I have a strong hunch that they are utterly devastated by his death.
Photo credit: Colin Burnett
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01/30/09
 Several canine and feline medical conditions require home treatments that incorporate needles or syringes. For instance, cats with kidney disease may receive regular injections of fluids under their skin. Cats and dogs with diabetes often require daily (or twice daily) injections of insulin.
Needles and syringes can be safely used only once. This means that many pet owners must store and dispose of used needles that are generated by their pet’s treatment.
Historically two disposal methods have been commonly used. Many people would simply throw the used needles away. This technique was legal but frowned upon because sharp medical waste is inherently dangerous. In the second method, people saved their pet’s used needles and returned them to their veterinarian for disposal.
What very few people, including veterinarians, realize is that both of the commonly used methods are now illegal in California. On September 1, 2008 new regulations took effect to protect public safety by barring the disposal of needles in trash cans or recycling bins.
The only legal way to dispose of needles and syringes that are used at home is to take them to an official “home-generated sharps consolidation point”. Such points must comply with specific state regulations. A special application is required to register as a consolidation point.
This means that unless your veterinarian has taken special measures to register his or her facility as a home-generated sharps consolidation point (and I’ll bet your vet has not), you cannot legally return used needles or syringes to your vet’s office.
The new regulations also address the storage of used needles until they can be taken to the consolidation point. In the past, people often used plastic bags or tupperware containers to store their sharps. Now people must use specially designed and approved sharps receptacles.
For more information on the regulations, click here.
Photo credit: William Rafti. Photo license: CC
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01/24/09
 Hey Dr. Barchas, I have a Maine Coon cat and he is
22 pounds. Is this normal?
Madison
Abbotsford, BC, Canada
Maine Coons are known for being large. I have known plenty of healthy Maine Coons who weighed in at 15 pounds or more. And, in the course of my career, I have met two healthy cats who weighed more than 20 pounds. They were both Maine Coons.
To answer your question, a 22 pound cat is not normal. It is exceptional. Very few cats weigh that much.
However, it does not matter whether your cat is normal. What matters is whether his weight is healthy.
A 22 pound cat is roughly equivalent to a 250 pound person. Most 22 pound cats, and most 250 pound people, are overweight. But there are exceptions. For a very tall person, 250 pounds could be a healthy weight. And for a very large-framed cat, 22 pounds could be fine.
Remember that obesity in cats is linked to a number of serious medical conditions such as diabetes, kidney failure and bladder inflammation. I recommend that you have a vet assess your cat’s weight. If his weight is fine, then don’t worry. If he is overweight, discuss weight control measures with your vet.
Photo: Chloe’s weight looks fine to me.
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01/18/09
 My seven-year-old Malamute quit eating. Her Dr. said that all
blood work and fecal, etc. were fine she just
won’t eat!! She stopped eating her dog food, and now
barely even eats p-butter.
I think it may be a tooth,but the Dr.
disagrees. Regardless of what it may be, how do I
get her to eat?
Jill
Largo,FL.
Animals do not suddenly stop eating unless something is wrong. To get your dog eating again, you need to find out what is wrong and correct it if possible.
A very large number of diseases and syndromes may cause a seven-year-old pet to lose its appetite. Many, such as kidney disease, bladder infections and advanced diabetes, are detectable on basic blood and urine tests. Others, including certain intestinal disorders, foreign objects in the intestines and most forms of cancer, are not.
I think your dog needs more tests. I would recommend X-rays and ultrasound of the abdomen as the next step.
Dental problems cause pets to lose their appetites rarely. However, if a thorough diagnostic evaluation fails to determine what’s going on, you may want to consider dental work.
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11/06/08
 What would cause a dog to drink a large amount of
water at one time several times a day? Otherwise
seems to be normal. Energy is good and eats normal
for a 8-month-old pup. No other symptoms.
Lorraine
Roseburg
Any time a client mentions that their pet is drinking excessive amounts of water, my ears perk up. Increased thirst can be a sign of many different diseases and syndromes.
Diseases that cause increased thirst include diabetes, kidney disease, thyroid disease, other glandular disorders, some types of bladder problems, some infections and certain types of cancer.
Most of the diseases that cause increased thirst cause other symptoms such as weight loss, weight gain, decreased appetite, lethargy or a poor-quality coat of hair. And most of the diseases that cause increased thirst occur most often in middle-aged or older pets.
Thankfully, increased thirst is not always caused by a serious disease. Dogs that exercise a great deal, eat salty food or live in hot climates may drink large amounts of water.
And, for their size puppies drink relatively more water than adults. This is because they require extra water (and food) to support their high metabolisms and growth. And this is what I suspect is going on with your pup.
If your pet fails to grow or thrive, loses its appetite, becomes lethargic or develops increased thirst that is more pronounced I’d recommend a trip to the vet. But I have a hunch that there is nothing wrong with your dog.
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The other day I was at Costco. En route to the checkout line I passed an enormous display of plants for sale. The display consisted entirely of sago palms. (This article discusses cycad sago palms, not true sago palms.)
Today I saw a cat who was in serious trouble. He was in the prime of life. He was an indoor-only cat. He appeared to be in perfect health. Unfortunately, his face was covered in lily pollen. A conversation with the owner confirmed my worst fears. The cat had chewed on stargazer lilies.
You have questions. 