 If you’ve been sheltering at home during the pandemic, your pets have gotten used to having you around all the time. Puppies and kittens adopted during lockdown might have never been home without people. Take these steps to prevent separation anxiety in your pets when you start spending more time away.
Gradually Change the Schedule Dogs and cats feel most secure when their environment is predictable. If meal and walk times will be changing, start the new schedule in advance to give them time to adjust. You might also need to gradually alter the timing, frequency, and duration of play times (but make sure they still get plenty of exercise). Make Departures No Big Deal A standard recommendation for pets with separation anxiety is to stay calm when you leave and when you return. It’s fine to say hi when you walk in the door, but excited greetings and prolonged goodbyes can be counterproductive. You don’t want to focus too much of their attention on the fact that you are going or coming. Start With Short Departures Have everyone leave the house for a few minutes to see how your dog reacts. Some signs of separation anxiety are barking, whining, scratching at the door, urinating or defecating in the house, and chewing the door frame or other objects. A video camera (if you have one) can pick up signs like pacing, panting, and lip licking. If all goes well, gradually increase the length of time you’re gone. If your dog seems anxious, progress very slowly and use positive reinforcement like treats when you leave. Simply picking up the keys or touching the doorknob is enough to trigger anxiety in some dogs. Dogs that already have separation anxiety might need a veterinary consult. Use Toys and Treats Giving your pets toys or treats when you leave can serve 2 purposes: distraction and counterconditioning. A time-consuming toy like a food puzzle gives them something to think about other than the fact that you’re gone. Never leave your pets with toys they can swallow whole, chew apart, shred, mangle, break, or choke on, though. Counterconditioning means giving an animal a positive stimulus, like a yummy treat, at the same time as an unwanted event, like you leaving. Counterconditioning can help animals form positive associations with things they don’t like but have to put up with. Confine Pets Safely If your dogs can’t safely have the run of the house while you’re away, accustom them to a crate or an appropriate room in advance. Make the space a familiar, comfortable environment for them, using positive reinforcement as needed. Don’t Punish Destruction and house soiling aren’t signs that your dog resents you or wants your attention. These could be signs of anxiety, boredom, lack of exercise, or (with house soiling) just needing to be taken out more often. Punishing animals after the fact increases their anxiety and does nothing to keep the behavior from happening again. Look for the cause of the problem instead. Doggie Daycare? It Depends Dog daycares and kennels might or might not be open in your area. Follow your local public health precautions. Dogs and cats don’t seem able to transmit COVID-19 to humans, and the risk of them becoming infected appears to be low. To be safe, however, the American Veterinary Medical Association recommends limiting contact between pets and people who are not part of the household. If any people or animals in your home are sick, don’t send your dog to daycare. And don’t put face coverings over pets’ noses or wipe them down with household disinfectants. For More Information COVID-19: 7 steps to help your pet prepare for your return to work. American Veterinary Medical Association. Published June 12, 2020. Accessed July 3, 2020. https://www.avma.org/news/press-releases/covid-19-7-steps-help-your-pet-prepare-your-return-work McConnell P. Preventing separation anxiety in the time of COVID. The Other End of the Leash. Published April 27, 2020. Accessed July 3, 2020. https://www.patriciamcconnell.com/theotherendoftheleash/preventing-separation-anxiety-in-the-time-of-covid Photo by Eric Ward
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Laurie Anne Walden, DVM  Make plans now to keep your pets safe over the July 4 weekend. Large fireworks shows might be canceled this year, but fireworks stores across the state line are open and home fireworks pose risks for pets.
Fireworks in neighborhoods are traumatic for many animals. The loud bangs are random and sporadic, so they’re hard to predict. For pets at home, neighborhood fireworks are louder than big fireworks shows because they’re closer. And fireworks set off by individuals tend to continue for several hours, often over a few days, instead of being limited to the duration of a fireworks show. Containment Animals startled by loud noises can bolt unexpectedly. Take these steps to keep your pets from getting lost and increase the chance of finding them if they run off:
Noise Phobia Noise phobia, or irrational fear of certain noises, is common in dogs and is often triggered by fireworks. Noise phobia goes further than just disliking loud sounds. Animals with noise phobia have reactions that range from hiding under the bed to destroying parts of the house. Some symptoms, like seeking attention, are subtle. This anxiety condition often gets worse with time and can seriously affect an animal’s safety and welfare. If you think your pet might have noise phobia, call your veterinarian. Your pet might need a combination of short-term treatment (like antianxiety medication) that you can use right away and long-term behavior modification measures. The sooner you address noise phobia, the better it will be for your pet. Various therapies have been used to help dogs with noise phobia. Some work better than others. A survey published in May 2020 asked dog owners how they managed their dogs’ fireworks fears and how well various techniques worked. The most effective measures, indicated by at least 69% of owners, were counterconditioning (giving the dog something desirable when the noise occurred), prescription antianxiety medication, and relaxation training. Pressure vests and desensitization using fireworks recordings were less effective. Pheromones, nutraceuticals, and herbal remedies worked for the fewest dogs.[1] Fireworks Toxicity Fireworks contain hazardous substances like fuel, oxidizers (for combustion), and heavy metals. If swallowed, these chemicals can cause vomiting, diarrhea, seizures, liver disease, or kidney disease.[2] Lit fireworks and smoke are obviously a risk to animals’ eyes and skin. Keep your pets completely away from new and used fireworks:
References 1. Riemer S. Effectiveness of treatments for firework fears in dogs. J Vet Behav. 2020;37:61-70. 2. Fireworks. Pet Poison Helpline. Accessed June 19, 2020. https://www.petpoisonhelpline.com/poison/fireworks/ Photo by Andy Thrasher Laurie Anne Walden, DVM  Feline infectious peritonitis (FIP) is a serious disease caused by a coronavirus infection in cats. The disease is usually fatal, although a new antiviral drug under investigation has had promising results in some cats.
Cause Cats very commonly carry a strain of feline coronavirus that lives in cells of the intestines. This virus, feline enteric coronavirus, does not cause disease in most cats. In some cats, though, the virus mutates into a disease-causing strain that invades a type of white blood cell and spreads through the body. This strain is FIP virus (FIPV). The disease it causes, FIP, results from the body’s immune response to the infection. Transmission Feline enteric coronavirus spreads easily among cats housed together, especially in shelters and catteries. This virus is shed in the feces, and cats can be infected if they share litter boxes or have close contact with infected cats. Cats with no symptoms can spread the virus to other cats. Cats are often exposed to feline enteric coronavirus as young kittens. Why feline enteric coronavirus mutates into FIPV in some cats is not fully known. Virus genetics and individual cat factors (genetics, immune function, and possibly environment) are likely to be involved. Most cats that develop FIP are kittens or young adults. Cats housed in groups, male cats, purebred cats, and cats that have not been spayed or neutered are at higher risk than others for FIP.[1,2] The mutated virus strain, FIPV, does not appear to spread directly from cat to cat. Feline enteric coronavirus and FIPV are not known to infect humans. Symptoms Most cats exposed to feline enteric coronavirus do not become ill. Some cats have an episode of diarrhea or vomiting, which is usually mild. Because FIPV spreads throughout the body, FIP affects many body systems and can cause a wide range of symptoms. The clinical signs are not specific; they can be caused by diseases other than FIP. Typical FIP signs are caused by fluid accumulation in the abdomen and chest, by inflammatory changes in various parts of the body (such as kidneys, nervous system, liver, heart, or eyes), or both. The symptoms depend on the body system affected and can change over time in the same cat. These are some of the possible symptoms of FIP:
Diagnosis Diagnosing FIP is not straightforward and can’t currently be done with a simple blood test. Because so many cats have been exposed to feline enteric coronavirus, a positive antibody test (indicating virus exposure) doesn’t mean that a sick cat has FIP. The diagnosis is usually based on a combination of clinical signs, results of baseline blood and urine tests, and analysis of abdominal fluid and samples taken from affected organs. Treatment Until recently, the prognosis for cats with FIP was uniformly bleak. Conventional treatments, including various antiviral medications and drugs to manage the immune response, have had variable success at prolonging cats’ survival times. Cats are usually treated with supportive measures to maximize their comfort for as long as possible. A new antiviral drug, GS-441524, successfully treated some cats with FIP in a study published in 2019.[3] This drug is closely related to remdesivir, which was originally developed as a treatment for Ebola virus infection and is now being studied as a potential treatment for coronavirus disease 2019. GS-441524 may prove to be effective for some cases of FIP, but it is not currently approved by the US Food and Drug Administration. Prevention Preventing FIP is difficult because feline enteric coronavirus spreads so easily among cats and because the factors that cause it to mutate to FIPV aren’t known. A vaccine for FIP has been marketed, but it is not very effective and is not currently recommended for use in cats.[4] Practicing good husbandry in high-density environments like shelters and keeping individual cats in good health might reduce the risk. References 1. Levy JK, Hutsell S. Overview of feline infectious peritonitis. Merck Veterinary Manual. Updated January 2014. Accessed May 6, 2020. https://www.merckvetmanual.com/generalized-conditions/feline-infectious-peritonitis/overview-of-feline-infectious-peritonitis 2. Felten S, Hartmann K. Diagnosis of feline infectious peritonitis: a review of the current literature. Viruses. 2019;11(11):1068. doi:10.3390/v11111068 3. Pedersen NC, Perron M, Bannasch M, et al. Efficacy and safety of the nucleoside analog GS-441524 for treatment of cats with naturally occurring feline infectious peritonitis. J Feline Med Surg. 2019;21(4):271‐281. doi:10.1177/1098612X19825701 4. Scherk MA, Ford RB, Gaskell RM, et al. 2013 AAFP Feline Vaccination Advisory Panel Report. J Feline Med Surg. 2013;15(9):785‐808. Published corrections appear in J Feline Med Surg. 2013;15(11):NP2 and J Feline Med Surg. 2014;16(1):66. doi:10.1177/1098612X13500429 Photo by Timothy Warrington Laurie Anne Walden, DVM  New information about coronavirus disease 2019 (COVID-19) continues to emerge as the pandemic progresses. The information in this article is current on the date of posting (April 1, 2020). For the most recent updates, see the resources linked at the end of the article.
Can pets get sick with COVID-19? This question is still being investigated. A vast number of pets have lived with people with COVID-19 without getting sick, so the risk of human-to-animal transmission is probably extremely low. The Centers for Disease Control and Prevention (CDC) has not had any reports of animals in the United States getting sick with COVID-19. There have been rare reports of pets in other countries having positive tests for SARS-CoV-2, the virus that causes COVID-19. (A positive test for a virus doesn’t necessarily mean the virus will cause illness in that animal. It also doesn’t show whether the animal can pass the virus to another animal.) These animals each lived with a person with confirmed COVID-19 and were almost certainly exposed by the infected person. Two dogs in Hong Kong had positive tests for SARS-CoV-2 but had no symptoms (they didn’t actually get sick with COVID-19). One cat in Belgium reportedly had a positive test and symptoms, but because of missing or questionable evidence about this cat, the World Organisation for Animal Health has not confirmed this as an infection. Can pets spread COVID-19 to people? Multiple infectious disease experts and international health organizations say there is currently no evidence that dogs and cats can spread the COVID-19 virus to people. There is no need to avoid, neglect, or surrender pets out of fear of COVID-19. (This has reportedly been happening in some places.) Pets and people live in close contact and can share other diseases, so health organizations recommend washing your hands after handling animals and practicing good hygiene in general. Can pet hair or accessories (leashes, food bowls, etc) transmit the COVID-19 virus to people? According to the most recent data and guidance, transmission through pet accessories is theoretically possible but hasn’t been shown to actually happen. SARS-CoV-2 mainly spreads from person to person. Touching an object that has virus particles on it and then touching your face could possibly transmit the virus, but this route is not considered a major source of infection. If the virus can be transmitted through pet hair or accessories at all, transmission is probably more likely with smooth, solid objects like food bowls than with porous or fibrous objects like hair. Coronaviruses can stay on surfaces for hours or days, according to the World Health Organization. The virus particles might or might not be able to infect a person during that whole time, depending on the environmental conditions. Although it seems unlikely that the virus would be transmitted by a leash, food bowl, or pet hair, it’s always a good idea to clean pet accessories regularly and wash your hands after handling an animal. If someone in my household has COVID-19, how should I protect my pets? The CDC recommends that people who have COVID-19 stay separated from pets. CDC guidance states that people with COVID-19 should “avoid direct contact with pets, including petting, snuggling, being kissed or licked, sleeping in the same location, and sharing food.” This guidance does not apply to service animals, who can stay with their handlers. If possible, someone who does not have COVID-19 should take over the pet care. People with COVID-19 who have to continue caring for their pets (including service animals) should wash their hands before and after handling their pets. The American Veterinary Medical Association adds that people with COVID-19 should wear a face mask around their animals and shouldn’t share food, dishes, or bedding with them. No one is recommending that pets wear face masks, in case you were wondering. Face masks could actually harm animals by hindering their breathing. How should I prepare for pet care in case I get sick with COVID-19? Plan ahead, just as you prepare for natural disasters like hurricanes. Identify someone who can take care of your pets if you’re unable to. Make sure you have a couple of weeks’ worth of pet food and medications. Check your supply of monthly heartworm and flea preventives and contact your veterinarian if you need a refill. If your pet has medical needs, be ready to provide a list of instructions for another caregiver. Consider preparing a letter for your veterinarian authorizing your backup caregiver to approve treatments. If my pet needs to see a veterinarian, what should I do? Contact your veterinarian to find out if your pet should go the clinic. Depending on local guidance, the clinic might be postponing non-urgent procedures to help reduce community spread of COVID-19. Some clinics might be able to treat established patients through telemedicine (virtual visits). Under North Carolina’s current stay-at-home order, veterinary clinics are considered essential businesses. Your pets can still get the care they need. If your pet needs to be seen at the clinic, you will probably be asked to stay outside the building while your pet is taken inside to help keep you and the clinic staff safe. If I am (or might be) sick with COVID-19 and my pet needs to see a veterinarian, what should I do? Call the clinic. Your clinic might not have sufficient personal protective equipment for staff to use when handling animals from a household with COVID-19. Your veterinarian might be able to treat your pet via telemedicine or refer you to a clinic with available protective equipment. If your veterinarian confirms that your pet should come to the clinic, have someone else (ideally not living in your household) transport your pet to the clinic. For more information and updates:
Image: colorized scanning electron micrograph of cell infected with SARS-CoV. Credit: National Institute of Allergy and Infectious Diseases, NIH; https://www.flickr.com/photos/nihgov/49680300342/. Laurie Anne Walden, DVM  Indoor cats need mental stimulation and physical activity to stay happy and healthy. Playing games with your cat and providing cat-appropriate toys can make life better—and more fun—for both of you.
When and How Long to Play Always let your cat choose whether and when to play. Cats might nip when they’re overexcited or want to stop interacting, so watch your cat’s body language (for example, pinning the ears back or twitching the tail) and be ready to end the session before things go too far. When you’re petting your cat, remove your hand every minute or so and watch her reaction. If she ignores you or walks away, it’s time to stop. If she rubs her head against your hand, she probably wants more head or face petting. Some cats are overstimulated by being touched for very long on the lower back near the tail and prefer to be petted on the front half of the body.[1] The ideal length of a play session probably depends on the individual cat. The results of a 2014 cat owner survey showed a possible link between the length of play sessions and cat problem behaviors: owners who played with their cats for at least 5 minutes at a time reported fewer problem behaviors than those who played for 1 minute at a time. However, the survey didn’t show whether longer play resulted in fewer problem behaviors or whether owners just didn’t engage as much with cats who had behavior issues.[2] Choosing Toys To choose toys and games for your cat, start by thinking like a cat. Cats are born hunters, and even cats living the good life indoors need to be able to act on their natural instincts. Cats play by acting out predator behaviors:
The toys you provide should allow your cat to perform all of the instinctive predator behaviors. Cats tend to like moving objects they can stalk, which is why your feet might be a target. Try a variety of toys that mimic the movements of prey animals like rodents and birds. These can include toy mice, balls, toys dangling from the end of a wand, or toys pulled on a string. Of course, don’t leave strings or toys your cat can swallow within your cat’s reach when you’re not there to supervise. Cats can become frustrated if they can’t catch what they’re chasing. If you use a laser pointer, hide a treat for your cat to find after stalking the moving light. (And don’t point the light into your cat’s face.) Balls inside circular tracks might not be attractive to some cats because they can’t capture, hold, or bite them. Cats get bored with their toys, so don’t leave the same toys out every day. Rotate your cat’s toys to keep her mind stimulated. You don’t have to buy a lot of cat toys to play with your cat. Paper bags, boxes, crumpled paper balls, and socks all make great toys. Think about engaging all of your cat’s senses with objects that look, smell, taste, sound, and feel different from each other. For more ideas for toys and enrichment for indoor cats, check these resources:
References 1. Delgado M. Do cats have petting preferences? Yes! Cats and Squirrels website. December 29, 2014. Accessed March 19, 2020. http://catsandsquirrels.com/pettingprefs/ 2. Strickler BL, Shull EA. An owner survey of toys, activities, and behavior problems in indoor cats. J Vet Behav. 2014;9:207-214. 3. Playing with your cat. International Cat Care. July 30, 2018. Accessed March 19, 2020. https://icatcare.org/advice/playing-with-your-cat/ Photo by Kim Davies Laurie Anne Walden, DVM  Colorized transmission electron microscopy image of avian infectious bronchitis virus. Credit: CDC/Dr Fred Murphy; Sylvia Whitfield. Coronaviruses cause disease in many animal species. Most coronaviruses affect either the respiratory tract or the digestive system. Some coronaviruses cause no symptoms or only mild illnesses like the common cold. Others cause serious disease.
New information continues to emerge about SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19). At this time (early March 2020), there is no evidence that this virus can spread between humans and companion animals like dogs and cats. For updated information about COVID-19, see these resources:
Coronaviruses got their name from spike proteins that cover the surface of the virus particles and look like a crown (corona in Latin) on electron microscopy images. Coronavirus spike proteins bind to receptors on the host animal’s cells and allow the virus particles to fuse with the cells. Spike proteins and the receptors they target vary according to the type of coronavirus. Because animal species don’t all have the same molecular receptors and different coronaviruses have different surface proteins, coronaviruses tend to be species specific. A coronavirus that causes disease in cows, for example, doesn’t normally cause disease in cats. This is also why your dogs don’t catch your cold even if you sneeze in their faces. Some coronaviruses are zoonotic, meaning they can be transmitted between animals and humans. Coronaviruses jump to a new host species through genetic mutation. Mutation changes the virus proteins and creates a genetically different coronavirus that can infect a different host. Jumping to a new species might also be easier if the molecular receptors in the new host species are similar to those of the original host species. Coronavirus infections in livestock and companion animals can be severe. However, until 2002, coronaviruses usually caused only mild disease in people with fully functioning immune systems. In 2002, an outbreak of severe acute respiratory syndrome (SARS) occurred in China, and in 2012, Middle East respiratory syndrome (MERS) emerged. Both of these outbreaks were caused by coronaviruses thought to have begun as bat viruses. Bats and people don’t have much contact, so the viruses that caused SARS and MERS spread to people through intermediate hosts: civets for SARS and camels for MERS.[1] COVID-19 is the third coronavirus disease to cause serious outcomes in humans.[2] Animal Diseases Caused by Coronaviruses Diseases caused by coronaviruses have been identified in many mammal and bird species. Some examples of coronaviruses that cause serious disease in livestock are transmissible gastroenteritis virus and porcine epidemic diarrhea virus in piglets, infectious bronchitis virus in chickens, and bovine coronavirus in cows.[3] The coronaviruses of most concern in cats and dogs are feline coronavirus, canine coronavirus, and canine respiratory coronavirus. Feline coronavirus usually causes such mild symptoms they aren’t noticed at all. In some cats, though, infection leads to feline infectious peritonitis, a devastating disease that is nearly always fatal. (Feline infectious peritonitis will be covered in more detail in another article.) Canine coronavirus is passed through the feces and causes vomiting and diarrhea, especially in groups of dogs in kennels and animal shelters. Infection usually carries a low risk of death, but a more severe strain of canine coronavirus can be fatal to dogs.[4] Canine respiratory coronavirus is one of the causes of canine infectious respiratory disease (kennel cough). The emergence of SARS and MERS in humans prompted more research into coronaviruses, so new therapies for coronavirus diseases may be available in the future. References 1. Cui J, Li F, Shi ZL. Origin and evolution of pathogenic coronaviruses. Nat Rev Microbiol. 2019;17(3):181-192. 2. Coronaviruses. National Institute of Allergy and Infectious Diseases website. Updated March 2, 2020. Accessed March 5, 2020. https://www.niaid.nih.gov/diseases-conditions/coronaviruses 3. Fehr AR, Perlman S. Coronaviruses: an overview of their replication and pathogenesis. Methods Mol Biol. 2015;1282:1-23. 4. Decaro N, Buonavoglia C. Canine coronavirus: not only an enteric pathogen. Vet Clin North Am Small Anim Pract. 2011;41(6):1121-1132. Image source: https://phil.cdc.gov/Details.aspx?pid=15523 Laurie Anne Walden, DVM  Mast cell tumors are common in dogs and somewhat common in cats. In dogs, mast cell tumors are usually lumps on or under the skin. Mast cell tumors in cats can affect the skin or the internal organs.[1]
Mast cells are a normal part of the immune system. They are most often found in the skin, digestive tract, and other areas that are exposed to substances from the environment. Mast cells are full of granules that contain histamine and other chemicals that are released as part of allergic and inflammatory responses. You’ve seen mast cells in action yourself: the itchy lump you get after a mosquito bite is caused by mast cells in the skin releasing histamine and other substances. Mast cell tumors are cancerous growths made up of mast cells. Signs in Dogs Mast cell tumors are most common in older dogs but occur in dogs of all ages. Dogs of any breed can develop mast cell tumors. Breeds at higher risk than others include retrievers, shar-peis, and brachycephalic (flat-faced) breeds like boxers, pugs, and Boston terriers. In dogs, mast cell tumors can look similar to other conditions. Some look and feel just like benign fatty lumps. Mast cell tumors in dogs vary in appearance and behavior. A mast cell tumor might be a smooth, round, raised skin lump; a red, itchy lump; or a soft lump under the skin. Some are solitary growths, and some are clusters of lumps or small bumps. Some grow very slowly, with no apparent change for months; others grow quickly. Mast cell tumors sometimes get bigger (or pinker or itchier) and then return to their normal appearance. This change happens when they release histamine. More serious effects of histamine release include decreased appetite, vomiting, diarrhea, blood in the stool, and collapse.[1,2] Signs in Cats Most cats with mast cell tumors are older, although an atypical form is most common in young cats. Siamese may be more likely than other cat breeds to have mast cell tumors.[3] In cats, the signs of mast cell tumors depend on their location (skin or internal organs) and the tumor subtype, which determines how aggressive they are. As in dogs, mast cell tumors in cats can mimic other conditions and do not all look and behave the same way. Mast cell tumors in the skin can be smooth, round growths or flat red patches, and they might grow quickly or very slowly. Mast cell tumors inside the body most often affect the spleen or digestive tract and can cause decreased activity, decreased appetite, vomiting, diarrhea, and other general signs of illness.[1,3] Diagnosis Most mast cell tumors of the skin can be diagnosed during a veterinary appointment with a needle aspirate, in which a small sample of cells is removed with a needle and syringe and examined under a microscope. Because putting a needle in a mast cell tumor can cause histamine release, veterinarians often give an antihistamine when they aspirate a mast cell tumor. A needle aspirate can show that a patient has a mast cell tumor, but it doesn’t give enough information to know the prognosis. Some mast cell tumors are single lumps that don’t spread to lymph nodes or distant parts of the body. Others are more invasive and have a high risk of spreading through the body. Currently the only way to know the grade or type of a mast cell tumor, and hence the prognosis, is by surgically removing all or part of the tumor and sending this biopsy sample to a laboratory for analysis. Patients with high-grade or aggressive mast cell tumors, including cats with mast cell tumors in internal organs, benefit from further tests to find out whether the cancer has spread or is causing other problems. This workup can include blood and urine tests, lymph node aspiration, imaging (such as ultrasound or computed tomography), and bone marrow analysis. Whether to do these tests before or after biopsy depends on the patient and the tumor. Treatment Surgical removal is recommended for most mast cell tumors and might be the only treatment (other than antihistamines) needed for low-grade mast cell tumors of the skin. Cancerous mast cells extend past the edges of the visible lump, so a wide area of normal-appearing skin around the tumor must be removed. The biopsy report indicates whether all of the tumor was removed during the procedure. Chemotherapy, other medications, and radiation therapy are available for patients with aggressive tumors, cancer in internal organs, tumors in areas where wide removal isn’t possible, or tumors that aren’t completely removed during surgery. Your veterinarian is likely to recommend referral to an oncologist if your pet might need these types of treatment. Prognosis The prognosis is good for patients with mast cell tumors that haven’t spread and are completely removed with surgery, radiation therapy, or both. These patients sometimes develop another mast cell tumor later, so all new lumps warrant a visit to the veterinarian. For patients with other types of mast cell tumor, the prognosis depends on tumor grade, location, and response to treatment. References 1. Blackwood L, Murphy S, Buracco P, et al. European consensus document on mast cell tumours in dogs and cats. Vet Comp Oncol. 2012;10(3):e1-e29. doi:10.1111/j.1476-5829.2012.00341.x 2. Couto CG. Mast cell tumors: to cut or not to cut. Paper presented at: 2018 Michigan Veterinary Conference; January 26-28, 2018; Lansing, Michigan. Accessed February 14, 2020. https://www.michvma.org/resources/Documents/MVC/2018%20Proceedings/couto_04.pdf 3. Henry C, Herrera C. Mast cell tumors in cats: clinical update and possible new treatment avenues. J Feline Med Surg. 2013;15(1):41-47. Photo by JC Gellidon Laurie Anne Walden, DVM  Radiograph of 3 cat teeth undergoing resorption. Tooth on the far right is in an advanced stage of resorption. Image by Rebecca Johnson, DVM. Tooth resorption is a potentially painful dental problem that is common in adult cats and occasionally affects dogs. The condition gets worse over time and can involve many teeth or only a single tooth root. Animals with tooth resorption and mouth pain might not have any obvious symptoms.
Description Tooth resorption is the process of tooth breakdown and reabsorption by the body. Tooth root resorption is normal in baby teeth. Think of how a baby tooth looks after it falls out: it has a jagged edge instead of long roots. Its roots were resorbed as the permanent tooth moved into its place. If its roots had not been resorbed, the baby tooth would stay in the mouth instead of falling out to make room for the permanent tooth. For reasons that are still unclear, many cats experience abnormal resorption of adult teeth. Resorption of adult teeth can affect only the roots or both the roots and the crown (the visible part of the tooth above the gumline). Resorption is not the same as cavities, which are rare in cats and dogs. Tooth resorption in adult teeth usually begins with the loss of a small amount of the hard outer tooth surface at or below the gumline. Resorption progresses until it reaches the soft pulp at the center of the tooth. Another type of tooth resorption begins in the pulp and works its way outward.[1] The process involves bone remodeling along with tooth destruction, and in the final stage the root mostly disappears and is replaced with bone.[2] Inflammation plays a part in tooth resorption, although whether inflammation causes resorption or resorption causes inflammation is not known.[3] In any case, many cats with tooth resorption also have gingivitis or more severe inflammation in the mouth. Whether tooth resorption is painful depends on the degree of inflammation, location of the resorbed area (above or below the gumline), stage of resorption, and presence of other problems like infection. Symptoms Tooth resorption is very often a hidden condition that isn’t found until a cat is under anesthesia for a dental procedure and has dental radiographs (x-ray images) taken. Cats and dogs can have mouth pain with very subtle or no symptoms of discomfort. Gingivitis is sometimes a sign of underlying tooth resorption. Animals with tooth resorption might have these symptoms:
Diagnosis Tooth resorption is diagnosed with dental imaging (radiographs or computed tomography) and a full oral examination that includes probing around all sides of the teeth. These procedures require general anesthesia or at least deep sedation. Examination of a cooperative awake patient can reveal resorption that affects the crown, but it won’t show resorption of tooth roots. Treatment Currently the only effective treatment for tooth resorption is extraction of the affected teeth. If the tooth roots have already been replaced by bone, only the crown of the tooth might need to be removed. Decisions about whether to extract, when to extract, and how much tooth to extract are based on how the teeth look on radiographs and whether the condition is likely to be painful.[3] Medical treatments like antibiotics and steroids don’t stop tooth resorption. Tooth resorption can’t be prevented because the cause isn’t known.[2] The best way to catch the problem is with regular dental care, including an oral examination and radiographs under anesthesia as recommended by a veterinarian. References 1. AVDC nomenclature: tooth resorption. American Veterinary Dental College website. https://avdc.org/avdc-nomenclature/. Accessed January 31, 2020. 2. Reiter AM. Tooth resorption in small animals. Merck Veterinary Manual website. https://www.merckvetmanual.com/digestive-system/dentistry/tooth-resorption-in-small-animals. Updated May 2014. Accessed January 31, 2020. 3. Smith MM. Tooth resorption in cats: don’t think you know; know you know! In: VMX 2020 Proceedings: Small Animal & Exotics, Book 1. Orlando, FL: North American Veterinary Community; 2020. Laurie Anne Walden, DVM  The anal sacs, or anal glands, are a pair of small sacs located under the skin on each side of the anus of dogs and cats. These sacs contain smelly material that is normally squeezed out when an animal passes stool. If your dog is scooting his bottom across the floor, he might have an impacted (clogged) anal sac.
Anal Sac Anatomy Anal sacs lie between the anal sphincter muscles, the circular muscles that close the anus. Each sac has a small duct that leads to an opening in the skin next to the anus. Anal sac material is liquid or pasty in consistency, ranges in color from cream to brown, and has a characteristic fishy odor. The function of anal sacs is not entirely clear but might have to do with scent marking and communication. Symptoms of Anal Sac Problems Dogs and cats with anal sac disorders have symptoms of anal discomfort (these are more common in dogs):
Other problems, like parasites, fleas, and orthopedic pain, can cause some of the same symptoms. Types of Anal Sac Disorders The most common anal sac problem by far is impaction, in which an anal sac can’t empty on its own and material remains in the sac. Scooting the bottom on the floor and licking the anal area are typical symptoms. Impaction happens more often in small dogs than in large dogs or cats. The causes of impaction are not fully known. Many dogs go through their entire lives without ever having impacted anal sacs; others experience it regularly. Allergies, skin disease, and changes in stool consistency might make a dog more likely to have clogged anal sacs. Impacted anal sacs can become inflamed, a condition called anal sacculitis. Anal sacculitis causes painful, swollen sacs and often redness of the skin around the anus. Infected anal sacs can form abscesses. An anal sac abscess first appears as a painful swelling beside the anal opening. It may rupture through a skin wound that drains pus or blood next to the anus. Anal gland tumors are less common than impaction, inflammation, or infection. They can cause swelling, bleeding, or discomfort in the anal area. Treatment Veterinarians usually manage an impacted anal sac by gently expressing the material out of the sac. This process can be uncomfortable for the patient, especially if the material is too thick or dry to be easily removed. Some patients benefit from anal sac flushes or warm compresses applied to the anal area. Anal sac inflammation and infection are typically treated with antibiotics and pain relievers. The anal sacs can be surgically removed in patients with anal sac cancer or as a last resort for patients with other anal sac problems. (Surgical removal is not generally recommended for patients with simple anal sac impaction because of the possibility of complications after surgery.) What You Should Do If your dog or cat doesn’t have any symptoms of anal sac trouble and your veterinarian hasn’t found a problem, you don’t need to do anything in particular. There’s no need to change your pet’s diet or have the anal sacs expressed if they’re working normally. But be aware of the signs of anal sac impaction so you can have this uncomfortable problem taken care of before it becomes more painful for your pet. Photo by Sheri Hooley Laurie Anne Walden, DVM  Dr Ponce and Rocky Acupuncture, the technique of stimulating points on the body by inserting tiny needles through the skin, is being used more frequently to treat animals. Most scientific studies of acupuncture have been conducted in humans. However, the existing evidence in animals led the American Animal Hospital Association and American Association of Feline Practitioners to endorse acupuncture as a treatment option for chronic pain.[1]
Anna Ponce, DVM, and I recently sat down to chat about acupuncture in pets. Dr Ponce provides acupuncture services for dogs and cats and has completed the coursework and examination requirements for certification in veterinary acupuncture. (Interview has been edited for length and flow.) LAW: How did you decide to start doing acupuncture? AP: My biggest push to learn acupuncture was having geriatric cats come in with arthritis. Some of them have kidney disease, and there is just no good long-term arthritis medication for these cats. Acupuncture is one of the modalities that has been mentioned, so I decided to explore that avenue and see what I could do to help arthritic cats. And that really opened my eyes to so much more that can be done with acupuncture. What conditions do you think acupuncture helps the most? It can really help with any condition: heart disease, kidney disease, coughing, behavioral issues, anxiety. But I think what we know it most commonly for is arthritis. Which patients do you recommend it for, and how does it help them? For example, this morning I recommended it for a dog that has arthritis in her knees, elbows, back, and hips. She’s had x-rays, so we know arthritis is there. It took a long time to get her on the right combination of drugs to be comfortable, but she still has off days and I absolutely think she would benefit from acupuncture. Acupuncture has local effects like decreasing inflammation and pain, and it also helps get the body back in balance. Chronic issues are obviously going to take more time. Acupuncture is not going to make these issues disappear. It doesn’t miraculously make degenerative joint disease return to normal, but it definitely helps the pain and inflammation. [It helps the body release] serotonin, endogenous opioids, and beta endorphins. In my opinion, there’s not a pet that can’t benefit from acupuncture, even if it’s as a preventive measure. When would you not recommend it? I wouldn’t not recommend it for just about any patient, but the biggest consideration is whether the patient will tolerate acupuncture. Some dogs and cats fall asleep, they snore, they love their acupuncture, they look forward to it, they’re very relaxed. And then some patients are just not going to tolerate having needles placed in them. You would not want to put a needle through infected skin. You wouldn’t want to put a needle in a tumor because it would increase blood supply to that area. Certain points are contraindicated in pregnant dogs to avoid inducing labor. And you would not do electroacupuncture [delivery of electrical current through acupuncture needles] in a dog with seizures. But other than that it’s very safe. There’s really not a patient that I would say should not get it. It’s a matter of whether they tolerate it, which I feel most of them do. How do cats handle it? I have one cat patient who is very good for his acupuncture. He tells me when he’s had enough needles, so he dictates how many needles he gets. When he starts to meow a little bit and get a little twitchy, we’ve reached our limit, and then he walks into his carrier, lies down, and rests there [with the needles inserted]. Another cat that I treated really enjoyed it and just lay there the entire time, comfortable. Can you describe a typical acupuncture session? We use very tiny sterile needles that go in acupuncture points throughout the body. The needles are even smaller than insulin needles. I do a traditional Chinese exam along with my Western exam, make my traditional Chinese diagnosis, and pick acupuncture points based on that. A session might include 5 to 40 needles, depending on what I’m treating; it’s normally 10 to 20 needles. The time patients sit with the needles inserted could be anywhere from 10 to 40 minutes. Placement of the needles is based on meridians through which qi (chi), or energy, flows and where acupuncture points are located. The strongest points tend to be on the limbs, but those can also be more tender points for dogs and cats. So we often use more points on the back because they’re easier to access and they tend to not be quite as sensitive as the points on the limbs. When a needle’s inserted it causes a de-qi response, essentially a tingling or warming sensation, and sometimes a muscle twitch. I also use different modalities. Dry needling is insertion of the tiny needles. In electroacupuncture, we hook up electrodes to get higher stimulation. In aquapuncture, we inject vitamin B12 under the skin at acupuncture points to get a longer effect. How do you integrate acupuncture with Western medicine? I believe that they complement one another. I think that acupuncture can benefit the patient in ways that Western medicine can’t, especially with end-of-life comfort and pain relief. I definitely wouldn’t throw out Western diagnostics. Bloodwork and x-rays are very important and can help tailor your acupuncture treatment. I think the best type of medicine is an integrative approach, having them work together. Would you describe your acupuncture training? You have to be a licensed veterinarian to practice acupuncture [in animals], but you do not have to have a certification in acupuncture to practice it. Being certified shows that you have gone through the training and that you know what you’re doing. I took a 6-month course through the Chi Institute [of Traditional Chinese Veterinary Medicine] in Florida. The course is 150 credit hours in 5 sessions: 2 online lecture sessions and 3 on-site sessions including lectures and a hands-on lab. After you complete the sessions you take a 200-question written exam and a practical exam. The final requirements for certification are a 30-hour internship with a certified veterinary acupuncturist and submission of a case study of a patient that you have followed for at least 3 months. I’ve done all of the coursework and the test. Once my internship hours are finished and my case study has been approved, I’ll get my certification. Reference 1. Epstein ME, Rodan I, Griffenhagen G, et al. 2015 AAHA/AAFP pain management guidelines for dogs and cats. J Feline Med Surg. 2015;17(3):251-272. |
AuthorLaurie Anne Walden, DVM Categories
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June 2020
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