As the weather cools down and the holiday season approaches, keep an eye out for potential hazards for your pets.
 
Halloween, Tailgating, and Other Fall Festivities
You probably already know that chocolate isn’t safe for pets. Other potentially dangerous foods that pets can get hold of during autumn festivities include xylitol (sweetener in some candies and store-bought baked goods), raisins, onions, garlic, raw yeast dough, and alcohol.
 
Corncobs, candy wrappers, and decorations are choking hazards and can also get stuck in the digestive system if they’re swallowed. If you want to give your dog corn, use corn kernels instead of cobs (and no salt or butter). Glow sticks and glow jewelry contain a liquid that tastes bitter and can cause drooling, gagging, and vomiting.
 
If you dress your pet in a Halloween costume, use one that has no dangling strings and doesn’t interfere with your pet’s vision and mobility. Also think about your pet’s comfort: does your pet actually enjoy wearing a costume, or do you need to either skip the costume or leave it on just long enough for a photo?
 
During trick or treating, keep your pets safely away from the open front door. Make sure their microchip information is up to date in case they escape. Strangers in costumes can be scary for animals, and some pets react to doorbells.
 
Outdoor Hazards
Autumn crocus (Colchicum species) is toxic to animals. If swallowed, it can cause vomiting, digestive tract bleeding, liver and kidney damage, and seizures. Chrysanthemums are mildly toxic and might cause vomiting, diarrhea, or stumbling gait. Most mushrooms are safe but some are deadly, so keep your pets away from all wild mushrooms.
 
Compost piles and leaf piles can contain toxic molds. Leaf piles might also harbor rodents, dangerous objects, and bacteria, so take care before letting your dog jump in them.
 
While camping or hiking, keep dogs on leash so they’ll stay on trails, away from hunters and most wildlife (including snakes). It’s a good idea to wear bright colors for visibility during hunting season. Some dogs need to wear clothing for extra warmth. Dogs that aren’t used to camping might be startled by campfires. Use commonsense fire safety precautions to protect pets from sparks and embers, and keep them away from fire starters and chunks of wood that could pose a choking hazard.
 
Change of Seasons
Some kinds of antifreeze are deadly to animals; pets can be exposed as their families prepare cars, boats, and campers for the winter. Mothballs can cause vomiting, liver and kidney damage, and red blood cell damage if swallowed. As the weather changes and fields are harvested, rodents are on the move and might enter houses. If you need to remove rodents from your house, use nontoxic methods like traps. Rodenticides (mouse and rat poisons)—and rodents that have been killed by these poisons—are highly toxic to dogs and cats.
 
Back to School
When kids head back to school, pets are at increased risk of exposure to medications for ADHD (attention-deficit/hyperactivity disorder). In dogs and cats, these stimulant medications can cause hyperactivity, restlessness, tremors, vomiting, and diarrhea. As respiratory viruses spread, pets are also at risk of exposure to cold and flu medications, many of which have ingredients that are dangerous for animals. Watch out for lunch boxes; grapes and raisins cause kidney damage in some dogs.
 
Image source: https://unsplash.com/photos/white-and-brown-long-coat-small-dog-on-brown-dried-leaves-during-daytime-WakdTA5ZqqU

Mange is skin disease caused by infection with mange mites. These tiny parasites cause skin inflammation, hair loss, and (sometimes) itching. Some types of mange are contagious to people and other animals. Mange is much easier to treat than it once was; some prescription flea, tick, and heartworm products are also effective against mange mites.
 
Signs
Mange looks very similar to skin disease caused by allergies, fleas, bacterial infections, or yeast infections. Animals with mange often have bacterial or yeast skin infections at the same time. The signs of mange depend partly on the type of mange mite involved, but these are the most common:

• Patches of hair loss
• Reddened skin
• Scaly or crusty skin
• Oozing skin sores
• Itching

 
Diagnosis
Mange is diagnosed by using a microscope to look for mites in skin scrapes or other samples. Mange mites can be hard to find, so skin scrapes can have false-negative results. Blood tests for some types of mites are available.
 
Treatment
In most cases, mange is treated with prescription flea, tick, and heartworm preventives like moxidectin, selamectin, fluralaner, afoxolaner, and sarolaner. These medications are available as spot-on topical products, chewable tablets, or injections. Because these medications are so effective against mites, they are often begun when mange is suspected but mites aren’t found on skin scrapes. Older treatments include lime sulfur dips and amitraz dips (dogs only).
 
Types of Mange in Dogs
Sarcoptic Mange (Canine Scabies)
Sarcoptic mange, or scabies, is caused by Sarcoptes scabiei. These mites are highly contagious to humans and other animals. Scabies is very itchy. Affected dogs usually also have bacterial and yeast skin infections. If untreated, scabies can cause severe generalized infection. Because scabies is contagious, all dogs in the household need to be treated.
 
Demodectic Mange (Demodicosis)
Demodex mites (usually D canis) live in the hair follicles of almost all dogs and usually don’t cause a problem. These mites are transferred from mother dogs to newborn puppies, but they are not contagious to people or other animals. Although D canis mites are benign in most dogs, they can cause 3 types of mange.

• Localized demodicosis: a few isolated scaly hairless patches, usually on the face or front legs, most often in dogs younger than 1 year. About 90% of these cases get better with no treatment; about 10% progress to generalized demodicosis.
• Juvenile-onset generalized demodicosis: severe skin lesions affecting much of the body and the feet, usually along with signs of general illness (fever, loss of energy, etc), in dogs younger than 1 year. In puppies, generalized demodicosis is caused by a genetic defect of the immune system, so affected puppies should not be used for breeding.
• Adult-onset generalized demodicosis: the same type of skin lesions as the juvenile form but first appearing in dogs at least 1 year old. In adult dogs, generalized demodicosis is usually caused by cancer or another disease that suppresses the immune system.

 
Types of Mange in Cats
Notoedric Mange (Feline Scabies)
Scabies in cats is caused by Notoedres cati. As with scabies in dogs, this type of mange in cats is contagious and intensely itchy.
 
Demodectic Mange
Like dogs, cats normally carry Demodex mites without any problem. Two types of Demodex mites cause 2 different forms of demodectic mange in cats.

• D cati lives in the hair follicles (like D canis), is not contagious to other animals, and causes either localized or generalized skin disease. Mange caused by D cati usually means that the cat has an underlying disease suppressing the immune system.
• D gatoi lives on the surface of the skin and is contagious to other cats, so all cats in contact with the affected cat need to be treated.

 
Image source: https://commons.wikimedia.org/wiki/File:Dogmangeeee.jpg

Coyotes live in Charlotte, as you know if you’ve seen one or heard them singing at night. Although coyotes can pose a risk to people and small pets, there are steps you can take to avoid conflict and keep your pets safe.
 
The tips in this post are from 2 excellent resources that have lots more information about coyotes: the Urban Coyote Research Project (https://urbancoyoteresearch.com/) and the North Carolina Wildlife Resources Commission (https://www.ncwildlife.gov/species/coyote).
 
Remove Coyote Food Sources
Coyotes that find food where people live are rewarded by coming near people and lose their natural fear of humans. These coyotes can become a danger to people and pets. Coyotes are omnivores: they eat prey animals (mostly rodents but sometimes bigger animals), fruit, and other food items they scavenge.

• Don’t feed coyotes or use coyote bait stations.
• Feed your pets indoors; don’t leave pet food outside.
• Secure your garbage cans.
• Make sure there is no food in compost piles that could attract rodents or coyotes.
• Keep bird feeder areas clean and use feeders that keep seed from falling on the ground (seed on the ground attracts rodents).
• Clear away fruit that has fallen from fruit trees.

 
Keep Pets Secure

• Keep cats indoors.
• Keep dogs indoors, on a leash during walks (no running loose), or outdoors only with supervision, especially little dogs.
• For dogs that must be outdoors unsupervised, use a fence that is (relatively) resistant to coyotes: more than 6 feet tall with a ground barrier to prevent digging underneath and a roll bar across the top.
• Automatic or remotely activated outdoor lights might deter coyotes from your yard.
• Keep your pets’ rabies vaccinations current.

 
Don’t Run From a Coyote
If a coyote comes near you, be an intimidating human: make noise, wave your arms, and throw something at it. Don’t run away or crouch down.
 
Leave Coyotes Alone
Coyotes that are just doing normal coyote things and avoiding people aren’t a cause for alarm. Don’t approach them or harass them; respect them and don’t create conflict. Coyotes can’t be rehabilitated legally in North Carolina, so if you see one that seems orphaned, sick, or injured, leave it alone.
 
Report Dangerous Coyotes

• Coyotes that show no fear of humans or show signs of aggression (snarling, growling, or lunging) are dangerous. Coyotes can also carry rabies.
• If you see a potentially dangerous coyote, contact Animal Control, the NC Wildlife Resources Commission (which has jurisdiction over coyotes in North Carolina), or a licensed wildlife control agent.
• Find a list of licensed wildlife control agents on the NC Wildlife Resources Commission “Have a Wildlife Problem?” web page: https://www.ncwildlife.gov/connect/have-wildlife-problem.

 
Image source: https://www.flickr.com/photos/santamonicamtns/35970298854/in/photostream/

Your pet has swallowed an object, something toxic, or medication intended for another animal or a person. Should you try to make your pet vomit? Here are the short answers:

• Cats: NO
• Dogs: maybe

 
If your pet has been exposed to something that might be dangerous, seek veterinary advice before giving any treatments at home. Call your veterinarian’s office, a local emergency clinic, or an animal poison control hotline:

• ASPCA Animal Poison Control: 888-426-4435
• Pet Poison Helpline: 855-764-7661

 
Animal poison control services have a consultation fee, but calling is usually well worth the cost because their consultants are veterinary professionals with extra training in toxicology and access to specialized information.
 
Cats
None of the products that might be used to induce vomiting at home are safe for cats. All of the possible home remedies given by mouth (like hydrogen peroxide) can severely damage a cat’s esophagus and stomach.
 
At the veterinary clinic, we use injectable drugs to induce vomiting in cats. These drugs have some additional effects, like sedation, that need to be monitored and possibly reversed with other medications. Cats don’t always vomit even after receiving these drugs, so they might need other decontamination methods. The veterinary joke (we love cats so we tease them where they can’t hear) is that cats vomit when you don’t want them to but don’t vomit when you do want them to. Still, injectable medications given at a clinic are safe and usually effective for inducing vomiting in cats.
 
Dogs
The only vomit inducer that can be given by mouth and is safe for dogs (in some cases, not all) is 3% hydrogen peroxide. It’s sensible to keep a fresh bottle of peroxide on hand if you have a dog. But don’t use it unless a veterinarian tells you to. Making an animal vomit can be dangerous:

• Irritating substances and sharp items can damage the esophagus on the way back up.
• Some items are a choking hazard when they come back up.
• Liquids, especially oils, pose a risk of aspiration pneumonia (from being inhaled into the lungs) if they are vomited up.
• Animals that are drowsy/sedate or have impaired neurologic status are at risk of aspiration pneumonia if they vomit.
• Brachycephalic (flat-faced) animals are at increased risk of choking and aspiration pneumonia if they vomit.
• Hydrogen peroxide at too high a volume or too high a concentration (greater than 3%) can irritate the esophagus and stomach.
• Vomiting won’t remove the item or toxin if it has moved out of the stomach into the intestines, so the window of time to induce vomiting might have passed.

 
Never give a dog salt, syrup of ipecac, oil, or mustard to try to induce vomiting; these are all unsafe for dogs. Don’t try to induce gagging by putting a finger or object down a dog’s throat—it’s not likely to work and would put you at risk of being bitten.
 
To induce vomiting in dogs at the veterinary clinic, we use drugs given by injection or as eye drops. Dogs that receive these drugs need to be monitored and might need other medications to reverse the effects.
 
Image source: https://unsplash.com/photos/selective-focus-photography-of-dog-lying-on-ground-uKtvYMGe8ls

A heart murmur is an abnormal whooshing heart sound. A heart murmur isn’t a diagnosis of heart disease; it’s a clinical sign showing that something has made blood flow within the heart turbulent. Some of the things that cause heart murmurs are benign and don’t need treatment. Others are serious conditions that can lead to heart disease and heart failure.
 
Causes
Anything that alters the flow of blood inside the heart can cause a murmur. Leaky heart valves (flaps that control blood flow between heart chambers) and disorders of the heart muscle are the most common causes of murmurs in adult dogs and cats. Examples are mitral valve degeneration, usually in older dogs or inherited in Cavalier King Charles spaniels, and hypertrophic cardiomyopathy in cats. Anemia—“thin” blood with a low red blood cell count—can also cause a murmur because of the change in blood consistency.
 
Young puppies and kittens sometimes have congenital heart murmurs, which are murmurs present from birth. These murmurs are usually benign and disappear on their own as the animal grows. However, some congenital murmurs are caused by structural defects of the heart or the large blood vessels around the heart, and these defects can have severe consequences if they aren’t (or can’t be) repaired.
 
Signs
Heart murmurs are usually heard for the first time during routine wellness examinations in animals with no signs of heart problems. Early diagnosis and treatment improves the prognosis for animals with heart disease, so listening to the heart with a stethoscope is a crucial part of the annual examination.
 
Heart murmurs are graded according to their loudness, ranging from barely audible to so loud they can actually be felt with a hand placed on the rib cage. The loudness of a murmur doesn’t necessarily correspond to the severity of the condition that caused it (serious conditions can cause quiet murmurs).
 
These are some signs of heart disease and heart failure:

• Coughing
• Labored breathing
• Lack of energy
• Swollen belly
• Blue or purple gums
• Fainting or collapse

 
Diagnosis
The best way to identify the source of a heart murmur is with an echocardiogram, an ultrasound study of the heart. An echocardiogram, usually performed by a veterinary cardiologist, shows the shape of the heart valves, thickness of the heart muscle, blood flow within the heart, and measures of heart function.
 
Chest radiographs (x-ray images) can be used to diagnose heart disease once the disease has progressed to the point of changing the size and shape of the heart chambers. A blood test that can be used to screen for heart disease is the concentration of NT-proBNP (N-terminal pro–brain natriuretic peptide), a substance released by heart muscle cells in response to excessive stretch and strain.
 
If your pet has a heart murmur, start monitoring the sleeping respiratory rate. An increased sleeping respiratory rate can be a sign of heart disease. Wait until your pet is asleep, count the number of breaths (each rise of the chest) in 15 seconds, and multiply by 4 to calculate the number of breaths per minute. A sleeping rate of more than 35 breaths per minute or a rate that’s increasing over time warrants a visit to your veterinarian.
 
Treatment
Treatment depends on the cause of the heart murmur and whether the animal has heart disease. Heart disease is treated with medications and possibly prescription diets. Dogs and cats don’t get coronary artery disease (plaque in the arteries) like humans do, so the treatments and dietary recommendations are not the same for animals as they are for humans with heart disease. All animals with murmurs, whether the cause is serious or thought to be benign, need regular monitoring (sleeping respiratory rate, veterinary examinations, and possibly follow-up echocardiography) so changes in heart function can be identified and treated promptly.
 
Image source: https://unsplash.com/photos/a-brown-and-white-dog-sitting-on-top-of-a-wooden-floor-OktYfwY5ZQI

Pets that are traveling need to meet regulations set by individual countries and states. Meeting the travel requirements and completing the paperwork takes time—several months in some cases—so start preparing as soon as you know your pet will be traveling.
 
The USDA Animal and Plant Health Inspection Service (APHIS) regulates animal transport into the United States. The regulations are complex and subject to change, but the APHIS website has lots of information to help pet owners. Always check the APHIS website before you plan your pet’s travel: https://www.aphis.usda.gov/pet-travel
 
Some veterinary clinics and pet owners use pet travel concierge services to help navigate the rules and work out the time frames for everything that’s needed before international travel. Some countries require specific procedures performed in a specific order during a specific time window before an animal enters the country. Figuring out what needs to be done and when is especially complicated when an animal will be traveling to (or through) more than one country.
 
If your pet will be traveling, the steps you’ll need to take depend on the animal and the travel origin and destination:

• Type of animal: pet or other category
• Travel out of the United States to another country (export)
• Travel into the United States from another country (import)
• Travel between US states or territories (interstate travel)

 
This article summarizes the information on the APHIS website as of November 15, 2024.
 
Type of Animal
Animal import and export regulations are not the same for pets as for animals in other categories (like livestock and poultry). APHIS defines a pet as a companion animal that is privately owned, not intended for research or resale, and in one of these groups: dogs, cats, ferrets, rabbits, rodents, hedgehogs/tenrecs, reptiles, amphibians, and some (not all) birds. More information is on this page: https://www.aphis.usda.gov/pet-travel
 
Travel to Another Country
For international travel, pets must meet the requirements of the destination country. Typical requirements include a health certificate, vaccines, parasite treatments, and laboratory tests. The type of animal might also be regulated; for example, the United Kingdom bans certain dog breeds. Airlines and shipping lines might have additional requirements.
 
Dogs that return to the United States after traveling to certain countries must also meet the CDC’s dog import requirements (see this page: https://www.cdc.gov/importation/dogs/index.html).
 
APHIS recommends the following steps:

• Find the requirements of the destination country on this page (requirements change, so check every time you travel): https://www.aphis.usda.gov/pet-travel/us-to-another-country-export
• Find a veterinarian accredited by the USDA to issue health certificates for pets.
• Know the type of pet, the destination country, countries through which your pet will travel (to clear customs, for example), the date of departure, and how your pet will be traveling (alone, as cargo, or with a person).
• Read the details about submitting health certificates on this page: https://www.aphis.usda.gov/pet-travel/us-to-another-country-export/pet-travel-guidance-pets-traveling-another-country-united  

 
Travel Into the United States
Requirements for entry into the United States depend on the type of animal, the country from which the animal is traveling, the federal agencies involved in regulation of that species, and the US state or territory that the animal will be entering. Dogs that are returning to the United States after a trip out of the country must meet all import requirements. APHIS lists import requirements according to type of animal on this page: https://www.aphis.usda.gov/pet-travel/another-country-to-us-import
 
Interstate Travel
APHIS doesn’t regulate interstate pet travel, but individual states have their own import requirements. For example, South Carolina requires dogs, cats, and ferrets entering the state to have a Certificate of Veterinary Inspection (valid for 30 days) and proof of a rabies vaccine. North Carolina requires dogs, cats, and ferrets to have a current rabies vaccine but no longer requires a Certificate of Veterinary Inspection. Links to each state’s requirements are on this APHIS web page: https://www.aphis.usda.gov/pet-travel/state-to-state
 
Image source: https://unsplash.com/photos/a-white-dog-sitting-on-a-rock-formation-near-a-large-mountain-pond-915UJQaxtrk

Medications used to treat attention deficit disorder and attention deficit hyperactivity disorder (ADHD) are commonly prescribed for humans, so pets are at risk of accidental exposure. Swallowing even a small amount of these medications can cause severe and possibly life-threatening problems for animals. However, most animals recover if they are treated promptly.
 
If your pet has chewed or swallowed an ADHD medication, contact a veterinary clinic or animal poison control hotline right away:

• ASPCA Animal Poison Control: 888-426-4435
• Pet Poison Helpline: 855-764-7661

 
Types of Medications
Most ADHD medications are stimulants that increase levels of neurotransmitters (chemical messengers) in the brain. These medications typically contain either amphetamines or methylphenidate.
 
Amphetamines and methylphenidate are controlled substances. They are in legal prescription medications used to treat ADHD and narcolepsy and are also in some illegal drugs.
 
These are some brand names of prescription drugs that contain amphetamines or methylphenidate:

• Adderall
• Concerta
• Desoxyn
• Dexedrine
• DextroStat
• Evekeo
• Focalin
• Methylin
• Ritalin
• Vyvanse
• Zenzedi

 
Illegal drugs that contain these substances include crystal meth, ecstasy, and methamphetamine.
 
Signs
In dogs and cats, amphetamines and methylphenidate cause problems with the nervous system, heart, lungs, and digestive system. These are some of the signs:

• Hyperactivity
• Pacing
• Restlessness
• Agitation
• Tremors
• Increased heart rate
• Increased body temperature
• Panting
• Drooling
• Vomiting
• Diarrhea

 
Treatment
Animals with amphetamine or methylphenidate exposure usually need to be hospitalized at a 24-hour facility. Treatment includes decontamination (removing or inactivating drug that’s still in the stomach, if possible and safe for the animal), medications to treat the neurologic and cardiovascular effects, and supportive care such as intravenous fluid therapy and body temperature regulation.
 
If your pet has swallowed one of these medications, don’t try to induce vomiting at home unless a veterinarian has instructed you to do so. Making a pet vomit is not safe in some situations, depending on the species (don’t give peroxide to a cat!) and the pet’s clinical signs.
 
Image source: https://www.pexels.com/photo/adorable-yorkshire-terrier-in-autumn-leaves-29056473/

Injury of the cranial cruciate ligament in the knee is a common cause of hind limb lameness in dogs. Surgery is often the best treatment option.
 
The cranial cruciate ligament is one of the main structures that stabilizes the knee joint. This ligament is called the anterior cruciate ligament in humans. In humans, injury to this ligament is usually caused by trauma, especially while playing sports. In dogs, cranial cruciate ligament injury is more often caused by long-term, gradual degeneration that results in a partial or full ligament tear.
 
Some of the factors involved in cranial cruciate ligament degeneration in dogs are age, knee conformation, genetics, and body weight. Because these factors affect both knees, many dogs with a ligament tear in one knee develop the same problem in the other knee within a year or two.
 
Many dogs with cranial cruciate ligament injury also have a torn meniscus in the knee. The meniscus is a cartilage pad that provides cushioning between the femur (upper leg bone) and tibia (lower leg bone). A torn meniscus is painful. A meniscal tear can happen at the same time as the injury to the cranial cruciate ligament or much later as a result of knee instability.
 
Cranial cruciate ligament injury causes knee arthritis. The rate of progression of the arthritis partly depends on how the cruciate ligament injury is treated (with surgery or with medical management alone), meaning how soon the knee joint is stabilized.
 
Signs
A sudden full tear of the cranial cruciate ligament causes significant lameness; dogs are often unable to bear any weight on the affected leg. The signs of partial ligament tears and chronic ligament degeneration are less obvious. In these cases the lameness might improve with rest but doesn’t entirely disappear. Meniscal tears can cause a clicking sound in the knee joint. Arthritis resulting from chronic cruciate ligament injury eventually causes thickening of the knee joint.
 
Diagnosis
Full cranial cruciate ligament tears can often be diagnosed during a physical examination with tests that reveal instability in the knee joint. However, dogs are sometimes too tense (because of knee pain) for these tests. X-ray images sometimes show evidence of cruciate ligament rupture and can also help rule out other possible causes of the lameness. Partial tears and meniscal tears are harder to diagnose and are typically found with advanced imaging techniques or seen during knee surgery.
 
Treatment
Cranial cruciate ligament injury is treated either surgically or with medical management alone. The choice of treatment for an individual dog depends on the type of injury; the dog’s size, age, activity level, and state of health; and the owner’s preferences and financial resources. For dogs with a complete ligament tear, surgical treatment followed by physical rehabilitation usually yields the best functional result.
 
A number of surgical options are available and are typically performed by a veterinary surgery specialist. The torn ligament can’t actually be repaired, so the goals of surgery are to stabilize the joint and remove damaged (painful) parts of the meniscus. Some surgical techniques change the biomechanics of the knee joint by cutting into the tibia to adjust the way the large leg muscles attach to the front of the knee. Other techniques use suture material to mimic the function of the cranial cruciate ligament. All surgical options require strict exercise restriction for several weeks to a few months after the procedure.
 
Medical management involves exercise restriction and anti-inflammatory medication. Physical rehabilitation and custom orthotics, or knee braces, might help some dogs. Weight management is crucial for overweight dogs with knee ligament injuries.
 
For more information about treatment options, see the American College of Veterinary Surgeons website: https://www.acvs.org/small-animal/cranial-cruciate-ligament-disease/
 
Image source: https://unsplash.com/photos/yellow-labrador-retriever-puppy-lying-on-white-textile-biW4WcdmZyA

A hands-on physical examination is a valuable part of annual wellness visits as well as sick-animal visits. Examinations during wellness visits often uncover problems that weren’t obvious at home. That is the point of a wellness exam: we want to find problems early, before they become more serious and harder to treat. Wellness exams also let us track an animal’s changes over time. For sick animals, the physical exam is a crucial part of the diagnostic workup.
 
Not all veterinary visits involve a full physical exam. Recheck visits typically include assessment of only a single area (like the ears). And high-volume, limited-service settings like vaccine clinics generally don’t offer full physical exams.
 
A veterinarian can often complete a physical exam within a few minutes, so you might not realize how much information your veterinarian is gathering by looking at, touching, and even smelling your pet. The following basic assessments are part of a comprehensive physical examination.
 
Breathing effort, mental status, posture, gait, general appearance, and reaction to clinic environment: The veterinarian assesses these elements before ever touching the animal. These items are clues to the urgency of a sick animal’s condition and also tell us an animal’s overall state of health, basic neurologic status, and anxiety level. If an animal without an urgent medical problem shows signs of significant fear and anxiety in the clinic, the veterinarian might stop the examination at this point and recommend returning another day with previsit antianxiety medication.
 
Temperature, pulse, and respirations (TPR): The TPR is part of the standard vital sign assessment, along with mucous membrane color and capillary refill time (assessed with a quick touch of the gums). Some animals object to rectal thermometers, and other types of thermometers aren’t always accurate, so the veterinarian might skip temperature measurement for a well animal.
 
Eyes, ears, nose, and oral cavity: Dental disease is very common in dogs and cats, and external ear disease is common in dogs. These problems are often first noticed during wellness exams. The veterinarian might or might not use an ophthalmoscope and otoscope to examine the eyes and ears, depending on the animal’s clinical signs and comfort level (inserting an otoscope into an inflamed ear canal could be painful).
 
Chest: The veterinarian listens to the heart and lungs with a stethoscope to check heart rate and rhythm, identify abnormal heart sounds like murmurs, and assess lung sounds.
 
Abdomen: Gentle palpation of the abdomen can reveal discomfort and possibly abnormal size of individual organs.
 
Musculoskeletal system: The veterinarian assesses muscle mass, especially in senior animals that might have arthritis, and checks the joints for common problems like patellar luxation. Animals that are limping receive a more comprehensive orthopedic examination including range-of-motion tests of multiple joints unless this would be too painful without sedation.
 
Skin and lymph nodes: The veterinarian looks for external parasites like fleas, evidence of itching (saliva staining of the paws, for example), hair loss, signs of skin infection, skin lumps, mammary gland masses, and enlarged lymph nodes. Skin problems are very common in dogs and cats and often turn up during wellness examinations. Many skin problems need further diagnostics, such as looking at a sample of cells through a microscope.
 
Neurologic system: For well animals with no signs of neurologic disease, the veterinarian assesses basic neurologic function and mental status. A more comprehensive neurologic examination includes tests of nerve function of the head and limbs. For animals with neck or back pain, the veterinarian carefully palpates the spine to pinpoint the location of the pain.
 
Urogenital system: Male dogs that have not been castrated have their testicles checked. They might also have rectal palpation to evaluate the prostate. Female dogs and castrated male dogs get a quick glance at the external genitalia and receive a more thorough examination if they have signs of a problem.
 
Image source: https://www.flickr.com/photos/armyrotc/52943246855/

Tracheal collapse causes a chronic dry cough that sounds similar to a goose honk. The disease tends to get worse with time. Tracheal collapse can’t be cured, but for most patients, medical treatment reduces the severity of the cough. In the most serious cases, tracheal collapse interferes with breathing and requires emergency care.
 
Tracheal collapse can affect dogs of any breed but is most common in small-breed dogs like Yorkshire terriers and Pomeranians. It’s rare in cats.
 
Cause
The trachea (windpipe) is a tube held open by rings of cartilage. In animals with tracheal collapse, the cartilage rings soften and become weakened over time. The cartilage rings lose their ability to hold the trachea open and the trachea flattens during breathing or coughing, blocking the flow of air.
 
The severity of the signs depends on the percentage of airway that’s blocked. The signs also partly depend on the location of the affected section of trachea: outside the rib cage (in the neck) versus within the rib cage.
 
In dogs with tracheal collapse, coughing is made worse by pressure on the neck, excess weight, stress, excitement, exercise, respiratory irritants like smoke, and respiratory infections. Some dogs with tracheal collapse also have abnormalities of the larynx and the bronchi (airways inside the lungs). Chronic coughing causes airway inflammation, which in turn leads to more coughing.
 
Tracheal collapse and heart disease are both common in middle-aged and older small-breed dogs, so many dogs have both diseases at the same time. Both diseases cause coughing and exercise intolerance. Figuring out which disease is most responsible for the cough can be a bit of a diagnostic challenge.
 
Signs

• Harsh, dry, honking cough
• (Possibly) a cough that gets worse with pressure on the neck or with exercise
• Wheezing
• Exercise intolerance
• Blue or purple gums caused by low oxygen level (medical emergency)
• Collapse or fainting (medical emergency)

 
Diagnosis
Tracheal collapse is suspected on the basis of the patient’s history, the sound of the cough, and physical examination findings. A definite diagnosis is made with imaging studies. Radiographs (x-ray images) sometimes show a collapsed trachea and are also used to evaluate heart size and the appearance of the lungs. In many dogs the trachea collapses only on inhalation or only on exhalation, so fluoroscopy—an x-ray “movie”—can reveal collapse that doesn’t appear on radiographs. Tracheoscopy is examination of the inside of the trachea and bronchi with a fiber optic camera in an endoscopy tube. An advantage of tracheoscopy is that it allows samples from inside the trachea to be collected for laboratory analysis; a disadvantage is that it requires general anesthesia.
 
Dogs with tracheal collapse might have bloodwork to assess their overall condition, especially if they are older or have concerning clinical signs. Because the signs of tracheal collapse and heart disease overlap, dogs with suspected or known heart disease also benefit from echocardiography to evaluate heart function.
 
Treatment
Tracheal collapse isn’t curable, so medical treatment needs to continue for life. Medications chosen for an individual patient might include cough suppressants to break the cough cycle, corticosteroids to reduce airway inflammation, bronchodilators, and antianxiety medications or sedatives to reduce stress. The choice of medication can change over time as the dog’s disease progresses.
 
Nonmedical management is crucial for dogs with tracheal collapse and includes the following:

• Weight management
• Use of harness instead of leash and collar
• Elimination of respiratory irritants like smoke and scented air fresheners

 
Surgical procedures like tracheal stent placement are available for dogs with severe signs. However, surgical options don’t cure the underlying tracheal problem and might not eliminate the cough.
 
Image source: https://unsplash.com/photos/a-small-dog-standing-under-a-wooden-bench-HSs4t4TWPFg