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Thursday, November 26, 2009


Today in the US was the holiday of Thanksgiving.  The origins are meant to celebrate how some of the original English colonists made it through a hard winter with the help of Indians and gave thanks afterwards. But nowadays it is mostly a time to get off work, eat a ton of food, hang out with family, and prepare for huge after-Thanksgiving sales in the stores.

We're also supposed to reflect on the things we are thankful for.  Many people find this difficult in the current economy, with job losses, lower pay, and less joy overall.  But I think if anyone tries hard enough, they can find something to give thanks about.

I'm thankful for God and His blessings.  For my beautiful and wonderful wife, who is endlessly patient with me.  For two great children who fill my life with joy and help teach me patience.  For a good job with great prospects.  For a healthy family and money in the bank (though barely so!).  For a father who has given me great guidance over the years and continues to be proud of me.

Everyone has different traditions on this holiday.  We do the standard ones of eating, spending time with family, and goofing off.  But a bit of a different sort of thing that we do in the Bern household is decorate for Christmas.  I take care of the lights and outside decorations while my wife makes things festive inside.  Yeah, I know we have a full month until Christmas, but we love the season so much that we can't wait to get it all up.

I hope that all of you can find something to be thankful for, and that you enjoy your own traditions.  Happy Thanksgiving!

Wednesday, November 25, 2009

A Cat's Dietary Needs

Clearing out my inbox, Jodi poses this set of questions about feline nutrition.

why does it seem that so few veterinarians are interested in nutrition?? I believe a cat is a carnivore .Isnt an ideal diet one that consists of high qulity meat, very little carbohydrate, and no grain? My mothers cat has struvite crystals and bladder stones......all he has eaten is good quality canned food and very little dry. the special diet the vet wants him to eat is garbage!
Since when do cats eat corn? and wheat? and by prodcuts and artificial (and toxic) preservatives?

Isn't there a way to feed him and acidifying diet that has good quality nutrition? Even if this diet gets rid of his problem how can it be good for him?? He'll be free of crystals but malnourished!

Thank you for any help or resources you may have,

Well, Jodi, nutrition is actually much more complicated that it may first seem, and many veterinary schools don't emphasize this particular topic enough (in my opinion).  I have done a lot of personal research on this in the last year because I realized the failings in my own knowledge.

You have to realize that pet food is a bit of a compromise.  Until someone is able to create and successfully market a cat food that is made up of ground whole rodents and birds, we won't be 100% accurate in replicating a cat's natural food.  And truthfully, do we want to duplicate the natural conditions of cats?  Pet cats live far longer, healthier lives than wild ones, and that is in part due to good nutrition.

However, I concede that the current diets are not always ideal.  Recent research has suggested and supported the viewpoint that our feline friends should have a "catkins" diet.  This means high protein and low carbohydrates.  A few studies have shown that this helps regulate weight, lean muscle mass, and blood sugar levels better than the typical foods.  However, the only way you're going to get the right balance of protein and carbs is in canned food.  Canned foods are more expensive and more hassle to feed daily than dry foods.  In order to make a food maintain it's shape and consistency as a dry kibble, you have to have more carbohydrates than might otherwise be ideal.  This is most commonly and inexpensively achieved through the ingredients of corn, wheat, and rice.

Now the first thing to realize is that corn and wheat are NOT poor nutrition.  Ground corn is actually very nutritionally dense, and is not filler.  I have consulted with several independent veterinary nutritional specialists to come to this realization.  No, it's not a natural part of the diet of a wild cat, but I doubt you're going to feed such a diet. When you're ready to go to the pet store and buy mice, hamsters, and small lizards to give to your cat as it's food, then we can talk about the realities of a "natural" diet.

Along a similar line, by-products are NOT bad.  Here's the official definition used by the Association of American Feed Control Officials (AAFCO), the organization that determines the nutritional requirements of all pet foods sold in America.
The non-rendered, clean parts, other than meat, derived from slaughtered mammals. It includes, but is not limited to, lungs, spleen, kidneys, brain, livers, blood, bone, partially defatted low temperature fatty tissue, and stomachs and intestines freed of their contents. It does not include hair, horns, teeth and hoofs.
Think about this for a minute.  In the wild, what do dogs and cats eat?  Do they eat only the muscle meat?  Nope.  They eat the entire animal, including organs and bones.  And that's exactly what by-products are! So you can in no way say that by-products are poor nutrition.  In fact, there are many important nutrients found in organs such as the liver that you can't find in muscle (what we normally term "meat").

Here are a few other probably little-known facts. 

AAFCO mandates minimal nutritional requirements in any pet food sold in the US, regardless of who manufactures it.  Now admittedly, the food company can meet these requirements by nutritional analysis rather than actually feeding it to pets.  Look on the label somewhere around the ingredients list.  If it says "tested" or words to that effect, then a nutritional analysis was made on pets actually fed the food;  "formulated" means a chemical analysis of the food was done without testing.  Testing the food is a better analysis of the quality than merely formulating it, though formulating can be acceptable if the company is good.

ALL cat foods currently on the US market will acidify the urine!  That is a legal requirement mandated by AAFCO.  Decades ago the incident rate of struvate crystals in cats was very high.  It was discovered that by acidifying the urine, we could help prevent formation of these crystals (which can lead to bladder infections and stones), and so it became a requirement of cat foods. However, there is another type of crystal, calcium oxalate, which will form in acidic urine!  And this type of stone is much harder to deal with than struvite.  So really, we traded a tendency for one kind of crystal for another one.

Crystal formation is also more complicated than merely the pH of the urine.  Many other things play a factor, including genetics, urine concentration, mineral intake, and so on.  There are some dogs and cats that will develop bladder stones despite the best diets and medications. 

So what can you do?  First, follow the vet's recommendations.  A pet with a tendency for these stones needs to be on a specific diet.  This may acidify the urine, but ideally should result in a moderate to slightly acidic pH.  If you get too acidic you can increase the risk of calcium oxalate stones.  You also want dilute urine.  This means that the food should be designed to promote drinking water (by slightly increasing salt content and therefore stimulating thirst) or by containing more water, such as in canned foods. 

I can assure you that by feeding these recommended diets the cat will NOT be malnourished.  We have many decades and millions upon millions of dollars worth of research to show that these diets give complete and balanced nutrition.  And it's not all done by food companies to promote their products.  Much of this data is from independent, government-sponsored, or university-sponsored research.  And even the data from the food manufacturers can't be discounted, as it is reviewed and studied by people outside of the food industry.  It's also in the manufacturers' best interest to have high-quality foods that promote healthy pets.

Hopefully this helps answer your questions, Jodi, and shows you some of the realities behind pet nutrition.

Tuesday, November 24, 2009

A Medical Mystery

Here's a truly bizarre case sent in by Erin. 

Okay, this is going to be kind of long so I apologize in advance. Let me just say first that we have had our 4yr old beagle, Daisy, to at least 11 different vets, including one internist in Jacksonville, FL as well as the vets at Auburn University's small animal clinic. Whew! :) Okay. After seeing all of those vets and endless tests we still do not know what's wrong with her. Here are her symptoms:

About every 3-7 days she'll have what I call an "episode" where out of the blue she'll start frantically licking the floor (or anything else), and swallowing in a very exaggerated manner. She'll make this sucking noise through her nose (not  reverse sneezing) and swallow more as if she can't get something down. She will also occasionally hack and cough up white foamy mucus and sometimes stomach contents. This can literally go on for HOURS. If we crate her she will lick anything she can get her mouth on, if we don't she'll eat fuzz off the floor that she wouldn't normally touch. If I hold her she'll just continue to lick the air or occasionally try and eat my hair. When she finally does settle down, usually from exhaustion, she'll wake up and cough a mucusy sounding cough occasionally. She's been examined by internists and we've talked to a neurologist and a behaviorist. Nothing....

Here are links to some videos that we took:

Anyway, on a normal day her breathing will sometimes sound congested and we're pretty sure she has allergies, although she hasn't been tested.

Tests we've done (all were normal):

Endoscopy (only throat and back of nasal cavity
Full blood panel (several times)
Throat Wash
Chest X-rays (several times)
Abdomen X-rays
Sinus X-rays (also looked at her throat)
Urinalysis and Fecal tests
Heartworm tests regularly

(I think that's it...)

Meds/things we've tried that don't work:
Many antihistamines (both prescription and over-the-counter)
Pepcid and Tagemet
Food Trials
Several Antibiotics
Anti-nausea meds (both liquid and a shot during one of her episodes)
Valium during an episode

(That's all I can think of right now)

What works (don't know why):
Giving at least 1 Temaril-P per day, every day
During an episode, letting her completely gorge, and I do mean gorge, herself on grass. Sometimes she throws it back up, sometimes she doesn't. But she'll eat it for as long as I'll let her for the most part, or until her belly is bulging.

So basically, no one knows what's wrong with her and we've been dealing with this since we adopted her two years ago. It's stressful and it makes me sad that she has to go through this. Anyway, all the vets we've seen are stumped and any advice you may have would be wonderful. I'm just trying to get as many opinions as I can, hoping that someone may have seen something like this before. The vets at Auburn want to do surgery and explore her stomach to see if she has a sliding hernia, but a)it's extremely expensive b)they're not even sure that's what she has, so it could be pointless and c)I just don't know if I want to put her through it if we aren't sure it will give us an answer.

Anyway, sorry this was so long. Hopefully you can make sense out of it! I greatly appreciate any direction you may be able to give.

Wow, Erin, that’s some problem!  And I hate to tell you, but I’m not going to be much help either.  But there are a few things that I can try to share.  First, if this many specialists at this many high-quality locations can’t figure it out, then I hate to say it but I’m concerned that you won’t find answers too easily.  Honestly, I can’t think of any problems I’ve heard of that has gone through this many doctors without being solved.

One of my first impressions on watching the video was of an unusual kind of seizure activity.  But from what you’ve stated here, this has been ruled out by specialists and anti-seizure medication.  And all of the other tests would rule out many of the other things I would consider.

Temaril-P is medication mostly used for allergies.  It is a combination of a steroid and an antihistamine with the two of them working synergistically.  I do have one question, though.  You said that antihistamines alone don’t help.  Have you tried prednisone by itself?  I would suspect that it would help, which may indicate that this is an inflammatory process.  The inflammation could be caused by allergies or by some other situation.  If steroids help, they may the only solution that helps even a little.  As much as we don’t like to use them long-term, sometimes we have to.

Sorry I couldn’t give you a better answer, but you’ve already been to some of the top people in the field.  Good luck.

Monday, November 23, 2009

Sore Throat

Matt sends this in,

The last couple of days my dog has been yelping out of nowhere, and when she barks it is a bark that quickly turns to a yelp.  We removed her collars thinking it was maybe constricting her throat but in the last day she has been less active and just lays around yelping occassionally.  She still has an appetite but you can tell that it is difficult for her to swallow.  Is there anything we can do to cause her to expel the object and help it's way down the rest of the way if you feel it is indeed an object in her airway?

If there was something truly stuck in her throat, she likely wouldn't be eating, or would have more difficulty breathing.  Honestly, "stuck in the throat" is a common concern of clients but is a rare occurence.  She could have laryngitis or a similar inflammatory process in the esophagus or trachea.  It may also be a problem in her neck, with the muscles being sore or a partially slipped disc in the neck.  In these cases, any sudden movement of the head or neck can cause pain.

I definitely recommend taking her to your vet as soon as you can.  This is something that needs to be seen in-person, and your vet can help figure out exactly what is wrong.

Saturday, November 21, 2009

Reverse Sneezing

It's common for vets to get clients concerned about a strange coughing/sneezing/hacking/wheezing in their dogs.  It's a scary thing to watch, as it seems like the dog can't breath, and people worry that they might die or have severe problems.  Most vets, myself included, have actually gotten pretty good at duplicating the noise as we try to figure out what the problem is.  But now I can go one better.  Here's a video...

This condition is called reverse sneezing, and it's just like the name implies.  It's basically a sneeze that goes backwards in the throat rather than forward out the nose.  Anything that irritates the nasal passages can potentially trigger it, such as allergies, dust, strong odors, or even rapid movement of air through the nose.  As disconcerting as this may seem, it's really a harmless condition.  If it happens frequently, talk to your vet about using antihistamines to help.  If it's infrequent, you really don't have to worry about it.  Some people have advocated holding the nose closed to force the dog to breathe through the mouth, which will stop the sneezing.  This method has debatable effectiveness, and I don't normally recommend it.

The main thing to keep in mind is that this is a harmless condition that doesn't cause any long-term effects.


Thursday, November 19, 2009

The Joy Of Play

There's a video making it's rounds of the Internet that you may have seen.  A lecturer at the conference I attended last week had it in his presentation, and my father sent it to me today.

This is incredibly adorable and cute!  But I think it reminds us how important play is.  As adults we get so bogged down in our work, bills, and life troubles.  We wish we could be as free as our kids, and marvel at how much they enjoy playing.  Don't we forget to play enough? How many of us can just revel in the sheer joy of the moment?  We forget what even animals know.  As part of my degree in animal behavior I studied play behaviors.  One thing that surprised me is how universal certain stances and actions are across mammals.  Wide eyes, open mouth, a lowered front end, and a raised hind end indicate a desire to play in many different species.  Play is actually universal, and can be witnessed in many different kinds of animals.  Why do adult humans have to be the exception?

So take some time today to play.  You may not have a mud puddle to jump in, but you can find something.  Enjoy the day!

Wednesday, November 18, 2009

Skeeter Update

Back in July, I received a question about a very strange case (you can review it here).  Last week I received this update from Denise.

I am sure you remember me, I have the cat 'Skeeter' and you ran a post on her and helped me when her wrists had broken down.  I wanted to update you.  Skeeter deserves to be on the show Medical Mysteries.  

When the 8 kittens went to kitten food, I had them on Purina One Chicken and Rice Kitten.  At about 6 or 7 mos old I believe, could have been sooner, I switched them to Diamond Naturals Kitten food.  If you recall she was about 10 mos when I noticed the wrists breaking down. 

A few months later I switched her and all my others back to Purina One Chicken and Rice.  The second week of October (she was at this time 13 mos old) I noticed she was not toeing in so much and that her wrists were straightening out.  I attached two photos taken the 13th, showing how they were straightening out on their very own.  Today they are almost perfect, I need to get updated photos. 

We did not go for surgery or any treatment and she has not been spayed even.  With my daughter having a baby we opted to hold off, more monetary wise than anything and hoping to get her to CSU when we move back to Denver.  Skeeter's wrists broke down even more in August and September and I was really getting worried about her legs and healthy lifespan.  But wham, all of a sudden they fixed themselves.  Nothing else has changed, I am not sure if the food is what caused it and corrected it with switching back or what happened.  Maybe a calcium deficiency in the Diamond?  I would think that Diamond beats Purina in nutrition but my cats have always done very well on it, healthy, happy, super shiny coats, and now the mystery cure for her. 

One thing I am so glad about is, that I did not have the money for surgery and we were forced to wait, or we probably would have had he go through the surgery. She would have had both front legs fused for life and the problems that probably would have come later from the surgery, and for nothing.  Her legs just keep getting stronger.  Right
now I suppose it is a mystery if they will stay corrected, but it so far it appears they will.  She is back to retrieving and playing like she did prior, she is back to herself.  She is a beautiful cat and this is just amazing.

Do you have a clue?   I am just so elated and was so stoked when I noticed they were correcting them self.  So bizarre but a true blessing!

That is certainly a strange situation.  Purina ONE is a good food, and the Purina company overall does good nutritional research.  But I don't think it would be significantly different than Diamond, which is also a good food.  I doubt it was a single deficiency in the food, as you would notice it with your other kittens.  Also, a severe calcium deficiency would have resulted in more problems than dropped wrists.  Honestly, I think that they probably healed on their own as she continued to grow and develop.  A very, very odd case! I sometimes tell clients that pets will get better in spite of us rather than because of us.  In the end, I'm not bothered by this as long as the pet is better.  Keep me updated on Skeeter!

Monday, November 9, 2009

Oh, My Achin' Butt

It's time for continuing education again, something that most professionals have to do. Once or twice each year I go to a conference to learn about new developments or procedures in veterinary medicine, refresh my memory on things I thought I knew, and get free stuff from the various vendors. It can be very interesting and educational, but most of us run into a common problem...butt fatigue.

You see, most vets are pretty active people at work. We're going from room to room and case to case. On our busiest days we may never sit down and may not even have time for a lunch break. Our minds are having to shift gears every 10-20 minutes as new patiets come in, hospitalized patients get discharged, or lab results become available. Mentally and physically we're pretty much on the go for the whole workday.

Now take a normally active person and make them sit in a chair for 1-2 hours at a time for an entire 8 hour day. Ouch! Even in the most engaging lecture I'll find myself getting bored and restless. My hind end starts to literally hurt and I'm shifting positions to keep comfortable. In one of my lectures this morning we didn't have a break for an entire 2 hour period. For someone who is normally moving around a lot, this is a minor form of torture.

But we get through it. My colleagues and I know that we have to go through this to keep ourselves informed about current medical trends and information so that we can be the best doctors possible. I guess it makes us appreciate those days when our feet hurt instead of our behinds.

Friday, November 6, 2009

No Longer "Swine" Flu

The spread of the H1N1 influenza virus, commonly called swine flu, has been a bit of a panic for many people world-wide. Back in September I blogged about the flu, and said that pets couldn't get it.  I made that statement because at the time there was no evidence of that.  I now have to change that opinion. 

Here in the US it has been confirmed that at least one cat became sick with H1N1, though it survived.  Several ferrets have been confirmed to contract it and died.  This last fact is not surprising, as ferrets are very susceptible to human influenza viruses.  But the fact that a cat contracted it is more concerning.

Viruses can mutate to change and affect different species.  The virus we now call parvo mutated from the feline panleukopenia virus to be able to affect dogs.  Now only canines can get parvo even though is started as a strain of feline disease.  HIV mutated from a monkey disease to affect humans.  Avian flu has changed to be able to affect species other than birds.  And now H1N1 is affecting species it has never been seen in.

As scary as this may seem on the surface, I would caution people not to panic.  In the recent cases of this cat and the ferrets, the pets acquired the disease from their owners, not the other way around.  And these are extremely isolated cases, the only ones documented so far.  However, if the disease goes one way it can also go another, so a risk of transmission from pets to people is not impossible.  Sick pets should be taken to see the vet, but any human risk is extremely low.  Be cautious, but don't be overly concerned. 

Thursday, November 5, 2009

Too Easy Tech?

My associate vet told me about a rather strange situation that happened to her.  When her husband looked at their cell phone bill, apparently there was $80 in songs downloaded to her phone.  She had no idea how this had happened, as she didn't do it herself.  After some investigating they realized that their 16 month-old daughter had done it!  Apparently if you hit the "Select" button on her phone three times in a row, you've gone through the proper menus to order a song.  So their little girl was playing with the phone and by simply pressing buttons had ordered dozens of songs!  Her mother didn't even know how to do it!

My kids are older, 6 (almost 7) and 8, and they have been able to use the camera on our cell phones for a few years now.  It took them no time at all to figure it out, and we had to disallow them from playing with the phones because my wife and I would sometimes find odd pictures or videos on our phone.  These kinds of things come naturally to this generation, and it almost seems like they were born with a BlackBerry in their hands. 

This is a generational thing, and completely natural.  I know that I have always been far more tech-savvy than my parents.  I remember when my parents got a new RV and my father was trying to figure out how to set the clock on the microwave.  By the time he looked and found the instructions in the manual, I had simply looked at it, figured it out, and set the proper time.  With the speed of technological development nowadays it can be hard for adults to keep up.  But the kids grow up around this and find it easy and expected.  My kids have never known a time when cell phones, laptops, satellite TV, and video games didn't exist. 

Thankfully I'm a bit of a geek and technophile, and I can still surpass my kids.  However, I'm waiting for the day when I get a new holographic projector and while I'm perusing the instructions my son just walks up and gets it running. 

Wednesday, November 4, 2009

Rockwilders and Datsuns

One of the things I have to sometimes snicker and shake my head at is the way that many people butcher the names of certain breeds.  It's even more amusing and pitiful if the client actually owns that breed!  And having practiced in many parts of the country, I can't say that it's localized to one region. I can somewhat understand that people may have a problem with some names, as many breed names are from countries that don't have English as the primary language.  But these people usually are completely confident in what they call the breed and are completely ignorant of the proper name.  Let me give you some examples....

Rottweiler--I commonly hear them called "rockwilders", which butchers the name in so many ways.
Dachshund--I've heard both "datsun" and "dash-hound"
Shih-tzu--Oh, don't get me started on this one!  "Shit-zoo", "shee-zoo", and so many other mistakes.

I'm sure there are others that I haven't heard or just can't recall.  Really, it gets humorous until you realize that the people are completely serious.

Anyone have other examples of breed names you've heard people mess up?

Monday, November 2, 2009

Leave The Horses Alone

So this month's poll is finished, and it probably isn't too surprising.

It is acceptable to slaughter horses for food:  18%
It isn't acceptable:  66%
Not sure:  15%

As I mentioned when the poll began, eating meat has a cultural bias.  What might be perfectly acceptable in one country would be completely abhorent in another.  In this case, eating horse meat is considered common and even a delicacy in many parts of the world, including parts of Europe.  In the US I bet there are many people who aren't even aware that this goes on, let alone that there is a controversy.  Because of the bond that Americans have with horses and the importance that these animals have had in the development of our country, it would be strange for most people to consider killing them for food.

Now, my discussion hinges on humane treatment of these animals, including housing and slaughter.  I know that this doesn't always happen, and I am against that as well.  But I also realize that many animals exist in their current breed or state merely because we humans decided that they were a food source.  We have selectively bred them for better meat, and keep them in existence solely for that purpose.  Humans have always eaten meat, and most always will.  That doesn't mean that we can abuse these animals, but should try to avoid most discomfort for their brief lives.

So those of you who are against horses as food sources, I would be interested to hear your views.  Feel free to express them in the discussion.

Oh, and a new poll is now up!