Causes Of Vomiting

Back from the Thanksgiving holidays and back to answering questions.  Here's one from Megan.

My name is Megan. I started following your blog about two weeks ago and have found it entertaining as well as informative, so first of all thank you for writing. I was wondering if you might answer a question for me. I have a 2 year old long haired female kitty who used to have seizures at least twice a month (I did take her to see a vet about this) but since I moved to an apartment 6 months ago and made her a 100% indoor cat, she hasn't had a single seizure since. She's been a picture of health til a few days ago when she started vomiting frequently. The vomit looks like mushy cat food. There doesn't seem to be much else in it. She does not appear to be over eating, and has otherwise been herself. I would take her to a vet, but at the moment my husband and I can't afford it, and I'm not even sure it's something to be worried about... Is it?

Megan, the short answer is to have your kitty checked out by a vet.  Unfortunately, vomiting is one of the most common symptoms we see and can indicate numerous problems, from serious to simple.  But let's see if we can narrow down things a little bit.  Three things come to mind based on this limited information:  gastric foreign body, inflammatory bowel disease, and dietary indiscretion.  

Some things can become lodged in the stomach or small intestine without causing a complete blockage.  This can be irritating to the gastrointestinal tract, leading to vomiting.  However, most foreign objects in the GI tract cause more serious illness than simple vomiting, and it doesn't sound like your kitty is that sick.  So I would put this lower on the list but not rule it out.

Inflammatory bowel disease (IBD) often rears its ugly head as frequent vomiting.  Most commonly this is an inflammatory process secondary to a food allergy.  There is no specific test for this other than surgical biopsy (sometimes endoscopic biopsy will be sufficient), so we end up running tests to rule out other problems and then look for a response to therapy.  This therapy is normally a combination of steroids and hypoallergenic foods, and often requires life-long treatment.

Dietary indiscretion is a fancy medical phrase that means "eating things they shouldn't".  Cats are notorious for getting into plants, garbage, and other things around the house.  Look around your home and see if this might be a possibility.

Sorry this wasn't much help, but if this doesn't stop soon or if your cat acts sick, I would recommend a vet visit, planning on the possibility of blood tests and x-rays.  Good luck!

Flexibility Is Important

Some stories you just can't make up.

Yesterday I saw a couple and their yorkie puppy.  The owners were, shall we say, rather "stout".  Normally I wouldn't mention this, but it's an important mental image to keep in your head.  It was a pretty routine exam and vaccines on a healthy puppy.  On the previous exam my associate hadn't felt the puppy's testicles, so I paid particular attention to this particular area and gladly told the owners that both were present.  Since we were in that area, the wife asked me about the "dumbells" on his genitals.

Now I need to interrupt the story for a little anatomy lesson.  Male dogs have erectile tissue at the base of their penis called the bulbus glandis.  This is a normal structure and can enlarge with any excitement, whether it be sexual, play, or just about anything.  The true function is to act as a "knot", allowing the male to "lock" with a female during intercourse.  The male inserts into the female and the bulbus glandis enlarges, locking him into a position inside her.  This allows him to stay inside longer, prolonging the amount of sperm and keeping another male from mating right afterwards.

One of the most interesting things about all of this is that once the male is locked, he swings his body around so that he is butt-to-butt with the female, while staying inserted!  It looks something like this....

While it seems a bit strange to us, this is normal in all canines, increasing the chances that the male will fertilize the female.

Back to the story....

I was explaining that the "dumbells" were the bulbus glandis and then described what it was and it's purpose.  I ended up describing the locking of the male and female, with the male ending up facing away from the female without coming out.  The wife gets a wide-eyed expression, turns to her husband, and says, "Dadgum!  Why aren't you that flexible?"

My jaw dropped as I struggled to save myself from the suddenly awkward situation.  We moved on to other topics, but I must say that was a mental image I certainly didn't want to have.

Making The Boys Cry

It's never easy when you have to euthanize pets, especially when the owners cry in front of you.  And for whatever reason, it seems to be harder to see men cry than women.  Today I had opposite ends of the age spectrum of owners do this.

The first one was an elderly man on Social Security and a limited income.  His cat had had a decrease in appetite and was acting a little lethargic.  When I examined the kitty he was very sweet and purring, but had a noticable jaundiced appearance to his skin and gums.  This usually indicates a liver problem, but can also indicate red blood cell destruction.  Since this was a very obese cat who had lost 6 pounds (24 to 18 pounds) in a month, I was very worried about a serious and potentially deadly condition called fatty liver syndrome.  Because the owner didn't have much money we ended up euthanizing to keep the cat from suffering.  As we were talking about it and doing it, there were tears running down the man's face. 

The second one was later in the afternoon when a mother and her sons brought a hamster in.  I quickly saw that he had a large tumor around his testicles and rectum and a smaller but still worrisome tumor on his left hind leg.  There wasn't anything we could do, so I started gently talking about euthanizing him.  Before I actually came out with the words one of her sons started crying.  He was 10, the same age as my own son, and obviously taking it hard.  While crying he said he didn't want to do it, so I gave the mother some time alone in the room and she explained to him how this was better.  Thankfully the end was quick and painless for the hamster.

After both of those I felt pretty rotten.  I realize that in both situations we did what was best and most humane for the pet and the owners had every right to grieve.  That knowledge and assurance still didn't make me feel any better and I hated seeing the naked emotions.  But it's not the first time I've dealt with either circumstance, so I can make it through.

These are the human interactions that many vet students and new vets aren't prepared for, but will regularly be faced with.  We perform merciful actions and help ease animal suffering, but at the same time we are "causing" tears in the owners.  It's a sad necessity. 

Tomorrow I'll share a rather amusing comment that happened between these cases and kept the day from being a complete downer.

Does Major Matter?

Ashley sent this in...

I am interested in becoming a vet and am wondering if i should major in Biology or Zoology?  Many people have given me different answers to this question, but i don;t know what to believe.  Which one is a better Undergraduate course for someone who wants to become a Veterinarin?

First just a few caveats and disclaimers.  I am only familiar with US veterinary colleges and even with the 28 we have there can be differences in the entrance requirements for one over another.  The best thing to do is to check with the school or schools that you are considering and see what their specific needs are.  Also, search back through my blog (search box on the top left) and you can see other responses to questions about getting into veterinary school that might help with any other questions you have.

I honestly don't think your major matters in the least.  In my experience the vet schools don't actually look at your major itself.  They have specific courses that they require, many of which may not be obviously applicable, such as calculus.  The admissions office looks at whether or not you have those courses, as well as your GPA in them, rather than looking at your major.  Most vets I know had a Biology, Zoology, or Animal Science undergraduate degree.  But I've known people with majors in teaching, computers, chemistry, English, media/publishing, and so on.  From everything I've seen it really doesn't matter what your major is as long as you have the appropriate classes.  For the record, I have a Bachelor's in Biology.

When you're getting to something as small as a difference between Biology or Zoology, look at what each major requires and how many classes for vet school you can get in each.  I would recommend picking whichever major already includes the most pre-vet classes.  If it's pretty much the same, pick whichever you find more interesting, which in the case of someone going into veterinary medicine would probably be Zoology.  Personally I've always been bored by botany and much of ecology, so you may be able to avoid some of those classes with a Zoology  major.  But in the end the decision is up to you, and I really don't feel that one of these majors is going to be "better" for getting into vet school than another.

I hope this helps, Ashley.  Best of luck!

Aqua-geek

Any regular reader of this blog will know that I am a big geek.  Being a vet is pretty much what I do to support my other interests as well as my family, and those interests are usually geek-related, involving sci-fi, fantasy, comic books, and so on.  Just look back through this blog for my annual attendance at Dragon*Con in Atlanta, Georgia.

One of my favorite comic book characters is Aquaman.  I've always loved the idea of being able to swim underwater and communicate with animals.  I also enjoy the stories told about him and have followed him through his various incarnations in comic books and animations.  When I was younger I did competitive swimming and often used Aquaman as my inspiration, pretending I was him when I was practicing or simply playing in the pool.  I was excited when his new comic book started (with the entire reboot of DC comics) and have really enjoyed the story and art so far.  I have several Aquaman action figures and plushes, and have even gotten into minor arguments with friends about how awesome Aquaman is.

Earlier this year I found a site called the Aquaman Shrine, written and updated by a true Aqua-fan.  One of the things he does is maintain a fan designation called "F.O.A.M.", which stands for "Friends Of AquaMan".  To achieve F.O.A.M. status you must send in something unique and Aquaman-related.  It can't be simply a picture of an Aquaman action figure, or a website with an Aquaman hoodie, as those are common.  It has to be something new, obscure, unique, or otherwise different.  And today I earned my F.O.A.M. membership!

I love comic strips (the "educational" section of the newspaper, as my father calls it) and read most of mine on GoComics.com.  One of my favorites is Thatababy, which frequently has geek-related themes, but is funny even without that.  Today's comic is what caught my attention.

I sent that in to Rob, the webmaster of Aquaman Shrine, and he sent me my F.O.A.M. membership certificate!

So now I proudly claim the title of "Friend Of Aquaman", Aqua-fan, and geek!

Modern Pet Ownership

For the last few days I've been treating a very sweet mastiff for sudden kidney failure.  She didn't respond to any treatment and her kidney had completely shut down, so today we euthanized her.  But her medical condition isn't the focus of my blog today.

Yesterday I learned that the ownership was a little bit complicated.  The owner and his ex-wife had apparently included their dogs in the divorce settlement.  They didn't have children and really loved their dogs, so they officially and legally had joint custody of the dogs.  All of this came to light when each owner came to check on their dog individually and told me about the situation.  They were both involved in her decisions and were talking to each other, but lived separately.

Today when we euthanized her the man was there with his current girlfriend.  When it was time to give the injection the girlfriend left while the ex-wife came in to be present when we did it.  Once it was over she left and the girlfriend came back in.  All-in-all it was one of the stranger situations I've been a part of, and seemed very much like situations I've heard of when ex-spouses have to come together over the illness of their child.

I guess this is a reality of modern pet ownership and something we may see more of.  Pets are increasingly a part of our extended families and people feel very strongly about them.  When people separate there can be as much disagreement over the pets as there is over the car or house.  This can also make it challenging to vets as we may have to deal with situations like this that we are not trained for and have to deal with more complicated decisions over their pets' well-beings.  

I'm certainly not looking forward to dealing with a joint-custody situation where the co-owners disagree on what to do.

Financial Impacts On Medicine

World-wide there are financial crises, from the persistent recession in the US to the near-default in Greece and with several other European countries not far behind.  We hear about these issues on the news but I'm not sure if we always realize the trickle-down impact such economic problems can have.

Veterinary medicine is certainly not exempt.  There have been many articles in veterinary journals over the last few years about the significance of economic downturns on the way we practice medicine and the clients that we see.  Many people are out of work or "under-employed" and have less money to spend.  This usually means that their pets come in less often and they do less care, sometimes with serious consequences.  For several years now overall veterinary visits have been on the decline, especially with cat owners.  And that was the reason for my latest poll.

This time I asked questions of each group of readers differently.  For pet owners I asked whether or not they had spent less at the vet in the last 12 months.  The results showed that 29% (16) said "Yes", 63% (35) said "No", and 7% (4) weren't sure.  My veterinary readers were asked if they had seen less spent at their clinics in the last year.  Seventy-six percent (16) said "Yes", 14% (3) said "No", and 9% (2) weren't sure.  As usual, this is a very unscientific poll since my readers are likely skewed towards the better pet owners, and there wasn't anything physically keeping owners from answering as vets and vice-versa.  Still, I think the results can tell us some things.

Most vets said that clients were spending less, yet most clients (at least here) said that they didn't spend less.  So there appears to be a discrepancy between what clients think and what vets think.  Though as I said the data here are likely skewed, this does seem to reflect other studies that show differences in how vets and clients perceive the care that pets are receiving.  And despite what some clients may think, other studies and polls show that pet care and veterinary visits are declining.  What's interesting is that overall spending on pets is increasing some, which means that people are spending more money on pet supplies but not on veterinary care.  To me this is the wrong emphasis for clients to make.

I think that this poll also gives a little insight into this blog's readership, though that wasn't originally the intent.  There were 21 respondents who classified themselves as vets and 55 who said they were clients.  Some of the "vets" may include students or techs, but there are still quite a lot of readers in the profession. 

So in any case, make of the numbers what you will.  And while I do agree that when money is tight spending should be focused on the human members of the family first, we also don't want to forget proper care on our fuzzy, feathered, and scaled friends.

Please Come In!

Here's something I can't emphasize enough:  If you have any concerns about your pet, take them to a vet!

Today I saw a cat that I spayed last Saturday.  By Monday the incision had started to slightly open at one end.  The owner looked on the internet and determined that it wasn't anything she needed to be worried about and that it was normal to do this.  Today she brought the cat in because the incision had become infected and was looking rather nasty.  Luckily, the abdominal wall was still in good shape and a cat spay incision is pretty small, so with some antibiotics and time she should be fine. However, she should have brought the cat in much earlier.

Later in the day I vaccinated a kitten.  A couple of hours later the owner called, worried that her kitten was having a reaction to the vaccine because it's eye was closed.  We recommended bringing her back in, though it didn't sound like a typical reaction based on her description.  When we rechecked her it was obvious that she wasn't having a reaction and had some hair in her eye.  A little saline flush and she was fine.  But this way we could be sure to document the incident and make sure there wasn't anything serious going on.

I am always quick to tell my clients that if they ever have any concerns, come in and let us take a look at their pet.  I would rather they take the time to come in and us tell them that there isn't anything serious than to have them wait it out and something worse develop.  It's always better to see a problem early when it's easier to treat.

People also need to be very, very careful about advice they seek on the internet.  And yes, I say this having had a blog for three years that involves giving advice and recommendations.  If the first client above had not listened to something on the internet maybe she would have brought her cat in sooner.  No matter what you say, read, or do, there is no way that something found via a computer can take the place of a skilled vet actually looking at the pet.

I know that many people don't want to take their pet in for something trivial, pay the office visit, and then be told that there's really nothing wrong.  But take it from me, there are times when someone comes in for something "simple" and it turns out to be anything but.

If you get nothing else from my blog, remember this.  Any time you have any concern about your pet, go in and have a vet take a look.  NOTHING takes the place of doing this.

Getting Ready For Winter

Here in the northern hemisphere we're gearing up for winter.  Some parts of the US have already seen an unusually early snow storm, though it won't be the last.  As the weather cools down and snow and ice loom we have to take a look at how we care for our pets.  Which brings us to this question from Sam.....

My dog refuses to wear booties but NEEDS a daily walk even in winter. My friend swears that using Vaseline on his paws before a walk will protect them from ice balls and salt. I would wipe them off after the walk but am not sure how safe this is. What would you advise a client regarding Vaseline? Also, when is it too cold. Anything below 0•F?

First, just to point out to everyone, the pads of a dog's feet can be very sensitive.  Yes, as they age the pads thicken but we still have to be concerned about their feet, especially in cold weather.  The traditional salts used to de-ice driveways and sidewalks can be very irritating to the skin and can cause gastrointestinal upset if swallowed.  In sub-freezing temperatures you can also get damage from ice due to the severe cold, or irritation from balls of snow and ice getting trapped in the fur between the pads and toes.  So these are legitimate concerns.

I really like using booties for dogs, as they are specifically designed to protect the paws against many different kinds of irritants or damage.  Rescue dogs often wear them when going into areas of rubble and debris.  But I do realize that some dogs simply won't tolerate them.  The first thing I'd do, Sam, is work with your dog with the booties.  Put them on and let him stay in the house.  Give him praise and a treat if he lays there without trying to take them off.  If he starts walking around without problems, give him more rewards and treats.  Most dogs can become accustomed to booties, but it's not natural to them so it's common for them to try and get them off.

If this doesn't work, you can try the Vaseline.  Personally I've never heard it used this way, but this and other petrolium jellies are pretty harmless, even if swallowed.  Some of my readers may have more experience using it this way and could give opinions.  But I certainly don't think that it would hurt, even if he swallows small amounts.

As far as being too cold I think it depends on the dog and the temperature.  Certainly anything below freezing can potentially be dangerous, and the farther you get below freezing the greater the risk increases.  I don't think that most dogs should be left outside for long periods of times in sub-freezing temperatures.  The breed is also important, and the coat of a dog like a Siberian husky is going to be more protective that that of a chihuahuah.  The size of the pet is also important, as larger pets have a smaller surface area to body weight ratio, enabling them to maintain their body temperature more easily (this is why you tend to see larger animals in the Arctic and smaller ones in the desert).  So a small short-haired dog would suffer adverse effects more quickly than a large thick-coated dog.  Use your best judgement, but I do realize that most dogs need to go outside at least a little bit each day, even in cold weather.

Getting A Start

Caitlin emailed me the following....

I am 17 and a junior in high school. I have always had a love for animals and I've dreamed of becoming a veterinarian since I was in elementary school. I have shadowed at my local veterinary hospital and volunteered with animal rescue groups. What advice do you have for a high school student wanting to pursue a career in this field? I know that I still have another year before starting my undergrad in pre vet, but what can I be doing now to ensure I have the best chance possible to get accepted into veterinary school? Also, any idea what jobs are typically offered at animal hospitals for my age group?

Good questions, Caitlin.  Do a search on my blog, as over the years I've talked about various aspects of getting into vet school.  You can find the information here, as well as what life is like as a vet which may influence your decision.

The number one bit of advice that I would give is exactly what you're looking to do.  Get a job in a veterinary clinic.  There is simply no better way to get an idea of what it's like to be in the field than to work alongside a vet.  You get to see the often long hours, hard decisions, cases that go bad, and the rewards that can go along with the hardships.  You can also talk to the vets one-on-one about their specific paths and what they like and dislike about the job.  And you get to see if you can really handle the blood, pus, diarrhea, and other gross things.

Depending on where you live state laws limit what you can do as a minor.  You are limited to how many hours you can work and what kinds of things you can do.  For example, in my state you are not allowed to assist in taking x-rays if you are under 18 years old.  A veterinary clinic is also unlikely to hire an inexperienced teenager into an important or skilled position, which means you may start out as a receptionist or helping clean kennels.   And there's nothing wrong with these jobs!  My first job was working for my local vet as a kennel worker, cleaning cages and walking dogs.

Truthfully, any work you do prior to being in college isn't going to be looked at during the veterinary school admission process.  At this point you need to focus on whether or not this is really the career path you want.  You still have several years before you will even think about applying to vet school, so use this opportunity to explore the field and talk to vets about what career options you have within the various aspects of veterinary practice.

Again, do research, get ANY job in a veterinary clinic, and ask lots of questions to the vets around you.  Best of luck!