Greenies Safety

Tiffany asked a very good question...

I was doing some research about the chewy Greenies. I have already given my 2 dogs these chewies for the last week. I have a 6 year old winnie dog (male) and a 5 year old basset hound Blossom (female). Both dogs LOVE them!

But last night/today Gir was severely constipated and I'm worried perhaps its the Greenies? I have seen alot of bad press reguarding the Greenies but most of the damning reviews are from years ago and not so many either way in recent years. I read that the company did change their formula and supposedly that "corrected" some of the issues. I did read where you allowed a Greenie to soak overnight and it did dissolve. So that's slightly setting my mind more at ease about it.

I just ordered another 36 Greenies for my Basset hound and now I'm on the fence wither I should continue to allow them to consume them.

In your opinion as a veterinarian, I understand fully you havent seen or examined my animals, do you think the "new formula" Greenies are OK for dogs as long as they dont swallow them whole? I'm just getting conflicting opinions from my vet, the internet and friends.

Personally and professionally I'm a big supporter of Greenies.  They are one of the most effective methods of tartar control other than brushing the teeth and are considered safe.  The safety concerns started about 7-8 years ago and involved cases where dogs died or required surgery because of obstructions.  In all of these cases the dog had swallowed a large piece of the Greenie rather than chewed it into small pieces.  At the time the treats didn't dissolve easily, resulting in serious intesintal blockages.  This was absolutely a problem with the treats.  However, it involved a very, very small minority of dogs who used the treats.  I don't remember the actual number of cases, but it amounted to significantly less than 1% of the millions of dogs who were given them.  Though it was a legitimate risk and was talked about a lot in the media, it was actually not a wide-spread issue.

Because of these events Greenies changed their formula to make it easier to dissolve.  As I mentioned in the previous blog post I have personally seen it soften and break apart easily after soaking overnight in plain water.  Since that I have not seen any reports in the trade journals, newsmagazines, or even anecdotally of obstructions due to Greenies.  In my opinion and based on what I've seen (or not seen, as the case may be) the change in formula worked.

Pets should always be supervised when given chew toys and treats.  These things are designed to be chewed on gradually, not swallowed in chunks.  ANY toy or treat can cause a problem if a large section is ingested, so you should be very aware of your individual dog's chewing habits.  Dogs who are likely to swallow rather than chew shouldn't be given any treat like this.

A general warning for any pet owner...be very careful what you read on the internet, especially on message boards.  Snopes.com is filled with details on various urban legends, especially emails that are passed around or posted on Facebook.  If someone sends you one of these chain emails or messages, always check Snopes first because odds are it's false.  In relation to pets you can find tons of reports of various foods or products causing pet deaths, serious illness, and so on.  In most of these cases the reports are overblown and are not a real concern. I've personally seen messages from people saying that "hundreds of pets have died!" but when you look at the FDA/USDA reports it turns out it was maybe a dozen and most of those were probably not related to the product people are worried about.  Always check around to various sources and ask for specific examples rather than a blanket statement of "I know someone who heard that a friend of theirs read a report...."  Then look at the true incidence compared to the number of pets who use such products.  Also keep in mind that many of these web pages or posters have a very personal vendetta against a product or vet and are griding their axe.  They may have a valid concern, but understand where they are coming from and why they are reporting the information.  Heck, take anything I say with a grain of salt!  I'm fully confident in my comments and firmly believe in having evidence to back up my opinion, but I'm not infallible and I don't know everything.

Tiffany, I hope this helps!

Dog 1, Pants 0

I deal with difficult patients on a daily basis and it's just part of the job.  But sometimes we get pets that really seem to go out of their way to be especially frustrating.

Today I had a young Rottweiler, about a year old, in for a neuter.  He wasn't aggressive but didn't seem like he had been trained and was extremely resistant to any restraint.  Vets and our staff are trained in safe and effective restraint techniques that work for us most of the time.  But this dog wasn't having any part in that!  We couldn't hold him still to even collect blood for pre-anesthetic testing.

But the worst part was when I attempted restraint.  I'm stronger than most of my staff so I end up holding pets that others can't handle.  I got him into one of my almost sure-fire grips and then he started to struggle.  His back leg landed on my inner thigh and he started to push and squirm.  His claws dug into my pants and leg and I ended up not being able to hold him.  I made the decision that rather than continuing to fight against him we would give him a sedative to knock him out enough to collect blood and place a catheter.

That's when I noticed my pants.  His struggles had split the seam on the inside of my thigh, leaving a large gap several inches long.  It was high enough on my leg that if I wore boxers you'd be able to see the Batman logo.  This was less than an hour into my day!  There was no way I was going to be able to make it through the day potentially flashing my clients.

Thankfully we are located next to a Target store.  Between morning appointments I ran over there and quickly bought a new pair of pants.  Thankfully there were no more "events" and the second pair of pants made it through the day without incident.

This kind of problem is exactly why I never wear nice clothing to work.

Q & A With A Vet

Recently I was contacted by a new web site, Jobstr.com, about doing questions and answers about the veterinary profession.  The site is set up to have representatives of various careers (police officer, teacher, investment banker, gentleman's club manager, etc.) available to answer questions about their jobs.  Really, it's not that different than what I've been doing for the last almost four years, but is geared more towards "what the job is like" than fielding case-related questions.  

So far I've been getting some good questions, different than what I have gotten here.  Since the answers are short it isn't really taking much time to do, so I'll continue to blog here.  But check it out and feel free to ask questions there.

Jobstr Veterinarian Q & A

Dogs Snacking In the Litter Box

Shirley emailed me with this question...

I have three cats and one dog. I feed all of them Iams food, as well as pet-intended treats, but not to excess. I also have two cat litter boxes that are cleaned each day. You probably see where this is going ;) . Why, in the name of all that’s not gross does Star-the-dog insist on snacking from the litter box? Everyone is at a healthy weight and has no medical problems for which they’re being treated. Is it just a case of “she’s a dog, and that’s what dogs do.”? 

This is actually a very common situation and one many pet owners face.  That includes me!  The litter boxes are in our laundry room and we keep a baby gate in the doorway to keep our dogs out of the "kitty crunchies".

One of the first things we have to remember is that a dog's palate is different than ours.  Things that make us gag just thinking about them are absolutely delicious to a dog.  Their taste buds are oriented to things like raw flesh and organ meat, so while few of us would dream of dining on raw intestines and liver, dogs are designed to be drawn to these things.  They are going to find many things tasty that we are repelled by.

Feces contain quite a lot of ingredients.  Besides the obvious waste, there will sometimes be food particles that pass through without being completely digested (something we've all witnessed in our own toilets with corn kernels).  Such undigested or partially digested food becomes more prominent if a pet has intestinal absorption issues or enzyme deficiencies, or if the pet is being fed more than their body needs.  Certain ingredients may also give a stronger odor as they are passing through, and these odors can be attractive to a dog.  If a dog is hungry or the odors are "good" enough, they will take to snacking on other animals' feces.

Additionally, feces are used for scent marking.  Dogs and cats have glands on either side of their anus that produce very malodorous secretions and are normally expressed onto the stool during a bowel movement.  Taste and smell are very closely connected, so licking or chewing something with a scent mark can be a way of getting a more detailed examination of the substance.

There are several ways to try and curtail this behavior.  First is to do something similar to what I do and keep the dog from having access to the feces.  Making sure there are no health problems and you aren't over-feeding is the next step, and it sounds like you have both of these situations covered, Shirley.  Lastly there are products you can get from your vet that are food additives which will make the feces less appealing.

In the end, though, the short answer is very much along the lines of "she's a dog and that's what dogs do."

Record-Breaking Stone? Almost.

I take out several bladder stones each year, and it's come to be a pretty routine and fun surgery for me.  I've posted about these before (here and here) and normally don't want to repeat myself.  However, this case was pretty remarkable and worth sharing.

Most stones that I remove are pretty small, no more than a centimeter or so in diameter.  You can see pictures of typical sizes of stones in the above links.  But this one was quite different.  The patient was a 100 pound Rottweiler that we started seeing this year.  Way back in February she was having bloody urine problems and we felt a possible mass in the abdomen.  Antibiotics resolved the issue then, but during exams for other issues over the last few months we kept noticing an abdominal mass.  The owners always declined doing x-rays.  Earlier this month she started having severely bloody urine and antibiotics didn't help this time.  I was convinced that she had a bladder stone and finally the owner agreed to radiographs.  Lo and behold, there was a large stone!  And thankfully they agreed to the surgery.

All of this is pretty typical.  But the size of the stone wasn't.  Here's a picture during surgery (don't worry, only a little gross).

There was only one stone, and it was rather big.  The bladder wall was also extremely thickened and inflamed, much thicker than a normal bladder.  That wasn't too surprising considering that this stone has been sitting there rubbing against the inside of the bladder for at least 4-5 months.  

Here's a better photo to appreciate the scale, with the stone cleaned up.

Yes, this came out of a dog's urinary bladder! Is it any wonder that she was having bloody urine?  And just for fun here's a picture of what it looked cut in half.

The analysis of the stone showed that it was mostly struvite, which is the most common stone type I see.

All of that is very interesting and this was a really big stone.  But it's actually not the largest one I've removed!  About nine or ten years ago I removed one from a dog that was flatter and had a larger diameter.  Instead of filling up most of my palm it covered my entire palm!  Unfortunately I took that out long before I had a digital camera so I don't have any pictures of it.  It was pretty amazing, though!  And to this day, that remains my record urinary stone.

Repeat After Me: "I Won't Change Inuslin Without Permission."

Sometimes I wonder why people come to a vet in the first place.

Earlier this week my colleague received a call from a vet who was boarding a patient of ours.  The cat had recently been diagnosed as a diabetic and had just started on insulin injections.  The vet was calling because the original prescription had been written for 2 units, and someone had crossed that out and written 1 unit.  It took a little digging, but apparently the owner had done this.  Why?  She had switched from dry to canned food and for whatever reason decided that this meant she needed to decrease the insulin dosage.  The cat wasn't regulated yet and she had never called to check with one of us.

It's not an isolated incident.  Several months ago I talked to a client who hadn't been consistent with the insulin doses on their dog and on a routine exam the blood glucose was too high.  Apparently the owner was changing the dog's dosage every day based on it's mood.  Nope, they weren't checking the blood sugar levels at home or talking to us about the case.  They were just altering insulin from dose to dose based on how the dog was acting.

Insulin is a serious drug with serious consequences.  If you give too little the blood sugar remains high, which could lead to life-threatening situations (ketoacidosis) if there are prolonged elevations.  At the minimum the pet is uncomfortable and can have chronic changes such as cataracts.  Give too much and the blood sugar can drop precipitously, reaching the point where the brain is starved of energy.  A very low glucose level can result in neurological signs, seizures, and even a coma.  There are also several different types of insulin!  Some act longer than others, so you can't just switch from one to another while keeping the dosage the same.  If you go from a short-acting insulin to a long-acting one you may have to decrease the dose or frequency in order to prevent hypoglycemia.

Altering insulin doses should never be done without veterinary advice and counseling.  We make changes based on clinical symptoms at home as well as repeated blood tests to measure the glucose levels.  When you are nearing proper regulation there won't be significant behavioral or personality changes, so you can't tell just by watching a pet.  For numerous reasons an owner should never change or stop insulin that their vet has prescribed without first talking to the vet.  Ignoring this advice can lead to very serious health problems.

"He'll Starve!".....Nope....

We're very spoiled in modern Western civilization.  Despite the very real numbers of underfed people in the US and other first-world nations, the large majority of people in these countries have never truly gone hungry.  If we miss one meal we say that we're "starving" and lament on how hungry we are.  Most of us (myself included) don't know what it's like to actually starve and have rarely missed a meal.  This kind of attitude also carries over to our pets, where many (if not most) clients seem to think that if their dog or cat misses a single feeding then they're quickly on the way to death.

The average person or pet can go for days without eating and have no significant adverse effects.  I have personally done a 10-day fast of only liquids and personally know someone who has done a 40-day liquid-only fast.  Though you have to do extended fasts carefully in order to remain healthy, it certainly can be done.  The same is true of dogs and cats.

The reason for bringing this up is what happens when people see their pet miss a meal.  The scenario is all too common....a dog or cat misses one feeding, often for less than 24 hours and the owner panics.  Suddenly they worry that their pet will starve to death and scramble to get them to eat "anything".  They may offer ham, hot dogs, steak, hamburger, cottage cheese, rice, bread, and many other things, usually food items that we recommend never to feed.  It can be really frustrating to vets as these things can cause or compound disorders besides whatever caused a decrease in appetite in the first place.

So let's be clear here.  If your pet hasn't eaten in a few days, please don't try to feed them whatever you have available in a desperate attempt to get nutrition in them.  Unless they are severely underweight already, are very young, or of a species that needs to eat frequently (such as some rodent species), they won't starve to death in a couple of days.  Even breeds of dogs that may have a tendency for hypoglycemia are usually going to be fine.  Now, if there is some underlying medical condition such as diabetes you certainly want them eating regularly.  But that is the time to see your vet, not try random foods.  Many human foods can cause digestive upset, pancreatitis, blood sugar imbalances, and even potential toxicities.  If the pet is just being picky, by giving in to them and feeding human food you are actually encouraging and reinforcing such behavior.  Don't do it! 

There are reasons why pets will decrease or stop eating.  It might be pickiness or it might be a serious illness.  Regardless of the cause the answer is never "feed anything".  Talk to your vet, get to the root of the problem, and then choose appropriate and healthy measures to correct the issue.