Capeway Veterinary Hospital Blog

                                  As a veterinarian schooled and practicing in North America, I never dreamed I would (or could!) operate on animals in an abandoned amusement park with limited equipment and medicine, but that’s exactly what I found myself doing last week when a chance search of the American Veterinary Medical Association’s website led me to an island in the West Indies called Nevis.

I was fortunate enough to join a wonderful organization called World Vets. World Vets is a non profit group that provides surgical and medical treatment to animals in developing nations across the globe, as part of a preventative program or for disaster relief. Volunteers range from veterinarians, to vet techs, to pre-vet students, to people who just have a love of animals and a desire to help. At any given time, a number of projects are underway, with the goal that improving the health and welfare of animals improves the health and welfare of the people who live with them.

My team in Nevis, the sister island to St. Kitts, consisted of 5 vets, 3 techs, 2 pre-vet students and a former Animal Control Officer. In any country World Vets goes to, they must coordinate with a local animal welfare group; our group was C.A.R.E Nevis Animal Society.  C.A.R.E is a powerful little force with a most impressive roster of local volunteers who didn’t hesitate to roll up their sleeves and get dirty, taking care of the animals before and after surgery, taking care of us before and after surgery!

I was told that our prime objective would be to spay and neuter stray and owned pets, with the occasional medical consult and non routine procedure. I was told the volume would be high. I was told the days would be long. I was told the conditions would not be “ideal”. What I was not told was how much fun I would have.

People either tied their dogs to the fence surrounding the amusement park with  notes, or checked in at the former ticket counter. We also had drivers roaming around the island picking up strays!

Once we got rolling, I didn’t move much from my surgical table. The 5 of us vets had tables set up in the open air cafeteria. The amazingly efficient technicians would induce anesthesia, prep the patients and bring them to our tables. When 1 surgery finished, there was a quick table sterilization, glove and instrument change, and the next patient was brought over. Post op patents were taken to recovery, make- shift pallets under the former beer garden tent!

I know it sounds like hard work but here’s the great part. Maybe because there was no paycheck associated with the work, maybe because we didn’t have the pressures of day to day clinic life, or maybe because everyone was working towards a common goal, I had a blast. Though we were constantly on the move, we had the tunes going and the jokes flowing. Volunteers generously brought us lunch and refreshments daily. Everyone pitched in to help everyone else. At the end of each day, we were exhausted but satisfied.

I feel so fortunate to have met everyone on my team, really laid back but hardworking people. And I can’t say enough positive about CARE and their volunteers. What I did in 1 week, they do on a day to day basis and my hat goes off to them and their tireless efforts. But I would be remiss if I didn’t mention the stars of the show, the island dogs! I have never met such well mannered, intelligent, docile sweeties. I already have future adoption plans in mind!

What started out as a 2015 bucket list objective for me will hopefully become an annual event. Though the point was to benefit the animals, I feel like I benefited the most.

www.worldvets.org

www.carenevis.org

Imagine sitting in your car, wearing a full length fur coat waiting for a friend to come out of Stop N Shop.  Imagine it being the middle of August. Your friend took the keys. The AC is off. The windows aren’t open. And everyone in the 12 items or less line has 13 items. Or more. How long could you stand it? Did you know that the temperature inside a car , even with the windows cracked, on an 85 degree day can reach 102 degrees within 10 minutes? Think about it, a car is basically a metal shell, a great absorber of heat. An oven. Your furry friend does not want to be in an oven.

Heat, and especially humidity, can be a dangerous, sometimes lethal combination , causing heat exhaustion or heat stroke in pets, mostly dogs. The risks increases if the dog is

a) overweight

b) has existing heart or lung problems

c) brachycephalic (i.e. smoosh faced dogs like Pugs and Bulldogs who have increased resistance to air flow through their already flattened nasal passages)

d)  elderly (airways aren’t as elastic to expand and contract smoothly)

e) overactive (increased muscle activity generates more heat)

Most people know that, unlike us, dogs can’t really sweat to cool down (except a little from their pads). Dogs release heat by panting.

We’ve been pretty lucky so far this summer, having had only one case of heat trauma in a black pit bull mix who was chasing the lawn mower back and forth. Her owners quickly recognized she was lethargic, was struggling to breathe, and brought her in right away. Their prompt action led to a successful outcome. Some clinical signs of heat exhaustion are dark pink or red gums, excessive panting with thick ropy drool, trembling muscles, a rapid heart rate, vomiting, diarrhea and a change in personality. Dog’s eyes can glaze, they can act confused, disorientated and dull. They may stumble when they walk, become weak and even collapse. As the core body temperature rises, the internal effect on organs is, well, like they are being baked. If the brain is affected, a dog may have seizures. The liver and kidneys can fail and basic clotting can be compromised.

If you recognize any of these signs in your dog at home, a rectal temperature may confirm heat exhaustion. A normal dog temperature is between 100 and 102.5. Temperatures between 104 and 106 degrees Fahrenheit are cause for concern and action. Cool the dog down. You can apply ice packs to less haired areas like the groin, armpits,  belly and head. Turning the garden hose on the dog is a good idea, just make sure you let the water run and check it is cool before turning it on him,  you don’t want to burn him with old water that has baked in rubber under the hot sun.  We usually immerse dogs in cool water baths (not ice cold, that can cause too rapid cooling and hypothermia ), start intravenous fluids to combat dehydration  and improve circulation to organs, and use drugs to combat any inflammation, infection or seizures. If the dog is having serious difficulty breathing, it may need to be sedated so we can intubate it and improve its oxygen intake.

Some practical tips to avoid disaster. Air conditioning is your friend. And your best friend’s friend. Your dog doesn’t want to go to Walmart or spend every minute with you. It wants to stay home, not in the Easy Bake Oven your car becomes within minutes of the AC being turned off.  I believe in exercise, just do it smart. Early morning and evenings are best. Watch your dog;  if he is lagging behind or hanging is head or panting a lot, stop.  Be careful of hot asphalt, it can burn pads. Carry fresh water everywhere. Look into cooling vests or mats. I know some dogs are outdoor dogs. Just remember, dog houses are not well ventilated and shade moves.

Many years ago I tried to adopt a Golden Retriever from a local rescue organization. I was turned down because at the time I lived in an apartment and didn’t have a fenced in yard. I was a new veterinarian and didn’t play the “vet card”. I mostly forgot that incident, randomly bringing it up as a “can you believe they denied a vet a pet” anecdote. A few incidents have made me remember that rejection however.
Example 1 A rescue organization called to get a history on a client and her past pet. Our receptionist was specifically asked if the owner brought the pet in for vaccines. The answer was no. The call ended, and the owner was denied adoption, despite attempts to explain that the owner was new to our practice, we only met her and her senior pet late in the pets life when we sadly diagnosed a terminal illness. The organization did not want to hear how this owner pursued every diagnostic and treatment option available, and in the end nursed her friend with love and devotion during his last days.
Example 2 A rescue organization called to get a history on a client and her current pet. We were specifically asked if the owner gave heartworm preventative medication and how frequently. They were told yes, but only seasonally. The owner was denied. This owner brings her pet in every year for a physical exam and performs recommended tests. She has brought the pet in when it was sick. She has never missed a year.
Anyone who has a TV has seen the images of homeless pets in desperate need while Sarah McLaughlin sings mournfully in the background. Yet are the standards by which certain organizations grant or deny a person a pet too high? Should a person be denied a pet because they
a) live in an apartment ? (FYI, everyone in New York City lives in an apartment and it is one of the most dog friendly cities I have ever visited…everyone walks their dogs and everyone picks up after them)
b) have a pool that a cat or dog may fall into and drown?
c) choose to give heartworm preventative only in the warmer months in a non heart worm endemic area?
d) have a child, are divorced, are expecting a baby, live with elderly parents, have roommates, travel for work, make less than a certain income, don’t have a doggie door, plan on crating their dog (I have found these very questions on different applications)
Shouldn’t the goal of a rescue organization be to get more dogs and cats out of shelters and into loving homes?
Are rescue organizations private entities or are they funded through public donations and government grants? If they are charitable organizations, who decides the adoption criteria? Is a yay or nay an individual or a committee decision? Is that process made transparent to donors?
And what are the success rates of these organizations? How many pets are placed? How many are returned? How many still reside in the shelter or in foster, waiting for that perfect home?
I am the first to defend and champion those who work in the field of animal rescue. It is an overwhelming job done by dedicated folks operating on a shoe string budget. I have met many wonderful people over the years from various animal rescue organizations and have always been struck by their tirelessness, their hard work, their never ending compassion. I also know they see the worst of the worst…too many dogs tied to their front door, too many kittens left in garbage bags, too many post Christmas surrenders, too many returns because it just “wasn’t a good fit”, too many “I didn’t know he was going to get so big!” They want their decisions on adoption to be good and right and permanent.
But shouldn’t that compassion be tempered with reality? A lesson I have learned with age and experience is that life is not black and white, it really is grey. The recommendations I make as a vet and the standards I follow as a pet owner may not be possible for everyone. I understand that. It doesn’t make someone an unfit owner or unworthy of a pet.
There has to be a middle ground between giving a pet to anybody with a drivers license and $50 in his pocket and the 10 page long application that requires home photos, a home inspection, verification of income and more hoop jumping that getting into Harvard.

I often have clients ask me “What’s the best food to feed Fluffy?”  Sometimes I have people tell me that the Big Name pet food companies produce inferior products with a lot of fillers. And every so often I get the opinionated few who inform me that certain pet foods contain beaks, fur, and hooves in their products!  I have found that opinions on pet food can be very strong, often like opinions on religion. So, it is not my goal to change anyone’s opinion, but to help people make better informed decisions. I recently had the privilege  of listening to an excellent  lecture given at The North American Veterinary Conference by an esteemed veterinary nutritionist from Tufts University, Dr. Lisa Freeman. Much of this blog is a summary of what I learned.

Labels

There is in fact no one best food for every pet because, as every pet owner knows, every pet is different and special. Decisions should be made on evaluation of the product, reputation of the manufacturing company, age and health of the pet, cost, and of course palatability. Too often, choices are made based on media, how attractive the label is, and negative ad campaigns (“would you feed your dog brand X food that contains corn?!”) Effective advertising sells, there is no getting around that (I myself am a Maxxinista), but what do Rachel Ray or Chef Michael know about dog food? Here are a few tips on how to read a label, without falling for the dog howling at the moon pretty picture on the front.

– The most important thing on a label is not the ingredient list, but the Nutritional Adequacy Statement. This tells you if a food is complete and balanced, as well as how they make that claim. The Gold Standard way to make the claim of nutritional adequacy is if the manufacturer states the food went through feeding trials (ie testing the food on actual animals), established by AAFCO. AAFCO is the Association of American Feed Control Officials, a regulatory body that oversees pet food labeling.

– The second most important thing on a label is the manufacturer. This is where the average person doesn’t do a lot of research, but if you really want to know if a company has a good reputation, don’t read 100 opinions on the internet,  ask a few questions. Does the company employ a full time nutritionist with credentials? ie a board certified veterinarian or a PhD. Does the company have a research and development department and if so, do they have any peer reviewed studies of their products to back up their claims? Can they list their quality control standards? (where do their ingredients come from, how is the quality of ingredients assessed, are ingredients and end products tested for toxins, how often are their manufacturing plants inspected)?

– What most people evaluate a pet food by, the ingredient list, is actually one of the least important things on a label. Ingredient lists can be misleading because ingredients are listed in decreasing order BY WEIGHT, which includes water weight. So meats and vegetables may be listed first because of their high water content, but actually contribute less nutritionally than a dry ingredient like corn meal listed further down. Ingredient lists also do not tell you the quality of those ingredients. And if something is at the end of the ingredient list, it is often in too small of an amount to actually provide any nutritional benefit. But it may make the product look appealing to a consumer.

A few words on marketing

– “grain free” – whole grains are actually digestible sources of protein, vitamins and minerals, and fibre. They seldom cause allergies, obesity or diabetes and are not fillers. If a food is labelled “grain-free” see what the grain has been replaced with. If it is tapioca or potato, it may actually be less nutritious.

– “human grade” “premium grade” “holistic” – there are no AAFCO definitions for these terms. Anyone can put these on a label as there are no standards to be met.

– “by-products” – these can be internal organs but do not include beaks, fur, nails or intestinal contents. They vary in quality, just like meat, and do not indicate an inferior product. In fact, people spend good money to eat goose liver…its called Foie Gras!

Information on regulations, labeling and other facts about pet food : www. petfood.aafco.org/

FAQ’s about pet foods : www.tufts.edu/vet/nutrition/faq/general_pet_nutrition.html

Pet Food Institute : Information on ingredient definitions, nutrition myths, labeling regulations –  www.petfoodreport.com

World Small Animal Veterinary Association Nutrition Toolkit – www.wsava.org