Dr. Phil Zeltzman’s Blog
I recently became Fear Free Certified.
What exactly does it mean? Fear Free is a nationwide effort to decrease fear, anxiety and stress in cats and dogs visiting a vet clinic.
Dr. Marty Becker, “America’s Veterinarian,” founded this certification program that teaches Drs. and their nurses make visits to the vet something pets and their owners can both look forward to.
Here are a few simple things that could be done during a “Fear Free” vet visit. The Dr and staff might:
. Initially avoid eye contact with your pet and focus on you instead
. Provide non-slip surfaces for your pet to stand or rest on to improve balance
. Use gentle pressure to soothe the pet using a towel or compression garment
. Create a calming environment with pheromone diffusers and aromatherapy
. Play calming music to promote relaxation
. Actively work to reduce stressful noises
. Create a relaxing environment through calming hospital colors and gentle lighting
. Prescribe anti-anxiety or other calming medications & supplements
If your pet is showing excessive signs of fear, anxiety, or stress, the team may delay or postpone the exam or other procedures until your pet is more relaxed
5 ways you can help make the veterinary visit Fear Free for your pet
1.. Prep your pet
Positively accustom your pet to the carrier or restraint device and condition happy experiences in the vehicle. Using low calorie treats is a great way to do that.
2.. Limit food before the appointment
Unless medically contra-indicated, bringing your pet in hungry increases the reward value of food during the visit to better condition your pet to the positives of care. Of course, you can’t do that if your pet will have anesthesia, or before certain blood tests. So please ask what you can do.
3.. Explore waiting room alternatives
Work with the receptionist or other team members to determine the optimal location to wait with your pet. In some cases, it could be your car. In other cases, you may need to bypass the waiting room and go straight into an exam room.
4.. Be open to non-traditional techniques
This can include not taking your pet’s temperature, examining your pet in your lap or on the floor. Treats and toys can be used to move a dog willingly onto the scale, into the exam room and onto the exam table
5.. Consider new strategies to reduce fear, anxiety, and stress
In many cases, pets will benefit tremendously from pre-visit medications, supplements or sedatives, as well as conditioning the pet to specific aspects of vet care prior to their next visit.
To learn more about signs of stress, see the table below. Some signs may surprise you.
Stressful veterinary visits can be a real problem for pets, pet owners and veterinary healthcare team members. So I see the Fear Free initiative as the ultimate win-win-win situation.
For more information, visit www.fearfreepets.com
SIGNS OF STRESS
- Avoiding veterinary team members
- Closeness to you or climbing up on you
- Dilated pupils
- Fidgeting (circling, barking, not able to sit still)
- Hypervigilance (looking around everywhere, seemingly paranoid)
- Licking lips, or lips drawn back
- Piloerection (hair raised)
- Snarling, or biting avoiding veterinary team members
- Tail down, tucked, or high over the back
- Turning away when you look at him, or turning his back to stimuli
- Whining, growling, snarling, or biting
Bella, a 4 year old female Labrador, kept having bladder infections despite several rounds of antibiotics.
Her family vet at www.brodheadsvillevet.com eventually diagnosed her with a redundant vulvar fold. This means that a simple exam of her back end revealed a little surprise: an extra fold of skin covering her vulva. This common condition is also called vulvar fold dermatitis or recessed vulva. My impression is that many dogs have this problem but haven’t been diagnosed yet.
How on earth can an extra skin fold cause bladder infections?
The excess skin forms a pocket where urine gets trapped. The moist, warm and dark environment creates ideal breeding grounds for bacteria. This can cause a foul odor in addition to ongoing infections.
In addition, Bella became very reactive & even aggressive toward the other pets in the household.
Signs of bladder infections may include licking of the vulva, scooting of the back end, bloody urine, urinary incontinence and “accidents” in the house. Other conditions may cause similar signs, so your family vet should eliminate other problems, such as bladder stones and even bladder cancer.
So what is the treatment of this bizarre condition?
- The Band-Aid approach is the “medical” treatment. We treat the symptoms by cleaning the area and giving antibiotics. But we are not treating the cause, so it can be rather frustrating every time the infection comes back.
- The best treatment is surgery. Yes, we can do cosmetic surgery on a dog’s vulva. Call it nip and tuck! Surgery allows removing the excess skin in order to provide better ventilation to the area.
The reconstructive surgery is called a vulvoplasty or episioplasty. The main challenge of the surgery is to remove just the right amount of skin: not too much and not too little.
Recovery generally takes 2-3 weeks. I don’t place skin sutures, so there are no stitches to remove in this sensitive area… All stitches are internal and eventually dissolve. An E collar (plastic cone) is critical for the full 2-3 weeks to prevent licking and to protect the incision.
Overall, this is a common yet frustrating condition. Fortunately, surgery is typically successful and pet owners are usually very happy with the end result… as well as their dogs!
Bella’s owner wrote: “I am ecstatic to say… Bella has not had a bladder infection since surgery!!”
The pet insurance branch of Nationwide recently released a report that shows that brachycephalic dogs have a higher risk for several diseases.
Brachycephalic dogs have a flat face. They tend to have a shorter skull, a shorter snout or muzzle and bulging eyes. Because of the shape of their skull, they often have breathing difficulties.
In an English Bulldog, the poster child for brachycephalic dogs, the nostrils are routinely very small (“stenotic nares”). This limits the flow of oxygen. In addition, a Bulldog can have a soft palate that is too long (the back part of the roof of the mouth), everted laryngeal saccules (small fleshy parts inside the larynx or voice box), and a small wind pipe (trachea). This blocks the flow of oxygen even more, which is why these dogs pant all the time. They are literally suffocating.
The smooshed face also leads to extra skin folds that can become irritated or infected.
The report shows a higher risk for skin diseases and eye problems.
Besides Bulldogs, brachycephalic dog breeds include the Affenpinscher, Boston terrier, boxer, Brussels griffon, old English bulldog, shih tzu, cavalier King Charles spaniel, dogue de Bordeaux, French bulldog, Japanese chin, Lhasa apso, mastiff, Brazilian mastiff, bull mastiff, English mastiff, Neapolitan mastiff, Pyrenean mastiff, Tibetan mastiff, Spanish mastiff, pekinese and pug.
What should you do?
All of these dogs can be wonderful pets, you just need to be aware of the health risks before you adopt them.
So what should you do if your dog has similar problems? The secret to avoid breathing problems later in life is to widen the nostrils as early as possible. Several articles* recommend at 3 to 4 months of age. The challenge is to operate on these dogs before the usual age to spay or neuter a dog. I agree 100% with these articles, early intervention is key.
As to the other issues, mainly skin diseases and eye problems, they are a whole different story. See your vet early on, before the problems go out of control.
Phil Zeltzman, DVM, DACVS, CVJ, Fear Free Certified
* Source: Here is a quote for an article about these patients: “It is recommended to perform rhinoplasty in puppies with this abnormality at 3 to 4 months of age to avoid progression to secondary changes, such as laryngeal collapse or pharyngeal edema.”
Many large cities face an ongoing problem with rodents. For example, if you’ve taken the subway in New York City, you have likely seen a few rats running around.
Same issue in sewers, businesses, docking areas, food and merchandise warehouses, and yes, restaurants!
Another big issue for cities is feral cats. NYC is estimated to have half a million stray cats. Volunteer groups are working all over the country to trap and neuter these cats. In some cases, cats can be relocated.
Cats and rodents typically don’t exactly go along very well…
The simple smell of a cat has been shown to ward off rodents (to be more specific, rats can detect cat pheromones). A recent twist on the trap and neuter concept is to relocate stray cats to areas that have a rodent problem.
To convince the cats to stay in the new location, trained volunteers set up huge dog crates with beds, toys, litter boxes and food. If the new location is a business, the owners must feed the cats twice daily and pay for any needed veterinary care. Once used to the new area, the cats are released and they “take care” of the rodents. This process usually takes about one month.
The alternative until now was to hire expensive pest control services, and they use chemicals. Now, cities like NYC and Chicago use more natural methods.
One success story reported in New York magazine is “Venkman the Cat,” who takes care of rodent at a Chicago brewery. He is a local star and even has his own twitter feed!
(Source: Chicago’s Empirical Brewery and New York Magazine)
Do you think this is a good idea? Do you think it’s ethical to relocate cat colonies and use them to control the rodent population?
Jessie, a 9 year old Border Collie mix, came into Brodheadsville Vet Clinic to have an ugly mass evaluated on her belly (see picture 1).
It had appeared a few months prior and grew fairly quickly. It was also starting to look bumpy, oozing and hairless. Jessie’s vet was concerned that it could be cancer due to its appearance and quick growth (see picture 2: compare the size of the mass to the thermometer in her behind).
Jessie was scheduled for surgery the following week. The owner was well aware that the mass could be cancerous, but she was ready to do anything for her beloved dog. Chest X-rays did not show any sign of spreading of the tumor to her lungs.
Jessie was put under anesthesia and went to surgery. The mass was about the size of a pineapple. It started just under the skin but it was now actually invading into the wall of the belly! The mass was carefully removed, both from under the skin and from between the muscles (see picture 3 – the coin is a quarter).
Everything was stitched up and Jessie was recovered from anesthesia (see picture 4).
She was sent home with an E collar (plastic cone) to prevent her from licking the incision. She received antibiotics and pain medications for a week. The mass was sent to the lab for biopsy. After about a week, the results came back. Amazingly, the mass was not cancerous! It was a benign, fatty tumor called a lipoma!
Jessie’s owner was thrilled and relieved. By then Jessie was walking and feeling great, enjoying her new life without a big mass interfering with her walking.
Moral of the story: just because a mass looks “ugly” and grows quickly doesn’t necessarily mean that it’s cancer.