What May Feel Sultry to Us Can Be Deadly to Them



Lincoln

Meet Lincoln. Typically Lincoln is a happy-go-lucky fellow who loves life and everybody in it! This picture depicts another side to Lincoln’s life, however, and reminds us that these hot summer months bring with it very real and scary risks for our pets. Lincoln first came to our emergency hospital last summer after overheating while boarding. He was just being himself, but his excitement, the heat, and the fact he is brachycephalic, (short-nosed), quickly put him in a life threatening state.



Truman

Lincoln, Truman (also pictured), Boxers, Boston Terriers, and Pugs are some of the breeds with a higher risk of overheating. Their skull bones are shortened in length, but their soft tissue structures are not proportionately reduced, resulting in narrowed air passages and a challenge to breath. This challenge jumps to critical when they cannot get sufficient air to help them stay cool. When an animal suffers from hyperthermia, heat stroke or exhaustion is a risk and there is little time before serious damage, or even death, can occur. It is important to remember that heat stroke can even occur on a mild day!

This summer when Lincoln came into our emergency hospital with heat exhaustion, he had been at home…and inside the house! True to his nature he was playing and having a great time until his respiration became stressed. Soon he fell into a vicious cycle – the harder he worked to breath, the hotter he became – the hotter he became, the harder it was for him to breath. With supportive medical care, Lincoln recovered again, but his family wanted to lower his risk of repeated episodes and elected to have surgery. Lincoln had his nares (front part of his nose) opened up a little wider, his soft palate resected (shortened) and his laryngeal saccules (fine membrane in the larynx) removed. This gave him more room for air to pass so he can better control his body temperature.

Lincoln and his fellow short-nosed breeds need special consideration during the summer, but all of our pets can suffer hyperthermia. Avoid any type of outdoor exercise on a hot day and make sure pets have access to ample fresh, cool water and shade. Never leave your pet alone in a car on a warm day, regardless of whether or not the windows are open. Signs of heat stroke include: panting or difficulty breathing, dark red and dry gums, thick saliva with excessive drool, disorientation, lying down with an unwillingness to rise, collapse, seizures, elevated rectal temperature, and increased heart rate.

If you suspect your pet is suffering from heat stroke, remove him/her from the source of the heat and place him/her in front of a fan or in air conditioning, contact your veterinarian and make plans for transport immediately. You can begin cooling your pet with luke warm to cool wet rags, concentrating your cooling efforts on the head and feet. DO NOT use ice or cold water – extreme cold will cause blood vessels in the skin to constrict, preventing the body’s core from cooling. Cooling measures will be continued at the veterinary clinic where IV fluids, oxygen therapy and testing will be performed. A long hospital stay with repeat testing to check organ function is often necessary.

COURAGE DOESN'T ALWAYS ROAR...

We are pleased to announce that Bobbie Werbe, RVT, BS, CCRP, CERP joined our Surgery and Physical Rehabilitation Departments this month and brings with her just about as much knowledge and expertise as you can get in this field! The list of credentials behind Bobbie’s name gives you a good sense of her dedication to the world of veterinary physical rehabilitation!

Bobbie received her BS in Veterinary Technology from Purdue University and went on to become a ‘Certified Practitioner’ in both Canine and Equine Rehabilitation at the University of Tennessee. She is also pursuing a Vet-Stem Certification, is a published author, and has traveled the country to participate in symposiums on veterinary rehabilitation and physical therapy. What motivates Bobbie to achieve this level of proficiency? Could it be a little ten pound Dachshund named Billie?

Bobbie’s interest in rehabilitation began when, as a competitive runner, she injured her ankle and was told her running days were all but over. That challenge, combined with her love for animals, paved her way to explore and contribute to this emerging veterinary specialty.

She and Billie crossed paths in 2006 after Billie suffered a herniated disc, leaving her paralyzed and without a place to call home. Two weeks after Billie’s surgery, she was fitted with a wheel chair and Bobbie began rehabilitation with her twice a day, every day. Although there are no set rules for how long it takes a patient to regain mobility, Billie’s condition was not showing significant signs of improvement. Bobbie did not give up on her, however, and began taking daily activities and developing them into therapeutic exercises. Bobbie credits Billie, saying it was her little dog’s brave heart that motivated them both to continue. A year later, Billie took her first independent steps and went on to become a certified therapy dog through HABIT (Human Animal Bond Initiative in Tennessee). In 2009 she suffered a second herniated disc. This time Bobbie began rehabilitation just twelve hours after surgery and within three days, Billie was back in the underwater treadmill and walking on her own! Soon she and Bobbie were again visiting hospitals and bringing hope to others.

Today Bobbie is still a competitive runner and she and Billie share their home with a second rescued Dachshund named Winnie. She intends to enlist both the ‘girls’ in a pet visitation and therapy program here in Indiana once they have settled in. Bobbie admits she has ‘fallen’ for this breed, admiring their tenacity and courageous spirit. Hmmmmm…might this describe Bobbie as well?

...SOMETIMES COURAGE IS THAT QUIET VOICE AT THE END OF THE DAY SAYING, "I WILL TRY AGAIN TOMORROW".

Clinical Trials Prove Beneficial to Suffering Patients

A series of Pfizer clinical trials conducted in Circle City’s Dermatology Department have benefited several patients who otherwise would have little choice but to suffer through chronic pruritus (itching) and infection caused by allergic skin disease (atopic dermatitis). Pictured here is “Cal”, a patient and participant in this detailed 3-part trial that concluded recently. Cal is one of the select few who have been approved by Pfizer and the FDA to continue use of this experimental drug under ‘compassionate care’ guidelines. Many patients were involved in these trials and responded positively. Cal has been given special permission to stay on the drug while it continues through the FDA approval process because he failed to show adequate response to other conventional forms of treatment. If Cal was not allowed to stay on this experimental medication, he would most likely revert back to his suffering with little hope of success. Cal’s owners, Christy and Michael, are relieved that he has been approved for compassionate use of the test article. Christy stated Cal was, “…running out of options. Since he has been on this medication his hair has returned, he is back to his old self, and leading a normal life again.” Sixteen patients who participated in this trial have preliminary approval from the FDA to continue under a compassionate care agreement. Three are currently enrolled and the rest are in the final stages of this rigorous application process.

Circle City’s practice owner and head of the Dermatology Department, Terry Grieshaber, DVM, Diplomate, ACVD, has been involved with this clinical trial since the beginning. Pfizer’s site monitoring and compliance leaders have recognized Dr. Grieshaber and his support staff for their attention to detail, compliance with study guidelines, and professional standards and have utilized Circle City as a training site for their team members. Because of this success, Pfizer has asked them to participate in additional trials evaluating new alternative modalities for the treatment of Atopic Dermatitis.

A 4th ‘discovery’ trial is now in the process of closing and a completely new trial is tentatively scheduled to begin in June. The details of this 5th trial remain sketchy; however Dr. Grieshaber has been advised that training for his team should occur in the middle of May. Details will be provided as they become available. As with previous trials, clients will be compensated for their participation. Interested parties should call Circle City’s office and ask to speak with Shawna Zeilstra.

FDA Warns Pet Owners about Xylitol

On a regular basis we see dogs in our Emergency Room that have found or been given what looks and smells like a wonderful goodie, but can be a serious health threat to them. We are pleased to pass along the recent Food and Drug Administration's warning to pet owners about the risks from accidental consumption of xylitol by dogs and ferrets.

Xylitol is an artificial sweetener found in many sugar-free candies, oral hygiene products, and chewing gum. It is also found in many over-the-counter drugs like chewable vitamins and throat lozenges. In addition, Xylitol is now available in packaging for home baking.

Although perfectly safe for humans, xylitol can be very harmful to dogs and ferrets, causing a sudden drop in blood sugar, seizures, and liver failure. Symptoms such as depression, loss of coordination, or vomiting can occur quickly or appear several days later.

Keep all items not meant for your dog or ferret in an area where curious critters have no access, read all labels carefully, and if you suspect one of them has ingested xylitol, contact us or your family veterinarian immediately.

Canine Rehabilitation – We are back up and running!

Rehabilitation has increased in popularity in the veterinary world over the past 10 years. The goal of rehabilitation is to restore, maintain and promote optimal function, fitness, wellness, and quality of life to the patient. The potential candidates for rehabilitation are numerous and include: pre-surgical conditioning, post-surgical orthopedic patients (femoral head and neck ostectomy, lateral suture, TPLO, fractures, etc.), post-surgical neurologic patients (hemilaminectomy, ventral slot, etc.), non-surgical neurologic patients (FCE, degenerative myelopathy, etc.), chronic osteoarthritic or soft tissue injury patients, athletic patients for conditioning and also overweight patients. It is important  prior to starting a patient in rehabilitation that they have an accurate diagnosis and complete physical, including both orthopedic and neurologic examinations.

We are pleased to announce Dr. Kate Fitzwater, our surgeon, has taken over the head role for rehabilitation at Circle City Veterinary Specialty & Emergency Hospital.  She was involved with an intensive rehabilitation program both at North Carolina State University and Ohio State University during her surgical training. New initial appointments, which are 2 hours long, are now available on Monday and Wednesday afternoons.   One hour long conditioning appointments are also available on those same days.   

Rehabilitation modalities we currently offer include:

• Complete physical examination including orthopedic and neurologic evaluations
• Massage
• Moist heat
• Cryotherapy
• Stretching
• Balance training
• Endurance training
• Underwater treadmill therapy
• Underwater jet massage therapy

If you have any questions or have a case/pet you would like to discuss with Dr. Fitzwater, please feel free to make an appointment or you can email her at kfitzwater@circlecityvets.com.

Do We REALLY Have to Sedate for This Procedure?

Many pet owners express concern when their pet faces sedation or anesthesia for a medical procedure. The primary reason animals require sedation is the need to remain absolutely still while the procedure is being performed. Movement at the wrong time can cause harm to the patient and prevent successful completion of the procedure.

Physical restraint of patients causes fear and anxiety. Animals don’t understand it is for their own good. What they see is that their owners have handed them over to strangers who are causing them more pain and discomfort! Sedation helps control this anxiety so they can relax and the doctor can perform a more thorough exam. It is also important to understand that when animals are painful, it is a normal, “Survival of the fittest”, behavior to hide what hurts. That natural instinct can make it more difficult to diagnose the true problem. Pain medications are part of almost every sedation protocol. This allows the doctor to do the necessary exam without causing further pain.

When sedation or anesthesia is in order, our veterinarians take every precaution to make sure a procedure is completed as safely as possible. Most drugs are broken down and excreted by the liver and kidneys. Blood work before sedation or anesthesia helps identify any problems with these organs and the drug protocol can be modified to account for any abnormalities.

Once a pet is sedated or anesthetized he or she is monitored continuously by one or more highly trained technicians. Monitoring equipment usually includes continuous ECG, blood pressure, temperature, oxygen, and carbon dioxide levels. Even when the procedure is over, someone is watching over the patient until he/she is fully recovered from the effects of the sedation or anesthesia.

Procedures that usually require sedation: radiographs, orthopedic examination, oral examination, minor laceration repair, minor wound care, arthrocentesis (joint taps), skin biopsies, intradermal skin test for allergies, ultrasounds, and some bandage changes.

Procedures that require general anesthesia: invasive or painful procedures like extensive wound debridement, oral surgery (dental extractions, root canals, and dental radiographs), tumor removal, orthopedic surgeries (fractured bones, stifle/knee surgery), and exploratory surgeries

Sedation or anesthesia is recommended to help facilitate the best care possible for your pet. We want both you and your pet to have a positive experience while in our care, which includes controlling pain, discomfort, and anxiety in our patients. Every doctor at Circle City Veterinary Specialty and Emergency Hospital is happy to talk with you about the benefits and risk of anesthesia before a procedure is performed. Please do not hesitate to ask.

Promising Clinical Trials Continue at Circle City Veterinary Specialty & Emergency Hospital

In 2009 and 2010 our Veterinary Dermatology Department, under the leadership of Dr. Terry Grieshaber, DACVD, participated in three clinical trials to evaluate a new compound, developed by Pfizer, to treat Atopic dermatitis in the dog. These trials were conducted nation wide with Circle City among those clinics that enrolled the highest number of evaluable cases in each trial.


We are flattered to announce that Pfizer has once again invited Dr. Grieshaber and Circle City’s Dermatology Team to participate in two additional clinical trials in 2011. These trials are designed to evaluate two additional new drugs that again were developed to treat Atopic dermatitis in the dog.

Training for the first of these two trials will begin the end of January. Although we currently have scant details about what these trials will entail, based on previous experience, requirements will likely include that Atopic dermatitis has been confirmed by history and/or allergy testing and that dietary allergies have either been ruled out or controlled. In previous trials those clients who participated were generously compensated.

Please keep this option in mind as you see your Atopic patients and perhaps develop a list of clients that may be interested. Additional information will be provided as we receive it.