Happy Thanksgiving From the Staff at Circle City Veterinary Specialty & Emergency Hospital

Few days on the calendar year are as closely associated with family and tradition as Thanksgiving. And as diverse as America is, so are the memories and traditions of American families' Thanksgiving celebrations. In the spirit of the holiday we here at Circle City Veterinary Specialty and Emergency Hospital thought it would only be appropriate to share some of our favorite Thanksgiving memories and traditions. We hope you enjoy

Our Thanksgiving food drive was a success!
Happy Thanksgiving from our family to yours.

reading these and want to wish you and your family the happiest of Thanksgivings.

Aubrey Barth, Registered Veterinary Technician: I loved waking up to the sound of the Thanksgiving Day parades on TV in the living room, helping my dad mix the stuffing by hand in a huge foil pan, and that it took my brother 18 years to figure out how to correctly eat cranberry sauce (not by itself, but along with a forkful or turkey, potatoes, or stuffing).

Amy Rader, DVM, Director of Emergency Services: The first time I met my husband's family was at Thanksgiving. I met the ENTIRE family, everyone made me feel welcome and part of the family.

Jamie Riddle, Registered Veterinary Technician: My favorite moments of Thanksgiving are getting together with my crazy family. Each year the table has been getting bigger and bigger, but I love taking a breath, not worrying about the world and being able to look across every angle of the table and see someone that I love, then stuffing our faces :).

Megan Anderson, Registered Veterinary Technician: Before my grandparents passed away, we would always go to a buffet type brunch around 10:00 a.m. No one in my family likes cooking, but there would be an "in the spirit of the holiday" turkey cooked by my mother, to be nibbled on for the following weeks. After joining the Anderson family, and attending a true dinner with the family, it's a weird transition into a hustling and bustling clatter and clash of bodies packed into the tiny kitchen, preparing several dishes at once. I quickly learned to bring a cold dish as contribution so as to not need space in the oven or an electrical outlet. After the rest of the family leaves, we build a fire in the fireplace and trim the tree. We sip hot cocoa and talk about gifts we are considering and tease the young kids about making sure to get their letters done to Santa. Thanksgiving passes quickly into Christmas.

Kiely Clark, Registered Veterinary Technician: One of my favorite holiday memories was while working on Thanksgiving. Dr Grieshaber bought us a big 'ol turkey. We got it out of the oven and went to carve it but couldn't find a knife! We carved our turkey with a pumpkin carving knife...later we found a real knife in the pumpkin roll :).

Rachel Kulaga, Client Services Administrator: My favorite tradition is always going out with my family to pick out our Christmas tree the night of Thanksgiving. My favorite memory is making it home just in time for Thanksgiving the year I studied abroad in Europe. I've never been so happy to eat Thanksgiving Dinner and watch the Lions lose ;)!

Ray Schmitt, Public Relations/Marketing Representative: There was always a battle between myself, my brother, my sister and our cousins as to who would get to lick the beaters from the electric mixer after the mashed potatoes were made. Even now that we're all grown we all want them. Also, to close out the night my family always gathered around the table for a card game we call Blackout. It's similar to Spades and a lot of fun.

Danie Lodge, Registered Veterinary Technician: I like dipping my turkey in mashed potatoes & gravy!

Amanda Audo, DVM (Emergency Dept.): To me, Thanksgiving always meant driving from Detroit to Columbus to visit my great-grandmother. Her favorite restaurant was the Brown Derby, so we would go there every year for Thanksgiving dinner. Then we would get to play with our favorite toys we kept at her house.

Cassi Naden, Customer Service Representative: Everyone knows that the wishbone is a "prized" part of many Thanksgiving traditions. In my family, after everyone is done eating we play the card game Phase 10. The first and second place winners are the ones that get to break the wishbone.

Katherine Good, Veterinary Assistant: It was the first time I was in charge of Thanksgiving dinner - the turkey, sides and dessert. My first time ever making turkey. I did the normal; season the turkey, add water and butter to it. Set in the oven to slowly cook overnight. Well in the middle of the night we woke up to the smoke detector going off and smoke everywhere. Turns out I put too much water in the pot and it boiled over with fat in it. Elvis my dog wasn't too concerned he wanted to see if there was anything he could eat. My nephew slept through the whole thing. Everything else went great. The turkey had a smokey taste to it.

Tina Beers, Registered Veterinary Technician: My favorite memory is going up to Wisconsin to my aunt and uncle's house. My mom, aunts and grandmother would cook (I would try to help, but it never worked out for me), while my grandpa and uncles watch football (usually the Bears) and having a house full of kids. Afterwards we would set up the Christmas tree and all of my aunts would get ready for black Friday shopping.

Kelly Fisher, DVM, CCRP: After getting married, Kreg and I wanted to start our own family tradition. The morning after Thanksgiving we get up early and go to the tree farm to pick out, and cut, our Christmas tree. Two kids later, we still look forward to Friday morning and picking out that special tree.

Kate Fitzwater, DVM, MS, DACVS: One aspect of Thanksgiving that I look forward to are the leftovers, I can eat them for lunch and dinner all the way until Sunday! Good thing no one else likes them that much in my family, the more for me :).

Kim Wirth, DVM, DACVIM (Oncology): My favorite Thanksgiving tradition is my parents fighting over the time of the meal and my Dad disappearing into the garage for the remainder of the day.

 

Cataract Surgery in Dogs

Cataract Surgery in Dogs

By Rachel Mathes, DVM, MS, DACVO

Cataracts are opacities or white areas in the lens which is located inside the eye and functions to focus light on the retina (back of the eye) for visual processing. Cataracts in dogs have many causes with the most common type of cataract being heritable, or breed related. Another common cause of cataracts in dogs is systemic diabetes. In fact, up to 80% of dogs will develop diabetic cataracts within sixteen months of a diagnosis of diabetes. Whether a patient develops cataracts is not dependent on how well the diabetes is regulated. Cataracts may remain stable for long periods of time or may progress over time, with a variable rate of progression. Cataracts cause inflammation inside the eye and may cause other serious diseases such as glaucoma, lens displacement or retinal detachments. The biggest concern, however, with cataracts is that they often cause vision loss or blindness.

The diagnosis of cataracts may not be straightforward because other conditions of the eye can cause “cloudiness” or white discolorations. A full ophthalmic examination with a board-certified veterinary ophthalmologist is recommended to assess cataracts. If cataracts are diagnosed, they may be treated with phacoemulsification, otherwise known as “cataract surgery.” Surgery is typically pursued if there is significant vision loss causing changes to a patient’s lifestyle or behavior. This may vary depending on the dog’s level of activity and daily routine. Often, vision loss may not be recognized until the pet is taken to a different environment with which he/she is not familiar. Common signs of vision loss include bumping into objects, falling on or missing stairs, increased sleeping due to reluctance to move around, hesitancy to move in unfamiliar environments or increased contact with the owner (e.g. following the owner around more than usual). These signs may appear gradually or may occur quite suddenly depending on the progression of the cataracts. 

Cataract surgery involves removal the abnormal lens and replacement with a new, artificial lens. This is done through a very small incision on the side of the eye. The new lens is foldable and able to be placed through this small incision. The small incision decreases overall anesthesia time and complications after surgery. The procedure in dogs is the same surgery that is performed in humans for cataract surgery, even though the canine or dog lens is approximately four times the size of the human lens. The success rate of cataract surgery in dogs is 90-95 percent. While no surgical procedure carries a 100 percent success rate, the success rate of this surgery is very high, especially if done by a skilled board-certified ophthalmologist. The surgery is able to restore normal vision for a blind or significantly visually impaired pet, often completely changing their behavior and activity level. Many people state that cataract surgery “gave their dog back their life,” enabling them to play with toys, run outside and interact with other dogs again. The change in a patient’s demeanor after cataract surgery is often dramatic and one of the best events to witness for a veterinary ophthalmologist. This surgery is offered here at Circle City Veterinary Specialty and Emergency Hospital with myself (Dr. Rachel Mathes), a board-certified veterinary ophthalmologist, so be sure to ask your veterinarian about options for a referral here.   

A cross section of the eye is depicted with the black arrow indicating the lens. This structure is normally clear, but may become milky or whitish with cataract formation. 

A photograph of a patient with cataracts is depicted. The lens is whitish-gray and this patient was blind before surgery. 

 

A photograph of a patient after cataract surgery is depicted. The new, artificial lens can be seen. This patient had normal vision after surgery.  

A photograph of a patient after cataract surgery is depicted.  The new, artificial lens can be seen.  This patient had normal vision after surgery.  

Pets and Ebola

If you have been anywhere near a newspaper, television news broadcast or computer screen in the last month then you heard about the death of Liberian national Thomas Eric Duncan who contracted Ebola. He was the first Ebola patient diagnosed with the disease in the United States. Duncan was treated at Texas Health Presbyterian Hospital of Dallas and during that time two nurses who provided care also contracted the disease responsible for over 4,000 deaths during the current outbreak in western African nations.

You may not have heard, however, that healthcare workers in European nations are also dealing with exposure to Ebola. In fact, a Spanish nurse was hospitalized with the disease earlier this month and government officials there elected to euthanize her dog as a precautionary measure. On the flip side of the coin, however, the Cavalier King Charles spaniel that belongs to one of the sick Dallas nurses has been placed in quarantine with no plans to euthanize the animal. Additionally, the Centers for Disease Control and Prevention indicates that no evidence exists to prove that pets can spread the Ebola virus to people or other pets, and no reports of dogs or cats falling ill with Ebola have been filed.

Photo: CDC / Cynthia Goldsmith

While Ebola continues to dominate the national conversation it is inevitable that pet owners will have questions and look to their veterinarians for answers. And that is the best place to turn - your veterinarian. The worldwide web is a valuable source of information but oftentimes there is no way to verify the accuracy of information on a website or what the source of that information is. That's why your veterinarian should always be your most trusted source if your pet becomes ill.

In the meantime there are some proven facts about Ebola and pets that you can find online. We turned to our friends at the American Veterinary Medical Association to help compile some important facts for you:

• In the United States the relative risk of exposure to Ebola is low. As of today there are only three documented cases of Ebola patients in the country. Duncan contracted the disease while traveling in Liberia (he since passed away) and the other two were nurses who provided care for Duncan. There are no documented cases of pets contracting the disease.
• Ebola is spread only through the transmission of bodily fluid. It is not an airborne disease like the flu.
• Currently there are no approved vaccines or drugs available to treat Ebola. According to the CDC Ebola patients are treated according to their symptoms as they appear.
• Ebola is a zoonotic disease. There is, however, no evidence that it has ever been transmitted from a human to a dog. The AVMA references a study conducted during the Ebola outbreak in Gabon from 2001-2002 that found no infected dogs in the area, and reported no signs of symptoms or deaths among Gabon's dogs during the outbreak.
• Two organizations, the World Small Animal Veterinary Association and the CDC, do not recommend euthanization for dogs that could have been exposed to Ebola. The WSAVA says that the animals should be quarantined, while the CDC maintains that the animal's risk of exposure needs to be evaluated and an appropriate course of action planned out based on that evaluation.
• No evidence has been found by animal health professionals that domestic animals play an active role in transmitting Ebola to humans.

The AVMA website has a wealth of information regarding Ebola, pets and humans. You can visit it yourself to conduct more research but don't forget that your family veterinarian is your best source of information. And, as always, we are here for you 24-7 in case of an emergency. Call us at 317-872-8387 or visit us at 9650 Mayflower Park Drive in Carmel if we can help you in an emergency.

Mammary Cancer In Dogs and Cats

By Kim Wirth, DVM, DACVIM (Oncology)

The month of October is famously known as Breast Cancer Awareness Month and all across the nation pink is prominently displayed to raise awareness in the fight against the disease. According to the 2013-14 version of the American Cancer Society's Breast Cancer Facts & Figures publication an estimated 232,340 cases of invasive breast cancer were diagnosed in women in 2013 and 2,240 men were diagnosed as well. Additionally, roughly 37,000 women died from breast cancer in 2013 which made it the second deadliest cancer in women behind only lung cancer.

Those figures clearly demonstrate a continuing need to keep the fight against breast cancer in humans at the forefront of our collective conscious. What might not be so commonly known, however, is that in the pet world mammary cancer is as big of a concern as breast cancer is in humans.

Mammary gland tumors are the most common tumors in dogs and the third most common tumor type in cats. Unspayed females have the greatest risk of developing mammary cancer and this can increase with each heat cycle. Mammary gland tumors can be benign or malignant and in contrast to dogs, at least 85 percent of feline mammary tumors are malignant. Approximately 50 percent of canine mammary tumors are malignant.

The principal sign is a painless lump or mass. Most masses occur in the glands closest to the groin. A mass may be large or small and can feel just like a small ‘bb’. Some masses are freely movable, while others adhere to the overlying skin or underlying muscle. Occasionally the mass ulcerates the skin and bleeds.

Malignant tumors can spread (metastasize) to lymph nodes, lungs and other organs. Chest x-rays are recommended prior to definitive treatment to evaluate for any evidence of spread to the lungs. Abdominal ultrasound is useful in determining whether there is any lymph node or internal organ involvement.

Treatment involves surgical removal of the lump with adequate margins of normal tissue. How much tissue will be removed depends on the species, size and location of the tumor. Removing a small tumor with a rim of normal tissue is called a lumpectomy. A simple mastectomy is the removal of the entire mammary gland. A complete unilateral mastectomy is the removal of all five mammary glands on one side of the body. The local lymph nodes are often included in a unilateral mastectomy. A specimen is then submitted to a pathologist for a tissue diagnosis to determine the prognosis.

The prognosis for mammary cancer depends on the how aggressive the tumor is. Some patients with aggressive tumors or evidence of spread may require chemotherapy treatment after surgery and some patients are cured. Cats tend to require a larger surgery and often need chemotherapy as well. 

Please remember that the only reliable way to determine if mammary cancer could be affecting your pet is through regular checkups at your family veterinarian. Additional testing and treatments can be performed here at Circle City Veterinary Specialty and Emergency Hospital so be sure to ask your veterinarian about your options for a referral here.

Happy Fall To You and Your Pets

Tuesday marked the official arrival of fall and, for many, that news is better than music to the ears. Crisp days filled with sunshine, colorful foliage, weekends filled with football, the opportunity to wear hoodies almost anywhere and, of course, every kind of pumpkin spiced foods and beverages are just some of the things that make this time of year so special. Like summer before it, though, the autumn does come with some potential pitfalls to pets and their owners. And while we are here 24-7 to help with any emergency situation you and your "furkid" encounter, we also believe in education and taking preventative measures to avoid such scenarios.

So as the leaves begin to change please keep in mind these pointers and tips so that you and your pets enjoy this fall to its fullest.

Be Aware Of Seasonal Allergies
Dogs and cats, just like humans, are prone to allergens in the atmosphere. The arrival of fall brings about higher levels of ragweed pollen in the air and it can trigger allergic reactions in your pets. Ragweed tends to hang around until the first frost falls so its effects can linger. Also be aware that your pets can react to mold and dust mites that come around this time of the year.

If your pet is having an allergic reaction it can exhibit symptoms through its skin. Behaviors such as excessive licking, biting or scratching are clues that there could be a problem. Bear in mind, though, that these behaviors can also be indicative of food or drug allergies. If you notice abnormal licking, biting or scratching please consult your primary veterinarian and be sure to ask about the option of seeing a specialist. Our board-certified dermatologist, Dr. Terry Grieshaber, can talk you through all of the testing options that can help uncover an allergy and how you can manage it.

Chocolate Toxicity

Whether you are hosting a Halloween bash, taking the kids trick-or-treating or setting up shop at your home to pass out candy you are
likely to have chocolate around the house this fall. This has the
potential to create dangerous situations. Make sure that your candy is always stored in a place that is safely out of reach of your pets or, if candy is out, that you don't leave your pets unmonitored around it. Take special care that those trick-or-treating bags aren't left on the living room floor!

Different chocolates (dark, semi-sweet, white, milk, etc.) have different toxicity levels. If your pet happens to ingest any chocolate it is important to contact a veterinarian right away. We provide 24-7 emergency care so if your primary veterinarian is closed we are here to help.

Outdoor Dangers
Harvest festivals abound in the fall as communities come together to celebrate farmers reaping the rewards of a hard summer's work. It is worth noting, however, that harvest time can be dangerous to farm dogs and cats. Always be sure to double (or triple) check that all of your dogs or cats are not out exploring the fields and are out of harm's way.

Hunting and trapping season is quickly approaching and this presents dangers to those of us who take to the outdoors for quality time with our pets. When hiking stay on well marked paths and do not let your dog walk off-leash to avoid the dangers of traps that have been laid. Take precautions against hunters by dressing yourself and your pet in bright colors that do not blend in with the scenery. Be aware of all the parks and walking trails in your area that are restricted from hunters and stick to those during hunting season. If you do venture away from the safest locations, use these links for some information that will help you avoid the danger of hunters:

Indiana hunting seasons
Indiana legal hunting hours

Poisons
Rodents can be a problem in the fall whether you live somewhere rural, suburban or urban. Rodenticides are highly effective in dealing with unwelcome critters looking to escape colder

temperatures by entering your home, garage or barn. However, they can pose a serious threat to household pets. If you suspect your pet ingested any amount of rodendticide it is essential that you contact a veterinarian immediately. Different brands of rodenticides contain different ingredients, but new products on the market contain a chemical that is especially dangerous according to Dr. Amy Rader, director of the emergency department at Circle City Veterinary Specialty and Emergency Hospital.

"Most of the rodenticides on the market now contain bromethalin which is toxic and there is NO antidote. Immediate treatment to decrease contamination and supportive care is the only chance we have at saving them."

If you plan to add antifreeze as part of preparing your car or truck for the colder temperatures take extra care to protect your pets. Ethylene glycol, the main ingredient in antifreeze, is highly toxic to animals. Store your antifreeze containers safely out of reach of your pets, and keep them away from the area whenever you add antifreeze to your car. Any spill should be cleaned immediately with the cloth or paper towel disposed of in a place where your pets can't reach it. Doctor Rader also states that "there are pet friendly anti-freezes on the market and can be found at most stores, so if a pet owner has to add coolant or winterize the pool the pet friendly versions are less toxic." It's a good idea to check with your local retailer to find out if it carries that type of antifreeze.

We hope that this information helps you and your pets have a great fall season both outdoors and in. For more information you can reach us 24-7 by calling 317-872-8387 or visiting us at 9650 Mayflower Park Dr. in Carmel (between Michigan Rd. and 96th). You can also find us on the web at www.circlecityvets.com.

Paralysis: It doesn’t have to be permanent

Paralysis: It doesn't have to be permanent

by Kate Fitzwater, DVM, DACVS

Dachshunds are the number one breed to suffer from intervertebral disc problems. The intervertebral discs are located beneath the spinal cord, in between each vertebra, and are like jelly doughnuts. Each has an outer fibrous layer, like the crust portion of the doughnut, and an inner nucleus pulposus, like the jelly portion. Dachshunds and other breeds like Beagles, Pekingese, Cocker Spaniels can develop mineralization of their discs, which causes the nucleus pulpous (jelly portion of the doughnut, remember) to become like bone, which makes it more predisposed to rupturing.

When the disc ruptures, the nucleus portion of the disc causes compression on the spinal cord. The most common place for rupture is at the thoracolumbar junction or mid-back. It can also occur in the neck, but this article will not address this location. Depending on how compressed the spinal cord is directly correlates to the severity of the clinical signs. Pain is the first sign, which can progress to complete paralysis (loss of all movement in limbs) and loss of deep pain (unable to feel and recognize a painful stimulus to the limb). Prognosis for recovery depends on how severe the clinical signs are and what treatment option is pursued; each case is different. Surgery is most commonly recommended to remove the disc from around the spinal cord if the signs are worse than just walking wobbly, which is called ataxia.

Prognosis for complete recovery with surgery is 85-90% as long as the dog still has deep pain sensation. It is best to not wait until the dog is completely paralyzed, but as long as deep pain is still intact, the prognosis is good with surgical intervention. Once deep pain is lost, there is a 50:50 chance of walking again if surgery is pursued soon after injury.

Rehabilitation with underwater treadmill therapy is the mainstay of recovery after back surgery. Here at Circle City Veterinary Specialty Hospital, we have a CT scanner available for imaging the exact location of the ruptured disc prior to surgery. In some cases myelogram may also need to be done, which injects contrast material around the spinal cord to highlight the ruptured disc. Our two boarded surgeons, myself (Dr. Kate Fitzwater) and Dr. Rebecca Ball that can perform the surgery, even on emergency basis if needed and work closely with our in-house rehabilitation team of two certified rehabilitation practitioners, Dr. Kelly Fisher and Dr. Karen Hull for continued therapy after surgery.

Diagram of a ruptured disc compressing the spinal cord, which is the dark gray structure

What To Do When You're Pet Doesn't Travel With You

The Fourth of July is just in the rearview mirror, high temperatures are here to stay and it's smack-dab in the middle of baseball season. That can mean only one thing - summer is in full swing! It's the time to be thinking about an upcoming trip to the beach or lake, or making final preparations before attending that friend's or relative's wedding that you've been looking forward to. But what is a pet owner to do with all of that travel ahead?

As you may know, there are many hotels, restaurants, parks, etc. that are attuned to the needs of a family traveling with pets (and if that's you please don't forget about our guide for making an emergency kit). Still, though, travelers often elect to hit the road without the company of their four-legged friends. Those folks then have to decide how their pet will be cared for while they are away. Whether you favor having a friend, family member or professional pet sitter come to your home to provide care or taking your pet to a boarding facility, there are important things to consider before making a final decision.

When hiring a pet sitter you should:

• Ensure that the sitter has proper insurance in case of an accident. A pet sitter who owns an insured and bonded business is your safest bet.
• Lay out a specific schedule for when your sitter will provide services. You will want to make sure that your pet's daily routine stays as close to normal as possible while you are away.
• Have the sitter produce a written service contract for you both to sign.
• Get a list of references that you can contact.
• Discuss a back-up plan in case your sitter becomes ill, has car troubles, is drawn away by a family emergency or any other situation that might arise.
• Inquire about any job-specific training the sitter has received.

When looking into a boarding facility you should:

• Confirm that the kennel has a policy that all pets must be up-to-date on vaccinations with documented proof.
• Personally check out the indoor and outdoor facilities so that you know they are clean, well maintained and kept at the proper temperature.
• Ask how often the facilities are cleaned.
• If the kennel has outdoor runs or an outdoor play area, ask about what steps are taken to make sure that no animals escape the facility.
• Trust your senses. If you have a bad feeling about a certain kennel then your dog or cat will likely feel the same way.
• Make sure that the kennel allows you to bring your pet's favorite blanket, toy or other comfort from home that will make their stay better.

Once you've found the perfect person to sit for your pet, or the perfect place to board them, there's one last item that has to be covered before you hit the road; what will happen in the event of an emergency? Circle City Veterinary Specialty and Emergency Hospital's own Dr. Amy Rader says that communication is key.

"What I tell my clients is that any time they are going out of town and their pets are either being boarded or cared for by a pet sitter they need to leave clear (written) instructions as to their wishes for 'Fluffy's' care. That includes, in the event of an emergency, whether the owner would prefer their pet be transported to their primary veterinarian for treatment or if they would prefer to have their pet taken to a 24 hour facility like

Circle City Veterinary Specialty and Emergency Hospital."

Pet emergencies are always a stressful situation and the stress only grows if something happens to our pets while we are traveling. The cost of care in an emergency is a big part of that equation and Dr. Rader has important advice for how to ease that burden.

"Contact the clinic prior to your trip and advise them who can authorize treatment for the pet until the owner can be reached, and possibly leave a credit card number on file with the clinic. Also, you can make an agreement with the pet sitter for the initial cost to be paid by them and then the owner reimburse them as soon as they can."

To help guarantee that all the right people have the proper contact information while you travel simply fill out and distribute this Emergency Contact Card.

With all of that information you are ready to make the best arrangements for your pet's care while you are traveling. So get out there and enjoy all that summer has to offer!