Healing, Caring & Sharing

Unavailable medications - the new normal?

2011-08-19T11:24:00.000-07:00

A new trend in human and veterinary medicine has become all to common. Whether we blame the economy or natural disasters, previously available medications that we rely on day-to-day are just GONE. We get comfortable and complacent about access to these drugs and assume they will always be there when our patients need or require them. Over the past year it has been an ongoing challenge but a new shortage and now outage of melarsomine has created a real problem in the veterinary industry.

Melarsomine is the active ingredient in Immiticide, the drug manufactured by Merial to treat adult heartworm infection. It is the only approved treatment for heartworms and Merial is the only manufacturer. As of right now Immiticide is completely unavailable with no return date in sight. At Grandview Animal Hospital we treated two heartworm positive dogs this week and our supply is now depleted. Any dogs diagnosed with heartworms will be in an indefinite holding pattern until the drug is consistently available again. Those dogs will be waiting for treatment until the supply of raw ingredient is stabilized.

We routinely diagnosis a dog with heartworms every 1-2 weeks and the treatment for this infection is costly. Involving a 1-3 week hospital stay and weeks of cage rest at home, the cost is usually between $500-$1000. The good news is that heartworm disease is preventable and affordable. We talk to our canine clients daily about the importance of monthly heartworm preventive but now those conversations will have an undertone of urgency. If preventive is lapsed and a dog becomes infected we will be unable to initiate treatment due to the Immiticide shortage. There is no safety net for missed doses when there is no treatment.

Please ask if you have questions about affordable heartworm preventive for your dog or cat and if you have questions about the timing of testing. We can help you figure out what to do if you have missed doses and get you back on track. Email reminders are available as backup - let us know how we can help!

The Cat Quandry

2011-05-07T07:16:00.000-07:00

"Ryan", our clinic cat, showing off his smile

Cats are living longer! When people began keeping cats exclusively indoors something amazing happened. They weren't getting hit by cars, attacked by dogs or fighting with other cats. With the simultaneous developments in preventive and wellness care - cats started dying at much older ages and due to old age diseases like kidney failure and cancer instead of trauma. Routine labwork, advances in nutrition and parasite control have allowed us to keep cats healthy and maintain a proactive approach to their veterinary care. Sounds good right? Unfortunately with these changes we started to see another trend emerge within our feline population - OBESITY. This topic needs to be tackled without finger-pointing or guilt - let's just look at it from the cat's point of view.

This topic has gotten plenty of press and the feline obesity phenomenon has oddly paralleled the American obesity epidemic. As humans have access to processed food and video games our waistlines have expanded. As cats become sedentary, indoor creatures and have access to overflowing bowls of high quality kibble they have transformed from lithe, athletic carnivores to round, lumbering type II diabetics.

The "I'm feeding you because I love you" and "don't get up, I'll bring the food to the couch" mentality has negatively impacted our feline friends mentally and physically. One thing I have discovered is that pet owners typically don't want to feel like they are depriving their pets of ANYTHING. The feeling that they are with-holding resources, "starving", or in anyway causing their cat's stress is not a way to foster and nurture the human-animal bond. We try to discuss feline weight issues from the perspective of ADDING, IMPROVING and ENRICHING their lives - not just taking resources away.

1. ADDING in canned food. This is an idea that is fast being accepted by feline health experts and just makes sense. Cats are designed to eat 8-10 small meals per day - typically small rodents or birds. These meals are about 30 calories each and between each meal they are THINKING, STALKING, HUNTING and then KILLING their prey. Each attempt is NOT successful. Our typical house cat may have access to food all day which would facilitate this "grazing" behavior but we have made a few fatal mistakes. Our pet cats don't have to work at all for these meals. Nothing! Just hop off the couch and lumber to the bowl. A bowl full of high carbohydrate kibble DOES NOT EQUAL a bowl full of mice and 8-10 meals of dry food will usually lead to weight gain. Canned food is as close to "a mouse in a can" as we can get (without feeding raw which is another subject entirely!). High protein, low carbohydrate and mostly water - tailor made to a cats metabolism, body physiology and bladder health. Yay! Yes it smells and is more expensive but 100% canned food (usually 3-5 ounces every 8-12 hours) is an awesome compromise. Most owners perceive that their cats LOVE canned food and use it as a treat - what a better way to show our love than give them a treat every day! Cat Feeding FAQ

2. IMPROVING our cat's quality of life and mental outlook by providing high quality nutrition, safe exposure to the outdoors and regular veterinary care is POSSIBLE. We love to help people find a great combination of affordable foods to use on rotation, have amazing ideas for outdoor habitats and will create a wellness program to fit your cat and budget.

3. ENRICHING your indoor cat's environment should become a passion. Cats don't just like it - they NEED access to perches. Vertical space is power to a cat and providing a tree, tower, shelf or similar structure for perching will do amazing things for your cat's well being. Check out our favorite cat tower or design your own CatVantage Modular Tree. Hiding food for your cat to find while you are at work, a vigorous game of chase the LASER and providing sights, sounds and structures to STIMULATE your cat all will pay dividends. I do really believe that cats need access to the outdoors but the question becomes how to do that safely. The answer is easier than you think but may require a trip to Home Depot. I absolutely LOVE the idea an outdoor cat habitat and this may be the single most significant thing you could do to improve your cat's quality of life. Check out our friends at Habitat Haven for loads of inspiration and give access to the outdoors some serious thought.

One of my favorite websites is the home of The Indoor Cat Initiative and it is full of great ideas about helping indoor pets act and feel like their DNA is directing. I think everyone should check out the feline life stressors and basic needs - they are full of great information from the cat's perspective.

The take home point that every cat, every family and every situation is unique. The information here is just designed to stimulate discussion, encourage research and educate people about their amazing feline friends! There is no doubt that treating our cats like cats is a win-win situation!

Dr. Snyder
Questions or comments? Email us today - check out our website at www.grandviewvet.com.

'tis the season...

2011-03-19T18:19:00.000-07:00

In my 12 years as a veterinarian our home has adopted an open door policy. Sick, well, young & old - we have been a sort of halfway house for various animals with various needs. Pediatric patients and hospice care - sometimes you just have to bring your work home with you! My work typically won't fit into a briefcase but my kids know what it means when Mom carries in a "box"! Typical for Spring, this weekend's lodger is a "parvo puppy". Technically she is a parvo survivor - a teeny, tiny 1 pound survivor. This little gal was giving her owners a terrible time - refusing to eat well and demonstrating just how low a blood sugar can go! After a couple visits in a hypoglycemic crisis it became clear that we needed 24 hour monitoring and regular feedings - translation - sleeping in my bedroom.

Canine Parvovirus is a nasty illness. Highly contagious and easily spread it is common in the Spring and Summer when conditions are good for the virus to survive. It spreads via a fecal oral route and is near 100% preventable with an inexpensive vaccination. The first symptom is usually loss of appetite and that is followed by frequent vomiting and bloody diarrhea. Survival rates can approach 80% if treatment is aggressive and early. There is no cure but supportive care (fluids, antibiotics, pain medication and anti-emetics) can mean the difference between surviving and succumbing to the virus. The virus is easily and quickly diagnosed, most commonly in unvaccinated or undervaccinated puppies. Certain breeds such as Rottweilers seem to be more susceptible to parvo. Immunity is most likely lifelong after a pediatric vaccination past 16 weeks of age and a booster vaccine 1 year later. Education and vaccination are the key components in parvovirus prevention.

As for this little puppy, she is "recovering" in the arms of a 9 year old and getting regular doses of love and comfort. We are cheering and cooing when she eats a couple bites of food or uses the piddle pad. She will get better, go home and we will file the memory away. Then when I least expect it my kids will say, "Mom, remember when you brought Madison home?" and we will all smile at the memory. I'll tell them about the last time I saw her at the clinic, how she is all grown up now and doing great. They will start a grand retelling of stories about all the amazing animals who have touched our lives one at a time - right here in our living room.

Click here for more information about canine Parvovirus

Dr. Snyder

1,000,000 Dogs

2011-03-07T19:14:00.000-08:00

I just saw a statistic from the American Heartworm Society that 1,000,000 dogs are infected with heartworms right now. There has been interest of late in the number of infected dogs and the geographical patterns of infection. The Mississippi River Valley seems to be the "hotbed", starting in Cape Girardeau, MO and extending South. Some theories involve Hurricane Katrina or the socioeconomic status of the residents in those areas. Heartworm and mosquito gurus can't agree on what exactly is happening with these pockets of infection, many positive dogs were on preventive. They are reluctant to say we have a super-heartworm that is resistant to the preventives on the market but some people are crying resistance. All the preventives available are in the same class of drugs and that generates speculation that we don't have a long term solution.

What does this mean for YOU and YOUR DOG - right now?

Heartworm preventive is available and affordable - explore your options
Geographic areas outside of the MS river valley are NOT experiencing preventive failure
If you have a heartworm positive dog within a one mile radius of your home your unprotected dog has a 50% chance of becoming infected
If your unprotected dog is kenneled outdoors - that just rose to a 75% chance of becoming infected
Heartworm disease is dangerous or fatal if left untreated
Heartworm treatment is expensive, uncomfortable, lengthy and requires cage confinement

Ask someone at your veterinarian's office about your pet's options for heartworm preventive. Educate yourself about the disease, how it is transmitted and what the benefits and limitations of preventives are. With a little information you can find a preventive that fits your pet's needs and your preferences.

American Heartworm Society

Companion Animal Parasite Council

Heartworm Information Center

Dr. Snyder

Under Construction

2011-03-01T17:16:00.000-08:00

Welcome to our blog! With the best of intentions we will officially start blogging as Grandview Animal Hospital and grab on to this opportunity to share thoughts, pictures and information with our clients and friends. I'll title the blog "Healing, Caring & Sharing" because that is our mantra! It is our battle cry, gentle reminder and OFFICIAL MOTTO. Maybe those three words used individually are a bit cliche for a veterinary clinic - but stack them together and presto chango you have "us"!

I'll title this post "Under Construction" - because construction is really on my mind. I have Spring fever and that has morphed into Spring cleaning. We have had a winter of transition at GAH and the change of seasons is ushering in much more than just pollen. We are all a bit cagey, testing our boundries and suffering some growing pains. We have adapted to change, reset our normals and are looking ahead for the next pitch. I feel like the captain of a ship and have my hand above my eyes, scanning the horizon for ways to make GAH a tiny bit better - tweaking this and that while looking to maximize efficiency, patient safety and client comfort. Is it working?

We have been a bit self indulgent too. Modifying an existing office into the ever elusive "break room" was a big change for us and just today I witnessed some real life bonding between my staff members over lunch. We are looking for small modifications to our 60 year old building that make our jobs easier and better utilize our ever shrinking space. But admittedly the most self indulgent project is my own office. My under paid, much appreciated, never complaining and oh-so accomidating handyman has been hard at work. The doctor's office is getting an extreme makeover and I can't lie - I am so excited! I feel empowered, organized and just plain important to have such a wonderful thing happening. But with this gift comes responsibility...

Charts done on time, phone calls returned immediately, efficiently researching cases between appointments, uber organized workspace... CAN I EVER MEASURE UP? Thank goodness my staff and clients are an understanding group. They take me and my shortcomings as part of the package and know that it is going to take more than a new desk and bookcase for this old dog to learn a new trick. Thinking of the shiny new and the expectation that brings with it makes me smile with pride. Our clinic isn't shiny new but it is an incredible place. We are a bit rough around the edges but that should not diminish the expectation of excellence. I hope we can surprise and keep you guessing as we deliver high-tech medicine from an old fashioned exam room. Our clients shouldn't have to notice all those small and subtle changes but can grow to love the end result.

So that is my philosophy and vision. That long after our projects are completed we will still think of our hospital as "under construction". Every day we need to be fluid, changing and willing to modify our environment to meet the needs of our patients. So don't expect the dust to settle any time soon.

Dr. Snyder