Poison Prevention Week 2018: 31 Admissions in 62 Days

poison prevention

Every morning at about 5 am, the Animal Medical Center’s overnight admissions list is distributed via email. The list is a fascinating snapshot of our emergency room. I have written about this list in a previous post highlighting AMC’s ER.
Since March 18-24 is National Poison Prevention Week, I have used the overnight admissions list to collate all the pets hospitalized for poisoning between December 21, 2017 and February 21, 2018. In those 62 days, 31 pets were sick enough to require hospitalization following ingestion of a toxic substance. The admissions list did not capture those pets treated in the ER and immediately discharged. Even so, the numbers tell how serious an issue poisoning is in our ER.

Every Age and Type of Pet Can Be Poisoned
The majority of hospitalizations for poisoning were dogs. I would have guessed the list would be composed of lots of silly puppies with indiscriminate eating habits. Wrong. Yes, there was a 2-month-old puppy, but the list contained several 12, 13 and 14-year-old dogs who should have known better than to eat what they did. The list also included three cats and a cockatoo.

Chocolate takes gold, while medications and marijuana tied for silver
Of the 31 pets admitted for poisoning, 11 had overindulged in chocolate. Six dogs, including a cute two-month-old mixed breed puppy and an 11-month-old poodle sniffed out their family’s marijuana stash and helped themselves to earn their spot on our ER list. Six different dogs overdosed on some form of human medication; and the most surprising to me was the dog who ate a bag of cough drops while his flu-stricken family struggled to recover from their illness.

Cats and Lilies
Only three cats were hospitalized during this time period and all three cats came to the ER because they had eaten lilies. Any form of lily, including Easter lily, tiger lily or Asiatic lily, can cause kidney failure if ingested by a cat. Happily, all three of these cats recovered and were discharged from the hospital to relieved families.

AMC’s ER has a wealth of experience in managing poisoning in pets, but many of these pets would not have required medical attention if chocolate and medication were stored carefully and floral arrangements selected judiciously.

Accidents do happen and here are the contact numbers for animal poisonings:
ASPCA Animal Poison Control

Pet Poison Hotline

For more in-depth information common toxicities in pets, please view a lecture by Dr. Carly Fox, staff doctor in Emergency & Critical Care at AMC.

Should You Be Concerned About Fatty Tumors in Your Dog?


The Animal Medical Center’s Usdan Institute for Animal Health Education provides our clients and the broader community with important, relevant, and timely animal health information. A dog owner reached out to the Institute for information on lipoma, a fatty tumor found most commonly in dogs. I will recap my answer to their question here.

What is a lipoma?
A lipoma is the most common skin tumor found in dogs and is a benign accumulation of fat cells. Some dogs never have one, and others can be very lumpy because of multiple lipomas. Because medical terms can be confusing, be sure you don’t confuse lipoma with lymphoma. Lymphoma is a malignant tumor of lymph nodes and is the most common malignant canine tumor treated by AMC oncologists.

What does a lipoma look and feel like?
A lipoma is a mass under the skin, which you may notice because the lipoma causes the fur to stick up funny, or you run into the lump when you are petting your dog. Lipomas are usually soft and easily movable; they are not attached to the underlying body wall. Some lipomas can attain giant proportions and cover the entire side of your dog, without causing any medical issues. Veterinarians cannot rely on how the skin mass looks or feels to determine if the mass is a lipoma. Mast cell tumors and soft tissue sarcomas, two potentially malignant tumors, also develop under the skin and can feel soft and squishy just like a lipoma. I have seen dogs with ten lumps, nine are lipomas and the tenth is a nasty mast cell tumor.

Should I have my dog’s lipomas removed?
The presence of a lump on your fur baby is worrisome to many dog families, but the vast majority of lipomas never cause a problem in a dog. Occasionally, a lipoma becomes very large and interferes with ambulation. These are often found in the armpit, and removal improves the dog’s quality of life immeasurably.

Are lipomas ever malignant?
The word, lipoma, implies a benign tumor, but there is a malignant version of lipoma, a liposarcoma. A liposarcoma is not a lipoma gone bad, but a tumor arising from juvenile fat cells. Dogs affected by a liposarcoma can have a good prognosis, but usually need a major surgical procedure to completely remove the tumor.

My dog is really lumpy, now what?
Lipomas are easily diagnosed via cytology. Cytology can sort out the difference between mast cell tumors and soft tissue sarcoma as well. Talk to your veterinarian about any lumps you find on your dog. If the lumps are sometimes hard to find, use a permanent marker or white-out painted on the fur to make finding them easier during your pet’s examination.

What Could Be Better Than a Puppy?


The title of the blog is a direct quote from the human belonging to one of my patients. This gentleman was delirious at the prospect of the new fluff ball with puppy breath about to come into his life. The family already included a very sociable, well-mannered adult dog and they thought this dog would like a canine little brother, hence the new puppy.

Over the years, I have discovered pet owners develop a selective memory about the effort involved in raising a new puppy. Somehow, all the family can remember are the cute antics, the playful exuberance, and the fun associated with a new furry family member. The lack of sleep, the mess and damage inflicted by those razor sharp puppy teeth fades quickly from their minds once the puppy grows up and I often hear lamentations about the work of having a new puppy.

Jake arrived for his first examination and did not disappoint. Simply said, the puppy was darling and very peppy. His human was not so peppy. Housebreaking and training a puppy requires time and dedication 24/7 and the lack of sleep was taking its toll on the human, but it did not dampen his enthusiasm and delight with the puppy scampering around my exam room.

A clean house?
With any puppy, accidents will happen. Be prepared with an odor neutralizing cleaner, a carpet cleaner formulated for pet accidents, and an extra shipment of paper towels. Making clean up quick and easy gives you more time to throw that ball and give treats for its return.

Perfect furniture?
The family of another one of my patients swore their new puppy was not a Cavalier King Charles Spaniel, but a dog-beaver mix. Coco chewed her way through just about anything she could put her mouth on: the other dog’s ears, shoes and the legs of the kitchen chairs. Chewing is normal for teething puppies. Baby teeth start to fall out at about four months of age and the permanent teeth are all in by about 6 months or so. During this time, it is critical to protect important objects and divert your puppy’s chewing to appropriate toys. The Animal Medical Center’s dentists say no to furry tennis balls, nylon bones, real bones, and hooves because of their tooth-damaging properties. They recommend sturdy cloth, rope and rubber chew toys.

A crate, lots of chew toys and another dog?
In addition to the chew toys, a crate is an invaluable puppy accoutrement. The crate provides your puppy with a space to call their own and keeps them safe while you run to the store or jump in the shower. Most puppies prefer not to eliminate where they sleep, so the crate also facilitates housebreaking. Jake was a lucky puppy, with an older brother to show him the ropes. The humans in Jake’s family were grateful for the efforts of their older dog who helped to diffuse some of Jake’s boundless puppy energy allowing them to revel in the camaraderie of their furry family members.

So in the end, maybe selective memory happens because sleep, a clean house, and perfect furniture don’t really matter because NOTHING is better than a puppy!

New Travel Regulations Affect Service Animals

emotional support animal

“Can peacocks fly?”
“Pets on the fly”
“Delta tightens the leash on emotional support animals”

These are but a few of the clever headlines online and in print over the past few weeks regarding emotional support animals traveling in airplane cabins. The topic of traveling with emotional support animals came to the forefront when Delta Airlines announced that beginning March 1, 2018, it would require additional documentation for customers traveling with an emotional support animal. For travel after March 1, passengers will need to provide documentation from a certified mental health professional, a veterinary health form documenting the health and vaccination records for the animal, as well as confirming that the animal has appropriate behavioral training. I completed the veterinary health form for a patient of mine today. Forms were readily accessible on the airline’s website.

Can Spiders, Sugar Gliders or Hedgehogs Fly?
One of the issues highlighted in the series of articles with clever titles was the story of an emotional support peacock denied the opportunity to board his flight and occupy the seat his human purchased for the trip. The peacock, named Dexter, was trying to fly on a United Airlines flight, but even if he had switched airlines, he would have also been disallowed on a Delta Airlines flight for not meeting several requirements for a flying service animal: must fit under the seat, cannot occupy a seat intended for a person, must be a household bird. In addition, the emotional support animal cannot encroach on other passengers. Whoever was booked to sit next to the support peacock probably doesn’t know it, but they really dodged a bullet on that flight. I also found a report of some support bees that were not allowed to board a Southwest Airlines flight.

Delta Airlines has a very specific list of what animals cannot be accommodated in the cabin. I could not find a similar list for United, but Southwest Airlines will not accept rodents, ferrets, insects, spiders, reptiles, hedgehogs, rabbits, or sugar gliders, a list nearly identical to Delta’s.

Before You Go
Before traveling with your emotional support animal, service dog or any animal, you have some legwork to do before you buy tickets. First, check the website of your airline for their requirements for traveling with pets or support animals. If you plan to travel outside the United States, each country sets its own rules regarding animal importation. The United States Department of Agriculture maintains a very informative website to assist pet families in navigating these rules. Start early in getting your pet’s travel papers in order as some countries require preapproval and special blood tests for entry. One, you know what tests and documentation are required, make an appointment with your veterinarian to obtain the proper travel papers.

Are Purebred Dogs Sicker than Mutts?

westminster dog show

This week was the week New York City went to the dogs; the annual Westminster Kennel Club Dog Show was in Madison Square Garden on Monday and Tuesday and there were activities all over the city related to man’s best friend. The Animal Medical Center veterinarians were at the Show triaging dogs unlucky enough to get sick during the second longest running sporting event in the United States.

I always love to visit the rows and rows of cossetted purebred dogs in the benching area of the show. But all those purebred dogs made my veterinary mind drift to lists of diseases prevalent in certain breeds: Addison’s disease in Nova Scotia duck tolling retrievers, renal dysplasia in Shih Tzu dogs, or cardiomyopathy in the Doberman pinscher, to name a few. I can also assure you all three of these diseases are not exclusive to purebred dogs and can be diagnosed in any dog.

Is Hybrid Vigor a Myth or “Dog”-Ma?
The list of diseases associated with purebred dogs is long, but does that mean purebred dogs are less healthy than the basic Heinz 57 model? Probably not. One way to assess health is to look at cause of death. In a study of over 70,000 dogs from North America where the cause of death was known, the number one cause in most breeds was cancer, but the number one cause in mixed breed dogs was also cancer! The fact that cancer is so common in our canine companions reflects the high-quality medical care available to dogs in the United States and Canada. Well cared for dogs don’t die of distemper or parvovirus, they get vaccinated. Dog owners use heartworm preventative and flea/tick medications to prevent parasitic and tick-borne illnesses. Few people let their dogs off leash unattended, protecting them against trauma from automobile accidents. Good health care allows dogs to live to a ripe old age where they are at risk for developing cancer.

Common Diseases Occur Commonly
A recent study of Border Terrier health from England looked at common disorders in this healthy, hearty breed. When seen by a primary care veterinarian, dental disease, ear infections and obesity topped the list of diagnoses in this group of British Border Terriers. Compare that to a widely published list of pet insurance claims and you see the same disease in a large population of insured American dogs, where ear infections and tooth abscess are included in the top ten list. Seems that no matter where you look, dogs all seem to have similar problems.

Lifestyle and Disease
Lifestyle may play as much a role, if not more, than breed does when it comes to health. The study of 70,000 dogs reported infectious disease as the most common cause of death in Treeing Walker Coonhounds. These dogs are commonly used as hunting dogs and their outdoorsy lifestyle may predispose them to infections. The bold Jack Russell Terrier most commonly fell victim to trauma, perhaps due to daredevil personality. Age plays a role in cause of death as well. Young dogs were more likely to die from traumatic causes, but rarely cancer.

The best way to have a healthy dog, purebred or mutt, is to keep him at an ideal body weight, feed a good quality food, make sure he has plenty of exercise and at a minimum, an annual veterinary visit. Hats off to all the Westminster competitors, all of us at AMC think you are all top dogs.

February is National Pet Dental Health Month

pet dentistry

Maintaining dental health is an important part of your pet’s preventive health care regimen. Dental health is so important at the Animal Medical Center, we have a Dentistry Service staffed by three veterinarians devoted to full-time dentistry for dogs and cats (and the occasional less common pet!). In honor of National Pet Dental Health Month, I have amalgamated some prior blogs on the topic of dentistry to serve as a resource for pet dental issues.

Inside the Mouth
Many pets resist an oral examination in the veterinarian’s office and completely refuse to let their family even have a peek inside their mouth. In the photo blog post, “Hound’s Tooth and Cat’s Teeth,” you can view some great images of the inside of dog and cat mouths. Better yet, you can see the magic a good dental cleaning can do for your pet’s teeth in some before and after photos highlighting AMC’s dentists’ work.

Dental Do’s and Don’ts
AMC’s dentists have a list of do’s and don’ts for your pet. I found the fact that tennis balls are a don’t to be fascinating. The felt on tennis balls abrades a dog’s tooth enamel, which is how the dayglow yellow balls landed on the don’ts list. Who knew? Our dentists recommend felt-less tennis balls.

Smile, If You Have Clean Teeth
Prophylactic tooth cleaning is generally recommended every 12-24 months, but certain dogs and cats have dental problems requiring a different protocol. Many pet families resist dental cleaning recommendations made by their veterinarian because of the need for anesthesia to properly perform a comprehensive veterinary dental cleaning. Read about anesthesia in veterinary dental care which explains why your pet will get optimal dental care only if the procedure is done under general anesthesia.

Have I convinced you to take better care of your pet’s teeth? Watch our video on dog tooth brushing to get you started. Check out the list of Veterinary Oral Health Council approved products and choose the ones that best meet your pet’s oral health needs.

Dog Etiquette in Public Places

dogs in public

I read a really instructive blog this past week, posted by a local dog training school. Since it is winter in New York City, where both the Animal Medical Center and the dog school are located, the blogger created a list of 20 places to warm up with your dog this winter. The list includes coffee shops, bars, hotel lobbies, and books stores — all places where you and your favorite pooch can spend a cold winter afternoon as an antidote to cabin fever. But before you zip up your coat and put your dog’s winter wear on him, review these guidelines on pet etiquette in public places.

Basic Manners for Both of You
As the person responsible for your dog, it is your job to see that she is under control. Keep her on a leash at all times and don’t leave her unattended for a minute. Train her not to bully other dogs and to be quiet. No one wants to listen to a barking dog every time another person or dog enters the bar.

Take Only a Healthy Dog
To protect your dog against diseases they might catch from dogs they meet, check with your veterinarian regarding vaccination recommendations. Canine influenza and kennel cough are two respiratory illnesses rapidly transmitted in places where dogs congregate. A rabies vaccine is a must since in most states it is legally required, and protects your pet if he is bitten by a strange dog. If your dog is feeling under the weather, be polite and stay home to protect other dogs.

Clean Up Your Mess
While the establishments on the list welcome dogs, they might not be prepared for any dog messes. Walk your dog before going inside and be sure your handbag contains poop bags and a few paper towels to mop up any accidents.

Bring Dog Snacks
Even though dogs are welcome, these businesses may not provide water bowls and dog treats. A collapsible water bowl that fits in your backpack would be perfect in this situation. Take some dog treats too as a reward for good behavior. To encourage your dog to be patient, consider taking their favorite chew toy or a feeding toy to occupy him while you finish your latte.

Ask Before You Pet
If you are a member of the public and see the most a-dor-able dog in your local bookstore, please ask before you pet. Adorable, does not equal friendly and if you startle a dog, the dog may snap or bite. If you are the accompanying human, be honest. If your dog is not fond of strangers, then ask members of the public not to pet your dog. My friend Susan was bitten by the dog of a less than honest person.
The remote possibility of a bite injury to a person is just another reason your dog needs to be up to date on his rabies vaccine.

Not Every Dog
Some people are gregarious and others homebodies who would never think of spending an afternoon hanging out in a hotel lobby. Dogs are no different. The homebodies will be restless, anxious and miserable in an unfamiliar environment surrounded by strangers. Let them stay home and invite their favorite dog friend over for a playdate or sleepover.

I hope everyone finds a great winter hangout and makes new friends while hanging!

Concerning Intestinal Parasites

pets and parasites

The New York Times published a disturbing article in last week’s Science Section.
The article highlighted the risk to humans of worms transmitted in the feces of dogs and cats to children. In Linnaean taxonomy, the worm is known as Toxocara (cati in cats and canis in dogs); in the veterinarian’s office, the worm is known as an intestinal roundworm.

Parasites from Animals to Humans
Toxocara infection in children provokes concern because after ingestion, the worms may ultimately migrate to the brain. Doctors are concerned the presence of the parasite may compromise cognition in children who are infected. Sometimes, roundworms migrate to the eye and compromise vision.

Toxocara is not the only animal parasite that can be found in the playground. Baylisascaris procyonis, the raccoon roundworm, rarely infects humans, but again, the resistance of children to handwashing puts them at risk for ingesting raccoon roundworm eggs when playing outdoors. Hookworm eggs, Ancyclostoma caninum, are shed in the feces of dogs and can migrate through the skin and cause itchy red skin lesions.

Protecting Pets and People
Because veterinarians know Toxocara and Ancyclostoma can be transmitted to humans, every puppy and kitten is routinely dewormed during veterinary visits for vaccinations. This practice makes puppies and kittens healthier and protects humans as well. To control Toxocara and other intestinal parasites on an ongoing basis in adult pets, monthly heartworm preventatives commonly include a compound that eradicates most intestinal parasites. Toxocara and other intestinal parasites still cause problems despite these efforts because stray dogs and feral cats are not routinely dewormed and can spread worm eggs when they defecate in parks, playgrounds and sandboxes. Children playing outdoors in areas contaminated with the eggs of Toxocara and other intestinal parasites can become infected if they forget to wash their hands before eating and ingest the eggs.

How You Can Help

  • Be a good citizen and pick up after your dog.
  • Follow your veterinarian’s recommendations regarding deworming your dog and cat.
  • Administer monthly heartworm preventative to prevent intestinal parasites in your pet.
  • Keep your dog on a leash to prevent him from snacking on raccoon feces.
  • Make sure your children wash their hands thoroughly after playing outdoors.
  • Prevent your children from eating dirt or sand while engaging in outdoor activities.

Everyday Medicine: Packed Cell Volume

packed cell volume

“Everyday Medicine” is an intermittent series of blog posts highlighting tests, treatments, and procedures common in daily Animal Medical Center practice. Some past examples of this type of blog post include “Cytology” and “Blood Pressure.” Today’s post focuses on packed cell volume.

What is Packed Cell Volume?
Despite the fact that a packed cell volume is measured dozens of times a day at the Animal Medical Center, most pet owners have never heard of packed cell volume, sometimes referred to as a hematocrit. If one of your pets has experienced a serious issue with anemia, then you might have heard your veterinarian talk about this test. Also known as PCV, packed cell volume is one measure of the number of red blood cells in the blood. There are other methods to assess the number of red blood cells, but these take more time and much more sophisticated laboratory equipment. The laboratory can count the number of red blood cells; there are millions in a drop of blood. The oxygen-carrying protein hemoglobin contained inside of red blood cells can also be measured; like red blood cells, hemoglobin decreases when a patient is anemic.

How is PCV Measured?
First, a blood sample is collected from the patient, typically about ½ teaspoon. Some of the sample is sent to the lab, but a drop or two is placed into a very thin glass tube called a capillary tube. One end of the tube is filled with a soft clay which acts as a stopper to keep the blood in the tube. The tube is placed in the centrifuge and in just a couple of minutes, the centrifugal force “packs” the red blood cells in the bottom of the tube and leaves the clear plasma above. The PCV is the volume percentage composed of red blood cells in the tube. In a normal dog or cat, the PCV is 35-50%.

But Wait, There’s More to a PCV Than Red Blood Cells
The remainder of the volume in the capillary tube is a few percentages of white blood cells and platelets in a section called the buffy coat. A bit more than half of the tube is plasma, or the liquid component of blood. The PCV not only gives a clue to anemia but if the percentage of plasma decreases, dehydration may be part of the diagnosis. In a normal patient, plasma is clear. If plasma is bright yellow, that signifies jaundice and testing of the liver will be necessary. The capillary tube can be snapped open and the plasma put on a handheld device that will measure the protein level of the blood. High protein indicates dehydration; low protein suggests there is protein loss or severe malnutrition. If the percentage of white blood cells increases, then veterinarians worry about infection or leukemia.

When Do Veterinarians Use a PCV?
Because a PCV gives information about anemia, blood protein and hydration status, nearly every patient coming to an animal ER has a PCV obtained. A PCV is a common preoperative test because a PCV is quick and easy. The small volume of blood required for a PCV means the test can be repeated in the operating room without taking excessive amounts of blood from the patient. Any veterinarian monitoring a patient with anemia may rely on a PCV for quick assessment of the patient’s status.

Given its simplicity, speed with which the results are available and the helpful information obtained, the packed cell volume is clearly an everyday test.

Keeping Animals Healthy in the Winter

pets in winter

Winter can be a harsh time for everyone, animals included. Diseases spread more easily when everyone is cooped up inside; cold weather can be hard on pet feet and wildlife struggle to survive. Here are a few suggestions to keep the animals in your life healthy during the long winter months, which have only just begun!

Plan Ahead When Boarding Your Dog
If you are making a quick trip to somewhere sunny and need to board your dog at the kennel, make sure he is up to date on vaccinations and is well protected against infectious diseases. In any place where dogs congregate, boarding kennels, doggie daycare or dog shows, infectious diseases can spread quickly. Ask your veterinarian if she recommends one of the canine influenza vaccines. Vaccines are available for both strains of the canine influenza virus and also against Bordetella bronchiseptica, a common bacterial cause of kennel cough. You might want to check and see if the kennel serves your dog’s usual fare. If not, consider sending his food to the kennel to prevent tummy upset from an abrupt diet change.

Provide Food and Shelter for Outdoor Cats
My neighborhood in New York City does not have many outdoor cats, but outside of Manhattan, whole colonies of cats are threatened by inclement weather. Some animal shelters and rescue groups can provide shelters for these outdoor cats. If you are the caretaker of an outdoor cat, you can create a weather proof shelter from a large plastic tub. Here are directions provided by the Danbury Animal Welfare Society for a do it yourself shelter. If you live in NYC, the Mayor’s Alliance NYC Feral Cat Initiative has workshops on building cat shelters.

Also remember to feed dry food in the winter as canned food can freeze and become inedible. You may also need electric water heaters to keep fresh water available even on subzero days.

Backyard Birds
Winter time brings beautifully colored birds like blue jays and cardinals to backyard feeders. To keep your pretty winter visitors as healthy as possible, follow these suggestions from Oregon State Wildlife Veterinarian Dr. Colin Gillin:

  • Use feeders made from non-porous material like plastic, ceramic, and metal. These are less likely than wood to harbor bacteria and other diseases, which can kill backyard birds.
  • Clean feeders, water containers and bird baths monthly by rinsing with soapy water and then dunking the feeder in a solution of one third cup of chlorine bleach per one gallon of water.
  • Install multiple feeders to prevent all visiting birds from congregating in one place where illness can readily spread.

If you find injured wildlife, birds or mammals, don’t try to rehabilitate them yourself. To find the appropriate rescue group, check this blog post about injured pets and wildlife for resources.