The shortage of opioid drugs affects veterinary medicine, too. Here’s how
By Kim Campbell Thornton
Andrews McMeel Syndication
If you don’t take pain medications or haven’t had surgery recently, you probably don’t think the opioid crisis you’ve been hearing about on the news has anything to do with you. But if you have pets, they could be affected. Not because they’re at risk of falling prey to drug dealers pushing controlled substances, but because pets who need surgery or treatment for acute pain are beneficiaries of the same pain-relieving medications used in humans.
A shortage of the medications — caused by a double whammy of inspection issues and production delays related to upgrades at a Pfizer facility in Kansas, plus a DEA-mandated 20 percent decrease in overall opioid production in an attempt to curb abuse by humans — means the drugs are less available for use in veterinary medicine.
Veterinarians use injectable opioids such as morphine, fentanyl, methadone and hydromorphone for surgical procedures and acute pain from trauma. Human doctors get priority when those and other opioid drugs are distributed, leaving veterinarians to scramble for ways to manage pain in pets.
“The opioid crisis the government is talking about is people OD’ing,” says Sheilah Robertson, a veterinarian who specializes in analgesia and anesthesiology and who is the senior medical director for Lap of Love Veterinary Hospice. “It’s a different crisis to us. Our crisis is that we’re short of opioids that our patients need.”
The shortage is expected to continue into 2019, according to a June 19 statement by the Food and Drug Administration. In one attempt to mitigate the shortage, the FDA and Pfizer coordinated the release of some products that were on hold due to potential quality issues, distributing them with instructions for safe handling and use to reduce risks to patients.
What the shortage means for pet owners is that in some instances, a pet’s surgery or other procedure may need to be postponed or performed with drugs that are less effective in managing pain, says pain expert Robin Downing, DVM, director of the Downing Center for Animal Pain Management in Windsor, Colorado.
The potent drugs are a cornerstone of pain relief before, during and after surgery, Dr. Downing says. Their use in anesthesia reduces the need for inhalant anesthetics. In turn, that reduces the risks associated with general anesthesia.
To get around the shortage, veterinarians are having to think creatively. They may use less-potent opioids such as butorphanol and buprenorphine in combination with drugs that provide local anesthesia and nonsteroidal anti-inflammatory drugs, known as multimodal analgesia. Local anesthetics completely block pain, and a single dose of some new drugs in that category work for 24 to 72 hours. Multimodal analgesia can also help to reduce grogginess, nausea or vomiting after surgery.
Sometimes there’s a learning curve to using unfamiliar drugs and techniques, though.
“I’ve taken calls from numerous veterinarians asking about alternatives to the opioid they usually use, which they are now having difficulty obtaining,” says Jordyn Marie Boesch, DVM, a lecturer in anesthesiology at Cornell University College of Veterinary Medicine. “The good news is that there is often an alternative opioid available. The silver lining is that the shortage is introducing veterinarians to many other ways of providing analgesia that they may not have been familiar with before.”
Veterinarians also hope drug companies will take steps to have some opioids labeled specifically for use in animals. In Europe, for instance, versions of fentanyl are made specifically for use in dogs and cats.
“If there’s a human shortage (of opioids in Europe), it doesn’t affect veterinarians, and that’s what we would like to happen here,” Dr. Robertson says. “We know that taking a drug through all the trials and FDA costs a lot of money, but we can no longer depend on our supply from human-labeled drugs anymore.”
Cat recovers well after hip surgery
• Fridgey, a 2-year-old Bengal cat who has had bilateral hip problems, gave veterinarians at Purdue Veterinary Teaching Hospital in West Lafayette, Indiana, their first opportunity to perform total hip replacement surgery — a common procedure in dogs — on a cat. He underwent the surgery in March, followed by extensive physical rehab sessions to get him back in shape, including sessions on an aquatic treadmill. Fridgey has recovered well, his veterinarians report. Between surgery and rehab, the cost of Fridgey’s care was approximately $10,000, but owners Tyler and Faith Goldsberry had pet health insurance, which covered 80 percent of the expense.
• Summer is still in full swing. If you haven’t been to the beach with Rover yet, here are eleven dog-friendly options: Muir Beach in Marin County, California; Dog Beach in Fort Myers Beach, Florida; Jekyll Island off the coast of Georgia; Montrose Dog Beach in Chicago; Long Meadow Dog Beach in Brooklyn’s Prospect Park; Cape Hatteras National Seashore in North Carolina’s Outer Banks; Ecola State Park in Cannon Beach, Oregon; Kinney Shores in Saco, Maine; Edisto Island Town Beach and State Park in South Carolina; Padre Island National Seashore in Corpus Christi, Texas; and Magnuson Park in Seattle.
• Got a constipated canine or a cat who’s hacking up hairballs? Add a little plain canned pumpkin to his diet. The added fiber can get things moving in your pet’s digestive tract, and it also helps to reduce the incidence of hairballs. For pets with mild diarrhea, the fiber helps to firm up loose feces. Pets on a diet will appreciate some pumpkin mixed with their food to help them feel fuller. Ask your veterinarian how much to give, based on your pet’s size, and be sure to use plain canned pumpkin, not the sweetened pie filling. — Dr. Marty Becker, Kim Campbell Thornton and Mikkel Becker
Some dogs and cats seem to be wusses when it comes to pain. Is there a genetic reason behind it?
By Kim Campbell Thornton
Andrews McMeel Syndication
Does your dog or cat act as if you’re killing him when you trim his nails, even if you’ve never “quicked” him? Scream bloody murder when all the vet tech has done is wipe her skin with alcohol? Some breeds have a reputation for being crybabies because they have what seem to be excessive physical or vocal reactions to even minor procedures. Are they wimps, or could there be a genetic reason for their behavior?
Some breeds do seem to feel pain more acutely than others, according to Michael C. Petty, DVM, who presented a lecture on managing pain in surgical patients at the 2018 VMX conference in Orlando, Florida, in February. He specifically calls out beagles, Shetland sheepdogs, and Northern breeds such as Siberian huskies — known for their excessive vocalizations. Other veterinarians agree.
“I think Arctic breeds probably do have a heightened pain response,” says Tamara Grubb, DVM, assistant clinical professor of anesthesia and analgesia at Washington State University’s College of Veterinary Medicine. Right now, she’s speaking simply from experience, but she believes that one day researchers will find that certain breeds have a genetic predisposition for a heightened pain response.
We know from studies in humans that complex environmental and genetic factors result in a high degree of individual responses to pain. Subtle changes in DNA may at least partially explain the different ways people perceive and express pain. There appear to be a number of genes in humans and animals that influence sensitivity to pain.
The genes that dictate coat color may also affect behavior or pain sensitivity in some way. It’s been found, for instance, that people with red hair are more sensitive to certain types of pain because they have specific gene variants. In his lecture, Dr. Petty says, “These people have a lower thermal threshold, need higher levels of anesthetics and don’t always respond to the effects of lidocaine like other people do. I suspect that some animals have the same issue.”
A study at the University of California, Davis Veterinary Medical Teaching Hospital found that cats with calico and tortoiseshell coats are more likely to hiss, chase, bite, swat or scratch when being handled by humans. Maybe their coat color genetics are linked to greater sensitivity to pain, although one of the authors, Melissa J. Bain, DVM, said they didn’t look at reaction to pain in their study.
It could also be that there’s no real link between coat color and certain behaviors. It may simply be what’s known in evolutionary biology as a spandrel: a byproduct of the evolution of some other characteristic — in this case, pain sensitivity — but with no direct relationship.
Some animals who more readily express pain also react differently to certain drugs. Veterinary anesthesiologist Jordyn Boesch, DVM, says breeds such as Siberian huskies and Alaskan malamutes become restless, anxious or depressed under the influence of certain doses of opioids used during procedures requiring anesthesia. That doesn’t mean that opioids shouldn’t be used with them, but that they should receive the lowest effective dose, she says.
Can you teach your pet to exhibit less drama when you trim nails or visit the vet? Dr. Petty noted that dogs and cats may benefit from Fear Free techniques or the feline-friendly handling guidelines developed by the American Association of Feline Practitioners. Techniques for at home and in the veterinary clinic include providing emotional and physical support, including offering a favorite treat or toy during the procedure; reducing the risk of nausea and vomiting by providing medication before car rides to the vet and prior to surgery; and environmental management of light, noise, odors, slick floors and other factors that can affect a pet’s comfort level.
Nine of the best new pet books to read this summer
By Kim Campbell Thornton
Andrews McMeel Syndication
Summer reading can be an escape, an education, an entertaining way to while away a few hours or all of the above. If you’re a pet owner, you have an astonishingly wide array of literary pleasures and educational treasures awaiting you during long, lazy days of vacation or simply while you’re waiting for the kids to get out of day camp. The following new releases cover all the bases: mystery, science, photography, behavior and humor.
In “Fear on Four Paws,” book seven in Clea Simon’s Pru Marlowe pet noir series, the animal communicator faces a drugged bear, a ferret who’s not sharing any secrets, her own crabby tabby and a town whose pets are disappearing. Marlowe herself becomes a person of interest in a murder, and a tempting job offer further complicates the situation. Can she identify the killer and return the missing pets to their homes?
Blue cats, big cats, plush cats, silly cats. If your happy place involves looking at pictures of cats, you won’t want to miss professional cat photographer Larry Johnson’s book “Show Cats: Portraits of Fine Felines.” In its pages, more than 180 images depict cats in all their glory: color, eyes, ears, tails, coat type, in motion and more. The accompanying text shares information and insights about the cats themselves and the challenges of photographing them.
If you’d rather see cats trip on ’nip, look for Andrew Marttila’s “Cats On Catnip,” photographic documentation of the silly, bizarre and delightfully unhinged behaviors cats exhibit under the influence of the herb.
How do dogs smell? Frank Rosell set out to answer that question in his book “Secrets of the Snout: The Dog’s Incredible Nose.” He does a terrific job of explaining dogs’ olfactory obsessions as well as exploring the different types of work dogs do, including finding lost pets, search and rescue, and detecting explosives, pests and diseases. Sniff it out.
Ethologist Adam Miklosi brings together anatomy, behavior, biology, evolution and history to present the latest in what we know about dogs. His art- and photography-rich book “The Dog: A Natural History” ranges from the controversies over where and when domestication began to our current dog-loving culture and the attachment between humans and dogs.
Marc Bekoff’s “Canine Confidential: Why Dogs Do What They Do” is a fine companion to Miklosi and Rosell’s books, bringing the latest science on cognition and emotion to canine personalities, play, marking habits and more, including the eternal question: Why do dogs roll in stinky things?
I must confess, my co-writers Dr. Marty Becker and Mikkel Becker and I are among the contributors to the next book, “From Fearful to Fear Free.” Subtitled “A Positive Program to Free Your Dog from Anxiety, Fears, and Phobias,” it addresses how fear affects the canine brain, types of fears dogs can develop, such as separation anxiety and noise and thunderstorm phobias, and how to use reward-based techniques to reduce or even prevent fear at the veterinary clinic, out in public, on the road and more.
Kids who love animals and want to learn more about animal welfare can’t go wrong with Beth Adelman’s book “Dogs and Cats: Saving Our Precious Pets.” In easy-to-understand language, she addresses pet overpopulation, breed-specific legislation, genetic diversity, declawing and health problems caused by extreme physical characteristics, to name just a few of the important issues to consider when we live with animals. A quiz and suggested research project at the end of each chapter help readers remember what they’ve learned and find out more.
In “Catnip: A Love Story,” Michael Korda’s doodles of his cats’ imaginary lives — reading the newspaper, happy hour at the local pub, a Fourth of July celebration — are a joyful and humorous representation of the love for cats he and his wife shared.
This delightful ailment can be treated by adopting one of the furry darlings at a local shelter, but a pedigreed kitten is also an option
By Kim Campbell Thornton
Andrews McMeel Syndication
Every kitten is adorable, but some people look for breeds with a certain look, size, personality, activity level or other desirable trait. From Abyssinians to Turkish vans, there’s a pedigreed cat to suit anyone’s feline desires.
Not everyone starts out looking for a particular breed. Sometimes their choice of cat is a happy accident. That was the case with Ramona Marek of Portland, Oregon, who began looking for a new kitten after the death of her 15-year-old Maine coon-mix. Marek’s previous cats had been found — in a ditch, on the side of an expressway, in an apartment complex laundry room. But this time, she and her husband searched several local shelters and rescue organizations, as well as Petfinder, with no luck.
“The kittens we were interested in had either been adopted or were on hold,” Marek says. “We went to a cat show in hopes of finding a kitten for adoption, since shelters often have a space at the shows.”
She didn’t find a kitten, but she did learn about cat breeds that matched the traits she was looking for: longhaired, social, affectionate. They included Maine coons, Norwegian forest cats and Siberians. With no shelter kitten available yet, Marek located a Siberian breeder who had a litter of 6-week-old silver tabby kittens, to be available when they were 12 weeks old. They put down a deposit but continued looking for a kitten to adopt. None turned up, and a month later, they went home with their little prince, Tsarevich Ivan, who still rules 13 years later.
Some people seek out cat breeds with reputations for being hypoallergenic, such as Siberians, Cornish rexes and sphynx. No cat is truly free of allergens, which are found not just on skin but also in saliva and urine. Individual cats may produce less of the proteins that trigger allergies than others, so spend lots of time with several different cats to make sure you’re comfortable around them before acquiring one.
Cats such as Persians are often in demand for their beautiful appearance and gentle nature. If there is such a thing as a couch potato cat, the Persian is it. The beautiful longhaired cats have a drawback, though: They shed. A lot. They also require daily grooming. Cat lovers who like the Persian personality but not the time required to comb them may choose an exotic, a shorthaired variety. Another consideration: Some Persians have a flat face, which can cause them to have breathing difficulties. Avoid cats with extreme characteristics.
Want an active, mischievous cat who might enjoy an adventurous lifestyle? Consider an Abyssinian, but know what you’re getting into. The cats are highly intelligent and can run you ragged as you try to stay one step ahead of them.
Any cat, pedigreed or not, can experience health problems, but some pedigreed breeds may be prone to specific diseases or conditions, ranging from hypertrophic cardiomyopathy to periodontal disease.
“Be educated about potential health issues,” says veterinary cardiologist Sarah Miller, DVM, who lives with a pair of Maine coons. “Make sure the breeder is screening for the health problems that are inherent in the breed and that the breeder is breeding responsibly in order to keep these problems out of their lines.”
Buy from a breeder who puts the cat’s health and welfare foremost. That includes being willing to take the cat back at any point if you’re unable to keep him. Buying from a breeder has other advantages. Think full-time “tech support” from an expert. A reputable breeder will always be there to answer questions about behavior or development.
Before acquiring a pedigreed kitten, learn as much as possible about the breed by talking to breeders and other owners about activity level, health concerns and grooming requirements.
“Look at the kittens and both parents, if possible, and ask many questions,” Marek says. “For me, the experience was positive, educational and rewarding on many levels.”
Medical therapy plus behavior modification may help dogs and cats with anxieties, phobias and compulsive behaviors
By Kim Campbell Thornton
Andrews McMeel Syndication
Primrose, a 3-year-old Pyrenean shepherd, has always had a lot of nervous energy — to the point that her behavior could be annoying, says owner Deb Rabuck of Allentown, Pennsylvania.
After Rabuck had Prim spayed last August, the dog’s behavior changed, and not for the better. Already aggressive toward unknown dogs and people, she began urine-marking in the house and developed signs of anxiety such as panting and pacing. Prim’s behavior kept Rabuck from sleeping at night and disturbed her other dogs.
“I had to separate her from my other two dogs,” she says. “I was afraid they would kill her. She drives them crazy with all that energy.”
Rabuck took Prim to veterinary behaviorist Jacqueline Wilhelmy, VMD. After running lab tests to rule out possible health problems, Dr. Wilhelmy prescribed Prozac and gabapentin and offered behavior modification advice. It has been 11 days, and while Prim is still urine-marking, Rabuck is now able to sleep through the night.
Pet behavior problems such as separation anxiety; thunderstorm or other noise-related fears; compulsive disorders such as excessive chewing, licking, tail chasing or other repetitive behaviors; or aggression toward other animals or humans can all respond to many of the same psychoactive medications that help humans. They include fluoxetine (Prozac), a selective serotonin reuptake inhibitor; gabapentin, an antiseizure medication sometimes used off-label for pain and anxiety; tricyclic antidepressants such as amitriptyline; and benzodiazepines such as Xanax and Valium.
“Not in every case do we use a medication, but when it is indicated, it can really facilitate the progress of the case quite dramatically,” says Patrick Melese, DVM, a veterinary behaviorist in San Diego, Calfornia.
Medications used in humans have the same or similar effects in dogs and cats because the nervous systems of animals and humans operate in a similar manner. The goal is to normalize brain chemistry and improve the way the animal processes information.
Shannon Gillespie’s border collie Fizz has taken Prozac for more than five years because she would “explode” when frustrated or excited and was unable to calm down quickly. About four years ago, when Fizz’s veterinarian prescribed gabapentin for torn bicep and supraspinatus muscles, Gillespie noticed a further positive change in her behavior. Now Fizz takes both medications to help her maintain a calm demeanor.
“Medications can help decrease the animal’s overall level of anxiety, aggressive behavior, and reactivity and help with impulse control, says Wailani Sung, DVM, a veterinary behaviorist at San Francisco SPCA Behavior Specialty Service and co-author of the book “From Fearful to Fear Free.” “They are typically prescribed when the animal has a high level of anxiety, aggressive behavior and reactivity, (and) when the inappropriate behavior occurs daily or multiple times a week or is very intense.”
It can take several weeks on medication before pets become calm or relaxed enough to start learning new ways of coping or adjust to changes in the household or interactions with family members or other animals. How long medical therapy continues depends on the individual animal and situation. It can range from a few months to a year to a lifetime. Animals may stay on the same dose or have it gradually reduced as the situation improves.
Medication by itself won’t solve a pet’s behavior problems. Behavior modification and environmental changes, if needed, are a necessary part of treatment. (The exception, Dr. Melese says, is urine-marking in cats, which typically responds well to medication alone.) A veterinary behaviorist or certified applied animal behaviorist can develop a plan to help the animal respond more appropriately to the circumstances that trigger the behavior.
Arthritis pain can go unrecognized in dogs and cats. Here’s what to look for
By Kim Campbell Thornton
Andrews McMeel Syndication
Excited by the prospect of going for a walk, Harper, my 10 1/2-year-old cavalier King Charles spaniel, sprang down the hall, then skidded to a halt, yelping in pain. A physical exam by her veterinarian and subsequent X-rays showed osteoarthritis in her lower back.
Osteoarthritis is chronic joint inflammation that causes damage to articular cartilage — which covers and protects the ends of bones — as well as changes to synovial fluid and narrowing of the joint space. Because cartilage in an osteoarthritic joint is brittle, it cracks a little when the pet moves or jumps. The cartilage becomes thinner and less able to retain fluid. Eventually, inflammation and cartilage destruction lead to painful bone scraping on bone.
Some 20 percent of dogs and an unknown percentage of cats develop osteoarthritis. We think of it as a disease of senior animals, but it can affect pets at any age, especially if they are overweight or have congenital conditions such as hip or elbow dysplasia, says Joyce A. Login, DVM, senior manager of veterinary specialty operations at Zoetis, which counts pain medications among its products.
Pet owners are often surprised and dismayed to learn that their pets are in pain from osteoarthritis, says Robin Downing, DVM, a veterinary specialist in pain management and sports medicine at Downing Center for Animal Pain Management in Windsor, Colorado. Too often, they assume that a lower activity level or stiff gait is normal, chalking it up to advancing age. Dr. Downing often hears the following statements from owners who don’t recognize behavior changes that indicate pain:
• “We used to walk 3 miles, but now she only wants to go 1.”
• “She used to play fetch for 20 minutes and now she’s done at five minutes.”
• “She stops and thinks about it before she walks up the stairs.”
• “She doesn’t like to be groomed or touched in certain areas.”
• “He’s not eating as much as he used to.”
• “My cat doesn’t groom himself very well anymore.”
• “My pet doesn’t jump on the bed or sofa anymore.”
• “My cat has stopped using the litter box.”
Decreased stamina, reluctance to perform previously normal actions, and resistance to touch can all signal joint pain. Pets who aren’t eating as much may have lower back pain that makes it painful to lean down to the food dish. And animals who stop using the litter box or have accidents in the house may do so because it hurts to climb in and out of the litter box or squat long enough to completely empty their colon. Pets in pain may isolate themselves to avoid being petted or groomed. When the veterinarian performs a pain palpation, the animal may react by twitching the skin, moving away, crying out or trying to bite.
A plan for managing pain from osteoarthritis may include non-steroidal anti-inflammatory drugs (NSAIDs); injectable chondroprotectants such as Adequan Canine (also used off-label in cats); nutritional supplements with anti-inflammatory or immune-modulating effects, such as microlactins and omega-3 fatty acids; weight loss; laser; and physical rehab. The goal is to break the pain cycle quickly and effectively.
NSAIDs tend to be a cornerstone of treatment, Dr. Downing says, but multiple strategies and products allow her to target pain and inflammation in different ways. Reducing reliance on NSAIDs to treat chronic pain gives her the option to reserve them for use with acute pain, such as that caused by a tooth extraction.
“Each pet is an individual,” Dr. Login says. “There’s not one specific product or treatment that I think you can lean toward. We can’t always fix it, but we can make them happy and comfortable.”
Shelter or rescue group staff or volunteers can have valuable insights into pets available for adoption
By Kim Campbell Thornton
Andrews McMeel Syndication
When you’re ready for a dog or cat to come into your life, you want him now, right? You look online or go to the shelter, walk through once or twice, and, hey, that one in the third cage to the right looks like what you had in mind. But is he really the right choice? Adoption counselors and volunteers at shelters and rescue groups say people don’t ask enough questions about the pets they’re interested in, leading to mismatches in personality and lifestyle.
“I do Abyssinian rescue,” says Linda Kay Hardie of Reno, Nevada. “Some people are attracted to the beautiful looks of the Aby, but they don’t realize the high activity level and intelligence of the cat. One of my Abys came to me after he was returned to the breeder by someone who didn’t know that Abys are high energy and need a lot of attention.”
Ask about health needs, especially if you are interested in a particular breed. Veterinary care isn’t one-size-fits-all. Nicole Morrison of Houston, who was rescue coordinator for her local cavalier King Charles spaniel club, says cavaliers, for instance, need regular teeth brushing and dental cleanings, as well as weight control to prevent obesity. A breed rescue coordinator should be able to fill you in on specific needs of the breed and an individual dog or cat.
Think about your lifestyle and how you enjoy spending time with a dog or cat. More important, ask what the animal you’re considering likes to do and whether that matches your activity level and what you’re looking for in a companion animal.
Common questions potential adopters ask include “Is she housetrained?” “How much does he shed?” “Is she a lap cat?”
Those are good questions, but be aware that appropriate house manners or desired behaviors such as lap sitting may not appear until the pet is comfortable in new surroundings. Maryanne Dell, one of the founders of Shamrock Rescue Foundation in Orange County, California, says even well-trained animals may have accidents in a new home because environmental changes can be upsetting. It’s important to give them time to settle in and ensure that they don’t have opportunities to make mistakes.
“Many rescue pets have been turned over by their owners because they are old or have medical or behavioral issues,” Dell says. “Others are saved from kill shelters by rescues for the same reasons. A good rescue will disclose any and all of the issues that might affect an animal and how he may act in the new home.”
Former shelter adoption counselor Sharon Melnyk of Berkeley, California, suggests some more in-depth questions to ask:
• Is this animal well-socialized or accustomed to interacting with people?
• How does this animal react to children?
• Does this animal get along with other cats or dogs?
• Are there any dogs or cats I should consider who haven’t caught my attention?
Consider behavior and personality, not just looks. Melnyk says it can be heartbreaking to see sometimes shy or reserved cats pawing at people as if trying to get their attention, only to be ignored. Even if a particular animal isn’t what you had in mind, give him a look. You may find a friend for life.
Laura Anne Gilman of Kenmore, Washington, recalls going to a shelter with the idea that she wanted a black kitten. A large orange adult cat reached out to grab her arm both times she walked by. She stopped to see him, and he snuggled his face into her neck. She and Boomer have been together for 15 years now.
Pet travel safety focus of new program
• Animals traveling by air may have better protections with a new standardized global certification program developed by the International Air Transport Association. Based on IATA Live Animals Regulations, developed with input from veterinarians, animal welfare experts and government agencies, the program provides training and on-site audits by independent inspectors. In a statement, Nick Careen, IATA’s senior vice president of airport, passenger, cargo and security, said: “Animal owners and shippers rely heavily on airlines to carry their precious cargo. As an industry, we have a duty of care to ensure that standards and best practices are in place around the world to protect the welfare of these animals.”
• If you haven’t taken a pet first-aid class, now is a good time to sign up for one: April is Pet First-Aid Awareness Month. Knowing how to stop bleeding, clean and bind wounds, recognize signs of shock and other emergency conditions, and what to keep in a pet first-aid kit can help to save your dog or cat’s life. Courses are available from the Red Cross, humane associations and other organizations.
• Does your dog or cat have a health problem that’s difficult to treat or about which little is known? You may want to see if there’s a veterinary clinical trial or study that needs canine or feline participants. The American Veterinary Medical Association has a health studies database (ebusiness.avma.org/aahsd/study_search.aspx) that allows pets and their owners to contribute to veterinary knowledge and maybe even get helped themselves. Current studies include a University of Pennsylvania study on the role of the microbiome in treating canine chronic enteropathy, and another on the use of noninvasive cardiac ultrasound for diagnosis and management of congestive heart failure in cats. Your veterinarian can help you decide if participation is a good choice for your pet.
— Dr. Marty Becker, Kim Campbell Thornton and Mikkel Becker
April is Prevention of Cruelty to Animals Month; which states fall short in their protections?
By Kim Campbell Thornton
Where does your state rank in terms of legal protections for animals? If you live in Iowa, Wyoming, Utah, North Dakota or Kentucky, you might be dismayed to learn that those states have the weakest protections for animal welfare, with Kentucky in last place for the 11th consecutive year. That’s based on annual review of state laws by the Animal Legal Defense Fund, which recently published its 12th annual rankings report.
States with low rankings may have passive flaws, such as outdated language or not keeping up with changing attitudes toward companion animals, livestock and wildlife, but others prohibit actions that could help animals. In Kentucky, for instance, it’s illegal for veterinarians to report abuse and neglect without a court order, subpoena or client waiver. Utah, Wyoming and Iowa don’t prohibit veterinary reporting of cruelty, but they also don’t mandate it.
“Veterinary reporting is a really important part of any animal cruelty investigation,” says Lora Dunn, director of ALDF’s criminal justice program. “Veterinarians are sometimes the only humans besides the perpetrator who actually witness the abuse or neglect.”
Poor definitions of care, weak or nonexistent penalties, and limited or no restrictions on ownership for people convicted of cruelty can also put states at the bottom of the pack.
Defining standards of care, such as the terms “adequate food,” “potable water” and “living space,” helps law enforcement officials determine whether a crime has been committed. When those criteria are not spelled out, neglect and cruelty become a matter of opinion.
States with low rankings often label cruelty, neglect and abandonment as misdemeanors, not felonies. In the bottom five states, humane officers lack broad law enforcement authority.
To determine its rankings, the organization looks at 15 categories of animal protection: general prohibitions; penalties; exemptions; mental health evaluations and counseling; protective orders; cost mitigation and recovery; seizure/impound; forfeiture and post-conviction possession; non-animal agency reporting of suspected animal cruelty; veterinarian reporting of suspected animal cruelty; law enforcement policies; sexual assault; fighting; offender registration; and “ag-gag” legislation, which are laws that punish whistleblowers revealing abuse on factory farms.
Top dogs in animal protection laws are Illinois, which has held first place for the past 10 years, plus Oregon, California, Maine and Rhode Island. Illinois ranks highest for such provisions as felony penalties for cruelty, neglect, fighting, abandonment and sexual assault. The top five states have a full range of statutory protections, require mental health evaluations or counseling for offenders, and restrict ownership of animals after a conviction. With the exception of Rhode Island, those states permit animals to be included in domestic violence protective orders.
In the past five years, more than half of all states have made improvements in their laws, Dunn says. Last year, Pennsylvania made the biggest leap, from 44th to 24th place. Improvements there included a new felony provision for first-time offenders of aggravated animal cruelty, including torture, and granting civil immunity to veterinarians who report suspected animal abuse.
One nationwide trend is “hot cars” laws addressing “reckless endangerment” of pets. In more than 25 states, including Arizona, California, Colorado, Indiana, Massachusetts, Nevada and Oregon, it’s now illegal to leave an animal in a vehicle in certain conditions and temperatures. The laws may also offer civil or criminal immunity to people who remove animals from vehicles, if they meet criteria such as seeking the owner or calling law enforcement before doing so.
“The majority of states have updated and improved their animal protection laws over the past 12 years, and that is a direct reflection of the public’s demand for change and for better protection of animals and animal victims,” Dunn says.
FLIGHT OR FIGHT?
A flight attendant’s carelessness causes a puppy’s death. How to avoid a similar situation.
By Kim Campbell Thornton
Pet lovers across the country were horrified and angry last month after a United Airlines flight attendant placed a carrier containing a French bulldog puppy named Kokito into the overhead storage bin — over the owner’s protests. By the end of the three-hour flight, Kokito was dead from lack of oxygen.
In this case, a language barrier complicated the situation, with the flight attendant not hearing, misunderstanding or ignoring the owner’s statement that a pet was in the bag.
United has taken responsibility for the dog’s death and refunded the passengers’ ticket costs — including the hefty pet fee. Starting this month, it will place bright yellow tags on pet carriers to alert flight attendants to four-legged occupants.
It’s not yet known if the owners will seek additional damages, if the flight attendant will be fired or if criminal charges will be filed. In the aftermath, Sens. John Kennedy of Louisiana and Catherine Cortez Masto of Nevada introduced the Welfare of Our Furry Friends Act, or WOOFF, to create regulations to protect future air-traveling pets from improper stowage.
But as all pet lovers know, no amount of compensation, punishment of the perpetrator or legislation can make up for the loss of a dog’s life, especially under circumstances that should never have happened in the first place. It’s unlikely that this exact scenario will ever be repeated, but there may be other instances in which a pet’s life is put at risk during travel. What can a dog or cat owner traveling by air do to either avoid or deal with a similar situation?
?Be prepared. Know what size pet carrier is permitted on board. Measure yours to make sure it meets the requirements, and bring a copy of the airline’s rules with you in case of a dispute.
?When choosing seats, some people prefer the aisle because it’s easier to get in and out of the seat with the carrier, but there is also more risk that the service cart will run into it or people walking by will accidentally kick it. A CNBC news story reported that Kokito’s carrier was slightly protruding into the aisle, prompting the flight attendant’s demand that it be placed in the overhead space. It may be safer, more comfortable and less stressful for your pet if you are in a middle or window seat.
?Remain calm and polite, but advocate for your pet if a flight attendant asks you to do something that you feel endangers your animal. The Federal Aviation Administration says passengers must follow flight attendant instructions regarding proper stowage of pet carriers. Pet carriers go beneath the seat in front of you, never in the overhead compartment. Ask to speak to the purser or chief flight attendant if there is disagreement.
?If you see something, say something, even if it’s not your pet. It’s OK to express concern to authority when you witness something that appears unsafe. Again, ask to speak to the purser if you aren’t satisfied with the response.
Whether you are an onlooker or the owner, record the incident on your smartphone or ask someone else to do so.
?For your pet’s safety and comfort, as well as for that of other passengers, keep him inside the carrier. This prevents accidental escapes or negative interactions with other passengers or flight attendants.
?Finally, some people have criticized Kokito’s owner for complying. That is wrong. We have all seen news stories of people removed, sometimes forcibly, from flights when they refused to comply with a flight attendant’s direction. Flight attendants have full authority on flights, and questioning one can be intimidating, especially if English is not a passenger’s first language.
How to take the fear — yours and your pet’s — out of pet dentistry
By Kim Campbell Thornton
Andrews McMeel Syndication
My parents have a 12-year-old toy poodle named Spike whom they love dearly. Spike is as cute as he can be, but boy, does he have bad breath. My dad won’t get his teeth cleaned, though, because that means putting him under anesthesia, and he’s afraid Spike will die.
That’s a common fear. Many places try to counter it by offering non-anesthetic dental cleanings. In other words, they scrape the visible plaque and tartar off the teeth. And it’s not like the recent dental cleaning I had, which involved lying back in a comfy chair and watching Anthony Bourdain eat his way through Sicily. Pets must be restrained during the process, which can be distressing for them, or even cause injury if they squirm at the wrong moment and are accidentally jabbed with a sharp scaling device.
Pet dentals are done under anesthesia for many reasons. The aforementioned squirming, for one. Anesthesia ensures that pets remain still and don’t experience fear, pain or discomfort during the procedure. Besides reduced pain and stress for pets, anesthesia allows the veterinarian to better perform a complete examination of the mouth, clean tooth surfaces thoroughly, get beneath the gumline where bacteria hide, and take X-rays of teeth to ensure no damage or infection is lurking.
By the numbers, anesthesia is a low-risk procedure. The risk of death associated with general anesthesia in both healthy and sick dogs and cats is approximately 1 in 500, says Bruno H. Pypendop, DVM, a professor and veterinary anesthesiology specialist at the University of California at Davis School of Veterinary Medicine. In the case of healthy animals, the risk drops to 1 in 2,000.
“Many factors have improved anesthesia safety over the years,” Dr. Pypendop says. “These likely include drugs with more consistent and predictable effects, better knowledge of the effects of drugs on vital function, better ability to monitor and therefore prevent or treat abnormalities and better pre-anesthetic screening.”
Your pet won’t have the option to watch Animal Planet while he’s worked on, but pre-anesthetic blood work ensures that he doesn’t have any underlying health conditions that could be affected by anesthesia. Monitoring of blood pressure, blood oxygen saturation, respiratory rate, body temperature and other vital signs during the procedure helps all pets stay safe and comfortable.
“More advanced equipment for monitoring pets during anesthesia allows for thorough assessment of the pet’s status during the procedure,” says Cheryl Blaze, assistant professor of anesthesia at Tufts Cummings School of Veterinary Medicine. “There has also been increased emphasis on continuing education training for technicians to increase their skills.”
Sedation beforehand, in the form of drugs such as trazodone or gabapentin, help him relax before the procedure, and a local nerve block minimizes pain if extractions are necessary. Long-acting medications provide pain relief after the procedure.
Why the assortment of drugs? Pain travels the body through multiple pathways and involves different neurotransmitters and receptors. Using a combination of medications, known as multimodal pain management, ensures that as many routes of pain to the brain as possible are blocked.
If your pet is a senior or has health problems, your veterinarian may consult a specialist in anesthesiology about the best ways to minimize risk and manage pain.
“Even older animals can be safely anesthetized when a thorough pre-anesthetic evaluation and dedicated monitoring during anesthesia are consistently done,” Dr. Blaze says.
Ask to see a practice’s anesthetic safety record. There is always some risk when a pet (or person) goes under anesthesia, but advanced anesthesia drugs and techniques used help to ensure that all goes well.
Heroic German shepherd recovers from wounds
• Hero dog Rex is recovering well after taking three bullets during a home invasion last month to protect his owner, 16-year-old Javier Mercado. The German shepherd was shot once in the neck and once in each hind leg. Jennifer Weh, DVM, a veterinary surgical specialist at BluePearl Specialty and Emergency Hospital in Renton, Washington, repaired the fractured left hind leg by inserting a surgical pin and screw. Rex was expected to go home to his family to continue recovery. The family was able to pay the $2,000 needed to stabilize the dog, and public contributions covered the $8,000 cost of the surgery.
• In North Sacramento, California, a shelter for people who are homeless has begun to accept their pets as well. It houses more than 100 dogs and eight cats who are permitted to sleep next to their humans, reports Cynthia Hubert in the Sacramento Bee. Dogs and cats living in the dormlike shelter receive veterinary services from the city’s Front Street Animal Shelter, and shelter residents must feed, walk and clean up after their pets, as well as prevent squabbles between pets or injuries to humans. Three bite incidents at the shelter account for a small percentage of all dog bites investigated by Sacramento’s animal control agency, says chief animal control officer Jace Huggins.
• The 2018 Winter Olympics may be over, but some communities are hosting Dog Olympic Games in the coming months. Is your dog ready for the Ball Lottery (dogs retrieve numbered balls; the dog with the highest total wins), Clean Plate Club (self-explanatory); and a dog trick showdown, to name just a few of the events? Look for competitions in Dunwoody, Georgia, on March 17; St. Paul, Minnesota, at the Minnesota State Fairgrounds on April 15; or check your local shelter to see if events are planned. — Dr. Marty Becker, Kim Campbell Thornton and Mikkel Becker