Why Dogs Drag Their Butts: Anal Gland Disease, Anal Pruritus, Etc.

     Picture this heartwarming image in your mind: A Thanksgiving Day feast with the whole family sitting around a large table overflowing with a bounty of delicious and scrumptious foods. Dad is there at the head of the table reverently preparing to carve the succulent, perfectly-cooked, plump and juicy turkey. Grandma and grandpa are there, as well as brother-in-law Joe and his family from Alabama. And just as this Norman Rockwell-moment is about to reach its blissful conclusion, sweet little Fifi, the family’s slightly obese apricot poodle comes scooching by, in plain sight of everyone, dragging her nasty butt on the dining room carpet.
      Discussing the topic of anal pruritus (Pruritus ani is the medical term for having an itchy butt hole) can be a little bit embarrassing. That having been said, it’s still an important aspect of your pet’s health, and if there is a problem, a visit to your veterinarian is in order. Most of the time, the problem is uneventful; on rare occasions, anal itching can be a sign of potentially life-threatening disease.
      Hands down, the most common problem I see with regards to a dog’s (and occasionally the cat’s) itchy rear end is anal gland disease in all of its various forms. For owners who are not familiar with anal glands, here is a short description. Dogs, cats, and skunks have two structures in their anus called anal glands. And what they are, are scent glands. Located at 4:00 o’clock and 8:00 o’clock within the muscles of the anal sphincter, what is supposed to normally happen is that when the dog poops, as their feces pass through the anus it squishes theses glands which then empty their, pungent, musky-smelling, contents on to the dog’s poop. This glandular secretion represents the dog’s unique smell. It is this smell that other dogs are trying to distinguish when the sniff each other’s butts or crap. The normal condition of anal glands is empty. When anal glands fill up to full capacity, they hurt the dog like a tooth ache!
     This leads to the most common cause of itchy butts: Anal Sac Impaction. With anal sac impaction, FOR REASONS UNKNOWN, the dog’s anal glands don’t empty like they are suppose to. Dogs with impacted anal glands will drag their butts (known as “Scooting”), rub their rear ends against trees and door jams, and generally seem to look back at and appear anxious about their back sides. Sometimes, and quite most commonly, the only symptom the owner notices is their poor dog “just don’t act right”. I get that last symptom a lot! They sometimes will also chew and mutilate their tail heads, crotch, or area around the anus.
     The cure for anal sac impaction is to just have the sacs emptied by your veterinarian. It may be the only time it may need to be done in the dog’s life; it may need to be done monthly. My personal rule-of-thumb is that if the anal sacs have to be emptied (the medical term is expressed) less than monthly, then the owner should consider having the glands removed. Although it is not a bonding experience between you or your pet, I have also taught owners to empty their dog’s anal glands.
     Before I proceed, clients usually ask me what they can do to help prevent impacted anal glands. The answer to this question is that there is NO Answer. The cause has been blamed on everything from being over weight to lack of exercise to the phases of the moon to the Clinton administration. There are a lot of claims to curing this problem, but I’ve found none to work with any reliability.
     Closely related to anal sac impaction is Anal Sacculitis. This is a condition where the anal glands become inflamed and are very often infected. This is a very painful problem for your dog and needs to be attended to medically by your veterinarian. Most of the time they respond well to simple antibiotic therapy. Again, THIS CONDITION MUST BE TREATED. If it isn’t, it can lead to anal gland rupture!. These are pus-filled, draining tracts to the outside skin in the region below the dog’s butt hole.
     Finally, with regards to the various types of anal gland diseases, is Anal Gland Cancer. Known medically as apocrine gland adenocarcinomas, these tumors are a very serious problem that cannot wait to be taken care of. These tumors tend to be quite aggressive and often the outcome is not good. Besides the usual symptoms of itching or scooting, other signs you may see are difficulty in pooping, and in advanced cases, signs of drinking lots of water and peeing.
     Other problems that cause your pet to constantly have itchy butts are bacterial, fungal, or parasitic skin infections (dermatitis) and their very close cousin, skin allergies (I see this a lot!) This problem is sometimes difficult to diagnose precisely. But what I tell my clients is that if the dog or cat is itching all over, licking their feet obsessively, or are constantly shaking their heads and having ear infections, than dermatitis must be included as a possible reason for the pet’s itchy butt.
     Other causes of anal pruritus that are closely related to dermatitis are having worms and fleas. For reasons that have always completely baffled me, having worms is the first reason that owners seem to think of when they see their dog scooting or itching his or her butt. In my experience, as it pertains to itchy rear ends, worms are very uncommon. That having been said, routine worming with a worming product recommended and dispensed by a veterinarian should be part of your pet’s larger overall health care history.
     Fleas, on the other hand, are quite common. For reasons known only to the flea, these pesky little critters love the area around the dog’s anus. Maybe they like the flavor. Treat the pet for fleas, and if the dog stops itching their butt, then that’s likely the problem. My preferred treatment for fleas is a product known as Advantage, or its close cousin, Advantix.
      The other causes of itchy rear ends in dogs and cats are not all that common, but include constipation, bee stings, bug bites, a bone stuck in the butt hole, etc. Sometimes we veterinarians can’t find any obvious problem. Sometimes, it turns out that dogs just like to lick and itch their butts!
Thanks again

FOR WHATEVER THEY’RE WORTH: THE SAYINGS OF DR. ORZECK.

One of the constant fears that we who work with the public have is the sudden realization that people (sometimes) are actually listening to what we have to say. I’ve even recently had a client tell me that he finds my humble quotations and witty sayings so profound, that he actually writes them down for future reference! With all this in mind, and with the most humblest of intentions, I’ve decided to record for all prosperity a few of my more famous quotes and share them with the whole world. ● “Given the choice of your dog throwing up in your car or my office, I much prefer he/she do so in your car.” Most-treasured readers, there are two things in this world that I can’t handle well: Baby poop and vomit. I have no problem at all with fetid rotten flesh or maggot-infested cow afterbirths on a hot August afternoon. I could probably even stand up to my waist in chicken manure and eat a hot dog! But if I see or smell—or even think about—a pile of vomit, I’m toast. ● “If you can never know the answer to a question, then there is no point in asking it.” I learned this quote during my college statistics class. For example, the tomcat who comes back home after a night out on the prowl, who’s favoring his left-hind leg, ain’t gonna tell you how it happened. Therefore, there is no point in knocking yourself out trying to find out why. Yes, it’s possible that when that comet struck the planet Jupiter a few years ago, it could have thrown off space debris that fell to earth in the form of a meteorite. This in turn could have bounced off a telephone pole, ricocheted off a stop sign, and then smashed into your poor cat’s leg. Or the poor beast could simply have been dinged by a car. ● “If there is the slightest chance of an event occurring, then given enough time, it will.” This is a corollary to the above previous quote. Yes, your cat’s gimpy hind limb could have been caused by an impact with a meteorite, but playing the odds, it was more likely hit by a car. ● “If you hear hoof beats, and you are in Upstate New York, then first think horses, not zebras.”( For my beloved readers on the African Continent, the opposite of this may apply.) I learned this most-important of quotes in vet school. As an example, your testicularly-intact black Labrador, who has just returned from a weekend of he’ing and she’ing with the neighbor’s poodle, could be throwing his guts up because he’s contracted a case of Congo River fever, or, he’s puking because he decided to stop along the way to devour some of your other neighbor’s compost pile. Because we don’t see a lot of Congo River fever in my Upstate New York clinic, I’ll most likely will diagnose the cause of his vomiting on his eating something he shouldn’t have. ● “Having an owner express (empty) his or her dog’s anal glands is typically not a bonding experience between this person and their dog.” There are many things that work towards the strengthening of the wonderful gift of the human-pet bond. Expressing their anal glands is not one of them. ● “It is what it is.” I personally find a lot of comfort in this saying. It answers for me a lot of the unsolved mysteries of this mind-boggling earthly existence. However, my fourth grade English teacher, Mrs. Nave, I’m sure, would not approve of the grammar. ● “Poop happens.” This simple saying sums up a lot of what happens in the world as well. I would add the following addenda: “Poop happens the most when you can least afford it.” “Poop happens most when you have the least time for it.” “Poop will always happen when you least expect it.” ● “You can’t fight nature.” Unless they are physically restrained, un-spayed cats, young sailors on liberty after being at sea for 50 days (not myself, of course, when I was in the Navy, I was always a perfect angel!), un-neutered Labradors, and former US presidents from Arkansas, can be depended upon to do any and everything in their power to find someone to mate with. ● “A farting horse never tires; a flatulent man you should always hire.” This one was one of my dear Dad’s favorite sayings, and he was right. ● “Tis better to perish in the hollowing infinite, then to be ingloriously dashed upon the lee.” From one of my most favorite books of all times, Moby Dick. These are words I try to live by. Thanks again

TICKS, OUR DOGS AND CATS, AND OURSELVES: A TRULY SISYPHEAN TASK!!!

     Dear readers, its starting all over again, only it seems to be earlier than normal. That is, its time again for having to deal with ticks. I know, most-precious readers, that I just spoke about these little guys last fall, but I’ve got to do it again because there are still pet owners freaking out and doing all sorts of bizarre things to remove these repulsive little critters from their pets. It isn’t even May yet, and I’ve already seen an olive oil-doused tick, a nail-polished tick, and a barbeque-butted tick. This last one barbequed the poor cat as well. (The cat survived, but will be missing portions of his ears.) 

     But first—as I am prone to doing—I need to ramble a bit.
I learned a new word yesterday. While researching this article on the internet, I came across the words “Sisyphean task.” From the second I saw this phrase, I knew it had to be talking about me and my unending task of trying to save cats and dogs from the “good intentions” of their owners. The phrase takes its roots from the Greek myth of Sisyphus. In the myth, Sisyphus, a king of Corinth, was punished by Zeus by being condemned to eternally roll a heavy stone up a hill. And each time he neared the top, the stone would roll back down again forcing him to have to start all over again. A sisyphean task, therefore, relates to any endless and futile undertaking.

     But the myth of Sisyphus is also about perseverance. And that’s why I keep on trying to get this important stuff across. It seems that for every intact and living tick that a client brings in for me to remove from their cat or dog, there are another five pets brought in with the tick dead, mangled, or decapitated for me to dig it out. (Ticks, by definition, don’t have heads; they have a capitulum.) I’ve seen ticks slathered with nail polish as well as coated with nail polish remover. I’ve seen ticks with their rear-ends barbecued to well-done by a cigarette, and others that have had their butts blown-up by a burning match. I’ve seen them doused with mineral oil, olive oil, basalmic vinegar, kerosene, rubbing alcohol, vodka, flea spray, Tabasco sauce, gasoline, and yes, I’ve even seen them gobbed-up with my dastardly old friend, udder balm.

     I can hear the talk out there now. “Ah, come on, Doc! Quit pickin’ on us. We only did what we thought was best. Our mother-in-law/neighbor/website/guru/cousin from Arkansas all told us their method would work every single time.” Most-treasured readers, I don’t say this stuff to pick on you, or make fun of you, or any of that other nonsense; I do it because all of the methods I mentioned above are wrong ( actually, some are down-right stupid.) And its important to KNOW these techniques are wrong because, when it comes to ticks, there could be life or death consequences for your pets.

     By killing the tick violently with any of the above mentioned substances or techniques, you cause them to lock-up, or clamp shut, their mouth parts. This clenching-down reflex of their jaws is the reason a tick will leave it’s ‘head’ in our pet. But even more dangerous than just simply leaving their ‘head’, is what happens just before the tick dies.

     What happens is that as the tick wiggles and writhes in it’s death throes because of whatever junk you applied to it, the poor little beast will expel whatever blood it has in it’s guts into the dog or cat. Unfortunately, along with this regurgitated blood will come whatever disease organism the tick may be carrying.

     I can hear it out there now: “So Doc, what is the proper way to remove a tick? My favorite way is to part the pet’s hair away as best as possible and then grasp the tick between my thumb and forefinger as close to the point of attachment of the tick as possible, and then gently pull it straight backwards. Unless it’s a mentally-deprived tick, it will let go. A rubber or exam glove should be worn, and make sure afterwards, you wash your hands. If you are too squeamish to touch one of these little guys, you can grasp the tick as close as possible to the skin with a pair of tweezers, and gently pull straight backwards. There is a new invention out there called a Tick Twister that seems to work good as well. http://www.ticktwister.com/index.html.

     After pulling the tick out, be sure to look at it in a good light to see whether or not it has it’s pincer-like mouth parts (its ‘head’). If it don’t, or if you’re not sure, bring it, and your pet, in to you veterinarian. Thanks again.

How Rudolph Got His Red Nose

There is a little-known event that occurred shortly after the time of our Lord Jesus’s birth which, for unknown reasons, the authors John, Matthew, Luke, or Mark chose to leave out of their Gospels. The wondrous biblical story of the shepherds out tending their flocks around Bethlehem and their seeing a star in the sky announcing the birth of the newborn king is well-known to all; likewise is the tender nativity story of the infant Jesus lying in a manger surrounded and being warmed by the breaths of cows and sheep and donkeys.

But what was not told in the Gospels was that there were also reindeer at the nativity of Jesus. It turns out that one of the three wise men from the east was actually more from the northwest, from the area of the present-day countries of Russia and Finland. It was this wise man who brought along his herd of nine reindeer. And it’s the exploits of these reindeer’s selfless courage that is one of the greatest untold stories of all time.

It turns out that while the nativity scene we are all familiar with was playing itself out, a savage and bloody battle of monumental consequence was occurring in the pasture land surrounding the stable. King Herod in Jerusalem, upon hearing of a newborn king being born in Bethlehem, sent an armed patrol of Temple guards out to find the baby Jesus and then to kill him. But as the soldiers approached the stable, the reindeer, whose super-strong sense of smell detected the danger several minutes in advance, stood prepared to defend the infant Jesus, even if it meant losing their lives in the process.

And fight, they did!

Even though the soldiers had the advantage of having sharp, hardened-steel swords, the reindeer had for themselves just as good a battle weapon: their large antlers. After an hour of heated combat in which one after another of Herod’s soldiers fell from their wounds or fled out of horror at the fighting skills of the fearless warrior reindeer, it was finally all over. The evil King Herod had lost, and baby Jesus would live to adulthood to carry out his earthly mission to save mankind.

But there was one very serious problem: The bravest warrior reindeer of them all, Rudolph, was mortally wounded. In the heat of the battle, one of the soldiers’ swords hit its mark on the fearless reindeer and had seriously sliced off the end of his nose and muzzle. He now lay on the cold and rocky ground, profusely bleeding to death. Because there was nothing else they could do, his brother and sister reindeer comrades, either by instinct or divine guidance, all at once gently slid their huge antlers under the nearly lifeless body of their fallen comrade and carried him into the warmth of the stable.

Not quite sure what was going on, Mary, the mother of Jesus, was at first a little apprehensive about letting these huge animals too close to her newborn son. But her heart was softened when the word began to filter in of the brave defense they had just put up to protect them all, and she agreed to let them set the wounded reindeer down in the warm straw next to her son. As Rudolph lay there clinging to life, struggling with every ounce of energy in his body to breathe through his severed mouth and nose, the baby Jesus began stirring in his cradle with an obvious great agitation. Seconds later, as if he could actually see and understand what was wrong with Rudolph, the infant reached out his right hand toward the reindeer.

Maybe it was the bright red blood-soaked head that caught His attention, perhaps it was the loud and heart-wrenching gurgling noise being made by Rudolph as he lay there gasping for breath; or maybe it was His infinite compassion at the sight of one of His Father’s creatures suffering so badly that made him want to reach out and touch the wound. Whatever the reason was, seeing that Jesus wanted to be closer to this brave reindeer, the wise man from the north knelt down beside Rudolph and very gently lifted the reindeer’s head upward so it would be in reach of the newborn king.

When the reindeer was close enough for him to do so, baby Jesus reached out his hand—just as he would in later life do with the lepers and the blind and all of the afflicted of mankind—and placed it upon Rudolph’s bloody mutilated nose, and then he just left it there. All who watched on that cold winter’s night were in awe of the miracle they were to witness.

As His precious hand rested upon Rudolph, the reindeer’s nose began to glow with the radiance of a hundred suns. And as the minutes passed, the reindeer began to breathe normally; soon the animal was beginning to stir. After what seemed an eternity, baby Jesus removed his hand. In another minute, Rudolph—still very shaky—began to stand up.

After yet another minute, with all his senses fully back in his control, Rudolph managed to reduce the intensity of his bright, shining, and now-healed red nose to near normal so it wouldn’t blind everyone present. He then turned toward the baby Jesus and lowered his head in solemn reverence and thanks to the newborn king of Kings.

Baby Jesus looked back at him and smiled.

And it was from that holy night over two thousand years ago that Rudolph and all of the brave reindeer who fought so valiantly to save the infant Jesus were entrusted with the duty of helping all the children in the world on every Christmas Eve.

CONSTIPATION IN OUR PETS: A REALLY HARD [Sorry!] SUBJECT TO DISCUSS

I was talking with my friend Stanley the other day about a small problem I was having. *For new readers to this humble column, Stanley, is my garbage man/philosopher friend who is a profound observer of the human condition and one of the greatest thinkers I’ve ever met. My problem was about how to tastefully (perhaps that’s not the right word to use) discuss such a hard [sorry!] and very crucial issue such as constipation without straining [sorry!] or offending any of my treasured readers’ delicate sensibilities. After all, constipation just isn’t something that is discussed in polite company. And as he always does, however, Stanley had the answer.

He reminded me, that first of all, I was a doctor, and that doctors are supposed to talk about this stuff like constipation. Bowel movements are life and death important! Secondly, he reminded me that one of the more less-notable side-effects of the Clinton Presidential Administration was that personal topics that were historically considered taboo with regards to decent public discourse, suddenly became part of our nation’s collective awareness. From the press conferences in which President Clinton discussed his personal choice of underwear with teenage girl interviewees, to embarrassed parents having to scramble for answers to their kid’s questions of just what exactly the big deal was concerning Ms. Monica, our great country found itself bound-up [sorry!] in an all-time lowering of public and private standards from which it has yet completely recovered. And so with those thoughts in mind, I’ll just get things moving [sorry!], and boldly go [sorry!] where no Veterinary Blogger has gone before.

I’ll begin by saying that your pet’s bowel movements are an important reflection of its overall health. By definition, constipation (dyschesia is the medical term) is the inability of your pet to perform a bowel movement (defecate, pooping, crapping are other words that can also be used.) In any discussion I have about constipation, one of the first questions people always ask me in regards to their pet’s bowel movements is, “how much and how often is normal?” The answer is, “whatever is normal for your pet.” From conversation I have with clients on the subject, twice a day seems to be the average frequency for bowel movements. But please keep in mind that once every two or three days is not uncommon either. “Nothing in, nothing out” as the old saying goes, is very appropriate, especially in dogs. If they eat a lot, they will poop out a lot.

Dogs and cats that are constipated most often will look and act like their having difficulty in defecating. They hump-up like they gotta go but nothing comes out. Often they will cry out in pain. This behavior is important to keep in mind because I get quit a few phone calls and office visits from clients who feel their pets are constipated just because they haven’t had a movement for a couple of days. Sometimes they’re bound-up, but most of the time they just haven’t pooped because they didn’t need to. In advanced cases of constipation, the pets will begin vomiting.

The causes of constipation in dogs (and cats) are many. They could have impacted or infected anal glands. Impacted anal glands leads to severe discomfort during defecation and, ultimately, to constipation. Some medications and drugs can cause constipation. On long-haired dogs, feces can become entangled in the fur around the butt and physically block the flow of feces. With these pets, it’s important to keep them groomed. Another cause of constipation are swollen prostates in un-neutered male dogs.

But almost exclusively, the biggest cause of constipation I see is when the poor critter consumes more bones than is good for it. The consumed bones splinter as they are chewed, and these fragments then become like sharp knives sticking out of the sides of the feces which then cause the dog tremendous pain. And the list goes on: psychological stress, dehydration due to insufficient water consumption, lack of fiber in the diet, etc. And I’m outta room Thanks again. PS: If you were offended by Stanley’s political commentary, address the hate mail to him, not me. His address is: stanleythegarbageman@google.com

THEY HAVE MUCH IN COMMON: CATS IN HEAT AND YOUNG SAILORS

It was just past eleven o’clock when the phone rang. I’d been asleep for about an hour. Before I could even speak a word, the client on the other end screamed, “Dr. Oz, you gotta help me! My poor little Fluffy (her seven-month-old kitten) is having seizures. She’s thrashing around the kitchen floor and shrieking at the top of her lungs in agony. Doctor, please, you gotta help me!”

And sure enough, over the sounds of a crying baby, a squalling kid, and a shouting husband, I could hear in the background their cat meowing at the top of its lungs. After calming the terrified lady down some, I then asked her a couple of questions. It didn’t take long for me to reach the conclusion that something, indeed, was wrong with sweet little Fluffy. The poor little cat wasn’t having seizures; she was in heat.

I am forever amazed that in this modern day and age, with all its high-tech computers, the Internet, and the information superhighway, I’m still being asked by pet owners this most basic of questions: “Doc, what exactly do you mean when you say our pet is in heat?”

When I answer this question, the first thing I do is remind the pet owner that only females who have not been spayed (fixed) can come into heat. Next, I explain that the sole, bottom-line purpose of a female cat (or any animal) being in heat is to attract a male tomcat so that she and he can mate, thus guaranteeing that she becomes pregnant.

The heat cycle normally begins between seven and twelve months of age but can occur as young as four months. Being in heat is an enormously complex phenomenon that involves the entire cat’s body. What owners notice most is the change in their cat’s behavior. Cats in heat will become extremely affectionate, roll around, and start rubbing against everything. The worst aspect of a cat in heat is the meowing (it can be more like a howl). I can hear it out there now: “OK, Doc, what does a cat being in heat have in common with young Navy sailors?”

While in heat, female cats act like many of my former, unmarried shipmates from back in my old Navy days. That is, after being at sea for forty to fifty days, nonstop, with no wine, no women, and very little song, these guys’ first and foremost goal for as soon as the ship dropped anchor was to hit the beach, and try their level best to find someone to mate with. This all-consuming need to find a mate at any cost is what nature has programmed these in-heat female cats to do. (I’d like to make it very clear that I, of course, never did such things during my days in the 7th Fleet. Instead, I always did volunteer work at orphanages or visited the local museums and other exciting tourist sights; if it was Sunday, I’d go to church. Then, when the day was done, I’d always stop off at the NCO club on base for a glass of freshly squeezed orange juice or perhaps, if I was feeling adventurous, I’d order a cool and refreshing tropical coconut drink.)

These females can also be quite devious in their quests to find a tomcat. Besides the most common method of simply escaping through an open door, I’ve treated a cat that jumped from a third-story rooftop patio to get away, and still another who jumped from a fifth-floor balcony. Another time, I had to suture an ear back onto a cat who slashed her way through a screened-in porch. I’ll say it one more time: these girls will do everything in their power to find a tomcat.

There are two basic cures for being in heat. The first and most irresponsible is to just let her get pregnant. Some people I’ve spoken to just open their back door, let the cat out, and literally let nature take its course. If the poor little cats survive not getting hit by a car in their frenzied state or, even worse, getting mauled by some big-jowled, Godzilla tomcat, you can rest assured she’ll be adding to the surplus kitten supply in about sixty-two days. The second and most humane method (the only one that I recommend) is to avoid the problem altogether and get the female spayed before her first heat at five to six months of age.

Thanks again.

TAPEWORMS IN OUR CATS AND DOGS: A SLIMY SUBJECT

At the busiest moment of my Friday-afternoon’s office hours, an emergency phone call came in from a dear client who I’ll call Miss Jones. Normally soft-spoken and always very reserved, the elderly Miss Jones was now on the other end of the line screaming uncontrollably in what seemed to me a state of mortal terror. When finally I could ask her what was wrong, she screeched at the top of her lungs that she and Muffy (her pampered white Persian cat) were watching the Oprah Show on TV. Hoping to calm her down some, I sort of jokingly said that she shouldn’t watch Oprah if it scared her so much. I could tell by the short pause and her low growl that she wasn’t amused.

She continued on to say that as she was sitting there on her sofa, engrossed in the tragic plight of Oprah’s latest guest, she suddenly became aware of a cool wetness on her bare leg. Looking down toward little Muffy (who was sound asleep on her lap), she noticed to her absolute horror that a slimy little white worm had crawled out of the cat’s rear end, and was now scootching its way across her lower thigh.

From the description that she had given me, I told her it was probably just a simple tapeworm, but I’d like to see it just to make sure. Could she bring it in? She answered that this was no longer possible because she smashed the repulsive little critter beyond recognition with the TV remote control.

Tapeworm infection in dogs and cats is very common and, fortunately, the methods of diagnosing the disease are fairly simple. Most of the time, my clients will actually see the white and sometimes wiggling parasite in their pet’s feces. Other times, the owners will find only the dried, rice-like worm segments around the anus of the pet or on the furniture where the animal sleeps. Dogs will often drag their butts on the ground (scooting) to ease the irritation of the emerging worms. Sometimes the only clue an owner may have of a tapeworm infection is that their pet has a dull thin coat or a sickly appearance or is just not as active as usual.

A major culprit in the spread and continuous reinfection of tapeworms is the common flea. When I tell my clients this, I always get one of those looks of disbelief. But it’s true. Put very simply, a flea eats a tapeworm egg. This egg then hatches inside the flea and undergoes a couple of larval growth stages. Then, in the course of grooming itself, the dog or cat unknowingly eats the tapeworm-loaded flea and, in the course of digesting this flea, releases the tapeworm into the intestines. Here it attaches to the gut wall and sets up housekeeping. Your pet can also catch these parasites by eating rodents and consuming the uncooked meat and guts of tapeworm-infested domestic and wild animals.

Besides being just plain gross to look at, tapeworms can be a serious health risk to both pets and humans. Managing tapeworms should be part of a broader parasite control program that includes all of the nasty intestinal worms that our dogs and cats can get. Treating tapeworms with over-the-counter worm pills is rarely successful because the most common breed of worm is resistant to these products. The worm pills sold by most veterinarians are the only ones that will work with any reliability. Keeping fleas under control is also an important part of tapeworm management.

Thanks again.

Being Blocked: Urethral Obstruction in Tomcats.

***My wish is that everyone in the world who owns a male cat reads this article. You can help by showing it to your cat-owner friends who in turn can send it to their cat-owner friends, who can then send it on to their cat-owner friends.***

Treasured readers, urethral obstruction is such an important topic that—HOLD ON TO YOUR HATS—I’m gonna get right to the point; no stories, no rambling, no bull poop, not even any presidential jokes! Well, maybe a short story first, just to set the mood.

Across the exam table from me stood Mrs. T.

Doing all she could to hold back her tears, she said, “Doctor, something is terribly wrong with Little Fifi (her eleven year old white toy poodle). I’m worried to death about her!”

As I looked at Little Fifi standing there on my exam table, eyes clear and alert, hair bright and shiny, and tail a wagging to beat the band, I couldn’t help but think that her owner could possibly be imagining things. But I knew her to be a very calm person and not the type to panic over the smallest things. Gently, I asked, “Mrs. T., what is it that makes you suspicious that something is wrong with Little Fifi?”

“Well, Doctor, this morning, when I let her outside to do her business, she circled around three times before she pooped. Something must be terribly wrong. I just know it! She always, always, always spins around only two times before she goes. Doctor, what’s the matter with her?”

As I stood there, my first reaction was that she was trying to put one over on me. But again, the tears that were welling up in Mrs. T’s. eyes as she recounted these intimate details of Little Fifi’s bowel habits told me more than words ever could that she was dead serious.

“Well,” I said, “I’m not sure yet what Little Fifi’s problem could possibly be, but let me just give her a good physical examination, and I’m sure I’ll find something.” After a careful and very meticulous exam, the only abnormal finding I could discover was that the scent glands in Little Fifi’s rear end were abnormally enlarged. I explained to Mrs. T. how, when these glands are overfull, they cause small dogs like Little Fifi a great deal of discomfort. This pain, in turn, leads to a reluctance to defecate. I then expressed (the medical term for emptying) the scent glands and gave Mrs. T. the prognosis that everything would be all right by morning.

And sure enough, when I followed up with a phone call the next day, Mrs. T. happily informed me that her Little Fifi had performed the perfect number of pirouettes that morning before pooping, and she was perfectly pleased with her performance.

I can hear it out there now: “Great story, Doc, but what’s your point? What does a dog diligently dancing before defecation have to do with urethral obstruction in cats?” My point dear readers is that even though as pet owners you don’t have to be quite as observant as Mrs. T. was with her Little Fifi, it is still important that you pay attention to your pets and how they normally behave, especially their eating and toilet habits.

There’s a disease out there that I often see in male cats (and, rarely in females) known as urethral obstruction. A common expression that we veterinarians use for this condition is “being blocked.” (Plugged-up, occluded, and obstructed are other words used to describe this disease.) In this disease, the male cat’s penis literally becomes blocked and then, because of this blockage, he can no longer pee.

Urethral obstruction (being blocked) is one of the few actual life-or-death emergencies that exist in veterinary medicine, and it can be diagnosed by your veterinarian in about a second just by feeling the poor guy’s abdomen. Sadly, however, because it’s such a very sneaky disease, most owners don’t recognize the problem until it’s too late. Death from urethral obstruction can occur within a day due to a ruptured bladder, metabolic disorders, kidney failure, or cardiac arrest. And this death is a painful, agonizing, death. These poor guts really hurt!

Symptoms of this disease show up in many ways. What most owners notice is that the cat seems to be spending a lot of time in the litter box and not actually doing anything. Sadly, many owners mistake this difficult elimination behavior for constipation or worms, and then waste precious hours trying to doctor the cat with laxatives or hairball or worming medicine. Sometimes the cat wants to just hide behind the refrigerator or be left alone under a bed. Most of the time, however, the owner’s only complaint is the cat “just ain’t acting right.” And to confuse the matter even more, these same symptoms can also be seen in simple bladder infections.

Treating this disease can be very challenging. The patient nearly always has to be put under anesthesia to be unblocked. Because of the possibility of damaged kidneys, this process alone can be life-threatening. Once under anesthesia, we will then try to dislodge the blockage through a combination of catheterizing and back-flushing. If this procedure is successful, an indwelling catheter (a tiny plastic or rubber pipe) is often inserted up the penis. This will allow the bladder to drain accumulated urine, which in turn will allow the bladder to heal itself.

Complications of this medical procedure are many. Some of these complications, but not all, are: not being able to unblock the poor kitty in the first place, becoming blocked again a day or two later, ending up with an atonic bladder (one that will no longer empty on its own), kidney failure, or urinary incontinence.
I can almost hear the question being asked, “So, Doc, what causes it?”And I know already that you’re gonna be unhappy with my answer.

Despite what the cat food ads say, what the popular press and cat care books all say, or, what all the Internet armchair veterinarians say, the truth is that there is no one single cause. Over the years, the ash content of the various cat foods (both wet and dry) has been blamed, obesity has been blamed, bladder and kidney infections have been blamed, too early neutering has been blamed, too late neutering has been blamed, too much salt or too little salt have been blamed, the mineral content of one’s well water has been blamed, and on and on. Again, no one knows for sure.

I knew you wouldn’t be happy with this answer.

So, what can you do? By far, the most important thing you can do is just be aware that the problem exists and be watchful for it. Pay attention to your cat’s habits. The earlier the treatment begins, the greater the chance of success. If you even vaguely suspect the problem, please don’t waste time messing around with the home remedies. Hours are precious with this disease.

And I’m running out of room. By the way, did you hear the one about the time former President Clinton saw the ghosts of Washington, Jefferson, and Lincoln . . .?

CONSTIPATION IN OUR PETS: A REALLY HARD [Sorry!] SUBJECT TO DISCUSS.

I was talking with my friend Stanley the other day about a small problem I was having. *For new readers to this humble column, Stanley, is my garbage man/philosopher friend who is a profound observer of the human condition and one of the greatest thinkers I’ve ever met. My problem was about how to tastefully (perhaps that’s not the right word to use) discuss such a hard [sorry!] and very crucial issue such as constipation without straining [sorry!] or offending any of my treasured readers’ delicate sensibilities. After all, constipation just isn’t something that is discussed in polite company. And as he always does, however, Stanley had the answer.

He reminded me, that first of all, I was a doctor, and that doctors are supposed to talk about this stuff like constipation. Secondly, he reminded me that one of the more less-notable side-effects of the Clinton Presidential Administration was that personal topics that were historically considered taboo with regards to decent public discourse, suddenly became part of our nation’s collective awareness. From the press conferences in which President Clinton discussed his personal choice of underwear with teenage girl interviewees, to embarrassed parents having to scramble for answers to their kid’s questions of just what exactly the big deal was concerning Ms. Monica, our great country found itself bound-up [sorry!] in an all-time lowering of public and private standards from which it has yet completely recovered. And so with those thoughts in mind, I’ll just get things moving [sorry!], and boldly go [sorry!] where no Veterinary Blogger has gone before.

I’ll begin by saying that your pet’s bowel movements are an important reflection of its overall health. By definition, constipation (dyschesia is the medical term) is the inability of your pet to perform a bowel movement (defecate, pooping, crapping are other words that can also be used.) In any discussion I have about constipation, one of the first questions people always ask me in regards to their pet’s bowel movements is, “how much and how often is normal?” The answer is, “whatever is normal for your pet.” From conversation I have with clients on the subject, twice a day seems to be the average frequency for bowel movements. But please keep in mind that once every two or three days is not uncommon either. “Nothing in, nothing out” as the old saying goes, is very appropriate, especially in dogs. If they eat a lot, they will poop out a lot.

Dogs and cats that are constipated most often will look and act like their having difficulty in defecating. They hump-up like they gotta go but nothing comes out. Often they will cry out in pain. This behavior is important to keep in mind because I get quit a few phone calls and office visits from clients who feel their pets are constipated just because they haven’t had a movement for a couple of days. Sometimes they’re bound-up, but most of the time they just haven’t pooped because they didn’t need to. In advanced cases of constipation, the pets will begin vomiting.

The causes of constipation in dogs (and cats) are many. They could have impacted or infected anal glands. Impacted anal glands leads to severe discomfort during defecation and, ultimately, to constipation. Some medications and drugs can cause constipation. On long-haired dogs, feces can become entangled in the fur around the butt and physically block the flow of feces. With these pets, it’s important to keep them groomed. Another cause of constipation are swollen prostates in un-neutered male dogs.

But almost exclusively, the biggest cause of constipation I see is when the poor critter consumes more bones than is good for it. The consumed bones splinter as they are chewed, and these fragments then become like sharp knives sticking out of the sides of the feces which then cause the dog tremendous pain. And the list goes on: psychological stress, dehydration due to insufficient water consumption, lack of fiber in the diet, etc. And I’m outta room Thanks again. PS: If you were offended by Stanley’s political commentary, address the hate mail to him, not me. His address is: stanleythegarbageman@google.com

THEY’RE NOT FURRY FOUR LEGGED PEOPLE: THREE THINGS THAT CAN KILL YOUR DOGS AND CATS

In my first bestseller, Sometimes It Breaks Your Heart, I tell a story from my student days of three sisters who brought their dying 140+ pound Labrador to Cornell Vet College. They were there because their local vet in Brooklyn couldn’t do anymore to save the poor creature. I was the senior year student assigned to the case, and it was a genuine heartbreak.

It was one of those “kill the animal with kindness” stories that we veterinarians see all the time. In the case of poor ol’ Buddy, his gentle owners gave him a painkiller called Excedrin® Extra Strength. When I asked them why, they said they “didn’t like seeing him in pain.” (The poor old dog had severe arthritis and hip dysplasia.) “It always worked well on my arthritis,” said the oldest sister. The trouble with this Excedrin® product is that its main active ingredient happens to be acetaminophen, more commonly known as tylenol. In Buddy’s case, about three days after being on the drug, he stopped eating and began to turn yellow (jaundiced) in the eyes. After five days of intense hospitalization, despite all of the best veterinary care in the whole world, Buddy died. And it was awful. In my practice, well-meaning owners give tylenol (and all of its cousins: Advil®, Alleve®, Motrin®, etc.) for all kinds of absurd reasons. “He had a fever(?).” “She cut her paw.” “The poor dog wouldn’t eat.” The bottom line, gentle reader, is never ever give any of these types of painkillers to your pets. You might get away with it once, or twice, but the drugs will eventually destroy their livers.

I learned about a new product that is unintentionally killing our pets just last week. It’s called Xylitol. For those readers who have never heard of it, Xylitol has been used as a sugar substitute since the 1960s. Derived from fruits, berries, corn cobs, birch and other hardwood trees, xylitol is approved as a food additive in unlimited quantity, and appears (so far) to be completely safe for humans. The product has been a God-send to people with diabetes, it has been proven to help reduce tooth decay and help reduce ear infections in children, and has been a large component in tons of weight loss products. Again, it seems to be completely safe for people. However, a recent article in the Journal of the Veterinary Medical Association had an article on eight dogs who died of liver failure after eating products containing xylitol. The article mentioned that there were 138 cases reported to The Animal Poison Control Center in the first six months of 2006. In mild cases of the xylitol ingestion, the product seems to cause a sharp decrease in dog’s blood sugar levels. The signs of this are weakness, stumbling, dizziness, and seizures. In more drastic cases, we see signs of liver failure: not eating, vomiting, diarrhea, and jaundice. The take-home message here, treasured readers, is to not give any sweetened products to your dog at all. (I know no one will listen to me on this one.)

And with my sincerest apologies in advance to my much valued grape farmer friends, the final—but certainly not the last—common foods I’ll talk about today that can kill dogs and cats, are grapes and raisins. All grapes, both seeds or seedless, white or purple, organic or not, have been found to be harmful. The toxic component is still not known. The cause of death in fatal cases is kidney failure. The only report I found regarding how much you need to cause clinical signs, are three and a half ounces of grapes, or a half an ounce of raisins, per 10 pounds of dog. Signs seen in mild cases are vomiting, diarrhea, and loss of appetite. In severe cases, the pet develops a progressive weakness, has possible abdominal pain, and begins to drink and urinate excessively. And like all of the above examples, I know there will be readers who’ll tell me they’ve been giving their pets raisins for years with no problems: All I can say is, “I’m glad your pet is still alive, but now that you know better, it’s best if you stop.” Thank You.

PYOMETRIA, OVARIAN AND BREAST CANCER: DISEASES OF UN-SPAYED DOGS AND CATS

There are three potentially life threatening diseases that are commonly seen in un-spayed (pets that still have their reproductive parts) female dogs, and I had to deal with each of them last week. They are pyometria, ovarian cancer, and breast cancer. The original full-length version of this story can be found on my website: http://www.doctoroz.com

Until they’ve had to deal with one in their own dog or cat (human women can get them also), pyometra is a disease most people probably never heard of. But it’s out there. The word pyometra comes from the Greek words ‘pyon’ meaning pus and ‘metra’ meaning womb. And that’s exactly what the disease is: a very serious, life-threatening, disease in which the uterus of the un-spayed female fills with deadly, fetid-smelling, pus.

Most people have never heard of pyometra because most owners spay their female dogs or cats. Obviously, if your pet doesn’t have a uterus (the uterus and ovaries are removed during a spay), it can’t get a uterus infection. Spaying also addresses the second disease I mentioned, ovarian cancer. These tumors can be scary! But, again, spayed dogs don’t have to worry about ovarian cancer because their ovaries are removed during the spaying surgery.

The last disease which can be greatly reduced in numbers by spaying you pets is breast cancer. Although veterinary researchers say the cancer can still happen, in the hundred or so breast cancer surgeries I’ve done, every single dog and cat was not—I’ll say it again with emphasis—NOT spayed.

So why don’t people spay their dogs or cats? The reasons are very complex and the conclusions would fill this column for the next ten years. The reasons involve multiple issues that range all the way from simply not wanting to spend the money on the surgery, to the almost sacred notion of an owner not wanting to deprive their pet of it’s God-given right to reproduce. It wears me out just thinking about it.

Pyometria is seen in dogs and cats usually over the age of four years. Most of the time owners complain of the animal having a foul (and they really do smell) and sometimes bloody vaginal discharge that comes on very suddenly. With both pyometras and ovarian cancer, sometimes the only sign will be a prolonged bloody ‘spotting’ that is likely to be confused with a regular heat. With both diseases, frequently the only complaint is the dog or cat is very lethargic and is off their feed. All of these gals will die unless attended to; and some, despite heroic efforts, sadly will die anyway from the infection or cancer which spreads to other parts of the body. Treatment always involves an emergency ovariohysterectomy (spaying), usually on a Saturday night when the vet is outta town.

Breast cancers show up as hard nodular swellings along the mammary gland chains on the bellies of cats and dogs. Observant owners usually find them early and their removal is usually curative. However, just like in human women, the cancer can spread—especially in cats. Less observant owners usually wait until a softball-sized mass bursts open on the poor pet’s belly and then it’s too late.

Thanks again.

A TALE OF THREE GOLDENS AND A LUCKY YELLOW LAB: CANCER IN OUR PETS.

*In memory of three GREAT golden retriever patients of my practice who all chose last week to pass beyond the Rainbow Bridge.

Excessive exuberance! That would be the only way to describe Charlie, the two-year-old yellow Labrador who I, my wife, and his frazzled owner were trying to get to hold still on my exam table. Bounce, bounce, bounce; smell, smell ,smell; pant, pant, pant; wag the tail, bang, bang, bang; bounce, bounce, bounce. The whole effort was like trying to hold back the wind.

Charlie had been limping on his left front leg for almost a week. His beloved owners, logically, had done a good job of checking his paws for thorns, etc., and felt that it might have just been a strain on one of his joints. And that’s a reasonable conclusion. Just like with ourselves, sometimes a tincture of time is all that’s needed to heal. Even though he wasn’t getting any worst, he wasn’t getting any better either. So they brought him in.

In spite of his boundless and care-free behavior (Labradors DO seem to always enjoy themselves!), I did manage to get a reasonably good examination of both his front legs. With the exception of a slight swelling to his left carpal joint (ankle), I could find nothing obviously wrong. I then spent the next five minutes giving the owner a long list of what the possible problems might be that Charlie could have: 1.) Most likely it was a soft-tissue trauma (pulled tendon, partially-torn ligament, bruised or pulled muscle, etc.) 2.) It could have been one of the long lists of “growing pain” disorders that occasionally affect large breed dogs (panosteotis, HOD, OCD.) 3.) A possible hairline fracture. 4.) One of the large-breed dog birth defects (elbow or hip dysplasia.) 5.) A joint infection.

There was a last possible problem, that, because of the dog’s young age, I didn’t worry too much about. But, in order to be thorough, I gently suggested that I do an X-ray of Charlie’s swollen ankle. My reason for being gentle about suggesting the X-ray is that my doing so frequently alerts the pet’s owner that I might be thinking about something really bad.

And that turned out to be the case with Charlie’s owner. Without me even mentioning “the C-word,” I saw his loving owner’s eyes begin to redden and her tears begin to flow. “Doctor, he doesn’t have cancer, does he?”

[We X-rayed Charlie and he was fine. Probably his limping was just some strain of his joint.]

CANCER!!! The very word strikes terror at the heart of those who hear it. Everyone who has been alive on this planet has been affected by this horrific disease. Either they’ve had it themselves, or have know someone who has had it. As a medical professional, I am very cautious on how or when I use the word. Just like in the example of young Charlie, I can give a laundry-list of common ailments that most probably are the reason for a pet’s problem, but as soon as I mention “the C-word,” everything I’ve previously said is totally forgotten.

As common as the disease is, most people have no idea of what cancer exactly is. Likewise, most people are surprised to hear that their pets (and even plants) can come down with the disease as well! I’m going to try and explain the disease, but please keep in mind that there are entire medical research libraries filled with hundreds of thousands of books on the subject, as well as professional and dedicated researchers who’ve spent their entire life studying cancer who still haven’t completely figured it out.

Keeping in mind that dictionary definitions of cancer can go on for pages, what I tell my clients is that cancer is simply just uncontrolled cellular growth. For reasons that are still unknown, a single body’s cell—or a small group of cells—begins to divide and duplicate itself uncontrollably. In the example of my three golden retriever patients that sucumbed to cancer in the past week, the first one had a bone cell in his left fore-arm that went berserk (once again, I’m using language that non-medically educated readers might relate to) and grew into a very painful bone tumor (osteosarchoma); the second golden had a group of lymph node cells start to divide out of control resulting in whole-body lymph node cancer (lymphoma); and the third, a great dog named Sonny, had a liver cell that started growing wildly, resulting in liver cancer (hepatocarcinoma). The same can be true of any other organ or part of the body: If the un-controlled growth occurs in a mammary gland, the result will be breast cancer, the spleen (hemangiosarchoma), the blood vessels (pericytomas), the brain (astrocytomas), etc., etc.

Why this outta control cellular growth begins is still not completely understood. Greater medical minds than my bumbling self still haven’t reliably figured it out for each and every type of cancer. Everything has been blamed from cosmic radiation, to the Reagan Administration; from chemical agents, to cell phones. The best answer I give my grieving clients is “that there is no answer. All we can do is enjoy our time with each other and our treasured pets the best we can.” Thanks again