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: email@example.com
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.
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.
*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
Regular readers of my humble webpage know that I constantly rant and rave—to the point of being annoying, I’m sure—about the need for dog and cat owners to stay up to date on two things with regards to their pet’s health: their pet’s vaccinations and their pet’s parasite control. And over the years I’ve used many stories and parables to try and highlight my never ending struggle to get the word out to you dog owners with regards to an especially deadly disease of dogs called parvo virus. I think the following story of the myth of Prometheus sums up my never-ending battle perfectly.
The gods of ancient Greek mythology were really quite a bunch of rascals. And although many of them seemed obsessed with mating with various hapless human mortals, and inflicting all kinds of plague, corruption, and despair upon us, there were a few who tried their best to improve the human condition. One of the more famous of these ancient gods was Prometheus.
Prometheus, whose name in Greek means Forethought, was the son of Iapetos and Klymene. He was given the task by Zeus to form man from water and earth. After doing so, Prometheus took a great delight in his creation and, despite Zeus’s warnings against doing so, gave mankind all sorts of good stuff: brickwork, woodworking, healing drugs, numbers, the alphabet, yoked oxen, carriages, ships, and, perhaps the most precious gift of all, fire.
He stole fire from Zeus by hiding it inside the stalk of a fennel plant. When Zeus realized what Prometheus had done, he was mad—REALLY MAD. And so as a punishment for his disobedience, Zeus had Prometheus chained to Mt. Kaukasos in the Caucasus Mountain Range to hang there until his anger subsided. To make the ordeal even more difficult for Prometheus, Zeus sent a gigantic Caucasian eagle to feed on his liver. And so it went for 30,000 years. Each day, Zeus’s eagle would peck away and devour poor old Prometheus’s liver. And each night, the torn immortal flesh would mend, so that the next day, the eagle could peck away at it again.
I can hear it out there now: “This is a weird story, Doc, but what does it have to do with parvo virus?” Well, it’s like this.
In my veterinary practice, as I’m forced to stand there looking down at these sad, innocent, and dying young dogs on my exam room table, and all the while having to listen to the blah, blah, blah, endless number of feeble excuses their owners are giving me for not having had their poor beast vaccinated, I often feel like good old Prometheus. But instead of having my liver pecked out, it’s my heart being ripped out instead. And sometimes it’s tough to take.
Parvo virus is a ghastly disease that can affect all dogs, mostly puppies, that literally causes them to vomit and crap themselves to death. Most victims tend to be the offspring of mother dogs who themselves were never vaccinated. The disease is spread mostly by fecal/oral contamination. That is, an unvaccinated or poorly-vaccinated dog catches the disease by smelling/licking the diarrhea and vomit of another infected dog, or, by coming into contact with a disease infected environment, such as a dog park, kennel, or infected household. Parvo disease is HIGHLY CONTAGIOUS.
Without hospitalization at a medical center that has a quarantine facility, parvo disease is almost always fatal. It is, however, nearly 100% preventable by vaccination. In my practice, all dogs should be vaccinated at six, nine, and twelve weeks of age. They should then be vaccinated again at one year of age. From this point, a parvo virus vaccination schedule should be followed as recommended by your veterinarian.
Sometimes, in spite of having had a wondrous and personally-challenging veterinary education, I discover that every once in a while that I just don’t seem to have all of the answers to all of the questions my treasured clients ask me. And when it happens, I find it quite frustrating. “Doc, why did my cat urinate on my boyfriend’s brand new cowboy boots?” I don’t know, maybe your cat has better tastes in men than you do! “Doc, why does my dog pass wind when my son feeds him Coco Puffs?” I don’t know, but you shouldn’t let him give your dog Coco Puffs (and you probably shouldn’t be feeding your kid Coco Puffs either!)
In today’s article, I’m going to jump into the abyss of controversy—AGAIN!!!—and try to answer a question that I’m asked nearly every day. And what it is that boggles my mind the most when I’m asked this question is that nearly all of the people who ask the question already know what the right answer is. They know the answer already because nearly all of them are already doing it. What these loving cat owners are looking for is just for my permission to do it.
The question on everyone’s lips is: “Doc, is it OK to feed my cat milk?”
I’ll begin by answering this question with another question: How many of you gentle readers out there have ever heard of a cat actually dropping dead from drinking milk? Hum? In my short and sweet eighteen years here in this business of saving cats and dogs—as well as the occasional rabbit or cow—I’ve never ever seen or have heard of a cat dying from drinking milk.
I then tell the story of how, way back in the olden days when I still tended to sick dairy cows, nearly every farm I went to had a bunch of old car hub-caps or cereal bowls lying around in the center of their barn floors. During milking time, when the farmer pulled the milking machine off of her first cow, the first thing she would do is fill these hubcaps and bowls up to the brim with fresh, warm, milk. Then, seemingly out of nowhere, would come billions and billions of barn cats to slurp up this milk. And I don’t recall seeing a single one of these cats dropping dead.
Likewise, in my pre-veterinarian days when my wife and I were dairy farmers, we, also, were guilty of giving our barn cats milk; we just went on and on in ignorant bliss, and innocently filled those hub-caps to over-flowing at every milking. In humble first book, Sometimes It Breaks Your Heart, I tell the story of how I gave our cat Suzie (who lived nineteen wonderful years) milk every morning. Likewise, on this very morning as I’m writing this story, when I poured my first cup of coffee, I also gave a big dollop of milk to our cats, Bugsy and Screwball.
With regards to an actual medical reason for not drinking milk, I’ve never been able to get a straight answer from any of my colleagues in the world of academia. It seems to be one of those urban myths that have been passed on from generation to generation of veterinary students. If I had to make a guess, the most likely answer to the mystery would probably go something like this: About fifty years ago, some poor old professor’s cat got run over by a milk truck, just as the driver of this milk truck was running off with the professor’s wife. Then, after the telling and retelling of the story, only the keywords, milk and cat and death, got forwarded on.
In all fairness to these great veterinary minds, however, I have gotten some answers. They tell of possible lactose intolerance in some cats, possible bladder stone formation, and even the possibility of causing malnutrition. But these reasons are all kind of wimpy and none have been objectively documented, at least in my researches. One beloved professor frankly told me that the only reason she said no to feeding milk, was because she worried that some cat owners would then feed only milk—and nothing else but milk—to their cats. In short, the advice to not feed cats milk seems to be one of those folk wisdom tales whose logic seems to defy people’s real world experiences, as well as all common sense.
My final thoughts are as follows: If you’re not comfortable about the concept of feeding your kittycats milk, don’t do it!!! No real rocket science there. However, keep in mind that milk is one of nature’s most perfect foods. It contains lots of nutrition, calcium, and proteins. It’s a good laxative, which is an important thing as well for older cats. If you’re already feeding your cat a treat of milk, and everything is OK, then I know of no logical reason to stop. But please keep in mind that moderation is the key. Don’t over do it, and don’t feed only milk; make sure he/she eats cat food as well.
If you want to start giving a treat of milk to your cat, try giving him or her a small amount at first. If they don’t vomit or get diarrhea, then it’ll probably do no harm. If they get the screammy-meemie poops, then they’re likely to be lactose intolerant and you should then stop.
Clients are always asking me for advise on how to cope with the loss of their dear pets. The answers, of course, to such an emotionally-charged issue aren’t simple. Hundreds of books have been written on the subject. But here are a few things that I feel pretty much sums it all up.
As I stated in my first bestseller Sometimes It Breaks Your Heart (sorry about the shameless plug for the book), if an owner is lucky, they will be blessed with the precious gift of watching their beloved pet grow from an exuberant young puppy or kitten full of energy and life, into a mellow and faithful middle-aged companion, and then finally into a mature and loving old age. It’s a snapshot view of our own lives and of our human destinies, all summed up in 15 or so years.
The ancient Greeks described three different kinds of love. The first “philia” describes the love of a spouse, a family member, or of brotherhood. Next was “eros,” the wild and breathtaking love of sexual passion. And finally, there is “agape.” This is the unconditional, active, and boundless love that we Christians attribute to the Lord.
Although may not be on quite the same level, this agape form of love is pretty close to the sort of love our pets have for us. They love us unconditionally no matter what our mood, the way we happen to look, or how mundane our thoughts and actions might be. And it is when this emotional bond our devoted pets have developed with us is taken by death, that a large part of us then dies as well.
Those are my thoughts on pet loss. I can hear it out there now, the collective cry of all my treasured readers: “And so, Doc, how do we avoid having our hearts ripped out and stomped on the ground every time we lose a beloved pet?”
My answer is, “You can’t! Not if you’re human.”
We, that is, all of us thinking two-legged creatures have two choices when dealing with any acquaintances or experiences we run across on our journey through this life. We can chose to ignore, hide from, or just superficially deal with these encounters, and move on—and that’s OK, but only sometimes. Or, we can engage with, open up to, and exalt in the pleasures and energy and life-force of other living beings that God has chosen to place in our paths. The more we do so, the more we can learn about ourselves and the richer our lives will be.
However, separation by death is unavoidable. For many people, this is where the hard part comes into the picture. By actively engaging with our pets, and by truly sharing the gift of life with them, many owners are devastated when the time comes to let go of their precious friends.
And that’s OK also.
What I usually remind people of at this time, is that while they mourn their dog or kitty’s loss, they should also remember all that they were able to share with their lost pet, all that they learned about life from them, and how blessed they were—how truly blessed—to have had them in their lives to make their own personal journey through the world more bearable.