Dogs (and heartworms) on the move

A great point was brought up by Kathy on my last post.  Unlike those of us in the Midwest she is fortunate to live in a part of the country where many parasites are virtually non existent.  However, times are changing.  Data provided by the American Heartworm Society shows that heartworms have been diagnosed in all 50 states now and incidence of heartworm positive dogs are on the rise as shown in the following maps.

There are likely several reasons for this.  One is an increase in testing-if you don't look for it, you won't find it!  I can guarantee if every dog was tested these numbers would go up substantially, especially in endemic areas.  As annual testing is more widely recommended across the country then we will obtain more accurate pictures of the true heartworm incidence in the nation.

Another reason is the increased mobility of our human and canine populations.  As people travel with their pets, relocate for jobs or other reasons they are bringing diseases with them to new parts of the country.  With the increase in popularity of dog sports and shows people are traveling more widely and more frequently with their dogs on a regular basis.  Think of what happens when a national event is held in a heartworm endemic area?  Thousands of dogs travel from all over the country and may be exposed to things they ordinarily would not see in their home area.

Furthermore dogs are bought, sold and shipped all over the country.  This includes rescue dogs who are frequently moved across many state lines to areas with better shelters, more resources, etc.  The most significant example of this is the dogs rescued after hurricane Katrina.  These dogs came from a heartworm endemic area (as you can see on the map) and were literally moved all over the country-taking their heartworms with them. 

Finally there have been some very limited reports of heartworm resistance or preventative failure not linked to client compliance.  These failures are very geographically limited at this time but they are being very closely investigated by parasite experts as spread of this strain (or strains) of heartworms could be catastrophic in our canine companions. 

As a side note I saw a disturbing number or anti-heartworm preventative websites while looking for graphics to use in this post.  These people are concerned with putting unnecessary drugs and toxins in their pet.  I wonder if they realize that if their pet contracted heartworms it would need to be treated with very painful, very toxic injections?  I'm not saying there isn't a a place for natural or holistic treatments but really, this isn't it.  One website advocated giving the preventatives every 6-8 weeks instead of every 4.  This is not a good idea.  Does heartworm efficacy stop directly at 30 days.  No, but it may very well drop to less than adequate levels by the 6-8 week mark.  Each product varies and you take a huge risk by using it only every 2 months.  Trust me, we don't sell it as a once monthly product to make money-it's because that is what is best for your pet.  And finally, don't fall prey to the my pet is indoors/long-haired/etc and can't get heartworms myth.  Remember when I got Lyric she was just 2 years old, long-haired, indoors and heartworm positive.

So, talk to your vet, determine your risk, and come up with a plan that works for you and your pet.  Personally, no matter where I lived I would use year round prevention.  Partly because I don't want my pet to ever go through treatment and partly because the preventative I use also protects against a wide range of intestinal parasites that can easily be picked up many places. 

Bugs Be Gone

As parasite season approaches (or continues depending on where you live!) choosing the right heartworm/flea/tick preventatives can be a challenge.  The market is flooded with choices and it can be confusing for the pet owner to know what to use and also hard for the veterinary clinic to know what to stock!  It would be nice if there was one perfect, safe, effective, economical product that eliminated all parasites.  But, there is no such thing.  My focus today will be on products that control one or more of the following-Heartworms, fleas, and ticks, although many products also control additional parasites. 

As a side note Heartworm prevention (and sometimes flea prevention) is recommended year round where I live but may vary in other parts of the country.  Check with your vet about what is recommended for you.

Advantage (Imidacloprid) is a topical product for both dogs and cats.  Advantage controls only fleas and lasts for 30 days.  Advantage is a very safe product and has a relatively fast kill rate.  It is available over the counter.

Advantage Multi (Imidacloprid/Moxidectin) is also a once monthly topical product for dogs and cats.  Advantage multi controls heartworms, fleas, hookworms, roundworms, whipworms, and ear mites. It does NOT control ticks.  While I have not used this product personally it sounds like a good choice for someone looking for broad spectrum parasite control.  A recent study showed that it performed very well as a heartworm preventative against a tough strain of heartworms.  This is a prescription product. 

Capstar (Nitenpyram) is an oral tablet that kills all live fleas on the pet within approximately 30 minutes.  It only lasts 24 hours.  Personally, I think this product is a waste of money for most pet owners.  The only time this product is useful is if your pet picked up  few fleas at the dog park, etc.  However, if you don't know how long the fleas have been there they may have already laid eggs, or if you are not sure where the fleas came from (as in, they might be in your yard) then this product won't eliminate the problem.  At a cost of $3-$6 apiece you can spend about $10 more and get one of the 30 day products.  Capstar is available for both dogs and cats.

Comfortis (Spinosad), commonly known as the "flea pill" is a chewable tablet that controls fleas for 30 days.  For those concerned with chemicals in their pet Comfortis is a nice choice because spinosad has been awarded the green chemistry award and is approved in a topical version for organic farming.  Comfortis should be given with food as it makes the occasional pet vomit.  It is only approved for dogs, largely because cats will not eat it.  Comfortis kills fleas within four hours before there is a chance to lay eggs.  This is what I use in my personal dogs most of the time.  It is a prescription product. 

Frontline Plus (Fipronil/(s)-methoprene) is a topical product for dogs and cats lasting 30 days.  Frontline kills ticks and all stages of fleas including flea eggs.  Many people have expressed concern that Frontline is not working as well as it used to.  It's hard to say if this is due to compliance or flea resistance but may be a combination of both.  Frontline is available over the counter. 

Heartgard Plus (Ivermectin/Pyrantel) is a meaty chewable tablet that is give once monthly.  Heartgard controls heartworms, roundworms and hookworms.  It is available for dogs and cats and is a prescription product. 

Interceptor (Milbemycin oxime) is a once monthly chewable tablet that controls heartworms, hookworms, roundworms, and whipworms.  It is a prescription product and is available for dogs and cats.  This is my product of choice for my personal dogs. 

Iverhart Plus and Tri-heart Plus (Ivermectin/Pyrantel) are essentially  generic versions of Heartgard but do not come in a meaty tablet.

K9 Advantix (Imidacloprid/Permethrin) is a once monthly topical product.  This product was Bayer's attempt to get in on the tick market.  This product control fleas and ticks and repels mosquitoes.  However, there are some studies that show the addition of the permethrin reduces the length of the flea killing to 3 weeks.  Although it claims to repel mosquitoes this product should not be used as an alternative to to heartworm prevention.  This product is for dogs only and use on cats can cause a toxic reaction to the permethrin.

Preventic collars (Amitraz) control ticks for 3 months and is available for dogs.  Amitraz is not safe for cats. 

ProMeris (Metaflumizone/Amitraz) is a once monthly topical that controls fleas and ticks.  ProMeris is widely known for it's unpleasant odor and because the amitraz has made several dogs ill.  Based on the places I have worked it seems this is a relatively unpopular product and I don't recommend it.  It's most useful niche is as a very convenient treatment for demodectic mange.  There is a cat version that does not contain amitraz and only controls fleas.

Revolution (Selamectin) is a once monthly topical product for dogs and cats.  Revolution controls heartworms, roundworms, hookworms, fleas, ticks and ear mites.  However the Revolution works best on ticks after several months of consecutive use.  For this reason the company provides a free preventic collar with purchase of a six month supply of Revolution (for dogs only).  At least that was still true last time I checked!  Revolution is my product of choice for cats although Advantage multi is likely similar.  Revolution is a prescription product.

Sentinel (Milbemycin/lufenuron) is an overrated product in my opinion.  This products controls heartworms, hookworms, roundworms, and whipworms and sterilizes flea eggs but does not kill live fleas.  For approximately the same price you can use Interceptor and one of the better flea products.  This is a prescription product. 

Vectra 3D (Dinotefuran/permethrin/pyriproxyfen) is a once monthly topical for fleas and ticks.  The 3D product is for dogs and cannot be used on cats due to permethrin toxicity.  There is a Vectra for cats minus the permethrin which only controls fleas. 

Proheart 6 (Moxidectin) is an injectable product that controls heartworms for 6 months and roundworms and hookworms for approximately 3 months.  Blood levels of Moxidectin drop to nearly negligible levels at the end of the six months so it is important to not be late for the next injection.  Use of the product has some restrictions and requires signing a consent form.

*New* Trifexis (Milbemycin/Spinosad) just arrived on the market and is essentially Interceptor and Comfortis combined in one chewable pill.  As these are my favorite products I'm anxious to see how this product performs.  It will control heartworms, hookworms, roundworms, whipworms and fleas.  This cost is reported to be only slightly higher than Comfortis alone.

This may not make it any easier to choose but hopefully it will make it less confusing!

Cats...no snow

Here are some pictures of Jelly.  Obviously not in the snow because she doesn't go outside.  As you can see, she prefers to nap on the back of the couch. 

Ok, so I lied, here is just a little snow!  This might be the last as we transition to tornado season (also commonly referred to as shaking and hiding under the bed season) here...which is much less scenic than snow.

Yep, there's more

It's cool, rainy and muddy now but don't worry, I still have snow pictures. 

Legend posing with her beloved football

 This is the one I like.

 Two happy dogs

 Po-po playing in the snow!

 This one turned out kind of weird but I call it "snowgility"

 Zodiac thinks it's never too snowy to herd!

It's not child abuse if...

1.  She goes in herself

2.  She shuts the door

3.  She has an iPhone with her.

In the less cute division I had a "first" at work today.  Everyone probably realizes that there a lot of unpleasant smells in my line of work.  But of all of them, the one that makes me sick to my stomach is dog poop.  The worse the poop, the more I don't handle it well.  Today we had a sick dog in that had a major blow out of diarrhea.  I tried to help clean up but after spending approximately 2 seconds in the room I literally almost threw up and ran out.  My poor tech had to clean it all up while I tried to clean off the dog.  I've suffered through a lot of parvo and other nastiness but this is the first time I knew I would have actually puked if I had stayed in that room!  Fortunately the dog is much better and went home. 

Almost perfect

This morning Legend Q'd again in jumpers-that's 5 Qs in a row!  But alas she had one wrong course in standard.  Still though, a fantastic weekend with Q's in 5/6 runs, two QQs and 59 points.  I'd be plenty happy with that every weekend!

Lyric almost had a Q in standard but had a refusal at the table.  I see table work in her future as we had some issue with the table every day.  But she capped off the weekend with another Q in jumpers for her 2nd MXJ leg.  Plus she got first place and double MACH points.  This is the first time any of my dogs have gotten a first place in an Excellent B class!

So basically it was a really good weekend! And I was home before dark!

Perfect...so far

It's been a slow blog week so I thought I would give a trial update with one day left to go.  Plus I can hardly wait-obviously by the post title you might suspect it is going well!

Legend has a had a perfect weekend so far!  That's right, 4/4 with 2 QQs in a row.  First time she has been 4/4 since Novice and Open.  And yesteday she ran a faster standard course than she ever has and earned her greatest one day MACH point total!  I'm so proud of her-this weekend we turned all those "almost Qs" into actual Qs.

Lyric is running well too.  Her first run of the day has been super fast but not without errors, but she is gaining speed and confidence and putting everything together.  Plus she is having fun.  Pretty soon I think she's going to be awesome.  Yesterday she only missed one weave pole or she would have qualified in jumpers.  Today she did get a jumpers Q and her first 5 MACH points!  I thought that was pretty good since she did her weave poles pretty slow.  One more day to go!

Warm-up

This weekend was a "warm-up" both literally and figuratively!  First the temps are way up here-snow is melting and mud is forming like crazy.  But I'm also considering this weekend's trial a warm-up for the slew of spring trials we have coming up.  Because of the snow we didn't get in much training before the weekend but I was still really proud of how the girls ran.

Lyric was super fast and focused-getting some of her best course times ever,  no sight-seeing or visiting and no hesitation or lack of confidence about any obstacles.  However she did not successfully weave on the first attempt on any of her runs and so did not get any Q's.  We also had a bit of issue of me pulling her off a few jumps but that's just working on our timing. 

Legend was great too.  Saturday she did her random refuse the A-frame the first time thing but that was her only error.  She then Q'd in JWW on a tricky course.  Sunday we had a miscommunication about the tunnel but otherwise she ran very well in standard and then went on to get another JWW Q with one of her fastest times ever. 

I got to use my video camera for the first time too so I might post some of the videos later on.  We brought Po along and pretty much everyone thought he was cute but no takers yet.  We are off to a three day trial this weekend so I am hoping for more good runs!

Wrestlemania

I am fortunate to be blessed with some of the most tolerant dogs on the planet.  They are great puppy raisers.  Secretly, I think they like it.

Horses in the Snow

More snow photos...bigger critters this time!

Snug as a bug

 I made this bed for Legend because sometimes she sleeps on the floor.  Lyric likes it so well she has been sleeping on it instead of with us.  Legend either shares with her or sleeps us.  Zodiac slept on it one night but we told him it was a girl bed so the next night he went back to the boy bed. 

Because we had more snow today I didn't have to work.  Wednesday is the day I work pretty far from home and it was too far to drive in the winter weather advisory.  So I spent the afternoon baking dog cookies to take to the trial this weekend ( I made some regular cookies for Jerry too so he wouldn't feel left out).  Some will be for the raffle to benefit border collie rescue, some are for sharing and of course some are for my little agility stars, who are of course, not practicing at all this week. One day I had Legend weave in the snow, but it's too deep for Lyric. 

Po got neutered today and he apparently thinks nothing happened and is not happy to be cooped up in his crate.  He gets to go with us to the trial this weekend where I am sure he will have a good time, even if he doesn't find a home.

And don't worry, I have more snow pictures to post, I just haven't gotten around to editing them yet.  I know you are very excited.   

Pet Poisons Part 8

Ibuprofen, Aspirin, and Tylenol

Ibuprofen (Advil) is a common OTC non-steroidal anti-inflammatory agent.  Because it persists in an animal's circulation longer than a human's it is significantly  more toxic to pets and should never be administered to them as a substitute for a a veterinary approved drug.  GI signs can occur at doses of 25-125 mg/kg and include vomiting, diarrhea, depression, anorexia and dark tarry stools.  These signs are due GI ulceration and bleeding and worst case scenario-catastrophic GI perforation.  The lower end of this dose is equal to 350 mg for a 30 lb dog (about 1.5 tablets) or 113 mg for a 10 dog (less than one tablet!).  Doses of 175 mg/kg are associated with renal damage (cats only 50 mg/kg is required).  This is equivalent to approximately 12 tablets in a 30 lb dog or 4 tablets in a 10 lb dog (one tablet in a cat).  Central nervous system signs including seizures and coma are seen at doses of 400 mg/kg.  If you have been doing the math you probably realized we are basing this on regular OTC strength tablets of 200 mg.  Keep in mind if you have prescription strength Ibuprofen in your home, these are 800 mg.

Treatment is aimed at preventing GI ulceration and perforation as well as renal failure.  Routine decontamination techniques are used as well as I.V. fluid therapy, and drugs such as misopristol and sucralfate which help prevent and treat ulcers.  Appropriate monitoring of bloodwork is also employed.  Prognosis is good in animals treated right away but becomes more guarded with any delay of treatment and can vary with dose. 

Aspirin (acetylsalicylic acid) toxicity often results in GI signs such as vomiting, blood in stool, and abdominal pain.  Severe intoxications can cause seizures and coma.  Renal failure is less likely to occur than with Ibuprofen toxicity but occasionally liver insult does occur.  Doses as low as 25 mg/kg in dogs can cause GI bleeding and decontamination is recommended at doses of 150 mg/kg.  Cats are more sensitive and doses of 25 mg/kg should be considered toxic.  Treatment is similar to Ibuprofen ingestions with additional therapy instituted as needed-usually in case of very extreme exposures. 

Tylenol (acetaminophen) can cause methemoglobinemia (The toxic metabolite of acetaminophen causes damage to red blood cells resulting in a product called methemoglobin. This product is problematic because it does not have the oxygen carrying capacity of regular hemoglobin.) and hepatic injury.  Because cats are deficient in a particular enzyme they are especially sensitive to the effects of Tylenol and more commonly develop methemoglobinemia whereas dogs usually develop hepatotoxicity. 

Signs include depression, difficulty breathing, increased respiratory rate, cyanosis (turning "blue") and icterus.  Facial and paw swelling are common in cats are are associated with the methemoglobinemia.  Signs of methemoglobinemia can develop within 2-6 hours while signs of hepatic dysfunction may take up to 72 hours to show.  Doses of 100 mg/kg in the dog can cause hepatotoxicity.  This is approximately 1400 mg in a 30 lb dog or 500 mg in a 10 dog.  Doses as low at 10 mg/kg can be toxic in a cat which is approximately 50 mg in an average sized cat. 

Antidotes exist for acetaminophen toxicosis and early administration along with good supportive care usually leads to recovery over 2-5 days.

A lazy "Summer" Day

In case you are tired of snow pictures, here are some "Summer" pictures!

Lyric in the Snow

Lyric's turn...isn't she the cutest thing ever?

Zodiac in the Snow

We got more snow today soooo.......more pictures!  Today is Zodiac's day, the others will follow but I was excited to actually get some good ones of my boy!

 This is the same one as above but in black and white (not that the other one isn't, but you get it).  I couldn't decide which version I liked better.

 Another one in black and white...

 Another pretty face!

 Getting ready for the big game Sunday!

Just for fun...

 I think this one is my favorite.  Seriously, have you ever seen a better looking dog?

Pet Poisons Part 7

Xylitol

Xylitol is a sugar substitute and is a more recently recognized toxin in dogs.  Xylitol is often used in baked goods, desserts, gum, candy, toothpaste and other oral care products. 

Ingestion of xylitol can cause diarrhea and excess gas production but the more severe signs are hypoglycemia (low blood sugar) and hepatic (liver) disease.  Signs of hypoglycemia include weakness, ataxia, and seizures.  These can be observed as soon as 30-60 minutes after ingestion but may be delayed several hours.  Hepatic failure may be observed within 9-72 hours of ingestion and signs can include weakness, depression, vomiting, lethargy, abdominal pain, hemorrhage, and seizures. 

As little as 0.15 grams/kilogram xylitol can cause hypoglycemia.  This is equal to 2 grams in a 30 lb dog or 0.7 grams in a 10 lb dog.  Ingestions of 0.5 gram/kg or more can put dogs at risk for hepatic disease.  This is equal to 7 grams in a 30 lb dog or 2.25 grams for a 10 lb dog. 

So what does this mean in terms of gum-a common source of exposure?  This can be difficult as many gums only list the total sugar alcohol content on the label.  It can be estimated that if xylitol is the primary (first sugar alcohol listed) then 1-2 grams per piece can be present.  If xylitol is not the first sugar ingredient then estimate that there is 0.3 g xylitol per piece of gum.  So approximately one-two pieces of gum could be toxic in a 10 lb dog.  For baked goods, 1 cup of xylitol weighs about 190 grams.

Treatment of the asymptomatic patient includes inducing vomiting and possibly oral sugar supplementation.  For symptomatic patients IV fluids with dextrose and hourly blood sugar monitoring are needed as well as hepatic protectants and antioxidants along with appropriate serum chemistry monitoring.  Prognosis is good in animals who only develop hypoglycemia but guarded in those with full blown liver disease. 

Pet Poisons Part 6

Mushrooms

Mushroom toxicity is a relatively rare diagnosis in veterinary medicine, although this may in part be due to difficulty in recognizing cases and definitively diagnosing it.  There are multiple types of mushrooms with toxic principles which cause a variety of clinical signs, none of which are uniquely diagnostic for mushrooms.  Most cases are diagnosed or suspected based on witnessing the pet ingesting a mushroom or finding mushroom pieces in the vomitus.  It can be very difficult to identify a mushroom based on a photo and identification is best done by a trained mycologist.  If one is not available locally then the mushroom can be preserved in the following manner (taken from Western States Veterinary Conference Proceedings 2008, Patricia Talcott)

"Preservation of the sample is critical due to the high moisture content of mushrooms. Once picked, mushrooms decay quite rapidly, so identification should be performed quickly. If rapid identification is not possible, one can dry the mushroom (let sit at room temperature or place in the oven on a cookie sheet at low temps--100F). All specimens, whether fresh or dried, should be placed on a white sheet of paper, then wrapped in wax paper, and placed in an airtight plastic bag or paper bag with a dry paper towel for transport. Taking a picture of the mushroom prior to shipping can be extremely helpful. Information about the mushroom's location (e.g., lawn, garden, woods, mulch pile, etc.) should always accompany the specimen. Making a spore print prior to shipping is also helpful. To make one, cut off the mushroom's stalk close to the base. Place the cap, with the gills or pores facing down, on a piece of white paper (dark paper may be used if the gills are white). Then cover with a glass. Some mushrooms produce spore prints in a few hours, others take longer. Samples of vomitus and lavage washings for toxicology testing should be frozen."

The toxic mushrooms can be broken down into groups based on mechanism of action and clinical signs.  I'm going to include some photos of the toxic species but please don't use these as a diagnostic tool.  As I said, diagnosis can be very difficult in pictures as many mushrooms look alike; often it's the parts you can't see in the photo that help differentiate between safe and toxic. 

Category A includes mushrooms in the genera Amanita, Lepiota, and Galerina.  These account for the majority of fatalities and primarily affect the GI tract, liver and kidney.  A single mushroom can be toxic to an average sized dog or cat.  Clinical signs start with GI or abdominal symptoms for 6-12 hours and then these subside for up to three days  At this time severe hepatic and renal dysfunction set in.  Treatment is induction of vomiting, gastric lavage, activated charcoal, Penicillin, Silymarin and supportive care.


Amanita phalloides or "Death Cap"




Galerina autumnalis

 Category B includes the genus Cortinarius which is rare in the United States but causes GI and kidney disease.  Treatment is decontamination and supportive care.  Prognosis is guarded.

Category C include species in the genera Amanita and Trichloroma.  These cause a rapid onset of GI signs, ataxia (wobbliness), muscle spasms, and other neurologic signs including agitation, seizures, and drowsiness.  Treatment includes decontamination and supportive care.  Occasional fatalities are reported. 

Trichloroma pardinum

Category D includes the genera Psilocybe, Panaeolus, Gymnopilus, Coocybe, and Stropharia.  These are your typical "magic" mushrooms and anywhere from 1-20 caps can be toxic.  Signs include vomiting, disorientation, hallucinations, tremors, lethargy and dilated pupils.  Recovery is typically uneventful and usually occurs in approximately 6 hours.

Gymnopilus junonius

Category E include the genera Gyromitra, Helvella, and Verpa.  These mushrooms affect multiple systems and cause a variety of symptoms ranging from GI signs to coma.  Treatment is aggressive and supportive.  Prognosis is guarded.

Category F include mushrooms in the genera Coprinus, Clitocybe, Boletus, Inocybe, Entoloma, Mycena, Omphalotus, and Amanita and are the muscarine containing species.  Signs usually begin within two hours and include vomiting, diarrhea, salivation, tearing, increased urine production, hypotension, decreased heart rate, and dyspnea (difficulty breathing).  Treatment is with a drug called Atropine which reverses some of the signs as well as I.V. fluids, oxygen and bronchodilators. 

Omphalotus illdens

Category G include multiple genera which cause a self-limiting GI upset and recovery in 1-2 days.

It is also important to note that of the thousands of species of mushrooms present in the United States only 50-100 are toxic.  So if you see mushrooms in your yard it's still not a bad idea to dispose of them, but don't necessarily panic!

SNOW!

I realize most of these are of Legend but what can I say-she takes great snow photos!

 Lyric got all dressed up to go out...

 but really wasn't that impressed.

 Po thought it was good fun for awhile.

 This was the only decent picture of Zodiac.

 And then Po started thinking this stuff was a bit cold!