by Dr Nina Mantione

I’ve never been inspired to write a blog by a mosquito before. That is, until now. We were at the beach enjoying an evening walk by the ocean when the familiar whine and hum of these diabolical little insects had us running for the car.

“Mosquitoes ruin everything,” said my daughter as we slammed the door on an army of the tiny pests.  Just at that moment, I watched a man jog by with his dog. “Yes, they do.” I replied. I watched the dog round the corner and hoped he was up to date on his heartworm prevention.

Mosquitoes are vectors of many diseases. Most people know that for humans mosquitoes can spread West Nile Virus and Malaria, among other diseases. But for our pets, it is heartworm disease that mosquitoes harbor.  Heartworm disease is a usefully named parasite because the name pretty much sums up the disease.  It is indeed a parasitic worm, and if not always taking up residence quite in the heart itself, they lodge close enough to cause devastating effects.  A heartworm infection can lead to heart failure and lung problems. And while it can be treated (if it is detected on a yearly blood test), the treatment itself can be fraught with danger.

As pet owners, we are in luck.  Heartworm disease is exceptionally easy to prevent.  The parasite is very susceptible to de-wormers. So as long as we remember to give the de-wormers on their prescribed monthly basis, the heartworm parasite should succumb without a fight.

The key to the above sentence is, “as long as we remember to give them!” I know we have all experienced the moment of “Uh oh…when did I last give Fido his heartworm tablet?” Luckily for those scatterbrains among us (umm, myself included) we do have a little bit of leeway to be late with heartworm administration. But a little bit is a little bit - say a week or so. But it is far better to make it a habit to give your dog a heartworm preventative on the same day of each month. (For me that is on the 15^th because that is the day I also pay bills.)  If you are still worried you may forget, ask your veterinarian if they have a reminder service, or try out the website www.remindmypet.com, which will send you monthly email reminders.

This simple step of giving your pet a monthly preventative could be the difference between life and death.  And it also lets you rest assured that when those rotten mosquitoes attack, they are just an annoyance, and not a major threat to our pets’ health.

By Dr Nina Mantione

We had a rabies scare in our office a few days ago. Again.  This time, it was an unvaccinated outdoor cat was brought in after developing neurologic signs that caused concern in two women and a small troop of children, all who had handled the cat in their attempts to help it.  The cat bit two of our staff members. With rabies, one can never be too safe: unvaccinated + neurologic = rabies suspect.  

I work in a rabies endemic area, which means that our local wildlife population is harboring this deadly virus. Almost every week our local newspaper has a report of a rabid skunk, raccoon or fox that has been identified in a surrounding neighborhood.  At least twice a year we see a potential rabies case, typically an unvaccinated outdoor cat with neurologic signs.  A few years ago, one such outdoor cat did have rabies, resulting in post-exposure treatment for six of our staff.   However, don’t be fooled into thinking that being an indoor only pet is an adequate way to prevent an exposure.  There are several instances of rabid, bizarrely behaving wildlife making their way indoors and exposing indoor pets.  After all , a neurologic bat is an irresistible plaything to any cat.

I, personally, have a healthy respect (read: fear) for the rabies virus. Rabies is an amazingly devious virus.  Like something created in an evil villain’s science lab, it is perfectly designed to maximize its spread.  Once in a new victim, the rabies virus travels to the brain and the saliva glands.  The brain - in order to create the aggressive behavior that we all associate with rabies, and the saliva glands – in order to ensure it is spread via a bite wound.  It is terrifying and genius – all in one.

Interestingly, many people are reluctant to give their pets the rabies vaccine.  Perhaps, because of the scariness of virus itself, the vaccine carries with it a certain uncertainty in some circles. Or, what we see more frequently, because of a false belief that “it could never happen to my pet.”  I can assure you that the disease the vaccine prevents is far worse than any vaccine reaction I’ve ever seen.  And this disease is too serious to leave to hope and chance. The rabies vaccine is one of the only vaccines we give that prevents a disease that can infect people as well, and in my state of Pennsylvania, and most others, this fact alone makes it a law for pets to have the  rabies  vaccine. For me, all of my pets, indoor cats included, are vaccinated against rabies, and I rest easy knowing that I never have to worry.

By Dr Nina Mantione

I love summer, but as much as I love the endless summer nights, I hate the endless  itching! In my area, it seems like every other patient I see this time of year is an itchy, scratchy mess. And my patients’ pet parents are bleary eyed from being kept up half the night by the thumping and licking of a scratching pet.  By the time they come to see me, or a veterinarian like me, things are usually a little desperate.

Summer (actually late spring through mid-fall) is the season for allergic dermatitis, aka: atopy; seasonal allergies; or allergic skin disease. These are the very same allergies that give people hay fever.  Allergies to pollens from grass and trees manifest more commonly with skin symptoms in dogs and cats, rather than the respiratory symptoms typically experienced by people.  And – sadly – for those of you hoping for a magic pill, as the billion dollar antihistamine industry can attest to – there is no cure for allergies. 

I feel for my itchy patients.  I see little white dogs whose feet are pink from licking, and Labradors with secondary ear infections stinky enough to stop you in your tracks.  My affected cats seem to be able to lick themselves half bald without their owners ever seeing them actually grooming.  Having once been the victim of a horrible case of poison ivy, I can sympathize with the torment of a summer full of enough itchiness to make your skin bleed.  I do my best to hold the symptoms at bay.  Pet owners leave the office with loads of antihistamines, steroids, antibiotics and expensive shampoos, but the relief these provide is often temporary.  More expensive therapies are available, and, while they better (and are covered by Petplan pet insurance) they too are not 100% guaranteed to be effective.  I probably make more referrals to the veterinary dermatologist in the months of July and August than I do in all of the other months combined.

Unfortunately, there is nothing we can do, short of moving to Antarctica (I’m fairly sure that all of that ice will lower the pollen counts), to get rid of the seasonal allergies altogether.  We just have to buckle down, ensure there isn’t an underlying food allergy, control the symptoms, fight the itching and wait for the first frost to come.

By Dr Nina Mantione

Yesterday, one of my colleagues voiced to me his frustration about the fear of sedation.  He wanted to sedate a dog in order to properly flush its badly infected ears.  This would be the medically sound thing to do, as removing all of the debris would allow the medications he was prescribing to work more effectively. The dog’s ears were much too painful to attempt this procedure while he was awake.  Unfortunately, as soon as he mentioned anesthesia, the pet parent became nervous and refused the procedure.

I truly understand this fear of anesthesia. It can be disconcerting to think about – especially for pet parents who are making decisions on behalf of their loved one. However, most pet parents I talk to fear that their animal will fail to wake up.  And in reality, this fear is a very, very remote possibility.  In my office we anesthetize hundreds of animals a year, of all ages and health statuses, with very few complications.  However, what we as veterinarians do fear is that inadequate treatment of a problem – such as severe ear infections, terrible dental disease or a rapidly growing mass – carries a much higher risk to a pet’s life and health than sedation ever could. 

Unfortunately, no matter how reassuring we try to be, a large number of pet parents would rather deny procedures that require sedation because of a fear of the unknown.  As with any medical procedure, I cannot say that sedation and anesthesia are 100% without risk, however; I can say that they are a better option than allowing medical problems to go untreated or making a pet endure a treatment in a fractious, frightened and painful state.

So, at my colleague’s request, I am writing this blog to remind pet parents that when it comes to the question of sedation, please understand that your veterinarian has your pet’s best interest in mind.  It is important you feel comfortable, so ask lots of questions, and weigh the pros and cons. Most importantly, consider the health implications – both short and long term – for your beloved pet. In the end, your vet wants to provide your pet with the best possible, least traumatic care possible. And you both want your pet to quickly get back to what he or she does best: showering you with love and affection, of course!

by Dr. Nina Mantione

We’ve all heard the expression “the way to a man’s heart is through his stomach.” But what about “man’s best friend?”  A patient of mine, Lola, lives with a loving family who shares everything with their darling girl – including their table scraps. So, is sharing caring? Not necessarily – especially when it comes to our pets’ diets.  

Lola is a four-year-old Beagle/Terrier mix who I have cared for since she was eight-weeks-old.  Her pet parents are a sweet mother and teenage daughter duo, and Lola is clearly a cherished member of their family.  A year ago, when I saw Lola for her wellness check up, I was dismayed when I walked into the exam room.  Lola had gone from a little bit on the plump side the year before, to grossly obese. As I entered the room, she struggled to her feet and waddled over to me, breathing heavily.

I think I let out an audible gasp, “Oh!  She’s gotten so fat!”  Tactful? No.  But I was upset to see this young dog struggling to move around the room. Mother and daughter looked anxious, and I had a heart-to-heart discussion with them about weight loss and exercise.  They both cited Dad as the source of a never-ending supply of table food and promised to set him straight.  Lola’s obesity was so remarkable that I ran some bloodwork to make sure nothing else was amiss.  Obesity in pets is a major contributor to health problems.  It has been implicated in orthopedic disease, pulmonary disease, and diabetes among others. 

Six months ago, I saw Lola again for a vaccine booster and was disappointed to see that she had gained two more pounds.  This time I was stern with her owners.  I told them that her quality of life was being diminished by her obesity.  At her age, Lola should be in her prime, chasing squirrels and playing ball, not waddling and wheezing her way across the floor for another nap.  I challenged them to get the weight off of her.  For the second time we discussed diet options and exercise programs.  Dad came up again as the source of extra calories and I gave them the task of laying down the law for NO MORE TABLE FOOD.  I told them to quote me.  They left my office with fire in their eyes. I watched them leave with Lola waddling after them. Honestly, I wasn’t feeling too hopeful this time.

I saw Lola last week. I opened the door to the exam room and a bouncy slim version of Lola ran over to me and jumped up on me.  Once again I gasped in surprise.  The owners were beaming at me. Mom and daughter rushed to tell me about extra walks and diet food, and that Dad was cooperating and not feeding Lola from the table. Here was Lola, almost 20 pounds lighter, acting ten years younger.  I beamed back at the owners with tears in my eyes. I actually hugged them (to their surprise).  They bragged about her speed and ball playing and I told them how proud I was of them, because no matter how well I do my job, it is a pet’s family that really holds the key to their health.

Playing ball in the backyard? Catching Frisbees in the fields? Chasing a puck in the pasture? (Enough alliteration yet?) Regular exercise for you and your pet is a must, but be aware that your canine quarterback can suffer from sports-related injuries in much the same ways as human athletes. In fact, the most common orthopedic injury in our dogs is directly analogous to one of the most well-known professional sports injuries – the dreaded ACL tear. The anterior cruciate ligament (ACL) is one of the supportive ligaments in the knee joint. Complete or partial tears of the ACL cause pain, swelling and often instability of the joint. In animals, because of a difference in anatomical terminology, we tend to use the term cranial cruciate ligament (CCL) more commonly, but the two terms are often used interchangeably.

So, how do these injuries occur in pets? Well, it usually takes a severe twisting or jarring motion to cause the CCL ligament to rupture, but studies suggest that around 75% of pets that suffer CCL tears have a degree of predisposition due to genetics, obesity, age or concurrent disease. Additionally, when one knee has suffered an injury, there’s a much increased chance of the other knee also suffering a tear within the next 12-28 months.

Fortunately, medical advances and better post-operative care mean that there’s never been a better chance of getting your superstar back on all four feet in record time. However, advanced surgical techniques like tibial tuberosity advancement (TTA) and then after-care like hydrotherapy can come with a hefty price tag – surgery alone can top $5,000. When you consider that Americans spend over $1.2 billion dollars per year on CCL repairs alone, you can see why more pet owners are looking to pet insurance to help manage the financial trauma.

So, as head coach for your pooch:

-          Make sure they spend as little time on the bench as possible, make sure your pets stay lean and fit.

-          Look out for anyone that needs to go on the injury report; keep a keen watch out for any limping after exercise and contact your vet immediately.

-          Preparation before any big game is key; get a pet insurance policy in place BEFORE your pet runs into a problem.

by Dr. Nina Mantione

I love my shelter cats.  That is not to say I am immune to the blue-eyed charms of the beautiful Himalayan I saw in my office for her wellness visit a couple of weeks ago, but my cats from the “wrong side of the tracks” have a charm all their own.

Last September, our sweet 17-year-old cat, Lillith, passed away from kidney failure.  A month after we lost her, I read an article about how crowded our local shelter was becoming.  Still missing my Lillith, the article reminded me that 17-years-ago my husband and I chose her after she thrust her skinny little kitten leg through the bars of the cage at a shelter and beckoned us over.  This memory, along with the troubling article, prompted me to drag one patient husband and four excited kids to the overcrowded shelter to find a new feline addition to our family.  A shelter volunteer us  told us they had over 600 cats in need of homes!  I wanted to teach my children about animal shelters and adoption, so naturally we couldn’t leave empty-handed.  And even though we went there for just one cat, we couldn’t help but fall in love with two!

A week later we returned to pick up our two newly spayed and neutered young adult cats.  Shelter rules stipulate that no animal leaves if not spayed or neutered – even when the adopter is a veterinarian! This rule ensures that there are no “accidental” litters finding their way back to the shelter, and saves the adopting family the full cost of a spay or neuter.

When you consider the health benefits of spaying and neutering, as well as the fact that spayed and neutered pets receive a discount on their pet insurance, adopting a cat is a bargain that is hard to resist.  The adoption fee covers all of the medical care the pets have had while in the shelter, and any additional amount allows the shelter to help other animals in need. 

So, while they may not have the stunning beauty of a purebred, my scrappy duo is a charming pair.  Sookie, short and stocky, has an opinion about everything and has appointed herself “spokescat” for the household.  Godric’s Roman nose gives him character as he sprawls on our bed, looking  around as if he can scarcely believe his good fortune to have gone from a two foot square cage to a fluffy, clean, down comforter. 

Best of all is our family’s good fortune to have been able to provide homes for these two very grateful (and now somewhat spoiled) alley cats. Almost every day one of my children will say to me, “These cats are sure lucky we picked them!”  But I tell them that we are the lucky ones.

So, as I tell my clients all the time – do yourself a favor and visit your local shelter.  Find your own grateful new addition, and you may find yourself feeling equally as smitten!

Every Monday here at Petplan, I receive a list of the week’s more unusual pet insurance claims. This week, two of these jumped out at me because they were for a relatively unusual breed: the Vizsla. It’s not uncommon for a couple of our “I-ate-a-spatula-with-cake-mix-on-it” or “running-full-speed-into-the-tv-because-there-was-a-rabbit-on-it” claims to be for Golden Retrievers or Labradors, but it was surprising to see Vizslas featured twice.

For those unfamiliar with the breed, they’re a sporting dog originating over 1,000 years ago in Hungary as companions and working dogs of the Magyar tribes. Fancy heritage, no? As you can see from the picture, they’re easy on the eye, too!

My experiences with Vizslas in a clinical setting has been pretty wide and varied but speaks volumes of the breed. A couple of examples are below:

-          Severe chest lacerations – As with many sporting breeds, if a Vizsla spots a small, running animal (if they’re not on the leash) they can be off like a shot. In a recent case we saw, a rabbit caught the attention of our brave hunter but then a barbed wire fence made the hunter the hunted! Fortunately, the lacerations healed well but required several minor operations. Cost? Around $1,500.

-          Diabetic chocolate ingestion – Intelligent, curious, hungry. Not a good combination when Dad’s special valentine chocolates have been left lying around. Now, chocolate is bad news for dogs and ingestion of a mixed box of milk and dark chocolate can be tough to treat. However, in this case the bad news was compounded by the fact that diabetic chocolates tend to use the artificial sweeteners mannitol or xylitol. Unfortunately, xylitol can be highly toxic and, since the confectioner was closed, we had to treat this as a worst-case scenario and treat aggressively. Fortunately, everything worked out well but the bill topped $2,000.

-          Routine blood draws – One of the reasons vets and techs love athletic breeds like Vizslas, Weimeraners and Greyhounds is that their veins are fantastically easy to draw blood from! There’s nothing better than having a nice, plump vein to draw blood for annual heartworm and blood tests. The drawback? Being on the smart side, they often know something’s awry and the “blood-draw- 3-legged-dance” with a vet or tech hanging onto the other foot is not uncommon!

These days, Vizslas are becoming increasingly popular as pets because of their incredibly sweet nature, impressive athleticism and generally high level of intelligence – making them ideal dogs for young, active families.