Wednesday, March 15, 2017

Canine Congestive Heart Failure: What Is It and How Is It Treated?

(Photo by Razvan Antonescu)
A Note From Dr. John:

Here at PetMart, we talk a lot about congestive heart failure.  Some of our most popular medications are Vetmedin, Spironolactone, Furosemide, and Enalapril- all used to treat pets in congestive heart failure.  Once a pet is diagnosed, they are typically on these medications for life.  But what exactly is this condition, and how is it treated?

First off, it is worth noting that both dogs and cats can suffer from congestive heart failure.  That being said, feline congestive heart failure has a very different presentation and treatment plan than that of canine congestive heart failure.  Here, we will focus on heart failure in dogs, however, we'll discuss this condition in cats in a later article.  

Congestive heart failure is the result of end-stage cardiac disease, typically found in older dogs.  Both small and large dogs can develop congestive heart failure.  Though the underlying disease processes that lead to this condition can vary, the end result is often the same.  In order to understand heart failure and how it is treated, it is important to first understand the physiology of the beating heart.

The canine heart is a four-chambered pump which functions to provide blood to the bod's organs.  Between each heart chamber are valves which prevent backward flow of blood during each heart contraction.  As the heart ages, the valves can start to leak and the heart muscle fibers begin to stretch, allowing blood to flow backwards.  If this happens with the left side of the heart, fluid builds in the lungs, causing coughing and respiratory issues.  If the right side of the heart fails, fluid accumulates in the abdomen, causing abdominal distension, diarrhea, and difficulty breathing.  As you can see, heart failure can lead to many different clinical signs that may seem completely unrelated to the heart.

Unfortunately, heart failure cannot be cured.  Thankfully, it can be managed with the help of your veterinarian.  Therapeutic drugs such as furosemide and enalapril have been around for decades.  These drugs help to remove excess fluid from the body, allowing for resolution of clinical signs such as coughing, respiratory distress, and abdominal distension.  A newer drug called Vetmedin, has proven to be a game changer when treating heart disease as well.  With its release, the veterinary field has been able to improve the lifespan of dogs identified as having underlying heart disease (the leaky valve variety, not the stretched heart variety) that have not yet developed the classical clinical signs of coughing and respiratory issues.  Studies show that when implemented early, Vetmedin can increase lifespan by a whopping 15 months!  That's an incredible number, and as a veterinarian myself, I could not be more excited!

Remember, canine heart disease is a complex issue that comes in many different shapes and sizes.  Always consult your veterinarian to ensure that your pet's condition is accurately diagnosed and safely treated.

Our information is not intended to replace the advice of your veterinarian.  Do not use this information for diagnostic purposes. Always take your pet to your veterinarian to obtain a diagnosis and course of treatment. 

Wednesday, March 1, 2017

Could My Pet Be Suffering From Seasonal Allergies?

(Photo by Chinda Sam)
A Note From Dr. John:

Springtime is fast-approaching.  That means sunshine, warmer temps, and ALLERGENS.  If your pets are anything like mine, they could suffer from more than just one allergy.  In fact, your pet could have reactions to multiple allergens- weeds, grasses, insects, etc.  Most of the time, allergies are mild with signs such as itchy skin, runny eyes, and sneezing.  Clinical signs can last several hours to several months depending on your pet.  

There are multiple treatment options, such as steroids and antihistamines, that have been proven effective in treating allergies.  Steroids include Prednisone and Prednisolone. Both are generally administered on a tapered dose and have similar side effects such as increased appetite, thirst, and urination.  Keep in mind that steroids will require a prescription from your veterinarian.  Examples of antihistamines are Vetadryl (Benadryl), Cetirizine (Zyrtec), and Chlorpheniramine.  Antihistamines can either be administered on a daily basis or as needed for flare ups.  These medications can be purchased over the counter and do not require a prescription from your veterinarian. 

Other allergic reactions are much more severe and necessitate immediate medical attention.  Signs of a severe allergic reaction include hives (red spots on your pet's skin), facial swelling, vomiting, diarrhea, difficulty breathing, and collapse.  The best approach to severe allergic reactions is to get to your veterinarian as soon as possible.  For long-term care, identifying allergens that set off the reaction is vital to help avoid a serious reaction in the future. 

Our information is not intended to replace the advice of your veterinarian.  Do not use this information for diagnostic purposes. Always take your pet to your veterinarian to obtain a diagnosis and course of treatment. 

Wednesday, January 25, 2017

The Importance of Finishing a Prescription

(Photo by Octavio Fossatti)
A Note from Dr. John:

Depending on the demeanor of your pet, giving medications could be a breeze, or it could be a nightmare.  For many conditions, your pet's symptoms and/or behavior may seem to have improved after only a few doses of the medication prescribed by your veterinarian.  In other cases, you may not see any obvious improvement in your pet's heath after days or even weeks on a medication.  Many clients are tempted to stop giving the remainder of a prescription once one of these scenario occurs.  What most people don't realize is that doing so can be extremely detrimental to your pet's health and recovery.  Here are a few of the most common prescription problems encountered in veterinary medicine:

  • Antibiotics.  Antibiotics and antibiotic resistance have gotten a lot of attention in the human medical field as bacteria have emerged that are resistant to all known antibiotics.  One of the noted causes of this phenomenon is failure to complete antibiotic regimens prescribed by doctors.  The same outcome is frequently discussed in the veterinary medical field.  It is not uncommon to see resistant ear infections and skin infections in dogs due to failure to properly finish medications.  Usually, this is due to difficulty administering the medicine or an overly busy schedule for pet owners.  If you run into problems medicating your pet, talk to your veterinarian about alternative forms of medication that might be easier to administer.  Putting in the effort to complete an antibiotic regimen will effectively kill off harmful bacteria rather than creating more resistant strains.
  • Steroids. Pets are treated with steroids for a whole host of reasons.  Whether for something as simple as itchy skin or for something as involved as an autoimmune condition, steroids are an integral part of the veterinary medical field.  Whereas antibiotic regimens are usually very straight forward and dosed once a day or twice a day, steroids are dosed on tapering schedules. This means that the dose is started highest in the beginning and then gradually decreased over a period of time before being fully discontinued.  Tapering schedules allow the body to restart making its own natural steroids.  If steroids are discontinued too rapidly, your pet's body will not be able to recover this ability.  This can lead to what is called an Addisonian crisis during which your pet can experience dangerous drops in blood pressure, vomiting, diarrhea, and other very serious side effects.  It is much safer to finish the medications as prescribed than to end up at the emergency hospital from stopping steroids too quickly. 
  • Anti-depressant medications. Anti-depressant medications are being prescribed more and more frequently as separation anxiety and other anxiety-related behaviors are reported by pet owners.  Some of these medications are long-acting, such as fluoxetine and amitriptyline.  These medications must be given for a minimum of 1-2 months prior to reaching the therapeutic levels in the blood stream.  This means that you may not see results in your pet's behavior until you have consistently administered the medication for two full months.  Many times, failure to improve on medication is due to pet owners discontinuing medicine before allowing this to occur. 
Our information is not intended to replace the advice of your veterinarian.  Do not use this information for diagnostic purposes. Always take your pet to your veterinarian to obtain a diagnosis and course of treatment. 

Tuesday, January 17, 2017

What Treats Should I Be Feeding My Pet?

(Photo by Andrew Branch)
A Note From Dr. John:

To feed or not to feed, that is the question... if only treat choices were that easy.  Unfortunately, with so many treat options on the market and pet health issues increasing in prevalence, the decision on what and how much to feed can seem overwhelming.  The rate of diabetes, arthritis, dental disease, and other illnesses seems to be ever-increasing.  Many of these conditions, however, can be prevented with the right daily care- this includes the types of treats that your pet receives.  Here are some treat options based on different life stages and health statuses:

  • Dental disease.  Plaque and tartar inevitably accumulate on your pet's teeth as they age.  Trying to brush your pet's teeth may not fit into your busy schedule or it may not be something your pet particularly enjoys.  If this is the case, dental treats are a great way to reduce the speed of tartar accumulation.  Check out C.E.T. Hextra Chews, OraVet Dental Chews, or Greenies Dental Chews.  Select the right size based on your pet's weight range and let your pet show off his or her pearly whites!
  • Obesity.  Obesity rates are estimated to be at a staggering 30-50% in dogs and 20-50% in cats.  Obesity predisposes pets to multiple ailments such as diabetes, arthritis, cancer, and pancreatitis.  Preventing obesity is all about calories in versus calories out.  One of the biggest sources of excessive calories for pets is treats.  For the couch potato pets, your best bet is a low calorie option such as Lean Treats or Lite Snackers.  
  • Arthritis.  Pets are just like people.  As their bodies age, the cumulative stress on joints leads to arthritis and the subsequent pain associated with it.  Unfortunately, there is no going back once arthritis sets in.  One of the best ways to prevent and manage it once it has arrived is to provide your pet with the right joint supplements, such as glucosamine and chondroitin sulfate.  Dasuquin and Cosequin are packed with these supplements and are a great daily treat as well.

Remember that treats are just that- treats! They are intended to supplement your pet's regular caloric intake from a balanced diet.  Don't fixate on one problem (dental disease) only to replace it with another (obesity and diabetes).  And, as always, consult your veterinarian to help determine the best treat option for your pet.  

Our information is not intended to replace the advice of your veterinarian.  Do not use this information for diagnostic purposes. Always take your pet to your veterinarian to obtain a diagnosis and course of treatment. 

Tuesday, December 20, 2016

Traveling With Pets

A Note From Dr. John:

Thanksgiving, Christmas, and the New Year mean great food, family time, and often, extended travels.  The thought of traveling is exciting for many of us; for others, it's stressful.  But what about for your pets?  Some pets LOVE to travel. Others get nervous, scared, or nauseous at the mere sight of a car.  For those of you whose pets like to travel- congrats!  Your job is easy.  For those whose pets do not travel well, there are numerous options to help alleviate the stresses of car rides. 

  • Nausea. For those pets who are apt to "toss their cookies" in your newly washed and vacuumed ride, try administering an anti-nausea medicine.  The best option on the market is Cerenia.  This medication is very safe and is used at high doses for car sickness.  The anti-nausea effects are going to last about a day, but they may leave your pet feeling drowsy (although maybe that's a good thing if they are stressed in the car).  Other options include ondansetron, meclizine (non-drowsy Dramamine), and Benadryl.  Your selection is going to depend on your pet's need as well as your budget, so make sure to consult with your veterinarian.  
  • Stress.  If a short ride in the car is your pet's idea of purgatory, the thought of an extended trip to Grandma's house might push them over the edge.  The good news is that there are many anxiety medications that can be very effective for fear of car rides (as well as fear of fireworks, loud noises, etc.).  Short-acting options such as trazodone and acepromazine are also great options, however, both have side effects, so make sure to discuss these medications with your veterinarian prior to trying them out. 
  • Uneasiness/instability.  Let's say that your pet likes to ride but has a hard time getting comfortable.  Maybe they are old and arthritic.  Maybe they are top-heavy and have terrible balance like my dog.  Or maybe you just want to make sure that your new leather seats aren't destroyed in a single car ride.  Whatever the reason, we've got you covered.  Check out the many harnesses, seat belts, baskets, and seat covers that are available to make your pet's ride as comfortable as possible.  These items will give your pet a "safe space" in the car and provide some stability as you make your way to Granny's for the holidays.  

Our information is not intended to replace the advice of your veterinarian.  Do not use this information for diagnostic purposes. Always take your pet to your veterinarian to obtain a diagnosis and course of treatment.  

Monday, November 28, 2016

Heartworm Disease: Why All the Fuss?

(Image from the American Heartworm Society)
A Note From Dr. John:

You’re constantly told to keep your pet on heartworm preventative.  But why all the fuss?  What is heartworm disease, and what threats does it really pose for your pet?

Heartworms are worms that grow in the hearts of cats, dogs, and other canid species (wolves, coyotes, etc). If allowed to grow unchecked, the worms move into the blood vessels of the lungs, causing clinical symptoms such as coughing, labored breathing, decreased activity and decreased appetite. Eventually, untreated heartworm disease is fatal.

Heartworms are spread by mosquitoes, (what we call the disease vector), meaning the prevalence of the disease depends of the region where you live. We are located in the Southeast, the hotbed of heartworm disease in the United States. Because of the prevalence of mosquitos, we recommend that all pets (dogs, cats, and even indoor only cats!) be on heartworm prevention year-round. Areas like the Pacific Northwest have much lower prevalence due to a relative lack of the disease vector. It is important to talk to your veterinarian about your individual pet’s risk of exposure to mosquitoes and develop a prevention plan accordingly. The good news is that heartworm disease is a preventable condition with easy once monthly medications.

Prevention is much easier than treatment—easier on your pocketbook and much easier on your pet’s health. Once your pet develops heartworm disease, treatment involves very expensive intramuscular injections that can cause muscle soreness. Pets being treated require strict confinement until the heartworms die off, which can take weeks to months. Treatment can also lead to serious complications, including sudden death.  Prevention, on the other hand, will simply require monthly administering.  Want another great reason to use heartworm preventatives? Most medications also protect against several forms of intestinal parasites and can even prevent flea infestations- all good things!

Now are you sold on heartworm preventative? So am I! Head on over to and check out our great selection of preventative medicines at affordable prices.

For more information on heartworm disease, visit the American Heartworm Society

Our information is not intended to replace the advice of your veterinarian.  Do not use this information for diagnostic purposes. Always take your pet to your veterinarian to obtain a diagnosis and course of treatment.  

Tuesday, November 8, 2016

Preparing for the Holidays: How to Keep Your Pet Safe This Holiday Season

A Note from Dr. John:

Who doesn’t love the holidays? Great food, friends, and family galore. And whose pet doesn’t love the holidays? All those people around feeling extra generous with their food and gifts. Here at PetMart Pharmacy, we love the warmth of the holidays, too, but we want to make sure that your furry friends stay safe. Here are a few pointers to help make sure you spend your free time at home with family and not at the vet’s office with a sick pet.

Holiday Dangers to Avoid:
  • Chocolate.  Dogs are particularly sensitive to the effects of chocolate on blood pressure and heartrate, leading to many potentially serious side effects. All chocolates are not created equal in tingling your taste buds or in effecting your dog’s cardiovascular system. The general rule is the darker the chocolate, the more harmful. Baker’s chocolate is the most dangerous, followed by dark chocolate, then all the way down to milk and white chocolate. The best approach is to prevent your dog from eating chocolate in the first place, so make sure it’s stored away safely. Just because it is wrapped up nice and tidy under the Christmas tree doesn’t mean Fluffy won’t tear that package right open and gobble down a bag full of delicious chocolate—and wrappers! If your dog eats chocolate, the best thing you can do is contact your veterinarian or the Poison Control Hotline (855-764-7661) for advice.  
  • Fatty Foods.  High fat foods such as ham sure taste great to many of us and help bring on those wonderful post-lunch naps. For dogs that rarely eat fatty food, however, ham and other foods can cause severe pancreatitis. This can lead to prolonged treatment, lots of time spent at the hospital, and less time at home with the family. Tempted to give your pet a taste of the wild by offering him or her a turkey or ham bone? Better to avoid the upset stomach or potentially perforated intestines (yikes!) from a sharp bone fragment. Warn Uncle Larry that he pays the bill if he drops the bone!
  • Toxic Plants.  Poinsettias and Lilies can make for beautiful seasonal decorations. However, Poinsettias can cause upset stomach and vomiting for both cats and dogs if ingested. Also, certain types of Lilies (but not all) are very toxic to cats, potentially causing kidney failure if ingested.  Common toxic Lilies include Day Lilies, Tiger Lilies and Easter Lilies. Safe varieties include Peace Lilies, Calla Lilies, and Lily-of-the-Valley. Again, best to play it safe and keep these plants out of reach of your pets.  You can read more about toxic plant varieties on the ASPCA website. 
  • Holiday Decorations.  Tinsel looks great on your Christmas tree, but its twinkle can catch the eye of a curious cat. Although watching your cat bat around some lifeless decorations can be very entertaining, these items can get anchored under his or her tongue if ingested.  This can cause choking, vomiting, and likely requires sedation and removal at your veterinarian’s office. Not a great way to spend the holidays!

Here’s to a happy and safe holiday season from our family to yours! 

Our information is not intended to replace the advice of your veterinarian.  Do not use this information for diagnostic purposes. Always take your pet to your veterinarian to obtain a diagnosis and course of treatment.