A Night in the Life of an Emergency Pet Hospital Vet

TV shows often chronicle the dramatic goings-on in the emergency room of hospitals, but what about emergency pet hospitals? Here, Dr. Katy Nelson, an associate emergency veterinarian and a certified veterinary journalist in Alexandria, Va., describes what goes on at such hospitals from her perspective.

How an ER Shift Starts
Nelson says a typical shift in an ER starts and ends the same way: with rounds. “Vets, just like doctors, have to turn over their patients so that the incoming doctor knows all the ins and outs of each case, knows what to watch for, and what the plan is.”

After this work comes what she and some other ER vets call “SOAP.” This stands for “Subjective, Objective, Assessment and Plan.” The acronym refers to many different activities, from fielding owner questions, to communicating with other veterinary hospitals, to handling all of the emergency cases that come through the front door. Some nights, this process goes very quickly; other nights, it goes on and on. “The reality of emergency medicine is that it’s like Forrest Gump’s box of chocolates -- you never know what you’re going to get,” says Nelson. But she says most “emergency types” thrive on the uncertainty.

Cat ER Patients
Nelson says that most cats come into the emergency room for the following health problems: vomiting, diarrhea, urinary problems, respiratory issues and lack of appetite.

“Cats can be very vocal and very physical, so you’ve got to use caution when dealing with them,” says Nelson. “For the most part, they’re just scared, so by dealing with them slowly and with patience, you often can achieve what you need to get done by simply assuring them that you’re not out to hurt them.”

How ER Pet Hospitals Differ From Others
As opposed to a regular veterinary office, most ER facilities stay open for 24 hours, or handle cases after normal working hours. Emergency hospitals are typically more expensive, with care costing about 20 percent to 30 percent more due to higher overhead and higher liability, as well as what Nelson calls “the convenience factor.” As opposed to other care facilities, some ER hospitals would rather that the owner not be in the treatment area at the time of the emergency. This is much like a human hospital, where the family is frequently kept outside in the waiting room.

Reasons to Visit an ER
Because of the ER cost and the often late-night hours, some cat owners try to wait out their pets’ health problems until the morning, figuring that their cats’ usual veterinarians can handle the issues then. Nelson, however, says you should never wait until morning if the following symptoms surface:

  • Respiratory distress. It could be tied to asthma, congestive heart failure or a clot in the lungs, all of which can be fatal.
  • Nonproductive urination. A urinary obstruction can be life-threatening.
  • Vomiting/diarrhea/lack of appetite for more than 48 hours. This can lead to severe and life-threatening liver damage among cats.
  • Ingestion of string or a possible toxin. It’s better to be safe than sorry in such cases.

What to Do Before Going to the ER With Your Cat

Nelson offers the following three tips:

1. Try to bring a copy of the medical records with you (and not just a receipt) so that your ER doctor can have a complete picture of your cat’s history rather than just having to go on your memory alone, which is not always that great during an emergency.

2. Always bring your cat in a carrier. Remember that there will be other pets in the hospital. For your own pet’s safety, having it in a carrier is key.

3. If you know your cat gets aggressive or has required sedation during prior visits, please tell your veterinarian or technician immediately so that no one gets hurt.

Nerves and emotions run high at ER hospitals, so by following such advice, you can eliminate additional hassle. You might also help to save your pet’s life.

Are You Protecting Your Cat’s Health?

We all want our pets to live healthy lives, but are we as informed as we should be? Take this quiz to see how you measure up.

1. I schedule basic veterinary checkups for my adult cat:

a. Once a year

b. Twice a year

c. When needed

Optimal answer: b. Twice a year

Although annual visits are a good start, twice-yearly exams are your best insurance against hidden diseases, says Dr. Ernie Ward, a veterinarian based in North Carolina. “I also recommend checking your pet’s blood test and urinalysis once a year in patients over 7 years old,” he says.

2. I treat my cat with over-the-counter medicines (e.g., painkillers):

a. As soon as symptoms appear

b. Only in emergencies

c. Never

Optimal answer: c. Never

The No. 1 cat poison is human medication. “Simple human drugs, like acetaminophen, can be fatal to cats,” says Dr. Patricia Joyce, an emergency veterinarian in New York City. Keep your pills to yourself.

3. I check my cat’s ears:

a. Once a year

b. Every few months

c. Every few weeks

Optimal answer: c. Every few weeks

Ear infections are preventable with careful monitoring. “If the earflap is red and inflamed; if the canal is narrow, has a heavy buildup of debris or is smelly; or if touching your cat’s ears is painful; you have a problem that needs to be addressed,” says Dr. Bernadine Cruz, a veterinarian in California.

4. My cat gets its teeth cleaned:

a. Once a year

b. Twice a year

c. Every five years

Optimal answer: a. Once a year

Annual cleanings are recommended, but Dr. Katy Johnson Nelson, a Virginia-based veterinarian, says some cats need more. “Just like some people have more cavities, some cats have significantly more severe dental disease than others. Your veterinarian will be able to determine how often they need those teeth cleaned,” she says. Between cleanings, brush your cat’s teeth at least weekly.

5. I bring my cat for vaccine renewal:

a. Yearly or sooner

b. Every three years

c. Every five years

Optimal answer: a. or b. Yearly or sooner, or every three years

Core vaccinations are given every three years, others last a year or less. Discuss this with your veterinarian and know the schedule for each vaccine.

6. I enrich my cat’s environment by:

a. Leaving toys out

b. Creating a window perch

c. Dedicating part of a room to my cat, with toys and structures

Optimal answer: c. Dedicating part of a room to my cat, with toys and structures

“Even though cats can be elusive, dedicating a part of the room to them -- with toys, perches and attention -- is essential to making them feel part of the home,” says Nelson. This simple step can help prevent behavior problems and unwanted pounds, and it can even prevent disease.

7. I exercise my cat:

a. Daily

b. Weekly

c. Seriously? Exercise my cat?

Optimal answer: a. Daily

To keep your cat lean and healthy, and to prevent many behavioral problems, daily exercise is key. “Two to three five-minute play periods using interactive toys, laser pointers, dancing feathers or whatever your cat enjoys is just as important as nightly chin-scratches,” says Ward.

8. I let my cat roam outside:

a. Never

b. All the time

c. Only when I go out

Optimal answer: a. Never

“Today’s outdoor environment poses many dangers for cats,” says Ward. “Whether being struck by a car, attacked by a dog or poisoned by trash, it’s always better to keep your kitty indoors.” Cruz recommends a microchip implant, just in case.

9. My cat’s food bowl is made of:

a. Plastic

b. Ceramic

c. Metal

Optimal answer: b. or c. Ceramic or metal

“Plastic is associated with allergies, ulceration of the lips and chin acne,” says Nelson. Plastic is also more likely to retain bacteria.

Score:

Eight to nine correct: Congratulations! You are doing a great job of safeguarding your cat against medical problems. But remember that as your cat ages, you’ll need to adapt too. Maintain a close relationship with your vet and your cat will live a long, happy life.

Five to seven correct: Looks like you’ve got a decent foundation when it comes to safeguarding your cat against medical problems, but there’s room for improvement. Go back over your incorrect answers and take action on them!

Zero to four correct: Oh no! We’re sorry to say it, but at 50 percent or less, you scored an F. You’ve got some work to do when it comes to safeguarding your cat against medical problems.

Can a Pain Management Center Help Your Cat?

From dealing with bad knees to recovering from a recent surgery, cats nationwide are benefiting from new interest in animal pain management treatments. These veterinary practices specializing in pain alleviation are now available to help you and your cat, no matter the situation, whether you have an elderly cat or one suffering from a more chronic condition.

How the Process Starts
All veterinarians offer pain medications, but you might want a specialist in pain management. If so, and depending on where you live, you might wind up at places like the Animal Pain Management Center in Snyder, N.Y.; The Downing Center for Animal Pain Management in Windsor, Colo.; or at Mountain Ridge Animal Hospital & Pain Management Center in Lafayette, Colo.

Even if you are seeking a second opinion, your cat will likely have to undergo routine blood work and X-rays. “These allow us to see exactly what’s going on,” says Michele Beveridge, practice manager of Mountain Ridge. Cats are notorious for hiding pain and illness. Conversely, some of their behaviors might be misinterpreted as pain. It’s therefore essential to find out the truth behind the symptoms. “We cannot just pass out medications,” says Beveridge. “If medications are prescribed, we also have to run routine blood tests, since each individual handles medications differently.”

Available Treatments
Once a diagnosis is made, one or more pain medications may be prescribed. Alternative treatments are also possible. These could be offered in addition to the prescribed meds. They may include one or more of the following:

  • Acupuncture Small-animal acupuncture care is becoming more common both nationally and internationally. Mark Bianchi, a holistic veterinarian at the White Oaks Veterinary Clinic in Edmond, Okla., is certified to provide veterinarian acupuncture by the International Veterinary Acupuncture Society. “As pets age, natural wear and tear on the joins can lead to pain and reduce a pet’s ability to move comfortably,” says Bianchi. “Pets that have sustained an accident injury may also suffer recurring pain, even after the injury has healed. Pet acupuncture is a natural way to relieve this pain by restoring balance to the nervous system and enhancing a pet’s natural endorphins for pain relief.”
  • Laser Therapy Laser therapy involves a low-light laser that is run over areas of the cat’s body. Doctors now use this kind of therapy on humans too. “It can decrease inflammation, improve blood flow to target areas and may decrease pain,” says Beveridge.
  • Stem Cell Therapy To treat pain and chronic conditions, some veterinarians now also use another carryover from human medicine: stem cell therapy. “It requires a surgical procedure,” says Beveridge. “Fat is removed from the animal’s stomach. Stem cells are harvested from the fat and are then later injected into trouble sites.” Rob Landry, veterinarian and owner of Mountain Ridge, says she has successfully treated both dogs and cats with stem cell therapy.

Cats Can Live a Pain-free Life
Thanks to new therapies and animal pain management specialists, your cat has a very good chance of living a long, healthy and pain-free life. If your cat suffers from a serious illness, sometimes discomfort can hurt the chances for healing. For example, many cat cancer patients suffer from appetite loss after chemotherapy. Bianchi believes acupuncture can help to both relieve pain following cancer treatments and prevent this loss of appetite that often happens. Your cat then has a better chance of eating as usual, keeping your pet’s strength up at a time when fortitude is needed.

Your cat’s behavior might even improve for the better. “Many times, a pet may act out or be aggressive toward other humans or animals because of pain,” says Bianchi. “By relieving the pain, a pet’s natural even temperament emerges, resolving the behavioral problems.”

6 Ways to Keep Your Cat Healthy in 2012

With the turn of every year, countless people resolve to improve their health by losing weight, exercising and more. The vast majority breaks those promises and ends up disappointed. So rather than subject yourself to another year of self-defeat, why not resolve to improve the health of your cat instead? Below are a handful of both timely and timeless ideas to choose from.

1. Assess your choice of cat food. As your cat ages, its nutritional needs will change. “Aging brings with it physiological changes. Some are obvious, others are not,” says Dr. Amy Dicke, a technical services veterinarian for Iams. “Skin and hair coat changes may be obvious, while lean muscle mass loss and digestive or immune system failure may be less evident or hidden.” The science behind today’s cat food has gotten specific enough that there are different blends for almost any situation. Talk to your vet about whether your cat is due for a change.

2. Upgrade your cat’s ID tag. The classic heart-shaped metal collar charm may help your cat get returned if it wanders away, but technology allows for so much more. Dr. Patricia Joyce of New York City Veterinary Specialists says, if possible, to use a GPS tracker that allows you to find your cat wherever it is. Another option is a QR code tag, like those offered by PetQRTag. The tags are the same size as a regular ID tag but are not as constrained by space. They point a person to a Web page that can hold as much information as you’d like to give, from contact info to special medical issues your cat has. As your cat ages and your contact information changes, the tag never needs to be replaced.

3. Hop on the social media bandwagon. Social media sites like Facebook and Twitter can help you diagnose and work through potential health problems. A standout is PetPop.com, where pet owners create profiles and link up. In the PetPop Healthy section, a panel of veterinary experts fields questions from site members and provides advice.

4. Enrich your cat’s environment. Scientific evidence continues to show that when a cat is stressed, it can get sick. The good news is that the same scientific data has now shown that an enriched environment can help prevent illness. “Happy cats are healthy cats, and their environment plays a role in that,” says Dr. Tony Buffington, a professor of veterinary clinical sciences at Ohio State University. “There’s now good evidence for this.”

5. Don’t ignore dental health. According to the American Veterinary Medical Association, periodontal disease is the most diagnosed problem in cats. But it doesn’t have to be that way. “Dental disease is one of the most preventable conditions in veterinary medicine,” says Dr. Katy Johnson Nelson, a veterinarian in Arlington, Va., who is a member of the Iams Pet Wellness Council. Schedule an appointment with your cat’s doctor for a teeth cleaning, and start doing brushing on your own as well.

6. Get pet health insurance. Sometimes even the best prevention can’t stop disease or an accident, and veterinary bills can add up quickly. It can put pet owners in the most difficult of positions: You either set yourself up for extreme financial hardship, or consent to putting your cat down. Health insurance allows an alternative. Thanks to more modest monthly premium payments, decisions to undergo costly procedures are easier to make.

So this New Year’s, let yourself off the hook and make a resolution for your cat. Whether you opt for the tried-and-true or the timely and trendy, following through with just a few of these tips can make a world of difference.

Cat Cancer Study Sheds Light on Human Cancer

Cancer is the leading cause of death in cats, according to the Pet Cancer Center. Among humans, cancer remains a primary cause of death around the globe, the World Health Organization reports, with up to 84 million people projected to die of cancer by the year 2015.

Such statistics are daunting. But for reasons not yet fully understood, cat cancers tend to be among the most aggressive among mammals. It’s possible that we’re just not detecting them early enough. Researchers, however, are learning more about cancer, with treatments improving with advanced science, knowledge and technology. Kim Selting, an associate teaching professor of oncology at the University of Missouri-Columbia College of Veterinary Medicine, shares some of her latest findings, which could also apply to our health.

The Mammal Cancer Connection

Researchers, like Selting, are working to establish connections that can benefit all mammals suffering from cancer. “Recent initiatives in medicine emphasize the fact that despite differences in anatomy, the basic parts are the same across species, especially mammals,” she explains. “And despite minor differences in physiology, those parts have very similar functions and responses to disease across species.”

As a result, her university has created the One Health, One Medicine initiative. It emphasizes research on numerous animals -- not just rodents, which used to be the norm for cancer studies. Selting recently coauthored such a study, published in the Journal of the American Animal Hospital Association. In it, she suggests that the following five factors can apply to cancer in cats, dogs and humans:

1. Genes Selting explains that “breed affects cancer risk just as race/ethnic origin can do so in human medicine.” This is because the genes among individuals in certain pet breeds, or human populations, are likely to be similar. “If said genes, such as tumor suppressor genes, are faulty and are related to the risk of acquiring a certain cancer, then it follows that these cancers will be overrepresented in a given population.” Siamese cats, for example, can be predisposed to intestinal and breast cancers.

2. Environment Selting suggests that cats that breathe tobacco smoke, for example, may have a heightened risk for lung diseases. “Cats are fastidious groomers, and every environmental contaminant that is present in the air and settles on the fur is then exposed to the cat’s mouth and system as they lick their fur.”

3. Diet Food may also contribute to disease prevention or instigation. “Feeding a good-quality diet logically can improve health, though no particular diet is known to abrogate cancer,” says Selting.

4. Lifestyle Countless studies conclude that exercise and stress levels can impact cancer.

5. Medical Care No tests can currently predict cancer occurrence in cats, but “early detection often offers a better prognosis,” says Selting. “Any change in a cat’s health should be investigated.”

Cancer Prevention for Cats and Humans

While much about cancer still remains a mystery, the new studies at least suggest a course of preventative action.

  • Pay attention to genes. Consult with your doctor and your cat’s veterinarian and discuss the risk factors related to your ethnic origin and your cat’s breed.
  • Do not smoke, and keep your home clean and free of potentially dangerous chemicals.
  • Follow the latest research concerning food and cancer prevention.
  • Both you and your pet need to exercise. Our bodies evolved to handle ample activity, so talk with your doctor and your cat’s veterinarian about what exercise would be best.
  • Note physical changes in both you and your cat. Schedule regular medical appointments, which can detect cancer before symptoms even surface.

While Selting and others prove that studying cancer in cats can shed light on human cancer, researchers are also driven to learn more about cats. “Companion animals rely on humans for food and shelter, but they repay the favor with devotion and companionship. We are their voice and are responsible for their quality of life,” says Selting.