StemCell Therapy

Skye is a 10-year-old German shepherd whose DNA was tested for degenerative myelopathy (DM) after she stumbled and fell as she walked down the steps outside her homean early warning sign of the disease. Soon after, Skyes family noticed that her back legs were wobbly and slipping out from under her on a regular basis. Her familys fears were confirmed when Skyes DM test results indicated she was at the highest risk level for developing the disease.

What is degenerative myelopathy?A progressive disease of the spinal cord that leaves once-healthy dogs paralyzed and ends their lives prematurely, DM is similar to ALS (Lou Gehrigs disease) in humans. It begins in the spine, when the outer coating (myelin) dies off and stops protecting the inner white matter that sends messages from the brain to control movement of a dogs legs.

DM is seen most often in German shepherd dogs between the ages of 8 and 10. Recently, the disease has been identified in several other breeds, including American Eskimo, Bernese mountain, borzoi, boxer, Cardigan Welsh Corgi, Chesapeake Bay retriever, golden retriever, Great Pyrenees, Kerry blue terrier, Pembroke Welsh Corgi, French poodle, pug, Rhodesian ridgeback, Shetland sheepdog, soft-coated wheaten terrier, and wirehaired fox terrier.

Some early warning signs of DM include:

As DM progresses, the signs become more pronounced:

Drs. Joan Coates and Gary Johnson and associates at the University of Missouri along with Drs. Kirsten Lindblad-Toh and Claire Wade at the Broad Institute at MIT and Harvard have identified the mutated gene responsible for degenerative myelopathy. They found that dogs with two copies of the mutation are at greatest risk of developing the disease.

The team of researchers also developed a DNA test that dog owners can administer at home and mail in for results. The test returns one of three possible results: normal, at risk, or carrier. The home DNA testing kit can be ordered through the Orthopedic Foundation for Animals.

Skye has been lucky; her disease has progressed slowly, and her family has been able to take care of her needs 24 hours per day. Now, 2 years after that first fall, Skyes hind legs are completely paralyzed, she is incontinent, and shes having trouble sitting up on her own. She has gone from using a dog wheelchair and keeping her body strong by swimming regularly to enjoying daily walks in a dog stroller. Despite her handicap, Skyes family says she is still happy and full of lifeand theyre happy to give her the care and love she needs.

Photos of Skye courtesy of Dorri Modic.

Sharon Seltzer is an animal writer who founded Lessons From A Paralyzed Dog, a website for owners of dogs with neurological and mobility disorders.

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Is your dog at risk for degenerative myelopathy? | AAHA

5 things you need to know about the AAHA/AAFP Fluid Therapy Guidelines

We all know how important water is to living beingswithout it, we couldnt survive. Water in our cells helps regulate body temperature, aids in digestion, transports oxygen and nutrients (as well as waste), lubricates joints, energizes muscles, and basically keeps our organs functioning.

Thats why fluid therapy is such an important part of veterinary medicine. If an animal is dehydrated due to illnessor needs a boost during surgeryveterinary teams can administer fluids to help them stabilize. The AAHA/AAFP fluid therapy guidelines thoroughly prepare animal hospitals to best administer these life-saving fluids and customize treatment to the needs of each individual dog or cat.

Here are the top five things to know:

Lift your pets lip and run your fingers along his gums. If he is well-hydrated, his gums will be slippery and moist to the touch. If your finger sticks to the gums because they are dry or tacky, then he is dehydrated and you should seek veterinary care immediately.

Gently pinch your pets skin between his shoulder blades or at the top of his head between his ears. If he is well-hydrated, once you let go of the skin, it will quickly flatten out back to normal. If he is dehydrated, the skin will remain tented for a second or two. Seek veterinary care if this is the case.

Look at your pets eyes. His eyeballs should be slightly jutting out of his eye sockets. With severe dehydration, the tissue and fat behind the eyeball shrinks and the eye sinks deep into the sockets. You guessed it: Call your veterinarian if you suspect dehydration.

What to ask your veterinarian about fluid therapy:

Related articles:Heatstroke and your petKeep it cool for pets on warm daysSix things to consider when choosing a new veterinarianWhy theres no substitute for advice from your own veterinarianCommunication 101: Get the most out of your vet visit

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Fluid Therapy Guidelines | AAHA

Mindy Tehan, RVT, gives laser therapy treatmentsto a patient at Animal Care Unlimited. Photo courtesy of Lindsay Melia.

Denver resident, Sue Kohut, was alarmed when her Great Dane puppy, Beauxmont, became lethargic and developed swollen legs that were hot to the touch. At just five months old, the pup was diagnosed with hypertrophic osteodystrophy (HOD), a painful bone disease that can occur in fast-growing large and giant breeds.

It can be cripplingin certain cases, a puppy would have to be euthanized, Kohut said. I had this big puppy who was in so much pain. I was like, Just fix him!

Fortunately, Kohuts veterinarian developed a treatment protocol that included laser therapy. Unlike surgical lasers that cut through tissue, therapy lasersor cold lasersstimulate the bodys cells to promote healing and alleviate pain.

I literally noticed an improvement after his first treatment, Kohut said. He was less lethargic and seemed like he was in less pain.

After three or four laser therapy treatments, Beauxmonts condition was completely resolved. Two years later, Beauxmont, who is also deaf and blind in one eye, is a loving pet who is simultaneously graceful and goofy.

Beauxmont is just one of a growing number of pets who have benefitted from laser therapy, particularly over the last decade as the technology has evolved. Jamie Bobulsky, DVM and medical director at AAHA-accredited Animal Care Unlimited in Columbus, Ohio, said the practice invested in a therapy laser in 2010 and has since seen some remarkable results. In fact, the hospital now includes laser therapy in treatment plans for everything from surgery to arthritis to ear infections.

Laser [therapy] causes many physiological and biochemical processes to occur, Bobulsky said. It stimulates the release of endorphins, causes vasodilation, and promotes lymphatic flow, which brings more blood to the area and flushes out inflammatory mediators and swelling, and accelerates tissue repair by increasing the rate of cell division and activating cells needed for repair. I explain this to clients as bringing in the good cells and taking out the bad ones.

Bobulsky said laser therapy is a valuable pain management tool, particularly for older dogs with arthritis who are starting to lose the use of their back legs, or those with compromised livers that prevent them from being able to take pain medication. It is a great option for cats as well, since there are fewer pain control options considered safe for them.

Therapy lasers are also useful in treating exotic animals that may not take medication easily, Bobulsky said. In addition to dogs and cats, her team has performed laser therapy treatments on birds, rabbits, guinea pigs, rats, ducks, sugar gliders, and wildlife, including owls, hawks, bald eagles, peregrine falcons, red-tailed hawks, and turtles.

There was a cockatiel named Beaker that suffered an unknown injury to the base of his tail and plucked out all of the surrounding feathers. After several laser treatments and some pain medication, he healed beautifully and all of his feathers grew back, she said. We have also used laser therapy on raptors with a condition called bumblefootsores on the bottoms of their feet. This is notoriously difficult to correct and sometimes requires medications and bandaging. They heal more quickly when we use the laser.

Software on many therapy lasers helps calibrate the proper dosage for each animal and length of each session by prompting the veterinary team to enter the pets weight, skin color, and hair coat length, as well as the medical issue and area to be treated.

Therapy lasers emit a pleasant warming sensation and most patients seem to relax and enjoy their sessions, she said. Typically, multiple sessions are most effective, so the practice offers special packages to achieve the best results.

Though the laser cost about $25,000, Bobulsky said it has been a good investment. She expects the technology to continue to evolve so the machines become more affordable, allowing more veterinarians to offer the modality to their clients.

Bobulsky absolutely suggests pet owners try laser therapy for their pet if their veterinarian recommends it.

It is noninvasive and can be very beneficial, she said.

Freelance journalist Jen Reeder loves writing about lasers of any kind because she grew up watching "Star Wars" and "Battlestar Galactica."

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Laser therapy: A promising trend in veterinary medicine | AAHA

What is a pet wellness plan?A wellness plan offers a way to prepay for pet health care services. Different than insurance, a wellness plan often requires a pet owner to sign a contract for a particular time period, usually 12 months. The pet owner then pays a monthly fee and receives a set of services that may include exams, laboratory tests, vaccinations, spaying or neutering, nail trims, deworming, heartworm testing, dental care, and others. Participants in pet wellness plans also often receive discounts on additional veterinary services. Several plans may be available based upon the type of pet you have and how old he or she is. There may also be different tiers or levels depending on the services bundled into the plan. For example, a puppy plan that includes spay/neuter, microchipping, and other services may be more expensive than an adult dog plan that doesnt include these one-time services. In addition to the monthly fee, there is often a sign-up fee or one-time membership fee, which is paid up front.

How can a wellness plan help your pet?A wellness plan makes it easier for you to take your pet to the veterinarian as soon as you suspect a problem without worrying about the cost of the office visit or exam. Getting your pet to the veterinarian early means a diagnosis can be made earlier and treatment can begin earlierboth of which are potential life savers. Preventing health care problems or addressing them early gives your pet the best chance for a long and healthy life.

How will a wellness plan assist you in paying for veterinary care?Being able to budget for the cost of veterinary care is one of the many benefits of pet wellness plans. Rather than facing a large veterinary bill after your pets annual exam, vaccinations, or other health care services, a wellness plan allows you to pay for your pets care in manageable, monthly payments.

Will a wellness plan save you money?Preventing an illness is much easier and less expensive than treating it. A wellness plan allows and encourages pet owners to seek medical care for their pets when needed, rather than putting it off for financial reasons. Wellness plans offer more veterinary visits and services and can save you several hundred dollars each year because of the discounted services.

Does your veterinarian offer a wellness plan?Pet wellness plans are beginning to appear in veterinary hospitals across the country. Some hospitals have had them for years. Ask your veterinarian if he or she offers prepaid wellness plans to help keep your pet (and your wallet) healthy.

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What a wellness plan can do for your pet (and your ...

This summer, U.S. pet owners will celebrate Take Your Pet to Work Week, which wraps up with Take Your Dog to Work Day on June 22. This is a great opportunity for animal lovers to bring their dogs and cats to the office, and for employers to see the benefits of pets in the workplaceand in fact, those benefits are prompting a growing number of businesses to be pet-friendly all year long.

According to Chris Meiering, director of innovation at Zukes, a natural pet treat company located in Durango, Colorado, an average day at the office includes 25 staff members and 10 dogs, though sometimes there are more than 20 dogs on the companys campus at one time.

Having them by our side makes us happy, lowers our stress levels, and creates an environment that is comfortable, open, and flexible, he said. Some offices have water cooler conversations; we have dog playtime conversations. Their presence really builds camaraderie in the office.

Meiering said the dogs also remind employees to take breaks throughout the day.

They may need a walk, but really, we need one too! Its not uncommon for a lunch at Zukes to include a romp alongside the stream or a hike through the mountains, and a midday stretch can easily turn into a game of fetch among the trees, he said. This time with our dogs rejuvenates us and makes us more productive.

In addition, Meiering said the pet-friendly policy has led to staff retention over the past 20 years.

Life is better with the love of a dog, and if a tail-wagging friend is with you at the office, the same holds true for work, he said.

Tips for a dog-friendly workplace

Chris Meiering, director of innovation at Zukes, offers these tips for a successful dog-friendly workplace:

Weve been dog-friendly for over 20 years, so its an easy, natural environment for us, but from time to time, there will be problems, such as a dog that is consistently disruptive or aggressive, or an older dog with bladder issues. The best way to handle issues is to talk about them, Meiering said. Work together to find a solution thats best for the workplace and the dog.

Scientific studies have also confirmed the benefits of pets in the workplace. For example, a 2012 study by researchers at Virginia Commonwealth University found employees who brought their dogs to work had reduced stress throughout the day compared to colleagues without pets.

Studies have demonstrated that pets in the workplace contribute to stress reduction, as well as employee teamwork and satisfaction. Employees who can bring their pets to work are also more productive, said Steven Feldman, executive director of the Human Animal Bond Research Initiative (HABRI) Foundation in Washington, D.C. Employees feel supported and have a better perception of their employers if they can bring their pets to work. They are also more likely to collaborate and work better in teams because pets help forge social connections.

Humans arent the only ones benefitting from pet-friendly policies, either. In 2004, researchers at the University of Missouri-Columbia found that humans who petted a dog for 1530 minutes during a study experienced approximately a 10 percent drop in blood pressure, while the dogs blood pressure dropped as soon as the humans began petting them. A day at the office also provides more stimulation for a dog than a day spent home alone in a crate or the backyard.

In addition, Feldman says the trend will increase the positive impact pet ownership has on U.S. health care costs.

We know that pets reduce stress, alleviate depression, improve heart health, and reduce obesity. We also know that pet owners visit the doctor less often than non-pet owners. In fact, pet ownership saves the U.S. healthcare system $11.7 billion every year, he said. Once we calculate the improved workplace productivity, the benefits will be even higher.

Feldman said companies considering a pet-friendly workplace should first develop common-sense policies for pets.

For example, pets must be current on their vaccinations, be on flea and tick prevention, and be well-trained. Veterinarians play a key role in partnering with pet owners so that their pets are ready for the office, he said. If having a happy, motivated workforce that works together is important, companies should strongly consider written pets-at-work policies.

Award-winning freelance journalist Jen Reeder considers herself extremely fortunate to work at home with her Labrador retriever mix, Rio.

Photo courtesy of Sarah Sturm

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The many benefits of pets in the workplace | AAHA

As too many cat lovers know, kidney disease is very common in felines, particularly as they age. The kidneys are responsible for many key bodily functions, from regulating blood pressure to removing toxins from the bloodstream. Unlike acute kidney failure, which occurs when a cat ingests something toxic, like antifreeze, lilies, or human anti-inflammatory medication, chronic kidney failure is irreversiblefunctioning kidney tissue is replaced by scar tissue, resulting in a loss of kidney function over time.

Treatment options can be daunting, particularly if the disease is advanced. Your veterinarian may recommend dialysis or other methods of keeping your cat comfortable. But theres another alternative to consider: kidney transplantation.

Success rates have been high for the few dedicated veterinary surgeons who perform feline renal transplants in the U.S. While most cats live an average of three years post-transplant, Lillian Aronson, VMD, BS, CACVS, founder and coordinator of the Feline Renal Transplant Program at the University of Pennsylvania School of Veterinary Medicine, had one feline patient live an additional 13 years with his transplanted kidney.

For the right cat, it can be an excellent treatment option, said Aronson, who has performed over 150 feline kidney transplants. Ninety-three percent of our patients have left the hospital. Approximately 70 percent are alive and doing well at one year [post-transplant].

One of the things that makes kidney transplants a viable option for cats is the relative ease in finding a donor match.

Most cats have the same blood typeAand unlike dogs, they dont need to be related to be considered compatible.

Additionally, cats, like people, can live normal, healthy lives with just one kidney. In fact, Aronsons team conducted a study of 99 feline kidney donors from the program and found most had no associated long-term effects from kidney donation.

There is one caveat, however: If your cat needs a kidney transplant and a potential donor is found from an animal shelter or elsewhere, you must adopt the donor cat regardless of the outcome of the surgery, an ethical practice supported by the American Society for the Prevention of Cruelty to Animals (ASPCA).

Fortunately, Aronson said thats typically not an issue. Most owners are so grateful to the donor cat for helping save the life of their pet, they happily welcome a new addition into their home.

People get very attached, very quickly, Aronson said. Its really nice to see.

Feline renal transplants require a great amount of commitment, and whether youre ready to adopt a donor cat isnt the only thing to keep in mind. An uncomplicated surgery can cost anywhere from $15,000$18,000, plus $60$100 a month for anti-rejection medications and other drugs. While some pet insurance companies will help cover the cost of feline kidney transplant surgery and associated treatments, it is important to read your policy carefully and be mindful of any pre-existing conditions before scheduling the procedure.

After surgery, the recipient cat will need to have frequent veterinary exams to make sure the new kidney is working and to monitor potential complications. You will also need to give immunosuppressive medications at the same time every day to prevent your cats body from rejecting the new kidney.

While pursuing a kidney transplant for your cat is not a decision to be made lightly, some owners say its worthwhile despite the high level of commitment involved.

New York archeologist Andre Gonciar said he is glad he and his wife, Laure, decided to pursue a kidney transplant for their beloved cat, Oki, who was a sick, abandoned kitten when Gonciar rescued him years ago. Aronson performed Okis kidney transplant on May 18, 2015, removing a kidney from a donor cat named Cherry.

Now Oki and Cherry have celebrated their first transplantiversary and are both doing great. Cherry is settling into life in the Gonciar household, and Oki is a happy bubble of a cat, according to Gonciar.

There is no doubt in my mind that we have done the right thing, he said. Some sacrifices had to be made and caring for Oki forced quite a few changes in our lifestyle, getting it on a rather strict schedule. But at the end of the day, he falls asleep purring in my arms and we are all happy.

Award-winning pet writer Jen Reeder was thrilled to be able to donate her left kidney to her husband in 2012.

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Kidney transplants for cats: A viable option | AAHA

Learning your dog has cancer is a frightening experience, but according to the National Canine Cancer Foundation (NCCF), it is a diagnosis one out of every three dogs will receive during their lifetime. The good news is, about half of all canine cancers are treatable if they are caught early and several promising research studies are currently being conducted to help find a cure.

Cancer comes in many forms, including carcinoma, sarcoma, melanoma, lymphoma, and leukemia, and can occur at any age in both mixed breeds and purebreds. Listed below are the most common types of cancer affecting dogs and the signs to look for at home.

Lymphoma: Lymphoma occurs in cells in the lymph nodes or bone marrow and is most commonly diagnosed in dogs between the ages of 6 and 9 years old. Lymphoma affects the dogs immune system and can spread rapidly if left untreated. It is classified in five progressive stages and treatment options vary depending on the stage. The first sign of lymphoma is typically a painless, swollen lymph node in the neck or behind the knees.

Hemangiosarcoma: Hemangiosarcoma is a malignant cancer of the blood vessels. It is more common in dogs than any other species. Hemangiosarcoma is commonly diagnosed in the spleen, liver, and heart, but can travel to any organ or occur just under the skin. Because there are no distinct early warning signs for hemangiosarcoma, many dogs are not diagnosed until the disease has reached its advanced stages. It is often seen in German shepherd dogs, golden retrievers, and other large breeds.

Early warning signs of cancer:

Abnormal swelling

A sore that does not heal

Weight loss

Loss of appetite

Bleeding or discharge from anyopening on the body

Unpleasant or unusual odor

Difficulty eating or swallowing

Loss of energy

Ongoing lameness or stiffness

Difficulty breathing, urinating, or defecating

*Information from the National Canine Cancer Foundation (NCCF)

Mast cell tumors: Mast cell tumors are an extremely common form of cancer in older dogs and mixed breeds, as well as boxers, Boston terriers, Labrador retrievers, beagles, and schnauzers. Mast cells are found in the skin and other tissues, like the intestines or respiratory tract. They contain large amounts of histamines and enzymes that protect the body, but when tumors develop, that protection turns against the immune system. The first sign of a mast cell tumor is usually a lesion on the skin. Some mast cell tumors can also be uncomfortable and cause agitation.

Melanoma: Melanoma is a type of skin cancer that can be found in the nail beds, footpads, and eyes, but the vast majority of melanoma tumors start in the mouth or around the lips. Melanoma tumors are highly aggressive, growing deep into the skin to invade vital organs. The first sign of melanoma might appear as a swollen paw, an eye that drains, or a sore in or near the mouth.

Osteosarcoma: Osteosarcoma is cancer of the bone. Approximately 85 percent of osteosarcoma tumors are malignant, and grow very quickly. Osteosarcoma commonly affects large breeds between the ages of 4 and 7 years old, including Great Danes, Irish setters, Doberman pinschers, Rottweilers, German shepherd dogs, and golden retrievers. While osteosarcoma can occur in any bone, it most commonly affects the limbs. Initial signs of osteosarcoma may include swelling and lameness.

Mammary cancer: According to the American College of Veterinary Surgeons (ACVS), mammary tumors are more common in female dogs that are either not spayed or were spayed after 2 years of age. About 50 percent of all mammary tumors are malignant and have metastasized, or spread to other areas of the body, by the time they are surgically removed. Signs of mammary cancer are often overlooked because the tumors appear as a small nodule on or around the dogs nipple; however, this type of cancer can also present itself as a painful tumor around the nipple.

Promising canine cancer research

Yale School of Medicine has developed a new vaccine that may help dogs with cancer. They have teamed up with the Veterinary Cancer Center in Norwalk, Connecticut for a clinical trial to test the vaccine on real cancer patients. The vaccine is injected into a dog with the goal of producing antibodies to fight cancer. Yale University tested this vaccine in the laboratory and found it was successful at targeting and shrinking malignant tumors. Now they hope to create the same results with dogs battling the disease.

UC Davis School of Veterinary Medicine is also performing a clinical trial to help dogs with lymphoma. They are reformulating the way the popular cancer drug, doxorubicin, is administered. Doxorubicin is widely used to treat cancer, but the medication can affect a dogs heart. UC Davis has developed a method to turn the drug into tiny particles and administer it by infusion. The goal is to have the medication flow directly to the tumor and lessen the chance of damaging other organs.

Both studies are in need of patients for the clinical trials.

Sharon Seltzer is a freelance writer and founder of Lessons From A Paralyzed Dog, a website for owners of dogs with paralysis and other mobility disorders. Shes a pet mom to two dogs and two semi-feral cats.

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6 most common canine cancers | AAHA

Vaccines have become an emotional issue among pet owners. And, while the science of pet vaccines is always a work in progress, there are some undeniable facts.

No medical development has had a greater impact on the prevention of diseases and general health of people and animals than the development of vaccines against various diseases, says Michael Paul, DVM, past president of the American Animal Hospital Association (AAHA), and frequent vaccine task force advisor.

Animal vaccines help to control disease, many of which can affect people. At the top of the list is rabies. On WGN radio, Cook County Administrator of Rabies Control Donna Alexander, DVM said, Make no mistake, rabies does occur in the United States. We have a wildlife reservoir of rabies. The only reasonand I do mean the only reasonwe dont see it in [people] in this country is because we have laws mandating vaccination.

According to the Centers for Disease Control and Prevention (CDC), more than 55,000 people around the world die from rabies each yearthats approximately one death every 10 minutes. In the U.S., one to three people succumb to rabies each year.

Another disease controlled by vaccination is canine parvovirus. The disease emerged in the 1970s, and for some time veterinarians were powerless to stop it; dogs with parvovirus often died, and they still can. Today, however, the canine parvovirus barely occurs in some places. Its not because the virus has done a disappearing act; its because enough dogs are vaccinated to provide community protection, or herd immunity.

Where populations are less protected against the canine parvovirus, such as shelter populations, the virus appears and often spreads among those individuals not vaccinated.

So, vaccinations do what theyre supposed to do. But can there be too much of a good thing? Are we vaccinating our pets too often? This is a topic often discussed, and while theres some disagreement within the ranks, veterinarians do agree that just because a vaccine is available doesnt mean that all pets should receive it.

Factors that affect vaccine protocolsAccording to the AAHA Canine Vaccination Guidelines, whether a vaccine is suggested or not is dependent on the following factors:

Also, to lessen the possibility of adverse reactions or side effects, its often suggested that not all vaccines are given during the same veterinary visit.

To vaccinate or not to vaccinateSometimes choosing whether or not to vaccinate is easy. For rabies, its the law. Sometimes, however, those decisions arent so black and white.

During the recent canine influenza epidemic in Chicago, veterinarians werent all in agreement about supporting vaccination with the dog flu vaccine. Thats because the current vaccine was created for a flu strain called H3N8, and may not be effective against the strain of dog flu that infiltrated the Chicago area, called H3N2. Anecdotal evidence indicated the vaccine did offer some protection against the newer flu strain, and because the old flu strain still existed most veterinarians did recommend the vaccine for social dogs.

Far less was known 20 years ago about how often to immunize our pets and when to booster. Today we know more, but theres still much to learn. Organizations like AAHA, the American Association of Feline Practitioners, and others have created guidelines based on current scientific and medical knowledge, which veterinarians can consult when making health care recommendations for their patients.

Another tool to help determine which vaccinations are appropriate for a particular pet is a titer, although this tool is somewhat controversial. A titer is a laboratory test that measures the presence and amount of antibodies in blood that could defend against a particular disease. For example, instead of receiving a vaccine against the canine parvovirus, the dog could be titered. If the dogs titers are at a specific level, the veterinarian may deem no vaccine is necessary. Titering is not a perfect tool, however, and titers arent available for all vaccinations. Many veterinarians dont believe titering is an effective way to ensure a pets ability to fight off certain diseasesthey believe vaccinating the pet is the safest and most effective way to prevent disease.

At the end of the day, my hope is that pet owners develop a trusting relationship with their veterinarian, says Paul. Discussing each immunization is serious business, and you should review with your veterinarian whats right for your individual pet.

Steve Dale is a certified animal behavior consultant, author of a syndicated newspaper column (Tribune Content Agency), and the host of two national radio shows, including Steve Dales Pet World on WGN radio in Chicago, Ill.

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Pet vaccinations 101: What you need to know | AAHA

When a pet is diagnosed with cancer, chemotherapy treatment is often offered as a possible treatment option. The thought of putting a pet through chemotherapy can be frightening for some pet owners, though, particularly those who may have seen family or friends suffer through the side effects of chemo, or even experienced those side effects themselves. Dogs and cats, however, usually fare much better than their human counterparts when undergoing chemotherapy and dealing with the side effects of treatment.

Your veterinarian will advise you of specific side effects associated with the drugs theyre using to treat your pets cancer. While it is important to be aware of these possible side effects, it is also wise to watch your pet closely for any other signs that something is awry. Fever is a sign of infection and should be brought to the attention of your veterinarian immediately. Also watch for signs of lethargy or changes in appetite. Remember: No one knows your pet better than you, so if you think something is wrong, tell your veterinarian.

The three most common side effects of chemotherapy are bone marrow suppression, alopecia, and gastrointestinal upset.

Bone marrow suppressionChemotherapy drugs attack cells in the body that are rapidly dividing and producing, which is precisely what cancer cells typically do. There are good cells in the body, however, which also rapidly divide. White blood cells, produced in the bone marrow, are an example of these. Red blood cells can also become suppressed during chemotherapy, causing anemia in the animal.

Your veterinarian will check your pets white blood cell count through regular blood tests to determine how the chemotherapy is affecting the bone marrow. If the level of white blood cells is low, your veterinarian may prescribe antibiotics to prevent infection introduced by opportunistic bacteria, which are normally kept in check by the white blood cells.

AlopeciaWhile alopecia, or hair loss, is a common side effect of chemotherapy in humans, it is not all that common in animals. Certain breeds are more likely to experience hair loss, and they are usually breeds with continuously growing hair, such as poodles, Portuguese water dogs, shih tzu, and Maltese. These breeds may expect to see a general thinning of the hair coat, rather than a total loss of hair.

Hair may also be slow to regrow in areas that have been shaved. If your pet is receiving chemotherapy via injection into a blood vessel, your veterinarian will need to shave a spot to place an IV catheter to give the injection.

The coat usually grows back after the course of chemotherapy is completed, however, like humans who receive chemotherapy, the hair that regrows is sometimes a different color or texture than it was before chemotherapy. This may or may not change back over time.

Cats, and sometimes dogs, can also lose their whiskers during chemotherapy treatments. Like the hair coat, the whiskers may grow back after chemo looking different than they previously did.

Gastrointestinal upsetLike blood cells in the bone marrow, the gastrointestinal tract (throat, stomach, and intestines) is also made of rapidly dividing cells. Chemotherapy drugs are unable to discern these good cells from the bad cancer cells and will attack them. If the good gastrointestinal cells are seeing more than their fair share of attack from the chemo drugs, your veterinarian may adjust the dose of the chemo to balance the effect on your pet.

Vomiting and diarrhea may be seen 1-3 days post-chemotherapy treatment. Duration is usually short term, and your veterinarian may prescribe medications to ease these side effects. You might also want to adjust your pets diet during this time; a bland diet may be easier on your pets tender tummy. Boiled chicken and rice are often go-to options to try when your pets regular food doesnt seem to be sitting well.

If you notice signs of gastrointestinal upset, be sure to notify your veterinarian: she may want to treat the side effects if they warrant it.

Are the side effects worth it?The main goal of veterinary cancer treatment is to maintain quality of life. Although pets may experience some side effects of treatment, those symptoms are typically milder than symptoms that humans experience, and many pets go into remission after just a few doses of chemotherapy.

If your veterinarian recommends chemotherapy for your pet, be sure to discuss all the ramifications thoroughly. While your pet may experience some unpleasant side effects, the hope is that all those bad cancer cells will be wiped out by the chemotherapy drugs, and your pet will go on to live a happy life.

iStock.com/Igor Skrbic

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Pets and chemotherapy: Side effects to prepare for | AAHA

Ive never seen such a look of betrayal as was in Tomkins eyes when he came home from the veterinary hospital. Traumatized by the poking, prodding, bright lights, and sharp tools, he cowered in his corner, refusing even his favorite treats. It took days before he finally showed his sparkly new grin, and I knew I could never subject him to a nonanesthetic dental cleaning again.

The 2013 AAHA Dental Care Guidelines for Dogs and Cats clearly state cleaning a companion animals teeth without general anesthesia is considered unacceptable and below the standard of care. This means the pain and stress a pet faces during a nonanesthetic dental cleaning are so great that to subject your pet to this type of procedure when safer, more comfortable methods are available is considered cruel. Thankfully, the use of anesthesia and a personalized pain control plan can mitigate many of the risks associated with nonanesthetic procedures.

Pets rely on their owners to provide for their needs. When dogs and cats undergo a nonanesthetic dental cleaning, they can often be overwhelmed by the bright lights, loud equipment, and strange people restraining them. This can place your pet under significant stress and even cause lasting trauma. Anesthetized dental procedures allow your pet to rest comfortably while the veterinary team performs a thorough exam and cleaning without the risk of injury to himself or others.

Anesthesia also allows your veterinarian to properly evaluate your pets teeth. Did you know that 60 percent of a dog or cats tooth is hidden beneath the gum line? Dental X-rays obtained while the pet is under anesthesia allow the veterinarian to fully examine each tooth and identify problems that cannot be seen with the naked eyeand additional treatment can often be provided on the spot.

So, what should you expect when your pet undergoes general anesthesia? First, your veterinarian will want to examine your pet and perform a blood test to ensure there are no health issues prior to the procedure. Based on the results and your pets medical history, your veterinarian will create a customized plan and anesthetic protocol for your pet.

Most pets recover from anesthesia quickly. According to the American Veterinary Dental College (AVDC), many patients are fully recoveredmeaning they are awake and standingjust 1520 minutes after the procedure is completed. Anesthetized dental cleanings are also an outpatient procedure, so your pet can go home with you the same day.

Just like humans, pets are at risk for cavities, periodontal disease, and broken teethall of which are sources of significant pain. By taking your dog or cat in for an anesthetized dental procedure in which the veterinary team can thoroughly examine and clean all their teeth safely, you ensure a healthy, happy future for your pet.

Chris Nichols is a freelance writer living in Michigan with her cranky cat and elderly dog.

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The truth about dental anesthesia | AAHA

If your aging dog or cat starts acting strange, dont chalk it up to old age or think he needs a refresher course in potty trainingmake an appointment with your veterinarian.

Why? There may be several causes for unusual behavior in senior pets, including one most owners typically dont think about: cognitive dysfunction syndrome or CDS.

Many pet owners mistake the gradual advancement of dementia as aging changes that are to be expected in an elderly dog or cat, says author and columnist Jeff Nichol, DVM, of the Veterinary Emergency & Specialty Hospital of New Mexico in Albuquerque, New Mexico.

Senior pets should function mentally almost as well, if not as well, as they did as youngsters, Nichol says. While older pets may have moderate hearing and/or sight impairment, they should not have noticeable changes in their mental activity.

For pets with CDS, however, it is another story. CDS is a degenerative inflammatory disease of the brain very similar to the human dementia of Alzheimers disease. Studies show that it affects more than a third of dogs over age 11 and more than two-thirds over age 15. In cats, those numbers are likely similar; however, less is known about cats because fewer studies have been conducted.

Because they are with their pets daily, pet owners will be the first to notice the symptoms, says Gary Landsberg, DVM,DACVB,DECAWBM, veterinarybehaviorist at North Toronto Veterinary Behaviour Specialty Clinic.

Pets suffering from CDS may seem disoriented, perhaps going to the wrong side of the door when wanting to go outside or wandering aimlessly around the home. They may be restless or wake at night and be less active during the day. They may become anxious and irritable. They may have decreased interest in interacting or, just the opposite, may become clingy. They may also forget their house training behaviors.

While research is advancing understanding of CDS, a cure has not yet been found. However, there are ways to slow its progress. Because the disease can be significant, a visit to the veterinarian at the first sign of atypical behavior is key.

Diagnosis is based on recognizing the behavioral changes and excluding other medical conditions and drug side effects. If it is determined that your pet has CDS, discuss possible treatment options with your veterinarian.

Treatment options may include:

Nichol has been working on his own research into CDS and found that a varied approach of supplements and daily exercise is helping many of his patients.

If you dont get on it early and decisively, you may not have time, he says, noting that some pets deteriorate rapidly while others have a slow decline.

Some of these pets get so totally confused. They dont remember their owners or their house training. They walk into corners and stand there. They really have no life anymore, he says. [Thats why] pet owners need to bring their concerns to the veterinarians attention.

Maureen Blaney Flietner, an award-winning freelance writer, photographer and artist, has been mom to several dogs, cats, and horses over the years.

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Alzheimers-like disease in pets needs quick attention | AAHA

One of the most common questions veterinarians hear each week is, When should I spay or neuter my dog or cat? With so much conflicting advice from friends, breeders, and the Internet, it can be difficult to find an answer, which is why the best option is to talk to your pets veterinarian.

Patrick Mares-Ziehmn, DVM, veterinarian at AAHA-accredited Prescott Animal Hospital in Prescott, Ariz., says he counsels pet owners about spay and neuter issues every week. If clients are not planning to breed their pets, Mares-Ziehmn says he typically recommends spaying female dogs or cats when they are 4 to 6 months oldbefore the first heat cycledue to the medical benefits.

If you spay a dog after her first heat cycle, she goes from having a 0.5 percent risk of [developing] mammary tumors up to an 8 percent risk, he says. If you wait until after her second heat cycle, its almost a 26 percent risk.

This benefit extends to cats as well. According to the American College of Veterinary Surgeons (ACVS), kittens spayed before 6 months old are seven times less likely to develop mammary cancer.

Mares-Ziehmn also suggests spaying dogs to avoid pyometra, a life-threatening infection of the uterus. By age 4, he says 15.2 percent of unaltered female dogs will develop pyometra. By age 10, that risk rises to 2324 percent.

While Mares-Ziehmn notes that the risk is reduced if the dog has several litters, a spay surgery, which removes the uterus and ovaries, eliminates the risk completely.

Neutering a young dog or cat is a simple procedure that may be performed as early as 8 weeks of age. In fact, AAHA supports pediatric neutering to help reduce the overpopulation problems affecting companion animals.

One major health benefit to neutering a dog is that it virtually eliminates the risk of prostate issues, including infection and prostatic hyperplasia, an enlargement of the prostate that creates difficulty defecating.

By age 6, 7580 percent of unaltered male dogs will have benign prostatic hyperplasia, thanks to testosterone, Mares-Ziehmn says. By age 9, its 95100 percent. If you neuter them, you take that [risk] off the table.

He adds that neutering dogs also prevents the spread of transmissible venereal tumors (a sexually transmitted disease) and perineal hernias, in which testosterone weakens the muscles around the anus and allows abdominal content to push though, while neutering cats protects against testicular cancer.

Neutering also reduces or eliminates unwanted behaviors like spraying in male cats, roaming in dogs, and aggression before theyve had all that testosterone build up in their system, he says.

Some pet owners may have concerns that sterilizing their pets will lead to obesity. This is a valid concern, though Mares-Ziehmn points out that proper diet and exercise can easily solve the issue.

We have control of the food. Most dogs and cats cant access the refrigerator or our food, he says. That should be a non-problem when deciding whether to spay or neuter, in my opinion.

Other pet owners say they want to wait to spay their dogs or cats until after they produce a litter so their children can witness the miracle of birth. However, Mares-Ziehmn says, not every birth is smooth, and animals shouldnt have a litter until they have reached full adult size if they are to be bred responsibly.

Instead, he suggests his clients consider fostering a pregnant dog or cat from a local animal shelter.

Then youre doing a good deed and not bringing even more animals into the world, he says.

Mares-Ziehmn has also heard concerns about the risks of anesthesia, and questions about Zeutering, a chemical castration process. He says he has never performed a neuter this way because there are not any long-term studies on the procedure.

Instead, he says AAHA mandates excellent anesthesia protocols that make the risk of anesthesia for young, healthy animals astronomically low. As a matter of fact, Mares-Ziehmn says AAHAs strong anesthesia protocols are one reason he works at an accredited practice.

Finally, Mares-Ziehmn said spaying and neutering pets is important not just from a health and behavior standpoint, but because it helps address the issue of pet overpopulation. Each year, approximately 1.2 million dogs and 1.4 million cats are euthanized in the U.S., according to the American Society for the Prevention of Cruelty to Animals (ASPCA).

As a society, we need to make that choice of whether we want to tackle that problem head on, he says.

Freelance journalist Jen Reeders dog, Rio, was neutered at an animal shelter when he was 12 weeks old, and he has been healthy and happy ever since.

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January is Walk Your Pet Month, a great time to get outside and exercise with your pup. But what if your dog needs space from other dogs or people? Dont resort to walking your dog at midnight. With patience, ongoing training, and expert advice, you can successfully manage your dogs leash reactivity.

It's easy to get overwhelmed with all the information circulating out there about what to do with your reactive dog and how best to help them improve, said Scott Raymond, MS, CPDT-KA, a certified professional dog trainer with Synergy Behavior Solutions in Portland, Oregon.

Misleading information can also result in the development of even more significant behavioral issues, he said.

Contrary to popular belief, you don't need to punish a dog to make them act better, Raymond said. Having a consistent management plan and a solid rewards-based approach to training can help a lot.

According to animal behaviorist, ethologist, and adjunct professor in zoology at the University of WisconsinMadison, Patricia McConnell, PhD, CAAB, it is important to gain confidence walking your reactive dog to build resiliencethe process of adapting well in the face of significant stress.

Exercise and time outdoors have a profound effect on dogs and people, both on healing from drama and building resilience, she said.

Below are great resources and tips you can put to use right away to help correct and manage reactive behaviorand create a better walk for you and your dog.

Setting your reactive dog up for success

Training ideas

At the veterinarian

Living with a reactive dog also presents challenges when it comes to veterinary appointments.

AAHA-accreditedFrontier Veterinary Hospitalin Hillsboro, Oregon, created special corrals that keep reactive pets separate in the waiting room for this very purpose.

Our biggest tool, however, is our workflow, Frontier's practice development director, Sara Fleissner, said. We room clients as soon as possible upon entering the building. Sometimes, the customer service representative sees [clients] in the parking lot and greets them the moment they walk in. Then, everything happens in the room: taking of history, doctor exam and communication, and most importantly, checkout. This minimizes the interaction between patients in the building.

This is important for all patients, whether they are fearful, reactive, or excited, Fleissner added.

Many dogs need space. If you live with a dog that has leash reactivity, there are many solutions and tools at your disposal. Remember that walking a reactive dog at midnight is one option, but not the only option.

As a certified veterinary technician, longtime PR veteran, and content marketing expert, Christy Caplan brings her unique understanding of social and digital media to connect dog lovers to brands both on and offline. She lives with three houndstwo doxies and a beagle/basset hound mixwho constantly teach her about life and companionship. Christy is a member of the Dog Writers Association of America and writes for Spot Magazine, City Dog Magazine, and regional animal publications. Follow Christy at mylifewithdogspdx.com.

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Walking a reactive dog: Tips and tricks | AAHA

Those of us who have experienced an injury or surgery know just how beneficial physical therapy can be. Rehabilitation exercises lessen pain, strengthen muscles, and speed up the recovery process, helping the body to get back into shape after a traumatic event.

But physical therapy isnt just for humans anymore. Rehabilitation is increasingly prescribed for our canine companions to address issues such as mobility, pain, and joint damage due to orthopedic surgery, musculoskeletal injury, arthritis, obesity, paralysis, neurological disease, and more.

If youve seen one of those cute videos of a dog trying to walk on an underwater treadmill or balance on a big exercise ball, you have seen a small part of canine physical therapy at work. Common conditions that benefit from physical therapy may include:

Physical therapy techniques

There are many different physical therapy techniques available for pets, including:

Where to find a physical therapist

Veterinary physical therapy is a relatively young profession. Some of the first specialists were physical therapists for humans who wanted to share their skills with animals. Today, private and university-based programs certify veterinary professionals and physical therapists in animal rehabilitation.

Despite being a relatively new form of treatment, rehabilitation is a growing resource for dogs and their owners and practitioners can be found in most major cities. Talk to your veterinarian to determine whether physical therapy is a good fit for your dog. If so, she can provide a referral or you can find a local qualified therapist through an online directory, such as Canine Rehabilitation Institutes Find a Therapist tool.

Sharon Seltzer is a freelance writer and founder of Lessons From A Paralyzed Dog, a website for owners of dogs with paralysis and other mobility disorders. Shes pet mom to a Rottweiler puppy named Bailey and two semi-feral cats.

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Could my dog benefit from physical therapy? | AAHA

It seems like my dog Rios tail is always wagginghes a goofy Labrador retriever mix who sometimes even wags in his sleep. So one day when he was a few years old, I was shocked to discover his tail hanging limp like a wet noodle. He wouldnt even wag for a treat.

Panicked, my husband and I rushed Rio to his veterinarian, who asked if wed noticed him injure his tail. We hadnt. Wed been camping all weekend by a lake, where Rio spent a lot of time swimming. Then we took a long hike and he wagged his tail the entire time, sometimes so enthusiastically that I started taking video because it was so charming.

Our veterinarians diagnosis: limber tail syndrome. Basically, Rios tail-wagging muscles were overworked and had become very painful. However, we were relieved to learn limber tail isnt a permanent condition. With rest and anti-inflammatory medication, Rio was back to his happy, wagging self in a couple of days.

Joe Spoo, DVM, DACVSMR, co-owner of AAHA-accredited Best Care Pet Hospital in Sioux Falls, South Dakota, and author of the GunDogDoc blog, said he tends to see an influx of patients with limber tail at the start of hunting season, when the weather starts to warm up and dogs spend more time recreating outside.

The tail either hangs limp from the base, or juts out horizontally for a few inches and then droops.

The first time anybody sees limber tail, they panic and think their dog broke their tail, he says. The tail just dangles.

Limber tailalso called swimmers tail, Lab tail, cold water tail, or pointer tailis especially common in sporting breeds, but can affect any breed with a long, active tail, Spoo says.

We can see the condition in any dog that goes from not using his tail to overusing it, whether it be swimming or playing or just being happy, he says.

While limber tail tends to occur in the first three years of a dogs life, it probably has less to do with age than the dogs muscles not yet being trained to handle a typical workload, Spoo says. Often, a dog only experiences limber tail once, but there are exceptions.

I used to say it was a one and done [condition], but well see it in a few dogs where it repeats every time the new workload starts, Spoo says. I do have a couple Labs that seem to have it once a year at the start of hunting season.

Mild cases of limber tail will resolve with rest in less than 24 hours. For more severe cases, Spoo prescribes an anti-inflammatory medication to help with the pain and recommends restricted activity to rest the tail. Dogs typically recover in two to three days.

Diagnosing limber tail is fairly easy. Other causes of a non-wagging tail, such as trauma, can be ruled out if the tail hasnt been stepped on, pulled, slammed in a door, or otherwise injured, while more serious causes, like neurological issues, would be accompanied by other signs, Spoo says.

If you suspect your dog has limber tail, do not treat him at home with over-the-counter (OTC) anti-inflammatory medications for humans like aspirin or ibuprofen. Dogs do not have the same enzymes humans do and cannot break down these medications effectively, Spoo says.

Dont think, Im going to make a self-diagnosis and I have an anti-inflammatory for me, so Ill just give it to my dog. [You] can end up in a way worse situation than a day or two of a painful tail, he says. Consult your veterinarian.

Freelance journalist Jen Reeder was moved to tears when she realized her dog developed limber tail syndrome from wagging too much on the first family camping trip after her husbands kidney transplant.

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When the wagging stops: Is it limber tail? | AAHA

Providing regular health care for your cat is essential for a longer, healthier, and more comfortable life for her. Many cats, however, dont get the regular veterinary care they need due to the amount of stress caused by simply trying to get them to the veterinary hospital. Here, a few tips to make the trip to your veterinarian less stressfulfor both your cat and you.

Happy carrier, happy catTrips to the veterinarian should not be the only time your furry friend encounters his carrier. You want your cat to associate his carrier with positive experiences. Have him enter the carrier on a regular basis so hes more comfortable in it. Leave the carrier in a room where your cat spends lots of time and give him time to become familiar with it. Placing soft bedding or clothing inside may help him feel more secure.

Getting her inTreats, toys, or catnip placed inside her carrier will help to encourage your cat to enter. It could take days, or maybe even weeks, for her to begin to trust her carrier, so be patient. Always reward your cat for the behavior you want, so if she is sitting near or exploring the carrier, give her a treat.

If your cat is not yet used to the carrier, but needs to go to the veterinarian right away, try putting her in a small room that has few hiding places with the carrier. Put a special treat in the carrier to encourage her to enter. If the treat doesnt entice her and your carrier has an opening at the top, try to gently cradle her and lower her into the carrier. If your carrier allows, remove the top half, place your cat into the lower half, and calmly replace the top.

Picking the right carrierBefore deciding which of the many cat carriers on the market is best for your cat, consider your cats size, how well he tolerates handling, and which carrier is easiest to transport. It should be safe, secure, sturdy, and easy for you to carry. Some of the best carriers are hard-sided and open from both the front and the top. An easily removable top allows a cat who is fearful, anxious, or in pain to stay in the bottom half for exams by the veterinarian.

En routeYour furry friend will be safest in the car if you secure her carrier using a seat belt. If she seems anxious, it sometimes helps to cover, either partially or completely, her carrier with a blanket or towel, although some cats would prefer to be able to see whats going on outside of the carrier. There are also products that you can spray into her carrier to help with anxiety.

Need other ideas?If your cat is particularly stressed about getting into his carrier, ask your veterinarian for more ideas on how to make your cats travel away from home, whether its to see the veterinarian or not, more calm and pleasant for everyone. For more information, visit catvets.com.

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Kitties and carriers: Getting your cat to the vet with ...

The general practitioner youve been seeing for 15 years suddenly announces his retirement. You panic. Who are you going to rely on when youre sick? Hes the only one in the world who knows your medical history and the fact that lollipops can, in fact, calm your nerves!

Logically, however, you know there are steps you can take to find another great doctor. Recommendations from friends, trial visits, and online sources that provide information about a potential practitioners qualifications and experience level will certainly help you come to a sound decision.

When seeking a new veterinarian, your pet deserves the same considerations. While the task may seem daunting, taking the time to find the right veterinarian will ensure the safety, health, and happiness of your beloved pet for years to come.

Consider the following before you commit to a new veterinary practice:

AAHA accreditation: The American Animal Hospital Association (AAHA), the accrediting body for companion animal hospitals in the U.S. and Canada, regularly evaluates veterinary practices on approximately 900 standards of veterinary excellence, which means they are recognized among the finest in the industry. Use AAHAs hospital locator to find an accredited practice near you.

Communication: Understanding what style of communication you prefer and asking what you can expect will help you decide if a veterinarian (or practice) is a good fit for you, says Rose Barr, DVM, of AAHA-accredited Tender Touch Animal Hospital in Denver, Colo.

One vs. many: Do you prefer to speak with only one person about your pets health, or do you prefer a practice that offers several medical experts?

Proximity and hours: How much time do you have for a veterinary visit? Take travel time into account as well as the visit itself. Do you need to get there quickly and then hurry back home or to the office after your visit? Is it easy for you to get there? Does the practice offer evening and weekend hours? Knowing how much time you have to commit to a visit will help you in choosing which practice is best for you.

Services offered: Services play a large role in choosing a veterinary hospital. Does your new practice provide what you need and want? You will find with AAHA-accredited hospitals, they are able to take X-rays and run in-house laboratory samples that will lead to getting answers faster, Barr says.

Emergency care: What do you do when theres a medical emergency and your veterinary office is closed? Plan ahead! Barr says. Many of the 24-hour care facilities are AAHA-accredited. The beauty of these hospitals is that they often have specialists available should the need arise for advanced care. Be sure to know where the closest emergency care facility is and know how to get there ahead of time.

Remember that even the best research cannot replace an in-person visit. Stop by prospective practices and ask for a tour before you decide.

You have options, Barr says. If you arent getting the service you expect, its OK to try something new.

Katie Meyer is an animal advocate who enjoys fostering dogs for PawsCo, a nonprofit rescue in Denver, Colorado.

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Six things to consider when choosing a new veterinarian | AAHA

Can you imagine going a day without brushing your teeth? Of course not! Yet many people dont brush their pets teeth, so most dogs and cats have evidence of dental disease by the time they are just 3 years old.

A good home dental care regimen can help your pet stay healthy and even save you money by prolonging the need for dental cleanings or tooth extractions, according to Morgen Deramus, DVM, associate veterinarian at AAHA-accredited Advanced Animal Care of Colorado in Fort Collins, Colo.

Training when theyre young and making sure youre doing it in a way that creates a positive association is the most beneficial for them, she says. With dogs, I usually recommend approaching it like any other traininglots of positive reinforcement, going slowly and stopping before that puppy gets aggravated or irritated with the process.

Deramus suggests starting with special pet toothpaste flavored like beef or poultry. Then:

Deramus says cats can be trained in a similar way, though large toothbrushes are too big for their mouths. Instead, use an infant finger brush or a gauze square to brush the teeth in a circular motion, just as you would brush your own teeth. If you have issues with your cat moving too much while brushing, you can wrap him in a towel and hold him close to you.

Beware of nonanesthetic dentistry

Some groomers, pet stores, and even nonaccredited veterinary hospitals offer nonanesthetic pet dentals, but buyer beware: This procedure is stressful for pets, does not treat any issues beneath the gum line, and can be potentially dangerous.

Be very cautious of people who offer those anesthetic-free dental cleanings, Deramus says. [Nonanesthetic dentistry] is not a safe way to clean teeth. It can often lead to secondary issues when the dog is awake and moving such as slicing gums and breaking teeth. It creates huge divots in the enamel, and doesnt protect [the pets] airways, either.

AAHA issued a mandatory dental standard in 2013 that all dental procedures in AAHA-accredited practices must be performed under anesthesia with patients intubated, and that cleaning a companion animal's teeth without general anesthesia is considered unacceptable and below the standard of care. The position was endorsed by the American Veterinary Dental College (AVDC).

Cats can be trained just like dogs if you put your mind to it, Deramus says.

If, despite your best efforts, tooth brushing is still impossible and has begun to affect your bond with your pet, Deramus says many other products, like food and water additives or dental chews, can help. Just be sure to look for the Seal of Acceptance from the Veterinary Oral Health Council (VOHC) when shopping for them, she says.

Indications of dental disease include bad breath, discoloration of the teeth, and redness of the gums. AAHAs dental care guidelines recommend annual professional, anesthetized cleaningsbeginning at 1 year for cats and small dogs, and 2 years for large breedsto prevent these and other oral health problems.

According to Deramus, this includes the transfer of bacteria and infection into the bloodstream, which can affect your pets overall well-being.

When this happens, the blood then goes into the major organs of the body and can cause major damage there, she says.

Finally, abscessed teeth and other dental issues should be taken care ofor better yet, avoidedbecause they are painful. Since cats tend to be pretty silent in their disease, Deramus has seen seemingly standoffish animals who would hide from people become happy and outgoing after dental treatment.

It can really unmask the true nature of that animal when you take care of things that cause chronic pain, she says. And what do we want for our animals? More than anything else, I think we want quality of life.

Award-winning pet writer Jen Reeder brushes her dogs teeth with poultry-flavored toothpaste. He will also cooperate for vanilla.

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How to brush your pets teeth (and why you should) | AAHA

Coffee with a calico? Tea with a tabby? Or just want to unwind with a feline?

Enter the cat caf.

Its an idea that apparently started in Asia and then spread to Europe. Now its come to the United States as an engaging way to find permanent homes for cats and kittens.

The first cat caf in the U.S. was a temporary one in New Yorka four-day collaboration that took place last April between North Shore Animal League America and Purina ONE. Cat lovers had the chance to sip complimentary "cat'achinos" while visiting with 16 cats up for adoption. Fourteen of the cats were adopted by the end of the event with the remaining 2 finding homes within the month.

Now permanent cat cafs are opening, working with health code laws by keeping food preparation areas separate from the cat areas.

The first permanent U.S. cat caf, Cat Town Caf at 2869 Broadway in Oakland, Calif., opened in October. Its an expansion of the work of Cat Town, a nonprofit cat rescue, to find homes for cats being held by Oakland Animal Services.

Adam Myatt, known as the Cat Man of West Oakland because of his feral cat calendars, opened the caf with Cat Town founder and friend Ann Dunn. Split into a caf and cat zone to work with health code laws regarding food preparation areas, Cat Town Caf allows 14 people every hour to observe and play with cats.

The limit on the number of people, says Myatt, is to prevent stressing the cats who might face up to 154 people per day, 8 a.m. to 7 p.m., five days per week.

Near the end of the first month of operation, 30 cats had already found new homes, says Myatt.

[Cat Town Caf is] doing pretty well, he noted. Its been a process to see which cats are going to do best in this space. A cat caf is not for every cat. It has to be one that can handle meeting hundreds of people.

The hardest part, he says, is curbing peoples expectations. Cat activity varies, as cat lovers know, he says.

Cats sleep a lot and dont always want to play, so some people might be disappointed. But if visitors really want to interact, we recommend that they reserve a time in the morning when the cats are super playful, ready to go crazy, or around 5 or 6 p.m. when they start getting active again.

We dont have Wi-Fi or a ton of seating. Most of the space is the cat zone. Its not a caf you would try to work in or bring your laptop to. But we do have great coffee and bagels and sell T-shirts, and were really trying to make this a super-fun, magical space for cats.

In San Francisco, cat enthusiasts Courtney Hatt, David Braginksy, and Benjamin Stingle are getting ready to open KitTea, part gourmet tea house, part cat and human oasis, at 96 Gough Street in late March.

Its been a lot of work after starting with a complete blank slate. There was a lot of construction and customization to cover, as well as permits, the cost of San Francisco, very busy contractors in a fast-growing city, and trying to dot all of the i's and cross all of the t's, says Hatt.

How will it work when it opens?

You will enter KitTea through a vestibule that keeps the tea and cats separate and be greeted by a friendly host/hostess who will take your order. From there you will walk into the cat/human oasis and be alerted once your tea and/or snacks are available for pickup at the hostess desk.Due to strict health regulations, no employee of KitTea can serve you tea or snacks in the space due to the risk of cross contamination in the two spaces.

If you choose to only come to KitTea for the tea, says Hatt, you can take a seat in our tea space. There you can view all the happenings in the cat area through a glass partition while you relax and learn about Japanese tea service.

KitTea is working with Give Me Shelter Cat Rescue, providing a space where the rescue can house its adoptable cats and thus make more room for rescuing other cats in California and across the U.S.

How do these operations help adopt cats?

At shelters, Hatt explains, cats who are scared will often come off as aggressive, aloof, and, in general, completely different from who they really are.

In these cafs, she says, the cats are going to be far less stressed than they would be in a shelter situation.

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I'll take my coffee with a cat | AAHA

When exploring medical privacy issues, it's very useful to have an overview of the laws that affect control and privacy of medical information. We encourage you to read our legal overview.

GINA, HIPAA, and genetic information privacy

Genetics is the new frontier of medicine and genomic data is the raw material of some of the most advanced medical research now underway. Genetic testing is the current paradigm for diagnosis and treatment of many diseases. Its likely that within 10 years genetic tests for disease markerssuch as presymptomatic testing for the risk of developing adult-onset cancers, Alzheimer's, or chronic diseasesand possibly even whole-genome sequencing will be as routine as urinalysis is now. And the greater availability of population-wide genetic information is happening alongside its digitization in a given individual's electronic health record (EHR).

Genetic data can be obtained from cells we routinely shed, is easily shared, and is in high demand for cutting-edge medical research. Genetic data might be used to develop cures for cancer, paranoid schizophrenia, common tooth decay, and far moremultifarious areas of research that can seem irresistibly compelling. So what can protect the privacy of genetic data in such a world?

Not much, actually. Some laws limit how the information can be used, but none truly protects privacy. And that may not even be possible, because genetic information is unique to every individual. It cannot be de-identified; even if separated from obvious identifiers like name and Social Security number, it is still forever linked to only one person in the world. The de-identification checklist safe harbor from the Healthinsurance Portability and Accountability Act (HIPAA) doesnt include genetic information.

Genetic nondiscrimination laws

The federal laws that deal with genetic information are GINA (the Genetic Information Nondiscrimination Act of 2008) and, more recently, HIPAA. GINA is essentially an anti-discrimination law that has nothing to do with privacy. It prevents group health and Medicare supplemental plansbut not life, disability, or long-term care plansfrom using genetic information to discriminate against you when it comes to insurance.

Title II of GINA prohibits the use of genetic information to discriminate in employment decisions, such as hiring, firing, and promoting. It also restricts employers from asking for or buying genetic information. GINA does not apply, however, unless the employer has more than 15 employees. An Executive Order that accompanies GINA prohibits federal government agencies from obtaining genetic information from employees or job applicants and from using it in hiring and promotion decisions.

The federal Equal Employment Opportunity Commission (EEOC) investigates and enforces GINA claims. One EEOC lawsuit filed in 2013 alleged that a company violated GINA by requesting and requiring job applicants to indicate whether or not they had a family medical history for a variety of diseases and disorders as part of its post-offer, pre-employment medical examination; it was settled for $50,000. A week later the EEOC filed a similar lawsuit against the Founders Pavillion nursing and rehab center in Corning, NY. As of late July 2013, the EEOC "is sifting through about 170 claims filed by workers, applicants and former employees who say companies unlawfully asked for genetic information or used it to discriminate."

In 2013, the HIPAA Omnibus Rule amended HIPAA regulations to include genetic information in the definition of Protected Health Information (PHI). It also prevents use of the data in underwriting for all other types of health insurance plans, but still not for life, disability, or long-term care insurance. Excluding long-term care insurance guarantees that anyone with a tested genetic predisposition to Alzheimers, for example, will be uninsurable. According to the definition, genetic information includes your genetic tests and a family members, your or a family members fetus or embryo, and evidence of a disease in a family member. It does not include your age or gender.

Californias broader genetic anti-discrimination law, known as CalGINA, not only prohibits genetic discrimination in employment (GINAs scope), but also in housing, provision of emergency services, education, mortgage lending and elections. CalGINA amends the Unruh Civil Rights Act to add genetic information to the list of Californians civil rights that entitle them "to full and equal accommodations, advantages, facilities, privileges, or services in all business establishments of every kind whatsoever." The Government Code contains the employment and other membership provisions of the FEHA. Other sections can be found on the California Department of Fair Employment and Housing website.

One problem with GINA that the Omnibus Rule perpetuatesand CalGINA does not address eitheris that GINA is based on a genetics framework that is more than 20 years old. GINA only prohibits discrimination based on genetic information about someone who has not yet been diagnosed with a disease; that is, the disease is not yet "manifest." Today there are many tests for genetic markers that mayor may notbe precursors of a disease and also may mean that you could benefit from preventive treatment. If the presence of genetic markers is considered a manifestation of a disease, then neither GINA nor HIPAA applies to the information.

Protecting genetic information privacy

With genetic dataor any personal health information (PHI)its important to remember that HIPAA only applies to an organization if it is either a "covered entity" or the business associate (BA) of one. Many non-covered entities collect genetic information, such as online genetic testing companies like 23andMe and genealogy websites like Ancestry.com. At the moment, such businesses are only self-regulated, although the federal Food and Drug Administration (FDA) recently told 23andMe that its over-the-counter saliva collection kit and Personal Genome Service (PGS) was being marketed in violation of the Federal Food, Drug and Cosmetic Act. As the FDA put it: "if the BRCA-related risk assessment for breast or ovarian cancer reports a false positive, it could lead a patient to undergo prophylactic surgery, chemoprevention, intensive screening, or other morbidity-inducing actions, while a false negative could result in a failure to recognize an actual risk that may exist."

Obviously, existing laws that deal with genetic information fall short in many ways. One corrective approach to the limits of GINA and HIPAAand not only where genetic information is concernedwould be to apply protections to the data itself, rather than making them dependent on who has the data. This dispenses with the patchwork created by "covered entities."

Some major unaddressed issues concerning genetic information privacy

As accessing and recording genetic information progresses, it raises some serious issues.

A recurring issue in medical privacy is lawful uses of information based on overly broad compelled authorizations, such as in states where individuals must sign a release for substantially all of their health records as a condition of employment or when applying for life insurance or government benefits. In the context of widespread use of EHRsinteroperable, comprehensive, lifetime individual health records that vastly increase the amount of data that can be disclosedthese kinds of releases create significant privacy risks for all health information, including genetic information.

Newborn screening is another problem that arises with EHRs and genetic data. Tests done at birth vary from state to state, but all states must screen for at least 21 disorders by law, and some states test for 30 or more. Currently, tests are limited to conditions for which childhood medical intervention is possible and may be beneficial.

What if that practice changes to includeor mandatetests for adult-onset disorders that cannot be treated in childhoodor for which there is no known treatment, such as ALS, Huntingtons disease, or Alzheimers? The privacy implications of starting a lifetime EHR that includes information about genetic diseases are enormous, and become even greater if the record comes to include evidence of a genetic propensity toward future, as yet incurable, diseases (not to mention the emotional impact on those designated at birth to succumb to a tragic and incurable disease). A great deal of thoughtful analysis and decisionmaking is required to protect this dataand the individuals connected to itfrom exposure, while at the same time not excluding this data from important research.

There is the growing practice, at all levels of law enforcement, of collecting genetic data from suspects when they are arrested and storing the information in a database for later reference. The Supreme Court held in Maryland v. King that such DNA collection, while subject to the Fourth Amendment (using a buccal swab on the inner tissues of a persons cheek in order to obtain DNA samples is a search), does not require a warrant: when there is already probable cause for a valid arrest for a serious offense, collecting a DNA sample is analogous to taking fingerprints or a photo. (See EFFs blog posts on Maryland v. King.)

The Ninth Circuit Court of Appeals, en banc, recently upheld a controversial California law that requires people who are arrested for a felony to provide DNA samples that will be stored in a criminal database accessible to local, state, national, and international law enforcement agencies. The requirement is not limited to serious or violent offenses. The plaintiff in the case, Haskell v. Harris, was arrested for protesting the Iraq war, but was never charged or convicted. The Court compared the California law to the Maryland law upheld by the Supreme Court and found no difference and no Fourth Amendment violation.

The United States has the worlds largest database of DNA profiles. As of November 2013, the FBIs National DNA Index (NDIS) contains over 12 million profiles, and it is still growing. These are primarily from criminals and criminal suspects, but the database also includes parolees, probationers, and people who were simply arrested. It is bound to grow as more states expand the categories of people compelled to give DNA samples for law enforcement. Law enforcement is also known to collect DNA surreptitiously from suspects cigarette butts and coffee cups.

Responding to the difficulty in making an exact DNA match from crime scene evidence, in 2008 California became the first state to authorize familial or kinship matches, which are by design less precise.

Another area of concern in law enforcement DNA collection is the current trend for predictive modeling or behavioral genomics. It raises questions about the potential use of DNA databases to reveal the genetic tendencies of individuals toward certain types of criminal behavior, like violence. Could this lead to practices like preventive detention or protective custody of individuals believed to have a genetic disposition toward crime or anti-social behavior?

Finally, there is a complex ethical issue around the consent for disclosure of genetic information or biospecimens that contain DNA, for research purposes and otherwise. Were used to thinking of consent as individual, which makes sense when the health information is mainly about that person. Genetic information is different: analysis of an individuals DNA is highly informative about his or her offspring, siblings, and parents. The Supreme Court of Iceland, for instance, found in 2003 that a woman had a right to opt out of her fathers genetic information being retained in Icelands national DNA database. Genetic information also bears on demographic categorization, as many genetic predispositions toward specific diseases or conditions are strongly associated with specific ethnic or racial groups. Is individual consent appropriate when DNA analysis can reveal significant information about other peopleas we now see for familial DNA searches?

For a critique of existing genetic information non-discrimination laws, see Are Genetic Discrimination Laws Up to the Task?, an interview with Mark Rothstein in Medscape Today. Rothstein holds the Herbert F. Boehl Chair of Law and Medicine and is the Founding Director of theInstitute for Bioethics, Health Policy and Law at the University of Louisville School of Medicine.

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Genetic Information Privacy | Electronic Frontier Foundation