Tube Talk

by Dr. Marty Becker, Kim Campbell Thornton and Mikkel Becker

Pet Connection | January 21st, 2019

A feeding tube can save a sick pet’s life and make it easier and less stressful -- for both of you -- to give special diets and medications

By Kim Campbell Thornton

Andrews McMeel Syndication

Franny had a benign mass that ruptured, almost causing her to bleed out. Emergency surgery saved her life, but her recovery was rough. It was a struggle to get her to eat enough.

Veterinarian Julie Fischer placed a feeding tube in the 12- or 13-year-old beagle-mix, allowing owner Eliza Rubenstein to keep her dog medicated and at an appropriate weight.

“It removed the stress from her mealtimes and made food something we could enjoy together as a positive experience during her senior years,” Rubenstein says.

Placing a feeding tube may seem invasive, but most pets accept it well -- possibly better than their humans do. One of the major hurdles is convincing owners that the short anesthetic procedure to implant one will be beneficial for their sick, feeble companion, says Gary Marshall, DVM, of Island Cats Veterinary Hospital in Mercer Island, Washington.

A feeding tube can provide good quality of life and nutritional support during an illness that prevents pets from eating adequately: conditions that cause mouth pain, for instance, such as tumors, ulcers and trauma; postsurgical recovery, as with Franny; or chronic pancreatitis or kidney disease. In the latter case, cats may eat well enough but need the tube for medication and additional fluids. It’s often impossible for owners to give these effectively without increased stress to the patient and possible injury to the human, Dr. Marshall says.

“If we then look at these tubes as medication and hydration delivery ports, they can save that life and the relationship.”

Cara Quinn cared for her mother’s dog, who had pancreatitis, kidney failure and irritable bowel disease. The dog refused to eat, so a feeding tube in place for six weeks allowed her to recover without stress.

“She totally accepted it and was very calm about the entire process,” says Quinn, who also had to give the dog 12 medications daily through the tube. “It has been a year, and she is stable and doing great.”

Susan Rosenau’s dog Bacon had a functional ileus, meaning his digestive system was paralyzed. He couldn’t take food, water or medication by mouth, vomiting it back up right away, so he lost a lot of weight, Rosenau says. A feeding tube saved his life.

Dr. Fischer, who placed Franny's tube, says pets tend to tolerate esophageal tubes well. They can be placed quickly and easily and used immediately for as long as necessary, and they are easily removable. She has implanted some 300 esophageal feeding tubes in dogs and cats over the last 20 years.

“I’ve had maybe a dozen where either the pet or the owner -- or both -- did not do well with the tube, which I think is a pretty good success rate,” she says.

Pet food can be blended into a slurry that is then placed in the tube. For pets with kidney disease, liquid therapeutic renal diets are available, which pass easily through even narrow feeding tubes.

There are several types of feeding tubes, each suited to different conditions or circumstances. Depending on the type of tube and the pet’s needs, placement can require only local anesthetic or brief general anesthesia. Commercially available washable wraps to hold the tube in place make long-term maintenance easier. And certain types of tubes allow pets to eat naturally as well if they choose.

The most common complication is tube-site infection, easily treatable and minimized by good tube hygiene. Tubes can become clogged, so it’s important to flush them thoroughly before putting in food and water.

Franny later developed a predisposition to pancreatitis, and a feeding tube again allowed Rubenstein to give her the bulk of her calories through special liquid or blended diets and supplement with foods the dog enjoyed.

“I know that we had a couple of happy years together that we wouldn’t have had otherwise, and I would cheerfully do it all again for another beloved dog friend,” she says.

Q&A

Can outdoor cats

live happily indoors?

Q: We hope to move in a couple of years. Are there any steps to prepare our four outdoor farm cats to become permanent indoor house cats? They do come inside the house in the wintertime.

A: If your cats are already used to spending some time indoors, it’s possible that they could adjust to living indoors full time. Planning and indoor enrichment beforehand will help, especially if you have a couple of years to prepare. These tips from Fear Free can help.

Since it’s winter now and your cats are spending more time indoors anyway, start making your home a more interesting and exciting place for them. Cats like to survey their living area from on high, so place a cat tree or two in areas that give them a view, either of the outdoors or of areas where you and your family enjoy spending time.

Turn mealtime into hunting time. Using commercial or homemade puzzle toys (see foodpuzzlesforcats.com for ideas), hide meals around the house to give your cats the opportunity to use their keen sense of smell and feline hunting techniques to find their food.

Institute regular playtime. Using fishing-pole toys, large peacock feathers and other interactive toys, spend a few minutes a couple of times daily to give your cats some fun activity combined with attention from you.

Use feline pheromone sprays or diffusers, catnip and silver vine to give your cats a sense of calm and comfort inside the home.

Continue these activities throughout the year, not just in winter, to encourage your cats to spend more time indoors. When you move, make sure you have the new home set up with their familiar-smelling cat trees, beds and toys before bringing them in. Finally, if possible, build a “catio” so they can still enjoy the sights, scents and sounds of the outdoors in a safe way. -- Dr. Marty Becker and Mikkel Becker

Do you have a pet question? Send it to askpetconnection@gmail.com or visit Facebook.com/DrMartyBecker.

THE BUZZ

Overweight pets have

Upset Stomach?

by Dr. Marty Becker, Kim Campbell Thornton and Mikkel Becker

Pet Connection | January 14th, 2019

Vomiting and diarrhea can be signs of multiple disorders, making gastrointestinal disease in dogs and cats difficult to diagnose and treat. Here’s what you should know

Andrews McMeel Syndication

If you’ve taken your dog or cat to the veterinarian recently -- especially during the holidays -- chances are it was for stomach upset. That’s one of the most common problems veterinarians see in pets -- and not just during holidays, when pets are given (or steal) extra goodies to eat, but year-round.

Vomiting and diarrhea are obvious signs of intestinal upset, but you may also notice appetite loss, weight loss, blood in the vomitus or stool, or even more subtle clues, such as changes in attitude or decreased energy levels. But because these signs can indicate any number of disease states, getting to the root of the problem can require high-level detective skills on the part of your veterinarian. Possible causes include viral or bacterial infections, dietary indiscretions (aka garbage gut), ingestion of toxic substances, intestinal obstructions, allergic reactions, parasites and Addison’s disease.

“One of the most common things we see in both dogs and cats is something termed chronic enteropathy, which refers to conditions of the intestinal tract that result in gastrointestinal signs of at least three weeks duration,” says internal medicine specialist Sara Wennogle, DVM, at Colorado State University Veterinary Teaching Hospital. “However, we only arrive at the diagnosis of chronic enteropathy after the exclusion of a lot of other common causes of these clinical signs."

One of the diseases that must be excluded before a diagnosis of chronic enteropathy is Addison’s disease. Certain indicators from the pet’s history, breed or lab work will suggest the need to screen for other diseases as well.

Veterinarians typically begin by excluding the most obvious suspects. They’ll ask whether your pet’s diet has changed recently or if he has gotten into the trash or been somewhere that he could access something toxic, and they may order a fecal exam to screen for intestinal parasites such as hookworms, roundworms, Giardia and cryptosporidium.

Once the basic baddies are ruled out, your veterinarian may pull out the big guns: complete blood count, serum biochemistry panel, urinalysis to check for evidence of kidney disease or imaging such as abdominal ultrasound or X-rays to see if there’s a foreign object causing a blockage or an intestinal mass.

Certain indicators from lab work or the animal’s breed may suggest screening for Addison’s disease. For instance, Dr. Wennogle says, a 5-year-old poodle should probably have Addison’s excluded. No single test can indicate that a pet has, say, inflammatory bowel disease.

The diagnostic testing of chronic gastrointestinal signs in pets can be lengthy and costly. Fortunately, not every pet with chronic gastrointestinal signs requires a $2,000 workup. In many cases, a simple change in diet can solve the problem. A large proportion of both dogs and cats have a positive response to dietary change. It’s a mainstay of therapy in managing chronic GI disease.

“There’s good evidence that dietary constituents will contribute to gut inflammation,” Dr. Wennogle says. “Therefore, manipulation of the diet has a lot of value in treating underlying diseases.” Some diets available from veterinarians contain prebiotics or probiotics that can be helpful or alterations in the fatty acid ratio that can help modulate inflammation.

Another tip: Take your pet to the veterinarian sooner rather than later for signs of gastrointestinal disease.

“We have a better chance for cure the earlier the client can bring in the dog or cat,” says M. Katherine Tolbert, DVM, an internal medicine specialist at Texas A&M University College of Veterinary Medicine & Biomedical Sciences. “It takes a long time to get control of a chronic disease. If the disease has been going on for months, we often can't achieve remission within one week.”

Take pets to the veterinarian immediately for sudden signs of severe illness such as weakness, continual retching and inability to keep down water, says Michael Stone, DVM, an internal medicine specialist at Tufts University’s Foster Hospital for Small Animals in North Grafton, Massachusetts. Don’t let vomiting go on for more than six hours, and take pets in right away if they appear weak.

Q&A

Cat’s new fear

is a mystery

Q: We adopted our 8-year-old female cat when she was a kitten, and she is an indoor-only cat. She has always been somewhat timid and easily frightened by loud noises. Last week, we couldn't find her; we finally discovered her hiding behind the couch. At first, I thought she might be sick, but she acts normal as far as eating and using the litter box. She seems to have been terrified by something. She spends almost all her time in the basement and won't go into our bedroom. This is abnormal. She used to cuddle with me and would run to the door when we came home. We have no other pets. Can you give me some ideas on how to help her return to her old self?

A: Although your cat is eating normally and using the litter box appropriately, she could still have an underlying health problem. Her abnormal behavior may be her way of telling you that she doesn’t feel right. Any time an animal has a sudden change in behavior, whether it’s eating more or less than normal, breaking housetraining or acting fearful for no apparent reason, it’s a good idea to have your veterinarian check for health problems.

Have there been any changes in your home environment? Visiting guests? Remodeling? A child off to college? A trip? Cats generally like things to stay the same. Many cats adapt to change with little problem, but cats who are already timid may have a more difficult time with it.

Another possibility: Is an outdoor cat coming around your house? Even if that cat can’t get inside, seeing, hearing or smelling him could cause your cat stress or anxiety.

Your veterinarian can refer you to a Fear Free-certified veterinary behaviorist for additional help or may have other suggestions to help your cat. -- Dr. Marty Becker and Mikkel Becker

Do you have a pet question? Send it to askpetconnection@gmail.com or visit Facebook.com/DrMartyBecker.

THE BUZZ

Single odors not so

easy to sniff out

-- A complex “soup” of odorants is easier than a single scent for animals to detect, according to a recent study conducted at Great Britain’s University of Sussex. Professor Thomas Nowotny and Ph.D. student Ho Ka Chan found that complex mixed odorants are detected more quickly and reliably by olfactory receptors and can be identified over a wider concentration range than pure odorants. The study, published in the journal PLoS Computational Biology, adds to what is known about sense of smell. “Everything we take in from our environment is mixed smells, so it makes evolutionary sense that our olfactory systems would be better at those type of smells,” Professor Nowotny says. “Similarly, animals secrete odorant mixtures as communication signals, pheromones, so it is vital that they can quickly and accurately identify these chemical signals so they can decode the message they are being sent.”

-- There’s a lot for pet lovers to celebrate in January. It’s National Train Your Dog Month, Walk Your Pet Month and Adopt a Rescued Bird Month. Also on the calendar are National Dress Up Your Pet Day on Jan. 14, National Answer Your Cat’s Question Day (in other words, try to understand what your cat is communicating) on Jan. 22, Change a Pet’s Life Day on Jan. 24 and the 90th anniversary of the founding of Seeing Eye Guide Dogs on Jan. 29.

-- Did you get a sweet new cellphone, e-reader or other gadget for the holidays? Place it out of pet reach to keep it safe. Pets love to chew on cables: Dogs will swallow just about anything that fits in their mouth, and cats are notorious for swiping pricey electronics onto the floor just to see them die. Protect wiring with cable wraps, and buy a tough cover for items that might hit the floor. -- Dr. Marty Becker, Kim Campbell Thornton and Mikkel Becker

ABOUT PET CONNECTION

pets

Pet Grief

by Dr. Marty Becker, Kim Campbell Thornton and Mikkel Becker

Pet Connection | January 7th, 2019

Do animals grieve the loss of human or animal family members and friends? We can’t ask them, but their behavior sheds light on the subject

By Kim Campbell Thornton

Andrews McMeel Syndication

The day before Thanksgiving, we learned that our 81-year-old neighbor, Mary Lou, had died unexpectedly in her home. Besides missing her presence ourselves, my husband and I felt bad for our dogs, Harper and Keeper. They loved Mary Lou with a passion -- could it have been the treats she handed out so freely? -- and their love was returned a hundredfold. I wished I could explain to them that she wouldn’t be there anymore.

For a dog or cat, the disappearance of a person or animal from their life -- whether by death or the breakup of a family through divorce -- disrupts life in many areas: routine, companionship and social relationships. Pets who have lost a human or animal friend often show signs of depression, says Wailani Sung, DVM, behavior specialist at San Francisco SPCA. Decreased appetite, a lack of energy, lethargy, vocalizing, pacing and weight loss are among the actions that can signify grief. Many people say their pets express grief in a number of ways.

Becoming attached to the area where the pet or person slept is common. On the death of Navarre, a flat-coated retriever, his fellow flat-coat, Izzy, slept on Navarre’s bed for a week, says Jill Gibbs of Billings, Montana. Reegan Ray’s boxer, Winifred, was caring for her week-old puppies when her mother, Pip, died. Ray had a few of Pip’s beds stacked outside, and at first Winifred simply gave them a quick sniff as she went out, wanting to get back to her litter quickly. After another week, though, she pulled the beds down and rolled in them. Ray says Winifred and Pip did the same thing together when her male boxer had died three years previously.

Lynn Williams says her brother was a favorite of her cavalier King Charles spaniel Bella.

“I brought home things he had with him when he died, but the dogs paid no attention to them,” she says. “A few weeks later, I brought Bella to his house. She was so excited, running through the house until she got to his bedroom. She stopped and ran to the front door and wanted out immediately. I thought that was when she ‘got’ that he was gone.”

Often, pets search for their missing friend. Susan Conant of Newton, Massachusetts, says her Chartreux cats, KC and Celeste, were devoted companions. For weeks after Celeste died, KC looked everywhere in the house for her.

“Her search was heartbreaking,” Conant says.

Aidan, a fawn Abyssinian, lost weight mourning the loss of his human friend, Jack. “Aidan grieved for about two years,” says owner Linda Kay Hardie. “He finally put some weight back on after being scary skinny for a while.”

Sometimes pets develop separation anxiety or lose housetraining.

Corgis Gael and Rhiannon never seemed close, but when Rhiannon died, Gael began having accidents in the house, says Susan Ewing of Jamestown, New York. “We couldn’t leave her for even 20 minutes without coming back to a puddle,” she says. “When we got our new puppy, all was fine once again.”

Incidents like that may be related to patterns developed with the other dog, says Debra Horwitz, DVM, a veterinary behavior specialist who practices in St. Louis. What might happen is that one dog patterned when to go out based on the other dog’s habits but never learned to “ask” to go out on his own.

“What I normally tell people is if the dog or cat had a certain routine with the other housemate, I suggest they try and find a new routine for that animal,” she says.

Harper and Keeper still want to go to Mary Lou’s front door, but we’re taking Dr. Horwitz’s advice and trying to build new habits with them. But no matter what, we’ll always miss Mary Lou.

Q&A

Where to look for

a dog to adopt

Q: My workout partner wants to adopt a Maltese who is good with children, housetrained and 2 to 3 years old. Where should she go?

A: Start with the website of the national breed club. The American Maltese Association Rescue is a nonprofit organization affiliated with the American Maltese Association, and it is dedicated to helping down-on-their-luck members of the breed. Its volunteers may also be able to refer your friend to local or regional Maltese rescue groups. She should check local shelters or humane societies for dogs who meet her criteria, and put the word out to friends, neighbors, dog groomers, trainers and veterinarians who may know of dogs in need of homes.

She has one problem, though, and that is that many rescue groups and reputable breeders won’t place toy breeds such as Maltese in homes with young children. Maltese can be fragile and easily injured if accidentally mishandled or dropped by a child. Unless the children in question are responsible teenagers, your friend may be turned down for a dog she wants to adopt.

It’s great that your friend has some specifics in mind for what she wants in a dog. That helps people narrow their choices. But it’s also important to keep an open mind when looking. Getting stuck on a particular breed or age can cause people to pass up the perfect pet without even knowing it.

Rescue group volunteers know these dogs well and will have a good idea of which person or family is the best fit. They may suggest another dog if the one she likes might not be a good choice for her situation. When people go with the process and are open to alternatives, they can find themselves with the perfect dog -- one they might never have considered on their own. -- Mikkel Becker

Do you have a pet question? Send it to askpetconnection@gmail.com or visit Facebook.com/DrMartyBecker.

THE BUZZ

Study finds size

increase in cats

-- Many animals become smaller with domestication, but Viking cats from the medieval era took a different path: They became larger than the average cat. It’s the first time that this type of size change has been documented, according to Belgian archaeozoologist Wim Van Neer of the Royal Belgian Institute of Natural Sciences in Brussels, commenting on a study conducted by Julie Blitz-Thorsen and Anne Birgitte Godfredsen. The bones studied encompassed a period of some 2,000 years, ending in the 17th century. Researchers aren’t sure yet of the reason for the size difference, but they suspect the cats may have had access to more or better food, possibly from greater amounts of discarded food waste or a higher number of rodents attracted by edible garbage.

-- A Siberian husky made the news for detecting his owner’s ovarian cancer not once, not twice, but three times between 2013 and 2016. Sierra sniffed at Stephanie Herfel intently several times and then went and hid. Herfel, who had been experiencing abdominal pain, took note of the strange behavior and decided to see the doctor just in case. She was diagnosed with cancer and underwent treatment but experienced two recurrences. Each time, Sierra displayed the same behavior, alerting Herfel that something was wrong.

-- Sighthounds are sleek and speedy dogs who hunt by sight, chasing anything that moves and running it down for the hunter. They are known for their long, narrow heads -- the technical term for their head shape is “dolichocephalic” -- long legs, deep chests and graceful movement, almost as if they’re floating. This type of dog likely originated in the Middle East, based on recent genetic findings. Sighthound breeds include greyhounds, Afghan hounds, salukis, borzoi, Irish wolfhounds, Scottish deerhounds, silken windhounds, whippets, Azawakhs and sloughis. The Italian greyhound is a sighthound in miniature. -- Dr. Marty Becker, Kim Campbell Thornton and Mikkel Becker

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