Doubly Complicated: Caffeine AND Xylitol Pet Toxins

July 20th, 2015 by pcvh

Dr. Amanda Stolpa, DVM

Mateo, an adorable 5 year-old Miniature Australian Shepherd, was brought to us early Memorial Day weekend after ingesting a bottle of caffeine pills!

When I first examined him it was clear to see he was not feeling well. He was salivating at the mouth, had a mild tremor-like movement, and his heart was racing. The owner was extremely upset as Mateo had demonstrated seizure-like activity at home, and she rushed him to #PetCare immediately.

To treat Mateo, I needed to know the number and specific type of caffeine pills ingested. The owner did not know the details, so I advised her to rush home and grab the bottle for me, and in the meantime I would stabilize Mateo.

Nurses collected blood and urine to run a baseline panel, and then placed an IV catheter to start flushing Mateo’s system with intravenous fluids.  I spoke with Animal Poison Control (1-888-426-4435), and they confirmed my concerns regarding the caffeine intoxication and how to treat Mateo.

caffeine-pillsAbout Caffeine and Xylitol Toxicity

  • Caffeine is absorbed rapidly, and can cause extremely high heart rate, heart arrhythmias, seizures, tremors and high blood pressure.
  • Caffeine pills that contain Xylitol can cause extremely low blood glucose levels. This can have severe effects on the brain cells, neurons and other organs, as well as liver failure at higher doses.

When the owner returned with the bottle, I was able to confirm that there was xylitol present in the caffeine pills! This complicated Mateo’s case even further and made his prognosis more guarded.

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Pet Dental Anesthesia: Better Safe Than Sorry!

July 1st, 2015 by pcvh

Home brushing helps too!

Dr. Kim Soderholm, DVM

“I want to avoid anesthesia, so I take my pet to a person who cleans her teeth while she’s awake.”

To many well intentioned owners this statement makes sense. After all, people are awake when their teeth are cleaned, and even though pet dental anesthesia is incredibly safe, it can still be scary. What exactly could be harmful about having your pet’s teeth cleaned while he/she is awake?

Unfortunately, the consequences of anesthesia-free cleanings are significant.

Not only is your pet at risk of being injured by the sharp instruments, but more importantly it is impossible to effectively clean and examine every surface of “even the most cooperative” patient’s teeth while they are awake. Even if the crowns of the teeth can be hand scaled, such services rarely polish the teeth afterwards.  This leaves grooves on the teeth which allow the plaque and tartar to adhere even faster after a cleaning. The area below the gum line is left untouched to smolder and fester resulting in ongoing infection and eventually pain and tooth loss. Not to mention  the fact that dental x-rays are never taken which leaves roughly 50% of each tooth unexamined.

felix-1-cropSuch was the case for Felix, a Dachshund, whom I cared for:

Felix’s owner wanted the best for him, and she had been taking him to an anesthesia-free dental service every 6 months for a few years. In fact, he had been seen just a couple months prior to his visit to PetCare. His owner brought him to me because he was not wanting to eat hard food and had developed bad breath. When I looked in his mouth, the surfaces of his teeth were indeed clean. However, he did have some receding gums and terrible breath which hinted that there was more disease lurking.

The dark areas under each tooth show the bone loss that you cannot see without an xray.

The dark areas under each tooth show the bone loss that you cannot see without an xray.

It was not until after Felix was anesthetized and a full exam with dental x-rays was performed that the full consequences of the anesthesia-free cleaning were identified. Felix was found to have advanced periodontal disease. In fact, 25 teeth were so severely affected that the only way to alleviate Felix’s pain was to extract them.

If Felix’s mouth had been evaluated under anesthesia years earlier these teeth could have been salvaged, and more importantly, Felix would have been spared many months of pain. Within a matter of days after his extractions, Felix was happily eating and quickly made a full recovery.

Anesthesia-free dental cleaning may improve the cosmetic appearance of the teeth, however it provides very little benefit to a pet’s overall dental health.

It  gives owners the false sense that they are helping their pets while the reality is they are not. The only way to effectively treat periodontal disease is to clean all surfaces of each tooth above and below the gum line. Without dental x-rays substantial disease can easily be missed.

Please visit the site below and read the American Veterinary Dental College’s position statement against the practice of scaling pets’ teeth without anesthesia.



Assisted Living for Senior Feline Citizens – Part Two

June 30th, 2015 by pcvh

shutterstock_1394975Dr. Rhonda Savage, DVM

Taking care of disease early can make your older cat’s senior years more comfortable and happy.

In Part One of this blog series, we discussed nutrition and weight. Here are a few more guidelines that I use in helping my 21 year old cat age gracefully, and that I hope you will consider as well.

Organ Function Check

This can only be done by your veterinarian – we recommend blood work every 6 months in healthy appearing geriatric cats.


It is a good idea to pay attention to how your cat breathes when he/she is breathing normally and comfortably. Whether or not they breathe quickly or with an increase in effort can be significant.

Look at your cat when they are lying around (not purring) and count the rise and fall of the chest for 30 seconds and write this down. If you start to see this going up over time it can be a sensitive indicator of an early problem.

Just a note:  Most cats do not breathe with the mouth open, this usually indicates the need for a veterinary visit or call ASAP.

Grooming older cats

Many older kitties get matted fur because of lack of grooming and perhaps dehydration. Be cognizant of this and diligent to gently work with your cat with your fingers, special wide tooth combs, (not scissors!), brushes, and sometimes loofah sponges, to assist with grooming. Sometimes cats need to be groomed at the veterinarian if the matts are too extensive.

Monitor for signs of fleas and other parasites like tapeworms that can look like living rice in your cats stool or around the anal area. Older cats that are debilitated are much more susceptible to these parasites and there are safe treatments for them.

Older cats tend to need nail trims and are prone to having thick nails that can grow all the way around into the toes causing pain and infection. Most of the time two experienced people are needed to do cat nail trims – ask your vet for a lesson if this seems appropriate.

Dental care is paramount in the older cat!

Unfortunately, this is a challenge for most people, including myself, at home unless your cat has been taught early on to allow brushing.

Whereas a cat can usually be taught new things no matter how old, this is still quite difficult for most people. Therefore, having vet visits every six months with special attention to dental health is important. Your vet can teach you techniques to try to brush your cat’s teeth if you would like to learn.

Play/environmental modification

Don’t forget that even older cats might be amenable to play – my old guy will still chase a feather toy and roll around with a little toy mouse at times. Some trainers recommend changing the toys out every five days or so – removing old ones and replacing with new and then re-introducing the old ones later.

Heated beds for inside use are a big favorite among older cats – there are discs that you can heat in the microwave and electric beds made for this purpose. If you use any of these, make sure that you follow all safety instructions and feel comfortable with this addition.

Lastly, remember to enjoy the Buddha in your kitty every day.

#cats #pethealth

Assisted Living for Senior Feline Citizens – Part One

June 15th, 2015 by pcvh

shutterstock_893298Dr. Rhonda Savage, DVM

As a general practitioner of 15 years, I often tell clients who are feline guardians that cats are masters of disguise.

Cats can hide disease until they are very sick, usually meaning that the disease is fairly advanced. Older cats (12 years of age or older are considered senior) have their own fairly common ailments that can be managed, especially if detected in the early stages. Not only can these conditions be treated or managed – taking care of disease early can make your cat’s senior years more comfortable and happy.

Some of the most common diseases of older cats are kidney disease, heart disease, thyroid disease, and cancer. Other chronic living conditions that can be managed include dental disease, hygiene/grooming, chronic pain, weight maintenance and in some cases weight loss.

Below are some general guidelines that I use and that I hope you will consider as well.

Nutrition for older cats

Some kitties like dry food, some like canned, some like a mixture of both. Most kitties as they get older do not eat a high enough volume of food to maintain a healthy weight. This can sometimes be improved by allowing them access to fresh food 2-4 times a day.

Some cats like to be petted and have attention while eating and this usually means that they will eat more. Taking the time to do this also allows you to note if they have trouble picking up the food or dropping the food which could indicate a problem with dental disease and pain.

For some kitties of advanced age, putting treats on top of their food can encourage them to get started eating. A trick that I use with my 21 year old cat is to take a few pieces of food at a time and lay them out in front of him and pet him to get him to eat them. We continue this until he has eaten his fill.

Weight maintenance

I encourage clients to purchase an inexpensive kitchen gram scale with a flat surface (not a tray) for weighing your cat. You will need to make sure it weighs up to your cat’s current weight, e.g. 15 pounds or so. You can use a cut out cardboard box or other shallow flat bottomed container to place on top of the scale, zero it out, and weigh your cat.

Start by weighing once a week for one month and write it on a calendar. If the weight is static and no problems, only record weights once every 1-2 months. Weight loss of even 1/3 to 1/2 pounds are significant and your cat should see the veterinarian. (A baby scale can also be used but seem to be more expensive than a kitchen scale.)

Water consumption

An early sign of kidney disease and some other diseases (diabetes, thyroid disease, etc.) is an increase in water consumption. One way to detect this is to pay attention to the size of the clumps of urine in your cat’s litter box. If they once were the size of golf balls and now are larger than an apple, then your cat is likely drinking too much water. (Note: If you have a multi-cat family this is more difficult to monitor.) Make an appointment for a check-up if you notice this.

Don’t forget to just enjoy your cat! as it’s easy to get caught up in looking for problems.

Join me for assisted living tips for older cats – Part Two

#cats #pethealth

Summertime Pet Safety Tips

June 2nd, 2015 by pcvh

shutterstock_2560199Dr. Amy Saucke-Lacelle, DVM

As we’re heading into summer, many families will be taking their pets on hikes, to the beach, or just spending more time outdoors.

Here are a few pet safety tips to take into consideration when playing outdoors with your furry friends.

Hyperthermia and Heat stroke

Hyperthermia is a condition that occurs when our pet’s body temperature rises above normal body temperature (100-102.5°F) due to warm/hot environmental temperatures. When the body temperature rises above 105°F, our pets develop heat stroke where they are unable to dissipate their body heat adequately. This is an emergency situation, which can result in multiple organ failure or even death.

Heat stroke most frequently occurs when our pets are kept in a small-enclosed environment with inadequate ventilation, such as a car in the hot summer months. Studies have shown that a car parked in direct sunlight in 80°F weather had an increase to over 120°F inside the car within less than an hour.

Signs of heat stroke include heavy panting, fast heart rate, lethargy, dizziness, vomiting and diarrhea or decreased consciousness. Contact your veterinarian or closest veterinary emergency hospital immediately if you suspect that your pet is suffering from heat stroke.

In order to prevent heat stroke, never leave your pet alone in the car (even while running short errands). Always provide adequate amounts of drinking water and ensure your pet has a cool, shaded environment to rest at home.

dog_snakebite_300Rattlesnake bites

In general, rattlesnakes will try to avoid humans and our pets, however they will bite as a defense mechanism when they feel threatened. Many dogs and cats will be intrigued by these animals and have a tendency to approach snakes, without realizing the danger associated with a snake bite.

A rattlesnake bite is a medical emergency, which generally requires antivenin, antibiotics and pain medication. If you suspect that your pet was bitten by a snake, please seek medical care immediately.

In order to prevent rattlesnake bites, always stay watchful and keep control of your pets while in rattlesnake habitats. On hikes, always stay on open paths and keep your dog on a leash. Training your dog to avoid snakes through rattlesnake aversion courses can prevent bites in many cases.

A preventative rattlesnake vaccine is also available, and although it will not prevent a snakebite, it may help neutralize some of the rattlesnake venom and therefore decrease the severity of signs when your pet is bitten. Please discuss this vaccine with your regular veterinarian.


Foxtails are a type of weed that has little spikelet seeds, which are abundant in the Sonoma area. These pesky plants can work their way into your pet’s nose, ears, eyes or skin and migrate through the body causing severe infection in certain cases.

If your pet starts suddenly sneezing, shaking his head, pawing at his ears, hacking, gagging or if you notice any swollen areas on his body, please bring him into your regular veterinarian for evaluation immediately.

Please stay vigilant with all these summer hazards and have a wonderful summer with your furry friends!

#dogs #cats #petsafety

Is Anesthesia Safe For My Pet? – Part Three

May 26th, 2015 by pcvh

SAM_5553Dr. Gil Robello, DVM, MS
Diplomate, American College of Veterinary Surgeons

Before surgery, we will often give a “pre-anesthetic,” which may contain a combination of a tranquilizer and a sedating pain medication.

This will calm the patient down and decrease their anxiety about being treated. Also, these medications may allow for decreased doses of the general anesthetic used. Routinely, an intravenous catheter is placed to deliver IV fluids and other medications that may be needed. Having intravenous access is important and can be life-saving in an emergency. Another drug may be given to “induce” an anesthetic state. This drug will cause the patient to lose consciousness quickly, where we could get control of the airway with a breathing tube (endotracheal tube) and assist in breathing. A gas anesthetic is administered via the endotracheal tube to maintain anesthesia.

While anesthetized, a patient’s heart rate, breathing rate, EKG, blood oxygenation, body temperature, blood pressure and CO2 are monitored.

They are usually on a heated table and surrounded by a warm air or warm water blanket. On recovery, we stop administering the gas anesthetic while continuing oxygen. When they are able to swallow, the breathing tube is removed. Often, additional pain medications are given in anticipation of the patient’s needs when they wake up.

Your pet will be monitored closely following anesthesia.

Their vitals are monitored regularly until they return to normal, they receive heat support while they recover. PetCare is a 24 hour facility, so even if your pet’s surgery occurs at night, your pet is never alone.

Recovery from anesthesia may vary. With today’s anesthetics, many of which are reversible, most pets should be almost normal by the time of discharge. Many pets can remain sleepy or tired for twelve to twenty-four hours after anesthesia.

Follow the weekly series:
Part One:
 Why anesthesia is necessary, and how it works.
Part Two: What happens when your pet needs anesthesia?

#pethealth #veterinary

Is Anesthesia Safe For My Pet? – Part Two

May 19th, 2015 by pcvh

surgery-1Dr. Gil Robello, DVM, MS
Diplomate, American College of Veterinary Surgeons

What happens when your pet needs anesthesia?

At PetCare Veterinary Hospital, a specific anesthetic protocol is created for each pet, and this protocol is tailored to the needs of the patient for the specific procedure the pet is undergoing. This may include a combination of injectable and inhaled agents to obtain the level of anesthesia needed.

A pre-anesthetic examination and blood tests are important aspects of evaluating your pet.

We want to be as certain as possible things will go smoothly. This will include an examination, obtaining vital signs, an accurate body weight, and having the blood evaluated for blood counts, kidney/liver tests, electrolytes and blood sugar. This may help us identify patients that are poor candidates, or help identify problems that can be addressed before the anesthetic event. Some patients may have a more extensive evaluation, which may include x-rays and an ultrasound examination.

It is extremely important to follow the peri-operative recommendations by your veterinarian.

Providing all information about your pet’s health with your doctor prior to the procedure – including all medications your pet is taking (even those that can be obtained without a prescription) . This will allow us to make decisions as to which type of anesthesia and drugs are safest for the patient. Continue the usual medications unless the anesthesiologist or surgeon recommends against it. Be sure to follow the recommendations regarding feeding. This is extremely important!

In general, withhold food for 12 hours and clear liquids for at least 4-6 hours before general anesthesia.

This will decrease the risk of nausea, vomiting or regurgitation surrounding anesthesia, which can lead to aspiration pneumonia (a life-threatening lung infection). It is surprising how often we find a pet was fed before before being brought in for a surgical procedure; resist the temptation to “just give a little bit.” Be sure to let everyone in the household know to withhold food.

Follow the weekly series:
Part One:
 Why anesthesia is necessary, and how it works.
Part Three: Anesthesia during surgery and recovery

#pethealth #veterinary

Is Anesthesia Safe for my Pet? – Part One

May 12th, 2015 by pcvh

anesthesiaDr. Gil Robello, DVM, MS
Diplomate, American College of Veterinary Surgeons

Many times, the fear of anesthesia is greater than the fear of the surgery itself.

Many of us have heard terrible stories of loved ones lost under anesthesia for relatively minor procedures. Concerns about general anesthesia in our pets is understandable, as there is risk associated with any anesthetic procedure.

General anesthesia is not taken lightly; however, it is necessary in order to make the procedure possible.  Because it is common for pets not to understand why they are being treated, often they won’t sit still or often become frightened in the hospital. We use drugs and anesthetics more frequently than a human doctor would. Procedures such as dental cleanings/extractions, x-rays and some minor procedures that can be done on people can not be done safely on animals without sedation or anesthesia.

In the past, many drugs that were used were less predictable and had greater side effects.

Anesthetic drugs used today are actually very safe. Many injectable anesthetics now have a drug that can reverse the effects. The gas anesthetics used today are quickly eliminated by breathing oxygen or room air and breathing the anesthetic out of it’s system. Some desperately sick patients are in a more stable condition under general anesthesia than when awake and breathing by themselves. Their vital functions, such as blood pressure, the amount of blood pumped by their hearts, etc. can be improved by the anesthesia, extra IV fluids, medications, and oxygen.

It is common to use a combination of drugs in a patient undergoing anesthesia.

Using multiple drugs in a controlled fashion can result in smaller doses and therefore can be less risky than a single drug. Many of the drugs are “titrated” to effect; a dose may be calculated based on body weight, and the amount given is just enough to maintain the pet on as light a plane of sleep needed to perform the procedure. This amount may be different for each pet.

The risks of anesthesia may differ for different procedures, and is also influenced by the health of the pet undergoing the operation.

In general, the larger the operation, the greater the risk of complications. Similarly, the unhealthier the pet, the greater the risk of complications. Some of the complications are relatively minor, however, some can be life threatening. These risks in most cases are small, and these risks can be further reduced. In general, the risks associated with general anesthesia has been quoted to be 0.01%, or roughly 1:10,000.

Follow the weekly series:
Part Two: What happens when your pet needs anesthesia?
Part Three: Anesthesia during surgery and recovery

#pethealth, #veterinary

April is National Heartworm Awareness Month

April 20th, 2015 by pcvh


Dr. Alex Miller, VMD

Spring showers us with beauty, and the threat of heartworm disease

There’s no better season than Spring to take a long walk with your four-legged friend. Sadly, dogs and people are not the only ones to thrive in warm spring weather. Mosquitoes proliferate in huge numbers during these warming months and bring with them the spread of heartworm disease. Though a threat all year long, heartworm disease is most commonly acquired in the warmer months when mosquitoes are more active.

What is heartworm disease?

Heartworm disease is caused by the heartworm parasite, which is spread from dog to dog or dog to cat through mosquito bites. Mosquitoes bite an infected dog, ingesting the heartworm microfilaria. These microfilaria mature to larvae inside the mosquito over about 2 weeks, and these larvae are transmitted to a new host through a bite. Over the course of about 6 months, the heartworms travel to the lungs and blood vessels near the heart.


Signs of heartworm disease may be mild at first but can quickly develop to a life threatening emergency. A sudden development of symptoms usually arises when a worm dies and the body launches a severe immune response. The following are common signs of heartworm disease:

  • cough
  • exercise intolerance
  • collapsing episodes
  • difficulty breathing

Heartworm disease is completely preventable

Though the diagnosis may be made in dogs through a simple blood test, the treatment for heartworm disease is expensive and may take months. Sadly, some pets do not survive. But there is good news! Heartworm disease is 100% preventable with a monthly preventative such as Heartgard or Trifexis. The medicine works by eliminating any larvae accumulated over the previous month.

Not just dogs

Cats can be infected with heartworm disease too. While cats who spend time outside on decks or in backyards are more commonly affected, any cat with exposure to mosquitoes is at risk. Because cats are not the natural hosts for heartworm disease, the illness is especially devastating and life threatening. Diagnosing heartworm disease in cats is more complicated; however, it is just as preventable as in dogs! Heartgard is available for cats, as are the monthly topical heartworm preventatives Revolution and Advantage Multi.

Keeping your dog or cat on monthly heartworm preventative year round ensures many happy “Springs” for years to come.

#heartworm, #cats, #dogs

Is My Dog Fat?

April 14th, 2015 by pcvh

Dr. Shyla Myrick, DVM

According to the Association for Pet Obesity Prevention over half of the dogs and cats in America are overweight.

So, YES, there is a really good chance that your dog is fat. And as it turns out, mine is too.

guiness 2Meet Guinness “Hoover” Myrick.

He likes his dog food, his sister’s dog food, chicken bones pulled out of the trash, entire blocks of gorgonzola, chocolate cookies, cocoa butter lotion, used paper towels… the list goes on.

How do I know Guinness is fat?

He has no waist, and I can’t feel his ribs. I should be able to feel his ribs easily  (although not see them) like the back of my hand.

Why do I care?

Because I don’t want is arthritic joints to hurt when he walks. I don’t want to give him a shot twice a day to treat diabetes. I don’t want to hospitalize him again for four days for pancreatitis. Most especially though, I want him to live forever and ever and ever and grow old with me.

How do we get Guinness healthy?

Easy! I measure how much I give him a day in actual cups, and decrease it by 1/3, and I cut his treats in half.

This chart is a great reference.  (Click to enlarge). I would call Guinness a “four.”



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