Healthy Pet Blog

Crawford Dog and Cat Hospital

2135 Jericho Turnpike
Garden City Park, NY 11040

(516)746-1566

www.crawforddogandcathospital.com


International Bring Your Cat to the Vet Day - 08/06/2018

Dr. Sandra Wu


August 22, 2018 is Bring Your Cat to the Vet Day, but “My cat hates going to the vet, she seems fine, why should I bother bringing her?”

We all know how much cats hate to travel, but it is essential to your cat's health to make that annual trip for the physical examination. Here are some major reasons why:
  1. Cats age faster, even than dogs in the first few years. In the first year, cats become 15 in human years; after the 2nd, they are 24 human years. Every year thereafter they gain another 4 years. A lot of changes can happen over these years. Annual examinations help us to detect changes and provide preventative care.
  2. Cats are survivors who know how to mask disease and pain until they are so far gone, it makes it difficult for anyone to help them. By bringing them in routinely, we can examine and evaluate them for earlier signs of disease. By detecting diseases earlier, we have a much better chance at helping them.
  3. They are not just “fluffy.” More than 50% of cats are overweight, which puts them at risk for diabetes, heart, kidney and lung disease. We can help regulate a diet and exercise plan to keep your kitty from becoming a statistic.
  4. Adult cats have 30 teeth that most owners never brush. And those mouths get gingivitis and cavities that can be so painful, their teeth chatter when we touch them. Let us check out those teeth and make plans to keep them healthy.

So how do I get unwilling “Fluffy” to the office?
  1. Get a carrier that feels safe - a hard-sided carrier with top and front doors that can have the top removed. Try stuffing your cat into a tiny carrier door and you'll understand why it's nice to have the top hatch through which you can lower her into the carrier. Being able to lift the top off at the office so she can still hide in the towels make her feel safe.
  2. Leave the carrier out for a week before using it so your cat can get used to the smell. You can place treats in the carrier so he associates good things with it. He may even climb in it to check it out on his own, it makes a nice hidey-hole!
  3. If your cat is a bit resistant or aggressive about getting into the carrier, we can occasionally provide medicine or recommend products like Feliway to calm him down before coming. Call us for sugggestions.
  4. And if all else fails and there is no way you're getting your cat to come into the office, we also do housecalls! Call us to set up an appointment for a doctor to make the trip to your cat instead.
Call us to schedule an appointment or request an appointment on line.  We are working on special offers for this event, so stay tuned to Facebook and check your e mail for details.  


Cruciate Ligament Injury - 07/11/2018

This Article can be found on our pet informational page It is provided for our clients courtesy of Veterinary Information Network and is protected by their copyright.  Additional articles about cruciate ligament injury in dogs as well as other pet health topics can be found on the same web page.  We would like to thank Dr. Wendy Brooks for the article and hope that it is helpful for owners with pets that have knee injuries.



By Wendy C. Brooks, DVM, DipABVP 
Educational Director, VeterinaryPartner.com

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Ruptured Cranial Cruciate Ligaments in Dogs

First, the Basics

Drawings by MarVistaVet
The knee is a fairly complicated joint. It consists of the femur above, the tibia below, the kneecap (patella) in front, and the bean-like fabellae behind. Chunks of cartilage called the medial and lateral menisci fit between the femur and tibia like cushions. An assortment of ligaments holds everything together, allowing the knee to bend the way it should and keep it from bending the way it shouldn't.
There are two cruciate ligaments that cross inside the knee joint: the anterior (or, more correctly in animals, cranial) cruciate and the posterior (in animals, the caudal) cruciate. They connect from one side of the femur on top to the opposite side of the tibia on the bottom, the two ligaments forming an X (hence the name cruciate) inside the knee joint. They are named for their attachment site on the tibia (the cranial cruciate attaches to the front of the tibia and the caudal cruciate attaches to the back of the tibia). This may be hard to visualize based on the description but the illustration above shows the orientation of the two crossing ligaments effectively. The anterior/cranial cruciate ligament prevents the tibia from slipping forward out from under the femur.
Finding the Rupture
The ruptured cruciate ligament is the most common knee injury of dogs; in fact, chances are that any dog with sudden rear leg lameness has a ruptured anterior cruciate ligament rather than something else. The history usually involves a rear leg suddenly so sore that the dog can hardly bear weight on it. If left alone, it will appear to improve over the course of a week or two but the knee will be notably swollen and arthritis will set in quickly. Dogs are often seen by the veterinarian in either the acute stage shortly after the injury or in the chronic stage weeks or months later.
The key to the diagnosis of the ruptured cruciate ligament is the demonstration of an abnormal knee motion called a drawer sign. It is not possible for a normal knee to show this sign.
The Drawer Sign
The veterinarian stabilizes the position of the femur with one hand and manipulates the tibia with the other hand. If the tibia moves forward (like a drawer being opened), the cruciate ligament is ruptured.
Another method is the tibial compression test where the veterinarian stabilizes the femur with one hand and flexes the ankle with the other hand. If the ligament is ruptured, again the tibia moves abnormally forward.
If the rupture occurred some time ago, there will be swelling on side of the knee joint that faces the other leg. This is called a medial buttress and is a sign that arthritis is well along.

It is not unusual for animals to be tense or frightened at the vet's office. Tense muscles can temporarily stabilize the knee, preventing demonstration of the drawer sign during examination. Often sedation is needed to get a good evaluation of the knee. This is especially true with larger dogs. Eliciting a drawer sign can be difficult if the ligament is only partially ruptured so a second opinion may be a good idea if the initial examination is inconclusive.
Since arthritis can set in relatively quickly after a cruciate ligament rupture, radiographs to assess arthritis are helpful. Another reason for radiographs is that occasionally when the cruciate ligament tears, a piece of bone where the ligament attaches to the tibia breaks off as well. This will require surgical repair and the surgeon will need to know about it before beginning surgery. Arthritis present prior to surgery limits the extent of the recovery after surgery though surgery is still needed to slow or even curtail further arthritis development.
How Rupture Happens
Several clinical pictures are seen with ruptured cruciate ligaments. One is a young athletic dog playing roughly who takes a bad step and injures the knee. This is usually a sudden lameness in a young large-breed dog.
A recent study identified the following breeds as being particularly at risk for this phenomenon: Labrador retriever, Golden retriever, Rottweiler,Neapolitan mastiff, Newfoundland, Akita, St. Bernard, Rottweiler, Chesapeake Bay retriever, and American Staffordshire terrier.

On the other hand, an older large dog, especially if overweight, can have weakened ligaments and slowly stretch or partially tear them. The partial rupture may be detected or the problem may not become apparent until the ligament breaks completely. In this type of patient, stepping down off the bed or a small jump can be all it takes to break the ligament. The lameness may be acute but have features of more chronic joint disease or the lameness may simply be a more gradual/chronic problem.
Larger overweight dogs that rupture one cruciate ligament frequently rupture the other one within a year's time. An owner should be prepared for another surgery in this time frame.
The cranial cruciate rupture is not limited to large breed dogs. Small dogs can certainly rupture their ligaments as well and, while arthritis is slower to set in when the patient is not as heavy, there is an association with cruciate rupture and medial luxating patella that is very common in small breed dogs. With the patellar luxation, the kneecap flips in and out of the patellar groove. If the condition is relatively mild, it may not require surgical correction but it does stress the cranial cruciate ligament and can predispose to rupture and need to correct both conditions surgically.
The cranial cruciate rupture is not limited to large breed dogs. Small dogs can certainly rupture their ligaments as well and, while arthritis is slower to set in when the patient is not as heavy, there is an association with cruciate rupture and medial luxating patella that is very common in small breed dogs. With the patellar luxation, the kneecap flips in and out of the patellar groove. If the condition is relatively mild, it may not require surgical correction but it does stress the cranial cruciate ligament and can predispose to rupture and need to correct both conditions surgically.

What Happens if the Cruciate Rupture is Not Surgically Repaired
Radiographs by MarVistaVet
Without an intact cruciate ligament, the knee is unstable. Wear between the bones and meniscal cartilage becomes abnormal and the joint begins to develop degenerative changes. Bone spurs called osteophytes develop resulting in chronic pain and loss of joint motion. This process can be arrested or slowed by surgery but cannot be reversed.
  • Osteophytes are evident as soon as 1 to 3 weeks after the rupture in some patients. This kind of joint disease is substantially more difficult for a large breed dog to bear, though all dogs will ultimately show degenerative changes. Typically, after several weeks from the time of the acute injury, the dog may appear to get better but is not likely to become permanently normal.
  • In one study, a group of dogs was studied for 6 months after cruciate rupture. At the end of 6 months, 85% of dogs less than 30 pounds of body weight had regained near normal or improved function while only 19% of dogs over 30 pounds had regained near normal function. Both groups of dogs required at least 4 months to show maximum improvement.
What Happens in Surgical Repair?
There are three different surgical repair techniques commonly used, and a fourth method that has fallen out of favor in recent years.
Extracapsular Repair
This procedure represents the traditional surgical repair for the cruciate rupture. It can be performed without specialized equipment and is far less invasive than the newer procedures described below. First, the knee joint is opened and inspected. The torn or partly torn cruciate ligament is removed. Any bone spurs of significant size are bitten away with an instrument called a rongeur. If the meniscus is torn, the damaged portion is removed. A large, strong suture is passed around the fabella behind the knee and through a hole drilled in the front of the tibia. This tightens the joint to prevent the drawer motion, effectively taking over the job of the cruciate ligament.
  • Typically, the dog may carry the leg up for a good two weeks after surgery but will increase knee use over the next 2 months eventually returning to normal.
  • Typically, the dog will require 8 to 12 weeks of exercise restriction after surgery (no running, outside on a leash only including the backyard.
  • The suture placed will break 2 to 12 months after surgery and the dog's own healed tissue will hold the knee.
Tibial Plateau Leveling Osteotomy (TPLO)This procedure uses a fresh approach to the biomechanics of the knee joint and was developed with larger breed dogs in mind. The idea is to change the angle at which the femur bears weight on the flat "plateau" of the tibia. The tibia is cut and rotated in such a way that the natural weight-bearing of the dog actually stabilizes the knee joint. As before the knee joint still must be opened and damaged meniscus removed. The cruciate ligament remnants may or may not be removed depending on the degree of damage.
This surgery is complex and involves special training in this specific technique. Many radiographs are necessary to calculate the angle of the osteotomy (the cut in the tibia). This procedure typically costs substantially more than the extracapsular repair as it is more invasive to the joint.
  • Typically, most dogs are touching their toes to the ground by 10 days after surgery although it can take up to 3 weeks.
  • As with other techniques, 8-12 weeks of exercise restriction are needed.
  • Full function is generally achieved 3 to 4 months after surgery and the dog may return to normal activity.
Tibial Tuberosity Advancement (TTA)
The TTA similarly uses the biomechanics of the knee to create stability though this procedure changes the angle of the patellar ligament. This is done by cutting and repositioning the tibial crest where the patellar ligament attaches and implanting a titanium or steel "cage," "fork," and plate as well as bone grafts to stabilize the new angle. Like the TPLO, bone is cut, special equipment is needed including metal implant plates. Similar recoveries are seen relative to the TPLO.
Which Procedure is Better?
The TTA and TPLO are much more invasive, much more expensive, and require special equipment and specially trained personnel. They have greater potential for complication. Are they worth it? For dogs under 45 lbs, it generally accepted that there is no clear advantage of the newer procedures over extra capsular repair. For larger dogs, there is great controversy. For all the theory behind TPLO and TTA, results one year post-operative seem to be the same regardless of which of the three procedures the dog had performed. There is some evidence that recovery to normal function may be faster with the newer procedures. Controversy continues and there are strong opinions favoring each of the three procedures. Discuss options with your veterinarian in order to decide.
General Rehabilitation after Surgery
Rehabilitation following the extracapsular repair method can begin as soon as the pet goes home. The area can be chilled with a padded ice pack for 10 minutes a couple times daily. (Do not try to make up for a skipped treatment by icing the area longer; prolonged cold exposure can cause injury.) Passive range of motion exercise where the knee is gently flexed and extended can also help. It is important not to induce pain when moving the limb. Let the patient guide you. Avoid twisting the leg. After the stitches or staples are out (or after the skin has healed in about 10 to 14 days), water treadmill exercise can be used if a facility is available. This requires strict observation and, if possible, the patient should wear a life jacket. Rehabilitation for patients with intracapsular repair is similar but slower in progression.
Rehabilitation after TPLO or TTA is gentler. Icing as above and rest are the main modes of therapy. After 3 to 4 weeks, an increase in light activity can be introduced. A water treadmill is helpful. No jumping, running or stair-climbing is allowed at first. Expect the osteotomy site to require a good 6 weeks to heal.
What if the Rupture Isn't Discovered for Years and Joint Disease is Already Advanced?
A dog with arthritis pain from an old cruciate rupture may still benefit from a TPLO surgery and possibly from the TTA. Ask your veterinarian if it may be worth having a surgery specialist take a look at the knee. Most cases must make do with medical management. Visit our section on arthritis treatment.
Meniscal Injury
We mentioned the menisci as part of the knee joint. The bones of all joints are capped with cartilage so as provide a slippery surface where the bones contact each other (if the bones contact each other without cartilage, they grind each other down). In addition to these cartilage caps, the stifle joint has two blocks of cartilage in-between the bones. These blocks are called the menisci and serve to distribute approximately 65% of the compressive load delivered to the knee. The only other joint with a meniscus is the jaw (tempero-mandibular joint).
When the crucial ligament ruptures, the medial (on the inner side of the knee) meniscus frequently tears and must either be removed, partly removed, or ideally repaired. This is generally done at the time of cruciate ligament surgery and we would be remiss not to mention it.
Pets with meniscal damage may have an audible clicking sound when they walk or when the knee is examined, but for a definitive diagnosis the menisci must actually be inspected during surgery. It is difficult to access the menisci and thus repairing a tear in the meniscus is problematic; furthermore, poor blood supply to the menisci also makes good healing less likely. For these reasons, removal of the damaged portion of the meniscus is the most common surgical choice. This leaves some meniscus behind to distribute the compression load on the knee but removes the painful, ineffective portion.
Areas of current research include techniques to improve blood supply to the healing meniscus so that repair can be more feasible. If meniscal damage has occurred in a cruciate rupture, arthritis is inevitable and surgery should be considered a palliative procedure.
Enhancing Recovery after Surgery
ConfinementEnhancing recovery post-operatively is largely about strict confinement early. This cannot be over-emphasized. Be prepared to crate your dog our employ a pen such as a child's playpen depending on the dog's size. A corral of sorts can be constructed with boxes and a baby gate. Be sure you understand the instructions with regard to gradual return to exercise over several months.
Adequan Injections
A series of Adequan injections can help with joint inflammation as well as lubrication. Typically injections are given twice a week for a total of eight injections.
GlucosamineOral joint supplements such as glucosamine contain cartilage building blocks to help the body repair cartilage damage. This is an excellent time to begin supplementation and there are numerous brands.
Weight ManagementOverweight dogs have an increased risk for arthritis and for cruciate rupture. A weight management program can reduce the potential for arthritis and can reduce the risk of rupture of the opposite cruciate ligament. If your dog is overweight, ask your vet about a weight management plan that might be started during the recovery period.
Professional Rehab/Physical TherapyNothing compares to professional rehab for return to function. If you are lucky enough to have such a facility in your area, consider utilizing their services. A list of home exercises may be obtained and/or the dog can visit weekly or a few times weekly for exercise and treatment. Some facilities allow the dog to board and have daily treatment. Ask your vet about this option.

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Gross and Dangerous: TICKS! - 06/13/2018


If I say tick, most people’s immediate response is something along the lines of eww, or yuck, or gross.  They are truly disgusting, and we have been seeing a lot of them on both dogs and cats in the office this spring.  It appears that although the weatherman cannot predict whether or not it will rain in the next hour accurately, the parasitologists have hit the nail on the head with their prediction of a bad tick season this year. And, unfortunately, the cool, damp spring is not helping matters any.

Most pet owners are worried about Lyme disease and with good reason.  The incidence of infection with Borrelia Burgdorferi, the bacteria that causes Lyme disease is way up this year in our area.  While Lyme Disease is an important problem for dogs and their owners, there are many other tick borne diseases that we need to be concerned about.  Different ticks carry different parasites and we have seen spikes in positive tests for Anaplasma and Ehrlichiosis as well as Lyme disease this spring.

Along with emerging diseases spread by ticks, we are seeing changes in the species of ticks that we are seeing in our area.  Lone Star Ticks, named for the single white spot on the back of the bug (not for the state of Texas) are emerging as a problem, especially out east.  They are problematic because many tick preventions are not as effective against this species as one would like. They also spread diseases like Tularemia and Human monocytotrophic ehrlichiosis.  If that’s not bad enough, they also can cause a serious and sometimes lifetime allergic reaction to red meat.  That’s right, as bizarre as it sounds, a protein in the saliva of the Lone Star Tick can cause it’s bite victims to become allergic to all red meat. 

  A new species of east Asian tick has raised it’s ugly head in New Jersey and we are girding ourselves for it’s appearance on Long Island in the near future.

So, what can we do to keep ourselves and out pets safe? 

Prevention:  

Stay out of tall grass when possible.  Treat your yards if you are in high tick areas.  Use an effective tick control product.  We recommend Simperica oral chews or Seresto collars for our pets.  Pyrethrin treated clothing for humans.

Detection:  

Ticks need to attach for a period of time to spread disease.  Check your pets and yourselves daily for ticks.  A useful tool is a tape lint roller up and down your pet after it comes in.  Ticks will stick to the tape.  If you find an attached tick, gentle traction with a small tweezer, close to the skin will get the tick to release.  Do not crush it with your fingers.  If you need it identified, put it in a plastic baggie and bring it to your veterinarian.


Testing:

  Have your dog tested regularly for tick borne diseases.  It’s a simple blood test.

Vaccination:  

We have effective vaccinations against Lyme disease, the most common tick transmitted disease in our area.  If your pet is at risk, vaccination is imperative.

We have a special program for testing, vaccination, and prevention with discounts and manufacturer rebates.



H3N2 Dog Flu and You - 05/11/2018



Canine Influenza Virus (CIV) has been a cause of canine cough in the US since 2003.  The original strain of the virus was first seen in racing Greyhound kennels and rapidly spread throughout the country and is now endemic to many states including Colorado, Florida, Pennsylvania, New Jersey and New York.  The original strain of CIV is s subtype of an Influenza A virus, identified by it’s protein receptors as H3N8.  It causes a dry hacking cough, similar but more serious than that associated with Bordetella, the bacteria that causes Kennel Cough.  It is easily spread through direct contact, nasal aerosols (think coughing and sneezing), and fomites (objects and clothing that has been sneezed or coughed on).  Since it was a new virus on the block, all dogs were susceptible to infection, there was no immunity.  A vaccine was quickly developed and we were able to control infection in our pet populations.

The game changed again in 2015 with the appearance of a new strain of the virus, H3N2 CIV.  Unlike human influenza viruses, this was not simply an annual mutation of the virus but an entirely new strain.  The H3N8 is still around.  Originally appearing in the Midwest, H3N2 has since started to spread.  We monitored the spread of the outbreaks (somewhat more severe than the original CIV infections) and since there was no spike in cases in our area, we did not change our vaccine protocols. However, an outbreak of H3N2 CIV has been identified just last week in Brooklyn and so now we are trying to get the word out to dog owners so that they can protect their pets.

While flu season in people is winding down, dog flu season is just getting started.  That’s because the risk factors increase as the weather gets warmer.  We see increased exposure for dogs that go to boarding, day care, dog runs, grooming, social groups, or now, go into Brooklyn and they need to be protected against this virus.

What does this mean for your dog?  If your pet has any of the above risk factors, we recommend vaccination against both strains of CIV.  An initial series of 2 vaccinations is followed by annual boosters.  If you are anticiapating a high risk situation (boarding for example) the series should be completed at least 2 weeks prior to potential exposure.  If your dog has had the H3N8 vaccine, it just needs the new vaccine.  If it has not had a flu vaccine in the past, it will need to be vaccinated against both strains, which can be done at the same time.

We will be setting up some clinic times for flu shots so that we can keep the cost down for owners.  Patients of ours that have been seen in the past 6 months and have no health issues can just receive the flu shots without and examination or office call fee.  If your dog is not a patient of ours, we will perform a courtesy examination during clinic hours to make sure that it is healthy enough to vaccinate before we administer the vaccines. 

Details for vaccination clinics will be posted on our facebook page so keep an eye out.  We will also be reaching out to our clients via text or e mail to let you know when the clinic hours will be available.




The Results Are In! - 04/23/2018


Our April 12th Free Pee Jubilee was a huge success! Thanks to all our clients who had the messy job of catching the urine, our staff for processing all those samples, and Stanley the Sedivue for analyzing all of them. Amidst the dozens of pee jokes all day, Stanley tested 58 samples of urine, which means we learned more about 58 dogs (sorry, nobody managed to collect any cat urine!) that day. By evaluating urine, we can screen for lots of diseases and possibly prevent some life threatening ones. Out of these 58 samples, we found abnormalities in 28 of them! We found 10 urinary tract infections, 10 with crystals, 9 with an abnormal pH. And, except for one known diabetic, all of those dogs were clinically normal; the owners were not expecting to hear anything was wrong with the urine.





This result surprised us as well and confirmed our belief that something as simple as a urine sample can give us so much insight into our pets' health. Since our pets are very good at hiding illness, we all learned that getting that small sample can help us provide better health care for our patients. So the next time we ask you to bring in a sample, please try to get one, it could make a huge difference to your pet!

Dr. Sandra Wu

 

 

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Tuesday 8:30am 6:30pm
Wednesday 8:30am 6:30pm
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**Hours can vary slightly due to circumstances beyond our control.  Please call first to confirm.

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