Healthy Pet Blog

Crawford Dog and Cat Hospital

2135 Jericho Turnpike
Garden City Park, NY 11040


A complete archive of all of our blog posts can be found at Healthy Pet Blog

Spring Is Here and So Are the Ticks - 05/08/2019

Spring is officially here.  How can I tell?  Well, first off, my car is coated in a yellow powder from all of the tree pollen. The sky is finally blue and the air is warm enough for me to go running without donning 57 layers of clothing. Days are longer, and, oh yeah, I am seeing dogs and cats with ticks almost everyday in the office.

Now, ticks alone are gross enough but these blood sucking parasites also spread diseases.  Some you have heard of like Lyme disease and Rocky Mountain Spotted Fever.  Others, such as anaplasma, ehrlichia, and tick paralysis (yes, it is a real thing), may not be as familiar.  Do to a second mild winter in a row, we are expecting a bumper crop of ticks, and so, a bad season for tick borne diseases.  Quick side note, epidemiologists have a really cool way of predicting the incidence of Lyme disease.  You see, the deer tick that carries Lyme disease actually spends part of it’s life on a mouse.  When we have a good acorn crop, the mice have lots to eat.  When the mice are well fed, well, mice will be mice, we get a lot of mice.  A population increase in mice mean more hosts for deer ticks, and subsequently, a bad tick and Lyme season.  You’ve probably guessed it, great year to be in acorns for the second or third year running and we are expecting another bad year for Lyme disease infections in our pets.

How can you keep your pets safe?  The first leg of the protection platform is to detect and remove ticks before they can attach and transmit disease.  It takes about 48 hours for a tick to infect your dog with Borrelia burgdorferi, the bacteria that causes Lyme disease.  A useful hint is to run a lint roller over your dog whenever you suspect that there has been a potential tick exposure.  The little buggers will stick to the lint roller.  The second leg is to use an effective tick control product to kill those ticks that you didn’t catch with the lint roller.  We recommend an oral monthly product such as Simperica or a 6 month Seresto Collar.  (Bella wears a collar).  Please be aware, there are counterfeit products out there, we saw a counterfeit collar brought in by a client that purchased it on line last week.  Check out our Facebook or Instagram pages to see a picture.  Finally, vaccinate your dog against Lyme disease.  There are no vaccines against the other tick borne disease, but Lyme is the most common in our area and vaccination is an important component of disease prevention.

In cooperation with Zoetis Animal Health, we have put together a special package to help you protect your dog.  If you vaccinate your pet and purchase a years worth of Simperica oral flea and tick control product from us, we will discount the package 10%, offer a manufacturers rebate for the Simperica purchase (total rebate varies according to their current program), and Zoetis will offer a $7500 insurance policy towards treating your dog for Lyme disease should it become infected.  Details are on our web page and this package is a great way to save some money while using the best technology currently available to protect your pet.

Oh, did you think I forgot about your cat?  While felines are less susceptible to Lyme disease than dogs, they can get other flea or tick borne disease.  Protect them with a Seresto Collar or a monthly topical application of the new Revolution Plus which will protect them from heartworm, intestinal worms, fleas and ticks with an all in one treatment.

- 04/22/2019


Dr. Stephanie Waters

What to do if you pet has a seizure:

Some of the common signs that your animal is having a seizure include twitching of the eyelids/lips/body, abnormal leg movements (often can be stiff but can be flaccid), chatter of the teeth and decreased consciousness. Other common signs may include your pet may defecate, urinate, salivate (drooling), vomit or have diarrhea. Seizures may feel like they last forever, but in reality they commonly last a few second to minutes. If your pet is having a seizure lasting more than a few minutes, they should immediately be taken to the veterinary emergency clinic for further care and treatment.

What to do during a seizure?

Make sure you stay calm. Seizures can be very scary for both owners and their loving pets. This is not a time to panic but instead be proactive by making sure your pet is in a safe place. You can use towels or pillows to protect or move your pets’ head and also to keep him/her steady without falling off the couch or stairs. During a seizure, owners can lower the lights or cover your pets eyes with a small towel or blanket. The decrease in stimulation can be calming to your pet as they come out of the seizure. If possible, record a video to show your veterinarian.

What NOT to do during a seizure?

While in a disoriented and confused state, your pet can accidentally act aggressively and bite. It is important to not pick up or put your hands/face, other family pets or young children near your pet while they are have a seizure. Safety for everyone is the main goal of getting through a seizure successfully.

What to do after a seizure?

After a seizure it is important to continue to monitor your pet. They may have a post seizure phase that can involve them being very sleepy, confused and/or show signs that lead into another seizure. Another task would be to think back and record any triggers or clinical signs that may have occurred before your pet had the seizure. It is also a good idea to record; the date, time, clinical signs, how long the seizure lasted and how many seizures occurred. Lastly, please contact your veterinarian to discuss details/questions and schedule a vet visit. It is important to discuss these details with a medical professional in order to help figure out the cause of the seizure and ultimately to avoid any future seizures. Your veterinarian may recommend diagnostic testing to try to find a cause for the seizure and medication to help prevent future seizures.

Is your Pet Afraid? - 04/04/2019

One of our greatest challenges in the office is dealing with fearful pets.  It makes it harder to do a complete and thorough examination, can change lab values for blood tests, and is a horrible stress on the pet and the owner.

As many of you know, Dr. Stephanie Waters has been certified as a Fear Free Veterinarian. She has taken post graduate education to help her help your pets have better experiences both at home and in the office.  We have seen many pets show great progress with some of the techniques that she has brought to our office.

There is an upcoming event that she will be attending and as a public service, wants to share with pet owners. While we are not presenting or sponsoring this event, she will be attending and hopes to see owners with fearful pets there.  So, if  you are available and the subject matter will help you, please consider attending.  Look for her and say hello.  Hopefully, she won't be dressed like this.

Do you have or know a fearful, shy or aggressive dog? Please read below for an overview of an upcoming event that may be life changing for you and your family! Dr. Waters will also be attending this event because she knows learning new techniques and ideas can be very helpful with her fearful dog Revit Waters.
With Debbie Jacobs, CPDT-KA, CAP2
Saturday, June 22nd 2019 -- 9:00am - 4:00pm
Hilton Garden Inn, Roslyn, NY 11050
Author of A Guide To Living With & Training a Fearful Dog and Does My Dog Need Prozac? and creator of and the Fearful Dog Facebook group
This seminar will feature information about why dogs behave the way they do and the most effective and humane ways to change problem behaviors in dogs. Pet owners, shelter and kennel staff, groomers, veterinarians and technician, dog trainers, pet sitters, day care staff, and anyone else interested in dogs will find this an informative and enlightening seminar on dog behavior!
Seminar Outline:
The content in this presentation is based on the scientific study and research of animal behavior and how dogs learn. This information is the foundation for further and continuing learning about working with fearful dogs.
    Topics include:
-         Why dogs are afraid
-         What fear/stress looks like and its impact on behavior
-         How to interact with feral or unsocialized dogs
-         How to work with fear based behaviors
-         The use of play in the rehabilitation of fearful dogs
-         Understanding the effects of reinforcement & punishment on fearful dogs
-         What is learned helplessness?
-         Myth of reinforcing fear
-         Equipment
-         Medication
-         Other resources
-         Gradual exposure and counterconditioning
-         Managing environments for fearful dogs
-         Skill building exercises for fearful dogs
-         Question and Answer session

“Many of the problem Behaviors we see in dogs, including aggression, have their own roots in fear,” Jacob explains, “When people learn how to respond appropriately to their dog’s behavior we can see significant and long lasting improvements.”

Organizer Description:

This event is hosted by Dana Seyfriend & Next Generation Dog Training, Long Island NY. Dana is a Pat Miller Level 1 Academy graduate and a Pat Miller Affiliate trainer. Two of her household of five dogs are fearful dogs. They inspire and motivate her as a trainer, and are her teachers of empathy and compassion towards all who live and work with fearful dogs.
*refreshments and light snacks
* This is a people only event, no dogs please.
Early Bird Special $99.00
Regular Admission $119.00

House Calls. - 03/21/2019

House Calls

I'm going to try to highlight some of the services and events that Crawford Dog and Cat Hospital offers to the pets and their owners in Nassau County and Queens in a series of blog posts.  Today, House Calls.

I have been making house calls on Long Island since 1990. Originally it was all I did, but as the practice grew, I had hospitals that needed my attention.  Now, we are back to a single location and the staff at Crawford Dog and Cat Hospital are on the road almost every day, visiting our patients in the comfort of their own homes.

Who makes house calls?

Many practices claim that they make house calls, but just try to get an appointment.  That's when you'll find out that the one doctor that does go out for home visits is available on alternate Mondays when the moon is full.  At Crawford Dog and Cat Hospital, Drs. Niesenbaum and Waters are on the road most weekdays.  We are fortunate that Dr. Wu is available to hold down the fort back at the office so that one of us can usually sneak out.  Now, that doesn't mean that we are available for emergency calls, we just can't always fit those in.  However, if you do have an emergency, John and Hector will jump in our ambulance for pet transport and bring your pet to us.  We can almost always accommodate an emergency pick up.  Our technicians, Kim, Miriam, and Ellie are also on the road, doing blood draws, nail trims and laser therapy along with other outpatient services.

Who uses our house call service?

Lot's of people prefer to have us come to the home to help with their pet's veterinary care.  Many of our senior owners have difficulty transporting their pets to our office.  People with multiple pets will often find it easier to have us come out and see everyone in one visit, rather that ferrying pets back and forth to the office.  Cats especially appreciate not being put in a carrier for transport and prefer the comfort of their own couch for veterinary visits. Older pets have difficulty getting into the car and are more comfortable in their own beds at home.

What services are available in the home?

Our doctors can perform most outpatient services in the comfort of your home.  Examinations, vaccinations, blood tests, physical therapy, and even needle biopsies and skin cytologies can be done without a trip into the office.  Dr. Waters has a special gift when working with anxious pets as she is fear free certified and has a whole bag of tricks to put you and your pet at ease.  And of course, when the discussion turns to end of life care, our staff can offer palliative care programs to keep your pet comfortable until it is time for them to part.  We offer compassionate euthanasia services at home so that you don't have the stress of taking your pet out of the home for that final trip to the vet.  We can make whatever arraignments that you want for care of the body, including holding your pet for burial, individual cremation with the remains returned to you, or group cremation. 

How do you schedule a house call?

That's the easy part.  You can call our office at 516 746-1566. Or, request a house call by using our on line form.  Someone will get back to you to confirm the appointment. So, if the stress or inconvenience of a trip to the vet is keeping you from making sure that your furry friend is healthy, give a house call a try.  Remember, keep the light on for us.

Musings From Our Newest Veterinarian - 01/02/2019

Dr. Robin Sturtz

As the newest member of the Crawford family, I’m delighted to have this opportunity to talk a bit about veterinary practice. First, though, I want to thank everyone at Crawford Dog and Cat Hospital: the doctors, the technicians, the assistants, and the staff. They have made me feel welcome and have given me all the support I need. Many thanks!

Although I do love all animals (well, except spiders), I have worked solely with felines since I graduated from veterinary school in 2004. Cats are an endlessly fascinating species. Their personalities vary from calm and people-oriented to very active and….not so people-oriented.

The science of ethology is the study of animal behavior, especially normal behavior in their typical environment. What we learn about this can help us devise ways to work with them in an “abnormal” environment, such as a hospital or clinic. In addition, we can also rely on medications and nutraceuticals (chemicals that are not drugs but can help with certain behavioral or health problems). We use  many supplements, techniques, and sometimes medications, to decrease your cat's stress and make your visit easier. Feel free to call us before your appointment so that we can help make the experience as pleasant as possible for everyone.

We talk a lot about the Human-Animal Bond (HAB, for short). Cave paintings in Lascaux, France, dated to 20,000 years ago, depict animals, not humans. The importance of the animal for food, clothing, and shelter is evident.

 The nature of the relationship we have with domestic animals varies quite a bit from family to family, and even country to country. In many places, animals are used for work, or for play, but are never brought into the house. In some countries, what we think of as companion animals are quite rare, and food animals are of far greater importance.

In the US and many other countries, however, pets are considered as family members. We value their companionship, are fascinated by their behaviors, and do everything we can to make them happy and healthy. What they give us in return is love, and actual health benefits. (and hairballs)
Watching fish swim has been known to cause human blood pressure to decrease. People with dementia, such as patients with Alzheimer’s syndrome, can improve their personal hygiene and communication when they get regular visits from a pet – even as little as half an hour, once a week. Children who have communication issues such as speech and language delay can become more interactive when working or playing with animals. A famous example is the interaction between horses and children on the autism spectrum. In many cases, the HAB is so strong that many homeless people who have pets will refuse to go into a shelter because animals are not allowed. Recognition of these facts is crucial in working with people in these situations.

The fact that you bring your animal companion to the veterinarian shows how strong that bond is. We applaud your caring!

I look forward to meeting everyone, furry and otherwise, as we go along. I am in the clinic on Sundays, for our cat only office hours. Stop by to visit, say hello, or to tour our new feline boarding area.

Have a wonderful new year!      

Fleas, Ticks, and the FDA. - 11/05/2018

We’ve gotten several calls about the FDA press release last month with respect to oral flea and tick control products and adverse effects.  Considering that here we are, well into November and the temperature is still cracking 60 degrees, well above the active temperature minimum zone for parasite activity, I thought that I would address the issue.

Flea and Tick Diseases

First off, I think it is important to realize that ticks and fleas should be a concern beyond the icky factor that bugs crawling on our pets elicit.  These parasites carry diseases.  We know that ticks carry Lyme disease which can infect dogs, cats and us.  But they also carry Ehrlichia, Anaplasma, Rocky Mountain Spotted Fever as well as a host of other diseases.  One tick causes an allergy in people (and possibly pets) to red meat.  That’s right, one bite and say good bye to slow cooked barbecue next summer. Fleas can carry a host of diseases as well including Bartonella (cat scratch disease) as well as typhus, plague, and tularemia. So the question is not should you use flea and tick control, but rather which product is the safest and most effective.

What We Used to do About Fleas and Ticks

Historically, (going way back to ancient history), we used really toxic products, many banned due to their horrific side effects for pets and people.  These sprays, dips and powders killed fleas and mammals.  I think back with a shudder to the summers that I worked in kennels as a student applying organophosphate dips to dogs.  No fleas on them, and no mosquitoes on me. Hopefully, I’ll have no long term ill effects.

A revolution in flea and tick control came about with the release of Frontline.  The active ingredient is Fipronil to kill adult fleas and ticks paired with a growth inhibitor to prevent the immature fleas from developing into adults.  The product was safe for mammals and when applied once a month prevented fleas and ticks from pestering our pets.  It is actually used in agriculture as well to treat food crops.  It was rapidly followed to market by Advantage and Advantix (dogs only) for topical use to prevent flea and tick infestations in our pets. A host of over the counter products made their way to market, some less effective, many more dangerous.  A few years ago, we started to notice that there was resistance developing in the fleas and ticks and these products were starting to lose their effectiveness.

What We Do Now About Fleas and Ticks

Bayer had the next innovation in external parasite control.  The Seresto collar kills fleas and ticks for up to 8 months.  We have found them to be very safe and effective, for both dogs and cats.  The efficacy is diminished by frequent bathing so we recommend changing the collars every 6 months.  This is the product that I use on Bella. 

Many people don’t like the idea of a collar and their cats do not go outdoors.  That does not put them at zero risk for fleas or heartworm, although the chances of picking up a tick is quite low. For these pets we recommend Advantage Multi or Revolution once a month.  This product will safely prevent fleas, heartworm and intestinal parasites.  Combine with the collar for full protection.  We did have a case of feline heartworm this month in a cat that hasn’t been outdoors for over 10 years.  Go figure, mosquitoes can get in the house.

The next round of products to market was for dogs.  Isoxazolines are an oral product that will kill fleas and ticks, some for up to 3 months (although not all ticks and not as well as the monthly products).    These are the products that the FDA released the new warnings about, so let’s talk about that for a bit.  

The FDA 

When a new drug is approved, it must go through thorough testing for both safety and efficacy.  Drugs must be shown to be effective, that’s why we picked the two drugs that we prescribe, Simperica and Credelio, both are very effective over the dosage interval of once a month.  As far as safety, new drugs must be given to a group of animals at the label dose, as well as 3x and 5x the label dose, alone and in combination with other commonly administered medications.  All side effects must be reported.  A single dog, under 6 months of age, had transient neurological side effects at 5x the label dose of Simperica.   Therefore, the FDA granted a label for Simperica for dogs over 6 months of age.  Credelio did not report this side effect so was given a label for dogs over 8 weeks of age.  We are currently following the label recommendations.  Puppies under 6 months old get Credelio, over 6 months we are satisfied with the safety and efficacy of Simperica.  We have had no side effects from either medication in our patients.  Furthermore, when I questioned my colleagues, none have reported any side effects in their patients.  However, there must have been some side effects reported to the FDA, because they are working on adding more information to the labels for all drugs in this class.  Keep in mind, that the current package insert already carries this information where applicable.  Furthermore, if you read the entire press release, beyond the sensational headlines that are springing up all over the internet, you will find that the FDA says that “these products continue to be safe and effective for the majority of animals”, adding that it <the FDA> carefully reviewed studies and other data on Bravecto, Credelio, Nexgard, and Simparica prior to approval. The agency is asking the manufacturers to change product labeling in order to provide veterinarians and pet owners with the information they need to make treatment decisions for each pet on an individual basis.”

We recognize our clients’ concerns for their pets’ safety and continue to monitor studies as they become available.  Not using flea and tick control is not safe either as insect borne diseases are seriously dangerous to our pets and ourselves.  We are striving to provide a balance so that we can keep our pets and families safe.

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,

Print this article  Email this article
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? 


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.


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.


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


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.