EmmyLou8112014

Fake Medicine Advice From Two Physicians

maxxonladder

Maxxi is SUCH a help when I’m painting. Here, you see him holding the ladder for me. Can’t you just see how much stability he adds?

Drs. Mike Roizen and Mehmet Oz co-write a column that appears in many newspapers around the country. Their posts appear in our regional newspaper, The Sun Herald about four times each week.

Recently they wrote a piece entitled “Beware those fake meds online.” In it, they identified the impetus for these scams, “they’re big business.” Some examples:
• In Britain, 237 people arrested for storing $31 million of phony “meds” scheduled for distribution from 10, 600 websites worldwide. The two doctors say 72% of the fakes were from India, 11% from China.
• The FDA blocked the sale of a “weight loss med,” B-Perfect, contained a pulled-off-the-market, controlled substance called sibutramine and a known carcinogen, phenolphtalein.
• FDA also blocked the sale and distribution of erectile dysfunction (ED) medications, “Full Throttle” and “Hard Up” that contained impure toxins along with the active ingredients found in Viagra and Cialis. If taken with certain medications, such as nitroglycerine, they can lower blood pressure to dangerous levels. ED is common in patients with diabetes, high blood pressure and heart disease, so the combination is not unlikely.
• They also say, “Recently, the FDA shut down 1,677 illegal pharmacy websites that sold fake ‘brand name’ and ‘FDA-approved’ meds that were neither.” They recommend checking www.FDA.gov “to identify dangerous supplements in ‘miraculous’ weight loss, muscle building and sexual enhancement products. Remember, if it looks too good to be true, it probably is.”

If scammers will take advantage of people with people medicines, they will certainly not hesitate to ruin your pet’s life and health.

The good news is that you have a way to check on such products marketed for people. The bad news is, there is no such central clearinghouse for pet products. What’s a pet owner to do? The simple answer is deal with someone you know.

Your veterinarian may have been in his location for years, and he’s likely going nowhere. Veterinarians purchase our medications directly from manufacturers or distributors, so we are confident of the genuine source of the pharmaceuticals, and, if there ever is a problem, you know where to find him. Furthermore, if a problem needs to be addressed, you can look him in the eye as you discuss the event.

Try doing that with an online pharmacy.
See you next week, Dr. Randolph.

Maxx_WillieLR2014

This Year’s Friend-Eddie Donation Story

EddieDonationScooby

Sweet Scooby, diabetic poodle, helped along by Eddie’s annual donation and a ton of love from his owners.

Regular readers will remember that my high school best friend, Eddie, sends a gift each year to be used to help a pet or pets whose owners cannot afford their care. Click here to read the original story. Each year I write about the recipient(s) of Eddie’s largesse.

Here is this year’s story.

It was a Monday, in fact, a week ago today. I was at a regional grocery-store chain, Rouse’s, that is based in Louisiana but has several stores here on the Mississippi Gulf Coast. They have an eat-in/take-out food bar and I try to eat there at least every Monday (and, usually, several other days of the week) because Monday is traditionally Red Beans and Rice Day. The legend goes that the custom started when housewives assigned washday duties to Monday, which took all day. The ladies needed a hearty meal that didn’t take much time to prepare. A pot of white rice could be cooked up quickly. Dried beans could soak all Sunday night, be thrown into a pot to simmer Monday morning, adding onions, sausage and spices, then the dish was on autopilot for the rest of the day while washing went on.

Son of a real Louisiana native, I grew up with red beans and rice in my baby bottle. To this day it remains one of my most favorite meals. Mama served them with sliced bananas with sugar sprinkled on them. With or without the sugar, bananas and red beans and rice have a wonderfully complimentary taste. As a kid I drowned the beans in catsup, too. I can no longer “afford” the calories in the white sugar or the red!

A week ago today I was enjoying my RB&R at Rouse’s when my cell phone rang. Well, it didn’t actually ring, because the clinic’s ringtone is actually a barking dog. Assistant Sicily was on the phone, telling me that another doctor’s office had seen a canine patient, tested its blood sugar and found it to be 344, and was sending the poodle and his owner to us for a diabetes mellitus workup.

Scooby was his name, and he belonged to a local pastor and his mother, both residents of Long Beach. Scooby was pitiful, his once-pretty grey hair dull, mucus draining from his eyes, no appetite and dehydrated. It was going to take a lot of work, and money, to turn Scooby around, but Pastor Jerry was determined that Scooby would make it.

Scooby was in DKA, diabetic ketoacidosis, meaning that in the absence of insulin his body had to convert from metabolizing glucose for energy to burning fats. Ketones are a byproduct of fat metabolism. That meant his condition was particularly worrisome, especially since he had not eaten in two days.

“Proper” treatment of DKA is highly intense and very expensive. We needed to find a way to treat Scooby and provide for as many of his needs as possible while still controlling costs. The good news is that we did, and today Scooby is having his first glucose curve, which shows that he is responding well to treatment. He is mostly eating on his own and is back to running and playing like he used to.

Thanks, in great part, to Eddie’s gift Scooby has a new lease on life.

Pastor Jerry, his mother and I give thanks to God for sharing His healing power, and for Eddie’s love and generosity.

Maxx_Willie

Getting Good Information Online

MaxxInYourFace

Maxx and Willie know they will always be able to obtain the best in health care because their owners don’t trust potentially-unreliable sources of information.

MyPetsDoctor.com has reminded readers many times that 64% of the medical information online is either outdated, or just plain wrong.

Drs. Mike Roizen and Mehmet Oz have recently written pieces in their weekly newspaper column about inaccurate online medical information.

Of Wikipedia, they say, “A new study compared info on Wiki’s medical articles to facts from peer-reviewed medical journals: 90% contained false or misleading information!”

They go on to say, “reviewers spotted mistakes that could lead you to treat yourself incorrectly or pass along faulty info to your doctor.” Wikipedia “often had missing or incorrect info on dosages, interactions and contradictions.”

These physicians recommend using the site of the National Institutes of Health instead (nih.gov). They also endorsed other .gov sites.

For example, I like the Center for Disease Control and Prevention site, cdc.gov.

Because there are many diseases that affect people and pets similarly , a search on one of these reliable sites may lead you to information you can extrapolate to your pet’s health.

You can always have confidence in the information you read on MyPetsDoctor.com, also, because we study thoroughly before posting.  And, if any information we’ve provided previously goes out of date, we remove it from the site.

Ultimately, however, you should discuss your findings with your pet’s doctor before taking any medical steps. He is the expert who can tell you when the information you’ve read is accurate, or inaccurate.

Visit often, Dr. Randolph.

Chinesejerkytreat

Jerky Treats Sicken Humans And Dogs

MaxxWillie

No Chinese treats for Maxx or Willie! No jerky treats for ANY of our patients!

Can you believe it? Pets are still getting sick on jerky treats, despite the widespread dissemination of information about how dangerous they are. Click here to read MyPetsDoctor.com’s original post about jerky treats.

Now, not only have additional pets been injured, some humans foolishly ate the treats and were made ill.

Even after seven years of looking into the problem, the FDA has not been able to determine a cause for the deaths.

However, one child who recently ate the dog goodie was diagnosed with salmonella poisoning.

Two national chain pet stores have promised to remove Chinese treats from their stores, but not immediately.
You can, however, stop buying them immediately.

Pet owners, there are simply too many non-jerky, American-made treats available to take a chance on sickening your dog or cat with jerky, regardless of where it is manufactured.

And, what if it was your toddler who got into the dog’s chewies and was sickened? You would never forgive yourself.

catherinepuppy

Hemangiosarcoma In Dogs

joniface

Golden Retrievers are substantially overrepresented among hemangiosarcoma patients. The Golden Retriever Lifetime Study evaluates them for osteosarcoma as well as hemangiosarcoma.

Hemangiosarcoma (HSA) is a common cancer of dogs, usually occurring beyond middle age and the following breeds are most frequently afflicted: Golden Retrievers, German Shepherds, Portuguese Water Dogs and Skye Terriers.
Hemangiosarcoma is one of the cancers being studied in the Golden Retriever Lifetime Study. Roughly 20% of Golden Retrievers will suffer from hemangiosarcoma in their lifetimes.

Although it is a long word, hemangiosarcoma can be understood by looking at the etymology: “Hemo” is from the Greek haima or haimatos meaning “blood.” “Angio” is from the Greek prefix angeion, meaning “vessel.” “Sarco” comes from the Greek combining form sarcos meaning “flesh” or “body.” Dorland’s Medical Dictionary defines sarcoma as “a tumor made up of a substance like the embryonic connective tissue; tissue composed of closely packed cells embedded in a fibrillar or homogeneous substance. Sarcomas are often highly malignant.”

We often oversimplify the explanation of hemangiosarcoma by saying “it is a tumor composed of blood vessels.” Actually, the body has made an even more serious mistake, because the mass will consist of endothelial cells and a fibrous component. Endothelial is the adjective form of the noun endothelium, which is the lining of the inside of blood vessels. It comes from the Greek prefix endo, meaning “inside,” and thele, meaning “nipple.”

Not surprisingly, endothelial cells arise from the bone marrow, where most red and white blood cells originate. Starting as stromal cells, they differentiate in several stages into cells lining the inside of every blood vessel.

INTERNAL AND EXTERNAL LOCATIONS

HSA typically is found in the spleen, right atrium of the heart and skin. Hidden deep inside the body, it has usually progressed far beyond treatment by the time it is observed.

VISCERAL (INTERNAL) HEMANGIOSARCOMA

Most of these patients expire due to fatal hemorrhage. Because the cancerous endothelial cells are imperfect, they are fragile and subject to failure.

Some patients experience small bleeding episodes, resulting in weakness, fainting and lethargy. If the tumor is in the spleen, the abdomen can swell and contain a large amount of blood with no other signs.

Bleeding from a tumor on the right atrium may fill the pericardium (sac surrounding the heart). If the bleeding volume results in pressure becoming great enough to interfere with cardiac function, the patient may become weak, with low pulse strength and rapid, labored breathing. A larger volume of bleeding may so compress the heart that it is unable to pump, and circulation failure occurs. If the pericardium ruptures and blood escapes into the chest, lungs may be compressed, again resulting in difficult breathing, but with stronger pulses unless a critical volume of blood has escaped.

Stopping an internal bleeding episode is impossible.

There is little to be done therapeutically for visceral hemangiosarcoma patients, as the masses do not lend themselves to surgical removal and frequently will have metastasized to other organs by the time of initial diagnosis.  Chemotherapy can extend lifespan minimally, with median survival time about six months.

CUTANEOUS (SKIN) HEMANGIOSARCOMA

The cutaneous (skin) form can respond to surgical resection, and its tendency to metastasize (spread) has been found in one study to be proportional to its depth in the skin; i.e., deeper lesions are more likely to show up again in the same or a new location.  Chemotherapy is somewhat more helpful in cutaneous hemangiosarcoma compared to the visceral form.

Retersdorfpup

Use Caution At Your Pet’s Doctor’s Office

MatildaMean

When you walk into your pet’s doctor’s office, you never know who or what you might encounter. All dogs must be on a leash or held in the owner’s arms. All cats must be securely in carriers.

PLEASE keep your pet on a leash!

I needed to stop in at a colleague’s office this afternoon on a matter of mutual interest. Parking in front of the clinic, I headed for the front door, where I was greeted through the glass by the cutest little brown dog, about 6 inches high. Barely cracking the door open, I asked her owners, “Do you have a good grip on the leash?”

“Oh! She’s fine,” said the young lady with the dog, at which point she flung the door open, revealing the sweet pup to be totally leashless, not 50 feet from one of the busiest streets in our town.

I cringed.

Earlier, at my own office, I had to warn two pet owners not to let their dogs touch noses, as one had a cough and neither owner knew the temperament of the other person’s dog.

Without a leash or carrier, your pet is vulnerable to attack by a bigger and/or more aggressive dog. Once the fight starts you may be helpless to rescue your pet without a lanyard with which to extract him from the battle.

Or, he might be attacked by an aggressive airborne disease.
When you enter your veterinarian’s hospital, treat every other animal there like a leper. There is nothing to be gained by interaction and potentially much to be lost.
And there is no shame to your pet’s wearing a leash attached to a collar or harness.
It could be a matter of life and death.
MMLEPER

MMLEASH

pooprint

Steps For Spoiled Pets

Oscar Sunny

Oscar in one of his favorite places: Sunning in a window.

This post combines three things I’m passionate about: pets, writing and woodworking (I couldn’t figure out how to include bass fishing). When my Wisconsin pen-pal and fellow worker in wood, Steven Johnson, told me he was building a piece of furniture for his cats, I thought, “Now, there’s a blog post being written for me!”

Steve and I both write for Highland Woodworking’s online magazine about woodworking (more on that below).

You’ve seen Steven’s cats on MyPetsDoctor.com before. Pictured at right is Oscar and at lower left is Dewey.
This is the text of the message Steve sent me recently:

Thought that you being ‘My Pet’s Doctor’ you might enjoy seeing one of the projects I Deweywill be covering in the next Down To Earth Woodworks column… this started as an idea for a simple set of pet steps for my spoiled kitties, then morphed into ‘Oh, it could also have some storage,’ to ‘Oh, it’s going to be in the house so I better make it pretty,’ to ‘If I am going to put doors on it, I might as well put them on both sides so I can orient it either way and still have access,’ to ‘curly maple.’ There’s not much left to say after ‘curly maple.’
“I also figured that it would make a pretty plant stand if someone wanted to build it for that purpose. Do your projects ever get out of hand?

Well, no, I told Steve, because (a) I’m not talented enough for my projects to blossom beyond their basic destiny, and, (b) I don’t have enough woodworking time to let my mind go beyond a specific task. Those are two pretty limiting characteristics.

dtew19

Doesn’t Steve do beautiful work? And his design is proportional and flowing.

At the time of that e-mail Steve already had the project mostly finished, and sent me these photos below:

It occurred to me that other pet-fanciers might also like to build this project, so to read Steve’s post on their construction, click here.

If you would like to subscribe to Highland Woodworking’s free monthly online magazine, click here.

As you probably already figured out, Steve’s column is called Down To Earth Woodworks. Mine is Tips From Sticks-In-The-Mud Woodshop and to see this month’s column you can click here.

dtew20

Here is Oscar checking out the steps for the first time. You can tell by his expression that he’s a little leery. In a short time, however, he will be enjoying the view from every perspective.

If you decide to build Steve’s design, please send photos so that we can see how yours turned out. Be sure to include pictures of your pets enjoying it!  There is an e-mail link at the bottom of my Tips column.
See you next week, Dr. Randolph.

fructosamine

Standard Time Undone

Maxxyawn

Maxx doesn’t like Daylight Saving Time. It makes him sleepy and messes up his schedule.

I gave in.

You may recall that we recently made the decision to leave our Maxx’s automatic feeder on Central Standard Time so that he didn’t have to make the ridiculous adjustment we humans must. (Click here to read it if you missed it.) We made that decision based on the assumption that he could continue to eat when his biological clock told him it was feeding time.

It seemed like a good idea at the time, but it turned out that he keys more on what we are doing than what the clock is saying. He would “forget” to eat at some of the times his feeder was putting groceries in the bowl, but he would stand on my bathroom vanity and look at me when I got dressed in the mornings, because he associated that activity with food appearing in his bowl.

Just add one more clock to adjust this Fall when we “fall back.”
See you next week, Dr. Randolph.

snort

Exocrine Pancreatic Insufficiency In Dogs And Cats

Oscar SunnyLike many mammalian organs, the pancreas is two organs in one. It has an endocrine (hormone) function, producing insulin, which allows cells to utilize glucose for energy. It also has an exocrine (secretive) function, producing enzymes that aid in the breakdown of fat and other major components of food so that they can be absorbed through the intestinal wall, as well as other factors important in digestion and absorption of nutrients.

Famed veterinary gastroenterologist Dr. Jorg M. Steiner defines exocrine pancreatic insufficiency (EPI) as “a syndrome, which is caused by insufficient synthesis and secretion of digestive enzymes by the exocrine portion of the pancreas, leading to insufficient activity of digestive enzymes in the lumen of the small intestine.”

Dogs with EPI seem to be genetically programmed to defective and degenerating acinar cells, the pancreatic cells that are supposed to produce the missing digestive enzymes. The “poster child” of pancreatic acinar atrophy (PAA) is the young to young-adult German Shepherd dog, although the condition occurs in many other breeds, as well.

Cats, on the other hand, follow the path of humans to EPI. Chronic inflammation of the gland, termed pancreatitis, results in scarring and destruction of both enzyme-producing and hormone-producing cells. Thus, the pancreatitis patient may experience both EPI and diabetes mellitus.

Just as we are born with more kidney and liver capability than we need, called reserve function, the exocrine pancreas is similarly endowed with extra. In humans, it is known that about 90% of the exocrine function of the pancreas must be lost before a person exhibits clinical signs of EPI.

Digestive malfunction occurs via two mechanisms. The first is that pancreatic enzymes are necessary for efficient breakdown of large food molecules. Second, the enzymes are needed to transport nutrients across the wall of the intestine and into lymphatics and the bloodstream.

CLINICAL FINDINGS

One result is that the EPI patient will have an unusually-large stool volume, as well as a particularly bad stool odor due to undigested food components, especially fat. In addition, weight loss is common because of nutrient loss. Bacteria thrive on the excess nutrients in the GI tract and overgrowth of those bacteria is a common finding. Failure to absorb vitamins, such as B12 and folate, can lead to other nutritional deficiencies.

DIAGNOSIS

Definitive diagnosis comes from a blood sample. Cats and dogs have separate tests for serum trypsin-like immunoreactivity (cTLI and fTLI). Readings below a known specific level in the bloodstream diagnose EPI with reliability.

TREATMENT

Enzyme replacement is the treatment of choice in dogs, cats and people. Commercially-available extracts of the pancreases of cattle and swine can be mixed with meals and greatly improve the digestive-tract status of most EPI patients. Products available for pets include Viokase® and Pancrezyme®, among others. Dr. Steiner says, “The clinical impression in dogs and cats that powder is more effective than tablets, capsules, and especially enteric-coated products has also been substantiated in human patients with EPI.” Your veterinarian will give you a starting dose, which may require adjustment as therapy proceeds.

Food should be thoroughly mixed with enzymes before feeding. Dr. Steiner opines that preincubation of the food with enzymes is unnecessary.

Food choice is important, also. Certain forms of fiber interfere with pancreatic enzyme function. Foods should be low in insoluble or non-fermentable fiber. Your veterinarian can help you choose the best food for your pet’s total needs.
Rarely, some dogs may experience oral bleeding when eating food treated with enzymes. A slight reduction in the dosage and moistening the food usually resolves that problem.

If fat absorption is insufficient in the face of proper enzyme administration, an oral antacid may be prescribed by your pet’s doctor. Doing so may raise the pH of stomach acid and reduce gastric destruction of lipase in the supplement.
Vitamin B12 (cobalamin) and folate (the ester form of folic acid, vitamin B9) may be deficient in EPI patients. Therefore, blood levels of these nutrients must be measured on a regular and recurring basis.

Dr. Steiner reminds us that patients failing to respond may be suffering from intestinal bacterial overgrowth, concurrent inflammatory bowel disease (especially cats) or other gastrointestinal maladies.
See you next week, Dr. Randolph.

MMEPI