First, I will mention that Lyme does not have an "s" on the end.  Thus, it is Lyme Disease, not Lymes Disease or Lyme's Disease. 

I think one of the most important things that one should know about Lyme Disease is that the whole subject tends to be very controversial in the Veterinary world, as far as diagnosing, treating, and vaccinating.  It is also important to realize that Veterinary Medicine is not an exact science.  This means that there may not be one right way to do things; or too little is known to be able to determine which way is the best.  So, as Veterinarians, we draw on our experiences as a Doctor, and as a pet owner; and do our due diligence in researching the current journals to see what "they" (the "experts") are recommending.  But, even the experts don't agree!  So, we must come up to our own conclusions.

The major symptom of Lyme disease that I see is limping.  Dogs do not get the "bulls eye" lesion that people get.  Often in the Spring in our area, there are some bugs that bite the belly of dogs, and they get bright red flat circles on the belly.  Those can be mistaken for a "bulls eye".  Contact your Veterinarian if you are concerned about any skin lesions that you see.

The second most common symptom is kidney problems - protein in the urine, or full blown kidney failure. Sometimes, the only thing we will find is protein in the urine on a routine screen,and the pet is asymptomatic.  There are a lot of reasons why a pet can have protein in the urine, besides Lyme.  Your Veterinarian may want to do a urine protein:creatinine ratio on the urine to determine if the protein on the screening test is at a level to be concerned about.  You may notice your pet drinking more, urinating more, losing their appetite, or vomiting if your pet is in Kidney Failure from Lyme.  Confirming that Lyme is the cause of the kidney failure can be difficult, as there are also many causes of Kidney failure.  Lyme disease is fatal when it effects the kidneys.

Their are a couple different tests that can be done for Lyme disease.   I feel that the best test that is available is the Idexx 4DX  for a screening test; and the Lyme C6 for a confirmation test by Idexx.  The C6 can also be used to follow the treatment along.  Do I think the C6  is a perfect comfirmation  test?  Doubtful.  But, I believe it is the best test we have out there.  As I discussed earlier, your Vet may have his/her own experiences and opinions on this. 
Another lab, Antech, recently came out with a similar screening test to the 4DX, but uses a different methodology. 

If your pet has a positive Lyme test, a urine sample should be tested for protein to see if there is any kidney involvement.  Full blood work may also be done to look at the other kidney parameters (BUN and Creatinine, amongst others). 

The most common antibiotic for Lyme disease is 4 weeks of Doxycycline.  Amoxicillin can also be used, but is not generally considered the first antibiotic of choice.

If a Lyme C6 was done before treatment, it will be repeated 6 months after treatment is done.  We look for a 50 % reduction in the C6 level. 

Where does the controversy lie?

First, as previously mentioned, which test is best is controversial. 

Secondly, when a dog tests positive on the Lyme test, it means that the dog has been EXPOSED to Lyme, and has a LYME TITER (antibodies to the Lyme organism).  It does not mean they have Lyme Disease.  In order to have Lyme DISEASE, they have to have a TITER, and SYMPTOMS.

So, should pets with a titer be treated?  Some say they should not because we don't want to build up antibiotic resistance.  Others say they should because it is only a short course of antibiotic; and pets can die within a 2 week period if the Lyme gets into the kidneys. 

Another part of the controversy is whether a pet that has a TITER (positive on the test, thus antibodies to Lyme) should be vaccinated.  Some say that the antibodies that are produced from the exposure to Lyme will protect the pet if they are exposed again.  Others believe that those pets are at greater risk for getting Lyme again, so they should be vaccinated.  If the pet is treated with antibiotic, they would be vaccinated at the end of the 4 week treatment period.

I believe that most Veterinarians now feel comfortable with vaccinating pets at risk in Lyme endemic areas.  But, the Lyme vaccine is not needed for all pets, so it can be controversial as to who to vaccinate.   A small dog that rarely goes out, and never has ticks on them, will likely not get the vaccine.  Cats don't seem to get Lyme Disease. 

Dr. Mazzola has had a pet with Lyme Disease, and can add her own pet experience to aiding her clients in determining what is best for their pets.

This article is meant for information only, and contains Dr. Mazzola's personal experiences and opinions.  Please contact your Veterinarian if you are concerned about Lyme Disease in your dog.

If you have a dog with anxiety for any reason (thunder, fireworks, etc), the Thundershirt may work for him.

Losing a pet can be a difficult thing for adults, as well as children.  I hear many people brush off the importance of a loss of a pet to a child, saying "kids are resilient".  However, when I talk to many adults, they can vividly remember the loss of a pet.  Worse yet, they may be still angry at the lies that their parents told them years and years ago.  One of the biggest non-truths that parents tell their children is that "Fifi went to a farm".  Eventually, all children grow up, and find out that was a lie.  Rather than dealing with the loss in the "here and now", they feel betrayed by their own parents.

So, I would start off by saying to be honest with your child. Tell them that the pet has indeed passed away.

In dealing with death with children, I have found that it is important to let children know that pets die when pets are :
1)  Really, really sick
2)  Really, really hurt
3)  Really, really old

For me, it is important to tell them that the pet is "really, really" sick, etc; so that they don't get nervous every time that another pet is sick; thinking that the pet may die. 


Let them go through all the stages of grieving.

Be empathetic, and listen to them.  You don't have to "solve" their healing.  Just listen to them talk, without trying to "make it all better".  It will get better, if they go through the stages of grieving. 

"Mirror" their feelings, by first listening to them; then recapping what they just said.  This way, they were heard and understood. 

Let them cry, for as long as they need to cry.  Don't stuff the feelings, by trying to coax them to stop crying.  Again, you don't need to solve their pain.  You just need to be their for them. 

It may be a good idea to have a memorial service to celebrate the life of the pet.  You can gather pictures of the pet, and talk about the things that you loved about that pet.  Ask the children if they want to draw pictures of the pet.  Have a candlelight ceremony in honor of the pet.  RainbowBridge.com has a Monday night virtual lighting ceremony, and pet loss support. 

If you need to talk to someone more about pet loss, I would recommend Susan Dowd Stone, a licensed, clinical social worker and an animal companion bereavement specialist and advocate.  You can view her website by going to Pet Loss Help

It can happen to even the best owner: their pet gets loose or gets out of the yard.  Here is what I recommend as the steps to take when you realize that your pet is missing:

1) Call your local police department first. When people find pets, this is often the first place they contact.
2) Call animal control. In our area, the police department will notify animal control
3) Contact Local Shelters.
Rockland: Hi -Tor 845-354-7900
Bergen: RBARI 201-337-5180
               BCAS 201 -229-4600
4) Contact local Veterinarians.
5) Faxing and e-mailing pictures to Shelters and Vets
6) Social Media

As a crucial preventative measure, it is a good idea to have your pet microchipped.  A tiny implant, the size of a piece of rice, is placed under the skin.  This takes as long as giving a vaccination.  The microchip has a number that is registered.  Shelters, Veterinarians, and animal control have readers to red that number that is unique only to your pet.  The registry is called, and the owner is reunited with their pet. 

As with most Veterinary treatments, there is more than one way to do things.  This may even be more true with alternative therapies.  Please see the blog titled "Hypothyroidism" for information about they symptoms.   Here are some suggestions for alternative treatments for hypothyroidism.

1)Armour (Thyroid Tablet USP) – Desiccated thyroid extract, containing T3 and T4 thyroid hormones. This is a suggested conversion from synthetic Thyroxine. 

Armour Thyroid                 Synthetic Thyroxine
Tablets 15 mg (¼ grain)             0.012 mg
Tablets 30 mg (½ grain)             0.035 mg         
Tablets 60 mg (1 grain)              0.075 mg
Tablets 90 mg (1½ grain)            0.1 mg
Tablets 120 mg (2 grain)             0.15 mg
Tablets 180 mg (3 grain)             0.2 mg
Tablets 240 mg (4 grain)             0.3 mg
Tablets 300 mg (5 grain)             0.35 mg  

in "Small Animal Endocrinology", Feldman and Nelson state:
'Crude animal-origin thyroid preparations are not recommended for the treatment of hypothyroidism in dogs. Nevertheless, these preparations have been used successfully. The recommended dosage is 15-20 mg of dessiccated thyroid per kg of body weight once daily (Rosychuk, 1982). Ideally the tablet should be crushed and administered with a small amount of food.'
    

Caution:  Dogs love the taste of Armour, and may ingest the entire bottle.  Keep it in a safe, secure location.    

Armour is expensive.  For example, if you had an 80 pound dog on 0.8mg of Thyroxine, it may cost $0.20-0.30 per tablet; and it could cost $3.00 to $3.50 for the appropriate dose of Armour Thyroid.      

2) Canine Thyroid Support (Standard Process) – thyroid, liver, adrenal, digestive, kidney support.  This can be used to lower the dose of thyroxine.

3) Musculo-skeletal support (Standard Process) – If muscle weakness.  Supports muscles, tendons, nerves, liver, kidney, and adrenal.

4 ) Coenzyme Q10 – strong antioxidant.

5 ) Alpha-lipioic Acid (Naturals) – antioxidant that can also increase the activity of other antioxidants, which is important in thyroiditis.   

6) Chinese Herbs – Hypothyroidism is a Spleen and Kidney Qi and Yang deficiency. 

These are just suggestions, and your Veterinarian can decide on what your specific pet needs, depending on what symptoms you pet is exhibiting.  For example, if you pet is having skin and ear issues, an Essential Fatty Acid may be added. 

Should you feed your cat soup when its stomach is upset?  Well, no, not exactly.  But, just like we need a bland diet of soup and crackers, pets need bland diets when their stomach's are upset.  And, "no", that dry kibble you give you dog and cat is NOT bland.  It may look that way, but it is not the soup and crackers of the pet world. 

These are the instructions that I give to my Veterinary clients for a bland diet when their pet is vomiting or having diarrhea.  Please remember to always check with your Veterinarian, as different recommendations are made depending on what we see on physical exam.  Most notably, when a pet has Pancreatitis, we pull them off of food for a few days and put them on IV fluids.

Bland Diet:
1) If vomiting, pull them off of food and water for a time determined by your Veterinarian (12-24 hours is typical).
2) In cases of diarrhea, we will sometimes pull them off of all food and water for a period of time.  Other times, we just start on the bland diet.
3) For the next 3 days (or until the diarrhea is resolved), do not give any regular food or treats.  Just give the bland diet.
4) Vomiting should resolve quickly.  If it does not, contact your Veterinarian again.
5) DOGS should be given a 50:50 mixture of a carbohydrate and a protein.
Carbs:  sweet potato, rice,  or pasta 
NO SAUCE!!
Protein: boiled chicken, boiled beef, or cottage cheese
6) CATS should be given human baby food (beef, chicken, etc).  I have found that Prairie brand canned chicken only food mixed with Gerber baby rice works like a charm for diarrhea, and they love it. 
7) After the 3 (or more) days of just bland diet, slowly start to reintroduce their regular food.  Take 3 days to switch back to the regular diet.  Each meal, decrease the bland diet, and increase the regular food. 

Your Veterinarian may recommend probiotics, such as pro-pectalin, or Forti-Flora; and antibioitcs to help with the bacterial overgrowth that pet get when they get diarrhea.  Remember, Our House Call Vet can always get the medication compounded into a flavored liquid, especially for those finicky cats.

If your pet is continuing to have symptoms, diagnositc (x-ray, ultrasound, bloodwork, etc) may need to be done;  as well as admitting the pet to the hospital for IV fluids. 

Our House Call Vet hopes that your pet is feeling better soon!!!

 

OK, so I was trying to make it a top 10 list!   But, there are just too many reasons to use a house call Veterinarian.
1)  Less stress for your pet
2)  Less stress for you
3) If you have children, you don't have to pack up the kids and the pet to haul them to an office.
4)  Your kids can play at home, while your pet is seen;  so you don't have to worry about making sure  that they don't get into the sharps container, or inadvertently come into contact with an aggressive dog (or dog owner..haha) at the Vet's office.
5)  Time is money!  If you work from home, you don't have to take time off to sit in a waiting room...sometime for hours.  The only time you stop working is when your pet is seen.  You resume working as soon as the Vet leaves. 
6) Most cats, and some dogs, hate cars. 
7) Some dogs and cats get car sick.
8) Most pets hate the smell of a Vet's office.  This alters their vitals that we check on physical exam and blood work.
9) Almost all cats hate having a big dog's head sniffing at them in a carrier in the waiting room!
10) No worries of your pet catching the current infection that is going around from the waiting room.  After all, other sick dogs and cats are going there.
11)  Geriatric dogs have a hard time getting into the car, and walking on the slippery surfaces at the Vet's office. 
12) Pet's can be humanely put to sleep in their favorite spot with their favorite people.
13) You and your pet get the Veterinarian's undivided attention
14) Elderly, or disabled, clients that are unable to get to the Vet's office can still get quality care for their pet.
15)  You just love convenience!!!

Cynthia Mazzola DVM has been practicing quality Veterinary medicine for over 20 years.  She loves the relationships that she builds with owners and their pets, especially when they are seen in their own home with Our House Call Vet in Rockland NY and Bergen NJ

This is absolutely amazing!

Hypothyroidism (under-active thyroid) in a disease that effects dogs.  Cat's thyroid disease tends to be limited to hyperthryroidism (over-active thyroid).

The thyroid gland controls the metabolic rate of all the organs.  If it is under-active, a dog can have one, or many, of these:
1) act sluggish (lethargic, quiet)
2) slow heart rate
3) have hair loss which is "bilaterally symmetrically" ie. each side of the dog's hair loss pattern matches the other side.  The hair loss is usually along the back of the dog.
4) "rat tail" appearance to the tail. 
5) overweight or obese
6) anemia - low red blood cell count
7) chronic or intermittent ear infections.
8) elevated cholesterol
9) elevated liver enzymes (ALT or SAP)
10) Aggression or other behavior issues
11) Less common manifestations include eye and nervous system diseases; paralysis of the larynx (laryngeal paralysis); or enlarged esophagus (megaesophagus).

As with most diseases, these symptoms may not be just seen with hypothyroidism. Remember, Veterinary Medicine is not an exact science.  For example, allergies, parasites (fleas, scabies, demodex, etc), Cushings (adrenal gland dysfunction), and many other ailments can cause a pet to have hair loss.  Overfeeding can cause a pet to be overweight, etc.

The most common breeds that tend to be prone to Hypothyroidism:
Labrador Retriever
Golden Retriever
Dashchund
Boxer
Cocker Spaniel
Greyhound
English Bulldogs
Great Danes
Doberman Pinscher

There are different tests that can be used to test for hypothyroidism.  There are times when screening tests are done, and confirmation tests need to be added on.  Some pets will have part of the thyroid panel abnormal, but other parts will be normal.  There may be something on screening blood work that may give your Veterinarian reason to believe that you pet may be hypothyroid. For example some enzymes, such as SAP or ALT, and cholesterol may be elevated on the blood work, which could indicate hypothyroidism.So, it is not as simple as just picking one test and having that be abnormal.  Multiple tests may need to be done.  If hypothyroidism is ruled out as a possibility, then your Veterinarian may need to look into other possibilities for your pets symptoms.   

Once a diagnosis is made of hypothyroidism, your pet will be put on medication that they will stay on life-long.  Since each animal is an individual, the dose of the medication may need to be adjusted.  I generally recheck the thyroid level a month after starting the thyroid medication. If it is still low, the dose will be adjusted, and the level rechecked in a month.  If the thyroid level is OK, then the level should be rechecked every 6 months.  Remember, individual variations do exist, so please follow your Veterinarians recommendations.  Most Veterinarians will require that the recheck thyroid levels be tested 4-6 hours after the medication was given.   

If you would like to read more, I recommend Dr. Jean Dodds book, " The Canine Thyroid Epidemic: Answers You Need for Your Dog"

This blog is informative only, and should not be used to replace a Veterinarian's evaluation.  The article included Cynthia Mazzola DVM's opinions based on more than 20 years of practicing Veterinary Medicine.  Remember: there is more than one way to do things, and they could both be correct.