Oasis Animal Clinic is committed to providing you with compassionate, caring and convenient service
We place a special emphasis on Senior Pet
There are many medical problems in pets that we commonly treat. What is very familiar to us may be very unique to our clients. Below are some of the questions we frequently hear followed by the best answers we can give without knowing all the specific details. Remember that every situation is slightly different and may require a professional examination in order to make a proper recommendation.
Q. Why do I have to bring my pet in to get a refill on medications?
A client calls the clinic requesting a refill on ear medication that was dispensed by Oasis Animal Clinic one year ago. The dog has the “exact same symptoms” and the owner wants to stop by and get the medication and treat the ears again. If the pet doesn’t get better in a week, they promise to bring him in.
They are told that we must see the pet again to see if the condition is the same. And yes, there is a Professional Exam involved and there will be charges.
A. The first “rule” of medicine is “Above all, do no harm.” To Oasis Animal Clinic this means that we are responsible to make sure that every pet is getting the best care possible. Part of our treatment plan usually involves dispensing prescription medicine. Because they are “prescription”, they generally have specific uses and actions that require supervision and evaluation of the progress. Most medications also have side effects. A prescribed therapy should result in a “cure” or improvement in symptoms so that the need for the drug should decrease. Generally, if a refill is requested, it means that the medication did not give the desired result or a new condition has arisen.
Some chronic conditions are not curable, but are treated continuously or intermittently for the remainder of a pet’s life. Epilepsy, thyroid disease, arthritis, allergies and heart conditions are examples of this. These pets will require medications for the rest of their lives.
The law requires, and good medicine dictates that we have a CURRENT, personal knowledge of a condition in order to prescribe a drug. This means that we have to have seen the pet for the specific disease we are treating within the past 3 months, in order to be “current” about the care of that pet. Most clients understand this and are happy to schedule an appointment.
So, the bottom line is that we must see and reevaluate pets regularly in order to properly treat conditions. If we were to refill medications without seeing the pet recently for that condition, we would run the risk of misdiagnosing and mistreating the disease, overlooking the pet’s improvement and breaking the law that governs the practice of Veterinary Medicine in Arizona. We do have policies in place for chronic conditions like those listed above, whereby we can refill medications for a long period of time without rechecks. But even those conditions may require repeated blood work to assure that the body is handling the medications without developing adverse reactions.
Perhaps the most preventable disease with serious long-term effects in pets is dental disease. Yet many pets never have their teeth cleaned at any time during their entire lives.
Why is this vital service so often neglected?
Cost?
Ignorance on the part of the owner?
Fear of the anesthesia that a pet must undergo to do this procedure in a safe and proper manner?
Below we discuss the following:
Why is Dental Disease so common?
Prevention
Diagnosis
Treatment
Is Anesthesia Risky?
What are the other "Serious Health Consequences" of Dental Disease?
How often should my pet have his teeth cleaned?
Why do dogs and cats get dental disease so easily?
Try to imagine what your mouth would be like if you never brushed your teeth, but were given an animal cracker from time to time, to "clean your teeth". At first, you would notice the bad taste developing in your mouth, but in time you would have a major infection going. This is what happens in the mouths of our "best friends".
Plaque, a combination of bacteria, saliva and food particles, forms in pets' mouths every time they eat. Over time, the minerals, bacteria and saliva form a hard substance known as dental calculus.
The bacteria continue to invade the tissue around the teeth and gums, resulting in erosion of the gum line and loosening of the tissues that support the teeth.
No breed of dogs is exempt from getting dental disease, but it seems small breeds have more serious health consequences from dental neglect.
How do we prevent and treat dental disease?
Prevention
Prevention is the key to long-term oral hygiene. Brushing and rinsing the mouth with the proper products is essential. In addition, Hill's has pioneered a special food, TD, that we generally recommend be used as a treat. It has a very unique property of not crumbling when pets bite down on the kibble. It essentially cleans the teeth via a squeegee action, leaving healthy teeth much more free of plaque. It is not effective in pets that already have dental disease. Next time you're in the clinic, please ask for a demonstration of how to properly brush your pet's teeth.
Diagnosis
Dental disease is easy to detect. In fact, many clients notice bad breath early in their pet's life. During the annual physical exam, one of our veterinarians will look in your pet's mouth, around the cheeks and gums to determine if there is an infection that needs to be treated. The first site that heavy tartar and calculus accumulates is usually on the cheek-side of the big, grinding teeth in the back of the mouth. There is a salivary duct that empties right there, and food particles often get lodged there as well.
Treatment
Proper treatment of dental disease requires professional cleaning and polishing of the teeth. This is not to be confused with the service that groomers provide, where they essentially brush the teeth (a waste of time and money if the underlying problem is not being treated). Steps we take at Oasis Animal Clinic to perform a proper dental cleaning are as follows:
Professional examination of the mouth.
Pre-anesthetic blood work to assess kidneys, liver and other parameters of internal health. Yes, this procedure requires general anesthesia, and we therefore do not cut corners in assuring a safe outcome.
Proper monitoring throughout the procedure. We place an internal stethoscope in the throat, adjacent to the heart to listen to the heart rate, rhythm and strength. Other vital signs are monitored as well.
The teeth are each examined, ultrasonically scaled, evaluated for strength of the root and connective system, and polished. The mouth is rinsed with a safe disinfectant and every pet has a tube placed in the trachea (airway) and is sealed to prevent the bacteria and debris from entering the lungs. This procedure can take from 30 to 60 minutes (cleaning alone) and requires dexterity, patience and training.
Isn't anesthesia risky?
Anesthesia is a significant portion of the cost of dental cleaning. Until we can train our patients to gargle, rinse and spit, we will have no other alternative. In addition, most pets that require dental care are older. The need for care and caution is great. That's why we perform a physical exam and pre-anesthetic lab work on all patients prior to performing a dental. In spite of the risks, we have a very good safety record with dental procedures. And consider, avoiding a dental when it is medically necessary creates a risk as well. See below...
What are the Health complications of dental disease?
The same bacteria that live in the mouth of dogs, also thrive on the heart values. In fact, adult onset heart murmurs and cardiac disease often have their origin in dental disease. Gums can be so infected that the pet is literally showered with bacteria every time he eats. Circulating bacteria are often filtered in the kidneys and start infections there as well. In a very real sense, untreated dental disease is a constant, serious and progressive disease that debilitates pets.
How often should my pet have his teeth cleaned?
When we diagnose a dental problem that requires cleaning, we usually recommend that the pet return with 6-12 months for ultrasonic scaling and polishing. We will discuss follow-up care when we perform the dental cleaning.
One of the most common conditions we see at Oasis Animal Clinic is ear infection. Several factors combine to make pets’ ears far more prone to infection than people. Dogs are much worse than cats.
Why do dogs get ear infections?
- Allergies are the main underlying cause of "Otitis Externa" or inflammation of the ear. The allergies cause your dog’s ears to itch, which then leads to self-trauma and more inflammation. The cycle worsens. With more itching and swelling, infection sets in and finally, your poor dog is suffering terrible earaches.
- Moisture is a contributing factor. Ears that have moisture in them for long periods of time will become infected. Moisture can get into ears while swimming, while being bathed or any other time pets are around water.
- The shape of the ear makes a difference. Floppy ears trap moisture inside, incubating bacteria and yeast. That’s why Cocker Spaniels are more prone to infection than German Shepherds.
- Some breeds have excessive hair accumulation in the ear canals, preventing airflow and trapping bacteria, moisture and yeast in the ears.
- Foreign bodies such as foxtails are another serious cause of infections.
- The shape and length of a dog’s ear canal is a major contributing factor to ear infections. Dogs have an "L-shaped" ear canal, with a long horizontal and vertical portion.
- Otitis Externa is related to hypothyroidism (under-functioning thyroid glands) in some dogs.
How do we diagnose an ear infection?
Most clients have made the diagnosis by the time they set the appointment. They see their pet scratching and crying. They see the brown wax exuding from the ear opening. And ear infections stink! We make the exact diagnosis based on several tests:
- Cytology of the ear. This is where we take a "Q-Tip"-like swab and sample the contents of the ear. Under the microscope, we can tell generally if the infection is caused more by bacteria, yeast or both.
- Otoscopic exam. We use the Otoscope to look as far down the ear canal as possible. Sometimes the ear canal is so swollen that we cannot see the ear drum. Other times we find the cause of the problem right in the ear canal. Foreign bodies such as foxtails and even ticks can cause irritation.
- Culture and sensitivity. If we treat an ear infection in the usual manner, and fail to get the expected response, we culture the ear discharge and submit it for bacterial culture and sensitivity. Some organisms are resistant to prevalent antibiotics and anti-fungal medications, so we are forced to find the ones that will work for that pet.
What about sedation?
Many pets are so uncomfortable or the ear canal is so clogged that we must sedate or even anesthetize a pet to safely and comfortably treat an ear infection. Obviously, we don’t want to cause harm or unneeded pain to treat an ear.
What about rechecks?
Ears are especially hard to cure from infections. They are nearly impossible to thoroughly clean. Infections that are under-treated are more prone to set up resistant infections. We therefore recommend that all pets be rechecked every 2 weeks (or more frequently in more severe cases) until the condition is resolved. The charge for the recheck is less than a regular professional exam.
Why can’t I just call for a refill on the medications?
Many clients notice an ear getting bad early and want to re-fill a prescription "…before it gets too bad." When they call, they are sometimes frustrated because we don’t allow the re-fill. Why is that?
- Many, many times the condition has changed slightly and the same medication is not indicated. That is why we repeat the cytology and other tests.
- The laws governing veterinary medicine and pharmacy require that we have CURRENT knowledge of a condition and it is under the immediate care of a veterinarian. This means that we are required to re-evaluate the condition.
Can ear infections be prevented?
Not all ear infections can be prevented. But proper care and cleaning can be very important in reducing the number and severity of infections a pet has. We recommend using a commercial rinse like Oti-Calm to clean ears and prevent infections.
Q. What is Heartworm Disease and is my pet at risk?
A. For years, dogs have been afflicted with a potentially deadly parasite, Dirofilaria immitis, commonly known as Heartworm Disease. It is spread from one dog to another by the bite of an infected mosquito. When the mosquito has fed on an infected dog, it draws tiny larval stages of the parasite, called microfilariae, into its system. Later, when it feeds on the next dog, it injects the microfilariae under the skin. In the course of a few months, the second dog begins to carry the infective larva in its bloodstream and becomes a source of infection to other dogs.
Treatment for Heartworm Disease is very costly and potentially dangerous. In effect, we have to gradually kill the adult heartworms that live in the bloodstream on the right side of the heart. As the Heartworms die they can cause serious complications to the infected dog such as circulatory collapse, anaphylactic shock and death. Left untreated, many dogs succumb to Heartworm Disease.
Fortunately, there is a simple way to prevent your dog from ever getting infected. By giving a single, monthly chewable medication called Heartgard®, the risk of developing Heartworm Disease is extremely low. We can safely assume that young puppies are negative of Heartworm Disease. They can start and stay on the monthly dose of Heartgard® anytime between 4 weeks and 5-6 months. If dogs are over 6 months when an owner first decides to start Heartworm prevention, the dog must first be tested to determine that the disease is not already present. Giving Heartworm preventative to a dog that is already infected with Heartworm Disease is not effective in preventing the disease from progressing in the dog. It may also result in a serious or fatal reaction to the medication!
Luckily, outbreaks of Heartworm Disease are not a common occurrence in Arizona. This is primarily due the fact that we do not have much moisture, and therefore fewer mosquitoes than most areas of the country. The first cases of Heartworm Disease in dogs native to Arizona occurred in the mid-1980’s. In recent years the incidence has increased, due in part to the many pets that have been brought here from other Heartworm-endemic areas. In addition, there are more artificial lakes, which are breeding ground for mosquitoes. The summer of 1999 represented a high mark for Heartworm-positive dogs at Oasis Animal Clinic. In one two-week period, three patients were diagnosed positive.
Intestinal Parasites
There are other benefits to treating pets monthly with Heartgard. The formulation we use also has medication to rid pets of several of the most common intestinal parasites. In fact, intestinal parasites are far more common than Heartworms among the dogs tested at Oasis Animal Clinic. There is also risk of infection of intestinal parasites to humans when in contact with infected dogs.
Q. Why do I have to test my dog prior to starting Heartgard®?
A. When puppies begin taking Heartgard monthly prior to 6 months of age, we permit them to refill the medication for the first year without testing. But after one year, the best and most knowledgeable scientists and researchers strongly recommend that all pets be retested. Occasionally, our clients become frustrated that we recommend retesting when we have been giving assurances that the medication is very effective. No drug is 100% effective, and many times owners think that a pet has eaten a Heartgard® treat, when in fact they may not have done so.
Q. What is the Oasis Animal Clinic Heartgard Assurance Bonus?
A. If a client has had a pet on Heartgard, continuously for the preceding 12 consecutive months, and the Heartgard was purchased from Oasis Animal Clinic, we will provide the annual Heartworm test free of charge! This test is usually over $23.00. In effect, we are rewarding our best clients by reducing a potential obstacle to providing premium health care for our patients. Call the clinic for details.