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COVID-19 Update

With coronavirus, or COVID-19, dominating the headlines, you may be wondering, “How does this affect me and my pet?” The truth is, there is still a great deal we don’t know about this novel virus. Its origin is still under investigation, and whether pets can actually contract it is still a matter of debate. (There was a case in Hong Kong of a weak positive test in a dog, but according to numerous news sources, pets can carry but are not susceptible to the disease.)

Now that cases of COVID-19 are being reported in the U.S., the main objective is to prevent the disease’s spread, and there are several steps you can take to minimize its impact on your family. Our advice to our pet parent clients is very similar to that of what your primary physician might recommend and closely follows the guidelines put forth by the Center for Disease Control and Prevention:

 

  • Wash your hands often and thoroughly, particularly after touching animals.
  • If at all possible, avoid people who are displaying symptoms of COVID-19. These include coughing, sneezing, and difficulty breathing.
  • If you’re sick, stay home and try to avoid close contact with your pet while you’re symptomatic.
  • Stock up on your pet’s medication. As the disease progresses around the globe, pharmaceuticals may be hard to come by; in the event of a home quarantine situation, you don’t want to run out.
  • As a veterinary hospital, we are considered an essential business and will be here to attend to your pets’ needs. Be open to explore our TeleMedicine services.

 

Bottom line? Plan ahead, be responsible and don’t panic. If you’d like more information about COVID-19 and pets, check out this article from the American Medical Veterinary Association. Keep in mind you’re always welcome to contact us at Worth Street Veterinary Center with questions or concerns.

 

 

-Dr. Francisco DiPolo, DVM, CVA, CCRT

Medical Director & CEO

Curious about CBD and what to get?

CBD is advertised everywhere these days, as the research shows, there is a good reason for that. CBD is considered to be a very powerful molecule with a variety of beneficial medical applications and with a very wide safety profile. In our practice, this product is commonly integrated in the protocols for the management of painful inflammatory conditions like arthritis, epilepsy, and even in the treatment of anxiety.

How do I know what CBD product to purchase?

 

The two most important factors to consider when purchasing any high quality CBD product are the concentration of Cannabidiol in the bottle and the form in which this CBD is presented. Common methods of delivery are through an oil, tincture, edible treats, topical creams, and more. The concentration refers to how powerful, and therefore, cost efficient the particular product is. While the presentation, or method of delivery, will have a more important role on how bioavailable the Cannabidiol (CBD) is once administered to the pet or human.

 

In my personal opinion, any product that has less than 250mg of Cannabidiol (CBD) per bottle will lack the concentration that is required to treat pets in a cost efficient way. In fact, in our practice, we only use products that are concentrated at 750mg per bottle or more. These concentrations allow the use of very small doses, making it not only more cost effective but also easier to administer.

The most common forms of presentation are oils, tinctures, edible treats and topical creams. Since CBD is a lipophilic molecule (meaning that it has a physical affinity to fat/oil), the oil form is the most powerful and bioavailable. This is especially true when absorption happens through the oral or nasal mucosa. The tinctures are absorbed the same way, but they are not as powerful and also lack the terpenes present in the oil form, while edible treats require the digestive absorption making it the least bioavailable. You can learn more about this in this study.                                                                                                               https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6038832

 

CBD oil in particular has the added benefit of other compounds called terpenes. These terpenes are molecules that not only potentiate the effect and absorption of CBD but also have other beneficial effects in the body. Based on this current knowledge and taking into consideration the criteria of bioavailability and cost efficiency, our preferred CBD brand and the one we carry at our practices is Veterinary Botanics, now available for online purchase at vetbotanics.com

 

DR. FRANCISCO DIPOLO, DVM, CVA, CCRT, USDA ACCREDITED

 

Cannabidiol (CBD)

There has been a lot of hype these days about the use of CBD as an adjunctive treatment option for many ailments. This promising molecule is derived from the Hemp plant of the cannabis family and for many decades its use has been regulated under the controlled substances act. However, CBD extracted from the Hemp plant has very little to no THC, which is the compound that causes the psycho-stimulating effects normally attributed to marijuana, and can be legally sold in certain states as long as it contains less that 0.3% of the THC. With the changes in the regulatory environment and the recognition of the potential efficacy of this molecule, there is renewed interest in its scientific study. At the moment there are multiple clinical trials in human and veterinary medicine regarding the multiple applications of this molecule and the results are very promising.

CBD stimulates the endocannabinoid system present in multiple organs of mammals including humans and pets. This system is very active in the process of homeostasis, which consists of returning things to normal function. Since the CBD receptors are present in almost every important organ, the potential benefits of this molecule are extensive. Currently it is commonly used in supporting the treatment of epilepsy, most inflammatory and painful conditions like arthritis, as well as cognitive and other anxiety disorders.

At the moment CBD is not regulated by the FDA. Subsequently, it can be treated as a supplement and can be found in multiple forms such as oils, treats, gummies, creams, etc. This has created a large amount of confusion for consumers who are interested in the benefits of CBD but don’t have the information regarding quality, dosing, better presentation, and possible side effects. This is made worse by the lack of regulation in the supplement industry. A 2015 study found that about 25% of all CBD products tested didn’t have any or enough CBD in them, or have other undesirable elements like heavy metals, pesticides, etc.

Based on the information currently available, the best delivery method for CBD is in oil form, which is extracted by applying CO2 pressure to the plant. This also allows for the extraction of other molecules, called Terpenes, which participate in the general benefits of CBD. These oils are more bioavailable when absorbed by the mucous membranes, therefore the best administration method is by putting it under the tongue.

It seems that most of the current studies about the efficacy are being done with doses that are much higher than the current recommendations for most commercial products, so I believe that we will see some dose adjustments as we learn more from these studies. For this reason, it is important to know the concentration of the oil available for purchase since this varies greatly among producers; the higher the concentration the more cost efficient it becomes.

I am very excited about the potential applications of this molecule in veterinary medicine, and even though I strongly support its use, I don’t think it is a panacea to all diseases as some people claim and feel that your veterinarian should be included in the conversation of when and how to administer this therapeutic option.

Feel free to reach out to us at Worth Street Veterinary Center if you would like to learn more about the applications of CBD or to find out if your pet may benefit from it.

– Dr. Francisco DiPolo, DVM, CVA, CCRT, USDA Accredited

Tips for keeping your pets happy and comfortable during fireworks season.

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With Memorial Day behind us, a summer full of barbecues, bonfires, and fireworks is now upon us. While beautiful to look at, fireworks can pose dangers, both emotional and physical, to our pets. In fact, July 4th tends to be the busiest time of year for animal shelters, who take in run-aways spooked by the large crowds, bright lights, and scary sounds. We often find dogs will “do anything” to escape these frightening and overstimulating nights, including running through windows, screen doors, or attempting to flee wherever they are in search of a calmer environment. Pets that are anxious may display signs of stress including panting, restlessness, trembling, vocalizing, and salivating. Others may act more clingy or attached than usual, whining to jump into their owners’ laps, hiding, or running away.
While there is no one-size-fits-all approach to minimize the stress caused by fireworks celebrations, we at Worth Street Veterinary Center have listed some suggestions that you may find helpful to keep your loved ones safe and calm during the festivities.
ENVIRONMENTAL CHANGES:
In order to minimize the sensory overload that often comes with fireworks for your pets, here are some quick tips:
– Provide as safe a space as possible for your pet. This can include basements, where available, or even keeping him or her in room away from the windows.
– We find that anxious pets tend to drink more water, so ensuring that water bowls are full is important. Doubly so given the heat and humidity during summer!
– A white noise machine (or even simply leaving the radio or television on) can help drown out a lot of the outside noise. Similarly, keeping the curtains drawn and the lights out may also be effective.
SUPPLEMENTS AND OTHER COMPLEMENTARY THERAPIES:
There are a variety of supplements that can be used to decrease stress or anxiety.
– Pressure wraps such as Thunder Shirts can be used to have a calming effect.
– Ear muffs and calming caps can be used to decrease overstimulation.
– Pheremone Collars such as Adaptil (dogs) and Feliway (cats) are synthetic hormones used to replicate the hormones that lactating females give off to calm their puppies or kittens.
– CBD oil has been shown to successfully decrease anxiety or stress in pets.
– Other natural supplements such as Composure Chews, Solliquin, and Anxitane are mild anti-anxiety supplements containing L-theanine.
– Zylkene is another mild anti-anxiety supplement containing milk casein derivative that can be used alone or in conjunction with other supplements to achieve the desired effects.
MEDICATIONS:
If the above supplements are not effective, or if your pet suffers from extreme anxiety, there are a variety of prescription medications that can be effective to help decrease the stress of fireworks season. These include medications such as gabapentin, trazodone, alprazolam, and others. While some medications such as fluoxetine do not reach peak effect until given regularly for 1-2 months, others can be more helpful in a pinch. Please feel free to contact us to discuss what options are best for you and your pets.
IMPORTANT FACTS:
While we often will reach for medications that are also used in human medicine, please consult your veterinarian prior to using any medications that you have at home. Dosages are very different between pets and humans, and some medications can be highly toxic to animals. We are happy and available to discuss the safest and most appropriate protocols for your pets with you at any time.
For the majority of therapies, they are most effective if given before a pet is already anxious or “up-regulated.” Giving a sedative after the fireworks start may be insufficiently effective, so anticipating fireworks-induced stress in advance may be incredibly valuable.
Each medication has a different effect in each pet. As a result, we recommend giving supervised “test” doses prior to the fireworks so that we can best customize your pet’s protocol.
LASTLY:
Identification: Making sure your pet is microchipped (and registered with your up-to-date contact information!) will hopefully help any worst-case-scenario end happily. If your pet does escape, a collar and name tag (with phone number) and/or microchip can help trace him or her back to you.
We hope these tips will be of value to you and your fur family, but should any questions arise, please don’t hesitate to call us at 212-257-6900 or e-mail us at help@worthstreetvet.com. From all of us here at Worth Street Veterinary Center, we wish you a very happy and safe summer and 4th of July!
 

Dr. Levine and the Worth Street Veterinary Center Team

What you need to know about Canine Influenza

Given the most recent outbreak of Canine Influenza in the New York area, we wanted to share the article below with you to help to answer some of the questions you may have regarding the virus. As always, feel free to call us anytime at 212-257-6900 if you have additional questions.
-The Worth Street Veterinary Center Team

The risk of contracting canine influenza is greater at places where dogs gather, such as competitions, boarding, dog parks, and day care. Photo by Mary Buck.

Just like people, dogs can be affected by different strains of influenza, a highly contagious respiratory infection. There are two strains of canine influenza known to affect dogs internationally. H3N8 broke out around 2004 in Florida and continues to cause sporadic disease; H3N2, a milder strain first seen in Chicago in 2015, is closely related to an Asian strain first identified in 2006. These viruses are different strains of Influenza Type A. Whether or not H3N2 will have the staying power of H3N8 remains to be seen.

After exposure, some dogs will produce enough antibodies that they don’t have any signs of illness. The signs in both strains range from fevers, listlessness, coughing, sneezing, and a runny nose to life-threatening pneumonia, but typically it’s much like having kennel cough.

Where have cases been reported?

In May 2017, canine H3N2 influenza was diagnosed in dogs in Florida, Georgia, North Carolina, South Carolina, Texas, Kentucky, Tennessee, Missouri, Louisiana, and Illinois. This was the same, newer strain of H3N2 involved in the 2015 outbreak in Chicago. More cases are possible as the this outbreak may or may not spread.

For the newer H3N2 strain, geographic locations expanded in the months after the initial outbreak in March, 2015.

What are the signs?

There is a mild form of the disease and a more severe form that is accompanied by pneumonia.

Mild form
Dogs suffering with the mild form of influenza develop a soft, moist cough that persists for 10 to 30 days. They may also be lethargic and have reduced appetite and a fever. Sneezing and discharge from the eyes and/or nose may also be observed. Some dogs have a dry cough similar to the traditional kennel cough caused by
Bordetella bronchiseptica/parainfluenza virus complex. Dogs may also have a thick nasal discharge, which is usually caused by a secondary bacterial infection.

Severe form
Dogs with the severe form of influenza develop high fevers (104⁰F – 106⁰F, 40⁰C – 41⁰C; normal is 101⁰F – 102⁰F, 38⁰ – 39⁰C) and have clinical signs of pneumonia, such as increased respiratory rates and effort. Pneumonia may be due to a secondary bacterial infection.

Fatal cases of pneumonia resulting from infection with influenza have been reported in dogs, but the fatality rate is less than 10 percent. Most dogs recover in two to three weeks.

How is canine influenza transmitted?

A dog is most likely to be contagious before showing any signs at all.

Influenza viruses are hardy: they do not persist in the environment for very long. However, they do spread easily between individuals. Transmission generally requires direct contact with an infected and contagious dog’s fresh saliva or oro-nasal secretions. The problem is that an infected dog is usually contagious before showing any clinical signs. Therefore, apparently healthy dogs can transmit the disease.

When should I see the veterinarian?

A dog living in an area where outbreaks are being reported should be considered to have canine flu until proven otherwise. If your dog is from such an area, or there has been mention of canine flu on your local news, and he has a cough (and especially if he’s feeling sick), see your veterinarian. Don’t ignore it. Canine flu is very contagious, so clinics might request that you come in through a separate entrance.

The tests and treatments your veterinarian might recommend depend on the severity of the illness. For mild disease, the veterinarian might take samples to identify the cause, but only treat the signs. For more severe cases, chest X-rays (radiographs) are often taken to look for pneumonia. Dogs with severe disease can require hospitalization with oxygen and fluid therapy.

The very young and seniors (who may have compromised respiratory systems or concurrent diseases associated with age) may be more likely to have severe signs of illness.

Should I vaccinate?

As with human flu shots, a vaccine for one strain doesn’t help prevent another strain. The existing vaccine for H3N8 does not prevent the new H3N2. The new vaccine for H3N2 that became available in late 2015 does not protect against H3N8. As with most infectious respiratory disease viruses, the vaccine does not protect completely against or eliminate the virus, but reduces how ill your dog can be with it as well as lessening your dog’s ability to transmit the virus to other dogs.

Initially, the vaccine for H3N8 is given two to four weeks apart, and the second one should be completed at least three to four weeks before the dog goes to anywhere like a boarding kennel or dog show. The H3N2 vaccine must be given twice spaced at three weeks apart. Flu viruses require relatively close contact to spread from individual to individual and do not persist well in the environment.

A regular kennel cough vaccination will not prevent influenza.

To decide whether or not your dog should be vaccinated for either strain, talk to your veterinarian about the likelihood of any dog getting either strain in your area.

How is a diagnosis made?

In a perfect world there would be a simple test that could be performed on a single sample and yield unequivocal results, but that’s not the case with canine flu. Tests that broadly detect influenza A virus should effectively detect both H3N8 and H3N2 strains. However, tests targeted directly at the older H3N8 are unlikely to identify H3N2 infection because of limited cross-reaction between their respective antibodies. Commercial PCR assays against H3N2 are currently unclear and it has been reported that tests used in several laboratories will not detect this virus. Testing for viral shedding (e.g., viral antigen ELISA, PCR, virus isolation) is effective but needs to be done as early in the course of disease as possible because shedding is generally early and brief. Checking blood for antibodies tends to be more effective later on, but that’s only if the test can detect the strain involved. More information about specific testing for H3N2is expected in the near future as we continue to learn about this virus.

What is treatment?

Dogs with mild signs receive supportive care, typically fluids, cough suppressants, or anti-viral medication, depending on their signs and how long the dog has been sick. Severely affected patients usually get antibiotics to prevent or treat pneumonia. Pneumonia cases often require hospitalization.

In high-risk cases antibiotics are given to control secondary infections. Pneumonia results from secondary bacterial infections (i.e. bacteria invading the lung after the virus has damaged the tissue and compromised its ability to defend itself). Pneumonia in dogs is almost always secondary after some other condition has damaged the lung, and treatment is similar regardless of the cause. Unlike other pneumonias or respiratory diseases, the anti-viral medication oseltamivir (Tamiflu®)can be helpful but only if used early in the course of infection or to prevent infection in exposed dogs.

A rapid onset of disease – four to six hours – is matched by an equally rapid improvement in clinical signs after treatment begins.

Can the influenza be prevented?

The best preventative measures are to limit or prevent exposure as lifestyle plays a factor in the risk of getting either strain of flu. Dogs that go to day care, dog parks, performance competitions, dog shows, training classes, or boarding kennels have a higher risk. Dogs that spend most of their time at home or rarely come into contact with other dogs have a lower risk.

Don’t let your dog socialize with coughing dogs.

Can people or cats be infected by dogs?

There is no evidence that people can get H3N8. While there is also no evidence that people can contract H3N2, studies in Asia have shown limited transmission to cats. Sheltered cats in Indiana were found to have H3N2; however, the canine vaccine will not work for cats. In Asia, the H3N2 strain that infected cats and caused disease was considered to be of avian origin. Current information about the U.S. H3N2 strain suggests that it might be of porcine origin

Date Published: 04/17/2015
Date Reviewed/Revised: 06/19/2017
veterinarypartner.vin.com

Protecting Your Pets While Outdoors

Ollie in field with yellow flowers on Wednesday, March 30, 2011.

Summer may be coming to a close, but there is still plenty of time to spend in the sun. The warmer months present a wonderful opportunity for you and your pet to enjoy the outdoors, but they also come with an increased chance of run-ins with unwanted topical pests, otherwise known as ectoparasites. While this might be a discomforting thought, we are here to help you understand what to look for and how to prevent these bugs from getting the best of your pet. 

The three most common ectoparasites we deal with in NYC are:

Fleas:

A flea is a parasitic insect which hops from one host animal to another, but can be picked up from the outdoors as well. Once a pet is infected, fleas usually spend their time on the abdomen, rump, and neck areas. However, they can be found anywhere on the body. These ectoparasites cause itchy bites, can spread illness, and, if not treated, their populations can grow quickly. While they do bite humans, they would prefer to hang around our four-legged companions. 

Ticks

A tick is a parasitic arthropod usually picked up from the outdoors (mainly, but not exclusively, in areas with woods or heavy brush). After climbing onto their host, they will latch on and feed. As they feed, they will grow in size making them easier to detect with the naked eye. They are able to move to new areas on the same host or go onto other hosts, including humans. These arthropods are associated with many illnesses including  Anaplasmosis, Ehrlichiosis, and Lyme disease which are the three most common tick-borne illnesses seen in the East Coast. 

Mosquitos:

Mosquitos are flying insect and well known pests to both humans and pets alike. Unlike with humans, the main concern when pets are bitten is the spread of heartworm disease. Heartworm disease usually affects dogs but can be contracted by cats and other animals as well. Heartworm disease has been diagnosed in all 50 states of the USA and is becoming more commonplace in NYC because of environmental changes. 

HOW DO I KNOW IF MY PET IS INFECTED?

Fleas, ticks, and mosquitoes can cause dermal and behavioral clinical signs that you can easily recognize, such as increased itchiness, skin lesions, visualization of the ectoparasites, and discomfort or irritability. Furthermore, ticks can spread tick-borne diseases that can have a variety of clinical signs which include, but are not limited to, reduced energy, lameness, decrease or loss of appetite, generalized discomfort, pain, stiffness, swelling of the joints, respiratory distress, increased bruising/ blood spots (petechia) in mucous membranes, and occasionally, neurological abnormalities. Lastly, heartworm disease tends to be asymptomatic until the late stages of the disease, which is why it is recommended to screen your pet at least annually or when advised by your veterinarian. 

While these symptoms are commonly associated with ectoparasites infection, they do not guarantee that your pet has had contact with any of these pests. With that said, it never hurts to do a physical check at home for any ectoparasites before setting up an appointment with your vet. 

For Fleas:

To check for fleas, we recommend purchasing a flea comb from your local pet store and carefully going through the layers of hair on the neck, rump, chest, and stomach areas. It will probably be easiest to see them if you lay your pet down and look at the exposed stomach. Fleas will be most easily found there if you observe the area for a few minutes. (Looking through your pet’s hair with a flea comb can also help find ticks.)

For ticks:

If you find a tick, you can remove it with pointed tweezers or with a tick key (which is often found at the pet store). It is important to make sure the tick’s head is removed with the body, although that may be easier said than done. If you are unsure about the removal, we recommend calling your veterinary center to bring your pet in for a tick removal and further tick check.  

WHAT DO I DO IF I FIND A TICK?

As ticks carry a risk of transmitting disease, we recommend setting up an appointment with your veterinarian to run blood work that screens for common tick-borne illnesses.  At Worth Street this is called the Heartworm/Accuplex test and it is used to check for both heartworm disease and the most common tick-borne illnesses found on the East Coast. We recommend this test to be done 6 – 8 weeks after finding the tick. We also screen with this test annually, even if you haven’t found any ectoparasites. Both heartworm disease and tick-borne illnesses can be easily prevented, and this test is one step in those protective processes.

WHAT CAN I DO TO PREVENT FUTURE INFECTION?

As we have had a very warm winter, we expect to have an increased prevalence of these parasitic insects. As such, we highly recommend starting a flea/tick and heartworm regiment as soon as possible if you haven’t already begun. 

The easiest and most common precautionary measure for fleas and ticks is to give oral or topical flea and tick prevention. Depending on which preventative is used determines how often it needs to be updated. At Worth Street Veterinary Center, we recommend using Vectra as a topical (spot-on) monthly preventative, Seresto as an 8-month topical (collar) preventative, or Nexgard as a chewable monthly preventative. We also recommend Heartgard, a monthly oral preventative, as the best safeguard against heartworm disease. Your pet’s health, needs, and lifestyle will determine which product(s) would be the best fit. Please discuss this with your veterinarian prior to starting. 

WILL THESE MEDICATIONS BE ENOUGH IF MY PET IS OUTDOORS A LOT?

The flea/tick and heartworm topical or oral medications should be enough to help protect your pet against fleas and mosquitos. For extra protection you can also use a flea/tick collar in tandem with the monthly treatments. However, if you know your pet has a high risk of coming into contact with ticks, we recommend asking your veterinarian about the Lyme disease vaccination. This vaccine is especially recommend for large-breed pets as tick-borne illness can exacerbate commonly occurring joint-aliments, potentially creating more debilitating circumstances overall.    

Should you have any further questions on ectoparasites, or about which preventions, screening tests, or treatments would be best for your pet, please feel free to reach out to us via our app, website, email, or phone. We are always happy to help.

-The Team at Worth Street Veterinary Center

The Benefits of Ultrasonography in Aging Pets

It is no surprise that advances in health care technology have resulted in an increased life expectancy for both humans and their furry companions. Although ultrasound technology has been around for more than half a century, recent improvements in the quality of images and equipment cost have allowed this technique to become a standard diagnostic instrument in veterinary care. The use of this equipment gives veterinary professionals a window into the abdominal cavity, heart and other soft tissues; something blood tests, radiographs, CT scans and other non-invasive procedures can’t provide.

Traditionally, ultrasonography has been used in veterinary medicine as a diagnostic tool to assess illness or suspected abnormalities. However, we at Worth Street Veterinary Center believe that the pet population can benefit from routine imaging screenings during their senior years as well. Since animals age faster than humans, your pet’s annual trip to the veterinarian is the equivalent to us visiting our primary physician every four to five years. As one can imagine, this is not always adequate, especially for pets in their golden years, who may need a more aggressive approach to their general healthcare.

As with humans, aging pre-disposes pets to a variety of ailments including kidney failure, gastrointestinal inflammation, liver and splenic cancers, and abnormalities of the adrenal glands, prostate and other vital organs. Early detection is a key factor in managing these diseases and we believe your pet’s life can be positively impacted and extended with a proactive annual screening. Ultrasonographic evaluations are safe, painless, non-invasive, and unlike other diagnostic tests, don’t subject your pet to ionizing radiation. Starting this year, we at Worth Street Veterinary Center will be giving our clients the option to add a routine ultrasound to their senior pet’s annual exam at a very affordable cost. To learn more about your senior pet’s healthcare, or if you are interested in taking advantage of this valuable technology, please call our office at 212-257-6900.

We look forward to speaking with you soon!

Dr. DiPolo and the Worth Street Veterinary Center Team

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