All I Want for Christmas is My Two Front Teeth

This popular holiday song is a perfect Practical Pet Vet blog topic on Christmas Day. However, every day of the year veterinarians are confronted by toothless dogs and cats. Unfortunately there is no Kris Kringle Tooth Fairy waiting in the wings to deliver a second set!

As pets are living longer and are viewed as furry family members, dental care is becoming an increasingly important part of veterinary care. Aside from causing terrible breath, the oral bacteria associated with plaque enters the bloodstream and travels throughout the body to cause disease in the liver, kidneys, heart, brain, and elsewhere! Moreover, severe dental disease (bleeding gums, loose teeth, abscess) is known to be painful and decreases a pet's quality of life. Most owners don't recognize this change in their pet until after the pet has healed from a dental procedure. Then many report their dog or cat is acting like a puppy or kitten again!

As with most medical conditions prevention of dental disease is preferable to treatment. Regular tooth brushing is the best prevention. No, crunchy dry food is not going to do it. (If you ate nothing but carrots and corn flakes you would still need to brush your teeth and see your dentist!) Dogs and cats can learn to enjoy tooth brushing as a special treat or bonding time with you...ask your veterinarian for suggestions on how to do this. Certain treats and chewies will help reduce tartar, but some, like real bones, can actually break teeth so again check with your veterinarian.  There are many gels, sprays and water additives available through your veterinarian that can also help reduce the disease-causing bacteria in your pet's mouth. And for dogs there is an annual dental vaccine!

So what if your pet already has bad breath, severe tartar and missing or loose teeth? It's time for a dental procedure. No matter how nice your dog or cat is, sedation or anesthesia is required to properly clean the teeth and perform any surgical procedure. Some groomers offer tooth brushing or "cleaning" as part of their services. Any type of oral care your pet allows is great, but not even the best groomer on the calmest pet can clean the teeth below the gumline where the majority of tartar and disease resides. Cleaning the exposed part of the tooth above the gumline creates a nice smile and reduces halitosis but creates a false sense of security that all is well in the mouth!

Like people most dogs and cats over the age of 3 would benefit from preventative dental cleanings (yep, under sedation) at least once a year. Very small dogs (e.g., Yorkies, Maltese, Chihuahuas, etc.) ideally would have cleanings twice a year!

Some owners bring their pets in for dental cleaning and request that the veterinarian "not pull any teeth unless absolutely necessary." Oh, boy. Obviously, these people have never had to extract a fractured and painful but not yet abscessed and mobile tooth before. It is no walk in the park. Nope, veterinarians (the ones I know at least) would never extract a non-diseased tooth just to rack up the final bill! Really, it's not worth the effort.

The goal is to AVOID needing this many extractions!
However, this dog undoubtedly feels better without
the chronic toothache these diseased teeth caused!

If by the end of the dental procedure (or after lifelong dental procedures) your pet's smile is more toothless than toothy, don't fret too much. The missing teeth would have eventually fallen out anyway (with more pain, more chance of complications like retained roots and no antibiotic therapy), and your pet will probably still eat dry food. Most dogs and cats don't chew their food well with teeth (another reason regular dry food does not prevent tartar formation). I've even met some dogs with few remaining teeth who actually still enjoy gnawing their chewies!

If you've been told your dog or cat needs a dental procedure, here are some questions to ask your veterinarian:
1. Will my pet have pre-anesthetic blood testing done?
2. Do you expect my pet will need any extractions?
3. If my pet has extractions, what kind of medications will s/he go home with (pain relievers, antibiotics)?
4. What can I do at home after the dental procedure to keep my pet's mouth healthy?
5. Can I get an estimate for the dental procedure?

February is National Pet Dental Health Month. With the winter holidays behind us by then, February is the perfect time to focus on getting your furry family member scheduled for dental assessment and/or treatment!

'Tis the Season to be Gentled

Farm boy gentles foal

The happy conclusion of Laura Ingalls Wilder's Farmer Boy (the biographical story of her husband Almanzo's childhood) is Mr. Wilder granting Almanzo's greatest wish--a horse of his own--with the promise "We'll take him out on a rope, first thing tomorrow morning, and you can begin to gentle him."

Gentle (v.) 1. To make less severe or intense. 2. To soothe, as by stroking; pacify. 3. To tame or break (a domestic animal, for instance). 4. To raise to the status of a noble. (American Heritage Dictionary)

I'd read Farmer Boy as a child but my strongest memories of this term are from veterinary school when I volunteered to socialize the school's training dogs so they could find real homes.  These dogs had been used to teach veterinary students restraint and examination skills. However, students were increasingly bringing their own pets in to practice on, and the teaching dogs were happily becoming obsolete. It was time for them to retire. The kennel workers who cared for these dogs' needs really cared for these dogs, but years spent in a cage had made the dogs socially inept. It was up to us volunteers to help the dogs learn how to be human companions.

We followed a behavior modification protocol developed by a veterinary behaviorist. The first step in the program was "Gentling and Body Massage." In this program, "gentling" is described as the process of raising a gentle adult animal. The dogs we worked with were already adults and used to being handled, but we needed to be sure they felt relaxed and comfortable around people. Gentling involves establishing trust that human hands are positive, safe things. Anyone who has successfully tamed a feral cat or kitten has used gentling techniques.

Gentling is basically petting that progresses to massage and manipulation of the body parts. As with any behavior modification program, this was a gradual process. The animal's tolerance for touch dictated the rate of progress. If at any point the dog tensed, pulled away, became apprehensive or aggressive, we had to stop and slow down or rework the previous stage of gentling before proceeding. Eventually all the dogs learned to appreciate not only regular petting but more thorough touching of their feet, ears, lips and bellies. Being comfortable with this level of touching would allow their future owners to provide them a higher level of care (e.g, checking for ticks, tooth brushing, trimming nails, etc).

Once the dogs had been thoroughly gentled (it took weeks for some dogs, months for others), we were encouraged to work on deference training. Deference training is essentially teaching a dog manners. Proper deference training is gentle and consistent, never harsh or violent. We do not need to force the puppy or dog to submit (the popular model of human as "alpha" has fallen from favor and is far more detrimental than helpful!) In deference training, every good thing the dog receives -- meals, treats, petting, playtime, walks, etc. -- comes after the dog is sitting calmly and attentively. This behavior can then be built on for advanced obedience, retrieving, agility, and even canine assistance.

Relaxed dog sitting calmly

Satisfied that the teaching dogs were relaxed around people and understood basic commands, our final task was to help acclimate the dogs to the outside world. Having grown up in simple kennel with limited exposure to a fenced exercise yard and classrooms, some of the dogs were unnerved by things like bicycles, strollers and umbrellas. Even children were a strange new species to the dogs. Relying on the trust we'd established through gentling and deference training, we attempted to expose the teaching dogs to as many new experiences as possible. If the dog became anxious we asked it to sit and watch us. By focusing on us and watching us for cues, the dog became used to the strange new thing and learned not to fear it.

After months of socialization and training, all the former teaching dogs found loving new homes. The new owners were taught the gentling protocols so they could reinforce and advance their new pet's training.

According to the American Heritage Dictionary, taming a domestic animal may be done by "gentling" or "breaking." Although used synonymously these words imply very different techniques. Gentling is the time-tested and animal-lover approved way to tame and train animals of all kinds. That doesn't mean people don't find it challenging to do properly. In our fast-paced modern lives, the patience required to slow down and work at another being's preferred speed may be hard to summon. However, the rewards of "gentling" an animal rather than "breaking" its spirit are worth the effort. Because in the end, a gentled animal will act gently and, if American Heritage is correct, perhaps even nobly.

The Twelve Days of Christmas...Pet Vet Style

On the first day of Christmas my pet vet sent to me:
a wellness exam for my pet


On the second day of Christmas my pet vet sent to me:
2 core vaccines
and a wellness exam for my pet


On the third day of Christmas my pet vet sent to me:
3 x-rays
2 core vaccines
and a wellness exam for my pet


On the fourth day of Christmas my pet vet sent to me:
4 fecal floats
3 x-rays
2 core vaccines
and a wellness exam for my pet

On the fifth day of Christmas my pet vet sent to me:
5 microchips
4 fecal floats
3 x-rays
2 core vaccines
and a wellness exam for my pet


On the sixth day of Christmas my pet vet sent to me:
6 tips for barking
5 microchips
4 fecal floats
3 x-rays
2 core vaccines
and a wellness exam for my pet


On the seventh day of Christmas my pet vet sent to me:
7 dental cleanings
6 tips for barking
5 microchips
4 fecal floats
3 x-rays
2 core vaccines
and a wellness exam for my pet


On the eighth day of Christmas my pet vet sent to me:
8 kittens neutered
7 dental cleanings
6 tips for barking
5 microchips
4 fecal floats
3 x-rays
2 core vaccines
and a wellness exam for my pet

On the ninth day of Christmas my pet vet sent to me:
9 wellness blood screens
8 kittens neutered
7 dental cleanings
6 tips for barking
5 microchips
4 fecal floats
3 x-rays
2 core vaccines
and a wellness exam for my pet

On the tenth day of Christmas my pet vet sent to me:
10 toenail trimmings
9 wellness blood screens
8 kittens neutered
7 dental cleanings
6 tips for barking
5 microchips
4 fecal floats
3 x-rays
2 core vaccines
and a wellness exam for my pet


On the eleventh day of Christmas my pet vet sent to me:
11 joint supplements
10 toenail trimmings
9 wellness blood screens
8 kittens neutered
7 dental cleanings
6 tips for barking
5 microchips
4 fecal floats
3 x-rays
2 core vaccines
and a wellness exam for my pet


On the twelfth day of Christmas my pet vet sent to me:
12 heartworm tablets
11 joint supplements
10 toenail trimmings
9 wellness blood screens
8 kittens neutered
7 dental cleanings
6 tips for barking
5 microchips
4 fecal floats
3 x-rays
2 core vaccines
and a wellness exam for my pet!

Your Pet Pooped on the Floor: Why Your Vet Can't Assume It's Behavioral

Here's the scenario. A family adopts two "teenaged" spayed female cats from the shelter. These two teeny boppers are welcomed into the household by the older neutered male cat and the family's dog. The introduction appears seamless. The new kitties cuddle with the labrador and cavort with the cat. But someone has pooped on the couch! And the rug! The owners know it's one of the cats but which one? Is it Mister, latently unhappy about sharing his digs? Is it one of the new kitties, unsure of her surroundings or just reveling in her new freedom to go where she pleases? The poops are pretty normal looking, so it seems like a behavioral issue.


As the family's veterinarian, my first response is "we gotta get a stool sample and run some tests." The only way to diagnose a behavioral toileting problem is to rule out medical causes first.  


"But how will we know whose poop is whose?"

Sometimes that matters and sometimes it doesn't. I like to run the fecal tests on the aberrant stool...one that's softer or yuckier than most or the one that's been deposited where it doesn't belong. The owner of the stool-- when we're talking cats--usually doesn't matter if the problem is infectious or parasitic. Because cats generally share litter boxes we assume that if one of them has worms (for example) they all have worms and all need to be treated accordingly.

Before long I was in possession a fresh sample from one of the new kitties. When evaluating a stool sample for abnormalities, the first test is simple observation. Yes, it's gross, but what does it look like? How does it smell? Sometimes we'll probe the sample with a be-gloved hand checking for foreign material or worms, but 3 out of 5 senses is as far as it goes! This sample happened to be soft but formed with a portion being slightly runny. 

In my veterinary practice a complete fecal test includes a smear, a float and a Giardia "snap" test. These in-house tests identify the most common causes of inappropriate defecation and outright diarrhea.

The fecal float is the test most well known. This checks for parasites such as worms and Coccidia. Coccidia are a species-specific protozoa that commonly affect young or immune-suppressed pets. As for worms, most animals with light worm loads do NOT have worms visible in their stool, so please don't get a false sense of security that your pet is worm-free just because you see no worms! The fecal float helps us identify intestinal worm infestations by showing those worms' eggs. If the worms inside the pet are not reproductively mature or simply not shedding eggs on a particular day, this test may be falsely negative for worms.

The fecal smear helps identify a bacterial overgrowth of the intestines. Every normal gut has a mixture of beneficial bacteria that help digest the food and provide essential nutrients. A wide variety of internal or external factors can destroy this delicate balance and cause abdominal discomfort and/or diarrhea. Luckily most abnormal findings on the fecal smear are not contagious to other pets and people.

Meet Giardia

The final part of the complete fecal test a Giardia "snap" test. This is a highly accurate test to identify active Giardia infections. Giardia is a contagious and zoonotic (i.e., affects people) protozoal parasite that is  common in the environment. The parasite unfortunately also rears its ugly head in shelters and breeding facilities from time to time.

Lo and behold, while the first two tests showed no significant abnormalities, the kitty's Giardia test was an obvious positive. Wow! Even though the kitty's stools have appeared pretty normal, she has an infectious and contagious medical condition. This is the most likely explanation for poop on the couch and rug, NOT a behavioral quirk. 


The good news is this kitty has a treatable medical condition rather than a behavioral problem. The bad news is all the dogs and cats in the house need treatment because of their close quarters. Shed in the feces, Giardia cysts (i.e., eggs) can remain viable in the yard, litter box, bedding and pets' fur and cause re-infection, so a thorough environmental scouring is necessary. The pets were bathed, their bedding and litter boxes washed, and the yard picked up. Each pet is currently undergoing treatment for Giardia to be on the safe side. The owners have been warned to practice good hygiene when handling the animals and to contact their physician for further advice regarding the zoonotic nature of this parasite.


It is said time and again in veterinary school, "You miss more by not looking than by not knowing." Even though the stool appeared normal and there were plenty of possible explanations for the couch poop, we discovered an important medical problem with our thorough test. Thank goodness we checked! And I'm sure the owners will feel the same way after they've completed a hellish week of medicating three feisty felines!

Nutrition 101: Reading Your Pet Food Label

In this season of over-nutrition (I just enjoyed my second Thanksgiving feast in 3 days), it seems appropriate to discuss a popular topic in veterinary medicine: pet nutrition. If I only had a nickel for every time I was asked, "What brand of food should my pet eat?" There is no simple answer, but a brief response is "Whatever your pet does well on that you are comfortable feeding." Now prepare for the long answer...


Actually, there are no answers to this question. I've looked, listened and asked. In veterinary training, professional seminars and published research. And the board certified veterinary nutritionists repeatedly respond with guidelines but never any hard and fast answers. Some rules of thumb for narrowing down your pet food choices are discussed below.


Rule #1: Be skeptical of marketing. I've heard "rumors" that big pet food companies are just out there to make money. Well, duh. A company has to be profitable to continue offering its products and services. I guess the boutique brands that cost twice as much as the traditional brands are in it solely for a love of animals. Right.


Yes, there are times you get what you pay for. And sometimes what you pay for is a pretty package and a guilt-trip. Read on for some tips for sorting through the marketing messages to find a nutritious food...


Rule #2: Find the AAFCO statement on the back of the bag. It's got to be there somewhere. If not, pick a different food. AAFCO is the Association of American Feed Control Officials, a voluntary membership association of local, state and federal agencies charged by law to regulate the sale and distribution of animal feeds and animal drug remedies. Pet food companies submit their foods and/or recipes to AAFCO for nutrient analysis (good) or feeding trials (best). Meeting AAFCO standards means that--among other things--your cat is getting adequate taurine (see the postscript on my Cat Carrier post) and your St. Bernard pup has the nutrients necessary to develop a sturdy skeleton.

Rule #3: Make sure the AAFCO statement includes a phrase about being "complete and balanced." Dry kibble has become the mainstay of most of our pets' diets, so it must contain the right amounts of protein, fat, fiber and other necessary nutrients. Checking for "complete and balanced" is especially important if much of your pet's daily nutrition comes from a can. Many canned foods are actually intended to be fed as a supplement or treat and may not be "complete and balanced" for lifelong nutrition!


Rule #4: Choose a food appropriate for your pet's current "life stage." A diet for all life stages is NOT a good thing! The most expensive foods seem to tout this phrase as a selling point, and it drives me crazy! "All life stages" meets nutritional guidelines for growth and development (i.e., puppies and kittens). A chubby spayed senior dog absolutely does not benefit from puppy nutrition. Juveniles need a formula for "growth and development" and adults need a "maintenance" formula. There is no such thing as a "senior" diet...they are typically just modified adult formulas and may be a good choice for certain minor health conditions in younger pets! 


Rule #5: Don't be suckered into thinking "by-products" and "meat meal" are disgusting fillers.  First let's remember that given an opportunity most felines will feast on mice and dogs will gorge on roadkill. Now that is disgusting! But it is "all natural" nutrition. :-)  


"By-products" are the nutritional parts of the animal carcass, which Americans prefer not to eat themselves (e.g., non-skeletal meat including heart, liver, kidneys, etc.) Many by-products such as liver offer superior taste when used in pet foods. (By-products do NOT include hair, horns, teeth and hooves per AAFCO standards.)  


"Meat meal" (e.g., chicken meal) is nutritional meat with the majority of its water content removed. Meal contains the same nutrients as its whole meat source but weighs less because it is dehydrated. (Meal does NOT contain blood, hair, hoof, horn, hide trimmings, manure, stomach and rumen contents per AAFCO standards.)


Rule #6: Be skeptical of phrases such as "holistic," "gourmet," "human grade" or "organic." These terms have no legal definition in the pet food industry and are primarily marketing terms. On the other hand, a pet food that claims to be “natural” must have no chemically synthesized ingredients (e.g., preservatives or artificial colors), but may contain added vitamins or minerals if stated as such on the label. Please don't ever buy a "preservative-free" pet food. It's just plain rancid. "Natural" preservatives are less potent, so foods preserved this way need to be consumed within 2-3 months of manufacture.


In summary, your average 3-year-old kitty's pet food label will ideally read something like this: "Brand X SuperChow Cat Food has undergone feeding trials to meet the nutritional levels established by the Association of American Feed Control Officials (AAFCO) cat food nutrient profiles for adult maintenance."

Overwhelmed? You want a quick and dirty way to pick a pet food brand? My professional preference is to choose a brand with an equivalent veterinary prescription diet. In the U.S., this means you will be frequenting the aisles holding Iams/Eukanuba, Hill's Science Diet, Purina, and Royal Canin. (No, I do not get a kickback to promote these brands.) As a scientifically-trained person I put more faith in companies that devote substantial time and money to research and development and have internal quality control for ingredients and accountability. With veterinarians and nutritionists on staff, these companies have formulated diets to dissolve bladder stones, cure diabetes* and help kidney failure patients live longer, healthier lives. If these companies can accomplish the delicate balancing act of providing precise nutrition for ailing pets I'm confident they can handle puppy chow.  


* Most diabetic felines suffer from type-2 diabetes related to obesity and related nutritional excesses. Managing weight and feeding an appropriate diet can reduce the amount of insulin needed to control the cat's diabetes -- and sometimes eliminates the need for insulin altogether!  

Deck the Halls -- and Avoid an Emergency Visit to Your Vet

It's a well known fact among veterinary professionals...emergency cases spike around holidays and full moons. As a pet owner you can't do a thing to prevent astrological influences on your pet's health, but you can create a pet-safe holiday environment.

1. People food is not for pets. It's tempting, I know, to share a chunk of turkey or the ham bone with your furry family member. However, gastrointestinal upset ranging from a little diarrhea to pancreatitis, broken teeth, or intestinal infection is the most common veterinary complaint following holiday meals.
2. Some sweets are toxic treats. Chocolate is probably  the most well known toxic sweet; however,the cookie tray and buffet table may contain other less obvious threats to pets. Macadamia nuts, avocado, grapes/raisins, onions/garlic/chives, and goodies containing xylitol artificial sweetener should not be ingested by pets.
3. Dangerous drinks? I'm sure some dogs love to lick the foam off a good brew, but really...alcohol should be kept away from pets. Also keep your pets away from caffeinated beverages such as coffee and tea.  Egg nog (even alcohol-free) is not a good choice for pets either. Fresh water is still the best.
4. Pets and fire safety. Each holiday season fires kill hundreds and cost millions in damages. The warmth and beauty of a flaming candle or crackling fire can quickly turn disastrous in the presence of a curious cat or a wagging tail. Never leave burning candles unattended.
5. Hang the mistletoe up high. Many holiday plants can be toxic to pets. Make sure no one nibbles the holly, mistletoe, poinsettia or lillies in your holiday decor.
6. Tree tip #1: Tinsel is beautiful on the tree but wreaks havoc on the digestive tract. Avoid emergency surgery for your cat by steering clear of this holiday hazard.
7. Tree tip #2: Electric shocks and oral burns can occur when curious pets chew or play with strands of lights. Keep light strands out of reach to reduce the risk of injury and fire. 
8. Tree tip #3: Home-made garlands of cranberries and popcorn may tempt pets into mischief. My darling yellow lab EdGrrr once devoured the natural garlands I draped on an outdoor evergreen for the birdies. Imagine the disaster if he had clambered up our indoor tree! Also the string, like tinsel, could lead to intestinal dangers.
9. Fragile family heirlooms? Like toddlers, pets don't understand how to behave around your precious antique stemware. Best to keep your fragile treasures out of harm's way entirely.
10. Gift trimmings are not cat toys. Ribbons, bells and other pretty trimmings can be choking hazards or cause intestinal blockage if swallowed. Plus it spoils the surprise if Fluffy inadvertently unwraps the gifts under the tree!

Heeding these holiday warnings does not mean furry family members have to be left out of the festivities. On average pet owners will spend $46 on gifts for their pets during the 2011 holiday season. Topping the gift list are toys and treats. From experience, I suggest you hide the gift wrapped tasty treats until the appointed moment of celebration or Fido and Fluffy may just help themselves a little early!

The Cat Carrier: Converting a Torture Chamber into a Clubhouse

As pets, cats outnumber dogs by about 10 million in the United States! However, veterinarians see far more dogs for preventative care than cats. In fact, studies show that the number of feline veterinary visits is declining steadily each year.

Why is that? Are cats naturally healthier than dogs? Not necessarily so. It may seem obvious, but it bears saying: cats are not little dogs. They have unique nutritional requirements*, a distinctly feline pysche and their own set of health concerns.

Cats do appear to be more self-sufficient and less high maintenance than dogs. Historically cat owners are used to leaving out enough food and water for a week and provide a box to toilet in. Fluffy's exercise often consists of watching the birds from a sunny window perch. In comparison dog owners must supply Fido with several meals a day, multiple walks outside, playtime and plenty of toys. Cats may seem to require less veterinary preventative care than dogs, but it is not so.

I myself have heard clients brag that their cat has not seen a vet in over 10 years. I'm glad their pet has not been overtly ill, but I cringe inwardly. Cats classically hide symptoms of illness. In fact, hiding is a classic sign of illness in cats. As cats age they are prone to developing dental disease, arthritis and organ diseases like diabetes and kidney failure. Thorough and regular veterinary care allows for early diagnosis and management of many debilitating and life-shortening conditions in cats.

Many pet owners have the best of intentions to provide a high level of preventative care for Fluffy. If only they could get her in the carrier! It's a common problem. I recommend getting Fluffy accustomed to the carrier so that she doesn't freak out when she sees it that one time of year, knowing it means a trip to the veterinary clinic.

Helping Fluffy see the pet carrier as a clubhouse and not a torture chamber requires some time and patience. Most pets actually feel safest in a snug enclosed area, so the goal is to create that feeling about the carrier. Start by getting the carrier out and leaving it out -- not just when going to the veterinary clinic. (Fluffy may have the same negative learned response toward suitcases -- their arrival in the bedroom signals the imminent departure of her favorite humans!)

Next, start feeding Fluffy her meals in increasing proximity to the carrier until she will actually (happily) eat while the bowl is inside the carrier. NEVER close her into the carrier against her will during this acclimation period! You can start sticking her favorite treats in the carrier for her to discover when she explores the interior more closely.  Eventually she may adopt the carrier as a snug hideout making it a lot easier for you--and less stressful and traumatic for her--to get her to the veterinarian for her annual check up.

Yep, I said "annual." Even though most feline vaccines do not need to be given every year, an annual veterinary visit is essential to keeping Fluffy healthy and happy for years to come. Depending on your cat's lifestyle, age and  clinical signs your veterinarian may recommend blood or urine screening tests, deworming or weight management programs. As cat owners already know, cats are not small dogs and require a special touch. But they still do require veterinary care.

* Prior to the 1970s cats ate a modified dog-food formula which was low in the nutrient taurine. Taurine deficiency led to blindness and heart disease in many cats. Since the 1970s, pet food companies have designed foods to meet the unique nutritional requirements of cats.

Snips and Snails and Puppy Dog Tails

I try really hard to follow my own advice about kids and pets, but toddlers move so fast it's almost impossible to prevent disaster sometimes. 

The other day while I was getting ready for work, my toddler starting shrieking in pain down the hall. I rushed out to see our new kitten Larry dropping unceremoniously from my son's arms and a fresh scratch mark adorning the boy's face. My son is lucky that his introduction to claws was at the paws of an innocent kitten who meant no real harm!  

Babies and pets co-exist peacefully in many homes. There are amazing stories of devotion--and even heroism--from dogs and cats toward their human babies. However, I have also seen terrifying and unexpected violence from family pets toward infants. In a particularly gruesome case, a female Golden Retriever grabbed the newborn's head in her mouth and shook repeatedly! Thankfully, the baby survived the incident.  My rule of thumb has become never leave an infant and pet unattended.

For years I have warned clients with small infants not to feel too secure in their dog or cat's love for the new baby. At the newborn stage, Fluffy probably thinks of Junior as a curiosity with his strange squalling, aromatic diaper changes and many accoutrements (strollers and swings, etc.) that make a great place for a cat nap. Once Junior starts dropping tasty tidbits from his high chair, Fido undoubtedly becomes his biggest fan (and gains a few pounds in the bargain). But when Junior gets mobile, WATCH OUT!



Try as I might, I could not keep my pet and toddler
separate 100% of the time (much to the Spaniel's chagrin).



Once Junior starts to move around on his own, keeping him away from the family pets can be a huge challenge. That soft four-legged creature under the table is an awfully attractive nuisance. Often the only solution is strict segregation. Doing so not only keeps Junior safe but also allows Fido and Fluffy to truly relax. (Have you ever witnessed a resting dog warily watching the creeping baby? The dread is almost palpable.) 

I'm full of sage advice regarding pets and kids, but I'll admit not even I could keep my sons from being nipped at by our family dog. Statistics support what I've experienced in my home: dog bite injuries are higher among boys than girls. We used to call our daughter "The Dog Whisperer" because we'd catch her with her tiny cherubic face inches away from the muzzle of our highly annoyed spaniel. This same spaniel did not tolerate the same proximity from our first and third children -- both boys. I think in general boys -- "snips and snails and puppy dog tails -- must be perceived as more dangerous than girls -- "sugar and spice and everything nice." Any dog that feels trapped in a threatening situation (under a table, in its kennel, on a chain or leash) is more likely to bite even if it's not in her nature to do so.

While bites of varying severity happen daily in households across America, I should mention that any animal bite or scratch that breaks skin may require rabies quarantining (even of puppies and kittens).  If you are concerned, ask your veterinarian for advice.

Happy Howl-oween!

The witching hour approaches on the eve of Halloween. I spent a good deal of my day helping my kids prepare for Trick-or-Treating.

My kids--a ghostbuster, pink-haired witch and tiny dragon--husband, sister-in-law and I braved trick-or-treating in the rain this afternoon. It was typical trick-or-treating weather for Wisconsin and certainly not the worst. Amazingly the dreary drizzle did not deter other macabre revelers. Costumed kids and grown-ups--and not a few festive dogs--thronged the sidewalks of Fond du Lac.

Dressing up dogs has become a real sport. Dogs have been wearing sweaters for ages and for good reason. Very small dogs and those not designed for Wisconsin winters have a hard time maintaining their body temperature. A husky may finally be at his ease on a drify December day, but a Boston Terrier may refuse to even go out to use the bathroom!

Animal clothing has gone far beyond practical nowadays. Our pets are budding fashion models it seems. I've seen raincoats for labradors and tutus for teacup poodles. Some creative pet owners fashion their own designer dog digs out of newborn baby clothes.

It's no surprise that Halloween has become a huge event for dressing up pets. Pet outfits range from minimalist to elaborate. A dog adorned with a funny hat is one thing. A dachshund wearing a hotdog bun and mustard shirt is quite another. Here's to all the good natured dogs out there who not only tolerate but seem to enjoy the spectacle of dressing up!

Happy Howl-oween!

So You've Been Adopted by a Stray Kitty. Now What?



Larry, Day 1

Heading into the clinic after lunch Friday, a strange baby cry greeted me by the back door. A tiny, bedraggled kitten ventured toward me. Cautiously I picked him up. Immediately his little velcro claws stuck to my shirt and a disproportionately loud purr began. I was hooked.

Has this happened to you yet? So many of my feline patients began their lives as strays, the arrival of little Larry seems like a perfect time to discuss how to bring a stray into your home.

1. When interacting with a stray cat (or any unknown animal), use caution! He may not be used to being handled and could bite or scratch out of fear. Rabies does affect cats, and many do not exhibit the classic Cujo signs of rabidity.

2. If the stray is amenable to being handled, make a veterinary appointment for him as soon as possible. Until then, keep him quarantined from your other pets to limit transmission of contagious diseases and parasites. Best not to let your children play with him either until he passes veterinary inspection.

3. Fleas are very common on strays. Poor Larry was covered in them. Where the black pellets of "flea dirt" (i.e., flea poop which is digested blood) had gotten wet, his white patches of fur were stained red! I DO NOT RECOMMEND GIVING A FLEA BATH. The chemicals in flea shampoos can be toxic--especially in cats and debilitated animals (which most strays are). Call your veterinarian for alternatives to flea baths.

4. After handling your new stray or his litter box, wash your hands thoroughly. If you have other cats at home, you may want to change your clothes after handling the stray to avoid transferring contagions.

At your stray's first veterinary check-up here are some things to expect:

1. The stray should be scanned for a microchip. Some strays are actually lost pets. The rightful owners will be grateful to know he has been found safe and sound!

2. Especially if you have other cats at home, a Feline Leukemia Virus (FeLV) and Feline Immunodeficiency Virus (FIV) test should be done. This is a simple blood test that can show if the stray has these viruses. Inadvertant introduction of theses viruses into your existing cat household can be devastating.Your veterinarian can explain the details of the diseases and testing.

3. The stray should be dewormed according to your veterinarian's protocol. Aside from tapeworms, most intestinal parasites are not readily obvious in the stool. Assume all strays have worms. After all, if the cat was eating rodents to survive he surely has worms!

4. Your veterinarian can treat the fleas, ticks, ear mites, lice or other external parasite(s) found. Be sure to ask if you need to clean where the kitty has been hanging out at home. Many parasites can only be eliminated after multiple treatments plus environmental decontamination.

Larry, Day 3

5. Many strays have upper respiratory infections stemming from common feline viruses. Your veterinarian may recommend vaccinating against feline distemper to help prevent complications from these infections. Depending on the stray's estimated age, your veterinarian may recommend the rabies vaccine as well.

6. Once your new kitty has been determined to be in good health, it is time to consider sterilization surgery. It is easy to tell if an adule male cat has been neutered, but much harder to tell if an adult female has been spayed. Spaying and neutering not only eliminates unwanted litters, but reduces unpleasant behaviors and future health problems.

Now that your stray kitty has a clean bill of health, you can settle down to enjoy the rare pleasures that come from feline companionship! You have been chosen by this kitty to provide the care necessary for his comfortable life. If your stray is like most I've met (including Larry), he is overflowing with affection and devotion.

The Real World, Cat Style

Feline dynamics are not easily understood. Sometimes, as if a switch has been flipped, two cats who have been best of friends for years suddenly act like mortal enemies, and only time will tell if they can recover any of their former fondness.

I worried a little about this possibility after performing an elective surgery on two feline sisters this week. Raised in a small cage at a local shelter, these girls had been unavoidably inseparable their entire lives. So following recovery from anesthesia, we moved the girls into the same large kennel for the duration of their hospital stay. Would the stress and strangeness of their situation unhinge their happy friendship? I sighed with relief when Inky and Binky* started grooming each other affectionately.


Earlier in the week I visited with the owners of a tiny stray kitten. This cute little fuzzball joined a household with two older cats. The male adult is tolerating the kitten's presence (barely) but the older female has objected vehemently! The kitten has been found cowering under a bed in the spare room. She hesitates even to venture out to use the litter box. "Given enough time will they start to get along?" the anxious owners ask. It is impossible to predict how their relationship will change over time.

Cats have unique personalities just like people. A feline household's emotional and political dynamics would probably make a great reality TV show. Let's imagine the above scenario in these terms. "Queenie" is the established feline ruler in this home. She and "Tom," the adult male, have worked out some very intricate rules for coexistence. Queenie puts up with Tom, and Tom has learned to stay out of her way. Introduce little "Orphan Annie." Like a child Annie doesn't understand adult rules of engagement; like a child she can be a whiny, unruly pest. Already henpecked into submission, Tom just rolls his eyes and sighs. Queenie, however, is ticked off that she has to share her space with yet another cat--an obnoxious bratty one to boot--and she is not going to give in without a fight!

Just imagine what it would be like to be locked in a house with another person or two. Not only must you share the same bed and bathroom with these perfect strangers, but you are also expected to eat off the same plate and drink from the same cup for every meal. Now imagine if one of these people is that overbearing, opinionated coworker you just can't stand. Will you ever learn to get along in this artificially constructed home environment? Probably. Will you eventually be best of friends? Eh, probably not.

If Queenie, Tom and Annie are going to find peace in this home they need their own space and resources and plenty of time to work things out. A rule of thumb in cat households is "one litter box per cat plus one." So this home needs four litter boxes. And more importantly, they need to be spaced far apart so Annie doesn't get bullied when she has to go. Queenie should likewise have her own food bowls and dining area so she can eat in peace. Tom, used to putting up and shutting up, will probably be happier with these changes, too.

While Queenie, Tom and Annie may never adore each other like Inky and Binky do, their owners can do a lot to ensure a peaceful coexistence. There are many tips and techniques for introducing new human and animal family members into an existing human-pet dynamic. Ask your veterinarian for suggestions and resources.

UPDATE: I just learned today that Annie has found a new home where she is the only feline family member. She is incredibly happy and doing well!

* Names have been changed to protect privacy.

The ABC's of Anal Glands

Anal glands are probably one of the most mysterious and misunderstood anatomical features of dogs and cats (yes, cats!) Barely a day goes by that I don't address an anal gland question.

Anatomy
The anal glands are little sacs just inside of the dog or cat's rectum. If the rectum is a clock face, the glands reside at approximately 4 o'clock and 8 o'clock positions.

Physiology
Normally the anal glands are emptied each time the dog or cat defecates. But as many pet owners know, anal glands can spontaneously empty of their odiferous contents--usually on the couch cushion, car seat or owner's bed--when the pet is startled or upset. This stinky secretion is yet another way animals communicate through scent, much like urine marking.

Pathology
Most dogs and cats do not need their anal glands expressed on a regular basis by human intervention. Pets that have a bout of diarrhea or chronic soft stools sometimes have anal gland problems. Occasionally a pet's unique anatomy (i.e., the position and opening of the glands internally; obesity) may inhibit proper emptying. Finally, some pets with repeated anal gland problems actually have an underlying allergy. This is a complicated issue that should be discussed with your veterinarian

Classic Scooting

Symptoms
When the anal glands do not empty fully the contents can build up. The dog or cat may lick their butt excessively or drag their bum on the ground in an effort to release the pressure. If these efforts fail the secretions become thicker and harder to expel and may become infected. Some pets with infected anal glands present with ruptured and draining abscesses on their hinder -- ouch!

Treatment
Pets that scoot or lick their behind excessively should have their anal glands checked. Gentle manipulation of the anal glands by a trained professional expresses the contents and gives the pet relief. Additional medication or therapy may be needed if the anal glands are infected or inflamed. Depending on the pet's history, weight loss, diet change or fiber suppplements may be needed.

Prognosis
Some dogs and cats have one or two episodes of anal gland difficulties during their lifetime which are easily managed. However, some pets require frequent anal gland expressions to keep them comfortable, and some pets wind up having their anal glands surgically removed.

Differential Diagnoses
Scooting is not always because of an anal gland problem. As mentioned before, allergies can cause itchy rear ends, and scooting in these animals can continue even after surgical removal of the anal glands. I have also seen itchy butts in pets afflicted with intestinal parasites such as round worms!

My Prescription
If your pet has an itchy butt, don't be shy about it. Talk to your veterinarian! Examination and a detailed history can do wonders to bring your pet relief and prevent a recurrence.

When Cats Attack!

Admitting to a struggle with a bit of writer's block on Facebook, I received several immediate and interesting questions and suggestions. Yet I can't get the following image out of my head and feel I should find a way to make it work.

The other day my toddler son--enamored of our cats as most toddlers are--grasped Cheeks by the armpits, hoisted her up and buried his face in her soft belly fur. Usually a very tolerant feline, Cheeks sort of freaked out at this! She wrapped her limbs around my son's head and held on for dear life as he blindly stumbled about in a panic. We rescued the cat from the boy (and vice versa), relieved to find not the slightest injury to either.

Cats being predatory and often aloof animals, it's easy for me to joke that if we humans were smaller or if they were much bigger, our cat companions would probably pounce on us like mice and toy with us a while before enjoying us for a snack. I have been observed more than once by a pint-sized feline with a chillingly calculating stare.

Mountain Lion

Domestic Short Hair

Some cats actually do lie in wait for their humans, leaping at unsuspecting legs, biting and clawing without provocation. Fortunately, this sort of excessive "play" behavior is the exception to the rule. Many more cats, like Cheeks, tolerate innumerable indignities without complaint (think kitties wearing bonnets being carted around in baby buggies). I have been absolutely shocked by the restraint demonstrated by some cats in situations that would make a less conscientious feline tear a person to shreds. Years ago during a bath, my cat Abe locked his front paws (with piercing claws out) around my arm in an effort to stop me and yowled in protest. Amazingly, he did not make a scratch!

When cats do lose control of their weapons--either in play or fury--the results to people can be disasterous. Cat Scratch Fever ain't just a kickin' Nugent tune. More than one veterinary professional has wound up in a hospital bed on IV antibiotics after a decent cat bite or scratch. It's like a game of Russion roulette. I've been bitten repeatedly--once so hard it bruised my thumbnail for months--and although each bite hurt like heck the wound healed without intervention beyond an initial thorough scrubbing. But I remain vigilent for myself, my kids and my clients because a simple little scratch can send you to the ER.

Cats biting cats can produce nasty cat bite abscesses, too. I know it's gross (it's a vet thing), but there is nothing more satisfying than draining an explosive, stinky cat bite abscess. With the pressure relieved, the cat feels better and the wound generally responds well to a short course of oral antibiotics. This type of injury is typically seen in unneutered outdoor male cats, but I've seen plenty of indoor female cats suddenly sicken from an abscess produced by a housemate's wrath.

The moral of this story is to wash thoroughly even an innocent scratch or nip and be grateful for your cat's unusual restraint during times of insult and injury!

If it were your pet what would you do?

One of the most dreaded questions veterinarians face: "If this were your [dog, cat, horse, cow, etc.] what would you do?" It's an innocent and reasonable question. I regularly find myself asking the same sort of question of the experts in my life--my mechanic, financial planner, hair stylist...

The question of "what would you do?" is a good one. It indicates trust and partnership in the veterinarian-client relationship. Why it makes me cringe is because it is so darned hard to answer sometimes!

Rarely do medical conditions have predictable black-and-white outcomes. As the veterinarian, each set of test results presents a complex algorithm. An algorithm is a flowchart of "if this, then that" scenarios that help us reach a diagnosis, plan treatment and assign a prognosis (i.e., outcome). For example, if the pet's kidney values are markedly elevated and the red blood cells are decreased and the pet is severely dehydrated, then the expected outcome of treatment is much different than if the kidney value elevation is the only abnormality. Sometimes, just as importantly, the algorithm for deciding a pet's care also includes financial considerations: if one has a big piggy bank, then one might choose to do a certain diagnostic test or treatment.

When asked to place myself in my clients' shoes, I want to give an honest answer. The trouble is, how I believe I would act if faced with the same predicament is not necessarily how I will act when the time comes. Considering the situation from the client's point of view works because I can share my personal rather than clinical take on the situation. But I often feel as though I'm not being entirely truthful. Can I really begin to guess what I would do if it were my pet?

This past Thursday I was faced with the worst choice my clients have to make. Our surly spaniel GrrrD, limping and crying for several days despite a thorough workup and aggressive pain management, became terribly lethargic. An x-ray of her suddenly distended abdomen showed several abnormalities which may or may not respond to surgical intervention. So, for this 13-year-old dog with multiple, seemingly unrelated symptoms and obviously suffering...what should I do?

I did what my clients do. I asked a veterinarian, my dear friend and collegue Dr. Trisha Fasse, for advice. We talked for some time about GrrrD's symptoms, her age, her test results and my feelings. My inner debate raged on. GrrrD the Snerd was my husband's puppy since college. She was a steady part of countless apartments and homes. She was our "kid" before we had kids. How could I not do everything and anything possible for her now?

Resolution finally came when Dr. Fasse reversed the age old question and asked me, "What would you do if it was your client's pet?" It became clear. The Snerd was suffering. She had inexplicable symptoms. She was not responding to pain medications. The likelihood of extending the length and quality of her life through exploratory abdominal surgery was highly questionable. Surgery in her condition was risky and I expected a difficult recovery. And just because we could do everything medically possible doesn't mean we should.

We will reflect on the many wonderful
 memories we share of GrrrD the Snerd.

Difficult as it was to let GrrrD go, my family decided it was best to alleviate her suffering. I have cried during and after numerous pet euthanasias with clients. Still it took me by surprise the strength of my emotions as I euthanized my own pet surrounded by my family. We all miss her, but we wanted to do what was best for her. I'm grateful for the advice I was offered by my veterinarian friend when making the decision, and now I understand even better why my clients ask me.

In Tribute to Tuffy

Children and pets may keep us young at heart, but their aging is a dramatic indicator of the passage of time. It seems like just yesterday GrrrD and her Canadian brother Tuffy posed in these pre-wedding photographs with their college buddy owners. That was over six years ago. Both men now have established careers and several children apiece. GrrrD is a crotchety senior spaniel, and sadly, Tuffy has passed away.

Tuffy's recent death has been a topic of much reflection in my home this week. He was a beautiful and funny dog, and he touched many lives--internationally!

The strength and endurance of the sibling bond between Tuffy and GrrrD was enchanting. GrrrD (aka "the Snerd") has always been a persnickety female dog. Around other dogs she typically remains aloof, protesting loudly and viciously when another canine crowds her space (luckily she is all bark and no bite). But she loved Tuffy. And amazingly she never forgot him!

On two occasions GrrrD accompanied my husband, oldest son and me to Manitoba to visit our dear Canadian friends and their dog Tuffy. Both times we watched in wonder as GrrrD leapt from the car after the long drive, exchanged a civil sniff with her black-and-white brother and immediately fell into crazy "puppy" play. It was unusually friendly behavior for GrrrD on any account. What makes it even more amazing is that it had been years since the littermates had last seen each other!

The bond between these spaniel siblings was special but not unique. As a veterinarian I've had more than one pet anxiously watch me examine its pal, showing more trepidation than the animal under inspection. I've met numerous dogs and cats who have grieved the loss of a fellow housemate (I don't think they necessarily grasp the concept of death, but loss they certainly do). I find these demonstrations of animal empathy and loyalty remarkable! The relationship between Tuffy and GrrrD has shown me that animal fondness can withstand separation by both miles and years.

Good dog, Tuffy.

This is Garbage Gut

EdGrrr pilfers a cantalope rind

It may seem like a matter of semantics but vomiting and diarrhea are not normal in a dog. They may be common (depending on the dog), but they are not a normal and simply over-lookable occurrence.

Vomiting and diarrhea are common and vague symptoms of illness in dogs (and cats!). Sometimes, like in people, these problems are mild and self-limiting. The causes of innocent short term GI upset range from non-threatening viruses to eating something that "disagrees" with the pet. On the other hand, vomiting and diarrhea can also signal more serious problems such parasite infestation, pain, infection, organ failure, intestinal blockage and cancer!

The good news is that these latter causes are far less common than the former! Dogs, especially those that enjoy moderate levels of freedom in their day-to-day activities, very frequently ingest things that make them barf. To most dogs, edible is an all encompassing descriptive term that includes decomposing animals, poop from just about any other living thing, and refuse--among other things.

Many times, "dietary indiscretion" results in a short bout of decreased appetite, soft stool, and possibly vomiting. But sometimes "garbage gut" produces such severe gastrointestinal discomfort that dogs require veterinary intervention and medications. In the worst case scenarios, a dog's dining habits may result in life threatening pancreatitis or surgery to remove a foreign body!

What do you do if your dog starts having soft stools, vomits or rejects his dog food? You know your dog best. I find that owners are often a good judge of the severity of their pet's illness (denial is, of course, a powerful and detrimental part of medical cases and can unfortunately delay treatment of serious problems). If you are not sure, it's never a bad idea to call your veterinarian and describe your dog's symptoms.

A Happy Ending for a Blind Dog

This past winter I had Lasik eye surgery to correct my terrible vision. Without glasses or contacts I was legally blind. Swimming and sports were a hassle. Staying up too late made my eyeballs scratchy. Since the surgery I have enjoyed the freedom of perfect vision.

Because we humans are so dependent on our sense of sight, we often forget that other animals are not as reliant on it and therefore do not miss it much when it is gone. I recently had the honor of examining a sweet blind Golden/Lab mix named Nellie.* Nellie has Progressive Retinal Atrophy (PRA), a genetic form of progressive blindness that can affect a number of breeds, including Labrador Retrievers. Although only 3 years old, Nellie was nearly euthanized because she could no longer be a decent hunting dog. Fortunately Nellie was sent to a blind dog rescue group and was recently adopted by some dear clients.

A blind Golden/Labrador mix like Nellie

Although Nellie is completely blind, she is attentive, obedient and gentle. In a strange place, she gingerly picks her way around the room and occasionally bumps into objects. Once she has settled in, though, Nellie (like many other blind dogs and cats) will easily maneuver through familiar surroundings as confidently as a seeing animal. When explaining a diagnosis of blindness I often reassure clients that their pet will adapt quite well "as long as you don't move the furniture around." Compared to humans, dogs have poor vision at the best of times. They use their heightened senses of smell and hearing to understand and respond to their environment. Therefore, blindness to a dog is not a complete tragedy.

I have no doubt Nellie will adapt to her new home and be a fine companion for her human family. The real tragedy in this story is that PRA and many other hereditary diseases can be avoided with careful breeding programs. There is a DNA blood test available to determine if potential doggie parents carry the genes for PRA. Most dogs should also undergo Canine Eye Registration Foundation (CERF) examination by a certified veterinary ophthalmologist prior to breeding.

This recommendation comes from personal experience. I nearly made the mistake of breeding our English Springer Spaniel GrrrD. She was a lovely hunting dog, free of obvious defect, and it seemed like a good idea to allow her to procreate! During my veterinary school training, my faithful "guinea pig" GrrrD was diagnosed with retinal dysplasia. Even though GrrrD had adequate vision, any future pups could have been blind. With that knowledge in hand, it was an easy decision to spay her.

Hereditary blindness is dramatic, but thankfully not that common. There are many other more painful and difficult conditions that can be avoided through informed decision making at the time of breeding. Ask your veterinarian for information before breeding. Future pet owners will thank you for your diligence.

*Name changed to protect privacy.

The Mushroom Vaccine?

We all do it. We misunderstand a word or a phrase we hear in music or conversation and verbalize something amusing as a result. Recently my first grader informed me that she does not like "toxic water" but enjoys eating "octopus testicles." I was glad to have less household competition for my favorite summer refreshment (tonic water), but explaining that her recent seafood dining experience involved tentacles not testicles produced several other awkward anatomy questions.

Adults are not immune from publicly garbling unfamiliar words or phrases. I'll admit I walked around for some time talking about "lost leaders" in reference to a pricing strategy used by some big box department stores. In this strategy the company offers a ridiculously low-priced item to lure customers into the store knowing the average customer spends a substantial amount on more profitable items once there. Finally my accountant, chuckling, informed me that I probably meant to say "loss leader" unless there actually was a missing manager (a lost leader) in my scenario.

I'm sure that every professional out there--from plumber to physician--has heard some very funny alternatives to technical terms they use every day! It certainly happens in veterinary medicine, especially with vaccines.

I'd wager the oldest vaccine terminology mix-up involves "distemper." The "distemper" vaccine is given to dogs and cats to protect against a collection of viral and bacterial diseases. It is not given to improve the behavior of pets with surly or unruly temperaments! Usually when I hear this mix-up, the client has requested the "temperament" vaccine with a smile and a laugh, and I'm not sure if he is putting me on! To set the record straight, the Distemper virus in dogs can cause serious if not fatal neurological, respiratory and gastrointestinal illness. In cats, feline distemper (actually panleukopenia virus) can result in dangerously severe immune suppression. Thankfully, the vaccines available for canine and feline distemper are very safe and effective.

Another common terminology goof-up involves the Kennel Cough vaccine. One of the important causative agents of Kennel Cough is a bacteria called Bordetella bronchiseptica. (Yeah, it's a mouthful!) Each year, dogs that may come in contact with this infectious organism at kennels, dog parks or grooming facilities receive the "Bordetella" vaccine. It is understandable that some clients--who only have to think about this organism once a year when they get a reminder card from their veterinarian--remember just enough of the scientific name to request the "portabella" vaccine when making the appointment. 

Please forgive us if we smile when you accidentally say your pet needs a "mushroom" vaccine. It's a common enough mistake. We know what you mean, and we appreciate your effort to provide good veterinary care for your pet!