Encouragement for DVMs

It’s the usual summer busy season in veterinary hospitals. On top of that, we are still in the season of COVID-19, so add those together and you get complete chaos on some days! As a newer grad, I am still learning the ins and outs of daily life in practice. I have found more confidence as the weeks progress, but I still wake up some days with anxiety about what the day may bring and if I will be good enough for my patients. I am hoping with more experience those feelings will subside, but in the mean time I believe I am growing as a person and as a doctor.

I recently had a fully booked day of appointments with several patients needing diagnostics and treatments done. In addition, we had about twelve drop-offs added to the schedule that morning. Needless to say, I was quite busy, and at one point I was managing six hospitalized cases- a diabetic dog getting a glucose curve, a dog with hemorrhagic gastroenteritis, a dog with pancreatitis, a blocked cat, a dog with chronic kidney disease, and a dog with a brachial plexus avulsion. That is quite the variety! It was one of those days I couldn’t wait to be over so I could breathe.

The demands of daily practice, especially during this time, can be overwhelming. We are a profession of compassionate caregivers. We push ourselves and replay cases over in our heads wondering if we made the right choices. We strive to be perfect and get discouraged when we can’t possibly live up to that standard. That is too heavy a load to carry even for the most seasoned veterinarians! Trust me, I need to remind myself of this daily.

It’s okay to not be perfect. It’s okay to make mistakes and then learn from them. It’s okay to ask for guidance, and it’s okay to give yourself grace because we are only human and can only do so much. At the end of the day, what matters is that we’ve done our best to advocate for our patients. All we can do is our best, and that is enough.

Leptospirosis in Dogs & Zoonotic Risks

When you take your dog to the veterinarian for vaccines, you may wonder why he or she needs a leptospirosis vaccine. Leptospirosis is a zoonotic disease, which means it can transfer from animals to people and cause similar sickness in both species.

What is it?

Leptospirosis is an infection caused by a type of spirochete bacteria. Dogs most commonly contract this disease by coming into contact with infected urine of other dogs and wildlife. It may be transmitted by contaminated surfaces in the environment as well. The spirochetes cause infection by penetrating mucus membranes or damaged skin and then spreading to tissues via the bloodstream. They replicate rapidly within many different organ systems, and serum antibodies will typically clear the infection. However, even when antibodies are present, the spirochetes can persist and replicate within the kidneys for several years, remaining infectious when eliminated in the urine.

What are the clinical signs?

Infected dogs often have fevers early in the disease process. Other clinical signs may include muscle pain, lack of appetite, vomiting, uveitis (eye inflammation), hematuria ( blood-tinged urine), fever, increased thirst and urination, or petechia (small skin hemorrhages). In advanced stages, outward signs of liver and kidney disease may be seen, including the presence of icterus (yellowing of the mucus membranes and sclera) and poor perfusion or inflammation of the blood vessels.

How is it diagnosed?

When leptospirosis is suspected, dogs should be placed in isolation to avoid the spread of disease while a diagnosis is confirmed. Your veterinarian will want to perform bloodwork and check the urine for signs of infection. We may see increased kidney and liver values, changes in white blood cell counts, and low platelets depending on the stage of disease. A SNAP test or serum titers can be performed to check for exposure to and antibodies against leptospirosis, respectively. However both of these tests do not tell us whether your dog has an active infection. They simply tell us that exposure has occurred at some point in his or her life. Performing PCR on the urine can detect an active infection and is most useful in diagnosis.

How is it treated?

Penicillin can be administered to eliminate the acute phase of infection for 3-5 days. This treatment is followed by an additional antibiotic, such as doxycycline, for 3-5 weeks to eliminate the bacteria that remain within the kidneys. In some cases, your dog may need to be hospitalized on fluid therapy to help flush the kidneys and to replenish any fluid losses that may have occurred through increased urination or vomiting. Infected dogs will need to be isolated until the infection has fully cleared.

Is it zoonotic?

Leptospirosis is zoonotic, which means it can be transmitted from infected animals to humans. This mode of transmission is less common than people becoming infected from environmental exposure, but it is still possible. The infection may cause fever, joint pain, and other flu-like symptoms in humans. It can also cause abortions in pregnant women. Treatment is largely supportive care with hospitalization on intravenous fluids, antibiotics, and liver protectants.

Is it preventable?

Since there is a zoonotic risk, it is important to vaccinate your dog against this infection to protect both of you. Vaccinations should be updated annually for full protection in at-risk dogs. In addition, reducing your dog’s exposure to puddles or other areas where wildlife or canine urine may be present can help prevent this infection.

Mental Health Awareness in the Veterinary Profession

Mental health is a huge problem in the veterinary profession. Veterinarians have higher depression and suicide rates than any other profession as well as the general public. There was an incredibly sad month where we lost six amazing people from this profession this past year. People question why this is occurring and what we can do to curb these devastating losses. I think it’s important to think about a couple things that could be contributing to this issue.

The veterinary profession is made up of some of the most compassionate people you will ever meet. Not everyone places such importance on protecting and caring for animals the way that we do. Unfortunately having the hearts that we do is sometimes a double-edged sword. It is difficult for us to leave the negative comments behind when we have done everything we could for your pet but the outcome did not turn out as planned. It is difficult for us to see you take the advice you read on Google over our own. Your veterinarian cares deeply for your pet. They went to school for nearly a decade to obtain the clinical expertise and medical knowledge that they provide. You have no idea what your veterinarian went through to earn his or her doctorate degree.

Another emotional part of this profession is losing pets. We have a great honor of allowing pets a peaceful passing. However, it is not easy and sometimes we struggle just as much as the pet parent during these times.

Then there is a recurring theme that veterinarians are “just in it for the money.” Your veterinarian is not in this profession for the money. Diagnostics are not recommended simply to increase the bill. Your vet likely took on more student loan debt than your house mortgage to follow this career path! We truly have your pet’s best interest at heart when making medical recommendations.

It is a shame that we keep losing intelligent, talented professionals each year. Changing this starts with awareness. There is not enough mental health awareness or resources available to veterinary students or veterinarians today. It is difficult to discuss because of the stigma that currently exists. No one should feel ashamed to ask for help. We can’t expect change if we don’t start talking about it. We need to leave this profession better than when we started- for future generations of veterinarians, our clients, and our sweet patients.


Common Causes of Skin Allergies in Pets

In my previous post, I discussed the link between allergies and skin issues, like hair loss and itchiness. In this post, I wanted to dive a little deeper into this topic. So what are the possible allergic causes that could be making your furry friend downright uncomfortable? Below are three of the most common causes of allergic skin disease in pets.

Fleas

The most common pet allergy is caused by fleas. Fleas are parasites that feed on your pet and their saliva can trigger an allergic reaction, resulting in hair loss, redness, and intense itching. We will typically see the hairless regions near the base of the tail in dogs and cats. Cats will sometimes experience hair loss around their chin as well. If your veterinarian suspects a flea allergy, he or she will check for evidence of live fleas and flea dirt.Your veterinarian will be able to make recommendations as far as an effective topical or oral flea preventative product as well as ways to rid the environment of fleas and their larvae. It can unfortunately take several months to resolve a flea infestation.

Environment

Another allergy we commonly see in pets is environmental. This is medically referred to as atopic dermatitis. These allergies are very similar to what we, as people, experience during different seasons. Something in the environment, whether it is grass, pollen, dust, etc, causes your pet to become itchy after multiple exposures. We usually see hairless regions or redness on the paws and inguinal regions since these are the most likely areas allergens touch when your pet is walking or laying down. As you can imagine, these allergies are a little more difficult to conquer. However, if further testing beyond your primary care veterinarian is required, he or she can refer your pet to a dermatologist who is well-equipped to perform specific allergen testing.

Food

Some pets also develop food allergies. I can remember several occasions when I have had clients say, “..but he/she has been on the same food for years and hasn’t had these skin issues until now!” I had to explain that this is actually how a food allergy develops. Your pet is on the same diet for a long time and then suddenly (or so it seems!) develops an allergy to it. It seems counter-intuitive, but these allergies develop from repeat exposure over time as the body becomes sensitized to a certain component of the food. Typically the allergic component is the protein. Resolving a food allergy involves strict diet trials over several months. Recurrent ear infections can also point towards possible underlying food allergies.

As always, if you notice changes to your pet’s skin or coat, it is best to schedule a veterinary visit to get to the bottom of it!


Overview of Pet Skin Issues

A large portion of the questions I receive from people looking for pet advice are about skin issues. Hair loss, itching, scaly skin, redness… the list goes on! The truth is skin issues can cause frustration in pet parents because they can be difficult to resolve. This is because each pet is different and there is a vast array of underlying issues that could be playing a role. I’ll just touch on a few here.

When thinking about skin issues, it is important to look at the full picture. Have there been any recent changes in your pet’s environment? Is your pet current on flea and tick prevention? Has your pet been experiencing increased thirst, changes in weight, more frequent urination, or lethargy? What kind of diet is your pet being fed? These are just a few of the questions that are important during a patient’s exam to narrow down the cause.

Many endocrine diseases can actually outwardly manifest as alopecia (hair loss) or abnormal coat. Hypothyroidism and Cushing’s Disease are a couple examples we commonly see in dogs that can be associated with changes in skin or coat. Most of the time these endocrine diseases are diagnosed based on the distribution of skin abnormalities, by understanding patient history and other clinical signs, and through diagnostic testing.

When a pet is experiencing scratching and itchy skin, allergies are at the top of the list. Allergies are usually caused from fleas, the environment, or diet. These can be a little more tricky to diagnose! Other parasites, such as mites, can also result in intense itching and can be easily ruled in or out by looking at a skin scrape under the microscope.

Of course, skin issues can be a result of an infection, such as bacteria or yeast overgrowth as well. These most commonly cause dermatitis secondary to an underlying issue that allows the bacteria or yeast to proliferate.

With a good patient history, physical exam, and diagnostic testing, your veterinarian can work with you to determine the underlying cause and best course of treatment to make your pet happy and healthy again!

If you’d like to learn more about allergic skin disease, please check here!