Most pets gain weight in the winter just like their owners, many times due to a decrease in exercise. Pet obesity is often worsened during the winter when short days and cold weather means less opportunity for proper exercise. Find new ways to make exercise a priority, even when it’s cold outside. Maintaining your pet’s health with proper diet and exercise will help assure that you both have a happy winter season.

Bill-Client Pet of the Month

             

            Bill is a 13 year old, male neutered Golden Retriever. His owner had noticed a new mass on his chest and brought it to the doctor’s attention. This mass was actually a lymph node. The doctor recommended that we perform an FNA and cytology. An FNA is a fine needle aspirate. This involves inserting a needle into the mass and aspirating cells out of it. These cells are then put onto a slide and analyzed by a pathologist at the lab. Our doctors feel that about 70% of soft tissue aspirates give a diagnosis. This is because only a very small sample of cells is being evaluated. A biopsy, or removal of the entire mass, generally will give a definitive diagnosis.

            In Bill’s case his cytology confirmed lymphoma. Lymphoma (or lymphosarcoma) is the most common tumor of white blood cells affecting dogs and cats. It primarily affects lymph nodes or visceral organs such as the liver or spleen.

            Chemotherapy drugs are most active against rapidly-dividing cells. Most tumor cells are rapidly-dividing, while most normal cells are not. Normal cells that are rapidly-dividing are mostly in the gastrointestinal (GI) tract, which is why GI signs are the most common side-effect of many chemotherapeutic drugs. Chemo also has a large effect on bone marrow (termed myelosuppressive). Bone marrow is a flexible tissue that is found in the interior of bone. It produces new blood cells, such as platelets, red blood cell and most white blood cells. A CBC (complete cell count) should be run 1 week after administration of chemotherapy to ensure that white blood cells are not too low. Depending on the level of white blood cells, the chemo can be reduced, or postponed completely until the levels are within a safe range.

            Bill’s chemotherapy protocol involves 16 treatments over 6 months. The first 8 doses are given weekly (with a break between the 4^th and 5^th doses) and then treatments are given every other week for 8 additional treatments. This protocol will put >85% of patients in to a complete remission and on average the patients will have a good quality of life for 1 year with 25% of dogs living 2 years or longer (longer and shorter times, though, are possible). Patients living longer than a year may need additional chemotherapy.

            Bill’s specific chemotherapy drugs included Vincristine, Asparaginase (Elspar), Cyclophosphamide (Cytoxan) and Adriamycin (Doxorubicin).

            Vincristine is a drug derived from a flowering plant called periwinkle. It is frequently use in combination with other drugs. Possible side effects include muscle weakness, constipation, hair loss and jaw pain.

            Elspar is an enzyme derived primarily from the bacterial E.coli and is used commonly in cancer treatment of some animal and human cancers. Possible side effects include vomiting and/or diarrhea, hives on the skin or restlessness and difficulty breathing (rare). Because a hypersensitivity reaction is the most common when using Elspar, we premedicated Bill with Benadryl prior to administration to help prevent a reaction.

            Cytoxan is a frequently used drug in cancer chemotherapy. It is particularly irritating to the bladder, and can often cause bloody urine. Other side effects also include low white blood cell counts, loss of appetite and nausea/vomiting (rare). Because of its effects on the bladder, we gave Bill an injection of Furosemide (Lasix) as a diuretic to help increase urination and flush his bladder.

            Adriamycin is the hardest of these chemotherapy drugs on the body. It is considered cardiotoxic (toxic to the heart), and an echocardiogram is recommended prior to administration. An echocardiogram is an ultrasound of the heart. The day he received Adriamycin, we checked an ECG (rhythm strip of the heart) prior to giving the Adriamycin to ensure that there were no abnormalities prior to giving the medication. It was normal. We also gave Bill an injection of Benadryl to help decrease the chance of reaction.

            In addition to these drugs, Bill was also receiving Prednisone as an oral steroid at home throughout his treatments. It acts as an immunosuppressive drug to help slow the progression of cancer cell multiplication. In addition it also increases appetite and thirst.

            Bill received his first dose of chemotherapy on December 16^th, 2010. He received an injection Benadryl, and then had an IV catheter placed. He received Vincristine IV and Elspar IV, and then was maintained on IV fluids for several hours afterwards. Bill’s owner reported that he was ‘super dog’ two days later! He tolerated the drugs fine and felt great.

            His second dose was administered on December 23^rd. We ran a CBC prior to the chemotherapy and his white blood cells were normal, but his red blood cells low (also known as anemia). Dr. Miele did not feel that this contraindicated receiving his chemo this week, but if it continued to drop, we may want to postpone his treatments. He received Cytoxan IV and Lasix also IV. He was similarly kept on IV fluids for a few hours after the treatment. The following day Bill returned to the hospital because he was vomiting and lethargic. Dr. Nieh felt as though it could have been a reaction to the Cytoxan. Other causes could be that he ate something that he didn’t agree with and it was not related to the chemotherapy at all, another disease process, or even the lymphoma spreading. Bill was sent home with oral medications; an appetite stimulant (Mirtazapine), a stomach protectant (Sucralfate), a gastrointestinal antibiotic (Metronidazole) and an acid reducer (Pepcid). We rechecked a CBC on December 28 and his white blood cells were normal and his anemia was stable. He was OK to receive his next dose of chemotherapy on schedule.

            Bill received his third dose on December 30^th. He received Vincristine again alone. Again he was maintained IV fluids for a few hours afterwards. Because of his stomach upset after the second dose of chemotherapy, we sent Bill home with medications to have on hand in the event that he had a similar reaction. He was sent home with Metronidazole for potential diarrhea and Cerenia for vomiting. When we called the following day to check in, he was doing great. No vomiting or diarrhea was seen, and he seemed to be acting normally.

            Bill’s fourth dose of chemotherapy was administered on January 7^th. Prior to treatment we checked a CBC and . We checked an ECG as well, and he had a normal rhythm. We gave an injection of Benadryl and then gave the Adriamycin IV slowly over 1 hour. We listened to his heart and lungs closely every few minutes during this administration to ensure that there was no change in his heart rate or rhythm. He received IV fluids for a few hours after the treatment. The following day Bill was lethargic, his appetite was down and he had intermittent tremors/trembling. We had decreased Bill’s dose of Prednisone after the Adriamycin, so Dr. Nieh recommended that we increase it back to the previous dose. She also recommended he receive Cerenia for vomiting/nausea, Pepcid as an acid reducer, and Mirtazapine as an appetite stimulant. If his thirst and appetite did not improve, we may need to admit him to the hospital for IV fluids. Bill seemed to have waxing and waning symptoms at home from the 7^th until the 11^th. He did seem to slowly improve over time.

            Bill’s fifth chemotherapy treatment was administered on January 20^th. We checked a CBC prior to giving the chemo and his white blood cells were normal and anemia stable. On examination, Dr. Miele was concerned that Bill’s abdomen was large. He was worried that his abdomen was fluid-filled. His abdomen could have also been bloated secondary to the Prednisone use, or because his organs were enlarged. Fluid can build in the abdomen for several reasons when a pet has cancer;

• The lymphatic system can become backed up or obstructed due to the cancer, and the abdomen can fill with lymph fluid.
• The cancer could have spread to the gastrointestinal tract, and perforated the intestines, causing bacteria to infiltrate the abdomen, causing sepsis.
• The cancer could have spread to the heart, causing heart failure, and heart failure can cause fluid build-up in the abdomen as well.

Dr. Miele recommended that we take abdominal x-rays to evaluate what could be the cause of the bloated abdomen. There was no fluid seen in his abdomen, but his liver was very large. This could be due to the Prednisone use (because it can effect the liver), or also due to spread of the lymphoma. We continued as planned with his treatment. He received Vincristine IV and fluids afterwards. The following day we called to check in, and Bill seemed to be doing well. He was eating a new food, Hills n/d (the ‘n’ stands for neoplasia, meaning cancer). This food is specially formulated for patients with cancer. Overall he seemed to be doing well.

            Bill is currently doing well. We are not anticipating that this will be a cure of his cancer, but that it may give him more quality time at home with his family.

Congrats to Brandi Schroeder!

Congratulations to Brandi Schroeder! Brandi is a Veterinary Technician at Princeton Animal Hospital and has been with us for about a year and a half. She is a hard worker and loves working with clients. Congrats for the arrival of her newest family member.

Did you know that dental care is an extremely important component of your pets overall health? More than 80% of dogs and cats over the age of three suffer from dental disease. Dental disease can lead to secondary conditions affecting your pet’s heart, liver and kidneys. Infected teeth and gums are especially dangerous to your older pets. Princeton Animal Hospital provides comprehensive dental care including regular dental cleanings.

Lifesaver of the Month

My name is Cassandra and I’m a veterinary technician at the Princeton Animal Hospital. We work with healthy animals, sick pets, and life-or-death situations on a daily basis. Having worked here for almost 2 years, I already knew the staff was knowledgeable and friendly. I never realized the impact the Princeton Animal Hospital’s staff really has on the families of our patients until I experienced it first hand.

            On Sunday, October 10, 2010, my dog Luna, a four year old Welsh Corgi, started showing abnormal urinary signs. She urinated a normal amount at 11 AM, but shortly after, she was straining to urinate. I brought her to work with me that day to have Dr. Jones examine her. She had a normal temperature and heart rate, and her lungs sounded clear. The only abnormality Dr. Jones found was a slight tenseness in her abdomen. This tenseness can be associated with urinary tract infections or bladder stones. Dr. Jones recommended x-rays, blood work, or sending her home on antibiotics. Because she is a young, healthy dog, and was having no other urinary issues, I decided to take her home with antibiotics.

            As soon as I got home that night, she passed a stone and began urinating large amounts of urine with blood in it. I assumed this blood was normal because she had just passed a stone, but, just to be safe, I immediately called Princeton Animal Hospital. The doctor and I discussed whether this was an emergency: should I bring her right out or could it wait until the morning? The doctor said there wasn’t a major blood vessel that would cause any profuse bleeding. I decided to wait until morning since she would only be alone for a few hours overnight.

            When I woke up the next morning, Luna was laying on the floor, cold, covered in bloody urine, and barely responsive! At the Princeton Animal Hospital, there are technicians available 24 hours a day to help with emergencies, so I called immediately. I told them she had taken a sudden downhill turn and was very sick, and I was on my way. I was nervous I wasn’t going to make it in time, and blasted the heat in my car to keep her temperature up.

            Once I arrived, Aleisha, the overnight technician, helped me take her inside. She placed an I.V. catheter in her leg and started giving her fluids. Dr. McCann took her temperature, checked her blood pressure, and ran blood work. While they were working with her, the rest of the morning staff arrived. All the doctors and technicians helped with my sweet Luna! They took x-rays and found she had a bladder full of stones. The owner of the Princeton Animal Hospital, Dr. James Miele, assured me that he would perform the surgery to remove the stones once she was stable. I knew this surgery would be costly, but I was willing to do anything to save my Luna’s life! After the diagnostic tests were competed and Luna was stable, Dr. Miele performed the surgery. Luna was ready to go home after a few more days in the hospital! I will never be able to thank everyone enough for saving Luna. I am so happy to have her back! It’s a relief to know I can call anytime, day or night, for emergencies. Today, Luna is again, a healthy happy dog thanks to the staff at the Princeton Animal Hospital. 

Congratulations Dr. Ross!

Dr. Kelly Ross had her baby! Mia was born Tuesday February 8th at 6:14 pm after she had to be evicted (induced) from her home. 24 hours of labor. She is 6.12 pounds! Dr. Ross can't wait for everyone to meet her!

 

February's Cutest Pet is.....

Congratulations to Leon, the winner of February's Cutest Pet Contest. So many precious pictures this month. Thank you for taking part. Your entries will be added to next months contest as well. If you did not send one in this month, be sure to enter next month.

 

Employee of the Month

Princeton Animal Hospital would like to honor Kelly as our Employee of the Month for February. Kelly is a Veterinary Technician and we are proud to have her as a part of our team!

Princeton Animal Hospital Winter Storm Totals

Hours of working on the parking lot:  28 hours 

Amount of times the parking lot were plowed:  8

Amount of Salt Purchased:  1,400 pounds, yes pounds)

Inches of snow removed:  First storm: 7 inches, Second Storm Part 1: 7 inches, Second Storm Part 2: 16 inches

Staff members stranded getting to and from work: 1 (Thank you Policemen) 

Staff members able to make it to the hospital: 10

Amount of Appointments Seen: 83 during the storms

Hours we were closed: 0

The reason why we do it: 

HAVE YOU SEEN MOE?

Moe is a client's beloved pet that is currently lost. If you see Moe, please let someone at Princeton Animal Hospital know. We would love to get Moe back to his family.

Valentine's Day Tips

Valentine’s Day is a day for romance and love, but don’t forget the hidden dangers to your pets in those wonderful boxes of candy. Chocolate is highly toxic and often fatal to both dogs and cats if ingested in large enough quantities. Candles can also be a danger to pets. Make sure that burning candles are set out of their reach. Make sure your pets are safe as you celebrate Valentine’s Day.

Limping

Lameness, limping, or the favoring of one or more legs, is a relatively common problem in dogs.  Sometimes the cause of the problem is as simple as a pulled muscle, sprain, or strain.  This type of minor injury can often be treated simply with rest and anti-inflammatory medications available from your veterinarian.  However, sometimes the cause of the lameness can be more serious, including fractured bones, torn ligaments, arthritis, tick-borne disease, or even a bone tumor.

One of the more common ligament injuries seen in dogs is the tearing of the Cranial Cruciate Ligament of the knee.  This ligament is known as the Anterior Cruciate Ligament, or ACL, in people.  A torn Cruciate ligament often produces pronounced lameness of the affected hind limb.  This type of injury will not heal on its own, but can be repaired surgically.

Smaller dogs can be predisposed to patellar luxation.  This is a condition in which the knee cap pops out of its normal position.  Some mildly affected dogs have few clinical signs.  Others will favor one or both hind legs occasionally.  Mildly affected dogs can be managed non-surgically, with medications and supplements to help prevent degenerative changes in the affected joint.  More severely affected dogs require surgery to stabilize the joint.

Arthritis is a very common problem in older dogs.  Even young dogs can develop arthritis, particularly if they have any predisposing conditions, such as hip dysplasia.  Arthritis is best managed with multi-modal therapy.  It is very important that a dog with arthritis be kept in good body condition, as extra weight adds more stress to the joints.  Two supplements which can be useful are Glucosamine/Chondroitin and Adequan.  Glucosamine and Chondroitin supplements are given orally on a daily basis, and act by strengthening the cartilage and also have an anti-inflammatory effect.  Adequan is a supplement which is given as an injection on a weekly or twice-monthly basis.  It not only improves functioning of arthritic dogs, but is thought to be the only medication that can actually preserve the remaining cartilage within the joints over time.  Additionally, several medications can be useful depending on the patient.  Canine-specific NSAIDs (non-steroidal anti-inflammatory drugs) can decrease pain and are therapeutic as well, acting to decrease inflammation in the joints.  Other medications include opioid pain medications, and sometimes even a type of anti-convulsant medication can bring relief in more severe cases. 

Fortunately, bone tumors are not as common as arthritis.  However, in middle-aged to older, especially larger breed dogs, bone tumors are something we need to rule out when a dog becomes lame.  While not all bone tumors are noticeable to the touch, most are readily diagnosed with x-rays of the affected limb.  There are options available for keeping your pet more comfortable after such a diagnosis has been made.

Lyme disease in dogs commonly infects the joints, causing lameness in one or more limbs.  Lyme Disease can be severe if not treated, but treatment with antibiotics can clear the infection.  It is important that treatment be started in a timely manner to prevent other complications associated with Lyme disease, such as kidney dysfunction.

Given the wide array of problems that can cause limping, it is important to see your veterinarian if your dog begins to limp or show signs of discomfort when walking.

Sandy at Princeton Animal Hospital trimming a dog's nails.

February is National Pet Dental Health Month, so make sure your pet's dental health needs are being cared for.

At Princeton Animal Hospital we are weathering through this blizzard.

NEW HOURS

We have new hours! Princeton Animal Hospital proudly offers the most extensive general practice hours in Central New Jersey.

 

Chocolate and Pets

Chocolate!  Who doesn't like chocolate? Including our pets.  We want to remind you that Valentine’s Day is just around the corner and your pets love candy and chocolate just as much as you do. Chocolate, in all forms is dangerous for both cats and dogs.  If you suspect your pet has gotten into chocolate, or any other harmful substance; please call us right way and we'll guide you on what to do next.