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My seven year old golden retriever, Yukon Jac, had to have surgery this week at our vet clinic here in Pickering Ontario to repair a ruptured cruciate ligament. I thought it would be a good time to explain the injury and to talk about the surgical procedure Yukon Jac had to repair the knee.

What and where are the cruciate ligaments?

Cruciate Ligament

The word cruciate means “to cross over” or “form a cross.” The cruciate ligaments are two bands of fibrous tissue located within each knee joint. They join the femur and tibia (the bones above and below the knee joint) together so that the knee works as a hinged joint. One of the important functions of the cruciate ligament is to prevent forward and backward sliding of the femur on the tibia bone. In dogs, the most common knee injury is a rupture of the cranial cruciate ligament.

Humans have a similar anatomical structure to the knee, but the ligaments are called the anterior and posterior cruciate ligaments. Anterior cruciate ligament rupture is a common knee injury of athletes.

How does a cranial cruciate injury occur?

Acute or traumatic cruciate rupture is caused by a twisting injury to the knee joint. This occurs most often when the dog (or athlete) is running and suddenly changes direction. This places the majority of the body weight on the knee joint, and excessive rotational and shearing forces are placed on the cruciate ligaments. A cruciate ligament rupture is usually extremely painful and the knee joint becomes unstable, resulting in lameness.

Obese dogs appear to be more predisposed to developing a cruciate rupture. In these dogs, the injury may occur with minor trauma to the knee, such as stumbling over a rock while walking.

A more chronic form of cruciate damage can occur due to progressive weakening of the ligaments as a result of repeated trauma or arthritic disease. Initially, the ligament becomes stretched or partially torn and lameness may be only slight and intermittent. With continued use of the joint, the condition gradually gets worse until a complete rupture occurs.

There are various surgical techniques performed to stabilize the knee joint following cruciate rupture, but Dr. Wood used a relatively new technique called a TPLO procedure (Tibial plateau leveling osteotomy). In this procedure the tibial plateau, the portion of the adjoining the stifle, is cut and rotated (see x-ray below) so that its slope changes to approximately 5 degrees from the horizontal plane. This prevents the femur from sliding down the slope of the tibial plateau when the dog puts weight on its knee. A bone plate and screws are used to hold the repositioned tibial plateau in position until it heals (this usually takes 8-12 weeks). The plate and screws are usually permanent.

Yukon`s hind leg before the surgery

Yukon`s hind leg after surgery

Cutting the tibia may seem pretty invasive, but this procedure compared to other techniques results in

• a more rapid recovery
• better range of motion of the joint
• development of less arthritis
• return to athletic or working activity

There are photos of the actual surgery on our facebook page at www.facebook.com/AmberleaAH.

Hear I talked about the TPLO procedures, but there are a number of options to handle cruciate ligament injuries, so, as always talk to your veterinarian about the best treatment for your pet.

All the best, Dr. Fulop.

Source articles: Tibial Plateau Leveling Osteotomy – TPLO, Dr. Daniel A. Degner, Board-certified Veterinary Surgeon (DACVS) and LifeLearn

Veterinarians Blog 2013
Amberlea Animal Hospital serving Durham, Pickering, Ajax, and Whitby, Scarborough, and the GTA

For many of us, the New Year is a time to start fresh. It’s the time when we set personal goals and make resolutions, but don’t forget about our companion animals. Have you ever considered making a New Year’s Resolution for them? There are many ways that you and your pet can help each other make 2013 one of the best years yet.

Here are some suggestions for your pet’s New Year’s Resolutions.

1.  Exercising regularly is good for our physical and mental health. These benefits extend to your pet(s) as well. If you normally walk your dog a few minutes a day try to increase that by 5 minutes weekly until you are walking at least 30-45 minutes a day, unless you have an older dog like my Charley Girl, who has joint issues. For older pets, take them on more frequent shorter walks. For Charley, she gets 2-3 shorter 10 minute walks during the day. The important thing is to get them out to enjoy the outdoors – even if it is for a good sniff! A dog that gets appropriate exercise has fewer behavioural issues and will “act out” less.
Many cats enjoy strolls outside on special cat harnesses and leashes. Spend time playing with your cat – they love the attention and can benefit from the exercise as well. Remember our pets count on us to provide them with exercise and enrichment.

Wynne's (our Client Care Rep) dog Sam playing in the snow.

2. Eating smart is good for us and also for our pets. Invest in the best food you can for your pet. Whether you are feeding a store- bought brand or home-made, pet food options have increased in recent years. Foods can be tailored towards dietary needs, activity level and your pet’s age. Talk with your veterinarian or veterinary staff member about your concerns. Good food can help your pet with weight loss as well as improve his or her health. I’ll only give my dogs healthy pet treats and definitely avoid the following list of “bad foods”:  chocolate and cocoa, sugarless gum and candy containing xylitol, leftover fatty meat scraps, yeast bread dough and fruit cake. Particularly dangerous, fruit cake often contains raisins and currants, which can result in kidney failure if ingested by a dog. Some fruitcakes are also soaked in rum, resulting in alcohol poisoning; when ingested by a dog or cat, it can cause a dangerous drop in blood sugar, blood pressure and body temperature, potentially leading to seizures and respiratory failure. As I have said before, thank goodness I am not a dog – and I still have 9lbs of chocolate to eat.  Any volunteers?

3. Take your pet to your veterinarian at least once yearly or for those pets over the age of 7, at least twice yearly. Pets may not require vaccinations every year but they do require at least yearly examinations. “Raindrops on roses and whiskers on kittens. Crisp apple strudels and schnitzel with noodles” – these may be a few of my favourite things BUT heartworm, intestinal parasites, fleas and ticks – these are a few of Yukon and Charley’s least favourite things. I resolve to ensure that they get their preventive medication on time every month!!

Dr. Fulop at home with Amber.

4. We all know that life gets busy, and the New Year is a time to reflect on what is truly important in our lives and how we choose to use our time – like spending more time with loved ones. Getting home from work sooner allows us to spend more time with our pets and this has been shown to lower stress and increase overall happiness. I resolve to spend more time with family and friends – including my pets, so that I can treasure special moments and memories.

I love my pets so much that I want them around as long as possible. If you are like me, then we all need to start 2013 with firm resolutions to provide the best pet care we can, because your pet deserves nothing less.

The holiday season is in full swing here at our veterinary clinic in Pickering. We have had many enjoyable visits from clients and we have received great cards and gifts. Thank you to all.

I wanted to pass along this article from Pet Poison Helpline as a reminder that some holiday items can be harmful to your pets.

Pet Poison Hotline Article: The holiday season is a magical time to reconnect with family and friends, deck the halls, and celebrate the spirit of giving. Most pets seem to enjoy the holidays too and some are lucky enough to get their own stocking stuffed with new toys and treats. But fun times can quickly turn to tragedy when pets are exposed to potentially poisonous holiday foods, certain yuletide plants, and some common holiday decorations.

“Many dogs and cats simply cannot resist the smell and taste of new things, sometimes causing them to ingest items that can land them at the emergency veterinary clinic on Christmas eve,” said Ahna Brutlag, DVM, MS, DABT and assistant director at Pet Poison Helpline. “During the holidays, our homes are filled with new and interesting items, but some can pose a potential poison threat to dogs and cats when ingested.”

Keeping pets safe during the holidays involves first knowing what items are dangerous and then keeping them out of the reach of pets. Pet Poison Helpline shares the top holiday danger threats that can cause physical harm or poison dogs and cats during the holidays:

Holiday Foods and Alcohol

The holidays bring delicious baked goods, confections and other rich, fattening foods. People love them, but they can be very harmful to pets. Some of the most common dangerous holiday foods are chocolate and cocoa, sugarless gum and candy containing xylitol, leftover fatty meat scraps, yeast bread dough and fruit cake. Particularly dangerous, fruit cake often contains raisins and currants, which can result in kidney failure if ingested by a dog. Some fruitcakes are also soaked in rum, resulting in alcohol poisoning; when ingested by a dog or cat, it can cause a dangerous drop in blood sugar, blood pressure and body temperature, potentially leading to seizures and respiratory failure.

During the holidays, it is best to keep pets on their regular diets, and it is perfectly acceptable to discourage holiday guests from feeding them any human food.

Yuletide plants

Often misinterpreted as poisonous, the relative toxicity of poinsettias has been quite exaggerated—the sticky white sap of poinsettias usually causes only minor mouth or stomach irritation if ingested by a dog or cat. Instead, the bigger threat is lilies. As little as 1-2 leaves or petals—even the pollen— can result in severe, acute kidney failure in cats. Certain lilies commonly found in bouquets, including tiger, Asiatic, stargazer, day and Easter lilies pose the biggest threats. Thankfully, dogs are not affected, and only develop mild stomach upset with lily ingestion.

Like poinsettias, American mistletoe has been rumored toxic. This is likely because its cousin, European mistletoe, can be toxic to pets. Ingestion of American mistletoe leaves or berries may cause mild stomach upset, but not serious poisoning.

Dogs and cats can also experience vomiting and diarrhea after ingesting Christmas cactus. Likewise, the spiny and leathery leaves of the Christmas or English holly can result in irritation and damage to the stomach and intestines of dogs and cats. The holly’s berries have mildly toxic properties, but are fairly tolerable in most pets. While death is not likely, it’s best to keep these plants out of pets’ reach.

Tinsel and Liquid Potpourri

Avoid using tinsel for decorating trees. For households with cats, tinsel should be in one place only – the garbage. Tinsel looks like a shiny toy, but it can be deadly. If ingested, it can result in a severe linear foreign body, meaning the stringy tinsel can wrap around the base of the tongue or anchor itself in the stomach, making it impossible to pass through the intestines. As the intestines contract and move, tinsel can slowly saw through the tissue, resulting in severe damage to your pet’s intestinal tract. Treatment involves expensive abdominal surgery. It’s best to keep tinsel, as well as ribbon, yarn and thread out of your pet’s reach.

Some liquid potpourris contain chemicals called cationic detergents, which if ingested by cats, can result in severe chemical burns in the mouth, fever, difficulty breathing and tremors. Dogs are not as sensitive to the chemicals, but its best to keep potpourri out of their reach.

Beware of Handbags

When guests arrive, be sure to stow handbags safety out of pets’ reach. Dogs and cats find handbags and their contents incredibly interesting, which can lead to trouble. Handbags are reservoirs for things toxic to dogs and cats. The most common worrisome purse items include prescription medications, pain medications (e.g., Tylenol, Advil, Aleve), sugarless chewing gum (with xylitol), asthma inhalers, cigarettes, coins, and hand sanitizers.

For more information visit http://www.petpoisonhelpline.com/

The holiday season is less than 4 weeks away! Please keep your pets in mind when decorating. Injuries can be caused by dogs and cats chewing on cords. Try to conceal the cords as much as possible. Ingestion of ribbon and tinsel, while not poisonous, can cause problems in the intestinal tract that may require surgical intervention – especially in cats.

Bright ornaments can also make your pet curious, and many animals will chew and swallow them. Place glass and paper ornaments high on the tree, and pick up any broken pieces, which can cut your pet’s mouth, throat and intestines besides presenting a choking hazard.

What comes to mind when you hear “visit to the veterinarian?” You may automatically think of pet vaccinations or annual shots. You aren’t alone; many people make the same associations. While these are routine veterinary procedures, they aren’t on the list of the most common reasons why pets go to the vet. Those reasons, based on nationwide studies, may surprise you.

Based on information reported* in 2011, the top 10 reasons why dogs visit their veterinarian are:

1. Ear infection
2. Skin allergies
3. Skin infection
4. Non-cancerous skin growth
5. Upset stomach
6. Intestinal upset/diarrhea
7. Arthritis
8. Bladder infection
9. Bruise or contusion
10. Underactive thyroid

What about cats?
Cats are, literally, a whole different ball of fur than dogs. Their physiology is considerably different from dogs, as are their health risks and the diseases they may face. While ears and skin are the most pervasive problems for dogs, feline bladder infection was the most common reason for cat visits to veterinarians in 2011.

What are other reasons why cats go to the veterinarian?
The 10 most common reasons* why cats visit their vet are:

1. Bladder infection
2. Chronic kidney disease
3. Overactive thyroid
4. Upset stomach
5. Periodontitis/dental disease
6. Diabetes
7. Intestinal upset/diarrhea
8. Ear infection
9. Skin allergies
10. Lymphosarcoma

Aren’t pets healthier than they used to be years ago?
Chronic diseases in pets are actually on the rise, according to the State of Pet Health 2012 Report from Banfield Pet Hospital (TM). With better nutrition and care, many pets are living longer. Unfortunately, many of these same pets are not seeing a veterinarian on a regular basis. And that means many conditions that could be prevented or managed are going unnoticed and untreated.

How can a trip to the vet prevent trouble?
“Some pets try to hide pain or discomfort. So even the best pet owners may not realize their dog or cat has a health problem until there’s a crisis,” said Heidi Lobprise, DVM, Virbac Animal Health. “Regular visits to the veterinarian help to detect and identify problems early, which can spare a pet from pain and also be easier on the family budget in the long run.”

Overlooking preventive steps or delaying visits to the vet can make treatment more difficult. Delaying care can even lead to chronic conditions that can severely impact the quality of a pet’s life and become costly to treat and manage. With regards to cost, in the long run prevention is less expensive than treating a severe illness. For example, you can purchase 11 years supply of heart worm prevention medication for the same cost of treating heart worm disease.

How do I keep my pet off the top 10 list?
I believe “an ounce of prevention is worth a pound of cure”. If it’s been more than a year since your dog or cat has been to the veterinarian, do your pet (and yourself) a favour. Make an appointment and follow through on your vet’s advice.

All the best, Dr. Fulop.

*Veterinary Pet Insurance 2011 claims data.

Source article: Virbac AH Inc.

Veterinarian Blog 2012
Amberlea Animal Hospital serving Durham, Pickering, Ajax, and Whitby, Scarborough, and the GTA

This past weekend I was saddened to hear that a photo was circulating showing coyotes eating a cat in Rotary Park in Ajax. It is frightening to know that coyotes are so close to our neighbourhoods. With all the new developments around us, their habitats are being taken away from them, forcing them to come closer to us to find their food source. This includes our pets. In my neighbourhood I often see notices of missing cats or small dogs, and it makes me cringe thinking that a coyote or fox has gotten them. Please keep your cats indoors and your dogs leashed and under close supervision.

A few weeks ago I was out walking Yukon and Charley and there was a coyote sunning itself in the school yard. Too close for my comfort.  A neighbor was walking her dog down towards the lake and when she got to the path, there was a coyote laying there.  We must be careful.

Besides the concern of our pets being attacked, there is also mounting evidence that the tapeworm Echinococcus multilocularis (E. multi) may be spreading amongst coyote and fox populations in Canada. This has some researchers concerned about spill-over of this infection into dog and human populations where there is urban-wildlife interface.

Some types of E. multi infections can cause serious health problems in human and animal populations (e.g. cyst formation), however the risks for such an infection are low – only a handful of cases in humans have been diagnosed in North America.

Risks can be minimized by:

• Proper handling of dog and wildlife feces and proper handwashing
• Controlling rodents and preventing pets from catching and eating rodents
• Preventing dogs from eating wildlife feces
• Routine deworming should kill E. multilocularis and if a dog is at a particularly high risk, more regular testing and treatment may be indicated

Please speak to your veterinarian about intestinal parasites that can be a concern to you, your pets and your children.

Take Care, Dr. Fulop.

The Star Article: ajax-coyotes-cat-dinner-adds-to-residents-unease

University of Guelph Article: Echinococcus multilocularis

Source information: CVMA

In my last blog I talked about dogs and their behaviour, so this week I thought I would focus on kittens.

Kittens taken from their mother before 2 weeks of age can be fearful and overly aggressive towards humans and other cats. Adoption before 6 weeks of age is not recommended, however the socialization period is 3-9weeks of age, and research has shown that early handling may result in less fear-based behaviour toward humans allowing bonding with the family. It is encouraged to introduce the kittento as many different people and places as possible during this time and during its first year of life.

Four new members of our veterinary clinic in Pickering.

Make a safe place for your kitten. Allow the kitten to explore its new environment on a daily basis. Make sure your kitten is supervised and returned to its safe place frequently so it will learn where the litter box is.  This can be anywhere in the home and it should include a bed, toys, food and water and litter box. The rule of thumb is one litter box per cat. Make sure the litter box is tailored for you kitten – easily accessible, away from busy areas and the sides are low. The food bowl and water bowl should not be side by side. If we think of cats in the wild, when they feed it’s messy and they don’t like to contaminate their water source. The water bowl should also be a larger bowl – like a small dog bowl. Cats like to see their reflection in their water source and they don’t like their whiskers touching the edge of the bowl (although some will drink out of the tiniest cups).

Play is important for kitten development. All play should occur with toys, never human hands or feet. This will help avoid injury to people. Predatory play behaviour is an integral part of kitten play. There are feeder toys that allow food to be dispensed through manipulation and play, mimicking a more natural feeding behaviour.

Scratching is a normal behaviour. Kittens need a scratching surface that is appropriately sized and different options should be provided ie. horizontal, vertical, carpet or sisal until the kitten decides its preference. A rule of thumb is to provide a scratching post that is tall enough so that the kitten can completely stretch out when standing on its hind legs with front legs outstretched. Location is essential when getting the kitten to use the provided scratching material. Place one preferred scratching surface in the safe place and another where it spends time with family. Sprinkle a little catnip on the post or mat to make it more attractive. If your kitten is scratching things you don’t want it to, you can use double-sided tape on furniture and plants or again make sure your kitten is supervised so you can discourage it from scratching in the wrong places (a squirt with water may help).  Start this early with your kitten and then maybe it won’t be necessary to get them declawed.

Gentle handling techniques several times per week, like grooming with a soft brush, touching its feet and ears,  opening its mouth, trimming 1 or 2 nails can also benefit your kitten. Pick a time when your kitten is quiet and relaxed and keep these handling sessions short. Always provide treats before, during and after sessions to help associate them with good things.

Kittenhood is the best time to get your kitten used to crates and car travel, making traveling to your veterinarian less stressful. Top opening crates facilitate easier entry and exit, however different crates are available. Leave the crate out and open. Treats and comfortable bedding should be placed inside. Praise and provide treats every time the kitten is in the crate. Kittens can also be trained to wear a harness and leash for safe outdoor exploration.

All the best, Dr. Fulop.

Source article: Clinician’s Brief July 2012.

An informative article on crate training can be found at catcouncil.com/programs/carriertraining.htmlA helpful crate-training video can be viewed at catalystcouncil.org/resources/video/?ld=102

Veterinarian Blog 2012
Amberlea Animal Hospital serving Durham, Pickering, Ajax, and Whitby, Scarborough, and the GTA

This week a client came to our veterinary clinic here in Pickering with a dog they rescued. A big thank you to them for rescuing this very cute and good dog. However, there were subtle signs that the owners were not picking up that the dog was fear aggressive. Canine aggression is the most common reason for dogs being euthanized or relinquished to shelters. Therefore, this week I wanted to present some body language cues that dogs give us all the time that we may not recognize, but are important to know to keep us and our pets safe. People and dogs do not speak the same language, so understanding the behavioural basis of dog bites is an important step toward prevention.

1. Yawning is a sign of stress. Anxious dogs will display signs such as yawning, lip-smacking, panting, big eyes and dilated pupils, pinning their ears back or turning their head to avoid eye contact. Some dogs will simply “freeze”. They are more likely to bite in this situation.
2. A dog’s way of saying “STOP” can be rolling onto its back. If you approach a dog to interact with it and it rolls onto its back, this is the dog telling you to walk away. However, if the dog approached you and then rolled onto its back, it is looking to play. Watch body language. If the dog is stiff and tense, don’t touch it. If its relaxed and wiggling around, then play is OK.
3. Just because the tail is wagging doesn’t mean the dog is friendly.  Dogs can wag their tail as a sign of fear, stress or from happiness and a tail-wagging dog can still bite. Watch body language again. An excitedly tail-wagging dog that greets you when you get home from work may stand completely still except for wagging its tail when approached by an unfamiliar person. You should not assume the dog is friendly in the latter situation.
4. Dogs don’t always want to befriend strangers. When guests are meeting an unfamiliar dog, the best approach is “no touch, no talk, and no eye contact”. Let the dog approach you and even then do not assume that all is going to be OK.
5. Let sleeping dogs lie, or resting dogs. If a dog is sleeping and then startled, it is more likely to bite defensively and quickly. What is more confusing is when your dog is awake but growls when approached or touched.  This can be referred to as “resource guarding”, the resource being the bed the dog is laying on or the couch. The dog may feel “trapped” by you approaching it, with no place to go. Put yourself in your dog’s position. I know when I’m half asleep on the couch and I get nudged and told to go to bed, I get pretty cranky myself.
6. Do not pull, push or nudge a dog to move it. Again, if you ask a resting dog to move and it doesn’t, the automatic response is to nudge or pull the dog. The dog’s response could be to growl, snap or bite (again, I would). It is safer to use a verbal cue and better yet, to lure it with a treat. Long term success is assured using positive reinforcement  (chocolate works for me).
7. Do not teach a dog to relinquish a possession by unexpectedly taking it away. When a dog has something in its possession and all of a sudden it is removed, it makes no sense to them. The first time they may be surprised, but they may become defensive of their belongings in the future. If you take something away, make sure you give your dog something else it is allowed to have.
8. Always supervise your dog around young children. Never leave your dog unsupervised with children or vice versa. Bites happen quickly so it’s not enough for a parent to be nearby. If there is any distractions i.e. phone or dinner preparations, the dog should be securely separated. Baby gates are wonderful tools.

No matter how much a dog is loved, the relationship with its family will be jeopardized if the dog bites someone. Aggressive behaviour cannot be cured, but it can be minimized or sometimes prevented by following the above mentioned principles.

Again, if you have any questions don’t hesitate to talk to your veterinarian.

All the best, Dr. Fulop.

Source Article: Clinician’s Brief, May 2011.

Veterinarian Blog 2012
Amberlea Animal Hospital serving Durham, Pickering, Ajax, and Whitby, Scarborough, and the GTA

Dogs and cats are as important to owners as are siblings and parents. Those relationships can provide a protective mechanism, as pet owners are both physically and emotionally healthier than their non-pet owning peers, according to 3 studies that have been conducted. Pet owners were found to do better in several well-being measures (eg. Self-esteem, exercise/fitness level, loneliness) and individual-difference measures (e.g. More conscientious, more extroverted, less fearful and less preoccupied).

I know when I come home after a long hard day, and Yukon and Charley greet me at the door I feel 100% better — my stress just melts away looking at those beautiful faces.

Think of your pets as friends with benefits.

All the best, Dr. Fulop.

Yukon and Charley greeting Dr. Fulop at the front door.

Source article: J Pers Soc Psychol 101:1239-1252, 2011.

Veterinarian Blog 2012
Amberlea Animal Hospital serving Durham, Pickering, Ajax, and Whitby, Scarborough, and the GTA