Sunday, July 27, 2014

Why We Are Phasing Out Use of "Antibacterial" Handsoaps

Here at Cat's Meow Veterinary Clinic we have always used (and will continue to use) surgical scrub soap containing chlorhexidine for use on patients and prior to gloving up for surgery. But our everyday handsoap for use at sinks throughout the hospital is another matter.

Some years back I made the decision to switch to "antibacterial" handsoap containing triclosan because, well everyone was doing so and it seemed to make sense. But the devil is in the details. In the ensuing years there have been disturbing reports of environmental persistence by this chemical (yeah, we REALLY need another DDT, don't we?), and more frighteningly, its negative effects on soil and water microbes.

Now there are plenty of microbes we want to have a negative effect on: specifically the potential pathogens found on dirty hands. But the last thing I'd ever want to see is for those effects to spread beyond my hands and into our waterways and outdoor ecosystems. And that is exactly what is happening.

In 2011 Tufts University produced a white paper evaluating triclosan. They expressed concerns about bioaccumulation in fatty tissues of animals including humans, contributions to antibiotic resistance, and environmental effects.

I decided, based on these concerns, that it would be wise to end our use of products containing triclosan wherever possible. So we've been gradually using up the jug of Dial Antibacterial Handsoap we had on hand (I felt this was preferable to sending it en masse to a landfill - dilution is the solution to pollution in this case) - and I am happy to report that we are now down to the final 8 ounces or so in the final dispenser.

Research studies have shown that vigorous handwashing with ordinary soap removes just as many bacteria as soaps containing triclosan, with far less environmental impact. It's all about mechanical removal, it turns out, and not about "sterilization" of hands (which is physically impossible anyway).

So I'm about to do a little happy dance as the last of that nasty orange stuff goes away. I now use a handsoap with no dyes, though it does have some fragrance. And as soon as I can find a jug of fragrance and dye-free handsoap, I will phase that in. I believe I spotted one at Whole Paycheck, but avoiding those pesky unintended consequences is well worth the cost.

Saturday, July 12, 2014

Updated Information on the Rabid Skunk in Long Beach

We just got this press release from the Long Beach Health Department. I am relieved that it was NOT the skunk variant, which would have been an ominous development with serious public health implications, particularly for our local feral cat population.


July 3, 2014
Contact: Mitchell Kushner, MD, City Health Officer, 562.570.4047
For immediate release
  
First rabid skunk to test positive in Los Angeles County
since 1979 confirmed to be rabies variant carried by bats

The California Department of Public Health confirmed today that the rabid skunk found last week in Long Beach was infected with a rabies virus variant from the Mexican-free-tailed bat. While bats in the area have tested positive for rabies in past years, this was the first confirmed case of rabies in a skunk in Los Angeles County since 1979. Mexican-free-tailed bats are very common in Southern California, and are the species of bats that most commonly carry rabies in the state.
  
Bat-to-mammal transmission is not uncommon, and the rabid skunk likely had an encounter with a bat infected with rabies. “This is the time of year that we might see more bat rabies, and potentially spillover to terrestrial mammals,” said City Health Officer Dr. Mitchell Kushner. “We do not anticipate that this spillover event is anything more than an isolated incident.”
  
The testing was important to determine that a skunk variant of rabies, which is only noted in Northern California, has not be re-introduced to Southern California where it has not been seen since 1979.
  
Continued vigilance in testing wildlife that is ill or exhibiting unusual behavior is still recommended. Anyone noticing obviously ill wildlife or unusual symptoms by animals should contact Animal Care Services at 562-570-7387. The Health Department and staff from Animal Care Services remind residents that they should not try to capture or trap wildlife, and that all domestic pets should receive their scheduled rabies vaccine to prevent pets and humans from getting rabies from other animals.
  
For more information on rabies, call Long Beach Animal Care Services at 562-570-7387.
  
# # #

Tuesday, July 8, 2014

Preventive Care for Kittens

It's been quite a while since I wrote the previous edition of my kitten prevention recommendations, and I can't find the post easily, so I think it's time to write an updated version.

Kittens should be seen promptly when first acquired (within a day or two) to assess their age and look for any urgent problems, in addition to coming up with a game plan for vaccinations, parasite control, diagnostic testing, and neutering. Generally this first visit is at about 8 weeks, but in younger kittens it can be much earlier. We do recommend that, whenever possible, kittens stay with their mom and litter mates until 8 weeks to allow the greatest chance of normal psychological and behavioral development.

At 8 weeks:

FVRCP-C #1 - first in series of three distemper/upper respiratory preventive vaccinations
Parasite control - flea control and internal parasite treatment as indicated - typically we administer an oral dewormer and outline what external parasite control you should be using, depending on individual circumstances.
Basic physical examination - eyes, ears, skin, mouth, heart/lungs, abdominal palpation
Q&A - be sure to come with a list of questions to ask the doctor because that's one of the most important parts of the visit

At 12 weeks:

FVRCP-C #2 - second in series
FeLV #1 - first in series of two feline leukemia preventive vaccinations
Parasite control - another oral deworming
Physical examination - just like the first time, but looking for normal weight gain and growth and development of any abnormalities or signs of illness
This is the earliest possible date to do FeLV/FIV testing, but obtaining a blood sample at this age is difficult so we usually defer it unless the kitten looks suspicious.
Q&A - ask away

At 16 weeks: 

FVRCP-C #3 - final in the series (boosters annually or every three years depending on brand)
FeLV #2 - final in the series (boosters every 1 or 2 years depending on brand)
Rabies - not part of a series (booster in one year, then every 1 or 3 years depending on brand)
Physical examination - weighing again and looking over to make sure all appears normal
FeLV/FIV test if kitten cooperative.
Q&A - keep asking - we're here to answer

Neutering:

We recommend spaying females at 6 months of age and males at 8 months. Yes, it can physically be done earlier, but we feel that it is not in the cat's best long-term medical interests to jump the gun. It is rare for females to come into heat before even 5 months, and if she goes into heat it doesn't need to change our plans for surgery - it just costs a little more. We do NOT wait until she goes out of heat because that takes months and is unwarranted. Just be sure to keep her indoors 100% of the time until she has been spayed.

As for males, we especially do not want to do surgery prematurely as this has been associated with hip fractures in young males, and in our experience it also increases the risk of obesity and urinary obstruction down the road. It is quite rare for males to spray prior to 1 year of age, and if the stinky urine odor from hormones kicks in and bothers you too much, we can move the date up 2-4 weeks to keep you from going crazy.

We most commonly get our blood samples for FeLV and FIV testing at the time of spaying/neutering since the patient is 100% cooperative when anesthetized and we don't have to scare them to get it.

Down the road: 

This isn't the end of medical care for kitty - it's just the start. All cats, regardless of lifestyle, breed, or owners' perception of risk, need to see a vet annually for an exam and vaccinations through age 8, and then twice a year after that, at a minimum. Once cats are mature, one calendar year ages them like four years in a human. These annual visits are a great way to discuss any concerns you have about ongoing minor concerns.




Monday, November 4, 2013

CDC's New Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents

The CDC has come out with its new guidelines for HIV patients regarding prevention of zoonoses and opportunistic infections. It once again wisely advises patients to use meticulous hygiene around pets and emphasizes that there is no need to "get rid of the cat".

The guidelines just emphasize what we vets already know about basic handwashing and commonsense pet husbandry. HIV patients should of course avoid contact with cats less than 1 year old, cats or kittens with diarrhea, and cat feces in general. And cats should be on an appropriate external and internal parasite control regimen.

Sunday, August 11, 2013

I've Been A VERY BAD Blogger!

I know I haven't been blogging here. I'm sorry. I'm a BAD person.

I've been posting on Facebook, however, and I just started working on the side as a Cat Veterinary Expert over at Pearl.com. If you have cat health questions, you can ask me them over at this link:

http://www.justanswer.com/veterinary/expert-calcatdoc/

No, it's not free. But it's certainly not expensive, either. I cannot diagnose your cat or prescribe medications, but it is a very useful format for having your cat health questions answered. I look forward to hearing from you!

If you live locally, of course, I'd especially love to see you as a real life client at my brick-and-mortar cat hospital, Cat's Meow Veterinary Clinic. You can call us 8-6 M-F and 8-1 Sat to set up an appointment for me to see your cat(s).

Here's a question box, but it doesn't go directly to me - you can ask any pet question here:



JustAnswer.com







Monday, March 11, 2013

Cats With Fight Wounds

Spring and summer are the seasonal breeding period for cats, so this is when the toms are out and about, looking for trouble and creating it where there's a lack. They will typically beat up on the spayed females and neutered males in the area, causing all manner of injuries.

We tend to see claw scratches on the face, and serious eye injuries can result. But claws do not deliver the most significant fight injuries - that honor goes to the teeth.

Cats have long, sharp, pointed fangs (canines in doctor-speak) which deliver small but deep puncture wounds. The fangs also do a great job of inoculating bacteria deep inside the wounds, which then seal up rapidly due to their small entry point. After a day or two of incubating, the bacterial population in the wound explodes, the cat's immune system throws a few million white blood cells into the mixture, and you've got a smelly, oozing mess full of pus.

Most people are more than happy to come running to Cat's Meow Veterinary Clinic at that point, which makes me a happy camper. I not only get to do surgery on an abscess that is enough to turn the strongest of stomachs, which is reward enough in itself - I also get paid to do my magic. In spite of their horrible appearance and nasty odor, bite wound abscesses are among the most rewarding and simple of conditions I am asked to treat.

The downside is this: abscess treatment easily runs $300-400, and can go higher depending on circumstances and if complications develop. It's not cheap, and in spite of pet medical insurance being available for decades, most clients still haven't jumped on board with the idea.

But it doesn't have to be like this. All bite wound abscesses begin with a bite wound. If clients were to bring their cats in within the first 6-8 hours of a fight and we had the chance to put it on prophylactic antibiotics, most of these would never develop into an abscess in the first place. And that's a whole lot less expensive.

So the next time you suspect or know that your cat has been in a fight, make an appointment for an immediate exam so we can assess the need for treatment before it ever gets icky.

Friday, March 8, 2013

A Sick, Elderly Cat

Well, I feel terrible about not blogging for a while. I don't have an excuse other than that I spend too much time on Facebook - to my credit, this time is often spent sharing fascinating (and not-so-fascinating) web articles about various aspects of cats and cat health. Ok, I confess: Grumpy Cat, Simon's Cat, and Henri pics and videos, too.

Meanwhile, back at the clinic (oh yeah, I have doctor responsibilities), we had an interesting case today. Little old Charlotte, an elderly female domestic medium-hair who a loyal longstanding client of mine adopted a couple of years ago. came in with a complaint of eating ravenously but losing weight, accompanied by chronic vomiting. On exam my most remarkable finding was a heart rate of 280.

Lest you be trying to faint on me, you should be aware that 280 beats per minute is not the highest heart rate I've ever observed in a cat - that honor goes to the elderly Siamese nearly 20 years ago who topped out at around 320. But 280 is bad enough.

This particular set of symptoms, along with the cat's age (16 years or more), makes me highly suspicious of hyperthyroidism. Feline hyperthyroidism is not rare in older cats, and is fatal if untreated. I proposed a diagnostic workup along the lines of a blood panel and complete urinalysis including culture and sensitivity if indicated. We also cleaned the cat's teeth, which were still remarkably solid in spite of a heavy accumulation of calculus (yes, I know that I am always calling it "tartar" in casual conversation, but the correct term is calculus - so sue me).

This particular client has fallen on hard times lately, but he has a long track record with us and always tries to do as much as he can for his kitties. When he leaned toward declining the dentistry and urinalysis due to cost, I took the opportunity to offer covering whatever he couldn't with funds in our Cat's Meow Veterinary Clinic Charitable Fund. So Charlotte got the whole shebang, and her owner won't wind up on the street.

We created our charitable fund with this sort of situation in mind, along with using it to help the occasional homeless or about-to-become-homeless-and-needs-fostering cat - we've had more than a few of the latter come through here over the years. We accept donations in any amount - you can add a small amount to your bill when you check out, or you can just come in and donate, or mail us a check. We are always looking for suckers aka kind, generous cat lovers to pitch in and help the cause.