More Than Skin Deep: Human Topical Medications Can Have Serious Effects on Pets

Topical medications (creams, gels, sprays, patches) are commonly prescribed and used for many conditions in human medicine. They are often incredibly effective for the conditions they treat, but if pets are inadvertently exposed to them (through casual contact/petting, or by the pet ingesting the product), they can be hazardous. The following list is not meant to be all-inclusive, but contains some of the more common and/or dangerous medications.

  1. Fluorouracil (Efudex®, Carac®, Fluoroplex®): This topical medication, usually supplied as a cream, is used to treat human skin conditions including solar and actinic keratosis, as well as some superficial skin tumors. It is particularly dangerous for dogs and cats exposed to it, as it is very rapidly absorbed, and low doses may be fatal. It causes seizures, stumbling, tremors, vomiting, heart rhythm abnormalities, diarrhea, and respiratory issues, usually within an hour of ingestion. If the pet survives the initial illness caused by this medication, they aren’t out of the woods yet – bone marrow suppression may occur and persist for up to three weeks.

 

  1. Calcipotriene (Dovonex®): This topical psoriasis treatment causes high blood calcium levels if ingested and may result in kidney failure, heart failure, and may lead to death. Lethargy, weakness, and decreased appetite are usually seen within one to two days of ingestion.

 

  1. Hormonal preparations (Evamist®, Estrogel®, Divigell®, Estrasorb®): Hormone replacement creams and sprays are often prescribed to lessen the adverse symptoms associated with menopause. They typically contain estrogen and/or progestin, which may be absorbed by pets after the product is applied – usually to the owner’s arms or legs. The pet can then exhibit signs of “feminization” – including enlarged nipples, mammary glands, and vulva, and possibly vulvar bleeding in female pets, or enlarged nipples and mammary glands in males. Pets may also exhibit patterns of hair thinning or hair loss. These effects are reversible once the exposure is halted, but it can take up to several months for the pet to fully recover.

 

  1. NSAIDs (Non-steroidal anti-inflammatories): Used for topical pain relief, these usually contain diclofenac or ketoprofen, and may be supplied as a cream or a patch. If a dog ingests only a small amount, the only sign may be gastrointestinal upset; however, if a larger amount is ingested, or if a cat ingests some of the product, then gastrointestinal bleeding, perforating stomach/GI ulcers, kidney failure, and death are possible.

 

  1. Patches: Used transdermal patches generally still contain significant amounts of drug, so proper disposal is crucial to preventing unintentional exposure to pets.
    1. Nicotine – These smoking cessation aids can be dangerous. Ingestion initially causes drooling and vomiting, and can progress to high blood pressure, rapid heart rate and breathing, tremors, and seizures. Some signs can show later, and include central nervous system depression, respiratory distress, stumbling, and seizures; if enough has been ingested, it can be fatal.
    2. Lidocaine – Patches containing lidocaine are generally applied to or near painful areas. Ingestion may cause seizures, stumbling, low heart rate, low blood pressure, and cardiac arrest or death at very high doses.
    3. Fentanyl – This potent pain medication is related to morphine. Effects have been seen in small pets after they have simply licked their owner’s skin in an area where a patch was previously applied. Initially, a mildly affected pet may only appear “drunk” – sleepy, stumbling – and recover within a few hours; in more severe cases with higher ingestion/exposure, the pet may have a low heart rate and low body temperature, become unconscious and severe respiratory depression may lead to death.

If you have been prescribed any of these medications, discuss with your physician best practices to ensure no pets (or children) will be exposed. If you think your pet may be affected by or might have ingested a medication you have been prescribed, please do not hesitate to contact your veterinarian.generic-products

 

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Hyperthyroidism in Cats

Snazzy and Hyperthyroidism

HayleycatDOOM

The Diaz family brought their cat, Snazzy, to Longs Peak Animal Hospital for her yearly checkup recently, but noted when making the appointment that she has been acting strangely.

 

The Check-In:

As the technician got a weight for Snazzy and took her temperature, she asked about Snazzy’s recent behavior.

“She just turned 13, but she has been meowing incessantly and racing around the house like a wild kitten all of last month,” said Mrs. Diaz.

Young Billy Diaz added, “She’s usually really sweet, but she hissed and swatted at me a few times this week too. It really scared me!”

Mrs. Diaz also noted that Snazzy’s usually-glossy calico coat has seemed a bit drier and duller for a while now, and that she hasn’t been grooming herself normally.

Mr. Diaz piped in as well: “I believe she may be eating more lately, too. I feel like I’ve been buying cat food more often.”

 

The Exam:

After listening to the technician’s summary and reviewing Snazzy’s medical history, Dr. Marsella came into the room to begin the exam.

Even though Mr. Diaz said her appetite had increased, Dr. Marsella noticed that Snazzy was looking a bit thin, and her medical records revealed some weight loss since last year’s check-up. He also noted Snazzy’s unkempt hair-coat.

Mrs. Diaz then remembered to mention that she has taken to changing the litterbox more frequently, as the urine clumps are building up faster than before. She wasn’t sure if this was important, but Dr. Marsella assured her that relaying any changes in behavior can be helpful.

Upon listening to Snazzy’s heart, Dr. Marsella noted a fast, pounding heartbeat as well as a heart murmur that hadn’t been noted previously in her medical record.

He also felt abnormal lumps on Snazzy’s throat—a “thyroid slip.”

Because of Snazzy’s behavior and physical exam findings, Dr. Marsella recommended bloodwork.

 

The Assessment:

Snazzy’s bloodwork revealed high thyroid hormone levels, but the remainder of the bloodwork was not concerning.

Dr. Marsella told the Diaz family that the most likely culprit for Snazzy’s strange behavior, the abnormal physical exam findings, and the bloodwork changes was hyperthyroidism. He explained that hyperthyroidism is caused by a benign (non-cancerous) process, but that 1-2% of cats with the disease can have a type of thyroid cancer.

 

Treatment Options:

Dr. Marsella presented several treatment options that might help Snazzy:

“Some cats respond well to daily medical management with a pill or a cream. For others, a diet change to a prescription food can help the problem, but since you have other kitties in the house, that might be difficult.”

He also explained that a visit to a specialty hospital for a type of radiation therapy was also an option.

After considering their options, the Diaz family agreed that their first strategy would be to treat Snazzy using the pills since many cats will take them crushed and mixed in canned food. We filled the prescription through our in-house pharmacy and a Recheck Exam was scheduled for three weeks later.

 

The Recheck Exam:

After a few weeks of medication, the hyperactive and aggressive behaviors had subsided; Snazzy wasn’t crying for food all day, and her fur was starting to improve.

Snazzy’s bloodwork was repeated and her thyroid hormone was normal. In six months, Dr. Marsella will check the thyroid levels again to make sure the dosage of thyroid medicine is still correct.

Now that her hyperthyroidism is being appropriately managed, the Diaz household has returned to normal and Snazzy is able to relax and enjoy her favorite windowsill where she has a great view of the bird feeder.

Tularemia – “Rabbit Fever”

rabbit

Over the last few Colorado springs and summers, the U.S. Department of Agriculture has seen an increase in Tularemia, also known as “rabbit fever”.  Tularemia is a bacterial infection (Francisella tularensis) which has the potential to infect dogs, cats and people.

There are two main sources of transmission, and both are associated with rabbits.

  1. Meat: If a dog, cat or person consumes infected meat from a rabbit.
  2. Ticks: A tick that has fed on an infected rabbit now carries the bacteria and can infect a dog, cat or person. The bacteria can persist for long periods in the environment (soil, water, animal carcasses).

Clinical signs to watch for include: fever, depression, anorexia (lack of appetite), lymph node enlargement, and ulcers or wounds in the mouth. These symptoms are common with other diseases, but a specific test to diagnose Tularemia is offered by the State Health Department and can be submitted through Longs Peak Animal Hospital, PC.

Antibiotics are the treatment of choice for Tularemia and can be started while waiting for test results.   Depending on the severity of the infection, hospitalization may be necessary. We recommend flea and tick preventative (topical or oral) to limit exposure.

There were 46 cases of Tularemia reported in 2015 for Boulder, Larimer, and Weld counties. If you notice an unexplained die-off of a rabbit population near your home, please contact the County Health department. Keep in mind that it is best to avoid contact with all rabbits.

  • Katie Becker, DVM
Longs Peak Animal Hospital, PC – 9727 Ute Highway – Longmont, CO 80504
303-776-6666  – http://www.longspeakah.com

The Importance of Routine Veterinary Care for Older Cats

cat on barrel

Do you have a senior citizen kitty? By definition, a senior feline is any cat over the age of seven. While cats routinely go on to live well into their mid to late teens (or even their early twenties!), older cats are at higher risk for developing many diseases which may have only subtle symptoms.

 

Vomiting: A common misconception is that frequent vomiting, or bringing up food and hairballs, is normal. In truth, chronic vomiting or hairballs can be a sign of underlying disease. Although your cat many be a fast eater, a fastidious groomer, or “just a puker,” vomiting is never normal. Even hairballs can indicate abnormal function of the stomach and intestines. If you have noticed that your cat is vomiting frequently, we recommend scheduling an appointment with your veterinarian to rule out possible causes including certain inflammatory bowel conditions, lymphoma, diabetes, or kidney disease.

Increased drinking and/or urination: It is also important to monitor your cat’s water intake and urination. For many feline diseases (like diabetes mellitus or kidney disease), your cat’s water and urine habits may change drastically. For example, diabetic cats have very high blood sugar which causes increase thirst and urination. Things to watch for include excessive drinking, larger urine clumps in the litter box, filling water bowls more frequently, or urinating outside of the litter box.

Arthritis: Arthritic cats may not have obvious pain or limp but you may notice that your senior feline friend is less playful, no longer jumps on high furniture, or chooses to lay in unusual spots lower to the ground. While arthritis is an irreversible condition, there are a number of supplements and medications that may help to reduce pain and increase their quality of life.

Dental disease: Dental disease can be easily diagnosed by your veterinarian on physical examination. At home, you may notice weight loss, decreased appetite, or bad breath. Advanced dental disease can cause serious health complications including severe pain, weight loss, tooth infections, and tooth loss. Did you know that dental disease can even affect the heart, liver, and kidneys? There are many good products that you can use to help prevent dental disease but the best thing for preexisting dental disease is a professional veterinary dentistry to remove dental tartar and to address any diseased teeth.

Hyperthyroidism: Hyperthyroidism is a very common condition in older cats. The most noticeable symptoms include weight loss, a dry/scruffy coat, and vomiting. These cats suffer from overproduction of thyroid hormone from the thyroid glands located in the neck. Unlike many other diseases, cats with hyperthyroidism often maintain a good appetite or may even be ravenous. Luckily, when hyperthyroidism is diagnosed early it can be easily treated.

If your cat hasn’t been to the veterinarian for their regular yearly check-up, or if you have noticed any of these symptoms, we recommend giving us a call to schedule an examination. Routine veterinary care is important for your cat’s well-being to ensure they live a long and healthy life!

  • Erin Schellinger, DVM
Longs Peak Animal Hospital, PC – 9727 Ute Highway – Longmont, CO 80504
303-776-6666  – http://www.longspeakah.com

Cold Weather Pet Care Tips

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Scout W. enjoying some outdoor play time in our Daycare yard.

The first day of winter is on Monday, December 21st, 2015. After our recent bout of chilly winter weather here in Colorado, Dr. Conrad wanted to share some important cold weather pet care tips:

Outdoor Pets: Pets who spend a large amount of time outdoors or who live outdoors require more food for fuel to keep their bodies warm in the winter time. Also be sure to check those outside water bowls daily to ensure they don’t freeze.

Indoor Pets: Consider a sweater or an extra blanket for your furry family members. Just because they have fur themselves doesn’t mean they couldn’t use a little help warding off the chills during those cold Colorado nights.

If you use space heaters or a fireplace, be careful of burns. Do not allow pets to sleep on or near space heaters, and always use a fireguard screen. Be particularly careful with wagging tails near fire, and never allow pets to play near fire or heaters.

  • Joseph Conrad, DVM

Holiday Plants and Your Pets

Alex & Lily celebrating the season.

Alex & Lily celebrating the season.

As the holiday season approaches, it is important to be mindful of the types of plants you choose to decorate your home with or give as gifts to others that have pets. There are several plants that can pose a health risk to pets if chewed on or consumed. Below is a summary of common holiday plants to avoid if you have pets in your household or if you are thinking of giving someone with pets an arrangement of flowers.

  • Mistletoe: A common fixture in many homes during the holiday season, this plant poses a danger to pets that ingest any part of it (leaves, stems, or berries). Initially, symptoms may be delayed but can affect the gastrointestinal system (stomach and intestines), heart, and/or nervous system leading to signs including vomiting, diarrhea, seizures, collapse, and death. If you know your pet has consumed mistletoe, it is important to seek veterinary care immediately.
  • Lilies: This pretty flower is common in many bouquets and other flower arrangements. Lilies can cause fatal kidney failure in cats within 24 to 48 hours. Cats that have eaten any part of the lily plant (leaves, flowers, or stems) should be seen by a veterinarian as soon as possible.
  • Holly: The leaves and berries of this plant have the potential to cause upset stomach, vomiting, diarrhea, and occasional neurologic signs (tremors, seizures). Veterinary treatment may be necessary.
  • Amaryllis: The bulb is the toxic part of this flowering plant. Signs are usually mild and self-limiting but may depend on how much your pet consumes. Symptoms include vomiting and diarrhea.
  • Poinsettia: This popular holiday plant is often falsely believed to be highly toxic. In actuality, severe toxicity following ingestion is rare. If a pet consumes the leaves or stems of the poinsettia plant, irritation of the mouth or throat may occur. This may cause pets to cough, retch, or paw at their mouths. If large quantities are eaten, vomiting and diarrhea can occur which could necessitate veterinary treatment.
  • Christmas trees: While the tree itself is non-toxic, pet owners should be careful of curious pets that may ingest ornaments, chew on electrical cords, or drink water with chemical additives from the tree stand.

Treatment for plant toxicities depends on the type and amount of plant ingested. If you suspect your pet has eaten a potentially toxic plant, seek veterinary care as soon as possible. The sooner a veterinarian can intervene after a pet has been exposed to any kind of toxin increases the chances of successfully decreasing or eliminating severe, life-threatening toxic effects.

This is not an all-inclusive list of toxic plants. For more information, please refer to the ASPCA Animal Poison Control toxic plant database (http://www.aspca.org/pet-care/animal-poison-control). The ASPCA Poison Control (888-426-4435) is also an excellent source to contact in the event of a poison related emergency when your regular veterinary office is closed.

Visit longspeakah.com for more information about our hospital and services and follow us on Facebook.

 

  • Erin Schellinger, DVM

Marijuana Toxicity in Pets

 

DrHrenchir

Since the passage of two amendments to the state constitution in Colorado (Amendment 20 in 2000, allowing medical use of marijuana and Amendment 64 in 2012, allowing recreational use), exposure of pets to marijuana in our area has increased, and toxicity from these products can be serious in animals.

Pet exposure occurs most frequently in dogs, but cats and other pets are also at risk. Different forms of marijuana can contain drastically variable levels of THC (short for tetrahydrocannabinol, the main psychoactive component in marijuana and other cannabinoids). Exposure can occur to marijuana plants, loose leaf marijuana, edibles, oils, or second-hand smoke.

For pets who have ingested items containing THC or inhaled marijuana smoke, signs of toxicity can include nervous system changes, such as stumbling, sleepiness, mental dullness, and disorientation; rarely, an affected pet may show signs of CNS stimulation. Severely affected pets may go into a coma. Dogs usually display urine dribbling as a sign, and their third eyelids are usually prominent. Affected pets may also show an extreme sensitivity to stimuli such as touch or sound. Cannabinoids can cause vomiting, but this is rarely seen as they usually produce profound anti-nausea effects.

If a pet has consumed a large amount of edible product (i.e. – brownies, candy, cookies, etc.) or plant material, gastric lavage (aka “stomach pumping”) may be necessary, and it is important to seek veterinary care as soon as possible. Activated charcoal may be administered orally to minimize further absorption of THC. In more severely affected cases the pet may need to be hospitalized for supportive care, which can include warming, oxygen, IV fluids, and sedation if needed. There is no specific antidote for THC toxicity.

While marijuana toxicity is rarely fatal, it can indeed be serious, and immediate veterinary care is always best. Recovery time for pets is highly variable, but most pets are back to normal within 12 to 24 hours. If you have any specific questions about marijuana toxicity, ask your veterinarian or veterinary technician.

Please visit longspeakah.com for more information about our hospital and services.

  • Kristin Hrenchir, DVM