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Matthew Kearns

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By Matthew Kearns, DVM

In the Aug. 13 article we focused on the causes of chronic otitis externa (external ear infections). This article will focus on treatment. First, relieve yourself of the guilt that you did not treat the “infection” correctly. If your pet has chronic ear infections, that usually indicates some predisposing factor (usually genetic in origin). Second, get over the frustration of assuming that because we veterinarians use the term “ear infection” that if treated once, it will never return. 

Chronic otitis externa is a problem that can be managed, not cured.  Therefore, general maintenance of the ear is much better than waiting for things to get out of control. Talk to your veterinarian about ear cleaners, or if you look for an ear cleaner at the pet store make sure it states that it is a cleaner and a drying agent. This means it will have some isopropyl alcohol and usually propylene glycol to not only break up the wax but also to dry the lining of the ear canal.

Those dogs (or cats) that produce excessive wax should have their ears cleaned regularly (once to twice weekly).  If your pet’s ears are really inflamed/infected, you will need medication from your veterinarian to get things under control. However, once the infection clears up, maintenance cleaning is imperative. I have many a pet owner tell me how guilty they feel about cleaning their pet’s ears because they know it hurts and the pet runs away.

However, these same owners usually wait until there is a full-blown infection. Therefore, it is much easier to clean the ears when there is no infection, as compared to waiting until the lining of the ear canal is inflamed and sensitive.  Remember, “an ounce of prevention…”

There are some cases that get so out of hand that your veterinarian may suggest sedating your pet to obtain samples for testing (ear cultures, etc.), as well as a deep ear flush to evaluate the ear drum and the middle ear behind it. Although the problem may originate in the external ear canal, it can progress to a middle ear infection (otitis media) and systemic medication may be indicated. 

Talk to your veterinarian about exploring the underlying causes of the ear infection. As we discussed in the previous article, it is estimated that 80 to 90 percent of recurrent ear infections are secondary to allergies. Newer, more accurate blood tests can diagnose food allergies, seasonal allergies or both. Avoiding certain foods (including treats), as well as managing seasonal allergies can decrease (or sometimes eliminate altogether) the need for cleaning the ears at all. 

As a last resort, there are two surgical procedures that can be performed in severe cases. The first is called a lateral ear canal ablation. This procedure reconstructs a portion of the external ear canal so it more resembles a human ear canal. This allows better airflow and makes cleaning and treatment easier.

The second procedure is called a total ear canal ablation and bulla osteotomy, or TECA-BO (pronounced, “teeka-boo”) for short. This is reserved for end-stage ear canals where over the years so much scar tissue has developed, no medication can be introduced into the canal. This procedure involves removing the entire external ear canal and part of the middle ear as well.

A percentage of patients lose their hearing, but it will eliminate a significant source of chronic pain. The good news is that in almost every case, the patient is deaf before the surgery secondary to chronic disease. 

I hope this sheds a little light on a confusing (and sometimes frustrating) disease in pets. 

Dr. Kearns has been in practice for 16 years and is pictured with his son, Matthew, his dog, Jasmine.

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By Matthew Kearns, DVM

“Ooooooh … those itchy ears. My dog or cat is constantly scratching or shaking its head. I feel terrible for them and it sometimes keeps me up at night. My vet calls it an ear infection. It clears up on the medication but once finished it keeps coming back. Why does this happen?”

That is the million dollar question (actually, I’m sure millions of dollars are spent on ear infections every year).  To call every dog or cat that comes in with itchy ears an ear infection is misleading. 

These pets have otitis externa, and “otitis externa” literally means inflammation (not infection) of the external ear canal. Although we veterinarians commonly dispense medications with antibiotics and antifungals in them, the bacteria and yeast we are treating are considered natural flora (in the ear canal at all times in lower numbers).

So why do we get “flora gone wild”?  Usually some other primary trigger is involved and the infection is secondary overgrowth. Examples are parasitic infections (ear mites), pets that swim or get baths and get water (and shampoo) in their ears, ear tumors (both benign polyps and cancerous tumors) etc.  However, the most common cause of recurrent otitis externa is allergies. I consulted with a veterinary dermatologist, and she estimated that between 80 and 90 percent of all recurrent otitis externa in dogs is related to allergies. 

To understand why an allergy would cause such problems in the canine and feline ear canal we first have to describe the anatomy. Unlike a human ear canal, which has a shorter external component in a horizontal direction only, the canine and feline external ear canal is much longer and has both a vertical and horizontal component. Therefore, there is a much greater distance from the opening of the ear canal to the ear drum. This shape and extra distance plays a critical role in otitis externa.

Also, the healthy ear canal is lined with three types of cells: epithelial cells (those similar to skin), ceruminous cells and apocrine cells (cells that produce earwax).  Just like the epithelial cells of the skin, these cells will be replaced every few days. The new cells push the old (dead) cells out to the entrance of the canal, and the small amount of earwax produced in the healthy ear migrates out with the dead epithelial cells.

However, if the lining of the ear canal becomes inflamed, it narrows due to swelling and excessive earwax is produced. This not only overwhelms the ability to clear the wax, it also leads to a warm, dark and moist environment and allows the normal bacteria and yeast to overgrow and a true ear infection is produced.

This will clear up with medication but, if your pet is exposed to the same trigger, it will come back again. Certain breeds such as Labrador retrievers, golden retrievers, cocker spaniels, shar-peis and many others may have complicating factors such as hair in the ear canal, floppy ears, narrow ear canals or a combination of these things. Now, this does not mean that every member of these breeds is guaranteed to have chronic ear infections, rather it means that if you have a member of these breeds and they have even low-grade allergies the ears can spiral out of control quickly.

In my next article I will describe how to manage chronic or recurrent otitis externa.

Dr. Kearns has been in practice for 16 years and is pictured with his son, Matthew, and his dog, Jasmine.

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By Gerard Frank Schafhautle

Wild dogs, such as wolves, are carnivorous by nature, whereas domesticated dogs have adapted to more omnivorous diets. Therefore, there are plenty of plants that, in moderation, may be consumed by our canine comrades. Some examples include carrots, blueberries, white rice and yes, peanuts. Whether butter in a jar or nuts in a bag, peanuts are generally a safe choice (in moderation) compared to many other plants that we call nuts.

Ironically, peanuts are not actually nuts, but rather legumes, like peas and beans. The true nuts are those from trees, such as walnuts, pecans, hickory, hazelnuts, macadamia, cashew, Brazilian nuts, Cocoa (Chocolate), and acorns. Before venturing into the harmful effects of tree nuts, allow me to explain an oddity in the nut family that was not mentioned — almonds.

Almonds come in two varieties: sweet and bitter. Bitter almonds are more related to the fruit tree family of peaches and apricots. If you were to crack open the pit of an apricot or peach, you will see one or two seeds that look suspiciously like almonds. Bitter almonds and the center of a fruit pit all contain a cyanide-related chemical called benzaldehyde as well as other harmful chemicals, which are capable of symptoms ranging from lethargy to fatality. So be careful of bitter almonds and pets, as well as letting them chew on a fruit pit.

Nuts from trees can be contaminated with a mold type fungus called Aspergillus. This type of mold fungus secretes a type of poison called aflatoxins. Aflatoxins can cause damage to the liver and potentially lead to cirrhosis (scarring), or carcinoma (cancer). Best not let your fluffy family members eat any fallen tree nuts.

Although chocolate tastes great, cocoa products contain theobromine, which is deadly to your pets in even small amounts. Theobromine is found in all forms of chocolate and cocoa butters, in increasing concentrations from white chocolate (the least) to dark chocolate (the greatest). Theobromine is a stimulant that could lead to irregular heart rhythms and seizures. Both could be fatal.

Nuts of the arboreal nature may contain one other toxic substance harmful to your pets. Walnuts, American black and English, amongst other species, are formed under a thick leather skinned exterior. The space between the nut’s shell and this protective barrier is filled with a soft black resin full of tannins. Tannins are substances that act as astringents which bind proteins and amino acids in the body. The effect is rapid onset vomiting and diarrhea, followed by life threatening and sometimes fatal kidney and liver damage.

Peanuts. Finally we come around to the safe “nut” — well , almost. Peanuts are high in fats, which can clog up the liver and pancreas, which can lead to pancreatitis, inflammation of the pancreas and/or hepatitis, inflammation of the liver. These issues are easily treated by your veterinarian by switching your dog to a bland, low-fat diet and halting the “treating” of peanut butter in a hollow bone toy. Chemicals originating from tree nut consumption are much more difficult to treat, and may require special attention by the animal poison control hotline or an emergency veterinary clinic or hospital.

Benjamin Franklin once said, “an ounce of prevention is worth a pound of cure.” Do not allow your dog access to any human-edible tree nuts. Keep your veterinarian’s office phone number, as well as the closest after-hours veterinary emergency clinic and animal poison control hotline, in a spot that is accessible to all family members. Finally, if you feel the need to treat your pet with a few peanuts or some peanut butter, do so in careful moderation. Be safe, be wise, and be informed.

Gerard Frank Schafhautle has worked for Dr. Matthew Kearns at Countryside Animal Hospital in Port Jefferson for 6 years. He has a certification in Animal Science and will be attending Stony Brook University this fall, working toward an undergraduate degree in Biology.

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By Matthew Kearns, DVM

I recently authored a two-part series entitled “A Long (and Fat) Winter’s Night,” with ideas on the management of the obese patient. However, if your pet is not obese but the long winter has affected them, what do we do? Stiff, creaky joints may make it difficult for him or her to rise. Just doesn’t seem to be able to finish those long walks (or even have the willingness to take them).  These are difficult to see in our aging babies but are also something that can be addressed. Physical therapy along with low-impact exercise can be helpful in not only improving our pet’s mobility and stamina but also has a positive effect on their sense of well-being.

Before I discuss physical therapy and low-impact exercise specifically, I would recommend that all pet owners visit their veterinarian’s office to rule out possible underlying or concurrent disease. This may be something that you already do during an annual wellness exam. However, if you’ve missed a few years, please do make an appointment to have your four-legged family member examined and consider some basic diagnostics (if warranted) such as blood work, X-rays, etc. If all is well, then let’s get started.

The one good thing about physical therapy (unlike missing a dose of medication) is every little bit helps. If you can perform certain exercises and therapies only once daily instead or more often, remember every little bit helps.

Heat Therapy and Massage: It has been shown that heat therapy causes vasodilation and improves circulation to tissues. This increases tissue oxygenation and transportation of metabolites. It has been proven that five to 10 minutes of heat before physical therapy and exercise can reduce joint stiffness and increase range of motion. Make sure to use a blanket or towel as an insulating layer between your pet’s skin to prevent burns. After heat therapy, gentle massage therapy manipulates muscles and tissues around joints to reduce pain, stiffness, muscle knots/spasms, increase blood flow and promote relaxation.

Range of Motion and Stretching Exercises: This type of exercise helps improve joint motion and flexibility in patients. Simple flexion and extension exercises are excellent. Find a part of the house where your pet will feel most relaxed and least likely to try to get up and move around. Manipulate each affected joint only as far as your pet will tolerate initially but hold for 15 to 30 seconds at full flexion and again at full extension. Repeat the process for three to five repetitions.

Low-Impact Exercise: The most accessible (and most commonly used) low-impact exercise is controlled leash walks.Controlled leash walks (slowly at first) will help to achieve the most normal gait possible. Slow walks increase flexibility, strength and weight bearing. After slow walks have been mastered, then we can increase the pace, incorporate gentle inclines or different surfaces (e.g., sand) to further develop endurance, strength, balance and coordination.

Swimming: Swimming is somewhat controversial in veterinary medicine. Some believe swimming (because of the non-weight-bearing component) is the ideal at-home exercise for older patients. Others believe the movements are too “herky-jerkey” and could lead to hyperextension of already arthritic joints. First, access to a pool that has stairs that the pet can walk in and out of is important (this eliminates swimming in the ocean or above-ground pools). Make sure active swimming only continues for five minutes before taking a break. It would also be a good idea to purchase a pet-specific life jacket to ensure that if your pet does tire there is no risk of drowning.

There are other physical therapy modalities such as therapeutic ultrasound, therapeutic laser, transcutaneous electrical nerve stimulation (TENS), underwater treadmills, etc. Unfortunately, these modalities are neither readily available nor inexpensive so I thought I would concentrate on therapies one could do at home. If interested in more advanced therapies, make an appointment with your veterinarian to discuss them.

Dr. Kearns has been in practice for 19 years.

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By Matthew Kearns, DVM

I recently read an article in Time magazine entitled, “The Mystery of Animal Grief” and found it fascinating. The author, Jeffrey Kluger, referenced evidence that crows and elephants hold “wakes” for their fallen mates, and female chimpanzees have been known to carry their dead young sometimes as long as two months. This forced me to ponder the fact that as much as I know how people feel about their pets dying, how do pets in the household feel? And how can we get them through the grief?

Yes, it is proven that dogs and cats grieve after the loss of both another pet and a human owner. However, dogs and cats see this loss as more of a change in the dynamic of the pack or pride. If we can understand that concept, it will make it not only easier to tolerate their behavior but help them through this difficult time as well. Remember, we are grieving also; behaviors that do not make sense to us might make us less patient during these stressful times, as well as create lifelong behavioral issues for our pets.

The biggest mistake made in interpreting (or misinterpreting) any animal behavior is anthropomorphizing. Anthropomorphizing refers to giving human characteristics to things not human. Dogs and cats are not furry little humans, and we should not expect them to act as such. When dogs and cats grieve, it is usually for a much shorter period of time (sometimes as little as 3 to 5 days), and, in some cases, they do not grieve at all. If the pet that has passed was the dominant partner, the surviving pet may have been repressed (and now suddenly thrives). Do not resent this lack of remorse but rather realize what stress this pet was going through up until this time. Also, the more dominant pet may show no grief and this is normal also.

What to do? In the immediate aftermath, let the pet grieve. If your dog or cat is still eating/drinking normally and somewhat active, give him or her 3 to 5 days to adjust to the change in the “family” dynamic. In cases of severe grief, positive training may be the release he or she needs.

Positive training is really just setting aside some time for activity or interaction at the same time every day either with the guidance of a certified trainer or just the two of you. Positive training could be long walks, trips to the park for off-leash exercise, playing with toys (if your pet is more active),  short walks to the mailbox or grooming/massage (if your pet is less active). In rare cases, medications like anti-depressants are necessary.

What about adding a new pet? It is recommended to not replace a deceased pet immediately. Many dogs and cats are just as happy to live out the rest of their lives with just humans, so it may not be necessary to get a new pet. If you do decide to get a new dog or cat, make sure that you know the new pet will get along with the existing one. Consider getting a new pet of opposite gender even if the previous one was of the same. This will help to reduce the risk of fighting.

It is never easy to lose a member of the family, but I hope this article gives some general information on both the way that pets grieve as well as how to help them through this difficult process. Remember, each case is different, so consult your veterinarian for specific questions or concerns.

Dr. Kearns has been in practice for 17 years.

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By Matthew Kearns, DVM

In our previous article we discussed predisposing factors to obesity such as breed, spay/neuter status, age and underlying disease. This article will focus on a brief overview of tackling the obesity problem. The short answer here is there is no magic bullet for weight loss, but rather the same answer there is for humans: diet and exercise. With that said let’s take a closer look at that and give some more specific recommendations.
Diet:    In a veterinary article I recently read, management of obesity in dogs and cats is as easy as following the three A’s: awareness, accurate accounting and assessment.

Awareness refers not only to coming to terms with obesity in your pet but also certain risks as well (breed, spay/neuter status, etc.). How does one identify obesity in a pet? Usually it’s a vet (the bad guy) that hints at the fact that Spike has gotten a little husky or Fifi a little fluffy. However, you can actually assess your own pet at home. Just go online and look up “Body Conditioning Score,” or “BCS” for short. If, after reviewing information online you are still unsure, I would recommend scheduling an appointment to consult with your veterinarian.

Accurate accounting may be the hardest thing (for us as pet owners) to face.  Food can be an act of bonding not only with other people but also with our pets.  We had one pet owner at our clinic with an obese dog she swore was only getting its food and no extra snacks or table food. After a bit of investigation I found out that the owner loved to cook and the dog was the “official taster” for every meal.  No table food meant no food directly from the table. This was a smart woman, but she felt that the dog would no longer love her if she took this bonding moment away. Unfortunately, this also meant the dog would soon have to be rolled into the clinic and not walk in under its own power.

To make life a little easier, there is a way to actually calculate calorie requirements by using a calculation called the Resting Energy Requirements, or RER for short. The RER is a starting point, and then in conjunction with your veterinarian or a veterinary nutritionist you can calculate how much food to give at each meal. After accurately calculating how much food your dog needs for the whole day, you can break that up into as many meals as you’d like. It has been found that it is more effective to feed at least two and up to four smaller meals a day to lose weight than to free feed (fill up the bowl).

Treats also have calories and should not exceed 10 percent of the diet. There are now low-calorie treats available both commercially and as prescription low-calorie treats through your veterinarian.

Lastly, in terms of assessment, it is important to either weigh your pet at home or bring your pet to your veterinarian’s office for a weight (this helps with consistency especially for larger pets). We encourage pet owners with obese pets trying to lose weight to bring their pets in (at no charge) to be weighed.

Exercise: Exercise is key to good health for many reasons: It helps to maintain and strengthen muscle, it promotes cardiovascular health, it provides mental stimulation, and it increases energy expenditure and fat oxidation.

Obese dogs should be given low-impact cardiovascular exercise (a longer walk or swimming rather than chasing a ball) to avoid heat stroke or injury.

Obese indoor-only cats should have their play geared toward outdoor hunting and playing behaviors (climbing, balancing, scratching). Toys work well for some cats, while others prefer cat trees or play stations.  Interactive toys with the owner are best (especially for single-cat households) to lose weight, as well as promote bonding with the owner.

I hope that this series of articles will help to make our pets the healthiest and happiest pets ever this summer.

Dr. Kearns has been in practice for 16 years.

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