Ask the Veterinarian

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By Matthew Kearns, DVM

Dr. Matthew Kearns

Working in a general practice for many years now, I am commonly asked the question of whether or not a growth under the skin is something to worry about or not. The good news is the majority of subcutaneous (under the skin) lumps are benign, or non-cancerous. They are usually lipomas (benign tumors made up of fat cells), or cysts. Some, however, can be cancerous and are better off being removed before they get too big or invade the surrounding tissues making it more difficult or impossible to remove completely. How are we to tell?

It is always good to bring any new growths to your veterinarian’s attention as soon as possible. When I evaluate any new subcutaneous growths I was taught to look for three characteristics:

Is it hard or is it soft? A growth that is hard is not always malignant, and a growth that is soft is not always benign. However, in my book, a growth that is hard is more concerning than a growth that is soft.

Is it freely movable or well attached to underlying tissues? Growths that are soft and freely movable are more likely to be benign than growths that are hard and well attached.

Is it painful, or non-painful? subcutaneous growths that are non-painful to palpation are less likely to be malignant.

I like to have the three criteria in combination to feel confident in telling a pet owner that the growth is something just to be monitored. Therefore soft, freely movable, non-painful is good, and firm, well-attached, and painful is concerning. 

I also like to recommend owners monitor these growths closely for change. The two changes I look for is a rapid change in size, and/or a change in character. If a growth doubles in size in a month or less, or a change in character (soft to hard, freely movable to well attached, non-painful to painful) then please have your pet seen again immediately.

There are different ways to test these growths. My favorite first test is a fine needle aspirate and cytology. This test involves inserting a needle into the growth and aspirating a sample of cells. The sample is then sprayed onto a microscope slide, allowed to dry and sent to the lab for evaluation by a pathologist. 

Cytology is the evaluation of individual cells so it is not as accurate as a biopsy but one can get a lot of information from individual cells. A fine needle aspirate is something that is well tolerated by most patients so sedation or anesthesia is not usually required to perform this procedure. 

There are cases where the fine needle aspirate and cytology are inconclusive and a biopsy is needed. However, I feel a fine needle aspirate and cytology is an excellent first step. I hope this information helps.

 Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine. 

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By Matthew Kearns, DVM

Dr. Matthew Kearns

The summer is not over and what better way to spend a hot day than to go to the beach and there is no better friend to bring than your happy canine. Just be aware that there are also hazards at the beach for your dog. 

Saltwater/Seawater: Saltwater is a hyperosmotic. Hyperosmotic means the large amount of salt in seawater pulls fluid to it. Pulling fluid from the body into the gastrointestinal tract not only causes severe vomiting and diarrhea and secondary dehydration, but also can pull water from the tissues surrounding the brain. This will cause a secondary cerebral edema, or brain swelling and neurologic signs like seizures. 

The second concern are the microscopic creatures living in the water. Seawater contains increased levels of bacteria from runoff, as well as cyanobacteria (blue green algae). These microorganisms can cause severe gastrointestinal symptoms, potential sepsis, and neurologic symptoms. If the beach is closed to humans, it is probably not a good day to walk with your dog on the beach even if they want to go into the water.

Cuts/lacerations/burns to feet: Cuts on dogs footpads are quite common on the beaches of the north shore of long island. We usually get 4-5 cases at our clinic alone each summer and we are not even an emergency clinic. Shells, sharp rocks, broken glass can all cut deeply into a dog’s pad. Sand, bacteria and other debris can then get into these open wounds. Also remember that the asphalt in the parking lot can become very hot leading to burning of the pads. 

It is best to purchase some protective booties (if your dog will leave them on) to protect their feet from these sharp objects and excessive heat.

Toxicity: Not long ago this summer a couple brought their 5-month-old puppy into the clinic disoriented and difficulty walking. They had been walking on the beach that evening and the puppy was off leash. He did not return and, when they found him, he was in the condition I described above. 

When the owners arrived, I was not sure what had happened but I knew the puppy needed to be monitored overnight. We immediately transferred this puppy to the emergency clinic and, at the emergency clinic, the puppy was diagnosed with marijuana toxicity. Rotten food and other sharp objects such as bones, etc are a concern for toxicity, intestinal obstructions, or perforations. Therefore, be careful with your dog off leash that they don’t get into anything that may have been discarded. 

Heat stroke/sunburn: There really isn’t any shade at the beach unless you bring a beach umbrella with you. Remember that affects our dogs as well. Make sure to provide them with shade, do not let them run around excessively during the hottest time of the day, and apply sunscreen protection to hairless areas if you will be at the beach all day with your dog.

Please enjoy a day at the beach with your dog, but also take certain precautions to make sure the day is enjoyable for you both. 

Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine.

Pixabay photo

By Matthew Kearns, DVM

Dr. Matthew Kearns

The last day of school has passed and summer is here. What better time to take advantage of travel with the family? And family for many of us includes four legged members. 

Nowadays more and more hotels and rentals are pet friendly and, with a quick search on the internet, it can be easy to find establishments that accept pets. Camping is also a popular vacation choice and many campgrounds will accept pets. 

Check with your veterinarian that your dog or cat is up to date on their vaccines, as well as discuss any additional vaccines against diseases that your pet may be at risk for when traveling (especially at campsites). Make sure you know where the nearest local veterinary emergency clinic or, in more rural areas, which veterinary clinic may offer emergency services.

What about travel itself? Some pets make excellent travel companions, while others don’t and become agitated in the car. Dogs or cats that become just mildly agitated in the car can get by with a more holistic approach.

One way to soothe our pet’s anxiety is to use scents. Lavender is an excellent way to calm dogs during travel induced excitement (one study used a lavender scented oil that could be sprayed on a blanket), whereas for cats a synthetic facial pheromone (scent hormone) is more effective. 

Some pets are just too wound up to use any aromatherapy or pheromones and need medication. Certain sedatives or tranquilizers can be used for short to medium length trips, whereas medications such as selected serotonin reuptake inhibitors (SSRIs) or antidepressants are needed for really high-strung pets to take both during travel and a stay in an unfamiliar environment. 

If you feel something like an SSRI or an antidepressant is warranted make sure to start well enough before leaving on vacation. Most of these medications have a four week induction period (meaning they are not truly at therapeutic levels for at least four weeks) and need to be weaned off after returning from vacation. Some pets also require pre medication bloodwork (to make sure our pet’s organs can safely tolerate the medication long term) so make an appointment well in advance of your vacation to see your veterinarian.  

Antihistamines can be used for motion sickness but have been proven to make terrible sedatives for travel so check with your veterinarian before considering “self-medicating.” In conclusion, making our pets traveling guests can really enhance a vacation.  Just travel safe.     

Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine. 

It has been found that training, play and exercise play a key role in slowing the decline of aging pets. METRO photo

By Matthew Kearns, DVM

Dr. Matthew Kearns

People often ask me of their aging pets, “do dogs and cats get Alzheimer’s disease or dementia?” The answer is both no and yes. Although the terms Alzheimer’s Disease and dementia are not used in veterinary medicine, pets can have behavioral changes similar to that as their brain ages. 

MRI’s on aging pets have revealed that the brains of dogs and cats both decrease in size and develop pathologic changes. Pathologists have also evaluated the brain tissue on deceased pets and found changes within the tissue itself such as a degeneration of cells and buildup of something called amyloid plaques. The disorder is called Cognitive Dysfunction Syndrome, or CDS for short.

The behavioral changes associated with CDS can be summarized in the acronym DISHA: Disorientation, Altered Interactions with people or other pets, Altered Sleep-wake cycles, House-soiling, and Altered activity levels. Other behavioral changes could also include a decrease in sensitivity to any stimuli and an increase in agitation or anxiety.

Impairment in memory or learning is not as affected in pets as compared to humans with cognitive decline but the ability to adapt to change may be more pronounced in these pets. The symptoms of other diseases such as brain tumors, infections, glandular disease, organ dysfunction, etc. can mimic CDS so testing is as important as a thorough patient history and physical exam. 

The gold standard of diagnosing CDS is using an MRI but most people just are not able to pursue an MRI (MRI’s are both expensive, as well as only available at referral hospitals). However, I recommend some basic diagnostics such as bloodwork, possible X-rays or ultrasound is recommended to rule out underlying diseases before starting treatment.

Treatment includes both cognitive enrichment, as well as medications and diet/supplements. It has been found that training, play and exercise play a key role in slowing the decline of aging pets. Certain medications that increase dopamine levels and/or increase bloodflow to the brain have been found helpful in slowing cognitive decline. Diets that are high in both antioxidants and certain fatty acids also slow the progression of CDS.

If you feel you pet is developing a cognitive decline and are concerned about it make sure to check with your veterinarian.

Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine. 

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By Matthew Kearns, DVM

Dr. Matthew Kearns

Can a dog or cat have a stroke? That is an interesting question. In humans, strokes are the third most common cause of death (after heart disease and cancer). In dogs and cats, strokes (also known as cerebrovascular accidents) are much less common but do happen. Just as in humans, a vascular accident occurs as the result of a emboli (blood clot) or bleeding. 

Circumstances that could cause a cerebrovascular accident are: conditions that could lead to a hypercoagulable state, conditions that could cause bleeding in the brain, atherosclerosis (plaque buildup in the vessel), or conditions that cause systemic hypertension. Hypercoagulable states include: Cushing’s disease (hyperadrenocorticism), immune mediated hemolytic anemia, sepsis, cancer and some others. Conditions that cause bleeding include: trauma, certain infections, congenital malformations of blood vessels in the brain, tumors, etc. Lastly, hypertension can be caused by kidney failure, heart conditions, etc.

Depending on the portion of the brain affected, the symptoms will follow. The cerebral cortex is an area where higher functions take place so we would see a decreased alertness, weakness, circling, head pressing in corners, and possible seizures. The thalmus or midbrain would affect balance and eye movement. The cerebellum controls movement so a lesion there would lead to hypermetric (jerky) movement, slowed reflexes and generalized weakness.

The best way to diagnose what type of cerebrovascular accident is with either a CT scan, or an MRI. This is tricky because there is limited availability for these tests, they are expensive, and require general anesthesia. Sometimes the patient is not stable enough for anesthesia. Most times a workup to include bloodwork, x-rays, and sometimes ultrasound will help to rule in or out concurrent diseases to help with a prognosis and to see if a CT/MRI is safe to perform or would make a difference in treatment.

Treatment usually includes supportive care (fluids, oxygen, antibiotics if indicated, etc), as well as treating any underlying/concurrent disease. Medications to prevent additional bleeding or emboli are also used. Physical therapy is performed but many times by the owners after the patient is discharged due to expense.

Prognosis depends on the area of the brain that is affected and how severe the event was. The good news is that symptoms did not usually worsen after 24-48 hours (for those pets that lived that long) so, if your pet is not too severely affected and does not worsen after the first 24-48 hours they have a chance of a longer survival period.

In conclusion, pets do have strokes. On the positive side, strokes are much less common in pets than humans. On the negative side, strokes are usually secondary to serious underlying disease which affects the short and long-term prognosis. 

Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine. 

Pixabay photo

By Matthew Kearns, DVM

Dr. Matthew Kearns. 

You can’t log onto the internet without finding some sort of clickbait story about a dog attack. It is estimated that approximately 370,000 people are bitten by dogs every year. Although I believe that aggression is never appropriate and should not be condoned, recognizing aggression and problem situations is the key to avoiding bites. Here is a list of the different types of dog aggression:

Territorial Aggression — the need to protect its territory is hardwired in dogs long before they were domesticated. If a dog senses (or perceives) that someone or something has violated its territory, it will feel the need to defend itself. This could refer to the dog that is barking and snarling at the fence. Dogs do not differentiate property lines and will soon consider any portion of the block their territory.    

Fear Related Aggression — this is where a normally friendly dog becomes so fearful that any type of interaction is taken as a threat and they respond with aggression to “defend themselves.” This very commonly happens at the veterinarian’s office. 

Food Aggression — growling and snapping if a person comes near the dog when they have a treat, near the food bowl, etc, is inappropriate and intervention is needed.  

Approaching a dog with your palm down and above the head is an act of dominance. Pixabay photo

Dominance Aggression — this type of aggression can be directed against other pets in the household or family members and will manifest itself when the dominant dog is challenged.  

Here are a few tips on avoiding potentially dangerous situations:

■ Always approach a dog you have never met before with your palm up below their muzzle. This is an act of deference or neutrality, whereas approaching a dog with your palm down and above the head (as if to pet the dog) is an act of dominance or aggression.  

Also, if a dog is growling, barking, or snarling but still is wagging its tail; believe the growl/bark/snarl.  I have seen many a dog attack another dog (or person) while still wagging its tail.

■ Beware of dogs roaming the neighborhood. Although most have just escaped the yard and are no threat, approach with caution and have an escape route for yourself.

■ If a dog is growling and hiding in a corner do not try to engage them, but rather ignore the behavior and let them come to you.  

■ If you notice any signs of aggression as a puppy bring them to the attention of your veterinarian and consider one on one training with a behaviorist.

I hope this helps to recognize aggressive behavior to either avoid dangerous situations or intervene early on so that we can all enjoy our barking, furry family members safely. 

Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine.

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By Matthew Kearns, DVM

Dr. Matthew Kearns

This week is Pet Poison Prevention Week and I thought a review of rodenticide toxicity would be prudent. Rodenticide toxicity is on the top 10 list of why pet owners call the ASPCA Animal Poison Control Center. Bait for rodents and gophers are the two most common sources of poisoning. Exposure can come from either ingestion of the poison, or ingestion of a dead animal that still has the poison in its digestive tract.  

Rodenticide toxicity is broken into two categories: anticoagulant toxicity, and non-anticoagulant toxicity. Anticoagulant toxicity will antagonize, or block the vitamin K dependent factors in the clotting cascade. This will cause signs of bleeding and bruising including spontaneous bleeding in the chest or abdominal cavities. 

In some cases the pet owner has witnessed the patient ingesting the poison. If seen, bring your pet immediately to a veterinarian’s office or pet emergency clinic where the doctors can provide decontamination (induce vomiting and give activated charcoal to prevent further absorption) and vitamin K. If your pet is already showing signs of active bleeding or bruising they will need to be admitted for care. This could include blood transfusions, plasma transfusions, or both, as well as decontamination and vitamin K therapy.

Non anticoagulant toxicities include bromethalin and cholecalciferol. Bromethalin is a neurotoxin which means it effects the nervous system. Bromethalin will cause damage to the cells in the brain leading to brain swelling and loss of function. Symptoms include tremors, elevated body temperature, seizures, coma, respiratory failure and death. Witnessing the patient eating the poison is imperative because symptoms can start as quickly as 30 minutes after exposure and, when symptoms are seen, it is almost too late. Intravenous fluids and medications to absorb the medication from the blood stream, control seizures, and reduce brain swelling will help but not guarantee success.

Cholecalciferol toxicity is an overdose of vitamin D. Vitamin D is added to milk and other dairy products in small amount to improve calcium retention in the body. Excessive amounts of vitamin D will lead to mineralization of the internal organs and, potentially, organ failure. The organ system most sensitive to this are the kidneys. Symptoms usually include loss of appetite, vomiting, lethargy, seizures and, ultimately, death. This is another poison that we hope someone witnesses the pet ingesting so that decontamination can be performed before the toxin is absorbed from the digestive tract.

The best thing is to avoid exposure to any bait. However, if you witness or are suspicious of exposure, bring your pet immediately to your veterinarian’s office or a veterinary emergency clinic.

Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine. 

White-tailed deer are prevalent on Long Island. METRO photo

By Matthew Kearns, DVM

Dr. Matthew Kearns

I recently saw an article that researchers in Canada were concerned with transmission of COVID-19 from deer (white-tailed deer) to a human, as well as deer. I thought that we only had to worry about white-tailed deer as a reservoir for Lyme disease. Now COVID? Ugghhh!!! 

The Canadian scientists that performed this study did not have definitive proof that the individual that tested positive was infected directly from a deer. However, this individual had the same strain of COVID as the deer in the area and the individual did spend a considerable amount of time around deer.

The good news is a human has a much higher chance of catching COVID from another human than from a deer. Also, the symptoms this individual had were not more severe than a human to human infection. Canadian health officials do caution hunters to take additional precautions such as washing hands thoroughly, wearing goggles, and wearing a well-fitted mask when handling the respiratory tissues of a deer.  

Previously, the only documented cases of animals passing the virus to humans were in mink. Six countries — Denmark, the Netherlands, Spain, Sweden, Italy and the United States — have reported cases of farmed mink infected with the coronavirus to the World Health Organization. Danish authorities also documented over 200 humans that contracted the virus from mink. Unfortunately, many of these minks were required to be culled to prevent further spread. 

The main concern with any animal reservoir is the ability of the COVID, or any coronavirus for that matter, to mutate so easily. 

The good news? Of the 31 species of animals that have been documented infected with COVID, current data shows that dogs and cats are terrible reservoirs of the virus. Although there are documented cases of both dogs and cats testing positive for COVID-19, there is no evidence that a human has been infected directly from a dog or cat. The CDC advises all pet owners to avoid contact with their pets when isolating with an infection (if possible). If a pet is exposed, symptoms are usually very mild or none at all.  

Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine.

Pixabay photo

By Matthew Kearns, DVM

Dr. Matthew Kearns

I just returned from a veterinary conference and I thought it wise to attend some lectures on periodontal disease in dogs and cats just to update myself with the latest information. One of the lectures focused on home care to prevent periodontal disease. Studies have shown that 85% of pets have some degree of periodontal disease by age three. 

Periodontal disease refers to pathology of the structures around the tooth: gingiva (gums), the periodontal ligament, perialveolar bone. Periodontal disease begins with plaque. It has been proven that even within 24 hours of a professional cleaning, a thin film of bacteria, saliva, and food (also known as plaque) accumulates on the enamel of the tooth. Plaque that is not removed mineralizes within 10 days into tartar or a calculus. 

Once tartar takes hold a shift develops from aerobic bacteria (bacteria that need oxygen to survive) to nasty anaerobic bacteria (those that need little or no oxygen to survive). Anaerobic bacteria secrete toxins that inflame the gums and lead to small abscesses or pockets under the gums. Bacteria start to destroy the support structures around the tooth which is very painful. If not treated then the tooth will need to be removed. 

Brushing is still the most effective way to prevent the development of plaque and tartar. There are a variety of toothbrushes available for pets. Make sure the toothpaste is veterinary approved. Swallowing human toothpaste is harmful because it has too much sodium, fluoride, and sweetened with saccharin. 

Pet safe toothpaste comes variety of flavors that pets will like (chicken, beef, fish, etc). When you first begin just to put a little toothpaste on the end of the brush and let your pet investigate. Hopefully they sniff, lick, or even just chew on the brush. Start by gently just brushing the front teeth. Once they tolerate that, start to work towards the back teeth. 

If this makes you groan, you are not alone. I myself do not have time to brush my own pet’s teeth every 24 hours and, even if I did, they would not let me. There are other options. Certain prescription diets (Hill’s t/d®, and Purina Pro Plan DH®) literally clean the teeth as your pet eats. There are also treats that do the same. Look for the Veterinary Oral Health Council (VOHC) seal on the packaging. These insure the product is safe and effective. If you can’t find a VOHC approved treat, remember this slogan: “if you wouldn’t want to get hit in the knee with this dental treat/chew, don’t let your pet chew on it.” That means if it is too hard your pet runs the risk of damaging their teeth. 

Rinses are the least effective because there is no abrasive component to remove plaque. Look for the VOHC seal of approval. The safest and most effective rinses contain chlorhexidine. Chlorhexidine is most effective against the development of plaque and chlorhexidine-based rinses are considered the gold standard of veterinary oral rinses. Rinses containing xylitol, or fluoride should be avoided in my opinion because of their potential for toxicity.

This is not a complete list of dental home care products so, as always, please consult with your own veterinarian for a more in-depth conversation. In addition, I can’t guarantee that even if you follow through with all these recommendations that your dog or cat will not need professional dental care (including extractions), but it certainly helps.  

Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine. 

Pixabay photo

By Matthew Kearns, DVM

Dr. Matthew Kearns

This year I’ve transitioned to all artificial holiday decorations but I do reminisce about the days of live trees, etc. For those that decorate with live plants/trees be careful.  What looks good can be dangerous to dogs and cats. Below is a list of holiday plants that can be dangerous to pets.

Poinsettias: Poinsettias are beautiful and always remind me of the holidays. Luckily, they are not very toxic. They do contain a compound called diterpene esthers. This compound can cause vomiting, diarrhea, and tremors but only in large quantities. Try to keep your pets away from poinsettias but the risk of toxicity is low.

Live Christmas Trees: A live tree is beautiful and smells great but can also release resins, or oils that can irritate a pet’s mouth and digestive tract. These resins accumulate in the water used to keep the try hydrated and pets tend to drink it. This can lead to ulcers, or sores in a pet’s mouth, vomiting, and diarrhea. These symptoms can be quite serious causing dehydration and potentially leading to hospitalization for IV fluids and medications. The needles from the trees are sharp and can cause a mechanical irritation leading to the same symptoms.

Mistletoe: Pucker up buttercup if you’re around the mistletoe. Luckily, ingestion of mistletoe only causes mild gastrointestinal upset (vomiting, diarrhea) and rarely needs attention by a veterinarian. If you do catch your pet near the mistletoe, make sure to give them a smooch before chasing them away.

Holly: Known as the “prickly plant,” holly will only cause symptoms associated with gastrointestinal symptoms such as vomiting and diarrhea. This rarely needs treatment at the veterinarian’s office

Amaryllis: The amaryllis plant contains certain chemicals called alkaloids, and another specific chemical called galanthamine. The alkaloids cause irritation of the mouth, stomach and intestines which leads to drooling, vomiting and diarrhea. Galanthamine is a cholinesterase inhibitor. This chemical can lead to tremors and, in larger volumes, seizures. Luckily, both of these chemicals are in low concentrations in the leaves. The highest concentration is in the bulb which pets tend not to eat.

Lilies: Although lilies are not a flower that blooms around the holidays, they are commonly part of holiday bouquets. Not only can lilies cause irritation of the gastrointestinal tract, but also cause damage to the kidneys (cats are particularly sensitive to this). I would recommend being very careful in having lilies around during the holidays.

Most of the common plants described just cause an upset stomach so having live plants and trees is not extremely dangerous. However, I would caution using caution when bringing live plants in the household and restrict your pet’s access to them (as best you can).

I want to thank the readers of this column, as well as wish everyone a Happy Holidays and Happy New Year. I would like to also thank Heidi Sutton, editor of the Arts and Lifestyle section, as well as all the staff at Times Beacon Record News Media for another great year!

Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine.