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Dr. Matthew Kearns

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By Matthew Kearns, DVM

A diagnosis of separation anxiety in  understanding the cause of our dog’s behaviors can make it much simpler to treat. Treating separation anxiety requires patience and persistence to work. There are always steps backwards (even if you are doing everything correctly) and treatment is lifelong.  

Modifying behavior is a very simple concept: reward the good behavior, and ignore the bad behavior. This is easier said than done. Coming home to a chewed/scratched up door or a nice smelly present after a long day at work would make anyone lose their cool. However, dogs live in the moment and do not understand why they are being scolded for something after the fact. They only understand that they were happy to see us when we arrived but we started yelling at them. This is not only ineffective, but also been can exacerbate the problem. We have to start with behavioral modification, or changing our dog’s behavior by changing our behavior. How can we do that?

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Leave the room: Start by leaving your dog alone for very short periods of time and reward them for staying calm while you are gone. A short period of time refers to a minute or less in the beginning. Before leaving, put them in a relaxed sit-stay position: initially tell your dog to sit and, after they sit, tell them to stay before leaving the room. If the dog follows, do not scold them, just start over. If they do the sit-stay successfully, give them a treat when you come back. Don’t get frustrated if you are having little success. It can take weeks of training every day to try and get your dog to stay even for a minute when the condition is severe.  

Change your schedule: Change up any clues that might let the dog know you are going out.  If it is at set times, then mix up when you leave (even if it is for 15 minutes to get your dog used to being left alone).  

Crate training: Crate training can start at any age but is best started when a puppy is very young (ideally, we start between eight and 12 weeks of age) and a dog with separation anxiety will not always adapt. Crate training (if instituted at the appropriate age and used correctly) is designed more as a “safety area” when you are out of the house. If one is going to try to crate train an adult dog with separation anxiety, reach out to a certified trainer to help you through the process. Confining a dog that already has a nervous breakdown every time you leave will set you up for disaster. You don’t want to come home to a broken crate and possibly an injured dog.  

Medications: In severe cases, medications are used in conjunction with treatment.  There are medications to use on an everyday basis (maintenance medications), as well as medications to use during periods of crisis. Medications, when used appropriately, are not designed to cure the problem, but rather help to treat in conjunction with behavioral modification. The goal is medication and behavioral modification initially. Then wean off medication and continue behavioral modification alone.

I hope this sheds some light on the condition separation anxiety and offers solutions to a very stressful problem.   

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

Luckily, with more people getting vaccinated, things are opening up and people are going back to work. This also means many dog owners previously working from home are leaving some distressed (and possibly destructive) doggies. The term separation anxiety refers to the anxiety your pet feels when you leave. The frustration of behaviors associated with this condition is a common cause of surrendering pets. This two-article series should hopefully give an overview of the disorder and treatment options.

Separation anxiety occurs in dogs of any age, breed (even mixed breeds), and gender. The disorder is seen in a higher percentage of dogs adopted from shelters. Previously, it was theorized that separation from mom and littermates and changes in environment (surrender to a shelter) may play a major role. More recently, we’ve seen owners that are spending almost all their time sheltering in place with their dogs having the same problems. 

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When my son turned two I learned very quickly what separation anxiety is in humans and what triggers it. He would scream and cry when his mother left the room. When we spoke to his pediatrician about this behavior the doctor explained that at that age my son was aware enough to understand that his mom was leaving, but still too young to understand when (and if) she was coming back. 

Dogs that suffer from separation anxiety are the same way. It may manifest as “spiteful” and this behavior is unacceptable, but these dogs are purposely “spiteful” or “bad dogs.” They are actually having the equivalent of a nervous breakdown every time you leave.  

The most common sign of separation anxiety is destructiveness (scratching, biting, urination, defecation) when you are not home, especially if it is aimed at the door you just exited or windows near the door. One pet owner described their dog as running upstairs every time they left. One time the dog became so agitated it broke through a screen and jumped from an upstairs balcony. 

Another common sign is vocalization (barking, howling, whining) after you have left (this will not make you popular with your neighbors). Self-trauma (the pet licking or chewing at itself sometimes until bleeding) is also very common.  

DO NOT GIVE UP HOPE.  THERE IS HELP AVAILABLE. First speak to your veterinarian about making sure there is not a medical/neurologic disorder mimicking these behaviors (seizures, pain, etc). An exam and certain diagnostics (bloodwork, X-rays, fecal analysis) are a good baseline to make sure nothing else is going on. If that is ok, help with a trainer or animal behaviorist are a real good idea (especially one that can assess your dog in his/her home environment). Sometimes medication in conjunction with behavioral modification is needed. 

The next article will focus on behavioral modification and medications to treat separation anxiety. 

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

When I hear the term “hot spots,” I usually think of free Wi-Fi. However, in veterinary medicine this term refers to a painful skin condition that is common this time of year (hot and humid weather). 

“Hot spots” is a layman’s term. Pyotraumatic dermatitis or acute moist dermatitis are medical terms for hot spots and refer to rashes that pop up suddenly on the top layers of the skin (by suddenly, I mean within hours). The rashes resemble a human eczema type condition as the rash begins to weep. Patients appear to have been burned, are very warm to the touch, and have this condition more commonly in the warmer months. Therefore, the term “hot spot” is very appropriate.  

What causes hot spots? They are usually the result of some allergy or irritation. Triggers included bug bites (including fleas and ticks), matted hair, contact irritations, seasonal allergies/food allergies, etc. The patient develops a focal rash that may be further irritated by self-trauma (chewing, licking, or scratching at the area). The most common sites are the neck and ears, followed closely by the thigh and tail region.  

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These rashes are commonly complicated by a Staphylococcus bacteria. This Staphylococcus species is considered normal flora, or bacteria that lives on the body at all times. Normally, they do not cause a problem because they are kept in check by the immune system. However, it can be a bit naughty if the conditions are right. When this bacterium proliferates it also releases an exfoliative toxin. An exfoliative toxin refers to a toxin produced by the bacteria that causes the cells of the skin to exfoliate, or fall off (like foliage falling off a tree). The dead skin cells, bacteria, and fluid from inflammation/self-trauma make a gooey mess. 

How do we treat hot spots? If they are not too severe, they can be treated topically. Shaving and cleaning the area with antiseptic rinse or shampoo and topical medications (sprays, ointments, or powders) may be enough. However, many times these rashes are too painful (or at least initially too painful) to treat just topically. I will try to shave these areas but, if the patient is in too much pain, systemic medications like anti-inflammatories (corticosteroids, or cortisone derivatives) and antibiotics are needed to resolve these rashes. 

If the rash is not resolving, your veterinarian may consider other causes that resemble hot spots and recommend additional testing (a culture or biopsy) to find the cause.   

I hope this sheds some light on a condition with a weird name.  Stay cool!!

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

My last article focused on the older treatments for atopic dermatitis with some of the treatments largely ineffective in more severe cases and, others, having too many adverse side effects. Very briefly, atopic dermatitis in pets is defined as, “a chronic, itchy, inflammatory skin condition that occurs in genetically predisposed animals,” or a rash associated with seasonal allergies. Here are some of the newer medications available for the treatment of atopic dermatitis.

Cyclosporine (Atopica®): cyclosporine is classified as an immunosuppressant but, overall, it is much safer than corticosteroids (cortisone derivatives) long term for the use of treating chronic atopic dermatitis. Cyclosporine prevents the activation of a certain type of white blood cell called T cells and the inhibition of certain chemicals called interleukins, as well as others. The main side effect is gastrointestinal (nausea, vomiting, diarrhea, flatulence). Cyclosporine has also been linked to increased risk of certain types of neoplasia (tumors, cancer) in certain breeds. 

Oclacitinib (Apoquel®): oclancitinib is classified as a novel, selective immunosuppressant. Oclancitinib inhibits the enzyme janus kinase. Janus kinase acts as a signal for the immune system to attract cytokines, or mediators of inflammation. Specifically, oclancitinib inhibits a type of cytokine called interleukins. The interleukins inhibited are pro-inflammatory. There is a benefit to inflammation in immune responses to fight diseases however, the interleukins inhibited are responsible for itching and rashes associated with atopic dermatitis. At least 60% of dogs have responded with a substantial decrease in itching and rashes when oclancitinib is used long term.

Lokivetmab (Cytopoint®): lokivetmab is classified as an anti-canine IL31 monoclonal antibody, but technically lokivetmab is an allergy vaccine. “IL31” is short for interleukin-31. Interleukin-31 is a cytokine that specifically triggers pruritis, or itching in the brain. Injecting itchy dogs with lokivetmab, or antibodies against IL31 reduces itching in over 50% of dogs treated. Unfortunately, lokivetmab is not effective in preventing the rashes and skin infections. Therefore, secondary treatments (antibiotics, antifungals, medicated shampoos or sprays, etc) may be required to manage atopic dermatitis in some patients.

Allergy Specific Immunotherapy (ASIT): this refers to testing for what a patient is allergic to and attempting to desensitize them to those allergens. The testing can be either: serum (blood), or intradermal. Many veterinarians will be able to draw the blood needed to send out for testing. Intradermal testing is usually done under the guidance of a veterinary dermatologist. Testing should include both food and environmental allergens. This way we can avoid certain diets that would definitely cause a reaction, as well as desensitize the body to known environmental allergens with a customized injection or sublingual (under the tongue) drops. Both are quite effective. 

I have found that some cases require short courses of some of the old school medications for “flare ups” at certain times of the year even if they are doing well on the new school treatments for most of the year. As always, check with your own veterinarian as to which treatment is best for your pet. 

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

The weather is changing and I’m getting more itchy patients coming to my office. Owners describe scratching and rashes appearing seemingly out of nowhere and they want relief for their pets. I explain to these owners that their pet most likely suffers from atopic dermatitis. 

Now, before I discuss treatment options for atopic dermatitis, we need to clearly define what it is. Atopic dermatitis in pets is defined as “a chronic, itchy, inflammatory skin condition that occurs in genetically predisposed animals.” 

What triggers this chronic condition? Pollens, mold spores, dander, dust mites, etc. Basically, atopic dermatitis equals seasonal allergies in pets. There are more choices in treatment these days and I would like to briefly go through the options.

Omega-3 Fatty Acids:  Omega-3 fatty acids are actually classified as supplements. However, they can be effective in controlling less severe cases of atopic dermatitis, or in conjunction with actual medications. The source of the highest levels are cold water fish so fish oil capsules or fish-based diets are recommended. There are also topical formulations of fatty acids that are applied directly to the skin. These oils prevent pro-inflammatory chemicals the body produces such as prostaglandins and leukotrienes. 

Omega-3 fatty acids are very safe because they are supplements but, in my experience, are rarely effective alone in treating atopic dermatitis. They work better in conjunction with some form of medication. 

Antihistamines: Histamine is a chemical produced by the body which, in small amounts, has a beneficial effect on the body. Histamine plays a role in normal cell metabolism. However, atopic patients produce larger amounts of histamine and larger concentrations of histamine in the body causes inflammation and terrible itching. Antihistamines block the histamine receptors on cells. These medications are very safe, readily available over the counter, and inexpensive. Unfortunately, they are in my opinion, very variable in their effectiveness and the least effective compared to the other choices.

Corticosteroids (cortisone derivatives): Corticosteroids include medications like dexamethasone, betamethasone, prednisone, isoflupredone, etc. These corticosteroids of different names vary in strength and half-life, or how long it takes to clear the system. These are very powerful medications and this means two things: 1) they are the most consistently effective medications in controlling the itch of allergies, and 2) they have a lot of side effects. 

The most common benign side effect is drinking and urinating more. Increased appetite and panting are also common. However, when corticosteroids are used short term for what are considered “flare ups,” the medication is generally considered quite safe. However, when used long term even at low doses, the detriment of adverse effects outweighs the benefit of the medications. These adverse effects include diabetes, pancreatitis, a suppressed immune system, stomach and intestinal ulcers, organ dysfunction, etc (this is not a complete list). 

Corticosteroids do have their place in treating what are called “flares” or acute, severe dermatitis short term in conjunction with a safer, long term treatment.

In my next article I will discuss some of the newer options used in the treatment of atopic dermatitis. As always, consult with your own veterinarian before choosing any treatments or medications.

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

It’s wonderful to see so many puppies and kittens that were purchased or adopted during COVID. Sometimes they come with some unwanted traveling companions like intestinal parasites. Diagnosis and treatment of intestinal parasites is important because some carry zoonotic potential (potential to be passed from animals to humans). Here is a short list of intestinal parasites carried by puppies and kittens. 

Roundworms: Roundworms are very common. They are transmitted from mother to offspring either in the womb, or shortly after birth through the milk. Signs of roundworm infestation are chronic intermittent vomiting and diarrhea, lack of weight gain, a pot belly, anemia and intermittent passage of worms. The risk of zoonosis is low because all one has to do is wash one’s hands but for very young children hand to mouth is very common. The main complication in humans is called larval migrans, referring to the parasite migrating from the intestines into other organs such as the eyeball, central nervous system, lungs, liver, etc.  

Hookworms: This parasite is less common than roundworms and also causes an upset stomach (symptoms similar to roundworm) and anemia. The zoonotic concern associated with hookworm is called cutaneous larval migrans. Hookworm can actually penetrate the skin and lead to painful rashes. 

Tapeworms: This parasite can lead to severe diarrhea and poor weight gain in puppies and kittens. With tapeworm in adult dogs and cats most times one will only see tapeworm segments passed. Segments appear to look like small rice segments and sometimes move around. Zoonotic concern of tapeworms will usually cause chronic diarrhea and abdominal pain but rarely these worms can migrate to the liver or lungs with serious complications.  

Whipworms: This parasite is not one that is zoonotic but can cause significant disease in dogs (cats are not affected). Adult whipworm lives in the large intestine and symptoms include diarrhea (many times bloody), cramping, lethargy, and straining to defecate. Whipworm eggs can survive for years in the environment under extreme conditions. This means that even after treatment your property is permanently contaminated and you should monitor your dog for repeat infections.  

Coccidiosis: This parasite is also one that is not zoonotic but can lead to significant disease in puppies and kittens such as diarrhea, abdominal pain, poor weight gain, and dull, crusty coat.  

Protozoal: The two most common protozoal infections seen in dogs and cats are Giardiasis and Toxoplasmosis which are both zoonotic. Giardia will lead to diarrhea and abdominal pain. Toxoplasmosis is more common in cats and can lead to diarrhea, vomiting but also central nervous system problems. Toxoplasmosis is zoonotic and has been linked to birth defects in pregnant woman but there are some simple precautions to avoid exposure. Talk to your veterinarian, as well as your physician before you make any drastic decisions.  

Although most shelters, animal rescues, and breeders/pet shops routinely treat for parasites, it is always a good idea to have a stool sample checked through your regular veterinarian at the first checkup (for their well-being and ours).  

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

It seems that after we have a few warm winters, Mother Nature wants to let us know she can “still bring the pain.”Our pets feel it also. Here are a few tips to keep our pets safe during this cold weather.   

Hypothermia is a problem in pets as well as people (especially in breeds with a shorter coat). The very young, the very old and the debilitated have more trouble maintaining normal body temperature so limit time outside for any indoor/outdoor pet. Also consider a sweater or coat for a short-coated breed (I have seen some really stylish outfits already this winter). Cold air can be very difficult on pets with diagnosed respiratory or cardiac conditions. Consider (if possible) training your pet on “wee-wee” pads so they do not have to go outside if they have a cardiac or respiratory condition.    

Frostbite occurs more readily in areas with less hair (e.g., the ear tips, nose, bottom of the feet/pads, etc.) so monitor for sudden areas of hair loss and bring it to your veterinarian’s attention. Skin and nails become dry and brittle in the cold, dry winter weather and rock salt used to melt ice can be very irritating to our pet’s feet. Try to let your pet out only on grass (if possible). If you are forced to walk your pet on the street always wipe their feet or consider booties. Snow can hide sharp objects so be careful about letting your dog run in fields that have not been maintained or they may step on broken glass (or another sharp object) without realizing it.

Arthritis is a condition that will be exacerbated by cold weather just the same as humans. Arthritis is also complicated by weight gain and weight gain is common in pets in cold winters due to inactivity. Consider giving a little less food and be very judicious with treats (COVID has fattened up some pets at our practice with owners working from home). Pets with arthritis are more likely to slip on snow or ice so make sure to clear a path for them when they go out and assist them if necessary. Joint supplements are excellent year-round but, if you have forgotten to continue through the winter we recommend restarting immediately. 

Non-Steroidal Anti-Inflammatory Drugs, or NSAIDs for short can be helpful on bad days as long as used judiciously. Make sure to consult with or, better yet, purchase those medications from your veterinarian. Not all older pets (especially those with pre-existing conditions that may be on other medications) can handle NSAIDs and not all over the counter NSAIDs are safe for pets. We routinely run bloodwork to evaluate liver and kidney function for older pets that need NSAIDs. 

I hope these tips help to get our pets through this wicked winter we are experiencing (especially since Punxatawney Phil saw his shadow).  

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

February is National Pet Dental Health month so I thought a discussion of periodontal disease is appropriate. Pets tend to suffer less from dental disease, and more from periodontal disease. 

Dental disease refers to pathology specifically related to the tooth like caries (superficial decay in the enamel), cavities (deeper decay in the enamel), and tooth fractures. Periodontal disease refers to pathology related to the structures around the tooth. These structures include the gingiva (gums), periodontal ligament (thousands of strands of microscopic strands of connective tissue that hold the tooth in the socket, or jaw), and the perialveolar bone (the bone of the jaw around the tooth).

Periodontal disease usually starts with a buildup of plaque. Plaque is a thin film of saliva, old food and bacteria that can accumulate on the surface of the tooth within 24 hours. If this plaque is not removed, it mineralizes and becomes tartar. Tartar allows a matrix where pathologic bacteria can hide. These bacteria cause chronic inflammation and this inflammation will lead to recession of the gums, breakdown of the periodontal ligament, and resorption of the perialveolar bone. This process is slow and painful because while single rooted teeth may just fall out without intervention, many teeth are multi rooted where one or two roots could be rotten and the third intact. That requires dental extractions at your veterinarian’s and I have yet to meet a pet owner that is happy to hear that. 

The key to intervening in this pathology is preventing plaque. No plaque, no tartar. No tartar, no periodontal disease. How do we prevent plaque? Let’s go through the options: 

Brushing — brushing is very effective, but also the most frustrating option in my opinion. Brushing needs to be done every day to be effective. If you have the time and your dog or cat is more patient than mine, go for it. Make sure you use pet safe toothpaste. Human toothpaste has too much sodium, fluoride, and is sweetened with saccharin.

Treats, toys, or diets — there are certain toys, treats, chewies, and even special diets to help to clean the teeth. These items will have an abrasive action similar to brushing, increase the production of saliva, and some are treated with special enzymes or compounds to help control the production of tartar. Make sure that if you look in the pet store you find the Veterinary Oral Health Council (VOHC) seal of approval on the packaging or ask your veterinarian which products they recommend. 

Do be careful. Many of the treats and diets tend to be calorie dense and can cause an increase in weight if overused. Also, remember you don’t want anything that’s too hard and may cause damage to the enamel or a fractured tooth. There’s a saying, “If it’s something you wouldn’t want to get hit in the knee with, it’s too hard for your pet to chew on.” 

I hope this information helps. Remember, “keep on smiling.”

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

The holiday season is a time of gathering and thanks but, during these stressful and uncertain times, it can be difficult to find anything to be thankful for. The exception is pet ownership. One thing I hear over and over is, “I am thankful for my pets.” Now, more than ever, pets provide stress reduction and help to fend off loneliness. They are good for mind and body.

How do we know that interacting with a pet reduces stress? I read about a study where individuals were induced into a stressful state and then offered a rabbit, a turtle, a toy rabbit, or a toy turtle. Those individuals that pet a real rabbit or turtle showed a significant reduction in stress compared to those that pet a toy rabbit or turtle.

More recently, a study comparing pet owners (dogs and cats) to non-pet owners during COVID found that owning a pet reduced the feelings of isolation by having an individual (even if not human) to talk to throughout the day. Some of the participants even relished the fact that they were able to spend more time with their pets during lockdown than before. This is so important in the new era of online meetings, classes, etc.

Pet ownership also benefits physical health. Previous studies both in the United States and abroad have concluded that just owning a pet significantly reduces the risk of cardiovascular disease, such as a heart attack or stroke, reduces the risk of type II diabetes, and lowers cholesterol.

Even before COVID it was known that owning a pet motivates us to exercise more. The national physical activity guidelines recommend 150 minutes of moderate exercise per week but a CDC analysis states only about 50% of Americans get that total. In contrast to this data, research shows that dog owners walk an average of 22 minutes more per day. Not only do dog owners exercise more, but also the type of exercise is healthier. The type of exercise is described as at a moderate pace which refers to getting the heart rate up.

A more recent study found that dog owners were more likely to take their dogs for walks during COVID and, as a result, lost more weight than non-dog owners. So let us give thanks to the furry, four-legged members of our family who enrich our lives every day.

I give thanks to all the readers who enjoy this column. 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.

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By Matthew Kearns, DVM

I recently had a client from our clinic call who was interested in adopting a cat. The individual our client was adopting the cat from mentioned that she herself had tested positive for COVID-19 and had recovered (the cat never exhibited any symptoms). Our client was concerned that the cat could be an asymptomatic carrier and potentially infect her with COVID if she adopted.

I would like to be clear: there is no evidence of risk at this time. There are documented cases of both dogs and cats that have tested positive for COVID (some exhibited symptoms), there are no cases that dogs or cats have spread COVID to people. This question got me thinking: what diseases should we be concerned about?

Any infectious disease that can be spread from animals to humans is termed zoonosis (plural zoonoses), or a zoonotic disease. The human population most at risk for zoonotic diseases are young children (under 5 years of age), the elderly (over 65 years of age) and the immunocompromised. This following list of zoonotic diseases is not a complete list, but rather the most common I have seen in dogs and cats.

Intestinal Parasites: Giardia and Toxocara species (roundworms) are common. These parasites can be quite significant, especially if you have young children in the household. This is why veterinarians always recommend bringing in a fecal sample with new pets or on an annual exam.

External Parasites: Fleas and ticks can not only suck blood and irritate the skin, but also transmit disease. Ticks carry Lyme disease, Rocky Mountain Spotted fever, and many other diseases. Fleas carry Bartonellosis, or cat scratch fever, and bubonic plague. Certain mites such as Sarcoptic mange can lead to scabies.

Skin Infections: Dermatophytes, or ringworm, is very contagious. I usually see cases of ringworm infections in kittens that spread to humans. Certain bacteria such as Staphylococcus spp. can be of concern. Both dogs and cats carry numerous bacteria in their mouths that are dangerous so any bite or scratch should be evaluated immediately.

Viral infections: The most dangerous viral disease carried by dogs and cats, Rabies, has a vaccine available for prevention. Make sure both for your pet’s safety, as well as your own, you keep them current on their Rabies vaccine.

Remember to keep your pet safe, as well as yourself during these uncertain times. Remember to bring a fecal sample to your pet’s annual exam, stay current with vaccines, and maintain parasite control. Also check with your own veterinarian with any other concerns you may have.

Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine. Have a question for the vet? Email it to [email protected] and see his answer in an upcoming column.

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