Senior Health

Who Peed on the Rug?? Or...Feline Idiopathic Cystitis (FIC)

A complaint cat owners sometimes have is that their cat is urinating outside of the litter box. There are various medical and behavioral problems that can cause this, but we will focus on one condition in particular called feline idiopathic cystitis, or FIC for short. FIC is a sterile inflammatory disease of the bladder in cats, particularly indoor cats.

While all the causes of FIC are not entirely understood, stress is an important component. Research has shown that in susceptible cats, stress can result in inflammation of the inner lining of the bladder. Once this happens, the cells in the bladder can become further irritated by the urine and cause even more inflammation. Some cats are more prone to feeling stressed when their owners' schedules change, new people or animals are around the house, stray cats are in the yard, if there are any changes to the litter box, etc. 

Just because your cat is lounging around the house does not mean he is not stressed! Cats are good at hiding their feelings so we do not always know what they are thinking or feeling.

Signs you may see at home can include urinating out of the litter box, urinating small, frequent amounts, straining to urinate, and bloody urine. Male cats with this condition can develop a urinary obstruction, meaning that they have an obstruction in their urethra (the tube that goes from the bladder out) preventing them from being able to urinate: this is a medical emergency. Signs of FIC are often mistaken for a urinary tract infection (UTI). UTIs in young, healthy cats are actually quite uncommon (less than 1-2% incidence), so it is important to check for infection before treating with antibiotics! Bouts of FIC usually run their course in 3-7 days, so just because a cat has been treated with antibiotics and improved does not mean there was an infection present. This inflammatory disease is often a recurrent problem, which can be frustrating for owners and uncomfortable for the cats.

If you notice any of these signs in your cat, he or she should be evaluated by a veterinarian and have tests done (usually a urinalysis and urine culture) to make sure there is not an infection present. There are some medications that can be used to help decrease pain and spasming of the urethra, but ultimately the inflammation has to run its course. Crystals can sometimes be seen on the urinalysis, but unless there are bladder stones present (which would be seen on x-rays), these are considered secondary to the disease, not a primary cause, and therefore do not necessitate treatment.

There are, however, some changes that can be implemented at home to help decrease the risk of recurrence or decrease severity of signs:

  1. Water Intake: It is believed that increasing water intake can help to promote more frequent urination and prevent accumulation of debris which can trigger inflammation or cause an obstruction. This can be done by feeding wet food rather than dry, making sure there are multiple bowls of fresh water, adding tuna juice to the water to entice water consumption (although be sure to change this frequently to make sure it does not go rancid), or by getting a running water bowl.
  2. Litter Boxes: Maintaining an adequate number of clean litter boxes also serves to promote more frequent urination. There should be one litter box in excess of number of cats (for example, if you have two cats there should be three litter boxes). It is also important that the boxes are cleaned regularly. If clumping litter is used, it should be scooped every day to every other day (ideally twice daily!) and cleaned entirely every 1-2 weeks. Many cats do not like liners or covered boxes as well, so if this is present it is recommended to remove the liner and uncover the box.
  3. Environment: Environmental enrichment, especially for indoor cats, can help decrease stress. This includes making sure there are an adequate number of toys and positive interaction with people by setting aside play time every day. It is also important to have areas that the cat can call his or her own to escape to, as well as providing elevated surfaces (for example, cat towers) they can climb and sleep on. Sometimes leaving music or television on while you are gone can be helpful. Also, it can be stressful for cats inside to see another cat outside in the yard in their territory. If this is the case, blocking the window so that they stray cat cannot be seen may help decrease stress.

Combating Cabin Fever

We all know the phrase "Cabin Fever," and how boredom can make us do things we may not normally do if we were otherwise pre-occupied or content. This is something our pets may feel all too well. Statistics show that boredom, or lack of enrichment, can lead to many behavior problems if not caught soon enough. Lack of mental stimulation or opportunities for our pets to satisfy their natural instincts and behaviors can cause them to act out in ways that we only understand as "bad behavior." In a perfect world, humans and domesticated animals would live together in perfect harmony while entertaining one another's instincts.

Because this world does not exist, we must find ways to satisfy our pets' needs that don't involve our dogs digging to China in our backyard or our cats knocking every single item off of every shelf in an attempt to see which one will play back with them. The idea of enrichment is to provide mental and physical stimulation for our pets to help them live more rewarding and full lives. In the long run, this will help avoid naughty behaviors that may eventually break down that bond you and your four legged child may have.

We all know that ideally dogs would love to walk miles and miles each day and sniff every single blade of grass along the way. Cats would love to chase butterflies in the sunshine for hours on end. Unfortunately, because of our busy lives, this is not always an option. This does not mean there is no hope for your dog or cat. There are many ways to help them achieve the mental stimulation they need. Many of these things can be accomplished with household items you may already have.

Tips to Combat Your Pet's Cabin Fever

Toys: A rule of thumb is that 3 toys should be provided per pet, per day. These items can be switched out and reintroduced every 5 days to help maintain novelty. Keep in mind that you should be cautious of your pet's normal chewing behavior to avoid ingesting any part of the toy. Examples for dogs are rope toys, tennis balls, squeaker toys, and Kongs. Some options for cats are toy mice, jingle balls, and feather toys.

Environmental: Animals naturally enjoy viewing their environment from different angles. This may be easier to accomplish for cats because they are more inclined to climb on counters, shelves, and basically anything in reach. If an option, it would be valuable to allow your cat to have an area, or several, that they are encouraged to climb up on. Empty shelves mounted on a wall that create a ladder effect work great but a standard cat tree is beneficial as well. An idea for dogs is to allow visual access through a window or door. Not all dogs are a good candidate for this especially if they are typically reactive to seeing other people or dogs outside. A good option for those dogs is to leave on the television or radio.

Exercise: This category is one of the most important ones. This is beneficial for overall health but can also have a major effect on naughty behavior such as separation anxiety and and other negative results of pent up energy. Routine walks for your dog are certainly beneficial but there are particular reward neurotransmitters (nerve messenger cells) that are not released unless your pet undergoes high intensity endurance running. Essentially, there are certain functions of your pet's brain that are not stimulated unless this type of exercise exists for them. If you are not typically a runner, dog parks, open fields that allow pets, and even your back yard are a great option to help them reach these needs. It wouldn't be recommended to harness your cat and take him on a 3 mile run, but they can get their daily workout with a little help from you. A cat will chase a feather string toy or laser light for hours. This is encouraged to help them burn energy but it also has a great effect on their self-confidence.

Brain Puzzles: With a little creativity, you would be surprised how many ways you can provide your pet with enrichment. Dogs and cats love new scents. Think of all the things there are to smell while they are on a walk or outside. By using a spray bottle and infusing scents like cinnamon, rosemary, lavender, or chamomile onto your pets favorite bedding or toys, you can provide them with a change to seek and explore. Toxicity potential should be evaluated before using any product. Alternating scents is the best way to keep this a fun adventure for your pet. Empty cardboard boxes with windows cut in them can provide a fun hideout for your cat to explore. Laundry baskets with or without fabric in them placed in various positions provide a new obstacle for your cat to conquer. Switching out different types of fabrics can create an opportunity for your pet to rub and roll for more tactile stimulation.

Fun with Food: Food puzzles are a wonderful opportunity for your pets to engage in their natural instinct to hunt for food. These puzzles can be purchased at most pet stores or made by using cardboard boxes and plastic containers. If you live in a single pet household, spreading his or her meal out in separate rooms gives your pet a great excuse to sniff and search to find the food. If your pet is food motivated, using food puzzles during stressful events like thunderstorms or separation can keep him or her occupied and help with counter conditioning. Using empty egg carton containers to feed your cat or small dog is an easy option. As a treat, you can fill a Kong with peanut butter or freeze a bowl of water mixed with treats or chicken broth to entertain them for a while.

The possibility for enrichment ideas are endless! As always, you must take your pet's individual needs and current health into consideration as not all of these options are suitable for every pet and household. For assistance or questions about anything in this article, don't hesitate to contact us!

How To: Brush Your Dog's Teeth (video)

Dr. Rainwater and her dog, Zulie, demonstrate how to brush your pet's teeth. Just 1 minute, every day for healthy teeth and gums. You CAN do it!

Tips

  1. Use a pet-specific, enzymatic toothpaste instead of a human toothpaste.
  2. Start with a fingerbrush and work your way up to a toothbrush.
  3. Create a routine to brush teeth before a meal or treat to reward the behavior.
  4. Start slow! Let your pet lick the toothpaste as a treat and brush a few front teeth.
  5. Brush each tooth and the gum line in a circular motion.
  6. Focus on the outsides of the teeth. (The tongue will clean the insides.)
  7. Make sure to brush all of the molars in the back of the mouth - they're easy to miss.

From Your Pet’s Dentist

An Introduction to the Canine and Feline Dental Treatment Process

February is approaching, which the veterinary profession has designated “Dental Health Month” in primary care practices across the country.  Here at Daniel Island Animal Hospital, we want to put a special emphasis on the importance of dental care for your pets. In the next few blogs through the month of February, we will be addressing oral health and preventative care for dogs and cats.

Like many of my clients, I grew up with many dogs and cats and we never paid much attention to their dental health. I couldn’t tell you whether they had dental tartar or not. If dental care came up, it was a reaction to horrible breath, not eating, or bleeding from the mouth. Since those days, the veterinary profession has come a long way in recognizing the importance of dental health to the well being of our canine and feline companions.

What is dental disease?

Dental disease in pets is no different from that found in people. It all starts with plaque bacteria that colonize the tooth surface just as they do in our mouths. Without regular bacterial removal by brushing or chewing, eventually the bacteria develop into a hard cement called calculus or tartar. This cement grows on itself, and eventually the constant presence of bacteria causes inflammation of the gums, known as gingivitis, also generally called periodontal disease.  If the inflammation and bacterial infection continue to progress, they cause the gums to pull away from the teeth, causing deep gingival pockets around the teeth. Eventually, the gums recede from the teeth and the infection proceeds to destruction of the bone that holds the teeth in place, eventually causing them to fall out. Gingivitis and periodontal disease are a significant source of discomfort for many pets, and there may be other potential health risks associated with a constant bacterial infection in the mouth.

What’s involved in a “Dental”?

Unfortunately, many pets, ESPECIALLY pets that have sensitive or painful mouths due to dental disease, don’t really let us get a good look around in their mouths during a routine visit, much less allow us to do anything about a problem that we may see. This is why veterinary practices have developed the basic protocol for what is called a dental prophylaxis treatment, often referred to as a “Dental” for short.  Although preventative care is implied in the name, the process usually involves both the prevention AND treatment of dental disease.

If you think back to the last visit made to your dentist, hopefully you experienced a comprehensive evaluation of each tooth, measuring the gingival pockets, scraping away tartar, taking dental x-rays, doing treatments as needed, followed by thorough cleaning and polishing.  Your dentist should have also evaluated your mouth as a whole, including the gums and tissue of the insides of the cheeks, lips, hard palate, throat and tongue. The veterinary dental prophylaxis is no different – we have 30 (adult cats) to 42 (adult dogs) individual little tooth patients that need to be thoroughly evaluated and treated appropriately.

Why is it so expensive?

Unfortunately, our pet’s reluctance to voluntarily submit to a tooth-by-tooth evaluation makes anesthesia necessary for effective dental prophylaxis treatment.  Which leads to the biggest obstacle to pet dental prophylaxis treatment for most people - the cost.   Inhalant anesthesia, done properly with pre-anesthetic blood screening, appropriate premedication, temperature, circulatory, and respiratory system monitoring throughout the procedure (including ECG, blood pressure, carbon dioxide and tissue oxygen levels), intravenous fluid support, and post-anesthetic monitoring, adds a significant cost. However, it also adds a significant value to the procedure.

Removing calculus when pets are awake, or even performing“sedation” dentistry, where animals are placed in a mild version of anesthesia and tartar is removed by hand, is unequivocally rejected by the members of the American Veterinary Dental College as being inadequate (see http://www.avdc.org/dentalscaling.html).  Removing the tartar you can see only addresses the visible part of the problem for pets with dental disease, but it doesn’t deal with the bacteria under the gum line, which is what leads to painful periodontal disease.  Unfortunately we just cannot safely and effectively remove tartar above and below the gum line, check for and treat periodontal disease, get full dental radiographs and thoroughly examine the mouth for other oral problems with an animal in an unpredictable state of sedation.  It’s unsafe for the patient, personnel and equipment and it is not providing the level of medical care that your pet deserves.

Now I will be the last person to ingnore or underplay the risks of anesthesia. It is ALWAYS a risk, for any person or pet, to undergo. However, when all the necessary precautions are taken and it is carefully monitored, anesthesia carries a fairly low risk for even older pets with other underlying medical conditions. When compared to the increase in welfare that can be achieved by removing a constant source of inflammation and infection that is present in the mouth of pet with dental disease, it is usually a risk well worth taking.

How do you “treat” dental disease?

In general private practice, we rely on removal of plaque bacteria and calculus and topical and/or systemic antibiotic therapy to resolve most of the dental disease we see.  In cases where the disease is severe, especially if there has been significant bone loss or there is an abscess at the tooth root (which we can see with our digital radiographs), then dental extraction may be necessary.  Since our dogs and cats aren’t out chewing up carcasses to survive, the loss of teeth is generally well tolerated and a much better alternative to continued pain and disease.  In some cases however, advanced techniques such as periodontal surgery, root canals, crowns and even orthodontic treatments may be the best option for your pet. At this time, we refer cases such as these to a board certified veterinary dental specialist on an individual basis. 

How can I prevent dental disease? 

Once the teeth and gums have been evaluated, cleaned and treated, we move on to the most important step – taking care of your pet’s teeth at home.  Home dental care, especially brushing to remove plaque accumulation, is the best way to extend the amount of time between necessary dental prophylaxis treatments under anesthesia. It is so very critical to your pet’s well being, that it has become one of my preventative care soapboxes, as my clients will attest to ;-)! In an upcoming blog I will go step by step through the process of brushing my own dog’s teeth, cat dental care and give tips on how to work on getting them to accept it.

Your job between now and then is to email us with ANY questions you have about dental care in your pets. In our final dental blog I will address any questions that come up directly, so that we can help all of you better take care of your pet’s teeth at home.

OH! My aching back!

Well, it has finally come to fruition that I suffer from a disease I readily see in our canine patients. Fortunately, it is not infectious (so no quarantine needed!) and it can be corrected. Unfortunately, I have had to learn the hard way the degree of discomfort some of our four-legged friends have had to deal with (and quite admirably, I might add) What is this often debilitating problem? Inter-vertebral disc disease (IVDD). Some big words for a relatively little, but much needed and ungraciously overlooked (at least in my case) cushion in our bodies.

What is IVDD

Inter-vertebral discs are the cartilage pads that connect the vertebral bones of our spinal column. The disc's job is to act like a shock absorber and spread out the compressive forces we subject our vertebrae to every second of every day and night. Interestingly, they account for 16 percent of the length of the articulated column in dogs and about 25 percent in humans! They are also one of the organs in our body that consistently show degenerative changes with advancing age. Each disc is composed of two parts: the nucleus pulposus (central part) and an outer anulus fibrosus. The nucleus is a semi-fluid tissue that is maintained under pressure by the encircling bands of fibrous tissue of the anulus fibrosus.

Insidious changes occur to both the nucleus and anulus relatively early in life.  Calcification of the nucleus can occur which decreases its shock absorber abilities which imparts less flexibility of the spine. In humans and pets this is noted by a stiff, and possibly guarded, gait.  Pain is not uncommon either, often from surrounding muscles that spasm. Mircofragmention of the anulus may also occur which allows the nucleus to bulge or escape completely ("bulging or herniated disc"). The nucleus most commonly escapes in the direction of the spinal cord where it may compress nerve roots (nerves that innervate our peripheral body) - usually termed "pinched nerve" - or it may cause inflammation or, worse, compression of the spinal cord. Let me tell you from personal experience a herniated disc HURTS!!! Besides pain, it can also cause muscle fasciculations (not visible to the eye), tingling, numbness, paresis (weakness), or even paralysis.  Degenerative changes can occur in any disc, but the effects are most severe in the regions that are most mobile: the neck and the lumbosacrum.

Who is Predisposed

There are particular breeds of dogs that are genetically predisposed for developing IVDD and they typically fall under the category "chondrodystrophic breeds". Some of these are: dachshunds, beagles, Pekingese, basset hounds, and shih tzus. These breeds have a genetic disorder with their cartilage and bone development, hence abnormally developed discs may form. However, any breed can develop a disc problem, so any abnormal gait ("stilted walk", "holding neck funny"), PAIN!, or any weakness or non-use of a leg or legs should prompt an immediate visit to your veterinarian.

How it's Treated

Diagnosing a pet with IVDD is often straight-forward with information gleaned from the physical exam and, often, survey radiographs.  Many cases are mild and can be managed with anti-inflammatory medication (often steroids, since they are POTENT at reducing inflammation), pain control, muscle relaxers, and most importantly, STRICT REST - ideally, the pet is crated. More severe cases are referred to a veterinary neurologist or orthopedic surgeon where surgery may be indicated to extrude the herniated disc material and then fusion of the 2 adjacent vertebrae. Many of these pets recover remarkably well following spinal surgery. 

After my recent disc herniation, I have a renewed and deeper empathy of the pets we see for neck and back pain. Neurologic-related pain is INTENSE and should not go untreated.  We are here to help diagnose and treat the ones that can be managed medically, and we also have 2 specialty groups, Veterinary Specialty Care and Charleston Veterinary Referral Center, in the Charleston area that provide surgical care for those cases that need it.

Why there is no such thing as an “all stages” pet food

Have you ever wondered why dog and cat foods are labeled “growth” for puppies and kittens and “mature” for older dogs and cats?  There are very important reasons

  • Do we eat the same foods as a teenager and as a sixty year old? 
  • Do we eat the same way when pregnant and after turning fifty? 

Pets also need food that is formulated appropriately for their specific stage in life – to receive adequate, but not excessive, amounts of important nutrients.  Puppies, kittens and lactating mothers need more protein, vitamins, and minerals than adults to ensure proper growth.  Foods for adults and for senior pets should be formulated differently to meet the changing needs of dogs and cats as they age.

Why is “all stages” written on the label?

The pet food industry is regulated by AAFCO – the Association of American Feed Control Officials, a “voluntary membership association of local, state and federal agencies charged by law to regulate the sale and distribution of animal feeds and animal drug remedies.”  AAFCO defines an all stages diet this way:  “The pet food has to be suitable for puppies, kittens or pregnant/lactating adults.”  http://www.petfood.aafco.org/ 

Here are some examples of how AAFCO standards for an "all stages" diet (to meet a puppy’s needs) match up to an adult dog’s daily nutritional needs:

  • Protein (% minimum) is 22% higher than recommended daily allowances
  • Crude Fat (% min) is 60% higher than recommended daily allowances
  • Sodium (% min) is 400% higher than recommended daily allowances

Daily recommendations for a senior dog are even lower, and the findings are similar in cats.  Overweight condition is the number one contributor to arthritis pain and mobility problems in dogs and cats.  Excess sodium is related to hypertension (elevated blood pressure) and heart disease.

Also from the AAFCO web site:

  • AAFCO has no statutory authority to regulate pet products.
  • AAFCO does not regulate, test, approve or certify pet foods in any way. 
  • AAFCO establishes the nutritional standards for complete and balanced pet foods, and it is the pet food company's responsibility to formulate their products according to the appropriate AAFCO standard.

It is the state feed control official's responsibility in regulating pet food to ensure that the laws and rules established for the protection of companion animals and their custodians are complied with so that only unadulterated, correctly and uniformly labeled pet food products are distributed in the marketplace and a structure for orderly commerce.  

It is up to the company to comply.  Some companies do an excellent job - by using science, doing food trials, employing veterinary nutritionists and other specialists, and formulating foods appropriate for the labeled use.  These companies spend money on food trials and nutritional testing that is not required to put their products on the market. 

These companies share their information with veterinarians so we can educate clients appropriately.  Two companies I trust – two companies from which I purchase foods for my own pets – are:

Some companies do not provide veterinarians with information, even when we ask for it.  Sometimes they do not even have information to provide – no food trials, no nutritional formulas.  They emphasize words that sell products:  “natural” “organic” and “grain free” are some examples of words which are unregulated and unimportant to your pet’s nutritional health.

These buzz words are for your sake – the consumer – because they appeal to you.  The “all stages” foods are marketed to pet owners who look for the convenience of one food for more than one pet.  But it just is not possible to meet their individual requirements at different stages of life with one formula.

These marketing techniques do not benefit our pets nutritionally.  Some of the premium diets sold at boutique pet stores can cause your pet problems.  Most are calorie dense, “filler free” foods without the fiber and carbohydrate our pets need to stay healthy.

Dogs and cats become ever more obese and pet owners find it ever harder to afford their care.  Don't spend money on the wrong things.  Who can help you sort this out?  Your veterinarian, who studied nutrition, physiology, medicine and disease – who spent eight years in college specializing in animal health and wellness, is equipped to help you prioritize your funds devoted to pet care.  We can help when they are sick- and we are the best source of information on how to keep them healthy.

Please don’t fall for marketing schemes and ask the advice of perhaps well-meaning, but untrained employees in the pet food and pet store industry!  They just don’t know.

 

What's that lump?

lump.jpg

Dogs and cats are notorious for developing lumps and bumps on their bodies over their lifespans. {Ferrets, guinea pigs, hamsters, rabbits, and rodents are not immune to lump (mass) formations either}. Many of these are benign growths, and often self-resolving, but some may be malignant or infectious in nature so an accurate diagnosis is warranted.

We recommend any new swelling or growth on your pet be examined as soon as possible once detected. We will examine the mass by visual inspection and by palpation. Some common growths may be identified by gross examination alone, for example, oral papillomas and sebaceous adenomas. However, the vast majority of growths need to also have a microscopic evaluation to obtain a diagnosis. This is accomplished by a Fine Needle Aspiration (FNA) of the mass.

Fine needle aspiration is performed in the clinic during most routine exams and sedation is very rarely needed. A small gauge needle is inserted into the growth and gently maneuvered within it. Gentle suction is often applied to a connected syringe. The maneuvering of the needle and the suction help to obtain a sample of the cells that make up the growth. The sample is then delivered onto a slide which is allowed to dry, then stained, and viewed under the microscope. General veterinary practitioners are able to make confirmed diagnoses a vast majority of the time. There are some instances where suspect diagnoses need to be sent to a veterinary pathologist for further identification and/or confirmation.

I try to inform pet owners ahead of time that growths may be "wall-to-wall" cells, so obtaining and observing a cell sample is relatively easy in that case. However, there are many growths where the cells may not exfoliate well or the growth may be more like a blueberry muffin and the abnormal cells are the blueberries that we are attempting to "blindly poke". In these scenarios we may not always get a diagnostic sample (even after repeated sticks with the needle) and so we'll often recommend that a surgical biopsy or complete excisional biopsy should be performed.

It's important to pay attention to any new growth/lump/bump/swelling on your pet and have it examined as soon as you can.  We will often be able to give you a diagnosis of what it is the day we check it out and then lay out a recommended treatment plan.  Many times we'll recommend "watchful neglect", but there are those lumps that may be cancerous or painful to your pet and so the sooner we diagnose the sooner we can manage it.

Is Pet Health Insurance Right for You?

When it comes to insurance, people seem to be in one of two camps: those who love it and those who hate it. For those of you who love it, prefer to pay bills in smaller monthly payments rather than occasional large chunks at a time, or for those that simply have accident/illness prone pets - keep reading!

We recently took some time to really dive into plans from the pet insurance company, VPI, to determine if it could be a worth-while investment for our clients. While there are lots of different pet insurance carriers out there, we chose to evaluate (and ultimately recommend) VPI due to its track record and notable financial underwriter, Nationwide. This said, we're happy to accept any pet insurance plan you choose and encourage our clients to shop around to find the deal that's best for them and their pets.

Before I get into the nitty-gritty of individual plans, let me start by explaining what pet insurance is, and what it is not. In the eyes of the underwriters, pets are treated as possessions and are therefore insured more like cars and less like people. While I personally may not agree with this philosophy, (my dog, Marlie, is practically human!) it does make insurance significantly less complicated. Another aspect to mention is that all pet insurance plans are by reimbursement only. This means you pay for your pet's care at checkout as usual, submit your paperwork, and then the insurance company will send you a check. Plans are available for pets of any age, but have the best coverage and are most affordable if started when your pet is young and at its healthiest.

To help our clients receive the maximum reimbursement possible, one of our receptionists, Lori, is now our official insurance guru. Before submitting your claim, she will scour your pet's medical record and confer with your veterinarian to find the most accurate and beneficial diagnosis to list. With the safety net of insurance, it is our hope that our clients will have the financial freedom to say 'yes' to our veterinarian's best medical recommendations for your furry companions.

Which VPI plan is best for you?

(This is my personal summary of each plan. Please refer to VPI's website: or call 888-899-4VPI for complete information.)

Major Medical Plan

  • Most comprehensive plan with largest reimbursement allowances (typically allows more than enough to have 100% reimbursement for our service prices)
  • Covers injury and illness including chronic conditions, multiple conditions, and advanced diagnostics
  • Covers hereditary issues after 12-month waiting period
  • New plans available for dogs and cats less than 10 years old
  • Plans activate 14 days after application
  • Average premium $15-$40/month based on deductible size, pet age, and pet breed/size.
  • Annual deductible options of $100, $250, or $500 

Medical Plan

(Similar to the Major Medical except...)

  • No hereditary condition coverage
  • Has reimbursement allowancesthat typically will cover 80-90% of our service fees
  • Monthly premium runs a few dollars less

Injury Plan

  • Coverage for accidents only (not medical illness claims)
  • New plans available for cats and dogs of any age
  • Plans activate 24 hours after application
  • Average premium $12/month
  • Flat annual deductible of $250

Cat Plan

  • Coverage for the 15 most commonly seen medical conditions
  • Reimbursement allowance of $600 per condition per year
  • New plans available for cats less than 10 years old
  • Plan activates 14 days after application
  • Average plan $12-15/month
  • No annual deductible

CareGuard Wellness Coverage

(can be added to the above plans)

  • Coverage for wellness exams, vaccines, heartworm prevention, tests, microchips, and +/- spay/neuter/dental procedures
  • Reimbursement allowances will break even for most of our patients
  • Monthly premium $12-22

As with any insurance, there are some products/services/conditions that are not covered in any plan. For VPI, this includes:

  • Food/Nutritional Supplements
  • Congenital/Developmental Conditions
  • Behavior Problems/Training
  • Breeding/Reproductive Conditions
  • Cosmetic Conditions (including declaws)
  • Pre-Existing Conditions

Please let us know if there is anything we can help you with in regards to pet insurance (or anything else for that matter!) If you decide to purchase a plan, please let Lori know and she will be happy to help you with paperwork after each visit.

Inappropriate Urination-Behavioral or Medical

Chances are in your pet's lifetime, she/he will have some sort of urinary issue. My own dog urinated in the house twice in the last week and initially, I blamed it on myself (that we had asked her to hold it too long.) After running some tests, I found out that she had a urinary tract infection which is currently being treated with antibiotics.

The goal of this article is to inform you:

  1. How to identify at home if there is a problem
  2. What tests are used to diagnose
  3. Possible causes and treatment

It is important to realize that most pets are going to show only subtle signs of a urinary tract infection. Pets don't commonly show signs that infections in other parts of the body might cause such as fever, lethargy or appetite loss.

The most common signs of a bladder infection that you will notice are:

  • urinary accidents in the house
  • attempting to urinate frequently with little to no urine produced
  • increased drinking
  • inability to hold urine the normal amount of time 

Bloody urine is also something owners can detect if the pet urinates on a light-colored surface. 

If your pet presents to us with these symptoms, the first test we will run is a urinalysis.  This test involves a chemical analysis to look at pH (acidity of urine), specific gravity (concentration), and the amounts of sugar and protein in the urine. A veterinary technician then reviews the urine sediment (this is what is obtained after spinning the urine in a centrifuge) under a microscope to look for abnormal cells or crystals.  This test helps us to identify the specific medical problem.

The other tests we may run for chronic conditions are: 

  • urine culture
  • x-rays
  • ultrasound
  • blood work to evaluate kidney function

A urine culture is run on urine we have obtained here in the hospital because the test needs to be run on sterile urine. Sterile urine (meaning without contamination) is most commonly obtained through a method called cystocentesis which means using a needle and syringe. Yes, this does sound scary but this process is no more painful than a vaccination! A culture involves sending the urine to a lab where they incubate the urine for 48-72 hours in a special container and identify whether bacteria is present. If bacteria grows in the urine, then the lab performs another test to identify which antibiotics are best to use against that specific bacteria type. X-rays and ultrasound are used if a bladder stone or bladder tumor is suspected. 

The most common urinary conditions we diagnose are:

  • bacterial urinary tract infections (UTI's)
  • sterile cystitis (inflammation of bladder wall without infection)
  • bladder stones
  • bladder tumors

Dogs more commonly get UTI's while cats more commonly have sterile cystitis (inflammation without infection.) Antibiotics are the treatment of choice for a UTI. A 14 day course is typically prescribed. Most patients' symptoms will resolve within a few days but it is SO IMPORTANT that the entire 14 day course be finished so the infection doesn't return. A recheck urinalysis is always recommended to ensure that the UTI has resolved fully. Diet changes, reducing stress in the home, and supplements to improve bladder wall health are the treatments of choice for sterile cystitis.  Bladder stones can occasionally be dissolved by a prescription diet but typically require surgical removal.

One other important fact to know about UTI's is that they are NOT CONTAGIOUS! They cannot be caught from other dogs or cats! The bladder is usually a sterile environment but bacteria can ascend or "climb" from the external genitalia (which naturally have bacteria) to create a bladder infection.

If you notice any of the above symptoms in your pet, please have them screened for a urinary condition. We will help with collecting the urine sample-have no fear!

What's in a Wellness Exam?

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Recently, many of the veterinary specialty colleges have started recommending an increased frequency of veterinary checkups for our patients, particularly our senior dogs and cats. At Daniel Island Animal Hospital, we recommend a 6 month wellness check in addition to the more extensive yearly exams where we do heartworm tests, fecal examinations, routine blood work and vaccines as needed. Many people who are used to only doing yearly appointments may be wondering what the value of a 6 month checkup is. To answer that I’d like to go through exactly what it is we are looking for on a physical examination. Although it doesn’t take long, we get a lot of information every time we see your pet, and it helps build a solid medical record so that we can monitor for small changes.

Why every 6 months?

It’s important to remember that our pets age the equivalent of  4-7 years for every calendar year. This means that every 6 month check is about the equivalent of you going to the doctor every 2 – 3 years. This becomes very important for senior pets who may be at risk of developing serious diseases that can show only subtle signs at home. Pets who we may think are just “slowing down” with age may actually have underlying problems that, if undetected, may compromise your pet’s comfort and/or longevity.

What goes into the physical exam?

Every veterinarian has a different approach to physical examination that they are comfortable with, but in general, a thorough physical examination is generally done with the owner and covers the pet from nose to tail.  We like to have the owner present so that you can help to point out things you’ve noticed and we can ask you questions about anything we find (i.e. – have you ever noticed this lump?)

When I start a physical examination, I like to work my way from the front to the back:

  • Eyes – the doorway to the soul? Maybe, but they are also good indicators of discomfort, neurological disease and high blood pressure in addition to any primary problems such as trauma, cataracts, glaucoma, conjunctivitis or tumors of the eye or eyelid. We may use an ophthalmoscope or an indirect light and lens to further examine the structures of the eye for problems. Tests for tear production, corneal ulcers and eye pressure are also common follow-ups when a problem with the eye is observed.
  • Ears – Ears should be fairly clean and pink. If the inside of the ear is red, dirty, swollen, smells funny or if a pet is shaking his/her head frequently, this is where we find out what is going on. We also thoroughly examine the pinna (ear flap), for any injuries or masses. An otoscope is used to examine the deeper ear canals and the tympanum or eardrum.
  • Nose – Noses should be cool, clean and moist. A dry nose doesn’t necessarily mean that a pet is sick, but nasal discharge or abnormal nasal skin can be indicators of allergies, immune mediated disease, infections and some kinds of cancers.
  • Mouth – We check the teeth, gums, tongue, cheeks and back of the throat for dental disease, ulcers, masses or abnormal color. How much information we get depends a lot on how well our patients cooperate, so in some cases we may need to perform a sedated exam to really probe into the areas in the back of the mouth and throat.
  • Lymph nodes – dogs and cats have lymph nodes under the chin, in front of the shoulders, in the armpits (also called axillae), inside of the thighs (the inguinal area) and behind the knees. I usually check all of these at once while doing a good once over of the whole pet by touch to see if I feel any abnormal skin or masses.
  • Heart / lungs – Just like your physician, we listen to the heart and lungs with a stethoscope to detect heart murmurs, arrhythmias and lung crackles or wheezes.  Sometimes in heavily panting dogs or purring cats we may have to close the mouth or adjust the position of the animal to get a good listen. While listening to the heart, I often will feel the femoral pulse, on the inside of the back leg, to make sure the heart beat and the pulse are going at the same time.
  • Abdominal palpation – ideally we like to get a feel of both kidneys, the tip of the liver, the stomach, spleen, intestines and colon, and check for any abnormal masses or areas of discomfort. In overweight or very tense pets we may not be able to be as thorough. A rectal examination is commonly used for intact male dogs to evaluate the prostate, however it may be performed during any physical examination to evaluate the rectum and anal glands for masses. 
  • Musculoskeletal / Nervous system – evaluating the eyes, ears, nose and mouth can tell us a lot about the nervous system, as does watching the pet move around the room.  A full orthopedic examination, including a check of reflexes and range of motion of each joint, is necessary any time lameness appears or if there is concern about possible pain or difficulty moving. We also check closely for pain and normal reflexes in the neck, back and tail.
  • Skin – from head to toe we are evaluating the coat and skin for abnormal color, texture, lumps, bumps, cuts, bruises or smells. This includes between the toes and in the area around the genitals and anus.  

Just like in people, the key to good health is preventative care and early detection of problems. Regular physical examinations help us catch things earlier and give us a better chance of successful treatment! In addition, it gives us a chance to talk with our patient’s owners about anything from behavior training to diet to dental home care and help ensure that we’re doing all we can for your furry companions. It’s what we like to call “good medicine”!