Become a Getting2Zero featured supporter AND...dates with your dog: online shopping

This week SAT was mentioned on the Getting2Zero Take Action page, which is a real honour as this is a fantastic and worthy movement. If you want to read more about the fantastic people who are all working towards Getting2Zero (that is, achieving zero killing of healthy cats and dogs), check out the site or read our interviews with inspirational shelter vet Dr Lila Miller, animal trainer Cecile Ashen Young, compassion fatigue scholar Rebekah Scotney and dynamic coordinator Nell Thompson (who I reckon has the happiest dogs on the planet).

You can read about the scope of the problem of "surplus" animals in this fantastic interview with veterinary student and researcher Diana Chua.

The more people who get behind G2Z, the more successful it will be. You can contact G2Z and let them know how you are taking action. 

It seems I created something of a monster with the post about GIANTmicrobes, prompting several SAT readers to engage in some online shopping sprees and send me their finds. I'm not huge on shopping, especially as I like to spend my free time with certain beings that aren't routinely allowed into shops (though I must say when Phil is in his bag, as pictured above, he seems to be admitted anywhere!). 

Online shopping, however, is something the whole fur family can participate on, whether its by sitting on your keyboard, tearing up reciepts as they inch their way out of the printer, or sitting on your lap. So here are some online gems.

Useful stuff

Does THIS happen every time you try to go away? Why not go-with-the-flow and use your suitcase to create an awesome DIY pet bed.

Check out these awesome veterinary pharmacology apps and resources. 

Vets, veterinary students and nurses might appreciate the utility pouches available online.

If your budget is limited, why not create a do-it-yourself dog bed. I love the use of old beside tables, and the outfitted suitcases are perfect (NB can also be adapted for cats and other snuggling species).

I'm a big fan of gifts that support animals, such as adopting a rescued farm animal or aiding in animal-related appeals. You could also buy one of these awesome Getting2Zero tees, an RSPCA diary or a "People who don't like cats are weirdos" bib for your bub (if you have one - if you don't, Cat Tee Mission stock plenty of awesome tees - and the funds support feline causes!).

Somewhat more frivolous yet nonetheless awesome items

Animal lovers always enjoy a portrait of their pets. Phil and I are big fans of Jenny Parker from Shootyapooch Pet Photography because she a) loves animals; b) packs awesome treats; c) has patience in spades. So we signed up for her Christmas mini session and took Bosca with us. You can check the results here.

For the driver who spends a lot of time on the road, this kitty windscreen wiper enhancement could be the perfect gift.

Surgeons and the anatomically inclined might appreciate a box of hand-made, anatomically accurate chocolates.

The carnivorous nerds in your life might appreciate a synthetic bacon Mobius strip.

(The non-carnivorous might prefer lunch or dinner at Susie Spoon’s Vegetarian Butcher, or some of Ms Spoon’s vegan bacon).

Or you could just make these cat doughnuts at home. They contain pumpkins and almonds so MUST be healthy. For human consumption only.

Just a warning: don't spend TOO much time online shopping, it really isn't a substitute for time with your pet. If you're in any doubt, this comic should clear things up.

Three things I learned: treatment of toxicities in dogs and cats

Chocolate. Delicious to humans and dogs, but potentially fatal to the latter. (Does make me wonder though...maybe this stuff is just killing me slowly?).

In recent months I’ve treated animals for toxicities and potential toxicities (i.e. decontamination) secondary to ingestion or exposure to zinc sunscreen (the dog ate it), lead, a gigantic and formerly delicious dark chocolate-and-raspberry brownie, batteries, permethrin, ivermectin, anticoagulant rodenticides, xylitol, NSAIDs (most recently ibuprofen), contaminated excrement (yep) and human anti-depressants.

When it comes to potential toxins it pays to be paranoid. Better to induce vomiting if you're unsure that the dog or cat ate your pills than wait until (potentially irreversible) clinical signs develop.

Toxicities are common in companion animal practice and are a major threat to pet health. According to Emergency and Critical Care specialist Dr Trudy McAlees, who gave an excellent webinar via the Centre for Veterinary Education, the main determinant of the outcome in small animal toxicities (apart from the dose the animal was exposed to and the interval between exposure and treatment) is the supportive care. And that rings true. I have been working on a toxicology project and the majority of cases require similar treatment – with a little tweaking.

Effexor aka venlafaxine hydrochloride: exttemely tasty yet toxic to pets.

Decontamination may be achieved by inducing emesis/activated charcoal or gastric lavage +/- a cathartic, or dermal decontamination. The benefit of inducing emesis varies with the toxic agent and the clinical signs of the animal, and may be contraindicated (e.g. in a seizuring or obtunded patient).

[As an aside, a pearl of wisdom for new graduates: you will want to monitor your patients CLOSELY when you induce vomiting. If the patient found it tasty the first time, there is a good chance they will attempt to ingest it a second time. Better to catch the expelled material in a vessel like a cat litter tray and whisk it out of reach].

As so many toxins induce seizures (e.g. metaldehyde, chocolate, pyrethroids), seizure control is essential. Dr McAlees uses 0.5mg/kg diazepam or midazolam IV in the first instance, although she also mentioned that the intranasal route is a reliable route for absorption. If administered per rectum the dose should be doubled to account for the first pass effect.

If this does not work she uses phenobarbitone (10-20mg/kg as a loading dose (takes 10-20 minutes to reach peak effect)) then anaesthesia with alfaxalone CD/propofol or thiopentone (the latter two possibly reducing the metabolic requirements of the brain).

Seizuring animals are at great risk of developing hyperthermia which may exacerbate cerebral oedema. If the core body temperature is 40 degrees Celsius or above, heat sock is a risk. Active cooling via tepid water and a fan is most effective. Dr McAlees stops active cooling when the body temperature reaches 39.5 degrees Celsius. Interestingly, she mentioned that ice packs can cause local vasoconstriction and may not lead to core cooling.

Besides a thorough history, Dr McAlees recommends a PCV/TPP, venous blood gas, lactate, electrolytes and APTT as the minimum database for the intoxicated patient – as well as CBC/biochemistry if possible. Animals whose lactate decreases by 50 per cent of more within six hours have a better prognosis. Commercial kits from the pharmacy can be used for drug detection in urine.

Antidotes are few and far between but may include naloxone for opioid toxicity, atipamezole for alpha-2 overdose and flumazenil for diazepam overdose, in addition to tick antiserum and snake anti-venom.

This greyhoud ate so much ivermectin (left on a bench) that she was comatose for almost a week. She has since made a full recovery. 

The main toxins she focused on were metaldehyde, chocolate and pyrethrins. Her treatment of choice for pyrethrin intoxication is methecarbamol, but she also commented that intravenous lipids may be useful in drawing toxins out of the system (it is also useful in the treatment of ivermectin/moxidectin toxicity, baclofen ingestion, Ca+ channel blocker overdose and THC toxicity – but is off-label). She added that cats which ingest pyrethroids from their fur may also experience an allergic reaction to the carriers and may require dexamethasone.

What toxicities do you see in practice? 

What to do when you FIND a dog: TELL SOMEONE

Bosca is home safe and sound thanks to a good samaritan called Caleb...and a dog tag with a phone number on it!

Somewhere out there is a dude called Caleb. I don't know who he is, but he's a hero in the eyes of myself and my family (if you haven't met Bosca, he's Phils "brother from another mother" - just 17x Philograms worth). Here's how it went down.

On Tuesday there was a huge storm. Gale-force winds. Rain pouring so hard on the patio roof you had to yell to be heard by the person next to you. Dark clouds. Thunder. Tumbleweeds. The works. 

Like many dogs, Bosca has a phobia of storms. He was hanging out in the backyard when the storm hit. It just happened that no one else was home. 

He has plenty of shelter and warmth, but whether it was a gust of wind or a clap of thunder, something spooked him so hard he managed to either shrink himself ala Alice in Wonderland and slip under the fence, or pole vault over it, trying to escape whatever it was.

Bosca is an angel of a dog, but not everyone is comfortable approaching 35kg of frightened ridgeback-cross hurtling down the street at 50kph. And when it's pouring rain? When it's pouring rain AND they are in their cosy car and they could just drive past? 

Not Caleb. He pulled up and tried to coax pour soaking wet Mr B into the car. Bosca wasn't having a bar of that...but Caleb reached out, read Bosca's name tag and rang the number. Mum raced home, and there was poor Bosca trying to break in to the backyard. Had she not known he was out, he might have given up and headed off into the sunset (or into the path of a motor vehicle). A thousand million what-ifs which never eventuated.

So THANK YOU CALEB. You taking the time to slow down, read the tag and make the call quite possibly saved Bosca. He's home now recuperating - shaken and stirred, but uninjured.

Bosca resting in his bed after taking himself for a "walk". 

If you do find a lost dog or cat there are plenty of things you can do to help:

1. Look for a name tag or phone number imprinted on the collar and ring that number. If it goes to voicemail, leave a message! Sometimes people don't even know their pet is missing til they come home from work.
2. Take the animal to the nearest veterinarian where it can be scanned for a microchip. Together with good samaritans that bring in animals, our clinic reunites dozens of lost animals with their owners every year thanks to microchips.
3. Call Pet Search and notify them of your find.

You must just save a life.

Interview with Dr Mark Kelman about philanthropy, veterinary science and Pets in the Park

Dr Mark Kelman is one of the nicest guys I've come across in veterinary-land. As a final year veterinary student I worked with his sister-in-law, and met Mark soon after. He's passionate about all things veterinary, whenever I talk to him he's training for yet another fund-raising marathon (the guy can run) and he is an absolute delight to collaborate with) we co-wrote a paper on amitraz intoxication in a young dog). The wonderful Dr K  found time to talk with SAT about what he is up to with his veterinary career and a cause dear to his heart, Pets in the Park. Pets in the Park needs plenty of community support so if you're keen to help out, please read on.

Can you tell us a bit about who you are and what you do? 

I'm Dr Mark Kelman, and I do a few different things - to try and sum me up: I'm a vet, I work in pharmaceuticals, I'm also a property investor, an educator and a philanthropist. I graduated from vet school in 2000 from Murdoch University, and spent 6 years in clinical practice and loved it. Then I decided it was time for a change and moved into veterinary pharmaceuticals with Virbac Animal Health, where I have had several roles, mainly around Technical Services Management. I have been fortunate to have a very interesting position which includes research in veterinary animal health, including disease surveillance. I also attend many conferences, both to speak and listen. I train people on the science around veterinary health, and write scientific papers, journal articles, for magazines and much more. I also work with the commercial teams and other aspects of the business. 

As well as my veterinary role, I have been a property investor for the last 10 years. I run my own company, investing in residential property and also teaching people how to get started in this field. I am a strong believer in sharing knowledge and truth. In the world today, having one profession may not be enough and I am passionate about people being well informed about investing and financial education. I have written a book that is just being released in the next months and also run seminars in Sydney on this topic. More info on this side of my work can be found at www.achieveproperty.com. 

Lastly, I try to be involved as much as I can in philanthropy and charities/volunteering. I think this is an important part of our world as there are many who are not as fortunate and we are all here to help each other. I am lucky that through my various careers and investing I can use my skills and resources to try to find ways to help others. 

What motivated you to become a veterinarian? 

I always wanted to be a vet. I remember being 7 years old and in primary school standing on stage as we all told the assembly what we wanted to be. My twin brother went up first and said he wanted to be a vet. I had exactly the same feeling. We were both lucky enough to get into vet school and graduate into this career. In particular my passion is companion animals - our canine and feline friends, and big cats which I think are pretty amazing. 

You coordinate Disease Watchdog. What does that do? 

Disease WatchDog is Australia's national disease surveillance system for pets (cats and dogs). Sadly, often our companion animals are overlooked when it comes to medicine and research, and there are some very common diseases that a lot of people aren't aware of. Researchers often look at the interesting (one-in-a-million cases) diseases, but we overlook diseases that can affect thousands or even tens of thousands of pets every year (in Australia alone!). Some of these diseases can be fatal and most are almost completely preventable. 

I designed and launched Disease WatchDog in 2010, and we run a web-service database that vet clinics record cases of disease into. We can then track disease cases and outbreaks and use the data to do research trying to find ways to stop disease before it happens. We also use our information to help communicate on disease risks and outbreaks - advising the public and vets about risks. 

You can view information on the system at www.diseasewatchdog.org. There is a smart-phone friendly version that will display on Androids, iOS etc and this is available to the public. Vets have their own log-ins that they use when entering case data. We have published 5 peer-reviewed journal articles from Disease WatchDog so far, and have a number more in the pipeline. 

Why is it so important to understand where these infectious diseases are cropping up? 

It is vital to know where diseases are occurring for several reasons - firstly because this is an indication often that 'herd immunity' is not sufficient in this area (this applies to infectious disease). Where this immunity is not sufficient (e.g. where we are not vaccinating enough) there is an increased risk for unvaccinated pets. If we can raise herd immunity in these regions then we can stop outbreaks and prevent future outbreaks from happening. It's also important to know where infectious diseases are occurring so that we can figure out what we need to do differently so we can try and reduce or even eradicate these diseases in the future. I firmly believe that diseases like Canine Parvo (that likely infects 3,000 - 5,000 dogs in Australia every year of which half of these may die) can be eradicated. 

Have the findings reinforced or challenged your views about the importance of vaccinating pets? 

There is still much research to do. Likely in many areas of science, we more we learn, the more we find out that we need to research further. Our findings to date certainly confirm that vaccination is vitally important and there are more areas than I could have imagined that animals are not adequately vaccinated and where disease outbreaks happen. I get to hear of more disease outbreaks than most people, and I am even shocked that there others occurring that no-one is talking about. The science of vaccination at a population level is a complex one and this is a topic that more research and better recommendations are needed in animal health. 

How did you become involved in Pets in the Park? 

My friend and colleague, Dr Mark Westman told me about the project over a year ago and I was immediately interested. I think he actually approached me to see if Virbac could sponsor the project and provide vaccines, which we proudly do, but I was interested in being involved more personally as well. Dr Westman and a few friends who are also part of the animal health industry (vets and nurses) set up the charity to help provide veterinary support to the homeless and socially disadvantaged around Sydney. I have been volunteering for the Wayside Chapel (a homeless shelter in Kings Cross, Sydney) for a few years and I knew already that there was a great need for this kind of support. Pets In The Park is a registered charity, consisting of dedicated volunteers who give their time to provide veterinary care and preventative medicine as well as provide a social event for people in these areas (PITP meets and provides a free vet clinic once a month). They also provide a free desexing clinic which helps alleviate the pressure of unwanted puppy and kitten births from undesexed pets. 

Why is it important to provide treatment to this cohort of animals?

These animals play a really important role in society - both personally (for their owners) and for society as a whole. It's funny, but the volunteers of Pets In The Park often comment that the pets that they see have a stronger bond with their owners than pets of other people in wider society. The clients of Pets In The Park would not uncommonly go without food themselves to feed their pets. Or they might travel long distances to provide the care that their pets need. On the other side of the equation, these pets provide a priceless gift to their owners - not only companionship (which can be hard to find when you are living on the street) but for people who may be having difficulties finding a reason to live, their pets can be that. Our pets can be our children, our confidantes and our best friends, and to many people, all of the above. Anything we can do to help support and maintain this bond is invaluable. 
Furthermore, these pets are at risk because of a lack of funding for medical and preventative care. People living in lower socioeconomic areas are aware of the risk of disease (our research has proven a link between socioecomonics and Parvovirus outbreaks) and by targeting these pet populations for adequate vaccination, we can aim to not only protect these pets, but lower disease overall, and potentially stop seed cases that could start outbreaks elsewhere around the city or country. Being a preventative program, we may never know the true benefit of the work that we do. 

How can vets, nurses and students help out? 

Anyone interested in helping out should check out the Pets In The Park website at www.petsinthepark.org.au and information on the charity and how to contact them is available there. The charity is looking for volunteers who can regularly attend their clinics and as more clinics are set up there will continue to be a need for volunteers. 

How can pet owners and members of the public help?

Members of the public and pet owners (and vets/nurses) can help out by donating to the charity. It is a fledgling charity and so money is very tight, and any donations are very welcomely received. Pets In The Park has many things that would help provide a better service, and medicines offered are constantly being used up or expiring so there are always ongoing costs. Other goods can also be donated, the need for these varies month-to-month depending on supplies and season (e.g. pet bedding, clothes to keep pets warm, food, flea and worm preventatives etc) 

The charity also has a gala ball coming up really soon - November 14th - and everyone is invited. Information on this is also available on the website. 

For any information or to contact Pets In The Park, go to www.petsinthepark.org.au.

Thanks Dr Kelman for stopping by!

Three things I learned: insulin pens managing diabetes mellitus in dogs and cats

Equipment for measuring blood and urine glucose in veterinary patients.

Diabetes mellitus is one of the most common endocrine diseases in companion animal practice, and management requires commitment on behalf of the owner and veterinarian.

Aside from requiring insulin injections twice a day, diabetic animals must be monitored closely, treated for comorbidities such as urinary tract infection and cataracts, and fed consistently. Veterinarians are often required to troubleshoot poor glycaemic control, which may be due in part because of the way insulin is administered. Better glycaemic control means fewer complications and better quality of life for diabetic patients.

So I was fascinated to learn more about insulin dosing pens via a webinar presented by Dr Linda Fleeman. Dr Fleeman runs Animal Diabetes Australia, a clinical service designed specifically for diabetic dogs and cats, across three veterinary practices in Melbourne.

Insulin dosing pens are commonly used in human patients, but they’re not widely used in veterinary patients within Australia. They deliver a more accurate and precise dose than an insulin syringe, which is really important when we are talking about very small volumes (in some cases 0.5U). With syringes, the dose delivered often exceeds the intended dose – one study found that when people thought they were drawing up 1U, they were drawing up anywhere between 0.6 and 2.8U!

So the first thing I learned was that insulin pens deliver a much more accurate dose.

According to Dr Fleeman, insulin pens are adopted much more readily than syringes and needles. Clients are more familiar with these (they are used for human diabetic patients, people receiving IVF treatments etc). Dr Fleeman also reported that these injections are less painful.

Currently available insulin pens within Australia are all designed for human patients, but a veterinary specific pen (VetPen) will soon be on the market. One pen will deliver increments of 0.5U to a maximum dose of 8U, while the larger pen gives doses of 16U at 1U increments. This is designed for use with U40 insulin.

They last for a while, perating for around 3000 uses (at 2 injections per day or 1500 days it would last around four years). Needles are changed daily.

As glargine is the first insulin choice for diabetic cats, the Lantus Solostar pen can be used. This is a disposable pen containing 3ml of insulin which can be ordered for feline patients.

The second thing I learned is that the most important thing to remember is that pens need to be primed before every single injection. To do this, the client needs to dial up a specified amount (usually 1-2U) then fire off the dose). With a new pen you may need to do it 5-6 times before insulin comes out.

When troubleshooting poor glycaemic control in animals being treated with insulin pens, veterinarians need to remember to ask how and how often the pen is primed.

It is important that the right insulin is used for the right pen to ensure the correct dose is delivered (i.e. pens are designed to fit specific insulin cartridges).

Insulin dosing pens do not need to be kept in the fridge which means they are easy to travel with. They should be kept away from light and below 28 degrees Celcius.

The way Dr Fleeman teaches people to time their insulin dose is to count to four. On one you lift the skin, two insert the needle, three depress the button and on four remove the needle. They may be a drop of insulin on the tip of the needle afterwards – this is normal.

When choosing needles, 12mm needles are best for dogs and cats.

Needle-less insulin delivery systems are available but the cost is prohibitive at this stage.

One other thing that I learned is that new research is emerging that occult UTI in diabetic human patients may be protective against infection with more pathogenic agents. That is, if urinalysis does not reveal inflammation it may not be beneficial to treat these patients with antimicrobials.

Dr Fleeman uses continuous glucose monitoring systems for sick diabetic patients in hospital which picks up trends that the average blood glucose curve cannot – such as nocturnal hypoglycaemia. I suspect we will be seeing more of this in the future.