Sunday, April 25, 2010

What's in the "shots?" (Part 2 - Cats)

In this episode:

Pet joke of the week: Quote from Will Rogers
Personal comment: What's in the "shots?"

Transcript of personal comment from this episode of The WebDVM:

On to tonight's personal comment, let us move on to vaccines in kitties. For those of you watching for the first time and wish to also learn about canine vaccines, please refer to last week's episode. Like in dogs, there are established core vaccines or, vaccines for diseases that represent a universal risk to cats regardless of lifestyle or where they may live; as well as vaccines for diseases where risk is lifestyle or geography specific. Just like in dogs, rabies is a core vaccine in cats. The 3 year rabies is as effective in cats as it is for dogs, but the adjuvant, or substance present in the vaccine that extends the duration of its protective capacity to 3 years, has been linked to the rare development of malignant tumors at the injection site. As such, I favor the yearly adjuvant free one year rabies. The only adjuvant free one year feline rabies vaccine presently is the Purevax, manufactured by veterinary pharmaceutical, Merial.

The other core vaccine in cats is the 3-in one FVRCP, which protects against panleukopenia virus, rhinotracheitis, and calicivirus. This vaccine is effective and safe administered once every 3 years. Some vets give this vaccine as a 4-in one called the FVRCP-C, that adds immunization against chlamydia. I do not agree with this addition of chlamydia protection, since chlamydia typically infects the eyes and upper respiratory system of cats, only as a secondary infection in cats infected with certain viruses. As such, it is only an opportunistic infection in cats, not a primary disease, which also tends to respond very favorably to treatment with antibiotics. In case that is confusing, I like the prefer the 3-in-one FVRCP given as a 3 year core vaccines versus the 4-one FVRCP-C that also adds protection against chlamydia.

Feline leukemia is an imminently deadly retroviral disease for which there exists no effective treatment. There is a very effective vaccine for this disease, but I would not consider it a core vaccine, since only cats that are allowed around other unknown cats or who share the home with a leukemia positive cat, are at risk. This would include outdoor cats either part time or full time, and cats that are prone to escape. Like rabies, adjuvanted feline leukemia vaccines have been linked to rare malignant tumor development at the injection site, so I favor the yearly administered adjuvant free feline leukemia vaccine with the only one presently available currently, like the one year rabies, only made by Merial.

FIV, similar to HIV in people, is a retroviral disease for which there is no cure, causing imminent death by opportunistic infections or cancers resulting from immune suppression. Like in humans HIV, no effective vaccine currently exists, but unfortunately, it has not stopped one particular company from mass producing and marketing a vaccine. Rest assured, this vaccine does not work, and worse, it creates false positive results on blood screening, interfering with our ability to diagnose disease.

FIP is yet another imminently deadly viral disease in cats, for which there is no effective treatment. There is also no effective vaccine for this disease, but this still has not stopped a pharmaceutical from mass producing and marketing one. Like the FIV vaccine, this vaccine also leads to false positive results on blood screening, interfering with our ability to diagnose disease. Worse yet, some feel that there is credible evidence that FIP vaccine actually enhances the magnitude of clinical disease once they are infected with FIP. Folks, stay away from this one, even with a 10 foot pole!

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Dr. Roger Welton is the President and chief veterinarian at Maybeck Animal Hospital in West Melbourne Florida, as well as CEO of the veterinary advice and health management website

Sunday, April 18, 2010

What's in the "shots?"

In this episode:

Special tribute to Layne
Pet joke of the week: Blame it on the dog
Personal comment: What's in the "shots?"

Transcript of personal comment from this episode of The WebDVM:

Onto my personal comment tonight, I am sure many of you watching take your pets regularly to the vet for "shots," only, aside from rabies, many pet owners do not really take the time or even seem to care to ask what shots are being given to their pets, and why. This was always curious to me, since, as a pet owner, and now as a father, I want to know exactly what my children, human or furry are getting injected into their bodies. I am here to tell you tonight that you SHOULD care about what is being injected into your pets since, while vaccines are an invaluable infectious disease prevention tool, they are not to be used lightly, as the mechanism by which they impart protection places stress on the body.

With this in mind, the American Veterinary Medical Association, or AVMA, the governing body of United States licensed veterinarians, early in my career set forth vaccine reforms whereby research into the duration of protective vaccine titers, and the prevalence of disease based on geography and lifestyle, was used to determine a minimally necessary vaccine protocol for each individual patient based on overall risk. The result is an approach to vaccines where we give the minimum number of vaccines necessary to keep patients safe, without overdoing them.

Since we only have limited time here on YouTube, I will focus on dog this week, and discuss feline vaccines next week. We already mentioned rabies, which is considered a core vaccine, or, a vaccine that is common to all dogs, as rabies is present everywhere. Rabies is both safe and effective to be administered as a 3 year vaccine, and is state law in all states that I am aware of given its risk to humans.

The DHPP is a 4 in one vaccine, which protects for distemper virus, viral hepatitis, parainfluenza, and parvo. This is also a core vaccine, which is also effective given once every 3 years as per AVMA recommendations. Some vets give this vaccine as a 5 in one DHPPC, which also adds immunization for cornavirus. But I am not a proponent of this, since coronavirus is not a serious disease, causing only mild to moderate diarrhea, which usually does not even require veterinary care. Others give this as a 6 in one DHLPPC, also adding immunization for leptospirosis. I vehemently oppose the use of this vaccine opting against coronavirus for reasons I just noted, but also for the inclusion of leptospirosis. Leptospirosis is a very serious and deadly disease, but overall risk is very specific to lifestyle first of all, and secondly, even if a dog is deemed to be a leptospirosis risk, it is a yearly vaccine and should not be given as a 3 year vaccine along with the core DHPP.

Regarding leptospirosis, this is a bacterial disease that tends to persist in standing fresh water environments, such as marshes, lakes, ponds, and large puddles. Therefore, only dogs who live in close proximity to fresh standing water, frequent ponds and lakes, are used for hunting, or spend the majority of their time outside, are candidates for this vaccine, making leptospirosis not one of the core canine vaccines. If candidates, dogs should receive a leptospirosis vaccine once yearly. Vaccines against bacterial diseases generally have significantly less duration of activity than viral ones.

Bordatella is disease that causes bacterial upper respiratory infection that leads to a hallmark hacking, gagging type of cough. The human bordatella variant is responsible for whooping cough in people, however, cross species infection is highly unlikely. Risk of disease is also lifestyle dependent, making this vaccine also not a core canine vaccine. Dogs that are at risk for this disease are ones frequently in contact with numerous other dogs, such as boarding kennels, dog shows, bark parks, and groomers. For occasional exposure to other dogs, the vaccine is recommended yearly, but in patients where there is frequent exposure, the vaccine is recommended once every 6 months. The most effective form of the vaccine is the intranasal version, administered up the nose much like a nasal spray.

Lyme Disease is not a core vaccine, but is a serious disease for which dogs are at risk in climates and wildlife that support proliferation of the tick called Ixodes Scapularis, commonly known as the hard deer tick. For example, in Long Island, NY, where I practiced early in my career, the risk of disease was very high due to high persistence of the infective ticks. Diagnosing at least 5 new infections per month, I recommended Lyme vaccine. Here on the Florida Spacecoast, however, the specific types of ticks that transmit Lyme are rare, making disease rare to non-existent, owing to my recommendation against vaccination.

Giardia vaccine I must tell you is a complete farce. Giardia is a protozoal parasite that infects the gut, the consequences of which typically cause nothing more than diarrhea, which easily and effectively resolves with appropriate treatment. The vaccine has never been proven to actually prevent giardia, but those who are proponents of the vaccine, claim that it decreases the impact of the disease if the patient gets infected with the parasite, a ridiculous reason to give the vaccine even if that were true, since disease is typically mild, and resolves quickly with treatment.

So that is canine vaccines in a nut shell. Now next time your take your dog to the vet for "shots," you are now armed with the information you need to know if what is begin given is something that really NEEDS to be given. If in doubt, ask questions, we are there to serve you and your pets, and you should be fully informed about what it is we give your pets and why. If you want to have this information on you as a reference the next time you go to the vet, as always, a transcript of this personal comment will be posted at my blog at, which you may feel free to print a copy of.

Don't forget to join me Mondays 9pm EST for my live toll free call-in radio show at:

Also, catch my for my live video webcast Wednesdays 9pm EST at:

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Dr. Roger Welton is the President and chief veterinarian at Maybeck Animal Hospital in West Melbourne Florida, as well as CEO of the veterinary advice and health management website

Sunday, April 11, 2010

The unsung hero of veterinary medicine

In this episode:

Special guest host and blogger, Melissa Welton, CVT
Personal Comment: The unsung hero of veterinary medicine

Transcript of personal comment from this episode of The WebDVM:

As pet owners, when it comes to our pets' health care, we tend to center our attention on the veterinarian, for it is he who we see examine our furry family members, interpret their clinical signs, offer a list of possible diseases, make diagnostic recommendations and interpretations, formulate a treatment plan, and perform surgery. Indeed we should see veterinarians as the engines that drive our pets' healthcare. However, like the car that cannot function with an engine alone, needing other integral parts to translate that power into a functional automobile, so does the veterinary technician channel the veterinarian's vision into a fully functional hospital. Tonight's personal comment, is a tribute to these individuals that perform an invaluable contribution to your pets' healthcare, but do not always receive the recognition they deserve.

So what does the certified veterinary technician do? Well, let us start with the veterinarian's initial assessment. He has an idea of possible diseases based on history and physical examination, and consequently orders diagnostics to narrow down his list. Whether it is blood work, urinalysis, x-rays, or EKG, to name a few, it is the certified technicians who collect the blood and urine, shoot the x-rays, and hook up and run the EKG. All lab work is properly processed, packaged and sent out by the veterinary technician, or in the case of ours and many other hospitals, the technicians actually load the samples into blood machines for on-site, express processing.

Based on the veterinarian's interpretation of the diagnostics, he will formulate a treatment plan, of which the technicians will administer the vast majority of, whether it be injections, fluids, oral medications, or topical wound treatment. If there is a surgery to be done, the technician performs all necessary pre-anesthesia injections, induces the patient, places a tracheal tube to protect the airway and administer gas, then monitors the patient's vitals throughout the procedure. If an assistant is necessary, it is often a veterinary technician who serves as scrub nurse assisting the veterinarian in surgery. If a patient is hospitalized, the technicians perform most treatments, monitor vitals, feedings, and report all data to the attending veterinarian.

When lab reports are faxed to the hospital, it is usually the technicians that collect the forms, attach them to the appropriate records and place them in the veterinarian's box for review. If refills or other medications are to be dispensed, the technicians fill the prescriptions, write or print out the instruction labels and place them on the bottles.

As you can clearly see, the veterinary technician is the natural extension of the veterinarian, the gears in the machinery so to speak, and a vital component to patient healthcare and a full service veterinary hospital. The veterinary technician is especially important in relatively young hospitals like that of my husband and I, where practice debt has not yet been fully paid and practice growth is still a work in progress: unable to take the financial leap to carry another full time doctor, my husband Roger has only a part time relief vet, necessitating that he carry the caseload of two doctors. What enables him to successfully manage such a heavy caseload? Of course his own early career experience as an ER vet makes him a natural case juggler, but it is his reliance on his experienced and highly competent veterinary technicians, myself included, that go a long way toward lightening his burden.

So the next time you are at the vet, take notice of the technicians and assistants, and know that they work very hard to help your vet deliver the best possible healthcare. Your vet may have sacrificed many years at great expense to learn and study his most noble and highly skilled craft, but your technicians spent 2 years of their own in formal training and passed a national board examination for their certification. They toil along side your vet, in the trenches implementing his vision with no less passion, vigor, and concern for the well being of your pet. Perhaps even a thank you may be in order.

Guest blogger Melissa Welton, CVT

Don't forget to join me Mondays 9pm EST for my live toll free call-in radio show at:

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Dr. Roger Welton is the President and chief veterinarian at Maybeck Animal Hospital in West Melbourne Florida, as well as CEO of the veterinary advice and health management website

Sunday, April 4, 2010

Relief for pets with arthritis

In this episode:

Pet Joke of the Week: Top 10 Dogs Peeves About Humans
Personal Comment: Relief for Pets with Arthritis

Transcript of personal comment from this episode of The Web-DVM:

For my personal comment this evening, I chose perhaps the most common disease of dogs and cats, arthritis. Arthritis, causes chronic pain, adversely affects patient quality of life, and in the advanced stages, can be utterly debilitating. These days, however, your pet does not necessarily need to suffer, with both holistic and medical treatments that go a long way toward keeping arthritic patients comfortable, even turning back the clock on disease.

Let us begin by defining arthritis, since many pet owners do not fully understand what the term completely means. Many think arthritis is a stiff and painful joint, which is more the outcome of arthritis, than the actual term. Arthritis simply put, means inflammation of a joint. It occurs most commonly from age related wear and tear of joints, but can occur in younger patients as the result of genetic joint deformities like hip dysplasia, injury to a joint, or severe obesity.

Whatever the cause, arthritis leads to the breaking down of the cartilaginous surfaces of a joint followed by, in the body's attempt to protect itself, the laying down of bone where soft, articulating cartilage used to be, and a subsequent stiff, less mobile joint. This process is known as degenerative joint disease or DJD.
So what do we do when our pet has arthritis and/or DJD? Well, let us start with what you should NOT do.

- Don't allow your pet to get fat. Obesity will cause early onset arthritis and will accelerate the progression of arthritis.

- Don't try to self medicate your pets with over the counter human grade pain relievers. Aspirin, ibuprofen, naproxen, and Tylenol are highly toxic to dogs, leading to dangerous, even deadly consequences.

- Don't waste your time with commercially sold joint health nutritional supplements. These products are no FDA regulated, with many subsequently regularly found to lack the ingredients they claim to have. Opt instead for veterinary grade nutritional supplements as recommended by your vet.

Step one of arthritis and DJD management is to recognize if you pet is overweight. Obese arthritic patients' quality of life often improves greatly just from weight reduction decreasing stress on the joints. Reducing food or opting for a weight management diet can go a long way in managing arthritis.

For early stage arthritis, I like to engage in a holistic approach to making the the joint less inflamed ,stronger, and more stable. In this regard, I like to combine the oral joint health supplement Dasuquin, with injectable Adequan. These nutraceuticals, as they are called, contain powerful collagen building products, as well as natural anti-inflammatory agents. The net result is the body gets a strong boost in its own ability to restore cartilage and other connective tissues and reduce inflammation.

If there are specific areas of DJD that are markedly affected, as is often the case with the hips or shoulders, combing nutraceuticals with regular treatments with a therapeutic low level laser is invaluable. Therapeutic laser delivers low level photons of energy to an injured joint, opening the blood vessels to more efficiently deliver healing cells, provide energy to cells to absorb nutrients faster for optimal tissue regeneration, and stimulate trigger points to relieve pain and inflammation. The laser is perhaps the most profound technological advancement in the field of arthritis management.

For more advanced cases, holistic approach with nutraceuticals therapy laser are still invaluable, but at least in the early phases of treatment, for pain relief and inflammation reduction, it is s good idea to start the patient on a good veterinary grade anti-inflammatory pain reliever. For dogs, I favor Previcox for its exceptional safety profile for long term use. However, since Previcox is still a drug that must me ultimately processed by the liver and kidneys, I engage aggressively with holistic management to try to wean the patient off it, or at least scale back doses to a minimum.

Cats generally do not do well with anti-inflammatory pain relievers, even veterinary grade ones, making weight and holistic management all the more important for this species. Once disease gets so advanced that holistic management no longer is able to keep the patient comfortable, oral or injectable corticosteroids can be used.
So if you have a stiff, painful pet, don't let him suffer needlessly, as you can see there are many options for management of arthritis and degenerative joint disease. If your pet is fat, begin by making a concerted effort to get weight off, then schedule a consultation with your vet to begin a proactive approach to regaining a good quality of life for your pet.

Don't forget to join me Mondays 9pm EST for my live toll free call-in radio show at:

Also, catch my for my live video webcast Wednesdays 9pm EST at:

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Dr. Roger Welton is the President and chief veterinarian at Maybeck Animal Hospital in West Melbourne Florida, as well as CEO of the veterinary advice and health management website