Tuesday, October 15, 2019

The Right Fit ~ Meredith, Veterinary Nurse

Shortly after my daughter Kenleigh was born, I had to put my lab mix Lyza down, but I still had my two cats. It was very important to me that Kenleigh grow up around animals. I didn't want her to be afraid of them, and I also wanted to be a voice for them.

Fast forward two years, and I decided that I was ready for another dog. We were going to Myrtle Beach for the weekend, and I had been looking at different shelters and animal rescues, since I feel strongly about rescuing vs. buying. I found three dogs that I wanted to meet while we were in Myrtle Beach at the humane society there. One by one, a staff member brought each dog out, and none of them seemed to be quite the right fit for us; I was looking for a more mellow dog for Kenleigh's first experience. She thought for a moment, and then she said, "I have one more I can show you; her name is 'Sparkle'." 


When she brought her out, Sparkle immediately went over to Kenleigh and kissed her hand, and I said, "That's the one!" None of the other dogs we met had acknowledged Kenleigh, and they were very hyper, but Sparkle (now known as Breeze) went right to her as if to say, "That's my new kid." We did all the paperwork to adopt her, got in the car, and she immediately fell asleep. She was home! 


Fast forward three years, and we've been so happy with Breeze! She adjusted well right away, and she and Kenleigh are best buds! 


She cries when Kenleigh leaves, and when I tell Kenleigh it's bedtime, Breeze runs into the bedroom and gets in the bed before Kenleigh. They both will turn five this fall. Rescues seem so grateful in my opinion and make amazing family members!



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Sunday, September 15, 2019

Pre-Adoption Consultations ~ Shana C. Silverstein, DVM, CVA

I recently received a request to chat with a family looking to bring a dog into their home. They own geriatric cats and wanted to make sure that the dog would not be a safety concern for the cats. They had contacted me because they had selected a breed and were strongly considering adopting a puppy. They had a few final questions before putting down a deposit.

When I called them back to find out what questions they had, it came to light that they chose the breed based upon a childhood adoration of the breed (not the specific temperament). They were seeking a puppy because they felt that a puppy raised with cats would be less likely to chase or hurt the cats compared to a newly adopted adult dog. Part of this conclusion was drawn after a relatively disastrous attempt to foster an adult border terrier (who attempted to devour the cats).

Over the course of our conversation (which they allowed me to share with all of you!), we realized that there were some things to reconsider in their Doggie Acquisition Project. First, a small terrier is the last breed that I would choose for two geriatric cats. Despite working with a rescue group that tried to pick a good candidate for their home, it was a bit of a recipe for disaster. Second, their work schedules were really not conducive to raising a boisterous puppy. Also, old cats who had never lived with a dog don’t necessarily love the idea of a curious, playful puppy.

After some further conversation, we talked about the option to adopt from a foster organization that could suggest a dog currently fostered with cats. We also discussed the breeds that I thought would be less successful due to general temperament (terriers!). By the end of our conversation, this family decided that a puppy might have not been a great idea for their particular home. They also know that if they see a dog via a foster group, then they can forward me the link, and I’ll give them my thoughts. In addition, we discussed some good sites to search, reputable organizations, etc.

In contrast to this “almost bought a puppy” experience, we often meet pets soon after being purchased or adopted. Some owners come to the appointment with a contract that they don’t completely understand, recommendations/requirements made by the breeder, and sometimes unclear vaccine records. Sometimes there are questions that I would have loved to see asked prior to purchasing the dog (questions about screening the parents for particular health conditions), or temperament tests to consider performing in choosing a pup from a litter. Once you’ve purchased the dog, I’ll do all that I can to keep that puppy healthy; however, I would love for you to start with a healthy, balanced dog versus one set up for health issues lifelong!

What is the moral of this very long story, Doc?  I want all of you to know that prior to pet acquisition, please remember that we are a valuable resource for you. Consider scheduling a pre-adoption/purchase consult  or phone consult if you are “shopping,” and let us help you become an informed consumer! If you are considering a species that you haven’t owned previously, then you might want to touch base with one of us to understand the requirements of that pet. For instance, puppies need to go out mid-day. Exotic pets can have very specific housing and nutrition needs. Tell us the make-up of your home so that we can take that into account (young children, other pets in the home, allergies, etc). For instance, did you know that the likelihood of inter-cat aggression (or stress) is significantly higher between two female cats and highest between female litter-mates? So if you already have a female cat, you might want to seek a male for number two.

Education is something that we truly enjoy at Shiloh. We love empowering you to become the best pet owners that you can be, and that starts by picking the best match for your home. Please don’t hesitate to reach out to us if we can be of any assistance!

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Friday, August 16, 2019

Reflections on the Year ~ Talitha, Veterinary Nurse


I am always in awe of and enjoy reflecting on the seasonality of life—how jobs, friendships, pets, and even homes come and go in seasons. One year ago this month, I moved to the Triangle area from a small town in Colorado in the heart of the Rocky Mountains. My first job out of undergrad was at a local veterinary office and pet boarding facility. It was during this time that I adopted my rescue pup, a 2.5-year-old 60-pound female boxer/pit bull mix named Baby-Nugget-Nova-Jugs (she usually just goes by Nova). Shortly after Nova and I found each other, we made the move to North Carolina.

Making the transition from kennel staff to technical staff as a Veterinary Nurse was a huge learning curve. And on top of learning a new position, I was also acclimating to summer in the south and an entirely new life and community after my big move. Looking back on how much I’ve learned and grown over the past 13 months has given me a lot of hope, as well as major feelings of accomplishment. And I know I couldn't have done it without my faithful four-legged best friend.
The biggest thing I learned this past year is how to be a better pet parent. Nova is my first dog as an adult. I grew up with family pets my whole life, but I have never raised one on my own, and as many of you know, adding a young, large, energetic dog into your life can be quite a game changer. Working at Shiloh has taught me everything from choosing the safest toys that she will enjoy, to working on adult dog socialization, to managing Nova’s seasonal allergies.

Working in the veterinary industry has been the best crash course in being a responsible pet owner that I could have ever hoped for. Adopting an adult dog and a ‘bully breed’ has come with its own set of challenges. Nova is muscular and has a (wonderfully) big block-shaped head. Sometimes kids are scared of her. I missed a lot of critical training and socialization time with her as well, and we have spent our time together catching up on a lot of canine manners that she didn’t learn before we met. 

All that said, I can’t imagine raising Nova without the support of my knowledgeable and kind coworkers at Shiloh. And this move would have been impossible without having her as my loving companion. So, it’s all worked out quite beautifully. The folks here have equipped me to be the best pet parent I can be, and for that, I am forever grateful.


With Love,
Talitha and Nova



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Sunday, July 14, 2019

Cola’s Casa: Surrounded by Puppy Love ~ Tara, Veterinary Nurse

A lot of people already know that pet sitting is a big part of my life. I came across this hobby of mine about two years ago. I was looking to make a little extra spending money but was not in the position to get a second job on top of working full time as a veterinary nurse. I tried everything from having yard sales that would bring in money but not be long lasting, to thinking of things I could make and sell (which did not work because I am not crafty in the slightest). 

One day, out of the blue, my sister sent me a link to an app made for pet sitters and helping them find clients. Once I investigated the logistics of the app, I was very interested in pursuing this option. Two years later, I have a strong list of clients, some of whom I have gotten to know and have become great friends with. 

I have welcomed a number of dogs (and even a couple of cats) into my home to stay with me while their owners go out of town, and I have also stayed at some client’s homes when I can as well. I named my little business “Cola’s Casa” after my dog, Cola, who is as much a host to these new visitors as I am. Along with learning each pet’s schedules and habits, Cola and I have learned much more from having this business.

I have learned how to manage my time better because of the pets that must go out or have medications at different times of the day. I have learned the proper way to introduce two dogs together in a different home environment. I’ve learned that no matter how a dog acts in its home environment, it will most likely act completely different in other environments, whether it is more nervous, excited, or even a little aggressive. It has also taught me about Cola and his little quirks with other dogs. 

I have said a number of times that I don’t know what I would do without pet sitting. This is true financially, but also true because it keeps me on my toes; I have met so many great pets and their people. I cannot imagine coming home and not having a house full of sweet pups (and the occasional kitty friend). 





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Saturday, June 15, 2019

Summer: Is Your Dog Overheating? ~Julie, Practice Manager


The hot days of Summer will soon be approaching, and we need to be aware of the signs and symptoms of overheating in our pets. By understanding how our dogs keep cool, we can ensure that they do not overheat, and we can enjoy those dog days of Summer to the fullest. 

When dogs get hot, they do not sweat the way that we do. Sweating to us is a cooling mechanism; however, dogs cool themselves by panting and breathing. When dogs pant, the air passing over the saliva in their mouths helps them cool down. The lining of the dog's lungs also serves as an evaporative surface, kind of like our skin when we sweat. Blood vessels in their face, ears, and feet can expand, also helping to dispel heat from the body. The normal temperature in a dog is between 100.2 and 102.8 Fahrenheit. When a dog's cooling mechanism is overwhelmed, the body may not be able to cool itself adequately, thereby causing overheating. 

Signs & Symptoms: What to Do?

Your pet may be overheating if there is excessive panting and breathing, collapsing or convulsing, bright red or blue gums, vomiting, or diarrhea.

1.)   Immediately bring your pet in out of the heat.

2.)   Alert your veterinarian.

3.)   Run a COOL shower on your pet, especially to the back of the head and neck.

4.)   If getting your pet in the shower or inside is not practical, use a garden hose to cool the dog or place them in a pool of cool water. 

5.)   Use a small bag of frozen vegetables applied to the head to help lower the body temperature.

6.)   Massage the legs (this helps with circulation and reduces the risk of shock).

7.)   Offer cool water and add a pinch of salt to the water bowl, as this will help replace the minerals lost through excessive panting.


When It’s Just Too Hot!

                     Air Temp 770             Asphalt Temp 1250
                     Air Temp 860             Asphalt Temp 1350
                     Air Temp 870             Asphalt Temp 1430


How do you know when it’s too hot to take your pet for a walk? The 5-10 second hand rule can be used. If you cannot hold your hand or foot on a walking surface for a complete 5-10 seconds, then it is too hot for your pet. Something to keep in mind when venturing out with your pet during the hotter part of the day is that ground temperature is hotter than air temperature. Being a better radiator than air, the ground is able to cool more quickly. Shortly after sunset, the earth’s surface is slightly cooler than the air directly above. 

Which surfaces are the hottest? Some synthetic materials, asphalt, brick, concrete, and sand are five of the hottest surfaces that retain more heat than others. Sand is often forgotten because we associate sand with beaches. If you have ever walked on the beach barefoot on a hot, cloudless day, you know how scorching the beach sand can be. 

Walking your pets on these surfaces when the temperatures are extreme can also lead to pad burns. If the pads are extremely burned, blisters can occur. Signs of a burned pad also include licking, chewing, a red or pink hue on the pad, or even limping and not wanting to move. Cool down the feet with cold water or apply a cold pack or compress, and take your pet to the veterinarian if the pads are burned. Treatment may include antibiotics to combat possible infection, and the pads may need bandaging until they heal. 

Armed with the knowledge of how to recognize overheating and how to respond to it (or avoid it in the first place), you can have a safe and fun-filled Summer with your four-legged friend.   

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Sunday, May 12, 2019

Looking for Treats? ~ Amber, Receptionist

A huge question that we get from new dog owners is regarding what chews and treats are safe to give. Whether you are using treats to train your puppy or using them to keep them occupied for a while, (puppy teething is always so fun) you want to make sure that you are giving them something healthy.

Many treats are high in calories and are not supplying your new puppy with any added nutrients. When we got our puppy last winter, I was constantly trying new treats and chews to keep him occupied and happy through his teething. I was always driving to different pet stores in search of healthy treats that were also good for him.

Since he is a larger breed, he destroyed many toys in minutes, and there was always that worry of him eating something he shouldn’t. After doing a lot of digging around on the internet for what other people were buying, I stumbled across a brand called Real Dog box. 

They are a small company based out of San Diego that makes air dried treats and chews for dogs. They locally source all of their treats, so you are always getting the freshest meats for your dog. The best part is that they will mail the treats and chews right to your home! You can sign up for four different size packages that will arrive every four weeks. 

One of the boxes is designed for those in search of treats to help with training and promoting good behavior, as well keeping your dog busy and giving you some free time. For my dog, who is now a fifty-pound lab mix, I get the treat and chew box. 





With this box, you get three bags of chews and three bags of fresh treats. This box includes six to seven pounds of fresh meat and seafood that is air dried. This means you are getting 100% single ingredient treats. 


This is super awesome for dogs that have allergies, which usually makes finding treats more difficult. If you do have a dog that has a chicken or fish allergy, you can customize your box’s plan to reflect your dog’s dietary restrictions. Along with the treats, they include cards that explain what each treat is made out of and all of the benefits that it entails.



A big reason why I love this company so much and recommend it to a lot of our clients is their customer service. With many subscription boxes on the market, it is hard to find one that truly customizes for you. If I ever need to add extra treats or get a box shipped sooner, they are always willing to accommodate.  You can even text their help desk and talk to one of their employees right away. If you ever receive a treat that you are not 100% happy with, they are always willing to ship you a new treat in your next box at no cost.

An added bonus with this company is how much information they put out to the public. If you look them up on Instagram, their page is loaded with awesome options and ideas to try with your dog. They have built such an awesome community of people who have their dog on raw food, a mix of kibble and raw, or people who just like to create awesome homemade treats. As someone who feeds her dog dry kibble usually (working full time makes it hard to make fresh food), I find their blogs and videos super helpful on how to add great supplementary nutrition to my dog’s diet.

One of the most amazing things that their Instagram showcases is how great their chews are for removing plaque from your dog’s teeth. Many owners let their dogs have bones and antlers for a daily chew. These can cause a lot of wear and damage on your dog’s teeth, and they can also splinter and be swallowed, resulting in dangerous intestinal blockages. Our office sees numerous amounts of broken and chipped teeth that are caused by these hard chews. The chews that you get from Real Dog are soft enough to not hurt your dog’s teeth, but they will last long enough to keep them busy and help maintain dental health in the process.

If you are someone who is a first-time dog owner, or if you are someone just looking to add healthy beneficial treats in your dog’s diet, I highly recommend Real Dog Box. If you decide you want to try out their treats, they will give you half off your first box, and they will even throw in a free bag of treats if you use me as a referral. Just message them at help@real.dog and let them know that Amber Gaudreau sent you! 😊


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Wednesday, April 17, 2019

Canine Atopic Dermatitis ~ David Kleisch, DVM, MBA

Spring time. Warmer weather, longer days, and gorgeous blooms. Living in North Carolina, we typically group all of these wonderful things with the all too common “allergies”. Everyone knows someone who exhibits allergies, and they are driven by a little substance called the allergen.

Allergens are typical harmless substances that are capable of triggering a response of the immune system, and that response can result in an allergic reaction. For you and me, that can be manifested as itching, sneezing, watering of the eyes, stuffy nose, and then the coughing/sneezing. For our canine companions, allergies are typically manifested as skin irritation and dermatitis, triggering an over-active immune system and called “Canine Atopic Dermatitis”.
Atopic dermatitis in dogs (AKA allergic dermatitis or canine atopy) is a hypersensitivity or over-reaction to any variety of commonplace and otherwise harmless substances in the environment. These allergens can range from environmental plant pollens, to house hold dust mites, storage mites, or mold spores. Most allergic dogs begin to show signs between one and three years of age, but the age is not specific to the patients.
Presenting Clinical Signs

Atopic dogs will scratch, chew, lick, or rub areas of the body such as their paws, face, and rear end. They can have recurrent skin or ear inflammation and typically have secondary skin infections. This itchy behavior, or pruritus, can cause hair loss and reddening and thickening of the skin. The cardinal location of skin thickening and redness in canines is around the eyes, under the arms, between the legs and around the tail base. Dr. Olivery at North Carolina State University, Department of Dermatology describes these areas as the target zones, meaning while they are the hallmark areas they are not the only areas. If you notice your dog itching/scratching in general, it is recommended to have them evaluated for the underlining cause, and potentially for atopic dermatitis.

Image result for atopic dermatitis canine
Dr. Olivery at NCSU Dermatology shows classical presentation for canine atopic dermatitis. a Diagram showing the distribution of skin lesions (red) in dogs with classical phenotypes. b-e Skin lesions in a crossbred dog with AD of classical phenotype. From a distance, lesions can hardly be seen (b), but erythema, hyperpigmentation and self-induced alopecia are visible on the axillae, groin (c), periocular and perilabial areas (d), and flexures of the elbows (e; right [R] and left [L]). (2) 1

Diagnosis

Unlike other diseases where tests can be performed, atopic dermatitis is a clinical diagnosis. Doctors typically form diagnoses based on history, clinical symptoms present, and the seasonality of the symptoms. Many clients ask if we can complete allergy testing. Yes, we can complete an allergy test, but this is not a test for atopic dermatitis. This test is for identification of the allergen that is causing the increase and over-activity of the immune system. This is beneficial because we can remove this allergen, however, this does not treat the disease.

Treatment
If a dog is diagnosed with atopic dermatitis, there are broad treatment options and targeted therapy options. Additionally, specific treatment for any secondary infection is a cornerstone of the treatment plan.  
  • Avoiding allergens: This is the HARDEST to do, and it is usually impossible to remove all allergens from a pet's environment, because even a small amount can trigger a dog’s allergies. However, bathing can help remove allergens from the skin. A hypoallergenic cream rinse or spray can re-moisturize the skin after bathing.
  • Medications: A variety of anti-allergy drugs are available. These drugs include antihistamines, steroids (cortisone), cyclosporine, and newer drugs such as oclacitinib (Apoquel). However, these medications all have side effects, and they have come out with biologics that treat canine symptoms without any side effects. These medications are “immunotherapy” medications, and Cytopoint is the best Immunotherapy known.  
  • Allergen specific immunotherapy: Immunotherapy involves giving a series of diluted allergens based on what your dog is allergic to. Allergen-specific immunotherapy makes dogs less sensitive to their allergens, and 60-80% of patients improve on immunotherapy. However, improvement on immunotherapy takes time, and it is important to try the immunotherapy for several months so it can take effect. When helpful, immunotherapy is usually continued life-long but can be given less frequently over time.

Treating any Secondary Infections

Atopic dermatitis will likely have an associated opportunistic secondary infection. Secondary infections involve bacteria (usually Staphylococcal) and/or yeast (Malassezia) at the site of the itchiest areas on the body. These organisms live naturally in the skin, but when the skin is irritated, they gain access to inner tissue layers and proliferate. Sometimes they actually come to generate further allergic response in the skin. These infections tend to recur and are the usual cause of recurrence of itch symptoms in a patient who was previously controlled.
  • Broad Spectrum Therapy: When atopic dermatitis is first diagnosed, the goals of therapy are balancing the treatment of the infection, restoring the comfort of the animal, and decreasing the inflammation (if present). For major flare-ups, using a corticosteroid as a broad spectrum therapy is rrecommended. Corticosteroids (prednisone, prednisolone, triamcinolone, dexamethasone, etc.) are very useful as the first line of defense against itchy skin. While we use these for initial flare-ups, the broad spectrum therapy includes undesirable side effects when used long term. So, while we use these for acute flare-ups, these medications are not great management drugs for atopic dermatitis. Therefore, we consider this broad spectrum therapy of steroids useful for acute flare-ups, then once controlled, we move to focal and targeted therapy. 
  • Targeted Therapy: Targeted therapy ranges from immunotherapy (Allergy injections) to pharmaceutical therapy, including medications like Cyclosporine or Apoquel, or biologics similar to Cytopoint. These are decided on a combination of clinical signs and trial and error, along with the ease of medication administration for the owner and patient. As mentioned above, the best way to manage atopic dermatitis is to remove the allergen. Unfortunately, this is impossible. So, we can attempt to desensitize the patient to the allergens with allergen immunotherapy. 
  • Desensitization (Allergen Specific Immunotherapy): Allergy Shots are a great treatment of choice for atopic dermatitis. All the other medications are basically just itch relief; only desensitization actually changes the immune system. Most dogs experience some improvement but not all dogs experience great improvement. Allergy shots require approximately 8 to 12 months to begin working. 
       ~ An estimated 33% (1/3) of atopic dogs will not respond 
       (these are usually the animals allergic to multiple allergens).

       ~ 25% will require prednisone or similar steroid at least at 
       some times.

       ~ You will most likely have to give the allergy shots yourself.

       ~ Referral to a veterinary dermatologist might be necessary.


Oclacitinib (Apoquel)
Image result for apoquel
This is a new medication best used for itch relief and blocking itch symptoms. It is popular, as it works fast. It does not address the inflammation in the skin; it just stops the itch sensation. This means that infection still needs to be controlled. 

Canine Atopic Dermatitis Immunotherapeutic (Cytopoint®) Injections 
Image result for cytopoint
This is a new treatment that uses vaccine technology to eliminate one of the main mediators of itch sensation. The injections provide relief from itching for 1 month in 80 percent of dogs and show effectiveness usually within 24 hours of the injection. For many dogs, relief of itch stops the vicious cycle of itch/infection. Again, any infections still need treatment, but the sensation of itch is usually controlled. For more details, visit cytopoint4dogs.com.

Atopic dermatitis is commonly seen in canines in the allergy season, and it is important to get your canine evaluated if the hallmark clinical signs are seen and to keep them controlled year round with one of these therapies.
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