February is Dental Health Month
“According to the American Veterinary Dental Society, up to 80% of dogs and 70% of cats over the age of 3 years have some form of tooth and gum disease.”
Dental and gum disease can cause bleeding and swollen gums, tooth decay, bad breath, pain, and difficulty eating. If dental disease progresses, it can lead to serious health problems such as liver, heart, or kidney disease. Below are pictures of a dog’s mouth before and after a professional dental cleaning.
We are celebrating National Pet Dental Health Month by offering all of our clients a $20 discount on their pet’s dental cleanings in February!
We are equipped with state-of-the-art dental equipment including digital dental x-rays, Digicare multi-parameter patient monitors, safe patient warmers (Bair Hugger and HotDog), and enamel bonding. Dental x-rays allow us to evaluate the large portion of the tooth that resides below the gumline. They are an invaluable tool for our Doctors to evaluate the health of the entire tooth. Our trained technicians, patient monitors, and patient warmers ensure the safest possible anesthesia for your pet during his/her dental. We now offer enamel bonding which can help seal and preserve minor damage and chips in the teeth.
Please call us today 406-255-0500 to get your pet on our February schedule!
Toshiba Aquilion CT Scanner
For some time, we have wanted to add a cost-effective advanced imaging unit to our clinic to benefit the pets, clients, and Veterinarians in the Billings area. We are pleased to announce that we have added a new Toshiba Aquilion 16 slice helical computed tomography (CT) unit to our facility, as part of our recent expansion. Our 16 slice Aquilion scanner is the same one used at several veterinary teaching hospitals (Cornell University and Virginia Tech) and several veterinary referral centers.
The Aquilion CT machine significantly improves our imaging and diagnostic capability. Patients are placed on a table which advances into the gantry, which is a rotating tube that generates x-rays as it spins 360 degrees. A detector captures the beam and generates highly detailed cross-sectional images. The gantry can take 16 anatomical pictures at one time which allows visualization of entire regions of the body in a matter of seconds. Because the unit works so quickly, we can briefly sedate animals and generate high-quality diagnostic images of the body. The cross sectional images can easily be transformed into informative 3D images.
The digital CT images are sent to an off-site radiologist for review. We currently submit the CT images to Dr. Kenneth Waller, DVM MS DACVR, a board certified veterinary radiologist at University of Wisconsin School of Veterinary Medicine. Because the scans are so brief and all the images are digital, we usually have a comprehensive radiology report the same day the scan is generated.
Many patients that undergo a CT examination also receive intravenous (IV) contrast agents which highlight blood vessels and blood supply to normal tissues and tumors. We can use the CT to image almost any region of the body. Most frequently, our CT studies are made of heads, spines, elbows, as well as a wide variety of cancers and metastasis (spread of cancer).
We are the only veterinary facility in Billings which has an in-house CT machine. We perform CT scans for our regular patients as well as referral patients from Montana, North Dakota, and Wyoming. Please contact us with any questions: 406-255-0500
USDA APHIS Travel Website
USDA APHIS has launched a wonderful new website for pet parents who travel with their furkids.
The website is very user friendly and covers both international and domestic travel.
Travel requirements vary greatly depending on the destination country (or state: Hawaii). Sometimes months of preparation is required to ensure smooth travel into a new country.
Although we are always here for counsel and help with travel and health certificates, we hope this helps you prepare ahead of time.
Happy travels to all!
2016 Expansion & Remodel
In February 2016, we broke ground on the first expansion/remodel project at Best Friends Animal Hospital. For some time now, we have been running short on cage space, boarding runs, treatment space, and exam rooms. Simply put, we are outgrowing our current 5,000 square foot facility.
The expansion will add an additional 7,000 square feet of finished space. The expansion includes:
- 5 additional examination rooms
- double the amount of treatment space
- increase number of hospitalized dog and cat areas; add large hospitalized dog runs
- dedicated orthopedic surgery room
- large indoor daycare room
- physical therapy room
- increased numbers of small and large dog boarding
- sun-lit luxury cat boarding area
- dedicated dental suite
The current facility will also have several areas which will be remodeled and improved.
We ask for your patience as we all deal with the mess and noise of construction. We promise to do our best to minimize the impact on your visit.
We’d like to thank our wonderful clients who trust us with their animal family members! We want to provide you with the best care, and this involves continual improvement and change. Without your support and referrals, we wouldn’t have the opportunity to do this!
Benny – Pet in the Spotlight
Benny is a 3 year old terrier mix who was rescued by his parents from a shelter. He was a healthy boy and, before January, all of his visits to our clinic had been for regular preventive care.
In early January, Benny was with his mom in a car when they were hit by another vehicle. Benny’s mom had serious injuries and went straight to the human hospital. Benny was brought directly to our clinic.
On presentation, Benny was painful but stable. Radiographs (x-rays) revealed no major injuries. He did have one area in his spine that looked slightly abnormal; however he had no neurologic signs. He was treated for pain and went home that evening with his dad.
The next day, Benny seemed more comfortable but did not want to eat. He also began having problems moving around. His dad brought him back to the clinic and a physical examination revealed severe neurologic deficits in his hind end. Repeat X-rays didn’t show any significant changes but, because of his neurologic signs, we were very worried about injury to his spinal cord. Poor Benny’s mom was still in the hospital in significant pain and was terribly worried about Benny. Fortunately, Benny’s family was prepared to do everything possible to save him.
That evening, Benny had an MRI which revealed a significant spinal cord injury. He had a fractured vertebrae in his back and a disk that was protruding into his spinal canal. Benny needed emergency surgery for the best chance at regaining normal function.
Benny needed the best, and he got the best. Dr. Smith collaborated with Dr. Brown and together they performed back surgery to remove the disk material and to apply an internal fixator to the fracture site. Benny did well with surgery and started the long road to recovery.
Benny’s rehabilitation and recovery after surgery were truly remarkable. Every single day we could see improvement. Within days he could bear weight on his hind legs, and within two weeks he was walking. Here is a video of Benny taking his first few steps after surgery.
As soon as his mom was released from the hospital, she came to visit Benny almost daily. Benny went home with his parents approximately 3 weeks after the original injury.
We had the joy of seeing Benny recently for a follow-up exam and he is doing fantastically! His mom is also doing well, and the two continue to support each other through their healing.
From day one, Benny was nothing but a kind, happy dog. Even with a severe, painful spinal cord injury he never once offered to bite. Spending time with Benny only leaves one word to describe him: “HAPPY.”
We all love you Benny and we are thrilled you are comfortable and home with your family!
JPS – Juvenile Pubic Symphysiodesis
With the development of PennHIP radiographs or xrays, it is now possible to evaluate a puppy’s risk of developing arthritis from hip dysplasia as early as 4 months! This helps breeders choose dogs for their breeding stock much earlier than before. Additionally, it helps us identify dogs with hip dysplasia during their growing phase, where early intervention can reduce the development of arthritis.
Juvenile Pubic Symphysiodesis (JPS) is a minimally invasive procedure which changes the dog’s hip joint conformation. It is generally performed in puppies age 4-5 months (the earlier the better) if indicated by PennHIP radiographs. At this point in their development, puppies are still growing and changing. The goal of the procedure is to cause premature closure of the cranial pubic symphysis (pubic growth plate). The cranial pubic symphysis causes most of the longitudinal growth in the pelvis. If we “fuse” this growth plate, it stops growing. The rest of the pelvis, however, continues to grow. What results is the outward rotation of the acetabuli (the “sockets” of the hip joint), which improves the coverage of the femoral heads (the “balls” of the hip joint).
Patients undergoing JPS are placed under general anesthesia for the procedure. An incision is made between the hind legs to access the growth plate. Electrocautery is used to destroy the growing cells in the cranial pubic symphysis. Depending on what time the surgery is performed, the patient will either go home the same day or the day after the procedure.
After the procedure, it takes approximately 10-14 days for the incision to heal. Puppies should be leash-walked, no running or jumping after the procedure for 4-8 weeks.
Research has shown that this procedure is very successful at reducing laxity in the hip joint and arthritis if the patient is selected appropriately (based on age and PennHIP xrays).
The JPS procedure itself is relatively simple and associated with minimal postoperative complications.
Puppies should have PennHIP xrays at 4 months of age in order to select candidates for JPS. Dogs benefit is the greatest when the JPS procedure is done as early as possible.
Hip Dysplasia – PennHIP and OFA Radiographs
Hip dysplasia is the abnormal growth or development of the hip joint. We see this condition somewhat commonly in dogs, and it can be frustrating to treat. Once a dog develops arthritis from hip dysplasia, medical treatment can help, but is expensive and lifelong. Hip replacement surgery can be very helpful, but is only done at surgical referral centers and can be cost prohibitive.
Normal hip joints (above). Dysplastic hip joints (above).
Because there is a genetic component to hip dysplasia, we often check the hips on breeding dogs to help determine which dogs are good candidates for breeding programs. We also check the hips on young non-breeding dogs. If we identify hip dysplasia in young dogs (< 5 months old) it’s possible to surgically intervene and change the conformation of the developing hip joint, greatly reducing the chance of developing significant arthritis. The two main ways to check the hips are PennHIP testing and OFA (Orthopedic Foundation for Animals) testing. Below I will describe each type of test and the pros/cons of each test.
OFA Hip Radiographs
OFA radiographs (x-rays) have been used for many years to help diagnose dogs with abnormal or dysplastic hips. For this procedure, one radiograph is taken of the dog’s hips in a standard extended hip position. Sometimes dogs are sedated for the procedure, but it is not required. The radiographs are subjectively reviewed by a veterinary radiologist and given one of seven “grades.” The grades are Normal (Excellent, Good, Fair), Borderline, and Dysplastic (Mild, Moderate, Severe). Click here for a more detailed explanation of the grades from OFA’s website.
- No sedation is required.
- Because no sedation is required and only one radiograph is taken, cost is lower.
- Any veterinarian can perform OFA radiographs – certification is not required.
- Dogs have to be at least 24 months old. Cannot be performed on dogs under 24 months of age.
- OFA recommends NOT performing this test in animals in estrus (heat).
- OFA certification is no guarantee that a dog will not develop hip dysplasia symptoms in the future, and does not guarantee that the offspring will not develop hip dysplasia.
More recently, Dr. Gail Smith (University of Pennsylvania Hip Improvement Plan) developed a different method of evaluating a dog’s hips. Instead of simply looking at the static bony anatomy of a dog’s joint (OFA xrays), he developed a method to evaluate the bony anatomy and soft tissue structures to give us a better indicator of the actual joint stability. In the hip joint, the soft tissue structures include the joint capsule and the ligament of the femoral head. Both are major factors in stabilizing the hip joint and maintaining proper anatomical weight bearing along the acetabulum (cup) and the femoral head (ball). If there is increased laxity (looseness) in the soft tissues of the hip joint, then there will be poor conformation during weight bearing and subsequent joint trauma and osteoarthritis development. Because PennHIP testing evaluates both bony and soft tissues, it is a more comprehensive picture of joint stability and a better predictor of which dogs will develop arthritis.
For PennHIP testing, the veterinarian must be specially trained and certified, and specific equipment must be used. It is required that the dog is heavily sedated for the procedure and a series of radiographs (compression view, distraction view, and hip extended view) is taken. The radiographs are sent to a veterinary radiologist who objectively measures the distraction index. Ideally a tighter fitting joint has less distraction and will be less likely to develop disease.
PennHIP Compression View PennHIP Distraction View
Hip Extended View
- The PennHIP method of evaluation is more accurate than the current standard in its ability to predict the onset of osteoarthritis (OA).
- The procedure is more objective (comparing numbers) than OFA radiographs.
- PennHIP radiographs can be done as early as 16 weeks of age. This means dogs with dysplastic hips are identified much earlier in their development, when interventional procedures (JPS, triple osteotomy) can be performed. Breeders can also make informed decisions about their breeding stock much earlier.
- Only certified veterinarians can perform PennHIP radiographs. Find one here.
- Sedation is required.
- Because veterinarians must be trained and certified, sedation is used, and several views taken, the expense is approximately 35% more than OFA testing.
At Best Friends Animal Hospital, we offer both PennHIP and OFA radiographs/testing. Studies show that PennHIP testing provides more accurate information about which dogs will develop arthritis from dysplasia. Because of the significant Pros of the PennHIP method, we do far more PennHIP tests than OFA. Please call us if you have questions about either procedure or would like to schedule testing on your dog – 406-255-0500
Canine Influenza in Montana!
Our clinic has been flooded with calls today! For the first time, Canine Influenza has been diagnosed in Montana. (January 12 Helena article here).
We hope our information below helps pet owners better understand the virus and aids in prevention!
Canine Influenza was first diagnosed in dogs in the USA in 2004 – during an outbreak in Florida. This strain or type of canine influenza was H3N8. Since then, it has caused small pockets of infection around the country, but not in Montana.
In 2015, there was a large outbreak of canine influenza in the midwest/Chicago area. This outbreak was a different strain of canine influenza – it was H3N2. It made the news because it was highly contagious and approximately 5 of the 1000 infected dogs actually died from the infection.
Fast forward to January 2016. Two days ago in Helena, Montana, a dog was diagnosed with canine influenza strain H3N2. This is the same strain that caused disease in the midwest in 2015
Is there a Vaccine?
Currently, there is a commercially available canine influenza vaccine but it is only effective against the H3N8 strain.
Zoetis (Pfizer) is working on a vaccine for the H3N2 strain, but it hasn’t completed all of the required testing. This vaccine is “Conditionally Licensed” for use in dogs. Simply stated, the preliminary safety and efficacy (effectiveness) studies in dogs (approx. 600 dogs) found no evidence of harm other than the usual vaccine-associated adverse effects. The preliminary tests showed that the vaccine reduced virus shedding in vaccinated dogs compared to placebo controls after challenge with the H3N2 strain. Long term safety and efficacy studies are underway but, because these tests take time, they have not been completed yet.
* Vaccine shipment is delayed – we should have the conditionally licensed H3N2 vaccine available at our clinic by 1/20/16.
Should I vaccinate my dog?
The choice of whether or not to vaccinate should be based on the pros/cons of the vaccine and the risk of exposure. H3N2 canine influenza is highly contagious but doesn’t survive very well in the environment. Because of this, any place where dogs congregate in large numbers (boarding kennels, shows, traveling, going to dog parks, training classes, and performance competitions) means there is an increased risk of exposure to your dog. If attending these facilities is unavoidable, vaccination should be considered. Dogs that have diseases or treatments that suppress the immune system (e.g. corticosteroids, cancer etc.) are at higher risk. If your dog stays mostly at home and is healthy, their risk is relatively low.
What are the clinical signs of canine influenza?
Canine influenza is highly contagious and can cause signs ranging from mild fever and lethargy to severe, life-threatening pneumonia. Most infected dogs have signs/symptoms that are typical of kennel cough.
How is canine influenza diagnosed?
Tests that broadly detect influenza A virus (e.g., broadly targeted influenza A real time RT-PCR) should effectively detect both H3N8 and H3N2. However, tests targeted directly at H3N8 are unlikely to identify H3N2 infection because of limited cross-reaction between H3N8 and H3N2 antibodies.
How can I prevent infection?
For dog owners living in the affected areas, the best prevention is to minimize contact with other dogs. I would not recommend bringing dogs into areas with infected dogs (don’t take your dog with you to Helena right now). Consider avoiding places such as dog parks, dog day care, grooming facilities, boarding, training classes, and group gatherings. Walking your dog alone is low risk, as the virus doesn’t survive well in the environment.
If your dog in the affected areas has respiratory signs, such as coughing, hacking, gagging or difficulty breathing, call your veterinarian before your appointment to let them know your dog has respiratory signs so that they can take appropriate precautions to minimize the possibility of contaminating the facility. When you get to the clinic, go in first without the dog or call from your car to coordinate entrance into the facility.
Can people or other animals be infected?
Currently, there is no evidence that people can contract this virus. However, studies in Asia have shown limited transmission to cats. Whether this can happen with the strain currently involved in the U.S. outbreak is unknown.
How is canine influenza treated?
The virus is treated similarly to how we treat kennel cough dogs. We often prescribe cough suppressants. Although antibiotics have no direct action against the influenza virus, they are sometimes used to prevent secondary infections in immunocompromised dogs or dogs with severe disease. Dogs that develop pneumonia may need to be hospitalized for supportive care (fluids and intravenous antibiotics).
* Above information and facts written by Dr. Emily Gocke-Smith with reference to information published by Dr. Mark Rishniw, BVSc, MC, DACVIM
For more detailed information from VIN about canine influenza, click here.
Pet in the Spotlight – Jax
UPDATE: Two months have passed since Jax sustained his injuries and surgical repair. We are quite happy to report that he is up walking, playing, and acting like a relatively normal young dog. He will still need continued rest and substantial follow up care to assess his healing fractures yet he is doing incredibly well. Here are videos of Jax at his most recent visit:
Jax is a handsome 6 month old male heeler mix. We met Jax in early September, after he had been hit by a car. Fortunately, Jax did not have any internal or immediately life threatening injuries. Unfortunately, every limb in his body was broken or fractured. This poor guy’s injuries included a total of 7 FRACTURES:
- LEFT FORLIMB: A comminuted (broken into many pieces) fracture of the left humerus.
- RIGHT FORELIMB: A comminuted fracture of the right radius and ulna (forearm).
- RIGHT HINDLIMB: An open (bones protruding through skin) highly communited fracture of the right tibia (shin bone). A growth plate fracture of the right femur (thigh bone).
- LEFT HINDLIMB: A comminuted fracture of the tibia (shin bone). A comminuted fracture of the left femur (thigh bone).
Literally without a limb to stand on, Jax was in need of multiple orthopedic surgeries to give him the chance for a functional life. Many of his fractures were complex, requiring an experienced surgeon to repair them. Repair would take multiple surgeries and a team committed to provide pain relief, rehabilitation, and TLC 24 hours a day/7 days a week for several weeks. Although this is something our hospital is equipped to provide, the total cost of providing this care is significant and would be cost prohibitive for many families.
After a long conversation with Dr. Smith, our orthopedic surgeon, Jax’s family thought long and hard about what they wanted to do, and eventually decided to pursue treatment. This was an enormous financial and emotional commitment to make, without any guarantee of a normal dog.
Jax had a total of two surgeries, each lasting 6-7 hours. The goals of the surgery were to stabilize all of the fractures so that Jax could bear weight and walk on his legs as his fractures healed. During the first long surgery, Dr. Smith repaired both of Jax’s forelimbs. The next day, he performed a second lengthy surgery to repair the four fractures in his hindlimbs. The repairs consisted of multiple bone plates, pins, and screws. Below are pictures of the fractures before and after fixation.
Hardware in Jax’s hindlimbs after fixation:
After both surgeries were completed, the long process of rehabilitation and recovery began. At first, he was very immobile and had both an intravenous and urinary catheter. His pain management and basic daily care was demanding. He had laser therapy daily and for the first several weeks, he had to be supported with a sling. As he healed, he became stronger and was able to do more of the things a “normal” dog does. After over a month of extensive care at our hospital, he finally went home to heal with his family.
Jax was extremely fortunate to have a family as committed as his willing to pursue treatment. All of us at Best Friends Animal Hospital have come to love Jax – he truly is a special dog. We were fortunate to be able to do what we are most passionate about – returning a healthy, healing pet to his family.
Kennel Cough – Facts and Common Misconceptions
It seems like almost daily at the clinic, I see a dog with “kennel cough.” Kennel cough is a term that generates so much confusion because it sounds ONE disease with ONE cause – which is NOT the case. The problem is that upper respiratory infections in dogs are COMMON and can be caused by MANY different pathogens (not just one). Many of these infections have similar symptoms including a harsh, hacking cough which can be dry or produce a foamy, white saliva. Commonly, people think that their dog has “something caught in their throat.”
Part of this is our fault – for years we have commonly referred to the Bordetella vaccination as the “kennel cough” vaccination. But, the truth is the Bordetella vaccine protects a dog from getting an upper respiratory infection from just Bordetella. It does not protect against the other numerous pathogens that can cause the same symptoms.
Here is the current list of pathogens that can cause the symptoms of “kennel cough”:
Viruses: canine distemper, canine parainfluenza, canine adenovirus ty 2, canine influenza, canine herpesvirus, canine reovirus, canine respiratory coronavirus, and canine pneumovirus.
Bacteria: Bordetella, Mycoplasma, Streptococcus, and Chlamydophila.
It seems like every year, they add a name or two to the list.
We have vaccines available to protect dogs from some of these pathogens. The DA2PP vaccine or canine “distemper” vaccine protects dogs from three viruses that can cause upper respiratory symptoms: canine distemper, canine adenovirus ty 2, and canine parainfluenza. The Bordetella vaccine is a separate vaccine that protects dogs from getting the infectious bacteria Bordetella. There is also a canine influenza vaccine that protects against one strain of canine influenza (canine influenza has not been diagnosed in Montana yet).
So why do we see so many dogs with infectious coughs if we have vaccinations? Because if you look at the list, there are at least 7 other pathogens (and probably more in my opinion) that can cause similar upper respiratory symptoms.
Can we test to see which pathogen a dog has? There are two types of tests that can tell us which type of infection a dog has. The first is a respiratory disease PCR profile. The PCR test is accurate at detecting several of the potential pathogens. The test, however, is expensive and does not cover ALL potential pathogens. Additionally, the tests are not always 100% accurate depending on when the patient is sampled during the course of disease. The second type of test is a paired serology test. Although this test is the most accurate, it requires multiple blood samples and is often cost prohibitive.
Treatment: The good news is that most of the dogs we see with upper respiratory infections have self-limiting disease – they resolve with little or no treatment. There are times that we prescribe cough suppressants and/or antibiotics on a case to case basis. Antibiotics are only beneficial if the patient has one of the bacterial causes of upper respiratory infection.
Most cases of canine upper respiratory infections are highly contagious. It is not uncommon to have “outbreaks” at places that have high dog concentrations such as grooming facilities, shelters, boarding facilities, and day care facilities. Dogs spread the disease by coughing infectious particles and/or direct nose to nose contact. Depending on the pathogen, sometimes they are most contagious right BEFORE they start coughing, which adds to the spread as we don’t even know they are sick at this time. If your dog is showing symptoms, he/she is most likely contagious, so please limit his/her exposure to other healthy animals.
My take home tips are:
1. Vaccinate your dog for DA2PP (distemper, adenovirus, and parainfluenza) and Bordetella. Consider the canine influenza vaccine if the disease is present in your area.
2. Know your dog will always have some level of risk of picking up an upper respiratory infection if he/she is in contact with other dogs or housed with other dogs.
3. If your dog does become sick with a cough, have them checked by a veterinarian. We can help discern how sick they are and what treatment (if any) is recommended.
4. Keep your dogs away from other dogs until they are no longer showing any symptoms to help limit the spread of disease.
5. Call your veterinarian if your dog doesn’t recover as expected or if you have additional concerns.