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Heatstroke is a life-threatening illness triggered in dogs and cats by a combination of increased heat production, environmental heat, and inadequate heat dissipation. The body’s thermoregulatory mechanisms fail, leading to cellular damage and death. In early stage hyperthermia, the pet experiences increased cardiac output and decreased peripheral vascular resistance. As hyperthermia advances, blood pressure and cardiac output decrease when the body can no longer compensate and without treatment, perfusion to vital organs decreases, resulting in widespread organ damage.

Thermal injury becomes widespread, involving neuronal tissue, cardiac myocytes, hepatocytes, renal parenchymal and tubular cells, and the gastrointestinal tract. Decreased organ perfusion, enzyme dysfunction, and severance of oxidative phosphorylation result in decreased aerobic glycolysis and an increased tissue-oxygen debt. The combination contributes to increased lactate production and lactic acidosis, which may occur as quickly as 3 to 4 hours after the initial heat-induced injury.
Hyperthermia may also lead to neuron damage, neuronal death, and cerebral edema; altered mentation is a common clinical sign. Severe central nervous system depression, seizures, coma, and death may be seen as the illness progresses.

During exposure to high ambient temperatures, the heat load increases faster than the animal can dissipate heat from the body.
Large- and giant-breed dogs are at increased risk for heatstroke, as well as animals that have predisposing conditions such as obesity, laryngeal paralysis, tracheal collapse, and thick coats, or are brachycephalic.

In human medicine, a continuum of heat illness ranging from the least to most severe occurs. Heat cramps characterized by muscle spasms that result from the depletion of sodium and chloride would be on one side of the continuum. Fatigue, weakness, muscle tremors, vomiting, and diarrhea are representative of heat exhaustion. Severe central nervous system (CNS) disturbance associated with multiple organ dysfunction is the result of heatstroke.

Heatstroke happens quickly, especially in poorly ventilated environments such as inside a car with the windows closed, even on a moderately hot day. Temperatures inside a closed car in direct sun may exceed 120° F (48° C) in less than 20 minutes and death may occur in less than one hour.

Therefore, time is of the essence and veterinary team members must be familiar with the clinical signs and treatment options so they can intervene quickly from the outset. Education should emphasize the importance of instituting cooling measures when the animal is found, before he or she is presented to the practice

Clinical Signs
It is important that team members are familiar with the clinical signs so they quickly recognize heatstroke and can begin cooling measures as soon as possible.
Patients with heatstroke or heat exhaustion often present with one or more of the following signs:
– Extreme panting
– Collapse
– Vomiting
– Diarrhea
– Ataxia
– Hypersalivation
– Seizures

Physical examination findings in patients suffering from heat-induced illness vary with the intensity and duration of the increased body temperature and the individual pathophysiologic responses.

Rectal temperature may be decreased, normal, or increased dependent upon tissue perfusion and implementation of cooling measures. Pulse rate is often increased because of a compensatory sinus tachycardia. Respiratory rate is typically rapid.

Most patients arrive at the practice in a hyperdynamic state. Mucous membranes are frequently hyperemic with short capillary refill time. Hypovolemia secondary to evaporative fluid loss, vomiting, diarrhea, and vasodilation cause a weak pulse. Sinus tachycardia is common.

Evaporation through the respiratory tract, which provides heat dissipation, should be carefully evaluated. Loud, noisy breathing, especially if audible without a stethoscope suggests an upper airway abnormality (eg, tracheal collapse, laryngeal paralysis, edema) or obstruction (eg, brachycephalic syndrome). The healthcare team should always perform careful auscultation for loud airway sounds or pulmonary crackles and consider aspiration pneumonia if a patient is vomiting.
Veterinary team members should also be cognizant of less common signs, including lethargy, muscle or head tremors, an altered mental state, hematuria, cyanosis, epistaxis, swollen tongue, vocalization, stridor, and dilated pupils.

Initial Management

First, move the patient out of the heat into an air-conditioned facility or shaded area. Then, spray or cover the animal with cool, not cold water.
Managing hyperthermia includes the following:
– Instituting cooling measures
– Restoring circulating intravascular blood volume
– Improving glomerular filtration and renal blood flow
– Stabilizing electrolyte balance
– Reducing complications of bacterial translocation/sepsis.

At the Practice
When a heatstroke patient is presented at the practice, place cooling packs in the axillary and inguinal areas. Use fans to disperse heat. Increase the convective cooling mechanisms—cooling the patient to 103° F (39.4° C) within 30 to 60 minutes is ideal. Cooling blankets, iced gastric or peritoneal lavage, cold water enemas, and intravenous fluids are also effective.

Take care to not overcool the patient. Immersion in ice or cold water is currently discouraged, because it may cause peripheral vasoconstriction, lead to an increased core body temperature, and prevent vasodilation, an animal’s primary method of thermoregulation.

Heatstroke can result in widespread, permanent organ failure (eg, renal, hepatic, cerebral). A hyperthermia patient’s prognosis depends on the following:
– The time taken to implement cooling measures
– The presence of underlying diseases and/or complications
– The time and intensity of the condition.

Concomitant renal failure, obesity, and disseminated intravascular coagulation (DIC) increase the risk of death associated with hyperthermia. As well as organ failure, the patient’s hypothalamic thermoregulatory center may also suffer permanent damage, predisposing the patient to additional hyperthermic or heatstroke episodes.

Death from heatstroke typically occurs within 24 hours, but patients that survive 48 hours usually have a favorable outcome. Thus, early recognition and quick treatment implementation are of the essence.


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Five Ways to Protect Your Pet from Lyme Disease

Lyme disease is transmitted to people, dogs and cats when a deer tick infected with the bacterium Borrelia burgdorferi attaches itself to the skin for a blood feast. Cats don’t appear to get sick, but the Lyme bacterium can cause serious disease in some dogs—and ticks can fall off cats to feed on people or other household pets. There are a few simple steps you can take to lessen the chances that your pet will become infected, says Michael Stone, a clinical assistant professor at Cummings School.


1. Take care of your yard. Mowing the lawn regularly will make your backyard less attractive to ticks. Be sure to pull tall weeds and to remove leaf litter, particularly from under shrubs and around the perimeter, because that’s where ticks hide. Secure your outdoor trash cans to discourage rodents that carry deer ticks.

2. Use a tick preventive on your pet. Make sure you choose a veterinarian-recommended product that is safe for all the animals in your household.

3. Check your animals for ticks daily. If your pets spend time outside, feel them for bumps, parting their fur so you can see where the coat meets the skin. Pay particular attention to under the legs, around the neck and inside the ears.

4. Talk to your veterinarian about a canine Lyme vaccine.
Some research suggests that vaccination appears to work well in preventing infection in dogs not previously exposed to the Lyme bacterium. However, it’s still important to use a tick preventive on your pet.

5. Protect yourself. Use repellent, wear treated clothing, shower after being outside and regularly check yourself for ticks. They can hop from you to your pet.

– See more at:

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Case of the Month

Gracie was presented for swelling under the right eye. This is typically how a tooth root abscess of the upper fourth premolar presents . Upon examination, Gracie’s teeth were fairly worn down and the right upper fourth premolar was visibly cracked. Other than being worn down, the rest of the teeth were not bad.


Even though it was very obvious that the upper right fourth premolar was the problem, at All Creatures, it is our standard of care to do full mouth radiographs on all of our dental patients.

Sure enough, the radiograph of the suspected tooth also showed a textbook case of a tooth root abscess. To our surprise, the radiograph of the same tooth on the other side which had no swelling and appeared perfectly normal with only a small amount of tartar present, also showed a tooth root abscess. Had we not radiographed this tooth, the abscess and pain associated with it would have been missed.


We extracted both teeth and sent Gracie home on pain medication and antibiotics. Gracie’s owner were given instruction for soft food and no hard toys , bones etc.and to recheck in 2 weeks. Gracie owner reports she is doing great.

Thanks to our advanced standard of care, we were able to take away Gracie’s pain, even when we had no idea it was there.

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Dog flu sickens every dog at local animal shelter

We offer the only H3N2 vaccine on the market with efficacy and safety data available. It only takes 4 weeks to get your dog protected. Contact us now to schedule your appointment!

An outbreak of the dog flu has infected every single dog at the Humane Society Calumet, and one dog has died.

The shelter is going to remain closed for weeks, possibly even for a month, as they try to control the illness. It started with two dogs getting sick with respiratory problems one week ago and then spread frighteningly fast.

“By Saturday there were 25 animals sick, Sunday 50, pretty much Monday almost all of them, and surely Tuesday every single animal so all 99 of the dogs were all sick,” said Humane Society veterinarian Brenda Dines. “Sometimes in a shelter, you have maybe 10 out of 100 sick, and that’s scary. But when you have almost 100 animals sick, that’s terrifying.”

One of the most obvious signs is the croaking bark caused by the respiratory congestion. Staff here are giving the dogs nebulizer treatments several times a day, along with a lot of extra TLC. But sometimes that’s not enough.

“We actually did lose one dog, which was really heartbreaking for us,” Dines said. “Nothing that anybody ever wants.”

A couple of dogs are in critical condition and at least five are sick enough that staff are “very concerned.”

Another room is being scrubbed down with bleach so it can be used as an additional treatment area. Dogs are getting outside if they feel well enough, but many just sit in their cages, waiting to feel better.

It’s really hard to see a lot of dogs that are normally really energetic and happy and running, lethargic and coughing and we can’t help them,” said shelter director Jessica Petalas

The shelter put out a call for donations of cleaning supplies, soft dog food, treats and many other items to care for the dogs. Medical supply companies and neighboring clinics as well as people in the area have responded generously.


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Toby Hannah

1489190_10152215326982774_219485306_nWe went in looking for a guinea pig and came home with you. Thank you for being a part of our lives. And leaving us with so many great memories. You are deeply missed.

Born: 2000/2001
Adopted: October 2002
Died: October 2015

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Could Your Pet Be Hiding Signs Of Diabetes?

Could Your Pet Be Hiding Signs Of Diabetes?Type 2 diabetes is on the rise in people, and it is also common in cats. But signs of diabetes can be subtle. Also, cats have evolved an exceptional ability to hide signs of illness – a survival instinct that has helped them thrive, but may make it difficule for you to recognize your cat is sick until the disease has reached an advanced stage.

The good news about feline diabetes is there are signs you can learn to recognize, if you know what to look for.Take your cat to the veterinarian if you see any of these signs:

  • Increased thirst and drinking more water than usual
  • Urinating more than usual. If you use clumping litter, you may notice more clumps or larger clumps than you normally see in the litter box.
  • Increased appetite and eating more food than usual.
  • Weight loss, even with increased food intake.
  • Weakness in the back legs. You may notice your cat’s stance is different.

Help – and hope – for cats with diabetes
Finding out your cat has diabetes may seem overwhelming, but you’re not alone. To help you learn to manage the special care your cat will need, your veterinarian may:

  • Prescribe an insulin
  • Show you how to inject insulin
  • Recommend exercise or a special cat food
  • Help you plan a home care routine
  • Schedule regular checkups for your cat

With the right care, a diabetic cat can live a long and happy life!

Credit: Boehringer Ingelheim Vetmedica, Inc.

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Chocolate Poisoning in Dogs – By Dr. Dan Meakin

Chocolate Poisoning in DogsEach holiday season, veterinarians witness an increase in accidental chocolate poisoning in dogs. The
majority of pet owners do not realize the potential for intoxication that chocolate possesses.
Theobromine, caffeine and theophylline are all naturally occurring molecules that are found in several foods, plants, beverages and human and veterinary medications.

Based on the number of calls received by The National Animal Poison Control Center and the Rocky Mountain Poison and Drug Center, one of the most commonly encountered poisonings in pet dogs is theobromine, or chocolate, poisoning.

Theobromine comes from the plant Theobroma cocoa and is present in chocolate, cocoa beans, cocoa bean hulls, cola and tea. Milk chocolate is obtained from seeds of theobroma cacao after fermentation and roasting. Milk chocolate has about 44 mg/ounce of theobromine; a 4.5 oz. milk chocolate bar has about 240 mgs. of theobromine. Unsweetened baking chocolate has even more — about 390 to 450 mgs of theobromine per ounce.

Relative theobromine content per ounce for various products is:
• Milk chocolate: 50 – 60 mgs/oz
• Semi-sweet chocolate: 160 mg/oz
• Unsweetened baking chocolate: 450 mg/oz
• Cacao meal: 300 – 900 mg/oz
• Cacao beans: 300 – 1200 mg/oz
• Hot chocolate: 13 mg/oz

The toxic dosage of theobromine in dogs is between 100 and 150 mgs/kg, or about 2 oz. of milk chocolate for every 2.2 pounds of body weight. However, serious non-fatal poisonings have been reported in dogs after eating much smaller amounts.

Deaths due to theobromine have been documented in horses who ate cocoa bean hulls used in bedding and in other livestock fed cocoa waste products. No chocolate poisonings have been reported in cats, which is probably a reflection of their eating habits.

The first signs of chocolate poisoning are vomiting and diarrhea, increased urination and nausea. These can progress to cardiac arrhythmias and seizures
Treatment includes:
• Emesis (vomiting)
• repeated doses of activated charcoal
• controlling seizing with diazepam
• monitoring/controlling arrhythmias with mertoprolol.
• catheterize the bladder since theobromine can be re-absorbed in the bladder
• Supportive care until complete recovery
Dogs definitely have a sweet tooth, and the problem with giving a dog milk chocolate as a treat is that it develops a liking for chocolate. Dog-proof for home to keep your dog safe. Milk chocolate should never be given to your pet and it should be kept well out of reach. Unsweetened baking chocolate should be kept in closed containers in upper, latched cupboards.

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Do Cats Get Heartworm?

Image00040The answer is an unequivocal yes but the feline situation is vastly different from the canine situation. While it is true that the feline infection is not as common as the canine infection, the feline infection has recently been found to be a much more widespread problem than previously believed. In the past, a common statistic was that within a given geographic area, the feline heartworm infection rate was approximately 10% of the canine infection rate. Recent research indicates this is not so; in heartworm endemic areas like here in Clermont county, the incidence of feline heartworm infection rivals or surpasses that of feline leukemia virus or feline immunodeficiency virus. An incidence of 15-20% of all cats has been reported for our area, making heartworm a concern for any cat living where there are mosquitoes.

The Parasite and its Migration 

  • The cat is not a natural host for the heartworm, which means the migrating larval heartworm is not likely to complete its life cycle.
  • Whereas a moderate heartworm infection in a dog would involve 25 to 50 adult heartworms, infected cats typically have less than six adult worms. Because the feline heart and blood vessels are so small, these few worms can wreak havoc. In a dog, six worms or fewer might not be considered worth treating. In a cat, a single worm could easily represent a lethal infection. 
  • Whereas worms found in the canine heart can reach lengths up to 14 inches, the average length of worms found in feline hearts is only 5 to 8 inches long. 
  • While an adult heartworm can expect to live 5 years in a dog, it will only live 2 to 3 years in a cat, probably due to the cat’s strong immune reaction.

Heartworm disease in cats is caused by the inflammatory reaction generated by the worm’s presence.

In dogs, heartworm disease is mostly about the obstruction of blood flow from the physical size of the worms.  

Symptoms of Disease

Symptoms of infection in cats tend to be more immune-related than heart-failure related. Cats develop more of a lung disease, complete with respiratory distress, and chronic coughing or vomiting. Feline heartworm disease is often misdiagnosed as feline asthma. Sudden death may occur just as it may occur in infected dogs. Heartworm disease is primarily a lung disease in cats, not a heart disease.

Diagnostic Testing

No single test is reliable for heartworm testing in the cat. The American Heartworm Society currently recommends using both an antigen test and an antibody test for screening apparently healthy cats. If a cat is sick and heartworm disease is suspected, both these tests are recommended, plus chest radiographs and/or echocardiography to assess heart and lung disease.


Since the major signs of disease in cats are due to inflammation and immune stimulation, a medication such as prednisone can be used to control symptoms. In general, if the cat does not appear sick, the American Heartworm Society recommends attempting to wait out the worm’s 2 to 3 year life span and simply monitor chest radiographs every 6 months or so.


The good news is that feline heartworm infection is 100% preventable and there are currently four products on the market that are reliably effective.
Revolution® is a product that covers fleas, roundworms, hookworms, and ear mites in addition to preventing heartworm in cats. Uniquely, this product is applied topically rather than orally.

The American Heartworm Society recommends monthly preventive for ALL CATS in heartworm endemic areas like Ohio. 
By Dr. Dan Meakin

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So Leptospirosis – What’s That?

On this past Friday, before taking off to a week of CE on exotic pets (reptiles, rabbits, chinchillas, ferrets etc.), a dog came into our Anderson practice that had survived being treated for leptospirosis by All Creatures. The woman reminded me that 2 years ago she had come to our practice desperately seeking for veterinary advice on how to help her dying dog. Before finding us, she had been to two other veterinary practices whose only advice had been to keep giving the pills because they didn’t know what was wrong with her dog. She is “forever grateful to our practice” that she now can expect, in addition to the 2 past years, the rest of her dog’s years to be enjoyable. Preventing our dog patients from getting lepto, is one of the main reasons we have not switched to an every three year vaccination protocol for dogs. Leptospirosis vaccination is required annually to protect your dog from contracting the disease.

For the record, leptospirosis is an infectious bacterial disease that affects both humans and animals. When leptospirosis is suspected in your dog, some precautionary steps are recommended. The infectious leptospirosis organisms usually are not shed in urine until 7 to 10 days after your dog is exposed to the bacteria, but you and other pets in the household may be at risk from the original source of contamination. If your dog is being treated for leptospirosis, you and family members are considered at low risk of contracting the disease from your dog but remain at risk if exposed to areas that were already contaminated by your dog.

If your dog has been confirmed or is suspected to have leptospirosis, please use the following precautions:

  • Avoid direct contact with urine.
  • Keep your dog away from standing water while it is urinating.
  • If possible, have your dog urinate on a concrete surface that can be cleaned with a 3% to 10% (1:30 to 1:10 dilution) of bleach solution.
  • Wash your hands after having contact with your dog.
  • Wear gloves when cleaning up urine.
  • Inquire whether other pets in your home need to be treated and vaccinated.
  • Seek medical attention if you or family members become ill at or around the same time your dog was diagnosed.

Steps you can take to help prevent leptospirosis:

  • Have your pets examined by your veterinarian and vaccinated for the disease annually.
  • Avoid contact with animal urine or bodily fluids, especially if there are any cuts or abrasion on your skin.
  • Do not swim in, walk in, or swallow water that you suspect has been Contaminated by animal urine.
  • Bathe your dog and yourself immediately after swimming in dirty water.
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