Preventing Heartworms: Going Above and Beyond the Call of Duty

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Almost every pet owner in central North Carolina is aware of heartworms. This dreaded pest is all too common in our area, and can cause significant disease (and even death) in affected animals. Thankfully we have some very good medications that can kill immature heartworms before they can cause disease. Moreover, these medications have additional benefits that make it that much more important to give our pets a heartworm preventative every month. Here are a few facts about heartworms and their prevention:

  1. Heartworms are transmitted by mosquito bites. While the mature heartworm lives within (and causes damages to) the heart, immature heartworm larvae float through an infected animal’s bloodstream. Mosquitoes can ingest these larvae as they take their blood meal, and eventually can transmit the heartworm larvae into the bloodstream of other animals when the mosquito takes another meal. Mosquitoes may slow down over the winter, but they do not go away – heartworm prevention is therefore imperative every month where we live.
  2. Heartworms are not contagious. Heartworm larvae must live in the mosquito for a while before they can be transmitted to another animal. Nonetheless, heartworm disease is much more common in areas where mosquitoes and unprotected dogs and cats abound.
  3. Cats can also suffer from heartworm disease. In fact, the incidence of heartworm exposure in cats is equal to, if not greater than, the incidence of feline leukemia (FeLV) or feline immunodeficiency virus (FIV). Cats may suffer a number of heartworm-related illnesses that can range from a chronic cough to sudden death. And not only can cats develop heartworm disease, there is no treatment available for cats. Please do not be lulled into thinking that your indoor cat is safe from heartworms; in a recent North Carolina study, 28% of cats diagnosed with heartworms were indoor-only. Mosquitoes can and will find their way into your house.
  4. Heartworm prevention kills more than just heartworm larvae. Commonly-used medications like Heartgard Plus and Revolution also kill the larvae of a number of intestinal worms, like roundworms and hookworms. Intestinal worms share one characteristic with heartworms – they are endemic to our area. They differ in several other respects, however. Intestinal worms are not transmitted by mosquitoes; instead, intestinal worms produce eggs which pass out of the infected animal when it defecates. These eggs are rather sticky, and attach to other animals’ paws when they walk across ground where infected animals have defecated in the past. The animal then licks its paws, and the eggs are transported to the animal’s intestines where the worms quickly set up residence. This is but one example of the timeless “fecal-oral” route of transmission, which is rather gross but all too common.

Another unpleasant thing about intestinal worms – people can get them. We seem to be pretty resistant to heartworms, but not intestinal worms. If you have a strong stomach, Google the phrase “larval migrans” and look at some of the images. This is not something you want a family member to contract!

I’ve often thought that heartworm prevention should be called worm prevention. It does not prevent every intestinal worm out there, but it does prevent a number of the more common varieties. And so, for both the safety of your pet as well as your family, please be sure your dog or cat receives a good heartworm preventative every month without fail.

The Surgical Approach: How We Perform Pet Surgery at North Hills Animal Hospital & Resort

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One of the interesting things about being a small-animal veterinarian is the variety of tasks we perform. We jump from general practice for wellness exams and vaccines, to internal medicine for ill patients, to dentistry, and to surgery – often all in the same morning. In speaking with clients, I notice that many questions tend to focus on pet surgery: what’s it like? How do you do it? Is it fun, scary, or both?

A surgical procedure at North Hills follows many steps. The first step, which usually takes place before the surgery date, is to discuss the procedure with the client. We talk about the underlying problem, the manner in which surgery may help, post-operative care, and the relative risks and rewards of the procedure. We also prepare an estimate of the costs, which we are happy to discuss with our clients if they have questions.

As many of you know, we ask that you withhold food from the patient on the morning of the procedure. A stomach full of food increases the risk of vomiting, which is one thing we’d prefer to avoid during or after surgery. The patient arrives at North Hills bright and early in the morning, no doubt wondering why no breakfast was served. We examine the patient (we do this even if we had examined the day before surgery) and make sure that heart sounds, breathing, pulse quality, and overall condition are conducive for surgery.

We also usually run blood work to make sure that the patient’s blood counts, electrolyte levels, kidney function and liver function are acceptable for surgery. I say “usually”, because we may not need to repeat blood work if it had been run recently and everything looked fine.

Once the surgeon examines the patient, evaluates blood work and gives the OK to proceed, the patient is given a pre-anesthetic medication that serves to relax the patient and provide some early pain relief. One of our skilled veterinary technicians will then place an intravenous catheter, usually in a front leg. An intravenous catheter serves many functions: it allows us to give medications through the catheter; fluid administration through the catheter helps with hydration as well as blood pressure maintenance; and it provides ready access to a vein in the highly unlikely, but always possible, event that we need to provide emergency assistance to a patient during anesthesia.

The next step is to anesthetize our patient. An intravenous medication is given through the catheter that provides immediate, albeit short term, anesthesia. We then intubate the patient, and use a combination of oxygen and a gas anesthetic to keep the patient under a comfortable plane of anesthesia. Anesthetized patients are monitored in many ways. In addition to the doctor and technician paying strict attention at all times to the patient, we monitor heart rate; oxygenation of blood; pulse; ECG; and blood pressure. We always keep emergency medications and equipment close at hand, and we calculate doses for such medicines prior to surgery.

Then comes the interesting part: the operation! Putting scalpel to skin is daunting at first, but one gets used to it after a while. You’d be surprised at how little an incision into skin bleeds – at least if it is done with a scalpel. Other tissues bleed much more readily. If the sight or smell of blood makes you squeamish, don’t pursue a career in surgery!

People may be surprised at how much movement can occur among abdominal organs. Intestines and spleen in particular can move around quite a bit. People may also be surprised at how visible and tangible many illnesses are. Terms like cancer, pancreatitis or inflammatory bowel disease may seem like ethereal concepts, but in reality they are quite physical and, often, readily apparent.

One of the most time-consuming parts of any surgical procedure involves suturing. If a dog has a large mass under its skin, for example, I can usually remove it in 10 minutes or less. Closure of the incision, however, can take much longer. Proper suture technique involves an approach that allows for both a cosmetic and permanent closure – not always easy to accomplish.

A vital component of any surgical procedure is the post-operative recovery of the patient. We frequently discuss the need to maintain a certain amount of “post-op paranoia” in order to prevent even the slightest lapse in patient monitoring during the recovery phase. It is critical that vet technicians and doctors monitor the patient until it is extubated, conscious, breathing on its own and sitting up in the recovery area.

The last aspect of any surgical procedure involves discussing the outcome and findings with the owner, as well as transcribing our surgical record. If the patient is going home with medication, we will get those ready as well as a summary of discharge instructions.

So, what is it like to perform surgery? It can be daunting the first few times, but one quickly becomes accustomed to it. Surgery also provides a satisfying closure (literal and figurative) that medical cases often do not. With surgery, it either works or it doesn’t.

As with most things, surgical success requires proper preparation beforehand. If the surgeon and staff are well-versed in a procedure, the procedure should be almost routine. I say almost, because pet surgery reminds me of what pilots say about flying: 99% boring, 1% exciting. At North Hills Animal Hospital & Resort, we strive to keep our surgical procedures as boring as possible.

Feline Health Care

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One of the many pearls of wisdom I learned from my anatomy professor in vet school was that cats are not small dogs. It sounds obvious, yet veterinary medicine has often tried to fill the gaps in our knowledge of feline medicine by extrapolating from what we know about dogs. Not surprisingly, that hardly ever works. Cats are different, at times even mysterious… and that’s what makes them so special. Listed below are a few aspects of feline medicine to which the doctors and staff at North Hills Animal Hospital & Resort pay particular attention:

Signs of Illness.

Cats are adept at hiding an illness until it becomes serious. Subtle changes in weight, hair coat, facial expression, appetite and thirst can be the initial, and easily-missed, symptoms of illness. This is one of the reasons an annual examination is so important for your cat.


Cats can get cavities, but it is not from eating too much sugar. Instead, their mouths sometimes take too many minerals away from the teeth, and the teeth slowly dissolve. The medical term for this painful condition is feline odontoclastic resorptive lesion, or FORL. Dogs can do the same, but don’t suffer from resorptive lesions as frequently as cats do. Oral health, including teeth brushing and dental cleanings when needed, is just as important for your cat as it is for your dog.

Exposure to Insects.

We frequently see cats with bald patches on their bellies or legs, and/or with scratches around their faces. We search carefully for fleas on each such cat, and inquire about whether the cat’s owners have noticed any fleas on their pet. In most instances, neither we nor the owners see fleas. And in that case, the most common thing we end up doing is… treating for fleas! Cats are a quandary in this regard: even one flea bite can trigger an allergic skin reaction, but cats are so good at grooming that fleas themselves are rarely found. Another veterinary school pearl of wisdom: in central North Carolina, an itchy cat has fleas unless one can prove otherwise. Sadly, this is true for both indoor and outdoor cats. Indoor cats are protected from many dangers, but are still susceptible to bites from mosquitos and fleas. Our current favorite preventative for cats (and the one I apply to my indoor cat) is Revolution. This monthly topical product can help protect your cat from heartworm disease and fleas, as well as certain mites and intestinal parasites.

Urinary Tract Issues.

Cats can show a variety of symptoms that are consistent with urinary tract infection: straining to urinate, vocalizing, blood in urine, going outside the litterbox, and even urinary tract blockage are not uncommon. But in cats less than 8 years of age, infection is rarely present. Instead these cats are displaying an inflammation of the lower urinary tract that occurs for reasons we do not yet fully understand. The terms used to describe this condition are feline cystitis and feline lower urinary tract disorder. We do know certain risk factors for this inflammation, such as youth, weight gain, dehydration and stress. Young overweight male cats are at particular risk, because the inflammation can cause a life-threatening blockage that must be treated as soon as possible.

Drug Metabolism.

Cats simply do not tolerate many of the medicines we use in dogs or that are formulated for people. And certain medications, such as Tylenol, can be lethal. It is critical to keep all medications out of reach from your cat.

Weight Management.

Maintaining a healthy weight is of course a vital component of health for all mammals. In cats, being overweight can lead to the urinary tract issues described above, arthritis, and diabetes. One of the interesting things about cats is that they frequently lose weight when we switch them from dry food to canned food. It seems counter-intuitive, yet often works.


Cats are partially-domesticated carnivores. Their behavior can be fascinating, mysterious, maddening… and sometimes all three at once. Your cat may not always show it, but she (or he) will benefit greatly from human interaction and a cat tree or other structure that allows your cat to attain an elevation off the floor. Cats also appreciate having a safe place from which they can escape stressors such as other pets, children, guests or loud noises. If your cat spends a fair amount of time under furniture, she is trying to tell you she does not feel safe. This is where a cat tree or other elevated perch, particularly if it is located in a quiet room, can come in handy. Cats also love to play with toys that allow them to act out their predatory nature; however, toys with long strings or ribbons can be fatal if swallowed. The “circle” toys that allow a cat to swat at a ball in an enclosed tube are a fun, safe option for your cat.

Cats are so fascinating that I could go on for several more pages if allowed. We are always happy to work with you to keep your cat happy, healthy and safe!

Pet Dental Health

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If​ ​your​ ​pets​ ​are​ ​anything​ ​like​ ​mine,​ ​chances​ ​are​ ​they​ ​love​ ​food.​ ​​ ​Unfortunately,​ ​so​ ​do​ ​bacteria! And​ ​when​ ​food​ ​gets​ ​stuck​ ​in​ ​the​ ​crevices​ ​between​ ​your​ ​pet’s​ ​teeth​ ​or​ ​below​ ​the​ ​gum​ ​line, bacteria​ ​take​ ​advantage​ ​of​ ​that​ ​ready​ ​supply.​ ​​ ​To​ ​make​ ​matters​ ​worse,​ ​pets​ ​rarely​ ​agree​ ​to​ ​brush their​ ​own​ ​teeth.​ ​​ ​Your​ ​pet’s​ ​mouth​ ​is​ ​therefore​ ​the​ ​equivalent​ ​of​ ​a​ ​bacterial​ ​sanctuary​ ​–​ ​safe, secure,​ ​and​ ​with​ ​plenty​ ​of​ ​food.​ ​​ ​How​ ​then​ ​do​ ​we​ ​protect​ ​your​ ​pet’s​ ​teeth​ ​and​ ​gums​ ​against otherwise-inevitable​ ​decay?

The​ ​first​ ​and​ ​most​ ​important​ ​item​ ​is​ ​done​ ​at​ ​home​ ​–​ ​brushing!​ ​​ ​Brushing​ ​provides​ ​the​ ​same benefits​ ​for​ ​your​ ​pet’s​ ​dental​ ​health​ ​that​ ​it​ ​does​ ​for​ ​us:​ ​namely,​ ​it​ ​can​ ​remove​ ​the​ ​sticky​ ​film​ ​of plaque​ ​from​ ​your​ ​pet’s​ ​teeth​ ​before​ ​it​ ​hardens​ ​into​ ​tartar,​ ​and​ ​it​ ​can​ ​reduce​ ​the​ ​number​ ​of bacteria​ ​in​ ​your​ ​pet’s​ ​mouth.​ ​​ ​While​ ​pet​ ​dental​ ​treats​ ​and​ ​water​ ​additives​ ​can​ ​help​ ​to​ ​a​ ​certain degree,​ ​a​ ​good​ ​pet​ ​toothpaste​ ​and​ ​brush​ ​are​ ​far​ ​more​ ​effective​ ​at​ ​keeping​ ​your​ ​pet’s​ ​mouth​ ​clean.

If​ ​you’ve​ ​never​ ​brushed​ ​your​ ​pet’s​ ​teeth​ ​before,​ ​or​ ​if​ ​you​ ​have​ ​tried​ ​and​ ​had​ ​little​ ​success,​ ​here are​ ​some​ ​tips​ ​that​ ​hopefully​ ​will​ ​make​ ​the​ ​process​ ​easier:

  1. Obtain​ ​a​ ​proper​ ​toothbrush​ ​and​ ​toothpaste.​ ​​ ​Even​ ​children’s​ ​brushes​ ​are​ ​generally​ ​too hard​ ​for​ ​your​ ​pet.​ ​​ ​The​ ​ideal​ ​brush​ ​will​ ​be​ ​pet-specific​ ​with​ ​a​ ​handle​ ​long​ ​enough​ ​to​ ​reach​ ​your pet’s​ ​back​ ​teeth​ ​and​ ​extra​ ​soft​ ​bristles.​ ​​ ​Smaller​ ​dogs​ ​and​ ​cats​ ​may​ ​benefit from​ ​a​ ​finger​ ​brush. Pet​ ​toothpaste​ ​should​ ​contain​ ​an​ ​enzyme​ ​to​ ​help​ ​control​ ​plaque.​ ​​ ​It is​ ​best​ ​not​ ​to​ ​use​ ​a​ ​human toothpaste,​ ​as​ ​they​ ​may​ ​contain​ ​ingredients​ ​that​ ​are​ ​not​ ​good​ ​for​ ​your​ ​pet.
  2. Start​ ​early!​ ​​ ​Most​ ​pets​ ​are​ ​accepting​ ​of​ ​tooth​ ​brushing​ ​when​ ​they​ ​are​ ​young. However,​ ​even​ ​adult​ ​pets​ ​can​ ​learn​ ​to​ ​accept​ ​the​ ​brushing​ ​process​ ​if​ ​you​ ​start​ ​off​ ​slow​ ​and provide​ ​lots​ ​of​ ​praise​ ​when​ ​finished.​ ​​ ​You​ ​can​ ​begin​ ​the​ ​acclimation​ ​process​ ​by​ ​using​ ​a​ ​cloth​ ​or gauze​ ​square​ ​to​ ​wipe​ ​the​ ​teeth​ ​at​ ​first.​ ​​ ​Praise​ ​your​ ​pet​ ​both​ ​during​ ​and​ ​after​ ​the​ ​process.​ ​​ ​You can​ ​also​ ​offer​ ​dental-friendly​ ​treats​ ​after​ ​brushing​ ​(dental​ ​chews​ ​or​ ​green​ ​beans).​ ​​ ​Do​ ​this​ ​process twice​ ​a​ ​week​ ​until​ ​your​ ​pet​ ​is​ ​acclimated.​ ​​ ​Next,​ ​start​ ​using​ ​the​ ​toothbrush​ ​soaked​ ​in​ ​warm​ ​water. Use​ ​the​ ​brush​ ​on​ ​a​ ​daily​ ​basis,​ ​first​ ​on​ ​a​ ​small​ ​area​ ​of​ ​your​ ​pet’s​ ​mouth​ ​and​ ​gradually​ ​increasing the​ ​treated​ ​area​ ​until​ ​your​ ​pet​ ​tolerates​ ​having​ ​its​ ​entire​ ​mouth​ ​brushed.​ ​​ ​Once​ ​your​ ​pet​ ​accepts having​ ​its​ ​mouth​ ​brushed​ ​with​ ​warm water,​ ​it​ ​is​ ​time​ ​to​ ​add​ ​the​ ​toothpaste.
  3. Use​ ​good​ ​brushing​ ​technique.​ ​​ ​Try​ ​to​ ​get​ ​the​ ​toothpaste​ ​between​ ​the​ ​bristles​ ​of​ ​the brush.​ ​​ ​Pay​ ​most​ ​attention​ ​to​ ​the​ ​outsides​ ​of​ ​the​ ​teeth.​ ​​ ​Place​ ​the​ ​bristles​ ​at​ ​a​ ​roughly​ ​45​ ​degree angle​ ​where​ ​the​ ​gums​ ​meet​ ​the​ ​tooth,​ ​and​ ​brush​ ​in​ ​an​ ​oval​ ​pattern.​ ​​ ​Cover​ ​three​ ​to​ ​four​ ​teeth​ ​at​ ​a time,​ ​and​ ​gently​ ​brush​ ​ten​ ​times​ ​in​ ​an​ ​oval​ ​pattern​ ​before​ ​moving​ ​to​ ​the​ ​next​ ​area.

The​ ​second​ ​aspect​ ​of​ ​pet​ ​dental​ ​care​ ​is​ ​the​ veterinary​ ​dental​ ​cleaning​.​ ​​ ​The​ ​process​ ​is​ ​actually much​ ​more​ ​than​ ​a​ ​cleaning,​ ​as​ ​it​ ​involves​ ​a​ ​thorough​ ​assessment​ ​and​ ​charting​ ​of​ ​the​ ​mouth​ ​and teeth;​ ​scaling​ ​off​ ​tartar​ ​above​ ​and​ ​below​ ​the​ ​gum​ ​line;​ ​and​ ​polishing​ ​the​ ​teeth​ ​after​ ​cleaning. Veterinarians​ ​refer​ ​to​ ​the​ ​process​ ​as​ ​the​ ​oral​ ​ATP,​ ​which​ ​stands​ ​for​ ​comprehensive​ ​oral assessment,​ ​treatment​ ​and​ ​prevention.

As​ ​many​ ​owners​ ​know,​ ​the​ ​ATP​ ​sometimes​ ​involves​ ​the​ ​extraction​ ​of​ ​diseased​ ​teeth​ ​as​ ​well. The​ ​roots​ ​of​ ​a​ ​dog​ ​or​ ​cat’s​ ​teeth​ ​can​ ​be​ ​quite​ ​well-anchored.​ ​​ ​When​ ​necessary,​ ​we​ ​utilize​ ​surgical extraction​ ​techniques​ ​to​ ​ensure​ ​all​ ​of​ ​the​ ​tooth,​ ​including​ ​root​ ​tips,​ ​are​ ​extracted.​ ​​ ​We​ ​will discuss​ ​all​ ​aspects​ ​of​ ​tooth​ ​extraction​ ​and​ ​post-operative​ ​care​ ​in​ ​the​ ​event​ ​extractions​ ​are warranted.

A​ ​proper​ ​ATP​ ​is​ ​performed​ ​under​ ​anesthesia,​ ​as​ ​no​ ​self-respecting​ ​cat​ ​or​ ​dog​ ​will​ ​allow​ ​someone to​ ​remove​ ​tartar​ ​from​ ​underneath​ ​the​ ​gum​ ​line​ ​while​ ​awake.​ ​​ ​North​ ​Hills​ ​Animal​ ​Hospital​ ​& Resort​ ​takes​ ​pride​ ​in​ ​the​ ​precautionary​ ​steps​ ​we​ ​take​ ​ensure​ ​your​ ​pet’s​ ​cleaning​ ​is​ ​safe​ ​and worry-free.​ ​​ ​Please​ ​feel​ ​free​ ​to​ ​ask​ ​one​ ​of​ ​​our​ ​veterinarians​​ ​or​ ​​technicians​​ ​about​ ​our​ ​anesthetic protocols​ ​–​ ​we​ ​will​ ​be​ ​glad​ ​to​ ​discuss​ ​them​ ​with​ ​you.

Daily​ ​brushing,​ ​plus​ ​an​ ​oral​ ​ATP​ ​when​ ​needed,​ ​provide​ ​the​ ​best​ ​chance​ ​to​ ​keep​ ​your​ ​pet’s​ ​mouth clean,​ ​healthy​ ​and​ ​smelling​ ​fresh.​ ​​ ​North​ ​Hills​ ​Animal​ ​Hospital​ ​&​ ​Resort​ ​carries​ ​a​ ​range​ ​of dental​ ​products​ ​for​ ​your​ ​pet,​ ​including​ ​toothpaste,​ ​brushes​ ​and​ ​treats.​ ​​ ​We​ ​also​ ​offer​ ​a​ ​discount on​ ​dental​ ​cleanings​ ​during​ ​the​ ​months​ ​of​ ​February​ ​and​ ​October.​ ​​ ​​Let’s​ ​work​ ​together​ ​to​ ​keep your​ ​pet’s​ ​teeth​ ​pearly​ ​white!

Noise Phobia

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The​ ​baritone​ ​rumble​ ​of​ ​an​ ​afternoon​ ​thunderstorm,​ ​the​ ​flash​ ​and​ ​bang​ ​of​ ​a​ ​fireworks​ ​display… aren’t​ ​the​ ​sights​ ​and​ ​sounds​ ​of​ ​summer​ ​great?​ ​​ ​Not​ ​if​ ​you’re​ ​a​ ​pet​ ​with​ ​noise​ ​phobia!​ ​​ ​It​ ​is​ ​a​ ​sad fact​ ​that​ ​approximately​ ​20%​ ​of​ ​dogs,​ ​and​ ​a​ ​smaller​ ​percentage​ ​of​ ​cats,​ ​develop​ ​a​ ​genuine​ ​fear​ ​of loud​ ​noises.​ ​​ ​Pets​ ​with​ ​noise​ ​phobia​ ​become​ ​terrified​ ​by​ ​approaching​ ​storms,​ ​and​ ​can​ ​make summer​ ​afternoons​ ​quite​ ​the​ ​ordeal​ ​for​ ​pet​ ​owners.​ ​​ ​Here​ ​are​ ​some​ ​tips​ ​on​ ​how​ ​to​ ​deal​ ​with​ ​this common​ ​issue.

1. Have​ ​a​ ​safe,​ ​secure​ ​place​ ​for​ ​your​ ​pet.​​ ​​ ​Pets​ ​with​ ​noise​ ​phobia​ ​should​ ​have​ ​a​ ​small,​ ​secure, “den”​ ​like​ ​area​ ​in​ ​which​ ​to​ ​stay​ ​during​ ​storms​ ​or​ ​fireworks​ ​displays.​ ​​ ​This​ ​area​ ​ideally​ ​should​ ​be an​ ​indoor​ ​room​ ​away​ ​from​ ​windows​ ​if​ ​possible.​ ​​ ​If​ ​the​ ​room​ ​does​ ​have​ ​windows,​ ​be​ ​sure​ ​they are​ ​completely​ ​covered​ ​to​ ​minimize​ ​the​ ​anxiety-inducing​ ​effects​ ​of​ ​lightning​ ​flashes.

2. Diminish​ ​the​ ​outside​ ​noise.​​ ​​ ​This​ ​can​ ​be​ ​done​ ​through​ ​the​ ​use​ ​of​ ​classical​ ​music​ ​played​ ​over a​ ​stereo​ ​or​ ​a​ ​white-noise​ ​machine.​ ​If​ ​your​ ​pet​ ​will​ ​tolerate​ ​it,​ ​you​ ​can​ ​also​ ​place​ ​cotton​ ​balls​ ​in​ ​its ears​ ​–​ ​just​ ​remember​ ​to​ ​remove​ ​the​ ​cotton​ ​balls​ ​after​ ​the​ ​noise​ ​has​ ​diminished.​ ​​ ​Certain companies​ ​even​ ​make​ ​ear​ ​muffs​ ​for​ ​dogs​ ​–​ ​​Mutt​ ​Muffs​​ ​is​ ​one​ ​such​ ​example.

3. Try​ ​to​ ​divert​ ​your​ ​pet’s​ ​attention.​​ ​​ ​​ ​​ ​Fill​ ​a​ ​​Kong​ ​toy​​ ​with​ ​a​ ​tasty​ ​snack​ ​that​ ​will​ ​take​ ​some time​ ​and​ ​effort​ ​for​ ​your​ ​pet​ ​to​ ​get​ ​out​ ​of​ ​the​ ​Kong.​ ​​ ​Banana,​ ​dry​ ​kibble,​ ​and​ ​peanut​ ​butter​ ​are good​ ​options.

4. Try​ ​over-the-counter​ ​calming​ ​agents.​​ ​​ ​No​ ​agent​ ​is​ ​100%​ ​effective​ ​at​ ​calming​ ​pets​ ​with noise​ ​phobia.​ ​​ ​Nonetheless,​ ​some​ ​pets​ ​do​ ​seem​ ​to​ ​feel​ ​better​ ​with​ ​the​ ​use​ ​of​ ​the​ ​following:

  • Thundershirt​.​ ​​ ​This​ ​wraps​ ​snugly​ ​around​ ​your​ ​pet’s​ ​body​ ​and provides​ ​a​ ​swaddling sensation​ ​that​ ​some​ ​pets​ ​find​ ​comforting.​ ​​ ​A Thundercap​​ ​also​ ​exists​ ​to​ ​minimize​ ​visual​ ​stressors like​ ​lightning flashes.
  • Adaptil​​ ​for​ ​dogs,​ ​or​ ​​Feliway​​ ​for​ ​cats.​ ​​ ​These​ ​products​ ​are appeasing pheromones​ ​that​ ​can​ ​help​ ​alleviate​ ​your​ ​pet’s​ ​stress​ ​in​ ​a number​ ​of​ ​situations.​ ​​ ​The​ ​products come​ ​in​ ​a​ ​variety​ ​of​ ​forms: plug-in​ ​wall​ ​diffusers,​ ​sprays​ ​and​ ​collars​ ​are​ ​available.
  • ​​Zylkene​.​ ​​ ​This​ ​is​ ​a​ ​natural​ ​calming​ ​agent​ ​that​ ​can​ ​help​ ​with​ ​pet anxiety​ ​in​ ​general.​ ​​ ​It does​ ​not​ ​work​ ​immediately,​ ​so​ ​must​ ​be​ ​given on​ ​a​ ​daily​ ​basis.

5. Desensitize​ ​your​ ​pet​ ​to​ ​loud​ ​noises.​​ ​​ ​Purchase​ ​a​ ​CD​ ​of​ ​storm​ ​noises,​ ​and​ ​play​ ​it​ ​on good-weather​ ​days.​ ​​ ​Play​ ​it​ ​quietly​ ​at​ ​first,​ ​then​ ​gradually​ ​turn​ ​up​ ​the​ ​volume.​ ​​ ​Do​ ​not​ ​play​ ​the CD​ ​on​ ​days​ ​of​ ​potential​ ​stormy​ ​weather.

6. Do​ ​not​ ​reward​ ​your​ ​pet’s​ ​anxiety.​​ ​​ ​It​ ​is​ ​natural​ ​to​ ​try​ ​to​ ​comfort​ ​your​ ​pet​ ​when​ ​it​ ​is​ ​stressed. However,​ ​our​ ​efforts​ ​to​ ​alleviate​ ​the​ ​situation​ ​by​ ​giving​ ​attention,​ ​food,​ ​kind​ ​words​ ​and​ ​petting only​ ​serve​ ​to​ ​reward​ ​our​ ​pets​ ​for​ ​being​ ​anxious.​ ​​ ​Similarly,​ ​do​ ​not​ ​try​ ​to​ ​reprimand,​ ​correct​ ​or punish​ ​your​ ​pet​ ​for​ ​its​ ​anxiety.​ ​​ ​Treat​ ​loud​ ​noises​ ​as​ ​no​ ​big​ ​deal.

7. Medications.​ ​​ ​​We​ ​do​ ​sometimes​ ​use​ ​​prescription​ ​medications​​ ​to​ ​help​ ​with​ ​noise​ ​phobia.​ ​​ ​It​ ​is important​ ​to​ ​note​ ​that​ ​medications​ ​alone​ ​are​ ​not​ ​the​ ​answer,​ ​and​ ​also​ ​have​ ​the​ ​potential​ ​for adverse​ ​side​ ​effects.​ ​​ ​Nonetheless,​ ​some​ ​pets​ ​may​ ​receive​ ​an​ ​additional​ ​benefit​ ​from​ ​medications such​ ​as​ ​the​ ​following:

  • Clomipramine​:​ ​an​ ​anti-depressant​ ​medication​ ​that​ ​can​ ​be​ ​given​ ​daily​ ​during​ ​the​ ​storm season​ ​to​ ​help​ ​with​ ​noise​ ​phobia.
  • Alprazolam​​ ​(generic​ ​for​ ​Xanax):​ ​an​ ​anti-anxiety​ ​medication​ ​that​ ​can​ ​be​ ​given​ ​as needed.​ ​​ ​However,​ ​it​ ​will​ ​be​ ​of​ ​no​ ​use​ ​unless​ ​it​ ​can​ ​be​ ​given​ ​well​ ​before​ ​your​ ​pet​ ​becomes​ ​aware of​ ​an​ ​approaching​ ​storm​ ​or​ ​the​ ​sound​ ​of​ ​fireworks.​ ​​ ​It​ ​also​ ​has​ ​the​ ​potential​ ​to​ ​cause​ ​certain​ ​pets to​ ​act​ ​out​ ​in​ ​ways​ ​they​ ​ordinarily​ ​would​ ​not​ ​do.

Working​ ​together​,​ ​we​ ​can​ ​help​ ​minimize​ ​the​ ​stress​ ​your​ ​pet​ ​experiences​ ​from​ ​loud​ ​noises,​ ​and make​ ​the​ ​summer​ ​a​ ​better​ ​season​ ​for​ ​all​ ​of​ ​us.

The Veterinary Physical Exam: What’s It For?

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A trip to the veterinarian with your pet might include several tests and procedures. Items such as vaccinations, intestinal parasite tests, heartworm tests and annual blood work may all be involved. But in the push to get these tests and procedures accomplished, it is possible to overlook the value of the most important item of all: the physical examination.

A veterinary physical exam at ​North Hills Animal Hospital & Resort​ combines the work of both the ​veterinary technician​ and the ​veterinarian​. The technician first speaks with the owner to obtain a history of how your pet has been doing generally at home and to discuss the items that are due for your pet at that time. The technician then obtains the following information for your pet:

  • Weight
  • Body condition (which measures how appropriate your pet’s weight is for its size)
  • Dental health
  • Temperature (normally between 100 and 102.5 Fahrenheit for a healthy dog or cat)
  • Heart rate (normally 60 to 160 beats per minute for a dog, and 140 to 220 for a cat)
  • Respiratory rate (normally 10 to 24 breaths per minute for a dog, and 20 to 30 for a cat)
  • Mucus membrane color (gums and conjunctival tissue around eyes should be pink)
  • Capillary refill time (when pressed with a finger, gums should blanch as blood flow is constricted and then turn pink again within 2 seconds after pressure is released)

The technician will also obtain any samples that might be needed for ​testing​. Normally these samples consist of fecal material to check for evidence of intestinal parasites and blood to check for heartworms (in dogs), as well as for annual blood wellness testing at our lab. The technician then discusses the patient with the veterinarian, and remains in the exam room to help the vet perform her exam as well as to transcribe the medical record.

Next, the veterinarian performs her own examination. The veterinarian assesses the following:

  • Body condition and overall muscularity
  • Hair coat
  • Skin condition
  • Neurologic status
  • Eyes
  • Ears
  • Dental health
  • Mobility and range of motion in limbs
  • Heart rate, rhythm and sound quality
  • Lung sounds
  • Abdominal organs (through palpation of the abdomen)
  • External lymph nodes
  • Pulse quality

That’s a lot of information from one test! The primary purpose of the veterinary physical examination is to assess the overall health of your pet. A side bonus is that the exam ensures your pet is sufficiently healthy to receive any vaccines that may be due. The exam drives the vaccines – it is not the other way around.

The last part of any examination is a discussion with the owner about the exam findings. North Hills schedules a full thirty minutes for an exam in order to provide sufficient time for a thorough discussion with the owner.

Want to ensure you are receiving the biggest bang for your buck in small animal medicine? Make sure your pet gets a thorough veterinary physical exam at least once a year.

Springtime and Our Pets

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Spring is such a beautiful time of year in Raleigh. The sun rises earlier and conveys more warmth; flowers, grasses and new leaves replace the gray of winter; and birds burst into song. What’s not to like?

Well, pollen for one thing! And biting insects. And rising heat and humidity. Spring might be beautiful, but it does come at a cost. Here are a few ways that cost might be paid by your pet and how to alleviate your pet’s symptoms.

Seasonal Pet Allergies.

Our pets are not immune to the effects of springtime allergies. Pollen, dust mites, danders and mold spores are a common source of allergies for both people and pets. Unless you hermetically seal your house and pipe in air from the North Pole, these allergens are unavoidable where we live.

Pets can get watery eyes and congested sinus passages that humans with allergies suffer from, but it is much more common for an allergic pet to develop skin issues. The more common symptoms of allergies in pets are:

  • Red, flaky patches on the back or abdomen
  • Hot spots
  • Excessive licking or chewing at paws
  • Recurrent ear infections

Seasonal pet allergies are all the more problematic because they can worsen with age. For milder symptoms, we might try antihistamines and fish oils along with baths in hypoallergenic shampoo. Pets with more severe allergies can usually be helped with medications like Apoquel, Atopica, and the new once-a-month injectable product Cytopoint. While we cannot yet cure allergies, we can make your pet a lot more comfortable.

Biting Insects.

Certain insects, like mosquitos and fleas, never go away during the winter. They slow down but some are always present. They do, however, become more prevalent as the weather starts to warm.

Ticks are harder to predict. The largest number of ticks I have seen on a dog to date occurred in February of 2003. I forget the exact number, but we removed more than 140 ticks from a Chesapeake Bay Retriever that year. And it was cold! However, we usually see at least one sudden outbreak of ticks at some point in the spring.

Other insects also become more prevalent in the spring. Yellow Jackets, those stinging bee-like insects that like to burrow into the ground or live under fallen pieces of wood, are a particular nuisance for dogs who like to explore with their noses.

Mosquito bites, as I am sure most of you know, are the way that dogs acquire heartworms. Fleas can be a terrible nuisance, and ticks harbor some pretty wicked diseases as well. Pets in our area simply must be on heartworm and flea/tick prevention throughout the year. North Hills Animal Hospital & Resort carries a variety of products like Heartgard Plus, Revolution, Nexgard, Bravecto, and Frontline Gold to keep heartworm disease, fleas, and ticks at bay. We are here to help if your dog pokes its nose into a Yellow Jacket nest!

Heat and Humidity.

Rising temperatures and humidity in the spring can be a surprise after the shorter, chillier days of winter. Pets with thick coats, excess weight or flatter faces, such as Bulldogs, Pugs and Shih Tzus, are at particular risk of overheating when they go for longer walks in the spring. Let your pet acclimate by going on shorter walks at first. Take fresh water for your pet as well as yourself. Try to avoid walks during the hottest part of the day. Watch the surface your pet is walking on, as heated concrete or asphalt can be rough on foot pads that may have softened up over the winter. Of course you can always send your pet to doggie day care at North Hills, where we have plenty of shade, soft surfaces, water… even a wading pool!

All of us at North Hills Animal Hospital & Resort hope you and your pets have a wonderful spring!

Behind the Scenes at North Hills Animal Hospital & Resort

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North Hills Animal Hospital & Resort welcomes Dr. Charles Livaudais to the team. One of his goals is to write a monthly blog post discussing a range of veterinary-related topics, from medical or surgical procedures to behavioral issues. This blog will also provide a “behind the scenes” glimpse as to what it is like to work at an animal hospital.

The Vision for North Hills Animal Hospital & Resort

As those of you who have been to North Hills Animal Hospital & Resort can attest, Dr. Lora Evans has built a large and beautiful facility. Dr. Evans’ stated intention in building this animal hospital is to provide outstanding and personalized care in a luxurious facility designed to make your beloved pets feel at home. The same concept is summarized in our motto as Modern Medicine, Old Fashioned Care.

Modern Medicine

Our goal is to offer our patients state-of-the-art medical and surgical services. Our exam rooms, surgical suite, laboratory, and treatment area are designed with that specific purpose in mind. We do our very best to explain the reasons behind our medical recommendations as well as the value of a particular test or procedure. At the same time, we recognize that our clients are usually paying for their pets’ medical care from their discretionary income. We can work with you to provide the best care possible within a given set of financial parameters.

Old Fashioned Care

The concept of Old Fashioned Care can best be summed up in the word “personal.” North Hills does not follow the recent trend of veterinary clinics that seek a high patient volume with rapid room turnover and limited time for clients to speak with the doctors. Instead, we intend to provide personalized care and attention to patients and clients alike. We want to know you and your pets, and we take it personally when your animals are not doing well. Appointments are scheduled for at least 30 minutes so we can address all concerns and questions you may have. We ask our entire staff to maintain the same high standard of customer service. Our goal is to exceed expectations in all aspects of your experience.

North Hills Animal Hospital & Resort is about two years old now, which is still quite a new hospital. We are in a stage of very strong growth and we strive to maintain the highest standards for medical care and customer service.

Behind the Scenes at North Hills Animal Hospital

Has a veterinarian or technician ever told you they were taking your pet to “the back”? Have you ever wondered what this mysterious “back” might be? Basically, “the back” refers to the treatment area. This is the place within an animal hospital where we can obtain samples and perform in-house tests, administer medications, and perform non-anesthetic procedures. It is also the place where you can usually find the veterinarians and most technicians during the day. The treatment area at North Hills Animal Hospital & Resort is quite large and expansive. Our treatment area is located in the center of the hospital – another reason we promise not to use the term “back.”