Wednesday, February 6, 2008

Healthy,well pets and preventative screening, oh my!

I was reminded a couple days ago of the importance of regular check-ups for pets who otherwise seem healthy. A rabbit came in with "diarrhea" and with feces clagged around her back end. As I reviewed her records, I noted that 6 months previously I had had extensive discussions with the owner about diet and how to prevent loose feces such as this (the official diagnosis is cecal dysbiosis, but that's a different story!). I wondered what had happened such that the rabbit had gotten into such a state. It turned out the family had just slipped a little in their feeding regime - feeding more pellets than the rabbit needed, not enough hay or grass and a few too many of the wrong type of vegetables. This left their beloved pet with a sore and gassy tummy and unable to recycle her cecotrophs causing them to stick to her back end! By simply having a physical exam and discussing the daily feeding we were able to overcome a problem which, if left, could have escalated into a problem requiring costly hospitalization and danger to the pet's life.

As vets we like to see our young healthy pets once a year and older pets every 6 months (or more often for animals with certain conditions). This helps us do our job of looking after the health of the pet and allows us to build a relationship with the pet and the owners. In many countries, annual vaccinations give us a good excuse to do this. The 6-monthly myxomatosis vaccine for rabbits in England was very useful for regular discussions of diets and teeth checks. In the US, though, the distemper/parvo vaccine and the rabies vaccine for dogs are now able to be given every 3 years. If these are the only vaccines your pet has, should they only see the vet every 3 years? Certainly not!

Annual check-ups go by many names: wellness exams, preventative medicine screens, healthy pet exams, etc. They enable your vet to check teeth, listen to the heart and lungs, feel the abdomen, and weigh your pet. Many owners can't do this for themselves, or don't know what they're looking for. You can discuss diet and subtle changes in your pet's behavior. Many vets are starting to incorporate blood screening into these annual exams. This gives them one more tool to diagnose conditions early while they can be easily treated and before they become a real problem for your pet.

In our practice, for dogs and cats, we recommend a pre-operative blood test prior to spaying or neutering a pet -- even those that are only a couple months old. This allows us to check that the kidneys and liver are able to handle the anesthetic, to check that there aren't any clotting problems in the pet, and to be sure they aren't anemic or harboring an infection that should be treated before "stressing" the body any further. After this we recommend a similar blood test (without the clotting profile) annually along with an annual fecal exam until the pet is 7 years old (5 for giant dog breeds). After age 7 we like to do a more comprehensive blood test that includes thyroid levels and a urine screening in addition to the regular fecal test.

Why do we want so much blood year after year? Pets are very good at hiding when they are a bit under the weather (or we humans aren't as good at noticing!). It is easy to see that your 10 year old cat is a bit sluggish and just attribute it to getting older. In reality she may be a bit sore with arthritis or feeling a bit nauseated from kidney disease. By the time a cat shows the typical signs associated with kidney disease of drinking too much and losing weight (similar to signs of thyroid disease and diabetes) 75% of their kidney function has been lost and cannot be recovered. If, however, at age 9 that cat had had a screening and the vet had seen that her kidney values were up from the previous year's test and the urine was more dilute, he could have put her on a special diet that would slow down the progression of the disease and help her feel better for longer.

This all becomes much more important with flock and prey species. With birds we rely heavily on our annual blood and fecal screenings - once a bird starts showing clinical signs it's nearly too late! We can pick up things like subclinical respiratory infections or early liver disease from an inappropriate diet. Rabbits also often harbor subclinical infections that can only be detected with a CBC (complete blood count - a count of the red and white blood cells in the blood).

So work an annual exam into your calendar - ask your vet to send you a reminder if you aren't sure how long ago you were last there. Be prepared with a list of questions/topics to discuss and be ready to have that blood sample taken - it may improve your pet's life and give you more time together to enjoy each other's company!