Dear Dr. Forsythe: I have something to ask you but it is kind of embarrassing.  I guess the best way to ask it is just to come right out and say it.  My dog has terrible stinky farts.  They are so bad that some friends won’t even come over to our house anymore.  She is a Lab, about 60 pounds, and she is five years old.  She eats Nutro food, so we don’t exactly skimp on her.  Please give me some advice because her silent and deadly farts are more horrible than words can say. Sign me: Down wind and nauseous

Dear Down wind:  First I should begin by empathizing with you:  I have lived with several English Bulldogs over the last 10 to 15 years.  Each and every one of them “took my breath away” and NOT from their couture beauty.  My last companion, the late great Dooney who was the greeter at my pet hospital for several years, used to have that problem.  More specifically, our wonderful receptionist Kathryn, under whose desk he would lay between appointments used to deliver a noxious flatus with no warning whatsoever.  This wonderful team member, Kathryn, who spends her days giving five-star service to customers would periodically suffer near fatal asphyxiation from his “mustard gas” emissions.

Everyone has a breaking point, after watching my amazing teammate suffer in agony, we treated Dooney with a combination of metronidazole and amoxicillin to eradicate what must have been the most ghastly and horrific gram negative intestinal maladies ever.  In addition, we upgraded his diet and I (with both guilt and remorse) turned the case over to my associate, Dr. Abbie Whitehead.  Within a few weeks of Dr. Abbie’s improved nutritional recommendations, and the three-week course of antibiotics, our beloved Dooney was feeling less bloated and Kathryn was breathing easier and having more harmonious work days.  In short, everyone in the office was breathing easier.

Remember every pet is different, every dog, and every cat.  No two creatures have identical intestinal tracts with identical digestive enzyme amounts, the same exact metabolism, or the same numbers of cells lining the gut, which help digest and utilize nutrients.   Your pet may not be digesting her food well, may be allergic to some ingredient in it, or could have a gram negative (gas producing) infection.  The good news is that your veterinarian can probably help you regain your friends with a medical intervention for your pet.  I doubt very much that she is simply a “gassy Cassie” so having her checked out and just being direct and blunt with your veterinarian may really help.
– Dr. F

Dear Readers:  I wanted to take a moment to let you know that my colleague Dr. Whitehead, who is not only a great veterinarian and friend, but also an avid writer has been “throwing her two cents in” when she sees me writing my column every week.  This got me to thinking that I should try and include her in this fun and cathartic endeavor to share some writing duties with me in the future.  I hope all of you appreciate our input and I think Dr. Whitehead will enjoy answering some of the questions we receive regularly.  Most come via email, but other questions arise in our exam rooms or when one of us is interacting with a pet lover while we are out and about.  So without further ado, here is a message from Dr. W.

Hello Sonoma Sun pet lovers:  When Dr. Forsythe asked me to think about contributing to his weekly column, I realized that participating with him was akin to starting the new year doing something I have always wanted to do.  The idea of calmly answering any of the myriad of fun, interesting, and at times befuddling questions we get was both exciting and daunting.  I hope I can achieve the wit and aplomb he has given his loyal readers over the years.

Dr. F. and I agreed that I should best start by simply introducing myself to you.  I’ve been working at Altimira Veterinary hospital for almost two years now.  I graduated from the U. of Florida College of Veterinary Medicine in 1990.  Before that, I was a farrier for twelve years, and I even rode a mule from Pennsylvania to Pensacola with the Vision Question wagon train.  Since finishing veterinary college, I’ve had the opportunity to work with all types of animals and served 10 years in the Army. Prior to joining Altimira, I also worked for six years in shelter medicine.  I also chose to spend one splendid, hair-splitting and very rewarding year home-schooling my daughter Olivia which was much more demanding and exhausting than most would ever realize!  After that experience, I sent her back to school and will forever confirm that educators are saints. Period!

I’m really lucky to have had some great adventures working in veterinary medicine in different venues over the years, and I hope to share some of my stories and experiences with you alongside Dr. Forsythe.  Please send questions for me to deardr.abbie@altimiravet.com. If you aren’t the e-mailing type, send me a note at the hospital or call me up!  I have the same attitude about questions as Dr. Forsythe:  if you are wondering something, there are probably many other readers wondering the same thing!  There really are no such things as dumb questions and if you want to know about a pet or a situation with a pet, have problem or simply want to share a wonderful tidbit of enlightenment, don’t hesitate to contact either of us.

With excitement and happiness to help when I can.  – Dear Dr. Abbie

Dear Dr. Forsythe:  Our 11-year-old terrier was recently diagnosed with diabetes.  We are going back to the vet soon to get insulin and more information on this disease.  I wanted to know your opinion regarding quality of life issues with pets who have diabetes.  My boyfriend and I do not want to prolong “Woody’s” life by giving shots twice a day and feeding special food unless we can expect him to maintain a good quality of life.  Do you think it is worth putting him through these shots.  Do they hurt? – N.G., Napa

Dear N.G:  In my opinion, dogs and cats that are diagnosed with diabetes usually enjoy a high quality of life once we regulate their disease with proper insulin injections and improved nutrition. Getting a diabetic pet “regulated” means making sure that their blood sugar is controlled as well as possible so that it is as close to normal as we can make it for the majority of each day.  Insulin shots are administered via a very tiny syringe with a needle that is very thin.  I imagine that the shot itself hurts less than a flea bite. However, I always caution clients with a newly diagnosed diabetic animal that they may expect increased veterinary costs in the future and that all pets respond differently to treatment.  Some pets (dogs in particular) become well regulated quickly and easily, while others (more often cats) can be more difficult to get to a steady state.

Diabetic pets are prone to urinary tract infections as well as developing other complications such as cataracts.  It is a big commitment to “Woody” to take on the duty of seeing that he gets insulin administrated twice daily (at the same time each day) and eats a diabetic appropriate diet for the rest of his life.  While this an adjustment that will impact your family, the reward will probably be huge when you see Woody start to feel better and will continue to enjoy the vast benefits that come from having a loyal family pet.  As long as you have realistic expectations and you are willing to elevate the level

of veterinary care he may need in the future, I suspect you will be very glad you moved forward with his diabetes treatments.  I have many happy patients who have been dealing with diabetes for several years, and in practically every case, the clients are so grateful to have their beloved pet with them living a happy life.  I hope this information has helped, and that Woody will do very well in the future. – Dr. F

Dear Dr. F:  Can you please tell me what “hospice” care means in veterinary medicine?  I have a 12-year-old Cattle dog who was diagnosed with a cancerous growth in her stomach.  I can’t afford the operation to try and remove it, and besides there are no guarantees that the doctors would be SURE they could remove it all.  Besides, we just didn’t think it was fair to put her through a big involved surgery at this age.  So we decided to take the veterinarians advice and give her hospice care.  What exactly does that involve?  I remember with my late mother it was pain medication while we waited for her to pass.  Is that the same thing I can expect for my dog?  I don’t want to put her to sleep because she still seems happy and I also don’t like the thought of doping her up as her condition worsens.

I guess I’m between a rock and a hard place.  I just want to do whatever is best.  Do you agree with hospice for dogs?  Sign me – Between a rock and a hard place

Dear Between:  I haven’t had personal experience with a human loved one going through a hospice situation, but I do provide this service for pets, and

I think it is a really useful topic for veterinarians to address, so I’ll tell you what my thoughts are on this delicate and difficult time for both your pet and your family.

Hospice is regarded by many veterinarians as a point at which “there is nothing more we can do.” This can mean that the veterinarian feels very limited and only has the option of sending home pain medication and tranquilizers with the hope that it will help.  I see hospice in a completely different way:  I feel it is an opportunity for me as a veterinarian to provide the best comprehensive help to a family and their pet through what is clearly a difficult transition in the pet’s life.  In such cases, it is important to lay out a comprehensive plan for the pet which his owners can implement in order to take into account their furry family members’ mind, body and soul.  This means addressing any medical aspects as painlessly and inexpensively as possible.  In addition, it means addressing the pet’s nutritional needs, reducing stress, and making sure the pet is receiving the highest level of love and interaction with his family.

Depending on the severity of the mortal condition a pet is dealing with, there is ALWAYS a way to deliberately and proactively make the final time he will have left in this world as worthwhile and joyous as it can be.  The important thing is to remember that you are NOT between a rock and a hard place but rather making a reasonable choice to provide the best end-of-life experience as you possibly can for your dog.  Once you make that choice, my opinion is that it was the RIGHT choice for you to make, so I suggest

you see the potential to spend the remaining time you have with your dog as a phase in which you are there for her when she needs you most.   I hope that as her condition progresses, you will be able to use some of what I’ve said – not only to make her feel better, but for you as well.  So in my mind and heart, I will now revise your signature to be “helping my pet when she needs me most”.  I think that is a much better way for you think of yourself.  Good luck and my best thoughts are with you now. – Dr. F

Dear Dr. Forsythe:  I have an 11-year-old dachshund that has ongoing pancreatitis and needs to be on medication frequently.  In fact, over the last year he had five or six different bouts of it and needed to be hospitalized every time.  I was wondering if there was any preventative you could suggest to decrease the frequency of his outbreaks.  It is very stressful when he gets sick with vomiting and my wife and I look at each other knowing it’s the pancreatitis setting in.  Any suggestions for our little boy?  We love him and wish we could prevent all his pain and suffering. – A.M, Oakmont

Dear A.M.:  Chronic pancreatitis is a difficult illness to cope with.  There are many causes, such as pets eating high fat food or human scraps, but there are also cases of idiopathic pancreatitis (no known cause for the disease).  Some pets have percolating, recurring bouts of this irritating illness, and it is frustrating that they seem to break out with sickness such as vomiting and diarrhea for no discernible reason.

I have a few clients with dogs that have a similar story to yours.  They find themselves staring at their pet just waiting for the dreaded clinical signs of pancreatitis to visit.  For cases like this, it is important to do as much as possible to prevent another outbreak.  Feeding a low fat food such as W/D by Hills can help, and avoid feeding any scraps at all.  In addition, your veterinarian may want to provide ‘pulsing” antibiotics year round.  An example of this would be prescribing two weeks of antibiotics, then one month off.  After the month off, start the antibiotics again and repeat this on and off pattern long term.  Several cases of prolonged recurring pancreatitis can be warded off somewhat successfully using this tactic.  Of course, many people (including veterinarians) detest the idea of filling dogs and cats with large amounts of antibiotics, and I understand this concern.  However, for clients who own a dog who suffers from this painful, life-threatening disease, this extreme type of medical management can be successful.  It may be something to consider chatting with your veterinarian about – especially considering all the misery your pet has had to endure.  I hope things improve and next year is healthier for him than the last.

– Dr. F.

Dear Dr. Forsythe:  My roommate just had a little Chihuahua given to him by a friend who got into trouble with the law.  “Andrew” is not sure how long he is going to be in charge of the little dog, but it looks like it could be up to a year.  The problem is that Andrew calls the little dog a she, but it is a male.  He also has different names for the little dog, including “Snuggles, “Riley” and “Snickers.”  At first I thought it was funny him calling the dog a “her,” but now I think it is kind of strange.  And can’t it be confusing for a dog to ever know who he is if the owner calls him by several different names?  I’ve told him my opinion, but Andrew hasn’t listened.  I was wondering if you agree with my concerns or not. – Roger W., American Canyon

Dear Roger:  I agree with you that it is a little strange to constantly refer to one’s pet using the wrong gender.  Hopefully you can point out the dog’s vital anatomy and really ask him why he thinks the dog is a “she.” In addition, I agree that using several different names for a pet is like rearranging the furniture by surprise at a blind person’s house.  Unless Andrew settles on one name and can develop some consistency with the pet, I suspect that “Snuggles” or “Snickers” will be getting the last laugh with trouble potty-training, obeying, and settling into the house.  Tell your ninny roommate to “notice the anatomy” and commit to one name.  Pets really don’t CARE if you refer to them as a he or she, but his ditsy-ness with this pronoun makes me question how focused he is as a pet caretaker.  I suggest you purchase a nice name tag for the little Chihuahua and present it to Andrew to help him take a step forward.  I hope the poor confused thing has a good year – and the little dog too!! – Dr. F

Dear Dr. Forsythe: Our border collie has gotten injured several times over the last few months. Every time she gets hurt, she is chasing a wild animal on the hill behind our property. She has gotten into fights with skunks, possums, and even a porcupine. We didn’t realize when we got her as a puppy that she would become a dog that attacks wild animals and gets into repeat scuffles all the time. I am worried about her and was wondering if this is normal behavior for a dog or is there something wrong with her? Also I should let you know she is great around other dogs and doesn’t so much as even bark. It is only when she goes out in the back yard that these incidents take place. What are your thoughts on this? How can we keep her out of situations like this without penning her up? – ML, Sonoma

Dear ML: Border collies are a wonderful breed of dog that have uncanny abilities and instincts that make them popular pets in homes and as herding animals on farms. It sounds like your dog is a wonderful pet but a switch goes on when she is out in the more wild terrain at your house. I do not think she needs to be “penned up” but I would recommend you keep her inside more hours of the day and consider putting a loud bell on her when you do let her out. Another solution may be for you to fence off your property to divide the recreational areas from the wild property above: if she can’t gain access to the area where the wild animals lurk, she won’t be getting into scuffles any more. I realize this is just a mechanical separation, but it would be better to change her surroundings and alter her lifestyle than to try and correct years of breeding and instincts. It is probably a simple protective instinct that makes her go into a predatory phase when she sees a possum or skunk.

Border collies are excellent at what they do, but I know of a few cases where the dogs have trouble separating “work from play.” I have one client in particular who owns and enjoys small herds of both goats and sheep. She is also the mother of seven children under the age of 10. The two border collies in her house do very well with the livestock, but they also take turns “herding” the children when they are all out playing in the back yard. I know this sounds amazing, but the dogs actually surround the large group of kids (several of whom are toddlers) and use their noses to gently “push” a wandering child back to the rest of the group while they are outside playing. This type of remarkable multi-tasking is not unusual for the breed. Your pet has a very strong predatory sense and is going after these animals in order to protect you and your family. I recommend you try the things I mentioned and please let me know if you need more advice

In addition, I want to recommend that with the presence of several wild animals in your vicinity, and skunks in particular, I would urge you to have your pet vaccinated for Leptospirosis. This is a spirochete bacteria that is spread in the feces and urine of skunks and other wild animals. The bacteria are zoonotic so it makes sense to consider including this in your dog’s core vaccine schedule. – Dr. F

Dear Dr. Forsythe: Please tell your readers about the dangers of feeding candy and chocolate to a dog. Our dog Suzi passed away last year eating a whole bag of candy with the wrappers. We knew it was because she ate so much Halloween candy that she got violently ill. The doctor told us her pancreas got infected and agreed it was most likely due to the sweets. It has been nearly a year, and our new puppy is never going to get any treats at all except for the ones made for dogs. We will never forget that day a year ago or how bad we felt when Suzy was in the hospital. Please tell your patients about this so they can be extra careful. – Ms. Amelie F, Petaluma

Dear Ms. Amelie: I’m so sorry about the loss of your Suzi and I appreciate your desire to warn others and prevent this from happening to their pets. Candy and treats are indeed very dangerous to pets – the chocolate contains an ingredient that is harsh on their liver and is very difficult to metabolize. In addition, many candies are high in fat which can cause a big shock to the pancreas and lead to a life threatening illness called pancreatitis.

Not only is Halloween a time for caution with pets, but so is Thanksgiving. Pets are often very susceptible to eating human foods such as turkey and gravy. There is a big surge in pancreatitis cases following festive holidays where families tend to gather for feasts. Although you learned a painful lesson about this disease, it has made you more cautious and probably a much better pet owner. Hopefully, after reading this column, people will be less apt to feed scraps to their pets or leave any candy or other human food in a place where the dog can get into it. And readers should also know to seek veterinary assistance quickly after they notice their pet has eaten something questionable; don’t wait until a pet becomes sick with vomiting or anorexia or diarrhea. Pancreatitis, as you know too well, can become very dangerous very quickly. All my best thoughts go out to you and your family, and your new puppy. I’m glad you have used this unfortunate experience to bring this problem to light. Kudos to you. – Dr. F

Dear Dr. Forsythe: My 89-year-old mother-in-law has had a female cat named Dolly for 17 years.  My husband says the cat has always had a problem with peeing in places other than the litter box.  This cat has ruined carpeting in my husband’s home, she ruined carpeting in my mother-in-law’s last home, and now the cat is peeing on the carpet in her new apartment here in Sonoma.  The smell of urine is so strong it burns my eyes when I go to visit, and it makes me sick to my stomach to be in her apartment for more than a minute or two

My husband is worried that his mother will be evicted due to this problem.  My mother-in-law loves Dolly but denies there is a problem and says she doesn’t smell it.  She is very protective of Dolly and doesn’t want us to take the cat to see a veterinarian.  The odor is so strong that it lands on her clothes, so I can smell it on her even out in public.  Do you have any ideas about what we can try?  My husband wants to steal the cat away from her and have it put to sleep.  We already know that carpet cleaning or replacement is going to be expensive.

Any suggestions you might have will be greatly appreciated.  Could there be a medical reason for this problem? Dolly cat is terribly obese as well, her stomach drags on the ground when she walks.  What can we do?  Many thanks for your advice. – J & J T., Sonoma

Dear J & JT: This sounds like a problem that needs to be dealt with swiftly but with sensitivity.  It seems as though Dolly has been such an important part of your mother-in-law’s life that she has adjusted herself to cope with the aberrant urination by living in denial over it.  Lucky for her she has a family to look out for her well-being.  Cat urine contains high levels of ammonia, and the sour, awful smell is really quite dreadful indeed.  If your husband is correct in saying that Dolly has had a urination problem for 15 years, that is about 14 years longer than I COULD HAVE PUT UP WITH IT!  Ordinarily, when a cat is peeing outside the box, we presume there is a bladder infection and this is causing the problem.  There are a few other differentials, such as bladder stones or F.L.U.T.D. (feline lower urinary tract disease).  But if the problem has persisted for so many years, I would be inclined to think that Dolly has a behavioral/stress problem that is interfering with her ability to potty correctly.  Once a urinalysis is done and your veterinarian has ruled out a medical issue, there are medications for cats that decrease stress and usually calms them down sufficiently to train them to use the litter box.  I would recommend a check up and let the veterinarian rule out a bladder infection and, once this is done, consider a “kitty downer” to help with the problem.

Although I can see that your husband is fed up and stressed out, I don’t think euthanasia needs to be done right away without the benefit of a urine test and medication.  However, I am not walking in you and your husband’s shoes: it must be very stressful and disconcerting to have a beloved elderly family member smelling like urine and living with that filth.  I urge you take action immediately so your mother-in-law can live in a cleaner, more sanitary environment.  It may be that Dolly has such a poor prognosis due to the chronic nature of the problem, and in this case euthanasia may be best for all concerned.  If this is the case, I suggest replacing Dolly with another cat very soon so your mother-in-law can pour her love into a pet.  Thanks very much and good luck with this complex issue. – Dr. F

Dear Dr. F: The problem I’m writing about is my son Doug, whose wife Edna cares more about breeding her Fox Terriers than being a wife.  Every time I go visit my son in Gardnerville, Nevada, their house is filthy and stinks something awful.  There are always eight to 10 dogs and puppies running around the house soiling where ever they please.  There are more dogs housed in wire cages in the living room, dining room and kitchen.  Edna says they are the “breeders” and insists that a messy house is a small price to pay considering how fabulous their dogs are.  Not to sound too picky, but Edith doesn’t even bother to run a brush through her hair anymore.  Whenever I visit, I feel so sorry for my son.  What do you think about people who get so caught up in their dogs that they let their house become filthy and no longer prioritize the important things in life.  The last time Doug had a home-cooked meal was during my last visit here, I assure you. – Patty Hanson, San Francisco

Dear Ms. Hanson: I’m afraid that you are shooting yourself in the foot by complaining about Edna so much.  While everything you say may be the God-awful truth, Doug is a grown man and I assume knew what he was getting into when he married her.  I agree that the situation you are describing sounds gnarly, and it is a shame that people let their breeding pets take over the home and hearth to the point of stink and filth permeating the entire area.  But people make choices, and some people are so crazy in love with their dogs that they really just don’t care about the conditions that most of us take for granted.  While I agree that it would be nice for Edna to brush her hair once in a while (and a little smattering of lipstick probably wouldn’t hurt either), you best play your role diplomatically and let the effect of the fabulous terriers run right off your back – if not, I assure you, it won’t be long before you are no longer invited to their house – since the dogs clearly come first.  Good luck navigating these tricky waters, but please do so with grace and humility, not pushiness or with lots of negative feelings. – Dr. F.