Dear Dr. Abbie: For the last two weeks, I have heard someone’s cat yowling out beyond my back fence. I don’t know whose cat it is. I keep mine indoors. Is there a cat deterrent I can use? – Hissing mad and losing sleep

Dear Hissing mad: I know what you mean! I hate being woken up in the middle of the night! The cats you hear are probably feral cats. They don’t belong to anybody. They belong to everybody. I prefer to call them community cats. Like any good euphemism, community cats sounds friendlier, less threatening and more inclusive. But make no mistake, these cats are not friendly, so don’t try to pick one up!

The cats are just doing what the warm weather and longer days are telling them to do. Breed. Cats are really noisy about it! First there’s the boxing match between males with its yowling and scratching and rolling around. After mating, the female will scream because the male’s penis has barbs that point toward him. Ouch!

There are people who can help you get a good night’s sleep. Pets’ Lifeline in Sonoma has a feral cat program. The phone number is 996.4577.  Sonoma County Animal Services also has a voucher program for spays and neuters.  The website is Sonoma-county.org/shelter.

Good luck!  – Dr. Abbie

Dear Dr. Abbie: We adopted a spayed dog a few years ago. Lately she seems to be swollen ‘down there’ and licks herself a lot. Does she have a yeast infection? We’ve noticed a stray dog around our house lately. He is really pushy, and it scares her as much as it does us! – Angelina’s mom

 Dear Angelina’s mom: Unfortunately for you, Angelina’s big lips are an attractant to male dogs. Actually, it’s the pheromones emanating from said swollen lips that will bring a male dog from miles away. On occasion, a tiny bit of ovary is left during a spay procedure. Over time it will grow to secrete enough estrogen and progesterone to create signs of heat in supposedly spayed females.  Your vet can take a blood sample and have the laboratory check her hormone levels. She may need exploratory surgery to find that bit of leftover ovary.

Licking can cause or worsen a skin infection, so either way, she needs relief whether it’s from yeast or stray males. It’s the male that has the itch so no wonder she’s scared! Angelina will need to see your vet soon, before someone else’s male dog gets run over trying to get her and sues you for damages! But after that troublesome speck is removed, Angelina will be able to live in spayed peace for good. – Dr. Abbie

Dear Dr. Abbie:  We just went to a cabin in Tahoe for a nice little vacation and got eaten alive by fleas! We got our money back, but now we are afraid our dog will infest our house. Help! – Creeped out

Dear Creeped out:  Parasites have it all figured out. They will be here long after the world’s oil reserves have been depleted and we will no longer be able to drive our SUVs to the nearest Starbucks. You need flea birth control!

Like most insects, fleas go through metamorphosis. But, the adult fleas we see are only about 5 percent of the population.  The other 95 percent are “flea children,” just lurking around waiting for you or your dog to breathe. Adult fleas are killed with monthly topicals. Topicals are often enough for animals with low flea exposure, so if you are using a product like Frontline, and don’t see fleas, then topicals are enough. But to control an infestation you need insect growth regulators (IGRs).  Insect growth regulators prevent the eggs from developing into larvae, but nothing short of a hand grenade kills the pupae.  Pupae are hard, sticky shells (hard to vacuum up) containing a small, hungry adult flea ready to jump out and get a blood meal. They can actually detect the small amounts of carbon dioxide in mammals’ breath. They hatch and jump, in the blink of an eye, onto whoever just exhaled.  An insect growth regulator (IGR) is the birth control you need to prevent a flea infestation in your house. Your vet will be able to advise you which one is appropriate. Your pet may need an oral insect growth regulator.

Next time you go to a nice cabin in Tahoe, just hold your breath the whole time and the fleas won’t be able to find you! – Dr. Abbie

Dear Dr. Abbie:  Our dog Harley is getting old, and we would like to prepare for his end of life. We will be heartbroken when he goes. My mom had hospice, is there hospice for pets? – Harley lover

Dear Harley lover: Your concern about Harley’s end of life planning shows just how much he means to you. We all wish for a peaceful passing in the arms of our loved ones.

People working through a pet’s dying process need 24 hour a day support from veterinary staff and grief counselors trained in hospice for pets. It is important to realize that the natural dying process can take over a week once an animal stops eating, and not feeding a pet for that long is antithetic to the way we think about caring for our pets. This is not an endeavor to attempt alone. It is very important that the pet’s need for comfort be held at the forefront, and for the family to be in agreement with this choice. This route must be well planned out with a veterinarian knowledgeable about pet hospice.

Pet hospice is a movement that is beginning to take hold, and more veterinarians are starting to provide hospice services. The Nikki Hospice Foundation was founded to help pet parents and veterinarians find ways to support end of life care for animals that reflects, at the end of their days here, the magnitude of love they have given us. The website is pethospice.org.  – Dr. Abbie

Dear Dr. Abbie: We just got a new puppy a few weeks ago. When we got him his shots, the vet said we needed to start brushing his teeth. We never did this with our old dog. How do you brush a dog’s teeth? – Chewy’s Mom

Dear Chewy’s Mom: There are so many things we do with our pets now that we never used to do in the good old days, and teeth brushing is one of them.

The pet industry is now a two billion dollar a year industry.  Our dogs now have special beds, and different foods depending on their breed. We can have matching outfits, and Fifi just has to have a new collar and leash for every holiday.  Veterinary medicine has improved so much recently, also. One of the areas of improvement is in oral care for pets.  Brushing is the best way to keep your pet’s teeth pearly white, along with twice yearly check-ups at the vet.  I wonder what would happen to dogs’ health if people spent money on getting their dog’s teeth cleaned at the vet instead of new collars, leashes and beds for every season.

The American Veterinary Medical Association has a great short video about how to introduce the toothbrush to your pets. Here is the link: http://www.avma.org/animal_health/npdhm/default.asp

Like any new activity not innately addicting like cigarettes or TV, it takes about a month of regular practice for the routine to become a habit.  Remember those New Year’s resolutions? – Dr. Abbie

Dear Dr. Abbie: Our groomer does teeth cleaning for dogs. It is way less expensive than what our vet charges. Why can’t I just take our dog to the groomer for his teeth cleaning? Signed, Allegra’s Mom

Dear Allegra’s Mom: Thanks to you both for asking dental related questions during Dental Health Month! But let me ask you… Do you get your teeth cleaned at a hair salon? No, you go to the dentist and the hygienist cleans your teeth while the dentist is in the office. A dentist attends universities for at least eight years to become licensed to take care of people’s teeth and gums. The licensed dental hygienist needs college for two years. If you did not have dental insurance, this service would cost around $200.

Clinical research in people shows that regular dental care improves human life. You get to keep your teeth for eighty some odd years, and hopefully, the dog is not the only one still willing to kiss you. If your stylist did your teeth? You want teeth lightened, and they came out orange?  An up do? Feathers, anyone?

Seriously, your groomer is not licensed to perform veterinary medicine, and teeth cleaning is considered a veterinary procedure. Veterinarians, like ‘real doctors,’ go to universities for eight years or more earning a license to help keep your pet healthy, or intervene medically or surgically when needed.  Many veterinary technicians are also licensed. A botched hairdo can make a person very unhappy, but botched dental work? Even worse.  Thanks for writing.  – Dr. Abbie

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