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