The Animal Medical Center of Seattle (AMCS) and Animal Surgical Clinic of Seattle (ASCS)

There is a growing trend in veterinary medicine in this country for practices to be owned by large corporations. In fact, one corporation known primarily for its candy brand now owns most of the large specialty referral centers in our area, and a huge number of specialty centers and private practices across the US. A notable exception is the Animal Medical Center of Seattle (AMCS) and the Animal Surgical Clinic of Seattle (ASCS). These two referral clinics are still privately owned and share a large modern veterinary facility in Shoreline.

The AMCS provides 24 hour emergency services, and has board certified specialists available for internal medicine and oncology referrals. The ASCS is staffed with board certified veterinary surgeons that perform advanced surgical procedures by referral.

Dr Ken Sinibaldi, the original  founder of the ASCS, actually leased space at Eastlake Veterinary Hospital for three years while building the original surgery facility on Stone Way. The AMCS was founded in 2009 by Dr Adam Reiss when the new surgery/emergency/referral center was built in Shoreline.

For over thirty years we have referred to the skilled surgeons at ASCS, and we have utilized the equally skilled emergency clinicians, internists, and oncologists at the AMCS from its inception. The board certified specialists in both clinics have gone out of their way to help our doctors care for our client’s pets, frequently taking time out of their busy schedules to counsel us by phone on difficult cases. Both the ASCS and the AMCS have provided quality continuing educations for our doctors and technicians as well. I find it refreshing to have such a good relationship with both of these clinics, and encourage our clients to utilize their emergency and specialty referral services if the need arises.

Carl D Anderson, DVM

Eastlake Veterinary Hospital

February Dental Month!

It’s that time of year again! Receive a 15% discount when you schedule your pet’s dental cleaning during the month of February.

Why is it important to have my pet’s teeth cleaned?

In veterinary dentistry our main concern is the health and comfort of our patients.  As with people, studies in dogs have shown a correlation between periodontal (gum) disease and internal organ dysfunction. The fact is that periodontal disease can have significant negative health consequences in dogs and cats. In the early stages of periodontal disease, teeth cleaning and subsequent care at home may be all that is needed. In late stage periodontal disease extraction of diseased teeth may be the best option. It is important not to ignore fractured teeth as these will invariably abscess and cause discomfort. Treatment of fractured teeth involves either root canal therapy or extraction.

In human dentistry existing problems can be easily diagnosed with the patient awake. Thorough exams and x-rays are performed prior to performing any procedures. In veterinary dentistry a really thorough exam including dental x-rays cannot be accomplished until the patient is under anesthesia. So, the dental cleaning (prophylaxis) is both a diagnostic and treatment modality in dogs and cats.

There are those who recently have been advocating teeth cleaning in dogs and cats without the benefit of general anesthesia. Dr. Greg Dupont, a local board certified veterinary dentist and past president of the American College of Veterinary Dentistry, describes this as “no more than tooth grooming with no appreciable health benefit to the patient.” Also, anesthesia allows an endotracheal tube to be placed to prevent inhalation of particles dislodged during scaling.

What happens when my pet has a dental procedure?

Since dental procedures in dogs and cats are performed under general anesthesia, you will have the option of a preanesthetic blood test; in pets ten years of age or older the preanesthetic blood test is standard. The next step is the administration of a preanesthetic medication to relax the patient. After this an IV catheter is placed and an injection is given to induce anesthesia. An endotracheal tube is then placed in the windpipe to assist breathing and administer gas (isoflourane) anesthesia. IV fluids are started and in many cases an intravenous antibiotic may be given. Anesthesia is monitored carefully during the entire procedure.  Pulse oximeters to measure oxygen saturation, and dopplers to assess blood pressure, are utilized in this regard.

The first step in the dental cleaning is to remove large gross calculus or tartar if present with a forcep. Calculus or tartar is mineralized plaque. Plaque is that sticky film which adheres to your teeth consisting of saliva, food particles, and bacteria. In the final analysis it is plaque that causes periodontal disease. After gross calculus is removed, the remaining calculus and plaque is removed using both a high speed ultrasonic scaler and hand scalers as needed. The most important area to address for your pet’s health is under the gum line. This is the primary reason that dental cleanings in dogs and cats are performed with sedation.

After the teeth have been cleaned the mouth is thoroughly examined. In rare cases oral tumors are discovered during routine dental cleanings. The teeth are evaluated for fractures, malocclusions, and periodontal pockets. Deep pockets around the teeth indicate significant periodontal disease. Dental radiographs using our Schick digital dental x-ray equipment are taken as needed. Sometimes an x-ray will be taken just to evaluate how much bone is being lost around the teeth due to periodontal disease. Generally speaking, problems discovered are addressed with the owner’s consent at the time of the dental cleaning. This avoids the expense of additional anesthetic procedures.

Finally, the teeth are polished to smooth the tooth surface and a dental sealant is applied. The purpose of this is to slow the rate of plaque and calculus accumulation in the future. In dogs we dispense Oravet Sealant Gel to be applied weekly at home. This sealant alone will reduce plaque accumulation by 40%! When your pet is discharged in the late afternoon further instructions will be given regarding strategies to prevent disease recurrence. These may include brushing, special diets,  dentifrices, specially formulated chews, and others. If extractions or oral surgery have been performed we will dispense an analgesic (pain) medication to make your pet comfortable during the healing process. Additionally, oral antibiotics may be prescribed for a week or so.

To set up an appointment for a dental cleaning please call our office. If we have not examined your dog or cat within the last six months a brief predental exam may be recommended. At this visit any appropriate preanesthetic tests can be performed as well as an approximate estimate of what will be done during the procedure. We are looking forward to hearing from you regarding this important health issue for your dog or cat.

Canine Atopic Dermatitis Therapeutic

Canine atopic dermatitis is a very common allergic skin disease in dogs. In fact, some dermatologists estimate that up to one third of the dog population is affected. The primary symptom of atopic dermatitis is itching which can result in hair loss and skin infections and reduced quality of life. Like hay fever, atopy is triggered by seasonal pollen and other airborne allergens.

Canine Atopic Dermatitis Therapeutic (CADI) is a new therapy introduced by Zoetis that helps reduce the itching in atopic dogs. It is a monthly antibody injection that mimics the dog’s immune system to help neutralize the main cause of itching in this population of dogs.

In a study of CADI it was found to reduce itching within one day after a single injection, control itching for a full month, and improve skin condition caused by atopic dermatitis.

I recently treated Tess, my 10 year old German Shepherd with chronic atopic dermatitis, and the response has been amazing. She has not been this itch-free and this comfortable in years.

Carl D. Anderson, DVM

Should I Spay or Neuter my Dog and If So, at What Age?

I recently attended a seminar put on by the WSVMA on this topic. The panel of speakers included two boarded veterinary surgeons, one boarded veterinary behaviorist and one veterinary reproductive expert. At the end of the day I realized there are no easy answers to these questions, and the decision as to when or whether to spay and neuter needs to be an informed decision made by the dog owner.

Here are some facts which came to light during the discussion. Keep in mind that the knowledge in this area is based on retrospective studies, some of which have a limited sample size.

  1. Dogs that are spayed or neutered generally live longer. Of course it may not be that the spaying or neutering is causing the increase in longevity. It could be that dogs that spayed or neutered dogs, on average, receive better care during their lifetime.
  1. Certain cancers are more common in dogs that are spayed or neutered. Examples are bone cancer, hemangiosarcoma, lymphoma, transitional cell carcinoma, and mast cell tumors. The incidence of these tumors is somewhat breed related. For example, osteosarcoma in the general dog population has an incidence of 0.2%, but in Rottweilers and other large breeds the incidence is much higher. So in Rottweilers a 2-3 fold increase in incidence off osteosarcoma due to spaying or neutering is much more significant than it is in the general population. Some of the findings for specific breeds are complex. For example, the incidence of hemangiosarcoma in Golden Retrievers spayed after 12 months of age is 4 times that of unspayed females or females spayed prior to 12 months of age.
  1. Mammary (breast) cancer is almost eliminated if spaying is done prior to the first heat cycle and is significantly reduced if performed prior to the second heat. Dogs spayed after the second heat have a 26% chance of developing mammary neoplasia during their lifetime, and 50% of these are malignant. Compare this to the low incidence of osteosarcoma which is 0.2% of the general population. A 2-3 times increase of a very low incidence cancer is still rare.
  1. It appears that there is a greater incidence of orthopedic disease in spayed and neutered dogs. The most common conditions affected are cranial cruciate ligament injury (CCL) and hip dysplasia (early arthritis of the hip joint). Most of these studies compare dogs spayed or neutered before 5 months of age to ones spayed or neutered after twelve months of age. It is felt that waiting to spay or neuter until after the dog is finished growing should reduce the negative effect. However, it is not clear when exactly the growth plates close. In general it is felt that in small to medium breeds the growth plates close prior to a year of age, but in large breeds it could be over a year.
  1. There appears to be no real health advantage to neutering male dogs except preventing certain forms of prostate disease. Prostate cancer is higher in neutered dogs. There may be some behavior benefits to neutering but one study indicated that early neutering is associated with certain behavioral problems e.g. separation anxiety, aggression.
  1. Spayed and neutered dogs appear to be at an increased incidence of hypothyroidism and other immune mediated diseases.
  1. Spayed dogs have a greater incidence of urinary incontinence. This is particularly true when spaying is done prior to three months of age.
  1. Uterine infection (pyometra) has a significant incidence in dogs that are not spayed. It is estimated that close to 23% of unspayed female dogs will develop pyometra by 10 years of age. And pyometra is a life threatening condition that requires early intervention.

In summary, it appears that the incidence of many cancers with a low incidence are increased by spaying and neutering, and one form of cancer (mammary cancer) with a high incidence is increased by failure to spay prior to the female’s second heat cycle. Unspayed dogs have a high risk of developing a life threatening uterine infection.

Spayed and neutered dogs may have an increased risk of developing certain immune mediated diseases, e.g. hypothyroidism. There are conflicting reports in the literature regarding the effects of spaying and neutering on behavior, but some studies indicate an increase in certain behavior problems in dogs spayed or neutered prior to 6 months of age. Other studies indicate that neutering male dogs may help with certain behavioral problems such as aggression, urine marking, and mounting behavior.

So there is really no clear cut answer. One of the panel participants, the reproductive expert, recommended ovarian sparing hysterectomies for female dogs and vasectomies for male dogs. But the ovarian sparing hysterectomy is a complicated surgery and does not address the mammary cancer issue, and there are frequently problems related to vasectomies in male dogs.

Several of the panelists felt the best summary article in this area for clients to read is “Determining The Best Age At Which To Spay of Neuter” by Margaret Root-Kustritz, DVM, PhD.

The conclusion of this paper reads:

“For female dogs, the high incidence and high frequency of mammary neoplasia, and the significant effect of spaying on decreasing its incidence make ovariohysterectomy prior to the first heat the best recommendation for non-breeding animals. The demonstrated increase of urinary incontinence in bitches spayed before 3 months of age and the possible effect of CCL injury in bitches spayed before 6 months of age, suggest that spaying bitches after 6 months of age but before their first heat cycle is most beneficial. For bitches of breeds predisposed by ovariohysterectomy to highly malignant tumors and for breeding animals, spaying at a later age may be more beneficial.

For male dogs, castration decreases incidence of disorders with little health significance and may increase incidence of disorders of much greater health significance. For non-breeding animals, evaluation of breed and subsequent predispositions to disorder by gonadectomy should guide when and if castration is recommended.”

Carl D. Anderson, DVM