Monthly Archives: September, 2013

Potty Talk by: Dr. Melissa Roth – North Charleston, Emergency

Potty Talk

“The cat peed where?  On the new couch!  Is she trying to tell me something-do I need to come in?”  This sentiment, or variations of it, has been heard by almost every practicing veterinarian at one point in time.   If one incident has occurred, it is possible that it was a true accident.  However, if your feline friend has changed up his or her bathroom habits this may warrant some investigation as this may be a clue to a lurking underlying issue.

Signs to watch for include straining to urinate (which can be confused with straining to defecate), urinating in small bursts, urinating outside of the litter box, licking at the genital region, and pink/red tinged urine.  If any of these signs are noted, it is important to contact your local veterinarian.    Possible causes for these signs include (but are not limited to) urinary tract infection, feline idiopathic cystitis (inflammation of the urinary tract), urinary stones, other illness (for example diabetes, kidney disease) behavioral causes, etc…

Depending on what your veterinarian finds, further work up and/or treatment may be indicated.  If your veterinarian suspects your kitty may be having some anxiety in the home, there are some things you can try to help make life easier on your little one (and you).

1)      The Golden Rule of the litter box:  you should have one litter box for each cat in the home plus one.  For example, if you have one cat, you should have two letterboxes.

2)      Do not place the letterboxes side by side, this effectively creates one large litter box.  If need be, they can be in the same room, but try to have as much space between them as you can.

3)      Try an uncovered litter box.  Although covered letterboxes can be nice for us (we do not have to view the contents of the box, the smell is reduced, etc…) it can be not so welcoming for your cat (when was the last time you enjoyed a porta-potty?)  If your cat is a kicker of litter, try purchasing a large, clear plastic tub and cutting a door into the side of it.  If the cut sides are rough, try placing tape or fabric over the edges so your kitty does not hurt themselves.

4)      If you are lucky enough to have multiple stories, please keep a litter box on each level of your home.  Also, try to not place impediments like baby gates in the doorways to rooms where the litter box is contained.  Although this may keep out other pets or children from the litter box, it may also be making the litter box a hard to reach place for your kitty.  Especially if they are overweight and/or are suffering from arthritis.

5)      Try keeping the litter box in low traffic zones.  Places like the laundry room may be convenient for us, but it can be loud and uninviting for our feline friends.

6)      Some kitties are very fastidious about their litter box.  Try scooping their litter out 1-2 times a day and cleaning out the entire litter box once per week.   Try staying away from heavily performed products as this may be off putting to your kitty.

7)      Try a little pheromone help.  Feliway is a synthetic pheromone that has been shown to reduce anxiety in the home.  Luckily for us, it can be found in most large pet stores and online.   The plug in diffuser can be used in multiple rooms and the effects last for roughly 30 days.

8)      Clean up on aisle 5!  Clean up urinary accidents with enzymatic cleaners to make sure there are no products of urine left behind to entice your little one to keeping urinating in the same spot.  Options include Nature’s Miracle, Anti-Icky Poo, and Urine Away.  Try your local pet store or online.

9)      Try picking up/blocking items that your cat seems to be targeting with their urine.  Favorites of kitties can include laundry (clean or dirty), bath mats/towels, and your bed (try shutting your bedroom door).

10)   Make sure your kitty has hidey holes galore!  This may include cat trees with hiding areas or something as simple as paper bags (never plastic).

11)   Get your play on!  Laser pointers and other cat friendly toys are available at your local pet stores and online.  Please visit for play recommendations and other tips for your inside cat.

12)   Always keep in touch with your regular veterinarian.  If the abnormal bathroom behavior continues or other signs of illness arise, it is important that the situation be addressed as early on as possible to ensure your cat’s well being.

13)   At any time you are unsure if your kitty is urinating, they look weak/lethargic, their behavior has changed (they were once very friendly and now they are hiding constantly or vice versa), your kitty vomits, or otherwise appears ill, please treat this as an emergency situation.  A blocked cat can be seriously ill within hours and they can unfortunately pass away due to this condition.

With our busy schedules it can be easy to put off visiting the veterinarian for urinary accidents.  However, for the best outcome for you and your furry friend, it is always best to tackle the situation at the onset.  Hopefully, it may be a simple issue that can be resolved quickly and efficiently, and if not, your prognosis is almost always likely to have improved by early diagnosis and treatment.  Listen to your cat, they are telling you something, but it is up to you and your veterinarian to figure out what that is.


When should you call the emergency clinic?




While attending the Pet Expo last weekend, Dr. Henri Bianucci and I (Dr. Perry Jameson) held a question-and-answer session and met a lot of you and your pets.

One of the questions that came up frequently was “when should I get worried and call your emergency clinic.”

This is a great question, and I have compiled some guidelines to help you.

Many of these are obvious, but others are more subtle but can indicate severe underlying problems. By being proactive, we can often prevent complications from developing.

1. Bleeding.

OK, this one is obvious. If your pet is bleeding, take the time to assess the severity of the bleeding. Is it a significant volume? Did it stop on its own after 1-2 minutes?

Small lacerations can be monitored at home as long as the bleeding stops within several minutes.

Bleeding from the nose, mouth, vomiting with blood, skin lacerations and blood in the stool (fresh or dark tarry stools) are all emergencies. If the bleeding persists, it should be evaluated.

2. Broken/trauma.

Another obvious one if you actually see the traumatic event (hit by car, etc.) or if you can tell that something is broken, but sometimes all we see is lameness.

If your pet is in pain and holding up a limb and not placing any weight on it, you should have them evaluated.

3. Blue/respiratory distress.

Sometimes it can be difficult to tell the difference from panting and respiratory distress. Here are a couple of clues to help you.

Look at their gums: If they are grey, pale, or blue, this is an emergency. If you pet is extending its head/neck or open mouth breathing, this is an emergency.

Watch the pattern of breathing: If there is abdominal effort to the breathing or the respiratory rate/effort does not improve with rest, you should call the emergency clinic.

4. Collapse/weakness/ seizures.

Collapse can be due to many causes and several can be life threatening such as bleeding into the abdomen or an arrhythmia. Sometimes, acute weakness is the only sign we see.

Seizures also can be due to many causes such as low blood sugar, liver disease, toxins, and primary neurologic diseases to name a few.

A physical examination and basic blood work can help determine how to treat the signs and what other diagnostic tests need to be performed.

5. Foreign body ingestion.

The sooner these pets are brought into the emergency clinic, the more treatment options are available. For some objects, we can induce vomiting or perform endoscopy to remove the object. Once the object is in the small intestine, surgery is required and this equates to a more invasive procedure and greater expense. If you see your pet eat something it shouldn’t, don’t wait to see if it will pass. Call the emergency clinic.

6. Toxin exposure/snake bite.

Again an obvious one. Toxins (plants such as sago palm and lilies, anti-freeze, rat bait) all have the potential to be deadly. If you know of ingestion or even suspect possible ingestion, do not delay. Seek emergency help as soon as possible. Snake bites are common in this area and can also be deadly. Anti-venin can be administered within the first four (and possibly up to 72) hours in an effort to decrease the severity of the effects of the venom.

7. Inability to urinate/ defecate.

This is probably one of the most difficult signs to notice if your pets are allowed out a dog door or are indoor/outdoor cats. Signs you might notice in the house are lethargy and hiding. Sometimes if you feel your pet’s belly, they might seem uncomfortable and “full” back toward the rear of their belly.

These signs should trigger you to monitor the urination/defecation habits and call the emergency clinic. Unproductive straining or frequent attempts to posture to urinate/defecate should be evaluated by a veterinarian.

Cats in particular can develop stones, crystals, inflammatory debris, or mucous plugs that if go unnoticed, can be life threatening … not to mention uncomfortable.

8. Unproductive vomiting.

With 6 pets in our house, vomiting is a weekly occurrence. We typically don’t worry about it unless it is frequent (daily or several times within a day), contains blood or if it is unproductive. Unproductive heaving can be an indicator of bloat. This is a life-threatening condition in which the stomach distends and twists. Surgery is often needed to correct the twisted stomach.

9. Swollen abdomen.

Some causes of a distended abdomen are due to loving our pets with food (obesity), but others can indicate a more sinister underlying problem. Acute changes in the distension of the belly (especially in combination with weakness or lethargy) can be due to a bleeding mass or heart failure and should be evaluated.

10. Ocular changes.

Squinting, tearing, trauma to the eye, an enlarged eye, cloudiness to the eye and ocular pain are all considered emergencies. While some of these changes can be simple to treat such as a superficial ulcer, others can indicate more severe disease such as glaucoma, a corneal perforation or an underlying systemic disease process (cancer, autoimmune disease, etc.).

11. Reproductive issues.

If your pet is pregnant and having strong abdominal contractions for 45-60 minutes without producing a puppy/kitten or weak and infrequent contractions for 4-6 hours without producing a puppy or kitten, this is considered dystocia and is an emergency. If your pet has a puppy or kitten stuck in the birth canal or is in pain, you should call the emergency clinic.

Hopefully, these tips will help you decide when you need to contact the ER, but the bottom line is that if you are worried in any way, please contact your veterinarian or the closest emergency clinic. The veterinary technicians and doctors will be able to give you advice and let you know if you need to come in.

Small dog – big problem by Nora Schmidt, DVM

Many of us get very excited when we head to a breeder or pet store to pick out a toy breed puppy to adopt – be it a yorkie, maltese, toy poodle, chihuahua or other variety. Loving, cuddling and caring for such a tiny, helpless creature brings out the nurturing instinct in all of us. Many breeders adopt these tiny puppies out at 5-8 weeks of age, when they weigh only one to two pounds. What people don’t realize is just how fragile these little pups are and how demanding their metabolisms are at this stage. A toy breed puppy needs to eat a high-quality puppy food every few hours in order to keep its blood sugar level up. If this puppy were to miss a meal or lose nutrients because it is vomiting or having diarrhea, its blood sugar would most likely drop to a critical level very quickly. This drop leaves us cradling a very weak, tired, floppy puppy in our arms. Sometimes this can progress to wobbly movement and even seizures. We rush to the car and drive to the nearest veterinary clinic.
Upon arrival at the veterinary clinic, our fading puppy will have its blood sugar checked, which only requires one drop of blood. When the blood sugar is found to be low, which is known as hypoglycemia, an IV catheter will be placed and an injection of dextrose (a type of sugar) will be given intravenously. If our puppy has been vomiting, having diarrhea or not eating, the veterinarian will run the appropriate diagnostics in order to be able to treat our pup successfully.  Any sick puppy or weak, tired puppy should be brought to the nearest veterinary clinic immediately.
People often ask what they can do for their tiny puppy when it is fading at home since feeling helpless to assist those we love is a terrible feeling.   If a toy breed puppy or dog ever appears weak and tired or wobbly, their owners can rub some corn syrup on the pup’s gums. This small amount of sugar should be enough to help stabilize the pup’s blood sugar for the short ride to a veterinarian’s office. If the puppy is sick or won’t eat, it should be brought to a veterinary clinic immediately. However, if a healthy pup has missed a meal but is interested in eating, it should be fed right after the corn syrup is rubbed on the gums. A good meal should hopefully help resolve the hypoglycemia.  There is also a product, Nutri-Cal, which is a nutrient-dense paste. Nutri-Cal is a must-have for anyone with a toy breed puppy as it can be applied into the pup’s mouth when a nutrient boost is needed.
Ideally, toy breed puppies should be adopted out to new homes at twelve weeks of age. At that age, they are more able to stabilize their own blood sugar, though the risk of hypoglycemia still exists. Regardless of what age a toy breed puppy is, a few simple rules should always be followed. Always make sure they are eating frequent, high-quality meals. Have corn syrup and Nutri-Cal at the ready in case of emergencies. And always make a trip to the vet immediately if the pup shows any signs of illness, including vomiting, diarrhea, inappetence or weakness. Adhering to these rules will help you and your toy breed pup spend many happy years together.