Quality of Life and Euthanasia

The Decision

piggie10When a pet owner and a veterinarian decide that a pet’s health is failing and their quality of life is poor, the possibility of putting them to sleep (also called “euthanasia”) may be considered. Whether this is a decision arrived at gradually as a pet’s health declines with age, or suddenly in the event of catastrophic injury or illness, the choice is never an easy one to make. Our goal is to help you understand how, when, and why we may consider euthanasia when it is beyond our ability to keep an animal comfortable and feeling well.

How do we decide when an elderly pet whose health has been in decline is finally having so much trouble that euthanasia should be considered? Every pet’s situation is different, and there is no single answer that applies to every owner’s choice. Here are a few things that may be taken into consideration:

1. “Three Favorite Things” – What were your pet’s three favorite things to do when they were well and in optimal health? Can they still do at least one or two of these things? If not, their quality of life is in decline, and it may be appropriate to consider euthanasia.

2. Basic Needs – When a pet can no longer urinate and defecate easily, if they cannot easily access food or water when they need it, if breathing is difficult with minor exertion, and if they cannot rest comfortably, these are serious factors to consider when evaluating their quality of life. Not all pets will necessarily stop eating when they are very ill, but a complete loss of appetite would be a strong indication that the pet is uncomfortable. Furthermore, if a pet seems to be losing interest in what is going on around them, their quality of life is declining.

3. Your Ability to Provide Care – An owner who is retired and can spend all day tending to the needs of a sick or elderly pet is in a very different situation than a person who works ten-hour days and cannot assure their pet is comfortable and well attended-to at home. While some owners hesitate to consider their own needs when deciding what is best for a pet, it is appropriate to consider what you will be able to practically handle at home.

The Process

When facing a stressful situation, it often helps to know what to expect. Some owners make an appointment to discuss their pet’s quality of life with a doctor as they begin to consider putting an animal to sleep. Others are already certain that euthanasia is the best course of action in their situation. In either case, a pet owner will have the opportunity to speak to the veterinarian before making a final decision.

badeau4Different veterinarians and different veterinary practices may have slightly different protocols and preferences in terms of which medications are administered for euthanasia. Sometimes, an initial medication dose is given to help an animal feel calm and relaxed, or even completely asleep, before the euthanasia drug is given. This drug which directly causes death is a barbituate given at a high dose (at a low dose, a barbituate would cause sedation). In simple terms, this drug causes the pet to fall asleep and then stops function of the heart and lungs. The veterinarian will give this drug via a needle or catheter into a vein, wait a few moments, then listen to check that the pet’s heart has stopped. Sometimes an animal will take a few last deep breaths or experience some muscle twitching after they have passed away. These are just the effects of the body’s cells losing oxygen after death, they are not anything the pet feels or is aware of.

When a pet is deceased, the owner may choose to have them cremated or take their remains home for burial. Bolton Veterinary Hospital works with a reputable pet cremation service, Inserv. A pet’s cremated remains may be returned to the owner, or alternatively left with Inserv (the company scatters the ashes in an environmentally friendly manner on a Long Island property). An owner who chooses to have their pet’s ashes returned to them may also choose to have a clay imprint of their pet’s paw made as a keepsake.

All of us in the veterinary profession have been in the position of having to decide whether it is time to say goodbye to a pet whose health is failing. We know how difficult this decision is, no matter the circumstances. It is quite normal for a pet owner, and even other pets in the household, to experience a grieving process after the loss of a pet. We have provided a series of resources for grieving pet owners below.


The Pet Loss Support Page – http://pet-loss.net/

The Pet Loss Support Hotline – http://www.vet.cornell.edu/org/petloss/

Books on Pet Loss and Grieving – http://www.petlossathome.com/pet-loss-books/

Inserv Pet Crematory – http://www.inservcorp.com/

Cremated Remains, Claw Paws, and Urns

Quality of Life and Euthanasia – View/Print as PDF

Feline Nutrition: The “Carnivore Connection”

Have you ever considered the differences between dog food and cat food? Or the differences between what our pet’s ancestors would have eaten, and what we feed them today? There is no species to whom this matters more than our feline friends. Both dogs and cats prefer to eat predominantly meat, but a cat’s physiology is quite different than a dog’s. Cats are considered “obligate carnivores,” meaning they would rely almost exclusively on eating prey, not plants, in their evolutionary setting. Dogs, by contrast, are more omnivorous, and can more readily use both plant and animals sources of nutrition. Cats’ evolutionary past sets them apart in a variety of ways, and this has important consequences for what we should feed them today.

What Wild Cats Eat and Why It Matters

brianacat11A wild cat’s prey would be predominantly rodents and small birds. These are food sources high in protein, with moderate levels of fat, and very few carbohydrates. Cats require two to three times more protein than omnivores, and a kitten’s requirement is even higher. Protein and fat are used as a source of energy, to synthesize new proteins, rebuild cells, and carry out all of a cat’s normal biochemical functions. If a dog is fed a diet low in animal protein, it isn’t a critical problem; dogs, humans, and other omnivorous species can synthesize the proteins they need from plant sources and their metabolism can adapt to what is available. Cats are not able to do this, and illness will result from a severe or long-standing deficiency. It isn’t just the lack of protein that presents a problem; an overabundance of carbohydrates may contribute to obesity, diabetes, osteoarthritis, urinary tract disease, liver disease, and skin conditions.

Cats’ unique nutritional needs do not end with protein. They also have a greater need for a variety of B vitamins, as well as vitamins A and D. Healthy cats rarely run into trouble with this, but a deficiency can develop quickly if a cat stops eating.

Prey is also a major source of water for wild carnivores. Cats are evolutionarily a desert species, and as a result they do not readily feel thirsty when they are becoming dehydrated. Research has demonstrated that a cat eating kibble takes in 50% less water in the course of a day than a cat who eats canned food. Cats who eat predominantly kibble may spend a significant portion of their lives dehydrated, constantly putting a strain on their kidneys.

So, What Should We Feed?

Pet food companies might have you believe that a “grain-free” diet is a “carb-free” diet. This is not the case. Carbohydrates are still present in all kibble diets, and in many canned diets too. A carbohydrate is necessary to form a kibble (trying to make kibble without a carbohydrate source is like trying to make a pancake with only eggs, milk, and oil). So how does the pet food manufacturer manage this? An alternate carbohydrate source such as potato flour will be used. It’s not a grain, but it’s still a carbohydrate! A carbohydrate source will ALWAYS appear somewhere on a dry food ingredient list, but a canned diet can be made truly carb-free. Paté-style canned foods are typically lower in carbohydrates compared to chunks-and-gravy style foods.

zoey2Will your cat eat canned food? If so, great, even if you find it convenient to still offer kibble at another meal. You can mix additional water in with her canned food to make it “soupy” and increase her water intake further. Look on the ingredient list for animal-sourced proteins as the first few ingredients: meat, poultry, fish, eggs, whey, etc. Do you see something like “poultry by-product” on the label? Fear not – it may not be the wrong choice. “By-product” earned its unpalatable-sounding name because it consists of parts of animals not typically used as human food, such as organ meat (liver, kidney, etc), fat tissue, bone, and viscera. Organ meat in particular represents a rich nutrient source. The word “meal” refers to the how the ingredient is prepared prior to use, in terms of size. The small particle size of a finely-ground meal aids in digestion; turkey meal may be more easily digested than whole turkey. Do plant sourced ingredients (such as rice, soy protein, wheat gluten, corn starch) feature prominently on a canned food label? They do not need to be there. The lower they are on the ingredient list, the better.

Does your cat prefer kibble? While it can be more challenging to meet a cat’s nutritional and water needs via a kibble-only diet, it has been suggested that a dry food contributes less to dental disease than canned food. Choose a variety of dry food that most closely matches the needs of an obligate carnivore by selecting one that lists animal-sourced proteins as the first two or three ingredients. Encourage your cat to drink plenty of water by providing multiple water bowls in different locations around the house.

mg24The array of pet foods available may seem endless, and there is no single best food to suit every cat. Food allergies, taste preferences, and lifestyles all come into play. If this article leaves you still wondering exactly what to feed your cat, we hope you will talk to your veterinarian about it at your next appointment. You might also be interested in reading further in our blog: we have also written an article called “What Should I Feed My Pet?

Feline Nutrition – View / Print as PDF


References and Further Reading:

The information in this article is based upon “The Carnivore Connection to Nutrition in Cats,” by Debra L Zoran, DVM, PhD, DACVIM. The original full-text article appeared in the Journal of the American Veterinary Medical Association, Vol 221, No. 11, on December 1, 2002, and can also be found at http://www.catinfo.org/docs/DrZoran.pdf.

There is a great deal of additional information at Dr. Zoran’s website, www.catinfo.org.


Worried About Vaccine Reactions?

“My friend told me her puppy had an allergic reaction to a vaccine, and it made me worry. Are all these vaccines really necessary?”

While some vaccinations are considered “core” or required by law, many others are lifestyle-dependant, and certainly not all pets require every vaccine. On one hand we are fortunate that some of the most ominous diseases can be prevented with something as simple as a vaccine, but of course there are some pets whose immune systems do not respond as well to vaccination as we’d like.


What kind of reactions are we talking about? The vast majority are more of an annoyance than anything else. It is not uncommon for dogs and cats to feel a little tired or sore after receiving vaccines, particularly if they have had multiple in one day. This represents the immune system’s normal function and is nothing to worry about. Some may develop a low fever, experience soft stool or an episode of vomiting, and this kind of reaction is concerning only if it continues or the pet seems really uncomfortable. The kind of reaction that is really concerning (and fortunately rare) is an animal who develops hives, continues to vomit or have diarrhea, seems restless or agitated, experiences swelling (most commonly of their face), or has difficulty breathing. Not to worry, even the most severe reactions can be reversed – this is why your veterinarian will advise you to keep a close eye on your pet for a little while after vaccines, especially as a puppy or kitten.

The first step, of course, is to discuss your pet’s lifestyle with your veterinarian and determine which vaccines make sense to use. Does your cat go outdoors and interact with other cats? Does your dog enjoy a weekend hike in the woods, or does she attend doggie day care? If the answer is no, some vaccinations are altogether unnecessary. Do you regularly apply a tick preventative product and find it to be very effective? Then we might consider skipping the Lyme vaccine, even if your dog spends a lot of time outside.

What should be done about a dog who we’ve determined SHOULD have a given vaccine, but in the past, she has had a serious reaction following vaccination? And what about pets who have autoimmune diseases, and we are concerned their condition may flare up due to the stimulation of the immune system that is caused by a vaccine? Fortunately, there are steps we can take to ease these concerns.

For a pet who has had a history of a vaccine reaction, simply giving a dose of Benadryl before vaccines can prevent a similar reaction. Your veterinarian can advise you on an appropriate dose of Benadryl to give at home before the appointment, or it can be given by injection just prior to giving vaccines. We might also avoid giving multiple vaccines on the same day, to make the immune system’s job easier and reduce the likelihood of any reaction. Your veterinarian also knows that some specific brands or categories of vaccines have a slightly higher reaction rate that others (data is continually collected on this, and even the most reactive vaccines affect less than 2% of dogs and cats), and she may already be avoiding these products altogether for your pet.

For a pet who is at risk of having a severe reaction, we have a chance to avoid vaccination altogether, while still assuring the pet is protected from infectious diseases. An antibody titer is a blood test that can be sent to a laboratory and determine if your pet already has immunity lasting from the previous time they were vaccinated. Many pets do! The required vaccines for adult dogs and cats are typically considered “good” for up to three years, many pets will actually have immunity longer than this. Not all will, of course – but we may be able to avoid unnecessary re-vaccination in majority by checking a titer.

Why don’t we do this for everyone, you wonder? The answer is due to cost. Regardless of what veterinary hospital your pets visit, a titer is likely to be significantly more expensive than a vaccine. And because less than 1% of pets have serious trouble after getting their vaccines, it usually makes sense to go ahead and give a booster shot. But for the occasions when we want or need to know if vaccination is necessary, a titer test is available. We hope you will discuss the need for vaccinations or titers with your veterinarian if you have any concerns about vaccine reactions in your pet.

Vaccines and Reactions – View/Print as PDF

Considering Pet Insurance?

You may have heard of the concept of pet insurance and wondered if it is worthwhile for your pet… you might also have begun looking into it and become overwhelmed by all the companies offering it, and the lists of different plans and options. We’re here to help – and we’ll begin by telling you that this is an unbiased review of pet insurance. We promise you that any product or service we review in this blog is completely impartial, not influenced by sponsorship or advertising, and presented exclusively to help you decide what is best for your pet.

1. Pet insurance is like any other insurance: There is a monthly or yearly basic cost, and a co-pay and/or deductible paid per-event.

Just as your own insurance costs you “X” dollars per year and if you see the doctor there is a co-pay, pet insurance requires a basic monthly cost as well as a co-pay and/or deductible for a vet visit. These costs vary depending on your pet’s age and breed, what area of the country you live in, and what kind of policy you choose. It is also possible that an annual or lifetime limit on payouts may be applied. Most companies have a website that can readily provide you with a price quote.

2. There are two basic types of pet insurance: Indemnity and Major Medical. Not all companies offer both.

Most pet insurance is meant to help a pet owner cover “indemnities” – the sudden and unexpected expenses of illnesses or injuries. Pet indemnity insurance is a lot like car insurance: if something goes wrong, a large portion of your bill is covered, but basic necessities are not accounted for. For a car, basic necessities are things like gas, oil changes, and routine maintenance. For a pet, basic necessities are things like annual wellness exams, vaccines, and flea control products.


Major medical insurance for pets is much like human medical insurance. Whether you go to the people-doctor or the doggie-doctor for an annual physical or because you are sick, a large portion of the cost is covered by your insurance. Because major medical insurance covers more of your expenses, it generally costs more per month and/or has a higher deductible.

US-based companies that offer each type of insurance are listed at the end of this article.

3. Unlike human insurance, you will pay up-front and then be reimbursed by your insurer. 

With human insurance, we are accustomed to walking out the door after paying a small co-pay. Pet insurance generally does not work this way. If your pet is hospitalized at a cost of $800, you will need to pay your veterinarian this amount at the time of hospitalization. Your veterinarian will then help you submit a claim form, and a little while later, your pet insurance company should reimburse you some portion (or all) of this cost. How much is reimbursed will vary with each company, and some have more straightforward rules than others.

4. There is NO pet insurance company that covers pre-existing conditions. bday

It makes sense, after all – You couldn’t crash your car into a ditch and then try to buy insurance to get it repaired the day after. Pet insurance is no different. If your vet finds out your pet has a heart murmur and recommends he be evaluated for heart disease, you cannot buy insurance to cover diagnostics and treatment after the murmur is discovered.

Some companies will also exclude certain conditions based upon breed. For example, bulldogs are prone to develop breathing problems due to the shape of their head and face. Given the high likelihood of any bulldog having breathing problems, a pet insurance company may exclude coverage of this type of condition for all bulldogs. Different insurance companies may have very different coverage as far as hereditary (breed-related) conditions – be sure to research this (or adopt a mutt!).

5. You can use any veterinarian with any insurance.

Veterinarians have no silly rules about which pet insurance they will accept. It’s all fine with us! It helps, though, if you bring a copy of your claim form with you so your veterinarian doesn’t have to puzzle out what kind of paperwork you need (they’re all different).

6. Your pet’s lifestyle may affect their likelihood of illness or injury, and therefore the type of insurance your pet should have (if any).


An indoor-only cat doesn’t lead a very treacherous lifestyle; by keeping your cat safely indoors, you’ve ruled out scores of illness and injuries that might otherwise affect her. On the other hand, a labrador puppy is a furball of trouble on four legs, and you should probably plan for a lifetime of sock eating, ear infections, torn toenails, wildlife encounters, and maybe even a little jaunt out playing in traffic somewhere along the way (it happens!).

Some companies also offer coverage for exotic pets. Again, consider your pet’s lifestyle: Are they likely to be injured? An adventurous parrot whose flight feathers are not clipped can find himself in quite a lot of trouble, whereas a hamster’s life is generally far less perilous. Would the cost of treatment for an exotic pet affect your willingness to bring them to the vet if they become seriously ill?

7. You might be better served by saving up an “emergency fund” and skipping the insurance.

If you are a person who can stick with a budget and is generally responsible about your finances, the best course of action is to save up an emergency fund BEFORE you adopt a pet, so that you can proceed confidently knowing you are ready for anything. An emergency fund of $1000 – $2000 is a reasonable goal, and with over $3000 you can comfortably cover the initial cost of just about any trouble your pet may run into. Do these amounts sound terribly high? If that is the case, pet insurance may be a good choice for you, taking down your expenses to something along the lines of $20 – $50 per month. But hey – if you saved that $50 per month, you’d have a generous emergency fund all set in a few years.sx21

If this all sounds entirely out of reach, we hope you will honestly consider whether now is the right time for you to adopt a pet. When you adopt a pet, you take on a responsibility for their care, no matter what life brings. As veterinarians, we wish the question of money was never an issue, but for many pet owners, it becomes a deciding factor. We hope you never find yourself in that terribly difficult situation, because it’s one we don’t want to face either!

Still overwhelmed?

Call, email, or visit your vet – they can help you decide the best course of action. You may also find the links below helpful.

PetInsuranceReview.com – An unbiased review of US and Canadian pet insurance companies (see the left sidebar for links to a summary of each insurer)

PetPlan – The world’s largest pet insurance provider. Offers indemnity and major medical insurance. Hereditary conditions are covered.

Healthy Paws Insurance – Offers indemnity insurance only. Hereditary conditions are covered, except hip dysplasia in dogs who enroll after age six. No payout limits apply.

Pets Best – Offers indemnity and major medical insurance. Hereditary conditions are covered.

Trupanion – Offers indemnity insurance only. Hereditary conditions are covered. Hip dysplasia is covered. No payout limits apply.

AKC Pet HealthCare – Offers indemnity and major medical insurance. Hereditary conditions are not covered.

Embrace – Offers indemnity and major medical insurance. Hereditary conditions may be covered.

PetFirst Healthcare – Offers indemnity and major medical insurance. Hereditary conditions may be covered. Addition of the chronic coverage rider is recommended.

VPI – The first and largest US-based pet insurance provider.  Offers indemnity and major medical insurance. Hereditary conditions may be covered.

24 PetWatch – Offers indemnity insurance only. Hereditary conditions may be covered.

PurinaCare – Offers indemnity and major medical insurance.

ASPCA Pet Health Insurance – Offers indemnity and major medical insurance. Hereditary conditions may be covered.

Protect Your Bubble – Offers indemnity and major medical insurance. Hereditary conditions may be covered.

Pet Premium – Offers indemnity and major medical insurance. Hereditary conditions may be covered.

Considering Pet Insurance – View/Print as PDF

What Should I Feed My Pet?

How do I decide what to feed my dog or cat?pugs_psnd2

Assuming your pet is generally in good health, without any specific dietary sensitivities or food allergies… There is still no simple answer! There are countless options to choose from in a maintenance diet for dogs and cats, and a healthy pet will do reasonably well on almost any of them. That being said, some diets simply meet the basic requirements for nutritional content, while others provide higher-quality protein sources, more “natural” ingredients, supplements to support healthy joints or a shiny coat, fewer preservatives, and so on. It is worth mentioning that any brand – inexpensive or premium – can potentially have a recall.


So what is the difference between a bag of kibble that costs $15 at the supermarket and a premium brand for $40 at the pet store? Do these differences matter, or are pet owners just being tricked into spending more?

Let’s start with protein quality and digestibility. Any dry or canned food labeled as a complete diet meets the basic standards for protein content, but the sources of protein can vary. Both meat and grains are sources of protein, but in general, higher-quality meat is a superior protein source due to the fact it provides a better amino acid balance.

Read the label of your pet’s food – you may see the words “poultry,” “poultry byproduct,” or “chicken meal.” These terms may sound vague (and have you fearing what “byproduct” might contain), but they have specific meanings:

Meat – The flesh of any species of slaughtered mammal, typically pork, beef, or sheep.

Poultry – The flesh, skin, and bone of domestic poultry; typically chicken, turkey, or duck.

Byproduct – Parts of animals not typically used as human food, such as organ meat (liver, kidney, etc), fat tissue, bone, and viscera.

Meal – Any ingredient that has been ground down to a small particle size (for example, “chicken meal” would mean the flesh, skin, and bone of chicken).

Though the organ meat (liver, kidneys, etc) contained in a “by-product” is not typically part of an American diet, these are excellent nutrient sources and provide high-quality protein. Bone meal is a good source of calcium, but the protein it contains is not readily digested by cats and dogs.

“Whole chicken”  as a first ingredient may give us the impression of a less-processed superior quality diet, but whole chicken used in pet foods is high in fat and may contain 65-70% water! This high volume may earn it the first place in the ingredient list, but leaves it as a small contributor to protein content and is more important as a fat source.

Plants such as corn, soybean, and flaxseed may also be used as protein sources. Their digestibility is equivalent to some animal protein sources, but they are deficient in some of the amino acids required in canine and feline diets, so for this reason we would hope not to see plant-based products as a primary ingredient. If soy accounts for 50% or more of a diet’s protein, loose stool and flatulence may result.

All this information may leave you with more questions than answers about your pet’s food. We invite you to discuss your pet’s diet with your veterinarian at your next appointment – as we began saying, every pet is an individual with their own needs and preferences – there is no simple answer!


What about limited ingredient diets? Grain free? Raw diets?

For pets with special needs (food sensitivities or allergies, for example) a specialized diet may be the key to solving their problems. However, there is a specific way to determine the best diet for a food-allergic dog… just switching brands is not likely to be the answer. Feeding a raw diet is a point of controversy and is not without risks, but if done correctly, it may provide a solution as well. These topics are beyond the scope of this blog post (we’ll write another, we promise), but we hope you’ll talk to your vet about changing your pet’s diet if you are concerned food allergies or sensitivities may be affecting your pet’s health. There is no single solution that works for every animal. 


How much should I feed my pet?

No quick answer here either! Most brands of pet food will provide guidelines for how much to feed based upon weight. This amount is frequently an overestimate (after all, they’d like you to buy more of their product!), so you may use this as a starting point, but pay attention to your pet’s weight and adjust accordingly. Feed a measured amount – not “a handful” but a measured cup – so that you will be better able to increase or decrease the amount fed as needed.


How do I know if my pet is overweight?

Of course your veterinarian can provide guidance on this topic, but in general, your pet should have a “waist” when viewed from above or from the side. Place your hands flat over the sides of her chest… with very gentle pressure, you should be able to easily feel where her ribs are. If finding her ribs requires poking in with your fingertips, or if you can’t feel them at all, she is overweight. Maintaining an appropriate weight contributes to better overall health and even an extended lifespan!


Can I feed a home-prepared diet?

Many recipes are available for home-cooking for your pets. However, it is essential to be certain what we choose to feed on our own is nutritionally complete, particularly if the recipe being used is not approved by a veterinarian. Many veterinary teaching hospitals and referral centers offer a nutrition consult service, and can tell you exactly what vitamins and supplements may be necessary to balance any home-cooked diet. Here are links to a few:

Angell Memorial (provides recipes), CornellOhio StateDavis

We hope this article has given you a solid starting point in finding the best possible diet for your pet’s lifelong health. And if you have any lingering questions, look to your vet for the answers!

What Should I Feed My Pet – View/Print as PDF

Flea Control

Fleas: Prevention is Key

A few fleas that make their way onto your pet can quickly escalate into a serious problem in your home. Without a comprehensive plan for flea control, owners can find themselves fighting a losing battle. A flea-infested dog or cat can introduce hundreds of new flea eggs into the home each day! The best way to manage fleas is through prevention, but this article will help you control fleas in your home even if they are already present.
Adult fleas (the biting stage) spend most of their life on the pet. Eggs are laid on the fur and fall off into carpeting, furniture cushions, bedding, and the soil outdoors. The eggs hatch and transform into larvae, pupae, and eventually adults to begin the cycle again.

Pet owners can break the cycle of flea development by eliminating the egg-laying adults. Several treatment options are listed below. A variety of other products can be found over-the-counter; we have included the products that we feel are safest and most effective on this list. Please note that these products may need to be supplemented with a bath using a soap-free shampoo (so as not to wash off spot-on product), especially if the animal is allergic to fleas. However, a flea bath alone will NOT be effective in controlling a flea infestation, as there is no long-lasting effect.

Spot-on products

Vectra™ – Repels fleas for one month. Available from veterinarians without a prescription & typically a less expensive, yet effective product. Please note there is a specific Vectra for cats, the dog product “Vectra 3D” also includes tick control and is NOT safe for use on cats.

Frontline Plus™- Kills adult fleas on pets for one month. Available over-the-counter. Please note a small percentage of pet owners have reported fleas being resistant to Frontline. Safe for cats.

Revolution™ – Prevents and controls fleas for one month. Small volume, ideal for pets with sensitive skin. This is also a heartworm preventative. Safe for cats.

Advantage Multi™ – Prevents and controls fleas for one month. Small volume, ideal for pets with sensitive skin. This is also a heartworm preventative. Safe for cats.

Advantage II™ – Prevents and controls all life stages of fleas for one month. Small volume, ideal for pets with sensitive skin. Safe for cats.

K9 Advantix™ – Repels fleas and ticks for one month. This product is NOT safe for cats.


NexGard™ – Flavored like HeartGard, this chew tab protects against fleas and ticks in dogs for one month.

Simparica™ – This flavored chew tab protects against fleas and ticks in dogs for one month.

Credelio™ – This flavored chew tab protects against fleas and ticks in dogs for one month.

Bravecto™ – This flavored chew tab protects against fleas and ticks in dogs for three months.

Sentinel™ – Prevents flea eggs from hatching for one month.  Also a heartworm preventative. Safe for cats.

Trifexis™ – Protects against fleas, heartworm, and some intestinal parasites; lasts one month. Not recommended for dogs with a history of seizures. Can be given with a topical product if separated by at least one week.

Capstar™ – Kills adult fleas quickly, lasts 24 hours. Available without a prescription. Safe for cats.

Comfortis™ – Kills adult fleas, lasts one month. Can be given with a topical product if separated by at least one week. Safe for cats.


Seresto™ – Controls fleas and ticks, one collar lasts up to eight months.

Scalibor™ – Controls fleas and ticks, one collar lasts up to six months. Not safe for cats.

If you are already experiencing a flea infestation…

cat1How would you know if your pet has fleas? Run a fine-toothed comb through your pet’s fur, especially towards their hind end. If you find little black “crumbs” in their coat, or live fleas, you’ve got a problem.

1. All animals in the home must be treated for a minimum of 3-4 months to prevent re-infestation. Why 3-4 months? This is the duration of the flea life cycle. New fleas will continue to hatch in your home for 3-4 months, and by treating the pet with a preventative, we can “starve them out.” Be sure to use species-appropriate products (some dog products cannot be used on cats).

2. The environment must also be treated. Frequent vacuuming of carpeting & upholstered furniture (empty the bag or canister each time!) and washing bedding on a hot cycle are essential. Heavily contaminated bedding should be discarded if not washable. An area spray or fogger may be used for quicker results or in the event of a heavier infestation. The fleas go where the pets go! If your pet sleeps in your bedroom and spends most of the day in the living room, focus your efforts here.

3. All parts of the flea life cycle must be addressed. Cleaning and treating the home removes flea eggs, larvae, and pupae. Treating the pet with a spot-on, pill, or collar will eliminate adults.

4. The process may take time; patience and persistence are key. However, by following this guide, you will find your way to the most efficient and cost-effective plan possible. Pets with flea allergies may require medical attention and a prescription for a steroid or antibiotic to control skin infection and irritation until the infestation is resolved.

Special Situations

mg24 Kittens present a unique challenge, as most products are not labeled as safe for very young kittens. They can die, as well, from anemia caused by a heavy flea burden. Preventing fleas from affecting adult pets in the home will reduce the likelihood the kittens will be affected. However, if fleas are already present, treating the home environment as described above will reduce the flea burden for kittens. A flea comb can be used to physically remove fleas from a young kitten. In some situations, a veterinarian may use a flea control product at a smaller dose in younger/smaller kittens when the risk of flea anemia outweighs the risk of using a product.

Multi-pet households require extra effort in terms of prevention and control. With more pets in the home, flea problems quickly escalate. The tenets of control are the same, just more intensive. All pets in the home (or who visit the home!) must be treated.

Additional Resources

Pets and Parasites – Flea life cycle and control

Flea Control & Prevention – View/Print as PDF

When Your Pet Needs Surgery…

sx01A pet may require surgery and a hospital stay for a variety of reasons, from a routine spay or neuter to an emergency abdominal exploratory surgery. Whether the procedure is planned in advance or comes up unexpectedly, we want to put your mind at ease and show you exactly what your pet experiences when he stays with us in the hospital.

Meet Jebediah – here he is checking in for a routine neuter. His very first stop is the scale in our exam area. Even though he has seen us recently for vaccines, we’ll need a current weight to calculate dosages of the medications he’ll need for his surgery. The doctor will do a full physical exam to be sure nothing else has changed since his last visit.


Jebediah is a young and healthy dog, but we’d like to check a full blood panel just to be sure he is in ideal condition to undergo anesthesia. Sometimes, abnormalities of blood clotting, liver function, or kidney function do not have obvious clinical signs, but will show changes on bloodwork.


As each pet enters the hospital, whether for surgery or any other type of procedure or care, they receive an identification collar with their name and owner’s name. If a pet’s bedding or toys are accompanying them on their hospital day, we’ll do out best to label that as well and keep track of it while they are here… but if you plan to send items from home to the hospital with your pet, please remember this is a big and busy place, and sometimes things manage to disappear into the laundry!! We can provide your pet with all they need while they are here, and you can keep their “valuables” safe at home waiting for them to return.


Jebediah has received his first “pre-medication,” a combination of sedatives and pain relievers that will have him drowsy and relaxed as we begin working with him. It is often difficult to predict exactly what time a pet’s surgical procedure will begin as our hospital also sees emergencies, and a pet in need of an urgent surgical procedure may need to skip ahead of the routine procedures.


sx08     sx10Now Jebediah is very relaxed, and ready to have his IV catheter placed. IV access allows us to run IV fluids, give medications quickly and easily, and if needed, intervene if a pet has any sort of trouble under anesthesia. While some very brief procedures do not require an IV catheter, for longer and more involved surgeries having an IV catheter in place is the safest way to proceed.


Jebediah’s IV catheter is used to induce anesthesia, leaving him completely asleep for the rest of the procedure. A tube is placed in his airway, and a combination of oxygen and anesthetic gas is administered to keep him sound asleep. The probe on his tongue measures the oxygen saturation of his blood, leaving us certain he is stable and breathing well under anesthesia.



Jebediah’s owner has chosen to have a microchip implanted, so that if Jeb ever goes missing he has the best chance of being returned to his home. While this can be done in an animal that is awake, the needle used to implant the microchip is larger than the type used for a vaccine, so we prefer to place a microchip when the animal is asleep whenever possible.



This is also a great opportunity to cut toenails!! You don’t even need to ask… Our anesthesia team can hardly be stopped from cutting toenails on a sleeping pet! We will also frequently clean ears, brush out a matted haircoat, and check for fleas or ticks on a sleeping pet.




Next, we’ll put socks on Jebediah’s feet… not just because they are adorable, but to keep his feet warm during surgery. Towels, blankets, and a circulating warm water pad are also typically used to keep a pet warm during surgery (especially small pets). Body temperature is checked before surgery begins, during surgery for longer procedures, and as soon as a pet begins to wake up from anesthesia. If it’s too low or high, we’ll continue to check throughout the pet’s hospital stay until it is back on track.



sx14A new sterilized surgery pack is used and the surgeon scrubs in for every procedure. Bolton Vet follows the sterilization procedures required by the American Animal Hospital Association to be sure that all out supplies, however commonly or infrequently used, are clean and ready whenever we need them.

sx15     sx16Jeb’s procedure is completed in about twenty minutes. His heart rate, breathing rate, oxygen saturation, and blood pressure are monitored continuously, and IV fluids are provided throughout the procedure.




The procedure is completed, and a small scar remains. We’ll keep a close eye on how this incision looks for the remainder of Jeb’s time in the hospital, and tell the owners to watch it at home too. It is expected to look a little red and swollen at first, but this should decrease from day to day. Any sign of increasing inflammation or yellow-green discharge is suggestive of infection.



Jebediah wakes up with the careful supervision of his anesthesia technician, who has been monitoring him the whole time. He remains a little groggy for the rest of the afternoon, and he will stay in the hospital this evening to be sure he is comfortable and has no trouble with his incision. His pain medication will last for 24 hours after the last dose is given, and depending upon how he seems to feel, he may be given a few more doses at home afterwards.


Jeb’s recovery is uneventful, and he is back to his usual ridiculous self at home in no time at all.   🙂

Tips for Exotic Pet Care


The title “Exotic Pets” refers to a huge range of animals – birds, reptiles, small mammals, even insects – but there are a few general ideas that can be applied to all of these “special species” to better manage their care.

1. Get the Basics Right – A huge proportion of exotic pets’ health problems are the result of owners not providing the correct care for the animal. It can be challenging to meet the needs of an animal that is native to any environment from a rainforest to a desert! Before choosing to adopt an exotic pet, seriously consider whether you can care for them properly. Reptiles and amphibians can be particularly challenging even for experienced pet owners to keep healthy in captivity. Research your pet’s needs thoroughly. In some cases, websites and pet store employees can be good sources of information, but often they are not up-to-date on the best level of care. Please, please, please, call or email your vet to get the best information. They may discuss the best standard of care with you in detail, or refer you to a web resource they trust.


2. The Value of a Routine – Exotic pets are often prey species, and as a result, they will generally hide signs of illness as long as possible. The reason for this is simple – if a prey animal allowed itself to appear sick or hurt in the wild, it would quickly be captured and eaten by a predator. Even though our exotic pets are safe from predators in our homes, this inclination to hide signs of illness is “built in.” How, then, do we know if an exotic pet is not feeling well? Subtle signs will often be present if we know how to look for them. One of the most helpful things an exotic pet owner can do is maintain a routine for their pet. Provide fresh water and a measured amount of food at the same time every day. This way, if less is consumed, you will notice the difference more readily. If you offer a new food item, begin giving just a small amount at first, and never give too much of any treat. Know what times of day your pet is normally active and alert and what times they generally rest. A pet who hides or sleeps more than usual may not be feeling well.

3. Monitor Health at Home – We must continually be on the lookout for signs of illness in our exotic pets. A few sneezes, a loss of appetite, or a day spent hiding may be the only clues our exotic pets provide before becoming seriously ill. One more tool we can use is monitoring our exotic pets’ weight. A gram scale – a kitchen scale or postage scale – can allow our small exotic pets to be accurately weighed once weekly. Young animals should continually gain weight and never lose it. Most species will reach their adult weight and maintain it, with only very small losses or gains over time. Some species, like reptiles, may continue to gain weight at a slow rate throughout their lives. Write down your pet’s weight weekly – if you ever notice a significant decline in weight that is outside of the usual pattern, this is likely a sign of illness. Of course, being significantly overweight is also a health concern.


4. Visiting the Vet – Exotic pets are often more stressed by a trip to the vet than our dogs and cats, and the benefit of seeing a vet has to be weighed against the fear they may experience as they leave their familiar environment. Fortunately, we can take steps to reduce the stress of a vet visit for exotic pets. Transport your exotic pet in a small solid-sided container (such as a Kritter Keeper), preferably covered so that it is dark. For some species, small fabric pet carriers available in pet stores work well. For others, a simple cardboard box may be effective if it can be closed securely. Assure your exotic pet is kept warm during transport in the colder months. Particularly for birds and reptiles, even a brief chill can be dangerous. Warm water bottles may be effective; there is also a product called a “Snuggle Safe” which is a microwavable heating pad that stays comfortably warm for several hours.

5. Talk to the Vet – If you notice something out of the ordinary and are concerned, feel free to call or email your vet before making an appointment – it may or may not be necessary to visit. In some cases, emailing a photo or video of what you are noticing can be helpful, too.

Here are some of our favorite online resources for exotic pet care:

Ferrets – Hugawoozel

Rabbits – The House Rabbit Society

Guinea Pigs – Guinea Lynx

Rats – Rats Rule

Birds – Up At Six 

Reptiles – Melissa Kaplan’s Herp Care Collection

Tips for Exotic Pet Care – View/Print as PDF

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