Tag Archives: dog

Holistic Veterinary Medicine

In recent years, pet owners and veterinarians have taken a greater interest in a holistic approach to health care. By definition, a holistic health exam should include discussion of all aspects of the pet’s lifestyle: Their medical history, diet, activity level, and their social interactions with humans and other pets are all taken into zoey2consideration. A holistic approach to medical care may incorporate both traditional diagnostics and therapeutics, such as prescription diets, medications, and dental care, as well as complementary and alternative modalities, such as acupuncture, herbal supplements, massage therapy and more.

The scope of complementary and alternative veterinary medicine is vast, and not all modalities are believed to be equal in their efficacy. In some cases, research has been conducted to fully understand how or why a given therapy works. In other cases, the effect a therapy is supposed to have is largely unsupported conjecture (and in some cases it may just be a sales gimmick!). This article is meant to help you understand which therapies we believe are helpful.

Acupuncture and Acutherapy

  • Traditional Chinese medicine, as it has applied to human health for centuries, is used as a basis for veterinary acupuncture.
  • Specific points on the body are examined and stimulated by use of acupuncture needles. Additional means of stimulation can include pressure, moxibustion (application of a heated substance), injections of saline or B-vitamins at specific points, low-level laser therapy, and more.
  • Acupuncture and related therapies are accepted as an effective mode of therapy in human medicine, and they are widely believed to be effective in animals as well. The American Veterinary Medical Association recognizes acupuncture and acutherapy as an accepted and “fully integrated” approach to therapy.
  • Veterinarians may elect to pursue formal training in traditional Chinese medicine and the use of acupuncture outside of the standard veterinary school curriculum. Ask your veterinarian if they (or their colleagues) have been trained to perform acupuncture, low-level laser therapy, or related practices.
  • At Bolton Vet, Dr. Cassandra Oswald and Dr. Michelle Pesce are formally trained in veterinary acupuncture. Many Bolton Vet doctors routinely make use of low-level laser therapy. You may search for an acupuncture and Traditional Chinese Veterinary Medicine practitioner local to you at www.tcvm.com.

Veterinary Chiropractic

  • The scope of veterinary chiropractic includes the evaluation, manipulation, and adjustment of specific joints. It does NOT include prescribed medication or supplements, surgery, or injections, and it cannot be considered a replacement for standard veterinary care.
  • Clinical and anecdotal evidence suggests that veterinary chiropractic can be beneficial, but formal research is limited.
  • Veterinarians may elect to pursue formal training in veterinary chiropractic outside of the standard veterinary school curriculum. Ask your veterinarian if they (or their colleagues) have been trained to perform chiropractic medicine.
  • At Bolton Vet, Dr. Cassandra Oswald is currently pursuing training in veterinary chiropractic. You may search for a certified veterinary chiropractic practitioner at animalchiropractic.org.

Veterinary Physical Therapy & Massage Therapy

  • laser1Veterinary physical therapy is the use of noninvasive techniques, such as low-level lasers (see photo to right), electrical sources, magnetic fields, and ultrasound; rehabilitative exercises; hydrotherapy; and applications of heat and cold for the rehabilitation of injures.
  • Veterinary massage therapy includes only the use of a person’s hands and body to massage soft tissues.
  • Physical therapy and massage therapy techniques may be performed by a veterinary technician under the supervision or referral of a licensed veterinarian who is providing concurrent medical care.
  • Many veterinarians, particularly those who perform orthopedic surgeries, will make recommendations for physical rehabilitation and can instruct a pet owner in basic protocols and techniques.
  • Physical rehabilitation techniques are incorporated in a modern veterinary school curriculum, but veterinarians may elect to pursue further training independently.
  • Local to Bolton Vet, formal physical therapy programs include Wizard of Paws in Colchester CT and Pieper Memorial’s physical therapy department in Middletown, CT. Many Bolton Vet doctors routinely make use of low-level laser therapy.

Veterinary Homeopathy

  • Veterinary homeopathy incorporates an interesting strategy: Tiny amounts of substances that are capable of causing clinical signs in healthy animals are administered to sick/injured animals with those same clinical signs. The therapy is believed to work because the doses administered are extremely dilute.
  • The human and veterinary medical communities’ understanding of how homeopathy may work is not complete. It is among the less scientifically-supported modalities (that is to say, it may not be effective at all).
  • Many pet owners are not aware that HOMEOPATHIC medicine is not the same as HERBAL medicine (see below for more on herbal medicine…)
  • Clinical and anecdotal evidence suggests that veterinary homeopathy can be beneficial, but formal research is very limited.
  • Buyer (or Googler) beware, homeopathic products are not FDA-regulated, so there is no guarantee a homeopathic product actually contains what is on the label (!!).
  • Since some of these substances may be toxic when used at inappropriate doses, it is imperative that veterinary homeopathy be practiced only by licensed veterinarians who have been educated in veterinary homeopathy.
  • Veterinarians may elect to pursue formal training in veterinary homeopathy outside of the standard veterinary school curriculum.
  • At Bolton Vet, Dr. Cassandra Oswald is formally trained in veterinary homeopathy. You may search for a Certified Veterinary Homeopath local to you at theavh.org.

Veterinary Herbal/Botanical Medicine

  • spring9Veterinary botanical medicine is the use of plants and plant derivatives as therapeutic agents.
  • There are many examples of the use of herbal/botanical products in veterinary medicine:
    • Citronella oil (an extract of lemongrass) is widely recognized as a mild insect repellent.
    • Cranberry extract is frequently used to prevent recurrent urinary tract infections in humans and animals, and its mechanism of action has been studied and is well-understood.
    • Supplements containing Milk Thistle are generally considered a standard of care in the treatment of some types of liver disease.
  • Buyer (or Googler) beware, there are many herbal products and “natural” supplements that are quite costly, yet not necessarily effective. Supplements are not FDA-regulated, so there is no guarantee a herbal product actually contains what is on the label (!!). Your veterinarian can recommend trusted brand-name supplements.
  • Since some of these botanicals may be toxic when used at inappropriate doses, it is imperative that veterinary botanical medicine be practiced only by licensed veterinarians who have been educated in veterinary botanical medicine. Safe dosing of herbal medications is just as important as safe dosing of prescription medications.
  • Veterinarians may elect to pursue formal training in veterinary botanical/herbal medicine outside of the standard veterinary school curriculum. You may search for a Certified Veterinary Herbalist at www.vbma.org.

Nutraceutical Medicine

  • Nutraceutical medicine is the use of micronutrients, macronutrients, and other nutritional supplements as therapeutic agents.
  • Research in this field is ongoing. There are many examples of the use of specialized nutrition or neutriceutical products in veterinary medicine. Some are believed to be more effective than others:
    • There is a great abundance of carefully formulated prescription dog and cat diets to treat or help control a wide variety of diseases, including allergies, obesity, joint pain, kidney failure, and liver disease.
    • Glucosamine and omega-3 fatty acids are widely recognized as a dietary supplements for joint support and prevention of arthritis
    • St. John’s Wort is believed to have analgesic (pain-relieving) and anxiolytic (anxiety-relieving) properties; yet at an excessive dose, this plant extract can be toxic, potentially causing skin ulceration and dermatitis.
    • Some skin conditions are responsive to zinc supplementation, however, excessive dietary zinc can also be quite toxic.
  • Nutrition and veterinary neutraceutical medicine are incorporated in a modern veterinary school curriculum, but veterinarians may elect to pursue further training independently.

References & Further Reading:

AVMA Guidelines for Complementary & Alternative Veterinary Medicine (PDF)

International Veterinary Acupuncture Society

Holistic & Complementary Veterinary Medicine – View / Print as PDF


Arthritis Management

Arthritis management is best approached comprehensively, by managing pain, preventing further degeneration of joints, maintaining muscle mass, and assuring a pet’s body weight is not making matters worse. Here are the key elements to consider…

bday1. Weight loss. As arthritis develops and joints began to hurt, a dog may become became less able to exercise or tolerate long walks. Less exercise would lead to weight gain if a dog’s diet were not modified accordingly. Carrying additional weight is additional strain on joints, and an arthritic dog needs to keep moving in order to maintain muscle mass. But how can they if they’re in pain? This brings us to the need for joint support & pain control.

2. Joint support. Supplements such as glucosamine and fish oil (and some you probably haven’t heard of, called PSGAG and Type II Collagen) are often given to help sustain the formation of molecules in joint fluid that cushion the joints, and promote an overall anti-inflammatory state in the animal. It is ideal to start giving these supplements before clinical signs of arthritis develop, in order to protect the joints from becoming damaged in the first place. There are also a few options for prescription diets that incorporate joint support supplements (and can potentially help with weight loss as well).

3. Pain control. Depending on how severe a dog’s arthritis pain is, a joint supplement alone may be adequate, or it may be necessary to rads1provide pain medication. Hesitant to start a drug? Anti-inflammatory medications designed specifically for use in dogs are safer and more effective than human medications like aspirin. When they are given with food, stomach upset is less likely to occur. It is ideal to do bloodwork prior to starting medication long-term to be sure the liver and kidneys are healthy enough to metabolize the medication. If a dog does not tolerate a given medication well, many other options are available.

4. Alternative therapies. Some dogs may also benefit from alternative or complementary therapies such as acupuncture or cold laser therapy. As arthritis progresses, there may be other ways to accommodate a dog’s changing abilities and needs. Placing a ramp on the stairs or putting carpet runners down on slick floors for improved traction may not strike you as a “treatment” for arthritis, but if it helps your pet get around more easily, it should be a part of your approach.


Arthritis Management – View / Print as PDF

Conventional vs Natural Flea Control

dog2Many pet owners have taken an interest in natural parasite preventatives to protect their pets from fleas and ticks. Motives for using natural products may include less potential for side effects or lesser expense than conventional or prescription products. There are many factors to keep in mind when considering which flea or tick product of any type to use for your pet. We’ll start by introducing the three classes of products (or if you’d like to cut to the chase, see our last section where recommendations are provided).

FDA-registered products are officially considered “drugs,” approved by the same organization that manages drugs for humans – the Food and Drug Administration. As drugs, the safety and efficacy of these products have been closely studied. Doses are specifically calculated to maximize safety and minimize the chance of adverse effects. The majority of these products are available only with a prescription from a veterinarian. Some of these FDA-registered products include: Advantage Multi, Capstar, Comfortis, Revolution, Sentinel, and others.

EPA-registered products are officially considered “pesticides,” with guidelines for use determined by the same organization that examines pesticides and insect repellants used by humans – the Environmental Protection Agency. As pesticides, these products are available without a prescription and are demonstrated to be generally safe and effective when used as described on the label. They are not necessarily safe when used for a different purpose, for example, on a cat instead of a dog. Some of these EPA-registered brands include: Advantage, K9 Advantix, Bio-Spot, Frontline, Hartz, Parastar, Sergeant’s, Sentry, Vectra, and many others.

Unregistered products – the category that includes natural products – contain ingredients that are considered by the EPA to be of “minimal risk” and are therefore unregulated. There are two important points to keep in mind: (1) The EPA’s concern is primarily for HUMAN safety in use of these products; other species may respond differently. (2) These products have been evaluated only for safety, not efficacy. This does not necessarily mean they are ineffective, however, they may or may not meet your expectations and needs. So let’s examine this category further: What are the active ingredients of these products, and do they work? Do they carry any risks? Read on…hollydog7

Here is a list of natural essential oils and related compounds present in many alternative flea & tick products. Some of these compounds are also present in EPA-registered products.

Pyrethrins – Pyrethrins are a group of botanical insecticides derived from chrysanthemum flowers. They work by altering nerve function in insects, eventually resulting in death.

Pyrethroids are synthetic, with a chemical structure adapted from the pyrethrins, modified to increase their stability in sunlight. Despite the safety of these compounds in dogs, they are highly toxic to cats.

Pennyroyal – Derived from Mentha pulegium and Hedeoma pulegiodes, pennyroyal oil has a long history of use as a flea repellent. However, this herb is noted to have toxic potential for dogs and cats even at recommended dosages, causing potentially fatal damage to the liver even when applied topically (on the skin).

Citronella – Citronella oil is an extract of several plants in the genus Citronella, recognized to have insect-repellent properties. In fact, it has been registered by the EPA for this purpose. According to the EPA, “Oil of citronella is a biochemical pesticide which has a non-toxic mode of action. It is registered as an insect repellent (feeding inhibitor).” It has the potential to be a skin and eye irritant, and may be mildly toxic if ingested or inhaled, but only at very high concentrations far beyond normal usage. In order to be maximally effective, it would need to be applied on a daily basis.

Cedar – Cedarwood oil is a natural component of wood and leaves in trees of the family Cupressaceae, and can be used as a non-toxic insect repellent and feeding depressant. Cedar oils have been shown to be a respiratory irritant to birds and small mammals when present in high concentrations, but are not thought to pose a significant risk to humans, dogs, or cats with typical use. In order to be maximally effective, it would need to be applied on a daily basis.

Lemon – The active component is d-limonene, which has been proposed to kill fleas. Lemon-containing products should not be applied to irritated skin or around eyes. In order to be maximally effective, it would need to be applied on a daily basis.

Garlic – The use of garlic both internally and externally has been suggested as an insect repellent. Some sources suggest that garlic in a dog’s diet leaves them distasteful to insects. Please note that garlic can have toxic effects in dogs at high doses (no more than  one clove per 50 pounds body weight is recommended). Cats are more susceptible to the toxic effects of garlic, and therefore use of garlic as a flea preventative in cats is not recommended.

Here are two additional non-chemical means of addressing flea and tick control:

Diatomaceous earth – This is a flour-like powder containing shards of silica, which has the ability to cut through an insect’s exoskeleton, effectively drying them out and resulting in death to the insect. It works by physical, non-chemical means. It may be used as a component of flea control when applied to carpeting, bedding (prior to vacuuming or laundering), or outdoors. Food-grade diatomaceous earth may also be applied directly to pets, but it may dry the skin and has the potential to be an eye and respiratory irritant.

Sodium polyborate powder – As found in Borax, this powder can be used in the indoor environment to interrupt the flea life cycle in conjunction with vacuuming & laundering. This compound is generally very safe for use in a household around pets (not directly applied to pets), but may cause illness if large amounts are ingested.

So what’s the bottom line? Here are our recommendations:wyeth

(1) In general, the products most widely recommended by veterinarians are those known to be the safest and most effective: the FDA registered products and a select few EPA registered products. Many of these products offer the added benefit of being effective against internal parasites as well. Of course, every pet is an individual and there is no single solution that suits every animal or owner.

(2) If you are seeking to prevent fleas and/or ticks from seeking out your pet as a host, you may try whatever product you feel is the safest and most effective for your pet. Be an educated consumer, do research with trusted resources, read the label, use the product as intended, and of course, talk to your veterinarian about any questions you have along the way.

(3) Remain vigilant – Is the product working? It is possible for any product to fail; check your pet for fleas and ticks with a fine-toothed flea comb frequently. Is the product safe and free of side effects for your pet? Any animal can have an adverse reaction to any drug, chemical, or natural compound. Monitor your pet carefully, particularly after any new product is applied for the first time, and if anything seems amiss, call your veterinarian.

(4) If your pet and home are infested with fleas, it is in the best interest of you and your pet to use a conventional FDA or EPA registered product whose efficacy is well understood. In this type of situation, it is not safe or efficient to spend time trying products that may or may not be effective. Fleas and ticks are not just an annoyance, your pet risks becoming ill from a heavy parasite burden if the product chosen does not work. Flea-borne diseases such as Bartonella and tapeworms can affect humans as well.  Once the situation is resolved, you may consider using a natural-type product to prevent future problems. Your veterinarian can work with you in finding a product that you are happy and comfortable with using, and works best for you and your pets.

Conventional vs. Natural Flea Products – View/Print as PDF

Allergies in Pets

leia1Do your pets have trouble with itchy skin? Ever noticed your dog chewing at his feet? How about infected ears or inflamed skin, or even diarrhea? These can all be manifestations of allergies in dogs and cats. Allergies in pets are a common problem, and it can be complicated and frustrating to figure out what works. The very first tool you need to fix your pet’s allergies is a good understanding of the problem. Let’s begin…

Food or Environment?

There are two main categories of allergies. An animal (or person) may be allergic to food, or to environmental factors such as pollen, dust mites, or mold. Certainly they may be allergic to items from both categories, but we are often able to narrow it down to just one. In the northeast, among dogs with clinical signs of allergies, about 85% have environmental allergies and only 15% have food allergies. Food allergies are much more common in cats at about 40-50%.

Diagnosing & Treating Food Allergies

Determining if an animal has a food allergy is more complicated than many owners expect. “But I changed his diet, it didn’t help!” many owners exclaim. If you changed the brand of food but both types included chicken as an ingredient, and your dog happens to be allergic to chicken, of course it didn’t help. You’d have no way of knowing that chicken was the problem food, either! The way to find out which ingredients are the problem is by doing a food trial. While blood tests for allergies exist, the blood test results for food allergies are generally not very accurate. Demonstrating that a specific ingredient is a problem by excluding it from the diet and looking for an improvement in allergy symptoms. If the food is then reintroduced, symptoms will return.

Food allergies are to a specific protein ingredient in the food: chicken, beef, lamb, fish, egg, whey, rice, soy, wheat, corn, barley, etc. (notice it is not just the grains we are blaming!). No need to worry about the vitamin and mineral supplements (with names like “calcium iodate” or “niacin”) that also appear on the ingredient list – they are not at fault.

Here are the steps to follow for a successful food trial with results that can be trusted:puppy1

1. Find a new diet that does not include ANY of the same major ingredients as what you are currently feeding, or have fed in the past. This requires you to read the whole ingredient list on the back of the bags, not just the description of the diet on the front of the bag (a diet called “Lamb and Rice Sensitive Skin” surely includes many more ingredients than just lamb and rice). You may be able to find a kibble that works, or you may have an easier time preparing a home-cooked limited ingredient diet. This can get complicated, we know, and we don’t expect you to figure it out on your own. If you’re uncertain of how to proceed, don’t guess – talk to your veterinarian.

2. Eliminate any other foods you are currently feeding, as these may also contain the allergen at fault. This means NO TREATS, NO TABLE FOOD, no rawhides or marrow bones, and no flavored medications (such as Heartgard or Rimadyl). “No treats!? But Barkley will be so sad!!” Barkley will also be sad if we don’t get his allergies under control… But fortunately, if you follow the same rules for choosing a new diet, you can find an appropriate treat to offer. For example, if Barley’s previous diet did not include duck as an ingredient, you can safely use a freeze-dried duck liver treat. If he has never had carrots before, you can offer this as a treat. Several of the limited-ingredient diets aimed at allergy management also make a treat to “match” the diet, so this may be an option as well. And for the flavored medications that must be excluded, your veterinarian can help you find safe alternatives to use during the food trial.

3. Continue this new limited-ingredient diet for 8 weeks, and watch for an improvement. If you do not see an improvement and are certain you did everything right, the problem is not a food allergy. It’s as simple as that.

4. Continue the limited-ingredient diet, or try adding in other ingredients one at a time and watch for a reaction. You can continue the limited-ingredient diet forever if it is practical to do. If you are using a home-cooked diet, though, you will need to make sure it is nutritionally complete before we decide to continue it forever – your veterinarian may suggest you contact a university nutrition service to get it exactly right.

lavender2Diagnosing & Treating Environmental Allergies

When symptoms vary by season, environmental allergies are more likely at fault. Sometimes it is important to determine exactly what in a pet’s environment they are allergic to, while at other times it is not going to change the treatment chosen. For example, you can potentially control allergies to any sort of pollen or mold just by giving a daily antihistamine. On the other hand, if the dog’s allergies are caused by flea bites, the fleas must be found and eliminated to solve the problem. Here are the general steps we take to treat environmental allergies WITHOUT a specific diagnosis.

1. Remove the allergen, if possible. Check for fleas, and if found, get rid of them for good. Is pollen the problem? Giving your pet a bath regularly (perhaps weekly) during allergy season will physically remove it from their fur. Any shampoo will clean away allergens, but your pet may benefit even more from a medicated shampoo that also treats yeast or bacteria causing irritation to the skin.

2. Address any infection of the skin that has developed as a result of allergies. Ear infections and skin that has developed “hot spots” or has become raw, inflamed, and infected from scratching need to be addressed, usually with an oral antibiotic and a steroid. It is ideal to avoid using a steroid long-term, but your pet may need to rely on one for a brief period of time to reduce severe inflammation.

3. Try giving a daily antihistamine and/or fish oil supplement. Antihistamines work best when they are given daily as a PREVENTATIVE, rather than as a response to an allergy flare-up. Allergy medications sold for human use (such as Benadryl or Zyrtec) are generally safe for pets, but please talk to your vet about the most effective types and appropriate dose for your pet. Some can be given once daily, others require higher or more frequent doses for pets than people. NEVER give an antihistamine that also contains a decongestant or anti-inflammatory ingredient to your pet. Generics, however, are less expensive and no less effective than the corresponding brand name drug. Fish oil has the potential to reduce inflammation and moisturize the skin, but remember, if fish is on your pet’s list of foods to avoid, a fish oil supplement is not an option.

4. Consider an immune-modulating medication. In some cases, allergies are so problematic for an animal that your vet must consider a drug using a drug that alters how the immune system works. Granted, the immune system is important to prevent infectious disease and we’d rather not mess with it! Fortunately, newer drugs are better targeted to controlling allergies while leaving other aspects of immune function nearer to normal. Your vet may discuss these types of drugs with you if the need arises.

5. Consider allergy testing and immunotherapy (allergy shots). This is the most advanced and most specific tool we have against allergies in pets. It gives us the opportunity to “re-teach” the immune system to ignore allergens while leaving its disease-fighting function completely intact. Remember, allergy testing is useful against environmental allergies, NOT food allergies. We hope you’ll consider this approach as your best option for a pet with severe environmental allergies that cannot be adequately controlled by antihistamines or reducing allergen exposure.

Allergies in pets are a complex problem, and regardless of the cause, it can take some persistence to find the best solution. This article is meant to set you off on the right path, and your veterinarian is ready to guide you along the way.

Allergies in Pets – View/Print as PDF

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.   🙂