Heart Disease: Information for the Pet Advocate

Both cats and dogs have the same heart structure. Heart disease occurs when the heart is unable to effectively pump blood into the lungs to allow oxygenation or out to the body to deliver oxygen and remove the waste products.

Heart disease can be caused by valve leakage, muscle weakness, rhythm abnormality, or a congenital abnormality.


Three main types of heart disease

VALVULAR DISEASE - The heart has 4 valves: the mitral valve between the left atrium and left ventricle, the tricuspid valve between the right atrium and right ventricle, the pulmonic valve between the right ventricle and lungs and the aortic valve between the left ventricle and the aorta.

When a heart valve leaks, it changes the direction of blood flow which can develop into congestive heart failure.   The term congestive heart failure means the blood is not being pumped appropriately to where it needs to go.  Like traffic congestion the blood stagnates somewhere when it should be moving forward.

Acquired mitral valve disease is the most common heart disease. With this disease, the valve between the left chambers of the heart thickens causing some leakage of blood back into the previous chamber when the heart pumps. This is also the most common reason for a heart murmur in a dog. This syndrome is seen more often in small breed dogs. A physical exam shows a left sided murmur at the apex of the heart. These can be benign with no clinical signs for the life of the dog.  However, any dog with a murmur who develops a cough, exercise intolerance, increased respiratory rate or effort should be checked. Chest films, echocardiogram, blood pressure and blood tests should all be used to monitor the condition.

Tricuspid valve disease is less often a problem though some dogs with chronic airway disease can have changes in this valve from higher pressure in their lungs (pulmonary hypertension).

Aortic valve disease is rare and is more often a congenital problem or an infection that can affect the valve if bacteria is circulating in the blood stream.

Pulmonic valve disease or narrowing is most often a congenital issue in breeds like Bulldogs and Mastiffs.

MYOCARDIAL DISEASE/ARRHYTHMIA - Diseases affecting the heart muscle itself or the electrical conduction through the heart which impacts the ability of the heart to pump.

Dilated cardiomyopathy is when the heart is not able to adequately contract and as a result the chambers enlarge, and the heart pump essentially cannot move blood forward.  Larger breeds are more likely to get this disease.

Hypertrophic cardiomyopathy occurs when the heart muscle thickens and the chamber that holds blood becomes too small - like the walls of a room closing in.  As a result, the heart cannot pump as much blood - causing the body to feel deprived of blood and oxygen.  This type of myocardial disease is most common in cats with some breed predilection: Maine Coons, Ragdolls and a few others.

Arrhythmias occur when the electrical impulse that runs through the heart is abnormal causing the contraction of the heart to be altered and inefficient.  Too rapid of a heart rate can cause inefficient pumping leading to collapse. In these dogs poor blood flow results as the heart acts like a spasming bowl of jelly rather  than an efficient pump. Boxers and Doberman Pinschers are prone to this type of heart disease. Too slow of a heart rate can also cause the pump to fail and dogs with this disease may require a pacemaker to prevent fainting episodes. 

CONGENITAL DISEASE AND BREED PREDILECTIONS - Congenital disease occurs when the development of the heart is altered in utero.  Septal wall defects allow communication between chambers of the heart.  Many of the congenital diseases we see are similar to those in humans. Listed below are breeds that might more commonly show these congenital findings:

Patent ductus arteriosis: Poodles, Chihuahuas, Maltese, Shetland Sheepdogs, Pomeranians, Bichon Frise, CKCS, German Shepherds, Newfoundlands and Labrador Retrievers.  Females are more likely than males.

Pulmonic stenosis: Beagles, Samoyeds, Chihuahuas, English and French Bulldogs, Cocker Spaniels, Mastiffs, Newfoundlands, Labradors and other terriers and spaniels.

Aortic or subaortic stenosis: Golden Retrievers, Rottweilers, Mastiffs, Newfoundlands, Boxers and German Shepherds.

Atrial septal defects (ASD): Standard Poodles, Boxers and Samoyeds.

Ventricle septal defects (VSD): English Springer Spaniels, English Bulldogs, and Westies.

puppy heart.png

If your pet is diagnosed with a heart murmur ask your veterinarian about your options, including the most thorough step which is seeing a veterinary cardiologist. She or he may recommend an echocardiogram to help guide therapy and determine prognosis as well as recommendations for medications and follow up. 

If you don’t have the resources to pursue this degree of diagnostics, ask your veterinarian what signs to look for that would indicate progression of heart disease and/or concern for the development of congestive heart failure.

Usually my basic recommendations are to monitor resting respiratory rate, coughing, exercise tolerance and comfort when sleeping at night.  Any fainting should be investigated.  Any of those signs are an indication that your pet might be developing heart failure and a visit to the veterinarian blood is indicated.

Keeping pets lean and getting regular exercise with a balanced diet are the best ways to prevent heart disease in your pet.

Fleas and Ticks

One of the joys of living in California is our wonderful weather allowing us to be outside most of the year. As our pets join us in those outdoor activities they are prone to exposure to ticks and fleas. In the past decade products to control fleas and ticks have evolved as resistance develops in some insects. It would be impossible to cover the gamut of products out there - though the veterinary information network has an updated list of products with details of their action which can help people decide on specific products.

Most of us count on our veterinarian to guide us based on our pets’ habits, environment and sensitivity to fleas. Dogs and cats with flea allergies need to have vigilant control so they are not miserably itching themselves all day. As Lyme disease becomes more prevalent in California and we learn more about tick borne diseases, stopping the spread of such diseases with tick control is important. Pet owners also have concerns about the chemicals needed to control these insects and how their pets might react to medications. Animals with seizure disorders should not get certain types of flea control and some owners prefer a topical versus oral medication.


Because of the spread of vector borne diseases like Lyme, Ehrlichia and Bartonella as well as some of the feline infectious anemia (mycoplasma) diseases that cats can get from fleas some type of control is needed for most pets. In addition to topical or oral preventatives pet owners should regularly wash bedding in very hot water and vacuum the house to help removal of flea eggs and larvae that accumulate in those areas. A daily examination of your pet to find any ticks that might have crawled on board during the day is also recommended.

Listed below are links to the current products available and their activities.  Scroll through to learn a little more about them, however a frank discussion with your veterinarian or their office staff regarding the particular needs of your pet in it’s environment is suggested.

Current products available and their activities:

Flea/Tick Chart for Dogs

Flea/Tick Chart for Cats


When do I REALLY need to go to the emergency with my pet?


Many of us pet owners (and parents alike) experience angst when our loved ones are ill.  A common consideration is whether to rush in to the emergency or not.  People who want to be thoroughly safe are going to choose an early decision to go.  This is never wrong because some illnesses are hidden well by pets – the risk is mostly to your finances if you don’t have the resources available. 
Here are some pretty clear guidelines for when you should take your pet to emergency

  1. Fever:  Dog and cats have a normal body temperature ranging from 99 to 102.5 degrees Fahrenheit.  If you pet is feeling poorly and has a fever over 103 then a visit to the vet or emergency is indicated. Pets with a temperature of 106 or greater will start to suffer brain damage and need to be cooled with fluids or other therapy
  2. Vomiting repeatedly and unable to hold down water is another time when you should take action. An animal with severe gastroenteritis or an obstruction in the intestines will become dehydrated and start to have organ dysfunction within about 12 hours of not being able to hydrate.  Weakness and a fast heart rate further indicate a visit to emergency is needed.
  3. Seizures particularly when a series or cluster of seizures occurs, unless your pet is a known epileptic and you have been guided otherwise.  A seizure can be the result of a single event from changes in the brain chemistry, the first sign of a seizure disorder or an indication of metabolic abnormalities such as low blood sugar, low blood calcium or other electrolyte disorders.  It can also be from ingestion of certain toxins. Because the brain can suffer permanent damage from repeated seizures making sure an underlying cause is not present is essential and checking for a treatable cause can save a life.
  4. Toxin exposure.  If your pet has consumed prescription medication then the best start is poison control.  You can call yourself and talk to someone at the ASPCA poison control (888) 426-4435 . There is a charge in the $60 range and they can help you decide whether to go the emergency or monitor at home. They can also tell you what to look for.  Some of the other toxins of concern include chocolate which you can check to see whether your dog got a toxic amount here. Other toxins that might demand a visit are xylitol (causes severe low sugar and is life threatening), poisonous mushrooms (some emergency rooms can help you determine if your pet consumed a poison mushroom especially if you bring it with you or have a picture to identify it), and antifreeze which may cause your pet to seem drunk and causes   life threatening kidney failure.  Snail bait in the Spring is a common toxin that causes tremors and seizures and requires a visit to the veterinarian.
  5. Collapse and inability to move can be from heart disease, orthopedic disease or neurologic damage to the brain or spinal cord.  Ideally your pet should be seen if this occurs because correction of neurologic disease is time sensitive and can make the difference between saving their ability to walk or not. Heart rhythm abnormalities can be life threatening if not addressed.
  6. Trauma to the body (hit by car), dog fights with resulting puncture wounds to the chest or abdomen and trauma to the eye can have underlying hidden damage that might be life compromising or vision compromising so the safest option is to have your pet evaluated if they experience such trauma.

At BirchBark Foundation we want all pets to stay happy and healthy in their loving homes and hope this gives you some guidelines for keeping it that way in your home.

Happy Holidays

Holiday Pet Health Alerts

As the holidays approach we all take the time to reflect on the year, celebrate friends (two and four legged), loved ones and life. At this busy time when the traffic in the home is increased and schedules change… it is important to remember how our patterns and environment can affect our pets. Here are some concerns to keep in mind about your cat or dog during the holidays



1. Tinsel, ornaments and ribbon are so attractive to cats and kittens with the curly cue pattern and springing sparkling visual. Removal of ornaments, tinsel and ribbon from the intestinal tract of cats and kittens is a common emergency procedure using either the digital endoscope or surgery depending on where in the intestines the ribbon is found. Be sure to watch you cats for increased interest in these shiny holiday decorations

2. Indoor cats getting out is a concern during the holidays as doors are more often ajar to share holiday cheer. If you know guests are arriving try to close your indoor cat into a back room until all increased traffic has settled

3. Fear of strangers and change in life habits. Some cats are very sensitive about their environments and company. When great changes like house guests or loud parties happen in their home environment- they can act out with behavioral changes that create problems. Most common is inappropriate urination to mark some place or thing as their own. In extremely anxious cats, urinary blockage, a hunger strike resulting in liver disease or destruction of furniture or household items can also occur. Tune into your cat at least once daily during the holidays to help them keep a physical as well as a mental sanctuary



1. CHOCOLATE and candy are the BIGGEST and most concerning risks for dogs during the holiday season. I can recall a family of four dogs who found their way into the pantry and consumed close to 2# of dark chocolate. This amount creates great risk for the heart and blood pressure as well as intestinal tract in dogs, so we induced vomiting to prevent such toxicity.

Your response to the smell of chocolate changes when that is how you were last exposed to it. Chocolate in high doses can be fatal causing arrhythmias and significant vomiting and diarrhea. If your dog has consumed chocolate you can figure out if a toxic dose was ingested at either of these sites.

petmd.com • veterinaryclinic.com

Call your veterinarian or emergency clinic if you are not sure. 

2. HIGH FAT foods causing pancreatitis is the other holiday illness that we see. Dogs cannot handle high fat foods without consequence and if they get their own Thanksgiving plate with everything including the CoolWhip… then there may be consequences. The pancreas is the organ that makes digestive enzymes and usually squirts them into the small intestines as needed to help digest food. After a high fat meal, the hormones affecting the intestines change and can cause inflammation and inappropriate excretion of digestive enzymes causing inflammation around the pancreas. As a result, dogs will become nauseous, vomit and often refuse to eat with painful abdomen because of the inflammation. Supportive care in the hospital and resting the intestines are part of how dogs heal from this disease. 

3. Anxiety around change in patterns and the home environment also apply to dogs. If you have a very shy dog who can be overstimulated easily putting them in a back room as guests arrive and depart will help them cope with the abrupt change and decrease the chance of injury, escape or excess anxiety and behavioral changes that often go with such events. Once again give the gift of time and gratitude to your dog: walking them before large gatherings so they can release energy and taking the time to hug them at the end of the evening when guests have retired or departed.

More on Leptospirosis

We Californians who have the drought fresh in our recent memory hope for another rainy winter. Not too much at once, but enough to keep the reservoirs full and to decrease panic associated with an inadequate water supply. For our dogs a wet winter means a little more vigilance to watch for an infectious spirochete that can cause serious health issues. Cat owners have little to worry about with this disease.

 Dr. Burtch's son Cassidy helps to clean an elephant at the facility

Dr. Burtch's son Cassidy helps to clean an elephant at the facility

Although it has been documented, it is very rare for cats to contract it thanks to their hypervigilant immune system. 

Leptospirosis has a variety of strains and the L in the DHLPPa combination vaccine is intended to prevent infection.  DHLPPa is the abbreviation for distemper, hepatitis, leptospirosis, parainfluenza and parvovirus.  It is the most common part of the vaccine to cause a negative side-effect reaction and when first developed it only prevented infection caused by two of the most common strains or serovars.  Now the updated vaccine has up to 4 serovars included, yet even that does not cover all of those that may cause disease.  Pets who love water play and who spend time in standing water or in rivers and who have significant contact with horses, rats or pigs have a higher likelihood of being exposed. 

 Staff members and Dr. Burtch draw the blood from the back of the elephant’s ear.

Staff members and Dr. Burtch draw the blood from the back of the elephant’s ear.

If your dog loves to wade through water or you take him to the barn or you have rats in your backyard, be aware that as the rains come these bacteria are transmitted via the urine of an infected animal and may be transmitted through the skin or in oral cavities. 

You can read more about the disease and its clinical signs here.

Years ago, Dr. Ann Gratzek, a veterinary ophthalmology specialist, consulted with me on a case at the Vision Quest ranch park. She found uveitis (inflammation in the eye) in an elephant and needed to determine the cause of the disease and recommend treatment.  I went to the facility to help obtain a sterile blood sample from the elephant to culture the blood for bacteria.  While there the trainer shared that this particular elephant had become very close friends with a zebra who had recently arrived at the facility. Based on suspicion of possible transmission of leptospirosis via the nuzzling trunk of the elephant eating hay and other foods from the floor of a paddock shared with the zebra, we also ran a leptospirosis test on the blood from this elephant.  It was positive and we found the source of the eye inflammation and were able to treat and cure the infection. 

Vaccines: the good, the bad, and the ugly


In the press, lately is the debate over vaccinating our pets. The incidence of documented rabies cases in wildlife close to populated areas brings concerns. As certain pet-owning populations strive to minimize vaccines, we need to review the value and risk of vaccines. A similar movement occurred years ago with children when vaccines were thought to play a role in the development of autism.

The GOOD is vaccines prevent highly infectious diseases from spreading among the unvaccinated population. Distemper — a potentially fatal respiratory and intestinal virus, feline leukemia virus causing immune system malfunction, and rabies are great examples of diseases that are much less prevalent because of good vaccine protocols and practice in our pets.

Other diseases for which we vaccinate cause morbidity (illness) but not necessarily mortality (death). Such diseases include leptospirosis, feline herpes, calici and rhino tracheitis viruses, and bordetella (kennel cough). In high-density pet areas such as kennels and daycare, these vaccines reduce risk of disease more likely to occur because of the population density we create. 
The BAD is that any vaccine is a stimulation of the immune system — good in that we want the memory cells of the immune system to immediately recognize the protein of a virus or bacteria so that when the “real thing” comes along it is contained and destroyed.   
Sometimes the immune system over reacts to the stimulus of a vaccines and the pendulum swings too far — the immune system is triggered to create antibodies against part of the “self.”  Examples include auto immune disorders such as immune mediated polyarthritis and immune mediated hemolytic anemia where the joints and red cells respectively become the target of an over reactive immune system.
These diseases can also be life threatening particularly if destruction of the red cells is greater than production and life-threatening anemia occurs.  Treatment for these diseases involved strong suppression of the immune system to stop the abnormal antibody formation.
Many years ago, cats were developing a cancer called fibrosarcoma which developed at the site of vaccine administration. The theory is the local stimulus of the vaccine adjuvant created over reactive fibrocytes (connective tissue cells) which mutated to an aggressive cancer that sends tendrils into the body resulting in life threatening illness. 
The UGLY is that there is no clear answer of what the best will be for each pet.  The AVMA has guidelines for vaccine use that are even controversial in our own profession.

Where vaccines are given has also been standardized with feline Leukemia in the left rear leg, rabies in the right rear leg and other specific recommendation so any localized reaction can be determined and monitoring in a vaccine site.
Some choose to vaccinate through the puppy series then follow the guidelines to age 5 or so. After that the use of titers to determine if an animal has adequate immunity to a disease can be measured, rather than introducing a protein to stimulate the immune system when it is not needed.  Some will vaccinate to the age of 10 years. If an animal has cancer or a misfire of the immune system like auto immune disease, then vaccines are often not recommended for those pets.  
Advocacy for our pets is one of the many responsibilities we embrace when they join our family.  Understanding where the health risks and benefits are for our particular pets is part of being a good advocate.  If in doubt discuss this with your veterinarian for your particular pet at their age and with respect to their health status.


Canine Influenza – Are my dogs at risk?

Canine influenza or the “dog flu” is an Influenza A virus that affects dogs and causes respiratory signs such as coughing and discharge.  Canine influenza was first identified in Florida amongst racing greyhounds in 2004 the H3N8 strain which is thought to have spread from horses to dogs. This virus spread to other parts of the country after the many canine victims of Hurricane Katrina in 2006 were shipped around the country for rescue. A vaccine for this virus was developed in 2009.  The virus is highly contagious but like any strain of influenza the right circumstance of density, shared germs and stress determine whether an animal contracts the disease.  Dogs in boarding facilities and kennels are therefore more susceptible to contracting the flu.

In 2015 a new strain of Canine influenza H3N2 emerged in Chicago affecting dog daycare facilities and requiring some to temporarily close.  It is thought to be mutated from an avian influenza virus reported in the Asia in 2006.  It has since been identified in many parts of the country.  Clinical signs include coughing, congestion, eye and nose discharge and in some cases a fever.


Currently there is a low risk of canine influenza in California and the central coast- however the constant movement of people and their pets within the country makes it a possibility at any time.  The virus is spread through airborne viral particles during coughing and barking.  Clinical signs can range from very mild to more serious including the need for hospitalization.  Vaccination is recommended for pets who frequent daycare, grooming or boarding in areas where the virus has been identified. 

Here are further links to learn about the Canine influenza virus including a map of confirmed cases of the H3N2 strain from Cornell university:





Blog Post Author:
Merrianne Burtch, DVM, DACVIM

Cancer Sucks!


We all have someone, human or otherwise, in our lives who has been touched by cancer.  Rogue cells that disregard the rules of living in our body and operate with a purpose of their own.  Cancer is the most common reason for death in dogs over 10 years of age.  Over the past five years, many advances have been made in the treatment of cancer and progress in this field is moving forward at an incredible rate.  Fortunately, veterinary medicine has fewer regulatory restrictions for medication use when treating cancer- allowing us more opportunities for clinical trials and novel approaches to therapy than human medicine.

Targeted therapy and use of monoclonal antibodies are some of the newer approaches, which are replacing traditional chemotherapy in many cases.  Veterinary oncologists often have a different approach to treating cancer in companion pet patients than doctors treating their human counterparts. Veterinary oncologists set a goal of improving the quality of life rather than compromising quality for the sake of more quantity of life.  


Unlike human medicine where a protocol for treatment is determined by the American Medical Association based on the type of cancer diagnosed, veterinary cancer specialists often modify treatment protocols based on a pet’s response to therapy and side effects to the medications.  Taking the lifespan of our pets and their inability to describe the side effects of cancer therapy, we can choose a treatment plan with minimal consequences and change our course of action if side effects become evident.  

Some of the most challenging and aggressive cancers to treat in veterinary medicine are mast cell tumors, malignant melanoma, and osteosarcoma. These now have newer therapeutic options, which have been developed in the past few years such as Palladia- targeted therapy, melanoma vaccine -using the immune system to attack cancer and soon to be available armed antibodies for osteosarcoma (bone cancer).  


We are fortunate to have many local resources and veterinary oncologists to provide guidance to the general practice veterinarians with diagnosis and therapeutic options for pets diagnosed with cancer. Locally, we have Dr. Theresa Arteaga at Animal Cancer Center in Monterey and Dr. Jay Stone at Santa Cruz Veterinary Hospital. There is also SAGE Centers for Veterinary Specialty and Emergency Centers, which is currently installing stereotactic radiation therapy. This is a state of the art use of radiation that allows fewer treatments and more focal use of radiation. 

Not too far away, is our own University of California – Davis where a world-renowned veterinary teaching hospital is conducting amazing clinical trials. Here is a link to the current 22 trials they are conduction on cancer patients alone: 


Other resources for pets and their people can be found at these websites http://www.acfoundation.org/ and http://vetcancersociety.org/.

If you have a pet diagnosed with cancer, researching options and finding a veterinary oncologist may help you broaden the available choices for therapy for your pet.

Blog Post Author:
Merrianne Burtch, DVM, DACVIM

Foxtails - Plants of Concern

Record-setting amounts of winter rain were so welcome for California this year.  We have green hills and full reservoirs after years of drought.  We also have a thick carpet of plants, which become a concern when pets get into some that cause problems.


Foxtails are the most notorious of these. They have arrow-shaped plant seed appearing with fox tail- fluffs of one directional barbs, which allow them to move only in a forward direction.  These plant awns move into the nose, ear, eye, interdigital areas of feet and other sites of direct skin contact and sometimes even the lungs of dogs and cats, who travel through high grass and fields.  Dogs who chase balls and Frisbees at a high speed can suck these plant awns into their lungs and cause an abrupt cough.  In each of these locations, the plant awns can cause serious damage. In some cases, they migrate through the body and resulting in the loss of an eye, a lung lobe with a severe chest infection or the creation of abscesses in body cavities.  Rare but documented is the migration of the foxtail from the nose or eye to the brain, or from the lungs to the spinal cord. 


If you have these plants on your property, do your best to cut them down when green before drying out can create firmer more dangerous seeds. If your pet has sudden shaking of the head (ear); paroxysmal sneezing sometimes with blood (nose); closing of an eye and discharge from that eye; or a sudden onset cough after running hard through a field- then a foreign body such as a foxtail is a strong possibility and warrants a trip to the veterinarian.  

Grasses and sticks in fields are also a concern.  In the course of my career using bronchoscopy- which is a digital video scope used to examine the deep nasal passages, trachea and the airways of the lungs- I have removed sticks, grass, pine branches and rocks from the respiratory tracts of both cats and dogs.  A very important part of differentiating a foreign body as the source of coughing or sneezing is the history of recent activities for that pet, the environment in which it lives and the acuteness of the signs.  Usually, the presence of a foreign body means acute onset – essentially zero to 60 in a cough or sneeze. 

Dogs like to eat grass and both they and cats may have the rough surface of grass catch on the soft tissue of the mouth and soft palate.  Cats allowed outside who appear to be swallowing hard or who don’t want to eat might have grass caught in the back of their throat- particularly if a foul smell develops in their mouths. These grasses need to be pulled out under anesthesia because the small barbs on the grass grab the tissues of the throat requiring traction to dislodge them.   

I have removed sticks from the trachea and throat of dogs (and 1 cat). Often these are exuberant dogs that have run hard and inadvertently impaled themselves or aspirated plant material.  Again a sudden onset of cough and mouth pain are indicative of foreign material being lodged. Some dogs who like to chew sticks may break off a small piece in the back of their mouths creating a nidus for infection that will show up as facial swelling or pain on chewing sometimes associated with a foul smell in the mouth.

In this celebratory Spring where the green and sunshine brings smiles to our faces, keep your pets safe by removing high grasses and foxtails on your property and watching for signs of a foxtails or grasses affecting your pet. 

Blog Post Author:
Merrianne Burtch, DVM, DACVIM

Safety tips for driving with your dog

 It might look fun but this is a terrible idea!

It might look fun but this is a terrible idea!

We all love to take our pups on car rides with us, and most of them really enjoy the ride!  While this can be good entertainment and a source of bonding, there are some inherent associated risks. All too often in veterinary medicine we see pets that were simply running an errand with their owner, when an accident happens and the pet is now in the emergency room with multiple severe injuries.  

Often these accidents occur when pets are not restrained in the car, or the window is down. One wrong turn and this can lead to severe damage, including fractures, ruptured urinary bladders, internal bleeding, and trauma to the chest causing a pneumothorax. These can be life-threatening injuries, which require extensive care and surgery to resolve.  

These injuries are often preventable with a few simple steps and planning ahead.

  • Pets should always be restrained while riding in the car.  There are many pet seat belts/harnesses available that click right into your current seat belt.  If this is not an option, a section of the car can be sectioned off to prevent jumping and/or falling.
  • While dogs love to stick their heads out the window, it is not necessary to have the window all the way down for them to enjoy the fresh air.  Keeping the window slightly cracked to allow fresh air, but not open enough for the dog to jump out the window is acceptable, and safe.
  • Believe it or not, dogs have been known to step on the window controls and lower the windows themselves.  Keeping the child lock on the windows prevents dogs from performing this action, and keeps them safe.
  • Never allow dogs to ride in the bed of a truck to be unrestrained.  Dog's can safely travel in the bed of the truck IF kept in a crate that is tied down.

Dogs are wonderful companions, and it is fun for everyone for them to travel with the family. Being cautious and thinking ahead can prevent severe, life-threatening injuries. Harnesses, seat belts, and crates are readily available in local pet stores and online.  This relatively inexpensive purchase can save the life of your four-legged friend.

Blog Post Author:
Melissa Arbaugh, DVM, MS, DACVS
Pacific Veterinary Specialists and Emergency Service



Our Pets and Toxins


The other day I covered an emergency shift at the hospital.  I noted that 2 of the dogs were there for toxicity ingestion.  One had enjoyed a box of chocolate truffles, which resulted in vomiting, increased heart rate and the need for intravenous (IV) fluid support.  The other had consumed an entire bottle of flavored chewable arthritis medicine intended for her canine sister.  The dose was more than 3x the toxic dose for her kidneys and required a few days in the hospital on IV fluids for her as well.  So, I thought it might be time to remind people that the common sense we use to decide our actions does not extend to our pets.

 Cats less often get in trouble with inappropriate ingestion. However, I have used my endoscopy equipment to pull from the feline stomach my share of holiday ornaments, hair ties and just last weekend an electrical cord.  Cats are more discerning for what they put into their mouths, however, very playful cats will end up accidentally swallowing thread, string or other linear objects particularly when they catch on the sandpaper tongue of cats. 


One of the first areas to examine is under the tongue of a cat that presents for vomiting- a string will catch under the tongue while the intestines are trying to move the string through the intestines.  We call this a linear foreign body. It will create an accordion effect on the intestines with a potential for the foreign material to saw through the intestines and warranting emergency surgery to remove it.  Cats will sometimes drink cleaning solution and irritate their mouth and esophagus, or eat poisonous flowers, which can irritate the throat. 


Important this time of year is knowing that ingestion of plants from the Lily family can cause acute kidney failure in cats- so do not let your cat chew on flowers you bring into the house.  Lastly anti-freeze, which results in ethylene glycol toxicity, is an important thing to avoid. Anti-freeze can leak from the radiator of cars and it is a sweet tasting solution. Ingestion of a very small amount can result in acute kidney failure and death.  Immediate medical care is needed to save the life of these pets as the substance is converted to a toxic form in the body over the first 12 to 24 hours after exposure.  Alternate sources of anti-freeze are available for pet owners. Knowing that your pet may have been exposed to this substance is crucial to preventing potentially terminal illness.

Dogs are a bit less discerning in what they are willing to put into their mouths, so may require a little more “house-proofing” to keep them safe.  The number one toxicity for dogs is human pharmaceuticals so be sure your blood pressure, anti-inflammatory, and other medications are kept out of reach.   Dogs can be crafty in their ability to get things off the counter including chocolate, raisins, and medication.

Our new concern in the industry is xylitol, the sugar-free option being used in gum, mints and peanut butter.  This sweetener causes a significant release of insulin from the pancreas and life-threatening low blood sugar or hypoglycemia. Dogs have died from consuming a batch of cookies made with xylitol and cats can also be affected. 

Marijuana toxicity is another concern as the brownies or cookies taste as good to our pets as to us.  If you think your pet has been exposed to a toxic substance, then the ASPCA poison control website: http://www.aspca.org/pet-care/animal-poison-control is a great resource.  Calling your veterinarian or the closest 24-hour emergency hospital is very helpful. Try to have the information about the medication or substance consumed, how much was consumed, your dogs’ weight and how recently your pet has been exposed to it.  

The staff at most 24-hour hospitals can help you determine the degree of the emergency.  Sometimes the weight of the dog and the amount of ingested material is “safe”.  There is actually a published “chocolate wheel” that helps determine what is a safe amount for dogs- dependent on the weight of the dog, amount consumed and whether it is milk or dark chocolate -we can tell people whether a visit to the ER is needed.


If the exposure is recent, inducing vomiting to help remove the toxin from the body can be indicated, as long as the substance will not be caustic to the tissues in the mouth or throat. Remember to err on the side of safety in keeping potentially harmful substances from your dog.

Being an advocate for the health of your pet and taking part in preventative and proactive medical care is part of what we at BirchBark Foundation support, whether through education, community building or financial grants for those whose pets are experiencing catastrophic or life threatening situations.  We hope the information on this website helps each reader to be a better advocate for their pet and that the community of Santa Cruz and Monterey county continue to support the mission of BirchBark foundation.

Blog Post Author:
Merrianne Burtch, DVM, DACVIM



With all the amazing rain that California is finally getting, pet owners need to be aware of a bacterial infection seen more often during the rainy season. Leptospirosis is a spirochete bacteria which is transmitted through urine and contaminated water sources.  Multiple strains of the bacteria exist and vaccines are available for many of these strains. Dogs are susceptible to infection and the strain contracted determines the clinical signs that are seen.  Most often the kidneys and liver will be affected.  The organism causes inflammation in the small blood vessels (vasculitis) and affects different organs.


Dogs at risk include those who drink from outdoor native water sources -more often slow moving water, running on rural property accessible to wild or farm animals.  Some dogs can be exposed and not become clinically ill, though in other dogs the disease can be fatal, particularly if the kidneys are damaged by the disease enough to fail acutely. Signs of illness can be nonspecific: fever, lethargy, change in urination pattern, appetite loss and intestinal signs.  If the liver is affected, then jaundice- yellowing of skin and gums can occur.  Bleeding and breathing problems are also evident in some cases. 

Leptospirosis is diagnosed by a blood and urine test. Prior to any antibiotic administration, samples can be sent to the lab for PCR (polymerase chain reaction) testing to look for the genetic material of the organism.  Veterinarians can also run a titer to the organism to determine which strain might be affecting a patient.  Other tests are done on patients to determine which organ system might be involved and to what degree. These include blood tests, urinalysis and radiographs and in some cases ultrasound.  Treatment dependent on the severity of the case may include intravenous fluids to help flush the kidneys and/or liver, as well as antibiotics (doxycycline or ampicillin) to clear the organism from the blood, kidneys, and liver.  If the kidneys start to shut down and the amount of urine produced drops, more aggressive therapy, and in some cases hemodialysis, may be needed to save a pet.

Leptospirosis is a zoonotic disease meaning people can contract it and get fever like symptoms. If a dog is suspected of having this disease, avoid touching the urine, don’t let the dog urinate near water and use good hygiene practices.  People more often contract this disease from water rather than an infected pet. However if one becomes ill around the time the pet is diagnosed, the pet owner should check with their physician, particularly if they are immune compromised.

Prevention includes vaccines administered annually for at-risk dogs: those who swim in slow moving water, spend time around farm and wild animals and have high contact with rats or other outdoor dogs.

Birchbark was able to help save a patient with acute kidney failure from Leptospirosis in 2014: Kiki who lives with her developmentally disabled owner Howard. You can read about her at http://www.birchbarkfoundation.org/success-stories/kiki

You can learn more about this disease at these websites and discuss with your veterinarian whether your pet might be at risk for leptospirosis.




Blog Post Author:
Merrianne Burtch, DVM, DACVIM

Pemphigus foliaceus

Pemphigus foliaceus (PF) is one of the most common autoimmune skin diseases in domestic animals. In this disease, the connections between skin cells are targeted by autoantibodies, resulting in the separation of the cells from each other. When the cells separate, they may form pustules/pimples that eventually form into crusts/scabs.


Pemphigus can start almost anywhere on the body; however, face, ears, tip of the nose, and pawpads are most commonly affected. Other diseases can mimic pemphigus foliaceus, so it is important your veterinarian rules out the chance for bacterial or fungal (i.e. ringworm) skin infections first. A skin biopsy, involving taking a segment of skin tissue, is required for definitive diagnosis of the disease.

There are many therapeutic options for pemphigus foliaceus; however, treatment may vary based upon areas of the skin where the pet is affected, if there’s any other infections on the pet, and suspected cause of the disease.

Corticosteroids (i.e. prednisone or similar) are the mainstay of therapy for PF and necessary in order to get the disease into remission. Once in remission, the medication is tapered to a maintenance dose over many months. Many dogs require additional immunosuppressive or anti-inflammatory therapies in order to be able to decrease the dose of steroids. The pet may need monitoring bloodwork throughout the therapies to ensure no untoward side effects.

While no therapy is without the chance of side effects, pemphigus foliaceus can be life threatening if not treated. It is the goal of the vet to be able to balance the side effects of any potential therapy with the severity of the disease. Seeking a referral for a board certified veterinary dermatologist may be of benefit, as they manage many pets with pemphigus foliaceus and various other autoimmune skin diseases. Few pets may not respond to therapy; however, the vast majority of pets will do well, even on life long, low, doses of steroids.


Blog Post Author: 
Katherine Doerr, DVM, Dip. ACVD
Dermatology for Animals



Auto-immune diseases

Our immune system is a remarkable network of communicating cells that helps our body fight the daily influx of bacteria, viruses and fungal organisms.  We are able to live in a non-sterile world with billions of cohabitating bacteria in our gut and not succumb to infection. Researchers continue to consider ways to use the immune system to fight cancer while HIV demonstrates the effects of a broken one.  Sometimes the immune system makes mistakes- it takes what should be recognized as “self” and turns it into the enemy. 


Auto-immune disease is a catchall term for when the immune system misfires and focuses an attack on the “good guys” (our own cells) in our bodies.  Antibodies are small proteins that normally label foreign material and bacteria for destruction. If a patient receives a transplant organ, then special medication needs to be given to help prevent that patient’s body from rejecting the new tissue by developing antibodies to the unique transplant  protein.  Veterinary patients also develop these self-destructive diseases where vital systems may be attacked. Red blood cells that carry oxygen, platelets that allow blood to clot and blood vessel lining cells are just some of the body parts that can be affected by auto immune disease.  Antibodies can develop against receptors between the nerves and the muscles rendering a patient unable to walk and swallow in a disease called myasthenia gravis. 


We often don’t know why these diseases develop. Some think there is a correlation between receiving vaccines (a stimulus to the immune system) or certain medications that might trigger the misfire that creates an autoimmune disease.  Animals that have immune mediated hemolytic anemia can lyse their red cells over days or in severe cases hours- creating a medical emergency as the oxygen carrying cells are destroyed and inadequate delivery of oxygen creates a life threatening illness. In the case of platelets being the target, those patients may bleed into their lungs- creating the inability to breathe, their intestines may undergo massive blood loss, or the brain may experience severe neurologic damage. In each case prompt care to suppress the immune system is needed to prevent irreversible damage. You can read more about the many autoimmune diseases at this link.



Therapy is focused on decreasing the production of antibodies-usually by reducing the number of antibody producing cells such as lymphocytes. The aim is also to decrease the ability of the faulty antibodies to attach to the targeted proteins particularly because in these cases the proteins are part of “self” not “other”. This helps slow the process of destruction of the cells and the damage to certain parts of the body. Prednisone is one of the first line medications with cyclosporine, mycophenylate, leflunomide and in some cases intravenous gamma globulin (Privigen) to block the receptors for erroneous antibodies. If massive blood loss or rapid hemolysis of red cells are present survival rates are often less than 50%. A lengthy hospital stay or treatment period may be needed with prognosis remaining unclear for a week to 10 days in many cases. 

Prevention of auto immune disease involves monitoring your pet and creating a carefully thought out vaccination protocol with the guidance of your family veterinarian. Be sure pets are protected from common infectious diseases, based on their lifestyle, and that they have additional vaccines to protect from illness, but not more than necessary.  Many people are choosing to run vaccine titers on their pets. A blood test can confirm the presence of adequate antibodies to certain viruses- distemper, parvo virus and Rabies in order to avoid unnecessary administration of additional vaccines. The best prevention for any illness is close careful observation and regular interaction to know the attitude, energy and personality of your pet, so changes are apparent when they occur.

Blog Post Author:
Merrianne Burtch, DVM, DACVIM

Mushrooms - A Silent Killer

Our coastal environment is a haven for mushrooms, relatively mild moist times like fall and winter allow them to thrive here. Keep your pets away from mushrooms and try your best to remove them from your yard and property to minimize exposure for your pets. For dogs- they are a big concern. Puppies in particular may find the mushroom interesting and certain types are incredibly toxic resulting in acute liver failure and are fatal if not caught very early.


Amanita mushrooms are the most concerning for their toxicity but with prompt identification and very aggressive therapy we can save some of the dogs that ingest them. However, cost and severity of the clinical illness often prohibit the ability for some owners to treat their dogs.

If you see your pet consume a mushroom, taking a picture of it is recommended and if you can take a sample to the veterinarian. Get your pet to the veterinarian immediately. Local fungus experts (mycologists) can often help identify the toxicity of mushrooms which allows us to give some idea of prognosis.

If we are not able to make the dog vomit the mushroom (needs to be within an hour or two of ingestion) and the toxin has been absorbed, then prompt medical therapy is indicated. Supportive care to maintain blood sugar, hydration and adequate protein levels is essential to survival. Intravenous medications to help minimize the damage to the liver and in some cases draining the bile from the gall bladder is done since studies in humans indicate survival is increased with that procedure.

Here are a few links to learn more about mushroom toxicity and if in doubt call poison control or your veterinarian or veterinary emergency clinic to prevent this potentially fatal toxin.

http://pacificveterinaryspecialists.com/wp-content/uploads/2015/10/pacifictide- 2012-06.pdf

http://aspcapro.org/sites/pro/files/zd-vetm0207f_095- 100_.pdf

http://veterinarymedicine.dvm360.com/toxicology-brief- mushroom-poisoning- dogs



Blog Post Author:
Merrianne Burtch, DVM, DACVIM

Fat Cats

Cats, like people, have different body types, eating habits, and life styles.  It is true that a larger framed cat will carry more weight just like “big boned” people. Healthy Maine Coons and Norwegian Forest Cats, for example, easily weigh in at 18#.  However, many cats, particularly those that are indoor only and limited in their exercise, are overweight. This can sometimes create health problems such as arthritis, diabetes mellitus and hepatic lipidosis.

Arthritis is an aging change in the joints that can occur in cats, but will be exacerbated by one carrying too much weight. If your pet is sedentary and loves to eat then develops either knee or hip arthritis, the lack of muscle tone combined with too much weight can compromise that pet’s mobility when they become older. If your cat is overweight, talk to your veterinarian about a weight loss program. Just like people, decreased calorie intake and increased exercise is the best remedy. Some people feel feeding only canned food helps since it is lower in carbohydrates and higher in protein. Lower carbohydrate diet can help with weight loss.

Diabetes Mellitus in some cats is thought to be similar to type II diabetes in people. Too much carbohydrate “exhausts” the pancreatic cells that make insulin and those cells take a vacation and stop making insulin, so cats will have high blood sugar. As a result those cats drink more water, urinate more and are very hungry while they lose weight.  Some medications, such as steroids and synthetic hormones, can increase the chances of developing Diabetes Mellitus, particularly in overweight cats. In some cases diabetes can be reversed with a high protein diet, perhaps with short term use of insulin. More often reversal is successful if insulin therapy is used.

Hepatic lipidosis is a life-threatening disease that occurs when the body moves fat to the liver after a period of fasting. Big changes in the environment - moving to a new house or a new pet - or medical conditions that cause cats not to eat, can trigger this disease which can occur after about 4 days of not taking in calories. Overweight cats are more prone to this because they have more fat to mobilize. See your veterinarian if your cat has such a hunger strike for ANY reason, more so if you cat is overweight.

Keeping your cat on the thinner side can be a challenge particularly for those of us that work long hours and struggle to exercise them.  Using a laser light, food dispensing toys and restricted calories as well as frequent weigh-ins will all help in keeping your cat healthy.

Blog Post Author: 
Merrianne Burtch, DVM, DACVIM

Skinny Cats

Many cats will lose muscle mass and in some cases weight as they get older. In some cases it is a natural progression for the body type, but in other cases a medical reason can cause weight loss. It is important to make sure that your older cat is not suffering from an underlying disease if s/he is getting thinner with age. Common diseases in older cats include hyperthyroidism, kidney disease and gastrointestinal disease.

Hyperthyroidism is a disease that usually occurs in cats over 10 years of age. A benign growth on the thyroid gland excessively secretes the thyroid hormone significantly elevating the metabolic rate. These cats eat more, drink more and lose weight. They can become hyperactive and also urinate more in some cases. A simple blood test as well as palpation of the thyroid area can help determine if your cat is hyperthyroid. Treatment options include radioactive iodine which has a high success rate or medication given orally or topically that controls the thyroid level by blocking production of the hormone.  Surgery was historically a treatment, but many cats are not adequately treated with surgery.

Chronic kidney disease (CKD) occurs in many older cats. The capability of the kidneys to remove toxins from the body decreases over time and the cats will drink more and urinate more and in some cases lose weight. The word chronic is used because many cats will do well with a modified diet, monitoring of their weight and in some cases supplemental fluids. Cats can live a relatively good life for some time with a diagnosis of CKD.  Developing a close relationship with your family veterinarian, setting expectations and regular rechecks can help maximize that time and quality of life.

Gastrointestinal disease is a little more of an enigma in older cats. Older cats with weight loss may not seem to be sick at all until a significant amount of weight is lost. In many cases family veterinarians are looking for a metabolic reason for the weight loss in a blood test, but cats that have relatively normal blood tests will still lose weight. First task is to measure that cat’s calorie intake. If a cat is consuming enough calories and still losing weight, then something may be wrong with absorption or digestion of their food. These cats may need careful monitoring and discussion with your veterinarian on how to address the weight loss. In some cases these cats may need ultrasound or endoscopy and biopsies of the intestines to determine the reason for weight loss.

So, if your cat seems to be getting skinnier as it gets older there may be a medical reason and you should check with your family veterinarian to determine the cause.

Blog Post Author: 
Merrianne Burtch, DVM, DACVIM

Summer Time Blues

Summer is the season for outdoor fun. Our pets enjoy sharing that time with us at the beach, in the yard, camping, hiking and swimming. Many potential dangers present themselves during this season. Pet owners should know about these risks and do what they can to avoid injury.

Foxtails, a California specialty, are spike-like clusters of a grass that resemble the tail of a fox. Due to the unique shape, the foxtail only travels in one direction. It can be inhaled into the nose or lungs, caught in the fur or enter the ear canal and cause damage. In twenty years of practice I have taken foxtails from about every orifice you might imagine including lungs and unfortunately even the brain in one case. Keeping your yard free from foxtails and encouraging your pet to avoid running through any fields with foxtails is a start. Dogs with longer fur on their feet who frequent areas with foxtails should have their feet shaved to avoid getting these caught in the fur because they can migrate up between the toes through the skin. Check your dog’s ears, feet and coat for evidence of foxtails upon returning from an outing where foxtails are present.

Cocoa mulch is a popular additive to gardens and on sale at many garden stores. Because the mulch is made from shavings of cocoa beans, it often contains a percentage of theobromine—a caffeine-like substance used in chocolate that can have negative effects on your dog. Smaller amounts will just cause intestinal upset, but as the amount increases—say 4 to 8 ounces of mulch for a 50-pound dog—then the risk increases as well. Symptoms include increased heart rate, seizures and in extreme cases, death. If you use cocoa mulch in your yard check the brand since some companies remove the chemicals harmful to dogs. Any form of chocolate or caffeine can be toxic to dogs.

Snakebites and bee stings are another concern in the summer. Rattlesnake bites can be very dangerous for dogs particularly because they stick their curious noses into the sound of the rattle and often get bit on the face or the neck. Swelling, pain and anti-clotting affects of the venom create serious swelling for dogs. Anti-venin can be used to decrease the reaction but is very expensive. A vaccine is in place for rattlesnake bites but is controversial as to its effectiveness. Many people who hike in dry hot areas with their dogs in summer will get the vaccine in hopes it will decrease the reaction of their dog. Dogs also get stung around the face by bees, since they are often chasing the bees with their mouths. Cats more often get stung or bit on the feet since they engage these animals with their paws. Your pet may have an allergic reaction when stung by a bee.  Monitor your pet for swelling where bit, hives in the skin or change in breathing pattern. If you see any of these, a visit to the veterinarian is indicated to prevent severe allergic reactions.  Some people will use anti-histamines to help decrease the swelling but that might be inadequate therapy for a pet with a serious reaction.

Summer is one of the best times to be a pet owner enjoying the outdoors. Camping and hiking with your pet can bring such a sense of peace and appreciation for nature. Enjoy it well and be aware of the risks for your pet and do what you can to keep them safe.

Blog Post Author: 

Merrianne Burtch, DVM, DACVIM

What is the best way to prevent ear infections in dogs?

Dogs can get frequent yeast and bacterial infections in their ears. Dogs with heavier ear flaps (pinna) and more hair on and around the ears—cocker spaniels are classic for this problem—generally have more problems and infections. If your dog swims often it is best to try and make sure the outer part of the ear is dried afterward. Talk to your veterinarian about preventative wash with drying agents and how frequently you should use them to help keep infections from recurring.

What are some signs to watch for regarding dementia in aging animals?

What precautions might pet owners take if/when it develops? My dog has started barking, when she seldom did before. She also seems to be about 95% deaf. Is her new found barking because of deafness or might it be related to onset of dementia?

Many older dogs will display aging changes mentally as well as physically. It is possible that both the hearing loss and aging changes are contributing to your dogs new found barking. Similar to senility in people, dogs can get Cognitive Dysfunction Syndrome (CDS) which can manifest as behavior changes or loss of ability to perform routine activities. A dog’s loss of sensory input (deafness) and decreased vision at times causes them to use other means of “communication” to feel comfortable in their environment. Since talking with our dogs is how we communicate and deafness takes away this option, other methods become necessary. Some people feel a high pitched whistle still works in dogs that have lost hearing. You might try to work with a whistle and reward her when she comes to create a new form of communication. You may want to put a flashing light on her collar during the summer trips so she will be easier to locate.

There are options for trying to increase her cognitive skills. Talk to your veterinarian about your options and to see what you can safely try on your girl, i.e., diet, supplements and medications. Make sure she is not on any medications that might interact anything you give her. You can read about canine cognitive dysfunction syndrome at http://pets.webmd.com/dogs/cognitive-dysfunction-syndrome-dogs. Good luck!