There is thought to be a genetic basis to EPI and while it can develop at any age, it is usually seen before the age of 4.  The incidence is reportedly much higher in German Shepherd Dogs and Rough-Coated Collies, but it has been diagnosed in many other breeds.

The main symptoms of EPI include weight loss or the lack of weight gain, and soft stools or diarrhea.  Diagnosis is based upon physical exam, pertinent historical information and a serum blood test for a specific enzyme.  The test is called the TLI or trypsin like immunoreactivity test.  There have been other tests used in the past but they are not as accurate as the TLI test.  Keep in mind that dogs with EPI can have other concurrent medical issues so it is always a good idea to have a full work up done including a general health screen blood panel, urinalysis, fecal parasite check and the levels of folate and cobalamin measured.

If a dog is diagnosed with EPI then treatment is centered on supplementing for the missing enzymes.  There are a variety of choices of enzyme replacements available so discuss with your veterinarian about cost, form and quality.  You should also discuss the manner in which the supplement is given to your dog.  If other medical issues are discovered then additional medications or a diet change may be indicated.

While EPI is not a curable disease and does require life long medication, it can be managed so your dog can have an active healthy life.

The post Exocrine Pancreatic Insufficiency (EPI) appeared first on Muller Veterinary Hospital.

http://www.assisianimalhealth.com/news/2012/10/04/animal-acupuncture/

Jennifer Yamamoto, DVM, is the second subject in our series of interviews with rehabilitation and veterinary specialists using the Assisi loop. Dr. Yamamoto completed her bachelor’s degree in biology at UCLA and her veterinary degree at UC Davis. She has been practicing small animal medicine in Contra Costa County, California since 2002. In 2006, she earned her veterinary acupuncture certification through Colorado State University, and offers this complementary therapy to her patients at Muller Veterinary Hospital and the Canine Rehabilitation Center in Walnut Creek.

NG: Thank you so much for joining our veterinarian interview series. To start out with, if you could describe yourself, what you do, and how you first heard of the Assisi device and started using it.

JY: I’m a small animal veterinarian and I’ve been in practice for about ten years. I do mainly general practice and I’ve been practicing animal acupuncture for the last 5 or 6 years. We have have a rehabilitation center in our hospital, so I get to see a lot of referrals from other hospitals for arthritis, neurological problems, post-operative back surgeries, rehab for orthopedic surgeries, etc..

We started using the Assisi loop a few years ago and have been getting good results. We use the bulk of the loops for conditions like degenerative joint disease and post-operative healing. We’ve also used some on a couple of chronic skin non-healing issues, and I’ve prescribed it a lot for back pain.

I used one on my own cat who has lumbosacral disease. That experience is really what convinced me that it could be a helpful adjunct to the treatments we have available. She did not respond to any of the medications I tried or acupuncture, but she did improve with the assisi loop.

NG: So how can you sense improvement? How can you tell the animal is doing better?

JY: We rely on feedback from owners. In the case where I was watching my own pet, I measured her mobility and vocalization. Prior to the loop, her sacral disease made her scream constantly, so it was easy to see that she was in horrible acute pain. After using the loop she was able to jump without screaming and I could tell that she was feeling better. She would also hold her tail up, whereas she wouldn’t do that before being treated.

NG: So these are things that the owner who is around the animal and knows its behavior can sense?

JY: Exactly. It’s mainly noticing behavior changes and an increased ability to move. Pain or difficulty moving often manifests when the animal is transitioning from a sitting position or laying down position to a standing position. When the loop is helping, owners notice the pet is doing that more easily or is more willing to move around. Or the dog is able to go for a walk longer than it used to be able to. Other people seem to notice–especially when I’m treating back disease–that the dog is initially really hunched or kyphotic (hunchbacked) and that treating the back seems to relax and straighten out the muscles around that kyphotic area.

NG: And what about those cases with the skin disease that you mentioned?

JY: One was a mast cell tumor surgery where we had to remove really wide margins of the skin and the site wasn’t healing for a really long time post-operatively. So we decided to try the loop. I think that helped–it took a while, but eventually the skin did heal up and close over and we were able to close that defect.

That’s the only example I can think of off the top of my head. I would love to try some on lick granulomas [sores caused by compulsive self-licking] or hygromas [swelling on or near a dogs elbow] that just never heal. I haven’t had anyone take me up on that yet but I think it’s a promising area.

NG: When do you tend to use the Assisi loop instead of animal acupuncture or other alternative therapies?

JY: I find a lot of animals either, number one, don’t tolerate needles very well, or, two, the owner has a hard time getting them in for a treatment as frequently as a I need them to. The Assisi loop is a good alternative for a lot of those patients.

Some animals just don’t handle the stress of acupuncture treatments. I’ve found in general that if the pet gets nice and relaxed and accepts the treatment, it tends to be more effective. But if they’re stressed and panting and struggling and associating the treatment with something painful or unpleasant, it’s not as effective. The stress response overrides the body’s positive response to the needles. So for those pets I offer a loop–of course, only if the owner is willing to do the treatments everyday for the amount of time that they need to.

And then we also have clients coming from a fair distance. They’re driving an hour or more to get here for rehab. For animal acupuncture to work best you need to come at least once a week and for some of them that’s really difficult. Oftentimes the loop is the best option in this situation. I’ve had good luck with that.

NG: When you see animals for acupuncture what are you usually treating them for?

JY: Because we have the rehab center here I see a lot of referrals–back surgeries, animals that are in pain or paraplegic, paraparetic or ataxic. In other words, patients who are just not bouncing back after surgery. They’re not walking, they’re uncomfortable, they’re incontinent. For most of those dogs acupuncture works great; but again, there are those few who just hate the needles or hate being here, and we have to try something else.

Through general practice I’ve used the loop on a lot of soft tissue pain. Many active dogs tend to strain their psoas (a deep set muscle used for running and jumping) or their hip flexors. I feel that oftentimes animal acupuncture falls short at dealing with generalized muscle strain discomfort. But probably 60-70% of the dogs I’ve used the loop on for that improve pretty significantly. And I’ve had a lot better luck treating elbow arthritis with the loop than acupuncture. That’s one case where I usually tell people, let’s try the loop first.

NG: When you talk to your clients about using pulsed electromagnetic therapy (PEMF), how do people respond? Do they ask if it’s magnetic therapy?

I get a variety of questions. Some clients just say, “OK, that sounds really weird.” My response is, “You know what, take a look at some literature and look it up online.” There’s quite a bit of information out there. I usually tell them people use the technology too, which can increase their confidence.

But I have had people ask, “Yeah, is it the same thing as wearing those magnets or having the magnet beds?” And then I’ve had some people say be really excited about trying it. So its a really wide range depending on the clientele’s experience, background and how they tend to approach these problems.

NG: Do you recommend Assisi to other vets?

Yes! It’s nice that it’s non invasive and it doesn’t hurt the animals at all. People can administer it at home, they don’t have to drive their pet here for it. And, actually, over the course of months is ends up being fairly inexpensive. It’s a lot less expensive than animal acupuncture as well if you plan on continuing with it long-term (laughs).

The post Alternative healing: Interview with animal acupuncture expert Dr. Jennifer Yamamoto appeared first on Muller Veterinary Hospital.

We are all struggling right now with the right choice of  heartworm prevention for each dog.  There have been supply issues with established products as well new products that we may be unfamiliar with and it makes it all very confusing.

Let’s start first with the basics that can clear up some misunderstandings.  According to Dr Mark Kittleson DVM PhD DACVIM ( Cardiology) at UC Davis, all heartworm preventatives are from the macrocyclic lactone family. This  family is further divided into avermectins, which includes ivermectin as in Heartgard Plus, and milbemycin which is in Interceptor, Sentinel and Trifexis.  Even more important to know is that the amount of ivermectin in Heartgard Plus is not now nor ever has been toxic to ANY breed of dog regardless of MDR1 status.  The dose of ivermectin in Heartgard Plus,  6-12mcg/kg,  is far too low to cause a toxicity.  Ivermectin toxicity  occurs at a dose of 50mcg/kg in the MDR1 mutant dogs and at a dose of  > 100mcg/kg in non- mutant dogs. Keeping this in mind, Heartgard Plus is a safe option for heartworm prevention in any dog. There are occasions where ivermectin can be prescribed at much higher doses than is present in Heartgard Plus and this would not be done in a dog suspected or confirmed sensitive to ivermectin .    If you are still not convinced that you want to put your dog on an ivermectin containing product, then  the milbemycin-containing products such as Trifexis, Sentinel and Interceptor would be another option that is just as safe for monthly protection.  (Sentinel and Interceptor are not currently in production as of the writing of this article).

I hope that this helps put your mind at ease and makes it easier for you to make the right choice for your dog.

(This article can also be found on Dogtrekker.com)

The post Canine Heartworm Disease Prevention appeared first on Muller Veterinary Hospital.

Prior to the donation, most of the county’s fire departments were not equipped with the kits.  Marin County fire departments will put the kits on their fire engines, according to officials.  Each kit includes three sizes of oxygen masks, oxygen supply lines, a rescue leash, decals and instructions on how to use the equipment. 

Dr. Troy and Muller Veterinary Hospital designed the kits and have been providing them to various fire departments throughout the country.  In addition, Dr. Troy is a FEMA instructor and has participated in training dog handlers in the field on canine first aid and other canine medical emergencies, in order to enable the handlers to be self sufficient when on site at a national or international disaster!

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