No one likes coming home to find a mess - whether that's an object torn to shreds, furniture damaged, or pee or poop to clean up. But chances are, your dog (or, very rarely, cat) isn't actually out to get you. He or she is more likely to be scared or nervous, and the mess is the symptom of that anxiety.

It's normal for pets to be unhappy when their owners leave. But most pets can settle down to nap while their owners are away. 

So what is separation anxiety? Separation anxiety is a medical condition where your dog experiences distress when left alone. These pets may cause harm to themselves or their environment in their need to escape or their drive to comfort themselves. 

Signs of separation anxiety include:

• Housesoiling - urine and/or stool 
• Vocalizing - constant barking or whining
• Panting excessively
• Pacing and being unable to settle down
• Destructive behavior - chewing up objects, furniture, parts of the home
• Trying to escape

What triggers separation anxiety?
Any change in routine can trigger anxious behavior. This can include absence of a family member, like a new work or school schedule or a trip. The absence doesn't have to be long, and some pets will start to show anxious behaviors before the person even leaves. Moving is another stressful even that can trigger anxious behavior. Puppies can show anxiety when separated from their littermates, and senior dogs can develop anxiety in their old age.

How do you treat separation anxiety?
The first thing to do is consult your veterinarian. Your pet may have a medical condition that is causing the behavior change, and treating the problem may fix the behavior. Some examples include pets who are uncomfortable from arthritis, drinking, urinating, and panting more than usual because of Cushing's disease, or are hyperactive or aggressive from an overactive thyroid (cats). 
Once medical issues are ruled out, training starts. Many pets will also benefit from calming supplements and/or medications to allow their anxiety to subside enough that learning can occur.  

The first step in training is to provide your pet with proper exercise. A bored pet is more likely to get into trouble. A tired pet is more likely to rest until you come home. Make sure to stimulate your pet's mind as well as body with new games and activities.

Now, start training your pet to "settle". This is a command that you train, just like "sit" or "stay". It means your pet goes to a designated spot like a bed or a crate and relaxes in place. At first, your pet will settle for a very short time. Gradually increase the length of time and the distance you move away before releasing your pet from the command. Use treats and positive reinforcement to keep teaching this command stress-free. Be patient! Once you can leave the room for a short time and return without your pet moving from their settle, you are ready to leave the house for a short time. When you come home, great your pet with the release word and a calm demeanor.  

Severely affected pets need additional help beyond training. 
Solliquin or Zylkene are calming supplements that decrease the fight-or-flight response and allow learning to occur. Some pets will also respond well to hemp-based supplements - but be careful to avoid any THC, which is extremely toxic to dogs and cats.
Anti-depressants like fluoxetine or clomipramine are also very helpful to get the process started for some pets. Start with an appointment with your veterinarian to get your pet the help they need. 

When is a mosquito bite more than just an itchy annoyance for your dog, cat, or ferret? When that mosquito is carrying a parasite called heartworm (Dirofilaria immitis). Found in all 50 states but most prevalent in the South and Midwest, heartworms are transmitted from one pet to the next by a mosquito.

Heartworms start as tiny microfilaria that can only be seen under a microscope. Over the next 6 months they lodge in the vessels of the heart and lungs and grow to be over a foot long. Adult heartworms can live in your pet for up to 7 years, and create thousands of baby heartworms that will be transmitted to other pets through new mosquitoes.

The novel coronavirus outbreak has many people worried for their health and the health of their families and pets. Concerned owners in China have even started putting face masks on their cats when outdoors to minimize the risk of exposure. Should you be worried about your pet? In a word, no.

​The current outbreak is caused by a novel coronavirus named Sars-CoV-2, that causes a disease known as COVID-19. As of February 18, the World Health Organization reports it has infected over 73,000 people and caused almost 1900 deaths. That's a lot of people, but let's put it in perspective: the CDC estimates that there have been at least 26,000,000 (yes, million) cases of influenza since October 2019 and at least 14,000 deaths this season here in the United States alone. Companion animals like cats and dogs don't become ill from COVID-19, but it is conceivable that they could carry the virus from one person to another. So a person infected with COVID-19 should minimize contact with their pets to protect other people in the household.

The best protection against viruses is to wash your hands frequently, avoid touching your nose and mouth, and use alcohol-based hand sanitizers after touching public objects (like doorknobs). Stay home if you are ill, and if you are coughing or sneezing in public cover your nose and mouth with a tissue or your elbow to minimize the spray. 

So as we all practice social distancing to slow the human spread of COVID-19, there's no reason to panic for our pets. Practicing good hygiene and limiting exposure to sick people and animals are reasonable precautions, but there's no need to fit your cat with a mask. (A disappointing fact: surgical masks don't actually block virus particles. Only properly fitted N95 masks can do that, and those should be reserved for medical personnel caring for sick people. Paper surgical masks will remind you not to touch your mouth and nose while you're wearing them, and do block most of the droplets from spreading to others when you cough or sneeze. So they're the considerate thing to wear if you are feeling ill and don't want to share your infection with others.)

We've all been there - waking up in the middle of the night to the sound of our cat hacking and retching up a hairball. Or better yet, not waking up and getting the squishy surprise of stepping in it the next morning. Ick. But why do cats get hairballs? When should you worry?

What is a hairball?
Cats are self-grooming creatures, so they ingest hair on a daily basis as part of their normal routine. They may also groom their friends and ingest hair from housemates. Have you ever noticed how rough your cat's tongue is? Those tiny papillae point backwards and help the cat catch loose hair and untangle knots. They also prevent the cat from spitting out most of this hair, so instead they move hair towards the back of the mouth to be swallowed. Most of this hair will pass through the GI tract uneventfully and be passed in the stool.  Sometimes the hair accumulates in the stomach or esophagus, leading to a hairball. When enough hair is trapped in the stomach it will often trigger the urge to vomit. Bringing up a hairball is usually an active process for most cats. They may make noise, hack, retch, or cough before bringing up the hair. A healthy hairball can be anywhere from 1-5 inches long, and is usually tube shaped from coming up the esophagus. The fluid around the hairball can range from clear to yellow to green to brown and still be normal. It will depend on how recently your cat ate and drank.

How many hairballs are normal?
Healthy cats can bring up a hairball on a weekly basis. Some will do so much less frequently (or never), and some cats will increase their hairballs during their twice yearly major shedding cycles. Cats who are distressed by their hairballs, vomit repeatedly, or bring up hairballs more than once a week should see the veterinarian.

Ah-choo! Cats can sneeze for a variety of reasons ranging from no big deal to serious illness. Here's how to tell whether to stay home and relax or call the vet.

Sneezing is a normal response to nasal irritation. Occasional sneezes are nothing to worry about, especially if your cat is immediately back to normal after the sneeze.

Sneezing can produce clear spray or thick snot. In general, clear spray sneezes are often viral or allergic in origin, while thicker green or yellow snot can mean bacterial or fungal infection. The nasal discharge can be present on both sides (bilateral), or just from one nostril (unilateral). Unilateral nasal discharge usually means something is structurally wrong, like an abscessed tooth or a foreign object stuck in the nasal passage. It always warrants a trip to the vet. 

When to see the vet:

• Any sneezing cat with a decreased appetite needs to see the veterinarian. Cats are very sensitive to smell, and many will not eat if they can't smell their food. A thick snotty nose definitely impairs ability to smell, so these cats need help quick. Offering smelly canned foods and tuna can perk up an appetite, and hanging out in a steamy bathroom or near a humidifier can also help loosen nasal secretions. 
• Fever is another reason to see the veterinarian. If your cat has decreased energy or is running a fever (most accurately measured rectally by your veterinarian), veterinary care is needed.
• Lethargy or trouble breathing - if the congestion impacts your cat's ability to play and exercise or if your cat ever appears to be in distress, seek veterinary care immedicately.
• Unilateral (one-sided) nasal discharge or bloody nose - since this often means there's a foreign object or structural reason behind the sneezing, seek veterinary care quickly.
• Thick green/yellow snot, or any sneezing that lasts more than a couple weeks

When you can wait:

• Acute sneezing with clear discharge and a happy cat - if your cat sneezes but is playful, alert, and has good appetite, it's usually safe to monitor at home for a week or so. Viral upper respiratory infections will run their course and you should see improvement after 7 days.
• Mild seasonal sneezing with clear spray - sneezing that recurs each year during a specific season may be allergic in nature. As long as your cat is otherwise acting fine you can try antihistamines at home as needed (talk to your vet about dosages).  Stop all smoking within the home, scented air fresheners, and candles, and install an air purifier to decrease inhaled allergens. This will minimize their discomfort.

 If in doubt, call us! While sneezing can be a normal sporadic part of a cat's life, any chronic sneezing or ill cats should be evaluated and treated. 

Did you know that summertime is flu season for dogs? Or that parvovirus is more common in warm weather? Summer is a great time to review your dog and cat's vaccines to make sure they're fully protected while they play.

Who needs what?
Vaccinations prevent infectious diseases. We carefully select vaccines that are safe, painless, and effective to provide your dog and cat with the best protection with the least risk of side effects. Vaccinations are divided into two categories by the American Animal Hospital Association (AAHA) and the American Association of Feline Practitioners (AAFP): core and noncore. Core vaccinations are for every pet. Noncore vaccinations are selected based on what diseases are present in your area and your pet's individual risk factors and lifestyle. 

How to decide which noncore vaccines your dog needs:
Social dogs should be protected against kennel cough and dog flu. That includes dogs who go to day care, dog parks, grooming, or boarding facilities. It also includes dogs who may come into contact with friends on neighborhood walks. We've had 2 outbreaks of flu here in Cincinnati, and several boarding facilities even had to close temporarily to stop the spread. Both flu and kennel cough are airborne. They are spread by sneezing and nasal discharge.

Here in Cincinnati, we strongly recommend that all dogs be protected against leptospirosis because our local raccoon and opossum populations are carriers of the bacteria. The bacteria are hardy in moist conditions, so all it takes to get infected is for a raccoon to pee in your yard and your dog to sniff/lick the area. Then the bacteria multiply and cause damage to the liver and kidneys. Even more scary is that leptospirosis is contagious to people, so you are at risk if you come into contact with your sick pet's urine.

Lyme disease vaccination is not usually needed for dogs who stay in Cincinnati as long as they are on year-round tick prevention. That may change in the future, however, as our tick population becomes more infected with the bacteria and the risk for the disease increases. Dogs who are not protected against ticks or who travel to the northeast or northern midwest should be vaccinated.

Which noncore vaccines does my cat need?

​Cats who go outside where they may come into contact with other cats should be protected against FelV (Feline leukemia virus). That virus is spread through saliva, so sharing a water dish, mutual grooming, or fighting can lead to virus transmission. The virus can lead to a supressed immune system and even the development of certain cancers like lymphoma.

Cats who live with an FIV-infected cat can receive the FIV vaccine. This virus is transmitted from cat to cat by biting. Only cats who are microchipped should receive this vaccine, because it will cause the cat to test positive for the disease on the screening tests used in most veterinary offices. So if your cat ever gets lost, he or she might be mistakenly diagnosed with the disease and considered sick and contagious. FIV causes immunosuppression, making your cat more susceptible to infections.

Chlamydophila, Bordetella, and FIP vaccinations are rarely needed for cats in the Cincinnati area. 

I'm not sure there's anything redeeming about ticks. They crawl, they bite, and they carry diseases. Thankfully there are some easy ways to just say no to ticks this spring - and all year long.

Here's what you need to know to keep your pets (and your family) safe from ticks. 

1. Ticks can be tiny. A nymph deer tick is the size of a poppyseed, and can easily hide in fur, hair, or under jewelry. 
2. Ticks are active. There are 5 common species of tick found in the Greater Cincinnati area. Each has a slightly different life cycle, so the end result is we have ticks out and about every month of the year (yes, even in January). But May is the "tickiest" month - that's when the most ticks are active. 
3. Ticks carry diseases. Lyme disease, ehrlichiosis, anaplasmosis, Rocky Mountain spotted fever, and cytauxzoonosis are just some of the nasty infections that ticks transmit to the animals they bite. Some of these diseases can have long term consequences even with treatment, so this is one area where an ounce of prevention is more than worth a pound of cure.
4. It's easy to prevent ticks. First, create a tick-free zone in your yard. Ticks prefer moist environments, so they're less likely to venture to the middle of the lawn. Rake up leaves, cut back grasses and brush, and try to decrease wildlife traffic through your yard to keep tick numbers down.
   
5. Then, protect your pet. There are a number of safe, effective products to keep your dogs and cats safe. They come as oral chews, topical products, and collars. 

As you can see, there are a number of effective options available. Some are available in pet stores, others through your veterinarian.

• For households with children, the oral products - Bravecto, Simparica, and Nexgard - are often the best choice since there's no need to separate the pet until the product dries.
• For outdoor cats, applying topical Bravecto once every 12 weeks can be the most practical.
• The Seresto collar is a great option for pets who wear collars all the time.
• Vectra 3D has the added advantage of repelling mosquitoes, so it makes a good adjunct to heartworm prevention.
• Frontline and Advantix are readily available in pet stores (be careful not to purchase Advantage, which lacks tick protection).

Talk to us or your local veterinarian to find the best product for your pets' lifestyle - but the bottom line is that your dog or cat deserves to be protected from those tick-borne infections.

Found a tick? Now what?
Gross - you just found a tick. First, take a deep breath and don't panic. Next, how to remove a tick: grab a pair of tweezers, firmly grasp the tick as close to the skin as possible, and pull straight out. This applies to ticks on people as well as pets. The goal is to get the tick's head and mouthparts out if possible. Do NOT pour alcohol on the tick or try to burn it - those techniques just make the tick regurgitate more into the wound and increase disease transmission. Do save the tick and send a photo of it to the folks at tickencounter.org for identification. They will let you know what the risks are for that particular species, and then you can decide whether to pay to have your tick tested for diseases.
Watch for illness - watch your pet closely for lethargy, fever, limping, swollen joints, bruising, or changes to thirst or urination. These are signs of several of the tick-transmitted infections like Lyme disease or Ehrlichiosis. Seek veterinary care quickly if your pet becomes ill.  
Test for disease - make sure your veterinarian screens your dog every year for the most common tick diseases, even if you've been using prevention. This can usually be done with a few drops of blood right in the office. A positive result means your pet has been exposed to the organism, and further testing is needed to see if treatment is recommended.

February was Pet Dental Health Month, so we're going to focus on those (hopefully) pearly whites today. Not so pearly or not so white? Probably time for a checkup and professional cleaning. Because even veterinarian's dogs get dental problems too, here's my Truffle's dental story from last month.

There is a new swelling on the left side of her face, underneath her left eye. Trace the jawline and it will become more clear (I'm sorry, she's a black fuzzy dog so photos aren't as obvious). The picture to the far right has the swelling outlined in red.

The most likely cause of a lumpy swelling on the face in dogs is an infected tooth. If the whole face is swelling or the eyes are swollen, think allergic reaction and seek treatment immediately. Unfortunately, tumors are also a possible cause, especially in older pets, so it's important to get a diagnosis quickly to address the problem.

After a week of antibiotics, Truffle's face was almost back to its normal shape. This made a tooth root infection the most likely reason, so we proceeded to dentistry to find the culprit.

This is what Truffle's teeth looked like once she was asleep. The orange tube goes into her airway and is connected to an anesthetic machine  giving her oxygen. It allows us to closely adjust how deeply she's asleep and even breathe for her if necessary, and is one of the many precautions we take to ensure safe anesthesia. 

Not too bad, right? But on probing carefully around each tooth, I found a pocket in the center of the largest upper molar. We took x-rays:

After the bad tooth was surgically removed, the gum was stitched back together to provide quickest healing time. Here is Truffle's mouth at the end of the procedure.

A week after the dentistry, I let Truffle start chewing on rawhides and dental treats again. Her mouth is pain-free, and the swelling on the side of her face is much improved. She may never be exactly symmetric again, but now she has a chance to heal and the source of the infection is gone for good.

So here's the moral of the story - even teeth that look ok can hide some pretty nasty problems. Have your pets' teeth checked every time they visit the veterinarian, and follow up with an anesthetic dental cleaning if recommended. Scraping the teeth while your pet is awake will miss a problem like Truffle's every time.

Heartworms are scary, and unfortunately, they're here in Cincinnati. We earned the dubious honor of being the city with the fastest growth in the country of new heartworm cases last month. You can't see them, and they can make your dog or cat seriously ill. Heartworms are parasites that live in the heart, lungs, and large blood vessels of dogs and cats. They are transmitted as microscopic larvae by mosquitoes. Luckily, there are effective ways to prevent your dog and cat from getting heartworms.

As you can see from these maps, heartworm disease is steadily spreading across the country, and unfortunately Cincinnati is now in the red zone.​ We'll get the next updated map in 2020.

How do you get heartworm disease?

From a mosquito. A mosquito bites an infected dog, and ingests baby heartworms, called microfilaria. She then carries these microfilaria to the next dog or cat, and infects the pet when she feeds.

Those heartworm larvae now spend 2 - 4 months migrating through the tissues of the new dog or cat, growing up into adult heartworms when they reach the vessels of the heart. Heartworms can grow to be over 12 inches long, and can live for 7 years inside your dog. The heartworm preventions are only effective during the first 2 months from infection by the mosquito. 

What should you do?

Protect your dog and outdoor cat every single month with heartworm prevention.
Common tasty chewable brands include Sentinel, Interceptor, Heartgard, and Triheart. Topical heartworm preventions are also available for cats and dogs - Revolution and Advantage Multi. There are many options, and they're all just about equally effective at preventing heartworms from reaching adulthood as long as they're given monthly. There is even a long-acting injection, ProHeart 6, which provides 6 months of protection.

We can help you decide which heartworm prevention is the best for you. They are all slightly different in what other parasites they treat, but they are equally effective at preventing heartworm. But they all MUST be given EVERY SINGLE MONTH in order to work. Talk to us about which particular medicine is best for your pet's lifestyle. Once those baby heartworms become adult, they are resistant to the preventatives and your pet needs treatment for the disease.

How to diagnose heartworm disease:
A couple drops of blood is all it takes to check your dog or cat. ​Here at Montgomery Animal Hospital, we will also screen your dog for tick-borne infections with the same test. Check with your vet about which test is being run, since some tests screen for heartworm only.

How to treat heartworm disease:
Heartworm treatment is a long, arduous process for dogs. There is NO treatment for cats - we are limited to supporting their hearts and lungs as best as we can until the worm dies on its own, a process that can take years. While it's worth it in the end to save your pet's life and lungs, it's not a fun thing to go through. 

• The first step is staging the disease to see how much damage has been done - this requires bloodwork, urinalysis, and chest radiographs.
• A heartworm prevention is given under medical supervision to stop the spread of heartworm disease and prevent any more worms from reaching adulthood. Often steroids and antihistamines are used too to reduce the chance of allergic reaction when the microfilaria are dying.
• Next, an antibiotic is given for a month to eliminate a commensal bacteria, Wohlbachia, that supports the heartworms. Without this bacteria, the heartworms start to wither and are less likely to produce the baby microfilaria.
• A month later, the first dose of melarsomine treatment is administered to start eliminating the weakened heartworms. Here's where the danger intensifies. The injection kills some of the heartworms, and now the dog's immune system must digest the worms to get them out of the blood vessels. But if the dog runs, plays, or has any excitement that quickens the heart rate, those worm pieces can be thrown into the circulation and cause a fatal blood clot. This injection is painful, and we support the pets with pain relievers and use steroids to decrease inflammation as the worms die off.
• One month later, the next two doses of melarsomine are administered. The exercise restriction remains strictly in place for another 6 weeks to allow the immune system to digest all the worm pieces.
• Finally, 5 months after diagnosis, the dog is allowed to run and play again. Bloodwork in 6 months is needed to confirm that all the heartworms were eliminated, and if not, the process starts again.

warning - graphic photograph below