Pets will lose about 75% of their renal function before azotemia is noted on the labwork. This is why staging is important to determine how far underlying renal disease has progressed, so that supportive measures and appropriate intervention can take place.

What is Chronic Kidney Disease?

Chronic renal disease is kidney disease that has been going on for months or years (longer term). This is different than acute renal failure which occurs suddenly and more severe (such as with antifreeze or lily toxicity). There are many possible causes of chronic kidney disease including:

  • Chronic bacterial infection
  • A defect of the kidneys at birth
  • Hypertension (high blood pressure)
  • Autoimmune disease (such as lupus, glomerulonephritis, or amyloidosis)
  • Infectious diseases (such as Lyme or Ehrlichia)
The intricate vasculature of the kidney is illustrated in this model.

The intricate vasculature of the kidney is illustrated in this model.

The kidneys contain thousands of nephrons (the functional unit of the kidney). The kidneys help to filter blood waste (from toxins, foods, cells, etc.), conserve water and electrolytes, and regulate calcium and Vitamin D levels. They also produce erythropoietin which helps the body to make new red blood cells.


Pets can have many symptoms, most commonly including decreased appetite, occasional vomiting, weight loss, and increased drinking and urinating.


Labwork often shows anemia of chronic disease (non-regenerative), elevated BUN and creatinine (azotemia), increased phosphorus, dilute urine, proteinuria.

Staging is helpful to determine severity of the renal failure. The International Renal Interest Society (IRIS) provides a helpful algorithm for staging renal failure in pets. IRIS Kidney Disease Algorithm

Tests to help determine the underlying cause of kidney disease include x-rays or ultrasound (to look at kidney structure and look for kidney stones), a renal biopsy in cases that are suspected autoimmune or congenital, urine culture and MIC, blood pressure, and urine protein:creatinine ratio.


Treatments can include diets limited in protein, phosphorus, and ash, phosphorus binders if the phosphorus is high, weekly (or more frequent) subcutaneous fluids for renal support, antacids (such as famotidine), and others. The treatment plan varies per patient and is tailored to each individual based on lab findings, stage of renal disease, underlying complications (such as hypertension), and clinical status.

IDEXX Advanced Diagnostics for Kidney Disease


Feel the Breeze!

"Pam" the dog feelin' the breeze!

“Pam” the dog feelin’ the breeze!

Simply put, it isn’t enough for a dog to live in a home with a yard. A yard to play in does not equal a “daily walk.” I am not saying it isn’t fantastic, because it is. I am just saying a daily walk and living in a home with a yard are not synonymous.

Often, clients come in with complaints of behavioral issues such as barking, fighting or dominance issues with other dogs in the home, or chewing up things around the house. The first question I always ask is, “How many walks does he/she get per day?” And most of the time there is silence because the answer is none. Or the response is, “None…but we have a backyard.”

Dogs still need to have their minds stimulated. They need to get out of the house and go for a walk, or a ride in the car, or have a pet play date.

When we as humans get home from work and are tired and ready to relax, the dogs are excited and happy to see us! They are ready to start their activities with us and be busy. Remember, they have likely been sleeping all day or just waiting for us to come home. Their whole world revolves around us. So as hard as it might seem to get up early for a morning walk, or to go for that evening walk after a long day, just commit to it for yourself and for your dog. It is good bonding time and frankly a necessity for the whole household!

It reminds me of a quote I recently saw, “To the world you may be just one person, but to one person (or dog in this case) you may be the world.” -Bill Wilson


What is Plague?

Plague is a disease caused by the bacterium Yersinia pestis. You may have recently heard about it in the news, as the first case of a dog to human transmission was reported in Colorado.

Dog Transmits Plague to Its Owner

Yersinia pestis photomicrograph, courtesy of NIAID

Yersinia pestis photomicrograph, courtesy of NIAID

How is it Transmitted?

Plague is most common in the Western to Mid-Western states, and is mostly seen where there is a high incidence of infected rodents such as prairie dogs. The bacteria are carried by fleas. When an infected flea bites an animal, the bacterium is transmitted and continues to spread in this manner, by the flea taking meals from infected animals and going on to the next. Dogs or cats running around outside chasing or eating vermin are at a higher risk of getting infected as the disease is transmitted through infected bodily fluids. Cats are very susceptible and are a more common source of infection in humans.


In humans, symptoms can include fever, chills, headache, weakness, coughing, enlarged lymph nodes (bubos or Bubonic form) and/or the development of pneumonia. The pneumonia form (Pneumonic plague) is the most contagious as it most often occurs from inhaling bacteria due to close contact with infected people or animals. Symptoms usually occur within 1-3 days after being exposed to the disease.

In cats, the most common presentation is high fever and abscessed lymph nodes (submandibular lymphadenitis). Cats can spread plague to humans through bites, scratches, contact with fluids ( it is not recommended to aspirate the lymph nodes if plague is suspected without proper protection), or infected fleas may be brought indoors via the cat or dog.

Contact your local health authorities about how and where to send tissue samples, and make sure to use proper protection if samples are taken from an animal.


Plague is treatable with antibiotics. However, late diagnosis can prove fatal, as the disease can be overlooked. The most common drugs used for treatment include doxycycline or gentamycin.

The CDC provides an excellent presentation on plague:

Centers for Disease Control Plague Training Module


We see lots of senior pets in practice. Here are a few pointers you can share with your clients!

1) Good Nutrition– all senior pets need a diet that is tailored to keeping them healthy. All foods are not created equal. You must talk to your veterinarian about which diet is best for your pet. For example, a dog with early kidney disease should be on a lower protein diet. A dog with constipation issues may need more fiber. Less active dogs may need a senior food with lower calorie content.

2) A Good Quality Bed– a nice supportive bed to lay on is beneficial to their joints and muscles as they age. While they may prefer to rest on the cool tile, having a bed available to them is important. Crib mattresses make great dog beds (they can’t be soiled, they have plenty of room, and they have great orthopedic support)!


Lucy out for a “stroll” in her stroller. Her walks are limited after neck surgery.


3) A Daily Walk– most dogs benefit from daily walks. Just to get out and stretch their legs and move around helps with mobility longer term. Nothing rigorous is necessary. Just getting out for a walk is good for body and mind and is special bonding time between dog and owner. Many senior pets will just sleep all day, so getting them up for that walk helps to keep them mobile. If your pet can’t walk for some reason or tires quickly, consider taking them out for a “stroll” instead or when they get tired! If they are not used to going for walks, start small. A walk down to the end of the sidewalk or block may be a good place to start until you know their limits. Never go out when it is too hot. Older dogs overheat more easily and may exert themselves more.

4) A Weekly Massage– gently massaging your dogs legs and back muscles has many benefits. Increased blood flow, anti-inflammatory effects, endorphin release, and stimulation of the immune system are just a few of the benefits this can provide. Daily is great, but even once a week is helpful. Who doesn’t love a massage?!

5) Joint Supplements– glucosamine is used to protect joint cartilage and helps to prevent progression of arthritis. Even though it may be difficult to see direct evidence of the benefit of joint supplements in some cases, it can help the joints and may help with longer term mobility.

6) Routine Grooming– Pets still need routine grooming and care as they age, and sometimes more often.  When they are routinely groomed, they feel better. If it is too stressful to take them to the groomer, consider having the groomer come to you (mobile service).

7) First Dibs– If you have a senior pet, there is a good chance you may also have a younger dog in the house. While the youngster may try to be dominant, allow the older pet to get first dibs. Let them be first to have their food bowl put down, first to have their leash put on, first for their treat, etc.

8) Good Oral Care– as pets age, we tend to be more reluctant about upkeep on the teeth.  Disease often starts in the mouth. Bacteria and chronic gingivitis are a bad combination and can lead to heart disease, kidney disease, or other systemic illness as the bacteria gets seeded into the bloodstream. Continue to have routine dentals as long as your pet is healthy and your veterinarian recommends doing so. Brushing, appropriate dental-friendly treats, and sometimes oral rinses can help in keeping the gums healthy.

9) Ramp for bed or couch, minimize stairs– We see a lot of injuries in the clinic of older dogs who jump off the bed or couch and cause serious injury to one of their legs or their back. Getting them used to some stairs or ramp up to these areas can be a great way for them to keep their independence and avoid injury. For arthritic dogs, use a baby gate to keep them from going up and down the stairs multiple times a day if you have stairs in your home.

10) Extra TLC– We all get busy in life. Take that extra few minutes when you can to really spend it with your pets. Look at them, talk to them, play with them, pet them. These may seem like obvious things, but in many households, things get hectic and time gets away. If a new pet comes into the household, make sure to give the same or more attention to your senior pet. Often when a new dog or puppy comes into the house, the older dogs get left out. Be aware and take extra care! We already know our pets don’t live as long as we wish they would, so don’t take that time with them for granted.


There is currently a severe outbreak of Canine Influenza Virus (CIV) in the Chicago area, on the brink of being an epidemic, which you may have seen in the news. The disease has caused more than a thousand cases and the death of at least 5 dogs from January through March (as reported by the Chicago Tribune). Chicago Tribune: Canine Influenza Article and Video

Canine flu is not as common as many other viruses in dogs that you are used to hearing about. So, what is it?

  • It is a virus and a contagious respiratory disease that has affected thousands of dogs in the United States. It is a relatively new virus, which is why you may not have heard much about it. Remember the outbreak in Florida racing greyhounds with a new respiratory disease in 2004? That was Canine Influenza Virus. Then in 2005, outbreaks began occurring in boarding facilities and others involving pet dogs throughout the nation. It is thought that it may have gotten started in the greyhounds due to the mutation of the equine flu virus and exposing those greyhounds in the racetrack environment.
  • It does not appear to be contagious to humans, or at least no cases have been reported of CIV in humans.
  • Because it is a virus, there is no specific treatment, other than supportive care and treatment for secondary bacterial infections (similar to treatment of the flu in humans).
  • It is one of the viral causes of infectious tracheobronchitis (kennel cough).
  • Symptoms include coughing, sneezing, sometimes a fever, runny nose with eventual mucopurulent discharge, tachypnea/breathing harder than normal, decreased appetite, and lethargy or depression. Some dogs may also have sub-clinical infection and never show symptoms.
  • Most dogs fight the infection between 1-3 weeks. Hospitalization is required for development of pneumonia, high fever, or other issues.
  • Dogs with CIV should be kept isolated from other dogs for 2 weeks.
  • Dogs may shed the virus even before clinical symptoms start, meaning they may have already exposed other dogs to the virus before they are acting sick.
  • Veterinarians and technicians/hospital workers should wear protective clothing, including gowns and gloves, when caring for infected dogs. Hand-washing is always one of the most important ways to prevent spread of any disease.

In general CIV is very treatable and dogs typically recover when they are diagnosed and treated as quickly as possible. In immune-compromised animals, the disease is more serious as the immune system has a harder time fighting the virus and these animals are more susceptible to pneumonia and other complicating factors. There is a vaccine available. Although not a core vaccine, it should be considered for higher risk pets (boarding, going to the dog park, or traveling to areas with outbreaks or higher incidence of the disease).




In the news recently, the debate about vaccinations for children was at the forefront during the measles outbreak. There has been a similar debate going on in the veterinary community about vaccines for pets. Clients are electing not to vaccinate their pets or are inquiring about why they should, and if they really need to vaccinate their pets every 3 years? What is the appropriate and recommended protocol? Are we currently over-vaccinating?

chihuahua and syringe

In 2011, the American Animal Hospital Association (AAHA) recommended that ALL of the core vaccines go to a 3-year protocol while also stating that “among healthy dogs, all commercially available (core) vaccines are expected to induce a sustained protective immune response lasting at least 5 years.”  Many clients and professionals will still argue that an every 3-year protocol is still over-vaccinating and in fact most adult animals will have lifelong immunity without the need for repeated vaccination. Should we go to a 5 year or longer protocol for the DHPP and FVRCP vaccines?

The issue is that the immune system of every pet is different. How can we be sure our pet patients are protected? How can both sides of the argument be satisfied? One solution on the forefront is antibody titer testing. In lieu of a vaccination, a small blood sample can be taken and a “titer” test can be performed. This titer test will essentially say if this pet still has enough circulating antibody against a particular disease (canine parvo, distemper, etc.) In the past this has been very expensive to perform and samples had to be sent to an outside lab with results taking several days to come back. Now in-house testing kits are available to veterinary clinics and results in as few as 20 minutes.

Antibody Testing Kits For Veterinary Clinics 

Guide to Vaccine Antibody Testing

For owners who have concerns about routine vaccination,  a vaccine titer is a reasonable recommendation, and it may be that in the future this becomes a standard of care. Now that in-house fast titer testing is becoming available, it makes it more cost effective for clinics and for clients.

Lastly, one size does not fit all. The vaccine needs for our pet patients should be assessed yearly and the vaccination protocol should be modified as needed based on that pet’s risk, lifestyle, age, health, medical conditions, and travel as concurs with the recommendations of the AAHA task force.

AAHA Vaccination Guidelines

This is National Wildlife Week!
Most of us working in practice don’t get to work much with wildlife or exotic animals. What is it like to be a vet tech in a wildlife or zoo job?
Did you know that veterinary technicians can specialize? VetTech Specialists 
One of the areas can be zoo medicine or wildlife.
Kemp's Ridley sea turtle having surgery

Kemp’s Ridley sea turtle having surgery

Wildlife veterinary technicians perform many duties. These may include:
  • Assisting with exams or surgeries
  • Helping to capture or tranquilize animals for handling
  • Helping to transport animals if needed
  • Drawing blood, taking x-rays, and assisting with procedures
  • Helping with breeding programs
  • Assisting with husbandry issues
  • Administering vaccinations or medications
  • Assisting with rehabilitation or sick or injured animals
 Are you interested in learning more or trying something new? There are several opportunities coming up this summer! Consider volunteering for your local wildlife rehabilitation center or refuge, as almost all areas have one. Or, consider applying for a wildlife or a zoo internship/externship either here in the U.S. or abroad!

A 10-year old Golden Retriever presents with a history of unsteady gait. The owner reports she is walking like she is drunk and she has vomited a few times. You are taking a history in the room and notice her tilting her head to the left. Upon closer look at her face you see that her eyes are moving side to side rapidly. The veterinarian asks you to perform a blood pressure. The blood pressure is 200/120 mmHg. Answer the quiz questions, then scroll to the bottom for the answer explanations.


1) What medication may help to treat hypertension (high blood pressure) in this dog?

a) Benazepril
b) Prednisone
c) Phenobarbital
d) Furosemide

2) The condition from which this dog is suffering is also known as which of the following?

a) Vasculitis
b) Vestibular syndrome
c) Disseminated Intravascular Coagulation (DIC)
d) Syncope

3) Which cranial nerve is likely involved in this process?

a) cranial nerve III (oculomotor)
b) cranial nerve VII (facial)
c) cranial nerve VIII (vestibulocochlear)
d) cranial nerve V (trigeminal)

4) Which endocrine disease is often associated with hypertension?

a) Cushing’s disease
b) Addison’s disease
c) Diabetes mellitus
d) Hypothyroidism

5) The eyes moving side to side rapidly is also known as:

a) Vertigo
b) Nystagmus
c) Postural thrust
d) Bupthalmous

Answers: This dog is exhibiting symptoms of vestibular syndrome, which has many possible causes. Because this dog has a very high blood pressure (should be less than 150 systolic in a nervous dog), the likely cause is a vascular accident (a stroke type of event).

Hypertension can be sometimes be associated with Cushing’s syndrome in dogs, and with hyperthyroidism in cats. Hypertension in dogs may be treated with benazepril and/or amlodipine. Amlodipine is the treatment of choice for cats.

Vestibular syndrome is a results of the inflammation or disturbance of cranial nerve VIII (8), the vestibulocochlear nerve which helps with sound in the ear and with equilibrium (balance). Dogs that have vestibular syndrome are often  nauseated and have a history of vomiting. The eyes moving back and forth or side to side is also known as a nystagmus.

For further information on vestibular disease, hypertension, and cranial nerves, please visit our other blog pages on these important topics:

Vestibular Disease Review

The Dangers of Hypertension

Review on Cranial Nerves


It isn’t all that uncommon. A client has a dog that has been bitten or exposed to a rabies “suspect.” Whether it be a fox, a skunk, coyote, or bat, any wild animal could be a potential hazard for transmitting rabies to our domesticated pets.

State law is very strict regarding pets and exposure to rabies. There was a story in October 2014 that raised some controversy over this issue. A 10-year old Schnauzer was bit by a rabid skunk. The dog’s rabies vaccine had only expired 10 days prior to the attack. The options were to euthanize the dog, or quarantine for 3 months in a kennel with then another 3 months of strict home confinement. The owner was devastated but ultimately chose euthanasia.

For currently vaccinated pets exposed to rabies, they must receive a rabies booster immediately and then be under home confinement for 45 days.

As we know, there is a very high chance that even if the rabies vaccine has lapsed, the animal likely still has immunity. This is why this case is so heartbreaking.

A new JAVMA study, published for January 15, 2015 looks at a Comparison of anamnestic responses to rabies vaccination in dogs and cats with current and out-of-date vaccination status.

Full Abstract Here


Findings in this study “supported immediate booster vaccination followed by observation for 45 days of dogs and cats with an out-of-date vaccination status that are exposed to rabies, as is the current practice for dogs and cats with current vaccination status.” 

This is important information to keep in mind for pets that have been vaccinated and exposed to rabies, even if their vaccine has recently expired. While state law will still be in effect, this can provide some additional information to pet owners who find themselves in this predicament.