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How to Administer Eye Medications

Background

If your pet has sustained an eye injury, has an eye infection or an internal medical condition that is affecting the eyes, or is recovering from eye surgery, it may be necessary for you to give one or several medications into the eye(s) to help with healing. At first the idea of one person giving eye medications to a wiggly pet may seem like a daunting task, but it is possible. Practicing the following approach should help you safely deliver the recommended eye medications into your pet’s eyes.

Getting Started

Depending on the severity of the eye problem, one or more medications may have been prescribed for your pet. The first step in handling eye (“ophthalmic,” “ocular”) medications is understanding how much of each medication to give, when to give them, and which ones (if any) should be refrigerated. This information is on the label of most eye medications and can be explained to you by a veterinary technician if it is unclear.

It is common to be required to give eye medications from 1-8 times daily, equally spaced apart over time throughout the day. In some situations, continuing a schedule through the night may be important in the short term to prevent progression of an injury or infection and to potentially avoid eye surgery. In these situations, you should discuss with your veterinarian what the best schedule is before your pet leaves the hospital.

It is also common to need to place an Elizabethan collar (E-collar, “lampshade”) on your pet. This simple device can be tremendously helpful in protecting the eye from your pet’s desire to rub it, especially once it starts to heal and becomes itchy. These collars provide the best protection when they are worn 24 hours a day, since it only takes a few minutes to damage delicate tissue that has taken days to heal.

With medium- or long-nosed dogs, an E-collar can be kept on when administering eye medications, but with short-nosed dogs and many cats, it is easier to remove the E-collar and then replace it after giving the medication.

Troubleshooting Beforehand

If your pet is extremely energetic or has a small face or short snout, it may be more difficult for you to get medications into the eyes. At first, it may be helpful for you to have a second person available to help hold the pet still.

If you are applying more than one kind of drop, or both ointment and drops, then be aware of timing and order of administration. Drops are always first, and ointments are always last; otherwise the ointment can create a barrier that prevents the drops from working. To allow absorption of each medication, it is ideal to leave 5-10 minutes between giving each medication.

Allowing for extra time in your daily routine to accomplish this type of schedule is almost always necessary. In some cases, this is temporary (if the injury or disease is cured), whereas in other cases this type of treatment continues long term or permanently. You can ask your veterinarian about what is expected in terms of having to continue to give ocular medications.

Procedure for Administering Eye Medication

First, situate yourself so that you can hold your pet’s head. For cats and small dogs, this means putting them on your lap or placing them on a table. For medium and large dogs, this means kneeling down or arranging them so their hind end is between your knees or ankles while you are standing. This approach should also help keep them still.

Second, lift your pet’s head so the eyes and nose are pointing as straight upward as possible, ideally towards the ceiling. For a right-handed person, this is done using the left hand.

DROPS: Hold the bottle or dropper like a pencil in your right hand, and use the edge of your right palm to slide back the skin above the upper eyelid. This will lift the upper eyelid and expose the eye. Use the middle finger of your left hand, which is still elevating the chin to keep the head pointing towards the ceiling, to draw down the skin below the lower eyelid, further exposing the eye. Without allowing the applicator tip to touch the surface of the eye, bring the bottle/dropper close to the eye, and squeeze the bottle such that the correct number of drops of the liquid medication falls onto the eye surface.

OINTMENT: Using the same approach described for drops, squeeze approximately a 1/4-inch strip of ointment from the tube, and drape this strip of ointment across the surface of the eye, again taking care not to touch the eye with the applicator tip.* When finished, close the eyelids, and gently massage the strip of ointment over the surface of the eye.

*An extra precaution is to elevate the third eyelid. To do this, simply place gentle pressure with the tip of your left middle finger (which is helping hold the lower eyelid down) on the skin below the eyelid. This pressure on the skin of the eyelid, directed inward into the eye socket, elevates a membrane that rises across the eye: the third eyelid. The advantage of doing this is to further protect the surface of the eye from any contact with the tip of the ointment tube, in case of a sudden head movement.

Some surgeries to the eye require that the lids are temporarily secured closed with sutures (stitches). Some infections or traumatic injuries cause massive swelling to the eyelids. In both these cases, sometimes only a small portion of the eye can be seen. Often, the visible portion of the eye is the corner near the snout. In giving eye medications in these situations, the approach described can still be used, but the drops or ointment are placed in the corner of the eye. Drops should run across the eye (under the eyelids) easily on their own. Normal movement of the eye will help distribute ointment.

Afterwards

If you find that it is only possible to give eye medications by first removing your pet’s E-collar, be sure to protect the eyes from rubbing against the collar when you remove or replace it. For example, if you slip the collar over their head without taking the collar completely apart, you should hold your hand over their eyes as you slide the collar back into place. This will help prevent damage to the eye(s).

SOURCE:

Clinical Veterinary Advisor: Dogs and Cats, Second Edition
By Etienne Côté, DVM, DACVIM (Cardiology and Small Animal Internal Medicine)

www.clinicalvetadvisor2.com

How to Assemble and Use an Elizabethan Collar

Background

Elizabethan collars (“E-collars”) are lampshade-shaped devices a dog or cat wears around the neck to protect its own tissue from self-trauma during healing. Commonly an E-collar is worn after surgery to keep the animal from licking, chewing, or otherwise disturbing the area of the body that was operated on. A dog or cat’s licking, contrary to popular myth, is not helpful but in fact delays tissue healing and favors infection. Other common uses of E-collars include protecting bandages or dressings that cover wounds and during treatment of ear infections or facial lesions to protect these areas from being scratched with a hind paw.

Troubleshooting beforehand

All types of E-collars are available in various sizes and should be sized appropriately. An E-collar that is too big can easily slip off, whereas one that is too small can irritate or even cut the skin around the neck or interfere with breathing. A properly sized E-collar is comfortable and effective at blocking self-trauma.

The main points to watch out for when placing the E-collar on a dog or cat (either for the first time or if it has slipped off) are:

  • Make sure the E-collar is properly assembled and clean.
  • When putting the plastic E-collar together, don’t worry about whether it is inside-out or right-side-out (same thing).
  • Make sure plastic tabs and any other protruding parts don’t poke the pet’s eyes or ears while you are slipping it over the face and head. With hard plastic collars, you should firmly bend the loops that hold the string or gauze (which will tie the E-collar in place around the neck) outward, away from the hole for the head, for easier passage of the collar over the face.
  • Make sure the string or gauze that will be tied around the neck is loose and is kept away from the pet’s mouth when you slip the collar over the face and head.
  • When putting the E-collar on the dog or cat, there should always be one hand on the animal and one hand holding the collar. A common pitfall to avoid is to try putting an E-collar on a dog or cat by holding just the collar, not the animal. Holding the E-collar by the outer edge with both hands in an attempt to thrust it through and over the head in one quick motion is likely to frighten, annoy, or injure the pet and is not recommended.
  • Make sure it is long enough to accomplish the goal of an E-collar: the length of the collar, when resting as far back on the neck as the pet’s shoulders, should still extend past the tip of the pet’s nose.

Procedure: Placing the E-Collar on Your Pet

This procedure assumes the E-collar is already assembled, meaning it is cone or dish shaped. If it is not (i.e., it is a flat sheet of plastic), see below for assembly.

  1. Sit or stand beside your dog or cat. For a right-handed person, be on the pet’s left side. Both of you should be facing in the same direction, meaning the pet is along your right thigh. Face to face does not give you control and challenges the pet to escape.
  2. Pick up the E-collar by the edge, at the large end of the cone, with your left hand.
  3. Reach around with your right hand to the right side of the pet’s head, and hold the side of the head (cats, small dogs) or the side of muzzle (larger dogs).
  4. Guide the nose and head through the smaller end of the E-collar as you slide the cone to sit in place, past the ears and around the neck.
  5. For cats, it can be helpful to use your right elbow to create a nook with your right thigh (when you are sitting on a couch to do this, for example) that restrains the cat’s hind end, preventing the cat from backing out and away.
  6. Likewise, keep the edge of the collar out of the cat or dog’s mouth by keeping the pet’s mouth closed with your right hand and pointing the nose through the hole of the E-collar. In other words, one hand takes the whole head (cats, small dogs) or just the muzzle (bigger dogs) and guides it nose first through the opening in the E-collar until the back edge of the collar has come to rest well past the ears.
  7. Tie the string or gauze in a shoelace-type knot, snugly but not too tight. You should be able to slip two or three fingers comfortably between the neck and the tied string/gauze.

Procedure: Assembling the E-Collar

When the collar is already in a cone shape, see above.

If you need to assemble the hard plastic E-collar (new—flat sheet of plastic in the shape of a semicircle):

  1. First identify the edge with the open square holes and the other edge with the slits. Note that on one edge, there are two or more parallel rows of slits. In step 3, you will need to choose the appropriate row of slits to create a collar that is the correct size.
  2. Bend the collar into a cone shape such that these edges overlap. The square holes on one edge of the collar should lie on the outside (convex surface) of the cone on top of the slits on the other edge. To assemble the collar, the square holes and the slits will be held together by weaving a long plastic strip through them.
  3. Since there are two or more parallel rows of slits, this is the opportunity to size the E-collar properly. Choose an amount of overlap (i.e., a particular row of slits) so that the hole for the neck is just large enough to allow the E-collar to pass over the head and ears snugly.
  4. With the square holes lined up with the chosen row of slits, you can now use the long plastic strip to weave the two edges of the collar together in overlapping fashion. Bend the long strip of plastic to the outside (convex surface) of the collar, and slip it through the closest square hole and the first slit beneath that hole. Pull the strip all the way through into the concave part of the collar. Then feed the strip through the second slit and back through the same square hole, and pull the whole tab through to the convex surface of the collar. Pull firmly on the long strip to firmly seat the edges of the collar together; there should be two small plastic “shoulders” that prevent it from feeding too far in. You should now have the long strip forming a loop then diving into the collar and back out again, binding the two edges of the collar together at that point.
  5. Repeat this “weaving” process with the second and third square holes (and their underlying strips) to fasten the edges of the E-collar together at three points and make a solid, firm cone.
  6. To make loops for the gauze ribbon or lace that will hold the E-collar in place around the neck: curl each of the three or four small tabs toward the convex surface of the collar, and push each one first through the bottom slit (pointing it to the concave surface of the collar) and then back out through the second slit.

Afterwards

When removing the E-collar, be sure to protect the pet’s eyes when slipping it on or off.

SOURCE:

Clinical Veterinary Advisor: Dogs and Cats, Second Edition
By Etienne Côté, DVM, DACVIM (Cardiology and Small Animal Internal Medicine)

www.clinicalvetadvisor2.com

How to Deal with Incessant Barking

Background

Barking can be a normal means of communication for dogs. They may be alerting an owner to a stranger, danger, or simply playing. Barking may increase when any type of reinforcement is associated with it. For example, a barking dog that is fed as soon as barking starts will consider the food to be a reward and has learned to bark in order to obtain the food. Barking can provide a dog with a sense of satisfaction when any type of reward is obtained. However, incessant barking can be a part of medical disorders such as separation anxiety or canine cognitive dysfunction syndrome (senility in aged pets). In some dogs, as in some people, there is simply a tendency to be more vocal about things that would not elicit a response from most other individuals.

Troubleshooting

The behavior of incessant barking in dogs can be difficult to correct, and different methods of correction may be needed. Dogs may bark to receive attention, in defense of a stranger or another dog, out of fear, or due to separation anxiety. Barking is never improved with yelling at the dog or physical punishment; dogs that bark playfully will simply bark more, whereas yelling or punishing dogs that bark out of fear or confusion will only worsen their problem and can bring out other problems (destructive behavior, urinating/defecating in the wrong places indoors, etc.).

If dogs are punished with the owner present, and the stimulus of the barking is not addressed, the dog may stop barking in the presence of the owner but may continue when the owner is not present.

Procedure

  • Identify and eliminate the cause of the bark:
    • Is the bark a new habit? If so, recent changes may help explain the onset of the bark, and modification of these changes may decrease barking.
    • Is your pet older than 10 years and showing signs of “aging” such as decreased awareness of people and places around the home? And/or changes in behavior such as new-onset bouts of unprovoked aggression? If so, cognitive dysfunction (senility) may play a role in barking, especially if the bark is not clearly directed at anything identifiable to you.
    • Does your dog systematically bark more than other dogs but interacts well with other dogs and with all members of the family? If so, that amount of barking may be normal for your dog but inappropriate for the context (for example, living in an apartment with neighbors that are bothered by it). In this case, specific interventions that seek to decrease barking may be useful.
  • Avoid stimuli that induce barking.
  • Desensitize the dog to the stimuli. This means identifying a trigger that causes barking and repeating it at a very low level, then gradually increasing the intensity while praising lavishly when the dog does not bark. An example is barking when there is a knock at the door. For desensitization, simply record the knock and replay it at a lower volume. When your dog does not bark, give him/her extensive praise. However, when he/she does bark, distraction/diversion is the best response: offer him/her a chew toy that contains food (e.g., Kong toy), requiring him/her to use the mouth and therefore making barking at the same time impossible. Scolding or reprimanding systematically fails to improve the outcome of barking in dogs and should not be used.
  • Reward quiet behavior. This is in the form of praise, a treat, or extra attention, as examples.
  • Afterwards

    Anti-bark devices and citronella collars may temporarily stop the barking, which offers an opportunity to begin training and desensitization. Such devices are rarely permanent solutions.

    Immediately and consistently interrupt the barking pattern with diversionary or distractive activities.

    Providing dogs with interaction (with you, with other people, with other dogs) is indispensable for managing a dog whose excessive barking is simply due to a desire for more attention. Physical activity (Frisbee, throwing the ball, going for a jog), obedience classes, and incorporation into leisure activities all can decrease the need for attention through barking.

    Veterinary behaviorists are available for consultations. These specialist veterinarians are experts at determining the cause of the bark and providing solutions that are practical and as likely to succeed as anything else. You can ask your veterinarian for the name of a veterinary behaviorist in your area.

SOURCE:

Clinical Veterinary Advisor: Dogs and Cats, Second Edition
By Etienne Côté, DVM, DACVIM (Cardiology and Small Animal Internal Medicine)

www.clinicalvetadvisor2.com

How to Effectively Induce Weight Loss in a Dog or Cat

Background

Obesity is a serious problem in the modern pet population. Just as in people, obesity can lead to and worsen diseases such as diabetes, arthritis, and respiratory disease. It can also contribute to tearing of the cruciate ligaments in the hindlegs, as well as trigger back pain and spinal disease in small breed dogs. It is imperative to help an overweight pet lose weight in a safe, effective manner. Leaner pets live an average of 1.8 years longer than those that are overweight and may also have delayed onset of the diseases mentioned above.

Because weight loss is not “just a number” but rather individualized for each pet, a numerical system for tracking body condition (degree of leanness or overweight) is important, and you should feel comfortable assessing your pet’s body condition. The ideal body condition on the charts below is a 5 (out of 9). Pets with a body condition of 5 have a slim but well-fleshed body contour in which a waist line can be visualized and the ribs can be felt. The hips and spine are not protruding but can easily be seen. Many people feel these pets are too skinny when, in fact, they are an excellent weight. Society has come to accept obese animals, and we must retrain ourselves to understand that more food and more weight are not real testimonies of affection and caring in the long run. Obese pets that have a body condition of 8 or 9 do not have visible ribs, hips, or a spine that can be seen or felt through the body fat, and have a large abdomen. This is the situation to be treated and improved with gradual weight loss.

Pets must utilize a combination of techniques to lose weight. Nutrition intake, activity levels, and pet health must all be considered when developing a weight-loss program for pets. Your veterinarian can perform lab tests (typically from blood and urine samples) to assess for any concurrent illness or organ dysfunction that might interfere with weight loss.

Getting started

The most important subject to be addressed is nutrition. Your pet's energy intake (caloric intake) should be monitored. Remember, dogs and cats in general only need 300 to 500 kcal per day. Every calorie a pet ingests should be counted.

Every pet food has a different amount of calories per cup; therefore, when changing foods, you must read the bag for recommended feeding amounts. An overweight-management food is recommended and is available from every major pet food manufacturer. These foods have been tested to ensure that the recommended amount of food will meet your pet's requirements. Some foods may be higher in fiber to aid in weight loss, while others will be higher in protein. If your pet does not respond well to one type of food, you may have better success with another.

Ideally, an overweight or obese pet's activity level should increase. This can be challenging with dogs that also have other medical disorders such as heart disease or arthritis, and is virtually impossible in any substantial way with cats. However, taking dogs on brief leash-walks at least once a day, slowly increasing the distance over a period of weeks, can be very helpful. Dogs and cats also enjoy retrieving balls, sticks, or play mice. Using toys to increase your pet's activity level is a good idea; however, be sure that whichever toys you choose are safe for your pet and not small enough for him/her to ingest.

Successful weight loss takes time. Perhaps the greatest predictor of successful weight loss is endurance on the family’s part. Pets should only lose a maximum of 10% of their body weight per month. This is a small amount compared to what humans can lose. For example, a 20-pound dog should only lose 2 pounds per month.

Troubleshooting

The entire family must be on board when starting a weight-loss program. Treats must be monitored and strictly limited. Often, pets are obese just as much from the treats they are eating as from their actual food. Any extra calories the pet receives can be detrimental to the weight-loss program.

If a pet begins to limp, is unable to get up after walks, or becomes extremely inactive, please contact your veterinarian. These could be signs of excessive physical activity and/or morbid obesity.

Procedure

Begin by determining, with your veterinarian, what an ideal lean body weight is for your pet (target weight) and what a realistic time frame is for decreasing the weight to this level. Then mathematically, you and/or your veterinarian can calculate how much food to feed if providing slightly fewer calories per day than the body uses, causing the metabolism to switch to consumption of excess fat as fuel. The typical time frame is 3 to 6 months to restore normal body weight.

Weigh your pet at least once a month to ensure weight loss. If your pet is not losing weight with your current methods, then some changes need to be implemented. This may include diet and/or exercise methods.

  • Keep a food diary of the food your pet eats. Include all treats the pet receives and the number of cups fed per day. Calculate the total number of calories and determine if this is 10% less than the recommended baseline caloric intake for an animal of the age and size of your pet. Treats may have to be decreased or substituted; elimination of treats is ideal but rarely acceptable to the family, so substitution is an option. Alternative treats with few calories include baby carrots (fresh), pieces of apple, wedges/quarters of plain rice cakes, and individual Cheerios. These can give a dog the impression that he/she is eating something offered by hand (so it is a treat) without the richness and caloric bulk of commercially processed treats or table food. Many pets love vegetables such as green beans, squash, or broccoli and think they are getting a special treat when they receive this kind of human food.
  • Measure the food. Free-fed pets will likely gain weight. When dishing out portions of food measured in cups, make sure your measuring cup is an 8-ounce (250-mL) cup, not a large disposable beverage cup.
  • Instead of showing your pet love by feeding them, show them love with attention. Some of the greatest success stories about healthy pets that have reached a lean body weight also involve a greater bond as a result of the process.
  • Make pets work for their food.
    • Dogs: Hollow, thick rubber (Kong) toys can be excellent distracters. Place kibbled dog food inside the Kong toy and they must push the toy around for the kibble to drop out.
    • Cats: Place food bowls in different parts of the house; this makes the cat go from place to place to eat.
    • Feed pets half the daily portion twice daily. Doing so can help keep blood sugar levels more stable and can decrease begging behavior.

Therapeutic diets are available from your veterinarian if the diet you are feeding is not providing results. These are diets that are flavorful but energy/calorie-restricted. Veterinarians should evaluate your pet prior to dispensing these foods.

Afterwards

Once your pet has lost weight, be sure to keep the lean body condition you worked so hard to reach. You will now know how much your pet can eat and still feel well; be sure to stay within that range, including treats.

Maintain the activity level you have reached. Many dogs enjoy running, jumping, and playing, and many cats enjoy climbing and chasing; these activities, when encouraged, can help them stay trim.

Older pets are at higher risk for arthritis, just as people are. Your veterinarian can provide medication to relieve the symptoms associated with this condition if it occurs, so physical activity can still take place comfortably.

SOURCE:

Clinical Veterinary Advisor: Dogs and Cats, Second Edition
By Etienne Côté, DVM, DACVIM (Cardiology and Small Animal Internal Medicine)

www.clinicalvetadvisor2.com

How to Give Ear Medications

Background

Ear medications are often administered to pets that have an ear infection, inflammation, or a condition within the ear canal that requires treatment. It is important to treat the ear canal correctly, ensuring the solution reaches the target location. With practice, instilling medications into the ear canal is easy and can be done at home as needed.

Getting Started

Your veterinarian should have prescribed a specific medication to administer into your pet's ear. You should wear latex (or similar) medical exam gloves to prevent you from coming in contact with potential bacteria or fungi that your pet may harbor, as well as with the medication.

Troubleshooting

The ear that is affected should begin healing within the first few days of medication application. In serious conditions, healing may take longer. However, if you notice any of the following symptoms, you should contact your veterinarian immediately:

  • Increased discharge
  • Increased redness, swelling, or heat from the ear
  • Increased pain
  • Increased shaking or scratching of the head
  • Spreading of the condition
  • Inability to instill the medication (for example, if your pet will not allow it or because you feel you are not doing it correctly)

If your pet shows resentment to having this done, stop the procedure and call your veterinarian for further advice. The ear may be too painful to treat without additional medications, and it is imperative that you neither hurt your pet nor put yourself at risk of a nip or bite. Resistance to treatment may also be an indication that an infection is worsening and needs to be rechecked immediately.

Procedure

  • In calm pets, medications can be administered into the ears by just one person, but with young, excited animals or pets that dislike (or are unfamiliar with) having the ears handled, it may be necessary to have one person distracting and/or holding the pet while another person instills the medication. The whole process should take less than 5 minutes. If it is too complicated or difficult, notify your veterinarian to discuss whether there are alternative strategies.
  • If your veterinarian provided you with a solution to clean the ears, this must be done before instilling medication. This allows ear debris to be loosened before the application of the medication, and if the medication were placed first, before the ear cleaning, the cleaning solution would eliminate the medication altogether.
  • With one hand, gently flip the ear flap straight up. This is best done by cupping the ear flap (pinna) in your hand, with the haired part of the ear against the palm of your hand and your thumb on the hairless inner surface of the ear flap. You should be able to see the inside of the ear (ear canal) this way. Some breeds of dogs have naturally erect ears, and in these dogs, the hand can simply be cupped behind the ear.
  • Holding the ear flap cupped in the palm of your hand means that the ear canal takes on the shape of a funnel. You can then drip the medication directly into the deepest part of the ear canal. Be sure not to put the tip of the nozzle (or medication tube) directly into the ear canal. Rather, place the tip of the tube or bottle well outside the ear canal, and aim the nozzle so the drops of medication fall into the greatest depth of the ear canal. Do not allow the nozzle tip to touch the ear canal, which would contaminate the bottle/tube and its contents. Massage the entire canal, allowing the medication to work through the entire ear.
  • If your pet scratches their ear excessively, an Elizabethan collar (E-collar) may be necessary while the medication is taking effect. These collars can be purchased from your veterinarian or a pet supply store. Scratching the ears can cause self-induced damage and therefore must be prevented.
  • Remember that the medication is cooler than body temperature and may feel cold to your pet when you apply it in their ear, especially on raw or sensitive areas. Apply a small amount at first, allowing the pet to become comfortable and adapt to this type of treatment. The comfort that the medication brings makes it worthwhile.

Afterwards

Once you have finished cleaning the ears, discard any remaining used gauze and gloves. Replace the cap on the medication and place in a safe area, out of reach of children and pets.

SOURCE:

Clinical Veterinary Advisor: Dogs and Cats, Second Edition
By Etienne Côté, DVM, DACVIM (Cardiology and Small Animal Internal Medicine)

www.clinicalvetadvisor2.com

How to Give Oral Medication

Background

Veterinarians routinely prescribe medications, either in a liquid oral form or a tablet form. With either one, the goal is for your pet to receive the medication as easily as possible in your home. It is important that you give your pet the medication as directed by your veterinarian and for the entire time prescribed. Many health conditions may not improve without proper medication.

Getting Started

Equipment/materials needed for oral liquid medication:

  • Medication
  • Syringe (if liquid)

Equipment/materials needed for tablet medication:

  • Pill splitter (if each dose is less than a full tablet)
  • Food
  • A syringe with 3 mL of water

Troubleshooting

Many dogs will take tablets hidden in a small piece of food such as cheese, peanut butter, or canned dog food. Others may find the tablet and spit it out. Cats often are much more clever (or discriminating): they can smell the medication and will often not take it in food.

If your pet shows resentment to receiving medications this way, stop the procedure and call your veterinarian for further advice. There may be other treatment alternatives, such as compounding, where the medication is transformed into a meat- or fish-flavored syrup that most animals will take willingly. Do not cause risk to the health of your pet (no veterinarian likes to hear “It takes three of us and a wrestling match, but we’re getting the medication in,” because the stress may cause serious harm to the pet). Do not put yourself in harm’s way or allow yourself to get bitten.

For tablets: always give your pet water to drink or a small amount of food to eat after the tablet has been given (a “chaser”). This helps ensure that the medication will travel to the stomach. Without doing this, some medications will get stuck in the throat and can cause sores as the medication sits and dissolves against the wall of the esophagus.

If your pet has vomiting or diarrhea after medication administration, or what you feel may be an intolerance to the medication or other adverse effect, call your veterinarian. The medication your pet is receiving may have to be changed.

Procedure

ORAL LIQUID

  • Fill the oral syringe or bulb with the desired amount of medication.
  • Allow your pet to keep his/her mouth closed throughout this process.
  • Insert the tip of the oral syringe into the corner of the lips on either side of the mouth.
  • Hold the head pointing slightly upward (chin elevated), and squeeze the plunger gently to administer the medication into the cheek pouch over a period of 3 to 5 seconds. Often this is accompanied by licking movements of the tongue as the pet swallows the medication.
  • Keeping the head elevated (lift the pet’s chin) helps ensure that the medication trickles to the back of the mouth and is swallowed.
  • The cheek pouch approach is preferred over prying the mouth open and squirting the medication into the back of the mouth, because keeping the mouth closed is more comfortable to the pet, and it is less likely that a vigorous squirt will hit the back of the throat, causing gagging or coughing.
  • Instead of this approach, you may try placing a small amount of medication on the food and see if the pet will eat it. This should be done just as an attempt, because some pets will not eat food that has medication sprinkled on top.

TABLET

  • If the medication must be cut in half, place the tablet in a pill cutter (available at your local pharmacy) and cut directly in half. Place half of the tablet back into the medication vial.
  • For dogs, try placing the medication in a small piece of cheese, peanut butter, or canned food. Give the dog a piece of food that does not have the medication in it. Next, give the food with the medication in it, followed by another non-medicated piece. Ensure your dog did not spit out the tablet and that it is not caught in the lips.
  • Tablets may also be placed in Pill Pockets, a hollow, semimoist treat designed to hold medication. Be sure, if you are using these or a treat (cheese, peanut butter, other), that your hand that touches the tablet does not touch the treat. Some dogs and many cats have a sufficiently sensitive sense of smell that they will detect the smell of medication on the outside of the treat that came from you touching the outside of the treat with powder or residue from the tablet.
  • For dogs that will not take the medication in food, place one hand on the top of your pet's nose/mouth (your right hand if right-handed). With the other hand, open the mouth and place the tablet on the farthest point of the back of the tongue using your index finger. Quickly remove your hand; shut the mouth and hold closed. Gently squirt a 5- to 20-mL (1 to 4 teaspoons) syringe of water into the cheek pouch to encourage the pet to swallow. You may also rub your pet's throat to encourage him/her to swallow. Again, check the mouth, lips, and floor to ensure your pet has swallowed the tablet and not spit it out.
  • For cats, place one hand behind your pet's head, using the thumb and forefinger to stabilize the upper jaw (use your right hand if right-handed). With the other hand, open the mouth and place the pill on the farthest point at the back of the tongue with your index finger. Quickly remove your hand; shut the mouth and hold closed. Gently squirt a 5-mL (1 teaspoon) syringe of water into the cheek pouch, encouraging the pet to swallow. You may also rub your cat's throat to encourage him/her to swallow. Again, check the mouth, lips and floor to ensure your pet has swallowed the tablet and not spit it out.
  • Pill Poppers may also be used to aid in the medicating of pets. Pill Poppers are a thin, rigid tube that contains a plunger (to be pressed by your thumb) and a rubber pill holder at the tip. To use a Pill Popper, begin by placing the medication in the rubber pill holder at the tip. You should then hold your pet's head as described above. Insert the Pill Popper into the mouth, directly toward the back of the tongue. By depressing the plunger with your thumb, the tablet will pop out of the rubber holder and into the back of the throat, where it is swallowed. Be sure to follow the pill with a syringe full of water as described above, ensuring the medication is swallowed.
  • Medications may also be crushed and sprinkled on top of food, if needed. (This should be the last method used; many pets will not eat food that has medication sprinkled on top.) To crush a tablet, you can place it between two spoons and apply pressure to break it into small fragments and powder. Alternatively, pharmacies also sell handheld pill crushers.

Afterwards

Pets are clever and often do not understand that medications are intended to help them. Often, pets find a way to avoid taking medication. If they do, you must change the method used to medicate your pet, ensuring he/she is receiving the entire dose.

Your veterinarian may request to see your pet for a recheck during treatment or once the medication has been finished. You should call and schedule your appointment, and be sure to bring the medication with you to confirm that what you are giving and what the veterinarian thinks you are giving are the same thing.

Always keep medication out of the reach of children. Ensure that all caps or lids are closed well, and wash your hands after you administer the medication.

SOURCE:

Clinical Veterinary Advisor: Dogs and Cats, Second Edition
By Etienne Côté, DVM, DACVIM (Cardiology and Small Animal Internal Medicine)

www.clinicalvetadvisor2.com

How to Monitor a Surgical Incision During Healing

Background

The normal healing process of any wound involves mild inflammation of the skin: a rosy pink color is expected along the edges of a surgical incision while it heals. However, excessive inflammation, swelling, and drainage of fluid from the incision are cardinal signs of infection, which can be a potentially serious (and common) complication after surgery. Identifying excessive inflammation early can prevent complications. Therefore, it is important to be able to identify excessive inflammation and signs of infection, and the goal of the summary here is to explain how to do this as well as how to minimize the risks of infection before a problem occurs.

The term suture is the same as “stitches.” Some sutures are made of a material that is absorbable. These are under the skin or in the body and are not visible. They do not have to be removed later because they dissolve over time. More commonly, sutures are nonabsorbable and are visible on the surface of the skin. Alternatives to nonabsorbable sutures are “liquid sutures” (tissue glue), which bond the skin together when the incision is small (and need not be removed), and steel surgical staples, which must be removed like nonabsorbable sutures but using a special staple remover clamp. Any of these kinds of suture is acceptable, alone or in combination, for surgery in dog and cats. Any nonabsorbable sutures or staples will have to be removed by your veterinarian or veterinary technician once they have determined that the incision has healed.

Getting Started

The process of monitoring an incision is simple: no equipment or materials are needed, only a well-lit area to see the incision and a repetitive routine for consistent monitoring.

Checking at your pet’s incision morning and night, every day for the first 7-14 days after an operation, will allow you to see the healing process. This will also provide you with the opportunity for early detection of infection or irritation. Ideally, you should ask your veterinarian or a veterinary technician to look the incision over with you before leaving the veterinary hospital. If this makes you uncomfortable, it is a good idea to ask a family member or friend to be there and to help with the monitoring.

Looking at your pet’s incision when you first get home from the veterinary hospital will provide you with a baseline mental point of reference. Continue to inspect the incision each morning and night, and more often if your pet is showing an interest in licking or scratching it or if you detect any abnormalities in the incision or your pet’s behavior.

Some types of incisions/wounds require placement of drains. A drain is usually a thin, flat, latex tube that is secured with sutures under the skin and soft tissue. It allows fluid to drain around it (not just through it) so tissues can heal appropriately.

Although your pet’s incision may look very securely repaired immediately after surgery, pets can take out external and internal sutures as well as drains quickly through licking or scratching. There are various options to help you protect your pet’s incision from licking and scratching, including Elizabethan collars (lampshade-type collar), T-shirts, bandages, or covering the paws with soft fabric (socks). Sometimes one or more of these protective measures is needed, depending on a pet’s personality and energy level. It is just as important to protect an incision from other pets in the house that might lick it. An easy way to avoid extra visits to your veterinary hospital is to be committed to monitoring and protecting the incision as it heals, which is typically a 2-week period of time.

It is common to receive prescriptions of antibiotics and pain medication to give to your pet during his/her recovery. While they are not required in every situation, when these medications are prescribed, it is important to give them as instructed by your veterinarian (and on the label) until they are finished. Antibiotic therapy, pain medication, and incision monitoring are all important means to support a healthful recovery.

Troubleshooting Beforehand

Frequently the activity level that is normal for your pet will be enough to cause extra oozing or swelling at a surgical site within the first several days after surgery. To avoid these complications that delay normal healing, it is best to restrict exercise to a few on-leash walks daily during recovery. If your pet is very active inside the home, then restriction to a kennel or crate may be necessary.

If you notice already that an incision is turning darker red, is oozing more than when you first came home from the veterinary hospital, the margins of the incision appear to be coming apart, or your pet refuses to eat, is restless, is trembling or becomes obsessed with trying to lick the incision, there may be a problem. It is possible that the incision has become infected, is painful, or both. Your pet may need additional treatment, and if you observe any of these symptoms, a prompt recheck (within 1 day) is recommended.

Procedure

Look at your pet’s incision in a well-lit room. If the incision is on the abdomen (belly), for example, carefully roll him/her over, keeping the four legs bunched together to avoid stretching the belly wall, and then examine the belly so you can inspect the incision clearly and completely.

When looking at the incision, be sure to note the color of the skin at the incision line, the amount of swelling in the area and surrounding areas, and whether or not there is any discharge (oozing of fluid). One helpful tip is to take a photo of the incision on the first day home so you can compare objectively in the future by looking back at the original photo for comparison.

Color: At the incision edges, the skin may be pink to light red initially. Monitor for fading of these light colors back to the normal color of the skin, which is normal for healthy healing. If the color of the incision appears to intensify over time (from light red to dark red), an infection may be developing. Bring these changes to the attention of your veterinarian immediately. It is possible to have some bruising in this area as well. These findings should lighten and resolve over the next several days of recovery. It is normal for a bruise to change from light red to purple as it heals. However, if you notice that new bruising develops that your veterinarian was not aware of, it is important to alert your veterinary staff immediately.

Swelling: Mild swelling can be expected at an incision site immediately postoperatively. The amount of swelling depends on the type of surgery and the reason for the surgery. A routine surgery may have minimal swelling, whereas a traumatic injury repair may have more. If swelling progresses rather than resolves after surgery, tell your veterinarian.

Discharge: The amount of fluid that oozes from an incision depends not only on the reason for the surgery but the location of the incision. Your veterinarian can discuss the amount of discharge you can expect to see with your pet’s specific incision. The discharge is normally light red in color. A change in color of this discharge from light red to dark red (like blood), together with an increase in amount of fluid discharge and a reddening of the incision edges, may indicate an infection is developing. If the color of the discharge becomes yellow, white, or green (like pus), an infection is almost certainly present, and a recheck examination of this surgical site is necessary to identify the best treatment.

If your pet’s wound repair required a drain, routine cleaning will likely be necessary. It is preferable to use sterile gauze moistened with povidone iodine (Betadine) solution, diluted with tap water to a light tea color, or chlorhexidine solution (light blue or pink, may be provided by your veterinary hospital) for lightly wiping or dabbing the incision or drain for cleaning. It is good to carefully remove dried discharge from an incision and around a drain, because caked discharge may seal a drain closed and stop the draining process. It may be easier to clean and more comfortable for your pet to first hold a very clean, warm wash cloth to the area for several minutes to moisten and soften any dried discharge.

Afterwards

When drains are placed, they generally should be removed 3-5 days later. When they are removed is based on when the wound is done draining. This will be determined by your veterinarian or veterinary technician prior to removal, but you should keep track of whether the amount of fluid discharge from a drain is increasing, decreasing, or staying the same over time. This will help with the decision to remove a drain or leave it in place for a few more days.

Sutures and staples are usually removed in 10-14 days. Sometimes an incision may look healthy on the outside when in fact it has not actually finished healing. It is important to return to your veterinary hospital for the suture removal so your veterinarian or veterinary technician can examine the incision and ensure it has properly healed prior to suture removal. If an incision has not completely healed, the veterinary staff will be able to respond quickly and provide you with a new time line for continued care.

SOURCE:

Clinical Veterinary Advisor: Dogs and Cats, Second Edition
By Etienne Côté, DVM, DACVIM (Cardiology and Small Animal Internal Medicine)

www.clinicalvetadvisor2.com

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