Pages

Rabies in NYC

A few weeks ago, I received a summary of animal rabies and testing in NYC from the New York City Department of Health and Mental Hygiene.  I knew that the incidence of rabies was increasing here, but I had no idea how much!  The report was pretty enlightening. In 2010, a record 145 (!) animals from NYC tested positive for rabies.  The main reason for this was the rabies epidemic in raccoons in Central Park.  Rabies in raccoons was first discovered in NYC in 1992.  In 1993, there were 53 cases.  That was a record high at the time.  In 1998, there was only 1 case of raccoon rabies in NYC.


Historically, most rabid animals in NYC had been identified in the Bronx and Staten Island, with a few isolated reports of rabid raccoons in Queens.  That all changed in 2010. Manhattan had the most, of course (123), because of Central Park.  Eighteen cases of rabies were reported in the Bronx (12 raccoons, 3 bats, 1 skunk, 1 cat, and 1 coyote).  Two cases were seen in Queens (1 raccoon, 1 opossum), and two in Brooklyn (raccoons). (This was the first time ever that raccoon rabies was ever reported in Brooklyn.) There were no cases of raccoon rabies (or any other type of rabies) on Staten Island in 2010.  Bat rabies, however, continues to be found in all five boroughs.

Because of the high incidence of raccoon rabies in Central Park, a trap-vaccinate-release program was conducted from February to April 2010, in an attempt to slow the spread of the virus amongst the raccoons and to prevent humans and pets from being exposed.  A second round was conducted in September, October, and November, with the goal being to vaccinate the juvenile raccoons born in the spring.  A total of 396 raccoons were vaccinated in Central Park, Morningside Park, and Riverside Park.  Pretty impressive!

Since 1992, a total of 519 terrestrial animals have tested positive for rabies in NYC.

As for dog rabies, there hasn’t been a case of canine rabies in NYC since 1954.  However, dogs with the raccoon variant of rabies have been reported in neighboring areas just outside NYC.  Long Island was free of raccoon rabies until 2004, when the virus was identified in Nassau County.  Now it is also in Suffolk County.  In 2010, Nassau and Suffolk Counties reported no rabid animals, but Westchester did.  In fact there were 39 cases of rabies in Westchester in 2010:  21 raccoons, 7 bats, 5 skunks, 5 cats, and 1 conservative radio talk show host.

We tend to think of rabies as being more common in dogs than cats, but that’s not true in the U.S., and in NYC. Since 1992, rabies has been diagnosed in NYC in 12 cats, mostly strays. With all of the rabies cases being reported in NYC, dog and cat owners need to keep their pets’ rabies vaccination status current.
With all of the rodents in NYC (squirrels, rats, mice), people worry about them being a source of rabies.  Not to worry. Squirrels, rats and mice are not considered to be vectors of rabies.  I’ve known this about squirrels since 1978, when I was bitten by a squirrel in Washington Square Park.  I was a freshman at NYU, and I was feeding a squirrel in a peanut, and it took the peanut and bit me on my finger.  Ungrateful little varmint.  I went to the NYU nurses office, where she told me that rabies wasn’t a worry.  Members of the rabbit family are also not considered to be vectors of rabies, except groundhogs. A groundhog tested positive for rabies on Staten Island in 2007, and a few rabid groundhogs have been found in neighboring areas outside NYC.

I myself have never diagnosed a case of rabies, and have never seen one. I’ve submitted samples for rabies testing, however.  It is not a pleasant task.  When testing for rabies, you have to submit the brain.  I’ll spare my readers the details.

In my senior year in veterinary school, there was a horse in the large animal ward with interesting neurological symptoms.  Many of the students were talking about it, and a lot of our classmates were told to take a look at the “interesting horse” out in the barn.  I never bothered to go out and look.  The horse ended up being diagnosed with rabies, and all faculty, staff, and students who had any contact at all with the horse had to receive post-exposure rabies treatment, just to be on the safe side.  Forty of my classmates received treatment.  Not me!

Rabies kills about 55,000 people a year.  When people get exposed to rabies, they need to get prompt post-exposure treatment if they are to survive.  Once the symptoms of rabies develop, it is almost invariably fatal.  I say “almost” because in 2005, a teenage girl was the first person to survive a rabies infection.  She was put into an induced coma once her symptoms appeared.   The doctors hypothesized that the harmful effects of rabies were caused by temporary brain dysfunctions, and that partially halting brain function, temporarily, would protect the brain from damage while giving the immune system time to defeat the virus. After 31 days of isolation and 76 days of hospitalization, the girl, Jeanna Giese, was released from the hospital, with no after effects.  Her treatment became known as the “Milwaukee protocol”.  Twenty five other people were treated with this protocol, and two survived. The protocol was further modified and an additional 10 patients were treated with the new protocol.  Two of them survived.  In April 2008, an 11 year old boy in Colombia also survived rabies after a coma was medically induced.   These are the only six known cases of a person surviving rabies once the symptoms develop.  There is only one single case of a person surviving rabies after symptoms developed in which the patient received no treatment before or after symptoms developed.  One case!  In short, rabies is NOT a good disease to have.

Let me close by saying… vaccinate your cats and dogs against rabies!!  Just do it!

---

Related Post: "Why We Vaccinate (even indoor cats)"
reade more... Résuméabuiyad

Tropic of Cancer (a.k.a. lymphosarcoma. a.k.a. lymphoma)

I see a lot of cancer in my cat practice.   A major reason is that cats are living longer than ever before.  Now that they’re living to 17, 18, (and even longer), they’re living long enough to develop cancers that we never saw when they died at 12 or 13.  Another reason is that major medical advances have given us the technology to detect cancers that previously went undiagnosed.  An increased awareness of cancer, coupled with more sophisticated technology, has allowed veterinarians to become pretty adept at making the dreaded diagnosis.

The diagnosis of cancer in a beloved cat can be devastating.  However, it is important to realize that, as in human cancers, many types of cancer in cats can be treated, managed, and sometimes even cured.  Chemotherapy is one of the most effective ways to treat cancer.  Fortunately, the most common type of cancer that we diagnose in cats – lymphosarcoma – is very sensitive to chemotherapy. (Note: lymphosarcoma is sometimes called lymphoma.  The terms are synonymous.)

I think the incidence of cancer is increasing.  Last year, we diagnosed maybe four cases of high-grade lymphosarcoma.  This year, we’ve diagnosed four cases, and we’re only half-way through March.

Chemotherapy is the treatment of cancer with anticancer drugs. The drugs are toxic to malignant cells.  Some of these drugs are given intravenously.  Others are given by mouth.  In some cases, chemotherapy is the only line of treatment.  In other cases, chemotherapy is given in combination with other modalities, such as surgery or radiation.  For example, chemotherapy may be given after surgery or radiation to help slow the growth of cancer that may have already spread.  In other cases, chemotherapy may be employed before surgery, to shrink the size of a tumor prior to surgery, or to make your cat more comfortable while living with the disease.

For many people, the word “chemotherapy” has terrible connotations, with visions of hair loss, vomiting, and other distressing side effects.  Nearly everyone has some personal experience with chemotherapy, and many cat owners are concerned about “putting their cat through chemo”. The reality is that most cats handle chemotherapy very well.  Cancer treatment for both people and pets has become more sophisticated over the years, and the side effects of the drugs we use have become less severe.  In addition, the chemotherapy protocols used in veterinary medicine are less aggressive than those used for humans, so side effects, if they occur, are often very mild. In human medicine, the goal of treatment is to achieve a cure.  In veterinary medicine, the goal of chemotherapy is to extend your cat’s life while maintaining its quality.

There are many different chemotherapy protocols.  Some of the drugs used in these protocols are given by a simple injection.  Others are infused intravenously over a few hours in the veterinarian’s office. Yet others may be given orally, at home by you.  Some drugs are given daily.  Others are given weekly, or once every three weeks.  

Owners of cats who are undergoing chemotherapy are always concerned about possible side effects of chemotherapy.  Fortunately, pets suffer fewer and less severe side effects compared to people. Chemotherapy works by attacking the rapidly dividing cells in the body. Cancer cells fall into this category, however, cells found in the intestinal tract, bone marrow, and hair follicles also fall into this category. Chemotherapy, therefore, may result in gastrointestinal upset, bone marrow suppression, and hair loss in some cats. Gastrointestinal upset may manifest as decreased appetite, vomiting, and diarrhea. Bone marrow suppression may lead to decreased production of white blood cells, which in turn can lead to an increased susceptibility to infection.  As for hair loss, this is uncommon in cats.  When it occurs, the whiskers are most commonly affected.  For most chemotherapy, side effects begin three to five days after administration. Most cats experiencing gastrointestinal side effects can be managed at home; rarely is hospitalization required.
 
Most cat owners are pleasantly surprised at how well their cat does with chemotherapy.  Most cats maintain a good quality of life, and it is very gratifying to have the extra time with a treasured companion.

Treating a cat with chemotherapy is a commitment – a time commitment, financial commitment, and emotional commitment – and it can be a bit of an emotional rollercoaster for cat owners. 

 Chemotherapy for low grade lymphosarcoma is pretty benign.  Treatment typically consists of two drugs, prednisolone and chlorambucil, and most cats tolerate the drugs very well and go into remission which can last for months and months.  In fact, one cat in our practice, “J” , is at month number 43 on chemo.  She holds the record for our practice.  Next is “O”, who is at month 31.  Not bad!

High-grade lymphomsarcoma is a more aggressive cancer.  Most of the cats I treat go into remission.  Currently, we’re treating four cats.  “B” was diagnosed with lymphosarcoma of the colon.  It had spread to the lymph nodes at the time of diagnosis.  We began our treatment protocol approximately 11 weeks ago.  The cat instantly went into remission. The huge colon tumor had practically melted away after only two doses of chemo.  It was fantastic.  We’re at week 11 of chemo, and the cat is thriving.

 “M” is a big sweet cat who had lots of sneezing and a chronic nasal discharge from one nostril only.  Rhinoscopy and biopsy revealed high-grade lymphosarcoma.  I forgot how far along he is in our chemo protocol (I think week 8), and he is in remission and doing great.

 “O” is the third cat we diagnosed this year.  She’s an interesting case.  She was losing weight, and endoscopy revealed what was called “low-grade” lymphosarcoma of the stomach.  After the diagnosis, we performed abdominal ultrasound to look for any other signs of cancer, and there were changes that suggested high-grade lymphosarcoma in the kidneys and perhaps a part of the intestine.  We aspirated the kidneys, and indeed, the pathologist diagnosed high-grade lymphosarcoma.   So, we switched from the low-grade protocol to the high-grade protocol.  Now, after about six weeks of chemo, a recheck ultrasound revealed “O” to be in remission.  The kidneys are normal and that small mass involving a portion of the intestine is no longer visible. 

 “L” is the fourth cat, and is perhaps not doing as well as the other three.  She was diagnosed, many months ago, with inflammatory bowel disease.  She was put on prednisolone and was doing fine.  Then, she developed what I thought was an enlarged lymph node in her neck.  I removed the node and sent it in for biopsy.  It turned out that the lump was actually a salivary gland, and that there was low-grade lymphosarcoma in the gland.  Nowhere else was there evidence of lymphosarcoma.  So we added chlorambucil to our medical regimen, and she did great.   Many months later, however, she began to lose weight.  I suspected that her inflammatory bowel disease had flared up. We performed abdominal ultrasound and discovered, however, what looked to be cancer.  There were nodules in the spleen, and the intestines looked suspicious for cancer.  We aspirated the spleen, and the diagnosis was high-grade lymphosarcoma.  “L” took her first treatment very well, but the drug that we give during week 2, called Cytoxan, seemed to make her feel poorly.  Her appetite dropped and she lost weight.  I was worried about her and was going to postpone the week 3 treatment, but she bounced back very well.  We saw her today, and she was doing well, eating and being feisty as usual. We went ahead with her third treatment today.  I’m hoping she gains the weight that she recently lost, and that the drug we gave today (adriamycin, a very potent drug) doesn’t cause any adverse effects.  Every cat we’ve given it to has had no side effects, but “L” is the smallest and most frail of the bunch.  I feel that she’ll do okay.

I find treating these cats rewarding. The vast majority do well, with no adverse effects, and my clients get to spend more quality time with their kitties.  I’ll keep you all posted on how these cats are doing over the next few months.

---

Related Published Articles

"Feline Cancer"

"Gastrointestinal Lymphoma in Cats"
reade more... Résuméabuiyad

IMPORTANT: RECALL of Phenobarbital tablets Containing Acetaminophen


Some phenobarbital tablets may be mislabeled, FDA warns

March 10, 2011 -- Today, the U.S. Food and Drug Administration (FDA) issued a warning to veterinarians about the possibility that tablets produced and labeled by Qualitest Pharmaceuticals as phenobarbital may actually be hydrocodone tartrate and acetaminophen tablets.

The company issued a recall of the phenobarbital tablets on February 5, 2011, but the FDA reports that it has recently received reports of severe adverse events associated with the administration of the mislabeled product to pets.

**The affected products are Phenobarbital tablets, USP, 32.4 mg, NDC 0603-5166-32 in 1000-count bottles. Affected lot numbers are T150G10B, T120J10E and T023M10A. (The lot numbers are printed on the side of the bottle).

The recalled lots were distributed between Sept. 21, 2010, and Dec. 29, 2010, to wholesale and retail pharmacies nationwide, including in Puerto Rico.

If you have any of the affected lots in stock, discontinue use of the product immediately and contact Qualitest at 1-800-444-4011 for reimbursement. If your patients have experienced any adverse events related to the use of these products, please report the events to the FDA's MedWatch Safety Information and Adverse Event Reporting Program via their online reporting system (www.fda.gov/MedWatch/report.htm) or by calling 1-800-332-1088 to request a reporting form, which you would then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178.


** NOTE: If you picked up any Phenobarbital prescriptions from Manhattan Cat Specialists, your medication is NOT affected by this recall.  All Phenobarbital purchased from Manhattan Cat Specialists is safe.
reade more... Résuméabuiyad

Pet Social Networks

Pet social networks are a great way to show off your friends to your friends, find information about your pet, and even adopt new pets. (thanks )

Catster

Pet Social Networks - Catster
Catster, the sister-company of Dogster, is the most popular social network for anything that meows, hisses, or just ignores you to play with a ball of yarn. Along with being able to share pictures of your cat, you can also look to adopt one, or put your own up for adoption.

Dogster

Pet Social Networks - Dogster
The most popular pet-based social network, Dogster gets nearly half a million visitors each month. Dogster allows you to show off your pooch, find advice on dogs, and even find out what type of dog breed you are.

MyDogSpace

Pet Social Networks - MyDogSpace
MyDogSpace is a community of dog lovers who can share information, pictures, videos and even has a Twitter-like feed called "Dog Barks." Along with creating a MySpace for your dog, you can also compete in fun contests such as cutest dog and guess the breed.

MyCatSpace

Pet Social Networks - MyCatSpace
The sister site of MyDogSpace, this cute little social network caters to cat lovers and lets your kitty become a star through shared photos and video. Like MyDogSpace, there is a Twitter-like feed called Cat Meows and plenty of trivia and games to participate in.

Petbrags

Pet Social Networks - Petbrags
Petbrags is a small but growing community of pet owners who welcome all kinds of pets from dogs to cats to fish to reptiles. So, if you want to show off your albino ferret, Petbrags is the place to do it.

UnitedDogs

Pet Social Networks - UnitedDogs
United Dogs is a great international social network of dog lovers who've come together to show pictures of their puppies and make their pooch a star of their own video. There is also a wiki on dogs and a mashup using Google maps to point out great dog places on the map.

UnitedCats

Pet Social Networks - UnitedCats
An international cat-lovers social network, UnitedCats lets you create a webpage for your kitty and find cat friends from around the world. You can even show your cats on your MySpace or Facebook profile.


Zootoo - Zootoo is the online home for pets and the people who love them.


Petzume - Petzume is an online pet community dedicated to pet lovers and their friends. Members of the community create profiles for their pets, upload their pet photos and videos, create blogs and connect with other pet lovers from around the world.


Petizens - Petizens is a social network for pet lovers, where you can make an amazing webpage for your pet. The webpages are not like others, you make the page by dragging and dropping photos, videos, stickers and your blog onto the page.


Cuteness - Create a detailed profile for , each of your pets with photos, videos, Twitter status updates, friends, comments, and more! Can't get enough? Try visiting the Cuteness Hall of Fame, or party it up with your anipals in the Dog Park - where EVERYONE is welcome to come and play!


Here's 25+ pet-related websites via Mashable


25 Awesome Social Networking Sites for Animal Lovers


Do you have a favorite pet-related social network or website?  Tell us about it in comments.
reade more... Résuméabuiyad