Pet Parent Resources: What Is a Veterinary Specialist Anyway?

At San Francisco Veterinary Specialists, we’re often asked by our clients why their pet was referred to a specialist. What’s the difference in a specialist and a general (or primary) veterinarian? At SFVS, we believe that the partnership among you, your veterinarian and our medical team helps to ensure the most comprehensive care possible for your pet. Our team of doctors keeps both you and your pet’s general veterinarian updated on your pet’s condition. We recently came across two articles on the what’s, when’s and why’s of veterinary specialists. Below are excerpts and links to the full articles. As always, feel free to comment or send questions to us!

The Bark: Veterinary Specialists, When, why and how to find one

Veterinary specialists—experts in everything from anesthesia to zoological medicine—were all but unheard of when most of us were young (and romping with the dogs of our childhood). The first specialties were recognized by the American Veterinary Medical Association (AVMA) in the 1950s, when the association established the American Board of Veterinary Specialties (ABVS) to serve as an umbrella organization for all AVMA-recognized specialty groups.

Today, the ABVS represents 39 distinct specialties, which are practiced by members of 20 specialty organizations, some of which encompass several disciplines (for example, the American College of Veterinary Internal Medicine, or ACVIM, covers large and small animal internal medicine, plus oncology, cardiology and neurology). More than 9,000 U.S. veterinarians—roughly 9 percent of all vets in the country—are card-carrying members, or board-certified diplomates, of these organizations. To obtain diplomate status, a vet must complete postgraduate coursework and residency and pass a certification exam. In some cases, that means several years of additional training after vet school.

Dolittler: Top ten pet problems requiring specialists (how to know if you need to see one)

(Note: This post is from a general veterinarian’s perspective. The list of issues is the writer’s own opinion, not set-in-stone guidelines. You’ll see there are differing opinions in the comments section of the Dolittler blog.)

So where does that leave pet owners who really need to know when it’s best their pet see a specialist? Kind of in limbo, I would think, considering that every veterinarian has their own personal philosophy on this issue. And because this is my blog, I’ll offer you mine.

To that end, here are the top ten problems for which I recommend specialists:

#1 Any second opinion.

#2 Any lack of trust (a corollary to #1).

#3 Any legal matter.

#4 Any orthopedic surgery or thoracic surgery.

#5 Any exploratory surgery.

#6 Any time it takes more than a trio of visits to solve a problem.

#7 When better equipment is required.

#8 Any heart murmur.

#9 Every X-ray or ultrasound image.

#10 Every time critical care is required.

Pet Parent Resources: Holiday Hazards for Your Pet!

[cross-posted from Dr. Yin's blog, AskDrYin.com/blog]

Holiday Hazards That Can Ambush Your Pet

By Sophia Yin, DVM

The Holiday Season is always filled with unexpected expenses. Like monsoons in Manilla, you never know exactly when and how one’s going to hit. Will it be more gift-giving than planned or higher heating costs than last year? Well, if you’re an out-of-luck pet owner, it could be a surprise veterinary bill, because believe it or not, the season to be jolly also doubles as the season for Spot to visit the vet-on emergency.

If you think about it for a second the reasoning is clear. The house, usually just a ho-hum array of couches, chairs and tables, suddenly becomes an indoor pet playground. New plants decorate the mantle, aromatic candles dot the tables, mystery boxes overflow with flashy, fluttering ribbons, and a medley of taboo foods awaits at every turn.

Stockxpert.com

Which temptation will catch your pet’s fancy first? If you turn your attention away at just the right moment, you may find out the hard way. Suddenly Kitty’s scaling the pine scented jungle gym in a quest for the angel at the top, or Fido, the intact male is enjoying his new Douglas Fir port-a-potty.

Unless kitty topples the tree and gets a concussion or Fido short-circuits the Christmas lights, these infringements are just a minor nuisance. But if Kitty or Fido have a propensity for chewing, things can turn ugly fast. Tinsel in the tummy or ornaments in the esophagus, both can put a halt to all food flow through the intestinal tract. Some small foreign objects can snake their way through without plugging things up, but don’t count on it. At minimum the trip through the GI tract will leave a trail of inflammation leading to a few days under the weather. But on the dark side, an obstruction often spells surgery. Even an innocent string or ribbon can back things up, often in the worst way. It’s apt to drag through slowly gathering loops of intestines tighter and tighter like the drawstrings on a sac of potatoes. Enough pulling and the intestines finally cry uncle. They give way with a rip or tear and their contents leak out contaminating the abdomen with bacteria and debris. At this stage, even the most heroic efforts can lead to an unhappy ending.

If you have one of those wiser, smarter pets who know better than to eat inanimate objects, you’re still not in the clear. Tasty plants can also pose a problem. Toxins from holly and mistletoe berries can turn petite pets cross-eyed, causing a medley of intestinal or neurologic signs, and Poinsettia sap can irritate both the eyes and the stomach on contact.

Sometimes foods meant to be eaten can cause serious gastrointestinal grief too. That wonderful turkey feast is fine for humans, but toss the bones rather than feeding them to Fido. With or without meat, dogs swallow the bones whole or crush them into bits that can form a concretion leading either to a case of constipation or to yet another possible cause of obstruction. As an added complication, both raw and cooked bones can fracture into sharp fragments that can scrape the intestines as they’re passing. Or worse yet, they can puncture all the way through.

Even the holiday meal without bones can be dangerous. Like the indigestion you get after an overfill of fine foods, Rover may also suffer a case of upset stomach from his sudden holiday diet change. While the upset may start out mild, a twelve-hour wait and the situation could take a bad turn. And if the pancreas, which makes digestive enzymes and insulin, comes into play expect a protracted hospital stay with no guarantee of recovery.

So how do you know when to suspect a serious problem?

If Kitty the cat is suddenly lackluster, or Hank the chowhound suddenly refuses a regular meal, it’s time to scour the house for telltale signs. If Fido’s hacking up evidence of his holiday loot or pooping pancakes instead of his regular firm feces, it’s a neon sign-take him to the vet!  And of course, if you see signs of a suspicious ingestion-a box of chocolates ripped to shreds, a garbage can knocked over with its contents gone, a string protruding from Rover’s rear-don’t take matters into your own hands. Call your veterinarian pronto.

Your veterinarian will evaluate King or Kitty with a physical exam and follow up with diagnostic tests if needed. She may use radiographs or ultrasound to look for foreign objects or evidence of intestinal inflammation or blood work to look for pancreatic involvement as well as other complications. Then treatment could be as simple as a special diet and fluids to prevent dehydration, or it could become extremely involved.

In any case, a visit to the vet hospital before the symptoms get really bad and better yet, before you even see signs of illness could save days of hospitalization and could easily mean the difference between life and death.

Now that you know how hazardous the Holiday Season can be for your pets, here are some precautions you can take:

1) Keep all human foods out of reach and empty garbage cans filled with taboo items.

2) Inform your guests that there’s no slipping scraps to Fido. He’ll get his treats later.

3) If you’re bent on sharing your meal with Fido, limit the scraps to less than 10% of his regular daily meal and avoid high fat, spicy foods. Also avoid chocolate and onions. They’re toxic in dogs and cats.

4) If your pet has a propensity for chewing on chords, toys, presents or plants, keep him out of tempting rooms when unsupervised. Alternatively you can set up a scatmat barrier around the off-limits area. Then if Fido or Kitty step on the mat they’ll get a static surprise that’s sure to keep them away next time.

5) Be sure King and Kitty get their regular amount of attention and exercise so they won’t have to look for alternate forms of attention.

Client Story: Meet Elli the Norwegian Elkhound!

Elli + Dr. Fong

Today we meet a special furry friend named Elli the Norwegian Elkhound. Elli, who very much enjoys keeping tabs on all those raccoons and squirrels out there, recently got some sort-of-scary news. She and her guardian, Tiffany, were told Elli has a tumor in her lung (hence the recent heavy panting and Elli’s desire to stay right by Tiffany’s side all the time).

After finding out the tumor didn’t have any “friends,” Tiffany decided to go the holistic treatment route with Elli for a number of reasons, opting not to undergo surgery at this time. Here begins Elli’s and Tiffany’s SFVS story. We’re still early in the telling of this tale, but we know that Elli is receiving excellent care, enjoying a high quality of life (homemade meals and lots of walks!), and soaking up and sharing all the love she can right now.

In Elli’s own words, a short summary:

My owner called San Francisco Veterinary Specialists and made an appointment with Dr. Fong. … When it became appointment time I knew it for Tiffany doesn’t feed me when we ride in the car. I have motion sickness. So, when my owner didn’t feed me I knew something was up. The drive into the city was new for me so I was not too happy about getting out of the car and going into a place that smelled of other animals. However, this place was bright and full of smiles.

Dr. Fong asked a lot of questions while looking at the x-ray and reading the previous Adobe vet info. Tiffany was answering and writing at the same time. I was on the floor kinda shaking. Dr. Fong examined me and said my coat is very healthy, though my tongue was on the purple side. He also asked how I slept, curled up or stretched out. He created a plan just for me with the primary goal to halt the tumor’s growth for as long as we can and shrinking it at the top of our list. My diet was to change and I was to take Chinese herbs mixed in with my food and tablets twice a day.

My new diet meant no chicken as chicken feeds cancer; we need to remove things that can heat up my body and feed the tumor. So we are giving me food that builds up my immune system and starves the tumor. …

Elli + Tiffany

Now, Tiffany was delighted to hear I could eat ‘people food.’ Like, lima beans, wild rice, duck, pork, mung beans, broccoli, carrots, red chard, squash, etc. Next thing I knew we were at Whole Foods and out she came with a bag of Wellness dry fish meal base and duck jerky. My owner also got on the internet and ordered some special biscuits from Foster & Smith. That nite ‘my personal chef’ cooked up broccoli, wild rice, carrots, squash and pork mixed in with the Wellness dry…heaven! Hey, the quality of my life has been jacked up about tenfold….not a bad way to go out! I feel much better and love eating twice a day. I am breathing a little better though I still have my moments.

My energy is good as the six raccoons sitting on the roof of an old building behind our house were my prime targets. I let them know who was boss even though a stone wall separated us. They were not going to run across the top of the wall while I was outside.

Thank you, Elli, for sharing your story. For more, visit Elli’s blog (!): Embarking on a new path by Elli

SFVS Video: Holistic Veterinarian David B. Y. Fong

To round out the week, here’s a new SFVS video featuring David B. Y. Fong, DVM, L.Ac., Dipl. Oriental Medicine. Dr. Fong is head of SFVS’s complementary and alternative medicine department. (Keep your eye out for a VERY relaxed dog getting acupuncture.)

For more on Dr. Fong, see Staff Spotlight: Q+A With Holistic Doc David Fong

SFVS News: Ella Woods, DAOM, on Cancer-Detecting Dogs

Dr. Ella Woods

SFVS’s Ella Woods, Doctor of Acupuncture and Oriental Medicine, recently answered a San Francisco Chronicle reader’s question about the ability of dogs to sense cancer in humans.

The question: About one year ago, my friend’s dog suddenly became very fearful of her for no reason. Wouldn’t sleep with her, join her for walks and would even leave the room if she entered it. Just recently, my friend was diagnosed with terminal cancer. I’ve heard that dogs are being used to detect cancer. Is it possible her dog sensed that something was wrong?

For the answer, read today’s SF Chronicle’s Ask the Vet column: Could dog have sensed cancer before she did?

SFVS Video: Pet Oncologist Aarti Sabhlok, DVM

Today in the SFVS video series, we hear from one of SFVS’s oncologists, Aarti Sabhlok, DVM, Board-qualified (Oncology). She talks about how she became interested in veterinary oncology and provides a brief overview of cancer care at SFVS.

Read more at the SF Gate’s Tails of the City blog: The “C” word: when pets get cancer

SFVS Video: Veterinary Surgeon Dr. Margo Mehl

Continuing our series of video interviews with SFVS veterinarians, today we’re posting a clip featuring Margo Mehl, DVM, DACVS. Among other things, Dr. Mehl fills us in on common surgeries at SFVS, such as foreign body removal. (“Dogs seem to eat towels and bath mats, and cats seem to enjoy eating those earplugs people use.”)

For more on Dr. Mehl’s work, see In Focus @ SFVS: Intrahepatic Portosystemic Shunts.

SFVS Video: Hear From Internal Medicine Specialist Dr. Alan Stewart

SFVS is continuing our series of video interviews with our medical staff! Earlier we posted a video with Dr. Diana Bowen. Today we hear from veterinary internist Dr. Alan Stewart. We hope these clips will help you learn a little more about the people behind SFVS.

On choosing veterinary medicine as a career, Dr. Stewart says: “It’s all I ever wanted to do.”

For more on Dr. Stewart, see Staff Spotlight: Q+A With Internal Medicine Specialist Alan Stewart, DVM, CVA, DACVIM

And stay tuned! More videos coming soon.

SFVS’s Holistic Oncology Services Featured in Fetch the Paper

At SFVS, we want to deliver the best possible treatments for our patients. In some cases, this means that our doctors work collaboratively on a pet’s treatment … such as when SFVS oncologists team up with the holistic veterinarians to care for a dog or cat with cancer.

Fetch the Paper features an article this month, written by SFVS’s Ella Woods, DAOM, LAc, Dipl. Oriental Medicine; Aarti Sabhlok, DVM, Board-qualified (Oncology); and David B.Y. Fong, DVM, LAc, Dipl. Oriental Medicine, that describes the benefits of holistic oncology:

Why the inclusiveness? Most oncologists find that patients tolerate their regimen of Western treatments better when they’re receiving some sort of supportive care. As an example, studies have shown that acupuncture can significantly reduce the nausea and vomiting that is sometimes associated with cancer chemotherapies.

Dogs and cats can now benefit from the same kinds of integrative therapy that humans receive. At San Francisco Veterinary Specialists, we work collaboratively to deliver the best treatments possible for our cancer patients. Oncologists and holistic clinicians work together to create customized treatment plans for our patients, ensuring that the patient’s quality of life is kept at its optimum while the best cancer-defeating protocol is brought to bear. …

For the most part, chemotherapy for animals is kinder and gentler than chemotherapy for humans. Still, pets can suffer from side effects, perhaps feeling a little down and lethargic after a treatment, or having poor appetite, or occasionally experiencing diarrhea. Chemotherapy can also be hard on the kidneys and liver, which are responsible for filtering impurities and drugs from the blood. Offering holistic treatments alongside chemotherapy and other Western approaches can help manage these issues, getting the patient in the best possible shape to defeat the cancer. In effect, holistic treatments can “free up” energy in the patient’s body so it can more effectively deal with the cancer.

For the full article, visit Health Matters: Alternative Treatments for Cancer

As a special note, we wish Fetch the Paper the best as the publication goes from a print format to online. We’ve enjoyed reading both the print and online versions for years now, and look forward to what Fetch has in store. For more information, read Gone to the Dogs: a four-year journey from print to pixels.

SFVS News: Dr. Carlo Vitale on Feline Dandruff

SFVS dermatologist Carlo Vitale, DVM, is featured in this week’s Ask the Vet column in the San Francisco Chronicle. The subject? Tallula the Cat’s dandruff problem.

The reader’s question: My cat, Tallula, is well groomed and has insanely soft fur, but occasionally she is covered in dandruff. It’s inconsistent: One day she has dandruff and the next day none. I feed her Science Diet dry food and occasionally the same brand in wet food. What might be the causes (and cure)?

For the answer, read: Causes for feline dandruff include obesity