Fears, Phobias and Anxiety

How do animals show fear?

Fear is a physiological, behavioral, and emotional reaction to stimuli that an animal encounters. The physiological reaction results in an increase in heart rate, increased respiratory rate (panting), sweating, trembling, pacing, and possibly urination and defecation. Behaviorally, an animal will exhibit changes in body posture and activity when afraid. The animal may engage in an avoidance response, such as fleeing or hiding. A fearful animal may assume body postures that are protective, such as lowering of the body and head, placing the ears closer to the head, widened eyes, and tail tucked under the body.

If the animal perceives a threat, the response can also include elements of defensive aggression. Whether an animal fights or flees when frightened depends on its genetic predisposition, previous experience (what it has learned from similar situations in the past), and the environment that it is in (see below). The emotional reaction in animals can be difficult to gauge because animals are nonverbal. However, by observing body postures and facial expressions, it is possible to conclude that an animal is afraid. On the other hand, pets may modify their behavioral responses with repeated exposure to the stimulus if the stimulus has been successfully removed by aggression or if escape has been successful. Therefore, what you see at the present time may not be the same as when the problem first began.

Is fear ever an abnormal response in animals?

In many situations, it is “acceptable and understandable” for an animal to be afraid. However, there are times when animals exhibit fear when it is maladaptive or dangerous for humans. When animals are frightened, they may become aggressive (fight), run away (flight), or stay still (freeze). The response a pet exhibits depends on the pet’s personality, the type of stimulus, previous experience with the stimulus, whether the pet is on its own property (where it is more likely to fight), whether it is in the presence of offspring or family members (where it is more likely to fight), or whether it is cornered or restrained and unable to escape (where it is more likely to fight).

“Whether an animal fights or flees when frightened depends on its genetic predisposition, previous experience, and the environment that it is in.”

What is a phobia?

This is an intense response to a situation that the animal perceives as fear inducing. The response is out of proportion to the stimulus and is maladaptive. Common phobias in animals involve noises and places. Phobic responses have physiological, behavioral, and emotional responses similar to fear, but they are extremely exaggerated.

What is anxiety?

The human definition of anxiety is a diffuse feeling of impending danger or threat. It appears that animals can exhibit this diffuse type of anxiety, often manifested as generalized anxious behavior in either specific situations (the veterinary hospital, new locations) or in a nonspecific way (anything out of the routine schedule or environment). Anxiety is manifested by some of the same physiological signs as fear but also may be displayed as displacement or redirected behaviors, destructive behaviors, or excessive vocalization and may become stereotypic or compulsive over time.

What types of stimuli might trigger fears, phobias, or anxieties?

The triggers for these behaviors are as varied as there are breeds of dogs and cats. Animals may be frightened of people, other animals, places, or things. Others may only respond with fear or phobia in one particular situation such as toward a thunderstorm.

What causes fearful, phobic, or anxious responses?

Sometimes fear is the result of an early experience that was unpleasant or perceived by the animal as unpleasant. If the fearful response was successful at chasing away the stimulus, or if the pet escaped from the stimulus, the behavior has been rewarded and therefore is likely to be repeated. Owners who try to stop the behavior by providing treats or affection may not help calm the pet or diminish the fear and anxiety. In some situations, the animal may see your actions as reinforcing the behavior the animal is performing at that time. Also, it should be noted that punishment, in close association with exposure to a stimulus, might further cause fear and anxiety toward that stimulus. If the owner is frustrated or anxious or the stimulus is threatening, this too will further aggravate (and justify) the fear. Finally, if the stimulus retreats or is removed during a display of fear aggression, the aggressive display will have been reinforced.

It does not always take an unpleasant experience for fear to develop. Any stimuli (e.g., people, places, sights, sounds) that a dog or cat has not been exposed to during its sensitive period of development, which is up to3 months of age in dogs and 2 months of age in cats, may become a fear-evoking stimulus. For example, the dog or cat that is exposed to adults, but not to children, during development may become fearful when first exposed to the sights, sounds, or odors of young children. The pet’s genetics also contribute to its level of fears and phobias to stimuli.

“The triggers for these behaviors are as varied as there are breeds of dogs and cats.”

Phobic responses can occur from just one exposure or gradually increase over continued exposure. In many cases of anxiety, neurotransmitter (brain chemical) function and levels may be altered and contribute to the overall behavior. Again, learning or the consequences that follow the phobic response (rewards, escape, punishment) may aggravate the problem.

Illness, pain, or the effects of aging may lead to an increase in fear or anxiety in situations where there was previously little or no problem. These changes may alter the way a pet perceives or responds to a stimulus. Age-related changes in the brain (cognitive decline) or in the sensory system (hearing, sight), arthritis, diseases that affect the hormonal system such as an increase or decrease in thyroid hormones or an overactive pituitary gland (Cushing’s), and organ degeneration (liver, kidneys) are just a few examples of health- and age-related problems that might contribute to increasing fear and anxiety. A full physical examination and diagnostic tests, if indicated, are warranted for any pet with fear or anxiety, but especially those that are intense and generalized, that have any other concurrent signs, or that did not arise until adulthood or older age.

“There is a phenomenon called ‘one trial’ learning, where an event is so traumatic that only one exposure can create fears, phobias, or anxieties.”

Is it possible to prevent fears, phobias, and anxieties?

A good program of socialization and exposure to many new and novel things while an animal is young can be helpful in preventing fears and phobias. However, there is a phenomenon called “one trial” learning, where an event is so traumatic that only one exposure can create fears, phobias, or anxieties.

Owner responses when their pet experiences a new situation that could potentially be frightening are important. Calm reassurances; happy, cheerful tones; and relaxed body postures of owners help pets experience new things without fear. Bringing along treats and play toys and giving them to the pet when it enters new environments (e.g., veterinary clinic, schoolyard) or when it meets new people or other pets can help turn the situation into one that is positive. However, if the animal is not calmed by these things, then removing the pet from the situation might be best. Conversely, if you show anxiety, apprehension, or frustration with your pet, or if you try to use punishment to stop undesirable behavior, you will likely make your pet more anxious. Knowing your pet and its individual temperament will help determine what situations you can and should expose your pet to. There is a phenomenon called ‘one trial’ learning, where an event is so traumatic that only one exposure can create fears, phobias, or anxieties.

How can these problems of fears and phobias be treated?

Each time your pet is exposed to an anxiety, fear, or phobia-inducing situation and is unable to calm down, the problem is likely to worsen. Finding a way to control, relax, calm, or distract your pet in the presence of the stimulus is needed to correct the problem and to teach your pet that there is nothing to be feared. This usually entails teaching the pet a new response when it is calm and not in the presence of the fear-provoking stimulus. A pet’s fear and anxiety will be lessened by an owner who is calm and in control. For most cases of fear, behavior modification techniques, where the pet is exposed to mild levels of the stimuli and rewarded for nonfearful behavior, are utilized. For low levels of fear or anxiety, especially when the pet is being exposed to new stimuli, many pets will calm down with continued exposure, as long as nothing is done to aggravate the fear. Consequences that reinforce the fearful behaviors (inadvertent rewards or retreat of the stimulus) or aggravate the fear (punishment) must be identified and removed. Exposure to stimuli that have an unpleasant or negative outcome (e.g., an aggressive dog, a child that pulls the dog’s tail) also serve to instill further fear. Drug therapy may be a useful addition to behavior therapy techniques and may be necessary in the treatment of some phobias.

This client information sheet is based on material written by: Debra Horwitz, DVM, DACVB & Gary Landsberg, DVM, DACVB, DECAWBM © Copyright 2013 LifeLearn Inc. Used and/or modified with permission under license.

Ringworm in Cats

What is ringworm and what causes it?

“Ringworm” is the common name given to a fungal infection of the superficial layers of the skin, hair and nails. Ringworm infections can occur in humans and in all domesticated species of animals. The name comes from the classical appearance of the round, red, raised ‘ring’ marking the boundary of inflammation in people infected with the disease. The common name of ringworm is somewhat misleading, in that it is not an infection caused by a worm, and the infected areas are not always ring-shaped. The organisms that cause ringworm infections belong to a specialized group of fungi known as dermatophytes, so the medical name for this disease is dermatophytosis.

Some species of dermatophytes are species-specific, meaning that they will only infect one species, whereas others can be spread between different species of animals or from animals to man. In cats, one species of dermatophyte, called Microsporum canis, is responsible for almost all ringworm infections, and this species is infectious to cats, dogs and man. Occasionally ringworm infections in cats may be caused by species such as Trichophyton mentagrophytes. Both of these species are zoonotic, meaning that they can also infect humans.

What does ringworm look like?

“The lesions of ringworm in cats may be very mild or even undetectable.”

Ringworm can be challenging to detect in cats, since the lesions of ringworm may be very mild or even undetectable. Ringworm fungi feed on the keratin that is found in the outer layers of the skin, hair and nails. A “cigarette ash” scaling in the depths of the coat may be the only visible indicator of ringworm infection in cats. Some cats may have round thickened patches of skin with hair loss. Hair loss (alopecia) occurs when the spores infect the hair shafts, resulting in increased fragility of the infected hairs.

In cats, the main sites for these lesions are the skin on the head, chest, forelegs and along the ridge of the back. These lesions are not usually itchy. Occasionally, infection of the claws known as onychomycosis may occur. The claws become rough, pitted, and develop a scaly base; they may ultimately become deformed. Ringworm may sometimes cause a more generalized disease where a much larger area of the body is affected, often seen as patchy hair loss.

Some cats, especially longhaired breeds, may have ringworm without any clinical signs or hair loss. This condition is known as an asymptomatic carrier state. These cats may infect other animals or people, especially in shelter or multi-cat environments, without caregivers suspecting they may be infected.

How is ringworm transmitted?

“Ringworm is contagious and can be passed between infected and non-infected individuals through direct contact or by contact with contaminated objects.”

Ringworm is contagious and transmission occurs by direct contact with the fungus. It may be passed by direct contact with an infected animal or person, or by handling contaminated objects or touching contaminated surfaces.

The fungal spores may remain dormant on combs, brushes, food bowls, furniture, bedding, carpet or other environmental surfaces for many months (reportedly up to 18 months). Spores may be killed with a solution of chlorine bleach and water (one pint of chlorine bleach (500 ml) in a gallon of water (4 liters), or a dilution of 1:10 to 1:100), where it is feasible to use it.

Contact with ringworm fungus does not always result in an infection. The amount of environmental contamination is an important factor in the development of a ringworm infection, as is the age of the exposed person or animal. Healthy adult humans usually are resistant to infection unless there is a break in the skin such as a scratch. Elderly people, young children, and adults with immune system weaknesses or skin sensitivities are especially susceptible to ringworm infection. If your child has ringworm, he or she may have acquired it from your pet or from another child at school. If you or any of your family members develop suspicious skin lesions, see your family physician immediately.

How long does it take to get it?

The incubation period between exposure to ringworm fungus and the development of ringworm lesions usually ranges from seven to fourteen days; some cases may take up to 21 days before signs of infection develop.

How is a ringworm infection diagnosed?

The majority of cases of feline ringworm caused by M. canis will glow with a yellow-green fluorescence when the skin and coat are examined in a dark room under a special ultraviolet lamp called a Wood’s lamp. However, not all cases show clear fluorescence and some other dermatophytes like Trychophyton mentagrophytes do not fluoresce. Some skin ointments and other materials will fluoresce and may give a false positive result.

The preferred method for diagnosing ringworm in cats is by culture of the fungus in a laboratory. For this, samples of hair and skin scrapings are taken. A positive culture can sometimes be confirmed within a couple of days, but in some cases the fungal spores may be slow to grow, and culture results can take up to four weeks, meaning that a suspected case cannot be called negative for at least a month. Cats are often tested after one to two weeks of treatment, and then at weekly intervals until two consecutive ringworm cultures are obtained.

There are numerous causes of hair loss in cats. Before making a diagnosis of ringworm, your veterinarian may recommend additional testing to rule out some of these causes.

How is ringworm treated?

“…treatment of the disease is always indicated to minimize the spread of the infection…”

Although ringworm is a self-limiting infection in many cats, with resolution typically taking three to five months, treatment of the disease is always indicated to minimize the risk of spread of infection to humans, especially children, and other pets.

The most common way to treat ringworm in cats is to use a combination of topical therapy (application of creams, ointments or shampoos) and systemic oral therapy (administration of anti-fungal drugs by mouth). In order for treatment to be successful, all environmental contamination must be eliminated.

1. Topical treatment

Occasionally, topical therapy is used alone for treatment of ringworm, but more commonly it is used in combination with oral medication. Various creams and ointments are available to apply to localized areas of the skin affected by ringworm. If there are only one or two affected areas, shaving of the hair from these areas may be sufficient. If there is more generalized disease, or if your cat is a longhaired breed, your veterinarian may recommend clipping the pet’s hair short to aid in treatment, along with bathing the cat with a medicated shampoo, typically twice a week. It is extremely important only to use preparations that have been specifically provided or recommended by your veterinarian. Topical treatment will usually be necessary for a period of several weeks to several months.

After bathing or treating your cat, be sure to wash your hands and sanitize any surfaces your cat been in contact with.

2. Oral treatment

In the majority of cases of ringworm, effective treatment will require administration of an oral anti-fungal drug. The most widely used drug for this purpose has traditionally been griseofulvin, although newer drugs such as itraconazole or terbinafine (Lamasil) are being used more frequently and are often preferred since they have fewer side effects. The response of individual cats to a treatment varies, and if therapy is stopped too soon, the disease may recur. Treatment must usually be continued for a minimum of six weeks, and in some cases, much longer therapy is required. Ringworm cultures are generally taken one to two weeks after the start of treatment to determine if your pet is still infected, and treatment is typically continued until two consecutive negative ringworm cultures are obtained.

If there is more than one pet in the household, try to separate infected from non-infected animals and just treat the infected ones. In some situations, it may be preferable to treat all of the pets. Your veterinarian will advise you on the best treatment given your individual circumstances.

3. Environmental cleaning

Infected hairs contain numerous microscopic fungal spores that can be shed into the environment. Infection of other animals and humans can occur, either by direct contact with an infected cat or through contact with fungal spores in a contaminated environment. In addition to minimizing direct contact with an infected cat, it is also important to attempt to keep the environment free of spores.

“It is also worthwhile to restrict the cat to certain rooms of the house that are easy to clean.”

Clipping of infected hairs (with careful disposal) combined with topical antifungal treatment of affected areas of skin may help to reduce environmental contamination. Damp mopping or using electrostatic cleaners will aid you in removing pet hair from floors and furniture.

It is also worthwhile to restrict the cat to certain rooms of the house that are easy to clean. Environmental contamination can be minimized by thorough damp mopping or vacuuming of all rooms or areas that are accessible to your cat; this should be done as frequently as is possible (e.g. daily). In addition, the use of diluted bleach (1:10 to 1:100 bleach to water dilution) is recommended in areas that can be readily disinfected.

In multi-animal facilities such as animal shelters or kennels, treatment of ringworm can be extremely challenging and costly, and environmental contamination can be difficult to contain..

How long will my cat be contagious?

Infected pets remain contagious for about three weeks if aggressive treatment is used. The ringworm will last longer and remain contagious for an extended period of time if only minimal measures are taken or if you are not faithful with the prescribed approach. Minimizing exposure to other dogs or cats and to your family members is recommended during this period.

Ringworm cultures are generally taken several weeks after the start of treatment to determine if your pet is still infected. Typically two consecutive negative ringworm cultures indicate your cat has been successfully treated.

Will my cat recover from ringworm?

The vast majority of cats, if treated appropriately, will recover from a ringworm infection within a few weeks. While the appearance of the lesions may not change much during the first week or so of treatment, some improvement should be evident within two to three weeks. Symptoms may recur if the treatment was discontinued too early or was not aggressive enough (i.e. only topical treatment was used), or if the pet has some underlying disease compromising the immune system. Occasionally, despite appropriate treatment, the infection persists, and in this situation, your veterinarian may have to try alternative anti-fungal drugs.

What is the risk to humans?

Ringworm can be transmitted quite easily to humans, particularly children, and it is important to take appropriate steps to minimize exposure to the fungus while the cat is being treated (see Environmental Cleaning above).

“If any humans in the house develop skin lesions, especially small patches of skin thickening and reddening with raised scaly edges, early medical attention should be sought.”

If any humans in the house develop skin lesions, especially small patches of skin thickening and reddening with raised scaly edges, early medical attention should be sought. Ringworm in humans generally responds very well to treatment. However, the ringworm fungus can remain infective for up to 18 months in the environment and re-infection may occur.

This client information sheet is based on material written by: Ernest Ward, DVM © Copyright 2010 Lifelearn Inc. Used and/or modified with permission under license.

Roundworm Infection in Cats

What are roundworms?

Roundworms are one of the most common intestinal parasites of the cat. They can be an important cause of illness, even death, in kittens. As their name implies, these are large-bodied round worms, averaging about 3-6 inches (8-15 cm) in length. They do not attach to the wall of the intestine, as some intestinal parasites do. Instead, they are literally “swimming” freely within the intestine.

The scientific name for the feline roundworm is Toxocara cati. Another less common roundworm, Toxascaris leonina, can infect both dogs and cats. Roundworms are sometimes called ascarids and the disease they cause is called ascariasis.

What are the clinical signs of roundworm infection?

“…large numbers may cause life-threatening problems in kittens and debilitated older cats.”

Roundworms are not particularly pathogenic or harmful to adult cats, but large numbers may cause life-threatening problems in kittens and debilitated older cats. In kittens, common clinical signs include a pot-bellied appearance, abdominal discomfort, depressed appetite, vomiting and diarrhea, or poor growth.

In both kittens and adult cats with small numbers of worms, there may be no clinical signs of infection.

How do cats get roundworms?

Trans-mammary or milk-borne infection is the major route of roundworm transmission in kittens. The immature roundworms called larvae are present in the mother’s mammary glands and pass through her milk to the kittens during nursing.

Both kittens and adult cats may become infected by swallowing eggs that contain infective roundworm larvae. These eggs may come from the feces of infected cats or from the tissues of paratenic hosts. In a paratenic host, the roundworm eggs do not mature into adults, but are merely transported. If a cat eats the paratenic host, the roundworm is able to complete its maturation. Common paratenic hosts for roundworms include earthworms, cockroaches, rodents and birds.

The lifecycle of the roundworm is complicated. Once ingested, the larvae hatch out in the cat’s gastrointestinal tract and migrate through the muscle, liver, and lungs. Some of these larvae may encyst in a dormant in these organs for years before migrating back to the intestines or even to the kittens across the placenta or through the milk. Most, however, return to the intestine within a few weeks to mature into adults. When the adult worms begin to reproduce, eggs will pass into the cat’s stool, thus completing the life cycle of the parasite.

How are roundworms diagnosed?

To diagnose roundworm infection, a small amount of the cat’s stool is mixed in a special solution that causes the eggs to float to the top of the solution. The sample is covered with a glass slide on which the floating eggs will collect, and the slide is examined under a microscope.

“The distinctive eggs are easily recognized under the microscope.”

The distinctive eggs are easily recognized under the microscope. Roundworm eggs are usually plentiful but, in some cases, it may take more than one fecal examination to find them. Occasionally, intact adult roundworms can be found in the cat’s stool or vomit.

What is the treatment for roundworms?

Fortunately, the treatment for roundworms is safe, simple, and relatively inexpensive. The dead and dying roundworms pass into the stool after administration of the anthelmintic or deworming medication. Since none of these treatments will kill the encysted forms of the worm or the migrating larvae, some cats may need repeated treatments during their life. Ideally, kittens are dewormed with each visit for booster vaccinations. If your adult cat goes outdoors, you may wish to administer doses of an anthelmintic every 3 months to prevent problems.

All cats should have their stools rechecked after deworming for roundworms to ensure that treatment was successful.

What is the prognosis for a cat diagnosed with roundworms?

The prognosis of a roundworm infection is good if appropriate medication is given promptly. However, in some instances, extremely debilitated kittens may die.

Can I prevent my cat from getting roundworms?

Prevention of roundworm infection should include the following measures:

  • Breeding queens (females) should be dewormed prior to pregnancy and again in late pregnancy. This will reduce the risk of environmental contamination or transmission from the mother to her new kittens.

“First deworming should be given at two to three weeks of age.”

  • Kittens should be appropriately dewormed as recommended by your veterinarian. The first deworming should be given at two to three weeks of age. Note that this is prior to the time most kittens are seen for first vaccines. It is entirely appropriate to present new kittens for initial examination and deworming only.
  • Adult cats remain at risk for re-infection with roundworms throughout their lives. Whenever roundworms are seen, the cat should be promptly dewormed. It is appropriate to routinely deworm all cats that remain at high risk for re-infection. For example, it is advisable for cats with predatory habits or indoor/outdoor cats to have a fecal examination several times a year or even to be prophylactically dewormed quarterly..
  • Control of insects and rodents is important since they may serve as sources of roundworm infection for cats.
  • Stool should be removed from litter boxes daily, if possible. Litter boxes can be cleaned with a soap and water to facilitate removal of eggs. Always wash your hands after handling litterbox material.
  • Appropriate disposal of cat and dog feces, especially from yards and playgrounds, is important. Roundworm eggs may remain viable in the environment for long periods unless they are exposed to direct sunlight or very dry conditions.
  • • Strict hygiene is especially important for children. Do not allow children to play in potentially contaminated environments. Be mindful of the risk that public parks and non-covered sandboxes pose. Even though stool may not be visible, roundworm eggs may be present. Sandboxes that have fitted covers are popular and help prevent infection of children with roundworms.
  • Contact your animal control officials when homeless animals are found.

Are roundworms a danger to my family or me?

Roundworms can be a health risk for humans. The most common source of human infection is by ingesting eggs that have come from soil contaminated with cat (or dog) feces.

“In suitable environments, the eggs may remain infective to humans and cats for years.”

As many as 10,000 cases of roundworm infection in humans have been reported in one year in the United States. Children are at an increased risk for health problems should they become infected. A variety of organs, including the eyes, may be affected as the larvae migrate through the body. In suitable environments, the eggs may remain infective to humans and cats for years. Because of the potential to affect people,Kingsbrook Animal Hospital recommends deworming all puppies and kittens for roundworms.

This client information sheet is based on material written by: Ernest Ward, DVM © Copyright 2009 Lifelearn Inc. Used and/or modified with permission under license.

Roundworm Infection in Dogs

Roundworms (nematodes or ascarids) are parasites that live freely in the intestine, feeding off of partially digested intestinal contents. Their name is derived from their tubular or “round” shape.

Toxocara canis and Toxascaris leonina are two important species of roundworms in dogs. Toxocara canis causes more significant disease and also may be transmitted to humans.

How did my dog get roundworms?

Infected dogs shed the microscopic roundworm eggs in their feces. Other dogs may become infected by sniffing or licking infected feces. Roundworm eggs can also be spread by other animals such as rodents, earthworms, roaches and birds. In these animals, the roundworms are merely transported, and do not mature into adults; if a dog eats this “paratenic” host, the roundworm is liberated and completes its maturation.

“In the dog, the roundworm undergoes a complicated life cycle.”

In the dog, the roundworm undergoes a complicated life cycle before mature roundworms are found in the intestinal tract. This involves several stages and includes migration through various bodily tissues. Roundworm larvae (immature worms) can migrate and encyst throughout the host’s body. This is important in the female dog because these encysted larvae will start to develop during pregnancy and ultimately cross the placenta into an unborn puppy. Thus puppies can be born with roundworms and can pass fertile eggs from adult worms in their stools by the time they are approximately eleven days old. Roundworm larvae may also enter the mother’s mammary glands and be transmitted through the milk.

Are roundworms a threat to my dog?

“The most common consequence of roundworms is growth reduction.”

Roundworms are most threatening to puppies. The most common consequence of roundworms is growth reduction. Since roundworms eat partially digested food in the intestinal tract, if there is a large burden of roundworms they will rob the growing puppy of vital nutrients.

The life cycle of Toxocara canis is more complicated than that of other nematode worms found in dogs. Roundworms can complete their life cycle in immature dogs, but as the pup’s immune system matures (usually by 6 months of age), the larval stages will become “arrested” or encyst in the pup’s muscles Roundworm larvae swallowed by adult dogs usually encyst in the dog’s tissues. Few roundworms will mature in the bowel of infected adult dogs. Consequently few eggs are passed in the stool leading to difficulty in definitive diagnosis and treatment.

In intact female dogs, encysted Toxocara canis larvae can resume development after estrus, and she can shed eggs in the stool at that time. With dogs that have been spayed or castrated, development of a roundworm infection may indicate that there is an underlying immune system disease that has allowed the encysted larvae to complete their life cycle.

Toxascaris leonina can complete their life cycle in any age of dog, or in cats.

How are roundworms diagnosed?

“In puppies, clinical signs such as stunted growth, potbelly, and recurrent diarrhea are a good indication of roundworm infection.”

In puppies, clinical signs such as stunted growth, potbelly, and recurrent diarrhea are a good indication of roundworm infection. Definitive diagnosis is made by microscopic examination of the dog’s feces.

Is it true that children can get roundworm infections?

If the infective eggs of Toxocara canis are swallowed by people, the larvae can invade the tissues and become encysted in various organs. Humans act like any other paratenic or accidental host. If a young child ingests a large number of infected eggs, clinical disease may become apparent.

Very rarely, liver problems may result from roundworm larval migration (visceral larval migrans). Even less commonly, the larvae can migrate into the eye and cause blindness (ocular larval migrans). Because of the risk of roundworm infection in humans, it is recommended by the Centers for Disease Control (CDC) that all dogs be de-wormed monthly. Modern monthly heartworm preventives also prevent roundworm infections and are highly recommend for all dogs and cats.

“Because of the risk of roundworm infection in humans, it is recommended by the Centers for Disease Control (CDC) that all dogs be de-wormed monthly.”

Because of the risk of roundworm infection in humans, it is recommended by the Centers for Disease Control (CDC) that all dogs be de-wormed monthly. Modern monthly heartworm preventives also prevent roundworm infections and are highly recommend for all dogs and cats.

How are roundworms treated?

Treatment is simple and effective. There are many safe and effective preparations available to kill adult roundworms in the intestine

Many heartworm preventives contain medications that are effective against intestinal roundworms help prevent future infections. Some of these preparations only the adult worms and do not affect migrating or encysting larvae. New products have recently been developed that will also affect the larval stages. Your veterinarian will advise you on the best treatment and prevention plan for your pet.

What about roundworm eggs shed in the environment?

Initially the eggs are not infective. After a period, which may vary from weeks to months, the eggs develop into infective larvae. Under ideal conditions, this takes approximately four weeks. These infective larvae can remain viable in the environment for long periods of time and are particularly resistant to changes in temperature and humidity.

The best environmental treatment is prevention. Remove your dog’s feces as soon as possible to prevent the spread and transmission of roundworms.

What is the most effective strategy I can use to control infection in my dogs, protect my family and reduce contamination of the environment?

Deworm pregnant dogs in late pregnancy, after the 42nd day or after six weeks of pregnancy. This will help reduce potential contamination of the environment for newborn puppies.

All puppies should be dewormed routinely, starting at about two weeks of age and repeated regularly. Your veterinarian will design the most appropriate deworming schedule for your pets.

The use of a heartworm preventative product that is effective against roundworms will stop the shedding of eggs into the environment.

Rodent control is important since rodents can serve as a source of infection.

Dogs should be prevented from defecating in children’s play areas and there should be prompt disposal of all dog feces, especially in gardens, playgrounds and public parks.

“Practice strict hygiene particularly with children.”

Practice strict hygiene particularly with children. Do not allow them to play in potentially contaminated environments and ensure proper and frequent hand washing.

This client information sheet is based on material written by: Ernest Ward, DVM © Copyright 2009 Lifelearn Inc. Used and/or modified with permission under license

Euthanasia Decisions and Your Dog

Our culture has evolved to embrace the human-animal bond with love and respect. Our dogs are members of the family, and many of us describe ourselves as “pet parents.” Because of advances in veterinary medicine and preventive care, as well as the migration of dogs from the backyard to the house and even into our bedrooms, dogs are living longer and in closer relationships with humans than ever before. The longer the relationship, the stronger the bond. The stronger the bond, the more challenging it is to consider the end of a dog’s life, including the difficult decisions around euthanasia. Although it is heart-breaking to think about the fact that our dogs’ lives are generally shorter than our own, thinking about your dog’s eventual need for euthanasia and making a plan ahead of time will relieve much of the stress associated with decisions made when the end of life is near.

“Making a plan ahead of time will relieve much of the stress associated with decisions made when the end of life is near.”

How will I know when euthanasia is the most appropriate and humane option for my dog?

Open and honest communication with your veterinarian and veterinary healthcare team throughout a dog’s life lays the foundation for effective communication when that dog’s life begins to draw to a close. At some point, most dogs will develop a life-limiting disease (such as organ failure or cancer). As soon as such a diagnosis is made, it is time to begin measuring the dog’s quality of life.

Quality of life is a fairly subjective concept, which is why Dr. Alice Villalobos, a veterinary oncologist, has created a qualityof-life scale to help dog owners assign some objective scores to everyday aspects of their dog’s life (see the handout “Quality of Life at the End of Life for Your Dog”). This quality-of-life scale helps us identify trends over time—specifically, declining quality over days and weeks. Your veterinarian will be better equipped to help you identify the right time for euthanasia if you keep him or her informed about the day-to-day details of your dog’s life at home. Discussion with your veterinarian will clarify any specific medical implications of your dog’s disease that can serve as benchmarks to suggest that euthanasia should be considered.

Quality-of-life-related questions that should be asked and answered as the time for euthanasia approaches include:

  • What disease signs and symptoms will I see that will let me know it is time for euthanasia?
  • What day-to-day activities will disappear from my pet’s routine?
  • How will I measure day-to-day quality of life?
  • How often will I measure quality of life?
  • How often will I discuss quality-of-life trends with my veterinary healthcare team?
  • Which categories on the quality-of-life scale will be the most important for my dog?

My spiritual beliefs prevent me from actively or willingly ending an animal’s life. Because I will not consent to euthanasia, how can a discussion of euthanasia benefit my dog and me?

“It is certainly possible to honor spiritual beliefs that prevent euthanasia while still providing and delivering appropriate pain management and comfort care.”

In this scenario, speaking with your veterinarian about your dog’s approaching end of life is even more important. It is certainly possible to honor spiritual beliefs that prevent euthanasia while still providing and delivering appropriate pain management and comfort care. In this case, your veterinary healthcare team may need to be a bit more involved in measuring quality-of-life trends to prevent your dog from suffering unnecessarily.

Where will euthanasia happen?

Most often, euthanasia is provided at the veterinary practice or in your home. In general, the location can be left to the discretion of the family. If you choose euthanasia at home, your primary care veterinarian may be able to provide that service. If not, there are house-call veterinarians as well as veterinarians who dedicate their entire practice to providing in-home euthanasia services. Veterinary professionals can help you, your family, and your dog to be quite comfortable at this challenging time.

What should I consider or plan for regarding what will happen after my dog’s passing?

There are a number of questions that should be asked and answered in preparation for the approaching death of your beloved dog. Some examples include:

  • How will my dog’s body be handled after death?
  • Do I want my dog to be cremated or buried?
  • Do I want to keep a memorial, such as a lock of hair or my dog’s footprint in clay?
  • How will my dog’s body be transported after death?
  • What should I do if my dog dies on his or her own?

By having a detailed plan in place ahead of time, you may feel a sense of quiet or peace that will allow you to focus on the remaining time you and your dog will share.

“The veterinary healthcare team will be an important partner as you negotiate the difficult days and decisions leading up to your dog’s death.”

The veterinary healthcare team will be an important partner as you negotiate the difficult days and decisions leading up to your dog’s death. It is important to communicate your wishes clearly so that they can be honored appropriately. A bit of planning can make this challenging event a little less painful.

This client information sheet is based on material written by: Robin Downing, DVM, CVPP, CCRP, DAAPM © Copyright 2012 LifeLearn Inc. Used and/or modified with permission under license

Hospice Care for Pets – Overview – Part 1

Providing hospice care for pets as they approach their end of life is a relatively young discipline within veterinary medicine. Although the foundational principles of veterinary hospice care are derived fairly directly from those of human hospice care, there are some critical differences between providing hospice care to a human family member and providing hospice care to an animal family member. It is appropriate first to have an understanding of how human hospice and end-of-life care began and evolved before turning attention to hospice and end-of-life care for pets.

What were the origins of human hospice and end-of-life care?

“Hospices” were originally charitable places for travelers on long or difficult journeys to find rest and shelter. Typically, such travelers were on pilgrimages to sacred places and shrines. Hospices that focused on care for the incurably ill emerged during the 11th century and were often overseen by religious orders. In the 19th century, hospice care shifted focus specifically to the dying. Dame Cicely Saunders, an activist nurse, is credited with defining and implementing hospice as we know it today, founding St. Christopher’s Hospice in south London in 1967. Currently, more than 100 countries around the world provide formal hospice care for their citizens.

What exactly is hospice care?

Hospice is supportive care provided to individuals in the final phases of terminal disease so that they may live as fully and comfortably as possible. Hospice care, by definition and as practiced, recognizes that death is a part of life and focuses on maximizing the quality of life for the patient during whatever time remains. Typically, hospice care avoids aggressive interventions, although no specific therapies are excluded from consideration.

Hospice care recognizes that death is a part of life and focuses on maximizing the quality of life for the patient during whatever time remains.

The primary emphases for hospice care are pain management and comfort care. These are very general terms that encompass many different approaches to and interactions with the patient in hospice. For humans, the concept of relief from “total pain” encompasses physical, psychological, social, and spiritual aspects of life. Although a physician ultimately oversees the coordination of hospice care, the key to hospice’s success is an interdisciplinary team that includes medical professionals, trained volunteers, the patient’s family, and the patient working together to honor the patient’s wishes. One Kingsbrook Animal Hospital 5322 New Design Road, Frederick, MD, 21703 Phone: (301) 631-6900 Website: KingsbrookVet.com aspect of hospice is palliative care, which generally involves more specific medical procedures, medications, and interventions to contribute to patient comfort (see the handouts “Quality of Life at the End of Life for Your Cat” and “Quality of Life at the End of Life for Your Dog”).

Where does hospice care take place? Is a hospice like a hospital?

It is important to understand that hospice is a philosophy of caring rather than a place where that care is delivered. Although there are physical hospice facilities, hospice care can be delivered anywhere—including in the home. It is this philosophy of caring that has been applied to pet end-of-life care in developing principles for pet hospice. The goal is to allow the pet to be comfortable in its own home, with its human family by its side, maintaining a mutually interactive relationship for as long as life remains desirable for the pet—either until death comes on its own or until humane euthanasia becomes the most appropriate choice.

The goal of hospice care is to allow the pet to be comfortable in its own home, with its human family by its side.

How does pet hospice care compare to human hospice care?

In its delivery, pet hospice care actually closely mirrors human hospice care. The veterinarian coordinates and oversees medical procedures, medication prescription and delivery, and comfort care, but the day-to-day hospice care happens in the home. The single biggest difference between human and pet hospice care is the opportunity veterinarians have to provide humane euthanasia when quality of life for the pet becomes unacceptable.

As with dying humans, pets with life-limiting disease (illness that cannot be cured) benefit from having a system that measures their quality of life day by day (see the handouts “Quality of Life at the End of Life for Your Cat” and “Quality of Life at the End of Life for Your Dog”). Once a baseline quality-of-life measurement is in place, it is important for the human family to partner with the veterinary healthcare team to determine the most appropriate interval for re-evaluation and to create a plan for responding to changes in the quality-of-life measurement—specifically how to define declining quality of life (see “Hospice Care for Pets – Overview – Part 2” for additional details).

With planning, forethought, and honest communication, it is possible to provide a dying pet with very reasonable and acceptable quality of life as the end of life approaches.

This client information sheet is based on material written by: Robin Downing, DVM, CVPP, CCRP, DAAPM Copyright 2012 LifeLearn Inc. Used and/or modified with permission under license.

Quality of Life at the End of Life for Your Dog

Each and every pet has certain needs that should be recognized and respected. Quality of life is a way to refer to and discuss the day-to-day life and lifestyle of a dog reaching the end of its life. If we can successfully meet an ailing or chronically ill dog’s basic needs, then we can feel confident that our efforts in preserving life are justified.

If we can successfully meet an ailing dog’s basic needs, then we can feel confident that preserving life is justified.

What are some of the conditions that might cause a dog’s quality of life to deteriorate?

Most senior pets develop one or more medical conditions that tend to worsen over time. Examples of chronic medical conditions common in the older dog include:

  • Blindness—Generally occurs gradually from fibrous changes in the lens of the eye.
  • Cancer—The risk of cancers of all types increases with age.
  • Chronic renal disease—This degenerative kidney disease leads to the decreased ability of the kidneys to filter biological waste from the blood.
  • Deafness—Generally occurs gradually over time as the eardrum becomes less flexible.
  • Osteoarthritis—Painful inflammation and deterioration of the joints.
  • Overweight/obesity—More than half of senior dogs are overweight or obese, undermining quality of life.

Is there a way to objectively measure my dog’s quality of life?

Dr. Alice Villalobos, a veterinary oncologist, has developed a quality-of-life scale for dogs so that owners can act on behalf of their beloved animal family members as a pet’s end of life approaches. The quality-of-life scale provides guidelines that help owners and veterinarians work together to maintain a healthy human–animal bond. The scale provides a tool with which to measure the success of a palliative care or hospice plan for a dog with life-limiting disease and to fine-tune that care/plan.

Dr. Villalobos’ quality-of-life scale looks at seven different parameters and scores each parameter from 1 to 10, with 10 being the best. A score above 5 in each category, or an overall score greater than 35, suggests that the dog’s quality of life is acceptable and that it is reasonable to continue end-of-life care and support. Kingsbrook Animal Hospital 5322 New Design Road, Frederick, MD, 21703 Phone: (301) 631-6900 Website: KingsbrookVet.com The categories to be measured can be remembered as “HHHHHMM.” This list of letters stands for Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More good days than bad.

The quality-of-life scale helps owners act on behalf of their beloved animal family members as a dog’s end of life approaches.

What does each category mean for a dog approaching the end of its life?

The HHHHHMM scale:

Hurt: 1–10

Adequate pain control, including the ability to breathe properly, is an absolute necessity. Most pet owners do not know that being able to breathe is ranked as an important pain management strategy. A dog may benefit from receiving oxygen at home, and it may not be as challenging to provide as you think! Other methods of controlling pain may include oral or injectable medication.

Hunger: 1–10

If a dog cannot eat properly or willingly, first try hand-feeding. If this is not successful, then it may be appropriate to consider a feeding tube, particularly if oral medication must be given. Blended or liquid diets may offer another alternative.

Hydration: 1–10

Fluid under the skin is an easy and well-tolerated way to supplement what an ailing dog is drinking. This is not a “heroic” measure and can really help an older dog feel better.

Hygiene: 1–10

Can the dog be brushed, combed, and kept clean? Is the coat matted? Can the dog move away from stool or urine if it has an accident? Is there a tumor that has outgrown its blood supply and now has an odor or discharge? Often, a dilute solution of lemon juice in water on a sponge or washcloth can be used to clear dead cells away without causing pain. The veterinary healthcare team can help work out the details of this kind of care. It is also important to turn bedridden pets regularly, keep them clean and dry, and ensure that they have adequate padding underneath to prevent bedsores.

Happiness: 1–10

Is the dog experiencing joy or mental stimulation? Dogs communicate with their eyes as well as by wagging their tails. Is the ailing dog still interacting with family members and with the environment? Placing comfortable beds near family activities helps a dog remain engaged in life. Dogs are social animals and can become depressed when they are separated from their “pack.”

Mobility: 1–10

If the dog can no longer move around on its own, it may be time to consider one of the many mobility devices that are available. A sling or harness for support may be all that is required. Other options, depending on how much support is needed, include two-wheel carts, four-wheel carts, and wagons. Mobility devices allow a dog to stay active. This is particularly important for bigger dogs that cannot simply be carried from place to place. Mobility and hygiene go together when a dog is bedridden. The veterinarian is an important resource when working through mobility issues.

More good days than bad: 1–10

When there are too many bad days in a row, or if the dog seems to be “turned off” to life, quality of life is compromised. Bad days may mean nausea, vomiting, diarrhea, seizures, frustration, unrelenting pain/discomfort, or inability to breathe.

How will I know it’s the right time to consider euthanasia?

A healthy human–animal bond requires a two-way exchange, and when that exchange is gone, the time for humane euthanasia has arrived. It is important to plan for the end of life before that time arrives, and the quality-of-life scale can help with that planning. You can help your dog maintain a good day-to-day life experience by using this scale to regularly measuring the parameters that evaluate how well your dog’s basic needs are being met. This scale can also help you clarify the decision for euthanasia, hopefully relieving anxiety and regret about your beloved dog’s end of life.

Can my veterinarian help me decide when to let go?

Veterinarians are often asked to help dog owners with the heart-breaking decisions around euthanasia. Your veterinarian is there to help with these very difficult decisions.

This client information sheet is based on material written by: Robin Downing, DVM, CVPP, CCRP, DAAPM © Copyright 2012 LifeLearn Inc. Used and/or modified with permission under license.