The Seresto Collar

The Seresto collar is one of our tools to prevent flea and tick infestation. Most of our clients are using Nexgard, Revolution or Bravecto, but we also recommend the Seresto collar for many patients. It is our most cost-effective flea and tick product and also easy to use as it lasts up to 8 months.

This week, USA Today published an article calling into question the safety of the Seresto collar. I have read the article as well as the response from Elanco, the collar’s manufacturer. The article refers to reports of disease or death in pets that have used the collar, where the owner told the company. The company is required to report adverse events to the EPA, and the EPA compiled a list of these events.

We have not seen any cases in our clinic of anything more serious than skin irritation from the use of the collar. As for the data given in the article, unfortunately it is anecdotal and not very useful for our purpose of deciding on the safety of the device. Here is a list of things that make the raw data not useful:

  • The product reported might not be Seresto but might be reported as Seresto (a lot of people use Seresto as a generic name like Kleenex).

  • The product could be counterfeit, as people are unknowingly buying counterfeit collars from online stores. We receive collars directly from the manufacturer, no distributor involved.

  • The patient could have had the disease before the collar was used.

  • When the disease is unrelated to the collar, the report looks the same as one that is related.

  • Reports can be filed even in cases where the person does not have a pet and where the pet never used any collar.

  • The clinical signs reported may not match the actual signs.

  • The span of time between illness and death could be very long. There are sometimes reports where a collar was used once at age 3, and then the patient died at age 10, and the person reporting thinks there must be a connection.

In other words, there is no validation of the raw data used in the article. USA Today didn’t do any validation of their own, and only found one case worth publishing on.

The scientific experts that were cited by USA Today were a former employee of the EPA who is unfamiliar with the product and the data, and an activist scientist who made such broad conjectures about medicine, which is not his field, that it really undermined his credibility.

Our experience with the collar is that it has been a very useful and safe device. We have had a few cases of itchy skin and have generally switched products. We have not seen any neurological signs with the product in our years of using it. So we rely on the EPA and the manufacturer to properly validate adverse events and figure out if they are associated with the collar.

There is always the possibility of incompetence or corruption of the companies or agencies responsible for handling adverse event information. If this turns out to be the case, you will know one very angry Veterinarian. But so far I have seen no reason to accuse the EPA, Elanco, or Bayer, the prior owner of Seresto, of such things.

I hope you find this information helpful and I will update it as we learn more.

Dogs, Cats and COVID-19

A lot of people have asked if their pets can contract or carry the virus that causes COVID-19. As far as we know, this is not a likely source of transmission and our pets are not at risk.

There have been cases identified in cats in New York whose owners had the disease, as well as in a dog in Georgia whose owners had the disease. These cases appear to be human-to-pet transmission. The dog did not have COVID symptoms but died of an unrelated disease. However, during the diagnostic process, a test for COVID was positive. The cats had mild respiratory symptoms that resolved quickly.

Meanwhile, we have also been asked questions about our hours and procedures. We are pleased to report that we are now scheduling Saturday visits for routine care by appointment. Generally we will be available on the first and third Saturday of the month from 9-2, but please call and make an appointment. We are not planning to accept walk-ins on those days and we are not leaving room for urgent care. For urgent weekend care please use Animal Emergency Center of Sandy Springs. We are open for full service from 8:30 to 5pm Monday to Friday. For boarding, we are able to schedule pick up from 4-5 PM on Saturday or Sunday, as well as whenever we are open normally.

Our groomer, Amanda, has been very busy! Please call early to schedule a grooming because her schedule fills up rapidly.

We will continue the curb-side service and keep our waiting room closed. We will do our best to accommodate your needs. One thing we have found is that a lot of our patients are much calmer without the extra hustle and bustle going on in the clinic, so that seems to be a positive result. If you are uncomfortable waiting in your car, we do have a bench by a shade tree, and we’re happy to let you drop your pet off for a half hour while you go for a walk or run an errand. Dr. Donelan likes to discuss matters over the phone, while I like to come to the car and talk. Please appreciate our technicians and assistants who are sometimes out in the hot sun working with you. Everyone is doing their part.

We hope to see you soon!

New hours and COVID-19 update

New Hours

We’re pleased to announce that we are now able to extend our hours. Starting Monday, May 18, we will be open Monday to Friday from 8:30AM to 5:00 PM, with an hour lunch from 1:00-2:00 PM. For your safety, we will continue curbside-only service for the reasons detailed below. We’re now also taking up the backlog of routine care because you are no longer being asked to stay at home.

A short summary of the stuff below: wear a mask, avoid restaurants, use curbside service where possible.

New COVID-19 Thoughts

How do we prevent Coronavirus? For the last month and a half, we have been on “lockdown” where most people have kept their contacts to a minimum and have stayed home. Most employers have closed their workplaces and all kinds of social activities are closed. The only thing remaining generally open has been stores that sell essential goods, like food and home supplies. This action has definitely reduced the rate of transmission of the virus. The number of new cases as well as the number of deaths per day has leveled off for the most part.

For a scientifically-minded guy like me it has been hard to find the information I would like. What activities are causing the spread? Are people who are isolating getting infected? Are runners getting infected? What about people who visit friends but stay 6 feet away, as per the recommendation? Is it foolish to play tennis or beach volleyball? Was there any point to closing the pool?

For the most part, this information has been lost in the aggregate numbers that are reported every day. We know that there were 46 new cases in DeKalb County yesterday, but we don’t know anything about them. What is the real epidemiology of this virus? Is it reflected in the national or state strategy for reopening?

I’m linking to a great blog post about these questions. This is written by a scientist although not an epidemiologist. But I feel that the insights are very reasonable.

Until I hear differently, I believe that most of the airborne spread of the disease will be in enclosed spaces where people are together a long time. That would be like restaurants, funeral homes, concerts, rehearsals, and unfortunately, medical visits, especially waiting rooms. If someone comes into an enclosed space and coughs/sneezes virus all over it, then the people who have to remain in that space are going to get infected. But asymptomatic people can spread the disease by breathing alone.

The other main way of spreading is through contact, either directly or through surfaces. We should continue to avoid shaking hands, hugging and kissing people casually. When we share objects like tools or papers, we should sanitize our hands before touching our faces. As we go through our day, we risk picking up the disease from doorknobs, handrails, and other surfaces we usually touch with the palm of the hand. We need to wash hands frequently and use sanitizer.

Wearing masks is a great way to reduce spread. It reduces the particles flying around from breathing, coughing, sneezing and talking. Simple masks like surgical masks or bandanas also reduce particles inhaled by 75%. N95 masks stop nearly all transmission of the virus but they are difficult to acquire and uncomfortable to wear. Most people I see are not wearing them correctly, so they are probably as effective as surgical masks in those cases.

Masks do not prevent you from acquiring an infection through direct or indirect contact, so be sure to be aware of touching your face, especially your eyes, nose and mouth. Wearing glasses can help prevent you from touching your eyes.

It seems that we should be able to enjoy a nice walk, jog or bike ride without too much risk. Tennis is probably also safe. Indoor sports are a bad idea right now. Hopefully, with good screening and social distancing, the gym will be OK.

Eating at restaurants is still pretty unsafe. It’s better to do takeout or at least sit outside if you can. Definitely do not join a crowd.

In the end, I don’t think that we will get rid of the virus. Eventually we will all be infected unless a vaccine is developed. But we can hopefully avoid a “second wave” of infections that overwhelms our healthcare system. I think if we have a huge uptick in severe cases, it won’t matter what orders the governor gives, people will be isolating and the economy will shut down again.

Let’s try to be smart as we reopen and we will hopefully be able to have the economy get back on track while we prevent the virus from getting out of hand. Wear a mask. Avoid restaurants and groups. Use curbside service.

Support the Paycheck Protection Program

I’d like you all to talk to your congresspeople.

The Paycheck Protection Program is a loan program that was authorized by the CARES Act in the end of March and started a couple weeks ago. The goal has been to keep people employed by having their employers pay them and not lay them off. In retrospect, this has been a good idea because a lot of people have yet to receive their enhanced unemployment benefits promised in the CARES Act, so the employers who have decided to keep employees on payroll during this time have done a great service to their employees. We are paying our employees to stay home and stay safe, so that they don’t have the additional stress of losing their income and filing for unemployment.

Unfortunately, there was not enough money authorized in the program. It was devised very quickly, without enough thought into how much money it should require. Rather than taking time to deliberate during an emergency, the Congress decided to act. Correctly, in my opinion.

The lack of funding means that businesses will run out of money unless the loans are funded. It’s as plain and simple as that. Businesses depend on cash flow. When there’s no cash, it doesn’t matter what the future revenues are going to look like, the business will be bankrupt before it can get to the future.

New funding has already been approved by the Senate. Again, the bill is probably not perfect. But it is already very late. Please call or write an e-mail to your Representative and ask him or her to approve this bill so that the small businesses you depend on can continue to serve you.

Thank you very much for your support!

Coronavirus Update

We have changed our normal way of working in order to limit exposure to protect you. We figure that we are at risk of becoming spreaders if we continue to see clients in the exam rooms and lobby, so we are going to change to a concierge model. It works like this:

1. You arrive at the clinic and stay in your car.
2. Give us a call at our main number (770)394-0030 and let us know you're here.
3. If you're here for an office visit, our technician will come to your car to retrieve your pet. Please make sure it can be brought in, either in a carrier or on a leash. We have leashes for dogs and an extra carrier for cats if needed. Feel free to take a walk on the path by the reservoir as long as we can contact you.
4. We will discuss the case with you using the telephone, or apps like Signal, WhatsApp, and FaceTime. Just let us know how you'd like to do it.
5. When we are finished we'll go over the charges with you and we can accept payment over the phone.
6. We'll then return your pet to you and you'll be on your way without much risk of getting coronavirus.

If you're coming for a drop-off or grooming, it's the same but you won't have to stay and wait. If we are just dispensing food, medication, or supplies, we'll just take payment over the phone and bring it out to you.

We may suggest that you can defer routine care that can wait a few weeks. Hopefully this period of social distancing will pass soon. We are reducing boarding capacity during this time to reduce number of staff who are exposed to each other each day. Depending on how things go over the next few weeks, we may have to change our hours, but for now there are no changes.

For supplies, be sure to check out our online store. (https://winterschapel.vetsfirstchoice.com/). It is easy to request your prescriptions there and pay online for home delivery. If you need assistance, give us a call.

We are here for you and we are doing our best to keep your pets healthy and happy, and keeping you safe. We're all in this together, so let us know if we can do something more to help during this time!

Diet and Weight

I am currently on a diet to lose weight. My clients reading this are probably laughing because, while I am tall, I have never been particularly wide. However, we all know how we feel better than anyone else can, and I know that at 183 pounds I have heartburn, trouble sleeping, achy joints, and less energy than I do at 165. Some of us carry more fat in the abdominal cavity (visceral fat), and others deposit more under the skin first.

I bring that up only because it gets me thinking about diet and weight in our patients. We want to do what is best for our pets and one of the levers of control we have as owners is the diet we feed. Let’s look at a little bit of research into feeding and see what we can learn.

I start with a very important study by Dennis Lawler’s group at Purina. In this study, 48 Labrador puppies were paired up with litter mates based on size and sex at 6 weeks of age. They were fed puppy food until 3¼ years old and then adult food until they passed away. They were left unneutered unless treatement of disease required neutering, in which case they neutered the pair. One dog was allowed to eat whatever it wanted each day. They then weighed that amount, and fed 25% less to the other dog in the pair on the following day. Thus, half of the dogs ate 25% less than their pair.

Lawler’s study showed that the average restricted dog had better body condition (normal vs obese), lived longer (2 years) and healthier (less joint pain, later development of cancer). They were all eating the same diet. Just some dogs were eating too much. This study showed that one of the most important things we can do for the health of our Labradors is not overfeed them. That means a body condition score of 4 or 5 out of 9 is ideal. At that body condition, they have a nice waist, you can’t feel fat on the ribs and they don’t have fat pads on the shoulders or hips, but they are not so skinny that the ribs stick out.

A large group of veterinary hospitals performed a review of their records for another study that showed that these findings generalize to all breeds. For example, Yorkshire terriers with healthy body condition live 4 years longer than Yorkies with obesity.

As for cats, we do not have as many good studies. I will keep looking for more. But we do know that overweight cats are more likely to get diabetes, joint disease, and skin conditions. We know that maintaining cats in a healthy body condition prolongs the healthy part of their life. Unfortunately, as cats age they often lose body mass and that is associated with worse outcomes. We would like to learn how to help those cats too.

So, why can’t dogs and cats just eat their food and stay a healthy weight? Do weight loss foods help? I will get to these questions in a future blog post, but for now take as a recommendation to pay close attention to the body condition. You want to back off on the food, treats or table scraps when you notice your dog getting padding on the ribs. You might need to feed meals to prevent your cat from getting overweight. An automated feeder that feeds measured meals can help with cats, as they can get very annoying in the morning when you feed them meals, trying to train you to wake up earlier and feed them.

Keeping a normal weight on your pet is more important, in general, than the choice of product you feed. But I think there will be interesting things to talk about in the next post on this topic, where we discuss the reward system and its role in overweight.

The New Human Coronavirus (COVID-19)

Many of us remember the SARS epidemic in 2002-2003. SARS was a severe respiratory disease that was first seen in China and that quickly spread across Asia. Some people were infected there and brought the disease to the US before they knew they were sick. In that time, travel restrictions and infection control measures reduced and eliminated the spread of the virus.

SARS was very scary because it had a lot of the features of the 1918 Pandemic Flu: healthy adults were getting sick and dying, there was no specific treatment aside from supportive care, and initially it seemed to be rapidly spreading across the globe. The severity of symptoms meant that patients needed hospitalization, both exposing medical staff and using up resources like hospital beds, ventilators and protective equipment.

COVID-19 is a disease caused by a similar virus to SARS, but it seems to be both more contagious (easily spread) and less virulent (disease is usually less severe).

What is a coronavirus?

Coronaviruses, like the ones that cause SARS and COVID-19, are a group of viruses with a similar shape and type of genetic material. Most coronaviruses are found in bats and birds, but they cross species into other mammals and then evolve in their new hosts. It’s believed that COVID-19 was previously found in a civet, a member of the feline family, that was being sold for meat in an open market, where the virus hopped to a human host. Thankfully, China has now banned selling wild animals for food.

There are several known coronaviruses of little concern for people. A couple types cause a common cold in people. Other ones infect dogs or cats but not people. The coronavirus of largest concern for veterinarians is called variant-systemic feline coronavirus. This is a mutant of a diarrhea virus that, in unlucky cats, causes feline infectious peritonitis (FIP). It does not help to vaccinate for this virus and the best method of prevention is to reduce unplanned breeding of cats, as most stray kittens get infected early on with the pre-mutated form. In dogs, there is a coronavirus that causes mild to severe diarrhea symptoms. There is a vaccine that reduces the severity of infection but it does not prevent the spread of the disease and does not prevent disease in all cases.

Can I get COVID-19 from my dog?

The short answer is probably not. We are keeping a watch on the situation but it is unlikely that we will see a third species of animal involved in transmission. In the SARS epidemic, there were dogs and cats that had been infected with the virus, but they did not have clinical signs and did not appear to be spreading the virus. With COVID-19, there has been at least one dog that tested positive in Hong Kong. It is much more likely that you will get infected and transmit it to your dog than the other way around.

In Hong Kong, they are recommending avoiding kisses with dogs. I will defer you to your own judgement as to whether you or your dog is a carrier.

What are we doing to prevent transmission?

We are taking standard precautions to avoid transmitting diseases in our clinic. We have increased the number of times per day we sanitize all the counters and seating areas. We are washing hands very frequently and using hand sanitizer after interactions with clients and their pets. We are checking the temperature of anyone who is sick.

We are going to try to avoid unnecessary palm-side hand contact like handshakes. If you get a fist bump, know that it comes from a place of love. We are trying to put clients into exam rooms more quickly so that we minimize the number of people in our lobby at one time.

What can clients do to help?

First, wash your hands. A lot of transmission will be prevented by more frequent handwashings. Resist the urge to wipe your eyes and face with your hands. If you use a tissue for a sneeze or to wipe your eyes or nose, throw it away. These basic hygiene measures will go a long way.

Stay healthy! Get full nights of sleep. Eat good food. Wear appropriate clothing when it is cold or hot. You know, the basics for avoiding a cold.

If you have a cough, call a doctor and get screened before going out. In this season it will be hard to tell the difference between an infection and allergies. Taking your temperature can help. If it is above 100°F then you should probably stay home and cancel your plans.

This virus will hopefully fizzle out like the SARS virus did, but if we end up with a pandemic, we need to be doing all we can to slow its spread. Even if we all are eventually exposed, slowing it down will keep resources available for those who need hospitalization. We are approaching COVID-19 with cautious optimism. We’re confident that our community will get through this outbreak and we will all soon breathe easily.

Photo by Rejaul Karim

Photo by Rejaul Karim Own work, CC BY-SA 4.0

How Vets Become Vets

Veterinarians get lots of questions from students, parents and the general public about how we got to where we are. Did I always want to be a vet? (I made the decision when I was 24.) How many years of school do you need after high school? (I have about 11.) Do you have to study hard? (Yes.) I have offered advice to lots of friends and acquaintances over the years. Here are some of my pointers for getting into our career.

The veterinary career should be a passion. It is a lot easier to get through all of the hard parts of the education when you have a goal of working hard doing something you enjoy. There are many careers that pay better that you can get into with similar amounts of hard work. People often ask if I thought about being a human physician. I did, and I took a practice MCAT. I thought deeply about it, and decided that I’m much more interested in helping animals and working with their owners.

When you are starting out pursuing this career, it is good to try some diverse experiences. Veterinarians work in many different capacities. While most of us are now small animal veterinarians in storefront offices like Winters Chapel Animal Hospital, veterinarians are found in larger central hospitals, mobile trucks that visit farms, zoos, shelters, research labs, diagnostic labs, corporate offices, and government. I know vets in all these jobs. Most of them will let you shadow or work with them for a period of time to see what the job is like. Sometimes, there is even a formal pre-veterinary program to generate interest in a particular field that is considered underserved.

The stereotypical future veterinarian is someone who announced that they wanted to be a veterinarian at 5 years old and still has that dream as they are finishing high school. It’s good to take a deep breath and get some shadowing experiences to find out if this is really what you want to do. Being a small animal veterinarian involves long hours, hard work, and lots and lots of client interaction. If you really don’t want to work with people, this isn’t the right career. There may be an aspect of veterinary medicine that will work, but it’s hard to avoid people and be a small animal vet.

Almost all veterinary careers are what I call service-oriented careers. This means that your typical day involves taking on small amounts of new work that you will be completing within a few days. I contrast that with project-oriented careers where you will take on longer term projects that you have to work on consistently until you finish before some deadline. Some careers involve both aspects, but most are predominantly one or the other.

What was my path? Nontraditional. I skipped biology in high school and followed a career in software with an eye toward business. I hated it. Software is a project-oriented career and I didn’t realize that it was anathema to how I like to work. I could enjoy it to the extent that I could work with other people to basically use my services to get the project done. After a dalliance with acting, I made the decision to go back to school, learn biology and chemistry, and apply to vet school. It turns out that my personality matches this type of work much better and I am quite content.

So, once you’ve made the decision to become a veterinarian, what is involved? Reasoning backwards, you need a license, which means you need to graduate vet school and pass the board exam. To graduate vet school, you have to get in, and to get in you need good grades in the right subjects and some experience in the field.

You can get into some vet schools after 2 years of college by taking all the required classes. This means you have finished Biology, Chemistry, Organic Chemistry, Biochemistry, Physics and several other classes depending on the school you’re applying to. For most people, I don’t recommend pushing through so quickly. The college experience is very worthwhile and it’s good to become well rounded by taking all sorts of classes in history, language, writing, political science, and mathematics. It’s good to spend 4 years with people who are probably going to become your lifelong friends. It’s also good to become as mature as possible before starting vet school. Finally, taking all the science classes together can be very stressful.

What kinds of grades should you get? Grades are very important for your application. If you look at most schools, the typical GPA is above 3.5. University of Georgia’s average is 3.7. Getting straight As will make a big difference. It’s better to do well in science courses than to take a lot of courses at once, so don’t overload your schedule. Beyond the requirements, take classes that interest you because, in the end, you’ll get better grades and your college experience will be more worthwhile.

What kind of work experience should you have? Relevant experience with some breadth. If you are small-animal focused like me, working as a veterinary assistant in a clinic gives great experience. But you should also do some work or observation with large animal medicine. If you say your dream is to be a zoo veterinarian, but you don’t have experience with exotic animals, that won’t be as believable.

There are other careers in veterinary medicine and having experience with them can definitely help your application. You can work with laboratory animals, public health, and production medicine (like chickens, pigs, and cows). You can be a veterinarian advisor to Congress or work with the USDA and FDA. You may want to demonstrate experience working in the state or national capital. Your experience should be congruent with what you claim you want to do with your career.

If you’re unsure about how to find experience in a particular part of the industry, don’t be afraid to call or write to people working in it. You can find them on LinkedIn, on websites where they work, and by talking to other veterinarians. You can attend the open house events at vet schools and talk to professors and administrators who can help you get in touch with other veterinarians. Put yourself out there, and you won’t regret it.

If you find yourself at age 30 with a history of bad grades and no relevant experience, you can still make it, but understand that your path is more difficult than someone who is 21, straight As, and has been working in their parent’s clinic since age 16.

Once you are accepted to vet school, it’s hard to fail out. If you fail a class in the first semester you can usually start again next year. As students we don’t compete against each other, so we are generally very supportive of each other. Our class started with 96 members, and 93 of those graduated. We also accepted a few transfer students who graduated with us. Vet school is hard. Like a marathon, not everyone can do it. But if you’re already a good runner, you’re probably going to finish. And, remember, the person who graduates at the bottom of their class from the worst med school in the country is still called Doctor.

Pursue your goals! If you want to be a veterinarian, go and do it. It’s very possible. Don’t do it for the money. You won’t be satisfied and we don’t earn as much as other professionals. Do it because you want to make a difference in people’s lives or because the work interests you. Get that experience so you know what it’s like. And don’t be afraid to learn about all the different careers in our field.

Joint Pain in Older Dogs

In the US, there are several options currently available. I use the acronym WEDS to remember them.

W: Weight. Dogs on the thin side have healthier joints. It is important to maintain muscle tone but have very little fat.
E: Exercise. Dogs with joint trouble should get at least 30 minutes per day of low-impact exercise. Physical therapy can also be performed. We work with partners to provide PT.
D: Diet and drugs.

  1. Fish oil. Omega-3 fatty acids from fish oil have been shown in controlled studies to be effective. Welactin is a great option for this.

  2. NSAIDs. Non-steroidal anti-inflammatory drugs can be prescribed that are generally safe and can make a big difference in joint pain and the progression of joint disease. We carry several different NSAIDs including a high-tech prostaglandin receptor antagonist, which is safer than traditional cox-inhibitor NSAIDs.

  3. Injectable polysulfated glycosaminoglycans. This is sort of a "nutriceutical" that is injected and can help restore the joint fluid. We carry this treatment.

  4. Intra-articular hyaluronan. These injections lubricate the joint and can protect the remaining cartilage. We refer to surgeons for this service.

S: Surgery. In some cases, surgery is an option to alleviate pain.

There are other procedures that are being evaluated such as cold laser therapy, shockwave therapy, ultrasound therapy and acupuncture. The jury is still out on these therapies.

Some supplements have less evidence but we hear positive things from our clients: Glucosamine, chondroitin sulfate, green-lipped mussel extract, to name a few. We carry veterinary products that provide these.

Can I Feed Eggs to my Dog?

Eggs are safe, but should be considered with respect to a balanced diet. For a German Shepherd, the occasional egg (77 kcal) will not make a large change to their ration. A 90lb (40kg) shep should be taking in around 1700 kcal/d, more or less depending on activity level and whether or not it is neutered. An egg is about 5% of the daily ration. However, for a 10-lb poodle, an egg is about 25% of the daily ration of 300 kcal.

Remember that raw eggs contain avidin, which binds the important vitamin biotin (Vitamin B7). Eating raw eggs frequently can lead to biotin deficiency. Unpasteurized raw eggs are also a source of salmonella poisoning. I would prefer to feed cooked eggs to my dogs.

Eggs seem like a decent food for dogs, as they are high in protein and fat, and not too high in sugars. Wild canids often eat eggs that they find, and so it seems to be part of the natural diet. Many dog foods have powdered eggs in them. I would not feed exclusively eggs, or anything like that. Moderation and balance are important considerations for dogs. So, if you have a "treat" portion of your dog's daily ration, using egg for that treat is probably not a bad idea.

Happy New Year! Happy New Puppy?

It's a new year! Did you gain a new furry family member along with a fresh calendar? In this month's article we will talk about the basics of a new puppy.

Just like a new human baby, a puppy has 5 basic needs: eating, sleeping, eliminating, entertainment, medical care. And, just like with a human baby, it's up to you to make sure all of these are provided safely and in a timely manner. A puppy up to about 12 weeks of age needs to eat 4 times a day. The amount and type of food will vary depending on the size and/or breed, but in general very young puppies can only eat a small amount of food at a time and need to eat frequently. After 12 weeks the frequency can drop to 3 times a day, then twice. Many dogs stay on a twice daily schedule for the rest of their lives; some prefer to only eat once. A lot of families free feed adult dogs, meaning they leave food down all the time. This is fine for a dog with no weight concerns and no housebreaking issues but is not recommended for puppies.

This brings us to the next topic: elimination. After each meal a puppy needs to go outside and be encouraged to urinate and defecate. Of course, trips outside may need to be more frequent than that, and at first the puppy may need to urinate at night. As they get older this need should rapidly disappear. Don't let the puppy make the rules! By 12-16 weeks most dogs do not need to go out at night and by 5 months most are fully housebroken. Some dogs take longer, of course. The most effective way to teach a dog to not eliminate in the house is to crate train. We can discuss this fully at your first puppy visit.

Depending on the age of the puppy at adoption, it may have had one or more sets of vaccines and/ or dewormings, and may even be spayed or neutered. Try to get records if at all possible. If no vaccine record exists we will assume none have been given and will start from scratch based on the puppy's age. Puppies need vaccines every 3-4 weeks starting at about 8 weeks of age and ending in the 4 month range. The best thing to do is come in with a new puppy as soon as you adopt him. A visit like that will give you an idea of what you should expect medically, and will also be a great resource for information about feeding, housebreaking, toys, classes, and anything else you need to know.

Don't forget safe playtime! Puppies need a lot of physical and mental stimulation to prevent boredom and destructiveness. Toys should be size and age appropriate and preferably difficult to destroy. Puppies chew-that's what they do. The more redirection available, the better the chance for survival of your shoes and furniture.

We look forward to seeing you and your puppy this month and for many years to come!

Healthy Holidays!

The end of the year is always full of activity and celebrations. Whether the family pets are included in the hustle and bustle or are just hanging around underfoot waiting for a treat, they are much more likely to come in contact with harmful foods and other dangers during this time of year. In this month's article I will touch on a few of the most common culprits.