Olathe Animal Hospital has made history! Thanks to our dedicated and compassionate veterinary team, the first stem cell procedure on a dog in the state of Kansas was performed at our hospital on Dec. 23, 2009. Our patient, Dr. Burcham’s own dog (Monty), is the lucky dog who is the first in Kansas and greater Kansas City to undergo stem cell therapy.

Monty, a geriatric shepherd mix adopted from Animal Haven in 2003, received an injection of stem cells that were processed from his own fat tissue, which is intended to help alleviate joint pain secondary to osteoarthritis. Monty underwent anesthesia and surgery on Mon. 12/21/09 to harvest stem cells from fat tissue behind his shoulder. The sample was sent by Fed-Ex overnight to the Vet-Stem lab in San Diego, CA, for processing, and then overnighted back to the hospital, and on Wed. 12/23/09, veterinarian Dr. Matt Peuser injected the stem cells into the dog’s painful hip.

Veterinarians must be credentialed before performing this procedure, and Drs. JC Burcham and Matt Peuser are now certified to perform stem cell therapy. This therapy is a form of regenerative medicine, and it is made possible by a company in San Diego called Vet-Stem.

“This is a breakthrough. The cells aren’t foreign to the body, engineered or modified in any way,” says Dr. Robert Harman, founder of Vet-Stem. “Fat stem cell therapy avoids the ethical concerns surrounding embryonic stem cell research because our process uses the animal’s own fat to isolate adult stem cells.”

A veterinarian who has completed Vet-Stem’s credentialing course can use fat stem cell therapy to treat arthritis, fractures, and tendon and ligament injuries in dogs. Drs. Burcham and Peuser join a pool of 650 vets in the USA and Canada who have performed this procedure.  Monty is the first dog in the KC metro area and in the state of Kansas to receive stem cell therapy.

Clinical studies have shown 80 to 90% improvement in dogs treated with stem cell therapy. One third of all dogs treated in the clinical trials were able to completely stop giving non-steroidal anti-inflammatory drugs, and another 28% were able to decrease the dosage after just 90 days.  Dogs treated with stem cells were also shown to have increased range of motion in affected joints, decreased lameness, and decreased overall pain.  The duration of the benefit from a single injection varies from several months to more than one-and-a-half years.

This technology has been used in horses, especially in race horses and other sport horses who have sustained joint, ligament and tendon injury, with amazing success. “We’ve seen stem cell therapy help dogs whose pain was previously so severe that they struggled to stand, jump into cars, chase balls or run up and down stairs,” says Dr. Robert Harman.

In the News

The Olathe News covered the story on Feb. 17, 2010. See the full article!

Fox 4 News covered this story on Feb. 19, 2010.

Here’s a short video Dr. Burcham made and posted on YouTube about Monty’s journey:

George is an 8-year old Boston Terrier. He and his buddy, Humbug, also an 9-year old Boston, have been coming to Olathe Animal Hospital since May 2009. True to Boston Terrier form, they are full of personality and spunk! George’s health issues in the last year or so have included a bout of pancreatitis and inflammatory bowel disease. At his most recent visit to Olathe Animal Hospital, his owner expressed some new concerns so we performed some additional diagnostics to check for other medical problems. Routine diagnostics, such as blood work (including thyroid test) are so valuable for senior pets because they help us screen for serious problems before they become unmanageable.

Pugs will eat anything–especially Hagrid! His mom is aware of his vacuum-like ability to slurp up anything on the floor that’s even remotely interesting (especially if it’s ”off-limits”). So when she accidentally dropped an Aleve (naproxen) tablet on the floor, and Hagrid snatched it up, she wisely knew she had a problem.

Naproxen tablets are a commonly used non-steroidal anti-inflammatory (NSAID) used for pain relief in humans, but dogs do not tolerate it very well, and it will cause stomach ulcers and GI bleeding in most dogs. How much ulceration and bleeding occurs depends on the dose. For a dog Hagrid’s size, ingestion of one 220-mg tablet can cause serious problems.

Luckily, Hagrid’s mom called as soon as this happened, so we instructed her to induce vomiting with hydrogen peroxide first. He did vomit some of the blue tablet, but it’s hard to know if it was all of it. So she brought him to Olathe Animal Hospital, we administered activated charcoal–or should we say, he gobbled it up! Silly pug! (One has to believe that stuff tastes awful!) Activated charcoal coats his GI tract and helps prevent absorption of the naproxen.

A few days after this incident, blood work was performed to check Hagrid’s liver and kidney values, and it all checked out fine. Hagrid has made a full recovery and is doing great. Unfortunately, he hasn’t learned his lesson, so his mom has to continue to be very careful about not leaving anything on the floor.

If you have an equally naughty dog who will eat anything and everything, we understand that this can be very frustrating. Even the most vigilant owners can’t prevent their dogs from eating potentially dangerous items. The best approach is to prevent access to ingestible items (i.e. keep everything clean and picked up, keep doors to bedrooms closed, keep trash in a cabinet or other inaccessible area). Make sure everyone in the family understands this and helps out. In extreme cases of pica (eating anything and everything non-food related), use of a basket muzzle can help prevent ingestion of potentially dangerous items.

If you think your dog has ingested naproxen, please contact your veterinarian to discuss treatment. The information contained in this article is not a substitution for direct veterinary care.

Would you be interested in protecting your dog from a devastating disease caused by worms blocking blood flow in the heart by our giving an injection once every six months as opposed to trying to remember to give a pill once a month and then having to remember to pick up refills?  What if it cost the same and we reminded you with a postcard or email when it was due?  You would?  Good, we can help.

Heartworm disease is a prevalent disease in the Kansas City area and exists anywhere that mosquitoes breed.  The mosquito carries the baby heartworm to the next dog.  A dog must be bitten by a mosquito to get heartworms.  For many years veterinarians have been preventing and treating heartworms.  In the early years medications had to be given daily.  Later new drugs were developed that could be given once a month.  In recent years a new product, ProHeart 6, became available as injection that works every day for six months.  A once a year product is now being developed.  Studies have shown that less than 50% of those dogs receiving monthly preventives receive their medication on time.

When ProHeart 6 first came on the market, many of our clients chose this product as an improved method of preventing heartworms.  Our hospital found the product as safe as or safer than most medications or vaccines.  Less than a handful of our patients had some soreness at the injection site.  Unfortunately, a few well-intended pet owners around the country blamed ProHeart 6 for many sad situations that were caused by other disease processes.  The product was voluntarily taken from the market by the manufacturer in 2004.  Additional studies over the next few years found the product to be as safe as it had been originally reported and it was brought back on the market.  You may view a PDF file on ProHeart6 at  http://www.proheart6.com/docs/client_info_03_09.pdf.

Due to the fact that the dog owner compliance in giving monthly heartworm preventives is poor, veterinarians recommend that dogs be tested once a year.  When ProHeart 6 is given every six months, the possibility of a heartworm infection drops to essentially zero.  Therefore, after any dog has been on ProHeart 6 for twelve months and then tests negative for heartworms, future annual testing is not required, as long as the injections are given on time.  This makes ProHeart 6 a less expensive alternative in the long run to oral preventives and provides more effective and continuous protection.

Below is a video of heartworm microfilaria visible on a blood smear:

Thankfully, we don’t see rat poisoning too often here at Olathe Animal Hospital. But the patient we saw recently was a good reminder of the importance of keeping dogs away from rat poison.

Penny is a healthy, 3-year old Maltese who came to see us after possible ingestion of a small amount of Ramik, an anti-coagulant type of rodenticide. The active ingredient is diphacinone. It had been about a day since she may have gotten into it, so we couldn’t induce vomiting (wouldn’t have helped this late in the game). Instead, we started her on Vitamin K. She will take one 25 mg capsule for 25 days. After that course of treatment, we plan to check some of her clotting times.

By starting her on treatment BEFORE she shows signs of bleeding (such as bruising, bloody diarrhea, or lethargy), we have the best chance of preventing problems.

If you’re interested in understanding why vitamin K is helpful treatment with rodenticide poisoning, read on.

Here’s what normally happens when a blood vessel breaks and there’s bleeding:

1. The blood vessel automatically constricts and spasms. This restricts the blood flowing to the damaged area and helps minimize blood loss.
2. The exposed pipe attracts circulating platelets, cloud-like cells that circulate ready to assist in clotting should the need arise. Platelets clump together over the tear in the blood vessel forming a plug within the first 5 minutes of the injury. This is all a good thing, but the platelets will stay in place unless a substance called fibrin can be made to bind them.
3. Platelets have on their surface binding sites for coagulation proteins, which also circulate normally in inactive forms. These coagulation proteins must be activated in order to produce fibrin. There are two ways to do this: a so-called intrinsic pathway and a so-called extrinsic pathway. There are twelve clotting factors involved between these two pathways and we will not confuse you by reviewing these steps, but suffice it to say that calcium is one of the factors as are four enzymes called serine proteases. It is the serine proteases that are relevant to rat poisoning. The end product of these pathways is protein fiber called fibrin, which binds the platelets and serves as a scaffolding for the permanent healing of the vessel tear.

Clotting factors are identified by number and the serine proteases (also called “K-dependent factors for reasons that are about to become clear) are factors II, VII, IX, and X. These factors are produced in an inactive state by the liver and go happily circulating through the bloodstream awaiting activation.

When a vessel tears and it becomes necessary to form a clot, these factors are activated in a process that requires Vitamin K (a fat soluble vitamin not as famous as its fat-soluble cousins Vitamins A and E). As the clotting factors are activated, Vitamin K is inactivated but later recycled by another set of enzymes to be ready to participate in clotting factor activation again later.

As long as there is plenty of Vitamin K, the serine proteases can be activated and clotting can proceed normally.

The anticoagulant rodenticides abolish Vitamin K recycling. This means that as soon as one’s active Vitamin K reserves are depleted, there can be no meaningful blood clotting.

In cases of poisoning one would expect symptoms to be nearly immediate, but in the case of anticoagulant rodenticide poisoning it takes several days to deplete Vitamin K. After that, even the smallest of jostles and traumas can lead to life-threatening bleeds.

This dog was diagnosed with allergies

Allergies are one of the most common and frustrating dermatologic ailments we struggle with in veterinary medicine. It’s absolutely amazing how expensive allergies are to treat, especially given that it’s not a life-threatening illness. However, they’re not curable and they DO affect quality of life.

When we discuss allergies with a pet owner for the first time at Olathe Animal Hospital, there are some important points to make regarding overall treatment and taking the next step in diagnosing the problem.

1. Antihistamines–Benadryl given every 8-12 hours (ask us for dose) can be helpful for the relief of itchy skin. If this isn’t helping, please let us know and we will provide a prescription antihistamine. Sometimes it’s necessary to try two or three different antihistamines in order to find one that helps.
2. Fatty acid supplements–every dog or cat with skin issues should be getting extra amounts of omega-3 fatty acids.
3. Shampoos–bathing mechanically removes pollen from the coat and skin, which is especially important for hairless parts of the body (footpads, groin, ears). Allermyl shampoo is a good choice for relief of itchy skin because of its micro-emulsion formula. Antibacterial shampoos (e.g. Hexidene) can be especially helpful for secondary bacterial dermatitis. Most therapeutic shampoos need to stay in contact with the skin for 5-10 minutes before rinsing.
4. Corticosteroids (Prednisone)–when a dog or cat is really miserable due to allergies, we often prescribe a corticosteroid such as prednisone to help provide more immediate relief of itching. Think of it as a “fire extinguisher” and not usually a long-term solution. Prednisone WILL increase thirst and urination!  Long term administration of prednisone can have severe consequences.
5. Dermatology diet–Hill’s makes a prescription diet called d/d (dermatology diet) which uses novel protein sources that help minimize skin and GI sensitivity. It also has a beneficial amount of omega-3 fatty acids. Some dogs or cats with food allergies will receive the most benefit by receiving a hypoallergenic diet called z/d. We will discuss with you which we recommend.
6. Alternative therapies: We may recommend trying an immune-modulating medication called Atopica (generic = cyclosporine). Because allergies are due to hypersensitivity of the immune system to something in the environment or diet, this medication helps to SAFELY reduce the intensity of allergic reactions. This medication needs to be given daily at first, often in conjunction with prednisone, but the goal is to reduce its frequency to 2-3 times per week (or less).
7. Allergy testing should be considered if the above treatments do not achieve adequate success. We perform a blood test (serum) and can check for either food allergens, environmental allergens, or both. Results are usually received within about 30 days. This can help guide our decision to consider hyposensitization therapy.

The patient pictured above and to the right was diagnosed with food and environmental allergies. Her allergy test showed sensitivity to trees such as maple and elm, and weeds like short ragweed. We started her on a 2-month trial of Hill’s z/d to help with food allergies. As you can see from the redness around her eyes (which is fairly common with allergies, especially in white dogs), she has been pretty miserable!

Radiograph of Milo's right stifle prior to surgery

Dr. Mark Romain has had special surgery training for a procedure called Tibial Tuberosity Advancement, or TTA. This surgery is performed on dogs who have sustained a cranial cruciate ligament injury (the “ACL” in people). Recently, Dr. Romain performed bilateral TTA on a beagle named Milo. This means both of Milo’s cruciate ligaments were injured, so he had the procedure done on both stifles at the same time.

The cranial cruciate ligament plays a crucial role in making sure the tibia bone does not slip out and forward from the stifle joint. ACL rupture in dogs is one of the most common causes of hindlimb lameness, and it almost always requires surgical correction.

Veterinarians can diagnose ACL rupture in dogs with a physical exam and radiographs (xrays). While stabilizing the femur in one hand, the other hand manipulates the tibia, and if the tibia slides forward like a drawer, this is indicative of cruciate ligament injury.

Radiograph of Milo's right stifle after surgery

The goal of TTA surgery is to limit this tibial thrust, which can be quite painful. Surgery begins by inspecting the stifle joint and removing the damaged cruciate ligament. The goal is to transfer the load of the joint from the patellar ligament to the quadriceps muscle. To achieve this, the veterinary surgeon makes a cut into the tibial tuberosity (bone). The tibial tuberosity is advanced into a position perpendicular to the tibial plateau, thus removing the load from the ruptured cruciate ligament. To keep this newly positioned tibial tuberosity in place, a titanium implant is secured to the bone, and a spacer and bone graft material is placed into the cleft between the bones. This helps stabilize the joint.

Post-operative care involves:

• Limited exercise
• Restriction of play
• Care of the surgical site
• Administration of medications
• Suture removal

Follow-up radiographs are usually taken 2 months after the surgery to ensure proper healing.

Milo had TTA surgery on both stifles, which is why he has bandages on both legs. This is taken the day after his surgery.

Milo’s surgery included an epidural to numb his hind limbs for 12-24 hours post-op, and he received a continuous IV infusion of hydromorphone, lidocaine, and ketamine (referred to as an HLK CRI in vet talk) for the next 48 hours to help control pain and provide optimum pain management.

Broken incisors

Earlier today, I examined a dog who had been adopted from a shelter. She was very sweet, albeit a little shy, and we could quickly see she’s a good snuggler. During my exam, I noticed some broken incisors and a broken canine tooth. Given her background, we’ll never know how she broke these teeth. Was she kicked? Hit by a car? Did she chew too hard on something?

What we do know is that 98% of broken teeth will eventually develop an abscess. Tooth abscesses, as any humans who’ve experienced this problem can attest, are extremely painful. Being the stoic creatures that they are, however, dogs may not show any signs of pain. The best treatment for this particular dog is extraction of the broken incisors and either extraction or root canal therapy of the broken canine tooth.

Lower left canine tooth is broken

Root canal therapy is a specialty procedure, and we can offer a referral to a qualified veterinarian if this is something you’re interested in for your pet. Remember, dental pain should not be ignored–the sooner it’s addressed, the sooner a dog can be on her way to healing and feeling better!

Do yourself and your new puppy a favor by enrolling in pet insurance as soon as possible. Most companies won’t cover pre-existing conditions, so the best time to enroll is when your puppy is perfectly healthy!

Pet insurance companies and options have expanded greatly in the past few years, meaning the consumer has lots to choose from–and the wealth of information can be overwhelming. Olathe Animal Hospital does not endorse a single pet insurance company for the same reason we don’t recommend just one brand of food for all pets–no one company will meet the needs of all pet owners. We encourage you to research the best policy for your pet by reading the reviews at www.petinsurancereview.com.

Endorsed by the American Veterinary Medical Association (AVMA)

• Pets Best Insurance - www.petsbest.com

Endorsed by the American Animal Hospital Association (AAHA):

• Trupanion - www.trupanionpetinsurance.com
• Purina Care - www.purinacare.com

We recommend having your dog or cat microchipped, which serves as permanent identification. If lost and turned into a shelter or vet office, the pet would be scanned with a chip reader, which easily picks up a number that corresponds to your name and phone number.  Olathe Animal Hospital uses HomeAgain microchips. Be sure to enroll your pet in HomeAgain’s membership service, which has many benefits, including up to $3000 lost pet medical insurance. ANY microchip can be enrolled in this service. If you choose to purchase a PetFirst comprehensive policy, you can be reimbursed for up to $60 for fees including microchipping, account set up, and annual membership. Call our office for more information about pricing.

It is very important to remember to register your microchip with your current contact information.  If you move to a new location, don’t forget to update your current contact information with the microchip company.  If your pet gets lost and the microchip is not registered, or your contact information is not current, it may not be possible to reunite you with your pet.  At Olathe Animal Hospital, we handle the initial registration for you, giving you one less thing to worry about!

Go to the AAHA Microchip Lookup Tool