Monday, November 15, 2010

Blood worms vs poop worms

Right here by popular demand: It's blood worms vs poop worms.  No it's not a WWE match.  But it is something I get asked about all the time.  And it is something that causes great confusion in the exam room.  So my office manager and vet assistants asked that I write this blog to try and clear up some myths about worms that we hear all the time when talking to pet owners.  So here are the top 5 worm myths that we hear.

Myth #1

I'm sure my pet doesn't have any worms because I don't see anything in its poop.

Answer of course is "seeing" or in this case "not seeing" does not tell you what is happening inside a dog or cat's intestines.  Tapeworms may the one exception as most tapeworm infections in dogs and cats are diagnosed when the owner either sees the worm segments in the animal's poop or sees the worms actually crawling out their pet's butt while they are snuggling together in bed.  Nice, eh?  These segments are where the tapeworm eggs are found and that is how they reproduce and spread.  But the other major worms (roundworms, hookworms and whipworms in dogs) just tend to happily attach to the lining of the pet's intestines eating and having sex.  Then they produce eggs that are passed into the poop and worm eggs are microscopic.  Adult roundworms are large enough to see easily, but adult hookworms and whipworms are much smaller and rarely if ever seen.  Unless there are hundreds of adult worms hanging out in the intestines or they are killed with deworming medicine, there is no advantage for these adult worms just let go and pass outside the body.  So they just hang onto the inside of your pet and pass microscopic eggs into the environment.

Then there are all the single cell parasites out there like Giardia and Coccidia.  They are not worms at all, but can make pets pretty gosh darn sick.  I challenge anyone out there to be able to see a single cell organism with the naked eye.  Ain't gonna happen.

Did you know that a single female roundworm can produce 100,000 of these microscopic eggs every day? (From CDC web site)

Myth #2

My pet had a negative stool sample, but I am seeing worms.  Your stool sample test sucks.

Answer is that the test does not suck, but it does have limitations.  Worms don't always produce eggs every single day of their lives.  Some worms are more likely to produce lots of eggs (roundworms) then others that produce few eggs (whipworms).  And as I mentioned above, tapeworms like to pass segments through the stool.  The eggs are inside these segments and that is what the fecal test picks up.  So if there is no segment in the poop sample, it will be negative.  Your pet still has worms. 

We still recommend stool samples be tested though because they are a good screening tool.  They will pick up a lot of worms that we would never know a pet has just by looking at the poop.  You just have to remember that once in awhile, a "negative" is not truly a negative.  (If you look at our medical records, we actually don't write "negative" in the results box, but rather we write "no ova(eggs) seen".)

Myth #3

We tell you your dog needs to be tested for heartworms.  You say that you brought in a stool sample a couple weeks ago and it was negative for any worms.

Answer is that HEARTworms live in the HEART.  So when they reproduce and have children, they do it inside the bloodstream.  You will not find baby heartworms in a poop sample.  We need to draw blood.  Adult heartworms live in and near the heart and when they give "birth" it is to little squiggly larvae called microfilaria.  Again, these microfilaria are microscopic and just waiting for a mosquito to suck up some blood and carry them off to another dog, cat, coyote, or whatever.  There are blood worms and there are poop worms.  Heartworms are in the blood.

Myth #4

My dog can't have heartworms because it is not around any other dogs and it hardly ever goes outside.

Answer is that heartworms are spread by mosquitoes and while you may not want to admit it, mosquitoes can and do get inside our homes.  Mosquitoes can also travel a good distance when the wind blows whether they like it or not.  My best example was a little dog that came to the city clinic where I worked about 20 years ago.  It was a little toy poodle that lived in a high rise apartment and pooped and peed on a pee pad inside the apartment.  Yep, the poodle got heartworms. 

Myth #5

My dog can't have heartworms because it doesn't even act sick.

Answer is that depending on how many heartworms are in a dog's heart, they could walk around for years before they start showing symptoms (coughing, getting tired more easily).  Dogs with lots of worms will show signs right away, but some dogs will only have a few worms.  By the time that they get symptoms, they are at risk for permanent lung or heart damage.  We need to test all dogs before they are sick.

Now if you read my last blog, you read about a lovely picture of bloody diarrhea that came out of a dog and ended up on the floor of the waiting room.  This dog's diarrhea was caused by massive hookworm infection and there were a few tapeworms thrown in for good measure.  If you don't want to look, then don't scroll down.  You have been warned.

The moral of the story is listen to your vets when they speak of worms.  Worms are a fact of life in dogs and cats and trying to ignore that worms exist can lead to trouble.  Let's keep our pets and families healthy!

Wednesday, November 10, 2010

All things gross and beautiful

Because of James Heriott, just about every pet lover is familiar with Cecil F. Alexander's hymn "All Things Bright and Beautiful".

All things bright and beautiful
All creatures great and small
All things wise and wonderful
The Lord God made them all

Well my take on this hymn is "all things gross and beautiful" should be the first line.  Earlier this year, I got the chance to do a career day talk at a local school.  After my little spiel, there was a question and answer session.  The first question by one of the students was "Do you ever see gross things?".  I think the teacher was a little taken aback and she tried to redirect away from that question, but leave it to a veterinarian to jump on any opportunity to talk about all things gross.  I thought that was a GREAT question and I was more than happy to talk about having a career that has daily exposure to bodily excretions of all types.  I know the human medical field has their fair share of the gross factor, but veterinary medicine excels in this field.  There is nothing like coming home from work smelling of anal sacs, tom cat urine and infected Cocker Spaniel ears all at the same time.  God bless the families of veterinarians.  They will surely achieve sainthood for putting up with such odors making their way into their entrance ways and laundry rooms.

A couple months after career day, one of our vet techs came running into the back room all smiling and excited and in search of the camera.  Something had happened in the waiting room and she wanted to get a picture for my blog.  Awwwww, thanks for thinking of me!  I had just seen a young large and gangly dog in the exam room that came in because it was having diarrhea.  After history and physical exam and a stool test, I determined that worms were the most likely cause of this dog's diarrhea.  As the client was waiting to check out, the dog deposited of pile of liquid bloody diarrhea complete with wiggling worms onto the tile floor.  I still have this photograph and might even use it for a future blog (you have been warned!).

Then last week I had another case of a dog that had pyometra (pus in the uterus).  I've seen a lot of pyometras in my career, but I don't think I have ever seen a case that had a vaginal discharge like this dog did.  It was creamy and mucousy and if you really want an accurate description, her discharge looked like the biggest nastiest ball of snot you could imagine.  Quite fascinating actually.

OK, stop.  I now realize that all of us in the veterinary field thrive on gross.  It is not that we wish bad things on our patients.  Far from it.  I would be happy if I saw nothing by wiggling puppies and purring kittens all day long.  But diseases happen and gross diseases fascinate.  When you actually step back and think about it, isn't it amazing how much pus can come from a cat abscess or how much diarrhea a parvo puppy can produce.  I think if you are in veterinary medicine your brain is just hardwired so the first words out of your mouth when you see something particularly gross is "Wow".  You may say "ewwwww" and hold your nose second, but "wow" is always first.  That response is what sets us apart.

By the way, the dog with diarrhea and the dog that had surgery for pyometra are both doing great.  So if your pet has something really gross going on, don't hesitate to take it to your veterinarian.  It may just make our day.

Wednesday, November 3, 2010

First hard frost and blanket month

What the heck does the first hard frost in the fall have to do with veterinary medicine?  Well not much except that it helps explain the absence of this blogger.  Unlike my early days just out of vet school, I actually have some semblance of balance in my life which means that sometimes I actually do things that aren't associated with veterinary medicine.  The biggest chunk of time outside of medicine revolves around the farm business that my husband and I own.  Most of you already know I raise meat chickens and laying hens although that is a very small part of the farm.  Most of the farm income comes from raising vegetables.  My husband is really the force behind the farm, but there are times during the height of the picking season that I will pitch in.  I've spent more than one evening after work helping the guys pack boxes of produce.  And as a by-product of living on a vegetable and poultry farm, I am in charge of food preservation for the family.  Eating fresh, locally grown, healthy food is very important to me.  So during the months of August, September and October, many of my days off from the clinic are earmarked for preserving food for the winter.  Of course we have butchering day for our meat chickens.  Then I'll spend a day blanching and freezing sweet corn.  Green beans get a day for canning.  Apples get made into applesauce and frozen.  Pumpkin gets made into pumpkin puree and frozen.  Broccoli blanched and frozen.  Tomatoes get canned.  Each of these is done on separate days and takes up much of my free time during the late summer and early fall.  Combine that with a very hectic schedule at the clinic and something has to give and it has been my blog.  So now the first hard frost has finally killed the garden.  The chickens are all butchered.  Only some winter squash is left to put up for the winter.  I can actually do some other things on my days off and maybe leave myself a little time to blog.

October was a very fun month for us at the clinic.  Everyone at work has expressed a desire to reach out to the community with various projects. (Do I not work with the greatest people on the planet!)  So October was Blanket Month.  We collected blankets to give to the Ashtabula County Animal Protective League and the Ashtabula County Humane Society and Dr. C. agreed to donate $1 for each blanket that was donated and the amount would be divided equally between our two local shelters.  The end result was so much more than I expected.  It was so fantastic.  We took in 249 blankets total. One of clients that works at one of the schools got the students involved and they brought in 182 blankets.  Now you have to understand that we have a kind of small building at the clinic.  There is no wasted space.  The doctor's office was already being taken over by bags and bags of blankets, so when Shannon dropped off 182 blankets, well, we were at a dilemma on where to store them.  My car got to be the designated storage location.

I now have an appreciation for people who hoard and their cars are full of stuff.  I drove around like this for two days before making it to the shelter to drop off my "treasures".  Unfortunately I never did make it up into town with my car looking like this.  I thought I could start some crazy rumor about why Dr. Di. has a car full of stuffed full trash bags.  Maybe my husband kicked me out of the house and I had no place to live.  It was close to Halloween, so maybe it could have been some creepy spooky rumor.  But no, just home, back to work, home, back to work and to the shelter with no chance for anyone to make up some juicy gossip.

Well we are doing a canned food drive at the clinic in November.  Maybe I'll get another chance.