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It’s been a long time between visits. It was 1967 when I came with my wife and two sons, ages four and six, to work for one year for the Food and Agricultural Organization of the United Nations. They had a project at the veterinary school of the University National Autonomous of Mexico (UNAM) and my job was to organize an ambulatory clinic service for them. My family spent a wonderful year here learning about Mexico, the language and the people, especially the people. The experience was transformational for me and, I believe, for my family. Since that time, I have not returned and the city is different, very different.

When we were here previously there were about eight million people living in Mexico City, estimates now are roughly thirty million. Much has changed, but after two full days here I believe the people are still the same. They are patient, and seem pleased that I’m trying while they struggle to understand my fracturing of their language, I don’t have the opportunity to practice much. It’s not just the servers in the restaurants, it includes people on the street. When Alexis or I have a question about a building, or something that arouses her ever curious mind they take the time to respond, in detail. I do my best to translate. They love music and have a great sense of humor, laughing at any remark I make that they perceive is a jest. Even if my Spanish is all wrong they don’t correct me, I guess that would be rude.

Yesterday we walked the short distance from our Airbnb apartment to Parque Mexico, a beautiful oasis in the Colonia Roma Norte neighborhood. Here’s a photo of the park.

In the middle of the park was an unexpected find, a well-maintained dog park of considerable size.

On the east side of the dog park a least eight or ten different pet adoption organizations had set up with displays of dogs and cats available for adoption. Puppies and kittens are hard to ignore and a considerable crowd gathered. All were seeking donations as well as trying to find homes for the animals. We emptied the coin purse that Alexis keeps for the coins, ranging from ten pesos down, that we receive in change from our cash purchases, almost always food. Each morning I go to the bakery/restaurant around the corner from our apartment where I get our breakfast para ir (to go), two cafe’con leche (coffee with milk) and two freshly baked sweet rolls. Total cost 95 pesos (less than five bucks). Take that Starbucks!

Some dogs waiting for homes.

I did notice that many of the dogs running joyfully untethered in the dog park were intact males. We saw at least one female dog in heat, her owner doing everything he could to keep all the interested males at bay.

We stopped for a glass of wine and an appetizer about five in the afternoon. Outside the extremely popular Trattoria across the street from the park, a young woman and a young man were singing opera arias, acapella, solo and duets, for tips. The woman went up onto her toes for the high notes. We gave them 50 pesos, about $2.50 for their remarkable performance. Most of the audience were passing over 20 peso notes, but one guy gave them a hundred. The currency is all different colors and easy to spot.

Each day we leave the apartment walking in a different direction, exploring the neighborhood. We have seen only one homeless person, so far. I expect they are to be found in the poorer sections of town, but maybe not. Perhaps they are taken care of, somehow. That will be my question for today’s walkabout.

Travels With Charlize, In Search of Living Alone is an Award-Winning Finalist in the “Spirituality: Memoir/Personal Journey” category of the 2016 Bookvana Awards”.

LOS ANGELES  –  Bookvana.com announced the winners and finalists of THE 2016 BOOKVANA AWARDS (BVA) on August 29, 2016. Over 70 winners and finalists were announced in over 40 categories. Awards were presented for titles published in 2014, 2015 and 2016.

The Bookvana Awards are a new specialty book awards honoring books that elevate society, celebrate the human spirit, and cultivate our inner lives.

Jeffrey Keen, President and CEO of i310 Media Group, said this year’s contest yielded hundreds of entries from authors and publishers around the world, which were then narrowed down to the final results.

First let’s talk about the thyroid gland. Dogs and cats have a divided thyroid gland located on either side of the trachea just below the larynx. Humans usually have just one gland more or less the shape of a butterfly. Some individual humans, dogs and cats can have ancillary thyroid tissue, usually small amounts, located along the trachea and airways. These are termed ectopic thyroid tissue and in some cases can maintain thyroid function if it is necessary to remove the thyroid gland surgically.

 

The thyroid gland is responsible for, or plays an important role in, many normal body functions. These include the regulation of body temperature, metabolism of fats and carbohydrates, weight control (both loss and gain), heart rate and cardiac output, normal function of the nervous system, growth and brain development in young animals, reproduction, muscle tone, and the condition of the skin and hair. So if the thyroid gland is not functioning normally we can expect changes in these functions and those changes result in symptoms or signs of the disease.

 

Thyroid disease is manifest as either low or absent thyroid activity (hypothyroidism) or excess thyroid activity (hyperthyroidism).

 

Signs of hypothyroidism include; weight gain, lethargy, generalized weakness, mental dullness, alopecia (loss of hair that can be generalized or in spots), excessive shedding, poor new hair growth, dry and/or dull hair coat, excessive scaling of the skin, recurring skin infections, and the inability to tolerate cold. In rare cases the animal may have seizures, a head tilt and infertility.

 

Signs of hyperthyroidism are, as one might expect, the opposite. There is a generalized increase in metabolism resulting in loss of weight despite an increased appetite. There is a general unkempt appearance and poor body condition. The animal may vomit and have diarrhea and frequently will be seen drinking water. This results in increased urine production. Some animals will have difficulty breathing and compensate with rapid shallow breathing. There is usually a rapid heart rate sometimes accompanied by so-called “gallop rhythm” a type of abnormal beat. The animals are usually hyperactive, and often the thyroid gland is enlarged.

 

Hypothyroidism is most common in middle-aged medium to large breeds of dogs. The condition is rare in cats. It is more commonly found in middle-aged dogs four to ten years of age. Anecdotal evidence seems to indicate that neutered males and females are at higher risk than intact animals. This condition is most commonly the result of inflammation of the thyroid gland or a decrease in active thyroid tissue from unknown cause(s). The condition can also occur as a result of treatment with the sulfa drug trimethoprim-sulfamethoxazole. In very rare cases iodine deficiency in dogs can result in hypothyroidism but commercially prepared dog and cat foods all contain adequate levels of iodine. The treatment for this condition is replacement therapy with levothyroxine or another type of thyroid replacement.

 

The diagnosis of hypothyroidism usually requires laboratory testing that includes a complete blood count, biochemistry profile, and urinalysis. Your veterinarian may be able to make an initial diagnosis based on the results of these tests, but it might be necessary to measure the levels of T3 and T4 and other endocrine lab tests. Your veterinarian may also recommend X-ray studies to check for other associated abnormalities.

 

Hyperthyroidism is the result of overproduction of thyroxin by the thyroid gland usually the result of a thyroid gland tumor. It can also be an aftermath of inappropriate overmedication for hypothyroidism. It is rare in dogs but can occur. It is most commonly diagnosed in older cats usually about thirteen years old or older. Less than five percent of cats with hyperthyroidism are under ten years of age. In addition to a thyroid tumor hyperthyroidism can also be the result of congenital disease, iodine deficiency or the result of inappropriate therapy. Sometimes it is impossible to identify the cause.

 

The diagnosis of hyperthyroidism is often initiated by palpation of an enlarge thyroid gland during a physical exam and documentation of clinical signs suggesting this disease. This will usually lead your veterinarian to measure a thyroid profile that includes T3, T4, Free T4 and TSH in the blood. If the T4 is higher than normal the diagnosis is confirmed however some early cases demonstrate T4 and the other hormone levels in the normal range. The performance of a T3 suppression test might be indicated and can produce a diagnosis. If the T3 suppression test results are still equivocal and if hyperthyroidism is still suspected further tests including nuclear isotope imaging may be necessary to arrive at a diagnosis.

 

There are three types of treatment for hyperthyroidism; life long oral anti-thyroid medications, surgical removal of affected thyroid glands and treatment with radioactive iodine. Tapazole (methimazole) is a specific anti-thyroid medication. This is a treatment that must be continued for the rest of the life of the animal unless surgical removal or radioactive iodine removal are indicated. Sometimes Tapazole treatment is used prior to surgery or radioactive iodine therapy to reduce thyroid hormone levels into the normal range to reduce the risk of surgery or radioactive isotope therapy. It is also indicated when the animal has congestive heart failure resulting from the hyperactive thyroid. Side effects from Tapazole include depression, vomiting, appetite loss and more seriously blood abnormalities. If surgical removal is the choice of therapy the surgeon must be very careful to avoid damage to the parathyroid glands. Removal or injury to these glands will result in significant problems.

 

As always if you suspect your animal has thyroid disease consult your veterinarian.

Most Common Pet Poison

According to the records of the Animal Poison Control Center (APCC) of the ASPCA human prescription medications top the list of potential toxins most commonly ingested by pets for the seventh year in a row. The APCC handled more than 167,000 cases in 2014, the most recent year for which statistics are currently available, and 26,407 of those cases (about 16%) were from owners whose pets snatched and gobbled medications prescribed for family members.

Dogs and cats explore the world with their mouths, similar to small children. Unlike small children our pets are strong enough and agile enough to locate and secure pill containers then chew through them to consume the contents. Dogs are especially attracted to containers they observe their owners handling on a daily basis. Notice Fido watching you the next time you take your pills. What happens if you drop one, do you retrieve it faster than your pet?

Over-the-counter medications, including herbal and other natural supplements are also potential toxicants. Toxicity is all about dose per size and many natural products are innocuous in doses appropriate for adults but can be toxic for smaller pets. These products resulted in more calls in 2014 than in previous years (about 25,000 calls) and there are over 6,900 different products that comprise this category.

Mitral Valve Disease

The mitral or left atrioventricular valve is one of four one-way valves in the heart. It controls blood flow from the left atrium, where oxygenated blood coming from the lungs collects, to the left ventricle where arterial blood is pumped out into the body. When the left ventricle contracts the mitral valve closes thus preventing blood from going back into the atrium. With a slight delay the aortic valve, the outlet valve from the left ventricle, opens and blood is pumped out into the arterial system.

Two kinds of mitral valve disease occur. Stenosis or narrowing of the valve results in interference with the blood’s ability to flow into the left ventricle. Insufficiency is the inability for the valve to close properly, and allows blood to be pumped back through the valve into the left atrium. Either condition can result in the valve not closing properly resulting in blood leaking, regurgitating, or flowing back into the left atrium. When this happens a murmur can usually be detected.

Mitral valve disease can be the result of a birth defect, or acquired as the result of bacterial or viral infections, some types of cancer that affect the heart muscle or just as a result of the aging process, particularly in smaller breeds of dogs. When the mitral valve does not function properly the ability of the left atrium to empty is compromised and the larger than normal volume of blood in the left atrium causes the pressure in that chamber to increase. As a result blood flow out of the lungs is compromised. Depending upon the severity of the lesion the outcome can be congestive heart failure characterized by pulmonary edema, the collection of fluid in the lungs.

Congenital mitral valve stenosis is more commonly found in Newfoundland and bull terrier breeds but can occur in any breed including mixed-breeds. Acquired mitral valve disease, particularly age associated degenerative valve disease, can occur in any breed of dog but appears to happen more frequently in the smaller breeds and is endemic in King Charles spaniels. Mitral valve disease in the King Charles spaniel has been shown to be a polygenetic disease that can afflict over fifty percent of all individuals of this breed by the time they are five years old. By age ten any of these dogs that survive almost always demonstrate signs of the condition.

Depending upon the severity and progression of the valve disease many dogs will have no clinical signs in the early stages. We usually notice that as the dog gets older it seems to lose energy. Your veterinarian will usually detect a murmur, the result of the blood regurgitating through the diseased valve. This results in turbulent flow and can be detected before any clinical signs are noticed. The loudness of the murmur is not always associated with the severity of disease. A small area of leaking can result in a very turbulent and noisy jet while a large area might not create enough turbulence to create a loud murmur. If the disease progresses the dog may exhibit exercise intolerance, coughing, trouble breathing, increased rate of respiration, weakness and collapse with exercise.

The diagnosis is usually made by auscultation, use of the stethoscope. If the dog is showing clinical signs of congestive heart failure your veterinarian, or the veterinary cardiologist to whom you have been referred, may need to take X-rays, an electrocardiogram, an ultra-sound exam or even catheterize the animal to determine the severity of the disease, the prognosis and the level of treatment required.

Treatment for this condition is palliative, designed to control the symptoms and delay the progression of the disease. Medical treatment cannot cure the problem. Because the valve usually degenerates slowly the treatment can change over time. A variety of drugs are used depending on the stage and progression of disease. These include diuretics, vasodilators, positive inotropic drugs (drugs that increase the force of contraction of the heart muscle) like digitalis, and other agents that may prove beneficial in certain individuals. In humans if the patient is showing signs of heart failure as a result of mitral valve disease the treatment of choice is open-heart surgery and heart valve replacement with a prosthetic valve. This is possible to do in dogs, and available in some very specialized institutions, but it is expensive and usually not an option to be considered.

This disease can also occur in cats and almost any other species of animals but is most commonly identified in dogs. The problem is reasonably easy for your veterinarian to detect and another good reason for regular physical exams.

TWC-front cover5star-shiny-web-review sticker

Reviewed by Lit Amri for Readers’ Favorite

“The purpose of this road trip was to try to figure out what I should do with my remaining years and how to do it. I’m seventy-six years old, and for more than fifty-two of those years, I was married to the only girl I ever truly loved. I’m not accustomed to making decisions on my own. Charlize is a good listener but doesn’t contribute much, except enthusiasm, to the decision-making process.” Travels with Charlize: In Search of Living Alone by David R. Gross is an open story of recovery.

Gross is on a mission to discover how to live without Rosalie, his late wife. Three-year-old Charlize is his third German shepherd, adopted less than two weeks after Rosalie’s passing. Charlize came with a different name, but, according to Gross who decided to mimic John Steinbeck’s Travels with Charley, he renamed her. Gross describes their bond as “two injured beings who need to support each other.” His travels with Charlize started with Old Blue, his 2012 Dodge Ram 1500 and The Frog, his camping trailer. Gross was pleased – “Frog pulled like a dream, sticking close to Old Blue’s tail.”

Travels with Charlize is truly engaging. Gross’s skill as a writer is evident. His narrative and thoughts not only focus on Rosalie and the travels, but also include his fond memories from his younger days, his sons, grandchildren and even his previous German shepherds. The pictures included in the book make the reading more appealing. The writing style is straightforward; I love the casual tone of the prose. Readers, whether or not traveling is their forte, should give this book a go and get to know Gross, and especially Charlize.

Patent Ductus Arteriosus, also known as PDA, is a congenital heart defect that can be found in any breed or species of animal including humans. When I graduated from veterinary school in 1960 we were taught about this condition but very few, if any, veterinarians were prepared to do thoracic surgery to attempt a correction.

One of the most helpful things I learned, after graduating from veterinary school, was that most clients wouldn’t talk to me when I had a stethoscope in my ears. It was a perfect time to think about what I had observed and how to communicate with the client.

While I was in school Dr. Smith lectured to our class about heart murmurs, including the continuous murmur associated with a PDA. I remember him standing at the lectern making a very particular noise, mimicking this murmur. The sound was “whoosh, whoosh, whoosh, whoosh.” I never heard the murmur in an animal while still in school but the first time I did hear the murmur it sounded exactly like the noise Dr. Smith made while leaning into the microphone in the lecture hall. The condition can also be detected by feeling the animal’s pulse detecting what is described as a water -hammer or continuous pulse.

When trying to explain this condition to a client, or to students while I’m teaching, I resort to a sketch where I draw a rough outline of the heart with the aorta coming off the left ventricle and supplying the body with arterialized blood and the pulmonary artery coming off the right ventricle going to the lungs so carbon dioxide can be expelled from the blood and oxygen taken on.

Before any mammal is born the lungs haven’t inflated yet, the fetus doesn’t need blood to go the lungs. There’s an opening between the pulmonary artery and the aorta so the blood can cross over into the aorta because until the lungs are inflated the pressure in the pulmonary artery is higher than the pressure in the aorta. The blood crosses over through a structure called the ductus arteriosus.

As soon as the newborn takes a couple of breaths the alveoli, the little air sacs in the lungs, open and the blood vessels that surround each alveolus also open. The resistance to blood flow into the lungs is reduced and the blood pressure in the pulmonary artery drops below the blood pressure in the aorta. This causes the aortic side of the ductus arteriosus to close since the ductus is more of a slit than a tube. So normally the ductus closes shortly after the animal starts breathing. Unfortunately sometimes, for reasons not yet completely understood, the ductus stays open. When that happens, it’s called a patent ductus arteriosus. Since the pressure in the aorta is higher than the pressure in the pulmonary artery, the blood leaks continuously through the opening. With each heartbeat, the pressure increases in the aorta and that causes the leak to be greater.

When we listen to the heart of a normal animal it makes a noise that sounds like; lub dub . . . lub dub . . . lub dub.” A continuous murmur makes the whoosh, whoosh, whoosh sound as the pressure and blood flow into the pulmonary artery increase with each beat while the blood flows continuously surging with the beating heart.

The defect causes both the left and right sides of the heart to work harder and harder. The heart enlarges and finally it fails. Since my time in practice veterinary medicine has made enormous advances. We now have board certified veterinary surgeons capable of performing the relatively simple surgery to tie off the patent ductus. We also have board certified veterinary cardiologists who, if they make the diagnosis early enough, can use a catheter system to deliver a plug to the ductus and correct the problem without surgery. The key to a successful outcome is early diagnosis before the animal goes into heart failure and that means a thorough physical examination by your veterinarian for your new pet while it is still young.

I am running this post again because too many people seem to be searching for a way to kill their neighbor’s dog or cat. Since it was originally posted on Jan. 31, 2012 this post receives the most hits almost every day and many reach it by searching, “how to kill an animal with antifreeze” or similar queries. Find information here about how to save your pet if it drinks antifreeze.

This is one of the most common forms of poisoning seen in dogs and cats. It usually happens when the antifreeze drips from your vehicle’s radiator forming a puddle on the garage floor or driveway. The active ingredient in antifreeze is ethylene glycol a syrupy liquid that seems almost addictive to some pets. You must take special care if you change your antifreeze yourself, since pets can get into containers left open or spilled. It is possible for a cat to poison itself by walking through a puddle then licking its paws. As little as five tablespoons of commercial antifreeze is enough to kill a medium sized dog. If you see or suspect your pet has ingested antifreeze you should make it vomit, by giving it a teaspoonful of hydrogen peroxide per five pounds of body weight, but not more than three teaspoonfuls at a time. If it vomits or not, take it to your veterinarian as quickly as possible and explain what you think has happened. If your pet has already vomited, do not try to make it vomit more. Do not try to induce vomiting if the pet is showing signs of distress, shock, difficult breathing or is unconscious.

Ethylene glycol is also an ingredient in some liquid rust-inhibitors, incorporated in solar collectors, used in many chemical manufacturing processes and can be found in a variety of household products. Check the labels! To be most effective, your veterinarian must administer treatment within three to eight hours. Ethylene glycol is actually an alcohol converted, by enzymes in the liver, particularly alcohol dehydrogenase, into oxalic acid. The oxalic acid combines with calcium in the blood to form calcium oxalate crystals that block the nephrons in the kidneys and result in kidney failure.

Since ethylene glycol is an alcohol, the early signs of poisoning resemble drunkenness; euphoria and/or delirium, wobbly gait, uncoordinated movements, nausea as evidenced by excessive salivation, lip smacking, dry heaving, and vomiting. This phase can persist for about six hours and the animal may appear to be better, not so! If untreated the signs progress to excessive urination, diarrhea, rapid heart rate, depression, weakness and eventually into fainting, tremors, convulsive seizures, and coma, all signs of kidney failure.

If you arrive at the animal hospital in time and give a history of your pet ingesting antifreeze, or your veterinarian runs appropriate tests and makes the diagnosis, before signs of kidney failure occur, there is a good chance your pet will be saved. Treatment involves the induction of vomiting. Using activated charcoal to bind any ethylene glycol still in the digestive tract is not effective, but may be indicated when other toxins are suspected. Since 1996, your veterinarian has had access to fomepizole (Antizol-Vet). This drug is an effective antidote, if administered intravenously before kidney damage occurs. Back in the olden days, we used grain alcohol as an antidote, significantly less expensive than fomepizole. Alcohol dehydrogenase has about 100 times the affinity for grain alcohol than it does for ethylene glycol. When used as an antidote the liver metabolizes less ethylene glycol and fewer oxalate crystals form. Depending upon the severity of kidney damage it still might be possible to save your pet with aggressive fluid therapy to flush the kidneys, and other supportive treatment. Some specialty practices may be equipped to provide kidney (renal) dialysis. You do not want to know how much a kidney transplant will cost, but it is possible, in both dogs and cats, in specialized centers with the necessary equipment and experience.

 

 

 

 

As a Pre-Thanksgiving offer Travels With Chalize will be available on Kindle for free downloads starting Sat. Nov. 21 and ending Tues. Nov. 24. It is available now and will continue to be available for KDP Select downloads. Don’t miss this opportunity.TWC-front cover

Writer’s Digest Judge’s Commentary*:

So much personality shown in Charlize–we get real emotion and expression in the way the author has painted every scene with the dog. We also get deep emotion (and tears) in the early conversation with his wife, where she says that he can get a dog now that her demise is near. What a selfless statement, a deep realization, and a wish for her husband to be okay after she is gone. This is truly moving, and we long for the author to find the perfect dog to connect with.

“Hope is the mantra of anyone sitting on a boat” on page 75 is a true gem of this book. Author peppers the story with these resonant thoughts. Well done. They stay with the reader.
The ending just drops off when he’s home again and happy to have arrived safely. We could use a description of his home that has been colored by his travels along the coast, the same excellent skill in capturing scenery and feeling. That would round out the story beautifully. A very good read.