Proactive Preventive Measures for Your Aging Pets

Music.

Really, the goal is just to use our stories to bring veterinary medicine to life for the pet caretakers of the world. And we're doing it because we believe that educating these caretakers is the most powerful thing that we can do to improve the life quality of all of the pets that we love. Good morning, or afternoon, or evening, depending on when you hit play. I always do that. But it's morning for us. And I'm Dr. Natalie Keith. This is Vet Tales.

And I have a really special co-host today. Today, she's making history. The very first non-DVM, but ever important, Heather. I am a civilian, yes. Yeah, she's like, I want to feel so civilian. I was like, well, I'm not military. Well. Here we are. So she's a little nervous, and she didn't want to do video, which is sad because I put on makeup today, which never happens, but whatever. Whatever.

So we're sitting here and today we are going to talk about seven plus screenings and or geriatric diagnostics, depending on how you talk about it. But first, I want Heather to tell us about herself. Well, my role here is inventory manager. I've been here since 2015. So we're going on a decade. Almost a decade. Yeah, she's one of the OGs. Yeah. Yeah. Started off teching.

Yep started off teching um and then gradually i don't even know i don't even remember when i started it was a trickle effect so i think it was when jesse first went to colorado jesse's back now but when jesse left which would have been probably we may need jesse to fact check this but yeah it's 17 17 maybe 17 yeah and it started off with hey can you count these pills jesse's leaving you're period okay what what are we doing yeah no i don't have a clue i know an inventory manager now

is like i mean that's your title but it's such a teeny fraction of what you do you know she's pretty humble but i'll brag on her literally this place wouldn't run without her there's not a day she doesn't get vacation days because we text her every day she's off so it's true yeah keeping Keeping the drug under drugs, medications, supplies. Ordering online pharmacies. Oh, yeah. Compound. Vaccine failure complaints.

Yeah. Things like that. All the drug rep liaison work. So the drug reps and the distributor reps are, you know, they make this place function. And they just, Heather's the go-to communication. Point of contact. Yes. I believe. The fancy words for that max is groaning in the background i don't know what about his life is so cush anyway and then you recently took on accidentally somehow i hear it again tag, but i felt like i feel like i felt like the water just flowed into your pool somehow like.

Don't ask me how because you were the most interest like you were so basically we knew we had to change software and we'd been on our old software system for like 14 years essentially 13 and a half or something and we were doing all this research on them and you were the one that was like actually engaging in the process of working through the pros cons trying all the different ones and yeah and keeping us like on point like there was one that you liked that some people originally were

like and then you're like but look and then eventually we were like oh you're were right this is so easy just try it so she became the point of contact for that yeah and so she helped us set up our entire new software system because they kind of build it to the practice and so that was an astronomical undertaking that we just launched eight days ago yeah eight very long days really really well i think everybody's catching on really i mean yeah there's some workarounds but that's yeah relearning

flow patterns really is the biggest thing it's It's just like, okay, we used to do it this way, but now we do it this way to make this system work. And I feel like everybody's really optimistic about it. We've had very few glitches. Like, it's gone really well. Clients seem to be bearing with us. Yes. Which is good. We haven't had a whole lot of complaining. No. Yeah. There's a couple of lost test results that were delayed, and that was really disappointing.

They got lost in between the migrations, but, you know, ultimately, we found them.

So that was good. it just was frustrating we're figuring out we're figuring out the best solution for yeah yeah yeah and you did such a good job with the training like setting up the trainings and and helping us all figure out how to work through our modules to get prepared sorry max is so extra after the edit if you're going to be able to hear all the whining going on behind us but he's like he's like the the princess and the pea with his bed situation he's literally nesting stacked on

top of each other it's not cushy we have to address this guys hold on you know you can't see what's happening but it's it's really really tragic to see him struggle to just have one dog bed that he's laying on right now.

I see honey this is why we should have videoed there we go there okay and we're back if i don't edit this out i hope that at least someone got a chuckle or maybe even an eye roll i'll take an eye roll he looks so happy now he's at two beds stacked on top of each other i know he's um he's good yeah i don't know he maybe he whined again what are we gonna do i'll have to post on our facebook a picture of him being the princess and the pea and then you guys can

really resonate with the struggle that is happening here at northside veterinary hospital in shawnee oklahoma with max in the work trailer on two beds okay so anyway back to the topic of the day which is screening tests i think there's a lot of misconception about what do they do why are we using them when are we using them what is the point and you know what do we do with that information and all all that jazz. Yeah.

So I really wanted you to be in this because you have a really great way of explaining it to clients to get them to understand why we're recommending it and helping them see the value in it.

So do you want to talk to us a little bit about like, what are you telling clients? Usually, if, you know, the screening tests are just basically we want to catch things that could be creeping up before you know it. You don't even know. Your dog's fine. He's eating. He's drinking. He's outside playing. But what's happening underneath?

Right. You know, you're getting older. I mean, even in human medicine, you know, you do your yearly screenings, right, just to make sure you don't have anything, you know, that you're missing. Right. Something that you could potentially catch. And resolve while there's still something to do. Exactly. So and that's what the screenings are for. Basically, yeah, you're, you know, you're doing your blood work or your ultrasound or your x rays, and you could potentially find something.

And when clients come in, I like to tell them, okay, well, let's check. Let's just check. You know, everything seems fine. But let's just go ahead and check, you know, nose to tail. Let's see, you know, your technician is going to go in there. We're going to look at your teeth. We're going to look at your eyes. We're going to look at, you know, we're going to, you know, give him lots of pets. But while we're petting, we're feeling. We're feeling for lumps. We're feeling for lymph nodes.

We're feeling the coat. We're checking the skin color. You know, we're doing all of these things for a reason. That looks like petting. It looks like petting, yeah. And he's in the dog's living. He's in lots of pets. And massages. Yeah. But yeah, we're looking for signs. minds. So the reason I want to talk about this today was actually because of a case that happened yesterday. I have this Doberman patient that I adore. I love Dobermans like in general. They're so gorgeous.

They are. And they're, there's such a calm breed. Like I've had very few that, you know, I know that they're a good watchdog, but like as veterinary patients, they're so chill and they're so polite. Just majestic. They really are. They really are. They're just so regal, I feel like. But anyway, Anyway, so I love this Dobie, as I do love all my Dobies. And...

He, I was upset, I guess, or I don't know if that's the right word, but like concerned because he had lost seven pounds since his last weigh-in in May, which at this recording would make it nine months ago. Yeah, nine months ago. And that's a lot, like to go from 72 to 65 pounds. And so I was concerned. And then, and actually, to be honest, it was Danielle, my technician, she was concerned before. Like she went into the exam. She was like, hey, like he's lost seven pounds. I am concerned.

And Dobies, they have a lot of like genetic predispositions to diseases as they age that we are already kind of high on the radar for. And so I go into the exam room and I'm telling him, I'm like, Hey, I'm worried. And then I noticed his gums were pale or like not crazy pale, but like not his normal pink. And I was like, I just, I'm nervous. But she said the same thing you just said, but he's eating and drinking and he's going outside and he's doing his thing.

And he's 14. What are we going to do anyway? And I was like, yeah, well, it depends on what's wrong. You know, there may be something going on that we can manage to give him the best quality of life, you know, aside from quantity alone. You know, what can we, we don't, you know, like you said, with human medicine, we don't just go, well, you know, we'll just play it out. And, you know, we intervene. Yeah. Make him as comfortable as we can for as long as they have.

Exactly. And then like I told them on too, I was like, okay, so really there's three possible outcomes of this. Let's say we do this screening test or test. It's like a package of tests that we're looking for different things in. There's three possible things that are going to happen. One is we do them all and they're fine. And we go, whew, great. Good news. Now we know. Yeah. Or we run the test and there's something that we really can't do much about.

You know, like we're maybe not going to put a 14-year-old Doberman through chemo, like in my opinion, you can, but I don't know that I'd recommend it. And so maybe he has like a liver tumor, but we can change his diet to help him metabolize it better. Or maybe we find he has heart disease and there's a medication via the EPIC study that shows that it could progress, it's still the progression of heart disease by up to 18 months.

That's a big deal. And so, you know, just because he's old doesn't mean we shouldn't be aware of what's happening with his body. So anyway, so the owner was going to think about it was the punchline of that story. I'll let you know later if he, if she wants me to do the testing, because I think, I think she was afraid to find out what was wrong. Yeah. Yeah. And I get that, but you know, at least, you know, yeah.

One thing I have noticed that we have found a lot in these packages is spleen tumors. They come out of nowhere. There's no symptoms. There's no symptoms and you never know until something is wrong. Yeah. Yeah. Like they're bleeding out. They're bleeding out. Yeah. And even if you were like, well, but I'm still not going to take my dog to surgery. Well, but there's medicines that we have for clotting to help them not hemorrhage and they can buy them six months just by taking a pill. A day.

It's not. These are not big hard things. And I have seen these pills like keep bleeding spleen tumors in check for six months. Which shocked the tar out of me. I really didn't think that they were going to work that well, but I was pleasantly surprised. I had several patients now that went six months when I wouldn't have given them a week without the medicine. Yeah.

So anyway, do you want to tell us about the tests? Like what all is in there? The 7 plus screening is, you know, you have your exam and then you have your blood work. I believe it's CBC and comprehensive. Yeah. And then you have the option to add either x-rays or an ultrasound. And it really kind of depends on the breed and size of the dog. Yeah, usually the doctor, the team is making that call, not that like the owner's not like, I'd really rather have x-rays.

It's like, well, you have a, you know, a 12 year old chihuahua. I'm worried about the heart versus you have a nine year old golden. I'm worried about the spleen. Exactly. So, yeah, just kind of, we, we just kind of determined by one symptoms if they have any and, you know, breed and size and things like that. Yeah. And the urinalysis, did you say urinalysis? No, I did not. Yeah. It does include urinalysis. Yeah.

Yeah. So, so yeah, blood work, urinalysis and imaging is kind of the nuts and bolts of it. Ideally, we'd like to see every patient, we call it the seven plus screening because we'd like to start these tests when they're seven-ish. You know, it depends, like if you're a chihuahua and you're seven, you're not near as old as if you're a Great Dane and you're seven.

Oh, yeah, definitely. Definitely. But, you know, doesn't mean it's a bad idea to start earlier because we can start watching trends in the blood work. If, you know, the blood works, you're looking at your kidney enzymes and they're, you know, low normal one year and they're mid normal the next year and they're high normal the next year, you start going, what is happening?

Yeah. And so you start being more aware and you say, okay, well, let's, let's try adjusting this, the protein level of his pet's diet. So we're not taxing the kidneys so much. And we can then actually see those levels go back to mid-normal just by tweaking a couple of easy things because we're paying attention. We're paying attention every year. Yeah. Yeah. You don't want to find out your dog has a spleen tumor when it has an abdomen full of blood. Like that is not the time to find out.

Because that's an emergency surgery. It is. Yeah. And it's not nearly as rare as you think it is either. No. It happens quite a bit. In the last nine years, I've seen so many splenectomies. One of the most heart-wrenching, I don't know if you remember it, but he was a smaller, like, golden mix. I don't know exactly what. His name was Jack-Jack. Sounds familiar. Yeah. It's been four or five years ago now, I think. But anyway, he was only seven and we hadn't done a seven plus screening on him yet.

He had come in for his wellness three months prior and he came in with a liver and spleen tumor that was just everywhere and blood in his abdomen. So it was, they ended up doing the emergency surgery and we stabilized him for a little while, but because it was already in his liver, it didn't, it wasn't as successful.

So that is yeah we do have some that turn out not with not happy ending yeah but that's true it's true which is i guess why we're always why we recommend it is because we're like we have seen the other side of this and if we could have just looked sooner you know and in jack jack's case it was like there there was no reason to really have it's like whenever you find like like let's say cancer in a young animal, it's like you can't prevent all of these things.

You can't reasonably screen for all this unless like once a month everybody brings in every pet. And that's not realistic, but it is realistic to think that dogs seven and older could be at higher risk for these diseases that we need to be monitoring for. The other thing too is like, I think it's worth talking about what shows up on blood work versus what shows up on imaging. Because I think a lot of people think, I know a lot of times what people will think is when we're taking the heartworm

blood, it's just three little drops of blood. And they'll be like, oh, yeah, my dog had blood work. And it's like, no, no, that's basically it was like a pregnancy test for heartworms. Yeah, that is all that tested. So when we're doing blood work, we have so many things that we're looking for. Do you want to talk about some of the favorite ones that you like to look for? Well, a comprehensive, of course, is going to look at your overall, your kidneys, your liver values.

You know your cbc he's got your hematocrit is the anemic is he you know got infection going on.

Yeah yeah the anemia is that is a huge one with the spleen tumors is they'll start to get low grade anemia and then another reason we check the gums that's right is looking in your dog's mouth that's right we're looking at their teeth but we're also looking at their gums um which you can have pale gums too from like cardiovascular disease which is you know another thing i'm about on my adobe friend is his heart not pumping well enough to keep his gums pink.

And there's so many different things. And that's why we know what to look for. And then you know what it can mean. Right. Exactly. Yeah. So Heather's like, I need to know what the dog's kidney and liver. And, you know, if we have enough red blood cells, do we have too many white blood cells? And so we know what tests to recommend. And then the other thing that is, I think, really commonly misunderstood is that people think that if a dog's blood work is normal, mold that they don't

have cancer. No, that's not the case at all. Blood work doesn't really tell about cancer unless it's maybe lymphoma or maybe leukemia. Like those are about the only times. And that's really heavily swayed towards cats, you know, dogs sometimes. But usually when you're finding a cancer or blood work like leukemia or lymphoma, you're really finding it on the cats, not dogs.

Yeah, your ultrasound is really going to be your go-to, I think, for cancerous tumors if they're visible at that point right which is another fair point like yeah they have to be a certain size before you can find them and so yeah you're ultrasounding the abdomen and then you're x-raying the chest because you you're having you unless i guess air is the enemy of ultrasound and so your lungs are full of air if things are going well and um it's going to be.

A very very large mass or a whole lot of fluid that you're going to have in the chest before the ultrasound is helpful and x-ray is much more diagnostic for tumors heart disease bronchial vascular disease airway collapse like there's so many things so from like you don't even have to know what you're looking that's why the screenings are so great you don't even need to know what you're looking for you just need to know where to look for problems exactly you just pop the hood mm-hmm and you

and look at that look what we've done yeah we just found so yeah yep so the screening is is awesome from that perspective in the sense that it can test like you know you were saying with the comprehensive blood work it's like we have kidney liver diabetes protein loss like all these things on one little test that that can shove us in the right direction as your analysis Oh, yeah. I almost forgot about that again. Yeah. It's deceptively helpful.

It is one of the earlier indicators of kidney disease. Your BUN and creatinine have to be way, you have to have way high percentage, like 75% kidney function loss before your BUN and creatinine elevate on your blood work. But you only have to have 66% before you have low specific gravity. Diabetes. Oh. Confirmed diabetes. Yeah, that's another like, yeah, you've got to have glucose in the urine to confirm your diabetes.

And protein loss in the urine is another like indicator of early renal disease. And you can manage the protein loss by giving them a supplement because that losing that protein is like kind of like traumatizing the kidneys all day long when the proteins are sliding through. It's almost like when you get mad at your kids for stretching the neck of their shirt out. And that's what's happening when proteins are sliding through the little holes

in the kidneys. It's creating all this trauma in there that you want to stop. And so if you don't know it's there, you're going to wind up with kidney failure far sooner than if you catch it at just the protein loss stage.

I want to say the word glomerulonephritis just for fun. That's way over my head. I'm sorry. It's okay. Now you're getting a little too deep. I know. I know. No, but it's such a fun word. Glomerulonephritis is essentially the inflammation of the glomeruli in the kidney. So nephritis is, so neph is kidney. Itis is inflammation. Glomerular is the little, it's like a little mitt. We would talk about it like being like a catcher's mitt in the kidney. And that's what's filtering the stuff. Right.

Okay. Yes, you can go. No, you can't, you know, and then if the catcher's mitt gets really worn out, like the neck of your kid's shirt that they keep tugging on, more things are going to slide through than they're supposed to. So when you have inflammation of the glomerulus in the kidney, it's glomerulonephritis and that causes this leakage of stuff. It's really common too, like in like lepto, you can get that, which is a podcast for another day. But, but essentially, Actually, yeah.

I mean, I just really wanted to say the word glomerulonephritis because I think everyone should practice saying it just for fun. I don't think I could say it. Okay, let's all say it again. Glomerulo? Glomerulo. Nephritis. Nephritis. There you go. That's a fun word to practice. Yeah. It's going to take some practice. Yeah. My other favorite one is pheochromocytoma, which is only third to paralophilus stren... Wait. Oh, no. I think I messed that one up.

Parallel oh my goodness i'm gonna have to come back with that there's a brain worm in deer, paralophilus tenuous something like that someone can fact fact check me but that was one that i used to have to practice saying a lot but anyway pheochromocytoma is a tumor in the adrenal gland in the middle of it that causes the dogs to basically like have increased adrenaline at all times so they'll be like hyperthermic and panting

and like like like beside themselves so So actually, I have a dog right now that I think may have one.

They're really rare, but Phaeochromocytoma, Glymeria linofridus, Perilophilus strenuous. Tenuous? I do have to say, we here at Northside, we learn a lot here. We get taught a lot, which is why we're good at our jobs. Like Dr. Keith and Dr. Trussell, they teach us a lot. And we lean on you a lot, too, because you guys are so aware of, you know, normal, you know, it's not normal. And you're you're always like your guts are spot on.

Right. Yeah. We know, you know, for the most part, we know what tests we should do, what's going on. And because you've taught us. I mean, we used to have, you know, Wednesdays we would do our meeting and we would learn about different topics. And that's I think that is was so, so valuable. Yeah.

Well, that's the thing, right? It's just education of the, it's the whole premise of this podcast is education of the pet caretakers of the world that gives power to us to give better care to our pets and improve the quality of their life. Like that's the whole, like if you guys want to flip back to the intro 24 minutes ago, that's the whole thing is we just really believe in education that, that everybody should have access to the same information to make the best decisions for their pets.

And empowering my staff and the people that I work side by side with every day just makes us all stronger because I am only one set of eyes.

And, and when you have two, they'll, they'll be like, Hey, did you notice that that dog's panting more or, you know, like anything that, you know, or they'll come in because the way that we run our rooms here is that, you know, the technicians will go get the pet from the lobby, weigh them, go in, do their vitals, check them out, talk to to the owners and the information they're bringing back to me is so valuable with what they've noticed

like just like danielle like hey he looks seven pounds he just doesn't look the same to me and you know i i do something's going on with that dog i don't know if we'll get to find out or not but yeah so we we know what tests are on what to kind of look for and you guys run with it and yeah then can go say all the big words that i can't pronounce yeah i have dollar word of the the day.

Anyway, so yeah, yeah, that's basically it is I think that I don't want clients to be afraid of knowing the truth. And I don't want clients to think that there's nothing to do with that information just because they're not going to do surgery or just because they're not going to do chemo. It doesn't mean that that information doesn't still have value. And also, you know, we do all the testing and it all comes back normal.

That's not a waste. Like sometimes we We get that like, well, that was pointless. No, it wasn't. Like, that is so empowering for the- Great news. Yeah, it's great news. And it's a great baseline. And the next year, something might not be normal and we can look back. Exactly. And say, yeah, this is- No regrets. You know, that's the thing is like you look back and you're like, okay, I did all the things I could do.

You know, we screened routinely and it was negative last year. This year is positive. Now we have a timeframe, you know, and we know we caught it as early as could be reasonably expected. Yeah.

All right. Any parting words of wisdom for clients or pet caretakers in the world? No, I don't think so. That's it. That's it.

She's not as chatty as me. Heather is definitely a quiet person by nature. I usually am. I don't talk much at all. This is the most talking I've been probably in a long time. Yeah. Well, especially now that you're not in rooms. You had to really say all the words when you were in rooms. but now it's like you and the computer and then just directing everybody in their, in their chaos. Heather, Heather, where is this? Heather, can you help us get that? How to do lies and fix it. Exactly.

No doubt. So it's a big job, but we appreciate you. Thank you. Thanks for being here today too. It was fun. Yeah, it is kind of fun. So that's the whole point, right? Fun and educational. Like PBS for kids. All right, then y'all have a great rest of your day. Music.