Frequently Asked Questions
New Client? View & download out a new client information sheet  here

Boarding a pet? View & download a boarding information sheet  here.

Bird Care
   Found a baby bird? Info Sheet

Other bird info: buffalobirdnerd.com

Birthing puppies/kittens - video
Boarding - Everything you need or want to know!
Critical Care Unit
            Visiting Hours
            Call backs, and other info
Cat info: catfriendly.com
Dental Health
           Really a big deal?
           Periodontal Disease
           Why is it important to have my pet's teeth cleaned?
           How to Brush Teeth
           Dental Cleaning
           Is my pet too old?
           How to Check
           Watch a video about dentals
Emergencies
Exotics
Heartworm Disease – Dogs and Cats
Hygiene
            Bathing Pets
            Cleaning Pets’ Ears
            Cleaning Pets’ Eyes
Lost Pets: What to do?
             How to keep your pet from getting lost.
Medical Questions/Concerns
            Benadryl
            Diarrhea
            Dog Licking
            Dog Scooting
            Eating Grass
            Heat Cycles
            Hit by Car
            Litter Box Problems
            Seizures
            Tylenol/Over the Counter Meds
Nutrition
Online Pet Pharmacies
Orphaned Animal Care
            Bird
            Puppies/Kittens
Parasites
            Fleas
            Heartworms
            Lice
            Ticks
            Worms
Pets, Worms, and Children
Poison – What to do?
Puppy/Kitten Care
Reptile Care
Rabbits - Care of Orphaned Bunnies
Senior Pet Care
Spay/Neuter
Travel: Health Certificate and Travel Information
Traveling With Pets: Safety Concerns
Vaccinations
            For Dogs
            For Cats


BOARDING - Everything you need or want to know about boarding at AMC!

BOARDING FAQS
 
Q: How many times a day do the dogs get taken out to potty during their stay at AMC?

A: The dogs are taken out four times a day by our Pet Care Specialists: twice in the morning and twice in the evening. Cats do not get taken outside, but they are allowed to get out of their condos [one at a time] and play while we are cleaning their area.
 
Q: Where do my dogs go out to use the bathroom during their stay at AMC?

A: We have an outdoor enclosure with 8 safely fenced-in runs. They are [measurements???] and your dog has plenty of room to play and exercise. There are water bowls provided at all times. Your pets are allowed as much time outside as the weather permits. Usually they can play and exercise for 15-30 minutes per outing. Dogs boarding together can be also be exercised together in the same outside run.


Q: What if my puppy has a potty accident in their boarding area?

A:
Your pet's area will be cleaned and disinfected twice a day. Our Pet Care Specialists are proud to show our clients how clean our boarding facility stays. If your pet has an accident, he or she will be taken outside or moved to another location while their area is being cleaned. Dogs who board more than one night will receive a complimentary bath on the day they are scheduled to be picked up.


Q: Can I bring my pet's personal belongings to stay with them while they board?

A: : Yes, you can bring your pet's bed, blanket, toys or food to leave with them while they stay with us. We only ask that you put your pet's name on his or her belongings so that if the items are washed they can be returned to the right pet. Food will be placed in a bin with your pet's name on it. If you do not wish to bring anything with your pet, that is perfectly fine also. AMC is stocked with blankets, toys, bowls, and food that will be available for your pet upon request. [ Please note that AMC is not responsible for any lost items.]

 
Q: My pet has special needs. Will he or she be still be able to board?


A: Of course! Animal Medical Center is an AAHA certified pet hospital. There are veterinarians, technicians and/or vet assistants here 24/7. If your pet needs special attention or has medication that needs to be given daily, AMC is the perfect place to board your pet. Our Pet Care Specialists are also trained to keep a close eye on all pets that board with us. They make daily notes of your pet(s) appetite, water intake, urination and bowel movements. If you have any questions, a technician will be glad to speak with you about medications or special needs.
 
Q: What are the different boarding areas available?
 
A: We have cages, runs, suites and cat condos available. Please view our site pictures or call to schedule a tour of our facility.
 
 
Q: My pet has never been boarded before, will they be OK?

A: There is a first time for everything, and most first time boarders do fine once they get used to the new place. AMC offers detailed tours of our boarding facilities for you and your pet so you know exactly where he or she will be staying. You may even meet a few of the people who will be taking care of your pet while you are away. We are committed to caring for each and every pet as if they were our own. Sometimes a little extra TLC is just the thing needed for nervous first-timers.

Q: If I chose not to bring my pet's food, what will AMC feed them?

A: AMC uses Science Diet Sensitive Stomach to feed our boarders unless your pet is on a special diet. We also have Science Diet Sensitive Stomach "Small Bites" for smaller pets.


Q: I have multiple pets. Will they be able to stay together?
 
A:Sure, as long as they get along well. There is one exception, though: Cats may board together in their condos and dogs may board together in their areas; but cats and dogs may not board together at all.
 
(Note: If pets do not get along during meal times, they will be separated for a brief period of time until they have both finished eating.)
 
Q: Do I need to make a reservation?
 
A:Boarding reservations are appreciated but not required. If you need to board your pet but have not made a reservation, you may call first to see what we have available or stop by and speak with one of our Client Services staff members.
 
(Note: Holidays tend to be our most popular boarding time, reservations are usually booked weeks in advance.)
 
Q: Everyone is going green! What does AMC do to help the environment?
 
A:AMC uses laminated paper and dry erase markers to fill out our new client forms instead of using paper. We then transfer the information to our computer system. We also conserve energy by turning overhead lights off and using natural light from our windows for twice a day to give our CCU and boarding pets time to rest and relax. We are currently utilizing an online program called Vetstreet which allows us to go paperless for pet reminders. If you have not given AMC your email address, please do so today so that you too can begin to enjoy the benefits of this convenient program.
 
If you have any other questions, please feel free to give us a call at (256) 236-8387.

CRITICAL CARE UNIT
My pet was admitted to the CCU, may I visit?
-          Absolutely!  We have set visiting hours for our patients in the Critical Care Unit.  Please call to confirm current visiting times:  256-236-8387

My pet is in CCU, but I have not heard from anyone.
-          Please bear with us as we assess and treat each pet in the Critical Care Unit.  Once our doctors and staff have finished all the treatment plans for the pets in CCU, someone will give you a call.
What does it mean that my pet is in the Critical Care Unit?
-          While an emergency is unfolding, or throughout recovery from a serious illness or accident, ongoing diagnostic and therapeutic care and constant monitoring of your pet’s condition may be required. Just as in human hospitals, our facility has 24-hour supervision of critically ill pets.
-          This facility is equipped to provide oxygen therapy, cardiac monitoring, blood transfusions, and nutritional support. This facility also has advanced diagnostic capabilities onsite, such as ultrasound and echocardiography. 

DENTAL HEALTH

Is Dental Health really a big deal?
 
-          Dental disease is a HUGE deal. Periodontal (gum) disease is the number one diagnosed problem in dogs and cats. By the age of just two, 80% of dogs and 70% of cats have some form of periodontal disease. In addition, 10% of dogs have a broken tooth with pulp (nerve or root canal) exposure. This is extremely painful until the nerve dies, at which point the tooth becomes infected! Infectious oral diseases affecting the gums and root canals create systemic bacteremia (bacteria in the blood stream, which can infect other parts of the body). Periodontal inflammation and infection have been linked to numerous problems including heart disease, strokes, kidney disease, emphysema, liver disease, osteoporosis, pregnancy problems, and diabetes. Therefore, oral infectious diseases are known as “the silent killer.”

In addition to systemic effects, oral disease can also cause inflammation to the eye, resulting in blindness. Furthermore, jaw bone loss from chronic infection can lead to a jaw fracture known as a pathologic fracture, and these have a very hard time healing. Finally, infectious oral disease can result in osteomyelitis (an area of dead, infected bone), nasal infections, and an increased risk of oral cancer.

Speaking of oral cancer, the oral cavity is the fourth most common place for cancer. Unfortunately, by the time that most are discovered, they are too advanced for therapy. Early treatment is necessary for cure. That’s why you, the pet owner, need to check your pet for oral growths on a regular basis. Anything suspicious should be shown to our veterinarian promptly.

In cats, a very common problem is feline tooth resorption lesions, which are caused by normal cells called odontoclasts eating away at the cat’s own teeth. Approximately half of cats over 6 years of age have at least one. They are similar to cavities in that once they are advanced, they are VERY painful and can become infected. They are first seen as small red areas along the gum line.

Other oral problems include bacterial cavities, painful orthodontic problems, dead teeth (which are commonly discolored), and worn teeth. Almost every pet has some form of painful or infectious oral disease that needs treatment. Unfortunately, there are few to no obvious clinical signs. (See below, what are the warning signs of periodontal disease?) Therefore, be proactive and ask our veterinarian for a complete oral exam, and perform regular monitoring at home.
 
Periodontal Disease
 
-           Periodontal disease is defined as the destruction of tooth attachment (periodontal ligament and jaw bone) caused by bacteria. It begins when bacteria form on teeth in a substance called plaque. If plaque is not removed immediately, two things occur. First, the plaque is calcified by the minerals in saliva to become calculus (or tartar). This is the brown substance on teeth that many people mistakenly equate with periodontal disease, but the truth is that calculus does not result in periodontal disease.

The other thing that occurs with chronic plaque formation is that it will start to move under the gumline. Once the plaque gets under the gum, it starts causing inflammation, which is called gingivitis. Gingivitis is the initial, reversible form of periodontal disease. If this inflammation is not controlled, the bacteria within the gingiva change to a more virulent type. These more virulent species create more severe inflammation. Eventually, the body responds to this inflammation. Part of this response is bony destruction, which continues until the tooth is lost. However, in most cases periodontal disease causes problems long before this happens. (See above, “Is dental disease really a big deal?”)
 
Warning Signs
 
-          Unfortunately, there are no obvious outward signs of periodontal disease until it is VERY advanced. The earliest sign is inflammation (redness or swelling) of the gums. This is generally accompanied by buildup of plaque and calculus on the teeth, but unless you are looking for these changes (See above, “Is dental disease really a big deal?”), they are not noticeable.

As periodontal disease progresses, the infection will worsen. The next signs within the mouth are receding gums or loose teeth. This increased infection may result in bad breath or blood on chew toys; however, this should NOT be relied upon for diagnosis. If your pet has bad breath or you see blood on toys, it is almost a sure sign of advanced periodontal disease requiring a trip to the veterinarian.

Late signs of periodontal disease include nasal discharge (blood or pus), eye problems, facial swelling or a jaw fracture.
 
Why is it important to have my pet's teeth cleaned?
 
-           There are two main reasons for routine cleanings. First, they help prevent periodontal disease. Second, and possibly more importantly, a cleaning allows for a complete oral examination. Only with general anesthesia can most oral health problems be noted. This includes screening for oral cancer, broken teeth, cavities, and in cats, tooth resorption. Finally, general anesthesia is required for periodontal probing, which is the method of diagnosis of periodontal pockets.
How to Brush Your Pet's Teeth
 
-           Start with a soft toothbrush and veterinary toothpaste. The malt flavor from Virbac appears to be the favorite of our dog and cat patients. Do not use human toothpaste, as it contains detergents that may cause stomach upset. Also, I do not recommend the fingertip brushes for two reasons. First, the bristles are not very effective at cleaning. Second, they put the pet owner’s finger at risk for a bite, from even the most placid animal.

Go slowly and be very positive, using food treats if necessary. Place the brush at a 45-degree angle to the gum line. Brush in a circular motion, with a firm stroke away from the tooth. Try to reach all tooth surfaces, but concentrate on the outside surface.

The hardest part is getting started. It’s best to start young, because the earlier you introduce brushing, the easier it will be for your pet to accept it. We recommend handling your pet’s mouth from the time you bring him home. For puppies and kittens, introduce the brush at around 6-7 months. Be consistent; animals like routines, so if you make it a habit it will be easier on both of you.

My dog eats hard food. Isn’t that like brushing his teeth?
 
-          NO! This is a myth, which came about from the surface of the teeth being slightly cleaner in pets fed dry food. Typical dry food does not protect against periodontal disease. This relates to the root cause of periodontal disease, which is subgingival plaque (plaque below the gumline). Supragingival (above the gumline) plaque accumulates and causes local changes in the gum tissue that allow attachment and growth of subgingival bacteria, however after this has occurred; supragingival plaque has little to no effect on periodontal disease. Traditional dry foods break apart at the tip of the tooth and have little to no dental benefit.

There are specially formulated and processed dental foods that effectively clean a pet’s teeth as the pet chews and are an excellent adjunct to routine tooth brushing.
 
Dental Cleaning
 
-           The first step is to place the patient under general anesthesia. Anesthesia-free dentistry is not recommended, and is even illegal in some states. Don’t be fooled by “sedation” dentistry. In our opinion, sedation dentistry can be more dangerous than general anesthesia for two main reasons. First, in sedation dentistry (or any other anesthesia-free dentistry), the trachea (windpipe), and therefore the lungs, are not protected from the particles generated during a dental cleaning. These particles are full of bacteria and, if inhaled, can result in pneumonia.

The other difference between anesthesia and sedation is the length of effect. Most practices today employ relatively short-acting agents to put the patient under anesthesia, and then a gas to keep the patient under anesthesia. If a problem occurs under anesthesia, the veterinarian can turn off the gas and the patient will recover quickly. But under sedation, the effects generally do not go away until the drug is cleared by the system, which can take too long. General anesthesia is very safe today, thanks to advances in anesthetic drugs, training and monitoring equipment.

A true dental prophylaxis consists of several steps, some more critical than others. The required steps that must be performed include:
  1. Supragingival scaling: This is the removal of the plaque and calculus above the gum line (what you can see).
  2. Subgingival scaling: This is the thorough cleaning of the area under the gum line to remove disease-causing bacteria. It is typically performed by hand and is time consuming, but it is the most important step of a dental prophylaxis.
  3. Polishing: Scaling slightly roughens the teeth. This promotes plaque and calculus attachment and reduces the lasting effect of the cleaning, so the teeth are polished afterward. There has been some controversy about this in human dentistry, due to the loss of enamel with many cleanings over time. However, in veterinary dentistry, with relatively fewer cleanings in an animal’s life, this is not a concern.
  4. Sulcal Lavage: Cleaning and polishing results in debris being caught under the gum line, this must be thoroughly rinsed out.
  5. Oral exam, periodontal probing and dental charting: This is a critical and often misunderstood part of the dental prophylaxis. There are teeth that cannot be thoroughly examined in a pet that is awake, when periodontal probing is not possible. With the patient under anesthesia, the mouth is thoroughly and systematically examined, and all findings are noted on a dental chart. Any diseased teeth or tissues are then properly treated.
Why does a dental cleaning have to be done under anesthesia?
-          It is impossible to do a thorough cleaning and definitive oral examination (including periodontal probing) on a pet that is awake. Our veterinarian can provide the appropriate pre-anesthetic protocol and treatment plan to provide your pet with the best care.

Is my pet too old?
-          NEVER. Healthy pets, even when they’re older, handle anesthesia quite well. Age does increase the possibility that the patient will have some degree of organ malfunction, and those with systemic problems will be at an increased risk. Therefore, we require pre-operative testing on all patients over 5 years of age, prior to anesthesia. The important organs include the liver, kidneys, heart, and lungs. Required tests include a complete blood panel, thyroid testing, and urinalysis in all patients.
As a pet owner, what can I do at home to prevent periodontal disease?
-          The gold standard of home care is tooth brushing. To be effective, however, it must be performed at least three times a week; daily brushing is ideal.
 
Another form of home care consists of rinsing with an antiseptic agent. CET® Oral Hygiene Rinse (Virbac) is an excellent antiseptic rinse for veterinary patients. The active agent (chlorhexidine) impregnates the teeth and gums, and its antibacterial effect lasts up to six hours.

It may be challenging for some pet owners to make the commitment to daily tooth brushing for their pets or to teach their pets to tolerate handling of their mouths. When frequent brushing is not practical, feeding an effective dental food provides a convenient solution. There are numerous products touted as “dental” foods or treats. Pet owners must be careful, as these typically only clean the tip of the teeth, not the areas that are necessary for control of periodontal disease. Of the dental foods available, only Hills® Prescription Diet® t/d® is clinically proven to reduce gingivitis, plaque and calculus. A combination of brushing and feeding the right dental food is best for oral disease control.

How to Check
-          Look for anything that appears abnormal. The first sign of periodontal disease is redness of the gums. No matter how minor it seems, if this is present, disease is present. The pet needs veterinary care in order to treat the disease and avoid all the problems associated with it. If periodontal disease is not treated early, advanced signs of disease include swelling of the gums, calculus on the teeth, receding gums, and mobile teeth. Any of these is a sign of advanced periodontal disease, and immediate medical attention is required.

Other things to watch for include swelling or masses, broken or worn teeth, and discoloration of the teeth. Any of these things should also be brought to the attention of a veterinarian right away.
What should a pet chew on?
-          There is a fine line between being too easy to chew up and swallow, and being too hard, possibly damaging the teeth. Many commercial chew toys are far too hard and can break the chewing teeth. There are two guidelines we recommend using:
  1. If you cannot make an indentation in it with a fingernail, the treat or toy is too hard.
  2. If it would hurt to hit yourself in the knee with it, the treat or toy is too hard.
Pets that are prone to quickly swallowing large pieces of chew toys should be monitored during their use, to avoid an obstruction.
Watch a video about dentals
 
 
EMERGENCIES

Our facility at 719 Quintard Avenue in Anniston, AL is open 24-hours a day for medical emergencies.  If you have an emergency, please call 256-236-8387.
Any of the following situations can be considered an emergency:
-          Difficulty breathing
-          Allergic reactions
-          Ingestion of a foreign object or unknown substance
-          Bleeding
-          Vomiting blood
-          Blood in the feces or urine
-          Swollen, hard abdomen that is painful to the touch
-          Serious wound
-          Suspected broken limb
-          Any injury to the eye
-          Loss of consciousness
-          Seizures
-          Inability to move or sudden weakness
-          Unusual or erratic behavior
-          Signs of extreme pain, such as whining or shaking
-          Straining to urinate (especially a male cat)
-          Labor that does not progress
-          Signs of a heatstroke
 
EXOTICS

Does my non-traditional/exotic pet need yearly exams?
-          Reptiles.Most of our "scaly" pets in captivity will benefit from a yearly exam with the veterinarian. Although there are not any vaccinesthat are given, the visit will always start with a thorough physical exam with a discussion on any weight changes and growth rates. A complete review of the diet, including any changes in appetite, and other husbandry issues are important topics to discuss. The needs of your pet will change as they get older, so a once-a-year visit is a great place to address these issues. This visit is even more important in turtles and tortoises that live outdoors and may be hibernating. Pre- and post-hibernation exams are critical for these animals as they can be at risk for disease during these stressful times.
 
-          Birds.For our feathered friends, vaccines are not routinely necessary unless they are in a breeding situation or aviary. If that's the case, then an onsite exam/visit at least twice a year is the best preventative medicine. But for our birds that are indoors and truly pets, a yearly trip to the veterinarian is just as important as it is for our cats and dogs. It is vital to do a complete exam and discuss issues such as diet, weight gains (or losses), feather growth and other health issues. In fact, having your bird weighed on a regular basis is a great way to monitor changes in health. It is also very important to address behavior problems as they arise before they get out of control! As our birds get older and live longer with us, signs of disease can be subtle and easy to miss. We can discuss doing routine blood work, radiographs,and other diagnostic tests as good preventative medicine to ensure their health.
 
-          Small Mammals.Vaccines are not part of the routine healthcare for our rabbits, guinea pigs, chinchillas, rats, hamsters, or other small pets. But annual doctor examinations are just as important for these pets for many reasons; for one, they tend to show old-age problems faster than our larger animal friends. Geriatricproblems and other health issues arise quickly, so veterinary care can be an integral part of maintaining a healthy pet for as long as possible. Diets are readily available from most pet and/or feed stores, but you might be surprised by what is truly healthy as opposed to what is offered on the shelf! These and other important husbandry issues can be covered during the yearly physical exam.
 
-          Ferrets.Ferrets are fast becoming one of the most popular pets in America, third only to dogs and cats. They are easy to keep and care for and have "clown-like" antics that will keep you entertained for hours! They are strict carnivoreswith very specific dietary needs; also, they are the only "exotic" pet that requires routine vaccines as a kit (a young ferret less than six months old) and yearly after that. Ferrets are susceptible to some of the same conditions as cats and dogs, and are prone to certain types of canceras they get older. Yearly exams and vaccines (for distemper and rabies), by a veterinarian familiar with this species, are extremely important for ferrets. With a lifespan here in the USA of about 7-9 years, a visit once a year can be critical for ensuring a long, healthy life.
 
 
HEARTWORM DISEASE

Heartworm disease is a serious and potentially fatal condition caused by parasitic worms living in the arteries of the lungs and occasionally in the right side of the heart of dogs, cats and other species of mammals, including wolves, foxes, ferrets, sea lions and (in rare instances) humans. Heartworms are classified as nematodes(roundworms) and are filarids, one of many species of roundworms.Dogs and cats of any age or breed are susceptible to infection.

Where is Heartworm Disease?

Heartworm disease has been reported in all 50 states.
 

How Heartworm Happens: The Life Cycle

First, adult female heartworms release their young, called microfilariae, into an animal's bloodstream. Then, mosquitoes become infected with microfilariaewhile taking blood meal from the infected animal. During the next 10 to 14 days, the microfilariaemature to the infective larval stage within the mosquito. After that, the mosquito bites another dog, cat or other susceptible animal, and the infectivelarvaeenter through the bite wound. It then takes a little over 6 months for the infectivelarvaeto mature into adult worms. In dogs, the worms may live for up to 7 years. Microfilariaecannot mature into adult heartworms without first passing through a mosquito.
 

What Are the Signs of Heartworm Disease?

For both dogs and cats, clinical signs of heartworm disease may not be recognized in the early stages, as the number of heartworms in an animal tends to accumulate gradually over a period of months and sometimes years and after repeated mosquito bites.
Recently infected dogs may exhibit no signs of the disease, while heavily infected dogs may eventually show clinical signs, including a mild, persistent cough, reluctance to move or exercise, fatigue after only moderate exercise, reduced appetite and weight loss.
Cats may exhibit clinical signs that are very non-specific, mimickingmany other feline diseases. Chronic clinical signs include vomiting, gagging, difficulty or rapid breathing, lethargyand weight loss. Signs associated with the first stage of heartworm disease, when the heartworms enter a blood vessel and are carried to the pulmonary arteries, are often mistaken for feline asthmaor allergic bronchitis, when in fact they are actually due to a syndrome newly defined as Heartworm Associated Respiratory Disease (HARD).

How Do You Detect Heartworm Disease?

Heartworm infection in apparently healthy animals is usually detected with blood tests for a heartworm substance called an "antigen" or microfilariae, although neither test is consistently positive until about seven months after infection has occurred.
Heartworm infection may also occasionally be detected through ultrasoundand/or x-ray images of the heart and lungs, although these tests are usually used in animals already known to be infected.

Prevention

Because heartworm disease is preventable, the American Heartworm Society (AHS) recommends that pet owners take steps now to talk to their veterinarian about how to best protect their pets from this dangerous disease. Heartworm prevention is safe, easy and inexpensive. While treatment for heartworm disease in dogs is possible, it is a complicated and expensive process, taking weeks for infected animals to recover. There is no effective treatment for heartworm disease in cats, so it is imperative that disease prevention measures be taken for cats.
There are a variety of options for preventing heartworm infection in both dogs and cats, including daily and monthly tablets and chewables, and monthly topicals. All of these methods are extremely effective, and when administered properly on a timely schedule, heartworm infection can be completely prevented. These medications interrupt heartworm development before adult worms reach the lungs and cause disease.
It is your responsibility to faithfully maintain the prevention program you have selected in consultation with our veterinarian.

Treatment 

Usually, all but the most advanced cases of heartworm disease can be successfully treated in dogs. Currently, there are no products in the United States approved for the treatment of heartworm infection in cats. Cats have proven to be more resistant hosts to heartworm than dogs, and often appear to be able to rid themselves of infection spontaneously. Unfortunately, many cats tend to react severely to the dead worms as they are being cleared by the body, and this can result in a shock reaction, a life-threatening situation. Veterinarians will often attempt to treat an infected cat with supportive therapy measures to minimize this reaction; however it is always best to prevent the disease.
 
Adult heartworms in dogs are killed using a drug called an adulticidethat is injected into the muscle through a series of treatments. When the dog is sent home, exercise should be limited to leash walking for the duration of the recovery period, which can last from one to two months. This decreases the risk of partial or complete blockage of blood flow through the lungs by dead worms.
Re-infection during treatment is prevented by administration of a heartworm preventive. These preventives may also eliminate microfilariaeif they are present. Dogs in heart failure and those with caval syndromerequire special attention.

Feline Heartworm Disease

Heartworm infection takes place when a mosquito carrying infective, microscopic-size heartworm larvae, bites into a cat for a blood meal. The larvaethen actively migrate into the new host and develop further as they travel through the subcutaneous tissue in the cat's body. At about 3-4 months, they usually settle into the arteries and blood vessels of the lungs, where they continue to develop to sexual mature male and female worms (Dirofilaria immitis). The average time from when the microscopic parasites enter the host until the females develop into mature worms and produce offspring is approximately eight months and is referred to as the prepatent period. This is about one month longer than in dogs.
As adults, the heartworms can mate and the females can release offspring called microfilariae(pronounced: micro-fil-ar-ee-a) into the blood stream. The cycle begins again when a mosquito takes a blood meal from the newly infected cat and draws the microfilariaeinto its system.
Cats are resistant hosts of heartworms, and microfilaremia, (the presence of heartworm offspring in the blood of the host animal), is uncommon (usually less than 20% of cases). When present, microfilaremiais inconsistent and short-lived. Some cats appear to be able to rid themselves of the infection spontaneously. It is assumed that such cats may have developed a strong immune responseto the heartworms, which causes the death of the parasites. These heartworms may die as a result of an inability to thrive within a given cat's body.
However, heartworms do not need to develop into adults to cause significant pulmonary damage in cats, and consequences can still be very serious when cats are infected by mosquitoes carrying heartworm larvae. Newly arriving worms and the subsequent death of most of these same worms can result in acutepulmonary inflammation response and lung injury. This initial phase is often misdiagnosed as asthmaor allergic bronchitis but in actuality is part of a syndrome now known as Heartworm Associated Respiratory Disease (HARD).

Which Cats Are Susceptible?

Although outdoor cats are at greater risk of being infected, a relatively high percentage of cats considered by their owners to be totally indoor pets also become infected. Overall, the distribution of feline heartworm infection in the United States seems to parallel that of dogs but with lower total numbers. There is no predictable age in cats for becoming infected with heartworms. Cases have been reported in cats from nine months to 17 years of age, the average being four years at diagnosis or death.

Clinical Signs

The clinical signs of heartworm infection in cats can be very non-specific, and may mimic many other feline diseases. Diagnosis by clinical signs alone is nearly impossible, but a cat may exhibit genericsigns of illness, such as vomiting intermittently (food or foam, usually unrelated to eating), lethargy, anorexia(lack of appetite), weight loss, coughing, asthma-like signs (intermittent difficulty in breathing, panting, open-mouthed breathing), gagging, difficulty breathing (dyspnea), or rapid breathing (tachypnea).
Signs associated the first stage of heartworm disease, when the heartworms enter a blood vessel and are carried to the pulmonary arteries, are often misdiagnosed as asthmaor allergic bronchitis, when in fact they are actually due to a syndrome newly defined as Heartworm Associated Respiratory Disease (HARD).
Some cats exhibit acuteclinical signs, with disease often related to the organs where the adult heartworms are thriving. Occasionally such infected cats die quickly without allowing sufficient time to make a diagnosis or offer appropriate treatment.

Clinical Signs Associated with Feline Heartworm Disease

Acute Chronic
collapse coughing
dyspnea vomiting
convulsions dyspnea
diarrhea/vomiting lethargy
blindness anorexia
tachycardia weight loss
syncope chylothorax
sudden death  
 

Diagnosis

Heartworm infection in cats is harder to diagnose than it is in dogs, and it is easy to overlook. Diagnostic tests have limitations, so negative test results do not necessarily rule out an infection. Antigentests, for example, only detect adult female or dying male worms. Immature or male-only worm infections are rarely detected.
The diagnostic plan for heartworm disease in cats can include, but is not limited to, a physical examination, radiography (X-ray), echocardiography(ultrasoundreadings of the heart), angiocardiography (X-ray of the heart with injected contrast fluid), CBC(complete blood count), serologic testing (antigenand antibodystudy), microfilariatesting, and necropsy(after death).

Treatments

Currently, there are no products in the United States approved for the treatment of feline heartworm infection. Most cats with heartworm infection that are not demonstrating clinical signs are allowed the time for a spontaneous cure to occur. If there is evidence of disease in the lungs and their blood vessels consistent with feline heartworm infection, such cases (possibly in the early stage) can be monitored with chest X-rays every six to twelve months as needed. Supportive therapy with small, gradually decreasing doses of prednisone (a cortisone-like drug) is recommended for cats with radiographic or clinical evidence of lung disease.
Cats with severe manifestations of feline heartworm disease may require additional supportive therapy, and may benefit from intravenous fluids, oxygen therapy, cage confinement, bronchodilators (which expand the air passages of the lungs), cardiovasculardrugs, antibiotics and nursing care.
Heartworm extraction with various surgical devices has been performed in cats in which the worms can be visualized with ultrasoundat the tricuspid valve or in the right atrium(of the heart), and especially in those rare instances of caval syndrome(obstruction of blood flow affecting the heart and the liver.

Preventives

It is generally recommended that all cats be tested for both antigens and antibodies (serology) prior to administration of a heartworm preventive. There are four heartworm disease preventive products approved by the FDAfor use in cats, Heartgard® for Cats (Ivermectin, orally) from Merial, Interceptor® (Milbemycin oxime, orally) from Novartis, Revolution® (Selemectin, topically) from Pfizer and Advantage Multi™ for Cats (Moxidectin / imidacloprid, topically) from Bayer. All of these products are considered effective in preventing the development of adult heartworms when administered properly on a monthly basis relative to the period of transmission.


HYGIENE

Bathing Pets
-          Dogs are like kids. Most of them don’t like to take baths. But even shorthaired, wash-and-wear dogs need proper grooming and an occasional bath. Bathing too often, however, can remove the natural oils that keep a dog’s skin and coat healthy. How much washing is too much depends on the humidity and the shampoo used.
In general, a good brushing is all that a pooch needs to get freshened up. In addition to removing dirt, a regular brushing will clean out loose hair and make your dog more comfortable. But bathing is appropriate when a dog has significant body odor – for example, when Fido has rolled in something he shouldn’t have. So remember – a dirty dog needs a brush and a smelly dog needs a bath.

Cleaning Pets' Ears
-          As a general rule, you should clean your dog's ears about once a month or when bathing. If your dog swims or gets his ears wet regularly, you'll want to do it more often. Ear cleaning starts with good general grooming.
-          First, remove excess, dirty, or matted hair from around the ear canal and the ear flap. In some cases, excess hair may need to be gently removed from inside. A technician or pet groomer can remove the hair if needed.  Next, choose a mild ear cleaner formulated especially for pets. Avoid using vinegar, alcohol, or hydrogen peroxide. There are several types of cleaners to choose from. Some cleaners break up wax, while others dry the ear canal. There are combination products as well.  Baby wipes work well, too.
-          Now, it's time to actually clean out the ear canals. Always be gentle! The ear canals and flaps are sensitive. Overly aggressive cleaning can actually cause damage to the delicate ear structures. Pick up an ear flap and dribble a small amount (a few drops) of the appropriate ear cleaning solution into the ear. The solution should flow down deep into the canal. Massage gently at the ear base for 10-20 seconds -- you will probably hear the solution squish around as you massage. This should not be painful for your dog. If it is, have him examined by our vet. Repeat the cleaning procedure with the other ear canal. 
-          After massaging, stand back and let your dog shake his head to bring softened wax up out of the ear canals. Use clean cotton balls to gently wipe out and up the canal, removing any wax, debris, or cleaning solution you see. For small dogs, you may need to use cotton balls or baby wipes that have been pulled in half. Avoid using cotton swabs -- a cotton swab placed too deeply or forcefully into the ear can cause ear drum damage, pain, and hearing loss.

Cleaning Pets' Eyes
-          You may be eyeing your dog's eyes, and realizing they need a good cleaning – especially if you have a pup with long fur. First, make sure that there is only dirt around the eyes – if you notice redness, pus, or swelling, call our veterinarian.  If all you see is a little bit of grime, carefully trim the hair around your dog's eyes, cutting parallel to the eyelid. This will keep hair from scratching your pet's eyes. Then use a soft, wet washcloth or special eyewipes to gently clean the eye area.  If the fur around your dog's eyes is stained, don't worry – this is a natural phenomenon. But if you're bothered by the sight of it, you can look for commercial cleaners that are designed to remove tear stains.
-          Of course, we are always here to help clean your pet’s eyes. To be safe, bring your pet by for us to check out the eyes to make sure nothing is medically wrong.

Lost Pets: What do do?

First, search your property thoroughly. Cats and small dogs can get into some mighty strange places.
·         We once had a cat that got stuck in an 8" ventilation pipe for 2 days right next to the house! We searched frantically, night and day, for him all during this time. Finally we heard his pitiful, faint cries coming from the pipe and saved him! (We immediately installed a screen over the outlet so that this would never happen again.)
·         The point is, look in EVERY nook and cranny. Don't assume that your pet would never crawl into some tiny space.
·         Look behind, under, and inside washing machines, clothes dryers, stoves, refrigerators, and dish washers. Look behind water heaters, in boxes, under furniture, under beds, in closets, in cabinets, in shelves and bookcases, in drain pipes, in sewer drains, in culvert pipes, under vehicles, in crawl spaces under the house, inside sheds and barns, etc. In the case of cats, also look in attic crawl spaces, on the roof, in roof gutters, and up in the trees.

Walk the neighborhood, talk to everybody, and leave your phone number.
·         Go to each house in the area where your pet was lost and talk to the residents. Write down a description of your lost pet and your phone number and leave it with them. Leave it attached to their door if they are not home.
·         Talk to everybody you run across. This includes the postman, paperboy, children, parents waiting at the school bus stop, school crossing guards, neighborhood crime watch groups, garbage pick-up crews, etc. Give them a written description of your pet and your phone number as well.
·         Try to get all the neighborhood children involved. Kids are great at finding lost pets!
·         Ask everybody if they saw or heard anything unusual in the neighborhood and carefully write down everything they tell you. This could include strange vehicles, work crews, people, or activities. Get detailed descriptions of everything.
·         Don't travel alone. Take a friend or family member with you.
·         Don't write down your name or address. Because of scam artists and other criminals in our society, it is never a good idea to publicize this information.
·         Offer a reward, but don't state the amount.

Make some noise while you walk around the neighborhood!Animals can hear you from great distances.
·         Have all your family members call the pet's name.
·         If your pet has a favorite "squeaky toy" bring it along and use it to help you make familiar noises.
·         Use an "Acme Dog Whistle" to get your pet's attention. The high-pitched sound from these whistles can carry up to a mile or more. Cats are attracted to this sound as well as dogs. (Note: this whistle is the "silent" ultrasonic type, but has a simple adjustment that lowers the tone into the human audible range. Use this audible tone when searching for your pet because the sound will carry farther)
·         Carry a box of your pet's favorite biscuits, chews, or other treats and rattle it loudly while calling your pet's name.
·         Make any other noise that your pet is familiar with.
·         It's also important to stop regularly, be quiet, and listen for your pet to make a noise in reply.
·         The neighbors will think you're crazy, but hey, this is your pet's life we're talking about here!
Bring a powerful flashlight(even during daylight hours) for checking in dark spaces.
·         A frightened or injured cat will hide in dark spaces and will not come to you. An injured dog will also hide in dark places.
·         Use your flashlight for checking under houses and other dark spots. Also check storage sheds, garages, dumpsters, trash cans, and under cars. Don't forget to look in trees for a cat.
Place strong-scented articles outside your home to attract your pet.Animals find their way by scent as well as sound.
·         Place some of your dirty clothes outdoors. Sweaty gym socks and jogging suits are great for this!
·         Place a cat's litterbox, bedding, and favorite toys outside.
·         Place a dog’s bedding and favorite toys outside.
·         Put out some smelly food such as tuna, sardines, or warm, freshly cooked chicken, liver, or other savory meat. Be sure to protect the food if you can, so that other animals don't eat it!
·         If it's cool or warm weather (not hot or cold), crate other family pets and place them outside in a SAFE and SECURE area.

Call local veterinary offices during the day.
·         Find out if your pet was injured and taken to any of these offices or clinics for treatment.
·         If an office has taken in or treated any animal that even remotely resembles your pet, VISIT THE OFFICE IN PERSON. Your description of your pet and their description of the same pet do not always match, so you must go see for yourself.  
·         Call any rescue organizations in the area and ask for their help and find out if they have your pet.
VISIT your local Animal Shelter and County Pound including the ones in surrounding areas.
·         You must actually visit the animal control and humane shelters every day or two. It works well if several family members can take turns visiting the shelters.
·         Your description of your pet and their description rarely match. YOU MUST GO LOOK! Be sure to check all areas of the shelter, including the infirmary. Also be aware that dogs may be housed in the cat section and vice-versa.
·         Leave a picture of your pet and your phone number at each shelter. Befriend them.
·         Find out the holding period of each animal control and humane shelter. Be aware of how much time you have to claim your pet before it is euthanized!
·         Some animal control agencies keep an animal for only a few days before they either adopt it out or euthanize. Try to be there!

Find out if your pet has been killed on the road.
·         This is a very sad, but necessary task. Otherwise, you may never know what happened to your pet and it could haunt you for years.
·         The road crews for your local and state department of transportation (DOT) usually pick up dead animals from the roadside and city streets.

It is extremely important to post MANY flyers about your lost pet within a 1-mile radius of where he/she was lost.
·         Overall, flyers or posters produce more "finds" than anything else. But don't neglect the rest of the tips!
·         Your budget will determine how many flyers you can afford to post, but the more the better.
·         DO NOT PUT YOUR NAME OR ADDRESS ON YOUR FLYER!
·         If possible, it is best to place a color photo of your pet on each flyer.
·         Use 8-1/2" X 11" fluorescent paper for high visibility.
·         List the date and place your pet was lost, breed of dog or cat, sex, age, weight, color, markings, and your telephone number. Offer a reward. Some experts recommend not stating an amount; others say to offer a larger reward to increase attention.  
·         It is important to withhold several identifying marks and characteristicsof your lost pet. You may need to use these later to verify that a person has actually found your pet and is not trying to scam you.
·         Post the flyers at waist level on telephone poles and at eye level in such places as veterinary offices, pet shops, barber & beauty shops, grocery stores, community bulletin boards, churches, pizza parlors, laundromats, convenience stores, near schools, and on school bulletin boards.
·         Examine your posted flyers frequently and replace the ones that are missing or damaged.

Place an Ad in your local newspaper.
·         Be sure to advertise in the Sunday edition as well as during the week.
·         Also place an ad in any "Buy-Sell" type of publications you might have in your area.

Check the newspaper "found" ads every day.
·         Check regularly in any other local publications.

Don't ever give up!Pets have been known to find their way back home after being lost for several months. Good luck!

A Few Words of Caution

There are dangerous people in our society who prey upon victims by using "found" pets as a ploy.
·         NEVERrespond to a "found" pet contact alone. Take a friend or two along with you.
·         Arrange to meet in a public place.
·         NEVERinvite the person to your home unless you happen to know them well.
Beware of money scams.A common one is a person calls you claiming to be a long-haul trucker. He says he picked up your pet and is out of state now. He heard about your ad, flyer, etc. and says he will return your pet if you will pay to ship it home. This person does not have your pet, he is only trying to take your money.
Don't wander around looking for your pet alone,either during the day or at night. Always bring a friend or relative. This is especially important in unfamiliar neighborhoods.
Use the identifying information you have withheld about your pet.Please remember that you should never give out all of the identifying features of your lost pet. If the person who claims to have found your pet cannot describe these features to you, they do not have your pet!
 
If you live in or near Calhoun County, please join this Facebook group:

http://www.facebook.com/groups/248508395218953/

It is dedicated to bringing lost pets back to their families.  I will start posting the notifications that I receive there.  It is an open group, so anyone who finds a lost pet or loses one can post there and everyone in the group will see that post immediately.  When a pet is lost, time is of the essence, so getting the info out ASAP is a must!

When You Find Your Pet
Go around and collect up all of your old flyers.
Thank everybody who has helped you.
Letus know! We are always glad to hear about lost and found "success" stories.

How to keep your pets from getting lost.

Safeguard your pets before they are lostby following the tips below.
Pet-proof your yard fenceso your cat or dog will be safely confined. Be sure to check your fence regularly for new escape routes.
Keep fence gates securely locked.This is for the safety of both your pet and any visitors (wanted or unwanted).
Never allow your pets to roam free in the neighborhood.Leash them at all times.
Always transport a cat in a carrier.Never take your cat to the Vet or anywhere else unless it is secured. A carried cat can bolt and hide if frightened by loud noises. When a cat is frightened in strange surroundings, especially with traffic noise around, it will hide and will not come to you.
The same goes for dogs.Always leash them when taking them anywhere. If a dog gets loose in an unfamiliar area its chances of ever finding its way home are practically nil.
Get some good photos of your pet now.
·         Take close-up shots so that details show up well.
·         Keep taking shots until you get a few good ones that really look like your pet. Most snapshots of pets look like any other cat or dog. You want your photos to be unique and your pet to be unmistakable.
·         These photos will be invaluable to you later if your pet is ever lost.
Train your pet (cat or dog) to associate an "Acme Dog Whistle" with pleasant things.Blow the whistle each time just before you feed them. They will then be more likely to come running to you when you use the whistle to find them when they are lost.
Ensure that YOU can be located if your pet is found.
·         Always keep a collar on your pet with a tag that has your CURRENT PHONE NUMBER on it.
·         Always have a CURRENT rabies tag and pet license tag attached to your pet's collar. You can be found by the number on the tags.
·         A collar and phone tag are the most important form of IDyou can have for your pet. However, pets can lose their collars on the streets. For real security, a backup is needed (see the next two items).
·         Talk to your vet about a microchip implant.A chip provides positive and reliable identification for your pet and all modern shelters scan animals for this ID device. Find out which brand of chip is prevalent in your area and go with that one. If you have a choice, we like the HomeAgainTM microchips.
The HomeAgainTM microchip is distributed by Schering-Plough Animal Health. The American Kennel Club maintains a nationwide database of these microchip numbers. The chip is constructed in a way that tends to prevent migration from the injection site. Call (800)234-6373 to find a Vet near you who offers this product.
·         Also ask your vet about pet tattoos.We don't like tattoos as well as we do microchips, but they also provide positive identification if done correctly. A tattoo is often very difficult to read because hair has grown over it and/or the lost animal is frightened and will not allow inspection. If you do use a tattoo, we feel that the best place to apply it is on the inner thigh. Pet thieves have been known to cut off a tattooed ear!
More about rabies tags.
·         It is absolutely vital that your pet have a CURRENT rabies tag on it at all times!
And finally, spay or neuter your pets!
·         Both males and females will be much less likely to wander if they are "fixed."
·         An added benefit is that they will live a longer, happier, healthier life if they are spayed or neutered.
 
Medical Questions/Concerns

Benadryl
-          Yes. Benadryl (Diphenhydramine Hydrochloride) is a commonly used drug in human medicine. It can also be used for allergic reactions in pets. As with any pet-specific information, the only correct answer is to check with our veterinarian before dosing your pet.

Diarrhea
-          If your dog is acting normally other than the diarrhea, then you can try withholding all food and water for 12 hours. After that time period, you can introduce small amounts of food at a time. However, if your dog is lethargic in any way, you should call a veterinarian for instructions.
-           
Dog LIcking
-          A dog that licks his feet, rubs his face, or scratches behind his elbows may be showing signs of an allergy. Dogs can be allergic to all sorts of things such as house dust, grass or weeds, food, or fleas. Call our veterinary office to schedule an appointment to consult with the doctor about this, especially if your dog is showing any hair loss.
 Dog Scooting
-          He may have intestinal parasites but that may not be why he is "scooting.” It is usually an indication that his anal glands are full and need attention by a veterinarian. Anal glands are small glands on either side of the rectum. They contain a fishy smelling substance and before domestication dogs and cats used them to mark their territory. Pets no longer have active control of these glands and therefore they can become full and need emptying. Cats will generally lick their rectal area excessively if their anal sacs are full.
 
Eating Grass
-          This is an age-old question. There are many possibilities: they like the taste of grass (especially the
soft new grass of spring), they are hungry, perhaps not feeling well, and eating something to see if
that helps (kind of like humans do sometimes!).
 
 Most dogs do best with 2 or more small feedings a day rather than one large feeding. A commercial
diet or well-prepared home diet should not be lacking in essential nutrients. If they have an empty
stomach, bile can reflux (flow back up in to the stomach from the intestine) and this is irritating.
This can cause vomiting of clear, yellow fluid.

Heat Cycles
-          If your female cat does not mate, she will go into estrus or heat, as often as every two to three weeks, for several months each year, until she either mates or is spayed. Cats as young as 4-6 months old can go into the heat cycle and they should be spayed as soon as possible unless they are pedigreed and you wish to breed from them. The cycle is extremely uncomfortable for her, even if it does not inconvenience you. Your cat will be in heat for one or two days, but won't really come all the way out of it until you have her spayed.
 
-          Non-spayed female dogs will go into "heat" or estrus usually twice a year. The age at which they start their cycles, usually about 6 months of age, and the duration, 4-21 days, of the cycle varies between the breeds of dogs and individual dogs.  For dogs that will be pets, it is recommended to spay them before the first heat, eliminating the risk of accidental pregnancy and reproductive diseases later on in life. Dogs may be spayed while in heat (or pregnant), but there is additional risk due to the engorged vessels and tissue of the reproductive tract -- a higher chance of bleeding during surgery or other complications. The cost of surgery while in heat or pregnant is higher as well.

Hit by Car
-          NO! Many times dogs hide a concussion which can be life threatening if not treated immediately. Also, dogs and cats can suffer from a condition called "traumatic lung syndrome,” a condition in which the lungs can become full of fluid after a sudden blow. It is best to contact a veterinarian anytime your pet has been in an accident with a car.

Litter Box Problems
-          Cats are very prone to a condition called “feline lower urinary tract syndrome." Basically, it is a urinary bladder infection or inflammation which can lead to urinary tract obstruction in male cats. This is a serious condition and you should contact the veterinarian office immediately if your cat is showing this type of behavior.

Seizures
-          Dogs and cats can have seizures or convulsions, just like people.  Seizures in pets can be caused by a number of different conditions.  An important thing to remember if your pet has a seizure is not to panic.  Your pet is unconscious and not in any pain.  (People that have seizures describe feeling dazed, tired, or confused after having a seizure, but that the seizure itself is not painful.) Make sure that your pet is on the floor on a soft surface so that it can't injure itself by falling off furniture or down a flight of stairs.  Do not try to open your pet's mouth or put your fingers in it.  It is not possible for your pet to "swallow its tongue."  During a seizure, you may see muscle spasms, and your pet may "paddle" their legs or extend them in a rigid fashion.  Many pets lose control of their bladder or bowel. 
-          If you have never seen a seizure before, you may think it is going on and on, but in reality most seizures last for less than a minute.  However, if the seizure does in fact not stop within a minute or two (check your watch!), or if several seizures occur within a few minutes of each other, the situation is an emergency.  In this case, you should get your pet to our veterinary hospital immediately.

Tylenol/Over-the-counter Meds
-         No!  Acetaminophen (Tylenol) is quite toxic to cats and ibuprofen (Advil, Motrin IB) is toxic to both cats and dogs, even in small doses. Pepto Bismol is toxic to cats. In general, it's never a good idea to just assume a human medication will be a safe and effective treatment for your pet. ALWAYS contact our veterinary technicians or veterinarians to discuss your options before starting any medical therapy.

 
NUTRITION

How much food should I feed my pet?
-          Choose a high-quality food and look at the recommendations on the label. Our Client Services Staff will
be glad to assist you with purchasing the proper food for your pet.
-          Remember, these feeding recommendations are simply guidelines, not absolutes. There is often a
wide range listed and there is little consistency in feeding guidelines between brands. You must
consider the following, and adjust the food amount accordingly: -          After you have started feeding your pet an appropriate amount of food, weigh your pet at least once a month to determine if you (and your pet) are on the right track. If necessary, increase or decrease the amount of food slightly until the pet stays at his ideal weight. You can easily weigh your small dog or cat on your bathroom scale - simply weigh yourself while you hold your pet, then weigh yourself without your pet and subtract the difference. Larger dogs can be weighed at our veterinary office. Remember, most pets are overfed and under-exercised - so, if in doubt about how much to feed initially, feed a little less.

ONLINE PET PHARMACIES

You’ve seen TV advertisements for internet pet pharmacies – they promote the convenience of home shopping with the benefit of big savings, but are they a wise option for you and your pet?

While most online pharmacies are trustworthy, some have questionable ethics and even some of the top pharmacies have been fined in several states. You are always welcome to call our office to discuss any questions you may have with veterinary online pharmacies.

Please review our requirements for working with am internet pharmacy along with the important benefits our pharmacy offers to you and your pet.
 
REQUIREMENTS: See next section

Keeping your pet healthy and happy is important. From routine to advanced optimal care, our veterinary practice is proud to offer the very best in veterinary medicine.

Can I have my pets prescription filled at an internet pharmacy?
-          Our clients always have the option of having a prescription filled at an internet pharmacy. However, because some internet pharmacies have dubious business practices, we will need a direct request from you with the prescription drugs you wish to have filled. In order to process a prescription the law requires that a veterinarian must have seen your pet within the past year. Depending on the patient’s medical condition and medication prescribed, this timeframe may be shorter.


-          Internet pharmacies will ask you to give them our contact information. They will call us or fax the request to us for approval. We will not approve any internet pharmacy requests. We only approve requests made directly by you, the client. This process is a little more involved than the TV advertisements would have you believe, but there are other important reasons why we feel an internet pharmacy is not always the best choice for our clients and patients.


-          If you need a prescription refilled at any time, a phone call to our office will have it ready for you to pickup within a short timeframe, or if you prefer we can drop your prescription in the mail.
Our pharmacy is a vital and integral part of our practice. It provides our clients and their pets with the latest technology, convenience, and the right medications – all at a competitive price.
 
Why does Animal Medical Center discourage online pet pharmacy interaction?
-          PRICE:Internet pharmacies are not always the cheapest source for medication. Our price for most items is typically less than most internet pharmacies would charge. In addition, some medications are temperature sensitive and require next day or 2nd day air delivery, which adds to the cost. Prescriptions sometimes need a signature on delivery, so you need to be home to receive the shipment.

GUARANTEE: Pharmaceutical manufacturers will only honor product guarantees when the medications are prescribed by and purchased from the pet’s veterinarian. Internet and mail-order catalogs do not qualify for these guarantees.

SAFETY: Any prescription medication purchased from our hospital has been inspected and approved by the FDA, and manufactured and packaged according to U.S. government regulations. Medications purchased online may have been purchased outside the United States and have different strengths and labeling than U.S. products. Sometimes you can tell by checking the label. If approved by the FDA, it should say, "Caution: Federal law restricts this drug to be used by or on the order of a licensed veterinarian.” Do not use products that do not have this warning or if the label has been removed.

REBATES: Our veterinary practice also passes on manufacturers’ promotions and/or rebates and these frequently result in greater savings. These rebates are not usually available from online stores or catalogs.

CONVENIENCE: Using an Internet pharmacy means a delay in getting your medication. It typically takes 1-2 days for the online pharmacy to contact us and process the prescription, then there’s a 2-5 day shipping time.

INSURANCE: Pet Insurance companies require that all prescriptions be FDA approved. If you have pet health insurance you may be reimbursed on medications when purchased from a legal online pharmacy. You will be required to provide a copy of your veterinarian’s prescription order and a copy of the Internet pharmacy’s invoice. When you purchase a prescription from our hospital there is no additional paperwork. Your hospital office call along with any prescription is all itemized on one invoice for easy submission to your insurance company.

EDUCATION: Every week representatives from companies like Bayer, Pfizer, Novartis, Merial, and others visit our office. These representatives have access to the latest data and research, and are a valuable source of up-to-the-minute information. In addition, our staff regularly attends veterinary conferences and reads the latest veterinary medical journals and research papers. We stay up-to-date on the latest disease trends in our region and stay abreast of recent advances in veterinary medicine. However, our first source of information about products and treatment protocols are the pharmaceutical representatives. Because we offer a full-service dispensing pharmacy on site, these folks make a point of visiting our hospital frequently.

 ORPHANED ANIMAL CARE
 
Baby Birds
 
-          Cardinals

The male cardinal is the only all red bird in North America with a crest. He has a black face patch at the base of the thick red bill. The female is yellowish-brown with reddish wings and crest. Adult cardinals are 7 ½ to 9 inches long with a wing spread of 10 to 12 inches and weigh an average of 43.75 grams. The adult cardinal’s metabolism functions best between 66º and 88ºF.

These birds reside in woodlands, thickets, parks and gardens and are known to live as long as 1-13 years in the wild. They are non-migratory and seldom travel more than a few miles from their breeding territory. Cardinals nest from March through August laying 2 to 5, 25 x 18 mm, pale green with reddish-speckled eggs in a bowl-shaped nest in trees, thickets or vines 4 to 5 feet above the ground. A pair may raise 2, 3, or even 4 broods in a season with the male feeding hatchlings as the female builds a new nest to incubate successive broods. Male cardinals have been observed feeding females prior to breeding perhaps aiding in building the strong bonds required for such intense breeding practices. Incubation requires 12 to 13 days with the young leaving the nest when 10 to 11 days old.

Description of hatchlings: Brownish-gray down; red mouth with cream-colored gape flanges; “bug” eyes.

Development: Eyes are open within a week. The young are feathered and hopping out of the nest by 10 days. They fly well by 2 to 3 weeks, even before fully feathered.

Natural diet: Eat at least 51 kinds of insects, 33 kinds of wild fruit and 39 varieties of weed seed.

Substitute diet:

Nestling: Small mealworms drowned in vitamin/mineral solution such as ¼ tsp. Plex-Sol C, 1 tbsp. Avimin, 8 oz. Water, and well-soaked Purina HiPro dog meal.

Fledgling: mealworms, insects, grains, fruit, seeds supplemented with greens and fruit.

Caging:

Nestling: berry basket lined with unscented facial tissue; external heat at 85º F.

Fledgling: 2’x2’x2’ cage minimum; move to a walk-in aviary (6’x6’x4’) when beginning to self feed until release.

Feeding: Nestling cardinals will readily open their mouths, but are unable to easily eat a whole piece of soaked Hi Pro. Pieces should be broken into smaller bites for feeding. These birds will eat an amazing amount of food for their size and although their crop will be bulging after feeding, it will be emptied in a 30-minute interval. They should be fed every 30 minutes during daylight hours a diet of 50% mealworms and 50% HiPro. Feed killed mealworms head first. Be sure to offer drops of distilled water at each feeding. Place the drops of water on the side of the bird’s beak, never directly into its throat.

Add greens to the diet when the cardinal begins to fledge. Chop fresh alfalfa sprouts and greens for each feeding. Cardinals are suspicious of long sprouts protruding from feeding tweezers, and are more likely to accept a few bites of greens which have been cut into smaller portions.

After moving fledglings to their larger caging, begin to leave a fresh variety of seeds (millet, oats, shelled sunflower seeds, etc.), greens (sprouts, lettuce) and fruit (apples, peaches, strawberries, figs, grapes, etc.) cut into small pieces in their cage. A shallow tray of water and a container of bird grit should be provided. Attach a cuttlebone to the side of the cage. Hand feeding of mealworms and Hi Pro may now be extended to one hour intervals, but do not assume that they are eating and drinking on their own. Continue to offer water at each feeding; cardinals become demanding for their water supplement.

When the cardinal begins to self-feed, hand feeding may be extended to two-hour intervals to encourage self-feeding. Live mealworms and pieces of soaked HiPro should now be added to their cage feeders as well as unshelled sunflower seeds. Discontinue hand feeding when the birds are readily eating a variety of foods on their own.

Release: Ready to release at 6 to 7 weeks old. They should be totally self-feeding, able to fly well and be unfriendly towards humans. These birds may be released at any time of year when the weather is satisfactory and where other cardinals are known to reside.

Back-up Feeding: Cardinals require back-up sources of seeds and will readily visit a feeder. Soaked Hi Pro may also be offered. Fresh water should be constantly available.


-          CHICKADEES:

Raise like wrens until self-feeding, then add greens and seeds to diet.


-          CHIMNEY SWIFTS:

The chimney swift is one of four regularly occurring species of swifts found in North America, and the most common one east of the Rocky Mountains. As their name implies, they are accustomed to building their nests in chimneys as well as old buildings and occasionally stone wells. Because of their close association with man, the adults and their young are frequent candidates for rehabilitation.

Adult chimney swifts are most commonly seen in flight. When soaring, their long, scythe-shaped wings span about 12 ½ “ to support a proportionately short body with a squared-off tail. The flickering, bat-like flight when flapping is due to short, massive wing-bones. Usually seen in groups, chimney swifts’ flight is accompanied by a sharp “chippering” or “ticking” call.

At rest, an average 5”, 22.8 gram adult is sooty gray to black with the throat slightly lighter in color. Both sexes are identical in appearance. The long wings cross by an inch or more over the tail feathers which are tipped by pointed bristles. All four toes on the small feet point forward and have sharp, curved claws. Both the claws and tail bristles are useful in clinging to rough, vertical surfaces. Swifts are unable to perch.

Chimney swifts winter in the Amazon Basin of Peru. They appear in March and are gone by late October. Nesting begins in May and has been known to continue into August. The female normally lays 4 to 5 (rarely 2 to 7) white eggs in a nest of twigs glued together with saliva and attached to a vertical surface. Because the nest is unlined, the eggs must be constantly incubated by alternating adults. After 18 to 19 days, the eggs begin to hatch.

Description of hatchlings: Naked at birth; sharp claws able to cling to textured surfaces; loud chattering when stimulated.

Development: Within a few days black pin feathers begin to appear; able to climb; begin to preen, even with no feathers.

8 to 10 days – feathers begin to unfurl

12 to 14 days – eyes open

3 weeks – fully feathered and “practice flapping”

4 weeks – flying

Nestling housing: Tall basket lined with cloth such as muslin. Unscented facial tissue in the bottom facilitates cleaning. External heat (85ºF.) with high humidity (60-70%) until feathered. Preferably a “hospital box” or incubator/brooder with automatic thermostat and indirect or filtered sunlight.

Natural diet: Flying insects and spiders

Substitute diet: Small mealworms drowned in a small amount of:

1 tbsp. Avimin liquid mineral supplement

¼ tsp. Plex-Sol C powdered vitamin supplement

8 oz. Distilled water


-          Soaked Purina HiPro dog meal dipped in a mixture of equal parts of full-strength Nutrical and plain, active-culture yogurt. The worms of HiPro should have a light sprinkling of Plus Yeast (brand) protein powder for essential amino-acids.

Feeding: Chimney swifts’ feeding responses can be triggered by tapping the basket, tapping their beaks or by a gust of wind (parent’s wings). They respond by bobbing their heads up and down, chattering loudly and gulping at anything close by. With a little practice, they can be taught to feed from above with a pair of tweezers. Each gapping bird should be given a small piece of Hi Pro (prepared as described in “Substitute Diet”) and as many mealworms as it desires every 30 minutes, 12 to 13 hours per day until its eyes are open; every hour until fully feathered; and every 2 hours until released. Because swifts feed on the wing and are unable to perch, they will never learn to self-feed in captivity.

One or two drops of distilled water from a curved irrigating syringe should follow each feeding. Place the drops on the beak: never put water into a bird’s throat. Chimney swifts become fond of these droplets, and may begin biting them from the tip of the syringe.

Caution: A swift’s nostrils are very far forward. Be careful not to get food in them. It will harden and be difficult to remove. Always clean the bird’s face with a damp tissue after each feeding.

Fledgling housing: Fledgling swifts require a large area for practice flying – at least 10’ x 15’ x 8’ tall. The larger the better. Any windows should be covered to prevent the birds from flying into them and becoming injured. Some textured substance should be provided on at least two opposite walls for the swifts to cling to. Fledglings must have access to this area during all daylight hours from the time they begin to fly until released.

Release: After a week of practice flying, and when the bird’s wings cross by an inch or more. Release should be considered. Chimney swifts are migratory and very communal. Always release them at least two weeks prior to normal migration time, and always into a known population.

Early on a calm morning, locate a group of chimney swifts and toss the bird skyward as they fly overhead. Usually if the new bird strays, some of the others will swoop down and show it the way.

Another method for release is to place the bird above the damper inside a chimney where other swifts are living. If all goes well, the bird will climb up to the others and join their colony. Check the chimney periodically to make sure the bird has not fallen back down or gotten into a bind.

Back-up feeding is not possible. However, if released where they are raised, some swifts do return for a few days.

Special Problems: If aspiration does occur when giving a bird water from a syringe or eye dropper, using distilled water will minimize the chance of causing pneumonia. Distilled water has no suspended particles to irritate the lungs.

Unlined baskets have caused problems of injured feet and broken primary feathers. These accidents can be avoided by lining the basket with a snag-free material such as muslin. An empty mealworm bag suits quite well.

Young swifts which are not given yogurt will not be able to properly digest their food, and may develop problems such as excess mucus in the mouth, off-color droppings, poor featherings and even death.

Injuries: Baby swifts are subject to several injuries simply because of the location of their nests. The sounds they make when begging for food are often mistaken for those of bats. Fires intended to drive them off cause poisoning from toxic fumes and burns. Internal injuries can sometimes be treated with an oral antibiotic such as Hetacin-K or Polyotic. Burns should be cleaned and treated with a topical antibiotic such as Furacin or Neosporin. Sometimes claws are ripped out when the youngsters are pulled from a chimney. An ointment such as Panalog will reduce swelling and stop infection. Be sure to consult us before using any drug.

Injured adults must be force-fed about six drowned mealworms and a small piece of soak-          soaked HiPro every two hours during daylight. They also need the water supplement. While vitamin and mineral supplements are not as essential as in growing birds, Nutrical, yogurt and amino-acids should be given at least once each day. Until able to fly, the bird should be confined to a small cage with a rough log or brick for it to cling to. Because swifts lie flat, care must be taken to keep the vent clean and open. Practice flying in a large room is necessary before release.

Some chimney cleaning companies openly advertise bird removal, and will illegally remove nests and baby swifts from chimneys for a fee. This activity should be reported to the State of Alabama Department of Conservation.


-          CLIFF SWALLOWS:

Description: Light gray down, yellow mouth, flat head, short legs

Housing: Nestlings need a cup-type nest with artificial heat necessary until feathered.

Natural diet: Flying insects.

Substitute diet: Small, drowned mealworms or other soft insects; Purina HiPro dog meal.

Feeding: Cliff swallows open their mouths readily when hungry and may even learn to peck at live food. They should be fed 5-8 bites per feeding, every 1-2 hours. They must learn to feed on the wing prior to release. Once they recognize the food, they will fly down and take it from your hand or from tweezers.

Development: Feathered at approximately 10 days; begin to fly at approximately 3 weeks. Once flying, they should be urged to take food in flight.

Release: At 5-6 weeks, after the bird is used to taking food in flight. They are migratory, leaving in mid-September and returning in March. Cliff swallows nest in colonies. Look for mud nests attached to the underside of bridges or eaves or in rocky cliffs. Always release young cliff swallows in a nesting colony.

Back-up feeding: Not possible


-          COWBIRDS:

Raise like cardinals


-          CUCKOOS(Yellow-billed):

Raise like a mockingbird, without fruit. Natural diet consists mainly of black hairy caterpillars. They are migratory, leaving by mid-October and returning in early April.


Abandoned Puppies/Kittens
 
Keep the babies together as long as they are about the same age; this will help socialize them to their own species and will help in keeping them warm. Try to assemble the following equipment:


-          The Nest Box
  1. The nest box in which the babies live should have tall sides so that they cannot climb out by mistake and become chilled. A cardboard pet carrier is perfect as it is portable, dark inside, and closable. These are inexpensive and should be available from a pet store or from Animal Medical Center.
     
  2. Place towels in the bottom of the box and cover them with a diaper so the babies rest directly on the diaper. Most diapers have elastic leg holes and may have to be trimmed so they will lie flat. Expect to change the diaper several times daily. Keeping the babies clean and dry is very important.
     
  3. Place a heating pad under the nest box so that only half of the nest box is warmed. This way the babies may crawl off the warm side of the box if they feel too hot. Alternatively, a water bottle filled with warm water can be buried in the blankets as a heat source as long as the babies have room to move away from it if they are too hot.
If the baby's temperature drops below 94F degrees, the heart rate drops and intestinal motion ceases. Death occurs if this is not corrected. Warming should take place over an hour or two to avoid shock.


-          The Diet
  1. Pet Ag manufactures KMR (Kitten Milk Replacer). It comes in a powder and a liquid. The powdered form seems less associated with diarrhea than the liquid; plus, with the powdered form, the water content can be adjusted in the event of dehydration.
For puppies, Pet Ag makes ESBILAC. Again, both powder and liquid forms are available.
  1. Mix up the powder according to the directions on the can. If you are using the liquid form, you may want to dilute it with one part water for every two parts of formula. As the babies get older, less water may be used whether you are mixing up the powder or the liquid. If diarrhea occurs at any time, you should add more water to the formula to make up for fluid lost as diarrhea.
     
  2.  Store the can of powder in the freezer after opening. Do not mix up more than a day's worth of formula. Use a blender to mix the formula several hours ahead to allow time for the bubbles to settle.
 
MAKESHIFT FORMULA UNTIL KMR/ESBILAC CAN BE OBTAINED

PUPPIES
1 cup whole milk
1 tsp. salad oil
1 drop multi-vitamins (if you have any)
2 egg yolks

KITTENS
1/2 cup whole milk
1 egg yolk
1 drop multi-vitamins
3 Tums (antacid) crushed

Mix in a blender.


-          The Bottle
  1. Obtain a pet nurser bottle from a pet store or Animal Medical Center.
     
  2. Use very fine scissors or a hot needle to make a hole in the nipple. The hole should be big enough that formula will slowly drip out if the bottle is held upside-down and gently squeezed. The nipple should not collapse when the baby is sucking.
     
  3. Warm the bottle in a cup of hot water. Always test the formula before giving it to the babies. Taste it to be sure it is not sour. Do not use a microwave oven to heat the bottle as it may not heat evenly with some areas of the bottle being scalding hot.
-          How/When to Feed
  1. Expect to feed them every 2 to 3 hours during the day. If this is done, the babies should be able to sleep through the night.
  2. Do not wake the babies at feeding time. Let them sleep. When they wake up hungry, they will let you know.
  3. During feeding be sure to tip the bottle so that no air is swallowed.
  4. Play with/rub them after feeding to "burp" them.
  5. Occasionally small amounts of formula will come out of the nose. The baby is drinking too fast. If excessive amounts of formula appear to be coming out the nose or if you are concerned, call your veterinarian.
  6. Maintaining proper weight gain is crucial to survival. Kittens with birth weights of less than 3.2 oz (90 grams) have a 59% mortality rate (though a less than 10% weight loss in the first 24 hours of life is considered normal). After the first 24 hours, weight gain should be steady: 0.25 to 0.35 oz per day for kittens and 5% to 10% of the birth weight daily for puppies. An accurate postal or kitchen scale is helpful during this early period to be sure the baby is on a healthy track. If the baby is not gaining weight as desired, try to adjust food intake
    .
 
-          Urination/Defecation
  1. Infant animals are unable to take care of these matters alone and must be given help. Normally their mother's tongue does the job as she washes them. Use a cotton swab, tissue, or your finger to gently rub the baby's genital area. Have a tissue ready to catch the urine.
  2. Rubbing the anal area as well may also be necessary if the babies do not seem to be defecating as much as expected. Watch for diarrhea. Normal infant stool is normally very loose but should not be watery.
-          Bathing
  1. Using baby shampoo and warm water, bathe the babies a couple of times daily. Urine will burn their tender skin and caked feces can lead to infection so keeping the babies clean is very important.
  2. Take care not to submerge the infant in water. Be careful that it cannot drown or choke on the water and be sure the water temperature is acceptable.
  3. Gently blow dry the babies when the bath is over. Do not allow chilling.
-          How to be Sure You are on Track

The best way to be sure everything is going well is to track weight gain in your new babies. A postal scale or food scale (ideally one that measures weight in grams) will be helpful. A puppy or kitten should gain 10% of the birth weight every day and should be drinking 22 to 26 cc of formula per 100 grams of body weight over the course of the day. Puppies are variable in growth expectancy depending on breed but kittens are more predictable and should gain 50 to 100 grams weekly.

Kittens weighing less than 90 grams (approx 3 oz) at birth have a very high mortality rate.


-          Starting Solid Food
  1. When the babies start biting and chewing at their bottle instead of sucking (3-4 weeks of age), they may be started on some finely textured canned food. At first it may be necessary to mix solid food with a little formula and /or smear a little around their mouths gently with a finger.**Friskies canned Kitten Meals for kittens **Chicken or turkey baby food for puppies
  2. Between ages 4 and 6 weeks, they should begin readily accepting solid food. New homes may be found for them at age 8 weeks. Be aware that in many states it is not legal to transfer ownership of a puppy or kitten until this age anyway.
NOTE
Colostrum is the first milk produced by the mother shortly after giving birth. It is rich in antibodies which will protect the babies for the first several months of life.

Without colostrum (if their mother did not nurse the kittens during the first 2 days of life) the babies are virtually without an immune system. Especially great care should be taken in cleanliness and the babies should be vaccinated at 2 weeks of age. They may require a plasma transfusion to make up for the colostrum. There is no substitute for a real mother.

For more information on raising orphan kittens see: http://www.hdw-inc.com/tinykitten.htm
 
Parasites
What is a parasite?
 
-          A parasite is an organism that lives at the expense of another living being. In our pets, these usually take the form of intestinal worms (internal parasites) and fleas and ticks (external parasites).

Fleas
How do I control fleas on my pet?
 
-          With the advancement of flea control like Advantage, Advantix, Frontline, and Comfortis fleas are no longer the nuisance they once were for you and your pet. Advantage, Advantix, and Frontline are a liquid applied down the pet’s back which kills all fleas and continues killing them for 1 full month. Comfortis is a pill that is given by mouth every month with a meal. Both products are SAFE for your pets. Do NOT confuse these products with others you find in the pet stores. Those products are insecticides which can potentially harm your pet.
 
Are flea collars very effective?
-          Not really. Since they are placed around the neck of the pet, they usually cannot kill any fleas which are around the tail of your pet. The insecticide from flea collars is designed to be absorbed into the pet’s blood stream and can be toxic. There are much better forms of flea control. Call us for more information.


 
Heartworms
 
What are Heartworms and how can I prevent my dog/cat from getting them?
 
-          Heartworms are parasites that actually live in the dog's heart. There is a blood test available to test for heartworm. Heartworms are transmitted by mosquitoes, so dogs and cats both are susceptible to this parasite. There is a once a month tablet (for dogs) and a once a month topical (for cats--Revolution) that is used for prevention.  
 
Lice
I think my dog has lice. What can I do?
 
-          Lice are small grayish parasites that attach themselves right to the skin and tend to be on the front end of the dog. Advantage, Advantix, and Frontline do kill lice as well, but we recommend repeating the treatment every 2 weeks instead of every month. Lice are very species specific and cannot be transferred to you.
 
Ticks
How do I prevent my dog from getting ticks?
 
-          Preventic Tick Collars and Frontline or Advantix Liquids are available for tick prevention on dogs. (Frontline can be used on cats). You should know that ticks carry a vast array of diseases including Lymes Disease. There is a vaccination for dogs against Lymes Disease but the best protection is prevention with the above products.
 
Worms
How can I tell if my dog or cat has worms?
-          Certain parasites, such as tapeworms, are visible to the naked eye, but others must be detected under the microscope. If you will bring in a stool sample we will be glad to examine it microscopically to see if your pet has worms.  But remember that all pets must have an annual exam to be receive a prescription medication.
 
I saw small worms caught in the hair on my pet’s hind legs and tail. What are they?
 
-          Small white worms about the size of a grain of rice in length are tapeworm segments. They come from swallowing fleas or from eating mice. There are tablets you can purchase from your veterinarian to eradicate tapeworms.(All pets must have an annual exam – by an Animal Medical Center veterinarian, before a prescription medication is administered). There are NO products in the pet stores or grocery stores to kill tapeworms. Also, in order to keep them away, you should practice good flea control.

Pets, Worms, and Children
-          Dogs and cats are born with worms contracted in the mother’s uterus and should first be dewormed at 3 weeks of age. Puppies and kittens also are infected from their mother’s milk and need to be dewormed after they are weaned. Kittens and pups should be dewormed at least four times between 7-16 weeks of age and then rechecked at 6 months and 1 year of age.
 
-          This intestinal parasite control program is the one recommended by the Centers for Disease Control and Prevention (CDC) due to the incidence of hookworm and roundworm infections in humans. Under normal situations, it is rare for children to become infected with worms from animals. However, we strongly recommend good sanitation and parasite control to keep you family’s risk at a minimum.

What To Do If Your Pet Is Poisoned?
-          Don’t panic. Rapid response is important, but panicking can interfere with the process of helping your pet.
-          Take 30 to 60 seconds to safely collect and have at hand any material involved. This will be of great benefit to our veterinarians, as they determine what poison or poisons are involved. In the event that you need to take your pet to a veterinarian, be sure to take the product’s container with you. Also, collect in a sealable plastic bag any material your pet may have vomited or chewed.
-          If you witness your pet consuming material that you suspect might be toxic, do not hesitate to seek emergency assistance, even if you do not notice any adverse effects. Sometimes, even if poisoned, an animal may appear normal for several hours or for days after the incident.

-          Call Animal Medical Center in the event of an emergency.  The telephone number is (256) 236- 8387
-          Be ready with the following information:

·  The species, breed, age, sex, weight and number of animals involved.
·  The animal’s symptoms.
·  Information regarding the exposure, including the agent (if known), the amount of the agent involved and the time elapsed since the time of exposure.
·  Have the product container/packaging available for reference.
·  Please note: If your animal is having seizures, losing consciousness, is unconscious or is having difficulty breathing, telephone ahead and bring your pet immediately to the our office.
Be Prepared
-          Keep the telephone number of Animal Medical Center somewhere you can reference it quickly—(256) 236-8387—Stop by the office and pick up one of our complimentary refrigerator magnets.
-          Invest in an emergency first-aid kit for your pet. The kit should contain:
·  A fresh bottle of hydrogen peroxide, 3 percent USP (to induce vomiting)
·  A turkey baster, bulb syringe or large medicine syringe (to administer peroxide)
·  Saline eye solution
·  Artificial tear gel (to lubricate eyes after flushing)
·  Mild grease-cutting dishwashing liquid (for bathing an animal after skin contamination)
·  Forceps (to remove stingers)
·  A muzzle (to protect against fear- or excitement-induced biting)
·  A can of your pet’s favorite wet food
·  A  pet carrier
·  Always consult a veterinarian for directions on how and when to use any emergency first-aid item.

ASPCA Poison Control:  888-426-4435
Open 24 hours a day, 365 days a year.
Please be advised, they may charge your credit card a $65 consulation fee.
 
 
Puppy and Kitten Care
Bringing home a new puppy or kitten is such a joy! Give your new pet a great start by making an appointment with us within the first few days. Together, we will develop a healthy plan for your new youngster, providing the best possible care at every stage of your new pet’s life.

Eating Right
-          High quality puppy or kitten food is necessary for the healthy growth and development of your new pet. Always offer fresh water and never give your young pet table food. Baby animals have sensitive digestive systems that need to be protected. Avoiding table food from the start helps prevent obesity and finicky eaters. Consult one of our veterinarians regarding high quality pet foods and treats and an appropriate diet plan for your new pet.

Baby-Proof Your Home
-          Most young animals love to chew, so eliminate any hazards from their space and provide them with appropriate chew toys. If your young pet is to be left alone for periods of time, find a clean, dry space that is safe—most puppies do well in gated areas or crates, while kittens may need to be closed into a room or rooms that have been made safe for them. Remove any accessible houseplants or chemicals from this area to avoid accidental poisoning and provide a warm, dry bed.

A Social Life
-          Remember that your puppy or kitten is a baby. Leaving them alone for long periods of time fails to socialize them, so make sure that your baby has company—lots of it! You can never over-expose puppies or kittens to other animals and people. Socializing is critical to avoiding a very shy or fearful pet that may exhibit behavior problems. We do offer resources for training your new pet.

Pet Vaccinations, Medical Care, and Spay-Neuter
-          We recommend all puppies and kittens not intended for breeding be spayed or neutered at 6 months. This results in a healthier pet that will generally live longer and be a happier companion in your home. We have provided a general schedule for basic puppy or kitten care below. Bring your questions and concerns, along with a stool sample, to your first visit. We look forward to meeting the newest member of your family!

Kitten Schedule
7 Weeks
  • Feline Viral Rhinotracheitis/Calicivirus/Panleukopenia (FVRCP #1)
  • Stool exam/deworming
  • Feline leukemia testing at first visit
  • Begin heartworm and flea prevention
10 Weeks
  • Feline Viral Rhinotracheitis/Calicivirus/Panleukopenia (FVRCP #2)
  • Feline leukemia vaccine #1
  • Stool exam/deworming
13 Weeks
  • Feline Viral Rhinotracheitis/Calicivirus/Panleukopenia (FVRCP #3)
  • Feline leukemia vaccine #2
  • Stool exam/deworming
16 Weeks
  • Feline Viral Rhinotracheitis/Calicivirus/Panleukopenia (FVRCP#4)
  • Rabies
  • Stool exam/deworming
6 Months
  • Stool exam/deworming (if needed)
  • Spay or neuter
Puppy Schedule
7 Weeks
  • Distemper/Hepatitis/Parainfluenza/Parvo virus (DHPP #1)
  • Bordetella vaccine #1
  • Stool exam/deworming
  • Begin heartworm and flea prevention
10 Weeks
  • Distemper/Hepatitis/Parainfluenza/Parvo virus (DHPP #2)
  • Bordetella vaccine #2
  • Stool exam/dewormng
13 Weeks
  • Distemper/Hepatitis/Parainfluenza/Parvo virus (DHPP #3)
  • Stool exam/deworming
16 Weeks
  • Distemper/Hepatitis/Parainfluenza/Parvo virus (DHPP #4)
  • Rabies
  • Stool exam/deworming
6 Months
  • Stool exam/deworming (if needed)
  • Bordetella vaccine #3
  • Spay or neuter

Rabbits - Care of Orphaned Bunnies
Trying to raise orphaned wild rabbit species such as cottontails, hares, etc., is rarely a rewarding venture. Bunnies are often orphaned when people unknowingly disrupt a nest. Lactating does (females) nurse their young for only 3-5 minutes in the early morning hours of each day, giving the uninformed observer the impression that the new mother is neglecting her litter or that she has abandoned it all together. This is how people mistakenly make orphans out of bunnies that are, in fact, being well and properly cared for by their mothers. Causes for abandonment of the nest include agalactia (doe with no milk), mastitis (doe with infection of the mammary glands), hypothermia (chilling) of the young, and physical disturbance of the nest itself.
 
Whenever possible, orphaned bunnies should be placed with a doe nursing her own litter. Success is most likely if the orphans are less than 2 weeks of age and within 2 days of the age of the litter belonging to the foster doe. A drop of perfume or a pine oil-type scent applied to the nose of the foster doe helps to prevent rejection of the orphaned bunnies. Orphaned bunnies under 3 weeks of age can be fed warmed, supplemented Esbilac (Borden). Substitute milk formula should be given slowly 2-3 times daily. Up to 5 cc (1 teaspoon) can be given the first few days. The volume is increased slowly to 15 cc ( 1 tablespoon) the second week, and to 25 cc (nearly 1 ounce) by the third week. The anal area should be gently swabbed with a warm water-soaked cotton-ball to stimulate defecation and urination. Aspiration pneumonia, hypothermia and diarrhea are frequent consequences of hand-feeding orphaned bunnies.
 
Senior Pet Care
Thanks to advances in veterinary medicine, pets are living longer than ever before. However, with this increased lifespan comes an increase in the types of ailments that can afflict senior pets. As pets reach the golden years, there are a variety of conditions and diseases that they can face, including weight and mobility changes; osteoarthritis; kidney, heart, and liver disease; tumors and cancers; hormone disorders such as diabetes and thyroid imbalance; and many others. Just as the health care needs of humans change as we age, the same applies to pets. It’s critical for pet owners to work closely with our veterinarians to devise a health plan that is best for their senior pet.
To assist veterinary hospitals in offering optimal care for senior pets, AAHA has issued a set of Senior Care Guidelines for Dogs and Cats. These guidelines provide a framework for veterinarians to provide optimal care for all senior pets.

When Does “Senior” Start?
-          So when is a pet considered a senior? Generally, smaller breeds of dogs live longer than larger breeds, and cats live longer than dogs. Beyond that, the life span will vary with each individual, and our veterinarians will be able to help you determine what stage of life your furry friend is in. Keep in mind that some small dog breeds may be considered senior at 10-13 years, while giant breeds are classified as seniors at ages as young as five. Our veterinarians are your best source for more information to determine when your pet reaches the golden years.

Senior Health Exams
-          Scheduling regular veterinary examinations is one of the most important steps pet owners can take to keep their pets in tip-top shape. When dogs and cats enter the senior years, these health examinations are more important than ever. Senior care, which starts with the regular veterinary exam, is needed to catch and delay the onset or progress of disease and for the early detection of problems such as organ failure and osteoarthritis. AAHA recommends that healthy senior dogs and cats visit the veterinarian every six months for a complete exam and laboratory testing. Keep in mind that every year for a dog or cat is equivalent to 5–7 human years. In order to stay current with your senior pet’s health care, twice-a-year exams are a must. During the senior health exam, your veterinarian will ask you a series of questions regarding any changes in your pet’s activity and behavior. The veterinarian will also conduct a complete examination of all of your pet’s body systems. Client education and laboratory testing are also key components of the senior exam.

Laboratory Testing
-          Veterinarians depend on laboratory results to help them understand the status of your pet’s health. When your pet is healthy, laboratory tests provide a means to determine your pet’s “baseline” values. When your pet is sick, the veterinarian can more easily determine whether or not your pet’s lab values are abnormal by comparing the baseline values to the current values. Subtle changes in these laboratory test results, even in the outwardly healthy animal, may signal the presence of an underlying disease. AAHA recommends that dogs and cats at middle age undergo laboratory tests at least annually. During the senior years, laboratory tests are recommended every six months for healthy dogs and cats. At a minimum, the following tests are recommended:

·         Complete Blood CountThis common test measures the number of red blood cells, white blood cells and platelets in a given sample of blood. The numbers and types of these cells give the veterinarian information needed to help diagnose anemia, infections and leukemia. A complete blood count also helps our veterinarians monitor your pet’s response to some treatments.
·         UrinalysisLaboratory analysis of urine is a tool used to detect the presence of one or more specific substances that normally do not appear in urine, such as protein, sugar, white blood cells or blood. A measurement of the dilution or concentration of urine is also helpful in diagnosing diseases. Urinalysis can assist the veterinarian in the diagnosis of urinary-tract infections, diabetes, dehydration, kidney problems and many other conditions.
·         Blood-Chemistry PanelBlood-chemistry panels measure electrolytes, enzymes and chemical elements such as calcium and phosphorous. This information helps our veterinarians determine how various organs, such as the kidneys, pancreas, and liver, are currently functioning. The results of these tests help our veterinarians formulate an accurate diagnosis, prescribe proper therapy, and monitor the response to treatment. Further testing may be recommended based on the results of these tests.
·         Parasite EvaluationMicroscopic examination of your pet’s feces can provide information about many different kinds of diseases, such as difficulties with digestion, internal bleeding, and disorders of the pancreas. Most importantly, though, this test confirms the presence of intestinal parasites, such as roundworm, hookworm, whipworm, tapeworm and giardia.
-          For cats, an additional routine blood test is recommended in order to check for hyperthyroidism, a common ailment in senior cats. Additionally, depending on your individual pet’s condition and other factors, other tests and assessments might be recommended. These include heartworm tests; feline leukemia/feline immunodeficiency virus test in cats; blood pressure evaluation; urine protein evaluation; cultures; imaging such as x-rays, ultrasound, and echocardiography; electrocardiography, and special ophthalmic evaluations, among others. Additional tests become especially important in evaluating senior pets that show signs of sickness or are being prepared for anesthesia and surgery.

The Effects of Age
-          Sensory Changes with the senior years comes a general “slowing down” in pets. As their major senses (sight, hearing, taste, touch, and smell) dull, you may find that your pet has a slower response to general external stimuli. This loss of sensory perception often is a slow, progressive process, and it may even escape your notice. The best remedy for gradual sensory reduction is to keep your pet active—playing and training are excellent ways to keep their senses sharp. Pets may also be affected mentally as they age. Just as aging humans begin to forget things and are more susceptible to mental conditions, your aging animals may also begin to confront age-related cognitive and behavior changes. Most of these changes are rather subtle and can be addressed in a proactive manner. Regular senior health exams can help catch and treat these problems before they control your pet’s life.

Physical Changes
-          The physical changes your pets experience are generally easier to spot than the sensory changes. As the body wears out, its ability to respond to infection is reduced, and the healing process takes longer. Therefore, it is crucial to consult a veterinarian if you notice a significant change in behavior or the physical condition of your pet. Many of the signs indicating that animals are approaching senior citizenship are the same for both cats and dogs, but they can indicate a variety of different problems (see Signs of a Problem, below). A very common and frustrating problem for aging pets is inappropriate elimination. The kidneys are one of the most common organ systems to wear out on a cat or dog, and as hormone imbalance affects the function of the kidneys, your once well-behaved pet may have trouble controlling his bathroom habits. If you are away all day, he may simply not be able to hold it any longer, or urine may dribble out while he sleeps at night. In addition, excessive urination or incontinence may be indicative of diabetes or kidney failure, both of which are treatable if caught early enough.

Nutrition
-          Many older pets benefit from specially formulated food that is designed with older bodies in mind. Obesity in pets is often the result of reduced exercise and overfeeding and is a risk factor for problems such as heart disease. Because older pets often have different nutritional requirements, these special foods can help keep your pet’s weight under control and reduce consumption of nutrients that are risk factors for the development of diseases, as well as organ- or age-related changes.

Exercise
-          Exercise is yet another aspect of preventive geriatric care for your pets. You should definitely keep them going as they get older—if they are cooped up or kept lying down, their bodies will deteriorate much more quickly. You may want to ease up a bit on the exercise with an arthritic or debilitated cat or dog. Otherwise, you should keep them as active—mentally and physically—as possible in order to keep them sharp. Surgery for the Older Pet In the event your veterinarian is considering surgery or any other procedure in which anesthesia is needed, special considerations are taken to help ensure the safety of your senior pet. AAHA recommends all senior dogs and cats undergo the laboratory testing mentioned above, ideally within two weeks of any anesthetized procedure. A blood pressure evaluation and additional tests might also be recommended, depending on your individual pet. These screening tools can provide critical information to the health care team to help determine the proper anesthesia and drug protocol for your pet, as well as make you aware of any special risk factors that might be encountered.

Pain Management
-          Pets experience pain just like humans do, and AAHA recommends veterinarians take steps to identify, prevent, and minimize pain in all senior dogs and cats. The AAHA guidelines encourage veterinarians to use pain assessment as the fourth vital sign (along with temperature, pulse and respiration). The different types of pain include acute pain, which comes on suddenly as a result of an injury, surgery, or an infection, and chronic pain, which is long lasting and usually develops slowly (such as arthritis). You can play a key role in monitoring your pet to determine whether he suffers from pain. For more information, see our article on Pain Management for Pets. To help ensure your pet lives comfortably during the senior life stage, it’s critical to work with our veterinarians to tailor a senior wellness plan that is best for your dog or cat. Be sure to monitor behavior and physical conditions and report anything unusual to our veterinarians, who can help your pet head into the twilight years with ease.

Signs of a Problem:
·         Sustained, significant increase in water consumption or urination
·         Sudden weight loss or gain
·         Significant decrease in appetite or failure to eat for more than two days
·         Significant increase in appetite
·         Repeated vomiting
·         Diarrhea lasting over three days
·         Difficulty in passing stool or urine
·         Change in housebreaking
·         Lameness lasting more than five days or lameness in more than one leg
·         Noticeable decrease in vision
·         Open sores or scabs on the skin that persist for more than one week
·         Foul mouth odor or drooling that lasts more than two days
·         Increasing size of the abdomen
·         Increasing inactivity or amount of time spent sleeping
·         Hair loss, especially if accompanied by scratching or if in specific areas (as opposed to generalized)
·         Excessive panting
·         Inability to chew dry food
·         Blood in stool or urine
·         Sudden collapse or bout of weakness
·         A seizure (convulsion)
·         Persistent coughing or gagging
·         Breathing heavily or rapidly at rest
 
Spay/Neuter
WHY SPAY OR NEUTER YOUR SPECIAL PET?
 
-          Problems for Intact Pets
Spaying and neutering, in addition to controlling the pet population, has many medical benefits: The average lifespan of a spayed or neutered pet is 40% longer than an unaltered one.  Un-spayed females may develop breast cancer or uterine infections by 8-10 years of age.  Spaying a female before first heat almost eliminates her chance of developing breast cancer.
 
-          Problems associated with intact pets include:
·         Un-spayed female cats are in heat frequently, which is noisy and troublesome
·          Un-spayed female dogs experience messy heat cycles two to three times a year
·         Un-neutered male cats tend to mark their territory by spraying urine
·         Un-neutered male dogs are at risk of testicular tumors, prostate disease, & peri-anal tumors
·         Intact pets tend to be territorial and wander, leading to automobile injuries, fight wounds, and exposure to contagious disease.
·          Neutering can help control or eliminate associated behavioral problems such as aggressiveness, urinating in the house, and running away from home.
 
-          The Solution: Spay or Neuter
Spaying or neutering your pet is a safe, routine procedure, generally performed at 6 months of age. Prior to surgery, all pets receive a pre-anesthetic physical exam. We require surgical blood screening for pets over 5 years of age (It is optional until this point.), which helps us detect many potential problems and increases anesthetic safety for your pet. We also provide postoperative pain medication, ensuring a comfortable, speedy recovery for your pet. The surgical procedure is performed under general anesthesia, so your pet sleeps painlessly throughout. Anesthesia choices used in our hospitals are the same as those used in human medicine. No pet should be taken home the same day of surgery, as monitoring, rest, and re-examination are important.
 
-          When Your Pet Has Surgery
These surgical procedures can be scheduled Monday – Friday. Here are some points to remember:
·         Please call at least 24 hours in advance to make your appointment
·         Plan to drop off your pet at the hospital between 6:00 and 7:30 AM.  Plan a few extra minutes for your drop off.  A surgical technician will have a few questions for you.
·         Withhold food after midnight the night prior to the surgical procedure.  Your pet may have water, but minimize the intake amount.
·         Your pet will stay with us overnight and be discharged the following day, unless noted. (Example: declaws stay two nights)
·         Most pets will go home with pain medications to be given for the days following surgery and some may also receive antibiotics. The doctor will make these decisions and advise you upon discharge.
 
REMEMBER: Spaying or neutering your pet will help it to lead a healthier, happier, longer life
and you will have done your part to reduce the pet overpopulation problem!
Top of Form
 

VACCINATIONS

Is vaccinating my pet a risk to his or her health?
-          Vaccination against disease is a medical procedure and, like all medical procedures, carries some inherent risk. As in any medical procedure or decision, the benefits must be balanced against the risks. Veterinarians recommend that no needless risks should be taken and that the best way to accomplish that is to reduce the number and frequency of administration of unnecessary vaccines. As is the case with any medical decision, you and your veterinarian should make vaccination decisions after considering your dog’s age, lifestyle, and potential exposure to infectious diseases.

What possible risks are associated with vaccination?
-          Vaccine reactions, of all types, are infrequent. In general, most vaccine reactions and side effects (such as local pain and swelling) are self-limiting. Allergic reactions are less common, but if untreated can be fatal. These can occur soon after vaccination. If you see such a reaction, please contact your veterinarian as soon as possible. In a small number of patients, vaccines can stimulate the patient’s immune system against his or her own tissues, resulting in diseases that affect the blood, skin, joints or nervous system. Again, such reactions are infrequent but can be life threatening. There is a possible complication of a tumor developing at the vaccination site in a small number of pets, most frequently cats. Please contact your veterinarian for more information.
-          Again, severe reactions are uncommon, but any needless risk is unacceptable. In general, vaccine reactions and side effects (such as local pain and swelling) are self-limiting. Allergic reactions are less common, but if untreated can be fatal.
-          In a small number of patients, vaccines can stimulate the patient’s immune system against his or her own tissues, resulting in diseases that affect the blood, the skin, the joints, or the nervous system. Again, such reactions are infrequent.
-          In a tiny percentage of cats, there has been an increase in a particular form of tumor that is strongly associated with vaccine administration. The reported incidence of this side effect is one in 10,000. Researchers are currently studying this phenomenon to learn what causes the problem so that vaccines can be redesigned to avoid this unacceptable side effect. Meanwhile, reducing risk by reducing the number of unnecessary vaccines given to cats is the safest option.

How do I know which vaccines my pet needs?
-          There are two general groups of vaccines to consider: core and noncore vaccines.
-          Core vaccines are generally recommended for all dogs and protect against diseases that are more serious or potentially fatal. These diseases are found in all areas of North America and are more easily transmitted than noncore diseases. The AAHA guidelines define the following as core vaccines: distemper, adenovirus, parvovirus and rabies. Noncore vaccines are those reserved for patients at specific risk for infection due to exposure or lifestyle. The AAHA guidelines classify kennel cough, Lyme disease and leptospirosis vaccines within the noncore group.
 
Vaccinating Your Dog
Vaccinations are a critical component to preventive care for your dog. Thanks to the development of vaccines, dogs have been protected from numerous disease threats, including rabies, distemper, hepatitis and several others. Some of these diseases can be passed from dogs to people — so canine vaccinations have protected human health as well. Recently, studies have shown that vaccines protect dogs for longer than previously believed. There have also been improvements in the type of vaccines produced. In addition, there is increased awareness and concern that vaccination is not as harmless a procedure as once thought. These factors have led to a growing number of veterinarians who recommend reduced frequency of vaccinations while at the same time tailoring vaccine recommendations to specific risk situations.
To assist veterinarians with making vaccine recommendations for dogs, the American Animal Hospital Association has issued a set of canine vaccine guidelines. Developed by a group of infectious disease experts, immunologists, researchers and practicing veterinarians, these guidelines were first released in 2003 and revised with new information in 2006. One of AAHA’s key recommendations is that all dogs are different — and thus vaccine decisions should be made on an individual basis for each dog. Issues to consider include the age, breed, health status, environment, lifestyle, and travel habits of the dog. Health threats vary from city to city and even in various sections of cities. You can work with your veterinarian to tailor an immunization program that best protects your dog based on his risk and lifestyle factors.

How often should my dog be vaccinated?
-          Make sure that your dog completes the initial series of core vaccines administered at the puppy stage, as well as booster shots at one year of age. Following these one-year boosters, the AAHA Canine Vaccine Guidelines recommend that the distemper, adenovirus and parvovirus core vaccines be administered once every three years. States and municipalities govern how often rabies boosters are administered. Some areas require a rabies booster be administered annually. Others require a three-year-effective rabies booster be given every three years. Still others allow either a one-year or a three-year rabies vaccine to be utilized. Noncore vaccinations should be administered whenever the risk of the disease is significant enough to override any risk of vaccination. For example, kennel cough vaccine may need to be administered up to every six months in a dog repeatedly being kenneled or exposed to groups of dogs at grooming salons or dog shows. There is a history of yearly vaccinations boosters, and some veterinarians do not feel it is prudent to change that recommendation just yet. However, the AAHA Canine Vaccine Guidelines reflect that there is growing support for extended duration of protection. Thus more veterinarians are vaccinating less frequently and more selectively.

Does this mean I only need to see my veterinarian every three years?
-          Regular wellness examinations — at least once or twice a year — are the most important preventive measure that you can provide for your dog. Vaccinations are just one component of the wellness visit. To help keep your dog in optimum health, regular wellness examinations are critical — regardless of how often vaccines are administered. Remember, dogs age at a much faster rate than humans, so a once-yearly exam is similar to a human getting a physical every 5-7 years. Plus they don’t always show signs of early disease, and they can’t easily communicate discomfort to us. During the wellness exam, your veterinarian has an opportunity to detect and prevent problems at an early stage.

My whole life I have been told my pet needed yearly vaccinations. What has changed?
-          First you need to know that veterinarians have always acted in what they believed to be the best interest of pets and pet owners. Vaccines against infectious diseases have done much to reduce sickness and death in companion animals.
-          The tradition of annual boosters was based on manufacturers’ recommendations and labeling. To date, few studies have been done to prove how long vaccines are effective. In addition, veterinarians found vaccination to be a safe procedure that was generally free of side effects and risk.
-          Recently, there has been a growing degree of evidence indicating protection from vaccination is longer lasting than previously believed. In addition, there is increased awareness and concern that vaccination is not as harmless a procedure as once thought. This awareness and concern have led to a growing number of authorities (such as infectious disease experts, immunologists, and researchers) as well as practitioners who recommend reduced frequency of vaccinations while at the same time tailoring vaccine recommendations to specific risk situations.
 
Can my veterinarian conduct a test to see if my dog needs to be vaccinated?
-          Tests that measure protective antibody levels for diseases are called titers. In recent years reliable titer tests for some diseases such as canine distemper and parvovirus have become more readily available and economical. Veterinarians may recommend using these titer tests in some cases to determine whether or not vaccinations are needed. Our veterinarians can provide you with more information on titer testing.
 
Vaccinating Your Cat
Vaccinations are the most important preventive measure you can take for the health of your pet. Health threats vary from city to city and even in various sections of cities. Therefore, your veterinarian can tailor an immunization program for your pet based on local conditions. Your dog or cat generally can be immunized for the following diseases: Dogs can be immunized against distemper, hepatitis, leptospirosis, parainfluenza, parvovirus, coronavirus, Bordetella, rabies, and Lyme disease. Cats can be immunized against feline panleukopenia (distemper), rabies, feline rhinotracheitis, calicivirus, chlamydia, feline leukemia, and FIP.
In recent years some veterinarians have changed their recommendations regarding the frequency of vaccinations. The following fact sheet provides answers to important questions concerning vaccinations.