By Dr. Becker
I recently ran across an online column about the importance of being proactive in identifying health issues in pets.
"At least once a week I diagnose a pet with a terminal illness that in the parents' eyes came on suddenly," writes Dr. Perry Jameson of Veterinary Specialty Care in Mt. Pleasant, SC. "But I know it took months to develop."1
Dr. Jameson writes about Sadie, a 7-year-old Golden Retriever whose appetite and energy level had been down for less than a week before her owner brought her in. The ultrasound showed fluid in Sadie's abdominal cavity, masses in her liver and spleen, and several enlarged abdominal lymph nodes. Jameson knew he was looking at metastatic cancer and a very poor prognosis.
Sadie's devastated mom couldn't believe that her precious dog, visibly sick for less than a week, had a terminal illness. But Jameson knew the cancer had been spreading in the dog's body for much longer.
"Dogs and cats are so good at masking symptoms," says Jameson. "A small discomfort that you and I would complain about, they tolerate. They want to please us and will act normal as long as they can until the disease process reaches a point they can no longer tolerate. Occasionally by that time, it has reached a point where there is little therapy we can offer."
Detecting Health Problems Before They Become Crises
While it was too late for Sadie, Jameson also wrote about a cat patient with a newly diagnosed heart murmur. The kitty was acting normally according to his owner, but an echocardiogram showed significant heart changes that left untreated would have likely led to blood clots or heart failure.
In another case, a dog was sent to Jameson because her calcium level was elevated on a blood test, and she was drinking more water than usual. Dr. Jameson discovered she had an anal sac tumor, which was producing a hormone that caused elevated calcium levels, along with increased thirst and urination. Fortunately, the mass was found early enough to be removed before it spread.
Finally, Jameson wrote about an 8-year-old Springer Spaniel whose regular veterinarian had noticed a slight liver abnormality on the dog's annual bloodwork. She had been acting normally and was very energetic according to her owner. However, an ultrasound showed a small tumor on her right adrenal gland that had invaded a major vessel in her abdomen.
The dog had surgery right away and the mass was removed successfully. According to Dr. Jameson, "Had she come in when symptomatic, the tumor probably would have grown to a size where removal was impossible."
Why I Recommend Regular Wellness Visits
Dr. Jameson encourages pet owners to take their companions to the veterinarian for at least one physical a year, and twice annually for animals over 8 years of age.
As a proactive wellness veterinarian, I prefer to see each of my healthy patients twice a year, and more frequently as necessary for older pets and those with chronic conditions. A dog's or cat's wellness and nutritional needs change yearly, and over the age of 8 can require fine-tuning every 4 to 6 months. I want to regularly review each patient's weight, muscle tone, joint range of motion, diet, supplement protocol and exercise habits with the owner.
My goal is to help my clients avoid preventable disease in their pets. I don't follow the traditional medical approach, which is to wait around until an animal is sick or debilitated and then attempt to fix the problem or simply treat the symptoms.
I view regularly scheduled wellness visits as opportunities to check the status of your pet's health and take proactive steps to prevent serious disease from developing.
Wellness exams are a perfect time for you and your vet to discuss any and all changes in your pet's health, for example, if your pet's endurance level has changed, if there is plaque or tartar on any teeth, if there have been changes in sleep or bathroom habits or water intake, or if your pet has had exposure to ticks or other infectious pathogens that may need to be addressed.
We want to keep your pet in the white zone of good health and out of the black zone of disease. In between those zones lies the grey zone, which is where dysfunction in the body begins and gradually moves the state of your pet's health in the direction of full-blown disease.
To successfully reverse or stall dysfunction in the grey zone, we have to deal with it there, which means we must regularly check your pet's health status. For pets over the age of 8, I almost always find a health related change occurring at every 6-month exam that we can address proactively.
Most importantly, by making intentional, regular changes to a pet's wellness protocol (via a supplement, diet, or therapeutic exercise routine), we can dramatically slow down aging and potentially slow the onset of degenerative disease.
Organ Function Should Be Checked at Least Yearly
For middle-aged and older pets, Dr. Jameson also recommends that a complete blood count (CBC) be done annually to check for liver, kidney, and thyroid issues, protein levels, and calcium and electrolyte levels.
One of the best ways to keep on top of a patient's health is by tracking blood work changes over time. Let's say your cat's kidney enzymes (BUN and creatinine) are climbing, but are still within normal reference ranges. Many veterinarians will note the elevation but wait until the levels climb out of the normal range before taking action.
However, my approach is to view those slightly elevated levels as requiring attention, and long before your kitty is diagnosed with chronic kidney failure, I'll make recommendations for supporting and enhancing kidney function so that we can prevent full-blown disease.
In addition to organ function evaluations, I suggest completing a urinalysis and internal parasite analysis annually as well.
Wellness Exams Should Be a Proactive Review of Your Pet's Health
Being proactive means being focused on initiating change rather than simply reacting to events as they occur.
In my practice I use what I call the Three Pillars of Health as a proactive approach to wellness. These pillars form the foundation for your pet's health, quality of life, and longevity.
- Pillar #1 is species-appropriate nutrition. The diet you feed your cat or dog should be balanced and biologically appropriate for a carnivore. Over time there will be changes required to your pet's diet which may include the reduction or increase of balanced fats (depending on your pet's activity and metabolic health), an increase or change in protein sources, an increase in antioxidant or phytonutrient intake, and/or an increase in essential fatty acids, depending on your pet's lifestyle and age.
- Pillar #2 is a sound, resilient frame. This aspect of your pet's health involves maintenance of the musculoskeletal system and organs. In addition to maintaining your pet's weight (monitored by twice yearly weigh ins) proactive vets will monitor changes in your pet's muscle tone, range of motion, strength, balance, and brain-body connection, and suggest specific exercises or changes in your exercise routine to minimize atrophy and age related changes over time.
- Pillar #3 is a balanced, functional immune system. The goal here is to keep your pet's immune system in balance. It should protect against pathogens, but not be over-reactive to the point of creating allergies and other autoimmune conditions. Wellness veterinarians will replace vaccines with titers, offer detox protocols when necessary (if pets are exposed to heartworm, flea, or tick chemicals), and evaluate your pet's immune health risks that change over time, including your pet's risk of breed related cancers.
I wish more veterinarians would reject the traditional notion of preventive healthcare, which too often centers around re-vaccinations and chemical pesticides, and instead help their clients understand the value of a proactive approach to keeping their pets healthy.