Category Archives: Pet Care

Bandage Care

Bandage Care Guidelines
By Dr. Karen Burgess

  1. Protect the bandage from self-mutilation, other pets, and the environment.  It is not uncommon for pets to chew at bandages, whether it is their own or a housemate’s.  Keeping an Elizabethean Collar (E-Collar) on at all times may be necessary to prevent self-destructive behavior.  Limiting activity including play is also recommended.  A pet with a bandage should never be allowed unsupervised around other pets or in the yard.  Confinement in a crate or small room in an owner’s absence is recommended.  When going outside the bandage should be protected from the elements by either wrapping with a plastic bag or using a protective cover specifically designed for bandages.
  2. Ensure the bandage stays dry.  Wet bandages can harbor bacteria and lead to tissue damage.  The padding used in bandages and casts is soft allowing a cushion effect but at the same time is very absorbent and any moisture will not dry due to diminished airflow.  A wet bandage should be replaced immediately.  Pets are often more clumsy with elimination while wearing a bandage or cast and may unintentionally soil themselves.  When going outside the bandage should be protected from the elements by either wrapping with a plastic bag or using a protective cover specifically designed for bandages.
  3. Monitor tightness of bandage.  Bandage material can be constrictive affecting blood flow to an area.  In addition the loss of blood flow is often hidden by the bandage itself.  Watch for any swelling, increase in pain, or sudden increase in chewing as signs of a possibly too tight bandage which should be evaluated immediately.
  4. Watch for bandage slippage.  Take note of where a bandage or cast is positioned initially and watch for any signs of slippage.
  5. Do not attempt to modify a bandage at home.  Safely applying a bandage or cast should only be done by trained professionals.  It is very easy to cause damage with an improperly applied bandage often leading to more problems than a pet started with.  Do not be tempted to cut, add tape to, or reapply a bandage at home. 

Seek veterinary assistance immediately if a bandage is wet, slipping, has an odor, is causing swelling or increased pain, or in general appears to be malfunctioning.


Elizabethean Collars (E-Collar)

Elizabethean Collars (Protective Collars)
By Dr. Karen Burgess


Types of protective collars

  • The typical Elizabethean collar or E-collar is a hard plastic cone or lampshade shaped apparatus that fits over a pet’s head with the narrow portion (lampshade top) secured to the neck with a piece of gauze or collar.  E-collars are typically used to prevent either self-destruction or injury by a pet.  Common uses include after surgery, protection of bandages, prevention of scratching, or prevention of eye rubbing.  E-collars are often cumbersome for pets and their owners.  Subsequently several newer protective collars have been developed over the years.  Some examples include
  • Comfy Cone-made of stiff nylon fabric this washable collar this reusable; light weight version is less bothersome for many pets and their owners than the traditional hard plastic collar.
  • Recovery Collar-soft nylon fabric collar, typically more appropriate for smaller patients such as cats; does not provide the same degree of restriction as a stiff collar making it inappropriate for some conditions
  • Inflatable donut style-these collars do not extend around the head like traditional E-collars making the more tolerable for some.  There use is limited to conditions that pets cannot reach around and still access a given area.
  • Rigid Velcro style-similar to inflatable collars and resembling a human neck brace

How to properly fit an Elizabethean collar on your pet
An E-collar should fit snugly thus preventing removal by a pet.  A good rule of thumb is that if two fingers can fit between whatever is securing the collar and the neck than it is not too tight.  Pets should initially be closely monitored to ensure that the collar is fitted appropriately.  It is also important to ensure that the length of the collar does not allow access to whatever is being protected, extending just past the nose when viewed from the side.

Initial response to an Elizabethean collar
Pets will range in their response to having and E-collar on.  Some will accept it immediately and aside from some initial clumsiness not miss a beat.  Others will initially act as if they are paralyzed and unable to move.  Finally, some will fight the collar violently trying to paw it off incessantly.  Animals that become stuck in one position will typically adjust in a short time frame.  It may help to lay them down in a room and let them be while they adjust.  Pets that fight a collar may benefit from a walk outside, special treat, or ultimately require being put in a safe room where they are given the opportunity to work things out on their own.

Caring for an Elizabethean collar
General cleaning of the inside and outside of the collar with soap and water is recommended as it gets dirty.  Ensure that the collar is kept dry to prevent moisture induced issues.  Trimming of the fur may be necessary to assist with moisture control.


Some common concerns regarding the use of Elizabethean collars

  • Eating and drinking-pets should still be able to eat and drink with an E-collar in place.  Elevation of the food and water bowl two to four inches off the ground will assist with this.  Make sure the diameter of bowls is smaller than that of the E-collar.  Also be aware the in particular initially pets will be somewhat clumsy and more apt to knock their bowls over.  It may be helpful to handfeed your pet from their bowl initially so they can “learn” how to eat with the E-colla in place.  Some collars (ex. Comfy Cones) allow for the edge of the collar to be temporarily folded back providing easier access to bowls.  If removal of the collar is authorized for feeding this must only be done under direct visual supervision.
  • Outside play should be monitored while a pet is wearing an E-collar to avoid becoming trapped or injured unintentionally.
  • Running into objects and catching the E-collar on items (ex. stairsteps) is common in the first few days.  Peripheral vision and hearing may be affected.  Put valuables up and supervise your pet as the adjust to navigating initially.

Nutrition, Choosing Pet Food

What makes a good pet food?
By Dr. Karen Burgess

Pet food quality is an often discussed but poorly understood hot topic.  Ask ten people and you will likely hear ten different opinions on how to best feed your pet.  Unfortunately the pet food industry is not well regulated allowing many well-intentioned but often uninformed opinions to circulate.  Feeding decisions are often based on descriptive marketing, emotion, and passionate beliefs.  Addressed in this article are several objective ways to evaluate your pet’s diet.  While pet food is a 21 billion dollar industry, your pet is a one and only, and these tools will help make the best feeding decisions for them.

Essential in the selection of an appropriate pet food are the following:

  • Trust in the company producing the food, knowing that they have the ability to develop a safe product from recipe to the bag you open
  • Finding a food your pet does well with, there is not one right food for all pets, finding a product that your pet enjoys and thrives on physically is essential
  • Affordibility, good pet food does not have to be expensive
  • Accessibily, are you able to obtain fresh bags when needed

How important is the ingredient list?
While ingredient lists are the primary focus of many, it is one of the most misleading and easily manipulated areas in pet food production.  It is important to look at the complete nutrient profile of a food not just one or two individual ingredients.  For this reason, it is one of the last things Dr. Burgess would recommend using to choose an appropriate pet food.  Some common myths with regard to ingredient lists include

Myth-Whole meat such as chicken listed as a top ingredient makes for a better pet food.

What most do not realize is that ingredients are listed in order of weight from high to low before processing.  But this includes water which in the case of meat is typically 75% of its weight.  In addition, using chicken as an example, bone is included in the definition of chicken.  Thus a pet food could contain very little meat relative to bone and still have chicken listed as a top ingredient.

Myth-By products are low quality and undesirable in pet food.

Using chicken again as an example, by products which include liver, organ meat, and brain are often very nutritious and while not regularly eaten by people in the US, they are considered delicacies elsewhere.  It is the quality of the by-product being used that is important which comes back to a pet food company’s commitment to produce a safe and nutritious food every time.  This involves process and quality controls throughout.

Myth-Grain is not good for dogs and of no nutritional value.

Dogs are not pure carnivores and can absorb nutrients from non-meat food items.  Gluten intolerance is also extremely rare in dogs.  Often grain free foods are higher in calories and fat then traditional pet foods leading to weight gain and digestive issues for some pets.

Myth-Corn is a filler and if found in a pet food means it is lower quality.

Ground cooked corn is very easy for pets to digest and a good source of energy, fatty acids, antioxidants, and carbohydrates or energy.  Ground corn flour is considered a good protein source.  While often suggested to be allergenic, corn has been shown to be less of a problem than other proteins including dairy, wheat, chicken, egg, beef, lamb, and soy.

Other little understood facts.  All dry pet food contains preservatives.  Processed food can be as simple as peeling, cooking, or chopping of an item.  Just because a food is processed does not make it inferior.

Is the food manufacturer’s contact information readily available on the packaging?
Probably the easiest of the criteria to understand, it is surprising how difficult it can be to find contact information for a pet food manufacturer.  A reliable company should be easy to get ahold of and eager to answer a consumer’s questions about their product.  Information that should be readily offered includes caloric density of the food and complete nutrient analysis (NOT just minimum and maximum values).  Pre production regulation of pet food does not exist and problems are only addressed after complaints have been made and ironically proof is only required that a particular ingredient is unsafe, not that it is safe or of actual value.  This makes trust in a pet food company that much more important.

Who creates the diet (makes the formulations) and what are their qualifications?
Passion for pets and a love of cooking does not qualify someone to create a consistent quality nutritionally balanced pet food.  Unfortunately as far as the pet food industry is concerned, no real experience or education is required to develop pet food.  Nutrition is an extremely complex science.  Pet food development should involve a veterinary nutritionist or PhD in nutrition.  Larger companies such as Hills retain full time employees with these qualifications.

What is the diet’s AAFCO certification?
AAFCO (Association of American Feed Control Officials) is a “voluntary membership association of local, state and federal agencies charged by law to regulate the sale and distribution of animal feeds and animal drug remedies”.  They are the primary means by which pet food is regulated in the United States.  While having no regulatory power, AAFCO establishes nutrient guidelines for pet foods.  AAFCO statements are discussed in more detail in a separate handout, but foods are either formulated to meet AAFCO nutritional standards or have been fed to animals in an AAFCO approved food trial setting (more desirable and more expensive).

Where is the diet manufactured/produced?  Does the company own their plants or are they subcontracted/co-manufactured?
A co-manufacturer (or co-packer) is a company that is contracted to make pet food, provide ingredients, and often even develop the diet.  Large pet food companies like Hills and Purina will typically own their own plants and control the manufacturing process from ingredient delivery through distribution.  This involvement with the product from beginning to end is both an investment financially and contributes to the overall quality of the final product.

What type of testing is done on the food to ensure its safety (i.e from bacterial contamination) and consistency from bag to bag?
Ingredients are tested by suppliers, but proactive pet food manufacturers will independently test ingredients before accepting them into their plants to ensure their safety and quality.  Large manufacturers will test their food numerous times during the production process to make sure their product is reliable and safe from start to finish.  Hills will not release product from their plants until batch cultures and analysis are completed.  Feeding trials and palatability testing are not required but very beneficial in the development of a successful food.  Likewise shelf-life and packaging testing are not mandatory but obviously essential for a reliable product.

How well are the nutrients in the pet food analyzed?
Analysis of the nutrients in pet food is legally required in the US.  However the frequency is not.  Higher quality pet foods will have their fat, fiber, protein, carbohydrate, and moisture composition analyzed throughout the production process.  While this is more expensive it ensures that the final product retains the nutrient profile promised.

Are claims made by the company reputable?
Anecdotal claims are common in the pet food industry, and package labeling laws make these difficult for owners to determine what are opinion and what are fact.  Independent testing and peer-reviewed journal articles are reliable references that pet food companies should be able to provide for claims made.  Also be aware that advertisements and website claims for pet food do not have to be true, only the pet food label is regulated.


Pet Insurance Dilemmas
By Dr. Karen Burgess

We are frequently asked about purchasing pet insurance and whether it’s a good idea.  Ultimately, the answer is not the same for everyone and will depend on what you want pet insurance to do for you.

The first thing to realize is that pet insurance is not a way to save money on the regular costs of owning a pet.  Just as buying car insurance is not a way to “save money”, purchasing pet insurance will not reduce your overall pet care bills.  Even pet insurance plans that rebate you a portion of your wellness expenses will not save you money, because often those plans will just provide that much less coverage in other areas.

So, if pet insurance isn’t a way to save money, how does it help you?  The answer is simple: Because pets have accelerated life spans compared to humans, going from infancy to old age in 10 years, a lifetime of medical issues can be condensed into a few short years.  Pet insurance allows you to prepare for this.  When the time comes, you are able to focus on your pet’s needs without having to dip into your savings.

With that in mind, here are some guidelines for whether purchasing pet insurance makes sense for you:


Top 6 questions:

  1. How does it work?
    1. All pet insurance works on a reimbursement basis. You will pay for service upfront, and your pet insurer will reimburse you directly.  Reimbursement time varies from company to company, but expect to wait approximately two weeks.
  2. What is covered?
    1. All insurances will cover unexpected events (illnesses, injuries, diagnostics, medicines, hospitalization, etc). Some plans can also rebate a portion of your yearly wellness costs but may contain significant exclusions for illness and injury.
  3. My pet already has a problem or I suspect a problem. Can I get pet insurance?
    1. Not for the healthy problem your pet already has, as it is pre-existing. Pet insurance would cover future unrelated issues.
  4. How much does it cost?
    1. Although prices depend on various factors such as pet age and breed, expect to pay between $35-$55 per month.
  5. If my pet has had a problem in the past, will pet insurance cover it if it happens again?
    1. Probably not. If you are concerned about a problem coming back, chances are that your pet insurance company is too.
  6. I have a healthy puppy; do I really need pet insurance?
    1. If you ever see yourself buying pet insurance, it is better to do so when your pet is young rather than waiting till they get older. Additionally, certain hereditary and congenital defects can become evident while pets are still young so insuring young can prevent the pre-existing ‘clause’ in most cases.

What should you look out for or consider when shopping for pet insurance provider?

If you choose to purchase pet insurance, be sure you understand and are comfortable with how your chosen pet insurance company handles these issues:

  • Is there a max yearly or lifetime dollar limit? If so what is that limit?
  • After obtaining insurance, what is the waiting period for illness claims and accident claims?
  • Coverage for hereditary and congenital conditions.
  • Does the company pay “Actual fees” or do they pay according to a “fee schedule”? If they pay according to a “fee schedule”, are the reimbursement amounts realistic for the area you live in?
  • What happens when you file claims? Do your rates increase? Will those conditions be excluded from future cover?
  • What will prices be like when you pet is significantly older?
  • What wellness procedures are covered and what is the additional cost to have them covered?

Two excellent sources of information can be found on the web:

  1. For a basic understanding of pet insurance you can go to:
  2. For user ratings of pet insurers:

Resorptive Lesions, Feline

Feline Odontoclastic Resorption Lesions (FORLs)
By Dr Karen Burgess

What are FORLs?
Feline odontoclastic resorption lesions (FORLs) are a common (20-75%) dental disease in cats over 4 years of age. In this disease, cells known as odontoclasts, which originate in the bone marrow or spleen, migrate and attach to the external surface of the tooth root (portion of the tooth within the tooth socket) and resorb (i.e. destroy) the root surface. The odontoclasts are cells that are normally involved in the process of turning over “baby” teeth before the permanent teeth erupt. Although not known why, these cells remain active in the adult cat.

resorptive lesion, feline, dental, dentistry, Healthy Paws Animal Hospital

Over time, the root(s) of the teeth are completely destroyed, and in the latter stages of the disease, only the crown (portion of the tooth above the gumline) or portions of the crown remain. In many cats, the end-stage affected tooth is observed as missing.

FORLs were previously and incorrectly referred to as a feline cavity. We now know that cavities and FORLs are distinctly different diseases. Cavities are caused by bacteria, and FORLs, although their true cause is unknown, are not a bacterial disease. Many potential causes for this disease have been investigated, but to date, the true cause of the disease remains elusive, and is one of the current “hot” topics of research in the field of veterinary dentistry.

What are the symptoms of FORLs?
Cats with FORLs are often identified by the chief symptom of teeth “chattering,” sensitivity upon eating/chewing (i.e., dropping food or preferentially chewing on one side of the mouth). Patient’s suffering with FORLs may also salivate profusely. This suggests that there is significant oral pain. On examination, the veterinarian will identify either missing teeth or teeth where portions of the tooth crown are missing. In areas where portions of the crown are missing, the gums in the area are usually observed to cover the missing area, and a red spot is noticed on the crown. The teeth with early FORLs cannot be identified on gross examination, because the disease is localized to the root surface, and can only be documented by radiographs.

Symptomatic cats are usually those that have teeth with partially missing tooth crowns, and where the disease process has moved beyond the root surface. In other cats, despite the severe gross clinical appearance of the lesion, the cat remains unaffected in its behavior pattern: eating, gaining weight and content.

NOTE: Cats are very careful not to demonstrate pain.  Signs of pain can be very subtle with these cats.  You might notice more calculus (tartar) in specific areas, gingival inflammation (possibly the only sign), increased salivation or changes in food preferences.  Owners typically fail to realize their cat is painful until after they experience behavioral changes (happier and more playful cats) subsequent to treatment for these resorbing teeth.

What tests are needed?
Only the end-stage lesions involving the tooth crown can be identified readily on clinical examination, the remainder of lesions must be diagnosed by quick and efficient dental x-rays which is available at Healthy Paws Animal Hospital. Due to a high percentage of cats affected by this disease, cats over the age of 4 are recommended to have dental x-rays as a screening test for the disease when having their teeth cleaned.

xrays feline, radiograph feline, cat resorptive disease, Healthy Paws Animal Hospital

What treatment is needed?
FORLs are believed to be a painful disease in the cat, and cats with documented disease should be treated. The primary treatment for this disease is extraction of the affected teeth. When FORLs were believed to be similar to cavities, the lesions or defects in the crown were filled, similar to human cavities. As the disease was further investigated, and follow-up was performed on teeth that had been filled, it became clear despite our best efforts the filled teeth continued to resorb.

Extraction or crown amputation with intentional root retention, are the only currently accepted methods of therapy. The latter is a procedure where the crown of the affected tooth is removed with a bur; leaving the resorbing roots buried in the bone to continue resorbing to completion. The crown amputation procedure alleviates the clinical signs of disease because the exposed and sensitive portion of the tooth is removed. This procedure, however, is limited to affected teeth that have been appropriately x-rayed and have severe tooth root resorption. Teeth with severe root resorption are difficult to impossible to extract, and severe damage to the surrounding bone may result from overzealous attempts at extraction.

The prognosis following extraction or crown amputation of affected teeth is good, but affected cats will always have a predisposition to the development of additional lesions. Follow-up visits on an annual basis are recommended for FORL screening.

Preventative Care
It is helpful to brush your cat’s teeth daily or three times weekly at a minimum.  Dental products are available that have been noted to reduce plaque and tartar.  Products exhibiting the VOHC label have proven their efficacy and should be purchased over products that do not carry the VOHC label.  VOHC products include treats, food, and water additives.  Ask a Healthy Paws employee for a list of approved products.

Dentistry, Why to perform

Why Perform a Dental Prophylaxis?
By Dr Karen Burgess

Cats and dogs, like humans, are prone to an array of mouth issues ranging from tartar and plaque to retained, extra, missing or even twisted teeth!  Dental prophylaxes allow veterinarians to determine the overall health of your pet’s mouth, address any issues and prevent future problems.

Dental Disease
The most common oral problem in dogs and cats is dental diseases.  Without proper tooth brushing, the buildup of the plaque, tartar, and bacteria can lead to infection.  Over 68% of pets over the age of three have some form dental disease.  The most common problems are due to periodontal disease, gingivitis and cervical neck lesions.

Periodontal disease is used to describe inflammation or infection of the tissues surrounding the tooth.  Accumulation of tartar and calculus on the teeth contributes to gum recession around the base of the tooth.  Infection soon follows and the gums recede, exposing sensitive unprotected tooth surfaces.  Untreated infection then spreads into the tooth socket and ultimately the tooth loosens and is lost.

Dental Prophylaxis
A dental prophylaxis is performed under general anesthesia.  Probing and cleaning of the teeth would be impossible, incomplete, and painful without general anesthesia.  Once fully anesthetized all teeth are probed and charted.  If any abnormalities are noted, such as deep pockets, missing or extra teeth, digital radiographs are then taken.

Digital radiography allows multiple radiographs to be taken in a short amount of time.  This provides an abundant amount of information for the veterinarian to use in making recommendations for extractions or possible diagnosis.  Dogs typically require anywhere from 0-4 radiographs whereas cats get full mouth radiographs due to their high incidence of cavities.


Above is a great example of why preventative care is so important and the reasons to start young. Puppies begin losing their teeth at approximately 3 months of age and should have a mouth full of adult teeth by 6 months.  Around this same time dogs are typically spayed or neutered.  While being spayed/neutered at Healthy Paws Animal Hospital the teeth are counted and we make sure that there are no missing, extra or retained puppy teeth.  Finding the reasons for the abnormalities at 6 months can help to alleviate problems like the above cyst.  For this reason, Healthy Paws Animal Hospital provides spay and neuter estimates with full mouth radiographs listed on the high end.


After all radiographs have been taken and any extractions completed the teeth will then be cleaned with an ultrasonic scalar followed by a fluoride polishing.  The ultrasonic instrument is a vibrating probe which aids in the removal of the tartar on the teeth with minimal damage to the tooth enamel.

Preventative Care/Maintenance
Once the teeth are cleaned it is the best time to begin preventative care.  The most effective way of reducing plaque and tartar is to brush the teeth.  Surprisingly, toothpaste is not required- the abrasion of the toothbrush alone helps to remove plaque and tartar from the teeth.  In addition to brushing the teeth recent advances in nutrition have resulted in diets that reduce tartar accumulation such as Hills t/d® diet.  Preventative care has been made easier with so many options ranging from brushing teeth daily to chew toys or water additives.  One tip of advice:  purchase only products with the below VOHC seal of approval.  This seal indicates that the product purchased has proven the effects of tartar and/or plaque removal.