by Dr. Steve Nichols, CVA

Clients may become interested in optional approaches to their pet’s health for many different reasons. Even with the tremendous advancements in “Western” medicine over the last 50 years, there are those patients that present with conditions for which we have no therapy or at least not a good one. As veterinarians we are often challenged by cases that don’t adhere to the “textbooks.” These cases may appear to be straightforward, however they do not improve with conventional intervention. Additionally, it is not uncommon for patients to become less responsive to therapies. This is especially true for treatments that are given to address chronic conditions. Refractory cases can be the most challenging. Frustration levels are high because we have seen the patient do very well with a particular medication. Another subset of our patients develop side effects from long-term therapies. These side effects can be quite serious, to the point of preventing the use of similar medications to provide relief. Lastly, some or our clients may simply want a more “natural” approach to their pet’s healthcare. Acupuncture or another complementary therapy may prove beneficial in such cases.

There are several conditions that respond well to these “Non-Traditional” modalities. The majority of the patients that we treat have a chronic or degenerative condition. Some patients are afflicted by diseases that we can define…. arthritis, diabetes, allergies, renal failure, and cancer. Others are subjected to changes that may not have a clear label and are often considered “normal” aging. These can include: fluctuation in weight, loss of strength, diminished eye sight and hearing, increased anxiety, etc.. Clients are often searching for an approach that will, at a minimum, assist in preserving their pet’s quality of life.

Pursuing a different approach than the “norm”, can seem daunting. Just the terminology used in different forms of medicine can be overwhelming. Taking this journey does not mean that “Western” medicine must be left at the curb. Many of our patients enjoy their best health when we integrate our therapeutic options. We will present a prioritized approach to you in a concise yet thorough manner.

If you are interested in taking the next step, please call the Broad Ripple Animal Wellness Center at 317-726-2711. Seeking a new or integrated approach, may allow your pet to experience a greater sense of well-being.

Raising a puppy is not an easy job, just ask this veterinarian. I’m rediscovering the “joys” of puppyhood. Can anyone relate?

Number 1: Parasites happen! In our case, Giardia was the culprit—a lot of giardia. Even though I recommend treatment for this parasite all the time, and I know it’s a lot of work, I was still surprised. Giardia is a parasite that can cause diarrhea in some affected dogs, and Tilly seems to be one of those lucky dogs. On the upside, she took her medication like a champ (with the help of some canned food), and the daily hind-end baths were already happening since she was having daily accidents in her cage. For us, Matilda was a real life example as to why fecal testing is so important. We were lucky to find the Giardia on a routine sample before her symptoms got really bad.

Number 2: Crate training does get better. Sometimes it just takes a little longer than others. Even with a special food toy that she only got when she went in her crate, Tilly had a very rough time getting used to her crate. My last dog loved his crate after only a week, but Matilda took some more convincing. Although it is still not her favorite place in the world, she no longer cries for hours on end. We had to do things like rearrange our room to make room for the crate, and keep it with us whether in the living room or the bedroom. Often in the evenings, I would toss food treats into the crate to get her to explore it on good terms. Our next step was going to be to feed her in the crate, but she seems to have warmed up to it. It is definitely still a work in progress, but she is getting it. I know the rewards of her loving her crate and feeling safe in it are so worth it!

Number 3: Gentle leaders are lifesavers! In true “Tilly-style”, this took some work also, but she is getting it. We diligently watched the video that comes with it one Saturday morning, and expected her to get it pretty quickly. Unfortunately, she didn’t love it. Now she knows that she gets to go somewhere fun when she puts it on, so that is definitely working! Now, at least 80% of the time, she walks like a very good dog when we take her different places in the city.

Number 4: Socialization is so very important! Now that her vaccines are all on board, and her parents are gone, she gets to go see other dogs. Until now, she had spent most of her time learning bad habits from our cats—her favorite “squeak toys”. She loves other dogs, and just has to learn how to act around them. She doesn’t understand why my parents’ senior dogs don’t like her jumping all over them, and she isn’t great at taking a hint. I know that she will eventually “get it”, with lots of practice and more socialization.

If you are considering adopting a puppy, or are raising a puppy feel free to email Dr. Fruit with your questions at l.fruit.dvm@bracpet.com, or call the Broad Ripple Animal Clinic and Wellness Center for an appointment with Dr. Fruit at 317-257-5334.

When we think of toxic substances, we tend to think of chemicals, cleaners, and medications. However, there are common items you might find around any household that most people don’t realize can be toxic to their beloved pets. Here are four common items, you should take precautions with, if you have a cat or dog in your household:

1.  Xylitol:  This toxin is an artificial sweetener found in many different products including chewing gum, candies, and toothpaste.  It is a dangerous chemical that can cause its first sign of toxicity as earl as 10-15 minutes after ingestion.  It causes a marked decrease in blood glucose levels rapidly due to its quick absorption when ingested.  After that, since it is cleared by the liver, the liver is at risk.  Some dogs may exhibit liver damage even if they did not experience the low glucose initially, so blood monitoring is very important in cases of xylitol ingestion.

2.  Hops:  More and more people are experimenting with home brewing beer, and this may pose a threat to our pets if we are not careful with disposal of the hops.  Ingestion of hops can cause symptoms in multiple body systems, so immediate intervention is warranted.  Certain breeds are at an increased risk to some of the effects of hop ingestion.  These breeds include the Labrador retriever, greyhound, Saint Bernard, pointer, Doberman, Border collie, English springer spaniel, and northern breed dogs.

3.  Lillies:  With spring and the Easter holiday just around the corner and spring everywhere, lillies are also abundant.  These can be especially toxic to cats, and toxicity can come from ingesting any part of the plant.  This toxicity can cause kidney failure within hours of ingestion so early, aggressive therapy is warranted.  If your cat ever eats part of a lilly or if you think that he/she might have, please call for immediate assistance.

4.  Bread Dough:  Part of making bread and pizza dough often involves leaving it on a counter to rise.  However, this poses a risk to those counter surfer dogs out there.  Ingestion of bread dough can effect many body systems in multiple, sometimes severe, ways.  Again with this toxin, with early care and aggressive care, they can have a good prognosis.

If you suspect your pet has ingested any of these items, do not hesitate to call your veterinarian immediately! Even after hours, our Registered Veterinary Technicians are available until 10:00pm to answer your phone calls, Monday-Friday. If you have any questions, please feel free to call the Broad Ripple Animal Clinic and Wellness Center at 317-257-5334, or email Dr. Fruit directly at l.fruit.dvm@bracpet.com

Every year, veterinarians discuss the importance of flea and tick control, along with heartworm disease prevention. You’ve probably heard it every year and according to our medical records, only about half of our pet owners use some type of prevention for about six months out of the year. The question is, are we doing enough to protect our cats and dogs, and ultimately our families?

According to the Companion Animal Parasite Council, flea prevention should be administered to all kittens and puppies, as early as possible and for the lifetime of the pet. When it comes to heartworm disease, which is completely preventable, Indiana has been averaging 26-50 cases per reporting clinic, each year for the past ten years! So, are we truly doing enough? Probably not! What needs to happen this year, when we will surely be inundated with more fleas and more mosquitos than we would ever want in a single season? Get your pets protected NOW, and keep them protected every month all year long.

At Broad Ripple Animal Clinic and Wellness Center, we have three easy choices for you and your pet:

• Revolution is a topical product that you apply directly to your pet’s skin, once a month. When used properly, this product will protect your pet from fleas and heartworm disease. We recommend this product for both cats and dogs. If you purchase it from our clinic, a 10-dose purchase will get you two free doses, assuring your pet is protected year round. Pfizer Animal Health offers a convenient monthly email reminder program that you can sign-up for online at Revolution Reminders!

• Trifexis is an oral product for dogs. It comes in a once-monthly, beef-flavored tablet that will also protect your dog from fleas and heartworm disease. If giving your dog a monthly treat is more up your alley, and you want to support the concept of buying “local”, Indianapolis-based Elanco is offering a $20 rebate on 12-month supplies purchased from veterinarians. Simply go to trifexis.com/vet for more information.

• ProHeart 6 is a heartworm prevention that is administered by way of injection by a licensed veterinarian, every six months. This is the ideal solution for dog owners who have trouble remembering to give a monthly preventative. We recommend pairing ProHeart 6 with Comfortis to offer your dog broad range protection from fleas. Elanco will even send you a text or email reminder to give your dog’s Comfortis once a month, when you sign up at www.comfortis4dogs.com!

The last thing any of us want is a flea infestation in our homes, or bad news that our pet has heartworm disease! An ounce of prevention is worth having peace of mind. Stop by either the main clinic or the Wellness Center and we’ll help you determine which treatment plan is best for you and your pets. Time for your pet’s check-up? No problem—give us a call at 317-257-5334 and we’ll take care of all your pet’s preventative needs.

What is the purpose of vaccination?  It is to safely protect our pets from scores of debilitating and deadly diseases.  Taking your dog or cat to the veterinarian for vaccinations, though, is not as simple or as straightforward as you would think it should be.

First of all, vaccines need to be individually tailored to each pet.  Some vaccines are needed while others may not need to be given.  Some should be given every 6 mos. while others every 3 years.  Others are in between.  To iron this out, you should begin in our office with a consultation on what would be best for you, your pet, and your lifestyle.

Another thing to consider is vaccination safety.  In the veterinary field there are many manufacturers and types of vaccines to choose from.  We could choose our vaccines based on price, but this doesn’t always mean safest or most effective.  We can also choose vaccines that vary in their scientific technology.  Some vaccines for viruses and bacteria contain killed components, some are live but inactivated, and some contain only portions of their DNA or involve other aspects of genetic engineering.

With all these choices how do you know you are getting a quality safe product when you take your pet for vaccines?  This could be a problem.

I can assure you that we at the Broad Ripple Animal Clinic and Wellness Center are completely committed to your pets’ safety and protection.  We choose our vaccines accordingly and make sure we are always up to date on the latest national and regional recommendations.  In fact, as I write this blog, I am flying cross country to take part in an educational conference that will include, in no small part, proper vaccination.

It is, after all, our jobs as veterinary professionals to care for you and your pets and treat them as we treat our own.

There are so many things that make BRAC special, but one of my favorite things that sets us apart from many clinics is our wonderful team of veterinary technicians.  Did you know that BRAC currently employs ten Registered Veterinary Technician (RVTs) and Licensed Veterinary Technicians (LVTs) [the nomenclature differs slightly based on the state where training was completed]?   This is basically unheard of in non-referral, small animal general practice.

Veterinary Technicians go to school for two or more years to learn everything from anatomy to pharmacology to animal behavior.   They complete hands-on training with a variety of animal species, so they can assist and perform technical tasks in the exam room, the treatment area, and the surgery suite.   After years of schooling, they must pass a rigorous licensing exam, and only about 65% of those who take it will achieve a passing score.   As you can see (or hopefully already have seen if you are a BRAC client!), RVTs and LVTs are highly trained and skilled individuals that are passionate about animals and animal care.

What does this mean to me as a veterinarian practicing at BRAC?

1)  It means that I work in a place that cares about offering the best quality of medicine and care to its clients and their pets.   Imagine if you or a family member checked into a hospital that employed no registered nurses.   How comfortable would you be with having a blood draw or being prepped for surgery?   The fact that BRAC only permits these types of tasks to be performed by registered technicians tells me that we care about efficiency, safety, and the comfort of our patients.

2)  It allows me to leave those important technical tasks, such as drawing blood, running laboratory tests, placing catheters, performing dental cleanings, and monitoring anesthesia, to a veterinary technician.   This leaves me so much more time to examine patients, develop treatment plans, and most importantly –  talk with our wonderful clients about their pets’ needs!

Interested in becoming a veterinary technician?    Visit the American Veterinary Medical Association (AVMA) website to learn about accredited university programs.   Talk to our BRAC veterinary technicians about their experiences.   And, look us up when you graduate!

As a veterinarian at Broad Ripple Animal Clinic and Wellness Center, I discuss puppyhood with my clients on a daily basis. Raising a puppy can be a challenging, but very rewarding experience. I recently adopted a new puppy (Matilda) and have rediscovered my “inner client” when it comes to raising a pup.

1.  Patience is a virtue.  This is no joke.  I have had to learn to be very patient with the fact that my little Matilda knows no difference between right and wrong unless I teach her.  She is constantly testing her boundaries and learning new things (good and bad!).  Training is a process.  This is a phrase I repeat to myself many times a day.  The key to raising a good puppy is realizing that it does not happen overnight.  I must remain patient and continue to reward the good behaviors so she wants to repeat them.

2.  Consistency is vital.  Everyone in our house has to maintain a united front in favor of good behaviors; otherwise, Matilda takes baby steps back in her training.  Each time we forget to give her a treat or positive reinforcement for going potty outside or dropping something she shouldn’t have, she remembers.  She remembers everything!  She knew within days which family member would let her get away with more bad behaviors.  It is really hard to say no to that adorable little face, but sometimes it is necessary.  If we all follow the same rules, she eventually will do the same.

3.  Puppies have VERY short attention spans.  Short training sessions are the key to making them successful.  As long as you don’t overwhelm them, puppies are sponges for knowledge.  The problem comes when you work for too long at something and you or your puppy gets frustrated.  I have had to learn to walk away from training sessions with Matilda if she isn’t responding well.  We can always do something else for a while and try again later.  This also takes us back to my first point–patience is a virtue.

4.  Nothing is off limits in a puppy’s mind.  Nothing.  This means decorations, mail, clothing, toes, cats, things that cats leave in litter boxes, furniture, baseboards, etc.  Between baby gates and fantastic products like Bitter Apple, this problem can be dealt with, but it isn’t always easy.  This brings me back to my second point–consistency is vital.  If Matilda chews on one table leg that doesn’t taste terrible, she will likely try it again sometime.  She has taught me that everything is chewable to a puppy.

5.  Each puppy is unique.  She learns at a different pace than my previous dog, Elliott, and that is OK.  Not all puppies latch on to good behaviors right away.  Some do, but some don’t.  It definitely doesn’t mean that she won’t get it, or that she will never be a well behaved dog.  Matilda just learns at a different pace than Elliott learned. I am confident that (perhaps with a little help from the very smart people at Bark Tutor) Matilda will grow from a rambunctious puppy into a very well behaved canine companion.

Dental x-rays are a very important part of oral care for our pets. They are an integral step in the Complete Oral Health Assessment and Treatment (COHAT) plan that is performed when your pet goes under anesthesia for oral care. In addition to dental x-rays, this COHAT plan includes full cleaning above and below the gum line, careful probing and charting of the teeth and teeth structures, assessment of the tongue, gums, and soft tissues of the mouth, and often photography to document your pet’s oral health. This process is very similar to a visit to our human dentists.

So, why are good quality dental x-rays so necessary?

Dental radiography is often the only way to detect problems with teeth, gums, and bones beneath the surface of the gum line. Nearly 70% of tooth structure and the structures that hold the teeth securely and comfortably in the mouth are invisible to the naked eye and our handheld dental instruments. X-rays remain the only way to find hidden, and often painful or infected problems that we can’t visually see, and your pet can’t describe to us.

So, is this invasive? How is it performed?

It is not invasive at all, and for experienced veterinary professionals who have the training to perform it efficiently, it is safe and adds very little extra time to the COHAT process. At Broad Ripple Animal Clinic and Wellness Center, a state of the art digital dental x-ray receiver is placed in the mouth of your pet and an x-ray machine that emits a very low level of x-ray takes high quality, detailed images of the structures we otherwise couldn’t see. The images immediately appear on a large computer monitor, where we can see the anatomy and make any treatment decisions for hidden pathology. At the end of the procedure, the x-ray images can be printed out so you can see what was found and what needed to be done to keep your pet happy, healthy, and pain-free. For more information about pet dental care, please call the main clinic at 317-257-5334 or check out our dental website.

Trupanion has amazed us again!  Since our last discussion, the pet insurance company has now extended its “Free 30 Day Trial” to dogs and cats from 8 weeks to 14 years old.  Previously, the certificate was only valid for dogs and cats from 8 weeks to 12 months old, which may have been discouraging for pet owners whose interest was sparked by such an offer but their pet’s age exceeded the limits in order to take advantage of this deal.  This news is incredible given the misconception  that the older pets get, the less they will benefit from veterinary pet insurance or, that they aren’t eligible to participate in pet insurance programs at all. Trupanion is now aiming to prove otherwise! This trial offers coverage effective immediately once enrolled. No payment information is required, and once the 30 days end the coverage is automatically cancelled, unless the coverage is voluntarily continued by the pet owner.

There is one difference to be mindful of when taking advantage of the 30 day trial for a pet over 1 year old.  The deductible is $0 for pets under 12 months, but it is $250 for pets 1 year to 14 years old.  This is a very generous offer for pet owners should their pet have a major medical expense during that time.  Keep in mind this deductible is per condition over the lifetime of the policy not per visit, so pet owners should not be weary if their pet does not have a medical incident that is over $250, especially if coverage is continued beyond the free trial.

It is feasible that even if there is not a medical expense totaling more than $250 but one which is less during the 30 day trial and coverage is continued, Trupanion will cover 90% of the claim costs related to a condition over the lifetime of the policy once the $250 deductible is met. It is important to note that after the 30 day trial period expires pet owners can always adjust their deductible to fit their financial needs with only that specific condition remaining at the $250 deductible.

Naturally, the next important thing to think about when considering enrolling a pet that is over a year old is pre-existing conditions.  Trupanion’s policy on pre-existing conditions is certainly not any different for a pet that is 8 weeks old  than it is for a pet that is 14 years old, but, unfortunately, pre-existing conditions are much more likely to be present in an older pet than in a puppy or kitten. Trupanion defines a pre-existing condition as an illness that is present at or during the 18 months prior to the enrollment date or an abnormality that is detected or present at or during the 18 months prior to the enrollment date.

So, what does that mean for pet owners? Hopefully that a previously diagnosed or detected condition has not recurred/flared-up within 18 months of enrollment, but if it has pet owners should not overlook the fact that there can always be the unexpected medical expense.   Additionally, medical concerns can arise due to normal aging, so it is very likely that a pet will benefit from pet insurance regardless of age or previous medical history.  Quite simply, even a pet with a “pre-existing” condition still has a need for pet insurance.

Lastly, one additional topic to discuss when addressing Trupanion as a preferred pet insurance provider, even beyond the Free 30 Day Trial Certificate, is “Claims Express.”  “Claims Express” is a service that Trupanion offers to selected veterinary clinics to help pet owners with the unexpected major medical expense by working directly with the veterinarian to give preauthorization for a procedure and by paying the clinic directly.  What does that mean?  That means the pet owner would only be responsible for the cost of the exam fee, 10% of the claim, and his or her deductible (if there even is one) in order for the pet to get the medical treatment needed.  Moreover, that means that the claim is prioritized with Trupanion and treatment can begin immediately following preauthorization, which gives the pet owner piece of mind while also lightening his or her financial burden.  And yes, this offer is available to those pets covered under the 30 day trial period.

If you are interested in enrolling your pet, please contact the main clinic at 317-257-5334 or the Wellness Center at 317-726-2711.  The certificate must be activated within 24 hours of an examination, and with your consent, we will activate the certificate before you leave our office.  That’s one less thing for you to worry about!

In contrast to most of my veterinary colleagues, I do not remember exactly when I knew that I WANTED to be a veterinarian. For some veterinarians, the moment they know is as acutely remembered in all details as some of the big events in our society – like 9/11 or when Kennedy got shot, just more positive!  For me, it was a long slow dawning of realization over many years.  

I loved everything to do with animals as a child, but it never occurred to me, until I was 16 years old, that I could or should make a career out of my interest in animals. I then volunteered with our family veterinarian during my summer vacation, but, unfortunately, fainted when I first watched surgery, and was so embarrassed that I never returned!  The thoughts of that particular career went on hold for a few years after that. When I got to college, I started aiming for a career in science, but focused at that time on human medicine, and later went to grad school to become a physician assistant.  During all those years, despite the interest in human medicine, I still spent most of my time outside of school and work involved with animals.

After about 10 years of being a physician assistant, I realized that I wanted to go further in medicine and started toying with the idea of going to medical school. At about that time, I visited close friends in Ithaca, New York and they had just had their cat treated at the Cornell College of Veterinary Medicine, and raved about the hospital and the veterinary college there. They were absolutely positive that being a veterinarian was the right thing for me and insisted that I take a tour and speak to the admissions director just to see if I had some of the background needed. It made sense to me to combine what I enjoyed doing in work with what I enjoyed doing outside of work, so I went along with it.  I thought this career would be out of reach for me, but, surprisingly, it wasn’t, so I applied.  I DO remember with that crystal-clear detail the moment that I got the news of my admission to the Cornell College of Veterinary Medicine and learned that I actually COULD be a veterinarian.

However, the moment I remember best was when I knew that my decision to become a veterinarian was absolutely the RIGHT one – it was when, in 1997, I walked into the Broad Ripple Animal Clinic for the first time.  That was the moment I will never forget, because I relive it every day that I come to work.