Wellness Care for Your Pet

with a Chronic Condition

We recommend yearly examinations for all healthy animals and twice yearly examinations for all pets with a chronic condition such as arthritis, thyroid disease or diabetes. Many of these diseases can place your pet at risk for secondary problems such as high blood pressure, urinary tract infections and blindness. Our goal is to identify and treat these secondary problems before they impact your pet's quality of life.

Dogs

NSAID's:  Dogs on long-term NSAID's (Rimadyl, Metacam, Previcox, Deramaxx, Piroxicam) should have a blood panel performed every six months to monitor kidney and liver function.

Bladder Stones:  Monitoring dogs with bladder stones is tailored to the individual depending on what type of stone they had and how prone they are to recurrence. In general, a urinalysis and ultrasound or x-ray of the bladder should be performed every six months. Some dogs require more frequent monitoring of their urine to help prevent recurrence.

Hypothyroidism:  For dogs on thyroid supplementation, we recommend their thyroid levels be checked every six months. It is best to schedule the appointment for the blood draw four to six hours after the medication is normally given. The medication should be given consistently during the two weeks before the test is done and at the normal time the morning of the blood draw.

Diabetes Mellitus:  Diabetic dogs should have a glucose curve performed every six months and a full blood panel performed yearly. Because diabetic dogs are at a higher risk for urinary tract infections, they should also have a urinalysis and urine culture done every six months as well. Some dogs may require more frequent monitoring if they are difficult to control.

Seizures/Epilepsy:  Dogs on phenobarbital should have their phenobarbital level and liver values evaluated every six months and a full blood panel performed yearly. The medication needs to be given consistently for the three weeks prior to the test being done. It is best to measure the trough (lowest) level which is just before the next dose is given. This may mean a first morning appointment or late afternoon appointment is most appropriate depending on what time of day the medication is normally given. Other medication levels such as Keppra and zonisamide are not routinely monitored; however, dogs on these medications should still have a blood panel performed yearly.

Cushings:  Cushingoid dogs receiving trilostane or lysodren/mitotane should have an ACTH stimulation test performed every six months. Since they are also at risk for urinary tract infections, they should also have a urinalysis performed with a urine culture. A drop-off appointment should be scheduled for the ACTH stim test since this test involves two blood draws one hour apart. We can generally collect urine during this visit.

Addisons:  Addisonian dogs should have their electrolyte levels evaluated every six months and a full blood panel performed yearly.

Cats

Chronic Renal (Kidney) Failure (CRF):  The frequency of monitoring for CRF is very dependent on the stage of kidney failure and how your cat is acting, feeling and eating. Many cats do well with monitoring and adjustments made to their therapy every six months; however, some cats require more frequent monitoring especially as time passes and the disease progresses. Cats diagnosed with chronic kidney disease should have a blood panel performed at least every six months. Since they are at an increased risk for hypertension and urinary tract infections, they should also have their blood pressure measured as well as a urinalysis and urine culture every six months.

Hyperthyroidism:  Cats with hyperthyroidism who are on methimazole/tapazole therapy should have a blood pressure measurement, urinalysis and a blood panel run every six months. These cats are at risk for hypertension and urinary tract infections. It is important to give the medication consistently during the two weeks before the tests are run and at the normal time the morning of the blood draw.

Diabetes Mellitus: Diabetic cats should have a blood glucose curve and urinalysis with urine culture performed every six months with a full blood panel performed yearly. Because some cats have a profound "white coat syndrome" after a stressful car ride or day in the hospital, we encourage owners to perform blood glucose curves at home. Many cats tolerate this very well and we will be happy to get you comfortable with the process. The "numbers" can then be brought to the hospital with you for the physical exam and urine sample collection and we can evaluate the numbers from your at-home curve. If at-home curves are not an option, we may do in-hospital curves and/or fructosamine levels to assess control.