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A disease of the pancreas, diabetes mellitus occurs when this small but vital organ near the stomach stops producing insulin, doesn’t produce it well, or doesn’t produce enough of it to regulate glucose (blood sugar). Diabetes can also develop when a pet can’t effectively use insulin in the first place (a condition called insulin resistance).

Glucose is the primary source of energy for the cells of the body, and insulin is the hormone that regulates the level of glucose in the bloodstream and controls the delivery of glucose to the rest of the body. When a dog or cat has diabetes, blood sugar is elevated, but without insulin to tell the cells to absorb glucose from the bloodstream, they become starved for glucose. This causes the body to begin breaking down stores of fat and protein for energy instead.

If diabetes isn’t treated or remains uncontrolled, the pet may become very sick, requiring hospitalization.

Pets at Risk for Diabetes

Both cats and dogs can get diabetes, and the disease can begin at any age. However, diabetes does tend to more commonly affect pets who are older, with the disease typically diagnosed in middle-aged dogs and older cats.

Certain dog breeds are at higher risk, and female dogs tend to get diabetes more often than male dogs. The opposite is true in cats, with diabetes being more common in male cats than in female cats.

Causes of Diabetes Mellitus

Major risk factors for diabetes are obesity and long-term use of medications that contain corticosteroids. Other conditions can also make a pet more likely to develop diabetes or can make it more difficult to effectively treat diabetes; these include heart disease, hyperthyroidism (an overactive thyroid gland), hyperadrenocorticism (an overactive adrenal gland), kidney disease, pancreatitis, skin infections, and urinary tract infections.

Health Effects of Diabetes Mellitus

Untreated or poorly managed diabetes can make pets more prone to developing other diseases or conditions, such as bladder stones, cataracts (which can lead to blindness), hypertension (high blood pressure), kidney failure, pancreatitis, and urinary tract infections. Diabetes can affect every organ system in the body if the disease isn’t treated or managed properly.

Another potential complication is diabetic ketoacidosis, a medical emergency in which the amount of insulin in the body becomes extremely low. This condition can be life-threatening and can occur before diabetes is diagnosed or even during treatment.

Diabetes is becoming more common in both dogs and cats because the number of overweight and obese pets is on the rise.

Clinical Signs of Diabetes Mellitus

The main symptoms of diabetes in pets are:

• Increased thirst/excessive water consumption
• Increased urination
• Increased appetite
• Weight loss

These symptoms can also be signs of other diseases or medical conditions, so it’s important that we examine your pet to determine what’s causing them. If your dog or cat shows any of these signs, please let us know.

If your pet with diabetes stops eating and drinking, it may be a sign of diabetic ketoacidosis, which is an emergency and requires hospitalization. Other signs of ketoacidosis include:

• Sweet-smelling breath
• Rapid breathing
• Lack of energy/weakness
• Vomiting

Diagnosing Diabetes Mellitus

Your St. Francis veterinarian will diagnose diabetes based on the classic clinical signs, as well as through the results of blood and urine tests that show a persistently high glucose level in the blood and the presence of glucose in the urine. Pets with diabetes have excessive amounts of glucose in the blood. This excess glucose is removed by the kidneys and then flushed out of the body in the urine. Glucose in the urine is a primary indicator of diabetes.

To confirm the diagnosis of diabetes mellitus, your veterinarian may run a serum fructosamine test, which shows average blood glucose levels over a week or two.

Treating Diabetes Mellitus

Fortunately, diabetes mellitus can be managed in dogs and cats. It typically requires long-term treatment with daily insulin injections and careful monitoring of glucose levels.

Monitoring pets with diabetes is crucial to ensure that they are responding well to insulin therapy and other aspects of the diabetes management plan.

A well-balanced diet is an essential part of effective diabetes management. If your pet has diabetes mellitus, your veterinarian will likely recommend a dietary change to help manage the disease. A lot of factors go into deciding what nutrition is needed for a pet with diabetes; your veterinarian will select a diet that will work best for your individual pet’s needs.

Managing Your Pet’s Diabetes at Home

If your pet has been diagnosed with diabetes, you play an incredibly important role in helping to manage the disease. Giving insulin injections and monitoring glucose levels quickly becomes routine for most pet owners. We will make sure you understand how to give insulin and how to monitor your pet’s blood sugar so you become comfortable with the process.

Even more important than what your pet eats is feeding your pet consistently. Along with making sure your pet gets insulin at the same time each day, feeding your cat or dog a consistent amount of the same food (and the same treats) at the same time each day is also essential to helping keep your pet’s glucose under control.

Exercising your pet consistently and minimizing stress will also be important.

In addition, you’ll want to keep an eye on any new developments, such as changes in:

• Appetite
• Energy level
• Grooming habits (particularly in cats)
• Water consumption
• Urine output
• Weight

Preventing Diabetes Mellitus

Most pets who develop diabetes are predisposed to the disease, so preventing diabetes isn’t usually possible. However, because obesity seems to play a role in the development of diabetes in some dogs and cats, keeping pets at their ideal weight may help or at least make it easier to treat the condition.

Removing potential causes may lead to resolution of diabetes in certain cases. For instance, some medications may make pets more likely to develop diabetes; your veterinarian may recommend stopping these drugs to see if that helps. Do not stop giving your pet any previously prescribed medications without first checking with your veterinarian.

Cats with diabetes may go into diabetic remission, a condition that occurs when a cat’s blood glucose is regulated and stays at normal levels for more than a month without needing insulin injections or other glucose regulation. Some cats can stay in diabetic remission for months or even years. Cats have the best chance of going into remission when insulin therapy is started quickly and adjusted appropriately, with the chosen diet being given consistently.

Your Veterinarian’s Role in Your Pet’s Diabetes Management

If your pet has diabetes, we want to catch this disease as early as possible to help make sure it’s properly controlled and to minimize or avoid potential complications. We’ll walk you through how to give insulin injections and monitor glucose levels, as well as how to track any other changes.

In addition, your pet’s nutritional and insulin needs may change over the course of his or her disease. Through regular check-ins, your veterinarian will help you make sure your pet with diabetes continues to stay on track.

Give us a call today if your pet is showing any signs of diabetes or if you’re concerned about your pet’s health. As long as the disease is well managed, many pets with diabetes can enjoy a good quality of life.

Both dogs and cats can suffer from bladder stones, which are hard, rock-like formations of minerals that develop in the urinary bladder. Also called uroliths or cystic calculi, bladder stones can range from small, sand-like grains to larger, gravel-sized stones.

A pet can have several stones that range in size, but even just a single stone can cause pain and potentially be life-threatening. This is why, if you suspect your pet has bladder stones, please let us know immediately.

Signs of Bladder Stones in Pets

Symptoms of bladder stones in dogs and cats include:

• Blood in the urine
• Straining to urinate
• Abdominal pain
• Frequent urination, but only urinating a small amount each time
• Urinating in odd places
• Urinating in the house (dogs)
• Urinating outside the litterbox (cats)
• Licking the urinary opening
• Inability to urinate (this is a medical emergency!)

Some pets don’t show any obvious signs of bladder stones, and some of the signs may be the same as those of other, possibly related, conditions, such as a urinary tract infection.

If your pet is straining to urinate and nothing (or only a dribble) comes out, call us right away! It could mean that a bladder stone is blocking the urethra. This situation can cause the bladder to rupture and requires immediate veterinary attention.

Bladder stones can irritate the urinary tract or even inhibit the flow of urine. If your pet can’t urinate, call us immediately. Inability to urinate is a medical emergency!

Causes of Bladder Stones in Pets

Bladder stones form when certain minerals found naturally in a pet’s body aren’t processed correctly in the urinary system or if the levels of specific minerals are too high. These factors can cause minerals to crystallize and ultimately harden into bladder stones.

To complicate matters, there are several kinds of bladder stones, depending on what type of minerals are involved. The most common bladder stones in both cats and dogs are struvite (magnesium ammonium phosphate), calcium oxalate, and urate. Some stones are made up of more than one type of mineral, potentially making diagnosis and treatment trickier.

Depending on the type of stone, other conditions may contribute to bladder stone formation in a cat or dog:

• Dietary/nutritional imbalance
• Urinary tract infection
• Kidney disease
• Metabolic factors
• Decreased water intake
• Urine acidity (pH)
• Long-term use of certain medications
• Genetic or breed predisposition

Pets can get bladder stones at any age. Some types of stones are more likely to form when pets are younger or middle-aged, and others tend to be more common as dogs or cats get older. Older age can also make pets more prone to certain conditions that may lead to stone formation.

Diagnosis of Bladder Stones

If your veterinarian suspects that your pet has bladder stones, he or she will perform a physical exam on your pet and ask about your pet’s dietary history and any symptoms you’ve noticed. Your vet may recommend tests such as a urinalysis, urine culture, and blood work, as well as abdominal ultrasounds and/or x-rays (radiographs) to help locate bladder stones and determine their size.

Catching bladder stones early can help prevent complications such as urinary obstruction and may mean your vet could have more options to help treat your pet.

Treatment of Bladder Stones

Your veterinarian will recommend treatment for your pet based on the specific type of bladder stones, as well as other factors, such as the size or location of the stones and your pet’s overall health. Treatment options may include:

• Removing the stones surgically from the bladder (cystotomy) or the urethra (urethrotomy).
• Flushing the stones back into the bladder using a nonsurgical technique called urohydropropulsion, in which fluid is passed through a catheter placed in the urethra to try to remove a stone or stones that are causing an obstruction. Your vet may first perform a procedure called a cystocentesis to drain urine from your pet’s bladder.
• Feeding a diet specially formulated to dissolve certain bladder stones.

Surgery is the fastest way to treat bladder stones and is often needed if stones are blocking the urethra and preventing your pet from being able to urinate. However, surgery may not be needed or appropriate in every case, and other options may offer your pet relief.

If your pet is put on a special diet, he or she will likely need antibiotics for the duration of therapy to help resolve and prevent bacterial infection. In dogs, an infection is typically what causes the type of stones that dietary therapy is effective for, and bacteria can be released into the bladder as the stones are dissolved, potentially causing a new infection.

Dietary therapy may be needed for several weeks or months, and your veterinarian will need to check progress of stone dissolution through urinalysis and x-rays or ultrasound. Because this may be a slow process, your pet may continue to experience pain and other symptoms of bladder stones while on the diet. If the diet doesn’t work or a urethral obstruction occurs during that time, other treatment will be needed.

Prevention of Bladder Stones

We can’t necessarily prevent bladder stones from forming, but we can take steps that may help, including:

• Encouraging your pet to drink more water (either by adding water to your pet’s food or switching to canned food)
• Adjusting your pet’s diet to further reduce the concentrations of the problem minerals in the urine and to adjust the urine pH as needed
• Treating underlying infections or diseases

Don’t Wait to See What Happens!

If you notice any signs of bladder stones in your pet, give us a call. Because other diseases and conditions sometimes have similar signs, your St. Francis veterinarian will determine what’s causing your pet’s symptoms and recommend treatment options.

Bladder stones can become life-threatening quickly. Early diagnosis and treatment can make a difference in the outcome and recovery of a pet with bladder stones.

Is Your Pet Protected Against Heartworm Disease?

Heartworms, which are transmitted by mosquitoes, pose a risk to dogs, cats, and ferrets in and around Fredericksburg year-round. Here’s what you need to know to make sure your pet is protected.

Heartworm Disease Is Preventable!

When a mosquito infected with heartworm larvae (baby heartworms) bites a dog, cat, or ferret, the larvae enter the pet through the bite wound. Over the next few months, these tiny worms make their way inside the pet to the heart and lungs, maturing into adult heartworms and causing serious damage to these organs and associated blood vessels.

Your pet can get heartworms from just a single mosquito bite!

Although we can’t prevent a pet from getting heartworms, we can stop these worms from developing into adults and harming your pet. There’s a brief window (about 2 months or so after infection) when these baby worms can be killed off. If a heartworm disease preventive is administered during this crucial time, your pet will be protected against heartworm disease.

What If You Miss That Crucial Prevention Window?

If the immature worms are allowed to continue developing inside your pet, they will become resistant to heartworm disease preventives. At that point, treatment will be required to kill the adult worms. But treatment is only available for dogs, and it can be difficult, costly, and even deadly. No treatment has been approved for cats or ferrets with heartworm disease.

Untreated, heartworms can grow up to a foot or more in length. And even if they are treated successfully, heartworms can cause lasting damage to a pet’s heart, lungs, and blood vessels.

The best way to protect your pet against heartworm disease is by giving a heartworm disease preventive regularly.

What Are the Signs of Heartworm Disease?

In dogs, cats, and ferrets, heartworm disease can cause:

• Coughing or gagging
• Difficulty or rapid breathing
• Fatigue/weakness
• Reluctance to exercise or exercise intolerance
• Swelling in the abdomen
• Weight or appetite loss
• Sudden collapse or death

Heartworms may cause no symptoms, especially in the early stages.

Dogs with a lot of worms can develop what is called “caval syndrome,” in which the worms block blood flow through the heart, eventually resulting in heart failure. Ferrets can also suffer from this syndrome.

Cats with heartworms may also show other signs, such as vomiting or diarrhea, trouble walking, fainting, or seizures. Early signs of heartworm disease in cats may resemble those of asthma, when in fact, they’re symptoms of what’s referred to as “heartworm-associated respiratory disease” or HARD. Even just 1 or 2 heartworms in cats or ferrets can cause severe symptoms and be life-threatening.

Why Do We Test for Heartworm Disease?

Annual testing for heartworm disease is essential for all dogs. Even for a dog on year-round preventives, if a dose was accidentally missed or the pet vomited or spit out the medication unnoticed, for instance, the dog might not be protected against heartworm disease. If a preventive is given to a dog who has adult heartworms, it can be deadly.

What Do We Recommend to Prevent Heartworm Disease?

Protecting our patients against heartworm disease is a top priority for us at St. Francis. Although heartworm disease can be deadly, it is preventable. It’s also much easier and less stressful (for you and your pet) to prevent than to treat.

Because the temperature in Northern Virginia never stays all that cold for very long and it’s difficult to predict when mosquitoes will be active and feeding, we recommend that all our patients stay on a heartworm disease preventive year-round. That way, you don’t need to guess when your pet might be susceptible to heartworm infection.

Give us a call today to request a refill on your pet’s heartworm disease preventive, or book an appointment for your dog’s next heartworm preventive injection.

Ticks pose a risk to pets and people in Fredericksburg and throughout Virginia. The mild winter we’ve had means the 2020 tick season in our area will likely be just as bad as last year’s.

Besides feeding on blood, ticks can transmit diseases (like Lyme disease and ehrlichiosis) to pets and can cause serious illnesses and conditions, such as:

• Anemia (decreased number of red blood cells or hemoglobin, which in serious cases can require a blood transfusion)
• Cardiac complications
• Low platelets (blood cells that help blood clotting), which can lead to bleeding disorders
• Joint damage
• Kidney disease/failure
• Neurological disorders

This is why we want to make sure our clients are aware of the big problems these small parasites can cause—and how to help keep your pets protected.

Ticks in Virginia

There are around 900 tick species in the world, with 17 in Virginia and just a handful that pose a danger to pets and people in our area. The main ticks we have in Virginia are blacklegged (deer) ticks, American dog ticks, and lone star ticks. We also have brown dog ticks as well as a new tick species that has recently arrived in the United States, the Asian longhorned tick.

If you find a tick on your pet, you can submit a photo and information about the tick to TickSpotters, a crowdsourced survey tool that tracks ticks across the country.

Tick Diseases in Dogs

The ticks we have in our area can transmit several diseases to dogs, including:

• Lyme disease—Last year, more than 800 dogs tested positive for Lyme disease in Spotsylvania and Stafford counties, with more than 27,000 infected across Virginia. This year, we’ve already had more than 4,500 dogs test positive for the disease in our state.
• Ehrlichiosis—The risk for this disease in Virginia may be even higher than it is for Lyme disease, with more than 34,500 dogs testing positive in 2019.

The number of Lyme disease cases across the US has been steadily increasing in both pets and people for the past decade.

Ticks can also transmit other diseases to dogs, including anaplasmosis, babesiosis, and Rocky Mountain spotted fever, as well as tick paralysis, a serious, potentially deadly condition in which the nervous system is attacked by a toxin in the tick’s saliva.

Tick Diseases in Cats

Cats aren’t immune from ticks either. The parasites can cause tick paralysis and several diseases in cats, including Lyme disease, ehrlichiosis, and babesiosis. Other tick-borne diseases, such as cytauxzoonosis and tularemia, although rare, can be deadly in cats.

Even indoor-only cats can get ticks if the parasites hitch a ride inside on you or another pet.

Symptoms of Tick-borne Diseases in Pets

If you find a tick attached to your pet (or even if you don’t), let us know right away if you notice any of these signs of tick-transmitted diseases in your pet:

• Breathing difficulty
• Fatigue or weakness
• Fever
• Lameness (which may shift from one leg to another)
• Pale gums
• Sensitivity to touch
• Stiff, swollen, or painful joints
• Tiring easily
• Weight or appetite loss
• Vomiting or diarrhea

Lyme disease can also cause pets to walk stiffly with an arched back, but pets rarely get the characteristic bullseye rash seen in some people with Lyme disease.

Ticks can be tricky to spot, especially in your pet’s fur. Adult deer ticks are about the size of a sesame seed, and nymphs (immature ticks) are only about the size of a poppy seed or pinhead!

Prevention of Ticks and Tick-borne Diseases

You can take several important steps to help protect your pet and yourself from ticks and the diseases they can spread, starting with keeping your pet on tick preventive. Ticks remain active year-round in Fredericksburg. In fact, adult blacklegged ticks are typically active in the fall, winter, and spring as long as the temperature remains above freezing.

Learn more about how to prevent tick bites and create a tick-safe yard at these helpful sites:

• City of Fredericksburg, Virginia: Ticks and Lyme Disease Prevention
• TickEncounter: Protect Your Pets

The best way to prevent ticks on your pet is to keep your pet on a tick-control medication.

The Bottom Line

Ticks are a risk in our area. At St. Francis, we want to help keep our patients safe from these parasites. Call us today to make sure your pet is protected!

Arthritis in Dogs and Cats: Painful and More Common Than You Might Think

Osteoarthritis (OA) is a painful, progressive disease that causes joint inflammation, reduces mobility and flexibility, and lowers the quality of life in pets who suffer from it. OA cannot be cured, but it can be slowed, especially if it’s caught early.

How common is OA in dogs?

Arthritis affects at least 20% to 25% of dogs. And size doesn’t matter. Although larger dogs may be more prone to getting OA, any size dog can develop the disease. OA can be caused by wear and tear on the joints, but more often in dogs, it’s the result of developmental joint diseases.

Cats don’t get OA, do they?

Actually, arthritis is fairly common in cats. Studies have found evidence of OA ranging from 22% up to more than 90% of cats.

Isn’t arthritis just an old-age disease?

Although we may think of OA as a disease that develops as pets age, that’s not always the case. In fact, cats and dogs of almost any age can develop OA.

However, OA may become more noticeable in pets as they get older. Ideally, we want to catch the disease before it gets too advanced.

How do I know if my pet has OA?

Watch for any potential behavior or physical changes associated with OA. If your pet is older, don’t assume that any changes that you notice are just related to age.

Signs of OA-associated pain in pets include changes in mobility, activity, or sociability. These changes may be subtle.

Osteoarthritis is a painful, progressive disease. The earlier we catch it, the more we can do to help your pet—even potentially slowing down the disease.

In dogs, signs of arthritis include:

• Limping
• Favoring a leg
• Lagging behind on walks
• Reluctance to get up from a seated or lying position
• Trouble jumping up onto or off the sofa/bed or into or out of the car
• Reluctance to go up or downstairs
• Sleeping more
• Eating less
• Hiding or avoiding contact with other pets or family members
• Irritability, especially when handled or approached
• Chewing, licking, or biting painful areas
• Lack of interest in playing

In cats, signs of arthritis include:

• Making small jumps instead of a big leap to get up onto a table or countertop
• Reluctance to jump from heights
• Changes in daily routines
• Difficulty getting in or out of the litterbox
• Urinating or defecating outside the litterbox
• Trouble with or lack of grooming
• Reluctance to go up or downstairs
• Awkward movements (less graceful than normal)
• Hiding or avoiding contact with other pets or family members
• Changes in mood or tolerance of being handled (irritability)
• Sleeping more
• Eating less
• Lack of interest in playing

You can use these checklists to help spot arthritis pain in your dog or cat—and share the results with us:

• Canine OA checklist
• Feline OA checklist

Can I help prevent my pet from getting arthritis?

Although we can’t know for sure if what we do will prevent OA in pets, there are some steps you can take to help reduce the chance that your pet will get the disease:

• Keep your pet at a healthy weight.
• Make sure your pet gets enough low-impact exercise, such as walking and swimming.
• Ask us whether your pet could benefit from a special diet or supplement.

These steps can also benefit pets who already have OA.

How else can I help my pet with arthritis?

Although OA can’t be cured, your pet doesn’t have to live with the pain from arthritis. At St. Francis Animal Hospital, we have many options to help pets with OA.

Younger pets and those in the early stages of OA may not show obvious signs of the disease (such as limping). The earlier we detect the disease, the more we can do to help your pet with OA. That’s why it’s important for us to screen your pet for arthritis.

Schedule your pet’s OA screening today or give us a call to set up an appointment. We’ll work with you to get your pet moving more comfortably again and to make sure your pet stays as pain-free as possible.

References

• American College of Veterinary Surgeons. Osteoarthritis in dogs. https://www.acvs.org/small-animal/osteoarthritis-in-dogs. Accessed December 19, 2019.
• Godfrey DR. Osteoarthritis in cats: a retrospective radiological study. J Small Anim Pract.2005;46(9):425-429.
• Hardie EM, Roe SC, Martin FR. Radiographic evidence of degenerative joint disease in geriatric cats: 100 cases (1994-1997). 2002;220(5):628-632.
• KG MarketSense. 2018 Global Veterinarian and Pet Owner Market Research.
• Lascelles BD, Henry JB 3rd, Brown J, et al. Cross-sectional study of the prevalence of radiographic degenerative joint disease in domesticated cats. Vet Surg.2010;39(5):535-544.
• Mele E. Epidemiology of osteoarthritis. Vet Focus.2007;17(3):4-10.
• Slingerland LI, Hazewinkel HA, Meij BP, et al. Cross-sectional study of the prevalence and clinical features of osteoarthritis in 100 cats. Vet J.2011;187(3):304-309.

Keep Pets Away From Ribbon, Tinsel, and Other String-Like Objects

The holiday season is in full swing, so while you’re wrapping presents and putting up festive decorations, we wanted to take a moment to remind you of a potential hazard to pets. Many cats and dogs find long, thin objects like ribbon, tinsel, twine, and yarn fun to play with, but these “playthings” can quickly turn deadly if a pet swallows them.

Why Are Linear Foreign Objects Dangerous?

When a pet swallows what we call a “linear foreign object” or “linear foreign body,” it can create an incredibly dangerous situation for your pet.

The particular problem with long, string-like objects is that one end can get caught in one part of the digestive tract, like the stomach, intestine, or base of the tongue (especially common in cats), while the other end of the object continues to move through the gastrointestinal tract. When this happens, the string can become bunched up, much like an elastic drawstring in the waistband of sweatpants.

As the intestine tries to move the linear foreign object through the digestive tract, the motion can actually cause the object to tear or saw through the intestine. If the contents of the intestine spill into the abdomen, the pet’s life will be at risk.

If your pet has swallowed a string or string-like object, call us right away at 540-891-1275! This is a serious, potentially life-threatening situation, and the sooner we see your pet at St. Francis, the better chance your pet has for a fast and full recovery.

What Linear Objects Should You Keep Your Pet Away From?

These long, stringy objects can spell trouble for cats and dogs:

• Carpet fibers (such as from looped Berber carpets)
• Dental floss
• Ribbon
• Rope and rope toys
• String and toys with a string
• Strings from damaged or chewed leashes
• Threads from clothing
• Threads from towels or blankets
• Tinsel
• Twine
• Yarn

What Are Signs That Your Pet May Have Swallowed a Linear Foreign Object?

If your pet has swallowed a linear foreign body, he or she may show these symptoms:

• Vomiting
• Abdominal pain
• Dehydration
• Hiding
• Inability to get comfortable
• Lack of energy/enthusiasm (lethargy)
• Refusal to eat

Don’t delay! Contact us immediately if your pet is vomiting or showing other signs of possible linear foreign object ingestion.

What Should You Do If You Think Your Pet Swallowed a Linear Foreign Object?

At St. Francis Animal Hospital, we’ll perform a physical exam and use diagnostic imaging, such as x-rays and abdominal ultrasound, to help us determine whether your pet has swallowed a string or other linear foreign object.

If you think or know your pet has swallowed a piece of ribbon, tinsel, or other string-like item, call us right away at 540-891-1275. The quicker we can get your pet in to see a veterinarian, the better the chance of a full recovery and the lower the risk of possible complications.