40. Transforming Patient Care at AMC's New Veterinary Surgical Institute with Dr. Pamela Schwartz

Dr. Ann Hohenhaus interviews Dr. Pamela Schwartz, Department Head of Surgery at the Schwarzman Animal Medical Center, to discuss how the new Denise and Michael Kellen Institute for Surgical Care is transforming patient care. Tune in as they discuss:

• A "virtual tour" of the new surgical institute at AMC
• The cutting-edge technology now employed in the new operating rooms
• How the ORs can connect with people around the world
• Why keeping dogs and cats separate helps in their recovery
• Plans for clinical research and advances in patient care
• How will the surgery service integrate with the new Emergency Room and Intensive Care Units?
• Ergonomic improvements in the new surgical suites
• What veterinary innovations are coming next to AMC?

Also on this month's show: 

• Viral trending animal story about the pet octopus who laid 50 eggs, transforming a home in Oklahoma into a marine nursery
• Animal news, including the cat who was accidentally shipped in an Amazon box from Utah to California
• Pet Health Listener Q&A 

Do you have a pet question for Dr. Hohenhaus? Email askthevet@amcny.org to have your question answered on Ask the Vet's Listener Q&A.

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Transcript

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We want to remind our listeners that this program is for informational and educational purposes only and intended to substitute for professional veterinary medical advice, diagnosis or treatment. The Animal Medical Center does not recommend or endorse any products or services advertised by Sirius XM. Welcome to Ask the Vet with Dr. Ann Hohenhaus This is the place to talk about your pets and get advice for the top veterinarian from the Animal Medical Center in NYC. Hear from the leading authorities on animals and ask your questions. Now here's your host, Dr. Ann Hohenhaus. Hello and welcome to Ask the Vet, a podcast for people who love their pets and want the latest in pet health and animal News. I'm your host. I'm Dr. Ann Hohenhaus senior veterinarian and director of pet health Information here at the Schwarzman Animal Medical Center in New York City. Today, I'm going to highlight a transformative development here at AMC, which is the opening of the Denise and Michael Kellen Institute for Surgical Care. I'm going to be joined by Dr. Pamela Schwartz, who's the head of surgery at AMC. She will provide an insider's perspective on this cutting edge facility and explain how it's transforming the care we provide to our patients. I'm really looking forward to this conversation, although I have to confess, I have already seen the surgery suite before it opened and it really was very lovely, so quiet and so clean. The Schwarzman Animal Medical Center is the only level one veterinary trauma center in New York City, and we've been taking care of pets here for 114 years. If you're looking for advice on maintaining your pet's health, I'm here to help. Just send me your questions at askthevet@amcny.org and I'll answer your questions on next month's Ask the VET program. I'll give the email again later in the show. Remember it's askthevet@amcny.org. And now it's time for our Trending Animal of the Month. It's time for the Internet's most talked about animal. In the small town of Edmond, Oklahoma, the Clifford family embarked on a remarkable marine adventure that captured the hearts of people around the world. Which, if anyone's thinking right now, these people live in Oklahoma, which has no marine environment around it at all. It simply is landlocked. This family began when they welcomed Terrence, a California two spot octopus into their home, or probably more accurately, a tank in their home. Initially, they thought Terrence was a boy, but Terrence surprised everyone by laying 50 eggs, revealing that he was, in fact, she. This unexpected event transformed the Clifford's living room into a makeshift marine nursery. The family's dedication to caring for Terrence and her numerous offspring drew widespread attention on social media. They meticulously managed the nursery, ensuring optimal conditions for the health and growth of the baby octopuses. Which I wonder if that should be octopi. But we'll have to look that up later. Despite the odds, the Clifford's kept Terrence alive for several months beyond the typical life span of octopuses who usually die shortly after laying their eggs. Sadly, Terrence recently passed away, but her legacy lives on through her offspring. The strong bond she formed with her family and the heart she captured worldwide. You can watch these incredible moments on Instagram and Tik Tok at Dr. Puss, which is spelled DOCTOKTOPUS. Great story. And octopuses are not high on a list of of cat choices that many of us would make. And now it's my pleasure to welcome my colleague, Dr. Pamela Schwartz. Dr. Schwartz began her surgical residency at AMC two decades ago and has been a vital member of our team ever since. As the current head of our surgery service, she was instrumental in developing and launching of the Denise and Michael Kellen Institute for Surgical Care. This state of the art facility not only expands our capacity, but also raises the standard of veterinary care that we can give. So Dr. Schwartz, it's wonderful to have you with us. Can you start by giving us kind of a virtual tour of the new surgery suite? Thanks for having me, Dr. Hohenhaus I'd love to give you some ideas about what's going on on the seventh floor. We've obviously tripled our surgical space, so there is a much larger prep area for our surgical procedures. There's also a much larger recovery room where we have separate areas for dogs and cats. We have a new central sterile center, which basically means where we sterilize all of our equipment and we store our equipment is now on a separate floor from from our surgical suite. So it's actually on the sixth floor. We also have a minor procedures room. So procedures that are maybe less complex and don't require a very large or an integrated O.R. can go into the minor procedures room, for example, a spay or a simple mask removal. And for me, really, the standout features are the five new state of the art owners. It allows us more equipment. There are also cameras within each of the O.R. light handles for recording purposes. And even more exciting are the three kind of fully integrated areas. And that means these are designed for greater focus on functionality. The integration is this built in purpose built system that connects the advanced technology with information and also with personnel. So, for example, the owners have multiple screens. Some of them are on the walls and some of them are hanging from booms within the rooms. And you can project different images on the screen. So if I'm doing a case, for example, with a minimally invasive case, whether it's an arthroscopy or soft tissue surgery, I need to project that image on a screen. And so I can choose which screen I'm projecting that image on. And then I can simultaneously project other images that I might need to assist me during that surgery. For example, if I want to look at a CT scan, I can also project that either on a split screen or on a separate image. Within that room, there's also interconnectivity between the rooms, so they communicate with one another, which is pretty exciting. And then we can sort of message from within the rooms to other areas of the hospital. And then you can also create meetings outside of the hospital. So, for instance, if you want to communicate using the camera that you're doing surgery, you can get input from a surgeon in another state or for teaching purposes. For instance, if you wanted to project to the surgery that you're doing, it's a unique surgery and we wanted to have somebody in the university watching this surgery. You can project it anywhere you want to. So just for our listeners, I want to go back and help with Pam's visual about the surgery space on a very basic level, and that is that surgery now essentially has taken over the entire seventh floor. And the part that's getting added onto the side of the hospital, if you've been here lately, will belong to surgery, too, right? Yes. So that means that the surgery floor essentially extends from 61st Street to 67th Street. It's a whole block that's of surgery. And that that I think, tells you what a gigantic space this is, is that it is an entire block more. Yes. So that when I got my tour before surgery opened, I was really stunned by that distance, you know? Are your feet more tired at the end of the day in the new surgery space? Not yet. Not yet. But, you know, it does make a difference in our workflow, You know, being in a very small, confined space and now being in a much bigger space, we have to get creative and how our workflow happens. So what what does that look like? So it depends where, you know, before let's say when we were looking at a schedule, you know, the schedule was posted on a piece of paper that everyone could just go and look at because it was central to where everybody was working. Now we have to get creative because there isn't, you know, there's less of that central area. So, for instance, we're using electronic whiteboards where you can access them on any computer or any screen and you can update them in real time. So we're looking at doing certain things that help us in this new space. We're also looking for new ways to communicate. We're at work testing out some different equipment because before the assistance that we're helping us, we're just right outside of the O.R. And now, again, there's equipment on a different floor. So we're looking at ways to communicate with them differently than we were before. You know, so some of it is still getting used to the space and figuring out, you know, it's only been in there for about three months. And so we're we're getting creative with how to make the workflow as efficient as possible, given that we're in such a larger space. Bigger, bigger is better, except it has new issues, is what you're saying. They're just different issues, I think, and they're just issues that we didn't have previously. So it just means we have to think about things how you know, how we do things differently. So what would be a use messaging room to room? Have you done that yet? No, we haven't done that yet. But you can do messaging. For example, if I'm doing a knee surgery, I'm doing a t pillow, and I know my patient is going to be in the recovery area in about 20 minutes. So I need to alert the recovery room. Hey, we're going to be in recovery in about 20 minutes with a 25 kilogram dog. And so please have a set up in recovery. But I also need to alert the rehabilitation team because they're going to come and do some work with that patient so you can actually message different people in the hospital instead of having to call or send an email. You can send them these messages straight from this equipment to alert these people. We are fully using all of this technology, yet in the hospital, but it has those capabilities. It sounds great, though. Is it voice activated? So you just say, please send a message to rehab and then it does that. Yes, there is a voice activated capability. You had to have a headset on to do it. So probably the surgeons won't be utilizing it. I mean, it's kind of like Siri, you know, you say, okay, Stryker, and then you can talk to it and tell it what you want it to do. So the new surgery suite is is really being touted for its state of the art technology. What new pieces of equipment for surgery came with this new space? Well, there's lots of the different equipment that came with the space. And we're actually also looking to get more equipment as well. So what came with the spaces is the the booms that the equipment hangs from. So basically instead of having things on the floor that are kind of rolling around or taking up space, we basically have booms that come out of the ceiling that the equipment hangs from. And this allows you to utilize more floor space for other things. And we utilize the booms for imaging. We also utilize them for anesthesia purposes. And so that's what came within the O.R. themselves. And then we are obtaining new equipment to add now that we have more space. We're looking at bringing in additional equipment that basically works with the integration that we have. And what is it? What's your number one thing you're lobbying for? There's a couple of things we're really excited. I would say the two big ticket items are looking at what's called near infrared technology, which they've been using on the human side for some time now. And they're basically specialized cameras. And you can use them either in a minimally invasive way or in open procedures. And it is a wavelength of light that is just past what the human eye can see. So if you use this camera and you give a contrast, you can utilize this this camera to visualize certain structures that you couldn't previously see with the naked eye. And so it can enhance how we perform different types of surgeries. So for instance, we may be able to have more complete resection of cancer because we know that cancer is never just where we can see or feel the tumor, that there could be microscopic cancer cells that are beyond the tumor. So now with this technology, you can see those microscopic cells or you can see the lymph nodes that the tumor may have moved to, allowing us potentially a more complete resection of things like cancer. But there's lots of different applications. You can also visualize lymphatics or blood supply that we previously weren't able to see with the naked eye. And it can assist in a lot of different types of surgeries. So we've talked a little bit about workflow. How does how do these new rooms make your life better as a surgeon? Well, there's a lot of different things that can make it better. You know, getting creative with the new systems, the communication that we talked about. You know, there's there's some challenges that we are looking to overcome because we've tripled our new space, but we've not yet tripled the staffing. So I think that, you know, we're working on that. We've hired also two more surgeons that will be starting in September. So by having this new space, we can we have more options for teaching. We have more options for research and more advanced equipment. So, you know, I think that there's endless possibilities given the space that we have now. So early in our conversation, you talked about the recovery room, different dogs from cats. So how does this improve the recovery process for these pets? I think separating dogs and cats is important because as we know, cats are not small dogs, and cats are much more noise sensitive, especially if you have dogs that are barking or loud or are recovering and making it maybe being more vocal during their recovery. The cat recovery area is completely closed off from the dog recovery, making it more quiet. They also can't really they're not in direct sight of what's going on, where the dogs are recovering. So we're hoping that this will just make them feel safer, less stressed out, you know, when they're here in the hospital. It's not very common. But also, if a cat sort of, you know, as you're getting a cat out, if it gets out from its enclosure, it's still within a very confined space. So, again, less stressful. You're there's no worries that they're going to run over to where a dog might be recovering. That's always one of my biggest fears in this hospital is that a cat jumps off the table and then goes under something and you can't get it out. I saw a new cat patient this morning. I was like, we don't know this cat. Let's just put a little leash on its neck. Because then if it goes under something, we can we can get it back out that there's nothing worse than that. But the loose cat under. And you can I mean, if you stick your hand under there, it's not a good idea, you know, and they're just hiding because they're scared. So I'm sure the cats will greatly appreciate the new recovery area. They seem to like it. So what what are your plans for clinical research and advances in pet care that this surgery suite is going to make possible? I think that there is, especially with some of the new equipment coming in, we again, I think we have endless possibilities. And I think the important things that we are hoping to look at is that given the advances that we can improve outcomes, hopefully through less morbidity, less complication, and if we can improve the way we're doing surgery for, for instance, thoracic back surgery, keyless effusion, you know, it's a frustrating disease. And even with surgery, sometimes the calcification comes back. So, for example, with near-infrared technology being able to see that thoracic duct very easily compared to previously, our hope we don't know this yet is that the outcome is improved, that we can more accurately take care of taking off that thoracic duct or it's contributory. And then by doing so, that kills effusion, then goes away and does not come back. Of course, we don't know that yet, but these are things that we're going to be looking at in the future. So I think Dr. Schwartz just completely summed up research is that you you have an idea of what you're going to do and you hope it works, and then you hope that that that intervention improves the outcome. I mean, that's really a very simplistic view, but but still, I think. True. And what you're always hoping when you embark on some sort of research project is your hope. When your idea turns out to be a good one and makes everybody life better. So right now, the construction going on in the hospital is taking place in the space that surgery vacated on the second floor, and that's going to be turned into a better emergency room, a better ICU. How do you see surgery integrating with those facilities when they fingers crossed, come online sometime in 2025, maybe a year from now? I'm guessing. I mean, I think the ultimate goal is that by doing this expansion and all of this construction in the hospital is that we are making things more efficient for all of the departments. We're making things kind of more ergonomic so that not only are we helping the patients, we're helping the doctors and the support staff kind of be happier and healthier so that we can continue to do this for a long time. So I sort of think it is think of it in a way that we're treating not just our patients, we're trying to treat the people who work here and really to hopefully provide the ultimate goal of making everything more efficient and bringing the most advanced care that we can to, you know, dogs and cats as seamlessly as possible. So, you know, I'm not sure fully what's in store for ICU and the rest of the hospital as it comes to life. We'll know all these things. And I think we have to work together to figure out how we are working again in these new unique spaces, how it changes our workflow. You know, we always get creative in these things and come together for the patients. You know, the enhancements to the hospital are going to ensure that AMC basically continues to be a leader in the field of veterinary medicine. So one of the most important things. Well, let me let me ask about this. Did you ever get to work with Ms. Sharp, who's the veterinary architect that helped with this project? We had her on this program. Several, I don't know. Maybe I'd say several months or probably was a year ago. And that was really interesting. So did you work with her at all? Not that much. We definitely worked mostly in the beginning phases of the construction in terms of the floor plans and you know how many hours there were, where things were in terms of the workflow. So mostly it was in the beginning phases where you look at all the blueprints and then what what kind of ergonomic things does a surgeon need? The challenge for me always in surgery was I was short and so then if I worked with a tall surgeon, either I couldn't see or the surgeon had to like, put the table down and then their back was killing them. So how do you what ergonomic things have been done to make the owners more comfortable for the surgeons? There's a lot of different things. One of them is the type of flooring that's in there. So as you can imagine, if you're standing doing surgery for hours on end, it can do a number on your feet, your back, your shoulders. And so having a type of flooring that is actually softer to stand on is very helpful when you're in surgery for a long period of time. So that's one of the things that was very important to us when we were picking out things is the type of flooring that we're standing on, specifically inside of the glass. Other things are, again, the booms that we talked about where these screens come down. So for instance, previously, if you were doing a minimally invasive surgery, there was only one screen. And depending on where that screen was, you would have to look towards the screen, which can be very uncomfortable if the screen is not, you know, can't fit where you need it to your looking behind you or to the left or to the right for an extended period of time. What you should be doing is that screen should be directly across from where you're looking, so you're just looking straight ahead of you. So now that we have these booms and then we can move them the screens into any position, you're not having to kind of crank your head around to look in one direction for a half an hour. It's much more comfortable for you, the table height, even, you know, the table lengths and the table heights are, you know, they can go further up and down compared to previously. So when you're scoping and you're using the minimally invasive equipment, you don't really want your kind of arms and your shoulders kind of way up in the sky or kind of too low, you kind of want your elbows down to your sides and your shoulders relax. And so having tables that can move with the patient in a position that you can sustain that posture for a longer period of time makes it much more ergonomic for the surgeon. So there's lots of research on that, both on the human side and on the veterinary side. As it is, you're not comfortable when you're doing surgery, you're going to sustain injuries very quickly, you know, after just a few years of doing surgery. Yeah, I think the first practice I worked in, I'm not sure the surgery table went up and down. It tilted, but I don't think it went up and down. I think I stood on a box to be at the right height for that surgery table. I know the thought of me doing surgery is frightening to you, but at one time I did in fact do surgery on a daily basis. So in the grand scheme of this new surgery facility, community and philanthropic support have been pivotal in development. So how has the contribution from the Kaplan family and others influenced its progress? I mean, we're very grateful to quarters of the AMC who basically made these dreams a reality. And because of that ongoing support, we're able to provide the most advanced care possible. So again, looking at things like near infrared cameras, looking at 3D printers, you know, doing what is the most cutting edge technology is possible. And, you know, the advanced care is not only possible for those who can afford specialty care, but also through programs to provide assistance for, you know, people who maybe cannot support their pets in that way. So we're able to support everyone in the community, which is really nice. So looking ahead, what innovations or additions do you think are coming next to meet the health care challenges of the future? You know, a few things. We talk. I know we talked about the near infrared camera. We're also looking at 3D printing, which is really exciting for a number of different reasons. We already do 3D printing, but in order to do that, we basically have to send out a CT to another company that's typically in another state. Then we have to wait a period of time for them to show us does this look okay? And then they can send us a model. And sometimes that can take a couple of weeks. With software and 3D printing in-house, we can save costs. And also it cut down it cuts down on wait times for emergent cases and also elective cases. So if you had a case, for example, that comes in, it's a complex fracture and we're maybe not certain, you know, do we have the equipment that we need for it, you can pick up that emergency the morning of and see it that day. You could get a 3D printed model, the same day or the next day, which is a game changer and how you manage that, that patient. The other thing is you can print out, you can perform the surgery, for example, at orthopedic surgeries. You can perform them on the software before you do it in the patient and then print out guides that help you do the surgery. Just as you planned on the on the 3D software. So we've actually done this a couple of times now, and it's it's really helpful for complex cases where you can simulate the surgery on the computer. You can then print out how the limb looked before the surgery. You can print out how the limb looks after you've done the surgery, print out cutting guides that assist you in the surgery, and then you can even preplan what implants you want to put on the bone. Once you've corrected the. So there's lots and lots of things that we can do in the future. There's so much exciting things that we can do moving forward. You know, we're also looking to expand as we have more space. If we get more people, we can hopefully have less wait times for for pets to come in. So we're looking at expanding not just soft tissue and orthopedic surgery. We're looking to hire another surgical oncologist and also another orthopedic surgeon that will be, you know, specifically looking to development our current capabilities with joint replacement. So there's you know, there's endless possibilities. You know, I think that's a great place to stop, is that we now have endless possibilities in surgery. So I want to thank my guests, Dr. Pamela Schwartz of AMC’s Surgery Department, for joining me to talk about the new Kellen surgery suite that we have here. Thank you. I know that keeping your pet healthy is very important to you. And with that, I hope you'll reach out to me. If you have a question about your pet's health, I'll respond to your question on next month's Ask the Vet podcast. All you have to do is send a quick email to ask the vet at AMCNY dot org. We've got a short break coming up, but please stay tuned because there's lots of interesting animal stories. When we return, we're back with Dr. Ann Hohenhaus on Ask the Vet. Welcome back to Ask the Vet. It's now time for this month's Animal News. It's time for animal headlines. The biggest animal news from across the world. Like many cats, a Utah feline named Galena is naturally curious and has an affinity for boxes. Recently, her love for boxes led to an unexpected 650 mile journey from Utah to California. This unplanned adventure became inside incessantly when she slipped into an Amazon return box in her home without anyone realizing it. After her sudden disappearance, her worried owner searched tirelessly for a week but found no trace of the cat. The mystery was finally solved when the staff at a California Amazon return center discovered Galena, partially sealed in the box, had allowed her to breathe. And thanks to her microchip, a veterinarian was able to contact her owner and arrange for her safe return. Is that the most incredible thing. I just. Cats are too much Galena’s incredible journey not only underscores the importance of microchipping. Yes, absolutely. I was asked earlier today if all pets should be microchipped, unquote. Fully. Yes. And it also reminds us that we need to check boxes and I think luggage. I think there was a story a while ago about a cat who got zipped into a suitcase and then went through the X-ray machine and they you know, the TSA guy was like, hey, there seems to be a skeleton in your suitcase. But it was really the cat that kind of slipped in there. So Selina's owners are not alone in the fact that their cat went somewhere totally unexpectedly. So be sure to be very careful in closing suitcases and sealing boxes that your cat is, in fact, not in there. New research from our friends at the Royal Veterinary College, and that is in London, reveals that designer dog hybrids with curly coats such as Cavapoos, Cockapoos, Golden Doodles and Cavachon that a Cavalier King Charles and a Bichon mix face an increased risk of tick infestation. The study analyzed the health records of over 900,000 dogs across the UK and found that these cross breeds are significantly more susceptible to ticks compared to other dogs have. Cavapoos in particular showed the highest infestation rates. Owners are advised to regular check their dogs for ticks and keep their coats short to reduce the risk, but also tick to almost tick season, at least here in New York. And I would say don't forget to give your monthly or every three month flea and tick preventative to your dog. The companion Animal Parasite Council recommends that all dogs receive monthly flea tick and heartworm medication year round, and that's a byproduct of our global warming situation. Our third story today is a local one. We've kind of heard about it before, and that's New York City's persistent rat problem. Lawmakers are exploring new methods to manage the rodent population more humanely. And one proposal that's gaining some traction involves rat contraceptives as an alternative to lethal chemicals. The idea gained extra attention following the death of the escaped zoo owl Flaco, who was found with rat poison in his system at the time of his death. The contraceptive is distributed in bait form and disrupts the reproductive cycle of the rats, which is a more ethical solution compared to traditional extermination methods. While exterminators currently rely on traps and poisons, some argue that these approaches are inhumane and often ineffectual. So despite the ongoing efforts to combat rats, experts acknowledge the resilience of these creatures and the challenges in eradicating them. While the battle against rats may never end, adopting better strategies could lead to more sustainable solution in the long run. And now it's time for questions from our listeners. Our first question is from Christy in New York. Christy asks, I have heard mixed messages about the Lepto vaccine. Is it a vaccine that is recommended for all dogs? So I think Christy is probably picked up on a new recommendation made by the American College of Veterinary Internal Medicine, and they're advocating that leftover vaccine should be required essentially for all dogs. Lepto is short for leptospirosis, and it's related to the rat problem that we have in New York. But in other parts of the country, it's related to wild animals that carry the bacteria that cause leptospirosis. And then when pets encounter water that's contaminated with the leftover bacteria or urine from an animal infected with the leftover bacteria, then your dog can get leptospirosis. And for many years, it was thought that we should only vaccinate those pets at risk. But of course, the pets are at risk have expanded as rat populations have expanded, global warming has expanded the reach of rats more year round. And so the American College of Veterinary Internal Medicine is now recommending lepto for all dogs as one of the core vaccines, and that that is a new recommendation. So, Christy, you're actually not hearing mixed messages. You're actually totally up to date. Our next question is from Rachel Kaye. Rachel asks, Does my indoor cat really need flea and tick medication? So I understand why Rachel's asking this question because fleas and ticks come from outdoors, except when they don't. So when my sister moved with her cat to a new apartment either the carpeting in the hallway or the apartment that she moved in was infested with fleas left over from the prior tenant and her poor indoor cat, who never touched the ground outside of an apartment, was covered in fleas and miserable. So it's passed a bill that you might have a flea infestation in your apartment from If the people next door have a dog and the dog drops fleas in the and then the fleas come into your apartment. So that's one reason to consider that. The second reason is you never know if your indoor cat is going to scoot outside or if you have a cat and dog. The dog that goes outdoors might bring fleas into the cat. Now, if you are the only apartment on the floor in your building, I think you're not. Many of us have that in New York City. But if you're the only apartment and you don't a dog. Okay, maybe the cat doesn't need flea and tick medication, but there's a decent amount of opportunity for fleas come into homes from carrier dogs. So I don't think I think there's very little risk with the flea medication. And let me tell you, having been bitten by fleas that were in a veterinary hospital that I worked in, I was miserable and itchy. So you don't want to have that either. So just give the cat the flea and tick medication. And our last question today is from Debbie, also in New York City. She says, My dog recently started eating his poop. How dangerous is it for his health and how can I get him to stop? Okay, so I'm intrigued by this question because usually the question is I got a new puppy and the puppy eats its poop and usually puppies eat poop and then they grow out of it. And it's it's really not a long term issue. But Debbie says, my dog is eating its poop, and it sounds like it's a new behavior. So part of me is a little bit worried that maybe there's something wrong with the dog. It's caused him to start having this kind of unusual adult dog behavior and eating his poop. So I'm worried. It's a marker that the dog is sick. If your dog is on monthly flea tick and heartworm medication, probably your dog does not have intestinal parasites. And although it's gross, it probably is not going to harm your dog's health. But one of the reasons when we're managing intestinal parasite infections in dogs is that we pay them and we put an E collar on them and then treat the infection and then beat them again and then take the e collar off that E collar keeps them from licking their backside and re ingesting intestinal parasite eggs and re infecting themselves. So it is possible to cause a cycle of intestinal parasite infections by the dog eating its poop if it happens to have intestinal parasites. So I think the first way for Debbie to get her dog to stop eating the poop is to make sure the dog is not sick and that if we fix the illness, the dog might doing that. There are all kinds of home remedies for it. Some people say to put it off, meat tenderizer in the dog's food and that makes the poop less appealing. There are some over-the-counter products like I don't remember the names, but you'd recognize them because they're they have very clever creative names about don't eat the poop kind of thing. And then the other thing is pick the poop up immediately after your dog goes, and then there's not an opportunity for him to stop. Or if he goes to eat food, give a come command, give him a treat and teach him positively on, you know, to avoid the poop and then go pick it up as soon as you're done giving the treat. So I hope these suggestions help and I hope that your pooch is okay. Certainly let us know how he's doing. We're going to take a short break. And when I come back, we'll have important AMC information. We're back with Dr. Ann Cavachon on Ask the Vet. Hi, and welcome back to Ask the Vet. Now, I want to share with you some important information from AMC’s Usdan Institute for Animal Health Education. We're back on the topic, folks. Warmer weather means more time outdoors and a greater chance of encountering ticks. So your dog's first paradise for these parasites, which can carry dangerous diseases that can also infect humans. Not that your dog is going to give you the tick disease. It's that you and your dog both get ticks, and the ticks happen to carry diseases. It's not. The dog won't give it to you. It's not the dog's fault. It's the tick’s fault. The best way to protect your dog against ticks is year round notice. Year round? I don't say stop when it gets cold outside, because these days it's not getting always cold enough to kill the ticks that are out there. So you want to use a year-round Veterinarian approved flea and tick preventing product. And when I started as a veterinarian, there was nothing except like messy powders, collars that didn't work and really toxic sprays that you sprayed on your dog. This has gotten so much better. And I used to see dogs coming in, covered with ticks and fleas. Now, I hardly ever see a flea, occasionally a tick in the summertime because these products are really good. And you need to check with your veterinarian because there are oral medications, topical treatments, collars, and all of these can help keep ticks off of your pet. But you need to check with your veterinarian because every one of those medications is not exactly right for your dog. It's also important to check yourself and your dog for ticks whenever you've been outdoors in the yard or hiking in the woods. Check everywhere on your dog but eyelids around the ears under the collar, legs between the toes and the back part of their tummy and around the tail. Those are tick havens. If your dog has a tick, you might first think that you're feeling a bump, and that bump might be as small as a pinhead or as large as a pea. Depending on how much time that tick has spent in gorging with blood from your dog. So if you find a tick, you want to remove it right away. And if you're uncomfortable removing that tick yourself, then you can certainly take your dog to a veterinarian or a veterinary E.R. to have the tick removed. There's also a really kind of cool product that I saw at a trade show. Once. There are these little packets, and inside the packet is a little liquid soaked cotton, you know, like square. And you put that over the tick and it causes the tick to detach and makes it easier for the tick to remove. I want to say it was called tick off, but I'm not 100% sure that, but I'm sure you can find it at a hiking or camping store. But that seemed like a really easy way to get ticks off of your dog mask. Still, tumors are the most common type of malignant skin cancer in dogs and the second most common skin tumor in cats. They usually occur in older animals, but can affect any pet of any age. So coming up on Thursday, June 20th at 6 p.m. Eastern Time, Dr. Jonathan Ferrari, AMC's board certified surgical oncologist, will discuss mast cell tumors in dogs and cats. And this is a this is such a good topic for two reasons. One, Dr. Ferrari's great surgeon. But second, these tumors are really common and they're really confused. And I'm sure Dr. Ferrari will answer all your questions about this kind of common tumor. This, as usual, is a free online event hosted on Zoom. So that means you have to register because we need to send you the Zoom link. You can register for any AMC event at amcny.org/events. For free access to timely and relevant pet health articles and upcoming Pet Health Events, video tutorials, and other pet resources be sure to check out AMC's Usdan Institute for Animal Health Education by putting Usdan Institute in the search bar on our website. I want to give a special thanks to my colleague, Dr. Pamela Schwartz, for joining me today. And a big shoutout to all my listeners for your continued support Ask the Vet continues to be ranked fourth on Feedspot’s 45 Best Pet Podcast. Don't forget, if you want to know more about your pet's health or need health advice, just email me at askthevet@amcny.org and I'll answer your questions about your pet on next month's Ask the Vet Show. The Ask the Vet podcast can be accessed on the Sirius app across all major podcast platforms and on AMC's website. All of this thanks to AMC's long standing partnership with Sirius XM. Don't forget to check out AMC on social media on Facebook. It's the Animal Medical Center and Twitter and Instagram, it's @AMCNY and I would really appreciate it if you could take a moment to give Ask the Vet podcast a review and be sure to like and subscribe so you receive all our new episodes. I hope you'll join me again next month for another Ask the Vet podcast. Thanks everyone and have a great May!