Ask the Vet
Ask the Vet
Helping Pets and People Through Cancer with Dr. Renee Alsarraf
In this episode of Ask the Vet, Dr. Ann Hohenhaus is joined by her AMC colleague Dr. Renee Alsarraf for a heartfelt and informative conversation about cancer in pets. Dr. Alsarraf brings a unique perspective, not only as a board-certified veterinary oncologist, but also but also as a cancer survivor and pet parent to dogs who have faced cancer. Together, they discuss:
- The types of cancers commonly seen at AMC
- How radiation therapy works and when it’s used
- AMC’s use of linear accelerator technology for targeted treatment
- What’s changed in oncology over the years and what hasn’t
- How Dr. Alsarraf helps clients navigate difficult treatment decisions
- Insights from her memoir Sit, Stay, Heal: What Dogs Can Teach Us About Living Well
- What to expect from her upcoming webinar, Navigating a Pet’s Cancer Diagnosis
- How she stays hopeful doing emotionally challenging work
Also on this month's show:
- Viral trending animal story featuring Buford, a 150-pound ranch dog in Arizona who helped lead a toddler to safety
- Animal news, including a biotech company that claims to have brought back dire wolves, a new study showing that dogs understand meaningful words even in monotone speech... and the oldest known domestic cats in history, found in a 1559 shipwreck.
- Pet Health Listener Q&A, where Dr. Hohenhaus answers questions about what a giardia-positive test means in a newly adopted cat, managing inconsistent dog-to-dog reactivity, and whether gabapentin side effects in dogs are normal or worth reevaluating.
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.
We want to remind our listeners that this program is for informational and educational purposes only, and not intended to substitute for professional veterinary medical advice, diagnosis and treatment. The Animal Medical Center does not recommend or endorse any products or services advertised by Sirius XM. Welcome to Ask the Vet with Doctor 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, doctor, and ho and house. Hello everyone and welcome to Ask the Vet. It's 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, a senior veterinarian and director of pet health information at the Schwarzman Animal Medical Center right here in New York City. Today, we'll be talking about a topic that's very close to my heart, and that is cancer in pets. As a board certified vendor oncologist, it's a topic that I've spent much of my career focused on. It's a diagnosis that can bring difficult decisions and emotional challenges. And it's more common than many people realize. About 1 in 4 dogs will develop cancer during their lifetime, and nearly one half of dogs over the age of ten will be affected. In cats, cancer is diagnosed less often than in dogs, but it tends to be worse and cause many more problems to cats. And of course, cats being cats, it's harder to detect. Early to help us explore this topic. I'm going to be joined by my colleague, Doctor Renee Alsarraf, a board certified veterinarian colleges with decades of experience helping pet owners through these challenging cancer decisions. Doctor Alsarraf completed her internship and residency right here at AMC, and returned in 2023 to join our oncology team. I'm so glad to have her here today to discuss how we support pets and the people who love them through this difficult diagnosis. And I'm really looking forward to our conversation. The Schwarzman Animal Medical Center is the only level one veterinary trauma center in New York City, and we have 115 years of being the very best place for your pet. If you're seeking advice on maintaining your pet's health, I'm here to help. Just send me your questions to ask the vet at amcny.org, and I'll answer your questions on next month's show. If you don't have a pen or pencil to write down that email address, don't worry. Get one at the break and I'll give it later on in the show. And now it's time for our trending animal of the month. It's time for the internet's most talked about animal. A ranch dog in Arizona is being hailed as a hero after leading a missing toddler to safety last month. Buford, a 150 pound Anatolian Pyrenees, usually patrols his family ranch to keep wildlife out. But one morning, he appeared at the edge of the property with two year old Bodin Allen walking beside him. The toddler had wandered away from his home the night before, wearing only pajama pants, a tank top and sneakers. Search crews spent 16 hours combing canyons and rugged terrain, including the areas for mountain lions, have been spotted. He and the child traveled nearly seven miles from his home. Buford found the boy asleep under a tree and stayed by his side throughout the night. Buford has been honored by the local sheriff's office, gifted a search and rescue vest, and showered with treats and fan mail from around the world. Amazing isn't it, how a dog can outfox search and rescue crews who worked for 16 hours and the dog brought the little boy back home. And now it's my pleasure to welcome my friend and colleague, Doctor Renee Alsarraf Doctor Alsarraf is a board certified veterinary oncologist who earned her veterinary degree from Michigan State University and completed both her internship and residency here at the Animal Medical Center. Renee's association with AMC dates back to her student days, when she was a summer student on AMC's oncology service in the late 1980s. Over the course of her career, she established four different veterinary oncology practices and led three radiation facilities. In 2023, we were thrilled to welcome her back to AMC as part of our oncology team. Doctor Alsarraf is also the author of Sit, Stay and heal. And that's not HEEL, it's HEAL what dogs can teach us about living Well. A memoir inspired by her own experience with cancer and the profound bond between people and their pets. Renee, so happy to have you here today on asks the vet. So thanks so much for joining me. And it is my pleasure. Thank you so much. So I always like to start asking my guests about their pets, except that you and I already sort of know your pet pretty well. You and I both believe in free officemates, and your boxer, dusty often joins us with a rotating cast of foster kittens. So for our listeners, can you tell us a little bit about dusty and talk about your other dogs who've shaped your perspective as an oncologist? Sure. So dusty is a nine and a half year old female spayed boxer, and she came to me during Covid when she was four and a half. She had had two litters. She was already going a little bit gray, as you know, with boxers. They're they're totally wrinkly and a little bit unruly. And I thought, oh my goodness, I hope the dog and the owner don't really look the same. But she needed a loving home. And so we brought her into the home and gave her a wonderful place. And as you know, I have had five boxers, throughout the year, so I likely need therapy. They are, unfortunately, one of the number one breeds that get cancer. But despite that, they are very, very dear to my heart. You had, I think, when you were a resident. Didn't you have a fond boxer? I did Blitzen. Yes. Yeah, yeah, that would that that was a very nice boxer. So you've had the unique experience of being a vendor oncologist, a cancer patient, and someone who's cared for your own dogs through cancer. How's that shaped the way that you approach your oncology work? It has profoundly made me who I am. I have been on both sides of the table, so to speak, and I intimately know the feelings that come with both. I have brought some of my knowledge of veterinary medicine to help my own healing process. And conversely, I've seen what they do in human medicine to try to help our animal patients. I think it really helps when counseling pet parents as they're going through it, not just giving them the knowledge and the power to make the right decisions with information on prognosis and treatment options, but also to help them through the emotional aspect. I know that my goal, as well as the oncology team at AMC is goal is to help clients have hopefully no regrets, right? And to sort of minimize the scars that that we all get along the way. So you wrote a memoir called sit, stay, Heal that reflects on those experiences and what dogs have taught you about living well? What inspired you to write that book and what what's the takeaway for readers in 2018? What felt like a sucker punch to my gut. I was diagnosed with metastatic cancer. And for all the listeners, just as a little aside, let me be the poster child. I did not have one clinical sign. I wasn't lethargic, I hadn't even lost a pound. And I always want to lose a pound. And I went to my yearly, appointment. In fact, I had made it two months earlier that year, and I almost canceled it the week of because I thought, gosh, you know, who wants to go to the gynecology just two months early? But I had already booked out of clinics. I went and lo and behold, I was diagnosed with cancer at the time, age 51. I had never done any social media, but I ended up emailing all of my friends and family information along the way. Reason being is everyone was kind. They would call, they would text. They would send me emails asking me how I was doing. And while that came from a place of love and caring, it was exhausting to have to go over everything. So I took to emailing them about every two weeks with updates, and it was so beneficial. It was beneficial because I could read their kind words when I was strong and filled up to it. If I was having a really low period, I could go back and reread their words and they gave me strength and encouragement. What so many people also said was Renee, have you ever thought about writing a book? You really should write a book. I blew them all off. I convalescent, I got better, I went back to work and periodically I might bump into someone at the local grocery store or in car line at school and people would say, have you ever thought about writing a book? You really should write a book. My husband at the time, and I took a long weekend, to, hotel in Rhode Island. And I was really fortunate that the hotel always delivers a newspaper to your door, which now seems like such a luxury. I always read two sections and only two sections. The comics and the horoscopes. So I happened to read my horoscope that day for Scorpio. And I kid you not. It literally said you should begin writing your book today. And two days later, I began writing. The book is a true story. It is a memoir, and every chapter is about a different patient of mine, a dog patient, and either what that family learned from their dog or what I learned woven through then, is my back story. Every chapter has different life lessons from different dogs, but I think the overall writing theme is that dogs are not just wonderful companions for us, but they are incredible guides for when we struggle and we all struggle at times. It's truly life lessons from our four legged friends. So I just want to say that several of my friends who have been very sick used a website called Caring Bridge, and that's a website where the person who's sick or someone in the family can upload updates and they don't have to answer those individual emails every day. And you so you can look at it whenever you want, you can log on, you can log off. And if the person post, you get an email saying, you know, Greg has posted on his Caring Bridge site and I find that, really nice because then out of the book, the sick person for information and they can write as much as they feel up to or not, it's all archived. And of course, so many of my friends are veterinarians, and so they post their blood test and things, which makes me so happy because I'm always like, well, I wonder what their white blood cell count is today. And and so that I found that website, especially helpful when some of my friends have been really sick and the family has chosen to post on that website. So if you happen to be listening and are struggling with what Renee struggled with, which was how to deal with everyone, asking, how are you? That might be a solution for for some of you out there. So you and I both did our internships and residencies at AMC, and after many years of working elsewhere, you're back. What brought you back? Oh my gosh. Because truly, I love the Animal Medical Center. Ever since I did my externship back in the late 80s. Now everyone realizes how old I am. But, it is truly like no other place on Earth. I truly feel that I was meant to be a part of this incredible hospital. It is a large group of very diverse people, all with the intent of doing the absolute or giving the absolute best care for every patient and every patient's family. And it is my honor to get to be a part of this. I love the fact that we are the largest nonprofit animal hospital. I love the fact that we do have clinical studies to try to advance and improve medicine. I love that it is a big collaborative group where while I might be seeing a radiation patient, it has something else wrong with it and I can just go to internal medicine or surgery or behavior or dermatology and say, gosh, this is going on. And, you know, get a very, full and and detailed answer to try to help the pet. Yeah. The the opportunity to work with so many other really good specialists. It is a huge it's a huge benefit for the doctors at AMC, but it's also a benefit for the patients, that that they have the opportunity to have input from a lot of different people. So looking back, what do you think has changed the most in veterinary oncology? And then the reverse. What stayed the same? So let's go with what stayed the same first. That's what that I think that was the easy one. I think it is. It's the heart, right. It's that in general, we all become veterinarians because of our deep love for animals and wanting to help. But I think we take that one, if not two steps further in oncology, and that it tends to be a group of people that really want to make a difference in not just the pets, but the family's lives. We all take our I shouldn't say we all, many of us, especially me, takes my pets for granted. But I've noticed that once you begin treating with chemotherapy or radiation or immunotherapy, the the family begins to really appreciate every day that they have with that pet. And hopefully we can give them another holiday season or another three summers. But it's just a wonderful thing. So I think that's what stayed the same. The easy answer about what is different and thank goodness it's the medicine, right? One of the things that I like, and I know you do too, and about oncology is it's ever changing. There are always new studies, new trials, new different chemotherapy drugs. And we tend to be a scrappy group that that, you know, is is willing to battle cancer. We don't like to take no for an answer. So that for us to get to have new, improved ways of treating over the weeks and months and years and decades is is great. It's mentally stimulating, but it helps animals and it helps humans. I think lastly, the the other thing that has changed, which is fantastic, is society's view of animals as part of our family. Right. It's gone from sort of it's just the dog that gets let out at night to roam the neighborhood to a very special four legged family member. Where this really comes into play. Heaven forbid is when, pet, is no longer with us. That grieving family now is able to take PTO from their work, or have be able to talk about it with a wide variety of people. And back in the 70s, that wasn't the case. Well, I mean, AMC had one of the first social workers, for veterinary pet owners. I guess veterinary patients don't really benefit from the social worker their owners do. And, and we still have a social worker today, but that was a, a really on the edge thought in the I don't know, we probably got a social worker in the 80s at AMC and that that is huge, huge for clients and huge for the staff to when when they need some backup on helping a client work through a really difficult situation. So since returning to AMC, you've really focused on radiation therapy. So why don't you give our listeners a little hint or two about what kinds of cases are a good fit for radiation treatment, just in case they happen to have a pet with cancer right now? Okay. So that would be twofold. One is cases where surgery cannot go into remove something. Heaven forbid, like a brain tumor or a tumor in the nose. And thankfully for cats and dogs with radiation, those pets can often live for quite a long time, meaning 1 to 2, two and a half years with just a little bit of radiation, which is great. Other types of cancers might be, once the surgeon has removed the bulk of the tumor, but they were unable to take any wider margins because it's a skinny little dog leg and there's only so much tissue you can take. So sometimes there are cancer cells left behind and that is where radiation is fantastic at targeting those microscopic cells and getting rid of them and hopefully getting rid of the cancer. Things like a mast cell tumor or a soft tissue sarcoma can be treated that way. And then of course, there are so many other tumors thyroid tumors, bladder tumors, liver tumors. Oh my goodness. Even heart tumors we can treat with radiation and they can do quite well. So just the idea of radiation in their pet is really intimidating to a lot of pet owners. How do you help pet owners understand what the process involves and then reassure them that it's the right thing for their pet? So it's certainly understandable because thankfully, the majority of us have not had experience with radiation and hopefully haven't had friends or family members getting radiation. That being said, dogs and cats do very, very well with radiation. If you think about it. They basically are laying on a table which is called a couch. Even though it's nothing like a sofa. And so they're laying on this table and the radiation source, is in a machine sort of above them. And that radiation can spin around that table treating where it needs to treat for the patient. The patient always has some light anesthesia because they have to hold completely still. But the the animal does not feel anything. It is no different than when we go to the dentist and they take x-rays. We don't feel any of it and it just takes a matter of moments to happen. X-rays are in a sense a type of radiation, but not to the same extent or degree or dose as radiation is when we use it to kill cancer cells. Dogs and cats do much better than we do than people do with radiation. They do not get radiation toxicity, so they don't get that general malaise. They don't have that general lethargy or vomiting or diarrhea, and they're not nauseated overall. The side effects happen in the area that's being radiated. So again, if it's a little dog's leg and they're getting radiation there, the rest of the body is not affected. Depending on the protocol, there may be a 25 to 50% chance of having a sunburn like a cat in that area, 75% that that will never happen. They also might get what we call hyperpigmentation, which is the medical term for freckling. People with freckles, black little spots, dogs freckle our cats as a black patch. And then sometimes after radiation is done, the hair or the fur that grows back will grow back white, which is just a cosmetic issue. Looks sort of funny on a black cat to have a white patch. But it is more of a badge of of honor and courage. If we can get rid of the cancer. So when a client is facing a decision, as I know, on a day to day basis, that many of our clients face the decision between, does my pet need surgery? Should it have chemotherapy? What about radiation? Maybe I shouldn't treat my pet at all. What's your approach to guiding those patients? Well, Doctor Hohenhaus has it's the same approach as yours, but for the listeners. Right? It's the job of a medical oncologist. It's the job of the medical oncologist to take that case and to give the the pet parent as much information as possible. So we would tell them about the signal. In other words, who typically gets this cancer. And if there's any whys as to why they get it. And then we talk about the tests that might be needed to be done and the different treatment options and what those prognoses are. We will touch on radiation therapy and surgery and delve deep into chemotherapy. But the whole thought is that knowledge is power. And so if we as oncologists can give that family as much information as possible, then we have done our job well. It is not up to us as to whether or not or how a patient is treated. That is really up to the pet parent. We're there to help guide. So if we can give them all of this information, then they can make the best decision for their pet and themselves. So based on everything you've said, I think that you're going to lead a very interesting webinar next Wednesday that will be May 14th. And if you're listening to this podcast after May 14th, then check AMCs website, because the webinar will be archived on our site and you can listen to it on demand. But for those people who are planning to log in on Wednesday the 14th. What are you what what are your learning objectives for those people? So it is to understand, in a step by step process what goes into making that pet's diagnosis treatment plan? Understanding the different options and then also discussing that emotional rollercoaster that we all face. The lecture is meant for two different groups of people. Obviously it's meant for people whose pets perhaps have or are recently diagnosed with cancer, but it's also meant for pet parents who just want to be better prepared and more informed. Heaven forbid, should the time ever come to need this knowledge. Well, I think that for those of you who's pets have cancer, this is an easy, An easy. Yep. I'm going to sign up for this. But for those people whose pets don't have cancer, let me just say that the diagnosis of cancer in a beloved pet is a really difficult time. And both Renee and I see people every day who have a hard time making decisions because they're it's overwhelming. And we can explain what's going on. But in part, the pet owner has to be prepared to listen and be able to take in the information that we're giving. And so a little bit of pre-work on your part and listening to what goes into a cancer diagnosis and developing a treatment plan. If your pet does sadly develop cancer, you're going to be a bit ahead of the game. Because you know what we are. You know the kinds of things that the oncologist is going to say to you, and you'll have a better framework on which to hang, the information that the oncologist tells you specifically about your pet's cancer. So I think that that is, something for people to really, keep in mind, in signing up for this is you're going to be a step ahead if your pet doesn't have cancer. You'll be able to, be able to handle that rough diagnosis better. Now, with all of the challenges of being an oncologist, what helps you stay hopeful and motivate it? That's a great question. I would say the biggest one is the families, right? Getting to not just sit across from them, but to sit next to them and to understand the whys behind their treatment and to get to know their family and to see their appreciation for their pet. Doing better is what powers me to go on, because it's a hard topic. It really is. Having and getting to work with a strong team and strong medically, yes, but also strong as a cohesive unit where we can rely on each other and we can support each other when we have a hard day. That really helps. And then I think just getting a, warm kiss from a dog, a wet tongue or a nuzzle from a cat's nose, also helps to to put a smile on on our faces. That's such a nice answer to that question. Now, let's let's talk a little bit more about radiation therapy. Are there different ways to administer that radiation? So there are, the main way that is done in human medicine and with animals is, again, where that patient is on the table or the couch, and that radiation source is, outside of that patient or above that patient getting radiation. That is called Tela therapy. If you think of telephone, tela means far, right, at a distance. There is a type of radiation called brachytherapy. Brachy means short if you think of a smooshed faced breed, like a pug, they are a brachycephalic. And that would be where radiation, little seeds are implanted inside the tumor. I think a gentleman that has prostate cancer sometimes gets seeds put into his prostate. And then a third way is if radiation is, say, injected and courses through one's body and localizes to one side. And that would be how we treat, cats. Some cats with hypothyroidism, with radioactive iodine. Actually, you know what? There is a fourth. Another way is with strontium therapy. And if you think of almost a big felt marker, although much more scientific, where the radiation is actually, administered right on the, the small amount of cancer, think skin cancer or like an eyelid tumor in a cat, where we don't need a big powerful radiation machine. We don't need the radiation to penetrate deeply. We just need it on the surface. And thankfully, AMC is one of the very, very few radiation centers in the nation that is able to do strontium therapy as well. Yeah, I had a dog who had a little tiny plasma cell tumor between in of the gum between his front teeth, and so surgery would have required removing his front teeth to remove that tumor. But we treated it with strontium. And, that dog lived many, many years with no recurrence of that tumor. It only took one, maybe two strontium treatments, to make the tumor go away. And it was very effective. In, in controlling that. And so that's something that a lot of that's a kind of radiation therapy that a lot of people don't know about, partly because it's so rare. To have a strontium probe and then, we don't use it a ton, but when it's the right treatment, it's a fabulous, treatment. So we're, we're getting towards the end of our time here. And I just want to know, what is it that you would like pet owners to know about cancer or your upcoming talk or something else that you think they should know? Okay, so I guess I totally get that cancer is a very scary word. Let alone a diagnosis. I really hope that if they tune in, next week on Wednesday, that they will come away feeling more assured just by understanding the whole process. Getting to know some of the new things that we can do, that there are good treatments, like your dog with that tumor in the mouth, 90% of them are cured with radiation alone. It's great. And I hope that the lecture also alleviate some of their fears and concerns. Well, I think that's a great way to end this conversation. So I want to thank doctor SRF so much for sharing her insights today and for the compassion that you bring to your work every day. So if you'd like to sign up for doctor also Ralph's talk on, Wednesday, May 14th, you can sign up for Navigating a Pet's Cancer Diagnosis by going to www.amcmy.org/events. And if you're really interested in hearing more from Dr. Alsarraf, if you go to AMC's website and put Sit, Stay and Heal in the AMCNY.org search bar, you can watch a recording of her talking about her memoir in a Usdan Institute book club. Thanks so much again, Renee, for joining us. Thank you very much. I know that keeping your pet healthy is very important to you. And with that said, I hope you'll reach out to me if you have a question about your pet's health. I'll respond on the next episode of Ask the Vet. Just email me at Ask the Vet. One big word at amcny.org. We have 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 time for the animal news. It's time for animal headlines, the biggest animal news from across the world. Our first story is a Dallas based biotech company says it has brought dire wolves back from extinction, or at least something similar to a dire wolf. Colossal Bioscience has revealed it is genetically modified three gray wolf pups to resemble dire wolves. The ice Age predators made famous by the Game of Thrones investor and author George R.R. Martin, even posted with one of the pups, calling the development as stirring as the moon landing. The pups are not true dire wolves. They're gray wolves with 20 edited genes, and critics argue that this isn't de-extinction, it's marketing. And some say efforts like this distract from real conservation work, potentially sending the message that lost species can just be fixed later. I keep thinking Jurassic Park when I read this story, which didn't really end very well. Colossal says its ultimate goal is ecological restoration, including plans to reintroduce wooly mammoths. Actually, I'd really like to see that. I would really like to see a wooly mammoth. For real. So they're going to reintroduce wooly mammoths to the Arctic to help slow climate change. But experts question the science and the ethics of using elephants as surrogates for mammoth hybrids. While the technology behind Colossus work is groundbreaking, many scientists warn that saving species still with us should take priority over resurrecting those long gone. Our second story is also about dogs, but this is like the dog that sleeps at the foot of your bed. A new study suggests your dog might be better at eavesdropping than you think. Researchers from the University of Sussex and the University of Lincoln found that dogs can pick out meaningful words like their name or common commands, even when those words are buried in flat, monotonous speech that isn't directed at them. The study, published in Animal Cognition, tested 53 dogs of various breeds using recordings full of random chatter, none of it delivered in the usual cheerful use of good boy tone. Still, the dogs consistently perked up when they heard something that mattered, often looking towards their owner. In response to these key words. Turns out, then, that dogs are not just reacting to your tone when you say, who's a good boy or want to go for a car ride. These dogs are actually listening for meaning. And this challenges the long held belief that it's our singsong voices that grab a dog's attention and suggest that they're far more attuned to our words than we realized. And our last story today is about cats. Long before cats ruled the internet, two of them sailed into history and straight into a hurricane. A new study has identified the oldest known domestic cats in what is now the United States. An adult and a juvenile who died in 1559 shipwrecked off the Florida coast. They were part of a doomed Spanish expedition led by Tristan de Luna, whose fleet was wrecked in Pensacola Bay just months after arriving. Published in a journal called American Antiquity, the study confirmed that the cats found in this shipwreck were felis catus or the domestic cat, likely brought on board in Mexico. Isotope analysis showed the adult cat was not living off rats, but that it had a diet similar to the sailors, suggesting it was fed and maybe even treated as a pet. These two felines beat the Mayflower to the United States by 60 years and Jamestown by nearly 50, making them the earliest domestic cats on U.S. soil. Their voyage may have ended in a disaster, but it marked the start of America's centuries long bond with cats. And now it's time for questions from our listeners. The first question is from Esther F Esther asks. I adopted my cat on March 11th. Before that, the shelter gave him a single dose of Pyrantel. On March 1st, he previously lived with more than ten cats and has since tested Giardia antigen positive. Could this indicate a current infection or just past exposure? He hasn't had diarrhea or weight loss, but does have a voracious appetite. My vet recommended retesting of diarrhea develops. But should we test again now? So the quick answer is I think your vet is spot on and giving you really good advice. But let me expand a little. First of all, Pyrantel is not a treatment for Giardia. Pyrantel treats for common hookworms, Roundworms. And it's a very gentle medication. So very common that it's given in the shelter. Giardia is an intestinal parasite. It's not a worm like roundworms or hookworms. It's a protozoan. It's a little kind of one celled organism, and it can cause really bad diarrhea. And Giardia is common. In places where lots of cats congregate. So I suspect that your new cat might have had giardia in the past when he was living with ten other cats, which probably sounds like not a very good situation for the cat. And so the antigen test simply means that some part of giardia can be detected in the stool, but it doesn't mean the cat has an infection. It may mean the cat has a past infection. So that's why I agree with your veterinarian, is that if the cat develops diarrhea, we should retest. But I would also not treat this cat just based on a positive gradient antigen test, because that test does not equal infection about the eating. I mean, if this cat lived in a household with ten other cats, he probably had to fight for every mouthful of food that he gets. And I bet that now he he doesn't realize it. He's got a good deal going. And that dinner and breakfast are going to arrive on schedule every single day. And that it's all for him. So I suspect that his voracious eating might actually be behavioral because he used to have to compete for his food, and now he doesn't. Yeah, I'm sure you're providing with plenty of food, and therefore it's going to take him a little while to realize that he doesn't have to eat it all right away because someone else is going to eat it if he does it. So I'm so glad that you have a new cat, because I happen to love cats, and I hope that you and your new cat have a wonderful relationship. And many happy memories together. Our next question is from Barbara J. The question is my two year old female Jack Russell shows aggressive behavior toward some dogs, both on and off leash. She's eager to me. Almost every dog we pass in seems excited and anxious to interact, but sometimes the interaction escalates into growling, threatening behavior, or even lunging. Other times, the greetings go smoothly. It's inconsistent and unpredictable, and despite trying various approaches, I haven't found anything that works. What should I do? So I don't like everyone that I meet either. So I don't know why you think your dog should like everyone, but I don't lunge and growl at people I don't like. I just ignore them. And so I think you need to work with her about having a consistent behavior when she meets new dogs. So that's going to involve training and positive reinforcement. And sometimes with training you have to start at the very beginning. And I understand that Jack Russell terriers are stubborn as all get out. And so they're hard to train. But I think persistence and positive reinforcement are what you need. My thought would be that when you approach a new dog, instead of allowing your dog to run headlong towards the new dog, that you make your dog sit, and when it sits, it gets a treat. Positive reinforcement for good behavior. And then let that other dog come up and meet your dog while your dog sits. And then you can release the dog and say it's okay to meet and and, you know, sniff the other dog from head to toe. But if you put the brakes on that interaction at the beginning and then let your dog know that it has to sit in order to meet these new friends, you get in a situation where there's less opportunity for things to escalate. I also think that training for any dog is important because dogs need to know how to behave well. People. You train your children to behave well in public and you need to train your dog. So starting with something like canine AKC’s Canine Good Citizen would be a good place to start joining a training group at your local shelter, or dog training facility would be another thing to do. There's often group classes that you can sign up, and I think this dog would benefit from that sort of training. And then if you really can't make headway on your own, consider a trainer, you know, someone who's got, background in education, in training dogs. Or there's also the the highest level would be to see a veterinary behaviorist. I don't think it all you're at that point right now, but that's the hierarchy that you would follow to try and get your Jack Russell, in control with the dogs he meets on the street. And our last question is from Bill T. Yes. My dog was recently prescribed gabapentin for pain management after surgery. Since starting it, he's been wobbling a bit when he walks and seems more sedated than I expected. Are these normal side effects or could this be a sign the dose is too high? How do I know when to be concerned? So, Bill, nearly all medicines that treat pain cause some degree of sedation and wobbly ness in our canine friends. So this is probably normal now. Hopefully since the dog had surgery, it's only going to need the gabapentin for a couple of weeks and this will be a short term problem. However, if your dog needs this medicine long term, most dogs become less affected by the gabapentin over time and they can, tolerate that dose without so much wobbly ness. So I think it depends on how long your veterinarian is going to prescribe this for. If after two weeks wobbly lives hasn't improved and your veterinarian says that your dog is going to need to keep taking this for a long time, then have a chat with your veterinarian about maybe cutting the dose back. But if this is a short term issue, I'd work hard to control the pain. Keep your dog comfortable and know that the gabapentin is going to go away. As your pet recovers from surgery. And now we're going to take a short break. And when we come back, I'll have important information from AMC's Usdan Institute. We're back with Dr. Ann Hohenhaus on Ask the Vet. Hi, everyone, and welcome back to Ask the Vet. The people at the Usdan Institute want to be sure that you remember that it is tick season, and it is very important to check your dog regularly, especially after walks in grassy or wooded areas. Ticks favorite place to live is in leaf litter and on bushes, so the more you can keep your yard trimmed back, and leaf litter picked up, the fewer ticks you will have here in the northeast. Tick activity starts to rise in April and stays high throughout the summer, and New York State consistently reports some of the highest numbers of Lyme disease cases in the country. So prevention of ticks is really important. Ticks often hide in less obvious spots on your dog between the toes, under the collar, around the ears and eyes, and in the groin area. So after you've been outdoors, do take a few minutes to do full body check after outdoor activity. If you find a tick on your dog, use a fine tip, tweezers and grasp it as close to your dog's skin as possible and then pull up with steady, even pressure. Don't twist or squeeze the tick, because then parts of the tick can break off and stay in your dog. You want to grab the tick and pull gently, not yank the tick out. After you remove the tick, you can place it in rubbing alcohol and seal it in a small container or plastic bag in case your veterinarian wants to identify the tick. Now this should be a great place to use your phone's camera, in that you could take a photo of the tick before you throw it away, and that will help your veterinarian to identify the species later on or you can just drop the ticket your vendor into office and ask them if you should be worried about it. Then, after you pull the tick out, clean the dog's skin with soap and water and monitor that area to make sure that there's not, an infection developing at the tick site. Sometimes we see that the dog will get like a little teeny skin infection in that area. If you're not comfortable removing the tick yourself, then call your veterinarian's office and get an appointment to let them handle the tick removal. They're all kinds of little tick removing devices out there. And so that would be another thing you might want to have handy this summer is our tick removal device. I saw kind of a little spoon sort of thing with a slit in it. Then you slip the tick in there and pull it out. There flat kind of little comb things that you could comb the tick out. Be sure to check online. And there are plenty of things to help you remove the ticks. If you don't want to use your tweezers. And finally, remember that the best protection against ticks is a year round tick preventative prescribed by your veterinarian, and that might take the form of a monthly pill a three months every three month pill, a top spot you put on the dog, or a special flea collar. If you want more information about preventing ticks, you can visit the Euston Institute at AMC, NY dawg backslash used an institute. I want to take these last couple of minutes to thank Doctor Renee Alsarraf for joining me today. And if you're interested in learning more from her and her webinar, Navigating a Pet's Cancer Diagnosis that is coming up on May 14th at 6 p.m.. And remember, you can sign up at amcny.org/events. Don't forget, if you have a question for me, I'll answer your question on your pets well-being or health advice. If you email me at Ask the Vet at amcny.org, and I'll answer your question on the June show. The Ask Vet Podcast can be accessed on the SIRIUS app across all major podcast platforms and also on AMC's website. All of this is thanks to our longstanding partnership with Sirius XM. Don't forget to like and follow us on social media, Facebook is The Animal Medical Center and on X formerly known as Twitter and Instagram. It's @amcny. I'd appreciate it if you take a moment to give the Ask the Vet podcast a review and why not Like and subscribe. So you get new episodes as soon as they drop. And I'm looking forward to seeing all of you next month on Ask the Vet. Have a great day everyone, and I'll see you after Memorial Day.