To Declaw or not to Declaw? That is the Question.   Leave a comment


Recently I have had several questions concerning declawing cats.  Let me start by saying the purpose of this article is not to encourage or discourage this procedure; but rather, to clear up misconceptions about this procedure. Owners may elect to declaw their cats for several reasons.  The most common reasons being their cat may be destructive with their claws or their cat is aggressive. In either case, the behavior affects how well the cat fits into the home environment. In some cases, the behavior makes them unsuitable pets.


The correct medical term for declaw is Onychectomy. The goal of the surgery is to remove the tissue responsible for the growth of the nail; most commonly, it is done to the front feet only.  These results can be achieved in several different ways and some of these procedures are superior to others.  Contrary to popular belief, the nails are not “ripped out.”  In fact when done correctly, the procedure is no more painful than many other elective surgeries we perform such as spaying or neutering. The second popular belief is the declawed cats are unable to defend themselves. This procedure is not advocated for the “outdoor” cat where claws would be needed for hunting and defense. Indoor cats however, are not in need of protection nor are they required to hunt.


The first surgical method we will discuss is where the third phalanx, the last bone of the finger so to speak, is cut. This involves the actual cutting of the bone and fortunately is rarely done these days.  This method involves post-surgical discomfort which is why this method has fallen out of favor.


The second method involves removal of the entire third phalanx. With this technique, the removal is through the joint.  There is no cutting of bone which means far less discomfort. There are a couple of specific ways to do this. One is the use of a scalpel to dissect down to and through the joint space while the second method is the use of a laser. The laser method is far superior as it minimizes inflammation and post-surgical discomfort. Additionally, there is minimal bleeding due to the cauterization of the blood vessels by the laser. Most commonly, cats that have had this procedure do not exhibit any signs of discomfort post-surgery. From a cosmetic standpoint, the feet appear normal other than lacking a nail and the cat’s behavior remains unchanged.


Declawing is not for every cat or every cat owner; however, it does have its place. When done in a humane manner, it can make a cat a more enjoyable pet and family member.


Dr. Ronald S. Ball DVM, MS is a veterinarian in practice with Animal Care Extraordinaire in Stuart, Florida.  This small animal veterinary clinic has been located in Martin County for over 30 years. To learn more about the hospital, you may visit or call 772 287-2513.



30 Years of Veterinary Medicine   Leave a comment

Our veterinary practice is celebrating 30 years in business!  In celebration of this, I thought I would take a walk down memory lane and look back at the early 80’s. We all recall the Rubik’s Cube and Michael Jackson’s Thriller but what was the status in the world of veterinary medicine?  It was much different than today.

The early 80’s found the veterinary world faced with a new disease called Parvovirus. The disease first appeared in 1978 and by the early 80’s was widespread throughout the dog population. The disease was poorly understood and there was no natural immunity to the condition. Veterinarians feared this disease like no other as its aggressive progression typically resulted in the patient not surviving.  If this wasn’t bad enough, the highly contagious nature of the disease typically resulted in large outbreaks both inside and outside the clinic. Currently through advances in medicine and understanding of the disease, we are now able to prevent and, in most cases, effectively treat the disease.

Likewise, the prevention of heart worm disease in dogs was in its infancy back in the 80’s. Monthly preventatives had not yet been developed and we needed daily medications to prevent the infection by this parasite. Many of you may recall giving your dog Filarabits on a daily basis. Despite heart worms being described in the early 1900’s, it was not a primary disease until the late 1970 and early 1980’s. And even then, it was considered a regional condition that was confined primarily to the Gulf Coast region. Today, it’s one of the most commonly encountered diseases in both dogs and cats and one of the easiest to prevent. The new generation of monthly preventatives is highly effective in both species. These disease changes were not confined to the dog population.  The Feline Aids disease was non-existent and made its appearance in 1986 when veterinarians in California isolated the virus in cats.  Today, researchers are still working to develop effective vaccines to remedy this condition.

Fleas have been around for centuries.  However, in the last thirty years we have made huge technological advances in the control of this parasite. Back in the “olden days” we relied on applying toxins to our pets as well as to the environment in which they (and we) lived.  It was a delicate balance attempting to apply enough toxins to control the fleas without making the patient sick. With the advent of new non-toxic, monthly application, flea controls, there is no reason for you or your pet to be annoyed by the parasites.

During our time in practice, the advent of veterinary “specialists” has emerged.   Previously, these highly trained veterinarians were typically employed by universities and often unavailable to the general public.  Today, even a relatively small town like Stuart can successfully support a wide range of specialists which, in turn, allows for better care for our pets. We, ourselves, continue to keep current with technological advances. We embraced the advent of laser surgery and digital radiography as well as the latest technology in patient monitoring systems – all of which have helped provide “state of the art’ care.

Here’s a peek at how “Animal Care Extraordinaire” has evolved over the last thirty years.  First off, Dr. Diamond had more hair and the practice was a one man show.  Nineteen years ago, I joined the practice.  And yes –at one time, we even had a mobile animal hospital.  Throughout these years, we have developed close associations with community agencies allowing us to provide much needed services to the public.  We set up shop in Indiantown once a month for over twenty years.  We support and utilize the services of Animal Birth Control.  We provided one of our canine deputies with a bulletproof vest.  Our commitment to community continues.  Recently, we have begun a relationship with “Help Us Help Them,” a nonprofit organization dedicated to helping pets and pet owners in financial need.

But most important, over the last 30 years we have had the pleasure of caring for some very special pets, owned by some very special people. We hope that never changes.

“Please, not more lab work!”   Leave a comment


A question frequently asked during a pet’s annual exam is, “Is the blood work necessary?”   Blood work helps us to fully evaluate your pet’s overall health.   Changes affecting your pet’s health are not always visible from the outside. The primary goal in an annual examination is to find problems before they become debilitating and, this is where blood work is so important. Realistically, we want the blood work to be normal and, most of the time, it is. However, when it’s not, blood work gives us the clues to find problems.  


Of all the blood chemistries, there are certain values that are of greater interest. In a standard panel, we are looking at liver values such as Alkaline Phosphatase (SAP), ALT, Bilirubin and Albumin. 

  • SAP is the value we most frequently find abnormal. Elevations can have numerous sources including obstruction (partial or complete) of the gall bladder system, bone remodeling as seen in arthritis or severe dental disease, issues involving the adrenal glands which secondarily affect the liver, certain medications such as steroids and other anti-inflammatory drugs, and neoplasia in addition to primary liver disease. An elevated Alkaline Phosphatase is typically seen as a sign to take a closer look. 
  • ALT is also known as Alamine Aminotransferase or SGPT. Elevations in this enzyme are specific for disease or damage of the liver and like elevations in the SAP.  It’s a clue that we need to look further to determine the exact cause of the disease. Frequent causes of elevation in this value include heart disease which results in a decreased blood flow to the liver as well as infections of the liver. 
  • Bilirubin is a by-product of red blood cell destruction and it is the body’s attempt to recycle hemoglobin in the liver. When the liver is diseased or overburdened by too much red cell destruction, the bilirubin levels go up. There are a multitude of conditions which can lead to this.  These include an increase in the number of red cells that are being destroyed and recycled, liver disease, gall bladder disease and certain pancreatic conditions. Most cases of elevation in bilirubin result in a jaundice or yellow- skinned patient and require immediate attention. 
  • Albumin is the basic protein in our blood. This is produced primarily in the liver.  When we have long term liver problems, this decreases.  Albumin is also dependent upon the patient’s ability to absorb nutrients from their diet.  Animals with GI conditions where nutrition absorption is abnormal can result in low albumin levels. 


The next important group of values is an animal’s kidney values. These are primarily blood urea nitrogen (BUN), creatinine and phosphorous.

  • BUN is a by-product of protein metabolism which occurs regularly in the animal’s body. This by-product is removed by the kidneys.   When those organs are not functioning properly, the BUN becomes elevated. This response is rapid and dramatic to the onset of kidney disease; however, there are other conditions that can result in increases in the BUN as well. These include dehydration and poor kidney blood flow like you would see in heart disease. Elevations in BUN typically result in a sick patient who is lethargic, dehydrated and has had vomiting and diarrhea. 
  • Creatinine is also a waste product of muscle metabolism that is removed by the kidneys but, unlike BUN, there are few non-kidney conditions that cause it to be elevated. Additionally, an elevated creatinine does not necessarily result in a sick patient.  Animals can tolerate elevated levels well; however, when creatinine is elevated it is a reasonably accurate indicator that the disease is in the kidneys. 
  • Phosphorus regulation also falls in the functions of the kidney and when not functioning properly the levels of phosphorus increase. The levels can increase dramatically with urinary tract obstruction such as stones. 



Pancreas related values are also evaluated. These include glucose, amylase and lipase.

  • Glucose regulation is a function of insulin production by the pancreas. Insulin allows the glucose or blood sugar to enter the muscles so it can be utilized for energy. When the pancreas is unable to produce enough insulin, this function does not occur and the blood sugar becomes elevated. This elevation overwhelms the kidneys’ ability to reabsorb sugar so the excess sugar comes out in the urine, bringing water with it.  This results in an increase in urination. This commonly occurs in diabetic patients.
  • Amylase and lipase are pancreatic enzymes that break down starch and fat respectively. When the pancreas is inflamed, these levels become elevated. The same can occur with some types of cancers; however, interpretation of these levels can be difficult and other factors need to be taken into consideration.   


A broad category that we regularly monitor is an animal’s electrolytes.  These electrolytes include sodium, potassium, chloride and phosphorus. Rather than looking at these values individually, we tend to look at them as a group and how they relate to each other. Areas where we will see abnormalities in the electrolyte values relate to digestion of food.  When these values are not “in check”, the patient may have vomiting or diarrhea.  At times, this may manifest itself as a disease of the adrenal glands known as Addison’s disease. Significant abnormalities in our electrolyte levels will clue us into the need for further investigation. 


The “complete blood count” or CBC includes an evaluation of the white cell (WBC and differential) as well as the red blood cells (PCV or hematocrit and hemoglobin) and platelets.

  • WBC/differential is a white blood cell count where specific types of white blood cells are evaluated. Many people assume that an elevation in the white blood cell count is a result of infection.  While that is often correct, there are other causes for an increase in the WBC.  This is why the differential is important. Inflammation will cause an increase in white cells as the body is attempting to clean up inflammation. Certain parasitic infections will also cause an elevation in particular white cells as will allergic reactions. Dramatic increases can be a result of certain type of blood borne neoplasia. Low white cell counts are seen with immunosuppression which can range from viral infections to neoplasia to side effects from medications. 
  • Red Blood Count (RBC) evaluation comes in the form of a hematocrit or packed cell volume (PCV) and hemoglobin levels. A low PCV is known as anemia. There are many causes of anemia; like many of the other abnormal results we see in our blood work, a low PCV tells us we need to look further. Common causes of anemia include parasitic infections such as intestinal worms or heart worms, internal bleeding, failure to produce red cells because of bone marrow disease, increase destruction of the RBC, (hemolysis) and kidney disease. An elevated PCV is a result of dehydration. Hemoglobin levels are the oxygen carrying capacity of the blood. Low hemoglobin is typically seen with anemic patients; its causes mirror those that cause anemia. 
  • Platelets are one of the first lines of defense for bleeding. These cell fragments plug small vessels that are constantly rupturing.  The most common cause of low platelet counts is loss from bleeding although there are other conditions that can cause decreased platelet levels.  Auto-immune disease as well as the tick transmitted diseases like Lyme Disease or Rocky Mountain Spotted Fever can cause low platelet levels.


Finally, the last component of a Well Pet evaluation is the urinalysis. There is much information to be gathered from such a simple sample. It is not uncommon to find sub-clinical infections in the bladder.  These infections can be asymptomatic; yet over a long period of time, can contribute to significant disease such as the formation of bladder stones.  Previously we discussed low protein in the blood.  One of the more frequent reasons for low protein is loss through the urine.  On other occasions, we will find excess sugar in the urine when a patient is diabetic.Crystalsin the urine is a common problem in cats and identifying and preventing them before they collect and form bladder stones can save your cats life.


Lab work gives us additional information about your pet’s health than cannot be obtained in any other way.  It provides your veterinarian with the ability to identify a problem before it becomes an emergency. 


Poisons lurking in your backyard   Leave a comment

Poisons lurk in places you don’t always suspect. As residents of Florida, I suspect most pet owners have heard of the Bufo, or Cane Toad, which is notorious for poisoning pets.  However, there are many other potential toxins in our environment.

One group of toxins that I want to bring to my readers’ attention is one that pet owners seldom think, lurking in their own backyards. Plants…yes, plants. Many of the trees, vines and shrubs that we plant and cultivate and even those that grow naturally in our yards have the potential to be rather harmful to our pets.

Lady of the Night

My poison plant de jour is the Lady of the Night plant.  This plant has several names including Yesterday, Today, Tomorrow, Kiss-Me-Quick, Morning-Noon-and-Night, Fransiscan Rain Tree. This plant is popular due to its fragrant and beautiful flowers, however it also has the potential to be quite toxic. If the foliage or leaves of this plant are ingested, it is likely that your pet will experience seizures that last for several days or quite possible the effects can be fatal.



 Jessamine is another common plant that has the potential to cause serious toxicity with signs and symptoms similar to Lady of the Night. 

Many other plants are toxic with most causing moderate to severe gastrointestinal issues such as vomiting and / or diarrhea. Plants such as Holly, Pokeweed, Kalanchoe and Oleander should be avoided for this reason.  

We recently had a case of severe toxicity in our hospital. In our attempt to isolate the toxin in the owner’s yard, we identified Lady of the Night, Belladona (aka St Joseph’s Lilly), Begonia, Branching and California Ivy,  Kalanchoe, Snake Lilly, and Tree Philodendron. Each of these, growing in the yard, has a toxic potential of which the owner was unaware.  

Poisonous Plants of the Southern United States


I would suggest you take an inventory of your landscape. One of my preferred references for toxic plants in this area is Poisonous Plants of the Southeastern United States.

 The ASPCA Database  also has an extensive list of potentially poisonous plants.




Are you growing toxic plants in your own backyard??

Dr. Ronald Ball is a veterinarian in practice with Animal Care Extraordinaire in Stuart and Jensen Beach, FL. To learn more about the hospital you may visit or call 772-287-2513


New Year’s Resolutions for Your Pet   Leave a comment

At the beginning of each New Year, we make resolutions to improve the quality of our lives. With the best of intentions, we promise ourselves to eat better or to lose weight.  While we are making these resolutions for ourselves, there is no reason why we can’t extend these affirmations to our pets.

One of the most common problems veterinarians encounter during a pet’s exam is that of the overweight patient. Most of these cases are animals that are slightly overweight; however, even being slightly overweight can contribute to complications such as respiratory issues, arthritis, cardiovascular problems and diabetes.  Evaluating your pet’s weight is a rather simple procedure. One should be able to feel the ribs when gently rubbing the side of the chest and there should be a visible waist between the last rib and the hips.

 Like people, an animal’s nutritional requirements change over time.  With this in mind, our feeding habits should change as well. I am often asked “how much should I feed my dog or cat?”  Like people, the amount of food depends on the animal’s age, their weight, their activity level and their specific metabolism. Many cases of weight gain are not the result of overfeeding but rather “over treating.”  Treats composed of “human food” are typically high in calories and/or high in fat.   Even a few treats in a day can affect your pet’s weight.  The best food you can feed your pet is food that is specifically designed
for your pet.

So, as you make those New Year resolutions, think about including all of your family members – especially the furry ones!

To Treat, or Not To Treat, your Pet from the Holiday Table?   Leave a comment

As the holidays roll around, we pet owners tend to want to treat our loved ones to something special from the dinner table. Due to this, veterinarians see an increase in the maladies associated with dietary changes during this season. When pet owners give their pets such “treats”, they unknowingly increase the risk of several conditions that can potentially make our furry family members quite ill.

 The first condition we see is known as dietary indiscretion or “garbage gut”. This can occur with any change in the regular feeding habits of our pets. The quality of the food has little or no bearing on how sick your pet can become. In other words, your pets’ suffering does not mean you are a bad cook, only that the particular food does not sit well and will result in vomiting and/or diarrhea. In most cases of dietary indiscretion, gastrointestinal protectants are enough to solve the problem.

 The next condition is much more serious. Pancreatitis is an inflammatory condition of the pancreas, which can result in a life threatening illness. It is typically seen in dogs after they have eaten fatty foods and is more common in smaller and specific breeds such as Schnauzers. However, any breed is susceptible. The signs of pancreatitis in dogs are typically severe vomiting and diarrhea. Upon examination, the pet will display a sensitive abdomen, often accompanied with fever and anorexia. The condition can also occur in cats and does not need to be associated with a fatty diet. Also the signs in cats are much less specific and diagnosis is much more difficult. The signs can range from simple anorexia to vomiting to jaundice. In both species, treatment consists of antibiotics, fluid therapy, pain control and sometimes anti-inflammatory drugs.

 Many pet owners are aware that chocolate can be quite toxic to both dogs and cats. Chocolate contains theobromine which is a xanthine compound, thus chocolate ingestion is often referred to as bromine or xanthine toxicity. Dogs do not break this down as quickly as humans and because of this slow digestion, they are more susceptible to the toxic effects. These effects are similar to what a person would experience after ingesting a large amount of caffeine.  These symptoms include excitement, hyperactivity, increased urination, increased blood pressure and in severe cases, seizures.

 There are two points to note. Firstly, for true chocolate toxicity to present itself in a dog there must be a rather significant ingestion of chocolate. One piece of chocolate should not be enough to cause this reaction. As an example, a 50 pound dog would need to ingest approximately 1 pound of semisweet chocolate to reach the toxic level. Baker’s chocolate is nearly 2 times stronger; hence the same dog would exhibit signs of toxicity after ingesting only about 5 ounces. Secondly, chocolate can cause either of the above conditions of dietary indiscretion or pancreatitis to occur. Following the ingestion of chocolate, either of these illnesses is actually much more common than theobromine toxicity. 

 Think about these facts before you succumb to the urge to treat your pets. It is wise to try to avoid these fatty foods and chocolate—even small amounts.

Let’s talk lumps and bumps! November is National Pet Cancer Awareness Month   Leave a comment

Lumps and bumps are a common finding in dogs and cats of any age and of either gender. When evaluating any type of mass it is important to look at several criteria to help determine if it is something we should be concerned about.  Those benchmarks include:

  1. How old is the patient? It is not typical to see aggressive tumors in younger patient.  There are a few tumor types that do target younger patients however most of those are not aggressive.
  2. What species is the patient? Some tumors are more common in certain species; others are more aggressive. For example, mammary tumors in cats tend to have a much greater frequency of being malignant or cancerous than they do in dogs. Likewise species will affect our prognosis. Certain tumor types respond to therapy better in one species but not as well in others.
  3.  What breed is the patient? Many tumors have breed predilections.  Some carry a worse prognosis in certain breeds.  The classic example of this is the mast cell tumor seen in Boxers.  Another would be an increased incidence in lipomas in Schnauzers andLabradors.  We see more of these in overweight patients. 
  4. Is the patient spayed or neutered? Hormones can play a significant role in the formation of certain tumors. Tumors are more common in the non-altered patient.  This is one of the basic benefits of spaying or neutering your pet. Those tumors most commonly affected by the presence of a reproductive tract include perineal adenomas, mammary gland carcinomas and prostatic tumors. All these are found much less frequently in spayed or neutered patients.
  5. Is the lump hard or soft? Fatty nodules or lipomas are one of the more common types of masses we see. These are soft accumulations of fat and typically solitary. They are not usually aggressive.  However, many of our more aggressive types of tumors are hard to the touch so a general feel of the tumor helps to determine our course of action.
  6. Is the mass ulcerated? Masses that are ulcerated offer a couple of problems. Being ulcerated is typically an indication that the core is necrotic and thus is a constant source of infection.  Additionally, most ulcerated masses are rapidly growing where the mass has outgrown the blood supply resulting in the necrosis.  Ulceration is one of those key signs that a tumor needs to be removed.
  7. Where is the mass located? Certain tumors have an affinity for certain locations on the body and this may help to determine the course of treatment.  Remember the feline mammary gland example?  When these tumors are found, our first thought should be surgical removal.  Splenic as well as tumors in the mouth follow the same criteria.
  8. Is the mass solitary or are there many masses or other “bumps”?  Aggressive tumors spread through the body using either the blood or lymphatic system. Those utilizing the lymph system frequently present with multiple swollen lymph nodes. This is a key factor in determining our course of treatment as well as prognosis. 
  9. Is the mass bothersome? While many tumors may not be cancerous, they may require attention if they are causing an annoyance to the owner or patient. For example, tumors on the ear may increase head shaking while tumors in the ear canal may lead to greater frequency of infections. Tumors on the feet and legs may result in gait abnormalities leading to increased incidences of arthritis and other joint problems. So while a tumor might not be malignant or cancerous, many times it does require attention.

  There is only one true method to determine what type of tumor our pets have. That requires getting a sample of the cells that compose the tumor and having them classified microscopically by a pathologist. This can be done by pulling off some cells or by removing the tumor.

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