That's a good question, too, because it actually gets into the core of how heartburn prevention works. What exactly is it doing now? Essentially, a mosquito will bite an infected dog and then transmit it. It will go through a series of stages of development, a couple of stages that avail within a mosquito. Then the mosquito bites an unprotected dog and squirts this larva into the dog as it's sucking out the blood, in which case, there's more larval development inside the dog. Then it develops into adult heartworms, which live primarily in the heart but can also migrate into the lungs. How does heartworm prevention work? How does that fit into this whole sequence? When we think of heartworm prevention, we think we're preventing getting it in the next couple of weeks or six months. But it actually works backward. It is working to protect or eliminate any of the heartworms, the development, or the larva the previous 30 days when we're giving the once-a-month medication. If we're giving the medication, it works backward over the last 30 days. That's why it's imperative that you've got to keep your dog on prevention once a month. Don't try to cheat and go every 45 days or certainly not every couple of months because you're missing that window when the larva can develop and go on to the adult stage. Again, if you're going to start with prevention, be consistent. Make sure you're giving the medication every single month, about every 30 days. Let's be precise, how about every 30 days? If you get it every 30 days, your dog's going to be protected. But if you start skipping days and if you forget to give it, that's when we can run into problems. That's why we do have a six-month injection, and a 12-month injection for situations where we forget to give it or your dog doesn't really like to take the chewable tablet. We also have one topical liquid for people who don't want the injection or if their dogs won't take the chewable tablets. So essentially, that's the life cycle. The cycle starts when the mosquito bites an infected dog and sucks its blood. The larva develops, and the mosquito transmits it to an unprotected dog through a mosquito bite. Then the cycle just keeps on going that way. So please, the take-home message is to make sure you give your dog heartworm medication when it is supposed to be given.

It depends on the part of the country. In this part of the country in the Southeast, unfortunately, we do see heartworms. It is a huge problem throughout the southeastern US mainly because we have mosquitoes for a very long time. To be more specific, we potentially see heartworms or mosquitoes year-round. Mosquitoes start to emerge when the temperatures get into the low 50-degree range. So even in the months of January and February, we always are going to have some days where it's in the fifties or even up into the sixties. Even in the wintertime, we expect that. We're not going to see the mosquitoes in January and February as we do in August, September, and so forth, but the point is that we do see mosquitoes year-round. We do have a heartworm risk all year round in this part of the country from about Virginia all the way south. It is a horrible issue in the Gulf states, like Florida, Mississippi, Alabama, Texas, and Louisiana, because they also have a lot of low-lying watery areas. But particularly in the southeast, it's the biggest problem. Some places where it's extremely arid out west are not so much of an issue, but it does exist on the entire east coast and a significant part of the west coast.

Good question. No, they cannot. It is kind of interesting. I'm going to give a little bit of inside here. A lot of times when dogs come in, and we do a heartworm test, one of the things that I often ask as I'm getting the blood sample is if that particular pet parent happens to know how dogs get heartworms. Most of them don't know. Most people don't know how dogs get heartworms even though they're giving their medication to their dog on a monthly basis or getting the six or 12-month injection. It makes me realize that, somehow, as a profession, we have failed to educate people about this importance. I think people understand the importance of it, but it's more important to recognize how they get them in the first place because this gives you a sense of why it is a problem and a continual problem, particularly in the southeast part of the US. Quite simply, how do dogs get heartworms? Only from mosquitoes. So they cannot pass it to people. They cannot give it to another dog. Only mosquitoes can transmit heartworms from an infected dog to a dog that's not currently on heartworm prevention. That's it. Mosquitoes. That's the only way it can be spread.

Good question. That gets more into food allergies, and food allergies are a whole other subject. I will mention a couple of things about food allergies. I'm passionate about dermatology and its effects on dogs' skin health, and food allergies can be a big part of that. When we're dealing with a food elimination diet, what we're doing is we're trying to eliminate things that we think are causing intestinal distress or skin problems, biting, scratching, licking, itching, and chewing. So what we can do is go to an entirely different protein. We can introduce the new food the same way we mentioned a few minutes ago, by gradually introducing a new food with each meal you give less and less of the current diet.

That's an appropriate way to introduce a different protein or diet into your dog's routine. But just so you know, when it comes to food allergies, I'll speak to it very quickly. Do I ever do anything quickly? Probably not. When it comes to food allergies, chicken and beef are the two primary causes, followed by lamb and dairy, followed by pork, brown rice, wheat, soy, and corn. So if we suspect your dog has a food allergy, we want to get them off whatever the primary protein is, which is usually chicken or beef. We want to get them off that and get them onto an appropriate or a different protein that's significantly less likely to cause an adverse reaction. We can switch to salmon, whitefish, trout, venison, goat, kangaroo, or ostrich. So we've got several choices available to us. Essentially, that's what an elimination diet is all about. When we suspect food allergies, we're trying to eliminate the different proteins they were getting exposed to through their diet previously and get them onto something entirely different.

Not cause harm so much as maybe cause some intestinal distress. Nothing that would be permanent or lasting. Some dogs have no problems when we change a diet, and with a lot of dogs, you can just feed them different foods every day, and they're going to be absolutely fine. But some dogs are going to be much more sensitive. If that's the case, and if you happen to know that's going to be the case, then we need to make an appropriate change by slowly introducing a new diet while giving a little bit less of the current food. As far as causing any lasting harm goes, changing a diet will not. But as far as the potential for intestinal distress or upset, vomiting, or diarrhea goes, yes, that's entirely possible, but we can help manage that.

The best way is if your dog gets sick, either through vomiting or diarrhea. Granted, there could be a lot of reasons. It may not just be food. If your dog gets sick in the stomach, it could be something else. It could be an intestinal bug, like a virus or a bacterial infection causing the problem. It could be stress. It could be any number of things. But if we do see a dog that does get sick or we make a sudden change in their diet or something of that nature, and they don't seem to be able to digest it very well, then yes. So it certainly could be the case.

You can. I don't really have any problems with that. I am concerned about what food you're giving to your dog. The best way of saying this is that we know in our heart of hearts what's healthy, what's nutritionally appropriate for us, and what's improving the quality of our life. We know what's good for us, and that's fine if you want to give that to your dog. We'll talk about some more specifics. If you are sitting there with a bowl of popcorn, Cheetos, and pizza, and you think that's appropriate to give to your dog, no, it's simply not. Again, those foods are not nutritionally valuable or appropriate for your dog if you're going to be giving what we would consider snack food or junk food. End of story. So basically, yes, you can give them human food.

So let's say you've baked some chicken tonight. Great, that's fine. I don't have any problem with you giving that to your dog. I don't have any problem if you want to brown some ground beef and give that to your dog. Beautiful. If you want to give them some vegetables, you can. In fact, my favorite treat to give to dogs is vegetables. I am fine with anything from baby carrots to zucchini to cherry tomatoes. I would much prefer you give vegetables over fruit if you are going to give a treat. I will lean on treats for dogs a little bit. Honestly, if it comes in a box or a bag, I do not recommend it. It's much better nutritionally, calorie-wise, with fiber, vitamins, and minerals, to give some vegetables. You can make some zucchini sticks, cherry tomatoes, or baby carrots. Those are all appropriate to give to your dog. I don't have any problem with that. Getting to the question about giving dogs human food, just be intentional about it. If you're going to give human food, that's fine, but just ensure it's nutritionally appropriate for your pet as it would be for you.

When you think of toxic foods, you're not thinking about dog foods. We're thinking about inappropriate food that you and I would feed our dogs. There are about three or four different foods we need to be concerned about, primarily chocolate. I think most people by now know that chocolate can be toxic. The darker the chocolate, the more at risk your dog can be. Certainly also the smaller the dog. That can be more of an issue just because of the relative amount consumed in the dog's size, but also consider how much is consumed. Bottom line, please do not give your dog chocolate or make sure that you avoid access for your dog, especially during the holiday season, when you will have brownies or Halloween candy that can always be easily accessible for a lot of dogs. Please be mindful of that.

The other big issue, which most people are aware of, and if you're not, good for you for tuning into this, are grapes and raisins. Grapes and raisins have been proven to be potentially fatal to a lot of dogs. Not every dog will be affected, but you don't want to find out the hard way. So please do not give your dog grapes or raisins. Again, there is a potential risk of death for many dogs. Those are the key things we'd want to avoid. One of the things I am going to make a point about, which is not actually food, is raw hides. I have no problem with people giving raw hides, but I am very intentional about where those raw hides are coming from. We know that raw hides that are coming from Asia, in many cases, do have a lot of toxins in them when they're cooked in this vat. There can be different types of lead or mercury or things of that nature that can be a source of toxicity to a dog. So if you're going to use raw hides, that's fine. Please make sure that you're using something from North America. That's crucial. Hopefully, that'll give you some insights if you weren't aware.

I generally find with kittens and old cats, meaning those that are not as thrifty as they once were, they don't clean themselves as much, or those cats that go outside are at much greater risk of getting fleas and/or ticks. But I often see kittens and really older cats being much more of a risk because they don't have the tendency to clean themselves and remove these external parasites called fleas and ticks. Age can be a factor, and the more time they spend outside is a risk as well.