Resources

Patient Education

Clinical knowledge, written for the people who love their pets — by the veterinarians who care for them.

Pet Safety

Secondhand Smoke and Cancer in Pets

Most pet owners know that secondhand smoke is harmful to humans. What is less widely known is the documented link between tobacco smoke exposure and cancer in companion animals — particularly cats and dogs.

A study from Tufts University School of Veterinary Medicine, published in the American Journal of Epidemiology, found that cats living with smokers were significantly more likely to develop malignant lymphoma — one of the most common and lethal forms of feline cancer. Cats with five or more years of smoke exposure showed the highest risk, with some studies suggesting the risk of lymphoma may be more than doubled in smoking households.

The mechanism in cats is straightforward and disturbing: cats groom themselves. Smoke particles that settle on the fur are ingested during grooming. This means that a cat living with a smoker doesn't just inhale smoke passively — it also ingests concentrated smoke residue every time it cleans itself. The oral cavity and gastrointestinal tract receive a sustained toxic load that correlates with lymphoma development.

In dogs, the primary concern is respiratory tract cancer — specifically lung cancer and nasal cancer. Dogs with shorter muzzles (brachycephalic breeds such as Pugs, Bulldogs, and Boston Terriers) are at elevated risk because their shorter nasal passages filter less of the smoke before it reaches the lungs. Dogs with longer muzzles have longer nasal passages that filter more particles — but those particles accumulate in the nasal tissue, increasing the risk of nasal cancer specifically.

The message for pet owners is not a comfortable one, but it is clear: if there is tobacco smoke in the home, it is affecting your pets. Even "smoking outside" provides only partial protection, as smoke residue clings to clothing, furniture, and carpets. The safest environment for a dog or cat is a smoke-free home.

If you have concerns about your pet's cancer risk or have noticed symptoms — unexplained weight loss, enlarged lymph nodes, difficulty breathing, or nasal discharge — please call Northside at (703) 525-7115.

Xylitol Toxicity in Dogs

Xylitol is a sugar alcohol used as a sweetener in hundreds of consumer products — sugar-free gum, candy, breath mints, some peanut butters, vitamins, and oral care products. In humans, xylitol is safe and is even used to prevent dental cavities. In dogs, it is acutely toxic.

When a dog ingests xylitol, the compound causes a rapid and potentially severe release of insulin. Blood glucose drops precipitously — a condition called hypoglycemia. Dogs affected by xylitol-induced hypoglycemia may show weakness, loss of coordination, vomiting, seizures, and collapse within 30 minutes to an hour of ingestion. The hypoglycemic threshold is approximately 0.1 grams of xylitol per kilogram of body weight.

At higher doses — approximately 0.5 grams per kilogram of body weight — xylitol causes acute hepatic necrosis: liver cell death. This is more serious than hypoglycemia and can be fatal. The combination of hypoglycemia and liver damage makes high-dose xylitol ingestion a genuine emergency.

For reference: a single piece of sugar-free gum may contain 0.3–1.0 grams of xylitol depending on the brand. A 10-pound dog has a body weight of approximately 4.5 kilograms. The hypoglycemic threshold for that dog is 0.45 grams — achievable with one or two pieces of gum.

Brands known to contain xylitol include many sugar-free gum varieties. Additionally, some peanut butter products use xylitol as a sweetener — relevant because many owners use peanut butter to administer medications or fill puzzle toys. Always read the ingredients.

If you believe your dog has ingested xylitol, do not wait for symptoms to develop. Contact Northside at (703) 525-7115 immediately during office hours, or contact the ASPCA Animal Poison Control Center at (888) 426-4435 at any hour. Time matters.

Note: Xylitol does not appear to cause the same acute toxicity in cats, though cats should not be given sugar-free products for other reasons.

Common Household Toxins

Many common household products are toxic to dogs and cats. The following is a brief reference for pet owners.

ASPCA Animal Poison Control Center: (888) 426-4435. This line is available 24 hours a day, 7 days a week, and staffed by veterinary toxicologists. There may be a consultation fee.

Common toxins include: grapes and raisins (can cause acute kidney failure in dogs), onions and garlic (toxic to both dogs and cats in large quantities), chocolate (theobromine toxicity — baking chocolate and dark chocolate are most dangerous), macadamia nuts (neurological symptoms in dogs), avocado (particularly the skin and pit), alcohol, caffeine, and xylitol (see separate article).

Medications: Never give your dog or cat human pain medications. Acetaminophen (Tylenol) is particularly dangerous to cats and can be fatal in small doses. Ibuprofen and naproxen (Advil, Motrin, Aleve) cause gastrointestinal ulceration and kidney damage in dogs and cats. Many prescription medications are also dangerous — secure all medications in closed cabinets.

Household plants: Lilies (true lilies — Easter lily, tiger lily, daylily) are acutely toxic to cats and can cause kidney failure. Sago palm is severely toxic to dogs. Other common toxic plants include azaleas, rhododendrons, oleander, and English ivy.

For proper disposal of unused medications, the DEA sponsors National Prescription Drug Take Back Day twice yearly. Medications should not be flushed or thrown in the trash — take them to a collection site.

Seasonal Health

Seasonal Pet Safety: Year-Round Guide

Each season brings specific risks for dogs and cats in the Northern Virginia area. This guide covers the most common seasonal hazards.

WINTER: Cold weather and hypothermia

Dogs and cats can suffer from hypothermia and frostbite when exposed to cold temperatures for extended periods. Short-haired breeds and small dogs are particularly vulnerable. Signs of hypothermia include shivering, lethargy, and pale or blue-tinted gums. If you suspect hypothermia, warm the pet gradually and contact your veterinarian immediately.

Antifreeze (ethylene glycol) is acutely toxic and is often spilled in driveways during winter. Its sweet taste attracts pets. Antifreeze ingestion is a genuine emergency — even a teaspoon can cause kidney failure in a cat. If your pet may have ingested antifreeze, call Northside at (703) 525-7115 or the ASPCA Poison Control Center at (888) 426-4435 immediately.

Ice melts and road salts can irritate paw pads and cause gastrointestinal upset if licked. Wipe your dog's paws after outdoor walks in winter.

SUMMER: Heat and outdoor hazards

Dogs can experience heat stroke rapidly in warm weather, particularly in humid conditions. Never leave a pet in a parked car — on a 70-degree day, the interior of a car can reach 100 degrees within 20 minutes. Signs of heat stroke include excessive panting, drooling, lethargy, and collapse.

HALLOWEEN: Specific hazards

Chocolate, candy wrappers, and sugar-free candy (containing xylitol) are all hazards during Halloween. Keep candy secured and out of reach. Glow sticks and glow jewelry contain a bitter-tasting liquid that is irritating but not highly toxic — however, it can cause excessive salivation and distress.

HOLIDAY SEASON: Food and decorations

Holiday foods to keep away from pets: turkey bones, onion and garlic in stuffing, grapes and raisins, alcohol, xylitol in sugar-free desserts, chocolate. Holiday decorations can pose hazards: tinsel is attractive to cats and can cause intestinal obstruction; Christmas tree water may contain fertilizers; certain holiday plants (mistletoe, holly, amaryllis) are toxic.

Harmful Algal Blooms and Water Safety

Harmful algal blooms (HABs) occur when algae — including certain types of cyanobacteria (blue-green algae) — grow rapidly in warm, still, nutrient-rich water. These blooms can produce toxins that are dangerous to dogs and cats.

Dogs are at particular risk because they are more likely to swim in and drink from natural bodies of water. Contact with HAB-affected water, or ingestion of even a small amount, can cause serious illness including vomiting, diarrhea, seizures, liver failure, and death. Toxicity can develop within hours of exposure.

In the Northern Virginia area, HABs have been documented in the Potomac River, smaller lakes, and ponds during warm months (typically July through October). The CDC and local health departments issue advisories when blooms are detected.

Signs of HAB toxin exposure in pets include: vomiting, diarrhea, drooling, staggering, difficulty breathing, seizures, and collapse. If you believe your pet has been exposed to a harmful algal bloom, rinse the pet thoroughly with clean water and contact your veterinarian or ASPCA Animal Poison Control Center at (888) 426-4435 immediately.

Practical guidance: avoid allowing your dog to swim in or drink from water that appears discolored (particularly blue-green or greenish), has a foul smell, or has visible surface scum. After swimming in any natural water, rinse your dog with fresh water.

Dog Swimming Safety

Swimming can be excellent exercise for dogs — it's low-impact, provides full-body conditioning, and is particularly valuable for dogs with arthritis or joint disease. However, it carries specific risks that owners should understand.

Not all dogs can swim well. Despite the "doggy paddle" stereotype, many breeds — particularly brachycephalic breeds with heavy bodies and short legs — struggle in water and can tire rapidly. Dogs with heavy coats can become waterlogged. Never assume a dog can swim safely without supervision.

Pool safety: Dogs can drown if they cannot find the pool exit. If you have a pool, make sure your dog can locate and use the pool steps. Consider a dog life jacket for dogs who are new to swimming or who are poor swimmers. Ensure a safe, easy exit is always available.

Drowning risk: Dogs who have been swimming strenuously can become exhausted more quickly than they or their owners expect. Watch for signs of fatigue — labored breathing, low head position in the water, paddling that appears desperate. Remove the dog from the water before this point.

Post-swim care: Dry your dog's ears thoroughly after swimming. Trapped moisture in the ear canal creates an environment for infection — a condition called swimmer's ear (otitis externa) in dogs. Signs of ear infection include head shaking, scratching at the ear, and a discharge or odor from the ear canal.

Avoid allowing your dog to drink large quantities of pool water (chlorine irritation) or lake water (bacterial contamination, harmful algal bloom risk). Fresh water should always be available when dogs are active outdoors.

Dental Care

Pet Dental Health: What You Need to Know

February is National Pet Dental Health Month, but the conversation about dental health belongs in every wellness visit throughout the year. Periodontal disease is the most common clinical condition in dogs and cats over three years of age — and it is largely preventable.

Understanding dental disease progression Dental disease begins invisibly. Bacteria in the mouth form a film on tooth surfaces called plaque. If plaque is not removed, it calcifies into tartar (also called calculus), a hard mineral deposit that cannot be removed by brushing alone. Tartar provides an ideal surface for further bacterial growth, which begins to inflame the gumline — this is gingivitis. As inflammation progresses below the gumline, the structures supporting the teeth are damaged. This is periodontal disease, and it can result in tooth loss and chronic pain.

The systemic consequences extend beyond the mouth. Bacteria from diseased gum tissue can enter the bloodstream and affect the heart, kidneys, and liver. Dental disease is not merely cosmetic — it is a genuine health concern.

Signs of dental disease to watch for Many pets with significant dental disease do not show obvious signs of pain. Animals are often stoic about dental discomfort. Signs that warrant a dental examination include: persistent bad breath (halitosis), difficulty eating or dropping food, pawing at the mouth, bleeding gums, yellow-brown tartar deposits on tooth surfaces, and swollen or receding gum tissue.

What to expect at a dental appointment A dental cleaning at Northside requires general anesthesia — this is not optional, and it is not a sign of excessive caution. Anesthesia allows for a thorough, safe examination of every tooth and the surrounding tissue, accurate assessment of any pockets around the tooth roots, safe use of the ultrasonic scaler, and effective polishing. Attempting to clean teeth in a conscious pet produces an inadequate result and causes stress.

The pre-operative protocol is the same as for other surgical procedures: no food after 10:00 PM the evening before, drop-off between 8:00 and 9:00 AM. Pre-anesthetic bloodwork is available and is particularly recommended for older patients. Most dental procedures are same-day, with discharge in the early evening.

At-home dental care The gold standard of at-home dental care is daily tooth brushing with a pet-safe toothpaste (never human toothpaste, which contains fluoride and often xylitol). Veterinary Oral Health Council (VOHC)-approved products — toothpastes, dental chews, water additives, and other tools — have been tested and evaluated for efficacy. Not every pet will tolerate brushing, and that is fine; there are alternatives. Talk to Dr. Adam or Dr. Mary during your next wellness visit about an at-home dental routine that will work for your specific pet.

Medications & Toxins

MRSA and Your Pet

MRSA — methicillin-resistant Staphylococcus aureus — is a bacterial infection that has received significant public attention in human medicine. Pet owners often ask whether their animals are at risk, and whether they can transmit the infection to or from their pets.

What MRSA is Staphylococcus aureus is a common bacterium found on the skin and in the nasal passages of both humans and animals. Most strains are susceptible to standard antibiotics. MRSA is a strain that has acquired resistance to methicillin and many related antibiotics, making infections significantly harder to treat. MRSA has become increasingly common in healthcare settings and communities over the past two decades.

Pets and MRSA Dogs and cats can carry MRSA — typically colonized on the skin or in the nasal passages without showing signs of infection. Most colonized animals are asymptomatic and unaware of carrying the bacterium. The concern arises when MRSA causes active infection — typically through a wound, a skin fold, or another site where the skin barrier is compromised.

Transmission MRSA is transmitted through direct contact — skin-to-skin or skin-to-wound contact with an infected or colonized individual. Pets can acquire MRSA from their human family members, and humans can acquire MRSA from their pets, though pet-to-human transmission is considered less common. The primary concern is a household in which a human family member has an active MRSA infection — in this scenario, the pet may become colonized or develop an active infection.

Treatment MRSA infections in pets are treated with antibiotics to which the specific strain is sensitive — cultures and sensitivity testing are performed to determine the appropriate antibiotic. The treatment course is typically 3–6 weeks, depending on the severity and location of the infection. Pets are generally managed in the home during treatment, with standard hygiene precautions.

What you can do The most effective prevention is thorough, consistent handwashing. Wash hands before and after handling any pet, particularly if the pet has an open wound or skin infection. If you or a family member has been diagnosed with MRSA, notify your veterinarian so they can assess your pet and advise on precautions.

Diet-Associated Heart Disease in Dogs

In 2018, the U.S. Food and Drug Administration (FDA) began investigating a possible link between grain-free dog foods and a form of heart disease called dilated cardiomyopathy (DCM) in dogs. DCM is a condition in which the heart muscle becomes enlarged and weakened, reducing its ability to pump blood effectively.

The investigation was prompted by an increase in DCM cases in breeds not typically predisposed to the condition, occurring in dogs fed grain-free diets — particularly those containing peas, lentils, chickpeas, and other legumes as primary ingredients. These ingredients are often used as replacements for grains in "grain-free" formulations.

The mechanism is not fully understood. Initial concern focused on taurine — an amino acid important to heart function — as some dogs on these diets showed low taurine levels. However, not all affected dogs were taurine-deficient, suggesting other factors may be involved.

The FDA's investigation is ongoing, and causality has not been definitively established. However, out of an abundance of caution, Northside recommends the following:

If your dog is currently on a grain-free diet containing peas, lentils, chickpeas, or potatoes as primary ingredients, discuss this with your veterinarian at your next visit. This does not require an emergency call — but it is a conversation worth having. If your dog is showing signs of heart disease (exercise intolerance, coughing, difficulty breathing, weakness), contact us promptly.

For current information on the FDA investigation, visit the FDA website and search "DCM in dogs."

Avian Influenza (H5N1) and Companion Animals

Highly pathogenic avian influenza (HPAI) H5N1 has been the subject of significant attention since the beginning of the 2022–2023 outbreak, which affected large numbers of wild and domestic birds across North America. Pet owners have asked about the risk to companion animals.

Cats are known to be susceptible to H5N1 infection. There have been documented cases of cats becoming infected through contact with infected birds, infected poultry, or contaminated raw poultry products. Cats that roam outdoors and hunt birds, or cats fed raw poultry diets, are at elevated risk.

Dogs appear to be less susceptible to H5N1 infection than cats, though the evidence base is still developing.

What this means in practice: if your cat is an outdoor hunter, or if you feed raw poultry diets, discuss the current risk level with your veterinarian. During active HPAI outbreaks in your area, keeping cats indoors is a reasonable precautionary measure.

Signs of influenza in pets include: fever, respiratory symptoms (coughing, sneezing, nasal discharge), lethargy, and loss of appetite. If your cat has had contact with wild birds and is showing these symptoms, contact Northside at (703) 525-7115 and let us know about the potential exposure.

For current information: the AVMA maintains updated guidance at avma.org. The Cornell University College of Veterinary Medicine also publishes current outbreak and clinical guidance information.

Surgery & Recovery

Pre-Operation: What to Expect

If your pet is scheduled for a surgical procedure at Northside, here is what to expect before and on the day of surgery.

The evening before surgery Do not feed your pet after 10:00 PM the evening before the procedure. Water can remain available through the night. This is essential for anesthetic safety — a full stomach increases the risk of aspiration (inhaling stomach contents) during anesthesia.

Day of surgery: arrival Drop-off is scheduled between 8:00 and 9:00 AM on the morning of the procedure. Please allow time at drop-off for paperwork and a brief discussion with the team.

Consent forms At drop-off, you will review and sign consent forms for the procedure and anesthesia. Please read these carefully. If you have questions about anything on the consent form, ask — we want you to understand exactly what you are agreeing to before you leave your pet with us.

Pre-anesthetic options Before anesthesia, we offer optional pre-anesthetic bloodwork and an electrocardiogram (EKG). These tests help identify any underlying conditions — organ function concerns, cardiac abnormalities — that might affect how your pet responds to anesthesia. Dr. Adam will discuss whether these tests are appropriate for your pet's age and health status. For older pets, pre-anesthetic bloodwork is particularly valuable and is strongly recommended.

Microchipping If your pet is not yet microchipped, an anesthetic procedure is an excellent time to have this done. Microchipping takes only a moment and can be performed while your pet is already under anesthesia. Let the team know at drop-off if you would like to add microchipping.

Procedure timing Surgical procedures are typically performed between noon and 4:00 PM. Your pet rests comfortably and under monitoring in our care between drop-off and the procedure.

After surgery You will be contacted when your pet is awake and recovering well. Discharge for most procedures is the same day, typically between 6:30 and 7:30 PM. See our Post-Operation Care guide for full recovery instructions.

Post-Operation Care

After your pet's procedure at Northside, careful attention during the recovery period makes a significant difference in healing. Here is a numbered guide to post-operative care.

1. Keep your pet calm and quiet. Restrict running, jumping, and roughhousing for the period specified by your veterinarian — typically 10–14 days, though this varies by procedure. Leash walks only for dogs during this period.

2. Monitor the incision daily. Check the surgical site once or twice daily. You should see gradual healing — slight redness immediately after surgery is normal and will decrease. Contact Northside if you observe: increasing redness, significant swelling, discharge (particularly if yellow or green), or if the incision appears to be opening.

3. Keep the incision clean and dry. Do not bathe your pet or allow the incision to get wet for at least 10–14 days, unless instructed otherwise. Do not apply any ointments, creams, or antiseptics to the incision unless specifically directed.

4. Use the Elizabethan collar (E-collar). If you have been sent home with an E-collar, use it. Pets will lick and chew at surgical sites, which introduces bacteria and delays healing. The collar must stay on any time you cannot directly supervise your pet.

5. Administer all prescribed medications as directed. If your pet was sent home with antibiotics or pain medication, complete the full course even if your pet appears fully recovered.

6. Suture removal is typically scheduled 10–14 days after surgery. Please keep this appointment. Sutures left in too long can cause irritation or become embedded. Internal sutures are dissolving and do not require removal.

7. Call us if you have any concerns. You know your pet. If something seems wrong — unusual behavior, signs of pain, concerns about the incision — call Northside at (703) 525-7115 during office hours. Do not wait for the next scheduled appointment if you are concerned. After hours, if you believe your pet is experiencing a surgical complication requiring immediate attention, please contact an emergency clinic.

Recovery after surgery is a partnership between your veterinary team and your family. We are here to answer questions throughout the process.

Looking for More Answers?

Cornell University's veterinary team has developed two AI-powered pet health resources — CatGPT for cats, and Big Red Bark Chat for dogs. These tools are useful for general information but do not replace a consultation with your veterinarian.

CatGPT — Cornell AI for Cats Big Red Bark Chat — Cornell AI for Dogs

Suspected poisoning? ASPCA Animal Poison Control Center is available 24/7:

(888) 426-4435

During Northside business hours, call us first: (703) 525-7115