We Turn the Newest Pet Owner into an Expert with Cat and Dog Care Guides in Tucson, AZ

Are you a first-time pet owner? A long time pet owner? Taking care of your dog or cat can be overwhelming. The first step to keeping your pet healthy is to take them to a veterinarian when needed, but there are many other things you should do to raise and maintain a happy, healthy pet.

We’ve provided some resource guides below to guide you in your role as a pet owner. Read these guides to prepare yourself to provide the best care for your pet. Remember to call our office to set an appointment or checkup for your dog or cat.

Dental Care for Dogs and Cats

February is National Pet Dental Health Month, but dental care isn't just necessary in February. Dental disease is the most common health issue seen in companion animals. According to the American Veterinary Dental College, 80% of dogs and 70% of cats have some degree of periodontal disease by the age of 3 years! Periodontal disease doesn't just cause a foul or stinky mouth, but can aggravate heart, liver, and kidney issues, make it difficult to regulate chronic medical conditions, as well as causing unnecessary pain and discomfort. The bacteria and toxins released by untreated dental disease enter your pet's blood stream and can cause infections in various organ systems and make it difficult to treat common infections like Urinary Tract Infections, Upper Respiratory Infections, or skin infections.

Stages of Oral Health

Healthy Teeth and Gums

Healthy teeth should be white, unbroken or chipped and have no redness or swelling on the gums

Healthy teeth should be white, unbroken or chipped and have no redness or swelling on the gums.

Healthy teeth should have minimal tartar and plaque buildup. The gums should be pink and firmly attached to the tooth surface. There should be no fractures, cracks, chips or holes (known as resorptive lesions in cats). Gums should not be receded or bleeding.

Stage 1 Periodontal Disease

Plaque and tarter build up is a visible yellowish film or caking on tooth surface. Gums may be slightly inflamed or reddish nearest the tooth. Gums may bleed easily when abraded. This stage also includes clinical Gingivitis. You may begin to notice a foul or strong odor to your pet's mouth. Bacteria on the tooth surface are destroying the tissue that connects the tooth to the gums at this point. If your pet has Gingivitis (severe inflammation of the gingiva or gums), you may notice a preference for chewing on one side of the mouth, not chewing kibble or less interest in hard treats or dental chews.

Stage 1 periodontal disease is often dismissed or overlooked delaying dental care. It is this stage where we can do the most preventative care to preserve your pet's teeth, reduce pain, and reduce strain on the internal organ systems.

Stage 2 Periodontal Disease

Red gums are a sign of inflammation which can also lead to pain and behavioral changes

Red gums are a sign of inflammation which can also lead to pain and behavioral changes

Stage 2 periodontal disease is also known as Early Periodontitis. It is at this stage we see receded gums, some exposure to the tooth structures below the gum line, "pockets" or loss of gingival attachment, and heavy tartar buildup. The gums are very red, tender and sometimes swollen. You may notice what appears to be a film or "goo" between the gums and the tooth. Pets with stage 2 periodontal disease often have a very foul odor to their breath, can be resentful of having their mouth handled or touched, or may show a definite preference for soft or moistened food.

In some breeds, most commonly small breeds with overcrowding of the teeth, it is at this stage in which loose teeth may become noticed by owners.

Stage 3 Periodontal Disease

Infections along the roots from Stage 3 dental disease can cause facial swelling and mouth abscesses.

Infections along the roots from Stage 3 dental disease can cause facial swelling and mouth abscesses.

Stage 3 periodontal disease is classified by a loss of 20-50% of the attachment between the gums and the tooth. We commonly see moderate gingival recession where the gum has pulled up from the tooth exposing large sections of the underlying structures and roots. While this may not noticeable when the tartar is present, it is once removed. We may see pus from areas around the heaviest tartar build up. Dental infections are very common in this stage of disease.

Your pet's mouth is painful at this point. Chronic dental pain can affect more than just eating and drinking and sometimes is noticed as a pet who is "irritable" or "just cranky".

Stage 4 Periodontal Disease

Stage 4 Periodontal disease

The mouths above and below are extremely painful.

Stage 4 Periodontal Disease is very painful for your pet. There is extremely heavy buildup, pus around multiple teeth, very mobile teeth, gums that bleed easily and deep recession and pocketing. Your pet may have already lost multiple teeth by this stage. Deep infections in the jaw and nasal structures are very common from abscessed tooth roots. Pain from this stage of dental disease can cause decreased interest in eating, refusal to eat hard kibble or a sudden stop in eating, a lack of interest in toys, or behavioral changes.

dog with red gums

At this stage multiple extractions become necessary to get the extreme infection under control.

By stage 4 dental disease, regular professional dental cleanings are vital to returning your pet to health. Extracting severely damaged, infected and loose teeth can be an aid to reducing dental disease and home care will be essential to maintaining a healthy mouth for your pet.

Toothbrushes: Not Just for People

Home care following a dental cleaning is essential to maintaining oral health for your pet. The American Veterinary Dental College recommends brushing your pet's teeth daily in addition to twice yearly dental cleanings with your veterinarian. While this may seem daunting at first, with time and patience you can make brushing your pet's teeth a normal part of the daily routine. See How to Brush Your Pet's Teeth for our guide. You are also welcome to call our hospital to speak to a technician for even more tips.

Tooth Friendly Treats and Diet

dog chewing on a brush

This puppy shows it’s never too young to start proper dental care habits.

The type of treats you give your pet can play a big role in his or her dental health. Tooth fractures are common dental injuries and are seen most often in dogs that chew on cage or crate doors, fences, cow hooves, rocks or hard toys. Fractures can also occur due to fighting or traumatic injury which is commonly seen in cats. Just as in people, broken teeth hurt! Avoid "treats" such as cow hooves and don't give your dog hard plastic toys.

Dental friendly treats include C.E.T Chews. These chews are available through your veterinarian and contain a special enzyme which provides a more effective means of removing plaque and buildup than ordinary biscuits. We also carry Hill's Prescription diet T/D and Royal Canin Dental. Two of the few products awarded the Veterinary Oral Health Council's Seal of Acceptance for helping to reduce both plaque and tartar buildup. These can be fed as a standard diet or used as a treat and both come in a regular (medium to large breed), small bites (small and toy breed) and feline formulas.

It is never too early to start your pet on the right path for a healthy mouth. The veterinarians and technicians at Orange Grove Animal Hospital are here to help. Call to schedule your pets Dental Health checkup today!

Reviewed and edited: August 2018

Click Here to Download Dental Care for Dogs and Cats Care Sheet

Heartworm Disease Information

Heartworms are a roundworm scientifically known as Dirofilaria immitis which is transmitted by mosquitoes and can infect more than 30 mammal species including dogs, cat and people. While dogs are considered the definitive (or preferred) host, cats, ferrets and wild mammals like coyotes can also be infected. Heartworm is found in all 50 states although traditionally highest rate of infection is seen within 150 miles of the Atlantic and Gulf Coasts and along the Mississippi River. While some arid areas of the country such as Arizona have lower rates of infection, we do have the vector (mosquitoes) and are seeing an increase in native dogs testing positive for heartworm.

The Heartworm Life Cycle

The adult female heartworm, living in the artery or right side of the infected mammal's heart, releases microfilariae (young heartworms) into the bloodstream. An adult mosquito bites the infected animal and ingests the microfilariae with its blood meal. Over the next 10 to 14 days the microfilariae mature into an infective larval stage. When the mosquito bites another mammal, the infected larvae leave the mosquito in the saliva and enter the new host. Over the next 6 months, the microfilariae mature into adult worms and make their way to the heart and lung arteries, where they repeat the cycle again.

Adult worms can live for up to 7 years in the host mammal, reproducing and sending more microfilariae into the blood stream.

Symptoms of Heartworm Disease

In our companion animals, the clinical signs of heartworm disease may not be seen in the early stages and can mimic a number of other diseases and conditions. In dogs, as the number of adult worms in the heart multiplies, you may notice a mild persistent, non-productive cough, exercise intolerance and fatigue, decreased appetite, weight loss, or lethargy. As these symptoms mimic other frequently seen diseases in Tucson, your veterinarian may include heartworm testing with other laboratory tests if your pet is not on consistent or currently on preventative.

In cats, clinical signs can be even more vague and non-specific. Symptoms of chronic disease can include, vomiting, gagging, difficult or rapid breathing, lethargy, coughing, panting, open-mouth breathing and weight loss. Heartworm Associated Respiratory Disease can often mimic asthma or allergic bronchitis. Cats may also exhibit acute signs including collapse, convulsions, blindness, heart rate and rhythm disruptions, syncope (fainting) or sudden death.

Heartworm Testing

Routine, annual testing for the substance produced by the adult female heartworm, known as antigen testing, is the most effective method for detecting infection in dogs. Testing for the presence of microfilariae by reviewing blood smears is also used to detect early infection, the period before the adult heartworms has established residence in the arteries or heart and begun reproducing. In cats, we recommend antigen testing for the female adult heartworm and antibody testing for the male adult heartworm as cats can have male-only infections. Neither antigen, antibody nor microfilariae testing are accurate until about seven months after infection due to the development period for the adult form. False negatives by reviewing blood smears are also possible if the pet is given preventative medication inconsistently.

In addition to testing for heartworm disease, the test we commonly use here at Orange Grove Animal Hospital also tests for tick borne diseases such as Ehrlichiosis, known as Tick Fever and Lyme disease. Tick Fever is a common, life-threatening parasite carried by the tick native to our area, the Brown Dog Tick. We do not have the ticks that carry Lyme disease, Rocky Mountain Spotted Fever (Rickettsia sp) or Anaplasmosis, these diseases are migrating across the country and can be acquired during travel. Tell your veterinarian if your dog has been out of Tucson and where he or she has been in the last year.

Treating Heartworm Disease

Treating heartworm disease is done through your veterinarian by giving a series of injections of an adulticide (a medication that specifically targets the adult heartworms) into a muscle. There is only 1 medication approved by the FDA for the treatment of heartworm disease in dogs. Any "holistic" or "herbal" treatments should be avoided as risk of life-threatening complications is high as these products have not been evaluated for safety or effectiveness.

Owners are then instructed to restrict activity to very short leash walks and cage rest for 1-2 months while the adult worms are processed by the dog's body. It is very important that owners follow activity restrictions to decrease the risk of partial or complete blockage of blood flow to the lungs by the dead worms. Dogs undergoing heartworm treatment will need to be isolated from other dogs to prevent secondary infections such as upper respiratory infections (Kennel Cough) as their immune systems are under compromise from the parasite and treatment.

Untreated heartworm disease will lead to death as the heart and lungs become filled with worms that block blood flow, reduce the heart's ability to contract and prevent the heart valves from opening and closing properly. This reduction in blood flow can also lead to blood clots in the lungs, liver or kidneys.

Treatment may involve a hospital stay or intensive home care for several weeks, frequent rechecks to include xrays or ultrasound to evaluate if any permanent heart damage has occurred, and retesting to catch any new infections while the current infection is being treated.

Prevention: Safer & More Cost Effective

Prevention, even with yearly testing, is a fraction of the cost of treatment for heartworm disease. There are currently 6 medications approved by the FDA for prevention of Heartworm disease in dogs and cats which come in a number of formulations under several brand names. We recommend and carry Heartgard® Plus and Revolution®. Other preventatives can be purchased through our online pharmacy partnership with VetsFirstChoice. We do not recommend any of the many "organic" or "holistic" products described on the internet or at feed stores as their safety and effectiveness have not been clinically evaluated and approved for use nor are they recommend by the American Veterinary Medical Association or the American Heartworm Society.

As Tucson has the vector (mosquitoes) that transmit heartworm disease as well as a large unregulated coyote population which acts as a reservoir, all dogs, even native dogs who do not leave town and inside dogs who only go out for bathroom breaks, are recommended to be on preventative year round. Which preventative to use will be decided by your veterinarian based on your dog's risk factors, lifestyle and travel arrangements.

All dogs over the age of 6 months will need to be tested for heartworm before starting preventative. Products like Heartgard® Plus work by killing any microfilariae that may enter the bloodstream from a mosquito bite. Because preventatives kill microfilariae it is important to know if the dog has an adult heartworm load before beginning monthly preventatives due to the risk of side effects and the potential for false negative microfilariae tests.

Heartworm preventive medication is labeled by the FDA as veterinary only products to be used under the direction of a licensed veterinarian, therefore requires an active doctor-client-patient relationship and current prescription. Orange Grove Animal Hospital in accordance with state and federal laws and regulations requires us to have examined your pet within a year of the prescription and heartworm testing on the schedule recommended by your veterinarian.

For more information on Heartworm Disease visit the American Heartworm Society.

Reviewed and edited: August 2018

Click Here to Download the Heartworm Disease Information Sheet

How to Brush Your Pet's Teeth

Pets are an important part of our lives for many years. As such, dental care is important to extend your pet's good health and quality years with you. Dental disease is the most common problem seen in our pet population today. More than 85% of all dogs and cats presented to veterinarians are affected by dental problems. Periodontal disease is what causes bad breath as well as eventual tooth loss.

We recommend daily dental care at home for your pets, just like the rest of the family. It is best to begin home care at an early age (8 to 12 weeks) during puppy or kittenhood, but it is never too late. Visible tartar should be removed ultrasonically in a process known as scaling and polishing, just like when people go to the dentist. This makes your home care efforts easier and more effective. Always remember to make it fun!

Supplies needed:

  • Washcloth or toothbrush
  • Pet toothpaste (see products available in our hospital). Do not use human toothpaste as many contain artificial sweeteners that are toxic to pets.

Week 1 – Slowly Acquainting Your Pet with Mouth Care

Using your hand, gently open the pet's mouth and run your finger around his or her lips, lifting the lips, etc. This should being for just 30 seconds on day one and progressing to a couple of minutes by the end of the week. Reward your pet with a small treat at the end of each session (no "people food" please).

Week 2 – Introducing Toothbrush or Washcloth (Without Toothpaste)

This week, use either a wet washcloth wrapped around your index finger or wet toothbrush on the teeth. Lift lips. Massage the outer surfaces only of upper and lower teeth using a back and forth motion. Do this for 30 seconds on day one, progressing up to three minutes by the end of the week.

Week 3 – Add Toothpaste, Extend Brushing Time

This week use your dental cleaning instrument and now add ¾ of an inch of toothpaste to brush the outer surfaces only of the upper and lower teeth in a back-and-forth motion.

A Few Pointers:

  • Do not rush the process or else the pet may become resistant.
  • Always treat at the end of each session, making it enjoyable, PRAISE HIGHLY!
  • If your pet shows any indication of aggression (growling, bearing teeth, biting, scratching, etc.) stop immediately. Call the hospital for professional advice.
  • NEVER use a human toothpaste. Vomiting is common if this is done and newer toothpastes often contain xylitol or saccharin which are toxic to dogs and cats.
  • Cleaning at home will reduce the frequency of professional care needed.
  • Won't a Milkbone a day take care of it? NO! If you ate a Milkbone a day would you never have to brush your teeth? Of course you would still need to brush. Dental treats help, but they cannot do it alone. Our hospital offers a rawhide chew with an enzymatic coating which helps breakdown calculus but still does not replace the need for professional care.
Reviewed and edited: August 2018

Click Here to Download How to Brush Your Pets Teeth

Vaccination Protocol

Based upon the latest information from studies in immunology, we follow the most current recommendations for vaccine protocols for dogs and cats. Many leading researchers and specialists now believe that several of the vaccines that we routinely give to dogs and cats have a greater duration of immunity than had previously been thought. The duration of immunity is the length of time that a vaccine provides protection. In addition to this, some research is suggesting that over-vaccination of pets has led to some problems such as immune mediated hemolytic anemia in dogs and vaccine-associated sarcomas in cats. Although the vaccine manufacturers have not changed their labeling of these vaccines and still recommend vaccinating according to older protocols, many of the foremost veterinary colleges, as well as the American Veterinary Medical Association, the American Animal Hospital Association, the American Association of Feline Practitioners, and other leaders in veterinary medicine research now recommend new vaccine protocols. We are following these guidelines.

Vaccines for Dogs

  1. The Distemper virus combination and the Parvo virus vaccine (known as the DA2PP) have been shown to have a duration of immunity of multiple years. As a puppy, your dog will receive a series of vaccinations beginning at 6-8 weeks through 16 weeks for these viruses in accordance with current knowledge of developing immune systems. These combination vaccines will protect against: Canine Distemper, Adenovirus-2 (Canine Hepatitis), Parainfluenza, and Parvo virus. Your dog will be required to receive a booster for all of these at one year of age. After the one-year booster, we will begin staggering these vaccines. Your dog will receive the Canine Distemper, Adenovirus 2 and Parainfluenza (DA2P) vaccine one year, the Parvo virus vaccine the next year, and the Rabies vaccine in the third year.

  2. The Rabies vaccine schedule is government regulated and will not change. We will give the first vaccine after 12 weeks of age. A booster vaccination will be given in one year and then revaccination will occur every three years after that. Please let your veterinarian know if you will be traveling to other states or reside in another state part of the year so that we may verify the legal requirements for that state or county in order to keep your dog current for both locations.

  3. The Bordetella vaccination, commonly referred to as the "Kennel Cough vaccine", has been shown to have a duration of immunity of less than one year. Due to this, we will require that all boarding dogs be vaccinated for Bordetella every 6 months, regardless of which type of vaccine used (intranasal, injectable or oral). We would also strongly recommend that any dog that goes to grooming facilities, dog parks, dog training, or routinely comes in contact with other dogs be vaccinated for Bordetella. The Bordetella vaccine does not prevent many of the viruses associated with contagious upper respiratory infection in dogs, only against the organism Bordetella Bronchiseptica.

  4. Leptospirosis made a rapid and dramatic appearance in Tucson, Arizona following an outbreak in the Summer of 2017. Since then, we have begun to recommend this vaccine for those dogs who visit any of our local dog parks, dog day cares or training centers or those who travel to Phoenix or out of state. It is not currently required for boarding in our facilities, but may be required for other facilities. Regardless of the age of the dog, the initial series is two vaccinations 3-4 weeks apart and then a booster repeated annually.

  5. The Corona virus or Lyme Disease vaccines, though available at our hospital by special order for those canines who are at risk, are not part of our core vaccination protocol. Arizona, particularly Tucson, is a low risk area for these diseases and both these vaccines have a high rate of complications and reactions. If your dog is traveling to an area where these diseases are present or will be participating in activities which may increase the risk of exposure, please speak to your veterinarian about these vaccines.

  6. The Canine Flu (H3N8 or H3N2, or combination) vaccine is not currently offered. We are watching this virus closely and will change our recommendations based on the lifestyle needs of our patients if this disease arrives in or gets close to Arizona. Let your dog's veterinarian know if you travel to areas of high risk (particularly the East Coast).

  7. The Rattlesnake vaccine is not recommended. It is made from the venom of one of the 13 species of rattlesnake seen in the greater Tucson area, Crotalus Atrox, the Western Diamondback Rattlesnake. There has been very little peer-reviewed research on this vaccines safety, effectiveness or duration of protection. "Protective" titers are short lived and require frequent boosters. According to the manufacturer, there are no pending studies or plans for studies on their product. The vaccine does not protect your dog from being bit or change any of the treatment protocol for snake envenomation. Administration of antivenin is still the standard of treatment regardless if this vaccine has been used. For these reasons, our veterinarians do not recommend it and have no plans to offer it in the future.

Vaccines for Cats

  1. The Feline Rhinotracheitis, Calicivirus, and Panleukopenia vaccine (or RCP) will be given to kittens in a series of vaccinations beginning about 6-8 weeks until 16 weeks in accordance with the current knowledge of developing immune systems. After one year, your cat will receive a booster vaccination and then be revaccinated every three years. This vaccine is recommended for all cats, including those who are indoor only and have no to little risk of exposure and is required for boarding in our facilities.
  1. The Rabies vaccine that we are giving to our feline patients is a recombinant, non-adjuvanted vaccine. There is some evidence to suggest that this vaccine has a much lower incidence of rabies vaccine reactions (including vaccine-associated sarcomas) in cats. Currently the vaccine we carry is only rated for one year and will need to be repeated at your cat's annual exam. We strongly recommend this vaccine for all cats, not just those at highest risk (outdoor, indoor/outdoor, those cats who live in a house with an indoor/outdoor cat and those cats with a history of aggression towards other cats or humans). Cat have become the number one domestic source of rabies exposure to humans in the United States. A current rabies vaccine, while not required by law, is you and your cat's best protection from this fatal disease and from costly quarantines.
  1. The recommendations for the Feline Leukemia vaccine have not changed. The initial vaccination will require a series of two injections following a negative test at 16 weeks or older. Revaccination will then be required on an annual basis. The Feline Leukemia vaccine is recommended for cats that are outdoors or indoor/outdoors and cats that live in multiple cat households with other cats who go outside.

The non-core vaccines available for both dogs and cats are not routinely recommend for a variety of reasons. Some of the available vaccinations are for diseases not found in Arizona or the vaccine may have conflicting or low efficacy rates or high rates of severe or life-threatening reactions. If you have questions about any other vaccines, please ask our veterinarians about them. We are not following a "titer regimen" as there has been very little and unsubstantiated research on what is actually a protective titer range for each species and each disease. The only exception is the Rabies vaccine titer that is required for some international travel. This titer is not a replacement for vaccination but in addition to vaccination.

Please keep in mind that our vaccination protocol may considered extra-label usage depending on the vaccine. However, it is based upon the latest and best veterinary immunological research that is available. We will continue to routinely reevaluate our vaccine recommendations and make any changes to our protocol that is necessary to provide the best care and protection for your pet.

It is still important that your pet receive yearly or twice-yearly veterinary examinations even on a rotating or staggered vaccine schedule. Our pets age much quicker than we do and only your veterinarian can detect the subtle signs of disease.

Reviewed and edited: August 2018

Click Here to Download Vaccination Protocol Information

Valley Fever

Your pet has been diagnosed with Valley Fever or your veterinarian is suspicious that your pet‘s symptoms are caused by Valley Fever. Naturally you have a lot of questions and may be confused by the volume of information given by the veterinary staff. You may also be bombarded with myths and facts from friends, family, co-workers and the internet. The purpose of this page is to give you, the owner, a basic understanding of the disease, what causes it, treatment and monitoring. We will also separate fact from fiction and provide you with resources from the experts in this disease.

What is Valley Fever?

Valley Fever (coccidioidomycosis) is caused by a fungus that grows in our soil about 12-18 inches down. Coccidioides (or Cocci, for short), likes warm and dry climates such as those found in southern and central Arizona, Southern California and southwestern New Mexico. When it rains, the fungus multiplies then enters a dormant state when the moisture level drops. Spores from the fungus are thrown into the air by construction, farming, digging, extensive yard work, etc and then travel on the wind. These spores are then inhaled by your pet.

Once in the lungs, the fungal spores have their ideal environment for reproduction, warm and moist. The spores then begin to multiply and spread through the blood stream attaching themselves to nearly any organ or system. About 3 weeks after infection, the first symptoms may appear. For many pets, these symptoms are brief and self-limiting as the body's immune system deals with the invader. For other pets, "clinical" Valley Fever occurs. The immune system just can't handle the fungal load and more severe symptoms develop.

What systems can be infected? What are the symptoms?

The most common site of infection is the lungs. Since this is the first place the spores settle, many pets have what is called Primary Pulmonary Valley Fever. If the spores settle in another system or the primary form is not treated the pet can develop Disseminated Valley Fever. Sites of infection of Disseminated Valley Fever include the long bones of the front or rear legs, the bones of the spine, the central nervous system (brain and spinal cord), the eyes, the skin or in rare cases, internal organs (liver, kidneys, heart, etc).

The symptoms of Primary Pulmonary Valley Fever include cough (often described as dry and non-productive), decreased appetite, lethargy (tiredness), fever and weight loss. Some pets may develop a severe pneumonia if more than one lobe of the lungs is affected. Symptoms of Disseminated Valley Fever include the symptoms of Primary Pulmonary with or without the cough as well as any of the following: Lameness of or swelling on one or more legs, back or neck pain, seizures, ataxia (stumbling or seeming dizzy), skin abscesses that don't heal with traditional antibiotics, eye cloudiness or pain and/or abdominal pain. Sometimes the symptoms may be vague or mimic other diseases or even injuries. We like to say "It may be Valley Fever until proven otherwise". 

How is it diagnosed?

Valley Fever is diagnosed using a combination of tests. Blood work and radiographs (x-rays) are the usual starting point. The radiographs will give us a visual picture of the infected system. For example, if your pet is limping, the x-ray will let us see how much of the bone is affected, how large the lesion is and which bone or joint is infected. If your pet has a cough, we can see how much of the lungs are affected and sometimes if the infection is spreading to the bones of the chest. The blood work gives us a wide amount of information. A CBC (complete blood cell count) will let us know if the immune system is responding to the invader, how well it is responding and if we have a concurrent problem, like Tick Fever or anemia to contend with. A blood chemistry will let us know how well the major organ systems like the kidneys, liver and pancreas are working as well as electrolyte values. The last part of the blood work is known as the "Cocci titer". This not only tells us if your pet is positive for Valley Fever infection, but tells us the severity of infection and gives us a way to measure effectiveness of treatment. Sometimes cultures, aspirates of suspicious masses, ultrasound and cytology are used if less invasive methods are inconclusive.

What is a titer?

A titer is done by diluting the blood repeatedly and recording positive test results. Titers start at 1:2 (1 part blood, 2 parts dilution) and can go as high as required. Cocci titers are generally reported up to 1:256 (1 part blood, 256 parts dilutant). If at 1:256 your pet's blood is still positive it is reported as "greater than 1:256". The goal is to reduce the titer to "less than 1:2" or negative and have no symptoms.

Unfortunately, the incubation period for Valley Fever is about 3 weeks. This means your pet may have all the symptoms of either Pulmonary or Disseminated Valley Fever, yet the first titer sent out may come back negative. Your veterinarian will want to repeat the Cocci Titer if traditional antibiotic therapy is not eliminating symptoms.

In some cases, the pet will have a low or negative titer, yet have more severe symptoms than expected. This is often due to the pet’s immune system not responding as expected to the invader. If this is the case with your pet, your veterinarian will discuss with you a treatment plan specific for your pet.

How do we treat Valley Fever? And how does the medication work?

Valley fever is treated with a group of drugs called "antifungals" or "fungistatics". Unlike antibiotics we are familiar with, these drugs do not kill the fungal spore, instead they slow or prevent the spores from reproducing or multiplying. By preventing reproduction, the medication allows the immune system to take care of the older spores. There are currently three oral forms of antifungals approved for veterinary use. Fluconazole (Diflucan) is the most commonly used as it has the lowest incidence of side effects. Ketoconazole and itraconazole are older medications that are sometimes used in pets who do not tolerate or are not responding to fluconazole. These two medications have a higher incidence of side effects and different monitoring requirements than fluconazole. If oral medications are not providing the treatment response expected, you and your pet may be referred to the Valley Fever specialist, Dr Lisa Shubitz at Veterinary Specialty Center of Tucson.

All these medications are given in weight specific doses. The staff of Orange Grove Animal Hospital works with a number of compounding pharmacies in order to ensure the best price for your medication. If you have a pharmacy preference, please let us know.

What monitoring does my pet need?

For all pets, the current monitoring guidelines are:

Every 3-6 months:

  • Recheck Cocci Titer. This involves a simple blood sample taken by the Orange Grove Animal Hospital technicians and sent to our outside lab. Results usually come back to the clinic within 3-7 days.
  • Repeat x-rays. If your pet has a bone or spinal lesion, you veterinarian may want to check the x-rays to see if the lesion is decreasing in size. Also if your pet had pneumonia your veterinarian will want to repeat the x-rays to ensure the lungs are healing.

When the lab results come back, this is when your refill for medication will be called into the pharmacy. If your pet has gained weight, the dose may increase at this time. It is important to have your pet's blood work done before you run out of medication, usually when you have about 14 days left to allow for laboratory turn around and pharmacy shipping time.

Additional monitoring:

If your pet is older, is on other medications or has other diseases or conditions that are being treated, your veterinarian may recommend more extensive monitoring. Because fluconazole is mainly eliminated by the kidneys, your veterinarian may recommend monitoring kidney values, especially if your pet has diabetes or decrease kidney function. If your pet is on ketoconazole, itraconazole or a non-steroidal anti-inflammatory (Rimadyl, Metacam, DeraMaxx, etc), has decreased liver function or is older, your veterinarian may want to monitor liver enzyme values along with the kidney values.

What are the side effects of the medication?

Thankfully, fluconazole has fewer side effects than the older drugs like ketoconazole and itraconazole. A few pets may experience gastro-intestinal side effects such as nausea, vomiting, loss of appetite, diarrhea, or abdominal discomfort caused by GI upset (hunched up, reluctance to move or stretch, abdominal tenderness, restlessness). Giving the medication on a full stomach reduces the incidence of these symptoms. With ketoconazole, lightening of the coat color has also been seen. Itraconazole has been known to cause skin ulcerations.

If you notice side-effects or your pet is not tolerating the medication, please let us know.

Can I stop the medication if the symptoms go away?

No! Even if your pet no longer has a cough or limp and seems back to normal, stopping or decreasing the medication without veterinarian approval can only increase length of treatment. In many cases, symptoms return fairly quickly with increased severity. Stopping or decreasing the medication can also cause Pulmonary Valley Fever to worsen to the Disseminated form.

How long will my pet have to take the medication?

That is very hard to predict. Each pet is different with different levels of disease and different immune responses. Length of treatment will depend on many factors: how high the initial titer is, the severity of clinical symptoms, the response to medication (how fast the titer goes down and symptoms resolve), if there is another concurrent disease such as Tick Fever or age-related conditions, how quickly treatment was started after symptoms appeared and of course, dedication of the owner. You will play a big role in determining the success of your pet’s treatment. It is important that you don’t skip or miss doses of medication, have your pet’s blood work checked on time (one to two weeks before finishing current prescription), and provide good nutritional support. Having said that, there are those pets that have to be on medication for life. Your veterinarian will discuss this possibility with you.

What else can I do for my pet?

Nutritional support is very important during any illness. We recommend feeding a high quality food such as Science Diet, Royal Canin, Eukanuba, or Nutro. If your pet has lost a lot of weight or is slightly underweight, we may recommend returning to a high-quality puppy food for the initial few months of treatment. If your pet has stopped eating, we may recommend trying canned food that can be heated to encourage appetite. Occasionally, in very sick pets, we recommend feeding whatever your pet will eat, then switching over to a high-quality food once normal appetite has been established. In rare cases, we will go over detailed instructions on how to force feed your pet and which food to use. You can ask your veterinarian for recommendations regarding nutritional supplements.

Is Valley Fever contagious?

No! Valley Fever is contracted by the inhalation of the fungal spores. Your pet coughing is not spreading spores to you, your other pets or children. There is only one form of Valley Fever that carries a very tiny risk of contagion and thankfully it is very rare (your veterinarian can discuss this form with you). The reason we see some households with more than one pet with Valley Fever is that all the pets in the house have the same risk of infection.

My pet's titer is negative, can he have a relapse? Why?

Yes. According to the University of Arizona Valley Fever Center for Excellence, the relapse rate for people is between 30-50%. As of this time, there hasn’t been a study to find out the exact percentage for pets, but it is suspected to be about the same as it is for people. The causes for relapse are varied and not well understood. If your pet has a return of symptoms or new symptoms, even after having a negative titer for months or years, see your veterinarian as soon as possible.

Where can I get more information on Valley Fever?

The best place to start is the University of Arizona’s Valley Fever Center for Excellence.  Your veterinarian can also direct you to other reliable places for information. Remember to take any information gathered from a non-university or non-veterinary source with a huge grain of salt.

As always, the staff at Orange Grove Animal Hospital is here to offer support and information during the course of your pet’s treatment. You are welcome to call with questions at any time during business hours. A technician will return your call as soon as possible and will be happy to answer your questions.

Click Here to Download Valley Fever Information

Welcome to the Arizona Sonora Desert

The following has been designed by the veterinarians and technicians here at Orange Grove Animal Hospital to give an overview of the diseases and dangers our beautiful Sonoran Desert has to offer.  If you have any questions about the topics discussed, feel free to talk to our knowledgeable staff.  


            Coccidioidomycosis, more commonly known as Valley Fever, is caused by the fungus, coccidioides immitis, that lives about 12-18 inches down in our soil.  It can be found from California to Texas and as far north as Nevada and southern Utah. The spores from the fungus become airborne when ever the soil is disturbed by activities such as construction, gardening, landscaping, and digging done by pets. Once airborne, these spores are inhaled by people and animals.  Studies have shown that every person and animal is exposed to the coccidioides immitis spore within the first year of residence (either by birth or relocation) and that part time visitors have the same rate of exposure and infection as full time residents.  A large portion of the residents of our state have no clinical symptoms as the immune system quickly deals with the invader.  In some pets and people, clinical symptoms may develop and blood tests reveal that the pet has Coccidioidomycosis or Clinical Valley Fever.

            There are two forms of Coccidioidomycosis, Pulmonary (involving the lungs) and Disseminated (involving any other organ or organ system outside of the lungs).  The following table is a list of common symptoms of both forms of this disease.



Dry, Non-Productive Cough

Lameness in one or more limbs/joints


Swelling in one or more limbs/joints

Reduced Appetite

Swellings or lesions on the skin



Weight Loss

Weight Loss


Reduced Appetite or Anorexia




Generalized pain when touched


Seizures or other neurological symptoms


         If your dog or cat develops any of these symptoms or just seems off, you should see your veterinarian immediately. If you are visiting a veterinarian out of state, please mention that you have recently visited or spend part of the year here so that he or she is aware that your pet may have symptoms of a disease not native to that area. The only accurate way of diagnosing Valley Fever is to perform diagnostic tests such as blood work and/or radiographs.  If your pet is positive, your veterinarian will prescribe an anti-fungal medication for your pet to take and talk to you about the schedule for retesting and estimated length of treatment.

For more in depth information go to our Valley Fever page or visit the University of Arizona’s Valley Fever Center for Excellence at https://vfce.arizona.edu/valley-fever-dogs 


Another disease of significance is Ehrlichiosis, otherwise known as Tick Fever.  While we don’t generally have the right climate for fleas, we do have the perfect climate for Ticks, particularly the Brown Dog Tick.  This tick prefers dogs to any other species and is mainly found in areas where dogs live or have lived.  These ticks also carry a parasite called Ehrlichia spp.  There are several species of this parasite and all of them affect one or more types of blood cells.  It is contracted when an infected tick picks your dog as its next meal.  Within 1-3 weeks after the bite, the first symptoms may appear. In many cases, the owner never noticed the tick was on their pet.  There are two types of Ehrlichiosis, Acute and Sub-Clinical.  The following is a list of symptoms for both types:

Acute Ehrlichiosis

Sub-clinical Ehrlichiosis

Sudden, spontaneous bleeding

Spontaneous bleeding

Reduced appetite

Swollen lymph nodes

Weight loss

Swelling in limbs


Bleeding in eyes/sudden blindness


Reduced appetite

Distressed breathing


Head tilt or uncoordinated movement

Weight loss




Pain in joints




            If your dog has any of these symptoms, you need to visit your veterinarian immediately.  He or she will do blood tests to check for the most common species, as well as blood cell counts and chemistries. Depending on how clinically ill your dog is, your veterinarian may recommend hospitalization for a short period, especially if your dog is dehydrated, severely anemic or is actively bleeding.  With or without hospitalization, your veterinarian will prescribe a medication that is generally effective in killing the parasite. He or she will explain the need for re-testing after the initial course of medication and the potential that it may take repeated courses in order to fully kill all remains of the parasite.

            Your veterinarian and technician will also discuss how to prevent re-infection as initial infection does not provide immunity. It is important to make sure your home and yard are free of ticks to prevent re-infection. As it can be difficult to visually spot ticks, we can recommend several local companies that are experts in helping you remove well-hidden tick colonies.

            Other tick-borne diseases such as Lyme disease and Rocky Mountain Spotted Fever, are carried by ticks that are not found in Arizona so the incidence of these diseases are currently thought to be rare, but follow the same clinical pattern as Ehrlichiosis. Please let your veterinarian know if your dog or cat frequently travels outside of Arizona or just outside of the Tucson Metro Region, as his or her disease risk profile will include diseases not normally found in our area.

Heartworm & other Mosquito-Borne Diseases


Arizona was once part of the states where heartworm disease was unheard of. Our dry climate was thought to be the natural barrier to large mosquito populations. Unfortunately, due to our very mobile society in the last two decades, and urban moisture zones, heartworm has gone from being an Eastern Seaboard and Deep South issue to a nationwide disease. According to the Companion Animal Parasite Council and the American Heartworm Society, heartworms and heartworm disease are here in Arizona and here to stay. It is recommended that all dogs, indoor only, native born and even those who never travel, be on year-round heartworm preventative. For more information on Heartworms and Heartworm disease, please visit our Heartworm page.

There are other mosquito borne diseases in our area of health significance. Diseases such as West Nile Virus and St. Louis Encephalitis are of concern for our clients who are horse owners. Please visit the Arizona Department of Health Services’ Vector-Borne & Zoonotic Diseases webpage for more information at https://www.azdhs.gov/preparedness/epidemiology-disease-control/vector-borne-zoonotic-diseases/index.php



            There are 13 species of rattlesnakes in the Sonoran Desert and 8-9 species that make their home in the greater Tucson area.  Snakes are a vital part of the ecosystem as they are the primary hunters of pest species such as gophers, packrats and mice.  Snakes do not bite from aggression, but as a protective mechanism.  The majority of bites, to both people and dogs, are due to disrupting or startling the snake, or attempting to handle or move the snake.  The most common places for curious dogs to become envenomated are the muzzle or front paws. The most important thing to remember with dogs and rattlesnakes is that the size of the dog, not the snake, matters. The smaller the dog the more complications can arise from rattlesnake bites. Complications can also arise if your dog is on a non-steroidal anti-inflammatory such as Rimadyl or Aspirin.  Location of the bite is also a factor in predicting complications.

            If your dog is bit, the most important thing you can do is to stay calm and keep your dog calm.  Then head to your nearest veterinary clinic.  Do not attempt to provide first aid home remedies or “wait it out”.  The longer between the bite and appropriate medical treatment means the higher the risk of complications.

            The rule of thumb for snake activity is “If warm enough for a t-shirt, warm enough for a snake”.  Early spring and the cooler times of summer days are the most common times to encounter a snake. It is extremely unusual for any of our native wildlife to be moving about during the hottest parts of the day.  No matter what species of snake is in your path or yard, it is best to leave the snake alone and contact an expert to have it identified and moved to different location. We work closely with a number of humane removal experts who can also help you in making your yard and home unattractive to rattlesnakes and their prey. Keep in mind that rattlesnakes follow 2 things, food and water. If your yard is attractive to mice, then snakes will follow.

            We do not offer the “Rattle Snake Vaccine” as there is no evidence that it is an effective or necessary vaccine and is universally unsupported by reptile veterinarians and veterinary colleges.

            We do recommend “Rattlesnake avoidance” training for all dogs. We strongly urge our clients to use training centers and trainers who practice humane training for both the dog and the snake. Trainers who use snakes that have been “muzzled” or “defanged” will be unlikely to use humane techniques with your pet. We have included a few training centers who treated their snakes with as much respect and care as they treat your dog.


            Our local toad species are most active during and right after our summer rains.  The species of medical concern is the Sonoran Desert Toad (formerly known as the Colorado River Toad).  When frightened this toad secretes a toxin through the skin.  This toxin is then passed through the mucus membranes of the mouth when the pet bites or licks the toad.  As with rattlesnakes, the size of the dog and any current medications that the dog is on affects the severity of clinical symptoms.   The chemicals in the toad’s secretion affect the heart and nervous systems, if untreated these toxins cause heart rhythm irregularities, secondary hyperthermia, or continuous seizures leading to coma and death.  The goal of medical treatment is to control any seizure activity or heart irregularities. 

            Within 30 minutes to 1 hour of contact with the toxin the first symptoms of toxicity appear.  These are:


            Crying or pawing at the mouth                        Stiff or clumsy gait

            Increased salivation/ drooling                       Brick red gums and tongue


If your pet is not having seizures, rinse the mouth with copious amounts of water for 5 to 10 minutes.  Then go to your veterinarian where medical treatment can be started.



            Temperature is another major concern for our pets.  Our summer days can easily reach 110ºF or higher with varying humidity levels depending on the month.  Sadly, every year there are reports of children and pets being left in cars unattended and suffering serious injury or death.  On a 72ºF day, the interior of a car in sunlight even with the windows open can reach 110ºF within 1 hour.  On an average Tucson summer day of 90ºF or more, within 10 minutes the interior temperature can reach over 120ºF and within 1 hour hit 200ºF.  Studies have shown that it DOES NOT help if the windows are open.  As our pets have a reduced ability to cool themselves, within minutes your dog’s body temperature has risen to dangerous levels. 

            This has become such a problem that it is now illegal in the state of Arizona to leave an animal in a vehicle. ARS 13-2910, subsection A, paragraph 7, states: “Intentionally, knowingly or recklessly leaves an animal unattended and confined in a motor vehicle and physical injury to or death of the animal is likely to result” is a “Class I misdemeanor”.  Our laws also allow a law enforcement agent to use “reasonable force” to release the animal from the vehicle, which can include breaking windows. Our laws also protect Good Samaritans who break or damage windows to get animals out of hot cars. Keep in mind that for most of our summer you can bake cookies on the dashboard of your car, we don’t want our pets to bake either.

Our local ordinances also do not allow you to leave your dog outside without adequate water and shade provided.  Keep in mind that the dog houses sold in pet stores are insulated to keep in heat.  These act as an oven and do not provide cooling shade that the law requires.  “Tie Outs” or tethering a dog to any object that does not allow it to move away from sun or waste is illegal statewide.  

            Normal body temperature for dogs and cats is between 100ºF and 103ºF.  Symptoms of heat stroke are increased drooling, excessive panting, very red gums, respiratory distress, and muscle tremors.  Without veterinary treatment to lower internal body temperature, these symptoms can quickly progress to heart rhythm abnormalities, shock, seizures, coma, followed by respiratory and cardiac arrest.  Basic first aid is to wet the pet with cool, but not cold water, move the pet to a cool area and call your veterinarian.  If you find your dog having seizures, do not submerge the pet, but gently wrap it in a cold towel and head to your nearest veterinary clinic or animal emergency center. 

Burns to paw pads are another problem we frequently see due to road and sidewalk temperatures.  The test to see if the road is cool enough to walk or run with your dog is to put your hand on the asphalt (the black roadway) and count slowly to 20.  If you cannot keep your hand on the road for 20 seconds it is still too hot to take your dog walking.  We recommend limiting outdoor trips to early morning hours before the temperatures have risen and the surface has spent hours exposed to sunlight.  It is also recommended for new residents to slowly acclimate your dog to our temperatures, elevation and humidity levels. 

Important contact information

Lastly, we have included below a list of important numbers to have.  If you have any questions or would like information about any of the topics covered in this handout, please speak to one of our veterinarians or technicians. 

24 Hour Emergency and Specialty Hospitals           

Veterinary Specialty Center of Tucson
4909 N. La Canada Dr (La Canada and River behind Walgreens)

Southern Arizona Veterinary Specialty & Emergency Center
141 E. Ft Lowell Rd (between First Ave and Stone)
7474 E. Broadway Blvd. (between Kolb Rd. and Pantano Rd.)           

Other numbers

Arizona Poison Control (not veterinary specific, may not have current information)

ASPCA Poison Control (There is a charge for this service)

For more information:

University of Arizona Valley Fever Center for Excellence


Arizona Department of Health Services’ Vector-Borne & Zoonotic Diseases


Arizona- Sonora Desert Museum (the Digital Library, under Education, has a ton of information on local wildlife and plants)


Rattlesnake Avoidance Training:

Sublime Canine (520) 975-0878

Animal Magnetism (520) 440-5040

Humane Society of Southern Arizona (520) 327-6088



For topics not covered here, please visit Veterinary Partner, a pet owner information website authored by the veterinarians of the Veterinary Information Network.


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Orange Grove Animal Hospital
(520) 877-2626
3091 W. Orange Grove Rd
Tucson, AZ 85741

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