San Antonio Express-News (Sunday)
Pet’s illness can put family at risk
Q: Our family dog got sick and needed to be admitted to the veterinary hospital, where she was diagnosed with leptospirosis. The vet says she will pull through, but do I need to be concerned about my family?
A: A handful of diseases — called zoonoses — can be transmitted from dogs to humans. Of these, leptospirosis is the only one that can be transmitted by urine. It’s most likely your dog was in contact with an infected rodent in the house or yard, or it could have come from stagnant water where animal urine could be found.
Unfortunately, yes, the disease can be passed from your dog to your family, so you need to be vigilant in watching all family members for sudden onset of symptoms.
Leptospirosis is a bacterial infection that can cause serious illness. The most common initial signs are fever, muscle aches, shaking, chills and headache. These symptoms typically start suddenly. Redness of the conjunctiva, seen as redness in the white part of the eyes, is a typical finding, but there are other less-specific signs, including abdominal pain, cough, joint pain and rash.
I do not recommend medication to prevent infection in humans. Any symptoms should be evaluated by your regular doctor, whom you should tell about the dog’s diagnosis.
Carefully cleaning all hard surfaces (mix 1 part bleach to 10 parts water for an effective solution or use a professional antibacterial cleaning solution) and washing bedding where the dog has been would be wise. Once the dog has gotten the OK from your vet to come home, wash your hands after handling the dog, and use gloves if you are handling its waste.
There is a dog vaccine, which unfortunately is not 100 percent effective. There is no vaccine for humans. I would also consider professional pest control to make sure you don’t have any mice or rats living in the home.
Leptospirosis can affect many animals. Dogs are common, but in the rare case, cats
get it too.
Q: I am 72 years old and have developed severe tendonitis in my right shoulder. After having seen a doctor, receiving two shots, undergoing six weeks of therapy and trying my best to curtail use of my right arm, I find there is still significant pain. The doctor says the last remaining option is surgery, which I am not in favor of. I have been in pretty good health. Other than some prostate and heart issues, I believe I am in reasonably good shape, having done outdoor work and gardening. Any suggestions on moving forward?
A:
Tendon problems of the shoulder can cause very significant loss of function, and the best treatment is usually what you have done: physical therapy and sometimes joint injections.
I agree with you that surgery is not a great option. Try asking your therapist if you are continuing to improve, or are not
getting any better. If you are still improving, even if slowly, continue the exercise for at least another few weeks. Ask your therapist about home activity. Most often, they want you to do more, not less, so curtailing use at home might be the wrong move.
An MRI scan is considered standard before surgery and can help be sure there are no other issues. If the surgeon says you aren’t going to get better without surgery, and you aren’t getting better with more therapy (and possibly injections), I recommend getting the surgery done if your regular doctor says your heart issues make surgery safe for you. Having both arms working well improves quality of life a lot.
Q: I am a woman, age 68. When I was 12 years old, I was 5 feet, 5 inches tall. Now I am 4 feet, 8 inches tall. I have scoliosis plus degenerative arthritis of the spine and walk bent over.
While walking with a retired doctor, I mentioned
that I am not supposed to drink coffee, as it has a bad impact on my bones. With raised eyebrows, he pulled out his phone and said: “By golly, it’s true. Coffee is not good for the bones.”
I love coffee. So I put 1⁄8 teaspoon of regular coffee grounds in a cup of hot water. But, is decaffeinated coffee OK? Does it have a negative impact on bones? I cannot afford to lose more height.
A: Some medical questions require more than a cursory look at the results of an internet search. The effect of coffee (and caffeine) on the bones is complex, and there have been different studies with, apparently, different conclusions.
First, you didn’t mention one of the most common reasons that causes many women to lose height, which is a fracture of one or more vertebrae, caused usually by osteoporosis.
Scoliosis is an S-shaped curvature in the spine when looking at someone from behind, and one shoulder is almost always higher than the other. Kyphosis — also often caused by osteoporosis in older men and women — is an exaggerated curve of the spine seen from a person’s side (it used to be called a “dowager’s hump”).
Degenerative arthritis can worsen curvature and cause loss of space in the disks between the vertebrae. To the best of my knowledge, there is no effect of coffee or caffeine on scoliosis or degenerative arthritis.
Caffeine has been shown in some studies to accelerate loss of bone due to osteoporosis, and predispose a person to fractures. The effect was shown in studies with women consuming greater than 300 mg of caffeine, about 3 cups per day. This is highly variable by the strength and size of your cup, of course. Other studies have shown that for women who consume enough calcium in their diet, caffeine does not worsen osteoporosis, even when a woman drinks lots of coffee.
You should consult your doctor about osteoporosis, as you might very well have that in addition to your other back issues. But I think you have been unnecessarily depriving yourself of something you enjoy.
Q: I read about damiana as a treatment to increase sexual drive. Is this safe and effective?
A:
Damiana is an extract from the Turnera diffusa shrub, found in California and Mexico. There has not been a lot of research on damiana. Some animal studies show benefit in males but not females, with small studies in human females showing benefit in combination with a variety of other herbs.
There is very limited data on safety, with one possible case of cyanide poisoning following a very large ingestion of damiana extract, and another of reported case of convulsions. In recommended doses, damiana is probably safe, but I can’t recommend it based on current safety and efficacy data.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Drive, Orlando, FL 32803.