Canine potpourri by Dr. Deb Eldredge, DVM

In this column, I’d like to touch on a number of things – including some things I’ve tried with my own pets, or things I’ve seen with clients’ dogs.

Many of the heartworm preventatives now available also offer protection against internal parasites such as roundworms, whipworms, etc. I find that most of these products are very good as prevention tools. But, if your yard or dog pen has soil that’s saturated with the eggs of these parasites, you may need something more.

I can think of two cases where the families had chronic problems with whipworms and just using the heartworm medication wasn’t enough to clear the infestation. Therefore, we advise people using the internal parasite protection heartworm medicines to still have a fecal check done at least once a year. While these products are excellent, they can’t be expected to overcome overwhelming problems.

Always check with your veterinarian before you use multiple flea control products. Some of the new hormonal products can be combined with almost anything, including dips and powders. But you still need to be careful. We had one dog become quite ill from having a once-a-month flea control product put on him, and then getting a dose of flea powder from another family member two days later. Luckily, everything went well. Fido is fine and there are no fleas in sight!

Speaking of flea control products, I feel comfortable discussing two brands that I’ve used on my pets. I started with Advantage® for my barn cats, last year, and have been incredibly pleased. I haven’t seen a flea or tapeworm at all.

We’ve used this medication on fairly old and fairly young dogs and cats without any problems. We do sometimes see dogs who seem to get itchy about 4 or 5 days after application (a rare occurrence). If the dog seems too uncomfortable, we have the owners give him a couple of baths and then switch him to a different product.

In June, I attended some agility competitions in Massachusetts. When I went last year, I stayed with my parents. I ended up pulling 23 ticks off Beep, my Belgian Tervuren. This year, I also stayed with my parents. But I decided I’d put Frontline® – which is newly approved for use in New York – to the test.

Maybe it’s a mild year for ticks, but I didn’t find a single one on my dog this year. And I purposely walked them through the fields and woods to see how well the Frontline would work. (I did end up pulling two ticks off my Dad, though!)

This year, I’ve seen a number of dogs suffering from the heat, both at our clinic and at competitions. Please groom your dogs frequently and well. A dog with undercoat just begging to come out has just got to be uncomfortable. The same for matts, which can actually pull so hard on the skin that it causes sores underneath.

If you aren’t into grooming, take Spot to a good groomer and have the undercoat brushed out or even give him a shave. You do have to be careful about sunburn with some dogs after a shave, though, so first check with the groomer or your veterinarian.

Also, if your dog travels with you, take plenty of water. I try to freeze some water in a bowl. It then goes in the back of the minivan with the dogs. That way, they have a source of cold water – all the time – and odds are I won’t end up with a soaked car. Also, the water melts slowly. This means they can’t gulp it thereby putting themselves in danger of bloat. When we stop for food or drinks for us, I always ask for a cup of ice to add to the dogs’ water bowl.

There are some really neat portable fans available. You can order them from dog supply catalogs, or you’ll sometimes find them in camping stores. I have a battery-operated one which ran quite happily, nonstop, during two very hot days of agility trials. It has now worked very hard for five full days without a battery change – my kind of equipment!

For shade, try a canopy made out of the “space blankets.” They reflect the sun and heat. My dogs also use the tent crates which act as an 85% sunscreen, but still let in plenty of air. Of course, pets left at home should have plenty of shade and water, too, especially if they’re left outside.

The hardest part of warm weather competitions is knowing that it’s just too hot or humid to ask your dog to work. This is especially hard when you’ve planned for this weekend for months, and driven six or more hours to get there. But, hopefully, your dog will be your companion for many years to come, and there’ll be other competitions. After all, he certainly deserves consideration. And that weather’s probably too hot and humid for you, too!

Come fall rains, we have new hazards to think about. I don’t jump my dogs if the footing is questionable. A torn cruciate could mean the end of a performance career, to say nothing of later arthritis. And I want to keep my cruciates intact, too!

Much of what’s discussed here is just good common sense, but we all know how uncommon that truly is. So treat your dog companion the way you’d like to be treated, and have fun doing all those great dog sports together!

The Big C rears its ugly head by Deb Eldredge, DVM

I had another topic chosen for this column, but unfortunately the Fates have intervened. I have said right here in this column time and time again how important it is for you to check your dog’s body over each month – at home – to pick up problems early. I follow this program with my own pets and it may have extended my dog’s life.

In June, I noticed my little Lab, Gus, was drinking a bit more water than usual, occasionally missing a meal and having less stamina than was usual for her. I took her to work and did a blood panel, fecal and urinalysis. Everything came back pretty much normal, although she wasn’t concentrating her urine well. That can be an early sign of kidney problems, so I started adjusting her diet to one of the therapeutic diets for early renal failure.

I repeated that work about three weeks ago when I brought her back to the office to remove a small skin growth under local anesthesia. Her monthly physicals had all been fine. But I did decide to increase her home checkups to every 7 to 10 days just because of her age – she’ll be 12 in November. (I adopted Gus from the Humane Society of Huron Valley almost 12 years ago.) I checked her on September 8 and found nothing remarkable. Then on September 16, Gus skipped her evening meal and didn’t eat again the next morning. This was the first time that had ever happened, so I decided to check her over again.

This time I found a mass growing under and out from the right side of the end of her rib cage. It was firm, not very movable and definitely there. Off we went to work where I took a full set of X-rays. I needed to check Gus’ abdomen, thoroughly, and look for any spread of the cancer (metastases) to her lungs.

The lungs were clear, but the mass was actually larger than I could tell just from palpating it with my hand. An ultrasound added the information that her kidney on that side seemed to be okay. We were hopeful that it was a splenic tumor with adhesions to hold it to that side. A dog can lose her spleen without too many problems, so Dr. Martha Demson, one of my associates, and I set out to do just that – remove Gus’ spleen.

Life is never simple, however, and as soon as we opened Gus up we knew it was not the spleen and that this was a bad mass in a bad place. The right kidney, right ureter, caudal vena cava and aorta of the heart were all right there, associated with this tumor. We took a biopsy and closed her up, even as I debated whether I should just euthanize her right then and there on the table.

I took her home, hung her IV drip on the coat rack my father made for me last Christmas, and waited for the histopathology report to tell us what type of cancer we were dealing with. Gus, tough little dog that she is, drank within hours after surgery! She was a little wiped out because of the surgery and her pain medications, but she still insisted on walking outside to urinate. My four housecats chose to sleep beside her bed Wednesday night, looking for all the world like four little solicitous nurses. I set my alarm clock for every two hours to check her IV drip and roll her over. Luckily, she’s great about not bothering her IV.

Late Thursday the report came back: myxofibrosarcoma or leiomyofibrosarcoma.

These are both tumors that arise from connective tissue – tissues like muscle and ligaments. They tend not to metastasize rapidly, but are very locally invasive and difficult to get rid of. Plus, this one was in a bad location on an almost 12-year-old dog. Decision time once again: Do we settle for the time we have left together and go walk in the sun, or do we try harder? Gus is a fighter and in great shape otherwise, so I decided to try harder.

A call was made to Dr. Paul Bookbinder, a board certified specialist in veterinary surgery. He felt it was risky, but worth a try to see if he could remove at least part of the mass. So Friday morning, he rearranged his schedule to accommodate Gus and off we went.

I handed her over with complete faith in his skill and his compassion. I knew he would do the absolute best he could and if things looked hopeless, he would come out and tell me. So I sat in the waiting room, like any other anxious client, trying hard not to cry, and trying to think positive thoughts. When we got past 15 minutes, I figured he at least felt there was hope!

About one-and-a-half hours later, Paul came out to give me guardedly hopeful news: He had been able to remove all the abnormal tissue he could see, and felt that all the important structures were still fine! However (isn’t there always a catch?), undoubtedly there was cancer still between some of the muscle layers – even if only microscopic now – and the blood supply to the ureter (the tube that carries urine from the kidney to the bladder) was tenuous. So I am now checking her kidney function, urine and temperature carefully. And there are more decisions ahead.

This type of cancer is not very responsive to chemotherapy, though with only small amounts to deal with it might help. Radiation is a possibility, but I have to decide if the added trauma to Gus would be worth any additional time we gain. I will be thoroughly researching textbooks, calling specialists and searching both Gus’ soul and my own. I have temporarily put my immediate plans for competitions with Beep and Bubba, my two other dogs, on the back burner.

I’ve always made sure that each dog got special, individual attention each day, but Gus will now need even more. I’m digging out doggie recipes to make special treats that will entice her to eat and build up her strength after two surgeries in three days. I have to keep the other dogs from bothering her, and I take her out, separately, to walk. But any changes are worth it to have my little black dog rest quietly at my feet as I write this.

Hug your dog today and please do a quick home checkup!

Digestive mastermind – Deb Eldredge, DVM

The pancreas is an organ located between the stomach and intestines – sort of off to one side. It’s a very important mastermind for digestion. Most of the digestive enzymes are made in the pancreas so the dog can utilize his food. It also produces insulin so the body can use glucose. A problem with the pancreas can lead to malabsorption syndromes. This means you can’t digest or absorb the nutrients you eat. The pancreas is also involved with diabetes mellitus, with all the complications that stem from a lack of insulin.

The most common problem our dogs face with the pancreas is pancreatitis. This is an inflammation of the pancreas sometimes caused by bacterial infection. Pancreatitis can also be caused by trauma, eating fatty foods (“garbage can-itis”), or infarcts, which are areas of tissue death due to a blockage of blood flow.

The scary part here is that when the pancreas is damaged, the digestive enzymes sometimes leak out into tissues (as opposed to in the intestines where they do their normal work). These enzymes are not discriminatory in what they digest and will destroy tissues the body needs.

Acute pancreatitis can make your dog very ill, can be extremely painful and may even be fatal. Chronic pancreatitis, with small amounts of damage to the pancreas occuring over the years, is not as dramatically severe, but may eventually be just as bad – leading to diabetes mellitus or even death.

While it may sound like a case of pancreatitis is quite obvious, it can be difficult to make an exact diagnosis. Dogs with pancreatitis may show vomiting, diarrhea, anorexia (no appetite), fever, abdominal pain or any combination of these. Of course, any “stomach bug” could look just like this, too. I think the severe abdominal pain and depression dogs show with this are some of the more significant signs. There are lab tests to diagnose pancreatitis, but they need to be more refined. Amylase and lipase levels (digestive enzymes) are commonly checked, but sometimes these will be normal in ill dogs. Work is currently being done to develop a more precise test for pancreatitis.

Risk factors for pancreatitis tend to increase with age. It’s quite uncommon for young dogs (less than 1 year) to develop pancreatitis. Dogs that are overweight, already diabetic, hypothyroid (probably due to problems with fat metabolism), or frequently experiencing bouts of gastrointestinal inflammation (our garbage can raiders) all have a higher risk for pancreatitis than the average dog. A dog that has survived one bout of pancreatitis is often predisposed to recurring bouts – our chronic pancreatitis victim.

A recent study also looked at whether certain breeds were predisposed to pancreatitis. I would have bet money on miniature Schnauzers, but the high risk breed was the Yorkshire Terrier. There may be a hereditary component to their risk rate. Meanwhile, Labrador Retrievers and miniature Poodles are at low risk for this problem.

Treatment for pancreatitis can take a variety of forms, partly depending on the severity of the individual case. A mild case may do very well with fluids given subcutaneously and nothing to eat for a day or so. That way, the dog doesn’t dehydrate, but the pancreas gets a rest. More serious cases may need to be hospitalized for even a week or more and kept on intravenous fluids. Drugs for pain, gastric upset and antibiotics may be included in the treatment. The use of corticosteroids to reduce inflammation tends to be somewhat controversial. Some people feel that steroid use may contribute to cases of pancreatitis; others feel that it’s an important part of keeping the pancreatic inflammation down and reducing the amount of free enzymes.

One of the worst cases at our clinic required hospitalization for almost three weeks. This dog had to be on IV fluids and nutrients and couldn’t even drink water without vomiting for over a week. Many dogs that sick don’t survive. A severe case a friend of mine dealt with had to have the abdomen flushed in order to remove excess free enzymes. The dog also had to have plasma transfusions.

Obviously, pancreatitis is another one of those diseases you hope your pets never get. Looking at the risk factors gives us some things we – as pet owners – can do to try to avoid this problem. Keep your pets fit and trim. If your dog is hypothyroid, keep him on the appropriate dose of replacement therapy. Do not feed your dog fatty scraps from the table (probably the biggest cause of pancreatitis in our practice). Call your veterinarian right away if your dog has vomiting and/or diarrhea and a loss of appetite. There are many problems that show these symptoms and some of them could be serious – like pancreatitis. The earlier treatment is started, the better the prognosis. And with any luck, you’ll never have to deal with treating a digestive mastermind gone awry!

New treatments for congestive heart failure – Dr. Deb Eldredge

Congestive heart failure is when the heart weakens and can no longer work efficiently. The heart is a superb pump and when it fails, fluid tends to build up – either in the lungs or the abdomen.

There are many new and excellent medical drugs to help the heart beat more efficiently and steadily. What I would like to touch on are some of the dietary and non-drug treatments which are coming to light. Realize though, that many of these treatments are just now being subjected to controlled studies to determine if they truly are helping dogs with cardiac problems.

Some dogs with heart failure are classic couch potatoes – overweight and not active. Obesity can harm your dog’s heart in many ways – just as in people. Hypertension, increased heart rates, and decreased exercise all can occur with obesity, sometimes turning a mild heart problem into a more serious one. Overweight dogs are also much more prone to respiratory problems, which just compound the whole situation. So keep Bowser trim!

At the other end of the spectrum, we see what is called cardiac cachexia. These are dogs who are losing weight, including muscle mass. Poor absorption of nutrients can lead to weakness, a poorly functioning immune system, and even less desire to eat. Dogs may lose their appetite from some of the medications they are taking. Or the decrease in oxygen to the gastrointestinal system (due to the heart disease) can, at the same time, limit their absorption of nutrients and cause a hypermetabolic state. That means you have to pull out all the stops to get dogs with cardiac cachexia to eat the necessary nutrients. Warming food up, home-cooked meals and garlic powder (not garlic salt) all seem to help stimulate appetites.

Dogs with congestive heart failure can also benefit from sodium reduction – just like humans. Retaining extra sodium causes your dog to retain extra fluid and makes it harder for the heart to pump. Normal dog foods have about 0.47% sodium on a dry matter basis. For moderate sodium restriction, you want about 0.2%, and 0.1% or less sodium (dry matter basis) for very severe sodium restriction. Your veterinarian can tell you which foods fit these descriptions, or you can call the pet food makers.

While sodium-restricted pet foods has a reputation for being unpalatable, that is changing. Doing a gradual switchover from Fido’s favorite food can be all that is required. Do beware of treats! Many of these have quite a bit of sodium.

Potassium is another dietary component that affects how the heart works. Too much or too little can have serious consequences. Dogs on certain diuretics should have their potassium checked periodically. Kidney problems can show up when dogs are on a wide combination of diuretics, sodium restriction and medications to enhance the pumping of the heart. Remember, never change your dog’s drugs or dosages without first checking with your veterinarian.

L-carnitine is a dietary supplement that shows promise for helping some dogs in heart failure. This is a component of fatty acid metabolism – the way in which heart muscle gets its energy. Originally, this was tried on Boxers with cardiomyopathy (a specific type of heart failure), and it seemed to help. It may take weeks to months to see an improvement, but it’s safe. Expense can be a factor for large dogs, but about 40% of all dogs with cardiomyopathy seem to benefit from some extra carnitine.

Taurine hit the news as a factor in cardiomyopathy in cats. Since the feline research, it’s been tried in dogs with some notable successes. American Cocker Spaniels develop heart failure of a certain type which often responds quite well to a combination of l-carnitine and taurine. While that seems to be breed specific, Golden Retrievers with heart failure are now being studied in the hopes that taurine may help them, too. (Chicken is high in taurine.)

Two promising nutraceuticals (nutrients which may have medical benefits, but are not prescription at this time) are fish oils (with high levels of omega-3 fatty acids) and Coenzyme Q. These are supplements which have been shown to help some people and are now being tried on pets. The advantage to many of these nutraceuticals is that they seem to be very safe – so even if they don’t help, they shouldn’t hurt.

If your dog is diagnosed with congestive heart failure, this will give you some additional therapies to discuss with your veterinarian. While the treatments mentioned above won’t replace many cardiac drugs, they may help to increase the length and quality of your pet’s  life. And that’s something we all strive for.

Dr. Deb: The Ugly Side of Dogs

As many of you know, dogs are some of my most beloved friends and companions. This past month, however, I’ve seen their dark side.

I became embroiled in a “dangerous dog” case. It involves an unneutered male of a breed known for being independent and possibly having aggressive tendencies. This particular dog has become increasingly aggressive over time. He’s unlicensed, never has a collar on, and is never confined. Despite living on a fairly busy street, he’s managed to successfully dodge cars. He’s been seen roaming as far away as 10 miles from home.

While running loose (now, with another dog as a partner) this fall, he became even more of a nuisance. He’s been eliminating on people’s houses, defecating on their steps, threatening their dogs and starting to harass livestock.

People spoke to the owners about the need to confine this dog and the tragedies that could result. Obviously they didn’t care. Early one Tuesday morning, this dog became a suspect in the killing and wounding of a group of ducks. These ducks were used by dogs for herding training. The hapless ducks probably didn’t even panic at first, since they were used to being around friendly dogs. Those ducks who survived this attack may never work again.

The dog wasn’t caught then, but numerous people saw him. The owner said his dog had not been outside. According to the law in many states, dogs harassing or killing livestock can be shot on sight.

Later that same day, even while the dog control officer was taking a statement from the owner, the dog in question returned to the place where the ducks had been killed and attempted to get into the sheep’s pen. Fortunately, he was spotted before he could get in and was chased off. But he threatened, growled, and bared his teeth at the adult human who chased him off.

It was obvious that this dog had simply returned to kill again, as such dogs will. The owner agreed to take the dog to the humane society.

But the man did not take his dog to the shelter. He gave him away, instead! This dog will return and he will kill again. (He’s never in his life been confined and has roamed widely, as already mentioned.) It turns out he was already a suspect in the killing of a deer.

As I type, this dog’s rabies status is unknown. His owner won’t reveal his whereabouts, so we had to involve a sheriff and a judge. There was a hearing, where it became known that the dog had, months earlier, bitten a young boy in the face. This resulted in a trip to the emergency room for the child, where he was sutured. The boy will, obviously, have a scar. Unfortunately, the chain of communications between the hospital and public health officials broke somewhere down the line. Otherwise this dog would probably have been removed as a threat after the attack on the boy.

Is this a bad dog? Probably not. In the right hands — neutered and raised with care, training and socialization, he might have been a terrific dog. A very experienced, conscientious owner might have been able to steer him in the right direction. But now the dog awaits a decision on his fate: euthanasia or lifetime confinement in a secure, fenced enclosure.

The dog clearly shows a link (at least in his case) between aggression toward other animals and aggression towards people. Many dogs are aggressive towards other dogs, but wonderful with people. But this dog crossed the line. He represents a classic case of all that can go wrong in the partnership of man and dog.

After almost five full weeks, this case was finally resolved. The owner didn’t want to confine his dog (I have to admit, it would have been a rough life for a dog accustomed to running free), and agreed to have the dog euthanized.

Please train, neuter and confine your dogs. Any dog can get loose a few times by accident, but an untrained dog who runs loose all the time is a disaster waiting to happen. In addition, many states or municipalities have leash laws and regulate where a dog can run free.

Many dog attacks could be prevented with the simple use of a leash. Each time a dog runs loose and damages property, or frightens or harms people or other animals is another justification for the people who want to strictly regulate or even eliminate pets. Be a responsible pet owner so that you can be a pet owner!