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Archive - Dogs
This is an unindexed assortment of questions that I really didn't have a category for or are about
several completely different issues and may be found in some parts of the site but the
rest of the information needs to be worked in elsewhere or there is simply not at topic
page yet and I need to create one.
For an alphabetical index see Dog Index
Orthopedic books , hygromas and hyperflexation of carpus in bloodhound pup
Question: Dr. Richards,
You know how there are very few text books out that are very
useful in the orthopedic world, well there is a new one that has just been
translated from German and published. It is terrific. A good friend of mine
is a Vet and she is thrilled by it.Diagnosing lameness in Dogs
forgot the authors name but it is available at amazon.com for $79.95.
Anita (Vet) paid about $130.00 for it from Iowa.Also, what first drew me to your site was my search for information
about Hygroma's. I later found out a very helpful tip from another breeder.
If you vigorously massage the hygroma several times a day, it will decrease
it's size about 50% faster than if you do nothing. So far, I have followed
her advise and I have found that it really works. I will have a few questions
for you later. A pup that I bred, who is now four months old, has developed
what seems to be a hyperflexion of the tendon just below the carpal joint.
The carpal has been x-rayed and seems to be normal at this time but he looks
like he has a flipper instead of a paw. I have been involved in veterinary
medicine for some time and I have never seem something as bad as this. We
have an appointment on the 28th with a specialist and I really want to get
this taken care of ASAP. He is already 60lbs and I can only see this becoming
worse as he grows.Thank you for your time, Marcia
Answer: Marcia-
There is a condition in which hyperextension of the carpus occurs, causing the back of the carpal joint (wrist) to drop down towards the ground, or even to contact it. Most puppies with this condition overcome it without treatment. Veterinary nutritionists recommend making sure that the puppy is on large breed puppy food (lower calcium to energy ratio) and that it is not overfed. There seems to be some disagreement over whether to encourage exercise or not, but my personal opinion is that moderate exercise is a good idea. When this condition occurs in puppies the prognosis is usually good. When it occurs in older dogs it can be very frustrating and may require surgery to arthrodese and stabilize the carpal joint in order to prevent secondary problems.
Hopefully the puppy you are concerned with will stick with the majority and do OK in the long run.
Mike Richards, DVM
9/5/2001
Adrenal gland enlargement and Mitotane (Lysodren Rx) treatment
Question: Dr. Richards,
Thank you for the quick response to my last question. We just received
news that our 13 year old golden retriever does not have Cushing's disease.
He was tested (dexamethasone and other tests) and all was negative. He has
been drinking and urinating excessively. Now after an ultrasound it seems
the adrenal gland is slightly enlarged. He has no tumors and our vet (who
we think is terrific) wants to start a program of lysodren which we were
informed kills the cells of the adrenal cortex selectively. I wanted
to know your thoughts on this drug and problem.
Thanks again, Gina
Answer: Gina-
There are several possibilities when adrenal gland enlargement is
identified. The most likely problem is hypertrophy of the adrenal gland
due to stimulation from the pituitary gland, which is one of the two major
causes of hyperadrenocorticism (HAC, Cushing's disease). In this case,
there is not an adrenal gland tumor. The adrenal gland is doing exactly
what it should do in response to stimulation from the pituitary gland.If an adrenal gland tumor is present, it may be one of several types.
(metastasis from another site, adrenal gland adenoma, adrenal gland
adenocarcinoma, pheochromocytoma). In this case, the problem is
identifying the type of tumor present.Ultrasonagraphy of the adrenal glands seems to be difficult, based on
conflicts among the reported findings in adrenal gland tumors among the
clinical studies that I can find. I do not do ultrasonagrahic
examinations in my practice and my personal experience with this technique is
minimal, so this is simply my impression based on reviewing the available
literature. Given the conflicts in the literature, though, I think that
I would be cautious about using mitotane (Lysodren Rx) for an adrenal
gland tumor unless there was support for the diagnosis of
hyperadrenocorticism (Cushing's disease) in the lab work, since this therapy is directed at
adrenal gland carcinomas and adenocarcinomas and won't work for the
other types of tumors. The classic case of an adrenal gland adenoma or
carcinoma would be one large adrenal gland and one atrophied (smaller than
normal) adrenal gland, but in several studies this didn't always hold true. The
opposite adrenal gland can be enlarged because there is concurrent
pituitary dependent Cushing's disease, because of a tumor affecting
that gland too (adrenal origin or other origin) and also simply because it
didn't atrophy as expected.There are approximately 20 possible causes of increased drinking and
increased urination in dogs. Many of these can be ruled out quickly
based on the dog's sex, the medical history and general chemistry profiles.
The remaining possibilities are then usually the hormonal diseases
(hyperadrenocorticism, hypoadrenocortisicm, diabetes insipidus),
infections (pyelonephritis both sexes, pyometra in females) and cancers
(pheochromocytomas and metastatic cancers producing pseudohormones).
Sorting through these conditions can be very difficult.If both a low dose dexamethasone suppression test and ACTH response
test fail to show the presence of hyperadrenocorticism, the likelihood that
this is the problem is low, but unfortunately, not totally ruled out. There
are dogs who have Cushing's disease who do not test positive for it on
either of these tests. When this happens, an effort should be made to
eliminate the other possible causes of increased drinking and increased
urinating. If no other cause can be found and if there are other signs of Cushing's
disease, such as thinning of the hair coat, thinning of the skin, a
pendulous abdomen, panting, muscular weakness, calcinosis cutis
(calcium deposits in the skin), recurrent bladder infections or other less
common clinical signs, then it is reasonable to treat for Cushing's disease to
see if a response to therapy can be obtained. This has to be done very
carefully, since mitotane does kill adrenal gland tissue, which can
cause significant problems if hyperadrenocorticism is not present.With all of that in mind, there is still the question of what to do. It
is important to be sure that an effort has been made to rule out as many
of the other causes of increased drinking and urinating as possible. If
this has been done to your vet's satisfaction (and yours) and if he or she
still believes that Cushing's disease is most likely even without the
positive test results it is considered to be reasonable by many internal
medicine specialists to attempt treatment to see if it will help. On the other
hand, if the only symptom is increased drinking and urinating and if that
doesn't bother you or your dog too much, it is also reasonable to do nothing
and wait to retest at a later date. Sometimes, over time, further symptoms
develop or lab results finally match a disease process.Mitotane (Lysodren Rx) does selectively destroy adrenal gland tissue.
As long as that is appropriate for the disease process, it is a good
medication. Some dogs do react adversely to it and we have had one
death using it that we really feel was a direct result of the medication and
not from creating hypoadrenocorticism accidentally. We have also had
several dogs that we have treated with mitotane who did ultimately develop
hypoadrenocorticism that required therapy. Some of these eventually
returned to a Cushingoid state but we did treat one dog life long for
Addison's disease that we created with the medication. In a few dogs
who have Cushing's disease, mitotane brings a sudden worsening of clinical
signs when it is used but this is a complication of the disease more
than of the medication since it is likely this would have happened quickly,
anyway. If you and your vet do elect a therapeutic trial of the
medication you should watch carefully for signs of problems, such as a loss of
appetite or weakness and it would be best to monitor water intake as
closely as possible so that you can alert your vet when water intake
starts to decrease so that dosage adjustments can be made accordingly. I am
sure that your vet will go over this type of thing with you again but do
remember that you play a big role in the success or failure of Lysodren
therapy.I think that there are several notes with the list of possible
Mike Richards, DVM
differentials for increased drinking and urinating on our site but if
you can't find them, let me know and I'll send you a new one as I am
working on this for next month's VetInfo Digest.
9/4/2001
Severe spinal damage
Q: Hi,
I was just "surfing the net" for people with knowlege of dogs/animals for
veterinary assistance, and found your address at http://www.k9web.com/dog-
faqs/. I hope you are able to give me an opinion on my dog's condition.
The problem is my dog, (a Portuguese Water Dog) has the slipped disc, and at
first she limped a little about a week ago, and now it has resulted in her
inability to stand up. She is under intensive care at the vet, and has been there since
last Friday. I have heard that there are carts/wheels that dogs can travel
around in so they can continue on with their life. Have you seen dogs "on
wheels" continue on with a happy and healthy life? I want to do everything I
can in order to save my dog. She just turned 10 years old, and before this
happened she was the liveliest and happiest dog. Do you know if it there
would be good results if we put her under surgery? Have you ever operated on a dog
of this age and had successful results? She still has the will to live, when
we visit her at the vet she tries so hard to get up, but her back legs won't
do it. They aren't completely paralysed, but they could get worse with time.
Basically what I need is some advice and a second opinion because there has
already been talk of putting to her to sleep but I refuse and think there has
to be more to help her before we reach that ultimate decision. She is just
not the type of dog that you give up on and put to sleep.Thanks so much for listening and I appreciate any information you can give
me.Lauren
A: Lauren-
It can be hard to take care of a dog with severe spinal damage. In many
instances dogs that are paralyzed have also lost bladder function. It is
necessary to empty their bladder regularly and to provide a high level of
nursing care to ensure that they do not develop urine burns, cystitis or
other problems as a result of urine leakage or urine retention. I have had
several very committed owners who took care of dogs who were paralyzed or
partially paralyzed with good success. We have had two or three owners
purchase or make carts for their dogs and they seem to work well enough to
provide a reasonable quality of life.Surgery works best for disc problems causing paralysis if it is done within
24 hours of onset of the clinical signs. As time goes on the value of
surgery seems to diminish. It is not too late to consider it but there
would be less chance of it helping after several days. The best option if
you are considering surgery is to have your dog evaluated by a neurologist
or orthopedic surgeon who does back surgery and get his or her opinion on
how much benefit you can reasonably expect from surgery.Dogs can recover satisfactorily from severe disc disease in which paralysis
or partial paralysis has occurred without surgery in many instances.
Sometimes there isn't any recovery or there isn't enough recovery but it is
worth waiting a while to see what happens, I think. During the time you
are waiting you will have time to learn the nursing care requirements. This
will allow you to make a more objective decision about your capability of
handling the nursing care long term.A second opinion is probably a good idea. It would be best to get it from a
board certified neurologist or orthopedic surgeon if possible (or at least
an experienced surgeon). Your vet should be able to refer you to a
veterinary school or specialist in your area for an evaluation of your
dog's condition.Good luck with this.
Mike Richards, DVM
Problems in Older Lab
Q: I have a 11 yr old lab, spayed female. Two weeks ago, she "fainted" for
about 10 minutes. Took her to vet next day and the following two
weeks. Her PCV was down to 15, Amalase over 2000. She jaundiced and we
cleared that up. Ultrasounded abdomen, no "Sure" sign of tumor. Had
an emergence blood transfusion and put on prednisone/antibiotics. She
is extremely lethargic, with just enough energy to go potty. If she
even mildly exerts herself, ie: barking, climing stairs, her pulse
nearly doubles along with her respirations. The vets ( seven total,
including three specialists) have no idea what is wrong and they are
assuming autoimmune problems. I have found several other possibilities
such as Addison's. Also several months ago, I noted she was panting all
the time, which she never did...seems I should have had her checked
then, because it did get my attention.
Any ideas?Andrea
Q: Andrea-
My first thought with the symptoms you have seen so far, in an elderly
Labrador retriever, is hemangiosarcoma, a form of cancer. It can be very
hard to find this cancer as it does not always for large tumors. I have
been involved in cases of hemangiosarcoma in which three or four
veterinarians examined a dog and all assumed it must have immune mediated
hemolytic anemia or some other bleeding disorder, including me. When we did
an exploratory surgery with the idea of performing a splenectomy we
discovered several hundred small tumors scattered all over the dog's abdomen.This is not the only possibility. Many diseases can cause anemia and
panting can be associated with heart disease, respiratory problems,
Cushing's disease, pain from any source and probably a number of other
conditions that don't come to mind right away. If you live in an area in
which ehrlichiosis (a disease caused by a blood parasite) is a problem,
that would also be something to consider.Sometimes you just have to keep working with your vets as the symptoms
evolve until it becomes possible to put all the pieces together and nail
down a diagnosis.I hope that my first impression is wrong. Good luck with this.
Mike Richards, DVM
Pseudomonas and Oliver - continued
Q: Dr Mike,
I apologize for having to reach out to you again but I remain concerned
(terrified). You may recall that Oliver is the dog who had
(has?)
pseudomonas and was treated with both Gentamicin (sp?) and Geocillin.
He was on the Geocillin 2 weeks after I last wrote to you, a total
of 4
weeks. He went back to the vet who listened to his lungs and
did
x-rays. Based upon these two exams he determined the pseud.
was gone, I
was not so sure. I was not settled with this conclusion because
his
lungs have always "sounded" clear and the x-rays have never been
bad
(cloudy). Actually, before he had the endoscope the vet took
x-rays and
said "we don't need to do the endocope his lungs look fine."
I insisted
on the procedure and sure enough the lil' buggers were in his lungs.
As
such, I do not trust the notion that he is better. FUTHERMORE,
while
Oliver was outside playing last evening, on a sandy beach, jumping
in
and out of the water, he started to honk, with a gag at the end
(the
kennel cough type), the type of cough that he has had since January.
Also, FYI, Oliver has allergies (grass, weeds etc), we have not started
the kit yet because I want him to be healthy first.
He has been somewhat lethargic lately (but probably the humidity),
he is
eating fine. Has discharge from his eyes (probably allergies)
and seems
alert. Sometimes he seems a bit weary though.
I just spoke with my vet who says to put him back on the theophylline
(theochron) b/c he may be coughing b/c of the scar tissue.
He said to
try that for a couple of days, run him around as I did yesterday,
and
then we will decide what to do next if the coughing persists.
I am angry that my original vet did not send us to the specialist
well
before they did because I believe he would not have scar tissue
today.
Yikes!!
Please, if you will, tell me what you think about what is going on.
Could he cough from scar tissue (which apparently is not real bad)?
Could he cough like this from allergies? Could it just been
sand in his
trach (doubtful)? Or, should we just decide to do a course
of Batryl
and then do an endoscope shortly thereafter to see if it is gone.
I
hate to do another endoscope and find that it is there, then put
him on
Batryl and possible have to do another down the road again.
Thank you in advance for whatever insight you may have.
Suzanne (and Oliver)
A: Suzanne-
There is some reason to be concerned, since you feel that Oliver
is acting
tired. This is a symptom often associated with pneumonia or other
conditions in which oxygenation of the blood is not occuring properly.
However, we practice very close to the Chesapeake Bay and we get
a lot of
phone calls about dogs coughing when they are playing in the water,
so I
think that may be fairly normal. In addition, I have noticed that
pets that
have pneumonia will often cough when first exercising, or when exercising
hard, for as long as two or three months after treatment. So I would
be
concerned enough to advise keeping a very close eye on Oliver's
condition
based on these signs. At present, the best method for determining
if
pneumonia persists is probably to have endoscopy done again. A follow-up
transtracheal wash is another option.
It is best to try to make as objective an evaluation of his overall
condition as you and your vet can. Then decide if you are worried
enough to
warrant further diagnostics. Since there is some risk associated
with
anesthesia for endoscopy it is necessary to make a careful decision
on the
necessity of this procedure.
Allergies do not make dogs cough as often as they make cats and people
cough but it is a possible symptom of allergies. Runny eyes seems to
occur
fairly frequently in allergic dogs and I do consider this to be a symptom
that is closely associated with allergies, although there are other
causes
such as eyelid deformities, distichiasis and tear deficiency.
Another possible problem is allergic bronchitis. We have two patients
with
this condition who respond really well to antibiotics, most of the
time,
but who constantly get reinfected. They both cough a lot when there
is a
secondary bacterial infection on top of the allergies and they cough
less
frequently at other times. One of these dogs seems to go much longer
between crises when we use a low dose of prednisone every other day
to
control the allergic inflammation.
I know that it is frustrating not to know for sure what the situation
is.
Sometimes this can be downright frightening. Try hard to evaluate Oliver's
overall health and if you remain worried after doing that, talk to
your vet
about referring Oliver for a follow-up endoscopic exam.
I know that this really confuses the issue, but in reviewing information
on
Pseudomonas species infection in order to reply to your letter I found
a
brief statement in Dr. Plumb's Veterinary Drug Handbook which says
that
Geocillin Rx (carbenicillin, generic) is not effective for infections
other
than urinary tract infections when given orally. I was not aware of
this
and your vet may not have been, either.
Mike Richards, DVM
7.27.98
Pitbull Puppy
Q: Hello my name is Maria . My neightboor just
gave me a baby pitbull.
I'm not sure what to feed it. The previous owner was feeding him orange
juice, and milk. I don't think that milk and orange juice is the
proper diet. The puppy bites alot. I gave him some toys and
he does bite the toys but I'm not sure if that is very good for him. Could
you help me or
guide me to the right direction.
Thank you very much.
Maria M
A: Maria-
The best thing to feed the puppy, as long as it is at least 4 weeks
old, is
a good puppy food. If the puppy is not used to solid food it may be
necessary to soak the puppy food in water to soften it so that the
puppy
tolerates it better. It is not necessary to supplement the puppy food
with
anything, including milk.
Please make an appointment with a vet in your area and explain that
you are
a new puppy owner who needs information on feeding, housebreaking,
vaccination schedules and deworming. Your vet or your vet's staff will
be
able to give you a lot of guidance on puppy care.
Mike Richards, DVM
Anemia
Hi, my name is Alvaro, I live in Bogota, Colombia. I have a
one-year old black labrador who in the past two weeks has been
diagnosed with different diseases. Two weeks ago I took him to the
vet
because he was sick. The vet gave him a shot, one of the three shots
you are suppose to give dogs, and sent him some drugs. The
veterinarian diagnosed him with a respiratory problem. Since this
monday my dog showed problems again. I took him again to the vet but
she was not working, so I decided to take him to another vet. He
diagnosed him with a kidney disorder, he gave him two shots and then
sent him home. He did not show any signs of getting better so I took
him to a vet my current vet recommened. He diagnosed him with anemia.
The problem I have is that the vet doesnt know what the cause for his
anemia is. He told me that my dog is not able to produce red blood
cells. From what I've read on your website I beleive he suffers
aplastic annemia, how could I be certain he is suffering this type
of
anemia?? What do you recommend me to do?? And if there is anything
the
vet and I could do to make him get better??
He has already been transfused blood, and he is currently on serum for
the past two days.
I hope you can help me with my problem.
Sincerely,
Alvaro
A: Dear Alvaro-
It would be a lot easier to give you a list of possible conditions if
you
can provide the various lab values from the vets you have seen.
A condition that could cause virtually all of the symptoms you have
seen so
far is ehrlichiosis, a blood parasite infection. This is a world-wide
parasite so it seems likely that it could occur in Columbia but it
is more
prevalent in some areas than in others. It causes anemia in which the
body
does not make red blood cells (non-regenerative anemia).
Other causes of non-regenerative anemia include iron deficiency, severe
malnutrition, severe inflammatory diseases, kidney failure, liver failure,
severe hormonal disease, drug reactions to estrogens, trimetophrim/sulfa
antibiotics, chloramphenicol, phenylbutazone and probably some other
medications. Aplastic anemia is lack of production of red blood cells
because the cell lines that produce them die or do not develop.
It is not possible to tell you what to do next with the information
you
have given so far. If the kidney disease is severe it could cause the
anemia and it would be necessary to work hard to control the kidney
disease
while possibly considering the use of erythropoetin, a hormone that
the
kidney normally would produce that stimulates blood production. If
there is
a risk of ehrlichiosis then treatment with tetracycline or doxycycline
plus
blood tests to confirm the diagnosis would be a good idea. A bone marrow
biopsy may be necessary to diagnose aplastic anemia if it seems most
likely
after evaluation of all of the lab work.
Your best bet is to work closely with whichever vet you feel the most
comfortable with. It may take several tries to find the answer to your
dog's problem. Make sure the vet you choose has all the labwork done
so far
and do not be too upset if it is necessary to do more to really confirm
the
problem.
Good luck with this.
Mike Richards, DVM
Chronic colon problems
Q: hello DR.
I HAVE A GERMAN SHEPPARD ABOUT TWO YEARS OLD,OUR VET DID A SCOPE
AND BIOPSY,AND IT CAME BACK THAT HE HAS A LOWER BOWL DISORDER..HE WAS PUT
ON 50MG PREDNISONE EVERY 12 HOURS FOR 3 WEEKS THEN 1 EVERY DAY..OUR
$ 2,000 DINNING ROOM SET AND $5,000 CARPET IS IN BAD SHAPE...HE IS NOT
TAKEING TO THE PILLS SO I TOOK HIM OFF OF IT FOR NOW,HE WAS GOING STOOL
MOVEMENTS MORE ON THE PILLS THAN HE WAS WHEN HE WAS OFF...THE FOOD HE IS
ON IS SOILD GOLD...BEFORE THE PILLS HE WOULD HAVE A FLARE UP ABOUT
EVERY 3 MONTHS..ANY ADVICE ON WHAT WE SHOULD DO NOW..NEEED YOUR HELP..COREY
A: Dear Corey
It is not possible to offer much advice without more information
on the
diagnosis. It is important to let your vet know that the treatment
is only
partially successful, though. Chronic colon problems often require
several
attempts at therapy to hit the one that works for a particular dog.
Sometimes a diet designed to be hypoallergenic helps. Checking
for
digestive enzyme deficiencies is often a good idea in shepherds
but may
already have been done. Replacement therapy is necessary if they
are
missing. There are medications such as sulfasalzazine that are sometimes
effective for colitis. In some cases using an immunosuppressive
agent such
as prednisone is necessary. If that is the case but it isn't successful
alone it may be necessary to add a second medication such as azathioprine
(Immuran Rx). Your vet will probably continue to try various combinations
of these treatments until something works. If nothing is working
it can
sometimes be helpful to consult with an internal medicine specialist.
Your
vet can refer your dog if that becomes necessary.
Good luck with this. Keep in contact with your vet.
Mike Richards, DVM
Tumor and skin problems
Q: Dr. Mike, I have a 2 yr old pitbull who
has constant skin problems ranging
from a small tumor on his back leg which is being investigated by my
vet to
large black spots on his back. His hair is sparse in these areas
and they
seemed to have developed in response to scratches or nips when playing
with
other dogs. Could these dark spots be considered scars?
The areas are very
dry and seem to itch mildly but the spots have been there for months.
Is it
possible that the tumor is somehow associated with his skin irritations?
Also, my vet said that the tumor is probably benign. How can he tell
by the
appearance of the "lump"? Are there general characteristics of
benign
tumors?
It seems to be painful to the touch as he snapped at the vet for the
first
time when he (the vet) touched it. Could that be indicative of a benign
tumor?
The lump is a dark pink color that looks like a "ball" on the surface
of the
skin. Thank you in advance for your reply. Danielle
A: Dear Danielle
The bottom line answer to your question is that it is not possible to
tell
if a lump is a benign tumor, a malignant tumor, or something else,
in most
cases, without doing a biopsy or removing it and having a pathologist
examine it.
On the other hand, there are an awful lot of lumps that appear on dog's
skin and from a practical standpoint the expense and risk to the dogs
of
removing every single lump that appeared makes it impractical to consider
doing this. So most vets pick and choose which lumps to remove based
on
appearance, on the dog's age, on the breed and on other aspects of
the case
which help to determine if the lump is benign.
The lump you are describing sounds like a histiocytoma. Most of the
time
these are benign. Sometimes they itch. Itchy tumors are sometimes mast
cell
tumors. Mast cell tumors sometimes look like histocytomas. Mast cell
tumors
tend to be malignant. Since this is a case where mistaken identity
is
possible, I remove lumps that look like histiocytomas if they stick
around
more than a few weeks and if they are itchy I tend to remove them sooner.
Histocytomas will often go away on their own, so if the lump isn't
itchy
and has the typical appearance of a histocytoma I wait a while to see
if it
will go away.
Obviously, I can't see the lump on your dog, so I can't give my personal
evaluation of whether or not I think the problem is a benign one. I
do
that, just like your vet does and I am wrong sometimes. Over the years
I
have gotten a lot more likely to remove lumps since I discovered that
most
dogs will let me do it with a sedative and local anesthetic and since
I
figured out that I wasn't as good at guessing what the lump was as
I
thought. If you are worried about this lump, ask your vet
to remove it
and have it examined, even if he thinks it is benign. After all, this
is
your pet and your money, not his.
The other skin disorder is a lot harder to give you advice about. It
may be
worth asking for referral to a veterinary dermatologist if the problems
persist.
Mike Richards, DVM
Distemper possible
Q:
I've lived in Vancouver, Canada for 2-1/2 years now. My 12 year
old
baby (Pekingnese) in Manila, Philippines is very ill. I talked
to his
veterinarian there yesterday via overseas call and was informed that
he
has distemper. I am not well informed on this illness, but he
said that
it is slowly attacking his brain. My sister told me that my dog
sways
and falls down when he walks, shakes his head and his body trembles.
He
still eats but he has slowed down a lot, he's not responsive anymore.
He goes to my sister for pats when he's in pain. His vet informed
me
that he'll be in pain and it's gonna get worse and will be a slow and
painful death for my baby. It has been very painful for me since I
cannot be with him in his time of pain. I wish I could be with
him to
assure him that he will be okay. He's a very special dog and
has become
a part of our family. His vet suggested that he'd be put to sleep
this
week. I and my brother and sister in Manila have already discussed
this
matter and have accepted that fact that his time has come, that he
has
lived a good life, that he has brought us so much joy and happiness,
that he's already lived his life to the fullest and therefore time
to
let him go.
Please help me, I want to know what is wrong with him and if he has
hope
to live longer. I do want to see him again. I live him
so dearly, it's
already painful being away from him, and I don't think I can bear not
seeing him again. My mother who is also away for a 2 month holiday
loves him and has been taking care of him since I left. I also
want to
know if putting him to sleep soon is necessary. I really don't
want to
do this.
My baby's time is coming and I hope to hearing from you SOONEST.
Thank you.
Gigi C
A: Gigi-
I am sorry, but I can not tell you what might be going on based on the
information in your email. If your peke has been vaccinated for distemper
anytime in the last few years I would be suspicious of the diagnosis
but
that doesn't help you much. There are a number of possible problems,
including distemper. Peripheral vestibular syndrome is possible if
the
signs have been present for less than three weeks. That would be good,
because most dogs recover from that condition. On the other hand, a
brain
tumor is also possible, as is liver failure, kidney failure, other
cancers,
heart disease, diabetes, hyperadrenocorticism and many other illnesses.
If
it is possible to have labwork run (a blood chemistry analysis could
be
very helpful) that would help clarify the situation. If this is not
possible then it may be best to rely on the vet's judgement since he
has
been able to examine your dog and therefore has the best ability to
judge
the overall situation.
I know this must be hard for you. This is one instance in which separation
is extremely frustrating.
Mike Richards, DVM
Laryngeal paralysis
Q: My dog is a chocolate lab-springer spaniel mix, 14 years old. He has been diagnosed with laryngeal paralysis. The Dr. I took him to recommended surgery but considering his age and the fact that it would be very tramatic for him, I do not want to put him through that. I have have heard of medications that might help but can't remember the name. Can you recommend anything that might help my dog?
Thank you for any help you can give me.
A: S-
I know of no medication that will help much with laryngeal paralysis
unless an underlying disorder can be found. Hypothyroidism may cause laryngeal
paralysis but current evidence suggests that happens rarely. Hypoadrenocorticism
(Cushing's disease) has been associated with laryngeal paralysis and so
has myasthenia gravis. If your vet has ruled out these conditions as a
cause for the laryngeal paralysis it is very unlikely that
medication will help, as far as I know.
Mike Richards, DVM
Kidney failure in Chow
Q: My wife has a three-year old Chow that
is like a daughter. She has lost about
10lbs in about a month. We took her to the vet, and he has told
us that she has kidney failure and possibly liver disease. He put
her on an IV of some-sort, but I'm not sure. I know that her bloodwork
showed high levels of at least Phosphorous and Creatine. He said
that the "Cadillac" treatment is to take her to a specialty vet in Dallas.
He won't give us any other information about how serious this is.
He only says that we will have to keep bringing her in for IV treatment.
What is the honest prognosis? Do dogs live
relatively long with kidney problems? How much money might be
involved with a "specialist" Do dogs have multiple kidneys as humans
do?
Bill
A: Bill, your situation is serious and you must make some decisions quickly. In dogs, aggressive treatment is necessary in order to have a reasonable chance of treating kidney disorders successfully. There is a possibility that this will be expensive. If the cost of the initial visit is reasonable, spend that much and then decide what to do after consulting with the specialist. He or she will be able to tell you much more about what needs to be done and what it will cost.
Mike Richards, DVM
Subject: Dr Mike's info PDE
I'm not sure if I would want to subscribe to your digest when Dr. Mike
is giving out bad info. Re: PDE . The name Pug Dog Encephalitis came from
the first research of this disease being done on Pugs. It has been a known
fact that several breeds also get this form of encephalitis. All the Pugs
were from one kennel - Is it genetic? Is it a virus? It can not be replicated
to date. Check your info before misinforming!
A : K-
In any effort to produce a reference source of the size of the VetInfo site there are going to be some errors. To think otherwise is to ignore both human nature and common sense. The advantage of providing this sort of information on the Internet is that it is easy for people to contest the information presented and for us to make corrections when they seem to be warranted.
I am slightly mystified by the tone of your note. You seem to be implying
that we should not publish information suggesting that there may be
an
encephalitis problem in pugs, as if that somehow diminishes the breed.
It is important to consider all possible problems, particularly those with
some breed predilection, when drawing up a list of differential diagnoses
for an ill pet. While there may be disagreement, I strongly feel that it
is better to include and consider a differential than to leave it out becauseof
ignorance of its existance. From an editorial standpoint, I do intend to
continue publishing with that philosophy.
In the initial study published in 1989 by Drs. Cordy and Holliday at
UCD,
there were 17 dogs reported to have the condition, 11 of which were
from
the same kennel. The condition has been reported in another pug from
Germany by Hinrichs, et. al. from the Institut fur Pathologie in Hannover.
It seems reasonable to assume that this dog was not related, although
that
it not certain. I did find a reference to necrotizing meningoencephalitis
occurring in Maltese dogs with the same pathological findings, indicating
that it is likely to be the same disorder, published by I.H. Stalis,
et.
al. from the University of Pennsylvania (references cited were located
using the Veterinary Information Network database, 1-800-700-4636).
There
is also a reference to a similar, but definitely distinct necrotizing
encephalitis condition in Yorkshire terriers by B. Jull, et. al., from
the
University of Tennessee. If there are other references that you
are aware
of suggesting that this occurs in more than the Maltese and pug breeds
please send information on them.
At present the causes of this condition are not clear, as far as I know.
We will add the Maltese to the list of breeds known to be affected by
this
condition. I do appreciate you taking the time to write and hope that
you
will provide further references.
Mike Richards, DVM
Mange
Q: Mike, I have a 81/2 week old puppy who has been Dx with mange. I got a Rx of Mitaban for her and hope that it will help her. I lost an adult dog to the mange when I was a child and I'm very nervous about this. Could you tell me how effective this treatment is and how aggressive I should be. Thanks.
A: It would be very very unusual for a puppy of 8.5 weeks of age to have generalized demodectic mange, which is the type of mange that Mitaban is most frequently used to treat. If your puppy has sarcoptic mange the odds of success with treatment are nearly 100%. Mitaban (Rx) will kill sarcoptic mange but so will many other medications, some of which are safer to use in a puppy of this age. It would not be unusual to find Demodex mange mites on a puppy this young but it would be unusual for them to have spread to the point that generalized mange is present.
Amitraz (Mitaban Rx) is effective about 80% of the time for the treatment of demodecosis. When it does not work there are alternative treatments so it is possible to treat most, but not all, cases of demodecosis.
It is important to know which one of the mites is present and then to treat appropriately. If your vet feels that generalized demodecosis is present at this age it would be a good idea to get a second opinion, or at least to talk with your vet to confirm that this is the case. Most cases of generalized demodecosis occur in dogs that are over 12 weeks of age.
Mike Richards, DVM
Lab breed related problems
Q: Dear Dr. Mike: I've read through your Web site and you seem to have a lot of knowledge about breed-specific health problem propensities. I plan to adopt a rescue or shelter labrador next year, and as this will be my first dog (although I grew up around dogs), I am trying to get as informed as I can beforehand. Because I am unlikely to know much about the lineage or health records of a dog I adopt, can you tell me anything about what kinds of health problems are specific to Labbies, or things I should look out for? There's no rush on this, but since Labbies are so popular, it would probably be useful info for others as well. Thanks, Jill
A: We are going to develop a section for breed related problems over time, so you may want to recheck the site before you adopt but these are the things that I can remember offhand:
Hip dysplasia is very common in Labs. If you adopt a young Lab be sure to keep him or her thin during growth. This helps to prevent the development of this condition.
Labs are prone to progressive retinal atrophy (PRA). This is a cause of blindness. It may be a good idea to check on this if you adopt an older dog. Ophthamologists can often see the signs of this very early and many general practitioners are pretty good at it too.
Labs have a congenital muscle disorder ( a myopathy).
Food allergies may be genetic in Labs. I am of the opinion that atopy (inhalant allergies) are inherited in Labs but have not seen a reference to this effect.
Oculoskeletal dysplasia (dwarfism) occurs in Labs but I don't think that you'll miss that one.
Many people believe Labs are prone to hypothyroidism.
There are undoubtedly other conditions that are not coming to mind right off. We'll try to add more as we can.
Mike Richards, DVM
Possible neoplasia
Q: Kim has beaten aspiration pneumonia...had temps up to 107 after the myelogram anesthesia..about a week later..but ,now that the pneumonia is cleared , we cant get the fever to drop...runs 102.6 to a high of 107....ran mostly 104.6 to 105.1 today...she has been on primaxin for 5 days, now on ciftriaxone..(rocephin) as a lyme titer came back postive..despite the fact that a csf tap was negative for lyme... temperatures have been like this since the pnuemonia..Aug 11th..., no one seems to know what do do next..she has had an echocardiogram..negative, an ultra sound..no masses, no tumors.., no vegetative heart nor mumers...we just dont know what to do next...
and the csf tap cell cytology..it doesnt add up to degenerative myelopathy..for all intensive purposes..Kim should be up and walking..
any ideas..this has been posted to the vet info network..for ideas... perhaps you have some insight that may help...(oh, both doxycyline, and baytril were used the first week during the pneumonia..then the other drugs..nothing cultures out..yet..)now the rocephin with some sulfa drug too is being tried...
Any insight would be greatly appreciated, dr. mike
sincerely Scott
A: Scott- I am sorry for the delay in responding to you. I was trying to figure out the significance of the protein levels. I am not sure what I would do in your dog's case at this point. My instincts still lean towards suspecting neoplasia, even in the absence of obstruction of the dye on the myelogram. However, I am not sure how to prove or disprove this suspicion since you have already done the recommended testing for these situations. An MRI might be helpful but I have heard conflicting opinions on the usefulness of this procedure for spinal cord evaluation in dogs. A samoyed may be big enough for it to be useful, though. I wish I knew how to help more.
Mike Richards, DVM
Soft palate and Pugs
Q: Pugs are really human.Dr Mike, could you tell me is the operation for a large soft palate in a 1yr old pug simple or are there dangers?She was spayed recently and while under the anaseithic was found to have a very large soft palate.She is very nervy and tense for a pug and at times quite growly towards our other pug.She showed signs of this behavior before being speyed and has started doing this again, also i don't know if it is normal or not but her nails are changing from black to white,still good and strong just changing colour.Where we are in New Zealand there is not much information available about conditions like soft palate's etc;as pugs aren't all that common.I would appreciate any advise you can give me. Sharon
A: Sharon-
Soft palate surgery seems to be pretty safe when done by someone who is experienced in the procedure. I have only operated on soft palates when trauma or other situations made it necessary. Surgery does not seem to be technically difficult in this region. However, determining whether or not surgery is necessary does seem to be difficult to me, as well as deciding which surgery is best in many situations which obstructive airway disease is present. So I tend to refer these cases to surgical specialists. If this was not possible and a patient had obvious signs of respiratory distress, did not have have obstruction of the nostrils (pretty common in pugs) and seemed like a good candidate for surgery I think I'd be willing to try it. Since I have access to surgical specialists close by I think my patients are better served by referral, though.
We have done a number of the procedures for opening up nostrils and a couple of these dogs did seem to have positive behavioral changes associated with the increased ability to breathe.
I don't think I'd worry over the nails changing color unless there is inflammation around the nailbeds or other signs of problems.
Mike Richards, DVM
Diabetic Cushing's death
Q: I lost a diabetic cushioned dog 4 days after surgery for hind leg parlyses due to disk injury (not known if from natural circumstances or injury). I am looking for info on dopamine loss and adverse reaction drugs.Has anyone done any scientific research on any of the following drugs which were given together(at the same time):Reglan(a dopamine antagonist),Ranitidine(HCL),Sulcralfate,Baytril ,Valium and increased insulin(dog wasn't eating,but there was vomiting and diarrhea after drug medications).After the first drug combination the dog also experienced seizure like activity and later at night what appeared to be a grand mal seizure and was given valium.The following morning all drugs (except Valium) and increased insulin were given again.The dog became comatose and remained so until I arrived and asked for corn syrup (approx.1.00 -1.30 p.m. I brought him around and asked for water .He was extremely thirsty but had difficulty getting it as his mouth was stiff and pointed. I got him sitting up but he was extremely weak and did everything possible to try sitting.He was like he was drunk.His head was flattened on one side from lying on it and the eyes were wide open with an upward stare. He had gone from 8k down to 1.8k over the 4 days.(no food ,but lots of drugs and vomiting and diarrhea.) An hour later he tried to take a few sips of clear soup but was too weak.He took a fit and I asked a student to get the vet because he appeared very still and lifeless.He was dead. I have read info with regard to Reglan being toxic in an animal pretreated with an MAO inhibitor and have also found a warning on the internet about giving it to small children.There are precautions in drug books also. I always found his blood glucose elevated after Baytril.When the hospital gave him Baytril his glucose went up to 22 and they increased his insulin even though he wasn't eating .They also had changed the type of insulin.He was on a 40 i.u.before admittance and they changed it to a 100 i.u. insulin(which when previously tried on him made him lethargic).They also thought that they were giving him one half of his regular dosage.I do not believe that 3.5 of a 100i.u. insulin is the same as one half of a 40 i.u. insulin which he was receiving at home. They were also jumping from one insulin to another(NPH,Lente and Ultralente) The medical society has informed me that drugs given were within acceptable standards.Due to the severity of his case they had to try to stablize him. It is my felling that they did not treat his cushing's disease and gave him the incorrect insulin.By doing what they did I feel that they gave him drugs that increased the cushing's disease symptoms ,increased his ACTH which drove his glucose higher causing increased vomiting,diarrhea and eventual seizure ,coma and death.Since there was no food intake I also feel that he was living on his body's toxic fat which also contributed to the enormous weight loss and toxicity . His reports show his tests after drugs on the third .Many of the cushing disease symptoms appear there. I would like to get any info on anything relating to this type of case.I also would not want anyone else to experience this trauma. E.C
A: I am sorry to hear of the loss of your dog. I don't think I can answer all of your questions but can help with some of them.
Enrofloxacin (Baytril Rx) will react in some cases with sucralfate but in this instance the sucralfate interferes with absorption of the enrofloxacin and lowers the antibiotic's blood concentration. I have not heard of an interaction between enrofloxacin and blood glucose levels but this does occur with some antibiotics and falsely elevated levels appear in some instances when antibiotics are present in serum being tested for glucose. We have had difficulty with this problem in evaluation of diabetes when using cephalexin in diabetic pets.
Sucralfate is not absorbed well from the digestive tract, so most of its actions occur at the local level in the GI tract. It can decrease the absorption of several medications (including Baytril) so it is usually used several hours before or after administration of these medications.
Metoclopramide (Reglan Rx) is used for its ability to stimulate intestinal activity and to decrease vomiting. The method of action for the decrease in vomiting is probably dopamine antagonism. It may cause extreme hypertension in patients with pheochromocytoma (this is a cancer that is an unusual cause or concurrent problem in some cases of Cushing's disease in dogs) but patients with this problem seem to be prone to sudden death even without drug interference. It is very difficult to tell if pheochromocytoma is present (it is an adrenal gland tumor) without computerized tomography (CT) or magnetic resonance imaging (MRI). Metoclopramide may increase the absorption of diazepam (Valium Rx) from the small intestinal tract but probably not sufficiently to cause toxicity problems. It is also possible that metoclopramide would enhance the sedative effect of diazepam (or vice versa). Despite this, I can not find any warnings in the pharmcological references about using these medications concurrently.
I had a hard time following two parts of your note. It seems almost impossible for him to lose 6kg (13 lbs) of body weight in four days but that was the only interpretation I could make of the change from 8k to 1.8k. Perhaps I am misinterpreting this.
On the insulin dosing, if 0.35cc of U100 insulin was given, that would be 35 units. If 0.5cc of U40 insulin was given, that would be 20 units. If there was this much difference in the dosing then insulin shock does seem like a possible problem but there may be labwork supporting the need for the change or suggesting that it did not have an effect since you didn't mention low blood glucose in the labwork. I don't understand dosing with differing types of insulin except that changing from U40 to U100 of the same type of insulin should have no effect if the dosage is adjusted so the units are the same.
If you continue to believe that there was a medical error the best advice I can give is to contact your state board (I am not good with internet addresses -- I am hoping you live in the U.S.). They have the authority to review these cases and to take action if it seems appropriate. It is also a good idea to take your concerns to your vet and discuss them, if this is a feasible option. Ultimately, everyone gains if the research and discussion leads to a deeper understanding of the situation and it may help prevent problems for someone else or help you to resolve your concerns which would also be a good and important outcome.
Mike Richards, DVM
Ehrlichea
Q: We have just been informed by our vet that our dog (a black lab mix) has ehrlichea. We found this out because we were having her tested to try to find out the cause of seizures she was having. How successful are the antibiotics usually used to combat this disease? Where can I find out more info on the disease? Any help would be greatly appreciated. Thank you, Glen
A: Glen-
Tetracyclines, especially doxycycline, seem to be very effective for ehrlichiosis. Once in a while there is a recurrence of the condition despite apparently successful treatment. I hope this was the cause of the seizuring but suspect that it was not -- you may need to continue to treat that problem separately. Your vet will work with you that, I'm sure.
I'm pretty sure we have information on ehrlichia in our Dog Information area.
Mike Richards, DVM
Chest Trauma
Q: hi. i have a 12lb Pekinese that was just hit
by a car.the vet said that she has no internal bleeding but she has chest
trauma. she is gasping for breath and is very brusied.she is in alot of
pain.can you tell me how serious chest trauma is. the vet said we will
just have to wait and see if
she pulls through,but the wait is so hard.my question is are there
an symptoms that would indicate if this will be fatal.she has cracked vertebrae
in her back but no broken bones.she has been gasping for breath for 24hrs
now.i feel she is in bad shape. the life is gone from her little eyes.i
am
looking for some sort of answer if she could die from this. can you
help?
thank you
Tammy
A: Tammy-
I wish that I knew a good way to predict the outcome of chest trauma other than just waiting and seeing what happens but I do not. Most dogs do OK if there is not hemorrhage or air leakage from the lungs into the chest or a tear in their diaphragm, all of which show up pretty well on X-rays. Sometimes it is necessary to retake X-rays several times in the first 24 to 48 hours after chest trauma to be sure that air leakage is not occurring or that bleeding has not started, since both problems can occur for several hours after the initial trauma. Some dogs that I really thought would be fine have developed problems during the first day and some dogs that I really thought had little chance of survival are still coming in to the clinic years later.
I am hoping that you know more by now and that Gizmo is doing much better.
Mike Richards, DVM
Pancreazyme and Viokase
Q: Dear Dr. Mike,
I just subscribed to your newsletter and I look forward to recieving it. In the meantime I have a question regarding an enzyme product. Are you familar with viokase or panrezyme? Both products contain lipase, protease, and amylase. Is there another enzyme or ingredient you would suggest including that would improve these products? Or are you aware of any research addressing this topic? Any help or suggestions would be greatly appreciated.
Thank you,
Lisa
A: Lisa-
Pancreazyme (Rx) and Viokase (Rx) are approximately (or possibly exactly) the same product. Both are pancreatic enzyme preparations made from porcine pancreatic tissue and they do contain protease, lipase and amylase. These are the major digestive enzymes produced by the pancreas and the product is meant to be a replacement for these enyzmes in dogs that are not producing adequate quantities on their own. The powder form of the products is generally considered to work better than the tablets. The enymes do best if they are mixed with the food about 30 minutes prior to feeding.
If pancreatic insufficiency is the only problem that a pet has it may not be necessary to use any other products in conjunction with a pancreatic enzyme replacement. It is often necessary to adjust the amount of the powder used and it can take more than the label directions call for to achieve the desired effect. Some vets feel that the enyzmes are less likely to break down in the stomach if cimetidine (Tagamet Rx) or another H2 antagonist is used try to reduce the acidity of the stomach environment.
In many instances dogs with pancreatic insufficiency suffer from a number of other problems and it is often necessary to use medications to control the concurrent problems to get really good control of the diarrhea, weight loss and other problems that occur with pancreatic insufficiency. A particularly common problem is bacterial overgrowth with undesirable bacteria. It may be necessary to control the bacteria with an antibiotic like metronidazole (Flagyl Rx), tylosin (Tylan Rx) or sulfasalazine (Azulfidine Rx). When bacterial overgrowth occurs there can be a decrease in Vitamin B12 absorption and supplementing B12 may be necessary. If the pancreatic insufficiency is associated with inflammatory bowel disorders (IBD it may be necessary to use an immunosuppressive agent such as prednisone or azathioprine (Immuran Rx) to control the IBD.
Some veterinarians prescribe pancreatic enzyme supplementation for conditions other than pancreatic insufficiency. This is most commonly done in cases of chronic diarrhea or digestive disorders when nothing else seems to be helping much. Some vets use a product that is a mix of vegetable origin enzymes (Prozyme TM) that is reported to be helpful in a number of vague conditions such as poor haircoat, weight loss, chronic illness, etc. This is less expensive than the pork origin pancreatic enzyme supplements. If something like this is the reason your dog is on pancreatic enzyme supplementation the best approach would be to continue diagnostic efforts until an underlying cause for the symptoms seen can be identified and treated. If Prozyme seems to help during this process or as a maintenance medication then it may be continued, obviously.
If you need more specific literature references I can try to find some for you.
Mike Richards, DVM
Holiday problems
Q: Hi Dr. Richards -
I'm just about beside myself.... I went to the "Dog Pound" to rescue a puppy for my children (11 & 12)... I ended up with two darling puppies...
It wasn't bad enough that I'm now housebreaking 2 puppies, had to have both vaccinated and wormed ($$$$$), now my Australian Shepherd is coughing and it sounds like croop. He has all the symptoms of Kennel Cough, but last night, he chewed up my Christmas Twinkle lights and I'm afraid he may have glass in his throat, since he wasn't coughing before that. I owe the vet $70 dollars from my initial visits just last week and I REALLY can't afford to go back unless it's absolutely a necessity ! How do I know if it's Kennel Cough or Glass ? If it's glass, what can I do to help my poor puppy..... he could have eaten as many as 3 twinkle lights, and he chewed the wires completly in two!
HELP ! PLEASE !!!
Rhonda
A: Rhonda-
Every Christmas at least one of my patients eats a Christmas tree bulb or eats the lights off the Christmas tree. So far, in 19 years, not one of these patients has suffered any discernible ill effects. On the other hand, about 5% of the dogs that are adopted from the local humane society come down with tracheobronchitis (kennel cough). So I would say that the odds are very very much in your favor that this is kennel cough and not a problem from ingesting glass. If your puppy stops eating or begins to drink water excessively you should have him checked. Not eating can occur with kennel cough if pneumonia develops as a secondary complication and would almost certainly occur with esophageal inflammation which would probably occur if ingested glass did cause lacerations or problems.
Mike Richards, DVM
Vision Problems
Q: Dear Dr. Mike,
After leaving our dog outside during the school day (the weather was
nice) we returned and found that she kept her eyes closed when brought
into the house? Maybe something with the bright snow?? She is about
4yrs. old (mix large Beagle?) We plan to leave her inside and hope this
helps?? Please send some advice ASAP ? Thank You
Sincerely, Rich Hurley
A: Richard-
If your dog continues to hold her eyes shut you really should take her to your vet tomorrow if possible. I have not ever encountered a situation in which bright light made a dog keep his or her eyes closed very long after the light source was removed. It is possible for the retinas to be damaged by light and I think that there are cases in which people experience "snow blindness" so I guess it could occur in a dog but it would be unusual. Almost anything that can seriously irritate the eyes can make a dog hold them shut. It would be a good idea to find out if that is going on if she keeps holding her eyes shut.
Mike Richards, DVM
Greyhound Problems
Q: Dear Dr. Mike,
I live in a town where greyhounds are not very popular and vets are
not familiar with their breed. I am desperate for information on my greyhound
Bodie. I have adopted 3 greyhounds (the first died after only 1 year 9
months to leukemia). My 2nd one is having problems with creatinine levels.
He is at 2.9 right now and my local vet said that is normal in greyhounds
because of the high protein foods they were fed on the track! I have a
hard time believing this. I am still dealing with my 1st loss and now this...
My 3rd greyhound has skin problems and it seems that these poor creatures
are so abused that they all come with problems.. I love these "kids" so
much. Is there anything I can do?
A: Steven-
I do not qualify as a greyhound expert, either. I have treated a number of rescued greyhounds over the years but have not encountered all of the problems that seem to be common among them.
Greyhounds are fed a diet that is high in meat, and thus protein, when they are used for competition. This seems to cause some problems. Often, rescued greyhounds have moderate to severe periodontal disease which takes some time and effort to correct. While the greyhounds are on this diet it have been reported to cause a rise in serum urea nitrogen (SUN or BUN) and creatinine. The diet also may be a potential source of E. coli bacteria which seem to be the cause of a problem seen in greyhounds that is variously known as cutaneous and renal glomerular vasculopathy, Alabama rot, Greenetrack disease and probably other things. Dogs with this condition have skin sores that are reddened and swollen and may occur currently with kidney disease. Most dogs that just have skin sores can be nursed through the problem with persistent care. There seems to be some disagreement about the benefits of antibiotics since the effect is probably due to a toxin formed by the bacteria rather than bacterial growth but vets that deal with this a lot seem to favor using them. Fluid therapy, careful cleansing of the skin lesions with antiseptics, monitoring kidney function, improving the diet and general hygiene all seem to be helpful. Greyhounds seem to get dehydrated pretty easily and that may also contribute to the tendency in them to appear to have elevated BUN and creatinine levels. If dehydration is the cause of elevated lab values rehydration should correct them. Just like you, I have a hard time ignoring elevated creatinine levels even in a breed that is has a tendency towards having elevated levels. I would want to at least determine the specific gravity (SG) of the urine on several urinations. If a dog can elevate the SG above 1.030 it is very unlikely that it has renal failure. If it can't concentrate urine then chronic renal failure is much more likely.
Hopefully, Bodie will have the ability to concentrate urine and you will be able to relax a little about the creatinine levels.
Mike Richards, DVM
Demodex
Q: Dr. Richards, Sorry to bother you about this problem as I can see from your web page it is a hot topic. I have an eight month old German Shepard who has been diagnosed with this. It is under his chin and is about 3" in diameter. Two weeks ago it was 1 1/2" in diameter. I have been putting Goodwinol ointment on it religiously and my hand keeps getting hair on it leaving me to believe that it is still growing. I have temporarily taken him out of the local schutzhund club hoping that was the major stress. All those dogs intimidate him immensely. I was also thinking that maybe I should increase his food. I have been trying to keep him lean because it was my understanding that too much weight is harmful to their hips as they grow. I feed him 4 cups of Nutros Lamb & Rice puppy.
Is it normal for the spot to keep getting bigger? The skin seems thicker in the area and is still red. I can see that the outlying areas are beginning to lose hair as well. It is in only one location presently. Is this something that could be mis-diagnosed? He has had a hot spot previously, however, this isn't one because that is how I treated it initially before consulting a veterinarian. When should I give up on the ointment? Any specific name brands of shampoo I should buy? Should I H2O2 the area before applying the ointment? I was thinking that maybe I helped in the spreading by using the ointment on a larger area than infected. Kind of like spreading poison ivy. I want to get this under control fairly quickly if possible. Thanks in advance , Chip
A: Chip-
If you are not going to breed your dog (if he is neutered, preferably) then the quickest solution to the problem of demodecosis is to treat with a amitraz (Mitaban Rx) dip. This will kill the mites most of the time and it is the only approved medication that is effective at killing Demodex mites. If you do plan to breed him, you should not treat the mites. If he is intended for breeding it is important to find out if the mites will spread to become a generalized infection prior to treatment. The reason is simple. Localized demodecosis, such as your dog is currently experiencing, is probably not hereditary. If the mites spread and become generalized there is a very strong possibility that the underlying cause is hereditary and it would not be a good idea to breed your shepherd. The only way to find out which problem is present is to wait and see what happens. It is fine to apply Goodwinol ointment (TM) in the meantime, since it doesn't do much and won't affect the outcome. I usually just skip local treatment since not using a local medication works just as well, though.
It is pretty unlikely that this is a misdiagnosis. Demodex mites are easy to find on an examination and the description of the lesion is pretty typical for these mites. If you wish to be more certain you might ask your vet about referral to a veterinary dermatologist but that is probably unnecessary.
The good news is that 80% of the time localized demodecosis will clear up with or without treatment. The bad news is that it is a bad problem if it spreads and becomes generalized. Even then it is usually possible to control most infestations satisfactorily with proper medications.
Good luck with this.
Mike Richards, DVM
Pancreatitis and Diabetes in Schnauzer
Q: I have a 7 year old miniature schnauzer that has been having abdominal pain for about 9 months. He was diagnosed with diabetes about a month after the time he started having the abdominal pain. He does not have any problems with vomiting and other than the pain which occur early in the morning and late at night is a very playful dog. My dog has been on the chunky side since he was a pup and has had more than his share of table scraps. My Vet thinks that he has hyperlipidemia and has put him a special diet of Hill's r/d prescription dog food. He has been taking Rimadyl for pain and just recently my Vet has recommended Tagamet also. From what I have read about pancreatitis it sounds like my dog may have it. I understand that the hyperlipidemia may be causing the pancreatitis which may have caused the diabetes. My questions are: (1) Is this Pancreatitis? (2) Is this the right treatment, I do understand that his condition is complicated by the diabetes. (3) Do you think the Tagamet will help (4) If the pancreatitis, if that is what it is, is cured what are his chances of overcoming his diabetes? Any information/advise that you can give me is very much appreciated.
A: M- I think that pancreatitis has to be considered as a possible cause of chronic abdominal pain in a schnauzer because this breed has a known risk for this disorder. It is unusual for it to cause continuous pain so I might be tempted to look in another direction if this were the case. Episodic pain would definitely make me want to try to rule in or rule out a pancreatic problem in this breed.
Controlling the hyperlipidemia is the correct approach and r/d diet is often used for this. I am not sure whether cimetidine (Tagamet Rx) will help much but it isn't likely to hurt and there is a chance it will help some. Some veterinarians advocate using niacin administration to help lower lipid levels in the bloodstream. I do not know how successful this treatment might be.
It is highly unlikely that successful treatment of the source of abdominal pain, whether it is diabetes or some other cause, will help much with the diabetes. A reduction in stress levels might lower the insulin dose that is necessary a little bit but I would not expect the diabetes to go away.
I hope that this helps some.
Mike Richards, DVM
Lumbosacral instability in German Sheperd
Q: To anyone that could help me with a German Shepherd: My dog is about eight years old and full of energy. Unfortunately he was diagnosed with something called Lumbo Sacra Instability. At this time, he is dragging both of his rear legs. My veterinarian suggested that I should put him to sleep. I am trying to find out if there is anything I can do to help my dog, or if it would be better just to put him to sleep. I would appreciate any comments or suggestions. I love my dog and I want the best for him. Thanks for any help Gustavo.
A: Gustavo- There are surgeons working on surgical solutions for neuomuscular problems associated with lumbosacral instability and I believe there has been some success. It would be really important to rule out degenerative myelopathy as a complicating factor prior to considering surgery, though. This is a degeneration of the spinal cord that is a problem in the German shepherd breed. If you wish to prolong your dog's life and allow him to remain somewhat active despite paralysis you may want to consider using one of the carts made for dogs with rear leg paralysis. We have contact information for the companies that make these on our site or you may email Michal at yomike@inna.net and she can provide phone numbers or addresses.
Mike Richards, DVM
Demodex or red mange in Yorkie
Q: Dr Mike, I have a yorkie that I recently took to the vet. She had little sores up and down her spine at first I thought it was from my other dog biting her when they played. This really got worse right after I had her groomed also its only been about two weeks since I put this flea medication on her back. My vet says it is red mange, he did a skin scrape off her back. Don't notice this on her face. Could he be wrong? Should I consult another vet? The woman I bought the dog from says she took the mother dog to vet and she doesn't have this. Dog is now 6 months old. Please E-mail response Much appreciated Thank You, Sherrie
A: Sherrie- Demodectic mange is also known as red
mange. If your vet is using the term red mange to describe demodecosis
and not some other form of mange it is pretty unlikely that he is wrong
about the diagnosis. Your dog is in the right age range for this problem
and it does
sometimes start in other areas than the head (although head/face is
the most common initial spot to find problem with Demodex mites). Since
Demodex mites are a normal inhabitant of dog skin, it is necessary to find
bald spots and to find at least some evidence of juvenile mites to confirm
the diagnosis of demodecosis. You might want to ask your vet if he found
all adult mites or if juvenile mites or mite eggs were noted as well.
If you need the reassurance of a second opinion (there is nothing wrong with that), then do get this confirmed at another veterinary hospital or by asking your vet to check again, just to be sure.
Mike Richards, DVM
Sarcoptic Mange
Q: Dear Dr.Mike, I haven't heard from you yet,I know your busy,but I took Dakota to the vet yesterday because she is still itching!!! I guess she doesn't have pyoderma afterall. She had a skin scraping and was diagnosed with "skin mites". I am leaving for vacation soon and my mother-in-law usually takes her for us. My question is, is it contageous? The substitute vet at my place said the shot she gave her should take care of them.It was Ivermectin 1%. She also said humans can itch also! What about my cat? Should I be cleaning with something special? Are they in my rug? Truthfully my husband took Dakota and I had all these ??? for him and of course,"he didn't know and didn't ask". Which is par for the course. Anyway any help you could give me would be great!!!!! Thank - You, Kim
A: Kim- We were unprepared for the popularity of our site. The email volume is overwhelming since I also run a veterinary hospital fulltime. At present I am still trying to answer all the email, although slowly, but we may have to give up on this and concentrate on providing information online. For now, I'm just hoping to be able to catch up as winter slows the practice volume down!
Your dog probably had sarcoptic mange. It is contagious to people but the infection is self-limiting -- meaning that it will go away on its own. The sensation is probably about the same as being allergic to chiggers -- miserable but short-lived. As far as I know, this condition is not contagious to cats. It usually responds very well to treatment.
Hope all is well now.
Mike Richards, DVM
Vomiting blood
Q: I have a question about my dog. She's 3 years old and for the past day she has vomited blood 7 times. Later this evening when she had her bowel movement, she excreted blood. What should I do? I went to a clinic but they have no idea what the problem is. I currently live in Korea. She has no fever and is breathing abnormally. She shutters each breathe like the people breathe after sobbing for a long time. Please respond very soon. Thank You. Jay
A: I am sorry that it is not possible for us to respond on an emergency basis. I honestly don't know what to advise since you have already had your dog examined by a vet, though. Vomiting blood can occur with gastric ulcers, with damage in the lungs, in bleeding disorders (including poisoning with anti-coagulant rat or mouse poisons) and from tumors or problems in the upper respiratory tract, lungs, esophagus or gastrointestinal system. There are probably a number of other causes as well. The best thing I can advise is returning to the clinic for a re-evaluation or trying another veterinary hospital for a second opinion.
Mike Richards, DVM
International flight regulations - Rabies Vaccinations
Q: Dr. Moe, Absolutely love the web site - highlight of my day is reading your latest letters!!!!! Question, I am moving to the USA later this year from Australia, and plan to bring my Australian Cattle Dog X with me. She has had all vaccinations here, except rabies of course. Should I find a way to give her rabies vac. before she even leaves Aust. - or is a vacc. on arrival in the US sufficient? I am assuming it needs about a 30 day lead time for her to be fully protected, but I really don't know. Also - will she need booster shots one month after like with puppy vaccinations - or is it just the one off every year? Thank you very much for your help (yet again!) Carla
A: Carla-I would check with your vet in Australia in regards to air travel. I am almost certain that most airlines require your pet be vaccinated for rabies before flying and I believe your pet needs to be vaccinated before she arrives in the United States. There are certain regulations for international travel and these are different from country to country but your veterinarian should be able to find and fill out the necessary forms.If your veterinarian is unsure of the regulations, you may want to contact the American Embassy - they should have the information. I think the regulation states that the rabies needs to be given within a year from the date of travel so 30 days before departure for the rabies vaccination should be sufficient. Most international forms need to be filed sooner than 30 days but again, you will need to check on that to be sure. The rabies vaccination is good for one year if given to an animal under one year of age or is the first one the animal has received regardless of the age. Vaccinations after that are either annual to every three years depending upon the state you reside. The veterinarian in the state you decide to settle will know.
Moe Richards DVM
Lump in neck -Malamute
Q: I have just noticed that my mixed Malamute/Chow has a lump in his neck. He is 10 years old. I noticed it two days ago, and it seems to have gotten a little bigger. My question is, would worming dogs cause this problem in their glands. We just finished his doses for worms (I think its called Panacure). He seems to act normally, the hot weather has gotten him a little sluggish, we also recently sprayed him for ticks and fleas. I'm afraid all of the chemicals may have made this knot appear or maybe its something worse. Anything you could tell me would be appreciated. He is a great dog.
A: Cheryl- I have not heard of lumps or lymph node enlargement occurring after dosing with fenbendazole (Panacure Rx). I am pretty sure that something else is happening to cause the lump. We see a fair number of sebaceous cysts in Malamutes (these are a lump that occurs due to sebum (skin oils) collecting under the skin). If your dog was vaccinated at the time of the deworming a reaction to vaccination causing a lump is possible, too. I am sure you have probably had this checked out but if not and if it is still present it would be best to do that.
Mike Richards, DVM
Adding another dog
Q: Dear Dr. Mike: First, I would like to say thank you for the site, since I was able to access information when my cat Charlie had a severe episode of vomiting. I found out enough information to convince me to call our vet. After three days of sleeping, Charlie is fine, except he now comes right back in the house if he pulls one of his escapes--despite supervision and a "pet-friendly" neighborhood, he obviously got into something. My question: We have, in addition to two cats, a three-year-old lab/something/maybe shepherd mix. He is intelligent (and I am not just saying so because he is my pet) and has been through novice level in obedience classes. He also is ornery and mischevious and very, very playful; I sometimes think he needs more mental stimulation. He loves other dogs, our cats, and most people. We have the opportunity to get another dog who seems perfect for our situation; she is being fostered by another member of the humane organization to which I belong, so we know a lot about her personality. Would our dog benefit from having another dog in the family? Do most dogs benefit from this arrangement? Thanks, Diane P.
A: Diane- It would be hard for me to tell you that adding another dog to your household would benefit the dog you now own. Some dogs require alot of stimulation and would probably benefit from a companion, others are more content to have all of their owner's attention. Most dogs seem to like to have a "buddy" unlike cats which seem to be more content being loners but you know your pet better than anybody. You need to ask yourself first whether or not you want to take on the responsibility of another animal and the costs involved with that responsibility. If the answer is yes, then I would suggest you introduce the dogs on neutral territory to see if they get along first. Sometimes bringing another dog into the house will cause the dog already there to show territorial behavior even though there have been no signs of this type of behavior before. If things seem to go okay, then I would bring both of them home together so you are not bringing the "new guy" onto someone else's territory. I would make sure someone is around for the first few days to monitor the adjustment period since there will be an adjustment period for all involved. Hopefully things will go without any problems and both dogs will be happy (as well as you and your family). Good luck.
Moe Richards, DVM
Training dogs
Dear Dr. Mike: I have a dalmation/ lab mix dog that my husband & I took in. Long story. I have not been to this date able to find information re both breeds together. I have seen alot of suprising info re dalmation hip displyshia & seizures. If possible, can you recommend a book, video ect. so that we may be better able to take care of and train our beautiful dog with both breeds as a mix? We just found your web site, and we think it is wonderful!!!! Thank you for all your time and effort!!! Sincerely, Antoinette & Don
A: Antoinette and Don- I don't recall ever seeing a book or reference that discusses which traits are likely to predominate in dogs that are mixes of two purebreds of differing breeds. That is an interesting concept, though. I will try to see if I can find some information.
In general, mixed breeds are a little more likely to be free of genetic disorders since they are less likely to have a genetic influences that match from both parents. I think I'd still worry about problems seen in either breed. It is unlikely a mix would exhibit the tendency to bladder stones seen in dalmations but other breed problems are more likely.
Mike Richards, DVM
p.s. - I like the book "Raising A Puppy You Can Live With" by Rutherford
and Neil as a training guide.
Ornamental barley ingestion
Q: Dear Dr. Mike, My 2 year old aussie, Dill has been under the weather for almost 2 weeks now. We returned from a trip and the next day I purchased some ornamental barley from the area farmers market. Well, pieces of this fell to the floor and Dill loved it. Unfortunately, the sticky barbs from the top of the barley started to stick to her throat and she began coughing, gaging and vomiting. It got so bad that I had to take to the vet. He gave her two shots, one vetalog and another reglan. this seemed to calm her. A couple of days later she began drinking enormous amounts of water and urinating so often she sometimes couldn't wait to get outside. She rarely has accidents so I took her back to the vet and took in a urine sample. Although the dipstick test was normal, Dill was given and amoxycilam injection and we would wait until the next day for the results before starting the clavamox pills. Well, she seemed to be better, eating normally until two days ago. She vomited quite violently. I put her on a rice diet, and she seemed to be doing better. Today, she vomited again. Her stomach is making girgling noised and she refuses to eat rice. What do you think? I am worried about my little sweetie. Ann
A: Ann-I have not had a case of ornamental barley ingestion in my practice by there is a sticky form of milo that is grown in my area and we have seen one case of intestinal obstruction that we think came from ingesting the milo. I am hoping that an intestinal blockage was not present and that things are OK now.
Vetalog will sometimes cause severe increases in drinking and urinating and it is the likely culprit in that behavior. Unfortunately, intestinal obstructions also cause increases in drinking and urinating in some cases so that particular sign can be important despite the high likelihood of it just being a medication side effect. I know that the problems are resolved at this point, one way or another but this may be an important thing to remember for future reference.
Mike Richards, DVM
Heartworm treatment decisions
Q: Dear Dr. Mike, I have a 13 year old golden who tested positive for heartworm. I am unsure of which treatment to follow. I have been advised by one vet to minimize the risks by treating her with heartguard to kill the microphilaria and let the adult worms die over time and be reabsorbed in the blood stream. I am also contemplating having her treated with Immiticide. Although she doesn't exhibit the signs of a Class 3 dog with heartworm I think it best to treat her conservatively with one injection followed a month later with two shots 24 hours apart. Do you have any advice as to which method to try? She is otherwise healthy-blood workup was fine although xrays showed an enlarged heart. Also, as she is an older dog who is not especially mobile, is it necessary to keep her confined? If I did the three shot treatment would that mean keeping her confined for 10 weeks? I have scheduled treatment with Immiticide this Wednesday so if you read this and can get back to me before then it would be most appreciated. Sincerely, Steve
A: Steve- I am sorry this is coming too late to help in your decision but I strongly agree with the course of action you propose so I hope you went with it. Your dog's age does make this all more difficult to evaluate but we see goldens who live to be 15 not all that uncommonly and I would prefer to treat a patient in good shape otherwise, even at this age. Inactive dogs do not need to be confined as strictly as active ones -- it is a matter of being practical and remembering what the objective is. If the dog already acts like we want him to act (quiet, not likely to engage in short wind sprints chasing cats, cars, etc.) there is less reason to resort to caging, etc. to enforce rest. I always chose the three injection treatment with Immiticide (Rx) unless money is a very important consideration. Hope all is going well.
Mike Richards, DVM
Very ill Airedale
Q: I recently adopted a female airedale dog who is approximately 1 1/2 years old. She was sick when I took her home and her condition is only getting worse. I have taken her to 3 vets in my area and not one can give her a proper diagnosis. She has a severe eye infection in both eyes and has fluid coming out of her nose. She runs a fever of 104.5 and has no appetite. She does drink an accessive amount of water. She is also extremely lethargic and has had nose bleeds. Her throat is also sore. I have had her on a few different antibiotics and eye drops but nothing seems to work. The vet has given her injections of antibiotic that seems to work temporarily. Also, when I had the blood work done her white cell count was 20,000, when I took her back a week later to retest the blood work it went up to 200,000. But she still is sick if not worse. Some of her test results came back showing positive for rocky mountain spotted fever and is being treating for it. Most of the vets that have seen her suspect distemper but not one can give us a positive answer. The blood test did not show she has it. I don't know what to do, I have grown very attached to the dog and want nothing more for her to feel better. The first 2 vets I have taken her to say this is a very sick dog and suggested putting her down but how can I be sure that this is not something with the proper medication and diagnosis can be treated. I would appreciate any information or help you can give me. Thankyou! Leesa
A: Leesa- I think that Michal responded to your note after talking to me in the clinic but I did not have time to sit down and review your note until now. The three immediate rule-outs that come to mind are ehrlichiosis (a tick borne disease like Rocky Mountain Spotted Fever), a uterine infection (if she is not spayed) and fungal illnesses such as blastomycosis and coccidiodiomycosis. The fungal illnesses are more common in some areas of the country than others. We have seen a dog with a partial intestinal obstruction whose clinical symptoms were very close to those you describe except that he did not have nose bleeds. He did have a greenish tinged fluid that exuded from his nose on two occasions, though. Unfortunately there are a number of other possible problems.
A pretty good rule of thumb to follow is to consider asking for referral to a veterinary internal medicine specialist, veterinary college or large referral center when you have seen two or more local veterinarians whose opinions differ and the problem is not resolving. Please consider asking for a referral if this is possible and you have not done so yet, if you airedale is still ill.
Mike Richards DVM
Extended Boarding
Q: First a bit of background. I have a PBGV, the love of my life, who will be three in Sept. Buddy is a great dog, with me almost all the time. When it is too hot to bring him along, I leave him home, and, although he barks a lot when I return, he does quite well. I do secure valuable musical instruments, etc, and although he may get into some clothing, he is not destructive despite having pretty much the run of the house. Question. I am planning to be out of the country (SE Asia) for the better part of a month in Nov. I have previously boarded him at our Vet's kennel for 4 or 5 days and he did well. I will likely board him again, but am very concerned that with this length of time, Buddy may think I have abandonned him. I have tried to find views on this aspect of dog psychology but without success. I am aware the anxiety is very much my own, but I would still like to have some sense of how a dog reacts to this sort of separation. I wish I could tell him my being away is not permanent, that I will be back, etc. My thought is to do a few short boardings prior to my trip so he gets used to going and coming. Also to have family members see him during his board. Buddy travels well but obviously I can't take him on this trip. Any thoughts you have would be very much appreciated. Dr. Ross
A: Dr. Ross- We only have one petite basset griffon vendeen (PBGV) patient in our practice but I think that Buddy will respond similarly to other breeds. We have had several patients go through the long quarantines in Hawaii and in England. So far, all have done fine with no discernible long term effects and these are really long quarantines. Once in a while a dog does seem to develop separation anxiety signs after a trip to the kennel or an inadvertent stay at the humane society, though. The length of time doesn't seem to have much to do with that reaction. I am sure that often it has nothing to do with the kennel facility or staff but it is still important to check the kennel well in advance of leaving and to be sure you are happy with the choice. We have two very good pet sitters in our area and they will sometimes watch pets for extended time periods in the house. Some pets do better with this approach. It is even more important to trust your pet sitter, though!
I do think that Buddy will be OK based on the previous kennel stays working out fine. You probably have a good feel for the kennel now, too. You should ask your own vet, who knows Buddy better, too, though.
Have a good trip!
Mike Richards, DVM
Missing Heartworm pills - when to retest
Q: Dr. Mike: I live in an area that has lots of mosquitoes, so I have been giving my dog heartworm preventative medicine each month since she was a puppy. She's about a year and half old now. I give it to her on the 30th of each month, but I can't remember if I gave it to her on the 30th of June. What is the risk of skipping a month? Am I going to have to have her tested now, or can I just continue as usual with the monthly schedule? Thanks very much for your time. Patti
A: Patti- The monthly heartworm preventatives work to kill heartworm larvae that are 45 days or less in age and probably closer to 50 days. Since an every 45 day dose would be hard to remember and provide no leeway for error, the pills are approved for monthly use. We tell clients to give another pill if they are unable to remember if they dosed their pet and we can not help them determine if that happened based on our records (usually we can help in a single dog family but it is harder when several dogs are on the same pills in a household). We just check the dates the medication is sold and count pills from there. Administering another pill is safe if one was given at the beginning of a month because the medication is not time-release. It doesn't last in the body a month it just kills all the heartworm larvae that have accumulated in the last 30 days. It is pretty much completely cleared from the body in 72 hours. Since it takes 6 months for heartworms to develop to the age they can be tested for an immediate heartworm test is not necessary prior to restarting the medication. It is a very good idea to check for heartworms 6 months or so after a lapse in preventative medications, though. So the odds are with your that if a lapse occurred it will not cause significant problems. Try not to do that too often though!
Mike Richards, DVM
Exertional Myopathy
Q: I have a 6 year old lab/hound mix. He weighs about approximately 105lbs. 2 years ago he ran away and when we finally found him a few hours later he had gone approximately 5 miles. He had urine in his blood. When I took him to my vet she said he had a rare condition that is found in hunting dogs. She said they will not get any exercise and go out hunting and drop dead in the field. Since my dog does not get much exercise, she said his muscles began to break down and be processed through the kidneys. She only found one article on this and the only treatment option was an IV. He had pitted edema in his feet and was on an IV for 2 weeks. He leaked urine and wouldn't eat or drink. He is better now, although he developed diabetes insipidus. Do you have any additional information on this phenomenon? Should I worry about exercising him now? Thank you very much! Catherine
A: Catherine- There are probably several possible problems that could be affecting your dog. Exertional myopathy is probably the most likely -- which is pretty much what you describe. It occurs most frequently in out of condition (unexercised) dogs who suddenly are forced or choose to exercise excessively. They seem to do OK during the exercise in many instances but then later in the day or the next day become very stiff and sore. A breakdown in muscle is occurring and the by-products of this produce red to reddish brown to reddish purple urine. Some dogs will die from this condition. Prevention is best accomplished by building up to a regular moderate exercise program -- or by making sure the dog doesn't exercise excessively suddenly. I am not aware of a specific therapy but intravenous fluids and anti-inflammatory medications are probably a good idea.
Labrador retrievers have a muscular weakness disease that can be exacerbated by exercise. I don't recall there being urine changes with this condition but I have only been suspicious of it once or twice. This condition can be tested for if it seems like it might be a possible problem to your vet. There are several other diseases in which myopathy is possible but all are pretty uncommon.
I am not aware of a connection between any of the myopathies and diabetes insipidus.
Mike Richards, DVM
Vaginal Hyperplasia or vaginal tumors
Q: Dear Sir, My dog is only 2 1/2 years old. She is medium size and a mix. I had her spayed in February because she had 3 litters in a row. On the first time she had 5 pups. On the 2nd time it was 6 pups. The last time in September 1996 she only had 2 pups. Since a good 2 weeks now she has this big red lump in her Vulva. My vet said that the has contracted a virus that makes the vulva grow cancerous lumps. He says that he might be able to cure her. He injected into the vein a chemical. That is supposed to shrink the cancer. he did that this Tuesday but nothing has happened. I think that it is the same. She looks real terrible with this red lump sticking out like that. Flys and other insects also settle on it. My question is : Can it be really cured, does she have pain and how long can she live with that desease? Thank you in advance for answering my mail, Daniela
A: Daniela- I am not aware of a medical treatment for vaginal hyperplasia or vaginal tumors. That does not mean that there is not one, especially since you are in another country -- medication availability varies widely due to different licensing requirements. I hope that this situation is improving. If not, it might be a good idea to get a second opinion on it if you can.
Mike Richards, DVM
Dysautonomia
Q: We have been to 2 different vets in the past 3 months ,which cost almost $1,600.00.,including blood work to test for everything , but mainly for a possible thyroid problem,X-ray's,E.K.G. test, and an ultrasound .All we found out was that he has an enlarged heart, border line thyroid gland problem, and he is a little over weight.so he's been on thyroid meds.and a special diet for a month now with out any improvement. HIS SYMPTOMS ARE: 1.he has no energy at all will not even go in the sun 2.dry mouth 3.short of breath 4.bad breath 5.diarhia 90% of the time 6.there are also several very strange mole type things growing on him very quickly in various places (back,leg.chest,& chin 7. very cloudy eyes. I have had beau for about 7 years, I will do anything for him, I just want it to make him well. I would be grateful for any insight you might have . THANK YOU
A: James- I think I would be suspicious of dysautonomia with the signs you describe. This condition is being recognized in dogs more and more frequently in the last few years. I have been trying to locate a recent article on this that I read but have been unable to find it, so I am not able to provide particulars on diagnosis and treatment at this time but will try to follow up with more information when I get it.
Mike Richards, DVM
Panniculitis
Q: Our friend was diagnosed with "granulomatous panniculitis" and is currently being treated with steriods. However, our vet has never seen this condition before and is unable to tell us the specifics of it, such as what causes this condition and how do we prevent it from reocurring? Perhaps, you have some information on this condition. Thank you.
A: Hip-Panniculitis has a number of possible causes. I have not seen the designation "granulometous panniculitis" but am assuming that the possible underlying causes are the same. This disorder can occur for no discernible reason and that may be the most common "cause" but all of the following problems have been considered to be the initiating cause in at least a few dogs; trauma, infections, lupus, drug reactions, Vitamin E deficiency, lymphoma, vasculitis, and thromboembolic disorders. If the condition has not resolved, it is important to eliminate each of these disorders as a possibility and to treat any that seem likely to be present.
If an underlying cause can not be identified it may be necessary to use corticosteroids long term to prevent recurrence. Some dogs may respond to Vitamin E therapy on a continuous basis, as well.
Mike Richards, DVM
Rubbing gums/teeth
Q: My dog rubs his teeth/gums on our blankets - what does this mean?? He is 11 months old his gums are changing colors from pink to pink/brown. Is this normal? He also has a dried sore spot on his lower back - just before his tail. He is always chewing at it. What can we do about it? Thanks for you help.
A: Patricia- Both of the signs you describe can occur with atopy (inhalent allergies) and could possibly occur as the result of flea allergy as well. There may be two problems -- a combination of problems such as anal sac inflammation leading to chewing or rubbing over the tail and gum disease or other oral problems, as well. The best thing to do is to get a vet exam if you haven't done this already.
Mike Richards, DVM
Rabies vaccination schedule and diet plan
Q: Dear Dr. Mike I have a wonderful 4 month old dalmatian puppy named Patch. He is going to be neutered when he is 6 months old. My regular vet wants to wait until he comes in for neutering to give him his rabies vaccine. I have another vet that I use in emergencies when my regualr vet isn't available and he says that the rabies should be given at 3 months. What is the correct time frame for this innoculation? And are there any problems with giving this shot early? Shortly after acquiring Patch, I found out about the dalmatian tendency to form urinary stones. I am feeding him Nutro's Optichoice Puppy Food (chicken and rice) and plan on moving him to Nutro's Natural Choice Chicken and Rice food when he is 1 year old. I have recently switched my 8 1/2 year old cocker spaniel to this food because of skin problems and he is doing very well now. Is there anything else I should be feeding the Dal or doing to try to prevent him from having this problem? I would like to feed them the same thing when the puppy is an adult, but I also think it's more important to do what's right for each of them. Thank you very much, Cindy
A: Cindy- Rabies vaccination should be done between 12 weeks and 16 weeks of age.
I do not usually recommend altering the diet to try to control urinary stones in dalmations until after they occur once -- because the diets sometimes cause problems, too. So I would use a diet you trust and adjust it if necessary later.
Mike Richards, DVM
Small wound healing time
Q: My dog has a wound about the size of a dime on the back of his neck. I don't know how he got it. I washed the area with soap and water. How long, on average, does it take a dog to heal a small wound? Should I be doing anything else?? Thanks for you advise.
A: S- The time it takes a wound to heal depends a lot on where the wound is and what caused it. A burn takes a lot longer to heal than a surgical incision, for example. Some cancers resemble wounds and will not every heal without being removed.
A clean, traumatically induced wound on the back over the muscles will usually heal a little faster than a similar wound directly over the spinal column. A laceration that is clean and about the size of a dime will usually heal in one to three weeks if it is kept clean and does not become infected. If this wound is still present, please take your dog to your vet.
Mike Richards, DVM
Shaking and panting spells
Q: I have a one and one half year old female shelty/terrier. During the last month she has developed spells of shaking, followed by heavy panting. Other than this, she appears fine, and is still active and very affectionate. She has always been a dog who gets frightened easily, and we felt this might be the cause, but it seems to be happening even when she has nothing to be frightened of. She does look "distraught" during these incidences, and does go to a family member for comfort. Holding her and talking to her does not seem to stop the shaking. Can you give me any ideas on this? I do not have a great deal of money and would like to avoid a vet trip, unless, of course, this could be something serious. Thanks! David
A: David- I am sorry but I can't think of any one specific thing that might make your dog do this. Terriers have some myopathy/tremoring type diseases and perhaps one of these is possible. Many other conditions seem possible as well. If this problem continues it does seem to me that it would be best if you took your dog to your vet.
Mike Richards, DVM
Possible heat stroke
Q: Dear Dr. Mike, Hope you can help, our female german shepard recently ran away during a very hot and humid time. Someone finally found her and we immediately went to pick her up. She has lost a lot of weight. Upon finding her we gave her a jar of baby food as well as water. Someone had fed her and given her water. Her appetite seems never ending she is also drinking plenty of water. But she is shakey on her feet and also seems to have rapid eye movement. Could this possibly be heat stroke? She has improved in the few hours we have had her home. She remembers her commands and has gone outside to go to the bathroom. We decided to wait 24 hours before calling the vet. Do you have any suggestions not only for me but other pet owners who have found their lost animals in not so good shape. Thank you
A: Kevin- I hope that your shepherd is OK. My best advice on this situation is to always seek veterinary assistance whenever heat exhaustion or heat stroke seems possible. Even though most dog will do OK, there are many that will develop secondary problems. The most serious being blood clotting disorders that lead to death. This is a time to be cautious. I do hope all turned out OK, though.
Mike Richards, DVM
Severe digestive problem
Q: Dr. Mike....we are desperate for any suggestions you can offer ! We found a couple in Oklahoma that needed a new home for their teacup poodle as the dog has a history of problems and they couldn't find any help where they live. The dogs name is Lexi and she is a toy - teacup cross. At 5 months old, her colen came out of the rectum and the vets attached it to the stomach to keep it inside. This so far has worked. This procedure was done in September of 96 and in April of 97 she started vomiting all the time and losing ALOT of weight. She seemed to always be sick with little infections and fevers. When we got her in June of this year, she had a skin condition that made her look like she had been swimming in oatmeal and she had a sevearly infected mouth with blisters on her lips and basicly all over her body. My usual vet didn't seem interested in her case so I took her to another vet. This vet has diagnosed her skin to be Staph infection and has it almost cleared up with many meds. Her mouth seems alot better now and she is gaining weight. ( or retaining fluid) we are not sure. The major problem still is the vomiting and messing in the house which has got worse since we got her. She is only 11 months old and VERY sweet ! We feed her as if she definately has megaesophagus, but she still vomits unless she stays still. It doesn't matter how long after she eats, she still gets sick if she has even a small amount of movment. Can you offer any advice ? We are at the point that we think she may need to put her down, but really hate the thought of that as she is soooo good and very sweet and also sooo young. Thanks !
A: w- In a dog in which previous colonic or intestinal tack-down procedures have been done it seems like it would be a really good idea to see if your vet would do a radiographic study using the new BIPS capsules which are impregnated with a dye to make them show up on X-rays. Quantifying the time it takes them to clear various areas of the digestive tract could give a lot of insight into the problem you are having.
Mike Richards, DVM
Hip replacement surgery
Q: My 7 year old German Shepherd/Husky has developed arthritis in her left hip due to hip dysplasia. No vet had ever mentioned the problem to me, nor did my dog seem lame, so I allowed her to play rough with other dogs. She enjoyed playing so much. Now she no longer wants to play with other dogs, so she has limited this activity herself. She does still enjoy long walks with me and also playing ball for short periods. Overall, she is a happy dog and tolerates the problem very well. However, a couple of months ago, another dog ran into her, hitting her full force on the side with arthritis (she has dysplasia on both sides). After that, she has been unable to put her full weight on the leg. I took her to an orthopedic specialist who discussed the options with me. He also prescribed Rimadyl, which seems to have no affect. He described total hip replacement surgery, although he said he could not tell me that I should have it done - it depends on how my dog is handling the problem and what I expect for her. Because I want my dog to have the best life possibe, I am considering the surgery. Thus, I am researching it as thoroughly as I can. I liked the vet I went to, but am interested in information from other sources as well. I would appreciate hearing your opinions. Thanks.
A: Donna- We have approximately 10 patients who have had hip replacements in our practice and we think the results have been very good. If it is economically feasible for you it is the best option for dealing with hip dyplasia in a middle aged dog, based on our experiences. I am sure the orthopedic surgeon has checked for degenerative myelopathy but it might be a good idea to doublecheck on that since Rimadyl was not very effective. That always makes me worry that there may be problems other than arthritis, even it if it clearly present.
Mike Richards, DVM
Rock removal - good news
Q: Dr. Richards: You will be happy to hear that we had the surgery done on Thursday, and so far everything looks good. We were able to get our Vet to do the surgery herself, rather than have a specialist come in to do it. This enable us to afford the operation. It turned out that the rock was in his colon, and not in the small intestine, so the operation wasn't as complicated. Thank you very much for responding to my e-mail, and for your concern, Dave
A: Dave- Hope all turned out well. Keep him away from rocks -- I have removed rocks from one dog three times, so far!
Mike
Difficulty raising - xrays showed no arthritis
Q: Great information: I have a similar question about Carprofen. -- altho our vet prescibed 2 - 100 mg. pills a day at 1.84/pill. This is a tad out of sight for a NSAID product. Our 11 1/2 year old full size Collie weighs 70- 72 pounds. We were giving her two 325 mg. Ascriptin per day. According to one of your notes we can try a larger dose?? We were also giving her 2 SOD daily and we don't have a clue if that helps. She has difficulty rising to a standing position and increasing difficulty getting up the stairs at nite. Alto her legs shake a bit as she gets up she does not whine or make pain noises. On our last visit to the vets we had her x-rayed starting from the back and moving up to the mid spine. The vet (and we) were suprised when he saw NO arthritis, and NO displaysia (excuse spelling). He said only suggested followup if the carprofen didn't work would be a vet. neurologist. I think this type of vet would be a surgeon and surely we wouldnt do back surgery on our old love. We would like to see if we can find an effective dose of ascriptin. Thank you.. Do you e-mail responses or should I look back at your web site. ??
A: GMSLT- You can probably try a higher dose of aspirin. There are a wide range of suggested dosages but 10 to 15 mg/lb twice a day seems to be a common recommendation. This works out to about 2 aspirin twice a day for a dog of her size. Some of my clients think 1 aspirin three times a day works better in this size range. I haven't ever tried three times a day dosing with any of my own dogs.
Taking X-rays often confuses things in older dogs with signs of arthritis. We have been certain that was the problem several times when X-rays failed to confirm it. I think that there are a number of other possible problems including degenerative myelopathy (degeneration of nerves), hormonal disorders leading to muscle weakness, tumors leading to nerve damage and other causes of muscular weakness or nerve damage.
Neurologists tend to be internal medicine specialists first and surgeons second, at least the ones I know. There is a pretty good chance that a visit to a neurologist would provide a diagnosis. If not, at least you'd know a few more things that weren't causing the problem.
Carprofen may not help if the condition is neurologic and this is true of aspirin, too. In fact, if aspirin doesn't help at least some it is pretty unlikely that carprofen will make a big difference, either. Of course, you could try a short course of it and then see a neurologist if it wasn't helpful. You should know in about 5 days of continuous use whether or not it is going to help.
Mike Richards, DVM
Scottie cramp treatment
Q: I was wondering if you could explain the different drugs they use to control scottie cramp and offer any holistic/herbal solution .I have a 2 year old Scottish Terrier and her cramp has been getting worst for the last 3 months. She has her CD and NA (agility) title and is a very active dog but lately she cramps so much she can hardly run about. As far as I can tell nothing has changed in her environment except I have put her on a diet. Thanks, Kellie
Ps - we have an apppointment with the vet today but in the past he said their wasn't really anything he could do.
A: Kellie - The only treatment I know of for this
condition is the use of diazepam (Valium Rx). It is reported to work well
in most cases for this condition and has worked well for us in the few
(1 or 2?) cases we have seen of this condition.
Megaesophagus
Q: Dr Mike, I have a 13 year old golden retriever that has been diagnosed with megaesophagus. The consensus of our long-time vet and an internalist is to have the dog euthanized. Is there any known effective treatment? mp
A: Mike - Once megaesophagus is well established it is difficult to treat effectively. If it is caused by a treatable underlying cause which is caught early, there is hope. Myasthenia gravis is probably the most common primary cause of megeasophagus in older dogs. Hypothyroidism is reported to be able to cause this, as well. There are other causes (I think I have detailed them in a reply posted in the dog information area). Some dogs can live reasonably well if they are fed from an elevated position and a compatible food found. Most dogs do better with soft foods. When exactly to consider euthanasia in these cases is always hard to assess. Different dogs and different owners have different tolerance levels for the problems like retching and vomiting associated with this disorder. Secondary problems like aspiration pneumonia or weight loss can have a strong bearing on these decisions. If the decision to euthanize just doesn't seem right, explain that to your vet and ask for help living with the condition until the time is right.
Mike Richards, DVM
Paroxysmal respiration
Q:Dr. Mike: My 7yr old cock-a-poo sometimes makes a noise which I best can describe as a snorting noise. It usually lasts anywhere from 5 seconds to 30 seconds and then he will stop and then do it again a minute later. He may go weeks without doing it. Is this something that is common in cock-a-poos and what is it? Thank You, Rogie
A: Rogie- It sounds like you are describing a condition known as paroxysmal respiration, also known as a "reverse sneeze". It really appears that some dogs are trying to inhale a sneeze when they have one of these attacks. This can be related to allergies in some dogs but for most dogs it is hard to find a cause. Fortunately, this doesn't seem to cause significant problems very often. It won't hurt to have your vet take a look and make sure there isn't an underlying cause for this.
Mike Richards, DVM
Head shaking in Doberman
Q: Our 51/2 yr. old doberman had an episode of severe head shaking,even her teeth were clattering. It lasted for a few minutes during which time she did not seem to be in any discomfort. She was still bouncing around during and after. Can you please help me understand what is wrong with her?
A: Nedda- It would be best to have your Dobe examined by your vet. While this may have been a transient event there are some serious causes of head shaking in Dobermans. They a