What Doesn't Kill Her Will Make Her Stronger? Koda's Story

JJ is my dear friend. Her dog, Koda, is almost two years old, adorable Australian Shepherd girl. Koda has already had more struggles with her health than most old dogs ever will. Since a very young age, Koda had pee problems. 

When trying to get to the bottom of it, JJ was told that "puppies pee". And that was the beginning of their medical frustrations.

That got sort of solved, but not really resolved. Koda has been also suffering with frequent UTIs. This also never got explained or resolved.

Last fall Koda struggled with fleas and severe flea allergies. Was treated with prednisone, however remained a self-mutilating itchy dog who was peeing like crazy, again, on top of that. She also contracted tapeworm, so was treated for that.
 
Koda started becoming more and more fearful of everything. JJ also said that Koda seems to be having some vision problems, however, her eyes checked out when examined. With old issues lingering, and new ones piling up, this brings us to the recent events.

Picture this if you can. You and your sick dog are sitting in a little room, waiting for a specialist.

The internist pops in looking very ... sober ... and asks you what [the hell] you expect her to do.

So let's rewind.

The original vet visit was due to stool trouble, which turned into difficulty defecating. Blood test also revealed possibly low platelets. The vet prescribed FortiFlora, Amoxicillin (a penicillin-type antibiotic) and a stool softener three days later when Koda was still unable to go. This helped Koda with the eliminating. Follow-up blood test was scheduled.

The follow-up blood test showed some further drop in platelets and elevation in white blood cells.

In addition to the antibiotic, Koda was put on a massive dose of steroids. When JJ told me that Koda is getting six pills of prednisone a day I asked what the diagnosis was.

She wasn't told what the diagnosis was, not even when she asked. 

Apparently something to do with the immune system, that's all JJ got out of them.

Based on the little information available, the only thing we could figure the vets were suspecting was Immune Mediated Thrombocytopenia. Why else such a high dose of steroids?

Meanwhile, Koda was more and more depressed, very low energy and rapidly losing weight. 

So back to the vet. New blood test was done.

When I asked JJ for an update, she told me that the vet said that Koda's liver and kidneys were now in trouble also. 

That didn't sound good at all. How many things could go this wrong this fast while on prednisone? Could it be some kind of infection after all? No adjustment to the treatment was done, and no diagnosis in sight.

Clearly at a loss, they referred Koda to a specialist, but it was unclear when they'll be able to see them.

Meanwhile, JJ had an appointment with a different vet, which she made some time back. Hoping for some new insights she acquired copies of the lab work. I was very worried about Koda and asked to see the lab results.

Seeing the blood test results actually made me feel more hopeful.

I have seen, and discussed, enough Jasmine's lab results that I couldn't help but wonder why they told JJ that Koda's kidneys were in trouble. 

I wasn't seeing it on these results. I asked some of my veterinary friends, and they couldn't see any problem there either.

That was good news, the labs didn't look half as bad as it sounded from what JJ was told.

The liver was not happy, but was it because of the original problem or because of all the prednisone? The platelets were below normal, but they didn't seem anywhere near levels that would call for drastic measures? (I have seen some really low platelets after Jasmine's hyperthermia).

More importantly, after all the steroids, the platelets showed zero improvement.

So what is going on?

That appointment with the different vet didn't, sadly, bring any insights either. I was hoping they might at least do something about the prednisone Koda was still on, but that didn't happen.

My feeling is that they didn't want to get in the middle and washed their hands of the case.

They put Koda on a glycogen replacement supplement, which at least made her feel better.

They didn't offer any ideas, but they did drop another bomb – the word chemo, yet again, with no explanation or substantiation.

JJ was still waiting to get the appointment with the specialist, and Koda was still miserable and eating 6 prednisones a day (now for almost a month).

That was when I decided we needed to talk to somebody I can trust and I turned to VetLive.

Finally I was talking to somebody who was making sense! Dr. Laci of VetLive started by asking a lot of questions.

Right on! You cannot get answers without asking questions!

They asked to confirm the dose of prednisone, relative to Koda's weight (36 pounds when the treatment was started). They asked about the rate of her weight loss, how much Koda's activity level decreased, drinking and urination, and detailed information regarding stool amount, quality, color and texture.

VetLive: Color also matters more than you would think. Are any stools grey, yellow, green tinged, or even unusually greasy? When she was having trouble with bowel movements, how frequent were they? Were they normal to hard or soft and poorly formed? Has she had a rectal exam?

Koda was drinking ton of water and urinating proportionately large amount. She was eating more and more food, while losing weight. Her activity decreased probably by 70%. Koda's nick name used to be “psycho dog”; now she would barely respond to her name.

Koda's stools are formed most of the time, but soft. Fairly normal color.

VetLive: Is there any yellow tinge to the whites of the eyes, her mucous membranes, vulva, thin skin of the ears, or any other skin on her body that is skin and normally pink in color?

Fortunately, Koda was showing no signs of jaundice.

They asked about the behavioral changes and the time frame in which they occurred.

Koda started avoiding things and people she's known most of her life.

VetLive asked about the vision issues and suggested at home tests to evaluate the situation, to get an idea whether they should include the issue in the relevant symptoms: a cotton ball test and a small maze.

With the cotton ball test, the purpose is to test her vision with something that is near silent when dropped and has practically no smell that she can follow. Drop several cotton balls in front of her, and in her range of peripheral vision. Watch to see if she can follow them. The maze test is fairly self-explanatory—set up a small maze of some chairs, etc. and see if she has any trouble navigating this.

Koda passed both tests, she mainly has issues when it gets dark.

They asked whether JJ could see any improvement in Koda after the treatment was started. 

There was no improvement whatsoever, on the contrary. Koda became lethargic, started panting heavily, suffered from urinary incontinence and complete lack of stamina.

VetLive reviewed the lab work. They explained that any severe or prolonged blood loss, increased internal destruction of platelets, or impaired bone marrow production can lead to short-term (acute) or longer term (chronic) deficiency of platelets. Many diseases have thrombocytopenia as one component of the condition. For example many serious infections, neoplasia, immune system disorders, pancreatitis, and various drug therapies such as some anti-cancer treatments can result in thrombocytopenia. Some antibiotics can also lower platelet levels.

Koda was on the Amoxicillin.

VetLive also asked about the possibility of tick borne diseases. This would be of high interest, because ehrlichial diseases can cause mild to severe thrombocytopenia in dogs. 

They did run some tests for infections, including tick borne diseases and JJ was told the results were negative.

VetLive also didn't see any reason to worry about Koda's kidneys.

VetLive: I am not worried about kidney. I see the BUN slightly up at 31 on 4/17, but corticosteroid administration raises the value, and also, she is concentrating her urine wonderfully and there are no other signs on the lab work to make me think kidney. Also, decreased muscle mass can cause mild elevations in BUN. It does take significant losses so I am not sure if this could be a cause, but regardless a BUN of 31 with other normal values is not a flag to me.

Interestingly enough, hepatic insufficiencies often decrease BUN production. Decreased BUN may be an indication for hepatic function tests—not what is going on.

I also see that her liver values were normal before treatment. I am not terribly worried about the liver values since she was on high levels of pred.

A bile acids test would let us know if the liver is functioning properly. This test isn't perfect, but it is a good screening test for hepatic dysfunction and is easy to do. If you have enough money to do that, it would confirm if liver is a problem. Glucocorticoids are a regular and important cause of severely raised ALT and alk phos in dogs. Doing every test that will give us new info is the best course of action obviously, but the protocol for her values when systemic glococorticoids have been administered is to stop the drug therapy if possible and re-evaluated in 1-3 months. Given how quickly she is deteriorating, a bile acids test would give us valuable info without waiting 1-3 months, but I just wanted to give you that info to demonstrate that how commonly those values can be artificially raised.

VetLive also made notes regarding the platelets.

VetLive: Quoting from my professor in school and one of the gods of veterinary small animal internal medicine, Michael Willard

“Platelets circulate for approximately 5 days in dogs...Platelets are released into the blood in proportion to stimulation from thromobopoietin; criculating thrombopoietin concentration is controlled by the total circulating platelet mass, not absolute number; therefore there may be mild thrombocytopenia with macroplatelets.”

I wanted to mention that, as I saw platelet clumps noted on every test. I did see one manual count done of the platelets and they recorded they saw 4-5 per high powered field. Between 8 – 29 platelets/100x oild immersion field is normal for canines.

I think it would be in Koda's best interest to have a manual platelet count performed by Idexx. If  on a budget, as we most are these days, I would start here.

A tick panel would also be great, but I know it is more costly (not sure how much), and you can wait to find out the platelet count before pursuing it.

At the dose of prednisony that Koda has been on, it is expected that she would experience side effects of increased appetite, thirst, and increased urination. Heavy panting also is seen with high doses of prednisone, along with lethargy and depression. Prednisone at these high doses also can cause muscle wasting. It usually does cause weight gain, not weight loss, but just kind of a loss of tone to the body and sagging muscles and tissue without much definition.

Can you tell me if she was experiencing any of these before the prednisone? It is my understanding that she was experiencing some fearful behavioral changes. If she was having an excessive appetite, thirst, panting, etc. before the steroids that completely changes my differential list of illnesses.

VetLive recommended to discuss (with her vet or the specialist) taking Koda of the prednisone.

Regardless of the reasons that there may have been to start such an aggressive course of steroids, it was really time to evaluate what good this drug was doing, and more importantly, what harm.

VetLive: Animals that have received glucocorticoids systemically, other than with "burst" therapy (probably what she had for her flea allergy), should be tapered off the drugs.

Patients who have received the drugs at such high doses as Koda should be tapered off slowly as her internal corticosteroid function may return slowly. Should she undergo a "stressor" (e.g., surgery, trauma, illness, etc.) during the tapering process or until normal adrenal and pituitary function resume, additional glucocorticoids should be administered. I think you will see an improvement in a variety of things with Koda is we can get her off the steroids.

Finally we got some information that made sense! 

If you need a second opinion, start with VetLive. Truly. They offer second opinion service, where they'll review available labs and medical history, I was really impressed and relieved, finally a voice of reason!

This has helped to make some sense of all the mess.

Meanwhile, Koda got to see the internal medicine specialist. So fast forward to the latest update.

Picture this if you can. You and your sick dog are sitting in a little room, waiting for a specialist.

The internist pops in looking very ... sober ... and asks you what [the hell] you expect her to do.

So, we go back to day 1, when JJ went to the vet for Koda-can't-poop issues, and they did a blood test that revealed low platelets. They put Koda on antibiotics for the not-being-able-to-poop and scheduled to take blood again and sent it out to the lab.

[Internist: Antibiotics lower the platelet count. Platelets aren't considered low until they're getting near a 30 count (30,000); your dog's are near 100,000; I fail to see a problem.]
[Internist: Your dog was put on antibiotics for a UTI.]
[Client: What UTI?]
[Internist: There were white blood cells in her urine.]
[Client: Are you reading the right paperwork? There was no presence of infection according to my vet.]
[Internist: .....]

Second vet visit: They take blood and send it out to Idexx for a CBC

[Internist: I see here that no manual count was ordered. Why did you refuse it?]
[Client: A whosawhatsit?]

Third vet visit: we pick up a high dose of prednisone and a high dose of antibiotics.

[Internist: Where are the rest of the diagnostics?]
[Client: ????]
[Internist: You know, like xrays, ultrasounds...? Did you refuse them?]
[Client: ......... no. They didn't mention any. I didn't know they needed more than the blood test results, didn't know the low platelets aren't low enough to do something about (she needs monitoring...not immunosuppressant therapy).... I had to trust that the vet had my dog's best interest in mind.]
[Internist: Right. Great. Wonderful. Why did they also give her those antibiotics?]

[Internist: Well, she's not dead; you're lucky. I think we can rule out serious infection at this point.]
[Client: ..............]

Fourth vet visit: Dog losing weight; take more blood and send it to the lab. Contact internist when the results are ... weird.

[Internist: It's the pred; everything is the pred. Her muscles are wasting away, her liver is being damaged - reversible for now; keep her on it and it'll be a different story - and all of the blood changes and values are being caused by pred.]
[Client: ...............]
[Internist: The values on the first test are relatively normal; there are a few things we could test for --- Oh, wait, we can't do anything.]
[Client: ...???]
[Internist: The pred. There's not a test I can do while she's on it. It will give false readings, unreadable readings, and nothing to go on. It's a useless waste of money to run any diagnostics.]
[Client: Hence the, "What exactly am I supposed to do today?" comment.]
[Internist: Sounds about right.]

I ended up giving her Koda's real history (hate to say it like that), and we did decide to run a few tests. The only thing she got from the vets were the blood tests that Idexx ran. They didn't even include the one they did, or the baseline on in her records.

First, she did an ultrasound to make sure everything inside was all right, hadn't suddenly exploded, or developed strange masses. For all the damage the pred is doing, her internal organs are holding up surprisingly well. (Good dog!)

Second, we worked a little on the fact that she always has an infection - usually like a UTI - and she took a culture to see if she has an antibiotic resistant bacteria or something silly that is preventing the infection from going away. They also took another urinalysis. We are waiting on the results.

They told me watch for pinpoint bruises - they look like someone took a sharpie marker and pushed dots into the skin, and they usually happen around the ears, belly, etc. 

They also told me how to wean Koda off the pred. After she's off, they'd like me to do a work-up (it doesn't have to be there, but they'd like the results one way or the other).

As per her tapering schedule... it will be a full MONTH AND A HALF before any conclusive tests can be run. 

You know, the tests that should have been run before someone went off and decided to put her on the drug in the first place? (The internist implied very, very many times that SHE should have been the one making the call about whether to put the dog on pred, and that failing all of that, Koda should have been tapered off the pred before we scheduled to come about two to three weeks after she was done.)

Meanwhile, Koda is miserable.

We got to see an internist who genuinely couldn't help us because of the way Koda's case was handled.

The internist was very polite, but she made a few things clear. My veterinarian(s) jumped to a conclusion, didn't communicate the reasoning to me, got offended when I asked, and put my dog on a drug after deciding on a diagnosis without what the internist would call "any evidence". (Her WBC was normal, but her lymphocytes were high...that indicates something else to the internist that... oh, wait. She can't test for because the dog is on pred. The pred in combination with the high lymphocytes could have killed her, regardless of the antibiotics.)

So now we wait.

Read More

Adoption Monday: Nemo, Australian Shepherd, Deerfield, NH

Check out this beautiful boy at Mary's Dogs Rescue & Adoption!

Nemo is about 2 years old. He is loving and gentle.

You will fall in love with his spirited, happy and outgoing personality. Nemo loves people and other dogs as well.

Nemo will be a great family dog. He likes being on a go and he is always ready for some fun. That doesn't mean he won't enjoy a nice snuggle with you on the couch. His is house trained, neutered and up-to-date with his shots.

Nemo is ready for you. Are you ready for him?

Want more info on Nemo? Call Mary's Dogs: 603.370.7750 or send along an email: marysdogsrescue@gmail.com

Ready to bring Nemo home? Tell us about yourself and your interest in Nemo in our adoption questionnaire. Check out all the wonderful dogs on Mary's Dogs Facebook Fan Page.

***

Mary’s Dogs rescues and re-homes dogs and puppies from Aiken County Animal Shelter, a high-kill shelter in South Carolina, USA. They also serve as a resource to communities in Southern New Hampshire and pet owners nationwide by providing education and information on responsible pet ownership, including the importance of spay/neuter, positive behavior training, and good nutrition.

Read More

Dry Warm Nose - Is My Dog Sick?

Read More

Protect Your Dog From Snake Bites

by Jennifer Coates, DVM

Do you live in or travel to areas that are home to venomous snakes? I’ve been neighbors with rattlesnakes, copperheads, and water moccasins, and have treated dogs that have been bitten by some, if not all of these species. These cases can be incredibly rewarding or heartbreaking. It all depends on how much venom is injected by the snake, something we have no control over. So, let’s address some important issues that we can affect concerning dogs and snake bites.

Timber rattlesnake (Crotalus horridus) with clearly visible facial pits.
Image: Wikipedia

Know Your Surroundings

Do a little research. What are the common snake species in your area? Are any of them venomous (the vast majority are not)? Learn what the venomous snakes in your region look like and what types of environments they frequent so you can avoid them.

One oft cited adage states that a snake with vertical pupils is venomous while one with circular pupils is not. This does hold true in most cases, but do you really want to get close enough to an unidentified snake to make this determination? It’s better to get familiar with the skin colors and patterns and and head shapes that venomous snakes in your area might have so you can i.d. them from a distance.

A little snake savvy not only protects dogs, but the snakes themselves. I can’t tell you the number of times a client has brought in the “rattler” he killed on his farm only to learn that he just offed a benign hognose by mistake.

Rattlesnake. Image: Wikipedia

Prevention

Remember that given the opportunity, any self respecting snake will try to “run” away before risking its own well-being by biting. When hiking, walk your dog on a short leash and keep him on the trail. Training classes and the necessary refresher courses that teach dogs to leave snakes alone can also help prevent snake bites. Discourage snakes from making a home in your yard by keeping grass trimmed short and locating brush piles, stacks of firewood, or other similarly inviting habitats outside your dog’s fenced yard.

You may have heard about the “rattlesnake vaccine” that is now available for dogs. Veterinarians don’t have a lot of experience with it yet, so I can’t really comment on how useful it is. Keep in mind that it is only conditionally licensed for protection against bites from the western diamondback rattlesnake. It may offer some cross protection against other species of rattlesnakes, but how well it will work under these circumstances is also unclear. If you live rattlesnake country, talk to a local veterinarian about the vaccine’s pros and cons.

Copperhead snake. Image: Wikipedia

Don’t Delay Treatment

The initial symptoms of snake envenomation are rapid swelling and pain around the bite site. Small puncture wounds may or may not be visible. If you suspect that your dog has been bitten by a snake, get him to the veterinarian immediately. If you can safely identify the snake that bit your dog, do so. That information is very helpful in planning treatment.

When presented with a dog that is known or suspected to have been bitten by a venomous snake, veterinarians will typically put the patient on intravenous fluids, start antibiotics to deal with infection, and prescribe pain relievers and anti-inflammatories to keep the dog comfortable and reduce swelling. If other symptoms develop, additional forms of treatment may become necessary.

Once basic care has been initiated, the question arises whether or not to use antivenin. 

Water Moccasin. Image: Wikipedia

Because antivenins are species-specific, we can only use them when we are fairly certain of the type of snake responsible for the bite. Antivenin is expensive, but it may be the only way to save a dog that has received a large dose of venom in comparison to its body weight. The sooner antivenin is given, the better, but it may be helpful up to 72 hours after a bite has occurred.

Many dogs that have been bitten by a venomous snake can be saved with prompt and aggressive treatment. 

The key is to get to the clinic quickly while keeping your dog as quiet and inactive as possible. Don’t attempt to remove the venom yourself. Those home-remedies you remember from watching too many old westerns do more harm than good. At the very least, you’ll be wasting precious minutes and delaying the treatment that could save your dog’s life.

***

Jennifer Coates, DVM graduated with honors from the Virginia-Maryland Regional College of Veterinary Medicine in 1999.  In the years since, she has practiced veterinary medicine in Virginia, Wyoming, and Colorado.  She is the author of several books about veterinary medicine and animal care, including the Dictionary of Veterinary Terms: Vet-speak Deciphered for the Non-veterinarian. 

Dr. Coates has recently joined the PetMD team and she is now writing for the Fully Vetted column; great blog, do check it out.

Jennifer also writes short stories that focus on the strength and importance of the human-animal bond and freelance articles relating to a variety of animal care and veterinary topics.  Dr. Coates lives in Fort Collins, Colorado with her husband, daughter, and pets.


Articles by Dr. Coates:
Kidney Disease – Say What? 
What Happens In The Dog's Body When The Kidneys Fail To Function Properly? 
The Perplexities of Pancreatitis
The Other Side Of The Coin: The Cost Of Defensive Medicine
To Neuter Or Not To Neuter… That Is The Question
Don’t Forget the Physical Therapy
Common Misdiagnoses (Part 1)
Common Misdiagnoses (Part 2)
Picking the Right Dog to Breed
When Is It An Emergency?
Dog Allergies: Common, Commonly Misdiagnosed, or Both? 
Why Does The Spleen Get No Respect?

Related articles:
The Assumption Trap: Tosha's Snake Bite 

Read More

Veterinary Highlights: Platelet Rich Plasma Therapy

In addition to stem cell regenerative therapy, our vet has recently acquired the technology and have started treatments with platelet rich plasma. These two are similar ideas - cell therapy. I suspect one of the reasons for this move is the now again more complicated availability of the stem cell therapy up here in Canada, after the falling out between Vet-Stem and their Canadian partner.

Regardless of running a small veterinary hospital, he offers the best of what is available out there.

Image: Regenerexx

So what is platelet rich plasma therapy?

Platelet-rich plasma, or PRP, is derived from patient's blood. The blood is run through a special centrifuge, which separates the blood’s less dense components from its heavier ones. A portion of the blood is distilled to a platelet concentration that is much richer than regular blood. The process also removes red and white blood cells.

Why platelets? Aren't those just responsible for blood clotting?

Platelet indeed are involved with blood clotting. But they can do other exciting things too! They are responsible for bringing white blood cells to an injured area and they also release growth factors that assist tissue regeneration.

Platelet rich plasma therapy can be used to promote tendon, ligament, muscle, and joint injuries, which are normally slow to heal.

The procedure does require anesthesia, but it can be done in one visit.

Our vet has used the treatment on their resident rescue who came in with severe arthritis. I saw the dog three weeks post treatment, there is a marked difference. "He looks bad," our vet says, "but he looks awesome compare to what he used to look like. He's a big dog again, telling everybody what to do now."

Source article: Platelet Rich Plasma Therapy

Read More

Trying Out New FURminator Grooming Tools

I am a huge fan of FURminator.

It's been over four years since I discovered the FURminator deShedding tool, and I've been using it ever since. 

Once you try this one, you won't go back. That tool is awesome! In fact, my very first blog post was about the FURminator.

I can't even begin to count all the deshedding tools we tried, and hated, in the past. None of them worked for us. I never looked at another deshedding tool since we tried the FURminator.

The only other grooming tool I've been using was a regular comb, which worked fine for daily maintenance.

Now I got to try out new FURminator grooming tools!

The Curry Comb has already replaced my regular one.

I love the way it fits in the hand, secured by a strap. I always wanted one like that. It is so pleasant to use. I also love the hard molded rubber teeth. It removes dust and loose fur, but it also massages along the way.

I tried it on myself first, it gives one serious massage!

Such a good massage will stimulate blood supply to the skin as well as production and distribution of the natural skin oils. Indispensable, particularly for a dog such as Jasmine, with history of skin issues. In fact, the main reason I comb her daily is to keep her skin healthy. The Curry Comb has both mine and Jasmine's thumbs up.

I also got to try out the Large Soft Slicker Brush.

It is very well designed, with an ergonomic handle and two sets of bristles – straight on one side, and bent on the other side. It has a two-part flexible head. It even comes with a protective cover.

I tried it on JD,  and he seems to like it. His coat is smooth and he doesn't really get tangles or mats, so I cannot tell how well the brush would work on those.

To be honest, I always shied away from slicker brushes, because I worried that the bristles might be a bit too sharp. I was hoping that this one might be softer. In my opinion it still feels rather abrasive, and when I run it over the top of my hand it does mark the skin. I realize that dog skin is tougher than mine but I don't feel like taking any chances with Jasmine's, which has proven to be quite delicate in the past.

If you do like using slicker brush for your dog, though, I think you will like this one.

To check out FURminator's 2-step grooming solutions, visit Grooming Solutions for Dogs. Don't forget, grooming isn't all about the looks. Grooming is an effective way to improve your dog's skin (and coat) health.

Read More

Dog Cartoon Of The Week: Owner's New Job

***

Dog Cartoon of the Week is brought to you by Andertoons. Check out the website for more great cartoons.


Cartoonist Mark Anderson lives in the Chicago area with his wife, their children, two cats, a dog and several dust bunnies. You might have seen his cartoons in a number of publications including Reader's Digest, The Wall Street Journal, Good Housekeeping, Forbes, Barrons, Woman's World, Harvard Business Review, Saturday Evening Post, American Legion Magazine, Funny Times.

Read More

Idiopathic Vestibular Disease: Phoenix's Story

Phoenix's story is shared with us by Brook of ruled by paws. Thank you, Brook, for sharing your story!

Imagine coming home from a weekend away, excited to get back to your faithful companion.  Eager to get back into the dance of life.

Your husband parks the truck and goes inside to turn on the outside lights. As you collect your things and get out of the truck…you see your husband coming out the door carrying something. You ask where your best friend is and he hesitates before answering.

On November 28th, my husband and I packed two of our four dogs into the truck along with our suitcases.

We had decided to go visit some friends in Guelph for a few days and leave our other two dogs home with my step-dad.  We made this decision because one of my friends we were staying with had just welcomed a fourteen week old smooth coated collie into her home, and Phoenix no longer enjoyed puppies in his old age.

On December 1st, my step-dad was sitting on the couch in the living room watching television. He heard Phoenix coming out of our bedroom, so looked up to see if he wanted anything.

Phoenix stood in the doorway of our bedroom for a moment, trembled a bit, and then abruptly fell over onto his right side. 

Phoenix Showing Off His new Head Tilt

My step-dad rushed over to him and tried to help him back onto his feet, but it was no use. Phoenix couldn’t support himself.

We do not have a land line at our house, and my step-dad doesn’t have a cell phone or vehicle, so he did the best he could, knowing we would be home the following day. He carried Phoenix out to relieve himself every couple of hours. Helped him eat his meals and drink water.

Made sure he was comfortable. And watched him constantly, worried he would not be alive when I arrived home.

When we arrived home, Phoenix was in a terrible state. 

He couldn’t hold his head up. His eyes were twitching and moving side to side. He was drooling non-stop.  His nose was running like a tap.  But, the moment he saw me, he began wagging his tail and whining because he couldn’t get to me.

It was about 6:00pm when we arrived home. We knew we had to get Phoenix to the vet, but we also knew that by the time we got him to Guelph it would be 3:00am, so we decided it was best to have him sleep on the bed in between us and start the drive in the morning.

It was a long night.  

Both my husband and I were convinced it wasn’t going to be good news. We thought he had had a stroke or something, and knew that we had to do whatever Dr. Bianca felt was best. We promised Phoenix that we would do anything to make him better, but deep down we thought this would be the last night we ever had him nearby.

In the morning, my husband, my sister, my step-dad, our four dogs and I piled into our truck and began the seven hour drive to Guelph.

Phoenix On Our Bed

It was the longest and saddest drive of my entire life. We had Phoenix lying on a blanket in the backseat between my husband and I so that we could keep him comfortable, and I think I cried about every twenty minutes. Phoenix had been my dog guide for seven years, retiring in May of 2005. We had done so many things together. He went to high school with me, to university with me, and was by my side during my mom’s funeral and then later my grandmother’s. I just couldn’t imagine a life without my faithful friend.

We arrived in Guelph around 5:00pm. 

My husband carried Phoenix into Dr Bianca’s office and she had him place him onto an examination table.  We told her all of his symptoms and then she looked him over.

She then looked up and we got the best news in the world.

Dr Bianca told us that it is very rare for dogs to have a stroke and that what Phoenix had was called idiopathic vestibular disease, or geriatric vestibular syndrome. She explained that it is similar to vertigo in humans and comes on suddenly, so there was nothing we could have done. After giving Phoenix a homeopathic remedy, Dr Bianca explained what we needed to do to help Phoenix with his recovery and said that within seventy-two hours we would notice a drastic improvement – she was right!

Vestibular disease affects the ability of the brain to recognize abnormal body positions and also affects the brain's ability to correct these abnormalities.

There are two types of vestibular disease, central (to an abnormality within the brain), and peripheral (due to an abnormality within the nerves of the inner ear). Most cases of vestibular disease are peripheral and no known cause is determined.

The symptoms can be very drastic and frightening to the owner.
Source: PetPlace.com

Within 24 hours, Phoenix’s eyes were no longer twitching and he seemed to be able to follow our movements throughout the living room (watching from wherever we had laid him).

After about 72 hours, Phoenix began trying to bare weight and was no longer drooling excessively.

By Christmas, Phoenix was pretty much back to his old self, except of a slight head tilt.

I am so thankful to have had the opportunity to be home with Phoenix and help him with his rehabilitation.  Dr. Bianca said that in some cases, people have put their dogs to sleep because they were unable to provide the necessary one-on-one assistance. I couldn’t imagine having to make such a decision and was so thankful for Dr Bianca and her words of reassurance that Phoenix would make a full recovery “as long as I was willing to put in the effort”.

Even though Phoenix only lived eight more months after the onset of idiopathic vestibular disease (he was 2 months and 11 days shy of 15 years old when he passed), he never had a recurrence, and I think the changes we made after our visit with Dr Bianca (putting out carpet runners, switching the dogs to a raw diet, etc) helped us to have him just a little bit longer.

How idiopathic (of unknown cause) was Phoenix's vestibular disease really? That is a question to ponder.

Phoenix dealt with a lifetime of ear infections. We tried everything to help him shake them (antibiotics, daily cleanings ... ), but it wasn't until we started looking at a food allergies that things really started to become clear. Our vet at the time suggested we try a hypoallergenic food, and then slowly try to reintroduce things back into Phoenix's diet in order to rule things out.

We had Phoenix eat Waltham's Hypoallergenic food for twelve weeks, even using the kibble as treats, and noticed his ears began to clear up and he stopped chewing his paws.  

After a year of adding one thing at a time and taking things away if Phoenix showed any reaction to it, we determined that Phoenix was allergic to gluten. At this point, we decided to move him off of the vet prescribed food and onto a less expensive gluten-free kibble. With this dietary change and the help of antihistamines during the summer months, Phoenix enjoyed almost five years of infection-free life.

Around thirteen years of age though, Phoenix began to experience frequent ear infections again.  

Neither elimination diet or antibiotics were helping this time. Around the middle of November of that year, Phoenix's right ear flap engorged with blood and we we back to the drawing board.

About two weeks later, Phoenix's acute onset of idiopathic vestibular disease occurred and through discussions with Dr. Bianca we concluded that the IVD and year-long ear problems were indeed related.

***

Brooke is the human behind the blog ruled by paws. she lives in northern Ontario with her husband, four dogs and two cats. She has two university degrees, a Bachelor of Arts from the University of Guelph and a Bachelor of Social Work from McMaster University, but has been unsuccessful in her job search. 

She spends her days training for agility with her current dog guide, Cessna, a 7 year old female black lab and canyon, a 22 month old male golden retriever and hopes to enter competitions next summer. She received Phoenix and Cessna from the Liones Foundation of Canada Dog Guides. 

Phoenix has been retired since may 13th, 2005 and Cessna entered their lives just over a week later, on the 27th. In the future, she hopes to begin her own breeding program and small rescue, but for now she tries to learn as much as possible about dog nutrition, health and training, while supporting Golden Rescue through monetary donations when possible.

Further reading:
Idiopathic Vestibular Disease in Dogs
Vestibular Disease in Dogs
"Old Dog" Vestibular Disease

Related articles:
Phoenix's Chronic Ear Infections

Read More

Adoption Monday: Ranger, Labrador Retriever Mix, Deerfield, NH

Check out this beautiful boy at Mary's Dogs Rescue & Adoption!

Ranger is a friendly and very sociable year and a half old boy.

He is medium energy but no couch potato, Ranger loves activity. He will make a great companion or a family dog.

Ranger is house trained, neutered and up-to-date with routine shots.

Ranger is ready for you. Are you ready for him?

Want more info on Ranger? Call Mary's Dogs: 603.370.7750 or send along an email: marysdogsrescue@gmail.com

Ready to bring Ranger home? Tell us about yourself and your interest in Ranger in our adoption questionnaire. Check out all the wonderful dogs on Mary's Dogs Facebook Fan Page.


***

Mary’s Dogs rescues and re-homes dogs and puppies from Aiken County Animal Shelter, a high-kill shelter in South Carolina, USA. They also serve as a resource to communities in Southern New Hampshire and pet owners nationwide by providing education and information on responsible pet ownership, including the importance of spay/neuter, positive behavior training, and good nutrition.

Read More

Lumps and Bumps: Part II

Read More

She Can Move It Just Fine, She Just Doesn't Want to

For the longest time, Jasmine's chiropractor was concerned about her left elbow. It is true, that some time back the elbow was sore and Jasmine was visibly favoring it.

It's been a long time since I could see her having any problems with it at all.

Granted, I was enlightened that up to 25% of favoring won't be visible to a human eye. I still didn't feel that the elbow was giving her any trouble, though.

Based on the findings from her physical examinations, the chiropractor believed that the elbow had issues with arthritis. 

It kept me baffled. But when we brought it up to Jasmine's main vet, his findings confirmed the conclusion. Paranoid as I am, I was not seeing it. I couldn't make up my mind whether I should worry about the elbow or not.

During Jasmine's Tuesday's visit, as the chiropractor was manipulating the limbs to assess range of motion, the elbow wasn't going anywhere.

“Come on, girl, I know you can move it,” the chiropractor was encouraging her. Perhaps the conviction in her voice changed Jasmine's mind and she stopped resisting.

The elbow moves just fine!

“She can move it just fine, she just doesn't want to!” the chiropractor exclaimed. At the same time the PT technician walked in: “Yeah, I know!”

When Jasmine doesn't want to do something, she won't, and you can't make her. We're just thankful that usually she does want to. Why would she get consistently stubborn about that particular limb being manipulated is anybody's guess. Maybe because it's always the last thing that gets done and Jasmine is sick of being manhandled by the time the left elbow gets its turn.

The good news is that according to the latest assessment there is nothing wrong with the elbow.

The take-home message is that a successful physical examination requires cooperation of the patient. Just as it happened with multiple failed attempts to elicit the drawer sign on her injured knees. It was not going to happen.

Yet again this makes me wish for the thermal imaging camera! I wonder how would Jasmine manage to fool that one!

Jasmine, you're a stubborn girl! I love you anyway, though.

Jana

Related articles:
Toxins? What Toxins? Jasmine's Fur Analysis 
Jasmine's Fur Analysis: Starting The Plan
How Much Is The Health Of My Dog Worth To Me?
Back At Chiropractic Care
When A Symptom Isn't What You'd Think 
Jasmine Is Headed For Her Next Stem Cell Treatment 
Jasmine's Stem Cells Are In

Read More

Improving Vision In Dogs Undergoing Cataract Surgery

Ophthalmologists at North Carolina State University’s College of Veterinary Medicine are researching a new therapy to improve vision in dogs undergoing cataract surgery.

The study is testing effectiveness of a novel intra-ocular drug device.

This is intriguing to me, because one of the horses at the friends' farm had a cyclosporine implant. That was the first time I heard of something like that.


Cataracts are a leading cause of visual impairment in dogs and frequently progress to cause total blindness. Surgical treatment is the most common and successful ocular surgeries performed in dogs.

However, inflammation and cloudiness can occur. These are also referred to as "after-cataracts."

Preventing that requires long-term frequent use of topical eye midications.

This study will focus on testing special intraocular lenses they will provide a sustained release of anti-inflammatory drug (celecoxib) to prevent "after-cataracts."

If any of you had to give your dog eye drops, you will appreciate the advantage. I certainly would, Jasmine hated getting those and only very small portion of the drops actually made it into her eye.


Besides the obvious advantage, this approach would also deliver consistent therapeutic dose of the drug, directly into the eye.


Source article: Veterinary Researchers Test Therapies to Improve Vision in Dogs Undergoing Cataract Surgery

Read More

Chronic Versus Acute Pain In Dogs: What Is The Difference?

by Dr. Lorie Huston, DVM

Many people of think of chronic pain in the same way they think of acute pain. However, in reality, there is a world of difference between the two.

Let’s start out with a basic definition of both terms.

Acute pain is the type of sudden, very real, and sometimes very severe type of pain that results from something like a sudden injury. 

Though the pain may be extreme, it is usually short-lived comparatively.

Chronic pain, on the other hand, is pain that lasts for a long time. 

There may be frequent recurrences in cases of chronic pain also.
 
Chronic Pain Is Not Acute Pain that Lasts a Long Time

This is an important concept to understand. Chronic pain and acute pain are totally different from one another. This point was driven home for me recently when I attended a lecture presented by Dr. William Tranquilli at the 2011 Rhode Island Veterinary Medical Association annual veterinary conference. Dr. Tranquilli spoke at length about pain and various methods of pain control.

Here’s what you need to understand about chronic pain.

Chronic pain is actually associated with a dysfunctional nervous system.

For dogs (and people) that suffer chronic pain, the nervous system is actually not functioning as it should.

Where Does Pain Come From?

The concept of pain is a complicated one. There are actually many different types of pain. There is maladaptive pain, in which the concepts of normal physiology cannot explain why the pain is present. There is peripheral pain, which occurs as a result of damage or inflammation to the painful area. There is neuropathic pain, where pain is due to damaged or entrapped nerves. And there is central pain, a disturbance in the pain processing pathways that exist in the central nervous system. I mention these not because I think they’re important for the average dog owner to know about but only to demonstrate how complex pain really is.

Traditional thinking about chronic pain blames its existence on damage to tissues. 

However, more recent advances are leading us to understand that the severity of pain experienced is not necessarily a function of the amount of pathology present. It is instead based in how the central nervous system processes this pain.

In cases of chronic pain where the central nervous system may actually not be functioning as it would normally, pain may be perceived as much worse than what would be expected based solely on the degree of damage to the tissues involved.

In other words, a dog with arthritis may actually be feeling more pain than we would suspect merely by looking at the changes we are able to see in that dog’s joints.

Interestingly, Dr. Tranquilli also talked about the concept that there may even be a genetic predisposition for chronic pain. Apparently, in people, various genes have been identified as being involved in the appearance of fibromyalgia, a disease which is caused by overactive nerves. In addition, chronic pain has also been associated with many other disease processes in people, including depression.

Treating Chronic Pain in Dogs

Because chronic pain differs so much from acute pain, a different approach to treatment is sometimes necessary as well.

Dogs that are suffering from chronically painful conditions may actually be experiencing an abnormally heightened sensitivity to pain. This is a condition known as hyperalgesia. As a result, Dr. Tranquilli believes that medications that can inhibit the central nervous system’s pain response may be helpful for these dogs. He concludes:

“Adjunctive drugs such as gabapentin, amantidine, tramadol and even low dose opioid therapy that target the altered neurobiology of chronic pain can be initiated early on in therapy if base analgesic therapy is considered wanting or later when non drug techniques are becoming less effective.”

In real life, we see conditions that cause chronic pain in our dogs on a regular basis. 

Things like arthritis, hip dysplasia, and many other conditions can cause chronic pain for our dogs. With a better understanding of the reasons behind the pain that these dogs  feel comes the potential for better, safer and more effective ways to treat them.

***

Lorie Huston, DVM is an experienced veterinarian with over 20 years in practice caring for dogs and cats. 

She is an expert in pet health and pet care as well as being a talented free-lance author and blogger. 

In addition to numerous articles and posts both online and off, you can also find Lorie at her blog Pet Health Care Gazette. She is a co-host at the popular Animal Cafe and also works as a blogging/social media consultant and an SEO strategist. 

Her social media blog is Social Savvy Pets.




Articles by Dr. Huston:
Lyme Is Lame (Pun Intended)
The Ticking Bomb
Don't Let Heartworm Become A Heartbreak!
Summer Perils: Blue-green Algae
Your Dog And Leptospirosis
Canine Parvovirus
Canine Distemper Virus
Why Is My Dog So Itchy? Top 5 Causes Of Itching In Dogs 
Vaccination Concerns and Potential Side Effects 
Natural Flea Control for Dogs 
Vomiting in Dogs: Is He Actually Vomiting?
Causes of Vomiting in Dogs
Is Your Dog Showing Signs Of Kidney Disease? How Is It Diagnosed?

Read More

Dog Cartoon Of The Week: More Of A Media Watchdog

***

Dog Cartoon of the Week is brought to you by Andertoons. Check out the website for more great cartoons.


Cartoonist Mark Anderson lives in the Chicago area with his wife, their children, two cats, a dog and several dust bunnies. You might have seen his cartoons in a number of publications including Reader's Digest, The Wall Street Journal, Good Housekeeping, Forbes, Barrons, Woman's World, Harvard Business Review, Saturday Evening Post, American Legion Magazine, Funny Times.

Read More

The Assumption Trap: Tosha's Snake Bite

A friend of mine, Kevin, of Dog Lover's Digest blogged this story of his dog's Tosha's sudden lameness. If you're not familiar with his blog, do check it out, it's awesome.

It all started with a case of food poisoning.

If you have a multiple dog household, the last thing you wish for is a multiple dog belly trouble! They all shared the same offending food item, and they all ended up with a bad diarrhea.

Because they're all healthy dogs, they gastrointestinal tracts recovered fairly quickly.

Tosha, however, presented with a limp.

All dogs seem on the mend now, but I’m afraid Tosha may have injured a ligament in her right rear leg from straining while doing so many squats. We fear some possible ACL damage.

We are all biased by our past experiences and by what we've learned in the past. Would I suspect an ACL injury if I saw my dog limping on a rear leg? Most certainly so. Should I jump to a conclusion?

On one of her urgent potty breaks, Tosha lept up and dashed around the corner of the house to bark at something that required being barked at. Then she returned inside.

Later that day, Tosha started limping.

Jackie and I took a look at her right hind leg and noticed some swelling in her right hind hock, but didn’t see much of anything else.

I immediately thought of her straining to go and the little hop she did as she ended her previous bathroom session and pole vaulted to the conclusion that she had injured a ligament. She didn’t seem to have any other symptoms, and considering the food poisoning et al., she was in good spirits.

The next morning the swelling seemed to have subsided, even though Tosha was still a bit lame. She was also rather quiet, but so were the other dogs, recovering from their culinary adventure.

As the day went on, though, Tosha was much quieter than the rest of the dogs.

A thorough examination revealed swelling further up her leg, that was very hot. They decided to take Tosha to the emergency vet.

Once the vet shaved the area in question we knew she had suffered either a snake or spider bite.

Tosha left the emergency clinic with some antibiotics and Rimadyl for the pain, fever, and swelling. She has recovered very well.

What has bothered me as a result of this whole ordeal is, what could or should I have done different? How could I have better handled this?

In my opinion, I think I made the mistake of assuming her injury was a strained ligament. I should have done a more thorough check of the area instead of just chalking it up to circumstantial evidence.

Tosha was lucky that she didn't receive a more serious bite. And double so, because her parents got to learn from this incident without having to pay a high price.

We can all fall into this trap. 

We see what we expect to see, depending on our experiences. If your dog was bitten by a snake in the past, you will think of that first. If you had a dog with a knee injury, that is what will come to your mind.

The trick is not to give into assumptions, but instead, investigate.

When your dog starts limping, check everything, starting from the toes. There are so many things that can result in a limp, I'll write about that later.

If you cannot find anything, do keep an eye on your dog for any changes, such as Tosha's unusual quietness. Where we live, the chances of a snake or spider bite are quite low. If you live in an area where venomous snakes or spiders are common, do put it on your list of suspects.

***

The mission of Dog Lovers Digest is to provide information and spark debate about the training, health, behavior, and welfare of “Man’s Best Friend.”

Dog Lovers Digest is here to promote methods that are based on positive means. The blog focuses on ideas that have a basis in science and observation, not folklore. And, actions springing from the humane treatment of these furry members of the family.

Original article:
Snake Bit

Read More

Adoption Monday: Lucy, Hound/Labrador Retriever Mix, Deerfield, NH

Check out this beautiful boy at Mary's Dogs Rescue & Adoption!

Lucy is about 1,5 years old, house trained, spayed and up-to-date with her routine shots.

Lucy is spirited, happy and outgoing. 

She is friendly with people, children and other dogs. Lucy will make a wonderful family dog. Give her high energy kids and she'll be thrilled! She loves to hike and camping would definitely be her thing.

Lucy is ready for you. Are you ready for her?

Want more info on Lucy?? Call Mary's Dogs: 603.370.7750 or send along an email: marysdogsrescue@gmail.com

Ready to bring Lucy home? Tell us about yourself and your interest in Lucy in our adoption questionnaire. Check out all the wonderful dogs on Mary's Dogs Facebook Fan Page.


***

Mary’s Dogs rescues and re-homes dogs and puppies from Aiken County Animal Shelter, a high-kill shelter in South Carolina, USA. They also serve as a resource to communities in Southern New Hampshire and pet owners nationwide by providing education and information on responsible pet ownership, including the importance of spay/neuter, positive behavior training, and good nutrition.

Read More

Lumps and Bumps: Part I

Read More

Jasmine's Fur Analysis: Starting The Plan

After we got Jasmine's fur analysis results and recommendations, we consulted with her main vet. It was decided to give it a go. The only way to learn something new is by trying new things.

I am quite comfortable with trying this; after all, all we are using is food.

To play it as safe as possible, and also to have a baseline to see the progress, we started by a thorough physical examination and blood tests.

We did full blood panel, as well as checked her T4 levels, and tested for heartworm, Lyme and Ehrlichia.

The lab had a spring special on early disease detection for senior dogs, so we bundled in everything we could.

We specifically wanted to test for the tick born diseases, because of the tick Jasmine got in the fall. Dr. Frick's analysis also indicated evidence of bacteria, which really made me want to make sure we are not looking at Lyme. All these things were negative, so that was great news.

Jasmine's blood panel looked good; in fact, there was only very little difference between hers and JD's (taking advantage of the special we tested his blood also).

Jasmine has blood of a 4-year old! ;-)

An interesting finding were her T4 levels, which were higher than the last time she was tested. In the light of the fur analysis recommendations, that is interesting. It also gives us some wiggling room to experiment with the dose of her thyroid meds.

I was finally able to acquire all the suggested supplements. So far I have introduced four out of six, with no ill effects. With Jasmine one cannot be too careful. It is our policy to always introduce things one at the time.

If we introduced a whole bunch of things at once, and it didn't sit well with Jasmine, how would we know which of the new things is causing trouble?

So it is a good idea to always do one thing at the time. With a sensitive dog, this applies to just about anything, including food ingredients. It has happened enough times, that something we thought to be perfectly safe, turned out to be a problem.

So far so good though.

Once Jasmine is put on all the new supplements, then we wait and watch for changes. Follow up fur analysis will be done in three months.

The physical exam also revealed some enlargement of the popliteal lymph nodes (nodes under the knee) but no direct cause was found. The theory is that they are caused by Jasmine's muscle injury (she injured her iliopsoas). So we are working on getting those healed and will check the nodes again.

This is the same injury she had couple of years ago.

That time it took seven months to fully heal! These muscles are tricky to deal with because they are really tucked away. This time I decided to try reiki, so we'll see how that works out. It is hard to keep Jasmine subdued. She's just all go, no quit.

One of the new supplements are anti-inflammatory enzymes, so maybe they can help out with this also.

We are really curious what these new supplements can do for Jasmine.

Jana

Related articles:
Toxins? What Toxins? Jasmine's Fur Analysis

Read More