Wellness: Health Care
It can’t be cured but it can be managed—partnering with your vet is the key.
Failure is a harsh word. It signifies loss of hope, or defeat. So when your vet diagnoses your dog with chronic kidney failure, how can your heart not sink? That’s why some DVMs call it chronic renal insufficiency (CRI) or chronic kidney disease (CRD) instead.
Maybe you made a vet appointment because your dog spends more time at the water bowl, seems overly thin and shies away from previously loved food. Some pets with kidney disease may also have urinary incontinence, vomiting, diarrhea, bad breath, blindness, depression or lethargy—all of which may be signs that the kidneys’ multitasking capacity is impaired.
These two bean-shaped organs are responsible for water conservation, blood pressure control, salt balance, phosphorus and calcium regulation, and the initial step in red blood cell production. When their performance of these jobs begins to falter, many of the body’s functions start to tumble too. Blood levels of BUN (blood urea nitrogen), creatinine, calcium and phosphate escalate; protein spills into the urine; potassium levels fall; red blood cell counts drop; and blood pressure rises. Your dog starts to feel very unwell, indeed.
Where to Start
CRD affects one in ten dogs (compared to one in three cats), and the initial medical goals are to investigate and address an inciting cause in an effort to halt the disease. The origins of CRD are many: chronic bacterial infections, kidney stones, immune-mediated diseases, high blood pressure, congenital kidney malformations, leptospirosis, Lyme disease, grape/raisin or antifreeze poisoning, cancer. Often, we don’t find the specific reason. We also want to attend to the dog’s clinical signs—dehydration, nausea, weight loss, fatigue—with treatments fine-tuned by test results. If the dog’s getting nephrotoxic drugs like NSAIDs and certain antibiotics, we’ll take him off them too.
CRD is managed, not cured, and your vet will refine her treatment plan by regular monitoring of your dog’s health. Tests recommended every three months might involve a renal panel (CBC and chemistries), urinalysis, urine culture, urine protein/creatinine ratio and blood pressure.
The first signs of CRD—elevations in BUN and creatinine levels—typically occur when the kidneys have lost 75 percent of their function, which has made its treatment challenging. However, Idexx Laboratories now offers a blood test, SDMA (symmetric dimethylarginine), which catches CRD at the 40 percent mark and allows earlier intervention.
Treatment goals for CRD are life-long and supportive, aimed at improving quality of life and slowing disease progression. Since the kidneys perform numerous functions, various medications are used to address specific disorders. ACE (angiotensin-converting-enzyme)–inhibitors are prescribed for hypertension and/or urine protein loss, antacids like famotidine or omeprazole for GI ulcers and overly acidic stomach, maropitant and metoclopramide for nausea. When indicated, phosphate binders reduce nausea, and potassium supplements boost low levels.
Your veterinary team can teach you how to give subcutaneous fluids at home, if needed, to hydrate your dog and flush out toxins. You can also encourage your canine friend to increase his water intake by providing a pet water fountain, adding wet food to his diet, and placing clean bowls with fresh water in multiple rooms. Your vet will also likely suggest a diet change. Prescription diets like Hill’s K/D, Royal Canin Renal MP and LP, Iams Renal Plus, and Purina N/F restrict phosphorus and sodium, reduce protein and add omega-3 fatty acids with B and C vitamins, a combination that has been tested to increase lifespan and overall quality of life. Restricting protein too early, however, can lead to muscle wasting. IRIS, the International Renal Interest Society, endorses a kidney-specific diet when a dog’s creatinine level rises to 2.1 to 5 mg/dl (Stage III). You can also find online support for home-cooked CRD diets via veterinary prescription (see info box). To make it more likely that your dog will accept a new diet, make the switch slowly.
The body does not store water-soluble B-complex and C vitamins, so we need to replace them every day. When dogs have CRD, these essential nutrients wash out too easily with the dilute urine. Prescription foods compensate for these expected losses, and Renal Essentials by Vetriscience, a highly palatable and balanced supplement with vitamins, potassium, fish oil and herbs, can be given twice daily as well.
Studies document that high daily doses of oral omega-3 fatty acids enhance the function of joints, heart, skin, brain and kidneys. In one study, fish oils decreased mortality, improved renal function and diminished protein loss. The recommended dose of marine fish oil, omega-3 EPA and DHA, is 300 mg per 10 pounds of dog weight. Do not use cod liver oil, as it may have excessive A and D vitamins.
In the Manual of Natural Veterinary Medicine, Drs. Wynn and Marsden advocate traditional Chinese herbs for CRD, based on clinical experience. Studies in rats showed that Liu Wei Di Huang/Rehmannia 6 enhanced renal blood flow. Wynn and Marsden have also seen cats thrive for years when started in early-stage CRD on Shen Qi Wan/Rehmannia 8, another important formula. Rehmannia 8, with cinnamon and aconite, is warming, and this combination, when consistently used, can lower BUN and creatinine levels, reduce vomiting and thirst, boost appetite and weight, decrease urine volume, and increase urine concentration. Consultation with a TCVM vet is highly recommended for beginning and monitoring pets on Chinese herbs.
Rounding out a holistic kidney care plan, consider chiropractic to release spinal fixations and improve hind-end weakness that are common with CRD, and acupuncture to enhance the TCVM herbs’ effectiveness.
We who love dogs want our companions to live long and happy lives. If your canine has CRD, you can approach the disease from an integrative approach, maintaining quality of life and slowing kidney degeneration. Optimizing our dogs’ health may involve monitoring and close management, but they repay us with their company and more days of infinite joy.
Dog's Life: Work of Dogs
Expanding the frontiers of the canine capacity to help us carry on.
We can’t find our glasses, our car keys or the right word. We forget an appointment. We’re unable to bring to mind the name of a long-ago best friend. Many of us jokingly refer to these as “senior moments,” but the humor is only skin-deep. Underneath is the niggling worry that dementia—the term for a set of symptoms signaling a decline in mental abilities severe enough to interfere with our daily lives—lurks. This fear is fed by a sobering statistic: according to the Institute for Dementia Research and Prevention, in the U.S., at least 5 million individuals suffer from age-related dementias (Alzheimer’s disease accounts for roughly 70 percent of the total). These numbers will continue to rise as the population ages.
Severe memory loss is no laughing matter. The brain, a mysterious and complex organ, is, among other things, the repository of the very essence of who we are: our memories. Generally speaking, memory breaks down into three broad categories: sensory, short-term and long-term. Things as dissimilar as childhood recollections and how to walk, hold a spoon or comb our hair reside in our memory As damaged nerve cells (neurons) cease to function, they take much of this information with them. This is where dogs come in.
Dogs love routine. People with dementia have difficulty with routine, everyday activities. Roughly a dozen years ago, two people had the idea to put them together. When Israeli social worker Daphna Golan-Shemesh met professional dog trainer Yariv Ben-Yosef, they chatted about their respective occupations. As Ben-Yosef recalled, “It was clear to us that Daphna’s expertise in Alzheimer’s and my expertise with dogs could result in something new.” Together, Golan-Shemesh and Ben-Yosef pioneered the idea of training dogs to help those with dementia to not only feel better but also, to assist with daily activities.
Fast-forward to early 2012, when Alzheimer’s Scotland secured funding to study the possibility that specially trained service dogs could benefit people in the early stages of dementia. Four students at the Glasgow School of Art developed the initial concept as a service design project in response to the Design Council’s 2011 Living Well with Dementia Challenge. Focused on “finding practical solutions to social problems,” the competition required entrants to “design and develop products and services that rethink living with dementia, and launch them as real initiatives.” The Dementia Dog project grew from this call to action.
Dementia Dog is a collaborative effort, with Alzheimer’s Scotland, Dogs for the Disabled, Guide Dogs Scotland and the Glasgow School of Art pooling their respective areas of expertise. Last year, the research phase was completed, and the group is now in the early stages of a small-scale pilot program. As noted on the Dementia Dog website, the program “aims to prove that dogs can help people with dementia maintain their waking, sleeping and eating routine … improve confidence, keep them active and engaged … as well as provide a constant companion who will reassure them when they face new and unfamiliar situations.”
They are also developing programs for two more assistive functions: intervention dogs, trained to help the client with specifically identified tasks, and facility dogs, who enhance the emotional well being of those living in residential care.
The program’s dogs receive instruction at the Guide Dogs’ Forfar Training School. After 18 months’ work, the first two dementia service dogs—Kaspa, a Lab, and Oscar, a Golden Retriever—were certified last year, and two more dogs are currently being trained.
As noted in the program statement, the dogs help their people with core needs: support for daily living (exercise, balance, alerting to hazards, environmental safety), reminders (prompts to take medication), “soft” support (companionship, a bridge to social interaction, confidence building), and physical and emotional anchoring (staying with their person while the partner/caregiver shops, or helping their person feel safe and secure when alone).
The dogs are also trained to provide another critical service: getting their people home safely. The dogs’ collars are fitted with a GPS unit, and if the person doesn’t give the “home” command, the device helps families or law enforcement zero in on the pair’s location. Unlike guide dogs for the blind, dementia dogs operate at the end of a six-foot leash, which allows them to most effectively steer their people in the appropriate direction.
Dementia service dogs are being trained in the U.S. as well. DogWish.org, a California-based charity that trains and sponsors service dogs, lists “dementia dogs” as one of their training options, as does Wilderwood Service Dogs in Tennessee.
This service dog program taps into our almost primal love for dogs in a very personal way. The dogs of our present, the dogs of our past: their names and quirks and the bone-deep understanding of their nonjudgmental and unconditional love often stay with us when much else has been lost. A person living with dementia may not be able to recall what she had for breakfast or where she lives, but the dogs she loved? That’s another story.
In a 1.28-minute YouTube video clip that’s been viewed by more than 5.6 million people (go to see it for yourself), an elderly man with Alzheimer’s who’s lost almost all of his speech talks to and interacts with the family dog. It’s hard to imagine a better example of the very real value that dogs—purpose-trained or not—provide to the most vulnerable among us.
Read deeply touching comments from family members and caregivers about the ways dogs help their loved ones cope at dementiadog.org.
Wellness: Healthy Living
Investigating the microscopic worlds in our dogs may reveal pathways to better health.
The microbiome is the invisible world of the hundred trillion bacterial, viral and fungal microbes that live on us and in us—on our hair and skin, behind our ears and inside our eyelids. The bulk of these miniscule microbes are good guys, gut microbiota that congregate in the digestive tract, where they bolster the immune system, manufacture vitamins and digest food to generate nutrients and energy.
Microbial equilibrium is a delicate balancing act, and a broad spectrum of inflammatory and autoimmune diseases is linked to having too many microbes—or too few. For example, researchers know that significantly lower bacterial diversity is found in both people and dogs with chronic inflammatory bowel diseases.
Teasing out the biological interaction of trillions of miniscule microorganisms that colonize the body, and the role they play in well being, is a new frontier. Will it be a watershed moment in veterinary medicine? Scientists are hopeful. The human microbiome has become a hot topic in biologic investigations, and canine research is fast catching up, much of it inspired by the success of the Human Microbiome Project, launched in 2007 by the National Institutes of Health (NIH). Using stool and tissue samples to isolate microorganisms, researchers are mapping the diversity and normal profile of the human microbial community.
Another undertaking, the Human Food Project, invites the public to submit personal and family microbial samples along with samples from family dogs to better understand how a person’s microbiome compares to that of animals living in the same environment. (The project’s dog segment has been discontinued.) The analysis centers on the anthropological co-evolution of humans, animal and plant microbes to understand modern disease against the backdrop of our ancestral/microbial past.
It’s all about dogs at Companion PBx, a new startup that primarily targets the canine digestive tract. Its goal is to build a cumulative gut flora database and develop dietary products customized for dogs’ digestive health. In January 2015, the company launched a Kickstarter campaign to raise money for construction of the database.
According to Companion PBx Chief Science Officer Kelly Scott Swanson, PhD, who’s on the faculty at University of Illinois, Urbana-Champaign’s Department of Animal Sciences, “By sequencing the microbes in your pet’s sample, we obtain a fingerprint of the microbial community in your pet’s GI tract.”
Microbes in Common
Affected by age, environment, ancestry, evolution, genetics and diet, microbial communities vary widely between species and across individuals within a species. A recent study suggests that our housemates—including the family dog—may also affect the composition of our personal microbial signature.
If you and your significant other kiss, hug and/or share a bed with your dog, the three of you have more in common than you think. A study conducted by researchers at the University of Colorado, Boulder, revealed several similarities: Adults who share a dog have more similar mouth microbes than those who don’t. Dog-owning families have more diverse and different microbial colonies than dogless households. Parents tend to share more kinds of mouth bacteria with their dog than they do their children. And children raised with dogs have a wider variety of microbes than dogless kids (Song et al. 2013).
Whether these spit-swapped microbes serve a purpose or are just passing through is not clear. But research shows that children raised with dogs are less likely to be afflicted by eczema (Epstein et al. 2010) and asthma (American Society for Microbiology 2012).
The notion that microorganisms in the canine gastrointestinal tract might have unique properties is not new. Early Romans understood the medical value of a well-run therapy dog program. Health temples, the ancient equivalent of modern-day outpatient clinics, were staffed with live-in cynotherapists, gentle dogs who wandered about the grounds greeting patients and licking wounds. Were the dogs healing only psychosomatic injuries? Time and additional research funding will tell.
The idea that our microorganisms may to some extent be collectively beneficial is intriguing. People and dogs have been exchanging microbes for at least 30,000 years, since the first little cave girl kissed the first proto-dog puppy smack on the muzzle. That’s a long history of sharing. It’s possible that our microorganisms are at least symbiotic, and perhaps even played a role in the dramatic domestication of the dog.
Theoretically, many thousands of years ago, a population of carnivorous wolves or ancient proto-dogs (depending on where you stand in the dog-domestication debate) transitioned from a meat-heavy diet to one laden with grain, a consequence of the agrarian revolution.
Scientists know that the acquisition of a new diet is a fundamental driver for the evolution of a new species (Dale, Moran 2006). When species transition from carnivorous to omnivorous diets, the gut microbial community co-diversifies with the host and drives further evolution (Ley et al. 2008). As human diets changed, so too did those of Canis familiaris. Over time, as we incorporated these unique animals into our daily lives, we continued to reshape them.
In humans, autoimmune and inflammatory diseases are on the increase. Scientists can’t verify a similar pattern in dogs because epidemiological studies are rarely conducted in veterinary medicine. Additionally, many autoimmune conditions are diagnosed based on the patient’s subjective description of symptoms.
But this is not the case with itchy skin. Dogs who scratch themselves incessantly are highly likely to have allergies. When researchers compared microbial colonies on the skin of healthy dogs to those of dogs with allergies, they found that non-allergic dogs have much richer and diverse skin microbial communities (Hoffmann et al. 2014).
But when it comes to proving causality, scientists wisely err on the side of caution. It’s not understood if a change in the microbiome causes certain conditions, or if it occurs as a consequence of the conditions. Nor is it absolutely clear that more diversity is better than less. At this point, scientists cannot say with confidence exactly what a healthy microbiome should look like in the dog.
Moreover, what seems logical may not be so. For instance, anyone who has lived with a poop-eating pooch has wondered why some dogs do and other don’t. Are coprophagic dogs seeking microbes lacking in their gut? Surprisingly, research involving mice suggests that this might not be the case; coprophagia in germfree mice is the same as in conventional lab mice (Ebino et al. 1987).
Other questions arise: Are the microbiomes of individual dog breeds more similar to each other than they are to those of other breeds? And could these isolated microbial communities drive breed-specific ailments?
Jan Suchodolski, DVM, a Texas A&M veterinary medical and biomedical sciences researcher who studies dog and cat gastrointestinal diseases, says that this doesn’t seem to be the case. As he noted, “So far, we do not have any clear evidence that gut microbiomes are more similar within breeds. Environmental influences such as age, diets and antibiotics, and especially the effects of GI disease, are larger than any breed effect.
“It may be possible that we missed an effect, as we have not evaluated thousands of animals. But if there were a breed effect, it would probably be very minor. Even within puppies of the same litter, the microbiome shows huge inter-animal variation, so the animal effect is much stronger than any other effect.”
Idiopathic canine inflammatory bowel disease (IBD) is a gastrointestinal condition in which the digestive tract is chronically inflamed. Symptoms include vomiting, diarrhea and weight loss. Dogs with IBD have significantly lower bacterial diversity as well as microbial communities that are distinct from those of healthy dogs. In 2014, Dr. Suchodolski and his colleagues conducted a study of 22 companion dogs, half of whom suffered from idiopathic IBD (Minamoto et al. 2015). They wanted to know if traditional treatments—steroids and special diets—directly or indirectly created a more robust microbial community.
After treatment, the sick dogs felt a lot better. However, there was no change in their gut microbiota. The researchers concluded, “This study demonstrates intestinal dysbiosis [microbial imbalance] and altered serum metabolite profiles in dogs with IBD. But medical therapy doesn't seem to affect the intestinal dysbiosis.”
It could be that, rather than triggering the condition, microorganisms are compromised by it. Researchers also suspect that biological environmental stresses are involved in ways not yet understood. Dr. Suchodolski added, “It may be that we need longer follow-up periods of treatments to see potential improvements. Another reasonable theory is that with the current standard therapies—for instance, immunosuppression—we just control clinical signs, but the underlying etiology of the disease is ongoing.”
When it comes to treating dogs for myriad problems, vets often prescribe antibiotics, and for good reason: antibiotics save lives. But the war on infection sometimes puts good bacteria in the line of fire, too. When assaulted by repeated antibiotic use, some classes of gut bacteria struggle to recover. If the affected bacteria play a pivotal role in autoimmune health, overuse of antibiotics may coincide with a decrease in healthy autoimmune responses.
Antibiotics are not the only culprits. Scientists suspect that in human births, Cesarean deliveries may contribute to an increase in autoimmune weaknesses as well. In a vaginal birth, the fetus departs the womb without a single microbe but acquires them by passing through the mother’s birth canal. By the time the newborn takes his first breath, he is covered with colonies of bacteria that kick-start his immune system, establish a healthy digestive tract, help shape his growing brain and even protect him from psychiatric disorders. C-section babies start life without the microbes they would have picked up from vaginal delivery, suggesting that the colonization of the newborn might be delayed (Jakobsson et al. 2014).
Medical disorders connected to non-vaginal delivery and the slow introduction of protective bacteria have not been studied in the dog. Considering that a number of breeds with exceptionally flat, wide skulls—such as the Boston Terrier, French Bulldog and Bulldog—must have their pups delivered via C-section, it’s an area that deserves further study.
Or is diet the problem? Commercially manufactured dog chow was introduced in the U.S. in the mid-1920s. By the 1950s, processed dog food like Friskies, Sergeant’s and Purina were widely available through local grocery stores. Today in the U.S., we spend more than $10 billion a year on commercial pet food. The question arises: has the increase in autoimmune diseases paralleled the rise in popularity of processed dog food?
Because veterinary practices typically don’t collect this type of empirical data, the answer is, at best, a guess. But many dog owners think so, and have eliminated or cut back on processed foods in favor of raw meat and vegetables. However, as of now, there is no definitive evidence to show that fresh foods modulate the gut microbiota.
Sophisticated DNA sequencing technology has opened up the invisible world to scientific scrutiny. But determining its impact on the host species is difficult and time-consuming. Researchers need to locate and identify a microbe’s fingerprint, then remove a sample and grow it in a culture, a process especially difficult with shyer microbes that are destroyed by oxygen or stomach acid.
To figure out why we get sick and the role microbes play in illness, researchers must first determine how these trillions of organisms interact with each other. And the fact that scientists can prove a problem exists doesn’t mean they know how to fix it.
Developing therapeutic dog foods that target specific vulnerabilities may help, but will take time to develop. Although the probiotic movement may oversell their benefits, probiotics (friendly bacteria like those that live in the gut) are effective in some cases. And prebiotics, foods that encourage growth of good bacteria already present, may help as well.
The University of Pennsylvania School of Veterinary Medicine (Penn Vet) is recruiting dogs with acute symptoms of diarrhea and/or vomiting for a new clinical trail that will evaluate the role of the intestinal microbiome—the community of “good” bacteria that live in the gut—on chronic gastrointestinal diseases. Therapy will include simple diet change, treatment with antibiotics or combination therapy with steroids for more complicated cases.
Penn Vet researchers anticipate that their study may reveal how gut microbiota influence and respond to treatment, which in turn could lay the groundwork for future projects using treatments such as prebiotics, probiotics or fecal transplants (transferring “good” microorganisms from a donor’s healthy stool to the patient’s gastrointestinal tract). According to Research Assistant Professor Dr. Daniel Beiting, “Whereas past studies have used a single method to sequence bacterial DNA, the Penn Vet study will use a more sophisticated approach called metagenomics, generating a much more comprehensive catalog of bacteria in the stool and providing insight into what they might be doing.”
Penn Vet is currently looking for dogs with chronic gastrointestinal problems. People interested in enrolling their dog in the study—Evaluating the Role of the Microbiome in the Resolution of Canine Chronic Enteropathy—should email Penn Vet’s Veterinary Clinical Investigations Center at email@example.com, or call (215) 573-0302.
Future possibilities are exciting. In the meantime, kiss your dog. It’s good for you in more ways than one.
Wellness: Health Care
A low-stress approach paves the way to successful dog handling.
Elissa and David Miles moved from Manhattan to Mattituck, Long Island, to pursue their lifelong dream of opening a dog-grooming salon. Their shop, Groom + Gear, which has attracted a clientele of more than 400 since opening in late 2013, practices something most others don’t: low-stress handling.
“I learned about Dr. Sophia Yin’s philosophy of low-stress handling 14 years ago while apprenticing with Lydia DesRoche, a New York City dog trainer,” says Elissa. (DesRoche is the owner-operator of Sit Stay Dog Training.)
Dr. Yin, a veterinarian well known for her work in animal behavior, coined the phrase “low-stress handling” It describes her philosophy of helping dogs through unpleasant or scary encounters by using positive reinforcement and creating comfortable environments. (Her death, at 48, stunned a nationwide group of passionate followers.)
Dr. Yin’s lasting legacy of low-stress handling stands in contrast to the unfortunately still-popular philosophy of establishing dominance over a dog as a way of dealing with unwanted behaviors and aggression. Dr. Yin recognized that many of these behaviors—among them, lunging, guarding food or toys, aggression, and separation anxiety—are based on a dog’s fear.
Further, she found that exercising dominance or trying to force a dog (or cat) to become compliant in a situation in which they are fearful often causes the undesired behavior to escalate and worsen over time.
As a vet, I have too often experienced how quickly a dog or cat’s aggression can ratchet up; they can go from mildly uncooperative to full-on trying to bite and physically escape as the level of restraint is increased. It’s critical to recognize this dynamic before their fear takes over, and it’s smart to back off and try a “less is more” restraint approach, or to include their owner in the mix.
Back to other canine contexts … low-stress handling also benefits dogs who are undergoing what may be a challenging task, such as grooming.
Obviously, a dog who doesn’t have to spend the day in a cage, but rather, comes into a place to be groomed and goes home afterward will be much more willing to go there again, and will also be more cooperative about the grooming itself. This situation plays out at Groom + Gear, a cageless facility. “David grooms one dog at a time, and they are picked up right after their grooming’s finished, “ Elissa says, adding that she had seen this business from the inside when she worked at a groomer’s in New York City.
In many grooming facilities, she says, “The dogs are dropped off in the morning and spend the day in a cage. The dryer is noisy and attaches to the outside, blowing hot air around the dog.
“[In our shop,] we use earmuffs that stay on the dog’s head, or a hand-held, quieter dryer on about one-third of the dogs. We have a pheromone diffuser, which releases calming pheromones into the grooming room, and each grooming begins with a bath and massage by David. The dogs are strapped with a wide band that crosses the chest when they’re on the table—nothing around the neck. We only use muzzles when the dog is a known biter.” On average, David grooms five dogs per day. He takes his time with each, typically one-and-a-half to two hours.”
And not surprisingly, she says, dogs come running in to see him.
The more dogs are accustomed to being touched and being around other dogs and people when they’re at home, the less stress they will feel later when in a new environment or activity, like grooming or being examined at the vet.
“Typically, puppies don’t show intolerance to being touched,” says Kristi Vizza, a trainer at Andrea Arden in New York City. “When a new puppy comes into your home, handling [the pup while] giving treats [should] be part of the daily routine.”
According to Vizza, a puppy or dog who begins taking treats more roughly, or stops taking them altogether, is displaying signs of discomfort with being touched. Looking at your hand when you touch a sensitive area is another way dogs convey their unease.
“If you see signs of discomfort when touching a certain area of your dog, back off and move to touching another area. Typically, dogs resent their paws (particularly the hind paws), ears or tail being touched,” Vizza says. “Handling your dog is something you’re going to do [daily] for the first couple of years. It’s relationship building. Behavior issues pop up between the age of 7 and 18 months, so for the first 6 months, socializing and handling your puppy as much as possible is extremely important.”
Low-stress handling is about meeting dogs where they are. It sets them up for success by teaching them to be less shy, and to tolerate being handled. Owners need to know to expect some unwanted behavior issues with their dog—they can and will come up. It doesn’t mean that either the owner or the dog has failed, however.
Although low-stress handling is highly regarded among vets, it requires patience, time and staff training to implement. In busy pet-service operations, carving out additional time can be a challenge, but is eminently worth the effort. Sedation, muzzling or roughly handling a noncompliant dog or cat may be faster, but they are techniques that can take a toll on our companion animals. As public awareness of the low-stress-handling approach increases, the demand for, and number of, facilities that practice it should increase as well.
Male dogs, like their human counterparts, can get prostate cancer. Fourteen percent of men will develop this type of cancer, but 99% will survive because of advances in available treatment options. Now clinical trials, performed by Dr. Bill Culp, VMD, DACVS, at the UC Davis Veterinary Medical Teaching Hospital, are investigating similar treatments for dogs. One recent recipient of the innovative procedure is Kopper, a 14-year-old Belgian Malinois from Tennessee. Kopper, who worked to protect his community for the majority of his life, is a retired K-9 officer who was diagnosed with prostate issues by the University of Tennessee’s (UT) veterinary hospital. Veterinarians there were familiar with Dr. Culp’s clinical trial and referred Kopper’s family, Matt and Heather Thompson of Maryville, Tennessee, to UC Davis.
Matt, a corporal with the Blount County (TN) Sheriff's Department K-9 unit, along with Heather, traveled the 2,500 miles to California to see Dr. Culp. The treatment that was administered to Kopper is similar to a procedure in human medicine that has taken hold in the past few years for treatment of non-cancerous prostate enlargement. Known as prostatic transarterial embolization, the treatment is emerging as a minimally invasive alternative to other prostate cancer therapies.
Dr. Culp, along with a colleague who performs similar procedures on humans, Dr. Craig Glaiberman, MD, successfully performed Kopper’s procedure. Luckily, Kopper and his family returned home within a few days. To date, Kopper’s prostate has decreased in size, and he has been doing well. The hope for Kopper and all dogs undergoing this minimally invasive treatment, is that a decrease in tumor size will improve the quality and length of life for dogs with prostate cancer.
Dr. Culp continues this clinical trial. Recruitment of more dogs with naturally occurring prostate cancer is needed to help evaluate the effectiveness of prostatic transarterial embolization as an accepted standard-of-care procedure. To learn more about the trial, please see www.vetmed.ucdavis.edu/clinicaltrials.
News: Guest Posts
A New Virus Hits Canines in the United States
If you keep tabs on dog-related news, you’re probably already aware of the recent outbreak of canine influenza in the Midwest. Chicago appears to be at the epicenter of the epidemic.
The first dogs affected by this virus were observed in mid-March of this year. Since then, more than 1,000 known cases have been reported in and around Chicago, and there have even been a few deaths.
New virus within the United States
Until a week ago, the virus responsible for this canine influenza outbreak was thought to be H398, a strain of Influenza A that has been present in the United States for some time. Cornell University (thumbs up to my alma mater) recently reported that scientists there have isolated a brand new influenza virus from affected dogs in the Midwest. This virus, referred to as H3N2, is closely related to strains of influenza affecting dog populations in South Korea and China. H3N2 is now making its debut appearance within the United States. How the virus was introduced here is anyone’s guess.
Dogs living within the United States have no natural protection against H3N2 because their immune systems have never been exposed to it before. For this reason, it will remain highly contagious until canine populations develop immunity, either through natural infection or vaccination.
The contagious stage of canine influenza begins a few days before symptoms arise. In other words, the healthy-appearing pup at the dog park or doggie daycare center may be on the verge of developing viral symptoms. Spread of the disease occurs via respiratory secretions (discharge from nose, mouth, and eyes). Both dogs and cats are susceptible to the H3N2 virus. It is not transmissible to humans.
The symptoms most commonly associated with influenza virus include: high fever, loss of appetite, coughing, nasal discharge, and lethargy. In the best-case scenario, an infected dog may show only mild symptoms or none at all. Worst-case scenario, pneumonia may develop. Pneumonia was the likely cause of death in five dogs who have reportedly succumbed to this disease.
Many infectious bacterial and viral diseases are capable of producing the symptoms described above. Knowing that H3N2 is the culprit requires specialized testing performed on a mouth or nose swab. Cornell reports that the development of a blood test capable of diagnosing this disease is in the works.
Treatment of influenza ideally involves supportive and symptomatic care until the dog’s immune system wins the battle against the virus (requires approximately two weeks for most dogs). Therapy may include supplemental fluids, special diets to entice appetite, anti-inflammatory medications, and cough suppressants. Antibiotics may be prescribed to prevent secondary bacterial infection.
If evidence of pneumonia is present, much more intensive therapy is indicated and may include hospitalization for intravenous fluids and antibiotics, supplemental oxygen, and 24-hour monitoring by a veterinarian.
At this time, it is not known if the vaccine currently available to prevent H3N8 is also protective against the newer H3N2 strain. There may be some cross over protection, but just how much is uncertain. I suspect that updated information about the effectiveness of the current vaccine and/or development of a new vaccine will be forthcoming in the near future. For now, I recommend discussing use of the current influenza vaccine with your veterinarian.
If you live in or around Chicago, or if you learn that influenza cases are beginning to pop up in your neck of the woods, know that the very best protection involves keeping your dog away from popular, public, canine venues such as dog parks, boarding kennels, grooming parlors, pet stores, and doggie daycare facilities.
Please know that there is no cause for panic. The vast majority of dogs affected by this new strain of influenza fully recover. Talk with your veterinarian about the incidence of canine influenza in your locale to help determine the level of concern for your dogs.
Have you had any experience with canine influenza? If you live in the Midwest, are you taking specific measures to protect your dog?
For about a year, I’ve been supplementing our dogs’ quality kibble with homemade turkey burgers (along with whole-wheat pasta and cooked vegetables). Our three dogs eat twice a day; at each meal, our largest dog (45 pounds) gets half a burger, while the two smaller ones (30 and 25 pounds) roughly share the other half.
I developed the recipe myself, and while I tried to cover the bases in terms of appropriate canine nutrition, I had no particular agenda in mind—I mostly just wanted to make our dogs’ meals a little more interesting for them. Curious about the burgers’ nutritional value, I turned to Roschelle Heuberger, PhD, RD, professor at Central Michigan University and devoted Akita person, to find out how my culinary experiment stacked up.The Recipe
Makes approx. 36 3-inch patties, each about 3.5 ounces
Total prep time: 20 minutes
Total cooking time: 1 hour
Preheat oven to 400°
Mix well, making sure all the ingredients are completely incorporated. Shape into 3-inch patties, place on lightly oiled (with spray oil), rimmed baking sheet(s). Optional: Spread little ketchup (about 1/8 tsp.) on top of each patty.
Bake 45 minutes to 1 hour. A longer baking time will produce a drier and easier-to-crumble burger.
Tip: Deglaze the baking sheet with water, which makes a great gravy that can be used to moisten the meal. This recipe makes around 1 1/2 to 2 cups of this gravy. It’s also an easy way to help clean the baking pan.The Analysis
By Roschelle Heuberger, PhD, RD
There is much controversy within the veterinary nutritionist community about commercial pet food and home cooking. And, since manufacturing standards for canine food are so much different than those we apply in our own kitchens, it’s difficult to make an “apples-to-apples” comparison. Nonetheless, using proprietary nutrition software, it’s possible to determine the relative values of the major food components of Claudia’s recipe with those found in commercially produced dog food (in parens).
Analysis (per patty)
Note: All measurements are given in terms of 100 kilocalories (kcals) against measurement standards used by commercial food manufacturers.
Protein: 7.5 grams (8 grams is considered high protein)
Calories: 5.3 kcals (5 or more kcals is considered high calorie)
Fat: 2 grams (a low-fat food contains less than 2 grams, so this is neither high nor low)
Sodium: 30 mg (anything less than 100 mg per serving is considered low-sodium)
Fiber: 0.75 grams (neither high nor low)
Moisture loss with one hour covered cooking time is approximately 10 to 15 percent. High heat and long cooking time will destroy 90 percent of the thiamin and up to 50 percent of some of the other B vitamins in the burgers. On the bright side, it will also kill pathogens, so you don’t have to worry about the contamination that’s a concern when it comes to undercooked meats.
Used as a “topper” to both to increase palatability and provide calories, protein and other nutrients, the turkey burger is a great addition to a complete commercial dog food. Feeding turkey burgers as toppers may also be helpful for older dogs, who often have poor appetites, or dogs who have been ill or malnourished. In those cases, the turkey burger need not replace the commercial food, but rather, could be fed in addition to it.
As the recipe is given, it would not be advisable to feed turkey burgers as the sole source of nutrition because they may be too high-calorie for some dogs, and also because they’re missing some of the other nutrients dogs need. Obesity is becoming an epidemic among dogs, as it is in humans. Caloric restriction and regular exercise are important for weight maintenance, particularly as a dog ages.
As always, choose the best commercial food you can afford. To educate yourself on the options and issues, try out one of the online dog food evaluators; Dogfoodadvisor.com is a good place to start.
The Background: Canine Nutrition
Dogs, who are omnivorous, require the same sorts of major nutrients—proteins, carbohydrates and fats, and vitamins and minerals—as human omnivores, but in different ratios. For example, they have an absolute requirement for linoleic acid, an essential fatty acid, and for nearly a dozen amino acids, the building blocks of protein. These amino acids range from the complex (arginine and phenylalanine) to simple (leucine and valine).
We and our four-legged companions get all 22 amino acids from protein sources such as eggs or meats, which contain varying percentages of each one. Some protein sources contain most of them, others only a fraction. Meats, eggs and fish are among the best sources of complete amino acids, and their proteins are highly digestible; this means that the amino acids are absorbed more readily from the gut.
Standards for minimal nutritional composition of food for dogs are based on percentages, which are determined by a dog’s physiological status; the percentages are higher for dogs during growth, reproduction and lactation stages, and increase as the weight of the animal increases. Usually, the amount fed to achieve the minimal percentages required for maintenance of normal physiological function in the dog is based on dry matter per kilogram of body weight. That is why labels that show the number of cups of food to be fed per day base the measurement on the size of the dog. Companies formulate their foods to provide a specific amount of protein, linoleic acid, and calcium-to-phosphorus ratio.
If you’re cooking for your dog and want to do your own analysis, a number of websites allow you to do that, but none can be considered foolproof. For example, there’s the USDA Nutrient Database. This is a food calculator only, and doesn’t contain information on ingredients that one might use in a dog-food recipe, such as eggshells (a free web calculator that includes eggshells can be found here: nutritiondata.self.com).
Wellness: Healthy Living
A Virus Worth Watching
It’s not new, but a member of the circovirus family, usually linked to diseases in pigs and some birds, is now showing up in dogs. Research data from the University of California Davis School of Veterinary Medicine suggests that this emerging virus, either alone or as a co-infection, may be a contributing factor in canine illness in California.
Data collection is underway in multiple regions of the country to determine if exposure to circovirus is common and widespread. Dog-to-human infection has not been documented.
“We know from looking at dog samples that were stored in our archives that canine circovirus has been around for at least five years,” said Patricia Pesavento, DVM. PhD, associate professor, Pathology, Microbiology, and Immunology at UC Davis School of Veterinary Medicine. “We are seeing it in dogs now because we are looking for it, and we have the tools to diagnose it now. The canine virus is not a modified strain of porcine circovirus, but is a completely different virus from the same virus family.” The good news is that circovirus does not always result in illness, being found in the stool of 14 of 204 healthy dogs screened.
“From what we know now, circovirus is not a major cause for concern, and the cases we’ve identified post-mortem seem to be isolated,” said Dr. Pesavento.
Among dogs that were sick and had circovirus in their tissues, vomiting and bloody diarrhea were the common symptoms, said Dr Pesavento. “However, diarrhea isn’t necessarily predictable, since two dogs had clinical signs that were limited to the central nervous system, and in those cases blood vessels in the brain were most affected. This reflects the fact that the virus seems to affect the vascular system.”
A symptom as non-specific as diarrhea could come from wide variety of common causes including other infectious agents, ingestion of foreign bodies or toxins, overeating rich treats, and even stress. Dr. Pesavento added that, among infectious agents, parvovirus is very common and can cause vomiting and bloody diarrhea.
Circovirus is shed in feces, and transmission is presumably fecal-oral transmission. Doggie daycare and boarding facilities, where many dogs are gathered in one area, can be a prime source of infection for many illnesses, although the virus is not confined to boarding facilities.
To reduce the chance of any viral illness and to avoid infecting other dogs, apply the same simple measures that you would in a child attending daycare. Avoid contact with ill animals and contact with other dogs if your dog has symptoms of illness. Clean up your pet’s stool and avoid contact with other pet’s stool whenever possible.
“As you well know, dogs are not very picky about what they put in their mouths,” said Dr. Pesevento. “Monitor dogs carefully if they have ‘dietary indiscretion’ that causes vomiting or diarrhea that is mild and short-lasting. Blood in any vomit should be addressed quickly, said Dr. Pesavento.
Consult your veterinarian to get the correct diagnosis, including any laboratory testing. Prompt treatment, regardless of the cause, gives your dog a better chance of quick recovery and avoids infecting other animals.
“There is no circovirus-specific treatment, said Dr. Pesavento. “As with most viral infections, your veterinarian can treat symptoms with supportive fluid therapy or antibiotics to prevent secondary bacterial infections.”
A healthy pet is more likely to have a fully functional immune system to fight infections, so good preventive care is also important.
More than anyone, you know when your dog is not behaving normally. Prompt veterinary treatment can be critical to a good outcome, so address all illnesses early for the overall health of your pet.
Good Dog: Behavior & Training
Animals swallow the weirdest things
A shish kabob skewer, almost 4 dozen socks, a light bulb, 5 rubber ducks, 9 needles, 104 pennies along with a quarter, a hacky sack and a pocket knife all showed up—literally!—as winners in Veterinary Practice News’ annual contest called “They Ate WHAT?”
It’s frightening what dogs can swallow, but it’s also reassuring how often dogs are either able to pass or vomit up a dangerous item without injuring themselves further, especially when they receive proper medical care. It’s also comforting to realize how well dogs can recover from surgeries to remove objects from their insides that should have stayed on the outside.
In this ninth annual radiograph contest, the winning X-rays really are impressive. Not all of them are from dogs, but our canine friends are certainly well represented. This is no surprise—dog and stories of ingesting strange objects are a natural pairing.
Has your dog’s X-ray ever revealed something really special inside?
Wellness: Food & Nutrition
Feeding your dog for life
The modern dog food industry bears little resemblance to the dog food industry of 60 years ago. Rather than a handful of brands, a kaleidoscope of options is now available: preservative- and GMO-free, organic, raw, even some with varying degrees of “source to bowl” traceability. Many of the newer food companies were founded by people dissatisfied with the status quo—dog owners who wanted both the convenience of commercial food and the assurances of safety and quality that accompany food fit for human consumption.
For many, a high-quality commercial diet is an appropriate way to feed their dogs. Though this may sound blasphemous to home-feeding purists, when the number of contemporary foods that contain corn, wheat and far worse ingredients (for example, ethoxyquin, a preservative banned from food intended for human consumption in Australia and the European Union but still found in some dog foods) is taken into account, making a change to a healthier commercial diet could constitute a drastic improvement.
But as we have learned more about the marriage of food and disease, so too have we learned of the necessity to divorce ourselves from processed foods. Many a book has been written on the virtues of whole and natural foods in the human diet, and increasingly, science suggests that their benefits may apply to our canine companions.
According to the American Cancer Society, more than one-third of all human cancer deaths may be eliminated by a healthy diet, and while preventive or palliative canine cancer diets have been comparatively less studied, work done on the topic indicates that a similar effect may exist for our dogs. A Purdue University study found a significantly lower rate of bladder cancer among Scottish Terriers fed cruciferous vegetables (such as broccoli and kale) three or more times weekly (JAVMA 2005, 227 (1): 94–100).
As dietary changes to ward off or combat numerous canine diseases become more widely accepted, it’s likely that many owners will feed their dogs a homemade diet at some point in their pets’ lifetime. A diet rich in antioxidants and whole foods—the same protocol physicians recommend we follow ourselves—does not have to be an exercise reserved for sick dogs but rather, an approach taken on behalf of stacking the odds in favor of our dogs’ longevity.
To some, this is a radical notion. Few remember a time during which the family dog’s meal did not come from a bag or can and contain ingredients of uncertain properties and dubious origins. But despite the fact that owners might wrinkle their noses at the smell of their dogs’ food and struggle to decipher the ingredients list, most who continue to feed commercial food do it for a single reason: the food is “complete and balanced.”
It is true that a balanced diet is essential, and that most traditional commercial dog foods provide the vitamins and nutrients that most dogs need to survive. However, there is a vast distinction between surviving and thriving, and the inclusion of fresh, whole foods in the canine diet may well be the catalyst that transforms good health to great.
For example, antioxidants play a vital role in clearing the bloodstream of free radicals, which can damage cells and are believed to speed up the progression of cancer as well as cardiovascular and age-related diseases. With this in mind, an increasing number of dog food brands have added blueberries, cranberries and other fruits and vegetables rich in antioxidants to their recipes. However, some of these foods’ benefits can be destroyed in the manufacturing process, so their appearance on an ingredient list—frequently near the bottom—may not guarantee a positive effect. Merely incorporating a food is not beneficial if its nutritional quality is diminished or its quantity is not sufficient to be useful to the dog.
For many, the dog food recall of 2007 was a real (and rude) awakening. Even those unaffected by it became aware of the uncomfortable realities of the modern dog food industry, from the vagaries of food safety and sourcing to the ultimate question: what are we really feeding our dogs? The answers—at times limited—left owners wondering what aspect of canine nutrition was so complicated that it could only be understood by a rarified few and only met by a commercial product.
Following this landmark recall, many dog owners ventured into the world of home feeding, where they often encountered a thicket of contradictory information and complex formulas. While some were discouraged, others persevered, and discovered that home feeding need be neither costly nor complicated. It requires a primer on nutrition, a handful of decisions about cost and time, and finding a veterinary professional who can provide guidance on recipe formulation and how to create a balanced diet that optimizes the health of dogs over time.
Stepping into Home Feeding
The first choice is to decide between raw or cooked, which may require some research. There are many books and websites on the attendant benefits and drawbacks of the two approaches; a vet or vet nutritionist should be able to recommend reliable and useful resources.
The second consideration is whether to prepare the food from scratch or purchase a commercial product. While the latter may sound antithetical to the idea of home feeding, here, it refers to commercial diets that include the same whole, fresh ingredients as would be found in a “from scratch” meal, and that incorporate an appropriate nutrient balance. These come in raw, cooked, frozen or dehydrated forms and are manufactured without the harsh processing that can leach ingredients of nutritional value.
For owners who wish to pursue this option, a number of companies offer raw and/or cooked meals. Some provide information on the sourcing of their products, humane treatment of food animals and whether they utilize human-grade ingredients. Those who elect to feed their dogs commercially prepared raw food—pre-balanced, unprocessed raw diets and raw meaty bones—will usually find it in specialty pet-supply stores. (As a reminder, dogs should never be given cooked bones, which can splinter and cause serious problems, including the risk of internal damage.)
These options all offer convenience, sometimes at a price. Because their quality is generally quite high, commercial “homemade” diets can be a more expensive option. Some owners combine methods—for example, feeding a dehydrated food in the morning and preparing a meal from scratch in the evening.
Handmade at Home
Depending on the type of ingredients and where they’re purchased, preparing meals from scratch at home can be more or less expensive than purchasing premade options. Organic ingredients and a shortage of storage space can make it as expensive (or even slightly more expensive). On the other hand, buying in bulk, particularly at wholesale clubs, and being able to store and/or freeze ingredients make this type of home feeding much more affordable. For protein sources, an increasing number of reputable American farms offer individuals the option of purchasing bulk meats (including raw meaty bones) online at discounted prices, an excellent cost-saver.
Entirely homemade meals require attention to supplementation. In the aggregate, all elements need to be accounted for in proportions relative to a dog’s size, activity level, health status and tastes. Fish oil supplements can be an excellent addition, and canine multi-vitamins also can be useful, although they vary widely in quality; some are little more than treats, while others are a sound way to achieve balance. Consult your veterinary professional for guidance on selecting supplements that will meet your home-fed dog’s needs. Calcium is a particularly critical element, although dogs fed a raw diet usually get a large portion of the calcium they need from raw meaty bones.
Finding Your Way
For years, the holistic veterinary community has widely supported raw and cooked diets for dogs as a way to both prevent and manage disease. Veterinary nutritionists, who are fewer in number than holistic veterinarians, are also excellent resources. When looking for a holistic veterinarian or veterinary nutritionist, ask if he or she is familiar and comfortable with the type of diet you wish to feed. Regardless of the method you choose, work with a veterinarian to ensure that the diet is benefiting your dog. To find a holistic veterinarian, visit the American Holistic Veterinary Medical Association website; find a veterinary nutritionist at the American College of Veterinary Nutrition site.
There are a number of online recipe sites as well as canine cookbooks designed for either raw or cooked home feeding. Be aware that their quality varies, and that even in combination, the meals may not afford balance over time. However, if you like the idea of incorporating certain ingredients, take your ideas to the vet professional you choose to assist you in developing a meal plan for your dog. Also, before feeding any new food, check with your veterinarian to be sure it’s safe; a number of foods (including chocolate, grapes and onions) can be toxic to dogs. The ASPCA website also has information on this subject (aspca.org; enter Foods That Are Hazardous for Dogs in the search box).
In recognition of the impact our culinary habits have on the planet, an increasing number of dog owners are applying the same eating ethos they incorporate into their own diets to their dogs’ food regimen. Feeding homemade food also has the benefit of helping reduce our carbon footprint when we choose locally grown, seasonal produce (preferably pesticide-free). You can take that benefit one step further by growing your own fruits and vegetables. Another avenue to consider is buying meat raised humanely; grass-fed beef contains higher levels of omega-3 fatty acids and vitamin E. Improving the lives of our dogs can also translate into improving the lives of food animals.
Julie Mayer, an integrative veterinarian who has dedicated most of her 20-year career to holistic veterinary medicine, has a special interest in nutrition. She has seen firsthand the benefits of feeding dogs a homemade diet, and encourages all owners—even those who are not yet ready to feed homemade—to integrate safe, whole foods into their dogs’ meals. “Food is medicine, and what we feed our dogs can make a profound difference in their health,” she says. True for us, true for our dogs. And truly, there will never be a better time than the present for all of us to eat and live well.
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