health care
Wellness: Health Care
Bromethalin: not all blue-green rodenticides are the same

In 2008, the Environmental Protection Agency announced that it planned to restrict sales of certain rodenticides containing second-generation anticoagulants (such as brodifacoum and bromadiolone) to pest control professionals and agricultural supply stores only. Rodenticide manufacturers came up to speed with compliance in 2011, and  in doing so, began using bromethalin more and more instead of anticoagulants in their products. 

While the change was designed to make rodenticides safer for our children, pets and wildlife, there has also been some devastating consequences. Unlike anticoagulant rodenticides, bromethalin does not have an antidote, and there are still many people and veterinarians that are not aware of its toxicity. There has been an uptick in the number of cases treated since these regulations have been put in to place, and this toxicity is once again being highlighted in veterinary publications in hopes of raising awareness.  

If a dog had ingested a rodenticide in the recent past, it was very likely a D-Con-like product. Anticoagulant toxicities are relatively easy and cheap to treat if caught early as  there is a 2-5 day lag time before bleeding actually happens. This type of exposure can also be diagnosed with a simple blood test, known as a PT test, which checks the clotting time of the blood and confirms exposure if it was not witnessed.

This is not, however, the case with bromethalin.  Bromethalin is a neurotoxin which affects the cells in the brain by causing a rapid influx of sodium particles into its cells.  When this happens, body water follows the sodium particles and leads to swelling in the central nervous system. The symptoms come on much faster and neurological signs can be seen within as little as 2 hours of ingestion. These signs can include depression, a “drunken” gait, rigid limbs, seizures and coma. Because there is no antidote, treatment is aimed at decontamination, intensive, and expensive hospitalization for support of the body and treatment of clinical signs if they develop.

I am sure many people are thinking, “Who would keep this stuff around when you have pets?!” I often have the same thought, but you would be surprised by the number of dogs we treat for this toxicity.

Here is the take home message: 

  • Severity of signs are dose-dependent, and if the poisoning is discovered within 30 minutes to an hour of ingestion, you should attempt to induce vomiting at home* if you are not close to a veterinarian; this will lessen the amount in the body, and therefore lessen the severity of signs
  • Despite how little was ingested, always assume worst case scenario: your pet should be hospitalized on IV fluids for at least 24 hours, during which time multiple doses of charcoal will be given as well as treating for any brain swelling that develops
  • Always bring in any packaging to your veterinarian to help facilitate rapid treatment
  • The lowest average lethal dose of bromethalin for dogs is 2.38 mg/kg, meaning a 10 pound dog could die from ingesting 5 small cubes of bait- not an uncommon feat
  • If at all possible, avoid the use of any rodenticide if you have pets or children


* If you need to induce vomiting at home, you can administer 1 ml of hydrogen peroxide per 1 pound of body weight with a maximum of 45 ml being given. For example, a 10 pound dog would need 10 ml of hydrogen peroxide and 80 pound dog should get no more than 45 ml. Trying this at home is not without risk and there are words of caution to consider: ONLY attempt to induce vomiting if your pet is very alert and if you are further than 1 hour away from your veterinarian.  Also, do not "force" the peroxide in—your pet needs to swallow the peroxide, and because it tastes bad, there is a risk of your pet aspirating the peroxide into the lungs if they are resisting and it is being forced.  Another concern is the potential for aspiration during the vomiting process. Aspiration of peroxide during administration or through the process of vomiting leads to additional problems such as pneumonia. Another note: don't waste time waiting to see if your dog will vomit... gently give the peroxide, grab a blanket to cover your car seat, and begin driving immediately to your vet. 






Wellness: Health Care
Hops Can Be Lethal to Dogs

Home-brewing is a trend that is becoming more and more popular, and unfortunately, so is the occurrence of hops toxicity in dogs. Hops is the plant used in the process of brewing beer, and both the 'raw' or spent hops are toxic. True flowers or dried hops plugs tend to be more toxic than hops pellets (pellets have less residue), while wild hops have been found to be non-toxic. The diagnosis is generally made based on history of having home-brewing supplies as well as seeing hops in vomit.

The mechanism of toxicity is unknown, but may be related to essential oils, resins, phenolic compounds, or nitrogenous constituents within the plant. Many of the substances in hops are degraded or aerosolized during the brewing process, so the exact relationship between substance and toxicity remains unknown.

Clinical signs of toxicity can include agitation, panting, excitement, flatulence, rapid heart rate followed by life-threatening elevations in body temperature. Death has been reported in as little as 6 hours without appropriate treatment. I have seen rectal temperatures greater than 108 F, and these temperatures can be very difficult to control. The high end of normal of a dog’s temperature is 102.5 F, and any temperature above 106 F can lead to an “unwinding” of the body’s proteins as well as permanent brain injury, depending upon the length of time that the elevation in body temperature persists.   

Treatment consists of aggressive decontamination measures including induction of vomiting, gastric lavage (“washing out” the stomach under anesthesia), administration of charcoal, and enemas. Active cooling by any means available is extremely important. There are also specific medications that can be given in the hospital to help control the clinical signs.

Prognosis for survival is generally guarded to poor, and unfortunately, many deaths have been reported. We have had 2 cases of hops toxicity this past year in the ER, and thankfully, both survived with aggressive treatment.

Any breed of dog may be affected, but breeds that are predisposed to malignant hyperthermia (extreme elevation of body temperature for an unknown reason) tend to be more susceptible.  These breeds include Greyhounds, Labrador Retrievers, Saint Bernards, Pointers, Dobermans, Border Collies, English Springer Spaniels, and northern breeds.   

If you suspect your dog has been exposed to hops, seek veterinary care immediately! This is not something that can be managed at home. Quickly take a rectal temperature, and if it is found to be greater than 105 F, begin active cooling measures—such as dousing your pets body with cool water and wrapping icepacks in towels and placing them over its body—in addition to running the air conditioning in car while on your way to your veterinarian or local emergency clinic. This measure could help save your pets life and give him or her the best chance for survival.


Wellness: Healthy Living
Species-Spanning Medicine
When it comes to remedying diseases and disorders, dogs and people are in it together

Call it a movement, a philosophy, a revelation or a revolution.

Call it “one medicine,” “one health” or “zoobiquity.”

Call it something new, or—given that the “aha” moment on which the concept is based came in the 19th century—call it something old that’s been remembered and repackaged amidst the growing awareness that solving the mysteries of animal diseases and disorders, from injured spinal cords to cancer, can lead to possibly curing our own.

Over at least the past five years, there has been a rekindled recognition of the species-spanning nature of diseases, and of the value of species-spanning research. About 75 percent of recently emerging infectious diseases that affect humans have their origins in animals, according to the Centers for Disease Control.

On a theoretical level, the concept of “zoobiquity,” a term coined in the 2012 book of the same name, suggests that, no matter our species, we’re all in this together, subject to most of the same infirmities, capable of passing a lot of them back and forth, and more likely to find cures and treatments if we look at the big picture—at the earth and all its creatures —as opposed to focusing solely on humans.

On a practical level, species-spanning thinking—referred to by various monikers—has led in recent years to veterinary schools reinventing themselves; to a heightened spirit of cooperation between doctors and veterinarians; to new sources of funding for research; and to the realization that, when it comes to diseases shared by humans and animals, the latter may provide a quicker and less expensive route to a cure for all.

Where do dogs fit in? Right at the top. No other animal—if not physiologically, at least in terms of sharing our genetic markers and our home environment—is as close to us.

That’s why Texas A&M veterinarians and University of California, San Francisco, medical researchers have teamed up to study spinal problems in Dachshunds and other dwarf breeds and to test a new drug that blocks secondary infections. The research, which is funded by the Department of Defense, has potential application to battlefield injuries

That’s why, in New York, veterinarians with the Animal Medical Center have joined forces with physicians and researchers at the Memorial Sloan-Kettering Cancer Center to set up trials in which electrical impulses are used to treat tumors of the urinary tract in canines, with an eye toward possible human application.

That’s why the Mayo Clinic has partnered with two veterinary schools, a medical school and a private corporation to study the effectiveness of a device aimed at predicting and controlling epileptic seizures in both dogs and humans. While traditionally, research into canine epilepsy has been funded primarily by the American Kennel Club’s Canine Health Foundation and breed clubs, the Mayo Clinic collaboration received a $7.5 million grant from the National Institutes of Health.

That’s why Tobi, a paralyzed Golden Retriever, is getting stem-cell treatments that may help him walk again as part of a clinical trial headed by Dr. Natasha Olby, veterinarian and neurologist at North Carolina State University’s (NCSU) College of Veterinary Medicine. The trial will involve as many as 30 dogs over three years.

And that’s why Peggy, a Chihuahua from Albuquerque who was born with three legs, is being outfitted with a “bionic” paw at NCSU. Implanting the prosthetic device, which will have electrodes that connect to her nerves, will allow her to run and scratch, and could add to the growing use of comparable technology in humans.

Similarities between dogs and humans, especially when it comes to genes, are also the basis for Dr. Matthew Breen’s research into the most common cancer in dogs, non-Hodgkin’s lymphoma, at NCSU’s College of Veterinary Medicine. Breen and fellow researchers have, with help from the canine genome map, developed a test that can accurately predict how long a dog treated with chemotherapy will remain in remission. In collaboration with the Mayo Clinic and others, they’re in the process of converting the canine test to a human one.

“If that happens, it will be big news,” says Breen, a geneticist and professor of genomics. Breen lost his first dog to cancer when he was 12 and, as an adult, played a role in the mapping of the canine genome—a game-changing achievement that helped place dogs front and center when it comes to health research.

“It’s likely that we will learn more about cancer by looking at what happens in our dogs over the next five to 10 years than we will in the next 20 to 30 of looking solely at cancer in people,” he predicts.

But the key, he emphasizes, is looking at both at the same time.

“If we consider dogs as dogs, we’ll be able to do so much. If we consider people as people, we’ll do so much. But if we consider them both as mammals, and look at what’s common between them, we will find some intriguing answers.”

The possibilities extend well beyond non-Hodgkin’s lymphoma, and well beyond cancer. Dogs, long our antidote for loneliness, may hold the most promise of all animals when it comes to solving medical mysteries and curing what ails us.

“The answer to some of nature’s puzzles about genetics and disease,” Breen says, “has been walking right beside us for the last few hundred years.”


In reality, we’ve been turning to dogs for thousands of years, sometimes quite cruelly, to try to solve our human ills: from the time of Aristotle, who conducted experiments on live animals, and the era of Galen, whose second-century experiments earned him the title “the father of vivisection,” to the period of Pavlov, whose 19th-century experiments included severing the esophagi of living dogs to better study their digestion and, as a sideline, bottling and selling their gastric juices to the public as a cure for dyspepsia.

Many of the medical treatments we now take for granted were either discovered through the use of dogs or tried on dogs first.

In England during the 1600s, the first administration of medication intravenously was accomplished in a dog, via tubes and a pouch made of an animal bladder. In the 1920s, experiments on dogs led to Frederick Banting’s discovery of insulin. Banting and fellow researcher Charles Best surgically stopped the flow of nourishment to a dog’s pancreas and, after it degenerated, removed it, sliced it up, froze the pieces then ground them up. They named the extract “isletin.” When it was injected into another dog in which they’d induced diabetes, the dog’s blood glucose level dropped.

In the 1960s—long before they were ever slipped into clogged human arteries—stents were inserted into those of dogs. When a ballooning version was developed in the 1980s, it too was first tested on dogs.

Currently, as humans wait to take full advantage of its purported promise, stem-cell therapy is becoming more common—though expensive, at around $2,500 per treatment—in treating dogs with arthritis, hip dysplasia and spinal-cord injuries. Removing, treating and reinjecting stem cells (and even differentiated cells) have led to some miraculous recoveries.

Dogs may have access to novel cures and treatments yet to be made widely available to humans, but there’s a trade-off. They are still, in a way, being used as guinea pigs. The difference is—compared to Pavlov’s day, compared to some of the unsavory experimentation on dogs that still goes on—they’re not healthy dogs, or dogs in whom diseases have been induced. Most often, they’re patients, sick dogs who have run out of alternatives and whose owners have enrolled them in clinical trials in hopes of, if not curing their own pet, furthering research that might help other dogs.

The canine cancer samples from around the country that end up in Breen’s lab come from willing donors, or at least willing owners, many of whom see contributing to such research as a way their dogs can leave a lasting mark.

“By providing that data point, it’s almost a legacy for their own dog,” Breen says. “Every dog we recruit, we ask the owner for a picture to put on our wall of honor. We have hundreds and hundreds of pictures of dogs. It helps ground people in the lab, and makes them realize what they’re dealing with is not just a piece of tissue but somebody’s beloved companion that needs to be treated with the same kind of respect.”

Under microscopes, Breen studies chromosomal changes within cancer cells, changes that have been shown to duplicate those that occur in humans. “If we look at what overlaps, it’s those shared genes that highlight the major drivers in the cancer process,” he says.

The aberration of particular chromosomes allows Breen to identify which therapies will offer maximum survival chances. In lymphoma cases, up to 90 percent of dogs respond to chemotherapy and go into remission, but only about half live longer than nine months. By looking at the genetic differences between the dogs who survive for short times and those who survive longer, Breen’s team has developed a test that determines how long a dog will stay in remission; this test will, it is hoped, eventually be available for use with humans.

Experts estimate that one in four dogs will develop cancer in their lifetime. About 50 percent of those over age 10 will die from it. The types, incidence and outcomes aren’t always identical to those in humans, but even in those differences, other clues and opportunities may be found.

Bone cancer, or osteosarcoma, for example, affects a whopping 60,000 dogs a year. In humans, there are only about 900 cases a year and, as a result, its research has never received the kind of funding awarded to work being done on more widespread cancers.

By looking at the disease itself, as opposed to its effect on a singular species, some less high-profile diseases (in humans) can get more attention, and progress can be made more quickly, Breen says.

“We ignore whether it’s in dogs or people, focus on the cancer and get to the biology faster.”

Down the road, such research might keep someone else from hearing those five fateful words Breen remembers hearing as a child, when his own Border Collie cross was stricken with cancer: “There’s nothing we can do.”


Rudolph Virchow, though he wasn’t credited for it in his lifetime, is considered the father of “one medicine.” The 19th-century pathologist coined the term “zoonosis” and created the field of comparative pathology.

“Between animal and human medicine there is no dividing line—nor should there be,” he said. “The object is different but the experience obtained constitutes the basis of all medicine.”

Two centuries later, a variety of factors breathed new life into his old idea. Recently identified zoonotic diseases, like swine and avian flus and West Nile virus, became major public health concerns. At the same time, dissatisfaction was mounting with research studies involving mice, primarily because their findings often weren’t transferable to humans. There was a growing recognition that all animals, both wild and domestic, serve—like the canaries once used in British mines—as sentries for environmental hazards.

Dogs, while at the forefront of much modern research, also played a large role in reviving the species-spanning way of thinking. On top of the tremendous diagnostic and research value it held for dogs, the successful completion of the canine genome map in 2005 showed how similar dog genes are to our own. It also reinforced how much more quickly canine health research can progress. Mapping the sequence of the canine genome cost about $50 million and took one year, while mapping the humane genome cost more than $3 billion over 15 years.

It was one year after that benchmark, in 2006, that the American Medical Association and the American Veterinary Medical Association issued a joint declaration encouraging more partnerships and information sharing between the two branches of medicine.

For far too long, doctors of human medicine and doctors of veterinary medicine—and researchers in the two fields—operated on separate planes. By coming together and sharing their findings, proponents of one medicine held, new opportunities could be realized and new cures, possibly, found.

To those involved with treating and researching animal diseases, the increased respect from those in the world of human medical research is palpable. Dr. Jorge A. Piedrahita, geneticist and professor in the Department of Molecular Biomedical Sciences at NCSU’s College of Veterinary Medicine, remembers a time when overtures from the veterinary medical community to the human one would result in “blank stares, as if they were thinking, What would we want with you?”

“The human medicine field in the past has looked at us [veterinary schools] as technicians,” he says. “They came to us if they needed a pig or a dog, but they never saw us as partners. Now we sit with them really as equals.”

Piedrahita serves as director of the Center for Comparative Medicine and Translational Research, which was created seven years ago. Based at NCSU, one of the first vet schools in the country to fully jump on the one-medicine bandwagon, the center includes 116 researchers at five colleges. The thinking behind the center, he says, is “if we help one species, we’re helping all of them.”

Since then, Piedrahita says, the road between veterinary practitioners and doctors has become much more of a two-way street. “There have been an amazing number of new interactions, and we’re still a very young center. It’s really becoming almost like a partnership.”

Doctors and vets are not the only two cultures the movement has brought closer together, he notes. It has also led to “increased sharing between clinicians, or those working with patients, and researchers, who are confined to labs.” The result, he says, is faster and more efficient research, capable of reaching solutions sooner.

Breen’s cancer research is one example of that. Another is a project Piedrahita is involved with in conjunction with Wake Forest University’s Center for Regenerative Medicine, which is seeking a solution to urinary incontinence.

While it’s a significant issue for women, especially elderly ones, one might not think that dogs—generally a less-prone-to-embarrassment species—would rank it too high, even the spayed ones, in which it is most common. Piedrahita is quick to correct that thinking.

“It’s a very big deal,” he says. “It’s the reason many of them end up in shelters, or being returned to shelters. For the dog, it may not be that big of a deal, but for the owner, it is.”

Throw in its human applications, and it becomes even bigger.

Using cells from the patient—for now, canine patients—the treatment involves reinjecting cells, usually taken from a leg muscle, into the urethral sphincter itself, where they regenerate and build new muscle. The project has received funding from the American Kennel Club’s Canine Health Foundation, and clinical trials involving as many as 40 dogs were expected to begin in January.


Of all the microscopic matters detected in a typical veterinary research lab, irony is not usually among them. But here’s one that has surfaced.

Among purebreds, breeding for certain traits, and to get a certain look—most often accomplished by using dogs who are closely related—has led to recessive disorders, more than those found in any other animal except humans.

It’s believed to be why Boxers are prone to mast-cell cancer and brain tumors, Scottish Terriers to bladder cancer, and Bernese Mountain Dogs to histiocytic sarcoma. It’s why one in five Golden Retrievers is diagnosed with hemangiosarcoma.

But the limited genetic diversity that has led to cancer-causing mutations in many purebreds is also what has led to dogs becoming such a valuable tool in studying disease. Breen compares it to tuning in a radio station. With the dog genome, there’s none of the noise and static from competing frequencies—just a clear signal.

Pointing fingers is useless, Breen says. “I don’t blame anybody.” But he’s among the first to admit that limiting the gene pool has made purebred dogs “a very powerful tool for simplifying genetics.”

With their “less noisy” genetic make-up, purebred dogs offer a speedier research route. It takes thousands of human patients with cancer to identify risk factors, he notes, but the same can be accomplished with as few as 100 canine patients.


In the book Zoobiquity: What Animals Can Teach Us about Health and the Science of Healing, Barbara Natterson-Horowitz, a cardiologist who consults with the Los Angeles Zoo, delves into the many sicknesses we share with animals. (Editor’s note: For a review of Zoobiquity, see the October 2012 issue of Bark.)

Co-authored by Kathryn Bowers, the book points out that not only humans get breast cancer, but kangaroos, beluga whales, wallabies and sea lions—to name a few—do as well. Rhinos get skin cancer; gorillas get depressed; horses suffer from erectile dysfunction; and sexually transmitted diseases plague the non-human world as well, from syphilis in rabbits to chlamydia in koalas.

By looking at the big picture, we’re likely to further our understanding of species-spanning diseases, of the planet and of the environmental factors that contribute to ill health. Two annual conferences on zoobiquity have urged medical practitioners to do just that.

In terms of the latter, dogs, once again, serve as prime examples and perfect models. They sleep in our beds, share our food, lie on our flame-retardant-treated couches and frolic on our insecticide-treated lawns. When we go for a walk, it’s usually with them at our sides or pulling us along behind them.

They may soon lead the way in science as well, as rodents take a back seat when it comes to research examining the role environmental factors, such as secondhand smoke and household chemicals, play in causing disease. While much of it was going on years before the AMA-AVMA declaration was announced or the term “zoobiquity” was coined, research involving dogs (and cats) is increasingly looking at the link between pollutants and cancer.

On top of the fact that the canine genome is 80 to 90 percent similar to that of the human, dogs are constantly at our sides, making them perfect candidates for studying not just cures but also, causes.

Since dogs are such accessible and efficient, not to mention friendly, models, the question arises (or at least ought to): should one health/one medicine/zoobiquity—and more particularly, the view of dogs and other animals as sources of solution to our own diseases—raise animal welfare concerns?

Despite their all-inclusive, holistic and harmonious sounding names, none of the calls for a species-spanning approach to medicine state that all animals are our equals, or that their value parallels that of humans. Only that they get many of the same diseases we do.

As cures come closer and as dogs are increasingly seen as the road to such cures, could our zeal lead to what animal-welfare advocates might see as reckless driving?

The book Zoobiquity points out that in virtually all of the examples it uses, animals involved in the research were already sick. When, on ABC’s “Nightline,” Natterson-Horowitz was asked if the concept could lead to testing on healthy animals—if the Hippocratic Oath of “do no harm” should apply, for instance, to hippos—she replied, “I can’t give you a simple answer, because it’s a very complicated, nuanced question.”

Breen, for his part, doesn’t hesitate. “We don’t induce cancers in dogs. The key issue about cancers, and many genetic diseases in our dogs, is that these are all spontaneous conditions … All the dogs in our study are part of a family, sharing their homes and their lives. The path to discovery involving cancer and our dogs is one we walk along side-by-side with the owners.

“We have access to state-of-the-art technologies to ask key questions, but these are worthless without the willingness of the dog-owning community to collaborate by submitting cancer specimens from their dogs. By building a strong relationship with pet owners, and realizing that their pets are like family members, like a child … it actually means the chances of ever inducing disease are less. I just can’t see it happening; it wouldn’t happen in my lab, let’s put it that way.”

Breen’s bigger fear, when comes to biomedical research, “is that all this will raise people’s hopes too high and too soon.”

That applies to the owners of afflicted pets as well as those who are afflicted themselves, or have human loved ones suffering from a disease. We’re eager to find cures. Dogs, being such perfect models for study, provide what may be one of the quickest routes to them. While a resurgence in the use of otherwise healthy dogs in intrusive experiments isn’t likely, the future (which seems to be getting here faster and faster) isn’t crystal clear.

This much is, however: fairly early in their domestication—and in what was perhaps one key component leading to it—dogs exhibited their ability to stand sentry, to serve humans by warding off dangerous, life-threatening intruders.

In a way, thousands of years later, they’re doing it again.

Wellness: Health Care
Home Treatments For Moist Dermatitis in Dogs—Hot Spots

A recent request by a Bark reader was, “how can I treat a hot spot at home without seeing a vet?” Hopefully I can begin to answer this, but first, one must be able to “spot” a hot spot.

A hot spot is a superficial skin infection that happens when normal skin bacteria overrun the skin’s defenses as a result of damage to its surface. This damage is most often started by the dog chewing, scratching, licking and gnawing at itself. In the first stages of the formation, the skin becomes moist, red, itchy, and infected. Pus begins to ooze from the traumatized skin as infection sets in. Then, the dried pus and damaged skin surface will work to form a tightly-adhered crust, and you will likely notice hair loss over the infection site. This can be a very painful process, and frequently, dogs will show pain when the area is touched.

Dogs are their own worst enemy when it comes to hot spots, and they are generally created by their own over-zealous self-licking and chewing. They can arise surprisingly quickly: a few minutes of “work” can create an impressive area of self-inflicted trauma. The good news is that they almost always look worse than they actually are, and infection is usually superficial—often resolving with topical treatment alone.

So, what causes our dogs to begin self-chewing and licking in the first place? Good question, with a common denominator being anything that creates irritation to the skin, causing the dog to chew or scratch at the site, can cause a hot spot. Think insect bites (fleas, flies), skin allergies, excess skin-surface moisture, dogs with heavy or dense hair coats, matted hair, saliva accumulation under the fur (think of the pet that is always licking its feet), skin scrapes, or excessive humidity in the environment can all be sources for a hot spot to develop. Another interesting cause: good old-fashioned boredom.

The location of the hot spots may help your veterinarian determine the underlying cause of the problem. For example, a hot spot over the hip area could indicate flea infestation, hip arthritis, or an anal gland infection. Similarly, a hot spot near an ear could indicate an ear problem, an allergy, or a dental/nerve irritation. 

What you can do at home:

If the hot spot is small, non-painful, recognized early, and is uncomplicated, it may be possible to begin treatment at home with over-the-counter products made for this use. There are an array of topical sprays, medicated shampoos, and herbal therapies available—too expansive a list to discuss here. The important thing is to ensure that it is a pet-approved/pet-safe product and it is always a good idea to call your veterinarian and ask if your choice seems reasonable. You need to be very careful not to use human topical products as these may be toxic to pets when licked and ingested.  For example, zinc oxide can be toxic when ingested and it is a common carrier in many human skin ointments.

The basics of home hot spot treatment are:

  • If the area is small and non painful, carefully and gently clip the fur that is covering the area—this allows air and medication to reach to wound (word of caution: use approved grooming clippers, not scissors! I see many “accidental lacerations” in the ER because of this.)
  • Keep your pet from licking the area—you guessed it, get out that cone of shame.
  • Apply a warm, moist compress to the area 3 times daily for 5-10 minutes to keep the area clean, to calm the tissues, and to encourage good circulation; allow the area to fully dry before applying anything topically.
  • Use only pet safe, veterinary approved, over-the-counter treatments; as always, it is best to consult with your veterinarian prior to starting any home treatment.
  • Do not place any bandages or wraps to cover the area—you want the area to “breathe.”
  • Alleviate the itching or irritation that started the whole thing in the first place—get to the bottom of the source, otherwise you will be faced with a loosing battle.

Tips on prevention:

  • One of the things that can’t be stressed enough is appropriate flea control! Good flea control is important for any itchy pet and is the foundation of “itch prevention.”
  • In hot, humid weather, always thoroughly dry your heavy-coated dog after bathing or swimming.
  • Make sure your dog is groomed on a regular basis.
  • Keep boredom and stress at bay—provoide adequate exercise and opportunities for mental stimulation and play.
  • Introduce essential fatty acids into your pets diet to help keep a healthy coat.

When you can’t do it alone:

The bad news is that about 30% of the pets who develop hot spots actually have some other kind of skin disease such as a deeper skin infection, a bite wound or other trauma, or even immune-mediated disease. If you have any concerns whatsoever, it is best to have your veterinarian assess them.

Another time that veterinary intervention is needed is when the hot spot becomes so big and painful that it requires sedation to properly clip and clean it (can you imagine what it would feel like to have running clipper blades go over raw flesh? Ouch!). 

An additional potential concern is if a hot spot is accompanied by deeper skin infection, which would require more extensive therapy such as oral pain medications, oral anti-inflammatory medications and oral antibiotics in addition to topical treatments. The treatment your veterinarian chooses will depend on how bad the problem is, how much pain your dog is in, how long the problem has been going on, and if the problem is a recurring one. Some dogs may get one or two hot spots and then never get another one again (luck dogs!), while some may have frequent recurrences. 

Hopefully this helps take off some of the heat of hot spots, and thank you for the suggestion, Mona J!

Wellness: Health Care
Second Opinion: Degenerative Myelopathy
A Vet’s Perspective

Like so many of life’s firsts, first dogs have a special place in our hearts. Patch, the handsome and powerful German Shepherd of my youth, was no exception. I was a teenager when Patch’s healthy body began to deteriorate. At the time, I resigned myself to our family vet’s opinion that my 13-year-old dog was suffering from the chronic effects of hip dysplasia. However, with hindsight (and a veterinary education), I realize that Patch must also have been suffering from degenerative myelopathy (DM), a debilitating neurological disease of the spinal cord, which robbed him of his dignity during his final year of life.

From his belly forward, he was a normal dog—bright, eager to please and utterly without pain, defying time gracefully. Not so the back half, which was progressively turning into Jell-O. It was as though his body was controlled by two actors in a dog costume: the guy at the front was alert and coordinated, the guy at the back was falling-down drunk. I watched my best friend become trapped inside a dying body, the absence of pain making it worse, somehow. His heart was perfect. Mine was breaking.

Fast-forward 30 years, and it’s a clumsy Newfoundland named Tonka who has me thinking about Patch again. That’s because Tonka displays similar signs: stumbling and progressive weakness of the back end.

“Her spinal MRI was clear,” said her owner, “and that new test for DM was negative. So this has to be about her hip problems, right?”

As it happens, I agreed, but my confidence that Tonka could not be suffering from DM was based on more than the “new test,” a DNA analysis recently offered by the Orthopedic Foundation for Animals (OFA), working with the University of Missouri.

As a 2009 study* revealed, DM has an associated genetic marker, SOD1. To simplify the process, let’s say the abnormal gene influencing DM is A, and its normal equivalent is N. Since every dog gets one copy of each gene from each parent, there are three possible combinations—N/N, a dog who is highly unlikely to contract or pass on DM to its offspring; A/N, a dog with a low risk for contracting DM but the capacity to pass on an abnormal gene; and A/A, an at-risk dog who will always pass on a mutated gene to its offspring.

The test is simple, requiring only a saliva swab from the inside of the dog’s cheek and payment of $65, which covers the cost of the test kit, processing and registration in the OFA database.

Without doubt, this is a wonderful tool in the fight against DM, but as the University of Missouri takes pains to point out on its website, having two copies of the mutated gene does not necessarily result in disease. Many A/A dogs are completely normal, although they may develop DM later in life. Other now-unknown risk factors may also be involved.

The list of DM-affected breeds is extensive; among those on it are Golden Retrievers, Boxers, Corgis, Chesapeake Bay Retrievers, Bernese Mountain Dogs, Pugs, Poodles, Rhodesian Ridgebacks and, of course, German Shepherds.

To date, there is no scientifically proven treatment for DM. The best hope is prevention via responsible breeding programs guided by knowledge and understanding of an individual dog’s genetic makeup.

To be absolutely certain a dog has DM, the affected part of the spinal cord must be examined under a microscope, something that unfortunately cannot be done on a living dog. Barring that, the gold standard diagnostic tool is an MRI of the spine, says neurology specialist Dr. Avril Arendse, my colleague at MSPCA-Angell.

And this brings me back to Tonka and why I felt confident that all I had to worry about were her poor hips. Yes, her DM genetic test was normal, but more importantly, her spinal MRI ruled out the possibility of disk disease, tumors and other neurological causes of her clinical signs. Looking forward, Tonka has plenty of options, unlike my much-loved Patch, who, to this day, gave me my first and best lesson for owners nursing dogs with disabling diseases: empathy.

Wellness: Health Care
Dental Care Tips for Dogs
Brush Up!

February is national Pet Dental Health month— do you know where your dog’s toothbrush is? If not, put one on your list of things to pick up the next time you’re out, along with a tube of made-for-dogs toothpaste (human brands can upset a dog’s stomach, among other things). Daily brushing is one of the easiest things you can do to protect your dog’s overall health. Granted, few dogs will step up to the bathroom sink and let you give their teeth a good scrubbing, but with patience and a few positivereinforcement techniques, you can help your dog be more cooperative. (The American Veterinary Medical Association has an excellent instructional video on YouTube—see it here.)

When your dog goes in for her annual examination, your vet will check out her teeth and gums and may recommend a thorough cleaning, which requires anesthesia. Anesthesia free dental cleaning is also an option, though it too is best performed in the vet’s office; it has its advantages, but it’s not for all dogs, and ultimately, doesn’t result in as good a cleaning as one performed under anesthesia.

When all is said and done, the few seconds a day it takes to whisk a brush across your dog’s pearly whites will pay off in better health, not to mention sweeter kisses.

Facts and figures:

  • No matter how big or small your dog is, she has 42 teeth. If she’s one of the toy or short-nosed breeds, those teeth are likely to be crowded, which means greater potential for developing dental problems.
  • According to the American Veterinary Dental Society, roughly 80 percent of all dogs over the age of three have some degree of dental disease.
  • Dogs’ teeth are awash in bacteria-rich plaque, which, when combined with minerals in the saliva, hardens into tartar (or calculus) that traps even more bacteria. Left unattended, your dog’s gums can become infl amed, resulting in gingivitis and ultimately, periodontal disease.
  • Oral bacteria can enter your dog’s bloodstream and cause damage to her heart, liver, kidneys and lungs.
  • Most plaque buildup occurs on the cheek side of your dog’s teeth, so when brushing, concentrate your efforts there. And you need to be quick— dogs have limited patience with this kind of personal-hygiene exercise.
  • When used with supervision, rawhide, raw bones, special chews, dental bones and toys, and other healthy products that work by scraping off plaque (but not tartar) can also help, although they shouldn’t be relied upon to do the whole job.
News: Editors
How much is too much?

A story from the New York Times brings up a different twist to a quandary that many might have to face. If a senior dog needs surgery how much is too much to extend a pet’s life? The twist is that the dog didn’t belong to writer Roz Warren. It was Max, her son and his wife’s 13-year-old dog, who needed the gall bladder surgery costing $6,000—and it was Roz who offered to pay a third of it.

We didn’t want to let Max go. We wanted to try to save his life.

Was this crazy? “Would you pay $6,000 for a 70 percent chance of buying two extra years of life for an elderly dog?” I asked my dog-owning friends.

“In a heartbeat,” one said.

“No way,” another said. “When it’s time to go, it’s time to go. You grieve. Then you get another dog. Preferably from a shelter.”

Another friend admitted that when the vet told her a couple of years ago that her ailing Shih Tzu needed an expensive procedure to save his life, she had blurted: “Do whatever you have to do! I love this dog even more than I love my husband!”

“And I really do love my husband,” she told me sheepishly.

Luckily all went well with Max, even though the surgery found that his gall bladder had already ruptured, he recovered.

Even if he hadn’t made it through, knowing that we had done all we could for him would have been worth that price. More important, the whole experience has made me very hopeful about how Tom and Amy are likely to treat me when I’m old and frail.

That was a great gesture for a dog-grandmother to make. What do you think you would have done?

News: Guest Posts
Veterinarians and Vaccines: A Slow Learning Curve

Am I feeling frustrated and disappointed? You bet I am after reading an article titled, “Vets Slowly Move to 3-Year Vaccine Protocols” in the most recent edition of Veterinary Practice News. According to the article, approximately 60 percent of veterinarians continue to over-vaccinate their adult canine and feline patients by administering “core” vaccinations annually. This in spite of the fact that, for a decade now, it has been public knowledge that these vaccines provide a minimum of three year’s worth of protection.

Current canine and feline guidelines recommend that adult dogs be vaccinated against distemper, parvovirus and adenovirus, and adult cats against panleukopenia virus, herpesvirus and calicivirus no more than once every three years. Bear in mind, these are not rules or regulations (although I wish they were) they are simply guidelines. With the exception of rabies (mandated by state governments) veterinarians can vaccinate as often as they please.

The risks of over-vaccinating
What’s the downside to your pets receiving three-year vaccines once every year? My concerns extend far beyond wasting your money. (Please pause for a moment while I step up on my soapbox!) Vaccinations are so much more than simple shots. They truly qualify as medical procedures because each and every inoculation is associated with potential risks and benefits. While adverse vaccine reactions are infrequent and most are mild, every once in awhile a vaccine reaction becomes life threatening. As with any medical procedure, it is only logical to administer a vaccination if the potential benefits outweigh the risks. Giving a three-year vaccine once a year defies this logic in that the patient is exposed to all the risk of the procedure with absolutely no potential benefit. How in the world does this make sense?!

Why some vets continue to over-vaccinate
According to the Veterinary Practice News article, there are two reasons why approximately half of veterinarians continue to over-vaccinate. First, they believe as I do in the importance of annual health visits for dogs and cats. They also believe that the lure of a vaccine is the only way to convince their clients of the need for a yearly exam, and for good reason. In 2011, the “Bayer Veterinary Care Usage Study” documented that many people continue to believe that vaccinations are the only reason to bring their overtly healthy pet in for a veterinary visit.

The second explanation provided for over-vaccinating is that veterinarians don’t want to interrupt the revenue stream derived from annual inoculations. Despicable, in my book!

A possible third explanation is that some veterinarians remain unaware of current vaccination guidelines. If so, they must be living under a rock and begs the question, why would you want such an “outdated” individual caring for your pet’s health?

What you can do
Okay, now that I’ve ranted and raved a wee bit, I invite you to join me on my soapbox! Here are some things you can do to prevent over-vaccination.

- Stand your ground! If your vet insists on administrating core vaccinations to your adult pets every year, share a copy of current canine and feline guidelines. You may need to agree to disagree and/or find yourself a more progressive veterinarian. Remember, you are your pet’s medical advocate and you have the final say so!

- Bring your pets in for a yearly checkup, whether or not vaccinations are due. I cannot overstate the importance of an annual physical examination for pets of all ages. It’s a no brainer that the earlier diseases are detected, the better the outcome. The annual visit also provides a time to talk with your vet about nutrition, behavioral issues, parasite control, and anything else that warrants veterinary advice. Enough people bringing their pets in for annual wellness exams may convince more veterinarians to revise their vaccine protocols in accordance with current guidelines.

- Spread the word by sharing the information in this blog post with your pet loving friends and family members.

To learn more about vaccinations, I encourage you to read “The Vaccination Conundrum” in Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life.

How frequently are your adult pets receiving their core vaccinations?
If you would like to respond publicly, please visit Nancy Kay, DVM

Wellness: Health Care
Treatments to try at home

Paraphimosis is the inability to retract an extruded penis back into the preputial sheath, which is the skin that covers it. This can quickly turn into an emergency situation, as constriction of blood flow will lead to greater engorgement, necrosis (dying off of the tissue), and potential damage to the urethra. 

More common causes of this condition can include chronic licking, sexual excitement, or foreign bodies getting up under the skin. However, there are more serious causes including neurological disease (such as a herniation of a disc in the spinal cord), penis fractures, or muscular issues. Paraphimosis also needs to be differentiated from priapism, which is a state of continuous erection, usually due to a neurological problem.

A diagnosis of paraphimosis is generally based on simple observation of the penis extruded from the prepuce without any physiological reason. Paraphimosis accounts for approximately 7% of penile problems in the dog, and while not common, it can cause distress to pets (and their owners) and can have more serious consequences if left untreated or if it becomes a recurring issue. 

Treatment is generally conservative in nature, and many of these interventions can first be tried at home. Here is what you can do if this condition if noted in your pet:

  • First, thoroughly clean the exposed penis and inspect it for any foreign material such as foxtails or long fur that is “strangulating” the tissues of the penis.
  • Mix up a “sugar paste” using ordinary white sugar and enough water to make it into a  thick slurry.  Apply this mixture liberally to the extruded penis. The sugar works as a hyperosmotic agent, “pulling out” fluid from the tissues to help to reduce the swelling and shrink the penis. 
  •  Wrap up a bag of frozen peas in a light towel and place over the area for 5 minutes at a time, which also helps to reduce swelling of the tissues. Packaged peas work well because they are very moldable around the dog’s anatomy. 
  •  Lubricants, such as K-Y jelly, should then be applied. Lubrication helps aid in returning the penis back into the sheath.
  •  If the swelling does not resolve within 30 minutes, and if the penis does not stay retracted into the prepuce despite the interventions above, then immediate veterinary assistance is needed. I have unfortunately seen several cases where the tissue of the penis had died off due to lack of blood supply, and these poor pups required a partial penis amputation—this is a true emergency in our pets.



    News: Guest Posts
    One Lucky Puppy

    He didn't run like a puppy; he flopped like a seal. His back hunched when he moved as if he was stalking stray sheep. Lucas was born with his front legs curved inward, hobbling his every step. In February, he arrived at Glen Highland Farm's Sweet Border Collie Rescue in Morris, New York, run by Lillie Goodrich and John Andersen. His new caretakers were smitten with him. But what good was their 175 - acre wooded, stream-filled sanctuary to a badly handicapped pup?

    Worse, Lucas didn't seem to know he had any limitations. He tried to run and play as hard as any three month old pup; even though all of the bones in his elbows were displaced and separated, leaving him with no range of motion. His rescuers struggled to find solutions when veterinarians offered little hope. A canine cart? The “wheelchair” option led them to consider euthanasia. With his energy and powerful herding drive, Lucas might as well be imprisoned.
    Then they met Dr. Kei Hayashi, an orthopedic veterinary surgeon at nearby Cornell University, who told them about a new surgical technique that might offer the best outcome.

    The traditional way of reconstructing limbs is to cut bone and utilize biomechanical devices, such as pins and screws, to hold the bone in place as it heals. In Lucas's case, a traditional approach could help, Dr. Hayashi says, but his deformity was so severe that “there is no ideal treatment.”

    The chosen procedure would focus on stretching and adjusting the position of the muscles in order to reposition the bones. The method, which is inspired by a few veterinarians, including one from Cornell, doesn't replace other techniques, Dr. Hayashi says. “It's not very different from any other surgical procedures in principle,” he says. “It is a modification” of existing techniques used in other types of deformity. “Each case is different. Each deformity is different.”

    Lucas's defect is “very rare,” the surgeon says. While the cause is unknown, genetics probably play a role.

    In early March, Lucas underwent the operation at Cornell, where he is now in the first phase of physical therapy. Everything went well, but it's still too soon to gauge its success. “Lucas is still recovering and is fighting this tough battle, and he will probably need to go through more procedures,” Dr. Hayashi says.

    His rescuers anxiously monitor his progress. “The process will be a slow one since he has never stood upright on his front legs and has no muscle development” for such movement, Lillie Goodrich says. “His attitude is terrific and he is truly loved by all the team in the hospital. This first two weeks is a vulnerable time when the therapy is critical. Then he returns to the farm for continued therapy up until age one.” The costs are extreme and caretaking is only half the job. His rescuers must also raise the funds for his recovery.

    However, the future is looking a lot brighter for the once-unlucky puppy, who still has plenty of time to grow into his limbs. “His prognosis for a normal joint is poor,” Dr. Hayashi says. “His prognosis for a happy life is good.”