Wellness: Health Care
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:
Tips on prevention:
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
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
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:
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
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
Why some vets continue to over-vaccinate
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
- 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?
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:
News: Guest Posts
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.
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.”
News: Guest Posts
Should food that has been genetically modified be labeled?
Last November, California became the first state to put the issue on the ballot. Proposition 37, the “Right to Know Genetically Engineered Food Act,” called for such disclosure on the labels of some raw and processed foods sold in stores. It also prohibited them from being advertised as “natural.” And it didn’t give dog chow a free pass.
Although the measure targeted human consumers, the California Sherman Food, Drug and Cosmetic Law applies to both human and animal foods. So any pet food with a detectable level of genetically engineered content would also have to note on its label, “Partially Produced with Genetic Engineering” or “May be Partially Produced with Genetic Engineering.”
That would mean a lot of new label text in the dog food aisle. Over 90 percent of the nation’s soybeans and 85 percent of its corn is genetically modified, according to 2010 data from the U.S. Department of Agriculture. These crops, modified to resist pests or withstand high doses of weed killer, are common in processed foods such as cereals and dog food.
But even with strong consumer support, the label law failed to pass. The organic industry and other advocates were outspent by biotech companies led by Monsanto—the world’s largest supplier of genetically modified seeds—and the food industry, including Big Dog Food. Nestle, owner of Purina PetCare Company and Mars, the maker of Nutro and Pedigree dog food, donated funds to help defeat it.
The Pet Food Institute and Pet Industry Joint Advisory Council argued that the label requirements would increase costs for farmers, manufacturers and consumers alike. Heated editorials appeared on Petfoodindustry.com.
“Putting scary sounding labels on pet food packaging will likely mislead consumers and impact their purchasing choices,” states a “No on 37” Campaign flyer.
In one ad by the campaign, a befuddled-looking man held up a slab of meat and a pet food canister. The line read, “So dog food would need a label but my steak wouldn’t?” The ad aimed at exemptions in the law that might confuse consumers; in this case, that processed beef dog food would be labeled but beef from animals fed genetically engineered crops wouldn’t.
Label supporters say that, given the prevalence of genetically modified ingredients and the scale of the industrial supply chain, a label that covers many of these foods is a good start (for example, dog food with beef which may contain bioengineered ingredients, such as vegetable oils).
Some dog owners already consider mainstream pet food, with its uniform nubs of dry kibble or wet mush, mere canine junk food; fast, convenient, and nutritionally questionable. But are those genetically modified morsels unhealthy in other ways?
The science is inconclusive. A genetically engineered food is a plant or meat product that has had its DNA altered by the insertion of genes from other plants, animals, viruses, or bacteria. The traditional means—plant breeding—allows desired traits to be cultivated, or unwanted effects to be eliminated, over time. Gene-splicing also shortcuts the long process of adaptation and evolution that occurs between food and consumers,
The FDA has ruled that these foods are “substantially equivalent to conventionally produced foods,” and does not safety test them. Unless they contain a known allergen, there is only a voluntary consultation process with developers, who conduct their own testing. But scientists say that the potential for creating new allergens and toxicants in bioengineered foods is there. At the same time, corporate patent rights over seeds limit independent researchers’ ability to study them.
California’s failed initiative calls labels “a critical method for tracking the potential health effects of eating genetically engineered foods.” Dog owners may agree. How would anyone know if genetically altered foods are triggering disease in dogs? Shouldn’t vets know what the pets they attend to are eating?
One thing is clear: it isn’t over. Several states are now working on proposals for their own label laws.
Editor's note: Starting in 2018 Whole Foods will be labeling GMO foods. And even Wal-Mart has been looking at labeling as well.
Wellness: Health Care
A broken toe nail can be a painful and potentially expensive injury for our furry friends, and it is something that I often see in the ER. A common scenario is a pet suddenly begins to limp while out playing, and upon closer inspection, an injured nail is seen. Some nails have just a minor crack with some bleeding, while other injuries put a toenail at a 90-degree angle (ouch!). Because they can be painful or have bleeding, a cracked or broken nail may be best treated by a veterinarian. With that being said, it may not necessarily require an urgent trip to the emergency room. A broken nail may be something you can care for at home, or, depending on the degree of injury, it may be reasonable to wait to see your regular veterinarian in the morning.
So, what to do if your pet is suddenly favoring a paw and/or you see bleeding? First, get a good look at the paw—including in between the toes and webbing—to see if it is a cut, foxtail or other foreign object, insect stinger, or (you guessed it) possibly a broken nail. When doing so, be sure to look closely at the nail bed, as I have seen cracks and injuries in the nail that were actually hidden underneath the fur line, where the base of the nail goes into the toe. There are 3 general “types” of nail injuries: one where the nail has been completely broken off and is bleeding, one where the nail is cracked or broken but is loosely attached, and one where the nail is cracked or broken but remains firmly attached.
Usually, the best case scenario is when the nail is fully broken off and some bleeding is noted. In these cases, bleeding is usually mild but can be worrisome if it continues. These are the easiest types of injuries to treat at home as you generally only need to apply pressure with a gauze or clean cloth to the nail to stop the bleeding. The key is to hold pressure for at least 5 to 10 minutes with no “peeking to see” if the bleeding has stopped before this time is up. It is important to keep your pet calm during this time, as excitement increases blood pressure and works against a good clot forming. If bleeding continues despite applied pressure, you can apply styptic powder (such as Kwik Stop) and resume applying pressure for another 5 minutes or so. If you do not have styptic powder at home, sometimes a little baking soda can do the trick. If the bleeding continues despite these measures, then I would go to the ER rather than wait.
If you do happen to find a nail that is very loose and dangling, then you can attempt to remove it at home. It is important to have someone help restrain your pet safely while you gently try to remove the nearly broken off nail with a quick pull motion. Caution: only attempt removal if the nail is very loose! Think “loose wiggly tooth” like when you were a kid. Also, be careful during your inspection or attempt to remove a loose nail as this can cause a sudden and unpleasant pain sensation in which some dogs may nip or bite in surprise. If bleeding is noted following the removal, you can then use some gauze and light pressure, and/or Kwik Stop, as previously discussed.
Lastly, there is the type of broken nail that would ideally be treated by a veterinarian. These are nails that are cracked, continually painful, may be bleeding, and are still firmly attached. Treatment for these stubborn injured nails is typically some form of sedation with pain medication followed by cutting off the damaged nail just above the level of the crack. Sedation is needed because you are cutting through the very thick part of the nail with a live blood vessel and nerve, which is very painful. This is usually followed by styptic powder application and a bandage that is left in place for about 24 hours. The bandage promotes a day of rest so that a solid clot forms and the minor wound does not continue to bleed if it gets bumped on something. Although these types of injuries require professional care, it is something that can wait to be seen the following day if you are unable to get an immediate appointment with your veterinarian (unless your dog seems excessively painful, then I would not wait).
Whatever the type of nail injury, dogs are very good at keeping the area clean all on their own with licking, and antibiotics are not needed. A little licking is OK, and it is what a dog would do “in the wild” to keep it clean. With that being said, some of our babies get a little obsessed, and their good intentions can actually make the area more irritated by their constant worrying at it. Because of this, you should continue to monitor the area for any signs of redness, increased swelling, cloudy discharge, or increasing discomfort. The development of these complications is rare in my experience, but if noted, then an e-collar, pain medications and possibly some antibiotics may be indicated. No matter what kind of damage has occurred to the nail, it will generally regrow normally in all but a few situations. Sometimes the nail will regrow with a slight curve or different pigment, but usually returns to its normal appearance over several months - kind of like when us humans lose a nail.
As always, it is best to seek veterinary care if you are uncertain about the severity of any injury, but hopefully this may save you an unnecessary trip to the ER if this happens to your dog during a weekend while you are out having fun!
Smiling in Seattle
The design sensibility at Urban Animal, a veterinary office that opened last year in Seattle, is part Airstream and part 1978 Ford truck—both of which practice founder Cherri Trusheim, DVM, owns.
Located in an old medical building in what is arguably the city’s hippest neighborhood, the warm modern space features funky vinyl chairs and second-hand medical cabinets, paint-by-number dog portraits, an enormous vintage print of a cabin in the mountains (the Irish Setter pointing in the grass was added by an artist friend later), and, in the corner, a photobooth.
Yep, a photobooth, and not one of those unsatisfying digital numbers. This booth uses film and dispenses slightly wet prints in four minutes (for $4). It’s here for clients and patients to amuse themselves and perhaps take some of the stress out of a visit, but non-clients are also welcome to pop in for snapshots.
The photobooth isn’t the only unconventional thing about Urban Animal. Dr. Trusheim, who’s worked as a relief vet and at an emergency hospital, has a different plan. In addition to its all-walk-in, open-weekends schedule, Urban Animal has a strong commitment to keeping care affordable, an approach that might include not pushing for the most extreme and costly interventions. In an industry with spiraling costs, these ideas are as surprising as, well, a photobooth in a vet’s office.
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