Wellness: Healthy Living
Tonight my littlest dog Nellie came in the house sneezing. Any other time of year and I would be unconcerned, but in late spring and early summer an abrupt onset of sneezing after being outdoors is a “foxtail-in-the-nose alarm bell.” I’ll be watching Nellie like a hawk for the rest of the evening. Any crinkling of her nose, ongoing sneezing or bloody nose, and she’ll be my first patient tomorrow morning.
If you are unfamiliar with foxtails, count your blessings! These pesky, bristly plant awns grow in abundance throughout California and are reported in most every state west of the Mississippi. Once the plant heads dry, they become hell-bent on finding their way into dogs’ noses, ears, eyes, mouths and just about every other orifice. They can dive deep into a dog’s nostril or ear canal (beyond sight) in the blink of an eye. And a foxtail camouflaged under a layer of hair can readily burrow through the skin (a favorite hiding place is between toes). Foxtails can wind up virtually anywhere in the body, and associated symptoms vary based on location. For example, a foxtail within the ear canal causes head shaking, under the skin a draining tract, or within the lung, labored breathing and coughing. Not only is the dog’s body incapable of degrading or decomposing foxtails, these plant awns are barbed in such a way that they can only move in a “forward” direction. Unless caught early, they, and the bacteria they carry, either become walled off to form an abscess or migrate through the body causing infection and tissue damage. Once foxtails have moved internally, they become the proverbial needle in a haystack—notoriously difficult to find and remove.
Take the example of Emma Louise, an undeniably adorable Brittany Spaniel mix whose family told me that her favorite pastime is running through fields with her nose to the ground. They described her as a “foxtail magnet,” having accumulated several in her ears and nose over the years. I was asked to help figure out the cause of Emma Louise’s hunched back and straining to urinate. With abdominal ultrasound, I discovered a gigantic abscess tucked up under Emma Louise’s spine, extending into her pelvic canal. Given this girl’s history, I just knew there had to be a foxtail in there somewhere. The question was, would we be able to find it?
As is my medical tradition before launching a foxtail search, I recited a prayer to the “god of foxtails.” I then turned Emma Louise over to one of my surgical colleagues for exploratory surgery. After two hours of nailbiting and a barrage of expletives originating in the O.R., I heard a shout of, “Got it!” The foxtail had been located and removed, and sweet little Emma Louise made a rapid and complete recovery. Not finding the foxtail would have meant a lifetime of antibiotics to treat her foxtail-induced infection.
If you suspect your dog has a foxtail-related issue, contact your veterinarian right away to find out what steps can be taken (at home or in the veterinary hospital) to rid your dog of this unwanted plant material. Whenever possible, avoidance of foxtail exposure is the best and only foolproof prevention. If your dog does have access to foxtails, carefully comb through his or her haircoat—checking ears and toes, too —a couple of times daily to remove any that are embedded and poised to wreak havoc!
Good Dog: Activities & Sports
Helpful tips on shaping up with your dog.
Frank Wisneski of West Covina, Calif., started smoking when he was 11 years old. When hit by a heart attack at the age of 38, he weighed 215 pounds and had been smoking a pack a day for 27 years. He had a five-year-old daughter and a wife who was eight months pregnant. But it wasn’t until about seven years ago, when his daughter was diagnosed with Type 1 diabetes, that he knew he had to make changes.
“At the rate I was going, I realized I probably wasn’t going to be around to help my wife take care of her. That’s what pushed me to quit smoking. About six months after that, we got Major, and I’ve been running with him ever since.”
Major, his black Lab, is their service dog and Wisneski’s primary exercise partner, along with the family’s other black Lab and a Malinois. The four-pack runs four to five miles every weekday morning, starting out at 4 am, before Wisneski goes to work On weekends, he and Major hit the trails around a local lake, where the dirt is a bit easier on the joints, running up to 16 miles in a day.
Wisneski, who now weighs 180 pounds and has completed five marathons, gives his dogs full credit for his good health. “Dogs don’t care if it’s raining. Dogs don’t care if it’s cold. Dogs don’t have another meeting to be at or some other obligation. Dogs are the best training partners ever. They just want to spend time with you.
If you’ve got to get up and go run, you’ve always got a partner to go with you.”
Phil Zeltzman, DVM, a certified vet surgeon based in Pennsylvania and author of Walk a Hound, Lose a Pound, completely agrees. “People make up all kinds of excuses not to exercise, but dogs are always ready to go,” he says. Multiple scientific studies have shown that humans and canines derive similar physical, psychological and emotional benefits from exercise.
Zeltzman recommends that dogs of all ages have a complete physical exam before beginning any exercise program. He has a few other pointers as well: Tailor your activity to your dog’s breed, age, personality and health status. Start slow and progressively build endurance. If you and your dog are just starting to exercise, begin with simple walks, which can later morph into more strenuous activities. Read your dog for stress signals during and after exercise, particularly if your dog is a senior. However, age by itself isn’t a disqualifier, Zeltzman says. “Age is not a disease. I see 12-year-olds that act like six-year-olds.”
At the human end of the leash, the Centers for Disease Control and Prevention (CDC) recommends that adults—including those 65 and older who “are generally fit, and have no limiting health conditions”—get 150 minutes per week of moderateintensity exercise, such as brisk walking. These 150 minutes can be broken into 10-minute increments throughout the day. So, taking a break for a quick stroll with the dog is possible for even the busiest among us.
Walking is a great starting point. “You don’t have to run for hours with your dog to benefit,” Zeltzman says. According to the American Council on Exercise, even modest exercise improves circulation, bringing more oxygen to the heart and muscles and decreasing both the risk and severity of many diseases. Like dogs, people need to start slowly and build up the intensity and duration of their walks. Zeltzman suggests that adding variety to an exercise routine will help ward off boredom; switching up the routine can also help avoid a workout plateau. Following are a few of Zeltzman’s suggestions for doing just that.
Stair walking. For a terrific workout that benefits both the cardio system and leg muscles, find a stairwell, either outdoors or indoors. A variety of types of stairs (such as spiral or half-turn stairs) and/or a variety of stair surfaces (wooden, concrete, brick) can add a distraction for the dog that will ultimately build overall confidence. This comes with a caveat, however: many dogs don’t care for open stairs, and they should not be attempted until your dog is a well-seasoned stair climber.
Hiking. Find a trail at a local park and hit the dirt surface. According to Zeltzman, every organ in our bodies benefits from this type of exercise. Add a few obstacles, such as crossing logs and climbing hills, and you’ve engaged even more muscles, built intensity and spiced up the adventure.
Resistance walks. Lakes and beaches are prime territory for this activity, which involves walking in shallow water and/or on dry or wet sand. Dry sand is the more strenuous option; walking in it exhausts muscles pretty quickly.
Fetch. Retrieving can be a great boredom-buster while walking or hiking. However, this doesn’t mean that you get to relax on a stump while your dog fetches the ball or toy. Rather, you’ll be moving quickly, either toward or away from the dog, during retrieves. A Frisbee or a portable ball launcher such as a Chuckit complements exercise routines.
Power walks. Recommended for physically fit humans and canines, power walking provides a thorough workout. The brisk pace interspersed with intervals of jogging or running and/or armpumping doesn’t allow time to stop and sniff. You can also mix it up with squats, fetch or another activity you both enjoy.
Swimming. Taking your dog for a swim is easy on the joints and great for building endurance. Introduce your pup to water slowly, perhaps starting with resistance walks in warm, shallow water. Add a floatable ball and retrieves can be enjoyed by all.
“Dogs are the best for a healthy, active lifestyle. If a dog is by your side, he doesn’t care what he’s doing. And if he gets to smell a park along the way, that’s a good day,” says Wisneski, who credits his canine exercise partners with saving his life every day.
Wellness: Food & Nutrition
A vet speaks out on genetically modified pet food.
Most dogs now dine on some type of genetically modified (GM) food, often in the form of corn and soy in their kibble. As these ingredients increasingly enter the food supply, we have one more reason to wonder if our shopping choices might be harming our pets.
More animal feeding studies are needed, experts say, and a recent long-term, peer-reviewed report points out why. It found that a diet of GM corn and soy led to higher rates of severe stomach inflammation in pigs, which are physiologically similar to dogs.
Robert Silver, DVM, a Boulder, Colo., holistic vet, tackled the issue earlier this year when he presented his paper, “Genetically Modified Food and Its Impact on Pet Health” at the American Holistic Veterinary Medical Association conference in Kansas City, Mo. Why did he choose this controversial topic, one that few vets even acknowledge?
Silver—a pioneer in the field of holistic veterinary medical practice—says he was inspired by a seminar he attended in Boulder on GM foods and human health. The speakers included Don Huber, a Purdue University professor, and activist Jeffrey Smith, who discussed problems, including reproductive difficulties, that have occurred in livestock fed GM crops.
“I found this seminar mind-opening,” says Silver, the lone vet in attendance. “I had always believed the PR about GM foods—that they are going to feed the world and are a good outcome of our genetic technology.”
The Food and Drug Administration, which regulates the safety of GM crops consumed by humans and animals, considers most GM plants “substantially equivalent” to traditional plants and “generally recognized as safe.” Their regulation involves a voluntary consultation process with the developer before products are brought to market.
Smith, founder of the Institute for Responsible Technology, disagrees. On its website (responsibletechnology.org), he warns that “nearly all GM crops are described as ‘pesticide plants.’ They either tolerate doses of weed killer, such as Roundup, or produce an insecticide called Bt-toxin. In both cases, the added toxin—weed killer or bug killer—is found inside the corn or soybeans we consume.”
Silver says that while “allergies, GI problems, increased risk of cancer, neurodegenerative conditions” and other ills could all be, in part, related to GM foods, “there is no objective evidence of this yet” in dogs. “However, all vets will agree that there has been an uptick in [these diseases] in the past 10 to 20 years.” The advent of GM foods in the 1990s “fits into this timing of disease increases,” he says.
His presentation referred to studies that raise doubt about the safety of biotech crops, such as one reported in 1996 in the New England Journal of Medicine, which found that genes inserted into crops can carry with them allergenic properties.
Silver says that genetic modification introduces foreign proteins that may encourage allergies, and the widely planted Bt corn, which makes its own insecticide, “could possibly cause leaky gut, the gateway to chronic disease.” Corn is a major component of most commercial pet foods. “The big problem with commercial foods is that they are manufactured at high temperatures and pressures,” which alters them and makes them “potentially more allergenic.” And commercial foods contain industrial ingredients that are “more likely to contain GM and herbicide contaminants.”
A study published last year found that GM crops engineered to withstand the toxic herbicide Roundup must now be doused with even more herbicide, since weeds have also developed resistance to it. Residues of these chemicals on crops can find their way into pet food.
A 2013 study published in the science journal Entropy reports that the heavy use of Roundup could be linked to Parkinson’s, autism, infertility and cancers. It goes on to report that residues of Roundup in food can interact with, and enhance, the damaging effects of other environmental toxins. “Negative impact on the body is insidious and manifests slowly over time as inflammation damages cellular systems throughout the body,” the study’s researchers say.
According to Silver, heightened sensitivity to dietary ingredients “is probably what we are seeing with GM foods. It is of concern that this may be driving the increase in GI problems in pets.” Although gluten probably does account for some problems with grain consumption, “I think that grain-free diets, if they are also soy free and contain protein from animals not fed GM crops, can help many dogs, due to being GM free—and not due to some allergy or gluten issue.”
To a holistic doctor, food is medicine, and Silver strongly recommends home meal preparation from individually sourced ingredients to avoid feeding GM ingredients, especially to pets who have other health problems. “I am truly a holistic practitioner in that I believe an ounce of prevention is worth a pound of cure.”
Benbrook, C.M. 2012. Impacts of genetically engineered crops on pesticide use in the U.S.—the first 16 years. Environmental Sciences Europe 24: 24.
Ordlee, J., et al. 1996. Identification of a Brazil-nut allergen in transgenic soybeans. The New England Journal of Medicine 334: 688–692.
Samsel, A., and S. Seneff. 2013. Glyphosate’s suppression of cytochrome P450 enzymes and amino acid biosynthesis by the gut microbiome: Pathways to modern diseases. Entropy 15 (4): 1416–1463.
Wellness: Food & Nutrition
Veterinary nutritionists can be found in universities, teaching veterinary students and treating patients with special dietary needs. We may work in the pet food industry as consultants or by contributing to research, development and education efforts. We also work with veterinarians and their clients, providing answers or input aimed at resolving dietary quandaries.
As a veterinarian with more than 25 years’ experience and a Diplomate of the American College of Veterinary Nutrition (ACVN), I enjoy doing a little of all these.
For example, I may develop a homemade diet for a Labrador with copper liver storage disease, a very particular liver problem. Or I’ll check in with one of my consulting clients to see how a picky young German Shepherd with recurring diarrhea is doing with his new diet. A presentation for a large veterinary meeting focusing on diets that can be used to not only treat disease states, but also to perhaps prevent them may be on my to-do list. Conference calls with veterinary students to discuss nutritional biochemistry and how cats differ from humans and dogs also occupy my time.
But my favorite part of the day is reaching out to pet parents through my work with the Companion Animal Nutrition and Wellness Institute (CANWI), a grassroots not-for-profit organization focusing on optimal nutrition and wellness to improve and extend the lives of our furry children and best friends.
At CANWI, we recognize the difficulty people have in accessing companion-animal nutrition information not sponsored by the pet food industry, a multibillion dollar operation instrumental in providing the bulk of consumer information as well as in supporting veterinary nutrition research and education. While we agree that the industry’s goals align with the need for safe nutrition, we firmly believe that there is also a need for unbiased information on the subject.
As part of this effort, CANWI raises funds for veterinary education, including forums and programs that educate veterinary technicians, students and the pet-vested community. In fall 2016, CANWI named Danielle Conway, DVM, as its first Veterinary Nutrition Resident; the organization will support her two-year formal training program at the University of Tennessee College of Veterinary Medicine. Typically, this sort of advanced training is funded by the pet food industry. As CANWI president Patricia Micka noted when announcing the award, “To the best of our knowledge, this is the first time a nonprofit is funding a Veterinary Nutrition Residency program. It is our intention to make this an ongoing program and not a one-time event.”
Another CANWI mission is to fund scientific research to identify healthy, or what we term optimal or best, nutrition for our companion animals. Every day, we field queries from people interested in feeding their dogs and cats the best possible diet, one that will sustain longer, healthier lives.
While we humans are told to eat plenty of fresh foods, most of our dogs and cats are fed processed commercial foods throughout their lives. What effect does this have— do processed foods provide optimal nutrition and support longevity?
Heat processing improves nutrient availability, shelf life and food safety, but it is also known to cause the Maillard reaction, chemical reactions between amino acids in proteins and sugars that give browned food its distinctive and appealing flavor. Similar Maillard reactions occur in body tissues, especially with aging, and form what are termed advanced glycation end products, or AGEs. Diets high in Maillard reaction products (MRPs) have been shown to increase levels of AGEs in the body.
Studies in humans and rodents have revealed that elevated levels of AGEs in tissues are associated with a number of age-related ailments, including diabetes, cataracts, osteoarthritis, atherosclerosis and vascular diseases. The absorption of MRPs from the diet and their accumulation in the body’s AGE pool may be one of the ways foods have an impact on age related diseases in both humans and animals.
The role of dietary MRPs on health and disease in dogs and cats is unknown. Prior studies measuring MRPs in dry and canned dog and cat diets have shown that the intake of MRPs is estimated to be 122 times higher in dogs and 38 times higher in cats than the average intake for an adult human on a body-weight basis. In our study, we want to determine if it’s possible to modify canine and feline MRP intake by making dietary adjustments. Investigating the effects of a highly processed diet with high levels of MRPs compared to one that is more like homemade—or a whole food diet—with low levels of MRPs may help us unravel diet’s effects on our dogs’ and cats’ lives.
CANWI has given me a forum to share my veterinary experiences and my specialty training. It is truly my honor to work with the organization, which enables me to connect my passion for education and research with my desire to share the best nutrition and veterinary care with all my beloved animal patients, present and future.
Dr. Raditic invites you to join her in supporting this important work with a donation to CANWI, either online through PayPal or via the mail. For more information, go to companionanimalnutritionandwellnessinstitute.org.
Wellness: Healthy Living
We look at ways to make their lives easier.
In your eyes, your dog will alway s be a puppy, even if she’s getting up there in canine (and human) years, or her muzzle is beginning to gray. However, eventually the day will come when you notice that your pup is panting a little bit harder after a long walk and struggling to climb onto your bed. It’s time to start adjusting to the lifestyle needs of an older dog.
When a dog is considered a senior largely depends on breed. Smaller dogs (such as Chihuahuas or Terriers) don’t reach their golden years until they’re 10 or 12, while a Great Dane may attain senior status at the age of five or six. Beyond size and breed, genetics, diet and environment all have an impact on a dog’s life expectancy.
Just as modern medicine has extended the lives of people, with the right combination of attention and preventive care, it can also extend the lives of dogs. If you want your older dog to have a long and happy life, consider incorporating these strategies into your pet care routine.
Remember your dog’s teeth. Dental hygiene is particularly crucial as your dog ages. Regular brushing and professional cleaning can prevent painful dental disease and decay (and help your dog avoid the chewing problems mentioned earlier). If your dog doesn’t enjoy having his/her teeth brushed, consider dental treats and toys instead.
Watch your dog’s diet. Mature dogs often have food issues, including problems chewing, lack of appetite, obesity and digestive difficulties. Consult with your vet on the best diet and exercise plan for your aging dog. Dietary changes may include adding more fiber to aid with digestion or decreasing carbohydrates to maintain optimal weight. Supplements such as fish oil or glucosamine can be added to alleviate joint pain.
Exercise your dog’s body and mind. Like people, aging dogs experience pain and have difficulty performing physical activities they used to enjoy. However, exercise continues to be imperative to their health and well being. Take your dog on short, gentle walks and monitor his/her breathing and gait to make sure nothing is amiss. Your dog’s brain needs plenty of exercise as well. Stimulating toys such as food puzzles help keep your dog sharp.
See the vet more often. Take your dog in for a vet checkup at least twice a year. Just as elderly people need to be aware of health issues and visit their doctors more often, aging pets benefit from more frequent visits. Older pets may need additional blood tests, dental care and examinations. Additionally, many breeds have predispositions toward certain ailments, including arthritis, hip dysplasia, cancer and diabetes. Early detection can help catch these before they become major problems.
“Seniorize” your house. Just as you once puppy-proofed your home, you now need to provide your older dog with special accommodations. For dogs with hip dysplasia or joint issues, consider a special ramp or stairs so they can still get in the car or join you on the bed. Keep food and water in areas they can easily reach, especially if they are vision-impaired. Heated beds can soothe achy joints, particularly if you live in a colder climate. Finally, non-slip surfaces will prevent falls and help your older pet maintain traction when rising.
Pay attention. Monitor changes in behavior; appetite; weight loss or gain; dental issues; and any lumps, bumps or lesions and bring them to your vet’s attention. (A journal is a great memory aid.)
Taking care of an older dog may involve a little more work than you’re used to doing, but caring for a lifetime companion is a deeply rewarding experience. Your dog has been good to you (and for you) for years—now’s the time to return the favor!
Wellness: Health Care
My career as a physical therapist shifted dramatically 11 years ago after I adopted a dog named Teddy. Teddy came to me with a limp, so naturally, I wanted to help him. The first step was to find out what could be done. Several veterinarians later, the conclusion remained the same: rest and nonsteroidal anti-inflammatories (NSAIDs). As a licensed physical therapist, I knew there had to be something more; after all, bed rest and medication for the treatment of human conditions had fallen by the wayside decades ago.
After Teddy landed in a vet ER with a horrifying reaction to a prescribed NSAID, I was determined to help him myself. I began by going online to explore the comparative anatomy and biomechanics of canines and humans. During this search, I discovered a whole new avenue I could take to not only help Teddy, but also, to help his species: a canine rehabilitation certification program available for licensed physical therapists and veterinarians.
I enrolled in the program offered by the Canine Rehabilitation Institute (CRI), which is partnered with Colorado State University’s College of Veterinary Medicine. During my course of studies, I gained an appreciation for the differences and similarities in canine and human anatomy. The CRI program confirmed that all the methodology and expertise I had gained in physical therapy school and human clinical practice could transfer nicely to serving our four-legged friends. While there are certainly important differences between the two species, in general, the years of training I undertook to obtain my advanced PT degree proved to be a huge asset to the profession and practice of my animal rehabilitation career.
The goal of animal rehabilitation (aka rehab) is the same as the goal for humans: improve quality of life through restoration of function, increased mobility and reduction of pain. The best way to determine if your dog is a good candidate for rehab is to ask your primary veterinarian. If the vet is unfamiliar with the services these specialized professionals offer, do some research and become better acquainted with your options. Though the specialty practice of animal rehabilitation has been around for nearly two decades in some areas of the world, it is still in its infancy in the United States. Fortunately, the field is rapidly growing.
Rehab can help any dog with a musculoskeletal or neuromuscular problem, from young puppies to seniors. Some of my canine patients participate in agility, flyball, dock diving, rally, and search and rescue. Others are companions who prefer to hang out and get plenty of nap time. Because conservative methods have proven to be successful a high percentage of the time, the rehab therapist makes every effort to help the patient avoid surgery. When surgery cannot be avoided, post-operative rehab has also been shown to be beneficial for a faster reduction of pain and a quicker return to a more fully functional lifestyle.
PT CAN HELP
• Soft tissue sprains and strains
• Post-operative orthopedic recovery from cruciate ligament repairs such tibial plateau leveling osteotomy (TPLO) and tibial tuberosity advancement (TTA)
• Congenital and degenerative joint disease (dysplasia and osteoarthritis)
• Neurological rehabilitation following spinal decompression surgery (hemilaminectomy)
• Other forms of non-operative neurologic insult, such as fibrocartilaginous embolism (FCE) or spinal cord contusion
Before trying physical therapy with your dog, clear it with your primary veterinarian to ensure that it’s appropriate. There are underlying medical conditions that can rule out PT as an option, so a referral/medical clearance is essential for your dog’s safety.
Your dog’s first visit with a certified canine physical therapist or a rehabilitation veterinarian will involve a fullbody musculoskeletal and neuromuscular evaluation. This specialized, comprehensive, hands-on examination gives the practitioner information needed to develop an individualized treatment plan for your dog’s specific problem(s).
Once the problems have been accurately identified, the practitioner goes to work to address them. A range of approaches is used: skilled manual therapy techniques (joint and soft tissue mobilization), therapeutic strengthening exercises, range of motion/flexibility exercises, and proprioceptive and balance exercises. Additionally, physical agent modalities—“techniques that produce a response in soft tissue through the use of light, water, temperature, sound, or electricity,” according to the California Board of Physical Therapy—may successfully address pain and accelerate healing.
While physical therapy methodology and techniques transfer nicely from the human to the canine patient, canine PT has some important specifics that are beyond the entry-level competencies of human physical therapy programs in the U.S. Similarly, not all veterinary schools include physical rehabilitation as part of their core curriculum. So, finding the right practitioner with the right education is important. Physical rehabilitation rendered by a certified canine physical therapist assistant (PTA) or registered veterinary technician (RVT) is also an option, but these practitioners must be supervised by a qualified PT or DVM with additional training in canine rehabilitation.
State regulatory bodies across the country are currently looking at establishing better laws and regulations to govern this particular specialty. These are needed to allow both non-vet rehabilitation professionals—certified and licensed canine physical therapists—to practice and to determine competency standards for veterinarians.
In California, for example, these regulations have been hotly debated; efforts are being made to allow properly qualified animal physical therapists to practice on their own premises with a veterinary referral. Historically, the California Veterinary Medical Board has wanted to put qualified practitioners under the direct supervision of veterinarians, who may or may not have training in this specialty niche. A legislative task force has been created to work on more appropriate language.
Everyone who’s a consumer of veterinary medical services has a stake in this discussion. Get involved by letting your legislators know that being able to choose a qualified canine physical therapist is important to you. Those who live in California can find out more at caapt.org.
News: Guest Posts
What is Oratene Brushless Oral Care?
Oratene was created by the developer of Biotene, the #1 dentist recommended product for people with Dry Mouth. Oratene has been formulated specially for pets and based on the same 35+ year enzyme technology. Formerly known at Biotene Veterinarian Brushless Oral Care, Oratene features patented, dual enzyme systems which offer superior brushless oral care to help eliminate odor-causing bacteria and plaque biofilm.
Who will benefit most from Oratene?
All pets will benefit from Oratene but is especially beneficial to pets on medications.
What's the medication connection?
Just like people, pets can develop a condition called Dry Mouth (Xerostomia) due to their medications. Medications can alter the protective benefits of saliva by affecting the quantity or more importantly, the quality. Dry Mouth can lead to bacterial overgrowth, periodontal diseases, inflamed gums and even tooth loss.
What types of medications can contribute to Dry Mouth?
Some of the most common classifications are: Anti-hypertensive/diuretic/cardiac, behavior/anti-anxiety, incontinence, NSAIDs/Pain, anticonvulsants.
What is an indicator a pet may have Dry Mouth?
Halitosis and plaque are the most common; however, there are many others such as thick saliva, inflamed gums, periodontal disease and tooth loss.
Can both dogs and cats use it? Is there an age restriction?
Oratene is formulated to be safe for dogs and cats of any age. Does not contain Xylitol, alcohol, chlorine or toothstaining chlorhexidine so it is safe and recommended for everyday use.
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Wellness: Health Care
Treating lick granulomas with cold laser.
My first dog, Ouzel, a Lab mix, spent his last year worrying at a wart on his leg until it became a rough, raised, red patch—an acral lick granuloma. I tried bitter sprays, socks, steroid creams and an Elizabethan collar. I could not get him to stop. I was frustrated, he was obsessed. He died before I finished vet school and had learned about other treatment options.
The causes of this type of inflammation are many: referred pain from arthritis or disc issues, anxiety or boredom, food/flea/environmental allergies, wounds or lumps, cancer. Whatever causes it, once the licking starts, it’s hard to halt. The wound gets thicker, wider, deeper, becomes ulcerated and infected. The hair does not come back, and the skin darkens.
Lick granulomas occur most often in older, male, large-breed dogs, and treatment depends on what caused them in the first place. Deep infections often require six to eight weeks of oral antibiotics. Topical and oral steroids can help break the inflammatory cycle, and antianxiety medications can be tried. On the non-drug front, some dogs are calmed by the snug swaddle of an antianxiety vest; relaxing treats with L-theanine, an amino acid that raises dopamine— and perhaps serotonin—levels; Bach’s Rescue Remedy; a pheromone collar or diffuser; and consistent, ample exercise.
Holistic modalities are also important. Chiropractic can help disc-disease-related nerve pain, and an acupuncture approach I call “surrounding the dragon” encircles the wound with needles to reduce pain and inflammation. Finally, dog owners can elect surgery and CO2 laser, which uses highly concentrated light energy, to remove the sore.
Lick granulomas are recalcitrant and complicated, and a combination therapy may be more successful. Control rather than cure is common.
Vet medicine now has a newer tool to manage these granulomas, a Class IV laser, also called low level, or cold, laser therapy. Laser strength is described by class, and the stronger the wattage of the beam, the shorter the individual treatment. Lasers can be found in printers, CD and DVD players, bar-code scanners and light shows, but these are too weak to use medically. Toys like pointers, which some cats and dogs like to chase, are under 5 milliwatts and fall in the Class I-IIIa category. (Offtopic but important warnings here: never point any laser into the eye or at a reflective surface, like metal or glass. And laser-play can cause frustration in certain dogs, leading to obsessive-compulsive disorders.) Class II-III are used by dermatologists for skin treatments. Class IV’s light penetrates skin down into muscle, tendon, ligaments and bone.
A Class IV laser reduces inflammation, swelling, muscle spasms, stiffness and pain, and we use it at our clinic to address wound care, post-op incisions, otitis, pancreatitis, arthritis, limb edema and soft-tissue injuries. The light, which is slightly warming, also stimulates acupuncture points, which is good for patients who cannot tolerate needles. Animals tend to find the treatment relaxing.
How does light lead to recovery? On a cellular level, the laser enhances biological effects by increasing oxygen turnover in the tissues. Imagine a blood vessel as a moving sidewalk; as red blood cells cruise along under a spotlight (the laser), the beam heats the tissues and speeds up blood flow, which encourages oxygen uptake. With increased oxygen, more ATP (adenosine triphosphate) energy is made, which prompts healing. Present in every cell of the body, ATP is the body’s basic currency, energy used or stored in this nucleotide. When a group of atoms are cleaved off the side of ATP, energy is released to perform cellular activities.
Research conducted worldwide shows the widespread advantages of medical-grade lasers. Human studies found benefits for patients with fibromyalgia, tennis elbow, chronic neck pain, osteoarthritis, rheumatoid arthritis, traumatic neuropathic pain and compromised limb circulation. Wound healing and skin studies include positive effects for diabetic-ulcer healing, blood vessel growth, increased skin cell migration (fibroblasts), hair growth in canine non-inflammatory alopecia and survival of surgical skin flaps for wound coverage.
Laser treatment strength and duration are determined by the size of the area that needs to be addressed and whether the injury is acute or chronic, the wound is dermal or musculoskeletal, the fur is dark or light. After the veterinary team elects a treatment type, the machine calculates an appropriate and safe dose. Precautions are common sense: the light needs to be kept moving so that it doesn’t overheat skin, and it’s never used near a fetus or a tumor.
Laser treatments for lick granulomas focus on small areas. In fact, the less the light is diluted, the more successful the treatments tend to be. For example, if your dog has arthritis in his knees, back and wrists, it’s best to work on them one at a time.
Laser protocols for lick granulomas recommend starting treatments at two to three times a week for a few weeks, tapering to once a week, then to every two weeks as the wound shrinks over a month or so. The treatments have a cumulative effect, so it’s important to commit to the schedule.
With the addition of the Class IV laser, we now have a pocketful of treatment options for lick granulomas. Canine friends who spend their days and nights licking a limb might finally find the respite they need, which could improve our own sleep as well.
Wellness: Health Care
Let’s just get it out there: for a dog, coughing is never “normal.”
As a small-animal veterinarian, I hear this all the time. Clients tell me that their dog has been coughing for a while/off and on/when he’s excited/after pulling on the leash/after going to the groomer and so forth, but that they think he’s “okay.” However, a healthy dog should not cough, and a history of coughing always raises a red flag with me.
Coughing is caused by an irritation or inflammation of one or more of the respiratory organs. A problem anywhere in that system—the larynx, in the back of the throat; the windpipe; the airways (bronchi); or lungs—can cause your dog to cough. Heart disease, which is closely tied to the lungs and airways, also causes coughing.
Sometimes, the cause is benign, like a small bout of tracheobronchitis (an paralysis or a cancerous tumor that is pushing on respiratory structures can all cause a dog to cough.
When coughing is due to a problem in the laryngeal area, it can be a real pain in the neck, both literally and figuratively, and new research is showing that more coughing dogs have laryngeal problems than previously thought.
The anatomy of a dog’s throat is much the same as that of a human’s. The larynx (the area between the nose and the trachea), trachea (windpipe), epiglottis (a f lap of cartilage at the root of the tongue that is depressed during swallowing to cover the opening of the windpipe) and esophagus are the same in both. As well as housing the voice box, the larynx serves to protect the lower airways—trachea, bronchi and lungs —from foreign material and germs. The larynx is lined with secretory membranes, and comprises muscles, cartilage and ligaments.
Also like humans, dogs can develop laryngitis, an inflammation and swelling of the larynx secondary to infection, irritation by dust or smoke, inhaled foreign bodies (grass, bones), or trauma due to excessive barking or pulling against a collar. Older dogs can also develop laryngeal paralysis, a condition in which the muscles that move the arytenoid cartilages (a pair of pyramidshaped pieces of cartilage that open and close during breathing) stop working.
Dogs with laryngeal disorders typically exhibit what are called “upper airway signs” such as changes in their bark; loud breathing that sounds like “roaring”; and a dry, hacking cough that can be exacerbated by pressure on the larynx. Other upper airway signs that clue veterinarians into a laryngeal problem infectious inflammation of the airways more commonly referred to as kennel cough) that resolves easily with medication. Sometimes, the cause is more sinister; collapsing airways, pneumonia, a piece of grass or bone stuck in the back of the throat, parasites, the previously mentioned heart disease, laryngeal include difficulty swallowing, bad breath and an extended neck. A dog with laryngitis looks like he has a sore throat. When veterinarians see these signs, we suspect laryngeal disease and point our efforts in that direction. If we don’t see them, we look for other causes of coughing farther down the respiratory tract.
Generally, coughing dogs are not extensively evaluated for problems with their larynx. However, a study conducted by Lynelle Johnson, DVM, PhD, at the University of California, Davis, School of Veterinary Medicine and recently published in the Journal of the American Veterinary Medical Association* showed the importance of checking all chronically coughing dogs for signs of laryngeal issues. What’s interesting about the UC Davis study is that it found that a majority of coughing dogs who didn’t exhibit classical upper airway signs associated with the larynx had a laryngeal disease that may have gone undiagnosed. This study showed that they should be, and that we should be aware of the possibility of a hidden condition.
To investigate the prevalence of laryngeal abnormalities in this class of coughing dogs, Dr. Johnson enrolled 138 dogs in the study, which lasted for 13 years. Dogs were assigned to one of three groups, based on the duration of their cough: acute (less than two weeks), subacute (two weeks to two months) and chronic (more than two months). As part of the study, the dogs were sedated and their throat and airways were examined via endoscope (a medical device with a light attached), a procedure also known as “scoping.”
Interestingly, Dr. Johnson found that 19 percent of the dogs examined because of cough alone (no upper-airway signs) also had some form of laryngeal dysfunction, ranging from laryngitis to swelling to laryngeal paralysis. Dogs with an acute cough were not observed to have laryngeal inflammation, but it was noted in more than half of the dogs who had been coughing longer than two weeks.
Results also indicated that dogs with a cough of more than two weeks’ duration commonly have laryngeal swelling regardless of the underlying problem. This makes sense, as chronic coughing irritates the throat. Laryngeal paralysis or partial paralysis was also fairly common, seen in 19 percent of the dogs with a cough of more than two weeks’ duration. Remember, these dogs had none of the classic signs of laryngeal paralysis (such as excessive panting and loud breathing); the problem was only diagnosed when their throats were scoped.
Once their laryngeal problems were correctly diagnosed, the dogs received focused testing and treatment.
In dogs with laryngitis, treatment includes antibiotics if appropriate, as well as anti-inflammatories and pain medication. (Laryngitis hurts!) When the inflammation is caused by allergies, the allergies are addressed. A dog with a swollen larynx also benefits from humidified air; a warm, clean environment; and soft food. Dogs with a weak or paralyzed larynx can be treated surgically, or may require hormone therapy; there is anecdotal evidence that laryngeal paralysis may be related to hypothyroidism. Those whose dogs have laryngeal paralysis need to be advised on how to prevent overheating and aspiration pneumonia as well as informed of the links between paralysis and systemic neuromuscular diseases and megaesophagus.
The finding that dogs can have laryngeal disease even when they don’t have the classic signs has significant implications. If we as veterinarians aren’t scoping these coughing dogs, we might be missing something. The bottom line: if your dog has been coughing for more than two weeks, or if the cough doesn’t resolve with medication, talk to your vet about further medical evaluation.*Johnson, L.R. 2016. Laryngeal structure and function in dogs with cough. JAVMA 249(2):195–201.
Wellness: Health Care
A new device as a way to avoid osteotomy for cranial cruciate ligament (CCL) injuries.
THE CANINE KNEE—known as the stifle—is a large, complex and vulnerable joint. Damage to one of its four main ligaments, most commonly the cranial cruciate ligament (CCL), results in pain and lameness and is the reason many dogs wind up in their vet’s exam room. The CCL connects the thigh bone with the lower leg bone and helps stabilize the knee. When it’s torn or ruptured, surgery may be required, particularly for large or very active dogs. In the U.S., the most common surgical repair techniques are the tibial tuberosity advancement (TTA) and the tibial plateau leveling osteotomy (TPLO), both of which require implanted hardware as well as cutting the bone(s) around the stifle joint, a procedure called an osteotomy.
However, an innovative technique utilizing a newly designed device—the Simitri Stable in Stride™—makes it possible to skip the bone-cutting. A Simitri stifle repair involves putting a small plate on the bones on each end of the knee (the femur and the tibia) and connecting them with an interlocking hinge.
Developed by Neil Embleton and Veronica Barkowski, Canadian veterinarians with extensive experience in orthopedic surgery, as a way to avoid osteotomy and preserve maximum joint motion, the device provides immediate joint support with minimal change to its form or biomechanics. It also offers a potentially quicker and less painful recovery.
Partnering with a U.S.-based veterinary implant manufacturer, New Generation Devices (NGD), Embleton and Barkowski developed and tested the Simitri in medium and large dogs. Although the procedure is too new to have good data on its long-term outlook, initial clinical trial results have been promising. (It’s worth noting that there’s also a shortage of evidence-based info on long-term TTA and TPLO results; most of the literature reflects information from their initial development.)
The current sizes of the Simitri Stable in Stride implants are most suitable for dogs 40 to 90 pounds (20 to 40 kg); per correspondence with Dr. Embleton, he is now trialing a device for dogs 15 to 35 pounds (7 to 15 kg), and a version for dogs more than 90 pounds (40 kg) is currently in development.
Interested in exploring this option for your dog? Dr. Embleton suggests that you ask your vet about it, or contact NGD to see if a vet in your area already has experience with the Simitri.
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