Saturday, April 21, 2018

Top Veterinary Articles of the Week: Polyphagia, Puppy Strangles, and more ...

Polyphagia – When Your Pet is Eating You Out of House and Home

Dr. Christopher Byers/CriticalCareDVM

Top Veterinary Articles of the Week

Polyphagia is a fancy word that refers to excessive, "just can't stop eating" type of appetite.

For some reason, this reminds me of an old fairytale about a magic tablecloth. All you had to do was to put it on a table and order any food you wanted. And there it was. The one caveat was that should you eat if it long enough to have to loosen your belt, you would be cursed to keep eating until you exploded.

How would such a curse even work? Perhaps it would mess with the center of the brain that tells you that you had enough.

That's what happens with polyphagia. Your dog's hypothalamus is what controls appetite. To do that it receives information from the body. Simply put, the body reports to the hypothalamus what its status is, and the hypothalamus decides when your dog should acquire more nutrition--when they're hungry.

When any part of this system breaks down, your dog is trapped in the "magic tablecloth effect."

Things that can cause polyphagia include issues with the brain or central nervous system, hyperthyroidism, diabetes, exocrine pancreatic insufficiency, and other conditions.

To learn more about polyphagia, read Dr. Byers' article.

Homeopathy Is Less Likely to Kill Animals than Refusing to Take a Pet to the Vet

Dr. Pete Wedderburn/vethelpdirect

There is a war on homeopathy raging out there. There is a war raging on every other thing as it seems. There seem to be enough people who would like to see homeopathy outlawed. Science-based medicine ought to be the only thing allowed.

I have nothing against science; I love science but what does science-based medicine mean?

"Science-based medicine (SBM) evaluates health claims, practices, and products by the best scientific evidence available." ~the Skeptic's Dictionary

To me, this means the sum of available funding, subjective choice of topic and ways to study it. While science itself is objective, its application need not be. And lack of evidence is not evidence to the contrary. Perhaps the day is coming when science will understand and have an answer to everything. I do not believe that day is here.

I love science. I love and used regenerative medicine, immunotherapy, I am happy to have surgery or antibiotics available to use when my dog needs them. I have virtually never used homeopathy, but I have been using integrative medicine.

I do want to have the choice of using homeopathy for my dog if I so chose so. I do not like the idea of somebody telling me I'm not allowed.

"Successful veterinary treatment is not just about prescribing proven medication" ~Dr. Pete Wedderburn

You never know what might or might not work for your dog. I know people whose dogs benefited from homeopathy. I know there are things science is just catching up on. I want to have the choice.

One note I'd make here is that homeopathy is a holistic modality. Which means that choosing a treatment that worked for another dog will work for yours. Proper hands-on evaluation is essential regardless of the modality you want to use.

I appreciate Dr. Pete's article in defense of choice.

Puppy Strangles

Dr. Justine Lee

Puppy strangles is a rear disease that affects puppies. Considering how rare it's supposed to be, I feel I am aware of more cases than I should be. It certainly can happen.

Puppy strangles is a skin disorder. Doesn't sound like much, does it? However, this disease can be quite severe, and it requires early and aggressive therapy. It can lead to devastating scarring and even death if not treated.

Puppy strangles typically affects puppies up to 4 months of age; some breeds are more susceptible. It is not really known what causes it, but it seems to be primarily an immune-mediated disease.

To learn more about puppy strangles, read Dr. Lee's article.

Related articles:
Jojo Recovers from Puppy Strangles

7 Things You Need To Know About Heartworms

Dr. Anna Coffin/Guthrie Pet Hospital

Heartworm Society Mosquito
Infographic American Heartworm Society

Believe it or not, I already got several mosquito bites; in the house. I have no idea how they get in there, but they do. To clarify, we still have a couple of feet of frozen snow cover outside.

Last year, we found the odd mosquito inside while the temperature outside was -30 degrees Celsius. I kid you not. It seems they like to ride out the winter in our pile of wood, especially where it is close to the ground.

For that reason, and the fact that winters are not as consistent in outside temperatures as they used to be, I give heartworm preventive all year round. No, I don't like putting poisons into my dog's body, but I like the potential of heartworm infection even less.

Dr. Coffin lists seven things you ought to know about heartworms:
  1. Heartworm disease is prevalent in all 50 states.
  2. It only takes one bite from an infected mosquito to infect your pet.
  3. It takes six months after being bitten by a mosquito for the worm to reach the heart.
  4. It is 15 times more expensive to treat heartworms than to prevent.
  5. There is only one approved treatment for heartworms in dogs.
  6. There is no approved treatment for heartworms in cats.
  7. 1 million dogs in the United States have heartworms.

One million dogs in the US have heartworms. Can you imagine? It is certainly one thing I don't intend to take any chances with.

Read Dr. Coffin's article to learn why are heartworm infections on the rise, and other insights.

5 Things You Need to Know About Hip Dysplasia

Dr. Andy Roark/Cone of Shame

I'm always excited when Dr. Roark puts out another video. He's fun, easy-to-understand approach to explaining topics is well worth watching. Check it out.

Thursday, April 19, 2018

Symptoms to Watch for in Your Dog: Sudden Weight Gain

I believe that every time you find yourself using the word sudden when describing your dog's symptom, you should figure that the urgency of treatment is equal to the speed of onset. Sudden is a synonym for acute.

Obesity is a real epidemic, but no dog goes to bed skinny and wakes up fat.

When it appears that they do, something is seriously amiss.

Symptoms to Watch for in Your Dog: Sudden Weight Gain

There are conditions that can cause your dog to gain weight, or look like they did, relatively quickly, such as underactive thyroid or Cushing's disease. But that doesn't happen overnight either. None of these things should be ignored, but they don't constitute an emergency.

If it happens acutely, you're not looking at weight gain but distention or swelling.

In large breed dogs, a common cause of a sudden expansion of the abdomen--and a mother of all emergencies--is GDV, gastric dilatation-volvulus also referred to as bloat. While there is a difference between bloat and GDV, the former can quickly turn into the latter. The abdomen will be visibly enlarged, your dog might be retching without anything coming out and having difficulty breathing and acting distressed. GDV is extremely painful and can quickly become deadly.

If your dog has symptoms like these, call your veterinarian immediately.

Blood of fluid accumulation in the abdomen will also make the belly look enlarged.

A splenic tumor, for example, whether benign or cancerous, can rupture and bleed into the abdomen. Your dog may also act lethargic, weak, and have pale mucus membranes. This too is an emergency.

Excess fluid in the abdomen can be a common side-effect of some types of heart disease, liver disease,  or low blood protein levels that lead to fluid leaking out of the blood vessels.

Other potential serious causes of an enlarged abdomen can be swelling or enlargement of vital organs, infection of the abdomen (peritonitis), a ruptured bladder, or a large abdominal tumor.

Symptoms that can come with it may include lethargy, weakness, loss of appetite, vomiting, signs of discomfort and pain.

Severe intestinal parasite infestation can cause fluid build-up.

When you observe these things, you know you have a very ill dog on your hands.

Other areas of the body can swell up, such as legs with heart failure or swelling of the face or legs with lymphoma.

Even something as deceptively as benign as an allergic reaction with severe swelling can become an emergency in a hurry.

Do you know what your dog is telling you about their health?

Learn how to detect and interpret the signs of a potential problem.

Symptoms to Watch for in Your Dog now available in paperback and Kindle. Each chapter includes notes on when it is an emergency.

Symptoms to Watch for in Your Dog is an award-winning guide to help you better understand what your dog is telling you about their health and how to best advocate for them. 

Learn how to see and how to think about changes in your dog’s appearance, habits, and behavior. Some signs that might not trigger your concern can be important indicators that your dog needs to see a veterinarian right away. Other symptoms, while hard to miss, such as diarrhea, vomiting, or limping, are easy to spot but can have a laundry list of potential causes, some of them serious or even life-threatening. 

Symptoms to Watch for in Your Dog is a dog health advocacy guide 101. It covers a variety of common symptoms, including when each of them might be an emergency. 

Symptoms to Watch for in Your Dog has won the following awards:

Tuesday, April 17, 2018

When Your Dog Stops Eating: Julie's Story

When a Labrador stops eating and when a Border Collie becomes lethargic, even just a little bit, you know you ought to worry.

Julie is a two-year-old Border Collie, and she did both. Stopped eating and had less energy than usual.

Julie is a typical girl for her breed. Happy, active, spending a lot of time outdoors, living the perfect life a Border Collie should live.

She always enjoyed a good romp and a good meal. Until the day when she walked away from her bowl without touching what was in it. She refused her next meal as well.

Could it be the food?

Well, it could be the food though I'd think that is much rarer than one would figure. Dog food can spoil, the fats in it rancid. Or it can be a new bag with a different formula or perhaps even some contamination.

This was not a new food or a new bag, and Julie is not a picky eater. And she refused treats as well.

More importantly, she was acting somewhat lethargic.

Julie didn't have a fever, and her dad was confident she didn't get exposed to anything toxic. Some of their friends suggested that it is so unusual that a dog would occasionally go off food for a day or two. Which is true, it does happen, and it can be from an upset belly after some dietary indiscretion. But Julie has never stopped eating before and has not gotten into anything.

Julie's dad considered all the possibilities.

Your primary job is to know your dog and know when something truly doesn't add up. Julie's dad did his job.

The veterinarian examined Julie and recommended x-rays.

The x-ray images showed that Julie's belly was full of rocks.

However that happened, her dad did not see her eat them, Julie needed a surgery. I suppose the cause was a dietary indiscretion after all. But it was the kind that you don't just sleep off.

Julie's surgery was successful, and she's recovering well. The question, I believe, remains, what came first? The upset belly or the rocks?

Naturally, the rocks ingestion would make the belly upset. But what if the belly was already upset BEFORE?

Sometimes a dog can eat things that are not food because they're trying to fix their already unhappy belly.

For example, even though not listed as a common breed-specific health issue, according to one study, collies have an increased relative risk of chronic pancreatitis. So Julie's dad has a bit more work to do in figuring out why she figured that eating rocks was a good idea in the first place.

Related articles:
Symptoms to Watch for in Your Dog: Pica

Do you have a story to share?
Your story can help others, maybe even save a life!

What were the first signs you noticed? How did your dog get diagnosed? What treatment did/didn't work for you? What was your experience with your vet(s)? How did you cope with the challenges?

Email me, I'll be happy to hear from you.

Do you know what your dog is telling you about their health?

Learn how to detect and interpret the signs of a potential problem.

Symptoms to Watch for in Your Dog now available in paperback and Kindle. Each chapter includes notes on when it is an emergency.

Symptoms to Watch for in Your Dog is an award-winning guide to help you better understand what your dog is telling you about their health and how to best advocate for them. 

Learn how to see and how to think about changes in your dog’s appearance, habits, and behavior. Some signs that might not trigger your concern can be important indicators that your dog needs to see a veterinarian right away. Other symptoms, while hard to miss, such as diarrhea, vomiting, or limping, are easy to spot but can have a laundry list of potential causes, some of them serious or even life-threatening. 

Symptoms to Watch for in Your Dog is a dog health advocacy guide 101. It covers a variety of common symptoms, including when each of them might be an emergency. 

Symptoms to Watch for in Your Dog has won the following awards:

Monday, April 16, 2018

Adoption Monday: Sadie, Rottweiler & German Shepherd Dog Mix, Bowmanville, ON

Sadie is an absolute sweetheart !! Such a happy girl.

Sadie was brought into a shelter with her sister as owner surrenders around Christmas. She has been assessed as a wonderful girl.

Sadie is about 3 years old and would love to help her find her forever home.


ANML-RESQ is a dedicated group of volunteers looking out for the 4-legged creatures we share this world with. Their goal is to save a dog or cat from being euthanized in a shelter, through no fault of their own - just in the wrong place at the wrong time. If they don't have a foster home available they will work with other reputable organizations to find a place.

ANML-RESQ relies solely on donations and fundraisers to spay/neuter, vaccinate and microchip their pets prior to adoption.  They don't even use funds for gas to transport the pets in their program to their new homes!

Saturday, April 14, 2018

Top Veterinary Articles of the Week: Fever, Sago Palm Toxicity, and more ...

Fever in Dogs and Cats – Figuring Out Why Your Pet is Burning Up!

Dr. Christopher Byers/CriticalCareDVM

Fever is an elevation in body temperature as part of an immune response in order to enhance the immune response and to create an environment inhospitable to invading organisms.

Your dog's body temperature is regulated by the hypothalamus, the body's thermostat. When there is inflammation in the body, the hypothalamus turns on the heat. That's because that the common cause of inflammation is an infection even though other things can be at play such as drug reaction or an immune-mediated condition.

This is different from hyperthermia. Fever is on purpose, while hyperthermia is not; your dog will suffer hyperthermia when their body is unable to dissipate excess heat.

How to best address your dog's fever depends on what caused it in the first place. In other words, your dog needs to be diagnosed first.

How would you know your dog has a fever, or, in other words, how would you know to check your dog's temperature? It depends on the dog and on how high the fever is. Your dog might be slightly less active or lethargic. They might get picky about their food or stop eating altogether. They might feel warm to the touch. And they're likely to exhibit other symptoms related to the underlying cause.

If your dog has a fever, you should see a vet. How fast depends on how high the fever is and how severe are the symptoms.

Do you have a rectal thermometer in your dog's first-aid kit?

To learn more about fever, read Dr. Byers' article.
Related articles: Symptoms to Watch for in Your Dog: Fever

Will Elbow Surgery Help Your Dog’s Arthritis?

Dr. Marty Becker

Any joint, particularly those that have to withstand high impact, can be affected by arthritis. Most of the time you hear about knee and hip issue, but elbows can cause trouble as well. The dog's elbow is actually a very complex joint which too can be affected by dysplasia. Elbow dysplasia is an assortment of ways in which the joint can be deformed and not develop properly.

There are surgical solutions available, which even include an elbow replacement.

Read Dr. Becker's article to learn more.

Related articles: Hip and Elbow Dysplasia: Are They the Same Thing?

Are Anxiety Blankets Safe for Pets?

Dr. Wailani Sung/petMD

One of the latest inventions in the battle against dog anxiety are weighted blankets. This has been extrapolated from human use where studies have reported it being helpful. Currently, there are no weighted blankets designed specifically for use on pets.

The main two questions, like with any other treatment, should be whether it is effective and whether it's safe. Weighted blankets may or may not be effective; there are other similar concepts out there such as anxiety vests and wraps which do seem to help at least some dogs. They are, however, light and do not restrict movement.

When it comes to the safety of the weighted blankets, there are concerns. According to Dr. Sung, the smallest blanket might weigh anywhere between two to four pounds, simply too heavy for your dog. This may not only cause discomfort and decrease the ability to move but it might even place too much weight on the chest, making it difficult to breathe. That does not make it sound like a good idea to me.

And that's leaving the consideration of what happens if your dog chews it up aside. These things are filled with heavy plastic beads--not good or safe eating.

If it were me, I'd stick with the vests and wraps.

Read Dr. Sung's thoughts on the subject.

My Dog Just Ate a Sago Palm

Dr. Justine Lee

This story reminds me of the movie Jurassic Park, where the botanist was voicing concerns about some of the vegetation they chose to feature in the park. "You have plants in this building that are poisonous; you picked them because they look good. But these are aggressive living things that have no idea what century they're in, and they'll defend themselves, violently if necessary."

Being toxic is indeed part of the plants' defense mechanism. Works well, too; you're not going to feast on one of those twice.

As a human, you're not likely to come up with such a bright idea in the first place. You pick them for their looks. But your dog might have a different idea--and pay for it dearly.

"Ssago palm and plants from the Cycad family are VERY poisonous to dogs, and can result in death untreated." ~Dr. Justine Lee

Only about 50% dogs survive sago palm poisoning!

Before you select plants to decorate your home or yard, please check whether they could kill your dog.

Further resource: Plants Toxic to Dogs

Thursday, April 12, 2018

Dog Knee Injuries: My Two Cents on Cora-based Leveling Osteotomy (CBLO) Repair

If your dog injures their cruciate ligament, you have some serious homework to do. There are many treatment options out there, and the number continues to grow. You can explore everything from conservative management, holistic therapies, regenerative therapies, to surgical repairs.

Surgical solutions themselves include eight different techniques I know of at the time I'm writing this. That tells you something--there is no one perfect solution out there. Think about it.

Another thing to keep in mind is that out of all that, during a consultation, you are quite likely to be offered one or two.

Tibial Plateau Leveling Osteotomy (TPLO). is likely going to be on of them. It is the one most broadly recommended. It is not the latest one; it is just the one most popular with many veterinary surgeons.

The latest, and possibly greatest, is Cora-based Leveling Osteotomy (CBLO).

Logic would dictate that the best way to repair the knee ligament damage should be by actually repairing or replacing the ligament. That, however, is much easier said than done. There have been substantial difficulties with making this repair strong enough to hold up, though my veterinary friend in Australia says one of these techniques is still used there with comparable success. Australians seem to be freer thinkers when it comes to veterinary medicine.

Why is TPLO the number one recommendation and is it that great?

The funny thing is that the answer to this question is not really. At least, there is no conclusive evidence that it is reliably better than other interventions. Yet, it is undoubtedly the most popular. Why? Familiarity, perhaps. Don't get me wrong; familiarity does have its importance; you don't want a surgeon experimenting on your dog with a surgery they are not used to doing. However ...

The TPLO was originally developed in the early 1990's. While many surgeons think that it is the best thing since sliced bread, others had been trying to come up with different or improved solutions.

I confess that I never liked this technique much at all which is the reason why I keep up with what new surgeries are out there.

Tibial Plateau Leveling Osteotomy (TPLO). Image Elizabeth Street Pet Hospital

Is Cora-based Leveling Osteotomy (CBLO) an improvement?

CBLO was developed to refine the TPLO procedure and address some of the issues that can cause complications with TPLO.

The idea behind all of the cruciate injury treatment options is to restore stability of the injured joint.

With TPLO, this is achieved by altering the orientation of bones within the joint--changing the slope of the joint surface. Which works, after a fashion. It has been found, however, that the dramatic change in the joint anatomy results in abnormal mechanics and often damage to cartilage.

"One of the issues with TPLO is that in a lot of dogs the end result is that the load bearing axis of the tibia is moved further away from the anatomical axis of the tibia. CBLO addresses this by inverting the rotation which results in the weight bearing axis being brought into alignment with the anatomical axis." ~Eurocast Veterinary Centre

Natural anatomy matters. I've been trying to come up with a good metaphor, but the best I can think of is walking on very high heels. You can do it, but you are going to pay for it.

Cora-based Leveling Osteotomy (CBLO). Photo United Veterinary Clinic

The CBLO aims to address this problem.

CBLO too cuts the top part of the shin bone but in a different location and alters the rotation to better align the weight bearing and anatomical axis. If you compare the CBLO and TPLO illustrations, which one of them looks more natural to you? I like this approach much better.

An additional advantage is that CBLO combines the benefit of TPLO and Tibial Tuberosity Advancement (TTA) which is a technique that stabilizes the joint by modifying the angle between the shinbone and the patellar tendon.

Tibial Tuberosity Advancement (TTA). Image DePuy Synthes

To me, the CBLO looks much more sensible, elegant and sturdy as well as it seems much more logical. It is quite new, though, so finding a surgeon well-versed in doing it might be a challenge. It is also likely too early to have enough data to tell how much better it is or isn't.

Instinctively, though, I'd be much more likely to choose CBLO over TPLO any day. I don't like that it is just as invasive and I don't think it's the last we will see of new procedures. But if the choice was between the two, I think the CBLO could be superior. That doesn't mean something better won't come along tomorrow.

Do your research.

The main purpose of this article is to introduce what is new in dog cruciate injuries repair so you know there is more than the one or two options you might feel stuck with. Personally, regenerative medicine is the top of my list of considerations. Whether or not that might work depends on a bunch of factors, but platelet-rich plasma therapy did work for Cookie's partial tear(s).

For fully torn ligament, surgery is likely the best option for most dogs. But there is still the pressure of the choice of a specific procedure.

I recommend you do your homework so you can make an educated decision about what treatment you believe is going to be best for your dog. Talk to a lot of different surgeons. Remember that none of them are likely having tried all of the options to offer full insight. They are likely to recommend what they are most familiar with and what they've seen work. That doesn't mean that something else wouldn't work better.

The best strategy is prevention.

The best-case scenario, of course, is your dog never rupturing their cruciate ligament in the first place. There are a few risk factors which you can try and avoid, such as acute injury, spaying and neutering too early, obesity, unaddressed thyroid dysfunction, insufficient or high-impact exercise, and others, but unfortunately, some dogs are simply genetically predisposed to cruciate ligament disease.

Related articles:
What Is That Limp?
Talk To Me About Dog ACL/CCL Injuries (I do need to update this one)
Triple Tibial Osteotomy (TTO)
Simitri Stable in Stride
Is There Such a Thing as a False Drawer Sign?
Preventing ACL Injuries in Dogs
Preventing ACL/CCL Tears Part I
Preventing ACL/CCL Tears Part II (All or None or Partial) 
Full Cruciate Ligament Tears
Ruptured Cruciate Ligaments and Early Spay and Neuter
ACL Injuries in Dogs: Non-Surgical Alternatives
Platelet-Rich Plasma (PRP) Treatment for Cookie's Bad Knee(s)
Cruciate Ligament (ACL/CCL) Surgery Post-Op Care Example Plan
Surviving the Post-Op After Your Dog's ACL/CCL Surgery