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The Benefits of Hydrotherapy for Your Dog

Splish splash! These dogs aren’t takin’ a bath; they’re working out in pools large and small to get in shape, stay active, or recover from accidents, illness, or surgery. Whether swimming breeds or those that prefer to keep their feet dry, dogs of all ages have gotten stronger, decreased lameness, loosened tight muscles, increased coordination, improved balance, hastened healing, and increased stamina and flexibility with hydrotherapy.

dog hydrotherapy

Photo by Carol Helfer

Because of its effectiveness, hydrotherapy, or water exercise, has become popular at veterinary clinics and canine rehabilitation centers. The first hydrotherapy equipment was built for horses and racing Greyhounds, but the treatment is now available to dogs and cats in the United States, Canada, Japan, Western Europe, and the United Kingdom. Typically performed in a swimming pool or a plexiglass chamber holding an underwater treadmill, hydrotherapy stimulates the cardiovascular and lymph systems, strengthens muscles, and allows painful joints to move comfortably.

Hydrotherapy works because water makes exercise weightless. Swimming or walking in water exercises joints and muscles without the jarring effects of gravity and hard surfaces. Many patients with arthritis, hip or elbow dysplasia, joint pain, cruciate ligament ruptures, and bone fractures have made significant improvements thanks to water exercise. So have patients with neurological disorders such as degenerative myelopathy or problems caused by spinal strokes. A spinal stroke or fibrocartilaginous embolism (FCE) occurs when an obstruction or clot blocks the spinal cord’s blood supply, resulting in a loss of mobility.

In October 2010, Gracie, a nine-year-old Dalmatian who lives with Jeanne Stehno in Great Falls, Montana, suffered a painful back injury and underwent a hemilaminectomy, in which herniated disc material was removed from beneath her spinal cord. Manipulation of the spinal cord can produce neurological symptoms, and after surgery, Gracie’s hind legs dragged and she couldn’t walk. She was able to use a cart, but Stehno hoped for a more complete recovery.

At the animal hospital where Stehno works as a receptionist, an emergency veterinarian recommended Certified Canine Rehabilitation Practitioner Jennifer Hill in Helena, Montana, 90 miles away. Beginning in January 2011, Gracie and Stehno made the trip every 7 to 10 days for hydrotherapy.

“Gracie is not a fan of swimming,” says Stehno, “but the minute she got in the water, her legs began moving. By June, when she took her last swim, Gracie had learned to walk again and her legs were strong. She can go up and down stairs on her own, and while she still has occasional moments of being unsteady on her feet, it is exciting to take her for walks and admire her improvement.”

Underwater Treadmills for Dogs

In Portland, Oregon, veterinarian Carol Helfer, DVM, has offered hydrotherapy at her Canine Peak Performance Sports Medicine & Physical Rehabilitation Center for almost a decade.

“Because of our limited space,” she says, “we use an underwater treadmill. Most dogs use their front limbs significantly more than their rear limbs while swimming, and since I see far more problems with the rear limbs, walking on an underwater treadmill is an effective therapy for most patients.”

At the beginning of a treadmill session, the dog enters an empty plexiglass chamber by taking a shallow step up. The speed is set to accommodate the dog’s size and condition. Warm water (usually 80 to 88 degrees Fahrenheit, approximately 27 to 31 degrees Celsius) enters the chamber and the dog is soon walking in water. The level is adjusted to whatever the dog requires, such as shoulder-high for extra buoyancy after surgery or to relieve joint pain, or knee-high for a more vigorous workout.

Some underwater treadmill systems include adjustable hydrotherapy water jets, a reversible treadmill, or adjustable ramp angles that alter weight distribution or target specific muscles.

“Most dogs start out with one to three exercise sets, each lasting two to three minutes, depending on how they tolerate the activity,” says Dr. Helfer. “In most cases my goal is to get them up to 20 minutes of continuous walking. The time it takes to get there varies widely depending on the age and condition of the dog. I start patients at 0.3 miles per hour (MPH) and seldom get above 1 MPH. On occasion I’ll work with a dog specifically for athletic conditioning, in which case I may use speeds of 3 to 5 MPH.”

Dr. Helfer has exercised tiny Yorkshire Terriers and super tall Irish Wolfhounds on her treadmill, and no dogs have been too big or too small. 

Therapeutic Pools for Dogs

Hydrotherapy pools can be anything from large or small swimming pools to endless-lap pools in which continuously moving water creates resistance. Except for healthy, experienced dogs swimming for recreation or general conditioning, patients wear life vests. In some hydrotherapy pools, swimming dogs are supported and directed by overhead wires attached to their vests.

dog hydrotherapy

DVM.

When Apex Animal Hospital in Helena, Montana, was built last year, Jennifer Hill recommended installing a pool. “I am a licensed physical therapist and worked with human patients before I started working with dogs,” she says. “I spent my physical therapy internship in Hawaii, where I took aquatic therapy classes. I love being in the water with patients and like the flexibility that an endless pool provides. It’s wonderful for recreational swimmers, for targeted therapy, and for everything in between. The underwater bench at the edges of the pool and steps at the shallow end provide a stable surface for walking or standing. This is especially helpful for smaller dogs like Corgis and Dachshunds, which are the breeds most prone to back injuries. In addition, the pool’s adjustable water jets create a mild to strong current for swimming.”

Hill does more than help dogs swim in different directions. “If the hind legs are weak, which is often the case,” she says, “I present my hand as a target. Dogs appear to instinctively kick against whatever their feet touch. Active kicking is also good for the hips. If the front legs need work, I position my hands at the front feet. The harder I press against the paw pads, the harder the feet push away from my hand. I also tilt the dogs a little to the left or right, which shifts their center of gravity and creates an automatic adjustment.”

Hill lures swimming dogs with a tennis ball, toy, treat, or whatever they will follow so they turn left, turn right, and swim in figure 8s. “That’s so important for spinal motion,” she says. “Another thing I do for dogs with neurological damage from surgery or spinal strokes is pinch their toes in the rhythm of walking or swimming. Alternating and simultaneous rhythmic pinching establishes patterns that help treat ataxia, which is a gross lack of coordination.”

Some of Hill’s patients have taken advanced obedience or agility training. “It’s fun to work with a dog who responds to voice instructions,” she says. “You can say ‘left’ or ‘right’ and the dog will do her own figure-8s.”

Another option in pools is the use of a small floating platform, like a boogie board or miniature surfboard. “This works very well for small dogs,” says Hill, “and they get a serious core workout just keeping their balance. The board dips forward, back, left, and right, and for an added workout we turn on the white-water jets.”

Dogs recovering from surgery, illness, or injury at first require Hill’s hands-on attention, but as they grow stronger and more experienced, they can be supervised by a veterinary technician. “On swim days we live in our wet suits,” says Hill. “We’re in the water with the dogs and we encourage the owners to be right beside the pool so they can participate and see the progress their dogs make.”

As with underwater treadmills, the water temperature in hydrotherapy pools is typically 80 to 88 degrees Fahrenheit. Some facilities feature salt water, for which additional therapeutic claims are made. The term thalassotherapy refers to therapeutic baths in warm seawater, which is similar to the body’s own internal fluids and which is said to allow magnesium and potassium to be drawn into the blood stream while toxins are eliminated. 

Typical Canine Hydrotherapy Patients

Because dogs take up hydrotherapy for many reasons, most facilities define categories of treatment depending on their condition and medical history.

For example, Apex Animal Hospital defines four levels of treatment. Level 1 patients are the most incapacitated, and require two experienced handlers. “We use two people for safety,” says Hill, “and that refers to our own safety as well as that of the dog. As soon as a surgical patient gets a go-ahead from his or her vet, we move to the water.

“One of my favorite Level 1 patients was a Bernese Mountain Dog who had just arrived at the hospital to have both knees operated on when he ruptured a shoulder muscle. The knee surgery went ahead as planned but the shoulder repair was done later. There were serious complications with one of the stifle surgeries, so we actually could only work on the shoulder. That was a two-person job! In other cases the patient may be so out of condition or obese that it takes two people to help the dog into and out of the pool. One Labrador Retriever weighed 187 pounds and had never been in water when he came for his first swim. He has trimmed down to 164 pounds and, while he still has a way to go, he no longer needs both of us in the pool with him.”

dog hydrotherapy

Most patients with knee or stifle injuries or surgery, hip surgery, or fracture repairs receive four weeks of dry land rehabilitation therapy from Hill before swimming.

At Apex, dogs stay at Level 1 or Level 2 (with just the rehabilitation therapist in the pool) for five weeks and are re-evaluated. Level 3 dogs are still recuperating but require less supervision, and Level 4 dogs swim for play, recreation, or general conditioning with a veterinary technician.

The goal at all levels is to improve muscle strength and stamina, provide a cardiovascular workout, stimulate lymph circulation, increase range of motion, and bring all sides of the body into balance by moving in all directions.

“My hydrotherapy patients fall into three categories,” says Dr. Helfer. “These are geriatric patients, dogs recovering from surgery or neurological problems, and those with soft-tissue injuries. I see the most dramatic results in the geriatrics. It is quite remarkable how much these patients improve with the right kind of exercise. Elderly dogs who had trouble jumping into the car or onto the sofa start doing these things again, and their stamina increases on walks. I’m not going to turn a 13-year-old into a puppy, but owners often comment that Fluffy is doing things she hasn’t done for years.”

One of Dr. Helfer’s favorite patients was Noah, a Newfoundland who started hydrotherapy sessions at age 12. “That’s a grand old age for a Newfie,” she says. “He was in pretty good shape for an old guy but was having some trouble getting around. He improved greatly with twice-a-week sessions and finally passed away at 15½. I’m convinced that the quality of the last years of his life greatly improved because of regular hydrotherapy.

“Noah was a typical geriatric. We started with multiple sets of a few minutes at a time and gradually worked up to 20 minutes of exercise without a rest break. As far as I know, the hydrotherapy was the only exercise he got other than short walks around his neighborhood.”

The most common surgical patients Dr. Helfer sees have had knee surgery, usually for cruciate ligament tears or luxating patellas. “Dogs recovering from spinal surgery also benefit greatly,” she says.

Soft-tissue injuries respond more slowly to treadmill hydrotherapy, says Dr. Helfer. These injuries to muscles, tendons, and ligaments often result from slips, falls, or sprains. “Sometimes in the later stages of recovery I will use treadmill hydrotherapy for a very controlled return to activity,” she says. “I lay out a specific schedule of activities over a period of six to eight weeks. The biggest mistake I see people make with cases of soft-tissue injury is to rush things. Since dogs are usually eager to get back to being active, you can’t depend on them ‘telling’ you that one activity or another is difficult or painful. A few minutes too much of the wrong type of activity can set progress back for weeks.”

Hydrotherapy Isn’t for Everyone

Despite its exceptional benefits, hydrotherapy isn’t for every dog, such as dogs with cardiovascular issues, infected wounds, or a serious fear of water. A history of aggression can be a problem as well.

Just because a dog has never shown an interest in swimming doesn’t mean he or she won’t benefit. Many dogs have learned, with the help of a life vest and a good coach, that swimming can be fun. Dogs who are truly terrified of water because of a traumatic past event are better suited to land-based exercise.

Cost is another factor, for not every dog lover can afford hydrotherapy. Therapeutic swims or treadmill sessions with a veterinarian or Certified Canine Rehabilitation Practitioner (CCRP) – or a rehabilitation practitioner working with an assistant – cost more than recreational swim sessions. Most clinics charge different rates depending on the attention and treatment the patient requires. Therapeutic and recreational swim sessions may last 30 minutes or one hour. Fees vary by region and facility, with most offering discounts for packages of five or more swim sessions.

Long-Term Benefits of Hydrotherapy for Dogs

Although the evidence is anecdotal rather than from controlled clinical trials, veterinarians, rehabilitation practitioners, dog trainers, and owners agree that hydrotherapy can make a world of difference for dogs with physical problems.

Veterinary chiropractor Tia Nelson, DVM, of Helena, Montana, has noticed that dogs who take up hydrotherapy hold their chiropractic adjustments longer than they did prior to swimming. “This makes sense,” she says, “because swimming is a comfortable non-weight-bearing exercises that strengthens the body without stressing it. Swimming helps the body maintain its alignment.”

Dr. Helfer considers hydrotherapy an injury preventer. “The improvement in muscle strength and balance can save the day in a slip-and-fall situation,” she says, “or on an awkward landing in a jump.”

Older dogs who swim are often more active and agile than their non-swimming counterparts, and hydrotherapy has helped many dogs reach a ripe old age with energy and coordination.

“It’s excellent for post-op recovery,” says Jennifer Hill, “injury prevention, and general conditioning. Arthritic dogs become more active, dogs with hip or elbow dysplasia have an easier time climbing stairs, and some agility dogs and other dogs who compete in canine sports win or achieve their personal best after taking up hydrotherapy.”

Do-It-Yourself Dog Hydrotherapy

Dog lovers who have access to pools, lakes, the ocean, or other bodies of water can help their dogs stay active by taking them swimming.

Adele Delp, a veterinary technician and dog trainer, teaches puppy kindergarten classes in the hydrotherapy room at Apex Animal Hospital.

“I teach a six-week class that’s part of the American Kennel Club’s STAR puppy training,” she says. “STAR stands for Socialization, Training, Activity, and Responsible ownership. In addition to introducing puppies to basic behaviors like walking on a leash, greeting politely, and learning how to sit, I have them climb in and out of an empty shallow wading pool. The following week, the pool has an inch of water in it. The week after that, it’s a deeper wading pool, and a week later the deeper pool contains water. They also get used to wearing life vests. At the final session, they go one at a time into the pool with me and start swimming.”

The STAR-class puppies who love the water aren’t just Labs and Golden Retrievers. They’re as varied as Yorkies, Giant Schnauzers, Malamutes, Beagles, Chinese Cresteds, Weimaraners, and German Shepherd Dogs.

dog hydrotherapy

Delp does everything she can to make the experience positive. Puppies enter the water gradually and with lots of praise and rewards. This same approach can help your pup or older dog get used to swimming. If you live near a stream, lake, or river, look for a gradually sloping beach or bank that is smooth rather than muddy or rocky. Be sure the area is safe for dogs.

Having an easy way in and out helps dogs feel secure. If using a swimming pool, stay at the shallow end at first (dogs can’t climb vertical ladders), and through repetition teach your dog where the shallow end is. Keep the pool securely fenced off or covered when not in use.

Buy or borrow a canine life vest that fits securely and allows unrestricted front leg motion. A leash or line can be attached to the vest, but be sure your dog doesn’t become entangled.  

In a river or stream, keep your dog away from currents. Don’t throw rocks for your dog because they break teeth so easily.

“My motto is get in and stay in,” says Hill. “Try to avoid running in and out of the water because it is often during these transitions that injuries happen.”

All dogs have a fatigue level and symptoms of fatigue include a tongue that drags, darkens, or curls up at the ends while the dog is panting; bloodshot whites of the eyes; or an obvious slowing down. Provide ample rest periods.

Guard against excessive sun exposure with sunblock on the dog’s nose.

For dogs who are recovering from accidents, illness, or surgery, be sure to wait for your veterinarian’s OK before swimming.

If your dog will chase a tennis ball or other toy in the water, toss it to encourage distance swimming and frequent turns. For every turn to the right, add a turn to the left, and aim for figure 8s to exercise the spine. If you’re in the water with your dog, use a tennis ball or other lure to create turns with a tighter radius. Also try tipping the dog slightly to one side, which strengthens the tipped side as the dog regains balance. You can also try the toe-pinching and foot-touching exercises mentioned by Jennifer Hill.

If your dog doesn’t take to the water right away, don’t be discouraged. “Our hydrotherapy patients often need three sessions before they catch on,” says Hill. “A typical example is Shadow, a five-year-old Border Collie who experienced a spinal stroke. Shadow did not like the water at all, and his first two sessions weren’t much fun. Then during his third session a light bulb went on in his head and he realized he could fetch a tennis ball. He can’t do this on land any more, but in the water he’s an athlete. Now when his owners ask if he wants to go for a swim, Shadow screams and howls, he’s so excited.”

When Chloe started her swim sessions last April, my husband wondered whether Seamus, his seven-year-old Cairn Terrier, would enjoy swimming, too. Seamus will probably never jump into water on his own, and his first two sessions produced moments of high anxiety, but by his third lesson he caught on and he is now a strong swimmer. Today, Seamus loves being on the boogie board and that’s his favorite target. His spine and tail are straighter, his stamina on hikes has increased, his hind legs are stronger, and he is able to jump from the ground onto my car’s back seat and from the floor onto the bed or sofa, which he wasn’t able to do without assistance before he took up swimming. 

Rinse the Chlorine Off Your Dog

If your dog swims in chlorinated water, salt water, or swampy water, he’ll need a bath or at least a rinse afterward. Here are some favorite after-swim treatments:

Our article on Willard Water (WDJ June 2006) reviewed the many ways this concentrate can be used internally and topically to improve a dog’s health. Diluted at the rate of 1 teaspoon to 1 tablespoon concentrate per gallon of water and poured over the dog, Willard Water helps prevent dander, freshens the coat, and helps most dogs smell better. Willard Water concentrate can be added to shampoo or conditioner, but my favorite use after swimming is as a chlorine-destroying rinse. In 1991, shortly before his death at age 84, I corresponded with Dr. John Willard, who developed the formula, about its effect on chlorine. He confirmed that extensive laboratory testing proved that small amounts of Willard Water neutralize or destroy chlorine. In fact, he warned against adding Willard Water to any load of laundry using chlorine bleach. “The bleach won’t work,” he said.

Years ago, Colorado aromatherapist Frances Fitzgerald Cleveland was out of town when her dog, Jake, developed a hot spot. The steroid shot he received caused kidney failure and Jake died. In his memory, Cleveland blended Jake’s Canine Remedy, which contains purified water, apricot kernel oil, and a proprietary blend of essential oils. In our September 2006 article on hot spots, Cleveland described how Oscar, her black Labrador Retriever, swam every day, got sprayed every day, and never had skin problems. Jake’s Remedy has a pleasant, fresh, relaxing fragrance.

After her Willard Water rinse, Chloe gets sprayed with Jake’s Remedy, which I brush through her coat. For dogs prone to swim-related skin irritation under or next to the collar, Jake’s Remedy can be an effective preventive treatment.

Adele Delp’s favorite after-swim treatment is Sea Plasma All-purpose Skin and Hair Moisturizing Spray by Focus 21. Its key ingredient is Na-PCA, or sodium pyrrolidone carboxylic acid, a natural moisturizing factor in skin which is synthesized from glutamic acid, a non-essential amino acid.

“I dilute it at the rate of 1 part product to 10 parts water,” she says. “It isn’t a silky conditioner and it doesn’t make the coat shiny, but it penetrates the skin, helps keep the skin supple, reduces dander, and smells good.”

Jennifer Hill’s favorite after-swim rinse is chamomile-peppermint tea. Chamomile is a well-known skin soother that has a calming effect on dogs, which helps them relax and rest after workouts. It helps reduce skin irritations and is safe for sensitive skin. Peppermint’s fragrance is uplifting and refreshing. Mildly astringent, it heals abrasions, helps prevent hot spots, and is a natural skin toner.

To brew, pour 1 quart boiling water over 2 chamomile and 2 peppermint tea bags (available at supermarkets and natural food stores), cover, and let stand until cool. For a stronger solution, double the number of tea bags. One quart should be sufficient for small dogs. Brew up to 4 quarts (1 gallon) tea for large and giant breeds or for a more thorough application. Apply as a final rinse, work into the coat, and let dry. Because herbal tea can darken hair, it is not recommended for white dogs. Herbal tea rinses can be combined with Willard Water concentrate for increased effectiveness.

Freelance writer CJ Puotinen lives in Montana. She is the author of The Encyclopedia of Natural Pet Care and other books and a frequent contributor to WDJ.

Record Flooding in Thailand Means Epic Disaster for Dogs and Cats

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When most of us hear about animal caught in natural disasters, we sigh and fret – and then move on. One close friend of Whole Dog Journal has done more.

Rain has been falling relentlessly in Thailand since July, and many parts of the country are experiencing the worst flooding reported since World War II. Bangkok, the capital and the most densely populated city in the country (with more than 9 million residents) is suffering from particularly severe flooding. This is in part due to the fact that one of Thailand’s major rivers, the Chao Phraya River, flows through the city, and the city sprawls over the plains and river deltas that lead into the Bay of Bangkok. Bangkok, which lies at about 6 feet above sea level, is often referred to as the “Venice of the East,” due to the many canals and water passages found in the city. Of course, with the torrential rain, these waterways are swollen, and many inhabitants  — human and otherwise – have nowhere to escape the flooding.

Bangkok is also known as a city with one of the largest populations of stray dogs in the world. It’s been estimated that as many as 300,000 stray dogs roam the city’s streets at any given time. Thailand’s citizens are mostly Buddhists; they don’t believe in killing animals unnecessarily. Dogs are not eaten in Thailand. In fact, the street dogs are often fed by kind-hearted residents.

With the severe flooding, however, and people struggling to keep themselves and their families out of the water, dogs (and cats) are in dire straits. Mass evacuations of people are being carried out by the government, and people are not being permitted to take their pets. News reports show animals on roofs and in trees, and very few volunteers are available to help rescue, house, and care for them. Abandoned animals and permanently homeless animals alike are fending for themselves in the flooded city.

Sandi Thompson, a dog trainer and owner of Bravo!Pup Dog and Puppy Training in Berkeley, California (and frequent model for articles in WDJ), knows what it’s like to be waist-deep in water with no help on the horizon. In December 2004, Thompson was vacationing on a Ko Kho Khao Island resort in southern Thailand when she was caught in the Indian Ocean tsunami that killed an estimated 230,000 people in 14 countries. She and her traveling companion lost all of their possessions, but thanks to their credit cards, were able (over the course of 5 days) to secure spots on boats and buses and eventually make their way back to the mainland and fly home to the U.S. She’s been haunted by the deaths and devastation she witnessed during that ordeal, and admits to suffering post-traumatic stress, particularly when she is exposed to news like that coming out of Thailand right now.

As I said earlier, unlike most of us, Thompson couldn’t just read the articles and move on. She started researching and contacting animal-welfare organizations that help the street dogs, and asking if they needed “boots on the ground” to help in animal rescue operations in Bangkok. She very quickly learned that yes, help would very much be appreciated. As I write this, Thompson is boarding a flight to Thailand, having put her own dog (and training business) in the hands of friends and employees for the next three weeks.

Thompson is volunteering for the Soi Dog Foundation (Soi means “street” or “alley” in the Thai language), an organization that usually focuses on feeding and providing spay/neuter services for the street animals. The Soi Dog Foundation is one of a number of animal welfare groups in the country helping to rescue and evacuate animals in Bangkok. Using boats in the flooded streets, the Foundation has already rescued hundreds of animals and relocated them to a shelter facility outside of the city — and safe from the flood waters.

Thompson’s familiarity with Thailand and her skill with handling dogs and other animals (she’s a regular volunteer at the Oakland Zoo and has worked with a number of animals species there) uniquely qualify her for this rescue effort; she emphasizes that what’s needed the most right now are donations of dog and cat food, cages, crates, leashes, veterinary supplies – and money, so that all of these things can be purchased to help care for the animals until they can be reunited with their owners or new homes can be found for them.

On its website (http://www.soidog.org), the Soi Dog Foundation says, “Soi Dog is working with groups in the Bangkok area to rescue these animals. These groups are not large animal welfare agencies, but rather smaller groups working around the clock to save the dogs and cats before it is too late. Time is running out and they need your help. Your support will go towards rescue, veterinary care, shelter and rehoming for the dogs and cats. Please donate as generously as you can today! Time is of the essence in saving the lives of these animals!”

Many of the dogs rescued by Soi Dog are being taken to a refuge 150 km from Bangkok that is run by the Wildlife Friends of Thailand. It’s Thompson’s understanding that this is where she will be helping handle and care for the rescued dogs. (For more about this group, see http://www.wfft.org.)

We wish Sandi the best of luck in the endeavor, and encourage anyone else who feels called on to help the unfortunate animals of Bangkok to donate what they can to the Soi Dog Foundation, telephone 081-788-4222; info@soidog.org; http://www.soidog.org.

To see a video of some of the relief and rescue efforts already underway, see http://www.youtube.com/watch?feature=player_embedded&v=2Sqi6hplj9k

(The Power of Positive Dog Training #2) The Power of Positive Dog Training – Understand How Your Dog Reacts

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Your positive training program will go much more smoothly if you’re good at interpreting what your dog is saying to you and communicating to him in a way that he can easily understand.  Dogs are superior body language communicators. 

We often reach for our dog’s collars over the top of their heads… They see this is as a direct threat, they duck away in submission (or they bite) and learn to avoid us when we are trying to catch them.  We follow or chase them, intimidating them further or, alternatively, teaching them that if they take the lead, we follow.  The more we try to catch the more they avoid us. 

Start by associating gentle touch and restraint with which he is comfortable.  Feed him a tiny tid bit of something wonderful, and remove your hand.  Repeat this step until he turns his head eagerly toward you in anticipation of his tid bit when he feels  your touch.  Whether you are reaching out for their leash or for a hug, the more your dog accepts your touch, the more quickly you will be able to move through the counter conditioning and desensitization process.

Whether you’ve never trained a dog or are just switching over to positive training, Pat Miller’s book, The Power of Positive Dog Training will show that training your four-legged friend with positive training tools is easy, fun and effective. Available now at Whole Dog Journal.

A Fresh Look at the Pets…and Their Weight!

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I’ve been away from home for six days and nights (combined business trip and opportunity to see my kid play in a national championship for his sport). My husband was home feeding the animals (my dog Otto, niece’s dog/long-term foster Peanut, two former kittens/now juvenile cats/pests, three chickens). My first impression when I get home: none of the animals have had ANY affection since I left town (doubt this is true), and all the animals are too fat!

Now, I know that when I’m gone, the dogs don’t get walked or taken for off-leash play, and the cats get NO love (husband is not a cat guy; he’s not really a dog guy, either, but he does like Otto and Peanut). So, they were probably more obnoxious than usual about looking for attention and affection. Which my husband seems to translate as, “They must be hungry.”

Can animals really pack on the weight in just a week of overfeeding? Is it possible they were on the way to chubby before I left, and I just didn’t notice it because I see them every day? All I know is that with my just-home perspective, I need to hit the trail with the dogs, spend some time working the cats up and down the hall with their toys, and cut everybody’s portions back a bit.

Going away and seeing your pets with fresh eyes is a great way to really assess them. I just hope my husband’s not seeing *me* the same way, after a week of eating out and no exercise!

An Admirable Model: Lotus Pet Foods

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I’ve toured half a dozen dry pet food manufacturing plants, and to date, three wet pet food plants. In most cases, to secure the invitation for a tour, I am asked to sign a nondisclosure agreement, promising not to disclose anything that may be proprietary in nature for the owner of the plant or any information about which company’s products are made there. In the cases in which I was not asked to sign a nondisclosure agreement, I have been asked for my word about these issues anyway – which is fine by me. I’m not looking to become a pet food detective and spill company secrets; I’m looking for things that would be of some use to owners who want to know how to identify and purchase the best foods for their pets!

This is one of the reasons it was such a pleasure to be invited to a pet food plant with no strings attached. The owner and CEO of Lotus Pet Foods extended an invitation for me to tour their new (launched in February 2011) plant in Torrance, California. Could I bring my camera? Yes.  Could I take pictures and video of anything I wanted? Yes. Could I go through any door and see any label of any ingredient I wanted? Yes. Did I need to sign something? No.

One reason that the principals of Lotus are able to be so open: they do not yet produce pet food for other domestic pet food companies at their facility, so they don’t have to secure permission from anyone else.

Nevertheless, it was great to get to walk through a pet food plant and confirm that everything there looked exactly like how it’s described on the Lotus Pet Foods canned dog food label and on the company website.

Please check out our “2011 Wet Dog Food review” and our Web-only extra feature “How Canned Dog Food Is Made” and let us know: Were there any surprises? Do you still have questions about canned food?

(Understanding Dog Growling #1) Understanding Dog Growling and Dog Language

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Growling is a valuable means of communication for a dog – something that dog owners should appreciate and respect rather than punish. Of course, we don’t want our dog to growl at us, but neither do we want him to fail to growl if something makes him uncomfortable; that’s very important information in a successful canine-human relationship.

It’s very common for dog owners to punish their dogs for growling. Unfortunately, this often suppresses the growl – eliminating his ability to warn us that he’s about to snap, literally and figuratively. On other occasions, punishing a growling, uncomfortable dog can induce him to escalate into full-on aggression.

So, if you’re not supposed to punish your dog for growling, what are you supposed to do? The next time your dog growls at you, try this:

Stop. Whatever you’re doing, stop. If your dog’s growl threshold is near his bite threshold – that is, if there’s not much time between his growl and his bite, get safe. If his growl doesn’t mean a bite is imminent, stop what you’re doing but stay where you are. Wait until he relaxes, then move away, so you’re rewarding the relaxed behavior rather than the growl.

Analyze the situation. What elicited the growl? Were you touching or grooming him? Restraining him? Making direct eye contact? Taking something away from him? Making him do something?

If you need help to create and implement a behavior modification protocol, contact a qualified behavior professional who is experienced and successful in modifying aggressive behavior with positive, dog-friendly techniques.

For more details and advice on Growling, purchase Whole Dog Journal’s ebook, Growling – Understanding Your Dog’s Language.

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An Inside Look at How Canned Dog Food is Made

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[Updated December 19, 2018]

I’ve always wondered how wet dog food gets made – but it took a long time to find out. It seems like it’s more difficult for a journalist to get into a pet food cannery than into a factory that builds spy planes.

I’ve been in three. The first was Evanger’s Dog & Cat Food Company, located in Wheeling, Illinois, about six or seven years ago. A couple years later I was invited to tour American Nutrition, Inc. (ANI), in Ogden, Utah. Most recently I toured a brand new facility that was built, and is owned and operated by Lotus Pet Foods, in Torrance, California.

canned dog food manufacturing

Evanger’s has operated on the same site since the company was founded in 1935. Fred Evanger, a breeder of Great Danes, originally operated the facility as a horse slaughter plant/pet food supplier. The plant has been renovated and additions built to accommodate modern machinery – and of course, no animals have been slaughtered on site for decades. It’s a small operation, owned and operated by a family. The plant was not being operated when I was given a tour, so I didn’t get to see canning in action, though I was able to view the ingredients used by Evanger’s and their storage and manufacturing facilities.

canned dog food manufacturing

ANI has pet food production facilities in five states. I toured its Utah plant; the facility produces several types of pet foods: wet food, extruded dry food, andbaked treats and food for dogs.  The plant dates to the early 1970s and is quite large. The size and sprawl of the plant made it difficult for a complete newbie like myself to follow and fully comprehend the flow of ingredients through the plant. At the time of the tour, I was primarily interested in the various safety checks that had to do with mixing various formulas for a variety of customers. The manager of the plant showed me all the various steps that the employees took to make sure that only the specified ingredients made it into each batch of food and in the specified amounts.

canned dog food manufacturing

I got the clearest picture of how a batch of food is made from my most recent tour, of the very new Lotus Pet Food facility in southern California. The plant was put into operation in February 2011, so it’s still spotlessly clean – and without any “off” odors. It was built with plenty of room for expansion, so even very large pieces of equipment looked relatively small in various rooms in the gigantic warehouse-style building.

canned dog food manufacturing

As a result of travel delays, I didn’t get to see the day’s very first steps in the making of a batch of Lotus’ Beef & Asparagus Stew. The production crew was waiting for us to arrive so they could complete the mixing of the food and start canning the batch. We did some backtracking through the plant, however, so I could recreate the process.

canned dog food manufacturing

Wet Dog Food Ingredient Preparation

The batch actually gets started a day ahead. The meat used for the recipe that will be made the next day is moved from the deep freezers in the plant – where the temperature is kept between 5 and 10 degrees F. — to a refrigerated room, where the temperature is about 40 degrees F., to begin the thawing process at food-safe temperatures.

canned dog food manufacturing

Lotus uses all USDA-inspected and -passed meats – what people commonly refer to as “human-grade,” although that term is not legal. (Any meat that is brought to a pet food plant is automatically considered NOT human-grade, even if it washuman grade, the moment before the truck was opened at the plant.) Lotus’s  meat is in packages – shrink-wrapped in plastic in the case of the beef shoulders, and packed in heavy-duty plastic bags in the case of turkey or chicken – and boxed in cardboard. The boxes are stacked and placed on pallets in the refrigerated room.

canned dog food manufacturing

Mixing Canned Dog Food Batches 

Early in the morning, the crew will begin taking the still partially frozen meat out of its packages and feed it into a machine that subjects it to both grinding and steam. When this process is complete, the meat appears shredded and roasted. It’s packed loosely in tubs and taken to the “kettle” to await its next step.

canned dog food manufacturing

The water that is used in this process – meat broth, at this point – is collected and transferred to the kettle where the final “stew” is mixed. This is a giant vat, with a capacity of 6,500 pounds of food. The kettle is heated, bringing the broth to 180 degrees as blades spin slowly through the mixture, stirring and combining the ingredients into a “gravy.”  A number of ingredients are mixed into the broth; in the case of the Lotus Beef & Asparagus Stew that I saw made, these ingredients were egg whites, potato flour, the vitamin/mineral premix, flaxseed, kelp, and some healthy fat sources: wild salmon oil, olive oil, and chicken fat.

canned dog food manufacturing

Unlike many pet food makers, Lotus does not use any “gum” ingredients to thicken its wet foods: no guar, carrageenan, or xanthan gum. (Each of these gums are somewhat controversial; they are “generally recognized as safe” [GRAS] by the FDA, but some people have different concerns about each type of gum.) Lotus’ dog foods are all “stew” types, which have a higher moisture content (about  80 percent) than the “loaf” style foods, which are about 78 percent moisture; the stews don’t need to be as thick, so gum is an easy thing to omit in these formulas.

canned dog food manufacturing

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After the gravy is well mixed, the final ingredients — meat, fruits, and vegetables — are added to the kettle. The meats are shredded; the carrots and asparagus are chopped into small chunks; the blueberries are whole. In the Lotus formulas, there are no “restructured” meats ( a mixture of ground meats and powdered proteins that are mixed,  pressed into shapes, and held together with gluten binders and/or pork plasma) or powdered fruits or vegetables, although these ingredients would be added at this stage in a food that contained them. Lotus is somewhat wary of powdered ingredients, due to the ease with which they can be adulterated.

canned dog food manufacturing

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Dog Food Quality Control

canned dog food manufacturing

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Again, the food is brought up to 180 degrees F.  and well-mixed. A sample is taken to the laboratory so that the elements in the “guaranteed analysis” can be checked: protein, fat, fiber, and moisture content. The level of “ash” in the food (in a wet food, this is comprised largely of the mineral content) is also checked. Before a sample of the food can be poured onto the plate for the near-infrared analyzing unit, the sample is ground in a food processor, so the nutrients in the chunks of ingredients can be integrated in the food’s average values. With a good formula and ingredients that have all met the company’s quality inspections, there shouldn’t be any surprises.

Filling and Sealing Cans of Dog Food

canned dog food manufacturing

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With various pumps, the food is now moved through pipes out of the kettle, through a metal detector (which would dump that portion of the food out of the system if it detects even a tiny fragment of metal in the food, both ferrous and non-ferrous), and into the can-filling machine, where it will be dispensed into cans (or in other companies, into pouches). The cans have been transported into the can filling room through a small opening in one wall near the ceiling, arriving on a conveyer of their own that whisks them through a quick wash in boiling water, turns them upside down (to let the wash water run out), and then into the queue for filling.  An operator watches the control panel to make sure the computer detects no errors in the can-filling process.

canned dog food manufacturing

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The cans pass out of the filling machine and proceed directly to a can seamer, where the lids are positioned onto the cans and sealed.  Immediately following is a machine that checks the amount of food in the can; if the can has not been filled properly (too much or too little), the can is whisked by the machine off of the line and into a tub for disposal.

canned dog food manufacturing

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A quality control technician also inspects a number of cans at this point, randomly selecting a number from all points in the run. He checks the temperature of the mixture inside the cans, to make sure the food is still above 100 degrees; it needs to maintain this temperature until it’s placed into the retort (cooking and sterilizing) machine.

canned dog food manufacturing

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He inserts a device into some cans (which are then thrown away) that checks the vacuum pressure inside the can, to make sure there are no defects in the seal. (Before any of the cans are filled with food, some empty cans are run through the seamer, and the technician “tears down” these cans, visually inspecting the seal to make sure the seamer is working perfectly.  The vacuum seal must be perfect to preserve the food and maintain its safety.

canned dog food manufacturing

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The bottom of the cans are stamped with a batch code and “best by” date as they  pass through another small opening into the retort room. Here, the cans are gathered by a machine and organized onto baskets with dividers. The baskets are stacked with layers of cans (each layer is separated by a divider) until the basket  is filled. Then the baskets are moved into the retort machines.

canned dog food manufacturing

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The “Cook” (Retort)

A retort is a large chamber into which steam is pumped under high pressure. Computers monitor the “cook” – the combination of time, temperature, and pressure needed to sterilize the food in the cans. The process also cooks the vegetables and fruits, increasing their digestibility. In “loaf” type foods, the retort can activate certain ingredients (like carrageenan or xanthan gum) to gelatinize into a meatloaf form.

canned dog food manufacturing

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As workers carry out these tasks, others are busy scrubbing down all the machines that were used in the process of mixing the food. The steam cookers that were used to prepare the meat are scrubbed and sterilized with steam, as are the mixing kettle and can-filling machines. Steam is also used to flush out all the pipes that transported the mixture from machine to machine.

canned dog food manufacturing

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canned dog food manufacturing

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When Friends Breed Their Dogs

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I’m going to have to ask for forgiveness ahead of time: This post may well offend some of my friends, neighbors, and readers. I’m sorry – and conflicted.

I’ve been asked a number of times for my opinion about breeding dogs. Do I know a good male Jack Russell to mate with their female; would I suggest buying a puppy from that breeder who advertises puppies on the billboard by the highway; how long should they wait until they breed their German Shepherd Dog?

In each case, I probably initially appeared to be having a heart attack, what with the sudden paleness, dry mouth, sweat on my brow, and an enlarged artery throbbing at my throat. In every case in which my opinion has been solicited, my answer was that a truly responsible dog owner would find the puppy or dog of his or her dreams at a shelter or rescue group.

But oh!, my friends have unwittingly replied, we want to keep this bloodline alive, and all the puppies are spoken for already. We really want a dog who is related to all these other dogs we admire in the field. And we are looking forward to making some money on these puppies!

In none of these cases have I thought the person I was talking to had a valid reason to breed their dog.

Don’t get me wrong: I love, admire, and respect well-bred, purebred dogs – dogs whose parents were healthy, sane, sound, well-researched and thoughtfully selected (and scrupulously prepared for producing a healthy litter). 

Unfortunately, these are in the minority, and more amateurs getting into breeding aren’t going to increase their numbers. There are many, many purebred dogs – “AKC registered! With papers!” – that have been produced by genetically, physically, and/or mentally flawed parents at the hands of ill-informed owners. Other people buy or adopt these “registered” pups when they are darling, and their defects are not yet apparent . . . and many, many of them wind up euthanized in shelters and vet clinics all over the country.

I don’t know a single person who has spent a significant amount of time in an animal shelter who condones anything but the most stringent, selective, limited breeding of purebred dogs. There is something about seeing piles of dead pets, day after day, that pretty much turns off the desire to deliberately see more pets get produced.

What about people who work in rescue, or the very rare shelter that doesn’t kill (or transfer away) ANY dogs or cats? (Remember, most “no-kill” facilities do kill animals; they just label these ones “unadoptable” or they transfer the “unadoptable” ones to facilities that do the killing.) Folks I know in rescue work or “no-kill” shelters are also against breeding – not because they’ve seen so many dead animals, but because they are so completely overwhelmed with the oversupply of difficult-to-adopt living animals.

Look, I tell my friends and neighbors: At my local shelters, I can find a dog of any breed, size, age, color, and temperament that you want. It might take a little time to find that young make merle long-haired Dachshund or adult apricot toy female Poodle – but it can be done without breeding. I yearn for the day that this is different, when the shelters are well below capacity and every dog can find a home within days of losing another one.

In the meantime, unless you are one of those special few, who can recite bloodlines and honestly assess their merits, who produces just a few dogs each year and is  prepared to take each and every one of them back, for the life of the dogs – please don’t ask me about breeding.

Pet Food Peeve

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A recent headline for an article on petfoodindustry.com read, “Thank goodness for the humanization of pets.” The article discussed how industry sales data and recent surveys of pet owners suggest that pet foods that are made to appeal to human appetites are responsible for most of the growth in the industry. 

Nancy Kerns

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This isn’t the first time the phrase “humanization” has appeared in the pet food trade press. It’s used a lot – by industry analysts and pet food companies themselves. It’s just that the phrase isn’t often used in front of the shills – sorry, consumers – themselves. Pet food companies don’t make shelf displays that proclaim, “Now designed to appeal to your appetite, you silly dog owner!” even if that’s exactly what they are doing. Instead, they use the phrase only when they are talking among themselves.

For example, during Colgate-Palmolive’s second quarter earnings conference call for shareholders (held on July 28, 2011), the Senior Vice President of Investor Relations said, “Natural pet food is the fastest growing segment within the category as pet humanization and the inclusion or exclusion of specific ingredients are increasingly driving consumer behavior.”

Another example: Next month, there is a two-day conference presented by The Packaging Group, Inc. (“the world’s largest organization of targeted packaging conferences”), which “targets the emerging field of pet food packaging.” One of the two courses on the first day of the conference is devoted to “humanization of the pet food package.”

One could be insulted by the presumption that dog owners will buy a certain pet food just because its ingredient list sounds delicious, or because its package makes the food look perfectly scrumptious. But the truth is, it’s proving to be simple to manipulate many consumers by doing just that.

That’s why it’s so critical to inform yourself about your dog’s food. You have to go deeper than the pictures or words on the front label to determine whether a product is actually steak or just the “sizzle.” We try to teach dog owners about the ingredients panel and the guaranteed analysis – the only places on the label where one might gain meaningful information about the food. (Not that the ingredients panel is completely BS-free; there are plenty of tricks used there, too, to maximize the appeal of some perfectly ordinary ingredients.)

In the best possible world, ingredients that sound like real food items would appeal to educated dog owners because those ingredients are real food items – fresh, wholesome, and unprocessed. And that shouldn’t be a marketing strategy; it should be a basic pet care precept.

Complementary Care for Dogs with Cushing’s Disease

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[Updated July 18, 2018]

Because the diagnosis and treatment of Cushing’s disease can be confusing, expensive, and fraught with adverse side effects, many caregivers turn to alternative or complementary therapies.

For those who prefer treatments that have been proven in double-blind, placebo-controlled clinical trials, unconventional therapies are themselves fraught with peril. Product testimonials and anecdotal reports don’t prove anything, and by turning first to an herbal preparation or glandular extract, one might deny the patient an opportunity for effective treatment. Online reviews of nutritional supplements or herbal preparations range from reports about dogs that appear to be cured to heartbreaking stories of dogs whose condition deteriorated rapidly. Success stories are often not documented by laboratory test results, leaving readers to wonder whether the dogs that improved so dramatically actually had Cushing’s.

At the same time, the cost of veterinary tests, surgery, or prescription drugs for a dog is sometimes simply prohibitive. Because drugs can only relieve symptoms and cannot cure Cushing’s disease or slow its progression, there is little harm in trying alternatives if your dog’s quality of life is not impacted.

For some, the decision to pursue nutritional and alternative treatments is philosophical. Holistic veterinarians look at Cushing’s disease and every other canine illness from a different perspective than do conventionally trained veterinarians. They are likely to try holistic or natural treatments first and turn to symptom-suppressing conventional therapies later instead of the other way around.

Phosphatidylserine (PS), a phospholipid derived from lecithin, has been demonstrated to have a natural cortisol-suppressive effect on the adrenal glands. It can also help with cognitive dysfunction. Oral PS is available both by itself and in many combination supplements.

Elizabeth Knight, of Portland, Oregon, had some success using PS to treat her Welsh Corgi, Jasper, who was diagnosed with Cushing’s at age 11 and lived for two more years. “Two substances worked very well for us. For quite a while phosphatidylserine helped him a great deal with restlessness. And a Chinese herbal formula, Si Miao San, also helped with his restlessness and thirst. His polydispia and polyuria (excessive drinking and urination), pacing, and panting were controlled fairly well. I would say they helped about 80 percent.” Knight suspects that Jasper also had canine dementia.

In their book, Herbs for Pets, Greg Tilford and Mary Wulff recommend herbal therapy to support organs and systems that are subjected to additional stress because of the disease. “Dandelion root, burdock, garlic, and nettle are good choices for supporting an overtaxed liver and digestive system and to help replace potassium that is lost as a result of increased urination. Adaptogenic herbs such as Siberian ginseng or astragulus help buffer adrenal response to stress.” They also recommend avoiding licorice, borage leaf, and other herbs that stimulate adrenal activity.

Treating dog Cushings Disease Naturally

Susannah Blanchard of Wilmington, North Carolina, turned to holistic treatments when her 10-year-old Shih Tzu, Bandit, was diagnosed with pituitary-based Cushing’s. “At that time,” she says, “the conventional treatment was Lysodren [mitotane], but I had a really hard time putting him on something that could induce Addison’s disease and was almost restrictively expensive. So I researched and found Cushex, a blend of homeopathic and herbal ingredients from PetAlive/Native Remedies. We moved around some, and every new vet who saw Bandit was amazed that he had a Cushing’s diagnosis. I credit the Cushex for keeping his coat rather thick with none of the thinning that generally accompanies Cushing’s disease. Bandit lived another five years and passed away last June at age 15. Only in the last few months of his life did his coat and tailfeathers start to visibly thin out.”

(Editor’s note: Bandit’s initial diagnosis was never confirmed by later testing; it’s possible that his original symptoms were caused by something other than Cushing’s.)

Another plant-based product is Canine Vitex Plus (formerly called Cush X) from the English company Hilton Herbs. Medical herbalist Hilary Self, the director of Hilton Herbs, created the formula nine years ago for dogs with Cushing’s caused by adrenal adenoma. “However,” she says, “a virtually identical product formulated for equine Cushing’s disease, which is caused by pituitary adenoma, has proved to be equally successful. I would anticipate that it would work equally as well in dogs with pituitary adenoma.”

The formula is added to the dog’s meals. “Symptoms usually respond within three weeks,” Self says. “The supplement is by no means a cure, but it has proved to be beneficial to many dogs. It has enabled many owners to either delay having to use the conventional drugs or even reduce a drug’s dosage over a period of months if the dog is already on it. If the dog is on medication, it is vital for the dog’s veterinarian to carry out regular blood tests to measure the response.”

Treating Cushings Disease Naturally

Glandular supplements can also support the adrenal glands. “I think highly of Standard Process glandular products,” says Anita Moore, DVM, of Anne Arundel County, Maryland. “SP Canine Adrenal Support contains ‘functional foods,’ which are ingredients that have shown to benefit various organs and tissues in the body. It helps normalize adrenal function, making it appropriate for dogs with both Cushing’s and Addison’s disease. It doesn’t cure either illness, but it may help improve symptoms, as it has done with some of my patients.”

Diets for dogs with Cushing’s disease should be high in protein, which can help to combat muscle wasting; high-protein diets are also good for the skin and immune system. Fat should be moderately low, as Cushing’s predisposes dogs to hyperlipidemia (elevated cholesterol and triglycerides) and pancreatitis.

There is a lot of outdated information on the web about Cushing’s dogs needing a low-fiber, low-purine diet. It all appears to come from a single source, which references the third edition of Small Animal Clinical Nutrition (Lewis, et al, 1987). The newer fourth edition (Hand, et al, 2000), however, has no reference to purines, nor does it make any sense to restrict purines for dogs with Cushing’s.

Treating Cushings Disease in dogs Naturally

The newer edition of Small Animal Clinical Nutrition also suggests that a diet “lower in fat (less than 12 percent dry matter) and moderate in crude fiber (8 to 17 percent DM) . . . may aid in weight loss and control of mild hyperglycemia . . . in dogs with glucocorticoid-induced carbohydrate intolerance” as well as hyperlipidemia. Some of this reasoning is questionable, but the point is that it no longer recommends a low-fiber diet.

Dogs with Cushing’s are predisposed to the development of calcium oxalate bladder stones, due to elevated calcium in their urine. Avoid giving excessive calcium, which might be a contributing factor. Feeding a low-oxalate diet with other modifications, such as avoiding vitamin C, might be helpful (see “Stoned Again?” WDJ May 2010). Keeping your dog well-hydrated and allowing frequent urination can also help prevent stone formation. Make sure fresh water is available at all times.

It is not unusual for dogs with Cushing’s disease to graduate from holistic therapies to conventional treatments or to take both at the same time. Three years ago Stacy McDaniel of Kingman, Arizona, noticed that her Husky/Malamute, Mascara, was gaining weight, drinking, and panting more than other dogs. In addition, Mascara had a voracious appetite and was greedy and protective of her food. (She lives with four other Husky/Malamutes.)

“The closest holistic vet I could find was 100 miles away in Las Vegas, Nevada,” says McDaniel. “Mascara was placed on Energetix BioBalancer [no longer available], Rehmannia (a Chinese herb), melatonin spray, and essential oils. I also used selegiline [Anipryl]. Most Cushing’s dogs have a thyroid problem, and Mascara was placed on thyroid medication. This combination seemed to work, and every follow-up test was within the appropriate range until she was tested in February 2011.”

That’s when Mascara’s medication was changed from Anipryl to Lysodren (mitotane). “What a difference,” says McDaniel. “Mascara even acted different. She was like a puppy again, playing and jumping. I was initially terrified of Cushing’s, but I now understand it and have respect for the treatments that are available.

“Mascara will always be on her medication. Without it she would die an early death due to the havoc excessive cortisol wreaks on the body. I am all about the quality of life for my dogs, and right now, she has an amazing life.”

Diagnosing Atypical Cushing’s Disease in Dogs

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[Updated July 18, 2018]

What if your dog has all the symptoms of Cushing’s – excessive drinking, urination, and appetite; pot belly; skin problems; elevated alkaline phosphatase; etc. – but the tests say no?

Veterinary endocrinologists at the University of Tennessee in Knoxville (UTK) have been investigating this phenomenon. They found that many dogs have elevated steroid intermediates (also called steroid precursors or “sex steroids”) with normal cortisol. They call this condition “atypical Cushing’s disease,” or “adrenal hyperplasia-like syndrome.” It has been suggested that cases of atypical Cushing’s disease may be caused by a problem in the steroid production pathway. Elevated steroid intermediates have been linked to sudden acquired retinal degeneration syndrome (SARDS), which causes sudden blindness in dogs.

These steroid intermediate hormones include 17-hydroxyprogesterone (also called 17-OH progesterone or 17-OHP), progesterone, androstenedione, estradiol, and aldosterone. UTK developed a steroid hormone profile test to measure these hormones both before and after ACTH stimulation. Steroid hormone profiling is indicated when other tests of adrenal function are negative (ACTH stimulation and LDDS), but the dog still exhibits signs of Cushing’s.

One or more of these steroid intermediate hormones are increased in affected patients, both before and after ACTH stimulation.  Estradiol does not respond to either ACTH or dexamethasone, while 17-OHP shows an exaggerated response to ACTH administration in cases of both atypical and typical Cushing’s.

Atypical Cushing’s can be either pituitary or adrenal. Dogs with pituitary-dependent atypical Cushing’s usually have an enlarged liver, hepatopathy (liver abnormalities), and enlargement of both adrenal glands, along with increased levels of endogenous ACTH. Dogs with the adrenal form will also have an enlarged liver and elevated liver enzymes, but in this case only one adrenal gland will be enlarged (the other may be atrophied), and endogenous ACTH levels will be decreased.

Both forms cause the usual clinical signs of Cushing’s disease, including bloodwork changes and haircoat problems. If aldosterone is elevated, it can cause hypertension (high blood pressure), high sodium, and low potassium leading to muscle weakness.

medication for dogs with cushings disease

In some cases, adrenal tumors can secrete other steroids besides cortisol, and cortisol levels may be normal. Ultrasound is recommended to confirm whether a tumor is present before beginning treatment. If a tumor is found, surgical removal is recommended, especially since noncortisol-secreting adrenal tumors are almost always carcinomas. If that is not possible, mitotane (Lysodren) is the next choice, although it will not affect estradiol levels, and these types of noncortisol-secreting adrenal tumors tend to respond poorly to medical treatment. Trilostane is not recommended, as it can cause increases in intermediate steroid hormones.

Elevated estradiol, called hyperestrinism or hyperestrogenism, causes many of the same signs as elevated cortisol does. In dogs with hyperestrinism, ACTH stimulation and LDDS tests are usually normal for cortisol, thyroid function is normal or controlled, and liver problems are frequent and typical (very high alkaline phosphatase, enlarged liver, and other liver abnormalities). Symptoms frequently include excessive drinking and urination, along with haircoat problems. Panting may also be present. A skin biopsy will suggest endocrine abnormalities.

Veterinarians at UTK advise treating atypical Cushing’s and hyperestrinism with melatonin, which decreases cortisol and sometimes estradiol levels as well, and lignans, a type of phytoestrogen, which may also inhibit enzymes involved in the production of estradiol. Lysodren (mitotane) can be combined with melatonin and lignans to help lower sex steroid levels other than estradiol, along with suppressive effect on cortisol level.