Making the SDMA blood test part of your older dog’s wellness workup can help detec t developing kidney disease. Credit: Fat Camera | Getty Images
A telltale sign of early-stage kidney disease in dogs is increased thirst, which results in increased urination. You may be filling the water bowl more during the day because your dog is so thirsty. Of course, your dog is asking to go out more often or he is having accidents in the house. His urine may have a strong odor.
Sadly, with chronic renal failure, this change can be so gradual that owners don’t notice until it is far along. And that’s frustrating because some chronic kidney disease cases are simply a result of old age. In other words, the dog’s tissues are wearing out.
In addition to the increased drinking and peeing, your dog’s appetite may be off, and he may be losing weight. Some dogs will be nauseous. Bad breath is common, and his gums may be pale. If your veterinarian checks a urine sample, the results may reveal excess protein or even some blood.
Fortunately, the kidneys are remarkable organs and can keep your dog humming along until close to two-thirds of their function is lost. If kidney disease is caught early enough, medical treatment can often give these dogs years of reasonable life.
Early Detection of Kidney Failure
As with so many health problems in our dogs, the prognosis is better if kidney failure is detected early. While kidney disease can’t be reversed, the progress of the disease can be slowed, giving your dog extra lifetime with good quality. Doing an annual complete blood panel and urinalysis starting at 7 years of age is ideal.
As chronic renal failure progresses, your dog may become anemic and lethargic. The buildup of toxins can lead to neurologic signs. Acute kidney failure is worse, such as from ingesting a toxic substance. These dogs are dramatically sick as there is an abrupt loss of ability to filter out toxins and retain the electrolytes and fluid that are important for good health.
What Causes Kidney Disease
Kidney disease is common in dogs, and it has many causes, ranging from congenital defects that cause problems early on to a secondary ailment in senior dogs. It can be an acute episode from a toxin or a gradual decline in renal function.
Young puppies can suffer from congenital defects such as renal dysplasia and polycystic kidney disease. While these dogs can be managed, most have shortened lifespans.
Amyloidosis is another genetic kidney problem, often associated with Chinese Shar Peis. Puppies with early onset renal failure often drink and urinate excessively and may be difficult to house train. They are often noted as “failure to thrive,” lagging behind their littermates in growth and development.
Once we go beyond genetic defects (and some of those can show up clinically as late as 6 or 7 years of age), we are left with secondary kidney diseases. Toxins are high on the list for both acute kidney disease and chronic renal disease.
Acute poisoning, such as from acetaminophen (Tylenol), grapes and raisins, or ethylene glycol (antifreeze) can cause severe kidney disease, even fatalities. Immediate treatment can minimize damage, and some dogs recover completely. Toxic dogs are very sick dogs, however. You may notice vomiting, collapse, intense thirst, and seizures.
Infections can damage kidneys, sometimes irreversibly. As Lyme disease (a tickborne illness) has become more prevalent, veterinarians are watching for Lyme nephritis. The first sign is generally protein spillover into the urine. Any bacterial or viral infection that affects the kidneys may cause kidney failure.
What to Do If Your Dog Shows Signs of Kidney Disease
Like many diseases, kidney disease has “staging” protocols that recommend different treatments for each stage. The International Renal Interest Society has four stages for dogs in renal failure, using objective data from serum creatinine levels, plus looking at blood pressure and protein spills in the urine.
Depending on your dog’s stage, medical treatment will take into consideration hydration and nutrition first. Canned food, adding water to your dog’s meals, and eventually giving fluids subcutaneously can help to keep your dog hydrated.
From a dietary point of view, you want a diet with a lower protein amount—but still high quality for overall health—less dietary sodium and phosphorus, more B vitamins, more omega 3 fatty acids, and plenty of fiber. Several prescription diets that fit these parameters, or your veterinarian can guide you to sites that can provide custom balanced recipes for your dog, like Balance It.
Dialysis is rarely used for dogs with chronic kidney disease but can truly be a lifesaver for a dog with acute, toxic renal failure. In these cases, dialysis is generally done for a short period of time. Unfortunately, there are very few places, primarily veterinary colleges, that currently offer dialysis.
While kidney transplants are done with some frequency in cats, they have not been as successful in dogs. There must be a compatible donor (which you are then responsible for adopting) and follow-up care is extensive, requiring immunosuppressive drugs for the lifetime of your dog. Transplants have not been as successful in dogs as cats.
SDMA Senior Bloodwork
SDMA stands for symmetric dimethylarginine, which is an amino acid. This is used as a biomarker to evaluate kidney function in dogs and cats. This is one of the earliest and most sensitive tests for changes in renal function, showing increased levels with as little as 25% of kidney function being compromised. In addition, it is not as sensitive to some of the environmental factors that can influence tests for kidney health such as muscle mass and diet.
SDMA is now included in many senior pet blood panels, but if not, you should request it for your older dog. Test results over 14 micrograms/dl suggest renal problems developing, so further diagnostics will be recommended.
The bottom line: If caught early on, many dogs can have years of reasonable quality of life with a kidney problem. They will require consistent, and sometimes, comprehensive care, but they can be active and comfortable.
Periodontal disease is extremely common in dogs but can often be prevented with a good combination of at-home and veterinary dental care. Credit: Hillary Kladke | Getty Images
Most of us have or know a dog who has bad breath. Your face scrunches in disgust when they pant near your face or you are snuggling close on the couch. Veterinarians and veterinary technicians label that smell as “sewer mouth.” It is one of the signs of periodontal disease in dogs.
Periodontal disease is the inflammation and infection of the periodontium. The periodontium are the structures that support and surround the teeth. This includes the gingiva, cementum, periodontal ligament, and alveolar bone. Let’s examine the role of each structure in protecting and maintaining your dog’s oral health.
Each tooth has two parts—the crown and one or more roots. The crown is the part of the tooth you can see. Its role is to tear, chop, and grind food. The crown extends to just below the gumline. The roots anchor the tooth in the jaw and provide a blood and nerve supply to each tooth.
Each tooth root sits in a socket in the jaw. The socket is made of alveolar bone lined with a protective layer called cementum. The socket surrounds and supports each root. The root is attached to the cementum and alveolar bone by a periodontal ligament. Gingiva (also known as the gums) is the pink or pigmented fleshy tissue that covers the alveolar bone and the first part of the crown.
Infection and inflammation of these supporting structures leads to destruction of cementum and alveolar bone, loosening and destruction of the periodontal ligament, and gingival recession. Without the support of these structures, teeth become diseased, loose, and fall out.
What Causes Periodontal Disease in Dogs?
Periodontal disease begins with the accumulation of plaque on the crown of each tooth—both the part you can see and the part just below the gumline. Plaque is a combination of food particles, proteins and minerals in saliva, and bacteria that normally exist in the mouth. Think about that fuzzy feeling you get on the surface of your teeth if you haven’t brushed them in over a day—that’s plaque.
Plaque is initially soft and can be easily broken down and removed if the teeth are brushed. But left undisturbed, plaque continues to accumulate layer by layer on the teeth. Over time, minerals in saliva harden plaque and create calculus. Calculus is the hard, brown layer that you might see on your dog’s teeth.
Although calculus on the crown of the tooth looks awful, it’s the plaque and calculus under the gumline that starts the process of periodontal disease. Think about the last time you ate popcorn. Inevitably, the thin skin that covers a popcorn kernel gets stuck in your teeth, prompting you to perform an impromptu flossing. That kernel skin is actually getting stuck in the thin space between the crown of your tooth and the gingiva.
Plaque and calculus that accumulates in that thin space induces an inflammatory response in your dog’s mouth. Inflammation causes the gingiva to become red, irritated, and painful. This is gingivitis and is the first stage of periodontal disease.
Irritated and inflamed gingiva begins to break down and separate from the tooth and alveolar bone. This creates a space known as a periodontal pocket. Plaque and calculus move into this pocket, creating more inflammation. Destruction of alveolar bone and cementum begins, exposing each root under the gumline. The gums may bleed easily when touched. This is the second stage of periodontal disease.
As the periodontal pocket expands and fills with more plaque and calculus, more alveolar bone and cementum are destroyed. The strength of the periodontal ligament holding the tooth root in the socket is compromised and the tooth becomes loose. This is the third stage of periodontal disease.
The fourth and final stage of periodontal disease is characterized by greater than 50% alveolar bone loss around the roots. The tooth can now be easily moved in all directions within the socket.
All dogs are at risk for developing periodontal disease. Small and toy breed dogs are particularly predisposed to periodontal disease. Periodontal disease is more prevalent in dogs that have diabetes mellitus or hyperadrenocorticism (Cushing’s disease). Dogs with a malocclusion (misaligned teeth) or crowded teeth in a small mouth are particularly at risk for developing periodontal disease.
Treating Periodontal Disease
Early periodontal disease (stages 1 and 2) in dogs may be treated with a professional dental cleaning under general anesthesia. Removing the plaque and calculus that has accumulated under the gumline is essential to treating periodontal disease—the only way to safely accomplish this is when your dog is anesthetized. See the article “Dog Teeth Cleaning” for more information.
Treating moderate to advanced periodontal disease (stages 3 and 4) requires more advanced techniques to save the teeth. These advanced techniques include open root scaling and planing, gingival curettage, and installation of bone grafts and protective membranes. A board-certified veterinary dentist is the most qualified professional to complete these techniques.
Teeth affected by periodontal disease that cannot be saved will need to be extracted. Tooth extractions can be done by most general practitioners. Teeth that have become brittle, abscessed, or ankylosed in the socket by scar tissue may need to be extracted by a veterinary dentist.
Preventing Periodontal Disease in Dogs
The best way to prevent periodontal disease in dogs is with proper at-home dental care and annual comprehensive oral health assessment and treatment (also known as a dental cleaning or dental prophylaxis) performed by your dog’s veterinarian.
Brushing your dog’s teeth every day disrupts plaque as it forms on the teeth and prevents the formation of calculus. See the article “At-home Dental Care for Dogs” for more information on how to brush your dog’s teeth and promote good oral health at home.
Your dog should undergo a comprehensive oral health assessment and treatment once a year. This is a dental cleaning, visual examination of the teeth, probing of gingival pockets, and radiographic assessment of the tooth roots and alveolar bone. Gingivitis can be treated and reversed during this procedure before it progresses to more advanced stages of periodontal disease.
With proper at-home oral care and annual oral exams by your veterinarian, your dog’s oral health and life span can be improved. And that’s good news for us dog lovers that want to have as much time as possible with our canine best friends!
Unfortunately for some multi-pet households, dogs can be allergic to cat dander. Credit: chendongshan | Getty Images
Dogs can be allergic to a wide variety of environmental allergens including pollen from trees, weeds, and grasses. Other potential allergens include molds, dust and storage mites, insects, and dander from humans, birds, or other animals. This includes cat dander.
Symptoms of Cat Allergies in Dogs
Dogs that are allergic to cat dander may have symptoms of allergic conjunctivitis. These symptoms include redness of the inner eyelids and whites of the eyes, squinting, rubbing the eyes, and ocular discharge. Ocular discharge may be clear or white but may also be yellow or green.
Other symptoms of a cat dander allergy in dogs include itchy skin, coughing, sneezing, and runny discharge from the nose. Dogs with itchy skin will incessantly scratch and lick at their paws, face, ears, tailbase, and the underside of their body.
Dogs with a cat dander allergy are often allergic to other things in their environment. Your veterinarian may recommend allergy testing to determine which allergens are the most troublesome for your dog.
Treating Dog Allergy Symptoms
One aspect of treating a cat dander allergy and other environmental allergies is relieving the symptoms of the allergy. This may include antihistamines, eye drops for allergic conjunctivitis, and shampoo or other topicals to alleviate itchy skin.
The other part of treatment is modulating the immune system’s response to specific allergens. This may include medications—such as steroids, cyclosporine, Apoquel, or Cytopoint. This may also include allergy hyposensitization therapy—also known as allergy injections.
Additional Considerations
There are many other illnesses that can cause the same symptoms as allergic conjunctivitis. Your veterinarian will conduct a complete eye exam with an ophthalmoscope. She may recommend testing your dog’s tear production with a Schirmer tear test, determining your dog’s ocular pressures with a tonometry device, and staining the surface of your dog’s eyes with fluorescein to look for corneal ulcers.
With apropriate treatment, allergic conjunctivitis due to a cat dander allergy can be managed, leaving your dog with more comfortable eyes.
Cheatgrass awns can burrow into a dog’s skin, causing serious, potentially deadly injuries and infections. Credit: MoKa | Getty Images
Cheatgrass (Bromus tectorum) is well named. The invasive species—also known as downy brome—overwhelms native grass species, reducing wildlife habitat and livestock forage; increases the risk of wildfires in Western ecosystems; and is dangerous, even deadly, to dogs when its sharp, barbed seeds, called awns, enter the skin, typically through paws, ears and nose.
Cheatgrass usually appears early in the year soon after snow melts. It grows rapidly, producing a nodding head that droops with the weight of seeds. When they drop or are brushed against, they cling to socks and dog fur. Once trapped in a dog’s fur, there’s no place for the seed to go but in—and that’s when the trouble starts.
How Cheatgrass Harms Dogs
If they’re not removed, cheatgrass seeds burrow beneath skin, often entering at the toes or ears. They can also be inhaled into the nose or throat. They make their way through skin layers and can end up anywhere in the body: lungs, chest cavity, spinal column, eyes, muscles, and other areas. They can lodge in tissues and cause abscesses, inflammation, infections, and breathing difficulty from a buildup of fluid. Some dogs die if the problem isn’t discovered in time. In some cases, canine patients who died of peritonitis were later necropsied and found to have grass seeds in the abdominal cavity.
Most at risk are hunting, hiking, and farm or ranch dogs, who can encounter cheatgrass awns in grasslands, pine forests, and pastures. Seeds may be more likely to glom onto dogs with furnishings such spaniels, setters, and some retrievers. Doodles and other curly- or wire-coated dogs are also cheatgrass magnets.
Take your dog to the veterinarian if you can’t find any reason for violent headshaking or sneezing, ear scratching, or paw chewing. Development of a hematoma or abscess may be the least of your worries. Depending on where grass awns migrate, the extent of the infection or injury, and whether exploratory surgery or hospitalization is required, an encounter with cheatgrass can be an expensive proposition.
Signs that an awn may have migrated beneath skin or into tissues include little bubbly blisters between toes, unexplained gagging or coughing, increased respiratory rate or panting for no reason, bloody discharge from the nose, or excessive licking of a particular area. After sedation, your veterinarian can use a scope to examine ears, nose and throat and remove awns with long, narrow alligator forceps. Radiographs can indicate the presence of fluid in the chest cavity or lungs.
Bad Seeds
Other grasses with awns that can be harmful to dogs include Canada wild rye, foxtails, and needlegrasses:
Canada wild rye is often found in seed mixes because it produces ground cover quickly. Avoid purchasing seed mixes that contain it.
Many species of grass create seedpods that resemble fluffy foxtails, hence the name. Like cheatgrass awns, they can burrow beneath the skin. To find out more, see “Symptoms and Treatment of Foxtail Invasions in Dogs.”
Needlegrasses (members of the genus Stipa) produce barbed seeds that are difficult to remove once in a pet’s skin or tissues.
The website www.meanseeds.com was created by dog lovers to provide information on hazardous grass awns.
What To Do
Dealing with cheatgrass is an instance of an ounce of prevention being more than worth a pound of cure. Any time your dog has been outdoors where cheatgrass is present, do a thorough body check after you return home.
Grooming the entire body is key. Brush or comb fur thoroughly, getting down to the skin for a good look, especially if you have a double-coated breed. Keep hair trimmed, especially on paws, so cheatgrass awns are less likely to become trapped in it. You may also consider having your dog wear booties in cheatgrass areas.
Push gently up beneath paw pads to cause toes to spread out so you can check between them more easily. To remove any cheatgrass you find in your dog’s paw, take a pair of needle nose pliers that you’ve sterilized with boiling water or by soaking in isopropyl alcohol for 60 seconds. Grasp the feathery end of the cheat grass—think grabbing a badminton birdie by the flared end—and pull to remove. Do this only if you can see the feathery end; otherwise take your dog to the veterinarian. Do NOT use this technique to remove awns in the nose or ears or any that have already penetrated the skin; you could injure your dog further.
Know what cheatgrass looks like and avoid areas with it when possible. Go elsewhere when the plants are noticeably reddish and dry, usually early summer and into fall. This is when seeds are more easily dislodged and become embedded in fur or skin.
Cheatgrass Killer 101
Environmental groups, government agencies, farmers and ranchers, hunters and dog lovers are all interested in eradicating cheatgrass. On your own land, nontoxic, low-tech methods are hand-pulling, hoeing, or weed-whacking it early in the season before it matures and produces seed. Shallow, short, branching roots make it easy to pull. Bag plants and toss them in the trash so they don’t have a chance to germinate elsewhere. If you have goats, sheep, or horses, intensive grazing from late fall through mid-May is a good form of biological control. Find out if your county or state has programs to help fight cheatgrass.
Rototill the soil and plant native grasses and plants such as sagebrush species or bluebunch wheatgrass, choosing a beardless variety without awns. It will take a few years to see results, but your efforts can make a big difference.
: If you suspect your dog may have had a stroke, it is important to seek veterinary care right away. Credit: Anita Kot | Getty Images
At one time, strokes and mini-strokes were thought to only occur in people. When I was in veterinary college, I was taught that strokes almost never occur in our small animal patients. But with the increased use of magnetic resonance imaging (MRI) in veterinary medicine, we are finding out that strokes and mini-strokes in dogs are not impossible.
Thankfully, strokes (also known as cerebrovascular accidents, or CVAs) and mini-strokes (also known transient ischemic attacks, or TIAs) remain rare in our canine companions. CVAs and TIAs tend to happen in middle-aged to older dogs, although younger dogs with certain underlying conditions may be at increased risk. Strokes are seen more often in Greyhounds, Cavalier King Charles Spaniels, and Miniature Schnauzers.
What is a Stroke?
A stroke is an acute onset of one or more neurologic symptoms. It is caused by an interruption of blood flow to a particular section of the brain. This blood flow interruption could be partial or complete. A TIA is partial interruption of blood flow to a section of the brain. A CVA is the complete interruption of blood flow to a section of the brain.
A TIA is like the dimmer switch for a light. When you turn down the dimmer switch, you are reducing the amount of electricity reaching the light. The result is a light that still works but is not as bright as it would be if the dimmer switch was turned all the way up. A clot (also known as a thrombus) is like the dimmer switch. In a TIA, a thrombus partially occludes a blood vessel and reduces the amount of blood flowing to that section of the brain. The functions performed by that section of the brain are temporarily slowed and impaired.
Most dogs recover from a TIA within 24 hours. Dogs may continue to have TIAs in the future unless the underlying cause can be found and treated. TIAs may serve as a precursor to a CVA.
A CVA is like a clogged sink drain. When a drain is clogged, no water can get through the pipe. In a CVA, a thrombus completely occludes a blood vessel in the brain. The section of the brain served by that blood vessel quickly dies and then gradually swells. The swelling begins to subside after one to three days.
Another type of CVA is caused by a ruptured blood vessel. This is like a water main break. A break in a water main under the street results in a sudden rush of water from the pipe. The foundation under the street swells with water and causes the overlying pavement to collapse, flooding the street. A ruptured blood vessel in the brain is like that water main break. The brain tissue surrounding the ruptured blood vessel swells with blood and quickly dies.
Dogs that experience a CVA will have an acute onset of neurologic signs that gradually become worse over one to three days. After the swelling of the affected brain section subsides, most of these dogs show some improvement but may not make a complete recovery.
Causes of Strokes
Causes of strokes and mini-strokes can be divided into four categories: diseases that cause high blood pressure (also known as hypertension), diseases that cause clots or high amounts of lipids in the blood, and diseases that cause uncontrolled bleeding. The fourth category is idiopathic, meaning that the cause of a stroke cannot be found.
Hypertension can be seen in dogs that have chronic kidney disease or heart disease. Certain adrenal gland diseases—such as hyperaldosteronism and an adrenal gland tumor called a pheochromocytoma—can cause hypertension in dogs. Sometimes hypertension in dogs has no identifiable cause—this is called idiopathic hypertension. Hypertension can cause a blood vessel in the brain to rupture, resulting in a CVA.
The release of blood clots in the bloodstream can cause a TIA or a CVA. Heart disease, cancer, heartworm disease, infections of the brain, and sepsis are all diseases that can cause a thrombus to form. A condition called hyperlipidemia can cause a phenomenon similar to a thrombus. Diabetes mellitus, hypothyroidism, and hyperadrenocorticism (Cushing’s disease) are all associated with hyperlipidemia.
Spontaneous bleeding in the brain can cause a CVA. Brain tumors and head trauma can cause sudden brain hemorrhage. Immune-mediated thrombocytopenia is a condition in which there are not enough platelets to prevent spontaneous hemorrhage. Congenital clotting disorders, sepsis, and ingestion of an anti-coagulant rodenticide can also cause bleeding in the brain.
Diagnosis of a Stroke
If your veterinarian suspects that your dog may have had a stroke or a mini-stroke, she may recommend an MRI of your dog’s brain. This will allow your veterinarian to see if there is an occluded blood vessel or an area of brain hemorrhage. The cause of the stroke may also be visible on MRI, such as a brain tumor or congenital brain abnormality.
A sample of cerebrospinal fluid (CSF) may be obtained at the time your dog is undergoing an MRI. CSF can be analyzed for the presence of infection or inflammation—this can help to identify the underlying cause of a stroke.
Your veterinarian may also recommend bloodwork, including a complete blood count, chemistry panel, thyroid panel, coagulation panel, and heartworm test. Radiographs (x-rays) of your dog’s chest and abdomen may also be recommended. These tests can help identify the cause of your dog’s stroke.
Stroke Treatment
There is no specific treatment for strokes in dogs. Thrombolytic drugs (also known as clot-busting drugs) that are used in people have not been well-studied in dogs. Anecdotal reports of the use of thrombolytic drugs in dogs have identified serious side effects, including death. Thrombolytic drugs are only appropriate for strokes caused by a blood clot and may not be indicated for all dogs that have experienced a stroke.
Therapy for dogs that have experienced a stroke is aimed at maintaining proper blood flow to all parts of the brain, not just the part affected by a stroke. Therapy may include drugs to reduce pressure on and swelling within the brain, oxygen therapy, and drugs to normalize blood pressure. Identifying and treating the underlying cause of a stroke will minimize the risk of experiencing additional strokes.
Dogs that have lost functional use of their limbs may benefit from physical therapy. Physical therapy includes passive range-of-motion exercises, hydrotherapy, exercises to strengthen balance and coordination, and laser therapy. Many veterinary practices offer physical and rehabilitative services for dogs. Ask your veterinarian about what services they offer or inquire about referral to a practice that offers physical therapy.
Your dog’s ability to recover from a stroke will depend on the location and severity of the stroke, the underlying condition that caused the stroke, and your dog’s overall health. Some dogs may make a complete recovery while others may have a greatly diminished quality of life. You will need to work closely with your dog’s veterinary care team to determine the best treatment plan for you and your dog.
Everyone loves a playful puppy, but you should regulate your puppy’s exercise, so he doesn’t overdo it. Elbow dysplasia is an inherited developmental disease of the joint. Credit: Brighton Dog Photography | Getty Images
Your 6-month-old puppy is off on his left front leg. He seems to worsen with activity, but he is rarely three-legged lame. This may be a sign of dysplastic elbow, or “elbow dyspasia.” (Dysplasia means a developmental abnormality.) Elbow dysplasia is second to osteoarthritis as the most common lameness in dogs.
Elbow dysplasia results from a defect during the final development of the elbow joint in a puppy. The elbow is a complicated joint, involving the meshing of three bones: the humerus (big bone coming down from the shoulder) and the radius and ulna (two smaller bones that make up the forearm). Any change from normal in how these bones meet to form the elbow joint can lead to arthritic changes and corresponding lameness.
Can you prevent elbow dysplasia? Certainly, you can reduce the risk in an individual dog by only breeding, or purchasing from, parents with normal elbows per OFA report. Note: Some breed clubs consider Grade I to be basically the same as Normal, but others recommend only breeding dogs with a Normal rating. Selecting parents with normal elbows can reduce the incidence of elbow dysplasia in a breed over time. Keep in mind that this is thought to be a multifactorial problem, so it is not a simple fix. Diet, environment, and genetics are all interacting. In addition, it helps to:
-Keep your young growing dog at a good weight.
-Use an appropriate diet for your growing puppy.
-Regulate exercise for your growing dog. Limit jumping up and down, pounding on hard surfaces, etc. until your dog is fully developed.
-Discuss when to spay or neuter your dog with your veterinarian.
In most cases, when only DJD is marked on an OFA report (see sidebar), it can be assumed that lesions associated with coronoid process disease are present. This accounts for most elbow dysplasia cases.
What Is the OFA?
Elbow dysplasia is seen in a wide range of dogs, affecting over 79 breeds according to Orthopedic Foundation for Animals (OFA) statistics. The OFA screens dogs for inherited health conditions to help breeders improve genetic health within dog breeds. It is voluntary screening, done with an examination and forms from your own veterinarian who submits the results to the OFA, which then issues a certification score. The statistics can help breeders make better breeding choices to avoid inherited disease. Dogs do not have to be purebred to be part of the OFA and get screened.
The breeds with the highest rate of elbow dysplasia according to OFA statistics are the Chow and Bulldog. Interestingly, Beagles and Pyrenean Shepherds have no recorded cases of elbow dysplasia.
OFA Grades the Joint
If the joint isn’t normal, OFA grades it as the level of changes in the joint. The classifications for elbows are:
Grade I Elbow Dysplasia:Minimal bone change along anconeal process of ulna (less than 2mm).
Grade II Elbow Dysplasia: Additional bone proliferation along anconeal process (2-5 mm) and subchondral bone changes (trochlear notch sclerosis).
Grade III Elbow Dysplasia: Well-developed degenerative joint disease with bone proliferation along anconeal process being greater than 5 mm.
These grades are based on the amount of degenerative joint disease noted on radiographs. The bony degenerative changes are the result of joint defects. It is recommended to do elbow evaluations at 2 years of age. Over time, normal wear and tear on your dog’s elbow joints may lead to some bony arthritis changes, obscuring any genetic developmental problems.
Severe elbow dysplasia can be debilitating, but dogs with mild dysplasia may not show any lameness until later in life. Male dogs are more frequently affected. Both overweight and very active dogs are at risk for joint damage. Estimates of 30% to 80% of dogs will be affected bilaterally, which makes a diagnosis tricky. These dogs may not show the typical head bobbing we commonly associate with front-leg lameness but instead have an overall shortened stride and decreased range of motion. Both legs will show pain upon manipulation. If your dog is lame on one front leg, it is always wise to radiograph the other leg as well in case it is also affected.
With severe elbow dysplasia, the dog may have a swollen front leg at the elbow joint. Bony changes can lead to an almost fused joint, which will feel firm on palpation. In early stages, there may be warmth, fluid buildup, and inflammation, but this will change over time.
Diagnosis of Elbow Dysplasia
Diagnosis starts with a lameness exam, including flexing and extending the elbow joint as well as watching your dog move. Your veterinarian will likely recommend X-rays of the elbow joint. For OFA evaluation, an extreme flexed-joint X-ray view is required, but your veterinarian may take other views as well to determine the extent of the problem. If there is a question about the diagnosis, a CT scan or arthroscopy may be recommended, along with referral a board-certified veterinary surgeon.
Medical treatment can make your dog comfortable, but it won’t really slow down the progression of arthritis. Medical therapy may include painkillers, joint supplements, and rehabilitation plans to strengthen muscles and minimize strain on the joint.
What to Expect With Surgery
Surgery is generally recommended for the best prognosis for quality of life for your dog. The exact surgery done will vary depending on the exact defect.
Any bony or cartilage fragments will need to be removed. This can be done arthroscopically in many cases. If the joint needs to be realigned, more extensive surgery is required.
In rare cases, total elbow replacement may be suggested. There are limited facilities prepared to do replacement surgery, and elbow replacement is associated with potential complications. These include:
Infections of the surgery site
Instability of the prosthesis
Fractures around the prosthesis site
These complications tend to occur early on post operatively, with a rate of 15% complications in the first year. On the positive side, 75% or more dogs who have had elbow replacements are considered successful with a great decrease in pain and ability to resume normal, or near normal, activities.
Postoperative care and rehabilitation are important for elbow dysplasia cases. Your veterinarian will provide you with a full plan, starting with limited activity for healing to take place, and then exercises to gradually build back muscles.
The American College of Veterinary Surgeons emphasizes that surgery is not a cure, stating: “Once arthritis is established it will slowly progress regardless of any treatment. On average, with treatment 85% of cases will show some degree of improvement in lameness and comfort despite progression of arthritis on X-rays. The aim of treatment is to slow the progression of arthritis and prolong the patients’ use of the elbow. Unfortunately elbow dysplasia cannot be cured but it can be well managed, and our patients can have a good long-term prognosis and outcome with a combination of surgical and medical management.”
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This article is about tails, but make sure you look at the tail in context; don't ignore what the rest of the dogs body language is expressing. This dog may have a naturally high tail; it's high, but she doesn't look aroused: Her eyes look soft, her mouth is open and relaxed, her ears are off to the side (not pricked hard forward) and she is leaning back slightly. It looks like she's asking the photographer to throw the toy for her.
Why do dogs wag their tails? Everybody knows that when a dog approaches you wagging her tail it means she’s inviting you to pet her, right? Wrong! We may have all grown up thinking a wagging tail means a happy dog, but that is not always true. Misinterpreting a wagging tail has gotten countless well-intentioned dog-lovers bitten, sometimes quite badly.
So, here’s the thing: A wagging tail does not necessarily mean a happy dog. It simply means arousal of some kind. That can be happy arousal, or fear, excitement, or even aggressive arousal. Here are some tips to help you decipher the canine tail-wagging lexicon:
DOG TAIL MEANINGS
Given the shelter setting, it’s likely that this dog’s high tail is due to arousal (most shelters are a high-stress environment). But the dog’s “play bow” posture is a clear sign that the dog is displaying happy, friendly arousal.
Tail wagging works well for dogs in the canine world. Since dogs communicate primarily through vision and body language, dogs are generally good at understanding each other’s tail wags. (And, yes, dogs who are born with short tails or whose tails are docked are at a significant disadvantage when it comes to dog tail language.)
In general, the higher the dog’s tail and the faster the wag, the greater the level of arousal. While a very high tail indicates high arousal, a very low-wagging tail most often denotes fear and appeasement.
High tail wag. A “flagging” tail – straight up or even curved slightly over the dog’s back – moving at blur-fast speed, is an indication of strong emotion. Of course, some dogs naturally carry their tails straight up or curled over their backs (Huskies, Pomeranians, Pugs, Basenjis, and more), so you need to take that into consideration when reading a dog’s tail.
A high tail with a slow wag may indicate a happy dog with a lower level of arousal, but again, look at the whole picture. Did the wag just stop? Did he just freeze? His backward-leaning stance, hard eyes, and closed mouth suggest he’s conflicted.
But how do you know if it’s a fun-and-games, fast-wagging high tail saying, “I’m so happy and excited to see you! Yes, please, pet me!” or an aroused and angry high tail telling you, “If you try to pet me, you’ll be toast!”?
The simple answer: body language. The “Pet me!” dog is animated and wiggly, with soft eyes and an inviting open-mouth grin. Sometimes her whole body seems to wag!
In contrast, the “I want to eat you!” dog is likely to have a tense body and hard eyes, with all his energy focused forward with no wiggling. Even still, a happy aroused dog can do damage in her excitement, so you are better off waiting to engage even with a happy high-tail wagger until she calms down a bit.
Meanwhile, a high-but-slower tail wag suggests less active arousal, but it still can be a caution sign. She may just be happy and not as aroused, or it might be that an elevated level of tension has slowed the aggressive dog’s tail. It could be the beginning of an agonistic freeze just before the bite happens. (“Agonistic” refers to a continuum of social behaviors including all aspects of aggression, from appeasement and flight at one end, to warning signals, threat and actual attack at the other extreme.)
Again, reading the dog’s entire body language will help you determine what the dog’s tail means, and if it might be safe to interact, or not.
A half-mast, open mouth, and bright eyes complete the picture of a relaxed, happy dog.
Half-mast tail wag. A medium-height tail wag is generally an indication of a calmer, less aroused dog. The speed of the wag can further indicate how calm the dog might be.
I like to look for what I call “the half-mast swish,” where the tail is gently wafting back and forth at about hock level. A faster wag indicates more energy on the dog’s part (happy or angry energy), and a fast wag that slows to a freeze is always a warning sign.
A dog with a half-mast wag can still bite you. Watch all the body language, not just the tail. Happy, relaxed tail wagging is usually accompanied by a happy facial expression. A happy dog usually has bright eyes, a relaxed open mouth, and possibly a gentle pant.
Circle tail wag. This is my favorite, and the most unambiguous of all the tail wags. Most often, a dog will wag her tail in a circle if she is particularly overjoyed to see someone special, especially someone she hasn’t seen recently. A very friendly dog may offer this wag in happy excitement any time she meets someone she wants to call her friend, even someone new to her.
Although I’m sure there might be exceptions, I have personally never seen a dog do a circle wag who had any aggressive intent.
Low tail wag. When the wagging tail goes below half-mast, the dog is likely feeling fearful and defensive. The lower the tail wag, the stronger the emotion. The low tail wag is often accompanied by a lowered body posture and, sometimes, submissive urination. Also, the faster that lowered tail is wagging, the more emotion the dog is expressing to you.
It may be tempting to try to comfort the low-tail wagger. Don’t! All that appeasement behavior she’s offering is her way of telling you that you are making her very uncomfortable and she wants you to leave her alone. She may even roll over on her back as she wags her tail.
Sadly, this appeasement behavior is often misinterpreted as an invitation for a belly rub. Again, don’t. While some dogs may enjoy a belly rub, a low-tail wagger is likely pleading with you to go away; she feels very threatened by your proximity and is making a last-ditch effort to get you to leave her alone. Rubbing this dog’s belly is quite likely to result in a significant bite, often to the face of the person doing the rubbing, since you are probably bent over her for the rub.
Compared to dogs with more tail to communicate with, dogs with docked or short “pig” tails are definitely at a disadvantage. Dogs with extensive facial wrinkles are even more difficult to “read” (for other dogs and humans!)
Absence of wagging. The lack of tail movement can also give you information – again, in context with the rest of the dog’s body language.
If a dog is calm and relaxed, a motionless tail just means that the dog is being zen – not enough emotion happening to make the tail move. A fearful dog whose tail is still is likely shut down, afraid to move at all. An aroused, angry dog whose tail stops wagging may be doing the agonistic freeze mentioned above. And a happy aroused dog may be engaging in a whole-body “pause” prior to a play bow, a bounce, or some other play-invitation behavior.
Tail Wagging Takes Sides
A study done in Beijing in 2022, published in iScience, concluded that the direction in which a dog wags his tail may be a clue to what the dog is feeling. It’s not the first study to make this determination, which means there is validity to this theory.
In this study, Chinese researchers found that “tail wagging shifts from left side to right side as dogs familiarize with humans,” suggesting the shift as a “time-sensitive indicator of social familiarity.” In other words, dogs who wag their tail more to the right are likely happy or content.
The researchers added that, “Our results with laboratory Beagles and previously reported asymmetric tail wagging in pet dogs indicate that the left- and right-wagging bias might be indicators of negative and positive effects, respectively.”
Of course, the wise dog person pays attention to everything a dog is telling you, including his stance, eyes, general demeanor, and the situation at hand.
DOG TAIL LANGUAGE DURING DOG-DOG INTERACTIONS
The same interpretations of dog tail language hold true for dog-dog meet and greets. A high, fast tail wag indicates a significant amount of arousal; use caution with this introduction. Do parallel walking until the tails slow down and you can determine if the wagging is from happy excitement wagging or tension that could lead to a fight.
Two high tails: Too high? Not really; they are aroused, but there are no signs of potentially aggressive overarousal. The white dog is looser (open mouth, playfully lifted front paw), but while the brown dog seems still, he doesn’t look frozen; he may be about to “bounce” in play-invitation.
Hock-level wags are more promising, and a circle wag is ideal. A low-tail wag during dog introductions tells you that the dog is unsure, perhaps feeling threatened. If the more assertive dog responds appropriately to this by slowing down and toning down his energy level, all may go well.
If, instead, he continues an energetic, assertive approach, the dog offering appeasement signals may become defensively aggressive and a fight can ensue. Often the more appeasing dog gets blamed for this fight when, in fact, it’s the fault of the more assertive dog for not responding appropriately to the other dog’s signals!
It’s imperative that you intervene before a fight happens when you see that an energetic assertive dog is not honoring the message sent by a low-wagging tail. Again, parallel walking and controlled interactions may serve to salvage this relationship.
This dog’s tail is wagging – but the tail and overall low, tense posture is fear-based appeasement behavior. Many people would be tempted to try to comfort this dog, but the overall message she is sending is, “I’m scared to death! Please leave me alone!”
TAKE IN THE WHOLE DOG’S BODY LANGUAGE
Regardless of the likely dog tail meaning, you are safest when you let the dog approach you and initiate the interaction. Reaching out to pet a dog, even one with a soft half-mast swish, could trigger a defensive response. Let the dog come to you.
And regardless of whichever side a dog’s tail is wagging on, the more you pay attention to the whole dog, the better you’ll be able to understand what that wagging tail is really trying to communicate. Our dogs are talking to us all the time. Remember to listen with your eyes.
This is a stock photo, so it's likely (hopefully!) staged and not actually an unleashed, alert dog with an inattentive owner at an outdoor cafe. But it's certainly possible! Photo by brightstars, Getty Images.
I’m generally a fan of places or experiences that dog owners can enjoy with their well behaved dogs—but not so much when it’s with other people’s unruly, reactive, or loud dogs. Couple any of that with owners who make no effort to limit their dogs’ intrusion into other people’s space or hampering wait-staff, and any progress that has been made to include dogs goes out the window.
I was visiting my sister-in-law and niece in a nearby town recently when we decided to walk to a nearby burger-and-brew sort of place that has an outdoor patio. It was a lovely evening, so we weren’t dismayed when we were told it would be at least a 30-minute wait for an outdoor table; we were catching up and in the meantime we could enjoy the view of the sunset and the perfectly lovely early-summer temperature. When I glanced around the patio, to see how far along most diners were in their meals (and gauge how much time we might have to wait), I was surprised to see a dog at nearly every one of the eight or nine outdoor tables—but hey, I’m a dog lover! No problem!
However, when a server directed us to a table on the far side of the patio and we made our way across the area, I had an immediate instinct that the situation was borderline dangerous. Several of the dogs in the patio were standing or sniffing at the end of fairly long leashes, which were being loosely held (or sat on) by people who looked frankly inattentive to their dogs. I thought to myself, “This situation is ripe for a dog fight!”—and that was before I saw, lying flat in the space between our table and the one next to it, a very large dog, taller and heavier than my own 70-plus-pound Pit/Lab-mix, whose leash wasn’t being held or tethered at all!
To take a seat on the picnic bench for our table, my niece and I either had to step over the dog, or ask the owner to ask his dog to move. My niece, who loves dogs, was about to do the former when I gently arm-blocked her; there is absolutely no way to know how a strange dog would respond to opening his eyes in time to see a strange person stepping over him! I made eye contact with the dog’s owner and said, “Do you mind asking him to move so we can sit down?” He looked down at the dog, and then at us, and said in a slightly annoyed tone, “He’s OK, he won’t do anything.”
I could have been argumentative and said, “Hey, you know, I’m not going to put my beloved niece’s legs at risk of a dog bite,” but instead I took a more direct approach: I whistled to alert the dog, who immediately sat up. I smiled at the dog and his owner and said, “Oh, what a good dog!” and slipped past the dog so I could pull out the bench for my niece and I to sit on. I didn’t think the guy would have brought an aggressive dog to a crowded patio, but I wouldn’t ask any snoozing dog—and especially one who probably outweighs my niece—to tolerate being stepped over by strangers!
I gained more and more sympathy for the servers every time I saw them wend their way through the crowded patio, pausing for owners to pull their distracted, restless dogs back toward their tables so the servers wouldn’t have to step over (or trip over) the dogs’ leashes—but I also wondered: How do these owners not see how they are inconveniencing (at best) or endangering the wait-staff and other diners?
The last straw (for me, personally) was provided by a couple who seemed to be waiting for a take-out order, accompanied by a clearly dog-reactive Husky-mix. They were lurking near the edge of the patio, and every time the Husky caught sight of one of the patio dogs, she would start barking—which would set off a wave of barking and active reactions from the dogs on the patio. Why couldn’t that couple have waited with the dog a few yards farther away, within sight of the restaurant door, but where their dog wouldn’t keep being triggered by the sight of the other dogs (and thus, triggering all the other dogs on the patio to react)? The entire experience was not dissimilar to eating dinner in the kennels at an animal shelter.
Personally, I’m mortified when my dogs do anything in a public setting that could inconvenience or concern other people; for me, it’s an indication that my management and training of my dogs is not as good as it should be in order to have my dogs in public. But none of the people dining on this patio with their dogs seemed to be conscious of their dogs doing anything wrong at all. Perhaps they rationalized that since all the dogs were being loud and obnoxious, theirs wasn’t standing out in any way?
Have you had a bad experience with other people’s dogs in public? Or would you admit it if your dog may have been problematic for people around you?
Most dogs will shake if they get wet, but if your dog is frequently shaking his head for no apparent reason, that may be a sign of an ear infection. Credit: VivaZa | Getty Images
It’s one of the most common questions we hear at a veterinary visit: Why is my dog shaking his head (or ears)? While inner-ear infections occur more in dogs with drop ears, like Cocker Spaniels, any dog can experience an ear infection. Causes can range from yeast to bacteria to mites or allergy, and we will explain the causes, treatments, and prevention here.
Signs of an ear infection include any of these symptoms:
Discharge from the ears
Odor coming from the ears
Redness in and around the ears
Rubbing ears on the ground or on furniture
Scratching his ears
Shaking his head
Infections can be in one or in both ears. Sometimes the ear canal is so swollen, the opening is obscured, making it difficult to see what is going on in the ear canal. This also makes getting topical medications in the ear more challenging.
Causes of Ear Infections
A proper diagnosis of ear discomfort will usually require ear cytology, a diagnostic test in which a sample of the ear discharge is smeared on a glass slide. The slide is then stained and examined under a microscope, so the laboratory can determine the cause of the ear infection. Different causes of ear infections have different treatments. Quick tip: Don’t clean out or treat the ears prior to the veterinary appointment! This could lead to misleading test results and an inaccurate diagnosis.
Ear infection causes in dogs include:
Yeast (Malassezia pachydermatis. This is a common cause of ear infections. While small numbers of yeast can normally be found in the ears and on the skin of dogs, overgrowth of this organism can cause problems. Yeast infections are treated with an anti-fungal medication.
Bacteria. Multiple species of bacteria can cause ear infections. These infections are treated with antibiotics. Occasionally, first-line antibiotic therapy is not effective, and in these cases, the ear discharge is cultured to find out what species of bacteria is causing the infection, and the bacteria’s sensitivity to multiple antibiotics is measured to determine the best antibiotic choice. What we often find in these cases is that the bacteria are resistance to one or more antibiotics. Knowing what the invading bacteria are sensitive to helps tailor the therapy to the specific medication that will work.
Ear mites (Otodectes cynotis).These are mites that live on the surface of the skin and can often be observed in an otoscopic exam. This ectoparasite is contagious via direct contact. There are multiple treatments for ear mites, including topical drops for the ear canal, one-time treatments that are administered directly into the ear canal, and other topical medications that also have action against fleas.
Sometimes there are chronic ear problems that are non-seasonal, and these cases are often suspected to be related to dietary sensitivity (food allergy). The therapy of choice for a suspected dietary sensitivity is to do a hypoallergenic diet trial. The diet to try is one of two types: either a prescription hydrolyzed diet or a novel protein/novel carbohydrate diet (prescription or home cooked with recipe formulated by a veterinary nutritionist, to prevent contamination with other proteins that can often happen in over the counter foods and can confuse the results of the diet trial).
The trial would need to be at least 12 weeks in length and is very strict, which means no commercial treats, no table food, no counter surfing or garbage diving, no eating poop of a dog on a different diet.
During the duration of the diet trial, any other infections (see above) would need to be treated, as they will not magically go away without appropriate therapy.
Topical treatments are usually preferred, as the medication is placed in the site of the infection, and systemic side effects can be avoided. However, if the dog is too painful to treat topically, or is resistant to an owner administering medication at home, oral forms of the medications can be of benefit.
Follow-up visits to document success or failure of the treatment are important in managing each individual dog’s ear health. Don’t skip them! Ear infections left untreated or undertreated can result in chronic pain and inflammation, deafness, peripheral vestibular disease that can affect balance, or an aural hematoma, in which the ear flap (pinna) becomes distended as it fills with blood.
Aural hematomas, left to heal naturally, will result in scarring of the pinna that is similar to a wrestler’s cauliflower ear. American Cocker Spaniels are a breed that can develop ear canal issues even without infection.
When ear infections cannot be managed through medical therapy, total ear canal ablation (TECA) surgery may be considered. Even though this procedure essentially renders the dog deaf on that side (or totally deaf if both sides are treated), it provides relief to chronic pain and infection. The TECA surgery is also indicated if there are cancerous changes in the ear canal.
Prevention
Clearly, ear infections are no fun for dogs or humans! Dog owners can help prevent ear infections from starting in the first place by using these simple guidelines:
Work with your dog to accept procedures. As soon as a dog is adopted, owners should start work on cooperative care training, in which the dog is taught not only to accept, but consent, to veterinary procedures. At the very least, owners should be able to touch the ears and look down into the ear canals to monitor for changes. Getting a dog to accept regular ear cleanings is also extremely helpful.
Consider using an ear cleaner with a drying agent in it for frequent swimmers. Often ear infections are more likely to set up after exposure of the ear canal to water. This is particularly notable for dogs who swim. If the moisture is left to evaporate naturally, this can set up a warm, humid local environment in the ear canal, which is an ideal condition in which bacteria and yeast can thrive. To speed up the evaporation of excess water in the ear canal, flush the ear canal after the last swim of the day with an ear cleanser, preferably one that has a drying agent in it.
Stick with any prescribed dietary plans. If a dog has been diagnosed with a dietary sensitivity (see allergy above), stick to the strict diet plan to avoid an allergic flare, which can take weeks or months to calm back down.
Diet and weight play an important role in managing diabetes in dogs.
Picture it: You have just returned home from a dinner party to find that your dog has urinated on the kitchen floor – again. She has always been a good dog about going outside to do her business. Why is she suddenly leaving large puddles of urine in the house? Increased urination is one of the telltale signs of diabetes. Could your dog be battling canine diabetes mellitus? Maybe. The incidence of diabetes in dogs is on the rise, according to the North American Veterinary Community.
Symptoms of diabetes in dogs include:
Increased urination
Unusual peeing accidents in the house
Drinking large amounts of water
Urinating more often and in large amounts
Changes in appetite (eating more or less)
Weight loss despite good appetite
Cloudy eyes/development of cataracts
Increased infections, including urinary tract and skin
The chemistry panel for a dog with diabetes will show elevated blood glucose and sometimes will also show elevated cholesterol, triglycerides, and liver enzymes. The urinalysis will show glucose in the urine but may also reveal the presence of protein, ketones, and bacteria. Many dogs with diabetes mellitus have a concurrent urinary tract infection (UTI), so a urine culture and sensitivity will be recommended to confirm the presence of bacteria and determine the correct antibiotic for treating the UTI.
What Causes Diabetes in Dogs?
In dogs, diabetes is almost always caused by a decreased production of insulin. Insulin is produced by special cells in the pancreas called beta cells. When beta cells either produce less insulin or are destroyed by an episode of pancreatitis or an immune-mediated disease, the result is diabetes mellitus.
The AlphaTRAK 2 blood glucose monitoring system starter kit contains a monitoring meter, test strips, lancets, a lancing device, a control solution and a carrying case.
There are some conditions in which diabetes is caused by insulin resistance. In these circumstances, the dog’s beta cells are still producing insulin, but his or her body has a decreased capacity to utilize it.
Intact female dogs who are either pregnant or between heat cycles are at an increased risk of developing transient diabetes.
Dogs who are obese or are receiving certain chronic medications (such as steroids, progestins, and cyclosporine) are at risk for developing insulin-resistant diabetes.
Dogs who have a concurrent endocrine disorder, such as hyperadrenocorticism (also known as Cushing’s disease) or hypothyroidism, are also at risk for diabetes development.
Certain breeds of dogs are known to be more likely to develop diabetes mellitus during their lifetime. These breeds include Australian Terriers, Beagles, Samoyeds, and Keeshonden.
Treatment for a dog with diabetes
The mainstay of diabetes treatment in a dog is insulin therapy. Long-acting insulin is injected under the skin twice a day. The needle and syringe used to administer insulin are small. Dogs hardly even notice the injection, especially if they are being distracted by food or a treat! Your veterinary team will give you a demonstration on how to give insulin and will help you become comfortable with this process.
People who have difficulty reading the numbers on a syringe and feel uncomfortable with handling syringes may have an easier time with the Vetsulin pen.
There are three different types of insulin that are used to treat canine diabetes. Two of these insulin types are approved by the U.S. Food & Drug Administration (FDA) for use in dogs while one of them is not (but is still commonly used).
Both Vetsulin and ProZinc are FDA-approved insulins for use in dogs. Vetsulin is given twice a day and is available in two forms – vial and pen form. With the vial form, you draw up the appropriate dose in an insulin syringe and inject the insulin into your dog. With the pen form, you select the appropriate dose on the pen, insert the needle under your dog’s skin, and press the button to inject the insulin. People who have difficulty reading the numbers on a syringe or who feel uncomfortable with handling syringes may have an easier time with the Vetsulin pen.
ProZinc is given either once or twice a day depending on your dog’s response to the insulin. This insulin is only available in the vial form. Therefore, it requires the use of an insulin syringe to draw up and inject the insulin. Both ProZinc and the vial form of Vetsulin require U-40 size insulin syringes – this is different than what is used by humans with diabetes, who require U-100 size insulin syringes.
Novolin N and Humulin N are insulins used to treat diabetes mellitus in people. They are not FDA-approved for use in dogs but have been used “off label” for many years to treat diabetes in canines.
Options for insulin for dogs used to be limited and expensive. Vetsulin was approved by the FDA in 2013 and ProZinc was approved for use in dogs in 2019. Novolin and Humulin were also very inexpensive compared to the products approved for dogs. Fortunately, now both Vetsulin and ProZinc are typically less expensive than Novolin and Humulin. Vetsulin and ProZinc also last longer and function better in the canine body than Novolin and Humulin.
Diet for Dog Diabetics
Diet plays an important role in managing diabetes in dogs. Dogs who are overweight should be started on a weight-loss plan. It’s important not to lose weight too quickly and to weigh your dog once or twice a month to ensure weight loss is occurring at an appropriate rate. Your veterinarian may recommend a prescription weight-loss diet that is high in fiber to help achieve weight loss and better daily control of blood sugar.
Dogs who are at an ideal body weight or are underweight may also benefit from a diet that is high in both soluble and insoluble fiber. In certain circumstances, the addition of high-fiber vegetables (such as canned pumpkin or green beans) or fiber supplements (such as psyllium) may be beneficial. Talk to your veterinarian before instituting any diet change or adding any supplements.
There is no way to treat diabetic dogs without insulin. But there are two classes of medications that may help to improve glycemic control (daily control of blood sugar) in diabetic dogs. Acarbose works by inhibiting the absorption of glucose by the small intestine. This medication may be recommended in dogs for whom insulin therapy alone is not enough to control their high blood sugar.
Medications in the incretin class of drugs (such as Byetta, Bydureon, and Victoza) are hormones that work primarily by stimulating insulin secretion from the pancreas. These medications can only be used in conjunction with insulin. They are not substitutes for insulin therapy.
Monitoring a Diabetic Dog
The goals of treating a diabetic dog are to resolve the symptoms of increased thirst, urination, and appetite; to keep the blood glucose from becoming too low (hypoglycemia); and to keep the blood glucose below the level at which glucose enters the urine. This is different than the goals of treating a diabetic person, in which tight control of blood sugar is achieved through frequent monitoring of blood glucose and daily adjustments to the insulin dose.
There are several methods for monitoring diabetic dogs to ensure appropriate management. Your veterinarian will likely recommend a blood glucose curve be performed in their hospital, especially after the initial diagnosis. This is to ensure that your dog is not developing hypoglycemia (low blood sugar) when starting insulin therapy. A properly completed blood glucose curve will help determine the correct dose of insulin for your dog.
During a blood glucose curve, a very small sample of blood is obtained every two hours to measure the dog’s blood glucose. The blood glucose values are charted over a 12-hour period to see how your dog responds to his or her current insulin dose.
A blood glucose curve should be completed after starting insulin therapy and seven to 14 days after changing the dose of insulin. Then it should be completed at least once every three months to ensure your dog’s diabetes remains well-controlled. It should also be done when symptoms of diabetes return in a previously well-controlled diabetic or when hypoglycemia is suspected.
For dogs who are stressed by the idea of spending a day at the veterinary hospital, completing a blood glucose curve at home may be an option. The AlphaTRAK 2 blood glucose monitoring system starter kit from Zoetis contains everything you need to complete a blood glucose curve at home. Zoetis has videos available on their website that show you how to use the glucometer (blood glucose meter) and how to obtain a blood sample using the lancet that comes with the starter kit.
The AlphaTRAK 2 glucometer is calibrated to read blood glucose in both cat and dog blood. It only requires a very small drop of blood to obtain a blood glucose reading. Glucometers made for humans are not calibrated for use with dog blood and are not as accurate as the AlphaTRAK2. Your veterinarian probably uses the AlphaTRAK 2 to read your dog’s blood glucose in the hospital.
Zoetis also has an app for your phone that allows you to record your dog’s blood glucose readings and share them with your veterinarian. Talk to your veterinarian about the specific logistics of completing an at-home blood glucose curve if you are interested in this option.
For people who want to complete a blood glucose curve at home but are hesitant about collecting blood samples from their dog, there is a continuous glucose monitoring system called the FreeStyle Libre from Abbott. The FreeStyle is a small device about the size of a half-dollar that is temporarily attached to the skin on your dog’s back. The device reads your dog’s glucose every 15 minutes over a 14-day period. The glucose readings are sent to an app on your phone and can be shared with your veterinarian. Although the FreeStyle is not calibrated for dog blood, unlike other glucometers made for people, this device has been shown to be relatively accurate for dogs.
Urine glucose strips are used to detect the presence of glucose in urine. Although this seems like an easy way to monitor your dog’s glucose, urine glucose strips will not give you a complete picture of how well your dog’s diabetes is being managed. The urine glucose strip gives only an average reading over the period of time it takes your dog’s bladder to fill with urine. There may be moments during that period of time where your dog’s blood glucose is too low, normal, or too high. But the urine glucose strip will only show the average glucose over that time period rather than the potentially dangerous highs and lows. The only way to truly know how well your dog’s diabetes is being managed is by completing a blood glucose curve.
Complications of Diabetes
Dogs with diabetes are more likely to develop certain bacterial and fungal infections. These include infections of the bladder, prostate, skin, and lungs. Diabetes can also cause accumulation of lipids in the liver resulting in hepatomegaly (enlargement of the liver). Another possible complication of diabetes mellitus in dogs is the development of cataracts.
There are two life-threatening complications of diabetes in dogs: diabetic ketoacidosis (DKA) and diabetic hyperosmolar nonketotic syndrome (DHNS). Both conditions are caused by persistently high blood glucose levels. In DKA, the body tries to derive energy from fat since there is not enough insulin available to use glucose freely circulating in the bloodstream. The process of deriving energy from fat in the absence of insulin results in the production of ketones. The accumulation of ketones and glucose in the blood causes dehydration, abnormal electrolyte levels, and increased kidney values and liver enzymes. Dogs in DKA will often be vomiting, very lethargic, and will not eat. They may initially drink a lot of water. As the condition progresses, they may lay with their head next to or on the water bowl but not drink at all.
Dogs with DHNS also try to derive energy from fat, but there is just enough insulin available to prevent them from producing ketones. Dogs with DHNS are dehydrated and may have abdominal pain. They often vomit and decline to eat. They will be depressed and may even become comatose.
Although there is no final stage of diabetes, dogs who develop DKA or DHNS are sometimes euthanized because of the level of care they require to stabilize and correct their condition. Dogs with DKA or DHNS typically require hospitalization for two or more days in the intensive care unit of a hospital that is open 24 hours a day.
Canine Diabetes Survival
The median survival for dogs with diabetes mellitus is two years, but there are many dogs who live much longer than that. The faster a diabetic dog’s symptoms are recognized and he is diagnosed and receives proper treatment, the better his prognosis. With proper weight control, a well-managed diet and treatment, and regular veterinary assessments, dogs with diabetes can enjoy full, high-quality lives.
Counter surfing can “reward” dogs with a potentially high-fat food that may lead to pancreatitis. Credit: Yurikr | Getty Images
Pancreatitis in dogs is inflammation of the pancreas, a glandular organ in the abdomen that produces digestive enzymes and insulin. Signs of canine pancreatitis include not eating, vomiting, diarrhea, abdominal pain, and fever. While there are hundreds of reasons for a dog not eating, pancreatitis is always a possibility, especially if the dog has any of the signs listed below. And, make no mistake about it, acute pancreatitis is life-threatening.
Signs of Worsening Pancreatitis
Signs of pancreatitis include vomiting, loss of appetite, painful abdomen (which can look like a hunched up appearance, or the dog may posture like the yoga pose downward dog), lethargy, and fever.
Pancreatitis can be acute, meaning it comes on all of a sudden with no warning, or chronic. Acute pancreatitis can be severe and life-threatening. Many of these dogs must be hospitalized for intravenous fluids and supportive care. Chronic pancreatitis tends to cause waxing, waning symptoms repeatedly over time. Chronic pancreatitis requires careful, long-term management.
Signs of worsening pancreatitis in dogs include:
Protracted vomiting not controlled with medication
If you believe your dog is suffering from pancreatitis, get to the veterinarian immediately. This is an emergency. Call the clinic on the way to give them a heads up that you’re arriving. (This is yet another reason to know the name, phone number, and location of the nearest 24/7 emergency veterinary clinic.)
Pancreatitis also occurs in a chronic-active form, with milder symptoms that come and go. These dogs will intermittently need the help of antiemetic and pain-relieving medications and should always be fed low-fat food forever.
Other causes of pancreatitis include hormone imbalances, certain medications, trauma to the abdomen (like if dog is hit by car), and obesity. Some breeds are more predisposed to pancreatitis than others including Miniature Schnauzers, Yorkies, Poodles, and Cocker Spaniels.
Risk Factors for Pancreatitis
Schnauzers sometimes suffer from a condition called hyperlipidemia, which predisposes them to pancreatitis. Otherwise, predisposing factors for pancreatitis include:
If your dog is showing signs of pancreatitis, your veterinarian will likely take an abdominal X-ray to rule out other potential causes. Baseline blood work is done for the same reason. Your veterinarian may also run a blood test called specific canine pancreatic lipase (SPEC cPL), which is much more sensitive and specific for pancreatitis than the older tests veterinarians used to have to rely on (lipase, amylase). Many veterinary hospitals can run this test in-house. With results immediately available, your dog can get the treatment he needs right away.
For chronic cases, your veterinarian may recommend an abdominal ultrasound, as this can provide useful information regarding severity, which helps in determining prognosis.
Treatment for Pancreatitis in Dogs
Treatment for acute pancreatitis in dogs usually involves hospitalization. Intravenous fluids are administered to combat dehydration, restore circulation to the pancreas and aid healing, and to prevent shock.
Pain management is of the utmost importance. Pain medications are administered by injection in the hospital because vomiting dogs cannot hold down medications.
Anti-nausea and anti-vomiting medications (antiemetics) are also administered by injection. Once vomiting has stopped, small amounts of low-fat food will by started by mouth.
Panoquell-CA1 (fuzapladib) is an intravenous medication conditionally approved by the FDA for treatment of acute pancreatitis in the veterinary hospital. This drug prevents damaging white blood cells from entering the pancreas where they exacerbate the damage to the inflamed organ. This is exciting news, as anything that helps prevent worsening pancreatitis in dogs is paramount to a successful outcome with this serious illness.
Dogs who recover from severe, acute pancreatitis may suffer from diabetes in the aftermath, depending on how severe the damage to the pancreas was (remember, the pancreas produces insulin).
Once the pancreatitis is under control, your veterinarian may discuss low-fat dietary changes with you to for long-term maintenance.
