Last September, I experienced the death of a dear uncle. George had advanced pancreatic cancer that had spread to his liver and lymph nodes, and his doctors advised against treatment, which they said, would only make him suffer more. Georges partner, and one of my sisters and I arranged to bring George home for hospice care.
Georges healthcare directive clearly stipulated that, if he were ever unable to make medical decisions for himself and had no hope of recovery, he wanted to die without any life-prolonging measures not even fluids or intravenous feeding. Medication to keep him out of pain was the only thing he wished.
We brought George home on a Friday, and hired a live-in nursing assistant to help us care for him. Since it was a holiday weekend, we were put on a waiting list for an intake from a local hospice; anxious, we had to wait several days for the hospice workers to come to the house to help us do everything we could for George. We were able to talk to the on-call hospice nurse over the weekend, and she provided lots of support and practical advice over the phone, but wouldnt be able to come to Georges home until Tuesday.
As we made George as comfortable as we could, I couldnt help thinking about the deaths I had experienced firsthand. All were with animals; I was never present with a person who was near death. And all the deaths I attended of a number of dogs and cats, a horse, and a dairy cow whom I had hand-milked for several years were hastened by euthanasia medications. Never had I been present for a natural death; in each instance, I had opted to preemptively end the suffering of my animals.
As I watched George advance through the stages of dying, I found myself wondering: Is this kind? Is this humane? And I concluded that, yes, it was the kindest thing we could do for him. If he had been a dog, I almost surely would have arranged for a vet to come to my home to put him to sleep, to end his suffering. But thanks to pain medication, George did not suffer. He was home, with his partner at his side and his 20-year-old cat on her bed by his bedside. Those of us who loved George surely suffered, watching him fade from this world, but I know he did not.
On Saturday, George stopped taking the small bites of food he had accepted earlier in the week, and took only enough water to wet his mouth. By Sunday morning, he stopped speaking, though he was still responsive to us. On Monday he ceased to respond, and he passed away quietly that evening.
I used to think it is cruel that euthanasia is not available to people who are dying, the way it is for our animals companions. I used to think that a hastened end to my dying animals lives was the most humane gift I could give them. Im unsure about this now. What if the dying take an important spiritual journey as they pass from this life? And should our discomfort with death provoke us to speed it along?
Hospice How-To (this month’s issue) will help anyone who is considering providing hospice care for an aged animal companion, or one with a terminal illness.
Despite what many makers of conventional canned or dry pet foods would have you believe, raw diets for dogs are not a modern fad, but a return to the dog’s not-so-distant past. While many who advocate “biologically appropriate raw foods” (so-called BARF diets) for dogs point to the canine’s evolutionary diet as justification for this feeding paradigm, the fact is that dogs were thriving on bones and raw meats (and other table scraps) just a hundred years ago – not so long as to imagine that they have since “evolved” out of easily digesting these foods! Kibble and canned, if anything, constitute the modern feeding “fad.”
Most of our grandparents knew how to do a lot of things that most of us don’t know how to do anymore, like canning fresh foods or cleaning a fish. In the name of convenience, we’ve allowed industry to remove us from the process, and we’ve thus lost a lot of common-sense knowledge about the end product. Our grandparents’ generation knew how to feed the family dog – as well as the Best of Show winner at Westminster – on a home-prepared diet.
Fortunately, for today’s over-informed but under-smart dog owners (myself included!), there are companies that offer our dogs a source of food that has the convenience of a prepared diet, the nutritional benefits of a biologically suitable food, and confirmation of space-age laboratory testing that it contains all the nutrients a dog needs (as far as we know so far!).
Why raw? Why meat?
These diets all contain fresh meat – and here, we mean “meat” in its broadest sense; we’re talking about muscle meat, organ meat, bones, fat, connective tissues – all that prey animals have to offer carnivorous predators. Animal proteins offer the most complete array of amino acids required by canines, and the other tissues almost perfectly complete the dog’s nutritional requirements.
Lab tests confirm it: with a little added vegetable matter and some smart if minor supplementation, the best of these meat-based diets meet the nutrient profiles for “complete and balanced” canine diets established by the Association of American Feed Control Officials (AAFCO), just like most dry and canned foods do! Only, because they aren’t cooked, leaving the heat-sensitive nutrients in their fresh ingredients intact, many of these products do not require the addition of a vitamin/mineral supplement to accomplish this feat.
Don’t overlook the importance of raw bone in these formulas; the ones that don’t contain it must contain an adequate substitute source of calcium and other minerals. Many people who feed BARF diets use whole, raw meaty bones such as chicken wings and turkey necks as the major source of calcium in their dogs’ food. Most of these commercial raw diets include ground raw bones, to take advantage of their nutritional value without any of the hazards occasionally posed by bone consumption.
Practice safe steaks
One of the most frequently cited objections that veterinarians have to raw diets is the potential for bacterial contaminants present in the meat to infect and kill your dog, all his canine friends, and indeed, your hapless children and your elderly mother, too.
Well, it’s true: meat infected with E. coli., Salmonella, Campylobacter, and Listeria sickens thousands of people every year. Does this mean that no one should eat meat? Perhaps! Or maybe it means that you should act as if all meat in your home is infected, and handle it accordingly: Employ scrupulous meat-handling and sanitation practices, and leave the consumption of raw meat to your healthy dog, who is naturally and exquisitely well-designed to deal with ingested bacteria.
Handling raw meat in a safe manner is not rocket science. All of the normal precautions of handling the meat eaten by you and your family apply, including:
• People with immune system disorders should avoid handling raw meat. For that matter, raw foods are not suited for immune-compromised dogs, either.
• Keep food frozen until you are ready to feed it. Then, thaw small amounts (only what your dog will eat within a day or two) in the refrigerator. Never, ever allow food to sit for long at room temperature – duh!
If you need to thaw food in a hurry, seal it in a Ziploc bag and place it in warm water for not more than a few minutes.
• Wash your hands with hot water and soap immediately after preparing the dog’s food.
• Promptly wash everything that comes in contact with the food with hot, soapy water: bowls, knives, grinders, countertops and cutting boards. Periodically, use a disinfectant, such as a mild bleach solution. (My chef sister scrubs and soaks her cutting boards with sea salt and lemon juice.)
• Discard any food your dog leaves in his bowl after eating. Don’t allow him to “leave it for later.” Don’t even save it for later in the refrigerator!
• Don’t forget to wash the dog’s water bowl in hot, soapy water daily, as well. Many dogs drink right after eating, and could conceivably contaminate their water with bacteria in their mouths after eating.
Chill out
Ideally, you’ll be able to buy one of these frozen diets from a retailer near you, enabling you to whisk the food home to your freezer. Somewhat less ideal is receiving the product via overnight or two-day delivery, packed in dry ice and/or a cooler.
But anyone who has ever had a birthday present or Amazon.com order arrive late knows that stuff happens. Planes are grounded, storms close highways, etc.
Before you order any product, we suggest that you question the maker closely as to the company policy on shipping mishaps. Who will pay for meat that arrives at room temperature? Because you don’t want your dog to eat it!
Most of the companies ship on a certain day of the week – only on Mondays or Tuesdays, for example – and give you ample notice as to the expected time and date of delivery. Then it’s up to you to be waiting at the door for the delivery truck, so that costly package doesn’t linger on a hot porch.
A few good foods
On the following pages are a number of companies that make and sell raw canine diets (many make cat food, too). The type and quality of their products vary – that is, they vary within the upper- to top-echelon of raw pet food makers!
Some of the products contain grain; most do not. Some of them are “complete and balanced” – a real boon to people who have little experience with home-prepared foods or little support from their veterinarians; other products are meant to provide the foundation of a diet that you design and balance – a job best left to those with superior information resources and professional support.
(Speaking of which: We very much appreciate the companies who provide an overabundance of information about raw feeding in general and their products in particular. For example, every food maker – makers of dry and canned foods included – should be able to provide dog owners with a complete nutritional analysis of their products. And makers of frozen foods must include clear directions for thawing and safe handling.)
None of the companies on this list make food we wouldn’t recommend. But it’s a fact that they, just like dry or canned food makers, use meats of varying quality. Most claim to use USDA inspected and -passed (or “human-quality”) meats. A few claim to use only totally organic ingredients, or sources of meat that were grass-fed, or free of antibiotics and/or growth-hormones. We suggest looking for the best-quality ingredients you can afford.
As always, each dog warrants an individualized diet. Experienced raw feeders will be able to look at the descriptions of the products below and know instantly which foods might be of use to them in building their dogs’ diets. Those who are new to this method of feeding should, ideally, discuss the idea and plan an appropriate diet with their holistic veterinarian or a professional veterinary nutritional consultant who has experience with raw diets. Ask the food makers for their suggestions, too; they have a wealth of experience and a vested interest in helping to demonstrate the benefits, not the pitfalls, of this method of feeding healthy dogs.
Finally, please note that we have not ranked the products in any way; they are presented in alphabetical order.
– Take time to observe both your dog and other dogs. Start noticing in greater detail the body language signals they use to communicate with you, other dogs, and other humans.
– Watch videos and DVDs on dog body language – nice because you can back up and watch a segment repeatedly to fully analyze the behavior – and then look for similar behaviors in the dogs you observe.
– Look especially for appeasement and deference behaviors and train yourself to respond appropriately when they are offered.
Katie, our cranky, creaky, geriatric Australian Kelpie, is grumpy with just about every other member of the canine species. I was at least a little concerned when we brought home our most recent family member, Bonnie, a Scottie/Corgi/Whatever-mix.
At age five months, Bonnie came with a personality that was one of the softest and sweetest I’ve seen in ages. In fact, I suspect she was surrendered to the shelter by her owner of just one week in large part due to the fact that she urinated submissively the instant anyone spoke to or touched her. I worried that Katie’s gruff admonitions would be too much for her sensitive nature.
Quite to the contrary, Bonnie’s willingness to defer to Katie with obviously submissive body language at every turn has averted any potential conflict. In fact, Bonnie gets along with Katie – and the rest of our pack – better than any of our other dogs simply because she’s so appeasing. I was surprised and immensely delighted when I looked out my office window one day last week to see Bonnie and Katie playing, no, romping together in the backyard!
Reading Dogs’ Signals
Paradigm shifts in the dog-training world in the last decade have led dog owners and trainers to pay closer attention to the observation, interpretation, and understanding of canine body language. Norwegian dog trainer Turid Rugaas identified more than 30 body gestures that dogs make in social settings – whether with members of their own species or with humans – that, she postulated, demonstrated an intent to get along with other “pack members.” Rugaas coined the term “calming signals” to collectively describe these gestures and their purpose, and the term has found acceptance and everyday use as dog owners and trainers discuss dog behavior. Clumped behind that deceptively simple phrase, however, is a complex constellation of behaviors that accomplish many more purposes than just “calming.”
Rugaas has asserted that dogs purposely use “calming signals” to calm the other being with whom the dog is interacting. The suggestion is that the behaviors brought under this broad umbrella are deliberate.
Today, many ethologists (people who study animal behavior) speculate that the communications now popularly identified as calming signals are often hardwired, automatic responses rather than deliberate ones, and are far more complicated than a simple attempt to calm a dog’s social partners. They likely have more to do with the presenter’s own state of mind and/or an end goal to affect the behavior of the other dog or human for the purpose of self-preservation – rather than a deliberate intent to change the state of mind of the other being.
Communicative behaviors are adaptive in nature, helping canids maintain peaceful pack relationships without resorting to violence. Ethologists suggest that nonthreatening canine behaviors are more important in keeping the peace in packs than dominance behaviors – that relations are primarily maintained by deference behaviors exhibited by subordinates toward high-ranking members, not dominance displays by the alpha member. Canine social groups may more appropriately be described as deference hierarchies rather than dominance hierarchies.
As such, the dozens of behaviors that have been dubbed calming signals might more appropriately be separated into several subgroups called appeasement (active submission), deference (passive submission), displacement, stress signs, and threat (dominance) displays.
By observing dogs, learning to recognize and respond to the various behaviors in this constellation, your relationships with canines will become richer, and your translations of dogspeak more accurate. Let’s start by taking a closer look at the submissive/subordinate behaviors. We’ll examine other classes of behaviors in future articles.
Understanding Appeasement in Dogs
As stated above, subordinate behaviors can be grouped into two general categories: active submission (appeasement), characterized by increased activity and diminished posture, and passive submission (deference), denoted by decreased activity and lowered body posture. The difference lies in whether the dog offering the submissive behavior desires attention from the higher-ranking individual, or would prefer that the attention he’s receiving go away.
Active submission may also be identified as attention-seeking behavior: nuzzling, licking (including licking ears and lips), jumping up, paw lifts and pawing motions, “smiling,” teeth clacking, crouching, pretzeling, and play-bows. The dog’s ears may be pulled back, and his tail may be wagging expressively, with wide, sweeping movements or circles. These behaviors can often be seen during greetings between dog and owner, or between friendly, compatible dogs.
Passive submission usually involves a dramatic reduction in activity with a goal of diverting attention, and is most often seen in a lower-ranking dog when threats are directed toward him by a higher-ranking member of the social group (dog or human). The dog’s ears may be pressed flat against the head, with his tail tucked between legs. The subordinate dog often freezes, averting eye contact, lowering his head and body, sometimes to the point of going “belly-up” on the ground. Passive submission may also be accompanied by submissive urination.
Below are descriptions of several common submissive behaviors, and suggestions for appropriate responses when the behavior is directed toward humans. When directed toward dogs, submissive behaviors usually elicit appropriate responses from the other canine. In the future, I’ll describe one instance in which submissive behaviors don’t elicit appropriate responses from the other dog: when the other dog responds with increased intimidation – a classic “playground bully.” Dogs who respond to an overt display of submission with increased aggression are not displaying normal canine behavior, and may need special management to prevent them from traumatizing their social partners.
Active submission (appeasement)
Some of the gestures exhibited by a dog who is demonstrating active submission can be obnoxious to us humans. The important thing to recognize is that, with these behaviors, the dog is communicating his recognition that you are his leader, a higher-ranked individual. Be a good leader and let him know how he can best appease you by redirecting his behavior into something less bothersome.
• Nuzzling – Dog pushes muzzle against you, perhaps under your arm or hand. If you respond by giving the dog attention (petting, making eye contact, speaking to him) you are positively reinforcing the behavior and it will continue or increase. This is fine if you like the behavior – and some people do. It can, however, become annoying if the dog is very persistent.
You may prefer to extinguish the behavior using “negative punishment.” When the dog nuzzles you, turn away or even walk away. The dog is seeking attention. If nuzzling consistently evokes the opposite of the intended response – attention goes away – the behavior will stop. Of course, you must educate all family members and visitors to respond to nuzzling in the same way, or the behavior will be randomly reinforced and will persist.
Another option is to put the behavior on cue, and teach the dog that nudging only works to elicit attention when you ask for it. You can also preempt the nuzzle by consistently asking the dog for an incompatible behavior that gains him the attention he seeks. A “sit” or “down” can serve as incompatible and polite attention-seeking behaviors if you consistently give your dog attention for those.
• Licking – Dog licks body parts and clothes, including lip-licking, ear-licking, and nose-licking. Again, if you like this behavior, you can encourage it with positive reinforcement – giving your dog the attention he seeks when he licks.
If you don’t enjoy your dog’s licking, use negative punishment (licking makes you go away) and install an incompatible behavior in its place. Having your dog hold a toy in mouth when he approaches people is a great attention-eliciting behavior that’s incompatible with licking.
• Jumping up – Dog puts paws on human body, often projecting body against human with some force. A lot of small-dog owners don’t seem to object to jumping up as an attention-getter, and a lot of small dogs are incorrigible jump-uppers as a result. Not all people with small dogs like this, however, and most people who live with medium-to-large dogs much prefer four-on-the-floor.
Jumping as an attention-getting behavior is positively reinforced by attention, even behavior that dog owners may offer to try to reduce jumping up, such as pushing the dog away, or telling him to get down. Once again, removing yourself from contact with the dog – taking the attention away – will reduce the behavior, especially if you replace it by reinforcing an incompatible behavior such as sit or down. See the pattern yet?
• Paw lifts and pawing motions – Dog lifts paw or paws at human. While uncontrolled pawing behavior can be annoying, a simple paw lift is a lovely behavior to put on cue and turn into a series of fun and useful behaviors. A paw lift on cue can become “shake,” “wave,” “high five,” and “salute,” and pawing motions can be useful for turning appliances on and off, indicating found objects for dogs doing scent and search work, pushing a ball (canine soccer!), and playing an electronic keyboard. Persistent, annoying pawing is best extinguished by ignoring the behavior and putting an incompatible behavior on cue, such as four-on-the- floor, or a gentle paw lift.
• Teeth clacking – Dog’s teeth click or chatter. This is an innocuous behavior, and one that you can simply ignore – unless you’re an avid trainer and want to encourage it by clicking and treating when the dog offers it, then putting it on cue.
• Crouching – Dog lowers his body closer to the ground. This is also an innocuous attention-seeking behavior. If it bothers you, ignore it, and reinforce your dog when he approaches you standing taller. Training, using positive methods, will also increase your dog’s confidence and decrease incidents where he feels compelled to make himself smaller.
• Pretzeling – Dog corkscrews his body into a “C” shape. This is also a harmless, kind of cute behavior that I’d be tempted to reinforce and put on cue!
• Play bow – Dog lowers his forequarters while keeping his hindquarters elevated. This is a lovely behavior, and I can’t imagine someone wanting to extinguish it. I’d reinforce and put it on cue.
• Smiling – Dog lifts his lips into a grimace that is unaccompanied by other behaviors that would indicate at threat. I see no reason to try to make this behavior go away as long as humans around the dog understand that it’s not an aggressive behavior. I think it’s quite cute! I’d encourage it by clicking and treating when the dog offers a smile, and then put it on cue!
Passive submission (deference)
Deference behaviors are offered by the dog in response to a perceived threat – there doesn’t have to be any intent to threaten on the part of the person interacting with the dog. For all of the deference behaviors listed below, the appropriate response is to determine how/why the dog perceives a human or humans as threatening, and then work to change the dog’s perception through consistent positive associations with the perceived threat(s).
Human behaviors that can be perceived as threatening by a dog (thereby eliciting deference behaviors) include direct eye contact, a full-frontal approach, a loud voice, bending over the dog, and patting him on top of the head.
Punishing or “correcting” a dog for offering a deference behavior is the worst thing you can do if you hope to modify the behavior. He will only intensify his deference in a futile attempt to convince you he’s being subordinate. In a worst-case scenario, he may even become defensively aggressive if his deference signals aren’t working.
Instead, ignore the behaviors when they happen, and work to build your dog’s confidence in relationships by being consistently nonthreatening and insisting others do the same. You can also build confidence through positive training; when the dog has a better understanding of how to influence and predict his environment, his confidence will increase.
A dog’s deference behaviors may include any or all of the following:
• Tail tucked – Dog pulls his tail tightly against his belly to cover and protect his vulnerable underparts. Even dogs with “gay” tails or tails that curl over their backs can do this when sufficiently threatened.
• Freeze – Dog ceases all motion as he attempts to convey his submission to the party threatening him – usually in conjunction with averting eyes.
• Averting eye contact – Dog shifts eyes to avoid making eye contact, or actually turns head away.
• Lowering head and body – Dog ducks head and/or crouches closer to the ground.
• “Belly-up” – Dog rolls over on back and exposes vulnerable underparts. (Can also be a simple invitation for a tummy rub when not accompanied by other deference behaviors.)
• Submissive urination – Dog urinates in response to perceived threat (not necessarily an actual threat) in a person’s voice, touch or approach.
Major Misunderstandings Between Primates and Canines
Humans have long misunderstood their dogs’ submissive behaviors and reacted inappropriately as a result. In many human cultures, failure to make eye contact is a sign of someone who is untruthful, shifty, and sneaky. Similarly, dogs who display submissive behaviors such as averting eyes and lowering body posture (“slinking”) are often perceived as wimpy, cowardly, sneaky, manipulative, guilty, and disobedient – misinterpretations based on our familiarity with primate body language.
Unless wise to the ways of canid communication, humans tend to assume a dog offering lowered body-posture deference behaviors is expressing guilt, when in fact he’s only responding to a perceived threat in his human’s body language.
Sometimes the more the dog acts guilty, the more righteously angry his human gets, the more submissive (guiltier) the dog acts – a lose/lose cycle if there ever was one.
Submissive urination is another case in point. Owners who still employ the old-fashioned punishment dog-training paradigm may attempt to physically or verbally “correct” a pup for urinating submissively — the exact wrong thing to do.
A pup urinates submissively in response to a perceived threat, such as the assertive approach of a higher-ranking member of the social group. In the dog pack, this is a useful survival mechanism that effectively averts the wrath of most adult dogs, who could otherwise do serious harm to a young subordinate.
Unfortunately, when the higher-ranking member is a human, the behavior (urination) that should avert wrath often initiates or escalates anger in the human. The pup’s response is to urinate more – not less. The human gets angrier, the pup pees more, the human gets even angrier, the pup pees even more in a desperate attempt to turn off the anger – and another lose-lose cycle is born.
Even the submissive grin is misunderstood. Sadly, it can be mistaken for a snarl, and a dog who is actually anything but may be labeled as aggressive. It’s also often perceived as a doggy version of a happy smile — a less-damaging interpretation, but still a misinterpretation of a clearly subordinate display.
Interestingly, the submissive grin is believed to be an imitation of the human smile, since dogs don’t normally display this behavior to each other, only to humans.
While some behaviorists consider the grin to be an attention-seeking appeasement gesture, others consider it more of a threat-averting deference signal. In any case, it’s important to understand that the dog who grins is making a status statement (your rank is higher than his), and is exhibiting neither an aggressive threat nor a relaxed, contented smile.
More to Come
It’s been a joy to watch Bonnie develop over the past months. Training and a consistent lack of threats or intimidation in her relationship with us and the other humans in her life have increased her confidence. While she still offers appropriate appeasement and deference behaviors to Katie and the other canine members of our pack, her submissive urination with humans has ceased and her confidence and comfort with us has increased exponentially. It’s been weeks since a pat on the head resulted in a puddle on the floor!
In future articles, I’ll describe the other canine behaviors that have been (inaccurately, I think) called “calming signals” – what I would label as displacement, stress signs, and threat (dominance) displays.
Pat Miller, CBCC-KA, CPDT-KA, is WDJ’s Training Editor. Miller lives in Fairplay, Maryland, site of her Peaceable Paws training center.
Editor’s note: In last month’s article “Heartworm: Don’t Take It Lightly,” Mary Straus discussed the life cycle of the heartworm, and how it infects dogs. She also discussed heartworm prevention strategies. This month, she explains treatment for dogs who are already infected with heartworm.
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Whether or not you choose to use conventional heartworm preventatives, there is always the possibility that you may one day find yourself with a heartworm-positive dog, and be faced with the decision of how to treat her. Unfortunately, there is no one right answer when it comes to heartworm treatment. Decisions must be tailored to the individual dog, taking into account both the extent of the heartworm infestation, and the dog’s overall age, activity level, and health.
There are a number of reasons why someone may have a dog who is heartworm-positive. One of the most common is adopting a dog from a rescue organization. Especially in the South where heartworm is ubiquitous, most dogs that are not given heartworm preventative regularly will test positive for heartworm.
There is also a small chance that your dog could become infected with heartworms if you choose to extend the time between doses of the heartworm preventative you give your dog beyond what is recommended on the label, if you give less than the recommended dose, or if your dog should vomit up the pill without your knowledge. Your dog has a much higher risk of becoming infected with heartworms if you choose not to use preventatives or if you use alternative methods that have not been shown to be effective.
It is important to understand that heartworm infections are not detectable until about six months after a dog has been bitten by a heartworm-infected mosquito. (This is why it’s not possible to have a heartworm test performed monthly and give the preventative only if an infection is found.) Blood tests will not detect heartworms in a dog until the larvae have matured into adult worms, which takes about six months following initial infection. Symptoms, such as coughing, lethargy, and difficulty breathing, will not show up until the infection is advanced.
Judy Wilds, of Corpus Christi, Texas, adopted her dog, Taffy, in September 2004. Taffy tested negative for heartworms when adopted, and was started on a regular heartworm preventative schedule. Six months later, a routine heartworm test showed that Taffy was heartworm-positive. “Thankfully, a holistic vet had suggested that I have her rechecked six months after her first test, as it was possible (though unlikely) that she could have heartworms,” says Judy. In this case, Taffy was obviously infected when she was adopted, but had not had the infection long enough for it to be detectable.
It’s a good idea to run a heartworm test on an adopted dog with an unknown medical history immediately upon adoption and then again about six months later. The same would apply if there was a lapse in heartworm preventative dosing for more than two months during the heartworm “season.”
Staging the infection
A heartworm antigen test is the most commonly used procedure for detecting heartworm infection. These tests are extremely specific and have almost no false positives, but it is still a good idea to confirm any positive test results with a second test. There are a number of different heartworm antigen tests, so it is best to confirm using a different test than the one that gave the initial positive result.
If the dog has not been given heartworm preventative recently, then a test for circulating microfilariae can also be done, which will confirm the presence of adult, breeding heartworms in the body. However, a negative microfilariae test cannot be used to rule out heartworm infection for a number of reasons.
All heartworm preventatives kill the microfilariae that are in the dog’s blood, so any dog who has been given heartworm preventatives recently may be negative for microfilariae but could still have an infection. There are also cases of single-sex heartworm infection where no microfilariae are produced. A population of all male or all female worms cannot produce microfilariae. And, finally, in any dog with a very low heartworm burden – say, just a couple of worms – the microfilariae may not be detected (this can also cause a false negative on the antigen test).
Once heartworm infection has been confirmed, additional tests should be done to try to determine how extensive the infestation is. Radiographs can reveal inflammation and damage to the arteries and the heart, and blood tests will show whether the liver and kidneys have been affected.
Heartworm infection is divided into four or five stages (depending on the model used), based on the severity of the infestation and the age and health of the dog.
Stage 1 (mild) consists of young, healthy dogs with no symptoms and minimal changes evident on X-rays.
Moderate (stage 2) infection will show heartworm disease that is evident on X-rays, but symptoms are minimal, mostly coughing. Stage 3 is a severe infection, with weight loss, coughing, difficulty breathing, more damage visible on X-rays, along with liver and/or kidney damage.
Stages 4 and 5 are considered critical, with the dog often collapsing in shock. These dogs will not survive ordinary heartworm treatment, and must have the worms surgically removed if they are to have any hope of survival.
Heartworm treatments
There are three conventional methods of treating heartworm: a “fast kill” method using Immiticide (melarsomine); a “slow kill” method employing Heartgard (iver-mectin); and a surgical method in which the worms are surgically removed from the arteries. In addition, there are so-called holistic treatments such as Paratox homeopathic or herbal preparations.
In each case, and indeed even if no treatment is done, there is a risk of the dog dying from a pulmonary embolism caused by worm die-off. In addition, there is risk while the worms are present of damage to the heart, the arteries, and the rest of the body, due to inflammation and immune reaction.
When deciding which method to use, you need to take into account the age of your dog, his level of activity, and the severity of the infestation.
Immiticide (fast kill)
Standard treatment with Immiticide consists of giving two injections 24 hours apart, then keeping the dog strictly confined for the next four to six weeks. The injections must be given in a painful location – the muscle close to the dog’s spine in the lumbar (lower back) area. The worms start to die immediately. As their bodies begin to decompose, pieces are “shed” into the dog’s bloodstream and filtered out through the dog’s lungs. This can cause the dog to cough and gag, or lead to a fatal pulmonary embolism.
The dog must be kept confined and his physical exertion kept to an absolute minimum, in order to prevent pieces of the dead worms from being forced by a rapid heart rate and/or increased blood pressure into clogging the tiny blood vessels in his lungs, causing embolisms. This generally means that the dog must be kept crated or penned and allowed out to potty only on a leash. Aspirin may be prescribed to lower the risk of blood clots, though this is controversial. Remember that it’s dangerous to combine aspirin with any other nonsteroidal anti-inflammatory drug (NSAID) or with prednisone, and to give it only with food.
A safer approach, sometimes called a “split-dose,” “staged-kill,” or “three-dose” protocol, consists of giving one injection, waiting one month or more, then giving two more injections 24 hours apart. This has the benefit of reducing the worm burden by about 30 to 50 percent with the initial treatment, before the balance are killed by the second set of injections.
This protocol is more expensive, requiring three injections of the drug instead of two. Also, the dog must be kept strictly confined for a longer period of time. Nevertheless, this split-dose protocol over two months is recommended for dogs with heavy worm burdens or other health problems (Stage 3), and is also considered safer for dogs with a lower worm burden.
Judy Wilds treated Taffy (described above) using the fast kill method with Immiticide. Although it is recommended to keep treated dogs in a crate to limit their exertion, Taffy was unused to being confined, and her vet was concerned that crating her could be dangerous, as excess stress and barking could cause lung problems. Wilds used a small outdoor pen for Taffy, instead.
“Taffy handled the heartworm treatment quite well. One evening, however, she gave me quite a scare when she began gagging. Later, I realized that this was related to her heartworm treatment,” Wilds says.
Some coughing or gagging is considered normal in dogs being treated for heartworm infection. However, it is important to understand that, whatever method of heartworm treatment is used, any respiratory difficulty in dogs receiving therapy should be considered a life-threatening emergency.
If the coughing or gagging is very heavy, seems uncontrollable, or causes the dog distress, get her to a vet right away. Vomiting or any bloody discharge combined with lethargy, fever, and/or pale gums should also be considered an emergency, and the dog should be taken to the veterinary or emergency clinic immediately. Corticosteroids, fluids, and oxygen may be needed at this time to help the dog survive.
Immiticide (melarsomine) has a much lower risk of complications than its historical predecessor, another arsenic compound called Caparsolate (thiacetarsemide sodium). Unlike Caparsolate, Immiticide does not damage the liver and kidneys, and kills a higher percentage of worms, so that fewer treatments are needed.
However, the Immiticide injections will cause muscular pain and soreness for a few days. It’s critical that the injections be done in an exacting fashion in order to minimize this effect. This includes changing needles after filling the syringe before injecting, choosing the site with care, putting pressure on the site after injection, and alternating sites for future injections.
Corticosteroids (e.g., dexamethasone) can be given at the same time as the Immiticide injection to lessen the reaction. Combination painkiller and sedative drugs, such as xylazine, may also be used to reduce the pain of the injection. Pain medications, such as NSAIDs, are often prescribed for a few days.
Christie Keith, a Scottish Deerhound breeder from Northern California, had two dogs who were heartworm-positive. “Raven had some obvious clinical changes, and was showing some symptoms (coughing). Due to her hyperreactive immune system, I was concerned that the presence of the worms in her pulmonary arteries, with their known ability to stimulate autoimmune reactions, would further worsen her existing allergies. So I opted to do the conventional Immiticide heartworm treatment, with the thought that it would be best to get the worms out of her more quickly.”
Christie intended to treat Raven with the split-dose schedule, but a couple of weeks after the first dose, Raven, despite having been completely confined and kept from activity more strenuous than going out into a tiny potty yard on a leash, developed a series of pulmonary emboli (clots), and nearly died. “We rushed her to the ER and when we got there, my mom, who was with her in the back of the van, thought she had died. She was blue,” recalls Keith. Emergency treatment saved Raven’s life. Tests conducted after the first treatment revealed no trace of heartworms, so Raven didn’t have to undergo another round of treatment.
Heartgard (slow kill)
The “slow kill” method, which is a newer approach, consists of giving the dog Heartgard on a monthly basis. This heartworm preventative medication has some effect against the adult worms and should gradually eliminate them over a period of one to two years; without treatment, the worms can live up to five years. The earlier the treatment is started after infection, the more quickly it will work to eliminate the adult worms. Note that only Heartgard (ivermectin) should be used, as Revolution (selamectin) affects far fewer adult worms, and Interceptor (milbemycin oxime) almost none at all.
Although this method is gentler than the use of Immiticide, the danger from the dying worms is still present, and for a much longer period. A recent Italian study showed that pet dogs (as opposed to the caged laboratory dogs this method had been tested on before) did get pulmonary emboli and some of the dogs died of it. The more active the dog, the higher the risk.
In addition, damage is being done to the arteries leading to the heart, and possibly to other areas of the body due to inflammation and immune response as long as the adult worms are present in the body. Most vets recommend using the fast kill method to treat heartworms, unless the dog’s health will not permit it or the owners cannot afford it. In those cases, or in the case of a very mild infection, the slow kill method may be used instead.
Janice Adams adopted Pepper, a Border Collie/Chow-mix, in June 2000. A blood smear in the vet’s office at the time of adoption was positive for microfilariae. “Pepper didn’t seem to have any symptoms of heartworm disease, no coughing or shortness of breath, so, at the recommendation of my regular vet, I elected to start her on Heartgard monthly,” says Adams.
“Pepper is a very calm dog, and didn’t have any activity restrictions. I kept her on Heartgard monthly for about 18 months, then switched her to a low dose of Interceptor on a 45-day schedule. We live in Florida, so I give heartworm preventatives year-round. All subsequent heartworm tests have been negative. She didn’t seem to have any problems related to the heartworm disease or treatment.”
Christie Keith’s second heartworm-positive dog, Bran, had no radiographic changes and no allergies, so Keith opted not to do the Immiticide treatment on him. “I put Bran on Heartgard monthly. At the time, there was less research on the ‘slow kill’ method with Heartgard than there is today, but there was enough that I felt confident it would be effective. And it was; within a few months or a year, he tested heartworm-negative.”
Other heartworm treatments
Surgical methods of heartworm removal require specialized training and instrumentation, and are generally reserved for high-risk patients who would not otherwise be expected to survive. The surgery is followed by one of the standard treatments a few weeks later to kill any remaining worms.
So-called alternative methods to kill heartworms, such as Paratox, are no safer than conventional drugs, since they rely on the exact same action – they kill the larvae/worms in the bloodstream. It is the death of the worms that causes the greatest danger to dogs during treatment.
In addition, no studies have been done to show that alternative treatments are effective. If these treatments do have any effect, they would be comparable to the slow kill method, with the same drawback of continued damage to the body while the worms remain present.
Finally, some of the herbs used to treat heartworm are considered dangerous and may be toxic in the amounts used to try to kill the worms.
Additional information
Once the adult worms have been killed, there may still be circulating microfilariae in the bloodstream. Although these microfilariae will not develop into adult worms (they mature further only inside a mosquito), they can be a source of transmission of heartworm disease to other dogs, so it is best to treat the dog with heartworm preventative four to six weeks after heartworm treatment in order to kill them.
Normal monthly preventative doses of Interceptor (0.5 mg/kg) or high doses of Heartgard (50 mcg/kg, approximately eight times the preventative dose) will eliminate most microfilariae immediately. Normal monthly doses of Heartgard or Revolution will also work for this task, but more slowly, over a period of several months.
Because heartworm treatments can cause an allergic reaction due to the death of the worms and the microfilariae, veterinarians will usually give dogs Benadryl and/or cortico-steroids prior to each treatment. Monthly Heartgard (ivermectin), at preventative doses, should not be strong enough to cause this kind of reaction, although it’s a good idea to stay home the day you give it to your dog.
If Interceptor (milbemycin oxime) at normal doses, or Heartgard at high doses, is used to kill microfilariae following heartworm treatment, anaphylactic shock can occur, especially in dogs with high microfilariae counts. This treatment is best done at the veterinarian’s office under close observation for any adverse reaction.
The damage done
Although heartworm treatment can be dangerous, so are the heartworms themselves. Adult heartworms are large, growing up to 12 inches in length and living as long as five years. They can plug up the pulmonary arteries, and when the infestation becomes severe, they will start to back up into the heart and eventually fill it. They can cause blood clots, and force the heart to work abnormally hard to pump blood through the clogged arteries. In addition, heartworms cause an extreme inflammatory response in the arteries that can affect other parts of the body, especially the kidneys and liver.
Treatment for heartworm infection is one area where conventional veterinary medicine offers valuable options. Whether you elect to do the fast-kill method using Immiticide, or the slow-kill method using monthly Heartgard, either is preferable to leaving the dog untreated, or using unproven, alternative methods that may have no effect or even be harmful.
This is also a situation where steroids and antibiotics can be lifesavers, when used judiciously during treatment.
The decision of how to treat a heartworm-infected dog is not an easy one, and is best made after consulting with your veterinarian regarding the safest method to use for your dog.
-Mary Straus does research on canine health and nutrition topics as an avocation. She is the owner of the DogAware.com Web site. She lives in the San Francisco Bay Area with her dog Piglet.
1. Until you begin training your dog to be more confident with strangers, protect her from becoming more frightened than she already is by managing her interactions with people. Keep them positive or keep them away!
2. Make a list of all the people, or types of people, who your dog is shy with. This will help you organize a desensitization and counter-conditioning program.
Mickey is a dog who hides under the bed every time someone enters his house. Chula barks and slinks behind her person if a child approaches. When Josie is approached by men, she involuntarily urinates.
What do these dogs have in common? They are afraid of certain people: strangers, children, and men.
Dogs who are afraid of people are often described as shy, nervous, or cautious. Shy or fearful behavior is easy to recognize in dogs who move away, hide, or tremble when a stranger approaches.
But fear can show itself in a variety of other behaviors, too. Responses to fear include one or all of what trainers call the 4 Fs: Freeze, fight, flight, and fool around. Behaviors that may indicate uncertainty or fear include jumping up or seeking attention, urinating, panting, drooling, excessive shedding, and refusing to make eye contact. Growling, barking, and other aggressive actions can also be triggered by fear.
Why are Some Dogs Scared or Shy?
Shy dogs come in every size, shape, breed, or mix. Why are some dogs shy or afraid of people?
Popular sentiment holds that dogs who exhibit fear toward people must have suffered abuse or something very scary must have happened to them. While this may be true in some instances, the combination of genetic predisposition and a lack of social experiences in early puppyhood probably play a much larger role.
Most of us who have lived with shy dogs never know the exact root cause. Fortunately, you don’t have to know why a dog is afraid to help him or her overcome those fears.
People are Scary to Unsocialized Dogs
The first step to helping a dog overcome shyness is to identify exactly who your dog is shy around. Sometimes it seems as if a dog who is shy or afraid is randomly afraid. But thinking through and identifying exactly who he is afraid of and in what circumstances can be tremendously useful. It may be helpful to make a list of all of the people that your dog is afraid of. The list will be different for every shy dog.
For one dog I know, the list would include all strangers outside of the home. For another dog, it is only children younger than five. For yet another, it is only short, round women. The more specific you can be about what scares your dog, the better.
Once you know who or what scares your dog, you can take steps to minimize his fear response until he can become more comfortable. Environmental management is your best friend in the early stages of helping a shy dog.
Managing a Nervous Dog
Management, simply put, is avoiding the problem or thing that triggers the problem (scary people, in this case) by controlling the dog’s surroundings. Management alone won’t solve fears, but it can help prevent your dog’s fear response – such as cowering, submissive urination, barking, or growling – until he can become more comfortable around those people who scare him.
Management can help lower the stress for you and your dog, and help create an atmosphere favorable for training and behavior modification. In some cases, management is essential for safety. (Note: If your dog has bitten anyone – even in fear – consult with a behavior specialist such as a certified applied animal behaviorist, a board-certified veterinary behaviorist, or a certified dog behavior consultant.)
Each dog will require slightly different management strategies depending on who she is afraid of. For example, if you have a dog who is afraid of strangers, you might employ these management strategies:
• Avoid crowded areas where your dog may be overwhelmed by strangers.
• Use a leash, crate, or baby gate to prevent your dog from interacting with strangers in your home.
Think about ways you can protect your dog if you are caught off guard, too:
• If a stranger approaches and asks to pet your dog, you can say, “No, I’m sorry, but my dog is uncomfortable with people she doesn’t know.”
• Put yourself between the person and your dog.
• Create distance by crossing the street or going a different direction.
Once you have management in place and your dog’s overall stress levels go down, get ready to train, desensitize, and counter-condition!
Train Your Dog for Confidence
Basic training is fun and builds your dog’s confidence. Teaching a dog a few simple behaviors such as sit, down, and stay can lay a good foundation for your dog to look to you for direction when he or she is uncertain. In addition, advanced level training such as rally obedience, musical freestyle, or agility can really boost a shy dog’s overall confidence.
While all positive training will help settle a fearful dog, these three specific training exercises can really pump up a scared dog’s confidence:
• Ask politely for everything. Have your dog sit or down before you pet him, give treats, feed, play ball, open doors, etc. This builds structure, which appears to be stress-relieving for dogs, and it teaches your dog to look to you for guidance and for the good things in life.
• Rewards happen. Reward all positive behaviors around people. For example, if you are out in public and your dog sits in the presence of strangers, “mark” the behavior with a click! of a clicker or a word such as “Yes!” and give him a reward. If your dog politely approaches a friendly child, mark the behavior (click! or Yes!) and give your dog a reward. Give your dog rewards for these behaviors even if you did not ask for them! If you reward offered, appropriate behaviors, your dog may start to use them as a coping mechanism, which may help him reduce his own stress level.
• Train a default behavior. A default behavior (a behavior your dog offers when he doesn’t know what else to do) can be a great tool for an anxious dog. An excellent default behavior for fearful dogs is “Watch me,” meaning, “Look at my face and eyes.” This helps your shy dog orient toward you, as well as helps him disengage from people who are frightening to him.
In addition, you can transform the presence of “scary” people into the cue or command for the behavior. Once a dog knows the “watch me” behavior well, begin practicing around strangers or other people who frighten your dog. Work at enough of a distance that your dog is not worried about the people being too close (see desensitizing section, below).
Every time a scary person appears, ask for the behavior and reward your dog generously. When the dog sees the scary person and does the behavior in anticipation of your asking, jackpot by rapid-fire feeding your dog 10 or more wonderful treats while you give him tons of verbal praise.
Shifting a Dog’s Perceptions of New Things
While training specific behaviors can help build confidence and teach your dog how to behave appropriately around the people who may frighten him, desensitization and counter-conditioning can be key to helping a shy dog overcome those fears.
If you have ever dealt with a fear – say, a fear of heights or a fear of spiders – you know that you cannot reason that fear away. You can’t just say, “Well, it is silly to be afraid of spiders, so I won’t be scared anymore.” You probably also know that any exposure to spiders may make your palms sweat and your heart pump faster. You absolutely cannot control your body’s reaction. When a dog is afraid, he likely experiences something similar – an emotional and physical reaction.
Desensitization and counter-conditioning are great ways to help a dog overcome the frightened emotional and physical response to people.
Desensitization is exposure to a fear-evoking stimulus (strangers, for example) at a sub-threshold level (far enough away that the dog notices them, but is not upset). Counter-conditioning is presenting a pleasant stimulus (such as roast beef) in the presence of a scary stimulus (such as a stranger). The goal is to use the pleasant stimulus to change the dog’s emotional and physiological response to the stranger from fearful to happy and relaxed.
Put Your Training Into Action
Here’s how desensitization and counter-conditioning might look for a dog who is afraid of strangers:
• Identify what scares your dog – the more specific the better!
• Pick something special to use for a conditioning treat. This is the time to use the best and most wonderful thing your dog can imagine! For many dogs, meat is the best choice: roast beef, hot dogs, chicken breast. For some dogs, a high-value play object or game can be a great option. (I know a dog who quickly got over his fear of children when the neighborhood kids began playing ball with him.) Make sure that your dog is motivated; if you are using food for the reward, the dog needs to be hungry!
• Figure out the dog’s threshold. Consider how close the person is, how many people are present, and what they are doing. Let’s say that the dog is comfortable with one or two people at a distance of 30 feet.
• Ask your designated stranger to come into the environment at 30 feet away. Each time the person appears – and your dog notices – start feeding the special treats in a rapid-fire fashion. Spill the food out as fast as your dog can gobble it up.
• When the person leaves the environment, stop feeding the special treats.
• Repeat this exercise until your dog is thrilled – and looking to you for the special treats – each time the stranger appears.
• When your dog is comfortable with the stranger appearing at 30 feet, have him come a little closer, say 28 feet away.
• Repeat this (over several sessions on different days) with the person very gradually moving closer, for as long as it takes for your dog to be comfortable. For dogs with mild fears, it may only take a few sessions before a stranger can walk up and your dog is happy to see them. For dogs with more severe fears, it may take months and lots of repetitions with different people.
Be patient! Effective desensitization and counter-conditioning work is about as exciting as watching paint dry (unless you are a dog trainer and get excited about these things!) Remember that the goal is to work sub-threshold. It is slow and tedious, but the payoff is worth the effort.
Use Real World Opportunies
In an ideal world, counter-conditioning would always happen in conjunction with desensitization (i.e., exposing the dog to the scary people at a sub-threshold level, when he is relaxed and comfortable). In the real world, however, it may not be possible to keep your dog from seeing strangers or other people who scare him while you are working with him to overcome fears. That’s okay. Keep up the counter-conditioning (feeding the treats) every time you see a scary person, even if the scary person is too close and your dog becomes worried.
In fact, for dogs with milder shy or fearful behaviors, you may be able to simply incorporate your counter-conditioning into your daily life. When you take a walk and see a stranger, start feeding treats. When a friendly stranger comes to your home, feed your dog treats in the presence of that person. If your dog is comfortable enough, he or she can even be fed treats by the “scary” person.
If you are asking others to help your shy dog by feeding treats, help keep it safe by offering your helper specific instructions on what to do.
• Ask your helper to wait for the dog to approach; not to approach the dog.
• If possible, have your helper stand or sit to the side of the dog. Ask him or her not to lean over the dog or make eye contact.
• Have your helper hold out a treat on a flat palm and let the dog come and take it from his or her hand. If the dog is too scared to approach, the helper can gently toss treats onto the ground.
• Caution! A fearful dog may temporarily overcome his fears in the tempting presence of a high value treat, then bite the scary person when the treat is no longer there. Don’t have strangers/helpers feed treats until you are sure your dog has been desensitized adequately – that he no longer appears fearful when approaching or being approached by strangers.
Praise your dog when he or she shows confidence and comfortably interacts with the person.
Let Your Dog Set the Pace
One of the most important things you can do for your shy dog is to respect his fears and let him set the pace for getting used to new or scary people. Protect him from making behavior mistakes by providing good management. Teach him basic behaviors so that he or she will know what to do in new situations. Lavish him with large doses of great things in the presence of scary people to help him overcome his fears.
I’ve seen shy dogs with mild fears become more confident in a few short weeks. But I’ve also seen dogs take up to two years before they were comfortable. Whatever amount of time it takes, the time and investment will be worth it – both for you and especially for your dog! Helping a shy dog build confidence and overcome fears is not only one of the greatest gifts you can give your dog, it is a very rewarding experience for the human side of the team, too!
Will Medications Help My Scared Dog?
We live in a Prozac-happy time. Drug interventions to help people and dogs deal with behavior issues are common.
In some cases, especially with dogs who have pronounced fears, medications such as fluoxetine (Prozac) can have very positive and dramatic results. However, medication is not a magic bullet; it generally will not solve behavior problems without also employing behavior modification. And, medications should never be considered lightly; they can have serious side effects.
If you choose to consult with a veterinarian about medication, find one who is well-versed in the nuances of psychopharmacology. The various drug interventions can have subtle and dramatic differences, so you want to consult with someone who understands them well. Ideally, consult with a board-certified veterinary specialist in behavior.
Questions to ask a veterinary behavior specialist when considering medication:
– Should we consider medication? Why or why not?
– What medication is best for my dog’s particular behavior issue? Why is it the best choice?
– What are the possible physical side effects? What are the possible behavioral side effects? What should we know about using this medication safely?
– How long will it take to begin working? How will we know if it is working? How long until we see full effects?
– What behavior modification protocol should be followed in conjunction with the medication?
“Life is pleasant. Death is peaceful,” mused author Isaac Asimov. “It’s the transition that’s troublesome.”
Our culture’s ambivalence about death is no secret and no surprise. Leaving this mortal coil can be messy and exhausting, both physically and emotionally. So with our companion animals, we oftentimes beat death to the punch, scheduling it on our own terms by taking that teary-eyed ride to the vet’s office and saying a final goodbye on a tiled floor or steel table.
Susan Marino of Fort Salonga, New York, has devoted her life to helping companion animals go gently – and naturally – into that good night. A former intensive-care pediatrics nurse and a licensed vet tech, the 54-year-old is the founder of Angel’s Gate, the country’s first and only residential hospice for animals. More than 100 dying and disabled animals call Marino’s suburban Long Island ranch house home, from Rottweilers to Rat Terriers, calicos to cockatoos. And all but a handful have died there without euthanasia, in a home rather than a hospital setting.
“People think they may want to do hospice, but it’s not something that most people know anything about,” says Marino, who, with this writer, is the author of Getting Lucky: How One Special Dog Found Love and a Second Chance at Angel’s Gate (Stewart, Tabori & Chang, 2005). The same often applies to veterinary professionals: “Vets learned in school that when animals get sick with no hope of getting better, you don’t want them to suffer, so you euthanize them,” she says. “Many of them have never seen an animal die a natural death.”
Recognizing this emotional dissonance with the animals many of us love as family members, the American Veterinary Medical Association released its Guidelines for Veterinary Hospice Care in 2001. Less than a page and a half long, the 11-point document underscores that the hospice experience helps “the respectful closure of each unique human-animal bond” and stresses that “patients should be kept as free from pain as possible and in a sanitary state,” but does not offer many specifics.
And that is precisely the problem. Almost every day, Marino says, she fields a desperate phone call from someone who wants a terminally ill animal to die at home, but cannot find anyone to explain how.
Support at a difficult time
Jeffrey Krauss, 48, of Manhattan, is a case in point. In 2004, his 17-year-old cat, Babe, was diagnosed with kidney failure. When he told the vet he wanted to take her home to die, “I was scolded for being cruel.”
Krauss found the Angel’s Gate Web site and contacted Marino, who explained how to administer subcutaneous injections to keep Babe hydrated and comfortable. “She died a few days after we brought her home, which is what I was told would happen,” Krauss says. “But she didn’t die alone. I grieved, but was very comfortable with that decision.”
Last summer, when Krauss’s 8½-year-old black Lab, Mango, was diagnosed with kidney disease, he called Marino again. Mango needed to be hydrated with fluids. As problems arose – why was Mango shaking so much? – Marino gave suggestions: Mango can’t regulate her body temperature well, so make sure the IV fluid is warmed, and place heated towels around her.
Mango lived for five months after her diagnosis. She had bad days and good days, including “two miraculous ones that were real rare gifts,” Krauss remembers.
Self-analysis
It’s memories like those that are the whole point of hospice, Marino says. “Doing hospice allows me to intentionally spend good, quality time with the animals I care about, to say goodbye in a gentle, loving way,” she says. “I get to write the final chapter in that animal’s life.”
But just as all writers have different tones, choose different words, and focus on different angles, so too will all those final stories vary. Some caretakers will see their animal to the end; others will choose a point beyond which they will not venture. Still others may decide to end the chapter before it even begins.
“There is no right or wrong. Hospice is a decision that needs to come from your heart,” says Marino. “It’s a matter of choices, and it’s important to remember that we have them.”
To that end, here are some questions to consider in making the commitment to provide hospice care for a companion animal:
• Will my vet support my decision?
Though it seems counterintuitive, this is a question you need to ask while your dog is still healthy.
If you wait until a terminal diagnosis before broaching it, “the conversation is going to be clouded and very difficult,” Marino says. “Like anything else, the outcome will be much better if you’re prepared ahead of time.”
Ask some questions about the vet’s policy on euthanasia. Is she willing to work with someone who wants to care for a dying dog at home? Are there any circumstances under which she would not be supportive of doing hospice?
Once you have the conversation, keep reinforcing it, suggests Marino. “Every time you have your dog in for a wellness exam, reiterate it to make sure he hasn’t changed his mind. It’s very easy for a vet to say yes when there’s nothing going on. But that way, he also gets to know you and gets to know what your heart is all about.”
As in any partnership, trust between you and your veterinarian is essential. Consider pain relief. Veterinarians can prescribe controlled substances such as Butrophenol and Valium to keep a dog comfortable, but many are reluctant to send those drugs home with a dog because of concern that the drugs may be misused. “Your vet has to know when he or she hands over that narcotic that you’re going to use it properly,” Marino says.
If you are truly committed to providing hospice, then you need your veterinarian to embody the literal meaning of the word “doctor,” which comes from the Latin verb docere, meaning “to teach.”
“A doctor’s responsibility is to educate you so you can make informed choices, not to make choices for you,” Marino says. “A lot of times, people don’t want that responsibility. They want their vet to say, ‘It’s time to give up.’
“You need to decide what person you are,” she continues. “Do you want to be in charge, do you want the vet to be in charge, or do you want a mix of what’s in the middle?” Once you are clear on your own comfort level, then you can find the veterinarian who will best help you reach it.
• What illness am I dealing with, and do I understand the course it will take?
“You need to really research what’s going on with the animal, and understand what the disease process is,” says Marino. “You need to ask your vet what the end is going to be like. Are there going to be seizures? Will the animal have difficulty breathing?”
With some disorders, such as kidney disease, dogs can have relatively good quality of life until the very end. “If you’re consistent with giving fluids, that hydration is a sort of mini-dialysis for the kidneys,” she explains. Often, as the end nears, dogs follow a similar trajectory: They refuse food for a few days, then around the fourth day refuse water, and pass soon after.
“On that third day, often they perk up and eat,” Marino says of the pattern she’s observed. “They seem brighter, and you might think things are going to get better. But soon after, they’re gone.”
Other diseases are more complicated. With degenerative myelopathy, an immune-mediated paralysis that begins in the rear and moves progressively forward, a dog can live for a year or longer, depending on diet and stress levels. But ultimately, as the disease advances, the diaphragm will be affected, making breathing difficult and opening the door to pneumonia and other respiratory problems.
Because it is so hard on an animal, compromised breathing is often a sign that hospice should be ended and euthanasia considered. Denise Juliano of Lake Grove, New York, eventually euthanized her Collie, Winston, when his breathing became labored from lung cancer. But six months earlier, when her veterinarian gave her the bad news and suggested euthanasia, she looked at her still-active dog and decided to keep him comfortable for as long as she could.
“I don’t regret those extra months with Winston,” Juliano adds. “More than anything it was a lot of messes; he would throw up a lot, and he became incontinent on and off.” But that was minor compared to the joy of having Winston in her life for a few more months.
• Do I have the time?
“Dying is an evolution, a process,” Marino says. “In the beginning, the dog may not mind being left alone, and it’s not going to be a 24-hour job. There might be some back and forth to the vet, but that can be done on evenings and weekends.”
Eventually, though, the time will come when your dog will need you in attendance pretty much every day. At that point, you may need to take a leave of absence from your job, or hire someone to come to your home several times a day to walk or medicate the dog.
Flexibility is absolutely essential. “If you’re a person who likes structure and rigidity, you may have a hard time with hospice care,” Marino says, adding that your social life will be essentially nonexistent. “Animals can go into remission, they can have really good days and really bad days, and you have to be resigned to that.”
During the last three months of Mango’s life, Krauss carried the 60-pound dog down from his third-floor brownstone triplex every two hours because she refused to soil in the house. “That wasn’t easy, and I didn’t get much sleep, but I did it,” he says. “I like to think that if I were the dog and she were the human, she would do the same for me.”
Krauss points out that it’s not just the sheer time devoted to hospice care that’s demanding, but the quality of the time itself. “You have to be present as the animal you love deteriorates, knowing she will not get better,” he says. “You cannot be emotionally absent.”
• Do I have the funds?
“This is not a cheap investment,” Marino says. While it might sound crass, “you need to ask yourself, ‘How much am I willing to invest?’ I know people who are willing to take out a second mortgage to give their dog another six months of life. But if you are a working single mom with three kids and you’re giving up your grocery money so your dog can be treated, you have to check the wisdom and practicality of that.”
Cancer treatments such as chemotherapy and radiation might prolong a dog’s life, but they cost thousands of dollars. Those too squeamish to perform simple procedures such as subcutaneous injections can take their dog to the vet daily, or hire a licensed vet tech to come over and give them – all at a steep price.
Certainly, the more work a caretaker is willing to do herself, the less the financial impact. But the expenses will mount up: time off from work, the cost of dog sitters when you cannot be home, and supplies “more than likely will run in the thousands,” Marino warns.
• Can the humans in my life cope?
For all its moments of deep connection and quiet joy, hospice is very stressful, putting a strain on your energy, finances, time – and relationships. If there is any friction in your family situation, hospice will inevitably bring it to the surface.
“It’s so important to have a family in agreement; I have seen an animal dying in a home cause absolute turmoil,” Marino says. “Every family member has to lay his or her cards on the table and present what part they want to play. Some want to be more involved than others, but no one should be criticized for something they can’t give, or if someone else gives more.”
Such honesty forestalls any resentment on the part of a more involved caretaker who might be tempted to accuse another of not doing enough. Speaking of that last word, caretakers need to be very explicit about defining it. “The family has to be in agreement on when enough is enough. For some people, the dog becoming incontinent would be enough. For others, it’s when the dog can’t get up,” says Marino. “‘Enough is enough’ varies according to what people are willing to tolerate.”
But for many, the strain and exhaustion are a small footnote to the experience itself. “We went through the dying process that you would go through if a family member was dying at home,” concludes Krauss.
“There are tremendous gifts and learning that come from that: That you can care for a dying animal that you love even though it’s hard. That you can release them to let them go on. And that you can show them that even in their sickness, they are lovable.”
The down and often dirty
“Life is messy,” says Marino. “It’s not neat and clean.” The same goes for hospice care. Incontinence and vomiting, unpredictable ups and downs in an animal’s condition – all can seem like insurmountable obstacles unless a caretaker is perfectly prepared for them. Here are some essentials you’ll want to have at the ready:
• Diapers. The baby (not the adult) kind are best. Shop around for a brand that is ultra-absorbent, and modify each diaper with a simple snip to allow for a tail opening.
Diapers also help protect against urine scalds by drawing the moisture away from the skin. “Make sure the diaper is as dry as possible,” says Marino. As with a newborn baby, she uses a diaper-rash product such as Balmex or Desitin to create a barrier so the skin doesn’t get raw.
With long-coated dogs such as Collies and Huskies, Marino sometimes shaves the whole perineal area, especially in summer. “Because the coat is so thick, the dog can get maggots and you don’t even know it,” she says, noting that the fly larvae can hatch within 24 hours of being laid, and will immediately begin eating away at any necrotic tissue.
• Bedding. For incontinent or immobile dogs, Marino recommends doggie cots made out of PVC pipe and mesh fabric. Elevated off the ground, the beds are comfortable for the dog and easy to clean for the caretaker. She places a hospital-type blue “chuck pad” under the bed, or a tray of cat litter to make the area easy to clean.
Speaking of cleaning, consider devoting an area of the house for providing hospice. “It should be a place where if the animal is incontinent or vomits, it’s not on your $10,000 Persian rug,” Marino says. “It should be a place where the animal is comfortable, and so are you.”
• Supplies. Among the items that Marino recommends obtaining from your vet are fluids and disposable needles to do subcutaneous injections, which will be required in nearly every dog’s final days. Pedialyte, an oral electrolyte solution for children, is also good to have in the cupboard to combat dehydration.
Diarrhea is a common problem with terminally ill animals, and Marino always keeps a tincture of slippery elm on hand to deal with gastrointestinal upsets. For vomiting, she often turns to the homeopathic remedy Nux vomica.
Instead of a heating pad – a big no-no – Marino uses a warming disc that can be heated in a microwave. You can determine whether the disc is too warm, refrain from putting it near the dog until it’s at a safe temperature, and then feel confident that it will slowly cool (rather than heating up to a temperature that can burn, like heating pads are wont to do). Warming discs stay warm for 10 hours, and are especially good for animals with kidney disease.
Another must-have is a rectal thermometer. “Learn what temperature is normal for your dog,” Marino advises. “Typically, it’s 101 degrees, but it can range from 100 to 102 for some dogs.” And while a muzzle might sound like an odd item to keep handy, she notes that some dogs can nip during unpleasant procedures such as a change of wound dressing, or when they are frightened or out of sorts.
• As for nutritional supplements, Marino frequently gives her hospice dogs Seacure, a biologically hydrolyzed whitefish supplement that is easy for the digestive system to assimilate (and whose fishy odor tempts many dogs with delicate appetites into eating). She also uses colostrum to support the immune system and help ward off secondary infections, and Pet Tinic, an iron-rich vitamin and mineral supplement, to help boost oxygen-carrying red blood cells.
• Faith. While it sounds basic, caretakers need to believe in their ability to do their best for their animal. Marino remembers the day that Krauss’s partner Deb called, distraught. On one of the dog’s very good days, Deb had taken her hiking, but the next day, she was noticeably worse.
“She was feeling guilty, like ‘Maybe it was something I did,’” Marino recalls. “But the key in all this is to live life and savor it. It’s very important to focus on the days that we go hiking rather than the days when things don’t go so well. Those are the days you want to remember.”
-Denise Flaim is a staff writer and companion-animal columnist at Newsday, the daily newspaper on Long Island. She is also the author of The Holistic Dog Book: Canine Care for the 21st Century and Getting Lucky: How One Special Dog Found Love and a Second Chance at Angel’s Gate (Stewart, Tabori & Chang, $19). Denise shares her home with her husband, toddler triplets, and two naturally reared Rhodesian Ridgebacks.
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What could be better than curing your dog’s cancer? That’s easy! How about avoiding the illness in the first place?
No one has done any clinical trials or statistical studies that prove you can prevent cancer in at-risk dogs. “But common sense and clinical experience make a strong case for avoiding anything that exposes an animal to known carcinogens or weakens the immune system,” says Stacey Hershman, DVM, a holistic housecall veterinarian in Rockland County, New York.
Just like their human companions, dogs live longer, healthier lives when they eat the right foods, get enough exercise, breathe clean air, drink clean water, and stay away from harmful substances. They may also be helped by immune-boosting herbs, supplements, special foods, and a few things you might not have thought of. Here’s a review of recommendations from holistic veterinarians and other experts.
Good Genes
An important first step in selecting a puppy or adult dog is learning everything you can about the immediate family – parents, grandparents, siblings, aunts, uncles, cousins, etc. Some breeds are notoriously prone to cancer, and some lines within those breeds reinforce the trend. Look for good genes and good health when selecting puppies or adopting adult dogs.
Of course, rescued dogs seldom come with this documentation, and even the best-bred dog can develop cancer. But starting with good raw material can reduce the risk – and if you know that your dog may be prone to certain types of cancer, do what you can, starting today, to make that diagnosis less likely.
Spaying/Neutering
The statistics are convincing: female dogs have a significantly lower risk of developing mammary tumors if they are spayed before coming into season for the first or second time, and testicular cancer is obviously not a problem in neutered males.
But while early spaying reduces the risk of mammary cancer, it quadruples the risk of developing cardiac hemangiosarcomas (vascular tumors) compared to intact females. In addition, a study of 3,218 dogs neutered before one year of age showed that both males and females had a significantly increased chance of developing osteosarcoma (bone tumors) compared to intact males and females.
Understanding your dog’s inherited risks can help you make informed decisions about whether and when to schedule surgery.
Vaccinations
For Dr. Hershman and most holistic veterinarians, routine vaccinations top the list of things to avoid. “Vaccines really disrupt the immune system,” she says, “especially combination vaccines that are given annually.” Like many holistic veterinarians, she recommends a single-dose parvovirus vaccination at age 10 to 12 weeks, followed by a single-dose distemper vaccination four weeks later and a rabies vaccination after age six months.
“I check the effectiveness of these shots with blood titer tests,” she says. “If immunity is strong, there’s no need to revaccinate. If it’s weak, I repeat whatever the puppy needs for protection.”
Label directions warn veterinarians not to vaccinate a sick animal; Dr. Hershman includes injured or stressed animals in that caution. “Vaccinating a dog who’s being spayed, neutered, or treated for an injury is totally irresponsible,” she says. “You want the animal to be healthy, with a strong vital force, not in a weakened, vulnerable state, when you introduce substances designed to challenge the immune system.”
Responding to decades of research by immunologists, veterinary textbooks and colleges no longer recommend annual vaccinations for dogs, but most veterinary clinics continue to prescribe them. “They routinely prescribe antibiotics, steroids, and other symptom-suppressing drugs, too,” says Dr. Hershman, “and those take a toll on the immune system. Whenever you can use nutrition, homeopathy, acupuncture, medicinal herbs, or other natural therapies instead of symptom-suppressing drugs, you strengthen the dog’s immunity. A strong immune system is the best defense against cancer.”
The Right Diet
Advocates of home-prepared diets for dogs have long claimed that their animals are healthier than they would be on commercial pet food. Beth Taylor and Steve Brown, authors of See Spot Live Longer, agree. They blame dry and canned dog foods for a host of problems because they usually contain inferior-quality proteins, fats, and carbohydrates, a variety of toxins, highly processed grains, chemical preservatives, allergens, and other questionable ingredients.
Many veterinarians blame grain-based pet foods for diabetes, digestive problems, and other canine disorders. After all, the canine digestive tract evolved on a diet of prey animals, consisting mostly of meat and bones, not wheat and corn.
Every few years, aflatoxin, which grows on corn, rice, and other grains, contaminates pet foods and kills dogs (see “Yes, Dog Food Can Kill,” February 2006). In addition to causing liver damage, aflatoxin is a potent carcinogen, so even “safe” levels that don’t cause obvious disease outbreaks can contribute, over time, to cancer.
Another carcinogen found in grain-based foods is acrylamide, once believed to exist only in industrial waste. However, acrylamide has recently been found almost everywhere in the human diet. This tasteless, invisible by-product is formed when high-carbohydrate foods are fried or baked at high temperatures. French fries and potato chips contain the highest concentrations, but acrylamide occurs in breads and breakfast cereals as well.
The U.S. Environmental Protection Agency (EPA) considers acrylamide so dangerous that it set the “safe level” for human consumption at almost zero, with the maximum safe level in drinking water set at 0.5 parts per billion. A small serving of French fries contains over 400 parts per billion. No one has tested pet foods, but any processed foods that contain carbohydrates, especially those extruded at high temperature like grain-based kibble or canned under high heat and pressure, pose a risk.
“Considering how ubiquitous these carcinogens are,” says San Francisco-area dog health researcher Mary Straus, “and considering that cancer cells thrive on carbohydrates, avoiding grains altogether may be one way to help lower the risk of cancer.”
In addition to reducing levels of carbohydrates and carcinogens, feeding a home-prepared diet of pasture-fed, organically produced ingredients (see “Upgrading to Pasture-Fed,” July 2003) insures that your dog will not ingest pesticide and drug residues. Food prepared at home from conventionally farmed ingredients may not be free of pesticide residues, but it is unlikely to contain chemical preservatives, artificial colors or flavors, or the by-products of high-heat processing.
In his book, Work Wonders: Feed Your Dog Raw Meaty Bones, Australian veterinarian Tom Lonsdale observes, “We need more information about the cancer epidemic in domestic dogs. However, basic nutritional and medical principles tell us that diet is the likely main factor. Without waiting for extra information, and because cancer often takes years to develop, it’s best to start puppies on a cancer-prevention diet early. From the whelping box to the grave, let ‘Prevention, not treatment’ be our motto.”
Dietary Supplements
Antioxidant supplements, which help protect the body from damage by free radicals, have many health benefits, including cancer protection. Best-selling antioxidant supplements include vitamins A, C, and E, beta carotene, lycopene, and the mineral selenium. Bear in mind that some alternative cancer treatments, such as artemisinin, are not compatible with antioxidants.
Food-source antioxidants, vitamins, and other nutrients derived from whole foods are recommended by many holistic veterinarians because they are recognized as food by the body and are more easily assimilated than synthetic vitamins grown in a laboratory. The words “whole food” or “food source” indicate natural rather than synthetic ingredients.
One of the simplest cancer-resisting supplements you can add to your dog’s food, according to Bruce Fife, ND, is coconut oil. Dr. Fife, the author of several books about coconut’s health benefits, recommends feeding dogs 1 teaspoon of coconut oil per 10 pounds of body weight per day in divided doses. That’s 1 tablespoon (3 teaspoons) for a 30-pound dog and 2 tablespoons for a 60-pound dog. (See “Crazy About Coconut Oil,” October 2005.)
“The medium-chain fatty acids in coconut oil help treat or prevent all kinds of illnesses,” he says, “and they have significant anti-tumor properties. Giving your dog coconut oil every day is inexpensive health insurance.”
Dried shredded coconut (the unsweetened kind) is an excellent source of fiber, another factor in cancer prevention. Try adding a teaspoon to a tablespoon of shredded coconut to your dog’s home-prepared food. If feeding dry food, add a little water or soak the shredded coconut first.
Vegetables are controversial ingredients because they’re hard for dogs to digest. But a simple lactofermentation process not only improves the digestibility and assimilation of vegetables, it increases their vitamin content and makes them a valuable source of beneficial bacteria. In fact, the treated vegetables are both a prebiotic (food that feeds beneficial bacteria) and probiotic (food that contains beneficial bacteria). In Europe, lactofermented vegetables are the key ingredient in a popular cancer treatment.
To make lactofermented vegetables (see “It’s All in How You Make It,” March 2001), simply grate, shred, or puree carrots and other vegetables, add 1½ teaspoons unrefined sea salt per quart (4 cups) of vegetables, add the contents of a probiotic supplement such as acidophilus, and press everything in a bowl or glass jar until juice covers the vegetables. (The task is made considerably easier with a Japanese salad press; see “Cancer Prevention Resources” for purchasing information.)
Close the jar tightly or, if using a bowl, cover vegetables with a plate weighted by a jar filled with water. Let stand at room tem-perature until the vegetables give off a vinegar-like fragrance; this will usually take two to three days, depending on their con-sistency and room temperature. Refrigerate. Use to replace vegetables in any home-prepared recipe, or add 1 tablespoon to ¼ cup lactofermented vegetables to each meal.
Environmental Factors
Take two individuals from the same litter of puppies of a breed or family that has a high cancer risk. Place one with a family of heavy smokers who live next to a busy highway, use lawn chemicals, drink fluoridated tap water, and have high-current power lines in the backyard. Place the other pup on a pristine organic farm. Feed both the same diet and let several years go by. You don’t have to be an oncologist to know which dog is more likely to develop cancer.
Second-hand smoke is a serious problem for pets, especially those who spend hours every day at the feet of their smoking companions. “I tell all my clients who smoke that they’re putting their dogs’ health at risk,” says Dr. Hershman. “I saw it happen in my own family, and it breaks my heart. Second-hand smoke is as dangerous to dogs as it is to infants.”
Busy highways, driveways, parking lots, and areas where trucks and cars idle are dangerous for dogs because of gas and diesel exhaust. A dog’s nose is much closer to the ground – and exhaust pipes – than the human nose, so dogs are more likely to inhale damaging particles.
Lawn treatments and agricultural chemicals are known to cause cancer in animals (see “Canine Cancer Crisis,” November 2005). Dogs pick up pesticides, herbicides, and other chemicals through their feet and, when they sniff the ground, through their noses. Keep your dog off the grass in chemically treated neighborhoods, and explore organic alternatives for your own lawn and garden.
Even household chemicals pose a threat to our canine companions. According to the U.S. Consumer Product Safety Commission, more than 150 chemicals found in the average home are linked to birth defects, cancer, and psychological abnormalities. If labels carry a “keep away from children and pets” warning, or if product labels suggest they should be used only in well-ventilated areas, look for alternatives.
Fluoride has gotten such good press over the decades that most Americans think it’s essential for healthy teeth. It’s even added to some canine toothpastes. But in many countries, fluoride is considered a hazardous industrial waste, and its use in water supplies is prohibited. In September 2005, eleven unions representing more than 7,000 scientists and researchers at the EPA called for a national moratorium on the fluoridation of America’s drinking water, citing cancer risks.
A December 2005 analysis of more than 22 million tap water quality tests, most of which were required under the federal Safe Drinking Water Act, found that water suppliers across the U.S. detected 260 contaminants in public tap water. Of the 141 unregulated contaminants detected in water supplies between 1998 and 2003, 52 are linked to cancer, 41 to reproductive toxicity, 36 to developmental toxicity, and 16 to immune system damage. Water contaminated with 83 agricultural pollutants, including pesticides and fertilizer ingredients, flows through the taps of over 200 million Americans in 41 states.
Installing a water filter or using uncontaminated, unfluoridated bottled water sounds like a very good idea! So does avoiding fluoridated toothpaste.
Regarding sources of electromagnetic radiation, a study published in 1995 in the American Journal of Epidemiology compared dogs treated at a veterinary teaching hospital for histologically confirmed lymphoma. Electric wire codes and magnetic fields were measured at the homes of 93 diagnosed cases and 137 controls, and a correlation was found between magnetic fields emitted by power lines and electrical appliances and the incidence of lymphoma. Dogs living in homes with very high current codes had the highest risk, while dogs living in homes with buried or underground power lines had a lower risk.
Immunologist and veterinarian Richard Pitcairn, DVM, PhD, author of Dr. Pitcairn’s Complete Guide to Natural Health for Dogs & Cats, considers all sources of radiation (including repeated diagnostic X-rays) dangerous because their effects are cumulative in the body. He recommends that dogs not be allowed to rest near a color TV set. Fortunately, the new flat-screen TVs and computer monitors emit much lower levels of electromagnetic radiation than older cathode ray tube models. In general, the fewer electrical appliances in close proximity to pets, the better.
Topical Pesticides
Anyone who lives where fleas, ticks, or mosquitoes are a problem knows what a challenge they can be. Unfortunately, topical and systemic pest-control products contribute to a host of health problems, including increased cancer risks.
A well-balanced raw diet can help a dog repel parasites, but sometimes the attack is overwhelming.
“I definitely prefer natural alternatives to pesticide sprays or products like Frontline, which make the entire dog toxic to biting parasites,” says Dr. Hershman. “But alternatives don’t always work. One of my patients is a raw-fed Search and Rescue dog who often picked up more than 200 ticks on training weekends. He’s a German Shepherd Dog, so finding and removing them all was a time-consuming, stressful challenge. After his owner tried every natural repellent we could find, none of which solved the problem, he now applies K9 Advantix, a systemic pesticide that repels fleas, ticks, and mosquitoes, on a reduced dosage schedule only when needed.
“When it comes to cancer prevention,” she says, “the less often you use conventional pesticides, the better. A good diet and natural repellents are always worth trying first.”
Cancer Preventives
Several holistic cancer treatments, such as those described in “What Are the Alternatives?” (February 2006), can be used to help healthy dogs remain cancer-free. The thinking here is that cancer cells develop all the time, even in healthy bodies, but they don’t create problems until conditions encourage their growth. Preventive treatments disrupt cancer cells before they take up residence in vulnerable parts of the body.
Henry Lai, PhD, the University of Washington researcher who first tested artemisinin (an extract of Artemesia annua, or annual wormwood) on dogs with cancer, takes artemisinin as a preventive himself and has tested it on laboratory animals.
“It is hard to recommend a protocol for cancer prevention,” he says, “but, based on studies on rats, a good dose could probably be somewhere between 8 milligrams of artemisinin per kilogram of body weight per day at the high end and 10 mg/kg once per week at the low end. I take 100 mg per day for 10 days each month. Even though this approach hasn’t been tested yet on humans or canines, I think it makes sense.”
Following Dr. Lai’s example, a dog weighing 60 to 75 pounds could take 50 mg artemisinin for 10 days each month, and the amount could be increased or decreased as needed for larger and smaller dogs.
The antioxidant Protocel, also discussed in last month’s article, can be used in a similar way.
According to Illinois veterinarian Dan King, DVM, “This should be effective because Protocel works on early cancer cells as an antimetastatic. That is, it deals with individual cells and prevents them from spreading and growing. Because it works slowly, I would use Protocel on a preventive maintenance schedule of ¼ teaspoon twice per day for a dog weighing 50 to 75 pounds for three months on and six months off. Small dogs could take 1/8 teaspoon twice per day for the same length of time.”
Medicinal Herbs
Ask a dozen experts about their favorite herbs for cancer prevention and you’ll generate a list too long to publish here. But a few herbal products are so effective that they are recommended by almost everyone.
“Many mushrooms have anti-tumor and immune-stimulating activity,” says Carol Falck, VMD, of Pompano Beach, Florida. “They have been used medicinally for thousands of years in China and Japan, and they work very well for dogs.”
Dr. Falck often uses Myco-Immune by Thorne Research, which is a liquid extract of seven medicinal mushrooms, including cordyceps, reishi, shiitake, maitake, and turkey tail. “This combination stimulates the immune system in several ways, helping it resist the growth of cancer.”
She also recommends a green tea extract (G.T.-Ex by Thorne Research) because green tea enhances cellular immune function, increases natural killer cell activity, and may inhibit some cancer cell lines.
Another favorite supplement for dogs at risk of cancer is curcumin, says Dr. Falck. “Curcumin is the yellow pigment in turmeric, the spice that gives curry its distinctive color. Both turmeric and curcumin have been shown to inhibit tumor growth. I also like astragalus, an herb with strong immune-stimulating properties. I use several Chinese herbal formulas containing astragalus, depending on the patient, including Astragalus for Animals by Buck Mountain Botanicals.”
Garlic is well known and often used for its cancer-inhibiting properties. Small amounts of fresh minced garlic or aged garlic extract can be added to any dog’s dinner. Garlic is an ingredient in Herbal Compounds tablets created by Juliette de Bairacli Levy, whose Natural Rearing philosophy pioneered home-prepared diets and alternative medicine for animals.
“This formula is very antiseptic,” says Natural Rearing advocate Marina Zacharias, who imports the product from England. “It definitely helps the immune system.”
For patients at high risk, Zacharias likes a Chinese formula called Bioprin for its antiviral, antibacterial, antifungal, and anti-tumor properties. “I also use a probiotic called Florenz and, over the animals’ life span, a form of liver support given to match their needs, such as homeopathic Liver Terrain.”
Zacharias says she has seen good results from prevention efforts taken to protect individual dogs in high-risk families. “Of course, there is no empirical evidence to say that these measures prevented cancer, but when we see a good-quality, healthy life, it’s evidence that the efforts are warranted. We all have to die from something, but when we see cancer in a naturally raised dog, it’s usually when the dog is older, at the end of its natural lifespan.”
Closely related to herbal medicine is aromatherapy. San Diego holistic veterinarian Stephen Blake recommends massaging the paw pads of at-risk dogs once or twice per day with a drop of blended frankincense, sandalwood, and Douglas fir essential oils. For best results, use organic or wildcrafted oils from reputable distributors as described in “Essential Information” (January 2005). “These essential oils are great for detoxification and for supporting the immune system,” he says.
Exercise
Although few of us appreciate the important role it plays, the lymph system is a key factor in cancer prevention. Lymph is a clear fluid, similar to blood but lacking red blood cells. It contains the immune system’s lymphocytes (T-cells and B-cells) and circulates through channels that carry waste to the lymph nodes, filtering bacteria and other toxins.
The more lymph circulation is impaired, the less efficiently the body removes toxins and the more favorable conditions are for the growth of cancer. Lymph circulation improves with active exercise and deep, diaphragmatic breathing. Gentle to vigorous brushing that moves from the feet to the heart is a simple addition to daily grooming that also stimulates lymph circulation.
“Exercise is so important,” says Dr. Falck. “Exercise stimulates the immune system and releases endorphins, and an added benefit of consistent exercise is increasing gastrointestinal motility, which helps normalize stools and eliminate toxins from the body. It also facilitates weight management, which is important because obesity is a risk factor for some types of cancer.”
Malillumination
You probably haven’t thought about light as a cancer preventive, but it may well be. Not just any light, though. Unfiltered natural light, Mother Nature’s full-spectrum light, activates the hypothalamus and keeps the entire endocrine system balanced.
When photobiologist and time-lapse photography pioneer John Ott began to photograph living plants, he discovered that depriving them of unfiltered natural light interfered with their normal growth and reproduction.
He soon learned that the health of fish, birds, reptiles, and other animals (including humans) is adversely affected by insufficient light and by the wrong kind of light, especially fluorescent light. Ott coined the term “malillumination” to describe the phenomenon, which is now known to suppress immune function and contribute to skin damage, cancer, and other problems.
Light enters the eyes not only to facilitate vision but also to activate the hypothalamus. This region of the brain, in turn, controls the nervous and endocrine systems, which regulate functions throughout the body.
Exposure to natural light, preferably for several hours daily, is necessary for your dog’s health. A shady screened porch, the shelter of a tree, even an open window or doorway can give the dog’s body what it needs. Some plastics allow the transmission of full-spectrum natural light, but glass windows, windshields, and sunglasses (which we hope your dog doesn’t wear) do not.
Emotional Well-Being
For many healthcare experts, emotional well-being is as important to cancer prevention as diet and exercise.
“I believe strongly that emotions are linked to general health via the immune system,” says Dr. Falck. “We can support our pets emotionally by encouraging social interaction with people and other animals, by providing a safe and loving environment with balanced opportunities for play and rest, and by minimizing stress.”
Dr. Blake strongly stresses the importance of positive thinking.
“Never talk to an animal as though he or she is a tumor instead of a spiritual being,” he says. “Negative thoughts generate negative energy, which feeds the disease and weakens the patient’s vital force. No matter how serious the risk of cancer, it’s important to picture your dog as well and happy, not sick, and to engage him or her in meaningful conversation and meaningful activities every day.”
A long-time contributor to WDJ and author of The Encyclopedia of Natural Pet Care, Natural Remedies for Dogs & Cats, and other books, CJ Puotinen lives in New York with her husband, a Lab, and a tabby cat.
I remember a day several years ago when I put my dogs’ “stay” to the test.
We were on our usual morning neighborhood walk. All of a sudden, three children on bikes sped past us on the sidewalk, racing each other on the way to school. The faster and older children raced around the corner, leaving the younger bicyclist in their dust. Just then, the young biker skidded to the side and landed hard on the concrete about 20 feet in front of me.
The boy started crying. I quickly told my dogs to down and stay, and raced up to the child to see if he needed help.
I was not sure what my dogs would actually do. Would they stay as we had trained and practiced? Would they follow me down the street to see the crying boy? Would they venture into the neighbor’s yard after a rogue cat? All seemed very possible – after all, they were rowdy young dogs and the stay behavior, while practiced regularly, had never been really put to the test.
But they did stay for several minutes, just as we’d practiced over and over. I have to admit that I was a little more than surprised and impressed! (By the way, the boy was fine. His hands and knees were slightly skinned, but after a few short minutes, he hopped back on his bike and raced off to school.)
That day taught me what an important foundation behavior stay can be. Obviously, in a minor emergency, a stay is extremely helpful. But a solid stay can make a difference in other facets of life, too:
• Stay is a very useful behavior in everyday situations, like when you’re walking and need to tie your shoe, or if at a pet supply store and need to sign a charge slip.
• Stay helps develop your dog’s self-control and helps a dog settle during exciting times such as when you are fixing dinner or when you are gathering the leash and treats for a walk.
• Stay can be useful at the vet and during grooming.
• It is an essential behavior for dog sports such as competitive obedience and agility.
• It can be a life-saving behavior. For example, a good stay can prevent a dog from racing into the street.
The many faces of stay
What exactly is a stay? It means different things to different people. In fact, there are many “versions” of stay. You’ll need to identify the different ways you will use stay and train for each.
Stay can apply to different positions or places. For example, you may have a sit/stay, a down/stay, and a stand/stay. You may also teach your dog to go to his bed and stay, or to stay in a certain spot while you prepare his food.
Stay can also apply to a mind-set. Many people use stay to mean, “Relax and hang out.” Others such as agility competitors may use stay to mean, “Don’t move, but be alert for the next cue.”
Here are some common stay variations:
• The basic stay: I teach the basic stay as the dog remaining in position and place (sit, down, or stand) until released. For example, when asked to sit or sit/stay, the dog will put his bottom on the ground and remain there until I say “Okay.”
• Wait: While stay is a behavior that asks the dog not to move out of position or place, wait is a more casual version that can mean “hang out patiently for a moment or two, but stay alert because your turn is coming.” I use wait at doorways, for example.
• Go relax or go to bed: This type of stay is less about position and more about place and mind-set. Teach the dog to go to his or her bed or other place and hang out there. This can be taught with or without a distinct release.
• Dog sport stay: For those who play agility or obedience, a ritualized stay behavior is part of both sports. Using a specific cue, signal, or body language to initiate the stay and a specific and unique release cue can aid in a reliable dog sport stay.
Getting a reliable stay can be a challenge, and one of the reasons is that the variations are often taught in a blur – the dog is sometimes asked to stay in one position, sometimes asked to stay in one place, sometimes allowed to leave the position or place without the release, sometimes required to stay in the position until the release, sometimes released to a verbal cue, sometimes released to a hand signal . . . no wonder the dog becomes confused!
Before you start training the stay, develop a distinct picture in your mind of the behavior you are training. For the rest of this article, I’ll use “stay” for the basic stay described above: When you are asking your dog to put her body in a certain position (sit, down, stand) and stay in place until she is formally released.
The controversial cue
When you ask a dog for a stationary behavior (like sit, down, or stand) the expectation is that the dog will stay in that position until released. Essentially, the sit cue means, “Sit and stay there.” So do you need or use a separate stay cue?
While it may seem unnecessary, having a distinct cue for stay can be advantageous in certain situations:
• If you have trained different types of stays, using a distinct cue for each can help your dog understand what is expected.
• Using a stay cue or word can act as a back up or reassurance for your dog in difficult or emergency situations. For example it can mean, “Keep on sitting. You are doing great.”
• If you use the word “stay” with several positions (sit, down, and stand, for example), you may be able to easily transfer it to new or unique positions. For example, if the vet needs your dog to lie on his side, you can gently turn him to the side and then give the “stay” cue to help him know that you would like him to remain in that position while the vet pokes and prods.
• If you are not as consistent as you should be about using a distinct release from a sit or down, having a stay cue can be helpful clarification for you and your dog.
Consider getting the best of both worlds. Teach your dog that sit, down, and stand mean hang out in that position until you are released, and later, once the dog knows the behavior, you can add in a secondary cue or hand signal for stay.
Training the stay
When you first teach your dog to sit, you “mark” her performance of the desired behavior with a click! of a clicker or word such as “Yes!” and give her a treat the moment her bottom hits the ground. Most dogs will quickly place their bottoms on the ground, and then pop up the minute they hear the click! Here’s how you move from a brief sit (or down or stand) to a solid sit/stay:
1. When you ask your dog to sit, gradually extend the time between the dog placing his bottom on the ground and when you click or “yes.” For example, the dog sits and you count a half a second, then click or “yes” and treat; the dog sits, you count one second, then click and treat; the dog sits, you count two seconds then click and treat. Work up to 10 seconds.
2. At this point, alternate longer and shorter times between treating. For example click or “yes” and treat for 10 seconds, 3 seconds, 7 seconds, etc.
3. If your dog pops up, don’t stress! In the process of learning to stay in position, your dog may experiment a little. He may pop out of the position, come up to you, and wonder if it’s treat time. With most beginning behaviors, like sit, down, or come, the dog gets the reward when he is near you or when he comes up to you. So it is understandable that he might give that a try while he is learning to stay.
What can you do? Simply ask your dog to try again and make your criteria easier! This is critical. If your dog breaks the stay twice in a row, or if you are getting fewer than four out of five correct responses, make it easier and build up slower.
In addition, be patient and don’t use verbal scolding or “corrections.” Correcting a dog for leaving a stay may backfire, making him insecure and less likely to succeed the next time.
When he can successfully hold the sit at least four out of five times in a training session, then you can make it a little harder by extending the time you ask him to stay. Over the course of several training sessions, gradually increase the time until your dog can comfortably hold the sit for 30 seconds.
4. Don’t worry if your dog pops up after the click. If you would like your dog to stay until you give a distinct release, try this:
Click and immediately place the treat right under the dog’s nose so that he doesn’t need to get up to eat the treat. This placement of the treat will reinforce the position. In fact, if you follow the click with several treats in a row, your dog will learn to stay in position to see what is coming next! Follow the click and treat with a distinct release such as “Okay!”
5. At this point, you can also add in a hand signal or verbal cue for “stay.” Ask your dog to sit, say “stay” or give your hand signal, and continue practicing as noted above.
The three D’s
When training the stay, it can be very helpful to work on the three D’s: duration, distance, and distractions – separately. By consciously building the three D’s into your training, your dog’s stay will become increasingly reliable.
• Duration is simply how long your dog is doing the behavior. You’ve already been working on teaching your dog to hold the sit/stay for 30-second durations. Think about how long you would ideally like your dog to hold a stay. For a sit position, I suggest one to three minutes; for a down position, 2 to 5 minutes.
Note: Some people like to train their dog’s to hold a down for up to 30 minutes. I personally believe this is too long to comfortably be in one position without moving. If you would like your dog to be able to stay for 15, 20, or 30 minutes, consider teaching him to “go to bed,” where he can stay in a place for a longer period of time, but move his body position for comfort!
• Distance refers to both how far away you are from your dog when he is staying. Along with training your dog to stay while you move away, teach your dog to understand that stay means to stay even when your body is in a different position, such as if you turn away, kneel down, or step to the side.
When your dog can hold the sit for 10 to 30 seconds, start varying your distance from him and body position. Take a half step back, turn your body to the side, step slightly to your dog’s side, move your head, lower your body, etc. As your dog becomes more confident, you can gradually increase the distance. At advanced levels, you can teach your dog to stay while you step out of sight.
In the early stages of training, work on distance and duration separately. For example, if you are training for duration, work on increasing the time but keep the distance and your body position within your dog’s comfort level. If you are working on distance, move away from your dog, but only stay at a distance for a few seconds before returning. As your dog’s skill increases, you can combine the two with ease.
Note: To prevent your dog’s anticipation of the release (and his consequently breaking the stay and running to you for a treat) go back to your dog and click and treat while he is still in the position.
• Distraction training is equally important. Once your dog has the basics of sit/stay, begin training in different locations. Each location has different distractions, so you will need to lower your criteria.
For example, if your dog can sit/stay for two minutes in your living room, expect to begin with just three or four seconds in a new location. Start with easy locations, such as your kitchen, living room, and backyard. As your dog’s ability to succeed improves, practice on your daily walks and other places you visit frequently.
At first, add only distractions you can control, so you can stop the distraction if it is setting your dog up to fail. Start small, by waving your arms or jumping up and down, for example, and build slowly.
Eventually, you may need to practice with the things that tend to distract your dog most, such as people walking near your dog, other dogs moving by, or a ball bouncing across the ground. Again, for the best chance of success, set up situations in which you can control the distractions until your dog consistently succeeds at that level. With enough practice, your dog will learn to stay even in the face of the toughest “real-world” distractions.
The secrets of success
The secrets to a successful and reliable stay: Be realistic! Be consistent!
Work with your dog’s stay training at a level he or she can realistically handle. Pushing your dog past his abilities (so that he breaks the stay) is the fastest way for the behavior to fall apart. The more this happens, the harder it will be for your dog to have the confidence needed for a reliable stay. So if your dog breaks his stay, make it easier and build on successes!
Be very consistent when you are training the stay. If your dog is having trouble with the training, make it easier and move forward more gradually. For obvious reasons, calm, confident dogs may progress more quickly. But with patience and consistency, even high energy and insecure dogs can develop a rock-solid stay!
People have learned of the benefits of a natural diet and limited vaccinations, and have seen the health improvements in their dogs from these changes. Now, many want to know if they can discontinue administering heartworm preventatives to their dogs, or whether those can be replaced by natural options.
Heartworm preventatives can cause serious side effects in some dogs, including depression, lethargy, vomiting, anorexia, diarrhea, dilation of the pupil, loss of balance, staggering, convulsions, and hy-persalivation. Some dogs are especially prone to side effects from ivermectin, the main ingredient in one of the most widely used heartworm preventatives. Also, some of the preventatives are combined with drugs aimed at killing other pests such as fleas, mites, roundworms, and hookworms.
On the other hand, heartworm can be a devastating disease. Dogs with moderate or severe infestations display a chronic cough and can’t engage in much activity, as worms choke their heart and major blood vessels, reducing their blood (and thus oxygen) supply. The disease often leaves its victims incapacitated, incapable of doing much more than a slow walk without gasping for air, and kills many dogs. Even the treatment for heartworm disease can be deadly, regardless of which method is used, so it is important to understand the risks that you take if you choose not to give your dog heartworm preventative.
In fact, most (certainly not all) holistic veterinarians consider the use of pharmaceutical preventatives to be less harmful than a heartworm infection.
Some argue, but…
As the co-moderator of an e-mail list on dog health and nutrition, I frequently see people allege that as long as you have a healthy dog, feed a raw diet, and do not over-vaccinate, your dog will not get heartworms. If only this were true! These measures may help to some degree, but they are not foolproof. The only way to know for sure that your dog is protected is to give heartworm preventatives.
Christie Keith, who lives in an area of Northern California where heartworm is relatively uncommon and has raised Scottish Deerhounds naturally for over 19 years, learned this the worst way.
“I went 16 years not using any form of allopathic preventative on my dogs. At the end of that 16-year period, on routine testing, I found that two of my dogs were heartworm-positive,” says Keith. “One of the positive dogs was Raven, a Deerhound I bought from another breeder. She came to me at 17 weeks with bad ear infections and severe allergies, and no one could argue that Raven was healthy or had a normal immune system.
“In contrast, my dog Bran was a third-generation, naturally reared dog of my own breeding. He was unvaccinated other than minimally for rabies. He was raw-fed. His mother and her mother were raw-fed and unvaccinated other than minimally for rabies. He was, by any definition available, extremely healthy and robust. He had never been sick a day in his life.”
Christie successfully treated both her dogs, though Raven almost died of a pulmonary embolism during treatment. Bran became heartworm-free after months of using the “slow kill” method of heartworm treatment, with no sign of any adverse effects. Unfortunately, Bran died of acute renal failure not long after that. Necropsy results were inconclusive, showing that Bran had glomerulonephritis, but not why.
In her research to try to find the cause of her dog’s death, Christie discovered that glomerulonephritis is a potential side effect of heartworm infection. Although she and her vets eventually came to the conclusion that Bran’s renal failure was caused by Lyme nephritis rather than heartworm disease, it was disturbing to realize that heartworms can affect more than the heart and lungs.
“I have no intention of ever living through what I lived through with Raven and Bran. I can’t keep silent when I see people starting to believe that healthy animals don’t get heartworm and that we can blithely forgo using preventatives if we don’t overvaccinate and feed raw. It’s just not so. And it’s not realistic to rely on the health and natural disease resistance of our dogs to protect them from a threat that they are exposed to frequently, as is the case in heartworm-endemic areas.
“No creature is in a static state of health 24 hours a day, 7 days a week. If our dogs are frequently exposed to an infectious parasite, eventually they may well succumb to it, no matter how healthy they are normally.”
“Alternative” preventatives?
Some holistic practitioners recommend various herbal or homeopathic preparations for heartworm prevention, and anecdotal evidence from some dog owners can be found on many discussion lists devoted to natural dog care. However, consumers should be aware that none of these alternatives have been studied for safety or efficacy, nor are there any studies indicating that they are effective at protecting against heartworm infection. In addition, some herbal dewormers, such as wormwood and black walnut, are potentially toxic when used at dosage levels needed to control intestinal parasites.
Some homeopathic practitioners advocate the use of homeopathic nosodes for heartworm prevention. Again, there are no studies indicating that they are effective. In his book, Homeopathic Care for Cats and Dogs, Don Hamilton, DVM, says, “I do know of some cases where the nosode did not protect, however. I believe it does offer some protection, though it may be incomplete. … If you decide to try the nosode, you must understand that its effectiveness is currently unknown.”
What is known, is that conventional heartworm preventatives are the best form of protection currently available. Fortunately for those of us who worry about the side effects of using the conventional drug preventatives, there are numerous ways you can minimize their use and still protect your dog. I’ll discuss these methods after introducing the most common preventatives.
Conventional preventatives
The two most common (and generally considered safe) heartworm preventative ingredients used today are ivermectin (used in Heartgard by Merial, and other products) and milbemycin oxime (used in Interceptor by Novartis).
There is also an older, daily heartworm preventative available, diethylcarbamazine or DEC. For many years, this drug was available from Pfizer as “Filaribits.” Though Filaribits has been discontinued, you can still find generic versions of DEC.
DEC is very safe in terms of side effects, but can be life-threatening if given to a heartworm-infected dog with circulating microfilariae, due to the risk of a rapid die-off of the microfilariae and resulting anaphylactic reaction. Also, missing just one or two days of medication can allow your dog to become infected. If you use DEC, it is essential that you test for heartworms before starting this drug, and every six months while using it. (Avoid Filaribits Plus, which has oxybendazole added to control intestinal parasites and has been known to cause liver damage.)
There are other heartworm products that include drugs for other purposes. Heart-gard Plus adds pyrantel to control intestinal parasites, including roundworms and hookworms. Adult dogs rarely have problems with roundworms, but if your yard has been infested with hookworms, this product might be good to use until the hookworms have been eliminated.
Sentinel is a combination of the products Interceptor and Program (lufenuron). Lufenuron is a medication that acts to prevent fleas from reproducing; it’s not a pesticide and does not kill fleas or keep them from biting your dog. This may be helpful for a short time if you have a flea infestation, and employ several nontoxic methods to get the flea problem under control, such as diatomaceous earth to treat the house and nematodes to treat the yard.
I’m less enthusiastic about selamectin (found in Revolution by Pfizer), a more recent entry to the market. Selamectin is a topical product that is also indicated for fleas, one kind of tick, ear mites, and the mites that cause sarcoptic mange. While this may well be great if your dog had mange, fleas, ticks, and ear mites, I strongly prefer drugs with a minimal and targeted action over ones with broad-spectrum activity.
The injectable product moxidectin (ProHeart 6 by Fort Dodge) has been withdrawn from the U.S. market due to numerous reports of adverse effects, including death. I do not recommend the use of injectable heartworm preventatives at all, as there is no way to remove them from your dog’s system if there is a bad reaction, and the time release drug will continue to affect your dog for months.
Temperature and timing
So, how can you reduce your dog’s exposure to conventional heartworm preventative drugs, without decreasing his protection from the nasty parasite?
First, it is not necessary to give heartworm preventatives year-round in most parts of the country. Heartworm development in the mosquito is dependent upon environmental temperatures. Heartworm larvae cannot develop to the stage needed to infect dogs until temperatures have been over 57 degrees Fahrenheit (14 degrees Centigrade), day and night, for at least one to two weeks. The amount of time it takes will vary depending on how warm it is; the warmer the temperatures, the faster the heartworm larvae develop.
If temperatures drop below that point at any time during the cycle, development may be prevented, but I wouldn’t rely on this. Temperatures can vary according to where the mosquito lives, and may be warmer under the eaves of houses or in other protected areas than the general ambient temperature.
Heartworm preventatives work by killing heartworm larvae that have already infected the dog, but before they can mature into adult worms that cause damage. When you give your dog heartworm preventative, you are killing any larvae that have infected your dog within the last one to two months. Any larvae that have been in your dog longer than 60 days are more likely to survive the treatment and go on to mature into adult worms.
Also, your dog may become infected the day after you give heartworm preventative; the drugs do not provide any future protection at all.
If your goal is to provide full protection for your dog with minimal drug administration, you’ll have to monitor the temperatures in your area. Mosquitoes may be capable of transmitting heartworm larvae to your dog around two weeks after your local temperature has stayed above 57 degrees Fahrenheit day and night.
Give the season’s first dose of preventative four to six weeks after that to destroy any larvae that infected your dog during that time. Thus, the first dose should be given six to eight weeks after daytime and nighttime temperatures first exceed 57°F. Continue to give the preventative every four to six weeks, with the last dose given after temperatures drop below that level on a regular basis.
For some parts of the country, this can mean giving preventatives only between July and October, while in others, where temperatures remain mild all year, they may have to be given year-round.
If you do not give your dog heartworm preventatives (because the area you live in is very low risk or because the temperatures are not right for heartworms to develop), and then take your dog to an area where heartworm is a problem, you must treat him with heartworm preventative upon your return to protect him.
Dosage amounts
With at least one drug, you can give your dog less than the recommended dosage of preventative, without compromising safety.
Milbemycin oxime, the active ingredient in Interceptor, has been approved by the FDA at one-fifth the regular dosage to kill heartworms only, without controlling intestinal parasites, including roundworms, whipworms, and hookworms. Novartis has a product, “SafeHeart,” with this lowered dosage of milbemycin, but has not yet marketed it.
The actual recommended dosage of milbemycin oxime for heartworm prevention only is 0.05 mg per pound of body weight (0.1 mg per kg). Contrast this with the recommended dosage of Interceptor for control of heartworm and intestinal parasites: 0.23 mg milbemycin oxime per pound (0.5 mg/kg) of body weight. Heartworm can be prevented at a much lower dose than that needed to control intestinal parasites.
SafeHeart contains 2.3 mg of milbe-mycin oxime for dogs from 2 to 50 pounds, and 5.75 mg for dogs 50 to 125 pounds. Interceptor contains 2.3 mg for dogs up to 10 pounds, and 5.75 mg for dogs 11 to 25 pounds. So if your dog weighs more than 50 pounds, you can give the Interceptor for dogs 11 to 25 pounds; otherwise you can use the one for dogs up to 10 pounds.
Frequency of preventatives
It may not be necessary to give heartworm preventatives every month. The monthly dosage schedule was devised to make it easy for people to remember when to administer the drugs, and to ensure that dogs would still be protected if a dose were somehow not swallowed or later vomited before being absorbed.
The FDA approvals cite studies showing that Heartgard, Interceptor, and Revolution provide protection beyond 30 days. If you are very good about remembering to give medications, and you can watch your dog after administering the pill to be sure that it is not spit out or later vomited, it may be safe to use heartworm preventatives less frequently than every 30 days. Dosing your dog every 45 days is a conservative way to safely stretch your dog’s dosage schedule.
The drug manufacturers’ pre-approval tests indicate that even longer dosing sched-ules may convey protection from heartworm – but I wouldn’t stake my dogs’ well-being on dosage schedules extending beyond a somewhat arbitrary 45 days.
The original FDA approval for Heartgard states, “The target dose of 6 mcg per kilogram of bodyweight was selected from titration study 10855 as the lowest dose providing 100 percent protection when the dosing interval was extended to 60 days to simulate a missed-dose circumstance.”
The original FDA approval for Interceptor states, “Complete (100 percent) protection was achieved in dogs treated at 30 days post-infection, with 95 percent protection at 60 and 90 days.” This does not apply to SafeHeart, which was tested only at a 30-day dosing interval.
The original FDA approval for Revolution states, “Selamectin applied topically as a single dose of 3 or 6 mg/kg was 100 percent effective in preventing the maturation of heartworms in dogs following inoculation with infective D. immitis larvae 30 or 45 days prior to treatment, and 6 mg/kg [the recommended dosage amount] was 100 percent effective in preventing maturation of heartworms following inoculation of infective larvae 60 days prior to treatment.”
Splitting pills
The issue of splitting heartworm pills comes up frequently. I have spoken to representatives from Merial (maker of Heartgard) and Novartis (maker of Interceptor). Both said that their active ingredients are mixed into their products before the pills are formed, and therefore should be evenly distributed (though they cannot guarantee this). However, both manufacturers advise against pill splitting.
Splitting pills is inexact and may result in the dog getting less or more of the medication. If you do decide to split the pills, use a pill splitter (available at any drug store) and do not try to give the minimum dosage, as you cannot be certain that your dog will get enough of the medication.
No guarantees
It is important to realize that, if you do decide to modify the way these medications are given – by splitting pills, giving pills less often than monthly, or using reduced dosages – the guarantees provided by the manufacturers will be invalidated. Under normal usage, if your dog develops a heartworm infection while on one of these heartworm preventatives, the company will pay for treatment, but this is not true if you are using the drugs other than as directed on the label.
It is important to understand the risk that heartworm infection poses to your dog. Rather than relying on unproven alternative methods of heartworm prevention, or the unreliable method of depending on your dog’s health to keep him from getting infected, all of the methods discussed above will offer you ways of safely reducing your usage of conventional heartworm preventatives, while still giving your dog complete protection from heartworm infection.
Next month, we’ll discuss treatment – what you can do if your dog’s heartworm test comes back positive.
-Mary Straus does research on canine health and nutrition topics as an avocation. She is the owner of the DogAware.com web site. She lives in the San Francisco Bay Area with her dog Piglet.
Shaping, or as it’s formally known, “shaping by successive approximations,” simply means breaking down a behavior into tiny increments, and reinforcing the dog at each incremental step until you’ve achieved the full behavior. Some trainers believe that shaping is the ultimate approach to operant training, and that any steps that stray off the pure shaping path are detrimental to ultimate results. Others incorporate shaping as I do – as a valuable part of a multi-faceted training program.
The Science Behind Behavior Shaping
The shaping process works because behavior is variable. In any series of repetitions of a behavior, your dog will give you variations in the manner that the behavior is performed – faster/slower, bigger/smaller, higher/lower, harder/softer, etc. If you wanted to shape your dog for a perfect obedience competition sit – straight, fast, and in proper heel position — you’d break the behavior known as “Sit” into those three components and work on them one at a time, capitalizing on the variability of your dog’s behavior for each one.
Perhaps you choose to start with speed. Your dog’s average sit time might be three seconds. Your goal is a one-second sit. In any given number of repetitions of “Sit,” some will be faster than three seconds, some will be slower, and some will be right on the three-second mark.
If you were to be scientific about your shaping program, you’d time the sits with a stopwatch, only click and treat (mark and reward) those that were three seconds or faster, and keep a written journal of your progress.
If you are less rigorous, you’d guesstimate the times and strive to click the faster sits. Over time, your dog’s average elapsed sit speed time would decrease, perhaps to two seconds, as he realized that only faster sits get clicked, and deliberately tried to sit faster to make you click more often.
Now you raise the bar – only sits that are two seconds or faster get clicked. By breaking your goal of fast sits into smaller increments of time, you gradually shape your dog to do that lightning-fast one-second show-ring sit that you covet.
Shaping is not just for the show ring. It has a number of important applications and benefits for all kinds of training, including:
• Accomplishing a behavior that your dog finds physically difficult or confusing, such as a teaching a Greyhound to sit.
• Encouraging your dog to perform a behavior that he finds mentally difficult or confusing, such as teaching a crate-wary dog to enter his artificial doggie den.
• Fine-tuning a behavior your dog can already do, such as teaching fast, straight, close sits.
• Helping your dog learn how to offer behaviors, try new things, and think creatively in order to solve problems, through shaping games such as 101 Things to Do With a Box (below).
Shaping Techniques
There are several ways to shape a behavior. You can use “lure/prompt shaping” as a sort of hybrid technique: you’re still showing the dog what you want him to do by luring with a treat, or prompting with a target or other body language, and reinforcing increments of progress to the final behavior.
Shaping “purists” tend to scoff at lure/prompt shaping, but it can be very effective at getting behaviors more quickly, although slower at teaching dogs to think creatively and offer behaviors freely. Dogs in basic good manners classes are often taught the “Down” with lure-shaping, by luring the dog’s nose toward the floor with a treat, clicking and rewarding as the dog makes any progress toward the floor with his nose or other body parts.
You can use “basic shaping,” where you have a goal behavior in mind and, without any prompting, reinforce small increments that the dog offers, such as described above for a faster sit. And you can “free shape” – by doing training exercises without any preconceived notion of where you want the behavior to go. Free shaping is the most difficult concept for novice trainers, who are often legitimately perplexed by the idea of training without knowing what behavior you’re trying to train.
Lure/Prompt Shaping
Greyhounds are notoriously difficult to teach to sit. Theories abound as to why this is so; one theory has to do with the Greyhound’s unique anatomy – a body shape that makes sitting an uncomfortable position. Whatever the reason, it does seem that while most dogs offer sits easily, these long, lean, muscular dogs are somewhat reluctant to do it.
To lure-shape a sit in a reluctant sitter, hold a treat at the tip of your dog’s nose and lift it up slightly. If he lifts his nose to follow the tidbit, click and treat. Repeat this step, lifting the treat slightly higher and a little bit back over the head.
When each step seems easy for the dog, progress a little farther, continuing to move the treat back over the head. At the same time, watch for a bend in the hind legs. Be sure to click the slightest bend in the hocks, and when you start getting a consistent bend in the hocks, even a small one, keep luring, but only click the leg bend, not the head lifts. Reinforce gradually deeper bends in the legs until the dog is sitting.
Why not just push the dog into a sit, or “tuck” him into a sit by pressing in gently above the hocks? Certainly, some trainers do, and teach the sit successfully in this manner. However, some dogs are reluctant to sit due to back or joint pain, and need to learn to find a way to move into a sit that doesn’t hurt; your push may cause excruciating pain.
“Lure/prompt” shaping can be used to quickly get a new behavior; however, it doesn’t require the dog to figure out for herself what exactly it is that you want.
Other dogs resent being physically manipulated. That may or may not be the reason I had a recent client whose Scottish Terrier caused serious injuries to his prior trainer when she tried to push him into a sit. He resisted her first two push-sit attempts, and on the third try went up her arm with his teeth.
But other dogs may have other reasons for failing to catch on quickly. A case in point is a shelter dog I saw in my Intern Academy last summer – a beautiful English Pointer who had been purchased for hunting trial work but disqualified from competition due to a minor congenital rib deformity. At age four, he had never been asked to sit, and just didn’t seem to understand what we were asking of him.
In fact, he was the classic example of a shut-down dog – unwilling to offer any behavior at all. It took four days of the six-day academy, but on Thursday when his trainer finally got him to sit, the whole class applauded wildly. Best of all, the dog got it! His eyes lit up, and he proudly offered sit after sit after sit. In the remaining two days of the course he and his trainer caught up on all the lessons that had been on hold while they worked on the sit, and both graduated with flying colors and big smiles.
Basic Shaping
Some trainers profess to teach their entire entry-level classes using basic shaping only. I’ll admit I’m not that brave, but we do introduce the concept of basic shaping with our “Go to Your Place” exercise. I explain to my class that shaping is a Zen exercise – it takes patience and close observation, and that we’ll be splitting behavior rather than lumping. Lumping means to reinforce large chunks of behavior – capturing a sit, for example. In contrast, splitting means to look for the tiniest piece of movement, click and reinforce that, and build toward the final behavior. Splitting is the essence of shaping.
To shape a “Go to Your Place” behavior, set out a carpet square, dog bed, or blanket to designate “Place.” You can actually do this without a physical object to mark the place, but it’s easier for canines and humans to succeed with a visual marker – and then you can generalize the behavior easily by moving the marker to another spot.
Now stand back several feet from the carpet square and watch your dog very closely. You’re going to click and treat the tiniest motion toward “Place” – one step, a turn of the head, a flick of the ear … it doesn’t even have to be directly toward the spot – “in the general direction” will do.
If you’ve already reinforced your dog consistently for offered behaviors, he’ll probably catch on quickly. As he starts repeatedly making deliberate movements toward the rug to get clicked, you’ll hold out slightly longer to build more behavior. Just slightly! You want him to get a little frustrated and try harder (harder = bigger behavior), but if you hold out too long he may give up and quit offering behavior altogether.
As he gets closer to the mat you can move forward with him in order to keep delivering treats – but not ahead of him – that would be luring or prompting!
When he’s reached the mat, reset. Move yourself and your dog several feet back and start again. The goal is to shape him to go to the mat, not just to be on the mat. When he offers to go to the mat easily, start shaping him to lie down on it. The value of this exercise is to be able to park your dog there for a while. When he’s consistently offering to go lie down on his mat, you can add the verbal “Go to Your Place!” cue.
If your dog doesn’t offer behaviors easily, it may take longer to shape the Place behavior. Be patient, and remember to split – look for the tiniest of movement to reinforce. If he wants only to gaze adoringly into your eyes, look at the rug instead of him. If he just lies down at your feet for a snooze, invite him back to his feet, reposition him, and look for movement to reinforce as he repositions. The more you can find to reinforce, the less likely he is to lie down for another nap.
Dedicated shapers may write out their complete shaping plan, considering each potential step in the process, and measuring their progress against the written plan. Less scientifically disciplined trainers may work with just a mental picture of their shaping plan. You can do each shaping session for as long or as short as you like. Assuming your dog is happy to play the game, you can keep on playing! As with all training, try to end the session while your dog is still enthusiastic and successful.
Dubhy’s Picnic
Every piece of furniture is now a potential prop for Dubhy!
I decided to shape Dubhy to flip open a picnic basket with his nose. I could have used pure basic shaping, in which case the steps in our shaping plan might have looked something like the one below. Because I’m doing basic shaping with a behavior goal in mind, not free shaping, I wouldn’t click random offered behaviors that aren’t in the shaping plan.
Note that I would click and treat several times at each step, unless, of course, Dubhy took a quantum leap over several steps, in which case I’d be prepared to leap with him.
1. Looks at basket 2. Moves toward basket 3. Sniffs basket 4. Sniffs basket closer to basket lid corner where opening is 5. Sniffs basket at basket lid corner 6. Nudges lid corner (here I might need to hold out to wait for stronger behavior to get the nudge) 7. Nudges lid corner harder 8. Nudges hard enough to move lid corner 9. Nudges hard enough to lift up lid corner 10. Nudges hard enough to lift lid corner higher 11. Nudges hard enough to flip lid open
When I put my plan into action and began training Dubhy to flip open the basket, I chose to take a shortcut and do a little prompting with a target stick. That allowed us to skip steps 1-4 and go directly to step 5, sniffing the basket lid corner. From there, it only took a few minutes for Dubhy to repeatedly offer a strong, reliable “open the basket” behavior.
Now that we have reliability with the goal behavior of opening the basket, I could incorporate it into a trick routine – perhaps packing picnic supplies into the basket, or unpacking them and laying them out on a waiting picnic blanket. Or perhaps he could find a small “lost” dog who was trained to lie quietly hidden in the basket. Or…?
Free Shaping
Free shaping is great for encouraging a dog who is somewhat shut down to offer behaviors, because he can’t be wrong. Anything he does that even remotely relates to the exercise gets clicked and treated. Once the dog is easily offering random behaviors, then you can, if you choose, switch to basic shaping with a goal behavior. Here are a couple of free shaping exercises you can experiment with:
Every move is a winning one when playing “101 Things to Do With a Box.”
101 Things to Do With a Box – You can use any old cardboard box for this, or it doesn’t even have to be a box! You can play “101 Things to Do With Anything.”
Your dog can be on leash, or off, if he’ll stay and keep working with you. Set a chair a few feet back from the box or object, sit in the chair, and wait. As with the “Place” exercise, you’re looking for tiny pieces of behavior to click and treat – any behavior that relates to the box – a look, a step, a sniff, a push … only this time you have no specific goal in mind, and you don’t have to build up to a behavior – random behaviors are fine.
If your dog gets hung up on one particular behavior you can stop clicking that one and wait for something else. The more confident your dog is about offering behaviors, the more easily you can just quit clicking one thing and wait for another. At some point, if you wish, you can decide on a goal behavior based on the ones your dog has offered, and shape it into something specific – front feet only in the box; hind feet only in the box; all four feet in the box; turn the box over; fetch the box; or…?
Body Parts – Body Parts shaping helps your dog learn to offer behavior, and it also helps you realize how precise this process can be for shaping the tiniest of movements.
Sit in a chair with your dog facing you, and watch your dog closely for a movement in one of his body parts. Even a tiny movement will do. For example, you could watch for a flick of his ear, a turn of his head, the lift of a paw, or a tongue flicker.
This dog is learning to flick a light switch. At first, she’s rewarded for merely sniffing or licking it. Next she’ll have to actually flick the switch before she gets a treat.
When you have captured one of these movements with your click and treat, that’s the one you’ll continue to focus on. Sit and wait for another movement of that same body part. Click and treat. Your goal is to reinforce that accidental behavior until your dog begins deliberately offering it. When he does, you can name it, incorporate it into a trick routine, or keep working with it to shape it into something bigger if you choose.
I really came to appreciate the power of shaping when I first purchased agility equipment, set it up in the backyard, and ran to get Dubhy, to see what he’d do with it. To my delight, as I introduced him to each piece of equipment, he immediately started doing stuff – sniffing it, pawing at it, biting it, jumping on it, just trying out different things to see what he needed to do to get me to click. Made training a breeze!
Karen Pryor’s 10 Laws of Shaping
In her landmark book, Don’t Shoot the Dog, behavioral biologist and past dolphin trainer Karen Pryor says, “…a well-planned shaping program can minimize the required drilling and can make every moment of practice count, thus speeding up progress tremendously.” She also tells us that the successful application of shaping principles makes the difference between shaping that is frustrating, slow, boring, and disagreeable, and shaping that is happy, fast, and successful.
Here are the 10 principles that Pryor suggests you follow for the most enjoyable and successful training:
1. Raise criteria in increments small enough that the subject always has a realistic chance for reinforcement.
2. Train one aspect of any particular behavior at a time; don’t try to shape for two criteria simultaneously.
3. During shaping, put the current level of response onto a variable schedule of reinforcement before adding or raising the criteria.
4. When introducing a new criterion, or aspect of the behavioral skill, temporarily relax the old ones.
5. Stay ahead of your subject. Plan your shaping program completely so that if the subject makes sudden progress, you are aware of what to reinforce next.
6. Don’t change trainers in midstream; you can have several trainers per trainee, but stick to one shaper per behavior.
7. If one shaping procedure is not eliciting progress, find another; there are as many ways to get behavior as there are trainers to think them up.
8. Don’t interrupt a training session gratuitously; that constitutes punishment. (Author’s note: For example, you’re in the middle of training and the phone rings. You drop what you’re doing and run to answer the phone. This is “negative punishment,” because the dog may perceive that whatever he did made a good thing [you/ training] go away. Instead, take time to gracefully end what you’re doing with the dog to attend to an interruption. I use an “all done” cue that lets the dog know the training session is over.)
9. If behavior deteriorates, “go back to kindergarten.” Quickly review the whole shaping process with a series of easily earned reinforces.
10. End each session on a high note, if possible, but in any case quit while you’re ahead.
I’ve had a number of older owners book lessons with me lately—more than half a dozen individuals and couples in their 70s and even 80s, all wanting some training help with their new dogs or puppies.
