Addison's Disease: Owner's perspective

 In the grand scheme of things, there are certainly worse things than a diagnosis of Addison's Disease.

The period of time between your dog getting sick and being diagnosed can be very scary, indeed.  The symptoms of Addison's Disease (AD) can mirror that of so many other things -- things like cancer, tumors, liver failure, etc. -- all of which, in the long run, are far worse than AD.

Because this is a disease that your dog will have for the rest of its life, it is very important for the owner of an A-dog to become very educated about this disease and its treatment.  The good news is that modern medicine has made this a very treatable disease!  Once properly medicated, an A-dog can go on to live a completely normal life.  My dog, Luke, has earned five Championship titles in agility since being diagnosed in 2009!

The key to living well with AD is to work with your veterinarian to find the proper dose of medication for your dog.  There are two widely accepted forms of medications for dogs with AD. One is a daily dose of pills called Florinef.  Florinef contains a steroid component and thus no other medication is required.  Some dogs do very well on Florinef, although the consensus among the A-dog community is that most dogs end up needing higher and higher doses as they continue with treatment.  Sometimes this leads to the dog receiving too much of the steroid component, which can cause problems.  Those dogs ultimately tend to end up switching to alternate treatments.

My vet and I decided that the better option for my dog, Luke, would be Percorten-V, which is a shot that I give him every four weeks.  In addition, I must give him a small amount of Prednisone daily to make up for the cortisol that his body is no longer producing.  Luke gets 1.25mg per day, which is pretty miniscule.  In times of stress it is often helpful for the owner to up the amount of steroids given and this will vary by dog.  I have never come across a situation where my dog needs additional Prednisone.  Agility trials are happy stress for him, but he does fine on his usual dose.  Staying in a boarding kennel might be one situation where additional Prednisone is recommended.

Owners of dogs with AD can expect to become good friends with their veterinarians, as it will require frequent visits until the magic dose is found.  Once diagnosed and given the first dose of medication, generally you will return for weekly blood tests to make sure things are progressing as they should.  In these blood draws, we are checking the dog's electrolyte levels, always aiming for a happy range of Sodium (NA) and Potassium (K) levels.  These levels vary depending on your vet's machine, but we shoot for a ratio between 27-40.

When the blood tests reveal that the K is starting to rise and the NA is starting to drop, it's time for another shot of Percorten (or to give higher doses of Florinef).  Ideally you are hoping for this to happen within a range of 4-5 weeks.  Often times dogs are grossly overmedicated (per label directions) with Percorten and I've heard of some owners going three to four months before their dog is ready for another shot.  The negative aspect of this is that these overmedicated dogs often do not start to feel like themselves again until their levels start to balance out again, so the more we can avoid overmedicating, the better!  Finding the perfect balance of dose & duration is something that can take a bit of time, and until you settle on that sweet spot you will be making regular trips in for blood work.

Once you get there, though, life is pretty easy!  You graduate to doing blood tests quarterly, bi-yearly and then yearly at your dog's annual physical.  I write the date of my dog's next shot on my fridge and give him Prednisone every morning with his other supplements.  Aside from that, I don't do anything differently for Luke than my other dogs.  I do watch him closely, though, and I don't hesitate to take him into the vet for blood work if he seems to be feeling punky.  While most dogs settle on a single dose for Percorten and are fine there for life, sometimes there are dogs who will need adjustments later on.

There is a fantastic support group on Yahoo groups that I cannot recommend enough: http://pets.groups.yahoo.com/group/AddisonDogs_    Most of what I know, I learned from that great group of people.  It is moderated by owners of other A-dogs who have years of experience in treating this disease.  There are even a couple of respected veterinarians who make appearances (most notably, Dr. Nancy Kay, author of "Speaking for Spot" and also Dr. Julia Bates, known for being one of the first veterinarians to do a study on starting with lower doses of Percorten).  Often times owners of newly diagnosed A-dogs can feel tremendously overwhelmed.  Having a support network of other A-dog owners is invaluable and also helps those who unfortunately are dealing with veterinarians who are not well educated about the disease or its treatment.

It costs me approximately $40/month to treat Luke for Addison's Disease.  It is a paltry sum for the quality time I get to continue to spend with my dog!   :o)

Karissa

Addison's Disease

Also known as hypoadrenocorticism, Addison's is a disease characterized by a decrease in certain substances produced by the adrenal glands.

That makes the adrenal glands a good place to start.  The adrenal glands are very small glands associated with each kidney.  Normally you don't even notice them during abdominal surgery.  There are two parts to the adrenal gland, the medulla and the cortex.  The medulla is responsible for producing catecholamines like epinephrine.  The cortex is further divided into three zones, the glomerulosa, fasciculata, and reticularis.  The glomerulosa produces mineralcorticoids or aldosterone.  Mineralcorticoids control electrolytes and water balance.  The fasciculata produces glucocorticoids or cortisol.  Cortisol affects glucose, protein and fat metabolism.

Now, about the actual disease.  There are two types of Addison's-primary and secondary.  By far, primary is the most common form and is an idiopathic, immune-mediated destruction of the glomerulosa and fasciculata resulting in decreased production of mineralcorticoids and glucocorticoids.  The mineralcorticoid deficiency results in hypovolemia (dehydration and shock), decreased blood flow to the kidneys and decreased cardiac output (lowered circulatory ability).  The glucocorticoid deficiency results in GI signs such as anorexia and vomiting as well as lethargy.  Because glucocorticoids also help the body deal with stress, clinical signs may only show during stressful times in the pet's life in the early course of the disease.  Typical presentations include changes in mentation, lethargy, weight loss, weakness, anorexia, vomiting, dehydration, slow heart rate, increased thirst and urination and sometimes an episodic or waxing and waning course of disease.  Common labwork abnormalities include electrolyte imbalances ( increased potassium and decreased sodium), elevated kidney values, and mild anemia.  Unfortunately any combination of these symptoms and abnormalities can also be suggestive of other, more common disease such related to the GI system, urinary tract or even liver.  The fact that Addison's can imitate so many other diseases coupled with it's rarity can make it a diagnostic challenge and a disease that can sometimes be overlooked. This is particularly problematic because the dog will often respond will and stabilize with symptomatic therapy but crash again  later-recurrent events should be a red flag! Additional diagnostics include an ECG to check for abnormalities related to increased Potassium and imaging such as radiographs and ultrasound.  These may be suggestive of, but not diagnostic for Addison's.

To make a definitive diagnosis an ACTH stim test is performed.  ACTH is a hormone produced by the pituitary gland in the brain that stimulates the adrenal gland to produce more cortisol.  To perform the test you administer synthetic ACTH to force the adrenal gland to ramp up production.  But since that part of the gland is not functioning in Addisonian dogs, there is no response and cortisol levels remain low.

Immediate treatment for Addison's disease (assuming the dog has presented in crisis) is IV fluid therapy with appropriately balanced electrolytes and replacement of glucocorticoids.  Once stable there are two choices in treatments.  The first one is Florinef tablets (fludrocortisone acetate).  Some dogs do not respond well to this treatment and some develop undesired side effects at levels that adequately control the disease.  The better option is injections of Percorten (desoxycorticosterone pivalate or DOCP) which replaces the mineralcorticoids.  These injections are usually given in 25-28 day intervals and the owner can be shown how to give them at home if desired.  Prednisone is given in small doses to replace the glucocorticoid deficiency.  Sometimes, the amount of prednisone needs to be increased during stressful situations.

Follow up therapy involves checking electrolytes in specified intervals after the Percorten injections.  This will be more frequent at first until the desired dose for the individual dog is reached.  There are a variety of maintenance and monitoring protocols I have found and I won't even begin to speculate on which one is the "best" as I have never even diagnosed a case of Addison's!

Addison's is most common in middle age female dogs with no significant breed predilections. The prognosis for Addison's, once diagnosed and stable, is excellent although lifelong treatment is required.  Addison's is rare in cats.  Tomorrow we will have a special guest post from Karissa of Secret's Journey.  She will share her experiences as an owner of an Addisonian agility dog.

Spay Day

Spay Day is an annual event held by many shelters and humane organizations around the country to raise awareness about spaying/neutering or offer low cost spay/neuter services for pets that would otherwise not be altered.

Today was the day the clinic I help with decided to hold their event.  It is usually held in February but last year I guess so many of the cats (we only do cats on spay day) showed up pregnant that they decided to do it earlier.

So, we had a marathon of cat spays and neuters today.   This was my first time doing that many so it was a bit of an adventure.  It would be one thing if we spread them out over a normal work day, took a lunch break etc, but we needed them all awake in time to go home this afternoon.  This meant it was pretty much nonstop work.  There were typically 2-3 animals being prepped and waiting for me as I worked on the current surgery.  Just by chance we ended up with 15 males and 15 females.  We started with the females so we could finish with the easy ones.  I've got to say, by about #13 I was getting pretty tired and my hands were not quite as steady as when I started out.  Then two of the males turned out to be females and one was already neutered.  So 29 surgeries in all!  We finished in under 5 hours though which equates to about 6 cats an hour.

And while this was personally a satisfying way to spend the morning, it was also rather financially satisfying so we took a quick trip to the local outlet mall.  Although we did manage to leave with only a few t-shirts and socks so I got to take most of my check home!

Now resting up for a 9-10 mile run tomorrow.  My dogs may never get trained again at this rate!

Chew toys

I had a request to post about "safe" things for dogs to chew on.  Generally speaking, there is no such thing.  Sorry for the bad news.  End of post.

Just kidding.  It's true about the lack of truly safe toys, especially for aggressive chewers but I will elaborate on why and what is is better.

So what makes an object unsafe?  Basically if an object of soft enough not to break teeth it's soft enough to be chewed into pieces and swallowed possibly causing a foreign body.  It they can't chew it up then it's probably hard enough to break teeth.

Most commonly the tooth that breaks is the upper fourth premolar.  This is one of the largest teeth in the mouth and is labeled Carnassial tooth in the diagram.  When chewing on hard objects this tooth will frequently suffer a "slab" fracture where a slab of the tooth gets knocked off.  Best case scenario this is a superficial fracture that does not penetrate into the pulp cavity (where the nerve and blood vessels are) and is not a painful injury.

Worst case scenario is a deeper fracture which leaves a hole into the pulp cavity.  Not only does this cause pain (although dog may not act painful) but it allows a route for bacteria to invade and cause infection and tooth root abscesses.  A fracture such as this requires extraction or root canal therapy.  No one wants their pet to have a chronic toothache, surgery or go the expense of treatment!  Here is a picture of a slab fracture.

Ok.  So what does this all mean?  Lets start with rawhides.  I think rawhides are kind of medium hardness and get asked about them all the time.  I advise people that while there is a risk of tooth fracture it is fairly small compared to other objects.  I also tell them never to let the dogs have rawhide unattended as they can try to swallow a piece whole resulting in choking or foreign body.  I give my own dogs rawhides but usually choose the rolled ones-they seem somewhat durable but not as hard as the big knotted bones.  They also don't seem as prone to try swallowing the ends.

Up next, Nylabones.  These are one the veterinary dentist "don't" list and are apparently one of the top causes of fractured teeth.  Like rawhides though these come in varying hardnesses so in theory you could pick a softer one if you were worried.  However, I also give these to my dogs.  It has been some of the best money I have spent over the years!  Zodiac and Holli are chewing them as I write this.  I cringe a little when I see them really chomping down on the big one but I acknowledge the risk and am willing to pull the tooth or pay for the root canal.  I check the teeth often and so far we have not had a chewing accident.

Other items on the doggie dentist no-no list are cow hooves and natural bones.  Cow hooves are just plain hard.  Bones have a whole host of problems associated with them including fractured teeth, foreign bodies, and GI upset depending on the type, size, and cooked or raw status of the bones.

Deer antlers are also on the list of things hard enough to break teeth but I have no personal experience with those.

Another reasonable choice for chewing are the product usually referred to as "bully sticks."  These seem to be  chewy enough to last awhile but not hard enough to break teeth.  They also don't seem to chew chunks off and try to swallow them since they do get kind of stringy/chewy.

My favorite recommendation for a safe chew toy is the Kong. While there are some dogs that will chew up and ingest a Kong they are still great toys for the majority of dogs.  Always choose one the right size and toughness for your dog and watch them at first to see if they are aggressive enough to destroy it.  While there are other tough rubber toys that can be used for chewing the Kong is stuffable to make it enticing (dogs don't seem to like rubber much).  I like peanut butter for a quick fix but if you need your dog entertained for a longer period of time or have an aggressive chewer you can stuff it full of canned food and freeze it into a Kongcicle!  This is great because you can tailor it to your dog's dietary needs.  Plus they don't stain carpet or leave crusty rawhide goo on your dog's feet.

So that's best rundown I can give on safe and not-safe chew toys.  Basically use your best judgement for your dog and be prepared to handle a fracture or other issue if it arises.  Also one of the veterinary dentists recommends the "knee-cap rule" if you are concerned about dental damage.  Basically if you wouldn't want to bang it into your knee cap it's not something you should give your dog to chew on.

Running buddy

I decided to take Legend with us on our run yesterday.  Don't worry-I didn't plan, nor expect her to run the whole nine miles with us!  But I did want to see 1) if she would like it and 2) how she would behave.  Oreo used to love running with me, Zodiac not so much.

Well I'm pleased to report that not only did she seem to enjoy it but she was very well behaved!  Typically when I try to walk or hike with her on leash she is straining at the end of the lead, running all over trying to look at stuff and sniff and play.  But the pace seemed to suit her and she trotted along on a nice loose lead the whole time.  I put her pack in the car after 3 miles.  She was starting to lag a bit and I didn't want to  overdo it.  Although she was totally rejuvenated by the time we finished so I probably should have got her out for the last few miles!

Anyway I do see more running in her future as the weather warms up and we get more outdoor runs in.  It's probably good for her to build up some additional endurance anyway.

Around here

I didn't want to bore you with all the details of our life lately since not much has been going on but here is a quick summary.

Not much agility going on.  Since we don't have much coming up in the way of trials we are only training on days that the weather seems acceptable.  My definition of acceptable is probably different from that of my northern friends but nonetheless everyone has a standard!  We have not had many nice days lately that have corresponded with days I have been home.  I've been trying to work a lot lately to save up for vacations, home improvements and the tremendous amount of taxes we usually owe.

Also, my half-marathon training takes a good portion of my free time.  I'm up to about 20 miles a week and today we are heading out on a nine mile run.  We are also planning to book our flights today and have paid our entry fees so there is no turning back now.  This is the race we have chosen-it looks really pretty.  And as a special treat our moms are going with us to cheer us on-it is Mother' day weekend after all.

We had an adopter for Holli, but that fell through at the last minute so she is still here waiting for her forever home.  But I'm pleased to announce she does seem house-broken now.  I wouldn't leave her loose unattended all day or all night but she has not had an accident in over a month and I no longer need to take her out every 20 minutes!

I still have made no decision on the obedience thing.

I am in the midst of deep cleaning my house room by room.  This is mostly a hair and dust eradication project.  I'm glad to be done with three rooms but they were sort of easy.  Debating on starting another or just killing time until I have to go run.

So that's what's been going on here.  Not too exciting.  And it's not likely to get much more exciting for another 6 weeks or so.  If anyone has veterinary topics they would like covered feel free to suggest!

Stupidity pays the bills

It was surprisingly quiet Monday afternoon.  That should have been a sign.  All of a sudden it went from quiet to kind of chaotic with two emergencies back to back.  Not that the owners really seemed to think they were emergencies.

I took the first dog.  The appointment was made for possible UTI.  An older, unspayed, small breed dog was presented by two young girls.  They were not sure of the dog's age or vaccination history.  I didn't bother to ask about heartworm prevention.  They indicated that the dog was drinking excessively, not eating for a week and having occasional vomiting.  She was also having bloody vaginal discharge and was in heat a few weeks ago then started acting funny.  That history, along with the presence of a large fluid filled organ in the abdomen made me suspicious of a pyometra (basically a pus filled uterus that can be a life threatening emergency).  Bloodwork and  radiographs confirmed our suspicions and off to surgery we went.  Congratulations, you just had your dog spayed for more than three times the normal cost.

My employer took number two which was an underfed, overly pregnant large breed dog.  Presenting complaint was possible labor with no puppies produced for several hours.  Owner just wanted her "checked out."  Off to surgery that one went.  This is the second c-section this dog has required in her young life.  Personally, I feel every dog that needs a c-section should be spayed but not all doctors feel that way.  It's probably more of an ethical debate than a medical one but that's for another day maybe.  I should also mention these owners provide only minimal preventive care for their dogs and there was no sign of any OFA or other genetic testing in their file.  And as it turns out this time the dog had been accidently bred by the neighbor dog but they failed to have her spayed after the incident because they still wanted to raise another purebred litter from her!  Congratulations, you just contributed 16 (Yes-16!) puppies to the pet overpopulation and put your dog through a significant ordeal because of your greed and irresponsibility.  Not to mention the 13 puppies of questionable quality from the previous litter.  Fortunately they did elect to spay her this time.

Idiots like this drive me crazy but they do make a slow day more profitable! Of course I don't own the business, which might be good as I could possibly run off all the idiots and go bankrupt!

Fostering

Lots of people ask or assume with every foster dog that we will keep him or her.  They also frequently comment that they could never foster because they would get too attached.  I thought I would share some of my fostering secrets as well a little about the fostering experience so hopefully some of you will try it too.

First, never consider keeping the dog as an option.  Realize the dog belongs to the rescue and not to you-consider it more like pet sitting for a friend.  That's probably the most generalized way to keep from getting attached.  For us we have a three dog limit.  Plus I typically have a very specific dog in mind when I am looking for our next dog.  Most of the time the foster dog does not meet that criteria.  I tend to only foster dogs that meet that criteria when I am actually looking for a dog-hence Zodiac and Lyric.  Also I do dog sports with my dogs and time and money limit how many dogs I can reasonably deal with in that regard!

Many rescues or shelters will work with you on what kind of pet they place with you.  Foster homes are hard to get so one that is limited to a certain age, sex, etc is better than nothing.  They will usually also take into account your training experience and lifestyle to get you an appropriate foster pet.  Many rescues don't take in pets with aggression problems due to the safety of the foster family and their pets and the liability of adopting these animals out so this is usually not a concern.

Most rescues provide medical care but the ones I have worked with did ask the foster home to provide food for the pet.  One rescue we worked with provided an appropriate sized crate for us to use as well.  As a foster home our general responsibilities include crate and house-training, basic obedience and manners, using any opportunity we have to socialize the pets with other people and animals and evaluating the dog for tempermant and personality so we can write a bio.  We also try to get good picture to post on the website.  Different rescues will have different rules but I'm guessing most are pretty similar.

When choosing a rescue you could choose a breed rescue you are interested in, an overflowing local shelter or other group.  Possibilities are endless.  Personally I would choose a rescue that actively promotes their dogs-typically this means via website and petfinder as many people look for adoptable pets online  You want to make sure  you don't get "stuck" with a dog forever that isn't being advertised.  I also choose rescues that thoroughly screen the new owners.  I don't want to invest time, money and emotion into a pet that will end up being left tied to a tree with no medical care the rest of it's life.  Time of fostering can vary widely but is typically 3 weeks to 3 months.

Personally, I think there are lots of benefits to fostering.  Seeing a dog taken from a bad situation and ending up in a home that loves and adores him or her is a great feeling.  Watching the dog learn to love, trust, play and enjoy life is truly rewarding.  Fostering for an all breed rescue gave us the opportunity to live with all different types of dogs. Although most were dogs we would never normally choose for ourself it was still fun to have different ones around.  If you choose to foster puppies you can get a permanent "puppy fix." Watching them play with toys and  our other dogs can provide hours of free entertainment as well.  But  mostly, you are giving a dog a chance to have a great life when he otherwise wouldn't have.

However, be prepared for potty accidents, a few sleepless night of crate screaming and all the other stuff that goes along with adding a new dog to the household.  Sometimes it goes smoother than others but usually there are at least a few days of adjustment depending on the dog and the home situation.

I would recommend everyone give fostering a try.  Even if you  have never adopted a dog and never plan to, it's one way to help homeless animals without making a lifelong commitment.  And it can help you see how wonderful rescue dogs can be-if you didn't already know!

Before you choose a group to volunteer for these are the things I would ask

Who is responsible for vet bills, heartworm, flea prevention and food?
Are crates provided?
Who is responsible for transportation to vet visits?
Who takes dogs to meet potential adopters, do they only meet the dog after they have been approved, and who handles the actual adoption process?
How are adopters screened/what is the process?
How are the dogs promoted/advertised?
Are there any restrictions such as can the dog be boarded or traveled with?
What are the expectations as far as training/socialization?

Guess the breed

About 11 years ago my dad was at Wal-mart and saw a guy giving away puppies in the parking lot.  Much to the surprise of the rest of our family he was unable to return home without one.

This is Gus.  We don't really know what he is but the guy mentioned something about the mother being Rottweiler and Great Pyrenees.  He weighs about 100 lbs and has double hind dewclaws.  So what do you think he might be?

Holli Goes Herding

We took Holli to meet the sheep today.  She did show interest but the conclusion was, although she might herd someday, she is not quite mature enough yet.  But here is a clip which nicely concludes with her taking a pee break in the sheep pen.

And here is what she did most of the rest of the afternoon

That did not go well

Legend did pretty well at the last obedience trial. We still have a lot of work to do but I thought we were definitely making progress.  I was actually kind of hopeful she might Q this weekend.

Well, not so much.  It was awful.  I think we only passed three exercises and one was the down stay.  And the heeling was passable but not in the way I would have liked.  Generally she acted like I regularly beat her and even reverted back to the walking on the broad jump behavior.

I realize a large part of this is my fault.  I have not committed to obedience the way I have agility.  I don't know what started the stress in the first place (story of everyone's life right?) but now I really need to decide what to do.  I either need to commit to retraining and "fix" some stuff and actually do a lot of proofing or just move on and focus on agility.  Problem is, there are lots of things I like about obedience.  I just don't like them as much as agility. It's times like this I kind of wish I only had one dog.  Then I could spend all my time and money working that dog in all sports.  But I have three dogs, two still working.  I was actually contemplating working on a CD with Lyric-she could use some improved obedience skills.  But then that's two dogs working in two sports.  Lots of time involved in that.  But maybe over the winter we will work on some indoor stuff on the days we can't do agility.  Then we can see where we are later in the year.  I definitely won't be entering any obedience trials for awhile.  Actually we are not even going back tomorrow.  I don't want to wait until 3PM to show, have a miserable time and then get home late.  With any luck I can get home in time to take Holli out for a herding instinct test.  Sounds more fun.

Patella Luxation

This is a very common orthopedic disease of small dogs, although it can occur in dogs of any size.  Toy poodles, Yorkies, Pomeranians, Chihuahuas, and Boston Terriers are some of the most commonly affected breeds. The patella, or knee cap, normally sits in a groove along the front of the knee joint, but in some dogs the groove is not deep enough and the knee cap slips out of place.  Most of the time the patella will luxate towards the inside of the leg, known as medial patella luxation (MPL).  Sometimes it will luxate laterally, or towards the outside of the leg.  Lateral luxation is more likely to occur in a larger dog.

Mildly affected dogs will frequently have few to no clinical signs.  Often this is an incidental finding on physical exam that the owner was unaware of.  The classic clinical sign is a dog who is suddenly lame and carrying a leg, only to seemingly be magically cured after a few steps.  What happens is the patella suddenly slips out causing difficulty straightening the leg due to the tendons becoming displaced.  Once the patella slips back in the dog can ambulate normally again.

Patella luxation has varying degrees of severity and is graded on scale of 1-4.  A grade 1 luxation can be manually luxated but will pop back into place when the pressure is released.  A grade 2 luxation can be manually luxated but stays out of place  when pressure is released.  In a grade 3 luxation the patella is out most of the time but can be pushed back into place.  In a grade 4 luxation the patella is permanently out of place and can't be pushed back in.

Although the actual act of luxating isn't very painful, over time repeated luxation and misalignment can cause arthritis and malformation of the leg bones.  So, what to do?  There are several surgeries that will correct this malformation but surgery is not a blanket recommendation for all affected dogs.  Most dogs with grade 1 and 2 luxations will go on to live their life with minimal issues.  The occasional flare-up can be treated with rest and anti-inflammatories on an as needed basis.  Joint supplements such as glucosamine and chondroitin can also help.  Dogs with persistent lameness or those with severe luxations are candidates for surgery so that the deformity can be corrected before causing secondary issues.

This disease does have a genetic component and affected dogs, even if non-clinical and mild should not be used for breeding.  Half of all affected dogs will have bilateral involvement, but the grades can be different on each side.  In my experience large breed dogs are more likely to have clinical lameness than small breed dogs-but that is generally true of most orthopedic diseases.  Cats can also have patella luxations but rarely show clinical signs.

If you are curious, yes, Lyric does have bilateral grade 2 luxations.  She is rarely bothered by them-when they pop out she is able to stretch her leg in such a way as to pop them back in and has never limped.  One of the well-known orthopedic surgeons who taught me in school recommended I not pursue repair as long as she is not bothered by them, even as an agility dog.  Any surgery involving a joint will induce arthritis so you always need to weigh how much arthritis a dog will get if surgery is not pursued, as this can vary with individual dogs and various conditions.  I do keep her, and my other dogs, on a glucosamine/chondroitin supplement.

Distance work

You're probably thinking this is an agility post.  Well, it's not.  The dogs are not the only ones doing distance work these days.  I mentioned in my 2011 summary post I'd be running a half-marathon in 2012.  See, my friend is having, shall we say, a significant birthday this year.  She wanted to do something special, so rather than just run another 5K, or even a 10K she decided on a half-marathon.  In May. The trade-off is that she has relatives near Santa Barbara that will let us use their beach house.  So we get to run our half-marathon through scenic wine country and then spend two days basking in the California sunshine.  Fair enough right?

Anyway to prepare I have been running 4-5 days a week and making my long run a little longer every week.  I have been pleasantly surprised that adding another 1/2 mile each week has not been overwhelmingly difficult.  I definitely feel tired towards the end with my legs alternately feeling like lead or just numb but it's not until I actually stop running that all the exhaustion really sets in.  Then I feel a little bit like I want to die.  But I'm up to 8 miles and still doing ok.  That's the furthest I've ever run, even further than I ever ran in high school cross country training.

Also I tend to crave extremely unhealthy foods after my long runs.  Ben and Jerry's ice cream, McDonald's fries, you name it-and if I've run more than 5 miles that day....I WANT IT!  Which seems somewhat counterproductive.  So I'm having a salad for lunch tomorrow.  That works right?  Anyway, wish me luck.

Geriatric Vestibular Disease

Also known as Idiopathic Vestibular Syndrome, this can be a very scary disease when you don't know what is happening.  Hopefully by writing this some of you will be prepared if it happens to your pet and won't panic!

So that's a pretty long, fancy name right?  But it really doesn't mean much.  Geriatric obviously means old, idiopathic means we don't know the cause and vestibular has to do with the balance system.  This is essentially a disease of older dogs that causes dizziness and ataxia (off-balance) for no apparent reason.

Most dogs affected are older than 8, but it seems like the dogs I have seen with this condition are significantly older than that, often at least 12 years old.  It is most common in medium to larger dogs with all breeds and both sexes affected equally.  Other than being older, there appear to be no predisposing factors.

The onset is typically very sudden and can be very profound.  Classical presentation is a dog with a head tilt, ataxia with falling, leaning, or circling to the side of the head tilt, horizontal nystagmus (back and forth eye movements), vomiting and nausea.  The dogs may be unwilling to stand and walk due to the effect of motion sickness but they are able to walk.  Reflexes and strength remain normal.  Many owners (and some veterinarians) will misdiagnose this condition as a stroke or sometimes a seizure.  Because there is suddenly something very wrong with their very old animal most owners fear the worst and arrive at the vet clinic in tears and prepared to say their good-byes.

But this is a good news disease!  And actually a great disease for the vet because is makes them look a hero when after a brief exam they get to announce that your pet will likely be fine in a few days!  Although we don't know what causes it, this disease usually runs it's course over a few days to a few weeks.  Dogs are usually significantly better in 72 hours with a full recovery in a few weeks  Although at least a partial head tilt may remain for life.  Relapses occur occasionally.

I typically recommend some baseline bloodwork to check for other underlying conditions but if an owner is on a budget this is not a mandatory part of diagnosis or treatment.  Treatment is supportive with appropriate medications to fight the nausea and motion sickness and ensuring adequate food and water intake.  IV fluids may be necessary in severe cases as well as assistance when walking or going out to urinate and defecate.

If signs are not improving over a few days or are progressive then advanced diagnostics such as CT or MRI may be needed to look for a brain lesion.  Although brain lesions usually present with different or additional signs than vestibular cases.  I have diagnosed this a handful of times and none of those cases turned out to be a brain tumor or other disease with a poor prognosis.

Inner or middle ear infection can also be a differential but this can usually be ruled out with history and examination.

As a side note true stroke in dogs is rare but you can read about it here.

This condition can also occur in cats but is quite rare.  I think I have yet to diagnose this is a feline.

The Doodle Dilemma

I have a pet peeve.  Ok, multiple.  But one of my biggest is the deliberate breeding of mixed breed dogs.  Now, I don't have anything against mixed breed dogs.  Best dog I ever had was a mix.  And I will likely have one again.  I also realize that most or all breeds of dogs we have today are some mixture of ancestral breeds put together to create a certain type of dog that eventually became a new breed.  The difference is that most of those breeds were created to do something-hunt, herd, retrieve, guard, pull sleds, whatever.  The "breeds" people are creating today in large part don't do anything specific.  By and large most of the "designer" dogs created today are just pets.  And yes, I realize some of the current breeds we have now are also just lap dogs but we have plenty of those and hopefully breeders who are working to correct all the health problems that run rampant in some of those breeds

These designer dogs are literally no different than all the mixed breed dogs in the shelter.  So I absolutely fail to understand why people continue to purchase them.  I can see a person going to a reputable breeder and paying large sums of money for a healthy dog who was bred to perform some task.  If you need a working dog of some sort-herding, hunting, whatever then that's reasonable.  But why on earth would you pay big bucks for a yorkie-poo?  What is it exactly that you are paying for?  It's not health I'm guessing.  I'm obviously no breeder but I would think that any quality breeder of any breed would not be crossing their quality dogs with other breeds.  So that means all the indiscriminate breeders and puppy mills are producing mixed breed puppies with the same problems as their purebred parents (luxating patellas, underbites, hernias and so on).  And they can't be paying for a certain look because there is no standard for a mixed breed dog.  Again these are largely mixed breed lap dogs dozens of which can be found at the local shelter.

I don't know if people just don't realize this or don't care, but either way buying one of these dogs continues to support puppy producers who are contributing to the pet overpopulation.  At least in my opinion.

I also don't understand when a litter of whatever-poos or some similar cross comes in to have their tails docked.  I am very close to refusing to dock tails of any breed but absolutely won't dock the tail of any mixed breed dog for a non-medical reason.

That's all for now. Thanks for listening!

Changing vaccine protocols

Or alternatively, how the last generation of veterinarians messed up.  

Vaccines are great, they save lives, keep pets and in some instances their owners safe and healthy.  But the way we use them is changing.  It is commonly recognized (well, by those of us that pursue continuing education) that not all pets need all vaccines every year.  Vaccinating annually for "everything" has been common practice for years.  That wasn't necessarily wrong-after all it worked-pets were no longer getting the multitude of diseases they used to die from,  immunity from the vaccines seem to last a year, and it was a convenient interval at which to examine the pet and give the "shots."  But times change, we learn about risks, benefits, and side effects.  It's no different than any other medical practice like anesthesia, antibiotic use, pain management and more.

So where did veterinarians mess up?  By emphasizing the importance of the vaccines and downplaying the importance of the annual exam.  It was, and still is, in many clinics common practice to include the exam in the price of the vaccines, perform a free exam, or even neglect to do a thorough exam altogether.  So now, just as in all other facets of medicine we know more about vaccines.  We know that although very safe, they are not totally benign and can be responsible for unwanted reactions.  We also know that duration of immunity is longer than 1 year for many diseases.  At least 3 years for some and possibly much longer but no one wants to fund those studies.  

So now we have a situation where those veterinarians who want to keep up with quality medical care are extending some vaccine intervals to 3 years.  But clients have been told for years that their pet needs to come in when he is due for "shots" and so many of them don't see the need to come in if their pet is not due for vaccines.  

This is an unfortunate situation for those pets that don't get seen more than every three years.  Many things can change in 3 years.  I can't tell you how many "healthy" pets come in for vaccines and have ear infections, dental disease, arthritis, fleas, etc.  that their owners have not noticed.  In addition to this some vaccines don't last for 3 years.  So if your pet is at risk for these and your vet is not tailoring vaccine protocols to your pet then they may be unprotected.  Also there is annual parasite testing such as heartworm tests and fecal exams depending on where you live and your pet's lifestyle.  But the importance of these has also not been emphasized as they should be. If an owner does not understand the importance of examinations and parasite control they are very likely to let these things lapse since the pet is not due for vaccines.  Honestly, if an adult dog comes in and the owner financially needs to choose between vaccines and heartworm testing and prevention I would rather they do the heartworm.  They are much more at risk for this than parvo!  But getting yearly "shots" is so ingrained in people that it's hard to convince them otherwise.  It's an uphill battle for the next generation of veterinarians.  Many clinics in my area still do annual vaccines.  I have not always even agreed with the vaccine protocol of clinics I have worked at in the past or currently.  But, I don't own any of the practices and many owners are unwilling to take this financial gamble of retraining clients and earning revenue from services other than vaccines.  If a client has a particular vaccine request I am happy to oblige and help them determine the best vaccination plan for their pet.  

So what do I do for my pets and why? For the dogs I do DHPP every 3 years (roughly).  Probably they don't need it this often but it's what is currently recommended and I feel the risk of vaccination is low especially as none of my dogs have ever had any reactions.  As long as I can get a vaccine without corona I skip that one.  Corona is a mild and self limiting diarrhea of puppies and that vaccine is now on the not-recommended list.  I do vaccinate all my dogs annually for Lepto.  This is a disease we see occasionally, can be fatal and also can be transmitted to people and the immunity is typically a year or less.  The vaccine is not perfect-only protects against a max of four strains but better than nothing.  I also vaccinate annually for Bordetella.  This vaccine may only last closer to six months but I don't feel my dogs are at super high risk.  Even though they go to dog shows those are typically other well cared for house pets, not stray dogs at the pound, running the neighborhood, etc.  Plus I see lots of vaccinated dogs that have "kennel cough" like signs so it obviously does not protect against all pathogens.  Finally I vaccinate for Rabies according to law-which here is every 2 years.

The house cats get Rabies per law or per label (if I am using the special "cat" vaccine it's only labeled for 1 year) and FVRCP every 3 years (probably they don't really need this being in the house but that is the current recommendation and I feel with the newer cat products risk is pretty minimal).  The barn cats get Rabies per law/label and FVRCP every three years.  They also get feline leukemia vaccines annually.  Some will say that after the first annual booster they are immune to leukemia for life but other studies showed variable immunity that did not last 3 years.  Since this disease is uniformly fatal I elect to give it to those guys annually.  

I'm not sure that was as educational as it was an inside look at the changing face of vet med but hopefully some of you found it interesting nonetheless.

The best laid plans

This story requires a little background information first...

Most of the local rec centers will allow you to use their indoor walking track for free or a very nominal cost.  When Ozark  opened their new facility a few years ago they were no exception and this was very convenient.  Well, somewhere along the way they must have decided they weren't making enough money and started charging a full day pass price of $7 to use the track.  Clearly it's not reasonable to charge the same price to use the track which requires little maintenance and no support staff as it is to use the rest of the facility.  So my alternative plan was to drive to neighboring Nixa, who allows me to use their track all year for a one time fee of $10.

While the Nixa track is about 20-25 minutes away it is worth the drive for those days I do my long runs and don't want to be trapped on the treadmill.  Yesterday, I got off work at noon, went home for lunch, did a few chores and headed over to the gym. I was prepared with my iPod (phone actually but same difference), new sports arm band for said iPod, and my $10 to renew my pass.  As I pulled into the parking lot I realized I had forgotten my ear buds.  Grrr.

Options were a) gut it out for 7.5 miles to whatever they had playing at the gym, which prior experience told me would not be good, b) waste time and gas going back home to get them c) going home and running on the treadmill (which would be possibly more tortuous than running to the oldies station at the gym) or d) buying new ear buds at the wal-mart down the street.  I went with option D.

So, I went to wal-mart, got new ear buds and headed back to the gym.  Although I would barely consider ear buds electronics they of course come it those ridiculous plastic packages that are more difficult to get into than Fort Knox.  Since my multi-purpose tool was confiscated the last time we were at the airport I really didn't have anything to open the plastic armor with other than car keys.  So, I spent the next ten minutes working up a sweat in my car hacking, slashing, and gouging the dang thing open.  I felt like I had worked out before I even set foot in the door.

In the end I still got in my run and was home in time to clean up before taking Zodiac to pet therapy.  But I no longer take much comfort in the fact that you are supposed to able to use car keys as a weapon of self defense.  And more importantly, I now have a set of ear buds for home and for car so I don't get into such a mess again.

And yes, I realize if that was the worst part of my day, my life is pretty good!

Long weekend

Through as assortment of scheduling decisions I had a 5 day weekend.  Nice, but doesn't pay well.  But it gave us plenty of time for relaxing, training, housework, playing with dogs, training and shopping. 

We got in a couple of training sessions this weekend.  The first day went pretty good.  I was pleased with how they both did.  Yesterday, Lyric had a terrible time with discriminations.  She just locked onto one thing and that was it.  Wouldn't listen at all.  But she is doing better with "go" which is sending to an obstacle ahead of us and allowing my to fade out the manners minder (or really just move it so it's not a target).  I also introduced "back" (turn away from me) and she started working on that.  We are also proofing her teeter and that seems to be going well, of course it is our teeter. 

Legend worked well both days.  She is making progress with "go" and "back" and we are starting to use them in various ways and in sequences.  She doesn't always get it right but you can definitely see her thinking and trying to figure out what to do.  It's fun to watch them learn.  

We are going to have a pretty limited trialing schedule this year-during the first 6 months for sure anyway, due to other commitments, taking a break until march and spending two weeks/three weekends on our trip to nationals.  So hopefully all this training pays off and the trials we do go to are good ones!

Holli is doing great.  She's a bit stubborn and independent but sweet and pretty well behaved.  And doing tons better on house-breaking.  She loves playing with the other dogs, especially Legend.

 But sometimes Zodiac gets in on the action too.  I love this first one-so vicious!

But he gets worn our before Legend and Holli do!

Lyric is posing with the new Christmas quilt my mom made

 Icy says "Meowy Christmoose"

 Jelly, hanging out with the brownie mix

And a few videos of Holli-she's a funny girl.  Of course all the best stuff happens before I can get the camera rolling.