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Pouch-like Sacs on the Esophageal Wall in Dogs

Esophageal Diverticula in Dogs

Esophageal diverticula is characterized by large, pouch-like sacs on the esophageal wall. Pulsion diverticula is a pushing outward of the wall. This occurs as a consequence of increased pressure from within the esophagus, as seen with obstruction or failure of the esophageal muscles to move food through. Traction diverticula occurs secondary to inflammation, where fibrosis and contraction pull the wall of the esophagus out into a pouch. Diverticula most commonly occurs at the inlet to the esophagus or near the diaphragm, with food being taken into the mouth and getting caught in a pouch as it travels down the esophagus towards the stomach. Organ systems affected include the gastrointestinal, musculoskeletal, and respiratory. Although no genetic basis has been proven, it may be congenital (present at birth), or acquired. There is no specific breed or gender predisposition for this disease.

The condition or disease described in this medical article can affect both dogs and cats. If you would like to learn more about how this disease affects cats, please visit this page in the PetMD health library.

Symptoms and Types

  • Regurgitation following eating, difficult swallowing, lack of appetite, coughing
  • Weight loss, respiratory distress (aspiration pneumonia)

Causes

  • Pulsion Diverticulum
  • Embryonic developmental disorders of the esophageal wall
  • Esophageal foreign body or failure of the muscles to move food through
  • Traction Diverticulum
  • Inflammatory process associated with the trachea, lungs, lymph nodes, or lining of the stomach; causes fibrous tissue formation around the esophagus

Diagnosis

Your veterinarian will conduct an esophagram, or an esophagoscopy to examine the diverticula in order to determine whether there is a related mass. An X-ray of the chest area, and a fluoroscopal examination to evaluate the movement of food through the esophagus will give your doctor a better idea of where the diverticula is placed in the esophageal wall. An injection of a radiocontrasting agent into the esophageal passage may be used to improve visibility on an X-ray so that an exact determination can be made, as the substance flows down the esophagus, filling the pouches as is does.

stricture

A band of tissue that makes a passage narrower

trachea

The windpipe; it carries air from the bronchi to the mouth

lymph nodes

Small structures that filter out the lymph and store lymphocytes

esophagus

The tube that extends from the mouth to the stomach

diverticulum

The sac in the wall of a tube shaped organ

diaphragm

The muscle in the abdomen that aids in breathing

gastrointestinal

The digestive tract containing the stomach and intestine

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Why is My Dog Drinking So Much Water?

By Caitlin Ultimo

While it’s normal for dogs to take water breaks throughout the day, you may be a bit concerned if you notice your pet drinking excessively. Can a dog drink too much water? And, could it be a sign of something larger? “An owner should be concerned if their dog drinks the entire bowl at once and continues to drink every time water is offered,” shares Dr. Elizabeth Appleman, staff veterinarian at NYC’s Animal Medical Center. Further, if you find yourself constantly refilling the water bowl, if your dog suddenly starts drinking water from the toilet, or if you happen to notice that your dog is urinating more than normal, it could be a sign of a potential disease or condition. It’s a good idea to get a feel for how much your dog typically drinks when he’s healthy. If you notice a significant change, alarm bells should go off.

Why is My Dog Drinking So Much?

Drinking more water is medically referred to as polydipsia, and it is one of the most common problems seen in veterinary medicine, according to Appleman. Polydipsia has a wide range of underlying causes, “Certainly dogs can become polydipsic during warm weather, particularly right at the start of the change of seasons and before they have time to adjust to the hotter temperature,” says Appleman. Dogs will also drink more if their bodies are losing water through watery diarrhea, excessive panting or blood loss. “This represents the body’s attempt to rehydrate and restore normal blood volume,” she says.

Can Excessive Water Drinking Be a Sign of an Underlying Disease?

If your dog is drinking more than usual—some dogs even drink so much and so quickly, that they will regurgitate it right back up—it could be a sign of a medical issue. “It can be a long diagnostic process to figure out why a dog is drinking and urinating larger volumes, and sometimes it is difficult to ultimately find an answer,” says Appleman. Polydipsia, along with increased volume of urination (polyuria), can be caused by the following, amongst other things:

• Kidney insufficiency

• Diabetes mellitus

• Diabetes insipidus

• Adrenal hormone disease (such as excess cortisol production, called Cushing’s disease; or cortisol deficiency, called Addison’s disease)

• Liver disease

• Infection

• Abnormal electrolytes (high calcium, low potassium)

• Treatment with certain drugs (corticosteroids, diuretics, etc.)

• Psychogenic polydipsia

Is it Ever Normal for My Dog to Drink Excessively?

While excessive water drinking that is out of character for your dog may signal an issue, some dogs may simply drink a lot of water. “Some dogs are naturally excessive water drinkers,” says Appleman. “These tend to be large-breed, playful dogs that like to amuse themselves by drinking water, or are very active and need to replenish water loss from panting.” The most important aspect in deciding if there is a problem is identifying a change in baseline of water consumption. Try to be aware of how much your dog drinks on a regular basis, take note and consult your vet if the amount suddenly increases or decreases.

What Should I Do If My Dog is Drinking Too Much?

While most of the diseases that correlate with excessive water drinking have successful treatment options, “The difficulty is determining the correct diagnosis,” says Appleman. “Once the diagnosis is made, your veterinarian can almost always reduce (though maybe not fully resolve) water consumption and ameliorate the constant thirst and urination the dog is experiencing.” Many of the conditions that can cause dogs to drink a lot of water are quite serious. If you have any concerns about your dog’s water consumption, make an appointment with your veterinarian as quickly as possible.

See Also

Image:  via Shutterstock

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Why is My Dog Coughing? Common Causes and Treatment Options

by Jennifer Coates, DVM

The occasional cough in an otherwise healthy dog is usually nothing to worry about. But just like us, when a dog’s coughing becomes a constant or recurrent problem it can be a sign of serious illness. Knowing some of the most common causes of coughing in dogs can help you determine when you need to worry.

Coughing is associated with many different diseases in dogs and cats. Here are a few of the most common and some of the available forms of treatment.

Coughing Related to Infections

Viruses, bacteria, fungi, and parasites can all infect a dog’s upper respiratory tract, lung tissue (pneumonia), airways (bronchitis), or a combination thereof (bronchopneumonia), and cause dogs to cough. Kennel cough is the most common infectious cause of coughing. It can be caused by several different viruses and bacteria, alone or in combination. Canine influenza virus is becoming increasingly prevalent in the United States and leads to symptoms like coughing, fever, and nasal discharge.

Supportive care is an important part of treating coughs caused by infections. Dogs should be encouraged to rest, drink, and eat. Cough suppressants can help with especially severe symptoms.

Antibiotics are effective only against bacteria. Viral infections generally have to run their course. Other medications are available that work against some types of fungi and parasites.

Coughing Related to Heartworm Disease

Heartworms are transmitted through the bites of mosquitos that pick up larval forms of the parasite from one dog and pass them to another. The larva migrate to the heart and lungs of the newly infected dog, where they mature into spaghetti-like adults. Their presence and the inflammation that results can lead to potentially fatal heart and lung damage.

Heartworm preventative medications are extremely safe and effective. On the other hand, once the disease develops, treatment is costly and can be quite dangerous.

Coughing Related to Heart Disease

Many different types of heart disease can make dogs cough, including mitral valve endocardiosis, dilated cardiomyopathy, congestive heart failure from multiple causes, and more.

Depending on the specific type of heart disease a dog has, a veterinarian may prescribe some combination of medications that make the heart pump more efficiently, normalize blood pressure, and reduce the abnormal build-up of fluid (e.g., pimobendan, enalapril, or furosemide). Other interventions like surgery or the placement of a pacemaker may be appropriate in some cases.

Coughing Related to Collapsing Trachea

Small dogs are at increased risk for a weakening of the cartilage rings that partially encircle the trachea. This causes the trachea to collapse in on itself, which leads to tracheal irritation and a chronic cough that is often described as sounding like a goose honk.  Medications that dilate airways, decrease inflammation, suppress coughing, and treat secondary infections can help, but in severe cases, surgery may be necessary to provide these dogs with an acceptable quality of life.

Coughing Related to Laryngeal Paralysis

Dogs with laryngeal paralysis cannot fully open the passageway into their windpipe (called the larynx) due to weakness of the nerves that control the muscles surrounding it. This leads to coughing as well as noisy breathing and shortness of breath.

Surgery to permanently hold open one side of the larynx can help ease the breathing of dogs with laryngeal paralysis, but it also puts them at higher risk for developing aspiration pneumonia… another cause of coughing in dogs.

Reverse Sneeze

While technically not a cough, many dog owners mistake the sound of a reverse sneeze with coughing. Reverse sneezes tend to occur in clusters and are produced when something (postnasal drainage, foreign material, parasites, etc.) irritates the back of the nasal passages.

Just like “normal” sneezes, reverse sneezes are nothing to worry about when they occur infrequently, but if they become severe or frequent, the dog should be seen by a veterinarian for diagnosis and appropriate treatment.

Coughing Related to Chronic Bronchitis

When a dog is coughing due to chronic inflammation of the airways and no other cause can be identified, chronic bronchitis is the most likely diagnosis. Dogs with chronic bronchitis tend to have a dry, hacking cough that worsens with exercise or excitement and worsens over time.

Treatment includes medications that decrease inflammation (e.g., fluticasone or prednisolone) and dilate airways (e.g., albuterol or terbutaline). Ideally they are given by inhalation to reduce potential side effects, but they can also be given systemically if necessary.

Coughing Related to​ Foreign Objects

Sometimes dogs will inhale foreign material or objects that become lodged in their airways. The body’s natural response is to try to cough it out. If this is unsuccessful, the material must be removed either through the use of an endoscope or via surgery.

Coughing Related to Cancer

Coughing can be one of the first symptoms that owners notice when a dog has cancer of the lungs, other parts of the respiratory tract, heart, or surrounding tissues. Treatment may include surgery, chemotherapy, radiation, or palliative therapy.

Diagnosing the Cause of a Dog’s Cough

The first step in treating a dog’s cough is figuring out its underlying cause. Your veterinarian will start the process by asking questions about your dog’s health history, travel, preventive care, the onset and progression of symptoms, etc. He or she will then perform a complete physical exam. Sometimes a tentative diagnosis can be reached at this point, but oftentimes reaching a definitive diagnosis will require some diagnostic testing. Depending on your dog’s unique situation, some combination of the following tests may be necessary:

  • A blood chemistry panel
  • Complete blood cell count
  • Serology to rule in or out various infectious diseases
  • A B-type natriuretic peptide (BNP) blood test for heart disease
  • Urinalysis
  • Fecal examination
  • Chest x-rays
  • Echocardiography (an ultrasound of the heart)
  • Measurement of blood pressure
  • An electrocardiogram (ECG)
  • An examination of fluid samples taken from the airways

When is Coughing Serious?

If your dog has just recently developed a mild cough and seems to feel fine, taking a few days to see whether the condition will clear on its own is reasonable. However, if the cough is especially severe, worsens, or fails to improve over the course of a week or so, make an appointment with your veterinarian. Also, if your dog is lethargic, has difficulty breathing, isn’t interested in food, or has any other potentially serious symptoms, call your veterinarian immediately.

See Also

Image: Sneezing Dog, by Eric Sonstroem / Flickr

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What to Do When Your Dog is Diagnosed with Cancer: Treatment, Prognosis, and Costs

By David F. Kramer

Few diagnoses in the veterinary world bring more pain to a dog owner than one simple word: cancer. The mind instantly goes to the perceived harshness of chemotherapy, surgery or radiation treatments, the likelihood of remission, and the possibility of losing the battle altogether. And while conditions such as kidney and heart disease can be more difficult to treat and have a poorer chance of survival than some types of cancer, this doesn’t stop the specter of cancer from casting a dark shadow over your pet and family.

An obvious first question to a diagnosis of cancer in our dogs is simply, why? The truth is that there is often no definitive reason. While some cancers are more common in certain breeds and in a few cases, causative links to specific genes or toxins have been identified,  for the most part luck plays the biggest role in determining whether or not your dog may one day be afflicted.

RECOGNIZING THE SIGNS OF CANCER IN DOGS

According to Veterinary Oncologist Dr. MJ Hamilton of Crown Veterinary Services in Lebanon, NJ, there are many signs that could be indicative of cancer. “Usually, we’ll see big changes at home. So things like decreased mobility, lethargy, changes in appetite, collapse, or inability to urinate,” says Hamilton. The specific symptoms that a dog develops depends on the type of cancer involved, where it is located, and how far it has progressed.

Hamilton, says a diagnosis of cancer comes from further testing. “Usually it’s during a workup that you’ll find it; either through an ultrasound, biopsy, or cytology.”

TREATING CANCER IN DOGS

When it comes to treating dogs with cancer, chemotherapy, radiation, and surgery are typically recommended either alone or in combination. Veterinary medicine has made some recent strides in other treatments, such as immunotherapy or antibody therapy, but these are less prevalent than the first line treatments.

The course of your dog’s treatment will be determined by your veterinarian or veterinary oncologist, and will depend on the type of cancer, as well as other factors. Whenever it is feasible, surgery to physically remove as much of the cancer as possible is usually part of treatment. Surgery may be the only type of therapy that is recommended, or it will be performed before or after chemotherapy or radiation therapy.

While chemotherapy is a blanket term for using drugs to combat disease, such treatments for cancer come in several forms. According to Dr. Joanne Intile, staff oncologist at the East End Veterinary Emergency and Specialty Center in Riverhead, NY, chemotherapy can be administered orally, intravenously, topically, subcutaneously, intramuscularly, intratumorally (directly into a tumor), or intracavitarily (into a body cavity).

Chemotherapy can be adjuvant: used after a tumor is removed in the hopes of killing the remaining or residual cancer cells; neoadjuvant: which is used prior to surgery to reduce the size of an existing tumor; or induction: which is used to hopefully bring about a remission for specific types of blood borne cancers.

The majority of dogs treated with chemotherapy don’t suffer much in the way of serious side effects. Most dogs will not lose their fur during chemotherapy, but some breeds (those with continuously growing haircoats like Poodles and Old English Sheepdogs) might experience some thinning of hair. Your dog might also experience temporary diarrhea or vomiting and have less of an appetite. Bone marrow suppression is another worry with chemotherapy treatments because it can lead to anemia and/or increased risk of infection. But these types of side effects are typically treatable. The Clinical Oncology Service at the Veterinary Hospital of the University of Pennsylvania estimates that the chance of “severe side effects… is estimated to be less than 5% of all pets receiving chemotherapy. With proper management, most animals recover uneventfully within a few days.”

Your vet will keep track of your dog’s progress through regular examinations, bloodwork, and discussions with you regarding what you observe at home. He or she may make changes in the dosage or choices of drug that are used for treatment based on how your dog responds to them.

Depending upon the type of cancer and how it is affecting your dog, your vet may recommend radiation therapy rather than chemotherapy.

Dr. Rick Chetney Jr., of VRC in Malvern, PA, is a veterinary oncologist who specializes in radiation treatments to fight cancer. “Radiation therapy is a localized therapy, like surgery,” says Dr. Chetney.

“It’s often used for tumors that we can’t surgically remove because they’re up against necessary structures such as the heart or brain. Chemotherapy is a systemic treatment—once we inject it, it goes all throughout the body battling microscopic disease when it starts spreading to other locations. Again, radiation is more localized.”

“A definitive radiation therapy protocol is given once daily—usually with between 16 and 20 daily treatments—so it takes about three or four weeks,” says Dr. Chetney. “An individual treatment takes about an hour and a half to two hours, and most of that time is spent waiting for the patient to become sleepy from the sedative, and then later to recover from the anesthesia. The treatment itself only takes about 5-10 minutes.”

Animals are given varying levels of sedation for radiation treatments, mainly to keep them still. There’s no direct pain from the radiation treatment itself although some discomfort, skin problems, or fatigue may be associated with its effects.

If you live close to your treating oncologist, you might be able to bring your dog to its daily radiation treatments. If distance is an issue, the animal can be boarded during the week for treatments and be permitted to go home to recuperate over the weekend. 

HOW MUCH DOES IT COST TO TREAT A DOG FOR CANCER?

Once a cancer diagnosis is determined, among the first considerations is cost. Even with research into this topic, you may find very little definitive information. Consulting with your vet or oncologist will certainly help get you a ballpark figure, but he or she may be hesitant to nail down a specific figure since it’s impossible to predict just how your dog will respond to treatment. 

Veterinary insurance is an option and many types cover cancer treatment (most likely partially)—but as is the case with people, rules concerning pre-existing conditions will generally prevent you from getting coverage once your dog has been diagnosed. Your veterinary oncologist will lay out a treatment plan and proposed rate, but there are many factors that can affect the eventual cost.

“It varies wildly, and it’s something I really can’t answer,” says Hamilton. “There are some cancers that are very affordable and inexpensive to treat, and others that really start to add up. Some cancers can be a couple hundred dollars a month, and others that start to add up into the thousands before you’re done. Everything is completely customized to that pet, what we know, and what the wishes of the family are.”

According to the National Canine Cancer Foundation, an initial visit to confirm a cancer diagnosis can be upwards of $200. Major surgery to remove a cancerous tumor deep inside the body, or that will require reconstruction, can start at $1,500. Chemotherapy treatments might range from $200 to $2,000, depending upon the type and severity of the cancer. Radiation therapy can range from $2,000 to $6,000 or higher. You will also need to factor in additional medications that might be needed—such as pain relievers or antibiotics—which could cost another $30 to $50 per month for an indefinite period.

NATURAL REMEDIES AND DIET FOR DOGS WITH CANCER

During and after treatment for cancer, dog owners might be tempted to look to the East for a different approach to medicine. One veterinarian who uses the Eastern approach is Dr. Patrick Mahaney of Los Angeles, CA, who specializes in natural and alternative treatments for pets. According to Mahaney, this type of pet care is imperative before, during, and after a cancer diagnosis.

“It’s crucial that all veterinarians and pet owners be attuned to whole-body health, especially when a pet is diagnosed with cancer and is going through surgery, radiation, or chemotherapy,” says Mahaney. “What’s not totally addressed in the veterinary oncology community is nutrition. We’re so dependent on processed, commercially available pet foods, primarily kibble, and really it’s not the ideal thing for any pet to eat. It’s fairly simple to make dietary changes to a whole-food based diet that can really benefit whole-body health.”

Mahaney is dubious of the current state of most available pet foods that make up the multi-million dollar pet food industry. It all begins, he says, with the concept of “feed grade” products that are welcome for animals, but judged unsuitable to be fed to humans. Mahaney believes in a life-long pet diet that consists of whole and human grade foods.

“Whole food feeding is key. Human grade ingredients have lower thresholds for certain substances that can be toxic—even carcinogenic. Mold-produced toxins (called mycotoxins), including aflatoxin and vomitoxin, can irritate the intestines, suppress the immune system, and are carcinogenic (cancer causing). You want to be sure that while your pet is being treated that their food is not going to further contribute to cancer,” he says.

While a diagnosis of cancer in your dog is by no means a certain death sentence, it’s sure to be a stressful time for both dogs and their families. Your veterinarian and veterinary oncologist will work with you to give you options for treatment and help walk you through any difficulties that come with it.

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What Causes a Puppy to Stop Growing?

By Sarah Wooten, DVM

Puppies that are not growing at a normal rate or who are too small for their age are stunted; that is, something has prevented them from growing naturally or at a normal rate.

There are several things that can cause stunted growth in puppies, ranging from intestinal worm infections to genetics. In this article, we will address the most common concerns associated with stunting, and whether or not these concerns actually cause stunted growth in dogs.

Does Worm Infection Cause Stunting?

The most common reason why a puppy’s growth becomes stunted is because they are infected with hookworms or roundworms. Intestinal worms are extremely common in puppies in the United States — they either contract worms from their mother or from the environment around them. If a puppy has an extremely heavy worm infestation, the worms can steal enough calories from the puppy to slow down her growth. Puppies that have a heavy worm burden typically look unthrifty: they have a poor haircoat, diarrhea, a big pot belly, and are small and thin despite a voracious appetite.

The good news is that once the puppy is free of worms, the body can heal itself and regain normal growth and development.

To prevent worms in your puppy, follow the deworming schedule set forth by your breeder and/or veterinarian. If the schedules differ, follow the worming schedule set forth by your veterinarian.

Does Malnutrition Cause Stunting?

A common question puppy parents ask is whether a puppy’s growth can be stunted by taking him off puppy food too soon. The short answer is no, you will not stunt your puppy’s growth by switching to adult food too soon or by mildly under-feeding. Puppy food is formulated to support normal growth and development, and, while it is not ideal, there are millions of dogs out there that do just fine on a diet that is formulated for all life stages, and which are fine to feed to a puppy.

On the contrary, you can do much more damage to your puppy’s long term joint health by over-feeding or giving supplements while the pup is still growing. According to the lifetime studies conducted by Purina on Labrador Retrievers, dogs will live on average two years longer and have much less chronic disease if you keep them slim their whole life. Ask your veterinarian about what the right body condition is for your puppy, and for tips on how much to feed to keep your puppy in his ideal condition.

Just like a human child, your puppy will go through growth spurts during the first year. There will be days when she may need to eat more than the amount she will need as an adult. My 75-pound Goldendoodle, for example, eats two cups a day of dry dog food, but when she was growing (about eight months of age) she would eat up to four cups of food a day. You will need to be flexible about the amount you are feeding her sometimes in order to support her growth and development.

Another common question is whether malnutrition itself will cause stunting. To be sure, puppies that suffer under extreme situations like starvation are at risk for stunted growth. But most puppies that are in caring, loving homes with pet parents who measure the appropriate amount they feed to their puppies — food that is adequate for supporting bones, muscles, and other tissues as they grow — will not have stunting from malnutrition, even if they keep the puppies slim.

Does Spaying or Neutering Cause Stunting?

Having your dog spayed or neutered early will not stunt your puppy’s growth, but it might affect the joints of large breed dogs. Studies show that early spay/neuter does affect the growth plate, delaying its closure and causing dogs to grow taller than they should have. This can predispose the dog to later joint problems. 

This is an excellent topic to discuss with your veterinarian. For small or medium sized dogs, the standard recommendation is still to spay/neuter the dogs between 6-8 months of age. For large breed dogs, however, the recommendation is to hold off until the dog is older to lower the risk of joint disease. For females, spaying should wait until after the first heat cycle, and for males, neutering can be scheduled when the dog is around two years old.

Ask your dog’s doctor for her or his recommendations on when to spay or neuter your dog, and ask them for their reasons behind their recommendations.

Does Strenuous Exercise Cause Stunting?

Engaging in strenuous exercise with your puppy will not stunt his growth, but the excessive impact associated with running may damage the growth plates of the long bones and cause them to develop abnormally, predisposing your puppy to joint issues later in life. Again, this is more a problem for large breed dogs because they simply weigh more.

Playing fetch and allowing your puppy the space to run around until she is tired is fine, but don’t take her jogging or running until she is done growing. For clients who want their medium or large breed dog to be their jogging partner, my standard recommendation is to wait until after 15 months to allow for the bones to grow properly.

Are Certain Breeds at Risk for Stunting?

Is there any one breed that is more predisposed to stunting than another? There is a rare disease called pituitary dwarfism in German Shepherds and in some Labrador Retrievers that has a genetic component, but these conditions are very rare and not generally seen in companion animals.

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Vestibular Disease in Dogs

by Kerri Fivecoat-Campbell

Canine idiopathic vestibular disease, which is also sometimes called “old dog disease” or “old rolling dog syndrome,” can be very scary for pet parents. To the untrained eye, the symptoms may mimic serious, life threatening conditions such as stroke or a brain tumor.

The good news is that this condition, which is described by veterinarians as fairly common, typically disappears in a matter of days.

VCA Animal Hospitals define vestibular disease as a sudden, non-progressive disturbance of balance.

“Idiopathic refers to the fact that veterinarians can’t identify the source of the balance issue,” said Dr. Duffy Jones, DVM, a veterinarian with Peachtree Hills Animal Hospitals of Atlanta in Georgia. “There are a lot of theories such as inflammation, but as with some humans who suffer from vertigo, we really don’t know the cause.”

Dr. Keith Niesenbaum, DVM, a veterinarian with Crawford Dog and Cat Hospital in Garden City Park, New York, and who has been practicing for 32 years, said that idiopathic vestibular disease is more common in older dogs and there really isn’t a breed that is immune.

“Anecdotally, I’ve seen it more in large breed dogs, but it can also happen with small breeds as well,” Niesenbaum said.

Symptoms of Idiopathic Vestibular Disease 

Deb Hipp of Kansas City, Missouri, was preparing to go out of town for a few days when her 17-year-old dog, Toby, suddenly had more trouble than normal getting up.

“He has some mobility issues, so I thought he was just tired, so I waited another ten minutes and tried to get him up,” Hipp said. “On the second attempt, he was having trouble placing his paws to stand and I immediately took him to the emergency vet.”

Hipp thought Toby might have had a stroke, but the veterinarian made a note of Toby’s eyes, which were darting back and forth. After some blood tests and a more thorough exam, he diagnosed idiopathic vestibular disease. By that time, in addition to not being able to stand and the darting eyes, Toby also displayed other symptoms of the disease, which include:

  • Head tilt, which may be slight to extreme
  • Acting dizzy and falling down, which may remind people of someone who is drunk
  • Nausea and/or vomiting  
  • Dogs may also turn in circles or roll

“The symptoms are acute, or immediate,” said Jones. “The symptoms will not be a slow progression but happen all of a sudden. There really aren’t any symptoms that can be a sign this is coming on.”

Medical Treatment for Idiopathic Vestibular Disease

Jones said it is important to get your dog to its veterinarian as soon as you see any of the signs, as the symptoms are similar to that of other more serious conditions, such as an inner ear infection, stroke, brain tumor, or seizure.

Jones said idiopathic vestibular disease is confirmed by a veterinarian upon a complete physical examination, such as checking the eye movement, which would be rolling in cases of a stroke, and lifting the paw and flipping it over to see if the dog puts his paw back. “If the dog can flip his paw over, it typically isn’t a stroke,” said Jones.

Niesenbaum said that once the condition is diagnosed, the dog is typically treated at home unless the dog is vomiting and is at risk of dehydration, at which point he will hospitalize the dog so it can be put on IV fluids.

“If the dog goes home, we will typically prescribe an anti-nausea medication and something to help with dizziness,” Niesenbaum said.

Home Treatment for Idiopathic Vestibular Disease

Jones said that dogs can eat, but due to the nausea, they may not want to eat. He added that it is important to watch for hydration issues. Other concerns include keeping the dog in a confined area, and not allowing them to climb stairs or be on the furniture.

“The dog will really be off balance and if there are stairs or he gets on the furniture, he may fall and break bones,” said Jones.

Another consideration, especially if it is a large dog, is getting the dog outside to go to the bathroom. This was a big concern for Hipp, whose dog, Toby, weighs 60 pounds.

“Toby had mobility issues, so I had bought a special harness to help him up,” said Hipp. Still, when Toby was in the first days of idiopathic vestibular disease, he was dead weight, not being able to stand or walk at all.

After conferring with her veterinarian, Hipp was advised to hospitalize Toby.

“I was leaving town and didn’t want to leave him with the pet sitter. Although we were convinced Toby would recover, I didn’t want her to have to pick him up and take him outside,” said Hipp.

Niesenbaum said if you don’t have a harness, you can use a towel as sling to help your dog stand.

The good news is that like most dogs with this condition, Toby completely recovered within a matter of days and now even goes on his daily short walk. “It can sometimes take a couple of weeks, but if they’re not improving after 72 hours, we know it could be something more serious,” said Jones.

Some dogs do not recover completely from the head tilt. Even if your dog has appeared to have completely recovered, it’s important for the dog’s veterinarian to see the dog again just to be sure.

“I don’t get to give a lot of good news to owners of geriatric dogs when they have serious conditions, but this really is the ‘good news’ condition in that most dogs will survive and recover completely,” Jones said.

This article was verified for accuracy by Dr. Katie Grzyb, DVM. 

Related

“Old Dog” Vestibular Disease

Head Tilt, Disorientation in Dogs

Loss of Balance (Unbalanced Gait) in Dogs

Don’t Kill Old Rolling Dogs

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Yellow Skin (Jaundice) in Dogs

Icterus in Dogs

The term icterus (or jaundice) denotes a yellow discoloration of mucous membranes of the gums, nostrils, genitals, and other areas due to a high concentration of bilirubin, a normal bile pigment formed as a result of a breakdown of hemoglobin present in red blood cells (RBCs).

If there is an increased rate of RBC breakdown, as occurs in some diseases, abnormally high levels of bilirubin will form. These high levels of bilirubin cannot be excreted at a normal rate, and thus, accumulates in tissues. Bilirubin levels may also increase in conditions where normal excretion of bilirubin is hampered due to some disease (e.g., cholestasis), in which bile cannot flow from the liver to the duodenum (first section of intestine) due to some mechanical obstruction or neoplasia.

Higher concentrations of bilirubin are toxic and may cause discoloration of the skin (i.e., jaundice), liver and kidney injury, and may also affect brain tissue. All breeds of dogs can be affected.

Symptoms and Types

  • Vomiting
  • Diarrhea
  • Lethargy
  • Fever
  • Abdominal pain
  • Loss of appetite (anorexia)
  • Paleness
  • Yellowish discoloration of the skin
  • Change in color of urine and feces (orange colored)
  • Increased frequency (polyuria) and volume of urine
  • Increased thirst (polydipsia) and consumption of water
  • Mental confusion in advanced cases
  • Weight loss
  • Bleeding (especially in dogs with advanced liver disease)

Causes

  • Diseases, toxins, drugs leading to increased destruction of RBCs
  • Incompatible blood transfusion
  • Systemic infections impairing processing of bilirubin in liver
  • Collection of large volume of blood inside body cavity
  • Inflammation of liver (hepatitis)
  • Tumors
  • Cirrhosis
  • Massive damage to liver tissue (e.g., due to toxins)
  • Obstruction in secretion of bilirubin due inflammation of pancreas, presence of tumor, stones, or parasites.

Diagnosis

Your dog’s veterinarian will take a detailed history from you and perform a complete physical examination on your dog. Routine laboratory tests including: complete blood count, biochemistry profile and urinalysis will be conducted. These tests will reveal very valuable information for the initial diagnosis. Complete blood count tests may reveal changes in RBC structures, changes pertaining to underlying infections like severe anemia, blood parasites, and abnormally low levels of platelets (cells responsible for blood clotting). The biochemistry profile, meanwhile, may reveal abnormally high levels of liver enzymes pertaining to liver injury. And urinalysis will show abnormally high levels of bilirubin in urine.

There are more specific tests available for further diagnosis, including underlying causes. Radiographic studies will help in the determination of structure and size of the liver, which is the central organ of importance in this disease. These X-rays often find the liver enlarged, reveal the presence of a mass or tumor, the enlargement of the spleen in some cases, and foreign bodies. Thoracic X-rays may reveal metastasis if a tumor is the cause. Ultrasound will also be performed, enabling your veterinarian to evaluate the liver structure in detail, helping to distinguish liver disease from an obstruction of biliary tract, as well as differentiating a tumor from a mechanical obstruction.

Additionally, the veterinarian may decide to take a sample of liver tissue with the aid of ultrasound for a more detailed evaluation. Liver tissue samples may be taken through a needle or during surgery, which may be performed for confirmatory diagnosis and treatment.

pancreas

A gland that aids in both digestive and insulin functions

polyuria

Excessive urination

urinalysis

An in-depth examination of the properties of urine; used to determine the presence or absence of illness

jaundice

A condition in which the skin becomes yellow in color as do the mucous membranes; this is due to excess amounts of bilirubin.

polydipsia

A medical condition involving excessive thirst

hepatitis

A condition in which the liver becomes inflamed

bilirubin

A certain pigment that is produced when hemoglobin is destroyed.

bile

The fluid created by the liver that helps food in the stomach to be digested.

duodenum

The first part of the small intestine; can be found between the pylorus and the jejunum

excretion

Eliminating or the material that has actually been eliminated

anemia

A condition of the blood in which normal red blood cell counts or hemoglobin are lacking.

hemoglobin

The protein that moves oxygen in the blood

icterus

Another term for jaundice

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Wobbler Syndrome in Dogs

Cervical Spondylomyelopathy in Dogs

Cervical spondylomyelopathy (CSM), or wobbler syndrome, is a disease of the cervical spine (at the neck) that is commonly seen in large and giant-breed dogs. CSM is characterized by compression of the spinal cord and/or nerve roots, which leads to neurological signs and/or neck pain. The term wobbler syndrome is used to describe the characteristic wobbly gait (walk) that affected dogs have.

Intervertebral disk slippage and/or bony malformation in a narrowed vertebral canal (the bony canal surrounding the soft spinal cord) can cause spinal compression. Disk associated spinal compression is most often seen in dogs older than three years of age.

Doberman pinschers are predisposed to slipping intervertebral disks (in between the vertebrae). Vertebral malformation (bony associated compression) is most commonly seen in giant breed dogs, usually in young adult dogs that are less than three years of age. The bony malformation can compress the spinal cord from the top and bottom, from the top and sides, or just from the sides. Dynamic spinal cord compression (compression that changes with different positions of the cervical spine) always occurs with any type of compression.

Breeds that appear to be predisposed to this condition are Doberman pinchers, rottweilers, great Danes, Irish wolfhounds, and basset hounds.

Symptoms and Types

  • Strange, wobbly gait
  • Neck pain, stiffness
  • Weakness
  • Possible short-strided walking, spastic with a floating appearance or very weak in the front limbs
  • Possibly unable to walk – partial or complete paralysis
  • Possible muscle loss near the shoulders
  • Possible worn or scuffed toenails from uneven walking
  • Increased extension of all four limbs
  • Difficulty getting up from lying position

Causes

  • Nutrition in some cases – excess protein, calcium, and calories have been a proposed cause in great Danes
  • Fast-growth is suspected in large dog breeds

Diagnosis

Along with the standard medical tests, which include a blood chemical profile, a complete blood count, a urinalysis and an electrolyte panel to rule out other diseases, your veterinarian will take a thorough history of your dog’s health, onset of symptoms, and possible incidents that might have preceded this condition, such as traumas to the back or any previous illnesses. Any information you might have on your dog’s genetic background may be helpful as well.

Wobbler syndrome is diagnosed via visualization. X-rays, myelographs, computed tomography (CT) and magnetic resonance imaging (MRI) will allow your doctor to view the spine and vertebrae. X-rays should be used mainly to rule out bony disorders while myelographs, CT and MRI are used to visualize the compression of the spinal cord. Diseases that will need to be ruled out though a differential diagnosis include diskospondylitis, neoplasia, and inflammatory spinal cord diseases. The results of the cerebral spinal fluid (CSF) analysis should pinpoint the origin of the symptoms.

nerve

A bundle of fibers that are used in the process of sending impulses through the body

urinalysis

An in-depth examination of the properties of urine; used to determine the presence or absence of illness

malformation

Any growth or organ on an animal that is not normal

atrophy

The wasting away of certain tissues; a medical condition that occurs when tissues fail to grow.

ankylosis

A condition in which a joint is unable to move, usually due to some type of illness or medical procedure.

adhesion

Fibers that bond items together that would not normally be combined.

gait

The term used to describe the movement of an animal

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Weight Loss and Chronic Disease in Dogs

Cachexia in Dogs

When should your dog’s weight loss concern you? The standard is when the loss exceeds ten percent of normal body weight (and when it is not due to fluid loss). There are many things that can cause weight loss, including chronic disease. It is important to understand this because the dog’s entire body will probably be affected by the weight loss, and it ultimately depends on the cause and severity of the underlying medical condition.

Causes 

  • Insufficient calorie intake
  • Poor quality of food
  • Taste (palatability) of food
  • Spoiled food/deterioration from prolonged storage
  • Reduced appetite (anorexia)
  • Inflammatory bowel disease
  • Chronic protein-losing intestinal disorder
  • Intestinal worms (parasites)
  • Chronic infections of the bowel
  • Tumors of the intestine
  • Blockages in stomach/gut (gastrointestinal obstructions)
  • Surgical removal (resection) of segments of bowel
  • Disease of the pancreas
  • Liver or gall bladder disease
  • Organ failure (heart, liver, kidney)
  • Addison’s disease
  • Diabetes
  • Hyperthyroidism
  • Chronic blood loss (hemorrhaging)
  • Skin lesions that ooze and cause loss of protein
  • Disorders of the central nervous system that interfere with eating or appetite
  • Paralysis of the esophagus
  • Neurologic disorders that make it difficult to pick up or swallow food
  • Increased physical activity
  • Prolonged exposure to cold
  • Pregnancy or nursing
  • Fever or inflammation
  • Cancer
  • Bacterial infections
  • Viral infections
  • Fungal infections

Diagnosis 

Your veterinarian will begin with a variety of diagnostic tests to find the underlying cause for the weight loss. After an initial health assessment, the following are some tests that might be recommended for your pet:

  • Fecal studies to look for chronic intestinal parasites
  • Complete blood count (CBC) to look for infection, inflammation, leukemia, anemia, and other blood disorders
  • A biochemical profile that will evaluate kidney, liver, and pancreas function, and the status of blood proteins, blood sugar, and electrolytes
  • Urinalysis to determine kidney function, to look for infections/protein loss from the kidneys, and to determine hydration status
  • Chest and abdominal x-rays to observe heart, lungs, and abdominal organs
  • Tests to evaluate the condition of the pancreas
  • Ultrasound of the abdomen
  • Bile acids test to evaluate liver function
  • Hormone assays to look for endocrine disorders
  • Using a scope to view the intestines (endoscopy) and biopsy
  • Exploratory surgery (laparotomy)

palatability

The term used to describe how much an animal will like a specific taste or food

pancreas

A gland that aids in both digestive and insulin functions

leukemia

An increase in the number of bad white blood cells

esophagus

The tube that extends from the mouth to the stomach

biopsy

The process of removing tissue to examine it, usually for medical reasons.

anemia

A condition of the blood in which normal red blood cell counts or hemoglobin are lacking.

gastrointestinal

The digestive tract containing the stomach and intestine

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Weak Immune System due to Hereditary Disorder in Dogs

Immunodeficiency Disorders in Dogs

The immune system is a collection of biological processes that protects against disease by identifying and killing the invading pathogens, as well as tumor cells. It works 24/7, guarding against invading organisms and infections, detecting a wide variety of invading agents including bacteria, viruses, and parasitic worms. One key feature of the immune system function is that it is able to distinguish the invading organisms from the body’s own cells and tissues.

Primary immunodeficiency disorders involve weakened immune response when required. Primary immunodeficiency disorders are seen due to heritable defects in the immune system, whereas secondary immunodeficiency disorders are caused by some other primary disease.

Breeds predisposed to primary immunodeficiency disorders include basset hounds, Cardigan Welsh corgis, Jack Russell terriers, Beagles, German shepherds, Chinese shar-pei, Doberman pinschers, dwarfed Weimaraners, gray collies, and Irish setters.

Symptoms and Types

  • Prone to recurrent infections and failed response to conventional antibiotic therapies
  • Lethargy
  • Lack of appetite (anorexia)
  • Various skin infections
  • Poor growth (hallmark)
  • Post vaccination diseases
  • Other symptoms related to infections

Causes

Immunodeficiency disorders are a congenital disorder; i.e., dogs are born with them.

Diagnosis

You will need to give a thorough history of your dog’s health, including the onset and nature of the symptoms, to your veterinarian. He or she will then conduct a complete physical examination, as well as a biochemistry profile, urinalysis, and complete blood count (CBC) — the results of which may reveal various cell abnormalities or clues for infections. More specific tests are available for a more detailed evaluation of the immune system, and may be employed by the veterinarian with your consent. For example, he or she may take a bone marrow sample from your dog for evaluation.

urinalysis

An in-depth examination of the properties of urine; used to determine the presence or absence of illness