Sunday, March 17, 2019

Pet Poison Awareness Week: Risks, Prevention, and Response

March 17 - 23, 2019, is designated as Pet Poison Awareness Week.  This potential danger for our dogs should be on our minds every day, but having a designated week reminds us to strengthen our awareness of this important aspect of the care of our companions.  It is a good time also to make sure we are doing all we can to keep our pups safe from poisoning and that we know what to do in the event of suspected poison ingestion.

Signs of possible poisoning: One of the most frightening experiences we can have with the animals in our care is to find our companion acting ill and we have no idea what could have happened. Poisoning often needs to be a consideration but can be challenging because the signs vary depending on the poison and how recently it was ingested. In general, you might see any of the following in a case of poisoning:

GI signs such as vomiting, diarrhea, black or tarry stool, excessive salivation or drooling, nausea or loss of appetite, excessive thirst, or really bad breath; signs of internal bleeding such as coughing of blood, vomiting blood, pale gums, rapid heart rate, weakness or lethargy, loss of consciousness or collapse.  Some of these signs are indicators of potential kidney or liver failure. 

Signs of poisoning often are very subtle at first and then become more obvious. There might be a little tiredness, easy to dismiss as just due to a day of fun activity. Then more lethargy, or maybe a little vomiting, then more vomiting. Or something is "just not right" but it doesn't seem like any big deal, until it gets more "not right." Early intervention is critical if you have any reason to think your dog may have ingested a dangerous substance. 

In 2018, the ASPCA poison control center responded to 213,773 cases of potential animal poisoning.  Keep in mind those are just the cases for which someone called the ASPCA poison center. Undoubtedly many more were not caught in time or were dealt with in some other way, such as an emergency trip to the vet. Fortunately, there is a lot we can do to minimize the risk to our dogs and to help them in the event of suspected poisoning.

Common toxins in the home and yard: The ASPCA lists the following as the top animal toxins for which they received calls in 2018 (they have a top 10 list, but there is some overlap so I've condensed it for easy reading):
  • Medications, both over the counter and prescription products. This category includes vitamins and supplements. In some cases, this could be the result of someone trying a human remedy on a dog. In other cases, improperly secured medications were ingested by the dog. All products intended for human consumption, whether prescription or not, need to be stored securely and out of reach of pets, and not used on dogs without the guidance of a veterinarian.
  • Foods, chocolate, and artificial sweeteners. This includes a wide variety of items but xylitol, grapes, raisins, onion, and garlic were the top poisons in this group.  If you own any "sugar free" foods or candies, keep them far away from your dog. Many contain the highly toxic ingredient xylitol. Others may contain sweeteners known to cause diarrhea. Other foods to keep securely away from your dog include anything with caffeine or alcohol, macadamia nuts, and chives which are in the onion and garlic family.  Chocolate is extremely toxic with often fatal results, especially for dark or baker's chocolate.  Unfortunately, many dogs are drawn to this deadly item. The ASPCA center received approximately 60 calls per day about chocolate ingestion.
  • Veterinary products. This includes medications administered improperly or poisoning due to labels not being read correctly or not following directions of the prescribing veterinarian.
  • Household items. The typical house is loaded with highly toxic items. Look under your kitchen or bathroom sink to see the array of potentially deadly products stored there. Paint and glue, oils, antifreeze, cleaning products, even some health and beauty items such as lotions, soaps, and cosmetics can be toxic to a curious canine. Some essential oils also are highly toxic to dogs. Remember that whatever you use to clean the floor will end up on your dogs paws or fur, providing a mechanism for possible ingestion. 
  • Rodenticides and insecticides. The same thing that makes those baits appealing to rodents makes them appealing to our dogs. Keep in mind that a dog consuming a dead mouse is ingesting not just the rodent but whatever that rodent has eaten. If the rodent was killed by rodenticide, your dog has just consumed rodenticide also. Bug sprays, repellents, and ant baits are common insecticides your dog could contact.  Our dogs make contact with the floor constantly, so exposure is not just through obvious traps or baits but may also come from contact with residue that is licked off the paws or fur.
  • Plants.  It is possible to love houseplants, gardening, and also dogs. Some even like to help with the digging chores. But we do need to choose plants with care.  There are many available that are safe for pets, but some of the most popular ones are highly toxic. A bored dog can easily destroy that beautiful hyacinth and end up with a trip to the ER assuming you catch it in time. Is your dog inclined to chew on a fallen or low hanging branch? Consider your yard plants also as many of those are highly toxic as well.  The ASPCA has a comprehensive guide for house and outdoor plants that is a must read for any dog owner. When I moved into my current house, there were some beautiful azaleas and rhododendron in the back yard. Not any more. I did find a spot in the front for them, fortunately, outside the fence. Way outside the fence where my dog never goes. The deer are very happy I did that. But that points out just how the definition of "poisonous" varies by species. The deer eat them readily, and other bovidea species such as sheep and goats would do just fine, but my dog could end up in cardiac failure or neurologic crisis if he ate them. My dogs also have had an amazing ability to find poison mushrooms and toads, so I spend a lot of time in the summer doing yard patrol to remove such hazards. 
  • Lawn and Garden products. Fertilizers, bone meal, compost, mulch, treated hardwoods, and herbicides all can be highly toxic to your dog. But they told you the lawn was safe for your dog after the weed and feed application dried, you say? Short answer, no it is not. The label saying it is safe after it dries is based on specific testing.  Numerous studies have shown that residue can be transferred from grass to a dog's paws long after a liquid product has dried or a granular product has been watered into the soil or rained on. That residue will be on the grass, then on your dog's paws and fur, and then in your house.  Usually that amount of exposure does not cause immediate poisoning, but long term risks remain. Herbicides and fertilizer products themselves, however, could cause a more rapid poisoning. Some wood mulch, like some lumber prepared for outdoor use, is treated with toxic chemicals and can be poisonous if ingested.  Many dogs are very attracted to Cocoa mulch, sometimes called cocoa bean mulch, which is a byproduct of chocolate production. Cocoa mulch has the same components that make chocolate toxic and can be very dangerous if ingested.      

Usually we think of poisoning as the result of accidental exposure, but it can occur with intentional exposure as well. Some dogs have had toxic reactions to flea and tick products which, even when used as directed on the label, can have serious side effects. Each dog is an individual when it comes to sensitivity and reaction. 

This is by no means a complete list. But I hope that a look at the array of products listed, with special consideration to all the additional hazards that seem to come with lawn and garden season every year, will heighten awareness of the dangers our dogs (and we humans, too) face on an everyday basis. Be mindful of the hazards that exist, know what to do if you find your dog has ingested something it shouldn't, and keep the poison control center number handy just in case.

More information: One of the best resources for more information: 

https://www.aspca.org/pet-care/animal-poison-control

Here you can find details about all sorts of toxic substances your dog might encounter as well as a guide for selecting safe plants for your house and yard. The guide covers dogs, cats, and other animals since toxicity is not the same for all species.

What to do if you suspect poisoning: If you have a case of suspected poisoning, quick action is critical.  First, if you can, try to identify the potential toxin. If you know what your dog consumed, grab the container to stop further ingestion and so you can tell a poison control expert about the product. Next, call a pet specific poison control helpline. There are several, and most do charge for the service. Charges may be waived for dogs registered with certain microchip services. AKC Reunite microchips are associated with a free poison control helpline but the service must be activated in advance through the AKC reunite website. Another well known source for poisoning-related information is the ASPCA Poison Control Center (888-426-4435).  Know where your nearest 24 hour veterinary emergency center is also. While you are thinking of it, put this number and the number of your Vet ER in your phone. Think of it as insurance, something you really need to have but hope you'll never use. Do not try to treat the poisoning until you receive professional advice about the product ingested. Depending on the poison, it may be appropriate to induce vomiting, but vomiting can cause additional harm in some cases. Always get the advice of a poison control specialist first. Keep a fresh bottle of 3% hydrogen peroxide available, along with a measuring spoon and syringe or measuring dropper, in the event you are directed to use this to induce vomiting. Keep it sealed, and replace it before the expiration date. Fortunately, hydrogen peroxide is inexpensive, but it is worth a fortune if you have an emergency and need to use it to induce vomiting.

Hopefully you will never need it, but here's a video on how to induce vomiting using hydrogen peroxide. There is some good information here about when not to induce vomiting, also.  Be sure to contact a vet or poison helpline first.

How to induce vomiting in a dog (and when not to)


In the near future I will provide a blog post about natural alternatives for some common household products including my favorite recipe for a non-toxic flea and tick repellent that really works.

Stay safe out there!


Friday, January 25, 2019

Titers or vaccinations? (Or, is your dog really “due” for vaccinations?)


Be forewarned, this is a long entry, but I want you to have sufficient information to be an informed partner in decision making with your vet about what is best for your dog.  While I hope you will take the time to read this so you understand the current recommendations, I have provided a summary at the end of this post.  Spoiler alert: I have been getting titers rather than repeated core vaccines for my goldens for more than 20 years, which is as long as I’ve been able to find veterinarians who were willing to do that. I was living in Wisconsin early in this time frame and, with one of the best veterinary immunologists in the country not too far away, I may have had earlier access than many to titer testing as an option.  Still, I had to make a lot of calls to find a vet who shared my viewpoint. OK, now I’ve given away the ending to some extent, but there are many angles to this topic, so please keep reading.  Health care decisions about your dog need to be based on informed discussions, not quick sound bites that came from the internet.  

How immunity and vaccines work. Let’s start with a very simplistic overview of how vaccines work (my immunologist colleagues will cringe, but they’ll get over it).  Vaccines are created with actual disease-causing bacteria or viruses that have been altered so that they do not cause the disease with which they are associated. Vaccines come in a variety of forms; you may have heard the terms “killed virus,” or “modified live virus,” both of which describe the way a disease-causing organism in a vaccine is altered so it does not make your dog ill.  When a vaccination is given, one of the things that happens is the lymphatic system produces antibodies to fight off the invading organism in the vaccine.  The antibodies remain in the body for a time, sometimes a very long time, and are primed to attack that virus or bacterium should it be encountered in the future.  There are a number of complex and interacting mechanisms that are involved in the immune response and different types of immunity, but antibodies generally are the first line of defense and the one involved with the titer testing we will be discussing.  So I’ll leave it at that. 

Sometimes more than one injection of the vaccine is needed to generate sufficient antibody response.  This is the case with “puppy shots” and also the reason that follow-up or “booster” injections sometimes are recommended after the initial injections.   Some animals do not respond completely to the vaccine and develop weak or limited immunity, though this is uncommon.    

How long is my dog immune after a vaccination? For many vaccines, immunity may develop that can last for several years or, in many cases, much longer.  The type of original vaccine as well as the animal’s response will affect the duration of immunity (DOI).  For some, it may last only about one year, which is why the Bordetella vaccine and a few others are recommended for annual revaccination. 

Dr. Ronald Schulz of the University of Wisconsin (Madison) School of Veterinary Medicine, one of the leading researchers in the area of veterinary vaccines and an author on the recent guidelines created by the American Animal Hospital Association (AAHA) and the World Small Animal Veterinary Association (WSAVA), has done extensive research on the duration of immunity achieved with initial core vaccines.  His research, going as far back as the 1970s and using the best techniques for studies of this type, has demonstrated repeatedly that the core vaccines provide immunity on average for 7 years or longer and, in some cases, immunity from initial vaccination may last for the life of the dog.

Core vaccines are the ones considered to be critical to the health of the dog and are recommended for all dogs. They include only the following at present:
  • Modified Live Virus (MLV) or recombinant Canine Distemper
  • MLV Parvovirus
  • MLV Adenovirus-2
  • MLV Parainfluenza Virus
  • Rabies

Adenovirus is related to canine hepatitis, so you may know the combination vaccine as the DAPP or DHPP (distemper, hepatitis, parvovirus, and parainfluenza). All other vaccines are considered Noncore, or to be given only if individual circumstances warrant based on a balanced consideration of risk and benefit. Risk includes how likely the dog is to encounter the disease organism based on environment or behavior, the risk to the dog if it contracts the disease, and whether the protective effects of the vaccine warrant the risk of the vaccine administration. Risk assessment might also include whether the disease can be avoided in other ways, for example, through minimizing exposure or using other means of prevention. 

In 2003, with evidence increasingly showing that the prevailing standard for yearly re-vaccination was not necessary, the major veterinary and animal hospital associations revised their guidelines to recommend a 3 year interval for re-vaccination.  The 3-year interval was a compromise position based on a number of considerations, not based on evidence that immune status lasted only 3 years. Since that time, the recommendation has evolved so that the guidelines now read that the interval between vaccination administrations should be a minimum of 3 years, in other words, as a general principle, a dog should not be vaccinated with core vaccines any more often than every three years.  As stated in the current guidelines of the World Small Animal Veterinary Association, “above all, it must be remembered that even a 3-year license is a minimum DOI [duration of immunity] for core vaccines and for most core vaccines the true DOI is likely to be considerably longer, if not lifelong, for the majority of vaccine recipients.”

What to do when your dog is “due” for vaccination (after initial vaccination series is complete)?  Immunity does not fall off precipitously on the vaccination “due” date. In addition, there is all that evidence that shows that for many vaccinations immunity lasts much longer than three years, often for the life of the dog. That leaves us with several options: assume the dog continues to have satisfactory immunity and do not obtain additional vaccinations (might be ok, but we have no way of knowing so there is risk to your dog with this option), booster the vaccinations just to be sure (might ensure immunity but there are risks to your dog of unnecessary vaccinations), or do serum titers that provide a measure of current immunity (evidence supports this as best practice).  Re-vaccination, if not needed, is of no benefit to the dog; a dog with sufficient immunity does not become more immune, so it is at minimum a waste of money and may be harmful because of possible negative effects of vaccination.  An adverse response to vaccine can occur with an array of symptoms and severity that ranges from mild to life threatening. While this is relatively uncommon, it does occur. Animals that are immunocompromised or have other health problems may be more likely to experience adverse reactions and this response also is more common in certain breeds and smaller dogs.  There is some evidence that the risk of adverse effects might increase with repeated vaccinations.  Vaccines trigger a complex immune response and the outcome of this repeated triggering of the immune system may have detrimental health effects ranging from short term lethargy to serious autoimmune disorders. There is a need for more research in this area although both research and anecdotal reports show that there is at minimum some risk associated with vaccines. 

The titer option.  Fortunately, we do not have to rely on guess work or just hoping for the best to protect our dogs. Research has shown repeatedly that antibody titers are a good measure of immune status following the initial core vaccination series.  (Initial titers sometimes are done after that series to ensure that the dog responded appropriately to the vaccines as there are a small number of dogs who are “non-responders”). The AAHA guidelines note that “a ‘positive’ antibody test result [for the core vaccines] generally does correlate well with protective (sterile) immunity in dogs. This applies to not only laboratory-based testing procedures (quantitative testing) but to in-clinic point-of-care (qualitative testing) antibody kits as well."  One deterrent to titer testing had been the fact that it was more expensive, especially with samples sent to a laboratory for testing. As more people have sought titer testing in lieu of repeated vaccinations, and more veterinarians are receptive to this approach, prices have come down and new options are available, including the tests that veterinarians can perform in their own clinics. 

The WSAVA guidelines describe titer testing as the better practice compared to repeat vaccination:  “The [Vaccination Guidelines Group] recognizes that at present such serological testing might be relatively expensive. However, the principles of ‘evidence based veterinary medicine’ suggest that testing for antibody status (for either puppies or adult dogs) should be better practice than simply administering a vaccine booster on the basis that this would be ‘safe and cost less’.” Titers currently are available for all of the core vaccines. Titers should be monitored regularly to determine when revaccination might be indicated. Most people who use titers to monitor immune status repeat these with the yearly exam. The best interval can be determined by your veterinarian in discussion with you about your dog’s lifestyle and it also will vary depending on the specific vaccine administered previously to your dog. 

The rabies vaccination exception.  Unfortunately, we are faced with one exception to this decision making process due to the legal requirement for rabies vaccination. Rabies titers are available but few, if any, localities have changed their laws to match best practice for rabies vaccination.  Some local governments have a process to apply for an exception with exceptions being considered if the dig is debilitated or otherwise compromised such that the vaccination is likely to be harmful to the dog. These exceptions require approval by a local health officer and may be difficult to obtain.  Rules vary by locality.  In the event of a bite incident, the dog who is not up to date with rabies vaccination, even if only a few days past the due date, could face dire consequences, a risk that is greater than the risk of contracting rabies if the vaccination becomes past due.  So the rabies vaccine is needed when local laws dictate to protect the dog from legal ramifications if not the disease itself.  At least the rabies vaccination schedule has been changed to a 3 year interval, and the particular vaccine is of less burden on the immune system than some other vaccine types.  Further effort to extend that timeline or to gain acceptance for rabies titers will help alleviate this burden on our dogs.  

Summary – Current best practice

The current best practices regarding vaccines and your dog, supported by decades of quality evidence and as expressed in the guidelines of the American Animal Hospital Association and the World Small Animal Veterinary Association, support the following:

1.  Ensure baseline immunity through proper administration of core vaccine initial series.  For puppies, this involves administration, on the proper schedule, of the recommended “puppy shots” and booster. For adult dogs with unknown vaccine history, there are a couple of different options depending on what is known and the veterinarian’s approach. 

2. If finances allow, conduct a titer test to determine responsiveness to the initial vaccines. A blood sample taken about 4 weeks after the last vaccines in the series can be analyzed to determine that the dog is showing the desired immune response. The incidence of non-responders is quite low, so this is not essential, but if you want to be really certain that immunity has been established, this option is available. This may be particularly useful if the plan is to do titers in the future.

3. Avoid unnecessary vaccinations, including re-vaccination and non-core vaccines that are not indicated by your dog's individual situation. Consider carefully with regard to the dog’s lifestyle and risk whether any of the noncore vaccines are needed.  Balance the benefits of protection against the risk of the disease, both in terms of the risk of your dog contracting the disease and also the seriousness of the disease if your dog becomes ill.   

4. Perform serologic (titer) testing at intervals to determine maintenance of immunity. Revaccinate only when titers indicate booster is necessary (generally before it falls into the negative range) or if changes in the dog’s risk status warrant.  

5. If titers are not an option, then minimize vaccination by at least having your dog vaccinated no more frequently than necessary and with only the vaccines appropriate for your dog. Discuss with your vet the best management approach for your dog based on the dog’s lifestyle.

Wishing you and your dog the best of health!  



Links for more reading are provided below.  I welcome your questions and comments. 






Wednesday, December 26, 2018

New Year's Resolutions for Your Dog


Happy Holidays, everyone! 
      
This is Henry writing. As a rescue golden who has been around the block a few times (quite a few blocks, actually), my Mom asked me for my ideas for a blog to start the new year.  Whether you participate in creating resolutions for the new year or not, it’s always a good time to reflect on whether or not our dogs are on the best path.  Initially I wanted to write about my real goals, which include more decadent things to eat or to roll in, or perhaps both; partaking in new smells; and more opportunities to show people that dog hair all over their clothing is the best accessory possible.  But Mom insisted I stick with the basics.  You may already do most if not all of these things, so the list may represent a continuation of good practices rather than new behaviors.  Either way, it is a good reminder of just how much we all count on our humans for our health, well-being, and safety.    

1. I will eat only a high quality diet with proteins appropriate for my special needs. That means food from reputable companies with a good safety record and quality ingredients.  My Mom reads the label of everything I eat very carefully. Proteins are selected to address my allergies which previously contributed to my skin and GI problems and also chronic ear infections. Mom also uses ayurvedic and Chinese principles to help with my anxiety and it has made a big difference. In short, food is the foundation of health overall and one of the most important things our humans can do for us is make sure we have a good diet specific to our needs.   

2. I will maintain ideal weight. That means being able to feel my ribs when you run your hands along the sides of my body. They shouldn’t be pronounced, but you should be able to feel the ridges of the ribs a bit. I also should have a bit of a waist when you look at me from above.

3. I will get plenty of exercise and mental stimulation.  There’s a saying in dog training that a tired dog is a well behaved dog. As a former throw-pillow chewer (ok, there was one recent slip up, I’m really sorry), I have to get rid of my energy and, sometimes, my anxiety and nervousness come up, too.  We all have our issues and limitations, so activity has to be adapted to the dog and also for weather changes, especially our hot and humid summers.  I have puzzle toys and mom plays hide and seek games with me since I can’t get all the physical exercise I need because of some orthopedic issues.  I also go to new places frequently, take my walks using different routes, and walk in different locations just for a change of scenery and to build confidence and improve socialization. That also gives me more quality time with my human which is one of the most important things in my world.

4. I will brush my teeth daily. OK, daily is a tall order and I still don’t like it, but I’m getting used to it. I resisted at first, but my Mom is persistent when it comes to my health. By age 3 more than 80% of dogs have dental disease and that can lead not only to severe tooth and jaw problems but all sorts of serious medical conditions. Home tooth brushing on a regular basis can prevent the vast majority of those problems or, at minimum, decrease the need for professional cleaning.

5. I will have good pain control.  We are fortunate in Central and Eastern Virginia to have so much wonderful veterinary care available and a lot of treatment modalities. It may take some trial and error and openness to different types of treatment, but with so many options available and with attention to diet and exercise, it is possible to have a good quality of life in spite of our problems.

6. I will make sure my environment is safe.  So many problems can be avoided with attention to surroundings – my Mom knows the common poisons, avoids or minimizes chemicals around the house and yard, and makes sure everything is safe for me whenever she is not watching me.  She also knows what I have trouble resisting and keeps that out of reach (Hint: you will have trouble finding paper towels around my house). I will keep practicing my “leave it” command.  Now if I could just stop being so fascinated by those toads that show up every summer… 

7.  I will have appropriate and safe chew items available and be supervised while chewing them. I’m good at this now (except that one pillow slip up) because my Mom provides me with things that satisfy my need to chew and are safe for my teeth. I never eat rawhides and I know the source of my chews and that they are non toxic.

8. I will maintain good hygiene. Nope, I'm not going to take baths on my own, but I do understand the importance of regular brushing, baths on an appropriate schedule, and keeping my ears cleaned and nails trimmed. It’s not just for show, but important for my health. It also gives my Mom a good chance to check for hot spots, lumps, ticks (multiple times a day on that one!), and anything else that might be amiss. 

I have more I could add, but if I keep at these, I’ll have a great foundation for a long, healthy, and happy life. What are your resolutions?

What would you like to learn about this year? Indicate in the comments below and let's get my mom busy addressing some of your interests.  My mom loves reading up on veterinary issues and providing information that may be helpful to you all. Besides, if I keep her busy studying some topic, she might forget to brush my teeth one day at least...

Wishing you all a happy, healthy, and golden New year!

Henry



Monday, October 1, 2018

Dwarfs, Miniatures, and Maxwell, Oh My!


 The recent addition of Max (now known as Maxwell Strong) to our SEVA GRREAT family makes the subject of dwarfism and miniatures a timely topic for a blog post. Some of you may be wondering why being a dwarf is a concern. Other dwarf dogs have been around for decades, some dogs are bred intentionally for those characteristics (Dachshunds and Corgis, for example), so why all the worry about a dwarf golden retriever? I would bet that many golden retriever owners have wished, if only just once, that there could be a smaller version of their beloved breed. How convenient it would be if we could sweep them up in our arms to get them out of harm’s way, help them down stairs when they are older, or maybe have enough room in the RV for a human occupant in addition to the golden retriever (or is that just my problem?). Some famous dogs have been dwarfs, for example, the much beloved Smiley who warmed hearts around the world for years.  Some breeders now produce “Miniature Golden Retrievers.” What a deal. Or is it? So with Maxwell being a focal point of our SEVA GRREAT family, it’s a good time to take a closer look at “Miniature Golden Retrievers” and also the medical condition known as dwarfism and the differences between the two.

Miniature Golden Retrievers (also known by some Trademarked names) are not small golden retrievers but are an intentional crossbreed for the purposes of producing a smaller dog with at least some golden retriever characteristics. The label “miniature golden retriever” may be applied to any mix of golden retriever with any smaller dog for the purpose of producing a dog that is smaller than the golden retriever breed standard but still has some characteristics of a golden retriever.  Most commonly this is done by breeding a golden retriever with either a small golden doodle, cocker spaniel, or poodle.  The result, in terms of size, temperament, energy level, and other characteristics, is variable depending on which breed and characteristics are most highly represented in the offspring.  Some will look and act more golden, some more cocker or poodle.  There is a misconception that such crossbreeds are healthier, a belief that overlooks the fact that many dogs share common genetic predispositions.  The same rigor in screening for health risks should be involved for crossbreeds as for purebreds.  

The term dwarfism is used with an array of unique growth patterns.  Note that being a "miniature" and being a "dwarf" dog are not related in any way.  Sometimes dwarfism involves only small stature and may even be an intentional genetic mutation as is the case with Dachsunds and Corgis. We know, however, that dogs bred for such characteristics often have significant skeletal problems and other health challenges.  There are other types of dwarfism that involve a variety of serious health concerns in addition to the small stature. Our guy Maxwell has a particularly dangerous form that poses a severe threat to his health, a form known as pituitary dwarfism. This is a genetic condition that occurs when both the male and female used in breeding are carriers, though they do not need to be dwarfs themselves.  Max's pituitary gland is not producing the growth hormone needed for him to grow and be healthy. This is not just a problem for bone growth but affects all the tissues in the body. Growth hormone is essential for life; many of the cells in our bodies are constantly growing and being replaced and, without growth hormone, those cells gradually die. It is as if Max's development arrested at a very young age. He has not produced adult teeth, still has his puppy fur, and is about the size of a 4 month old in spite of his age of 6 months. In addition, without growth hormone, as cells in the body die, they cannot be replaced which leads to progressive decline.

Pituitary dwarfism is quite rare.  The German Shepherd Dog (GSD) community is most familiar with this condition and one estimate is that as many as 30% of GSDs are carriers of this genetic mutation. Most of the research has been focused on development of screening tests to avoid breeding GSDs with this recessive trait. As Maxwell's situation makes us wonder, the incidence could be on the rise and it is showing up in more breeds beyond the original limited array of dogs.  Researchers have identified the gene mutation responsible for this condition in GSD, but it is not known whether the same genes are involved in other affected breeds. Little is known, also, about treatment and long term outcomes as the majority of these dogs are euthanized. This may not be necessary, however. There is treatment available in the form of medication to stimulate the release of growth hormone from other tissues in the body since the pituitary is not working. Although this is not the same as what the pituitary would produce if it were working properly, there are limited studies showing that after a few years of treatment the dogs did grow, achieved a normal coat of fur, and improved in a number of ways although they did remain smaller than normal for the breed. Dogs with malfunctioning pituitary glands often have inadequate amounts of other hormones produced by the pituitary, so supplementation of those may be needed as well over time, particularly hormones affecting the thyroid and the kidneys.  

Maxwell’s case seemed like a good time to write an entry on this unusual topic and also one I never expected to write. I hope people reading this find this helpful not only in understanding this beautiful little guy's challenges but also the emergence of "miniature golden retrievers." If you find yourself wishing for a small golden, be aware that small may involve other changes or possibly health challenges beyond just being a bit on the petite side.

Visit Max's Go Fund Me page for more information or if you can help support his treatment.

Sunday, August 5, 2018

Dilated Cardiomyopathy - heart disease and diet link?


Recent news about a possible link between diet and a particular form of heart disease has drawn more attention to a longstanding problem in our beloved goldens.  Social media has been loaded recently with mention of grain free diets being bad for the canine heart and warnings to stop feeding diets of that type. Whether or not grain free is beneficial or necessary is the subject for another post. For now, let's look at this current news.  The concern about diet and a form of heart disease referred to as dilated cardiomyopathy (DCM) actually has a history dating back to the early 1980s with research ongoing since that time. Recognition of DCM occurring in some unique circumstances recently has led to new attention being given to this condition and a possible connection to diet. Golden retrievers are one of the breeds that may be predisposed to developing this dreadful condition. Let’s take a look at the heart disease part of this story and then the dietary component. 

In dilated cardiomyopathy, the heart enlarges (dilated) which makes the heart (cardio) muscles (myo) damaged or sick (pathy). A simple description of this condition is that the muscles of the heart enlarge which causes them to weaken. As a result, the heart does not pump properly. That leads to poor circulation of the blood throughout the body and the kind of damage you would expect with a poorly functioning heart. If you are familiar with heart failure in people, the process and outcome is the same in dogs. The heart has to work harder yet it continues to be less effective as it pumps.  Fluid builds up in the lungs and other body parts, and a dangerous process leading to heart failure ensues.  The valves in the heart may start to leak and the dog starts to show the same signs of congestive heart failure that we see in people. 

Early in this process there may be no symptoms, or the dog may seem to tire more easily, pant more, or not tolerate exercise as well. Your veterinarian may notice a heart murmur. As the disease progresses, there can be episodes of coughing, panting or heavier breathing, weakness or fainting. The dog becomes at risk of sudden death without treatment or if activity is not moderated. The heart may develop an abnormal rhythm which can lead to sudden death even without the other symptoms.  Proper diagnosis and early intervention are critical to at least slow progression to heart failure and minimize the risk of sudden death. Treatment is very similar to treatment of humans with heart failure and includes medication and activity restriction. The disease usually is progressive, meaning it will continue to get worse.  Medication can slow the progression, but it cannot restore a healthy heart.

A particular array of amino acids is critical to healthy heart muscle as well as to other body components and functions. Taurine is an amino acid that is especially important in cardiac function and is the amino acid of concern with the possible link between diet and DCM.  Dogs usually can create taurine from other amino acids so it is not typically added to prepared foods. Cats cannot, so it is common to see taurine on the list of ingredients on cat food labels.  Some dogs have problems synthesizing taurine, however, and there is evidence that golden retrievers, at least some of them, may be genetically predisposed to an inability to synthesize this important amino acid.  That means they need to get it through their diet or through supplements.

Over the last decade or so there has been some evidence of a possible link between DCM and diet especially for animals who cannot manufacture taurine. There are a couple of factors at play in this scenario. One is the use of “exotic” (uncommon) meats in diets with the meat sources possibly being deficient in the components that dogs need to manufacture taurine. The other factor is the substitution of protein sources in some diets with ingredients that do not provide the necessary amino acids. It is not the fact that a diet is grain free that is the problem but the ingredients overall that are included in many diets. Home prepared meals have been implicated in diets linked to DCM as well as some commercial preparations.  Foods that include peas, potatoes, lentils, and legumes as some of the first ingredients are thought to be particularly troublesome in regard to taurine deficiency whether the diet is grain free or not.  There is some early research showing that diets that are high in carbohydrates may displace amino acids or may interfere with taurine absorption. 

So, what do we do to protect our beloved companions? In time, research will give us better answers including dietary recommendations. In a future post, I will be writing about how to choose a good food for your dog. The good news in this situation is that DCM due solely to taurine deficiency might be reversible if caught early. There are some dogs with normal blood taurine levels, however, who still are at risk for DCM. What we know at present about golden retriever health tells us it is a good idea to do the following: If feeding a prepared food, make sure it is a high quality, balanced, AAFCO certified food from a reputable company and distributor. Read the ingredient label and make sure a quality protein is the first ingredient listed.  Typically this will be some form of meat, fish, or eggs. Keep up with visits to your veterinarian, annually at minimum.  As your dog ages, twice a year visits may be appropriate. Be observant for signs of activity intolerance such as your dog becoming tired more easily, a cough especially related to activity, or excess panting. Sometimes the cough will be more of a soft, throat-clearing sound than a harsh cough.  These can be early signs of many conditions with heart disease being among the possibilities.  See your vet as soon as you can if you notice any of these signs. During routine visits, talk with your vet and determine if any diagnostic tests are warranted for your dog related to DCM and other conditions common in golden retrievers.  If your veterinarian detects a murmur or has other concerns, be open to the additional diagnostic tests that may be recommended.  Since early detection is crucial, it is a good idea to have heart health, including DCM, on your “discuss with my vet” list for an upcoming visit. 


Want to read more?  

See the original FDA report here

Morris Animal Foundation has funded research in this area. See their news report









Friday, July 13, 2018

Introduction

I want to introduce myself as the Medical Coordinator for SEVA-GRREAT. This is a new position for the organization, and I am absolutely thrilled to be serving in this role. In this capacity, I oversee the health and medical needs and services for the dogs in our care and work very closely with the other members of the team to ensure our dogs get the best we can provide for them.  This involves not only management of the dogs needs but support for the foster families who are a critical part of our work. We couldn't do it without them!
A little info about me:
My name is Beth and I have been a registered nurse for a long time and a dedicated lover of golden retrievers for even longer. I am a university professor, administrator, and researcher with a special emphasis on chronic illness and helping people live the best lives they can.  Early in my career I worked in intensive care settings, but over time realized I really wanted to try to keep people out of ICU rather than work with them once there. My clinical work and research, along with my own personal interests, incorporate a broad perspective of health and wellness. This emphasis translates very well to our golden retrievers who, as we know, are prone to a number of health challenges but who also deserve the opportunity to live the best life they can.
I fell in love with my first golden when I was about 8 years old and have had the pleasure of sharing my life with 5 now.  I have done obedience competitions and therapy work with my goldens and, sadly, have a lot of experience with their health issues, too.  Mostly, I just cherish that incredible golden spirit.  My idea of fun is sharing new experiences with my dog and watching him continue to bloom (he is a rescue who came with a lot of baggage) and, of course, reading research about veterinary and other health issues. 
It takes a dedicated team to help a golden in need, and SEVA-GRREAT has an absolutely amazing group of volunteers who make GRREAT things happen for our goldens.  I am honored to work with this incredible group of people to assist in managing the health needs of the dogs in our care. 
Please check out our website at http://adoptagolden.com

You can sign up to get email notices when there are new posts to this blog and also, as the entries increase in number, use the search feature to find information posted previously. Thanks for visiting and I hope you find this site useful in the care of your own golden retriever.

Sunday, July 8, 2018

Safety begins at home

In this blog about health and related issues about golden retrievers, it makes sense to have one of the first entries focused on safety. Safety provides the foundation for everything else we do to help our golden retrievers live long, healthy, and happy lives. There are lots of areas in which safety should be a concern: playing, going for a walk, play dates with other dogs, riding in the car. A safe environment free of dangerous things your dog might ingest, however, is crucial in the world of golden retrievers. I'll never forget taking one of my golden retrievers to a local emergency room when she developed a very large swelling on her nose subsequent to a wasp sting. Fearing a more exaggerated allergic reaction, and of course it was a Saturday night, I wanted to make sure things did not get worse and cause some real problems for her. So, off we went to the vet ER. Upon walking in the door, we were greeted with a chorus from the staff,  all saying in unison "and what did yours eat tonight?" The waiting room had no fewer than 4 golden retrievers in it, all of whom had ingested something they shouldn't have.

Golden retrievers are notorious for putting just about anything in their mouths and, more often than not, swallowing it.  This can lead to an array of consequences ranging from simple intestinal upset from eating "junk," a situation veterinarians refer to as "dietary indiscretion," to bowel obstruction or even accidental poisoning. If you are new to golden retrievers you will discover this soon enough. If you have lived with golden retrievers before, you will learn that each one is a unique individual. The fact that previous goldens never touched your socks on the floor does not mean the next one will display those same good manners.  One may carry around a stuffed toy for weeks, while another destroys it in a flash.  My boy loves paper and systematically and methodically removes (and destroys) books from any bookcase he can reach. I now have the bookcases in any room he can enter stacked high on top with books while the shelves remain empty.  I tell people it's a new trend in decorating.

Keeping a safe home for a golden is an important part of sharing life with these amazing dogs. I hope the ideas below will help you create a safe environment with fewer problems for your dog and fewer worries for you.

1. Put away, securely, anything that could be harmful. Think like a 2 year old, get down low, see what the dogs see at their level, what can they reach, what would harm them if they did chew on or ingest it, and secure those objects out of reach or in another location.  Then stand up and do the same. Eye the countertops. Goldens can be expert "counter-surfers," so what you think is high enough may not be really out of reach for them, especially as they grow. Look especially for some of the items listed further below.

2. The ASPCA Poison Control Center is a wonderful resource. Put their number in your phone, on speed dial, on the refrigerator. Keep a fresh bottle of hydrogen peroxide in your doggie first aid kit. In the event of ingestion of something potentially poisonous, the ASPCA may advise you to administer a specific dose to induce vomiting.  Vomiting is not always the right thing in a case of accidental ingestion, so let the poison control center staff tell you what to do. They are excellent.  More info here:  https://www.aspca.org/pet-care/animal-poison-control

3. Poisonous plants: On the ASPCA site above, they also have a poisonous plant list that covers house and yard plants. Many very popular plants are quite toxic to dogs and need to be well out of reach. 

4. Common foods that can be very harmful to our goldens include 

a. Chocolate
b. Caffeine
c. Onions and their relatives, which includes garlic and chives. 
d. Grapes
e. Raisins
f. Macadamia Nuts
g. Alcohol
h. Artificial sweeteners, especially Xylitol - very common in items labeled "sugar free"

That is a just a starting list of some of the more dangerous foods. Of course other foods can cause gastric upset, diarrhea and vomiting, or the potentially life-threatening pancreatitis, especially foods with a high fat content. Check the ASPCA list for more info.

5. Human medications: use extra caution when storing or working with medications intended for humans. A dropped pill might be grabbed by your golden before you even know where it went. 

6. In the yard: be on the lookout for dangerous objects, chemicals and plants. Mulch is a very popular chew for goldens, especially puppies, and even the "natural" products can lead to significant dehydration or gastritis. Cocoa mulch is highly toxic. Insecticides and pesticides can be extremely dangerous. Eating grass with pesticide residue could cause problems also. Plants such as azalea, rhododendron and lillies are common in southern yards and can be dangerous if ingested as you will find on the ASPCA list. Be aware of small rocks and pebbles such as those used in landscaping which some young dogs find enjoyable.  At minimum, you could be looking at some expensive dental work. Things that run, slither, slime, croak, and scamper are fascinating, too, and some can be harmful. Be attentive to protecting the wildlife while also protecting your dog. 

7. Auto antifreeze: it has a sweet taste and dogs really go for it. Consumption of auto antifreeze has a high fatality rate. 

8. Other: here is a catch-all because, as noted above, goldens can and will eat anything. Some love plastic, some love paper, some love socks and other clothing items, any of which can cause gastritis or potentially life-threatening obstruction. 

This list might sound rather scary as if the world is full of things that will hurt our dogs. But unlike many risks we face in life, everything on this list is something we can manage or control. Keeping a safe environment for your golden in an important step in helping your companion live a long and healthy live. With a little effort, you won't have to hear the "what did yours eat?" question.