Updates on Current Respiratory Disease Concerns

I am monitoring a number of veterinary medical and news sources for any changes in information regarding the current respiratory disease that is in the news. On 11/30, I watched a webinar presented by two highly regarded infectious disease veterinary specialists. Here is a recap of that and what seems to be the current status of understanding regarding the recent round of respiratory problems.  These are individuals who experience a daily deluge of questions and are in the thick of the situation, so to speak, so have a good handle on the bigger picture with this round of Canine Infectious Respiratory Disease Complex (CIRDC).

1. Data: There are many, many questions about what is going on at this time. Meaningful data are essentially absent as there is not a useful, comprehensive database for disease tracking of conditions like this. One source of information is insurance claims data indicating how many claims have been submitted for certain conditions. People with dogs with respiratory illnesses are encouraged to have samples submitted so additional testing can be done to help answer the many questions around this condition.

2. Organism: There has been some interesting DNA sequencing from ill dogs showing organisms similar to mycobacterium, a well known genus of a number of bacterial diseases including pneumonia, and some sequencing that looks like a relatively new viral organism. But neither is definitively linked to current respiratory disease. Work is ongoing to identify possible causative organisms which will help a lot with devising effective treatment plans. 

3. Outcomes: There is a higher incidence of fatalities, but that could be due to more cases. More sick dogs naturally means more fatalities. Without good data, it is not clear if healthy dogs are succumbing or only high risk dogs. There are some anecdotal reports on the web and in the general news media of healthy dogs becoming seriously ill, but again not enough data to make meaningful connections. Cornell University confirms that this particular outbreak is associated with a longer course of illness and more severe outcomes for some dogs and does not respond to the usual treatment for other CIRDC illnesses. Many dogs do recover without problem, though it seems to take a bit longer in this current situation.  It is not known just what leads to different outcomes in different cases. Add this to the list of questions at present. 

4. Incidence: Claims data from Trupanion does show an increase in claims for respiratory conditions. Without a sound tracking system, claims data can be a somewhat useful indicator of cases. There are a lot of limitations to that, but there are limitations with all tracking systems due to reporting mechanisms. Claims are up as much as 70% in some areas. As of the end of October, Trupanion shows a 5.41% increase in the number of claims in Virginia.  Some of this may be due to higher awareness and more people seeking care for symptomatic dogs more quickly than they might have in the past. Another unknown. Regardless, 70% is a sizeable increase, so there is something going on. 

5. Vaccination status: This could be a factor. It is possible that people are more selective about vaccinations, perhaps foregoing some vaccinations altogether, or focusing only on the core vaccines. That would leave many dogs without Bordetella or parainfluenza vaccination, possibly opening a window for more infection and greater spread. This was one of many "hypotheses" presented by these specialists. Again, we don't know.

6. What to do: In spite of all the unknowns, they advised the standard caution for respiratory diseases, which are -- Keep vaccinations up to date, particularly Bordetella and parainfluenza. Influenza vaccine may be important as well depending on local data. That vaccine is not always available. Avoid contact with dogs of unknown health and vaccination status. Keep symptomatic dogs away from other dogs including in the same household. Good hygiene/sanitation around the house. They emphasized there is no need for panic, but also a need to be wise.  

More specific guidelines have been developed for dog-related businesses such as grooming shops, day care, and boarding facilities, etc. So while the "don't panic" message is clear from many sources, there is good reason to be diligent and cautious. 

I will continue to monitor credible sources of information and will update this blog entry when there is new information to share. Feel free to bookmark this page and check periodically for updates.

It's Always Respiratory Disease Season

Those of us on the human end of the leash are well aware of the variety of contagious respiratory viruses that seem to be ready to pounce on us as we innocently go about our daily lives. Unfortunately, our dogs are subject to their own array of respiratory illnesses. While many respiratory conditions might be considered seasonal or isolated to specific circumstances, it is now wise to be on the lookout and in protective mode throughout the year. Recent outbreaks of canine influenza across the United States serve as a good reminder of the need to raise our caution levels a bit more.  

Most dog owners are familiar with “kennel cough.” There are a number of different organisms that can cause a cough and respiratory condition including an array of bacteria and viruses. Because of the complexity of these infections this condition sometimes is referred to as Canine Infectious Respiratory Disease Complex (CIRDC).  One of the more common causative agents is Bordetella bronchiseptica and there is a specific vaccine available for that particular organism. Because other organisms can be responsible, the Bordetella vaccine does not offer complete protection, although it does offer a considerable decrease in the likelihood of infection with this agent. Other vaccinations are available for additional protection, particularly parainfluenza and adenovirus.  Distemper also has a respiratory component and is one of the recommended core vaccines but is significantly distinct from what we usually think of as “kennel cough.” 

In the last year or so, outbreaks of canine influenza have led to serious illnesses and the closure of a number of shelters and other facilities for dogs in order to control the spread of this dangerous disease.  Several of these have been in the mid-Atlantic area including D.C., Virginia, and North Carolina. Canine influenza is viral in origin with two specific subtypes of the Canine Influenza virus being responsible for outbreaks in the US so far.  Canine influenza gained considerable attention in 2004 when a number of racing greyhounds were affected. The causative agent for that outbreak was identified as Canine H3N8 influenza virus which is thought to have originated in horses. In 2015 another subtype (H3N2) was found in association with some severe cases during an outbreak in Chicago.  The H3N2 strain also has been found in cats who were presumed to have been infected by transmission from dogs. 

Illnesses associated with CIRDC are highly contagious. Similar to how respiratory disease spread among humans, dogs can spread infection before there are obvious signs of illness. This makes it much more difficult to control and, for us trying to keep our dogs safe, also to avoid exposure. In most cases an infected dog will show signs of illness, particularly an obvious cough. In addition to the cough, other signs that are easy to observe in other animals are noisy or labored breathing and nasal or eye discharge. Infection is spread through the close contact including sharing toys or water bowls, close play, or any close contact that enables a dog to inhale or ingest droplets from the cough or sneeze or saliva of an infected dog. A dog who is showing any signs of respiratory disease should be kept apart from other dogs. For the most part, we humans are safe from these particular pathogens. Only one of the causative organisms, Bordetella, is known to spread to humans but that is very rare and more of a concern for people with compromised immune status.

A hallmark sign of CIRDC is the sudden onset of coughing. It is common for the cough to have a loud honking sound, although this is not essential for diagnosis. Nasal and eye discharge may be present as well. The cough and other symptoms tend to appear suddenly, often within 2-3 days of exposure. Kennel cough can be self-limiting provided the lungs are not involved; similar to our cold viruses, the dog might recover on its own within about 10 days or so.  Canine influenza has the potential to be more serious with dogs in poor health otherwise or those very young or very senior being at greater risk. Since the owner cannot tell what organism has infected the dog or if the lungs are involved, it is best to have a veterinary examination to determine an appropriate plan for each dog.  The veterinarian will be interested not only in the examination of the dog but the dog's recent activities which gives a clue to possible exposure.

Any upper respiratory condition (the pathway that carries air prior to reaching the actual lungs) can progress to a more severe state if the lungs become involved (pneumonia). As with most illnesses, this is a greater risk for debilitated animals. The dog may seem distressed and uncomfortable from coughing and some symptomatic relief can ease the process for the dog and concerned owner as well.  Typically a cough suppressant is prescribed which can help the dog be more comfortable. Occasionally antibiotics are prescribed if there is suspected or bacterial infection or concern or developing a secondary infection beyond the initial cause. Antibiotics are not effective against viruses and should be used judiciously. In addition to these measures, supportive care can help the dog be more comfortable and make good progress through the disease. Supportive care includes ensuring adequate rest and maintaining good nutrition and drinking plenty of water.

CIRDC, including kennel cough and influenza, are ongoing concerns for our dogs. The dedicated caretaker or pet parent should be aware of the widespread nature of these diseases and the potential for outbreaks and take steps to protect dogs from becoming ill.  An important starting point is to ensure the dog is up to date with core vaccines (or titers) which offer some protection against several of the causative agents. Discuss with your veterinarian your dog’s lifestyle, including potential for exposure and risks associated with respiratory illness, to determine if any additional vaccinations are appropriate.  Stay alert to any news about outbreaks in your area or locations where you may travel with your dog. Minimize exposure to other dogs during times of high disease activity. This is especially relevant for dogs of unknown history such as at a public dog park. It may be safer for your dog to visit a dog play group or day care where someone supervising the dogs is likely to notice a cough or other signs of illness. Check what vaccinations are required for a dog to attend that facility. Consider your own dog’s health and risk profile to determine best ways for exercise and socialization. Of course, a healthy dog is better able to recover from any illness, so good nutrition, weight management, and exercise are beneficial for any dog.  If your dog does develop a cough, contact your veterinarian for an appointment. Be sure to tell the office personnel that your dog is coughing.  They will have specific directions for how you can bring your dog for examination while minimizing exposing other animals to a respiratory illness. Keeping your dog fit and healthy and taking just a few precautions can help you and your dog enjoy activities without interruption from a respiratory infection. 

 

What If There Were No Veterinarians?

At SEVA GRREAT, we take the health and well-being of our dogs very seriously, and our relationships with our veterinary partners is a crucial part of our work. We are incredibly fortunate to have access to amazing expertise, coupled with boundless compassion in our veterinarians and in all the members of the veterinary teams with whom we work. This skill and talent ranges from the front desk staff all the way to the veterinary techs, assistants, and kennel attendants. We could not be more grateful for what they do for our dogs and for the humans who care about them.

My title for this entry may seem a bit apocalyptic. But in just the last few weeks, I have read or personally experienced multiple public announcements or other communication from veterinary practices about the extreme stress they are experiencing and pleas for people to be understanding and respectful. This is showing up in the veterinary literature I follow as well, and it makes me wonder if my title really is that far-fetched. We are all experiencing longer delays for appointments, reduced access to urgent care, and much busier veterinary settings overall.  Emergency rooms are turning away cases that might have been seen just a few years ago. Veterinary hospitals and emergency facilities are having to make some difficult decisions to prioritize care to make sure those in greatest need are seen quickly. That means some others will have to wait longer than what has been the case previously.

No doubt some of the challenges are due to the changes that practices had to make to keep open and to ensure the safety of all the people and animals they encounter. Maintaining the high standard of care that our veterinarians provide is taking a little longer these days, and the demand for care has skyrocketed. As the stress and demands on these professionals have increased, some practices are making changes just to maintain the ability of the staff to keep functioning at such a high level.  Some clinics have reduced hours or have a time of shutdown during the day to enable everyone at the clinic to catch up on work. Some have days during which they close completely. Several of the emergency clinics we rely on have reduced hours or had complete shutdowns for a brief time, reducing access to care and obviously shifting the load to other facilities that are already operating at capacity.  Staff turnover has been high in a field that already had challenges hiring well prepared personnel, and it is not uncommon at some clinics to encounter many new personnel on the administrative side and often with the animal care side as well.  Add to the challenges the context of longstanding and under-recognized comparatively high rate of suicide among veterinarians.  (See link to Not One More Vet at the end of this entry.) I am hearing repeatedly, from a number of sources, that the stress and emotional demand on veterinary staff that has always been there is getting much worse.

What makes me most heartsick about this scenario, however, is the veterinary staff who report being routinely subjected to rude, hostile, demeaning, and sometimes threatening behavior by the people with whom they interact. Perhaps it is only a small percentage of people who behave that way. But it cuts deeply, and it leaves a lasting impression. As more than one clinic staff has reported, it may be just a few, but those are the ones you remember until you just don’t want to do it any longer. 

Big deal. We’re all stressed, you might think. We’re all struggling so what is the problem? Veterinarians surely are used to the stress and demands of the work. Many come to their positions through a long history of animal care, often starting as veterinary assistants in a practice. (One of the articles linked at the end of this post does an excellent job capturing some of the common themes in the life of a veterinarian.) But they are not used to the level of hostility and rude behavior they now encounter on such a frequent basis. No one should have to become used to that.  I have heard stories of people being threatened, arguments over costs and a client being willing to pay only a portion because that’s “all the service is worth.” There are stories of name calling and insults I won’t print here. It has gotten so bad that some have had to shut down practices for a time or, at minimum, adjust work hours in order to take care of themselves.  Research consistently has shown that when people are stressed and overloaded, performance suffers and mistakes can be made. Add hostility and name calling to the regular stress of the work and who can blame them for some of the changes they are instituting to protect themselves and the quality of the care they provide. Thank goodness it is likely only a few people who behave this way, but even that is too many.

But that can leave us feeling frustrated that we do not have the access to which we are accustomed, and it is frightening to think about what you would do if there were a true emergency and your nearest animal hospital is closed for a week because they had to restructure to keep working in this challenging environment. Even dealing with doggie diarrhea for an extra few days while you wait for an appointment can be distressing for you and your dog. So what are we supposed to do?

We can do a lot! We are facing a compelling, perhaps necessary, occasion to rethink our relationships and our expectations of our vets and also to improve our own ability to manage the health of our pets. While we might resent how things are, I prefer to see it as an opportunity for transformation that can improve the care of our dogs and our roles as their human caregivers. I asked a number of veterinary personnel for their suggestions given how things are these days and want to share those here, along with some other ideas that I think constitute best practice if you have an animal in your care.

1.  Number one, they told me: Be nice. This was the priority I heard from the veterinary staff with whom I spoke.  Your veterinary staff are doing everything they can, they really do care deeply about your animal, they are experiencing unprecedented demand, and they are working hard to provide the best care possible for everyone who needs them. You’ve probably heard the saying “If you can be anything, be kind.” If you’re a country music fan, feel free to substitute “always be humble and kind.” Either will work, and will be a welcomed interaction with your veterinary professionals. It doesn’t cost anything, it is sure to help, and there is no down side. In the world of medicine, it doesn’t get any better than that. If you are always nice, you say, then that’s terrific! Maybe do a little extra because I am hearing that there are plenty of people who aren’t being so respectful and kind.

2.  Adjust expectations.  It takes longer to get an appointment or a question answered or a refill. It just does. That isn’t such a big deal if we plan ahead. You know your dog needs a medication. Don’t wait till the last minute for a refill. Anticipate there may be shortages in some areas so prepare for that as well. Get extra food or other essentials if your dog has specific needs. Be aware also that veterinary medicine is using remote or telemedicine approaches just as human medicine is. Most state laws require that veterinarians examine an animal in person in order to write prescriptions. However, a telemedicine visit can be very helpful in narrowing down what is going on and how urgent the situation is and how to handle it until you can see your own vet. Our expectations need to adjust to incorporate some unique ways of getting care just as we are doing with our own medical care. 

3. Keep a focus on prevention and being proactive. Some of the main reasons dogs need ER visits stem from things that are easy to prevent. Your dog eats everything? Then make sure  there isn’t anything in reach that is harmful. Take 60 seconds outside every morning to pull up those mushrooms and scout the yard for other hazards. You can save yourself, and your dog, a serious and expensive health problem. Consider play dates with dogs you know and owners you trust rather than the dog park.  Choose appropriate toys and chews; the harder and more long lasting the chew, the greater the potential for a broken tooth. That is one painful and expensive outcome for you and your dog. Keep on schedule with regular exams at the vet. By all means, keep up the heartworm preventives and get refills well ahead of when you need them. Do everything you can for the health of your dog (hopefully this isn’t a change for anyone). Be proactive so problems are detected early and there is more time available to make an appointment. If your dog has a history of ear infections, allergies, or hot spots, to name a few common examples, check regularly so you catch a recurrence early. Talk with the vet about what you can do to minimize recurrence or at the first signs of trouble. Work with the vet to get to the cause of the problem so you may not even have to worry about recurrence so much! This can take some trial and error, but a dog with intractable ear infections or frequent bouts of diarrhea that finally are resolved after a thorough test of different diets is well worth the effort (every golden in my life would agree).

4. Along with the above, it is helpful to learn all you can about your dog. Get your info from good sources.  The American Veterinary Medical Association has a good page with resources for owners, linked below. Look for professional organizations or veterinary schools, veterinary offices, or the ASPCA as other useful sources. Learn what is normal for your dog and what might be an early sign of trouble. A daily lump, bump, ear, eye, teeth, and skin check takes less than two minutes depending on how thorough you are and how often you pause to throw in a few loving glances and “What a good boy!” praise. Not wanting to weaken my reputation as a “poop expert,” I firmly believe that every dog owner should see, fairly close up, at least one poop each day. That way you know that the dog pooped, whether there was any difficulty pooping, and whether it looked normal for your dog or not. Checking on urination is good, too. You might not see the output, but you will know the dog was able to go without difficulty and how often. Looking at one poop a day is a small sacrifice to make to avoid a much worse case of diarrhea and will buy you some time until your vet can see your dog if a visit even becomes necessary. 

5. Know how to handle the unexpected. Keep an emergency kit for your dog including hydrogen peroxide if directed to use it for accidental ingestion (check with animal poison control before using it, though, as it could be harmful if used incorrectly). While we’re on the subject, did you know the American Red Cross offers Pet First Aid Courses? They actually are quite good and cover Heimlich maneuvers and CPR for animals, along with basic first aid.  Your dog means the world to you and you would do anything at all to make sure it is well cared for? Well, there’s something you can do. The class currently is offered online and costs $25. If you feel helpless in case of injury, shock, bleeding, etc., completing such a class can be very empowering. Be aware that emergency facilities may only be able to see cases with true emergencies, the situations that threaten life, such as problems with breathing, bleeding, toxic exposure, foreign body ingestion, GI obstruction or bloat, heatstroke, and snakebite. Know where your local facilities are, know where there are urgent care options, call before going. If you know what to do in the interim, it just might save your dog’s life.  Can’t stand the thought of having to do some emergency care for your dog? Well, there’s that prevention thing described above.

6. Plan for the expenses.  This can help with your own stress around the care of your dog. It costs a lot to own a dog and provide it with proper food and medical care. Skipping routine care to save money may lead to bigger problems down the road, especially as the dog ages. I can’t think of a single situation in terms of human or animal health that is not improved by catching it early. One veterinary professional strongly suggested that people get insurance for their animals. There are numerous options available now and some workplaces even include a pet insurance option as a benefit, recognizing how important our animals are to our lives.   Those of us who know and love golden retrievers realize the particular challenges that come with that breed and the various scenarios we may encounter with them as they age. We hope many of those won’t come true, but need to be prepared for the expenses nonetheless.  The value of what we receive with stellar veterinary care and the advanced diagnostics and treatments available for our animals cannot be beat.

         Veterinary practices are experiencing tremendous stress and high demand at present. Some of the changes we are seeing may be around for a long time. But we have a wonderful opportunity to change our vision of the care of our animals. We must become better informed, more proactive, and more involved as we develop a quality relationship with our veterinary teams. Plan ahead, adjust expectations, and develop your own knowledge and commitment to your dog’s health.  Not only will this enhance the health and well-being of your dog, but it will make the best use of the professionals available. Follow the directions your veterinarian provides. Don’t skimp on all those “good boy (or girl)” interludes with your dog while doing those lump and bump checks. I know our veterinary professionals appreciate the same expressions of kindness and gratitude as well.   I don't want to think about what life would be like without them.

 

References

Alarming suicide rates reflective of stresses felt by veterinarians.  https://www.wisfarmer.com/story/news/2021/05/26/alarming-suicide-rates-reflective-stresses-felt-veterinarians/7361193002/

Not One More Vet.  http://nomv.org

American Red Cross, Cat and Dog First Aid training.    https://www.redcross.org/take-a-class/first-aid/cat-dog-first-aid

American Veterinary Medical Association, resources for pet owners: https://www.avma.org/resources-tools/pet-owners

American Veterinary Medical Association.  Veterinary telehealth: The basics.  https://www.avma.org/resources-tools/practice-management/telehealth-telemedicine-veterinary-practice/veterinary-telehealth-basics

Telemedicine and how it works (VCA handout). https://vcahospitals.com/know-your-pet/telemedicine-and-how-it-works

 

 

Don't Shave That Golden!

The temperatures are soaring, and we humans are running for pools, iced drinks, or whatever else brings us relief from the heat. Surely your fluffball golden must be miserable under all that fur! Time for the “summer cut” and let’s get rid of that extra hair so the poor thing can cool off, right? 

WRONG!! No, never, don’t even think about it, and no way. Big no-no as a matter of routine to shave your dog for summer. You mean leave all that fur on? Absolutely! 

We often refer to the dog’s fur as a “coat,” but that contributes to a misunderstanding of how the dog’s fur really works. Of course wearing a coat in summer the poor thing must be dreadfully warm! So let’s dispense with the word coat for this discussion. Instead, let’s think of the fur in terms of what it does, and that involves its functions for insulation and protection.  As you know with a house,  insulation is important to keep temperatures stable. You set a desired temperature on your thermostat, and the heat and air conditioning systems work to create and maintain that temperature. The insulation helps to separate the inside of your house from the outside so it is easier to get the temperature to stay where you set the thermostat.  Take away the insulation, and your mechanical systems are going to have a heck of a time keeping your house at the temperature you desire. The inside will always want to match the outside if there is a poor barrier between the two. 

The insulation function of a dog’s fur works in the same way.  Dogs have a core body temperature that they must maintain for the organs to function well. Generally this is in the vicinity of 100 to 102 degrees or so, give or take. The fur is what protects them from external stimuli that can cause that temperature to be harder to maintain. Without the fur as insulation, the heat gets in more easily and the body has to work that much harder to keep things stable.

Imagine shaving your head and being outside in the summer. Would it be cooler without that hair? Quite the contrary. You not only will feel the sun’s rays more intensely but you will be more subject to injury. OK, so you’re not shaving the dog down to the skin, so that isn’t a fair comparison, you might say.  The physics are still the same. The sun and the heat can more easily affect the dog because the fur is not there as insulation to protect the dog from the external environment. Even if the temperature outside is lower than the dog’s body temperature, the sun and all the other environmental characteristics are now acting more directly on the dog because there isn’t that important layer of fur to insulate the skin. Dogs can get sunburned, and you may recall a time when you were outside in 90 degree weather, feeling the sun on your skin and thinking it felt a lot warmer than 90 degrees! Add to that experience the heat of pavement or a patio which are well over the ambient air temperature, and things can become dangerous quickly without some insulation or protection. A  temperature of 90 degrees is barely suitable for a warm bath. But the sun hitting your skin with a 90 degree air temperature, or maybe more if you are near reflective or heat-absorbing surfaces? You will feel that! So will your dog, and it can be dangerous, especially for a dog without it’s normal protective layer of fur.     

Dogs like our goldens are designed well for maintaining a healthy body temperature. As double-coated animals, they lose their undercoat as the seasons change to warmer months. This loss of undercoat adjusts the insulation for them automatically. In the winter, they grow that back to provide more protection against the cold. You may have noticed how it can be snowing or sleeting like crazy and in spite of that 100 degree body temperature, the snow does not melt when it lands on your dog’s fur. That fur is doing a great job keeping that body heat regulated.  Mess with their fur by shaving them and you have disrupted that crucial thermoregulatory mechanism, which is a fancy way of saying the dog’s ability to maintain the temperature essential for life. Thermoregulation. It comes built in to the dog and includes their fur as a crucial component. So do not shave your dog.

Fur also serves another purpose, and that is protection from physical elements. Fur provides an additional layer of protection against injury to the skin such as might occur from a good roll in the grass. The topcoat, which is what you see when you first look at your dog, also helps to repel dirt and debris and sheds water to some extent. Check that out the next time your dog is out in the rain for a short time. The top layer of fur will be wet, but the skin can still be fairly dry (depending on how long they are out and how hard it is raining. Some of my goldens didn’t know, or want, to come in from the rain so your mileage may vary). 

Good care for a golden includes recognition that both the fur and the skin are important to your dog’s health. There is a need to be vigilant year round about good skin and fur care. Summer provides its own reasons and challenges in that regard. You and your dog may be outside more, playing in the grass, perhaps swimming or whatever summer fun you have in store together. Attention to cleanliness to remove contaminants (like all that wonderful pollen we have in Virginia) is important to keep the fur and skin healthy. Regular brushing and removal of mats will increase the effectiveness of the fur and the comfort of your dog. Keep the skin dry to help fight off hot spots. While tending to the fur, it is a great time to check for parasites like ticks and fleas; dangerous debris such as foxtails; and also lumps, bumps, or injuries to the skin. One of the best things you can do for your dog is catch a skin problem or a lump or growth early. To help your dog through the hot summer months, provide plenty of shade and water and monitor their activity and their behavior. Goldens do not always know when to quit when they are having fun. 

Help your dog keep that system of skin and fur working well through good grooming and examinations to catch problems early. Shaving and removing that fur just because it seems like a good idea in the summer heat does not help your dog. Good grooming and assessment will. Besides, you’ll have some nice bonding time as you groom your dog, and your dog will be gorgeous with a gleaming and healthy thermoregulatory system.   

   

Fireworks, thunder, and other scary noises

I am sure many of you are looking forward to celebrating the upcoming holiday, even though it may be different than in other years. But for all the opportunities that holidays provide, whatever the circumstances, for many dog owners the 4th of July is one to be feared. Of all the challenges we face as dog parents, the anxiety, fear, and sometimes outright panic and hysteria that can appear in our dogs as a result of loud noises and storms has got to be one of the most difficult. Our dogs truly suffer at times like this, and we suffer along with them. I will never forget my severely thunderphobic dog who literally climbed the walls trying to get away from whatever she was experiencing, standing on the back of the sofa, reaching high and clawing at the walls, anything to get away. It was obvious she suffered at times like that, and with each storm it just got worse.  Fortunately she was an older dog when it got to the point of being unbearable for her, and cardiac and other problems led her across the rainbow bridge before she had to face another storm season. I mourned the loss of that dog, but admit I felt some relief for her that she would never experience another storm again. I assured her there were no thunderstorms over the bridge, just sunshine and rainbows.

That experience taught me a lot, mostly that I never, ever want to see a dog go through that, and my heart goes out to pet parents who struggle with this in their pups. I have vowed to always make storms and loud noises fun, playtime, with special treats to counter-condition against an upswell of anxiety. When we get dogs who have not yet learned that this stuff can be really scary, it is much easier to reinforce for them that storms are nothing to worry about. We have to do that with ourselves, too, because we know they interpret our reactions and will learn to be anxious if we are anxious. So making storms nothing to fear on the human side is just as important, even if the fear is because of our concern for our dogs and not for our own well-being during the storm.

I've gotten a few questions about this in the last couple of days and shared my favorite tips and first steps to help people deal with this dreaded situation. I came across a new blog post recently, written by animal behaviorist Dr. Karolina Westlund, that offers a comprehensive review of many options. Her post includes several things not generally found in the information readily available to help deal with noises. She also includes references to research where relevant. Rather than repeat all the good tips, I'll provide a link at the end of this post. Her blog entry is fairly long, but that is because she explains the mechanisms in a thorough way and also provides a variety of options. There is no one-stop, works for everyone, approach to this. Trying some things, being consistent, and observing how your dog responds are key to figuring out what to do for your dog. Your dog also can change and what worked before may not be enough or they may have become accustomed to that and need something different. I know you will find some useful information here. 

Note that noise situations are different and may evoke a different response. Low rumbles may be perceived differently by your dog than loud bangs or rhythmic noise. The unpredictability of some sounds make them worse for some dogs. It isn't always just the noise that is a problem. Thunderstorm reactions have been hypothesized to be associated with a buildup of static electricity in the air, not just the noise. Dogs often will go to a bathroom where it is thought that the plumbing helps to dissipate that electricity. Since the advent of PVC pipe, that is less effective, but in older homes with copper or metal plumbing, it actually can provide some relief from the static for your dog. If you live in such a house, you may have noticed your dog likes to hang out in the bathroom. (It isn't always that they just have to follow us there, but there's that aspect, too.) It also is a relatively confined space and may be in an interior area away from outside walls and windows. If you have such a room, that may be a good "safe space" for you and your dog to enjoy the storm/noise together. Yes, I actually wrote "enjoy." I haven't had any luck teaching any of my dogs to play cribbage yet, but I've spent more hours than I can count sharing some food treat puzzle fun with them over the years to get through storms and other scary situations.

The foundation for management of any difficult situation is to keep the dog safe and make sure all humans remain calm. Building on that foundation, following are my main go-to actions in case you don't want to read the entire linked blog post. But I recommend that you do because it is full of wonderful information and you can't have too many options for dealing with this challenge.  

1. Humans absolutely must be calm. Think of storms, noise, as absolutely no big deal, just part of a typical day. Your dog will pick up very easily if you are on edge or anxious or if things are different, and can easily associate that change with the noise. Sometimes I think this is the hardest part.

2.  Above all else, keep the dog safe, monitor door openings and closings, have a talk with everyone else in the household so that the dog is safe. Maybe one person is designated as the primary caregiver to take the dog out to maintain consistency. Storms and fireworks are high risk times for a dog to get away and,  in their fearful state, it will be very difficult to find them and get them safely home. Even in fenced yards, I have taken my dog out on leash to keep them close and to know I had control and they were secure, just in case. They seemed to feel more secure keeping me close by, also. I think one of them thought she had me on leash for her control.

3. Help your dog associate the noise with something pleasant - a favorite toy, special treats, videos on tv (my dog loves Animal Planet). Distraction can be helpful in addition to the positive association. It's storming? Cool! Where's my ball? Your dog may not get to that point, especially if you did not raise them from puppyhood, but it can help with the counter-conditioning even in older dogs if they are not so traumatized that they can't get involved. Desensitization and counter-conditioning are the mainstay of dealing with phobias and other anxiety-producing situations. It's never too late to start. Most dogs can be helped with appropriate behavioral interventions.

4. Rescue Remedy is a wonderful product for all sorts of stress/anxiety situations. Rescue Remedy is one of the flower essence formulas created by Dr. Edward Bach (favored pronounciation now is "batch"). It has been in use in people since the early 1900s and has received widespread accolades among holistically oriented practitioners and rescues (the latter often dealing with high stress in dogs). It can be found in most pet supply stores. There is a form labeled specifically for pets that is best to use for our dogs.  Prior to that formula, the people version was used for pets, and that is available in many nutrition and vitamin shops. The difference between the two formulas is that the pet version is alcohol free, so it is a much better choice for your pet to get the form specific for them. I am extremely conservative about anything new I try, so I always recommend observing closely to see how your dog responds so you have that information to guide future interventions.

5. Create a space where you dog can feel safer and cannot harm themselves. A crate with a blanket over it, a table made into a fort/tent (remember those as a child?), their dog bed surrounded by soft stuffies, pillows, blankets, clothing from the owner so they get your smell, etc. The goal is not to confine the dog which can make things worse, but to give them a quiet and safe space where they can go in an effort to isolate themselves from what is bothering them. This is not a good time to put the dog in his or her crate, which can lead not only to increased noise anxiety but fear of the crate, too. The exception would be if the dog likes the crate and chooses that space. But leave the door open, and make sure it is the dog's choice to go there. Bathrooms can be good if located interior of the home, not just for thunderstorms but because an interior bath may provide some sound-deadening effect and a smaller (thus, to a dog, more manageable) space. Help create the safe space, but let it be your dog's choice where to go, and always make sure they can leave that space if they need to move.

6.  Thunder shirts or anxiety wraps work well for some dogs. Explained in the blog linked.

7.  Adopt a whole household approach so that everyone is consistent in their interactions. If one person is anxious and you're trying really hard to interest the dog in some play, the dog is going to respond to the anxiety.

You will find many other tips in the blog linked below. I hope some of this information is helpful and I wish you all a safe and stress-free summer and holiday. Note that on the blog post you will find a link to download the post as an e-publication for future reference.

Dr. Westlund's blog post on thunder, fireworks, loud noises

The New Year, a request to share what is on your mind, and a teaser about heartworm, flea and tick preventives

The New Year is just around the corner - hard to believe! As spring quickly heads our way, and in light of the crazy (but wonderful) warm weather recently, I'm working on a post for the near future on heartworm and flea and tick preventives. Keep an eye out for that coming soon. There is a confusing array of products available intended to prevent these devastating and distressing parasites. Some market their convenience, some argue their long-lasting effectiveness, and some now carry significant FDA warnings for seizure risks. As we approach the season to make decisions about what we want to do for our dogs, I'll help you sort through the options, the risks, and the research to make informed choices. 

What's on your mind? 
While I work on that, I am interested in knowing what you would like to read about. What challenges are you facing in the health care of your dog, or what have you come across that has piqued your curiosity and you would like to know more?  What New Year's resolutions would you like to share? Comment below with your suggestions for future blog posts, or your suggestions for care. I look forward to your comments and suggestions for future topics.

More resolutions for the new year
As for the New Year, Henry posted his top 8 resolutions last year. You can revisit that here in the December, 2018 post, or find it linked on the SEVA-GRREAT website under the "Medical" tab. This year he wants to add two more:

9.  Expose your dog to new places and stimuli regularly, within the limits of the dogs tolerance.   Anyone experienced with dog training knows that taking your dog to new places is critical to their socialization and the ability to have a well trained dog who is comfortable in a variety of settings. One of my favorite places for training is Lowe's, and a trip down the doorbell aisle where you can test the different chimes is a great place for exposing the dog to different stimuli. Of course, you want to do that carefully, with a dog who is ready for that degree of stimulation, and only one or two chimes during a visit. But that is an example of the kinds of different stimuli, noises, people, etc., that can help a dog gain confidence and learn to handle all sorts of different situations. Some of our rescues will not be ready for something like that for a long time, if ever. But you can accomplish something similar by varying your walking route. Drive a few blocks away and walk in a different area, visit a park. You are out in the world every day, going to work, stores, social events, restaurants, all sorts of things. Your dog's world is the walls of your home. Variety will help the dog grow, develop important skills, and be comfortable with different stimuli. Just to emphasize again, exposure needs to be appropriate to the dog and the ability to tolerate new situations and environments. For fearful dogs, that exposure needs to be very, very positive, perhaps with high value treat rewards. But careful exposure, in a positive way, can help to build confidence in addition to fighting boredom. Henry, once incredibly fearful, loves new smells and sounds and sights and people.... even if we go to the same park, we take a different path each time. At one time he was terribly fearful, and he still is a little unsure when we go to a new place. But he has gained a lot of confidence over time and I want that to keep building for him.

10.  Consider cooking with your dog (a golden retriever's dream, right? It involves food!). There are some very simple treats that are made easily at home where you can control the ingredients. This can also be a good savings approach as made at home treats often are less expensive than "store-bought." I like knowing what goes in my food, and in his.  You can find recipes for treats many places on the internet. Many do not involve cooking at all, or not much, anyway.  One of my favorites is dehydrated sweet potato chews, or I should say Henry's favorite, a good source of fiber and a tooth-safe alternative for some chewing satisfaction. They don't last long as a chew, but it seems to satisfy the urge to chew.  There's always the stuffed kong approach, too, which involves minimal prep and maximum pleasure. An easy recipe to start:  3 ingredient pumpkin and peanut butter dog treat

So while this may not be the typical "medical" blog, we know that good nutrition, healthy food, and good socialization and stimulation are very important to the health of our dogs.  We'll be back with something more specifically veterinary in focus soon when we look at flea, tick, and heartworm preventives. Remember to let me know what you would like to see here during 2020.

Till then, Henry and I wish you all a healthy, happy, and Golden New Year!

“Stop scratching!!” Common causes of itching and what to do about them

"Stop Scratching!" If you own a golden retriever, odds are really good you’ve said that at least a few times, as if the dog could obey this like a "Sit" or "Shake" command.  Rather than being just an irritating behavior, though, scratching is a signal that something is not right, something that could lead to much bigger problems for our dog.  Our first step is to figure out the cause so proper treatment is started and we can prevent those bigger problems. Some of the more common reasons for scratching that will be discussed here include parasites, environmental allergens, food and other sensitivities, and hot spots.

One of the first things to do if you see your dog scratching is to inspect that area closely.  Look for redness, hair loss, any sores or oozing, or parasites in the area. Look closely for ticks, fleas, or “flea dirt,” the tiny black specks of excrement left behind by fleas. A flea comb can be really helpful in determining if your dog has these awful parasites hitching a ride. Check the head and neck closely as these are prime areas for parasites since they have good access to a canine head poking around under bushes or in tall grass. Feet and legs are good access points also, especially if your dog is walking through tall grass or on trails.  Fleas like to hide in deep fur, so around the ears, armpits, and tail area are good spots for them. Every dog that goes outside should be checked thoroughly at least once each day for ticks and other parasites. It's a good time to feel for lumps and bumps while you're at it. If you find a tick, be sure to remove it properly to minimize disease transmission.

Check out this video for a description of proper tick removal:   https://www.akc.org/expert-advice/health/how-to-remove-tick-from-dog/

Here’s a good link and video about how to use a flea comb to find and remove fleas: 
https://www.petmd.com/dog/parasites/how-use-flea-comb-dog

Scratching around the head also can be an early sign of ear infection, so take a good look under the ear flap. Redness or heat in that area, a foul odor, or an ear flap with tiny specks of brown (typical of yeast infections) or that otherwise looks dirty may indicate an infection is building so a trip to the vet is in order. 

Another common cause of scratching is natural environmental allergens. Pollens and molds are abundant in much of Virginia.  These can be problems for both humans and canines. Some people may notice that when they start sneezing or feel the pressure of sinus congestion their dogs start scratching, too.  That may be a sign that environmental allergens are on the rise and a notice to be on the lookout for sensitivities in your dog. Dogs can have issues with pollens just from walking across grass, and rolling in it may bring instant pleasure but an itchy night later. Feet are particularly vulnerable due to contact with grass pollens (and chemical residue on many lawns which, despite advertisements to the contrary, can still be transferred to the dog long after application). In such cases, something as simple as a good foot wash for the dog (and shoe removal for the humans) before going into the house can work well to remove those irritants and limit the amount that enters the house.  A dog who likes to roll in the grass might benefit from a soothing rinse to remove irritants from the fur.  My current dog had no problems with itching before moving to Virginia (thank you, humidity and pollens!). Foot rinses during pollen season and HEPA air filters inside the house have made life much better for both of us. His bedding also gets washed weekly with mild, all natural, unscented detergent.  

Bathing - A complete bath may be needed but optimal schedule varies for each dog. Obviously baths are needed more often for a dog who swims and gets fur full of sand, one who frolics in mud, and dogs like one of mine who loved nothing better than rolling in dead alewives on the shores of Lake Michigan (if you’ve been to Lake Michigan, you know what I’m talking about).  Baths can be beneficial to remove irritants and restore a dog to a huggable condition, but they also can be detrimental if they dry out the skin, strip it of essential oils, or if the dog is not dried properly afterwards. The need for baths varies, but in general no more often than once each week and use only a mild solution made specifically for dogs. Many with skin sensitivities benefit from conditioning hypoallergenic or neutral shampoos which can be soothing as well as cleansing. Before bathing, a good brushing to remove loose fur and undercoat will make the bath more effective and avoid trapping of moisture against the skin by that cottony undercoat. Be sure to dry the dog thoroughly afterwards with a clean towel. If you use a dryer, use only low heat and keep the dryer a distance from the dog to avoid burns or excessive drying of the skin.

Dull, dry, flaky skin can be a cause of itching. If your dog fits this description, a quality fish, krill, or green lipped mussel based oil supplement can provide significant relief from dry, itchy skin. Fish oils are known to carry a lot of impurities, however, so processing and quality control are important. Look for products tested for purity by a third party lab and who make those results public.  With rare exception, most dogs benefit from fish oil/Omega 3s, not just those with skin problems. There is extensive research supporting their anti-inflammatory effects as well as benefits to nerve transmission and heart muscle health in both humans and dogs. The difference in skin condition can be remarkable as well and generally shows up fairly quickly if this is going to make a difference in skin and coat health.

Other causes for itching should be considered if the dog has chronic problems regardless of weather conditions or seasonal variations.  Food sensitivities or household products could be irritants for the dog, so there are other avenues to explore if problems with itching persist throughout the year. A discussion with your vet can help identify possible sources, but some easy things to consider in advance of that visit are possible irritants around the house such as cleaning materials or laundry detergents. Minimizing use of chemicals with which the dog may have contact, including scented laundry detergents or cleaning agents used on flooring, can be very helpful to the sensitive dog. A change in diet may be worth considering, especially if your dog has year round skin problems and is on a diet based on proteins often associated with sensitivities.

Hot spots – a phrase that strikes fear in many golden retriever owners.  Hot spots, also known as  “moist dermatitis,” arise quickly, spread rapidly, can be challenging to heal, and make your dog miserable. Since they often require a cone to restrict the dog’s access to the spot, we definitely want to do what we can to minimize occurrence and speed healing. Hot spots are preventable in many instances. Common causes include wet fur from swimming or bathing without proper drying; skin irritation from parasites; dermatitis from contact with various irritants including pollens or household products; and improper skin and fur hygiene, with matted fur provoking the dog to lick and chew and also trapping moisture and bacteria. High humidity such as we see in much of Virginia creates a double-whammy with these other conditions leading to an optimal environment for hot spots. It is important that we prevent these dreaded skin problems as much as possible, intervene quickly, and be diligent to put healing on a fast track.  

Hot spots arise when scratching and itching problems are not addressed promptly and the dog damages the skin leaving an open wound. This wound leads to more scratching and licking and chewing (keeping things moist) and in no time at all can be a significant size and also infected. Hot spots generally are associated with bacterial infections, so they need proper treatment and avoidance of scratching to heal. Hot spots appear as defined areas of redness. They are moist and often oozing with drainage that that collects in the surrounding fur. They itch terribly which makes it very hard for the dog to leave that site alone and which, of course, contributes to rapid enlargement. These wounds often have a secondary bacterial infection, so treatment by a vet is recommended.  There are a number of over the counter preparations and instructions on the internet for home remedies, but contents vary and some could be additional irritants or even toxic (such as some essential oil remedies I've seen). These could make the wound worse or at least they may be ineffective and delay healing. The usual veterinary treatment is to shave around the area so the wound is open to air, and then a prescribed process for cleansing with an antiseptic solution. Following cleansing, usually there is application of an antibiotic preparation. This antibiotic preparation may be combined with something to help manage the itching.  While it might be possible to manage these at home, especially with experience, the rapid spread and slow healing make it worth a trip to the vet to get treatment going before things get even harder to heal. Typical healing time is 10 days or more depending on the size and depth of the wound. It is important to keep the dog from injuring this area further while the spot heals, thus a cone or restrictive collar may be needed.  

Scratching is an important way for our dogs to tell us something is bothering them. We want to provide close inspection to see if we can determine the cause and also so we can report to the vet as much detail as possible. Early detection of parasites, good management of skin condition and hygiene, healthy diet, and limiting environmental irritants can do a great deal to keep your dog happy and itch-free. Dogs who have frequent problems may benefit from a variety of products to manage recurrences if needed and avoid complications of too much scratching. Many causes of itching can be managed very well at home as noted above.  For recurring problems that do not respond to such intervention, talk with your vet to determine what is going on with your dog and the best management approach. Diligence and early intervention, and consultation with your vet, are key to keeping your dog as itch free as possible and avoid bigger skin problems.