Canine Medical Information, Part II

Author

Cindy Moore, rpd-info@netcom.com
Copyright 1996.

Table of Contents


Prologue

Much of the information found in this article is summarized from Carlson & Giffin. I would like to thank them for their informative and accessible information. Any mistakes made in the summaries are my responsibility and not Carlson & Giffin's. I believe that I am within copyright laws by using summarizations (no direct quoting, except for the toxic plants section), my own organization of the material, and precise acknowledgement where relevant. -Cindy Moore

An excellent resource that details all aspects of health issues for dogs, and one that every conscientious dog owner should have is:

Carlson, Delbert G., DVM, and James M. Giffin, MD. Dog Owners's Home Veterinary Handbook (Revised and Expanded). Howell Book House, Macmillan Publishing Company, 866 Third Avenue, New York, NY 10022 USA (1992, 2nd ed). ISBN: 0-87605-537-4 (hardcover).

This comprehensive book is a complete guide to health care of dogs. It lets you know when you can treat the dog, or when you need to take it to the vet post-haste. It lists symptoms so that you may inform your vet of relevant information about its condition. The arrangement of the material facilitates rapid reference. Illustration of key procedures (pilling, taking pulse/temperature, etc). Lists poisonous substances, including houseplants. A must have home veterinarian handbook.

Hip Dysplasia (HD, or C(anine)HD)

An excellent source of information on hip dysplasia is:

Hip Dysplasia
A Guide for Dog Breeders and Owners
2nd Edition 1989
By E.A. Corley and G.G. Keller
A single copy is available for a donation and multiple copies are $3.00 each at Orthopedic Foundation for Animals, Inc, 2300 Nifong Blvd, Columbia, MO 65201, 573-442-0418. It is informative, and highly recommended.

The work is copyrighted and permission to reproduce the work was not given since the costs of production are still being recouped, so only highlights from the monograph are presented here. I do encourage you to get your own copy.

Another good source of information on Hip Dysplasia may be found in the chapter "Hip Dysplasia" in Genetics of the Dog by Malcolm B. Willis (Howell Book House). Information from this chapter is also presented below.

Other online information includes:

In general

Hip dysplasia ("bad development") appears in people and many species of animals. In some breeds of dogs, it is the most common cause of osteoarthritis or degenerative joint disease. Because both humans and dogs get hip dysplasia, dogs made a good subject to use in research. Most of these techniques below are also used on humans.

Research on hip dysplasia suggests that CHD is a more complex disease than was first thought. There are no simple answers or solutions to the problem. The complexity of CHD results in research findings that appear to be contradictory. However, many aspects of the disease have been repeatedly and independently documented and are generally accepted by the scientific community. Three important ones are:

Development

Regardless of what the initiating factor or factors may be, abnormal looseness of the hip joint after 2 weeks of age seems to be the event most commonly reported to result in hip dysplasia. However, there are exceptions to this, and dogs with tight hips have developed hip dysplasia.

The early changes are not easily detected. Severe cases may be diagnosed as early as 7 weeks of age; others may not show up in radiographs until over 2 years of age. This is why OFA only certifies dogs over two years of age.

Breeding

Most inherited traits in animals are polygenic. These traits do not follow patterns based on dominant/recessive pairs because polygenic traits are affected by many genes. Only some puppies will have the same combination of genes for a trait as the parents. Some will have a more desirable combination while others will have a less desirable pattern. As the number of involved genes increase, the possible outcomes also increase. In addition, remember that it is also possible for different genes to have a different level of influence on the trait, complicating the outcomes considerably. Predictions of a specific outcome from a particular mating involving polygenic traits is currently impossible.

In Corley and Keller's opinion, a dog with excellent hips but with more than 25% of its brothers and sisters affected with hip dysplasia is a poorer breeding prospect than a dog with fair hips and less than 25% of its brothers and sisters exhibiting dysplasia.

Clinical symptoms

(from Corley & Keller)

"...[T]he signs [of hip dysplasia] vary from decreased exercise tolerance to severe crippling. They include: a reluctance or inability to go up or down stairs, difficulty in rising from a sitting or prone position, bunny-hopping gait when running, stiffness early in the morning that improves as the dog warms up, change in disposition due to pain, lameness after exercise, wobbly gait, a clicking sound when walking, and many others. Many dogs will shift their center of gravity forward in an effort to relieve weight and pressure on the hips. These dogs generally present a front end that appears well-developed relative to the rear end.

"In dysplastic dogs, the hip joint is a weakened structure that is more subject to being injured by normal activity such as jumping off a couch, or rough housing with a playmate. Frequently, this results in an acute lameness that in the mind of the owner was caused by the injury, whereas the underlying dysplasia actually made the joint more susceptible to injury. Obviously, the normal hip can be injured, but the radiographic examination can usually distinguish between a hip problem due to dysplasia and one due to other causes.

"CHD can not be diagnosed by observing how the dog moves, acts, lies down, etc. The clinical signs may be caused by other problems; therefore, a complete orthopedic and radiographic examination is required before arriving at the conclusion that the signs are caused by CHD."

Environmental Influences

Environmental factors such as type of food and exercise in puppyhood have been shown to affect the displayed symptoms within the same litter. However, subsequent generations from both groups showed the same rates of dysplasia meaning that while the phenotype may be affected, the genotype is what determines whether a dog has the potential for being affected with HD.

In general, low protien diets and low activity levels through puppyhood reduced the symptoms of HD markedly. However, the degree of diet reduction and no activity may or may not be practical for the average dog-owner to attempt. (See Willis.)

It's best to keep your puppy from any kind of jumping for the first year or so in life. It's also best to keep from sustained exercise until at least a year old. Sustained exercise includes: jogging with owner, pulling weights, mushing, running with owner on bike, etc. Even for dogs not at risk from HD, it's wise not to exercise too strongly too early as such exercise may interfere with proper growth of joints, leading to similar problems such as arthritis on the joint or OCD.

Diagnosis of Hip Dysplasia

Any diagnosis of Hip Dysplasia must be made via expert radiographic diagnosis. This involves taking xrays of the joint and typically sending the film to organizations that will evaluate, register, and certify the dog. Veterinarians will often "diagnose" the film themselves but if the question is critical its best to have them properly evaluated (unless, of course, your vet is experienced with radiographic evaluation -- not all are).

You cannot, repeat, cannot make a reliable diagnosis of Hip Dysplasia on the basis of external symptoms such as lameness or gait.

OFA

The Orthopedic Foundation for Animals is the most well known registry in the United States. It grades all joints, most commonly hips, as severe, moderate, fair, good, and excellent. It will certify all passing grades given to dogs over 2 years of age. Contact: 573-442-0418.

PennHIP

PennHIP is a new evaluation technique that flexes the limbs differently to produce the xray pictures. There are only a handful of vets around the country that have been certified to take xrays using the PennHip method. See also:

Genetic Disease Control, UC Davis

There is a program here for radiographic evaluation of dogs. Wind Morgan is the most well known of these programs, offered to Labrador Retrievers. There are similar programs for Rottweilers and a few other breeds. Wind Morgan will certify at one year of age or older and requires xrays of hips, elbows, and hocks. They will hold clinics around the country to help hold costs down.

Genetic Disease Control is actually a larger effort to collect data on all kinds of genetic diseases, of which Hip Dysplasia is only one. They have registries and information on a wide array of diseases. All their registries are open, in an effort to make more information available to breeders in making informed choices about their breeding stock. For more information, write to

GDC
PO Box 222
Davis, CA 95617
916-756-6773

Outside the United States

Each country typically has its own hip evaluation program. These are not consistent from country to country and may differ with the evaluations give by the above US organizations. In Australia, dogs are evaluated by the Australian Veterinary Association that has an Australian wide scoring scheme with averages for each breed.

Life for dogs with Hip Dysplasia

First of all, be sure that your dog has been accurately diagnosed with HD. Many vets do not have the expertise in reading the x-rays, so you need to be sure that an experienced radiologist reads them. If you're not familiar with the competencies of the vets in your area, your best bet is to have the x-rays sent in to OFA for evaluation. You CANNOT definitively diagnose HD on the basis of external appearance or palpitation of the joint or anything like that. Many things can cause limping, some of which are correctible, so it pays to be certain you have the correct diagnosis.

Diagnosis of Hip Dysplasia is not an automatic death sentence for your dog! Because it is a polygenetic trait, the variability of expression is actually quite wide. Some dogs may experience little or no discomfort and you may never know they have HD unless you test for it. Other dogs may experience more pain, but it may be easily controlled with proper exercise and judicious use of aspirin under the direction of a vet. Only a small percentage of cases are so crippled by HD that they must be put down.

You should immediately neuter any dog that has HD. The only known means of eliminating this disease lie in well-managed breeding programs, so do your part by eliminating the possibility of your dog contributing to the overall problem.

Discuss with your vet appropriate strategies for dealing with HD. In most cases, the general advice is to keep the dog from doing any kind of jumping or causing other sudden stress to the joints. However, as solid muscle buildup around the joint helps to ease the pressure on the joint, regular exercise is generally recommended, with swimming topping the list as gaining the most benefit with the least stress to the joints.

Treatment of Hip Dysplasia

In many cases, simple restriction of exercise and perhaps aspirin as directed by the vet is all that the dog needs to remain comfortable. However, there are several options for the more severely affected dogs:

Non-traditional treatments (not validated by controlled trials):

Medical therapy (aimed at reducing pain/inflammation from arthritic changes): Surgical intervention When the dog's pain cannot be controlled nor alleviated

Prevention of Hip Dysplasia

There is no known method of preventing hip dysplasia except for a thoughtful and carefully executed breeding program with regular radiographic analysis of all stock before breeding. It is possible to reduce symptoms entirely to the point where the dog will radiograph much less severely [1], however followup studies show that these dog's offspring have the same risk for HD as they would have whether the parents had been so treated [2]. The implication is that it is unethical to use as breeding stock dogs that were treated to prevent their symptoms from disappearing. On the other hand, pet owners with no intention of breeding their dogs might consider reading [1].

[1] Kealy, et al. "Effects of limited food consumption on the incidence of hip dysplasia in growing dogs." JAVMA, v201, n6 Sept 15 1992.

[2] Willis, Malcom, Genetics of the Dog.

Radiographic Diagnosis and Control of Canine Hip Dysplasia by Joe P. Morgan, DVM, Vet.med.dr. (Stockholm) and Michele Stephens, DVM.

References of Interest

This is by no means a conclusive list, I add to this from time to time as I come across them. Feel free to send me more. Also, Working Retriever Central has a great list kept at http://starsouth.com/wrc/library/chd6696.shtml.

Belkoff, SM et. al: Development of a Device to Measure Canine Coxofemoral Joint Laxity. VCOT 1: 31-36, 1989.

Kealy, RD, Lawler, DF, Ballam, JM, Lust, G, Smith, GK, Biery, DN, Olsson, SE: Five-year longitudinal study on limited food consumption and development of osteoarthritis in coxofemoral joints of dogs. (J Am Vet Med Assoc 1997; 210:222-225)

Lust G et al: Joint Laxity and Its Association with Hip Dysplasia in Labrador Retrievers. Am. J. Vet. Res. 54: 1990-1999, No. 12, December 1993.

Popovitch, Catherine A., DVM; Gail K. Smith, VMD, Ph.D.; Thomas P. Gregor, BS; Frances S. Shofer, Ph.D. Comparison of susceptibility for hip Dysplasia between Rottweilers and German Shepherd Dogs. JAVMA, Vol 206, No 5, March 1, 1995

Smith, GK et al: Coxofemoral Joint Laxity from Distraction Radiography and its Contemporanious and Prospective Correlation with Laxity, Subjective Score, and Evidence of Degenerative Joint Disease from Conventional Hip-Extended Radiograph in Dogs. Am. J. Vet. Res. 54: 1021-1042, No. 7, July 1993.

Smith, Gail K., VMD, PhD; Catherine A. Popovitch, DVM; Thomas P. Gregor, BS; Frances S. Shofer, PhD. Evaluation of risk factors for degenerative joint disease associated with hip dysplasia in dogs. JAVMA, Vol. 206, No 5, March 1, 1995

Swenson, L, Audell, L, and Hedhammer, A: Prevalence and inheritance of and selection for hip dysplasia in seven breeds of dogs in Sweden and benefit:cost analysis of a screening and control program (J Am Vet Med Assoc 1997;210:207-214)

Swenson, L, Audell, L, and Hedhammer, A: Prevalence and inheritance of and selection for elbow arthrosis in Bernese Mountain Dogs and Rottweilers in Sweden and benefit:cost analysis of a screening and control program. (J Am Vet Med Assoc 1997;210:215-221)


Infectious Canine Hepatitis

(summarized From Carlson & Giffin)

This disease should NOT be confused with human hepatitis. This is a highly contagious disease transmissible only to dogs. It affects the liver, kidneys and lining of the blood vessels. It can sometimes be hard to distinguish from distemper as there are a variety of signs and symptoms that range from mild to fatal. Exposed dogs rapidly become contagious and remain contagious throughout convalescence.

Fatal form: the dog becomes ill, develops bloody diarrhea, collapses and dies. Puppies may die without symptoms.

Acute form: High fever, bloody diarrhea, possibly bloody vomit. Refusal to eat and painful movements. The dog can become light-sensitive.

Mild form: Lethargy, possible loss of appetite.


Interdigital Cysts

Interdigital cysts are a common problem in short haired breeds of dogs. Males do seem to be worse and Labs probably worst of all. There are a number of differential diagnoses to consider such as demodex, fungi, pyoderma secondary to atopy, dermoid cysts, etc. Dermoid cysts are invaginations of the skin which forms a pocket of hair and misc. junk. They are often infected and they always recurr unless surgically removed.

Especially if the cysts are recurrent, a good option is to have the cyst surgically removed and send it to a dermatopathologist, not a regular pathologist. It is expensive but it will greatly reduce the number of return trips to the vet. With that diagnosis, it will be easier to deal with future recurrences.

Other treatment includes long-term antibiotic treatment... three to six months may be required. Make sure the antibiotic choice and dosing is appropriate. Culture & antibiotic sensitivity tests are recommended.

Also demodectic mange may be underlying the problem. Skin scrapes can make the diagnosis, but false negatives are possible. Foot dips in mitoban (diluted) followed by warm soaks in dilute chlorihexidine may clear it up.

Fitting the dog with a rubber boot to protect the foot may help speed recovery following the removal of the cyst.


Kennel Cough (Infectious Tracheobronchitis)

This is characterized by a harsh, convulsive cough. It is persistent, contagious, and often develops into secondary complications, such as chronic bronchitis. This disease can eventually be fatal especially in the very young, very old, or already ill. If your dog is exposed to many other dogs, or will be boarded at a kennel, it should be vaccinated against this. It is so-called, because it spreads rapidly under "kennel" conditions -- many dogs kept relatively close together.

"Kennel Cough" is a generic name for a set of symptoms caused by a number of organisms. These include parainfluenza as well as bordatella, as well as many others. Dogs vaccinated with the bordatella vaccine can still get "kennel cough" because of all the bugs involved, but it tends to be much less severe.

Bordatella vaccine is squirted into each nostril of the dog and should be repeated semi-annually. Parainfluenza vaccine should be a normal part of your dog's regular shots.

The vaccination is not effective for the first 24 hours, so if you are getting your dog vaccinated because you will be boarding it, get it done at least several days in advance!


Kidney Failure

Acute kidney failure, or kidney failure, is sudden and extreme and requires urgent care. Usually the dog recovers completely if it survives at all.

Chronic kidney failure, or kidney disease, is common in old dogs. The kidneys slowly wear out over a long time. It can be diagnosed by a blood test or urinalysis. Early signs include drinking and urinating more, since the kidneys need extra water, and foamy urine is sometimes seen.

Treatment is mostly dietary. They need a very low protein diet that is also low in certain minerals. The kidneys are stressed by too much protein and will wear out more slowly on a low protein diet. Dogs with sick kidneys should be given all the water they will drink.

The best known kidney diet is Hills K/D, but there is also Hi-Tor Neodiet, Neura Kidney Diet, and others. Some "senior dog food" is low in protein as well, but not as low as the kidney foods.

If you have any reason to suspect it, have the dog checked by a vet. Many old-dog kidney cases live happily for years with no special care other than the food.


Laryngeal Paralysis

Causes

Causes appear to be multiple. Trauma, such as excessive pulling on the leash or other pressure/force to the neck have been implicated. Older Labrador Retrievers account for a large proportion of cases. Overactive thyroid levels can contribute to the problem.

Symptoms

While the symptoms can vary somewhat, you will notice coughing while exhaling, particularly after exercise. The coughing sometimes sounds very odd. As the condition progresses, the dog may have problems breathing and panting.

Secondary complications such as bronchitis, etc. may occur.

Diagnosis

As there are various possible causes for shortness of breath and/or coughing, you must have your veterinarian look at the dog. The vet may put your dog under in order to examine the laryngeal muscles, xray to check the condition of the dog's lungs. Anesthesia is required to be able to observe the laryngeal muscles at work.

Treatment

The standard treatment for dogs with LP is to surgically "tie back" one of the laryngeal muscles. This allows adequate air flow without giving pathogens, etc. completely unimpeded access to the dog's lungs. Typically, a specialist may be called in to do the surgery, it is not normally done in most veterinary clinics.

Leptospirosis

In most cases the disease is mild. Primary symptoms are fever, listlessness, loss of appetite and depression. Other symptoms involve the kidneys: a "hunched up" look due to kidney pain, ulcers on the mucus membranes of the mouth and tongue, thick brown coating on the tongue, bleeding from the mouth or bloody stools, severe thirst with increased urination. The whites of the eyes may turn yellow. Persistent vomiting and diarrhea are common. This disease is more prevalent in some areas than others. (Summarized From Carlson & Giffin.)

Many dogs seem to be allergic to the leptospirosis vaccination. If your dog is vaccination against lepto for the first time, keep a close eye on it for a few hours afterwards. If the dog goes into anaphylactic shock, get him back to the vet immediately.

Leptospirosis is a zoonotic disease, so if you come into contact with a dog that has Lepto, consult with your own doctor.


Obsessive Compulsive Disorder (OCD)

Summarized from a set of articles posted by Jim Jaskie,
jim_jaskie@tempeqm.sps.mot.com

Excessive licking:

Retrievers that lick their paws excessively, horses that "stump suck", Dobermans that "flank suck" share the same disorder. The disorder is generally mild and most people never notice it, but sometimes it can go too far and become a hindrance to normal functioning.

Dr. Judith Rapaport (head of the Child Psychiatry Branch of the National Institute of Mental Health and author of "The Boy Who Couldn't Stop Washing") explored this area thoroughly, because of similarities with a human malady called "Obsessive Compulsive Disorder (OCD)." This is a disorder that induces unusual behavior such as an irresistible desire to wash your hands, over and over, even when they are not dirty.

The experiments at NIMH showed that this behavior is caused by a lack of Seratonin. This lack can be caused by a genetic predisposition and also by stress. Proper medication was shown to relieve similar problems in dogs, horses and people! Some of the reported results were on Labradors that literally licked the hair off of their paws, dropping the habit completely after medication.

This research is also a landmark in the understanding of the effect of some of the neural transmitters and has led to a whole new family of some wonderful new medicines. This work has already saved dogs, horses and people from one of nature's less pleasant maladies, and promises to shed light on other problems such as epilepsy.

The medication that Dr. Judith Rapoport found to work for dogs with acralick dermatitis as well as Obsessive Compulsive Disorder (OCD) is Clomipramine (brand name is Anafranil). However, Fluoxetine (brand name is Prozac) is now being used very successfully for OCD and has fewer side effects. You should discuss this with your vet, who will be able to prescribe these medications for your dog if it has OCD.

Some old-ish but very informative articles that describe this problem are "Chemistry of Compulsion" by Robert Trotter in the June 1990 issue of Discover magazine and the very thorough but easy to read article, "The Biology of Obsessions and Compulsions" by Dr. Rapoport in the March 1989 issue of Scientific American. Only the first article specifically mentions Rapoport's work with dogs, but if you want to understand what is really going on, read both articles.


Panosteitis (puppy limp)

Also called pano, this is an inflammation of the membrane covering the bone and is relatively common. Rest, quiet, and sometimes a vet-approved painkiller are generally recommended for the puppy. Some vets recommend a reduced protien (usually an adult mixture) diet. This can strike anytime between 6-18 months of age and rarely lasts past two years of age.

If the limping goes from leg to leg (i.e., one day the dog limps on the right rear leg and the next it limps on the left front), it is very likely pano. Pano can also be diagnosed via x-rays.

Fortunately, lasting effects are uncommon, and most puppies outgrow it. It is not known what causes pano, the belief is that there is either a hereditary link, perhaps just a predisposition toward, causing pano.


Parvovirus

This is one of the most deadly viral infections for dogs. Young puppies who have not yet finished thier vaccination schedules and dogs with compromised immune symptoms are most at risk.

Transmission & Symptoms

The virus is easily transmitted through a fecal-oral route. You can track in fecal matter on your shoes and expose your dog to it at home. Parks that have many dogs using it are high-risk areas, as are unknown dogs which may be shedding the virus. Some breeds, for example the Rottweiler, are more subsceptible to contracting this disease.

Lethargy and listlessness, proceeding rapidly to almost uncontrollable diarrhea and vomiting.

Treatment

The puppy must be taken in immediately to the veterinarian for round the clock monitoring and IV's to replace the fluids the puppy is losing.

If the puppy survives, he will make a full recovery. There are no lasting effects of the illness and he will be fully immune to the disease thereafter, assuming a healthy immune system.

Prevention

A full series of vaccinations, with the last shot being scheduled for after 20 weeks of age is essential. Isolation -- don't let the at-risk dog be exposed to other dogs or their feces.

If you have an area (house and/or backyard) that has been exposed to a dog with Parvo, you can clean it up with a 3% bleach solution (3 parts bleach to 100 parts water).


Patellar Subluxation

Thanks to Edwin Barkdoll for this summary, and to Jeff Parke for comments:

There are many types and degrees of patellar luxation. The patella (kneecap) can luxate (dislocate) medially (towards the body midline) or laterally (away from the midline) and can be traumatic or congenital in origin. Small or toy breeds are much more likely to have this problem than larger breeds and they tend towards medial luxations; larger breeds tend to have lateral luxations if they develop this problem.

A system has been devised for grading patellar luxations: Type I - luxation seen only with leg in extension and when pressure is applied to the patella directly say during a physical exam by the vet, luxation resolves spontaneously when pressure is removed. Type II - patella is usually in normal position, but luxates with pressure or during flexion of the limb. The patella does not spontaneously return to normal but can be returned to normal manually or by the dog itself. Type III - patella is luxated most of the time but can be temporarily returned to normal position manually. Type IV - patella is always luxated and cannot be returned to normal position manually.

Surgical correction is not usually considered necessary unless the dog shows symptoms - pain, gait abnormalities - but you should talk with your vet about your options and get a second opinion if necessary.

Regarding surgical success, apparently about 50% of surgically treated cases demonstrate recurrent patellar luxation after 1-7 years although the severity of the patellar luxation at followup was reduced and about 90% (!) showed no signs of lameness. For the curious, the (incomplete) reference for these data is Willauer and Vasseur (1987) in Veterinary Surgery.


Poisons

If you need to induce vomiting, first make sure that it's appropriate to do so. Don't induce vomiting To induce vomiting:

Local Poison Control Centers

Check the emergency room of the local hospital and ask for the number of the local Poison Control Center. You should have this number up on the refrigerator alongside the vet's number and the emergency care number.

National Animal Poison Control Center

The National Animal Poison Control Center (NAPCC) provides a 24-hour emergency hotline that every dog owner should keep in plain sight. The hotline numbers are (800)548-2423 and (900)680-0000. The 800 number requires a credit card number and charges a flat $30; the 900 number is $2.95 per minute for a maximum of $30.

The NAPCC is a non-profit service of the University of Illinois and is the first animal-oriented poison center in the United States. Since 1978, it has provided advice to animal owners and conferred with veterinarians about poisoning exposures. The NAPCC's phones are answered by licensed veterinarians and board-certified veterinary toxicologists. They have specialized information that lets the experienced NAPCC staff make specific recommendations for your animals; plus over 250,000 records are in their database.

When you call, be ready to provide:

Household products and plants are the most common culprits in poisoning cases. In the case of poisoning from household products, many companies cover the costs the pet owners incur when it has been determined that their product is responsible for the reaction.

For further information, write to: The American Humane Association, 63 Inverness Drive East, Englewood, CO 80112-5117, or call (303) 792-9900.

Foods

Chocolate, tea, coffee, cola:

It is not chocolate itself that is poisonous to dogs, it is the theobromine, a naturally occuring compound found in chocolate. Theobromine causes different reactions to different dogs: dogs with health problems, especially epilepsy, are more affected by theobromine than healthy dogs. Theobromine can trigger epileptic seizures in dogs prone to or at risk of epilepsy. The size of the dog will also be a major factor: the smaller the dog, the more affected it is by the same amount than a larger dog. Therefore, toxicity is described on a mg/Kg basis.

Furthermore, theobromine can cause cardiac irregularity, especially if the dog becomes excited. Cardiac arythmia can precipitate a myocardial infarct which can kill the dog.

Theobromine also irritates the GI tract and in some dogs can cause internal bleeding which in some cases kills them a day or so later.

Theobromine is also present in differing amounts in different kinds of chocolate. milk chocolate has 44-66 mg/oz, dark chocolate 450 mg/oz and baking/bitter chocolate or cocoa powder varies as much as 150-600 mg/oz. How much chocolate a dog can survive depends on its weight (and other unknown circumstances). Under 200 mg theobromine per kg body weight no deaths have been observed.

Theobromine will stay in the bloodstream between 14 and 20 hours. It goes back into the bloodstream through the stomach lining and takes a long time for the liver to filter out.

Within two hours of ingestion, try inducing vomiting unless your dog is markedly stimulated, comatose, or has lost the gag reflex. If your dog has eaten a considerable amount of chocolate, or displays any of the above symptoms, take it to the vet without delay.

In the absence of major symptoms, administer activated charcoal. The unabsorbed theobromine will chemically bond to this and be eliminated in the feces. In pinch, burnt (as in thoroughly burnt, crumbling in hand) toast will do.

Nuts:

Walnuts are poisonous to dogs and should be avoided. In particular, there is a type of fungus common to walnuts (especially wet deadfall walnuts) that will cause severe episodes of seizuring. Many nuts are not good for dogs in general, their high phosporous content is said to possibly lead to bladder stones.

Misc:

Onions, especially raw onions, have been shown to trigger hemolytic anemia in dogs. (Stephen J Ettinger, D.V.M and Edward C. Fieldman, D.V.M. 's book: Textbook of Veterinary Internal Medicine vol. 2 pg 1884.) Also: "Six Cases of Heinz Body Haemolytic Anaemia Induced by Onion and/or Garlic Ingestion" - CM Edwards and CJ Belford Aust.Vet.Prac. 26 (1) March 1996, 18-22.

Potato poisonings among people and dogs have occurred. Solanum alkaloids can be found in in green sprouts and green potato skins, which occurs when the tubers are exposed to sunlight during growth or after harvest. The relatively rare occurrence of actual poisoning is due to several factors: solanine is poorly absorbed; it is mostly hydrolyzed into less toxic solanidinel; and the metabolites are quickly eliminated. Note that cooked, mashed potatoes are fine for dogs, actually quite nutritious and digestible.

Turkey skin is currently thought to cause acute pancreatis in dogs.

Poisonous houseplants

In assessing the risk to your dog from these plants, you need to consider both the age of your dog and it's propensity to chew on plants. Many of the below toxic plants rarely cause problems because most dogs don't chew them -- the exceptions being, of course, young puppies who are inclined to explore the world with their mouths, teething dogs who may chew on everything, and older dogs that are simply fond of chewing. Oleander, for example, is rather toxic, but most cases of poisoning involve 1) cattle, other grazing livestock 2) puppies and 3) human babies/toddlers.

Dumb cane is probably the one plant that should always be kept out of reach, since it takes only one nibble to have a potentially fatal situation.

(from Carlson & Giffin.)

Poisonous outdoor plants

(from Carlson & Giffin.)

Poisonous household items

Acetaminophen           	Laxatives
AntiFreeze			Lead
Aspirin				Lye
Bleach				Matches
Boric Acid			Metal Polish
Brake Fluid			Mineral Spirits
Carbon Monoxide			Mothballs
Carbuerator Cleaner		Nail Polish and Remover
Christmas Tinsel		Paint & Remover			
Cleaning Fluid			Perm Solutions
Deoderants/Deoderizers		Phenol
Detergents			Photo Developer
Disinfectants			Rat Poison
Drain Cleaner			Rubbing Alcohol
Dye				Shoe Polish
Fungicides			Sleeping Pills
Furniture Polish		Soaps
Gasoline			Suntan Lotions
Hair Colorings			Tar
Herbicides			Turpentine
Insecticides			Windshield Fluid
Kerosene			Woodstains
       

Poisonous animals

Bufo toads. Found in various areas, especially in south Florida. Very poisonous -- it can kill a small dog in a matter of minutes. It burns the mucous membrane of the mouth (gums) which is why they drool and foam, and that's also how it enters the bloodstream. It kills by elevating the heart rate and blood pressure to deadly levels, similar to the effects of chocolate. There is an antidote and the effects can be lessened if you immediately flush the dog's mouth with water before taking it to the vet.

Puppy Strangles

Puppy strangles occurs in puppies 4-16 weeks of age. It is a juvenile cellulitis of the face, ears, and lymph nodes. Affected puppies may have a fevero, be lethargic and not eat. The cause is unknown. An heritable immune dysfunction is suspected. CBC and biochemistry tests are normal in uncomplicated cases. Bacterial cultures of lesions are negative except with secondary infection. Biopsy results are multiple granulomas and pyogranulomas consisting of large epitheloid macrophages and neutrophils. Agressive therapy is indicated to prevent severe scarring of the face. Standard medications are usually steroids and antibiotics for secondary infections.

Rabies

Rabies is probably the oldest and most well known (if also misunderstood) of the diseases that can affect almost all warm blooded mammals. Dogs are easily vaccinated against rabies: most counties and cities require that all dogs be vaccinated before they can get their dog licences, and veterinarians must report all the dogs they vaccinate. Thus it has one of the highest compliance rates of all the routine dog vaccinations available.

Rabies is transmitted by body fluids -- urine, saliva, or blood. Ironically, if your dog tangles with a rabid animal, you may be more at risk than your dog, since your dog is the one with regular rabies shots whereas these are rarely administered to humans.

For rabies to infect you, it must come in contact with the skin or be ingested. Dogs and cats can ingest it by getting the saliva or blood of a rabid animal in their mouths where it will be absorbed through the mucous membranes. Humans are particularly at risk since we have so many minute cuts in our skin, that if we touch our dog or cat after he/she has met a rabid animal, we can become infected.

Keep in mind that bites are the most common way for humans to contract rabies from dogs, although other routes are possible. Some other methods, such as urine spray from flying bats have been documented as a means of transmitting rabies, but you are unlikely to encounter dogs flying overhead.

Rabies cannot be detected by a blood test since it invades the neural system. The only detection at this time is by examining the brain after death for signs of the infection. The incubation time is 3-6 months, which is why the standard quarantine for animals in some countries is 6 months.

Call the local health inspector, animal control officer, or police if your dog or cat has tangled with another animal that you suspect might be rabid. Dogs and cats which have been vaccinated against rabies should wear a tag at all times when not in the house to prevent being destroyed to check for rabies. Most veterinarians will recommend another booster as soon as possible if the dog has been bit or is suspected to have been bit. The sooner the better to help protect against the virus before it has time to spread.

References

Just Bats, Brock Fenton, University of Toronto, 1983, page 140.

Ringworm

(prepared by Edwin Barkdoll)

Despite the name, ringworm is caused by a fungus Microsporum canis and less frequently by other species. Ringworm infections remain limited to skin and superficial structures like hair and less frequently nails in cats and dogs. The infecting fungi require the keratin in superficial skin layers and nails, horns etc for their metabolism and furthermore do not grow well at the warmer temperatures of subcutaneous tissues, hence the superficial distribution. Note that ringoworm agents are obligate parasites - they normally live on the skin, although not in pathogenic numbers.

It can be transmitted between animals by skin abrasion or mild trauma, grooming tools, scabs etc particularly if the animal's immune system has been compromised, e.g. with steroids. In a normal, healthy animal ringworm infections are usually mild and self limiting, say 1-2 months. A major motivation for getting rid of a ringworm infection is to prevent you the owner from getting it.

If it is a mild infection topical application of lime sulfur is supposed to be good, although it can be smelly. Chlorhexidine shampoo is also effective as is also a relatively new 2% miconazole shampoo ($$$). If the infection is severe, oral griseofulvin is effective but also $$$.

The round, ring-like lesions are suggestive but _not_ diagnostic and are not even the typical lestion in cats and dogs. The animal may have itchy, scaly, crusty and hairless areas. Fungal culture is probably the best diagnostic method but many vets are not set up to culture fungi. A Wood's lamp can be used but not all ringworm agents will fluouresce so absence of fluourescence does not mean no ringworm, furthermore other things besides ringworm also fluoresce. In other words Wood's lamp is not a great test. Microscopic examination of skin scrapings may reveal the actual organism.

Finally, if you think your dog/cat has ringworm take it to the vet for diagnosis and treatment. If it does have ringworm, you can get it, but prevention is straightforward - treat your animal.


Thyroid Disorders

Common symptoms are: Dogs are often middle-aged or older, although this also occurs in younger dogs. According to the Merck Veterinary Manual, hypothyroidism is common in all breeds and all sexes, although the incidence is highest in spayed females. Treatment involves daily thyroid pills, a permanent regimen.

In the March '92 issue of Dog World is an excellent article, "Autoimmune thyroid disease" by Dr. Jean Dodds DVM (a nationally recognized expert on the subject) explains a lot about thyroid conditions in dogs. She also goes to great effort to explain that dogs can be hypothyroid without showing the "classic" signs. She also explains typical course of treatment and followups. There's also a long list of breeds that are "predisposed" to problems.

[As a counterweight, note that many vets do not take Dr. Dodds seriously because she does not publish in respected journals such as JAVMA but rather in "popular" magazines. So always discuss fully and candidly with your vet and bear in mind that many otherwise "asymptomatic" dogs are diagnosed with low or abnormal thyroid levels. This article is not attempting to argue one way or another over Dr. Dodds' credentials, it's merely trying to be as informative as possible.]

More subtle signs:

The article by Dr. Dodds points out that the "subtle" signs are just now being recognized by the veterinary community.

There is another article about thyroid problems in the Sept or Oct ('91) Dog World, and again, pointing out more unusual signs in the Sept. '92 issue of Dog World.

Padgett, George DVM "Caniine Genetic Disease" Dog World, December 1996, January 1997, and March 1997 (in three parts).

Bodner, E. "Hypothyroidism: a New Direction", AKC Gazette Feb 1997 , pp 40-42.

Inceasing attention is being paid to this problem. OFA now has a registry for thyroid function, details may be found at http://www.prodogs.com/chn/ofa/thyroid.htm.


von Willebrand's Disease

Contributed by Gary Mason

Von Willebrand's disease (vWD) is an inherited bleeding disorder. It is a complex and difficult disorder to deal with, because genetics, diagnostic abnormalities, pathogenic mechanisms, and sometimes conflicting clinical signs are all involved. The commonality between all vWD is a reduction in the amount or function of von Willebrand factor (vWF), which is manifested through abnormal platelet function and prolonged bleeding time. Different breeds exhibit different variations of the disease, and some individual animals appear to "acquire" vWD.

While the bulk of the information available is based upon purebred dogs, the disease is not unknown in mixed breeds. The total number of breeds affected by vWF exceeds 50. The disease also appears in cats, pigs, horses, and humans.

Human variants of vWD are broken into three main types which can be used to describe canine vWD. Type I vWD is characterized by a low concentration of normally structured protein. In screening studies done at Cornell over a period of years (1982-1992), percentages of dogs of some breeds tested as carrying the disease, and with concentrations of vWF less than 50% of standard (considered to be at risk) were:

	Breed                   Total # Tested          Average % Affected
				(through 1/93)          1982-87    1988-92
	-----                   --------------          ------------------
	Corgi                         3726                   29         42
	Poodle (std & min)            4048                   17         29
	Scottie                       6505                   14         30
	Golden Retriever              6906                   14         27
	Doberman                     22255                   64         74
	Sheltie                       9393                   22         34
	Akita *                        981                    0         27
	Cairn **                       411                    0         23

	* Totals for years 1989-1992.
	** Totals for years 1990-1992.
	All others for years 1988-1992.
Other breeds with a known prevalence of vWD in excess of 15% include Basset Hounds, Dachshunds (mini & std), German Wirehaired Pointers, German Shepherds, Keeshonds, Manchester Terriers (std & toy), Miniature Schnauzers, and Rottweilers.

Type II vWD is characterized by a low concentration of an abnormal vWF. Breeds in which severe type II-like vWD has been diagnosed include American Cocker Spaniels, German Shorthaired Pointers, and German Wirehaired Pointers.

Type III vWD is essentially the complete absence of vWF. Severe type III vWD has been diagnosed in Australian Cattle Dogs, Chesapeake Bay Retrievers, Fox Terriers (toy), German Shepherds, Scottish Terriers, and Shetland Sheepdogs.

In vWD dogs, bleeding can be spontaneous - usually from the mucosa of the mouth, nose, or gastro-intestinal tract. Injury that is accompanied by bleeding may continue unabated until a transfusion is administered. Whether or not bleeding from small wounds will stop without treatment is not predictable.

Living with one of these affected animals can get quite interesting. You must be careful with him in the house; by always having him on a leash or within our sight in a portable pen when outside; and by having a unit of frozen plasma at the veterinarian's at all times. Obviously, elective surgery is not advised. Required surgery can be preceded by transfusion with good results, though you can never be certain.

Lastly, most of these diseases can be stopped by testing before breeding, and through selective breeding. Unfortunately, experience and hearsay indicate that the AKC is not active in the enforcement of these preventive measures. Apparently the breeders, at least some of them, are not either. You should insist that the parents of a litter in a high risk breed have been checked prior to breeding -- and that the puppies have likewise been tested.

There is a definitive genetic test for Type III vWD in Scottish Terriers. The non-invasive test is available from VetGen (800-4-VETGEN).

For other breeds, test kits and instructions for vWD are available from:

Comparative Hematology Section - Diagnostic Laboratory
College of Veterinary Medicine, Cornell University
P. O. Box 5786
Ithaca, NY 14852-5786

607/253-3900 Voice
607/253-3943 FAX

These folks are very concerned and cooperative. I have exchanged several Emails and phone calls with them. They are interested in the dog's history, and are happy to hear anecdotal information - it is just one more piece to the puzzle. They also maintain a (large) kennel for affected dogs, so that might be an alternative if you can't keep one, but don't want to put it down.

NOTE: Most of the information above has been gleaned from data and information developed at, and published by, the New York State Department of Health Hematology Laboratory.

Additional Comments

The "traditional" vWD test (non DNA based) has enormous problems with accuracy and determination of precise vWD status. The blood collection for the vWD test must be done very carefully: you can only extract blood once, and you must not shake or separate the blood. If the test is done consistently and very carefully it can be useful. However, it is difficult to diagnose vWD without the test as there are many other things that can cause a bleeding problem, such as warfarin (rat poison) poisoning. So you might see non vWD dogs bleeding to death that are kept in a rat infested environment, for example.

Homozygous dogs rarely survive puppyhood. Heterozygous dogs generally have clotting problems (taking longer to stop bleeding and form a scab) which generally show up when the dog's tail is docked, dew claws are removed, or other surgery is done in which the problem becomes apparent.


Wobblers -- Cervical Vertabral Instability

"Wobblers" is the common term for a spinal condition called cervical vertebral instability (also caudal cervical spondylomyelopathy). It has not been proven genetic, but it is widely considered to be as it is quite prevalent in the Doberman breed.

There are several different types, but in sum the neck vertabrae are unstable, which causes the vertabrae to move or causes the disks in between to swell. Some dogs have no pain but are paralyzed; other dogs are in extreme pain but are mobile and some dogs are both.

Not very much is known about this disease. The mode of inheritance is unknown (and it is only suspected to be inherited, not proven). There is no cure. As a stopgap, surgical or medical intervention to reduce the swelling or stabilize the vertebrae can be tried. There is no easy, safe method of diagnosis. The only method of diagnosis is by myelogram which in itself can paralyze or even kill the dog.

(Thanks to Robin Nuttal for the basic information on this disorder.)


Canine Medical Information, Part II FAQ
Cindy Moore, rpd-info@netcom.com
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