Tuesday, November 29, 2016

Our Dogs' History of Adverse Drug Reactions (Part II)

Continued from part I

Jasmine's potential reaction to the NSAID was the first time we had a scary reaction to meds. Suddenly, the advice to watch for the usual (vomiting or diarrhea) was not good enough. The more I was reading all kinds of horror stories posted regarding the particular NSAID Jasmine was put on, the more I was freaking out.

Whether what was happening was a reaction to the meds or not, I stopped giving it immediately.

It was Sunday, of course, all horrors happen during weekends, don't they? The main question was whether the situation was dire enough to run Jasmine to the emergency or whether it could wait till Monday. Jasmine wasn't getting worse and by the end of the day I was able to get her to drink some chicken broth "shake".

Monday morning, after sending a lengthy email describing everything in detail, I was on the phone with the vet. He agreed we should bring her in, have her checked out and run blood work. Ruling out other causes, the NSAID came as the highest suspect. Particularly since things improved quickly once I stopped giving it. The vet himself used the words "an eye-opener."

Many dogs benefit from the use of NSAIDs and have no issues.

JD had them a few times and even Cookie did. They worked well and neither JD or Cookie had any adverse effects. I accept their use as a short-term crutch when quick pain and inflammation relief is needed. I would not use them long-term. Because Jasmine could not have any NSAIDs for the rest of her life, I quickly learned about all the available alternatives. There are many great options out there. For long-term management, those are my go-to solutions.

A note on using NSAIDs safely.

There is the right way of using NSAIDs and there is the wrong way.

To lower potential adverse reactions, proper screening needs to be done. That includes a medical history and blood work to make sure that kidneys are healthy and working properly. Though that doesn't mean thing cannot go wrong. Jasmine did have fresh blood work and everything was in order. However, I would not start my dog on NSAIDs without having blood work that is no older than a month.

Never give NSAIDs on empty stomach. They have to be given with food. Also, when Cookie was on relatively long-term course for her iliopsoas injury, we used stomach protectant as well.

Never mixed different NSAIDs. That also means aspirin and/or Tylenol. If you did give any of these to your dog prior the vet visit, let your vet know about it.  If switching between any two different NSAIDs, allow for "wash-out" period. This is the time it takes for all the drug to be cleared from the body. Recommended wash-out period is three to seven days.

If you're giving any other medications or supplements, make sure your veterinarian knows about it.

If you suspect your dog is having side-effects, stop the NSAIDs immediately and talk to your veterinarian.

When in doubt, ask, and ask, and ask again.

I also recommend getting the product safety sheet and reading it thoroughly. Many of the scary, serious side effects are very rare but you want to be aware should you run into them. Figuring out what is happening quickly allowed me to stop the medication and prevent further complications.

Continued here

Related articles:
Our Dogs' History of Adverse Drug Reactions (Part I)

Do you have a story to share?

Your story can help others, maybe even save a life!

What were the first signs you noticed? How did you dog get diagnosed? What treatment did/didn't work for you? What was your experience with your vet(s)? How did you cope with the challenges?

Email me, I'll be happy to hear from you.


Saturday, November 26, 2016

Top Veterinary Articles of the Week: Traditional Chinese Veterinary Medicine, Thoughts on Cranberries for Urinary Health, and more

Chinese Medicine Primer for the Uninitiated

Dr. Narda Rominson, Veterinary Practice News

I wrote about Traditional Chinese Veterinary Medicine (TCVM) a number of times. We decided to explore it when conventional medicine failed to provide neither answers or solutions to some of Jasmine's chronic issues. Since then, we use an integrative approach to maintaining our dogs' health. Some believe that an integrative vet is not genuine but I like the idea of being able to take advantage both modern science and technology as well as ancient wisdom.

It's been working well for us.

This article outlines the basic principles behind the TCVM approach.

Cranberry & Your Pet's Urinary Health—Miracle Berry or Just a Fad?

Dr. Jason Nicholas/Preventive Vet

Depending on who you ask how to treat your dog's urinary tract infection (UTI), many of those who answer will recommend cranberry juice. Is it a miracle cure? Spoiler alert - there is no such thing as a miracle cure, at least not yet.

We did, however, use a cranberry supplement when Jasmine started getting UTIs as a result of a combination of her mobility issues and being on steroids toward the end. We did so after consulting with her vet. As much as I might argue with my vet, I never do anything without their blessing. We did so as a supportive treatment, not as a sole cure. It's hard to tell whether it helped or not but it didn't do any harm.

Dr. Nicholas wrote a thoughtful article about the potential benefits and problems with treating UTI's with cranberries.

Do Dogs Get Colds? Everything You Need to Know

Dr. Jennifer Coates, DVM

Even though other viruses can be to blame, common cold is typically caused by a rhinovirus. Most viruses are picky about their species and rhinoviruses are one of those. Which means that the same virus that can cause common cold in me is not going to infect my dog. There are, however, viruses that can cause sneezing, congestion, coughing, runny nose and other cold-like symptoms in your dog. So, dogs can get what looks a lot like common cold but technically is not.

To learn more about whether or not dogs get colds and what to do about it, read Dr. Coates' article.

Don't Let Your Dog Suffer From Motion Sickness

Dr. Andy Roark/vetstreet

Dr. Andy Roark's videos are always priceless! You want to watch every one of them. Learn something and have a laugh.

Thursday, November 24, 2016

Dog Medical Emergencies Survey: Is Unproductive Retching an Emergency?

Most problems come with a combination of symptoms. Rarely will your dog exhibit a sole symptom or a sign. With some issues, it is important to consider them in context. Some, however, are reason enough to seek emergency care even if that's the only thing you notice.

Only 59.38% of you believe that unproductive vomiting is an emergency. Perhaps I should have used different wording, such as unproductive retching.

A dog who is trying to vomit but nothing is coming out is a major emergency. This is a telltale sign of GDV/bloat!

Photo Preventive Vet

Other symptoms of bloat can include:

  • distended/bloated abdomen
  • pained/incomfortable posture
  • pacing/restlessness
  • panting/difficult breathing
  • excessive salivation
  • rapid heart beat
  • pale mucus membranes
  • collapse

Gastric Dilatation and Volvulus (GDV) is the mother of all emergencies. Every minute counts.

Immediate, aggressive treatment is the only thing that can save your dog's life.

Why is GDV/bloat so dangerous?

In dogs, bloat goes beyond simple what we consider bloat in people. Yes, it involves an accumulation of gas, food or fluid in the stomach, causing it to expand. The stomach then puts pressure on other organs, restricting blood flow to the stomach lining, and the heart, and therefore to the rest of the body. This can cause hypovolemic shock.

If that wasn't bad enough, sections of this trapped stomach wall can necrotize (the tissue dies). It can also cause blood clotting to go crazy with small blood clots developing throughout the entire bloodstream ... When things get this far, prognosis is extremely poor.

And just imagine the pain from all that.

Note: The video was taken at the emergency vet's office while Flash's x-rays (confirming GDV) were developing. Unfortunately, he didn't make it, though.

The video was taken in hopes that even just 1 large-breed dog owner who is not familiar with the symptoms of bloat would watch this and be able to identify the symptoms and seek medical attention before it is too late.

Grueling picture?

If I painted a truly grueling picture, it was my intention. This is indeed the worst of emergencies. Know the signs of GDV/bloat and know that if you see them time is wasting. Particularly if your dog is large, deep-chested breed.

Further reading:
Help... My Dog's Stomach is Bloated! Understanding Canine Bloat, Torsion, and GDV

Related articles:
Gastric Dilatation-Volvulus (Bloat); RIP Barbie

Symptoms to Watch for in Your Dog now available in paperback and Kindle.
Each chapter includes notes on when it is an emergency. 


Tuesday, November 22, 2016

Our Dogs' History of Adverse Drug Reactions (Part I)

If you're anything like me, you have a love-hate relationship with medicating your dog. Perhaps more hate than love. That is not to say that drugs don't have their place and there are times when they can be life-saving. I medicate very conservatively; if there is an alternative option, I'll consider it first.

Drugs don't come without side effects.

Some side effects are more common than others, some rare ones can be quite severe. Experience has taught me to study the product sheet for any medication I give my dogs. I ask the prescribing vet and research how common some of the serious side effects may or may not be.

Jasmine's vet used to say that a drug with no side effects is a drug that won't do anything else either—is useless.

One reason for that is simply that they are imperfect in a way that they affect things other than those they target. NSAIDs, for example, inhibit enzymes involved in inflammation. (Different types of NSAIDs target different enzymes.) However, those very same enzymes have other jobs that get inhibited in the process.

Then there is always the potential of an allergic reaction to any substance. Most common side effects of any oral medications are digestive disturbances because it is the digestive system that has to process and absorb them. Drugs work like carpet bombing; there will be casualties. The day when scientists develop medications that will do only what they are intended to is yet to come. By then, though, we might find a completely different, better way of healing. For example, science is learning more and more about how much microbiome is involved in health and disease. Maybe one day, instead of treating the body, it will be the microbiome that gets treated.

For now, sooner or later your dog is likely to need drugs.

There was a time when I didn't think twice about it. A veterinarian prescribed medication, I gave it. I figured that if there was something else I should know, they would tell me. But seriously, how often does your veterinarian educate about potential side effects of the drugs they prescribed?

For a long time, we didn't have many problems with meds, other than upset stomach or diarrhea.

When Jasmine was prescribed NSAIDs for her arthritis, I did actually think to ask what side effects we should be watching for. "The usual," I was told. "Vomiting, diarrhea,"

Jasmine was on it for a couple of days when she stopped eating. This, however, wasn't all that unusual for her. She would get like that every now and then. But then she stopped drinking as well. Now I was worried. That has never happened before. Can you guess this happened over the weekend? I had nobody to talk to about what was happening.

Fortunately, since this problem was new, I figured that it might be caused by something newly introduced - Jasmine's meds. I went online to learn about side effects and I almost got a heart attack at what I was finding.

I have immediately stopped giving it, trying to decide whether we needed to take Jasmine to an emergency clinic or not.

Here is what the product sheet had to say about potential side effects:

Previcox, like other NSAIDs, may cause some side effects. Serious side effects associated with NSAID therapy in dogs can occur with or without warning, and, in rare situations, result in death.

The most common side effects associated with Previcox therapy involve the digestive tract (vomiting and decreased food consumption). Liver and kidney problems have also been reported with NSAIDs. Look for the following side effects that may indicate your dog is having a problem with Previcox:

  • Decrease or increase in appetite.
  • Vomiting.
  • Change in bowel movements (such as diarrhea, or black, tarry or bloody stools).
  • Change in behavior (such as decreased on increased activity level, incoordination, seizure, or aggression).
  • Yellowing of gums, skin, or whites of the eyes (jaundice).
  • Change in drinking habits (frequency or amount consumed).
  • Change in urination habits (frequency, color, or smell.)
  • Change in skin (redness, scabs, or scratching).
  • Unexpected weight loss.

It is important to stop the medication and contact your veterinarian immediately if you think your dog has a medical problem or side effects while taking Previcox tablets.

Needless to say, I was freaking out.

Spoiler, Jasmine made it through the ordeal without any serious lasting damage. But this was an eye-opener for me.

Continued here

Do you have a story to share?

Your story can help others, maybe even save a life!

What were the first signs you noticed? How did you dog get diagnosed? What treatment did/didn't work for you? What was your experience with your vet(s)? How did you cope with the challenges?

Email me, I'll be happy to hear from you.


Saturday, November 19, 2016

Top Veterinary Articles of the Week: ToeGrips in Rehabilitation Medicine, Medicated Shampoos, and more ...

A pooch-centric guide to medicated shampoos

Dr. Marty Becker

Medicated shampoos can be a life-saver. Every now and then, Jasmine had issues with skin infections. Strategic use of a medicated shampoo can help prevent them as well as manage milder cases.

Medicated shampoos can help fight parasites, bacteria or fungi, or relieve itchiness. We liked one where the active ingredient was sulfur and salicylic acid. It was very mild and worked well for Jasmine. We tried several others but has best results with this one.

When choosing a medicated shampoo for your dog, work with your veterinarian.

How Veterinary Rehabilitation Medicine Uses ToeGrips


Photo ToeGrips.com

The first time I've seen ToeGrips I thought it was a genius idea. Slippery surfaces can be a huge challenge for dogs with mobility issues or dogs recovering from surgery or injury. There is, of course, the option of covering all your floors with rugs and carpets. It is what we did when Jasmine underwent surgeries for her cruciate. We covered almost all of the floor with just a little bit of bare hardwood in the odd corner. It worked well. But then, when she suffered severe drug-induced hyperthermia and could barely hold herself up in standing position, those little patches of floor that weren't covered were like a magnet. She'd find them and slip on them. So we added more patches. That all works as long as the dog doesn't leave the home. Even a visit at a vet can be another challenge. And you can't really bring your rugs with you.

There are other non-slip products out there, booties, socks, even stickers, but I was always concerned about the dog not being able to feel the ground properly in them. ToeGrips don't mess with that and even encourage better proprioception.

When Cookie was recovering from her iliopsoas injuries, I was very happy that we could use the ToeGrips to keep her from slipping and injuring herself further.

The use of ToeGrips is on my list of survival hacks when it comes to dogs with limited mobility or dogs recovering from surgery or an injury.

Find out how Dr. Evelyn Orenbuch, DVM, incorporates the use of ToeGrips in rehabilitation medicine.

What Does Demodex Look Like and How Can It Be Treated in a Herding Dog?

Dr. Greg Martinez

Thursday, November 17, 2016

Primer on Coprophagia (Poop Eating)

Written and reviewed by John A. Bukowski, DVM, MPH, Ph
and Susan E. Aiello, DVM, ELS

Dogs seem to enjoy many smells and tastes that people find offensive, and they are generally attracted to the odor of feces while investigating their environment.  Some dogs, including puppies, will even eat the poop of cats and other animals, which is a condition called coprophagia.

This behavior is akin to scavenging, which is a common pack characteristic.

Eating feces is usually a behavioral problem, especially in curious puppies that explore different things by picking them up in their mouth.  In addition, coprophagia usually attracts a great deal of attention from the owner, which serves to reinforce the behavior.  Coprophagia in puppies usually clears up by the time the pup becomes an adult.  However, taking measures early can help reduce the possibility of behavior becoming a long-term habit.

Behavioral coprophagia is best corrected by preventing access to feces, keeping your yard thoroughly clean, and keeping your dog under constant supervision when outdoors.  

As soon as your dog begins to sniff or investigate fecal material, interrupt it with a firm command or a quick pull on the leash.  There is no basis for outmoded punishments such as “sticking the dog’s nose in it,” which can actually increase the problem.

Coprophagia can also be caused or worsened by certain medical problems, which are a more likely explanation when coprophagia develops in adult dogs.  

Your veterinarian may recommend some diagnostic tests to check for any underlying medical conditions, such as hormonal disorders, digestive problems, intestinal parasites, or nutritional deficiencies.  In addition, conditions that cause increased appetite (eg, diabetes, Cushing’s disease, thyroid disease, or treatment with corticosteroids) can lead to an interest in consuming feces.  In these cases, correcting the underlying medical problem generally also corrects the coprophagia.

Coprophagia can sometimes be corrected by changing the physical characteristics of the feces.  Your vet may suggest adding a substance to your dog’s food that can change the odor of the feces, and curb coprophagia.  Adding unpleasant tastes, such as hot pepper, directly on the feces is not often successful.

Saturday, November 12, 2016

Top Veterinary Articles of the Week: Thanksgiving Dangers, Herbs for Joint Pain, and more ...

Thanksgiving holiday dangers to avoid in your pets

Dr. Justine Lee

Up here, in Canada, we already made it through Thanksgiving safely. Our dogs do get their turkey breast, but that's the only thing we share. In order to avoid holiday trip to the veterinary ER, get a refresher on how to make it through the feast safely.

4 Herbs for Joint Pain and Inflammation in Pets


When you think about joint pain, the first things that come to mind are fish oil, glucosamine, and chondroitin. Fish oil is highly beneficial. The usefulness of glucosamine and chondroitin supplements has been questioned.

But what about herbs? If you haven't heard of them, you'll be happy to learn that there are herbs that can indeed help your dog a great deal. If your dog is having joint issues, consider researching turmeric, Boswellia serrata, and Hawthorn.

Boswellia Serrata. Photo Home Remedy

Hawthort. Photo nutrawiki

Histiocytic Disease in Dogs – A Challenging Complex

Dr. Christopher Byers/CriticalCareDVM

I remember the days when I had no idea what such things mean. Was I happier then? Maybe. But having some general understanding of things is always useful.

Histiocytic disease sounds scary. When it comes to lumps and bumps, though, histiocytoma is the word you do want to find on the biopsy report. When Cookie grew a lump on her belly, I was very happy that it was just a histiocytoma. It was a benign bump, one of those that often go away on their own. Though Cookie's was removed, but that's a long story.

There are more than one type of this disease, a couple of them are malignant, and one of them is quite a bad news too. A simple histiocytoma, though, is what you're most likely to run into.

Check out Dr. Buyers' informative article on histiocytic disease.

4 Reasons Not to Ignore a Pet's Broken Toenail

Dr. Ann Hohenhaus/vetSTREET

You would think that a broken toenail isn't a big deal. But it can mean a serious problem. Dog nails are quite tough and well-equipped for about anything a dog can throw at them. Unless they are too long, which can facilitate brakes or cracks, there can be a bigger issue behind it. A simple problem of a broken toenail can mean your dog has an infection or even cancer.

If your dog breaks a toenail, be on your toes. Have it checked.

Thursday, November 10, 2016

Primer on Glaucoma

Written and reviewed by John A. Bukowski, DVM, MPH, PhD
and Susan E. Aiello, DVM, ELS

Glaucoma in dogs is a condition where pressure builds up in the eyeball, thereby damaging the structures of the eye and leading to the dog's blindness. 

The eyeball of a dog is filled with fluid that nourishes the eye, cushions it, and helps it keep its shape. Some of this fluid is thick, like jelly, while some is thin, like water. The fluid is constantly moving because new fluid is added all the time while older fluid is removed.

Any problem that either blocks the outflow of fluid or increases the inflow results in pressure building up in the eyeball, a condition known as glaucoma.

 Over time, the increased pressure can seriously damage the structures of the eye, especially the delicate retina, and optic nerve, resulting in blindness.

Fluid drains out of the eye in the area between the lens and the cornea. Glaucoma can develop if this area is damaged from trauma (eg, car accident), a bacterial or viral infection, a tumor, parasites, etc. Genetic problems with the fluid outflow are seen in certain breeds of dogs (eg, American Cocker Spaniel, Basset Hound, Siberian Husky, Samoyed, and Shar Pei), which increases their risk of glaucoma.

In early glaucoma, signs include redness in the whites of the eyes, a slightly enlarged pupil, and an eyeball that is a little larger or harder than normal. In more advanced glaucoma, signs include an obviously enlarged eyeball, a noticeably enlarged pupil, and a cloudy cornea.

Glaucoma can also be very painful, so your dog may squint, paw at its face, or stop eating. Signs of illness often develop gradually but can occur quite suddenly if the fluid drainage from the eye is blocked abruptly.

If you notice signs of glaucoma, you should take your dog to your veterinarian as soon as possible. 

Signs that occur suddenly should be treated as an emergency. 

Your vet will anesthetize the eye with local anesthetic eye drops and then measure the pressure in the eye with an instrument called a tonometer. (If your dog is a member of a high-risk breed, your vet may recommend periodic tonometry so that if glaucoma does develop, it can be caught early).

Treatment is aimed at managing pain, decreasing the pressure in the eyeball, and preventing blindness (when possible). 

Eye drops can be prescribed to ease painful spasms and to enlarge the fluid drainage area. In some cases, oral medication can also be used to lower pressure in the eye by decreasing fluid production. Surgery may be needed to open up the drainage area or to place artificial drains that can help draw fluid off the eye. In such cases, your veterinarian may refer you to a specialist or veterinary teaching hospital.

In cases of long-term or advanced disease, in which blindness has already developed, surgery to remove the painful eye may be recommended.

Saturday, November 5, 2016

Top Veterinary Articles of the Week: Are You Smarter than a Vet Student? Best Chew Toys for Dogs, and more ...

Are You Smarter Than a Vet Student About Intestinal Parasites (Worms)?

Dr. Nancy Kay/Speaking for Spot

Tapeworm inside dog intestine / Copyright Juan Gaertner

This is Dr. Kay's ongoing series which I love. Yes, I'm striving to be smarter than a vet student. Though I have to admit that this one was hard for me because we had very little issues with parasites. Other than suspected Giardia when Jasmine was young and Cookie contracting tapeworm, my exposure to intestinal parasite problems has been, fortunately, nonexistent. I did give it a shot anyway for the opportunity to learn something new.

What about you? Are you smarter than a vet student when it comes to intestinal parasites?

Once you're done, you can find the correct answers in the follow-up article. Sorry, I didn't manage to get it here sooner.

Choosing the Best Chew Toys for Your Dog—The Good, the Bad, and the Ugly

Dr. Jason Nicholas/Preventive Vet

Is there such a thing as a safe chew toy? You might be surprised by Dr. Nicholas' overview. The short answer is, "not really." At the very best it depends on the dog.

Some of the listed items are things I would never use. Some of them I do. I mean, at the end, a dog has to chew on something, right? I actually do like giving what is referred to as entertainment bones. Raw, of course. Yes, there is the potential of a broken tooth. But I watch Cookie closely and she likes to gnaw off the meat and might tackle the ends which are tender enough. I do not let her try chewing the hard parts. The more meat and connective tissue there is on the bone, the safer it is in our case. They do indeed provide a lot of entertainment.

The important point Dr. Nicholas is trying to make is to be aware of potential risks and give the choice of a chew toy for your dog a lot of consideration.

Allergen-Specific Immunotherapy For Dogs And Cats

Dr. Jean Dodds/Dr. Jean Dodds' Pet Health Resource Blog

We came very close to trying allergen-specific immunotherapy for Jasmine. Would have done it except she came down with completely different problems. The immunotherapy got pushed aside and eventually it never happened.

I am a fan of the concept and I believe it is way better than trying to manage allergies with drugs.

Immunotherapy doesn't stop at allergies. Vaccines are really a form of immunotherapy as well as it's being employed as cancer treatment.

The definition of immunotherapy is that it is a type of biological therapy that uses substances to stimulate or suppress the immune system to help the body fight infection and diseases. Some types of immunotherapy only target certain cells of the immune system. Others affect the immune system in a general way. In other words, getting the immune system on the dog's side. Whether to wake it up or calm it down.