Ovary-Sparing Spay Surgery (OSS)

Photo Credit: Flicker CC, Smerikal, BeautifulMy last blog focused on the boys, specifically canine vasectomy, a surgical technique for sterilizing male dogs without removal of their reproductive organs (testicles). Now, it’s time to talk about the girls! The corollary surgery in female dogs is called ovary-sparing spay (OSS).

What exactly is ovary-sparing spay surgery?

The canine spay surgery traditionally performed in the United States is called ovariohysterectomy in which both ovaries (ovario) and the uterus (hyster) are removed. OSS surgery is simply a hysterectomy- only the uterus is removed and, as the name implies, the ovaries are spared. The hysterectomized dog is sterile, but her ability to produce reproductive hormones remains intact.

Why consider OSS?

There are a few different reasons why people might opt for OSS surgery:

  • They want a sterilized dog, but believe in the importance of maintaining normal reproductive hormones status. Over the past decade or so, we’ve learned considerably more about some deleterious effects of traditional spay surgery particularly when performed before one year of age. The studies to date have mostly been breed-specific (Rottweilers, Labrador Retrievers, Golden Retrievers, Vizslas, and German Shepherds). In these studies, removal of the reproductive organs increased the risk for development of behavioral problems, orthopedic diseases, urinary incontinence, and various types of cancers. At this point, we really don’t know if this information can be extrapolated to other breeds.
  • They want their sterilized dog to achieve “normal” or “breed typical” stature and conformation. Conventional spaying, particularly at a young age, tends to create a somewhat different physical appearance.
  • They want to eliminate the risk of pyometra (see below), but don’t want the loss of normal reproductive hormone production.

Not for everyone or every dog

While OSS makes perfect sense for some people and some dogs, there are a number of important factors to consider:

  • A dog who has had OSS surgery will continue to have heat cycles complete with a swollen vulva, behavioral changes, and an invitation to all the unneutered male dogs in the neighborhood. The good news is that the amount of vulvar discharge associated with the heat cycle should be significantly diminished.
  • Dogs who have had OSS surgery will be subject to developing mammary (breast) cancer, one of the most common malignancies in female dogs. Removal of the ovaries, particularly before the first heat cycle occurs, protects against this disease.
  • When the ovaries are spared, it’s super important that the uterus, including the cervix, is removed in its entirety. Most veterinarians do not have experience removing the uterus this “aggressively”. Leaving even a remnant behind can result in pyometra (pus within the uterus). This “stump pyometra” can make for a very sick dog, and treatment typically requires surgery. Correctly performed, OSS surgery prevents pyometra from ever occurring. If you opt for OSS surgery, pick your surgeon wisely. Consider working with a veterinarian who specializes in surgery.
  • Although she will be receptive to male dogs when she’s in heat, the female who has had OSS surgery should not be bred. Given that her cervix will have been removed, from an anatomical point of view she may not be able to accommodate the male dog.
  • Just like dogs who have not been spayed, dogs who have undergone OSS surgery may exhibit symptoms of pseudopregnacy, also known as false pregnancy. This is a truly interesting phenomenon in which reproductive hormones trick the dog into thinking she’s pregnant even though she’s not. So, at right around 60 days following her heat cycle, the pseudopregnant dog begins behaving just as she might if she were getting ready to give birth. She might exhibit behaviors such as nesting, aggression, panting, pacing, whining, and not eating. She may even begin producing milk. While none of these are symptoms that typically need to be treated, they can create a nuisance that lasts for quite awhile.

Would you ever consider OSS surgery for your dog?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at http://www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

 

Canine Vasectomies

Do you know that vasectomy surgery can be performed on dogs? Indeed this is true, Photo Credit: Nguyen Hoangnam, cute, Flicker CC licenseand, as we learn more and more about the impacts of traditional canine neutering (castration), vasectomy surgery is becoming increasingly popular.

What exactly is a vasectomy?

Whether performed on a human or a dog, vasectomy surgery involves clamping, cutting, or ligating (tying off) the vas deferens, the duct that transports sperm out of the testicle and into the semen. Local anesthesia is all that is needed to accomplish this surgery in men. (Most men will lie still when told to do so.) Vasectomy surgery is performed in dogs using general anesthesia.

Vasectomy versus castration

Castration is referred to as “neutering” because the reproductive organs (testicles) are removed. With vasectomy surgery, the testicles remain in place, so the dog is not considered to be “neutered.”

Whether castrated or vasectomized, the end result is a sterile dog. And, there is a period of surgical recovery with both procedures. Castration tends to be a “bigger deal” surgery in that the incisions are larger and there is more overall tissue trauma. Performed by someone with significant experience, a vasectomy tends to be considered a relatively minor procedure.

The testicles are where testosterone is produced. So, it makes sense that castration (removal of both testicles) reduces testosterone production to almost nil. A very small amount of testosterone continues to be produced by the adrenal glands. Vasectomized dogs maintain normal testosterone production.

Choosing whether or not your dog should live his life with or without testosterone is a big-deal decision these days. There is mounting evidence (pun intended) that removal of testosterone, particularly in dogs under a year of age, might be associated with negative health implications. There are plenty of pros and cons to consider, and they should be discussed at length with a veterinarian you hold in high regard. Be sure to do some investigating yourself. I have compiled a bibliography on canine spay/neuter research, including that which is most current. Please shoot me an email if you would like a copy.

Be forewarned

If you opt to sterilize your dog via vasectomy, here are some things to consider:

– There is no “Vasectomy 101” course being taught in veterinary schools (yet). Most veterinarians who perform vasectomies are somewhat self-taught. While this surgery is pretty darned simple, be sure that you are working with a surgeon who has several vasectomies under his or her belt (pun intended). If you are having difficulty finding an experienced surgeon, look for a surgical specialist. He or she will be able to handle your request.

– If ever you become unhappy with the role testosterone is playing in your vasectomized dog’s life (he’s humping everything in sight, he’s jumping the fence to be with the neighbor’s dog who is in heat), you can always opt for castration at a later date.

– Following vasectomy surgery, a male dog can successfully breed for up to two months. Do not let your vasectomized dog interact with a female in heat during this time period.

– You might be ostracized and/or interrogated at dog parks and other public venues where only neutered dogs (those without reproductive organs) are allowed.

– Proprietors of doggie day care facilities may refuse your vasectomized dog because they hold negative and sometimes inaccurate impressions of testosterone-driven behaviors.

Would you ever consider a vasectomy for your dog?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at http://www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

Guidelines for End-of-Life Care

Photo Credit: Shea Cox, DVM

Some truly lovely guidelines pertaining to end-of-life care for pets have recently been published. I use the word lovely because everything within this document feels exceptionally loving and humane, not only for the animals, but also for their human companions. The guidelines were a collaborative effort, created by the International Association for Animal Hospice and Palliative Care and the American Animal Hospital Association.

Here are some examples that will give you a sense of the wisdom and compassion found within these End-of-Life Care Guidelines.

End-of-life care and decision making embody the critical final stage in a pet’s life and are as important and meaningful as the sum of the clinical care provided for all prior life stages.

End-of-life care should focus on maximizing patient comfort and minimizing suffering while providing a collaborative and supportive partnership with the caregiver client.

Timely, empathetic, and nonjudgmental communication is the hallmark of effective client support.

Veterinarians should not allow an end-of-life patient to succumb to a natural death without considering the option of euthanasia and ensuring that other measures to alleviate discomfort and distress are in place.

Hospice care

The end-of-life care guidelines defines animal hospice as follows:

A philosophy or program of care that addresses the physical, emotional, and social needs of animals in the advanced stages of a progressive, life-limiting illness or disability. Animal hospice care is provided to the patient from the time of a terminal diagnosis through the death of the animal, inclusive of death by euthanasia or by hospice-supported natural death. Animal hospice addresses the emotional, social, and spiritual needs of the human caregivers in preparation for the death of the animal and the grief experience. Animal hospice care is enhanced when provided by an interdisciplinary team approach.

There are many similarities here between animal and human hospice care. The major difference is that, in human hospice, death is neither hastened nor postponed. With the exception of a handful of states, euthanasia is not legal in this country.

Some people do not believe in euthanasia for their pets, and these guidelines accept that the pet owner has the ethical and legal right to choose for or against this process. However, animal hospice does not accept the decision to allow a pet to die without euthanasia unless effective measures provided by a veterinarian are in place to alleviate discomfort and distress.

Hospice care pyramid

The end-of-life care guidelines feature a three-tiered “Animal Hospice Care Pyramid” that illustrates the many ways in which the hospice patient’s care is to be managed. The base of the pyramid addresses the components of maintaining the patient’s physical comfort, including:

  • Pain management
  • Management of symptoms
  • Hygiene
  • Nutrition
  • Mobility
  • Safety
  • Environmental needs

The middle tier addresses the animal’s social engagement with family members, both people and other pets in the household. The goals are to provide mental stimulation and avoid social isolation.

The very top of the pyramid addresses the emotional needs of the animal specifically at the end of his or her life. The objectives here are preservation of dignity (maintaining grooming, managing self-soiling with urine and feces), stress reduction, and, to the greatest degree possible, preserving the animal’s role in the household such as providing human companionship and barking at the UPS truck.

Client support

Found within these end-of-life care guidelines is a lengthy description of how hospice veterinarians can attend to the emotional needs of their clients. It is well recognized that most people begin the grieving process for their pets well before death occurs. It makes sense then that hospice care veterinarians must be prepared to provide emotional support at the time of their very first client interactions.

Other topics

The end-of-life care guidelines are rich with other important information including the specifics of the euthanasia process. Throughout, empathy is stressed. An example is, “Never rush the process- clients want, and and need your undivided attention and you have an obligation to give it to them.”

The guidelines also address compassion fatigue amongst veterinarians and their staff members. In depth suggestions for detecting this issue and providing emotional self-care are included within this document.

I encourage you to take a look at these end-of-life care guidelines. While no one wants to think about the loss of a beloved animal, reading this piece is ironically restorative in the sense that it’s filled to the brim with suggestions for creating a loving and gentle final passage.

Would you ever consider hospice care for your pet?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at http://www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

 

How to Ensure You Are There Should Your Hospitalized Pet Pass Away

Photo Credit: Jennifer Lombardo

Wherever I’ve worked, with one exception, I’ve had the ability to ensure that my clients were allowed cage-side access pretty much 24/7 with their very sick pets (and I didn’t last very long at the job where this wasn’t an option). I wanted my clients there, particularly if I felt that these might be their beloved pets’ final days, hours, or minutes.

Despite my darned good intuition about the status of my patients, every once in awhile, one would pass away unexpectedly. I still hold grief about these animals, knowing they took their last breath in a strange place, surrounded by strangers. And, I held such sadness for their human companions. These folks were often plagued with guilt at having not been with their pets at the time of death. Having facilitated a pet loss support group for several years, I know that navigating through the grief process is often far more difficult for those who have lost their pets under such circumstances.

Jen, Louie, and Bruno

Jen is one of my regular readers. Her email provided me with the impetus to write about this topic:

Hi Dr. Kay,

 

I am not sure if you are able to help me or give me some guidance. I am not even sure if I am headed in the right direction with this but here it goes…

 

I had two English Bulldogs, Louie who lived to be 11 years old and Bruno who lived to 8 years old. They died this year 3 months apart.

Bruno was first.  He died of sepsis caused by prostatitis. Louie died 3 months later from cardiac arrest after having a seizure during treatment for ventricular tachycardia. I feel that both dogs were sick and, in the end, would have died, but what bothers me the most is how I was unable to stay with them at the time they needed me the most.

 

I left Bruno in a cell in the hospital alone overnight for 12 hours where he slowly died due to his sepsis (despite all they were doing for him) and I wasn’t allowed to stay with him and be there to comfort him and let him know that I didn’t just abandon him.

 

I was with Louie when he died, but the doctor who admitted him was more concerned with the fact that I told her I was not leaving my dog than discussing a code status and a plan with me. Louie was intubated and had CPR done on him and I did not want that. I was in the next room and she could have sent someone to get me and ask me what I wanted done. If she had established this right at the beginning he wouldn’t have had to go through that.

 

So I am writing to you because I don’t know how I can help these animals that cannot speak and make their needs known, to be able to have their owners present during their hospitalization. I don’t know where to start and I have no idea if you can help me. If not, I understand, but thank you for listening to my story.

 

Jen

Ensuring you are with your pet

Jen’s story is pretty darned haunting, and it begs the question, what can one do to make sure that her story won’t become yours? Here are some pointers to ensure that you will be with your hospitalized pet when he or she passes away:

  1. Choose your veterinary hospital wisely. For help with this I encourage you read the chapter called “Finding Dr. Wonderful and Your Mutt’s Mayo Clinic” in Speaking for Spot. If hospitalization for your pet is necessary, look for a facility that provides round-the-clock care with constant monitoring, generous visiting hours, and a hospital policy dictating that you are to be called, any time day or night, the moment your pet’s condition declines.
  1. Have a heart-to-heart talk with your veterinarian about the seriousness of your pet’s condition. Does she think that it’s likely your pet could pass away while in the hospital? If so, what is her best guess as to when this might occur?
  1. Let the hospital staff know that you absolutely want to be contacted any time day or night should your pet’s condition take a turn for the worse. Emphasize how important this is to you.
  1. Provide the contact number for the phone that you will keep by your side, the phone that will be set to the loudest ring tone under your pillow while you are sleeping.
  1. Visit with your pet as much as your schedule and the hospital policy allow.
  1. Have a frank discussion with the veterinary staff about whether or not you would want your pet resuscitated (brought back to life) should he suddenly stop breathing or his heart stop beating. Unless you authorize DNR status (do not resuscitate), the staff will feel obligated to try to bring your pet back to life.
  1. If there is nothing more that can be done to reverse your pet’s terminal disease, and the quality of life has become vastly diminished, it is likely time to consider either euthanasia or home hospice care. Either way, you will be able to ensure that you are with your pet during this very important time.

When your pets passed away, were you able to be there?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at http://www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

Lymphoma’s Newest Enemy

Photo Credit: Flicker CC license, farm9, MieleFor the first time in a very long time, a new drug has been approved for dogs with lymphoma. The drug is called Tanovea-CA1 and it is produced by VetDC Inc., a startup company associated with Colorado State University. Earlier this month, Tanovea-CA1 received conditional approval from the Food and Drug Administration for treatment of dogs with lymphoma.

What is lymphoma?

Lymphoma is one of the most commonly diagnosed forms of cancer in dogs. Golden Retrievers are the unfortunate poster-puppies for this disease. Lymphoma arises from lymphocytes, normal white blood cells involved in the immune system. In dogs, lymphoma most commonly arises within the lymph nodes, spleen, and bone marrow, but because lymphocytes circulate virtually everywhere, it makes sense that lymphoma can grow anywhere within the body.

Lymphoma cells tend to be quite responsive to chemotherapy and radiation therapy, and it’s not unusual to achieve complete remission (no obvious trace of the cancer remaining) in response to treatment. What is very rare, however, is for lymphoma to be cured. Invariably, there is relapse of the cancer. While “rescue chemotherapy protocols” are often capable of zapping the cancer back into remission, over time those crafty lymphoma cells figure out how to develop significant drug resistance. With rare exception, lymphoma is a terminal disease.

Tanovea-CA1

The active ingredient in Tanovea-CA1 is rabacfosadine, first developed for use as a cancer-fighting drug in people. In dogs rabacfosadine has been documented to have anti-tumor activity in “naïve” lymphoma patients (those who have not yet been treated) as well as in those with a relapse of their cancer following treatment with other chemotherapy drugs. Tanovea-CA1 is an every-three-week treatment administered intravenously for up to five dosages. For now, Tanovea-CA1 has received “conditional” FDA approval, meaning it can be given to a dog for up to one year. The conditional approval may be extended with ongoing evidence of effectiveness.

How does Tanovea-CA1 compare?

The gold standard treatment for canine lymphoma utilizes a drug called doxorubicin that is often combined with three other drugs (cyclophosphamide, vincristine, and prednisone) in what is called a CHOP protocol.

In a study combining Tanovea and doxorubicin in 54 dogs with lymphoma, an 81% positive response rate was observed. This Tanovea/doxorubicin one-two punch was found to be generally safe and well tolerated.

The rate of response and duration of remission using the Tanovea/doxorubicin combination were both comparable to CHOP regimen results. Here’s the big difference. The CHOP protocol typically requires 12 to 16 treatment visits to complete. The Tanovea/doxorubicin treatment protocol was accomplished in only six visits. What a monumentally positive difference this would make, not only for the dogs, but for their human companions as well. I don’t yet know how pricing of the two protocols compares.

From my point of view, this is really great news on the canine lymphoma front. I’m on board with anything that makes effective treatment of this disease more efficient and less taxing for everyone involved.

Have you ever cared for or known a dog with lymphoma? If so, what was the breed?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at http://www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

Prostate Gland Cancer in Dogs

Photo Credit: Shirley Zindler

I periodically force myself to write about one of a handful of diseases I truly despise, and canine prostate gland cancer definitely falls into this category. Why do I dislike this disease so much? There is no cure for it and, for as long as I’ve been alive, there remains no effective treatment that consistently keeps it at bay for a significant length of time while preserving quality of life.

The only good news about prostate gland cancer is that it is relatively rare, accounting for 0.67% of all reported malignancies in dogs. And, it is far less common than the other far more treatable forms of prostate gland disease such as bacterial prostatitis, cystic disease, and benign prostatic hyperplasia.

Behavior of prostate gland cancer

The most common form of cancer within the prostate arises from its glandular cells and is called adenocarcinoma. Transitional cell carcinomas are less common than adenocarcinomas. They arise from transitional cells that line the urinary tract.

Prostate gland cancer is a disease primarily of middle-aged and older, large breed dogs. It occurs most commonly in neutered male dogs. This is a bit counterintuitive and we used to believe just the opposite, so I will state this fact again. Prostate gland cancer is more likely to occur in dogs who have been neutered.

Invariably, prostate gland cancer is a very aggressive disease. Not only does it expand within the prostate gland, it readily spreads (metastasizes) to other sites in the body beginning with local lymph nodes and then moves on to the lungs, abdominal organs, and/or bones.

Symptoms

There are often no symptoms whatsoever until the prostate gland becomes significantly enlarged and/or painful. Common symptoms include:

Straining to urinate

Straining to have a bowel movement

Bowel movements that are “ribbony” or small in diameter

Hind end/back stiffness

Hind leg lameness

Blood in the urine

Abnormal discharge from the prepuce

If there is a secondary bacterial infection within the prostate gland, symptoms can include fever, lethargy, loss of appetite, and vomiting.

Diagnosis

The diagnosis may be suspected based on clinical signs and palpation of a large, irregularly shaped, prostate gland that may be painful for the dog. Urine and blood testing are routinely performed as part of the diagnostic workup. A definitive diagnosis relies on biopsy samples collected from the prostate gland. Biopsies are typically collected using ultrasound guidance.

Once the diagnosis of prostate gland cancer is confirmed, other tests are commonly performed to determine the extent of metastasis. This process is referred to as “cancer staging.” Such testing usually involves imaging studies such as ultrasound evaluation, radiographs, and CT (computed tomography) scanning.

Treatment and prognosis

Effective treatment options for dogs with prostate gland adenocarcinoma are pretty much nonexistent. Neither chemotherapy nor surgery provides significant benefit. Radiation therapy is of limited value. Chemotherapy can provide temporary relief of symptoms for some dogs with transitional cell carcinoma. For most dogs with prostate gland cancer, treatment is primarily palliative, aimed at reducing the discomfort associated with the disease and enhancing quality of life.

Ultimately, the cancer-related symptoms become life limiting. It is at this point that either euthanasia or intensive hospice care is indicated.

Have you ever had or known a dog with prostate gland cancer?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at http://www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

 

Spay/Neuter Recommendations

Next month I’ll be speaking to veterinarians at the North American Veterinary Conference about, “Current Spay/Neuter Research: Tips for Counseling Your Clients.” I love this topic for a couple of reasons. Based on results of some relatively recent and compelling research, the veterinary profession must now question some of its long-held beliefs about neutering dogs. And, shaking up dogma within this profession is usually a really good thing.

Secondly, when it comes to neutering or any other medical or surgical issues, I’m a big believer in folks having the ability to act as informed medical advocates for their pets. Veterinarians play a super important role in facilitating this, and I am thrilled to have the opportunity to coach them on how to go about doing so.

Punching holes in neutering dogma

Here are a couple of examples of long-held beliefs related to neutering that my talk will call into question:

All dogs not being used for breeding should be neutered between four and six months of age.

By allowing dogs to reach sexual maturity before they are neutered (if indeed they are neutered at all), are there health benefits to be gained? Based on recent research data, this certainly appears to be the case for Golden Retrievers, Labradors, Rottweilers, Vizslas, and German Shepherds. Such breed-specific studies have documented that neutering before one year of age may increase the risk for development of behavioral problems, orthopedic diseases, urinary incontinence, and various types of cancers. Can and should this information be extrapolated to other dog breeds? We don’t know (yet).

Neutering prevents/eliminates aggression.

For decades, veterinarians in this country have been taught that neutering dogs prevents/eliminates aggressive behavior. While we know that castration definitely deters some undesirable male behaviors (urine marking, mounting, roaming), it does not pack nearly as mighty a punch when it comes to preventing or eliminating aggression, particularly that which is directed towards people. In other words, neutering is not the end-all, be-all for prevention or treatment of aggression.

What about female dogs? It’s been documented that aggression towards guardians can actually increase in dogs spayed before 12 months of age. And, in a study of Vizslas, the younger the age at the time of neutering the earlier the onset of aggression and other undesirable behaviors.

How veterinarians can counsel their clients

In my upcoming talk, my goal will be to provide veterinarians with tips on counseling their clients about if and when to neuter their dogs. (Unfortunately, I won’t have time to discuss the many options for “how” to neuter.). Here are the talking points I will recommend:

  1. What is the level of client responsibility? Will the dog be managed responsibly so as to prevent unintentional breeding? If not, neutering is a no-brainer. The pet overpopulation issue trumps all other considerations.
  1. What is the dog’s intended use? Will the dog’s occupation be breeding, showing, hunting, athletic competition, or simply couch surfing? If and when to neuter is, in part, determined by the dog’s intended purpose.
  1. An explanation of what we know and what we don’t know. I will provide the veterinarians in attendance with a current bibliography of spay/neuter research. This will hopefully enable them to talk to their clients about what we now know and don’t know with. Please contact me if you would like a copy of this bibliography.
  1. An explanation of the relationship between neutering and behavior. Before deciding when and whether or not to neuter, every client deserves an accurate understanding of the likely impacts of their decision on their dog’s behavior.
  1. Pick your poison! Be it pyometra, a torn cruciate ligament, hip dysplasia, behavioral issues, or cancer, we’ve all worked our way through significant medical and surgical issues with our beloved dogs. Such personal history definitely has a place in guiding decision-making about when, if, and how a personal pet should be neutered. See the example below.

A personal example

I will end my upcoming talk with a personal example involving Jacob, one of my children. When Jacob was in college, he fostered Tipper, a Hurricane Katrina rescue who was convalescing from heartworm disease. Tip was a gem, and the foster quickly turned into an adoption. This was Jake’s first dog independent of our family and, oh my, how he loved and cared for Tipper. He cared for Tipper through surgery and recovery for two torn cruciate ligaments. And, Jacob nursed his best buddy through his final months during which he finally succumbed to cancer.

Approximately six months after Tipper passed away, Jacob adopted an unneutered mixed breed puppy from a shelter in New Mexico. Fisher, as he came to be called, grew into an exuberant, loving, 65-pounder. Jake and I discussed when and if to neuter Fish. Based on his history with Tipper and recent research indicating that neutering before one year of age might predispose to cruciate ligament disease and/or cancer, Jacob opted to have Fisher neutered when he was approximately 18 months of age. Now, we will see what the future holds in store.

Food for thought

Are you aware that in some Scandinavian countries it is illegal to neuter dogs, and they have no animal shelters because there would be no animals to place there? I was shocked when I first learned of this, and it continues to blow my mind. This speaks volumes about the level of responsibility in caring for dogs there versus here in the United States.

More research about the impacts of neutering dogs is surely in the works, and I suspect that today’s neutering recommendations will be considered pure quackery a decade from now.

Clearly, there is no one-size-fits all in terms of if, when, and how dogs should be neutered. We must do away with the blanket recommendation that dogs be neutered between four and six months of age.

How do you weigh in on the topic of neutering dogs?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at http://www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

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journals.plos.org/plosone/article?id=10.1371/journal.pone.0102241

Support For Responsible Breeding

Photo Credit: Flicker CC license, m-gen, BulldogThe American Veterinary Medical Association’s (AVMA) Animal Welfare Committee has proposed a policy pertaining to breeding of dogs, cats, and other companion animals. The policy titled, “Inherited Disorders in Responsible Breeding of Companion Animals” is up for approval when members of the AVMA House of Delegates meet later this month.

The policy reads as follows:

The AVMA supports the responsible breeding of companion animals such that only animals without deleterious inherited disorders are selected for breeding. Companion animals exhibiting inherited characteristics that negatively affect the animal’s health and welfare should not be bred, as those characteristics and related problems are likely to be passed on to their progeny. This would include inherited conditions such as brachycephalic syndrome, some joint diseases, bone deformation (e.g., radial hypoplasia “twisty cats”, munchkin), heart and eye conditions, or poor temperament (e.g., Springer rage syndrome). The AVMA encourages veterinarians to educate breeders, pet owners and the public on the responsibilities involved with breeding and selecting pets to ensure that they are not contributing to poor welfare issues.

The potential impact of the policy

Assuming the AVMA will adopt this policy in January (they darned well better!), how will this policy statement be put to use? It’s not as though the AVMA has any direct control over the actions of people who want to breed their animals.

It sounds like the intent of this policy is to give veterinarians a kick in the pants to have more intentional conversation with their clients about breeding their pets (or not breeding them). Every veterinarian has exposure to irresponsible breeding yet, goodness knows, most of us have been far too silent on this topic. Guaranteed, there’s not a veterinarian whose been in practice for more than a few years who hasn’t been in the exam room with a sobbing client while euthanizing a beloved pet because of an inherited defect. And we’ve all examined animals with faddish extremes of conformation that we know will ultimately result in pain and suffering. How many of us have performed artificial insemination and cesarean sections on dogs who are unable to breed and whelp normally on their own?

Without question the majority of veterinarians could be doing a much better job advocating for responsible breeding practices. Perhaps this AVMA policy will help us step closer to this goal.

It’s about time!

While I’m certainly pleased to see that the AVMA is considering this policy, part of me wants to ask, “Where have you been all my life?” To my way of thinking, not only is this policy a “no brainer” now, it would have been so when my career began some 30 plus years ago. Call me impatient, but I can’t help but wonder why good things take so friggin’ long to come to fruition within large organizations. The bottom line is, whether now or then, anything that favors responsible breeders and removes others from the gene pool makes really good sense.

How do you feel about this policy? Thumbs up or thumbs down?

Happy new year,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at http://www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

 

 

Xylitol Toxicity in Dogs

Photo Credit: Trustypics on Flicker, CC licenseFor some folks, the start of a new year is a catalyst to lose weight and this may mean switching from plain old sugar to lower calorie sweeteners. Xylitol is one such sugar substitute that is safe for human consumption, but is toxic for dogs. In fact, it can be deadly.

What exactly is xylitol?

Discovered by German chemist Emil Fisher in 1891, xylitol is found in fruit and vegetable fibers. The xylitol we consume is manufactured by beginning with a product called xylan found in hardwood trees and corncobs.

Xylitol was first put to use as a sweetener in Finland during World War II when sucrose was unavailable. The growth in xylitol popularity is attributed to its many beneficial properties. To begin with, xylitol is as sweet as sucrose, but with far fewer calories. Additionally, compared to sugar, it causes very little insulin release in people and insulin is not required for it to be put to use as an energy source for the body. Lastly, xylitol has been shown to prevent mouth bacteria from producing acids that damage the surfaces of the teeth. For this reason, xylitol is commonly included in toothpastes, sugar-free gum, and other oral care products.

Species- specific effects

The effect of xylitol on insulin release varies dramatically between species. In people, rats, horses, and rhesus monkeys, xylitol causes little to no increase in insulin release or change in blood sugar levels. This is altogether different in dogs, cows, goats, rabbits, and baboons. In these species xylitol causes a marked increase in insulin release and drop in blood sugar and is the basis for xylitol toxicity.

Toxicity in dogs

After a dog consumes a significant amount of xylitol, there is a massive release of insulin from the pancreas. This, in turn, results in a dangerously low blood sugar level and symptoms such as weakness, trembling, seizures, collapse, and even death.

At higher dosages, xylitol can cause massive liver destruction (known as necrosis) in which large numbers of livers cells die abruptly. This produces an acute health crisis and, in many cases, death.

Vomiting is often the first symptom of xylitol toxicity. Other symptoms related to the low blood sugar level develop within 30 minutes to 12 hours following consumption. When xylitol-induced liver damage occurs, blood liver enzyme values typically begin increasing within 12 to 24 hours.

The dose of xylitol considered to be toxic for dogs is 0.1 gram or more of xylitol per kg of the dog’s body weight.

Treatment of xylitol toxicity

Emergency treatment is warranted after a dog consumes xylitol. If vomiting can be successfully induced within the first 30 minutes or so (before the xylitol leaves the stomach), the problem may be solved. Once xylitol leaves the stomach and triggers the pancreas to produce insulin, intensive treatment is warranted in order to try to counteract the effects of hypoglycemia (low blood glucose) and liver damage. Treatment includes hospitalization with round-the-clock care, blood monitoring, and administration of intravenous glucose and liver-protective agents. In some cases, blood transfusions are needed to counteract the effects of blood clotting abnormalities caused by liver failure.

The prognosis for xylitol toxicity varies and depends on how promptly the dog receives treatment as well as the amount of xylitol that was consumed.

Read labels carefully

Many foods and dental products contain xylitol. It is found in chewing gum, candy, peanut butter, cereals, and toothpaste, to name a few. Believe it or not, some products advertised specifically for dogs, such as toothpaste, contain small amounts of xylitol! What are these manufacturers thinking?!

Not all product labels clearly state if they contain xylitol. If a label states only, “artificially sweetened,” presume that it contains xylitol. If you opt to use xylitol-containing products in your household, be sure to keep them completely out of your clever dog’s reach.

What to do if your dog eats xylitol

If you believe that your dog has just eaten (as in you just watched it happen) something containing xylitol, contact a veterinary hospital staff member right away. You might be advised to induce your dog to vomit at home. This is accomplished by forcing your dog to swallow hydrogen peroxide.

If you’re not really sure when the xylitol was consumed (you’ve just returned home from work and the remains of sugar-free gum wrappers are decorating the couch), transport your dog to a nearby veterinary clinic or 24-hour emergency hospital right away. Be sure to take the label of the consumed product with you. Time is always of the essence when treating xylitol toxicity.

Look around your house and see if you have any xylitol-containing products. What did you find?

Happy new year,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at http://www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

New Years Resolutions for a Healthier Dog: A Month-By-Month Guide

Photo Credit: Flicker CC, DaPugletWith the New Year rapidly approaching, now is the perfect time to begin thinking about New Year’s Resolutions. This year, how about getting your dogs in on the act? Resolve to make their lives happier and healthier with assistance from the month-by-month guide below. Have a look and feel free to revise according to what best suits you and your pups.

January: Schedule a veterinary visit, even if your dog isn’t due for any vaccinations. An annual visit includes a thorough physical examination- important because, the sooner a problem is discovered the greater the likelihood for a good outcome. An annual veterinary visit also provides the opportunity to discuss your dog’s nutrition, parasite control, behavior, and any other topics that are on your mind.

February: Take some whole body photos of your dog. It’s fun to share them on Instagram and Facebook, and, if the unthinkable ever happens and your pup goes missing, you’ll be able to post current images to facilitate a safe return.

March: With the weather starting to warm up a bit, now is a great time to begin a dog-walking regimen. Get out at least once or twice daily and gradually build up your distance. This will be fantastic for your dog’s health and for yours as well.

April: This is National Heartworm Prevention month. Make sure your dog has been tested for heartworm disease (a simple blood test that is recommended annually) and that you are giving heartworm preventive medication exactly as prescribed.

May: This is “Chip Your Pet Month.” If your dog hasn’t been microchipped, make this a priority. If your pup is already microchipped, double-check that your current contact information is updated with the microchip registry.

June: Did you know that there is an actual “Take Your Dog To Work Day?” It happens this month! What a great way to spend quality time with your best bud and enjoy interacting with your coworkers in a new and different way.

July: Assemble a list of emergency contact information that is in or near your phone at all times. Include numbers for the ASPCA Poison Control Hotline, your family veterinary clinic, a local 24-hour emergency hospital, and people who can, spur of the moment, responsibly care for your dog.

August: Make a habit of grooming your dog or at least running your hands over every square inch of fur on a regular basis. Not only will this provide some bonding time, it will also enable early detection of fleas, ticks, skin diseases, and any newly forming lumps and bumps.

September: Commit to brushing your dog’s teeth on a regular basis (at least three times a week) and then stick with this game plan. Don’t know how? Get some help from your veterinarian.

October: Be prepared for National Pet Obesity Awareness Day. Is your dog too lean, too heavy, or just right? Do you know your dog’s body condition score? Check in with your veterinarian to help assess if your dog is at a healthy weight. If needed, get some advice on creating a healthy weight loss program.

November: Set up a pet trust. No fun to think about, but should you become incapacitated or pass away, a trust will ensure that your dog will be well cared for.

December: Prepare emergency evacuation supplies for your dog. Be sure to include a two-week supply of food and water (include a can opener if needed), food and water dishes, your dog’s favorite treats, a collar or harness with ID tags, a leash, a carrier (particularly if your dog is small), a favorite blanket or bed, a copy of your dog’s medical records, a month supply of any medications, a first-aid kit, and recent photos of your dog.

What resolutions have you made for your pets for the new year?

Wishing you and your loved ones a happy and healthy new year,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at http://www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.