Dogs and diarrhea (causes and remedies)

A common problem – here’s a good (long) read for you:
(From The Whole Dog Journal, Sep 2018)

Dog Diarrhea Causes and Remedies
The messy truth about dog diarrhea: diagnosing the cause of s dog’s diarrhea and firming things up can be complicated!
By Catherine Ashe, DVM

All dog owners know the feeling of coming home after a work day and smelling that smell. Uh-oh. Your dog has diarrhea. It’s a pretty common affliction of our canine friends. Now comes the inevitable question: “Should we go to the veterinarian?”
The truth is, much like people, sometimes dogs just get diarrhea. Much as we do not see the doctor for every bout of diarrhea, similarly, dogs do not always need medical attention for a short-lived enteritis (inflammation of the intestines). Often, diarrhea can be managed with at-home therapy and convalescent care.

Why Do Dogs Get Diarrhea?

The causes for acute diarrhea in the absence of other signs are varied and include dietary indiscretion (for example: getting into the garbage), gastrointestinal bacteria including Campylobacter, and GI parasites such as hookworms, roundworms, whipworms, and protozoal infections. In most cases of acute, self-limiting diarrhea, a cause is never identified.

If your dog seems otherwise normal, and he is currently on monthly parasite preventative medication, then symptomatic treatment at home is appropriate. Usually most diarrhea will run its course within two to four days, although in some cases, it can last longer. If there are any other signs of illness like vomiting, loss of appetite, depression, or pain, a veterinary trip is in order.

At-home treatment for acute diarrhea can include the following: a bland diet such as boiled hamburger or chicken with broth and rice for a few days, a probiotic such as Fortiflora (available only through veterinarians) or an over-the-counter probiotic and frequent walks. Avoid using human remedies such as loperamide, also called Immodium. This medication has an opioid in it, and it is easy to overdose a dog unintentionally.
If your dog continues to do well other than diarrhea, three to four days of at-home treatment is appropriate.

Diarrhea can make anyone sad and miserable, but if your puppy doesn’t respond to symptomatic treatment in a couple of days, or your dog fails to respond within three or four days, it’s time to head to the vet for an examination and testing.

If Your Dog’s Diarrhea Doesn’t Go Away:

If diarrhea doesn’t resolve with treatment, or your dog develops other signs, it is time to seek a veterinarian’s opinion. Diarrhea is considered chronic when it persists for more than three weeks despite treatment.

Diarrhea may seem like a simple problem, but it can actually be very complicated. Your veterinarian will proceed in a stepwise fashion (outlined below) to find the cause:

Thorough Questioning

Your veterinarian will ask a series of questions about your dog’s overall health, diet, vaccine history, and preventive care strategy. He will then ask more in-depth questions about the diarrhea itself. This will help determine what kind of diarrhea is occurring.
Diarrhea can be characterized as small bowel, large bowel, or mixed. In the case of small bowel diarrhea, you may see a normal to increased frequency, small volumes of loose, watery stool that can be tarry or black (representing digested blood). Often, your dog can “hold it” until going outside.

In the case of large bowel diarrhea, there will be an urgency to go. Your dog may not make it outside unless you are paying close attention. There is often mucus covering the stool, and there may be bright red blood as well. Your dog will usually strain for quite some time during or after having a bowel movement.

In some cases, the diarrhea can be mixed small and large, and this can be more difficult to sort out. Your veterinarian will likely ask many questions during this part of the visit.

Head-to-Toe Physical Examination

Next comes a thorough physical examination. Initially, your pet should be weighed. Weight loss is always a concerning sign. The exam will include checking the eyes, mouth, ears, palpating the lymph nodes, listening to the heart and lungs, deep palpation of the abdomen, and a rectal exam.

The rectal exam is the most important part! This will help the veterinarian see what the diarrhea looks like, as well as feel for any problems in the rectal area and descending colon. A temperature should also be checked. If a fever is present, this can help focus your veterinarian’s attention to certain areas such as viruses and bacteria.
Once this is completed, your veterinarian should have a good sense of what type of diarrhea your pet is having, possible causes, diagnostics, and treatment options.

Small Bowel Diarrhea

Generally, veterinarians will start out with conservative diagnostics and treatment for this type of diarrhea. The causes for small bowel diarrhea can be incredibly varied and run the gamut from fairly benign and treatable (parasites) to more serious (Addison’s disease).

Initially, a fecal examination may be the only test conducted. This requires a small sample of stool from your dog. The veterinarian will check this to rule out parasites such as hookworms, roundworms, whipworms, protozoal organisms, and bacterial overgrowth.
Even if your dog is up-to-date on monthly prevention, it is still possible to find breakthrough parasitic infection. This is why a fecal is done. If parasites are found, your veterinarian will treat with an anti-parasiticide like fenbendazole, pyrantel, and/or Albon. He will also discuss environmental control, as these parasites can persist in the soil for long periods of time.

If nothing is found on the fecal, your veterinarian will likely still prescribe a course of the dewormer fenbendazole in case of a false negative fecal. Other treatments at this stage should include a novel protein diet, as your pet may have a dietary sensitivity or allergy. This means switching your dog to a protein and carbohydrate source to which he has no previous exposure. Examples include bison, venison, duck, and kangaroo usually paired with potato, rice, or pea.

At this stage, many veterinarians also prescribe metronidazole (also known as Flagyl). Metronidazole is an antibiotic, but it is also thought to have immunomodulating properties that help calm an inflamed GI tract. Many dogs will have an “antibiotic-responsive” diarrhea that will clear up with this treatment.

With this initial approach, your dog should be back to normal within three to 10 days. If within a week, you are not seeing improvement in your dog’s signs, then your veterinarian will move on to further diagnostics and treatments.

A complete blood count and chemistry analysis should also be run (see “Physical Exams for Senior Dogs”). This will give a global picture of your dog’s health. Significant dehydration, a decrease in protein levels, or changes in your dog’s condition (loss of appetite and/or weight loss) can indicate a more systemic health problem.
If metronidazole is not helping, then Tylosin may be used. Tylosin is another immunomodulating antibiotic that can help with GI inflammation. It may also have a probiotic effect in the gut by increasing the numbers of enterococci bacteria in the small intestine. It is very unpalatable to dogs and cats, and your veterinarian will have this medication compounded, in most cases (or have you place it in their food).
Again, your veterinarian will monitor for around a week. If symptoms do not improve, more advanced testing will be recommended.

A gastrointestinal panel (blood test) must be submitted to an outside laboratory. The veterinarian will likely recommend fasting your dog beforehand. This evaluates levels of vitamins found in the body – particularly cobalamin (vitamin B12) and folate (vitamin B9). Dogs with gastrointestinal disease often display impaired absorption of these critical vitamins. This diagnostic also evaluates trypsin-like immunoreactivity. These tests can indicate whether there is a bacterial overgrowth or a condition called exocrine pancreatic insufficiency.

In the case of bacterial overgrowth, antibiotic therapy may be needed.
Exocrine pancreatic insufficiency is a common disorder of German Shepherd Dogs, as well as other breeds. With this disease, the pancreas does not secrete appropriate digestive enzymes. Treatment is supplementing the diet with enzymes to help break down food and assist your pet in absorbing nutrients.

Another test that may be done concurrently is a resting cortisol test. Cortisol is a steroid made by the adrenal glands. In Addison’s disease (also called hypoadrenocorticism), the body does not produce enough cortisol or water-regulating hormones (called mineralocorticoids).

Addison’s can be difficult to diagnose, as symptoms can present in many ways including weight loss, shivering, decreased appetite, lethargy, chronic diarrhea, intermittent vomiting, and electrolyte imbalances.

Treatment for Addison’s involves replacing the cortisol and mineralocorticoids that the adrenal glands are not making. There is also a form of Addison’s called atypical. This occurs when only cortisol production is reduced. Replacing this lack with oral steroids can manage this condition.

If all of these tests are normal, and no obvious cause is found for the ongoing diarrhea, your veterinarian may offer referral to a veterinary internal medicine specialist (DACVIM). At that time, more extensive testing such as abdominal ultrasound, exploratory surgery, and biopsy may be recommended. These will rule out invasive fungal infection such as histoplasmosis and pythiosis, inflammatory bowel disease, and cancer.

Large Bowel Diarrhea

Large bowel diarrhea presents a diagnostic dilemma. Frequently, the causes are difficult to fully diagnose. In many cases, a response to treatment rather than extensive testing is used to make a presumptive diagnosis.

Like small bowel diarrhea, large bowel diarrhea can be caused by parasites, particularly whipworms. An initial diagnostic test will be a fecal examination. Keep in mind, however, that whipworm eggs are very heavy and are not always found on a fecal examination.
If your veterinarian does not find parasites, as with small bowel diarrhea, he will likely still recommend a course of fenbendazole, an effective anti-parasiticide that kills whipworms. They persist for long periods of time in the soil, so managing the environment is critical to preventing re-infection. Further, not all preventives cover against whipworm infection. Check with your veterinarian regarding your monthly treatment to ensure that your dog is protected against whipworms.

An antibiotic trial may be the next step. Clostridial colitis is a possible cause of large bowel diarrhea. It is poorly understood, as some dogs can have Clostridium bacteria but not be ill, while others can become very sick. Diagnosis is very tricky and recommendations change continually. Generally, clostridial infections respond very well to amoxicillin or Tylosin, so your veterinarian may try a course of antibiotics to both diagnose and treat the diarrhea.

A fiber trial – a dietary trial with a fiber-enriched food – may also help diagnose and resolve the problem. In some cases, the addition of a fiber-enriched food may be all that your dog needs to get back to normal. Your veterinarian can help select a fiber diet appropriate for your dog.

Many dogs are allergic to certain components in food (the immune system responds and causes the diarrhea), while other dogs are just “sensitive to” to specific dietary items (immune system is not involved). Again, diagnosis might be tricky. As a result, your veterinarian will likely prescribe a dietary trial. In this case, your dog will be placed on a hypoallergenic diet. There are several on the market that are made from hydrolyzed protein. This is when the protein is broken down into such small units that the immune system does not recognize the initial protein. This type of diet must be rigorously followed if it is to be successful. Treats, flavored heartworm medications, and table food will render the trial useless.

At this point, more blood tests will likely be called for. If your dog has evidence of bloodwork changes and weight loss, concerns for more serious systemic illnesses such as fungal disease and cancer come to the forefront. At that time, you should consider that referral to a veterinary internal medicine specialist (DACVIM) is likely best for your dog.

A Note About Boxers

About 30 years ago, Boxers were noted to have a severe, progressive disease of the colon (histiocytic ulcerative colitis) that caused very bloody, mucoid, large bowel diarrhea and resultant weight loss.

It was recently found that this is highly responsive to a common antibiotic called enrofloxacin (also known as Baytril). If empirical treatment is attempted, it must be continued for several weeks to ensure that all the bacteria are killed; if the bacterial population is not completely eliminated, the most resistant bacteria can come back with a vengeance.

If enrofloxacin doesn’t work, a biopsy of tissue from the colon is the best way to diagnose or rule out other possibly treatable diseases such as fungal infections.

Dog Diarrhea: Not A Simple Matter

As you can see, diarrhea can be a complicated problem to solve. Keeping a thorough history on your dog, documenting his diet and parasite prevention strategy in particular, as well as monitoring bowel movements closely, can help your veterinarian tremendously.
When diarrhea becomes chronic, it can take weeks to months to sort out the underlying cause and find an effective treatment. Be patient and work closely with your veterinarian. Follow recommendations and do not try random remedies recommended by random sources! With time, patience, and a good veterinarian, a solution can generally be found.

Catherine Ashe graduated the University of Tennessee College of Veterinary Medicine in 2008. After a small-animal intensive emergency internship, she practiced ER medicine for nine years. She now works as a relief veterinarian in Asheville, North Carolina, and loves the GP side of medicine. In her spare time, she spends time with her family, reads voraciously, and enjoys the mountain lifestyle.

Disorders of the outer ear

Disorders of the Outer Ear in Dogs
By T. Mark Neer, DVM, DACVIM, Professor and Hospital Director, Center for Veterinary Health Sciences, Oklahoma State University ; Michele R. Rosenbaum, VMD, DACVD ; Patricia D. White, DVM, MS, DACVD

A variety of skin conditions affect the outside part of the ear, called the pinna. Most conditions cause tissue changes elsewhere as well. Rarely, a disease affects the outer ear alone or affects it first. As with all skin conditions, a diagnosis is best made when combined with the results of a thorough history, a complete physical and skin examination, and carefully selected diagnostic tests.

Insects and parasites commonly cause inflammation of the pinna—resulting in redness, swelling, itching or blistering—either through direct damage from the bite of the parasite or as a result of hypersensitivity. Tiny skin mites burrow under a dog’s skin, often on the edges of the ears. Because they are so hard to see and find, a veterinarian might take several skin scrapings before making a diagnosis.

Canine Juvenile Cellulitis
Canine juvenile cellulitis is an infection and inflammation of the tissues beneath the skin of young dogs. It is an uncommon disorder of puppies and is characterized by masses of small, round raised areas of inflamed skin filled with pus on the face and ears. The lymph nodes below the lower jaw are usually noticeably enlarged. It occurs in puppies 3 weeks to 4 months of age and rarely in older animals. Golden Retrievers, Gordon Setters, and Dachshunds appear to be at greater risk than other breeds. An inflamed, pus-filled, raised area of the skin of the ear canal is common, along with swollen, thickened pinnae. Early treatment is recommended to avoid scarring. Careful observation of the condition of your puppies will help you detect any masses or lumps on their faces or ears. Any lumps or masses, even small ones, are a good reason to take your puppy in for a checkup as soon as possible.

Ear Hematomas
Ear hematomas are fluid-filled swellings that develop on the inward curving surface of the outer ears in dogs. The cause for their development is unknown. Signs include head shaking or ear scratching due to itchiness. In dogs, the condition is seen with hereditary environmental allergies and food allergies in which the ear canals are the primary sites of allergic inflammation and itching. Treatment usually involves surgery to drain and flush the swellings. Frequently, the veterinarian will place a drain made out of a soft tube in the area to help prevent fluid from building up again.

Flies
Fly strike (irritation of the ears caused by biting flies) is a worldwide problem caused by the stable fly and typically affects dogs and horses. The fly bite causes small, hard, round bumps and raised, reddened areas with central bloody crusts that itch. Tissue changes are found on the tips or on the folded surface of the outer ears of dogs with flopped ears. Treatment includes fly repellents, controlling the fly population with environmental clean up (such as removing manure), and insecticides.

Frostbite
Frostbite may occur in dogs poorly adapted to cold climates and is more likely in wet or windy conditions. It typically affects body regions that are poorly insulated, including the tips of the ears. The skin may be pale or red, swollen, and painful. In severe cases, tissue death and shedding of the tips of the outer ears may follow. Treatment consists of rapid, gentle warming and supportive care. Amputation of affected regions may be required but should be delayed until the extent of living tissue is determined.

Hair Loss
Several ear edge skin disorders characterized by hair loss occur in dogs. Periodic loss of hair on the outer ear in Miniature Poodles involves the loss of hair on the outward curving surfaces of the ear. The hair loss starts suddenly and progresses over several months, but hair may spontaneously regrow. There are no other signs. Treatment is unnecessary.

Hair loss on the outer ear has been reported in Dachshunds, Chihuahuas, Italian Greyhounds, and Whippets and is thought to have a tendency to be hereditary. The age of onset is 1 year or more, when the hair coat begins to thin. Complete hair loss on the outer ear may occur by 8 to 9 years of age. Other commonly affected areas are the lower neck and chest and the back to the middle of the thighs. There are no other signs. No effective treatment has been reported, but certain drugs have been described as helpful.

Immune-mediated Diseases
Several immune-mediated diseases may affect the outer ear and the ear canal. Other areas of the body are typically affected and may include footpads, mucous membranes, skin and mucous membrane junctions, nails and nail beds, and the tip of the tail. Immune-mediated diseases are confirmed using biopsies of primary lesions.

Mange
Sarcoptic mange is an infectious skin disease caused by a parasitic mite that burrows into the top layers of the skin. It is common in dogs throughout the world. The condition begins with small, red, round bumps on the skin. These bumps progress to scaling, crusting, and raw, irritated open sores on the ear edges and other parts of the body as a result of scratching; however, in some cases only the red bumps and itching are seen. Itching is severe. Transmission of the mite is by direct contact with infected animals.

Diagnosis is based on signs, history of exposure, and discovery of mites on multiple skin scrapings. Treatment options include dips and injections. Your veterinarian will be able to prescribe the best therapy for your pet. Because mites can survive off the host for a variable amount of time, all bedding, brushes, and objects in your pet’s environment should be thoroughly cleaned.

Seborrhea and Dermatosis
Overly oily skin at the edge of the ear (seborrhea) or ear edge skin disease (dermatosis) is common in Dachshunds, although other breeds with ears that hang loose may be affected. The tips of the ears on both sides are usually affected, but the condition can progress to involve the whole ear edge. The cause is unknown. Signs include waxy gray to yellow scale sticking to the base of hair shafts. Plugs of hair can be easily pulled out, leaving behind skin with a shiny surface. In severe cases the ear edges are swollen and cracked. Treatments are available and can be prescribed by your veterinarian.

Ticks
Ticks can cause irritation at the site of attachment and may be found on the pinna or in the ear canal. The ear tick, found in the southwestern United States, South and Central America, southern Africa, and India, is a soft-shelled tick whose younger, immature forms infest and live on the external ear canal of dogs and other animals. Signs of infestation include head shaking, head rubbing, or drooped ears. Both the animal and the environment should be treated. Your veterinarian can recommend the most appropriate treatment for your pet and your local area.

https://www.merckvetmanual.com/dog-owners/ear-disorders-of-dogs/disorders-of-the-outer-ear-in-dogs?sf107126470=1

Pain treatment for dogs

Pain Treatment for Dogs Now Commonplace in Veterinary Medicine

Happily for our dogs, pain awareness and control are modern priorities for veterinarians.

By Denise Flaim

When Laurie McCauley was in college in the late 1980s, she worked for a veterinarian who was nearing retirement. Recalling his veterinary-school days earlier in that century, he told her of a fellow student whose senior-year project was to periodically take a dog, break multiple bones, and then fix them. As incredibly inhumane as that sounds to modern dog lovers, “this was accepted at the time,” says Dr. McCauley, now a board-certified rehabilitation veterinarian and medical director at TOPS Veterinary Rehabilitation in Grayslake, Illinois. “They believed that animals did not feel pain.”

We’ve come a long way, baby. In the last few decades, veterinary medicine has come to embrace the idea of pain management for dogs and other companion animals. “Some of this is due to better recognizing behaviors that indicate an animal is in pain,” says Beth Boynton, DVM, FNAP, a professor of wellness at the College of Veterinary Medicine at Western University of Health Sciences in Pomona, California. “They tend to ‘hide’ signs, so the subtle cues are often lost. And we have much more effective and safer medications to use to help them than in the past.”

As recently as the late 1980s and early 1990s, Dr. Boynton continues, many veterinarians recommended no pain control for animals after surgery, believing it would keep them “quiet” so they wouldn’t move around and would heal faster. “We know from studies since then that that is not the case in any animal or human,” she says. In fact, administering pain medication before a dog even awakes from anesthesia is now standard procedure, as discomfort is more difficult to control once the nerves that signal pain have been activated. “Pain control helps healing, and that control should be started early. In fact, it is part of the standard of practice for all veterinarians, and ‘relief of animal suffering’ is in our Veterinarian’s Oath.”

Indeed, this newly minted attention to pain relief in dogs is as much a response to good science as it is about compassion. “There is research that shows that 60 percent of pain receptors in the body are ‘sleeping,’ and if they get ‘woken up’ by pain lasting 12 to 24 hours, then any later pain incident in the life of the patient is exacerbated,” Dr. McCauley says.

All this has led to an unprecedented focus on avoiding pain in dogs, even before it begins. Administering pain relief for “routine” procedures such as spaying is now standard practice. Dogs who need to stay quiet while recuperating are given light sedatives along with their pain medications, as opposed to letting their discomfort keep them immobile. “Modern veterinary thinking is that all pain should be relieved – period,” Dr. McCauley says.

Types of Pain in Dogs

Pain is a response to cell damage or injury in the body. There are two types: Acute pain is often defined as pain that results from inflammation and healing after injury, and it can last for as long as the anticipated healing time, up to three months. Chronic pain is pain that continues on after that expected time frame.

Pain can also be classified by how it is generated. Nociceptive pain stimulates specific pain receptors, which may sense temperature, vibration, or chemicals released by damaged cells. Inflammatory pain derives more gradually from an activated immune system that responds to infection or injury. Pathological pain, which results from excessive tissue damage, produces extended discomfort and abnormal sensitivity. And maladaptive pain persists after healing has completed, caused by changes in the nervous system.

Earlier this year, in collaboration with the American Association of Feline Practitioners, the American Animal Hospital Association released updated guidelines for pain management in dogs and cats. The paper stresses that veterinarians need to anticipate their patients’ pain-management needs, and reassess continually until the pain is resolved.

The acronym “PLATTER” has been devised for pain management: PLan ahead with a patient-specific plan; Anticipate what the pain-management needs might be; TreaT, factoring in the type, severity, and duration of pain that is expected; Evaluate how effective and appropriate the treatment is, using a client questionnaire or a pain-scoring system, and Return to the patient to see whether pain management needs to be discontinued or modified further.

How Dogs Show Signs of Pain

It’s long been observed that dogs seem to try to hide any indication that they are in pain; biologists speculate this is based in some sort of survival instinct. If your dog has a potentially painful condition, you need to watch for little “tells” that indicate she may be experiencing discomfort.

Several veterinary institutions have developed scales that can be used to quantify the level of pain that a dog is feeling. The International Veterinary Academy of Pain Management (ivapm.org) offers a list of symptoms of pain, compiled by Dr. Michael C. Petty. They include:

Reluctance to walk on slippery surfaces or use stairs.

Becoming selective about what types of furniture to jump on and off of.

Attempting to stand with the front legs first.

Multiple “false starts” and circling when attempting to lie down.

Reduced running and jumping.

Abnormal wear on nails.

Unwillingness to initiate play or other interactions.

Aggression toward other animals.

Dislike of being petted or touched.

Change in sleep patterns.

Stiffness.

Decreased appetite.

Housebreaking lapses.

Types of Pain Medications for Dogs

The drug group most commonly used by veterinarians are non-steroidal anti-inflammatory drugs, NSAIDs (pronounced as “en-saids”). “They are great if there is active inflammation, but not as good if the pain is chronic in nature and the inflammation has ceased,” Dr. McCauley notes.

Examples of commonly used veterinary NSAIDs are carprofen (brand name, Rimadyl), etodolac (Lodine), meloxicam (Metacam), deracoxib (Deramaxx), and firocoxib (Equioxx and Previcox).

Aspirin is an over-the-counter NSAID, but should not be administered without a vet’s oversight because it has more harmful side effects and is less effective than approved medications. (And while we are on the subject of human pain relievers, owners should never administer acetaminophen, which is the active ingredient in pain relievers such as Tylenol. While some vets do use acetaminophen in dogs, it needs to be very carefully monitored.)

NSAIDs are generally safe, but can cause liver or kidney damage in some dogs. “Pets need to have blood tests prior to going on medications and be monitored appropriately while on them,” Dr. Boynton says. “Some pets develop serious liver or kidney disease while taking drugs and that needs to be detected as early as possible to minimize harm.”

Watch for adverse signs, such as behavior changes, reduced appetite, skin redness, vomiting, or loose or tarry stools, and contact your veterinarian immediately.

There are three other commonly prescribed pain medications in dogs:

Tramadol is a weaker opiate that does not require the extensive paperwork of more heavily regulated opiates such as morphine or codeine. (And in dogs as opposed to people, the drug is not metabolized into an opioid.) Unlike NSAIDs, Tramadol does not reduce pain and inflammation at the injury site, but rather changes brain chemistry to inhibit the reuptake of serotonin and norepinephrine, two chemicals associated with mood and responsiveness to pain. Used to control moderate to severe pain, Tramadol is sometimes prescribed for older dogs with chronic pain from arthritis or cancer. Side effects can include upset stomach, decreased heart rate, coughing, and constipation. In some states, Tramadol is now a controlled substance, requiring veterinarians to have a license from the Drug Enforcement Administration (DEA), and carefully log how it is dispensed.

Gabapentin is often used to control seizures in dogs and cats, because it stabilizes excessive electrical activity in the brain. But it also works well to help control nerve-related pain, and chronic pain from cancer and arthritis. Some dogs may experience vomiting, drowsiness, loss of balance or diarrhea.

Amantadine was initially used as an antiviral medication, but today is mainly used for pain relief. It works by inhibiting the nervous system’s NMDA receptor, which creates the sensation of chronic pain. Amantadine can be quite expensive, Dr. McCauley notes, but “is excellent for ‘big pain’ like an amputation.” Potential side effects include gastrointestinal disturbances such as nausea, vomiting, loss of appetite, flatulence and diarrhea, as well as agitation, which often dissipates after the first few days.

While all these medications can be used individually, they can also be used together so that their pain-relieving qualities outweigh the sum of their parts. And because less of each drug is used, this can mean little to no side effects. But, Dr. Boynton stresses, “this takes careful calculation, because some drug combinations are harmful or fatal.”

Opiates: Not for the Masses

Veterinarians can prescribe opiates such as morphine for their canine patients. There isn’t a concern about addiction, because dogs can’t manipulate veterinarians into prescribing more of a particular narcotic because they just want to get high. Their human counterparts, however, aren’t always as transparent.

“The problem the veterinarian has to watch out for is if the client gets the medications for the dog and then uses them for themselves,” Dr. McCauley explains. “For this reason, the DEA has done a great job of creating guidelines to prevent veterinarians from overprescribing scheduled drugs.”

“Sometimes opioids are the best choice or part of a combination approach, and many of these drugs are a concern for human toxicity or abuse,” Dr. Boynton adds. “Pharmacy tracking is being better developed to monitor for abuse.”

Because of all the paperwork and close governmental scrutiny, many veterinarians do not prescribe opiates. (And some worry that having them on hand in the practice may also encourage break-ins.) But such strong narcotics may have a place in your dog’s care – if, for example, you are performing at-home hospice for a dog who is dying from a painful cancer. In such cases, have a candid conversation with your veterinarian to discuss concerns on both sides of the exam table.

If your veterinarian writes a prescription for an opioid for your dog so you can have it filled at a human pharmacy, be sure not to allow substitutions, Dr. McCauley warns. “For instance, Hydrocodone commonly comes with acetaminophen, which can be toxic for dogs depending on the dose.”

Integrative Approach

Such a “multi-modal” approach isn’t just for pain-relieving drugs. In its 2015 guidelines, the AAHA discusses the importance of an integrated approach to managing pain – one that does not rely solely on drugs.

Dr. McCauley ticks off a long list of complementary modalities that can help relieve a dog’s pain and speed healing:

Rehabilitation is a combination of pain management and making the animal stronger, using exercise to strengthen the affected area to prevent further injury or degeneration.

Laser therapy has hit the veterinary field by storm, she notes. “Research shows that it not only significantly decreases the inflammatory mediators, but also affects the nerve cells to decrease pain and inflammation.”

Acupuncture has been around for millennia, though its introduction into American veterinary practices didn’t start until the 1970s. “More and more vets are accepting this as mainstream and using it for all types of medicine, not just pain relief,” Dr. McCauley says. While not all acupuncture-certified veterinarians are well versed in Chinese herbal medicine, many are, and they can prescribe herbs that can help with pain relief. (As always, veterinarians need to be careful about dosage, as well as how drugs and herbs may interact.)

Dr. McCauley is a proponent of tPEMF units such as the Assisi Loop (assisianimalhealth.com). A non-invasive, non-pharmaceutical healing device for animals, the loop uses low-level energy pulses to reduce pain and inflammation, and speed healing. “We use it for acute or ‘acute on chronic’ problems,” Dr. McCauley explains. (An example of the latter is when an arthritic dog compensates until he plays hard or goes for a long walk, and then is sore.) “A beautiful thing about this is that we can sell them to our clients, and they can do the treatments as needed and do it at home.”

Dr. McCauley notes that massage therapy, manual therapy (which uses joint manipulation and mobilization as well as muscle manipulation), and chiropractic therapy can all relieve pain as well as muscle and joint problems for diminishing or eliminating pain and allowing improved movement.

While there are many options for augmenting your dog’s pain management, don’t forget the basics: “First, the diagnosis should be accurately made,” Dr. Boynton reminds. “If there is a broken bone, for example, that needs to be fixed before the animal will get real relief. Many times what is assumed to be arthritis may be something treatable, or it could be a serious cancer or infection. Signs can be very confusing in pets.”

Don’t Be Part of the Problem

The AAHA/AAFP guidelines stress that pain management requires a “team oriented approach” that includes the owner as a vital link. Because pain diagnosis depends so heavily on the dog’s behavior, noting changes in how your dog acts, plays, moves, and interacts in his normal routine is crucial.

Dr. McCauley notes that the more emotionally invested an owner is in her dog, the more likely she will appreciate the importance of pain management. “The people who have a four-legged furry child who sleeps, if not in bed with them, then at least in the bedroom, are the population that care a lot about pain meds and quality of life,” she says.

Dr. Boynton adds that far too many owners are unaware of the importance of pain medication for their dogs because they don’t appreciate just how stoic many dogs can be.

“There is still quite a lot of resistance. People often don’t understand that an animal who isn’t whimpering may be in horrible pain,” she says. “Animal survival in the wild often meant that they had to hide pain and keep going with the group, so signs of pain are often very subtle. People also may think that medications are expensive or dangerous.”

Bottom line: It’s not humane to let your dog suffer, and the science shows it’s not healthy, either. Most dogs can be given some type of pain control: Work with your vet to determine the safest and most effective drugs or combinations of drugs to keep your dog comfortable while she’s on the mend.

Denise Flaim of Revodana Ridgebacks in Long Island, NY, shares her home with three Ridgebacks, 11-year-old triplets, and a very patient husband.

(Whole Dog Journal, Dec 2015)
https://www.whole-dog-journal.com/issues/18_12/features/Pain-Treatment-for-Dogs-Now-Commonplace-in-Veterinary-Medicine_21349-1.html?s=FB&medium=soc_083017B

Can my dog be stressed? Part 2

(From Victoria Stilwell’s “Positively”)

By Beverley Courtney

Here is the second of three excerpts from my forthcoming book – Building Confidence in your Growly but Brilliant Family Dog – which points out an area which will be affecting your dog mightily. Read the first excerpt here.

While you’re doing your best to improve the situation and you take a look at what may be making things worse, you cannot overlook stress.

Stress causes reactions to be exaggerated
Stress causes us to snap
Stress wears us out

Here’s another area of your dog’s life that may be building stress that may surprise you.

2. Not enough sleep

This one floors so many people! Adult dogs need to sleep 17 hours a day for mental and physical stability. 17 hours a day! Is your dog getting anywhere near 17 hours a day? If your dog paces and runs, chews and barks, jumps and dives, plays and chases all the time at home, he is not living the carefree life you may imagine! I have seen the dramatic improvements that result from getting this one right.

The ability to switch off, to relax and restore, is much sought after by people with enormously busy schedules and responsibilities. The most successful build naps and quiet time into their day as a matter of course – and that downtime is inviolable! They have learnt its importance.

Teaching your dog how to switch off is essential to his mental wellbeing. Some dogs don’t need to learn this! Cricket the Whippet is happy to spend 22 hours a day under a duvet, reserving her activity for mealtimes and short bursts of awe-inspiring speed. But she has an even temperament and no hang-ups over other dogs or people. Nothing even startles her!

But it’s a sure bet that your reactive and anxious dog will keep pacing and worrying and staying on guard-duty all day, unless rest-time is enforced.

Relaxation and sleep

Sleep – the great healerIf ever a dog needed its rest and restorative sleep, it’s the growly, fearful, or reactive dog. Think how you feel when you’re short of sleep and have a challenging day ahead with the family, or at work! You start off on a short fuse, and that may get shorter as the day goes on.
Ensuring your dog gets enough downtime is critically important. It’s often at the root of her troubles. Once she’s getting enough restorative sleep she’ll be better able to cope with all the trials and tribulations of life. As indicated above, dogs need a massive 17 hours of sleep a day for optimal stresslessness. Is your dog getting anything like that? If not, you need to help him into a comfortable routine which does not involve endless pacing and activity.

A quick case study

Have a look at Tim, the rescue Border Collie, who I was visiting to work on his dog reactivity outside the house:

While I was there, it became clear that this hyperactive dog was wearing himself out. For the first twenty minutes of my visit he never stopped. He raced in and out of the room, jumped up my front, my back, chewed my hair, poked the other dog, ran off again, paced … never rested.

So I quickly amended my training plan to include some relaxation work straight away. After some active games to get Tim to engage with me, I started teaching him to slow down and relax. After just five minutes of this, his owner expressed amazement at seeing her frantic dog actually lying down still for more than ten seconds at a time!

When I finished the short session and released him, what did he do? Do you think he went straight back into busybusy mode, panting and racing?

Nope. He just slid onto the floor beside us, and as he lay there his head started to loll, his eyelids drooped, and he was … asleep! To the total astonishment of his owner, who had never seen him sleep in the day.

Want to know what I did to achieve this blissful calm state? See the first book in the Essential Skills for a Brilliant Family Dog series: Calm Down! Step-by-Step to a Calm, Relaxed, and Brilliant Family Dog (free at all e-book stores) to get the exact program. Quite apart from the usefulness of this skill for any dog, anywhere, your reactive dog will hugely benefit.

Watchpoint: teaching calm and relaxation is not teaching a stay exercise (although you will get a solid stay as a result) with the traditional stern shouting and finger-waving. The object is quite different – to change your dog’s mental state, not to anchor his physical position.

Learning how to switch off can also help with Separation Anxiety. And, of course, your dog will be better able to cope with the challenges he’ll meet outdoors if his nerves aren’t jangling.

For a free e-course to help remove the stress from your life, and your dog’s life – and news about the new book! – go to www.brilliantfamilydog.com/growly

Antihistamines for dogs (and cats)

Anithistamines for dogs (and cats) Many of us are seeing an increase in allergies in our dogs at this time of year, and more often than not, it’s seasonally related (just like with humans and hay fever). Personally, I always start with Benadryl/Diphenhydramine if one of ours starts itching/nibbling, but my all-time favourite (for me too) is Rx Hydroxyzine. Do bear in mind that not every antihistamine works on every dog, just like with humans – you might need to try different ones to find one that works. And unfortunately, in some cases, you might need to go further, talking with your vet about low-dose steroids or other medications.

http://cheyennewest.com/antihistamines-for-dogs-cats/  

Alpha dogs and pack mentality

We’ve all heard the advice that as dog owners, we should be the alpha dog or pack leader in our house or else our dogs will assume the role, take over, and pretty much make our lives miserable. That’s the basic theory behind traditional dog training methods, made even more popular by a certain TV-show dog rehabilitator. The training style commonly uses dominance and force-type methods based on the notions of alpha dogs and pack mentality. Those concepts evolved from studies done more than half a century ago while observing wolves in captivity.

In contrast, positive reinforcement (+R or force-free) training takes a different approach based on using rewards to train and shape dog behavior, often controlling the resources a dog wants or needs and encouraging appropriate behavior out of the dog’s own self interest. In the world of positive reinforcement training, the terms alpha and pack leader are usually considered taboo, as they’re often associated with using force, threats or intimidation and sometimes create anxious or fearful reactions from dogs. But in this era of political correctness, have we gone too far in totally dismissing the notions of alpha dogs and pack mentality?

My Thoughts on Alpha Dogs and Pack Mentality

I’m a big believer in positive reinforcement training but I also know how effective a well-timed correction can be, as I talked about in the post Using Corrections With Positive Reinforcement Training. I believe domesticated dogs are still pack animals and even though we’re not part of a traditional canine pack with them, we are part of their social pack. As in any pack, there’s usually a leader that sets the rules for acceptable behavior and if the leader governs with fairness, rather than fear, there will be mutual respect and harmony within the group. In both animal and human social circles, I’ve noticed there’s usually a status ranking or pecking order between members of the social group. Here are a few examples.

Entering a new work environment is stressful because you’re often unsure about how you’ll fit in with your peers. Once you’ve met and sized up your co-workers, you feel more comfortable about your place within the business and social hierarchy. It can also be stressful to the group when a new co-worker joins the team as the team’s hierarchy could be restructured.

When my parents had their horse farm, it was interesting to watch the adjustment period when a horse was moved into a different pasture with an established group of horses. The pecking order would often get reshuffled as the newcomer tried to figure out where they fit into the existing hierarchy of the herd. After some kicking, chasing and displays of dominance and submissiveness by several of the horses, a new pecking order would be established and harmony was restored.

When taking a new dog into a dog park with a group of regulars that play together, you can expect the regulars will be anxious to check out the newcomer and along with lots of butt sniffing, there might be some growling, snapping and posturing as members of the now larger pack figure out how the newcomer fits in.

Am I the Alpha in Our Pack?

Yes, I do think of myself as alpha over Haley. It’s a popular notion these days for dog owners to think of themselves as equals with their dogs. Even the term dog owner is offensive to some people, but I’ll save that topic for another discussion. I don’t see myself as an equal to Haley because somebody has to create and enforce the rules, provide the food and shelter, drive to the vet’s office for medical care, etc. It’s my responsibility to assume the alpha role although I’m not sure Haley views me the same as she would view an alpha dog in a canine pack. What’s more important is the fact that we have a hierarchical structure based on mutual respect, and it works very well for us. Here are my roles and responsibilities as an alpha.

• Protector – The most important role is to protect Haley and keep her safe from harm. She should feel relaxed and confident knowing that I’m in control so she doesn’t have to assume the role of protector.
• Provider – Beyond providing the basics of food, water and shelter, I make sure Haley is healthy, fit and stays both mentally and physically active and challenged. She gets plenty of affection and playtime too!
• Teacher – There have to be rules and training for acceptable behavior and what works best for Haley is positive reinforcement techniques using clear communication and direction. But it’s not just all about rules. There are plenty of fun and exciting tricks, skills and activities you can teach your pup too!
• Leader – Dogs need leadership and guidance based on love, trust and respect. A consistent and fair leader with positive energy can keep even a pushy dog from becoming a nuisance without resorting to using force, threats or intimidation.

It’s a shame that the terms alpha and pack leader have become so closely tied to old-school, discipline and dominance-based training methods because the principles are still relevant and important. Some people may dislike the terms, but that doesn’t change the fact that someone has to lead, set the rules and keep the peace. In fact, the lack of leadership and structure is one reason some out-of-control dogs are surrendered to shelters by frustrated owners at their wits end. It’s also worth noting that every dog is different and some need more structure and guidance than others, but it should always be given via positive and humane methods built on trust and respect.

If your goal is to have a dog that listens and respects you, forget the notion of submissive alpha roles or making sure your dog never goes through a door before you. Focus instead on using positive methods of training your pup and you’ll become a truly benevolent and respected alpha in your pack.

Alpha Dogs and Pack Mentality – Revisited

Canine senior wellness checkups

Introducing a puppy and an adult dog: take it slow

by Eileen Anderson

Remember “Lessons for My Puppy,” my collaboration with Marge Rogers? She made some videos that I loved so much that I wrote blog posts to go with them.

Marge is still out there working with dogs and making great videos, and I’m featuring another one today. Although there is a lesson for a puppy in this video, and also a lesson for the adult dog, the biggest lesson here is for puppy owners. (Isn’t that usually the case, when you come to think of it?) In the video she shows how she gradually introduced Tinker, a fox terrier puppy she was boarding, to her own dog, young male Portuguese Water Dog Zip.

How many of you, when adding a new dog to your household, follow the “stick ’em together, stay close by, and pray” method? I have certainly done that in the past, though I don’t recommend it. I was more prudent and conservative by the time I got Clara, but even then, my situation was so unplanned and complex that I basically made digital decisions: this dog can hopefully be with the puppy, and these dogs definitely can’t.

Thanks goodness for Zani!

When Clara came into my household, I kept her permanently separated from Cricket, my small, elderly and frail rat terrier. Clara could easily have knocked over Cricket with her wagging tail alone. I also kept Clara separated from Summer for a good while. Summer has a history of moderate dog aggression and I wasn’t sure she would grant Clara a “puppy license.” But I immediately turned Zani loose with Clara, since Zani is incredibly friendly, likes puppies, and was well matched in size. Zani lived up to my expectations and became Clara’s buddy and babysitter.

But what I didn’t do was any controlled introductions and gradual exposures. If and when I get another puppy, I certainly will do that. All the dogs in a household, both the residents and the newbie, can benefit from good planning and making acquaintance with each other gradually with good associations.

A common and effective method that pro trainers often use when introducing a puppy into their household is classical conditioning of the adult dogs: whenever the puppy is brought into proximity, fabulous food rains down on the adult dog. This can help build pleasant associations and prevent jealousy, since puppies can be obnoxious and can take up a lot of the owner’s time. That method was not necessary in Marge’s case. Her dog Zip is naturally friendly and gregarious and was likely to enjoy the pup; he just needed some time to calm down and learn to be gentle.

This is not really a how-to post. All of our individual situations are different, and it would take much more than a standard-size blog post to cover even the basics of doing introductions.

What I want people to see is the visual of the dog and the pup getting to know each other safely and gradually, through a barrier and with good associations.

The Timing

One of the things I love most about Marge’s approach is that she didn’t have any sort of time schedule mapped out for “releasing” Zip and Tinker to play together. In fact, it would be great if we could even stop thinking about it in those terms. At the time the video was filmed, the puppy Tinker was a baby, and at an age where a scary experience could potentially have negative residual effects for the rest of her life. Zip, although a friendly dog as Marge points out, had zero experience playing with a puppy now that he was a (very) young adult. He was much larger than Tinker and had a history of exuberant play with dogs around his size (i.e., not tiny and breakable) as a youngster. So before even considering putting them together, Marge had to be sure of two things: Tinker wasn’t scared of Zip, and Zip wouldn’t be too rough for Tinker.

I love the visuals in this movie. It’s something that we rarely see, and it is so incredibly valuable. You can watch as Tinker gets acclimated to Zip with the fence of the exercise pen between them. Marge reinforced Zip for being calm in Tinker’s presence, and built good associations with Tinker for being near Zip. After a few days, Marge allowed them together, but kept Zip on leash as a safety precaution. Tinker was comfortable enough to climb on him!

Tinker was there for a week. If she and Zip hadn’t indicated that they were getting comfortable with each other, Marge would simply have kept them separated, using the ex-pen and other means. And if Tinker had indicated that even the ex-pen barrier put Zip too close for comfort, Marge would have kept them separated even further. The paramount concern with a puppy this age is providing positive experiences.

When Not To Do The Ex-Pen Setup

Putting the two dogs adjacent with a fence in between was a good method for this friendly adult dog and confident puppy. But there are many situations in which it would not be appropriate. Here are three of them.

If you have a grumpy, snarly mature dog, the last thing in the world you want to do is park him next to a puppy with only a wire fence between them.
You also wouldn’t do this if you had a large breed, exuberant puppy (who would enjoy bouncing on that fence) and a tiny, fearful, or frail adult.
And you wouldn’t do it with any two stranger dogs unsupervised, no matter how well they were apparently matched.
But take a look at how well it worked out for Zip and Tinker.

Patience and Barriers

Whatever method you use to integrate a new dog into your household, patience and barriers are your friends. Even if you are a gregarious person, you probably don’t want to spend 24/7 with an acquaintance you met yesterday. Most dogs probably don’t either. Take the introductions slow and easy. For instance, I didn’t let my dog Summer interact directly with the new puppy Clara until Clara was about 5 or 6 months old. That was more than 2 months. Some people wait a lot longer than that, depending on the situation.

If I had it to do over, I would probably do some classical conditioning with Summer: associate the appearance of the puppy with great food falling from the sky. I didn’t have it together to do that at the time. But when I did finally let them into the same space, I supervised closely and kept the sessions short. Summer in particular needs her “down time” so I made sure she had it. Clara needed to learn, without getting hurt, that Summer would probably never want to play with her and that it was not wise to pester her.

Back to Marge and Zip. As it happened, Zip never did get to play with Tinker off-leash during that week. He was too clumsy and goofy (did you see the paw to her head?). He did learn a lot though, including a softer approach and play style. Marge may have an “uncle dog” in the making! (That’s a term for a good-natured male dog who is good with puppies and good in general at putting other dogs at ease.) But she knew better than to rush things. This is another situation where “slow is fast” though. Zip earned off-leash time in two days with the next puppy who came to visit!

Being gentle with a puppy is not something a human can directly teach a dog, but Marge facilitated it with carefully controlled exposures and lots of breaks in the play. I know she is counting her blessings that between her efforts and the fact that Zip is friendly and socially savvy, he is learning gentleness through direct experience with the puppies themselves.

You can view Zip’s lovely interactions with his next puppy guest here: Off Leash Puppy Play.

Introducing a Puppy and an Adult Dog: Take it Slow