Compensation: An Attempt To Restore Harmony

by Susan E. Davis, PT

Harmony and balance: isn’t that what everyone really desires? Your beloved canine companion gives you a measure of that every day. They also need it in a physical sense in the way they stand, walk and function.

Their bodies, like ours, are designed for symmetry, in order to maintain structural integrity of joints, bones, muscles, etc.  

What you see in the normal canine posture and gait is like a symphony orchestra where all parts blend into a harmonious sound. For the dogs it results in a fluid, smooth pattern of standing and locomotion. In the orchestra, the best sound is achieved it through coordinated effort. If one instrumental part is not attuned to the whole, a musical “fault” will be heard and in order to go on with the show, other parts l overcompensate in an attempt to restore relative harmony.

A similar scenario occurs in dogs when one area of the body is injured or missing (through amputation), and thereby challenged to maintain homeostasis.

In order to have balance the body adapts an abnormal posture that compensates for the weakness by a redistribution of body weight.

It is considered to be a strategy, or an adaptive coping technique. This can be observed with the dog standing still (static) and during movement (dynamic).

During movement there is a reorganization of the locomotive system, required in order for the dog to remain functional.

The basics behind maintaining homeostasis in balance is keeping the center of gravity (COG) over the base of support (BOS).

The BOS is the stance position of feet/ toes on the ground.  The COG is the point in the body where mass is equally balanced or distributed in all directions. In the human it is located just in front of (anterior) the upper lumbar vertebrae.

The canine COG is at mid chest just behind the shoulder blades.

It needs to be kept in optimal position over the base of support to maintain balance. Therefore dogs always try to keep their COG just behind the front limbs. If the hind limbs are weak this pulls the COG backward.  The dog will try to control it or compensate by shifting weight forward (cranially)/toward the head, to try to return it to a normal place. The result is increased weight on the front limbs, beyond normal.

If this compensatory attempt goes on too long, potential problems can occur with overuse.

There can be overdevelopment (hypertrophy) of the neck, shoulder and scapular muscles, inflammation of the shoulder, elbow and wrist joints, and a widened stance.  Broadening of shoulders and positioning of front paws farther apart is an attempt to widen the base of support during gait.

As mentioned above, hind limb weakness is usually the source and occurs from ligament tears, hip dysplasia, spinal disc disease, etc. 

Sometimes widened front limbs are due to general obesity with large body mass. In dogs with neurological impairments the hind limbs will cross over or “scissor” and the front limbs will widen to compensate. 

A Veterinarian or animal- trained Physical Therapist will make a systematic observation from the back, front and side of the dog to analyze posture and assess gait as part of a total evaluation. The therapist’s eyes and hands are their most important evaluation tools.

They will look to see if weight is evenly distributed on the hind limbs, if there is lowering of the hips and pelvis because of an injury and the muscles cannot support the hips, etc.
 
Normal weight distribution is 60% on the front limbs and 40% on the hind limbs (it can change to 70% /30% with hind limb weakness).  

For this reason, “tripod” amputees missing a front limb are more challenged than those with an absent hind limb. In fact, there is very little gait change in a hind limb amputee.

The goal is to strengthen the weak areas and retrain the dog to shift weight back onto the affected area to avoid the compensation and restore symmetry.

Here are some tips and exercises for hind limb strengthening:

Basic “sit to stand” exercises, using low calorie treats, a clicker or a toy as a training aid for motivation strengthens the hip and thigh musculature.  Repeat the movement 5-8 times.  Watch for symmetry as the dog will tend to sit just on the stronger hip and rise toward that side.  A good technique is to start from a tight corner, such as in your kitchen, so the dog can’t “cheat” and use only the stronger side.  Use a treat and hand signals to walk the dog backwards into the corner first, and then ask them to sit, and then stand, etc.  You can also have them sit with their stronger side toward a wall and when they stand the wall will force them onto the weaker side, etc. 

An “indirect” way to force weight back toward the hind limbs is to alternately lift one front paw or limb and hold it up for a few seconds.  Alternate between the left and right 6 times.  You can progress to placing both of the front paws up onto a low step or platform and have the dog hold the position for 5-15 seconds.  You may have to use a sling to support the hind section.

Ideally you should have your Vet or PT demonstrate these exercises before trying them at home. 

They should assess how the dog tolerates them and provide you with starting parameters as well as how to progress, etc. 


Nothing beats the value of the controlled leash walk to increase hind limb strength.

It should be done slowly at first, then increase to a comfortable pace, but always “controlled”.

If the dog is limping, bobbing their head up and down with each foot fall or “bunny hopping” you need to slow the pace until the proper gait is seen.  

Start for 5 minutes and gradually increase the distance and time, 2-3 times per day.  Gradually add variations such a leash circles around a tree, making wide turns in a figure 8 pattern, vary the walking surface (grass or sand) , climb up and down low grade slopes, hills and  inclines, to increase the strength.  Intervals can be added to increase endurance, consisting of short 10-15 second bouts of faster speed, every few minutes.

Many other exercises exist using sandbag weights, theraband, carts, sleds, weave poles, cavaletti rails, physiorolls, rocker boards and treadmills, etc.  They are best performed by an “animal-trained” Physical Therapist or a Veterinarian trained in rehabilitation.

*** 

Susan E. Davis (Sue) is a licensed Physical Therapist with over 30 years of practice in the human field, who transitioned into the animal world after taking courses at the UT Canine Rehabilitation program.  She is located in Red Bank, New Jersey.

She has been providing PT services to dogs and other animals through her entity Joycare Onsite, LLC in pet’s homes and in vet clinics since 2008.

She also provides pro bono services at the Monmouth County SPCA in Eatontown, NJ.  Sue is the proud “dog mommy” to Penelope, a miniature Dachshund with “attitude”.  For more information see her website www.joycareonsite.com , or follow on Twitter @animalPTsue.


Sue is also the author of a fantastic book on physical therapy, Physical Therapy And Rehabilitation For Animals: A Guide For The Consumer.  

Physical therapy can do so many great things for your dog. Understanding all the possibilities physical therapy can offer will change your dog's life. This book definitely belongs on the shelf of every dog lover.

Further reading: 
Assessing Lameness
Comparative foot morphology
Measurement method on static weight distribution

Articles by Susan E. Davis:
Functional Strengthening Exercises: the What, Why and How
One Thing Leads To Another: Why The Second ACL Often Goes Too
Compensation: An Attempt To Restore Harmony
Paring Down to the Canine Core
Canine Massage: Every Dog ‘Kneads’ It”
Photon Power: Can Laser Therapy Help Your Dog?  
Physical Therapy in the Veterinary World  
Reiki: Is it real? 
Dog Lessons: Cooper  
The Essentials Of Canine Injury Prevention: 7 Tips For Keeping Your Dog Safer 

The Challenge Of Degenerative Myelopathy (DM): Knowledge Is Power (Part I)
Degenerative Myelopathy (DM): Top 10 Management Suggestions (Part II) 
Great (Or Not So Great) Expectations with Femoral Head Osteotomy (FHO) Part (I) 
Great (Or Not So Great) Expectations with Femoral Head Osteotomy (FHO) Part (II)

It's Not Just Walking, It's Therapy! 
Treatment And Prevention Of Canine Intervertebral Disc Disease (Part I)
Treatment And Prevention Of Canine Intervertebral Disc Disease (Part II Physical Therapy)
Range Of Motion: It’s A Matter Of Degree…
The Weight Of Water And How It Helps Dogs 
By Land or By Sea? A Comparison of Canine Treadmills 
Unraveling The Mystery Of Fascia And Myofascial Trigger Points (Part I)
Unraveling The Mystery Of Fascia And Myofascial Trigger Points (Part II) 
Scar Tissue: Is it Too Much of a Good Thing? 
Physical Therapy Tip Of The Month: Ramps! 
Physical Therapy Tip Of The Month: Indoor Duo Dog Exercises!
Physical Therapy Tip Of The Month: Best Practices After Your Dog’s Surgery


Related articles:
Don’t Forget the Physical Therapy
Why The Second ACL Often Goes Too

A Different Way to Spay

by Nancy Kay, DVM

This post presents an idea that will be new for many of you and may be new for your veterinarians as well.

Taking a fresh look at the things we take for granted can be wonderfully enlightening.  

Sometimes, the little light bulb overhead begins to sizzle and sparkle, illuminating a new and better way of doing things.  Consider this example- when some savvy veterinarians took a fresh look at performing spays, a surgery we’ve been doing the exact same way for decades, guess what happened!

They came up with a revised technique that accomplishes all of the objectives of the spay surgery with fewer complications!  How cool is that!

Spay is the term used for neutering a female dog.  

As I was taught in veterinary school, the medical jargon for spaying is ovariohysterectomy (OVH). “Ovario” refers to ovaries, “hyster” refers to uterus, and “ectomy” means removal of.

In other words, spaying the traditional way involves surgical removal of the uterus and both ovaries.

The objectives of the spay surgery are to render the dog infertile, eliminate the mess and behavioral issues associated with a female dog in heat, and prevent diseases that may afflict the uterus and ovaries later in life.

Thanks to some innovative veterinarians, what we now know is that ovariectomy (OVE)- removal of just the ovaries sans uterus accomplishes these objectives just as effectively as does the OVH.  

And, here’s the icing on the cake- removal of the ovaries alone results in fewer complications when compared to removal of the ovaries and uterus combined.

Here’s a simple short course in canine female reproductive anatomy and physiology that will help explain why leaving the uterus behind makes sense.

The shape of the uterus resembles the capital letter “Y”.  The body of the uterus is the stem and the two uterine horns represent the top bars of the “Y”.  An ovary is connected to the free end of each uterine horn by a delicate structure called a fallopian tube (transports the egg from the ovary into the uterus).

While the uterus has only one purpose (housing developing fetuses), the ovaries are multitaskers.  They are the source of eggs of course and, in conjunction with hormones released by the pituitary gland, ovarian hormones dictate when the female comes into heat and becomes receptive to the male, when she goes out of heat, when she ovulates, and when her uterus is amenable to relaxing and stretching to house developing fetuses.

After the ovaries and the hormones they produce have been removed from the body the uterus remains inert. The dog no longer shows symptoms of heat, nor can she conceive. Additionally, any chance of developing ovarian cystic disease or cancer is eliminated.

What happens when we leave the uterus behind- is it not subject to becoming diseased later in life? 

Here’s the good news- the incidence of uterine disease in dogs whose ovaries have been removed is exceptionally low.

Pyometra (pus within the uterus), is the most common uterine disorder in unspayed dogs, and typically necessitates emergency surgery to remove the uterus.  Without the influence of progesterone, a hormone produced by the ovaries, pyometra does not naturally occur. The incidence of uterine cancer is extremely low in dogs (0.4% of all canine tumors)- hardly a worry, and studies have shown that the frequency of adult onset urinary incontinence (urine leakage) is the same whether or not the uterus is removed during the spay procedure.

If you are not already convinced that the “new spay is the better way”, consider the following complications that can be mitigated or avoided all together when the uterus remains unscathed:

• Compared to an OVH, an OVE requires less time in the operating room.  This translates into decreased likelihood of anesthetic complications.
• Removal of the uterus requires that the surgeon perform more difficult ligations (tying off of large blood vessels and surrounding tissues with suture material before making cuts to release the organs from the body).  A uterine body ligation that isn’t tied quite tightly enough can result in excessive bleeding into the abdominal cavity and may necessitate blood transfusions and/or a second surgery to stop the bleeding.
• The ureters (thin delicate tubes that transport urine from each kidney to the bladder) run adjacent to the body of the uterus.  If a surgeon is not being extremely careful, it is possible to ligate and obstruct a ureter in the course of removing the uterus.  This devastating complication requires a second corrective surgery, however damage to the affected ureter and adjoining kidney may be irreversible.
• Removal of the uterus occasionally results in the development of a “stump granuloma”- a localized inflammatory process that develops within the small portion of uterus that is left behind.  When this occurs a second “clean up surgery” is typically required.
• We know that the degree of post-operative patient discomfort correlates with the degree of surgical trauma.  No question, of the two surgical options the OVH creates more trauma.

European veterinarians have been performing OVE’s rather than OVH’s for years.

In fact, the bulk of the research supporting the benefits of leaving the uterus behind has been conducted in Europe.

Slowly, veterinarians in the United States are catching on, and some veterinary schools are now preferentially teaching OVE rather than OVH techniques to their students.

What should you do if you are planning to have your dog spayed?

Talk with your veterinarian about this article and provide a copy for him or her to read.  Perhaps OVE surgery is already their first choice.  If not, perhaps your vet will be willing to take a fresh look at performing this old fashioned surgery.

***

DR. NANCY KAY wanted to become a veterinarian for just about as long as she can remember. Her veterinary degree is from Cornell College of Veterinary Medicine, and she completed her residency training in small animal internal medicine at the University of California—Davis Veterinary School.

Dr. Kay is a board certified specialist in the American College of Veterinary Internal Medicine and published in several professional journals and textbooks. She lectures professionally to regional and national audiences, and one of her favorite lecture topics is communication between veterinarians and their clients.   Since the release of her book, Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life, Dr. Kay has lectured extensively and written numerous magazine articles on the topic of medical advocacy.  She was a featured guest on the popular National Public Radio show, Fresh Air with Terry Gross.

Dr. Kay is a staff internist at VCA Animal Care Center, a 24-hour emergency/specialty care center in Rohnert Park, California. As a way of providing emotional support for people with sick four-legged family members, Dr. Kay founded and helps facilitate the VCA Animal Care Center Client Support Group.  She also facilitates client communication rounds for VCA Animal Care Center employees.

Dr. Kay was selected by the American Animal Hospital Association to receive the 2009 Hill’s Animal Welfare and Humane Ethics Award.  This award is given annually to a veterinarian or nonveterinarian who has advanced animal welfare through extraordinary service or by furthering humane principles, education, and understanding.  The Dog Writers Association of America selected Dr. Kay for two awards.  The first was the 2009 Eukanuba Canine Health Award recognizing Speaking for Spot as the publication that best promotes the health and well being of dogs. The second award was for the Best Blog of 2009 (www.speakingforspot.com/blog).

Dr. Kay’s personal life revolves around her husband (also a veterinarian), her three children (none of whom aspire to be veterinarians) and their menagerie of four-legged family members. When she’s not writing, she spends her spare moments in the garden or riding along the beach atop her favorite horse. Dr. Kay and her family reside in Sebastopol, California.

Further Reading:
Have we been doing it wrong? Ovariectomy vs. ovariohysterectomy in small-animal practice

Syringomyelia Awareness: What is Chiari Malformation?

My friend at Two Little Cavaliers is blogging Syringomyelia Awareness. Please do read her blog, she has a lot of important information about the condition and real life stories.

The first time I heard about syringomyelia was during our conversations with Annie of Ella the Cavalier King Charles Spaniel. Ella has syringomyelia, you might remember her story from my earlier posts.

As I learned about it I was horrified how much potential suffering this can really mean.

I include some of the information here, please visit Two Little Cavaliers to read more.

A Chiari Malformation (CM) occurs at the craniocervical junction.

This is where the skull and the top of the spine meet. At the bottom of the skull, there is a large hole called the foramen magnum. The foramen magnum allows the brainstem to exit the skull and become the spinal cord.

When the lower lobe of the brain, the cerebellum, is displaced to the level of the foramen magnum (mild CM) or through the foramen magnum (severe CM) there is overcrowding in the foramen magnum. This causes obstruction of the normal flow of CSF from the brain down to the spinal cord. Many dogs with CM develop syringomyelia (SM).

Syringomyelia is a condition where cavities, or holes, called a syrinx, develop within the spinal cord.

The spinal cord is made up of grey and white matter. Using a computer network as an analogy, the grey matter can be thought of as the actual computer, whereas the white matter represents the network cables connecting the computers together.

Clinical Signs

In a study by Dr. Clare Rusbridge et al, they found that pain is related to syrinx width and symmetry. Dogs with a wider, asymmetrical syrinx are more likely to experience pain, and dogs with a small, narrow syrinx may be asymptomatic.

Ventral Horn Damage - Syrinxes that damage the ventral horn, may result in neurological deficits such as decreased spinal reflexes, muscle atrophy and limb weakness.

Dorsal Horn Damage - Syrinxes that damage the dorsal horn of the grey matter are most likely to cause persistent pain. Dr. Clare Rusbridge also found that the larger the width of the syrinx, the more likely it was that the dog would exhibit pain and scratching behaviour.

For the full article and images please visit:
http://cavalierhealth.ca/PDF/Understanding_Canine_Chiari_Malformation_and_Syringomyelia.pdf

Related articles:
The Dark Cloud Of Syringomyelia: Fight For Ella
Fight For Ella Continues 
Ella's MRI Results And Update

3000 Dogs Treated With Vet-Stem Cell Therapy

It is no secret that we are big advocates of Vet-Stem and stem cell regenerative therapy. Jasmine got her first treatments together with her ACL surgeries over two years ago now. Here in Canada she was one of the pioneers.

Her knees and shoulders are doing great!

There is still some loose skin around her shoulders to remind us how broad her shoulders used to be compensating for her bad rear.

Jasmine's jaws also have arthritis and she hasn't chewed on anything for years. 

Recently she is showing interested in bones again!

Of course it wouldn't be Jasmine if she didn't come up with new challenges all the time.

Last year she got another treatment, this time for her elbow.

At the end of last year she kept suffering with recurring skin infections.

Vet-Stem read our call for help and they provided some financial support for the ongoing treatment of one of their favorite patients and one of their most fervent advocates!

Jasmine is currently undergoing a two IV dose treatment to help out her immune system. She got first IV last Tuesday and getting her second one on Wednesday.

I will write a more detailed update on Jasmine in one of my next posts.

Jasmine's vet is very excited about the therapy and had been treating more dogs with stem cells. Last Friday we found out that her TCVM vet is also excited to start treating his patients!

Vet-Stem has celebrated the new year with the milestone of the 3,000th treatment of a canine companion with stem cells! 

Vet-Stem first offered stem cell therapy for dogs and cats in 2007 and is honored that so many pet owners and veterinarians have placed their trust in Vet-Stem Cell Therapy to treat osteoarthritis and tendon and ligament injuries. Vet-Stem is proud and delighted to hear the stories of the reduction in pain and improvement in quality of life in so many dogs.

Here is one of the many success stories:

Vixen Miller - 11yr old Agility Champion
Border Collie and stem cell advocate since 2007

Vixen finished 8th out of 300 of the top agility dogs in the world in 2005 at the USDAA Cynosport World Games. She earned her MACH and ADCH titles-championship titles from two major organizations. Then in 2006 she suffered a normally career-ending hip injury that left her with a painful bone-on-bone condition. Often, she could barely walk. After stem cell therapy and recovery, Vixen competed against hundreds of dogs to become a finalist in the National Competition.

“I want to express my sincere gratitude to Vet-Stem and my veterinarian for giving Vixen her health, happiness and a pain free life using Stem Cell Therapy. At the age of 11, four years after the initial Stem Cell treatments, Vixen continues to enjoy an active, pain free life. Thank you, Vet-Stem.”
—Shannon Miller, Vixen’s owner.

“I met Shannon and Vixen at a competition recently and what a team! Vixen was the show celebrity because everyone knew the story of her struggle with pain and her incredible will to return to competition. Congratulations Shannon and Vixen!”
—Bob Harman, Vet-Stem CEO

If you have not taken the virtual tour of the inside of the Vet-Stem lab, please click here to see how this amazing process uses a small sample of your pet’s fat to provide stem cell therapy!

***

Vet-Stem has been providing stem cell training and services to hundreds of veterinarians in the U.S. and Canada since 2004. Over 6,000 animals have been treated for arthritis and/or tendon and ligament injuries, many of which were not responding to other treatment methods.

You can follow latest Vet-Stem news on Arthritis in Dogs Blog
or connect with Vet-Stem on Facebook or Twitter

Related articles:
Stem Cells for Dogs? Oh yeah, baby!
Interview with Dr. Robert J. Harman, D.V.M., M.P.V.M. - CEO and founder of Vet-Stem
Jasmine is Vet-Stem's poster child! 
Zeus Gets Stem Cell Treatment 
Jasmine Is Headed For Her Next Stem Cell Treatment 
Jasmine's Stem Cells Are In

Savannah: Heartworm Positive Momma Rottie

Savannah, a Rottie, was wandering, on her own, while pregnant.

She wound up giving birth to her puppies in a couple's yard. 

The couple moved Savannah and her puppies into their garage to keep them safe but when the puppies started moving around they feared they would run one of them over.

They were going to take the  family to the local animal shelter but we know what would have happened there.

Thankfully, someone mentioned a boarding facility that might be able to help the Savannah and her family find a rescue.

A rescue was found by the boarding facility but due to unforeseen circumstances a new rescue needed to be found for Savannah and her puppies asap. A friend of Castaway Critters Pet Rescue  asked if  CCPR would be able to help Savannah and her wee puppies find a new rescue.

A wonderful rescue in NY invited the family to their rescue. Castaway Critters Pet Rescue had extra spots on their puppy van so they offered the family, and two other dogs, a ride to NY.

When they arrived it was learned on top of everything else Savannah has endured she is also heartworm positive. 

The rescue is very kind and will get Savannah treated but they just pulled 3 other dogs who are also heartworm positive so funds are very tight.  The vet estimates Savannh's treatment will be between $450-$550 because of her size and weight.

Castaway Critters Pet Rescue feels a responsibility towards Savannah so we are helping to raise funds so she can receive her heart worm treatments.

When the treatments are completed Savannah will be able to find her forever family.

Thank-you very much for helping Savannah raise her funds so she can start her heart worm treatments. All donations are extremely appreciated and tax deductible.
http://castawaycritterspetrescue.chipin.com/savannah-hw-momma-rottie

Castaway Critters Pet Rescue is a nonprofit, no-kill animal rescue group based in Blairsville, Georgia.

Operating as a 501(C)3 organization and licensed by the state of Georgia Department of Agriculture, we serve Clay County in North Carolina, Towns and Union Counties in Georgia, and wherever the need arises.

We receive no public funding and operate solely on donations, adoption fees, and fundraising events. Because of this, Castaway Critters would not be possible without you.

Our mission is to save and nurture homeless dogs and cats to match companion animals with loving, life-long homes, to foster responsible pet care, to control overpopulation in our community thru spay/neuter programs, and to assist other shelters and rescue groups in any endeavor to benefit the animals. 

We believe that the same kindness, compassion, and generosity we extend to our two-legged neighbors should be given to our four-legged friends (who are not able to speak for themselves).

Symptoms To Watch For In Your Dog: Bad Breath (Halitosis)

Recognizing and understanding your dog's symptoms can be tricky.

You're dog won't come up to you and say, “Listen, my belly really hurts, I think I should see a doctor.”

That's why it is crucial to pay attention to non-verbal signs of disease, otherwise known as symptoms.

The best veterinarian in the world won't be of any help if you don't know when to bring your dog in.

Regular check-ups certainly help to discover trouble in the making, but not problem should wait that long.

When is bad breath a symptom of disease?

Your dog can get bad breath from eating something deliciously rotten. That of course doesn't count.

If however your dog has persistently bad breath, you need to take note.

The most common cause of bad breath in dogs is dental disease.

Now, dental disease is not an immediate rush-to-the-emergency-vet type of threat, but it isn't something to ignore either. Bad teeth are not just a cosmetic issue. They can be extremely painful and even lead to systemic disease!

The bacteria associated with dental disease can lead to life-threatening infections affecting the heart, kidney and liver!

You can read more about it in my earlier article: Know Your Dog's Enemies: When Bad Breath Can Kill!

If your dog has bad breath; discolored, loose, broken or missing teeth; red swollen gums that bleed easily; a painful mouth; or drools excessively, please have it checked and get those teeth taken care of!

Dental disease is a serious issue but it is not the only potential cause of bad breath.

Bad breath can also be a symptom of other serious health issues such as gastrointestinal, respiratory or autoimmune diseases; metabolic disorders; oral cancer; and more!

So please, instead of spending money on products that mask your dog's bad breath, look for a cause.

For example, severe kidney disease can cause significantly bad breath. Friends from the dog park had a dog that suddenly started having very bad breath. They figured his teeth needed cleaning and scheduled an appointment for the procedure. When they finally got him in, the veterinarian found their dog was in kidney failure. With dialysis they got one extra day to say goodbye to him!

Clearly, they must have missed a bunch of other symptoms too!

The best way to deal with bad breath is by treating the underlying disease!

It's your dog's health!
Jana

Related articles:
Know Your Dog's Enemies: When Bad Breath Can Kill!
Symptoms To Watch For In Your Dog: Excessive Drinking
Symptoms To Watch For In Your Dog: Excessive Panting
Where There Is Smoke, There Is Fire: A Symptom Is Your Friend!
When Is It An Emergency?

Reasonable Expectations: The Ability to Discuss Your Internet Research With Your Vet

by Nancy Kay, DVM

This is the sixth part of an ongoing series describing how people are developing new expectations when it comes to veterinary care for their pets. Parts one through five can be found at www.speakingforspot.com/blog.  Please take your time with this one- I realize it is a lengthy post, but there is a great deal to say about this worthwhile topic!

When your beloved pet develops a medical issue, chances are you’ll be inclined to do some Internet research and then talk with your vet about what you’ve learned.

Know that having this discussion with your vet is a perfectly reasonable expectation as long as you are careful to avoid using valuable office visit time discussing “whackadoodle” notions gleaned from cyberspace.

Here are some pointers to help you find instructive, accurate, worthwhile Internet information while avoiding “online junk food”. By the way, although I’m a veterinarian teaching people how to better care for their furry and feathered family members, please know that this information also applies to your own health care.

So, let’s begin.

How can you determine whether or not a website is dishing out information that is worthy of your time? 

Here are some general guidelines:

1. Ask your veterinarian for her website recommendations.  She might wish to refer you to a specific site that will supplement or reinforce the information she has provided.

2. Veterinary college websites invariably provide reliable information.  Search for them by entering “veterinary college” or “veterinary school” after the name of the disease or symptom you are researching.

3. Web addresses ending in “.org,” “.edu,” and “.gov,” represent nonprofit organizations, educational institutions, and governmental agencies, respectively.  They will likely be sources of objective and accurate information.

4. If your dog has a breed-specific disease, pay a visit to the site hosted by that specific breed’s national organization.

5. Avoid business-sponsored websites that stand to make money when you believe and act on what they profess (especially if it involves purchasing something).

6. Be ever so wary of anecdotal information.  It’s perfectly okay to indulge yourself with remarkable tales (how Max’s skin disease was miraculously cured by a single session of aromatherapy), but view what you are reading as fiction rather than fact.

7. I really love disease-specific online forums.  Check out those sponsored by Yahoo (http://groups.yahoo.com).  Not only do many of them provide a wealth of educational information, members can be a wonderful source of emotional support- always a good thing for those of us who share our homes and hearts with an animal.

If you are considering joining an online forum, I encourage you to look for a group that focuses on a specific disease (kidney failure, diabetes, etc), has lots of members, and has been around for several years.

For example, an excellent Yahoo group AddisonsDogs has 3,391 members and has been up and running for eight years.  A large group such as this typically has multiple moderators who screen participants, screen comments to keep things on topic, present more than one point of view (always a good thing), and provide greater round-the-clock availability for advice and support.

Look for presentation of cited references (clinical research that supports what is being recommended). Such groups should have a homepage that explains the focus of the group and provides the number of members and posts per month (the more the better).  They may have public archives of previous posts that can provide a wealth of information.

I happen to enjoy hearing about what my clients are learning online.

I sometimes come away with valuable new information, and I’m invariably amused by some of the extraordinary things they tell me- who knew that hip dysplasia is caused by global warming!

Surf to your heart’s content, but be forewarned, not all veterinarians feel as I do.

Some have a hard time not “rolling their eyes” or quickly interrupting the moment the conversation turns to Internet research. What can you do to realize the expectation of discussing your online research in a way that is neither irritating to your vet nor intimidating for you?  Listed below are some secrets for success:

• I may be preaching to the choir, but I cannot overemphasize the importance of working with a vet who is happy and willing to participate in two-way, collaborative dialogue with you (please reference my earlier blog about relationship centered care- http://speakingforspot.com/blog/?p=1174). Your opinions, feelings, and questions are held in high regard and enough time is allowed during the office visit to hear them. 

A veterinarian who practices this “relationship centered” style of communication is far more likely to want to hear about your online research than the veterinarian who practices “paternalistic care” (far more interested in telling you what to do than hearing about your thoughts, questions, or concerns).  Remember, when it comes to veterinarian/client communication styles, you have a choice. It’s up to you to make the right choice!

• Let your vet know that you appreciate her willingness and patience in helping you understand how best to utilize what you’ve learned online.

• Wait for the appropriate time during the office visit to discuss what you’ve learned on line.  Allow your veterinarian to ask questions of you and examine your precious poopsie rather than “tackling” her with questions and discussion about your Internet research questions the moment she sets foot in the exam room.

• Be brief and “to the point” with your questions.  Remember, most office visits are scheduled for 15 to 20 minutes, max.

• Let your veterinarian know that you’ve learned how to be a discriminating surfer!  You know how to differentiate between valuable online resources and “cyber-fluff”. You ignore anecdotal vignettes and websites trying to sell their products in favor of credible information provided by veterinary college sites and forums that are hosted by well-educated moderators who provide cited research references that support their recommendations.

• When you begin conversation about your Internet research, I encourage you to choose your wording wisely. Communicate in a respectful fashion that invites conversation as opposed to “telling” your vet what you want to do.

In the Internet, we have an extraordinary tool at our fingertips. I encourage you to be selective when choosing which websites you intend to take seriously and which ones you wish to visit for a good chuckle.

Approach conversations with your vet about your Internet research thoughtfully and tactfully.  These strategies are bound to facilitate constructive conversation and create a win-win-win situation- for you, your veterinarian and your beloved best buddy!

Have you had conversation with your vet about your Internet research?  If so, how did it go?

Now here’s wishing you and your four-legged family members abundant good health. 

***

DR. NANCY KAY wanted to become a veterinarian for just about as long as she can remember. Her veterinary degree is from Cornell College of Veterinary Medicine, and she completed her residency training in small animal internal medicine at the University of California—Davis Veterinary School.

Dr. Kay is a board certified specialist in the American College of Veterinary Internal Medicine and published in several professional journals and textbooks. She lectures professionally to regional and national audiences, and one of her favorite lecture topics is communication between veterinarians and their clients.   Since the release of her book, Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life, Dr. Kay has lectured extensively and written numerous magazine articles on the topic of medical advocacy.  She was a featured guest on the popular National Public Radio show, Fresh Air with Terry Gross.

Dr. Kay is a staff internist at VCA Animal Care Center, a 24-hour emergency/specialty care center in Rohnert Park, California. As a way of providing emotional support for people with sick four-legged family members, Dr. Kay founded and helps facilitate the VCA Animal Care Center Client Support Group.  She also facilitates client communication rounds for VCA Animal Care Center employees.

Dr. Kay was selected by the American Animal Hospital Association to receive the 2009 Hill’s Animal Welfare and Humane Ethics Award.  This award is given annually to a veterinarian or nonveterinarian who has advanced animal welfare through extraordinary service or by furthering humane principles, education, and understanding.  The Dog Writers Association of America selected Dr. Kay for two awards.  The first was the 2009 Eukanuba Canine Health Award recognizing Speaking for Spot as the publication that best promotes the health and well being of dogs. The second award was for the Best Blog of 2009 (www.speakingforspot.com/blog).

Dr. Kay’s personal life revolves around her husband (also a veterinarian), her three children (none of whom aspire to be veterinarians) and their menagerie of four-legged family members. When she’s not writing, she spends her spare moments in the garden or riding along the beach atop her favorite horse. Dr. Kay and her family reside in Sebastopol, California.

Blog The Change: Look What We're Doing!

Has healthy dog become an oxymoron? Why are so many of our dogs suffering from inherited disorders? And what is our role in all this?

Most diseases are affected to some extent by both genes and the environment. A genetic disorder is one in which an abnormality in the genetic make-up of the individual plays a significant role in causing the condition.

(source: Canine Inherited Disorders Database)

Like it or not, we are responsible for both - the environment and the bad genes!

While on one hand the  advances in veterinary medicine offer more and more tools to battle disease, our dogs seem to be getting sicker.

What is wrong with this picture? And what can we do about it?

The problem is in our priorities!

Let's start with the problem of breeding practices.

One of human biggest problems is greed. 

We are quite willing to exploit anything and everything for easy money. This actually has to do with both environment and genetics.

And on the day when greed and breeding came together under one roof, man created puppy mills.

Frankly, I find it mind boggling that puppy mills have survived to this day! There is no gray area here, there is no room for confusion—it is just plain wrong. It is exploitation at its worst. How is it possible that this is allowed to keep happening?

These are not good intentions gone wrong, these are not products of ignorance, this is just plain and pure greed with no regard and no remorse.

If you have seen the movie The Matrix, I'm sure you were appalled at they way the machines were farming human beings.

“Human beings are no longer born, we are grown.”

Well, I believe that puppy mills are worse than that!

Why? Those humans were at least provided with optimal biological conditions and nutrition. In their minds they could live out their lives any way they wanted. That is more than the puppy mills can say for themselves!

Puppy mills are the worst case scenario from both genetic and environmental perspective.

Of course those are just some particular individuals who are running those mills, right? We didn't do it, they did, right?

But what are we doing to stop it?

"He who does not punish evil, commands it to be done." 
—Leonardo da Vinci

There is just one thing puppy mills remind me of ...

Image from Quality Information Publishers, Inc.

We need to open our eyes and see. We need to speak up on behalf of those who cannot speak up for themselves.

Wow, would you believe that I originally planned on writing about something else all together? But this is one of those things that needed to be said (again) until no puppy mill is left in the world.

Stay tuned for more articles on breeding and dog health.

To read more about puppy mills check out these articles or just Google it:
Puppy Mill Dogs (and Puppies) and their Health Problems
Puppy Mills: What Can We Do to Stop Them?
Dog Health Problems: My Puppy Mill Plea
Blood Pup: The New Term For a Pet Store Puppy?
A New Way to Close Puppy Mills!

Jana

Hip And Elbow Dysplasia: Are They The Same Thing?

Hip and elbow dysplasia are common cause of lameness in dogs. They sound like they should be the same thing, right? Are they though?

The word dysplasia has a rather broad meaning. It is from Greek and it stands for malformation.

In the context of veterinary medicine dysplasia means abnormal development or growth.

(So if you happen to have a spineless boss that might qualify too!)

Both hip and elbow dysplasia refer to abnormal development of the respective joints. Result? Pain, lameness and progressive degenerative changes.

So much they have in common.

The hip is a relatively simple joint where the thigh bone (femur) connects to the pelvis in a ball-and-socket joint. 

image from Pet Surgery Topics

In a healthy joint, the femoral head fits tightly into a deep and well-formed socket and moves smoothly.

In a dysplastic hip, the ball and socked don't fit together properly.

Often both the socket is too shallow, and the ball is misshapen. This makes the joint unstable which leads to further degenerative changes. In severe cases the two parts of the joint can pull apart completely!

Treatment for hip dysplasia depends on the individual situation. Non-surgical treatment consists of treating of the resulting arthritis and supporting muscle strength.

There are a number of surgical treatments available, ranging from surgeries aimed at improving the fit between the ball and socket within the joint, to complete hip replacement. Check out Canine Hip Dysplasia at Veterinary Partner for more information.

In the elbow, three bones meet together to form the joint, and you can see that the structure is very different from the hip.

image from College of Veterinary Medicine WSU

The elbow is composed of three bones: the humerus (the boney support of the upper limb from the shoulder to the elbow); the ulna (which runs from the elbow to the paw along the back of the limb); and the radius (which supports the major weight-bearing along the front of the lower limb).
(source: Veterinary Partner)

All parts of the joint need to develop properly and in sync with one another so they can fit together perfectly.

The more parts, the more things that can go wrong.

Elbow dysplasia is a blanket term that can cover multiple abnormalities, each of which even comes with its own name! These can occur individually or in combination.

• fragmented medial coronoid process (FMCP)
  (malformed or fragmented bone and/or cartilage of the ulna)

• osteochondritis dissecans (OCD)
  (damaged or abnormally formed cartilage cracks or separates from the bone surface; can even result in piece of the cartilage breaking loose completely)

• ununited anconeal process (UAP)
  (a part of the ulna involved in the joint fails to fuse with the rest of the bone, resulting in fracture through the growth plate)

• elbow incongruity 
  (misalignment of the joint surfaces of the elbow)

Unlike in hip dysplasia, where the main problem is instability of the joint, the abnormalities associated with elbow dysplasia often result in pieces of bone and/or cartilage breaking loose and irritating the joint tissues.

While mild cases can do well with medical treatment only, surgery is the treatment of choice for most dogs. Arthroscopy is minimally invasive and it is preferred for both diagnosis and treatment of elbow dysplasia. Some cases might require an open elbow surgery.

For more information check out Elbow Dysplasia at Veterinary partner.

Hip and elbow dysplasia - not really the same thing, are they?

What they do have in common is that the earlier the treatment the better the results. Understand the medical challenges your dog might be facing.

It's your dog's health,
Jana

Further reading:
Hip Dysplasia in Dogs: Diagnosis, Treatment, and Prevention
Canine Hip Dysplasia
Elbow Dysplasia

Related articles:
Trago's Elbow Dysplasia Surgery And Stem Cell Treatment
Shiloh Is Headed For A Second Hip Surgery And Hopes To Find A Forever Home

Pet Blogger Challenge: The Motivation Behind My Blog

1. When did you begin your blog?

Dawg Business actually just had a one year anniversary recently! I posted my first article on December 14, 2009. It was a review of the FURminator—I know!

I kept trying to come up with something profound enough to be worthy of the first post and it only resulted in me not posting anything. So to take the plunge I resolved to writing the first thing that came to mind. But hey, it is a great product!

There is a lesson in that though. If you want to start something, just start it. Waiting for the right moment, right idea ... might just end up with you not doing anything!

2. What was the original purpose for starting a blog?

My original purpose is my only purpose - saving the world one dog at the time.

Jasmine has gone through so many health challenges and I do believe that many of these could have been avoided if we  knew better. But there were too many things we didn't know then!

I started blogging to share what we learned in hopes that it might help other owners to be better equipped to prevent and to deal with health challenges their dogs might be facing. If my blog could prevent just one dog from suffering, it had fulfilled its purpose.

3. Is your current purpose the same?

Yes, helping owners and dogs is and will remain the purpose of this blog.

I am very happy to see that people are finding the information and support they're looking for.

4. Do you blog on a schedule or as the spirit moves you?

I did read couple materials about blogging and learned that solid schedule is important. I did well so far posting regularly. When the spirit does move me I'll write the article but post it within my set schedule.

5. Are you generating income from you blog?

No, I haven't so far. I do hope to put some e-books together in the future and it would be nice if they generated some income. I do not monetize because I want to have full control about what my blog might be promoting. I wouldn't feel comfortable advertising something I cannot stand behind.

6. What do you like most about blogging in general and your blog in particular (bragging is good!)?

I love it when dogs get helped through my blogging. I love when people share their stories about health challenges they've gone through with their dogs. I believe that real life stories help to get the message across best.

I love how many wonderful people I have met and I love having wonderful veterinarian friends participating with their guest posts.

7. What do you like least?

The pressure I often feel as I feel responsible for every word I put out there.

8. How do you see your blog changing or growing in 2011?

Unless my readers have suggestions about what they would like changed or improved I think the blog works the way it is. I'd love if more owners shared their stories and I'd love if my veterinarian friends continued to guest post with me.

Real life experiences usually come at a great cost. Sharing those experiences is invaluable. That is Jasmine's legacy and it can be your dog's legacy also.

Jana

Our Journey to TCVM (Traditional Chinese Veterinary Medicine)

When Jasmine came into our lives seven years ago, little we realized what challenges were lying ahead of us. Over the years, Jasmine has been plagued with multiple-dogs-worth health issues.

She was the largest female from the litter, which, we believed, would had also made her the healthiest. Were we ever wrong!

When we brought her home, her stools were not very good, but we figured it was from the change and it would sort itself out. 

Well, it did not. However, frequent vet visits didn't bring either an explanation nor a solution. More over, it seemed that we were the only ones worried about it, as the vets certainly were not.

Gulible owners as we were at the time, our worries eventually turned into acceptance.

Perhaps she just has a weak system and bad stools and poor appetite were normal for her.

But this issue was soon overshadowed by another.

As she turned about two years of age, every now and then she'd have a restless night. She would be panting and pacing around the house, asking to go outside (but for no apparent reason), scratching at doors and corners, and looking distressed.

It was upsetting, but it didn't happen very often and we figured that maybe she smelled or heard something outside that got her agitated.

Slowly, however, they had increased on frequency, intensity and lenght. 

She was able to go this way all night! More vet visits and yet again no answers.

Figuring that perhaps her belly was upset I'd take her for walks in the middle of the night so she could walk it off. Sometimes it would help and sometimes it would not.

Nobody except me didn't seem to have been taking this seriously, possibly because I was the only victim who had to bare witness to the episodes, as we started calling them.

But, surprisingly, denial did not make them go away. 

In the spring of 2008 the episodes got so bad that I declared that neither her or myself can go on this way. We were going to the vet and we were not leaving until an explannation for this was found.

In desperation the vet decided to check her thyroid hormone levels, and indeed they were very low. 

What I think today about running test for T4 only and not looking any deeper won't change the past. Fact is, however, that starting Jasmine on thyroid medication seemed to have resolved the problem.

Her episodes slowly faded and I was very relieved that finally an answer had been found.

My relief was short-lived.

In the summer of that year Jasmine started limping on her rear left leg. As the lameness wasn't going away, it was discovered that she had a tear in her left crucial ligament and that the ligament in the right knee didn't look very good either. Recommendation was made for TPLO surgeries.

That's when I decided to finally take matters in my own hands. A lot had happened through that time, more detailed account of all the events is published on Dr. Huston's blog.

In the process we have found a new vet who is truly amazing and he diagnosed and fixed many of Jasmine's issues.

Her stool and appetite issues turned out to be a result of food allergies which by now had developed into eosinophilic gastroenteritis. With limited ingredient home-cooked diet there was improvement in the stool quality, but not in the appetite.

More importantly, Jasmine's episodes had returned. 

Her thyroid levels were stable. Could it be that the medication helping was just a coincidence?

Determined to help her we started investigating. Blood test, urineanalysis, more tests, x-rays ... all with no clear conclusion. Specialists (cardiologist, neurolist ...) at our teaching hospital reviewed her labs and a tape of one of her episodes and guess what they concluded? "It's probably just restlesness."

The one thing I KNEW it was not!

The best conclusions we could arrive to with conventional medicine were that it is either caused by pain from her IBD or pain from an abnormality that has been found in the spine in her neck. Solution? Either steroids or pain killers, with a coin toss in between those two.

We had reached a dead end. 

I believed that conventional medicine took us as far as it could and that if we want to go further we had to choose a different path.

I first heard of TCVM (Traditional Chinese Veterinary Medicine) some time back when I was researching alternative options for dealing with her bad ligaments. I talked to people who had great success using TCVM for treatment of various issues and became intrigued by the idea. I got my hands on Four Paws Five Diretions and studied the principles.

It was time to try something else and perhaps TCVM was a way to go. 

We talked to Jasmine's vet about my thoughts, explaining that we felt that he was a wonderful vet but limited by the tools he had available and that perhaps adding some different tools might be helpful. Of course he would remain Jasmine's primary physician. He warned us not to put much hope into that but argeed that'd we consult with a TCVM vet.

After the TCVM exam we did get our hopes up.

The TCVM vet came up with a diagnosis which did come with a treatment other than steroids or pain killers. We started a course of acupuncture and herbal supplements.

The herbs had very strong scent and flavor and just the fact that Jasmine accepted them in her meals surely meant something.

Today Jasmine has beautiful stools (I celebrate every one of them) and ravenous appetite. 

Her episodes have not gone away completely yet, but they had been curbed, and there seems to be continuous improvement.

Her main vet does feel that including the TCVM treatment did bring visible improvement. 

We are hoping that eventually this issue might get resolved completely.

Jasmine is a constant challenge and a work in progress but we are glad we integrated TCVM into our efforts.

Jana

Related articles:
When Modern Medicine Doesn't Have The Answer: TCVM
Why Integrative Veterinary Medicine?
Four Paws, Five Directions: The Theory Behind The Traditional Chinese Veterinary Medicine
What To Expect During A Traditional Chinese Veterinary Medicine Exam 
Healing You Dog With Food: More To Food Than Nutritional Value? 
Acupuncture In Not Voodoo

Did you see me today?

by Beth McDuffie of Eagle's Den Rescue

As you rushed past to the kennel with the five darling little pups -
seven people already there, rescues lined up to save -
...Did you see me today?

Did you see my eyes filled with hurt and torture -
ten years of neglect and pain
from my life in the back yard, on a chain...
Did you see me today?

Did you hear the cries my heart made?
Three days ago was my tenth birthday and almost ten years ago
I was in that same kennel you rushed to today.
I was a darling little puppy that everyone wanted...

that got too big, too fast...and was sent to live on a chain in the backyard -
too cold in the winter and too hot in the summer,
barely a kind word spoken...
I begged for attention that never came,got tossed food most days,

begged for just a drink of water on too hot days,
my throat parched and hurting.
My dirty matted coat my only protection from the heat and cold, rain and snow
ALWAYS NEEDING
No one saw me then either.

Then I got too messy, my cries for attention too loud ...
I just got too damn old.
No one saw me, and they brought me here to die.

That kennel you rushed to had six puppies then...
They dropped me off and took one from there
to fill my spot on that rusty chain in the backyard,
And I wonder... who is worse off - me or him?

I still have so much love in my heart, so much to share...
Did you see me today?
For a brief moment you stopped, and I thought our eyes met.

Was the smell of helpless death too strong for you,
my pleas for help too loud?

Did you see me today?
Will you go home, close your eyes in slumber
and recall the haunting look I gave...
Will you recall what was not seen today?

With the sunrise will you rush back to see?
I will not be here then.

Today, when the doors are locked
I will never be seen again...

Did you see me today?
(Written By: Beth McDuffie)
Please SEE THEM!

If you cannot save one, help us to save them. Pray for us... and send help if you can.

We are a non-profit and your donations are tax deductable. 100% goes to care for the animals. During the holiday season, things get a little tight...we understand...they are tight here too. One dollar will help to buy a bag of kibble for a worthy soul...Medical costs have been astronomical this year and we do need all the help we can get to keep running...

Thank You and May Creator smile upon you.
Eagle's Den Rescue