Health Conditions

Health conditions of the Portuguese Water Dog

Addison’s Disease:

It is the common name for hypoadrenocorticism, or adrenal insufficiency. It is a disease with symptoms that are common in many other ailments, making diagnosis difficult and sometimes a process of elimination. But once Addison’s is correctly diagnosed, a properly treated dog can live a normal active life.

The adrenal, one on each kidney, is made up of two layers, the cortex and the medulla. The outer area, or cortex, secretes corticosteriod hormones such as cortisol and aldosterone. The medulla, part of the sympathetic nervous system, secretes epinephrine (adrenaline), which is generally not affected by Addison’s.

There are three forms of Addison’s disease: primary, secondary and atypical. Primary and atypical Addison’s are usually the result of immune mediated damage to the glands. Secondary hypoadrenocorticism is from failure of the pituitary to stimulate the adrenals with adrenocorticotropic hormone (ACTH). It is important for you to know which type of Addison’s disease your dog is being treated for.

The symptoms of Addison’s disease can be vague. More importantly, they are similar to the symptoms of many different problems. Initially, the dog may be listless, or seem depressed. Many dogs are described as just seeming off, or losing the normal sparkle in their eye. Lack of appetite is a good indicator.

Other symptoms include gastrointestinal problems like vomiting and diarrhea. Pain in the hind quarters, or generalized muscle weakness such as a dog that can’t jump onto a bed or couch as he has done in the past is not uncommon. Shivering or muscle tremors may also be present. The most important thing to remember is that you know your dog better than anyone. If something seems amiss, have it checked out.

These symptoms may wax and wane over months or years making diagnosis difficult. If the adrenals continue to deteriorating, ultimately the dog will have an acute episode called an Addisonian crisis. Potassium levels elevate and disrupt normal functions of the heart. Arrhythmia can result and blood pressure drops to dangerously low levels. BUN and creatinine levels, generally indicators of kidney function, are often elevated. At this point many animals are diagnosed with renal failure, as the kidneys are unable to function properly. Typically animals are given IV solutions for rehydration, which may produce an almost miraculous recovery. This too, is a great indication that failure of the adrenals rather than of the kidneys is creating the symptoms.

Allergy, Hair loss / Follicular Dysplasia, Dermatology, Improper Coat:

Allergies: Many if not all breeds of dogs can suffer from as many allergies as people do. There are contact allergies, inhalant allergies and food allergies. Symptoms are itchiness, skin eruptions and irritations, digestive upsets, coughing, sneezing and irritated eyes. In some dogs it can show up when they are a puppy but it can develop it later in life.

Allergies are debilitating and can affect the quality of life of an affected dog. Treatments include avoiding the allergens. These can be ingredients in food, shampoos and conditioners, dust, fleas, other parasites, pollen, molds etc. Making changes in their diet and grooming products can help reduce or eliminate the symptoms when those things may be the cause. Certain medications can help as well.

Hair Loss / Follicular Dysplasia: Follicular Dysplasia is a genetic form of hair loss. The follicles of the hair are abnormal, or dysplastic allowing the hair to fall out. It usually shows up on the torso of the dog but can affect large areas.

In the early stages the hair will re-grow. Hair loss is often associated with stress such as inoculations, surgery and / or illness. There are two types of follicular dysplasia, structural and cyclic. The Portuguese Water Dog has been found to fall under the structural follicular dysplasia. Breeds with the cyclic problem produce normal hairs but the hair cycle is abnormal so the hair falls out. Dogs with structural follicular dysplasia such as the PWD produce abnormal hairs that become more abnormal with time. After numerous episodes, the hair ceases to regenerate. It has been found that all Portuguese Water Dogs with genetic hair loss have follicular dysplasia. It primarily presents itself in curly dogs produced from the mating of a curly sire to a curly dam. There has been no verification of a genetically wavy Portuguese Water Dog exhibiting this genetic condition to date.

Follicular Dysplasia does not cause itching or scratching.

Dermatology: There are non-heritable causes for hair loss. Thyroid deficiency, cushings disease, allergies, parasites, environmental toxins and drugs can cause temporary hair loss.

Improper Coat: This is another heritable hair coat issue in PWD’s. Portuguese Water Dogs with improper coats do not have the coat described in the breed standard. A wavy “improperly coated PWD” will tend to look like a Flat Coat Retriever or Border Collie. A curly “improperly coated PWD” will tend to look like an American Water Spaniel or Curly Coated Retriever. It is also possible for these dogs to have some undercoat and possibly shed. This condition only affects the PWD’s appearance not their health.

It is strongly recommended by the PWDCA that any PWD that exhibits genetic hair loss and / or improper coat, not be used for breeding.

Cancer:

Cancer can be divided into two broad categories:

  1. Carcinomas – malignant growths made up of epithelial cells (these are the cells that cover the lining of any body surface, such as skin, the bladder and blood vessels) that pass into the surrounding tissues and give rise to metastases (the spread of cancer cells);

  2. Sarcomas – malignant tumors that originate from connective tissue (such as bone, cartilage, muscle, blood vessels and lymph tissue). There is usually a prefix that describes the tissue of origin, for example, osteosarcoma is cancer of the bone.

Here is a list of 5 of the most common forms of cancer in dogs, and their symptoms:

1. Lymphosarcoma (Lymphoma): This cancer is associated with your dog’s lymphoid system, which is an important part of his immune system.

Lymphoid tissue is found in many parts of the body including the lymph nodes, liver, spleen and skin. The most common form of lymphoma in dogs is the multricentric form that occurs in the lymph nodes.

Symptoms of lymph node cancer are swellings of the lymph nodes, and there are 5 major lymph nodes that you can feel on your dog.

Other forms of lymphoma will show symptoms such as vomiting, weight loss and lack of appetite (gastrointestinal form), shortness of breath (chest form) and single or multiple lumps in the skin or in the mouth (skin (cutanaous) form)).

Middle aged to older dogs (aged approximately seven to ten years) are more prone to lymphoma, and no breed is particularly susceptible. The cancer can be very aggressive, and if left untreated the prognosis is a matter of weeks. With treatment your dog’s life can be extended by several months to a year.

2. Hemangiosarcoma: This cancer originates from the cells that form your dog’s blood vessels and can occur in any part of your dog’s body, but is mainly found in the spleen, liver, heart and skin.

The first sign of the cancer being present is usually a ruptured tumor, and because the tumor is formed from blood vessel cells, it is often full of blood.

If the tumor is in the liver or spleen, the ruptured tumor will cause anemia and weakness in your dog through the loss of blood.

If the tumor is present in your dog’s skin, then a lump may be felt under the skin, and if it’s in the bones then a swelling of the bone may be felt.

Hemangiosarcomas usually occurs in older dogs, and some breeds seem to be predisposed to it – Golden Retrievers, German Shepherds, Portuguese Water Dogs and Skye Terriers.

The tumors aren’t usually detected until their late stages, in internal organs this is usually when the tumor has ruptured, and the prognosis is poor; less than 50% of dogs will survive more than 6 months. Survival rates are better when the cancer occurs in the skin because it can usually be detected and treated earlier.

3. Osteosarcoma: This is cancer that originates in your dog’s bones, more usually in the limbs but can occur in any part of the skeleton.

Large dog breeds are more prone to osteosarcoma – Great Danes, Saint Bernards, Great Pyrenees, Newfoundlands, Bernese Mountain Dogs, and Irish Wolfhounds in particular. Heavily built dogs such as Rottweilers, Labradors, Golden Retrievers, German Shepherds, Dobermans, Weimaraners, and Boxers are also at an increased risk.

The symptoms include lameness, pain in the bones, swelling, and reluctance to exercise. 90% of osteosarcomas spread to the lungs and so your dog may show symptoms such as coughing and difficulty in breathing too. Unfortunately the cancer is rarely detected before it has spread from the bones to other parts of the body.

The prognosis is poor; less than 50% of dogs will survive more than a year.

4. Mammary Carcinoma: Mammary tumors are the most common tumor in female dogs that haven’t been spayed.

Provided the tumor is detected early enough, this cancer can usually be successfully treated. The symptoms are a solid mass or numerous swellings in the mammary glands; they tend to start off small and grow quickly grow in size.

As the cancer can spread to other parts of your dog’s body, any unusual swelling in the mammary glands should be investigated by your vet as soon as possible so that any malignant tumor can be treated.

5. Mastocytomas (Mast Cell Tumors): Mast cells form part of the body’s tissue and play a role in the body’s immune system.

Mastocytomas are most commonly seen in the skin, and can spread to the lymph nodes, spleen, liver and bone marrow. These tumors usually occur in older dogs.

Symptoms include raised masses on or under the skin – single or multiple lumps, which may be smooth, bumpy or ulcerated. Your dog may also show a lack of appetite, vomiting and abdominal pain.

The prognosis depends upon how far advanced the cancer is; broadly if the tumor is on your dog’s limbs then he has a better prognosis than if the tumor is in the nail bed, genital areas and mouth. Mast cell tumors in the internal organs have a poor prognosis.

Eye Diseases:

Microphthalmia and multiple congenital ocular anomalies:

Affected dogs have prominent third eyelids and small eyes which appear recessed in the eye socket (enophthalmos). A defect early in development results in the smaller than normal eye (microphthalmia).This is often associated with other eye abnormalities, including defects of the cornea, anterior chamber, lens and/or retina. Microphthalmia is also seen with coloboma – a cleft in a portion of the eye, particularly the iris.

Microphthalmia may be associated with other minor or major eye abnormalities. Where the changes are mild, there is usually no visual impairment. With moderate microphthalmia, the eyeball fills about half of the opening. About 50% of these pups will be blind. Where the defect is severe, all of the pups are blind. In general, microphthalmia is evident as soon as a pup’s eyes are opened.

Pups with microphthalmia with cataracts will usually have some visual impairment. The cataracts may be progressive resulting in a worsening of vision, or they may mature and be reabsorbed, resulting in improved vision. This is unpredictable. In the process of resorption, liquefied lens material may leak into the eye causing inflammation.

With their acute senses of smell and hearing, dogs can compensate very well for impaired vision.  You may not realize the extent of your dog’s vision loss, particularly in familiar surroundings. You can help your visually impaired dog by developing regular routes for exercise, maintaining your dog’s surroundings as consistently as possible, introducing any necessary changes gradually, and being patient.

There is no treatment for the structural defects. Complications that may develop, such as glaucoma, are treated as required.

Parents, normal-eyed siblings, and  affected dogs should not be bred.

Distichiasis:

Distichiasis is one of many diseases which can affect the eyes of a dog. In the case of distichiasis, eyelashes are found growing on the margin of the eyelid and these abnormally placed eyelashes can cause irritation to the eye itself, resulting in corneal ulcers or abrasions and/or conjunctivitis (inflammation of the tissue surrounding the eye).

The extra eyelashes or hairs which characterize distichiasis in dogs grow out of the Meibomian glands that are located on the eyelid margin. All dogs have Meibomian glands, a part of the normal anatomy of the eyelid. However, in cases of distiachiasis, two or more hairs grow out of these Meibomian glands in an abnormal fashion. The eye problem arises when these abnormally located eyelashes or hairs contact and irritate the eyeball itself and the surrounding tissues.

Distichiasis produces symptoms similar to those seen with other eye problems. Entropion is an eye disease of the dog which is frequently confused with distichiasis. However, whereas distichiasis is the result of extra eyelashes, entropion results when there is extra skin around the eye which allows the eyelid to roll inward toward the eye. Entropion results in conjunctivitis and corneal ulcers or abrasions due to the irritation of the eyelashes or normal hair contacting the surface of the eye, which does not occur in dogs with healthy eyes.

The symptoms associated with distichiasis in the dog can vary depending on the texture of the extra eyelashes, where the extra eyelashes are located, how long the eyelashes are and how many extra eyelashes are present. Distichiasis can cause symptoms ranging from minor to quite severe and extremely painful for the affected dog.


Symptoms often observed with distiachiasis in the eye of the dog include:

  • corneal ulcers

  • chronic pain in the eye/eyelid

  • excessive tearing resulting in an ocular discharge

  • squinting/holding eyelids closed or partially closed

  • increased blinking

Distiachiasis is most often seen in young dogs and puppies. Distichiasis can be seen in any breed of dogs.

Treatment for distichiasis in the canine eye involves destroying the hair follicles which produce the abnormal eyelashes, preventing the hairs from growing back. Methods available to destroy the follicle and prevent regrowth of the eyelashes include:

  • cryotherapy (freezing the eyelid margins where the extra eyelashes grow)

  • surgery to remove the extra eyelashes

  • electrolysis

Plucking the hairs from the eye margins will not cure distichiasis in affected dogs since plucking does not destroy the follicle and the hair will regrow with time.

Once the hair follicle is destroyed, prognosis for the affected eye is good.

Distichiasis is a commonly encountered eye problem in dogs which is often congenital in nature and is considered to be a heritable canine eye disease. Distichiasis causes a great deal of ocular discomfort for those dogs affected, but can be treated by destroying the abnormally located hair follicles and preventing regrowth of the eyelashes which irritate the affected canine eye.


Dogs diagnosed with distiachiasis affecting their eyes should not be bred because of the heritability of the problem and the likelihood of passing the eye problem on to the progeny.


Cataracts:

Cataracts are one of the most common problems affecting the eyes of the dog. There are many different forms and causes of cataract formation. They affect all breeds and ages of dogs, but certain types show up more commonly in certain breeds. Despite the fact that they are very common, there is still a lot that we do not know about canine cataracts. The only current treatment option is surgery, but with correct patient selection the outcome is very good.

Despite the fact that there are several different forms and causes of cataracts, they all develop in a similar fashion. The normal lens is maintained in a dehydrated state. It consists of 66% water and 33% protein. There is a complicated sodium water pump system in the lens that keeps this water/protein balance in check. When the biomechanical system in the lens is damaged, this pump system begins to fail and extra water moves into the lens. In addition, the percentage of insoluble protein increases. These changes result in the loss of transparency and cataract formation.

Congenital Cataracts: These are cataracts that are present at birth. These cataracts usually occur in both eyes. Despite the fact that the animal is born with them, they are not necessarily inherited. Infections or toxins may cause the formation of these cataracts in unborn puppies.

Developmental (Early Onset) Cataracts: Developmental cataracts are those that develop early on in life. As with congenital cataracts, they may be inherited or caused by outside sources such as trauma, diabetes mellitus, infection, or toxicity.

Senile (Late Onset) Cataracts: The cataracts that occur in dogs over six years of age are called senile cataracts. They occur much less frequently in dogs than in humans. Nuclear sclerosis, which is not considered to be a medical problem, is often confused with cataracts at this age.

Treatment for canine cataracts consists of surgical removal of the lens. Currently, there is not a good non-surgical treatment for this condition. With the increase in veterinary surgical skill and equipment, the surgical procedure to remove the problem lens is becoming increasingly more common. There are several different techniques used to remove the affected lens including; the removal of the entire lens and surrounding capsule, the removal of the lens leaving the surrounding capsule, phacoemulsification of the lens, and aspiration and desiccation of the lens. All of these techniques can offer excellent results. For a successful outcome, the affected animal must undergo a thorough examination to determine if he is a good surgical candidate. Diabetic animals that are not regulated, aggressive animals that are difficult to treat daily, or animals in poor or failing health, are not good surgical candidates

Persistent Pupillary Membranes:

Persistent pupillary membranes, or PPMs as they are often called are common findings on CERF examinations. They may or may not be a problem in a breed and/or individual dogs. PPMs are remnants of a fetal structure called the pupillary membrane. This membrane covers the pupil before an animal is born. It is part of the blood supply to the developing lens (the structure in the eye that focuses light on the retina). Normally the pupillary membrane completely absorbs before birth in foals and calves but is partially present and continues to disappear in neonatal dogs. Absorption may not be complete in puppies when the eyes first open and small strands or a web-like structure may be seen across the pupil. These strands normally disappear by four to five weeks of age. In some dogs these strands do not disappear and become PPMs.

PPMs may be found in several configurations in the anterior chamber. They may span across the pupil (iris to iris), from the iris to the lens, from the iris to the cornea, or they may float free on one end, only connected to the iris. In general, iris to iris PPMs cause no problems. They may be single strands or a forked structure. These PPMs may break and become less prominent as the puppy gets older, but they usually do not disappear completely. Iris to lens PPMs are more problematical. These PPMs cause opacities (cataracts) at the point where they are attached to the lens capsule. The cataracts do not usually progress and cause only minor visual deficits. Iris to cornea PPMs cause opacities on the cornea due to their ability to damage the corneal endothelium (the inner lining of the cornea). These opacities may be small or may be severe due to the development of corneal edema (fluid in the cornea). Severely affected puppies (with numerous strands) may be blind (they may improve as they get older). The strands may regress but do not disappear.

PPMs are found in many breeds of dog. In most of these breeds, iris to iris PPMs are classified by CERF as a “breeder option” problem. This means that most of the PPMs which have been reported in these breeds have been small and are probably sporadically occurring and not hereditary defects. Dogs with these small iris to iris PPMs who have been bred have not been reported to have puppies with vision problems. This does not mean that problems will never occur in these breeds. Owners with dogs diagnosed with PPMs should be aware of the situation and should probably either not breed affected dogs or should breed the affected dogs only to unaffected dogs.

Progressive Retinal Atrophy (PRA):

There are multiple forms of PRA which differ in the age of onset and rate of progression of the disease. Some breeds experience an earlier onset than others; other breeds do not develop PRA until later in life.

Normally, the photoreceptors in the retinas develop after birth to about 8 weeks of age. The retinas of dogs with PRA either have arrested development (retinal dysplasia) or early degeneration of the photoreceptors. Retinal dysplastic dogs are usually affected within two months of birth and may be completely blind by one year. Dogs with retinal degeneration are affected from one year to eight years of age and the symptoms progress slowly.

PRA worsens over time. The affected animal experiences night blindness initially because the rods are affected first. The condition progresses to failed daytime vision.

Signs may vary depending on the type of PRA and its rate of progression. PRA is non painful and outward appearance of the eye is often normal, i.e.; no redness, excess tearing, or squinting. Owners may notice a change in personality of their dog such as a reluctance to go down stairs or down a dark hallway. This is characteristic of night blindness, in which vision may appear to improve during the daytime. As the disease progresses, owners can observe a dilation of the pupils and the reflection of light from the back of the eye. If the blindness is progressing slowly, the owner may not notice any signs until the dog is in unfamiliar surroundings and the lack of vision is more apparent. In some animals, the lens of the eyes may become opaque or cloudy.

Depending on the form of PRA, characteristic changes in the retina and other parts of the eye may be observed through an ophthalmic examination by a veterinary opthalmologist. More sophisticated tests such as electroretinography may also be used. Both tests are painless and the animal does not have to be anesthetized. If no abnormalities are found during the exam by a board certified veterinary ophthalmologist, the dog can be certified free of heritable eye disease through the Canine Eye Registration Foundation (CERF).

Unfortunately, there is no treatment for PRA, nor a way to slow the progression of the disease. Animals with PRA usually become blind. Dogs are remarkably adaptable to progressive blindness, and can often seem to perform normally in their customary environments. Evidence of the blindness is more pronounced if the furniture is rearranged or the animals are in unfamiliar surroundings.

In the last several years, DNA testing is being used to identify which genes are responsible for PRA. DNA testing for PRA is available for PWD’s through http://www.optigen.com.

GM1 gangliosidosis – storage disease:

In affected Portuguese Water dogs, clinical signs of GM1 are typically observed at around 4 to 5 months of age. In most cases, the disease is clinically manifested as a neurodegenerative disorder. Common signs of disease include vision problems, lethargy, difficulty walking, and death in a period of approximately 8 months to 1 year of age.

GM1 gangliosidosis in Portuguese Water dogs shows an autosomal recessive mode of inheritance; therefore two copies of the defective gene, one inherited from each parent, have to be present for a dog to be affected by the disease. Dogs with one copy of the defective gene and one copy of the normal gene – called carriers – show no symptoms but can pass the defective gene onto their offspring.

A blood test for the diagnosis of GM1 gangliosidosis was developed in the late 1980’s and has been the most accurate method of detection of the disorder until recently. This test allowed the detection of dogs affected by GM1 gangliosidosis but failed to detect carriers of this disease since they display no clinical symptoms. Recently, a PCR–based assay for the detection of GM1 gangliosidosis in Portuguese Water dogs became available. This test implements the most recent advancements in molecular diagnostics by selectively targeting the gene associated with GM1 gangliosidosis. Using the PCR, this gene can be detected, amplified, and analyzed to determine whether a dog is affected (homozygous recessive) or a carrier of the disease. Since the gene for GM1 gangliosidosis is directly targeted by this method, results are 100% accurate.

Juvenile Dilated Cardiomyopathy (JDCM):

JDCM is a rare, fatal condition caused by an autosomal recessive gene. It affects young puppies between the ages of 6 and 27 weeks, who succumb to heart failure before reaching adulthood.

It is characterized by an enlarged heart and hepatic congestion. Seemingly healthy puppies suddenly develop anorexia, lethargy, rapid breathing and sometimes vomiting which results in death. As a simple recessive gene, it had been difficult to identify and was particularly heartbreaking as seemingly healthy puppies would suddenly die, often shortly after joining their adopted families.

Since a recessive gene is responsible, that means if at least one parent is “normal” (that is, it does not carry a copy of the cardio version of the gene), its offspring can not contract the disease. We now have a genetic marker test to identify carriers.

Orthopedic – Canine Hip Dysplasia:

To understand hip dysplasia we must have a basic understanding of the joint that is being affected. The hip joint forms the attachment of the hind leg to the body and is a ball and socket joint. The ball portion is the head of the femur while the socket (acetabulum) is located on the pelvis. In a normal joint the ball rotates freely within the socket. To facilitate movement the bones are shaped to perfectly match each other; with the socket surrounding the ball. To strengthen the joint, the two bones are held together by a strong ligament. The ligament attaches the femoral head directly to the acetabulum. Also, the joint capsule, which is a very strong band of connective tissue, encircles the two bones adding further stability. The area where the bones actually touch each other is called the articular surface. It is perfectly smooth and cushioned with a layer of spongy cartilage. In addition, the joint contains a highly viscous fluid that lubricates the articular surfaces. In a dog with normal hips, all of these factors work together to cause the joint to function smoothly and with stability.

Hip dysplasia is associated with abnormal joint structure and a laxity of the muscles, connective tissue, and ligaments that would normally support the joint. As joint laxity develops, the articular surfaces of the two bones lose contact with each other. This separation of the two bones within the joint is called a subluxation, and this causes a drastic change in the size and shape of the articular surfaces. Most dysplastic dogs are born with normal hips but due to their genetic make-up (and possibly other factors) the soft tissues that surround the joint develop abnormally causing the subluxation. It is this subluxation and the remodeling of the hip that leads to the symptoms we associate with this disease. Hip dysplasia may or may not be bilateral; affecting both the right and/or left hip.

Dogs of all ages are subject to hip dysplasia and the resultant osteoarthritis. In severe cases, puppies as young as five months will begin to show pain and discomfort during and after exercise. The condition will worsen until even normal daily activities are painful. Without intervention, these dogs may eventually be unable to walk. In most cases, however, the symptoms do not begin to show until the middle or later years in the dog’s life.

The symptoms are similar to those seen with other causes of arthritis in the hip. Dogs often walk or run with an altered gait. They may resist movements that require full extension or flexion of the rear legs. Many times, they run with a ‘bunny hopping’ gait. They will show stiffness and pain in the rear legs after exercise or first thing in the morning. They may also have difficulty climbing stairs. In milder cases dogs will warm-up out of the stiffness with movement and exercise. Some dogs will limp and many will become less willing to participate in normal daily activities. Many owners attribute the changes to normal aging but after treatment is initiated, they are surprised to see a more normal and pain-free gait return. As the condition progresses, most dogs will lose muscle tone and may even need assistance in getting up.

Genetics: Researchers agree that hip dysplasia is a genetic disease. If a parent has hip dysplasia, then the animal’s offspring are at greater risk for developing hip dysplasia. If there are no carriers of hip dysplasia in a dog’s lineage, then it is highly unlikely he will not contract the disease. If there are genetic carriers, then he may contract the disease. We can greatly reduce the incidence of hip dysplasia through selective breeding. We can also increase the incidence through selectively breeding. We cannot, however, completely reproduce the disease through selective breeding. In other words, if you breed two dysplastic dogs, the offspring are much more likely to develop the disease but the offspring will not all have the same level of symptoms or even necessarily show any symptoms. The offspring from these dogs will, however, be carriers and the disease will most likely show up in their offspring in later generations. This is why it can be challenging to eradicate the disease from a breed or specific breeding line.

Nutrition: It appears that the amount of calories a dog consumes and when in the dog’s life those calories are consumed have the biggest impact on whether or not a dog genetically prone to hip dysplasia will develop the disease.

Experimentally, it has been shown that obesity can increase the severity of the disease in genetically susceptible animals. It stands to reason that carrying around extra weight will exacerbate the degeneration of the joints in a dog; including the hip. Dogs that may have been born genetically prone to hip dysplasia and are overweight are therefore at a much higher risk of developing hip dysplasia and eventually osteoarthritis.

Another factor that may increase the incidence of hip dysplasia is rapid growth in puppies during the ages from three to ten months. Experimentally, the incidence has been increased in genetically susceptible dogs when they are given free choice food. In one study, Labrador Retriever puppies fed free choice for three years had a much higher incidence of hip dysplasia than their littermates who were fed the same diet but in an amount that was 25% less than that fed to the free-choice group.

Feeding a diet that has too much or too little calcium or other minerals can also have a detrimental effect on the development of the hip joint. However, with today’s complete and balanced dog foods this has become a rare occurrence. The practice of feeding home-made dog foods is popular with some dog owners. These diets must be carefully monitored for proper nutritional balance; not only for calcium and the other essential minerals but for all nutrients.

Exercise: Exercise may be another risk factor. It appears that dogs that are genetically susceptible to the disease may have an increased incidence of disease if they over-exercised at a young age. But at the same time, we know that dogs with large and prominent leg muscle mass are less likely to contract the disease than dogs with small muscle mass. So, exercising and maintaining good muscle mass may actually decrease the incidence of the disease. Moderate exercise that strengthens the gluteal muscles, such as running and swimming, is probably a good idea. Whereas, activities that apply a lot of force to the joint are contraindicated. An example would be jumping activities such as playing Frisbee.

OFA: The method used by the Orthopedic Foundation for Animals (OFA) has been the standard for many years. The OFA was established in 1966, and has become the world’s largest all-breed registry. The OFA maintains a database of hip evaluations for hundreds of thousands of dogs. Radiographs are taken by a local veterinarian using specific guidelines and are then submitted to the OFA for evaluation and certification of the dog’s hip status. Since the accuracy of radiological diagnosis of hip dysplasia using the OFA technique increases after 24 months of age, the OFA requires that the dog be at least two years of age at the time the radiographs are taken. Because some female dogs experience additional hip subluxation when they are in heat, pregnant or nursing the OFA recommends that the evaluation should not be performed during these times.

The radiographs are reviewed by three radiologists and a consensus score is assigned based on the animal’s hip conformation relative to other individuals of the same breed and age. The OFA then places the evaluated dogs into one of seven categories. Normal hips are graded as: excellent, good or fair. If the consensus is unclear the dog is graded as borderline dysplastic. And dogs with obvious radiographic signs of hip dysplasia are graded as: mild, moderate, severely dysplastic. Dogs with hips scored as borderline or dysplastic (mild, moderate, severe) are not eligible to receive OFA breeding numbers.

PennHIP: The diagnostic method used by the University of Pennsylvania Hip Improvement Program (PennHIP) uses unique radiographic views of the dog’s hips to more accurately identify and quantify joint laxity. This program was conceived in 1983 and became a usable system by 1993. To assure quality and repeatability among diagnostic centers using the PennHIP technique, veterinarians must take a special training course to become certified. Radiographs of the hips are taken with the dog under heavy sedation. These radiographs can be taken on a dog as young as 16 weeks. Two views are obtained with the hind limbs in neutral position to maximize joint laxity. These are known as the distraction and compression radiographic views. Weights and an external device are used to help push the head of the femur further into or away from the acetabulum. The amount of femoral head displacement (joint laxity) is quantified using a distraction index or DI. The DI ranges from 0 to 1 and is calculated by measuring the distance the center of the femoral head moves laterally from the center of the acetabulum and dividing it by the radius of the femoral head. A DI of 0 indicates a very tight joint. A DI of 1 indicates complete luxation with little or no coverage of the femoral head. A hip with a distraction index of 0.6 is 60% luxated and is twice as lax as a hip with a DI of 0.3. A third radiographic view is taken using the same positioning as the OFA. The “hip-extended” view is used to obtain additional information regarding the possible presence of degenerative joint disease (DJD) in the hip.

When the PennHIP DI was compared to the OFA scores for 65 dogs, all dogs scored as mildly, moderately, or severely dysplastic by the OFA method had a DI above 0.3.

Hip laxity as measured by the DI is strongly correlated with the future development of osteoarthritis. Hips with a DI below 0.3 rarely develop osteoarthritis. Although hips with a DI above 0.3 are considered “degenerative joint disease susceptible,” not all hips with a DI greater than 0.3 will develop osteoarthritis. It is known that some hips with radiographically apparent laxity do not develop osteoarthritis. A means of differentiating lax hips that develop osteoarthritis from those that will not is important in developing a prognosis and making treatment or breeding recommendations. In one study, the DI obtained from dogs at four months of age was a good predictor of later osteoarthritis, though the 6 and 12-month indices were more accurate.The PennHIP method has gained popularity and more and more veterinarians are becoming certified.

There are several surgical procedures available to treat hip dysplasia depending on the dog’s age, body size, and the severity of the hip joint’s degeneration.

Triple Pelvic Osteotomy (TPO): TPO is a procedure used in young dogs usually less than 10 months of age that have radiographs that show severe hip laxity, but have not developed damage to the joints. The procedure involves surgically breaking the pelvic bones and realigning the femoral head and acetabulum restoring the weight-bearing surface area and correcting femoral head subluxation. This is a major surgery and is expensive, but the surgery has been very successful on animals that meet the requirements.

Juvenile Pubic Symphysiodesis: A less invasive surgery for treating hip dysplasia is called Juvenile Pubic Symphysiodesis. This surgery prematurely fuses two pelvic bones together, allowing the other pelvic bones to develop normally. This changes the angle of the hips and improves the articulation of this joint, lessening the likelihood of osteoarthritis. Early diagnosis is critical, since the procedure must be done before 20 weeks of age, preferably 16 weeks, and before any signs of arthritis are evident.

Total Hip Replacement: This may be the best surgical option for dogs that have degenerative joint disease as a result of chronic hip dysplasia. Total hip replacement is a procedure that can produce a functionally normal joint, eliminate degenerative changes, and alleviate joint pain. The procedure involves the removal of the existing joint and replacing it with an artificial joint or prosthesis. To be a candidate for this procedure, the animal must be skeletally mature. With the new micro-prosthetics there is no minimum size limit. In addition, there is no maximum size limit. If both hips need to be replaced, there is a three-month period of rest recommended between the surgeries. As with the TPO surgery, this is an expensive procedure but it produces very good results. Most dogs return to a near normal level of activity without pain.

Femoral Head and Neck Excision: Femoral head and neck excision is a procedure in which the head of the femur is surgically removed and a fibrous pseudo-joint replaces the hip. This procedure is considered a salvage procedure and is used in cases where degenerative joint disease has occurred and total hip replacement is not feasible or if the expense of a total hip replacement is prohibitive. The resulting pseudo-joint will, in most cases, be free from pain and allow the animal to increase his activity, however, full range of motion and joint stability are decreased. For best results, the patient should weigh less than 40 pounds; however, the procedure may be performed on larger dogs.

Because of the high cost involved with corrective surgeries, medical management is many times the only realistic option for pet owners. Medical management is multifaceted. For the best results, several of the following modalities should be instituted.

Weight Management: Helping a dog maintain his recommended weight may be the single most important thing owner scan do for their pets. Surgical procedures and medical therapies will be far more successful if the animal is not overweight. You, as the owner, have control over what your dog eats. If you feed a quality food in an amount appropriate for your dog’s size, breed and activity level and keep treats to a minimum, your dog should be able to maintain an ideal weight. Considering that more than half of the pets in the U.S. are overweight, there is a fair chance that many of the dogs with hip dysplasia/osteoarthritis are also overweight.

Exercise: Exercise is equally important in losing and/or maintaining the appropriate weight. Exercise that provides good range of motion and muscle building as well as limiting wear and tear on the joints is best. Leash walks, swimming, walking on treadmills, and slow jogging are excellent low-impact exercises. Bear in mind that an exercise program needs to be individualized for each dog based on the severity of the osteoarthritis, his weight, age, and physical condition. In general, too little exercise can be more detrimental than too much, however the wrong type of exercise can actually cause harm. While playing Frisbee can be very enjoyable and fun for the dog, it is extremely hard on his joints.

Remember, it is important to exercise daily; only exercising on weekends, for example, may cause more harm than good. Regular exercise in shorter sessions is always better than long work-outs on weekends. Warming the muscles prior to exercise and following exercise with a “warm-down” period are beneficial. Consult with your veterinarian regarding an exercise program appropriate for your dog.

Warmth and good sleeping areas: Most people with arthritis find that the symptoms tend to worsen in cold, damp weather. Keeping your pet warm, may help him be more comfortable. A pet sweater will help keep joints warmer. In addition, you may want to consider keeping the temperature in your home a little warmer.

Providing an orthopedic foam bed helps many dogs with arthritis. Beds with dome-shaped, orthopedic foam distribute weight evenly and reduce pressure on joints. They are also much easier for the pet to get out of. Place the bed in a warm spot away from drafts.

Massage and physical therapy: Your veterinarian or the veterinary staff can show you how to perform physical therapy and massage on your dog to help relax stiff muscles and promote a good range of motion in the joints. Remember, your dog is in pain, so start slowly and build trust. Begin by petting the area and work up to gently kneading the muscles around the joint with your fingertips using small, circular motions. Gradually work your way out to the surrounding muscles. Moist heat may also be beneficial.

Making daily activities less painful: Going up and down stairs is often difficult for arthritic dogs; it can make going outside to urinate and defecate very difficult. Many people build or buy ramps, especially on stairs leading to their yard, to make it easier for their dogs to go outside.

Oral Supplements

Glucosamine and Chondroitin: Glucosamine and chondroitin are two compounds that have been widely used to help manage osteoarthritis in both animals and humans.

Glucosamine is the major sugar found in glycosaminoglycans and hyaluronate, which are important building blocks in the synthesis and maintenance of joint cartilage in the joint. Chondroitin enhances the synthesis of glycosaminoglycans and inhibits damaging enzymes within the joint.

When a dog has hip dysplasia, the joint wears abnormally and the protective cartilage on the surface of the joint gets worn away and the resultant bone-to-bone contact creates pain. Glucosamine and chondroitin give the cartilage-forming cells (chondrocytes) the building blocks they need to synthesize new cartilage and to repair the existing damaged cartilage. These products are not painkillers; they work by actually healing the damage that has been done. These products generally take at least six weeks to begin to help heal the cartilage and most animals need to be maintained on these products the rest of their lives. These products are safe and show very few side effects. There are many different glucosamine/chondroitin products on the market, but they are not all created equal. Drs. Foster and Smith’s line of Joint Care products or Cosequin are recommended.

Perna Mussels: Perna canaliculus, or green-lipped mussel, is an edible shellfish found off the shores of New Zealand. The soft tissue is separated from the shell, washed several times, frozen, and freeze-dried. It is then processed into a fine powder and added to joint care products. It is made up of 61% protein, 13% carbohydrates, 12% glycosaminoglycans (GAGs-an important component of connective tissue), 5% lipids, 5% minerals, and 4% water. It also contains glucosamine, a GAG precursor and one of the building blocks of cartilage. Glucosamine and GAGs are the compounds in the mussel believed to contribute to its beneficial effects.

Omega-3 Fatty Acids: Omega-3 fatty acids are often used for the management of the signs of atopy in dogs. Because of their anti-inflammatory properties, some have advocated their use in dogs with osteoarthritis.

Avocado/Soybean Unsaponifiables (ASUs): ASU’s are an extract of avocados and soybeans. There is some very promising research that indicates that ASU’s can help protect cartilage, support cartilage repair, and decrease the discomfort associated with osteoarthritis. ASU’s are thought to enhance the action of glucosamine and chondroitin.

Duralactin: Duralactin is a patented product obtained from the milk of grass-fed cows. It has been studied and marketed for the management of musculoskeletal disorders in dogs. This compound has anti-inflammatory properties and is available without a prescription.

It may be used as a primary supportive nutritional aid to help manage inflammation or in conjunction with non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids.

Methyl-sulfonyl-methane (MSM): MSM is a natural, sulfur-containing compound produced by kelp. Sulfur is necessary for the production of collagen, glucosamine, and chondroitin. MSM is reported to enhance the structural integrity of connective tissue, and help reduce scar tissue by altering components that contribute to scar formation. MSM has been promoted as having powerful anti-inflammatory and pain reducing properties, and is thought to work by blocking the pain perception in certain nerve fibers before the pain impulse reaches the brain.

Anti-inflammatory Drugs:

Carprofen (Rimadyl), etodolac (EtoGesic), deracoxib (Deramaxx), firocoxib (Previcox), tepoxalin (Zubrin) meloxicam (Metacam): These are non-steroidal anti-inflammatory drugs (NSAIDs) developed for use in dogs with osteoarthritis. They are very effective painkillers that also reduce inflammation. They are prescription products and because of potential side effects, careful adherence to dosing quantity and frequency must be followed. The manufacturers recommend that patients taking these medications have a thorough physical examination along with appropriate blood-work (especially tests for liver health) performed before starting these medications. In addition, patients taking these products should be periodically monitored to make sure that they are tolerating the medication. These products are often used initially with glucosamine therapy and then as the glucosamine product begins to work, the NSAID dose may be reduced or even eliminated. NSAID’s (including aspirin) should never be combined unless directed by your veterinarian. Acetaminophen (Tylenol), and ibuprofen (Advil) have many potential side effects and are not recommended without veterinary guidance.

Buffered Aspirin: Buffered aspirin is also an anti-inflammatory and painkiller used in dogs. It can be used along with glucosamine/chondroitin products. With all aspirin products used in dogs, there is a risk of intestinal upset or in rare cases, gastric ulceration. Using buffered aspirin formulated for dogs makes dosage and administration much easier. Do NOT give your cat aspirin unless prescribed by your veterinarian.

Corticosteroids: Corticosteroids have been used for many years to treat the pain and inflammation associated with osteoarthritis, however, their use is controversial. Corticosteroids act as a potent anti-inflammatory, but unfortunately, they have many undesirable short and long-term side effects. Because of these side effects and the advent of newer, more specific drugs, corticosteroids are generally only used in older animals with flare-ups where all other pain control products have failed. Corticosteroids are a prescription product and come in both a pill and injectable form.

When it comes to preventing hip dysplasia, there is only one thing that researchers agree on; selective breeding is crucial. We know that through selectively breeding animals with certified hips, we can significantly reduce the incidence of hip dysplasia. We also know that we can increase the incidence of hip dysplasia if we choose to use dysplastic animals for breeding. Breeding two animals with excellent hips does not guarantee that all of the offspring will be free of hip dysplasia, but there will be a much lower incidence than if we breed two animals with fair or poor hips. If we only bred animals with excellent hips it would not take long to make hip dysplasia a rare occurrence.

Seizure:

There are many, many causes of seizures. Epilepsy is the most common and of least consequence to the dog. The other extreme includes severe diseases such as brain tumors. Fortunately, most are due to epilepsy.

Seizures are one of the most frequently seen neurological problems in dogs. A seizure is also known as a convulsion or fit. It may have all or any combination of the following:

Loss or derangement of consciousness, Contractions of all the muscles in the body, Changes in mental awareness from non-responsiveness to hallucinations, Involuntary urination, defecation, or salivation, Behavioral changes, including non-recognition of owner, viciousness, pacing, and running in circles.

There are three phases of a seizure:

Pre-ictal phase: The pre-ictal phase, or aura, is a period of altered behavior in which the dog may hide, appear nervous, or seek out the owner. It may be restless, nervous, whining, shaking, or salivating. This may last a few seconds to a few hours.

Ictal phase: The ictal phase is the seizure itself and lasts from a few seconds to about 5 minutes. During this period, all of the muscles of the body contract strongly. The dog usually falls on its side and seems paralyzed while shaking. The head will be drawn backward. Urination, defecation, and salivation often occur. If it is not over within 5 minutes, the dog is said to be in status epilepticus or prolonged seizure.

Post-ictal: During the post-ictal phase, there is confusion, disorientation, salivation, pacing, restlessness, and/or temporary blindness. There is no direct correlation between the severity of the seizure and the duration of this phase.

Despite the dramatic signs of a seizure, the dog feels no pain, only bewilderment. Dogs do not swallow their tongues. If you put your fingers into its mouth, you will do no benefit to your pet and will run a high risk of being bitten very badly. The important thing is to keep the dog from falling and hurting itself. As long as it is on the floor or ground, there is little chance of harm occurring. If seizures continue for longer than a few minutes, the body temperature begins to rise. If hyperthermia develops secondary to a seizure, another set of problems may have to be addressed.

When a seizure occurs, we begin by taking a thorough history concentrating on possible exposure to poisonous or hallucinogenic substances or history of head trauma. We also perform a physical examination, a basic battery of blood tests, and an electrocardiogram (EKG). These tests rule out disorders of the liver, kidneys, heart, electrolytes, and blood sugar level. If these tests are normal and there is no exposure to poison or recent trauma, further diagnostics may be performed depending on the severity and frequency of the seizures. Occasional seizures are of less concern than when the seizures are becoming more severe and frequent. In this instance, a spinal fluid tap and fluid analysis may be performed. Depending on availability, specialized imaging of the head MRI may be performed. Fortunately, these additional tests are usually not needed.

Treatment is determined by how long it takes for another seizure to occur. That may be days, months, or years. At some point, many dogs have seizures frequently enough to justify continuous anticonvulsant therapy. Since that means that medication must be given every 12 to 24 hours for the rest of the dog’s life, medication is not recommend until seizures occur about every 30 days or unless they last more than 5 minutes.

It is important to avoid sudden discontinuation of any anticonvulsant medication. Even normal dogs may be induced to seizure if placed on anticonvulsant medication and then abruptly withdrawn from it. If there are no seizures for a significant period of time we can try to decrease and if possible even discontinuing the medication. This should only be done with veterinary supervision.

Status epilepticus bears special note. It is characterized by a seizure that lasts more than 5 minutes. When it occurs, the dog’s life is endangered. Unless intravenous medication is given promptly, the patient may die. If this occurs, you should seek emergency treatment by a veterinarian immediately.


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