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Wednesday, June 29, 2016

Happy "Make Dogs Freak Out" Day

In a few days the United States of America will celebrate it's 240th birthday.  July 4th is a day of celebration, barbecues, and fireworks.  Lots and lots of fireworks.  While we see some similar noise-making celebrations on Memorial Day and New Year's Eve, Independence Day is by far the most associated with big, noisy explosions in the sky.

At these times we see an abundance of noise-related anxiety in dogs.  While most dogs seem to do okay when fireworks are bursting outside, some have a serious problem with the explosions.  This can range from trembling and hiding under the bed to becoming destructive in their attempts to find a way to escape the noise.  

I was reminded of the upcoming holiday today when I was inundated with requests from clients for medications to help their dogs through the fireworks.  I had to authorize drugs for five different patients, which is about the same number that I've approved for the first six months of this year.  It's obvious that we have many patients that freak out when the fireworks start shooting off.

Joking aside, this can be a serious source of anxiety for many dogs.  Products such as Thundershirt and Storm Defender actually can work well in many patients with noise phobias.  I'm also a big believer in Dog Appeasing Pheromone, found in Adaptil and Comfort Zone.  All of these options are nice because they're readily available from pet suppliers, and will work without side effects.

For dogs who still suffer from severe anxiety despite using the above products, prescription medications are often necessary.  Historically many vets have relied on sedatives such as acepromazine or even diphenhydramine (Benadryl).  These drugs are not recommended by behavioral specialists because they don't actually remove the anxiety.  Instead, they make the dog sleepy enough that they can't act on the anxiety.  Your dog will still feel fearful, but they will be too sedated to do anything about it.

The most common anti-anxiety medications used for noise phobias are alprazolam and trazadone.  Both act rapidly, without the need for weeks of use before becoming effective.  They have a decent length of action, from around four to eight hours.  Personally I lean towards alprazolam, but many vets prefer trazadone.  Either one can be effective and may be necessary.

Very recently a new product came on the market for noise phobias, an oral gel called Sileo.  The chemical compound is dexmedotomidine, which is most commonly used as an injectable sedative.  Earlier today I did a little searching on this medication, and the impression I have come away with is that it isn't a very effective product.  At least two board-certified behavioral specialists stated on the Veterinary Information Network that they hadn't seen much of an effect on improving anxiety in dogs using the product, and they wouldn't recommend it for routine use.  My practice doesn't carry Sileo, and from what I've read about it so far I'm not impressed or eager to recommend it.

If your dog suffers from fear and anxiety related to fireworks or thunderstorms, find a vet who has some advanced skills in animal behavior and seek their advice.  Don't rely on sedatives that only mask the problem while still allowing your dog to feel anxious.

Saturday, June 25, 2016

Gimli's Guide To Bulldogs: Puppy Alarm Clocks

I've been asked many times by many people if I allow guest writers to contribute to my blog.  Since this is a personal and not a professional blog, I've always declined their offers.  However, for the first time ever I'm allowing a guest writer to contribute regularly to my blog.  I hope you enjoy!


Hai!  My name iz Gimli and I iz a bulldog puppy.  Mai new daddy sed that I shood tell everyone about bulldogz from mai purspective.  So thatz what Im gonna do!


Puppys need lotz of sleep.  I think I sleep about 20 hourz a day.  And I love to play teh rest of teh time!  But mostly I sleepz.



I like to sleep for a few hourz then wake up and let everybody know I wantz to play.  Daddy keepz me downstairz so I have to barkz really loud for him to hear me.  He sleepz really deep, so sometimez I haz to bark for a long time before he comez down to me.  When he openz mai kennel I iz soooooooo happy to see him!  I start to run, play, and bitez hiz toez, but he alwayz iz so grumpy when itz dark.  Daddy sayz something about "3 o-clock in teh morning".  But den a few hourz later wen I bark again he sayz "6 o-clock in teh morning".  Doz he really needz to sleep for 7 or 8 hours in a row?  Datz weird.

Puppyz like me sleepz for a few hours then we needz to go potty.  I barked and barked to let him know I hadz to go outside, but I pooped some in mai kennel when he didnt come fast enough.  I only stepped in it a little, but he made me take a bath.  Daddy waz growling about "5 o-clock in teh morning" when he didz it.  I wuz sorry cuz he waznt happy.  But he still gave me a kiss before he putz me back in mai kennel.  

Mai new Mommy said to Daddy "Happy Fadder's Day.  Hope you like yur new alarm clock."  I didnt understand why Daddy looked at me and laffed.  

Wednesday, June 22, 2016

The Importance Of Pet Adoption

Recently I posted about the new addition to my family, an English bulldog puppy that we have named Gimli.  One of my readers, Kelly, emailed me with a great and thoughtful question.  I had purchased a pure breed dog, which is fine when using a respectable breeder, but what about the pets who were in shelters and need adoption?  I thought this was an important point to bring up, and I want to address it.

I am a huge supporter of shelters.  In fact, when people mention that they may be getting a new pet I always direct them towards shelters and rescue organizations first.  Even if someone wants a pure breed dog I will let them know that they can find these in shelters and that there are rescue organizations that focus specifically on a given breed.  People really should start with a shelter and should seriously consider an adult dog rather than a puppy.

My own journey started in this way.  Earlier this year one of my local shelters was fostering an adult female English bulldog.  I immediately became interested in her and talked to them more about her.  She was overall healthy but was positive for heartworms.  Even so I really considered adopting her and was prepared to treat the heartworms as her new owner.  We took her home for a few days to see if she would fit with our family, especially our other dogs.  Unfortunately it didn't work out as she tried to aggressively bite the other dogs on a few occasions.  She was great with people, but not so good with other dogs.  I had to call the shelter and let them know that we couldn't keep her.

At that point I was really in the mindset to get a bulldog.  I checked PetFinder.com and some bulldog rescue groups, but couldn't find one that really caught my eye.  I was looking to have a family pet, not just to rescue a dog out of a hard situation.  I wanted a dog that could really mesh with our family.  

It was after the shelters didn't pan out that I started looking for a breeder.  I found several, talked to them, and decided on one that I thought was being extremely responsible.  For example, she only breeds her dogs every other year, only has a few litters each, and once they are retired from breeding she has them spayed and keeps them as family pets.  She is the kind of breeder I really love working with.

We have two other dogs besides Gimli.  Yvaine is a yellow lab, and yes, she's a purebred.  My wife really, really loves yellow labs so we again went to a good quality breeder to find one.  Our other dog, Inara, is a lab/husky mix that we got from a local shelter.  When we saw her we were looking for another dog to add to our family, and one that would be more for the kids.

Our previous dogs included another purebred yellow lab (who died from cancer at a young age) and a long-haired chihuahua that we adopted from a foster home that couldn't keep him.  Out of the five dogs I've owned as an adult, two were rescued and three were from breeders.  The only reason we used breeders is that we had very specific desires for a particular breed, coloration, and personality.  Otherwise I would only get dogs from shelters.

Why is it so important to adopt pets from shelters?  Millions are euthanized every year in the US and these dogs and cats are in desperate need for homes.  By looking at a shelter you can find a companion that otherwise might go homeless or die, get one cheaper than through a breeder, and help give a pet a forever home.  To give you an idea of the numbers, here is an infographic created by Orvis.com and the Petfinder Foundation.


Pet Adoption: The Numbers Behind the Need


Personally I will always have one Labrador retriever and hopefully one English bulldog, simply because I love the breeds.  Any other dog I own will be from a shelter or rescue group.

Sunday, June 19, 2016

Can Pets With Heart Murmurs Have Dental Cleanings?

Whenever I diagnose a pet with a heart murmur there is inevitably a moment of panic from the client.  The phrase "heart murmur" brings to mind serious disease and the potential for cardiac failure.  But truthfully it doesn't have to be really frightening, and in many cases doesn't need any kind of treatment.  Yes, they can even have anesthesia for dental cleanings!

What is a heart murmur?  There are valves between the chambers of the heart that keep the blood flowing in one direction.  If the valves don't close properly some of the flood can flow backwards.  In severe cases this can cause stretching of the heart chambers, abnormal wear on the walls of the vessels, fluid accumulation, and eventually heart failure.

Thankfully most murmurs in dogs are mild and don't cause serious problems.  Yes, the blood may not be flowing absolutely normally and there is indeed a problem with the heart, but functionally everything is fine.  Most of my patients with heart murmurs don't have to be on any kind of medication.

Anesthesia is only dangerous in these cases if there are physical changes to the structure of the heart.  An ultrasound (echocardiogram) is the best way to tell details of heart changes as the sonographer can see the abnormal valve and measure the size of the chambers and thickness of their walls.  But most vets still don't have ultrasound machines, and it can cost several hundred dollars to have it done at a specialist.

One of the best ways to assess the heart is a simple x-ray of the chest.  This is something any vet can do in their office.  Even veterinary cardiology specialist say that while doing both radiographs and ultrasound is the best choice, if a client can only do one they should chose the x-rays.  If the heart and lungs are normal on the x-rays there aren't significant enough changes to make anesthesia highly risky.

If the dog has significant periodontal disease the risks of this disorder outweigh an "innocent" murmur that isn't affecting the heart's function.  Many pet owners don't realize it, but dental infection can be a serious health concern, leading to problems with bone infection, liver disease, kidney disease, heart disease, and even an increased risk of diabetes.  Heavy dental calculus, gingivitis, gum recession, and loose teeth are never normal and should never be taken casually.

All of that being said, there are precautions that you should take when anesthetizing a dog with a heart murmur.  In my practice we use different anesthetic drugs in these patients than we would in an otherwise healthy pet.  We also use ECG, blood pressure, and blood oxygen monitoring in every anesthesia case so that we can keep track of any concerns in heart function before it becomes critical or life-threatening.

If your vet says "She has a heart murmur so she can't have anesthesia", and they haven't done any testing, honestly I would get a second opinion.  I have many patients who have had murmurs for years and still get an annual dental cleaning under anesthesia, never having any problems whatsoever.  We certainly want to be cautious in these cases and do more of a work-up than in a healthy pet, but a murmur doesn't automatically mean that anesthesia is unsafe.


Thursday, June 16, 2016

Welcome To Gimli

When I was 14 years old I started working for a local veterinarian, beginning in the kennels and working my way up through the rest of the clinic.  I stayed with that vet for about 13 years, up through graduating from vet school.  Dr. John Strasser was an incredible vet, businessman, and mentor who has influenced me as a vet and a leader.  But he influenced me in other ways.  You see, Dr. Strasser bred English bulldogs.  He is still known and respected for his knowledge and skills with the breed.  Growing up working for him I also gained a love for bulldogs, and have kept that love ever since.

For the last 30 years I have dreamed of having my own bulldog.  But as expensive as they are it simply hasn't happened.  At least, until now.

A few days ago I picked up our new addition, a nine week old puppy that we have named Gimli.  Being a big geek family, we couldn't pick a typical pet name.  For many years I had debated in my mind what I would name a bulldog, and the dwarf from The Lord of the Rings seemed like perfect inspiration.  Outwardly Gimli is short, stocky, strong, and gruff.  But all of that covers a truly caring, soft interior.  Sounds like a bulldog, right?

Here is Gimli as portrayed by the incredible John Rhys-Davies.


And here is our own little Gimli.





Yes, as a veterinarian I know exactly what I'm in for and the plethora of medical conditions this breed can have.  But I was ready for that after having been around this breed for three decades and having seen the best and worst cases.  But even so I can't help loving these little butterballs.  They are so ugly they're adorable, and they usually have the best personalities.

Of course we're having to go through the typical puppy situations.  We're working on housebreaking, getting the other pets used to him, and dealing with him wanting to chew on things.  The hardest part is that he has the idea that 6:00 am is the perfect time to get up and start barking, and he won't settle down after that.  I'm definitely not a morning person, and his wakeup time is about 90 minutes earlier than my typical one.

Even with all of the new puppy issues, I couldn't be happier.  This is a dream come true, and something I've wanted for the majority of my life.  He is very calm and personable, content just to be held and cuddled.  He's also very curious and has the most adorable expression when something catches his interest.

I'm losing some sleep, but it's worth it to have such a great dog.

Thursday, June 9, 2016

Animal Heroes

Recently I cam across a link of dogs who made a big difference in wars, especially in a very heroic way.  I had heard about Sergeant Stubby in World War I, but the others were somewhat unknown, at least to me.  As a veterinarian I find these kinds of stories of animal heroes particularly compelling.  We often think of animals as merely pets, often forgetting that they can be heroes in their own right.  How many times have we heard of dogs or even cats waking owners during a house fire?  Or pets protecting their owner from attacks by other animals?  I remember seeing this video a couple of years ago and being surprised at the cat going after the dog.


It takes a special kind of animal to be protective of its people or even other animals, just like it takes a special kind of human to step in and defend others in the threat of danger or violence.  I'm glad that the military doesn't forget to recognize how dogs have helped save lives and are as much heroes as their human companions.  I think it's important that all of us also remember these animals.

Monday, June 6, 2016

Dad To A New Driver

My son recently turned 15.  Where I live that means that he is now able to get a learner's permit and start driving.  I'm not sure that I'm completely prepared for this.

When I was growing up my father started teaching me how to use a manual transmission long before I was able to sit in the driver's seat.  He would have me shift from the passenger seat while he operated the clutch, which gave me a really good idea of how the car and engine felt and sounded when he needed to change gears.  By the time I started driving I knew how to operate a manual transmission better than an automatic one.

When I learned to drive it was taught as an elective in high school.  Apparently that isn't the case anymore and I am having to do all of the teaching myself.  Why me?  Because my wife absolutely refuses to be in the car with him driving until he is better.  I let him drive a few hundred yards in our subdivision one Sunday after church and she kept her eyes closed the entire time.  So with no official class and my wife bowing out, it's up to me.  

We had him study the book provided by the DMV (or DDS here in Georgia....Department of Driver Services) and he passed the written test with no problems.  In our state that is all that is required to obtain his permit, though he is restricted on when and with whom he can drive.  In a year and a day from when his permit was issued he is eligible to get his full license, though I have to attest to him having accumulated at least 40 hours of driving by that time.

How am I handling all of this?  Fairly well.  Thankfully it takes a lot for me to freak out and even when I'm doing so I can usually remain outwardly calm.  With him as a new driver I can't afford to make him too nervous, even when inwardly I'm cringing and trying not to brace for impact.  I also now have a much better understanding why driver's education cars have brakes on the passenger side.  I've certainly wanted them a few times.  

This is quite the milestone for me as a father, and one I've been dreading for years.  When I bought a new car in 2014 I almost got a Ford Mustang until my wife reminded me that we would soon have a teenage driver.  Instead I got a much more sensible Honda Civic (which I actually really like...though I still want the Mustang), knowing it would be safer and have lower insurance costs.  So I've thought about all of this for years and the moment is finally here.

My son is actually doing pretty well.  We've taken multiple drives in nearby residential areas and I've started having him drive around town when I'm running errands.  He's picking up on things pretty quickly and I'm not quite as worried whenever he is driving.  After several more weeks of this I think he'll be ready to tackle the interstate and the 70 mph speeds, though I know that will be frightening for both of us.

I now have a much greater appreciation for what my parents went through when I was learning to drive.  I remember my father taking me out in snow one time and telling me to hit the brakes so I would know what it felt like (the road was empty).  I didn't know that I was supposed to let up on the brakes and we ended up doing about a 270 degree spin, thankfully not hitting anything.  But I knew what it was like to brake on snow!  Another time I was pulled up too far at a stop sign and my father told me to back up a bit.  I did so, but didn't look behind me so I bumped into the car waiting to go after me.  Again I was lucky that there wasn't any damage to either vehicle, and I very vividly remember that moment 30 years later.  If I tell my son to back up, I will absolutely make sure that he checks the rear-view mirror first!  One time while driving on the highway I had to switch lanes suddenly because I was coming up on a semi truck too fast.  I didn't check the lane and forced another car to have to go off the road, though (once again) nobody was hurt and no cars were damaged.  My mother was scared out of her mind and really laid into me!

All of these are lessons that I learned from my mistakes, and because I remember them well I can help keep my son from doing the same things.  Unfortunately I will probably forget other lessons or mistakes that I didn't actually make and he will end up making ones of his own.  Which he will then remember and keep his own children from doing.


My daughter is 19 months younger, which means that in about a year and a half I'll be going through all of this with her.  Hopefully I will have learned some lessons about teaching driving by then!