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Thursday, July 28, 2016

Coyote And Wolf Hybrids....Bad Idea

Paula emailed me with this situation and question. 

I got a puppy in September. A beautiful red German Shepherd cross that looked identical to a coyote pup. We got him from an Amish farmer in Michigan near Ohio, who's Shepherd came into heat, got loose and returned home pregnant. The farmer was mad about the puppoes and weaned them at 6 weeks and locked them in a barn until they were all sold. I christened him Yohann Gutenberg, he grew rapidly and had a vigorous appetite and eternal thirst for water. He reached 50 pounds, went from red to gold all over his body and became aggressive. We thought originally he was fearful as he did not like people or other dogs, and we thought it odd other animals avoided him and people backed off from him. He continued to become aggressive, attacking my aunt and quivering and salivating when my uncle came over. He stalked our dogs and attacked them and eventually stalked and attacked my five year old brother. The more passive the personality the more apt he was too attack them. My sister spent the entire seven months we had him insiting upon his being half coyote. We blew it off. Then she googled traits and pictures of coyote half breds, it was as though I was looking at and reading about my dog.
Despite his being ulte-aggressive he was also ultra loyal. I could tell him to do whatever I wanted and he'd do it. I loved him.
At 7 months we euthanized him and the vert confirmed he was half coyote. Evidently it is very common for dogs and coyotes to breed near the Ohio border.
Have you ever had or heard of cases with coyote hybrids, or coydogs as they're called?

Her situation brings up some good discussion topics, so let's jump in.
Dogs, wolves, and coyotes are very closely related species, and therefore can interbreed rather easily.  The reason why it doesn't happen more is due to the behavior of each species that typically keeps them from getting together when a female is in heat.  A dog usually doesn't get along well with a wolf or coyote, and those wild animals aren't usually of a temperament to peacefully mate with a dog.  However, exceptions do happen, so pairings and matings do happen.  Unlike many hybrids (such as mules) these offspring are usually fertile and can breed and pass on their genetics.
Wolf or coyote hybrids do NOT make good pets!  There are significant behavioral differences between dogs and their wild cousins that allow dogs to be good companions.  Dogs have been  bred over thousands of years to bond with humans and be relaxed around most of our species.  Wolves and coyotes have a natural stand-offish disposition and wariness of humans shared by most wild animals.  Behavioral traits can be inherited and these tendencies have a strong genetic component.  This fact is why we can selectively breed dogs for personality, trainability, and temperament as well as for physical appearance.  The wild behaviors of wolves and coyotes are strongly influenced by their genes, and therefore hybrids of these species will share many of the behaviors.  The dog genes really don't significantly mellow the wild genes.
One of the biggest risk of wild hybrids is their unpredictable temperament and tendency for aggressiveness.  The loyalty and companionability of the dog competes with the shyness and wariness of the wolf/coyote.  It is not unusual for them to bond with one or two people and show severe aggression towards others.  But it's also not uncommon for them to turn on this bonded person at some point in their life. 
Some people will likely read this blog and have a wolf hybrid themselves, and will want to tell everyone how wonderful their pet is.  But if you ask any behavioral specialist, you simply cannot treat these hybrids in the same way that you would a dog, and you can't predict their behavior as you would a dog.  They have to be trained and handled in very specific ways that are often quite different from how we work with dogs, and will have to treat them differently for their entire lives.  Only someone with a strong understanding of these techniques and dynamics should attempt having a dog hybrid as a pet.
Wolf/coyote hybrids with dogs are a potentially significant risk to the owners and any pets or people around them.  Unless you have specific training with these animals, please avoid ever considering one as a pet.

Monday, July 25, 2016

Gimli's Guide To Bulldogs: Chewing!

Hai!  Itz me Gimli again.  Dis time I want to tellz you about one uv mai favorite tings.....chewing!

I loooooove to chew!  Im a puppie so I haz puppie teef.  Chewing helpz mai gums and itz lotz of fun.  Mai daddy sez deese teef will start falling out in a few weekz, and dat my gums will be soar so Ill chew even moar.  Datz okay wif me!!!!  We bulldogz luv to chew, so as a bulldog puppie itz an even bigger ting.

I haz lotz of chew toyz, so I can pick lotz of different tings.  Different bonz, a rope toy that one uv teth udder dogz in mai home also haz, and even plaztic bottles.  Mai daddy sez I haz to be careful what I chew, becauze my teefs is fra-gi-le and sumting too hard mite brake dem.  Wen my big boy teef come in I dont have to worry den.

But sometimez I wants to chew on tings dat daddy sez I shouldnt.  Like shooz and cloze hangerz.

I don't know why he doeznt like me chewing deez tings.  Teh shooz reely smell nice and taste yummy!  But he makez me stop when he seez me doing it.  Itz not too bad becauze he den gives me anudder chew toy so I can still haz fun.

Giving puppiez tings to chew is reely important.  But you haz to be careful with what we chew on.  Some tings mite be dangerous, and udders might just get us into trubble.  Make sure you give yur puppiez the right chew toys!

Friday, July 22, 2016

Sudden Unexpected Deaths

When a client brings a pet to the vet, death is rarely on the forefront of their mind.  Most of the pets that we see are not in a serious or potentially terminal condition, so to unexpectedly lose a pet can be difficult for a pet owner to understand.  While rare, completely unexpected deaths do happen.

My first experience with this tragedy was back in 1998, only about a year after I graduated from vet school.  A client had brought an old boxer to our clinic for a simple bath.  He was there all day and received his bath without any problems.  That afternoon the kennel assistant took him outside for a walk and to eliminate, again without any problems.  I even commented on how energetic and healthy he seemed for his age (around 10 years old if I remember correctly).  About an hour after he had been outside he was found dead in his kennel.  There were no warnings and no explanation for why it had happened.  And I had to explain to the owner that the apparently healthy dog she had brought in for a bath had suddenly and inexplicably died.

Earlier this year we had a small dog come in for a routine semi-annual exam, fecal check, and deworming.  The owner had stated that he had been breathing funny for a week or two and wanted us to evaluate this while we were looking at him.  It was an extremely busy day and I was running around trying to keep on schedule with everything.  This was one of those days that I didn't take any breaks at all and ate my lunch while typing medical notes and calling clients.  Initially we had kept the dog in the front treatment area to keep an eye on him, but he was extremely noisy and barked at anything that was in the room.  He was wagging his tail and obviously energetic.  Because he didn't seem like he was in any kind of distress we moved him to the back kennel area to save our ears and keep from stressing out the other pets who were sick or recovering from surgery.  By early afternoon I finally had a chance to look at him, and while he did have a slightly increased respiratory rate and effort, all other vital signs were normal and his lungs sounded clear.  I did want to do some chest x-rays, but had some rooms to see first before I could call the client and talk about my recommendations.  About an hour or so after we put him back (after my exam), one of my staff found him lying limp, not breathing.  I immediately examined him and he had apparently died within a few minutes prior to him being noticed like this.  There was no warning and no signs of something this serious earlier in the day, or even on my exam.  Yes, I thought he might have some kind of mild to moderate respiratory problem, but nothing warned me of imminent death.  When I called and talked to the owners they were understandably very shocked and upset, especially when I didn't have an easy explanation.

Last week I received a call from one of our local specialty referral centers.  I had sent a patient there for years of persistent nasal problems without any response to antibiotics, antihistamines, or steroids.  The clients allowed a CT scan to be performed, which was completely normal and unremarkable.  To allow this scan the dog was lightly anesthetized with low doses of intravenous drugs.  After the procedure was over the specialist noticed a very slow heart rate (18 beats per minute).  This resolved on its own to 80-90 BPM very quickly.  However, within the next 30 minutes the dog began having a serious arrhythmia that progressed quickly and didn't respond to medications.  The vet in charge was a board-certified internal medicine specialist.  He got a board-certified cardiologist involved, as well as one of their emergency specialists.  Between the three of them they still couldn't explain why the dog was deteriorating so rapidly.  They used a defibrillator three times along with manual CPR and multiple drugs.  In the end, despite three specialists and intense care, the dog died.  It was especially strange because for the last four years in a row we have done deeper anesthesia for annual dental cleanings on this patient without ever encountering any kind of problem.

In all of these cases (and others that I didn't mention), the staff were shocked and broken-hearted.  Even though we don't have the same emotional investment in the pet that the owner does, we are still affected by our patients' outcomes.  When I spoke to the specialist about the death of our mutual patient, I could hear the tension and sadness in his voice.  The death of the respiratory case changed my mood for the rest of the day and even resulted in me snapping at my assistant manger, something I've never done in the five years she's worked with us.

Despite the incredible knowledge and training that doctors have, we don't know everything.  And despite our best care and efforts, sometimes things happen to pets that defy easy explanation and result in tragic situations.  I of course encourage every client to ask questions and get a copy of the medical notes when things like this happen.  Some sudden deaths can be due to mistakes, negligence, or malpractice.  And when such a sudden thing happens I can understand that a client wants answers and is looking to figure out what happened.  But in many of these cases there isn't anyone to blame.  It's like a human suddenly dying from a heart attack.

Veterinary medicine isn't an easy profession for a multitude of reasons.  One of the biggest stresses is the daily life and death situations we face.  It's hard enough when we're expecting a possibly tragic outcome, but when one surprises us it makes it even worse.

Tuesday, July 19, 2016

Is It Okay To Split Flea Or Heartworm Prevention?

Regular reader Lynn recently emailed me with the following question.

I have 2 cats (12# and 15#) and one small dog (a 6# Yorkie). I have been using the same Frontline Plus formula for all of them. Years ago, my old country vet told me to buy the XL size dog vials and pour them into a dropper bottle, then apply 9 drops to each cat and 13 drops to the Yorkie.  This has saved me a tremendous amount of money and has always worked well.

My current Frontline Plus product (purchased over a year ago and which is almost gone) lists the active ingredients as Fipronil 9.8% and (S) methoprene 8.8%.  Now when I look online
The CAT’S formula says Fipronil 9.8% but (S) methoprene is 11.8%.  I don’t know if that has always been the case, or if Frontline has changed their formula? Now I’m nervous about using the same product on all of them!

Do you know which flea/tick products would be safe for me to use on both my cats and my dog, please? (I am willing to buy any brand recommended!) I understand why it could be considered “risky” to have your clients measure out their own doses, but trust me, I am meticulous!!!  Please help!

This is a good question and brings up multiple points which I will try to address.

Let's start with the challenge of a single product safe for both dogs and cats.  This is very difficult to come by for several reasons.  First, there are products safe for dogs that are dangerous or even fatal for cats.  Though most people see the two species differently, canines and felines actually differ significantly in several aspects of their physiology.  You should never use a product on a cat that is for dogs only, especially over-the-counter products.  Many flea preventatives clearly state "do not use on cats", and this is not a casual phrase.  Ignoring this warning could result in a cat dying or having to be hospitalized for extensive treatment.  Additionally the physiologic differences mean that sometimes the dosage between dogs and cats can be different, and therefore difficult to use interchangeably.  Dosages and warnings are there for a reason, and you shouldn't try altering them on your own.

Next, despite what many think, it's actually difficult to accurately measure doses from a split applicator.  You will inevitably lose a small amount in the syringe or dropper, and while this shouldn't cause any harm, it could result in under-dosing.  Even someone who is very careful cannot always ensure that you will divide the dose properly.  I'm also curious as to where the vet got the calculation for the specific number of drops. Again, this shouldn't result in harmful dosing as most of these products have a very wide safety margin.  I would worry about the more likely possibility of not using enough of the product to effectively prevent fleas.

As a follow-up to the last statement, everyone needs to be careful not to equate "no fleas" with "product efficacy".  I have many clients here in Georgia who have never used any kind of flea prevention and yet have never had a flea on their dogs or cats.  It always surprises me when I see the dogs who spend time outside yet never have any fleas despite a lack of prevention.  If we use the logic of "I've not had a flea problem when splitting a dose" then we must apply similar logic to "I've never used flea prevention and have never seen fleas".  Just because someone hasn't seen fleas doesn't mean that their particular method (or lack thereof) is actually effective.  Now, a split dose may indeed provide sufficient protection, but we can't automatically make that assumption with a single anecdotal story.  Correlation is not the same as causation.

Lastly, there is the broader consideration of product warranty.  Many flea prevention products contain some sort of warranty on their efficacy and safety.  However, that warranty is dependent on the consumer using the product as specified.  If a person splits a dose or uses a dog product on a cat, and there is some kind of subsequent reaction or toxicity, the manufacturer is unlikely to support the product or compensate the client.  When you use any product (not just flea prevention or in veterinary medicine) against manufacturer recommendations, you are often voiding the warranty and eliminating your chance for any recourse if it doesn't meet expectations or causes a problem.

Lynn, I hate to say it, but I don't think you're going to find that "magic bullet" you're looking for.  It will be difficult to find the same concentration and ingredients that are equally safe for both dogs and cats.  I also don't recommend splitting products that weren't designed to be used that way.  One of the consequences of having multiple pets is the increased costs that go along with that situation.  With three dogs, three cats, and multiple other pets I know this first-hand.

Saturday, July 16, 2016

A Conversation About Vaccine Responses And Reactions

Recently I had a reader, Bill, email me with concerns about his recently vaccinated puppy.  We began a brief email conversation which I think is valuable to share with everyone as it addresses some of the worries that clients can have, and how important communication is.

Bill:  My wife and I are freaking out.  We took our fun loving 3 year old Golden to the vet to get 4 vaccines: Bordatello, distemper, rabies, and the new lymes.
Anyway, my usually happy puppy barks and runs around every morning.
However, within an hour after the shots he became lethargic.  He stands in one place and acts like his hind legs hurt.
We took him to the ER and they said he was fine.  Breathing was fine.  Heart was fine.
Now today, 24 hours later, he walks very, very gingerly and he will stand in one spot for 20 minutes or more if you let him.
What did these people do to my happy puppy?  I was such an idiot for allowing all these shots at one time.
1. we got him to pee 3x today.
2. he pooed twice yesterday and NO poo today.
He went into the vet's a happy, active dog and now it looks like the life and fun was drained out of him.
Is any of this normal?
The ER prescribed tramadol for pain.
Thank you for any help you can provide.   We just never saw such a dramatic and downward attenuation of our puppy’s soul.

Dr. Bern:  Bill, I'm very sorry that your puppy doesn't feel good, but you're probably worrying too much.  It's actually perfectly normal for a puppy to be sore and slightly lethargic for 24-48 hours after vaccines.  What you're describing doesn't sound like anything that would worry me or keep me from vaccinating him again in the future.  If the ER vet said he's fine, I would trust that.  But talk to your vet about it and see if they may be willing to send him home with pain medication for a day or two after his next vaccines.

Bill:  As it turns out, your DX is amazingly spot on.  
Miraculously, after 21 hours, Charlie snapped out of it---three (3) hours after giving him pain medicine.
It's like the vaccines attenuated my puppies soul.
I think some puppy parents (like us) fail to realize that these are animals and not people.  
However, I get a general sense that doctors, vets, and interested corporations don't like to address vaccine related complications.
Maybe it's because there is a fear that any talk in this area may prevent people from vaccinating their pets.  
Had I been told, your dog might act like he is in a stupor for 2 days, then I might have been prepared.  Instead, the vet and all techs said it was "no problem" to hit my puppy with 4 separate vaccines in one day. 
Even our visit to the ER does not mention anything about a reaction to the vaccines.  Instead, it mentions only pain.  
Finally, I have to tell you, I was really upset when I wrote this email to you.  I can't thank you enough for your email.  Your response was incredibly intuitive. I think half your training as a vet must go to dealing with over the top puppy parents like me---please forgive me!

Dr. Bern: First of all, don't worry about being freaked out and "over-reacting".  You were concerned about your puppy and that always makes people emotional.  I completely understand that and deal with those situations regularly.  It typically isn't because a client is being irrational, but instead because they are worried about their pet.  That's understandable and even expected when something like this happens.
I can't speak to other vets, but my clinic always tries to caution people that there can be soreness and lethargy for 24-48 hours.  It doesn't happen in most dogs or cats, but can happen sometimes and we want people to be aware.  If a client is aware of the possibility they can prepare themselves and also watch for anything more serious.  We also try to let people know what more serious symptoms are (facial swelling, hives, profuse vomiting, sudden weakness or collapse).  I will sometimes compare it to a human getting a flu or tetanus shot.  Sometimes you don't feel anything at all, sometimes there is local inflammation and soreness, and sometimes you can have flu-like symptoms for a day or two.  All of these things are highly variable based on an individual patient's immune response, and are completely normal.  These symptoms are a "response" and not a "reaction".
Why does this kind of thing happen?  When we give a vaccination we are stimulating the immune system with a killed version of the infectious organism, or a part of that organism.  Doing so causes the body to develop antibodies against that organism so if they are exposed to it in the future the body can quickly attack and destroy the invader before illness is caused.  But think about what happens when the body responds to a natural infection, such as a cold or influenza.  The immune system responds to the organism by releasing various biochemical that have effects on the body such as raising the temperature, causing inflammation, making them lethargic, and so on.  When we stimulate the immune system with vaccines, we can potentially cause similar responses because they naturally occur as a result of certain immune cells responding in the way that they are designed.  This is normal and not a concern.  Think of it like a set of dominos that you have stood up.  When you knock the first one over the whole string will start to fall down in a cascade.  It doesn't matter if you knocked down the first one with your finger or a pencil, the response is the same.  That's how your immune system works.
True reactions happen when the immune system over-reacts.  Compare this to a toddler that wants a toy and doesn't get it.  Some may be sad but go on with the day.  Some may cry a little but quickly get over it.  Those are like a "normal" immune response.  But some toddlers throw themselves on the ground kicking and screaming, having a true fit.  This is a complete over-reaction, and is what can happen to the immune system at times.  Instead of a certain mild response, more biochemical are triggered which leads to a more serious effect on the body.
Various responses and reactions can occur no matter how many vaccines are given.  I will routinely give multiple vaccines at the same time to my patients and my own personal pets.  In general this is considered safe, but you might have a slightly more intense response since the body is working with multiple antigens at the same time.  I currently have a three month old puppy and have no hesitation giving him multiple vaccines on the same visit.
To me the main focus is proper communication and setting realistic expectations.  If your vet had explained even part of this to you it would have kept you from worrying and you could have just observed him.  You would also have been aware of when to start worrying and rush back to your vet or the ER. 
I hope this helps explain things a bit better, and I hope your puppy is continuing to do well!

There are a few lessons here. 

First and most importantly, communication from the vet to the client is extremely important.  With just a few seconds and a few sentences, the vet could have prepared Bill for what might happen and prevented a lot of worry.  Most people understand mild side effects from medical treatment, and don't worry if they see them.  However, they need to be prepared for it.  Clear communication is the key, and it's the responsibility of a veterinarian and their staff to make sure that clients are prepared.

Second, soreness and lethargy after vaccines are considered normal and not a true reaction.  When this happens it is absolutely appropriate to call the vet and describe the symptoms so the vet can determine if the pet needs to be seen.  Or, if you're really worried, take the pet in.  While we don't become concerned about these situations and consider it a routine variation, a good vet will understand a client's fears and help to assure them.

Thursday, July 14, 2016

A Start To Fixing Our Country

Last week saw some incredible tragedies here in the US.  Two men were killed in completely different incidents with police.  Then several police officers were killed by a sniper in Dallas.  After that there have been violent attacks against police in several other cities.  Some say that racism is the problem.  Some say that guns are the problem.

I disagree with both.  The problem is people's hearts.  Guns and racism are simply methods of showing what is in their heart.  If people were all the same color or guns were outlawed those with hate inside them would find another way to express it.  We need to combat these issues in some very different ways.  

Even as a white man who is far removed from the civil rights movement I have always found Martin Luther King, Jr. inspiring.  I do believe that he was an extremely wise man and one who understood how to bring about change in the right way.  Let's start by remembering some great quotes from him.

I know that I might be accused of so-called "white privilege" or "microaggression", but I think that many of the modern-day protesters need to go back and really read and listen to King's words.  We need to stop the divisions in this country between races and viewpoints.  Our country seems more divided and polarized than at any time I can remember in my 46 years.  It seems that people thrive on opposing others, and become heated to the point of violence.  What does that solve?  Really, nothing.  Just go back and re-read the quotes above.

So what can we do?  First, let's start with King's ideals, quotes, and example.  Many of the modern protesters and activists certainly aren't doing that.  Here is a great segment from an interview with Morgan Freeman on 60 Minutes ten years ago.

Let's stop talking about what divides us.  Let's truly ignore what race someone is and concentrate on their heart and actions.

Yes, this is very possible.  Here is a recent CNN video showing exactly what can happen when people try to peacefully bridge a divide without making accusations and without yelling.

I've come across a new movement called the Free Hugs Project ( that is truly inspiring.  The founder, Ken Nwadike, Jr., started the organization based on truth and love.  To him it's about reaching out in peace to bring people together.  Even when he's speaking on the idea of "black lives matter", he's rational with passion and pretty inspiring.  I want to share a few of his videos as examples of how we can come together and understand each other better.

If more people acted in a like manner to the above videos, we'd be in a far different situation.  If everyone stopped accusing and hating we'd be a step closer to really coming together to better our communities and our country.  We need to be coming together, not moving further apart.

I found this awesome meme on Facebook, and it's too good not to share.

I normally don't get into political or social rants on this blog, but since this is as much about the life of a veterinarian as it is about the profession itself, I feel that it's important to deviate into this area from time to time.  But I was really inspired by the sermon my pastor gave this past weekend.  He hit this topic hard and it really made me start thinking about things a bit differently.  Even if you're not typically the religious type, I think it's well worth watching and would encourage you to do so.

As a doctor I have been trained to know the difference between symptoms and disease.  Fever, pus, lethargy, anemia....these are all symptoms.  They are what happen as a result of a disease.  Sure we can treat the symptoms and make the patient feel better.  But if the disease isn't eliminated those symptoms will keep coming back again and again.  The only way to resolve the symptoms completely is to treat the underlying disease.

We need to address our social problems in a similar way.  We need to look past gun violence, racism, political opposition, and all of the other things that cause division between us.  Those are just symptoms, and if all we do is treat the symptoms we will never solve the problem.  We need to focus on the true disease itself, which is dark hearts and hatred.  

I pray that we can do so before our society fractures further.

Wednesday, July 6, 2016

A Touch Of Magic....New Etsy Shop

Shameless plug here......As long-time readers will likely know, my wife is an amazing seamstress.  She has made costumes for our family for many years, which we wear at cons and Renaissance Faires.  She had a custom costuming business for a while, until the commission requests became overwhelming in number.  Her costumes have won awards at cons and with local community theater groups.  More recently she has been making "casual geek" clothes for our family, which have been a big hit with everyone who sees them.  In fact, she is constantly asked "Do you have an Etsy shop?" 

Here are some examples of what she has created recently.

The question became regular enough that we started looking into it, and just set it up.  We're just getting started, so we're still building up the inventory of what is available, and it will change with some regularity.  All of the work is custom made upon ordering and these are one-of-a-kind designs.

Check out the Etsy site at the link below.  We also appreciate everyone who shares it!

Monday, July 4, 2016

Happy Independence Day

Happy July 4th, and Happy 240th birthday, America!

Friday, July 1, 2016

Gimli's Guide To Bulldogs: Easily Overheated

Hai!  Dis iz Gimli again.  I iz here to tellz you moar about bulldogz.

We getz hot eezy.  Reely eezy!  Mai new daddy sayz itz cause we has small noses and a "long sawft pal-at" (whateverz dat iz).  I just know dat when I startz getting hot I cant breeth eezy.  

Where we live itz reely hot rite now, espeshully in the day.  If I am outside too long, I could get reely sick from being so hot.  I haz to be outside for short timez, and den come back in.  My daddy sayz dat if I waz in teh sun too long I mite even die!  All bulldogz have dis same problem, and all of us need to stay cool.  I dont go for walkz rite now, but if I did I could only do it in teh morning or evening, when itz cooler.  

Mai new family went for a long car drive to seez my daddy's daddy.  On teh way home I wuz in teh back wif mai new brudder and sister, and I wuz hot.  Mommy saw me wif mai tongue out, so she put me in her lap in teh front so I couldz be closer to teh cold air.  Wow, it wuz nice!  At first I put mai face rite at teh air.  But den I gotz teh idea to get cooler, and I stoodz up to put teh air on mai belly.  It felt sooooooo gooood!

But den I gotz sleepyz, and mommy had a pillow in her lap.  I wanted to sleepz, but I loved teh cold air sooooooo much!  So I put mai face and neck on teh air, and got so sleepyz just like dat.  It wuz awesome!!!!

So teh lesson tooday is to keep yur bulldogz cool!  Dont let us get too hotz, or it can be very, very bad.  We like teh cool!