Thursday, July 2, 2015

The Evolution of Specialists: When and Why Should I See One?

Pet ownership grows more and and more annually, as do many other things. Our culture has long deeply respected the role domestic animals play in our lives, and it is offensive to pet owners for them to be considered anything other than "family". We spend more on them year over year, and where there is demand, there is better medicine.

Once upon a time, you had "your vet". They were close by, and they saw your pet from birth until death, dealing with all ailments they may incur. As veterinary medicine has evolved to suit the demand our pets receive as "family care", so has the field of specialists grown.

When asked by some "What's the difference? I mean, why can't my regular vet handle this?" the answer is simple: consider human medicine. Something aches, something is off, something is "wrong". We seek the care of our general practitioner, but when it's revealed to be something significant, they refer us to a specialist.  It's the exact, same thing.

Board Certified specialists went through great lengths to become just that, and have a deeper understanding of your animal's problems specific to their specialty. In addition to becoming a doctor, they went through many additional years of residency training and had to pass extremely difficult tests to become board certified. While they may not be cheap to consult with, you get what you pay for, and they are worth every penny.

Common specialities include, but are not limited to: Neurology, Dermatology, Dentistry, Cardiology, Ophthalmology, Internal Medicine, Surgery, Nutrition, and Radiology.

You love your 'regular' doctor, and you trust them. Perhaps you feel like you are betraying them by seeking a specialist, but you are not. Believe me, they'll be happy you did. They want your pet to receive the best care, and there are limits to their expertise as a general doctor. If they refer you to a specialist, or you seek one on your own, they will remain your primary doctor. They will consult with the specialist and become partners with them for the long term care of your pet. 

Specialist have more in depth diagnostic tools than your general practioner. They have ultrasound, scopes.. all kinds of fancy tools that your general doctor doesn't have. They are used to running special blood tests to pinpoint certain diseases, and they use the medicines they subscribe *all day long*. 

Consider it this way: When we shop for groceries, we buy a lot of things.  We do this every day: we pick up cereal, bread, milk, eggs. We know a ton about buying all of these groceries. If I really wanted to just know about eggs.. I mean, everything about eggs from top to bottom, inside and out, I'd ask an egg specialist!  Your general practice doctor doesn't know less generally speaking, they are just trained to know more about many things, and your specialist is trained to only focus on one thing.  It's all they do, and they are damn good at it.

A consult with a specialist, and diagnostics therein, may cost a lot at first. But what you save in the long run of going to an expert and getting the absolute best diagnosis and best treatment and guidance will save you in the long run.

So when do you go? When it's serious, and you know it.  It also depends on how much you're willing to do. I've met owners who are willing emotionally and financially to offer palliative care for diseases, but, for their own reasons, would never consider surgery, extensive diagnostics, or adding a roster of medications to their daily life. Honestly those with this mental approach tend to be those who feel "age is a disease", and consider less treatment because they perceive their pet to be "too old" for much. Remember, age statistics are an average. If your dog's breed lives an average of 10 years, remember some die at 7 and others live to be 15.  Assume yours may live longer, and never deprive them of support and care.

Bear in mind one important difference between human and animal medicine: with humans, we strive for longevity. We are afraid of dying, and we want to live as long as possible.  In veterinary medicine, these concepts to not apply. Our pets do not understand "life span"; they understand their own unique quality measures. For instance, when a human gets cancer, our goal is to kill it, at any cost. When our dogs or cats get cancer, we only aim to "kill it" if it's within a realistic measure of their quality and the realistic standards of their cancer. Mostly our goal is quality, and time within the measures of their understanding of quality.  A dog never asks, "Why now? I'm too young!"

If your pet has cancer and you don't want to do chemotherapy, there are still benefits to consulting with an oncologist: they see this all day long, and are familiar with the best methods of palliative care even if you don't want to be more aggressive. If you don't want to manage your dog's heart disease and/or heart failure for any measurable length of time, there are still benefits from the expert guidance of a cardiologist. If you know you will never take your old dog to surgery, still talk to a boarded surgeon: they may have amazing insight to offer you which will best guide your decision.

"I've been to the vet three times, and Molly still won't eat.  They still don't know what's wrong with her",  See your internal medicine specialist. "My veterinarian has just told me that Molly, after five years of having a heart murmur and no symptoms, is in heart failure now",  See your cardiologist. I just found out Molly has cancer, and I want to give her the best care possible.... so on, and so forth.

If and when you see a specialist, remember they are just that. Don't ask the dermatologist to examine Molly's limp, and don't ask the surgeon to treat Molly's ear infection. Can they do it? Sure.. but that's what your primary doctor is there for, and they deserve your ongoing business for those other issues. In fact, they are your best source for managing those other things. "Well, we're here, and we spent a ton of money.. why won't you give Molly her rabies vaccine?" The answer: the specialist is there to address whatever serious concern you have.  Once Molly is well, return to your general practioner and address those issues.

As with all illness, don't wait. Owners find themselves in denial and hope their animals recover from their issues with little to no intervention, whether guided by financial constraint or just a hope that nothing that bad is really happening. It is far better to be the owner who "panicked" and brought their dog to a specialist for a concern right away, then to be the one who waited and now has a pet in unstable condition who will ultimately, now, cost more than what you were afraid to spend in the first place.

Lastly, consider pet insurance. I've seen it cover amazing costs for owners, and therein enabled owners to do what was truly best for their pet. It's easy to put it in the back of your mind because your pet is young, but never forget that young pets get horrible disease also, as much as we don't anticipate it.

Friday, June 19, 2015

ASIA - Available for a FOSTER and/or ADOPTION (NGPR)


GENDER:  Female/Spayed
AGE: 3
WEIGHT: 84 lbs (underweight)
LOCATION:  Colorado

UTD on vaccinations
On flea/tick preventive
Asia is currently undergoing treatment for heart worm and should complete her treatment soon!

Housebroken and Crate Trained!
Gets along with...
Dogs (needs the right match as she is an Alpha girl)
Cats (curious, but respectful)
...and chickens!

Sweet Asia made a LONG journey to safety, traveling all the way from Louisiana and settling in her foster home in Colorado on 6/14/15!

Bless her heart, she had some seriously embedded dew claws upon arrival, but foster mom got that all taken care may not have been the most pleasant experience for anyone, but hey who could blame her (look at the size of that thing...OUCH)!  She did seem to be okay with the Dremel tool (for future reference)!

Asia could stand to put on a few pounds, but the good news is that she LOVES her food and treats, so we expect that she will be up to a good weight in no time!

She is good on the leash, pulls a little, but nothing a little practice can't fix!  She has met lots of other pups while walking on leash, and hasn't had any problems.  She likes to play with her ball sometimes, knows basics commands, and comes when called (for the most part...hey, she's a Pyr, can't be perfect all the time with recall :) ).

Asia spent most of her first years of life outside and was surrendered to rescue because she was consistently left unattended and escaped the fence.  With that said Asia has grown to LOVE people and is looking for a home with someone who will make her a priority and spoil her as all precious furbabies should be spoiled!

Asia and her current foster brother both want to be Alpha and it's just not a good match, so Asia is looking for a new foster OR furever home where she can either be an only dog or the Alpha girl.  Additionally, until she completes her Heart worm treatment, she will need to be on restricted activity so that she can heal properly without complications.

If you are interested in Fostering or Adopting this Precious girl, please fill out an application on the NGPR website!

Foster/Volunteer Application
Adoption Application

It's exhausting being this adorable!

About NGPR: National Great Pyrenees Rescue (NGPR) is not a shelter. We are a not-for-profit, tax-exempt coalition of Pyr rescuers and rescue groups. We save Pyrs and Pyr mixes across the country and place them in approved foster homes so we know how they will interact with your family. Please consider adopting or fostering. Every dog who is fostered or adopted makes room for another Pyr coming out of a kill shelter. Prior to adoption, NGPR dogs are fostered for a minimum of two weeks (usually more), spayed or neutered and fully vetted. Dogs coming from out of area are certified with a USDA health certificate before going to their new homes. Our rescuers adhere to the highest placement standards and will take back any dog whose adoption does not succeed. Visit to learn more about us, our mission and our breed.

More Information: Questions? The fastest way to learn more about a dog is to fill out the application form below. If you call or e-mail you are reducing your chances of adopting this animal as we direct our time and energy to first serving those who apply. For more information about our adoption process please visit our adoption information page.
Want to help but can’t adopt now? You can make a tax-exempt donation by visiting ourdonation pageThis exceptional Great Pyrenees dog has been selected for sponsorship by National Great Pyrenees Rescue (NGPR)We have many Pyrs and Pyr mixes who need homes and not all of them are posted. You can see more of these beautiful dogs by clicking on Rescue Dogs.

Friday, February 15, 2013

Our Dogs and Coughing

At some point, all of our dogs have likely coughed.  It happened a few times and stopped, or it persists.  As armchair doctors, we can find ourselves brushing it off.  Naturally we don't *want* anything to be very serious, and a cough seems simple enough to brush aside.  Even though stated several times on this blog, let me reiterate, before spending too much time considering your dog's cough, rely on your veterinarian for a diagnosis.  If your dog is coughing, read and educate yourself, but always take your dog to the clinic for an exam. Never wait, as many conditions only worsen if untreated. Below I describe only some of the more common reasons for coughing, but it is not all-inclusive.

Some sounds our dogs make can be easily described as a "cough", but often they sound like they are gagging, and is often described by owners as "it sounds like they are trying to spit something up", because they often make a retching sound at the end. I've met many owners who didn't think their dog was coughing at all.. instead they were "gagging", and the owners brushed it off that they "had something stuck in their throat". I've also met many owners who brush off coughs because they think it's allergies or that their house was too dusty. What is key to understand about coughs, is that not all coughs are indicative of a contagious infection.  While some coughing can be easily diagnosed and treated to be revealed to be just that, what's important to know about coughing is that there are many other potential reasons for it, and some quite serious.

If your dog presents to the clinic with a cough, the doctor will want to understand how long it's been going on, what "kind" of coughing it is, and other factors such as exposure to other dogs.  When a doctor hears "the dog is coughing", they may immediately glance at the age and breed of the dog to already begin a working list in their minds of what is the likely culprit. How long have they been coughing? Is it worse or unchanged? What else is wrong with them which may paint a larger picture?

If your dog is a puppy or young adult, or was recently adopted from a shelter or rescue, or they go to the dog park or daycare, their first inclination may be to rule out diseases such as Bordetella or Canine Influenza.  There are vaccines for both, but those are only 2 respiratory diseases in a sea of many.  Dogs *of any age* can get these, but younger dogs are most at risk. There is no way to "test" to determine what kind of respiratory infection your dog has, short of a more significant procedure called a 'tracheal wash'. Doctors only tend to recommend them if they do not respond to obvious therapies, and they need to take further steps to isolate what is going on.  If your puppy is around other dogs and hasn't completed their full vaccine series, they are still susceptible to infections.

Naturally dogs with pneumonia may cough.  Pneumonia can be secondary to another respiratory infection that was allowed to get worse, but it can also be created by things such as "aspiration", where they accidentally breathe in something, usually when vomiting.  Dogs with short airways, or "brachycephalic" dogs are more prone to aspirating, as are dogs who have seizures.

While dogs of all ages can get these infections, if they are older, especially seniors, your doctor may want to rule out more potentially serious things.  When our older dogs begin to get a cough, I've experienced many owners too quick to brush it off.

If your dog is a toy breed, be aware that they can develop a condition referred to as "collapsing trachea".  This is literally exactly what it sounds like.  The causes are largely unknown, but there is a frequency seen in smaller, toy breed dogs.  How much they are impacted can vary greatly, and typically doctors only treat the symptoms. Dogs with this condition can get an implant called a "tracheal stent", but there are risks so discuss this with your veterinarian.  An x-ray can help to diagnosis this in your dog, but they can sometimes miss it if the dog isn't taking an inspiratory breath as the x-ray is taken. There is an extremely specific sound dogs with collapsing trachea make (it has a bit of a honk), and experienced doctors will "know it" the minute they hear it regardless of the x-ray.

A serious concern with symptoms such as a cough is left-sided Congestive Heart Failure.  It is crucial to bear in mind that a dog of any age can have severe heart disease, and even puppies can be in heart failure if they were born with a defect.  Dogs with heart disease and no failure who cough tend to be smaller breed dogs.  They are coughing due to heart enlargement, and the heart grows big enough to press against the trachea and create the cough.  This can happen in dogs of any size, but is infrequent in larger dogs due to their confirmation.  Dogs in heart failure will cough because the heart has failed to be able to push blood through properly, and the fluid overload will back up into their lungs and create a condition called "pulmonary edema" (fluid in the lungs).  If your dog goes into heart failure and gets this fluid accumulation, it will *not* go away by itself and the dog must be seen as an emergency.  The fluid will continue to accumulate until treated, or they will succumb to it by essentially drowning. Not all dogs in heart failure will cough!  Dogs with failure to the left side of their hearts will cough, while right-sided heart failure may create fluid in the abdomen or around the lungs instead.

Anything putting pressure on the trachea can cause coughing.  So naturally, we need to rule out masses (tumors).  An x-ray may diagnosis this, but sometimes the doctor may recommend further diagnostics.

Sadly, and it goes without saying, dogs with lung cancer will have changes in their breathing.  Whether just labored or perhaps coughing, this can be visualized on x-ray.

 Lastly, it's key to understand that our dogs cannot catch colds from us.  Many owners have made the mistake of thinking that their dog caught the same bug going through their family.  Dogs have their own specific infections they can only get from other dogs; not us or even our cats can transmit them. 

I think it's easy for owners to consider their dogs "caught something" from the kennel, doggie day care, or the dog park.  Think hard on your dogs age and environment, concurrent illnesses or heart murmurs, and consider if you are making light of something potentially more serious.  For diagnostics, be prepared to partner with your veterinarian to properly diagnose your pet.  Chest x-rays will always be recommended, and potentially a cardiac ultrasound, or echocardiogram, if they are concerned about heart disease.

Sunday, February 3, 2013

Saying "Goodbye": When Angels become Angels

Throw a rock, and you will no doubt find endless resources regarding the death of our pet and grieving, and naturally guides and suggestions on how and when to face one of the hardest decisions in your life.  My work environment is such that I am around death, or the possibility of death, every single day and I witness many grieving, confused, and tormented pet families.

I've had the pleasure of working with many amazing veterinarians, all of which offer very different guidelines, perspectives, and experiences to the owners who seek their guidance regarding making the decision to euthanize their dog or cat.  On the whole, I have never truly disagreed with any perspective or advice I've overheard, but naturally the bedside manner and approach can leave me with things to be desired (but even that is the exception, not the rule). 

My largest observation is that the doctor tends to, whether realizing it or not, balance the emotion and approach in the room.  If the owner is being purely subjective and emotional, they will offer balance and objectivism.  They will focus on the "facts", whether it be the morbidity of the pet, the owners finances, or a combination.  Contrarily, when owners are cold (and that can sometimes mask how "in pain" they truly are) focusing only on finances, I see doctors bring more emotion to the table.  They don't want owners to make decisions purely based on financial constraints, and I see them appeal to the love the owners have for their dog or cat to make their decision; so they can "live" with their choice better and feel settled about it.

My own observations tend to cause me to feel that 1 in 3 owners wait too long, 1 in 3 euthanize too soon, and 1 in 3 do it when the time is right.  This observation, however, I reserve exclusively for dog owners.  With cats, I feel like everything changes, so for the purposes of this blog and site, I am going to focus on dogs.

The "too soon" is usually glaringly obvious to any of the medical staff observing, diagnosing, and treating your animal.  If you are actually worried it's "too soon", you are probably wrong.  The fear of this drives many owners into the "waited too long" category, so you really need to understand what not giving your pet a chance really means. 

Are they young, and can it be cured, fixed, or reasonably medicated?  I must stick to the description "young", here.  When I think of young, I do not think of young in terms of their breed's life expectancy... are they "young" for them?  I personally stress to owners that while your breed's life average may be 10, it's an average.  This means that some will live to be 8, and maybe some even 15.  It's wrong to condemn your dog based on a number that has little relevance to your relationship, observations, and overall health status of your dog.  Surely if we applied this approach to human medicine, we'd never come to terms that people die at 50, while some can live to 100.  Every animal is unique.  It is not wrong to take their expectancy into consideration, but don't let it be the only thing you consider.

Again, people who euthanize too soon may unfortunately have to take financial constraints into a much more weighty consideration than others, and we cannot condemn them for that.  Does it suck when people have diamond rings and euthanize over money?  Yes, but often it's the teary-eyed mother of 3 driving the used car and struggling to make ends meet.  It just doesn't *feel* that way sometimes, because those other types of people stick in your memory so much firmer.  When you think of it, we compromise our own health in our human lives for financial constraints, and I don't think it's always unique that some have to do the same for their pets.  It's key to ask and do your research however, because there are a lot of charities who help financially support the medical needs for owners without resources.

Cured, fixed, or reasonably medicated:  a dog with diabetes can be reasonably managed.  A hypothyroid dog, a dog with allergies, a broken leg;  there are so many diseases that can be reasonably managed with a little money, time, and medicine, leaving the dog with a great quality of life.  Too soon, you ask... yes, people have euthanized over the slightest medical concern..  and sadder than it being financial are those who feel they just "don't have the time" to help manage a condition.  Let's not think about those people too much.

The owners who wait for too late are often hit like a ton of bricks, because their emotional journey has made it such that they have lost their ability to "see" their dog through unbiased eyes.  I feel they live in a fair amount of denial, whether they are treating and medicating or just avoiding the vet's office because they don't want to know the truth.  By the time they arrive to euthanize, it's usually at the behest of a friend or family member who nearly forces their hand.  "Mom, you really need to let him go now".  They arrive on gurneys, unable to lift their heads, and perhaps haven't eaten in days and days.  To the defense of these individuals, they likely have been seeing "good days and bad days" with their dog.  While the idea of euthanizing has been looming for weeks, one day he seems more bright, more alert, and they convince themselves perhaps he is going to get better.  All the same, a tail wag is all it takes for an owner to put it off another day.  

For those in this difficult position, remember that our dogs are not objective, and lack the complete ability to be so.  Never mistake a tail wag for a desire to persist:  they live and breath and desire nothing other than pleasing you, seeing you, and making you call them by their sweet nick names.  If that desire is still present, it doesn't mean they aren't ready to go.  If that desire is totally vacant, you probably definitely have waited too long.  Perhaps that last tail wag can reassure you they still recognize you, and recognize that you haven't left them alone for their last, final journey.

I've heard many doctors give people the suggestion that they should really bare in mind the things that make their dog "them" and happy.  When that list of items diminishes to only a couple or none, then the time may be right.  For example, five things he loves: 1. walks in the park, 2. his treat routine, 3. chasing the squirrels, 4. snuggling on my lap watching TV, 5. doing tricks.  The theory is that if most of these things can no longer make him happy, perhaps his quality of life is such that the timing is right.  I like this idea, but I don't know if I could follow it.  The reason being is that I feel this list changes through life stages.  What made me happy at 20 certainly won't make me happy at 80.  Sure, maybe he cannot physically enjoy many of the outdoors and play activities he once did, so?  He's 100 years old in dog years, and systemically healthy for his age.  He's arthritic and his pain and discomfort can be reasonably managed to a degree, and maybe snuggling and watching TV with you is enough for him.

All things boil down to one important question:  "Is he suffering, and how can I ease his suffering?"  We can all struggle as we age: things hurt, joints are achy, but it doesn't mean we suffer.  An achy dog is suffering because if he was properly medicated, he would be reduced to struggling a little every day, but his suffering would taper.  An anorexic animal is suffering, but they can be potentially reduced to a a struggle if we can stimulate their appetite and try to manage underlying diseases.  The suffering begins when we either don't try to help them, or our help isn't working anymore.  How can I ease his suffering?  When medical treatments no longer work, then we must turn to letting them go.

We are all familiar with the suggestion "You will know when it's time".  I meet this expression with guarded agreement.  I think people on the whole are largely indecisive and unsure of themselves, and this has to play into the flaw in this phrase to some degree.  I think some owners are objective and healthy enough to really look into their dogs eyes and communicate with them, and they walk away feeling very confident they fulfilled their dogs wishes.  The rest, however, walk that line of "I think maybe", and they look to others to assure them it's time.  I think a healthy plan for people who know they are the later personality type need to orchestrate a proper objective support system of friends and/or family during this process.  "Dad, I'm going to rely on you to really tell me when I need to stop trying".  Find someone you trust, or even 3 people to preside over your intensely emotional state.

When it comes to end of life decisions, I cannot stress enough how important I feel it is to have found a veterinarian you truly, truly love and trust.  Someone who has known you and your dog for years, and someone whose advice you won't question after the fact.  Avoid getting lazy with your vet visits, settling for a less-than-ideal bedside manner because it doesn't matter to you, so long as he gets his vaccines.  I've seen people panic to find someone they like better at the last minute, because now is when it really matters, because their friend is sick, and they are not finding the kind of comfort and guidance they feel good about.  Unfortunately, some disasters happen where your pet must see ER and a vet you've never met before.  My only advice in that scenario is to really vocalize to that doctor what your needs are.  Tell them how you need to be communicated with, and how you need your pet to be handled.  It's your pet, your money, and your horrible moment.  It's very, very difficult to be a veterinarian, especially in emergencies and crisis, and they only want to do their job to the best of their ability, serving the best interests of the dog.  And remember, they are advocates for the pet first and foremost, not for you.  Doctors so rarely cannot come up with a treatment plan, so when they tell you it's time to let go, let go.

The one thing I hear often, that I am in complete agreement with, is that it's better to let go when it feels like "too soon" versus "too late".  This is a far cry from those who euthanize quickly at the slightest announcement of disease, rather I mean those of us who's mortgage our homes to save our pet, but we know they are terminal, critical, or chronic and it's only going to keep getting worse.  If it were you, what would you want?  As humans, we tend to cling very tightly to our own personal sense of dignity, having very clear lines in the sand of how we "wouldn't want to live".  Draw this line for your dog as well.

My hope for anyone who has faced this tough day, or will face it eventually, is to give themselves the courtesy of avoiding things like "I know he's just a dog, but.."  It's hard enough, and so many owners feel compelled to explain why they are in so much pain and why the decision is difficult.  Remember that your audience (doctors, techs) so love animals that they choose to spend their lives fixing them.  They are objective in your presence for your benefit, but given their own dog would likely be a frothy, wet mess just like you. 

There is nothing more pure, rewarding, and beyond define than the love and the relationship we have with our dogs.  They are like magical, mythical beings in that they can love so truly and without restraint, all while truly knowing the "real" you in so many ways and judging you only on how you treat and love them, purely and truly.  They never leave us, never lie to us, and never knowingly hurt us.  Their ability is such that even the most hateful, cynical, or jaded person can love and be loved by a dog.  Even the most independent or reclusive of types can find comfort and companionship by them.  As a society we have accepted they are family, and we have accepted that those who would consider them otherwise or use them for selfish or evil intention are the worst kind of humans.  We know that people who do not like dogs cannot be trusted, and we know that people who dogs don't trust are questionable.   It is no wonder saying goodbye to them, when it's entirely in our control many of the times, is the worst day in our lives.  

You may never feel good about your decision, but find a way to make peace with it.  Ask yourself: did you love him, and treat him with love every day? Did you always make decisions for him based on what you truly believed was best for him?  If the answer is yes, then cherish your memories, frame your pictures, and speak about them often in loving memory.

Friday, January 25, 2013

Great Pyrenees and Seizures

My Great Pyrenees dog began to have seizures at 3 years old. I have no experience which suggests this breed is in any way predisposed to this; any dog of any age and of any breed can be afflicted, and it's an interesting disease to familiarize yourself with.

Seizures are one of the most baffling, sad, and frustrating things an owner can deal with.  Many dogs can have 1 seizure in their life and never another one, while others suffer from them considerably, and it can be challenging to manage them. They are harder on the owner in many ways, as they can be difficult to watch, especially knowing we are relatively helpless in the moment. The reality is, your dog *doesn't know* he or she is having them; it's not a painful event.

Many seizures are "idiopathic" (we don't know why they have them), and this can be so frustrating for an owner who just wants to "fix" the problem, but if they are truly idiopathic, there is no cure, only medical management.  We monitor and watch them, and while veterinarians will have different approaches, my experience is that you begin medication when they have more than 1 a month.  

Outside of idiopathic seizures, there are many things which can cause seizures. Younger dogs, dogs around ages 2-3 typically are assumed to have idiopathic epilepsy in lieu of an MRI to confirm it, and in the absence of toxin exposure or blood abnormalities. Older dogs with their first seizure are prime suspects for a brain tumor, but again, without an MRI it is speculative. Electrolyte imbalance, low glucose (blood sugar), and toxin exposure can also lead to seizures.

MRIs can be performed on our dogs.  They are not cheap but the diagnostic is the only way to truly understand if their seizures are idiopathic or cancer when other factors are ruled out.  If your dog presents to your vet with seizures, they should recommend this diagnostic. You can treat the seizures without, but it is the gold standard of care.  The MRI will enable you to know if cancer is responsible, enabling you to have the option to consider treating the cancer.

Often times owners are challenged to understand if it even was in fact a seizure they witnessed.  It can be easy for a person to struggle to differentiate between fainting, collapse, or seizure.  If you are unsure, and able, record the event on your phone so you can show the doctor. Most owners, if uneducated or inexperienced, mistake seizures for syncope (fainting) and vice verse. While all dogs are unique, there tend to be some helpful differences.

Most seizures happen at night, while the dog was sleeping. You may hear them yelp out, they may fall out of your bed, etc. The typical dog may paddle fiercely, while drooling excessively and potentially urinating and defecating. The key is that after the episode, they are not "themselves" right away. They have a phase described as "post-ictal" where they are neurologically inappropriate for many minutes. My dog isn't himself for about an hour. They may seem blind, bump into things, or have other unusual behavior.

Syncopal dogs tend to have fainting episodes with moments of excitement. They may yelp out, become very rigid, fall over, and owners report "he seemed dead". After a few seconds or minutes, they rebound quickly and are immediately themselves again. Like seizures, they may also urinate and defecate, but they may not paddle, and they certainly shouldn't appear neurologically appropriate afterward.

Is there anything you can do for your dog, at home, should they suffer a seizure?  The short answer is no.  If you have drugs on hand because you already know they suffer, then naturally you can give those as advised. To elaborate, dogs with a history of seizures may have owners who have a drug at home to give rectally for seizures lasting over 3 minutes.  There is nothing you should try to "do" to stop the seizure short of those medications, and certainly there is no "home remedy" or "over-the-counter/human" medication you can give.

If you have a giant breed such as a Pyrenees, you need to be careful not to injure yourself, and you need to be prepared for the phase following the seizure where their behavior may be strange and unpredictable.  Let them have the seizure, do not get bit! They don't know it's you.. don't try to comfort them, hold them.. move things away from them which may injure them but that is all.

Seizures are an emergency (and these guidelines vary slightly) when they have more than 1 in a 12 hour period, or any seizure lasting longer than 3 minutes. I've heard various guidelines quoted, ie. more than 1 in 24 or seizures longer than 5 minutes.. but, you get the point.

If you are not too freaked out to do so, try to take note of the time the seizure started, and how long it lasted for.  If they have multiple seizures, likewise.  Before you jump in the car to get them to the doctor, also access if they had any potential exposure to toxins which may be to blame.  It's hard to concentrate when our pets are suffering, but in the least try to watch how long the seizure lasted.

Neurological diseases can be very serious and your dog should be seen by a neurologist if they have a persistent condition.  It's very important we feel confident it's idiopathic (via your vet) versus other reasons.  As with all diseases and abnormalities, never put things off.  And most of all, never be an armchair veterinarian.  Neurology is a very complex subject, and the items I touch on in this article likely just scratch the surface.

My understanding is that a vast majority of dogs respond well to seizure medication. I meet too many dogs who've been taken off their seizure meds because the dog had more, and the owners assumed it meant "the drug isn't working". It's not a disease you give up on, and like many diseases medications require fine-tuning to manage our dogs.

My dog was well-controlled on 1 medication for a year. He began to have "break through" seizures, and we tweaked his first drug. Time went by, and we needed to add a 2nd drug. I recently had to begin a 3rd seizure medication for him, and so far so good. It's a process, and we just have to watch them and commit to partnering with our doctors to manage their seizures.

Tuesday, December 25, 2012

Happy Holidays!

Happy Holidays to all the Great Pyrenees owners and lovers out there!