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.

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.

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.

My Dog Licks Their Paws!

Many owners think nothing of the fact that their dog seems to lick and chew on their feet a lot.  I've heard owners say they assumed their dog was merely grooming, and didn't give it more thought than that.

Cats groom themselves, but dogs do not... *not* in the sense that would explain away licking away at paws or other areas of their body.  We naturally see our dogs affectionately lick on their friends, but offering grooming and licks to a buddy is different than the focus they give to their own bodies. 

Your veterinarian may ask you about licking or chewing, and they do this because it isn't typically a normal behavior.  Dogs who pay this kind of attention to their paws are likely suffering from some kind of allergy, and their paws are itchy.  With excessive licking, they may become raw and irritated, and will likely "bronze".  Bronzing is easy to see in our white dogs, because their fur turns to the color of tea.  Their saliva causes these changes, and if they stop licking (are cured of the source of the itch), the bronzing will go away.

Seeing bronzing is a sure sign of excessive licking, whether it be around their mouths, their paws, or their abdomen.  If you do not notice your dog licking much, he or she may be doing it more when you are not home and if you notice discoloration of fur like this, have your vet talk to you about ruling out allergies.

In addition to this unwanted attention to their paws, if you notice itchy ears or reoccurring ear infections, allergies are a likely culprit.  (Keeping in mind there are *many* things which can irritate our dogs ears, such as baths, excessive hair in the canal, and swimming, to name a few). The only *real* way to determine if it's an allergy is to have a DVM do allergy testing.  It's just like how they do it in humans, where a patch of fur is shaved and irritants are injected under the skin to isolate what they are allergic to.  Not all general practice DVMs may do this, but they can refer you to a dermatologist.

Some of the most common allergens for dogs are dust, fleas, grass, pollen, and certain proteins they are consuming in their foods.  Based on my experience and conversations with veterinarians, some dogs who never had a particular allergic reaction to, say, cow, can develop one after a couple of years eating the same protein.  Your vet may recommend trying a new protein (anything else.. fish, chicken, etc.) for *no less* than 2 months to see if you see an improvement.  (Keep in mind that buffalo and cow are essentially the same protein). Switching for less than 2 months won't give their body enough time to respond.  If you do this, WATCH YOUR SNACKS..  make sure the correct protein is also within your snacks, not just their main meals.

While some dogs have an allergic reaction to vaccines, this *won't* be why you see this licking.  If you dog is allergic to vaccine, symptoms of that will show up the day of the injection and present, most commonly, as a swollen face.  (Anything other than being tired following a vaccine should be cause for concern and you should call your vet immediately).  

Our pups spend their entire lives on their feet!  We need to take any possible discomfort very seriously, whether it be allergens or even overgrown toe nails.  Always be cognisant of the surfaces they are walking on, especially in extreme cold and heat.  With winter coming, beware of salt placed on slippery surfaces, as this can irritate their feet as well.  In the winter, dogs are also more prone to pad injuries, because the ground is covered in leaves or snow, hiding lawn edgings and other potentially harmful items.

That being said, if you notice your dog licking or chewing, exam their paws.  Be sure to look closely between all their "toes", and ensure no nails are overgrown and rubbing into their pads.  If you have ruled out injury or irritation from a foreign object, take them into the vet.  It won't GO AWAY without a change in diet or reduction of allergens, and will likely grow worse and more irritated and possibly infected.  Dogs can be placed on medications to help manage allergies, just like us.

As with all things, an ounce of prevention is worth a pound of cure, and putting off addressing even things which seem minor save us a lot of money in the long run, not to mention the comfort of our best friends which is always paramount to anything else.

Vaccines and Your Dog

While we've mentioned certain diseases on this blog previously, it occurred to me that we never really just plainly talked about them as a whole.  It can be confusing: what you need and when and why, what is required by law, or what kind of a schedule your dog should be on.  Please note that different veterinarians will make different recommendations for your dog's particular age and health status, and also based on their lifestyle.  During those "puppy" series, there may also be some differing recommendations.  Always bear in mind that medicine is a constantly evolving arena, when it comes to new studies and illnesses. This article is meant to be a general guideline to help you get a better understanding of the recommendation that I am most familiar with at this time.  *As with all things* when it comes to your dog, seek advice and guidance from your veterinarian and use all other sources of information as general guidelines.

Rabies:

This vaccine is required by law, and it is only viewed as legal if administered by a veterinarian. Our dogs get this vaccine for the first time around age 16 weeks.  If your puppy is on a schedule of visiting the vet 3 times for a vaccination series, this vaccine would occur at your last visit.  For vaccines in general, puppies get vaccinated at 6-8 weeks, then 10-12 weeks, then at about 16 weeks.  After their first shot, they will return in 1 year for another, that will be good for one more year.  After that, if they visit on time when each vaccine is due, it will turn into a 3 year vaccine.  It is the same vaccine given, but the theory is that after we build that initial immunity with those first 2, one-year shots, they will only need the shot every 3 years to maintain vaccinated status.  This is considered a "core" vaccine, meaning one you really must get, beside the fact it is illegal if you don't.
More on Rabies

Distemper:
This is referred to as the "Distemper Combo" vaccine.  It can be abbreviated many ways, one of them being DHLPP.  This vaccinates against Distemper, Hepatitis, Leptospirosis, Parvo virus, and Parainfluenza.  It can also be just DHPP, as often Leptospirosis can be separated out from this vaccine and given separately.  This is also a core vaccine like Rabies, though not required by law.  Your puppy will get this shot 3 times, at each of those 3 puppy vaccine visits mentioned above.  After the last shot at 16 weeks, they will get the shot again in 1 year.  After that, they will get that vaccine every 3 years.
More on Distemper

Leptospirosis:
If not included in your veterinarian's Distemper combo vaccine, this will stand alone as it's own shot.  Alone, it is not considered a core vaccine, though it makes a lot of sense, especially for dogs in Colorado who have such an active outdoors lifestyle.  This vaccine can be given as puppies over two visits with the other puppy visits, and then it is given annually.  It is only good for 1 year each time.  If your dog is an adult who never received it, they will get an initial shot which will need to be boostered a few weeks later.  From there, it becomes an annual visit.
More on Leptospirosis

Bordetella:
This is commonly referred to as the "Kennel Cough" vaccine, and while it's not a core vaccine, it's the one that boarding and day care facilities will require.  Your pup may receive this twice during their puppy visits, and most facilities will ask for proof of vaccination every 6 months.  If you are not boarding or taking him to day care, your vet may just booster this once a year.  This vaccine can be given intranasally (liquid squirted into their nostrils) *or* via the typical injection.
More on Bordetella

Other vaccines:
Your veterinarian may make recommendations for others, such as Canine Influenza (a newer disease in dogs) or Lyme's disease, which is a very standard vaccine for dogs living in the Northeast. 

Vaccines are given, with the exception of intranasal Bordetella, as subcutaneous injections.  This means your vet or tech lifts their skin and injects the liquid just under the surface of their skin.  They use a very small needle, and it causes very little pain or discomfort. The injection itself is only about 1 milliliter of fluid.  They will often give each vaccine in different locations on your dogs body, so in the event of an allergic reaction, they will know which vaccine caused it.  Allergic reactions are possible, but on the whole vaccines are well-tolerated.  They all can cause some sleepiness afterwards, and this is normal.  What to look for to understand a potential allergic reaction would be things like extreme lethargy and/or face swelling.  If your dog acts anything other than "a little tired", call your clinic immediately. 

To dispel some myths I've heard from time to time, there is *no* vaccine that you give one time that works forever.  I've unfortunately met owners who thought that "they were vaccinated" meant it was done and over after one visit and shot.  There is also no vaccine against Heartworm Disease; you use your once monthly oral tablets for this.  Animals *can* get a sarcoma (tumor) from vaccinations, but this is the exception, not the rule.  If you are concerned about the risk factor to your pet, discuss all these concerns with your vet.  Your dog is *not* vaccinated the minute they get an injection.  If you vaccinate your pup for Leptospirosis today, and they drink from a contaminated puddle tomorrow, they may very well get the disease.  A body takes time to respond to the vaccine and build immunity.  Ask your veterinarian about the time frame they are comfortable with for your dog, before you expose them to contagions.  It is not wrong or uncommon for your doctor to hold off on vaccines if your dog is sick.  If their bodies are busy fighting something else off, it may make sense to let their bodies do just that, before introducing another job for it to do.  The last myth:  older dogs don't need vaccines.  It is potentially quite the contrary.  I've met owners who felt like their dog "lived all this time" and never got "anything", and they must be immune "by now".  Never mistake lack of previous exposure to immunity: they are not immune unless they are vaccinated.  We tend to think of Parvo and Distemper as puppy diseases, because they do get them the most.  They get them the most because their immune systems are not fully developed.  Just like in humans, as we age, our immune systems become weak.  Our older dogs are again at risk of diseases when they are immuno-compromised.  I once asked a vet what was the oldest dog he ever met with Distemper.  His answer: 10 years old.

Vaccines are not expensive, but treating the illness they get if they are not vaccinated is.  Even if you believe your animal to be one with little exposure to other animals, they are still at risk.  Believe your doctor when they explain that your puppy is "under-vaccinated" until they have received their 3rd and final round of "puppy shots".  I think it's important to understand how immunity works, and never take risks.  

Huh? Dogs and Ears

New owners ask a lot of great questions about their dogs when they first get them: contagious diseases, weight and dog food, and behavior and training.  In Colorado, I've had the distinct impression that more owners than not also take their dogs to the groomers.  There, someone else can address their coat, and the dreaded "nail trims".

I beg dog owners to not ignore the health of their dog's ears.  Nails and coat health may seem obvious, but as a Great Pyrenees owner, a dog prone to dirty ears, I beg new owners to take a hard look at ear health.

Some dogs have ears that are pink and pristine without any effort.  Other dogs, like our Pyrs, have floppy, hairy ears that trap a ton of moisture and dirt. Some other breeds, such as Poodles, can even have additional hair throughout their ear cavity which traps all kinds of cooties.  It's important to understand what kind of ears your dog has.

Dogs' ears are not like ours.  In humans, the eardrum, or "tympanic membrane", isn't as deep.  In our dogs, their ear canal is kind of like an "L" shape.  It goes deep and far, and what we see on the outside is far away from what is deeper into their anatomy.

In the rescue days, more often that not rescued Great Pyrenees had horrible ear infections.  We had several dogs come through that were diagnosed by the veterinarian with deafness, most likely caused by owners who ignored ear health.  Great Pyrenees ears, while not as floppy and fuzzy as some dog breeds, are still floppy and hairy.  All Pyr dog owners need to be educated about how to properly clean their dogs ears, how often, and with what.

Avoid over-the-counter ear cleaners.  While the temptation is great to purchase that cheap ear cleaner from the local pet store, many of those cleaners contain fragrance and ingredients not conducive to great ear health.  Purchase your ear cleaner from your vet clinic; it's only a few bucks and it's guaranteed to be gentle and effective, assuming your dog does not have a current infection.

If your dog is shaking their head or tilting it, do not assume that cleaning them is the solution.  By this point, the chances of yeast, bacteria, and/or infection being present is very likely.  I know they seem like "just ears", but before you try to clean and treat at home, it's important a vet looks at them.  They aren't just looking for dirt and infection, but rather to ensure that the eardrum is in tact.  Certain treatments and ear cleaners can be very detrimental to the ear drum if the condition of the ear drum isn't established first.  Damage to the ear drum doesn't need to happen through trauma, it can be the result of a number of things and it's important your vet does an assessment.

Not only our our dogs ears deep, they have many crevices in the external portion, the floppy part or "pinna" for dirt to become trapped and cause inflammation and irritation.  Owners should never use Q-tips to clean these portions, as your dog could move or jerk and you could cause trauma.  It's key to take your cleaner and a cotton ball and thoroughly clean those outer portions with care.

Every doctor will have a different recommendation, based specifically on your dog and their health, regarding frequency of ear cleanings.  The important thing to take away from this article, is that we must be proactive.  We do not clean our dogs ears after dirt has accumulated; we clean them proactively to prevent infection.  I have personally found that my Pyrs need their ears cleaned once a week to prevent nasty accumulation of dirt and debris.

They aren't going to like getting their ears cleaned, but we cannot rely on vet visits to address the ongoing health of our dogs ears.  Hearing is important, and it's key to not dismiss ear health the way owners are quick to dismiss a tangle or dread in their hair. 

Ask your veterinarian or their technicians to show you proper cleaning techniques.  Do not be shy; even if your dog isn't there for an ear problem, show the staff how much you love your animal by addressing any and all causes for health concerns.  Ask your vet about diet and allergies, as some of these things can contribute to persistent ear problems.

The Needs of Senior Dogs

Whether you are considering adopting an older dog, or you own a dog reaching their senior years, health care begins to change.  We look at our dogs, and we can often find ourselves seeing the same pup we always saw.  "Sparky" seems fine, and owners feel no need to run blood work and be proactive. Some dogs show age, others don't... on the outside.  I have met many senior dogs with little to no changes in body condition, eyes, or teeth, and yet their internal organ function has changed considerably in a year.

Black and darker dogs slowly reveal graying hairs, while lighter colored dogs rarely show signs of aging in the sense we relate to.  Often owners of older dogs don't understand the need for additional care in the later years, because their older dogs "look the same" and haven't really seemed to be slowing down yet.

Sadly, I see too many owners appropriately addressing the needs of the senior dogs only after symptoms of deteriorating health have begun to surface.  They may visit the vet once a year, refuse the annual or blood work, and then feel even more put off by the recommendation that senior dogs, dogs over 7 years old (regardless of size or breed) , get blood work done *twice* a year.

We all make jokes about "dog years", but how many of us really think about the "true age" of our dogs?  Like with most illnesses, if we wait for symptoms to emerge, there has already been damage occurring in the body.  By catching things earlier than later, we are better able to manage those diseases before they do additional damage to the body.  I always tell owners, "Don't wait to learn they are *visibly* sick".  Some owners really *get* this, while others think that since their dog seems fine, we are just trying to get more money from them in a visit.  Anything could be further from the truth.  Your veterinarian and their technicians deeply care about your pet, and nothing is more exciting than meeting an animal who has surpassed their life expectancy!

The reason senior pets should receive blood work twice a year, is because as their bodies age, we have more concerns.   Prior to reaching senior years, there may have not been a great concern that liver or kidney function would deteriorate between June 2011 and June 2012.  They are young, and barring any illnesses, injury, or congenital predisposition, annual blood work should be enough.  Simply put, dogs age faster than us.  What is 6 months to us, is much longer for their bodies.

We all can think about human senior citizens we have know.  Unfortunately, body systems seem to begin to potentially fail more frequently, and perhaps several years of being on a medication begin to take their toll on the liver and/or kidneys.  In addition, the health of an aging animal can be greatly enhanced by attention given to dental disease, where as when they are younger, we hardly think of it. (right or wrong).

"Seven" doesn't sound old, and it shocks some people.  The thing about this magic number, is I do believe it takes some discretion on the part of the owner.  Not in the sense that "I'll wait until they are older than 7 to consider them seniors, and pay for additional care", rather, if your pet had a hard life before you, perhaps you need to think of them as a senior at even 6.  Dogs who came from bad stories, who have had diseases; we know as people some people "are older" than their true age.  I think it's important to consider this when you pet is on the 'borderline' in ages.  Additionally, giant breed dogs, like our Great Pyrenees, can be considered "senior" by age 5, due to their life expectancy of 10-12. 

I began getting blood work done on a cat of mine, very few years into his life.  Some would think, "Wow, 3 years old?  Isn't that too young to have a problem?"  No, it most certainly isn't.  While a veterinarian wouldn't have necessarily thought to convince me into blood work, I knew my friend.  He wasn't super healthy when I got him, for starters.  Also, he seemed to get "off" or "sick" pretty easily.  He has had blood work twice a year since, and it's never been great.  But I know that due to my frequency, I will catch something before it erupts into a true, bad, disease condition.  Due to my thoroughness, we caught tumors on him at age 4 that were potentially cancerous.

There are some primary concerns with our senior dogs.  Of course, there is liver and kidney function.  In addition, we grow concerned about their thyroid gland. Dogs can get hypothyroidism, and it can often occur due to natural aging.  Arthritis becomes a huge consideration, and while x-rays can diagnose arthritis, often symptoms alone will cause your vet to make that diagnosis.  X-rays can help determine how bad the arthritis is, and where it is, and if you can, get them done if any stiffness or lameness seems noteworthy.  Unless congenital, aging animals can develop heart murmurs.  A heart murmur isn't a disease, rather a symptom of a disease.  Like us, hearts age.  With that aging, certain parts of the heart begin to do their jobs less effectively than when they were young, and diagnosis and treatment may be merited. Without those vet visits, those murmurs would go unheard.

Lastly, let's address the trepidation of owners to adopt older dogs.  While many people will lament at the prospect of "not enough years" together, I think there still exists some underlying anxiety about vet bills.  This isn't unfair, older dogs *do* cost more, assuming you are a great dog owner.  I think most people will agree that the value to life isn't in quantity, rather quality.  When considering your senior adoption, consider all the great care you have to offer.  Yes, twice annual vet visits will add up; but I feel we are quick to spend money on frivolous things and not think twice, but think that our companions should be *all bonus*.  They aren't; they are growing, aging, majestic creatures who are even that much more amazing with age.

I have met owners whose 4 year old dogs got cancer.  I can only imagine that their advice to others would be to find your soul mate, period.  It doesn't matter how old or young they are, because health isn't a guarantee.  We can do our best to give great treatment, but if the "make it or break it" of dog ownership is the naive assumption that younger dogs spend more time with us, think again.  That, of course, is the fair hope, but our fear of aging shouldn't put us off from adopting older dogs.

Regrettably, I've seen too many dogs surrendered, during old or geriatric years, due to increasing vet bills.  This is *unforgivable*.  Please take a moment, before adoption, to realize that 'forever' means 'forever'.  This means, one day, your dog will be very old.  He or she will need blood work, x-rays, pain killers, and any number of other things to make their senior  years pleasurable and as healthy as possible.  Listen to your veterinarian, and believe them, when they talk about the changing needs of your senior dog.

Great Pyrenees: Understanding Nature versus Nurture

One of the most important things about adopting a new dog, is understanding it's breed.  While great leadership and training will yield amazing results for just about any dog, each dog breed is unique.  There can be decades or even centuries of breed development which will almost ensure certain traits you can expect.  Our job as great owners is understanding what has been bred into our dogs to serve a beneficial purpose versus what is perhaps just naughty dog behavior, or just their unique personality.  A lot of dog traits are very intentional for what their "working" purpose is, yet can be undesirable in a home setting.  It's key to understand what your dog was born to think of as "good, I'm doing my job" so we can cater how we approach training if those behaviors are undesirable in the domestic setting.

So this is your first Great Pyrenees, what can you expect?  Like all large breed dogs, if it's a puppy, you can expect bursts of play followed by very important periods of rest and sleep.  If you've had a high energy breed puppy before, do not have the same expectations.  Pyr puppies still play like the best of them, but they can crash pretty hard and do need time to rest so their huge bones can grow properly.  Great Pyrenees tend to reach their full height at about 1 year old, and may continue to "fill out" for the next year.  Personal experience has told me that Pyrs don't tend to tolerate ear cleanings or nail trims very well (as they are a stubborn breed) so early exposure to these routine things is key, especially since double dew claws need trimming, and they can be prone to ear infections due to having floppy, long-haired ears which can trap moisture and breed yeast and bacteria.

Expect your Great Pyrenees to want to be by your side.  People often mistake the fact that they were bred as livestock guardians as a reason to think they will do well outside, alone, for long periods of time.  In the absence of a farm and flock, *you* become their flock, and your house the farm.  They are bred to always be with those things to protect them, and depriving your house pet of these can lead to depression and unwanted behaviors.  Because this breed was in fact bred for outside work, their coats are very resilient.  The coat of a Great Pyrenees reflects dirt and water very well, and requires more brushings to release dirt than baths every time they get muddy.  In addition, their coats serve as amazing insulators.  If you are concerned your Pyr is only a cold-weather dog, think again.  While they love the snow, they tolerate reasonable heat well.  Never shave a Pyr's coat, as this exposes them to direct heat and sunlight.

Pyrenees are "leaners".  While a lot of people like to take it as personal compliment (ie. "he likes me!") it's a breed trait.  Pyrenees didn't watch their sheep from afar, they nestled amongst them and watched for predators.  Leaning enables your Pyr to know where you are without having to keep eyes on you, freeing them up to survey their surroundings.  Because this is already in them, they will lean when not feeling threatened or not "working".  I've noticed that we can see this trait when leash-training our Pyrs.  In my experience, a Pyr is quick to lean against you as you are walking them.  While I'm not super confident I could train this out of a Pyr, I have never felt it to be a detriment to their other leash walking manners.

As most know, Great Pyrenees are prone to night barking.  If you have a Pyr pup, ensure you are addressing this right away.  We need to respect why they do this, and not consider them naughty for it.  Barking is ideal in a livestock guardian setting, as it scares away the threat.  Your Pyr will absolutely think he is doing his job, and will be confused when you say otherwise.  Natural, breed barking is in response to stimulus from surroundings.  If your dog, any dog, barks incessantly, there may be another underlying issue.  Often times, we cannot see or smell what they do, and their stimulus is beyond our immediate comprehension.  Versus reprimanding a barking Pyr, I have found it more effective to show them you "see what they see", praise them for a job well done, and they should cease so long as the threat doesn't persist.  This is natural for this breed, and should be expected upon adoption.  A well-balanced Pyr shouldn't bark more than is justifiable.

Bored dogs will dig, yet some dogs have digging in their DNA.  Pyrenees will dig, and this should be another consideration with your new dog.  If you allow them a spot or two to have their hole for coolness and comfort, they are likely to leave the rest of the yard alone.  It may take some patience on your part to let them find their ideal spot.

Expect your Great Pyrenees to be gentle and accepting of people, children, and other animals.  A Pyrenees who is aggressive with children or cats, for example, is not the breed standard.  If your Pyr shows these signs, this is something that could and should be remedied with training and guidance.  The only normal time for aggression would be in a guardian setting, where the Pyr felt threatened that another dog was impeding on his property.  This means your Pyr may be great with all dogs outside of the house, but potentially feel they are a threat to their "property" inside the home or the yard.  While I have found most Pyrs to be sweet 99% of the time, it would not be unusual for a Great Pyrenees to insist on being the only guardian if an alpha presented himself as a threat.

It is not in this breeds nature to have any predisposed health concerns specific to the breed.  Health concerns associated are more or less due to them being a giant breed, but not a Pyrenees specifically.  We worry about all our large and giant breed dogs when it comes to dental and bone health.  You can read a ton of literature and studies, and never see this breed pop up as a breed with specific health concerns.

Aloofness is in the nature of this dog.  Your Pyrenees isn't distant, cold, or disinterested because it stares off at times.  Being stoic, they tend to greet strangers thusly.  That stoicism is coupled with stubbornness.  Expect your Pyr to be resistant to training, perhaps only willingly sitting for a snack.  This nature is key to ensure these dogs are not easily tempted to leave their flocks.  If you were to visit a farm with livestock guardians and hold up a juicy slab of meat and call their name, they won't come.  Good job on their part.  Patience is required to teach our gentle giants to come when called and other various commands, and food/treat motivation is an expected component initially.

Understanding their nature is so important, so we select the right breed to begin with, and then to understand why they do, or don't do, certain things.  Owners, through education, can be spared having to hear themselves lament, "I can't stop her from doing that!".  While training does work wonders, understand you choose a Great Pyrenees, and love them for all their amazing breeding and characteristics.

-Shannon Murphy

What's With All These Tests?

I've heard many pet owners lament at various tests their veterinarian wants to run, especially when their pet isn't visibly ill.  I think owners shrink from asking too many questions on what each test is for and why, and they leave feeling uninformed and feeling a little like "they are just trying to get more money".  I can't blame them for feeling that way, if a doctor doesn't explain the 'whys' and/or the owner doesn't ask them.

I promise you, your veterinarian and their staff aren't trying to suck more money out of you.  Everyone entered this field due to love for animals.  If your doctor senses you are open to "more" tests, it's because you seem super committed to your pet's health and they'll recommend everything that *they* would do.  There are no 'secret tests' held to the side for owners willing to spend more money.  

There are a lot of tests out there (thankfully), but there are some basic tests your DVM will want to run when your animal is in good health.  There are key reasons to agree to these tests:

1. Animals can't talk.  They can't tell us when they are sick.  Plus, they hide it well, especially cats.
2. Establish a good base line.  If you only test organ function in your animal when they are sick, where were they a year ago?  For example: how progressive is this illness, and how will the doctor know that without history?
3. Be proactive.  Don't wait for them to become sick, monitor their bodies yearly.
4. Animals age differently than us.  Remember, your 4 year old dog isn't "4".  If it's a large breed, they are sometimes considered seniors at age 5, while most dogs are at age 7.
5.  Prevention is cheaper and smarter. If you think a $100-$200 bucks once a year is expensive, wait until they are truly sick. 

Pretty much all clinics offer "packages" to help reduce the overall cost and run more tests.  If your animal is older, typically your doc wants to run a "senior profile".  While I have seen varying tests included in the various packages, here are some basics:

1.  CBC.  This stands for Complete Blood Cell Count.  Within this test, your animals blood is being evaluated.  Primarily they are looking at red blood cells, white blood cells, and platelets.  This is absolutely essential to look at prior to any procedures.  This will (to name a few) rule out anemia, infections, and clotting disorders.
2. Heartworm.  This test is a separate test, and it naturally rules out if your animal has heartworm.  Never be quick to assume your pet doesn't need one because you don't see mosquitoes.  Perhaps their mom was positive when she was pregnant!
3. Chemistry panel.  This is where we are looking at the enzymes in your dog's blood.  Organs like the kidney and liver produce enzymes, which are found in the blood stream in certain levels.  Changes in those levels can indicate the health of vital organs in the body.  Included in this test is blood glucose levels which rules out diabetes.  If your pet is on medication, this is key to ensure the liver and kidneys are handling the stress certain drugs can place on them.
4. Thyroid.  This test is extremely important in cats and in older dogs especially.  Older dogs are at risk of developing hypothyroidism, which is a very treatable condition but extremely important to rule out, especially in older dogs with weight gain and changes in their hair coat quality.
5. UA.  Urine analysis.  I think people don't realize how much you can learn from examining your pets urine!  While this can rule out things like crystal formation in the urine, it also speaks novels to kidney function, and we can learn more about that function than just by enzyme levels alone.
6. Fecal.  While most owners feel confident their dogs don't have "worms" because they visibly inspect their dogs output, there are critters you can't see.  Giardia, a protozoa, cannot be seen with the naked eye and many animals can be asymptomatic.  

Never be too shy to ask why.  These are very basic tests, and sadly yes, they are all separate tests.  I merely touched on very basic, simplified things these tests can reveal, in the hope that owners can better understand why they are all important.  Your veterinarian will walk you through when they think these tests are necessary, based on the age and health of your pet.  Your doctor understands how all these tests together reveal how your animal's body is working in concert.

When your doctor says "I'd like to run..." I know your purse will flinch at those words, but listen to them.  Prevention is the goal, and prevention is cheaper than waiting for our beloved animals to become sick.  I sense a lot of owners are already stressed a little bit even being there, and even the exam costs can seem like a lot.  When you're already feeling overwhelmed, it's quick to shut your mind off and say no.  Ask your veterinarian what each test is for, and if you're so inclined, as them to review the results with you in greater detail.  You'll walk away feeling like the "Owner of the year" when you realize what a great thing you are doing for them by being proactive.

-Shannon Murphy

The Importance of Healthy Vet Visits

Vet bills are a drag.  Most of us are so accustomed to health insurance for ourselves, with a co-pay that lives happily within our budgets.  While there is pet insurance available for our animals, it seems more often than not, owners to not have insurance.

It seems as though you can't leave the veterinarian's office without spending over $100.00 on a healthy animal. Many people wait, and take their animals to the doctor when they seem to not be feeling so well.  It can be hard for these owners to justify the expense when they feel their animal is doing well.

All animals need a yearly visit to the vet.  Even if you don't want to pursue annual bloodwork, it's important to get your pet in front of a veterinarian.  There may be things going on that you can't "see", or that you think are not important.  Small changes in mobility may hint towards impending arthritis, and things like a heart murmur may warn of a condition that looms.  There may be conditions your dog's breed is prone to, and that small bump you think means nothing may have much more significance for your dog.

When you think of your animal, draw an analogy to your house.  That small imperfection in your plumbing or your roof may not seem like much now, but left unattended may turn into a situation that will cost a lot more time, money, and emotion.


Being proactive is key.  Animals cannot speak, so spending the money on annual bloodwork will help us understand what's really going on in their bodies.  If your animal is taking medication, it's key to check how their liver and their kidney are keeping up.  Our animals may be nearing the age where arthritis is possible, and while we think they seem fine, they may in fact be suffering from some degree of daily pain.

Too often owners are taken off guard by their animal's condition.  All of a sudden they are not well.  You find yourself at a clinic facing hospitalization and medications you didn't anticipate.  While being diligent with your annual visits may not put off such an event, they give a great record of health.

Imagine your 10 year old dog or cat never saw a vet's office because to you, they always seemed fine.  Now afflicted with a potential illness or disease, there is no history what-so-ever about organ function up until this point.  Your vet struggles to understand how acute their condition is, or how quickly it's progressed.

I recall the horrible food recall from pet foods manufactured in China from about 5 or so years ago.  Animals suffered with organ failure, and there was a class action lawsuit.  I spoke to my vet at the time, and he was sad.  He was sad, because too many animals had no history up until that point.  If they presented with kidney failure, there was no definitive, legal way to prove the food had caused it.  Without history, the animal in question could have easily been in failure already.  He was so happy to work with clients who had previous history so as to certify they were victims of this horrible food.

Owners wait ages on addressing their animal's teeth.  By the time the owners notice horrible breath and perhaps difficulty chewing, the mouth may already have a myriad of issues.  Now facing extractions and the like, the vet bill is now easily nearing $1000.00.  While an annual dental may still cost a few hundred dollars, it keeps the animal healthy and avoids the pain and cost of waiting.


Put money aside for your pet.  I know it's easier said than done.  Anticipate that every animal needs a 'rainy day' fund of a few thousand dollars.  If you don't need it for a long time, great.  Eventually all animals age and will need medications and more frequent vet visits.  If you are unable or unwilling to do this, pet ownership needs to be reconsidered before the pet is adopted.

It's not to say that only "rich" people should own pets, but rather we should be willing to find ways to cut back on our monthly expenses to accommodate the long term health of our pets.  I heard a woman lamenting about the $100.00 per month expense of her dog's newly prescribed medications.  She asked me if owners should euthanize when faced with these costs.  Everything in me wanted to suggest she go without a trip to the salon every once and a while.  This, is what loving owners need to be willing to do for the family member they love.

And why are the vet bills so high?  Veterinarians love their patients.  They don't wish to make care prohibitive or impossible.  I can promise you that no one cares for animals because they seek to get rich.  Sadly, these are just what things cost.  If your pet needs a specialist, the costs will be higher.  The fancy, amazing gadgets we use to save a life cost money to purchase and run.  The amazing, additional experience your specialists have, cost them money to attain. 

I've heard feedback that owners feel their doctors order unnecessary tests which drive up their costs.  I think it's key to understand that the best way to treat an animal is to understand what is going on in their bodies.  Often times, certain conditions can be caused by or made worse by other conditions.  Doctors have to play detective.  I urge owners to be vocal!  Ask questions about 'why' tests are run, and what it means if they are not.  It can seem that every additional diagnostic drives the bill up by the hundreds, and it's frustrating.  Do your homework; shop around for affordable veterinarians (within reason... you do *get* what you pay for) and shop around for avenues for cheaper medications.

Above all, be proactive.  Commit to preventing illness in any way you can.  Obesity and poor nutrition are huge components that are within our influence.  Ignored ear infections or ignored behaviors can lead to larger issues.  Sometimes our pets can begin to act differently, and we think it's behavioral when really it may be their only way to tell us they don't feel great.  New aggression, frustration, and changes in eating habits may not be indicative of not liking the home or the food provided, rather something else going on that leaves them not feeling well.  Animals don't want to be touched if they are painful. When our cats and dogs are "seniors", ensure they get annual or bi-annual visits *before* they start to feel bad.

-Shannon Murphy

What Is A Heart Murmur?

Some think that a heart murmur in your dog is a condition.  It is, rather, a possible symptom of an underlying heart condition.  The murmur itself describes "turbulent blood flow through the heart", and that turbulence can be due to any one of a number of different congenital or acquired heart conditions. (congenital means they were born with it, and acquired means they developed the condition).

When you take your new dog to the vet for their first wellness exam, your doctor listens to their heart.  They listen for how many beats they are producing in a minute, but also they are listening for this turbulent blood flow…a murmur.  Heart murmurs are graded on a scale from 1-6, with 1 being the softest heard and 6 being the loudest.  A grade 1 heart murmur (and sometimes a grade 2) can be very difficult to hear for the inexperienced ear.  The grade is less about severity and more about how loud it sounds.

In an over-simplified nutshell, the heart has 4 chambers: the right and left atriums and the right and left ventricles.  There are valves that separate the atriums from the ventricles on both sides (tricuspid and bicuspid/mitral valve), as well as all the avenues through which the blood enters and leaves the heart.  As you can surmise, there are several places along the path for the blood flow to be turbulent.  The actual conditions our dogs may have are too numerous to list, and if your dog is diagnosed with a heart murmur, a cardiology expert will do an ultrasound of the heart and pinpoint your dog's problem.

Some breeds are predisposed to certain heart conditions, so it's key to do your research.  In the CGPR days, I recall only 2 dogs having a heart problem.  One had a condition called Supraventricular Tachycardia and the other had Subaortic Stenosis (a condition found mostly in larger dogs). On the whole, we haven't seen too many instances of heart disease in Pyrs, but a cardiologist is your best person to answer those questions.  Some conditions are merely seen more in larger dogs than small, and vice verse.  

All puppies are at risk of having a heart murmur upon birth, called an "innocent heart murmur".  This is why your doctor may heart a heart murmur in your pups at birth that goes away shortly into their new lives.  In a simple terms, their heart chamber fills with a blood volume that their vessels are just a bit too narrow for, and it creates a turbulence as the blood leaves the heart.   This goes away quickly into puppyhood; your veterinarian can educate you best on the timelines for this to become normal.  Our puppy had a heart murmur upon his 4 week visit, and it was gone by week 8 when we got him.

If your general veterinarian diagnoses your dog with a heart murmur, again this is only a sound they are picking up when they listen.  It's crucial you take your dog in to get an echocardiogram (ultrasound of the heart) to make a diagnosis. While these ultrasounds are not cheap, they will ensure your dog gets a proper diagnosis and will live as healthy as is their full potential.  I'm meeting more and more animals who are living longer, healthier lives with heart conditions, all due to the excellent care their owners provide coupled with the cutting edge treatments of cardiology specialists.  Definitely see a Board Certified Cardiologist, as their expertise is worth every penny!



by Shannon Murphy

Article on a special needs heart dog

Dentistry Interview with Dr. Ken Lee, DVM

Dr. Ken Lee, a DVM practicing at Deer Creek Animal Hospital in Littleton, Colorado, is working towards achieving his official specialty in dentistry.  He is a wealth of knowledge regarding animal dental health and disease, and was kind enough to agree to answer some great questions for everyone.  This is an important read, please forward to fellow dog lovers!

General Questions:

1.     How long have you been a DVM, and what is your attraction to dentistry? 
25 years in May 2012. My older brother was actually my dentist when I was growing up. I also got introduced to Dr. Peter Emily a human dentist that was instrumental in building up the importance of good oral health in the veterinary field.

2.    Often time people surrender dogs because they could not appropriately anticipate the costs of dog ownership.  How much money would you advise people put in their 'rainy day fund' for annual dentistry visits? 
For a complete oral exam and cleaning under anesthesia ~ $300-350 depending on the age and the pre-anesthetic blood work required. However, there are some good pet insurance plans that some of our clients have taken advantage of and depending on the coverage elected can include help with maintenance dental care just like for people. More of our clients are purchasing pet insurance when they purchase their new puppy.  
How does this differ from younger years into being a senior? 
Obviously senior dogs have probably a greater share of dental disease, especially periodontal disease-bone loss around the teeth over time. But the younger dogs, especially the large breeds that like to chew frequently chip their teeth, which can open the porous part of the tooth to infection and cause tooth death.

3.    What do you say to owners who only anticipate yearly blood work costs, with regard to the importance of dental care and why they should make that expense? 
Annual blood work is important because for every year dog's age ~6-7 human years. There are many research studies in human medicine and a handful in the veterinary field that show a direct relationship of lesions developing in the heart, kidneys and liver secondary to periodontal disease, which happens to be the most common disease in dogs. In addition, dental disease can often lead to oral pain yet dogs rarely show signs of pain. They hardly ever stop eating or paw at their mouth. Only after we fix a dental problem that owners then notice an improvement in their dog's attitude.

4.    What are the specific dentistry concerns for Pyr owners, and/or just large breed dog owners in general? 
Fractured or chipped teeth and periodontal disease and oral masses as they age.

5.    At what age do we need to start getting dental prophys performed? 
At Deer creek animal hospital we recommend the first complete oral exam and cleaning under anesthesia ~ 2-2.5 years for small breeds and ~ 3 years for large breeds.

6.    My dog chews bark/sticks.  Should I be concerned? Although bark and sticks are usually not hard enough to break dogs teeth they can sometimes splinter and poke into the soft tissues in the back of the mouth and cause trauma and infection.

7.    What's the real truth about letting your dog chew cooked bones and/or versus raw bones? 
All cooked bones are potentially a problem. Chicken and turkey bones because they're hollow can splinter and cause serious damage to the intestinal tract. Beef bones can fracture teeth. There are some raw diets that I've seen work well with no digestive issues or risk to teeth fractures although there is a higher risk of some potentially serious bacterial infections.

8.    "I just cannot brush my dog's teeth"... what is my 2nd option?
Sometimes like any dog training issues it can take patience and time. Try offering just a finger in your pets mouth with something they like such as chicken flavored dog tooth paste or cheese and let them lick it off while at the same time moving your finger around in the mouth. Then try a toothbrush doing the same thing. This may take a few weeks or longer in some dogs. The gold standard in home dental care whether in people or dogs is mechanically wiping or brushing the goo (plaque) off the teeth. The goal is to wipe it away before it has a chance to form a hard brown covering called tartar or calculus. If your dog won't accept a brush I've had many clients that have been successful by using gauze wrapped around their finger. There are dental diets and dog appropriate chew toys that abrade and help keep teeth clean as other options.

9.    Puppy owners need to be educated about puppy teeth.  What 'teething' toys do you recommend? A general rule I give puppy and dog owners is if you can't break it or bend it or indent your nail into it, it's too hard to give. There is a website www.vohc.org that has appropriate dental chew toys listed that are relatively safe that have been tested by veterinary dental specialists. Also I feel good about the dental chews we have at Deer creek.

10. Ideally I'd brush my dog's teeth every day.  Most owners aren't going to do this.  What is the least amount of recommended brushing? 
Studies have shown that you need to try to do it at least 3 times a week to make a significant difference in preventing tartar build up.

11.  "My dog has a tooth that looks "dead".  It's dark and discolored.  Should I be concerned if it doesn't seem to be bothering him?" 
Dark teeth are a sign typically of a dead tooth with the potential of causing pain. The Hale study in 2001 showed ~92% of these teeth to be dead. Unfortunately, dogs rarely show signs of dental pain that I addressed in question #3.

12. My dog has bad breath.  Can he have bad breath without having disease present? 
Bad breath is the most common sign that dog owners notice and usually means significant dental disease or at least a trip in to your veterinarian to have it evaluated. Sometimes serious infections in the kidneys or liver can cause bad breath too.

Questions from Vicky, Boxer owner:

1. Many of those who feed a raw diet claim that this negates the need for dental care, as the teeth gain a thorough cleaning via the biting through soft bone and gnawing on the harder bones.  Have you seen this to be true? I have seen some positive results in dogs being fed this diet. However, dogs fed these diets can still develop periodontal disease under the gum line and fracture teeth that can cause them pain. A complete annual exam by a veterinarian can catch some of these problems, however since our furry friends don't communicate pain to us well a complete oral exam under anesthesia with dental x-rays is the only way to thoroughly evaluate for these dental problems.
2. Many treats (flossies, rawhides, cookies) and flavored bones of various types are sold in pet stores and claim to be good for dental health.  How much of this is true? Some of them are good, some are not. I refer you to Q#9.
3. What are the dental implications between feeding dry kibble vs. canned? Studies have shown that feeding strictly dry food diets compared to canned food can decrease tartar accumulation by about a 1/3.

Questions from Donna, large breed dog owner and dental hygienist:

1.     What's the best for cleaning a dog's teeth; nylabone, rawhide, greenies, real bones? Nylabones and real bones can break teeth. I refer you to the website www.vohc.org -appropriate chew toys 

2.    My vet's office always tries to get me to buy a liquid to put in my dog's water that is supposed to help keep their teeth clean.  What is it?  Being a dental hygienist I just don't believe there is a product that will really keep tartar from building up.  And if it is really does work why is it not safe for humans?  I'm an over protective dog mommy and I don't want to give my baby something that isn't safe for humans to consume. 
Yes, there are many products out there that are marketed as drinking water additives. Some contain chlorhexidine and/or zinc gluconate which are very good oral cleansing solutions for people and do a good job for cleansing solutions for dogs as well. I personally have not seen any real health issues from these drinking additives in dogs. Probably because they are so diluted ~ 1-2 TSP in a qt of water it doesn't cause a problem. So these products could potentially help with decreasing some bad breath but I have not seen any control studies that have shown a decrease in tartar and gingivitis. I always tell my clients there are only three things our dentists or dental hygienist gives us at our dental appointments. A toothbrush, toothpaste and dental floss. Dog teeth anatomy has significant enough space between them that floss is not needed, thank goodness. Again, mechanical brushing or wiping is the gold standard in preventative dental care in dogs and people.

3.    Also being a hygienist a lot of people ask for my old tools to clean their dogs teeth with.  We always tell them no.  They can do a lot of damage to the dog's gums, gouge the root surfaces, the dog could bite them or they could slip and the sharp instrument could go anywhere, and most of all they can't sterilize the instruments!  Is there any safe way to chip away at a dog's teeth at home? 
I agree with all you mentioned. These tools can cause micro-scratches in the enamel of the tooth and the roughen surface and can increase the tartar accumulation even faster. They also aren't addressing what's under the gum line, which contains the majority of the oral infection. 

4.    In dentistry we insist on putting a crown on teeth that have had a root canal.  The tooth gets dry and brittle and is highly likely to break off at the gum line in the future.  Is it recommended that we crown our dogs teeth post RCT as well?  They chew much harder things than we do.  Are they at risk? 
Yes to all of the above but I think client education on appropriate chew tows and addressing behavior problems is more important. Crowns can help protect a tooth from further trauma post root canal therapy and we do place them for that reason at Deer creek. However, I also have seen teeth broken with the crown still attached to them so a crown is no guarantee, especially with the increase bite power dogs can elicit with their jaw angle.

5.    Angus is a big time poop eater.  What impact does that have on his mouth? 
Other than the obvious nothing much different than feeding canned food.

6.    And just a random thing I've always wondered.  It seems like lapping water is so ineffective.  Should I add water to the dog food to make sure he is hydrated well enough? 
I have not seen problems with dogs hydrating themselves with their normal drinking activities.

Final Question:
If you could give 1 piece of advice to all dog and cat owners regarding dental health, what would it be? Prevention just like in people. Annual oral exams and cleanings starting at 2-3 years of age and consistent home care. Our pets will benefit with longer, higher quality lifespans.

by Shannon Murphy