Ear Infections (Otitis Externa) in Dogs

by

William T. Testerman, DVM

"Doc, you've got to do something for Snoopy. All night long he shook his head, rattling his collar, which meant no sleep for him or us." As Snoopy's owner pulled him into the exam room, his head was tilting to one side and he was guarding it from hitting the leash. Both dog and owner were unhappy and looking for help to resolve the situation.

This scenario is played out every day in exam rooms of veterinary hospitals. The diagnosis usually is "Otitis Externa" or simply an ear infection. The causes are many and the cure for the problem is not a simple one. The infections are painful for the dog and frustrating for the owner to treat which makes it imperative that the diagnosis is as accurate as possible and that the owner understands how to follow through with home care.

Some breeds are more susceptible to infections in the ear, especially if they have large, floppy ears or hairy ears, like Cocker Spaniels, Miniature Poodles or Old English Sheepdogs, but infections can occur in any breed. During the initial puppy visit to the veterinarian, it is a good idea to discuss preventative care for those breeds where a high incidence of ear infections is noted.

The diagnosis of an ear infection and the causes is the most important step in treatment. While young puppies often have ear mites, which can cause intense itching and head shaking, older animals will seldom have mites present. Adults usually have infections caused by bacteria and yeast, often occurring together. An examination with an otoscope, an instrument with magnification and light, is necessary to determine the presence of foreign material and if the eardrum is intact. A sample of debris from the ear can be examined under a microscope to determine the cause of infection. In some cases the irritation is caused by foreign bodies or small tumors which can only be seen with the otoscope. Often the ear is so painful that the animal has to be sedated to complete the examination and start the initial treatment.

An important part of the overall treatment plan is to determine the cause of the infection and correct any underlying diseases. The initial treatment will address the irritation and infection with medications locally and orally if needed. Many dogs that have chronic ear problems have allergies or low thyroid function (hypothyroidism). These conditions must also be treated to prevent future occurrences. Another complication with long standing infections is that excess tissue may be present, resulting in the ear canal becoming constricted and nearly closed. This makes treatment of the ear difficult. Often surgery is the only correction for this complication.

Applying medication to the dog's ear can be challenging and almost impossible, at times, due to pain and non-compliance on the dog's part. It is important that the owner understand how to best administer the drugs to achieve results. The dog's ear canal is "L" shaped unlike the human ear which is straight. For medication to be effective, it must reach the lower part of the ear. To do this, the ear should be pulled gently upwards with one hand and with the other hand apply a small amount of medication in the ear canal. The base of the ear should then be massaged between the thumb and finger until you hear a squishing sound. Release the ear and allow the dog to shake its head. Since most ear medications contain a wax solvent, there will usually be debris on the inner ear after the shaking. This should be cleaned with a clean soft cloth or cotton ball. Cotton tipped ear swabs should not be used as they tend to push debris deep into the ear canal.

Although ear infections are a painful problem for the dog, they can usually be treated and managed with careful diagnosis and treatment. Once the initial infection has been resolved, the owner must assume the necessary follow up home care to maintain a healthy ear. Communication between the veterinarian and owner on how best to accomplish this is the secret to a happy doggie and owner that sleep through the night with no sounds of the collar jingling.

Vaccinations: When, How Much and How Often?

by

William T. Testerman, DVM

When Dr. Edward Jenner began his practice in England, he had a keen curiosity and observation power that led him to make one of the most important discoveries of medicine. Although he lived in a time with very few technical aids, he was the first person to develop a method to protect people from the most feared disease of his time, smallpox. He did it by taking the fluid from a milkmaid that had developed cowpox and injecting it into a young boy. After the boy showed signs of cowpox (mild blister-like lesions), he then injected him with the deadly smallpox virus. The boy was protected and remained healthy. The word "vaccine" was developed by Jenner taking the Latin word for cow (vacca) and for cowpox (vacinia). From his work, all current vaccines have been developed.

Why are vaccinations important to our furry friends? If you have ever seen a rabid dog, or watched the terminal convulsions of a dog with distemper, you would never question the value of vaccines. Those diseases that were once common place are rarely seen now because of aggressive vaccination practices.

To understand more about vaccines it is important to know that there are different types, modified-live and killed. These give different immunity levels and also affect the animal differently. Modified-live vaccines actually give the animal a mild form of the disease which generally gives longer protection. Killed vaccines are considered safer and do not produce symptoms, however, the immunity produced is often shorter.

Although many vaccines are produced to protect dogs from diseases, they are divided into "core" and "non-core" to emphasis their importance. The core vaccines are recommended for all ages. They are: Canine Distemper; Canine Parvovirus; Canine Adenovirus-2; and Rabies. Non-core vaccines are recommended in special circumstances dependent on the exposure risk of the individual dog. They are: Distemper-Measles; Leptospira species; Borrelia burgdorferi or Lyme Disease; Canine parainfluenza; and Bordetella bronchiseptica or Kennel Cough.

Pet owners, especially those with older pets, are often confused about what vaccines their pet needs and how often. Basically it gets down to the risk exposure the owner is willing to take. If the doggie gets very little exposure to other animals and is healthy, the core vaccines could be spaced longer apart. The non-core vaccines can be given on an as needed basis. The manufactures recommendations are for yearly vaccines for all ages as they are aware that not every animal will react to the vaccination in the same way. Also, if the immune system is low the animal will be more susceptible to disease even if the vaccination is current. The only real way to assess the immune status is by doing blood titer levels to check the antibody levels before a vaccine is given. Although this is expensive, it does allow the owner and veterinarian to make a more intelligent decision about vaccination timetables.

In conclusion, vaccines are one of the great medical discoveries and have greatly reduced the fear of deadly diseases in animals and humans. It is probably much better to error on the practice of maintaining our pets on a regular schedule of vaccination especially as they become older and their immune system is weakened. You should always discuss your concerns and questions about vaccines with your veterinarian. Then you, as an owner, can feel that you are doing your best to prolong those "golden years" for Fido and Fiona.

IF IT HURTS ... BARK

by

William T. Testerman, DVM

As his owners led Laddie, a 12-year-old Labrador, into the exam room, he was wobbling and dragging one hind leg, and then he collapsed on the floor. I could sense his nerves and muscles screaming in pain as he was coaxed to rise. Laddie's owner explained that he could no longer climb the stairs, jump in the car, or take family walks. The overlying concern, however, was that Laddie seemed to be in pain. "What can we do to help him?" he asked.

This scenario of an older pet showing signs of reduced physical activity is played out in veterinary offices every day. More and more pets are living into the geriatric years and have symptoms of arthritis and other aging infirmities. A frequent question to veterinarians is how to know if pets are experiencing pain. Obvious signs are easy to recognize such as whining, biting at a body part or even aggression, if an injured body part is handled. More subtle actions that indicate pain may include withdrawal, restlessness, holding the ears flat against the head or keeping the tail down. Then there are the stoic animals that continue to wag their tails even though they may be hurting.

In an older pet the most likely cause of chronic pain is arthritis. One recent study showed that 20% of adult dogs (much higher in older animals) are affected by arthritis. Larger dogs, especially those overweight, have a much higher incidence. Some of the indicators to look for are: decreased activity, reluctance to climb stairs, stiffness, limping, difficulty rising from a resting position, lagging behind on walks, soreness when touched, and personality changes.

Most owners, at one time or another, have treated their animals for pain with drugs from their own medicine cabinet. While some medications may give temporary relief, they can result in damage to internal organs and even death. Drugs such as aspirin and ibuprofen are very effective for aches and pains in humans, but in animals they can cause serious problems when not used appropriately.

Effective treatment for pain, especially that of arthritis, is usually aimed at controlling the symptoms because no effective cure has been found. If an animal is overweight, a reduction of body fat is helpful to reduce the load on the joints. Massage, physical therapy, acupuncture, chiropractic manipulations, homeopathy, and herbal formulas are just a few of the measures that may help to lessen the pain associated with inflamed joints. Vitamins, fish oils (omega 3 fatty acids) and food supplements, such as those containing glucosamines, are beneficial for many animals. Steroids are effective in combating the acute pain associated with arthritis, but cannot be used over long periods due to their side effects on the body. Newer non-steroidal anti-inflammatory drugs that offer relief are available by prescription from a veterinarian and can be used for long term treatment. In chronic arthritis, veterinary surgeons can replace damaged joints, especially hips, and give new life to an aging pet.

In our society, companion pets are often treated as family members resulting in close interpersonal bonds. When our pets are in pain, it is a compassionate response to care for them as they have limited means to treat themselves. With newer advances in controlling the pain of arthritis, there is no need for them to suffer. The owner and veterinarian, working together, can be the animal's best advocate to lead a life as free of pain as possible.

Fido's Golden Years, and Beyond

by

William T. Testerman, DVM

When getting a new puppy, usually the first thing in our mind is to get a healthy pet exam from the veterinarian. During this time we go over what it takes to get them started on a healthy lifestyle. This usually includes a vaccination and worming program as well as discussing the proper nutrition for growth and development. If the exam shows any problems, we make the necessary treatment to correct them, then settle in for a long relationship with our new family member.

As our pet ages we tend to accept any changes in their behavior and health as "old age" that just comes along with life. While this is true to a certain extent, many of the conditions that come with age can be modified with certain treatments or life style modifications. Just as pet owners can make adjustments to slow their own aging process, the same can be applied to our pets.

Once we accept that our pets have reached that milestone in life, what we call middle age, it is a good idea to consult with your veterinarian about a geriatric exam. This will often include a thorough physical examination, blood tests, chest x-rays, cardiac evaluation, and nutritional counseling. The results of the tests and examination can help the veterinarian detect any early stages of heart, lung, kidney, liver disease, or hormone imbalances. If there are abnormalities, a course of action can be started to manage and control them resulting in a longer and better quality life for your pet. Because you are your pet's spokesperson, you can, and should, take an active role in assuring a long and healthy life for Fido.

A question often asked is, 'How old is my dog in relation to human age?' The old adage of seven years for each year of human age isn't necessarily true, as this varies greatly with size and breed. A Saint Bernard may actually be considered geriatric as early as six years of age while Toy Poodles may not show signs of aging until they are eleven years old. The following chart gives an approximation of human to dog years:

In future articles, more specific attention can be given to problems encountered in geriatric animals and how to deal with them. There are many things that you, as the owner, can do to slow or prevent conditions associated with the aging process.

Your Old Dog's Eyes: Dry Eyes

by

Terri L. McCalla, DVM, MS, diplomate ACVO (American College of VeterinaryOphthalmologists), Animal Eye Care, Bellingham, Washington

Old dogs can get dry eyes, just like older people can. The most common cause of dry eye in dogs is autoimmune disease, where the body's immune system attacks the tear glands, causing them to not work well. Dry eyes can be the result of not enough tears, or because the quality of the tears is poor. If tear quality is poor, the tears do not stick to the eyes for as long as they should, and they slide off the eye prematurely, leaving dry spots. In other words, eyes can still be dry even if the tear glands are producing plenty of tears!

The technical term for dry eye is keratoconjunctivitis sicca (KCS), which means dry, inflamed cornea and conjunctiva. I prefer to simplify things and just call it dry eye.

What are the signs of dry eye? The most common one is lots of thick, sticky discharge from the eye(s), especially in the morning. The discharge can be grey or clear, but can also be green or yellow if secondary bacterial infection has occurred. The eyes often are red, due to thickened, inflamed conjunctiva. In severe cases, the eyes are cloudy due to scar tissue forming on the surface of the cornea. In very severe cases, vision is impaired and can even be lost due to severe corneal scarring. Dry eye is also uncomfortable for the patient.

Diagnosis of dry eye can be difficult, especially if tear volume is normal. A general veterinary practitioner can perform a tear test (called a Schirmer tear test, or STT) to measure the amount of tears being made. However, if the dog's dry eye is due to poor tear quality, a STT will not diagnose the problem and a veterinary ophthalmologist needs to examine the patient.

Dry eye is most commonly treated with tacrolimus or cyclosporine drops or ointment. These drugs are technically antibiotics, but they are used to suppress the immune system's attack of the tear glands. They stimulate tear production, improve tear quality, and also reduce corneal scar tissue. If a dog is blind from dry eye, these medications often help to partially reverse scarring, improving vision (assuming that nothing else is wrong with the eyes). Tacrolimus and cyclosporine are used most commonly in humans to treat diseases other than dry eyes; both oral and injectable forms of these drugs are used to treat transplant patients to help prevent the immune system from attacking and rejecting the new organ. When treating dry eye in dogs, the drugs are diluted in strength and usually need to be compounded by a pharmacist because they are not available in a brand name form for eye use other than 0.2% cyclosporine ointment (Optimmune). In my experience, tacrolimus works better than cyclosporine in treating dry eyes in dogs. It is important to understand that LIFETIME treatment is needed, along with regular eye exams to ensure that the correct dosage of medication is being used.

Copyright © 2001-08, Animal Eye Care LLC - All Rights Reserved

Keeping Your Old Friends Fit

by

Michelle Schmidtke, DVM

  It doesn't seem fair. As they acquire the old dog patina of wisdom and serenity, their bodies are declining.

  Dogs are considered geriatric approximately after the age of nine. Many factors affect their longevity; some we have control over, others are determined by genetics.

  I want to discuss "the fat dog dilemma." As a veterinarian, I have cared for many dogs throughout their entire lifespan. My clients often ask me what they can do to help their aging companion live better, longer.

  I can't emphasize it enough: Keep him slim, keep him slim, and keep him slim&ldots;

  And everyone has their own idea of what "slim" or ideal maximum weight is and isn't. I have a model provided by Hill's (Science Diet) that my clients feel so they can acquaint themselves with the features of a slim dog. "You can feel his ribs and he's all tucked up?" they ask in amazement.

  It's really very simple. Three things are involved in obesity: too much food, too many calories, and too little exercise. I'd like to share with you the many explanations (excuses) I've heard over the years. In parentheses, I've added my own thoughts:

* "He's not fat, doc!" (Owner is, well, quite large.)

* "He eats next to nothing, doc." (And he does next to nothing and he visits the neighbors for some more nothing.)

* "He just gets into everything, I can't control him." (Hmm, so he opens the refrigerator and cupboards and helps himself?)

* "I can't control him." (Aren't we the ones with opposable thumbs?)

* "He won't eat that diet food." (Oh yes, he will if you practice some tough love.)

* "All he eats are those little sausages and chicken breasts." (All you give him are those little sausages and chicken breast; what a smart dog to train you so well.)

* "He must have some hormone problem." (Unlikely, although occasionally hypothyroidism may influence weight.)

* "He just wants to lay around on the couch." (Apparently, so do you.)

Remember, keeping your old dog slim is good for both of you.

Copyright 2006 Dr. Michelle Schmidtke, DVM and OldDog Haven. You may reprint this article with by requesting permission from OldDog Haven.

Pictured is Fred, who was placed by OldDog Haven when his family moved to New York and didn't take him with them. Fairly obese when he arrived, Fred suffered from arthritis and had no stamina. With a proper diet, Fred slimmed down considerably, but had trouble with his hind legs until he died 18 months after finding his final refuge.

The Ten Most Important Tips for Keeping Your Older Dog Healthy

1. Establish a relationship with the best veterinarian you can find. For most older dogs, it is advisable to make an appointment with a vet every six months. Your vet should be someone whom you trust and with whom you feel very comfortable.

2. Become informed about the conditions common to older dogs and the therapies used. Be alert to symptoms, bring them to your vet's attention promptly, and discuss treatment options.

3. Feed your older dog the best food you can afford. Consider feeding a home-prepared diet of two small meals daily rather than one large meal.

4. Don't overfeed your dog. Obesity will create health problems and shorten his or her life.

5. Consider the use of dietary supplements such as glucosamine / chondroitin for arthritis.

6. Give your senior dog adequate exercise, but adjust it to his or her changing abilities.

7. Attend to your dog's dental health. Brush her teeth daily and have them cleaned professionally whenever your vet advises it.

8. Tell your vet you wish to have your dog vaccinated only once every three years, as currently advised by the major veterinary colleges.

9. Be diligent in controlling fleas and ticks, and keep your dog and his environment scrupulously clean.

10. Make your senior dog as much a part of your life as possible, and do all you can to keep him interested, active, happy and comfortable.

(Of course, these ten tips also apply in large part to young dogs, too.)

  Copyright ©1997-2006... The Senior Dogs Project ... All Rights Reserved

And number 11: Give generous doses of LOVE.

No copyright on #11 ... so pass it on!

Your Old Dog ’s Eyes: The Lens

by

Terri L. McCalla, DVM, MS, diplomate ACVO (American College of VeterinaryOphthalmologists), Animal Eye Care, Bellingham, Washington

While dog eyes are in many respects similar to human eyes, there are some differences too.

It is very common for geriatric dogs to have bluish-colored pupils, instead of the pupils being black. This haziness of the pupil is often mistaken as being caused by a cataract, although it usually is not. A cataract is any white opacity of the lens through which light will not pass. Older dogs with bluish-colored pupils have nuclear sclerosis, which is a normal aging change of the lens that every old dog will have. Every older person also has nuclear sclerosis; in people this results in difficulty with near vision —we need reading glasses. This is because in order to focus up close, the lens needs to change its shape and become rounder. When the lens is sclerotic, it is not as flexible and cannot change its shape as well, leaving us with a loss of near-vision. Dogs don't read, so they do not miss their up-close vision as much as we do.

Think of the lens as the reverse of a jelly doughnut —hard on the inside (the nucleus) and soft on the outside (the cortex). The lens grows throughout life and adds new layers on the outside. The oldest lens tissue is in the inside —the nucleus. As the animal ages, the nucleus hardens (becomes sclerotic) and tak es on a bluish grey hazy “cast ”, first evident at around 6 years of age and increasing with age. Animals can see through this haze very well, assuming the rest of their eyes are healthy. Nuclear sclerosis is often mistaken for a cataract, even by general practitioner veterinarians. Slit lamp biomicroscopy performed by a veterinary ophthalmologist can differentiate between the two conditions.

Nuclear sclerosis does not require treatment of any kind. Eyes with nuclear sclerosis can also develop cataracts, however —the two conditions are not exclusive to each other. If one of your dog's eyes seems cloudier than the other one, then it probably does have some degree of cataract, because if the only condition present was nuclear sclerosis, then both eyes would "match" in the color and haziness of the pupils. Also remember that the amount of haziness that you see varies, depending on the pupil size; if the pupil is small (in bright light), then the iris is hiding most of the lens and you can't see the nuclear sclerosis. If the pupil is big (in dimmer light and also when the animal is excited), then you can see more of the nuclear sclerosis.

There is a picture of a dog's eye with nuclear sclerosis on my website -- scroll down to the section called "What is Not a Cataract?". This article also discusses what a cataract looks like. If you wish to read about cataracts and cataract surgery, please read the two articles on my website.

Copyright © 2001-08, Animal Eye Care LLC - All Rights Reserved