While dogs can get a variety of lip sores and red bumps, but one of the most common is chronic ulcerative paradental stomatitis, or “CUPS.” (It’s also sometimes called canine chronic ulcerative stomatitis.)

CUPS Looks like a Cold Sore

CUPS is a very painful lip-sore infection. Dogs with CUPS have inflammation on their gums, the inside of their lips, and possibly even on the roof of their mouths and their tongues. CUPS may cause small ulcers that look like a human’s cold sores.

The base cause of CUPS appears to be an overactive immune response to the bacteria that accumulate in the mouth, especially as plaque on your dog’s teeth. Even a small amount of plaque can lead to this intense and painful reaction. Some breeds seem to have a genetic predisposition to this problem, including Maltese, Cavalier King Charles Spaniels, Greyhounds, and Labrador Retrievers.

Symptoms of CUPS

Signs that might tip you off to a problem vary with the severity of the condition but can include:

• Excessive drooling
• Thick saliva
• Lack of appetite
• Doesn’t drink water
• Abnormally bad breath

Some dogs will develop lip-fold pyoderma as a secondary problem. Your dog’s mouth will be painful, and he may resist you looking in his mouth or working at his dental hygiene. Your veterinarian may sedate your dog to do a thorough oral exam.

Tooth Removal for Lip Infection

Now comes the shocking part: The best treatment is to remove all the dog’s teeth in the affected areas.

This is a difficult surgery that may be split into two sessions as it can take hours. Many of the teeth are not openly diseased or loose but still need to be removed. If any teeth are left, they need to be thoroughly cleaned. They may need to be removed in the future, if the condition recurs. Ideally, a board-certified veterinary dentist would do the surgery.

Aftercare involves pain medications and antibiotics to help prevent any secondary infections. Your dog may need soft, room-temperature food for a bit. Once the mouth is healed, most dogs happily go back to their normal diet, even if it is dry kibble. Any sutures that were needed will dissolve.

CUPS can mimic regular periodontal disease initially. That means an accurate diagnosis may not happen right away. A referral to a board-certified veterinary dentist may be needed to get the definitive diagnosis.

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Symptoms of Food Poisoning in Dogs

Symptoms of food poisoning in dogs include:

• Vomiting
• Diarrhea
• Bloating
• Loss of appetite
• Lethargy
• Dehydration

Depending on the pathogen consumed, some dogs also may show neurological signs:

• Tremors
• Loss of coordination

Preventing Food Poisoning in Dogs

Clearly, protecting dogs from food poisoning means keeping things they shouldn’t eat out of their mouths.

Garbage and compost should be kept out of reach as they pose multiple hazards. Cooked bones can shatter and perforate intestines, and corn cobs are a common cause of intestinal obstruction.

However, the bacteria and fungus present in rotting food poses the largest risk for food poisoning. As meat spoils, bacteria such as Salmonella, E. Coli, Listeria, and C. botulinum multiply. These bacteria produce toxins that are harmful to dogs and persist in the spoiled food even if the bacteria are killed.

Because of this, dogs should not eat expired foods or meat, even cooked. Like meat, rotting fruits and vegetables harbor harmful bacteria, but they also provide a perfect substrate for mold growth. Some molds produce mycotoxins, which can cause a variety of symptoms, from gastrointestinal (GI) upset to neurological issues, depending on the type and quantity ingested.

Dead Animals

Dead animals contain dangerous bacteria, viruses, and parasites that can be incredibly harmful to your pet as well. Be sure to keep your four-legged friend away from any dead and decaying items roadside, in the woods, or in the yard.

Feces, which many of our furry companions consider to be a delicacy, contains high levels of potentially harmful bacteria, such as Clostridium and Giardia, but it can also have parasites, such as hookworms, roundworms, and whipworms. Regardless of the species of origin, consumption of fecal matter can be the cause of an upset stomach in dogs and should be prevented if possible.

Harmful Foods

Recalled dog food and treats can also cause food poisoning in our pets. Diets may be recalled if they are found to have bacterial contamination, mold, or toxins present. While rare, recalls have occurred for all formats of food and treats, so be sure to keep an eye out for announcements from the Food and Drug Administration (FDA).

Raw and undercooked meat, eggs, and unpasteurized dairy products can also be a source of harmful bacteria. For dogs on a raw diet, food or ingredients should be high-quality and fresh from a reputable source. Proper storage and handling practices are essential to ensure the health and safety of our companions.

Contact Your Veterinarian

If you suspect your dog has food poisoning, practice safety measures when handling and cleaning up after them, as the pathogens making them ill can also cause illness in humans.

Wearing gloves, sanitizing bedding and surfaces, and quarantining your sick pup will minimize the spread to people and other animals in the home. If your dog is showing signs of food poisoning, especially severe symptoms like persistent vomiting, diarrhea, bloody diarrhea, lethargy, or neurological signs, contact your veterinarian immediately and seek treatment.

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Mastitis is an inflammatory condition of the mammary glands of intact female dogs. It can involve infection (bacterial or rarely, fungal). Mastitis is most likely to occur in situations of sudden decrease in milk consumption by puppies, for example, after abrupt weaning of the litter, or after death of nursing puppies. Sometimes mastitis can occur in late pregnancy, or in female dogs who experience pseudocyesis (false pregnancy).

Note: Swollen mammary glands in dogs not pregnant may be caused by a variety of problems, including cancer, so the dog should be seen by a veterinarian immediately.

Signs of Mastitis in Dogs

Clinical signs of mastitis involve abnormal changes to the mammary glands: redness or other discoloration, firm swelling, heat, and pain. Milk might be difficult to express, bloody or discolored. In severe cases, there can be fever, ulceration of the mammary glands, development of abscesses, or necrosis. In mild cases, the only clinical sign might be nursing puppies who fail to gain weight.

If mastitis is suspected, a physical exam by a veterinarian is recommended. A complete blood count might be normal in the early stages; more severe cases will result in an increase in white blood cells. Milk cytology will show an increased neutrophil count. Milk should be cultured from an aseptically obtained sample to direct antibiotic therapy.

Treating Canine Mastitis

Treatment of mastitis involves broad-spectrum antibiotics for suspected infection. Antibiotic choice will need to take into consideration whether there are puppies still nursing from the patient, and duration of treatment is usually for two to three weeks.

Cabbage leaf compresses can be used to address inflammation. Raw cabbage leaves can be applied to the affected glands and secured in place with a wrap for two to three hours, then removed for three to four hours (puppies can nurse when the cabbage leaves are removed). Therapeutic cold laser can also be helpful to address inflammation.

For nursing mothers, expressing the milk in the affected gland every six hours can help with swelling and pain. Massage and warm compresses can also help bring blood flow into the affected tissue and break up the congestion within the gland. Pain management should be considered.

If there is systemic illness, hospitalization might be necessary for intravenous fluid therapy and antibiotics. In severe cases, especially those involving gangrene, surgical debridement or mastectomy is necessary.

Note: If the patient is in a false pregnancy, do not express milk, as that will encourage more milk to be produced. Try to remove the objects she treats as her “puppies” to help decrease the production of the hormone prolactin, which also stimulates milk production. There is an oral medication that can help decrease prolactin levels (cabergoline).

Preventing Mastitis in Dogs

Prevention of mastitis involves keeping the nursing environment as clean as possible. It’s wise to try to prevent trauma to the mammary glands by eliminating sharp objects in the whelping box and trimming the puppies’ toenails. Make sure the puppies are nursing from all the teats to keep the glands drained (in small litters, rotate through each of the teats).

Mastitis can be a stressful complication of raising a litter of puppies, but it is rarely life-threatening if long as prompt veterinary attention is sought as early in this disease process as possible. Breeders should monitor the state of the mammary glands starting prior to whelping through past weaning to catch those early clinical signs.

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Causes of Hypoglycemia

Normal blood sugar levels in dogs range between 3.5-7 mmol/L. Low blood sugar, or hypoglycemia, in dogs is considered anything below 3 mmol/L. Causes of hypoglycemia can derive from either decreased glucose production, increased glucose use or excessive insulin.

Hypoglycemia can be caused by a variety of conditions including:

• Addison’s Disease
• Liver failure
• Cancer
• Insulin overdose
• Malnutrition
• Toxicity
• Delayed meal times
• Insulin producing tumors (insulinoma)

Signs of Hypoglycemia

Understanding the signs and symptoms of hypoglycemia is the first step in identifying and treating the condition.

Signs that your dog is experiencing hypoglycemia include:

• Lethargy
• Weakness
• Muscle tremors
• Low appetite
• Slow response
• Seizures
• Disorientation
• Poor vision
• Trauma

Diagnosing Hypoglycemia

Diagnosing your dog’s hypoglycemia and its root cause will be imperative for proper treatment and management, as well as having a complete understanding of their prognosis.

Using a glucometer is an easy and quick way to evaluate your pup’s blood glucose levels. A glucometer is a small, hand held device that can be utilized for blood glucose checks at home or in the hospital and is often used for diabetic patients. A small pin prick is all that is needed for evaluation and results are immediate. These results will help you and your dog’s veterinary team with next steps.

Further diagnostics may be necessary and include:

• Bloodwork
• Urinalysis
• Abdominal ultrasound
• Radiographs

Treating and Managing

If your dog is experiencing a hypoglycemia episode, he should receive immediate treatment from his veterinary team. Treatment will initially include stabilizing your dog’s glucose levels which can be achieved via oral or intravenous glucose administration such as corn syrup or intravenous dextrose.

Prognosis and future management of your dog’s hypoglycemia will be case specific and depend on your pup’s overall health and official diagnosis. For example, adjusting insulin dosage for your diabetic pup may yield more long-term treatment and management than severe liver failure. Work with your veterinarian closely during this process.

Establishing an emergency at-home plan for hypoglycemia episodes in your dog can be lifesaving.

A few considerations for your at-home emergency plan:

• Knowing your pup’s most common signs and symptoms
• Investing in your own glucometer and understanding how to properly use it
• Establishing an at-home glucose administration plan
• Easy access to your veterinarian and emergency clinic contact (including phone numbers, hours of operation and driving distance to each clinic)

When left untreated, hypoglycemia in dogs can be fatal. However, with early intervention and diagnosis, lifelong management and good quality of life are both possible. Utilizing an at-home emergency plan while remaining in constant communication with your veterinary team can be life-saving.

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Some dogs with pneumonia may cough, bringing up some discharge. Others will have rapid or painful breathing but lie quietly and not really cough unless they get up and are active. Nasal discharge, generally thick and often pus-like, may be noticed. Most of these dogs seem to feel sick, lying around and not eating or drinking well. Fortunately, the survival

Causes of Dog Pneumonia

The causes of pneumonia are numerous, with some more serious than others. How does a dog even get pneumonia?

There are four categories of pneumonia:

• Bacterial
• Viral
• Fungal
• Aspiration

Almost always, the dog must have inhaled a pathogen or infectious agent. He might have inhaled some droplets when another dog sneezed or coughed nearby and released viral particles or bacteria. Walking in the woods, he may have snorted in some fungal spores. While vomiting, he may have inhaled some food particles.

Less commonly, your dog may breathe in smoke or other toxic fumes. All these possible causes interfere with the normal exchange of carbon dioxide for oxygen in your dog’s lungs. The alveoli (air sacs) in the lungs may fill with fluid, pus, or inflammatory cells and interfere with oxygen movement.

Diagnosis of Pneumonia

The suspected cause of the pneumonia will influence treatment and prognosis. Your veterinarian will start with diagnostic procedures. Initially, auscultation (listening to your dog’s chest with a stethoscope) will give your veterinarian an idea of the problem. A complete history will provide possible exposures to various pathogens. Pneumonias often have multiple causes, such as bacteria acting with viruses to cause the illness.

The next step is usually X-rays. Some pneumonias will have a characteristic appearance on a film. Throat or nasal swabs may be taken and sometimes a tracheal wash (flushing some sterile fluid into the trachea and then drawing it back up) will be done. These lab techniques may identify bacteria or fungi and provide material for cultures, so your veterinarian can prescribe the most efficacious antibiotics.

Treatment of Dog Pneumonia

Treatment will depend on the pneumonia severity. Very ill dogs will need to be hospitalized, given intravenous (IV) fluids and supplemental oxygen, along with specific medications to battle the pathogen responsible.

Dogs who are still eating and drinking may be sent home with restrictions on activity. Nebulization can help, either with a nebulizer or simply keeping your dog in the bathroom while you shower. The warm steam helps to loosen debris in the lungs, making it easier for your dog to cough it up.

Coupage can help. In this nursing technique, which can be done at home, you use a cupped hand to lightly rap on your dog’s chest. This can help to loosen debris. Ask your veterinarian to show you how to do this.

Overall, about 80% of all dogs with pneumonia survive. Puppies, elderly dogs, and dogs with other chronic health conditions have a lower survival rate. Fungal pneumonias are notoriously difficult to treat and have a worse prognosis than bacterial pneumonia.

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The most common worms are roundworms or ascarids in puppies and tapeworms in any dog who has had fleas or hunts and eats his prey.

What to Do If You See Worms in Poop

If you find worms, bring them to your veterinarian for identification. For puppies, it’s important to do periodic microscopic inspection of feces (called “fecals”) even if you don’t see worms. Eggs can be identified under the microscope. Treatment is then tailored to any parasites found.

Roundworms are a zoonotic problem, meaning they can infect people as well as dogs, particularly children who might play in contaminated dirt on the ground and in playgrounds. Because humans are not a normal host for these parasites, the larval stages tend to migrate around human tissues. Common syndromes are visceral larva migrans with liver and pulmonary damage and ocular larva migrans, which has led to enucleation due to suspicion of cancer in some cases. I remember a friend growing up who had had an eye removed, and it turned out to be this parasite.

Roundworm infections need to be treated when detected and prevented, if possible. Almost all the monthly preventives for heartworm disease now cover the common intestinal parasites as well. Using one of these medications year-round can prevent roundworms in your dogs. It is also important to pick up after your dog to avoid fecal contamination of the environment.

Tapeworms in Dogs

Tapeworms are commonly noticed by owners in their dog’s stool. What you see most of time are really egg packets that get passed out with the feces. Occasionally a dog may vomit up whole tapeworms or pass adult worms in the stool, but that is uncommon.

The egg packets are visible to the naked eye and appear white and glistening when freshly eliminated on stool. Over time, they dry up and may look more like dried rice. Packets can stick on the hair around the rectum or in places where your dog rests, like his bed or your couch.

In general, tapeworms do not cause major health problems in dogs. A massive load might cause an intestinal impaction but rarely. The most common sign of tapeworm infestation is irritation around the anus. Dogs with tapeworms may lick and chew that area or “scoot” their butt, in a manner similar to a dog with an anal-gland problem.

The two tapeworm species seen most frequently in the United States are Taenia species and Dyplidium caninum. These two parasites have different life cycles and hosts. Your veterinarian can identify which type of tapeworm your dog has be looking at eggs under a microscope.

Taenia tapeworms come from ingested infected prey animals. For dogs, that means hunting, catching, killing, and eating wild rabbits. Many owners are shocked to find out that is how their dogs got tapeworms, but hunting urges are strong in almost all dogs, no matter what breed.

Dogs infected with Dyplidium have a different host. Fleas, or occasionally lice, are the intermediate host. A flea biting your dog won’t transmit tapeworms, but when your dog is biting and chewing from flea irritation, if he swallows some fleas, he can pick up tapeworms. (This is also true for any cats in your household, so if you have fleas, be prepared to treat your dogs and cats.)

Treating Tapeworms in Dogs

Treatment for tapeworms is slightly more complicated than treating for roundworms. The drugs praziquantel and epsiprantel are effective in most cases against Dyplidium, though some resistance to the drug seems to be developing. For Taenia species, praziquantel, epsiprantel, and fenbendazole are effective. Unlike roundworm treatment, where virtually all heartworm preventives contain medications to catch them, only a couple of these monthly medications (like Drontal Plus and Interecptor Plus) also cover tapeworms.

While tapeworms don’t have the overall health and zoonotic concerns of ascarids, aesthetically, it is desirable to treat them. No one wants dried (or fresh) tapeworm segments, or proglottids on their dog or on their furniture. Once again, prevention is key.

Once your veterinarian has identified the type of tapeworm your dog has, you can make a plan. Tapeworm eggs are almost never found on a fecal flotation (a laboratory method that separates the eggs from the feces), so you need to bring in some of the egg packets. Fresh or dried feces generally work. Your veterinarian will examine the packets under the microscope to identity the exact species involved.

If Taenia species are found, you need to limit your dog’s opportunities for hunting or be prepared to periodically deworm for these tapeworms. For Dyplidium tapeworms, you need to eliminate any fleas or lice. That means treating pets and the environment.

An unusual tapeworm, Echinococcus, can cause problems in dogs via liver damage and cysts. This is also a zoonotic parasite and can cause serious health problems in humans. Ungulates (hoofed animals such as sheep and deer) are intermediate hosts, along with some rodent species. Currently, cases of this parasite are very unusual in the United States with most cases confined to sheep herding dogs.

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Your dog’s tongue can be key to detecting increasing heat stress. If your dog is panting and his tongue looks abnormally long and wide, and/or his lips are pulled back to expose more of his gums and oral tissues, he is trying to maximize his evaporative cooling process through his mouth. His drool may look thick, and his mucous membranes may be bright red. All this adds up to a dog working hard to cool off.

Stumbling Into Heat Stroke

A dog moving into an emergency level of heat exhaustion, called heat stroke, may appear weak and even stumble. This dog needs immediate veterinary care. You may also notice:

• Muscle tremors and weakness
• Increased heavy panting
• Increased thirst but nose/mouth dry
• Vomiting
• Diarrhea
• Elevated pulse (check in the groin area)
• Abnormal gum color
• Increasing dehydration

Check for dehydration by gently pulling up a small amount of skin. The skin “tents up” when you squeeze it and doesn’t immediately slip right back into place. If your dog’s mouth is dry or his saliva is thick, flush his mouth with cool water and encourage him to drink.

As the heat exhaustion worsens and the body temperature elevates, the dog’s gums change from bright red to pale. The dog begins hyperventilation. His blood pressure will drop, and he may become unconscious, collapse, or go into seizures. With high enough body temperatures (such as 107 degrees F), organ failure sets in. Put your dog in the car, blast the AC, and get him to a veterinarian immediately.

What to Do for Heat Stress in a Dog

If your dog is panting excessively or collapses, get him cool!  Putting him in a tub of cool water is ideal. If not, pour cool water or run a hose over him, targeting thin-haired areas like the “arm pits” and the groin area (just hosing off his back is inefficient, especially if he has a thick coat, because the water just rolls off the coat and doesn’t quickly get down to the skin).

If you can monitor temperatures, try to get him down to 104. Add fans once he is in your car and turn up the AC, letting it blow on him.

Avoid Heat Stress

Clearly, prevention is the best way to minimize heat stress and avoid heat stroke. To do this:

• Limit play and training during hot weather.
• Stick to shaded, grassy areas if possible, including for rest.
• Always have fresh, cool water available in the shade and add ice cubes.
• If your dog is working, considering using cool treats, such as frozen-low sodium bouillon, doggy ice cream, or watermelon.
• Provide a kiddie pool (be sure water is fresh and cool), splash pad, or misting water sprinkler.
• Make your dog take a periodic break from playing.

If you are hiking, choose trails that are shaded and not too strenuous. Let your dog wade in a running creek. Caution: Avoid stagnant bodies of water as algae buildups can be toxic. Be sure you have drinking water for your dog (and you!) with you.

High-Risk Dogs

With dogs at high risk for heat stress include older dogs, overweight dogs, and brachycephalic dogs (the ones with short faces and muzzles), it is best to leave them safely at home. If not possible, someone should always be with them.

Some dog-sports competitors use dog cool coats to help protect the dog from the intense rays of the sun. These are coats that can be wet down and reflect the sun.

When I travel with my dogs in the summer, I leave my car open (minivan), with open weave shade cloths covering it, and fans on when I am parked. I park in shade if possible and orient my car to catch any breeze. I have extra fans and batteries. I stay with my dogs as much as possible.

Use drive-ups to get food and drinks instead of going into a restaurant. When purchasing gas, pull your car up so it is in shade.

So far, I have not had problems, but if it is truly hot, we stay home. Heat-related problems are serious. Even dogs who seem fine may show signs of organ damage a few days later. This is a health problem to avoid.

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Most dogs with HGE will need to be hospitalized and treated with aggressive intravenous fluid therapy to resolve their dehydration. Antiemetic medications—such as Cerenia and ondansetron—are administered to alleviate the nausea associated with HGE. Probiotics to promote healthy gut flora and fiber to provide nutrition to cells lining the colon are started.

Some dogs with HGE have such profound losses of protein and fluid from their diarrhea that they require one or more transfusions of blood products. Blood products used to treat HGE include albumin (a protein found in blood) and fresh frozen plasma (the fluid portion of blood).

Eating a high quality, easily digestible diet provides nutrition to the cells that line the gastrointestinal tract and helps them heal. But dogs with HGE are unlikely to begin eating right away during the acute part of their illness. Your veterinarian may recommend placing a nasogastric tube to deliver a liquid recovery diet to your dog until he starts eating on his own.

A nasogastric tube is a thin feeding tube that is inserted into one of your dog’s nostrils. The tube passes down the back of his throat, through the esophagus, and into the stomach. The nasogastric tube does not interfere with your dog’s ability to eat or swallow. Most dogs do not seem to mind having a nasogastric tube in place.

Dogs with HGE require close monitoring of their electrolytes, blood pressure, hydration status, and vital signs. This is best accomplished in the intensive care unit (ICU) of a 24/7 emergency and specialty hospital. A veterinary technician that specializes in caring for ICU patients will be dedicated to monitoring your dog’s vital signs and providing treatments to your dog. A board-certified veterinary criticalist or an emergency veterinarian trained to care for critical patients will help your dog recover from HGE.

Dogs that are hospitalized for treatment of HGE spend an average of two to three days in the hospital. They are discharged from the hospital once they are eating, no longer vomiting, and have returned to having soft or semi-formed stool.

What Causes HGE in Dogs

HGE is caused by an overgrowth of a bacteria called Clostridium perfringens. Clostridium perfringens is a part of the normal gut flora of the dog’s colon. The normal gut flora has a system of checks and balances that keeps any one species of bacteria from growing out of control.

It is not currently known why this system of checks and balances suddenly allows Clostridium perfringens to begin proliferating uncontrollably. There is speculation that dietary indiscretion (such as eating a toy or getting into the garbage), a change in diet without an appropriate transition period, intestinal parasites, food poisoning, or stress may be contributing factors.

There are five types of Clostridium perfringens. These include types A, B, C, D, and E. Clostridium perfringens type A produces a toxin called NetF. The NetF toxin creates pores, or openings, in cells that line the inside of the colon. This causes the cells to swell with fluid and burst like a balloon, destroying the cells.

The cells that line the inside of the colon act like a permeable barrier. This permeable barrier allows a controlled amount of fluid and electrolytes to move back and forth between the lumen of the colon and the blood vessels in the colon wall. The NetF toxin damages that permeable barrier, allowing some blood and massive amounts of fluid to enter the colon lumen. The result is a profuse watery, bloody diarrhea.

As the disease progresses, the population of Clostridium perfringens type A migrates from the colon to the small intestine. The NetF toxin produced by this bacterial species damages the mucosal lining of the small intestine. This worsens the diarrhea that is produced by the large intestine.

The damage done by the NetF toxin is confined to the small and large intestines. The NetF toxin does not affect the stomach. The term gastroenteritis refers to inflammation of the stomach and the small and large intestines. Since HGE does not affect the stomach, this condition was recently renamed acute hemorrhagic diarrhea syndrome (AHDS). This reflects the damage that occurs to just the intestines rather than the entire gastrointestinal system.

Diagnosis

There is no specific test for AHDS. Diagnosis is based on the acute onset of watery, bloody diarrhea, severe dehydration, and the exclusion of other causes of your dog’s symptoms. Your dog may be suspected of having AHDS if he meets the following criteria:

• One or more episodes of vomiting that start about 10-12 hours before the onset of diarrhea
• Sudden onset of watery, bloody diarrhea that looks like straight blood. Sometimes this can look like raspberry jam if there is mucus mixed in with the diarrhea.
• Young age (median age is 5 years)
• Small breed dog (median weight is 25 pounds)
• A packed cell volume (PCV) of 57% or greater. This is a blood test that examines the ratio of red blood cells to plasma (also known as the fluid component of blood).
• Relatively low total protein level in the blood

Your veterinarian may recommend additional diagnostic tests to rule out other causes of bloody diarrhea. These tests may include a complete blood count (CBC) and chemistry panel, a coagulation panel, abdominal radiographs (x-rays), and abdominal ultrasound. If your dog is not vaccinated for parvovirus or is a puppy in the middle of his parvovirus vaccination series, your veterinarian may recommend testing your dog for parvovirus.

Prognosis

Most dogs that receive timely and appropriate intervention for AHDS will make a complete recovery. However, serious complications can occur if appropriate treatment for AHDS is not started early in the disease process.

Dogs with AHDS may continue to have soft stool for 7-10 days following resolution of diarrhea. Their stool quality should improve a little each day during their recovery period.

Some dogs will develop chronic diarrhea following their recovery from AHDS. Diarrhea may be ongoing or intermittent. It may resolve with a change in diet or addition of a probiotic. Some cases may require treatment with medication to resolve the diarrhea.

The post Hemorrhagic Gastroenteritis (HGE) in Dogs appeared first on Whole Dog Journal.

Sadly, with chronic renal failure, this change can be so gradual that owners don’t notice until it is far along. And that’s frustrating because some chronic kidney disease cases are simply a result of old age. In other words, the dog’s tissues are wearing out.

In addition to the increased drinking and peeing, your dog’s appetite may be off, and he may be losing weight. Some dogs will be nauseous. Bad breath is common, and his gums may be pale. If your veterinarian checks a urine sample, the results may reveal excess protein or even some blood.

Fortunately, the kidneys are remarkable organs and can keep your dog humming along until close to two-thirds of their function is lost. If kidney disease is caught early enough, medical treatment can often give these dogs years of reasonable life.

As chronic renal failure progresses, your dog may become anemic and lethargic. The buildup of toxins can lead to neurologic signs. Acute kidney failure is worse, such as from ingesting a toxic substance. These dogs are dramatically sick as there is an abrupt loss of ability to filter out toxins and retain the electrolytes and fluid that are important for good health.

What Causes Kidney Disease

Kidney disease is common in dogs, and it has many causes, ranging from congenital defects that cause problems early on to a secondary ailment in senior dogs. It can be an acute episode from a toxin or a gradual decline in renal function.

Young puppies can suffer from congenital defects such as renal dysplasia and polycystic kidney disease. While these dogs can be managed, most have shortened lifespans.

Amyloidosis is another genetic kidney problem, often associated with Chinese Shar Peis. Puppies with early onset renal failure often drink and urinate excessively and may be difficult to house train. They are often noted as “failure to thrive,” lagging behind their littermates in growth and development.

Once we go beyond genetic defects (and some of those can show up clinically as late as 6 or 7 years of age), we are left with secondary kidney diseases. Toxins are high on the list for both acute kidney disease and chronic renal disease.

Acute poisoning, such as from acetaminophen (Tylenol), grapes and raisins, or ethylene glycol (antifreeze) can cause severe kidney disease, even fatalities. Immediate treatment can minimize damage, and some dogs recover completely. Toxic dogs are very sick dogs, however. You may notice vomiting, collapse, intense thirst, and seizures.

Infections can damage kidneys, sometimes irreversibly. As Lyme disease (a tickborne illness) has become more prevalent, veterinarians are watching for Lyme nephritis. The first sign is generally protein spillover into the urine. Any bacterial or viral infection that affects the kidneys may cause kidney failure.

What to Do If Your Dog Shows Signs of Kidney Disease

Like many diseases, kidney disease has “staging” protocols that recommend different treatments for each stage. The International Renal Interest Society has four stages for dogs in renal failure, using objective data from serum creatinine levels, plus looking at blood pressure and protein spills in the urine.

Depending on your dog’s stage, medical treatment will take into consideration hydration and nutrition first. Canned food, adding water to your dog’s meals, and eventually giving fluids subcutaneously can help to keep your dog hydrated.

From a dietary point of view, you want a diet with a lower protein amount—but still high quality for overall health—less dietary sodium and phosphorus, more B vitamins, more omega 3 fatty acids, and plenty of fiber. Several prescription diets that fit these parameters, or your veterinarian can guide you to sites that can provide custom balanced recipes for your dog, like Balance It.

Many dogs benefit from phosphate binders and medications to control blood pressure. Darbepoetin is a synthetic form of erythropoietin that may be recommended to battle anemia.

Dialysis is rarely used for dogs with chronic kidney disease but can truly be a lifesaver for a dog with acute, toxic renal failure. In these cases, dialysis is generally done for a short period of time. Unfortunately, there are very few places, primarily veterinary colleges, that currently offer dialysis.

While kidney transplants are done with some frequency in cats, they have not been as successful in dogs. There must be a compatible donor (which you are then responsible for adopting) and follow-up care is extensive, requiring immunosuppressive drugs for the lifetime of your dog. Transplants have not been as successful in dogs as cats.

SDMA Senior Bloodwork

SDMA stands for symmetric dimethylarginine, which is an amino acid. This is used as a biomarker to evaluate kidney function in dogs and cats. This is one of the earliest and most sensitive tests for changes in renal function, showing increased levels with as little as 25% of kidney function being compromised. In addition, it is not as sensitive to some of the environmental factors that can influence tests for kidney health such as muscle mass and diet.

SDMA is now included in many senior pet blood panels, but if not, you should request it for your older dog. Test results over 14 micrograms/dl suggest renal problems developing, so further diagnostics will be recommended.

The bottom line: If caught early on, many dogs can have years of reasonable quality of life with a kidney problem. They will require consistent, and sometimes, comprehensive care, but they can be active and comfortable.

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Signs of an ear infection include any of these symptoms:

• Discharge from the ears
• Odor coming from the ears
• Redness in and around the ears
• Rubbing ears on the ground or on furniture
• Scratching his ears
• Shaking his head

Infections can be in one or in both ears. Sometimes the ear canal is so swollen, the opening is obscured, making it difficult to see what is going on in the ear canal. This also makes getting topical medications in the ear more challenging.

Causes of Ear Infections

A proper diagnosis of ear discomfort will usually require ear cytology, a diagnostic test in which a sample of the ear discharge is smeared on a glass slide. The slide is then stained and examined under a microscope, so the laboratory can determine the cause of the ear infection. Different causes of ear infections have different treatments. Quick tip: Don’t clean out or treat the ears prior to the veterinary appointment! This could lead to misleading test results and an inaccurate diagnosis.

Ear infection causes in dogs include:

• Yeast (Malassezia pachydermatis. This is a common cause of ear infections. While small numbers of yeast can normally be found in the ears and on the skin of dogs, overgrowth of this organism can cause problems. Yeast infections are treated with an anti-fungal medication.
• Bacteria. Multiple species of bacteria can cause ear infections. These infections are treated with antibiotics. Occasionally, first-line antibiotic therapy is not effective, and in these cases, the ear discharge is cultured to find out what species of bacteria is causing the infection, and the bacteria’s sensitivity to multiple antibiotics is measured to determine the best antibiotic choice. What we often find in these cases is that the bacteria are resistance to one or more antibiotics. Knowing what the invading bacteria are sensitive to helps tailor the therapy to the specific medication that will work.

• Ear mites (Otodectes cynotis). These are mites that live on the surface of the skin and can often be observed in an otoscopic exam. This ectoparasite is contagious via direct contact. There are multiple treatments for ear mites, including topical drops for the ear canal, one-time treatments that are administered directly into the ear canal, and other topical medications that also have action against fleas.
• Allergy. Itchy ears also can be a consequence of an allergy. If the itchiness is caused by a seasonal allergy (atopy), controlling the itch during the season with either a steroid (oral or topical) or other anti-itch therapy (oral Apoquel, injectable Cytopoint) can bring relief.

Sometimes there are chronic ear problems that are non-seasonal, and these cases are often suspected to be related to dietary sensitivity (food allergy). The therapy of choice for a suspected dietary sensitivity is to do a hypoallergenic diet trial. The diet to try is one of two types: either a prescription hydrolyzed diet or a novel protein/novel carbohydrate diet (prescription or home cooked with recipe formulated by a veterinary nutritionist, to prevent contamination with other proteins that can often happen in over the counter foods and can confuse the results of the diet trial).

The trial would need to be at least 12 weeks in length and is very strict, which means no commercial treats, no table food, no counter surfing or garbage diving, no eating poop of a dog on a different diet.

During the duration of the diet trial, any other infections (see above) would need to be treated, as they will not magically go away without appropriate therapy.

When to See a Specialist

Ear infections should be treated under the direction of your dog’s veterinarian, or by a board-certified veterinary dermatologist.

Topical treatments are usually preferred, as the medication is placed in the site of the infection, and systemic side effects can be avoided. However, if the dog is too painful to treat topically, or is resistant to an owner administering medication at home, oral forms of the medications can be of benefit.

Follow-up visits to document success or failure of the treatment are important in managing each individual dog’s ear health. Don’t skip them! Ear infections left untreated or undertreated can result in chronic pain and inflammation, deafness, peripheral vestibular disease that can affect balance, or an aural hematoma, in which the ear flap (pinna) becomes distended as it fills with blood.

Aural hematomas, left to heal naturally, will result in scarring of the pinna that is similar to a wrestler’s cauliflower ear. American Cocker Spaniels are a breed that can develop ear canal issues even without infection.

When ear infections cannot be managed through medical therapy, total ear canal ablation (TECA) surgery may be considered. Even though this procedure essentially renders the dog deaf on that side (or totally deaf if both sides are treated), it provides relief to chronic pain and infection. The TECA surgery is also indicated if there are cancerous changes in the ear canal.

Prevention

Clearly, ear infections are no fun for dogs or humans! Dog owners can help prevent ear infections from starting in the first place by using these simple guidelines:

• Work with your dog to accept procedures. As soon as a dog is adopted, owners should start work on cooperative care training, in which the dog is taught not only to accept, but consent, to veterinary procedures. At the very least, owners should be able to touch the ears and look down into the ear canals to monitor for changes. Getting a dog to accept regular ear cleanings is also extremely helpful.
• Consider using an ear cleaner with a drying agent in it for frequent swimmers. Often ear infections are more likely to set up after exposure of the ear canal to water. This is particularly notable for dogs who swim. If the moisture is left to evaporate naturally, this can set up a warm, humid local environment in the ear canal, which is an ideal condition in which bacteria and yeast can thrive. To speed up the evaporation of excess water in the ear canal, flush the ear canal after the last swim of the day with an ear cleanser, preferably one that has a drying agent in it.
• Stick with any prescribed dietary plans. If a dog has been diagnosed with a dietary sensitivity (see allergy above), stick to the strict diet plan to avoid an allergic flare, which can take weeks or months to calm back down.

The post Dog Ear Infection Symptoms appeared first on Whole Dog Journal.

Signs of Worsening Pancreatitis

Signs of pancreatitis include vomiting, loss of appetite, painful abdomen (which can look like a hunched up appearance, or the dog may posture like the yoga pose downward dog), lethargy, and fever.

Pancreatitis can be acute, meaning it comes on all of a sudden with no warning, or chronic. Acute pancreatitis can be severe and life-threatening. Many of these dogs must be hospitalized for intravenous fluids and supportive care. Chronic pancreatitis tends to cause waxing, waning symptoms repeatedly over time. Chronic pancreatitis requires careful, long-term management.

Signs of worsening pancreatitis in dogs include:

• Protracted vomiting not controlled with medication
• Unrelenting abdominal pain despite pain meds
• Weakness
• Shock
• Abnormal bleeding (due to disseminated intravascular coagulation)
• Collapse
• Trouble breathing
• Death

If you believe your dog is suffering from pancreatitis, get to the veterinarian immediately. This is an emergency. Call the clinic on the way to give them a heads up that you’re arriving. (This is yet another reason to know the name, phone number, and location of the nearest 24/7 emergency veterinary clinic.)

Pancreatitis also occurs in a chronic-active form, with milder symptoms that come and go. These dogs will intermittently need the help of antiemetic and pain-relieving medications and should always be fed low-fat food forever.

Causes of Canine Pancreatitis

The most common cause of pancreatitis in dogs seen in general veterinary practices is dietary indiscretion with ingestion of high-fat food, aka getting into the garbage or stealing butter or other high-fat foods off counters.

Other causes of pancreatitis include hormone imbalances, certain medications, trauma to the abdomen (like if dog is hit by car), and obesity. Some breeds are more predisposed to pancreatitis than others including Miniature Schnauzers, Yorkies, Poodles, and Cocker Spaniels.

Risk Factors for Pancreatitis

Schnauzers sometimes suffer from a condition called hyperlipidemia, which predisposes them to pancreatitis. Otherwise, predisposing factors for pancreatitis include:

• Obesity
• Diabetes
• Cushing’s syndrome (overactive adrenal glands)
• Some medications

Diagnosis of Pancreatitis

If your dog is showing signs of pancreatitis, your veterinarian will likely take an abdominal X-ray to rule out other potential causes. Baseline blood work is done for the same reason. Your veterinarian may also run a blood test called specific canine pancreatic lipase (SPEC cPL), which is much more sensitive and specific for pancreatitis than the older tests veterinarians used to have to rely on (lipase, amylase). Many veterinary hospitals can run this test in-house. With results immediately available, your dog can get the treatment he needs right away.

For chronic cases, your veterinarian may recommend an abdominal ultrasound, as this can provide useful information regarding severity, which helps in determining prognosis.

Treatment for Pancreatitis in Dogs

Treatment for acute pancreatitis in dogs usually involves hospitalization. Intravenous fluids are administered to combat dehydration, restore circulation to the pancreas and aid healing, and to prevent shock.

Pain management is of the utmost importance. Pain medications are administered by injection in the hospital because vomiting dogs cannot hold down medications.

Anti-nausea and anti-vomiting medications (antiemetics) are also administered by injection. Once vomiting has stopped, small amounts of low-fat food will by started by mouth.

Panoquell-CA1 (fuzapladib) is an intravenous medication conditionally approved by the FDA for treatment of acute pancreatitis in the veterinary hospital. This drug prevents damaging white blood cells from entering the pancreas where they exacerbate the damage to the inflamed organ. This is exciting news, as anything that helps prevent worsening pancreatitis in dogs is paramount to a successful outcome with this serious illness.

Dogs who recover from severe, acute pancreatitis may suffer from diabetes in the aftermath, depending on how severe the damage to the pancreas was (remember, the pancreas produces insulin).

Once the pancreatitis is under control, your veterinarian may discuss low-fat dietary changes with you to for long-term maintenance.

The post Pancreatitis in Dogs: Causes, Symptoms, and Treatment appeared first on Whole Dog Journal.

Each anal sac is lined with sebaceous and apocrine glands—the same type of glands found in a dog’s skin. Unlike their skin cousins, anal sac glands produce a secretion that has a foul, fishy odor. Since they are lined with glands, these anal sacs have become more commonly known as “anal glands.”

Anal sacs are located just below the skin surface. They are sandwiched between two muscles that surround the anus. When a dog has a bowel movement, these muscles compress the sacs against the stool as it passes through the anus. It’s like squeezing the bulb of a turkey baster. This action squeezes the contents of each sac through a duct and onto the surface of the stool.

Anal sac secretions act as a scent marker on the surface of your dog’s poop. That scent marker is like a signature or a fingerprint—his anal sac scent marker is unique to him. It gives other dogs information about your dog’s approximate age, gender, health, and hormonal status (for those that are not spayed or neutered).

How to Know When Anal Glands are Full

Anal glands in dogs will continue producing secretions even if the anal sac is full. A full anal sac can feel like a dog has a marble stuck next to his anus. The pressure and pain caused by a full anal sac will make a dog uncomfortable.

Dogs with full anal sacs will try to relieve this pressure by scooting their butt on the floor or incessantly licking their butt just underneath the tail. They are trying to compress the anal sac to expel its contents and relieve the pressure.

Straining to defecate is another sign that your dog’s anal sacs may be full. The pressure created by full anal sacs can make a dog feel like they have to poop, even when there is no stool in the rectum. These dogs will squat and push in an attempt to relieve the sensation of pressure.

Anal sac secretions can range in consistency from liquid to a thick paste. Dogs with anal sacs that are overflowing with a liquid secretion may experience anal sac leakage when they are sleeping. If this occurs, you might find a small, foul-smelling brown spot where your dog was laying.

Some dogs may involuntarily express their anal sacs when they are frightened or anxious. This does not mean that their anal glands are full. Remember those two muscles that surround each anal sac? One of those muscles is under your dog’s control and the other one is not. The anus muscle that your dog does not have voluntary control over may contract when they are anxious or frightened, causing expression of the anal sac’s contents.

How to Express Dog Anal Glands

There are two methods for expressing a dog’s anal glands—the internal method and the external method. Most groomers use the external method. Veterinarians and veterinary technicians use the internal method.

There are a few supplies you will want to have on hand regardless of the method you use to express the anal glands. You will need exam gloves (latex, nitrile, or equivalent), paper towels, and a deodorizer (see the next section for suggestions).

The external method for expressing anal glands is just as the name suggests—squeezing the anal sacs from the outside of the anus. Don the exam gloves and lift your dog’s tail. Place your thumb and index finger on either side of the 4 o’clock position next to your dog’s anus. Gently squeeze your thumb and index finger together until a brown or yellow liquid emerges from your dog’s anus. Repeat for the 8 o’clock position next to your dog’s anus.

The internal method should not be attempted unless you have been shown how to perform it by your veterinarian or a licensed veterinary technician. Don the exam gloves and lubricate the index finger of your dominant hand with K-Y lubricating jelly. Lift your dog’s tail and gently insert your lubricated index finger about one inch into your dog’s rectum.

Feel for a small grape-sized sac at the 4 o’clock position of your dog’s anus. Place your thumb over the anal sac along the outside of the anus. Gently squeeze your thumb and index finger together until a brown or yellow liquid emerges from your dog’s anus. The anal sac should feel like a deflated balloon when it is empty. Repeat for the 8 o’clock position next to your dog’s anus.

Wipe your dog’s rear end clean with a paper towel. You may apply a deodorizer to rid your dog’s rear end of the foul anal gland smell.

How to Get Rid of Dog Anal Gland Smell

As Lynyrd Skynyrd so poetically sang, “Ooh, that smell!” There are few odors as noxious and distinct as the smell of anal gland secretions. That smell can be difficult to erase once it is on your dog’s fur, your clothes, or your furniture.

There are a few tricks that veterinarians and veterinary technicians use to rid your dog’s fur of that awful smell after expressing your dog’s anal glands. My favorite is an ear cleanser called Epi-otic (made by Virbac). Squirt a little Epi-otic on a gauze square and wipe the fur around your dog’s anus. Epi-otic has a pleasant, fresh scent that effectively neutralizes anal gland odor.

I have also used a product called AOE (Animal Odor Eliminator—made by Thornell). This product is available as a spray and a wipe—both can be used on the fur around your dog’s anus. The spray can also be used on surfaces (including fabrics) and as an air freshener.

Health Issues With Anal Glands in Dogs

There are a handful of problems that can affect anal glands in dogs—impaction, inflammation, infection, abscesses, and tumors. Thankfully, anal gland tumors are rare. But anal gland impactions, inflammation (also known as anal sacculitis), infections, and abscesses are fairly common. My very first case as a newly minted veterinarian was an anal gland abscess!

Anal gland secretions initially have an oily, liquid consistency. These secretions can become thick and pasty if they are not naturally expressed from the sac during bowel movements. Thick, pasty secretions clog the duct draining the anal sac. The glands lining the anal sac continue to produce secretions even if the sac is full. A full anal sac with a clogged duct is called an anal gland impaction.

An untreated anal gland impaction can quickly become an anal gland infection. Bacteria make the journey from your dog’s anus to his anal sacs every day. The bacteria comes from the normal skin flora around the anus and the normal gut flora in the colon. They get flushed out with the anal sac secretions when your dog has a bowel movement. But when an anal sac becomes impacted, the bacteria cannot leave. And then bacteria do what they do best—they grow and multiply. This leads to an anal gland infection.

As the anal gland infection intensifies, your dog’s body responds by sending white blood cells to the anal sac to fight the infection. This creates purulent material (also known as pus). The anal sac is now beyond full with both anal gland secretions and pus. The anal sac and the skin over it stretches so thin that both layers rupture, releasing the contents of the anal sac like a volcano. You may notice a small hole with blood and purulent discharge next to your dog’s anus. This is an anal gland abscess.

Anal sacs can become inflamed if they are expressed too often. This is called anal sacculitis. Anal sacculitis causes an increased production of glandular secretions so that the anal sacs fill faster than usual. In general, dogs should have their anal glands expressed only when needed and no more than once a month.

Dogs naturally empty their anal sacs every time they have a bowel movement. As I mentioned before, the muscles around the anus compress the anal sacs against the stool as it passes through the anus. The anal sacs will not be adequately squeezed if the stool is too soft, if the stool is firm but too small, or if your dog is having diarrhea.

Obese dogs may have difficulty emptying their anal sacs. Excess body fat will accumulate around the anus and between the anal sphincter muscles. Instead of compressing the anal sacs, the anal sphincter muscles will compress the layers of fat in the area around the anal sacs.

Dogs that have a skin condition called seborrheic dermatitis may experience increased production of anal gland secretions. These dogs produce anal gland secretions faster than they can get rid of them, leading to an increased risk of developing anal gland impactions, infections, and abscesses.

There are two types of cancer that can originate in the anal glands—anal sac adenoma and anal sac adenocarcinoma. Anal sac adenoma is a benign tumor of the anal gland that does not metastasize (spread) to other areas of the body. Anal sac adenocarcinoma is a malignant tumor that can metastasize to the lungs, lymph nodes, and abdominal organs. Unfortunately, the majority of anal gland tumors are adenocarcinomas.

Anal gland tumors can be detected during a routine physical examination. If a tumor is found, your veterinarian may recommend bloodwork, thoracic radiographs (chest x-rays), and an abdominal ultrasound prior to surgically removing the tumor and the affected anal sac.

Supplements for Anal Gland Health

Dogs that experience frequent anal sac impactions, infections, and abscesses may benefit from a daily anal gland supplement. Anal gland supplements provide a convenient source of fiber. Fiber creates a stool that is firm and bulky. This promotes proper expression of the anal sacs with each bowel movement.

Some anal gland supplements also contain prebiotics, probiotics and omega-3 fatty acids. Prebiotics and probiotics work with fiber to improve stool consistency. Omega-3 fatty acids may help resolve anal sacculitis. Glandex (made by Vetnique) is one of the more popular anal gland supplements that is recommended by veterinarians.

You can also try adding fiber to your dog’s diet to bulk up his stool. Canned pumpkin, cooked squash, and apple slices are good sources of fiber (and tasty, too!). Talk to your veterinarian about how much of these fiber sources to add to your dog’s daily diet.

Anal Sacculectomy

Dogs that have frequent and persistent issues with their anal glands despite medical and dietary therapy may benefit from having their anal sacs surgically removed. This procedure is called an anal sacculectomy.

Possible complications of anal sacculectomy include fecal incontinence, abscess, or the development of perianal fistula. Fecal incontinence is the most common complication and can occur in up to one-third of dogs undergoing an anal sacculectomy. This complication is usually temporary and resolves in the first few weeks. However, fecal incontinence can be permanent. The rate of complications with anal sacculectomy is greatly reduced if a board-certified surgeon performs the procedure.

Other Anal Problems

There are two other conditions that can look like an anal gland issue but are not. Perianal fistulas may look like a ruptured anal gland abscess. Perineal hernias will create a visible swelling along the side of your dog’s anus and look like an anal gland tumor or impaction.

Perianal fistulas are draining tracts that originate between layers of muscle, skin, and other tissues in the anal region. The anal sacs are sometimes involved but not always. Symptoms of a perianal fistula include one or more openings in the skin around the anus with a bloody or purulent discharge. Dogs may scoot their butt on the ground, lick their butt underneath the tail, or strain to defecate. Perianal fistulas can occur in any breed of dog but are most commonly diagnosed in German Shepherds.

Perineal hernias are when a portion of the rectum, intestines, bladder, or abdominal fat are pushed through the muscles around the anus and hind end (also known as the pelvic floor). Symptoms of a perineal hernia are a large, soft swelling on one or both sides of your dog’s anus. Dogs will strain to defecate and may go several days without having a bowel movement.

Perineal hernias can be caused by trauma (such as being hit by a car) and chronic excessive straining to defecate. Although rare, perineal hernias are most often seen in older, intact male dogs that have an enlarged prostate. The enlarged prostate compresses the rectum and the last part of the colon, causing a dog to excessively strain to defecate every time they poop. The chronic excessive straining weakens the muscles of the pelvic floor, causing a perineal hernia.

Thankfully, most issues with anal glands in dogs can be addressed through changes in diet or the addition of an anal gland supplement. Talk to your veterinarian about the best course of action for your dog’s anal gland issues.

The post All About Anal Glands in Dogs appeared first on Whole Dog Journal.