Addison's Disease

Also known as "hypoadrenocorticism" -- caused by insufficient secretion of glucocorticoids (cortisol) and mineralocorticoids (aldosterone) by the adrenal glands. From the UC Davis Book of Dogs: "The cause of the disease is unknown, although immune-mediated destruction of the adrenal gland is suspected in most cases. The loss of adrenal gland function is usually a gradual process, first leading to a partial deficiency syndrome with relatively mild clinical signs often occurring only during periods of stress (e.g., boarding, travel, after surgery). As destruction of the adrenal glands progresses, hormone secretion becomes inadequate even under non-stressful conditions, and a true metabolic crisis without any obvious inciting event then ensues."


Appetite Problems

Appetite loss can be a sign of underlying health problems. Check with your vet if your dog's appetite is depressed. Once the vet has checked your dog and given the okay to stimulate her appetite, you can try these tips:

Aside from a totally home-prepared diet (see the "Nutrition" section on this site), which most dogs seem to adore, you may perk up your dog's appetite simply by warming food up to room temperature or slightly more -- causing the aromas to become more apparent to your older dog's olfactory senses. You may also try topping commercial fare with such goodies as: sliced or grated cheese, canned gourmet cat food, chicken or beef broth or gravy, or canned tuna with its liquid. Cream of Wheat or Wheatina add both flavor and a new, interesting texture (along with B-vitamins that can stimulate appetite).

When changing or making additions to your dog's normal fare, introduce the new foods in small quantities very gradually to avoid gastro-intestinal upset.

Dogs who have lost some of their teeth can still have the crunchy biscuits they love if you put them into a food processor and grind them into small particles or powder.

A product called STAT is a liquid with a flavor that dogs find appealing. It provides total nutritional support. Just a couple of tablespoons a day can ensure your dog will get all the necessary vitamins and minerals needed for survival. According to the label, it is, "A concentrated high-calorie liquid diet for animals. Stat is formulated to contain maximum nutritive value in a minimum amount of liquid volume." A clear advantage to the product is that you can use a syringe to get it into your dog's mouth. KV Vet Supply is a source for it: 1.800.423.8211.

Hills and other dog-food manufacturers have special foods meant for dogs with inappetance. Consult your vet for a recommendation.


Arthritis

Arthritis is a disease in which joint cartilage deteriorates. The result is that surfaces that are supposed to glide over each other become rough, and lubrication within the joint is decreased. Movement is more difficult and often painful. The signs of arthritis in a dog are: difficulty in walking, such as limping or a stiff, slow, or ungainly gait; difficulty in getting up from a seated or lying position; difficulty climbing stairs; a creaking, crackling, or "ratcheting" sound in the joints; an overall decrease in mobility; an unwillingness to move; dragging the back legs so that the tops of the nails scrape the floor. Dogs who are experiencing the pain of arthritis also may become "snappish" if they are touched in the wrong place or made to move when they're not ready. They experience arthritis pain just as humans do.

You can help your dog's arthritis in the following ways:

(1) give him a reasonable amount of controlled exercise -- that is, the kind of exercise that does not overtax joints, but that helps maintain overall mobility and flexibility
(2) control your dog's weight
(3) get an early diagnosis and recommended therapy -- which means taking your dog to the vet for a definitive diagnosis and recommendations on exercise program, nutrition, and therapy.

Mobility aids for helping dogs with arthritis and joint problems to walk are discussed under the heading "Mobility Aids," linked from the navigation bar at the left. Hydrotherapy is another possibility; resources are linked under "Physical and Hydro-therapies" in the navigation bar at the left.

Therapies

When dealing with a dog's arthritis, pain relief is a major goal, since there is no cure for the condition. Pain relief may be achieved through conventional pharmaceuticals or through alternative therapies such as nutraceuticals and acupuncture. Nutraceuticals, such as glucosamine, work to improve the functioning of the joints and, in so doing, also relieve pain. Because of the side effects associated with some drugs, many people choose to have their veterinarians treat their arthritic dogs with alternative therapies. Glucosamine and chondroitin, for example, have no known side effects.

This report will give you some insight into various treatment choices. We cannot recommend dosages or prescribe a specific substance for a particular dog. Please consult a veterinarian for guidance on these issues. Note that if your dog is not helped by one substance, he may be helped by another. If, for example, glucosamine and chondroitin do not seem to work, your vet may want you to try MSM, described below. Similarly, if one non-steroidal anti-inflammatory drug does not work, another might. Note also that your dog may experience side effects from one type of NSAID but not from another.

Information for this report was derived from a number of sources including the March 1998 issue of Dog World magazine, the New York Times, the Whole Dog Journal, and the Veterinary Information Network.

Always seek your veterinarian's advice when administering any medication or supplement to your dog. Your veterinarian knows your dog's complete health history and is in the best position to help you help your dog. None of the information on the srdogs website is intended as a substitute for your veterinarian's advice, nor is it intended as a recommendation of any specific therapy for your dog.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

This website has extensive coverage on Rimadyl, a non-steroidal anti-inflammatory drug (NSAID) used to relieve the symptoms of arthritis in older dogs. Although the drug is extremely effective with many dogs, its side effects can be serious. If you would like to learn more, visit the Rimadyl page on this site. Other NSAIDs, such as Etogesic and aspirin, are discussed below.

In addition to Rimadyl, there are other NSAID therapy choices, such as aspirin and EtoGesic. Aspirin has a tendency to irritate the stomach, and, according to the March 1998 issue of Dog World magazine, " . . . serious side effects may result from the use of acetophenetidin (Phenacetin), indomethacin (Indocin), pentazocine (Talwin), phenylvutazone (Butazolidin), or piroxicam (Feldene)." Use these substances only as prescribed by a veterinarian, and be extremely alert to signs of gastro-intestinal side-effects such as vomiting and diarrhea.

According to the Merck Veterinary Manual, 1998 edition, aspirin dosage for dogs is 10-25 mg. per kg. of body weight, PO, (orally) b.i.d. (twice per day). To convert your dog's weight from lbs. to kg., multiply lbs. x 0.45.

Stomach upset and irritation can be minimized by using Ascriptin instead of aspirin. However, enteric-coated aspirin, such as Ecotrin, may not be effective because it is incompletely digested and absorbed by the dog's system, causing erratic results. Drs. Foster & Smith sell "Buffered Canine Aspirin," a timed-release capsule that is designed to be digested and absorbed properly by a dog's system. In addition, it is liver flavored. Approximate cost: 250 tablets of 120 mg for $7.99. (Drs. Foster & Smith website and telephone noted under "Resources," linked from the navigation column at the left.)

Naproxen (a prescription drug in use for 20 years with humans) is an alternative to aspirin, if aspirin doesn't seem to work. Some dogs get relief on a low dose given every other day. However, overdosing is a risk because the tablet is quite large; the liquid form is better for small dogs. GI bleeding and, in extreme cases, perforation are possible side effects with chronic use.

Ibuprofen (Advil and Motrin) can cause serious problems in dogs; there is no safe dosage. Acaetaminophen (Tylenol) is not an anti-inflammatory, and can also have toxic effects on the liver. Dogs are more sensitive than humans to drugs that are toxic to the liver, and Tylenol is known to have toxic effects in humans. Don't use Tylenol for relief of arthritis pain in dogs.

EtoGesic acts like Rimadyl. It is also a non-steroidal anti-inflammatory. It differs from Rimadyl in that it is given just once a day instead of twice. It does have gastro-intestinal side effects in some dogs, however, as well as dry eye syndrome and photosensitivity. There are some reports on EtoGesic posted on this website. For more information, you may wish to call the manufacturer, Fort Dodge Animal Health, 1- 800-477-1365, or to read the package insert.

Some dogs respond better to Rimadyl than to EtoGesic, and vice versa. Either drug can provide relief; either drug may cause side effects.

Side effects and fatalities have been reported in connection with Metacam, another non-steroidal anti-inflammatory medication. See Metacam FAQ's from the manufacturer.

Deramaxx is another entry in the canine NSAID market. It also has the potential for harmful side effects. You may wish to read the manufacturer's information on Deramaxx. You can also read the list of Deramaxx's reported side effects.

When using NSAID's it is best to to be especially alert to symptoms of toxicity -- e.g., diarrhea or vomiting, excessive urination, lack of appetite, lethargy, behavioral changes, etc. -- and to withdraw the medication immediately should these symptoms appear. Remember, also, to ask your veterinarian how to determine the lowest possible dosage that provides relief, which will thereby lower the risk of toxicity.

Glucosamine and Chondroitin Sulfate (Glycosaminoglycans or "GAGs")

Glucosamine alone and glucosamine and chondroitin sulfate in combination are widely recognized among "nutraceuticals" as those that have the most consistently-demonstrated beneficial effects in the symptomatic relief of arthritis -- in both humans and dogs. This class of substance, known as "glycosaminoglycans" or "GAGs," appears to enable the body to repair damaged cartilage, which, in turn, decreases the pain of osteoarthritis. According to The Whole Dog Journal (April 1999), "Glucosamine is thought to stimulate the formation of new cartilage and help repair damaged cartilage. Chondroitin seems to draw beneficial fluid into cartilage, restoring lost rsistance and elasticity, and slowing cartilage breakdown by protecting it from destructive enzymes."

The May 2000 issue of Consumer Reports magazine reported on research being conducted on humans as follows: "An analysis of 15 studies that was published in the March 15 issue of the Journal of the American Medical Association found a moderate effect on pain relief and improved mobility with glucosamine, and a large positive effect for chondroitin. The researchers caution that some of the studies analyzed may be biased or flawed and expect actual efficacy to be more modest than the studies imply. ... There's some evidence that the supplements may actually slow the progression of cartilage loss in affected joints."

More in-depth information on glucosamine's usefulness as a therapy for pets can be found on the Internet on the The Pet Arthritis Center of the "Arthritis and Glucosamine Information Center" site. The site states, "The Pet Arthritis Center has been set up to provide you with the information you need to identify and treat arthritis in your pets, inform you of the dangers of certain prescription drugs such as Rimadyl, share tips on how to maximize your pet's nutrition, explain how arthritis progresses in pets and how to recognize the common symptoms of arthritis and osteoarthritis. In a nutshell, we will help you prevent unnecessary pain in your dog, cat or exotic animal and empower you to make a positive change in your pet's life."

According to sources such as Jane Brody, the health columnist for the New York Times, supplements alone are not the total answer; " . . . exercises that foster aerobic conditioning, muscular strength and flexibility and a diet that counters overweight . . ." must be part of the equation.

Ms. Brody also notes that since the sale of dietary supplements is not regulated by the Food and Drug Administration, you must be careful about the source from which you purchase them. Prices will vary, too. It will be cheaper to buy a brand that contains just glucosamine and that does not carry the cost of patenting a specific combination of substances.

According to the March 1998 issue of Dog World magazine, "Glucosamines have been shown to stimulate glycosaminoglycan, proteoglycan and collagen synthesis in chondrocytes and fibroblasts. Chondroitin sulfate has been shown to lessen the destructive effect of degradative enzymes on cartilage."

N.B.: People and animals with diabetes should NOT take glucosamine.

Some sources for glucosamine (either alone or in combination with chondroitin and other substances) that have been recommended: Costco (sold under the name "Pain Free"; Drs. Foster & Smith (sold under the brand name "Joint Care"); K-Mart (sold under the brand name "Osteo-Bi-Flex"). These compare favorably for price and effectiveness to other brands and combinations. (Click on "Supplies/Medicines" in the navigation bar at the left for contact information.)

Some brands of commercial dog food havebegun including glucosamine and chondroitin in the formula. We received the following report from a website visitor:

"I have an eight-year-old Corgi-mix named Princess. Last year, she started having stiffness at the end of our long walks and had an exaggerated hind leg gait. We started her on Eukaneuba Bone and Joint Maintenence for Seniors, which contains glucosamine and chondroitin. Within two weeks, she was acting like a puppy again. Now we walk two miles every day, and there seem to be no residual effects. I could have put her on Rimadyl, as the vet offered to do, but I wanted to take a nutritional approach first." Rebecca V. Sweezey, BVDPTATC@aol.com

Arthramine, a brand name product, contains glucosamine in combination with bromelain, manganese, feverfew, vitamin C, and quercitin. There are no studies showing that these additional substances work better than glucosamine with chondroitin. However, some report that quercetin must be given along with bromelain in order to make it available.

Arthrasyn contains glucosamine, manganese, shark cartialge, boswellin, and yucca. Again, no studies clearly show that this particular combination works better than glucosamine or glucosamine-chondroitin in combination.

Adequan, the trade name for a substance known as polysulfated glycosaminoglycan, was approved recently by the FDA as an injectable substance for use with dogs. It is administered intramuscularly, rather than into the joint, and therefore eliminates the risks involved in intra-articular injection. It is believed that this drug does more than just relieve pain; it may actually slow down the disease. It is being called a "wonder drug" because of the way it quickly provides relief.

Some veterinarians are now combining two therapies for treating arthritis: the injection of polysulfated glycosaminoglycan followed by oral administration of glucosamine or glucosamine-chondroitin in combination. Reports on the result of this combination therapy are extremely favorable.

An October 1998 news release from Luitpold Pharmaceuticals, the makers of Adequan, states: "Veterinarians across the country have been having remarkable success with Adequan Canine. It is the first, and, to date, the only drug in a new class of drug called Disease-Modifying Osteoarthritis Drugs. Adequan Canine goes beyond pain relief. It works in the arthritic joints to slow down and even halt the disease process while also stimulating the dog's natural joint repair processes. Dennis Nelson, DVM, a veterinary medical consultant in Orlando, Florida, explains, 'Quality of life is only part of the equation if your dog has arthritis. If all you do is reduce the pain of a sore joint, you can actually worsen the condition because stress on a joint may cause further deterioration. Pet owners should understand the mechanics of arthritis and have their veterinarian tell them about possible side effects of some of the drugs that are currently used to treat the pain of canine osteoarthritis.' Adequan Canine is available only through a licensed veterinarian." More info at the Luitpold web site.

Information from Luitpold -- Specifics about Adequan Canine:

1. In efficacy studies dogs were treated with intramuscular injections of PSGAG. Possible drug related adverse reactions and/or side effects were reported after 3.1% of injections (out of a total of 1,248 injections). These included:
a) Injections Site Pain 1.8%
b) Diarrhea 0.6%
c) Transient Depression 0.5%
d) Vomiting 0.08%
e) Abnormal Bleeding 0.08%
All reported possible side effects and adverse reactions were mild and transient and none required discontinuation of treatment.

2. Any of Adequan Canine that is not protein bound or that remains in the body in free form is excreted from the body almost entirely by the kidneys. Kidney disease in a dog may alter or delay the body's ability to eliminate the drug normally; it should be used with caution in animals with abnormal kidney function.

3. PSGAG is a mild, transient inhibitor of blood coagulation and is chemically similar to the anticoagulant drug heparin. Dogs with known or suspected bleeding disorders should be evaluated by platelet counts and blood clotting tests. Remember that there are a group of drugs in the NSAID category that inhibit blood clotting and cause bleeding ulcers in the digestive system.

4. Abnormal bleeding has been noted, but only in dogs with pre-existing bleeding problems.

5. Rarely will a dog vomit or have transient diarrhea within hours of an injection. This effect may or may not be drug related.

Cosequin (glucosamine 250 mg, sodium chondroitin sulfate 200 mg, manganese ascorbate 33mg, manganese 5mg) and Cosequin DS (glucosamine HCI 500 mg, chondroitin sulfate 400 mg, and manganese ascorbate 76mg), are both manufacturered by Nutramax Laboratories, Inc. (1-800-925-5187). According to the manufacturer, "Manganese ascorbate is a co-factor necessary for glycosaminoglycan production." While many documented, reliable studies have been done that demonstrate the effectiveness of Cosequin and Cosequin DS, none demonstrate clearly that glucosamine and chondroitin sulfate are less effective on their own than when combined with manganese ascorbate.

Glycoflex (proteins, minerals, glucosamine, mixed glycosaminoglycans, trace elements) and Arthri-Nu (glucosamine, vitamin E, selenium, copper proteinate, zinc proteinate, omega-3 fatty acids) are other brands that combine glucosamine and other ingredients. Again, however, there is no clear demonstration that these combined ingredients perform better than glucosamine and chondroitin on their own.

The following specific brands and sources for glucosamine and chondroitin were recommended in The Whole Dog Journal, April 1999: Pet Central (catalog retailer, Sylvania, OH 1-888-892-7393); Bronson Vitamins and Herbals (catalog retailer, American Fork, Utah, 1-800-235-3200); Drs. Foster & Smith's "Joint Care" (1-800-826-7206).

Other sources for glucosamine (either alone or in combination with chondroitin and other substances) that have been recommended: Costco (sold under the name "Pain Free"; K-Mart (sold under the brand name "Osteo-Bi-Flex"). These compare favorably for price and effectiveness to other brands and combinations. Other low-cost sources for glucosamine and chondroitin are also noted on the "Supplies/Medicine Sources" page. (Click on "Supplies/Medicines" in the navigation bar at the left for contact information.)

You will encounter many brand names for nutritional supplements containing glucosamine and chondroitin; the important thing to know is how many milligrams of these substances are included. Many products are advertised as being more effective because they contain additional ingredients such as Vitamin C or garlic or yucca; however, the only substances that have demonstrated effectiveness are glucosamine and chondroitin, so that is what you should look for. If the label is misleading or difficult to understand, choose another (e.g., a product called "GP Flex" advertises that each ounce contains 2,500 mg of chondroitin sulfate without telling what each tablet contains).

Shark Cartilage

Reports of benefit from the use of shark cartilage seem to be entirely anecdotal. No clinical studies have clearly demonstrated its effectiveness for use in relieving the symptoms of arthritis. Some experts recommend against using chondroitin products that are based on shark cartilage because their quality varies significantly.

MSM

Methylsulfonylmethane is a natural nutrient that is supposed to scavenge free radicals and provide pain relief. Some veterinarians report that this product is effective and does not appear to have adverse side-effects. Other veterinarians are not convinced of its effectiveness. Derived from DMSO (dimethyl sulfoxide), an industrial solvent, it is often seen in popular medical literature. Proper dosage for dogs has not been clearly determined.

As reported on the Veterinary Information Network, one practitioner estimates ". . . about 80% of owners feel their pet is benefited by the use of MSM. I began by using it on animals that did not respond to or were not good candidates for NSAIDs. I have not see any side effects except a rare dog that would get soft BM from it. Almost all dogs and cats will accept it when mixed in their food. It is available from from Vitality Systems at 800-877-0177. They will give you some information and articles about the product. It looks like its claims haven't been documented scientifically."

Another veterinarian reports: "I've reviewed many MSM . . . products marketed with all sorts of claims for small animals and equines. None are approved (by the FDA), nor do they have any decent data to justify their use."

Cartrophen Vet

Rimadyl is also known as 'Carprofen.' There is another drug, developed in Australia before Rimadyl, called 'Cartrophen.' Although the generic names are similar, the drugs are radically different. Cartrophen Vet is not an NSAID (non-steroidal anti-inflammatory drug), as Rimadyl is. Unlike Rimadyl, which intends only to relieve the symptoms of arthritis, Cartrophen is purportedly a "disease modifying anti-osteoarthritic drug" that promotes the regrowth of cartilage and the generation of synovial fluid. Cartrophen Vet is like Adequan and Cosequin in this respect.

According to a note from the manufacturer (Biopharm of Australia; Arthropharm of Canada is the North American/Canadian distributor): "Cartrophen Vet is not available in the USA at this time. However, a USA file is almost complete for the product and we are doing research in Universities in the USA. At this time, the product is available in Canada and we understand that it can only be imported into the USA by individual veterinarians. Arthropharm Pharmaceuticals Inc., can be contacted at 613.738.8607." Cartrophen may be administered by injection and is also available in capsule form. It is sold by prescription only in Australia, England, and Canada. Arthropharm has a website at: http://www.arthritis.au.com and an e-mail address at info@arthritis.au.com.

The manufacturer labels the drug with the recommended dosage of one shot per week for the first 4 weeks and one shot every 4 weeks thereafter for the life of the animal. If the drug is used following surgery, it can be discontinued once healing is complete. Studies done on Cartrophen in England were based on one shot every 6 months rather than every 4 weeks; thus, the results may not truly reflect the efficacy of the drug when administered as recommended by the manufacturer. Nonetheless, the performance of the drug seems to have been reliable and good enough to warrant tests of its effectiveness on humans. These tests are currently being conducted in Australia.

Excerpts from anecdotal reports that attest to the efficacy of Cartrophen Vet follow:

May 1999, from John Lynch of Olympia, WA: "I have a soon-to-be (July 31, 1999) twelve-year-old German Shepherd bitch with severe arthritis in both of her elbows. The condition is secondary to ununited anchoneal processes (UAP) in each elbow, a condition that afflicts some Shepherds. I have tried every possible medication to ease the female's discomfort. Rimadyl nearly killed her; after six days she had extremely anomalous liver readings, and, to Pfizer's credit, their veterinarian concurred with mine and advised ceasing the medication immediately. She has had glucosamine and chondroitin sulfate as a supplement for years. She also takes 'Winston's Joint Formula,' which seems to afford some mild help. She is also dosed with two Tylenol extended-relief-for-arthritis tablets (650 mg. each) twice-a-day. She has had a full series of Adequan injections as well, including follow-ups, to no appreciable benefit. I've also tried other homeopathic herb/nutracuetical remedies as well (e.g., MSM, Evening Primrose Oil, Vitamin C, etc.)

"I first heard of Cartrophen Vet on the Senior Dogs Project website. I also found it referenced in a veterinary text on small-animal arthritis. I contacted Arthopharm, the company which manufactures Cartrophen Vet in Australia. Since I live 60 miles south of Seattle, I also asked for names of veterinarians in British Columbia. I contacted the closest clinic and made arrangements to pick up the medication for the initial course of treatments --- once a week for four weeks and once every month thereafter for four months. The total cost was just under $100 U.S.

"That following Monday, my dog had her first shot. She has now had all four weekly shots and is due for her first monthly supplement on May 24th. The effect has been dramatic. I have finally found something for her which has had a truly and markedly clearly beneficial effect.

From Richard Owocki (owocki@sympatico.net) in Canada: "I have an 8-year-old Border Collie named Megabyte. Just about a year ago his competition obedience marks went from 198's to 180's. He was always sitting off to one side. X-rays showed bad hips (HD) with the onset of arthritis. He started on .7cc of Cartrophen Vet once a week for six weeks and once a month ever since. I have seen no side effects. All I know is I have a pain-free Border Collie who enjoys Frisbee, agility, and racing around the fields with my other dogs. Cartrophen Vet has given Megabyte a second chance at what he loves to do. I feel all dogs everywhere should have that same chance."

Side effects of Cartrophen Vet known to occur in the first 48 hours after administration and then to disappear are: (1) lethargy; (2) a rise in body temperature. There have also been undocumented reports that, in the human trials currently being conducted, severe diarrhea has occurred along with small GI bleeds in almost 100% of patients. Stroke has been mentioned but not substantiated as a potential major complication, along with sudden death syndrome in dogs. Since the clinical trials are not yet complete, definitive conclusions cannot be drawn about these side effects. It has been determined, however, that Cartrophen Vet is contraindicated for dogs with cancer. Cartrophen increases the blood flow to joints and, at the same time, to tumors; therefore a dog who has been diagnosed with cancer should not take Cartrophen.

Alternative Medicine

Acupuncture is gaining acceptance in the veterinary medical community as an effective alternative therapy for relieving the pain of arthritis and to increase joint mobility. Information on veterinarians who practice acupuncture is available from the International Veterinary Acupuncture Society, P. O. Box 2074, Nederland, CO 80466 (telephone: 303-258-3767). There is also an excellent book on the subject by Dr. Cheryl Schwartz, entitled Four Paws, Five Directions.

Homeopathy, chiropractic, and holistic healing are not as well accepted or given as much credibility as acupuncture. Anecdotally, however, there is support for them. For more information, you may wish to visit the veterinary homeopathy website, the holistic veterinary website, and the American Veterinary Medical Association website.

Alternative "integrative" medicine for canine osteoarthritis is further discussed on the alternative medicine website.

Please also read some valuable hints and personal advice that has been offered by some srdogs.com's visitors.


Arthritis: Physical and Hydro- Therapies

Please see the special coverage of Physical and Hydro- Therapies on this site for information on how these might help your dog.


Arthritis: Rimadyl Therapy

An extensive report on Rimadyl is contained on another page on this site: Rimadyl Report



Auto-Immune Hemolitic Anemia

An excellent, comprehensive site on auto-immune hemolitic anemia is located at: http://www.cloudnet.com/~jdickson. It is kept by Joanne Dickson, whose dog was diagnosed with the disease when she was 3. Not expected to live more than a year or two at that time, at 9 1/2 years old today, she is not only surviving, but thriving.

Another website, reported to be approved and recommended by veterinarians, is maintained by Lorrie Beach. It is at: http://www.aihadog.net/


Blindness

See "Eye Conditions" below.


Bloat

Bloat is a life-threatening condition caused by a dog's ingesting food too rapidly or exercising too vigorously after eating. Feeding your dog -- especially your senior dog -- two or three small meals in the course of a day is far preferable to one large meal in many ways -- including its being a means of avoiding bloat. Have your dog rest a couple of hours after a meal before engaging in strenuous exercise. Any time your dog has not eaten for a prolonged period -- a day or more -- offer small portions of food over several hours instead of a large meal.

 


Body Odor

In an aging dog, body odor can originate in the malfunction of internal organs. If a dog's thyroid function is impaired, for example, this may cause a bad odor. Odor may also be caused by an ear or mouth infection or a skin condition. In addition, a very important factor can be quality of diet. If complete and careful bathing of your dog does not eliminate bad odor, see your veterinarian and discuss the various possible causes, including the kind of food you are feeding your dog.

Some alternative treatments that have received good reviews: Vitamin A is sometimes recommended to help skin conditions, and a bath in tea tree oil (1/2 teaspoon to 1 pint of water) may help, as well. Others have reported that changing to a home-prepared diet such as Dr. Ian Billinghurst's "Biologically Appropriate Raw Foods" (BARF) nutrition program has totally eliminated body odor. (BARF is described in the book, Give Your Dog a Bone, by Dr. Billinghust.)


Breathing Problems

See laryngeal paralysis.


Cancer

Traditional medicine, such as surgery, chemotherapy and radiation, are commonly used for dogs with cancer. Dogs do not seem to suffer the side effects of chemotherapy in the same way that humans do; the side effects do not seem to be as severe or as prolonged. The initial chemotherapy session may cause the dog to become ill due to the shedding of malignant tumor cells. However, subsequent sessions are usually tolerated extremely well.

Alternative therapies -- with nutritional and herbal components -- are currently under investigation and have been used by some dog owners. The report below on "Stella" describes one such experience.

If your dog has cancer, it is wise to explore various treatment modalities. Consult your vet to determine if traditional medicine or alternative medicine or a combination of both may be appropriate for your dog.

Robin Downing, DVM, gives us the benefit of her expertise as a veterinarian and her personal experience of dealing with her own dog's cancer in her book, "Pets Living with Cancer: A Pet Owner's Resource." The book is written in a warm, understanding, yet extremely informative and practical manner. Inspiring hope, the author states, "Cancer is the most curable of chronic diseases."

Published in April 2000, the book covers many of the most advanced treatments at that time for canine and feline cancer. It also deals with the emotional issues that must be confronted when this terrible disease strikes. Resources listed at the end of the book include other reading material, websites, and veterinary teaching hospitals where treatment can be sought.

Except for the very poor-quality photos, which add little or nothing to the reader's understanding, we like this book a lot. Since it was written in 2000, there are likely to be other more current therapies available. For more information see:

A veterinarians' website focused on cancer: http://www.vetcancersociety.org

Information on alternative therapies for pets with cancer:
http://www.caninecancer.com/alternatives.html

Endless Love is an E-mail list for people who have pets with cancer. Founded by Vicki Roudonis, it is a place to share the good times and the bad, ask questions, and share information. It's open to anyone who has a pet with cancer.

Cancer Treatment Center in Los Angeles: A cancer treatment center previously open only to humans is now open to pets at the University of California at Los Angeles (UCLA) Medical Center. Hospitals for humans prohibit treatment of pets on the same premises, and in the past vets have gone around the rules, admitting dogs for radiation treatments under cover at night. Now, thanks to an agreement made between UCLA and Veterinary Centers of America, Inc., veterinarians from the company's West L.A. centers will be able to arrange treatment for pets at the UCLA facility. The technicians will be instructed in calibrating the cobalt machines for pets by a veterinary oncologist from Colorado State University.


Stella's Holistic Health Care Program

Coordinator's Note: This material is intended for informational purposes only. It is an anecdotal report in support of holistic health care for one dog with a particular type of cancer. This report was written by Stella's owner, Drew Saitta, k9korner@address.com

"Simply defined, 'holistic' means 'whole.' A holistic pet food, for example, uses only whole meats, grains, vegetables, etc., and no by-products, fractionated grains, pulp, or glutens. The holistic approach to any part of pet ownership requires that we consider the whole dog -- breed, heredity, nature, environment, temperament, physical ability, and intellect.

"When our nine-year-old rescued Golden Retriever, Blanche, was diagnosed with an inoperable tumor next to her heart, we sought help from Dr. David Penney, a Holsitic vet and protegé of Dr. Cheryl Schwartz, founder of the East/West Animal Care Center in Oakland, CA, and author of the book, Four Paws, Five Directions, which is a guide to Chinese medicine for cats and dogs. Although Blanche's condition was terminal, the acupunture treatments along with herbal and food therapies kept her active, playful and happy right up to the day she died.

"Three months after Blanche died, we took our dog Stella to the vet for diagnosis of a fatty cyst on her side. The vet found a massed cell tumor. Determined not to lose her, too, we again consulted with Dr. Penney, who agreed that the first thing to do was to remove the tumor. Stella was 11 years old, but strong. She bounced back from the surgery like a trooper. We were told that, since the tumor was malignant, it was likely to grow back within two years. We immediately began a holistic health care program that we continue to this day. Stella had acupunture treatments monthly to strengthen her "qi" (pronounced "chee"), which is the Chinese word for the body's life- or energy-force. After only five acupunture treatments with Dr. Penney, my wife Jean and I were able to learn and take over doing acupressure and massage for Stella at home.

"Building a strong immune system is critical to fighting off disease and infections, and to boosting the body's recuperative power. We found holistic foods, treats, and supplements for dogs (and for cats), and we feed them exclusively to Stella and to our other dog, Buddha, a rescued Pug and the newest member of our 'pack.'

"Happily, three years later, Stella's tumor has not grown back. But cancer is a tenacious and aggressive disease. All it takes is a few cells floating through the body to cause trouble somewhere else. Last February, a pea-sized tumor was removed from Stella's thigh. We had been watching it swell and shrink for months, delaying surgery because I was confident that our holistic approach would keep her strong enough to fight the disease without it. It was a lot to ask of a 14-year-old dog -- and arrogant of me to play Russian roulette with her life. Well, the tumor was maglinant, which surprised even our vet, because it never metastasized and never grew bigger than a grape, which, given the aggressive nature of cancer, it should have. Were we just lucky? Was it the holistic health program? Was Stella some kind of canine "Terminator"? Maybe a little of each. At 15, she still eats like a horse (she is a Lab, after all), swims like a duck (okay, an old one, just paddling along), prances down the beach like she has for years (only slower and for shorter distances), and comes to work with me every day. She and Buddha guard the treats section in our store."


Cognitive Dysfunction Syndrome/Senility/Dementia/Old Age Syndrome

Early signs of canine cognitive dysfunction syndrome: pacing, crying, barking without apparent reason, loss of appetite, repeated attempts to get into small spaces, getting stuck in small spaces, diminishing interaction with family members, lack of recognition of family members, turning away from previously "favorite" family members, loss of house-training, sudden fascination with mirrors and staring into them, appearing hypnotized, appearing "lost." In the initial stages, the dog will have good days and bad days. Not all vets recognize the condition, attributing the symptoms to "old age." However, old age is not treatable and cognitive dysfunction syndrome can be.

Anipryl is a drug that can help a dog with cognitive dysfunction, although it does not help all dogs. It takes between 4 and 8 weeks to work. It is an expensive drug under its brand name, but there is a generic equivalent to the human form of the drug (Eldepryl): selegiline hydrochloride. Check with your vet to see if the generic form is acceptable. It is cheaper and can be purchased at any pharmacy with a prescription. For more information see Anipryl -- Help for Geriatric Pets?

Does Anipryl Help Older Dogs?

In January 1999, it was announced that Anipryl (Pfizer Animal Health) had become available to treat cognitive dysfunction syndrome. The drug is a reformulation of deprenyl, which has been used to treat Parkinson's disease in humans. Although Anipryl is effective in many dogs, it does not work for all. Usually, about two months of administration are required to determine whether it will help a dog with cognitive dysfunction syndrome.

On the positive side, we have this health history and glowing report about Anipryl from Lita Marie Flood (lita.flood@tatham.com) about her dog, Matt:

"My husband and I found an older dog on September 6, 1997. He was in very bad shape. We couldn't even tell what gender he was, because his fur was so matted and long. We took him home, cleaned him up (it took 3 baths and as many brushings to get everything out of his coat) and took him to the vet. It turned out he was a boy (dubbed "Matt") and quite old. The vet estimated between 12 and 15 years. He also had a severe bacterial infection in his mouth, in which 7 teeth had to be pulled, has a tumor (benign) in one eye and a cataract in the other. He also has an enlarged heart, arthritis and about 20% kidney failure. My husband and I talked it over and, since he was in no pain (the vet really couldn't believe it, considering what he had gone through), decided to keep him and add him to our family.

"Matt never was an overly affectionate dog, most likely from being so neglected and abused. Didn't respond to his name, even after a year, so we figured he was deaf, too. About two months ago, he began wandering all over the house at night and seemed generally miserable. He'd stand at the back door for what seemed like hours or stare at walls or into another part of the house for just as long. We just figured that was his way, being older and not seeing too well. Then we made a discovery: I looked through a recent DOG FANCY (March 1999) and I read the article about 'doggie senility.' The article listed 'symptoms.' Matty had at least ten of them. There was also an ad for Anipryl (the suggested drug) in the magazine. I printed out all the info from their web address, and my husband took it to our vet, who put Matt on Anipryl. As a result, Matt is a different dog! He sleeps at night! When I pick him up for 'morning love,' he lays his head on my shoulder and doesn't try to get away. The endless roaming and circling has stopped. He is even slowly responding to his name! Matt's only been on the drug for 16 days but the change is amazing!"

More on Anipryl.....

Chelsea and Canine Cognitive Dysfunction Syndrome By Susan Hickman
sehdor@aol.com

Chelsea was diagnosed with canine cognitive dysfunction syndrome (CDS) in October 2000, just before her 11th birthday. Chelsea's behavior changed in two primary ways. First, she began to wake us up at night with increasing frequency, panting, trembling, and appearing inconsolably terrified. This behavior was not completely new -- she had always reacted strongly to thunderstorms and loud noises from apartments above us. However, she started to act terrified several times a week and we were unable to identify any stimuli in the environment that explained her behavior. She would also pace for hours at night, her nails clicking on our hardwoods, and burrow into our closets in an attempt to hide. (One night I found in her in a guest room closet burrowing inside the bag that contained my wedding dress!) Second, she started to urinate on our bed (always on my husband's side), the guest bed, and the bathmat. This was not completely new, either. In the past, she peed on our bed once or twice a year. We called these 'revenge pees' because her behavior was always clearly tied to an event (e.g., bringing her home after boarding several days at the kennel). However, she started to pee on both beds as well as on our bathmat several times a month until it escalated to a minimum of once a week. Often the blanket or rug she peed on would be balled up as if she had dug and clawed at them before peeing (a behavior we often saw when she was frightened). Tests revealed no urinary tract infection or other plausible explanation. There had been no changes in our household. Her routine was stable. All of this left us feeling not just frustrated, but completely inept. Our vet was sympathetic but could only suggest that we crate her during the day and that we call Dr. Jacqueline Neilson for an evaluation.

The crating was helpful, as were the baby gates we purchased to keep her from peeing on the guest bed. However, it was too little, too late. By the time we a vet with advance training in animal behavioral problems, we were at our wit's end. After reviewing Chelsea's medical records (including requested labs)and interviewing us extensively about Chelsea, the vet (Dr. Jacqui Nielson of Portland, Oregon) agreed that her behavior seemed to make little sense--on the surface. However, she concluded that the symptoms we described were consistent with the diagnosis of canine cognitive dysfunction disorder syndrome. Dr. Neilson recommended Anipryl and we agreed to a trial after a few days of debating the expense.

She started off on 10 mg per day. We also were given sedatives for the nighttime episodes. Over the next month, we used less and less sedative until we stopped needing to give it to Chelsea all together, approximately five weeks after we started the Anipryl. The frequency of her nighttime fearfulness decreased, as did her inappropriate urination, pacing, digging, and other aggravating behaviors, until these behaviors virtually disappeared. We continued to crate her during the day, a new routine she adapted to surprisingly quickly. On three occasions, her medication has been bumped up following sustained changes in her behavior (as measured by how often we needed to give her sedatives) and she is now at 25mg per day. We now purchase the generic seledgeline through an on-line pharmacy at a cheaper price than we could find elsewhere. Although this treatment has not been inexpensive, it has been well worth it. The changes we have seen since starting the medication have been nothing short of amazing and everyone's quality of life has improved markedly. It has now been over six months since we have needed to give Chelsea a sedative at night (and five months since her third medication increase). She has not peed on our bed for at least a year (though she now goes on the floor). Chelsea rarely suffers from terrifying nighttime fearfulness (which had to be awful for her) and the people she depends on now respond to her with the compassion and kindness she deserves, instead of frustration.

It should be said that while the medication has effectively controlled symptoms, it has not stopped the underlying disease or advancing age. Chelsea's dementia is clearly progressing, even with the medication and the addition of a new food from Hill's Science Diet designed to slow the disease (started in the Summer of 2001). We frequently catch her staring at us as if she has no idea who were are, relaxing only after we offer our hand for her to sniff. A recent move has left her confused about which side of the door opens and new routines, such as where to turn on our walk, have been almost impossible to teach her. She is impulsive and will grab things from our hands and stick her head in the cat box in front of us. Chelsea sleeps approximately 20 hours a day. Recently, she has forgotten to pee and poop when outside and has gone on the carpet. Her weight has dropped from 35lbs to 28lbs, likely in part because she sometimes forgets to eat. She is now a frail 13 years -- her legs are weaker, she is going deaf, and she is peppered with gray. But we love her dearly and there is no question in our minds that the Anipryl enabled us to keep her in our family over the past two and a half years.


Congestive Heart Failure

Congestive heart failure often involves an increase in the left side of the heart because there is a "leak" in the heart valve, causing blood to flow back from the right to the left side, which then makes the left side work harder and become overdeveloped. In congestive heart disease, fluid accumulates in the lungs, which causes coughing and wheezing. A dog's breathing is very labored and coughing is common when congestive heart failure is present.

Medications that help with the condition are diuretics, vasodilators (which decrease resistance in the blood vessels), angiotensin-converting enzyme inhibitors, and sometimes digoxin. The drug Lasix is commonly used. However, Lasix is extremely hard on the kidneys. A blood test to determine kidney function is done prior to administering Lasix and during the course of treatment.


Cushing's Disease

Cushing's Disease (Syndrome) is a common hormonal disease in older dogs. It is an overproduction of the hormone "cortisol" by the adrenal glands. Signs of the condition are: increased drinking and urinating, an enormous appetite, excessive panting, bloated abdomen, weakness, and lethargy. Hair loss and changes in the skin, scaling of the skin, delayed healing of wounds, and hematomas may also be noticeable.

Surgery and medicines are available to treat Cushing's. More information at:

Cushing's Disease

Cushing's Disease e-mail list


Deafness

Some encouraging words and advice on deafness in a dog: "I don't believe dogs spend any time pondering the mysteries of life, dwelling on such questions as 'How come no one talks to me anymore?' They instead react to whatever stimuli are present in their lives. Remember that if your dog can't hear well, you won't want to charge up behind her and surprise her. And don't step over a sleeping deaf dog; she might awaken with a start and leap to her feet, causing you to trip." (From Jenny Daniel)

Recommendations from others: Tone of voice is important. Many dogs with hearing loss can hear deep or low tones but not the higher-pitched sounds. They can also "hear" (feel) vibrations, so walking firmly across the floor will give a deaf dog warning that someone is approaching.

Deaf dogs E-mail support group

Advice on living and working with a deaf dog

"Living with a Deaf Dog" by Susan Cope


Degenerative Spinal Myelopathy

Degenerative Myelopathy Online Resources: http://www.workingdogs.com/doc0159.htm

Degenerative Myelopathy Help and Advice --  Spanna's Site

http://www.mzjf.com/ -- a support group for the owners of GSD's who have the condition


Diabetes

Diabetes web page: http://www.petdiabetes.com/

The guardians of diabetic dogs also now have a message board. People really like the message board format, where messages and replies can be read in sequence over a prolonged period. On the Canine Diabetes Message Board, anyone can post messages.

A simple blood test and urinalysis done by your veterinarian are the best ways to diagnose diabetes. Symptoms to watch for are excessive thirst and urination. However, these are sometimes missed, and, in some cases, the first sign that is noticed is that the dog has begun to bump into things....which indicates a loss of eyesight due to the effects of the uncontrolled diabetic condition. Such sight loss can happen very quickly, but, if you take your dog to the vet semi-annually, as recommended, and have the appropriate lab work done, you are likely to catch the problem before it gets out of hand.


Disabilities -- Help for People Whose Dogs are Disabled

Internet support comes in the forms of a number of helpful Web sites that provide guidance, encouragement, technical information, and advice to people whose dogs are disabled. Please see:

Pets with Disabilities -- Web site of the Pets with Disabilities organization; many resources.

Also see "Mobility Aids" on this Web site.

K9 Carts provides wheelchairs for disabled pets with mobility issues, and typically donates a number of wheelchairs per year to various charitable pet organizations and individual pet owners in need. For more information, E-mail: info@k9carts.com


Epilepsy

The Guardian Angels website on epilepsy and hypothyroidism is an excellent resource for information and guidance. The site is described as follows:

"Our website has comprehensive information about canine epilepsy and canine hypothyroidism along with an overview of other causes of seizures such as lead poisoning, distemper, tick-borne diseases, etc. In addition, we have a group of people who will provide support and answer questions. Unfortunately, epilepsy is genetic and is becoming more and more common in purebred dogs. Some vets are still not knowledgeable about treating epilepsy and needlessly recommend that dogs be put to sleep. The goal of our site is to provide education and information that will enable dogs with these conditions to lead long and happy lives."


Eye Conditions

There is a great deal of information on the Eye Vet site. Also see:

Blind Dogs website

Vet Ophthalmologists Listing Page

Blind dogs e-mail list

Information about cataracts: dogstop website


Handicapped Pet Resources

A handicapped pet's life can be greatly enhanced with therapies and equipment. You'll find lots of ideas and products for handicapped pets at Handicappedpets.com


Heart Disease

If your dog has been diagnosed with heart disease, one of the medications your veterinarian may recommend is "Enacard." There are some known side effects of the drug, however, as in the following reports:

"My dog was put on Enacard and Lasix. He started having bouts of a little tremor followed by collapse. These bouts lasted a matter of seconds and would occur 8 to 10 times a day. He was fully awake and aware during them. The vet finally withdrew the drug, and the episodes stopped. He is now taking Lasix and Coenzyme Q10. He seems to be doing well. He weighs 14 pounds and was on 1 mg of Enacard a day. The vet said it was unusual for Enacard to have that effect; however, since these episodes have subsided, he does believe that Enacard was the cause." (There have been reports that Coenzyme Q10 is helpful for cardiomyopathies, and that it also seems to boost the immune system.)

"Enacard was prescribed for my 7-pound, 13-year-old toy poodle with a heart murmur at a dosage of 1.0mg daily. He took the drug for eight weeks; the side effects were frightening. He became confused and fatigued, had no appetite and none of his usual desire for play and exercise. My children were home for the holidays and were alarmed at how 'old' our dog had become in a few short weeks. Then I realized it might be the drug. Two days after withdrawing the drug, our dog is practically back to normal. Please be advised of the side effects of this potent drug. Always consider that with every drug there is a side effect and sometimes it may outweigh the benefits of the drug itself. Your pet cannot tell you what's wrong; you must be alert to signs of change and distress while the drug is being administered."


Hip Dysplasia

Although hip dysplasia is a congenital condition, it may not become apparent until later in a dog's life, when the condition becomes worse and inevitably leads to arthritis. Hip replacement surgery is generally recommended only in the case of younger dogs, and it is very successful. With older dogs, however, the most common course of therapy addresses the arthritis associated with the condition.

There is information at: http://www.k9web.com/dog-faqs/medical/medical-info.02.html#l_240902

For devices that can help with mobility visit the Handicapped Pets site.


Hypothyroidism

As dogs age, one of the more common problems they experience is thyroid dysfunction. In hypothyroidism, the thyroid gland does not produce enough hormone to properly regulate the many bodily functions affected by it. You can become familiar with the signs of hypothyroidism and learn more about its diagnosis and treatment by visiting the following websites:

http://www.thyroid-info.com/articles/dog-hypo.htm

http://www.canine-epilepsy-guardian-angels.com/Thyroid.htm

Controlling hypothyroidism is not difficult. Once it's been properly diagnosed and your veterinarian has determined the proper level of medication needed to replace insufficient hormone, your dog will "bounce" back beautifully. Here is what one visitor to the srdogs site reported:

"My 13-year-old Beagle suffered from hypothyroidism for several years before I discovered this affliction. She would sleep 22 hours a day, her coat felt like a bristle brush, her tail was starting to look like a stick from the hair coming off it, and her paw pads were very rough and scaly. She was also overweight, even though I moderated her food intake. After taking the drug Soloxine, I saw a marked change in her within two weeks. She is such a different hound now! Her fur and paw pads are very soft again and her colours are brighter, including some spots which have reappeared in the white areas. Her tail hair has grown back and looks like a Beagle tail now. She has lost over five pounds and has gotten her proper 'figure' back. Although she has arthritis, she is much more alert and gets around a bit faster and does not sleep as much."


Incontinence

Older dogs, like older people, sometimes have an incontinence problem. For dogs, as for older people, incontinence can be a very manageable condition -- with the proper diagnosis of the cause, the right medication, if indicated, and the appropriate environmental support.

People (and some vets) have said that when a dog is incontinent, he or she is "embarrassed" and "feels bad" about it. This is is not a reason to euthanize a dog. "Embarrassment" and "feeling bad" might occur at first, but, for a much longer period than you might think, incontinence problems can be effectively managed, and a dog can enjoy a happy, high-quality life. We like to quote this reminiscence from a contributor: "It just seemed to slip out in her sleep -- not every night, but most. We kept a clean pad or rug under her and cleaned it up in the morning. I never minded. We always had the rest of the day to spend happily together. She was such a good, sweet dog."

What causes incontinence?

Urinary incontinence is an inability to hold urine in the bladder. When dogs urinate while they are sleeping or particularly if they urinate when lying down and awake, this is the most likely diagnosis.

As a female dog ages, one of the most common causes of urinary incontinence is the decline in estrogen levels in the body. This can lead to a loss of muscle tone and possibly mucosal thickness in the bladder, which does often lead to incontinence.

There are several medicines that can be used to control urinary incontinence, but, before your vet can determine that one of them might work, other possible causes of the incontinence need to be ruled out. A bladder or urinary tract infection is one possible cause to be investigated.

There are also a number of neurologic causes of incontinence. Diseases like diabetes, hyperadrenocorticism, and kidney failure can all cause an increase in drinking and urine production, which can show up as incontinence in a dog that previously did not have problems with urine retention. It is also important to rule out bladder stones. In older male dogs, bladder stones are a fairly common cause of incontinence.

Of course, there may not be any underlying problem with urinary incontinence. As one contributor to the Senior-L e-mail list noted, her vet said she simply had ". . . an old dog who sleeps VERY soundly and whose sphincter muscle is wearing out."

How is urinary incontinence treated?

Depending on the cause of the incontinence, your vet, in almost all cases, can prescribe treatment to help control it. The first medicine of choice is usually phenylpropanolamine (PPA), given two or three times a day. If your dog has been diagnosed with "urethral sphincter incompetence," there is a 75 to 90% chance that PPA will work. PPA is sold over the counter as Propagest, Dexatrim, and Sudafed. One known side effect is restlessness. PPA may also affect the heart, and therefore should not be used for a dog with a diagnosed heart condition. Also keep in mind that, while "Dexatrim" and "Sudafed" are over-the-counter drugs, you should check with your vet before giving either to your dog for an incontinence problem. PPA is cheaper in its generic form than by brand name at the vet's office.

Spayed female dogs with urinary incontinence are sometimes treated with synthetic estrogen. Testosterone may work for male dogs. The most serious potential side effect of hormone therapy is bone marrow suppression, although it is quite rare. It may also be linked to breast cancer and obesity.

Imipramine, which is an anti-depressant, is sometimes used in conjuction with other medications to control urinary incontinence.

Alternative remedies include Thuja and Causticum (specifically for spayed females), which have been reported anecdotally to yield good results. Corn silk extract has also been favorably mentioned. Reportedly, a couple of drops of corn silk at every feeding act as an anti-inflammatory, helping the bladder to work more efficiently.

(A portion of the preceding information was derived from a veterinary information site at this URL: http://www.vetinfo.com/dincont.html#Urinary Incontinence.)

What about bowel incontinence?

There are many possible causes of bowel incontinence. Usually it requires an extensive medical work-up to diagnose the cause (or causes). Your vet will need to test for such things as neurological or musculoskeletal problems, disc disease, spinal tumors, other forms of cancer, etc., in order to advise the proper treatment and give a prognosis.

If bowel incontinence is only occasional, and particularly if it's the kind that "slips out" accidentally when your dog is asleep, you may simply need to manage the problem with the right equipment. This is assuming that your vet has ruled out a condition that requires other treatment.

In cases where a dog's incontinence is related to senility or "old age syndrome," the drug Anipryl can help the dog to sleep and eat better, and to have better control over elimination.

Managing Incontinence

If your vet has done everything medically possible, and your dog is still incontinent at times, you can manage well with the right "set up." Some of us with incontinent old dogs have completely redone our homes with linoleum. You don't need to go to that extreme, however. You can, for example, use the big, thick "doggie pads" or "puppy training pads" that have a cotton backing, absorb lots of water, and are totally washable (Petsmart and other pet supply stores have these). An old, washable mattress pad folded several times for absorbency can also serve the purpose. (When washing pads, use bleach to sanitize.) One senior owner we know puts on her dog a 4-inch-wide cloth band with a sanitary napkin attached to it. An elasticized "sport sock" can be used to hold a pad in place over a male dog's penis. Change it often, though, to prevent urine burn on the skin. Infant-sized diapers may also work. New England Serum also carries a full panty that attaches with velcro and is machine washable. You can just put a diaper inside.

Keep your dog's rear-end fur trimmed short and, after a bout with incontinence, rinse the fur (you can use a fine-mist spray bottle with warm water), dry well, and powder the skin. You want to keep the skin from being continually moist.

Never withhold water from your dog, no matter how much you think it affects her incontinence. Water is essential to your dog's health, and withholding it can cause or exacerbate kidney problems.

For bowel incontinence, in addition to a protective "set up," you may want to try changing feeding times so that your dog has finished digesting the last meal of the day before going out for a last walk. Hills ID is reported to yield the least smell and be easy to clean up.

For clean-up, use a product such as "Nature's Miracle" to eliminate stains and odors from any surfaces that were not protected by pads or washable bedding. For tough stains, a highly recommended product is Quick'N Brite, 1.800.223.9187.

Foam rubber mattresses with plastic covers and a washable, artificial sheepskin topper are useful. You can wash the sheepskin toppers daily.

Also be sure to look into a "SleePee-Time" or "Pupps ProFleece" bed. Instead of foam, these beds are made of very dense, high-pile, machine-washable material. According to the manufacturer: "Foam is not needed to provide support. The pressure relief this bedding gives is over specification for human hospital bedding. Best of all, it's not nearly as expensive as the orthopedic material and the bed doesn't have to be replaced until you've washed it nearly 100 times. A further benefit: moisture flows right through this bedding, so any accidents stay away from your dog's skin."

If your dog likes to sleep on your bed, but incontinence is an issue, here's a suggestion from a website visitor: "I put the underpads on the bed and then put a blanket over them (for my dog's comfort and to keep the pads in place). Then, if she had an accident, I had only one blanket to wash. Her final days with me were full of quality time and fond memories. I now also use underpads around my litter boxes, since we have an older male cat (18 years old) with some arthritis. He gets in the litter box, but his butt isn't always as low as it should be. If it weren't for those pads, we might have to euthanize him prematurely. Cat urine can ruin a floor; but what a poor reason to lose a faithful pet!"

Underpads can be purchased at any store that carries incontinence products for people, and is also available from various online merchants. (Use the "google" search engine (www.google.com) and the search term "underpads" to find them. (Editor's note: Our thanks to Maggie Friedenbach for this helpful report.)

One of the best tips, from an E-mail to the Senior-L list posted by MillyWilly@AOL.COM: "Things got so much better for us when we just accepted the situation, cleaned up after her, and acted like it was no big deal. Her housemate, Wolfie -- the nine year old rescue -- takes his cue from us and just acts like the piddle isn't there (he doesn't even sniff it any more and we're eternally grateful that he doesn't feel he has to mark her spots inside like he does outside). Milly has been so much happier since we accepted the situation. I hadn't realized how embarrassed she really had been."

Clean-up and deodorizing are important issues in a household with an incontinent dog. Here is a suggestion from Lin Robinson <petrescue@EARTHLINK.NET>:  "Odor was a never-ending battle here with 11 dogs and 15 cats (all indoors). Here's what solved the problem -- 100%! Sam's Club sells a product called 'Odor-Ban.' Not only does it smell good, it destroys odor rather than just masking it. Use a Hoover Rug Shampooer that is equipped to clean bare floors as well as carpet (the kind that looks just like a vacuum). Mix the Odor Ban approximately 50/50 with water in the tank of the shampooer. I just 'vacuum' with it every day. It takes no longer than just vacuuming the house would. You would not believe the results --ZERO odor!"


Inflammatory Bowel Disease

Inflammatory bowel disease occurs in middle-aged and older dogs. It is a reaction that the stomach or intestines have to chronic irritation. Vomiting and diarrhea may both be present, and, if the condition goes untreated, the dog will have a poor appetite and lose weight.

To treat inflammatory bowel disease, ideally your vet should diagnose the underlying disease that is causing the chronic irritation. If diagnosis is not feasible, however, a change in diet can be prescribed. If that is not successful, corticosteroids and other drugs can be tried.

Alternative therapy info recently posted to the Senior-L list by Docvite@AOL.COM:

Inflammatory bowel disease; irritable bowel syndrome; eosinophilic gastritis/enteritis/colitis. These are all variations on the same theme: Inappropriate intestinal inflammation. Causes include, but are not limited to: Food allergies; stressors such as physical/emotional trauma; sensitivity to xenobiotics in commercial food; the vaccinosis issue (inapropriate immune stimulation catalyzed by excessive antigenic stimulation from vaccines); in traditional Chinese medicine you have liver qi stagnation (stressors, chemicals, emotions, allergies) developing into heat (stasis of the metabolically active liver allows for internal developement of heat) overacting on some site within the GI tract. What to do?

1) Dietary management with a hypoallergenic (for the individual sensitivity of that individual patient) fresh food diet. Use wetly-cooked white rice, sweet potato, yam, squash or pumpkin, with a bland cooked source of protein. Studies in humans indicate that animal protein and animal fats contribute to this Inflammatory Bowel syndrome. Those studies also point out that the ration of Omega3 to Omega 6 oils needs to be about 1:4 for management and prevention of IBS. Be careful adding rich foods to the elimination diet, this includes the addition of flax oil (1 tsp/25 pounds/day)--do it gradually.Concentrated fish oil extracts containing standardized extracts of eicosapentaenoic acid and docosapentaenoic acid which help to inhibit the pro-inflammatory arachidonic acid eicosanoid cascade. Start this supplement gradually as well. Give 180mg EPA for each 25 pounds of body weight (work up slowly) Hypoallergenic commercial diets are bettter than no dietary change at all, have the client add wetly-cooked white rice to the meal to lower the percentage protein and added some GI benefit. The World Health Organization has sanctioned the use of rice water for the treatment of diarrhea in developing countries. Rice water has been shown to contain some special polypeptides that help to tighten up the intestinal cell tight junctions--thereby improving water resorption from the lower bowel. Anti-oxidants and anti-iflammatory agents such as Ester- C (250-3000mg/day), Vitamin A (5000-10000 IU/day), zinc(5-20 mg/day), Vitamin E (400-1200 IU/day) and selenium (25-150 mg/day) are supportinve of this healing process.

2) Intestinal support: Add beneficial bacteria and probiotic enhancers such as fructo-oligosaccharides, inulin and/or jerusalem artichoke flour; exogenous digestive enzymes to help support digestion and take some of the burden off a potentially inflammed pancreas; high doses of glutamine 500-3000 mg/day will help to support intestinal cell repair. Glutamine has been shown to have many functions, including the repair of intestinal villous atrophy. The use of soothing demulcent herbs such as aloe vera gel, marshmallow root, or slippery elm (caution, its an endangered species), or ground psyllium seed can help with the mucosal inflammation. A Chinese herb: pseudoginseng (500- 2000mg/day) can be very helpful with hemorrhagic inflammmatory bowel cases, and clinically cats claw (uncaria tormentosa) seems to work well in relieving inflammation. The Chinese herbal combination, Ginseng and Atractylodes, Coptis and Evodia, and the ITM formula Ginseng 18 have all been helpful in supporting the repair process.


Kidney Disease

Kidney disease need not result in kidney failure if it is treated. Dietary treatment is the most common therapy. Following are suggestions and observations concerning dietary treatment.

Traditionally, control of protein intake is the basis of kidney diets. However, recent research on restricted protein diets shows that they may put a dog in danger of protein deficiency. According to an article in the August 1998 issue of Dog Fancy magazine, "The main problem of low-protein diets is dogs often won't eat them. However, researchers found dogs more likely to eat a moderate-protein diet, which also helped maintain their muscle mass, energy level and normal activity."

More information and recommendations are at these sites:

Kidney Disease in Dogs

Canine Renal Disease

Nefrotec is a urinary antiseptic, antilithic, and diuretic that can help dogs with kidney failure.

One of the symptoms of protein deficiency is tenderness in the paws. Following is a report the Senior Dogs Project received from a website visitor concerning a 13-year-old Lab/Huskie mix who was diagnosed with chronic kidney failure in February 1998 and had been on Hills Science Kidney Diet KD):

"Max's appetite is fine, but he seems to be wasting away. He's unsteady on his feet and his feet hurt. He looks like he's walking on hot coals when on gravel (the same gravel he could easily run on 6 months ago), but he walks fine on asphalt or concrete; in fact you can see the look of relief on his face when he gets to the asphalt after traversing 100 feet of gravel."

Max's owners (E-mail: 104620.2450@compuserve.com) put him on a different regimen and reported the following results:

"It's not been a month yet, and Max is doing super. We've got him on a body builder's supplement along with his KD. We chose this particular supplement based on four criteria:
1. high quality protein
2. low phosphorus
3. low lactose (max is lactose intolerant)
4. specifically mentions panthothenic acid (symptoms of deficiency include sore feet, which Max had)

"The product we selected ("Designer Protein" by Next Nutrition, inc.) had all these. We give Max 3 tablespoons a day (he's 85-90 lbs), and he has bulked up and looks great. Four weeks ago, he just keeled over to lie down and struggled mightily to get up when he got up at all -- which wasn't often. He now lies down normally and gets up easily and frequently. His hip bones were poking through his back four weeks ago; now he has flesh over them. Even his forearms are pumped! And he looks like he enjoys life as opposed to four weeks ago, when he looked like life was a struggle. Max's appetite remains great. He dances as best he can for meals and licks the bowl clean. We consulted our vet , and he is tickled with Max's progress (as are we.)"

Some suggested recipes for a home-cooked diet:

Recipe #1

1/4 Lb. ground beef -- boil and pour off fat
2 cups cooked rice (white)
1 hard boiled egg
3 slices white bread
Makes about 3-4 cups.

Recipe #2

1/2 cup cream of wheat = 2 cups cooked
1 1/2 cups creamed cottage cheese
1 hard boiled egg
2 TBS brewers yeast (inactivated)
1TBS veg. oil (Canola is good)

Give one pet vitamin pill per day.

More information on low-purine diets...

The kidney diet recommended in Dr. Pitcairn's Complete Guide to Natural Health for Dogs and Cats has also been reported to be extremely therapeutic.


Laryngeal Paralysis

Laryngeal paralysis is common in older, large-breed dogs, although it can occur with any breed and any size dog. The initial symptom may be a change in the sound of the dog's bark. Other symptoms are labored breathing and panting when exercising -- even mildly -- or when excited. The condition can progress to severe and terrifying episodes in which the dog becomes so oxygen-deprived that the gums turn blue (a condition called cyanosis). A dog can die during such an episode. If you notice any of these symptoms or suspect your dog has laryngeal paralysis, remove your dog's collar and use a harness instead (the pressure of a collar can irritate the laryngeal nerve). Keep your dog calm and resting until you can get to your vet.

There are other conditions that may produce symptoms similar to laryngeal paralysis, but it is best to rule out laryngeal paralysis, since it can be lethal. For more information and support groups, see:
The Pet Health site's "Canine Laryngeal Parlaysis"
Information from the University of Prince  Edward Island


Liver Disease

Lack of appetite is the most common first sign of liver disease. Inflammation of the liver (hepatitis) most often develops in dogs at around ages 6 to 8.

The UC Davis Book of Dogs states: "The liver is able to heal if the patient is provided with a diet that supports an optimal return to normal function. The liver cannot heal if the patient does not eat; thus, it is important to ensure an adequate food intake. The diet must be based on protein from milk and/or soybean; healing is impaired when the protein source is meat. The diet should be prepared by the person feeding the dog; no commercially prepared foods are acceptable. In general, the diet is formulated with cottage cheese and or tofu (as a source of protein), a source of starch such as boiled rice, a source of fat (animal fat is acceptable and is more palatable than vegetable fat), and a vitamin-mineral mixture to balance the diet. It is important to ensure that adequate vitamin C and zinc are added. In some cases the diet shold be low in copper because of copper's accumulation and toxicity in some forms of liver disease. Since vitamin A can be toxic to the liver, any amount added to the diet should be minimal. Vitamin E is protective to the diseased liver and be added in greater than usual quantities."

Alternative therapies for liver disease: Milk thistle has been identified as the chief liver herb. Balch and Balch in "Prescription for Nutritional Healing" (1997, Avery Publishing Group, Garden City Park, New York) write: "It contains some of the most potent liver-protecting substances known. Prevents free radical damage by acting as an antioxidant, protecting the liver. Also stimulates the production of new liver cells and prevents formation of damaging leukotrienes."

Vitamin C in large doses is recommended by some, although it must be introduced slowly into the diet. Start at 500 mg, and build up gradually to as much as 6,000 to 10,000 units, cutting back if the dog has diarrhea.


Pain

In keeping with their preservation instinct, most dogs tend to avoid showing any sign of pain or weakness. As our dogs age or become debilitated with illness, we want to be sure they do not suffer undue pain. Since they will try to hide pain, we need to know what to look for beyond any obvious symptoms. Here are some possible signs:

Limping
Scratching
Favoring
Licking an area
Unusual mouth movements
Turning the head to look at an area frequently
Roaming in circles
Pacing
Erratic movements
Uncharacteristic aggression -- snapping at people or other dogs
Reluctance to get up or lie down
Reluctance to climb stairs or climb into a car
Panting for no apparent reason
An odd look to the eye or face
Trembling
Seeming inability to curl up comfortably
Becoming quieter than usual and wanting to be close
Unusual tail position
Unusual tension in the face and throughout the body
Awkwardness/stiffness of movement
Lack of appetite/refusal to eat
Withdrawal and passivity, even in situations that would normally evoke fear or avoidance
Choosing remote places to lie or sleep in, away from all activity

If your dog is clearly in pain, you must take him to the vet as soon as possible. However, even if you have only a suspicion that your dog may be in pain, you should have your vet examine him.

Always consult your veterinarian about the medication to give your dog for pain. Your vet may recommend over-the-counter medication meant for humans, including aspirin. Note that aspirin may cause stomach upset and irritation, but it can be minimized by using the Ascriptin form. Enteric-coated aspirin, such as Ecotrin, may not be effective because it is incompletely absorbed by the dog's system, causing erratic results.

Not recommended for pain: Ibuprofen (Advil and Motrin) can cause serious problems in dogs; there is no safe dosage. Acaetaminophen (Tylenol) can have toxic effects on the liver. Dogs are more sensitive than humans to drugs that are toxic to the liver, and Tylenol is known to have toxic effects in humans.


Skin

Lumps under the skin are common in older dogs. Grooming, petting, and generally keeping your hands on your dog will alert you when they appear. You will want to read an excellent article by Sarah Probst of the University of Illinois on what to do when you find a lump.

Itchy skin is not a condition that is exclusive to older dogs, but it tends to occur more frequently as skin ages and becomes drier and less resistant to environmental irritants. Be sure to check your dog's environment for fleas and other pests. (See information on "Fleas and Ticks" linked from the navigation bar at the left.) There are also some excellent suggestions to relieve itchy skin on the Mar Vista Veterinary Hospital website.


Stroke

Many dogs recover completely from a stroke. There will be a major difference in a dog's recovery if immediate medical attention is obtained. If you suspect your dog has had a stroke, take him to the vet right away.

Reports from owners of older dogs who have had strokes:

Still Running after a Stroke: "I was with my dog when the stroke happened and rushed her to my vet. My vet administered a strong anti-inflammatory. It was amazing; by the end of the day, she had a complete recovery. Getting help quickly in the event of a stroke seems to be important. Now when I run her, I make sure my car is nearby in case she has another stroke. She brings great joy to our family, and we hope to have her as long as we can."

The first report on "Gator": "I'm desperately looking for information on whether (or how much) a dog's quality of life can improve after a stroke. My11-1/2 year old Rottweiler, Gator, who is my heart, apparently had a stroke on Monday. His symptoms were mild on Monday; it actually appeared as if he had a virus. Then the symptoms became worse yesterday. He's disoriented, confused, stumbles into walls, etc. If I don't guide him, he walks in circles. I took him to the vet, expecting to say goodbye. The vet prescribed Dexamethazone. She said she has seen dogs improve after a stroke and told me to give it two weeks. Gator had a very bad time of it last night. He is an intelligent dog; he knows something is wrong, so he is very anxious. I'm wondering if I did him a disservice."

The follow-up, some days later: "Gator is doing so well, I don't think one could tell he had a stroke! He just looks like an old gent with a touch of weakness in the rear."

It is extremely important that you give your dog as much support as possible during recovery from a stroke. Be sure that she eats and gets enough water. Pet her and massage her, gently and patiently. Keep her near you. Help her to go outside when she needs to. Your physical contact, presence, and attention will keep her focused on returning to normal behavior patterns following a stroke.


Urinary Tract Infections

According to the UC Davis Book of Dogs, "Bacterial infection of the urinary tract is the most common infectious disease of dogs. At least 10% of all dogs seen by veterinarians for any reason have a urinary tract infection in addition to the problem for which they were presented."

It is important to properly treat a urinary tract infection, not only for the sake of a dog's comfort, but also because untreated infections can lead to kidney failure or a chronic, recurrent infection.

Antibiotic therapy is the normal treatment for urinary tract infections. Some strains of bacteria are resistant to specific antibiotics, making it necessary in some cases to try several before the right one is found. Baytril is often mentioned as a particularly effective antibiotic. The course of antibiotic therapy can be lengthy (several months), if the infection is entrenched.

Theoretically, causing the urine to become more acidic by the addition of apple cider vinegar or cranberry concetrate capsules ("Cranactin" by brand name) to the diet is supposed to help the condition, although it does not cure it. Vitamin C has also been mentioned as being helpful in some cases.


Vestibular Syndrome

In older dogs, a sudden loss of balance and coordination, circling, rolling, abnormal eye movements, uncontrollable tilting or turning of the head (sometimes resulting in vomiting) are indications of vestibular syndrome. Usually these signs disappear after a short time (about a week) without treatment. Prednisone can be used to alleviate the symptoms while the dog is recovering. Also suggested are rest and quiet during recovery, and if the dog needs to be lifted, keep his paws in contact with the ground and his eyes on the horizon.

An excellent suggestion from a website visitor (Parkosew@gateway.net): "I wanted to share with your readers a suggestion to aid the mobility of a dog with idiopathic vestibular syndrome. My dog is currently recovering from this distressing syndome, and the vet tech at the pet emergency clinic suggested something that has made our lives a lot easier. She told me to get a seat-belt-type harness found at most pet stores. This fits under the chest and has a nylon loop centered over the top of the dog's back, making it very easy to support and stabilize the dog during stair climbing or walking. The long loop makes the harness easy to hold onto and eliminates excessive bending."

The website of the Encyclopedia of Canine Veterinary Medical Information has additional information on vestibular syndrome.


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