Our own Dr. Libbye Miller was kind enough to share her notes from the AKC Canine Health Foundation Parent Club conference recently. These really are very interesting notes applicable to many of our dogs at one time or another.

Dr. Miller’s mention of the “ABTC” refers to the American Belgian Tervuren Club. She has provided a great synopsis of the talks given about Bloat- What’s New in 2015, Brain Aging and Nutrition, Osteosarcoma, Update on the Latest Canine Epilepsy Researc, Regenerative Medicine Techniques to Treat Cartilage Disorders, Fungal Microbiome of Healthy and Allergic Canine Skin and more. Our thanks to Dr. Miller.

AKC CANINE HEALTH FOUNDATION 2015 NATIONAL PARENT CLUB CANINE HEALTH CONFERENCE

It’s hard to believe that twenty years have passed since the AKC Canine Health Foundation was founded. With the continued support of organizations including the ABTC, $44 million dollars has been raised to fund their mission of advancing the health of our dogs through sound, scientific research and education. This year’s conference brought together close to 300 participants including parent club representatives, scientists, and veterinary students. Once again, I was honored to be the ABTC representative and hope that you will enjoy hearing about some of the exciting research that may one day benefit both dogs and humans!

You can get more information on canine health through the many articles and podcasts available at www.akcchf.org

STEM CELL THERAPY FOR SUPRISPINATURS TENDONOPATHY by Jennifer Barrett, DVM PhD

The field of regenerative medicine brings hope of a cure for many diseases of dogs, humans, and other species. Use of these methods may renew, replace, and regenerate injured tissues
back to their original quality so there is perfect healing rather than just repair via scaring. Osteoarthritis, ligament, tendon, muscle injuries and fractures may benefit from these new healing techniques.

There are several different kinds of stem cell. Embryonic stem cells can make any tissues in the body but they can be hard to control with regard to tumor formation. Adult stem cells can make many but not all tissues and they are easier to control. Most commonly harvested from fat, bone, or cartilage these cells self-renew, moderate inflammation, call in new cells and blood vessels and make extracellular matrix for new cells to grow on. Adipose (fat) tissue provides the richest supply of stem cells. These stem cells are capable of doubling their population in 29 hours. Bone marrow stem cells can make bone, cardiac, muscle and cartilage cells but they are more difficult to obtain and don’t grow as quickly.

Platelet rich plasma (PRP) is also useful to promote healing. Plasma from the patient’s own blood is treated to concentrate the platelet cells which contain growth factors and provide a matrix for stem cells to attach to. PRP is often used as a carrier for the stem cells.

Tendons connect muscle to bone where they transmit forces and store elastic energy. Degeneration of the tendons occurs with aging and failure to remodel after repeated use. Within the tendon, collagen is bundled and folded back and forth in a crimp pattern to provide elasticity. With injury, scar formation results from an influx of disorganized cells causing loss of the crimp pattern and lowered elasticity. Natural repair is slow and re-injuries are common.

The supraspinatus is one of the muscles on the front of your dog’s scapula (shoulder blade). The tendon attaches the scapula to the humerus (upper arm) and it’s responsible for stabilizing and extending the shoulder. Overuse injuries are common in agility dogs as they do weave poles and make quick changes of direction. In this study, ultrasound was used to guide stem cell injections directly into the injured area of the supraspinatus tendon. In a group of 57 dogs, 50% of whom had been lame for more than a year, 88% went sound when treated with stem cells and PRP. Soundness was determined by advanced gait analysis techniques.

Patients with supraspinatus tendonopathy are currently being recruited for a regenerative medicine study with Dr. Canapp at Veterinary Orthopedic Sports Medicine Group. For more information see http://www.vosm.com/akcchf-study.

Regenerative Medicine Techiques to Treat Carilage Disorders by
Brian Saunders, DVM, PhD, DACVS

The weight bearing surfaces of joints are covered hyaline cartilage. This highly specialized, glassy appearing tissue is low-friction and wear resistant, designed to let the joint move smoothly through millions of load bearing cycles over a lifetime. Hyaline cartilage lacks a blood supply so it is nourished mainly by diffusion of nutrients from the joint fluid. Lacking blood supply and innervation, hyaline cartilage has very limited repair ability if it is damaged by
arthritis, trauma, osteochondritis dissecans or cranial cruciate rupture. This poor repair capacity leads to disease progression.

Osteoarthritis (OA) will develop in some 80% of dogs over their lifetime. It is in the top 5 presenting complaints in veterinary practices. In the US, 52 million people are affected by osteoarthritis. Research into ways to repair joint surfaces has far reaching significance for both dogs and humans.

Dr. Saunders work involves growing stem cells on a cylindical 3D gel scaffolding creating “Regenerative Osteochondral Plugs” (ROP). This tissue engineering allows control of size and layer thickness of little” pellets of cartilage” so that they’re a perfect fit for the defect resulting in complete restoration of normal tissue structure and function. ROPs are close to actual clinical use.

Brain Aging and Nutrition by Yuanlong Pan DVM, PhD

Commonly reported problems with senior dogs include loss of housebreaking, inability to recognize family members, loss of memory and learning ability, difficulty navigating, decreased attention, and increased anxiety. Cognitive decline in dogs begins around age 6-7 years as the brain’s glucose metabolism changes. The brain is only 2-3% of body weight but it uses 25% of the body’s glucose so changes in glucose metabolism can have a large effect. The blood glucose level remains normal; the brain cells just lose the ability to use it. These same changes are seen in humans at middle age.

While the middle aged brain loses some of its ability to metabolize glucose, ketones from fat metabolism can compensate for this change improving brain function. Ketones don’t require insulin for use and can be quickly converted to ATP, the brain’s energy source. While ketones can be increased by fasting or a high fat/high protein/low carbohydrate diet, the best way to increase availability of ketones for our purposes is with supplementation of medium chain triglycerides (MCT). These simple fats are easily digested and absorbed and their metabolism is not blocked by carbohydrates. Ketones are a normal end product of the metabolism of MCT.

Coconut oil is the richest natural source of MCT which compose nearly 60% of its content. MCT enhance cognitive function if given before brain atrophy occurs. Giving 20 grams of MCT daily increased brain function in humans with Alzheimer’s and supplementation has long lasting cognition enhancing effects.

Dogs on a diet with 5.5% MCT added had 46% fewer errors on cognition tests. Purina Bright Minds food has this level of MCT added.

Senior Cognition and Brain Aging by Gary Landsberg BSc, DVM DACVB, DECAWBM (Behavior)

Cognitive dysfunction syndrome (CDS) in dogs is a gradual decline in cognitive function with increasing brain dysfunction. Brain pathology including increasing ventricular size, neuronal loss, and an increasing beta-amyloid deposition coupled with decline in learning, memory, and social interaction is analogous to early Alzheimer’s in humans but dogs do not progress to the end stage.

Changes associated with CDS include increased fears and anxiety, disorientation, decreased social interaction, changes in sleep/wake cycles, house soiling, deficits in learning and memory, changes in activity levels such as aimless pacing, and increased vocalizations. While the deficits in learning and memory are often not noticed by owners until late in the disease progression, early changes can be seen with cognitive testing as early as 6-8 years old.

At 11-12 years old, 28% of dogs will show signs of mild CDS with 10% being rated as severe. By 15-16 years of age, 68% of dogs will have mild CDS with about 35% showing severe signs. CDS is a diagnosis of exclusion so medical issues should be ruled out. Video may be very helpful to the vet in making this diagnosis.

Treatment is multimodal and includes:
* Environmental enrichment-increased exercise and mental stimulation, learned behaviors that are practiced are less likely to be lost, “use it or lose it;”

*Medical treatment-Selegiline (Anipryl) approved for use in dogs with CDS. This drug is also used in human Alzheimer’s patients. It improves neuron transmission and nerve cell health and is an antioxidant.

* Nutritional therapies-Hill’s b/d contains anti-oxidants, fatty acids and mitochondrial co-factors. Pro Plan Bright Minds is supplemented with medium chain triglycerides as a source of ketones which have been shown to improve cognitive function. Senilife contains Phosphatidylserine + Pyridoxine + Ginkgo Biloba+ Resveratrol+ Natural Vitamin E which act as antioxidants to improve brain function. S-adenosylmethionine (SAM-e, Novifit, Denamarin); Apoaequorin (Neutricks), and DHA supplementation have all demonstrated some effect in either clinical or laboratory trials of cognitive decline.

Osteosarcoma by Bruce Smith, VMD, PHD

Osteosarcoma accounts for about 6% of canine cancers. This aggressive tumor is especially common in large and giant breeds. Even with amputation and chemotherapy the prognosis is poor because the tumor has already metastasized to the lungs on a microscopic level. These “micromets” aren’t visible on pre-surgical radiographs but will usually show up as tumors in the lungs within 3 months. Less than 20% of dogs survive to 2 years with most dying within a year of diagnosis.

Dr. Smith’s novel approach to finding these micromets before they can develop involves using adenovirus 2 (the same virus used to immunize your dog against Canine Hepatitis) which has been engineered to infect only the tumor cells. Once it invades the tumor cell, the virus replicates until it kills that cell, then the copies go out and infect more cancer cells. The body’s immune system may also recognize the adenovirus and kill the tumor infected cells.

This therapy is now being tried in as small number of clinical cases coupled with amputation and conventional chemotherapy. The engineered virus was found to be well tolerated causing no anaphylaxis or tumor lysis syndrome. Survival in 4 dogs ranged from 4 months to 26 months.

Quality of Life in Senior and End of Life Years by Alice Villalobos, DVM, FNAP

For us, the human-animal bond is more necessity than luxury. Pets give us a daily dose of joy and playfulness as well as providing feelings of belonging, loving and being loved, responsibility and personal contact. Pets may make us feel safer, enrich the lives of children, and provide motivation to carry on when life is hard. People with pets have been shown to have shorter hospital stays. Your chance of surviving one year post heart attack increases from 72% to 94% if you have a pet. Dogs especially, encourage us to walk which has great health benefits.

As our dogs age or become ill, our bond with them only grows stronger and we want to make the best decisions possible in regard to their quality of life. Cancer is the most common cause of death in dogs (25% of deaths under 10 years of age, 50% of deaths at greater than 10 years of age).

Questions to ask yourself when making end of life decisions for your pet:

*What are your priorities?

*What are your goals?

* What are your fears?

* What tradeoffs are you willing to make for quality of life vs. longer life?

* Will treatment improve quality of life?

Not everything needs to be “medicalized”. For example, it is OK to decide not to treat cancer in

an aged pet or one with co-morbidities such as severe arthritis, kidney failure or other conditions. The decision comes down to treatment vs. hospice-like palliative care vs. euthanasia. Dr. Vallalobs said that frank conversations (with your vet) about incurable diseases and the prognosis for terminally ill dogs will help avoid unhelpful surgery and futile medical efforts.

The Quality of Life Scale

This scale may be used on an as needed basis from hourly to monthly depending on the condition of the pet. Scoring is from 0 (worst) to 10 (best) in each category with a total score of 35 or over indicating an acceptable quality of life.

* HURT-Is pain control well managed? Can the pet breathe properly?

*HUNGER- Is the pet eating enough? Are nausea and vomiting under control?

*HYDRATION-Is the pet drinking enough? Getting IV or SubQ fluids? Diarrhea under control?

* HYGEINE-Can the pet be kept clean? Adequate wound care? Pressure sores managed?

* HAPPINESS-Is the pet responsive and interested in surroundings? Happy to see family?

*MOBILITY-Can the pet get up unassisted? Walk with assistance?

*MORE GOOD DAYS THAN BAD-When the bad days outweigh the good; quality of life may be too compromised.

Once the quality of life declines below an acceptable level, euthanasia becomes the gift of peaceful and painless passing. After the loss of a pet, grief may be either healthy or harmful. It is normal to experience the stages of grief (denial, anger, guilt, depression, acceptance, and resolution) and progress through the stages varies in time from person to person. Relief is also a natural part of grief as the burdens of care and worry are lifted. Give yourself time to grieve and heal and rejoice that your life was made better by your beloved dog.

For more information on making end of life decisions and coping with death Dr. Villalobos recommended the books:

Being Mortal-Medicine and What Matters in the End by Atul Gawande, MD (2014)

Knocking on Heavens Door-The Path to a Better Way of Death by Katy Noura Butler (2013)

Fungal Microbiome of Healthy and Allergic Canine Skin by
Jan Suchodoiski DVM, PhD

An organism’s microbiota (formerly known as microflora) is the collection of all the microorganisms (bacteria, protozoa, fungi, etc) living within the ecosystem. Some 100 trillion bacteria live within the intestinal tract of mammals. In fact, 90% of the body is comprised of bacterial cells. The intestinal microbes contain 100 times as many genes as the host organism. This collection of microbial genes is called the microbiome.

In the gut, these resident bacteria add to the development of the intestinal wall, stimulate the immune system, provide nutritional benefits by producing fatty acids and vitamins and help protect the host from pathogens. Changes in the microbiome may be involved in the development of Irritable Bowel Disease (IBD), cancer, diabetes, obesity, and stress related disorders.

Each organism has its own very unique microbiota which is influenced by genetics and environment. Though generally stable over time, the microbiota can be modified by diet, antibiotics, environment, stress, etc. The microbiota is resistant to change and tends to return to its pre-disruption stage once the event is over. This is why prebiotics and probitotics don’t make lasting changes. Antibiotics may lead to more lasting and in some cases permanent
changes to the microbiota.

Dysbiosis means the microbiota has become abnormal. This microbial imbalance may be due to factors such as genetic predisposition, diet, environmental exposures, and antibiotic use.

Dysbiosis may predispose the animal to chronic inflammation due to lack of protective factors from a normal microbiota.

Dogs and humans with IBD have been shown to have decreased diversity of the intestinal microbiota along with altered percentages of gut bacteria. In other words, they have increased numbers of harmful bacteria along with decreased numbers of helpful ones. In other studies, mice fed sub therapeutic levels of antibiotics when young or maintained on high fat diets had changes in their microbiota which were associated with obesity and insulin resistance.

The skin microbiota is much more diverse than that of the GI tract and it’s also unique to each individual. Its make-up depends on host genetics, climate, life style, hygiene and location on the skin. Dogs with atopy (allergic dermatitis) had reduced diversity of the skin biota. Dr. Suchodoiski’s study has found up to 120 species of fungi on normal dog skin. He found 80 mold species that induced hypersensitivity in atopic dogs with the presence of Malassezia
pachydermatis (a yeast infection commonly seen in dogs with atopy) being correlated with the disease severity in atopic dogs. Current research is looking at the use of skin probiotics as a treatment for atopic dermatitis.

The Cutaneous Micrbiome and Resistome of Healthy and Atopic Dogs by Charles Bradley, VMD, DACVP

Atopy (allergic skin disease) is very common, affecting some 10-20% of dogs. Typical allergens include pollen, mold, wool, dust mites, and grain mites. Atopic dogs may scratch, sneeze, rub their faces, lick their feet, and experience frequent ear infections. As things progress they may traumatize their skin resulting in recurrent secondary pyoderma (bacterial and yeast infections). Age of onset is usually under 3 years old with indoor dogs being most commonly affected. Atopy is thought to be caused by an inherited tendency to develop IgE antibodies when exposed to allergens that are inhaled or absorbed through the skin.

IgE responds to these allergens by causing the release of histamines which prompt allergic reactions.

Atopy cannot be cured only managed with therapy aimed at reducing the itching and keeping secondary pyoderma under control. Treatments may include antibiotics, steroids and other immune suppressants, medicated baths, antihistamines, fatty acids, and hyposensitization.

Antimicrobial resistance is increasing in both human and animal medicine. Atopic dogs with secondary pyoderma should have bacterial cultures done if there is less than 50% resolution after 2 weeks of antibiotics, if new lesions occur after 2 weeks, if there are still lesions present after 6 weeks of antibiotics or if bacterial rods are found on skin cytology.

Staphyloccous pseudintermedius is the most commonly cultured bacteria. In 2003 25% were Methicillin resistant but in 2014 it was up to 51% leading to concerns about the transfer of bacterial genes that cause antibiotic resistance.

Dr. Bradley’s work focused on determining the microbiome of both normal and atopic dogs. He found that the microbiome of atopic dogs had decreased diversity of microbes as well as increased proportions of Staphylococcus and Corynebacterium during their allergy flare-ups. With proper antibiotic treatment, their skin microbiome began to look more like that of the healthy dogs.

Gastric Dilatation-Volvulus: Big Problems for Big Dogs by
Laura Nelson, DVM, MS, DACVS

Bloat may be either gastric dilatation (GD) where the stomach distends with gas or gastric dilatation with volvulus (GDV) where the stomach fills with gas and then twists on itself. The gas in the stomach is not room air; it is a product of bacterial fermentation possibly from the normal bacteria that live in the upper small intestine. Once the stomach becomes distended, circulation is compromised leading to decreased cardiac output, pooling of blood in the spleen, and loss of blood supply to the major organs.

Symptoms include pacing, non-productive attempts to vomit, enlarged abdomen, weakness, depression, coma, and death.

Risk factors for bloat include being a large or giant breed, being “deep-chested”, increasing age, having a first degree relative who bloated, and having an anxious temperament. Studies sometimes have conflicting and confusing results. “Association is not causation”. More studies are needed to determine which risk factors might be controllable.

Mortality rates are currently estimated between 10-43% with early intervention and excellent emergency care. Dogs that are depressed before surgery have a 3 times greater risk of dying. If they are comatose it increases to 36 times greater risk. Dogs with clinical signs for more than 5 hours before surgery have a mortality rate of about 46%. Plasma lactate levels were 82% accurate as an indicator of stomach necrosis and 88% accurate in predicting final outcome.

Mortality rates if the dog needs a splenectomy during surgery to correct bloat is 32%. If part of the stomach wall must be removed due to necrosis the mortality rate is 35%. If the dog requires both a splenectomy and partial gastrectomy the mortality rate rises to about 55%. Heart arrhythmias during or after surgery are also associated with higher mortality rates.

Dr. Nelson’s research on the causes of bloat is focused on the role of gastric motility. In dogs, the stomach works on a 90 minute cycle. During Phase 1 the stomach is quiet. In Phase 2 there are increasing irregular contractions. Phase 3 involves 3 to 5 minutes of strong contractions to push out the non-digestible solids.

Stomach motility is regulated by hormones such as Motilin and Ghrelin, the vagus nerve, and special “pacemaker” cells within the stomach wall. Dogs with GDV have impaired Phase 3 contractions which may leave contents in the stomach allowing for bacterial overgrowth. Stress has also been shown to inhibit Phase 3 contractions.

Preliminary studies have shown that gastric emptying time and gastric pH may be important. It may be that higher gastric pH (seen in Danes) favors gas producing bacteria. A similar condition in cattle has been linked to increased Motilin levels so that is also being studied.

Studies are done with a “Smart Pill” capsule that transmits ph, temperature, pressure, and time as it passes through the GI tract.

Bloat-What’s New in 2015 by Elizabeth Rozanski, DVM, DACVIM (SA-IN),

The most important factor in a good outcome is early owner recognition that the bloat is happening. Prompt detection at the hospital may require that the owner insist on an x-ray especially in a big deep- chested dog. If the spleen is palpable as a hard lump it means that the stomach is twisted. This sign may be found early before the dog is obviously bloated. Once bloat is detected the dog will need emergency surgery to correct the condition. It is also recommend that a gastropexy (tacking the stomach to the body wall) be done during surgery as 75-80% of dogs will bloat again if this procedure is not done.

In a group of 100 bloated dogs, 20 were euthanized at diagnosis, 10 were euthanized during surgery, 40 had an uneventful recovery from surgery, 20 had a drawn-out clinical course but eventually recovered, and 10 died or were euthanized after a drawn-out recovery.

Euthanasia may be chosen at the time of diagnosis based on the patient’s age, co-morbidities such other chronic illnesses or infirmities, and the owner’s financial situation. Costs to treat a bloat may range upwards of $8000 depending on the dog’s course.

Decisions to euthanize during surgery are necessary if more than 70-80% of the stomach needs to be removed due to necrosis (tissue death), if necrosis occurs in the area where the esophagus connects to the stomach, or if the dog’s quality of life will suffer after the gastric resection.

After surgery the dog should be carefully monitored for infections from the surgical incision, failure of the stomach repair, and aspiration pneumonia. The patient must also be monitored for irregular heartbeat and disseminated intravascular coagulation. Some patients may experience MODS (multiple organ dysfunction syndrome) in which function of their heart, lung, liver, kidneys, or circulatory system are compromised due to tiny blood clots, inadequate oxygen, and damage due to shock. Patients may recover from dysfunction one of these systems but problems with additional systems are associated with an increasingly poor prognosis.

Ongoing research involves the use of biomarkers and EKGs to monitor for heart problems after surgery. Another study measures the pressure inside the stomach of bloated dogs as a way to better predict which dogs may do well and which ones may have problems. Very high pressure may indicate that stomach necrosis is likely while low pressure may warn that stomach rupture has already occurred. Other ongoing studies include measurement of the ligament between the stomach and liver to see if it’s longer in bloat prone dogs, collection of samples from affected dogs for genetic sequencing, and study of the microbiome of the stomach contents and fecal material of bloated dogs to see if particular microbes might be involved and if dietary changes could help with prevention.

Brucellosis by Matthew Krecic, DVM, MS, MBA, DACVIM

Brucella canis (B. canis) is a small bacterium that lives inside the cells in dogs and wild canids. This bacterium is zoonotic which means it can infect humans via transfer in bodily fluids from infected dogs. Dogs may also be infected with the cattle organism (B. abortus) or the swine organism (B. suis). In some states, infection with B. canis must be reported to state health officials.

B. canis can be spread through aborted material, vaginal secretions, urine, and semen. The bacteria may be picked up through the mucous membranes of the mouth, nose, eyes, or through sexual contact. B.canis can be also transmitted through the use of infected frozen semen.

Symptoms of infection may include swollen lymph nodes, shrinking of the testicles, prostatitis, infertility, abortion or resorption of puppies, vaginal discharge, inflammation in the eye, and spinal lesions. Many cases produce no symptoms at all.

Dogs testing positive are considered infected for life as there is NO EFFECTIVE TREATMENT.

The AKC and Society for Theriogenology (the branch of veterinary medicine which deals with reproduction) recommend that all dogs intended for breeding be tested either at the time of breeding or every 6 months. Cases of B. canis are increasing in the U.S. with up to 18% of tested dogs being positive in some areas. The rise in incidence is likely due to increased interstate and international transport of untested dogs. This disease is probably significantly underreported.

Prevention of B.canis includes quarantine of all new dogs entering the house or kennel with TWO negative tests 30 days apart before letting the new dog mingle. Routinely test 3-4 weeks prior to breeding or semen collection. Remember that asymptomatic carriers may be a source of infection.

An excellent series of podcasts and articles on reproductive issues is available at http://www.akcchf.org/news-events/multimedia/podcasts/

Update on the Latest Canine Epilepsy Research Developments: Genetics, Drugs and EEGs by Ned Patterson DVM, PhD

Epilepsy is defined as recurrent seizures over time. Seizures result from an imbalance in excitatory and inhibitory transmissions between neurons in the brain. Everyone has a seizure threshold and can have a seizure if the excitatory and inhibitory transmissions become unbalanced.

Epilepsy is the most common neurological disorder in dogs, affecting up to 5.7% of the general population over their lifetime. Idiopathic epilepsy, meaning there is no identifiable cause,

accounts for 70-80% of recurrent seizures in dogs. It is presumed to be genetically influenced. Seizures most often begin between 6 months to 6 years of age. About 50% of epileptic dogs are well controlled by one medication. Another 20% are controlled by the use of two drugs and 30% are still not well controlled with the use of 3 drugs.

Phenobarbital is still often the drug of first choice because it is often the most effective. It may cause increased hunger and thirst and 20-30% of dogs may have some liver issues. Potassium Bromide, Keppra, and Zonisimide are also used alone or in combination to control seizures. Keppra has been shown to be very safe and is the drug of choice if liver issues arise.

No genes have yet been proven to cause idiopathic epilepsy in any breed. It is likely a polygentic trait in most if not all breeds and work is ongoing.

Ongoing research includes an implanted vagal nerve stimulator for difficult to control epileptics. In one study they found a 50% reduction of seizures in 1/3 of the dogs, a 30-50% reduction in 1/3 of the dogs and no response in the remaining 1/3. Another project involves use of an implantable EEG monitor which sends signals to a pager-like device to predict seizure’s before they occur so that caretakers can administer treatment in a timely fashion.

Nutritional Management of Canine Epilepsy by
Prof. Holger A. Volk, DVM, PhD, DipECVN, MRCVS, FHEA –
Royal Veterinary College

Treatment for seizures should be started if:
* The dog has an episode of status epilepticus -a continuous seizure lasting more than 5 minutes;

*The dog has cluster seizures- multiple seizures within a short period of time with only brief periods of consciousness in between;

*The dog has severe effects after the seizure- confusion, salivation, pacing, restlessness, temporary blindness, behavior changes such as aggression;

* The dog has increasing frequency or severity of seizures;

*The dog has 2 or more seizures within 6 months;

Patients are considered drug resistant if the use of two drugs at therapeutic levels does not reduce the frequency of seizures by at least 50%. Males have more tendency to be resistant to treatment. Poorly controlled epilepsy may shorten life by 2-3 years along with causing a reduced quality of life and behavior changes. Seizures not only affect the dog’s quality of life but also that of the owner. Dr. Holger’s research is aimed at helping affected dogs be seizure free.

Areas of research include:

* Hypoallergenic diets-50% of human epileptics have allergic diseases. A pilot study showed 7 of 8 drug resistant epileptic dogs had skin or gastrointestinal allergies. Seven of these dogs had reduction in seizure frequency when on an exclusion diet.

*Fatty Acid Supplementation-One study in dogs showed no effect on seizure frequency

*Ketogenic Diet-High fat, low carbohydrate, low protein diets have shown some efficacy in humans, especially in children, but a randomized double blind study failed to show efficacy in dogs

*Medium-chain triglycerides- A randomized trial in dogs on one or more drugs having at least 3 seizures in the preceding 3 months showed 3 dogs were seizure free, 7 dogs had a 50% reduction in seizures, 5 had a reduction of less than 50% and 3 dogs had no
response

Dr. Volger introduced a very nice phone app the RVC Pet Epilepsy Tracker. This app contains a wealth of valuable information about epilepsy as well as logs to track the pet’s seizures and

medications. These logs can be emailed to your vet as a PDF with the click of a button. The app is free and available at the iTunes App Store for iPhones and at Google Play for Android.

*Note-this is a UK based app so the emergency phone numbers won’t apply to US users.

Why It Is Critical To Know Your Dog’s Normal Body Temperature at Work, Rest, and Play by Dana A. Vamvakias, DVM, CCRT, cVMA

Hyperthermia occurs when the dog’s temperature rises significantly higher than the accepted normal range of 99.5 to 102.5 degrees. Classical (nonexertional) hyperthermia occurs when the dog is unable to cool itself due to environmental conditions, a dog left in a hot car for example.

Exertional hyperthermia occurs when their activities generate excessive heat and the body is unable to adequate cool them. Active dogs in hot climates may experience both kinds of hyperthermia. An elevated temperature alone does not necessarily mean the dog is having a heat crisis. For that there must be clinical signs plus a temperature above 105 degrees. It’s not unusual for working dogs to have temperatures above 106 degrees with no evidence of distress.

The most common time for performance dogs to have a heat crisis is in the spring as dogs need time to become acclimated to warming temperatures. Pay particular attention to the humidity as it can greatly affect a dog’s cooling capacity. (*my note-I use the temperature plus humidity adding up to 150 or greater as a measure of when it’s just too hot to work dogs).

Other factors that predispose dogs to a heat crisis include obesity, underlying illness, and “high drive dogs who become hot with excitement” before training or events.

Early recognition of a heat crisis may save your dog from a potentially catastrophic heat stroke. Signs include excessive panting, spoon shaped tongue hanging way out, pulled back lips exposing back teeth, brick red gums, changes in mental focus. Without early intervention signs may progress to uncontrollable panting, weakness, stumbling, and possibly vomiting and diarrhea. Finally the dog experiences a full blown heat stroke which may progress to collapse, seizures, coma, and death.

If you see signs that your dog is getting overheated STOP THE ACTIVITY AND COOL IMMEDIATELY! Apply cool water from a hose or pool to the underside of the dog where main arteries and venous are accessible (underside of neck, armpits, and groin). Take the dog to shade, fan, or air conditioning. Stop the cooling measure when the temperature drops to 103 degrees to avoid rebound hypothermia resulting in dangerously low body temperature.

Dr. Vamvakias stressed the importance of knowing your dog’s “working temperatures”. Record your dog’s temperature before training, at the mid-point of training or when you see heavier
panting, at the conclusion of training, and 30 minutes after training. Keep in mind that many dogs get excited when they’re about to engage in an activity so you may see a temperature of greater than 103 degrees even before exercise begins. Follow this procedure on days with different temperatures and humidity. You’ll soon find out your dog’s optimal working temperature and become much better at noticing behaviors that mean your dog needs a break, shade, and a cool drink. Remember “high drive working, performance, and active dogs will NOT self-modify their activity because they are getting too hot; as the owner you must make the decision to prevent heat injuries in your dogs.”