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Posts Tagged ‘Health’

Dogs have been in close contact with humans for thousands of years. Estimates range from 9,000 to 30,000. Due to this long association dogs are thought to have the ability to not only understand but to communicate with humans. Many researchers in this field attribute these communication skills to the manifestation of unique traits that enables dogs to be acutely sensitive to cues supplied by their humans.

 

Recent research in canine cognition has shown considerable variability, depending upon the design of the experiment(s) and probably the agenda of the person(s) doing the research but it seems clear that at least some dogs can and do follow pointing and gaze cues, can fast map novel words and according to some studies have emotions. Since they cannot communicate with us with spoken language researchers have mostly had to closely observe behavior in a wide variety of experimental designs and infer how the canine brain functions by speculation.

 

Now we can use functional magnetic resonance imaging (fMRI) to study brain function. Gregory S. Berns, MD, PhD is a neuroscientist and director of the Center for Neuropolicy at Emory University. He recently published a book entitled: HOW DOGS LOVE US: A neuroscientist and his adopted dog decode the canine brain. He describes in this book and in articles published in scientific journals how his group trained dogs to lie still in the MRI machine while fully awake and found that the reward-prediction error hypothesis of the dopamine system provided a concrete prediction of activity in the ventral caudate of the dogs studied, i.e. the dogs were able to respond to specific hand signals associated with either giving a food reward or withholding it. During the experiment the dogs were not given the reward, just the hand signals they had been conditioned to. The results demonstrated the specific areas of the brain that anticipated the pleasurable reward. These same brain locations have been associated with dopamine release in many studies conducted in awake humans and primates. There was significantly less dopamine sensitive response when the withholding reward signal was given. The interpretation of these results indicates the dogs brains responded THINKING they were going to receive the treat.

 

Dr. Berns and his research group believe they can extend these studies to characterizing many questions about our ability to communicate with dogs including their ability to respond to human facial expressions and how dogs process our spoken words. Perhaps we are on the verge of understanding how dogs respond to our emotional state and perhaps if and how they grieve for a lost loved one. Maybe we can even find out if they really do love us or just manipulate us so we will feed them.

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One aspect of growing old, for animals and us humans, is that joints wear out. Osteoarthritis is characterized by loss and/or degeneration of the cartilage in joints. The process is accompanied by osteophytes new bone growth where it is not wanted or needed, the body’s unfortunately ineffective effort to immobilize the joint and stop continued wear and tear. This is a problem I am quite familiar with having treated many old dogs, cats and horses trying to alleviate the pain and discomfort associated with the condition.

For several years I suffered from severe osteoarthritis in my left ankle necessitating the use of a cane and even with that I was unable to walk Charlize for more than a few blocks without considerable discomfort.  Two columns ago I wrote about the surgery I underwent in an effort to do something about the problem. The aftercare for the procedure involves ten to twelve weeks, or more, of no weight bearing on the operated leg.  The surgery was done on Oct. 9, the initial cast was removed on Oct. 22 and I was fitted with a plastic boot. I get around on crutches and something called a “knee scooter” that is kind of fun to scoot around on. However it is a bit of a hassle to get up and down stairs with the knee scooter, as in impossible. It is also difficult to get the scooter in my vehicle and take out again while managing crutches. I do have a problem with allowing people to help me, something my sons are constantly giving me grief about. Can’t help it, it’s the way I am.

One of the smarter things I did was to hire a very nice young lady to just be around if I need her. She helps out during the day, walks Charlize, does some chores and errands and keep me company. My regular cleaning lady also stepped up to help the old man manage. An added benefit is the sixteen-month old daughter of my helper. I was, somehow, smart enough to insist that she shouldn’t pay a babysitter, just bring the baby with her. I relate well to animals, young and old and to small children and the little girl is a happy, no joyous, child who speaks a language that not even her mother understands. She loves Charlize and Charlize reciprocates. She keeps me smiling whenever she is here with her mother almost every day.

The first couple of weeks post-op were not fun, post-op pain masked by the mind-numbing effects of the painkillers prescribed along with the side effects of those opioids. I was able to stop taking them in just a few days but the toughest part was sleeping on my back with the leg elevated for the first two or three weeks. Got past that and am now able to sleep on my side again, what a relief!

The next obstacle was getting out then back into the house negotiating the two steps down into the garage. After the weeks of not being able to get out of the house I was suffering significant cabin fever. Perseverance and practice with the crutches finally paid dividends when I realized I had to trust the crutches to hold me up, balance by holding the bad leg forward and swinging down or up instead of trying to hop. Once out of the house and into the vehicle driving is not a problem since it is my left leg and the vehicle has an automatic transmission. Maneuvering on crutches to be able to get into the vehicle also took practice but I am free again! Able to get to the Corner Coffee Café for my regular fix, take myself on errands, including grocery shopping, a chore I found to be very difficult to assign to others since my habit is to go to the store with a list of things I’m out of but to shop for inspiration of what to prepare.

Throughout this experience Charlize has been good. She loves going for her twice a day walks with my helper and I’m hoping it won’t be too long before I will be able to reclaim that time with her. When we are alone in the mornings and evenings she is very attentive and obviously concerned about me. I’ve been having long conversations with her about the resumption of our travels. I think she misses the open road as much as I do. We still have another four to six weeks of no weight bearing to get through and I’m hopeful we will be back to some semblance of normality afterwards.

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She was back again. Sweetness was a thirteen-year-old collie dying from chronic interstitial nephritis. Each time the Watkins family brought her in, I thought her long struggle was over.

Mr. Watkins carried her in, struggling despite the fact she had been shedding pounds off her originally much too plump frame for the past several months. Mrs. Watkins was trying to comfort their thirteen-year-old daughter Emily.

“She only lasted six days this time Doc,” Mr. Watkins announced.

I glanced at Sweetness’ chart. “I see that.”

I was treating the dog with intravenous fluids to flush her body of the metabolic toxins that accumulated because her kidneys were no longer functioning properly. The first time I treated her she lasted for almost a month with a special diet and fresh clean water always available. She drank a lot, urinated a lot and with restricted activity seemed to do pretty well. The next time I treated her she lasted a little over two weeks, the third time was six days ago.

“Can’t you do something else?” sobbed Emily. “This isn’t working she’s so weak and just sleeps all the time and won’t play with me.”

“There must be more you can do Doc,” Mr. Watkins insisted. “You know cost is not a problem for us.”

I glanced out the front window at their barely operational car. I also knew the neighborhood they lived in and the state of disrepair of their home.

“We can try peritoneal lavage that might work. I can smell the urea on her breath, she’s very toxic. Actually, she needs kidney dialysis and a kidney transplant but neither are available for dogs. Most people who need those treatments can’t get them.” It was 1963.

“Do what you can Doctor,” Mrs. Watkins chimed in. “We’re not ready to give up on her you know she and Emily were babies together.”

“OK, leave her with me and I’ll see what I can do.”

After they left, I reviewed my veterinary school notes on peritoneal lavage and started the treatment. Sweetness encouraged my efforts with a single-thump of her tail on the treatment table. I finished infusing the dialysis solution I mixed up and started drawing it off. Two hours later, I removed all the fluid I could retrieve and she seemed slightly improved. She rolled up on her sternum and gave my hand a lick. I took some blood to check her kidney function again and found it was only slightly improved. I put in an intravenous drip and decided to see if I could flush her out again. Over the next several hours she seemed to improve, then regress. I couldn’t leave but couldn’t think of anything more to do, so I just maintained a vigil and kept the intravenous fluids running. At three in the morning, she took a final breath.

Still wondering what more I could possibly have done I called the Watkins home to tell them Sweetness had passed. Without saying anything about my diligence, I wanted them to know I gone the extra mile with her.

“OK Doctor,” said Mr. Watkins. I could hear Emily crying. “I’m certain you did all you know how to do.”

“That’s true, what do you want to do with her body?”

“We anticipated this, we’ll send someone. How much is the bill?”

I felt guilty about Sweetness dying, not knowing what more I could have done.

“Uh, let’s see,” I had spent at least eight hours working on the dog and used over a hundred dollars of drugs and supplies.

“I think a hundred and fifty will cover it.” I felt guilty about charging so much.

“Uh, just a minute, I added wrong, a hundred will do it.”

“OK Doc, I’ll get a check to you in a month or so.”

The next morning a man drove up to the clinic in a Nash Rambler. A sign on the driver’s side door advertized “Paradise Pet Cemetery”. He opened the back, took out a cart then took out a polished wood casket and placed it on the cart.

“I’m here for Sweetness Watkins,” he announced.

“Follow me,” I said. “That’s a very nice casket, just curious, how much is this costing the Watkins?”

“Four hundred and fifty, plus perpetual care, paid in advance,” he smiled. “Mind if I leave some business cards with you for future clients?”

That was the last time I felt guilty about legitimate fees.

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I leased my practice in Phoenix and moved my family to Mexico City after accepting a one-year appointment with the Food and Agricultural Organization of the United Nations. FAO was operating a project with the veterinary school at the National Autonomous University of Mexico. The purpose of the project was to aid the college in upgrading their programs. My job was to help establish an ambulatory clinic to give the students hands-on experience diagnosing and treating animals on the farm.

While visiting a small community a group of students and I diagnosed a mule with tetanus. It was a textbook case and I decided that as many students as possible should be able to have the experience of observing and treating the animal. I explained to the owner, in my rudimentary Spanish, that the prognosis was very poor but that I would like to arrange to move the mule to the veterinary hospital to give as many students as possible experience with this kind of case. I was careful to explain that since the case was valuable as a teaching tool he would only be responsible for the cost of the drugs used and then only if the animal recovered enough to work again.

He agreed to the arrangement and I arranged transport for the mule to the veterinary teaching hospital at the university. Various groups of students assigned to the case treated it under my supervision for over three weeks. At one point, we had to put him in a sling because he was unable to stand on his own, but he made a miraculous recovery. It was extremely unusual for an animal with tetanus to recover in 1967. I arranged to transport the mule back to the owner the next time we went to the village where he lived.

I explained to the owner how to care for the mule until he fully recovered and handed him a bill for five-hundred pesos, about forty dollars, a small fraction of the cost of all the drugs we used in the treatment. I explained that I had substantially reduced the bill by charging for only a fraction of the drugs we had used because so many students had benefited by working on the case.

“But Senor Medico you say me I would not have to pay if the mule could not work. You see he is very weak, he cannot work.” He was speaking in elementary school Spanish so I could understand.

“I understand,” I said. “He will recover and when he does you will accept this obligation, true?” I fully understood that the poor farmer probably only earned twenty-five pesos a day, maybe less and five-hundred pesos was a fortune to him, but the mule was worth at least a thousand or more pesos.

Two months passed and we visited that village three or four times. Each time the farmer took pains to seek me out and explain that the mule was still too weak to work. I told him I understood and smiled to myself.

Three new students were with me in the truck a few weeks after my last conversation with the mule’s owner. As we drove past the village, I saw my man out in a field plowing with the mule. I stopped the truck.

“Now you will experience the practical side of veterinary medicine,” I told them and related the story. All of them knew about the mule and were amused that I had been unable to collect the bill, interested to see how I would handle the situation.

“Buenos dias,” I greeted my client.

“Muy buenos dias Sr. Medico,” he replied.

“I see the mule is fully recovered and working well.”

“Si senor, but it was not your medicine.”

“Oh?”

“You see the leather thong on his left front fetlock?”

“Yes.”

“A curer in the market at San Angel sold me that. It is treated with many special cures (mostly urine my students explained later) and the curer said me it would make the mule completely recover if I tied it around his left front fetlock.”

“What if you tied it around his right fetlock?” I asked.

“He said me it would only function if I did it properly and with the correct knot he showed me.”

“And it obviously worked,” I smiled.

“As you see, the very next morning he was cured.”

I turned to the students.

“Today’s lesson is to never believe you are smarter than your clients.”

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There is some evidence that Polybrominate Diphenyl Ethers (PBDEs) may be involved in hyperthyroidism in cats. Feline hyperthyroidism may be the most common endocrine disorder in cats. It is associated with benign tumor(s) of the thyroid gland and usually appears in middle-aged to older cats, without preference to breed or gender. The signs of hyperthyroidism are weight loss, hyperactivity accompanied by a voracious appetite. Cats can also demonstrate increased water intake, more frequent urination, along with intermittent vomiting and/or diarrhea. Cats with severe hyperthyroidism suffer from increased heart rates, arrhythmias (irregular beats) and congestive heart failure. About 10% of cats with hyperthyroidism develop a condition known as apathetic hyperthyroidism. These animals show depression and lack of appetite with fast weight loss.

The diagnosis of hyperthyroidism is by measuring increased circulating levels of the two thyroid hormones. Your veterinarian can verify the diagnosis by the use of special thyroid imaging called planar thyroid scintigraphy. Hyperthyroidism can be treated successfully with anti-thyroid drugs, surgery or the administration of radioactive iodine, the latter is currently the most commonly employed and probably the most successful.

There are three different types of PBDE compounds commonly used as flame retardants. They can migrate out of the flame retardant products then accumulate in indoor air and house dust and eventually contaminate the environment. Since the PBSEs do not break down quickly in the environment they accumulate in air, soils, sediments, fish, marine mammals, birds and other wildlife and well as in meat, poultry and dairy products. We should expect a decrease in these contaminants in this country since two of the most commonly used types were discontinued in 2004 and the third will be phased out in 2013. However, exposure from existing building materials, furnishings and consumer products, especially those imported from countries still using these products will continue.

A paper recently published in the Journal of Toxicology and Environmental Health suggested a link between PBDEs and hyperthyroidism. The researchers studied 21 normal cats, 41 cats diagnosed as hyperthyroid and 10 normal feral cats with no exposure to household dust. Although the total PBDE concentrations in the serum of normal and hyperthyroid cats were not significantly different, the total PBDE in dust from homes of hyperthyroid cats was significantly higher than the dust from homes of normal cats. The levels of PBDE in dust and one of the thyroid hormones (T4) were significantly correlated. Although this study does not prove a cause and effect between PBDE levels in household dust and hyperthyroidism in cats it is another indication that household pets could serve as sentinels for environmental toxicants that could affect humans. A major problem with most toxicology studies is that the effects of low levels of toxicants, over long periods of time, are too expensive to conduct and therefore are almost never done.

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Yes, well sort of, it depends, is that clear? Actually chocolate poisoning is not unusual in dogs, maybe because many dogs will eat almost anything. Cats are more discerning. I found one reported case of chocolate poisoning in a horse. That is weird because the toxic dose of chocolate is dependent on body weight. The published toxic dose is 100-200 mg/kg. (a mg, milligram, is 1/1000 of a gram, a kg, kilogram, is 1000 grams, a kilogram is equal to 2.24 pounds, 16 ounces to the pound. Let your fourth grader do the math.) To complicate matters veterinarians at the Poison Control Center of the ASPCA have reported problems with doses as low as 20mg/kg, of theobromine. So we will go with the lower toxic dose.

Chocolate comes from the beans of the cacao tree. The beans contain methylxanthines, a class of drugs that include theobromine and caffeine. Most humans can metabolize, break down, both theobromine and caffeine without much difficulty, in two to four hours. The half-life of theobromine in dogs is 17.5 hours, the half-life of caffeine about 4.5 hours, about the same in cats.

To complicate matters further the levels of theobromine depend upon the type of chocolate. Dry cocoa powder has the most theobromine, about 800 mg/ounce. If your five-pound Chihuahua (about 2.25 kg) ingests an ounce of cocoa powder, he will have ingested 800 mg of theobromine. Anything more than 45 mg could cause problems for him. Unsweetened Baker’s chocolate, contains about 450 mg/oz of theobromine, an ounce is still very toxic to your Chihuahua. Semisweet and sweet dark chocolate contain about 150-160 mg/oz and milk chocolate about 44-64 mg per oz so your Chihuahua could still be in trouble. However, your 70-pound Golden Retriever (much more likely to snarf down your chocolate) will have to consume about 14-16 oz of milk chocolate to get sick on it. A 400 kg horse would need to ingest about 8,000 mg of theobromine, that’s about 17-18 oz of Baker’s chocolate. If caught feeding Baker’s chocolate to a race horse you will be banned from the track, maybe prosecuted, it’s considered a stimulant. White chocolate contains very small quantities of the methylxanthines.

Both caffeine and theobromine are readily absorbed from the gastrointestinal tract and distribute throughout the body. Both compounds are metabolized in the liver. The metabolites are excreted in the urine along with small amounts of the original, un-metabolized, compounds. So, if your pet is old, or has liver or kidney disease, the toxic effects can be intensified. With normal liver and kidney function, it will take about two days for your pet to eliminate a toxic dose from its system.

Signs of chocolate toxicity in dogs and cats include diarrhea, vomiting, increased urination, muscle twitching, excessive panting, hyperactivity, whining and when severe, seizures, rapid heart rate and circulatory collapse. Treatment is to induce vomiting and use activated charcoal in an attempt to bind the theobromine and prevent its absorption from the GI tract. You can induce vomiting with 1-2 teaspoons of hydrogen peroxide, repeated two or three times every 15 minutes, if needed. One to,3 teaspoons of syrup of Ipecac, based on the size of the pet, will also do the trick. If your pet is showing signs of intoxication, get it to your veterinarian. S/he can sedate the animal to control seizures and flush with intravenous fluids to hasten elimination from the body.

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Epistaxis (bleeding from the nose) is more common in dogs than in cats, in my experience, probably because most cats are indoor pets these days. It can occur from one or both nostrils and can vary from slight bleeding that usually stops without treatment to profuse, possibly life threatening bleeding, that resists treatment. As with most abnormal conditions your pet may suffer, proper treatment depends upon establishing the cause.

Some incidents start with sneezing and traces of blood in the discharge from the nose while others can start with alarming, and profuse, bleeding. Any cause of persistent and/or violent sneezing can result in a nosebleed. The most common cause is a foreign body such as a foxtail, grass seed (awns), a small blade of grass or a burr. Other causes of sneezing are nasal infections from bacterial and/or fungal organisms and, of course, allergies that initiate sneezing episodes. In rare cases, the infection from a rotten tooth can extend into a nasal sinus and/or the nasal cavity and cause bleeding. Of course, trauma to the head or nose can result in a bleed and cancers of the nasal cavity, particularly hemangiosarcoma, frequently invade the nasal cavity and result in persistent bleeding.

Less common causes include problems with blood clotting that can result from hemophilia or von Willebrand’s disease (a specific type of hemophilia) and hypertension (high blood pressure). The ingestion of warfarin-based rodent poisons, either directly or after eating a rodent poisoned by one of these agents, can be a cause, as well as systemic infections that involve the blood (septicemia) or bone marrow. The bacteria that responsible for Rocky Mountain Spotted Fever and Ehrlichiosis can cause epistaxis. Other infectious causes include the feline leukemia virus (FeLV) or feline immunodeficiency virus (FIV) in cats. Very ill animals can develop disseminated intravascular coagulation (DIC) with nosebleeds, as can animals with immune-mediated thrombocytopenia. The use of some drugs including methimazole (a drug used to treat animals with a hyperthyroid condition), estrogens, sulfa drugs and some chemotherapeutic treatments for cancer can cause bleeding as well.

If your pet has a nosebleed first try to keep it calm, then hold an ice pack on top of the muzzle. If the bleeding stops then returns, or does not stop, take it to your veterinarian. Do not treat your pet with aspirin or non-steroidal anti-inflammatory agents (NSAIDs). Tell your vet if the animal has been on any kind of medication, been exposed to rat poison or other pesticides, dead rodents, or to a place where s/he could have sniffed up a grass awn or other seed head. You must tell your vet if your pet has been roughhousing with other animals, sustained a trauma to the head or face, been sneezing or rubbing at the nose, had blood in the mouth or gums, a black tarry stool or had “coffee-ground” vomiting. Any of these signs could help with the diagnosis.

After a thorough physical exam, your veterinarian may need to examine the nasal cavities with a small endoscope, do blood work, radiographs, nasal swab cultures and antibiotic sensitivity tests and/or fungal cultures and possibly allergy testing. In cases of neoplasia (cancer), a CT or MRI scan may be necessary. The good news is that most nosebleeds are not serious and once the cause is determined and removed the nosebleed will no longer be a problem.

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