Category Archives: Health Conditions

Grapes

Grapes and Dogs, Is it a Big Deal?

Short answer: Yes.

But the “why” is interesting and grapes are no where near the epidemic they make it out to be on television.

Grapes are substantially and prevalently non toxic to dogs and most dogs don’t have a reaction to grapes, [similarly to dogs and their potential (0.5% odds) reaction to onions].  Recent research (probably ten years old now, but has not filtered down through television vets yet) is that there is / are (as-yet-unidentified) insecticides, fungicides or herbicides on grapes that ARE deadly when present or there is a rare, idiosyncratic ‘reaction’ to grapes.
Means: If the grape your dog ingested was/were dusted / sprayed with something toxic to dogs, you’ll see a kidney disaster.
Even then, it’s a thing with the size of the dog, how many grapes were consumed, and which chemical is present, and in what amount.
Alternatively: If the grape-reaction is an oxidative injury (0.5% odds) the result is the same.
If neither condition exists, your dog could eat grapes all day long and never have a problem.
The first time I heard there was a problem with grapes I was confused because I have a personal friend in Napa California who owns a family vineyard. And he would take off bunches of spoiled grapes and toss them to his Labrador. Who ate grapes sun up to sun down (inasmuch as a family vineyard can produce spoiled grapes heh heh) and he never had a problem. Jim never used any herbicides / fungicides nor insecticides.
(If you leave spoiled grapes in the vineyard it brings birds, so you dispose thoroughly and in his case, via dog.)
So, what about these grapes?  
The FDA / EPA has “Grapes” in the top twenty most chemically treated / hazardous imports to the US food market.  They checked forty-eight-thousand (48,000) imported foodstuffs. And grapes are in the top twenty. 
I eat grapes because they never hurt me. Yet. But I suppose we shouldn’t unless we know for a fact they were organically grown? Or at least not imported? Side bar.
If grapes (or their chemical burden) intends to hurt the dog, it’s not a delayed reaction. If kidney issues have not shown up in the bloodwork within 72 hours of ingestion, problems are intrinsically unlikely.
So, why do doctors and emergency clinics make such an enormous deal out of a grape ingestion?
Several reasons:
  1. If you’ve ever seen that dog with kidney shut down from a grape, you never want to see it again
  2. If you’re dismissive, and DO NOT make a big deal out of it, and that dog is the 1:100 reactor, you will be crucified in small claims court.
  3. People don’t bring their dogs to clinics just to have their concerns minimized or dismissed
  4. Owners and vets don’t want to take any risks, even half a percent
Do I give Ajax grapes? Yes.
Would I give him more than a few at a time, or a bunch? Absolutely not. I also can’t help buy into the media hype around grapes. It’s ingrained in my industry and the lay literature, even though it’s not anywhere near as bad (or as often) as they say.
“So, Dr Johnson, have you ever seen a grape-kidney-case in 32 years?”  Nope, never*.  But there’s always a first time.
*(I worked for a vet for ten years before I became one 22 years ago, so there’s 32 years behind a veterinary counter)
Doc Johnson

Post Nasal Drip Hack and Gag Canine

Post Nasal Drip Hack and Gack

A colloquialism for those dogs with a cough that ALSO isn’t anything else. What does THAT mean?

PND Hack n Gack is an allergy to airborne pollutants including pollen, smoke, smog, and moulds. It’s got certain characteristics and can be a ‘thing’ for a dog’s whole life.

Post Nasal Drip Hack and Gack – What an Owner Should Know About This Diagnosis.

Kidney Disease in Dogs and Cats

Cat and Dog Kidney Impairment

So you’ve been told that your cat or dog suffers from kidney impairment. Doc’s going to look at several things and run a couple tests to make sure that it isn’t caused by anything except old age.

If the kidney issues are age-related, this document details what you should know about kidney disease, how it’s assessed and what the prognosis is. Treatments are listed, but the details of those should be provided in separate documents.

Kidney Disease from Old Age in Cats and Dogs: What it means and what are the pet’s chances?

Colitis In Dogs

Colitis / Chronic Diarrhea in Dogs and Cats

Why does it take “a few tries” to get a bowel to “simmer down”?  Why isn’t it just “He’s got diarrhea” and “Here’s your medicine?”

Sometimes it is, often, it’s not. Here’s a thorough discussion of diarrhea / colitis  for folks who have a dog with chronic colitis. I guess if you’re going to have to live with it sometimes, you might as well know why and why not?

Chronic Diarrhea – Colitis in Dogs And Why It’s Not So Simple?

Oravet Chews and When They’re The Best

Not needing another dental saves you dollars, and saves the dog the aggravation.

The short read:

  • There’s a treat (we have them) that coats the teeth and makes them impervious to re-accumulation of tartar. Seriously, stop laughing I am not making this up.
  • They are called Oravet Chews.

Sidebar: Oravet Chews are not usually recommended until after the teeth are optimized. There is no point in coating crappy teeth.

The longer read:

You can “coat” the freshly cleaned teeth super easily every day and literally never need a dental scaling again.

Oravet Chews are basically a “plastic” (huge oversimplification) coating for teeth that is applied via a simple chewy treat. I wish I had invented it.

The dog chews up this teal-colored, chew enzyme-rich treat and it sticks to their teeth…..deliciously.

By the time they get it chewed and swallowed, the teeth have been enzymatically “cleaned” and coated with the bioactive ‘wax’ for the day. I mean, I don’t know, maybe days but Ajax has one a day after his morning walk.

Is this salesy? You know I hate being “salesy” because it’s just not my style but this is something that honestly, a person would be more-within-their-rights to speculate that the reason we did not recommend this after the dental was so we could line up another dental, and nothing could be further from the truth.

Your dog’s dental was done to topple infection and pain in their mouth. No one cares how the teeth LOOK. In that vein, keeping the teeth germ free and the gum line protected is the “thing” entirely.

Oravet Chews Especially After a Dental Scaling (download or read PDF)

Zymox Ear Management

Zymox Enzymatic “Cleaner” (Ear Remediation)

Downloadable or online-readable PDF about Zymox and why I am recommending it to you.

Especially after a successful Claro treatment.

Zymox

After Claro treatment there’s four realizations:

  1. Your dog is not like other dogs, for whatever reason, they’re (genetically/breed?) prone to ear infections.
  2. Your dog may have a lifestyle that contributes to ear infections, for example: Swimming. Tiny ear holes. Too much hair.
  3. For a LOT of dogs, ear infections come from #ATOPY and that’s chronic
    1. com/atopy
  4. Your dog’s ear “environment” has just been cannon-balled by strong medication to achieve ‘wellness’ and needs help restoring a proper pH and bacterial balance.

Zymox is scarcely more than an (ear-appropriate) oil-base which lifts excess wax off the walls of the ear canals and restores the proper pH and bacterial colonies which actually belong in the ear.

  • It’s squalene, and that’s water repellent making it awesome for swimmers.
  • Squalene makes the ear canal too slickery to hold onto dark wax.
  • It has enzymes which digest organics, break down wax, and inhibit/outcompete yeast organisms and untoward germs.
  • It has compounds to down-regulate the acidity in the ear.

All you do is just apply a little (like oiling a clock or oil on a whetstone, just a bit) Zymox to both ears on days of the week containing a “T” for example Tuesday, Thursday and Saturday. Or of course, any three days a week you can remember.

You don’t have to wipe, rub or anything. Just a few drops to create a slight glisten, and you’re good.

Proin – Phenylpropanolamine For Leakers

PPA, Phenylpropanolamine

We use this for “leakers” which are dogs with relaxed (too relaxed) urethral muscles allowing them to leak urine especially when sleeping. Dogs get up from a urine/wet spot.

Used to control that with hormone replacement and it worked. And worked to cause other problems. Now we use THIS medicine and it works, too.

And yes, (little did I know) very occasionally a cat can have this. With the same presentation  as dog “leakers” —> Getting up from urine puddles.

Phenylpropanolamine Proin PPA for urinary issues. Downloadable / Readable PDF

I am not the author of the article. It’s annotated to the authors. I curated the two articles for this document.

Bradycardia

Bradycardia with PVC’s

Doc: I am not the author of these notes. I take no credit for these nor do I link to these notes. They are for me future reference and while they are in my website, they are principally put here for my consumption.

Bradycardia with compensatory sVPC

For bradycardia:
Propantheline bromide, albuterol, terbutaline, or theophylline

Dosing Albuterol (Proventil, Ventolin)

Summary
Albuterol, a bronchodilator, is available by prescription in multiple forms. Contact your veterinarian if your pet experiences fever, vomiting, excitement, dilated pupils, or abnormal heart rates while taking albuterol.

GENERIC NAME
Albuterol

BRAND NAMES
Proventil, Ventolin

TYPE OF DRUG
Bronchodilator

FORM AND STORAGE
Oral: tablets, capsules, syrup Aerosol For inhalation: solution or capsules. Unless otherwise specified by the manufacturer, store at room temperature. Leave capsules for inhalation in original packaging until needed.

INDICATION FOR USE
Treatment of bronchospasm, asthma, or cough.

GENERAL INFORMATION
Not FDA approved for use in veterinary medicine. It is an accepted practice to use albuterol in specific cases, but it is not a common treatment. Available by prescription. This medication works by relaxing the bronchial smooth muscle and opening airways making it easier for the pet to breath. It is used orally and by inhalation.

USUAL DOSE AND ADMINISTRATION
Dogs and Cats: 0.01-0.03 mg/pound by mouth every 8-24 hours. Duration of treatment depends on reason for treatment and response to treatment. For inhaler doses contact your veterinarian.

SIDE EFFECTS
May see increased heart rate, tremors, excitement, restlessness, dizziness, or nervousness. These tend to be dose related and mild.

CONTRAINDICATIONS/WARNINGS
Not for use in patients hypersensitive (allergic) to it.

Use with caution in patients with diabetes mellitus, hyperthyroidism, high blood pressure, seizures, heart disease, or abnormal heart rhythms.

Monitor potassium levels in the blood, as supplementation may be needed.

Not for use in pregnant or nursing animals.

DRUG OR FOOD INTERACTIONS
Increase risk of heart/respiratory problems if used with other sympathomimetic drugs like phenylephrine or ephedrine.

May have decreased effect if used with propranolol and other beta blockers.

May have increased effect if used with tricyclic antidepressants or monoamine oxidase inhibitors (MAOIs).

Albuterol lowers digoxin levels.

May increase risk of abnormal heart rhythms if used with gas anesthetics like halothane or isoflorane.

No known food interactions.

OVERDOSE/TOXICITY
May see abnormal heart rhythms and rates, high blood pressure, high body temperature, vomiting, excitement, dilated pupils, or low blood potassium levels.

Article by: Veterinary & Aquatic Services Department, Drs. Foster & Smith <= Ridiculous.

About Beta Blockers for arrhythmias:

BETA BLOCKERS

Medications Commonly Used for Heart Failure

Enalapril (Enacard, Vasotec), Benazepril (Lotensin), Lisinopril (Prinivil, Zestril).

These drugs are angiotensin converting enzyme (ACE) inhibitors. ACE inhibitors dilate blood vessels and moderate excess hormone activity that occurs with heart failure, resulting in less resistance in the blood vessels against which the heart must pump. These drugs have improved clinical signs of heart failure and prolonged survival in several studies. An ACE inhibitor may be the only drug needed early in the disease process.

The specific drug used and the individual pet’s disease influence the dose and frequency of administration recommended. Enalapril, Benazepril, and Lisinopril can be given either on an empty stomach or with food.

Adverse effects of ACE inhibitors could include vomiting or diarrhea, deterioration of kidney function, elevation of blood potassium levels, or low blood pressure (hypotension). Other adverse effects that have been reported in people taking the drug include skin rash or itchiness, taste impairment, and certain abnormalities in blood and urine tests.

Furosemide (Lasix, Disal, others)

Furosemide is the diuretic (“water pill”) most often used to promote the loss of excess fluid in patients with congestive heart failure. The dosage varies depending on the clinical situation and the patient’s response, but generally the lowest dose that controls signs of congestion is used for chronic therapy. Signs of heart failure decompensation and congestion such as a persistent increase in resting respiratory rate or recurrence of cough may respond to an (often temporary) increase in furosemide dose. In most cases (check with your veterinarian first), if your pet has been doing well on heart failure medication but subsequently develops signs of congestion again, you can increase the dose or add an extra dose of furosemide for a day or so. If this becomes necessary, be sure to discuss each event with your veterinarian – reevaluation additional tests, and/or other therapy adjustments may be necessary.

Adverse effects of furosemide are usually related to excessive fluid and/or electrolyte losses (especially potassium) resulting in dehydration and weakness.

Digoxin (Lanoxin, Cardoxin, Cardoxin LS)

Digoxin is a positive inotropic (refers to the ability to contract) agent that mildly strengthens heart muscle contraction. It also moderates the excess neurohormonal activity that occurs with heart failure and helps control certain heart rhythm abnormalities. Digoxin is not necessarily indicated in every case of heart failure.

Digoxin is best given on an empty stomach since food as well as antacids and kaolin-pectin compounds decrease drug absorption.

The toxic effects of digoxin can be serious and even life threatening so the drug must be carefully dosed. Monitoring of the drug concentration in the blood is recommended. This is often done 7 to 10 days after starting the drug or after making a dosage change. The blood sample is taken 8 to 10 hours after a dose of the drug has been given. Reduced kidney function, dehydration, loss of lean muscle mass, low blood potassium levels, and certain drugs increase the potential for digoxin toxicity.

Adverse/toxic effects can include heart rhythm disturbances, loss of appetite, vomiting, diarrhea, and depression. If you suspect digoxin toxicity, stop giving the digoxin and contact your veterinarian immediately.

Diltiazem (Cardizem, Cardizem CD, Dilacor XR)

Diltiazem is a calcium channel blocker that is used to help control certain heart rhythm disturbances and to promote heart muscle relaxation in hypertrophic cardiomyopathy (especially in cats). In dogs with atrial fibrillation (a rapid, irregular, abnormal heart rhythm) it may be used with digoxin to slow the rate of the heartbeat.

Adverse effects are uncommon at standard doses but can include decreased appetite, slow heart rate, and rarely, other stomach/intestinal or heart effects.

Atenolol (Tenormin) and Propranolol (Inderal)

These drugs, among others, are called beta-blockers. They antagonize the effects of the sympathetic nervous system, and thereby slow the heart rate, reduce the heart’s oxygen demand, and help control certain heart rhythm disturbances. A beta-blocker may be used with digoxin to slow the heartbeat in dogs with atrial fibrillation. A beta-blocker may be useful in cats with hypertrophic cardiomyopathy as well as animals with certain congenital heart malformations.

Adverse effects are usually related to excessive beta blockade and individual animals vary considerably in their response; thus, low doses are used initially and slowly increased to effect. Dosage and frequency of administration also depends on the drug used. Adverse effects can include excessively slow heart rate, worsening of heart failure, low blood pressure, bronchospasm (more likely with Propranolol), depressed attitude, and possibly masking early signs of low blood sugar (especially in diabetics).

Nitroglycerin (NitroBid, Nitrol) and Isosorbide dinitrate (Isordil, Sorbitrate)

These drugs are prescribed sometimes to dilate veins and help reduce congestion. Nitroglycerin ointment is applied to the animal’s skin, often in the groin or armpit area or inside the earflap.

Gloves or an application paper should be used to apply this medicine to your pet. Do not get this medicine on your skin because you will absorb it also.

Isosorbide comes in pill form.

Spironolactone (Aldactone)

Spironolactone is another diuretic that works by a different mechanism from furosemide. It is sometimes used in addition to furosemide in the treatment of chronic, refractory congestive heart failure. Adverse effects relate to excess potassium retention and stomach/intestinal upset. If used with an ACE inhibitor or oral potassium supplement, blood potassium must be monitored closely.

Chlorthiazide (Diuril) or Hydrochlorothiazide (Hydrodiuril)

These drugs are diuretics that are sometimes used with furosemide for refractory heart failure. Adverse effects are usually related to excessive fluid and/or electrolyte losses.

This Pet Health Topic was written by O. L. Nelson, DVM, MS, Diplomate ACVIM (Cardiology & Internal Medicine) Washington State University.

Washington State University assumes no liability for injury to you or your pet incurred by following these descriptions or procedures.

Interaction
(Making it impossible to manage bradycardia and VPC’s together with medicine. It boils down to needing a pacemaker.

Monitor closely
propranolol oral + albuterol sulfate oral
Significant interaction possible (monitoring by your doctor required)

Propranolol oral decreases effects of albuterol sulfate oral by opposing drug effects
Propranolol oral + albuterol sulfate oral
Potential for interaction

Propranolol oral increases and albuterol sulfate oral decreases potassium levels in the blood

Conjunctivitis

Red eyes – conjunctivitis in dogs and cats

https://www.merckvetmanual.com/eye-and-ear/ophthalmology/conjunctiva

Source: Merck Veterinary Manual

When a dog comes in for a “check eye” visit my mind immediately worries about a corneal ulcer / scratch. That is the FIRST rule out and the BEST reason to have any eye condition checked when noticed.

But quite often if BOTH eyes are pink or red, it’s conjuncitivitis which has a bunch of possible causes.

  • Allergies
  • Atopy
  • Chemical / environmental irritation
  • Bilateral corneal damage
  • Infections
  • Low tear production

MOST cases are caused by atopic / allergic causes.

When bacteria are involved there’s often more “redness” instead of pinkness and very often there’s discharge (often yellowish) from the eye.

By fortunate happenstance most eye ointments I would prescribe for atopic / inflammatory responses ALSO contains antibiotic activity. Usually Neomycin, Polymyxin, Bacitracin, -or- Terramycin, Tobramycin. And even more recently, a quinolone antibiotic.

“Pink eye” isn’t usually a dog “thing” because they have their OWN version of pink eye which isn’t contagious to you. Caused by Moraxella ‘bovis’ which is principally a cow germ –  not a dog germ but sometimes crosses over and becomes a dog germ. People have their own contagious Moraxella species I forget what it’s called. But it’s not the dog version so don’t worry about getting ‘pinkeye’ from your dog. Nor should you worry about giving you dog pinkeye.

Under most circumstances I prescribe PBN-Dex or similar but on occasion, SIMILASAN is enough. I also “stain” the eye with Flourescein to make sure there’s no CORNEAL ULCER.

So that’s what you ought to know about conjunctivitis.

Doc Johnson