Levetiracetam: Use in dogs and cats (From the interweb)


This pyrrolidine-based anticonvulsant has an unknown mechanism of action. It has been used as an adjunct AED for dogs and cats and is occasionally used as monotherapy. In dogs, it has excellent oral bioavailability, does not appear to undergo hepatic metabolism, is primarily excreted unchanged in the urine, and has a half-life of ~4 hr. It appears very safe with no to few adverse effects (ataxia, sedation, vomiting) reported at the routine dosage ranges. Levetiracetam is initially administered at 20 mg/kg, PO, tid, in dogs; 10–20 mg/kg, PO, tid, in cats.

Dog: 10mg/lb 3x/day (9.09mg/lb)

Cats: 5-10mg/lb  (2.27 to 9.09 mg/lb) also 3x/day

If adverse effects occur, the dosage should be reduced to 20 mg/kg, bid, and increased to 20 mg/kg, tid, gradually. Studies suggest that 60% of dogs respond initially; however, after 4–8 mo, there is a loss of effect in ⅔ of previous responders because of development of tolerance. In dogs, the dosage can be increased every 2 wk in increments of 20 mg/kg if therapeutic benefit has not been noted. Adverse effects of salivation, restlessness, vomiting, and ataxia at dosages >400 mg/kg/day have been seen experimentally in dogs but resolved within 24 hr of discontinuing the drug. Therapeutic monitoring is generally not necessary when using this drug, and there does not appear to be a correlation between serum drug concentration and therapeutic efficacy. An IV formulation can be used in status epilepticus.

Source:  https://www.merckvetmanual.com/pharmacology/systemic-pharmacotherapeutics-of-the-nervous-system/maintenance-anticonvulsant-or-antiepileptic-therapy


Feline Uveitis: Causes and Treatment of Feline Uveitis

So I was seeing patients today and I met a cat with a pinkish rim around the limbus of the eye. All sorts of thoughts rushed through my head, and I got to thinking about FIV, FIP, Feleuk, and others. I decided to Google some images of this cat’s eye in case there was something obvious about it, and found out that a massive 60% of uveitis in cats is inexplicable.

Cat with uveitis
Cat with uveitis

It started a week ago as a runny eye. The cat was normal otherwise. And then 6-7 days later this appears.

So I did some digging and I found an article that provides a GREAT summary of cat uveitis. These are written and produced by their respective authors and publications and used here non-commercially and without intent to diminish the value of their work globally. A take-down request is welcome in the even of a problem.

Here are the links:

feline_uveitis_DVM 360

Feline Uveites


Itchy Cats: Pruritis / Itching in Cats Can Be Lots of Things

Cats with Itchy skin – Feline Pruritis

Most everyone has a cat that scratches now and then.

Some people have cats that scratch until they create bleeding sores all over their necks and rumps.

Cats scratch for a variety of reasons. Most commonly, they have fleas, and possibly an allergy to the flea bites. Some cats are “allergic” to their food (rare) or perhaps even more likely, intolerant to carbohydrates like grain, rice, barley etc. Finally, some cats have issues with their own immune system which is called Eosinophilic Granuloma Complex.  I can often tell by looking at some of these syndromes.

Routine allergies that cause scratching are the most common, and the most inexpensive problems to treat in the cat.

But there are other possible causes that have to be considered based on experience and a careful examination. Sometimes cats are allergic or intolerant to their food. Sometimes they are infected with a skin fungus called “Ringworm”.

And other times they are being bathed too often, and in a shampoo that dries the skin out.

Fascinating fact: Cats have no sweat glands in their skin. It is easy to dry out the skin, leaving it itchy and flakey.

Catteries with cats close together sometimes experience ringworm outbreaks
Catteries with cats close together sometimes experience ringworm outbreaks

When I look at your itching cat, I check to see if it looks much like Ringworm. If so, it may be suggested that a Ringworm culture should be done. This test is very inexpensive and prevents human infection by the fungus. Fungal / ringworm infections are rare in cats that are under little to no stress. In catteries / cat breeder operations, crowded together and being pushed for several litters per year of kitten mass-production, cats are more prone to Ringworm.

If it appears to be allergic, I may suggest a cortisone shot, which suppresses the allergic response to the fleas and gives the cat a great deal of comfort.

Finally, I may suggest a flea control method, like Frontline, Comfortis et al, or a shampoo that does not dry the skin, or a flea spray.

In rare instances, a special food may be tried, called Hill’s D/D diet, that reduces a cats allergic response to the food, but only if that is what I actually think is ailing the cat. Other times, choosing a food that uses oatmeal or rice in place of corn or wheat – can improve a tolerance / rejection issue with food.

No matter how you slice it, the vast majority of cats tearing themselves up out there do not have to be suffering like that, and the majority of those cats could be helped immensely.

Cat IAE Pee: Inappropriate Elimination In Cats

Inappropriate Elimination in Cats

If your cat pees outside the litter pan, this article will probably be better news to you than an incurable virus that only infects white supremacists.

Cats that urinate outside the litter pan that do not have FUS may respond well to a larger litter pan
Cats that urinate outside the litter pan that do not have FUS may respond well to a larger litter pan

I just happened to be walking through a big box contractor store and I saw these concrete mixing pans and it made me think of study that I read about 10 years ago that has served me very, very well in practice.

There is a college with a very good relationship with surrounding veterinarians. They were doing a study to figure out which kind of litter was the best to attract cats back to the litter pans (cats that were prone to peeing outside the box). They solicited about 100 cats from these area veterinarians to submit to the study. They tested litter like dirt, sand, vermiculite, peat moss, clumping litter, clay litter, scented and unscented litters. They got variable results with no clear winner.

Then they looked at variables that they had not controlled and they noticed a consistent result related to the size of the litter pan. In fact they noticed that the litter pans that were larger and not just a little bit larger but a lot larger were very successful in attracting the cats.

So they repeated the study with large litter pans. On par with small concrete mixing pans and had a conversion rate of around 70%.

That was huge. Improving on that in my practice since then, I have suggested using a counter intuitively *small* amount of litter, of the unscented unclumping plain clay litter at only 1 inch. It’s brought back around 80% of inappropriate-elimination cats.

And here’s why, and this is only my theory. I believe that when a cat starts to pee outside the litter pan people put more and more litter into the box. It makes sense to make it easier for the cat to bury their material. But it also creates an unstable footing and they get their feet buried in the litter. Worse, having the feet sinking into the litter sucks when the litter is a clumping litter.

When a cat starts to get clumping litter in between his toes it snowballs from there. Almost litterally. Ha ha ha litterally! Did you see what I did there?

I started to get a very high rate of conversion without the need for Prozac, caging, two pans, Feliway, earnest pleading and other calisthenics.

And I personally believe that for some cats, scented litter is like those old ladies who have no idea how strong their perfume is. Consider how strong a cats sense of smell is.

Anyway, so when I started to suggest *plain* clay litter at *1 inch thick* in these large concrete mixing pans, I started to get a very high rate of conversion without the need for Prozac, caging, two pans, Feliway, earnest pleading and other calisthenics. And saved a lot of cats being thrown outside.

But then again, keep in mind that among all the cats that pee outside the litter box, 20 to 30% of them are just asshats.

Now, I would also say this: nothing’s going to work if the cat has severe miliary dermatitis because they often complain about that, (and fleas) by peeing. And also nothing is going to work if they have a bona fide urinary tract infection so those things need to be ruled out.

FUS: Feline Urological Syndrome

Feline Urological Syndrom IAE

Cat in the litter pan having trouble going to the bathroom.
Cat in the litter pan having trouble going to the bathroom.

Stopping behavioral disorders which result in cats peeing outside the litter box is VERY difficult, I daresay, impossible to control entirely.

Feline Urolological Syndrome (FUS) is a disease of cats that can manifest itself in a variety of ways.

* Usually there is straining to urinate,

* increased frequency of urination, and the

* appearance of blood or “sand” in the urine which can lead to complete blockage of the urinary tract.

* frequent attempts to urinate with the passage of only small quantities of urine.

* Blood can be seen in the urine.

* Urination in inappropriate areas can also be observed.

* Male cats with urethral obstruction may also cry frequently and lick themselves under the tail.

* They may be unable to pass urine and will strain frequently, which may be confused with constipation.

* As uremic poisons accumulate, the cat will become depressed, lose his appetite, and may vomit.

Blockage is more common in male cats, and is often severe. Because blockage prevents the normal passage of urine, waste products normally eliminated by the kidneys accumulate in the cat’s blood stream and can lead to “uremic poisoning”.

The cause or causes of FUS are still controversial. Researchers feel that dietary compounds, viral infections, urinary acidity and possibly environmental factors all may play a role. The lack of a definitive cause of FUS makes it difficult for us to design a universal treatment plan which is consistently successful. Therefore, some cats will have recurring episodes of FUS.

Signs of FUS indicate an emergency condition and immediate veterinary care is required, or severe kidney damage and finally, death due to uremic poisoning may result.

If a cat with FUS has urethral blockage, we attempt to remove the obstructing plug by gently flushing with a sterile solution. While there is some risk of urethra or bladder rupture, this rarely occurs. We usually place a catheter in the bladder to permit the emptying of the urine and hopefully the excretion of the sand while other medicines are given. Within two or three days the catheter is removed, and with any luck, the cat remains un-obstructed, and is placed on a special diet. Long term complications of urethral blockage include loss of bladder tone, secondary kidney damage, bacterial infections of the urinary tract, and recurrent blockage.

If the cat is showing signs of FUS without blockage, we usually begin treatment as an outpatient.

The type of therapy that we recommend will vary, depending on your cat’s condition upon presentation. If there is indication of a bladder infection, we will place your cat on antibiotics, usually for 7-10 days.

The need for antibiotics may be shortened (or their effect enhanced) by acidifying the urinary tract with a special diet made to lower the urine pH. Examples are Hill’s C/D and W/D prescription diets.

Regular urination can be encouraged by frequently cleaning the litterbox. We also advise feeding your cat a low magnesium diet (ie: O.1% MG in dry matter).

Giving distilled water has also been shown to be favorably influential.


* Prescription Diet C/D or S/D for the first few months after FUS episode.

  • Royal Canin S/O Diet is excellent (my favorite for feline FUS)

* Can be on Feline C/D or the lower calorie W/D as long term diet.

Neutering Your Male Dog: How To Make Life Bearable For A Male Dog

Canine/Dog Neuters

Here’s a fact:  Neutered male dogs may gain weight. So, after the surgery, it’s not a bad idea to change to an adult, or less active formulation of dog food after neuter.

If you neuter your dog, he’ll turn Sissy, and won’t guard your home. In fact, he’ll hate you forever; and will probably run away.

That’s absolute bull, but people believe that.

Neutered male dogs don’t forget their territories, and I could show you a few dogs (neutered Akitas) that could tear up any intact male dog around.

We all know that in spite of the fact that Vets stole their spot in Vet School, breeders know more than they do.
We all know that in spite of the fact that Vets stole their spot in Vet School, breeders know more than they do.

If you have a beloved dog, and you want to avoid later prostate problems, stop roaming behavior, and you’re embarrassed by his “leg-jockey” routine, then neutering should be considered. Intact male dogs can make awesome pets, don’t get me wrong, and it’s imperative that you run this advice past a breeder because as we have all been told, breeders know WAY more about pets than veterinary doctors.  But read on patiently. I’ll fumble through it.

When we neuter a dog, we anesthetize him, and surgically remove his testes.

He goes home with an incision, but usually with no external sutures. The wound is closed from the inside to eliminate his chewing at the line.

We recommend that his exercise be very restricted for 3 days post operatively, but that’s it. They’re as good as new within the week.

What can you expect?

1) The dog will never have Prostate problems: Hyperplasia or Cancer.

2) The dog is also unlikely to develop Perianal Adenomas, which are dependent upon testosterone for their growth, and arenot uncommon in intact geriatric dogs.

3) The dog will stop playing leg-jockey with your guests.

4) The dog will quit roaming as much.

5) The dog would still eat the postman if he did before neutering. You see, their sense of territory is undiminished. It is only their rivalrous (gender) behavior that you curtail.

6) The dog makes short work of the lawn watering routine. Instead of marking 27 different trees, he goes out, and comes back in. This is a good thing come mid-February at about 3 A.M.

7) Some aggressive behavior associated with male-dominance is curtailed by neuter, but this cannot be relied upon. Most dogs maintain their demeanor, good or bad, after neuter.

Neutering isn’t a joke. You should do it for the health of your pet, and for the population at large.

A former iteration of this page held that a neuter would be $80 and I apologize for that because the inclusive cost is weight dependent and on average is $150 depending on weight.

Please schedule with our office. All animals submitted for surgery should be immunized against the important diseases facing their respective species. For dogs, that’s Rabies and Distemper-Parvo immunization. They can be admitted the same day on an empty stomach. Dogs go home the same day they’re neutered.

Apoquel and Cancer in Dogs

Dogs are contracting cancer from a new(ish) medicine (introduced in 2013) given to control itching. 
#apoquel #canine #dog #cancer #oclacitinib

In the most basic of “summaries”: You can’t use it in people, and it causes new cancer in about 15-18/300 NON-elderly dogs. Severe bacterial/fungal infections in @30-35/300 dogs.

Its not funny, but I should have read further to find out whether or not they reported “complete cessation of itching and breathing” in at least 5 to 12 percent of tested animals.

Now let’s get to the meat and potatoes:

dog with cancer on it's face from Apoquel, apoquel caused cancer in up to 12% of dogs tested by the company that manufactures it.
dog with cancer on it’s face from Apoquel, apoquel caused cancer in up to 12% of dogs tested by the company that manufactures it.

A customer asked me about a medication called Apoquel. It is prescribed for dogs that are itching because of allergic reactions to substances, fleas, and more. Apparently it is effective in many of the cases it is used in. If you check the internet, you will read hysterical reports from some of the dog breeder sites that say that “50% of animals getting Apoquel will die of cancer”. Not surprising for a few breeders to fly off the handle. Polyester fibers and hair curlers can cause hysteria with chronic, lifetime exposure. However a veterinary dermatologist who prescribes Apoquel regularly, arrived at a more refined / conservative conclusion per the packaging material and that is that about 5% of animals getting apoquel will suffer cancer. However in that author’s opinion (the dermatologist’s) it was thought that 5% of non-elderly animals would have gotten cancer over the course of a year anyway. I disagree. Because, if you read the testing results more closely they were able to attribute specific cancers to Apoquel. It was not usually random; in the types of cancer contracted. Later on in this article I will list the specific answers researchers found in Apoquel studies.

In almost all of the trials, cancer was not the most common negative side effect. Severe infections and pneumonia were also noted to the extent that in some cases the trial had to be stopped for those animals. Depending upon how you interpret the results of these studies, upwards of 10 percent and possibly closer to 20 percent of animals had significant reactions that compromised quality of life as a result of this medication.

Apoquel has been around a while. It was out in late 2013 and was not tested in many animals at all. It has a fearsome list of direct effects…..and to create THAT much cancer and pneumonia in such a tiny study group of no more than 500 dogs, total. :u(

Better than twelve percent of all dogs given Apoquel developed: pneumonia, bullous foot and node infections, or any one of a dozen cancers directly related to Apoquel.

It isn’t used in people, and even has hazard instructions if you simply get it on your skin. (Open / broken capsule)

300+/- Dogs in field trial:
Eighteen dogs were euthanized because of suspected malignant neoplasms: including thoracic metastatic, abdominal metastatic, splenic, frontal sinus, and intracranial neoplasms, and transitional cell carcinoma after 17, 120, 175, 49, 141, and 286 days of APOQUEL administration, respectively. Two dogs each developed a Grade II mast cell tumor after 52 and 91 days of APOQUEL administration, respectively. One dog developed low grade B-cell lymphoma after 392 days of APOQUEL administration. Two dogs each developed an apocrine gland adenocarcinoma (one dermal, one anal sac) after approximately 210 and 320 days of APOQUEL administration, respectively. One dog developed a low grade oral spindle cell sarcoma after 320 days of APOQUEL administration.

Oh, by the way. The above is quoted from Zoetis’ own package insert.

From the above statistic, what is commonly overlooked is that those all occurred within a group of less than 300 animals.

When they went from clinical to field trials; 6% (six-point-zero-percent) of their study got cancer!

Infections were essentially twice as common (@10%) but only a few were life-threatening or lethal.

It’s just too immunosuppressive.

Someone called my post out, “Stop the hysterics! You can’t believe everything you read on the Internet!!”

I’m not engaging hysterics. In fact, the proof of these cancers and the disturbing percentages comes from Zoetis’ research! They provided all of the information I included in this article in their package insert to the Food and Drug Administration. You can read it yourself.

Link:  Apoquel Product Insert, See page 1, the entire second column. 

The doctor-to-consumer selling point is; “It won’t cause thirst hunger and weight gain like prednisone-category meds”. Which is crazy-attractive I know. But the risks are too high in most patients with the garden variety itching.

This may come as a big surprise to some people, but drug manufacturers quite possibly rely on the fact that folks won’t read the fine print, and I suspect even some doctors won’t. When I refer to fine print I am NOT necessarily talking about the ‘massaged’ fine print provided by the manufacturer. Sometimes better and more accurate information can be interpreted from National Institutes of Health, publicly funded research and university level tracts, and PubMed. (Here’s my fave starting point: Click)

Apoquel is powerfully immune suppressive, not unlike Cyclosporine (Atopica°) however Apoquel is in a drug class and category by itself.

So far, I don’t know much that is as safe or cheap as steroids for skin issues (whose cause is exclusive to other infectious causes), but; nutrition is making headway. Cytopoint is absolutely amazing but at $50-100 a shot, it’s pricey.


Dr Erik Johnson
3100 Roswell Rd Suite 113
Marietta GA
TEL: (770) 977-5377
FAX: (770) 973-0301

Dec 2019: If I still have any patients on Apoquel, I don’t know it one–off. I’ve moved as many as I find over to Cytopoint. Which has resolved all but ONE of my atopic dermatology cases.

Dec 2017: I have posted a video of the first dog I’ve gotten off Apoquel (without cancer). We took advantage of information on low carb / carb intolerance in dogs. His video is somewhere in this thread. Sorry.
I put details and citations of this article at: drjohnson.com/apoquel.html
“Sciency” folks wanted me to ‘back up my random internet post’ so I just linked to Zoetis’ own prescriber information. That was easy peasy. I’m sure they wish they didn’t have to post their fine print on the internet LOL.

For the record, I don’t like Prednisone much either. It’s the mildest thing (that works) for now, but I am ALWAYS on the hunt for the Grail.

Addendum: Between the above writing and July 2017, I have put five cases on it after a lot of discussion with owners about possible consequences. I am already back down to four cases on Apoquel since Bella T. now has lymphoma and has left the group. In fairness, Bella was better off dead than in the skin she lived in before Apoquel. Which is the only criteria I use these days before putting a dog on Apoquel. Besides that pesky cancer thing, it works extremely well.

Puppy Safety: Puppyproofing A Home

Puppy Safety

Folks get a new puppy, and usually do everything they can to keep them healthy and happy, but there are still a few things that happen that could be avoided.

Take a moment to review this document and see if you might overlook any of the following:

* Pups will eat cigarette butts, with fatal or near fatal results. The best solution is to quit smoking. (Always gets a laugh). The next best is to keep ashtrays well out fof reach by curious pups.

* Pups will chew electrical cords. Shocks from this can be fatal or severely debilitating. Sometimes you don’t even know what happened until the Vet shows you the burns across the tongue and gums.

* Pups will chew up Christmas balls. The thin glass hardly hurts at all, but is disastrous in the mouth and digestive tract. Pups may jump on other ornaments, and receive bad cuts in the foot pads and mouth.

* Pups are attracted to flickering candles. Curiosity (and a house-fire) results in a “Christmas in the snow” for you and your puppy. Keep open flames well out of reach.

* A medicine bottle may be child-proof, but not puppy-proof. Given a few minutes of chewing, the pup will be into most medications, with potentially fatal results.

* Puppies may lap out of the toilet. Toilet bowl cleaners may cause burns in the mouth and digestive tract. Take care to leave lids down.

* You’d think pups would know better than to jump out a window in a car or house, but unfortunately, no. They’ll jump if they get excited enough.

* Pups don’t get complete immunity from their first immunization. Usually the second immunization confers the start of real circulating immunity, but I recommend you avoid alot of socialization with other pups until 16 weeks of age, when their immunity is peaking.

* Turkey and Chicken bones may go down without incident, but they may not. Most veterinarians have at one time or another removed a sharp poultry bone from the mouth or tract of a curious puppy or dog. Just don’t risk it.

* Puppies like to eat sewing needles and pins. The thread on the needles actually does more damage than the needle itself. You can avoid any trouble just by knowing that this strange attraction exists.

* Canines will lap up anti-freeze as though it were a treat. It’s sweet to the taste, and has an attractive scent. Survival rates are poor, even with swift treatment.

*Recalling that pups like to chew, please re-consider using baits and pesticide strips where the pup might eventually discover them.

* Read labels on any shampoo or dip you intend to use on your new companion. Some can be too much for pups, and only by reading the label will you know this.

#Shampoos that cause itching:  Pert, Palmolive, Prell, Johnson’s Baby Shampoo

#Shampoos that are good:  Pantene Pro V Shampoo AND Conditioner in One, and Neutrogena Triple Moisture in the Tube

* It’s not true that all plants are toxic to pups, but it seems like it sometimes. Most plants only cause drooling and sometimes vomiting in pups that chew them. Others like Lantana, Japanese Yew, Lily of the Valley, Nightshade, Oleander, and Castor Bean have more severe penalties for oral ingestion.




Itchy Dogs (Article I) How to Control Itching in Dogs

Itchy (Pruritic) Dogs

Some dogs actually seem to enjoy scratching. I doubt they do, but some of them do it alot.

You see them rubbing against shrubs and trees, and under the coffee table, and rolling around on their backs in the yard.

But sometimes scratching gets ugly.

They’ll scratch all night long, and cry while they’re doing it. Eventually; sometimes within hours, they’ll raise large, wet, red whelps under their ears or on their rumps (Hot spots or Moist Excema). Their tail may become hairless for all their digging.

The majority of these cases are allergic conditions where a flea may have bitten the dog, causing an itchy reaction in the skin.

But many such dogs are also “allergic” to house dust, pollens, and molds. (They call that “Atopy” which was once believed to be “inhaled” allergies. New information supports that it’s a contact allergy as well)

Rainy weather triggers some cases by spawning mold growth in leaf litter, however; dry weather and wintertime low-humidity triggers yet others. Some dogs are even allergic to their own food! New information suggests that some dogs have “carbohydrate intolerance” and their skin erupts the way some people’s skin erupts in response to milk/dairy. I hold that this is a COMMON cause of itching in dogs and switching to low-carb feeding helps the majority of cases.

Video on Low Carb Feeding You Should See: Starring ME!

Food allergy is comparatively rare. Among dogs, only one out of fifteen HUNDRED of them will be food allergic. However, there are MANY dogs which are intolerant of certain grains and fillers, much the same way people can be INTOLERANT of lactose, not allergic to it. When an animal eats a food it doesn’t digest effectively, diarrhea or soft stool may results, however, the colon can restore a LOT of normalcy to the stool, but the effects of the food intolerance can be indirect and serious.

When I look at your dog for itchy skin, it will be an exam to see whether the condition appears to be mange. Mange scrapes are a very reasonably priced diagnostic test. The results are available within minutes. While some vets DO scrape every single itchy dog that come$ into the clinic, I don’t automatically scrape every dog for mange, unless there’s a question that it could be mange.

If the skin appears to be infected with Ringworm fungus, then I might recommend that some hairs be pulled out and cultured for the fungus. This test takes a little longer, but can provide valuable information.

In the majority of cases, I can tell by a careful examination, and through a line of careful questions, that a condition is allergic/atopic or not, and then will discuss the treatment or diagnostic options available. Usually, the most practical treatment for allergies, with the highest success rate, is the use of cortisone, by injection.

Other treatments which may be recommended are Atopica (I don’t like it), Apoquel (Causes cancer I hate it) and Cytopoint (Hold a lot of promise but cancer statistics are unavailable now).

In some cases, there is also infection in the skin as evidenced by pus exuding from wounds. In those cases, an antibiotic is also sent home for you to give to your companion.

The majority of “itchy-dog-skin” cases can be seen and treated for well under a hundred dollars. Later, once the diagnosis is established, subsequent visits may sometimes involve a re-examination charge plus the cost of the treatment. That depends entirely on your vet of course but it’s not an unfair question to ask.

At Johnson Veterinary Services, we welcome discussions about your bill, and if you ask me, I’ll help you estimate the costs that may be involved, up front, so there will be no unpleasant surprises, and you’ll usually have money left in your pocket. I never exceed estimate without consent.

Allergies are usually *chronic* and are difficult to totally “cure”. In other words, the allergic symptom of itching usually returns when control of the allergic cause is relaxed. (For example, if the fleas are allowed to remain on the pet, or in the environment.)

In some instances, the best desired result could be the longest possible control of symptoms for the comfort of the pet; with the least amount of pharmacological influence. That’s by diet, skin conditioners, medications, raw honey, and other adjunctive care.

Frequently administered cortisone may have adverse effects, in some cases of extreme abuse. I can clarify and avoid these circumstances.

Whelping: Puppy Time: How To Meddle With a Natural Process

Canines – Dogs Giving Birth And How We Can Ruin-It-Up

A momma dog nursing her puppies
The mom dog (people love using the word bitch) milks puppies and needs calcium AFTER the puppies are born

The act of delivering, or whelping, is a natural process for many dogs, but there are exceptions where normal birth is extremely difficult or sometimes, impossible. Except in cases where a veterinarian must be consulted, it is best for whelping to take place at home in quiet, familiar surroundings. A special box (either cardboard or wood) roomy enough for both mother and puppies should be available three to four days in advance of whelping. The box should be situated in a place that is out of the way of household traffic, yet easily accessible. Several thicknesses of newspaper make the best bedding to use in the box. Sometimes if you use a blanket it can lose a puppy in the folds plus or minus smothering it. The inside edge of the box is sometimes equipped with a “bumper” that keeps the Mom from compressing a puppy against the side of the box. She leans on the bumper and the hapless puppy is protected under the lip.


Signs of pre-labor can occur anywhere from 8 to 24 hours prior to true labor. This period is identifiable by the following signs and these are SUPER indicative. To the extent that when someone calls the office and I think it’s a false-alarm I’ll have them take the temp. It’s a ‘thing’ that’s pretty consistent.

1. Moms usually refuse food.
2. Rectal temperature falls below 100 degrees.
3. Agitation is apparent and attempts to find seclusion may be made.


During true labor you will observe definite abdominal contractions. You don’t have to use your imagination. Should contractions persist for longer than TWO hours without the birth of a puppy, notify the veterinarian. (Or a dog breeder because they are actually better at veterinary medicine than Vets are, if you ask them) Shortly after the onset of true labor, you may notice the appearance of a distended membranous sac at the vulva (girl parts). These are the fetal membranes. They indicate that delivery of the first puppy is well underway. With continued straining, the pup will be delivered. Mom will usually chew the sac from around the pup and break the umbilical cord.

Sometimes you see a puppy with a kinked tail “since birth” and often, that’s when a new mom accidentally crimps the tail mistaking it for the umbilicus!

Continued licking of the puppy stimulates respiration and crying. If the mother fails to break the membranes pretty quickly after the delivery, you should do so yourself. It’s seldom necessary but you can use clean white thread to tie off the umbilical cord approximately 1 1/2″ from the abdomen. Then cut the cord with scissors (previously cleaned with 70% isopropyl alcohol). Brisk rubbing with a dry towel should be continued until the puppy is crying vigorously. Be careful not t smash it’s head or break its neck. Use common sense.

After the puppy is breathing normally, the umbilical stump should be painted with tincture of iodine. This is “nice” but not absolutely necessary.

Place the puppies in the whelping box (next to the mother or where the mother can easily see them). You may place a heating pad in the box on the LOWEST SETTING (and under a towel or blanket) or a hot water bottle. Puppy deliveries are normally spaced a half hour intervals, although an hour interval is not unusual. Total whelping time averages 6 to 12 hours. We had a Fila Brasiliero which took twenty four hours to produce all her pups. That delivery went overnight and so puppies were born on two dates. I can’t remember if we split up the litter on their papers or not ha ha ha!

Here’s something they almost never tell you:

The single most important thing you can do for a female in labor is offer good, appealing food to keep her energy up! Most dystocias (low calcium or “running out of steam”) can be avoided with this simple advice.

When whelping is completed, you should offer her a small amount of food and water, but don’t be alarmed if she refuses both.


1. Dark red or dark green discharge PRIOR to delivery.
2. Failure to produce a puppy after 2 hours of active labor.
3. Extreme depression and cessation of labor.
4. Gestation beyond 68 days with no signs of labor.

Calcium; in the form of yogurt, cottage cheese or a multi-vitamin (not milk) should be given soon after delivery, as milk-letdown ensues. Sometimes folks give a lot of calcium before parturition and what happens is that the parathyroid gland doesn’t get a ‘warm up” and so its caught off guard at let down (milk production after delivery) and eclampsia can result. 

Dr Erik Johnson


Companion Animal & Fish Health