Home made diet: Get some plain organic yogurt with live cultures, raw meat, Vit.c, Kelp,
Omega 6 oil, and Flax seed grounds.Very small amounts of the vitamins, 1 tsp or so of meat, 1 tbsp of yogurt, mix with the
kibble and there you have your own homemade wet food. Depending on weight, go up or down on the amount. If overweight,
try rice, vegatables, chicken and pumpkin for taste in the pm. It is working for me.
I am feeding Precise
Holistic.Please see www.greatdanelady.com. This lady has really done her homework. My additions are: Nupro or (Missing Link Detox
and recovery) to help fight off cancer. K9 Immunity Plus NZymes Probiotics Chrondrotin, Glucosamine and
MSM
Like large breeds and pugs, they are often
subject to hip dysplasia and other orthopedic problems. Studies indicate that when larger breeds are switched to adult food
at an earlier age, they are leaner and less likely to develop this condition. Kibble will be your pugs main staple. Hard kibble
will scrape off tarter on your pugs teeth too. TOO MUCH GROWTH TOO FAST, CAN RESULT IN ORTHOPEDIC PROBLEMS.
Tips
from the Whole Dog journal. Superior sources of protein. look for a whole meat source as one of the first 2 ingredients,
like chicken or chicken meat. Whole unprocessed grains, vegatables, and other foods. Stay away from brewers rice, wheat bran.
Be aware that there may be more rice than meat. Low quality foods. Generic fats or proteins, animal fat. Look for beef
fat or chicken fat; Animal protein is inferior to beef protein. BAD-Artificial preservatives including BHA, BHT or Ethoxyquin..
Artificial colors. Propylene glycol, sweetners.
Canned foods are frequently made with higher quality ingredients
than their dry couterparts, most significantly, fresh whole meats. They also generally contain a higher percentage of meat
than dry foods, most dry food extruders can't handle foods that contain more that 50 percent meat. canned foods usually
contain way fewer chemical additivces than dry foods because of of the moist fragrant nature of the meat based contents. Canned food also tends to have a higher energy content, ounce for ounce. Its hight moisture content is helpful for dogs
with cystitis or kidney disease. the high moisture content can also help a dog who is on a diet feel full faster.. Additives
are unnecessary and rarely seen in canned foods due to the sealed oxygen free environment that a can offers.
COMMONLY
USED CANNED FOOD ADDITIVES: CALCIUM CARBONATE, CARAGEENAN GUM, DICALCIUM PHOSPHATE-A CALCIUM AND PHOSPHOROUS NUTRITIONAL SUPPLEMENTS,
DI-ALPH TOCOPHEROL WHICH IS VITAMIN E, FERROUS SULTATE -IRON, LECITHIN= ANTIOXIDANT,, LOCUST BEAN GUM-THICKENS AND STABILIZES,
POTASSIUM CHOLRIDE-A SALT SUBSTITUTE,& SODIUM ASCORBATE-VITAMIN C, ZINC OXIDE AS A SUPPLEMENT. First, Reject meat-by
products or poultry by products and artificial colors, flavors or added preservatives.By products are not as good as muscle
meat. reject animal fat and meat by products can be from any mammal or a mix of mammals. Look for foods with whole meat,
fish or poultry as the first ingredient on the food labels. Fish and chicken broth is better than water as a filler. Look
for whole grains and vegetables rather than reconstituted parts, i.e., rice rather than rice flour, rice bran, brewers rice,
etc.ADVANCED PET DIETS, ARTEMIS, AVO-DERM, BLUE BUFFALO, CALIFORNIA NATURAL, CANIDAE, DR'S FOSTER AND SMITH, EAGLE PACK
HOLISTIC SELECT, ENTREE FOR DOGS, EVANGERS FOR DOGS, EVOLVE, INNOVA, MERRICK, NATURAL BALANCE, NATURAL LIFE, NEWMANS OWN ORGANICS,
WELLNESS, SOLID GOLD. >MORE, BUT THESE ARE A FEW THEY SUGGEST FOR WET CANNED FOODS THEY DO NOT RECOMMEND, EUKANUBA,
IAMS, OL'ROY, PEDIGREE, SCIENCE DIET ADULT. DRY FOODS;APPROVED ARE ARTEMIS, BLACK TO BASICS, BLUE BUFFALO, BURNS,
CALIFORNIA NATURAL, CANIDAE, CANINE CAVIAR, CLOUD STAR KIBBLE, EAGLE PACK HOLISTIC SELECT, EVOLVE, FOUNDATIONS, FROMM, GO
NATURAL, INNOVA, INNOVA EVO, LIFESPAN, MERRICK PET CARE, NATURAL BALANCE ULTRA PREMIUM, NEWMANS OWN ORGANICS, NUTRISOURCE,
ORGANIX, PERFORMATRIN ULTRA, PINNACLE, PRAIRIE, PROMIUN EDGE, PRIME LIFE PLUS, ROYAL CANIN VET DIET, ULTRA HOLISTIC NUTRITION,
WELLNESS. REMEMBER, REJECT ANY FOOD CONTAINING MEAT BY-PRODUCTS .WATER INSTEAD OF BROTH.>WHOLE DOG JOURNAL SAYS, ALL
DOGS ARE DIFFERENT; SOME DO BETTER ON HIGHER PROTEIN FOODS, SOME DO BETTER ON LOWER PROTEIN FOODS. SOME CAN'T DIGEST CHICKEN.
SOME BREAK OUT IF THEY EAT WHEAT. TRY A CANDIDATE FOR A MONTH OR TWO. IF YOUR DOG HAS PROBLEMS IT DOESN'T MEAN IT IS A
BAD FOOD. IT JUST DISAGREES WITH YOUR DOG. GIVE THE FOOD aWAY AND TRY ANOTHER ONE.
Home made diet: You can eliminate preservatives or ingredients
to which the pug is sensitive, a natural diet is good. Recipes can include meat, rice, yogurt or cottage cheese and vegetables
such as asparagus, peas, carrots and tomatoes. 50% or 60% natual diet and the rest kibble. Compare the first five ingredients
in every dog food on the shelves. Look for products that list a meat, poultry or fish first. Look for products that
use whole vegatables and grains. Organic ingredients are very beneficial, especially for dogs who have cancer. Expect
to have to look harder and pay a lot more for the best products. No food maker can afford to sell beef muscle meat at the
price of chicken guts and feet. Obesity is a contributing factor in heart disease, collasping trachea and joint problems
in knees and hips. Get those pugs out and exercise, but not in the heat! I also suggest not to spay or neuter your pug until
at least one year of age per Blanche Roberts, show judge and breeder.
ORAL CARE
Adverse
Effects of Poor Oral Hygiene
I asked a Diplomate of the American Veterinary
Dental College, Jan Bellows DVM, of Hometown Animal Hospital and Dental Clinic in Weston, Florida, about the adverse health
impact chronic periodontal disease can have on a dog. This is what he had to say, "The toxins from periodontal disease
are absorbed into the dog's blood stream. As the kidneys, liver, and brain filter the blood, small infections occur causing
permanent and at times fatal organ damage. After periodontal disease is treated, and the owners give proper home care, most
dogs respond wonderfully due to the decreased pain and infection."
The
adverse effects of periodontal disease are due in part, as Dr. Bellows states, to the toxins the bacteria secrete and the
damage these toxins cause to delicate kidney, cardiac, and brain tissue. In addition, many veterinarians believe that
actual bacterial colonies can spread via the circulation and set up housekeeping within the animals tissues, commonly in the
heart valve areas, kidneys and liver. Far better than extracting teeth, performing gingival flaps, filling erosions or doing
root canal procedures, would be to prevent the health damaging periodontal disease in the first place.
VIRBAC C.E.T. ENZYMATIC TOOTHPAST AND ORAL HYGIENE RINSE IS A GREAT PRODUCT. SO MANY DOGS I HAVE MET HAVE HEART
MURMURS AND KIDNEY ISSUES AT A YOUNG AGE AND IT IS DUE TO POOR ORAL HEALTH. LIFT UP THE LIP OF YOUR DOG AND LOOK
AT THE CONDITION OF THE GUMS AND TEETH. START BRUSHING THOSE TEETH!!
ANESTHESIA Your pug is not able to handle anesthesia under one year and if you wait, hormones will help
your pug to develop the characteristics he needs to look like a beautiful, charming pug, male or female. Please if you
can, use my vet that knows everything about pugs and anesthesia. Dr. Micheal Butchko, 909-686-2242. They are a walk-in clinic.
Don't let a vet talk you into procedures you are unsure of. Surgical anesthesia is much riskier in the pug than
in many breeds because of their flat faces and bulky bodies. Make sure your vet you choose has the equipment with modern instruments
and see if your vet is knowledgeable about the differences between a short faced breed and others. THE VET SHOULD NOT USE
INJECTABLE ANESTHETICS ON A PUG. THE PUG REQUIRES LESS DRUG THAN PREDICTED BY ITS WEIGHT AND ONCE AN INJECTABLE IS GIVEN IT
CAN'T BE WITHDRAWN. Pugs need support of a breathing tube, (endotracheal tube) to be sure that their own windpipe, the
trachea, doesn't spasm closed and the dog suffocate.
Isoflurane, a gas anesthetic used in human operations
as well, is an excellent product because it does not need to be metabolized by the liver or the kidneys. It is very safe in
puppies and in elderly dogs.The dog is usually premedicated with a sedative to reduce the patient's anxiety and minimize
the amounts of more powerful anesthetics needed and with an antocholinergic (antisecretion drug)to reduce salivation and mucous
production in the airways and maintain the heart rate during the procedure. Barbituates, barbital, tend to slow the pugs breathing
too much.
Acepromazine (ACE)can cause faulty rhythms
of the heart. Some vets use a mixture of ketamin and valium delivered very slowly. Half the syringe is usually
only needed and a minimal amount. Dr Butchko uses the old fashioned drug, Morphine, in a very small amount. If there is decreased
breathing, it can be reversed with an antidote very quickly. During surgery: Have the vet put a lubricating ointment
in the eyes to protect the cornea from drying which can cause blindness. Warm water gloves next to the body may be needed
to keep the temperature up on the pug. IV drip should be in place to prevent dehydration, low blood pressure and in case of
an emergency, to provide needed medications. >The EKG machine will show the rate of the heart beat and rhythm. A blood
pressure meter, and oximeter are also used. The oximeter measures the oxygen to the tissues, and everyone in the room should
observe the breathing, blood loss and color of the tissues to detect early problems that may develop.Pugs are great house
companions, in fact the pug would suffer if left outside in the heat and the isolation would kill them probably. Their short
bradycephalic head shape nose causes extreme sensitivity to heat. Their solid little bodies holds in heat as well. So if you
don't have a retreat for them from the heat like a doggie door, then don't get a pug.
PUG CARE
They do enjoy walks, but he is not a jogging dog. Just a short walk in the cool of the day will
do. Some like water and chasing balls, so any exercise when it is cooler is great for your pug. Pugs will drown in water,
so be sure to get a doggie life jacket and supervision. No unfenced pools. Pugs are demanding of your attention so if
you want a dog that stays away, then don't get one. Your lap is the best place. Pugs just love to snuggle, snort and lick.
Pugs are ideal for kids, and love to be LUVED. Small toddlers should be watched because they tend to poke at there big
eyes. so they are prone to eye infections and loss of sight. They will let you do anything to them. Children should always
sit down when they hold the very young puppy. They can become injured very easily.
If you want a serious, working
dog, forget it. Pugs have no work ethic. They only try to please and only when they feel like it or there is something worth
while in it for them like food. So another no-no is snacking. You can kill them with food, but not LUV.
Obesity
causes many health problems including difficulty in breathing and they will typically live a lot longer if they are fit and
trim. They do snort, snore, sneeze but not drool, and do shed seasonally and sometimes all the time. So your clothes
will have hair on them most of the time. Wheat germ oil I think helps in the diet with the coat and a good diet. Black Pugs
have a single coat and Black pugs bred to fawn will have a mixed litter. Fawn pugs bred to fawn pugs will always have
fawn offspring.
Pugs will go home with anyone and accept anybody. They are very curious so they will travel to
find friends and then forget how to return home. Most pug people have arranged double doors or gates at each exit to the outside.
A fenced yard is a must and identification on his collar and microchip is a MUST. If you loose him you may not get him back.
If you have a garden in your yard or potted plants, Check out www.Petco.com/pet care article for deadly plants for dogs.
Avoid plants where dogs will run, Foxglove, bulbs, lupine, caster bean, cherry, oleander, mushrooms, azalea, rhododendron.
Call your vet immediatly if your think your dog or puppy has ingested any leaf, stem, bulb, or seed.
Pug
Care: Simple grooming is only needed such as brushing to remove loose hair, and Nose/wrinkle Care: wipe wrinkle above nose
at least 2 times a week. Use a soapless cleanser or warm water. Dirt and sweat collect and it starts to smell after a few
days.Never have a vet talk you into having the wrinkle cut off. NEVER
Clean ears weekly with a cotton ball and
peroxide. Never use a Q-tip. I happen to raise my litters beginning at 4 weeks to use a litter box! they will
continue to use it when the puppy leaves here if you put it in a more confined place, like an ex-pen, with his bed, bowls
and litter box in the same area. Multiple boxes in the house may work also, but the bigger the area, the more confused
he may get, and just do it where ever. Be diligent, have a routine when he first comes home for a week or 2 and
he may just go where you want him too.They will always go on the lawn as well. That's a natural thing.
If
you have an empty lap and a fenced yard, and if you want a funny, charming, dignified, outgoing, adaptable, devoted companion
who gets along well with adults, children, and pets of all kinds, who is easy to groom and who asks very little from you other
than loving him being with him and keeping him secure, then DO GET A PUG.
The
materials, information, and answers provided by and through this website are not intended to replace the services of a trained
pet health care professional or to be a substitute for medical advice provided by a qualified veterinarian or other appropriate
health care professional. You should consult your own veterinarian or other appropriate health care professional on specific
medical questions, including matters requiring diagnosis, treatment, therapy or medical attention.
DOGS WITH SPECIAL FACES
Most people are not familiar with the
term "Brachycephalic," but if you own a pug, Boston terrier, Pekingese, boxer, bulldog, shih tzu
or any one of the other breeds with "pushed in" faces, you should become familiar with this word. The word comes
from Greek roots "Brachy," meaning short and "cephalic," meaning head.
Brachycephalic dogs have been bred so as to possess a normal lower jaw, that is, one in proportion to their body
size, and a compressed upper jaw. In producing this cosmetic appearance, we have compromised these animals in many important
ways and you, as an owner, must be familiar with the special needs of your pet.
Spice Sarnoff
BRACHYCEPHALIC DOGS
ARE THE MOST LIKELY CANDIDATES FOR HEAT STROKE.
Altogether, the upper airways of the brachycephalic
dog compromises his or her ability to take in air. Under normal conditions the compromise is not great enough to cause
a problem; however, an owner should take care not to let the dog become grossly overweight or get too hot in the Summer months.
Be aware of what degree of snorting and sputtering is usual for your individual pet plus, should your pet require general
anesthesia or sedation, your vet may want to take extra precautions or take radiographs prior to assess the severity of the
syndrome. Anesthetic risk is higher than usual in these breeds, though under most circumstances the necessary extra precautions
are readily managed by most animal hospitals.
EYE PROBLEMS
With most of the nasal bones compacted, brachycephalic dogs tend to have trouble with the way their eyes seat in
their heads.
First, recognize the prominence of the eyes on these dogs. The boney eye sockets
are very shallow. This means that any blow to the back of the head, even a fairly minor one, can cause an eye
to pop from its socket and require surgical replacement. This can happen also with too much pulling against the leash if the
pet is wearing a collar. You may wish to consider a harness for your pet.
Sometimes, the
eyes are so prominent that the lids cannot close all the way over the eyes. This will lead to irritation and drying of the
center of the eye unless surgical correction is performed. If you cannot tell by watching your pet blink, watch as your pet
sleeps. Dogs who sleep without closing their eyes all the way could do with surgical correction.
Eyelid problems are common in these breeds. Look for persistent wetness around the eyes. In some dogs,
the shape of the eyelids prevents normal tear drainage and there is an overflow. This problem cannot be corrected surgically
and is not uncomfortable for the pet; however, there is a more serious condition which looks similar. This second condition
involves the rolling inward of the eyelids such that the lashes rub on the eye. Surgery may be needed to correct this
problem.
Chronic irritation will show as a pigmented area on the eye surface, especially on
the side nearest the nose. This is hard to see without a bright light but if it is noted, a search for the cause is warranted.
Depending on the location of the pigmentation, surgery may be recommended.
OTHER
CONCERNS
The normal dog has 42 teeth in its mouth. The brachycephalic dog also
has 42 teeth but a lot less space to fit them in. This means that the teeth will be crowded and growing in at odd angles which,
in turn, traps food debris and leads to periodontal disease at a far younger age than in non-brachycephalics. The earlier
you begin using home care dental products, the longer you will be able to postpone full dentistry under general anesthesia.
Skin fold infections are common amid the facial folds of the brachycephalic breeds. Be sure to
examine these areas periodically for redness. The broad headed nature of these breeds makes reproduction a tricky matter as
Caesarean section is frequently needed. Difficult labor is common and, as surgical assistance is often necessary, it is important
not to breed females with tracheal stenosis (see above). Breeding is best left to the experts.
Altogether,
the brachycephalic breeds show plenty of personality and intelligence just as all dogs do but because of their special needs,
they require some extra knowledge of their owners. If you have any questions about your brachycephalic dog, please do
not hesitate to call your veterinarian if you have further questions.
Hypothyroidism is the most common hormone imbalance of the dog. It seems like it would be a straight
forward problem: the body does not produce enough thyroid hormone, problems result, a test shows thyroid hormone level is
low, the hormone replaced given in pill form, problem solved. Unfortunately, it is not quite so straight-forward in real life.
This article attempts to review the issues relevant to this condition and the pitfalls that keep it from being a simple problem.
WHAT IS THE THYROID GLAND AND WHAT DOES IT DO?
The thyroid gland is an “H” in one’s throat. It produces two forms of thyroid hormone: “T3”
which is the active form of the hormone, and “T4” which is the inactive form created to circulate in the bloodstream.
When T4 is absorbed out the bloodstream and into tissue cells, it is converted into T3. Most of the circulating T4 is
carried by blood proteins and is not available for tissue absorption; the portion that is not carried by proteins (the so-called
“free T4”) is the portion that is able to enter tissues for activation.
Production
of T4 is regulated by the pituitary gland at the base of one’s brain. (This gland is called the “master gland”
as it regulates hormone production in the adrenal system, the thyroid system, the reproductive system and more). The
pituitary produces a substance called “TSH” which stands for “thyroid stimulating hormone.” When T4
levels are dropping, the pituitary gland stimulates the thyroid gland to make and release more T4.
Active
thyroid hormone serves as a sort of a volume dial for metabolism. Since virtually every cell in the body can be affected by
reduced levels of thyroid hormone it is not surprising that reduced levels of thyroid hormone lead to symptoms in multiple
body systems.
WHAT IS HYPOTHYROIDISM?
In
short, hypothyroidism is the natural deficiency of thyroid hormone. This deficiency is produced by immune-mediated destruction
of the thyroid gland, by natural atrophy of the gland, by dietary iodine deficiency, or as a congenital problem. In
the dog, the first two causes listed account for almost all cases.
Hypothyroidim generally develops
in middle aged or elderly dogs. Breeds with definite predisposition to develop hypothyroidism include: the Doberman pinscher,
the Golden retriever, the Irish Setter, the Great Dane, the Dachshund, and the Boxer.
MANIFESTATIONS OF HYPOTHYROIDISM
Hypothyroidism is a classical disease
with a classical collection of clinical signs. One particularly well published survey of 162 confirmed hypothyroid dogs
showed the following common findings:
88% had some kind of skin abnormality
40% had hair loss (often this starts on the tail leading to a “rat tail” appearance or
a bald area around the collar is created)
22% had skin infection (often dogs are scaly
and smelly due to an excessively oily coat)
14% had brittle or dry coats (often
the outer hairs break off leaving a short, softer under coat, classically described as a “puppy-like coat”)
49% were obese
48% were described as
lethargic or listless at home
36% were anemic (had a reduced number of red blood
cells due to slowed red blood cell production in the bone marrow.)
One classical
finding in hypothyroid dogs is a thickening of some tissues, especially of the face and head. The skin in particular thickens
leading to more skin folds and what is classically referred to as a “tragic face.” This thickening is called “myxedema”
and can occur in some other tissues as well (such as facial nerves – see later).
Cardiovascular Signs – Hypothyroidism interferes
with the electrical fibers that more or less provide the wiring for the heart. The rhythmic contractions of heart muscle as
normally stimulated by these electrochemical fibers. Abnormal rhythms or slow heart rate occur in as many as 26% of
hypothyroid dogs; still, the significance of this in terms of overall lifestyle is not clear. Many specialists feel
thyroid supplementation should be started at a lower dose for patients with obvious heart disease.
Neurologic Signs – According to surveys
of confirmed hypothyroid dogs, only about 2-4% have nerve problems. There are several syndromes reported.
“Polyneuropathy” – In hypothyroidism, nerves simply do not conduct
electrical impulses normally. This may account for some of the general weakness and listlessness seen in hypothyroidism.
Response to thyroid hormone therapy is rapid (improvement within the first week of treatment).
“Focal Neuropathy” – Single nerves can get entrapped as they exit
the skull or spinal cord as they (like other tissues) swell with myxedema. Pressure on these nerves can lead to paralysis
of the facial muscles and/or head tilt, bizarre eye motions and balance disruption (“vestibular disease”).
Central Nervous System- may represent abnormal
electrical conduction within nerves; however, vascular disease has been found in hypothyroid dogs with central nervous system
signs. Clinical signs have involved ataxia (drunken gait), hemiparesis (weakness in front and back legs on the same
side of the body), hypermetria (inappropriate measurement of steps), head tilt, circling & cranial nerve abnormalities.
It may take several months of therapy to see a response. Coma from myxedema in the brain’s tissues is a rare possibility
but has been known to occur.
Ocular Signs – Ocular changes are not common in hypothyroidism but the high levels of blood cholesterol and circulating
fat can sometimes lead to eye changes. When these changes are seen, often thyroid testing is recommended. Corneal dystrophy,
an abnormal change in the clear covering of the eye, is such an eye sign. This finding is usually represented as a small white
spot (sometimes a white circle) on the eye surface. At this degree it is only a cosmetic problem and does not interfere with
vision. In more severe forms, painful bubbles can erupt on the corneal surface leading to ulceration. Obviously, this form
would require treatment.
Conditions not proven (but previously suspected)
to be associated with hypothyroidism: megaesophagus , laryngeal paralysis, infertility, and behavioral aggression.
VON WILLEBRAND’S DISEASE
For a long time, von Willebrand’s
disease, a hereditary blood clotting disease, was felt to have an association with hypothyroidism (when a dog borderline for
von Willebrand’s factor levels became hypothyroid later in life, the abnormal clotting ability would become evident.)
This theory has largely been abandoned but there does seem to be a positive effect when a von Willebrand’s dog is treated
with thyroid hormone.
TESTING FOR HYPOTHYROIDISM
One would think testing for hypothyroidism would be simple: a blood test of the T3 or T4 level could be checked
and if it is low, the patient is hypothyroid. Unfortunately, the situation is rarely so simple.
Measurement of “T4”: The
T4 level (also called the “total T4” level) is measured commonly and is included in most routine blood panels.
It would seem that a low T4 would indicate hypothyroidism and a normal T4 would indicate normal thyroid function. Unfortunately,
it isn’t that simple. Dogs on certain drugs (most notably phenobarbital, prednisone or other corticosteroids, or trimethoprim sulfa) or with illnesses other than thyroid disease often have depressed T4 secretion. These dogs will have low
T4’s but are not hypothyroid. This means a normal T4 indicates normal thyroid function but a low T4 may or may not indicate
hypothyroidism.
Measurement of “T3”: If T3 is the active hormone, why can’t we just test blood levels of T3? Due to assorted compensatory
mechanisms, T3 levels often fluctuate into the normal range in even truly hypothyroid dogs. This means that T3 values
are virtually useless in diagnosing hypothyroidism.
Free T4 – T4 is the precursor hormone which is not active but it converted by body
tissues into T3 which is active. T4 exists in two froms: the form which is carried around bonded to a blood protein
(this is called “bound T4”) and T4 floating around loose in the bloodstream (called “free T4”).
Only free T4 can enter cells and be converted to T3 and the concentration of free T4 corresponds to thyroid hormone activity
where it counts (ie at the tissue level). Free T4 levels are less subject to fluctuate into a falsely low range in response
to non-thyroidal diseases or drugs than is a total T4 level.
Because free T4 levels are typically
1000 times smaller than total T4 levels and tests for free T4 have to work in such a way so as not to convert bound T4 into
free T4 and thus interfere with results. It is somewhat difficult to test for free T4 and the only acceptable way to do this
is by a method called “Equilibrium dialysis.” At this time most labs offer equilibrium dialysis
free T4 but it is important to realize that a free T4 level on a lab report is not an equilibrium dialysis free T4 unless
it specifically says so. (Equilibrium dialysis free T4 is sometimes notated fT4(ED)).
TSH Stimulation and Endogenous TSH levels – Before
there was readily available equilibrium dialysis free T4, the test that was felt to be the gold standard of reliability was
called the TSH stimulation test. In this test, a T4 was measured and then compared with a value drawn 8 hours after administration
of an injection of thyroid stimulating hormone. Inability to respond to TSH was considered indicative of hypothyroidism.
The problem was expense, the need for 8 hours of hospitalization, and the fact that injectable TSH was frequently off the
market. This test is rarely performed nowadays.
But TSH can be directly measured in a patient’s
bloodstream. The idea is that the pituitary gland should be secreting high levels of TSH in a futile attempt to stimulate
a diseased thyroid gland. Measurement of TSH level is apparently a very important means of diagnosing hypothyroidism in humans
and a canine version of the test was long sought. Unfortunately, when it finally became available, it was found that
many dogs with true hypothyroidism did not have elevated TSH levels as one would expect; still, this test is often helpful
in making the diagnosis of hypothyroidism.
Testing with a Trial of Medication – Sometimes the only way to test for hypothyroidism is to simply administer
the medication for several months and see what happens. Often an improvement in attitude and energy level is seen within
the first week. Hair re-growth takes substantially longer (typically 4 months minimum) as the follicles must “reawaken”
and then grow a hair long enough to create a visible coat change.
TREATMENT
OF HYPOTHYROIDISM
At least treatment of hypothyroidism is relatively straight-forward.
Hypothyroidism is treated with oral administration of thyroid hormone (T4). Even hypothyroid dogs are perfectly capable of
converting T4 to T3. Pills are given usually twice daily to start but may be dropped to once a day after good thyroid
control has been achieved.
There are many brands of thyroid supplementation available and prices
are somewhat variable depending on the manufacturer.
TREATMENT
IS FOR THE LIFE OF THE DOG.
Occasionally
we are asked if it is reasonable to use dried or powdered thyroid glands of hogs or cattle as a more “natural”
form of treatment. The answer is simply “no.” These products are not produced with adequate quality
control to insure that they contain a reliable amount of thyroid hormone. Each dose may be completely different when
such a product is used.
Re-testing later on? Whenever
an animal goes on a medication long term, periodic blood testing is a good idea. In the case of hypothyroidism treatment,
it is important to know if the medication dose is too low or too high. Thyroxine (T4) is a very safe medication but if it
is not given in adequate doses, obviously the patient will not be adequately treated. If the dose is too high and given for
too long a time, excessive water consumption, weight loss, and restlessness can result.
Monitoring
with T4 The lowest thyroid level of the day is found by taking the blood sample right
before a tablet would normally be given. The highest level of the day is found by taking the blood sample 4-6 hours
after it is given. Expect one or both such tests to be periodically recommended. Our hospital recommends some type of
blood test monitoring annually.
Monitoring with TSH level The canine thyroid stimulating hormone level (abbreviated “cTSH”) does not seem to require any particular
timing issues and can be run on a blood sample taken any time of the day. The cTSH level will not indicate whether or
not the thyroid dose is too high but is quite accurate at determining if the level is too low. (Inadequate treatment is associated
with high TSH levels indicating that the pituitary gland is vainly trying to stimulate the thyroid gland with high levels
of stimulating hormone). This test may be run instead of or in addition to a T4 level when it comes time to monitor
thyroid hormone treatment.
IS THE DIAGNOSIS CORRECT?
Because of difficulties in diagnostic testing methods (especially before 1995), many dogs have been erroneously
diagnosed with hypothyroidism and have been on medication for years. If there is any question about a patient and one wishes
to re-test now that newer testing methodologies are available, thyroid hormone supplementation must be discontinued at least
2 months for blood testing to be valid. If possible, medications known to interfere with testing should be discontinued
for testing (though this is obviously not always possible).
(web page for soloxine, one of the more prominent brands of canine thyroid supplements)
Heart Enlargment Heart enlargement usually occurs because the heart muscles are weakening or one or more
heart valves are not working fully. This makes it harder for the heart to move blood efficiently and some blood isn't
pumped out of the heart chamber. The heart still needs to move as much blood as the body needs, though -- so the heart enlarges
in an attempt to hold both the amount of blood it can no longer get out of the chamber the valve leaks into and the amount
that it would have normally pumped into the circulation. This causes the heart to enlarge. In situations in which the heart
muscle is failing the enlargement occurs because the muscles simply are not strong enough to hold the normal fluid volume
and they just expand.
Sometimes the heart appears to be enlarged when it actually isn't. This happens when
there is a tumor attached to the base of the heart or when there is blood or fluid accumulation in the pericardium, the sac
that contains the heart in the chest. An ultrasound exam is helpful in distinguishing these problems from the valve or muscle
weakness problems.
Seek a second opinion. I would try a specialist as they tend to have more experience and often
better equipment for interpreting how severe a problem is.
Edited to add: Recent studies are showing that if a
dog's diet is low in Taurine, they see future heart problems. Dietary supplements can help such as:
Taurine
and Dogs - amino acid produced naturally by dogs. This substance helps to regulate heartbeat, helps calcium absorption during
times of reduced oxygen and protects the heart from calcium overload. In order to produce taurine (from vitaimin B-6), dogs
also need the substances methionine and cystine. Other good supplements are vitamins C and B-1. Taurine has no known side
effects, but safe dosage should be based on the recommendation of a Veterinarian.
Carnitine and coenzyme Q are
also often recommened by Veterinarians as they help with dog enlarged heart by bringing fatty acids into muscle cells which
is then converted into the needed energy. This substance is considered safe. Do not use D-carnitine or DL carnitine which
causes problems with muscle function and possibly angina.
Your Money-Pets
But
one of the biggest contributors to higher consumer costs was a comprehensive veterinary market study issued in 1999 by consulting
firm KPMG International.
It
found that the profession -- long stuck in attitudes personified by folksy James Herriot books such as "All Things Bright
and Beautiful" -- was charging too little. And worse, veterinarians were giving away care for free.
"Opportunities
abound," the executive summary of the study stated, but vets were held back by "inefficient structures, inappropriate business
practices and attitudes."
Many
professionals in the field, faced with stagnating incomes, took heed.
"It
was a sea change for the veterinary profession," said Jim Flannagan, marketing director of the trade association. And soon
thereafter came sticker shock for clients.
"Even
if your pet is perfectly healthy, vets are now ready with a battery of tests, shots and even X-rays for the annual wellness
checkup," Jeff Blyskal, a senior editor at Consumer Reports, said in a controversial 2003 article.
Not
all veterinarians take it that far. And as Hammer pointed out, medical care for animals still costs only a tiny fraction of
treatments for the same conditions in humans.
But
given the relatively scant use of pet insurance, you're likely to pay the vet's full bill out of pocket. VPI, the largest
company in the pet insurance field, maintains policies on about 450,000 dogs and cats, less than 1% of the 150 million total
dogs and cats in the country.
So,
here are some tips -- culled from nonprofit animal groups, industry watchdogs and veterinarians themselves -- on how to take
the bite out of pet health costs.
* Know your breed. Some breeds are more prone to expensive hereditary ailments. In analyzing data compiled by Purdue University's Veterinary Medical
Database, Consumer Reports
found, for example, that hip dysplasia was most commonly found in Labrador retrievers, golden retrievers and German shepherds.
(You can read the Consumer Reports article at www.consumerreports.org/Pets.)
* Know your breeder. If you want a purebred, you're much better off buying in a situation where you can speak directly to the breeder.
You want to make sure the animal was not the product of a puppy or cat mill, in which females are kept nearly constantly pregnant
to ensure high volume. Not only are these mills inhumane, they're also breeding grounds for expensive health problems.
* Get a mutt. They're not nearly as likely to suffer from hereditary conditions. But of course, they can still get sick, and expensively
so.
* Get a cat. According to the American Veterinary Medical Assn., cat-only households spent a mean of $244 on veterinary expenses
in 2006. Dog-only households spent a mean of $395.
* Use low-cost clinics. Many procedures -- such as spaying and neutering, vaccinations and the insertion of identification chips -- can be
done at discount or even free clinics, some of which are government-sponsored. Information often is available at nonprofit
shelters.
* Look for vet specials. In-office clinics can offer price breaks on vaccinations, teeth cleanings and other procedures. Also, there are senior
citizen discounts and package plans for puppy or kitten care.
* Go online. If a medication is not needed immediately, you can sometimes save money by ordering it online rather than buying
at a veterinarian office. Suppliers include Petmed Express ( www.1800petmeds.com),
PetCareRx (www.petcarerx.com)
and Foster and Smith ( www.drsfostersmith.com).
* Spread out your payments. It doesn't lower bills, but some veterinarians offer payment plans from CareCredit, a credit company owned by GE
Money. One type of plan allows you to make no-interest, monthly payments on an approved schedule. But if you miss a payment,
you get slammed with interest charges.
* Comparison shop.Los Angeles resident Aida Akhavan was told that her dog needed surgery that would cost about $5,500.
She called numerous veterinary surgeons before finding one who agreed to do the operation for $1,500.
* Ask about alternatives. If your veterinarian suggests an expensive treatment, ask about less costly methods that could also be effective.
* Consider insurance. Because of substantial deductibles and exclusions in pet policies, according to the Consumer Reports study, pet owners might be better off putting
what they pay in monthly premiums into a savings account. But coverage could play a major role in covering bills for very
expensive conditions.
* Limit tests. Extensive blood tests and other diagnostic tools can be nearly as expensive as the treatments. If a client is not
able to pay for a wide range of tests, some veterinarians will offer to proceed based on best guesses. "We make the client
sign a waiver saying they understand the risks taken without a full diagnosis," said veterinarian Sylvia Domotor, who heads
a four-doctor practice in Monrovia.
It's
a route she reserves for serious cases.
"Sometimes
we have to get creative," she said, "but I'm not going to let that pet walk out the door untreated."
