Vet Blog
11/02/09
 A few days ago a very nice woman brought her Miniature Schnauzer to my office. The dog had been acting agitated for several days. He seemed reluctant to sit down, but when he finally was seated the dog had a tendency to rub his hind end on the floor.
A thorough general physical examination was unremarkable (unremarkable is how veterinarians say normal–we can’t actually say normal because the word normal, according to some malpractice insurance providers, implies things that can be very dangerous if we have missed something subtle).
The symptoms were consistent with an anal gland problem. If you never have heard of anal glands, consider yourself lucky. You may want to stop reading now in order to preserve your innocence.
The anal glands are bulbs located adjacent to the anus. The bulbs are connected to the anus by ducts. The glands produce a fluid with a unique odor. It smells like a combination of rotting fish, feces, and tear gas.
Cats and dogs have anal glands. Skunks do too–the glands are modified in skunks and are responsible for skunks’ unique smell.
The anal glands normally empty when a cat or dog defecates. In some instances, however, this does not happen as it should. The result is anal glands that are impacted and distended. Animals with impacted anal glands often drag their rear ends along the ground.
Impacted anal glands are treated by manual expression. The most effective means of manually expressing anal glands involves inserting a finger into the animal’s rectum and massaging the accumulated fluid out of the glands.
This is what I proposed for my patient whose hind end was so uncomfortable.
The owner accepted my proposal. However, she declined to accept my recommendation that the procedure be performed in a section of the hospital where only employees were present. She asked to be present while her dog’s anal glands were expressed.
Palpation of the glands revealed that they were both markedly distended. Both glands were expressed with ease. A large amount of fluid was released.
As the smell of the fluid filled the room, the owner of the Miniature Schnauzer soon was ill at ease. She complained of light headedness and dizziness. She asked to sit down. She retched and nearly vomited.
The nurse and I escorted her to some fresh air. She rapidly recovered. I blame myself for not warning her vehemently enough that anal gland fluid smells really bad.
After enough time one becomes inured to the smell of anal glands. To the uninitiated, however, it can be overpowering.
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10/31/09
 I love Halloween. Sadly, tonight I am working at the veterinary emergency hospital. And I already know what the night is going to bring. People and dogs are very predictable.
People will leave Halloween candy unattended, in many cases just for a moment. Dogs will pounce upon and devour the candy, wrappers and all. I see the consequences of this every year, time and time again.
Fortunately, most Halloween candy contains milk chocolate (click the link to learn more about chocolate toxicity in dogs)–one of the least dangerous types. And many seasonal treats are made mostly of nougat, which isn’t technically toxic. The wrappers generally are harmless.
But any dog that eats enough Halloween candy is at risk of more than chocolate toxicity or an upset stomach. Each year I treat several dogs for pancreatitis after they devour a stash of sugary treats.
Pancreatitis is a life-threatening inflammation of an organ that is involved in the digestion of food. Dogs who recover from pancreatitis are at increased risk of diabetes later in life.
Have fun this Halloween. But watch the dog!
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10/30/09
 Dr. Barchas,
One of my Pit Bull rescues has patchy bald spots on his face. The vet has tested several spots on two separate occasions and consistently show negative for mange. Any ideas what else could be causing this?
Thank you!
Paoline
Atlanta, GA
You don’t mention how old your dog is. If he is less than two years old, I am guessing that puppy mange is causing the bald spots.
Yes, I know, your dog twice tested negative for mange. But the test for puppy mange (which is caused by a mite called Demodex) occasionally yields false negatives. The test involves scraping the skin with a scalpel blade. This process harvests skin (and any parasites contained within the skin) from the affected area. The harvested sample is scanned under a microscope. If Demodex organisms are seen, the diagnosis is clear. If none are seen, then one of two things could be going on: either puppy mange isn’t causing the spots, or no Demodex organisms happened to be present in the area that was scraped.
Puppy mange most commonly causes patchy baldness without skin irritation (the spots generally aren’t red or itchy). The spots most commonly occur on the face. In my experience Pit Bulls are extremely susceptible to the syndrome.
If your dog’s spots aren’t bothering him and they aren’t coalescing to take over his face, I recommend that you try to wait it out. Almost every dog outgrows the problem by two years of age.
For more information on the syndrome, go to my website:
http://drbarchas.com/demodex
Photo: no sign of puppy mange on Tank.
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10/28/09
 Swine flu, also known as H1N1 influenza, has been dominating the news recently. The viral strain appears set to cause the first influenza pandemic in a generation. Influenza pandemics are big deals. The pandemic of 1918-1920 caused more people to die from flu than from bullets or bombs during World War One.
Influenza viruses are known for infecting multiple species–as the name would imply, swine flu developed in pigs and then spread to people.
This may lead pet owners to wonder: can cats and dogs catch swine flu?
The answer appears to be no. DVM Newsmagazine reports that there is no evidence cats or dogs can contract, carry, spread, or suffer illness from H1N1 influenza.
H1N1 influenza has been isolated from a ferret. Fortunately at this time there is no evidence that ferrets can spread the disease to people.
Although it appears we can rest easy about our cats and dogs catching swine flu, remember that cats are susceptible to an even scarier form of influenza: bird flu (also known as H5N1). Cats contract bird flu by preying upon or being fed raw bird meat. The virus does not appear capable of spreading from cat to cat. That is a good thing, since the fatality rate among cats infected with H5N1 appears to be 100%.
Fortunately, it is easy to protect your cat from H5N1. If you feed your cat commercial or cooked food and keep him indoors, his chances of catching bird flu are nil.
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10/27/09
 Cody is an adorable two-year-old Lab/Beagle cross who saw me at the emergency clinic on Sunday. He clearly is a very well loved family pet.
Friday was Cody’s second birthday and on that night the family threw him a birthday party. Twenty-five people attended. Many of them were children. All of them brought gifts for Cody. Most of the gifts were edible.
During the party Cody received and immediately devoured several rawhides, pig’s ears, and sundry other dog treats. He also took the opportunity to hoover up any human food that was dropped during the party. His owner mentioned that one partygoer accidentally dropped an entire hamburger on the floor. Cody wolfed it down as the crowd sang Happy Birthday.
As the owner recounted this story I thought to myself that this massive amount of dietary indiscretion sounded like a good way for a dog to contract pancreatitis. Pancreatitis is a life-threatening inflammation of an organ (the pancreas) that is involved in the digestion of food. I began to get worried about Cody.
The owner’s story continued. The party ended uneventfully and everyone went to bed. The next morning (Saturday) Cody woke up feeling awful. He could barely move. He had no appetite (which, the owner assured me, was most extraordinary for Cody).
The owner was not very worried initially. But by Sunday afternoon Cody’s condition still had not improved. He refused to eat, and he still was extremely lethargic. He therefore wound up in my office.
When I examined Cody I was troubled. He was very lethargic. His abdomen was bloated and painful. He was extremely dehydrated. I recommended hospitalization and tests to rule out a serious problem such as pancreatitis or a foreign object (such as an undigested fragment of food) in his intestines.
Cody seemed to feel better after he was re-hydrated. And I was happy to see his test results. He tested negative for pancreatitis and other serious metabolic disturbances. His X-rays were not consistent with a foreign object in his intestinal tract.
However, the X-rays did show a very large amount of food in Cody’s stomach. This was most extraordinary in a dog who hadn’t eaten for two days. And it led to a diagnosis in the case–the best possible diagnosis considering the circumstances. Cody appeared to be suffering from a resolving case of glutton’s remorse (term coined by my friend Reading Maley).
Canine glutton’s remorse occurs when a dog overeats in the extreme. The stomach becomes massively and painfully distended, and the dog feels markedly ill for several days as the food slowly passes out of the stomach and through the intestines. The condition is painful and rarely triggers a life-threatening condition called bloat. However, most young dogs make it through episodes of glutton’s remorse unscathed. In my experience the condition is most common in Labs and Beagles (remember that Cody is a Lab/Beagle cross).
The nursing staff administered an enema to Cody in order to help keep everything moving through his system. I expect him to make a complete recovery. And I imagine that he never again will party as hard as he did on Friday night.
Photo: Feed me. Please. By Mzelle Laure.
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10/22/09
As I was driving home from work this morning after a night shift I heard a story about the health care debate on the radio news. The topic was one of the most poorly understood concepts in the debate: unnecessary diagnostic testing.
Many people have cited the elimination of unnecessary tests as a way to reduce health care costs. As a medical clinician I would like to know how an unnecessary test is defined.
It is not possible to know whether a diagnostic test is necessary without knowing the results. In other words, it is not possible to know whether a diagnostic test is necessary without running it. Only with hindsight can one determine whether the test was needed.
Consider the following example from veterinary medicine. Imagine your dog has suffered a two day period of lethargy and poor appetite. You authorize your veterinarian to run basic blood tests. The results are normal, but the ratio of blood sodium and potassium levels is on the low end of what is considered normal.
In cases such as this, the overwhelming majority of dogs do not have a serious condition. Transient gastrointestinal upset due to dietary indiscretion is most likely. An adverse reaction to a mild toxin also may be to blame. A self-limiting viral infection or dozens of other mild pathologies could be the cause of the issue. All of these problems generally resolve on their own.
But a much more serious problem can cause the symptoms and initial test results I have described: Addison’s disease. Addison’s disease is much less common than the milder problems I have described above. But if it is not detected and treated it is deadly.
The test for Addison’s disease is specialized and expensive. It is non-invasive and low risk. Without the test, it is not possible to know whether the syndrome is causing the symptoms. The treatment for Addison’s disease can be harmful to dogs who don’t have the syndrome.
Imagine that one out of every thousand dogs with lethargy, poor appetite, and a borderline sodium to potassium ratio has Addison’s disease. If a thousand dogs develop the symptoms I have described (and initial test results are as I have described), 999 of them will get better without treatment. One will die.
Those may sound like good odds. But what if your dog is the one?
If you think a one-in-a-thousand chance isn’t bad, I hope you don’t buy lottery tickets. The odds of hitting the mega jackpot make one-in-a-thousand look almost certain.
When I treat dogs like the imaginary one in this post, I always recommend the test for Addison’s disease. After I get the results, I usually learn that the test was not necessary. But every once in a while the test saves a dog’s life. In those instances the test was very necessary indeed.
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10/20/09
 A most remarkable and unnecessary case was at the emergency hospital over the weekend. If a human being had wound up injured in the manner described below he would have been a laughingstock.
Of course, in this case the dog was not at all to blame. His owners, on the other hand, could use a healthy injection of common sense.
The dog was a young, active large individual. He liked to run. The owners were more sedentary in nature. Recognizing that their pet needed exercise, they took him to a quiet road and set him free. They then followed behind in their car.
They followed too closely. The dog became tired and slowed down. Can you guess what happened next?
Fortunately, although the dog was injured when his owners struck him with the car, the injuries were not life-threatening. Pain killers, antibiotics, wound care, and nasal oxygen support were all that he needed.
But I am amazed that his owners failed to foresee the likely consequences of their way of exercising the dog. I worry about that dog’s future.
Photo: Blix demonstrates safe dog-car interaction. His risk of injury is minimal.
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10/19/09
 I have a year old chihuahua and for some reason her feet smell…I have washed them on and off which helps for a bit but it keep’s happening. Any idea whats going on with my baby’s feet?
Joann
Ridge, NY
Do your dog’s feet by any chance smell like corn chips? I am guessing that you are experiencing the infamous syndrome that Dogster folks refer to as Frito feet (click the link to see what I have written on the subject before).
Dogs’ feet have areas of reduced air circulation. The spaces between the toes on the top of the feet and between the pads on the bottom of the feet are most prone to this. The reduced air circulation in these areas allows more moisture to build up in these spots than elsewhere on the body.
Bacteria and yeast grow in slightly greater numbers in these humid areas. The bacteria and especially the yeast give off a slight odor that causes the characteristic smell of Frito feet.
The overwhelming majority of dogs with Frito feet do not have pathological infections. The syndrome is harmless. Eliminating the odor is very difficult, but it also isn’t necessary.
If your dog’s foot odor is truly offensive you should have a vet check him out to confirm that the skin is healthy and that something else isn’t going on. But I’m guessing that nothing’s wrong.
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10/17/09
 Vaccines, as I have mentioned many times on this blog, are perennially controversial. Many people worry that pets are vaccinated too often. Experts voice concerns that over vaccination may lead to autoimmune disease. Leukemia and rabies vaccines in cats have been linked to cancers at the injection sites.
The obvious goal for every veterinarian and conscientious pet owner should be to vaccinate pets neither too frequently nor too rarely. In an ideal world, we would vaccinate pets exactly as often as necessary. I predict that in the future this will be the norm. But as of 2009, it is impossible to say how often pets need vaccinations.
Some facts are clear. Juveniles (puppies and kittens) need vaccines more often than adults. Animals with different lifestyles need different vaccination protocols. And most important, every individual responds differently to vaccines. Every individual therefore has unique needs.
Measuring those needs is impossible. Blood tests called titers give some idea of a pet’s response to previous vaccinations, but titers measure only half of the picture. Titers measure antibody levels in the blood. However, antibodies cannot function without another component of the immune system called cell-mediated immunity. At this time there is no way to measure cell-mediated immunity. Therefore there is no way to measure a pet’s true level of immunity to disease.
I agree that many pets are vaccinated more often than necessary. On several instances I have treated animals for autoimmune disease and wondered whether vaccines might have contributed to the problem.
However, on hundreds of instances I have treated canine parvovirus. In every single one of these cases I knew with certainty that vaccination would have prevented the problem. I never have treated a properly vaccinated dog for parvo. The vaccine works.
I euthanized a 12-week-old puppy today because of parvo. A vaccine could have saved his life if it had been administered at the right time.
Over vaccination is a bad thing. Veterinarians and pet owners should work to prevent it. But don’t forget that under vaccination is even worse.
Your best option as a pet owner is to find a good vet who will take the time to discuss the controversies surrounding vaccines. Tailor a vaccination protocol to your pet based upon his or her needs, age, and lifestyle.
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Categorized Food for Thought.Tagged autoimmunedisease, cats, dogs, fibrosarcomas, leukemia, parvo, parvovirus, rabies, titers, vaccines, VAS.
10/16/09
 I have a nine-month-old mix — we got her at a rescue center and they do not know for sure her breed. We were told that she would weigh between 25 and 35 pounds (by our vet). Well at 55 pounds of solid dog I have a question – How many times a day should we feed her and how much? The vet thinks she has the following breeds mixed – Husky, Welch Corgi, Lab and Pit bull. She has short hair and seems to shed about every 4 months.
Nancy
Goodyear, AZ
You illustrate in your question the reason why I never try to guess how big a puppy will be when full grown. This is especially true of non-purebred dogs. Dogs are like people. Some grow early, and others grow late. Either can be normal, and this makes it devilishly hard to guess how big a puppy will be when it is an adult.
The tallest person in a sixth grade class may be among the shortest of the cohort during high school graduation. And the shortest person in the sixth grade could be among the tallest in the twelfth. In general I refrain from speculating on the final size that I expect juveniles of any species to reach.
But your question was about feeding. How much should a dog (or cat, or human) eat? There is no one-size-fits-all answer to that one. Different lifestyles, activity levels, and baseline metabolisms all come into play. The type of food eaten is important, too. Active dogs that eat low calorie food need to eat large amounts in order to survive. Sedentary indoor cats that eat calorically dense diets can get by on close to nothing.
Formulas exist to calculate energy needs for pets. I haven’t used them in years, but I do recall that they involve body mass to the 3/4 power. I also recall, vividly, that the formulas are useless. They make great theory, but real life is more complicated–and at the same time more simple.
I recommend that you feed your pet the amount of food necessary to grow, thrive, and maintain a healthy body weight. That may sound obvious, but it is true. The only method that truly works in my experience is trial and error. If your pet is overweight, feed him less. If your pet is underweight, growing or training for the Iditarod, feed him more. Tinker until you get it right.
Two meals daily is the standard for dogs in the United States, but this rule isn’t set in stone. Some animals, most notably small breed puppies, should be fed more often (young Yorkshire Terrier and Chihuahua puppies should be fed at least four times each day to prevent low blood sugar). I have some patients that eat three square meals every day. Others eat only one (although I generally don’t recommend one meal each day due to an anthropomorphic opposition to going 23 1/2 hours without food).
For most pets the number of meals fed doesn’t matter anywhere near as much as the total amount of food offered. Your dog, as you mention, is “solid”. To me it sounds like you’re doing things right.
Photo: Pogo’s weight looks fine.
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A few days ago a very nice woman brought her Miniature Schnauzer to my office. The dog had been acting agitated for several days. He seemed reluctant to sit down, but when he finally was seated the dog had a tendency to rub his hind end on the floor.
You have questions. 