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Demodex

A localized demodex infection over the left eye.

When I picked up Pooh Bear* for his walk on Tuesday, I immediately noticed something was off. His left eyebrow, usually bushy, was sparse, as if he had done a face plant and scraped the fur off in the process. Pooh’s parents had noticed the change too and headed to the vet for a diagnosis. The unusual location of the spot, over his eye, made the possibility of a hot spot unlikely. Hot spots can form in response to any kind of irritant but grow and linger when the dog scratches and licks the area. Without a monster tongue or ultra flexible paws, Pooh would have trouble getting enough leverage to create a full on hot spot on his eyebrow. Pooh’s dad’s money was on Demodex and the vet confirmed his suspicion. Little Pooh was suffering from an infestation of mites!

Demodex, a form of mange, is a genus of tiny, parasitic mites that feed on the skin cells and oils found in hair follicles. There are a number of different species which can infect mammals of all kinds (including humans) but demodex canis is the type most commonly found on domestic dogs. Many veterinarians believe that all dogs have a certain number of demodex mites living on their skin and most will never develop a full-blown infestation. But some dogs have fewer of the natural antibodies that help to defend them against demodex and may develop skin lesions in response to nutritional or environmental stress or an otherwise compromised immune system. Demodex is also common in newborn pups with undeveloped immune systems that may be infested by mites living on the mother’s skin when suckling. Despite popular belief, it is demodex does not seem to be hereditary, passed from mother to fetus.

Demodex infestations can be localized, like the single spot above Pooh Bear’s eye, or more generalized and found in multiple spots on the body. Localized infections are easier to resolve and may even do so without any veterinary intervention (however, adult on-set demodex may signify a more sreious underlying cause such as hypothyroidism, adrenal gland disease, or even cancer so it is important to take your pup to the vet to have him checked out). More wide-spread infestations may require closely clipping your dog’s fur, regular dips in benzoyl peroxide and Amitraz (a miticidal treatment), and possibly antibiotic therapy.

It is uncommon (though not impossible) that canine demodex will infect humans and, because demodex mites are likely present on all dogs, there is little risk that a healthy dog that comes in to contact with one suffering from a demodex infection will develop an infection of his own. To eliminate any real risk to others, though, keep your dog away from young puppies and older or sick dogs while he is suffering from a demodex infestation.

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Mobility

When Ginny began to have more trouble than usual standing about three weeks ago, we visited the vet. She was diagnosed with nerve damage in her spinal cord – a condition that would continue to deteriorate with time. Unusual in a 30lb dog under ten years of age, the vet believed she may in fact be more like 10-12 years old, instead of the 8-9 years she was identified as several months ago. We were given a prescription for a ten-day course of non-steroidal anti-inflammatories and asked to call with an update when the medication was complete.

I called Dr. Leyba at San Francisco Pet Hospital first thing in the morning on Monday and arranged to bring Ginny in the following day. When I returned to pick up my girl that afternoon, Dr. Leyba sat me down for a long discussion. From his previous examination, the doctor believed he would find the issue in the lower spine or hips of my little dog. He ordered x-rays but after close examination, saw nothing unusual; spacing between the vertebrae was wide and even. He extended his search further up her spinal column towards Ginny’s head and there, in her neck, he found the issue among three cervical vertebrae. Whether from past injury or a deformity, two of these small but vital bones had grown to compensate for the problem so that they are now almost fused together. A third vertebrae, not yet fused to the others, is separated by only a thin gap.

Spinal injuries – whether in the neck or back – can have a major impact on mobility. In Ginny’s case, the muscles around her fused vertebrae are likely stressed and causing spasms that are giving her significant pain and affecting her ability to rise from laying down. The doctor prescribed muscle relaxants and steroids to bring down her level of pain and strengthen her movements and discussed our choices.

There is no easy fix here. Surgery is an option but, as Dr. Leyba told us, as with any neck or spinal surgery the procedure is painful, recovery long, and improvement not guaranteed. Management may be the more appropriate choice in a dog of Ginny’s age, but management won’t actually change anything – it will simply help to keep her as comfortable as possible for as long as possible. In Ginny’s case, Dr. Leyba recommended several things, some of which we were already doing:

– Walking Ginny only with a harness, not with a collar so as not to put pressure on her neck.

– Carrying Ginny up flights of stairs.

– Decreasing Ginny’s activity. Walking is still a great option for her but should be done in shorter bursts of 15-30 minutes. Ginny’s not a rough-houser or ball player, but if she was, we would have to cut that out.

– Giving Ginny Glucosamine to help her bones and joints.

– Keeping Ginny at the proper weight.

– Continuing steroids for Ginny after her initial course is over. We will likely begin at a pill every other day but this will increase in frequency as she ages.

– Acupuncture.

Eventually, Ginny’s pain will become so severe that she will need daily opiates and, when those no longer help, the time will come to consider putting her down. Dr. Leyba feels confident that Ginny still has a couple of good years left if we pay close attention and do everything we can to keep her comfortable. Sadly, this is always a hazard of adopting a senior dog but I do not regret my decision. As when Franny came to me as a hospice dog, I am honored to give Ginny the best life she can have over her remaining years.

Heavy panting

Some nights Ginny wakes me up with heavy panting. Occasionally she gets to her feet and wanders in to the kitchen to gulp water and then returns to bed. But last night she lay there for hours, panting. Maybe she’s just feeling too lazy to get up, I thought. I grabbed a bowl of water and offered it to her. She drank a bit then turned her head away. A little later, the panting began again and she drank a little more water. But the panting continued. This is unusual; her nighttime panting is usually brief and easily quelled.

Panting is normal in dogs and usually comes after exercise or in excessive heat. Panting is also a common sign of stress and it can indicate chronic illness such as congestive heart failure, Cushing’s Disease, or respiratory disorders. Franny, my beautiful fospice dog who passed away with cancer in November, had Cushing’s. She would pant at night, too, but Franny drank ridiculous amounts of water, Ginny doesn’t. She also doesn’t display any of the other common symptoms like hair loss (on the contrary, Ginny just keeps getting fluffier) or a pot-bellied appearance. While heart failure is always a possibility, Ginny had a series of blood tests done a little over a month ago and there was nothing unusual. Respiratory failure often leads to heavy breathing throughout the day and Ginny rarely pants at unexpected times other than over night.

Heavy panting may also accompany an injury or pain. This is what concerns me. Since Ginny arrived in my home, she has dragged her back leg. It’s a stiffness that doesn’t seem to bother her – she limps a bit but enjoys walks – and manipulating her leg doesn’t cause her to flinch. But the last week or two I have noticed that Ginny’s leg has become more stiff. She has more trouble getting up and takes longer to get a “normal” gait. This change, combined with last night’s panting, may indicate that Ginny’s pain has increased. Ginny topples over quite a bit and has lately missed a occassional stair and slid backward down a couple of steps. Whether she does this because of pain or she has inadvertently increased pain, I’m not sure, but I do know that sudden behavior changes often indicate a health problem. So what next? A visit to our friendly vet!

Tears: not just for crying anymore

A few weeks ago I go an email from Bethany*. Her family had recently added a new canine member, Chloe*, and she was looking for a little guidance in furthering her training. At the age of three, Chloe had never been housebroken or taught basic commands so we set to work turning her in to a tiny, obedient ball of white fluff. A few sessions in to our training, Bethany asked if I knew anything about the peach colored stains developing under her eyes, on her paws and on her rear end. Though I was used to seeing this discoloration on white dogs, I had to admit that, no, I didn’t know anything about the staining. So, to the internet I went for a little research on the topic.

Discoloration on a dog’s coat is often caused by a yeast infection called Ptyrosporin or “red yeast” that develops from tears and saliva – though other possible causes include the oxidation of saliva or artificial dyes from foods and toys. This discoloration is most common in dogs with white coats but any dog can have excessive tearing if the eye sockets are too shallow, hair grows too close to the eye, or tear holes (puncta) become blocked due to inward turning eyelids or previous eye infections or damage that causes scar tissue. Some dogs – especially short-nosed breeds like Pekingese and Maltese – are more susceptible to these eye issues.

In the case of blocked tear ducts, there may be surgical options that can improve the drainage around your dog’s eyes but those dogs with shallow eye sockets are, unfortunately, stuck with them. In any case, minimizing irritation and discoloration is an option. Keeping hair short around the eyes can help, so can keeping the eyes clean. Your vet may prescribe antibiotics to reduce or eliminate tear stains but going this route could be dangerous if the bacteria forming the stains becomes drug resistant. If the cosmetic issue is paramount for your pup, there are a number of tear stain removers on the market. Carefully wiping the stains with hydrogen peroxide may also help to whiten the area.

If your dog is impacted by the staining of red yeast, check with your vet before beginning a whitening routine to rule out damaged tear ducts that may be further irritated by harsh products.

 

 

 

Luxating Lambie

Every dog is different and it can take some time to get to know the quirks of each individual. The first week I walked Lambie*, I was taken by her sweet, plucky nature but I was also concerned by an odd characteristic that seemed to come and go. As Lambie walked, particularly the faster she moved, she lifted her back leg. The action happened every few seconds – Lambie lifting her leg up, putting it down, and lifting it up again – and it was intermittent, occurring a few times during an hour-long walk. Having just met Lambie, I became concerned that she may be experiencing pain or have something prickly stuck to her paw but after checking her paw several times and manipulating her leg to see if she flinched or yelped, it seemed nothing was wrong.

I debated whether to talk to Lambie’s dad about it but, the more I thought about it, I began to recall other dogs in which I had seen this strange leg lifting action. Paku, the five-pound Chihuahua that temporarily resided in my home lifted one of his back legs up while running around the house or when he was let outside to do his business. Bertie*, a lovely Shiba Inu that brightens my world three days a week will lift up a leg while she runs at top speed down the stairs towards her building’s front door on the way to a walk.

In many cases, this action is caused by a luxating patella or “trick knee;” as the dog moves, the knee cap slips out of its socket. A luxating patella is most common in small breed dogs with weak ligaments, tendons or muscles and in dogs with a narrow or shallow kneecap groove. You may see a trick knee in one leg or two and there are different degrees of severity. The first grade – the lowest one – is when the kneecap can be moved by a vet but won’t slip out-of-place on its own. The second grade – the level that seems to be affecting Lambie – is a kneecap that occasionally slips (luxates) back and forth as the dog moves. Grades three and four may regularly cause pain through chronic lameness (grade three) or a kneecap that has permanently slipped to the side (grade four).

If your dog doesn’t seem to be experiencing pain, grades one and two probably aren’t causing any major problems. It may be a good idea to keep an eye on your dog’s movement and get the knee(s) checked out every couple of years by your vet to make sure pain doesn’t develop. If there is pain, your vet may prescribe a non-steroidal anti-inflammatory medication (steroidal meds have been proven to negatively impact the immune system and cause serious side-effects) which will not fix the problem but will help your dog to feel better. In very serious cases, your vet may recommend surgery. To help keep your dog’s condition from progressing, supplements such as Glucosamine may help; so may keeping your dog trim, his exercise moderate, and his diet high quality.

Uncontrollable urges

The dogs I foster go through a period of adjustment when they first arrive in my home. Many have been rescued from shelters where any previous housebreaking is easily undone by uncertain schedules and limited time outside their kennels. Ginny didn’t have this issue. In fact, she never once eliminated in the house…until last week.

This month I am taking an advanced canine behavior class at the Marin Humane Society which means a full ten hours away from the house. Luckily, my wonderful roommate has stepped up to help out. But last week, she went out to see a movie and returned to a large puddle of urine on the floor. She had been gone no more than 4-5 hours – a period of time that Ginny has had no trouble holding it for in the past. Two days later when I had to leave Ginny alone for about four hours, I purposely left the patio door closed so she had no access to the backyard. I needed to know if her accident had been a true accident or if it was the sign of something more serious. When I walked in to the living room, that puddle was right where my roommate had described it the other day. That evening, as we chatted about Ginny, she reminded me that I had been complaining that the dog had been waking me up barking and pawing at the patio door once, sometimes twice, each night to let her out. While she had done this on occasion in the past, it was a behavior that had escalated in the last week. I scheduled a visit to the vet for the next afternoon.

After checking the size and placement of her spleen and the pressure it might be placing on her bladder, Dr. Vega at Pets Unlimited suggested a couple of possible causes that would need blood and urinalysis to diagnose. In spayed female dogs of middle age a loosening of the “bladder sphincter” is common. Like in humans, this causes a female dog to be unable to control their bladder and have accidents. According to the ASPCA, incontinence is most common in female Cocker Spaniels, Springer Spaniels, Doberman Pinschers, and Old English Sheepdogs; but it can afflict any breed of mid to old age. Incontinence can be controlled with a daily medication that tightens the sphincter but it will be a daily presence for the rest of the dog’s life. Doggie diapers – belly bands – can also keep a dog from piddling all over the house. Other possible causes of incontinence or excessive or inappropriate elimination in dogs? A urinary tract or bladder infection, the onset of Cushing’s Disease, diabetes, or spinal injury.

The next afternoon we got a call that Ginny’s urine showed that she had a raging urinary tract infection. A ten-day course of antibiotics should knock out the infection and we will follow-up with the doctor in two weeks. Five days in, Ginny is back to normal and I get to sleep through the night again!

 

Fascinating changes

I adopted my second cat Phoebe almost a year ago. Bringing a new cat in to the home is always stressful for the animal and I can only imagine how she felt coming in to mine, with the smell of multiple dogs and another cat everywhere. I followed the protocol of introducing two cats – keeping the Phoebe in a safe spot that Osito couldn’t reach for the first several days – but the relationship between the two of them was rocky from the start. Whereas Osito and his former roommate Bat got along pretty well, chasing each other down the hall and playing the “door game” trying to get each other’s paws from either side of a door, he quickly assumed a new role as head cat. He would bully Phoebe when she was eating or sauntering around the apartment. He wouldn’t let her up on the bed so she made herself a nest underneath it. Not surprisingly, Phoebe, though sweet as could be when approached, wasn’t interested in getting close to Osito’s humans.

Fast forward to three weeks ago. Phoebe spends a lot of time outside, presumably getting some exercise, but it was clear she had put on some weight. Since finding Osito, I had left a bowl of dry food out for him, rather than feeding him a set amount at mealtimes. This is a no-no in the kitty health world but, at the time, Bat was such a food monster that I felt if I left him only the amount of food he was supposed to eat, she would gobble it up instead. When Phoebe came in to our lives, I continued the practice, now setting out two separate bowls so they could eat at the same time if they wished. But newly fat Phoebe needed a change to help her shed the extra weight so I decided to switch the cats to mealtime feeding only. I left the food out if they didn’t finish what was in their bowl, but once gone, they received no more until the next mealtime.

Almost immediately, we noticed a change in Phoebe. All of a sudden she was approaching myself, my roommate, and visiting friends on the couch, purring and rubbing against us. Before this, I had seen Phoebe do this so infrequently, I could count the number of snuggle fests on two hands. But new Phoebe not only solicited our attention, she laid down to nap next to me and collapsed in to my side in a heap of soft fur.

So why the change? Because the only difference in her life is the way I feed her, and the change is a positive one (i.e., not a sign that might encourage me to take her to the vet), it is logical to assume that it is in fact the feeding that has changed her behavior to make her a sweeter and more loving cat. I suspect this follows a similar principle to one used in the dog world – Nothing In Life Is Free. With dogs that are controlling or overly excitable, trainers often recommend that the owner change the way a dog is fed (and receives other things it likes such as toys, going outside, etc.). Instead of just giving food and treats away, the dog must work for their meal every time. In other words, dog wants dinner, you make him sit and wait first. A more advanced version of this is never putting out a bowl of food but instead feeding a dog its kibble one nugget at a time in exchange for obedience like sit, stay, come, down, leave it, and so on. In this way, the dog comes to understand that good things do not happen unless the owner makes them happen; and the only way the owner will do so is if the dog is obedient and well-behaved.

In Phoebe;s case, I believe that by changing her access to food, she has realized that food doesn’t just grow on trees (or in her food bowl, at least), it comes from me and if she solicits my attention, purring and acting all cute, I may be more likely to feed her. And in the midst of that thought pattern, Phoebe realized something else: getting pet and snuggling is pretty great and worth doing whether she is hungry or not.

Unfortunately I will never know exactly what Phoebe is thinking; all I can do is theorize based on observations of her behavior. But either way I hope this new Phoebe is here to stay!

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