Even Indoor Dogs Need Heartworm

                                                      Heartworms are parasites that a mosquito injects into                                                           your dog's blood system when it has finished feeding off your pet.

After about 6 months, the baby heartworm will travel through your dog's blood system to the heart where it grows into an adult.

One heartworm can do minimal damage over time, but a male and female heartworm can produce many newborn worms that make the 6-month journey through blood vessels and back home to the heart.

These worms eventually clog valves and arteries, damaging the heart muscle over time.  A dead heartworm that breaks into pieces can cause an embolism, or blockage, that may result in an excruciatingly painful death.

Dogs with heartworm infestation can be mildly tired and quiet, with a poor appetite and disinterest in activity.  Heartworm Disease progresses to more severe symptoms of coughing, exercise intolerance, and heart failure (resulting in swelling of the abdomen as fluid builds up and is not processed properly through the kidneys).

Heartworm preventative can be given every 30 days to prevent any baby heartworms your dog comes into contact with from developing to the adult stage.  Treatment once adult heartworms are living in the heart can be expensive and hard for your pet's organ systems to manage.

Most modern heartworm preventative brands also contain other medicines that get rid of intestinal parasites and even skin mites...depending on your needs, and the soil makeup where you live!

Most veterinary offices recommend periodic testing for heartworms just to make sure that the medicine has been working 100%.

Because even Indoor Dogs can come into contact with mosquitoes, and because the complications of heartworm infestation are so severe, it is best to invest in using a preventative medication EVERY MONTH, ALL YEAR LONG.
Avoid Diabetic Drama...

I often meet people who ask me for a recommendation of a tablet or homeopathic treatment for their dog's diabetic condition (in this discussion, I am referring to Diabetes Mellitus).  Sadly, the overwhelming number of cases of Diabetes in dogs are cases of Complete Pancreatic Failure to Secrete Insulin.  Prevention of the overweight condition that usually taxes the pancreas to the breaking point is critical to making sure your dog has the longest life possible--diabetic dogs are known to have abbreviated lives.  Proper diet and exercise can and do extend life for all species!

This is very different from Human and Feline cases of Insulin Resistance, in which the body's cells are unable to make use of the insulin that is secreted by the pancreas...in these patients, there are oral and other supportive measures that can be quite effective in preventing direct insulin therapy by increasing the body's sensitivity to any insulin present.  Many cats with Insulin Resistance are indeed able to recover functionality if treated as soon as symptoms arise.

If your veterinarian has diagnosed your dog as Diabetic, PLEASE FOLLOW ALL INSTRUCTIONS FOR INSULIN AND DIET CAREFULLY!  Twice-daily injections are best, since your dog's blood sugar does not stay the same all day long...a morning-only injection is just not a realistic way to go, and your pet is probably not as concerned about the pokes as you think!  The first few days of giving injections are the hardest, so just hang in there and let a routine develop.

Your vet may be able to recommend supportive nutritional adjustments and supplements, so be sure to ask...many vitamins, minerals and antioxidants are being reported as very helpful in maintaining the overall health and vigor of diabetic patients. 

As with all diabetics, your dog's body is less able to cope with infections and exertion...if your pet exhibits signs of weight loss, numbness, weakness or pain in the feet or legs, starts to drink more again and/or urinate frequently, or just feels poorly, please re-check with your vet right away!
While We're On the Subject of Nutrition....

      Everyone is becoming increasingly aware of the importance of nutrition...in prevention of certain developmental and birth defects, in proper growth rate and maintenance, in prevention of chronic deficiency syndromes and subtle illnesses, and in promoting longevity.  Vitamins, minerals and antioxidants are receiving a lot more attention than ever before.

Dogs do require a diet that is both balanced and complex...that is, many nutrient sources should be ingested at each meal.  Proteins, carbohydrates and fats must be from good-quality sources, and used in proper ratios.  Overfeeding is as dangerous for pet dogs as it is for people!

Skin, eye, dental, neurologic/behavioral and other serious conditions can arise in response to malnutrition.

Certain supplements and plants can be added to a diet to enrich nutrition and support health care treatments.  Many veterinarians are becoming better educated in usage of these nutrients; there are also specialized Holistic practicioners who can be consulted in specific cases.

For information about using proper diet and supplementation to improve or protect your pet's health, ask someone who understands what to do by clicking here.
     Lhasa Apso Aggression

    The brain is responsible for mediating many kinds of aggression, depending on a multitude of contributing factors.  It is seldom reasonable to expect a quick answer to the question, "My dog is aggressive--what do I do?" much less expect to implement a simple solution.

    Things that impact formation of aggression and its expression include (but are not limited to):
1) heredity, including all the genetically-based physiologic and temperamental causes;
2) socialization and critical developmental periods;
3) later interactions with humans and animals that leave no room to escape a tense and ambiguous situation;
4) levels of neurotranmitters and hormones in the brain and body-at-large...both congenital and those appearing during later developmental and disease stages, and can include brain changes related to low thyroid levels;
5) direct damage to the brain from epilepsy, viral, bacterial and fungal illnesses, accidents/head trauma, over-activation of the immune system (resulting in antibodies that attack neurons--many dog owners are pointing to certain vaccination incidents being timed with the appearance of this phenomenon in previously normal and healthy dogs), degenerative conditions of the kidneys, liver, pancreas and other bodily organs;
6) tumors growing directly in the brain, either at sites where aggression is mediated, or pressing in from adjacent locations over time...tumors growing from endocrine organs can cause overproduction of chemicals that adversely affect brain function.

    Dogs can be aggressive as an expression of Dominance, Fearfulness, Anxiety, Competitiveness (Possessiveness), or Habit.  Aggression can be Willful or Unconscious...that is, there may be targeting, or impulse involved.
    Entire articles can be written about each form and expression of aggression!
    Lhasa owners seem to have an increased chance of encountering a number of these sequella, and the ensuing threats and/or bites.  Although one might impulsively argue that Wolf genes are more apt to Solve Problems with Biting, careful observation of Wolf Packs actually indicates the opposite in healthy adults!!  Wolves cultivate a complex and beautiful sequence of behaviors that serve to defuse and deflect aggression between family members, and even competing packs, whenever possible.  We should never assume that a breed "is just that way", unless a breeder has spent specific time and effort to cultivate aggressive offspring.
    Seldom do bereaved pet lovers submit their deceased pets for brain necropsy, but I do strongly feel that this would be most helpful to breeders wanting to work to eliminate tainted genes from breed populations.  For example, Lhasas are prone to a horrific developmental disorder of the brain called Lissencephally.  Essentially, this is a genetically passed problem that keeps the outer part of the brain from developing properly...instead of being bumpy and grooved, the cortex is smooth.  Since the cortex is responsible for mediating movement, a sweet and compliant puppy may become fractious, uncoordinated, and lose eyesight by 6 months of age...abnormality in one part of the brain indicates problems at other locations as well.  Even if symptoms come on very slowly, the majority of these pups are euthanized for quality-of-life or safety issues by the age of 2 years.  If breeders were able to find out about such pups from their lines, they would certainly be better able to make adjustments to their breeding programs for the sake of future pups!
    The most common pre-disposing factor in Lhasa Aggression can affectionately be called "Owner Error"! Over-indulging possessiveness and pushiness, neglecting socialization and obedience training, and refusal to see a Dog as a Dog (instead of as a Human Baby) will all result in a pet that gets the idea that, "I get what I want when I want it as fast as I want it".  I have often heard people minimize their pet's aggressive behaviors both in the home and in public, without taking direct responsibility for providing their pet more realistic alternative rituals when stress is present.  Dog culture is quite a bit different from People culture, and we must always respect and honor the cultural needs of our companions.
    In order to get to the True Source of aggression, a pet must be evaluated by a prefessional who is familiar with all the medical and behavioral issues.  Tests to determine a dog's physical state of health are often combined with an interview about psychological development...the more information you can provide about when the behavior began, what seems to set it in motion or turn it off, who is present, what else is happening before-during-and-after the episode, the better able your support team will be in providing available solutions.
    Although general practitioners can be remarkably intuitive and successful, you may need to ask for a referral to a Veterinary Neurologist or trusted Behaviorist for complex and resistant cases.
Research is an important way to help your furry companions...BUT please consult qualified medical professionals for every case of disease prevention and treatment!  These articles are NOT a replacement for your veterinarian's advice and services! 
Canine Cushing's Disease

Cushing's Disease is the name given to a complex illness that is caused by an excess of the body steroid Cortisol produced by the adrenal glands (these organs lie on top of the kidneys).  It is usually found in concert with a pituitary gland tumor (in the brain) called a Microadenoma, or with a tumor on one of the Adrenal Glands (there are two in the body, one on top of each kidney).

    One of the first things you will notice is that your dog drinks A LOT and urinates quite often, as the excess cortisol affects the kidneys right away.  Later on, the abdomen will lose its elasticity and the belly will look swollen and pear shaped. Hair falls out and the skin becomes thin and fragile. The liver can also be badly damaged.

   Diagnosing this disease involves stimulating the adrenal glands to see if they are overproducing cortisol when activated to do so (ACTH Stimulation Test).  A Dexamethasone Suppression Test is performed to distinguish whether the illness is coming from the pituitary gland in the brain, or from an adrenal tumor.  Often, a Water Consumption Test is performed at home...measuring and noting the total amount of water a dog drinks in a day.  Borderline cases are further evaluated with certain urine tests.

Treatment(s) depend on all the test results.

Many dogs with Cushing's Disease are showing concurrent symptoms of Canine Cognitive Dysfunction (CCD, or CDS-Cognitive Dysfunction Syndrome, a kind of Dog Senility), perhaps due in part to liver damage.  Cushing's and CDS are both progressive, that is, they will continue to worsen over time.  A medicine called L-deprenyl can slow the degenerative brain changes, and even help to correct an elevated liver enzyme problem (ALKP).

  L-deprenyl replaces a neurotransmitter that seems to be in shorter supply as we and our dogs age.  Starting a treatment routine (each morning) sooner rather than later can help the brain function better for longer, and human generics (known to pharacists as "selegiline") are available at pretty reasonable prices.

    Sophisticated treatments (Lysodren and Trilostane) do have a variety of side effects, and must be carefully considered with your vet's advice and support. There are no "home remedies" that are effective against the excess cortisol.
Canine Cognitive Dysfunction--Is My Dog Senile??

Dogs can develop a number of neurologic side effects from illnesses such as hypothyroidism, liver or kidney disease, Cushing's Disease, and diabetes.  These illnesses are diagnosed by having some blood tests run, and should be ruled out first in any case of an adult or geriatric dog showing abberant behavioral changes not associated with environmental factors.  Slow-growing brain tumors can also lead to strange changes in behavior and temperament.

There is also now what we are coming to know as a kind of dog senility called Canine Cognitive Dysfunction, also called Cognitive Dysfunction Syndrome (CDS)

Symptoms include loss of attention to familiar people, failure to concentrate, difficulty with holding urine or stool (including voiding in the wrong places and/or not alerting you to their need to go outside), and other strange behaviors such as standing in a corner all day, going to the food dish and not eating, inappropriate aggression, or getting "lost" in familiar surroundings...people have told me of pets trying to sleep in the bathtub, or "nesting" under furniture!  Symptoms are often worse at night, some dogs even switch their entire day-night schedule or cry all night.

  CDS seems to be caused by a decrease in a brain hormone and can be treated by giving a medication called L-deprenyl (the human generic "selegiline" is very affordable).  This condition is progressive and worsens over time; treatment can reverse early signs and slow down the damage so that a dog can live a more normal geriatric life, but the lifespan is considerably shortened as brain systems progressively shut down and become increasingly dysfunctional.

Diagnosis is based on symptoms and testing to rule out conditions listed above, then response to medication is used to guide treatment.  Gaining additional quality time together can be an invaluble contribution to any human-canine bond facing end-of-life issues.

Talk with your veterinarian as soon as possible about any case of sudden behavioral changes in a pet so that you will be able to get answers and support quickly!

Some seizure disorders have a cause, such as pre-existing illness (lissencephaly, diabetes, kidney or liver failure, hypoglycemia), toxins, tumors or physical injury (like being hit by a car) that has damaged the brain.

Some seizure disorders are what we call Idiopathic (sickness without a known cause).   This would include developmental defects, and many conditions we do not yet know how to identify using current medical technology.

Sometimes a dog will have one seizure, and never another...these seizures are very hard to blame on any one thing or another.

Dogs that have regular seizures that are not linked with any other illnesses are said to be Epileptic.  Most dogs with simple epilepsy can be well treated with drugs.

Seizures can be brief or prolonged. They can be mild in their appearance or physically violent. The more vigorous and the more prolonged a seizure is, the more dangerous it is to the brain.  Dogs that do not lose consciousness, and even exhibit strange or out-of-character behaviors, fall into the class of Complex Partial Seizures...seizures confined to a very small part of the brain.  Grand Mal seizures are the typical thrashing, drooling events that most people are familiar with through the media.  There can be a whole range of variations in between.

An older pet experiencing a violent seizure, or repeated seizures, is more likely to be harboring a serious health problem, such as cancer, brain hemorrhage, or organ failure.

Diagnosis can be as simple as running some blood tests, or as complicated as undergoing an MRI to find a tumor or other brain-threatening condition.  Deciding what tests to run, or whether to seek the opinion of a Veterinary Neurologist are very individual decisions that depend partly on your pet's ability to undergo the testing and partly on your family's finances.

If a root cause of the problem can be found, then addressing it can stop the seizures from repeating in the future, but some conditions that affect the brain can also leave permenant damage.

If no root cause of repeating seizures is found (like Lyme Disease, Toxoplasmosis, tumor, etc), then medications are started to prevent new ones from developing.  Once a pet starts such a therapy, it should not be stopped without medical assistance...skipping doses can bring on worse seizure activity.  Blood testing is periodically used to make sure that your pet is getting the proper amount of medication.

Sometimes seizures "break through" medical therapy, and other drugs can be added to help control this as well.

Once a pet has been determined to need medication, it is not safe to assume that he will ever be able to do without it in the future.
Canine Hypothyroid Disease

The hormones produced by the thyroid glands do a variety of jobs throughout the whole body.  In addition to regulating weight, body temperature and skin health, they also interact with the cardiovascular system, the brain, the reproductive organs and immune system

Hypothyroid dogs are prone to infections, anemia, adrenal dysfunction, insulin resistance and a particular kind of coma. Abberant behaviors, including aggression, have been noted in dogs that are living with a low circulating thyroid hormone level ("hypothyroid").  Many dog owners first notice that their pet gains weight, gets generally sluggish and sleeps a lot...since thyroid hormones activate metabolism, these dogs often feel cold and gravitate to warm parts of the house, or spend the entire day in their bed.  The digestive system can get backed up and/or overloaded, so inconsistent bowel function or constipation can acompany this illness, but are seldom seen as causes to investigate for it!

As the deficiency progresses, hair loss (particularly on the sides and top of the tail) is followed by skin infections.  The skin can turn black and fragile if left untreated.  Open wounds can appear spontaneously even though no one sees the dog scratching.

Hypothyroidism is diagnosed with blood tests...some kinds of tests are more sensitive and helpful than others.  Even "borderline" cases can benefit from thyroid hormone replacement therapy, but these cases are harder to work with in terms of balancing hormone replacement therapy with the remaining thyroid function.

Since each individual has a unique degree of disease, each pet needs to receive a customized amount of replacement medication.  This means that your vet will start with an average dose for your pet's size and lab results, but should ask you to return to the office periodically to have blood re-tested.  Too much hormone can have other serious side-effects in the body.  Please follow all reccomendations about treatment and testing.  Sometimes a veterinarian trained in Traditional Chinese Medicine can be more helpful with borderline or difficult cases.
Lhasa Stomach Bloat, Gastric Torsion, GDV

Dogs with a deep chest are at high risk of twisting their stomach over on itself...this is called 'gastric torsion' or 'stomach bloat'.  Lhasas are one of the smaller dog breeds that will occasionally be presented in veterinary hospitals for an emergency evaluation of this condition.   The medical term for this condition is gastric dilatation-volvulus, or GDV.

A dog who's stomach has twisted back over itself will be in extreme pain and will have unproductive vomit, or not be able to swallow what he tries to eat.  Restless and unable to lie down, these dogs often wander around and ask to go outside, but will not pass any stool.

This is a fatal condition if not attended to in an emergency fashion by a qualified veterinarian.

Foods that produce a lot of gas in the digestive organs, or otherwise cause indigestion should be avoided (soy, peas, wheat).  Overfeeding is a notorious cause of excess gas build-up...DO NOT OVERFEED YOUR PETS!  Some nutritionists suspect that foods containing saponins are also to blame for poor digestive function (avoid peas, soy, yucca, and beet pulp to test your dog's response).

Lhasas do not burp up excess gas very well, and must sometimes be taught (positively reinforced) to do so!  Vigorous physical activity and play should be avoided for 1/2 hour after meals, and adequate time to pass stool and gas outdoors should be allowed.

Please call a veterinarian RIGHT AWAY if your pet ever shows any of these symptoms to get an emergency appointment.
Canine Parkinson's Disease????

Parkinson's Disease is a human neurologic condition that produces, among other things, a pronounced muscle tremor when the body is AT REST...something quite unique and distinct from muscle tremors produced during movement. 

There are a lot of conditions in humans and canids that can cause a muscle tremor.

1) Excitement is mediated through the brain by chemicals such as serotonin and norepinephrine.  It is possible for a dog's system to either produce too much excitatory chemicals, or to be especially sensitive to their presence.  Very prolonged "firing" of nerves in the muscles can cause discomfort.  Excited shivering can be considered normal in the absence of other symptoms of illness, and is ordinarily seen throughout a dog's lifetime beginning in puppyhood.

2) Pain in the joints associated with injury, arthritis or other degenerative bone diseases can cause the excitatory system to become over-active, due to the body's response to stress and exertion.

3) Tumors growing in the brain and/or spinal cord can press on nerves that control muscle movement. Other structural problems, such as severe arthritis or disc degeneration can cause severe nerve compression as well.  These compressions can become serious enough to cause paralysis of one or more limbs.  "Wobblers" is a condition that can appear in predominantly large breed dogs wherein the spinal cord bones in the neck interfere with signals to the lower body...shaking ("wobbling") in the hind legs is the most commonly seen symptom.

4) Degenerative conditions in the nerves and muscles themselves are often to blame in older dogs: these conditions are accompanied by reduction of muscle mass in the affected body part(s)...check your pet for thinness and boniness over the head and along the length of the legs:  this muscle wasting often occurs slowly over time and can be missed.  These nerve conditions are collectively called Myelopathies...many are autoimmune in origin, but some can be due to Fibrocartilaginous Embolism in the spinal cord.

5) Geriatric dogs that have trouble keeping up their routines around the house may be suffering from a degenerative condition known as Canine Congitive Dysfunction...a kind of dog senility that may be helped with early drug intervention.

6) Kerry Blue Terriers and Chinese Crested dogs have been identified as carriers of genetic mutation that leads to development of a Parkinsonian neurologic degeneration called Canine Multiple System Degeneration.  This condition develops from 3-6 MONTHS of age and progresses to fatal levels within 1-2 years.  Genes for CMSD may indeed be identified in other breeds in time.

7) Occasionally, we still do not know what causes these symptoms in older pets --Idiopathic Tremor--in this way, there is similarity to Parkinson's only in that more research is needed over time to find the root cause(s).

Approaches to treatment vary, depending on the root cause of the tremor and the familiarity of veterinary support...with more complex disease, a consultation with a Veterinary Neurologist is often helpful and most direct.
Lhasa Health and Behavior Center
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