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Help, My Dog Has Megaesophagus!

My Dog is Regurgitating Food!

My mom’s dog, Oscar, who passed away at the beginning of 2021, lived the last few months of his life with megaesophagus. We were able to keep weight on Oscar and help him feel his best with this disease. In this post, I am going to discuss what megaesophagus is, its causes, treatment, and what we did for Oscar.

Regurgitation, Not Vomiting:

While not the most pleasant topic, it is important to differentiate between regurgitation and vomiting. This was one of the major issues we had when determining what was wrong with Oscar. We initially just thought he was vomiting his food, and this seemed more likely because of Oscar’s kidney disease. It took us several weeks before we realized that Oscar’s food wasn’t even reaching his stomach; instead, his food was sitting in his esophagus. Oscar wasn’t retching or making any of the normal motions dogs make before they vomit, he would simply get a confused look on his face walk away from us, and all the food will come back up. This would occur within minutes of eating his meals.

Causes:

Most of the time, the cause of megaesophagus is unknown. This was true in Oscar’s case. Some dogs are born with megaesophagus, and others, like Oscar, develop it later in life. Sometimes, it is caused by another disorder, such as: myasthenia gravis, cancer, Addison’s disease, etc. It is important to treat an underlying cause, if present, as a component to handling the dog’s condition.

Diagnosis:

Once we figured out that Oscar was regurgitating food, and not vomiting, we were pretty sure of his megaesophagus diagnosis. Still, we got an X ray to visualize the dilation of his esophagus and confirm the diagnosis. X rays seem to be the most common diagnostic tool used for this disease. As stated above, since certain conditions can cause megaesophagus, it is important to do blood tests to rule out any of these other causes, such as myasthenia gravis or Addison’s disease.

Complications:

One of the most common complications associated with this disorder is aspiration pneumonia. Because the dog regurgitates food so often, it creates a situation where they are very likely to end up with some food particles in their lungs. This is potentially life threatening, so it is important to firstly, make sure you are doing everything you can to stop the dog from regurgitating food, and secondly, taking your dog to the vet at the first signs that they may have aspiration pneumonia.

Signs of aspiration pneumonia include (https://www.lakecross.com/site/blog-huntersville-vet/2020/10/22/signs-symptoms-pneumonia-dogs):

Coughing
Irregular breathing
Runny nose
Dehydration
Loss of appetite
High fever
Nasal whistling
Difficulty exercising
Lethargy

Treatment:

Treatment for megaesophagus consists of figuring out what food consistency is easiest for the dog to consume, and keeping the dog upright for 20 to 30 minutes after meals. From my research, most people recommend either feeding food in a small meatball form or grinding the food down to gruel. Also, dogs with megaesophagus tend to do better with three to four meals a day as opposed to one or two meals. Medications for an underlying cause are imperative if a cause of the disorder is determined.

Keeping the dog upright after meals can be one of the trickiest aspects. Many dogs do not like being kept upright while eating, as it’s an unnatural position for them. If the dog is small, he could be held by the owner for 20 to 30 minutes; this is what we did for Oscar while we awaited his Bailey chair (https://www.baileychairs4dogs.com/). After ordering and receiving the Bailey chair, Oscar still required supervision while he ate his meals and while sitting in the Bailey chair, as he would try to hop out of the chair if left alone even for a second.

In Oscar’s case, we discovered that grinding his food down and mixing it with beef broth seemed to help him the most. Oscar was on a prescription kidney food for his renal failure. While I cooked fresh food for Lady when she developed kidney disease, Oscar was not able to get the fresh food down with his megaesophagus, so we switched over to the commercial prescription diet. We would grind his kibble, grind his canned food, mix them together, and add enough beef broth to make the mixture very liquidy.

While many dogs with megaesophagus seem to do best with four meals a day, for Oscar, a four meal a day regimen did not work well. Oscar actually did better with three meals a day; breakfast, lunch, and dinner.

In addition to the above steps, Oscar’s veterinarian also prescribed sildenafil to help treat his condition. This medication really did help reduce the number of times Oscar regurgitated his meals, and I would recommend anyone caring for a dog with megaesophagus to give this medicine a try.

There is alot of trial and error when figuring out what works.

*Oscar would make quite a mess at mealtimes, so we started putting a bib on him to make clean-up easier.*

Prognosis:

Many of the articles I have read talking about this condition say that the prognosis for megaesophagus tends to be poor. Still, it is possible to find stories of many dogs living long, happy lives with this disorder. The most notable story is Gremlin’s. Gremlin was diagnosed with megaesophagus at one year of age. His devoted owner has helped him cope with his condition, and he did very well with his condition. I am not sure if Gremlin is still alive, but he certainly lived beyond the one year the veterinarians predicted he would live. Included here is an article talking about his story.

Dog overcoming disease goes on ‘barket’ list adventure

Summary

In summary, if your dog is showing signs of megaesophagus, you need to get an accurate diagnosis. Generally, an x-ray will show if megaesophagus is present. Blood tests will likely be needed to determine if an underlying cause is present.

For treatment, your dog will need

A chair to stay upright. Bailey Chairs work well for this: https://www.baileychairs4dogs.com/
3 – 4 small meals a day.
Sildenafil, if it helps.
Food needs to be either fed as “meatballs” or as a gruel, whatever works best for your dog.
Treatment of underlying cause, if present (ie, Addison’s disease)

Remember to monitor for signs of aspiration pneumonia, and keep close track of your dog’s weight to assure they are getting enough calories.

Conclusion:

Oscars megaesophagus was difficult to manage, but it was very, very rewarding to see him be able to keep his meals down. He was able to maintain his weight, which was very surprising to us, considering he had megaesophagus and kidney disease, both diseases that cause weight loss. Oscar lived several months with his megaesophagus diagnosis, and passed away unexpectedly in his sleep. Initially, I was worried that he possibly died of aspiration pneumonia, but from reviewing what symptoms are present with this complication, I do not think his passing was in any way related to megaesophagus or pneumonia. Oscar was approximately 15 years old when he passed away, and he was able to live out his last few months very happily even with the diagnosis of megaesophagus.

Epulis Tumors in Dogs

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Epulides in Dogs:

What is This Thing in my Dog’s Mouth?

Dogs can develop odd growths on any part of their bodies, and this includes the mouth. Epulides are (usually) benign, rather common growths that you can find in your dog’s mouth. Despite this, the growths can still create many problems for your dog, and it is important to take your pet to see a vet if you discover an abnormality of any sort in his mouth.

What Dogs are Most Likely to Get These?

Older dogs over the age of seven are also more prone to developing these as opposed to younger dogs. These tumors form in response to gum inflammation and trauma, which would lead one to believe that dogs with poor oral hygiene are affected more. Genetic predisposition can also play a large roll, as brachycephalic breeds are more likely to develop these, especially boxers. The shape of a brachycephalic dog’s jaw can allow for trauma to the gum to occur from misaligned teeth, and this is a likely cause of the increased incidence of theses breeds. A dog may develop only one or many of these tumors.

It is important to note that while brachycephalic dogs may be more likely to develop these, epulides can pop up in any dog’s mouth. My dog developed one, and she is not brachycephalic, and she has received good dental care since puppyhood.

Signs and Symptoms of Epulides:

The most obvious sign of an epulide is seeing one in the dog’s mouth. These tumors can cause many other signs though, including facial deformation, decrease in activity, bad breath, drooling, enlargement of the lymph nodes, bleeding from the mouth, difficulty eating, etc. The first sign my dog exhibited was repeatedly opening and closing her mouth as if she had something stuck to a tooth, but I didn’t discover it until she yawned one day when I was petting her.

When examining a dog with an epulis, the veterinarian will try to look at and may feel the growth. X-rays are helpful to see how large the tumor is and will also help the vet determine what kind of mass is present, but the only way to be sure of the type of growth is with biopsy.

Types of Epulides:

There are three types of Epulides that a dog may develop, and the only way to be sure what type an affected dog has is through biopsy.

Fibromatous epulis: This type of epulis often resembles a mushroom, as is grows as a tumor on a stalk. It can also be seen without a stalk. (www.veterinarypartner.com)

Peripheral odontogenic fibroma: These are very similar to fibromatous epulides, but these tumors have in osteoid matrix. While these can be more attached to the underlying bone, they normally don’t invade the bone of the dog’s jaw. (www.veterinarypartner.com)

Acanthomatous ameloblastoma: These are technically benign growths yet they are often described as have behaving “cancer-like.” This is because these tumors will invade the bone in the dog’s jaw. While it will not spread throughout the dog’s body, this invasion of the surrounding bone can be very damaging. While fibromatous epulides and peripheral odontogenic fibromas normally have smooth surfaces, acanthomatous ameloblastomas may be rougher in appearance and are often ulcerated. (www.veterinarypartner.com)

Treatment for Epulides:

Treatment for epulides is surgical removal. It is better to remove these growths when they are small to avoid them causing undo discomfort to the dog. If the epulis is an acanthomatous ameloblastoma, part of the surrounding jaw may also need to be removed if the growth has invaded the bone. Sometimes radiation is done if the mass can’t be removed, but this is not the treatment of choice.

Thankfully, tumors don’t usually come back as long as the entire tumor has been successfully removed.

If you are very lucky, your dog may take care of the problem herself. Raina had an appointment to surgically remove her tumor, but about a week before her appointment, I noticed the tumor was no longer in her mouth. She must have done some home surgery and bit it off herself. I took her to the vet just to make sure it was completely gone, and Raina was able to skip that surgery!

Conclusion:

Certain types of dogs are more likely to develop epulides than others, but any dog can end up with one. While only one of the three varieties of this tumor is likely to invade the surrounding bone, all of these tumors should be removed if possible so they can be correctly diagnosed. Prompt removal also prevents an epulis from becoming so large that it causes the dog unnecessary stress and discomfort, as even a small one can be very bothersome to a dog and large ones can interfere with eating, drinking, and stop the dog from closing his mouth.

Sources:

Dog Owner’s Home Veterinary Handbook, 4^th Edition

https://veterinarypartner.vin.com/default.aspx?pid=19239&id=6017279

https://veterinarydentistry.net/peripheral-odontogenic-fibroma-and-epulis-in-dog/

Commercial Diets for Dogs with Kidney Disease: Review

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Feeding your dog with kidney disease:

Feeding a dog with kidney disease can be a challenging endeavor and requires much trial and error when discovering what your dog is willing to eat. Below are some of the commercial foods I tried while caring for my elderly dog who had kidney disease. I kept track of which ones she liked and which ones she vehemently refused to eat. Hopefully, the information below may help you find a product that your friend will enjoy!

Commercial diets for CKD:

There are several commercial kidney diets available for dogs on the market. These diets are available only with prescription from your pet’s veterinarian. If your dog is diagnosed with renal failure, it is important that her diet be changed to slow the progression of disease. Most of the time, this is done by using one of the prescription diets produced by Hill’s, Royal Canin, or Purina. Many believe that the companies listed here use inferior ingredients in their products, and they would rather not feed these foods to their pet. While the ingredients may not always be the best in these products, it is important to feed a reduced phosphorus diet to dogs with kidney disease, so if the owner cannot prepare low phosphorus foods at home for their pet, they should feed the prescription diets instead of feeding a regular commercial diet or an unbalanced homemade diet.

Below are reviews on some of the renal formulas from Hill’s and Royal Canin.

Palatability:

One of the major issues many people have with the commercial kidney diets available is their palatability. Oftentimes kidney disease diminishes a dog’s desire to eat. The best food in the world is worthless if your dog won’t eat it. It is important that your dog continues to eat, as going without food is hard on the kidneys. If your dog refuses to eat the prescription food, ask your veterinarian for suggestions on improving their appetite.

To get your dog to eat, you may have to be a little creative. While for healthy dogs I generally use a tough love approach, it really is important to keep a sick dog eating. I will handfeed Lady when she is being particularly picky. Sometimes I will mix a very small amount of something she really likes with her prescription food, just to give it an odor she likes. When I say a small amount, I mean small spoonful, or less. You just want enough to encourage the dog to eat. Some of Lady’s favorites are chicken gravy, beef gravy, Nutrisource dog treats crushed to a powder and sprinkled on top of her food, or a little Fancy Feast cat food. Once again, try to feed the food without these temptations, and always consult with your vet. If your dog has been eating pretty well for a while and suddenly starts refusing food, take her to the vet. Such changes could be indicative of the disease progressing, or of other problems/changes.

As far as the palatability of prescription diets, I must say from my limited experience of trying to feed my dog with kidney disease, they are not very palatable. Below are the products I have tried with Lady, and the verdicts on each of them.

Hill’s k/d stews:

The tastiest product that I have found (according to Lady, who is rather picky) is the stew varieties of the Hill’s k/d line of products. The ingredient list is also not terrible compared to some of the other cans available through other brands. Lady will eat both the chicken and beef variety by themselves or mixed with some of her dry prescription diet. Even though she eats these pretty well, if she gets commercial food of any sort for more than a few days, she will start refusing to eat.

One of the things that I think really helps with Lady’s willingness to eat this product is the fact that it is not sticky. For instance, the Royal Canin cans I tried with her did not work out, in large part I believe not because she did not like the flavor, but because the consistency was so sticky that is was difficult for her to eat.

Hill’s k/d kibble:

This is not Lady’s first choice for dinner. She will eat it with canned food, or by itself, but she does so begrudgingly. I always have a bag of this in addition to a case of the k/d cans on hand for when I run out of fresh food/ when I forget to thaw food for her. A trick that works to get her to eat it is this: I will hand a few kibbles to the other dogs in the house, who gobble it down enthusiastically, and then I offer her some. This normally works. Hand feeding also seems to make her more willing to eat this food. Any time she seems especially hungry in the afternoon after she has had her dinner, I give her as much of this hand fed as she will eat.

A note about this food: when Lady was initially diagnosed with renal failure, I fed her k/d kibble predominantly while I was trying to come up with fresh food to give her. The food gave her a very bloated appearance. I am not sure if this was because of the food, or if it was because Lady was not used to eating lots of kibble prior to her diagnosis.

Royal Canin Renal Support A Kibble:

I currently have a full bag of this product in my cabinet because Lady will not eat this food. Nothing I did would get her to try this, even when her appetite improved for food in general. My other dogs did eat this kibble without problem (I let them have a few bites hoping that would cause Lady to try some.)

Royal Canin Renal Support A and E Canned:

Lady ate both of these. She seemed to like the taste, but it was so sticky it was difficult for her to eat it. The scent definitely enticed her, so if your dog is reluctant to eat, you might want to give these cans a try. I did not buy them long term because Lady’s appetite picked up for her regular food once we made some changes in her supplements.

Conclusion:

I hope this helps anyone who is trying to figure out what to feed their pet with kidney disease. It takes time and lots of experimentation, but it is usually possible to find a commercial kidney diet that your dog will eat. If no commercial diet works for you pet, you might want to try cooking for your dog with kidney disease. Consult with you veterinarian before doing so, so they can provide guidance. The sample diets that I used may also be beneficial (Sample Diets for Dogs with Kidney Disease).

What is Chronic Renal Failure in Dogs?

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What is Chronic Renal Failure in Dogs?

Chronic Renal Failure, also known as chronic kidney disease (CKD), is a condition in which the kidneys are slowly losing the ability to do their job. Symptoms, such as drinking more water and urinating more frequently, usually are only apparent once the kidneys have lost 75% of their functioning ability. Chronic renal failure is different from acute renal failure in that acute normally has sudden onset and is often the result of infection or other trauma, whereas chronic kidney disease comes on gradually.

What do the kidneys do?

Your dog’s kidneys are responsible for removing waste products from the blood, keeping sodium and other mineral levels balanced, and regulating blood pressure, among other functions. They produce urine, which contains lots of stuff that the body needs to get rid of to remain healthy. Since the kidneys provide so many important functions for the body, loss of kidney function greatly hinders the normal function of many other organs.

The kidneys are made up of functional units called nephrons. The nephrons are the units that do the filtering of the blood. When a nephron is destroyed, it cannot be replaced or repaired. Thus, chronic kidney failure is irreversible, as the kidneys cannot regain lost nephrons. The cause of chronic renal failure generally isn’t determined and knowing the cause of CKD normally isn’t necessary to treating it (this is not true of acute kidney failure). Treatment of CKD is aimed at preserving function of the remaining nephrons for as long as possible. This is normally done through diet and other measures. (See Sample Diets for Dogs with Kidney Disease)

Signs and symptoms of kidney disease in your dog:

As mentioned above, the first sign that something is wrong with your dog when he has kidney disease is often increased urination and thirst. Many people are surprised that there is anything wrong with their pet’s kidneys in this case, because the dog is producing so much urine. But it is the lack of the kidneys ability to concentrate the urine that causes the dog to pee so much. Because the dog loses so much water in every time he goes potty, he feels extremely thirsty and can easily become dehydrated. This is why it is very important that dogs with CKD have constant access to water, since they are at increased risk of dehydration.

Other changes are common. The dog’s coat may become dull, and his behavior may change. Loss of appetite and weight often result. In some cases the dog may develop an ammonia like odor to the breath as waste products continue to build up in the body. Vomiting is very common and very problematic as well, since vomiting can put the dog at an even higher risk of becoming dehydrated. (Dog Owner’s Home Veterinary Handbook). Proper treatment can help postpone these symptoms, and many medications can help the dog feel better once they are present.

Other diseases can cause these symptoms, so it is imperative to have your vet properly diagnose your dog as soon as changes in his normal appearance and behavior develop.

How is CKD disease diagnosed?

Kidney disease can be diagnosed with a blood test that will let the veterinarian look at the blood urea nitrogen (BUN) and creatinine levels in your pet’s blood. Creatinine and urea are both normal waste products that the body produces that the kidneys get rid of, but when the kidneys stop working properly, both of the substances can build up in the blood. Both of these values are elevated with kidney disease. Normal creatinine is between 0.5 – 1.6 mg/dL, and normal BUN is between 6 – 31 mg/dL. Higher creatinine levels correspond with more progressed kidney disease.

Urine tests can also indicate kidney disease. As the kidneys lose more of their functional ability, they cannot concentrate urine properly. The specific gravity content of the urine will indicate how well the kidneys are able to concentrate urine. The range of normal values can be rather broad, and interpretation of the results will many times be dependent on the particular animal. (http://www.iris-kidney.com/education/urine_specific_gravity.html) Dilute urine can indicate kidney disease, as can extremely concentrated urine (Dog Owner’s Home Veterinary Handbook). Generally to get accurate information for the urine specific gravity, vets recommend getting urine from the first time the dog potties in the morning.

Urine tests can also show whether or not the kidneys are losing protein in the urine. Protein in the urine (called proteinuria) indicates kidney problems. You can find more information on proteinuria here: (http://www.iris-kidney.com/education/proteinuria.html).

A relatively new test is the symmetric dimethylarginine (SDMA) test. This test is very beneficial because it can detect kidney problems even before changes in creatinine happen. More information on this test can be found on this website: http://iris-kidney.com/index.html. The drawback it that this test does not seem to be nearly as accurate as other tests of kidney function. Consequently, an abnormal SDMA doesn’t necessarily mean that your dog has early kidney disease, because while early kidney insufficiency can cause an abnormal SDMA, other things can also cause an abnormal value (https://www.2ndchance.info/test.php?page=SDMA2018).

Many other values can be unbalanced in kidney disease. Low red blood cells (anemia) and high amounts of phosphorus in the blood are very common in kidney disease. In routine blood work, your veterinarian can check these values and the others listed above to determine how well your dog’s body is functioning.

Conclusion:

Changes to your pet’s eating, drinking, urination, and behavior should never be brushed off. CKD, like many other diseases, has the best chance of responding to treatment when it is caught sooner rather then later. There is an abundance of information available on kidney disease that can help you give your dog the best care possible.

References:

http://iris-kidney.com/index.html

Dog Owner’s Home Veterinary Handbook, 4^th edition

https://www.2ndchance.info/index.htm

Additional resources:

https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4951452

http://www.dogaware.com/health/kidney.html

Sample Diets for Dogs with Kidney Disease

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Why Feed a Dog with Renal Failure Fresh Food?

Feeding a dog with kidney disease a homemade diet or a partially homemade diet is often beneficial for many reasons. Dogs with chronic kidney disease (CKD) often experience loss of appetite, and fresh food is generally more enticing than commercial food. Many believe that fresh food is more healthful than commercial food as many commercial diets are not made with human grade ingredients. Preparing your dog’s meals when they have a health condition can be extremely rewarding. As with all homemade diets, proper planning is needed to assure all of your dog’s nutritional needs are being met.

Basics to Follow:

Limit phosphorus: Dogs with CKD need a diet that is lower in phosphorus than dogs with healthy kidneys. This is one of the most important things to account for in a homemade kidney friendly diet. When designing a diet you should focus on choosing foods that are lower in phosphorus. Foods lowest in phosphorus include high fat meats, white rice, pearled barley, egg whites, and potatoes. Foods that are extremely high in phosphorus include egg yolks, lean meats, liver, dairy, and raw meaty bones (bones are loaded with phosphorus). These foods can still be fed, especially when the kidney disease is in its early stages, but they should be kept to limited quantities. On www.dogaware.com, is states to feed between 10- 18 mg of phosphorus per lb. of the dog’s bodyweight daily. (Going by these recommendations, a 36 lb. dog with moderate stage kidney disease may be limited to 540 mg of phosphorus per day, putting him at 15mg of phosphorus per pound of bodyweight.) The higher end value is good for dogs with earlier stages of the disease, with the lower amount being suitable for dog with more advanced kidney disease.

Protein: Protein is an extremely important to any dog’s health, yet for the longest time the consensus was that dogs with reduced kidney function should be fed low protein diets. Now, there is a divide amongst veterinarians and owners: some still believe protein is bad for dogs with kidney disease, but others hold firm that protein is still extremely important and should not be drastically reduced. The foods highest in protein tend to also be high in phosphorus, so when phosphorus is reduced protein levels are also cut down to a certain extent. I like the guidelines found on Mary Straus’ website www.dogaware.com. She recommends that unless the dog is uremic, he should still get 1 gram of protein per pound of body weight. So, a dog weighing 20 lbs. would need 20 grams of protein a day. More protein won’t hurt in most cases as long as the phosphorus is kept low.

Fat: Higher fat diets are often recommended for dogs with CKD. High fat foods are usually low in phosphorus, and they provide calories that are extremely beneficial for the dog that is not eating well. It was difficult for me to find information on exactly how much fat to feed. For Lady, who is 50 lbs. I would feed roughly 40 grams of fat to daily. Lady doesn’t tend to have a sensitive stomach. Some dogs are less tolerant to high amounts of fat in their diet. For these dogs, more carbohydrates will need to be fed to assure they are getting enough calories.

Carbohydrates: Low phosphorus carbohydrates are usually a necessary component to a kidney diet. There are many options to choose from, including pasta, white rice (short grain varieties tend to be quite low in phosphorus), pearled barley, sweet potatoes, butternut squash, white bread, etc. Whole grains usually have more phosphorus than refined varieties, so this is a case where whole grains aren’t better.

Calcium: Calcium is very important to any dog’s diet, but it is extremely important for a dog with kidney disease to get enough calcium. Calcium will help bind with excess phosphorus. Mary Straus recommends 1000 mg of calcium per pound of food. Feed regular amounts of calcium if other phosphorus binders are being used.

Fish oil: Omega 3 fatty acids play an important role in reducing inflammation in the body, and studies have shown that omega 3 helps protect kidney function. In her book Raw and Natural Nutrition for Dogs, Lew Olson recommends giving 1000 mg of fish oil per 10 lbs. of bodyweight. This amount may need to be adjusted if your dog is on any medications that may thin their blood, so consult with your veterinarian on the best amounts for your dog.

Other Supplements: If you begin feeding a homemade diet long term, it is imperative to assure all of the nutrients your dog needs are in his diet. There are many companies that produce vitamin and mineral supplements. For a dog with kidney disease, it is important to choose supplements that don’t add phosphorus to the diet. Balance It® has a supplement specifically for dogs with kidney disease that are being fed homemade diets. This may be a good option for your dog. Your vet may also be able to recommend a proper supplement. If you don’t want to worry about balancing your dog’s diet exactly, feed one of the prescription kidney diets in conjunction with homemade food. Feeding at least 75% commercial food should assure your dog is getting everything he needs.

Note: Calcium must still be added to the fresh food to balance out its phosphorus, even if kibble is also being fed.

Much of the information that I have learned about kidney diets comes from www.dogaware.com. I encourage anyone with a dog with kidney disease to read the plethora of information available on that website.

Sample Diets:

These are some of the recipes that I used for nearly 3 years with Lady. This past August, she began refusing most food, and I had to adjust how I feed her, but I truly believe that giving her mostly fresh food for as long as she was willing to eat it has helped keep her with me all this time. Remember to always discuss your dog’s diet with your veterinarian. None of these recipes are complete and balanced by themselves, so supplementation is necessary.

All of the below diets are for a 50 lb. dog that needs approximately 1000 kcal per day. I used www.NutritionData.com for analysis of each recipe

Beef and Barley Recipe:

5 oz. 80/20 ground beef (raw) Note: can substitute 80/20 ground lamb occasionally for variety
3 oz. boneless skinless chicken thigh (raw)
1 oz. beef liver (raw)
1 whole egg
2 oz. veggies (can use zucchini, broccoli, carrots, cauliflower, etc.)
2 oz. pearled barley (uncooked weight)
2 oz. sushi rice (uncooked weight)

Add: 1500 mg calcium

Cook grains according to package directions. Cook meats until done, do not drain the fat. Hard boil or scramble the egg. Steam and mash vegetables. Mix all ingredients together and serve when cool.

Nutritional analysis:

Protein: 63 grams
Fat: 38 grams
Phosphorus: 781 mg
995 kcal

Without proper supplementation, this diet will be low in magnesium, zinc, selenium, iodine, vitamin D, vitamin E, thiamin, and Choline.

Beef and Sweet Potato Recipe:

2 cups sweet potatoes (cooked weight) Note: can substitute 22 oz. cooked butternut squash
3 egg whites
1 oz. beef liver (raw)
2 oz. zucchini
8 oz. 80/20 ground beef (raw)

Add: 1500 mg calcium

Cook meat and retain the fat. Cook sweet potatoes by either baking, steaming, or boiling until very tender. Scramble egg whites. Steam zucchini. Mash ingredients together and serve when cool.

Nutritional analysis:

Protein: 64 grams
Fat: 47 grams
Phosphorus: 714 mg
1000 kcal

Without proper supplementation, this diet will be low in zinc, selenium, iodine, vitamin D, vitamin E, thiamin, and Choline.

Multiple Sclerosis in Dogs: Degenerative Myelopathy

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What is Degenerative Myelopathy?

Veterinarians are still not completely sure what degenerative myelopathy is, but it appears to be autoimmune in nature, much like multiple sclerosis in humans. It seems to run in bloodlines, and is quite common in German Shepherd dogs, although it also regularly affects Huskies, Pembroke Welsh Corgis, Weimaraners, and other breeds and their various mixes. While it starts off as weakness in the hind legs, the disease eventually progresses to complete paralysis. (Dog Owner’s Home Veterinary Handbook 4^th edition).

A more detailed description of what the immune system is doing in a German Shepherd Dog with DM can be found here: http://dog2doc.com/neuro/DM_Web/DMofGS.htm. This page also has information on medications and supplements that sometimes prove somewhat beneficial to German Shepherd dogs with the disease. Most research into the disease seems to be aimed at GSDs, since they are the most commonly affected breed. With this being said, I don’t see the hurt in using the information for a breed other than a GSD, as long as a veterinarian is helping alter the plan accordingly.

How is DM Diagnosed and what are the Symptoms?

DM is diagnosed through a process of elimination, because the only way to be certain a dog has the disease is to examine their spinal cord in autopsy (http://www.caninegeneticdiseases.net/dm/basicdm.htm). Other diseases that can have similar symptoms are hip dysplasia and slipped discs in the vertebral column. Dogs affected by DM are usually older dogs, aged 8 and above.

One of the ways a vet tries to determine if a dog has DM is by manipulating the dogs back paw so that the top of their foot is against the ground. A dog with a healthy spinal cord will correct this posture of the foot quickly. Dogs with DM that has progressed to a point will not “right” their foot automatically(http://dog2doc.com/neuro/DM_Web/Jack_Flash.htm). Dogs with DM will often drag their back feet, and their toenails consequently become worn down (Dog Owner’s Home Veterinary Handbook 4^th edition). As the dragging of the back feet becomes worse the dog may develop cuts and scrapes on the back paws. Lady in Snow editted

As degenerative myelopathy progresses, the dog loses more and more control over her back legs, resulting in paralysis. This can result anywhere from 6 months to 1 year from initial diagnosis (http://www.caninegeneticdiseases.net/dm/basicdm.htm).

From what I have read, degenerative myelopathy is not painful for the dog. What is extremely painful is watching one’s dog slowly lose the ability to walk, especially as the animal is completely alert and mentally still very healthy.

Treatment for Degenerative Myelopathy:

There is no cure for DM. With this being said, a veterinarian by the name of Dr. R. M. Clemmons makes several recommendations on medication and supplements that he believes prove beneficial for dogs affected by this disease. Dr. Clemmons specific recommendations can be found at here (http://dog2doc.com/neuro/DM_Web/DMofGS.htm) (same article referenced earlier).

This veterinarian emphasizes regular walks or swimming to help keep a dog with DM mobile for as long as possible. Because DM affects the nerves in the legs, it also results in muscle loss. Both walking and swimming will help the dog retain as much muscle tone as possible. The walks or swimming sessions don’t have to be extremely long according to Dr. Clemmons. He recommends working the dog up to two 30 minute walks and one hour long walk each week. Obviously, some dogs will be able to do more, and some dogs will need to do less.

In addition to regular exercise, Dr. Clemmons recommends a diet and supplement guidelines. Vitamin C, vitamin E, selenium, CoQ10, and omega 3 fatty acids are all recommended. As always, consult with your pet’s veterinarian before adding supplements to the diet, as not all supplements are safe for all dogs.

The two medications that may help dogs with DM are aminocaproic acid and n-acetylcysteine. Around 50% of dogs will positively respond to these drugs according to the Dog Owner’s Home Veterinary Handbook 4^th edition. Dr. Clemmons reports a higher number of dogs respond positively when medication, exercise, diet, and supplements are used in conjunction: “We always hope that all patients will respond to our treatment protocol. Unfortunately, it does not work in all cases; however, this combined treatment has been up to 80% effective in patients diagnosed at the University of Florida.”

Conclusion:

Many problems could be causing weakness in a dog’s back legs and hips. One of these issues that could be the source is degenerative myelopathy. The disease is devastating as it results in paralysis of the hind legs. With this being said, certain medications and supplements may prove helpful for some dogs. Chances of these therapies working are best when DM is caught early. For this reason, it is important to schedule an appointment with your veterinarian as soon as you notice changes in your dog’s mobility.

Cited:

http://dog2doc.com/neuro/DM_Web/DMofGS.htm

Dog Owner’s Home Veterinary Handbook 4^th edition

http://www.caninegeneticdiseases.net/dm/basicdm.htm

Walking your Dog: The Benefits and How to get Started

Healthful food feeds the body; petting and attention feeds your dog’s mind. Walking benefits your dog’s body as well as his mind. Many dogs who don’t get the walks they need, and this lack of exercise may negatively effect their mental and physical wellbeing.

Walking is very beneficial for both you and your dog. Below, the benefits of walking and how to train your dog to be a good walking partner are discussed.

Why You Should Walk Your Dog?

Walking is one of the best forms of exercise, because the physical exertion builds muscle tone and improves cardiovascular health. Walking is also very natural for dogs, with wild dogs and wolves being extremely active compared to their modern day counterparts. In addition to this, the sights and smells a dog is exposed to on a walk are good for his mind as well. [Dogs have 220 million olfactory receptors in their nose compared to our 5 million, so being exposed to different smells is very stimulating for their mind (“The Dog’s Sense of Smell”)]. The mental stimulation a walk provides is far superior to the limited sights and smells a dog has access to around his house and yard.

For high energy dogs in particular, walks are a must. A daily walk will help calm your dog down. If your dog is exhibiting bad behaviors, such as excessive chewing, digging, barking etc., you need to make sure he is being exercised regularly in conjunction with training. It is not fair to expect a dog to behave when he is not being given any outlet for his energy. While some dogs are so high energy that they may never be walked to exhaustion, regular walks will still take the edge off their hyper active nature and make them more responsive to training.

Even elderly dogs can benefit from regular walks. My elderly dog has arthritis, but she still enjoys slow walks around the neighborhood. Walks help keep her muscles strong, which reduces the stress on her joints. I also feel that walking my old dog helps keep her mentally sharp. Dogs can develop dementia just as people can as they age. While regular walks aren’t a tested and true way of preventing memory loss and confusion due to advancing age, it seems reasonable to me that the mental stimulation provided by walking can only be good for her mind.

It is important to check with your vet when exercising a dog with health conditions, and if your dog has any signs of pain, his exercise routine should be adjusted accordingly with the guidance of a veterinarian.

How much Walking:

Energetic Dogs: These are the dogs that never seem to settle down. Many are decedents from working breeds, such as herding dogs or terriers. Without exercise, these animals become destructive, disruptive, and unmanageable. For energetic dogs, a 45-minute walk is the bare minimum, with 1 – 2 hours of brisk walking being preferable. High energy dogs who can only be walked for shorter periods of time should also receive plenty of exercise in other ways, such as fetch and playtime with other dogs. You may also buy weighted vests to make walking more tiring for your dog.

Moderately Energetic Dogs: Moderately active dogs may behave without daily walks, but they will still be healthier and happier with regular chances to explore the great outdoors through walking. A 20 to 30 minute walk either daily or 3 times a week will greatly enrich the life of a dog with a moderate energy level.

Low Energy Dogs: If your dog seems completely disinterested in walking, you should probably take him in for a checkup at the vet. While some dogs really don’t have any interest in walking (like one of my own dogs), it is good to rule out any medical issues. Also, a dog who previously loved walking suddenly has no interest in his daily walks should be taken into a vet for a checkup.

True couch potato dogs can be exercised with a couple of short walks a week and/or regular play sessions at home and around the yard.

Safety While Walking:

Exercise your dog during the coolest time of the day in hot weather to avoid dehydration and heat stroke. Be very careful with brachycephalic breeds such as boxers and bulldogs. These breeds have less of an ability to cool themselves and are therefore much more susceptible to heat stroke.

In cold weather, make sure the temperature is bearable for your dog. Every dog is an individual, so what one dog can handle is very different from what another one can. An Alaskan Malamute is going to fair better in frigid temperatures than a Doberman Pinscher. Very old and very young dogs are also less tolerant to extreme temperatures.

Always walk in well-lit areas for both your dog’s safety and your own. If possible, walk with others. Carry pepper spray and/or a walking stick to defend yourself and your dog from stray dogs or dogs that aren’t leashed. I avoid streets where I know dog owners irresponsibly let their untrained dogs go about off leash. It only takes one bad experience with an aggressive dog for a previously friendly dog to become dog aggressive.

Training Your Dog to Walk Nicely on a Leash:

Some dogs walk nicely on leash from day one, but it seems to me that most dogs need to be trained to not pull while on leash. This is especially true for hyper active dogs, who ironically oftentimes don’t get the walks they desperately need because they are so poorly behaved while on a leash.

Before you begin training, decide how you want your dog to walk. Determine ahead of time if you want your dog on your left or right side, and also decide if you mind your dog walking in front of you as long as he doesn’t pull. Changing what your expect from your dog on a daily basis will slow training.

The most effective way I have found to train a stubborn dog to walk politely on leash is to abruptly turn and walk in the opposite direction when the dog begins pulling or surges ahead of you. When done consistently, this teaches the dog that it is most comfortable to pay attention to where you are. For the first several days, you may feel as if you are walking in circles, but most dogs get the point. A regular, well fitting collar can be used for this, but if you have a dog who is prone to backing out of collars, a martingale is a safer, better choice. Other training aids that can be used are addressed below.

Turning abruptly when the dog surges ahead is effective, but I feel it is a little too harsh for puppies, many small breed dogs, or for dogs that are simply more biddable to gentler methods. For these dog, simply stopping and remaining completely still when the dog surges ahead works very effectively. As soon as the dog puts pressure on the leash, plant your feet, and don’t begin walking again until your dog reduces tension on the leash.

Types of Walking Aids:

Martingale collars: Martingale collars will tighten enough to prevent a dog from slipping out of his collar when properly fit, but they will not tighten completely as a choke chain will. I love these collars for daily walks.

Harnesses: Not all harnesses are created equal. If you want a harness to reduce pulling, look for ones they are specifically labeled as tools designed to reduce pulling. Many harnesses will actually encourage a determined dog to pull and will give a strong animal more power to take you on a walk!

When using any harness, check your dogs chest and armpits regularly for chaffing and irritation, which can occur from the friction from the harness against your dogs skin.

Note: Small dogs often have delicate windpipes, and it is best to walk them on a harness as opposed to a collar to prevent damage to their throats. Also, if any dog of any size exhibits problems such as excessive coughing with a conventional collar, it is a good idea to try a harness to see if that helps the problem.

Headcollars: Headcollars can reduces a dog’s pulling. A popular headcollar, The Gentle Leader®, is the one I used with several of my dogs. While it would reduce their pulling ability, it made them snort any time they became excited on the walk, even when not putting pressure on the leash. While they never seemed to be in any pain, I would get strange looks from other people because of my dogs’ peculiar noises. Also, my most determined dog would still pull while wearing the headcollar if she saw something she really wanted to get, such as a squirrel.

As with most quick fix solutions, headcollars are no substitute for consistent training. If you do use one, I would recommend using it in conjunction with one of the methods given above and transitioning to a regular collar or martingale once your dog is reliable on leash, so you don’t become dependent on the training aid.

Conclusion:

Most dogs love walking, and it is one of the easiest ways to improve your dog’s behavior as well as build his cardiovascular health. While your dog may behave poorly on the leash because of his excitement over walking, regular training can correct this problem.

Cited Work:

“The Dog’s Sense of Smell” – https://www.aces.edu/pubs/docs/U/UNP-0066/UNP-0066.pdf

Dog with Kidney Disease needs surgery

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My Old Dog with Kidney Disease needed Surgery:

When Lady was 14 years old, I discovered a hard mass in one of her mammary glands. Lady has many lipomas that, while unsightly, are harmless; they bother us way more than they bother her! This newly discovered mass felt different, so when she was in for bloodwork I brought it to the attention of my vet. Upon inspection, the vet immediately recommended having it removed as it was a mammary tumor. Without a biopsy, we would not know whether the tumor was malignant or benign.

I wanted to have the mass removed as much as Lady’s vet did, but putting Lady through surgery scared me because of her advancing age and her chronic renal failure.

Before looking into what I did for my dog after discovering she had a mammary tumor, it is helpful to know more about what mammary tumors are, how they are treated, and what the prognosis is after treatment.

What are Mammary Tumors?

As their name suggest, mammary tumors are tumors that grow on the mammary glands. Interestingly, these tumors are actually very common in female dogs, with unspayed females having over a 25% chance of developing one in their lifetime. To put this in perspective, The Dog Owner’s Home Veterinary Handbook compares a dog’s chance of developing a breast tumor to a person’s chance. An unspayed female dog is 3 times more likely to develop a breast tumor than a woman. Mammary tumors in dogs have roughly a 50% chance of being benign (harmless) and a 50% chance of being cancerous. (The Dog Owner’s Home Veterinary Handbook, 4^th edition).

Hormones appear to play a role in whether or not a female dog will get a mammary tumor in her lifetime. A female dog that is spayed before her first heat has a less than 1% chance of getting breast cancer (The Dog Owner’s Home Veterinary Handbook, 4^th edition). Spaying after the first heat cycle but before her second puts her at an 8% risk, according to the same source. After two heat cycles, the above text states that there is no reduction in risk of a mammary tumor. I have read other sources that differ slightly in their statistics, but most fall around these numbers.

If the tumor is malignant, it can spread throughout the body as any cancer can given the chance. Tumors may have discharge and if allowed to continue growing may ulcerate. A tumor that breaks through the skin’s surface is considered an ulcerated tumor (“About Ulcerating Cancers”).

Note: There is another type of cancer called inflammatory cancer that can occur in the mammary glands. This isn’t what we are looking at here.

How to Prevent/Detect Mammary Tumors in my Female Dog:

As can be seen, the best way to prevent your female dog from developing a mammary tumor in her lifetime is to spay her before her first heat cycle. Lady was not spayed until she was an adult. Many shelter dogs like her aren’t spayed until they are adults, so it is important to check your female dog who is either unspayed or was spayed after going through a heat cycle regularly for breast tumors. This is especially important after the age of 6, although it never hurts to start keeping an eye out for issues at an earlier age. As with people, early detection is extremely important to improve chances of successful treatment. If you feel any lump or swelling, take your dog to the vet for a checkup.

How do I Know if my Dog’s Tumor is Benign or Malignant?

I have had pets get needle aspirations to check lumps and bumps many times. With mammary tumors a needle aspiration is not a reliable way to determine whether or not the tumor is malignant. The only way to determine this is to biopsy the mass and have it tested.

Treating Breast Tumors in Dogs:

As stated above, early detection is crucial to good prospects of recovery. If the tumor is malignant but is removed when it is an inch or smaller, the cure rates are favorable (The Dog Owner’s Home Veterinary Handbook, 4^th edition). Benign tumors are completely taken care of by removing them. Chemotherapy generally doesn’t seem to be really beneficial for dogs with breast cancer, but every case is unique, and it may be recommended for your dog (“Mammary Tumors”).

Before getting surgery, I would recommend asking to have x-rays taken of your dog’s chest. Breast tumors often metastasize to the lungs. If there are visible signs of cancer having spread to the lungs, I don’t see the point in putting the dog through the stress of surgery since the cancer has already become invasive throughout other parts of the body.

Lady’s Experience:

Now, let’s look at Lady’s circumstances, and how I made the decision to have the surgery even though she was a senior dog with kidney disease.

Lady’s Signs and Symptoms:

Size of tumor – 2 cm (0.79 inches)
Discharge
Mammary tumors are generally not painful
Lady has a history of high blood pressure that medication failed to improve.
Kidney disease
- Creatinine 1.9
- BUN 33
- Low urine specific gravity (meaning her kidneys cannot concentrate urine as much as they should. I did not know Lady’s exact number, but my vet said it put her in the category of late stage kidney disease. Her other numbers did not line up with this)
- All other values, such as phosphorus, were normal at the time of her surgery

Other than her kidney disease, Lady was in good condition when we discovered her mammary tumor. I think it is truly important to look at an elderly dog’s physical condition and not just her age when deciding if surgery is a good option. Some 13-year-old dogs may handle surgery better than some 8-year-old dogs. Lady’s kidneys weren’t great, but they were not that bad either. If her creatinine and BUN were more elevated and she had high phosphorus or other issues, my decision may have been different. Both Lady’s vet and I agreed that Lady’s constitution was good, and that there was more risk in leaving the tumor than in removing it.

Before surgery x-rays were performed to check to see if there were signs of metastasis. We also had the x-rays to check Lady’s heart. She had began coughing in the previous months, and her cough sounded frighteningly like the cough of a dog with congestive heart failure. The x-rays showed no problems with her heart (had there been a problem, I would not have had the surgery because the risk would be too great).

Before, during, and after the surgery Lady received continuous IV fluids to help her kidneys as much as possible. Her vet only removed the mammary tumor. I mention this because Lady has a harmless cyst on her ear that is rather ugly, but removing it would mean longer time under anesthesia. For a dog with kidney disease, it is important to minimize the time the dog is under as much as possible, so purely cosmetic procedures should be skipped.

Lady stayed at the doctor’s office for several hours after the surgery. We brought her home that afternoon and followed the instructions for the medication she received. Her vet prescribed tramadol and Tylenol. Other drugs are often used for post-surgical pain, but we were limited because of her kidney problems. The after effects of anesthesia make Lady extremely restless, so I was up with her throughout the entire night, but by the morning her personality was back to normal.

After the results from the biopsy came back, our vet called us with the news that Lady’s tumor was indeed malignant. The vet believed all the cancer was removed during surgery, but we were given information on a veterinary oncologist who worked with chemotherapy in case we wanted to pursue such treatment. Chemotherapy hasn’t been shown to improve survival rates in dogs with mammary cancer. This, in addition to Lady’s problematic kidneys, made my decision not to pursue chemo easy. Over six months later, Lady is now 15 and doing quite well.

Conclusion:

Making the decision to have surgery on Lady was extremely stressful, but it came down to weighing the benefits against the risks. Leaving the tumor to grow, not knowing if it was cancerous or not, seemed more dangerous than putting her kidneys through anesthesia. If your dog has kidney disease and needs surgery, work closely with your vet to decide if surgery can be performed safely.

Works Cited:

https://www.acvs.org/small-animal/mammary-tumors

https://www.cancerresearchuk.org/about-cancer/coping/physically/ulcerating-cancers/what

The Dog Owner’s Home Veterinary Handbook, 4^th edition

Good Articles on Kidney Disease and Surgery:

https://www.mypetsdoctor.com/neither-age-nor-kidney-failure-a-factor-in-anesthesia

https://www.vin.com/apputil/content/defaultadv1.aspx?pId=14365&catId=73673&id=7259246&ind=6&objTypeID=17&print=1