Health
Elbow Dysplasia Hip Dysplasia Hemangiosarcoma Bilateral Cataracts
Entropion Sub-Aortic Stenosis (SAS) Hot Spots
Osteochondrosis Dissecans (OCD) Thyroid Deficiency (Hypothyroidism)
GOLDEN RETRIEVER HEALTH ISSUES
Elbow Dysplasia
Elbow dysplasia is the term for an elbow joint that is malformed on X-rays. The mechanism of the malformation is unclear but it may be due to differences in the growth rates of the three bones that make up the elbow joint, particularly the humerus and ulna. In mildly affected dogs the only consequence may be arthritis. In more severely affected dogs, osteochondritis dissecans (OCD), fragmented medial coronoid processes and united anconeal processes can result from the stress in the joint. Some vets think that these problems may not be secondary but may actually be the primary problems and that the bone changes occur as a result of them. It is difficult to be sure but there does appear to be measurable differences in bone growth in dogs that have elbow dysplasia. There are a number of changes visible on X-rays and the OFA does evaluate X-rays for evidence of elbow dysplasia.
Due to the number of possible complications, it is hard to make predictions about how elbow dysplasia will affect a dog. If it can be identified at a young age before changes are severe, surgical correction has a reasonably good success rate. Once severe changes set in, it is much harder to prevent subsequent arthritic changes. Most dogs with this condition eventually become lame and the lameness can be very severe in some dogs, even to the point of disuse of one leg or severe difficult getting up and walking even short distances.
Treatment consists of surgical correction of whatever complications are present, if possible. Medical management using aspirin or other anti-inflammatory medications is helpful. Weight control is very important over the long term for success of either surgical or medical management of this condition.
Hip Dysplasia
Hip dysplasia literally means an abnormality in the development of the hip joint. It is characterized by a shallow acetabulum (the "cup" of the hip joint) and changes in the shape of the femoral head (the "ball" of the hip joint). These changes may occur due to excessive laxity in the hip joint. Hip dysplasia can exist with or without clinical signs. When dogs exhibit clinical signs of this problem they usually are lame on one or both rear limbs. Severe arthritis can develop as a result of the malformation of the hip joint and this results in pain as the disease progresses. Many young dogs exhibit pain during or shortly after the growth period, often before arthritic changes appear to be present. It is not unusual for this pain to appear to disappear for several years and then to return when arthritic changes become obvious.
Dogs with hip dysplasia appear to be born with normal hips and then to develop the disease later. This has led to a lot of speculation as to the contributing factors which may be involved with this disease. This is an inherited condition, but not all dogs with the genetic tendency will develop clinical signs and the degree of hip dysplasia which develops does not always seem to correlate well with expectations based on the parent's condition. Multiple genetic factors are involved and environmental factors also play a role in determining the degree of hip dysplasia. Dogs with no genetic predisposition do not develop hip dysplasia.
At present, the strongest link to contributing factors other than genetic predisposition appears to be to rapid growth and weight gain. In a recent study done in Labrador retrievers a significant reduction in the development of clinical hip dysplasia occurred in a group of puppies fed 25% less than a control group which was allowed to eat free choice. It is likely that the laxity in the hip joints is aggravated by the rapid weight gain.
If feeding practices are altered to reduce hip dysplasia in a litter of puppies, it is probably best to use a puppy food and feed smaller quantities than to switch to an adult dog food. The calcium/phosphorous to calorie ratios in adult dog food are such that the puppy will usually end up with higher than desired total calcium or phosphorous intake by eating an adult food. This occurs because more of these foods are necessary to meet the caloric needs of puppies, even when feeding to keep the puppy thin.
If clinical signs of hip dysplasia occur in young dogs, such as lameness, difficulty standing or walking after getting up, decreased activity or a bunny-hop gait, it is often possible to help them medically or surgically. X-ray confirmation of the presence of hip dysplasia prior to treatment is necessary. There are two techniques currently used to detect hip dysplasia, the standard view used in Orthopedic Foundation for Animals (OFA) testing and X-rays (radiographs) utilizing a device to exaggerate joint laxity developed by the University of Pennsylvania Hip Improvement Program (PennHIP). The Penn Hip radiographs appear to be a better method for judging hip dysplasia early in puppies, with one study showing good predictability for hip dysplasia in puppies exhibiting joint laxity at 4 months of age, based on PennHIP radiographs.
Once a determination is made that hip dysplasia is present, a treatment plan is necessary. For dogs that exhibit clinical signs at less than a year of age, aggressive treatment may help alleviate later suffering. In the past a surgery known as a pectineal myotomy was advocated but more recent evidence suggests that it is an ineffective surgical procedure. However, administration of glycosaminoglycans (Adequan Rx) may help to decrease the severity of arthritis that develops later in life. Surgical reconstruction of the hip joint (triple pelvic osteotomy) is helpful if done during the growth stages. For puppies with clinical signs at a young age, this surgery should be strongly considered. It has a high success rate when done at the proper time.
Dogs that exhibit clinical signs after the growth phase require a different approach to treatment. It is necessary to determine if the disorder can be managed by medical treatment enough to keep the dog comfortable. If so, aspirin is probably the best choice for initial medical treatment. Aspirin/codeine combinations, phenylbutazone, glycosaminoglycosans and corticosteroids may be more beneficial or necessary for some dogs. It is important to use appropriate dosages and to monitor the progress of any dog on non-steroidal or steroidal anti-inflammatory medications due to the increased risk of side effects to these medications in dogs. If medical treatment is insufficient then surgical repair is possible.
The best surgical treatment for hip dypslasia is total hip replacement. By removing the damaged acetabulum and femoral head and replacing them with artificial joint components, pain is nearly eliminated. This procedure is expensive but it is very effective and should be the first choice for treatment of severe hip dyplasia whenever possible. In some cases, this surgery may be beyond a pet owner's financial resources. An alternative surgery is femoral head ostectomy. In this procedure, the femoral head (ball part of the hip joint) is simply removed. This eliminates most of the bone to bone contact and can reduce the pain substantially. Not all dogs do well following FHO surgery and it should be considered a clear "second choice".
Hip dysplasia may not ever be eliminated by programs designed to detect it early unless some effort is made to publish the results of diagnostic tests such as the OFA evaluation or PennHIP evaluations, openly. This is the only way that breeders will be able to tell for certain what the problems have been with hip dysplasia in a dog's ancestry.
When an older dog is exhibiting signs of pain associated with this condition it is often possible to help them dramatically through medication and simple steps like providing a warm bed or warm spot to rest during the day. There is no advantage to pain and steps should be taken to ensure that the older dog is not in pain. Regular exercise can be very helpful and weight loss can have dramatic effects on the amount of discomfort a dog experiences.
Working with your vet to come to the best solution for your dog and your situation will enable you and your dog to enjoy life to its fullest, despite the presence of hip dysplasia.
Hemangiosarcomas
Hemangiosarcomas are a form of cancer which originates in the endothelium, which is the lining of blood vessels and spleen. As might be expected of a tumor arising in the blood system they are highly malignant and can be found almost anywhere in the body since blood vessels are necessary in almost all body tissues. There is a strong predilection for the spleen, pericardium and heart. These tumors are most common in middle aged or older dogs which are medium sized or larger but can occur in any breed. German shepherds are reported to be more susceptible to this tumor than most dog breeds. In our practice golden retrievers also seem to have a higher than normal incidence.
Because these tumors arise in internal organs there is often little warning that they are present prior to time they cause severe clinical signs of disease. A common estimate of the average time from discovery of the tumor until death occurs in affected dogs is six to eight weeks but death occurs more rapidly than this in a number of cases.
Visible bleeding, usually in the form of nosebleeds, and signs associated with blood loss, such as tiring easily, episodes of unexplained weakness, pale color to the mucous membranes of the mouth and eyes, increased respiratory rates, abdominal swelling and depression are the most common presenting signs for patients with hemangiosarcoma. A few dogs just suddenly die with no clinical signs having been noted by their families prior to death. Bleeding disorders associated with hemangiosarcoma are sometimes confused with immune mediated hemolytic anemia (IMHA) because the type of anemia caused by the two conditions is very similar and early clinical signs are often very similar, as well. Hemangiosarcomas can cause very large tumors, sometimes as large as ten or more pounds, when they affect the spleen.
In most instances tumors of this size in this location are found on physical exam. In other cases the tumor affects the heart and is hard to find on a physical exam and even easy to miss or X-rays. Sometimes there are hundreds of small tumors spread throughout the body and surgical exploration or an autopsy are the only ways to identify the problem.
The blood disorder that most commonly accompanies the presence of hemangiosarcoma tumors is disseminated intravascular coagulation (DIC). This is blood clotting that is occurring inappropriately inside the blood vessels. It uses up all of the blood clotting elements rapidly and dogs with this condition usually have platelet deficiencies, increased blood clotting times, decrease in fibrin content in the blood and an increase in fibrin degradation products (FDPs). This is probably the cause of death in most dogs affected with hemangiosarcoma.
Diagnosis of hemangiosarcoma can be accomplished in a number of ways.Identification of a tumor in the spleen or heart raises a high degree of suspicion for this tumor. Abdominal swelling is also highly suggestive in an older large breed dog. If fluid is aspirated from the abdomen and it looks like blood it is even more suggestive of hemangiosarcoma. If blood is drawn and will not clot when left in the syringe it is another sign that a dog may have this tumor. In some cases careful evaluation of the type of bleeding disorder present is necessary to raise the suspicion of hemangiosarcoma.
If a tumor is identified when it is small it may be possible to remove the spleen if the tumor is there or even to remove tumors found near the heart and prolong the pet's life. Most of the time this will not make much difference, though. These are highly malignant tumors and most have spread by the time they can be identified. To the best of my knowledge there is not a very successful hemotherapeutic or radiation protocol for this cancer at this time but dogs treated with chemotherapeutic agents do live a little longer than dogs that do not receive this treatment.
Treatment for the bleeding disorders and aggressive supportive care also prolong the life of patients with hemangiosarcoma. If treatment for IMHA or immune mediated thrombocytopenia (ITP) are instituted due to confusion over the underlying cause of clinical signs early in the diagnostic process there is not likely to be any harm to the dog.
Due to the tendency to look for an inciting agent in IMHA and ITP it is a good idea to consider an autopsy exam if a dog dies before a definite diagnosis of any of these conditions can be made. Finding hemangiosarcoma saves a lot of agonizing over possible causes of the death of a friend. There are no known predisposing factors other than size and breed that I am aware of for hemangiosarcoma.
Bilateral Cataracts
The lens is a unique living ocular tissue that is usually clear or transparent and is referred to as "the crystalline lens" by doctors. The normal lens focuses light on the light sensitive nervous tissue located in the back of the eye which is known as the retina. A cataract is an opacity (or cloudy change) of the lens that scatters light and looks gray or white. The cataract usually starts as small dots or microscopic blisters and progresses to involve larger areas of the lens. The rate of progression is difficult to predict and may be very slow or quite rapid. When a light is shined into the eye of a patient with a complete cataract, the patient only sees a white light and no images can be seen.
The first thing to do if your veterinarian indicates your pet has a cataract, is to have your pet examined by a veterinary opthamologist. The lens is an important link of the total visual system, yet the health of the entire eye should be evaluated before the lens develops a complete cataract. Not all cataracts lead to blindness. Evaluation will include the consideration, and the benefit, of cataract surgery.
Signs such as bumping into objects, failing to retrieve favorite toys and fear of being left alone may be signs of vision loss. These are especially significant if they occur within the pet's home or yard.
Entropion
Entropion is a common congenital defect of the eyelids. Sometimes entropion may be caused by dust or debris collecting in the eye, by eyelashes growing in the wrong direction, or by an eye injury. Entropion is the term given to the overall condition when the lower eyelid inrolls, bringing the eyelashes into direct contact with the cornea. This contact creates an irritation, making it necessary for the animal to blink constantly. As the animal blinks, it is compounding the problem by scraping the eyelashes across a more extensive area of the eye.
In breeds with large heads and loose facial skin, entropion can be found in the upper eyelids as well.
The entropion can also be complicated by blepharospasm. Blepharospasm is when the muscles around the eye spasms, causing severe squinting. Blepharospasm can be relieved by the application of anesthetic drops but the relief is temporary unless the factors causing the spasms has been removed.
Entropion should never be left to take care of itself. If left untreated, the condition could cause sore watery eyes, infection, ulcers on the cornea and even blindness. Entropion condition requires surgical correction by a veterinarian.
Sub-Aortic Stenosis (SAS)
Sub-Aortic stenosis is a common congenital (present at birth) defect, found most often in large dog breeds. This condition is an abnormal narrowing of the juncture between the left ventricle of the heart and the aorta. The narrowing is usually the result of a scar like tissue which has formed a ring just below the aortic valve.
Sub-Aortic stenosis can be extremely difficult to diagnose. Due to the wide range of possible stenosis (narrowing) ranging from minor to severe, the impact upon the dogs overall health and symptoms will also present a wide range of possibilities. Affected dogs may have few or no clinical indications of this condition, or have a heart murmur; while some cases are victims of "sudden death."
The genetic factor(s) of SAS are not known as yet. It is believed to be a polygenetic condition, and therefore very difficult to eliminate from the gene pool. Only through the testing of all breeding stock and strict culling of positive animals and producers of positive animals are there hopes to eventually eliminate this condition.
Hot Spots (Acute Moist Dermatitis)
A "Hot Spot" is an area of bacterial skin infection that increases through self-mutilation by the dog. An area of skin is irritated (flea bite, allergy or other irritant), the dog scratches or chews the area enlarging the opening, the area becomes infected, thus begins the cycle.
Hot spots are warm, swollen, painful patches of skin that exude pus and serum, and tend to give off a foul odor. These areas can appear suddenly, they tend to enlarge rapidly (especially in hot humid weather) and can reach a size of several inches in diameter. Hair loss is rapid. Between the dog chewing or clawing the coat out and bacterial spread the progress can be significant within a matter of hours. Hot spots most often appear on the neck, ears, chest, rump, flanks, and back (areas of access to clawing or chewing).
In breeds with double coats hot spots are most common just prior to shedding as the dog tries to relieve itself of the dead hair.
Treatment: Clip all remaining hair away from the infected area. This will allow air to dry the area and promote healing. Gently cleanse the area with a surgical soap (pHisoHex, Oxydex, or Betadine). Apply topical antibiotic-steroid cream such as Panalog to aid in reducing irritation and promote healing. Dependent upon the extent of the hot spot the dog may need oral antibiotics and steroids as well. The dog must be restrained from doing further damage to this area, this may necessitate the use of an Elizabethan collar.
To end the cycle the underlying cause must be determined. In the event of fleas - the fleas must be removed. In the event of allergies the irritant must be determined and eliminated to prevent hot spots from occurring elsewhere.
Osteochondrosis Dissecans (OCD)
Many of the dog breeds that are of the large rapidly growing variety, are affected by Osteochondrosis Dissecans. The age of onset is usually between 4 and 12 months of age. This condition most often occurs in the shoulders of elbows, but it can affect other joints as well.
Cartilage covers the head of the long bones, forming a joint. This cartilage serves as a cushion, which is subject to stress and prone to damage. Cracks can form in the cartilage, the cartilage itself can tear - forming flaps, or sections of the cartilage can tear away from the bone - free floating in or near the joint. The damaged cartilage leads to inflammation of the joint (arthritis), pain and lameness.
OCD is thought to be a combination of genetic and environmental factors. Genetic factors may be direct (polygenetic), or indirect (improper conformation of the parent(s) passed on to the offspring). Environmental factors can range from poor diet to trauma induced.
Small cracks in the cartilage can occasionally be healed through strict confinement. Other cases usually require surgical correction.
Thyroid Deficiency (Hypothyroidism)
Hypothyroidism is the condition resulting from an inadequate (low) production of usable hormones by the thyroid gland. Mild hypothyroidism is a common cause of skin and hair abnormalities.
The following is a list of symptoms that may present. Some dogs will show only one symptom, some will show numerous symptoms, and others will show no symptoms at all.
1. Hair condition changes- hair can get dry and brittle, falls out to the touch.
2. Hair loss - usually starting at the back of the ears, can also appear under the throat and down the thighs.
3. Motled coat - hair thin over ribs, normal down backbone and shoulders, thin under the neck and belly.
4. Dry flaky cool skin - no matter how often you bathe or comb your dog it has scaley skin with large flakes all the time. The belly skin feels slippery and cool to the touch.
5. Skin infection - secondary staphylococcus infection, skin infection characterized by small pustules most often on head and torso. Sometimes called "puppy acne."
6. Gains weight - in comparison with littermates puppy is eating much less than the others - yet maintains good weight. Dog is eating much less than would be considered "normal" for his age and either maintains weight or becomes overweight.
7. Lethargy - you will either notice that your dog is sleeping more and more or that a dog is sleeping much more than would be expected for a dog his age.
8. Heat cycle irregularity - in mature dogs the heat cycle can be too short, or too long, very irregular, or cease entirely to come. In young bitches hypothyroidism can cause an adolescent not to achieve first heat at a standard age.
9. Fatigues easily - will run and play hard for a short period of time and then is either asleep or resting when his littermates or other dogs are still playing.
10. Infertility - in bitches can cause only a few eggs to be released resulting in small litters; in dogs can cause low sperm count again resulting in small litters, or can cause total sterility in either sex.
11. Reduced sex drive - males can show little to no interest in receptive bitches.
12. Inconstant Bowel Movements - dog can exhibit prolonged diarrhea, or prolonged constipation, or erratically bouncing between constipated or diarrhetic; never achieving "normal."
13. Climatic sensitivity - dog exhibits discomfort from temperature extremes. Suffering on hot days, snuggling the heater on cold days.
14. Excessive skin pigmentation - spots on the groin or belly, spots can be light or dark.
A complete blood serum thyroid panel (T3,T4,freeT3,freeT4) is the only way to be assured that the dog does not have a thyroid deficiency problem. This is particularly important in breeds with a higher incidence of thyroid deficiency.
Treatment is available for thyroid deficiency, consisting of a thyroid replacement therapy (pills). Generally within 3 day of the beginning of treatment the dog's appetite will begin to return to normal. Within 2 weeks the skin scaling will decrease and the coat will be less dry. Hair growth can take 90-120 days to return to normal.
Warning: Once thyroid replacement therapy has begun, the dog is on treatment for life. Do not put a dog on thyroid replacement medication without a thyroid screening indicating that replacement is necessary - symptoms may clear, but you could be masking over a far more serious medical problems.
Diet can also impact your dog's thyroid. A diet high in usable protein and fairly low in fat is recommended.
At present thyroid deficiency is suspected of being inherited. Recent studies have shown that mother's on thyroid replacement therapy and stabilized at normal levels prior to conception can and do produce normal offspring. Thyroid deficiency may not be eliminated - but with proper treatment many types of thyroid related disorders can be drastically reduced.