Arthritis is very common in older dogs as an aging process. It can be very painful, cause limping and lameness, and lead to muscle atrophy (wasting) from reduced exercise. This condition is called degenerative joint disease and is a consequence of wear and tear on the cartilage that pads the bones from rubbing together. Inflammatory joint disease is an arthritic process that is not related to aging. Instead, infection or immune-mediated disease is the cause of joint stiffness and pain. Tick-borne diseases such as Lyme and Ehrlichia are common causes of this painful joint condition. Treatment for pain is indicated, but the underlying illness must be treated as well.

Hip dysplasia is a common cause of limping in dogs. It is not a disease, but a mal-formation or a poor confirmation of the hip joint. The femur bone in the rear leg is topped with a ball that fits into the acetabulum (socket) of the pelvis. In this heritable condition, the ball can slip around or completely out of the socket causing discomfort. Over time, arthritic changes occur as abnormal wear occurs. An x-ray can confirm hip dysplasia, but it may not predict the severity of symptoms that may arise as a result. Hip replacement and a “salvage” surgery called a femoral head ostectomy are recommended when pain is not controlled with joint health supplements and medications.

It is important to have any persistent limping checked by the veterinarian to determine the cause and provide pain relief.

Inhalant allergy (atopy) is the second most common cause of skin itchiness in dogs. It can be difficult to eliminate, because the allergens are in the air we breathe. Atopy is a complicating and/or primary factor in many skin disorders. It responds to antihistamines and corticosteroids. Allergy testing and desensitization serum injections are recommended to reduce the need for oral medications which may have side effects.

Sarcoptic mange (scabies) is a microscopic mite that burrows under the skin causing severe itchiness. It can be hard to detect on skin samples under the microscope; however, it makes its presence well known. Often, it is treated as a rule out cause for itching before pursuing other diagnostics. Dips and extra-label use of injectable de-wormers are used to kill scabies mites.

Ringworm isn’t a worm at all. It is a fungal infection of the skin. It causes the hairs to break off and leaves a scaly red patch on the skin that may itch. Mild cases may respond to topical anti-fungal ointments; whereas, generalized infection requires the use of oral antifungal drugs concurrently with medicated shampoos or dips.

Yeast (Malassezia) infections of the skin are notoriously itchy. They also exude an offensive musty odor from the skin. Hyperpigmented and thickened skin (elephant skin) is a common appearance for dogs with Malassezia infections. They require the use of anti-fungal drugs and shampoos, and are almost always secondary to an underlying hormone disorder or primary allergic dermatitis.
Diseases that cause the skin to be especially susceptible to pruritus are Hypothyroidism and Cushing’s disease. These hormone-related illnesses cause the skin to be prone to bacterial and yeast infections. Hypothyroidism is a condition where the thyroid gland does not produce enough thyroxine or T4. T4 is important in cellular function in all parts of the body. In Cushing’s disease, the adrenal gland over-produces cortisol (cortisone). This causes the skin’s immune defenses to stop responding to intruders like bacteria, mites, and yeast.

Food allergies are another potential cause for pruritus. The itching usually occurs primarily around the eyes, chin, and ears. The dog may also lick its feet. Recurrent ear infections are common in dogs with untreated food allergies. Hypoallergenic feeding trials are the method of diagnosing as well as treating allergies to certain food ingredients.

An Elizabethan collar can be used to prevent self trauma and the consequences thereof, but the underlying cause must be addressed to provide the dog relief from the urge to scratch.

It is always important to have skin problems checked out by the veterinarian sooner than later. While the primary cause of itching may be relatively straight forward to diagnose and treat, deep-seated secondary infection can be difficult, expensive, and time-consuming to resolve.

Vaccines protect your pet from contagious disease. Around six weeks old, puppies and kittens lose their maternal antibodies that had kept them safe since birth. Vaccinations are started at this age and boostered every three weeks until 12 to 15 weeks old. The immune system is not fully developed until then, so complete protection may not be achieved with the initial vaccines. During adulthood, vaccinations are boostered every one to three years depending on the specific disease risk in your area and the efficacy of the vaccine.

Proper nutrition is very important in all stages of life. A balanced diet that is AAFCO approved (Association of American Feed Control Officials) will provide all the daily requirements of nutrients, vitamins, minerals, and antioxidants that your pet needs to stay fit and healthy. Table scraps are not balanced and tend to be high in fat and salt. They only contribute to an overweight, picky eater. Your veterinarian will make recommendations as to the type of food that is best for your dog and cat.

Early detection of illness starts with regular wellness examinations performed by the veterinarian. Your vet may recommend tests that can discover early organ dysfunction or metabolic disorders like Diabetes, Thyroid disease, or Cushing’s disease. Older pets will have their blood pressure checked and may have an ECG performed or an x-ray taken if a heart murmur is detected. Catching a problem before there are any obvious symptoms greatly improves the prognosis and may even be reversible. Symptoms mean there is damage already being done to the body. Be sure to discuss any changes in water consumption, appetite, eliminations, and activity levels with the doctor.

Prophylactic dental care is proven to greatly reduce referred infection from the oral cavity into the heart and major organ systems. As well as teeth brushing, your dog and cat should have a professional dental cleaning before periodontal disease becomes established. Ultrasonic scaling and high-speed polishing of the teeth removes bacteria harboring tartar that leads to infection, pain, and tooth loss.

Continued parasite prevention is important to avoid diseases that are transmitted by fleas, ticks, and mosquitoes. Adult pets can carry intestinal parasites without showing any outward symptoms. Mosquitoes transmit heartworms, ticks carry infectious organisms that cause Lyme disease and Ehrlichia, and fleas are thought to be vectors of hemobartonella, a blood parasite that causes anemia in cats. Some of these illnesses are zoonotic or contagious to people. Your veterinarian will prescribe safe, easy to use, monthly preventive medications to keep your pet free of these harmful parasites and protect your family from serious zoonoses.

Keep in mind that a pet ages at a must faster rate than a person. A trip to the vet once a year is the equivalent of a person seeing a doctor about once a decade. Many changes can occur in between wellness exams. Veterinarians are recommending twice a year check ups for dogs and cats. Early detection of disease will greatly reduce the progression of damage being done and improve the outcome of treatment.

Bites from non-venomous snakes should be treated the same as puncture wounds. Bacteria from the dog’s skin and the snakes’ mouth are delivered beneath the skin by sharp, needle-like teeth. Because the teeth are so sharp, the skin may seal quickly over the puncture. The bacteria may then reproduce and cause an abscess. It may rupture and drain several days later. A large amount of tissue may slough off that was damaged by the infection. Oral antibiotics are usually prescribed prophylactically for non-venomous snake bites.

Venomous snake bites are a different story. It is important to get treatment for the dog as soon as possible. Try to keep the dog calm, and keep the bite wound below the level of the heart. Do not attempt to remove the venom yourself by any means. Venom from different snakes act differently on the body, so identification of the snake makes it easier to determine the appropriate treatment protocol. Initial treatment is symptomatic. Shock is controlled with rapid IV fluid therapy and steroid injections. Antivenin is a serum that neutralizes venom, but it comes with its own set of risks, so it must be known whether the antivenin will benefit the dog. This will depend upon which type of snake caused the bite. Antibiotics, anti-inflammatory drugs, and pain medications are all indicated. Some venoms cause intravascular coagulation, some cause localized tissue destruction, and some cause neurological effects. The dose of venom determines the severity of illness, therefore, small dogs are more at risk than larger ones because they will receive a higher dose of venom per pound of body weight. In any case, a venomous snake bite is a life-threatening emergency, and veterinary care should be sought immediately.

There is a vaccine available for venomous snake bites. It may be useful for hunting and working dogs. It causes the body to produce antibodies to the venom making the dog somewhat immune. The vaccine appears to be safe, but its efficacy and duration is limited. Even a vaccinated dog should seek medical attention immediately after a bite from a venomous snake.

Signs of separation anxiety include hypersalivation or drooling, inappropriate elimination with or without coprophagia, destructive chewing or scratching at exits from the house or crate, and incessant howling and barking. A puppy may seem impossible to housebreak when separation anxiety is a factor. They may have accidents in the crate which goes against the idea that a dog will not soil its den or bedding.

Desensitization will require very short stays alone before anxiety is at a peak and then positive reinforcement with praise and treats for appropriate behavior. This may require that the dog is comfortable sleeping in a crate even when the owner is in the next room. Baby steps are key. An extended time alone may cause the pet to revert to the separation fear. Also, the act of leaving the house should be uneventful. Triggers that induce stress include keys jingling, packing purses and luggage, etc. These signals must be avoided. Never reward inappropriate behavior with consolation. This may become an emotional trigger as well. The crate itself also can become a trigger of stress, and the goal of crate-training is not to lock the dog up every time you leave. It is a tool to teach a schedule that helps the dog establish boundaries.

For dogs with severe separation anxiety, medications are available to curb stressful emotions. They will rarely work alone without a behavior modification regimen. Some dogs respond better to one medication than another, but they include clomipramine, fluoxitine, and amitriptyline. A veterinarian must prescribe these drugs, and they often have withdrawal periods. They should never be stopped “cold-turkey” unless instructed to do so by the doctor. Never-the-less, these anti-anxiety medications can help tremendously when trying to desensitize a dog’s stress triggers.
Consultation with an animal behavioralist is also recommended for severe cases of separation anxiety. It is human nature to anthropomorphize (associate human emotion) dog behavior. An unbiased, outside party can help to analyze what role the owner may be playing to reinforce the anxiety.

Cats with separation anxiety display fewer symptoms other than one very annoying behavior, urinating and defecating on the owner’s personal belongings such as the bed and clothing. There are many health causes of inappropriate elimination in cats, so a medical reason should be ruled out first. Anti-anxiety medications can be the only option at times to resolve cat stress, as the triggers that cause separation anxiety can be subtle or un-apparent to owners.

It seems obvious to control pain after surgery, an injury, or during a painful illness like pancreatitis. But in fact, the practice of pain management has not always been widespread in veterinary medicine. The acknowledgement that our pets do indeed experience emotions like pain was not always a popular belief. Even in human medicine, pain is often under-treated. It is proven that untreated pain suppresses the immune system, delays healing, and prolongs recovery from surgery. It is our greatest responsibility as the caretakers of our pets to alleviate suffering, and there are fortunately many options available to ensure that we are successful.

Pain can be articulated by people. However in pets, it must be observed and measured. There are several pain scales that veterinarians can use to anticipate and measure pain. Dogs and cats exhibit pain differently than people except in the case of acute, excruciating pain where vocalizing occurs. Being pack animals, dogs tend to keep a low profile, staying away from others including human family members. They may refuse food and be defensive, cowering and growling or snapping in anticipation of discomfort. Cats will also hide and guard their wounds, and both dogs and cats may over-groom a tender area. Pain is also measured by empirical methods, assuming that an animal would feel the equivalent of a human after experiencing surgery, trauma, or an illness. Increased blood pressure, heart rate, and respiratory rate may also be used as indicators of pain.

Treatment for pain depends completely on the source and severity of discomfort. Medications, physical therapy, alternative therapies such as acupuncture, and other palliative measures can all be used alone or in combination. Multi-modal approaches to pain control tend to be the most effective.

For minor pain, heat and compression can give relief. Cold increases the perception of pain. Range of motion exercises can keep an arthritic animal limber and strong. There are specialists in physical therapy that utilize tools like water treadmills to increase flexibility and avoid muscle wasting caused by chronic pain.

Medications that alleviate pain are called analgesics. There are different categories of analgesics which have different mechanisms of action. Drugs are used for moderate to severe forms of pain. Non-steroidal anti-inflammatory drugs (NSAIDs) are useful for conditions like arthritis where pain relief is best achieved when inflammation in the joints is controlled. Opiates are reserved for severe pain, like after major surgery. They are usually not given long term because of the potential for side effects on the GI tract like constipation. Opiate drugs come in oral, injectable, and transdermal forms. Local anesthetics can be injected into the tissues around a surgical incision to completely numb the site. Just as in humans, epidurals can be given by injecting an opiate directly into the spinal canal, completely blocking the nerve pathways for entire regions of the body.

Pain should be assumed, predicted, and preemptively controlled in our pets. Because we can not tell an animal “this is going to hurt a bit”, even minor pain can affect their health and wellbeing significantly.

The first commercially produced NSAID was aspirin, or acetylsalicylic acid. It is a non-selective COX inhibitor. Isolated from tree bark (a folk remedy for headaches) in 1829, Aspirin was a miracle drug in treating minor pain without the risk of addiction to morphine. The side effects of aspirin include possible gastric ulceration and reduced platelet function. Because of the higher doses needed to achieve analgesia in animals, these side effects are even more pronounced in pets than in people. Aspirin was once the most commonly used NSAID in veterinary medicine, but alternative drugs have been developed that are safer for prolonged use.

A large group of NSAIDS called profens include selective and non-selective COX enzyme inhibitors. Ibuprofen (Advil, Motrin) is non-selective and carries the same risk of gastric damage as aspirin. It can be toxic to the liver; so, it is generally avoided as an analgesic for pets. Selective COX inhibiting profens include carprofen (Rimadyl), which is FDA labeled for use in dogs to treat pain. Carprofen can cause liver inflammation in some patients, and baseline liver values are measured before starting this and all NSAIDS. It should not be used in patients that have preexisting liver problems. Gastric ulceration is rare and is usually associated with over-dosage.

Other classes of COX-selective NSAIDS include the oxicams, arylalkanoic acids, and the coxib drugs. These drugs are less likely to cause stomach ulceration and bleeding than non-selective COX inhibitors in theory, however, the most common side effect seen with all of them is gastric irritation. Side effects are usually dose related. Meloxicam (Metacam), etodolac (Etogesic), deracoxib (Deramaxx), and firocoxib (Previcox) are all examples of these newer generation selective COX inhibitors.
NSAIDS are considered safe and effective for the treatment of pain when used according to directions. All of the drugs listed here, with the exception of aspirin and ibuprofen, are FDA approved for use in dogs. Cats do not tolerate most NSAIDS. There is only one drug approved for use in cats, and that is Metacam injectable. It is labeled for one time use only in cats. Other NSAIDS or the misuse of Metacam can be extremely toxic to cats. Never give a cat any pain medication that has not been prescribed by a veterinarian.
NSAIDS should never be combined with aspirin, corticosteroids, or other NSAIDS, as the risk of side effects will be greatly multiplied. Never give an extra dose or increase the dose without consulting a veterinarian. NSAIDS should not be given on an empty stomach.
All NSAIDS that are FDA labeled for use in dogs must display the following statement on their labels; “All dogs should undergo a thorough history and physical examination before initiation of NSAID therapy. Appropriate laboratory tests to establish baseline blood values prior to, and periodically during, the use of any NSAID are strongly recommended.”

One way to ensure your pet’s safety is to evaluate a blood chemistry profile before the surgery. This can detect compromised organ function, anemia, electrolyte imbalance, and bleeding disorders. Although it is impossible to screen for every possible disease process with one blood sample, the most likely problems that would preclude or complicate surgery can be ruled out.

Monitoring equipment used during surgery has greatly improved the safety and outcome of general anesthesia. In the past, the level of anesthesia could only be measured subjectively. Heart rate and respirations were observed to indicate the depth of anesthesia. Modern monitoring of blood pressure, blood oxygen saturation (pulse oximetry), and electrocardiogram (EKG) are much more accurate at assessing the patient’s wellbeing. The depth of anesthesia can be “fine tuned” using these parameters to improve safety and speed recovery.

The drugs used to induce and maintain anesthesia have become far safer as well. Induction agents and gas anesthetics are minimally metabolized by the body and are eliminated very quickly compared to older protocols. A rapid recovery reduces the chance of anesthetic injury to the kidneys and other organs. The pet is able to return to eating and drinking shortly after the procedure which prevents dehydration and boosts the immune system during healing.

A side effect of general anesthesia is lowered blood pressure. Intravenous fluids can be administered to normalize blood pressure and ensure adequate tissue oxygen perfusion. Life-saving drugs can be administered through an IV catheter in the case of an emergency.

Analgesia (pain control) is better achieved through the drug choices that veterinarians can utilize. It is a proven fact that pain suppresses the immune response, slows healing, and increases recovery times. Your pet will receive pre- and post-operative pain medications that will ensure their comfort and improve the outcome of surgery.

The veterinary staff will give you specific instructions to follow before and after surgery. The pet will need to fast for a period of time to reduce nausea during anesthesia. Vomiting while unconscious is very dangerous, and an empty stomach will avoid this problem. Be sure that you understand the fasting instructions. Withholding water for too long before surgery can lead to dehydration which may cause problems with recovery.

After surgery, you will be given aftercare instructions. Restricted activity, physical therapy, antibiotics, pain medications, rechecks, and scheduling suture removal are common follow up procedures to a surgery. You will want to monitor your pet’s appetite and attitude afterward and call the vet if there are any problems. An Elizabethan collar may be sent home to prevent the animal from chewing and scratching at the incision.

You should understand what will be done during surgery and the expected results. Discuss the procedure with the veterinarian and the nursing staff so that you are comfortable with your part in the follow up care of your pet.