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Dental Dilemmas

As we all know, Greyhounds are one of the most structurally sound breeds of dog around. But all breeds have their own specific health issues. When asked what is the most common medical condition affecting Greyhounds, the answer is simple – bad teeth!!

The majority of Greys, fortunately, have great dental health. Having a dolichocephalic (elongated) head shape, there is generally ample room for the 42 permanent teeth, so crowding is not an issue. The incidence of maxillary prognathism (undershot jaw) is higher in Greyhounds than many other pure breeds, as this genetic trait is not specifically selected against when planning a litter. (A racing Greyhound's value depends on its speed and soundness – not on the length of its jaws!!)

How many of you have had your hound poke his or her long face into yours and experienced unpleasant doggy breath, or halitosis? This is usually caused by periodontal disease – inflammation and infection of the gingival (gum) pockets surrounding the teeth. Clinical signs of periodontal disease include redness or swelling of the gum margins, recession of the gums from the tooth roots, the presence of purulent exudate or tartar buildup on the teeth and a foul odour (due to excess anaerobic bacteria in the gingival pockets).

With serious gum recession, teeth become loose and may fall out. Tooth root abscesses may develop, causing severe pain, osteomyelitis (infection of the jaw bones) or facial swelling. In less acute situations, ongoing discomfort, inability to chew properly and weight loss can occur. Low grade, chronic periodontal infections can lead to bacteraemia and lodging of bacterial organisms in vital organs such as the kidneys.

So – what can you do to prevent your Greyhound developing dental / periodontal disease? Probably the most important thing is to give your dog regular access (at least 2 or 3 times a week) to hard beef or lamb bones (brisket, shank, etc), whole chicken frames, pigs ears, roo tails or manufactured dental chews. Smaller chicken bones (such as necks or wings) are popular with most dogs, and can help the teeth a bit, but are usually too soft to make a significant difference. (Some dogs, like my Lilly, will swallow a chicken neck in one gulp, without chewing at all!). NOTE WELL: Only RAW bones should ever be given to dogs; cooked bones are rendered indigestible, causing splintering or constipation.

Although some owners are in the habit of leaving their dog with a bone / chew when they go out, it is advised only to give such objects when there is someone around to supervise. Dogs can, and have, choked to death when swallowing large chunks of bone or rawhide. In addition, if you own more than one dog, fights can occur over juicy bones or prized pigs ears.

Owners can brush their dog's teeth each day, just as they do their own. A range of meaty flavoured, non-foaming toothpaste is available from pet shops and vet clinics. Normal (soft) human toothbrushes can be used, but also available are special canine toothbrushes, which sit over the owner's index finger, a bit like a thimble. Alternatively, a piece of old stocking or pantyhose can be stretched over a finger and used as a mildly abrasive brush. Most Greyhounds will permit their owners to brush their teeth without too much fuss, especially if a special treat (food or toy) is given to the dog at the end of each session. GAP also stocks double-ended dental scalers for dogs that require slightly more aggressive dental hygiene measures!

Many vet clinics stock oral rinses or gels, often containing mild antiseptics, which the owner sprays or smears over the gums after brushing. This can be useful for dogs with chronic gum problems.

Some specially formulated commercial dry dog foods (eg Hill's canine t/d prescription diet) are designed specifically for dogs predisposed to dental disease. The large chunks require much more chewing than smaller pieces of kibble that Greyhounds often devour in seconds. Such foods can be useful for dogs that show little or no interest in chewing bones.

Despite all the above measures, a percentage of Greys will still develop moderate dental disease at a relatively young age. It is likely that these dogs have inherited some genetic predisposition to periodontitis and/or an inability of their immune system to deal with the normal anaerobic bacterial flora in their mouths.

Greyhounds with a noticeable build-up of mineralized tartar (calculus) on their teeth, or with moderately inflamed gum margins, will require an ultrasonic teeth clean, performed under general anaesthetic.

Osteoarthiritis

Osteoarthritis: how can we help our aging Greys?
Osteoarthritis (also known as degenerative joint disease) is a progressive degeneration and inflammation of one or more joints due to the effects of aging or injury. In the racing Greyhound, repeated trauma to the joints (especially in the long, slender toes) or fractures of the hock, are not uncommon. But on the positive side, degenerative conditions such as hip dysplasia or cruciate ligament injuries (which often have an inherited basis) are exceedingly rare in the Greyhound breed.
Clinical signs: Most Greyhounds are fairly stoic when it comes to chronic pain (as opposed to the "Greyhound scream of death" frequently experienced during minor, acute episodes of trauma such as when the nail clippers are produced!). Most dogs will display a limp of varying degree if one limb is more painful than others. But some dogs, with bilateral arthritis, may be equally sore on both forelimbs, for example, and a limp may not be so obvious. Limping is not always an indication of arthritis either – lameness could be due to a damaged or infected nail, a foreign body in the footpad, a corn (yes, Greyhounds get corns), muscle or tendon injuries, a sore neck or back, or more serious conditions such as bone cancer.
Other symptoms your Greyhound may display if they are developing arthritis may include: having difficulty getting up after sleeping; taking a long time to lay down; restlessness; stiff gait; reluctance to climb stairs or jump into or out of the car; reduced playfulness or exercise tolerance; behavioural changes (irritability or aggression) etc. Occasionally house training may deteriorate if a dog is sore and reluctant to get up and go outside.
If you suspect your pet has arthritis, a trip to the vet is in store so that a full physical examination can be made to pinpoint the sore spot(s) & undertake further diagnostic tests (such as X-rays) if needed.
Once a diagnosis is made, what can we do to help our Greyt companion?
Exercise: Regular (daily), mild exercise is important to maintain muscle tone & prevent joints from seizing up. Strenuous exercise or free running at the dog park, however, can be counter-productive. So a 10-20 minute walk on the lead, on level ground, is good for all concerned – remember the old saying: "Use it or lose it". And as with people, swimming can be a good form of low impact exercise for dogs with stiff joints.
Weight loss: Again, as with humans, increasing age and decreasing levels of activity often lead to a bit of middle-age spread. Apart from impacting on other risk factors (elevated blood pressure, diabetes, etc) carrying around extra baggage is no good for dogs with arthritis. Cut down your dog's food intake, or perhaps change to a "lite & mature" style dry dog food, with lower fat content.
Keeping warm and comfy: If your dog is suffering from arthritis it is even more important to provide him or her with a thick, soft, comfy bed located well away from draughts and off cold hard floors such as tiles or slate. In the colder months, a nice warm coat will also be appreciated.
Nail care: If a Greyhound's nails are allowed to become overly long it causes abnormal pressures to be placed on the toes and feet and this can exacerbate the pain of arthritis. Keep your dog's nails trimmed short using clippers, a Dremel® or metal hand file. This should be done every 2 – 3 weeks.
Dog ramps: If your hound is struggling to get up into the car, you can now purchase folding or telescopic ramps – several brands are available on-line. You can even get doggy stairs so your aging dog can still make it up onto your bed or lounge!
Prescription medication: If osteoarthritis is confirmed, your vet may prescribe anti-inflammatory treatments – which are generally either corticosteroids (cortisone) or non-steroidal anti-inflammatory drugs (NSAIDs). The latter group includes such drugs as Rimadyl® (carprofen), Metacam® (meloxicam) or Onsior® (robenacoxib). Both corticosteroids and NSAIDs can have serious side effects, especially with long term treatment, so short term therapy to alleviate severe flare-ups of inflammation and pain are best. Patients requiring longer term therapy should be checked and monitored (by blood tests) every few months. Please note that human drugs such as aspirin or paracetamol should NOT be used without very strict veterinary supervision (and the latter can be lethal in cats).
Another therapy your vet may recommend is a course of injections of Cartrophen Vet® (pentosan polysulphate). This involves four subcutaneous injections (approx 1ml dose for the average Greyhound) given at 5 – 7 day intervals. It has anti-inflammatory and cartilage protective properties and has virtually no side effects. Treatment course may need to be repeated every 3 to 12 months, depending on the severity of the arthritis.
Nutraceuticals: There are a large variety of nutraceuticals (a term coined in the 1980s combining nutrients and pharmaceuticals) available as dietary supplements for dogs with osteoarthritis. Many of these (such as glucosamine / chondroitin or fish oil) you may be taking yourself! Several of the premium grade commercial dog foods now incorporate these into their products, especially those marketed specifically for large breed or mature dogs.
A review article recently published in the veterinary literature (Vandeweerd et al, 2012) looked at 67 published treatment trials on the use of nutraceuticals in dogs, cats and horses. Of these, only 22 met the inclusion criteria for the review (controlled clinical trials evaluating clinical signs of pain or locomotion). An exhaustive evaluation of these 22 trials was conducted, with a grading of the quality of evidence for the following nutraceuticals: glucosamine, chondroitin sulphate (various forms), undenatured type II collagen, avocado & soybean, gelatin hydrolysate, omega-3 fatty acids (aka fish oils), hydroxycitric acid, green-lipped mussel powder, special milk protein concentrate and Indian & Javanese turmeric. The conclusions of the review were: "The evidence of efficacy of nutraceuticals is poor, with the exception of diets supplemented with omega-3 fatty acids in dogs".
Adjunctive therapies: Some dogs with osteoarthritis may benefit from other treatment modalities including acupuncture, chiropractics, massage therapy and even Traditional Chinese Medicine (TCM). The options are endless!
REFERENCE:
J. M. Vandeweerd, C. Coisnon, P. Clegg, C. Cambier, A Pierson, F. Hontoir, C. Saegerman, P. Gustin & S. Buczinski. Systematic Review of Efficacy of Neutraceuticals to Alleviate Clinical Signs of Osteoarthritis. Journal of Veterinary Internal Medicine (2012) 26 (3): 448 - 456

Urinary Incontinence in Dogs

Treatment of Urinary Incontinence in Dogs

It may not be a "dinner party" topic of conversation, but as some of our Greys are getting a bit longer in the tooth, the subject of urinary incontinence comes up from time to time.

Urinary incontinence can be a result of a number of factors:
• hormonal - eg. oestrogen deficiency
• neurological - eg intervertebral disc disease, degenerative myelopathy
• anatomical - eg congenital ectopic ureters, or
• pathological – eg. urinary tract infections, bladder stones or tumours, prostatic disease in males or kidney disease

Incontinence is an involuntary leakage of urine and should not be confused with inappropriate urination for behavioural reasons (poor house training, marking territory, submissive urination due to fear, etc)

All dogs with a recent history of incontinence or loss of house training should be given a thorough physical examination by their veterinarian, to exclude non urinary tract disease. This examination should also include collection of a fresh urine sample for urinalysis +/- bacterial culture.

Urethral sphincter mechanism incompetence (USMI) is the most common cause of urinary incontinence in middle aged to older dogs. It is reported more commonly in medium to large breeds and is much more frequent in females than in males. Causes are multifactorial – hormone imbalances, genetics, obesity, age related changes in urethral musculature etc. The most commonly observed symptom is leaking urine while asleep. It can occur daily or be episodic (eg. after hard exercise) and may be mild to severe.

Although desexing of bitches (ovariectomy or ovariohysterectomy) has been incriminated as a cause of USMI, the vast majority of desexed bitches do NOT develop urinary incontinence (incidence reported at approximately 20%). In those that do, incontinence can occur immediately or up to 10 years after desexing. Scientific studies regarding the optimal age at desexing are contradictory. Oestrogen deficiency is not likely to be the sole cause, as plasma oestrogen concentrations are similar between continent entire bitches and incontinent desexed bitches. Also, oestrogen therapy does not resolve all cases of USMI.

Medical management of USMI can involve several different drugs that all act to stimulate receptors in the urethral muscle & increase urethral sphincter tone:

• Diethylstilboestrol (Stilboestrol ®) – a synthetic form of oestrogen. Used to be commonly used in tablet form (starting off daily until appropriate response is seen then gradually tapering off to twice weekly or weekly administration). Cheap drug & still used by some vets, but can cause bone marrow suppression. Safer drugs now available.

• Oestriol (Incurin ®)

• Pseudoephedrine (eg. Sudafed ®) – works well, but increasing more difficult to obtain over the counter at pharmacies due to its frequent use in elicit drug (amphetamine) production

• Phenylpropanolamine (eg. Propalin syrup ®) Administered two or three times daily – can be squirted into the meal. This drug was previously used in humans but was withdrawn due to high blood pressure problems. Side effects in dogs may include restlessness, anxiety and rapid heart rate (tachycardia). Most commonly prescribed drug for urinary incontinence.

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