Ask The Doc

posted February 15th, 2016 by
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Ask The Doc

Gary Kubat, DVM / Veterinary Emergency & Critical Care Hospital BluePearl Oklahoma City
Q: I live near a location where the emergency sirens blow every Wed-nesday at noon. My Lab puppy, who has never heard this sound before, has started running outside and howling when he hears the noise. Why does he do this, and are the sirens hurting his hearing?
A: Ahhh… another great mystery of canine behavior that can only have a definitive answer when we learn to speak “dog” (and they learn to speak back). We may be disappointed in the canine’s answer as it is probably not as interesting or mysterious as it appears.
The general consensus is that the sirens are interpreted by your pet as another canine howling; hence, the natural response is to answer back in the instinctual language that is heard. This same reasoning could also apply to barking as it is heard progressing through a neighborhood. The howling may communicate a location, sex, dominance status—we simply do not know for certain, but it is likely not complicated.
Perhaps some dogs just enjoy the vocalizing! Someday a behavioral researcher with the time and funding may find a way to conduct fMRI tests on howling dogs to see which parts of the brain are activated and functioning just prior to the initiation of the vocal response; then we might have some insight into the reason.
It is unlikely that the sirens are causing discomfort. Observe dogs that are howling; they do not exhibit the expected signs of pain or fear. They do not try to run or hide; they do not tuck their tails or lower their ears or heads. Just as your dog, some try to run toward the sound outside rather than away.
Two of the greatest and most enjoyable sounds in nature are the howling of a wolf and, for those of us in Oklahoma, the howling-yapping of a pack of coyotes in response to sirens (it certainly serves to locate the pack!).
Meanwhile, here is another pack behavior to ponder. Why do some municipalities test storm sirens on Wednesday and others do it on Saturday? And who picked noon as the time?

Q: My dog has “hot spots” no matter what time of the year. I can’t clear them up. Any suggestions?
A: Hot Spots (more expensive-sounding synonyms are: acute moist dermatitis, pyotraumatic dermatitis, or just moist eczema) are always initially a problem of self-trauma. A focal itch or inflammation is scratched and rubbed until the skin becomes even more inflamed. This induces more itching, initiating a self-traumatizing progressive cycle. The lesion can become very large even in a few hours. At this point the lesion is painful to touch, and many dogs will require sedation just to clip and clean the wound to allow topical treatment.
The location of the lesion is often a clue as to the cause of the originating itch or lesion. For example, if the lesion is located on the hips or rear limbs, the prime suspect is flea infestation. You may only see one flea, but that is enough to start the problem. If the lesion is on the side of the face below the ear, the original problem may be an ear infection that resulted in the dog scratching at the ear area.
The hot spot skin lesion needs to be treated, but the initiating factor needs to be identified. Dogs do not spontaneously self-traumatize (exceptions exist: see acral lick dermatitis or lick granuloma). Other causes include staph skin infections; skin fungal infections; allergies, topical or inhaled, that result in skin itching; and many other factors.
Another common denominator is a moist environment, especially with a long-haired breed. The skin stays wet, becomes inflamed and itches, resulting in the scratch/rub response. Some dogs that drool heavily develop hot spots on the lower jaw as a result of constant excessive moisture. I once had a patient presented because the owner thought the dog had been struck by lightning, when in fact the dog had multiple hot spots all on one side of its body.
The dog had spent long periods of time in its dog house (with wet straw bedding) during a recent rainy spell of several days. The long-haired dog simply never dried out, and dermatitis developed, which the dog then self-traumatized. Another potential complication during the warmer months is an infestation of the lesion with fly larva or myiasis. The hot spots’ lesions are oozing serum and often smell strongly necrotic, attracting the flies. This is often a problem with older, arthritic or obese dogs that are not mobile enough to keep the flies off the lesion.
The treatments of the skin lesion include topical ointments with antibiotics and corticosteroids for the inflammation (after the lesion is clipped, cleaned and dried). Topical antiseptics may also help, as well as antihistamines. I usually dispense the topical medication as a spray since most patients are too painful in the area to allow application of an ointment. I also like to apply a topical anesthetic, such as lidocaine ointment, or an injectable anesthetic, such as Marcaine, for an instant although brief relief from the itching to break the cycle. Treating the actual lesion is relatively easy and usually responds well within a few days.
The real problem and solution is to identify the inciting cause, especially in your case of repeated episodes at all times of the year. Frankly, in Oklahoma, your problem is flea infestation until proven otherwise. If not fleas, then we proceed through the culprit list based on logically identifying the most likely cause. A skin allergy may be only seasonal, but if it is induced by household items (smoke, carpets, foods, straw in the dog house), it could be a problem year-round.
Some cases will require a skin biopsy to determine if a bacterial infection (pyoderma) or other disorder exists. If your pet is experiencing repeated year-round hot spots you need to be prepared to spend some time and effort with your veterinarian to resolve the problem.

Q: My dog got pancreatitis and almost died. It was really touch and go, and it was scary. What exactly is pancreatitis, and how does a pet owner prevent this?
A: First, let’s determine what exactly is a pancreas? It is an abdominal organ closely associated with the duodenum and liver that produces and secretes chemical enzymes that assist in digesting food. It also secretes insulin, associated with the most common diabetes. Amazingly, it does this without harming or digesting itself… normally. Pancreatitis is an inflammation of the pancreas that develops when the normal protective mechanisms of the organ are overwhelmed by pancreatic enzymes, resulting in autodigestion.
What is the cause? Anecdotally, most veterinarians (myself included) will blame a dietary indiscretion of a high-fat diet (often table foods) as the inciting cause most of the time. In truth, the actual causal agent of pancreatitis is frequently unknown. What we do know are a whole lot of related risk factors associated with pancreatitis and pancreatitis patients.
Certainly, ingestion of high-fat foods is on that list. But we have all heard the story of how the same dog has eaten the same table food many times without a problem, and the other dogs in the household ate the same thing and are having no problem. Pancreatitis is more common in obese animals (that probably eat more table food anyway, which is why they are obese). Hyperlipidemia (high levels of fats/lipids in the blood even when fasting) is associated with increasing frequency of pancreatitis.
The miniature Schnauzer is a breed often associated with hyperlipidemia and pancreatitis. But pancreatitis can also cause hyperlipidemia. Pancreatitis can also cause diabetes, at least transiently. Diabetes is also associated with hyperlipidemia, and it is not unusual for a miniature Schnauzer to be diagnosed diabetic. Which came first? Isn’t this complicated? There is more…
Some commonly used drugs have been associated with pancreatitis, including furosemide, a diuretic often used in cardiac dysfunction; if the heart is not functioning well, the pancreas may suffer from hypoperfusion or poor blood supply, which leads to pancreatitis as well). Potassium bromide, an anti-seizure medication, has been associated with a higher frequency of pancreatitis. Hyperlipidemia has been associated with seizures.
Now suppose you have an older, overweight, diabetic, hyperlipidemic miniature Schnauzer taking potassium bromide for occasional seizures, and on furosemide for mild heart disease. How do you prevent pancreatitis? Well, at the very least, be extremely careful with diet. The bacon fat can find some other use. Also, consider pet insurance.
If your pet is diagnosed with pancreatitis, it will usually be treated in-hospital at least during the acute phase. It was once believed that all oral stimulation and food should be withheld to avoid stimulating the pancreas to secrete enzymes, but current thinking is to provide oral nutritional support as soon as nausea can be improved. IV fluid support, antiemetics, antibiotics, and narcotic pain medications are usually the basis of treatment. Complications can involve the liver-bile duct system, sepsis, or in severe progressive necrotizing pancreatitis, surgery may be required to address the peritonitis (inflamed or infected abdominal cavity). Other complications can include pulmonary failure, kidney failure and blood coagulation problems. While most patients do recover, pancreatitis is not usually a 24 to 48 hour recovery. Expect your pet to be in-hospital for several days, and if complications do develop, the prognosis for recovery is reduced.
Although in some cases it may be unrealistic to completely prevent pancreatitis, you can certainly reduce the risk by eliminating associated risk factors as much as possible and adhering to very strict dietary control. You should work closely with your veterinarian to identify the risk factors you have the power to change. Specially developed prescription-only diets are very beneficial also.

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