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Adrenal Gland Tumors in Dogs

What Are Adrenal Gland Tumors in Dogs?

Adrenal glands are two small glands in your dog’s abdomen, just in front of the kidneys, and any part of these glands can develop tumors. Not all adrenal tumors are cancer. Some are benign, or noncancerous. Benign tumors within the adrenal glands may still be hormonally active, causing various symptoms.

A dog’s adrenal glands are crucial in regulating heart rate, blood sugar, blood pressure, and secretion of hormones during physical and emotional stress. The glands are divided into two parts: the outer area, called the cortex, and the middle area, the medulla.

The cortex is divided into three layers and secretes the following steroid hormones: 

Mineralocorticoids (such as aldosterone), which help control sodium and potassium electrolytes

Glucocorticoids (such as cortisol), which have a role in metabolism, reducing inflammation, and helping the immune system

Sex hormones, such as estrogen, progesterone, and testosterone

The medulla secretes catecholamines, which are important hormones during stress and fight-or-flight responses. In addition, the medulla releases epinephrine (also known as adrenaline) and norepinephrine.

The most common disease caused by adrenal tumors is adrenal-dependent hyperadrenocorticism, also known as Cushing’s disease. Dogs with Cushing’s disease most notably have excessive thirst, urination, and appetite. Cushing’s is very common in dogs, but most acquire the disease from dysfunction within their pituitary gland, not the adrenals. Only around 20% of dogs with Cushing’s disease have an adrenal tumor.

Other rare tumors of the adrenal glands may secrete aldosterone and cause a disorder called hyperaldosteronism, which may cause weakness and lethargy. More serious rare adrenal gland tumors can invade major vessels in the body and cause arrhythmias and clots while severely increasing blood pressure.

The most common adrenal tumors in dogs are:

Adrenal adenoma: A tumor that may be functional (secrete hormones) or nonfunctional (does not secrete hormones). Adenomas commonly secrete cortisol, causing Cushing’s disease, or aldosterone, causing hyperaldosteronism.

Adrenal carcinoma: a tumor that is malignant and can also secrete cortisol or aldosterone, causing Cushing’s disease or hyperaldosteronism. These metastasize, or spread, in up to 50% of cases. Metastasis sites are usually the liver and the lungs.

Pheochromocytoma: A rare tumor in the medulla that secretes epinephrine, norepinephrine, or both.

Paraganglioma: A rare tumor coming from the nerves that can secrete catecholamines.

Most adrenal gland tumors occur in middle-aged to older dogs, but there are no breed predispositions. Larger dogs may be at higher risk of functional tumors secreting cortisol, causing Cushing’s disease.

Symptoms of Adrenal Gland Tumors in Dogs

Symptoms of adrenal gland tumors in dogs vary, based on the type of tumor. Most commonly, tumors secrete cortisol, which is a steroid. Overproduction of steroids leads to:

Increased thirst

Increased urination

Increased hunger

Weight gain

Pot-belly appearance

Skin issues

Urinary tract infections

Hair loss

More serious tumors, called pheochromocytomas, secrete fight-or-flight hormones like adrenaline. These symptoms may be vague, and wax and wane. At times, the dog may even seem normal, but these types of tumors have profound cardiac and other manifestations, such as:

Abnormal heart rate and rhythm leading to weakness and collapse

Increased blood pressure leading to behavior changes or blindness

Increased thirst and urination

Weight loss and decreased appetite

Seizures

Panting

Fever

Cough

Gastrointestinal signs

Tumors secreting aldosterone result in high blood pressure and low potassium. Pet parents may notice:

Weakness

Blindness secondary to high blood pressure

Lethargy

“Dropped” legs in the back

Abnormal neck flexion

Collapse

Causes of Adrenal Gland Tumors in Dogs

Causes of adrenal gland tumors are mostly unknown. However, there may be a genetic predisposition to adrenal tumors and environmental, diet, or medication factors that make certain animals more prone to develop them. More studies and research are needed to better understand the cause of these diseases.

How Veterinarians Diagnose Adrenal Gland Tumors in Dogs

Most adrenal gland tumors are found with an ultrasound, which can assess size, shape, and structure. However, while ultrasound can confirm the presence of a tumor in the adrenals, it can only lead veterinarians to an educated guess about the type.

Benign adenomas are typically small and noninvasive. Carcinomas are usually bigger and can invade the surrounding tissue. Tumors typically only affect one, not both, adrenal glands. A biopsy is required for a definitive diagnosis, although not all dogs are candidates for this procedure.

Based on the clinical signs and severity of the disease, other important tests to diagnose adrenal tumors include:

Routine blood chemistry and complete blood count

Blood pressure measurements

X-rays of the chest and abdomen to evaluate for cancerous spread

Cardiac consultation to rule out heart failure

Advanced imaging to determine the extent of invasive tumors

Hormone testing

Endocrine testing, such as an ACTH Stimulation test or Low-Dose Dexamethasone Suppression Test

Treatment of Adrenal Gland Tumors in Dogs

Removal of the affected adrenal gland (adrenalectomy) is the treatment of choice. However, surgery may not be an option if the tumor has invaded major blood vessels or other organs or spread to distant sites (metastasis). An adrenalectomy is a serious surgery and should be performed by a surgical specialist at a 24-hour facility, as complications during and after surgery are common.

For dogs who are not candidates for surgery, medical management may be beneficial for a period of time. However, fatal complications, such as blood clots and arrhythmias, may occur at any time.

Dogs with adrenal-dependent Cushing’s disease may improve clinically on the drugs mitotane or trilostane, which work to suppress cortisol.

Dogs with nonresectable pheochromocytomas may benefit from drugs to treat their clinical signs, such as blood pressure or cardiac arrhythmias.

Dogs with nonresectable adrenal tumors secreting aldosterone may benefit from drugs like spirinolactone that help block the receptors for aldosterone.

Supportive care may be required during acute crises. Many dogs need to stay in a veterinary hospital on IV fluids, medications, and supplements.

Recovery and Management of Adrenal Gland Tumors in Dogs

Dogs with benign, nonfunctional tumors have the best prognosis, followed by dogs with benign, functional tumors. Hyperaldosteronism is rare, and the prognosis is usually uncertain.

Cushing’s disease, caused by a benign tumor, is commonly well-managed by surgery or medications followed by periodic exams and testing. Prognosis is good for these animals if symptoms are controlled.

Dogs with malignant tumors causing Cushing’s disease have a worse prognosis, with relatively high metastatic rates. Some of these dogs may live for a few years after diagnosis and adrenal removal, and just over a year if managed with medication alone.

Dogs with pheochromocytomas have a guarded to poor prognosis, as these are typically invasive and metastatic, with many severe side effects causing a poor quality of life. About 20-30% of dogs may not survive the surgery to remove the tumor. Dogs that do survive surgery have an average survival of around 1 year, with less than 60% surviving longer than 3 years. Survival time decreases as the tumor size increases.

Adrenal Gland Tumors in Dogs FAQs

Are adrenal gland tumors in dogs painful?

Tumors themselves likely do not cause dogs pain. However, secondary complications of tumors may cause them discomfort and a decreased quality of life.

How serious is a tumor on the adrenal gland?

Some tumors are life-threatening; the majority are less serious but still require medical attention and treatment.

How long do dogs live with adrenal cancer?

Depending on the type and treatment, dogs with adrenal cancer may live for months to years.

References

Bruyette D. Merck Veterinary Manual. Disorders of the Adrenal Glands in Dogs. June 2018.

Rothrock K. Veterinary Information Network. Hyperaldosteronism (Canine). January 2018.

Olin S. Veterinary Information Network. Pheochromocytoma (Canine). November 2021.

Rothrock K. Veterinary Information Network. Hyperadrenocorticism, Adrenal-Dependent (Canine). December 2015.

Etienne C, Ettinger SJ, Feldman EC. Textbook of Veterinary Internal Medicine: Diseases of the Dog and Cat. 8th ed. Elsevier; 2017.

Tilley LP, Smith FWK. The 5-Minute Veterinary Consult: Canine and Feline. 7th ed. Lippincott Williams & Wilkins; 2005.

Featured Image: iStock.com/Nastasic


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WRITTEN BY

Lauren Jones, VMD

Veterinarian

Dr. Lauren Jones graduated from the University of Pennsylvania School of Veterinary Medicine in 2010, after receiving her bachelor’s degree…


Lungworms in Dogs

What Are Lungworms in Dogs?

Lungworms in dogs consist of multiple species of worm parasites that can infect the airways and lung tissue of domestic and wild dogs. Species of lungworms in dogs include roundworm (nematode) and fluke (trematode). 

Roundworms are not specific to any geographical location, whereas the fluke lungworms are more common in some environments. 

For example, the lung fluke Paragonimus kellicotti is found in the Great Lakes region, Midwest, and Southern United States. This is because the fluke lungworm relies on specific species of snail and crayfish found in these regions as intermediate hosts for part of their life cycle.

Symptoms of Lungworms in Dogs

Signs of lungworms in dogs can include:

Non-productive cough (produces no mucus)

Rapid respiratory rate

Exercise intolerance (becoming out of breath more easily, not able to play as hard/long as usual)

Difficulty breathing

Dogs can also have a subclinical lungworm infection, which means they show no signs.

Causes of Lungworms in Dogs

A dog becomes infected with lungworms by eating lungworm larvae. 

Larvae may also be passed from a mother to her puppies through grooming and nursing. The immature larvae enter the gastrointestinal (GI) tract, penetrate the intestinal wall, enter the circulation system (blood or lymphatic), and are transported to the heart and lungs. 

Depending on the species of lungworm, the larvae can develop into adult worms in as little as 5 weeks after being ingested by a dog. However, in other lungworm species, maturation into adult worms can take up to 21 weeks. 

Female adult lungworms start depositing eggs that then hatch into first-stage larvae within the airways. These eggs and first-stage larvae are then coughed up and spit out or vomited. Any dogs that have contact with the infected dog’s spit or vomit can contract lungworms.

If the dog that coughed them up then swallows their own spit or vomit, the lungworm eggs and larvae travel through the dog’s GI tract. The dog sheds them in their feces, where they can infect other dogs that come into contact with the poop. 

How Vets Diagnose Lungworms in Dogs

Your veterinarian will likely recommend chest x-rays if your pet has a history of respiratory concerns. They will also take a fecal sample and may recommend an airway wash if they can’t confirm the diagnosis.

X-Rays

On x-rays of dogs with lungworms, the vet might see small spots of inflammation within the lung tissue, or larger areas of inflammation with possible pneumonia. If the lung is damaged severely enough, it can break open and cause air to leak into the dog’s chest. This is called a pneumothorax. 

One species of lungworm can produce thickening of the large trachea wall (windpipe) and/or trachea nodules (abnormal trachea growths), which your vet may be able to see on the x-rays.

X-rays alone cannot be used to diagnose lungworms in dogs, as other diseases can cause similar effects. However, your vet may have a suspicion of lungworm based on your geographical location and/or a history of recent travel with your dog.

Fecal Tests

Your vet will use fecal tests to look for lungworm eggs and larvae. They may have you bring multiple fecal samples from different days because the shedding of lungworm eggs and larvae in the feces comes and goes.

Airway Wash

If your vet can’t diagnose lungworms with x-rays and fecal testing, they may recommend an airway wash such as a transtracheal wash (TTW) or bronchoalveolar lavage (BAL), both of which are performed under anesthesia. 

The fluid obtained from your dog’s airways and lungs during the wash procedure may contain the lungworm larvae, eggs, and inflammatory cells that will lead to a diagnosis. 

Treatment for Lungworms in Dogs

Treatment to get rid of lungworms in dogs involves a dewormer that’s usually administered orally for 14 days.

Your dog’s immune system will generate inflammation as a reaction to the dead worms and larvae, so your veterinarian may also prescribe a corticosteroid anti-inflammatory medication. 

It is common for a dog to seem to get worse when first starting treatment, since this is the period when there will be the largest number of dead and/or dying worms. 

If you are concerned with how your dog is doing or have any questions, call your veterinarian in case additional treatment is needed. 

In more complicated lungworm cases, cysts can form in the lung tissue. If the cysts rupture, your dog can accumulate air that’s in the chest and outside the lung (pneumothorax). 

If enough air accumulates to cause your dog to have difficulty breathing, your vet might need to remove the air and place a chest tube until the air leak seals on its own.

Rarely, surgery may be needed to close the sites where air is leaking from the lung tissue. 

Untreated cases where there’s severe lung inflammation and/or lung damage can result in death. 

Recovery and Management of Lungworms in Dogs

Most cases of lungworm respond to medical management alone (no surgery). In order to monitor your dog’s response to treatment, your veterinarian will want to examine more fecal samples for the lungworm larvae/eggs.

If your vet found abnormalities on the original x-rays, they might want to retake the images to see how the abnormal areas look after treatment.

Scarring of the airway(s) is a possible complication of lungworm infestation. If the scarring results in coughing or other asthma-like signs, this may require long-term management.

Dogs that need surgery will require more time for recovery and healing. Depending on how long the chest tubes are in place and how extensive the lung surgery is, recovery can take 4-6 weeks.

Lungworms in Dogs FAQs

How does a dog get lungworms?

A dog becomes infected with lungworms by eating lungworm eggs and/or immature lungworm larvae. 

Once in the GI tract, the larvae penetrate the intestinal wall and migrate to the dog’s airways/lung tissue, where they live and produce more eggs and larvae.

The eggs and larvae in the airways are then coughed up and spit out, or they are swallowed by the dog, which results in reinfection.

Can you see lungworms in dog poop? 

No. Lungworm eggs and larvae cannot be readily seen by looking at dog feces with the naked eye. Your veterinarian can see both by looking at your dog’s fecal sample under a microscope.

Can humans get lungworms?

No, humans do not get lungworms. 

However, it is important to keep your dog current on deworming (once or twice a year), as there are some worm parasites that can cause problems in humans. 

References

Filaroides Lungworms. (n.d.). Veterinary Information Network (VIN):  Vincyclopedia of Diseases. https://www.vin.com/apputil/project/defaultadv1.aspx?pId=17256&SAId=1&catId=93497Nelson RW, C Guillermo Couto. Small Animal Internal Medicine. Elsevier/Mosby; 2013: 321-323.


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WRITTEN BY

Heidi Kos-Barber, DVM

Veterinarian

I am a small animal general practitioner in western Washington. The clinic I have worked at for the past 14 years sees a variety of…


Heart Beat Problems (Premature Complexes) in Dogs

Atrial Premature Complexes in Dogs

There are four chambers in the heart. The two top chambers are the atria (single: atrium), and two bottom chambers are the ventricles. Under normal circumstances, the heart works with exceptional synchronization between the various atrial and ventricular structures, resulting in a consistent rhythmic pattern. Atrial premature complexes result in an abnormal rhythmic disturbance, where the heart beats prematurely, before the normal timing, or pacing.

Excluding animals born with a congenital heart disease, atrial premature complexes often affect older dogs, especially small-breed dogs. Atrial premature complexes (APCs) can be seen on an electrocardiogram (EKG) as a premature wave called a P wave. This P wave may be biphasic, negative, positive or superimposed on the previous T wave on the EKG.

The P wave on an EKG represents the electrical conduction from the sinoatrial node in the heart to and through the atria of the heart. The QRS complex — a recording of a single heartbeat on the EKG — following the P wave represents the passing of this impulse through the heart’s ventricles after it passes through the atrioventricular node. The last wave on an EKG reading is the T wave which measures ventricular recovery (from charging) before the next cardiac contraction.

An increase in automaticity of atrial heart muscle fibers or a single reentrant circuit can cause a premature P wave to occur. These premature atrial beats begin outside of the sinoatrial node (ectopic) — the pacemaker of the heart — and disrupt the normal “sinus” heart beat rhythm for one or more beats.

Symptoms and Types

Although there may be no symptoms associated with atrial premature complexes, especially in older dogs or in dogs that are normally not very active, some common signs include:

Coughing and trouble breathing Exercise intolerance Fainting (syncope) Cardiac murmur Irregular heart rhythm

Causes

Chronic heart valve disease Congenital heart disease (defect from birth) Disease of heart muscle Electrolyte disorders Neoplasia Hyperthyroidsim Toxemias (toxic elements in blood) Drug toxicity (for example, overdose of digitalis, a heart medicine) Normal variation in many older dogs

Diagnosis

You will need to provide your veterinarian with a thorough history of your dog’s health leading up to the onset of symptoms. The full physical exam will include a chemical blood profile, a complete blood count and an electrolyte panel.

It is crucial to search for an underlying cause for the heart disease that is bringing about the APCs. An electrocardiogram (EKG) recording can be used to examine the electrical currents in the heart muscles, and may reveal any abnormalities in cardiac electrical conduction (which underlies the heart’s ability to contract/beat). Other diagnostic tools, like echocardiograph and Doppler ultrasound, can be used to visualize the heart and its performance (rhythms, velocity of contraction).

Treatment

The treatment your veterinarian administers will depend on exactly what kind of heart disease is affecting your pet and how severe it is. There are several different types of medicines that can be used, depending on the type of heart disease present. For congestive heart failure, a diuretic may be prescribed, and a drug to dilate the blood vessels (vasodilator). Digitoxin may be prescribed to decrease the heart rate and increase cardiac contractility.

Living and Management

Underlying cardiac diseases must be treated and kept as controlled as possible by your veterinarian. This means that you will need to take your dog to the veterinarian for frequent follow-up appointments. Sometimes, despite drug therapy, some animals will have an increased frequency of APCs, or will deteriorate to more severe signs of heart disease as the underlying disease progresses.

Depending on the underlying cardiac disease, you may need to change your dog’s diet to a low sodium diet. You will also need to change your daily routine with your dog, with less physical exertion so that the heart does not need to work hard. Your veterinarian will advise you on the diet and amount of activity your dog will need to be of optimum health.  


Severely Abnormal Heart Rhythm in Dogs

Ventricular Fibrillation in Dogs

Ventricular fibrillation (V-Fib) is a condition in which ventricle muscles in the heart begin to contract in a disorganized fashion, making them quiver. Due to this uncoordinated contraction, blood circulation may cease within minutes, which may be fatal. Although it can affect dogs at any age, it seems to affect those that are older.

Symptoms and Types

Systemic illnesses associated with cardiac disease Previous history of heart beat rhythm problems (cardiac arrhythmia) Collapse Death

Causes

Absence of oxygen in inspired gases or in arterial blood or in the tissues Blockage of the aorta (aortic stenosis) Heart surgery Drug reactions (e.g., anesthetics, especially fast-acting barbiturates, digoxin) Electrical shock Electrolyte imbalances Hypothermia Inflammation of the heart muscle (myocarditis) Shock

Diagnosis

Unless some underlying infection, metabolic problem, or other such condition is present, the results of routine laboratory tests are usually normal. Your veterinarian will, however, record the ECG (electrocardiogram) results, which is helpful in identifying V-Fib and other related heart problems.

Treatment

This is an emergency that requires prompt and aggressive treatment. In fact, without treatment, most dogs die within a matter of minutes. Often, electrical cardioversion is used, wherein an electrical defibrillator is used to deliver small electrical shocks to return the heart to normal rhythm. Initially, low intensity shocks are given; if the heart does not respond, the emergency veterinarian may increase the voltage.

If there is no access to an electrical defribillator, he or she may administer a precordial thump, whereby a sharp blow is applied to the chest wall over the heart with an open fist. Although rarely successful, it may be the only alternative.

Living and Management

Once the dog’s heart has returned to a normal rhythm, it will require hospitalization for a few days to fully recover. Regular follow-up exams with the veterinarian will also be required, so that he or she may evaluate the dog’s progress (typically with the ECG and other diagnostic procedures).


Shock Due to Decrease in Circulation in Dogs

Hypovolemic Shock in Dogs

A dog can go into shock for a variety of reasons, but when their blood volume or fluid levels drastically drop, shock can onset rapidly. Hypovolemic shock affects the renal, cardiovascular, gastrointestinal and the respiratory systems of a dog. Prolonged levels of shock can also severely damage the cardiac system. It is a serious condition that requires immediate medical attention.

Symptoms

Severe weaknessCool feetPoor pulse; a pulse that is difficult to readVery low blood pressureSevere lethargy or inactivityHyperventilationRespiratory failureHemorrhage

Causes

Blood and fluid loss can be caused by extensive vomiting, diarrhea, severe external burns and injury. Exposure to anticoagulant substances, recurring illnesses and hazardous materials may also bring on shock. If a dog has gastrointestinal bleeding, it may be unable to circulate blood volume, which is another way shock can occur.

Diagnosis

The first objective is to diagnose the underlying cause. Blood tests, including blood gas tests will help to determine electrolyte causes or blood related problems. Imaging can reveal if any cardiac problems have led to the shock. Electrocardiography will identify any issues with the dog’s heart. Blood pressure readings are used to determine if the issue is related to the heart’s pressure and its ability to circulate blood volume through the dog’s body.

Treatment

Treatment will need to be administered on an inpatient basis. Fluid therapy will be given immediately to increase the dog’s circulation volume and flow. Ongoing monitoring of the dog’s heart rate, pulse, respiratory rate, urine output and body temperature will be taken to ensure a successful recovery. Also, therapeutic steps will be taken to restore the dog’s blood volume and circulation levels. If the dog’s body temperature has dropped severely, warming techniques will be used immediately.

Living and Management

There are several possible complications of this medical condition, including electrolyte disturbances, anemia, low protein levels (hypoproteinemia), abnormal cardiac rhythms, and cardiac arrest.

Prevention

There are no known preventative measures for this medical condition.


Ibizan Hound

A rabbit hunter by profession, this breed is lithe and quick. The Ibizan Hound, which may share ancestral roots with the Pharaoh Hound, also has deer-like elegance and excellent jumping skills.

Physical Characteristics

As it has a slender build, the Ibizan Hound can easily execute the double-suspension gallop quickly and with agility, and trots lightly. The hound is a wonderful jumper that can reach great heights.

The characteristic features of the dog are large ears and a long body. It is almost like a deer in its graceful movement and expressions. The dog’s coat, meanwhile, which is generally white or red in color, can be short, wiry, or hard.

Personality and Temperament

While retaining its hunting instinct, the elegant Ibizan Hound uses its sharp senses of smell and hearing to search for small animals. It also loves to bark while chasing any creature (or anything that moves), thus setting it apart from most sighthounds. Most Ibizan Hounds are shy with strangers, while some are timid. By nature, this breed is faithful, even-tempered, gentle, and mild and is perfect as a calm house pet.

Care

Given soft bedding and warm shelter, the Ibizan can stay outdoors in cold climates, but it is not usually kept as an outdoor dog. As the hound is a skillful jumper, care should be taken when constructing an enclosure. The dog’s smooth coat needs just occasional brushing but the wire coat has to be brushed every week.

The athletic and independent Ibizan Hound should be given regular exercise in a safe and enclosed area. Good exercise enables the hound to stretch its body, but its requirements are also satiated through jogs on a leash, long walks and full running.

Health

There is no major health problem that affects the Ibizan Hound. Some of the minor ailments are seizures and allergies. The dog is sometimes prone to problems like retinal dysplasia, deafness, cataract, and axonal dystrophy and cannot tolerate barbiturate anesthesia. Eye tests are also suggested for the Ibizan Hound, which has an average lifespan of 12 to 14 years.

History and Background

The Ibizan Hound and the Pharaoh Hound supposedly share the same ancestral roots; the former bears an incredible resemblance to the dogs dedicated to the jackal god Anubis, portrayed in Egyptian tombs. Ancient Phoenician sea traders might have brought the dogs to the Balearic Islands, where they in seclusion.

Numerous nations, such as the Egyptians, Carthaginians, Chaldeans, Arabs, Romans, Vandals, and Spanish, held the royal scepter in Ibiza throughout the years. But when Spanish farmers in Ibiza used the dogs for hunting, the breed was kept in its purest form and crossbreeding was frowned upon. The tough island conditions also compelled the islanders to select only the best rabbit hunters or hounds for survival and breeding. This led to the production of a true-bred dog that has hardly been altered from its original stock.

The Ibizan Hound was introduced to the United States for the first time in the 1950s. The impressive physical appearance of the Ibizan Hound attracted people at first, but the breed would never become a very popular pet. The American Kennel Club, however, would eventually officially recognize the Ibizan Hound in 1979; today it continues to be a rare breed.


Jawbone Enlargement in Dogs

Craniomandibular Osteopathy in Dogs

A dog’s mouth is made up mainly of two bones, the mandible (lower bone) and the maxilla (upper bone). These two bones come together at a joint called the temporomandibular joint (TMJ). The TMJ is the joint that allows the jaw to open and close. Dogs use their cheek muscles to move the TMJ in order to open and close their mouths.

Craniomandibular osteopathy is a condition by which extra bone forms along the mandible and TMJ, making it painful and difficult for the affected dog to open its mouth and eat. Signs are usually seen in puppies that are four to eight months of age, and it is seen more in some breeds of dogs than others. Breeds that are the most commonly affected are Scottish Terriers, Cairn Terriers, and West Highland White Terriers. Breeds with a lesser incidence of this condition, but which also have a higher than normal diagnosis are Labrador Retrievers, Great Danes, Boston Terriers, Doberman Pinschers, Irish Setters, English Bulldogs, and Boxers.

Symptoms and Types

Pain when opening the mouth Difficulty opening the mouth Difficulty picking up food Difficulty chewing and concurrent loss of appetite Pain and difficulty eating get worse with time Fever that comes and goes Eyes that seem to bulge out (exophthalmos), due to swelling within the skull Swelling in jaw Excessive drooling

Causes

Inherited. The genetic predisposition is strongest with West Highland white terriers.

Diagnosis

Your veterinarian will need a thorough history of your dog’s health leading up to the onset of symptoms. Paying careful attention to your dog’s head during the examination. your veterinarian may be able to feel a decrease in the amount of muscle on the sides of your dog’s head, along with a thickening of the bone along the sides of the jaws. There will also be obvious pain when trying to open your dog’s mouth, and it may not even open all the way.

A complete blood profile will be conducted, including a chemical blood profile, a complete blood count, and biochemistry levels. These will be used to identify whether there are any abnormalities in your dog’s bones. Further blood tests may help to rule out or verify fungal or other types of infection. The most precise diagnostic tool for this condition will be x-rays images taken of your dog’s head, which will show the abnormal bone growth. In most cases these will be all of the tests that need to be done, but for some cases, your veterinarian may also want to get a sample of the bone (bone biopsy) to make sure your dog’s symptoms are not caused by a tumor or bone infection.

Treatment

Treatment with anti-inflammatory drugs for the swelling, along with pain relievers, will help to minimize your dog’s symptoms but will not effect an immediate cure. This condition has a “wait and see” outlook, since there is no method for slowing the progression other than for treating the swelling. The growth typically slows down at about a year of age, when the puppy’s growth slows, and the growth will often recede as well, but many dogs will continue to have a larger than normal jaw bone, and may have difficulty chewing normally for the remainder of their lives. In some cases, surgery may be used to repair the jaw enough to make your dog more comfortable.

You may need to feed your dog a special food during the treatment process, such as a high calorie soup or liquid if it is having trouble eating regular food. If your dog cannot eat even a liquid diet, surgical placement of a feeding tube into the stomach or esophagus will be necessary. Because prescribed medications can sometimes cause an upset stomach, it is important that you follow all of the instructions you are given about these medications.

Living and Management

Your veterinarian will want you to return for regular follow-up visits to make sure your dog is getting enough nutrition and is not in excessive pain. If you need to feed your dog through a tube, it is important that you follow all of your veterinarian’s instructions regarding how to use the tube and how often to feed your pet. Once your pet reaches ten to twelve months of age, the pain may decrease. The amount of extra bone which has built up on the jaw may decrease as well. How well your dog does will depend on the amount of extra bone which has formed around the jaw. Your pet may still need special food, or a feeding tube for the rest of its life.

Prevention

Dogs that are affected with craniomandibular osteopathy should not be used for breeding again, nor should siblings from the same litter, whether they have symptoms of the disorder or not. And it is recommended that you have your dog spayed or neutered to avoid passing this genetic abnormality along.


Urethral Shaft Abnormality in Dogs

Ectopic Ureter in Dogs

An ectopic (displaced) ureter is a congenital abnormality in which one or both ureters open into the urethra or vagina. Bilateral ectopia affects both ureters, and unilateral ectopia affects one ureter. Dogs affected with ectopic ureter will have the tubular shaft bypass the bladder floor (trigone) and enter through the bladder wall. Less frequently, the ureter opens into the bladder floor and continues as a trough into the urethra. 

The following dog breeds may be predisposed to displaced ureter: Labrador Retriever, Golden retriever, Siberian husky, Newfoundland, Bulldog, West Highland White Terrier, Fox Terrier, and Miniature and Toy Poodles.

Symptoms

This condition is rare, especially in male dogs. Occasionally, a dog with this abnormality may be asymptomatic and show no apparent urination problems. However, some common symptoms to look out for include occasional or continuous incontinence, and inflammation of the vagina (vaginitis) from urine scalding the vaginal tissue.

Causes

Ectopic ureter has an unknown mode of inheritance, but there does appear to be a component of breed predisposition.

Diagnosis

Your veterinarian will use a diagnostic technique called urethrocystoscopy, which uses an insertable tube with an attached camera. In this way, the veterinarian will be able to examine the dog’s bladder internally, and visualize the opening into the urethra or vagina. Your veterinarian will also be looking to identify holes (perforations) in the structure of the urethra (urethral fenestrations), depressions, striping (or streaking), and tenting in the bladder.

When this diagnostic method is performed skillfully, a more accurate diagnosis can be made than with external imaging techniques, such as X-rays. Another technique, urethral pressure profilometry, measures surface variations to detect coexistent urethral muscle (sphincter) incompetence. There remains the possibility that a displaced ureter will confound the results of this test, however.

 

Treatment

Treatment for repairing an ectopic ureter will involve surgically creating a new ureteral opening into the bladder, or removing a blocked or severely infected kidney. A portion of the displaced ureter will need to be removed, if feasible, and the ureter opening (ureterocele) into the bladder then repaired.

Incontinence may continue if your dog also has urethral muscle incompetence, and will be weakened to some degree during recovery from surgery. Some puppies with urethral muscle incompetence are able to control urination after their first heat cycle. Additionally, incontinent dogs should not be spayed before their first heat.

Living and Management

Your veterinarian will need to evaluate the effectiveness of the surgery in a follow-up visit. Internal imaging of the dog’s urinary organs and bladder using dye injection through the vaginal canal (for females) will follow the track of the fluid and will make it possible to visually inspect the healing of the surgical site. Surgically elevating the vagina to support the bladder neck (where the urethra and bladder join) using the colposuspension technique may correct the incontinence.

If incontinence persists, phenylpropanolamine, an alpha-blocker, may be prescribed to enhance urinary flow, or to relieve tension and pain, a tricyclic antidepressor agent such as imipramine can be prescribed. Reproductive chemical hormone therapy may increase the naturally occurring sensitivity of urethral stress response receptors. The nonsteroidal estrogen Diethylstilbestrol, meanwhile, is administered orally to spayed bitches for urethral muscle control. In some females, a combination of estrogen therapy and phenylpropanolamine, for controlling incontinence, may be more effective. 

In incontinent male dogs, steroid therapy may be prescribed. Testosterone propionate is administered initially to see if replacement therapy will be effective. For longer action, testosterone cypionate is used.

Reproductive hormone therapy is not advised in immature animals.


Aspiration Pneumonia in Dogs

What Is Aspiration Pneumonia in Dogs?

Aspiration pneumonia is an inflammation of the lungs caused by an inhaled material such as food, regurgitation, or vomit. 

This condition usually happens when there is an underlying problem with the normal reflexes of swallowing and pushing material down the esophagus. In aspiration pneumonia, food makes its way into the airways and is inhaled into the lungs.

Normal Anatomy vs. Abnormal Anatomy

In a normal anatomic structure, once food is chewed and mixed with saliva (food bolus), it is ready to be swallowed. The food bolus is then pushed by the tongue to the throat (pharynx). This space, called the pharynx, meets the end of the nasal cavity (nasopharynx), and is separated by a thin membrane of tissue called the soft palate. 

The larynx is the opening into the trachea. The pharynx and larynx are separated by a piece of cartilage called the epiglottis. The epiglottis is part of the structures known as the voice box. 

The tongue is a large muscle that extends down the throat and attaches to other muscles and cartilage around the epiglottis. 
The tongue, soft palate, and epiglottis work together to close the space leading into the trachea (larynx) and allow a food bolus to continue down the esophagus and finally into the stomach and intestines. When swallowing, there is a momentary stop in breathing to ensure that food travels down the correct path of the esophagus. 

With aspiration pneumonia, the laryngeal reflex gets overwhelmed, or it does not function properly, so food and liquid make their way into the larynx, down the trachea, and into the lungs.  

Stages of Aspiration Pneumonia 

Aspiration pneumonia can involve obstruction of the large airways and result in acute respiratory distress if large particles are inhaled. This would be considered a medical emergency. If you believe your dog is experiencing this, contact an emergency veterinary hospital immediately. 

Commonly, smaller particles are inhaled and may block small airways which leads  to an inflammatory response that produces mucus and inflammatory cells that create a tightening of the muscles of the airways, known as a bronchospasm.  This leads to coughing, wheezing, and overall makes it uncomfortable to fully breathe in and out.    

Another phase of aspiration pneumonia involves damage from inhaling acidic gastric enzymes. This change in pH easily damages the respiratory surface layer (epithelium) and lung surfactant (a chemical substance that aids in breathing) function. This may cause bronchospasms and acute respiratory distress syndrome (ARDS) that can result in a medical emergency. 

Lastly, a bacterial pneumonia may develop. The level of infection may overwhelm a dog’s immune system instantly or may occur later in the disease. 
 

Symptoms of Aspiration Pneumonia in Dogs

Symptoms of aspiration pneumonia in dogs may include:

Vomiting, regurgitation, or difficulty swallowing 

Coughing

Exercise intolerance

Fever

Nasal discharge

Difficulty breathing or respiratory distress

Breathing at a fast rate, but may not be panting

Cyanotic or blue gums and tongue

Causes of Aspiration Pneumonia in Dogs

Examples of instances that lead to aspiration pneumonia in puppies include:

Bottle-feeding puppies that have a normal anatomy but may choke on milk that pours out of the bottle too quickly.

Force-feeding a mentally dull animal that may be unable to swallow properly.

 A puppy with cleft palate where milk enters the nasal cavity and continues down into the lungs.

The most common cause of aspiration pneumonia in adult dogs is regurgitation due to a dilated esophagus (megaesophagus). Regurgitation is different from vomiting; it is a passive response that expels the contents from the esophagus usually before the food reaches the stomach. It can be delayed for several hours, or it can occur shortly after eating. Often, ingesta (food material) can be seen in a tubular form and appear undigested.  

Regurgitation may occur as a result of stress or anesthesia especially in brachycephalic breeds such as: Boston Terriers, Pugs, Frenchie, Bullmastiff, Cane Corso, Boxer, English and American Bulldogs, and Dogue de Bordeaux. 

Vomiting is an active response that requires the contraction of the abdominal muscles to actively propel food and liquid (may also include yellow bile) out of the stomach and small intestines.

Other causes of aspiration pneumonia include: 

Pharyngeal abnormalities (local paralysis, focal myasthenia gravis, and traumatic nerve damage) 

Esophageal abnormalities

Anatomical malformations

Generalized neuromuscular disease

Forebrain disease

Postictal phase (after a seizure)

Motor dysfunction

Post-operative laryngoplasty

Altered consciousness, sedation, anesthesia (during or in recovery)

Severe metabolic disorders

Force-feeding

Improper feeding tube placement 

Trauma 

How Veterinarians Diagnose Aspiration Pneumonia in Dogs

Dogs with aspiration pneumonia may be in shock and require aggressive care to stabilize them.  

If your dog does not have any signs of respiratory distress, your veterinarian may order bloodwork to look for an infection. Your vet may also order X-rays to look for a bronchoalveolar pattern in the gravity-dependent lung lobes. 

If your dog is in respiratory distress, a vet will ensure there is no visible obstruction by performing an oral exam to look in the mouth and the back of the throat. If a large obstruction is suspected, a bronchoscopy can be performed. An arterial blood gas test to measure oxygen may also be a part of the monitoring and evaluation in an emergency facility. 

To diagnose aspiration pneumonia, your vet will perform a tracheal or a bronchoalveolar wash to collect a sample of cells in the trachea or lungs. 

There are other medical reasons that your dog could develop aspiration pneumonia. Each medical condition has a unique test:

Thyroid test (to diagnose hypothyroidism) 

Adrenal function test (to diagnose hypoadrenocorticism, also known as Addison’s Disease, and polyneuropathy)

Antiacetylcholine antibodies test (to diagnose myasthenia gravis)

Antinuclear antibodies test (to diagnose systemic lupus erythematosus)

Fluoroscopy imaging with contrast (to diagnose a swallowing disorder, or dysphagia)

Treatment of Aspiration Pneumonia in Dogs

In severe cases of aspiration pneumonia, your dog may need to be hospitalized at a 24-hour facility that can provide an oxygen cage, bronchodilators to open airways, IV fluid therapy and antibiotics, and anti-nausea and gastrointestinal motility medications.

In mild cases, outpatient therapy may be possible. The prognosis depends on the underlying disease that caused the regurgitation and subsequent aspiration pneumonia.  
 

Recovery and Management of Aspiration Pneumonia in Dogs

The general timeline for recovery from aspiration pneumonia is at least 10 days after the resolution of symptoms. The key to treating pneumonia is to not stop therapy too soon. Treatment can last between 2 and 8 weeks, depending on the severity and underlying cause of the aspiration pneumonia.  

Prevention and prognosis of aspiration pneumonia greatly depends on the underlying cause. If the underlying cause is serious, and there is a high likelihood for more infections, then the prognosis is poor.

Aspiration Pneumonia in Dogs FAQs

Can dogs recover from aspiration pneumonia?

Dogs can recover from aspiration pneumonia if treated aggressively and appropriately.

How quickly can aspiration pneumonia develop in my dog?

Clinical signs of aspiration pneumonia may be obvious immediately, or it may take days to weeks for symptoms to develop. 

References

University of Pennsylvania. Brachycephalic Airway Syndrome (BAS). 

Dyce KM, Sack WO, Wensing, CJG. Textbook of Veterinary Anatomy. 3rd ed. Philadelphia: Saunders; 2002.

Nelson RW, Couto CG. Small Animal Internal Medicine. 3rd ed. Elsevier Health Sciences Division; 2003.

Tilley LP, Smith FWK, Jr. The 5-Minute Veterinary Consult – Canine and Feline. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2004.

Featured Image: iStock.com/Kateryna Kukota


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WRITTEN BY

Genell McCormick, DVM

Veterinarian

Dr. Genell McCormick graduated from St. George’s University in Grenada in 2007. She is an Arizona native and has been practicing in small…


Bolognese Dog Breed

The Bolognese dog was prized in its early existence in Italy, and has always been regarded as a great companion to people. This small Bichon type breed is calm and known to be very intelligent and playful, but is still a rare breed in the United States.

Physical Characteristics

Similar to other Bichon type breeds, the Bolognese has a long, fluffy, pure white coat. The single layer coat falls in long ringlets on the body and shorter on the face. This small breed weighs anywhere from 5 to 9 pounds, with a stocky, square build.

Personality and Temperament

This breed is a very loyal and loving family dog known for the bond it forms with its owners. Although the Bolognese is described as serious and docile, it is also known to be very happy and playful. This small dog is friendly with strangers and is a cheerful companion.

Care

This toy dog breed does not require an excessive amount of exercise, but should you be the exercising type, the Bolognese is likely to be able to keep up with you. The breed hardly sheds, but brushing its coat daily or a few times a week will keep the coat healthy and tangle free. The Bolognese can be an ideal apartment dog as it will do fine without a yard.

Health

The Bolognese has a life span of 12 to 14 years and has no known breed-specific health disorders.

History and Background

Although it is thought that the Bolognese existed some time before it gained popularity in Italy, there is no clear record before the eleventh century. This breed was named after the northern Italian city Bologna, and was a prize dog of the courts and the wealthy in Italy.

The Bolognese remained a popular pet until Europe’s aristocracy fell from favor. The breed was almost extinct by the end of World War II, but Italian breeders were able to restore the Bolognese to popularity again.

In attempts to bring more attention to the breed in the U.S., the Bolognese Club of America was founded in 1986 and currently holds the only U.S. registry for the breed. The Bolognese was recognized by the United Kennel Club in 1995, though it is still considered a very rare breed in America.

Featured Image: iStock.com/sssss1gmel