Archive : February

Hypercalcemic Agent Poisoning in Dogs

Hypercalcemia is defined as abnormally elevated calcium levels in the blood. Of the various types of substances that are poisonous to dogs, there are those that include hypercalcemic agents. Hypercalcemic agents contain vitamin D, medically known as cholecalciferol, which works by raising the calcium content in blood serum to high toxic levels, resulting in cardiac arrhythmias, and then death. Hypercalcemic agents are popular for use in rodent poisons, since rodents do not have resistance to cholecalciferol. In most cases, poisons containing cholecalciferol must be directly consumed by an animal for it to fall ill, however the exception to this is when a dog eats a poisoned rodent.

Dogs that have consumed hypercalcemic poisons typically will not show immediate symptoms. Signs of poisoning may show 18 to 36 hours after the cholecalciferol containing poison was consumed. Left untreated, a dog can die from cholecalciferol poisoning and the resulting hypercalcemia. If the dog does survive, it will have elevated calcium levels for weeks after the poisoning, and this excess of calcium can lead to secondary health problems, like renal failure.


FatigueVomitingIncreased thirstFrequent urinationGeneralized weaknessSeizuresMuscle spasmsElevated blood serum calcium


The main cause of hypercalcemic poisoning is from the ingestion of rodent poison. If you suspect that your dog has come into contact with rat or mouse poison, and you are seeing some of the symptoms listed above, you will need to bring your dog to a veterinarian before your pet’s health becomes critical.

Keep in mind that outdoor dogs (or dogs that go outside frequently) are at risk of rodent poisoning. It might be in a neighbor’s yard, in a trash bag, or in an alleyway. Dogs that engage in chasing and killing rodents may also be susceptible to this type of poisoning. Even if you do not live in an area where rats or mice are a concern, rodent poison may be used for other common suburban pests like raccoons, opossums, or squirrels.


Your veterinarian will perform a thorough physical exam on your dog, taking into account your pet’s background medical history, onset of symptoms, and possible incidents that precipitated this condition. A complete blood profile will be conducted, including a chemical blood profile, and a complete blood count. Your veterinarian will conduct a blood test to check your dog’s calcium levels and presence of poison. If possible, you should take a sample of your pet’s vomit with you to the veterinarian, so that it can also be examined for the presence of poison. If you have the poison that your pet ingested, you should take that to your doctor as well.


One of the side effects of hypercalcemic poisoning is dehydration, which can lead to organ failure and seizures. You will need to make sure that your dog is getting plenty of water, and is able to retain the water it is taking in. Increased salt can help to increase or maintain body fluid, as well as induce excretion by the kidney. Adding a small amount of salt to the water you are giving to your pet will encourage fluid retention. Your veterinarian will work on correcting your dog’s body fluids, electrolyte imbalances, and lowering the calcium levels using diuretics, prednisone, oral phosphorus binders, and a low calcium diet.


Living and Management

Dogs that have survived hypercalcemic agent poisoning may succumb to some long term side effects due to the high level of calcium in the blood and in the body’s organs. The kidneys, for instance, are commonly damaged as a result of hypercalcemia.


The best prevention is to keep rodent poisons placed in areas that are not accessible to your dog, and to supervise your pet so that it does not get a hold of a rodent that may have ingested poison containing a hypercalcemic agent.

IVDD (Intervertebral Disc Disease) in Dogs

What Is IVDD in Dogs?

Intervertebral Disc Disease (IVDD) in dogs is a neurological condition that involves the spinal cord, the vertebrae, or back bones (the small, round bones that make up the spinal column or spine), and the disc material between each vertebra.

The vertebrae protect the spinal cord and the nerves that transmit impulses to and from the brain and the rest of the body. The spine also supports the weight and movement of the body. When something is wrong with the spine, it causes pain or even immobility. In between each vertebra is a soft, jelly-like disc surrounded by thick fibrous tissue. This intervertebral material serves as a cushion to absorb shock and help provide flexibility to the body as it moves.

IVDD in dogs is a condition that occurs when the cushioning discs between the bones of the spinal column either bulge or burst into the space containing the spinal cord. When this disc material pushes on the spinal cord, it can cause pain, nerve damage, and even paralysis. This condition is also known as a slipped disc, herniated disc, or bulging disc.

Certain dog breeds that have a long back and short legs, including Dachshund, Basset Hound, Shih Tzu, French Bulldog, Lhasa Apso, Pekingese, and Beagle, are predisposed to IVDD. The disease has also been known to occur in large-breed dogs, such as German Shepherds, because with age disc degeneration occurs.

Types of IVDD in Dogs

Hansen Type I and Hansen Type II are the two main types of disease that affect the intervertebral disc, each causing a disc to press painfully against the spinal cord:

Hansen Type I occurs when the soft, jelly-like center of the disc becomes hardened. With one wrong jump or sudden impact, this rock-like disc shoots out of its thick shell and pushes upward into the spinal cord and its surrounding nerves. This movement of the disc material (called a herniation) causes compression and bruising of the spinal cord. This is a very sudden, sharp pain with varying degrees of reduced nerve function.

Type I disc disease is most common in Dachshunds and other similar breeds with the same body structure.

Hansen Type II involves a much slower degenerative process, where the disc material impinges on the spinal cord and spinal nerves over time from a matter of months to years. The thick fibers around the soft disc material will slowly collapse over time and push upward. This causes more long-term pain and spinal cord compression.

Type II disc disease is common in German Shepherds and other large breed dogs.

Symptoms of IVDD in Dogs

Clinical signs of IVDD depend on the type of disc herniation and location in the spinal column. Starting at the neck and moving toward the tail are five regions of the spine—the cervical, thoracic, lumbar, sacral, and caudal vertebrae. The most common sites of disc herniation in dogs are at the end of the thoracic vertebrae (T11-T12) and the beginning of the lumbar vertebrae (L2-L3). These herniations are painful impact a dog’s ability to move. Cervical (neck) herniations are less common, but if they do occur it’s almost always in Dachshunds, Beagles, or Poodles and they tend to create more pain but less loss of function.

Symptoms of IVDD include:

Limping or lameness, unsteady walking

Dragging back legs

Stumbling over back feet

Hunched back or neck with tense muscles



Unwillingness to jump

Anxious behavior (e.g., shivering, panting)

Decreased activity level

Decreased appetite

Loss of bladder and/or bowel control (urinary and/or fecal incontinence)

Difficulty posturing to urinate/defecate

Paralysis­ (i.e., complete loss of function in front or hind limbs)

Causes of IVDD in Dogs

IVDD is the result of a herniated disc and compression of the spinal cord. In chondrodystrophic dog breeds (those with a hereditary cartilage development abnormality), that include Dachshunds, Corgis, and Bassett Hounds, IVDD is commonly caused by an acute or sudden rupture of the disc material. While wear and tear damages the disc over time, the rupture generally occurs suddenly as the result of a forceful impact (e.g., jumping, landing).

In large-breed dogs, such as Shepherds, Labradors, and Doberman Pinschers, the discs become hardened over a longer period, eventually bulging or rupturing to cause spinal cord compression. This type happens gradually, and a specific forceful impact won’t be the cause of damage.

How Veterinarians Diagnose IVDD in Dogs

If you suspect your dog is having any back pain or difficulty getting around, have it examined by a veterinarian as soon as possible. With IVDD, the sooner you treat the problem the better the chance for a full recovery.

Your veterinarian will perform a complete physical and neurological examination including baseline blood and urine testing to assess your dog’s overall health. Based on the results of the examination, if IVDD is suspected your vet will likely recommend imaging tests to visualize the spine and surrounding tissues to determine the severity of the condition.

Plain radiographs (X-rays) are taken of the spine to look for areas of narrowing joint spaces in between the vertebrae, but X-rays do not show the spinal cord. An MRI can better identify the location of a spinal cord compression and material in the vertebral canal. MRI has become the technique of choice for the diagnosis of IVDD because it allows scanning of the whole spine so that the discs and spinal cord can be assessed in the same image. Depending on the severity of clinical signs and indications for surgery, other diagnostic tools including myelography, or computed tomography/CT scan) can further investigate the type of herniation and its location.

Treatment of IVDD in Dogs

Depending on the severity of the damage to your dog’s spinal cord, treatment can range from medical management to emergency surgery.

In mild cases of IVDD, treatment focuses on reducing pain, inflammation, and swelling. This is achieved using medications and strict confinement. Your dog should be in a crate or a small area where they cannot run, jump, play, or perform any exercise. The timeline of strict rest depends on the specific injury and rate of healing. Often, physical therapy is recommended to help speed recovery.

If the damage is severe and the dog has a degree of paralysis, surgical correction of the herniation is typically suggested. This is usually an emergency surgery to minimize any permanent neurologic damage. The goal of surgery is to evaluate the herniation and relieve the pressure on the spinal cord. This is done by removing a portion of the bony vertebra over the affected part of the spinal cord (called a laminectomy).

After surgery, the same activity restrictions apply, focusing on conservative management to allow the spinal cord to heal. Unfortunately, even with surgery, some dogs will not regain function and will have lasting neurological issues.

How Much Does IVDD Surgery for Dogs Cost?

IVDD surgery itself can cost between $2,000 and $5,000, depending on where you live and the individual veterinary office. This does not include pre-op and post-op treatment, consultations, lab work, medications, or other added potential costs that may be needed to treat the condition.

Recovery and Management of IVDD in Dogs

Prognosis varies significantly depending on the degree and the location of the injury. Most disc ruptures entail minimal neurological issues and the pup patient will have an excellent chance to return to walking. However, if the pet has lost the ability to sense pain in its legs before surgery is performed, it may never walk again.

The spinal cord recovers slowly, and extra care must be taken to prohibit running, jumping, going up or down stairs, playing with other dogs, and hopping on or off furniture. If your dog is diagnosed with a mild to moderate IVDD injury, treatment may include steroid and anti-inflammatory medications to help reduce pain and swelling, combined with strictly reduced activity for approximately four to six weeks. Recovery from IVDD surgery requires six to eight weeks of restricted activity.

It is not uncommon for a dog (mainly Dachshunds) to have additional herniations in other regions of the spine after surgery. Though it is difficult to prevent future disc herniations, the likelihood can be limited by avoiding activities such as jumping and explosive movements (e.g., frisbee, stairs). Dogs with back problems should be kept at a healthy weight to allow a quicker recovery from surgery and to avoid future strain on the back.

Surgery outcomes are most successful in dogs that have not lost their ability to walk. If your dog’s surgery is not successful in returning them to normal mobility, a dog wheelchair can help your pup enjoy a happy and active life while living with IVDD.

Featured Image:


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Barri J. Morrison, DVM


Barri Morrison was born and raised and currently resides in Ft. Lauderdale, Florida. She went to University of Florida for her…

Plague in Dogs

Yersinia pestis in Dogs

Plague is a bacterial disease caused by the parasitic genus Yersinia pestis. This condition occurs worldwide. In the United States, it is predominantly found in the southwest between the months of May and October. Carriers of this disease include rats, squirrels and mice; the disease is typically transmitted when a rodent either bites, or is bitten by a dog.

The infection travels rapidly to the lymph nodes, where white blood cells are produced. The resulting reaction from the lymph nodes is a rapid multiplication of white cells, abnormal fluid build up with swelling, and possible skin breakage. Dogs infected with plague will experience fever, inflammation, and excessive pain due to the lymph nodes being chronically swollen.

This disease is rare in dogs because they tend to have a high resistance to the bacteria. However, there are no gender or breeds more susceptible to plague.

Although it is quite rare, plague is transmittable to humans, and care should be taken to avoid fleas and body fluids from an animal that is suspected of being infected with the Yersinia bacterium.

Cats may also be infected with plague. If you would like to learn more about how this disease affects cats, please visit this page in the PetMD health library.

Symptoms and Types

There are three forms of plague: bubonic plague, pneumonic plague, and septicemic plague. Symptoms associated with bubonic plague will include painfully swollen lymph nodes, fever, inflammation, depression, vomiting, dehydration, diarrhea, enlarged tonsils, and anorexia. The head and neck area will swell considerably, and should the dog survive, its lymph nodes may abscess and then rupture and drain. Other symptoms include discharge from the eyes, mouth ulcers, and a loss of appetite, with visible weight loss being evident. Coma may follow.

The normal incubation period for bubonic plague is between two and seven days after the dog has been bitten. In the case of pneumonic plague, a lung infection will occur; and with septicemic plague, the same symptoms as bubonic plague will appear, along with systemic infection of the blood.


The Yersinia bacterium is transmitted to dogs when an infected flea bites them, or when they ingest an infected rodent. Another possible cause for exposure could come from the animal’s environment.

If the home is heavily infested with fleas, or if the homeowner resides near a wildlife habitat, where the dog is exposed to rodents, this could put the dog at a higher risk of contracting the plague. Garbage, woodpiles, and food sources can also be outlets for transmission of this disease.


Your veterinarian will run a full diagnostic evaluation on the dog, including blood samples, culture samples of fluids, and kidney and liver testing, in order to establish a definitive diagnosis of this disease. A swollen lymphatic system is a clear indication that infection is present and blood tests will show the level of white blood cells present, amongst other things, further aiding in identifying the presence of plague bacteria.

A thorough physical examination will be undertaken to check for swelling around the neck and head, liver and kidneys, and to check for signs of dehydration, fever, lung infection, or anything else that will conclusively pinpoint the plague as a cause for your dog’s illness.

Medication will be administered to treat the symptoms, and if plague is confirmed, or suspected, your dog will be isolated until the condition is resolved.

You will need to give a thorough history of your dog’s health, including a background history of symptoms, and possible incidents that might have precipitated this condition.


Your dog will require hospitalization to treat the more severe symptoms of plague, and will be given a full course of antibiotics. Dogs that are weakened and dehydrated, will require an intravenous drip to assist in rehydration. Flea treatment will also be required. The incidence of mortality is high for dogs that are not treated early and effectively.

Living and Management

Ongoing flea control and management of rodents is a must. There is no home management plan for this disease, and all cases of suspected infection should be reported to your veterinarian immediately. However, maintaining a flea free home and keeping rubbish, food, and woodpiles to a minimum will help greatly in reducing the risk of plague infection.

Dogs should be neutered, as this aids in subduing their hunting instinct. Additionally, indoor dogs are less likely to be exposed to the Yersinia bacterium. but if you do not have the option of keeping your pet indoors, you will need to provide preventive flea care to your dog.

When travelling to areas where the plague bacteria may be present, it is wise to make sure your dog is kept on a leash or in an enclosed environment at all times so that exposure to wild rodents or fleas that may be carrying this disease is limited. 

Pelger-Huët Anomaly in Dogs

Pelger-Huët anomaly is an inherited disorder characterized by the hyposegmentation of neutrophils (a type of white blood cell), whereby the nucleus of the cells has only two lobes or no lobes at all. For the most part, this is a harmless disorder which affects several breeds of dogs, including the American foxhound, Australian shepherd, and basenji.

Symptoms and Types

There are two types of this benign defect: heterozygous and homozygous. The heterozygous version is more common and is recognized because the dog’s mature neutrophils resemble bands (slightly immature neutrophils) and metamyelocytes (a predecessor of granular leukocytes). Heterozygous anomaly is not associated with immunodeficiency, with predisposition to infection, or with abnormalities of leukocyte (white blood cell) function. Conversely, the homozygous anomaly is usually lethal in utero. Dogs that survive may have leukocytes with round to oval nuclei on a stained blood smear.

Heterozygous anomaly and skeletal anomalies, such as abnormal development of cartilage and shortened jaws, are reported in Samoyeds; however a direct link with Pelger-Huët anomaly has not been conclusively confirmed.


Limited breeding studies may suggest autosomal (non-sex linked) dominant transmission of the anomaly in dogs. However, autosomal dominant transmission with incomplete penetrance (lacks full genetic expression of the autosomal dominance) occurs in Australian shepherd dogs.


In most cases, veterinarians discover the anomaly in your dog by accident while conducting routine blood tests. On a stained blood smear, nuclear hyposegmentation of neutrophils, eosinophils, basophils, and monocytes will be visible, whereby the nucleus of the cells has only two lobes or no lobes at all. The hereditary nature of disease is revealed by examination of blood smears from parents and siblings.


No treatment is required, as there is clinical disease associated with Pelger-Huët anomaly.

Living and Management

If breeding is a concern, genetic counseling can help with eliminating the trait from future generations.

Brain Inflammation Due to Parasitic Infection in Dogs

Encephalitis Secondary to Parasitic Migration in Dogs

Brain inflammation, also known as encephalitis, may be due to a variety of factors. For instance, parasites can migrate into the dog’s central nervous system (CNS), gain entry via blood or through adjacent tissues, including the middle ear, natural opening in the skull, nasal cavities and cribriform plate (part of the skull), or open fontanelles, also called “soft spots.”

These parasites may normally affect another organ system of the same host (e.g., Dirofilaria immitis, Taenia, Ancylostoma caninum, Angiostrongylus, or Toxocara canis), or a different host species (e.g., raccoon roundworm, Baylisascaris procyonis; skunk roundworm, B. columnaris; Coenurus spp., or Cysticercus cellulosae). Dirofilaria immitis is most often seen in adult dogs, while the other parasites generally infect younger pups that are exposed to the outdoors.

Symptoms and Types

Symptoms associated with this type of encephalitis will vary depending on the portion of CNS affected. Cuterebriasis, for example, occurs mainly between July and October in the U.S. and is characterized by the sudden onset of behavior changes, seizures, and vision issues. Meanwhile, a common rat parasite in Australia, Angiostrongylus cantonensis, may cause lumbosacral syndrome in puppies, which can lead to paralysis or paresis of the hindlimbs, tail, and bladder. In addition, parasite infections are often asymmetrical, affecting one side but not the other.


The most common way a dog acquires this type of encephalitis is by being housed in a cage that has been previously occupied by an infected host; e.g., raccoons, skunks.


You will need to give a thorough history of your dog’s health, including the onset and nature of the symptoms, to the veterinarian. He or she will then perform a complete physical examination as well as a biochemistry profile, urinalysis, complete blood count (CBC) — the results of which are typically normal unless the parasites have also migrated into other organs.

Computed tomography (CT) or magnetic resonance imaging (MRI) of the brain may reveal a focal lesion and/or cerebral tissue death from blockage of cerebral blood vessels, both of which are consistent with parasitic infections. A cerebrospinal fluid tap is another common diagnostic method used to confirm parasitic infection; however, the tap may yield normal results despite encephalitis.


Medication such as anthelmintics (dewormers) may be used to kill off the parasites, but they may also lead to other complications. Consult your veterinarian for the best course of treatment. Puppies with a mild form of angiostrongylosis may even recover fully with just supportive care and corticosteroid therapy. In other cases, surgical removal of intercranial parasites (e.g., Cuterebra) may be necessary.


Most parasitic infections of the central nervous system are incurable and progress in severity. To prevent your dog from contracting such infections keep it indoors and away from wild animals. Dewormers, anthelmintics, and dirofilaricides can also prevent infection.

Caring for an Emaciated Dog

By T. J. Dunn, Jr., DVM

At times, animal shelters or rescue groups are presented with a markedly thin and undernourished homeless dog. (The significant loss of body fat and muscle mass is termed emaciation.) The following presentation relates to the care and recovery assistance provided to dogs that have been homeless for days to weeks.

Ideally, the dog should be thoroughly checked by a veterinarian and veterinary advice should be given regarding the dog’s nursing care. However, if veterinary assistance is not available, shelter personnel should, upon initial admission to the shelter, do the following:

1. Create an individual animal chart for the dog so that daily records and notes can be recorded.

2. Conduct a thorough inspection for any identification markers such as ear or inner thigh tattoos and/or microchips. These subcutaneous tiny microchip implants can migrate, so scan the entire dog for a microchip implant.

3. Record the dog’s temperature, weight and also note an estimated normal weight on the chart.

4. Conduct a thorough physical exam. Don’t neglect to inspect the oral cavity for fractured teeth, bone fragments lodged between teeth, and lacerations to or under the tongue. Check for eye and ear infections; check under the tail for evidence of anal sores, tapeworm segments, or maggot infested moist infections. Check the paws for abraded pads or interdigital infections or foreign matter.

5. Gently probe with your fingertips all areas of the abdomen. This is most easily done having an assistant restrain the dog’s head while the dog is in a standing position. Stand/kneel at the dog’s hip and facing forward places the left hand fingers along the left side of the dog’s abdomen and passing the right hand under the belly and placing the right hand fingers opposite to the left. Gently bringing the hands together, and probing and pushing various areas along the abdomen will reveal important information.

Does the dog display pain? Does the dog “cramp up” and grunt when abdominal pressure is applied? If so, the dog may need veterinary care. If no pain is noted and the dog tolerates the abdominal palpation, the odds are good that there are no significant or life abdominal threatening problems.

6. Check the gums and tongue for color. A pale or grayish color may indicate anemia from blood loss or rodent poison ingestion. Likewise, if there are areas on the gums or whites of the eyes where blotches of hemorrhage are noted, veterinary care is needed right away. The gums and tongue should be pink to reddish.

7. Offer the dog a small amount of water and observe the dog’s interest and ability to drink.

8. Determine if the dog is dehydrated. The best way to do this is to gently grasp a fold of skin at the base of the neck and pull the skin upward, away from the dog. In a normal state of hydration when you let go of the stretched fold of skin, it readily snaps back into place. If, however, the skin fold does not snap back, but seems to dissipate in slow motion, that display of poor elasticity will only occur if the dog is dehydrated.


Non-veterinary care can be successful as long as the rescued dog does not have a serious medical disorder such as kidney failure, anemia, pancreatitis or bowel obstruction due to garbage or foreign body ingestion.

Since many dogs admitted to an animal shelter have been injured while homeless, they need careful evaluation for broken bones, burns or gunshot injuries. Garbage ingestion can cause bacterial enteritis and bloody diarrhea, severe pancreatitis, and intestinal blockage due to the consumption of bones.

What Happens During Starvation?

Researchers have studied how a dog’s body organs and biochemistry are disrupted by various lengths of time of starvation. If the dog is healthy to begin with, and no medical problems exist that, of course, would compound the starving dog’s medical status, a predictable sequence of adaptations take place.

The dog’s biochemical functions shift into survival mode within twenty-four hours with no nutritional intake. The highest priority of the dog’s metabolic processes becomes the necessity to keep the blood glucose concentration at a normal level. If the blood glucose (“blood sugar”) level drops too low for any reason, the brain, heart, muscles and kidney function shuts down rapidly and death comes quickly. So, when the dog has no opportunity to eat, the survival mode’s first concern is to mobilize stored glucose from liver and muscle reserves by changing the biochemical processes to different chemical pathways that make glucose readily available.

After about two days without food the liver reserves of glycogen (glucose) are depleted. So in order to keep the blood level of glucose in the normal range, new chemical pathways open, called gluconeogenesis, where the liver and kidneys create molecules from complicated biochemical reactions so that fats and proteins are extracted from adipose tissue and muscle. As the glucose reserves are tapped and diminished, chemical reactions kick in to create glucose internally from those protein and fat reserves. Energy to run the body’s machinery (muscle, brain, kidney, heart and other organ functions require energy to fuel their activities) is now fueled less by glucose and more by fatty acid extracted from fat reserves.


On the third day of food deprivation the dog’s metabolism slows down. This lower, or slowed, metabolic rate continues as long as no food is consumed. The lowered metabolism is a survival mechanism to decrease the utilization of body fat and muscle for energy. Lowered blood sugar levels changes insulin secretion by the pancreas, which in turn lowers thyroid hormone levels; and it’s the thyroid gland function that ultimately dictates the metabolic rate.

During starvation the liver releases chemicals called ketones into the blood stream; ketones are then used as a source of energy for the dog’s body cells. By creating ketones and fatty acids to be used as energy sources, the dog’s body conserves what little glucose is circulating so that glucose-dependent red blood cells and important kidney tissues can continue to access glucose. Interestingly, red blood cells and kidney tubule cells cannot utilize anything other than glucose for cell energy needs.

After five days of starvation fat becomes the main source of energy.

Feeding the Starved Dog

Animal caretakers must exert strict self-control when attempting to nurse a starved dog back to good health. The natural and common tendency is to overfeed the dog “because he’s ravenous.” If an emaciated and starved dog is suddenly overfed serious consequences, such as refeeding syndrome, await. This is because a sudden load of carbohydrates in a large meal can create serious shifts in potassium and phosphorus concentrations in all body cells.

Signs of Refeeding Syndrome are described as muscle weakness, muscle cramps, heart muscle damage and rhythm irregularities, seizures, red blood cell rupture and respiratory failure.

In addition, a prolonged lack of food does not “shrink the stomach,” but it does make the stomach much more sensitive to stretch receptor nerve impulses. The dog may feel as if full when the stomach has only a small quantity of food in the stomach. The increased sensitivity to gastric expansion will dissipate over 3 to 7 days.

The food being fed to the starved dog should have adequate mineral composition, especially phosphorous, potassium and magnesium. (Therefore, do not be tempted to feed, for example, just hamburger, which does not have a wide or balanced mineral content.) The amount of food, or total calories, should not exceed over 24 hours what the dog would normally eat at its normal weight. An emaciated dog is best served consuming a small meal every six hours (4 times a day) rather than consuming one or two larger meals.

A broad-spectrum vitamin and mineral supplement is important to include at each meal. Some evidence supports the addition of the amino acid glutamine to the recovery diet. Omega 3 and 6 fatty acid supplements are also beneficial to a dog recovering from malnourishment; the same holds true for the amino acid arginine. Dietary nucleotides are important contributors to the formation of DNA and RNA and assist in a number of metabolic activities of healthy cells. Diets rich in meat provide adequate nucleotides.

By feeding a highly digestible, meat-based “Puppy” or “Growth” food, along with certain supplements, recovery and weight gain should be evident in a short period of time — that is, as long as the dog has a normal appetite.

Also, until a normal appetite should return, it is recommended to divide the daily suggested amount of food (based on the dog’s estimated health weight) into four smaller portions. At each meal, closely monitor the dog’s intake and note it on a chart. For example, the record could state, 8:00 a.m. meal – ate 100% or ate 50% or ate 10%.

If, after two days, the dog does not consume an amount over a 24-hour period approximately equal to the amount expected to be eaten by a healthy dog of the patient’s ideal weight, assisted (forced) feeding may become necessary. Consult your veterinarian regarding how best to force feed the patient.

Keep in mind that some dogs raised on a single type of dog food may reject a different type no matter how hungry the dog may be. There are dogs that simply refuse to eat canned food, dry food or table scraps, so be prepared to be creative. Slightly warming the food or moistening with chicken broth, and presenting the food in tidbit amounts can tempt a reluctant appetite.

If you estimate the dog has been deprived of food for 7 days or more, the diet should be composed predominately of fat rather than carbohydrates. Never allow the dog, especially early in the recovery feeding process, to consume a large meal all at once. Small amounts fed at intervals during the first few days is very important. Free access to water is proper.

It is common to see occasional vomiting or loose stool in the early recovery time of a starved dog. By weighing the dog twice a day (a.m. and p.m.) and by noting the amount of food ingested versus the amount vomited and passed as feces, an assessment can be made regarding positive or negative weight gain. Veterinary care is needed if bloody stool or vomit is noted or if there is weight loss during the refeeding and recovery period.


Determining How Much to Feed

Nutritionists employ a number of methods and formulas to determine the average total caloric intake for dogs based upon the dog’s ideal body weight. Any estimate of “how much” to feed is inherently subjective and lots of variables will apply to each individual dog.

Some nutritionists rely on the (MER) Maintenance Energy Requirement to determine approximately how much food (actually how many calories) an average dog needs on a daily basis to maintain body weight. In spite of exceptions and variables, calculating the MER is sensible and useful.

Below is an approximation for an average dog’s maintenance daily caloric requirements:

Dog’s Weight in Pounds Total Calories Needed Per Day
11 456
22 725
44 1,151
66 1,508
88 1,827
132 2,394

The stress of recovery from a starvation state might demand a slightly higher caloric intake than estimated. When feeding the emaciated dog, the number of calories the dog should ideally consume during recovery from starvation should be approximately the same as what the dog would consume at its normal weight. For example, if a rescued Mastiff is extremely thin and emaciated and upon examination she weighs 88 pounds and you estimate that when healthy she would weigh 130 pounds, try to feed the dog a daily caloric amount calculated for a 132 pound dog. Therefore, during a 24-hour day you would provide the dog not with 1,827 calories but rather 2,390 calories.

Every pet food or supplement label must list the calories per unit weight of the product. Plus, the percent fat and protein are listed. For some mysterious reason carbohydrates (CHO) percentages are not often listed and, if needed, must be calculated by deduction from the percentages of everything else listed on the label. Fortunately, in the starving dog’s recovery diet our main focus is on fat and protein intake so calculating the calories supplied by carbohydrates isn’t a priority.

It is suggested that dogs mildly to moderately underweight be provided with a diet moderately high in fat and protein. These diets should have adequate levels of carbohydrates but not predominantly carbohydrate. Try to feed products that show (for dry food) fat content of 18% and protein 28-30%. (Liquid supplements will list seemingly lower percentages for fat and protein because they typically are 60 to 70% moisture whereas dry pet foods have only 10% moisture.)

For a markedly underweight dog that truly looks starved, an even higher fat content in the diet is recommended… but remember to start out slowly! Do not overfeed with too much at any single feeding. Also, check with your veterinarian before giving an emaciated dog a recovery diet.

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T. J. Dunn, DVM


Hydrocephalus in Dogs

What is Hydrocephalus in Dogs?

Hydrocephalus is abnormal expansion and accumulation of cerebrospinal fluid (CSF) in cavities inside the brain. CSF is the liquid that surrounds the brain and spinal cord to support and cushion those delicate tissues and also provide nutrients to keep them healthy. CSF is normally produced in cavities in the brain and is eventually absorbed by the body as it performs its essential functions.  

In hydrocephalus, the abnormal buildup of CSF can be due to: 

Increased production of CSF 

Decreased absorption of CSF 

A blockage of CSF within the brain 

This accumulation of fluid creates pressure on the brain. Because the skull prevents the brain to expand, and as a result of the pressure, significant damage to the brain can occur, resulting in behavioral and neurological issues. Possible complications include brain herniation and even death.  

Hydrocephalus is an extremely complex disease that veterinarians and researchers have yet to completely determine the underlying mechanisms behind. However, in general, hydrocephalus is broken down into two major types: congenital and acquired. Dogs with congenital hydrocephalus are born with the condition, while dogs with acquired hydrocephalus are born with normal brains but develop abnormal fluid accumulation over time.  

Symptoms of Hydrocephalus in Dogs

Hydrocephalus can cause a wide variety of symptoms in dogs depending on the specific cause and area of the brain that’s affected. Some dogs are asymptomatic.  

Symptoms may be acute or gradually progress and can include:  

Difficulty training and decreased awareness or lack of response to stimuli 

Visual deficits, often blindness 

Abnormal gaze (eyes fixed down and away) 


Head pressing 

Large, dome-shaped head, often with congenital hydrocephalus and with open fontanelles (the soft spot on the top of the skull) 

Brain dysfunction 

Abnormal behavior—inappropriate vocalization, over excitability, drowsiness, circling 

Gait abnormalities 

Increased intracranial pressure, often leading to stupor or coma 

Causes of Hydrocephalus in Dogs

Congenital hydrocephalus is one of the most common types of the disease. Congenital means “born with,” but does not necessarily have a genetic cause. There are numerous malformations within the brain that can cause obstruction of the CSF. Common causes of congenital hydrocephalus are: 

Genetic malformation 

Prenatal infection (often due to the parainfluenza virus) 

Exposure to substances that are toxic to a developing fetus 

Brain hemorrhage secondary to a difficult birth 

Prenatal vitamin deficiency 

Unfortunately, veterinarians cannot always determine a cause of congenital hydrocephalus. Veterinarians do, however, commonly diagnose congenital hydrocephalus with other malformations such as:  

An abnormality of the skull and vertebra at the base of the skull creating inadequate space for the brain to function 

An underdeveloped part of the brain called the cerebellum associated with cyst formation and subsequent fluid accumulation 

Abnormal cavities within the spinal cord 

A type of spina bifida 

Certain cysts within the nervous system 

Acquired hydrocephalus results when a previously normal brain develops an obstruction and subsequent dilation with CSF. Causes of acquired hydrocephalus include:  




Brain hemorrhage 

Inflammatory brain disease 

How Veterinarians Diagnose Hydrocephalus in Dogs

A vet may suspect hydrocephalus based on a physical exam alone. The veterinarian will examine the dog’s appearance and interactions with and response to stimuli. A dog with an enlarged dome-like head, open fontanelle (soft spot on the skull), and eyes positioned down and out are often evaluated for hydrocephalus.  


The vet may take x-rays to view your dog’s skull, and to determine if there are open plates and other signs suggesting hydrocephalus.  


If your dog has an open fontanelle, the vet may perform an ultrasound to visualize the dilated chambers within the brain.  

CT and/or MRI 

These imaging tests can provide a definitive diagnosis of hydrocephalus because they provide crucial information about internal brain structure and function that cannot be determined other ways. 

In some instances, the vet may also perform electroencephalography (EEG), which detects electrical activity in the dog’s brain and a cerebrospinal fluid analysis, which measures chemicals in the dog’s spinal fluid.

Treatment of Hydrocephalus in Dogs

Treatment of hydrocephalus involves addressing the underlying cause. Not all forms of hydrocephalus return to a “normal” state, but the goal is to stop progression of disease. Age, severity, and severity of symptoms all play a role in developing a treatment plan for a dog with hydrocephalus.  

Medicine to decrease production of cerebral spinal fluid is often the first treatment option, especially in dogs with mild to moderate disease. The most common medicine used to accomplish this are:    

Steroids such as prednisolone and dexamethasone 

Diuretics such as furosemide 

Proton-pump inhibitors such as omeprazole 

In severe cases or those that don’t respond to medications, the vet may suggest neurosurgery as a treatment option. Surgery typically involves implanting a shunt to remove fluid from the brain and relocating it to another location in the body, usually the abdominal cavity. Surgery has a 50% to 90% success rate in animals with hydrocephalus. 

If a dog is having seizures, the vet may administer valium and then prescribe other treatments such as antibiotics, surgery, or steroids, once the dog is stable.  

Recovery and Management of Hydrocephalus in Dogs

Long-term medical management of hydrocephalus with steroids and diuretics may lead to Cushing’s disease and electrolyte imbalances. It is important to maintain the recommended follow-up maintenance exams with the vet to closely monitor your dog’s health.  

Dogs who have surgery to place a shunt may require additional procedures to address blockages in the shunt.  

Dogs with mild cases of hydrocephalus may lead normal lives with minimal medical intervention. However, more severe cases can have a poor prognosis as the disease progresses and can eventually lead to brain herniation, seizures, and even death. In general, approximately 50% of the animals respond favorably to treatment, both medical and surgical.  

Hydrocephalus in Dogs FAQs

What is the survival rate of hydrocephalus in dogs?

The prognosis for dogs with hydrocephalus ranges from good to poor, depending on age, location, and severity of symptoms. Approximately 50% of dogs respond well to treatment.

Is hydrocephalus in dogs genetic?

Some forms of hydrocephalus are genetic.

Can a puppy grow out of hydrocephalus?

Not all puppies have clinical signs associated with hydrocephalus but once they do have signs it is unlikely they will outgrow or lessen in severity without treatment.

Can hydrocephalus be cured?

No, but hydrocephalus can be managed with surgery and medication.

How much does hydrocephalus treatment cost?

Medical management can be very cost-effective and inexpensive. Surgery requires veterinary specialists and can cost between $4,000 to $10,000 for surgery and intensive care before and after.


Biel M, Kramer M, Forterre F, et al: Outcome of ventriculoperitoneal shunt implantation for treatment of congenital internal hydrocephalus in dogs and cats: 36 cases (2001-2009). J Am Vet Med Assoc 2013 Vol 242 (7) pp. 948-58. 

Schmidt MJ, Hartmann A, Farke D, et al: Association between improvement of clinical signs and decrease of ventricular volume after ventriculoperitoneal shunting in dogs with internal hydrocephalus. J Vet Intern Med 2019 Vol 33 (3) pp. 1368-1375. 

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Lauren Jones, VMD


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

Fluid Retention and Tissue Swelling Due to Collection of Lymph in Dogs

Lymphedema in Dogs

Lymphedema is a medical in which localized fluid retention and tissue swelling are caused by a compromised lymphatic system. The watery fluid, also known as lymph, contains white blood cells and circulates throughout the lymphatic system and typically collects into interstitial spaces, especially subcutaneous fat.

Congential forms of the disease has been reported in bulldogs and poodles, as well as Labrador retrievers and Old English sheepdogs.

Symptoms and Types

The fluid accumulation (edema) is usually not painful and pits; that is, a depression develops if the skin is pushed with a finger (which eventually disappears if fibrosis occurs). Limb swelling, meanwhile, is present at birth or develops in the first several months. The swelling may be affect one or several limbs, and typically begins at the end of the limb and slowly moves upwards. In some cases, lameness and pain may also develop.


Hereditary and congenital (present at birth) forms of lymphedema are caused by malformations of the lymphatic system, such as aplasia, valvular incompetence, and lymph node fibrosis. Other potential causes include heart disease, trauma to the lymphatic vessels or lymph nodes, and heat or radiation exposure.


You will need to give a thorough history of your dog’s health, including the onset and nature of the symptoms, to your veterinarian. He or she will then perform a complete physical examination, as well as a biochemistry profile and complete blood count — the results of which are typically normal.

The most reliable test used to diagnose this condition, however, is called lymphography. This imaging examination uses a contrast substance, which is injected directly into the lymphatic system, to better visualize the affected region before taking X-rays.


Although there is currently no cure available for lymphedema, a number of medical and surgical treatments have been attempted with variable outcomes. Long-term application of pressure wraps and antibiotics to prevent infections may be successful in some patients, while rest and massage seem to not help in treating the condition. There are also various surgical techniques that are used to treat lymphedema, but none have demonstrated consistent results.

Living and Management

As there is no cure available, most veterinarians focus on alleviating secondary symptoms and complications such as lameness. Severe forms of lymphedema may be fatal for the dog; however, there are cases in which puppies with pelvic limp involvement fully recover. 

Skin Disease Due to Food Allergies in Dogs

Dermatologic Food Reactions in Dogs

Dermatologic food reactions are non-seasonal reactions which occur following ingestion of one or more allergy causing substances in an animal’s food. The physical reaction is frequently excessive itchiness, with resultant excessive scratching at the skin.

While the pathogenesis of these reactions is not fully understood, immediate reactions and delayed reactions to food are thought to be due to a hypersensitive immune response.  On the other hand, food intolerance is a non-immunologic idiosyncratic reaction due to the metabolic, toxic or pharmacologic effects of the offending ingredients. Since it is not easy to distinguish between immunologic and idiosyncratic reactions, any negative response to food is generally referred to as an adverse food reaction.

Symptoms and Types

Non-seasonal itchiness of any body locationPoor response to anti-inflammatory doses of glucocorticoids generally suggests food hypersensitivityVomitingDiarrheaExcessive gut sounds, passing of gas, and frequent bowel movementsMalassezia dermatitis (fungal skin infections), pyoderma (bacterial skin infections), and otitis externa (inflammation of the outer ear)Skin plaques – broad, raised flat areas on the skinPustules – pus-containing raised skin inflammationsErythema – redness of the skinCrusts – dried serum or pus on the surface of a ruptured blister or pustuleScale – flakes or plates of dead skin on the skin’s surfaceSelf-induced baldness due to scratchingAbrasions/sores on the skin due to scratchingLeathery, thick, bark-like skinHyperpigmentation – darkening of the skinHives – swollen or inflamed bumps on the skinGiant wheals (elongated marks) on the skinPyotraumatic dermatitis – infection of the skin wounds due to scratching excessively, and bacteria entering the wounds


Immune-mediated reactions – result of the ingestion and subsequent presentation of one or more glycoproteins (allergens) either before or after digestion; sensitization may occur as the food passes into the intestine, after the substance is absorbed, or bothNon-immune (food intolerance) reactions – result of ingestion of foods with high levels of histamine (an antigen known to cause immune hypersensitivity) or substances that induce histamine either directly or through histamine-releasing factorsIt is speculated that in juvenile animals, intestinal parasites or intestinal infections may cause damage to the intestinal mucosa, resulting in the abnormal absorption of allergens and subsequent sensitization to some ingredients


Your veterinarian will perform a complete physical exam on your dog, including a dermatological exam. Non-food causes of dermatologic disease should be ruled out. Your veterinarian will order a blood chemical profile, a complete blood count, a urinalysis and an electrolyte panel to rule out other causes of disease. You will need to give a thorough history of your dog’s health, onset of symptoms, and possible incidents that might have preceded this condition, especially regarding any changes in diet, and any new foods added to your dog’s diet, even if temporary.

Food elimination diets are advised for dogs thought to be suffering from adverse food reactions. These diets typically include one protein source and one carbohydrate source to which the dog has had limited or no previous exposure to. A clinical improvement may be seen as soon as four weeks into the new diet, and maximum alleviation of clinical signs may be seen as late as thirteen weeks into the food elimination diet.

If your dog improves on the elimination diet, a challenge should be performed to confirm that the original diet was the cause of disease and to determine what ingredient in the original diet triggered the adverse reaction.

Challenge: feed your dog with the original diet. A return of the signs confirms that something in the diet is causing the signs. The challenge period should last until the signs return but no longer than ten days.

If the challenge confirms the presence of an adverse food reaction, the next step is to perform a provocation diet trial: going back to the elimination diet, begin by adding a single ingredient to the diet. After waiting a sufficient amount of time for the ingredient to prove either agreeable or adverse, if there is no physical reaction, move on to adding the next ingredient to your dog’s diet. The provocation period for each new ingredient should last up to ten days, less if signs develop sooner (dogs usually develop signs within 1–2 days). Should symptoms of an adverse reaction develop, discontinue the last added ingredient and wait for the symptoms to subside before moving forward to the next ingredient.

The test ingredients for the provocation trials should include a full range of meats (beef, chicken, fish, pork, and lamb), a full range of grains (corn, wheat, soybean, and rice), eggs, and dairy products. The results of these trials will guide your selection of commercial foods, based on those that do not contain the offending substance(s).


Avoid any food substances that caused the clinical signs to return during the provocation phase of the diagnosis. Antibiotics or antifungal medications may be prescribed by your veterinarian if secondary pyodermas or Malassezia infections are taking place.

Living and Management

Treats, chewable toys, vitamins, and other chewable medications (e.g., heartworm preventive) that may contain ingredients from your dog’s previous diet must be eliminated. Make sure to read all ingredient labels carefully. If your dog spends time outdoors you will need to create a confined area to prevent foraging and hunting, which can alter the test diet. All family members will need to be made aware of the test protocol and must help keep the test diet clean and free of any other food sources. Cooperation is essential to successful treatment of this disorder. 

Heart Block (Complete) in Dogs

Atrioventricular Block, Complete (Third Degree) in Dogs

The heart’s sinoartial node (SA) is very much like a control center, responsible for controlling the heart rate. This electrical conduction system generates electrical impulses (waves), which propagate through the atrioventricular (AV) node and into the ventricles, stimulating the heart’s muscles to contract and push blood through the interior arteries and out into the body.

Complete, or third-degree, atrioventricular block is a condition in which all impulses generated by the SA node are blocked at the AV node, leading to independent and non-coordinated beating of atria and ventricles.

Cocker spaniels, Pugs, and Doberman breeds are predisposed to heart defects leading to complete heart block. Third-degree atrioventricular block also occurs in older dogs more frequently.

Symptoms and Types

Weakness Coughing Difficulty breathing Inability to perform routine exercise Slow heart rate (bradycardia) Fainting


Congenital (present at birth) heart defects Idiopathic fibrosis (scarring of heart tissue due to unknown cause) Inflammation of heart (myocarditis) Inflammation of lining of heart (endocarditis) Infiltration of heart muscle by some abnormal substance or cancer (amyloidosis or neoplasia) Drug toxicity (i.e., digitalis) Electrolyte imbalances Heart attack (myocardial infarction) Lyme disease Chagas’ Disease


You will need to give a thorough history of your dog’s health, including the onset and nature of the symptoms, to your veterinarian. He or she will then perform a complete physical examination, as well as a biochemistry profile, urinalysis, and complete blood count (CBC). Dogs suffering from infections of the heart will demonstrate high white blood cell count on blood testing, while biochemistry profile may reveal electrolyte imbalances.


Your veterinarian will record the electrocardiograph, or ECG, which is extremely beneficial to make an initial diagnosis. Echocardiography and Doppler ultrasound are performed in animals with abnormal ECG finding, and those with symptoms associated with heart issues.


The ultimate goal of therapy is to clear the blockage of electrical impulses at the AV node. To achieve this, a special device called a pacemaker is used to resolve the electrical impulse conduction problems and normalize the heart’s beating. (Chest x-rays are taken to confirm the proper placement of pacemaker.) Both temporary and permanent pacemakers are available, and your veterinarian will recommend which will work best for your dog. The blockage can be rectified surgically too, but this is often riskier for the dog.

Living and Management

If your dog has had a pacemaker implanted, he will require extra care as well as cage rest. Typically, permanent pacemakers are placed in a pocket created surgically under the skin. To prevent the pacemaker from moving, a bandage is applied over the surgical wound for three to five days. Because pacemakers are battery operated, a malfunction can occur at any time; the pacemaker may also become infected, dislodged, or run out of battery. In such cases, the dog’s heart may again go into a complete atrioventricular block. Therefore, it is vital that you restrict the dog’s movements and monitor him for untoward symptoms.

Depending on the severity of the underlying disease, the dog’s diet may require modifying. In addition, you will need to visit your veterinarian at regular intervals for ECG and chest radiography, which are used to assess proper pacemaker function. Unfortunately, long term prognosis of dogs with complete atrioventricular block is very poor.