Plateau Veterinary Hospital

Summer Safety Essentials for Your Pet - Part 1

2024-04-29

As the warm rays of summer beckon us outdoors, it's a perfect time to enjoy the season with our beloved pets. However, amidst the fun and excitement, it's crucial to prioritize their safety. In this comprehensive guide, we'll explore the essential tips to keep your furry companions safe during BBQs, fireworks, and travel adventures.

Cheatgrass and Foxtails in Central Oregon

2022-07-18

Cheatgrass and Foxtail Seeds are a growing concern in the Central Oregon area. We have been seeing an increase in cases concerning the removal and treatment of these harmful Grass Awns or Seed Pods.

Being aware of them, recognizing problems early, and having them removed quickly; are all keys to avoiding more serious or life threatening injuries.

Grass Awns are seed pods of certain tall grasses that grow as invasive weeds. Foxtails and Cheatgrass being common examples of these. These plants can produce thousands of seeds, which dry out and scatter in the summer. The pods typically have tiny barbs, allowing them to easily cling to animals and objects in order to spread and propagate.

Those barbs allow the grass seed to move in only one direction. Unfortunately this means that if it embeds into skin, it can only migrate deeper into the tissue as a foreign body.

Due to your pets height, this often means these seed pods find their way into paws, nostrils, ears, and eyes. They have also been known to find their way through the body wall and directly into chest and abdominal cavities.

The body, in an attempt to protect itself, responds with inflammation and may try to close off the area, forming an abscess. This can lead to serious infections and other complications.

Signs of Foxtail or Cheat Grass Problems in Dogs:

(Included, but not limited to...)

• Fever

• Lethargy

• Loss of appetite

• Swollen and/or painful lump

• Puncture hole

• Discharge or bleeding

• Licking, chewing, or pawing at the affected area

• Limping (if legs/paws affected)

• Shaking head (if ears affected)

If your dog has been in an area with tall grasses, be sure to check their body for grass awns, wounds, and swollen areas. Look at the paws closely, checking the tops and bottoms of the feet and between the toes. Check the ears and mouth. Brush out your dog's coat thoroughly after any off-leash walks in areas that may have tall grasses and remove any foreign objects from your dog's coat.

Be sure to have your veterinarian check any wounds or abscesses immediately. Early detection and treatment will help provide the best results for your pets health.

Thanksgiving Pet Safety Tips from Zoetis PetCare.

2020-11-18

7 Strategies for Keeping an Aging Animal Comfortable in the Home by Kaytie Carter

2019-08-05

7 Strategies for Keeping an Aging Animal Comfortable in the Home

As we get older, even our cherished pets that we may have gotten when we were younger also age. While factors like vitamin intake and regular health and dental checks are important to prolong the quality of life for your pet, there are other things you can do to help your pet’s physical comfort level increase.

1. Determine if you need to change your pet’s food

Just like people, a pet’s nutrition should change with age. Your furry companion’s digestive system can slow down as they get older. Look more into the details of your pet’s food and what types of food are easier for them to digest. In addition, it may be a good idea to elevate your pet’s food bowls. As your pets get older, the smallest of muscle movements can stress or make them fatigued, so try to keep the bowls at a comfortable height, so your pets don’t have to bend down as much while eating.

2. Pet-proof your house to help pets that are losing their eyesight

One of the first things that will falter in an aging animal is their eyesight. While your animal may not be totally blind, their peripheral vision and sense of depth will start to decrease in quality. This will make it harder for them to navigate objects within a room and pathways around your house. Be sure to pet-proof your house to have your pet avoid accidental injury.

3. Make your pet’s sleeping space warmer

Older pets lose hair more frequently than when they were younger. As your pet ages, be mindful that your home may be getting colder to them, even though you may keep it at a constant, set temperature. Line your pet’s sleeping area with more padding and warm and fuzzy materials. This will help them stay warm, especially when they’re sleeping. It will also give them a warm location to evacuate to when they’re cold. Another tip: if you live in a cold area, you can look into purchasing coats and sweaters for your pet when they go outside.

4. Remember to groom your pet

You know the phrase, “Look good, feel good?” This psychological technique may work on your pet, too. Having them groomed and bathed more often in their olden age is a great way to boost a pet’s energy and overall demeanor. Many pet owners have even found comfort in grooming their aging pets.

5. Invest in anti-slip materials

Slippery floors are hard for pets to begin with, but they’re especially tricky as pets age. The grips on the bottoms of your dog’s paws will start to disintegrate down with tread. A tip for this would be to line certain popular spots for your pet with some sort of gripped material and a rug. This could be by a window, by their food, or by their bed. Along with this idea, it’s also important to remember how tricky stairs may be for your pet. If you see your pet struggling with balance or slipping, try moving their common locations in the home to the bottom floor.

6. Pay attention to aching joints

When you think comfort, you probably think warmth and relaxation. Pet’s joints can swell and ache with age. Warmth helps with this! Create a time to pamper your pet with a little pet massage or a cuddle session. Another idea could be to make a towel become the pet’s towel and throw it in the dryer. Then, wrap your pet into it while it’s still warm. Soothing your pet’s joints will definitely be helpful for their comfort.

7. Make bathroom visits more regular

Bathroom breaks can be harder for pets as they age, but it can also be a time when they get some activity. Take your pet out more than usual for bathroom breaks. This will prevent them from accidentally soiling your home and is a good way to get them to exercise in the most minimal way possible. Stretching and movement can also help with the digestive system and with the joint aches mentioned earlier. It’s important to keep your pet on as regular a schedule as possible, but don’t be afraid to make changes that may be for the best!

Ultimate Pet Owners Guide for CBD Usage in Dogs - By John Maddigan

2019-05-06

The Ultimate Pet Owners Guide for CBD Usage in Dogs – Well Almost

Just a few disclaimers to start:

• Our veterinary hospital doesn’t sell any CBD products.

• I’m not a veterinarian, just the husband of one, who likes to do research on topical questions in veterinary medicine.

• I have no particular axe to grind, just doing the research and giving pet owners the facts without trying to take a point of view.

• I’m a pet owner, a pet lover, and only want the best for my pets and all the pet owners out there.

• This paper is not intended to be “medical advice” but instead to give pet owners more information about CBDs and what they should know before they ask their veterinarian about the use of CBDs for their pet.

Definitions

With that said let’s start with a few definitions so we are all on the same page. Cannabis is a genus (a class of things which have common characteristics) of plants that include both marijuana and hemp, an unfortunate fact for hemp. Because hemp is included in the cannabis genus of plants, it had been classified with marijuana as a Schedule One substance until 2018 with the enactment of the new Farm Act and its subsequent declassification (see below section on legality). Although they are in the same genus of plants, hemp and marijuana have very different compositions of chemicals called “cannabinoids.” Today much of the medical CBD (cannabidiol) oil is sourced from hemp because it has a higher concentration of CBD than marijuana and is legal throughout the country (marijuana is legal in some states but still illegal federally). The big difference between hemp and marijuana is that hemp contains higher concentrations of CBD and relatively lower THC (tetrahydrocannabinol) concentrations (no higher than 0.3 percent THC) compared to marijuana. THC is the psychoactive ingredient which is found in much higher concentrations in marijuana. As a result, it is not possible to get “high” with hemp sourced CBD. So, there it is, cannabis is a class of plants that includes marijuana and hemp and hemp has relatively higher concentrations of CBD and only 0.3 percent of THC, the psychoactive chemical, and marijuana has lower concentrations of CBD and higher levels of THC and that is why marijuana is still a federally regulated Schedule One drug and hemp is not.

Is It Legal?

Yep. In 2014, President Obama signed the Agricultural Act of 2014 (the Farm Bill), which allowed for the study and cultivation of industrial hemp for limited purposes. This led to the Industrial Hemp Farming Act of 2015, which allowed American farmers to produce and cultivate industrial hemp more widely. This legislation removed hemp from the controlled substances list as long as the hemp grown contained no more than 0.3 percent THC. This was reaffirmed in the December 2018 passage of the Agriculture Improvement Act of 2018 by Congress. The bill removed industrial hemp from the Controlled Substances Act, where it had been since 1937.

So Why Does It Work?

As a result of the demand for research on the effects of THC on humans, scientists discovered that every mammal, including us and our dogs, are born with a fully functioning endocannabinoid system (ECS). This is critical as CBD affects the endocannabinoid receptors, which are located in both the central nervous system and the peripheral nervous system. The ECS is a key component to our health and well-being, as it regulates homeostasis (stable equilibrium between systems in the body, in a word balance) in almost every system of mammalian bodies. The ECS controls the rate of production and degradation of the chemicals that our brain and cells use as signals and messengers, known as neurotransmitters. Research revealed that CBD is deeply involved in those endocannabinoid neurotransmissions in that they up-regulate and down-regulate neural transmissions as needed to maintain homeostasis, helping keep the body in a normal and healthy state (examples in humans would be the down-regulation of anxiety, noise phobia, epilepsy, inflammation, and emesis (vomiting)). The really amazing thing about this is that CBD can BOTH up-regulate and down-regulate neural transmissions and always act to move the body toward a normal state and thus doesn’t shift things in the wrong direction. This is an important characteristic of CBD as most pharmaceuticals either only up-regulate or down-regulate (think of stimulants or suppressants, they only work in one direction, not necessarily into a homeostatic state). This movement toward homeostasis reduces the likelihood of unwanted side effects and results in CBDs, in theory, having a safe profile for use in our dogs. An interesting factoid is that acupuncture is another treatment known to have the same type of homeostatic action.

Our cats and dogs have the same endocannabinoid system as humans. In addition, humans and mammals have approximately 95 percent similar genetic material so we are susceptible to many of the same illness and diseases i.e. diabetes, obesity, arthritis, etc. Subsequently CBDs act in many of the same ways on us as it does our dogs.

As mentioned above, the endocannabinoid system was only discovered after research into THC led to the discovery of the endocannabinoid receptors and following this, anandamide, a natural cannabinoid receptor agonist, was discovered in 1992 (see below in “What Can CBD Do section). The endocannabinoid system is a complex lipid-signaling (THC and CBD have low solubility in water, but good solubility in most organic solvents, particularly lipids and alcohols) network that modulates central nervous system activity, and its effects can be summarized as “relax, eat, sleep, forget and protect.”

That is why CBD works on us and our pets (we’re all mammals with similar genetic composition) in relatively similar ways (https://cannabis.net/blog/medical/can-your-pet-benefit-from- cannabis). It is VERY important to note that dogs (not certain about research on cats) are much more sensitive to THC than humans are, as dogs have a higher number of brain receptors for cannabinoids than humans. A 2012 study reported a fourfold increase in the number of dogs treated for marijuana intoxication between 2005 and 2010 and I can say with confidence that

this trend continues with the legalization of both medical and recreational use of marijuana in many states, and the presence of it in more homes now than ever before.

So, given the fact that CBDs help the body return to a homeostatic state it would seem reasonable to extrapolate that CBDs could be helpful in many ways, but sadly the research to validate these claims are totally absent. While scientists know “how” cannabinoids like CBD effect our endocannabinoid system there is almost no research on animals to validate the numerous claims that are being made every day on the internet.

Is CBD Safe?

The limited research indicates it does no harm but it is best to use hemp derived CBD as it is lower in THC than marijuana derived CBD. The most recent study by Dr. Stephanie McGrath at the Colorado State Veterinary College, found CBD to be harmless, or in other words SAFE. But much more work has to be done to confirm those smaller studies (Dr. McGrath’s study had only 16 dogs over a very short period of time in 2016). Currently there are no long-term studies on the effects of CBD on cats or dogs and to my knowledge and a review of the literature none are in process at the writing of this paper (April 2019). These longitudinal studies need to be done to make everyone feel comfortable about prescribing CBD and another other cannabinoids. The only study – done by Dr. Wakshlag – that does look at pharmacokinetics (the branch of pharmacology concerned with the movement of drugs within the body) will be discussed later in this paper.

Studies, Research or Hype?

A quick search on the internet will answer that question – hype. And article after article echo the sentiment in their headlines: Washington Post April 21, 2019: “CBD for pet’s ailments? Many people swear by it, but there’s very little animal research;” “Is the hype about CBD, cannabidiol real?” Still other stories have disclaimers up front stating, “this article is for informational purposes only and does not constitute medical or legal advice...”. This is done because the research is scarce but the hype is everywhere. A USA Today article starts with the question, “It’s hard to find something CBD can’t treat.”

Currently the marketers for the CBD manufacturer’s claim that CBD is a natural remedy for just about everything – I wonder if it could help with baldness?? But sadly, their therapeutic claims are not backed up with solid scientific research. This is an industry based not on scientific research but mostly built on anecdotal data and testimonials – Montel Williams is a perfect example and there are lots of other celebrities pushing various other products (Gwyneth Paltrow and Willie Nelson).

Despite ALL the claims there is just NO research to back up those claims. Currently there are only two animal studies on the effects of CBDs on dogs. At Colorado State veterinary neurologist Dr. Stephanie McGrath has completed one pilot study on epileptic dogs in 2016.

Her research found that nearly 90 percent of the epileptic dogs experienced fewer seizures when given chicken-flavored CBD, as compared 20 percent on placebo. While the results are encouraging the study only included 16 dogs and even Dr. McGrath acknowledged the limitations of the study. “Although really exciting results, it still has to be taken with a little bit of a grain of salt, because the power of the study is diminished when you don’t have a lot of dogs involved. Dr. McGrath is now conducting two clinical trials with 27 dogs, studying how effectively CBD can treat osteoarthritis and epilepsy. The only concern I have with this study is whether or not 27 dogs is a large enough sample to be scientifically significant.

The second study was conducted by associate professor and veterinarian Dr. Joseph Wakshlag (see study here https://www.frontiersin.org/articles/10.3389/fvets.2018.00165/full) at Cornell University. The participating dogs were suffering from multi-joint pain and osteoarthritis. The eight-month double blind, placebo-controlled study was done in collaboration with ElleVet Sciences and the pets were given ElleVet Mobility Chews (while the study lasted 8 months the drug trial lasted only 4 weeks for the dogs with a 2 week wash-out period between dosages). The primary goal of the Cornell-ElleVet study was to understand how dogs metabolized ElleVet soft chews, which are hemp-based supplements also containing glucosamine and chondroitine, two natural compounds that are already widely used in dogs and humans for arthritis. Although the sponsoring company is touting the results of the study it must be said that this study also only contained 16 dogs and the according to Dr. Wakshlag’s research article the dogs were also allowed to continue taking pain medications and other medications known to help with joint pain: “During the trial, dogs were only allowed to receive NSAIDs, fish oil, and/or glucosamine/chondroitin sulfate without any change in these medications for 4 weeks prior to or during the 10-week study period as standard of care for the disease process.”

While the results from the study were encouraging, with over 80 percent of the dogs showing significant improvement, the study size was small, just 16 dogs. Quoting from ElleVet’s press release here are the reported results of the clinical trial: “The Cornell study found that dogs who took ElleVet's proprietary hemp oil blend showed significant improvement over dogs that received the placebo. The study determined that ElleVet's hemp oil blend is "efficacious for pain in dogs with osteoarthritis, chronic joint pain and geriatric pain and soreness; with dramatic beneficial effects in our more geriatric patients." Over 80% of dogs who have used ElleVet Mobility soft chews have seen a significant or dramatic improvement. Veterinarians have called ElleVet soft chews, "A game changer that will change the face of veterinary medicine." Here's a link to their site and the study: https://ellevetsciences.com/pages/for-vets

Those are the only two studies of the effects of CBD on dogs – one study by Dr. Stephanie McGrath on epileptic dogs too small to be significant and the other by Dr. Joseph Wakshlag, with the same number of subjects as Dr. McGrath, that is being touted by the sponsor of the study to be “efficacious...a game changer.” You decide, but keep in mind that most nutraceutical products do NOT go through even this rigorous a study so kudos to ElleVet for doing it.

US based human trials are also very limited. Dr. Arnold Abrams, an oncologist and professor of clinical medicine at the University of California at San Francisco and a member of a National Academies of Sciences, Engineering and Medicine committee that issued the most comprehensive report to date on the evidence related to the health benefits of cannabis and cannabinoids says, “we really don’t know anything” about CBDs. Here is a link to the study: http://nationalacademies.org/hmd/Reports/2017/health-effects-of-cannabis-and- cannabinoids.aspx

Dr. Abrams reported that there have only been five randomized clinical trials that have looked at CBD, until the Epidiolex studies (used to treat two rare kinds of epilepsy). The amazing fact is that the largest of those studies was a 24-person trial – THAT’S SMALL!

What Can CBD Do?

Good question. Clearly ElleVet believes that their hemp oil blend products help with osteoarthritis but what about the claims about anxiety, epilepsy and seizure disorders, and decreased appetite. Other than the two studies cited above on epilepsy and osteoarthritis there is no scientific data to support any of the claims made every day by multiple manufacturers, regarding other treatment claims, but there IS LOTS of anecdotal evidence that seem to corroborate almost any claim. Here’s an example: today my veterinarian wife had a client tell her that she gave her dog CBD to help stop it from eating its own feces and it worked. She then recommended it to a friend with the same problem and it worked for her dog as well – go figure.

But a colleague also saw an older pet whose parent rubbed CBD on it to make it feel better – arthritic – the pet got very “high” vomited, aspirated (inhaled) some of the vomit and got aspiration pneumonia and ended up with a $1,000.00 vet bill. So you never know.

I personally wouldn’t trust any claim made on the internet as marketers of these products will make any claim BUT everyday feedback is almost overwhelmingly positive, so ask a friend if their pet is using a CBD product.

But if there is no scientific data to support the claims of benefits, how then do some of these marketing claims begin? The answer is mostly from human studies. Remember at the beginning of this article we discussed that the endocannabinoid system (ECS) is common to ALL mammals – us and our dogs. We humans have been using various forms of CBD (both hemp but mostly marijuana based) for many years and three synthetic cannabinoids - sold under the drug names Marinol, Syndros (both use the active ingredient dronabinol), and Cesamet (using the active ingredient nabilone) - for a variety of conditions including the treatment of anorexia in AIDS patients, and nausea and vomiting associated with cancer chemotherapy. So currently we are using very expensive man-made drugs that occur naturally in cannabis plants to treat patients where conventional drugs regimes have failed. For more information on these synthetic drugs you can visit this web page:

https://www.medicaljane.com/2017/05/01/the-3-cannabis-based-medicines-approved-by-the- fda/

So that’s where CBD manufacturers are making the leap from humans to our pets – we have a common endocannabinoid system that works similarly in all mammals. So, if it works in us why wouldn’t it work for our pets? Not an unreasonable assumption, however, veterinarians still don’t have any research to support that assumption. But there is a lot of science that can help us. Scientists know that the CB1 receptor in our brain and the CB2 receptors in the body that are stimulated by the synthetic cannabinoids listed above work basically the same in humans and dogs, the basic difference is that the message (the natural messenger cannabinoid in our dogs is called anandamide) sends a louder, stronger and longer message in dogs. That is why our dogs are much more impacted than humans by the THC in marijuana when they ingest or are given some. Drugs that can hang on longer to the natural messenger receptors are called an agonist – ergo why anandamide is called a cannabinoid receptor agonist. The chief agonist cannabinoids in marijuana are THC and CBD which is why of the hundreds of chemicals in hemp CBD is the one generating the most interest – it’s an agonist.

So what conditions are the pharmaceutical industry looking to treat with cannabinoids? As mentions above anorexia in AIDS patients (we all had heard of the funny stories about getting the “munchies” after smoking some marijuana, and it’s true). Synthetic cannabinoids have also been approved for use in treating nausea and vomiting in patients receiving chemotherapy. This is not a huge issue in dogs as they deal very well with chemotherapy but it could be used in parvo cases where fluid loss is critical. Cannabinoids are effective in the control of both acute and chronic pain. THC has also been shown to be effective in treating inappetence (a lack of appetite). So these are the areas where CBD manufacturers of pet products are making their most claims – pain control, osteoarthritis, epilepsy and seizure disorders and appetite stimulation.

And more progress is being made. On April 2, 2019 the FDA approved the use of one cannabidiol drug, Epidiolex, to treat seizures in young children from Lennox-Gastaut syndrome and Dravet syndrome two rare kinds of epilepsy. This is hopefully the first of a long list drugs developed from the cannabis plant.

So Why is Progress So Slow and Why Isn’t My Veterinarian Telling Me About CBDs?

This is still a very new industry with lots of issues to work out. Questions like: Where does your hemp come from? China, Eastern Europe or domestically as Chinese sources have high concentrations of heavy metals and pesticides. How is your product manufactured? CBDs are not water soluble so making certain it is bioavailable in the finished product is important. Smaller manufacturers may have poor or no quality control procedures in place, may be unable to test raw product (hemp) for concentration of CBD and THC. The result may be a product with a high degree of variability in the finished product from baTHC to baTHC.

But the biggest hurdle to date arises because marijuana is still a Schedule One drug, like heroine, according to the federal government. That makes it very difficult or almost impossible for researchers to get approval and access to marijuana to conduct research. The Schedule One designation also makes it more difficult to get funding (none from the feds) to conduct research. And even though marijuana is legal in many states it is still illegal for your veterinarian to carry or recommend cannabinoid products as the laws legalizing use in people do not apply to cannabis use in animals.

Yes, I mentioned that most of the CBDs come from hemp, but Congress only approved the use of hemp-based CBDs in December 2018 in the Agriculture Improvement Act, so there hasn’t been much time to conduct research, get it peer reviewed and develop drugs. Things are moving more quickly now, but access to marijuana and hemp have been the biggest hurdles in the past.

While marijuana research will still be slow and very limited because of its Schedule One classification, hemp derived CBD research will start to accelerate. The problem now is the lack of regulation of hemp based CBD products. Although CBD products fall under the jurisdiction of the FDA, the FDA really doesn’t regulate the industry, and that causes a myriad of problems for researchers and veterinarians. The FDA regulates CBD products much like it regulates nutritional supplements (i.e. vitamin C or B). Under the federal Food, Drug and Cosmetic Act, products for which therapeutic claims (i.e. helps reduce pain caused by osteoarthritis) must be approved by the FDA in order to be legally manufactured and marketed. The FDA approval process is the means by which the safety and efficacy of such products is demonstrated. Companies like ElleVet have done clinical trials BUT they have not received FDA approval for their products, but let’s give credit for serious clinical trials.

It is this lack of FDA approval that causes all sorts of other problems. Because non-FDA approved products cannot make therapeutic claims, the FDA won’t allow CBD producers to make marketing claims (that’s not working well) – which includes recommended doses. Although today some CBD products do have dosing instructions on the label, little is known about what doses are most effective or safe because it is unlikely that any serious clinical trials were conducted and certainly the product has not been FDA approved.

The dosing problem is further exacerbated by the fact that most products are mislabeled. In a 2017 study, Marcel Bonn-Miller, an adjunct assistant professor in the psychiatry department at the university of Pennsylvania’s Perelman School of Medicine, found that nearly 70 percent of the CBD products they analyzed were mislabeled. Some items were “over-labeled,” others “under-labeled,” and still others contained THC in amounts that could make you intoxicated or impaired. A big problem. But keep in mind this study was done on marijuana-based CBD which is now not how CBD pet products are manufactured. The issue is the inaccuracy of the labeling, not the presence of THC. This study was validated when the FDA also did some testing on CBD products and found that label claims rarely maTHCed the actual content. In fact, some products they tested had NO CBD in them at all. This is what the FDA has posted on its site, however, I could not locate the results of the FDA testing. https://www.fda.gov/NewsEvents/PublicHealthFocus/ucm484109.htm

But I did find a site that did report on the FDA testing and here is the link: https://www.newhope.com/botanicals/fda-finds-only-2-24-CBD-products-have-what-they-say- they-have-them The headline says it all: “FDA finds only 2 of 24 CBD products have what they say have in them” although some of the misses were very close.

To overcome this labeling problem manufacturers can go to a third-party laboratory and obtain a “Certificate of Analysis” which checks for contaminants such as heavy metals. This is important because both China and Eastern Europe are providing raw product (hemp) to manufacturers and much of those products contain heavy metals and other contaminants. The sourcing problem should soon be eliminated as hemp production is increasing rapidly in the USA, especially in Oregon(500 acres in 2016 and 7,808 acres in 2018 and still growing). If the company you are buying your pet products from don’t have a Certificate of Analysis on their web site find a company that does.

Although I’m placing all of the responsibility on the manufacturers they too have issues with raw product – hemp. In particular manufacturers are having difficult creating “clinically reproducible standards” because there’s so much variation with the quality and strength of ingredients (hemp). Here in Central Oregon numerous farmers have now just swiTHCed to hemp production but they are just learning how to best grow and harvest this new crop. They do not have a track record of production yet which may lead to variability in quality and consistency but it is likely this issue will be resolved soon with good old American “know-how.”

Currently dosing really is a problem as even the researchers don’t know how much CBD to give a dog in order to reach a therapeutic dose that achieves the desired effect that is also safe. For example, Dr. McGrath’s is now nearly doubling the dose in her second trial. In her first trial she used a dose of 2.5mg per kilogram administered twice daily. So, if you are using a CBD product start low and increase gradually.

So why doesn’t your veterinarian recommend CBD for your dog? Well first they are not allowed to, and second let me restate the numerous reasons why they are not prepared to do so:

• Not one scientifically reviewed research paper on the use of CBD in dogs or cats.

• No idea of the therapeutic dosage required for any illness.

• No certainty in the quality and efficacy of the products on the market.

• No idea what conditions/illnesses that can be treated with CBD.

• Uncertainty regarding both labeling (is it reliable) and dosage (is it accurate) to obtain a therapeutic dose that is both effective and safe.

• While some studies state that CBDs are harmless to pets (Dr. McGrath study showed CBD cause no harm) there are no scientific papers or research clearly stating that CBDs have no long-term serious side effects (note Dr. Wahshlag’s call for such research in his paper) and if so at what dosage/duration of treatment.

Side Effects – Pharmacokinetics 101

As mentioned above it is believed that hemp derived CBD is safe in pets – according to a study by Dr. Stephanie McGrath at Colorado State University of Veterinary Medicine. Besides Dr. McGrath’s study there is only one study that actually looks at the pharmacokinetic impact of CBD on dogs. This is the study performed by Dr. Joseph Wakshlag at Cornell University. This study showed that CBD is very bioavailable (the ability of a drug to have an active effect), eliminated from the body in approximately 3.8-6.8 hours (for a half-life of 4.2 hours) with no observable side effects. The short half-life is a positive as this means that the drug leaves the body quickly as it is quickly metabolized by the liver. The study showed that there was a slight increase in the alkaline phosphatase (ALP) levels but the increases were still within normal levels. However, the study does recommend that “it may be prudent to monitor liver enzyme values (especially ALP) while dogs are receiving industrial hemp products until controlled long- term safety studies are published.” The study also gives us some clues as to the best products to use: “When examining prior oral CBD bioavailability, it was determined to be low and highly variable (0-19% of dose) with three dogs showing no absorption. This may be due to first pass effect in the liver, and the product as not in an oil base, but a powder within a gelatin capsule being a different delivery vehicle.” As noted earlier in this paper oil is the best delivery system as it provides the most bioavailability, which is what you need for a drug to be effective. As Dr. Wakshlag concludes in his paper, this was a short-term (4 weeks only) study with no observable side effects (at the 2 and 8mg/kg dosing), but “further long-term studies with larger populations are needed to identify long-term effects of CBD rich industrial hemp treatment, however short- term effects appear to be positive.” Here is a link to Dr. Wakshlag’s study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6065210/#__ffn_sectitle

In a nutshell hemp derived CBD appears to be safe in the short-term but long-term studies need to be done to determine the long-term effects of CBD usage. So, if you are using CBD have your dog’s liver enzymes checked two weeks after starting (we do this with all dogs when they are first put on NASAIDS).

What’s Next?

For our pets there are lots of new products and new claims, but very little, if any, scientific proof. Sadly the status quo of buyer’s beware will continue. Our hope lies in the research being done on the human side on a number of fronts.

In a story in the Washington Post by Steven Petrow he states that, “Ziva Cooper, an associate professor of clinical neurobiology at Columbia University’s Irving Medical Center, who is doing research with CBD, says “based on animal studies, there seems to be a lot of promise for a number of disease states,” including its potential effects on inflammation...autoimmune disorders and addiction.” Cannabinoids’ effects are also being studied on the following conditions in people:

• Cancer – malignant tissues tend to express higher number of cannabinoid receptors than nonmalignant tumors and binding to those receptors can trigger cancer cell death.

• Nausea and vomiting – as mentioned previously synthetic cannabinoids are already approved to treat these issues in patients receiving chemotherapy.

• Pain – cannabinoids are effective in the control of both acute and chronic pain – ergo the Cornell study by Dr. Wakshlag to confirm these results in dogs.

• Inflammatory bowel disease, diabetes mellitus, glaucoma and infection with methicillin- resistant staphylococcus aureus.

So, there’s lots going on and the results of those studies will undoubtedly result in products being marketed as solving the same problems in our pets, likely without animal studies to affirm the results achieved in human studies.

Summary and Tips

• Because the accuracy of labeling is an issue, make sure your manufacturer has a “Certificate of Analysis” performed by a third-party laboratory.

• Oils are safer than edibles (and likely more bioavailable) because you have more control over dosage (edibles have the oil dissolved in butter so it may not be spread evenly in the product). Add the appropriate number of drops to your pet’s food to ensure that it is eaten immediately.

• Be patient, not all effects will be seen immediately, such as relief from chronic pain. Start with a low dose and increase gradually. If you still aren’t seeing results you may need to change products (the CBD levels listed may not be accurate). Have your veterinarian check your dog’s liver enzymes two weeks after starting treatment.

• Use hemp-based CBD as it has much lower levels of THC, which can impact your dog significantly.

• Oils are more bioavailable than powders so stay away from powder products.

• Oils and treats should be kept at room temperature sway from bright light or sunlight as cannabinoids are susceptible to degradation. If the oil has changed color, discard.

I hope this helps all pet owners looking to use CBD for their pet’s ailments. If you are using CBDs please tell me your story so we can use it to help other pet owners with the same condition.

News Story: Lilies and Cats can be a Deadly Combination

2019-04-11

ASPCA Poisonous Plants List

Vet says certain lilies cause kidney failures in our feline friends

By:

Jessica Fuller

TRI-CITIES, TENN. (WJHL) - As April showers make way to May flowers, veterinarians caution that not all plants are safe for our furry friends.

Dr. Rachel Fogg, a veterinarian at Robinson Animal Hospital, said it's best to keep true lilies and daylilies out of a home with cats as they are known to cause kidney failure for feline companions.

"Any portion of that flower is toxic to cats - the flower part, the stem, the leaves, even the pollen can cause kidney failure," Fogg said. "If cats ingest any part of it, even one leaf, even licking pollen off of their fur or drinking some water that had the pollen in it, can cause acute or sudden renal failure in cats."

According to the U.S. Food & Drug Administration, the toxin that causes kidney failure in cats has yet to be identified, but Fogg said the discovery of the correlation is rather recent.

Signs of kidney failure in cats include increased urination, increased thirst, hiding, decreased appetite, vomiting and lethargy within the first 24 hours of ingesting the lily.

Fogg said cats who have been poisoned by lilies may begin acting normally after the first 24 hours, but that's when the kidney failure has begun to set in. The FDA says fatal kidney failure can set in three days after the plant is ingested.

"If you have any thought that your cat ate any part of a lily, you should really bring it to your vet ideally within 12 hours, if not 18," Fogg said. "The sooner you bring your cat into the clinic, the sooner we can start giving it medications to try to and rescue that kidney function."

Story continues after chart.

Dangerous lilies for cats
Common name*	Description**
Asiatic lily (including hybrids)	Blooms in early-mid summer, range of colors, 4-6 inch wide blossoms
Daylily	Most bloom in "clumps," blooms last for 24 hours, various colors and patterns
Easter lily	White, fragrant, large trumpet-shaped blossoms, blooms early to mid-summer
Japanese Show lily	Fragrant, nodding blooms up to 6 in. wide, raspberry petals spotted with crimson, blooms in late summer.
Oriental lily	Blooms late summer into early fall, rich colors, large blooms, intense fragrance.
Rubrum lily	A variant of the Japanese Snow lily
Stargazer lily	A variant of the Japanese Snow lily
Tiger lily	Orange blooms spotted with crimson, blooms in mid to late-summer, a single bulb can produce up to 40 blossoms.
Wood lily	Slightly lemon-scented, canary-yellow blooms with narrow, upright petals about 2-3 in. long, blooms late spring.

*Source: www.fda.gov/animalveterinary/resourcesforyou/animalhealthliteracy/ucm206751.htm
**Source: www.gardenia.net, daylilies.org

While lilies aren't the only poisonous houseplant for cats, it is one of the most serious, Fogg said. Lilies may cause an upset stomach or vomiting in dogs, but Fogg said it doesn't cause organ failure like it does in cats.

She said she's already treated a few cats poisoned by lilies this year, and expects several more over the year. The American Society for the Prevention of Cruelty to Animals has a list of plants that are toxic to dogs and cats.

"My general recommendation for people with cats is don't bring lilies or daylilies into your house period," Fogg said. "Cats are pretty curious creatures by nature and if you bring a house plant into their (home), most of them are going to try to take a nibble of something."

Canine Obesity with John Maddigan

2019-04-09

Canine Obesity How it Happens, When Will I Know, Why Is It Such a Problem, and Simple Solutions

While all of my blog posts are designed to be healthful and impartial and to save pet owners money, some may be seen as controversial – see my blog on dog foods, the timing of spay/neuter and the multiple options for ACL repair – this is NOT one of them. Universally pet owners and veterinarians agree that obesity in canines (and felines) is a major health problem that is getting worse, but is entirely preventable. You are not alone. According to research from the Association for Pet Obesity Prevention (APOP), 58% of cats and 53% of dogs in the U.S. were overweight in 2014. Obesity in pets is a growing problem and the repercussions are serious.

Trust me if there is one thing that pet owners can do to save BIG money at their veterinarians - This Is It!!!

How It Happens

Like us, weight gain usually happens slowly and very gradually. Simply put, obesity is the accumulation of excess body fat and because it is so gradual it can be difficult for us owners to notice that our pet has become overweight. In addition, our idea of a “normal” weight has changed for both us and our pets. The attached guide below from Nestle Purina provides a great visual example of the “Body Condition System” for dogs. While most owners believe their dog is too thin, the reality is quite the opposite. The Purina “Body Condition System” chart shows that the “Ideal” weight means that your dog’s ribs are (easily) palpable without excess fat covering – which means when you run your hands over your dog’s ribs you should be able to feel them easily. Most of us dog owners would think that if that was the case our dog would be too thin, BUT we would be incorrect. In fact, dogs are considered to be overweight when they are 10-20% above their ideal weight and obese if they are 20% or more above their ideal body weight.

This happens because many of us dog owners equate food with love. For me it’s not extra food in the dog bowl but extra treats during the day. Fortunately, my wife (the veterinarian in the family) exercises all of the dogs so obesity isn’t a problem, but easily could be as I AM overfeeding.

Weight gain can be attributable to three factors:

Metabolism
Lack of Exercise
Overfeeding.

As pet owners there is nothing we can do about Metabolism, but we are solely responsible for Exercise and Feeding.

Some breeds are more susceptible to weight gain than others – here is a link to the Banfield Pet Hospital report on Pet Obesity, it has some cool interactive features especially on snacks and calories https://www.banfield.com/state-of-pet-health/obesity – and all pet owners should know that having their pet sterilized also contributes to the slowing of that pet’s metabolism. Simply put, sterilized pets require less food to maintain a healthy weight. Pet owners should also be aware that in many cases the recommended daily feeding guide on most pet food bags or cans are for unaltered pets, so if your pet (cat or dog) is spayed or neutered, feed 25% less than recommended by the manufacturer as a starting point. Our veterinarians recommend feeding by body condition – can you feel the ribs easily, does your dog have a “waist,” is his belly “tucked-up” underneath as it joins the hind end? If any of these are a “no”, feed less. (see Purina study below). Note that this is NOT always the case and here is the link to an article that details how tricky it can be to ensure that your pet stays at ideal weight while getting all of the nutrients recommended on a daily basis (https://truthaboutpetfood.com/pet-food-feeding-recommendations-concerns/). I am NOT endorsing the editorial content of this site only THIS article. Every site on the internet has an agenda so be aware of that.

If you bring your pet to your veterinarian regularly for a weight-in ask about obesity and the problems it can cause. But if that is not possible, always remember that nothing is more important than exercise (a daily walk is good for both us and our dog) and the appropriate feeding of a balanced diet.

When Will I Know my Dog is Overweight?

Likely when it’s too late – when your dog is already obese, or at least overweight. If you don’t weigh your dog regularly (and you don’t notice that layer of fat over the ribs) you likely have been normalized to the weight gain. Sadly, as the weights of both pets and humans have increased our perception of “normal” has also evolved. A CDC study released in 2015 showed that between 1960 and 2010 the average American woman went from 140 lbs to 166.2lbs and in the same time period the average American man put on an average of 29.2 pounds, going from 166.3 pounds in 1960 to 195.2 pounds in 2010. So, it’s not just a “normalizing” of weight gain with our pets, it is also a normalizing of our own weight gain (see chart at the end of this article).

So, unless we weigh our dogs regularly or have our veterinarian tell us our dog is overweight how will we know? Here are a few obvious signs to indicate that your dog may be obese or at least overweight:

• Exercise intolerance, decreased stamina (just can’t chase the ball like they could)

• Respiratory compromise (breathing difficulty)

• Heat intolerance (this can be a serious and sometimes fatal problem)

So Why is Obesity a Problem?

As with humans, dogs carrying extra weight place extra demands on virtually all of their organs, and when these organs are overloaded disease and even death are the consequences. I will briefly discuss the most common consequences of obesity in dogs but this is, by no means, the definitive list of consequences. These are the complications we see most often at our practice.

Damage to joints, bones, and ligaments

As one might expect extra weight puts extra stress on a dog’s joints. This can cause the cartilage in the joints to deteriorate, which leads to osteoarthritis(OA). It is believed that approximately 25% of overweight dogs develop serious joint complications. The risk of OA goes up with age as well as with increasing bone structure size, so the older and bigger the dog, the more likely it is to suffer from the inflammation and pain of OA. Unfortunately, dogs that are overweight or obese traumatize their joints over a very long period before we can see clinical evidence of the damage. It takes years of joint damage for changes from OA to show up on an X-ray. The end result is a visit to the veterinarian (me) and the transfer of money from you to me!! You will now likely need to buy pain medications from me for your dog (more transfer of money from you to me) but the best thing to do is have your dog lose weight.

Anterior Cruciate Ligament Rupture

While there can be many causes of ACL rupture, too much weight is a well-known risk factor for tearing the ACL (anterior cruciate ligament). If this happens you will be visiting me again and you know the story – the transfer of more money from you to me!!

Diabetes Mellitus (sugar diabetes)

As you know obesity in people is a leading cause of Type II diabetes and obesity is a well-known risk factor for diabetes mellitus in dogs. Obesity causes an increase in the secretion of insulin in response to the increase blood glucose level in the overweight dog. Insulin is also more in demand simply because there is a greater amount of tissue in an overweight dog. When requirements for insulin exceed the ability of the body to produce insulin, diabetes mellitus develops. If this happens you will be visiting me again, this time for insulin for your dog and you know the story, more money to me!! The real problem here is that controlling diabetes can sometimes be trick in dogs and very difficult in cats. This can be exacerbated by the shortage of insulin and the unstable pricing that results.

As mentioned previously extra weight can put extra demands on all organs and these extra demands can result in numerous, albeit less commons problems such as: heart disease, high blood pressure (hypertension), liver disease or dysfunction and increased risks of developing malignant tumors (cancer). Other, less common problems are collapsing trachea and laryngeal paralysis, which if left untreated could lead to respiratory crisis that could be fatal. Not surprisingly these factors can lead to increased surgical and anesthesia risk. This risk should not be overlooked as obese dogs, as mentioned previously, are at higher risk for ruptured cruciate ligament which require surgical intervention to repair.

The other major side effect of obesity is a shorter lifespan. A seminal study conducted by Nestle Purina in 2002 showed that feeding dogs a restricted diet extended their life span by 15%.

Attached is a brief summary of the study put out by Purina:

Purina® conducted the first-ever canine lifetime diet restriction study and showed that dogs maintained in lean body condition throughout their lives can extend their medial life span by 15 percent – 1.8 years – for the Labrador Retrievers in the study. Our veterinary nutritionist will explain what this means when it comes to feeding your own dog. “We all know that obesity, whether in humans or canines, is generally bad for health," says Dennis Lawler, PURINA scientist and lead study investigator. "What's exciting about this study is that, for the first time in a large mammal, we have shown scientifically that by simply feeding to maintain ideal body condition throughout a dog's life, we can increase the length of life while delaying the visible signs of aging. That's powerful stuff."

The 14-year study, which was started when the dogs were 8-weeks old, compared 48 Labrador Retrievers. Dogs were assigned to a control or lean-fed group. All the dogs ate the same 100 percent nutritionally complete and balanced diets for the entire study. The control group was allowed to eat an unlimited amount of food during the 15-minute daily feedings. Dogs in the lean-fed group were fed 25 percent less than the amount eaten by their littermates. Median life span was increased by 1.8 years, or 15 percent, in the lean-fed dogs compared to the control dogs. Median life span – the age at which 50 percent of the dogs in the group had died – was 11.2 years in the control group, compared to 13.0 years in the lean-fed group. The study showed that the lean-fed dogs maintained a significantly leaner body condition from six to 12 years of age than the control group dogs. On average, the lean-fed group weighed less, had lower body fat, and after a certain age, experienced a two-year delay in the loss of lean body mass as they aged, as compared to the control group dogs. “In addition, according to observations of the researchers, the control dogs exhibited more visible signs of aging, such as greying muzzles, impaired gaits and reduced activity, at an earlier age than the lean-fed dogs."

So, reduce your dog’s caloric intake by 25% and increase lifespan by 15%! Remarkable really, and thanks to Purina’s 14-year study we have scientific proof that a restricted diet does result in a longer lifespan. In addition to an increased lifespan your dog will suffer fewer of the ailments listed above, resulting in a much better quality of life for both you and your dog.

Simple Solutions?

Always remember that an ounce of prevention is worth a pound of cure. My best advice is don’t let your pet become obese as it easier to prevent obesity than it is to reverse it. There are many diets to help reduce weight but a slightly reduced amount of food each day, no treats or human food and a regular routine of walking and exercise will get the job done in time. Some experts recommend a slightly less palatable food to help with weight loss. While some pet owners may believe this is cruel, it is not. If I only ate what I loved - burgers, fries and milkshakes - I’d have a serious weight problem as well. But my wife makes me eat brussel sprouts regularly, not my favorite by a long shot, but important for a balanced diet. Once an ideal weight has been reestablished you can return to a more palatable food.

I hope you find this article helpful. If you have any suggestions or questions please write me at info@plateauveterinary.net

- John Maddigan

Guest Blog - Cindy Aldridge: "Relocating Fido: Tips for Making Moving Easier for your Dog"

2019-04-09

Guest Cindy Aldridge offers Tips on helping your dog(s) adjust to new environments.

THE ULTIMATE PET OWNERS GUIDE TO RUPTURED CRUCIATE SURGERY IN DOGS

2018-04-02

The Goal

My goal is to give dog owners the most comprehensive, scientifically based information to help them first determine if their beloved dog has cruciate damage, and then to help them decide how to treat the rupture. I am NOT selling any product or supplement so if you see anything for sale, first, it’s not me and second, DON'T BUY IT. This guide will have numerous links to articles and videos that I think are helpful and detail how and why cruciate rupture happens, and what a ruptured cruciate looks like (no blood or gore, promise). Many articles and videos will also explain the various procedures available, however, the field of veterinary medicine is progressing every day and there is a relatively new procedure (at least to America), developed in Europe, that is being used in America but there are not as many articles or videos on this procedure (MMP), although it has been used in Europe successfully for several years. I will provide a brief description of each article and video so you can decide for yourself if you want to read or view it. I will also provide a few scientific abstracts that compare the various procedures so you can let the experts(not your second aunt in Peoria with the blind chihuahua) help you decide which procedure is best for your pet. And if you STILL can’t decide email, me and I’ll have my wife (da boss and the veterinarian in this family look at the x-ray for you).

In addition, I will briefly explain how your dog can first avoid a ruptured cruciate and then explain the riskfactors, symptoms and diagnosis, and describe the most common procedures currently being used inveterinary hospitals across the country today. I will also briefly talk about non-surgical treatment of your dogs ruptured cruciate but because there are so many “options” to not treating I will not get into any ofthem in detail other than to state that there is NO scientific data to support ANY of the countless nonsurgicaloptions available if your dog has a complete cruciate rupture. If I haven’t found a study that exists, please send it my way and I’ll give it a look and ask an expert for their opinion. But please don’t contact me with 'stories' from your great aunt or non-scientific articles written by the 16-year old clerk at your local Petco. Let’s please stick with facts and let science and the experts rule the day. Here’s why - let’s say you ruptured your ACL, would you rely on the cashier at Walgreen’s (no disrespect to the cashier or Walgreens) to diagnose and recommend a treatment for your ruptured cruciate? If so you probably won’t find anything helpful in the guide, so just save your time, stop reading now and no hate mail please, just move on – thanks!

I Didn't Know

Most pet owners probably don’t realize that their dog can rupture their cruciate, but it is the most common orthopedic injury in dogs in America. Why it happens in dogs is still up for debate, but there are contributing factors such as obesity. The other reality is that large and giant bred dogs – labs, rottweilers, goldens, and pitbulls – suffer higher rates of cranial cruciate ligament (CrCL) rupture than small breed dogs. Cruciate rupture can happen in two ways: chronic injury and acute injury. Like humans, acute injury can occur during vigorous activity (weekend warriors playing football) or the dog that only gets occasional strenuous activity like chasing a frisbee in the park. But unlike humans, dogs can also have chronic cruciate damage just from day-to-day wear and tear on their knee joints simply because of the angle of your dog’s knee (I’ve included numerous videos that show this so don’t think that your dog has a defective knee joint, they are all built that way).

Below is a link to my website the has an article written by Lifelearn that nicely describes cruciate ligament rupture in dogs. To access the article follow these simple instructions: Under species select dogs and the under topic select surgical conditions select page three and click on “Cruciate Ligament Rupture in Dogs” and viola http://www.wvah.net/educational-articles/

If the link doesn’t work just go to http://www.wvah.net/ click on more and then educational articles and follow the same directions to find the article. This applies for the other two links listed below as well – thanks.

What can I do to avoid a cruciate rupture in my dog?

The best thing you can do is keep your dog slim and fit. I have mini aussies that run around like crazy all day long over rough terrain and over 21 years and five dogs I have yet to have a ruptured cruciate, but all of the dogs are (were) in great shape, did lots of running every day and were not overweight. Other than that, there is not much you can do. The other reality is that various studies show that somewhere between 30- 50 percent of dogs that rupture one cruciate will likely rupture the other within one or two years – not your fault, it just happens.

As mentioned above there is no definitive cause for a ruptured CrCl in your dog but there are a number ofcontributing factors: obesity, inactivity with occasional strenuous activity, conformation (very straight legged dogs, like pitbulls, put tremendous stress on their knee joint), hormonal imbalances (possibly from early spay or neutering) and inflammatory conditions. The reality is that most cruciate ruptures are not acute but chronic. Simply put, most cruciate rupture is the result of repetitive hyperextension micro-injury to the cranial cruciate ligament which results in long-term degeneration that weaken the fibers over time that finally rupture.

How will I know if my dog has ruptured a cruciate?If your dog has a full tear, you will likely know immediately. Your dog will hold their leg up in a slightly bent position and simply not use it and they will be very uncomfortable and in pain. This is often accompanied with fluid build-up in the joint (or as my wife says effusion). Call your veterinarian immediately and make an appointment. The more difficult diagnosis is a partial tear of the cruciate which can come from moderate activity as a result of chronic wear and tear on the joint as mentioned above. The problem with the initial partial tear is that as an owner you may observe subtle to noticeable occasional lameness that may last for a few days and then go away and return again in a few weeks. As the name implies “chronic” is both progressive and permanent deterioration of the joint cartilage and if left untreated will eventually result in rupture. If your pet has a chronic condition and experiences mild and intermediate lameness your veterinarian may likely say there is no need to perform a surgical repair until more damage is evident and may provide you with NSAIDS and or other supplements to help the joint recover.

Diagnosing a Torn CrCLDogs with CrCL rupture often have a history of a mild rear limb laments some months in the past, which may have resolved (a partial tear or an initial CrCL strain, which had gotten better, but comes back). They present with a persistent, often severe lameness in a rear limb.

What are the causes?

On physical examination:

1. Pain in the stifle joint when tested by your veterinarian

2. Positive “sit test” - that is, when the dog is asked to “Sit”, they are unable to do so squarely with the stifles fully flexed under the pelvis. The painful leg has joint swelling, so the dog sticks the leg out in a “crooked sit”.

3. Increased joint fluid pressure in the stifle, which makes the patellar tendon less easy to palpate physically. This may only be appreciated on radiographs.

4. Thickening of the inside of the stifle joint - called “medial buttressing”.

Radiographs:

Signs of arthritic changes in the bones of the stifle.
Evidence of joint fluid swelling
Absence of any fractures or bone cancer

Treatment Options Your veterinarians may have several options for your pet, but all of them must take into consideration several things: the age of your pet, the general activity of your pet (for example is it a house pet, or an agility champion working dog), your ability as an owner to perform the needed recovery care at home after the surgery, and also your finances, as the options can have very different costs.

1. House Rest and medications for inflammation and pain. This option is most viable in the cat (one who is not too overweight), and in very small dogs. Some dogs seem to manage pretty well with minimal lameness, so this option may be appropriate. It is obviously less expensive, but most individuals will never return to normal function. Research shows that most dogs will have continued long-term lameness when no surgery is performed and get more degenerative arthritis. Research is clear that performing ANY surgery is likely better than no surgery at all, except as noted above.

2. Tightening Procedures

a. Extracapsular Surgical Repair (ECR). Sometimes called Lateral Fabello-Tibial suture, it is a “tightening” procedure for the stifle. This option may be available to your dog with your general practice veterinarian, depending of their experience with orthopedic surgery. We have performed this surgery for over 20 years, and it is still performed even in many universities , and has a long track record of improving lameness even in larger dogs. While degenerative arthritic changes are inevitable with this ligament injury, dogs that have this surgery are likely to be at least 75 to 80% of normal, and most owners are satisfied that the procedure helps a pet dog to perform normal activities and be relatively comfortable in the long-term. This procedure usually involves the use of heavy nylon sutures outside the joint to mimic the function of the ruptured CrCL, stabilizing the stifle joint, and minimizing pain with weight bearing. ECR dogs are slow to weight bear after surgery - 1 to 3 weeks, and ECR relies on the body to scar down or thicken the joint capsule of the stifle over time to provide stability. The suture may break over time, but scar tissue should hold the stifle in an appropriate position for good function after 6 to 8 weeks. This means a return to normal activity over about 8 weeks.

b. Other “Tightening “ Procedures. Procedures such as Fascial Graft Techniques are generally done by older surgeons, and are less common today. Tightrope Procedure is a tightening procedure with a proprietary material which has experienced high rates of surgical infections,and failures, so this clinic no longer performs this procedure.

Here’s a great link on our website that gives a brief description these two procedures. http://www.wvah.net/educational-articles/ Under species select dogs, select topic surgical conditions, select page three and click on Cranial Cruciate Ligament Repair: Extracapsular Repair and TightRope Procedure. If the link doesn’t work just follow the directions above to access the article on my hospital’s website – thanks.

3. Bone-Cutting Procedures

a. Tibial Plateau Leveling Osteotomy(TPLO). Patented by a veterinary surgeon and engineer in Eugene, Oregon, this procedure has become the procedure of choice at least in the USA. Performed almost exclusively by referral Surgeons, this surgical repair for CrCL injury is much more expensive, much more technically difficult, but may also be a better approach to repair for large dogs, or those dogs that aim to go back to some level of athletic performance. The procedure involves calculating the angle of the tibial plateau (the top of the tibia or shin-bone), and cutting the tibia bone and rotating the top of the tibia to correct the instability during weight-bearing, to minimize the excessive forces on the stifle, minimizing pull on the joint capsule, and to attempt to minimize degenerative arthritis in the joint. Controlled studies are now available. There certainly seems to be less arthritis over time, and return to better performance compared to Tightening Procedures. Neither procedure gets the dog back to pre-injury performance, and few individuals are normal again, however, TPLO does seem to get a better consistency of long-term result. As with other bone-cutting procedures, dogs are walking on the leg very quickly after surgery. Because it involves bone cutting of the shaft of the tibia bone, and a thick bone plate on the leg, and time needed to heal the bone, the recovery from surgery is longer than in Tightening procedures, and client compliance on home care is vital. Return to normal activity can be as long as 3 to 4 months waiting for bone healing. While small and medium dogs might benefit from this procedure, it is very large dogs that seem to derive the most benefit from this more expensive procedure.

b. Tibial Tuberosity Advancement (TTA). This procedure was introduced in Europe, and has been performed by some surgeons in the United States over the last about 10 years. It is also a technically challenging bone-cutting procedure that changes the angle of the stifle joint, with a similar mechanical end-point as the TPLO. Moving, or “Advancing” the tibial tuberosity changes the patellar tendon angle and neutralizes the forces on the joint. TTA now has multiple studies that show nearly as good results as with TPLO. Our surgeon has had multiple years of experience with this procedure, and can discuss it with you. It is intermediate in cost, below that of the TPLO, because it does not require referral to a specialty hospital. For large dogs, it is a viable procedure for quick return to weight-bearing and good consistency of result, yet unlike the TPLO, leaves the tibial bone shaft intact for weight bearing after surgery. This procedure has had some increased problems with meniscal lameness months after surgery, averaging 10% meniscal tears causing lameness, but is a stout, strong fixation for very large dogs. Like the TPLO, it is quite invasive, and will take a couple of weeks to recover from the surgery trauma, although dogs will weight bear in 1- 2 days. Dogs with TTA are generally healed in 8 weeks, still less time than the TPLO for return to normal activity.

Here’s a great link on our website that gives a brief description of both the TPLO and TTA procedures. Same directions as above: Page 3 and click on Cranial Cruciate Ligament Repair; Tibial Plateau Leveling Osteotomy and Tibial Tuberosity Advancement http://www.wvah.net/educational-articles/ See note above if link to this article does not work.

c. Modified Maquet Procedure (MMP). This is a modification of the TTA procedure, which has about 30,000 clinical cases in Europe since 2010. We have been performing this procedure for over a year due to lower cost, less invasive tissue trauma, shorter surgery time, and good clinical outcomes. Like the other bone-cutting procedures, large dogs will be quick to weight-bear post-operatively, but we find much less pain due to a smaller incision, and less tissue trauma. This procedure, while still technically challenging, takes the surgeon much less time to perform. Like the TTA, a tibial tuberosity advancement is made, but the use of a patented titanium foam that is more biologically compatible with the bone leads to much quicker healing times, so faster return to function, and a similar 8 week recovery to normal activity as TTA. Later meniscal lameness is reduced to 5% of dogs, comparable to TPLO, and less than traditional TTA’s. But dogs are much less painful than with either of the other bone cutting procedures. Four weeks of very careful walking activity and NO loose activity or running is required, but after 4 weeks, return to brisk walks is allowed, and full function by 8 weeks. Studies have shown 91% of dogs return to “Full Function” which is comparable to both TTA and TPLO in a less expensive procedure.

A word to the wise: While veterinarians can give general expectations of the outcome of dogs, each dog is an individual, and there is always a “bell curve” of outcomes. While we can expect, say a “return to 80% function’” that is a majority of dogs. A few do better, a few could do worse.

So What Does the Scientific Research Say? Truth be known, there is not near as much scientific research in veterinary medicine as there is in human medicine. As a result, one or two good studies are often referenced over and over again in subsequent studies so while it looks like there are numerous studies that confirm a hypothesis, much of the research still relies on one or two pieces of research. For example, this study, “A Review of extra-articular prosthetic stabilization of the cranial cruciate ligament-deficient stifle” by C.A. Tonks, D.D. Lewis and A. Pozzi

https://www.orthovet.org/sites/default/files/vcot-full-paper/VCOT_2011_issue_OVSS_june.pdf/

refers to research done by Conzemius MG, Evans RB, Besancon MF, et al done in 2005 and another article published February 3, 2010 by Kevin K. Au, Wanda J. Gordon-Evans and Dianne Dunning University of Illinois at Urbana-Champaign.

While orthopedic specialists around the country will probably to a person recommend the TPLO procedure for all dogs, the above research does not support that belief. Both of the above papers compare the extracap procedure with the TPLO procedure (TTA was not being performed widely in 2005 so not studied as much) and the results were similar – no significant difference between the two procedures. Let me quote directly from the Kevin K. Au et. al. study.

Results – Thirty-five dogs had LFS( extra cap) and 30 dogs had TPLO. Radiographic OA scores were significantly increased at 24 months compared with preoperative scores in all dogs (i.e. they all got arthritis in the surgery leg). Radiographic OA scores preoperatively and at 24 months were not significantly different between treatment groups. PVF (peak vertical force) was significantly increased from preoperative to 24 months among both treatment groups but not significantly different between treatment groups preoperatively or at 3,5,7, weeks, 6 or 24 months.

Conclusion – No significant difference in outcome as determined by ground reaction forces (the gold standard in determining this –foot pressure on a plate) or radiographic OA scores were found between dogs with CrCL injury treated with LFS (extra-cap) or TPLO.

Clinical relevance – LFS and TPLO remain good options for stabilizing stifles and CrCL injury with all dogs showing significant functional improvement. This study does not support the superiority of either surgical technique.

This study studied both medium and large breed dogs – so an apples-to-apples comparison. The other study quoted above compared small breed dogs repaired with extra-cap procedure with large dogs done with TPLO. Again, the results were similar – no significant difference between the two treatment groups - BUT because the treatment groups were NOT the same, the study, in fact, compared the proverbial “apple to the orange”. This does not change the results but makes the comparison more difficult to assess.

Notwithstanding the research it IS believed by the veterinary profession as a whole that the extracap procedure should be performed on cats and dogs weighing less than 20kg and the bone cutting procedures should be performed on larger dogs. I say this because in larger breeds those dogs can put enough stress on their joint to snap the 80lb test fishing line that is used to secure their knee even after enough scare tissue has been grown to tighten the joint. Another factor is that most if not all studies only look at dogs 24 months post-operatively to come to a conclusion about efficacy. But any of us that have broken a bone or had an orthopedic procedure knows that 20 years after a surgical procedure arthritis sets in and it can be painful. With an extra-cap procedure arthritis is inevitable and is more severe than in bone-cutting procedures. This may not be as important if your dog is older when surgery is performed but certainly something to consider if your dog is young and has a long life ahead. As the table above shows pain from arthritic changes can be mitigated by NSAIDS (pain medications) but they are relatively expensive, can cause problems in some dogs and will require routine bloodwork.

The bottom line is this, if money is absolutely no concern, then a TPLO or TTA (according to the America College of Orthopedic Surgeons) would be the best choice for a young, active dog over 20kg. But as the research shows, extra-cap procedures, in the hands of a skilled practitioner that has done 100’s of them, can also be a very effective procedure in all cases. Optimally you would opt for an extra-cap procedure on a dog under 20kg, or on an older, sedentary dog that would not put too much stress on their joint and not live so long as to develop too much arthritis. For those owners that don’t feel like spending close to $5,000 on a TPLO procedure, the much less expensive MMP procedure (more than 30,000 procedures have been performed in Europe with much success) provides almost the same level of function post-operatively, is less invasive and has a shorter recover time. While this procedure is not done everywhere, there are practitioners across the country that are proficient at this procedure. Most of the veterinarians that perform this surgery are general practitioners and perform this procedure because it is much less expensive than TPLO’s (the choice of most board certified specialist in the country) and they want to give their clients an alternative that is almost as effective as a TPLO at likely half the cost of that procedure.

The Non-Surgical Approach

As mentioned above and I will repeat it, house rest and medications for inflammation and pain is most viable in the cat (one who is not too overweight), and in very small dogs. Some dogs seem to manage pretty well with minimal lameness, so this option may be appropriate. It is obviously less expensive, but most individuals will never return to normal function. Research shows that most dogs will have continued long-term lameness when no surgery is performed and get more degenerative arthritis. Research is clear that performing ANY surgery is likely better than no surgery at all except as noted above. For larger dogs a non-surgical approach for a complete cruciate rupture is not at all recommended as the dog will likely never regain full range of motion, never return to normal function and have much more arthritic pain than without surgery. But keep in mind, the non-surgical approach does not mean doing nothing and letting your dog heal on its own. For best results “conservative measures” should include use of pain medications and antiinflammatory medications like NSAIDS, some form of physical rehabilitation and possibly nutraceuticals. If all this is done outcomes can be quite good, but likely no less expensive than an extra-capsular surgical repair and will require much more work on the owner’s part.

The internet is FULL of alternative solutions from house rest, to a red-light therapy, to acupuncture and chiropractic (my wife is certified in both but does not recommend either as a replacement for surgery) to an assortment of supplements and pain medications. The reality is, in the long run – say 6 to 9 months - your pet will likely develop enough scar tissue to stabilize the knee joint to return to somewhat “normal” walking. When this day arrives owners of the non-surgical approach will conclude that their “alternative” approach worked. It might have, to a degree, but there are things to consider. Your pet was likely painful for an extended period of time, one can only hope that the scar tissue stabilized the joint at the correct angle, the pet will likely have much more severe arthritis and sooner than with a surgical procedure and the knee still may not be as stable as with surgery. In addition, the pet will likely have a more limited range of motion, will have less functionality of the joint and wil

l likely have a limp. Cats and smaller dogs can do without surgery, but likely would benefit from daily supplements (there are numerous good products for joint function just ask your vet, not that 16 year-old kid at Petco!!!) and pain and anti-inflammatory products such as Rimadyl or Metacam, which can be costly over time.

Another alternative I have seen are the use of knee braces. The issues I have with braces are numerous: 1. They HAVE to be properly fitted, therefore you just can’t buy one on the internet and “hope” it will fit and help; 2. It HAS to be worn all the time, from the minute your pet wakes up until they are put to bed in their kennel at night; 3. the braces I have seen that are substantial enough to support the knee of a medium to large bred dog are expensive - $850 is not unusual; 4. Your dog may still be in some pain and require pain meds and anti-inflammatories. The end result is your compliance is imperative, the costs with supplements and pain meds may not be much different than surgery. Braces are likely only a good idea for dogs than cannot go under general anesthesia or pets that are too old to risk a surgical procedure.

I will include just one article I found on the internet regarding a non-surgical solution to a ruptured cruciate in dogs to illustrate the difficulties for owners of relying on non-professional help. www.wikihow.com/Heal-a-Torn-Dog-ACL-Without-Surgery/

In point 1 they state that a dog under 20kg may not be a good candidate for surgery – incorrect. In fact, dogs under 20kg are excellent candidates for the extra-cap procedure, the least expensive and least intrusive of the surgical procedures commonly performed. Point 2 is good, keep your pet’s weight down – good advice. Point 3 restrict activity – good idea. But other information is incorrect, NSAIDS don’t “help” heal a torn ligament (helps with strained but not torn ligaments), the article talks about the use of braces BUT the illustration has the brace on the ANKLE of the dog NOT the knee. I know they mean well and make some good points but it is simply best to have this discussion with your veterinarian and then you can decide what to do.

Here are some of the articles I have read that you may find helpful when deciding what to do if your dog (or cat) has ruptured a cruciate. I’ll first start off with an article from the American College of Veterinary Surgeons. This is the group that certifies all of the Board Certified Surgeons across the country.

https://www.acvs.org/small-animal/cranial-cruciate-ligament-disease/

The article provides a good description of the bone cutting TPLO and TTA procedures but has no discussion of the MMP procedure probably because of the newness of this procedure. They note that “the TTA and TPLO share similar advantages and disadvantages…and the decision between TPLO and TTA is based purely on the opinion of your surgeon and their personal technical experience...to date, no published data supports one technique being superior to the other.” They also describe the extra-capsular (extra-cap) and note that “many surgeons reserve suture techniques for small breed, older, and/or inactive dogs as larger and younger patient have more complications.” Of interest, they also discuss knee/bracing/orthotics but note that “there is no published data that supports its viability as a reasonable treatment in dogs with CrCLD. Much of the enthusiasm for dog knee bracing is extrapolated from their successful use in humans with ACL injuries.”

Here’s a short article written by Ernest Ward, DVM (a well-known celebrity in veterinary medicine) and Robin Downing, DVM, CVPP, DAAPM. The article quickly goes through the two most common options recommended by board certified surgeons (Dr. Downing) and provides one of the best descriptions of both the TPLO and TTA procedures – brief and understandable for us lay people - and has a few pictures illustrating the procedure.

https://vcahospitals.com/know-your-pet/cranial-cruciate-ligament-repair/

One of most respected veterinary hospitals in the country, The Animal Medical Center in New York City have some great articles on their blog on TPLO and TTA procedures and a general discussion on cranial cruciate ligament disease in dogs. The links are listed in the order mentioned above. These articles can also be easily shared off this site as well.

http://www.amcny.org/tag/tplo/

http://www.amcny.org/tag/tta/

http://www.amcny.org/tag/cruciate-ligament/

If you are interested to know what veterinarians say to their colleagues, here’s an article from a trade magazine written by a board certified surgeon on cranial cruciate ligament repair. Short and sweet but thought you’d like to hear the inside skinny.

http://veterinarymedicine.dvm360.com/cranial-cruciate-ligament-repair-one-size-does-not-fit-all/

The next article I will include is authored by Dr. James L. Voss of the Veterinary Teaching Hospital of Colorado State University. Dr. Voss also discusses the extra-cap, TPLO and TTA procedures but this article is of note because he also addresses non-surgical options and writes, “In general, we do not advise this therapy as the ideal form of treatment, but it may be appropriate for individual dogs due to some combination of their very small size, inactive lifestyle…” Dr. Voss makes no recommendations or comments on the bone-cutting procedures but notes that the extra-cap procedure “seem to work reasonably well in small breeds and inactive dogs when performed by an experienced surgeon.”

http://csu-cvmbs.colostate.edu/Documents/orthopaedics-cruciate-ligament.pdf

The next article is from Fitzpatrick Referrals a referral hospital in Surrey, Great Britain. This article gives a nice summary of the causes, symptoms and diagnosis of CrCL and has great illustrations of what is happening inside the affected joint. The article also discusses TPLO, TTA and extra-cap procedures and concludes that, “The decision of whether TPLO or TTA is most appropriate is made based on the anatomy of the individual. In many cases, either surgery would constitute a suitable and appropriate choice.”

https://www.fitzpatrickreferrals.co.uk/orthopaedic/cranial-cruciate-ligament-injury/

This next article provides a good illustration of the hardware used in the MMP procedure and provides a good timeline for recovery from the procedure. Note that this is also a British hospital as the procedure is quite common over in Europe and around the world.

http://www.abbottswayvet.co.nz/mmp-for-cranial-cruciate-ligament-surgery/

The next article is more typical of the articles found on the internet regarding veterinary medicine issues. While the article is well written and mostly accurate, there are usually pop-up ads for nutraceuticals claiming to “rebuild joints, prevent injury and heal faster” information that does not add to the discussion about the issue at hand but in fact likely confuses the consumer regarding how to both prevent and heal the injury. Here is just one example of inaccurate information: “Studies have shown that dogs weighting less than 25 pounds can experience a full recovery from ligament damage without surgery.” The article does NOT quote the study because there are NO scientific studies that make that claim. So, while much of the article is accurate there are glaring errors in some of the assertions made. In addition, the descriptions of the procedures are extremely brief and do not give the pet owner any idea of what is really involved, what are the benefits and drawbacks of each procedure and which procedure is best for their pet. This is typical of most non-scientific articles that pet owners read.

https://dogkneeinjury.com/cruciate-ligament-injury-in-dogs/

There are also articles that fall somewhere in between the scientific papers and those that are suggesting studies where there are no studies. A good example are the articles in PETMD which are advertised as “vet authorized and vet approved.” Again, these articles are well written and mostly accurate but can make claims that require more explanation than the article provides. For example, in the article listed below this statement stands out to me, “Dogs less than 33 lbs (15kg) may be treated conservatively as outpatients; 65% improve or are normal within six months.” This statement makes it sound like doing nothing in smaller dogs works out fine 65% of the time, but what the article forgets to mention that this is likely only possible with a lot of caveats: lots of rest, use of pain meds and anti-inflammatories; extensive rehabilitation in the form of acupuncture, water treadmill treatments, etc.

This article also fails to mention that these dogs likely will never truly return to pre- rupture performance, will experience earlier onset of arthritis compared to surgically repaired dogs, and will likely have limited range of motion. These are important consequences of conservative treatment that need to be discussed if the dog owner is to make an educated decision about how to treat their pet. In my humble opinion, this article does a disservice to the pet owner looking to make an important decision about their pet’s long-term well-being.

https://www.petmd.com/dog/conditions/musculoskeletal/c_dg_cranial_cruciate_ligament/

These are just a small fraction of the articles available on the web regarding the treatment of CrCL in dogs but I believe a representative example of what the pet owner will find. My goal is make the pet owner “aware” that not all articles are helpful or give them the complete story about how to treat their pet for almost any condition. Keep in mind that almost everyone on the web has an ulterior motive than what appears obvious. I’m doing this so that people visit my veterinary hospital’s web site. But I’m also doing it because I believe that pet owners need to make informed decisions about their pet’s health.

Before I summarize this guide to ruptures cruciate surgery in dog’s I’d like to recommend a few videos that nicely illustrate the procedures I’ve talked about. Keep in mind that the individuals presenting also have a point of view to push. Board certified surgeons firmly believe that the TPLO procedure is the only way to go if your dog had ruptured it’s cruciate. Remember we all have some reason to be on the web other than altruism.

With that said here’s the first video from a board certified surgeon describing the TPLO procedure.

https://www.youtube.com/watch?v=hGIxCPekppk/

Dr. Bauer also has other videos that will explain ACL injury and others detailing TPLO healing and recovery which are very helpful for any pet owner considering any type of cruciate repair surgery. This next video discusses the TTA procedure, followed by a video describing the extra-capsular procedure.

https://www.youtube.com/watch?v=j7b1RChDIE8/TTA video

https://www.youtube.com/watch?v=3oJyS2SSqt8/ Extra-cap video

Sadly, I could only find two videos about the MMP procedure, one brief video from a veterinarian in Britain again and another on the web site of the company that provides the hardware for the MMP procedure. I have listed both below so you can see how this procedure is performed. This is also a bone-cutting procedure but is less invasive than either the TPLO or TTA procedures, takes less time and is less expensive and has similar outcomes to the TPLO and TTA procedures.

https://www.youtube.com/watch?v=gwMczy6GzPk/ UK video

https://www.youtube.com/watch?v=BLTw_k0z8jY/ OrthoMed video

Summary

For the most part, complete and acute CrCL ruptures are relatively easy to diagnose, but partial tears, especially if they are bilateral can be mistaken for hip dysplasia, another common problem in large breed dogs like labs. Most ruptures are the result of chronic ligament damage that result in complete rupture as a result of moderate activity. Your best bet for an accurate diagnosis is with your veterinarian. While most veterinarians do not perform the surgeries, most should be able to diagnosis the problem. If not, just go to a veterinarian that routinely repairs them as they also probably see more and are better able to diagnosis the problem.

When deciding what to do if your dog does have a ruptured cruciate, take in account several things: the age and general activity of your dog, your finances and the recommendation of your veterinarian. There are numerous surgical options available and if your veterinarian is not familiar with the range of options, visit one that is, to determine the best option for your dog. For small or older inactive dogs that may pose a high surgical risk, the non-surgical approach may be an option, but it should be accompanied with other therapies such as acupuncture, use of NSAIDS and anti-inflammatories, nutraceuticals, and other rehabilitation therapies such as water-treadmill or swimming pool therapy. Also, be aware that non-surgical approaches have consequences such as earlier onset of arthritis, limited range of motion and less functionality.

With respect to surgical options there are probably four that are commonly available in every major center in the country: TPLO, TTA, MMP and extra-capsular repair. While the vast major of Board Certified Surgeons will tell you that the TPLO is the gold standard, research (and their own certifying body) shows no difference between the efficacy of the TPLO and TTA procedures, so the choice will be made based the anatomy of your dog and the experience and comfort level and experience with each procedure of your veterinarian. The other bone-cutting procedure, the MMP, also has similar results to the TPLO and TTA procedures, is less invasive but is not as widely available in America but has been widely used across Europe, New Zealand and Australia. The oldest of the procedures, the extra-capsular repair has been performed on tens of thousands of dogs for the last four decades, and in the hands of an experienced practitioner, according to the research paper noted above, has been shown to provide similar results to the TPLO procedure. I would recommend this procedure for smaller dogs (and all but the most obese of cats) and older inactive dogs as a completely acceptable alternative. I hope this helps all dog owners out there that are looking for answers when they suspect their pet has ruptured cruciate.

The final reality that veterinarians must address with clients is the risk inherent with any surgical procedure. Anesthesia, while much safer than 20 years ago, does have some small risk of complications, including death.

All of the procedures discussed here have individual risk of not doing “as well as average.” Because of this, owners that don’t wish to risk these issues, do have the option of conservative management.

Good luck and if any of you out there find any great articles or references please send them my way so I can continue to update and make this guide more helpful.

- John Maddigan

Plateau Veterinary Hospital

Willamette Valley Animal Hospitals

Where do Oregonians get their Dogs?

2018-10-18

Years ago, many Oregonians got new family pet dogs from various sources: shelters, individual dog breeders, or pet shops. Today, by far, the largest source of pet dogs are rescue associations, humane societies etc. In Oregon, we actually have more people to adopt dogs than we have supply. So many potential “pet parents” would be without a best friend without humane associations importing dogs from various other locations in the USA and even around the world. This is a great situation to be in - more adopters of unwanted dogs than dogs to fill that need, so we have been able to help other areas of the county avoid unnecessary euthanasia of healthy wonderful pets!

At Plateau Veterinary Hospital, we work with a wonderful and caring group “Street Dog Heroes”, who adopts dogs rescued from all over the world. At our sister hospital, Willamette Valley Animal Hospital, we work closely with the Oregon Dog Rescue, who adopts both local dogs in the Portland Metro region as well as many dogs from California that would not otherwise get a home. These groups and others like them (as well as several cat rescue groups!) are an integral part of our mission as owners of small animal hospitals. These pets are universally neutered or spayed as a part of an overall mission to avoid pet overpopulation and unnecessary euthanasia. Rescue groups overall have been very successful in their mission around our country.

However, this is not the whole story about where Oregonians get pets. Pet stores, which historically have obtained and sold dogs from large commercial dog breeders, have in most instances stopped these practices and have joined humane groups to help rescue dogs. This is commendable and should be cheered on!

I think though, that we should also address the last common source of pet dogs: small and medium, reputable purebred dog breeders. These are committed people in our country and around the world that are breeding purebred dogs to be adopted into loving homes, to be used in competitions, both conformation and performance events of all kinds. Breeders like these conscientiously breed many different breeds of dogs for many different purposes and jobs. It is their livelihood or more often their hobby or “calling”, they are most often participating in improving their chosen breed over years or often decades. Most of these dogs are registered with their breed associations or in the USA, the American Kennel Club or other clubs. Without these devoted breeders, the many dog breeds which we all are familiar with, and others that are less recognizable would not be in existence. Each breed has a job, a purpose, and most breeders are absolutely committed to improving the individuals in their breeds.

I am one of those small breeders - every year or two we breed our best individuals. Mostly we love and participate with our dogs in competition, and occasionally sell puppies to well screened homes that will love and care for them as we do. In the past, to breed these dogs, breeders would travel hundreds or even thousands of miles to “meet” a prospective mate. Today, with advances in reproduction (the study of Theriogenology), veterinarians can help breeders to breed their dogs NOT in the “old fashioned way”, but with artificial insemination. This requires dedicated monitoring of female dogs, but we have gotten pretty good at not needing to ship dogs around the country or the world to help us improve our genetics and make “better” dogs for all to love.

Plateau Veterinary Hospital has recently decided to add reproductive procedures to its services. We have an in-house hormone assay machine (Progesterone monitor) that can be done more efficiently (answers within 30 minutes), and more economically to help breeders to follow their bitches’ cycles and improve reproductive success. We offer artificial insemination and surgical inseminations, depending on the need. We offer elective cesarean sections, and have a puppy incubator to help both with sick or newborn puppies after delivery. Our progesterone machine will help with making sure timing of cesarean sections is correct and more successful with puppy outcomes. We hope to let breeders know of our equipment and new education in this area and stand ready to help breeders in our area should they need these services.

Sheri Morris DVM,
Diplomate, American Board of Veterinary Practitioners (Canine and Feline specialist)
Member, Society for Theriogenology