Emergency Care | Skin Problems | Anethesia | Whelping | Thyroid | PRA | DNA |
By Robin M. Smith, DVM
In a serious emergency first aid cannot take the place of a veterinarian's professional services. Knowing how to provide assistance in an emergency, however, will influence the outcome of the case and will, in many instances, save an animal's life.
There is a time to assist your animals yourself, a time to telephone your veterinarian, and a time to seek professional assistance immediately. The purpose of this article is to help you select the proper action and hopefully, to give you assistance in those infrequent situations when you are unable to get your pet to the veterinarian. There will be occasions when no first aid treatment is appropriate and only veterinary services can be helpful. It is my hope that in this and following articles, it will enable you to better distinguish between the two.
Before I begin, I want to stress the importance of a good relationship with your veterinarian. This relationship should be comfortable enough that you feel that you can call and ask anything of your veterinarian. The veterinarian should provide you with advice, care and helping you understand conditions involving your pet and should be willing to see them in emergencies or refer to someone who can take care of them, i.e. an emergency hospital. These days with the ever growing pet population and the growing demands on veterinarians, a lot of veterinarians are using emergency hospitals to refer emergencies to. This is not because they do not value your business, but by providing a referral veterinarian who does only emergencies, as I do, your veterinarian is giving you the best care. A veterinarian who is up all night cannot function well the next day to see their regular clients. Also, most veterinarians do not have 24 hour care that some of the animals in emergency crisis need. So keep this in mind when your veterinarian sends you to an emergency clinic, it is the best thing in most situations.
The first thing you should have on hand in emergency situations, and actually you should do this now, is an updated record on all of your pets that includes their shot records and past medical history. In case you are referred to an emergency clinic, this helps the veterinarian who has never seen your pet.
Accident and Injuries
1.) Abdominal Distention
There are several reasons for an acutely distended abdomen and the degree of importance varies with its severity. Simple overeating is common in puppies and is normally not serious. However, gastric dilation and volvulus (twisting) is the utmost emergency. Abdominal distention's which need emergency treatment include severe overeating, overdrinking, air swallowing, and gastric dilation and volvulus.
Overeating: All breeds of any age are susceptible to overeating and overdrinking but it occurs more commonly in puppies or in animals that have not eaten regular meals.
Causes: Consumption of large quantities of food, Eating garbage, Excessive consumption of water after eating dry food, excessive water consumption following exercise or the unavailability of water for abnormally long periods of time.
Signs: Swollen abdomen, possible vomiting or retching groaning.
Treatment: Prevent further access to food or water and keep quiet and provide plenty of fresh air. ANIMALS WITH SEVERE ABDOMINAL DISTENTIONS AND RESPIRATORY DISTRESS MUST RECEIVE VETERINARY ATTENTION.
Definition: This is seen most often in large and giant breed dogs and deep chested dogs. That accumulation of gas in the stomach causes distention and a concurrent twisting of the stomach on its axis (volvulus). Its exact cause is unknown, but there is interference with blood circulation and shock, coma and death can occur in 2-3 hours. It is believed that the distention occurs before the twisting and may or may not follow ingestion of a large meal.
Signs: Enlarged abdomen, abdomen painful, especially when touched, and may sound tympanic if thumped with the forefinger. Excess salivation with unsuccessful attempts to vomit. Difficult breathing, evidence of shock (will cover later) and reluctance to move and often refusal to lie down or they lie down and will not move.
Treatment: MUST GET VETERINARY ATTENTION - EVEN WHEN YOU ARE NOT SURE, IT IS BEST TO CALL YOUR VETERINARIAN.
Management of external bleeding: Use proper restraint and avoid excitement. First try to control bleeding by direct pressure or a pressure bandage. Apply a tourniquet AS A LAST RESORT - only if blood loss becomes critical and SEEK immediate help.
Severe bleeding must receive immediate attention regardless of what other injuries are present. Bleeding from minor cuts and wounds generally stop within a few minutes. Profuse external bleeding resulting from blood vessel damage can usually be controlled by applying firm, direct pressure over the wound with a sterile or clean gauze or cloth such as a handkerchief or T-shirt.
Arterial blood will flow irregularly in time with the heartbeat and will be bright red; whereas blood from a vein will flow evenly and be dark red. Apply additional pressure between the heart and the wound from an artery and below the wound for a vein.
Application of a pressure bandage is normally the safest and best way to stop bleeding. Apply a sterile or clean cloth or sanitary napkin directly over the wound and bandage the area firmly with a 2-3" gauze roll. Torn strips of cloth approximately 3" across by 4' long made from bedding sheet or soft material can serve very well. Secure the gauze in place with adhesive, electrical or masking tape, or by tying the cloth together. Avoid frequent removal of the bandage to check the wound because bleeding may start again.
Application of a tourniquet should be reserved for bleeding that cannot be controlled by direct pressure, such as a severely mangled or crushed leg or tail. A tourniquet made of a 2" wide gauze bandage or cloth or necktie should be applied directly ABOVE the wound and should be released every 10 minutes. When properly adjusted there should be oozing from the wound and you should be able to place a finger under the bandage when it is in place. Do not apply a tourniquet unless absolutely necessary.
Bleeding from the ear, footpad or penis can result in fatal hemorrhaging and the potential seriousness of these types of cuts cannot be overemphasized. Normal clotting of blood in an ear injury is prevented by the whip-like action of the ear during head shaking. To prevent this, bind the head with a roll of gauze or tape or use a nylon or knee sock with the bottom cut out. A bleeding footpad should have a pressure bandage applied.
Hemorrhaging from the penis can frequently be slowed or controlled by applying cold compresses to the area. A female in season will excite the male causing uncontrollable hemorrhage. Remove the male from the area to avoid this complication.
Toenail Bleeding: One of the most frequent calls I get at the emergency hospital is from the client who cuts a nail too short and cannot stop the bleeding. Sometimes these nails bleed, at least to the layman, a lot. I first recommend using a bar of wet soap and having the person put the dogs' nail into the cake of soap to cover it. I also recommend flour or baking soda made into a mush and putting this on the nail. It is best to have the dog lying on its side when all these ate attempted because this relieves a lot of pressure on the foot. If it still continues to bleed profusely, you can wrap the foot in a bandage, BUT not too tightly.
3.) Management of Internal Bleeding
Seek veterinary help ASAP. Treat for shock (covered later) and do not give the animal anything to eat or drink. IMPORTANT - Internal hemorrhaging should be considered a possibility following any sharp blow or injury to the abdomen or chest. This is especially true if hit by an automobile.
Severe bleeding will cause the animal to show signs of shock and should be treated accordingly. Coughing up bright red, foamy blood indicates injury to the mouth, trachea and lungs. Vomit or excrement that is a bright red t dark reddish-brown may indicate injury to the stomach or intestines.
Signs of Internal Bleeding: Pale mucus membranes (the gum color above the teeth, it should be pink). (Of course one has to take into consideration the black pigment). When you put pressure on the gums and release, the gums should immediately be white and within a couple seconds should be pink again. Panting.
A true obstruction of the throat is rare in small animals, but dangerous when it does occur. It occurs more commonly in puppies or in some of the shorter nosed breeds. The presence of foreign bodies or wounds in the mouth or throat that do not obstruct air passage are much more common.
Obstruction of the Throat
Causes: Objects such as rubber balls or pieces of meat lodge in the back of the phyarynx or esophagus, throat swelling caused by insect stings or infection, allergic reactions that can cause throat swelling or the ingestion or inhalation of something irritating.
Signs: Sudden difficult breathing cyanosis (blue tongue) and collapse.
Treatment: Pull the tongue forward and inspect the throat (be very careful not to get bitten by the anxious animal). Hold the mouth open and carefully remove the object. Strike the side of the rib cage with the palm of your hand 3 - 4 times while the animal is lying on its side. Stand behind a large dog and lift up its forelegs while giving 3 - 4 forceful compressions on both sides of the chest.
Foreign Bodies in the Mouth or Esophagus
Signs: Apprehension, choking or gagging, salivation or spitting up white or blood-tinged phlegm, pawing at mouth and rubbing the side of the head on the ground.
Treatment: Press the thumb and forefinger of one hand into the upper cheeks, forcing the mouth to open wide. Gently remove the object with your fingers or a pair of long-nosed pliers. If wounds exist or the foreign body cannot be removed easily, please see a veterinarian.
Convulsions or seizures can be violent, and are involuntary contractions of the voluntary muscles. They are either acquired (secondary to some other cause) or congenital (those suspected to be of an inherited nature). There are many causes. The primary concern is not to determine its cause but to administer appropriate care for the animal. Minor seizures may last from a few minutes to a minute or to, with or without loss of consciousness. Major seizures last from a few minutes to several minutes and are characterized by the apparent loss of consciousness.
Signs: Restlessness with frightened or dazed appearance, hiding or wandering, head shaking, salivation, licking of the lips and snapping the jaw, dilated pupils, violent muscle contractions and s ometimes rapid leg movements, greatly increased respiratory rate and loss of urine and bowel control. Immediately following a seizure there is a period of confusion, disorientation, pacing, salivation, weakness, and temporary visual impairment.
Treatment: An animal with convulsions can be frightening and upsetting. Remain as calm as possible and intervene only as indicated. Treatment is limited to preventing injury to the animal and to you. During the seizure an animal has no conscious control over its actions. A completely effective treatment for a seizure at the time it happens is not practical since it involves an intravenous injection of an anticonvulsant drug. Do not physically restrain, keep children away, never place fingers between teeth and make the animal comfortable. Keep the pet on the floor and prevent it from falling. Use a blanket or coat for padding and protection. Keep the area quiet.
IMPORTANT: Continuos seizures require immediate medical attention. Poisons are a common cause of convulsions and should be treated accordingly.
6.) Ear Injuries
Causes: Bite wounds, foreign bodies inside the ear canal such as grass lawns and seeds, insect bites and infections.
Signs: Violent head shaking, scratching at the ears and neck, dragging ear along on floor, tilting the head to one side, tenderness when ear is handled, unusual odor, discharge from the ear and swelling of the ear.
Treatment: Control bleeding by applying direct pressure to the wound. Apply a head bandage to maintain pressure and prevent head shaking. You can clip the wound area and apply an antiseptic cream to it. If there is a foreign body and it is visible, try to remove it. Temporary relief of pain can be provided by pouring a bland oil, such as mineral, baby or olive oil, directly into the ear canal.
Complications: Hematomas are accumulations of blood between the cartilage and skin of the ear and may develop secondary to excessive head shaking and scratching. Surgical treatment is usually required.
7.) Eye Injuries
Proper initial emergency care not only relieves pain bit may also prevent permanent loss of vision. At our emergency hospital, anyone who calls in with a pet that has an eye injury, no matter how small, are strongly encouraged to bring the pet into the hospital.
Causes: Foreign bodies such as grass lawns, sawdust, and dirt are all potential sources. Lacerations and contusions result from fights, car accidents, blows and cat scratches. Chemical irritants such as acids or alkalis are also some causes.
Signs: Rubbing and pawing at the face/eyes, eye tightly shut, eyelids swollen, watering of the eyes, sensitive to light.
Treatment: Since the eyes are very delicate organs almost all injuries should be examined promptly by a veterinarian. If the foreign body is easily assessable, remove it. No attempt should be made to remove an object closely adherent to the surface of the eye. Irrigate the eye with eyewash and avoid touching or wiping the eyeball. Hemorrhage in the white of the eye (sclera) usually clears in a couple of weeks. However, it suggests the possibility of a more serious injury inside the eye with a dye to ascertain if there is a corneal injury or not. This is important as some medications, especially those with steroids, can make a corneal injury worse. That is why it is important to not put any medications in the eye without first checking with a veterinarian.
8.) Electrical Shock
Causes: Biting through live wires such as electrical cords, blankets or lighting.
Signs: Violent muscle contractions with the inability to release an electrically charges object, collapse and unconsciousness, no evidence of a heartbeat or pulse, no breathing, cyanosis (blue) signs of shock and burns.
Treatment: The first step is to separate the animal from the electrical source. It is very important not to touch the animal directly or use an object that conducts electricity or is wet. Shut off the current as a circuit breaker or fuse box. Disconnect an electrical cord from its connection. Push away with a dry pole or board while standing on something dry. GET TO A VETERINARIAN!
9.) Allergic Reactions
A potentially fatal, acute, generalized reaction caused by hypersensitivity in the body to certain materials or drugs. NOTE: Animals may go into shock within 1 to 15 minutes after contacting the offending substance. Death can occur rapidly, but fortunately anaphylactic shock is not common in small animals.
Signs: Restlessness, local swelling, vomiting, diarrhea, shock, and collapse.
Treatment: An injection of epinephrine should be given immediately by a veterinarian. Establish an airway; treat for shock if necessary. The veterinarian may keep the dog overnight to observe and may treat with antihistamines and/or steroids as needed.
Causes: Insect bites contact with chemicals.
Signs: Swellings develop within 10-30 minutes from an insect bite or from an ingested drug, within several hours, swelling of the face, head, lips, ears, or any surface of the body. The eyelids swell and the dog may rub its mouth and eyes along the ground.
Treatment: Wash the animal free of any chemical residues, cold pack the insect bites. Treat for shock.
In cases of allergic reactions that are mild, sometimes the use of an antihistamine is necessary. I use Benadryl and give it as a dose of 25 mg. For dogs under 50 lbs. (never use in dogs under 20 lbs.) and in dogs larger that that, I use 50 mg. and never use more unless instructed by a veterinarian. Antihistamines can increase pressure so make sure you keep an eye on your dog after administering. They will also make the dog sleepy.
Freezing of tissue usually occurs in the peripheral parts of the body which are sparsely covered with hair and where circulation of blood is poor. In dogs the most common sites affected are the scrotum, ears, feet, teats, and tail.
Signs: Flushed and reddened tissues, white or grayish tissues, evidence of shock, scaliness of the skin and possible sloughing of the surface tissue.
IMPORTANT: DO NOT RUB OR MASSAGE FROZEN TISSUES. NEVER APPLY SNOW OR ICE. Tissue damage is greatly increased if thawing is followed by refreezing.
Treatment: Prevent further contact or exposure and prevent self-mutilation of the area. Warm the affected area rapidly by immersing in warm water (102-105 degree F), or use warm moist towels that are changed frequently. Discontinue warming as soon as the affected tissues become flushed. Gently dry the affected tissues, lightly wrap in a clean, dry bandage, and protect from further injury. SEEK VETERINARY ASSISTANCE!
Since I have referred to treating shock several times I will try to explain what it is. Shock is the failure of the cardiovascular system to provide the body tissues with adequate oxygen.
Causes: Severe injury, blood loss, fluid loss (vomiting/diarrhea), poisoning, infection, heart failure, obstructions to breathing, electrical burns, and drowning.
Signs: Gums/lips are pale in color and dry. The pulse is weak and rapid. Breathing is irregular, shallow and rapid. The pupils are dilated and there is a cool feeling to the skin and legs. There may be weakness, collapse or unconsciousness.
Treatment: Keep the animal quiet. Clear the air passages and maintain them free of mucus, blood and vomit. Control any bleeding. Keep warm by wrapping in blankets or place in heated car. Transport to a veterinary hospital immediately. Fluids may be carefully given by mouth if medical treatment is not available within 2 to 3 hours. DO NOT give fluids to unconscious, vomiting, or convulsing animals. Use a warm water solution of ½ teaspoon bicarbonate of soda for each quart of water. Administer 1 ounce for each 30 lbs. Of body weight every 20-30 minutes for a total of 4-5 doses.
11.) How to Take an Animals Vital Signs
Capillary Refill Time: This is a measurement of blood flow through the body. Roll the animal's lip back and press down on a non-pigmented area of the gums with one finger. This area should turn from pink to almost white in color. Once the pressure is removed, the pink color should return within 1 to 2 seconds. If it takes longer, impaired capillary return is present which is a sign of shock.
Respiration's: Watch or feel the animals chest rise and fall. Count the rise and fall of the chest for 15 seconds than multiply by 4 to get the respiration's/minute. Normal respiratory rate should be 10-30 respiration's per minute.
Pulse: Place a hand over the chest to feel the heartbeat or place your first two fingers on the inside part of the thigh and count the heartbeats for 15 seconds then multiply by 4 for beats/minute. Note whether it is strong or if you can barely feel it. Normal pulse should be 60-120 beats/minute.
Temperature: Use a rectal thermometer only (one that has a rounded end bulb). Insert the thermometer into the rectum of the animal for 1 minute. Normal temperature should be 101-102 degrees F.
Assessing Hydration: Many times I ask the client to check if their fog is physically dehydrated, especially when vomiting or having diarrhea. The best way to check is to pick up the skin on the scruff of the neck and let it go. If it returns right back into place, the dog is not dehydrated. If it is slow in returning into place, the animal is dehydrated. Sometimes you can assess dehydration in puppies by looking at their urine. The urine should be as clear as water or light yellow, never dark yellow as this is a sign of dehydration.
12.) Hit By a Car
This is probably the most common cause of an animal being presented to an emergency hospital. First, calm the animal. If it is walking, have it lie down and note whether it was limping. Look at the gums and capillary refill time. Notice any bleeding. Notice whether the eyes are small, pinpoint, or dilated.
If the animal cannot get up: DO NOT TRY TO GET THEM UP. Get a heavy-duty board to help transport the animals. BUT FIRST, get some kind of gauze (a tie will do in a pinch) and tie it securely around the closed mouth as a muzzle. Even the best-tempered dogs can bite when in pain. After the muzzle is in place, get help and place the animal on a large board. You may want to use duct tape to keep the animal down. Treat only severe bleeding at this time by applying direct pressure or a tourniquet as previously mentioned. THEN GET TO A VETERINARY HOSPITAL. Do not worry about broken bones at this time. Make sure you mention to the veterinarian if you saw the dog limping, or if the dog was aware of its surroundings or anything that may help. Don't forget to tell the veterinarian about any drugs the dog is on. The hardest thing with our mastiffs is size. I have found that getting a large blanket and using this to transport the animal is easier that trying to pick the animal up.
Always Be Aware That a Painful Dog Will Bite.
The Mastiff and Skin Problems
By Robin M. Smith, DVM
I was asked to write an article about common skin problems in mastiffs and while I do encounter skin problems frequently in mastiffs, I must say it is not one of my favorite subjects. The primary reason I do not like dermatology or skin problems is because by the time I usually see the mastiff in question the dog has been treated with a variety of different medications and ointments and the dog is no better and the owners are frustrated. What I plan to do is to describe what I commonly see in mastiffs and tell you how I try and diagnose the problem and treat this problem. Please, as I have always said, before doing anything or giving your dogs any medication, consult with your veterinarian and do not try to treat your mastiff on your own.
As I stated, I frequently encounter very frustrated owners of mastiffs who have been to their veterinarians with skin problems. Over the years, my experience with mastiffs and their skin problems has taught me to treat each dog individually and how to rule out underlying problems before treating the disease. I must say that I have been very successful in treating mastiff skin problems. The dog will not get better overnight but with proper diagnostics and therapy I can get most skin problems at least under control in 4-8 weeks.
As I go through the diagnosis and treatment of mastiff skin problems, you must realize that there are thousands of skin conditions that are known. All I am going to talk about are the most common that I have seen relating ONLY to the mastiff. This, in no way, means that the mastiff cannot get other skin conditions and again, only your veterinarian will be able to thoroughly diagnose and treat your pet.
First, a general overview of the skin as an organ and its function is imperative to the understanding of the problems associated with the skin. The general function of the skin is that it maintains an effective, flexible barrier to the loss of water, electrolytes and macromolecules. It provides protection from physical, chemical and microbiological injury. The skin helps to preserve body heat. It is also a sense organ for touch, temperature, pain and itch. The skin is also a secretory organ. And lastly, Vitamin D is produced in the skin via solar radiation.
The skin is made up of the epidermis, the outer layer, and the dermis or inner layer which nourishes the epidermis and supports it.
The normal skin defenses are the hair, the epidermal layer, the sebum or oily secretions that have antibacterial properties, the skins immunoglobulins and the normal skin bacterial flora.
Note, that I said NORMAL flora. All skin has bacteria presiding on it. These include Staphylococcus and other species. The problem arises when there is a break in the barrier of the skin allowing access of these bacteria to deeper layers or allowing accumulation of bacteria to occur.
The MOST common skin condition that I see in the mastiff is pyoderma, or cutaneous bacterial infection. The bacteria usually involved is Staphylococcus intermedius.. However, other bacteria can also be found. Staphylococcus intermedius is probably a normal inhabitant of the dogs mucous membranes and transiently colonizes the skin without necessarily causing disease unless some other factor leads to impairment of the skins' resistance. Most dog skin is rather resistant to bacterial disease, and pyoderma is usually regarded as a secondary phenomenon.
Mastiffs with pyoderma exhibit a range of lesions. Pustules are usually the hallmark of the disease but usually not seen since they are so fragile and burst before we recognize them. The first lesions are usually papules that will sometimes form pustules if seen. These are found usually in the groin, ventral abdomen, and axilla commonly. In some cases the dorsal trunk and neck are involved and patchy hair loss can be seen at these sites. By the time I see some of these cases, there are not many pustules or papules. It is in the more chronic state. I see scaling and epidermal collarette formation (round lesions that sometimes are mistaken for ringworm lesions), crusts, and extensive hair loss.
The dogs are often pruritic or itchy. This is probably due to the production of inflammatory toxins and enzymes by the bacteria.
There are also different classifications of pyoderma such as superficial and deep. I will not discuss these here.
I will try and describe a typical mastiff pyoderma (if there is one). There is usually small black crusty lesions which seem to be more on the back and back of the neck. You can easily pull the hair out and the dog will start scratching when you run your hands through the back hair. The hair will feel oily and dirty. There may also be a nasty smell associated with this skin problem. Sometimes there are also ring type crusty lesions in the groin and ventral abdomen. All in all, the dog is miserable and you are too because it is nasty just petting them. Another common finding in mastiffs is a hair thinning skin darkening on the flanks of the dogs body and it is usually on both sides.
I try to get a good history as to when the symptoms first appeared, whether or not they are itchy and what has been done so far to treat them. I also like to know environmental conditions, what the dog eats and if the condition is seasonal. While I have encountered allergic type skin conditions in mastiffs, I have not found it to be very common as it is in other breeds.
With history in hand, I begin my diagnostics. Again, you must understand that I am usually the last resort for some of these dogs. I will obtain a full blood profile, a CBC and a chemistry panel and a thyroid panel sent to Michigan State. I will scrape all of the dogs to make sure that we are not dealing with an underlying mite or parasitic infection. I will scrape several areas. I will also do a fungal culture at this time. With the bloodwork, I am looking for any indication of a systemic problem since many diseases manifest themselves through skin lesions. I also do a urinalysis at this time. Most of the cases I see have negative skin scraping and their bloodwork is normal although I have encountered systemic infections in dogs that had severe pyodermas. It takes a few days to get the thyroid test results. I will also do a culture and sensitivity of the skin lesions. Hopefully, the dogs have been off of any systemic antibiotics for a week or so before. AND I examine the skin lesions under the microscope. I try to find a new pustule or one that hasn't been broken and lance it with a needle and then touch a microscope slide to it several times and let it dry and stain it. This technique using different types of stains can give a rapid interpretation of the type(s) of bacteria present and assessment of the inflammatory response. For the culture, I also try and use a pustule that is not open and lance it with a needle and swab the contents onto a sterile aerobic culture swab and send to the lab.
The most common underlying condition I recognize in mastiffs with skin infections that do not resolve is hypothyroidism. This is an underproduction of the thyroid hormone necessary for proper metabolism. I know that many of you are going to say, "Isn't that hereditary?" Yes, and no. There are two types of conditions that cause decreased thyroid levels. One is where there is an immune destruction of the thyroid tissue which has a hereditary mode of transmission and the other is where they thyroid gland is replaced with connective tissue and is not hereditary. Both occur with the same frequency or so the literature states. That is why I send the thyroid test to Michigan State because the interpretation will tell you if there are autoantibodies present in high enough numbers to be causing a self destruction of the gland and therefore being hereditary.
How does low thyroid cause skin problems? Hormones regulate physiologic processes in the body. Excesses or deficiencies result in changes in morphology or function of the skin. Cutaneous changes resulting form thyroid imbalances occur as a result of affecting lipid or fat metabolism in the skin, thereby affecting the permeability. The skin has a very high metabolic rate. In other words, there are new cells formed and old ones lost very rapidly. If you think about a person who is undergoing chemotherapy, you will be able to understand this high rate of turnover. Chemotherapy agents are targeted to affect very fast growing cells, such as cancer cells. But, as you can see from the side effects, other cells are affected also and they are the ones that have a high metabolic rate. You see hair loss and upset stomachs and gastrointestinal signs as diarrhea. That is because the skin and hair and gastrointestinal tract cells have a high turnover rate. I give you this example to demonstrate the higher amount of energy and metabolism that is necessary to maintain the skin. I also see our mastiffs as giant breed dogs needing a higher metabolism to maintain themselves as compared to a poodle. I say this because it will follow with what I am going to say on the thyroid and the mastiff. I mentioned that hypothyroidism is a common underlying condition causing skin problems in our mastiffs. BUT, I must follow this with saying that in many of the mastiffs I treat with skin conditions, their thyroid levels are within the normal ranges but usually low normal ranges. But with the number of mastiffs I have supplemented with thyroid medication and appropriate other therapy that had low normal thyroid levels that responded to therapy, I have to suspect that perhaps we need to look at these ranges a little more intensely when dealing with giant breeds. I am not advocating if your dog has skin problems to just put them on thyroid medication. Again, I believe that this is a decision that should be made with your veterinarian and with a thorough workup to rule out other causes.
The effective treatment of pyoderma with antibiotics depends on the use of the correct drug at the correct dose for a sufficiently long duration. Bacterial culture and sensitivily of skin lesions is controversial. But because the cases I see are usually chronic, I think it is very useful and it helps me with my drug selection. In most first time cases, veterinarians choose a drug that would be effective in most pyodermas, such as Cephalexin or sulfonamides. Neither of these is all that expensive. I will usually not use sulfa drugs because of certain reactions that have been reported in the use of these drugs and sulfa drugs can potentiate hypothyroidism by lowering thyroid levels even further. But again, I am usually working with the chronic case and there are a lot of secondary bacterial invaders in the skin. I still start on Cephalexin at 10 mg./lb twice a day until I get the culture back. My concern is that a lot of these skin problems have secondary Pseudomonus infections which are very tough to get rid of. Of the oral drugs that we use in veterinary medicine, only Baytril or enrofloxacin, will work on Pseudomonus. If the owners do not want to do a culture and sensitiviy for some reason, I will use this to start with. The bottle dose will not get the Pseudomonus. You must give it at at least 7 mg/kg up to 10 mg./kg twice a day. I have used 10 mg/kg once a day also. In our mastiffs, that is VERY expensive. BUT, it works. Again, that is why the importance of a culture and sensitivity. If I do not get a Pseudomonus back, I can use other drugs instead of the expensive baytril.
While awaiting the thyroid profile, I will start the dog on soloxine at .1 mg/10 lbs and divide this dose into two. For example, I will give a 140 lb. Mastiff a .7 mg soloxine twice a day.
So, the dogs are on soloxine and the cephalexin pending the thyroid results and culture and sensitivity results. I sometimes use topical shampoos. The most common I use is benzoyl peroxide and chlorhexadine. Benzoyl peroxide is a potent bactericidal agent. It helps to restore normal surface microenvironment. It can be potentially irritating and drying, though, so a concurrent conditioner should also be used. Chlorhexadine is also bactericidal and highly effective. It is less irritating than the benzoyl peroxide. One good effect of shampoos is that they will remove the crusts, scales and other surface debris.
This treatment is continued for at least one week past the resolution of the problem. This can be as short as 2 weeks to as long as 2 months. I usually recommend keeping the dog on a low level thyroid supplementation for life with routine thyroid checks to make sure the level is not too high. Sometimes, the dogs can even be weaned off of thyroid supplementation.
One thing I have not touched on yet is the itching that is present with these conditions. I will usually use a drug named hydroxyzine (atarax). I try to stay away from all steroids because of the secondary effects these drugs can have on other body systems. In very tough cases though, I have had to use steroid, very judiciously, and I try to get them off of the drug as soon as possible.
Again, I must remind you that this treatment of mastiff pyoderma is a regimen I have found to work in a great number of mastiffs I have consulted on. It by no means implies that there are not other treatment regimens and your veterinarian will be the best one to decide with you.
As I stated at the beginning, there are thousands of skin problems in dogs. Besides the commonly found Parasitic conditions, i.e. fleas, ticks, mange and fungal conditions, the next most common problem that is found is allergy problems. One could write a whole book on allergies and there are specialists that deal only with allergic conditions of the skin. Because this issue is so extensive, I will not go in depth here.. Food allergy dermatitis and atopic dermatitis are the most common type of allergies seen in the mastiff. I have encountered one skin condition in a couple of mastiffs where they were allergic to themselves. Actually, they were allergic to their own bacterial flora. I had to culture their skin lesions and send the culture to a laboratory that made a vaccine from the dogs own bacterial flora and we used this to desensitize the dog. In both cases, it worked great. The underlying condition may be an immune related problem but is difficult to prove.
Another common problem with mastiffs is ear infections or otitis. We have all seen the mastiff that has the greasy nasty smelling ear. I again, usually see these after the dog has had several different treatment regimens and they have failed. Most of these infections now have multiple organisms growing in those ears and take quite a long time to clear up. I always get a culture and sensitivity. I always look at a slide of the ear wax under the scope to identify yeast or Malassezia organisms. Depending on what the culture comes back with and whether there were yeasts then I will treat appropriately. Most of the time, systemic antibiotics are needed. Also on occasions where the exudate in the ear is so bad, I may suggest sedation and ear cleaning. Again, some of these can be linked to an underlying disease process like hypothyroidism. I routinely tell clients to clean their mastiffs ears out with a type of swimmers ear solution made with 3 parts alcohol and 1 part white vinegar and use it 2-3 times a week. This solution creates an acid environment that keeps yeasts and most bacteria from growing.
Anesthesia and the
By Robin M. Smith, DVM
I thought that I would talk about anesthesia concerns and the mastiff since that is the most frequently asked question I get from mastiff owners.
First off, you MUST have a veterinarian that is willing to listen to you and who is not afraid to be questioned about their anesthesia methods and how they monitor the pet once they are under anesthesia. If they do not want to discuss this or if they have a comment like, "well, I have always done it so and so way and I am not going to change", find yourself another veterinarian. I think that the public needs to be aware of exactly what is happening to their dogs and the risks that are possible. ALL anesthesias are putting the dog at risk... BUT there are some that are much safer than others and I will discuss these.
To start, I want to mention a few anesthesias that I would avoid if at all possible. In the past, most of these drugs were used exclusively, but with the advent of the new drugs and safer ones, they should not be used in the mastiff. Mastiffs are not just big chihauhas. The mastiff generally has a slower heart rate than smaller dogs and they also have inherently a lower blood pressure. They also, as you know, have a larger body mass. These things add to the risk of anesthetizing them.
I never use acepromazine anymore as a pre-anesthetic or tranquilizer. Acepromazine lowers blood pressure and dilates blood vessels thereby making the blood pressure even lower. It also is metabolized (gotten rid of by the body) very slowly and tends to accumulate in fatty tissues. Therefore, larger dogs and fatter dogs usually have to be given a larger dose than normal in order to have effect, and because of this, it takes these dogs sometimes days to get back to normal. I have used it a lot in the past... In fact, it was the "gold standard" for pre- anesthetic sedation, but not anymore. Many people have used it in tablet form for tranquilization during stressful periods, i.e. thunderstorms. Again, I used to use it for this, but do not now, especially in giant breeds... It is too unpredictable. Just to let you know, I use Benadryl for thunderstorms at a dose of 1 mg./lb but not to exceed 100 mg. and find it works very well to make the dog tired and rest better.
Xylazine (Rompun) is another drug I avoid. I haven't used it in about 5 years. It makes the heart more susceptible to the effects of epinephrine (adrenalin) that is in the body and therefore, making the dog more susceptible to heart abnormalities. It is a difficult drug to dose in giant breed dogs.
Acepromazine and Xylazine are the two drugs that I try to avoid if possible. If your veterinarian is also a large animal (cow, not mastiff) veterinarian, he may very well use the two drugs as they are used in farm animals a lot.
If for some reason, your veterinarian must use these two drugs, I think it is mandatory that the dog be monitored by an EKG machine during surgery and immediately post-operatively.
Other drugs that I do not use much although they are still used are the thiopentals. These are like sodium pentathol. They work very rapidly to knock the dog down, but are very powerful and stay in the system a long time. Also if the drug gets out of the vein (like if the dogs jump) the thiopentals can irritate the surrounding area and completely slough the area (all the tissue dies).
The drug(s) that I use the most in mastiffs are valium, ketamine, telazol, and propofol.
A combination of valium and ketamine given intravenously will be enough to knock the dog down in order to insert the endotracheal tube. Both of these drugs are very safe and I use them a lot in the older dogs. Neither one effect the heart much.
Telazol is very similar to valium and ketamine and also works well for anesthesia so that an endotracheal tube be place (I use .1 cc/lb and do not exceed 1.5 cc total).
I do use propofol (deprivan) for short procedures, i.e. OFA radiographs. Propofol is a fairly new drug in the veterinary field but has been used for a long time in the human field. It is a milky solution that after opening a vial cannot be stored. It gets contaminated with bacteria very easily. Because it is expensive, the veterinarian may try to cut corners and use old leftover propofol that is sitting in the fridge. It is given to effect or in other words, it is given IV until the dog goes down and then the dog is intubated and put on gas. The GREAT thing about this drug is that as soon as the animal is taken off the gas, the dog is awake and can walk out without assistance. I have also used the drug in C-sections to sedate the dog long enough to insert the endotracheal tube. It is a very top of the line drug. I do find the dosages of propofol to be a lot lower than the manufacturers literature dosage. One added thing: Propofol can lower blood pressure so the pet needs to be monitored while on that.
I also use oxymorphone for sedation and sometimes as the sole sedative for simple procedures like biopsy. It is an opiod and therefore it can cause respiratory depression, which means that the dog needs to be constantly monitored. There is a reversal agent called Naloxone that will reverse the effects of the drug and works quite well.
I will always put the dog on gas for a fairly short procedure. Isoforane is a gas of choice since it has fewer side effects. Halothane is still being used by some veterinarians. I do not use it since it (just like xylazine) sensitizes the heart which can cause irregular beats. But, as long as the dog is properly monitored, there should be no problem.
Prior to ANY anesthesia in any aged animal, I require a pre-anesthetic blood work up. I get a PCV (monitors whether anemic or dehydrated), a BUN (monitors liver and kidney function), Creatinine (monitors kidney function), ALT (monitors liver function), Alkaline phosphates (monitors liver and the biliary system), Total protein (monitors the immune system and hydration status), glucose and the electrolytes (sodium, potassium and chloride). I get these as I said even in young animals... It is just good medicine to know where the dog is prior to surgery and anesthesia so we will know how they will tolerate anesthesia. It is the base line. These test also guide me to my use of anesthesia. For example, if there is kidney damage I know to avoid drugs that have to go through the kidney to be eliminated from the body. The temperature is also monitored along with the heart by an EKG.
Atrophine was a drug that was used all the time as a pre-medication to dry up the saliva in dogs and cats and to keep the heart rate up. It is not used much anymore, or shouldn't be used in large and giant breeds. I don't use it in any breed anymore. Atrophine causes the gut to slow down and this is not good especially in the mastiff. I believe slowing the gut down predisposes the mastiff to bloating.
Routine spay or neuter. I hate the word ROUTINE used here because no surgery is routine. I used valium at .3 mg/kg and ketamine at 10 mg/kg IV and then I put the tube down the trachea and start the dog on isoforane gas anesthetic. I have not had problems with these in the mastiff.
OFA radiographs. I know many of you try to get OFA radiographs while the animal is awake. An unsedated animal is very hard to position correctly, but even more importantly OFA asks you to sedate the dogs. OFA believes that by not sedating the dogs, we're not getting good representative x-rays. I believe if the OFA radiographs are done with sedation, it would be very hard to miss a dysplastic animal. Depending on if the dog is going to go right home or stay in the hospital. I will use 2 anesthetics for each case. If the dog is staying, I use the valium/ketamine mixture and if the dog is not staying, then I use the propofol and then the dog is intubated. Just another added note. I always put an IV catheter in for a quick access to the blood stream in case something does happen and I need to give drugs quickly.
Cesearean Sections. The main goal here is to obtain the least sedation possible in the puppies. For the Ceaserain section, I utilize Propofol at a dose of 3 mg./ lb. or until I can get an endotracheal tube down the dog. If I had to choose a second choice I would give the bitch torbutrol and valium as a preanesthetic as described next and then intubate after masking down. I use torbugesic at .45 mg/kg and give it to the muscle. Then I give valium (.45 mg/kg) intramuscularly. We prep the bitch on the floor by shaving her belly and then when done, we put her on the table and mask her down. We put a large mask over her muzzle and turn the gas all the way until she is alseep enough to put the endotracheal tube in. While masking the bitch down, she may struggle since the dog thinks it is not getting oxygen, even though it is. The trick here is to get in and the puppies out ASAP. Propofol can also be used and I have had good results with it. The bitch is wide awake as soon as the last staple is in. I am comfortable with either one.
The Mastiff and the Thyroid
By Robin M. Smith, DVM
My bitch has dark brown spots on her flanks, what is it? My dog hardly eats anything and she or he is still overweight, why? My bitch does not seem to have normal cycles and I can't get her bred, why? My bitch was bred and confirmed pregnant by ultrasound but on her recheck at 30 days, the ultrasound showed evidence of resorption, why?
Many of you have had these same questions and are looking for answers. I believe there can be a multitude of causes for these problems and by all means your veterinarian is the first one for you to ask about your concerns. One of the causes for all of the above problems can be abnormal thyroid function. While I will talk about the thyroid and the diagnosis of thyroid problems and the treatment, I again prevail to you to seek your veterinarian's advise before doing anything. Sometimes, even if what I talk about is to you what you think is the exact think happening to your dog, you could create more of a problem by not getting it accurately diagnosed.
Hypothyroidism is a syndrome characterized by deficient thyroid hormone secretion that can readily be treated with synthetic thyroxine (T4). Once the diagnosis is established, virtually all clinical signs and related disturbances can be completely reversed by T4 replacement therapy. In a small percentage of cases (5%), however, reduced thyroid function occurs as a result of a more serious condition and recognition of the cause is at least as important as documentation of deficient thyroid hormone secretion.
Hyperthyroidism is rare in the dog and will not be considered here.
Hypothyroidism in most dogs result from progressive loss of functional; thyroid tissue due to a primary problem with the gland. In the dog, there are two distinct mechanisms of thyroid destruction: lymphocytic thyroiditis, which is probably an autoimmune disease, and idiopathic (meaning "unknown") atrophy, in which the thyroid gland is replaced by fat and connective tissue. There are other less common causes which will not be discussed here, since the above accounts for about 95% of the cases.
Although not proven, genetic factors may play a role in the origin of hypothyroidism. In a major study in 15 U.S. and Canadian veterinary teaching hospitals, the mastiff was not among any of the dogs tested. In this test, strong evidence for genetic transmission of thyroid pathology in dogs was found in data from selected groups of laboratory Beagles, in which that cause was lymphocytic thyroiditis. These dogs showed a higher frequency of autoantibodies (antibodies produced against oneself) to some thyroid molecules. Therefore, although good data conclusively demonstrating breed predisposition to primary cause, idiopathic atrophy, has not been linked to being heritable, it is hard to suggest sterilizing a dog unless the thyroid is biopsied and the diagnosis of lymphocytic thyroiditis is obtained. Also, the onset of canine hypothyroidism usually occurs later in life, after producing many puppies. With the advent of new diagnostic techniques, like the testing for autoantibodies, we may be bale to determine without surgical intervention, whether or not one is dealing with lymphocytic thyroiditis or idiopathic atrophy. I will deal more with the diagnostic in a later paragraph.
The clinical signs of hypothyroidism can be subtle to being very overt. Signs include mental dullness (your dog may not be as dumb as you think), exercise intolerance, lethargy, poor hair coats, hair coat color change, hair not regrowing when shaved (especially noticed after a surgery), infertility, irregular estrous cycles, resorption of fetuses after bred, neurological problems, bradycardia (slow heart rate), and cardiac arrhythmias (abnormal heartbeats). Not all of these symptoms will be seen, but whenever a breeder has a problem with reproduction, the thyroid should be examined.
Thyroid function and reproductive function have many interaction, any of which are not fully understood. In dogs, it has been shown that thyroxine (t4) is significantly higher during pregnancy that in any other reproductive rate. We usually think of the females when we speak of reproductive problems, but males are affected also. Affected dogs have decreases testicular size and lower fertility than nonaffected dogs. Poor semen quality has also been reported. Infertility, prolonged anestrus, short estrus, and poor libido are reportedly associated with hypothyroidism in bitches. An increased occurrence of abortion, stillbirth, resorption and mummified fetuses have been reported also. But, it has also been found that reproductive dysfunction is NOT always found in hypothyroid bitches. In human women, hypothyroidism has been shown to cause irregular cycles, including ovulation failure or cessation of cycles. When conception did occur, spontaneous abortion, low birth weight, and fetal death were common. It has been shown that pregnant women with clinical signs of impending spontaneous abortion who later did abort had lower T4 and T3 levels.
Where does all this leave us? Now that we know the thyroid can cause a lot of problems, what do you need to do? My recommendation, as a mastiff breeder whom is a veterinarian, is to have your dogs thyroid tested. The best place to send the thyroid tests at this time is Michigan State University. The reason I recommend testing all your dogs is that we do not have enough information on mastiffs on what is normal or abnormal. I have encountered bitches that have undergone resorption of fetuses, or low fertility tests. I have also had dogs with the typical dark skin patches on the flanks have normal thyroid function tests. In all these dogs, I have explored as many possibilities as I could to find other causes and have found none. After supplementing these dogs with thyroxine, the symptoms disappear and the bitches get bred and maintain their pregnancies. I am not saying we should just arbitrarily put dogs on replacement therapy, but I am saying we need to look at what is "NORMAL" for the mastiff breed. I believe if a particular breed or line of breed has demonstrable signs of thyroid abnormalities, and all other causes have been eliminated, that maybe we need to look at an alteration of "normal range" for thyroid function tests in that breed.
This is not the place to go into the physiological aspects of thyroid function. But I will say that there are more thyroid function tests than just the "T4" that many people test for. The actual thyroid hormone that is active in the body is T3. There is also reverse T3, free T4, bound T4, free T3 and bound T3, and circulating antibodies that can be measures and can help in diagnosing the problem. Michigan State tests all of these and give a good overall view of what is happening. A very important test, the antibodies produced, is important to know since these are often generated in association with lymphocytic thyroiditis, which we spoke of as possibly being hereditary. There is ongoing work to identify other important molecules, as TSH which once identified will lead to a new generation of thyroid diagnostic tests.
When diagnostic tests do not provide a cleat diagnosis, thyroid replacement therapy has been suggested as a valid diagnostic step in an animal suspected to be hypothyroid. Again, every attempt should be made to rule out nonthyroidal illnesses using history, physical examination, routine laboratory, and other appropriate testing before doing this. Your veterinarian is the best judge for this trial.
I believe that we have a lot to learn about the mastiff and the thyroid problems encountered in the breed. I am trying to collect information on as many mastiffs as I can and their thyroid profiles. Again, one must know what the :normal" is before we can diagnose the abnormal. I would appreciate your input and any thyroid test information that you have on your dogs as I am trying to put together information. The more I have, the more valid the information and the more we can all learn from it. If anyone has any questions regarding thyroid problems or would like more information, please feel free to contact me. Again, I am learning also and some of you have had much more experience with the breed and their particular problems.
Everything You Always Wanted To Know About Whelping
(And Were Afraid To Ask...Because Everyone Has A Different Answer)
By Robin M. Smith, DVM
As a veterinarian, I had courses in Theriogenology or the study of animal reproduction, so I figured I knew all there was to know about dogs and whelping. I knew that for the most part, dogs don't need intervention in their whelping and that the bitch would always take care of the puppies and the people would have little to worry about because nature takes care of her own. I even lead my early clients into believing this because I truly believed it.
Well....In the perfect world, I am sure there are perfect bitches that are perfect whelpers and have perfect puppies and have no trouble at all. Unfortunately, I do not live in this perfect world and most of us do not. We live in the world of Mastiffs....And while I must say, the mastiff is truly the perfect dog, they are also very reliant on us, their humans to take care of them and that means knowing all of their idiosyncrasies. That, my friend is the reason for this article. Over the years that I have been involved with mastiffs, I have found that contrary to all of my veterinary knowledge, they are truly a unique breed. I know many of you have learned the hard way how truly different our mastiffs can be and I do not want to have you change your ways at all. I hope to be able to give some of you helpful information that I have gathered over the years from working with mastiffs and whelping litters of mastiffs in combination with my veterinary background.
In veterinary medicine, we are taught that the normal length of pregnancy is 58-72 days after the mating. Most or all of our breeding in mastiffs are planned breedings and we breed several times to optimize the chances of pregnancy. I usually count the days from the first mating and the last mating and count forward 60 days. This gives me a window to work with. So I will have a window of about 5 days. Over the years, I have learned that some mastiff bitches just do not want to go into labor, and for that reason, I keep an accurate count. A very accurate way to determine due date is if you know the LH peak. With many of us doing progesterone testing and LH testing to optimize breeding, many times we do know this. If it is known, then whelping should occur consistently by days 64-66. I do not want her to go over her due date more than 2 days (or 48 hours) or I will automatically do a caesarian section. I know there are controversies about this and I do not want to get into them here. There are some more less accurate ways to tell when impending labor is close. The "stand by" temperature dropping has not been very reliable to me. Others talk about abdominal enlargement...well, in a mastiff, who can tell this? Other changes are mammary development...again, our mastiffs are great ones in the "false Pregnancy" department, so this is not reliable. Loss of appetite...A mastiff? I do not find this a good indicator either. Some talk about behavioral changes....again, I say..A Mastiff? With behavioral changes? That is every day life...Ha!. While all of these can be indicators of impending labor, I do not put a lot of stock into them. I will use progesterone levels sometimes. The progesterone will drop below 2 ng/ml about 24 hours prior to whelping. The problem is that all of the in-house progesterone kits can not distinguish between 2ng/ml and below 2 ng/ml...and a bitch can actually maintain her pregnancy at 2 ng/ml. So, since the progesterone would have to be sent off and the results not received until 24 hours later...this may not help. I think the best thing to do is to get an exact window for labor and have the bitch watched constantly during this time. And if the pregnancy goes over day 63, I recommend a C-Section.
First, lets discuss the whelping area for your bitch. It should be in an area where there is no draft. Some means of artificial heat is needed. I use a "no chill" lamp in an overhead lamp approximately 4 ft. above the nesting area. Just be very careful the bitch cannot be burned. Some people use hot water bottles for heat and cover them with towels. Bedding should be something that is easily cleaned. I prefer to buy the linoleum sheets for floors and then cover them with bathroom rugs and towels because the backing on the bathroom rugs allows for good footing but they are also easily washed. Some people use shredded newspapers on top of that. The whelping box should be in an area of low traffic.
Okay...we now have your bitch in the whelping box in active labor. How long to wait....what needs to be done...and how do I know if she is in trouble are the questions I get asked.
The first stage of parturition is the 2-3 days prior to whelping and is when the bitch is restless and shows nesting behavior. The beginning of straining, or the appearance of fetal fluid or a pup at the vulva, marks the change from first to the second stage. During the first stage, the bitch may shiver, vomit, begin panting, bite at flanks, lick her vulva and generally feel uncomfortable. All what I have just mentioned are textbook pregnancies. From my experience with mastiffs, I find they do not exhibit all of these signs. In fact, I have seen some mastiff bitches look absolutely comfortable one moment and the next moment...out comes a puppy and she didn't even look like she was in labor. I think that this has to do with the size of the mastiff. Because of their large bodies, the uterus may be contracting but it is not very visible to the outside of the dog. That is why I always have someone watching the bitch all of the time. I have even known a mastiff bitch that went outside to potty and squatted and it wasn't urinating, it was having a puppy. So always, be alert and one good rule of thumb...carry a flashlight with you at night when walking a bitch that is due to whelp.
Now we are in the second stage of labor....this is where there is the amnion (water bag) of the first pup coming out of the vulva. (This is where owners start panicking). It doesn't make a difference if the head comes out first or the tail. Both are considered normal in the bitch. I will first discuss this stage as though the world were perfect and our mastiffs never had any trouble whelping at all, then we discuss things that happen in the "hell birth". After the birth of the pup, the bitch will lick and rupture the amnion, and rupture the umbilical cord. Further licking will help to dry the pup and stimulate it. The bitch will usually try to eat the placenta and from experience, they are very quick to go for it. It is not necessary that she do so and it will cause diarrhea later, so I try to discourage it (fight her for it). The interval between puppies is variable. Hopefully, you have had a radiograph about a week or so prior so you know how many puppies to expect. It is often difficult to decide when a problem has arisen; but as a rough guide, unproductive straining for 30 minutes may indicate an obstruction, although a normal pup may be born after this time. If more pups are expected and the bitch is restless, will not let the pups suck for long, but is not straining, about 2 hours may elapse without trouble ensuing. I do not let the bitch go over 2 hours before intervention.
I find that many of our mastiff bitches do not have to have hard labor in order to get into trouble. My theory is that with large litters, the uterus will do fine contracting for a few births and then it wears out and trouble may ensue. With small litters, there may not be enough hormonal stimulation to finish whelping. I am very pro-caesarian section due to these situations. I have been involved in many mastiff whelpings and have found that in large litters, the bitch may do great delivering the first 4 or 5 pups but then never has any more contractions, or has contractions and nothing happens. I have taken these bitches to surgery at this time and in a few of them I have found their uterus has become very stretched and on the verge of rupturing. And the time it takes to get the bitch loaded up and into surgery in my case, since I am a veterinarian, is not very long. But for most of you, it would involve calling your vet, etc. and this can take time. While I know a lot of you think that C-sectioning is not natural and is promoting "bad" breeding animals, I must disagree. But, everyone must do what he or she feels is the best especially for the bitch. My feeling is that we are manipulating the breeding already by selecting the parents and breeding at optimum timing, etc. so we are already taking a lot away from nature in the first place. Again, I am not here to argue c-section or not, I am just letting you know when I intervene and when I get worried. I am sure you all have very good veterinarians and hopefully have good relationships with them so as to be able to call them when you are worried.
Again, what I described above as the second stage of labor is the textbook case. The bitch doing all the work. Well, if you have lived around mastiffs enough, you know they hate to work and they look at us with those big brown eyes and say, "Help me...I have no idea what is going on". So we do. I am sure some of you have experienced whelpers who are textbook..great...I envy you. But I have found that when the first pup is born, many mastiffs just look at it and go...what now? I will remove the sac from around the puppy and I will tie off the cord with thread. If the bitch is willing, I will let her lick and stimulate it. But, as many of you know, sometimes the puppy is not breathing well or is very full of fluid so we must intervene. I vigorously rub the puppy with a towel and hold it upside down while doing this to expel fluid from the mouth and nose. I know many of you use the "fling" technique where you hold the puppy firmly with head down in-between your hands then "fling" the puppy downwards in attempts to expel fluid from the lungs. This is a great method, UNTIL you fling a puppy across the room. SO, I now use the "puppy aerobic" method that was taught to me by a close friend and long time bullmastiff breeder. I hold the head of the puppy in one hand and the butt in the other with the legs downward or facing the floor and "bend" the puppy. I do this very rigorously. This will cause the diaphragm to push on the lungs and expel fluid. It also makes them squeak which is a noise I like to hear. If needed, I always have some dopram (a respiratory stimulant) on hand and put a few drops under the tongue just in case. As you are aware by now, mastiff breeders are really weird people. At least that is what I have been told about myself because I have been known to put my mouth around the puppies nose and mouth and suck out some of the fluid when a puppy gets in trouble. It is not for the faint at heart, but works great. Remember, nobody said this would be easy. I then put the puppy on the mom to suckle, as the suckling will stimulate contractions. Be careful though and supervise the mom always, they can get nippy and aggressive to the puppy. They can also bite the pup too hard.
I also will put a ribbon around the puppy, weigh it and sex it prior to putting it on the mom.
As I stated, it is not a perfect world and we do get into trouble at times with our mastiffs. Dystocia is termed as any problem, which interferes with normal birth. The two most common causes of dystocia are obstructive and primary uterine inertia. Obstructive dystocia is any problem, which causes unproductive straining; due to malpositioning of a pup, fetal oversize or a blockage in the reproductive tract. Each of these requires a C-section. DO NOT LET UNPRODUCTIVE straining go longer than 30 minutes.
Primary uterine inertia is the absence of uterine contractions. The uterus relaxes but pups do not enter the vagina and there is not sign of parturition-IF untreated the puppies will die. The cause is unknown but may be due in our mastiffs to small number of pups, thereby producing inadequate stimulus to initiate parturition. Or a very large litter causing overstretching of the uterus and preventing myometrial (uterine) contractions. That is why it is so very important to know the correct date for whelping.
There is also secondary uterine inertia, which I have encountered in mastiffs. This is the cessation of uterine contractions after they have started, presumably due to exhaustion of the uterine muscle. Sometimes this is the hardest to diagnose since there is normally some uterine relaxation after delivering a puppy. Just how long is too long? If it goes over 2 hours or if the next pup is dead, I immediately take to surgery. Also if the last puppy out had a lot of fluid in the lungs or was already out of the sac when it was delivered and I do not have another puppy within 30 minutes to maybe an hour, I take to surgery. This could mean that there is premature separation of the placentas and the puppies are getting into trouble.
If there is nonproductive straining for a period of 30 minutes but no longer than 1 hour, I take action. The first puppy may live for 6 hours after the onset of straining, but subsequent puppies usually die if they are not delivered after 1-2 hours of straining. So, if you wait 2 hours, it may already be too late, that is why I only give a 1 hours maximum time and usually I am on it in 30 minutes. What to do? I will put on sterile gloves and exam the vagina. If nothing is felt in the vagina-I do a C-section. If amnion (sac) felt, I will push up on the abdomen with my other hand and stimulate the dorsal wall of the vagina, which can cause contractions. If there is a puppy stuck, I will do a C-section. If I can feel the puppy and am pushing on the abdomen with my other hand, I can sometimes manipulate the puppy into position. I will sometimes push the puppy back into the uterus and this may be all that is needed to get the puppy turned correctly. I will sometimes grab the mouth and gently...GENTLY pull on it to see if I can help extract it. Pulling on the legs or the tail will many times disarticulate the limbs or tail. I do a C-section if no progress is made in 15 minutes or the bitch becomes distressed or there are a lot of pups left in the uterus. Only attempt this if you are experienced. You can really cause some serious vaginal trauma if you are not careful.
Some people advocate the use of oxytocin. I do not. If no pups have been born, you cannot determine if the cervix is open or not in our mastiff bitches. Their size alone does not allow for palpation of the cervix. This can only be determined by endoscopy. If you give oxytocin to a bitch with a closed cervix, you can cause fetal death or even uterine rupture. Oxytocin causes the uterus to contract very violently. I have seen the use of oxytocin cause uterine inertia. I do not use it anymore. What if a placenta does not come out with each puppy? The placenta is usually passed within 20 minutes of each puppy. Retention of placentas is suspected if a green/black discharge persists after parturition. If suspected, this is the one time I will use oxytocin to get the membranes expelled. I will also put the bitch on cephalexin 10 mg./lb twice a day for 10 days. If the discharge continues, you may need to have your bitch ultrasounded to make sure that a pyometra isn't developing.
Caesarian sections are becoming more popular so as to avoid problems during whelping. I will tell you how I perform them. I will shave and prepare the bitch's abdomen prior to anesthetizing. I put an intravenous catheter in. I use propofol injectable for induction purposes. It is a drug that has been used a long time in human medicine and has just become popular in veterinary medicine. Propofol is metabolized primarily in the lungs so it has a very short half-life in the dog. It causes minimal depression in the puppies. I give it at 3 mg/lb. or at least that is the dose I draw up. I give it to effect. In other words, I give enough of it to allow putting an endotracheal tube into the dog so I can hook them up to gas anesthesia; notably, Isoforane. I then surgically enter the abdomen and bring the uterine horns out of the body. I make as many incisions into the uterine wall as needed to get the puppies out. Veterinarians are taught to "milk" the puppies out of one incision in the body of the uterus. I find that a mastiff puppy cannot easily be "milked" and may tear the uterus trying. I have not found any problem with multiple incisions. And on subsequent C-sections in bitches, I have not seen adhesions being a problem. I will remove the sac from the puppy and clamp the cord and hand the puppy to an assistant who them ties the cord and works on the puppy. Each puppy is treating in this fashion. I also make sure that I remove all placentas. After removal of all puppies, I will suture all incisions in an inverting manner with 2-0 PDS suture material. I then flush the abdomen copiously with warm saline and then I inspect the rest of the abdomen since I am in there. I then close the abdomen routinely. The bitch is recovered fairly quickly and we put the puppies on her to suckle once before transporting home.
I also monitor the bitch on an EKG and pulse oximeter while in surgery. I will also run 1 Liter of fluids during the surgery. I always put the bitch on antibiotics afterwards.
None of the treatments mentioned in this article are absolutes. Each bitch is different and will react differently to being pregnant. I cannot stress enough the importance of a good veterinarian relationship when you are breeding mastiffs. While mastiffs are dogs, they are unique in some of their problems due to being giant breed dogs. Working with your veterinarians will be a learning experience for both of you. If your veterinarian isn't willing to talk with you about your concerns, find one that will. Don't wait until your bitch is in trouble to talk to your veterinarian. Make them aware of what you are doing and make sure they are available or have someone who will be during this time. It is stressing enough to have puppies, let alone having to find a veterinarian at the last minute if trouble occurs.
Progressive Retinal Atrophy
Progressive Retinal Atrophy (PRA) is a family of inherited progressive degenerative eye diseases affecting the retina which ultimately result in blindness. Typically the first symptom of PRA is night blindness followed by increased reflectivity of the fundus or a "green sheen" to the eyes when viewed in dim light.
There are several recognized forms of PRA some of which now have DNA gene or marker tests. Mastiffs now have a DNA gene test. These tests enable breeders to send in a blood sample and determine whether or not a dog has PRA, is a carrier of PRA, or is clear (has none of the genes for PRA) before the dog is old enough to develop symptoms. This also allows breeders to plan breedings that they can guarantee will not produce any pups that will be affected by PRA.
What is DNA Profiling?
Buried within the DNA of each and every individual is a special DNA signature that can be used to uniquely identify that individual. DNA profiling is the name given to the technique that has been developed to reveal this DNA signature. Initially, DNA-based approaches to identifying individuals were pioneered in humans, but the same technology has easily been transposed to the dog. Nowadays, special sequences found in DNA called microsatellites are used to build up this DNA signature. Microsatellites have become the system of choice for DNA profiling and genetic testing in humans. The US Armed Forces, FBI, Scotland Yard, The Royal Canadian Mounted Police and multiple forensic laboratories use microsatellites for their forensic, paternity and individual identification tests. The reasons that have made them come to the fore in humans are the very reasons that currently make them the system of choice for dogs.
The technique essentially involves preparing a DNA sample from an individual dog. For this we need to obtain some tissue from the dog in order to prepare the DNA. The ideal source of material would be a blood sample which will permit us to isolate DNA from the white cells; this however requires a vet to take the sample of blood before passing it onto the laboratory for testing. Less invasive techniques which don't require veterinary intervention have therefore been sought to make the procedure more convenient. One alternative source of tissue are the cells that can be easily removed from the inside of a dog's cheek, called buccal cells.
In this case all that is required is to gently rub a small plastic brush against the inside of the cheek to remove the buccal cells. The brush, containing the cells can then be returned to the laboratory for analysis. DNA can be made from both tissue sources, although considerably less DNA is provided by the buccal cells because they are considerably fewer in number.
Once isolated, the DNA can then be treated to reveal the individual-specific DNA signature. Several laboratories throughout the world have been using this technique successfully for a number of years. Many of you will have read in the dog press of the American Kennel Club's pilot study on DNA profiling which has recently been concluded. This particular study used the microsatellite-based DNA profiling that we intend to use on the Staffordshire Bull Terrier pilot study.
What can DNA profiling offer? Well, as I have explained, the DNA signature that is revealed can uniquely identify an individual dog. However, the profile is not just a means of identification because it also carries within it information on the parents of the dog. This is because a puppy inherits half of its DNA from its mother and the remaining half from its father. This essentially means that half of the components that make up the profile are maternal in origin and the other half paternal. So it is in these two areas that profiling has impact: individual identification and parentage verification.
The DNA profile is the ultimate in individual identification and offers a 'tamper-proof' means of identity. The profile need only be produced once and the DNA sample used to produce it can be stored as a permanent DNA record throughout the dog's life. Identification could be essential in a number of instances. For example, the availability of a profile could be used to identify an animal that may have been lost or stolen, and subsequently recovered. The profile could also be used to check the authenticity of a DNA sample being used to screen for the presence of disease-causing genes. Many such tests are being developed and it would be invaluable to be able to verify that the correct dog's DNA is being tested for the presence of the deleterious gene. Repeating the DNA profile on the same sample of DNA being used to carry out the gene test would be straightforward and prove conclusively that the correct animal is being tested.
Provided that the DNA profiles of both parents are available, pups in a litter can be profiled and their profiles checked with their parents' profile to verify that the correct parents have been registered. This will ultimately have commercial value in that it puts a premium on those litters that have been analysed by DNA profiling.