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Hernias

Horner's Syndrome

Hypothyroidism

Hip Dysplasia


Hernias

 

A hernia is a bulge of tissue or bodily organ that has passed through a tear or defect in a muscular wall. In dogs, the four most common types of hernias include umbilical hernias, inguinal hernias, perineal hernias and diaphragmatic hernias.

Umbilical hernias are the most common and occur on the midline of the stomach at the belly button.

Umbilical hernias pose no real health problems since fatty tissue is usually the only item that protrudes through the opening. These hernias can occur with both male and female dogs.

 

Inguinal Dog Hernia 

Inguinal hernias occur where the abdominal muscles meet that of the hind legs. They occur as birth defects or due to injury.

These hernias are more serious than umbilical hernias because the intestines can protrude, disrupting the normal digestive process. Replacement of the herniated material and suturing the tear or defective muscle must be done to correct this type of hernia.

 

Perineal Dog Hernia

Perineal hernias occur due to a weakening of the muscles located beneath the tail on either side of the anus.

These hernias usually occur in older dogs and can cause impactions and elimination problems if they are not corrected. Female dogs are not usually affected by this type of hernia.

 

Diaphragmatic Dog Hernia

Diaphragmatic hernias are the most serious type of hernia. A tear or rupture of the diaphragm, the wall of muscle that separates the chest cavity and lungs from the abdomen, can allow the intestines, liver or other vital organs to enter into the chest cavity.

This type of hernia can be congenital (your pet is born with it) or result from an injury such as a road traffic accident.

Breathing difficulties, weakness, and intestinal problems can occur and must be surgically corrected. X-rays are the only sure diagnosis of this hernia, but after repair the dog can resume a normal life.

 

Horner's Syndrome

Horner's Syndrome is a group of signs that occurs when specific muscles of the face lose their stimulation by certain nerves. It is caused by some type of injury to, or lesion of the nerves.

The injury may occur at the level of the brain, upper spinal cord, or between the spinal cord and the face. In the dog, the most common causes are:

  • Idiopathic (cause unknown)
  • Car accidents with trauma to the head, neck, or chest
  • Bite wounds
  • Intervertebral disc disease in the neck area
  • Infections of the middle ear
  • Disease of the orbit (area behind the eye)
  • Cancer involving the brain or chest
  • As a result of a treatment (e.g. ear cleaning) or medication

For an unknown reason, Horner's Syndrome appears to be more common in Golden Retrievers. Approximately 40-50% of the cases of Horner's Syndrome in dogs are idiopathic ie of no known cause.

Signs

The classic signs of Horner's Syndrome occur on the same side of the face as the injury, and include:

  1. Small pupil size (miosis)

  2. Protrusion of the third eyelid

  3. Drooping of the upper eyelid (ptosis)

  4. Sunken appearance to the eye

  5. Dilation of blood vessels on affected side of the face, which makes the area feel warmer to the touch

How is Horner's Syndrome treated?

Depending upon the location of the injury, phenylephrine eye drops are administered to relieve the clinical signs. The underlying cause such as a bite wound or middle ear infection should be treated. In cases of idiopathic Horner's Syndrome, the condition often resolves after 6-8 weeks. Horner's Syndrome caused by injuries to nerves outside of the brain and spinal cord generally have a better prognosis.

 

Hypothyroidism

Hypothyroidism is a common problem in dogs. The thyroid gland has a number of different functions, but it is most well known for its role in regulating metabolism. Hypothyroidism is the condition that occurs when not enough thyroid hormone is produced.

Hypothyroidism causes a wide variety of symptoms, but is often suspected in dogs that have trouble with weight gain or obesity and suffer from hair loss and skin problems.

Hypothyroidism is easy to diagnose with a blood test that checks the level of various thyroid hormones in the blood. Most hypothyroid dogs respond readily to treatment with synthetic thyroid medication.

Many dogs suffer from a low thyroid hormone level for years without treatment. If your dog has a long term recurrent skin problem, she may be suffering from hypothyroidism.

Although the onset of clinical signs is variable, hypothyroidism most commonly develops in middle-aged dogs between the ages of 4 to 10 years. The disorder usually affects mid to large size breeds of dogs, and is rare in toy and miniature breeds of dogs.

There does not appear to be a sex predilection but spayed females appear to develop it more often than intact females.

One of the best things about this disease is that it is easily and relatively cheap to treat. Treatment consists of putting the dog on a daily dose of synthetic thyroid hormone called thyroxine.

A dog is usually placed on a standard dose for his weight and then blood samples are drawn periodically to check his response and then the dose is adjusted accordingly.

Once therapy is started, the dog will need to be on treatment for the rest of his life. Usually after the treatment is started, the majority of the symptoms resolve.

 

Hip Dysplasia

Canine hip dysplasia is a very common degenerative joint disease seen in dogs. Hip dysplasia results from the abnormal development of the hip joint in the young dog. It may or may not be bilateral, affecting both right and left sides.

Most dysplastic dogs are born with normal hips but due to genetic and possibly other factors, the soft tissues that surround the joint start to develop abnormally as the puppy grows.

The most important part of these changes is that the bones are not held in place but actually move apart.

The joint capsule and the ligament between the two bones stretch, adding further instability to the joint. As this happens, the surfaces of the two bones lose contact with each other.

Dogs of all ages are subject to the symptoms of hip dysplasia and the resultant osteoarthritis. In severe cases, puppies as young as five months will begin to show pain and discomfort during and after vigorous exercise.

The condition will worsen until even normal daily activities are painful. Without intervention, these dogs may be unable to walk at all by a couple years of age. In most cases, however, the symptoms do not begin to show until the middle or later years in the dog's life.

Who gets Hip Dysplasia ?

It is primarily a disease of purebreds although it can happen in mixed breeds, particularly if it is a cross of two dogs that are prone to developing the disease.

German Shepherds, Labrador Retrievers, Rottweilers, Great Danes, Golden Retrievers, and Saint Bernards appear to have a higher incidence, however, these are all very popular breeds and may be over represented because of their popularity.

On the other hand, Greyhounds have a very low incidence of the disease.

What are the risk factors for the development of hip dysplasia?

If a parent has hip dysplasia, then the offspring are at greater risk for developing hip dysplasia.

Some researchers feel that genetics are the only factor involved, where others feel that genetics contribute less than 25% to the development of the disease. These factors include:

  • Nutrition - Overweight dogs are at a much higher risk. Another factor that may increase the incidence is rapid growth in a puppy during the ages from three to ten months.

  • Exercise - Exercise may be another risk factor. It appears that dogs that are genetically susceptible to the disease may have an increased incidence of disease if they are over-exercised at a young age. But at the same time, dogs with large and prominent leg muscle mass are less likely to contract the disease than dogs with small muscle mass. So exercising and maintaining good muscle mass may actually decrease the incidence of the disease. Moderate exercise that strengthens the gluteal muscles, such as running and swimming, is probably a good idea. Activities that apply a lot of force to the joint are contraindicated.

How is hip dysplasia treated surgically?

  • Triple Pelvic Osteotomy (TPO) - TPO is a procedure used in young dogs usually less than 10 months of age that have radiographs that show severe hip laxity, but have not developed severe damage to the joints.
  • Total Hip Replacement - may be the best surgical option for dogs that have degenerative joint disease as a result of chronic hip dysplasia. Total hip replacement is a salvage procedure that can produce a functionally normal joint, reduce degenerative changes, and help with joint pain.
  • Femoral Head and Neck Excision - Femoral head and neck excision is a procedure in which the head of the femur is surgically removed and a fibrous pseudo-joint (fake joint) forms. This procedure is considered a salvage procedure and is used in cases where degenerative joint disease has occurred and total hip replacement is not feasible.
  • Pectineal Myectomy - This is a somewhat controversial treatment for patients with chronic hip dysplasia. The pectineus is one of the muscles attaching the femur to the pelvis. By cutting and removing this muscle, the tension on the joint and joint capsule are reduced. This offers some pain relief for some patients, but does not slow the progression of the disease.

How is hip dysplasia treated medically?

  • Weight Management - Weight management is the first thing that must be addressed. All surgical and medical procedures will be more beneficial if the animal is not overweight. You, as the owner, have control over what your dog eats. If you feed an appropriate food at an appropriate level and keep treats to a minimum, your dog will lose weight.
  • Exercise - It is important to exercise daily; only exercising on weekends, for instance, may cause more harm than good if the animal is sore for the rest of the week and reluctant to move at all. Warming the muscles prior to exercise and following exercise with a "warm-down" period are beneficial.
  • Warmth and good sleeping areas - Most people with arthritis find that the signs tend to worsen in cold, damp weather. Keeping your pet warm, may help him be more comfortable.
  • Massage and physical therapy - Your veterinarian can show you how to perform physical therapy and massage on your dog to help relax stiff muscles and promote a good range of motion in the joints. Remember, your dog is in pain, so start slowly and build trust.
  • Making daily activities less painful - Going up and down stairs is often difficult for arthritic pets, and for dogs, it can make going outside to urinate and defaecate very difficult. Many people build or buy ramps, especially on stairs leading to the outside, to make it easier for the dogs to go outside.
  • Medication - Medical treatment includes steroids, non-steroidal anti-inflammatory drugs and chondroprotective or structure modifying drugs.

How can hip dysplasia be prevented?

Prevention of hip dysplasia can be established in the following ways: Take on puppies from parents with low ‘hip scores’. Do not overfeed or over exercise your puppy. Do not use food supplements if your dog is on a complete food.

What is the Hip Scoring Scheme?

The Hip Scoring Scheme - This is a scheme which was set up by the British Veterinary Association and the Kennel Club, about 30 years ago to try and reduce the incidence of hip dysplasia in dogs.

It is intended to help breeders choose good breeding stock. Dogs must be x-rayed, under general anaesthesia and under strictly controlled circumstances, to get a good view of the hip joints. Specialist radiographers give each dog a hip score.

This is a number, ranging from 0 to 106, the lower the better. Only dogs with hip scores well below the average for the breed are advised to be used for breeding purposes. Ask your vet for further advice on this hip scoring scheme.