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October 2017 – PBGVCA Health Committee Reference Center

Reproduction Link Resources

Canine Genetics for Dog Breeders: Part 1
By Dr. Matthew Breen, Jun 15, 2018 Learn more

The Ins and Outs of Pedigree Analysis, Genetic Diversity, and Genetic Disease Control, Author: Dr. Jerold Bell  Learn more

Progesterone Testing and Ovulation Timing
Source: Canine Semen Bank of Columbus Learn more

A Beginner’s Guide to COI (Coefficient of Inbreeding)
Dog Breed Health: A Guide to Genetic Health Issues for Dog Breeds
Written by Jemima Harrison: Learn more

Inbreeding – using COIs (Coefficient of Inbreeding)
The Kennel Club: Learn more

Population analysis of the Basset Griffon Vendeen (Petit) breed
The Kennel Club, September 2015: Learn more

Basset Griffon Vendeen (Petit)
Dog Breed Health: A Guide to Genetic Health Issues for Dog Breeds
Learn more

Canine Infertility·· A Silent Threat – Mycoplasmia Infection
By R.M. Brown, D.V.M . Learn more

Test for this Hidden Killer Before Breeding
By Susan Chaney, Posted in: Canine Health, Right Now! | March 1, 2012
Brucellosis could easily be called the AIDS of the dog world. Although not as common, it is more easily spread, is always fatal to puppiescarried by an infected bitch and has no cure. Learn more

Gonadectomy – Rethinking Long-Held Beliefs (2018)
Canine Sports Productions – www.caninesports.com
Those of us with responsibility for the health of dogs need to continually read and evaluate new studies to ensure that we are taking the most appropriate care of our canine companions. This article reviews scientific evidence that, taken together, suggests that veterinarians and dog owners should revisit the current common recommendation that all dogs not intended for breeding have their gonads removed at or before 6 months of age…   Learn more

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Zoetis Receives USDA License for CYTOPOINT™

December 21, 2016 Source: Zoetis

  • First monoclonal antibody licensed to help control the clinical signs associated with atopic dermatitis in dogs
  • Targets and neutralizes interleukin-31 (IL-31), a key itch-inducing cytokine (protein) in canine atopic dermatitis
  • Provides convenience and long-lasting relief from itch with one injection every four to eight weeks
  • Joins Zoetis’ APOQUEL ® (oclacitinib tablet), giving the company two targeted treatment options to offer veterinarians for canine patients with atopic dermatitis

PARSIPPANY, N.J.–(BUSINESS WIRE)–Zoetis Inc. (NYSE:ZTS) today announced that the U.S. Department of Agriculture (USDA) has granted the company a license for CYTOPOINT™, the first monoclonal antibody (mAb) therapy approved to help provide sustained control of the clinical signs associated with atopic dermatitis in dogs. CYTOPOINT targets and neutralizes interleukin-31 (IL-31), a key protein involved in triggering itch in dogs. It provides fast, effective relief of itching – the hallmark sign of the allergic skin condition atopic dermatitis in dogs – and offers the sustained efficacy and convenience of one injection every four to eight weeks. CYTOPOINT helps improve the long-term quality of life for dogs suffering from atopic dermatitis and eases the related frustration and concern of their owners. It is now available to all veterinarians in the United States

“As the owner of allergic pets, I understand the frustration that my clients feel, and as a person with allergies myself, I understand what my patients feel,” said Laura Stokking, PhD, DVM, DACVD, Veterinary Specialty Hospital, San Diego, CA.* “With CYTOPOINT, in a single injection we now have an excellent opportunity to help control the itch without leading to any secondary signs that can be more difficult to manage than the itch itself.”

“CYTOPOINT results from our acquiring a deeper scientific understanding of the causes of allergic skin conditions in dogs at the molecular level and developing novel, targeted, effective treatments based on these new insights,” said Dr. Catherine Knupp, Executive Vice President and President, Research and Development at Zoetis. “Veterinarians have told us that allergic dogs and their owners have a variety of needs and we are proud to offer them two innovative solutions with CYTOPOINT and with our oral tablet therapy APOQUEL. These first-in-class medicines give veterinarians effective, safe options to customize atopic dermatitis treatment for canine patients, and I am very proud of the breakthrough treatments our Zoetis team has developed.”

APOQUEL® (oclacitinib tablet) is the first Janus kinase inhibitor approved by the U.S. Food and Drug Administration for veterinary use to provide fast and safe itch relief for dogs at least 12 months of age that have symptoms associated with allergic dermatitis triggered by food, fleas or contact allergens, as well as atopic dermatitis.


CYTOPOINT is a ready-to-use, sterile liquid injectable containing a mAb specifically designed to target and neutralize cytokine interleukin-31 (IL-31), a key cytokine (protein important in cell-to-cell communication) involved in triggering the itch associated with canine atopic dermatitis. It works by mimicking the activity of natural antibodies to selectively bind and neutralize IL-31, thus interrupting the itch cycle in atopic dogs.

CYTOPOINT begins working within 1 day and delivers 4 to 8 weeks of relief from the clinical signs of canine atopic dermatitis, allowing the damaged skin the chance to heal. In clinical studies submitted to the USDA and published in Veterinary Dermatology, treatment with CYTOPOINT at a minimum dose of 2 mg/kg resulted in a significantly (P≤0.05) greater percentage reduction from baseline in pruritus on days 1–49, and skin condition scores on days 7-56(1), when compared to placebo.

It is safe for dogs of any age, even those with concomitant diseases, and can be used with many common medications. Moreover, because of its specificity in targeting IL-31, it has minimal impact on normal immune responses.

The USDA granted Zoetis a conditional license for Canine Atopic Dermatitis Immunotherapeutic (now branded as CYTOPOINT) in August 2015. During the conditional licensing period, Zoetis collected valuable feedback from dermatology specialists, a small group of general practice veterinarians, and pet owners to prepare for full licensure.

About Atopic Dermatitis

Itching is among the most frequent complaints of pet owners, affecting roughly 1 in 6 dogs whose owners seek veterinary help(2). There are a number of factors that can trigger an itch reaction, such as infections, allergies and parasites—and approximately 15-20 percent of all itchy dogs will be diagnosed with atopic dermatitis(2).

CYTOPOINT is now available for veterinarians throughout the United States. It brings mAb therapy – a fast-growing area of human medicine – for the first time to veterinarians for use to treat atopic dermatitis in canine patients. For more information, visit www.cytopoint.com.


Do not use APOQUEL in dogs less than 12 months of age or those with serious infections. APOQUEL may increase the chances of developing serious infections, and may cause existing parasitic skin infestations or pre-existing cancers to get worse. APOQUEL has not been tested in dogs receiving some medications including some commonly used to treat skin conditions such as corticosteroids and cyclosporines. Do not use in breeding, pregnant, or lactating dogs. Most common side effects are vomiting and diarrhea. APOQUEL has been used safely with many common medications including parasiticides, antibiotics and vaccines….

About Zoetis

Zoetis is the leading animal health company, dedicated to supporting its customers and their businesses. Building on more than 60 years of experience in animal health, Zoetis discovers, develops, manufactures and markets veterinary vaccines and medicines, complemented by diagnostic products and genetic tests and supported by a range of services. Zoetis serves veterinarians, livestock producers and people who raise and care for farm and companion animals with sales of its products in more than 100 countries. In 2015, the company generated annual revenue of $4.8 billion with approximately 9,000 employees. For more information, visit www.zoetis.com.

Forward-Looking Statements : This press release contains forward-looking statements, which reflect the current views of Zoetis with respect to business plans or prospects, future operating or financial performance, future guidance, future operating models, expectations regarding newly approved products and other products and other future events. These statements are not guarantees of future performance or actions. Forward-looking statements are subject to risks and uncertainties. If one or more of these risks or uncertainties materialize, or if management’s underlying assumptions prove to be incorrect, actual results may differ materially from those contemplated by a forward-looking statement. Forward-looking statements speak only as of the date on which they are made. Zoetis expressly disclaims any obligation to update or revise any forward-looking statement, whether as a result of new information, future events or otherwise. A further list and description of risks, uncertainties and other matters can be found in our Annual Report on Form 10-K for the fiscal year ended December 31, 2015, including in the sections thereof captioned “Forward-Looking Information and Factors That May Affect Future Results” and “Item 1A. Risk Factors,” in our Quarterly Reports on Form 10-Q and in our Current Reports on Form 8-K. These filings and subsequent filings are available online at www.sec.gov , www.zoetis.com , or on request from Zoetis.

* Dr. Laura Stokking has a consulting relationship with Zoetis.

1 Data on file, Study Report No. C863R-US-12-018, Zoetis LLC.

2 Data on file, IL-31 Positioning Research. IPSOS 2014. L-31 Pricing Research. SKP. 2015, Zoetis LLC.

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General Interest Link Resources

The Simple Dollar: A comprehensive listing of pet financial aid organizations for pet owners in need by Brian Robson Learn more

Vaccine Issues and WSAVA Guidelines 2015-2017
Published by DR. Jean Dodds’ Pet Health Resource Blog Learn more…

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Respiratory (nose, larynx,trachea, bronchi, lungs) Link Resources

Centers for Disease Control & Prevention – What is canine influenza (dog flu)? : Canine influenza (also known as dog flu) is a contagious respiratory disease in dogs caused by specific Type A influenza viruses known to infect dogs. These are called “canine influenza viruses.” No human infections with canine influenza have ever been reported. There are two different influenza A dog flu viruses: one is an H3N8 virus and the other is an H3N2 virus. Learn more

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Are You Prepared?:  How To Make Your Dog Comfortable in Older Age

Published Spring 2017

Written by Tiffany Cannon

We have 7 dogs in the house right now ranging in ages from 7 months to 10 ½ years. It’s obvious that they have different energy levels but they have different needs on a lot of different levels. As hard as it is to believe, dogs are considered senior somewhere between 7 and 10 years old. Vigilance and close observation will help you know when it’s time to make some changes to keep your best friend as comfortable as possible. 


Older dogs might have different dietary needs than they did when they were young. If they are particularly sedentary, eating the same food in the same quantity could lead to excessive weight gain. There are several foods formulated specifically for older dogs – some contain supplements that help manage joint health and provide necessary vitamins and minerals. But other foods advertised as ‘for seniors’ might be more marketing ploy than anything else. Consult your veterinarian to help you determine what food might be best suited to your dog’s dietary needs. Your vet might also suggest a supplement containing chondroitin or glucosamine. Finally, older dogs can develop sensitive stomach even when they previously had no problems at all. If you have always fed your dog once per day, it might be necessary to feed your old guy two or three times a day in smaller meals to help ease digestion issues.

Most people agree that table scraps aren’t good for your dog, but they can be even more dangerous for an older dog. Rich, fatty foods can cause all kinds of digestive issues including pancreatitis. Stick to low fat, dog-appropriate treats. 

Soft Bedding

I remember as a teenager when I loved laying on the floor. My brothers and I would play board games at night, lying on our stomachs in the living room, propped up on our elbows playing Monopoly or Battleship. If I tried to lay that way now for any length of time, my back would really start expressing its disapproval! My joints just aren’t what they used to be. Thirty years has taken a toll. I get up more slowly in the morning, stretch a bit to get the blood flowing and definitely prefer a softer bed to keep my back and hips comfortable at night. It’s important to provide soft padded bedding for your older dog too. They’ll sleep more comfortably but hopefully, you will too. Dogs that have comfortable bedding won’t tend to wander as much at night, they don’t need to reposition themselves as often to alleviate pain, they stay asleep and are more rested in the morning. Our old guys deserve comfort.

Home Accessibility

Stairs, jumping on beds and on furniture etc. can begin to present challenges they did not in earlier years. Observing your dog’s movement through the house can sometimes provide your first glimpse into aging behavior.

Older dogs (like older people) have less padding in those joints than they used to. This fact can have a lot of implications for you and your home. Our dogs love to hop up on the couch and lounge there during the day. Our older dogs can still hop up most of the time, but will be hesitant about hopping down. We don’t have any carpet in the den where the dogs stay during the day and it is obviously painful at times when they jump down from the couch to the tile floor. If my oldest girl Truffle sees me in the room, she will move back and forth until I come over and give her a “puppy elevator” ride to the ground.

I think I prefer having a girl who ‘sort of’ knows her limits though to one that still thinks he’s a puppy and tries to jump off the bed or the back of the couch. Older dogs are definitely more susceptible to injuries. If we leave really comfortable beds on the ground, our older girls tend to prefer sleeping on the ground level beds rather than jump on the couch. We have also needed to change up the types of beds we leave on the floor for the dogs. Our dogs have always loved having beds with walls – something they can nestle into and where they can have a built in pillow. We also have raised beds our dogs absolutely love. But arthritis has afflicted our oldest and at the end of an active day, she has trouble throwing her leg up over the wall. Putting down some flat Temper-Pedic-style beds has allowed the dogs to have options to fit their different daily comfort needs.

Slippery floors can be tough for older dogs to navigate as they begin to experience stiffness. If you have tile or hard wood floors, you might consider adding area rugs or runners in areas frequently navigated by your older dog. If you have slippery floors, you need to be especially vigilant with keeping toe nails trimmed as long toe nails exacerbate any traction issues your dog might already be having.

As your dog continues to age, eyesight changes are also common. Dogs who know the layout of their homes well can hide eyesight issues for a long time. If you move any furniture, watch your dog carefully the first few days to see if they are having any difficulties navigating the new configuration in their living space. While normal as part of the aging process, changes in eyesight should be discussed with your vet. Eyesight changes can lead your pup to experience more fear and timidity, especially in unfamiliar places.

Home accessibility is imperative because older dogs can be injured much more easily than flexible, muscular, active young dogs. Slips on the floor or an awkward landing coming off the couch can lead to painful leg and back injuries.

Another place where injuries can easily occur are in the car. Jumping in and out of the car can be even more awkward that jumping off items in the house. It’s also best to buckle up your dog while traveling by car of have him in a crate. We’ve all experienced the sudden stopping situation in traffic where our dog flies forward onto the floor board. This could be very dangerous for our older companions. 


Your older Peeb has most likely slowed down a bit, but will still need and appreciate regular exercise. Moderation is key, but exercise will help keep your dog’s appetite stimulated, will help keep muscles and bones strong and gives your dog something to look forward to. Most older dogs will be more appreciative of time to sniff instead of straining at the end of the leash. If you do have an old speed demon, it’s important that you control the tempo. Don’t let your older dog go too fast or too slow. They can overdo it easily in their enthusiasm.

Temperature Control

Dogs become more sensitive to temperature swings as they age. They will appreciate a warm, dry place to snuggle up when the temperature plummets in the winter and might find it more difficult to stay cool in the summer. Older dogs (like older people have a more difficult time regulating their temperature). 


Keep it simple and quick! Sacrilegious as it may be, I shave my two oldest girls. They hate being on the grooming table. They hate being brushed, combed, detangled, and having their toe nails trimmed. My oldest has always hated being groomed and has battled me from day one. It’s no surprise that she despises it even more now that she has arthritis. Cricket was a dream on the table as a young dog. But over the last couple of years, she has started fussing anytime we hit a tiny mat that needs to be pulled. Has she become more sensitive to pain in her advanced years or simply less tolerant? No way to know for sure, but she’s given us three litters and 18 babies. If she doesn’t want to be groomed any longer…she won’t be.

However you do your grooming, it remains a very important activity for your aging dog. Grooming provides private time when you can assess the general health of your old friend. This is your opportunity to check for unexpected wear and tear, find signs of a problem before it advances too far and become familiar with the stages of aging so you will be able to recognize changes when they are occurring.

Brush teeth every month to check for signs of decay. Watch for signs that your dog’s mouth is beginning to be painful. If your older dog stops wanting to eat kibble or crunchy treats but will eat soft food, there might be a problem with his mouth or teeth. Give your dog things to chew on such as Greenies, Hooves, Antlers and Bully Sticks which will help naturally keep plaque and tartar from building up. Consider having your dog’s teeth professionally cleaned at the vet when possible. This usually involves anesthesia so it’s important to discuss with your vet whether or not your dog is healthy enough for the procedure.

Trim Toe nails more frequently… Your older dogs aren’t running around like they used to. It seems like our dogs toe nails grow faster in older age…but the simple fact is that our veterans aren’t moving around as much. They don’t cover as much distance, they don’t move as quickly and they aren’t choosing to travel over the same rough terrain they did as youngsters. They are simply no longer being exposed to or experiencing the same surfaces and outdoor settings that naturally served to file down the nails as youngsters. If you take your dog for walks every day and walk your dog on cement, you will not need to trim toe nails as often as someone whose dogs get all their exercise in the back yard. 

Lumps and Bumps

Older dogs sprout all manner of lumps and bumps. Most are harmless and have no medical relevance. But it’s a good idea to investigate if you find that a new lump or bump has popped up in a new place. Skin tags, fatty tumors and cysts can seemingly grow overnight. But these can closely resemble cancerous growth and it’s a good idea for you to regularly check for changes in your dog’s skin. Your vet may want to perform a needle aspiration to determine if the lump is harmless or of concern. If you groom your dog at least once a month, you will have a good baseline of your dog’s “normal” state and will know when something out of the ordinary pops up. Be sure to remember to check in ears, mouth, in between toes and around private parts every time you groom.

Vet Care

If you have always gone to the vet only for an annual checkup, it might be a good idea to switch to a bi-annual visit. Ask your vet if a blood test is recommended. Kidney, liver and many other health issues might be detected at early onset when they will still respond to treatment. With your aging dog, the goal of a vet visit shouldn’t just be about treatment but prevention as well. It’s also important to act quickly when you do notice any issues to allow you to maximize treatment options.

Be Patient

Patience is a virtue and our older dogs will try our patience at times. But it is imperative that we have patience and demonstrate understanding to our old friends. In their advanced years, dogs slow down and take longer to comply with our requests to come. In fact, whether it is from discomfort or simply willfulness, they may ignore you altogether. Our 9 ½ year old Cricket was the only PBGV in my house who actually listened to me reliably and would come when called. Not anymore! She has decided she likes being in the front room where the other dogs aren’t allowed to be except when we are feeding. She stays in the kitchen and stares at the food container in the utility room or she will nestle down in the laundry pile in front of the washing machine. At night, when it’s time for bed, she will now only come willingly when bribed with an appropriate treat. She will not come for a milk bone…leaving her front room requires a piece of chicken or cheese. Any attempt to persuade her by calling is ignored and if you raise your voice to her, she slinks into kitchen and crawls into a crate. Older dogs have a tendency to operate completely on their own agenda.

Other age related issues we have to deal with are problems that are physical in nature. For Truffle, if I am trying to get her attention, I need to waive my arms and not just call her name. She can’t see far away any longer, but she can still pick up movement quite easily. Luckily, we haven’t had to worry about incontinence yet, but it is also a realistic issue that is completely out of our old dog’s control. If your older dog is starting to have accidents in the house, your vet might have something that will help and you will need to go out with your dog more frequently.

Fear Factors

You may notice your old friend is suddenly developing fears of things that never were a concern before. Our old ladies have suddenly developed a fear of thunder. Not unusual for a PBGV…but not normal for my crew. Noise sensitivity is particularly common as a cause for fear and concern. Ironic since this probably develops simultaneous to the beginning of hearing loss. Maybe there’s a connection?

With advanced age seems to develop an awareness that there are things in the world that can be scary and not in our dog’s realm of control. They seem quite aware of the fact that they are not physically up to meet a lot of the potential challenges they could face confidently as youngsters. With this realization, they look to their owners to give them that sense of security. It’s up to us to make our elders feel safe and protected. This might come in the form of a thunder shirt, or a crate kept in a quiet place where the old dog can hide in a safe place if they feel the need.

It is also common for older dogs to develop separation anxiety. 

Privacy & Socialization

Socialization is important for older dogs but so is Privacy! A safe, private area where they can retreat and feel completely confident that they are safe and secure is a must for aging dogs who live in a bustling household. Older dogs need the ability to get away from young and crazy pack members (including other dogs and young children). Place a crate against a wall or in a corner of a quiet room. The top and sides of the crate should be covered with the front door left open. Provide soft bedding for the dog to use for nesting material and make sure the older dog has access to the room throughout the day. We use sheets or towels so our girls can fluff the bedding to their hearts content. If they try to fluff a crate pad, they can inadvertently end up trapped underneath it.

Socialization can also be important. Don’t assume just because your dog wants to observe the action instead of participating that they don’t need socialization at all. It’s good for your elder to meet new dogs and people. This helps to keep them feeling confident and comfortable in new environments.


Spend time teaching your old dog new tricks. They love to learn new things and love to have the personal attention they get when you are spending time teaching them. Be realistic about the types of tricks you want to teach your old dog and limit the tricks to those that don’t involve difficult physical maneuvers. Limit the time devoted to each session so your dog doesn’t tire out or become frustrated. Then spend time doing what they want – sit on the couch, snuggle and take rides in the car or slow walks allowing them plenty of time to sniff.

Feeling the effects of age is an inevitable part of every life well lived. With some planning and preparation, our older dogs can enjoy life well into their middle age and the senior years.


“10 Ways to Make Your Old Dog Comfortable” by Cynthia Foley, Whole Dog Journal, April 2015

“9 Ways to Make Your Senior Dog’s Life Better” by Lori Tay­lor, I Love Dogs, November 17, 2015

“6 Ways to Comfort Your Senior Dog” by Lisa Spector, Care 2, May 27, 2015

“Old Dogs, New Habits: Ways to Make Senior Dogs More Comfortable” by Gina Spadafori, vetStreet.com, July 5, 2011

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Pancreatitis in the PBGV by Laura Liscum, PBGVCA Health Committee


Spring 2017

Inflammatory: (adjective) relating to or causing inflammation of a part of the body; arousing or intending to arouse angry or violent feelings. Provoking. Rabble-rousing.

Pancreatitis is an inflammatory disease. Imagine that inside the pancreas there is a tiny Thanksgiving din­ner table that brings together your Democrat and Republican relatives. In a typical year, the conversation might be a little tense and discussions might get a bit heated. But this isolated incident of inflammation is mild and reversible and the family bonds survive. Thanksgiving 2016, however, the political discussion would likely have been much more heated. This dinner likely resembled a severe acute pancreatitis attack in which there is permanent damage to the pancreas along with far-reaching inflammation that leads to multi-organ failure. This can have devastating consequences with a low survival rate despite rapid intensive care.

Pancreatitis in dogs is a poorly understood disease. The Journal of Small Animal Practice devoted its January 2015 issue to pancreatitis in dogs and cats, and the accompanying editorial stated, “The pancreas is a difficult organ to study because of its inaccessibility; no non-invasive diagnostic test is as sensitive and specific as we would wish and biopsy is invasive and has a risk of significant morbidity [causing illness]; the causes of pancreatitis in small animals are often unknown and treatment remains non-specific and supportive…. The problems are more acute in dogs and cats because there is limited research and so little evidence on which to base our decisions on diagnosis and treatment.”

This sounds grim, but fortunately PBGVs are not predisposed to developing pancreatitis. Nevertheless, occasionally PBGVs are stricken with this disease and, for some of those dogs and their families, the outcome can be devastating.

Chance was a fit, active 9-year-old PBGV who had never been sick before. One evening he was in sudden pain and vomiting. The vet ruled out bowel obstruction and gastric dilation/volvulus (bloat). Chance was quickly transferred to a tertiary care hospital affiliated with a veterinary school, where he received a battery of pain meds. They suspected pancreatitis and took a needle biopsy, the results of which were consistent with pancreatitis. Unfortunately, intensive treatment failed to help. Chance developed disseminated intravascular coagulation (that is, blood clotted throughout his body), which led to multi-organ failure. He went from a vibrant dog to euthanasia in 10 days. The clinicians could not find a risk factor that explained his acute disease. His family was left baffled and heartbroken.

What does the pancreas do? The pancreas is an abdominal gland that helps us convert the food that we eat into fuel for our body. It is divided into two parts. The more well-known part of the pancreas is the endocrine part, which secretes insulin and glucagon into the blood to control blood sugar levels. When the endocrine part of the pancreas fails, the individual will develop diabetes mellitus. This endocrine portion is only a tiny fraction of the pancreas; ninety-eight percent of the pancreatic mass is the exocrine portion. The exocrine part secretes enzymes into the digestive tract to break down the protein, lipid, carbohydrate, and nucleic acid in our food. These enzymes are powerful chewers and they cannot distinguish between the pancreatic tissue that they shouldn’t chew up and the food stuff in the digestive track that they should chew. So, the enzymes are made and secreted in an inactive form and only activated when they reach the gut.

Problems ensue when these powerful enzymes become active within the pancreas itself. If only a small fraction of the enzymes become activated, then control mechanisms kick in and inactivate the enzyme. However, when greater than 10% of the enzymes are inappropriately activated, the control mechanisms are overwhelmed and there is auto-digestion of the pancreatic cells. In response to the damage, immune cells arrive and release molecules called cytokines in an effort to promote healing. If cytokine release is too robust and not controlled, then the pancreas can experience what is called a “cytokine storm”, in which the immune cells cause damage to the tissue rather than repair. (Cytokine storms are thought to be responsible for the deaths that occur in influenza pandemics, sepsis, Ebola and smallpox infections, among other illnesses.) Often the cytokines will inadvertently damage the capillary bed in the pancreas in their misguided effort to help.

At this point, the acute inflammatory storm can resolve if the trigger subsides. If the trigger persists, however, the storm can cause damage to other organs and lead to coagulation of blood within the lungs, kidney and liver. The resultant multi-organ failure is what typically leads to death, rather than the damage to the pancreas itself.

Dryfus was a 16-year-old dog who was treated for pancreatitis his last two years. One morning he didn’t eat his breakfast and was panting heavily as if in pain. A blood test indicated high levels of pancreatic lipase in his blood. He received pain meds, Pepcid and Sulcrate (antacids), and a low-fat food. His panting subsided and appetite returned, but his stool had blood in it periodically over the next few weeks. Over the course of the next two years, Dryfus’s mom kept a diary of his appetite, elimination, treatments, and activity. The diary reads like a roller coaster of celebration when Dryfus ate his meal with gusto, zoomed around the house, or slept through the night, and worry when he wouldn’t eat, was restless and panting, and vomited or had diarrhea. Dryfus’s mom said that she received tremendous support and guidance from a Yahoo Group focused on canine pancreatitis. Through it all, his family tried many different foods and enticements to eat, offering four smaller meals throughout the day rather than one or two larger meals. His meds changed often to try to control his symptoms and make him comfortable. When his quality of life finally slipped, they made the difficult decision to let him go.

What are the signs of pancreatitis? Pancreatitis can be acute or chronic, and mild or severe. Acute pancreatitis generally occurs suddenly and can be mild (with damage that is localized to the pancreas and reversible) or severe (in which there is death of pancreatic tissue and failure of other organs). Pancreatitis is referred to as chronic when there is mild inflammation that develops slowly. In fact, some dogs may be afflicted with chronic pancreatitis for years without any clinically apparent signs.

Nellie was 5 years old when she had her single attack of acute pancreatitis. Her family noticed that she was stretching a lot as if in discomfort; also, her belly rumbles could be heard from across the room. She was taken to the vet where she received meds for an upset stomach and was sent home. In retrospect, her mom wishes she had insisted on additional tests. Nellie’s condition soon worsened and she developed jaundice. It took two weeks of intensive fluids, antacids, and antibiotics before she recovered. It was much longer before she gained back her full strength. Her family thinks that her episode was due to a prescription food for a urinary tract infection that she was battling. They are now especially careful of the foods and treats that she eats. No table scraps!

The clinical signs of pancreatitis vary widely. Those with mild disease might only show intermittent loss of appetite and weakness. Chronic low-grade inflammation of the pancreas and subsequent death of pancreatic tissue may lead to other diseases, such as diabetes mellitus or exocrine pancreatic insufficiency, with their own sets of clinical signs. The worst cases, those with severe acute disease, might present with sudden onset of appetite loss, weakness, vomiting, diarrhea, and abdominal pain. These dogs may be in cardiovascular shock and suffering multi-organ failure. These severe acute cases should be referred to tertiary care hospitals for intensive treatment. Unfortunately, the mortality rate for such referred cases in referral hospitals ranges from 27 to 58%.

Cooper was 4 years old when he lost his appetite and exhibited acute signs of discomfort and restlessness. Cooper’s mom suspected that he had gotten into some greasy food at the local chowder bar. After several trips to the local vet, Cooper was referred to a tertiary care hospital, where he underwent surgery. Unfortunately, the surgeon offered little hope for Cooper’s recovery and the decision was made to let him go. His mom was devastated to lose her heart dog.

What are the causes of pancreatitis? Dogs of any age, breed, or sex can develop pancreatitis. In most cases, the dogs are middle-aged to senior (> 5 years of age) and the causes are unknown (called idiopathic). Those who are diagnosed with pancreatitis likely have some genetic susceptibility combined with exposure to an environmental risk factor.

One morning when Desilu was 10 years old, she had a morning appointment with the vet and returned home with a clean bill of health. That afternoon, she began throwing up blood. Desilu was rushed back to the vet and tests indicated that she had pancreatitis. Her mom suspects that she had been eating the rich puppy food meant for the new puppy in the household. Desilu was switched to a low-fat diet and fully recovered. From that time on, her family watched her like a hawk to make sure that she only ate the appropriate food and she never had a relapse.

Among the causes of pancreatitis in dogs are a high-fat diet, dietary indiscretion (which is vet-speak for a dog that has eaten an entire package of hot dogs or some other no-no), and obesity. With a PBGV in the house, we have all learned the hard way to push scrumptious food to the back of the kitchen counter and to keep a sharp eye on our hound who can sniff out tasty trash during walks through the neighborhood. I know from personal experience that a moment of inattention in the kitchen can lead to the disappearance of a ham steak, a chunk of deer sausage, or a wedge of brie. In a dog with no other risk factors for pancreatitis, perhaps that indiscretion will simply lead to a single bout of vomiting or diarrhea. In combination with other risk factors, a susceptible dog might get very sick.

One PBGV was diagnosed when she was 10 years old. Her family brought her to the vet when she vomited, was arching her back in pain, and had black stool. Blood tests revealed high pancreatic lipase levels, indicative of pancreatitis. Her family thinks that, in retrospect, this picky eater had very mild chronic pancreatitis for several years. The acute attack was likely triggered by a home cooked pork meal that had too much fat. She went on Pepcid for her stomach, Tramadol for pain, and the antibiotic Flagel. From then on, her family kept her on a strict, home-cooked low fat diet, which fully managed her symptoms.

On the other end of the appetite spectrum was Star. No one could ever call Star a picky eater. She ate everything she could get into her mouth, including a leather jacket, slipcovers, underwear, stuffed animals, and a pound of chocolate chips. She and her littermate, Preacher, were both on Comfortis (to kill fleas). Preacher was 4 years old when he had his first symptoms of pancreatitis; Star had her first symptoms at 5 years old. Their mom is convinced that the Comfortis was a trigger since the symptoms stopped and started when she stopped and started the flea treatment. Despite eliminating this trigger, Star’s dietary indiscretions ultimately led to abdominal bleeding and severe acute pancreatitis symptoms. Fortunately, Preacher is doing well at age 13.

In humans, the majority of individuals with recurrent pancreatitis have genetic variations in genes that control pancreatic enzyme activation, coupled with environmental stressors such as alcohol or tobacco use. In dogs, it is likely that genetic factors also play a role since certain breeds are predisposed to the disease.

While alcohol and smoking are probably not contributing factors for the typical PBGV, there are drugs that have been associated with pancreatitis in dogs. These include azathioprine (used for immune-mediated disorders), potassium bromide with phenobarbitone (used for seizures), organophosphates (an insecticide), asparaginase (a chemotherapeutic agent used for lymphoma), sulphonamides (an antibiotic), zinc (an essential trace element that is toxic at high doses), and clomipramine (used to treat behavioral disorders). The interaction of specific drugs with genetic susceptibilities to pancreatitis has not been proven or disproven; to do so would require studying large numbers of dogs of various breeds.

The Amazing Al needs very little introduction. Al was a TDI-registered therapy dog who entertained children, seniors, and PBGV enthusiasts with his tricks and performance routines. Unfortunately, Al always had a sensitive tummy. Periodically he would pace in the night and then throw up. When he was 13, he had an acute episode and tests revealed that he had pancreatitis. Al was already on Dr. Jean Dodds’ liver cleansing diet of equal parts of sweet potato, potato and white fish. He also got baked chicken, eggs, white rice, and cottage cheese. After the pancreatitis diagnosis, Dr. Dodds recommended continuing the liver cleansing diet. He did best when his mom fed him 10 tiny meals every day. The only treats he was allowed were chicken and Rice Chex. He could no longer tolerate even the lowest fat kibble after the acute attack. Al had these periodic pacing and vomiting episodes from the time of his pancreatitis attack until his death. Of course, they were usually at night. His family had medications on hand to help him through, including Carafate to coat his stomach, Reglan for nausea, Pepcid to settle his stomach, and Tramadol for pain. Al’s career of entertaining came to an end when he was 14 and a half. His mom said “The pancreatitis didn’t get Al; he just wore out.”

How is pancreatitis diagnosed? Diagnosis of pancreatitis is a challenge since the disease is characterized by non-specific findings. Suspicion of pancreatitis should be raised if a dog has clinical signs plus a potential risk factor, as described above.

Dogs suspected of having pancreatitis should undergo a complete blood count, serum biochemistry profile, and urinalysis. These tests may exclude other diseases that are suspected. Abdominal radiographs are also typically taken to exclude other diseases.

The most sensitive test of choice, called Spec cPL, measures a pancreas-specific lipase in the dog’s serum. Transabdominal ultrasound is the imaging method of choice for diagnosis of pancreatitis but its accuracy depends upon the ultrasonographer’s expertise. There are also more advanced diagnostic imaging techniques that are used in humans; however, these are typically not available for small animals and are also very expensive.

The gold standard of diagnosis is histopathology; however, that requires anesthetizing the dog for a biopsy and is too invasive (and expensive) in most cases. Histologists will look for the presence of inflammatory cells, fibrosis and death or loss of exocrine tissue. Even histopathology is not perfect, however, since inflammation might be localized to one region of the pancreas and the biopsy might be taken from another region that is normal. Alternatively, pancreatic lesions might be seen that are clinically insignificant.

Patch was 4 years old when he started vomiting and showed signs of being in pain. Ultrasound and a pancreatic lipase test confirmed a diagnosis of pancreatitis. At the time, he was overweight and had been put on grain-free food. Patch received antacids and was switched to a low-fat food. Fortunately, he has not had another bout of pancreatitis in the past 6 years. Patch has developed pulmonary fibrosis, however, which is suspected to be a secondary injury caused by the acute pancreatitis.

How is pancreatitis treated? In human medicine, an individual with signs of pancreatitis will be assessed with clinical, pathological, and imaging tests. Their severity of disease will be scored in a standardized manner. Humans with acute pancreatitis receive standardized treatment that includes early aggressive fluid therapy, analgesia (pain relief), and early feeding. There is general agreement among clinicians that this standardized diagnosis and treatment has led to reduction in mortality from pancreatitis.

Unfortunately, veterinary medicine does not have a standardized method for scoring the severity of canine pancreatic disease. Also, there is not a similar consensus on treatment of pancreatitis in dogs. Current treatments are mostly based on case studies, laboratory research, expert opinion, and extrapolation from results in humans. Thus, it is difficult to predict the severity of the disease or the dog’s prognosis. Nevertheless, there have been efforts to standardize treatment for dogs with acute pancreatitis. This has resulted in the following current recommendations:

  • Severe acute pancreatitis should be treated in a referral veterinary hospital’s intensive care unit due to the high level of nursing support needed.
  • Intravenous fluid therapy is typically needed to counter the dehydration resulting from vomiting and lack of eating. Either saline or lactated Ringer’s solution are commonly given. The possible benefit of lactated Ringer’s solution is that it is an alkalinizing fluid (that is, it increases pH) and may prevent further inappropriate activation of pancreatic enzymes within the pancreas. There has been no proven benefit of transfusing plasma into dogs with acute pancreatitis, unless the dog is exhibiting coagulation problems.
  • Antiemetics are recommended for all dogs with acute pancreatitis. Clinical signs of nausea include licking of lips, swallowing attempts, and obvious aversion to food. Antiemetics should be given even to those with no overt signs of nausea or vomiting because this may encourage voluntary eating.
  • Pain should be managed. It is safe to assume that all dogs with acute pancreatitis are in pain to some degree. In order to manage the pain with the appropriate analgesics, it is important to determine the level of pain that the dog is experiencing. A dog with mild pain might be responsive to his/her surroundings, but be unsettled. With moderate pain, a dog might be reluctant to move and may flinch when his/her abdomen is palpated. A dog in severe pain may be non-responsive to surroundings and may scream or snap when palpated. Most referral veterinary hospitals have pain management specialists who can assess the level of pain a dog is experiencing and prescribe the appropriate combination of analgesic agents.
  • Food and water should be offered early in the recovery phase. The role of nutrition in treatment of acute pancreatitis has changed over the past two decades. It was previously thought that pancreatitis patients (both human and animal) should fast in order to ‘rest’ their pancreas. Current recommendation is that dogs with mild acute pancreatitis be allowed to eat voluntarily. If the dog does not eat for five days, then a nasogastric tube should be inserted for enteral feeding of a liquid diet. Dogs with severe acute pancreatitis should receive interventional food as soon as possible. Generally, during recovery from a bout of pancreatitis, a low-fat diet is given for a period of time after which a regular diet can be reintroduced (unless the dog has high serum triglyceride levels). Once a dog has had pancreatitis, the chances of a recurrent event is high. The dog’s diet must be monitored vigilantly and his/her treats selected with care.

Dottie was 11 years old when she became agitated, started pacing around the room, and began to bite the wooden knobs on a dresser. She then stretched her body out with her rear in the air. She was taken to the vet immediately. Blood tests indicated an acute bout of pancreatitis. Ranididine (Zantac) was given to reduce stomach acid production and she recovered over the course of a week. The cause of her attack was never known, but her family kept her on a low-fat diet as a precaution. Whenever her mom thought she might be have another attack, she was given the Ranididine and it never recurred. She is 14 now and a hearty eater who loves her walks and a cuddle.

Lessons from the hounds. What can we learn about pancreatitis from our beloved hounds? Several members of our collective pack suffered bouts of pancreatitis after a high-fat feast, either a cup of chowder or some puppy food or a delicious home cooked meal with too much fat. For others, there was no known dietary indiscretion, but it is reasonable to assume that fat was a contributing trigger since switching the dogs to a low-fat food and closely monitoring all foods and treats prevented recurrence. Many affected dogs can have good quality of life if their pancreatitis is caught early and treated with special diets and/ or medications for the rest of their lives. For other dogs, the inflammatory storm rapidly spread to other organs and the most advanced veterinary care was in vain. We hope that research into the causes of pancreatitis in dogs and development of specific treatments will, in the future, increase survival of those suffering severe acute attacks.

Abraham is our elder statesman at 17 years old. His first bout of pancreatitis occurred when he was 11. His mom noticed that he seemed uncomfortable walking and wouldn’t lay on his tummy, which was his usually resting position. The emergency vet gave him pain meds and performed tests that revealed signs of pancreatitis. The vet put him on a bland, unappetizing canned dog food, which Abraham totally rejected. His mom experimented with a modified Dodds’ liver-cleaning diet and Abraham’s appetite picked up. To this day, he cannot tolerate any fat in his diet. He gets three meals a day of a super low fat kibble mixed with white fish, dry curd cottage cheese, and baked sweet potato. Sometimes he gets boiled chicken instead of fish, canned pumpkin instead of sweet potato, and some jasmine rice. Sounds yummy to me! Abraham’s family surmises that his attack was triggered by his habits of rooting through the kitchen garbage and eating poop. They are vigilant on both accounts and, with his diet controlled, his chronic condition has been managed. Abraham has had a very active life, with Rally Advanced and Utility Dog titles. It is wonderful that he can rest easy in his senior years, knowing that most of the delicious cooking in the household is for him.


AKC.org health article. December 17, 2015. Pancreatitis in dogs – symptoms, causes, and treatment. (http://akc.org/content/health/articles/pancreatitis-in-dogs/?utm_source=newsletter&utm_medium=email&utm_ campaign=yourakc-20161226); LaRusch J. and Whitcomb, D.C. 2011. Genetics of pancreatitis. Current Opinion in Gastroenterology 27: 467-474; Mansfield C. and Beths T. 2015. Management of acute pancreatitis in dogs: a critical appraisal with focus on feeding and analgesia. Journal of Small Animal Practice 56: 27-39.; Watson, P. 2015. Canine and feline pancreatitis: a challenging and enigmatic disease. Journal of Small Animal Practice 56: 1-2.; Watson, P. 2015. Pancreatitis in dogs and cats: definitions and pathophysiology. Journal of Small Animal Practice 56: 3-12.; Xenoulis, P.G. 2015. Diagnosis of pancreatitis in dogs and cats. Journal of Small Animal Practice 56: 13-26.

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Canine Mycoplasma: It’s Role in Reproductive Disease

By Janice Cain, DVM and
Melissa Goodman, DVM

(Source: International Canine Genetics, Inc. News February 1994, pp. 1, 4.)

Mycoplasma infections have been implicated as a cause of infertility in both bitches and stud dogs. As a result, mycoplasma continues to receive attention as a potential concern for purebred dog breeders. The following article discusses what is currently known about canine mycoplasma infections and outlines a management approach for breeding animals.

Mycoplasmas are bacterial organisms that, because of their extremely small size, have been placed in a separate class. Also, unlike any other bacteria, mycoplasmas lack a rigid cell wall which makes them unaffected by antibiotics that act by invoking cell wall damage (for example, penicillin). Mycoplasmas are extremely fastidious organisms that are difficult to culture without special media, and even then may be difficult to recover. Ureaplasmas are a distinct type of mycoplasmas that have been subclassed and are identified by their own name.

Several mycoplasma species have been found to be normal inhabitants of the upper respiratory and genital tracts of dog and cats, and as a result they can be routinely isolated from oral, nasal, conjunctival and genital mucous membranes. Several studies have specifically looked at the frequency of mycoplasma recovery from the genital tracts of fertile versus infertile bitches and stud dogs, and no significant difference has been found. (1,2) Therefore, recovery of mycoplasma from a vaginal or semen culture does not always correlate to reproductive disease, and likewise does not always need to be treated. Since these organisms exist in the respiratory tract as well as the reproductive tract, aerosol transmission from dog to dog (airborne. licking, sniffing, etc.) is probably more frequent than venereal transmission.

While mycoplasmas may be normal inhabitants of the reproductive tract, they have been associated with infertility, lesions of the reproductive tract and sperm abnormalities. (3.4.5)As with many opportunistic pathogens (organisms that may cause disease but frequently don’t) clinical disease often results when an animal is under stress and/or exposed to high numbers of organisms. Close intensive housing conditions (as in a large kennel or at indoor dog shows) provide the opportunity for high numbers of organisms to develop. A healthy dog or bitch especially if housed individually, however, may not become diseased even after known exposure to the organism.

It has been found that the administration of broad spectrum antibiotics may suppress many other bacteria that make up normal flora and allow mycoplasmas to overgrow. Therefore, the prophylactic use of antibiotics prebreeding is not recommended as it may actually create a pathogenic state, and may contribute to the development of antibiotic-resistant populations of organisms.

A mycoplasma culture should be performed if:

1) A dog has missed several bitches (i.e., no conception).
2) A semen evaluation shows morphologically abnormal sperm cells.
3) A bitch has not conceived having been bred to a fertile stud dog on appropriate days.
4) A dog or bitch produces conception but has a documented high rate of fetal resorption.

It is important to remember that there are many other causes of the above problems, and so a mycoplasma culture should be only one part of a thorough diagnostic investigation performed by a veterinarian experienced in canine reproduction.

Due to their fastidious nature, mycoplasmas require special techniques for successful growth in cultures. As a result, mycoplasma cultures should only be sent to laboratories competent in the recovery of the organism. It is recommended that ureaplasma is cultured for at the same time, since it is a similar organism and has also been implicated in infections of the reproductive tract. (1)

Proper technique in obtaining the sample to be cultured is also extremely important. In bitches, it is recommended that the vaginal area close to the cervix be sampled using a guarded swab. In stud dogs, it is important that a semen specimen be collected using sterile technique, avoiding urethral contaminants.

Since mycoplasma is frequently cultured from the vagina of normal fertile bitches, routine prebreeding cultures of bitches are not warranted. Since mycoplasma is frequently recovered from cultures of the prepuce and/or semen of normal fertile males, routine prebreeding cultures may show some growth of mycoplasma as part of the normal flora However, some owners may choose to periodically have a dog’s semen cultured for mycoplasma. While a negative result is definitive, the significance of a positive result must always be determined by correlation to semen evaluation and clinical condition. Unfortunately, a dog’s fertility status cannot be determined on the basis of mycoplasma recovery.

Mycoplasma infection is only one of many factors that may impact canine fertility. Working with an experienced veterinarian with a thorough, systematic approach to investigating fertility problems will pay dividends to your breeding program.

A guarded swab recommended for proper vaginal culturing in bitches is available through TCG. Veterinarians may order the Accu-CulShure® Specimen Collection/Transport System by calling TCG at 800-248-8099.

1. Doig PA, Ruhnke HL, Bosu WTK: The genital mycoplasma and ureaplasma flora of healthy and diseased dogs. Can J Comp Med 45:233, 1981.

2. Bjurstrom L, Linde-Forsberg C: Long-term study of aerobic bacteria of the genital tract in stud dogs, Am J Vet Res 53:670-673, 1992.

3. Lein DH: Mycoplasma infertility in the dog: diagnosis and treatment. Proc SFT, Sept 1989, p. 307-313.

4. Holzmann A, Laber G: Experimentally induced mycoplasmal infection in the genital tract of the male dog. Therio 7(4): 167-188, 1977.

5. Lingwood CA et al: Common sulfoglycolipid receptor for mycoplasmas involved in animal and human infertility. Biol of Reprod 43:694-697, 1990.

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Malassezia (Yeast) Dermatitis by Judy Seltzer, BVetMed, MRCVS, DACVD

Malassezia dermatitis and otitis occurs most commonly in animals with allergies, endocrinopathies (hypothyroidism, Cushing’s disease), immunosuppressive diseases and other skin diseases. The most common causative organism is Malassezia pachydermatis. It is normal to find a small number of these organisms on cats, dogs and even people. However, overpopulation is common when the normal skin barrier is compromised.

Dogs of any age, breed, or gender can be affected by yeast dermatitis. Predisposing skin factors for Malassezia include warmth, moisture, increased humidity, exaggerated skin folds, obesity and inflamed skin or ears. Commonly affected breeds include West Highland White Terriers, Basset Hounds, Cocker Spaniels, Springer Spaniels, and Chinese Shar Peis. Other conditions that can be associated with secondary yeast infections include endocrinopathies (hypothyroidism, hyperadrenocorticism) and immunosuppression (neoplasia, animals on chemotherapy). Although less common than in dogs, yeast dermatitis can occur in cats, especially in Persian cats or cats with underlying internal disease. Malassezia is not considered to be contagious to other animals or people; however there are very rare reports of immunocompromised humans being at greater risk of infection.

Clinical Signs
Yeast infections can be localized (ears, perianal region, facial skin folds, interdigital spaces) or have a more generalized presentation. Affected animals are often pruritic and may be found licking and chewing the affected sites. The degree of itching does not always correlate with the actual severity of the infection. Some animals have fewer numbers of yeast organisms present but suffer from a hypersensitivity to these organisms. The skin of affected animals is usually erythematous, may have yellow crusting and scaling, and can become hyperpigmented and lichenified over time. Areas of the body commonly affected in dogs include the feet, nails, underside of the neck, axillae, abdomen, legs and under the tail. In cats, yeast infections can involve the chin or face, nails, or occasionally elsewhere on the body.

Malassezia is usually diagnosed by performing skin or ear cytology. Samples are taken by pressing a slide against the skin, using cotton swabs or acetate tape, or performing dry skin scrapings with a blade. After staining with Diff-Quik, the slide can be examined under the microscope at 1000x (under oil). A few yeast organisms (1-2 yeast organisms per microscopic field) found on the skin or ear are usually considered normal. However, a larger number of organisms in combination with erythema, irritation and pruritus is considered abnormal. Additionally, identification and treatment of the underlying cause of the yeast infection is very important, and other diagnostics may include trial therapy for scabies mites, a hypoallergenic diet trial, allergy testing, bloodwork for hormonal diseases, or skin biopsies.

The treatment for Malassezia dermatitis usually involves topical therapy with antifungal shampoos, sprays, wipes and lotions and/or systemic treatments with ketoconazole, fluconazole, itraconazole or terbinafine. The use of topical products alone may be adequate for treating mild or localized infections. Oral medications are recommended for more severe or generalized infections. Some infections require long term therapy for the best results. Occasionally, pulse therapy (therapy used only certain days of the week) is necessary to treat patients with chronic yeast infections. Most animals will also require oral antibiotics for concurrent bacterial skin infections. Treatment of the underlying cause is also very important and may involve trial therapy for parasites, a hypoallergenic diet, allergy hyposensitization injections based on allergy testing, or therapy for any underlying hormonal or internal disease.

The prognosis for yeast dermatitis is good, as long as the underlying cause is identified and treated. Some animals are not cured, but controlled with intermittent topical or systemic anti-yeast therapy.

Judy Seltzer, BVetMed, MRCVS, DACVD
Veterinary Medical Center of Long Island
75 Sunrise Highway
West Islip, New York 11795
(631) 587-0800; fax (631) 587-2006


posted 10/7/2017

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