Who's That?

School listening face

Yesterday was a school day for me. Getting a good education is a wise idea for anyone--children, adults, therapy dogs, and household dogs of all kinds. It keeps the mind engaged, shows us new possibilities, and is in general fun! Here I am demonstrating my listening face. One of the first things I learned as a puppy was "watch me." I hear that and I make eye contact with my human. It's the basis for everything we do. If I'm barking and out of control, a quick "watch me" will often break my attention and redirect me. Similarly, if i'm in a dangerous situation a quick "watch me" can reorient me so I can hear other commands (like come, down, leave it, and other similar things).

Jake demonstrating patience

School of course is also a time to get some good exercise while we are practicing our skills. This here is my friend Jake. Here you see him practicing waiting. he had already gone over two jumps. He was asked to stop here and wait until he got the go ahead to do two more jumps. At the end he got to push an exercise ball, ring a bell, and he got a tasty little reward. Pretty fun, eh? Jake is an advanced student. He was able to do this task in two steps. His human had him do a sit/stay in front of the first jump. She walked out to this jump. She called "jump" and he did just that. When he got to the step she called out "wait" and he did just that. She walked out to the ball and called him again. Being a younger student, I worked on a different level. Sometimes when my human says jump I will bypass the jumps and just run to him. I'm learning what the words for all the different equipment mean. The goal over time is for the human to say "jump" from any place in the room and I go to the jumps and do them. That'll take a while.

Dog Walk!

Here I am doing the dog walk. It's one of my favorites, mostly because in the middle of the dog walk there are a couple of wubba kong's tied to a bar. I like to try to grab them on my way past. I'm getting pretty good at this part of the circuit. I run up and over the A Frame, through the tunnel, across the dog walk, and then onto the table where I do a down/stay. The human has to be extra careful because he has a habit of banging his knees on the dog walk--we both do this circuit while running.

My friend Sunny

We had a little break in our educational activities at school yesterday. I used this interruption in my schedule to investigate an interactive toy that we have in the classroom. See what a good job it does keeping my attention? The food the human put inside it helps of course. Occasionally using toys like this are a great way to engage your dogs curiosity--especially on rainy days when no one seems to want to go out.

Ask Maggie: How can I help?

I was thrilled to wake up this morning to receive my first question in the mail. I hope this is something that becomes a regular feature on this blog. Keep your questions and experiencing coming. Click on the image to your left to send me an e-mail or visit the Ask Maggie page for more information.

The question that was posed to me is a serious one. It is one that is an issue that is close to my own heart: my mother had to endure with this situation. It's an issue that many of you in the northern hemisphere of the world will face more of in the coming months as summer approaches.

How can I help dogs tied to cement?

This wasn't an uncommon sight when my human was young. He grew up in the suburbs where people had big green back yards. During the summer months many of those back yards would have a dog resting in the shade attached to a tree or post by a long length of chain. His own dogs would often spend a bit of time enjoying the great outdoors safely tethered to a chain.

The key here is that the human's dogs enjoyed this for short periods of time. Dogs weren't left languishing on a chain for hours (or days) at a time. They had access to water and shade. They had access to human companionship. They had access to stimulating and exciting experiences and environments.

Other dogs aren't so lucky. They are tied outside and left alone for hours, days, and even weeks, months, and years. My mother showed signs of this sort of neglect--when she was examined after being rescued many of her teeth were ground down suggesting she spend many hours chewing or gnawing on a chain or fence. This summer the human saw a news report of a dog who was left tied up in the back yard of a house that was foreclosed. The owners moved out without bring their dog and left him hidden in the brush for weeks without a source of food and water.

If you have a dog, and chain them up for long period of time, the Humane Society of the United States offers some tips on how you can improve your dogs experience.

There are several organizations that have put together information on how someone can help a dog who is chained up. Some of the organizations have a network of volunteers who are trained to approach people who you think might be neglecting their dogs. Your local animal officer, animal shelter, or animal creulty association may also have resources.

Here are a few resources to get you started:  Paw Rescue guide to helping chained animals; Dogs Deserve Better; and the Human Society of the United States guide A Dog's Life: Chaining and Your Community.

Overdue update on my health

Have you ever noticed when there is a problem in life, every bit of your attention goes to that problem? Have you also noticed as soon as the problem goes away you forget about all that attention? I sure do. This past summer I was plagued with bladder problems. If you didn't know me back then you can read about my travails here and here.

The human took me to five different vets. Five! I was poked, prodded, tested, and forced to do very unpleasant things. I was finally diagnosed with having calcium oxalate stones--a condition that isn't treatable, persistent, and required bladder surgery. Even if I was to have surgery to remove the stones, I was told I would have to be on a bland (unhealthy!) prescription diet for the rest of my life and I would STILL be likely to get the stones again.

The human fired the first three vets--he felt like they were treating him like he was ignorant. One made me have a painful procedure without proper sedation. He fired the fourth vet because despite his vocal statements about not willing to put me on a prescription diet (do you know the main source of animal protein in most prescription foods are things like chicken feathers? Did you know that prescription diets are associated with their own set of health problems?) the vet continued to suggest I go on a prescription diet. That vet also refused to give me proper sedation despite my obvious and extreme display of fear during a procedure.

I was beginning to worry about my human. In rapid succession he fired everyone that met me. I was worried that he was the problem. As it turns out, he wasn't. He finally brought me to a doctor that understood my problem and was able to solve my problem. He also saved me from having surgery that would have cost over $1,800 and had the risk of life-long incontinence. I don't even know for sure at this point if I actually had the condition that I was supposed to get surgery for.

Anyway--that catches you all up to date. I don't think I told you all that I was better. I am. I am much better. The human took me to Dr. Dan's Integrative Pet Hospital. After carefully listening to my human's concerns, after gently examining me, and after some reflection together, Dr. Dan essentially said this is no big deal. He prescribed me a supplement called UT Strength STAT for dogs. This is the same company that makes the wonderful non-toxic non-scary flea and tick be-gone product that also changed my life (thanks Dr. Dan!).

I've not had a single problem with my bladder since then. With one product I went from having a life-long condition that would likely require multiple expensive operations to having no condition (I don't even use the supplement anymore). I thought you might all want to know, since I certainly complained enough about the problem when I was having it.

If any of you reading this have a similar problem, don't run out and order the UT Strength. You need to consult a vet that you trust: what worked for me might not work for you. What is important here, and what is the moral of this story, is take the time to find a vet you trust. Take the time to find a vet that is knowledgeable. If you believe in a holistic approach, by all means take the time to find a vet that is well trained in holistic medicine. Having a vet that speaks your language is what is important here.

In fact, you can ask my cat-brothers that very same question. They were lucky because the human already had a vet that specialized in cats (in fact, he only sees cats). Dr. Carlson at the Cat Doctor was the one initially responsible for getting the human so strident and uppity about pet food. After having two cats die from fatty liver disease the human finally found Dr. Carlson--and heard him say something along the lines of we've been killing cats for years with prescription diets and dry foods that cause problems rather than help prevent them.

My cat brothers, you see, were also having bladder problems. This was before I was born. The way the cats explain it they discovered painful (yet oddly pretty) crystals in their pee. The human stuffed the cats in a box, drove them all the way to New Hampshire, and upon exiting the box they saw Dr. Carlson. After an hour long lecture about how horrible many cat foods are, and being taught the evils of a dry food only diet, and learning a whole lot of other useful stuff... Anyway, the cats say Dr. Carlson said "wet food only" and "mix it with broth until it's like a beef slurpee." The cats have never had crystals again. Never.

Easy as that.

So--go find yourself a good vet. And as for Dr. Carlson and Dr. Dan--I know you both read this blog sometimes--thank you for being smart and thoughtful.

Flea and Tick Magic

The human is very allergic (and appealing) to fleas. He once lived in a house where a ferral cat crawled into the basement and gave birth to a litter of kittens. He helped take care of them--only to discover they were infested with fleas. He got bites all up and down his legs that swelled, itched, and required medical attention. Not much fun.

He has done what many of you all do: apply a month flea and tick treatment to my fur. It's done a great job. Not a single flea, fly, or mosquito has bothered me. Despite all my outdoor romping I've only gotten one tick on me (that we know of, at least). A pretty good testament to K9 Advantix. There are some concerning things about it. First, it's very toxic to cats. If Iggy and Spot would happen to lick me right after the medication is applied they would likely become very ill and die. There are also numerous reports of dogs having skin problems (rashes, sores), stomach upset (vomiting), and neurological problems (stumbling, etc.).

My vet just recommended an alternative that had immediate positive results. He recommended a product called Vetri-Repel which claims it is a natural repellent for fleas, ticks, mosquitoes, and flies. It smells kind of nice--made with lemongrass and cinnamon oil. As long as the human is careful not to get it in my eyes and nose, everything is just great.

Wouldn't you know it works? He sprayed it on me and we went for a walk. He noticed that I happened to be standing on top of an area where there were several creepy-crawly bugs. They were actually scattering from underneath me and running away. Pretty nifty, eh?

These Pesky Stones

So the human had a consultation with Rebecca Remillard Ph.D., DVM at Angell Medical Center. I'm glad he did: surgery is postponed. Here is the basic information: it's useful for any of you out there you might be coping with bladder stones.

Way back when this all started, the vet tried to get a urine sample but wasn't able to. Because I had all the signs of a UTI, I was put on an antibiotic. This was the first error. Had a urine sample been taken and cultured we might have already solved my problem. Dr. Remillard shared that if a culture of my urine grew staph, it would have been indicative of struvite stones. This could likely be solved through a nutritional intervention. An alternative culprit could be urate stones. These can be solve through nutritional interventions as well. Lastly, the initial diagnosis of calcium oxalate stones might still be correct. These cannot be solved through nutritional interventions.

Or, can calcium oxalate stones be remedied through diet?

In the May 2010 edition of the Whole Dog Journal featured an article on the diagnosis, treatment, and prevention of calcium oxalate kidney and bladder stones. It reviewed some anecdotal evidence that these types of stones can indeed be successfully treated by nutritional interventions. The diet focus on increasing water consumption, raising urinary pH a bit, feeding a diet low in oxalates, and various vitamin supplements.

Here are two highlights that were particularly interesting in the article:

• Standard treatment from many vets for stones of all sorts are prescription diets that among other things, restrict protein, calcium, and phosphorus. The article mentioned research published in 2002 by the American Journal of Veterinary Research. It showed that canned food diets low in protein, calcium and phosphorus and have the highest amount of carbohydrates were associated with an increased risk of calcium oxalate crystals. Whoops. No prescription diets for me!

• The American Journal of Clinical Nutrition and The Journal of the American College of Nutrition, among others, have published research four more than 40 years demonstrating that patients with long-standing, recurrent calcium oxalate kidney stones receiving supplements including magnesium oxide with or without vitamin B6 for five or more years demonstrate stone formation falling by more than 90 percent.

After consulting with my vet, we've decided on a different treatment plan that doesn't involve surgery right now. I'm finishing up my course of treatment with Baytril. After that, we are going to carefully watch any symptoms that develop. The small risk is that I'll get an obstruction which would be a medical emergency. Assuming that doesn't happen, 14 days after I stop the antibiotic I'll have a urinalysis to see where I am. Assuming that doesn't show anything significant we'll repeat the urinalysis again 30 days after I completed the course of antibiotics. If that shows signs of staph, I'll have my diet altered to treat struvite crystals. If there is no staph, we'll re-evaluate and go for plan B. Not sure what plan B is yet.

Okay, that's not exactly true. The human took the cats to the Cat Doctor of Bedford and Nashua this past Friday. Dr. Carlson was informative as always. He suggested that I talk to my vet about having a cystoscopy. They would use a special instrument to peek inside my bladder, see what is there, and remove a stone for analysis. Something worth discussing!

Calcium Oxalate. Say what?

For those of you who are regular visitors on my Facebook fan page, you know that I've been plagued by ongoing urinary tract problems for the better part of the last month. It's not been pretty. I used to love going to the vet--I walked in fearlessly and enjoyed all the attention. Now I'm digging my paws into the ground when I am outside the front door of the vet's office and once inside, I stand by the door with my nose against the doorjamb hoping that I can somehow escape.

I've had urinalysis done twice, two ultra sounds, x-rays, and blood work. Though it's not definitive, it is looking like I might have calcium oxalate stones in my bladder. These little stones roll around inside irritating the tender lining of my bladder and, well, it's uncomfortable.

The human first noticed all these problems four weeks ago. Almost overnight, I started needing to stop and pee five or more times on an hour walk. This is very unlike me--I usually once going once or twice. The vet first diagnosed it as a UTI. I tried a course of amoxicillin. That didn't do much. I was then put on Rimadyl as I finished the course of antibiotics. Little did I know there were a whole host of side effects with Rimadyl. Let's just say while I wasn't peeing a lot because of the stones, I was going outside a whole lot to do some other stuff. I promptly went off the Rimadyl and we got a second opinion from another vet.

A urinalysis, by the way, did not indicate that there were any bacteria. There also weren't any evidence of stones, either. My pH was a bit off, and there was blood in my urine. Both are problems. An ultra sound suggested that there might be stones in my bladder.

My second doctor (whom I'm very fond of, are you reading this Dr. A?) at Linwood Animal Hospital tried me on a second course of antibiotics. This time I tried Baytril. After a week there wasn't a significant change. The human had me pee into a cup (this must have been fun to watch) and I was back into the vet. Much to my horror I spent the morning at the vet. They shaved my belly and did x-rays and an ultra sound. The x-rays showed the outline of stones and the ultra sound confirmed it. The urinalysis shows no bacteria and traces of calcium oxalate.

This however is unclear: the human consulted Dr. Google and found clear evidence that when urine samples are refrigerated or more than 30 minutes old tend to precipitate calcium oxalate regardless of the presence of stones. The human tells his patients that Dr. Google is no substitute for the advice of an actual living doctor. The human needs to remember his own advice.

Dr. A's best recommendation is to have bladder surgery. They will open up my bladder, clean out all the stones, send them out for analysis, and close me back up. This however doesn't sound very pleasant. The human is investigating plan B.

The human is having a nutritional consult with Dr. Rebecca Remillard at MSPCA Angell. That might turn up a few options. We're also having a consult with Dr. Dan Cirnigliaro who is a local vet with a holistic outlook. That might turn some other stuff up too.

The human tried to see if there were less invasive options available to treat the stones (there certainly a whole host of possibilities in humans!). This was a disappointing adventure. Being wary of rising medical costs, the human was willing to pay for a consult as long as he knew there were other options potentially available. Despite being willing to pay for a telephone consultation to find out specifically if there were other options available for treating bladder stones, both Foster Hospital for Small Animals at Tufts Veterinary school and MSPCA Angell both declined to answer the question or put the human in touch with someone who could answer the question. The only way to find out about less invasive options is to schedule an appointment (at a rather significant expense) and travel to both hospitals. Great if there are other options. Not so great if the answer is the only treatment is surgery.

Of course, no one can suggest treatment just from a brief phone call--that makes sense. Every dog is different and every situation is unique. It just seems that a simple question (are there a variety of interventions available) deserves a simple answer.

Our friendly dog coach Maureen Ross provided a couple recent editions of The Whole Dog Journal. There was an excellent article in the May 2010 edition called "Stoned Again: Diagnosing, treating, and preventing calcium oxalate stones in dogs." The article reviewed some of the latest research and in particular, talked about the work done by Leslie Bean in bringing together some of the latest information about calcium oxalate stones in dogs. The article has given some hope that there are specific dietary interventions that can prevent the reoccurrence of the stones (which are pesky, and tend to come back within three years). The article also gave a bit of hope that it's possible for dietary intervention to resolve the problem without surgery.

Much more research is needed. For the time being I'm scheduled for surgery at the end of the month. The human is going to keep asking questions until he hears answers that he likes. If he doesn't hear answers that he likes--well that means something. It means that surgery is the best option.