Cutting-Edge Care for Older Dogs
Advances in treatment of 15 geriatric diseases for dogs parallel those for humans.
Susan Bertram, DVM |
Posted: Sun Jan 2 00:00:00 PST 2000
Advances in treatment of geriatric diseases for dogs parallel those for humans, ranging from simple nutritional therapy to sophisticated surgical techniques.
Red flags: Stiffness when rising from a lying or sitting position, limping and reluctance to climb stairs.
What's wrong?: Obesity, inherited joint disorders, such as hip dysplasia, and inappropriate exercise cause excessive stress on joints. Over time rough, abnormal bone builds around a joint and cartilage surfaces erode so they no longer glide smoothly.
Treatment: New drugs, such carprofen and etodolac, relieve pain and increase mobility. Acupuncture also may reduce discomfort. Obese dogs must lose weight to reduce stress on joints. Mild to moderate, low-impact exercise, such as walking or swimming, help by making supporting muscles stronger. Dog food and supplements with the nutraceuticals glucosamine, chondroitin sulfate and antioxidants may decrease inflammation in joints and heal and protect cartilage.
Red flags: Dilated pupils, excessively "glowing" eyes, tripping and running into furniture or doorways. A cloudy-looking pupil or surface to the eye, or a red, painful eye may signal a need for emergency care to preserve eyesight.
What's wrong?: Cataracts block light from passing through the lens of the eye. The retina, which functions as the "projection screen," can be damaged by glaucoma, an excessive fluid build-up within the eye, or high blood pressure. Progressive retinal atrophy is an inherited deterioration of the retina.
Treatment: Early treatment for cataracts, glaucoma or high blood pressure is essential to rescue eyesight. Surgeons use ultrasonic vibration to break up cataracts and follow up by implanting artificial lenses. For glaucoma, laser surgery is used to decrease the eye's ability to produce fluid, thereby reducing pressure on the retina Veterinarians control high blood pressure, caused by kidney or heart disease, by prescribing medications, such as propranalol. No treatment is available for progressive retinal atrophy.
Red flags: Pain, dysfunction of a vital organ, swollen lymph nodes, weight loss or lumps on or under the skin.
What's wrong?: Damage to the genetic code (DNA) causes cancerous cells to multiply at an accelerated pace at the expense of normal cells.
Treatment: A new therapeutic diet for dogs undergoing chemotherapy has adjusted levels of protein, fats, carbohydrates and omega-3 fatty acids to try to starve the tumor while providing optimal nutrition to the patient. In some cases of bone cancer, bone replacement surgery is an alternative to limb amputation.
Disorientation, marked by wandering aimlessly or getting lost in home or yard. Housetraining accidents.
What's wrong?: Age-related changes within the brain that affect memory, learning, perception and behavior.
Treatment: Last year the Food and Drug Administration approved L-deprenyl, first used to treat Parkinson's. Given daily, L-deprenyl may reverse abnormal behaviors.
Red flags: Slow or inconsistent in obeying commands and oblivious to noises. A dog that goes suddenly deaf may bark frantically.
What's wrong?: Long-standing ear infections decrease transmission of sound waves through ear structures. In dogs without a history of ear infections, age-related dysfunction of the nerve messages from ear to brain can cause deafness.
Treatment: For some cases of infection-related deafness, surgically removing abnormal ear cartilage and infected ear tissue may improve hearing.
Red flags: Foul breath, reluctance to eat, discolored teeth and red or purple gums.
What's wrong?: Tartar an d plaque build-up lead to bacterial infection of gums and even jaw bone. Bacteria from the infection can enter the bloodstream and harm other organs.
Treatment: In a dental cleaning under anesthesia, veterinarians fill pockets between the gums and the teeth with long-lasting antibiotic gel to fight infection at the source. To save a tooth affected by severe periodontal infection, veterinarians can apply enamel matrix protein, a natural substance that regenerates jawbone and gum attachments, around the tooth. Commercial therapeutic diets with a crunchy texture can help scrape off plaque.
Red flags: Coughing (initially at night), reduced tolerance for exercise, fainting and distended abdomen.
What's wrong?: Stiff or leaky heart valves or weakening of the heart muscle itself (cardiomyopathy) makes the heart less efficient at pumping blood. This causes fluid to backflow into lungs or other vital organs, or into the abdominal cavity.
Treatment: Enalapril, a new treatment for heart failure, dilates blood vessels to decrease workload on the heart. It also decreases the dog's cough and increases its energy level. Diuretics help clear fluid from lungs. Digoxin, a drug derived from the foxglove plant, increases the contracting ability of the heart muscle. Veterinarian-prescribed beta-blockers lower blood pressure and treat abnormal heart rhythms. Commercial low-sodium diets are available to decrease water retention.
Old Dog Vestibular Disease
Red flags: Sudden onset of head tilt to one side, loss of balance, circling, falling over, vomiting.
What' wrong?: Suspected problem within the inner ear, which functions in hearing and maintaining balance.
Treatment: Dogs typically recover within hours to weeks but need help with eating and drinking, and anti-motion sickness medications such as meclizine. Veterinarians may prescribe oral antibiotics to head off inner ear infection. Thyroid supplements are needed in cases where the nerve supply to the inner ear may be affected by insufficient hormone production of the thyroid gland.
Red flags: Increased thirst and urination, weight loss, muscle wasting, decreased appetite, vomiting, rapid respiration, pale mucous membranes.
What's wrong?: Kidneys gradually stop functioning. Waste accumulates to toxic levels in the blood when the kidneys are less able to filter waste products. Phosphorus, calcium or potassium levels also may become abnormal. Anemia develops because the kidney no longer stimulates the bone marrow to produce red blood cells.
Treatment: Therapeutic diets adjust protein levels and reduce phosphorus to decrease build-up of toxins. Phosphorus binders mixed into food prevent your dog from absorbing the mineral during digestion, so less needs to be eliminated by its failing kidneys. Injections of supplemental erythropoeitin, a human-derived hormone, stimulates red blood cell production to treat anemia. The anabolic steroid stanozolol can improve appetite and help slow muscle wasting. A kidney transplant can help some dogs.
Red flags: Jaundice, vomiting, disorientation, seizures, weakness, increased thirst and urination, distended abdomen.
What's wrong?: Chronic hepatitis (inflammation) or cirrhosis (scarring) of the liver causes backup of bile, and liver cells can't detoxify the blood and help digestion. Hepatitis and cirrhosis may be a result of bacterial or virus infections, auto-immune disease (where the body's immune system attacks itself) and environmental toxins. Cancer is also a possibility.
Treatment: Ursodeoxycholic acid oral tablets treat bile backup by inhibiting production of harmful acids. Oral medications that prevent toxin absorption, such as cholestyramine, lactulose and metronidazole, treat disorientation and seizures. Therapeutic diets with adjusted nutrien t levels decrease workload on the liver and can reduce symptoms. The immune-suppressing drugs prednisone and azathioprine treat auto-immune inflammation.
Intervertebral Disk Disease
Red flags: Hunched back, reluctance to move, pain, weakness, wobbly gait or dragging leg(s), urine or fecal incontinence and paralysis.
What's wrong?: The soft disk material in your dog's spine has bulged out (herniated) from between vertebrae and is causing swelling of the spinal cord or nerve roots.
Treatment: For sudden disk injury, intravenous injection of the corticosteroid methylprednisolone sodium succinate, a potent anti-inflammatory, reduces swelling. If your dog becomes paralyzed or weak, early surgery is the best treatment. Injecting an enzyme, such as chymopapain or collagenase into the affected disk, or laser surgery, are alternative treatments. Mild symptoms are treated with rest and anti-inflammatories.
Red flags: Reduced appetite, intermittent vomiting or diarrhea, or weight loss despite a good appetite.
What's wrong?: Changes of vital organs may reduce your dog's capacity to clear by-products of daily metabolism, and the excess waste acts like poison. Stomach pain and inflammation reduce appetite and interfere with absorbing nutrients.
Treatment: Commercial therapeutic diets help dogs with liver or kidney disease. If a specific disease isn't diagnosed, your dog may respond to a diet designed for easiest digestion.
Red flags: Subtle changes in behavior, including sleeping more, eating less and not wanting to go for walks. Trembling, whining and limping are other clues.
What's wrong?: Pain is the body's response to injury or inflammation.
Treatment: New non-steroidal anti-inflammatory drugs, such as carprofen and etodolac, provide superior pain relief. Skin patches containing the narcotic fentanyl provide continuous medication for cancer pain. Synthetic morphine-like drugs such as butorphanol, provide relief without extreme sedation. For chronic pain, combining anti-anxiety medications with pain relievers works effectively. Acupuncture provides relief.
Red flags: Excessive thirst and urination, patchy hair loss, distended abdomen, weakness, excessive panting and restlessness.
What's wrong?: The adrenal glands are overproducing cortisol, the body's natural cortisone. Cortisol has anti-inflammatory effects and regulatory functions on most body systems. In most cases a benign growth in the pituitary gland, a gland in your dog's brain that tells the adrenals to make cortisol, or a benign or cancerous growth on the adrenal gland(s) is behind the overproduction of cortisol.
Treatment: L-deprenyl is safe and can help some dogs with the pituitary gland form of Cushing's. Many dogs require treatment with the more potent drug Lysodren. If a tumor on the adrenal gland is to blame, surgical removal of the adrenal gland cures the disease.
Red flags: Unexplained weight gain, lethargy, dry, brittle coat or patchy hair loss, failure to regrow clipped hair, slow healing of wounds, skin and ear infections and seborrhea.
What's wrong?: The thyroid gland is not producing enough thyroid hormone, which regulates the body's metabolic rate.
Treatment: Daily supplementation of the missing hormone thyroxine.
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