Category: Frequently Asked Questions

Symmetric Dimethylarginine (SDMA)

SDMA Symmetric dimethylarginine is a new renal biomarker which can detect kidney disease when approximately 40% function has been compromised. SDMA is released into the circulation during protein degradation. Because it is almost exclusively eliminated via renal filtration it is a good estimate of GFR. SDMA is specific for kidney function. It is not impacted by extrarenal factors like BUN and creatinine. SDMA is an early indicator of kidney disease – it is not increased in animals with other various diseases. It is not dependent on the dog’s lean muscle mass. SDMA should be evaluated with other kidney tests such as BUN, creatinine, urinalysis,...

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“3L” Disease in Chinese Shar-Pei

Shar-Pei are the only breed I associate with this condition and it is often confused with Swollen hock syndrome which occurs in conjunction with Familial Shar-Pei Fever (FSF). 3L disease is unilateral or bi-lateral NON-PAINFUL swelling of the ankle joint in the absence of a fever. In the past this swelling has been termed “socks”. I believe there are two main causes behind this condition, both centering on hyaluronan production in the tarsus and/or metatarsus (the anatomical region below the stifle or knee and above the rear foot). I believe three mechanisms are involved (1) increased production of LMW- HA,...

SPAID – Shar-Pei Autoinflammatory Disorder

SPAID is a term to describe the spectrum of clinical signs due to systemic and persistent inflammation in Chinese Shar-Pei.  All the signs in SPAID are autoinflammatory in nature and are related elevated levels of hyaluronan, a molecule which functions as a danger signal (a DAMP) that triggers the inflammatory response.  SPAID resembles human AID (autoinflammatory disease) that also presents with multiple inflammatory signs.  Many Shar-Pei with SPAID also receive relief from disease by the use of IL-1β inhibitors which suggests a cytokine-driven inflammation and a dysregulation of the innate immune response.  SPAID definitely is linked to increased levels of...

Veterinary Pet Health Insurance

With the popularity of veterinary pet health insurance increasing and receiving more press I thought I should make a few comments: I don’t have any particular company or plan that I recommend at this time. Bear in mind that all plans currently reimburse the owner — you are initially responsible for the veterinary care costs. This is unlike the human health care insurance system. I recommend that pet owners set up an HAS or Healthcare Savings Account for their pets. This is simply a savings account that you periodically put money into on a regular basis for those emergency pet...

VACCINOLOGY

The subject of vaccines and vaccination protocols has become a hot topic in dog circles over recent years. Concerns have been raised about the increased incidence of immune-mediated diseases such as thromobytopenia (low platelet counts), hemolytic anemia (immune-mediated red blood cell destruction), immune-mediated arthritis and immune mediated skin disease as well as allergic vaccine reactions, seizures and other problems possibly related to vaccination. This discussion will provide some insight into the controversy and hopefully provide a rational approach to vaccination. The first point that must be made is that the vaccines available today are very effective. Since the advent of...

Urinalysis

The main information to evaluate on the urinalysis is the urine specific gravity and the urine protein. The specific gravity is a crude measure of kidney function. I recommend taking up the dog’s water after 9PM in the evening and then getting a urine sample first thing in the morning. By doing this we are testing the kidneys ability to concentrate the urine. In the early stages of kidney failure the kidneys lose the ability to concentrate urine. This happens when about 75-80% of the kidney is non-functional. Blood changes occur when about 85-95% of the kidney tissue is not...

T.R.A.P.S.

TRAPS stands for Tumor Necrosis Factor Receptor-Associated Periodic Syndrome. It is a rare disorder characterized by prolonged episodes of periodic fever and skin changes (in humans) manifested as erythematous macules, patches and edematous dermal plaques. The skin changes may last anywhere from 4-21 days. There are numerous other systemic signs and symptoms associated with the syndrome including conjunctivitis, periorbital edema, abdominal pain, myalgia, arthralgia, pleuritic chest pain, sterile peritonitis and headache. Amyloidosis can occur in this syndrome. The dermatologic lesions are characterized by a perivascular dermal infiltrate of lymphocytes and monocytes. In the past the syndrome has been known as...

Tight Lip Syndrome

Shar-Pei pups often have a condition called “tight lip syndrome” in which the lower lip pushes against the lower incisor (front) teeth or may even extend to cover those teeth. It is felt by some practitioners that the soft tissue of the lower lip impedes the growth of the lower jaw (mandible) resulting in an underbite. I don’t think that happens as I don’t believe soft tissue can impede bone growth but the lip pressure does cause the lower incisor teeth to angle back towards the mouth and it appears the bite is off. Rarely (I’ve not seen a case)...

Tick-borne Disease

Ticks can carry a number of organisms which can cause disease in dogs and people. Generally the organisms develop in the tick and are transmitted in the saliva as the tick feeds. There are six major groups of diseases we will briefly look at. Borreliosis (Lyme Disease) The infectious agent is a spirochete (motile bacteria), Borrelia burgdorferi, which is carried by the deer tick, Ixodes spp. The white-footed mouse is the main reservoir for the spirochete and the host for the nymphal and larval forms of the tick. White-tailed deer are the definitive host with dogs and people being exposed...

Thoughts on Picking a Vet

Being a good vet involves a balance between the following skills: People skills Caring/compassion for animals – animal skills Medical skills Philosophy of practice. It’s difficult to find someone with all the necessary talents. At any given time the same vet may fail in one of these skill areas. Is the owner willing to stay with the same vet for the long haul or bail out based on one mistake or bad encounter? I continue to be amazed at how many people jump from vet to vet or see multiple vets. It’s very hard to get to know an owner...