How NOT to Save Money with Your Working Dog Part I

Spring is in the air and so are fleas, ticks, mosquitoes, and other unsavory critters that not only make your dogs itch, but can pass on disease as well.  Invariably this time of year, people start looking into buying popular preventatives.  Seeing that online pharmacies market heavily towards pet owners, you may ask yourself, why buy my dog's heartworm prevention or flea/tick meds from my vet if I can save some money buying them cheaper online?

First, they are often  not necessarily cheaper.  I'm a housecall vet and I do not carry a large inventory of these products, but I do carry the generic form of Heartgard as well as Frontline spray.  I continually price shop online to get my clients the best price so they are priced the same as any of the online pharmacies.  There is a perception that they are cheaper, with promises of "free shipping" and coupons, but they are often marked up to mark down.  Ask your vet if they will match prices if they aren't already.

Second, if you look on the box of many of these products, they will say "for sale by licensed veterinarians only."  So if veterinarians are the only ones who are supposed to sell these products, how do they end up on 1-800 Pet Meds or Amazon.com?  Typically through diverted product.  Most companies state they do not sell to non-veterinary distributors, so what often happens is either staff are literally stealing product from the veterinary hospitals to resell or veterinarians no longer in practice may also purchase huge quantities from distributors just to resell them to these companies.  They also may come from other countries (many report they have different labels or stickers over the top of the original label).  Other products such as probiotics and joint supplements labeled only for sale through vets may be purchased in large quantities to get good prices, but they end up being about to expire, so a less than legit clinic or staff may sell them on Amazon.  A bottle of Dasuquin that is supposed to last 5 months that expires in a few weeks is not particularly ideal.

Another reason to purchase products from your veterinarian and not from online is that if you have a problem or your dog has a reaction, the reputable manufacturers will typically pay for some or all of the treatment.  For instance, I once had a client whose collie had a strong reaction to Advantage Multi, even at an appropriate dose for collies and even though he had been on other types of heartworm prevention before.  I am not married by any means to Bayer (the maker of Advantage Multi), but they did compensate me so I could treat the dog since the product came from me.  If the client would have purchased it online from one of these other outlets, it would have cost her well over $1000 to treat.

In addition, the reputable companies will also pay for heartworm treatment if your dog comes down with heartworm disease and you can prove your dog has been on it and purchased from a licensed veterinarian.  Heartworm treatment usually costs anywhere from $500 to well over $1000, so while heartworm resistance is still quite uncommon, it is worthwhile to get the legitimate product rather than trying to dose it yourself with cattle ivermectin or with product from an online pharmacy that has no guarantee from the company.  Also ask your veterinarian if any of the products they recommend are currently running specials for rebates or free doses.  This often brings the price to very reasonable levels as competitive if not more so than online pharmacies.

Lately I have also been seeing many posts on Facebook about mixing up homemade remedies to keep away fleas, ticks, and mosquitoes.  Unfortunately, these are typically only marginally effective and have to be applied multiple times per day per animal at best.  Two weeks ago, I had a client who used a natural remedy out of essential oils to apply on her dogs.  Both ended up testing positive for ehrlichia, a tick borne disease.  Although I am a holistic vet myself, these home remedies do not typically work as well.

Lastly, remember that your local vet is also likely a local small business.  Unless they are owned by Banfield or VCA, they are likely locally owned with locally employed staff and work hard to provide the best care for your animals.  It is harder and harder to compete with the "big box stores" and many clients don't always perceive how much overhead goes into keeping a clinic running.  Support your local vet and they will be there for you to provide excellent care for your working dogs. 

For more information on the FDA's recommendations concerning online pharmacies, see the following link:

http://www.fda.gov/forconsumers/consumerupdates/ucm048164.htm

Intro to Canine Sports Medicine

Here is a great podcast by Dr. Joe Wakshlag on an introduction to canine sports medicine.  Dr. Wakshlag is board certified in clinical nutrition and sports medicine/rehabilitation.  He has personal experience with running sled dogs.  

http://www.akcchf.org/news-events/multimedia/podcasts/intro-to-canine-sports.html

The Spring Itchies

Spring means pollen, fleas, ticks, swimming, and all sorts of things that make dogs itch.  We hear from clients these days that their dogs have allergies, but what does that really mean?  Simply put, an allergy is an over reaction by the body's immune system to something it perceives.  The three most common reasons for allergies are fleas, environmental allergies (also called atopy), and food allergy.  This post will break down each category.

	Flea
What causes it?	Allergic reaction to saliva of the flea when it bites
What does it look like?	Very persistent itching or chewing on flanks, lower back, tail
Diagnosis	Presence of fleas, flea dirt on pet or in the house
How to treat it	Many products available.  Unfortunately many natural products are not efficacious with heavy infestation
How to prevent it	Flea combs, monthly preventative especially during warm months of year
Other points	Do not have to see fleas!  Just takes one bite!

	Environmental
What causes it?	Allergy to nearly anything in the environment
What does it look like?	May be localized hot spot or can be generalized.  Often seasonal.  May end up with secondary bacterial or fungal infections
Diagnosis	Intradermal skin testing with a dermatologist
How to treat it	May require antibiotics/anti-fungals to get secondary infections down, omega 3 fatty acids, special shampoos, probiotics, diet trial, antihistamines, judicious use of steroids or immunosuppressants in some cases
How to prevent it	Avoid contact with the allergen.  Keep them on hard floors or vacuum religiously.  Use HEPA filters.  Rise feet/legs after walks
Other points	Also called atopy.  May also have some food allergy component to it as well

	Food
What causes it?	Immune system response to proteins in the food
What does it look like?	Vomiting, diarrhea, ear infections, hot spots, red belly, paws, or ears
Diagnosis	Strict novel protein/carb elimination diet for 8-12 weeks.  Note: the food allergy blood test is NOT reliable!  Too many false negatives/positives
How to treat it	Elimination diet, slowly add in potential allergens back in
How to prevent it	Avoid all forms of that particular food, including treats and heartworm meds.  Raw vs cooked may help, but not necessarily
Other points	Food allergies & intolerances are not the same thing, but present almost identically.  Always save at least one relatively obtainable protein source for testing.

The Effects of Vests on Heat Related Injuries in Working Dogs

An interesting study done by the University of Florida:

http://news.health.ufl.edu/2012/19118/colleges/college-of-veterinary-medicine/uf-study-looks-at-role-of-vests-in-heat-related-illness-of-working-dogs/

Article on Common Working Dog Injuries

This is a nice, if somewhat technical, article on working dog injuries.  I especially like how it covers injuries of the shoulders and elbows, as many people tend to focus most closely on the hind end.

http://veterinarymedicine.dvm360.com/vetmed/article/articleDetail.jsp?id=768613&pageID=1&sk=&date=

Pre Purchase Exams

When purchasing a puppy, most working/performance dog people know to make sure the pup's parents have passed health clearances that depend on the breed.  But what if you have your eye on an adult dog to purchase? The dog appears like they can do the work and they have a nice pedigree.  But are they a sound investment?  Horse owners are used to do pre purchase exams on their prospective performance animals.  Working dog owners should do the same.  Here are some pre purchase examination recommendations.  While these may cost you several hundred dollars up front, they may save you the same amount or more in headache and vet bills later on.

-Full physical exam:  Your veterinarian will examine the dog head to tail to make sure something is not obviously wrong
-Radiographs (x-rays):  Somewhat dependent on the breed, but all dogs should have their hips and elbows radiographed to make sure there are no issues.  50% of dogs with radiographic evidence of hip dysplasia show no obvious signs.  This one is a biggie!  What if the dog already had them done with a previous owner? It is not a bad idea to recheck to make sure there is not some other reason the dog might be unscrupulously being put up for sale
-Heartworm test:  Heartworms are a major medical problem to fix and an expensive one.  Dogs can also die from the treatment, so a simple test before will be very helpful.  Many heartworm tests also test for tick borne diseases that can cause serious systemic disease, such as Lyme disease and Ehrlichia.
-Fecal test:  Internal parasites such as roundworms can easily be spread into your home or kennel by a new introduction.  They are also extremely difficult to remove from the environment once they establish themselves.    It will also look for common causes of diarrhea, such as giardia and coccidia.  Getting the prospective dog a fecal floation test as well as on monthly heartworm preventative (which also treats intestinal worms) is important not only for the dog, but your other dogs and even other people in the household since roundworms and hookworms can be transmitted to people.

These are some guidelines of  things to ask your vet to investigate before agreeing to a sale.  With certain breeds, other genetic testing or examination may need to be done.  For example, German shepherds should be testing for degenerative myelopathy (a cheek swab test) and collie breeds should be given an opthalmic exam to look for diseases like progressive retinal atrophy (PRA).  If a male dog is going to be purchased as a potential stud dog, make sure to also schedule a breeding soundness exam to ensure his semen is of good quality.  While these tests involve more cost up front, they will save you money on a dud dog in the long run.

"But it doesn't seem to bother him..."

As a vet, I hear this phrase all the time, whether from working/performance dog folks or from pet owners.  It can be anything from dental pain to allergies to arthritis.  Owners tend to think "well, they aren't really crying out in pain when they are doing their job and they're still eating, so it must not be that bad..."  I want to caution people that just because they are not in agony, doesn't mean they are not in pain or that it's not causing a decrease in their quality of life or working performance.  If you are walking with a limp, you are likely in pain.  If you have a nerve exposed from a fractured tooth, you are likely in pain.  If you have a subluxated hip from a malformed joint, you are likely in pain.  You may be still able to function on some level, but it's not a great way to live.

We cannot ask a dog how much pain they are in, but we definitely know they suffer from pain.  Pain also increases stress, which increases cortisol (a stress hormone) and can interfere with the immune system and decrease healing.  Veterinary medicine has advanced significantly in its use of multi-modal pain management over the years and it doesn't need to be very expensive either.  So if a dog has a bad tooth or is limping or is even itching excessively (which would drive many people crazy), get it checked out!  If you don't feel your dog's pain is being addressed, be proactive with your vet and don't be afraid to ask if there's anything else that you can try.  If you don't have a vet that is progressive with pain management, get a second opinion.