Grain-Free Diet Guidance

Recent information has given rise to concerns about feeding grain free diets. There is increasing evidence linking these diets to a form of heart disease in dogs. The FDA, Tufts University, UC Davis, CVCA and others continue research regarding these concerns. For now, here are links to related information, as well as a statement from our local cardiology group.

From the Chesapeake Veterinary Cardiology Associates (CVCA) Website; Guidance for Pet Owners:

“At this point in time, we are not certain of the exact causal relationship between grain-free and/or high legume diets in atypical dog breeds with dilated cardiomyopathy (DCM). Taurine deficiency of these pet foods does not appear to be the primary issue in these DCM patients as we have found normal taurine levels in many of these pets with DCM. However, in some breeds such as the Cocker Spaniel and Golden Retriever, we have found low plasma taurine levels.”

At this time, if there is not a clinical reason (i.e. food allergies or gastrointestinal upset) for use of a limited ingredient, unique protein source (kangaroo, alligator, bison, etc.) diet, we would suggest using alternative diets. Consultation with a board-certified veterinary nutritionist should be considered. Another possible consideration is to use two/three pet foods from different manufacturers including a diet that is not full of legumes (lentils, chickpeas, peas) and has some grain in the product. As we continue to investigate the link between the increased incidence of dilated cardiomyopathy in atypical canine breeds with grain-free diets, we hope to ultimately determine the definitive issue but, for now, we currently do not have that answer.”

CVCA link for info on this grain free diets and heart disease concern in dogs.

Additional References from the FDA, Washington Post and NY Times:

FDA June 12, 2018 : FDA Investigating Potential Connection Between Diet and Cases of Canine Heart Disease

Washington Post:  Grain-free, exotic dog food linked to heart disease

New York Times, July 24, 2018:  Popular Grain-Free Dog Foods May Be Linked to Heart Disease


KAH Position Statement on Shock Collars

Dear Dog Owner,

Recently, we at Kingsbrook Animal Hospital have seen an increasing number of well-intentioned dog owners seek the help of trainers who use electric stimulation or “shock” collars to train their pets.  While the response is often quick, we as veterinarians see many dogs that in the long run are adversely affected by this method.  It is our position that there are better training methods available that can not only solve the problems at hand, but are also less likely to cause more problems down the road.

It is the position of Kingsbrook Animal Hospital (KAH) that effective animal training procedures lay the foundation for an animal’s healthy socialization and training and help prevent behavior problems. The general pet-owning public should be educated by organizations and associations to ensure pet animals live in nurturing and stable environments to better prevent behavior problems. In this effort, it is the position KAH that the use of electronic stimulation, or “shock” or “e-collars,” to train and/or modify the behavior of pet animals is not necessary for effective behavior modification or training and damaging to the animal. For the purposes of this statement, electronic stimulation devices include products often referred to as: e-collars, training collars, e-touch, stimulation, tingle, TENS unit collar, remote trainers.

Numerous countries have banned electronic stimulation devices, and KAH’s official position is that electronic stimulation can play no part of effective and ethical animal training. Studies and the experience of the doctors at KAH show that training and behavior problems are consistently and effectively solved without the use of electronic stimulation devices. Evidence indicates that rather than speeding the learning process, electronic stimulation devices slow the training process, add stress to the animal, and can result in both short-term and long-term psychological damage to animals.

Some common problems resulting from the use of electronic stimulation devices include, but are not limited to:

  • Infliction of Stress and Pain

Even at the lowest setting, electronic stimulation devices present an unknown stimulus to pets which, when not paired with a positive stimulus, at best is neutral and at worst is frightening/painful to the animal. Pets learning to exhibit a behavior in order to escape or avoid fear or pain are, by definition, subjected to an aversive stimulus. Studies indicated that dogs trained with shock displayed stress signals as they approached the training area and frequently work slowly and deliberately. In many instances, electronic stimulation causes physiological pain and psychological stress to the animal, often exhibited by vocalization, urination, defecation, fleeing and complete shut-down. In extreme cases, electronic stimulation devices may burn animal tissue.

  • Generalization

For behaviors to become reliable in random environments, they must be practiced in random environments (called “generalization”). When using an electronic stimulation device to train, this means the animal must be repeatedly subjected to electronic stimulation for the behavior to become reliable. To maintain the behavior, the pet will need to be subjected to the electronic stimulation on a periodic but random basis. Often, the behaviors never become reliable when the electronic stimulation device is not present because, as part of the cue system, it is missing when the animal is not subjected to it. Therefore, in addition to being an aversive stimulus, electronic stimulation collars are ineffective if not worn frequently or even constantly.

  • Escalation

If results are not immediately realized, many users of electronic stimulation devices will increase the level of stimulation, which often results in the animal attempting to escape or avoid the stimulus and even total shut down where it will refuse to perform. This creates a counter-productive paradigm in which little learning can occur. Additionally, some animals     are “stoic” and may fail to show a pain response despite increased levels of electronic stimulation. Other animals may become habituated to the pain and endure it, causing trainers to increase the level and frequency of electronic stimulation. The pain and stress caused in such situations has a significant effect on an animal’s physiology, increasing cortisol levels and heart rate.

  • Global Suppression, or “Shut-Down”

An animal repeatedly subjected to electronic stimulation for several different behaviors may go into a state of “shut down,” or a global suppression of behavior. This is frequently mistaken for a “trained” animal, as the animal remains subdued and offers few or no behaviors. In reality, they are afraid to move. In extreme cases, animals may refuse to perform any behavior, called “learned helplessness” and isolate themselves to avoid incurring electronic stimulation. This is counter-productive to training new behaviors.

  • Suppressed Aggression

The use of aversive stimuli is counter-indicated in animals with aggression because they suppress aggression and it may resurface at any time, without warning, generally in a more severe display (Hiby et al., 2004). Using electronic stimulation to reduce behaviors such as barking, lunging and growling may suppress behaviors that warn of a more serious imminent behavior such as biting. Without ritualized aggression behaviors, people and other animals will have no warning before the animal subjected to punishment feels forced to bite. It is KAH’s position that desensitization and counter-conditioning is the only ethical and effective paradigm in which to treat aggression in pet animals.

  • Redirected Aggression

Animals subjected to repeated electronic stimulation may be respondently conditioned to associate the fear/pain of electronic stimulation with certain contextual cues in their environment. As an example, many dogs trained to honor the boundaries of an electronic boundary (also referred to an “underground” or “invisible” fence) will approach a stranger on the other side of the boundary and encounter the painful/frightening stimulus. Repeated instances of this will generalize to the dog fleeing or acting aggressively toward strangers on the other side of the fence in order to avoid the painful/frightening stimulus. Similarly, animals subjected to repeated electronic stimulation may act aggressively toward the nearest human or animal near them in attempt to escape/avoid pain/fear caused by electronic stimulation.

  • Unintended Consequences

Electronic stimulation devices have not been studied in terms of health. There is currently insufficient data to determine whether prolonged use of electronic stimulation devices may pose a long-term health risk. However, there is clear data that electronic stimulation can cause burn injuries.


It is the position of the KAH that all training should be conducted in a manner in which to encourage animals to enjoy training and become more confident and well-adjusted pets.

We encourage the use of positive operant and respondent training methods, both personally and professionally.

Recommended Reading:


Pat Miller, Whole Dog Journal, February 2006 Shock or Awe

Pat Miller, Simply Shocking in Whole Dog Journal 2/03

Scientific Articles

Polsky R. “Can Aggression in Dogs Be Elicited Through the Use of Electronic Pet Containment Systems?” Click here for the article.

Hiby, E.F.; Rooney, N.J.; Bradshaw, J.W.S. “Dog training methods: their use, effectiveness and interaction with behaviour and welfare.” Click here for an abstract of the article.

Schalke E, Stichnoth J, Ott S and Jones-Baade R. “Clinical signs caused by the use of electric training collars on dogs in everyday life situations.” Click here for the article

Beerda, B. 1998 Behavioral, saliva cortisol, and heart rate responses to different types of stimuli in dogs. Click here for the article abstract

N.H. Azrin, H.B: Rubin, R.R: Hutchinson Biting Attack by Rats In Response To Aversive Shock. Click here for the article

Emily Blackwell, Rachel Casey The use of shock collars and their impact on the welfare of dogs: Click here for the article

Matthijs B.H. Schilder, Joanne A.M. van der Borg Training dogs with help of the shock collar: short and long term behavioural effects Click here for the article

Kristy Englert, The use of Electric Shock Collars vs. Other Training Methods: Efficacy, Stress, and Welfare Concerns Click here for the article

David Ryan, Negative impacts of training dogs using an electric shock collar Click here for the article.


Thanks to the American Veterinary Society of Animal Behavior for the above content.

Dog Behavior Problems – Submissive, Excitement, and Conflict Urination

Why does my dog urinate when he meets new people or when I come home?

In this type of house soiling, the dog appears to lose control of its elimination in a number of situations:

1. When the dog is fearful, anxious, or overly submissive about being approached and takes on a submissive posture with ears back, retraction of lips, avoidance of eye contact, cowering, lowered body and sometimes turning onto the back (see (48) Canine Communication – Interpreting Dog Language).

2. When the dog is overly excited, especially during greetings. However, when you look closely at some of these dogs, they are often exhibiting multiple competing emotions (conflictinduced behavior), in that they are socially attracted to the owner or visitor while displaying fear, anxiety or excessive submission.

These types of urination are most commonly seen in puppies and young female dogs.

For pets that are fearful, attempts to reach for or approach the puppy may elicit a fear response especially if it has been punished in similar situations in the past. For pets with submissive urination, a bold or assertive approach, reaching for the dog, or standing over the dog, will further aggravate the fear and submissive posturing. Excitement induced urination might occur when the dog greets family members, especially when they return home after an absence, or during vigorous petting. As indicated, the combination of any two of these emotions (conflict) may be the most significant factor. Owner intervention in the form of verbal reprimands or punishment only serves to make the dog more submissive, more anxious, more fearful and more conflicted at further approaches.

Although this problem can be seen in dogs of any age, these types of urination are most commonly seen in puppies and young female dogs. This could be because male puppies are somewhat more assertive or because they anatomically have a longer urethral tract. With age, many dogs grow out of this problem, perhaps either because they gradually become less excitable during greeting or because they develop greater urine control with sexual maturity. Treatment should focus on reducing the pet’s excitement and arousal, reducing the fear and anxiety, and training for calm and relaxed greeting behavior.

How can submissive and excitement urination be treated?

For submissive and fearful urination, it is important that the owner and all visitors interact with the pet in a less assertive or threatening manner. Approaches and greeting should be consistent and a loud tone of voice, sudden movements, reaching and direct eye contact should be avoided. All training should be reward based and physical restraint or physical punishment must entirely be avoided. It is important that a reaching hand is always considered to be a friendly and reassuring gesture by the puppy (see (62) Teaching Calm – SOFT and Handling Exercises). A focused sit with eye contact should be part of the relaxation and settle exercises (see (61) Teaching Calm – Settle and Relaxation Training). If any punishment is ever needed during training (but never during greeting or approach), you must never use your hand. If you catch your puppy in the act of house soiling, going into the garbage or chewing on something inappropriate, you might try a mild verbal reprimand, a noise device, a spray of water, or a pull on a long leash, but never anything physical.

What can I do to get started?

The goal of training is to teach your dog to greet and be handled in a manner that does not lead to fear, submission or excessive excitement. If you can avoid these reactions, the elimination might be prevented. At first you may be able to get your pet to display a behavior that it already does consistently without leading to urination. Consider what tricks or commands your dog does particularly well – shake a paw, sit up and beg, or fetch. You might throw a favored ball or treat so that your puppy learns to play when you enter or approach. If the dog anticipates food or ball playing at each greeting, it is less likely to eliminate. Another consideration is whether your dog might focus on a favored toy or treat or alert to a particular sound (e.g., squeaky toy, food jar). If this is the case you may be able to use these cues to get your dog to focus on something other than your approach.

What is the best way to overcome this problem?

The best solution is to replace the excited, fearful, and submissive responses with a settled method for greeting. At first you will need to identify and avoid those stimuli that might incite the behavior, while teaching your pet to sit and settle or go to its bed and relax to receive favored rewards (see (61) Teaching Calm – Settle and Relaxation Training). Use favored food rewards or toys as lures to train your dog to focus and settle. Gradually work to get a longer and more focused settle response. A head halter can be useful to maintain a sitting position and to gradually shape and increase more prolonged eye contact and a progressively more relaxed state. A “go to bed” or “go to mat” exercise would also be particularly useful to settle the dog away from the owner before allowing it to approach and greet. Before attempting to use these commands and exercises during actual greetings, you should gradually progress from teaching your puppy to stay in a focused sit while you walk away and return, and slowly work up to more intense handling. Practice approaching and kneeling beside the puppy when it is relaxed in its bed, then practice leaving and returning, throwing your dog a treat if it remains seated or lying on its mat.

The goal of training is to teach your dog to greet and be handled in a manner that does not lead to fear, submission, or excessive excitement.

When greeting the dog, you should begin by letting your dog approach you rather than going to your dog. Kneel down rather than stand over the dog, speak softly, and pet the chest instead of the head. When greeting a very fearful or submissive dog, you may initially need to completely ignore it at greeting, even to the extent of avoiding eye contact. Allow your dog some time to settle down and only allow it to approach you if it is calm. By using a favored toy or giving a favored chew, you may be able to entice your puppy to approach or to allow lifting and handling while it takes the food or plays with the chew toy. As you pat or stroke your dog, be careful to avoid inducing further fear or submission; also, avoid letting your dog get too excited.

For excitement urination, those stimuli that initiate the behavior should be avoided. During greetings, owners and guests should refrain from eye contact, physical contact, or verbal contact until the pet calms down. Greetings should be very low key and words spoken in a low, calm tone. The puppy might be taught to do an alternative behavior but the goal should be to practice a relaxed greeting (sit/focus or go to your mat). Stop and perhaps even walk away if the puppy starts to get excited. Another important aspect of treating over-excitement to visitors is repeated presentations of the stimulus, so that the dog learns the correct response. If visitors come only infrequently, the dog does not have the opportunity to learn a new behavior. By scheduling visitors to come, visit briefly, leave by another door and then re-enter, the dog may learn to be less excited and/or submissive with each entrance. Each time the person returns they are more familiar and less likely to stimulate the urination behavior. This allows the dog to “practice” the good behavior and reinforce the appropriate response.

Are there drugs that might help?

For refractory cases, the use of drugs to increase bladder sphincter tone might also be considered as an adjunct to behavior therapy. In some cases of fearful and submissive urination the synthetic canine pheromone (AdaptilTM) may be helpful.

This client information sheet is based on material written by: Debra Horwitz, DVM, DACVB & Gary Landsberg, DVM, DACVB, DECAWBM © Copyright 2013 LifeLearn Inc. Used and/or modified with permission under license

Xylitol Toxicity in Dogs

What is Xylitol?

Xylitol is a naturally occurring substance that is widely used as a sugar substitute. Chemically, it is a sugar alcohol, and in nature it is found in berries, plums, corn, oats, mushrooms, lettuce, trees, and some other hardwood trees and fruits.

Commercially, most xylitol is extracted from corn fiber, birch trees, hardwood trees and other vegetable material. Although it has been used as a sugar substitute for decades, its popularity has increased dramatically in the last few years.

How is it used?

Xylitol is manufactured into a white powder that looks and tastes similar to sugar. In many countries it has been approved for use in oral care products, pharmaceuticals and as a food additive. Products that may contain xylitol include sugar-free gum, candies, breath mints, baked goods, cough syrup, children’s chewable vitamins, mouthwash, and toothpaste, to list a few.

Why is xylitol increasing in popularity and use?

Xylitol is about as sweet as sucrose, but contains only about two-thirds of the calories. As a sugar substitute, it is lower on the glycemic index, a scale that ranks carbohydrate-rich foods by how much they raise blood sugar levels compared to glucose. Being lower on the glycemic index makes xylitol useful for diabetics or people on low carbohydrate diets.

With respect to oral health, research has shown that xylitol helps reduce the formation of plaque, inhibits dental cavities, and stimulates the production of saliva.

How safe is xylitol?

Xylitol is safe for use in humans. Xylitol, like most sugar alcohols, may have a mild laxative effect when eaten in large amounts, when first introduced to a diet. This occurs because, until the digestive system adapts, xylitol may not be completely digested in the intestines. This causes mild diarrhea and/or mild intestinal discomfort.

“Xylitol is extremely toxic to dogs.”

However, xylitol is extremely toxic to dogs. Even small amounts of xylitol can cause hypoglycemia (low blood sugar), seizures, liver failure or even death in dogs.

Why is xylitol toxic to dogs?

In the past 5 years, Pet Poison Helpline, an animal poison control based out of Minneapolis, MN, has had over 1500 calls for xylitol poisoning, due to the growing awareness of this common kitchen toxin. In both humans and dogs, the level of blood sugar is controlled by the release of insulin from the pancreas. Xylitol does not stimulate the release of insulin from the pancreas in humans. However, when non-primate species (e.g., a dog) eat something containing xylitol, the xylitol is quickly absorbed into the bloodstream, resulting in a potent release of insulin from the pancreas. This rapid release of insulin results in a rapid and profound decrease in the level of blood sugar (hypoglycemia), an effect that occurs within 10-60 minutes of eating the xylitol. Untreated, this hypoglycemia can be life-threatening.

How much xylitol is poisonous to a dog?

The dose of xylitol that can cause hypoglycemia in the dog has been reported between 50 milligrams (mg) of xylitol per pound of body weight (100 mg per kg). The higher the dose ingested, the more the risk of liver failure. The most common source of xylitol poisoning that Pet Poison Helpline gets called about comes from sugar-free gum. With certain brands of gum, only 9 pieces of gum can result in severe hypoglycemia in a 45 pound dog, while 45 pieces would need to be ingested to result in liver failure. With other common brands of gum (which contain 1 g/piece of gum), only 2 pieces would result in severe hypoglycemia, while 10 pieces can result in liver failure. As there is a large range of xylitol in each different brand and flavor of gum, it is important to identify whether a toxic amount has been ingested.

“Xylitol is estimated to be 100 times as toxic as chocolate to dogs.”

Intake of very high doses of xylitol (225mg/lb or 500 mg/kg body weight) has been implicated in liver failure in dogs.

What should I do if my dog eats something containing xylitol?

If you suspect that your pet has eaten a xylitol-containing product, please contact your veterinarian or Pet Poison Helpline (800-213-6680) immediately.

Do not induce vomiting or give anything orally to your dog unless specifically directed to do so by your veterinarian. It is important to get treatment for your dog as quickly as possible. As some dogs may already be hypoglycemic, inducing vomiting can make them worse!

What are the symptoms of xylitol poisoning?

Symptoms of xylitol toxicity develop rapidly, usually within 15-30 minutes of consumption. Signs of hypoglycemia may include any or all of the following:

  • Vomiting
  • Weakness
  • Incoordination or difficulty walking or standing (walking like drunk)
  • Depression or lethargy
  • Tremors
  • Seizures
  • Coma

In severe cases, the dog may develop seizures or liver failure. Dogs that develop liver failure from xylitol poisoning often show signs of hypoglycemia.

How is xylitol poisoning diagnosed?

A presumptive diagnosis of xylitol poisoning is made if there is a known or possible history that the dog ate something containing xylitol, coupled with symptoms of hypoglycemia. Since toxicity develops rapidly, your veterinarian will not wait for a confirmed diagnosis before beginning treatment.

Is there an antidote for xylitol toxicity?

No. There is no antidote for xylitol toxicity, although treatment with sugar supplementation, IV fluids, and liver protective drugs are beneficial.

How is xylitol poisoning treated?

Fast and aggressive treatment by your veterinarian is essential to effectively reverse any toxic effects and prevent the development of severe problems.

If your dog has just eaten xylitol but has not yet developed any clinical signs, your veterinarian may induce vomiting to prevent further absorption, depending on what your dog’s blood glucose level is. If clinical signs have developed, treatment will be based on the symptoms that are being shown. Since xylitol toxicity can cause both low blood glucose and low potassium levels, your veterinarian will perform blood work to determine whether these problems need to be treated. In all cases, your dog will require hospitalization for blood sugar monitoring, dextrose administration, intravenous fluids, liver protectants, and any other supportive care that may be needed. Blood work should be monitored frequently to make sure that blood sugar and liver function remain normal.

What is the prognosis for recovery from xylitol poisoning?

The prognosis is good for dogs that are treated before symptoms develop, or for dogs that develop uncomplicated hypoglycemia that is reversed rapidly. If liver failure or a bleeding disorder develops, the prognosis is generally poor. If the dog lapses into a coma, the prognosis is very poor.

How can I prevent this problem?

If you personally use products containing xylitol, make sure they are stored safely, out of reach of your pets. Do not share any food that may contain xylitol with your pets. Only use pet toothpaste for pets, never human toothpaste. Keep in mind that there are some veterinary products that contain small amounts of xylitol (e.g., gabapentin medication, mouthwashes). At prescribed doses, these should not result in xylitol poisoning; however, if ingested in large amounts, can potentially result in poisoning.

“If you personally use products containing xylitol,make sure they are stored safely, out of reach of your pets.”

The toxicity of xylitol for cats and other species is not documented at this time, although there has been some concern that other non-primate species (e.g., cats, ferrets, etc.) may react to xylitol in a similar manner as dogs.

With any poisoning, prompt decontamination and treatment is always warranted, as it’s less dangerous to your pet, and less expensive for you to treat early! Rapid diagnosis and treatment is imperative!

*Pet Poison Helpline, is an animal poison control service available 24 hours, seven days a week for pet owners and veterinary professionals who require assistance treating a potentially poisoned pet. Pet Poison Helpline is available in North America by calling 800-213-6680. Additional information can be found online at Pet Poison Helpline is not directly affiliated with LifeLearn.

This client information sheet is based on material written by: Cheryl Yuill, DVM, MSc, CVH & Justine A. Lee, DVM, DACVECC, Associate Director of Veterinary Services, Pet Poison Helpline © Copyright 2011 Lifelearn Inc. Used and/or modified with permission under license.

Whipworm Infections in Dogs

What are whipworms?

Whipworms are intestinal parasites that are about 1/4 inch (6 mm) long. They live in the cecum and colon (large intestine) of dogs where they cause severe irritation to the lining of those organs. Whipworm infection results in watery, bloody diarrhea, weight loss, and general debilitation. They are one of the most pathogenic worms found in dogs.

How do dogs get whipworms?

Whipworms pass microscopic eggs in the stool. The eggs are very resistant to drying and heat, so they can remain viable (alive) in the environment for up to 5 years. Once laid, they embryonate (mature to an infective stage) in the environment and are able to re-infect the dog in 10-60 days. The embryonated eggs are swallowed and hatch and mature to adults in the lower intestinal tract, completing their life cycle (see illustration).

How are whipworms diagnosed?

“Parasites pass small numbers of eggs on an irregular basis, so some samples may be falsely negative.”

Whipworms are diagnosed by finding eggs with a microscopic examination of the stool. However, multiple stool samples are often required because these parasites pass small numbers of eggs on an irregular basis, so some samples may be falsely negative. In addition, it takes approximately 11-12 weeks after hatching for a female adult to begin to lay eggs. Any dog with chronic large bowel diarrhea should be suspected to have whipworms, even if the stool sample was negative. Thus, it is an accepted practice to treat chronic diarrhea by administering a whipworm dewormer. Response to treatment is an indication that whipworms were present but could not be detected on fecal examination.

How are whipworms treated?

To resolve your pets current infection with whipworms, a dewormer called Panacur is being prescribed. This is administered daily for 3 days and then repeated in 3 weeks. Pets are more accepting of Panacur if it is either mixed in canned food or water-soaked dry food. Stools should be properly disposed of daily to prevent reinfection.

A fecal sample should be rechecked within one week of the second dewomer to be sure the whipworm infection is resolved. (_)

The most frustrating aspect of whipworm infections is the high rate of reinfection because the eggs are extremely hardy in the environment. Therefore, if a dog is diagnosed with a whipworm infection, it is very important to use a heartworm preventative that contains a whipworm medication, such as Interceptor or Sentinel, all year round. Whipworms are not nearly as common today because of widespread use of these modern heartworm prevention products.

Can I get whipworms from my dog?

No. Whipworms are not infectious to people. They are exclusive parasites of the dog.

For more reliable information on parasite related issues you can go to or feel free to call us with questions anytime.

This client information sheet is based on material written by: Ernest Ward, DVM © Copyright 2009 Lifelearn Inc. Used and/or modified with permission under license

Walking Your Dog for Weight Loss

Veterinarians often recommend walking as a key element of most canine weight loss and fitness regimens. This sounds simple enough, but is it? The following questions are commonly asked by dog owners who are about to embark on a walking program to promote weight loss.

What sort of equipment do I need?

Forget the leash and collar if you want to burn some serious calories with your dog. Collars can compress the trachea (windpipe) when pulled, causing difficulty breathing or even a neck injury. Choke chains or any other collars that work by applying a constrictive pressure around the neck are especially dangerous. Your safest choice is a head halter (Gentle Leader, etc.) or walking harness (Ultra Paws Easy Walkin’ Harness, Gentle Leader Easy Walk, etc.). Look for wide, soft, padded straps and breathable materials.

A leash of a relatively short length is preferable. If you wish to use a retractable leash, make sure it is no longer than 12 feet. You’ll be keeping your canine companion close to keep up a steady pace. Save the long leash for casual strolls around the neighborhood or explorations at the park.

For long winter walks in cold climates, protective booties and dog coats may be required. If you’ll be walking in hot weather (above 80-85°F or 26-29°C for most dogs), or if you’ll be walking longer than 30 minutes, don’t forget to carry water for both you and your dog. If you want your dog to be fashionably equipped, there are many different styles of portable water bottles available for dogs on the move.

What pace should I set?

“Few dogs will naturally walk at a pace that generates the elevated heart rates needed for sustained aerobic activity and weight loss.”

Few dogs will naturally walk at a pace that generates the elevated heart rates needed for sustained aerobic activity and weight loss. Based on observations, the average pace of people walking with their dogs is 25 minutes per mile, which is actually a slow stroll. They make frequent pauses (on average every one to two minutes) for the dog to smell an interesting object or mark territory. Walking for weight loss is very different than walking for pleasure. Make your objective to walk briskly from the beginning of the walk. Too often, if you start slowly, allowing the dog to sniff and smell everything, you may have a challenging time getting them to speed up. It’s not necessary to ‘warm up’ before a walk or a slow jog; as hunters, dogs have adapted to be able to accelerate rapidly with very little risk of injury.

“It’s not necessary to ‘warm up’ before a walk or a slow jog.”

Draw your leash close – generally within two to four feet of your body – and set off at a pace you feel comfortable sustaining. This should be about a 12-15 minute per mile pace. It should feel like a brisk walk and you should break into a light sweat. The key is to keep it up! Don’t look down at your dog when they inevitably want to stop and smell something or mark a fire hydrant. Continue moving straight ahead, tighten the leash (don’t jerk) and give a command such as “No stop” “Come” or “Here.” Head halters are a great method for training dogs to heel during a brisk walk. If your dog sits or refuses to walk, you may have to return home. If this happens, you should crate him or put him in a quiet space without your attention and try again another time. However, this is rare, since most dogs take readily to this new form of exercise.

How long should we walk?

For most overweight or obese dogs, providing they have normal heart and lung function and no other pre-existing medical conditions, we recommend starting with 30-minute walks at least five times a week. Ideally, you should do the walking for exercise seven days a week. A sample schedule follows:

Week 1

30 minutes per day

10 minutes brisk followed by 20 minutes casual pace

Week 2

30 minutes per day 15 minutes brisk followed by 15 minutes casual pace

Week 3

30 minutes per day 20 minutes brisk followed by 10 minutes casual pace

Week 4

35-40 minutes per day 30 minutes brisk followed by 5-10 minutes casual pace

Week 5+

35-60 minutes per day Try to do two 20-30 minute walks per day: 15-25 minutes brisk followed by 5 minutes casual pace

How often should I weigh my dog?

We recommend that you have your dog weighed at the veterinary clinic at least once a month. The weight should always be done on the same scale. At the time of weighing, have a veterinary staff member inspect the footpads for any injuries or problems. Once your pet reaches its desired weight, he or she should be re-weighed every three months to ensure that weight loss is maintained.

Remember, physical activity such as this should be thought of as “fun with a purpose”. When you combine exercise with proper diet and lifestyle, you contribute to your dog’s health and well being and improve the quality of life for both of you.

This client information sheet is based on material written by: Ernest Ward, DVM © Copyright 2009 Lifelearn Inc. Used and/or modified with permission under license.

Von Willebrand’s Disease Testing

What is von Willebrand’s disease?

“Von Willebrand’s disease is one of the most common hereditary bleeding disorders…”

Von Willebrand’s disease is one of the most common hereditary bleeding disorders in dogs, and has been identified in more than 50 different breeds. Breeds with an increased incidence of von Willebrand’s disease include the Doberman Pinscher, Manchester Terrier, Pembroke Welsh Corgi, French Poodle, Shetland Sheepdog (or Sheltie), and Scottish Terrier.

Clinical signs that may be noted with von Willebrand’s disease include bleeding from the gums, recurrent nosebleeds, and bloody urine or feces. Excessive bleeding following a simple procedure like clipping toenails may be noted. Surgery and minor physical trauma may also result in excessive blood loss.

What causes von Willebrand’s disease?

Von Willebrand’s disease is caused by a deficiency of von Willebrand’s factor, a blood protein that is required for optimal clotting of blood. Von Willebrand’s factor enhances the adherence or ‘stickiness’ of platelets to sites of blood vessel injury, as well as stabilizing one of the other blood clotting factors (factor VIII) in circulation so that this factor is not lost prematurely.

When the amount of von Willebrand’s factor is reduced, the dog is unable to deal effectively with blood vessel injuries, because an effective platelet ‘plug’ cannot be maintained at the site of the injury.

How can von Willebrand’s disease be diagnosed?

Initial Tests

“A few preliminary tests can be performed in the veterinary clinic.”

These include an evaluation of a CBC (complete blood count) to ensure that other causes of excessive bleeding, such as reduced platelet numbers, are not contributing to the clinical signs. Platelet numbers will be within the normal reference range in dogs with von Willebrand’s disease. The CBC requires a single blood sample.

A buccal mucosal bleeding time (BMBT) may be performed in the clinic. This test evaluates the ability of platelets to form a platelet plug at the site of a small cut in the upper lip. A spring-loaded cassette is used to produce a small, precise cut and the length of time required for bleeding to stop is evaluated. This time may be lengthened by both decreased platelet numbers and by decreased platelet function. Therefore, the BMBT is usually reserved for dogs that have normal platelet numbers but questionable platelet function. The value of the BMBT for dogs suspected of having von Willebrand’s disease is unknown because relatively large decreases in von Willebrand’s factor are needed before the BMBT is significantly increased.

“The results of coagulation panel testing will be normal in dogs with von Willebrand’s disease.”

Next, a coagulation panel (including the prothrombin time and activated partial thromboplastin time) should be evaluated to rule out reductions in other clotting factors as a cause of excessive hemorrhaging. Such coagulation panel testing requires a single blood sample that is sent to a veterinary referral laboratory. The results of coagulation panel testing will be normal in dogs with von Willebrand’s disease.

Specific Tests Dogs with a history of unexplained episodes of bleeding that have normal platelet numbers and a normal coagulation (clotting) profile are candidates for specific von Willebrand’s factor testing.

Immunoassays (enzyme-linked immunosorbent assay and rocket immunoelectrophoresis) can be used to determine the amount of von Willebrand’s factor in a blood sample. Immunoassays are performed at a veterinary referral laboratory using specific proteins called antibodies to capture or bind the von Willebrand’s factor for measurement. Von Willebrand’s disease is most commonly diagnosed by immunoassay

Functional assays for von Willebrand’s disease are not readily available except in a research setting.

Genetic testing for the von Willebrand’s gene in certain breeds of dogs is available at highly specialized referral laboratories and is typically reserved to screen dogs being used for breeding stock.

This client information sheet is based on material written by: Kristiina Ruotsalo, DVM, DVSc, Dip ACVP & Margo S. Tant BSc, DVM, DVSc © Copyright 2009 Lifelearn Inc. Used and/or modified with permission under license

Urethral Incontinence in Dogs

What is urethral incontinence?

Urethral or urinary incontinence is the loss of voluntary control of urination. It is usually observed as involuntary urine leakage.

What are the clinical signs of urethral incontinence?

The most common clinical sign is pooling or spotting of urine underneath the dog when it is sleeping or relaxed. Many dog owners report finding wet spots on the bedding or floor where the pet has recently been laying down or sleeping. Occasionally owners will report dribbling of urine while the dog is walking or after she urinates. In many instances the dog seems unaware of what is happening. It is estimated that urethral incontinence may affect over twenty percent of all spayed female dogs, especially large-breed dogs. Urethral incontinence is most common in middle-aged to senior, medium to large-breed female dogs although any dog may be affected.

What causes urethral incontinence?

There are several potential causes of urinary incontinence. These include:

  • Neurological Causes including spinal injuries, disruption of the nerves controlling the bladder and brain diseases or lesions.
  • Bladder Storage Dysfunction including bladder hypercontractility in which the bladder contracts frequently resulting in small amounts of urine leakage.
  • Urinary tract infections or bladder tumors, or any condition that compresses the bladder from the outside
  • Urethral disorders in which the muscles that close the urethra fail to tightly contract and urine leakage occurs. This is one of the more common causes and is often associated with hormone responsive urinary incontinence, urinary tract infection or inflammation, prostatic disease in male dogs and vestibulovaginal anomaly in females.
  • Anatomic Abnormalities such as a congenital defect, an injury or surgery that has caused damage or altered the normal bladder function. Ectopic ureters (ureters that are not in the correct anatomical location due to a birth defect), urethral hypoplasia, and vulvar or perivulvar conformation abnormalities are some of the anatomic abnormalities that can cause urinary incontinence.
  • Urine Retention results when a dog will not urinate due to stress, fear or behavioral abnormality and ultimately urine leakage occurs when the pressure inside the bladder exceeds urethral outlet resistance.
  • Mixed Urinary Incontinence occurs in both dogs and humans and is the combination of multiple factors affecting normal urination. Combinations of urethral and bladder storage dysfunction and anatomic and functional disorders are most likely to occur.

How is urethral incontinence diagnosed?

Urethral incontinence is diagnosed based on clinical signs, medical history and blood and urine tests. Bladder radiographs and ultrasonography are often performed to search for bladder stones or other abnormalities affecting urine storage and outflow. Neurological tests such as examination of the anal and tail tone, perineal sensation and various spinal reflexes will be performed if a neurological disorder is suspected. Urethral catheterization may be required if urine retention is observed, to determine if there is an obstruction or other urethral abnormality present. Cystoscopy may allow the veterinarian to see an abnormality within the bladder or urethra. In certain cases, specialized testing such as measuring the pressure within the bladder is performed.

“Treatment will be based on your pet’s specific diagnosis.”

Treatment will be based on your pet’s specific diagnosis. Medications that increase urethral sphincter tone such as phenylpropanolamine (PPA) or imipramine, or hormone replacements such as estrogen or diethylstilbestrol (DES) are commonly used alone and in combination. Many dogs that respond poorly to PPA alone will benefit from a combination of PPA and DES. Approximately 70% of all cases respond well to medical therapy alone. GnRH analogs may be considered in severe or refractory (failure to respond) cases. With long-term usage, the patient’s blood and urine should be periodically tested to ensure that there are no untoward side effects. Your veterinarian will prescribe the best treatment for your pet’s individual needs.

“Many dogs that respond poorly to PPA alone will benefit from a combination of PPA and DES.”

New research has focused on collagen injections and a novel substance called Tegress. These surgical solutions hold promise and should be discussed with your veterinarian to determine if any of the surgical specialists in your area are performing these procedures.

What is the prognosis for urethral incontinence?

While the prognosis is determined by the specific cause, in general the prognosis is good. Control of urine leakage will vary from dog to dog but most dogs can be managed successfully with medications, lifestyle changes such as more frequent trips outside to urinate, and close monitoring.

This client information sheet is based on material written by: Ernest Ward, DVM © Copyright 2009 Lifelearn Inc. Used and/or modified with permission under license.

Travel – Airplane Travel with your Dog

I’m planning to travel by air and would like to take my dog with me. What are some of the factors I need to consider before taking my dog on an airplane?

Having your dog accompany you during travel may add enjoyment to your trip. However, it’s important to keep your dog’s safety in mind when traveling, so be sure to check with the airline well in advance of your trip. Familiarize yourself with the airline’s pet travel requirements so that you can avoid a last minute crisis.

If possible, avoid flying your dog as “checked cargo” during times when temperatures on the ground are likely to be below 40ºF (4 C) or above 80ºF (21 C). Some airlines will not check pets as baggage in the summer months because of the heat and humidity in the cargo holds. If possible, use airlines that hand carry your dog (inside the pet carrier) to and from the aircraft. Otherwise, the pet carrier might simply be placed on a conveyor belt along with all the other baggage.

“Take direct flights whenever possible and try to avoid connections and layovers.”

Take direct flights whenever possible and try to avoid connections and layovers. Sometimes this is easier to do if the travel occurs during the week. This eliminates missed baggage connections and the chance that your dog will be left exposed in extreme weather.

Avoid the busiest travel times so airline personnel will have extra time to handle your dog.

Verify your airline’s policy regarding baggage liability, especially with respect to your dog. In some cases, your general baggage liability coverage will include your pet. Check your ticket for liability limits or, better yet, speak directly with the airline. If you are sending an economically valuable pet, you may want to purchase additional liability insurance.

Many airlines will allow one pet to travel in coach and one in first class, with some provisions. Since some airlines limit the number of pets traveling within the cabin area, be sure to book well in advance if you plan to travel with your dog in the cabin. Your dog must be in a standard carrier that will fit under the seat (a collapsible fabric carrier may be suitable), must remain in the carrier during the flight, and must not disturb your fellow travelers. Obviously, only small dogs qualify for this type of accommodation.

Are there any special veterinary considerations?

Have your dog examined by your veterinarian in advance of the trip, especially if it has been more than a few months since the last health check, or if the dog has any health problems. Travel by airplane can pose a health risk to dogs with heart or kidney disease, or with some other pre-existing medical problems. Dogs with short faces, such as Pekingese, Pugs English Bulldogs, Boston Terriers, et cetera, can run into respiratory difficulty in a confined carrier or if they are placed in the cargo compartment of the airplane, especially during hot or humid weather. Discuss these issues with your veterinarian prior to travel.

Purchase any pet supplies that you might need in advance of your trip. These include heartworm and flea preventive or any prescription medications that your dog may require. If your dog is on a specific diet, especially a therapeutic diet, you need to ensure that it will be available at your destination or take along a sufficient supply.

“If you are traveling to a foreign country, you may need to provide a specific international health certificate signed by a government-approved veterinarian or other government official.”

Update all vaccinations, especially rabies vaccination, and take written documentation with you. A health certificate for your dog may be required by your airline. If you are traveling to a foreign country, you may need to provide a specific international health certificate signed by a government-approved veterinarian or other government official. The specific requirements for travel vary by country, either within North America or to other continents, and it is your responsibility to ensure that you meet all the criteria for your chosen destination. Requirements may include written proof of certain vaccinations, blood tests or anti-parasitic treatment that has been performed within a specified time period. It may take several days or even weeks to get test results or obtain the appropriate paperwork so plan well in advance. You can obtain the specific requirements from the consulate’s office, or by searching the government website for the country of interest. You should also inquire about any quarantine requirements, especially if your destination is an island country.

How should I prepare my dog for the flight?

Make sure the travel carrier has specific feeding and identification labels permanently attached and highly visible. The information on the label should include your name, telephone number, flight schedule, destination, and the telephone number of someone at the point of destination. Do not rely on baggage tags as they may become lost or damaged.

Your dog should wear an identification tag attached to a collar or harness (a harness is preferable since it is more secure than a collar). You should provide a leash with the carrier, for secure restraint in case your dog needs to be taken out of the carrier. All tags should have updated contact information on them so that you or an emergency contact can be reached at all times. For additional security, all pets that travel should be microchipped prior to travel (and you should take a copy of the number with you for reference). For further information, see our handout “Microchipping”.

“Do not tranquilize or sedate your dog without first discussing it with your veterinarian.”

Do not tranquilize or sedate your dog without first discussing it with your veterinarian. If you feel that your dog needs to be sedated for travel, your veterinarian will advise you on safe medications. In order to determine the most appropriate dose, your veterinarian may recommend giving a “test dose” of the medication to determine its effect in advance of the trip.

Do not feed your dog within six hours of the flight. You should provide fresh water until flight time. Water should be available in the carrier during the flight whenever possible. Give the dog fresh water as soon as it arrives at your destination.

What do I need to consider when buying a travel carrier?

Your dog’s travel carrier will be its “home” for much of your trip. It’s important to choose the right carrier. Here are some helpful guidelines:

  • The carrier should be large enough for your dog to stand up and turn around easily, but not so large that the dog will be tossed about inside during turbulence. Crates are available for dogs from two to two hundred pounds. Make sure it is an “airline-approved” crate.
  • The walls and floor of the crate should be strong and waterproof. This will prevent crushing and waste (urine) leakage. You can place a disposable absorbent puppy-training pad or an underpad designed for bedridden people with bladder control problems in the bottom of the crate.
  • There must be adequate ventilation on at least three sides of the carrier. Holes and slits in the sides are characteristics of a good quality carrier.
  • The carrier must have sturdy handles for baggage personnel to use.
  • The carrier should have a water tray that is accessible from the outside so that water can be easily added when needed.
  • Try to familiarize your dog with the travel carrier before you leave for your trip. Let your dog play inside with the door both open and closed. This will help eliminate some of your dog’s stress during the trip.

Pet stores, breeders, and kennels usually sell carriers that meet these requirements. Some airlines recommend specific carriers that they prefer to use. Check with the airline to see if they have other requirements or recommendations.

What about carry-on kennels for my small dog?

Small dogs may be allowed in the passenger cabin as long as the carrier will fit under the seat. Soft, airline-approved, carry-on kennels, sometimes called Sherpa bags, are available. Be sure to check with your airline regarding their specific carry-on policies and requirements. There may be an extra charge to take your dog in the passenger cabin.

What arrangements should I make at my destination site?

“Do not try to “sneak” a pet into a hotel.”

  • Make sure that your hotel allows dogs. Many bookstores carry travel guidebooks with this type of information. There are also helpful websites, such as,,, or Do not try to “sneak” a pet into a hotel. Not only may you be forced to leave or be given a financial penalty, you will give the hotel a negative impression of pet owners.
  • If you leave your dog unattended in hotel rooms, make sure that there is no opportunity for escape. Leave the dog in the carrier or inside a closed bathroom. Be sure to inform housekeeping personnel about your dog and ask that they wait until you return before entering the room. Use the “Do Not Disturb” sign.
  • Should your pet get lost, contact the local animal control officer. If your pet is microchipped, give the number to them so that you can be contacted directly if your dog is located.

Remember, advance planning is vital to making the trip an enjoyable experience for both you and your dog. By applying a few common sense rules, you can keep your traveling dog safe and sound.

This client information sheet is based on material written by: Ernest Ward, DVM © Copyright 2009 Lifelearn Inc. Used and/or modified with permission under license.

Teeth, Teething and Chewing in Puppies

My puppy has started biting my hands, my legs, my children’s legs—pretty much any object he can get his mouth on. What is going on?

Your puppy is teething, the same way that human babies and children grow new teeth during their development. Like a human, your pup first grows a set of baby teeth (also called primary or deciduous, meaning they fall out). These teeth are pointed and sharp, which is why they’re sometimes referred to as needle teeth. Dogs have 28 deciduous teeth and end up with 42 permanent teeth. You may find baby teeth on the floor, but it’s more likely that you won’t. Often, puppies harmlessly swallow the teeth while they’re eating. It is not unusual for some bleeding to occur when the teeth fall or are falling out, but the amount is minuscule and owners usually notice it only if there is some mild red staining on a chew toy.

Why is everything being attacked?

Puppies will chew on people, furniture, and other objects (including ones you value) that are within their reach; this is part of normal puppy behavior. Dogs learn much about the world around them through how things feel, and a dog’s main means of touching and grabbing things is with its mouth.

Dogs learn much about the world around them through their mouths.

This tendency is particularly pronounced in breeds known to be “mouthy,” such as retrievers. Chewing also seems to alleviate what is assumed to be discomfort associated with the teething process.

When will my dog’s baby teeth fall out?

Puppies begin teething at around 3 weeks, and by approximately 6 weeks, all of their baby teeth will have erupted. The incisors (at the front of the mouth) and the canine teeth (the fangs) erupt first, followed by the premolars. Dogs (and cats, for that matter) do not have any baby molars. At around 12 weeks, the deciduous teeth begin to fall out, and the permanent teeth begin to erupt. By 6 months of age, normally all permanent teeth have erupted and all deciduous teeth are out.

Are there any common dental problems in young dogs?

Problems with baby teeth are few and far between. It is rare that a pup will have a dental problem that is serious enough to require advanced intervention or referral to a veterinary dentist. Some breeds, particularly smaller breeds and brachycephalic (short-nosed) breeds, have a tendency to retain some of their deciduous teeth. The most usual site is the upper canine teeth, although it can happen anywhere. Retained baby teeth can cause malocclusion (a bad bite) and discomfort. They also predispose dogs to future dental problems. Food can get trapped between the deciduous teeth, the permanent teeth, and the gingiva (gums), which can lead to periodontal (dental) disease. Retained deciduous teeth need to be removed. Usually a simple procedure, it is commonly performed at the time of the pet’s neutering or spaying.

What are acceptable chew toys, and which ones should be avoided?

Because dogs tend to chew nearly everything, nearly everything has been found to cause problems. This goes for rawhides, pigs’ ears, bully sticks, bones or other parts of animals given to dogs to chew, synthetic toys, tennis balls, etc. Some of these objects have caused gastrointestinal blockages or intestinal punctures, which often require surgery and can be lifethreatening; others have blocked the throat, causing dogs to asphyxiate.

Notwithstanding these facts, consider that millions of dogs have been chewing millions of objects for years, most without incident. So the risk does appear to be low, but as with most activities, it cannot be eliminated. Watch your dog when he begins chewing, and talk to your veterinarian about which chew toys are the safest bets for your puppy.

Talk to your veterinarian about which chew toys are the safest bets for your puppy.

Bear in mind that some objects that are safe from the point of view of ingestion or inhalation may still not be very good for your dog’s teeth. Most veterinary dentists recommend against allowing puppies and older dogs to chew anything hard. That would include objects made of nylon as well as “unbreakable” natural bones, such as marrow bones. Veterinary dentists often sum up this recommendation with the maxim, “Don’t let your dog chew anything that won’t bend.”

What should I do about my puppy’s chewing behaviors that I don’t like?

Do not reward behavior you don’t want, and don’t let others reward it either. If your puppy is chewing on your hands or any other body part, yelp a high pitched shriek like a puppy makes, pull your hand away, and go play elsewhere.

Do not reward chewing behavior you don’t want, and don’t let others reward it either.

There is no consensus about the best way to teach puppies not to chew. Some methods may even seem contradictory because what may work for one dog may be inappropriate for another. Check with your veterinarian for a personalized recommendation.

My children like playing rough with the puppy, and they say that they don’t mind the occasional scratch or gentle bite. Is this OK?

No! Permitting this behavior teaches your pet that hands are acceptable toys to use as he or she pleases. Your dog is not only learning that it is OK, but the pup is even being rewarded for this behavior when your children continue playing after being bitten or scratched.

Will my dog ever stop chewing everything?

Excessive chewing behavior seems to subside around 1-and-a-half years of age but will continue to some degree, depending on the dog, for his or her whole life. Remember that chewing, licking and mouthing are normal behaviors for dogs as a way of exploring and learning, and carrying objects from one place to the next. If chewing is excessive or aggressive, consult your veterinarian for behavior modification advice.

Should I brush my dog’s teeth?

Getting your puppy used to having something in his or her mouth other than food or a chew toy is a good idea. You also want to be able to retrieve objects from your dog’s mouth or look in there without risk of injury to your hand. In addition, because dental problems are among the most common (and costly) problems seen in dogs, getting your dog to tolerate brushing at an early age will get you started on a path that will help prevent many of these problems.

Getting your dog to tolerate brushing at an early age will help prevent many dental problems.

Buy a toothbrush and toothpaste suitable for dogs (human toothpaste is not appropriate for dogs and can make them sick). Start by just gently introducing the brush and paste, allowing your pup to sniff and lick the brush. However, don’t force the matter. Ask your veterinarian to demonstrate brushing technique and give you advice for getting your dog used to the routine. Most dogs can be taught to tolerate or even enjoy daily brushing.

Additional Help

There are many options available for more help with your dog. One of the very best in our area is Smart Dog University. Check out their website at for helpful newsletters, classes, and other cool dog info.

This client information sheet is based on material written by: Richard Lerner, DVM, MPH © Copyright 2012 LifeLearn Inc. Used and/or modified with permission under license.