Speaker 1: You were listening to Petlifradio dot com.
Speaker 2: And good morning or good afternoon wherever you may be.
Is it we after the East Coast. It's just after
noon by about one minute. And here in Sunday, southern California,
we are at nine am, and you are here for
the next thirty minutes with me, Doctor Jeff Weerber, host
of Askedveets with Doctor Jeff here on pet Life Radio,
our only live call in show here on pet Life Radio.
And we're live and we're calling because we want to
hear from you. We want to answer your questions. We
want to talk about your pets. That's why I'm here,
because we love talking pets. And if I don't get
people to call in and talk to me, then I'm
just going to talk about some topics that hopefully we'll
be of interest to you. We've been covering ground lately
for the last several weeks on some of the conditions
that you don't know how much you need to worry.
You can have a vomiting dog where you have to
worry a lot, and you can have a vomiting dog
you don't have to worry at all. And I'm just
trying to help you get through. What are the things
you'd have to worry about and when and what to
do if and those that you know what, give it
a day, watch them carefully, not a problem. And we
tell a lot by how it came on the history,
what vomited, how often or how soon after they eight
did they vomit, you know, et cetera, et cetera. And
after that we've been covering the limping dog. And that's
a big eie because, oh my god, I think that
is one of the most overdiagnosed problems, is the limping dog.
So I'm trying to give you a bunch of guidelines
as well to know is this something I need to
worry about or is it not? And I'm here again
thanks to our sponsors pro Sense Pet Products, the veterinary
quality products that you can find in the mass market
like in your local Walmart or Walgreens or Target, and
also the Kong And we are so happy to have
our sponsors on board that if you get the courage
the guts to give us a call here at eight
seven seven three eight five eight eight A two.
Speaker 3: Once again, it's easy eighty seven. It's a free call.
Speaker 2: Eight seven seven three eight five eight eight eight two,
or just log on to pet Life Radio and go
to the Ask the Vets with doctor Jeff tab and
join in on the conversation. We will see you joining
on the conversation, and if you give us a call,
if you send me a little text, a little note
during the show, we will send you out some free
products pro sense and a con product for your pet,
so you can't lose. To get free advice, a free
phone call, free internet. I mean, come on, this is
a no brainer if you ask me. And also it's
just good to hear because you know, I always tell
I've been doing this for a long time. This is
actually my thirtieth year, and actually I'm in my thirty
first year. That's even more frightening. And what I find
is that so many people will start a conversation when
they come in to see me, and I can tell
just by how they start the conversation what the question
is going to be, because the truth of the matter is,
there are only so many problems your pet could have.
And you know an expression I love to use is
well a couple of them, actually I use them off
at number one. If it looks like a duck walks
like a duck cracks like a duck, it's probably a duck.
And that helps me a lot in trying to decipher
what the situation might be, what a diagnosis might be.
And that's even before I have to do one test
just merely by the history, then another one. And I'm
sure there are places in your locale that this would
make sense. Here in southern California, we use Malibu, and
it goes like this. If you're running along the beach
in Malibu and you hear hoof beats chasing you from behind,
what are you thinking? Horses or zebras? And clearly it's horses.
So then I asked you, doctor Sown, so why were
you looking for the zebra when you didn't even rule
out the horses the most obvious things. You got to
go with the obvious things first. So after a while,
you hear the prelude to a question, and they're already
giving you, like some of the hints about what they're
going to ask, because it's embarrassing because it's just because
that and I'll finish it befo before they ask it.
And so that's how I feel. It's why it's so
important to hear from you, because I guarantee whatever question
you have, however weird a situation you have with your pet,
there are hundreds of you out there listening that have
the same problem and just are afraid or embarrassed to
call in. So at the very least those of you
that have the courage besides the freebies, is that you
will be helping a lot of other pet parents with
the same problems that they're having with their pasts, because trust.
Speaker 3: Me, it's more common than you think.
Speaker 2: So in the light of that, we have been discussing
over the last few weeks the limping dog and we've
been through some shoulder displays that we talked to last
week about hips and the importance of early detection. That
there is a surgical procedure that can be done. It's
called a TPO triple pelic osteotomy to sort of rebalance
the hips, to replace the socket of the ball and
socket hip joint over the ball and very effective and
what it does, it doesn't allow you to breathe. By
the way, if you had a breeding dog and you
thought that by fixing the hips it would be okay
to breed, wrong, absolutely not. This pet should be spade
or neuter like right away. Now, well, I shouldn't say that.
If it's under a year, you shouldn't be breeding anyway.
But if it's over a year in a large breed,
we want to wait till they're about a year of
age for large breeds. Small breeds still you can do
it at six months of age as soon the criteria
are this. When it comes to the small breed, it's
the teeth. And you say, what what do teeth have
to do with spang and neutering. It has a lot
to do with it. Why because small breed dogs typically
don't lose their baby teeth on schedule. The adult teeth
erupt on schedule. That one of the jobs of the
adult tooth is to push that baby tooth that it
is replacing out of the way, and that baby tooth
should fall out.
Speaker 3: But unfortunately, in many of.
Speaker 2: Our small breeds that doesn't happen, so we end up
with double teeth. Well, it's so silly to anesthetize to
spaye a neuter a dog it's say four months or
five months of age, only to have to go back
in reinesthetize a month later because there are two or
three or four deciduous teeth baby teeth left that need
to be pulled. That is ridiculous given the fact that
probably probably the most dangerous part. And I don't don't
be afraid because it's not. But if you have to say,
what is the most dangerous part the most you know
that we fear when we're doing surgery on a pet,
it's the anesthesia. I mean this way, there are more
anesthetic deaths then they are going to be from forgetting
to ligate or for what we call a slip ligature
when you're tying off one of the major vessels. So
it's the anesthesia we're worried about. To why put a
pet through a situation or you have to necessize them
twice in a short period of time, Wait until all
the adult teeth are in. At that point you can
easily tell which baby teeth needs to be pulled, and
then you do one anesthetic procedure and you get the
teeth and the spear and mooter at the same time.
Large breeds a different situation. Large breads don't usually have
problems with the situous teeth. Occasionally they will, but not
certainly not common. But large breeds, based on a new study,
there seems to be a very strong link to bone
can answer in older dogs and early spae neuter. So
clearly there is must be some protective benefit of the
sex hormones, the estrogens and the testosterones on growing developing
bone to prevent that bone later in life from developing
bone cancer. Therefore, the new recommendations are to wait until
these large breed dogs are fully mature about a year
of age, before you even think about spaine or neuter.
More so, on the male, there was a sixty five
percent greater incidents and long bone cancer in males were
pre puberly neutered, and a thirty five percent increase in
bone cancer and the females that were pre puberly spade.
So therefore no brainer. You know, a lot of municipalities,
including Los Angeles, to have this rule that the dogs
have to be spaded or neutered by four months insanity.
And what I do is I'll write letters, and they
want to fight, they can fight with me, but we're
not going to subject the dog to a sixty five
increase percent increase in bone cancer. Not happened on my
watch anyway. So as we move down the hind leg,
we talked extensively about the hips. Hyptasplasia common but usually
over diagnosed as a problem, especially an acute problem, a
sudden problem in hind limb lameness, slash, limping.
Speaker 3: Pain, et cetera, in an.
Speaker 2: Older dog, that the x rays of the radiographs clearly show hypdasplasia.
My contention, of course, being as we talked last week,
that if in fact the current problem is due to
the hips, then why wasn't this dog limping last week
and the week before, in the week before, in the
week before. Because I could bet you that if you
take an x ray but a ten year old dog
with arthritic hips, that those hips have been arth grated
for years, and yet he wasn't limping for the last
several years.
Speaker 3: So you need to look for.
Speaker 2: Another problem, a problem that is more typical of what
we call an acute ontet, a sudden onset, and the
same thing.
Speaker 3: We have with our knees.
Speaker 2: So there are a couple of classes times of knee problems.
And interestingly, you could tell a lot by the age
of the dog, the clinical onset of the symptoms, and
the breed the size.
Speaker 3: Here's what I mean.
Speaker 2: One of the more most common young small breed problems
we are going to see relating to the knee joint.
The stifle is what we call an MPL medial patella luxation.
MPL is a condition where we have a shallow femeral groove.
That's the groove in which lies the kneecap called the patella,
and it slides up and down as the dog bent's leg.
There is a patella tendon which comes from the quadricepus
muscle group, rides over the patella and then it turns
into a patella ligament. Because the patella is bone. Any
structure that attaches bone to bone is called a ligament.
Any structure that attaches muscle to bone is a tendon.
So actually we have a Pateller ligament and a Pateeller tendon.
The tendon of course coming on the upper portion originating
from the quadricepis muscle group, and the patella tendon which
attaches the lower portion of the tendon to what we
call the tibial crest. It's the top of the tibia,
and there's a piece that sticks out of the tibia
called the tibio crest, and that is where the Pteller
tendon inserts now what happens with these small breed dogs
a number of things. Number one, the pateller groove is shallow,
too shallow. And number two, the position of the tibial
crest and some of these small breeds is displaced medially
to the inside. So the combination of a very shallow groove,
typically the edge on the middle edge, the medial edge
being very low, and the natural pull of the pteller
tendin because of the positioning of the tibio crest. The
tibio tuberosity pulls that kneecap to the inside. We call
it medial patella luxation.
Speaker 3: And we have four grades.
Speaker 2: And very very common in the small breeds. We pick
it up early, early, when we're first examining them. We
can't always predicted it's going to be a problem, but
we certainly can predict the problem. How much of an
issue it's going to cause, we don't know. Thus, the
four grades, you have a grade one. Grade one is
probably the most common, and that is.
Speaker 3: Where you can take that kneecap.
Speaker 2: You can a little pressure or digital pressure sometimes happens
by itself. The kneecap will pop off of the groove
to a medial position. In an inside position, but with
a couple of steps it pops right back on.
Speaker 3: Those are usually not a problem. We leave them alone,
and that's a great one. Grade two.
Speaker 2: Grade two is where the kneecap is usually in the
groove where it belongs, but it can pop out by itself,
and when it does, it doesn't pop right back in.
It still spends more time inside the groove where it belongs,
but it can also spend.
Speaker 3: Some time out of the groove.
Speaker 2: Those questionable surgery are not. It all depends how much
in within the grade two it is.
Speaker 3: Grade three.
Speaker 2: Grade three is where that kneecap is living pretty much
outside of the groove. It will still pop in on occasion.
You're a veterinarian, and you if you learn how, you
can push it back in the groove, but within a
few steps it's popping out again. It's more comfortable outside
than inside. And that is Grade three. That is surgical,
and that leads u ultimately to a grade four. And
Grade four is where this poor kneecap has been sitting
outside of that groove for so long that it develops
a false joint and you can't reduce it push it
back into the groove. The federal groove, if you even tried.
That is the ones that caused most of our problems. Now,
how can you tell that a dog you see, smaller
breed is having a problem with ptello luxation.
Speaker 3: It's very simple. Watch them walk. When you see these.
Speaker 2: Little guys and they're cruising around and having a great
tim all of a sudden, that back leg, usually one
of them, but certainly both pops up and they'll take
four or five hops as they're running or walking, and
then sometimes they put it down again, sometimes they don't.
Speaker 3: That is a big clue of ptello luxation.
Speaker 2: As the problem progresses, especially if it's unilateral, meaning one sided,
another thing will notice because there is an effect on
the muscle usage of that leg.
Speaker 3: The leg actually gets.
Speaker 2: Smaller, the muscle mass starts to become reduced as atrophies,
and you can clear see when you're palpating, when you're
feeling the legs, how one is worse than the other. Now,
what happens when both are luxating? When you have a
media bilateral medial ptalaxation, you will notice this, This is
really cool. You will notice your dogs that are affected.
And I'm talking that there's often the small ones. It's
the Yorkies, it's the Maltese, it's the Pomeranians, it's the
Chihuahuas that as they're eating, or as they're walking, or
as they're doing anything, you'll notice that they're putting way
more weight on their front legs, so much so that
sometimes it looks like their back legs are barely touching
the ground. And that is a huge clue that we
are having some kind of hindlimb problem. And as I said,
unlike the arthritities, the arthritis conditions that happen in bigger
dogs or even smaller dogs that have them when they're older,
this is something that you're gonna notice in your young dog.
Speaker 3: So it's a young dog condition.
Speaker 2: It's often chronically progressive, and you're gonna either see hopping
you're gonna see if it's unilateral one side, and if
it's bilateral two you're going to see them putting a
lot more weight on their front limbs. This is definitely
reason to go see your veterinarian and have these evaluated.
Don't wait too long. I'll tell you why. It's a
very surgically correctable problem. If you wait so long that
the muscle atrophy progresses that the post operative rehab period
is going to be extremely challenging for both you and
your dog. So it's something that when you see it,
if it's diagnosed, if it's a grade two and a
half or more, I highly advise surgery.
Speaker 3: They do so well after surgery.
Speaker 2: And not only that, what happens when we have a
bone on bone situation, bone on bone rubbing over time
causes what's called an osteo arthritis. The longer we allow
this to happen, the worst her arthritis is going to be. Conversely,
the sooner we get to put that beecap back in
the groove where it belongs and to keep it there,
then we are going to slow down, if not prevent
the ultimate onset of our So it's very important to
when you see this in your small breeds, get them
to your veterinary and make a diagnosis early.
Speaker 3: And we have more to come back.
Speaker 2: We have some other growth diseases before we move on
to the injury condition that often happens using the bigger dogs,
and we'll talk about.
Speaker 3: That we come back after our break. Just a second.
Speaker 2: You're here with doctor Jeff at ASIVTS with doctor Jeff
caarent pet Life Radio.
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Speaker 6: Let's talk past it, Let's talk pets.
Speaker 1: On pet Life Radio Netline Radio, ptlfradio dot.
Speaker 6: Com and welcome back.
Speaker 3: You're at a pet life.
Speaker 2: We asked the best of doctor Jeff. I'm your host,
doctor Jeff Weerber. And during the break we did get
a email very easy and it's from Sarah and we're
going to talk to Sarah in just a second about
her dog. And it's perfect question because where always going
with this after talking about media ptaluxation usually younger, smaller dogs,
pretty much congenital problem.
Speaker 3: The only other growth related disease. I wanted to talk
about it briefly.
Speaker 2: It's just one of the other joints that can happen
is the hind end and that's called OCD and not
obsessive with compulsive disorder. It's osteo can drive us desiccns.
It can happen in any joint, much less common in
the knee joint. But it's something we always have to
look at and again an X ray can show we
want to go to And I'm so glad that Sarah
had spoken about this.
Speaker 3: I'll read it to you.
Speaker 2: It says hi, doctor Jeff, speaking of knees. My golden
dude was having knee problems. She had X rays and
was wiggled. Her knee was solid, but the joint was
swollen right away. The vets at ACL. That's anterior cruciate ligament.
Actually we all often call it a CCL in dog's
cranial crucia ligament. That's too surgery without the movement to
the knee, which I'll talk about a minute. I'm afraid
to spend money for surgery for something that might be arthritis.
So and to make that and this is this happens
so frequently. Sarah's daughter had ACL surgery about a year ago.
And how often do I make a diagnosis of like
diabetes or something or Addison's disease? And the owner said,
I'm my gosh, I have adisons.
Speaker 3: I have diabetes.
Speaker 2: So for some reason, we I think dogs mimic us.
They don't want us to feel badly, so they come
up with the same problems that we have. But anyway,
one of the things that we want to talk about
is the larger breed gold noodle fits the bill. Typically
an acute onset, and I like to talk to hear
more from Sarah about this, but an acute onset is
where literally it happens. They're out playing sometimes you're actually
lucky enough to hear a yelp, a cry, some sort
ofvocalization when it happens, and that's when that you're definitely
clued in to this problem. Next thing, you're going to
see the dog clearly favoring the leg. I mean, this
typically active dog is not gonna want to put this
leg down. And the first thing you think about when
you have an acute, sudden onset injury, often preceded by
a yelper scream, don't want to use the leg largely.
I mean, it is until proven otherwise it is a
cruciate ligament. But we don't do surgery based on that.
We need some clues to determine surgical need. Now I
will tell you, and this is for you too, Sarah,
that if in fact this is cruciate, surgery is the
only treatment. Unlike people I think we talked about this
a couple of weeks ago. But if a person stands
up and you look at the body position of the
distal limb, the leg, and how many bends natural bends
angles does it have when we are standing erect So
the hip that's great, that's perfect.
Speaker 3: The knee that's straight, that's perfect, the ankle the equivalent
of the dog's hawk.
Speaker 2: Ah, that's got a ninety degree bent, and the medic
tarsels joint and all the little filangies and digits are
again all flat on the ground, meaning there is one
bend and only one bend at the ankle in the
entire limb. Dogs at rest, however, if you look at
a dog, never look at a picture of a dog's skeleton.
There's a bend at the hip, a bend, a bend
at the hawk, a bendit the toes. So even at rest,
they have bends in every one of their joints, which
puts undue strain on this joint that badly needs that
cruciate ligament.
Speaker 3: So it is a surgical condition. Now, it may not
need surgery right.
Speaker 2: Away because a lot of times we will have what's
called a partial tear, the initial pain.
Speaker 3: And this is for you, Sarah.
Speaker 2: The initial pain might be why there's limping and swelling.
But as long as there's still adequate ligament that is functioning,
maybe your doodle can get lucky and need surgery.
Speaker 3: Why I say maybe because I know doodles. I own one.
Speaker 2: They are very hyper, very active, just like my two labradors,
and clearly a ligament that say it only eighty percent
is not going to be as strong as the one
at one hundred percent.
Speaker 3: So it's going to be.
Speaker 2: Something that we're gonna need surgery ultimately. But X rays
are important not only looking for that wiggle. We call
it an anterior or cranial drawer sign, which is I'm
sure what your veterinarian was looking for. If that's not there,
there are still other clues. Number one is called a
tibial thrust, and that's something your veterinarian can do. And
number two is what we call joint effusion. When those
fibers tear, even though they don't have a great blood supply,
they do bleed, and that bleeding sort of goes into
the joint space, and you can see it on X rays,
especially when you compare it to another the other leg
and the other side, and you can see evidence of
what we call joint effusion. If after all this there
is still confusion, then a bone scan could be done
or an MRI could be done, which will clearly clearly
elucidate the problem. So I understand the trepidation, the fear
of not jumping into surgery, especially if it's not gonna work.
But it is something that we really need to consider
in this case because if she had that cute sudden onset,
she's not using the leg. You can cansely wait till
the swelling can go down. There are anti inflammatories that
could be done. I would highly recommend maybe some laser therapy.
Let's get this swelling down. Let's see how much of
the current limping lameness is due to swelling versus due
to the actual injury itself. So there's no immediate rush
to surgery. And I'm going to underline that word immediate rush.
And as with the need the patella problem in the
small breeds, there is a concern if you wait too long,
and that has all to do with the muscle mass
atrophy because of lack of use.
Speaker 3: We call it disuse atrophy.
Speaker 2: Not to mention the onset of more arthritis in the joint,
but I will tell you that you know the question
was you said, is this You know it be arthritis.
Arthritis could be there for a long time, but it's
rare that the clinical presentation is sudden.
Speaker 3: So if this was a situation with.
Speaker 2: Her where she was out playing running and all of
a sudden comes up lame in a day to the
point where she wasn't this lame two days ago, four
days ago, a week ago, two weeks ago.
Speaker 3: Then it is an injury. It is an insult an
event that happened.
Speaker 2: And again I would say that if there is a
fusion and joint swelling, that's a possibility.
Speaker 3: Now other things that can be done.
Speaker 2: It's a joint tap and has to be done by
your veterinarian un are extremely sterile conditions, and that a
needle can be inserted into the joint space, some of
the joint fluid can be removed and evaluated. They could
see if it's bloody, you could see it's a severe
inflammatory condition or other things. So that too is something
that could be done if the joint remains swollen and painful. Anyway,
I want to thank Sarah. Sarah, We're gonna I'd like
you to stay tuned next week is we're going to
talk a lot more about the ACL, the CCL. It
is an extremely common injury. We see large breed active dogs,
especially dogs that have humoenously muscular thighs and legs, and
they just the need because of again the way they're
built just can't keep up, and because of the way
they're built, typically there needs to be surgical intervention if
in fact it is a cruciate ligament tear.
Speaker 3: So we're gonna keep you hanging. But thank you so much.
Speaker 2: If you could send me to doctor Jeff Dr Jeff
at Petlifeadio dot com your info, We're gonna get a
hold of you so we can send you out some
really cool.
Speaker 3: Products from Kong. I'm sure she'll love that and pro sense.
Speaker 2: I want to thank you all for joining us here
in pet Life Radios asked bets with Doctor Jeff. I'm
gonna be here next week, and in two weeks on
the fifth, I have doctor Heather Lenzer, a guest that
I've had before, is going to be returning onto the
show and we're gonna be talking about pet peeves.
Speaker 3: So anyway, thanks for joining us, have a great week.
I'm doctor Jeff Werber and we'll see you next week.
Speaker 1: Let's talk bets every week on demand only on pet
Life Radio dot Com. MHM