What can be done for these poor suffering creatures? I’ve talked about noise phobias before, but now we have a new tool in our fight against this major welfare issue.

Sileo: The New Noise Sensitivity Drug

Sileo (pronounced “SEE-layo” not “si-LAY-o”) is a syringe loaded with a gel containing dexmedetomidine, an alpha-2 agonist sedative. It’s the first time that a drug of this strength has been registered for dog owners to use.

Therefore, we have to be very careful, as you’ll see later. That’s also why dog owners can only get it prescribed after a checkup and a discussion with their vet.

Sileo is indicated for the alleviation of acute anxiety and fear associated with noise in dogs. Ironically, (but perhaps understandably given the difficulty) Sileo has not been evaluated during thunderstorms even though they are likely to be its main use. It has been trialled against fireworks, with the results you see above.

Sileo’s Safety In Dogs & People

The first thing you’ll notice once you get it is the extremely child resistant packaging. This should serve as a warning to keep it well away from children at all times and wear gloves when using. The good news it that is took me to actually read the instructions before I could open the box.

Vets already know too well that dexmedetomidine can cause low blood pressures, body temperatures and heart rates. We also see it being a little unpredictable from dog to dog. The same dose that ‘barely touches the sides’ in one dog can be dangerous to another.

For safety’s sake, please avoid using Sileo in any dog with significant sickness or pre-existing illness. This could include even temporary problems like the severe stress caused by the noise phobia itself if they become heat stressed or dehydrated. If it is used in very hot or cold conditions, you will also need to be careful that your dog’s body temperature stays in the correct range.

I would also be very careful combining it with other anxiety medications that cause sedation like trazodone or clonidine. Dogs with noise phobias often have a whole drugs cabinet and it would be very tempting to use more than one in times of stress.

Lastly, I would never use it in young puppies or in breeding females.

Having given all these dire warnings, the fact remains: there is a tremendous need for an effective drug for noise phobia in dogs. That’s why it’s often worth taking the risk.

When To Give Sileo 

Like all anxiety medications, Sileo will work best if it is given before exposure to whatever causes the fear. Therefore, try to predict the stressful event (such as by watching the weather radar for approaching thunderstorms), and give it 30 to 60 minutes before. This is how long it takes to work.

If you aren’t able to predict, it’s still worth giving the drug as soon as you hear the noise or your dog starts showing signs of anxiety. It just may not work as well under these conditions.

After giving the correct dose, do not give any more, even if the results are insufficient. After 2 hours, you can give a second dose, and then every 2 hours up to a maximum of 5 doses, as long as your dog remains free of side-effects.

Sileo is not supposed to be swallowed, and will probably not work if it is. Instead, it is applied to the inside of the mouth between the upper teeth and the cheek. Therefore, absorption could be a problem in dogs with severe gum or dental disease. It could also be a problem if you feed your dog shortly afterwards. I would wait 30 minutes.

How To Give Sileo

Sileo comes in a metered dose syringe with a rotating ring to set the correct dose. The earlier model had a locking mechanism but it caused many overdosages in the USA due to the ring lock not engaging. Having used this update, it seems hard to accidentally overdose.

Please read the enclosed leaflet very closely as it contains detailed descriptions and pictures of how to use it properly. 

In brief, you rotate the ring right down to the syringe barrel then back until the correct number of dots is exposed between the syringe barrel and the ring. It will then cause the plunger to stop at the correct place when you squeeze it into your dog’s mouth.

Sileo Dosage Chart

If the dose is more than 6 dots, divide the dose between both sides of the mouth.

Sileo Side Effects 

Alpha-2 agonists are known to cause vomiting in some dogs. Therefore, don’t be too concerned is there is a brief vomit as it starts to take effect. Any more than this and you will need to seek help. 

Other side effects will generally be related to excessive drowsiness and sedation, including a low heart and breathing rate, and low temperature. Adverse effects should not last more than two hours but there will be some variation between dogs.

If your dog appears excessively sedated, or breathing too slowly, please seek immediate veterinary care. There is an antidote available which should almost immediately reverse the effects.

How Well Does Sileo Work?

The graph at the start shows the results of a European placebo-controlled double-blinded field study. 71 dogs with a history of fireworks phobia were treated at New Year’s Eve with a maximum of five doses at two hour intervals. For comparison, 73 dogs were treated with a placebo containing no drug.

You can see that 75% of the treated dogs had a good or excellent response, compared with 33% of placebo-treated dogs. There was a statistically significant difference (p<0.0001) between dexmedetomidine and control in favour of dexmedetomidine.

At the same time note that there were still plenty of dogs who responded very poorly. And it’s also worth noting that in this study, the treatment was able to be started in most cases before the onset of the noise.

So:

• Sileo won’t help every dog enough on its own
• Sileo may cause excessive side effects in some dogs
• Sileo will be expensive for larger dogs if it’s needed very often

For all these reasons, we need to not forget the other options.

Medications For Noise Sensitivity

Dogs with anxiety to noise are treated with both drugs and environmental manipulations. A quick list includes:

• being a calming and reassuring presence
• creating a ‘safe zone’ where your dog likes to hide
• getting a dog behaviourist consultation
• benzodiazepines like alprazolam and diazepam
• clonidine
• trazodone
• gabapentin
• dexmedetomidine

Visit this page for a longer discussion of these options. One thing I will take the time to specifically warn you about here, though, is Adaptil. You can read why on this page, but a simple summary is that it just doesn’t do enough. The placebo effect shown above should be sufficient warning to always be guided by science when you can.

And one last grumble. As an ancient-language fan, the name ‘Sileo” grates on me a bit. It’s Latin for “I am silent”, which speaks all too loudly to how we sometimes approach mental health in animals. That is, as problems for us, not them.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

They are a great help, and I’m not going to tell you not to use them. But I want you to be careful.

What Is A Lick Mat?

A lick mat is a textured flat surface made out of rubber, usually with suction cups to attach it to the floor. The pattern on the top is designed to trap food and make it hard to eat quickly. The aim is to get dogs and cats to spend their time in licking instead of other unwanted behaviours, or to alleviate boredom and anxiety. Unlike other slow feeders, licky mats promote licking behaviour, instead of food seeking or foraging.

Uses For A LickiMat 

The uses being promoted for the LickiMat® on their website include:

• Entertainment & distraction
• Reduction of anxiety & stress 
• Boredom buster 
• Slow feeding
• Raw feeding
• Environmental enrichment
• Improving oral health

Some of these uses make a lot of sense. A lick mat is a great way to get a dog to tolerate unpleasant situations like bathing, grooming, nail clipping and vet visits. That’s only so long as your dog is highly food-motivated.

You could also use it as an aid to crate training and getting your dog accustomed to car trips. It’s also a great way to alleviate stress in temporary situations, like fireworks and thunderstorms, or owners leaving the house.

So what’s the problem? Firstly, some of the claims make little or no sense.

Do Lick Mats Improve Oral Health?

LickiMat’s manufacturers claim that by stimulating saliva production it can clean the tongue, teeth and gums. Well, as someone who is well-acquainted with the literature on what actually keeps pets’ mouths clean, this statement lacks any basis in fact.

In fact, the sorts of treats being used on these mats should logically make periodontal disease worse, not better. Always remember that periodontal disease in dogs and cats follows the same course as it does in humans: you wouldn’t expect your teeth to be better by licking peanut butter off a rubber tray either.

What about the claim that scraping the tongue freshens your pet’s breath? Ludicrous. I’ve been a vet for close to 30 years, and I’ve never yet seen bad breath caused by tongues!

Are Lick Mats Calming?

One of my major concerns not just with lick mats but more generally is the contrast between being busy and being happy. While I think these products are great for preventing anxiety in stressful situations, it’s a big claim to say that such products improve anxiety that’s already present. As with my complaints about Adaptil and Feliway, such claims might stop dog and cat owners choosing remedies that actually help them.

Beware the manufacturer claim that “the extended licking action promoted by LickiMat releases a calming hormone”. So far there’s no evidence for anxiety reduction with lick mats or any ‘hormone’ being released. Yes, a mat might keep them busy and less prone to expressing anxious behaviours, but that’s not the same thing.

These two complaints are minor quibbles compared with my concerns about safety. Here are two ways.

Intestinal Obstruction & Hygiene

In the past month we have seen two animals need veterinary attention as a result of lick mats.

The first is a dog called Murphy. He was left alone with a lick mat for just a moment, and promptly chewed it up and swallowed it. Thankfully his owners immediately saw what happened and brought him down. That’s his vomit in the picture at the start.

The second is Tex the cat. He ate a piece of his lick mat without anyone noticing. When he started vomiting, his owner realised what was wrong. That’s his x-ray below; the white rectangle in his belly is the piece, now blocking his intestines.

There’s also a picture above of that piece matched with the rest of the mat, after we took it out. Without major surgery, he would have been in a lot of trouble. The same could have been true for Murphy of course.

This should come as no surprise. Vets have always said that anything flavoured like food, but not digestible is extremely dangerous. So here’s the newly updated list:

• corn cobs
• satay sticks
• icecream sticks
• meat wrapping
• cooked bones
• lick mats

How To Use Lick Mats More Safely

“You must fully train your dog before leaving her/him alone with a LickiMat.” So say LickiMat.

These products are being promoted for pets left home alone, which in my view is madness. In the general enthusiasm for anything new, we’ve forgotten some basic rules.

It is my strong view that no dog should be left alone with a lick mat. Even after ‘training’, whatever that is. There’s no telling when a dog will get frustrated and just chew it up. Cats might be at a lower risk, but Tex shows us it can still happen, especially with the softer silicone products.

Another thing: watch out that these mats are properly cleaned after each use. This is particularly important if you’re using them with raw food. It would be smart to buy ones that are dishwasher safe.

What Can I Use Instead Of A Lick Mat?

I’m not opposed to using food as a distraction when they need to be left. If you do, I recommend slow feeder bowls, Kong Wobblers, Bobalots and Nina Ottoson products with long track records of proven safety. Or you can hide food around the house or garden.

To be fair, LickiMat make a ‘Tuff’ version, and even a keeper tray to make chewing harder. But I have seen both the red and black rubber Kongs destroyed and know only too well how destructive a determined dog can be.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

These are exciting times, but we also need to be cautious. No treatment will work on every dog, and after initial overexcitement, some new products end up being major disappointments. However, with Beransa there is real hope for dogs that we have a new and effective tool to improve their quality of life.

What is Beransa?

Beransa is a trade name for bedinvetmab, also called Librela outside of Australia. It neutralises nerve growth factor (NGF), which has been shown to be involved in the perception of pain. As a monoclonal antibody, it has the potential to be highly specific to its target, and block it almost completely.

In Australia, Beransa has been registered for the alleviation of pain associated with osteoarthritis in dogs.

How Well Does It Work & How Quickly?

In our clinic, Beransa has quickly become the number one treatment chosen by our vets for new patients with arthritis. This has been based on a number of factors:

1. A very high success rate, interestingly higher than in the trial featured below
2. Minimal to no observed side effects, especially compared with traditional anti-inflammatory drugs
3. A similar cost to other treatments, especially in larger dogs

What does the evidence say? The results of a single placebo-controlled study conducted by the parent company are shown here and referenced below.

They show that around one in two dogs show benefit after a month. Like with all arthritis treatments, there is a large caregiver placebo effect, so it is important to stay as realistic as possible about its efficacy in each patient.

How To Use Beransa

Personally, I believe the study shown here and our clinical experience are enough to recommend trying Beransa in the right dog. However, I also strongly believe that we should not forget the other tried and trusted remedies for arthritis in dogs.

This is especially because Beransa only targets pain, not the underlying disease process. Now make no mistake: treating the pain is the most important thing, but it isn’t everything. If we add the treatments known to slow down the arthritic process, our dogs should have better function in the years to come as well as right now.

In particular, I encourage all dog owners using Beransa to at least continue the Hills j/d diet and regular pentosan injections. Both are extremely safe and can slow the degenerative process.

Beransa Dosage & Frequency

Beransa is given at a dose of 0.5 – 1 mg/kg by subcutaneous injection. It comes in a variety of vial sizes to cater for dogs of different weights. If desired, the dose is repeated every month. It is generally recommended to try at least two doses before deciding whether it is effective enough.

NGF is important for foetal and juvenile development. Therefore, Beransa must not be used in breeding, pregnant or lactating dogs, or those less than 12 months of age.

Human Health Risks

Similarly, pregnant women, women trying to conceive, and breastfeeding women should take extreme care to avoid accidental self injection or needle stick injuries. To be safe, it is best that they take no part in giving the injection or even holding their pet.

Just to be clear, a treated dog poses no risk to humans.

Beransa Side Effects

Reactions such as swelling and heat may occur at the site of injection, but these seem rare. Hypersensitivity reactions are also possible but appear more common in the cat form of this drug, Solensia.

Our experience with monoclonal antibodies like Cytopoint shows us that they are much safer than traditional drugs like anti-inflammatories. This is because as naturally occurring proteins, they require minimal metabolism or detoxification by the liver or kidneys. However, until there are studies of their use with liver or kidney disease, caution is still advisable in these dogs.

Beransa appears safe when used in combination with other drugs, and at the time of vaccination. The only concern with using multiple treatments could be that if an adverse effect occurs, you may not be able to identify the cause.

How Much Does Beransa Cost?

The cost in 2023 for a single injection of Beransa is between $100 and $130 depending on the size required. This is in the same region as the higher price anti-inflammatory drugs.

Beransa or Librela may not be a silver bullet, but just having another option is a great blessing. Our experience so far is that for some dogs, it maintains their quality of life when other choices fail. It can also be used when other treatments aren’t safe enough to use.

Anyone who has an arthritic dog knows that we still aren’t doing enough for them. The development of monoclonal antibodies brings us just one step closer, and just might give us more time to enjoy our lovely old dogs.

Therefore, talk to your vet about whether it might be good for your dog.

References

Corral, M. J., Moyaert, H., Fernandes, T., Escalada, M., Tena, J. K. S., Walters, R. R., & Stegemann, M. R. (2021). A prospective, randomized, blinded, placebo-controlled multisite clinical study of bedinvetmab, a canine monoclonal antibody targeting nerve growth factor, in dogs with osteoarthritis. Veterinary anaesthesia and analgesia, 48(6), 943-955 Full Text

Kronenberger, K. (2023). In dogs diagnosed with osteoarthritis, how safe and effective is long-term treatment with bedinvetmab in providing analgesia?. Veterinary Evidence, 8(1) Full Text

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

Nowhere in dog care is there more argument than if bones should be fed as part of a regular diet.

You’ll see a lot of advice that it’s dangerous. It certainly can be. However, if you follow our bone feeding advice, you will minimise the risk, but not eliminate it.

You’ll also see a lot of advice saying it has no benefit, or that certain manufactured products are better. This is a much more complicated issue and as you will see, not entirely true.

Why Is There So Little Proof?

Absence of evidence is not always evidence of absence.

In other words, there can be no proof of benefit without studies designed to look for it. The problems with bones is that they generally lack companies with the financial incentive to fund major studies.

Therefore, we know that toothbrushing, Dentastix, Greenies, dental foods and even mouthwashes can help, but we just don’t know enough about bones. It was this gap that we attempted to resolve in 2010.

The Walkerville Vet Bone Feeding Study

For 12 months, we surveyed dog owners at the time of vaccination, asking many questions about their diet. We also gave their mouth a dental score.

At the end of the study, we had 479 completed surveys. Then, owing to the fact that we’re always busy, we put them aside for a few years but never forgot them.

In 2017 I approached a statistician at the University of Adelaide about publishing the study. He was very helpful, and together we statistically analysed the data so that this was possible. Here’s what we found.

Bone Feeding Study Results

The graph gives a quick summary of the dog dental scores we collected. There was a dramatic difference in the rate of periodontal disease based on how often bones were fed. This difference was statistically significant at several points.

We also found that certain breed groups (Terriers, Gundogs, Working Dogs) were less likely to have dental problems when compared with Toy breeds.

According to these results, the feeding of bones to dogs is associated with better periodontal disease scores.

Although this suggests that the bones are keeping the teeth clean, we must be careful to not claim causation; we can’t prove that one causes the other. For example, owners who feed bones might generally be more conscious of dental care in other ways. Of course, we tried to ask about such things in the study, but only a long-term study would answer that question properly.

Regardless, the results are compelling and unique. It certainly suggests that dogs who are given dietary bone will benefit.

So Why Isn’t It Published?

To the best of our knowledge, this is the first time any such study has been conducted anywhere in the world. But it still hasn’t made it into a scientific journal.

We have submitted the manuscript to several journals, and there are three main reasons why it remains unpublished.

1. We have not tried the low ranking journals. Any paper can be published if you’re not fussy about where.
2. Legitimate criticism has been made that we were too close to the data. Claire and me both knew the patients, and it’s conceivable that our dental scores were biased as a result. Of course we don’t think so!
3. The journal reviewers are leaders in the field of veterinary dentistry, which is generally antagonistic towards bone feeding. Just read this quote from one:

It has already been established that diets with coarser materials will help to decrease the incidence of plaque and calculus accumulation, however there are major concerns in regards to the other problems that raw diets and diets with bone can cause.  From an oral health stand point, the incidence in dental trauma  or fractured teeth and endodontic disease should also be compared.  Without this comparison it is irresponsible to recommend this type of diet.

It’s like saying we aren’t allowed to publish on the benefits of early reading in children if we don’t also look at associated eye diseases. The reviewer’s comments are, of course, not evidence-based as no one has looked at rates of problems with bones either.

I would love that study too, but no-one asked the dental chew manufacturers to prove their safety. Are we not allowed to show a benefit if it exists?

So we continue to try. In the meantime, here’s a link to the full scientific paper, including references to other bone studies over time. Enjoy, and feel free to ask lots of questions in the comments below!

Related: How To Feed Bones To Reduce Risk | Other Ways To Keep Dogs’ Teeth Clean

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

One disease in particular, myxomatous mitral valve disease (MMVD) is said to account for 75% of heart disease and affects 85% of small dogs over 13 years old. Not all of these will need treatment, but many will. Later I’ll show you how to tell.

There is no question that recent advances have made MMVD much less of a death sentence than it once was. So it’s good to get to know pimobendan, the newest, and most commonly used of these treatments.

How Pimobendan Works

Pimobendan is a drug that unusually has two separate positive effects. First, it increases the strength of contraction of the heart, increasing the amount of blood delivered. Second, it dilates blood vessels in the general circulation, reducing the heart’s workload.

Pimobendan needs to be given at a dose of 0.2–0.3 mg/kg twice a day on an empty stomach, leading to the following inescapable logic. If it needs to be given one hour before any food and 12 hours apart, then even starting with a 7am dose will result in an 8pm dinner time. Now of course, we don’t recommend feeding dogs after dark…

You can picture the disappointment in peoples’ faces when they think this through. It’s definitely a drug for the early risers in the house. The only other alternative is to make their main meal in the morning.

Lifespan Of Dogs On Pimobendan

Early work demonstrated that pimobendan could help dogs with MMVD, but by how much was uncertain, and so vets like me were slow to change treatments that were already working. Then two large international studies appeared. With them came a sea-change in how we viewed this drug.

Each of them has something important to say about both effects and side effects. Both are referenced below.

2008: The QUEST Study

252 dogs with naturally occurring MMVD and congestive heart failure were divided into two groups: one taking pimobendan and another taking benazepril, the leading heart treatment at the time. Both were allowed other treatments as needed. They were then studied over the following years until one of the following three things happened:

1. sudden death
2. euthanasia for cardiac reasons
3. treatment failure

For pimobendan, the median time to this endpoint was 188 days. For benazepril it was 140. So a good result, but far from impressive. However, it’s worth pointing out here that these survival times are artificially short; many dogs in the study had already been affected for some time before beginning.

Real life is better. The point is more that in matched groups, pimobendan outperformed its rival.

2016: The EPIC Study

To my knowledge, the EPIC study was the first in veterinary medicine to be stopped early because of what was found. 354 dogs were chosen who had MMVD but were not yet in heart failure. At this earlier stage they had enlarged hearts as determined by xray and ultrasound.

Up to the time of the study, treatment was not believed to help at this stage, and so they were divided into dogs given pimobendan and dogs given a harmless placebo instead. This time the endpoint was chosen to be one of:

1. development of left-sided heart failure
2. euthanasia for a cardiac reason
3. death presumed to be cardiac in origin

The median time to this endpoint was 1228 days in the pimobendan group and 766 days in the placebo group. In other words, dogs with enlarged hearts but without heart failure had an extra 60% or 462 days of disease-free life if they took pimobendan.

This of course was a stunning result. Once it became obvious, all of the dogs were put on pimobendan.

Pimobendan Side Effects

Similar rates of adverse effects were reported for pimobendan and benazepril. This suggests that the drug is at least as safe as other heart treatments,

Pimobendan also recorded similar side effects to the placebo. Deaths in the pimobendan group were 46.4% versus 57.2% in the placebo group. This suggests that pimobendan is safe compared with any drug.

If you want to take a closer look, I’ve included the reported side effects from both studies in two tables after the references.

Help! Pimobendan Killed My Dog!

What then do we make of online reports of terrible events after dogs took pimobendan? The high rates of death and side effects in the placebo group provide the best clue. These are old dogs with a high risk of illness from any cause.

We humans are notoriously bad at separating causation from correlation. In fact, with any one dog, it’s virtually impossible to decide if a sudden death is caused by a drug or not. It’s only by looking at large groups that we can see the trend. Sometimes it’s real, other times it’s not.

Pimobendan may in fact cause deaths in some dogs. Even if so, the evidence tells us that they are heavily outweighed by the dogs that survive for longer.

When Should My Dog Take Pimobendan?

Pimobendan is a much better drug at stopping dogs going into heart failure than it is in treating them once they do. So here’s a quick summary of how to use pimobendan in 2022 and beyond:

1. Get regular checkups (at least annually) to look for early signs of heart disease. This is mainly the appearance of a heart murmur.
2. Once a murmur appears, watch fitness, coughing and resting respiratory rate closely and get a checkup at least every 6 months.
3. Follow your vet’s advice on further testing. Sooner rather than later they will want to do chest xrays and possibly cardiac ultrasound to look for the signs of heart enlargement.
4. Even if things are normal, expect things to change and so repeat the tests every 6 to 12 months based on your vet’s advice. Eventually you’re likely to spot the right time to start pimobendan.
5. Once started, most heart disease will stabilise but dose adjustments and extra medications will still be necessary as the disease slowly worsens (hopefully over years, not months). Therefore, keep attending scheduled checkups and get advice straight away if anything changes.

Most importantly, trust the science. It’s very hard to judge the efficacy of any treatment used to prevent a disease instead of treat it, but we actually have a lot to go on here.

Related: A Dog With Dilated Cardiomyopathy (also treated with pimobendan) caused by a grain-free diet

Update: Mitral Valve Repair

I hesitate to add this as I fear giving dog owners false hope, but several comments below have spurred me to also discuss the surgical option. As of 2023, there are now several centres around the world that offer open heart surgery to improve mitral valve function. It is not replacement of the valve, but instead modifying its shape or adding support so that the leak is less significant.

Costs are extreme (I would guess $40-50K) and availability currently limited to the UK, France, Japan and the USA. If you Google ‘dog mitral valve repair’ you should find useful information from these sites. There is no doubt that this procedure will become more commonplace with time, and hopefully more realistic.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

References

Boswood, A., Häggström, J., Gordon, S. G., Wess, G., Stepien, R. L., Oyama, M. A., … & Watson, P. (2016). Effect of pimobendan in dogs with preclinical myxomatous mitral valve disease and cardiomegaly: the EPIC study—a randomized clinical trial. Journal of Veterinary Internal Medicine 30,(6), 1765-1779. Full Article.

Häggström, J., Boswood, A., O’grady, M., Jöns, O., Smith, S., Swift, S., … & DiFruscia, R. (2008). Effect of pimobendan or benazepril hydrochloride on survival times in dogs with congestive heart failure caused by naturally occurring myxomatous mitral valve disease: the QUEST study. Journal of Veterinary Internal Medicine, 22(5), 1124-1135. Full Article.

Keene, B. W., Atkins, C. E., Bonagura, J. D., Fox, P. R., Häggström, J., Fuentes, V. L., … & Uechi, M. (2019). ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs. Journal of veterinary internal medicine, 33(3), 1127-1140. Full Article.

Here I’m going to lead you through the evidence and end with advice on how to use fish oil most effectively.

Skip the next section unless you’re really interested!

Fish Oil Essential Facts

First, what exactly is fish oil, and how might it work?

Almost all the fatty acids available to land animals like dogs (and us) are omega-6. The body uses these to make arachidonic acid and from this to make various inflammatory molecules.

When the body uses an omega-3 instead of omega-6, the end result can be anti-inflammatory instead. It’s not that omega-3 is the more natural; in fact, the body in arthritis is promoting inflammation, not suppressing it. What we are doing by supplying omega-3 at high doses is ‘tricking’ the body into using it instead.

In dogs, the effective omega-3 fatty acids are eicosapentaenoic and docosahexaenoic acid (EPA & DHA). Linseed and flaxseed oils contain ALA, which is almost unavailable to dogs. EPA and DHA mostly come from certain fish, but certainly not all of them. Feeding fish without dietary analysis is very unlikely to give the same benefit.

Fish Oil & Omega 3 Dog Studies

Now to the evidence. I’ve read all the studies using fish oil in arthritic dogs that included a control group. The control group is fed a dummy diet or supplement so that the owner placebo effect can also be measured and removed.

In fact in nearly all of these studies the placebo group improved as well. It’s the difference we’re interested in. I have one concern though: fish oil is very hard to hide due to its smell!

Fish Oil As A Supplement

The first study comes from Finland³. They gave dogs with arthritis 110 mg of DHA/EPA per kilogram body weight. This gave a final dietary ratio of omega 6 : omega 3 as 11 : 1 and would equate to roughly 7 regular strength 1g capsules for a 20kg dog.

No differences in measured performance were found. The only differences were that owners were more likely to see improvement, and more likely to guess correctly when their dog had the treatment diet rather than the control.

The results of this study suggest that, if done this way, the benefit of feeding an omega 3 fish oil supplement to dogs with osteoarthritis is small. 

Purina Fish Oil Therapeutic Diet

The second paper⁴ evaluates a veterinary therapeutic diet marketed to alleviate the signs of arthritis. This diet contained 1.08% DHA/EPA with a ratio of omega 6 to omega 3 as 1.3 : 1.

In this study, there were no differences between the treatment and control groups either in measured performance or owner assessment. As the authors stated, “the present study cannot convincingly claim that VTD [= veterinary treatment diet] improved the limb function to a greater extent than a regular diet”

Interestingly, both groups improved substantially. This is almost certainly due to the study design: owners were asked to avoid any intense activities (jumping, running, throwing ball or Frisbee, etc.) during the study duration. Which just goes to show how important it is to stop high-impact activity in these dogs.

Hills Fish Oil Therapeutic Diet

Finally we have the Hills product called JD or j/d. My clients will know I recommend this, and now I hope you will see why. However, I also want you to see that the effect is still not very dramatic.

Hills Prescription Diet j/d has 3.5% DHA/EPA, with a ratio of omega 6 to omega 3 as 0.73 for the kibble and 0.68 for the canned form. Note this is the first time you have seen a diet with more 3 than 6.

There are four studies, and I’ll quickly summarise them:

• Dogs on j/d were able to have greater reductions in anti-inflammatory doses than dogs on control foods. Average final doses of carprofen were 3.5mg/kg vs 3.85mg/kg respectively¹.
• During initial investigations, a difference for lameness and weight bearing were noted between dogs on food A (0.8% omega 3) and those on food C (similar to the final product)². 
• Using floor pressure plates to measure leg use, dogs on j/d increased their peak vertical force by 5.6% at 90 days⁵.
• In a home feeding trial, owners of dogs fed j/d reported improvement in their dogs’ ability to rise from rest and play at week 6 and the ability to walk at weeks 12 and 24 after the feeding trial began⁶.

In all cases, improvements were found, but not huge ones. Each study also included many factors that did not show any change.

How Fish Oil Can Be Toxic To Dogs

Here are some of the ways fish oil could be harmful to certain dogs:

• Dogs prone to pancreatitis should not be fed diets with normal to elevated levels of fats and oils. Therefore, fish oil could cause severe illness or even death in these dogs.
• Dogs with fish-based food allergies could also react severely to fish oil.
• Even normal dogs can have unexpected gastrointestinal upsets when fed fish oil. These are usually mild vomiting or diarrhoea, and will stop if you cease giving fish oil.

What about the fact that the therapeutic diets are grain-based? As you’ll see here, vets advise against grain-free diets.

Can You Use Human Fish Oil Capsules?

A common question is whether you can use pharmacy fish oil to treat dogs. This is true for skin disease, but false for arthritis. The reason for this is that the food manufacturers, through mysterious means, reduce the levels of omega 6 before adding omega 3. It’s also just that fish oil incorporated in the diet is a lot easier to give!

As you can see from the doses above, it would be nearly impossible to achieve either a sufficient dose or an acceptable 6:3 ratio by adding fish oil to an existing diet. Such a dose would probably also be toxic.

Fish Oil Dosage Calculator

The main drawback of j/d is its price. If you find it too costly, then here is a quick formula for the maximum fish oil dose you can give. Using a scientific calculator (also my smartphone calculator if I turn it sideways), raise your dog’s body weight to the power of 0.75 and multiply by 370. As a rough idea, for a 20kg dog the answer would be 3500mg.

Now look at the fish oil jar to see how many milligrams (mg) of combined DHA and EPA each gram contains. For fish oil containing 300mg per gram, the final fish oil dose equals 3500 divided by 300, or eleven grams. Bear in mind that this will still fall short of ideal doses but it should do something.

As I hope you’ve gathered by now, whichever way you use it fish oil can be helpful, but it’s very unlikely to do enough on its own. The treatment of canine osteoarthritis is multimodal, meaning we come at it from multiple angles. So click here to see the other recommended treatments for arthritis.

And a final disclaimer: I sell Hills j/d so I can easily be accused of bias. To this I say: if I didn’t think it worked, I wouldn’t sell it or choose it for my own dogs! And in fact, you can now see why, when I can’t get j/d, I won’t sell you anything else to replace it.

Sources

1. Fritsch, D. A., Allen, T. A., Dodd, C. E., Jewell, D. E., Sixby, K. A., Leventhal, P. S., … & Hahn, K. A. (2010). A multicenter study of the effect of dietary supplementation with fish oil omega-3 fatty acids on carprofen dosage in dogs with osteoarthritis. Journal of the American Veterinary Medical Association, 236(5), 535-539
2. Fritsch, D., Allen, T. A., Dodd, C. E., Jewell, D. E., Sixby, K. A., Leventhal, P. S., & Hahn, K. A. (2010). Dose‐titration effects of fish oil in osteoarthritic dogs. Journal of veterinary internal medicine, 24(5), 1020-1026
3. Hielm-Björkman, A., Roine, J., Elo, K., Lappalainen, A., Junnila, J., & Laitinen-Vapaavuori, O. (2012). An un-commissioned randomized, placebo-controlled double-blind study to test the effect of deep sea fish oil as a pain reliever for dogs suffering from canine OA. BMC veterinary research, 8(1), 1-14
4. Moreau, M., Troncy, E., Del Castillo, J. R. E., Bedard, C., Gauvin, D., & Lussier, B. (2013). Effects of feeding a high omega‐3 fatty acids diet in dogs with naturally occurring osteoarthritis. Journal of animal physiology and animal nutrition, 97(5), 830-837
5. Roush, J. K., Cross, A. R., Renberg, W. C., Dodd, C. E., Sixby, K. A., Fritsch, D. A., … & Hahn, K. A. (2010). Evaluation of the effects of dietary supplementation with fish oil omega-3 fatty acids on weight bearing in dogs with osteoarthritis. Journal of the American Veterinary Medical Association, 236(1), 67-73
6. Roush, J. K., Dodd, C. E., Fritsch, D. A., Allen, T. A., Jewell, D. E., Schoenherr, W. D., … & Hahn, K. A. (2010). Multicenter veterinary practice assessment of the effects of omega-3 fatty acids on osteoarthritis in dogs. Journal of the American Veterinary Medical Association, 236(1), 59-66

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

Sometimes they’ll yelp, or limp, but other times it just looks bent or dislocated. There may even be a little bleeding. What do you do?

The dog’s nail in the picture above is a good example. His owner was told it was fine to wait for it to fix itself, but after several days she wasn’t so sure.

Will A Broken Nail Heal On Its Own?

Most broken nails will heal by themselves over 1-2 weeks. However this causes unacceptable discomfort in the meantime. The loose nail is still partly attached to the injured nailbed, and even the slightest movement creates intense pain.

Additionally, if untreated the area of separation between nail and nailbed quickly gets infected. You will notice this by the appearance of a smell around two days after the injury.

Remember the number one message from vets to dog owners is: they don’t complain.

Can I Pull The Nail Off Myself?

You will find people online advising you to remove the broken or damaged nail by pulling, cutting or snipping. Here’s why that’s a bad idea:

1. The nail fragment is often very well attached. Sometimes it also contains vital parts of the nailbed that should not be removed.
2. Pulling the nail often leaves small slivers that you cannot see still embedded in the nailbed.
3. Puling a broken nail is extremely painful. They may not complain, but it is likely that you will lose your dog’s trust in touching their nails for ever after.

The last point I have seen many, many times. As a young vet I (like most back then) would just ‘pull’ the loose nails and apply a dressing. It took years of experience to see how differently the dogs related to me afterwards. Pain is the best educator.

Those people online? I can only guess that they haven’t torn one of their own toenails yet. And here are my personal observations: their use of styptics on bleeding wounds is unacceptably painful, and their home dressings are generally too tight.

When Should I Go To The Vet For A Broken Nail?

A broken nail is rarely an emergency requiring out of hours care but you should make an appointment with your vet at their soonest available in regular business hours. Preferably, go in the morning and do not feed your dog.

Most vets agree that the best humane treatment is deep sedation to abolish pain before any attempt to remove the nail. This also allows us to clip and closely inspect the injury before action. You can see in the picture above that there is some pus and bleeding around the base of the nail.

Sedation also allows us to carefully ‘peel’ the nail away without tearing the underlying tissues. Any remnant pieces of nail which will cause ongoing infection are easily identified and removed. The area is cleaned and finally a dressing is placed.

How Long Does It Take To Heal?

Once the damaged nail is removed and the infection controlled, a new nail starts growing straight away. Then, as long as it is kept clean and dry, the dressing can usually either be removed after three days, or changed and removed after six.

The last thing to consider is prevention. Most nails that get broken are dewclaws that have got a little too long.

For this reason, you will notice that I check a dog’s dewclaw by sliding my finger underneath. If it catches my finger, this means it can get caught on anything else too. That’s when I get the clippers out: not to cut it very short, just to stop it being hooked on the end.

So to finish up, read my Guide To Good, Bad & Ugly Dewclaws

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here. The information provided here is not intended to be used as a substitute for going to the vet. If your pet is unwell, please seek veterinary attention.

While not all are simple to fix, after reading this you should have a good idea of what to do. I’ll rank them in rough order of frequency.

Before the list though, you need to do something unpleasant: make a close inspection of your dog’s body using both your eyes and nose. Pay particular attention to the crevices like armpits, groin, feet, ears, mouth and lips. We’ll use this information in a minute.

Skin Disease

The skin of dogs with chronic dermatitis almost always has a bad smell. You might describe it as ranging from an extreme ‘doggy’ smell to old socks. This is probably due to an overgrowth of secondary yeast and bacteria taking advantage of the skin’s weakness.

Affected skin often looks thickened or wrinkly, and may have a greasy or flaky surface. It can also become red or even black in colour.

Uncomplicated dermatitis on its own does not smell, and so an odour is a sign that the condition has progressed. The solution is never as simple as using antifungal or antibacterial shampoos. You will need to address the underlying skin problem, which you can read about here.

Ear Infections

Infections inside the ear canal are a specialised form of skin disease complicated by severe yeast or bacterial overgrowth. They nearly always smell strongly, and if you put your nose right up to the canal it there’s no mistaking the origin. Sometimes the infection is so deep that the ear canal looks normal on the outside.

Never, never just put cleaner into a smelly ear without your vet checking it first. As it’s probably infected by now, cleaning alone won’t work and it will sting harshly. Once you do this, your dog won’t trust you and treating the problem properly gets a lot harder.

Ear cleaners are great for prevention, but first read about the treatment of ear infections here.

Oral Disease

If you have identified the smell as coming from inside the mouth, there are still quite a few causes. The first is advanced periodontal disease, which is inflammation and infection of the junction between the teeth and gums. This is the most common cause of bad breath and tooth loss.

Once dental disease develops, you will need it treated under anaesthetic, but it can also be effectively prevented afterwards.

Any infection or ulceration in the mouth will also smell bad, so other causes I have seen include oral tumours, foreign material caught in the teeth or mouth ulcers from kidney disease. A smell from the mouth has never in my experience been caused by any area lower down like the stomach.

The smell from bad breath is often described as ‘fishy’ or ‘metallic’, leading to confusion with the next cause. The clue is to look at the location.

Anal Glands

Anal glands are special scent glands found just inside the anus. When a dog defaecates, they release an odour onto the poop which other dogs can detect. Anal glands malfunction when they release this scent at any other time.

The classic anal gland leakage situation is your dog sleeping on your lap and suddenly you smell a horrible rotten fishy odour. You might find a drop of brown fluid. Many of these anal glands are too full and not emptying by themselves.

If so, all you need to do is get your vet or groomer to express them every 3 months and the problem goes away. However others leak when they aren’t full, and these are much harder to fix. Some have infection inside, others just seem leaky. Read about their treatment here.

Skin Folds

Fold pyoderma is a localised infection in folded skin. It’s notorious in short-faced breeds like Bulldogs, but this is easy to see because the hair is short.

The more insidious form is found in dogs like Cocker spaniels and Golden retrievers. The lower lip often droops as they age and a fold forms which traps saliva in the hair. These can get very badly infected and smell like rotten meat.

The trick to finding them is to not just look inside the mouth, but also stretch out the skin on the upper and lower lips. Treatment involves antibiotic tablets or creams, then prevention with antibacterial wash and barrier ointments. Severe cases require a small facelift!

Flatulence

Passing smelly gas from the bowel is a common noxious odour, but at least no-one has trouble identifying it. The solution is almost always to find a food that agrees better with your dog’s digestion. Or put up with it, as the dog is usually untroubled!

Urinary Incontinence

Around 2.5-5% of dogs will develop urinary incontinence. In some females it can start very early, and may be more common after desexing. It is also common with urinary tract infections.

The stale ammonia smell is usually quite distinctive, but I see many dogs whose owners have got used to the scent until I point it out. These dogs can almost always be cured by either fixing an infection, removing a bladder stone or medications to prevent leakage.

Faecal Soiling

Having poop stuck in the hair might seem like an excessively obvious cause of bad smells. However, I see it regularly, especially with new owners of Poodles and Poodle crosses. The hair can quickly get thick and long around the anus to hide the buildup of soft faeces.

If this isn’t addressed urgently with a gentle bath and dry, you often end up at an overnight emergency vet. The faeces end up blocking the anus, and the resulting rash can be terrible.

Prevention is of course all about having a good relationship with a trusted dog groomer, and starting as early as possible. It’s also about avoiding soft faeces by the use of high quality diets.

Normal Doggy Smells

The last cause is the hardest and saddest. Never assume this is what is causing your dog’s bad smell unless you have consulted a vet first: it’s very rare.

Every now and again I see a dog owner who is disgusted by their dog’s terrible odour. Except that I can’t smell it at all, and neither can anyone else in the clinic.

These dogs smell normal. Nearly all of us with dogs have tuned out the natural odour of dogs and can no longer detect it. However, for an unlucky few it remains thick and intense.

I have no solutions for these people, as a bad smell can’t just be hidden under cologne or other scents. Putting a dog outside is definitely not the answer.

But let’s not be negative. Eight of the nine causes of bad smells on dogs are fixable, and the ninth isn’t a problem to the dog. Good luck working it out!

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here. The information provided here is not intended to be used as a substitute for going to the vet. If your pet is unwell, please seek veterinary attention.

The food that nearly killed her is a leading brand of grain-free dog food you can buy at nearly any Australian supermarket. I wish I could tell you its name.

Here’s what happened.

Rowdie’s Collapse

That’s Rowdie in the picture. She’s a 12-year old Beagle who’s always been in good health, including at a checkup early this year.

On the 16th of May, she was having a bath when she suddenly collapsed, rolled on her side and remained stiff and unresponsive for 10 to 15 seconds. She was taken to an emergency vet and had blood taken. The cause was thought to be a seizure.

I saw Rowdie a few days later. The first thing I thought was that it probably wasn’t a seizure: these go on for at least 30 seconds and have lots of muscular activity. Her history contained a further clue: she’d recently developed a moist cough.

Heart Disease, Not Seizure

More clues came from her examination. Her heart rate and her breathing were faster than expected, and I could feel fluid in her abdomen. Most importantly, she had a grade 3 heart murmur that wasn’t there just four months earlier.

The final clue was the bath. Seizures happen at any time, even during sleep. Rowdie’s collapse on the other hand happened at a time of increased activity.

I strongly suspected a heart problem and so we took chest xrays straight away. These showed an enlarged heart with pulmonary oedema (fluid on the lungs). Heart disease was confirmed.

Why Rowdie Though?

You see, Rowdie’s problem wasn’t typical. She’s not of a breed prone to heart problems, and she’d been normal so recently. Most cases of heart failure don’t come on without warning because we’ve been listening to the murmur getting louder for months or years beforehand.

Here’s where Rowdie’s luck turned the first time. Here in Adelaide we’ve always had a shortage of vets skilled enough to offer cardiac ultrasound, called echocardiography. Well just the week earlier I’d received news that a board-certified ultrasonographer was setting up a freelance service.

We started Rowdie on heart medications and booked her in for the soonest available appointment.

Echocardiography Saves The Day

The ultrasound exam saved her life. That’s because the results showed she had a very unusual form of heart disease that I never would have predicted: dilated cardiomyopathy or DCM.

DCM is when the heart muscle gets thin and weak, and it normally has a very short survival time. However, not in Rowdie’s case. It was while I was talking over the results with her owner that she got her second lucky break.

I remembered those reports about grain free foods. And so I asked about Rowdie’s diet.

Grain Free Diets & Heart Disease

It turned out that earlier in the year, Rowdie’s owners had started buying a grain-free dog food. Like most people, they assumed that if it was being proudly marketed as grain free, it must be better.

Vets have known for some time that this is not true, but we can’t get the message out to dog owners. The reality is that grain free diets are being regularly linked to dogs like Rowdie.

You can read more here. We don’t know exactly why, but theories include B vitamin deficiency, inhibition of taurine or carnitine metabolism, or unidentified, potentially cardiotoxic compounds. 89% of DCM-associated diets reported to the FDA contained peas¹.

Treatment of Diet-Related DCM

I advised Rowdie’s owners to put her back onto a quality grain-based diet, and added a taurine supplement as a precaution. She also needed to stay on the heart medications. There was no way of knowing if my suspicions were correct except by trying.

Even when DCM is caused by the diet, not all affected dogs can recover. It depends how much damage is already done, and her case was severe.

I saw Rowdie two weeks later. She was doing very well, which was probably just the effect of the heart meds. A month later she was doing even better, which by now was not what we expected for regular cases of DCM.

By the way, the best way to tell is by measuring sleeping or resting respiratory rate.

A Stunning Response

On the 11th of August we repeated the echocardiogram. Here is a summary of what was found:

• The dilation of the left ventricle had vastly improved, but was not completely resolved
• The left atrial enlargement had completely resolved
• The measurements of heart contraction (fractional shortening and EPSS) were now normal
• The regurgitation jet at the mitral valves was no longer visible

And here are the numbers:

The improvement was so great that it was debatable whether Rowdie needed to stay on heart medications any more. We’ve got one more ultrasound exam planned and then we’ll probably stop them.

A Warning To Dog Owners

What is critical for you, the reader, to understand here is how rarely dogs receive a cardiac ultrasound. Heart disease is one of the most common problems of dogs, but we lack the skilled sonographers to do all but a tiny fraction. I only ordered this test because there was something not quite right about Rowdie.

As nearly every case of canine heart disease has just one cause, it’s reasonable for vets to make assumptions. Especially in a user-pays system where any further investigation will add costs and delays. However, for Rowdie this would have been deadly.

There is no doubt in my mind that most cases of DCM caused by grain free diets will go undiagnosed. This would have happened to Rowdie too if she was a more ‘typical’ breed or had a more typical history. Which matters because this specific form often responds well to treatment especially if recognised early.

Without a realisation that the diet was to blame, Rowdie would have died quickly. Like the more regular cases of DCM, she would have responded briefly to the medications, but then started declining again.

These days I ask a lot more about the diet every time I hear a heart murmur. And I hope that the lesson for you is to avoid these diets until we can report which ones are faulty, and either fix or remove them.

Related: Why I can’t warn you about bad dog foods (yet)

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

Reference

1. Smith, C. E., Parnell, L. D., Lai, C. Q., Rush, J. E., & Freeman, L. M. (2021). Investigation of diets associated with dilated cardiomyopathy in dogs using foodomics analysis. Scientific Reports, 11(1), 1-12 Full text

Many of these dogs can go on to lead a normal life with the right treatment. Others cannot be saved, and treatment could do more harm than good.

Here I’m going to help you decide what to do if a vet finds a mass in your dog’s spleen.

Signs Of Spleen Tumours

There are three ways your vet might diagnose a splenic mass:

1. They might find it without any symptoms during a health check (vets routinely feel the spleen during a physical exam)
2. The mass might rupture, leading to sudden collapse or a swollen abdomen secondary to internal bleeding
3. A dog may start losing weight or become lethargic and the cause is found after investigation

The decision on whether to operate is often based on the chance of complete cure, which is only possible if the mass is benign. However, we don’t have any way to be 100% sure before surgery. All we can do is show you the odds based on your dog’s situation.

Splenic Masses: The Odds Of Malignancy

Here’s what we know:

• Overall, half to two thirds of splenic masses are malignant depending on the study (I believe it to be 50%*)
• Splenic masses found without symptoms are malignant only 30% of the time
• If a mass has bled into the abdomen, the odds of malignancy are around 70%.
• Small-breed dogs are more likely to have benign disease
• A dog with signs of weight loss or poor appetite is likely to have late stage disease

Once your vet performs some tests, we can further finesse these odds:

• Masses being found on the liver at the same time increase the chance of malignancy to at least 75% (especially if more than one)
• The smaller the mass is when it causes symptoms, the worse it is
• The presence of low blood platelets or nucleated red blood cells worsens the odds

If you have access to both blood tests and a good ultrasound examination, there is even an online tool designed to help you estimate the odds of malignancy. Find it here.

* Some studies have drawn their subjects from emergency services, which leads to a higher percentage of serious cases that in the general population

How Long Dogs Live With Splenic Tumours

The lifespan after diagnosis mainly depends on whether the mass is benign or malignant (cancerous). This is why an estimation of the odds of malignancy is so important.

• If the mass is benign, surgical removal is mostly curative and lifespan is around normal
• If the mass is malignant, survival times after surgery are typically less than 60 days

While there’s nothing wrong with a surgery that gives 1-2 months of good quality life, most people would not choose to operate if they knew, and that’s OK. These dogs are probably best kept comfortable and quiet until a humane decision is needed.

I’ve written before about how haemangiosarcoma is the disease often associated with so-called miracle cancer cures. Most of the time these cases will have had a benign lesion mistaken for a malignant one. This only goes to show how hard it is for everyone.

The reality is that you will never know with certainty before the spleen is removed, and it’s OK to base your decision on the little you have. No one should ever feel they have to operate. However, I hope I’ve given you a realistic guide for what to do if it happens to your dog.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here. The information provided here is not intended to be used as a substitute for going to the vet. If your pet is unwell, please seek veterinary attention.

Some Light Reading!

Cleveland, M. J., & Casale, S. (2016). Incidence of malignancy and outcomes for dogs undergoing splenectomy for incidentally detected nonruptured splenic nodules or masses: 105 cases (2009–2013). Journal of the American Veterinary Medical Association, 248(11), 1267-1273

Eberle, N., Von Babo, V., Nolte, I., Baumgärtner, W., & Betz, D. (2012). Splenic masses in dogs. Part 1: Epidemiologic, clinical characteristics as well as histopathologic diagnosis in 249 cases (2000-2011). Tierarztliche Praxis. Ausgabe K, Kleintiere/Heimtiere, 40(4), 250-260

Mallinckrodt, M. J., & Gottfried, S. D. (2011). Mass-to-splenic volume ratio and splenic weight as a percentage of body weight in dogs with malignant and benign splenic masses: 65 cases (2007–2008). Journal of the American Veterinary Medical Association, 239(10), 1325-1327

Leyva, F. J., Loughin, C. A., Dewey, C. W., Marino, D. J., Akerman, M., & Lesser, M. L. (2018). Histopathologic characteristics of biopsies from dogs undergoing surgery with concurrent gross splenic and hepatic masses: 125 cases (2012–2016). BMC research notes, 11(1), 1-5.

O’Byrne, K., & Hosgood, G. (2019). Splenic mass diagnosis in dogs undergoing splenectomy according to breed size. Veterinary Record, 184(20), 620-620

Stewart, S. D., Ehrhart, E. J., Davies, R., & Khanna, C. (2020). Prospective observational study of dogs with splenic mass rupture suggests potentially lower risk of malignancy and more favourable perioperative outcomes. Veterinary and comparative oncology, 18(4), 811-817

Wendelburg, K. M., Price, L. L., Burgess, K. E., Lyons, J. A., Lew, F. H., & Berg, J. (2015). Survival time of dogs with splenic hemangiosarcoma treated by splenectomy with or without adjuvant chemotherapy: 208 cases (2001–2012). Journal of the American Veterinary Medical Association, 247(4), 393-403