On this week's episode of The Vet Blast Podcast, our host Adam Christman, DVM, MBA, and special guest David L. Dycus, DVM, MS, CCRP, DACVS (Small Animal), break down managing canine dysplasia with an emphasis on the importance of a multimodal approach. Throughout the episode, Dycus and Christman highlight treatment options, including new options, conservative management, and when a surgical intervention could be needed. 

David L. Dycus, DVM, MS, CCRP, DACVS (Small Animal)

: Even before radiographs, I think you can get a lot of information on just your examination. Number one is listening to the pet owners on the history, because many times the dog may just get up and be stiff and sore, but then warm out of it and look totally normal, and that is not normal. A stiff puppy is not normal. So that's a big red flag. You know, these dogs aren't always just going to be head bobbing lame, and so you do need to watch them walk, and if it's a very mild lameness, you need to watch them trot, because you may miss it. But your exam can give you invaluable information. 

The first thing I'm going to do is, I'm going to palpate and ask myself, 'Is there a fusion in the elbow', meaning we can feel the medial and lateral epicondyle. So I'm going to palpate just in front and just behind that to feel if it feels a little softer, if there's a little bit of effusion. The next thing I'm going to do is I'm going to elevate the leg and I'm going to hyper extend the elbow to see if there's discomfort. But then I'm going to try to flex the elbow. Now, in a young dog, elbow flexion is probably going to be normal, but they should be like a loose noodle. Puppy should be like loose noodle. So if you go to flex the elbow and there's some resistance and they're fighting you, that's a big red flag that there could be an issue.

Want to learn more on orthopedics from Dycus? He will be speaking at our upcoming conference, Fetch Kansas City! Join Dycus and the rest of our amazing faculty August 23-25, 2024, in Kansas City, Missouri for 3 days of learning, networking, and fun. Register 

Podcasts

Learn more about canine elbow dysplasia, and how to treat it in this week's episode of The Vet Blast Podcast

What do you know about canine elbow dysplasia?

Woof, the dog toy maker known for the Pupsicle, is back with a new product aimed at improving dogs’ daily dental hygiene: the Bite n’ Brush. The V-shaped toy has a hollow center, meant to hold treats and encourage chewing. The treats are exposed to dogs through open slots, surrounded by bristles, which brush the dogs’ teeth while they chew. With similar functionality to a human toothbrush, Woof is selling the Bite n’ Brush as a toothbrush for dogs.

“The Bite n’ Brush is more than just a toy; it’s a game-changer in canine dental care,” Daniel Haarburger, founder and CEO of Woof, said in a news release.

 “Traditional methods of maintaining a dog’s teeth, such as toothbrushing or professional cleanings, can be expensive and stressful for both pets and their owners.”

A 2020 questionnaire study conducted by BMC Veterinary Research found that less than 4% of dog owners brushed their dog’s teeth daily. Of dog owners who did not already report daily brushing, 27.2% would consider adding it to their daily routine. According to the same study, periodontal disease remains the most common disease in dogs older than 3 years. The prevalence of periodontal disease is reported as high as 89%, though it is largely preventable by toothbrushing.

Although nearly 95% of responding Veterinarians recommend toothbrushing to improve dental health,2 alternative dental products can still be effective. A Rutgers University study by Lindsay Gallagher on “The Effect of Dental Products and Natural Chews on Canine Oral Bacteria” tested the efficacy of 4 distinct options for dog dental care: C.E.T. enzymatic toothpaste, C.E.T VeggieDent canine chews, bully sticks, and raw marrow bones. The study found each of the products to be successful in reducing bacteria on the dog’s teeth, and none of the treatment options were statistically different.

“The Bite n’ Brush makes dog oral care fun,” Haarburger said. “This really is a novel solution for dog owners everywhere.”1 The new product comes in sizes for both small (<30lbs) and large (≥30lbs) dogs. The treat slots are designed to hold Woof’s Dental Refills, made from ingredients like parsley, green tea extract, and peppermint oil.Each ingredient was chosen for their unique dental benefits, ranging from freshening breath to reducing plaque formation.

Dog owners who want to give the Bite n’ Brush a try can do so for $19.99, regardless of size. Dental refills are available for $14.99, and the Bite n’ Brush Starter Pack –consisting of the product with 1 dental refill pack–is available online for $29.99.

Woof Revolutionizes Dog Dental Care with the Bite n’ Brush. News Release. Woof. August 6, 2024. Accessed August 6, 2024. https://prnmedia.prnewswire.com/news-releases/woof-revolutionizes-dog-dental-care-with-the-bite-n-brush-302212710.html

Enlund KB, Brunius C, Hanson J, et al. Dental home care in dogs-a questionnaire study among Swedish dog owners, veterinarians and veterinary nurses. 

. 2020;16(1):90. doi:10.1186/s12917-020-02281-y

Gallagher L. The effect of dental products and natural chews on canine oral bacteria. 

. 2014. Accessed August 7, 2024. https://jbs.camden.rutgers.edu/index/letters-general-microbiology-2014/effect-dental-products-and-natural-chews-canine-oral-bacteria-lindsay-gallagher/

Articles

The Bite n’ Brush toy uses bristles to clean dogs’ teeth while they chew on treats

New toy allows dogs to brush their own teeth

Tiffany Day, a travel nurse, and her labrador retriever mix Luna had been in Illinois on an assignment but finally was able to travel home to Illinois. After their car ride to Illinois, Day realized that she was missing a few items and needed to go to the store. Day left Luna, along with her open travel bag she stored in the bathroom and headed to the store to get the items she needed. However, when she arrived back home, she did not expect to find a chewed up and open allergy medication bottle on the floor.

"I'm a travel nurse, and Luna and I had just gotten home from an assignment in Illinois, and I was exhausted from the drive. I thought, 'she's tired, she won't get into anything' and I ran out for a quick trip to the store. When I got home, there was a chewed-open bottle of allergy pills on the floor, and it was clear Luna had ingested some of the mediation,” explained Day, in an organizational release.

“I'd never heard there was a problem with giving your pets allergy pills like Benadryl, so I wasn't too worried. As the night progressed, however, she began barking at nothing, swaying, and walking into walls. It was then I knew she needed a veterinarian," she continued.

According to the release, antihistamines provide relief to those suffering from allergies, but medications like Benadryl contain diphenhydramine, which can be dangerous and in some cases, even deadly to pets if the dose is too high.

 For pets that ingest these medications, intentionally or not, pet parents should consult with a veterinarian before giving pets any human medication or immediately after if pets accidentally ingest something that could be toxic.

Luna, a labrador retriever mix, ingested her owner's allergy medication (Image courtesy of Pet Poison Helpline) 

Day then took Luna to the Roadrunner Veterinary Emergency & Specialty Hospital in Algodones, New Mexico, where the team had her call the Pet Poison Helpline to develop a treatment plan based on Luna’s exposure and situation.

"Many people give their pets human allergy medications that contain diphenhydramine," explained Renee Schmid, DVM, DABT, DABVT, a senior veterinary toxicologist and director of veterinary services at Pet Poison Helpline.

 "In most cases, a small dose is safe for your pets. If the dose is too high, however, it can result in some very dangerous reactions, including agitation or lethargy, aggression, abnormal heart rate, abnormal blood pressure, vomiting, diarrhea, and even seizures and respiratory depression with extremely large ingestions. In severe cases, such as with Luna's situation, the ingestion could be fatal."

Upon arrival to the hospital, Luna had developed mild signs and was administered an antiemetic to keep her from vomiting, placed on intravenous fluids, and was sedated due to agitation. The hospital was then advised to administer additional medications for tremors or seizures if they were to develop. Luna spent the night at the hospital and was monitored closely to be sure she did not develop any other severe signs and due to the care she received, Luna went home the follow day to continue to recuperate.

Although Luna made a full recovery from her diphenhydramine exposure, she developed immune-mediated thrombocytopenia (IMTP), a known but likely unrelated condition, which ultimately led to her passing away. According to Schmid, IMTP is a condition where the immune system attacks its own platelets which can lead to premature destruction of the platelets.

"Even though Luna later passed from a different condition, I wanted to share her allergy medication story," concluded Day. "If telling her story can help even one other pet, it will be worth it. You have to be on your game at all times. Keep all medications, even those you think are safe for your pets, away from reach. You don't think they'll get into it, but they will."

Common Allergy Medication Can Be Deadly to Pets. News release. Pet Poison Helpline. August 7, 2024. Accessed August 7, 2024. https://prnmedia.prnewswire.com/news-releases/common-allergy-medication-can-be-deadly-to-pets-302215797.html

As allergy season continues, the relief from allergy medication may not be universal for pet parents and their pets 

Common allergy medications pose serious risks to pets

Mucocele formation in dogs, a disease of the gallbladder characterized by the buildup of abnormal mucus, holds similarities to cystic fibrosis (CF) disease in humans.

 Recent research revealed that this canine gallbladder disease, also known as canine gallbladder mucocele (GBM),

 is caused by a dysfunction of the cystic fibrosis transmembrane conductance regulator (CFTR) gene. This differs from the cause of CF in humans, where a mutation in CFTR leads to the disease.

The study, which received grants from the Morris Animal Foundation and the National Institutes of Health, may hold significance for human patients with CF and animal models of the disease.

Gallbladder mucocele formation is a condition where thick, dehydrated mucus gradually accumulates, disrupting normal gallbladder function and eventually leading to obstruction and rupture. The disease primarily affects purebred dogs, with Shetland sheepdogs being the most commonly affected breed in the United States. In the United Kingdom, border terriers are more commonly affected.

 Other breeds commonly affected include Miniature Schnauzers and Cocker Spaniels.

“We really only started seeing this disease about 20 years ago in a handful of breeds,” Jody Gookin, professor of small animal internal medicine at North Carolina State University and corresponding author of the research, said in a news release.

 “What captured my attention was how similar these gallbladders looked to those in animal models of CF.”

In humans, the thick, immobile mucus seen in CF results from a defect, or mutation, in the CFTR gene. This gene normally deposits channels in epithelial cells that then secrete chloride and water. These channels help keep the mucus moist and mobile by lubricating the cell surface. In CF, the mucus becomes dehydrated and clogs the lungs and intestines due to an absence of these lubricating channels. However, the there is no buildup of mucus in the gallbladder of humans with CF.

Researchers conducted whole genome sequencing on blood samples from 8 Shetland sheepdogs with gallbladder mucocele formation and compared the location and frequency of CFTR gene variants with those found in 115 dogs from 12 breeds at high risk for mucocele formation and 2,519 dogs from 340 low-risk breeds. The comparison revealed no significant differences between the groups. Furthermore, the dogs with mucocele formation did not have CFTR mutations in the regions where humans with CF do.

“There are no recorded instances of naturally occurring CF in any non-human species, but when researchers study CF in animal models by knocking out the CFTR gene, those animals often develop the same gallbladder pathology that we see in dogs with mucocele formation, said Gookin in the release.

 “That led us to wonder whether dogs with mucoceles had a mutation in CFTR, but they didn’t. What they did have was a failure of CFTR to function.”

“What that means is that somehow these dogs are acquiring a dysfunction of the CFTR channel that is not based on a defect in the gene,” Gookin continued. “It could be due to the influence of other genes and environmental factors that influence CFTR function.”

Gookin revealed that the most surprising piece from the study for her was that a disease resembling CF could develop without being caused by a mutation in the CFTR gene. “Identifying the underlying cause of CFTR dysfunction in dogs with mucocele formation has important implications for people where similar factors might contribute to CF-like diseases, or reveal new treatment targets for CF,” she said in the release.

Going forward, Gookin explained that the research team’s next steps involve examining the entire genome of those dogs to see if there is anything else in their genome that plays a role in the formation of gallbladder mucocele.

Peake Tracey. How an emerging disease in dogs is shedding light on cystic fibrosis. News release. July 29, 2024. Accessed August 7, 2024. 

https://news.ncsu.edu/2024/07/how-an-emerging-disease-in-dogs-is-shedding-light-on-cystic-fibrosis/

Center SA. Canine gallbladder mucocele. Merck Veterinary Manual. August 2023. Accessed August 7, 2024. 

https://www.merckvetmanual.com/digestive-system/hepatic-diseases-of-small-animals/canine-gallbladder-mucocele

Gookin JL, Holmes JL, Clarke LL, et al. Acquired dysfunction of CFTR underlies cystic fibrosis-like disease of the canine gallbladder. 

American Journal of Physiology-Gastrointestinal and Liver Physiology

A study on gallbladder mucocele formation in canines revealed that this disease is caused by an acquired dysfunction of CFTR

Researchers discover cause behind cystic fibrosis-like disease in dogs 

Diego Diel, DVM, MS, PhD (right), director of the Virology Laboratory, led a tour for attendees before the event (Image courtesy of Cornell University)

During a ceremony at Cornell University, lawmakers in New York announced that $19.5 million in capital funding was granted to the New York State Veterinary Diagnostic Laboratory (NYSVDL). The laboratory, located at the university, will use the money to expand the building to help manage its increasing caseload.

According to the release, this event took place within the current Animal Health Diagnostics Center (AHDC) facility, which was built in 2010, and this new expansion will add 26,000 square feet.

 The additional space will contain additional laboratories, offices, workstations, training and conference laboratories, and space for material storage and preparations. This expansion will also help support workforce development for the laboratory to train highly qualified diagnosticians. Currently, planning for groundbreaking and construction is officially underway.

“We have put our nation’s best minds in the service of our communities, our economies and our societies,” said Michael Kotlikoff, VMD, PhD, interim president of Cornell University, in the release,

 where he also mentioned the important roles AHDC and NYSVDL played during the COVID-19 pandemic, testing more than 2 million human samples.

“This extraordinary partnership between the New York State Department of Agriculture and Markets and Cornell provides outstanding guidelines and services that benefit the citizens of the state,” he continued.

AHDC and NYSVDL has seen a submission load increase of 90% since the building open its doors in 2010 and processed over 3600,000 accessions in the last 12 months alone, leading to millions of diagnostics tests from veterinary professionals across the world. The laboratories range from anatomic pathology and virology to molecular diagnostics and toxicology. AHDC and NYSVDL also has programs for quality milk production as well as avian and wildlife health.

Around one-quarter of the operational budget for the organization is funded by an already existing contract with the Department of Agriculture and Markets with additional funding from the state’s Department of Environmental Conversation contract for wildlife health. Funding also comes from the USDA Veterinary Services to help the laboratories support high consequence disease surveillance, response, and mitigation activities.

The AHDC and NYSVDL is also a National Bio and Agro-Defense Facility/National Animal Health Laboratory Network liaison laboratory for the Northeast.

“The lab plays a key role in protecting public health by conducting robust pathogenic testing on both animals, and during times of great need, human populations to monitor outbreaks of infectious diseases, such as COVID-19 and the Highly Pathogenic Avian Influenza (HPAI) virus,” expressed Assembly member Anna Kelles (D-125th District).

“Given the growing prevalence of viral outbreaks in wildlife and the occurrence of viral mutations leading to the transfer of diseases across animal species and to human populations, this expansion of a world-class viral research laboratory could not be more timely,” she concluded.

Greaver Cordova M. NYS grants veterinary diagnostic lab $19.5M for building expansion. Cornell Chronicle. Published July 30, 2024. Accessed August 7, 2024. 

https://news.cornell.edu/stories/2024/07/nys-grants-veterinary-diagnostic-lab-195m-building-expansion

McCafferty C. Study finds veterinary diagnostic laboratories played crucial roles in COVID-19 response. dvm360.com. Published July 23, 2024. Accessed August 7, 2024. https://www.dvm360.com/view/study-finds-veterinary-diagnostic-laboratories-played-crucial-roles-in-covid-19-response

The New York State Veterinary Diagnostic Laboratory at Cornell University will receive $19.5 million in capital funding 

New York grants millions to expand veterinary diagnostic laboratory

VetPrep, a provider of veterinary test preparation, announced the upcoming launch of new North American Veterinary Licensing Examination (NAVLE) sessions. The program, titled PowerPrep, will contain 10 expert-led sessions on NAVLE topics and will be a free resource for veterinary students preparing to take the exam.

 with sessions designed to provide a thorough and detailed review of the NAVLE that can be incorporated into students’ study schedules, according to an organizational release.

 The sessions will be accessible on-demand to allow students to study at their own pace and convenience. The program will provide insights and a comprehensive understanding of the subjects that will appear on the NAVLE exam. The goal of PowerPrep is to improve students' readiness, thereby increasing their confidence and performance on exam day, according to VetPrep. The program will be sponsored by Chewy Health.

"At VetPrep, our mission has always been to empower veterinary students with the best possible resources to help them excel in their exams and future careers," Lindsey Kock, DVM, director of education, animal health at VetPrep, said in a news release.

 "The PowerPrep NAVLE sessions... represent a significant step forward in providing students with the comprehensive preparation they need. We are excited about this partnership [with Chewy Health] and the positive impact it will have on students' exam performance."

Katy J. Nelson, DVM, associate director of veterinary relations at Chewy Health, spoke on the motive behind the company's partnership with VetPrep for the PowerPrep program. "Chewy Health is steadfast in its commitment to advancing veterinary care by fostering the education and development of the next generation of clinicians and practice leaders," said Nelson in a news release.

 "Our sponsorship of the VetPrep PowerPrep sessions underscores our dedication to enhancing the health and wellbeing of pets and supporting those who tirelessly care for them. We are proud to collaborate with VetPrep on this important initiative to ensure veterinary students are thoroughly prepared to enter the field."

VetPrep and Chewy Health recently acknowledged the rising demand for veterinarians, stating the importance of offering veterinary students resources to help them succeed and develop as veterinary professionals.

 With the demand for veterinarians, there has been a rise in students pursuing veterinary medicine, as well as graduates taking the NAVLE.

 Yet, despite the increase in NAVLE test takers, there has been a decrease in overall test scores and in the number of graduating students from American Veterinary Medical Association (AVMA) Council of Education-accredited schools passing the exam. Over the last 5 testing cycles, a downward trend has been observed, with the passing rate going from 94% in the 2018 to 2019 cycle to 86% in 2022 to 2023.

In November 2023, the International Council for Veterinary Assessment (ICVA) changed its policy regarding the number of times a person can retake the NAVLE. Under the new policy, candidates are allowed up to 5 attempts, including incomplete attempts. The change will become effective on the November-December 2024 testing period and all attempts made before the new policy takes effect will count towards the 5-attempt limit.

The ICVA will also allow candidates to file an appeal with the ICVA board of directors to take the NAVLE more than 5 times. As part of this process, candidates must also obtain verification from a licensing board that it will accept their NAVLE score if they pass on the additional attempt.

“This policy follows assessment best practices by limiting the number of attempts made, which enhances test security while simultaneously providing a more accurate measure of a candidate’s knowledge level. It is also in line with the current retake policy for the Veterinary Technician National Examination (VTNE), providing more clarity for applicants and licensing board personnel,” wrote the ICVA in an announcement, according to the AVMA.

Master the NAVLE: Join our 12-week powerprep boot camp. VetPrep. Accessed August 6, 2024. 

VetPrep partners with Chewy Health to launch free PowerPrep NAVLE sessions for veterinary students. News release. VetPrep. August 5, 2024. Accessed August 6, 2024.

Larkin M. Number of NAVLE test takers increase as overall scores decrease. American Veterinary Medical Association. March 12, 2024. Accessed August 7, 2024. 

https://www.avma.org/news/number-navle-test-takers-increase-overall-scores-decrease

Amid an observed decline in test scores, VetPrep is preparing to launch a 12-week bootcamp for veterinary students 