Halitosis or Bad Breath

Bad Breath (Brushing Your Pet’s Teeth) – An Overview

  • Offensive odor coming from the mouth; bad breath (Brushing Your Pet’s Teeth).
  • Both dogs and cats can have bad breath
  • Small breeds and short-nosed, flat-faced breeds (known as “brachycephalic breeds”) are more prone to disease involving the mouth, because their teeth are closer together, and their owners tend to feed softer foods.
  • Older pets are more likely to have bad breath (Brushing Your Pet’s Teeth) than are young pets.

Signs/Observed Changes in the Pet

  • Bad breath or Brushing Your Pet’s Teeth is a sign itself.
  • If due to oral disease, excessive salivation (known as “ptyalism”), with or without blood, may be seen; the pet may paw at the mouth; and lack of appetite (anorexia) may occur.
  • In most cases, no clinical signs other than actual odor are observed.

Causes

  • Disease of the mouth—infection of the gums and supporting tissues of the teeth (known as “periodontal disease”) and/or ulceration of the tissues of the mouth; inflammation of the throat or pharynx (known as “pharyngitis”); inflammation of the tonsils (known as “tonsillitis”); cancer; foreign bodies.
  • Metabolic—diabetes mellitus (“sugar diabetes”), uremia (excess levels of urea and other nitrogenous waste products in the blood).
  • Respiratory—inflammation of the nose or nasal passages (known as “rhinitis”); inflammation of the sinuses (known as “sinusitis”); cancer.
  • Gastrointestinal—enlargement of the esophagus (the tube going from the throat to the stomach; condition known as “megaesophagus”); cancer; foreign body.
  • Dermatologic—infection of the skin folds of the lips (known as “lip-fold pyoderma”)
  • Dietary—eating malodorous or offensive-smelling foodstuffs; eating feces or bowel movement (known as “coprophagy”).
  • Trauma—electric-cord injury, open fractures, caustic agents.
  • Infectious—bacterial, fungal, viral.
  • Autoimmune diseases.
  • Diseases characterized by one or more masses or nodular lesions in the mouth containing a type of white-blood cell, called an eosinophil (known as “eosinophilic granuloma complex”).

Treatment

Dental Care

  • Usually outpatient treatment.
  • Once the specific cause of the bad breath (Brushing Your Pet’s Teeth) is known, direct therapy at correcting the cause; it is possible that multiple causes may be involved (for example, the pet may have infection of the gums and supporting tissues of the teeth [periodontal disease] and have a foreign body or cancer present in the mouth).
  • Dental disease—assessment of the mouth, performed under general anesthesia, with x-rays of the mouth (known as “intraoral radiographs”) and treatment, including cleaning and polishing the teeth and extraction of teeth with greater than 50% loss of supporting tissues (gum and bone) around the teeth (often multiple teeth are extracted when advanced periodontal disease is the cause of the bad breath (Brushing Your Pet’s Teeth).
  • Cancer of the mouth—surgical debulking (removing as much of the tumor as possible) or removal; radiation therapy; other cancer therapies, based on type of cancer.
  • Foreign body—removal of foreign body (may require anesthesia).
  • Dermatologic causes—treatment for infection of the folds of the lips may include antibiotics, antibacterial shampoos, and possible surgery to remove some of the folded tissue.
  • Dietary causes—prevent pet from eating malodorous foodstuffs (for example, keep pet away from garbage); prevent pet from eating bowel movement (for example, block off litter box so dog cannot get to cat feces; clean yard frequently).

Medications

Medications presented in this section are intended to provide general information about possible treatment. The treatment for a particular condition may evolve as medical advances are made; therefore, the medications should not be considered as all inclusive:

  • Medication is determined by the underlying cause of the bad breath (Brushing Your Pet’s Teeth).
  • Topical treatment with zinc-ascorbate cysteine gel usually reduces bad breath within 30 minutes of application, because of the effect of cysteine on sulfur compounds in the mouth.
  • Antibiotics are not indicated to treat bad breath (Brushing Your Pet’s Teeth); antibiotics are indicated in the treatment of infection of the lip folds and for cases of rhinitis and/or sinusitis, if bacterial infection is involved.
  • Controlling the bacteria that cause infection of the gums and supporting tissues of the teeth (periodontal disease) helps control dental infections and accompanying bad breath; Doxirobe Gel (Pfizer) may be used in dogs with periodontal disease.
  • Weekly application of OraVet (Merial), a plaque prevention gel has been shown to decrease plaque (the thin, “sticky” film that builds up on the teeth; composed of bacteria, white-blood cells, food particles, and components of saliva).
  • The use of oral home-care products that contain metal ions, especially zinc, inhibits odor formation due to the affinity of the metal (zinc) ion to sulfur; zinc complexes with hydrogen sulfide to form insoluble zinc sulfide, decreasing the odor.
  • Zinc ascorbate plus amino acid (Maxi/Guard Oral Cleansing Gel, Addison Biological Laboratory).
  • Chlorhexidine used as a rinse or paste also helps control plaque (the thin, “sticky” film that builds up on the teeth), decreasing eventual odor; many dental home-care products containing chlorhexidine are available commercially.

Follow-Up Care

Patient Monitoring

  • Periodic examinations to monitor results of dental professional and home care

Preventions and Avoidance

  • Varies with underlying cause
  • Daily brushing or friction wipes to remove plaque (the thin, “sticky” film that builds up on the teeth) and control dental disease and odor
  • Prevent pet from eating malodorous foodstuffs (for example, keep pet away from garbage); prevent pet from eating bowel movement (for example, block off litter box so dog cannot get to cat feces; clean yard frequently)

Possible Complications

  • Varies with underlying cause
  • Immature teeth stop developing.

Expected Course and Prognosis

  • Varies with underlying cause

Key Points

  • Bad breath or Brushing Your Pet’s Teeth is a sign; it is an offensive odor coming from the mouth.
  • Bad breath (Brushing Your Pet’s Teeth) generally indicates an unhealthy mouth.
  • Once the specific cause of the bad breath (Brushing Your Pet’s Teeth) is known, direct therapy at correcting the underlying cause.
  • Ensure good oral health by professional and home dental care (such as brushing teeth) to decrease bad breath (Brushing Your Pet’s Teeth).

Dental Exams

What Happens When My Pet Has His Teeth Cleaned?

By Kathy A. Sylvester, RVT

It has been suggested that your pet has its teeth cleaned. A dental cleaning for a pet is done a little differently than when we go to the dentist.

To understand the cost and why it is difficult to give an exact estimate prior to the cleaning, certain details regarding the procedure should be explained. To begin with, when a cat or dog is brought back to prepare it for the cleaning a blood sample is taken to check for any abnormalities that would prevent us from administering anesthesia), a catheter is placed in a front paw and an EKS (electrocardiogram) is run to check the heart. Pending the results of these presurgical tests, the pet is prepared for the dentistry.

First, the animal is given anesthesia and an antibiotic injection. He is put on the dental table and the procedure begins. The dental technician charts the entire mouth. This means every tooth is probed and evaluated to look for problems. All heavy tartar is removed to expose the crown of the tooth. Adult dogs have 42 teeth, cats have 30, and rabbits have 26-28. Veterinary dentists treat every tooth as a separate patient. So, this part of the procedure can take time if your pet has many problems.

Once all the charting and x-rays are complete, the game plan is then set. The veterinary dentist removes any teeth that need to be extracted, cleans diseased teeth below the gum line, or works on the gums. Once completed, the dental technician scales and polishes all the teeth. This procedure can take anywhere from 30 to 90 minutes, depending on how healthy the mouth is.

It should be pointed out that during the entire procedure your pet is receiving I.V. fluids and being carefully monitored (blood pressure, temperature, heart rate, and pulse checks).

It is now time to wake up your pet and allow him or her to recover in our nursing area. Once alert he or she will be placed in a heated (if necessary) cage to await your arrival.

This is the procedure for all of our dental patients, thought there are a few modifications when we work with exotic pets. If you have any questions please feel free to contact us.

Brush Your Pet’s Teeth

Brushing Your Pet’s Teeth

Dental care is an important part of your dog and cat’s health care. Pet dental issues are some of the most common problems seen at Tri-County Animal Hospital. Both dogs and cats need routine dental care, and a good dental program will provide comfort and longevity to your pet’s life as well as make them more pleasant to be around.

Dental disease is not just a cause of bad breath, but can lead to heart disease, kidney disease, liver disease and other problems.

We suggest that you start caring for your pets teeth while he or she is a puppy or kitten so that your pet will become accustomed to regular, at home brushing. During your pet’s physical exams, we will give your pet a dental exam and will recommend professional dental cleanings or other dental treatments as needed. We will also offer advice on home dental care and give you options on how to achieve the best results.

At-Home Pet Dental Care

Brushing your pet’s teeth every day will help to reduce or eliminate plaque buildup. Plaque, which is an accumulation of bacteria, will eventually loosen and destroy the tooth and possibly lead to bone loss if left untreated. The infection under the gum line can also spread to the liver, kidneys and heart.

Proper At-Home Pet Dental Care Supplies

    1. Proper Toothbrush

It’s important to spend some time finding the right toothbrush for your dog or cat. You can use a child’s toothbrush, but it is recommended that you buy a special toothbrush for your pet. It will make brushing easier and will be worth the money.

There are some rules for choosing the best brush for your dog or cat:

      • Be sure that the bristles are soft so they don’t damage the pet’s gums.
      • Please choose the right sized brush (just make sure it’s’ not too big or too small for your pet’s mouth).
      • Check that the handle is big enough for you to comfortably get a grip on the toothbrush.
      • Also available, is the “Finger Toothbrush”. This is an Ideal beginner toothbrush to help you and your pet become comfortable with the tooth brushing experience.
      • The staff at Tri-County Animal Hospital will be glad to help you select the best toothbrush for your pet.
    1. Proper Toothpaste

You cannot use human toothpaste on your dog. Rather, use a special high quality toothpaste with ingredients specially formulated for dogs. You need to spend some time choosing your toothpaste too. Cheaper brands might use ingredients that are harmful to your pet, and there are some common ingredients can make your pet sick. Read the labels carefully and check that the toothpaste does not contain salt, detergents or enzymes as these are dangerous for your pet. Feel free to stop by our office and we will be happy to recommend a pet toothpaste that is safe and effective for your pet’s proper dental hygiene.

How to Brush Your Pet’s Teeth

Brushing your pet’ teeth for the first time can be difficult; especially if they are not used to it. This can be avoided by starting when they are puppies or kittens – but if it’s too late for that don’t worry. The key is to be gentle, speak in a soft voice and do not force the pet. The key is to make it an enjoyable experience. Start from the back of the mouth and work your way forward in small circular motions.

If your pet really does not want to allow you to brush his teeth without a fight, you may want to try the finger brush with a beef or chicken flavored toothpaste. Try rubbing his teeth so he gets used to the sensation as well as your fingers in his mouth. Speak encouragingly and softly. After a few patient weeks the pet should allow you to brush his teeth without any hassles.

Start a Dental Routine

You should be brushing your pet’s teeth daily; but if you can’t manage that – once every second day should be fine. It’s important to stay consistent in order to avoid problems.

Please call us to schedule a dental exam with one of our veterinarians for your dog or cat, especially before starting a new dental care regime.

Maternal Behavior Problems

Maternal Behavior Problems – An Overview

  • Abnormal maternal behavior is either excessive maternal behavior in the absence of newborns (more common in cats than dogs) or deficient maternal behavior in the presence of the dam’s own newborns (more common in dogs than cats)
  • The female dog is known as the “bitch” or the “dam” and the female cat is known as the “queen”

Genetics

  • No genetic basis has been identified in dogs and cats, but a breed tendency in Jack Russell terriers indicates that a genetic component may be involved
  • Genetic models of deficient maternal behavior in mice have been identified; the genes responsible for deficient maternal behavior in mice are imprinted paternally—if this situation is true in dogs and cats, one would expect that rejecting mothers were normally mothered themselves, but their grandmother may have been deficient
  • The genetic basis should be investigated in dogs and cats

Signalment/Description of Pet

Species

  • Dogs
  • Cats

Breed Predilections

  • Poor maternal behavior may be more common in Jack Russell terriers and cocker spaniels than in other breeds of dog, but no quantitative study has proven this observation

Mean Age and Range

  • No particular age at risk, but first-time mothers (known as “primiparous females”) and older bitches seem to be at risk of deficient maternal behavior

Predominant Sex

  • Female generally, but some males may allow suckling behavior

Signs/Observed Changes in the Pet

Deficient Maternal Behavior

  • Absent maternal behavior; the mother simply abandons her offspring—this is most apt to occur after cesarean section

Poor Maternal Behavior

  • The mother stays with her offspring but will not allow them to nurse
  • The mother may show inadequate retrieval of young, insufficient cleaning of the young, or failure to stimulate elimination (urination and/or defecation) by the young
  • The bitch carries the puppies from place-to-place without settling down or, in the most extreme form, kills some or all of her litter

Abnormal Maternal Behavior

  • The bitch or queen may allow her offspring to suckle, but kills her offspring either at birth or over a period of days
  • Occasionally the bitch, or more rarely the queen, will abandon or attack her offspring, if it has changed in odor or appearance
  • A female may be disturbed by another animal or by people and can redirect her aggression to her offspring
  • A bitch accidentally may disembowel or even consume offspring completely while eating the fetal membranes (placenta) and umbilical cord; this should be distinguished from normal licking, which can be quite vigorous, even to the point of dislodging the puppy from a nipple

Maternal Aggression

  • Cats (queens) with kittens may be aggressive to other animals, especially dogs in the same household
  • Dogs (bitches) with puppies may be aggressive to unfamiliar people or even to familiar people, especially if they have low levels of calcium in their blood (condition known as “hypocalcemia”)

Excessive Maternal Behavior

  • The “pseudopregnant” bitch or bitch spayed during the latter phase of the estrous or heat cycle may show signs of a false pregnancy; she attempts to nurse and guards inanimate objects (stuffed animals or even leashes)
  • The pseudopregnant bitch may have breast or mammary development and may be producing milk (lactating)
  • The newly spayed queen may steal kittens from a nursing queen; queens also may produce milk (lactate) if suckled, following the spay (ovariohysterectomy)

Causes

  • The presence of kittens in the environment of the recently spayed cat is a risk factor for excessive maternal behavior and kitten stealing
  • The risk of excessive carrying of puppies, redirected aggression, or even cannibalism is increased if other dogs or too many people are present in the nest area
  • First-time mothers (primiparous females) or those delivered by cesarean section (c-section) are at higher risk than mothers that have delivered previous litters (known as “multiparous females”) or naturally delivering females
  • Large litter of kittens or sick offspring

Treatment

Health Care

  • Normal health care

Diet

  • Adequate diet for nursing bitches and queens to meet energy demands
  • Restricted diets for pets with false pregnancies (known as “pseudocyesis”), to discourage lactation and diminish milk production
  • In the case of deficient maternal behavior, the bitch or queen should be fed free choice (known as “ad libitum”) to encourage lactation

Surgery

  • Delay spaying for 4 months post-estrus to avoid post-spaying maternal behavior and its accompanying aggression
  • Spaying avoids future excessive maternal behavior in the absence of young

Medications

Medications presented in this section are intended to provide general information about possible treatment. The treatment for a particular condition may evolve as medical advances are made; therefore, the medications should not be considered as all inclusive:

Excessive Maternal Behavior

  • Mibolerone (Cheque Drops) was the drug of choice for bitches with false pregnancies or those exhibiting maternal behavior and lactation following spaying; mibolerone inhibits prolactin (the hormone that stimulates secretion of milk) and thereby inhibits lactation; this medication is no longer available commercially and is available only at some compounding pharmacies
  • Bromocriptine (Parlodel) can be used to inhibit prolactin
  • Cabergoline inhibits prolactin and has been shown to be effective in treating false pregnancies in dogs; not commercially available in North America

Deficient Maternal Behavior

  • Oxytocin (the hormone that stimulates milk release during nursing) may be administered either by injection or by nasal spray (Syntocinon)
  • Prolactin (the hormone that stimulates secretion of milk) appears to be necessary for maternal behavior in other species; therefore, a dopamine blocker (acepromazine) can be used; dopamine inhibits prolactin release and thus a dopamine blocker would increase prolactin

Follow-Up Care

Patient Monitoring

  • The puppies or kittens of females with deficient or poor maternal behavior should be monitored daily to be sure that they are gaining weight

Preventions and Avoidance

  • Place a nursing female and her litter in quiet, comfortable quarters—away from noise and disturbances by other animals or people
  • Do not rebreed females with poor maternal behavior; deficient maternal behavior can occur with each litter
  • Determine whether any other female offspring of the female with abnormal maternal behavior also exhibited poor maternal behavior
  • In other species, poor maternal behavior is a paternally imprinted gene; the father must contribute the gene for poor maternal behavior; the daughters of rejecting mothers will not reject, but daughters of their sons may have poor maternal behavior

Possible Complications

  • Loss of offspring
  • Hand-reared puppies and kittens frequently have abnormal or deficient social behavior, due in part to insufficient suckling time and to consequences of lack of maternal licking, which adversely affects response to stress and reproductive behavior

Expected Course and Prognosis

  • Excessive maternal behavior usually wanes around the time of normal weaning (6–8 weeks)
  • Poor and deficient maternal behavior can occur with each litter

Key Points

Abnormal or Poor Maternal Behavior

  • The bitch that is carrying her puppies or exhibiting redirected aggression to them should be isolated in a quiet, dark area
  • The bitch that bites her puppies should be muzzled; the owner must stimulate elimination (urination and/or defecation) of the puppies, because the muzzled female cannot do so
  • An Elizabethan collar inhibits cannibalism in queens
  • The bitch should be attended at the birth of the litter (known as “parturition”) and puppies should be removed temporarily if she is biting the puppies themselves in addition to the umbilical cord
  • Bitches and queens with poor maternal behavior may exhibit the same behavior with subsequent litters

Excessive Maternal Behavior

  • Cats that have stolen kittens should be separated from the biological mother and kittens
  • Mothered objects (such as stuffed toys) should be removed from the “pseudopregnant” bitch (that is, the bitch having a false pregnancy)
  • Food intake should be restricted to inhibit milk production (lactation)

Maternal Aggression Toward Animals or People

  • The best treatment for excessive maternal aggression is to separate the kittens; weaning alone may not suffice because the presence of the kittens alone may sustain or even reinstate maternal aggression in a queen separated from her kittens for several weeks

How to Handle a Dog That “Constantly Runs Off”

Dogs That Constantly “Run Off” – An Overview

A dog that runs off into the street or wanders through a neighborhood is exposed to many dangers and could prove to be a liability. Fortunately, this is a behavior that can be corrected through owner patience and a system of positive reinforcement / rewards.

Dog Training Video

In this VetStreet Video, dog trainer Mikkel Becker explains exactly how to prevent your dog from running off and what to do if it happens in the future.

House Soiling Dogs

House Soiling Dogs – An Overview

  • Urinating and/or defecating (having a bowel movement), as a means of eliminating or marking territory, in a location that the owner considers inappropriate

Genetics

  • Some dog breeds appear to be housetrained more easily than other dog breeds

Signalment/Description of Pet

Species

  • Dogs

Breed Predilections

  • Potential genetic breed-related likelihood for ease of housetraining and submissive or excitement urination (“submissive urination” occurs when someone enters the room or home and the dog urinates to signal that it is insubordinate to the person; this is “normal” dog-greeting behavior and is seen especially in dogs that are shy or do not have self-confidence—unfortunately, this “normal” House Soiling Dogs is not desirable; “excitement urination” occurs when a dog gets overly excited or enthusiastic and leaves “dribbles” of urine at your feet)

Mean Age and Range

  • Inappropriate elimination due to improper or incomplete housetraining primarily seen in younger dogs
  • Submissive and excitement urination seen primarily in younger dogs
  • Urine marking begins to be displayed as the dog reaches sexual maturity
  • Housesoiling is a common complaint from owners of elderly dogs

Predominant Sex

  • Female dogs generally are easier to housetrain than male dogs
  • Intact male dogs are more likely to urine mark than neutered male dogs and intact or spayed female dogs

Signs/Observed Changes in the Pet

  • Urinating and/or defecating in inappropriate areas (according to the owners), usually inside a home
  • Abnormal physical examination findings would be related to an underlying medical cause (such as urinary tract disorders) of inappropriate elimination; the urinary tract consists of the kidneys, the ureters (the tubes running from the kidneys to the bladder), the urinary bladder (that collects urine and stores it until the animal urinates), and the urethra (the tube from the bladder to the outside, through which urine flows out of the body)

Causes

  • Causes of housesoiling can be related to a primary behavioral problem or secondary to or in association with a medical disorder
  • May be associated with signs of other behavioral disorders (such as separation anxiety)
  • May be associated with lack of time spent on owner’s part to teach housetraining properly
  • May be associated with punishment of a dog that submissively urinates, which may make the problem worse
  • Determine potential triggers, via a complete behavioral history, including when, where, and how often the elimination occurs and reliability of outdoor elimination; triggers are situations or things to which the dog reacts, leading to problem behaviors
  • If no abnormal physical examination findings are identified, the housesoiling is probably due to a behavioral cause

Behavioral Causes

  • Lack of or incomplete housetraining
  • Marking behavior
  • Submissive urination
  • Excitement urination
  • Separation anxiety syndrome
  • Cognitive dysfunction syndrome (condition in which older dog is confused, forgetful, and may lose its housetraining)
  • Noise phobia
  • Fear-induced
  • Excessive thirst due to psychological need to drink water (known as “psychogenic polydipsia”) and excessive urination (known as “polyuria”)

Medical Causes

Degenerative Abnormalities
  • Hip dysplasia/osteoarthritis/degenerative joint disease
  • Kidney failure
Anatomic or Structural Abnormalities
  • Ectopic ureters (condition in which one or both ureters [tube from the kidney to the bladder] insert into the bladder in an unusual location, frequently leading to dribbling of urine)
Metabolic Disease
  • Incontinence (inability to control urination and/or defecation)
  • Diabetes mellitus (“sugar diabetes”)
  • Diabetes insipidus (“water diabetes”)
  • Liver insufficiency
  • Excessive production of steroids by the adrenal glands (known as “hyperadrenocorticism” or “Cushing’s syndrome”)
  • Inadequate production of steroids by the adrenal glands (known as “hypoadrenocorticism” or “Addison’s disease”)
Cancer
  • Kidney cancer
  • Bladder cancer
  • Other cancers causing weakness
Infectious/Inflammatory Diseases
  • Urinary tract infection
  • Crystals in the urine (known as “crystalluria”) in association with bladder inflammation (known as “cystitis”) or stones in the urinary tract (known as “urolithiasis”)
  • Inflammatory bowel disease
  • Pancreatic disease
  • Intestinal parasites

Risk Factors

  • Intact male
  • Co-existing behavioral problem, such as separation anxiety
  • Owners poorly informed or motivated to properly housetrain their dog

Treatment

Health Care

  • Any appropriate measures to assure continued good health of the dog

Activity

  • Take dog outside often to ensure that it has enough access to eliminate outside, or provide acceptable access to the outside, for example, via a dog door (if dog is trained properly)
  • Increase activity level to help in the treatment of other problem behaviors, as well as to improve the dog’s health

Diet

  • If the dog is eliminating bowel movements inappropriately, feeding meals at specific times (as opposed to free-choice feeding) may help in maintaining the dog on a schedule of defecation
  • Feeding a diet of higher caloric density may help decrease the urge to defecate as often
  • Water should not be withheld from the dog

Surgery

  • Neutering an intact male dog decreases urine marking rapidly in 30% of dogs, with a gradual decline in 20% of dogs, and no change in 50% of male dogs; the results are the same regardless of the age of neutering

Medications

Medications presented in this section are intended to provide general information about possible treatment. The treatment for a particular condition may evolve as medical advances are made; therefore, the medications should not be considered as all inclusive:

  • If urine marking or inappropriate elimination is anxiety-induced, medications may be helpful, but only in conjunction with behavior modification
  • Selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants/anti-anxiety medications (TCAs) may be helpful; an example of an SSRI is fluoxetine; an example of a TCA is clomipramine
  • Full onset of action of these medications can be 4–6 weeks after initiation of treatment, and owners need to understand the amount of time necessary before seeing response
  • Drugs are much less effective if anxiety is not part of the problem; will have negligible effect in dogs that are not housetrained or in dogs with submissive urination
  • Pheromone products potentially can help decrease anxiety
  • Progestins for control of urine marking are rarely recommended because of potential severe side effects

Follow-Up Care

Patient Monitoring

  • Monitor progress with the owner through follow-up visits or telephone calls; the owner should keep a journal of incidents, inciting factors, and treatments instituted to give an objective view of improvement

Preventions and Avoidance

  • Properly housetrain the dog
  • Neuter male dogs and spay female dogs
  • Treat any underlying medical condition
  • Treat any underlying behavioral condition

Possible Complications

  • Inappropriate elimination is the most common individual reason for relinquishment of a pet to a shelter
  • Recurrence of housesoiling may happen if owner does not continue medical and behavioral treatment

Expected Course and Prognosis

  • Prognosis for any behavioral problem is highly dependent on the owner’s ability to follow instructions; usually dogs with behavioral problems are not considered “cured” but instead they are “managed”
  • The following estimations of prognosis are based on the owner following instructions for behavior modification:
  • Prognosis for decreasing submissive and excitement urination is good
  • Prognosis for managing incomplete housetraining is good
  • Prognosis for urine marking in previously intact male: 50% improve (30% quickly, 20% more slowly) with neutering, even without behavior modification
  • Prognosis for managing urine marking in spayed or neutered dogs is good, if the triggers are identified and managed with avoidance or other forms of behavior modification
  • Some dogs with underlying medical causes of inappropriate elimination can still eliminate inappropriately after the medical cause has been treated properly

Key Points

  • Proper housetraining should be stressed with clients from the very beginning
  • Potential long-term management necessary to control the problem
  • Treat underlying/contributing medical problems
  • Treat other underlying/contributing behavioral problems
  • Clean the soiled areas with an enzymatic cleaner, to help eliminate any odor that may attract the dog to eliminate in that location again; if the object soiled is a piece of clothing or other smaller cloth object (such as a throw rug), wash it
  • Punishment is inappropriate, especially if the act of elimination (urination or defecation) has not been witnessed by the owner, as punishment may create anxiety, fear, and defensive aggression for the dog
  • Inappropriate elimination is the most common individual reason for relinquishment of a pet to a shelter

Incomplete Housetraining

  • Keep the dog completely supervised at all times; if supervision is not possible, confine the dog, unless confinement causes panic, destruction, and/or injury to the dog
  • Take the dog outside frequently to eliminate
  • Reward the dog for eliminating at the appropriate time and place; requires the owner to go outside with the pet
  • Thoroughly clean soiled areas
  • Use a consistent “key phrase” to help the dog associate the act with the location and timing of elimination
  • Feed on a set schedule and always have water available

Submissive or Excitement Urination

  • Do not punish the behavior, since this may make problem worse
  • Ignore the dog when it comes into the house (no verbal or physical interactions or eye contact)
  • The dog should go outside to eliminate before it is greeted by any person, including family members
  • The dog should be greeted in a non-confrontational and quiet manner; do not lean over the dog or institute interactive play at the time of greeting
  • Alternative activities at homecoming (such as asking for a toy or requesting a “Sit”) may help in mild cases
  • For excitement urination, much the same recommendations are applicable as for submissive urination, especially concentrating on not getting the dog overexcited

Urine-Marking Behavior

  • Neutering is effective in many dogs to decrease urine marking
  • Determine any possible triggers to the behavior, including anxiety-provoking stimuli
  • Address those triggers with desensitization and counter-conditioning and/or avoidance of the trigger, as appropriate; triggers are situations or things to which the dog reacts, leading to problem behaviors
  • Make the areas urine marked aversive to the dog by use of “booby traps,” such as upside-down plastic carpet runners or aluminum foil, or by use of remote punishment at the very beginning of each and every urine-marking episode, but only if the owner is able to catch the dog in the act of marking
  • Prevent access to preferred marking locations
  • Alternatively, change the significance of the area to a positive place, by feeding the dog in the area marked

Compulsive Disorders in Dogs

Compulsive Disorders in Dogs – An Overview

  • Repetitious, exaggerated, and/or sustained relatively unchanging sequence of activities or movements that may or may not be derived from normal maintenance behaviors (such as grooming, eating, walking); the compulsive behavior apparently is without stimulus, purpose, or function
  • Group of behaviors; signs include spinning; tail chasing; circling; fence running; pacing; light/shadow chasing; licking; sucking or mouthing an object or body part (such as the flank, tail, or leg); pica (appetite for non-food substances such as dirt, rocks); hallucinating (“fly biting”); hair/air biting; staring and vocalizing

Genetics

  • A genetic or inherited likelihood of developing compulsive disorders has been suggested
  • Certain breeds are more likely to exhibit specific compulsive disorders than are other breeds

Signalment/Description of Pet

Species

  • Dogs

Breed Predilections

  • Bull terriers—spinning, freezing
  • German shepherd dogs—spinning, tail chasing
  • Great Danes, German shorthaired pointers—self-directed oral behaviors, fence running, hallucinations
  • Doberman pinschers—flank or blanket sucking
  • Miniature schnauzers—hind end checking
  • Border collies—light/shadow chasing

Mean Age and Range

  • May be seen at any age; usually develop from onset of sexual maturity (6 months of age) to social maturity (12–24 months of age)

Predominant Sex

  • Some compulsive disorders may be more common in males

Signs/Observed Changes in the Pet

  • Wide variety of behaviors possible; behaviors may be repetitive or static (for example, “freezing” in place)
  • Signs may or may not be observed during physical examination
  • May see self-induced injuries
  • May have history or other signs of anxiety or other behavioral issues (such as separation anxiety, fear, Compulsive Disorders)
  • Videotape dogs in all circumstances where the client sees the behavior; a pattern may become clear; the videotape of the behavior will aid diagnosis and treatment planning
  • Behavior first shown as part of play or in situations of high arousal or stress; eventually occurs in numerous contexts without identifiable triggers (triggers are situations or things to which the dog reacts, leading to compulsive behaviors)
  • Certain compulsive disorder behaviors are expressed in situations with little to no external stimulation or evidence of arousal (for example, blanket sucking)
  • Compulsive behaviors occur whether or not the owner is present; if pet is punished frequently for behavior, it may avoid detection when owner is home
  • Hallmarks—behavior is ritualized, often exaggerated, and with time increases in frequency, intensity, and duration
  • May be difficult or impossible to interrupt behavior (even with physical restraint)
  • Behavior may interfere with normal functioning, such as eating, sleeping, and normal social interactions

Causes

  • No direct causes

Treatment

Health Care

  • Not all repetitive behavior is abnormal; it may represent a beneficial coping mechanism; if not harmful nor interfering with normal functioning, health, or the human-animal bond, treatment may not be necessary
  • Usually outpatient
  • Inpatient—pets with severe self-mutilation and self-induced injury; pets that must be protected from the environment until the medications reach effective levels (may require days to weeks of therapy); hospitalization may increase compulsive behaviors
  • Sedation may be necessary in severe cases; only a stop-gap measure, but necessary if serious and acute mutilation involved
  • Treat associated physical conditions
  • Treat with a combination of environmental modification, behavior modification, and medication
  • Medication—implement early; reduction of anxiety aids behavioral therapy
  • Environmental modification—reduce stress and anxiety; identify and remove triggers (triggers are situations or things to which the dog reacts, leading to compulsive behaviors) and/or begin desensitization and counter-conditioning exercises
  • Punishment should be avoided; may make the behavior worse and lead to the pet being more secretive
  • Provide structured, consistent interactions and routines; provide sufficient exercise, enrichment, and mental stimulation
  • Behavior modification—teach the pet to relax in a variety of settings; also teach a calm, desirable behavior to substitute for the compulsive one
  • Teach the pet to lie down with its head outstretched in response to “Head down”; in some cases, the use of a head collar (such as Gentle Leader, Halti) left on the dog will allow the owner to use gentle physical guidance in conjunction with verbal encouragement/cues to interrupt the compulsive behavior and to redirect it more effectively
  • Identify situations in which compulsive behavior occurs and attempt to preempt them by engaging pet in a desirable activity; if compulsive behavior occurs, disrupt it immediately and redirect the pet to an alternative behavior and reward to enforce the appropriate behavior

Activity

  • Depends on compulsive behavior exhibited and individual pet
  • Increase exercise

Diet

  • Depends on compulsive behavior exhibited and individual pet

Medications

Medications presented in this section are intended to provide general information about possible treatment. The treatment for a particular condition may evolve as medical advances are made; therefore, the medications should not be considered as all inclusive:

  • Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) increase serotonin levels in the central nervous system
  • SSRIs—fluoxetine, sertraline, paroxetine
  • TCAs—clomipramine, amitripyline
  • Synthetic pheromones (for example, Dog Appeasing Pheromone [DAP]) may decrease anxiety
  • L-theanine may reduce anxiety
  • Selegiline

Follow-Up Care

Patient Monitoring

  • Monitor behaviors via weekly videotaping and written logs; will provide unbiased assessments of change and help with alterations in treatment plans
  • Complete blood count, biochemistry profile, thyroid (T4) hormone levels, and urinalysis—semiannually to yearly if the pet is on long-term (chronic) treatment; adjust dosages accordingly
  • Medications may take 8–12 weeks or longer to show an effect on the target behavior—the first sign of effectiveness of the medication may be change in duration or frequency of bouts rather than total cessation of the undesired behaviors
  • Relapses can be common during stressful situations

Preventions and Avoidance

  • Monitor dogs that are related to dogs having compulsive disorders to allow early recognition of abnormal behavior and prompt intervention

Expected Course and Prognosis

  • If left untreated, these conditions almost always progress
  • Approximately 50% reduction in compulsive behavior is seen in approximately two-thirds of cases with appropriate medication and environmental and behavioral modification

Key Points

  • Compulsive disorder is unlikely to be cured; usually requires lifelong management
  • Recognize all body language and behaviors associated with anxiety
  • Compulsive behaviors occur whether or not the owner is present; if pet is punished frequently for behavior, it may avoid detection when owner is home
  • Hallmarks—behavior is ritualized, often exaggerated, and with time increases in frequency, intensity, and duration
  • May be difficult or impossible to interrupt behavior (even with physical restraint)
  • Behavior may interfere with normal functioning, such as eating, sleeping, and normal social interactions

Aggression in Dogs

Aggression in Dogs – An Overview

  • Action taken by one dog directed against a person or another animal, with the result of harming, limiting, or depriving that person or animal; aggression may be offensive or defensive
  • Offensive aggression—unprovoked response directed toward a person or another animal in order to control access to some resource (such as food or toys) at the expense of that person or animal; includes social status/dominance aggression, possessive aggression; intermale (that is, between two males) aggression and interfemale (that is, between two females) aggression, and predatory aggression; common targets are familiar people or animals
  • Defensive aggression—aggression is directed toward a person or another animal perceived as an instigator or threat; includes fear-motivated, territorial, protective, irritable (pain-associated or frustration-related), and maternal aggression; common targets are unfamiliar people or animals
  • Probability of overt aggression may be influenced by motivation, arousal, and anxiety; specific incidents of aggression may involve both offensive and defensive aggression
  • In all cases, medical explanations (including pain) as the cause or contributing factor to aggression must be considered
  • Aggression in dogs is the most common reason dogs are presented to veterinary behaviorists in the United States
  • According to a 2009 report by the Center for Disease Control and Prevention (CDC), about 4.7 million people are bitten by dogs each year in the United States and approximately 900,000 require medical attention for bite-related injuries

Genetics

  • Some breed-specific aggressive tendencies and bite styles have been selected for in breeding programs, although this cannot predict behavior of individual dogs
  • One study linked aggressive English springer spaniels to one breeding sire, suggesting a possible inherited form of aggression

Signalment/Description of Pet

Species

  • Dogs

Breed Predilections

  • Any breed may show aggression
  • Pit bull types and rottweilers are the most common breed types implicated in fatal dog bites in the United States, although comparative rates of aggression based on breed occurrence are not available
  • Selective breeding for certain behavioral traits may increase the likelihood that dogs will have specific types of aggression; for example, dogs of breeds bred for fighting may be aggressive toward other dogs
  • English springer spaniels appear at risk for impulsive (“rage”) aggression

Mean Age and Range

  • Any age puppy or dog may show aggression
  • Aggression commonly becomes more problematic at social maturity (1–2 years of age)

Predominant Sex

  • Any sex of dog may show aggression
  • Males—intact or castrated most commonly are implicated in dog bites

Signs/Observed Changes in the Pet

  • Behavioral warning signs include being motionless (immobility), growling, snarling, or snapping at air
  • Offensive aggression warning signs—head up, tail up with stiff wag, direct stare, face-on immobility
  • Defensive aggression warning signs—head lowered, tail down, body withdrawn, paw of front leg lifted
  • Physical examination usually unremarkable
  • Dominance-related aggression, fear-related aggression, or irritable aggression may be evident during the examination
  • Nervous system examination—abnormalities may suggest a disease process (such as rabies) as the cause of aggression
  • Signs vary, according to the situation and the type of aggression

Offensive Aggression

  • Often directed toward familiar household members
  • Signs include head up; tail up with stiff wag; direct staring; face-on immobility
  • People-directed triggers (situations or things to which the dog reacts, leading to aggressive behaviors)—reaching for pet; patting on head; approaching or displacing when on elevated resting sites; approaching food, toys, or stolen objects

Defensive Aggression

  • Often directed to unfamiliar people or dogs that approach, stand over, or reach for the dog
  • Certain familiar people may be exempt
  • Signs include head lowered, tail down, body withdrawn, paw of front leg lifted
  • May be location-specific, as when strangers approach the dog’s home, yard, or car
  • Aggression may increase if the dog is restrained
  • As distance from trigger (situation or thing to which the dog reacts, leading to aggressive behaviors) decreases, response may escalate to agitation, barking, lunging, baring teeth
  • Approach/avoidance behavior is common; “approach/avoidance” behavior consists of the dog approaching the stranger and then moving back away from the stranger
  • Maternal aggression is directed toward individuals approaching the whelping box/area or puppies

Causes

  • Part of the normal range of dog behavior; strongly influenced by breed, sex, early socialization, handling, and individual temperament
  • May be caused by a medical condition—possible but rare; medical causes of aggression should be considered in all cases

Risk Factors

  • Unneutered male
  • Inadequate socialization during critical period (3–14 weeks of age)
  • Traumatic or negative experiences
  • Environmental conditions may lead to aggression or may increase the level of aggression—such as associating with other dogs in a pack; barrier frustration or tethering; cruel handling and abuse; and dog baiting and fighting
  • Previous aggression/bite history (number of incidents, severity of aggression)
  • Presence of children, elderly people, or other people or animals at high risk living in or visiting household

Treatment

Health Care

  • The first tenet of management is to prevent injury to people
  • Euthanasia—appropriate solution in cases of vicious dogs; may be the only safe solution
  • Board the dog until an outcome decision or implementation of a safe management plan is made
  • Use physical barriers, to reduce risk of injury to people, until the owner obtains treatment
  • Identify specific situations that have led to aggression in the past; use a specific plan to avoid these situations
  • Improve physical control of the dog using reliable barriers (such as fences, baby gates), muzzles, leashes, and head halters
  • Calmly and safely remove dog from aggressive-provoking situations
  • Avoid punishment and confrontation; punishment and confrontation promote defensive (fear) responses and escalate aggression
  • Management success—combination of environmental control, behavior modification, and medication

Activity

  • Appropriate and safe exercise regimen should be incorporated into the treatment plan, since frustration and arousal may increase the incidence of aggression

Diet

  • A reduced-protein diet may be helpful in controlling territorial aggression in dogs

Surgery

  • Neuter or castrate male dogs

Medications

Medications presented in this section are intended to provide general information about possible treatment. The treatment for a particular condition may evolve as medical advances are made; therefore, the medications should not be considered as all inclusive:

  • No medications are approved by the federal Food and Drug Administration (FDA) for the treatment of aggression in dogs; discuss the risks and benefits of using medications with your pet’s veterinarian
  • No medication will eliminate the probability of aggression
  • Medication should be used only in conjunction with a safe management plan
  • Medications that increase serotonin (chemical messenger in the brain that affects mood and behavior) may be helpful to reduce anxiety, arousal, and impulsivity
  • Treatment duration: minimum, 4 months; maximum lifetime of pet
  • Medications that have been tried include fluoxetine, paroxetine, sertraline, clomipramine, amitriptyline, and L-tryptophan
  • Megestrol acetate has been used successfully with dominance-related and intermale aggression; however, it does have side effects that should be considered

Follow-Up Care

Patient Monitoring

  • Weekly to biweekly contact—recommended in the initial phases
  • Clients need feedback and assistance with behavior modification plans and medication management

Preventions and Avoidance

  • Avoid all situations that previously have lead to aggression
  • Use extreme care when handling aggressive dogs; use safe confinement, gates, halter, collars, leashes, or muzzles and other restraints to prevent injury to people and other animals
  • Reduce the risk of aggression in young dogs with positive socialization when puppies are 3–14 weeks of age
  • Avoid intimidation techniques for training and negative and/or fear-inducing situations

Possible Complications

  • Injury to people and/or other animals
  • Interdog aggression—” interdog aggression” refers to aggression between two or more dogs; people often seriously injured when interfering with fighting dogs, either by accident or by redirected or irritable aggression; owners should not reach for fighting dogs; pull apart with leashes
  • Liability to the owner; human injury, bite-related lawsuits, and loss of homeowner’s insurance can result from dog aggression

Expected Course and Prognosis

  • Aggressive dogs weighing more than 40 pounds (18.5 kg) are at risk for euthanasia due to their inappropriate behavior
  • Overtly aggressive dogs are never cured; depending on the situation, they may be managed successfully
  • Prognosis is case-dependent due to risk factors and management of each situation

Key Points

  • Overtly aggressive dogs are never cured; depending on the situation, they may be managed successfully
  • Behavioral warning signs include being motionless (immobility), growling, snarling, or snapping at air; offensive aggression warning signs include head up, tail up, direct stare, face-on immobility; defensive aggression warning signs include head lowered, tail down, and body withdrawn
  • Avoid situations that lead to aggression
  • Use extreme care when handling aggressive dogs; use muzzles and other restraints to prevent injury to people and other animals
  • Liability to the owner; human injury, bite-related lawsuits, and loss of homeowner’s insurance can result from dog aggression

Dog Behavior Problems/Training Assistance

Dog Behavior

Behavior problems in pets can become a nuisance, and sometimes a danger to the animal or others. Below, we have detailed a few of the most common behavior problems that are seen in dogs and cats. Please review the information and contact our office if you would like further assistance correcting these problems.

House Soiling in Dogs
Aggression in dogs
Compulsive Disorders in Dogs
How to Handle a Dog That “Constantly Runs Off”

Inflamed Skin & Allergies

Inflamed Skin & Allergies – An Overview

Overview

  • “Atopic” refers to “atopy”; “atopy” is another name for atopic dermatitis
  • “Dermatitis” is the inflammation of the skin
  • “Allergy” is an altered state of immune response to a foreign substance; “allergen” is a substance to which the pet has developed an allergy
  • Atopic dermatitis is a form of skin inflammation due to a hypersensitivity reaction of the pet to normally harmless or innocuous substances, such as pollens (grasses, weeds, and trees), molds, house-dust mites, skin (epithelial) allergens, and other environmental allergens
  • The skin inflammation (dermatitis) is long term (chronic) and relapses are common; it is not contagious and is characterized by itchiness (known as “pruritus”)

Genetics

  • Dogs–inherited susceptibility; however, the mode of inheritance is unknown and environmental influences are important
  • Cats–unclear

Signalment/Description of Pet

Species

  • Dogs
  • Cats

Breed Predilections

  • Dogs–any breed, including mixed-breed dogs, may be affected, recognized more frequently in certain breeds or families of dogs, which can vary geographically
  • In the United States, commonly affected dog breeds include the Boston Terrier, Cairn Terrier, Dalmatian, English Bulldog, English Setter, Irish Setter, Lhasa Apso, Miniature Schnauzer, Pug, Sealyham Terrier, Scottish Terrier, West Highland White Terrier, Wirehaired Fox Terrier, and Golden Retriever
  • Cats–no breed appears to be more likely to develop allergic skin disease (atopic dermatitis)

Mean Age and Range

  • Dogs–mean age at onset of signs is 1-3 years; range 3 months-6 years of age; signs may be mild the first year, but usually progress and become clinically apparent before 3 years of age

Predominant Sex

  • Both sexes are probably effected equally

Signs/Observed Changes in the Pet

  • “Itching” as demonstrated by scratching, rubbing, and/or licking (itchiness is known as “pruritus”)
  • Most skin changes caused by self-induced trauma (scratching, rubbing, licking, biting at skin)
  • Areas of the face, feet, and under the front legs are affected commonly
  • Signs may be seasonal initially
  • Recurring skin and/or ear infections (may be bacterial and/or yeast infection)
  • May have temporary response to steroids
  • Signs progressively worsen with time
  • Lesions–vary from none to broken hairs or saliva discoloration of the hairs (giving a rust-brown appearance to light colored hair) to reddened skin; small, raised skin lesions (known as “papular reactions”); dried discharge on the surface of the skin lesion (known as “crust”); hair loss (known as “alopecia”); darkened skin (known as “hyperpigmentation”); thinkening and hardening of the skin, usually associated with hyperpigmentation (known as “lichenification”); and excessively oily or dry scaling of the skin (known as “seborrhea”)
  • Inflammation of the moist tissues around the eye (known as “conjunctivitis”) may occur

Causes

  • Pollens(grasses, weeds, and trees)
  • Mold spores (indoor and outdoor)
  • Mallassezia a type of yeast found on the skin of animals
  • House-dust mites
  • Animal dander
  • Insects (controversial)

Risk Factors

  • Temperature environments with long allergy seasons and high pollen and mold-spore levels
  • Coexistent skin disorders characterized by itchiness (known as “pruritic dermatoses”), such as flea-bite hypersensitivity and adverse food reactions; these coexistent skin disorders increase the severity of the signs

Treatment

Health Care

  • Outpatient
  • Frequent bathing in cool water with shampoos designed to minimize itchiness can be beneficial

Activity

  • Avoid substances (allergens) to which the pet is allergic, when possible

Diet

  • Diets rich in essential fatty acids may be beneficial

Medications

Medications presented in this section are intended to provide general information about possible treatment. The treatment for a particular condition may evolve as medical advances are made; therefore, the medications should not be considered as all inclusive.

Immunotherapy (Hyposensitization or “Allergy Shots”)

  • Administration (usually subcutaneous [SC] injections) of gradually increasing doses of the causative allergens to the affected pet in an attempt to reduce their sensitivity to the particular substance(s)
  • Allergen selection–based on allergy test results, patient history, and knowledge of local plants that contribute pollen into the air
  • Indicated when it is desirable to avoid or reduce the amount of steroids required to control signs, when signs last longer than 4-6 months per year, or when nonsteroidal forms of therapy are ineffective
  • Successfully reduces itchiness (pruritus) in 60-80% of dogs and cats
  • Response to “allergy shots” is usually slow, often requiring 3-6 months and up to 1 year to see full effect

Cyclosporine

  • Cyclosporine (Atopica) is effective in controlling itchiness (pruritus) associated with long-term (crhonic) allergic skin disease (atopic dermatitis); many pets can be controlled adequately long-term with less frequent dosing (such as every 2-4 days), as directed by your pet’s veterinarian; frequent pet monitoring is recommended

Steroids

  • May be given for short-term relief and to break the “itch”-scratch cycle”
  • Should be tapered to the lowest dosage that adequatly controls itchiness (pruritus), as directed by your pet’s veterinarian
  • Prednisolone or methylprednisolone tablets
  • Cats may need methylprednisolone acetate treatment, administered by infrequent injection

Antihistamines

  • Less effective than steroids
  • Evidence of effectiveness is poor
  • Dogs–antihistamines include hydroxyzine, chlorpheniramine, diphenhydramine, and clemastine
  • Cats–chlorpheniramine; effectiveness estimated at 10-50%

Other Medications

  • Tricyclic antidepressants (TCAs, such as doxepin or amitriptyline) have been given to dogs to control itchiness, but their overall effectiveness and mode of action is unclear, not extensively studied in the cat
  • Topical triamcinolone spray 0.015% (Genesis, Virbac) can be applied to the skin over large body surfaces to control itchiness (pruritus) with minimal side effects

Follow-Up Care

Patient Monitoring

  • Examine pet every 2-8 weeks when a new course of treatment is started
  • Monitor itchiness (pruritus); self-trauma, such as scratching or licking; skin infection and possible adverse drug reactions
  • Once an acceptable level of control is achieved, examine pet every 3-12 months
  • A complete blood count (CBC), serum chemistry profile, and urinalysis–recommended every 3-12 months for pets on long-term (chronic)steroid or cyclosporine therapy

Preventions and Avoidance

  • If the substances (allergens) to which the pet is allergic to have been identified through allergy testing, the owner should undertake to reduce the pet’s exposure to these substances as much as possible; however, reduction of exposure seldom makes a significant improvement on the level of the pet’s itchiness
  • Minimizing other sources of itchiness ([pruritus], such as fleas, adverse food reactions, and secondary skin infections) may reduce the level of itchiness

Possible Complications

  • Secondary skin infection or inflammation of the skin due to yeast (Malassezia dermatitis)
  • Co-existent flea-bite allergy (hypersensitivity) and/or adverse food reaction

Expected Course and Prognosis

  • Not life-threatening, unless itchiness (pruritus) is not responsive to medical treatment and it is so disruptive that the result is euthanasia
  • If left untreated, the degree of itchiness (pruritus) worsens and the duration of signs lasts longer each year of the pet’s life
  • Some cases may resolve spontaneously

Key Points

  • Atopic dermatitis is a progressive skin condition
  • It rarely goes into remission and cannot be cured
    • Some form of therapy may be necessary to maintain quality of life