Testimonial From a Dog Food Convert

>> Sunday, March 10, 2013



I am very happy to share this article written by one of my clients. I think we can all agree that diet plays a huge role in our well being and when we have other illnesses, the quality and the content of our diets can play an even greater role. Unfortunately, not many of us have the time to cook for our selves, let alone our pets. Very often I see clients caught up in trying to sort out the best commercial food by reading labels. Pet food labeling is both confusing and deceptive. The key to sorting out the pet food dilemma is not label reading or consulting the pet store clerk, it is education. The effort Kira made for Adler has really paid off. Recently, when he was visiting my office for his semi-annual examination, he was not overweight (he had been), he had a beautiful coat, his epilepsy was well controlled and we are now able to decrease his anticonvulsant doses! I am grateful that Kira was willing to share her and Adler's story. JAH

DOG FOOD CONVERT
In April of 2010 our 6 ½ year old German Shorthair had his first seizure.  This was the start of a journey through medications, feeling helpless, many questions and also having our dog’s annoying side effects of meds almost drive me and my husband crazy.  We have been working with Dr. Hass since the beginning of this journey and got to a point in January of 2012 where the seizure frequency was twice a month and he was 20 lbs. overweight.  In addition to introducing a new medication, Dr. Hass suggested trying a hypo-allergenic diet based on some of the described symptoms.  I knew that the prescription dog foods were very expensive so she suggested a home-made diet.  
My first reaction to this was only crazy people make food for their dogs.  This reaction was based on childhood experiences working in a vet office.  I took care of the boarding animals and we had one lady in particular who would drop off Ziploc bags of pasta with marinara sauce and veggies for her enormous St. Bernard dog.  I was taught by the vet techs that this was crazy and that the dog wasn’t getting the essential vitamins he needed.
After some thinking, research at the library and visiting some blogs on line I changed my mind.  The mid to high price low fat “natural” dog food I was buying was obviously not working and Adler had this overall dullness about him.  Born and raised in San Francisco, I was taught the healing power of food and natural supplements and figured if I would do it for me why not my dog?  Even if he didn’t have a food allergy, he did not appear healthy or happy after trying multiple name brand pet foods.
After taking the plunge the visible changes in Adler were immediate.  He dropped the extra pounds, had more pep in his step and we were able to cut his meds in half or more.  His seizure frequency also decreased dramatically.  On a recent visit to see Dr. Hass she asked if I could share this success story with others as we both acknowledged it wasn’t easy to figure how to start.  I will warn you though.  There is no going back.  Your dog will most likely not want dry dog food ever again and the benefits of homemade food are so apparent that feeding store bought food just seems like a bad idea.
Original recipe by Donald R. Strombeck  (provided to me by Dr. Hass)
High-Fiber, High-Carbohydrate, and Low-Fat Diet (for 12-13 lb dog)

1 ¼ cups oatmeal or rolled oats, cooked
3 ½ oz (1/4 cup) kidney beans, canned
1 egg, large, hard-boiled
1 cup mixed vegetables, cooked and drained
1 ½ calcium carbonate tablets (600 milligrams calcium)
1 multiple vitamin-mineral tablet

To convert this recipe for larger weight dogs, I eventually discovered through a pet blog online that you need to use a nutritional calculator (the one I used is listed below, but there are many out there).  Using a multiplier based on weight / pounds is not correct.  


Food prep and cooking:
First you need to confirm how many calories a day your dog needs.  This is usually shown on the side of a pet food bag or you can search online or ask your vet.  Keep in mind the amount of activity per day can vary the calorie intake.  Then you can input the food ingredients (keeping the correct ratio) into the calculator until you have the right amount.  I entered the ingredients for the original recipe to see how many calories and grams of protein it provided to give some idea of a base line.  Once you figure out how much food is required in a day you multiply for a weeks’ worth of food.  For Adler this came to 6 cups of food per day (he is fed 3 cups twice a day due to meds and his insane hunger).  For one week’s worth of food I have the following recipe:

Adler’s recipe:
Oatmeal, cooked
  • 18 cups old fashioned oatmeal (about 1 ½ 42 oz containers)
  • 22 cups water
(2) 32 oz bags frozen mixed veggies, cooked and drained
(4) 15.5 oz cans of kidney beans
18 hard-boiled eggs

This recipe makes 1 more serving than required for a full week.  I recommend doing this so you have an extra bag on hand in case you can’t make food at the normal time.  This also allows you to build up a buffer of additional food in the freezer over time.

At this point my recommendation is to jump right in and start cooking.  During the first two weeks you need to mix the food with your dog’s current food so you will only be making half of the total quantity.  About a month into making this food I was able to find the exact recipe that worked.  

I make Adler’s food once a week.  I would prefer to make two weeks at a time but I found that it was an overwhelming amount of food to make without purchasing a set of enormous pots to cook with.  I cook everything separately and then split the ingredients evenly into to two large pots and mix to combine.  Then I scoop 3 cups each into quart size freezer bags and flatten the bags to allow for easy stacking in the fridge / freezer.  I leave 6 bags in the fridge and the remaining 8 or 9 go into the freezer.

Adler is crazy about this food.  I’m not sure if it is because he connects it with me making food (used to and still does get small amounts of table scraps) or if he is just crazy for any food based on his meds.  In addition to this food, Adler’s favorite treats are carrots and ice cubes.  I have also considered dehydrating slices of sweet potato for something chewy.

Supplements:
Second you need to decide what calcium and vitamin supplements to add to your dog’s food.  Based on my library research I had a pretty good idea of what a dog needs to stay healthy, but the trick was to find something that didn’t had a lot of other additives and was affordable!  There are many companies out there with some pricey vitamins for your pet .  

Vitamin supplement:
I found “Be Well for Dogs” at 1-800-PetMeds.  One bag last me about 1 ½ months and costs around $17.00 (usually there are always coupons too).

Calcium carbonate:
Based on reading I found that you can use leftover egg shells as an inexpensive way to provide calcium and with all the hard boiled eggs in this recipe it is feasible.  However, this does take extra time so I chose to purchase calcium tablets and give them to Adler right before eating (he is very good at taking pills at this point).  I confirmed how much calcium he needed using one of the charts in the reference books.

Reference material:
Home-prepared dog & cat diets : a healthful alternative 1st ed.  By Donald R. Strombeck  
The holistic guide for a healthy dog by Volhard, Wendy.

I see there are even more books out there since I did my research over a year ago.  I found that each author had a different take on exactly what was right and wrong regarding the food and supplements a dog requires and most do not dive into vegetarian diets too much.  I read them all and used the information I felt was consistent and not too extreme.

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Why And How Are Pets Vaccinated

>> Saturday, March 2, 2013


You have had vaccines, your pets have had vaccines, we have all had vaccines. But have you ever really pondered how or why they are given? 

Vaccines are administered to help prevent us and our pets from getting sick due to infection with common viruses, toxins and bacteria. Vaccines are also given to decrease the spread of disease. 

When you acquire a natural infection, like Chicken pox, your immune system begins to respond to the viral infection. The immune system learns how to defend itself against that disease and begins forming antibodies against the virus, antibodies attack and neutralize the infection. From that point on you have ‘immunity’ or antibodies that will attack and kill the virus should you be exposed to it again. The next time you are exposed, as long as your immune system is working properly, you will not become ill because your immune system has protected you. 

A vaccine works similarly, except the patient does not become ill. Vaccines are produced by taking a portion of the bacteria or virus or modifying the infective agent so that it will not make you sick. However, the modified infection is enough to trigger your immune system to respond. Sometimes there is a carrier or adjuvant that helps increase the immune response to the vaccine. Once the vaccine is administered, that bodies natural defense system, the immune system, is attracted to the injected material. Then the immune system begins to form antibodies against that disease. Basically the vaccine is teaching our bodies to develop immunity to a specific disease. The next time the vaccinated individual is exposed to that disease, the immune system jumps to their defense and prevents them from becoming sick. 

Vaccines infrequently cause reactions. Typical vaccine reactions can be soreness or swelling at the vaccine site. This is usually very brief, resolving in 24 hours. Patients may also experience fever and lethargy, this too may last only a few hours to a day. Even more infrequent are allergic type vaccine reactions where the patients face may swell and they develop hives and itching.Patients that have this type of reaction should be seen by their veterinarian and treated immediately. Typically, at our office, we suggest that patients that have vaccine reactions no longer receive vaccines since repeat exposure may result in even more severe vaccine reactions. Very infrequently, tumors can form at the site of the injection. This is seen in cats more than in dogs. Vaccines have been modified to to limit tumor formation and other reactions. Also, we have changed how we administer vaccines, giving them as far on the periphery of the pet as possible, so any tumor can be treated more effectively. 

In veterinary medicine our vaccines are typically given either subcutaneously (under the skin) or intranasally (liquid dripped or sprayed into the nasal passages). Unlike people, dogs and cats have loose skin and a large, subcutaneous (meaning under the skin)  space. Placing a vaccine or injection in this area is much less painful than an intramuscular injection (the type we humans commonly receive). It is very important that all vaccines be administered as far down on the leg as possible. Then, if there is a problem associated with the vaccine, it is not on the body where it may be more difficult to treat. This means that your pet may need to be gently restrained to be sure that vaccine is placed correctly. Subcutaneous vaccines may be a little more challenging to administer since it is easy to inject through the skin rather than under it! 
Intranasal vaccines are typically administered when we are vaccinating against respiratory illness, these vaccines are non-painful (no needles necessary), but the hardest part is convincing the patient to let us squirt a little liquid up their nose. 

We have become much more conservative in the use of vaccines in veterinary medicine. However, vaccines serve a vital function in limiting the spread and devastating consequences of many illnesses. The fact that rabies is an infrequent illness in pets and people in the United States is due to vaccines. Vaccines are the reason so many illnesses that were once common causes of death in our pets are  seldom seen.

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Dogs and Cats Are Not For Everyone

>> Sunday, February 10, 2013


I cannot imagine living in a home without pets. I am sure my house would be much cleaner, my gardens more pristine, but it just would not be the same without them.  It would be so quiet, so dull. The sound of the cats as they move about. The dogs as they jostle for position on the couch. The sound of the sugar gliders on their wheel. Yes, I said sugar gliders. We have two and two tortoises as well. 

There are so many different animals that you might adopt, depending on who appeals to you the most.The first thing to remember about the exotic pet is that there is more care and up keep than your average dog or cat. Just because they are not as demanding and they live in a cage this does not mean that they don’t require daily care. They need companionship, variety in their environment, special diets, and often specific environmental temperatures in order to flourish. Typically, these pets are not appropriate for children since they are fragile and need special care. If you are planning on caring for the pet with your children, making it a group project, that’s great! But remember, many of these pets, as long as they are well cared for, can live for 10, 20, 50 + years. Make sure you all are prepared for a long term commitment.  

Exotic pets, just like dogs sand cats, require regular veterinary care with annual examinations and check-ups when ever you feel they are not well. As I mentioned these creatures are fragile and get sick very quickly. Nutritional deficiencies are common problems and are difficult to correct once the pet is sick. Visiting with a veterinarian that has special training in exotic pet care can help get you and your pet on the right track. 

At our hospital there are staff members that work with reptile and amphibian rescue groups. It is amazing how many of these expensive and at times rare pets are surrendered or even released by owners that were not prepared for the responsibility of caring for these pets. Be sure you are well educated and willing to accept all the responsibilities that are included in caring for another living creature!

Here is some brief information about some of the exotic pets we see at our office. It is certainly not a complete list and be sure to visit many web sites and check out books at your local library so you are well informed. Let’s begin with the sugar gliders, ours are named Violet and Lizzie.

Sugar Gliders are nocturnal and marsupials. They are originally from the rain forests of Australia, Papua New Guinea and Indonesia. However, they are bred in captivity here in the U.S. They have a furry section of skin that extends from their ankles to their wrists and it allows them to glide through the air. They can be very tame and great companions, but they must be handled and entertained often. They are very social and it is best that they be housed with other gliders. They can live 12-14 years in captivity. They need a diet that has a great deal of variety, eating fruits, nuts, commercial kibbles, and protein from worms and eggs. Sugar gliders need a large cage with lots of toys and room to climb and jump (or glide!). When angered or stressed they do bite and even as youngsters you must work to acclimate them to being handled. I would suggest purchasing from a private breeder that hand raises the gliders or adopting from a rescue. 



The tortoise is an ancient species that can live more than a hundred years. Turtles can live several decades as well. Each animal needs a very specific environment with strictly controlled temperature and moisture. Diets must also be very specific and they must be fed, cleaned and interacted with daily! Tortoises enjoy getting outside or roaming the house, but safety measures must be taken. No animal wants to be confined to a cage all day, every day. All enclosures and tanks have to be sized appropriately and they need the appropriate bedding or water filtration for their 'house'. Make sure you understand the needs of the type of turtle or tortoise you are adopting. Some can be very difficult  and costly to maintain. 

Chinchillas can live 10 to 20 years and are originally from South America. They prefer a warm environment and enjoy the periodic dust bath. They too are nocturnal and require a special cage, periodic teeth trimming and a specific diet. They are very social. Rabbits are also social and live 10-15 years. They too do best when kept indoors and in a regulated environment. They enjoy being out with their people, but like chinchillas and sugar gliders, they must be supervised. Both have commercially available pelleted diets. The chinchilla enjoys hay and does not tolerate great variety in it's diet. Rabbits are able to have additional vegetables, hay and fruits. 



Snakes and lizards are very popular pets. I think they are among the ones that are either the most poorly cared for or the most likely to be surrendered. This is usually as a result of their owners tiring of them or the pet has become ill due to mismanagement. Snakes can live decades. They require special housing, temperature regulation and regular cleaning. They are typically fed live food. Lizards can be vegetarians or eat meal worms, bugs and sometimes birds, other lizards and snakes! Some lizards can live up to 50 years. They require very specific housing, temperature regulation and diets. 

Birds are wonderful pets and have very specific cage, temperature and feeding requirements. Birds, particularly parrots can be so long lived they survive longer than their original owners. They can be very social and enjoy interacting with people. Many birds can be taught to talk and sing songs. However, they are delicate and stress, poor diet and drafts can be fatal for birds.

The fact is, no pet is without major responsibilities. However, for all your hard work you can reap the benefit of their companionship. Be sure you do your homework before adopting one of these pets and have appropriate housing and food available for them when they arrive at their new home. Also, have them examined by a veterinarian skilled in caring for exotic pets and review with them how you are caring for your new pet, making sure you are both getting off to a good start.


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Intervertebral Disc Disease and Herniated Discs in Veterinary Medicine

>> Friday, November 30, 2012






The spinal cord is protected by a series of vertebra and small pads that sit between each vertebra, called intervertebral discs. There are 7 cervical vertebra with discs sitting between each except between the first vertebra, sitting adjacent to the skull, (called the Atlas) and second cervical vertebra (the Axis). Then there are 13 thoracic vertebra and 7 lumbar vertebra ( with a disc between each vertebral body)  and 3 sacral vertebra (there are no discs between the sacral vertebra). Finally the coccygeal vertebra make up the tail, the number of these vertebra varies depending on the length of the tail. 


Image 1

The intervertebral disc serve many important functions in maintaining both the stability and the mobility of the spine. The discs sit between the vertebral bodies, “beneath” or ventral to the spinal cord in veterinary patients (image 1). The disc acts as a joint and as a cushion between two vertebra. The disc is built like a jelly doughnut  with a center gel-like middle called the nucleus pulposus and an outer fibrous coating called the annulus fibrosis. The center of the doughnut is placed slightly off center, sitting closer to the spinal cord and the annulus is thinner in that area (Image 2). 




Image 2 
The discs can degenerate. Dogs are more prone to disc degeneration and herniation than cats. With animals that have congenital (inherited) disc degeneration (common in young dachshunds and spaniels, to name a few) the nucleus of the disc becomes dehydrated. Often these discs appear mineralized or calcified on radiographs. 

Older animals experience a fibrous degeneration of the discs that is less evident radiographically. The fibrous degeneration begins on the periphery of the nucleus and moves more centrally. The annulus can degenerate as well. As the disc becomes less ‘healthy’ and more and more fibrous it can no longer accommodate the movements of the spine. The tissues thin and eventually the thinnest part of the annulus gives way allowing the nucleus to move upward, or dorsally, towards the spinal cord.


Image 3
Discs can herniate very abruptly (called a Hansen type 1 herniation) or more slowly and progressively (Hansen Type 2). Discs may also herniate as a result of trauma (like being hit by a car) or as a result of other vertebral deformities leading to abnormal spinal alignment that contributes to the movement of the disc. The thoracic spine from the 2nd to the 10th thoracic vertebra is much less likely to experience a disc herniation due to a ligament, the Intercapital ligament, that runs along the floor of the spinal canal, preventing disc movement into the spinal canal. Therefore, herniated discs are most commonly cervical, thoracolumbar or lumbar in location. The location of the disc herniation will influence how each patient is affected. Patients with a herniated cervical disc may have the function of both their thoracic (front legs) and their pelvic (back legs) affected. Patients that have thoracolumbar disc herniation or a lumbar disc may only have their pelvic limbs, tail and bowel and bladder control potentially damaged. Regardless of the location of the herniated disc, almost all patients will experience pain. The discomfort often helps us in localizing the site of the herniation.

  The amount of damage done to the spine is defined by the extent and location of the disc herniation. The larger the volume and force of the herniation, the more damage is done. Type 1 discs cause very acute and forceful trauma that compromises the spinal cord through compression, bruising and alterations in blood flow and oxygenation of the nervous tissue. These patients not only exhibit pain, but decreased or absent motor function. Type 2 discs can be equally as traumatic, but tend to occur more slowly. 

Patients that have had a herniated disc may exhibit pain (most common sign), poor coordination (ataxia), inability to place the feet appropriately (knuckling or walking on the tops of their paws), weakness, inability to walk, abnormal posture, and loss of sensation (loss of deep pain). 

Any patient that is suspected of a herniated disc (spinal pain, difficulty or an inability to walk) should be seen by a veterinarian immediately. Prompt management either through initiating appropriate medications or surgery can be pivotal in the successful recovery of the patient. 

Each patient should have a thorough physical and neurological examination. This allows the veterinarian to localize the lesion or identify the approximate area of the spine that has been injured. These examinations also provide important information regarding the extent of injury and aid in identifying any other health issues that may be contributing to the current problems. 

Based on these examinations the doctor is going to recommend diagnostics that are tailored to further assess the patients health and examination the area of the spine that was injured. Initially blood work, thoracic radiographs and spinal radiographs may be discussed. If the patients signs are severe and surgery is to be considered even more detailed evaluation of the of the spine and spinal cord will be needed since we will want to know the exact location of the injury and define the injury accurately, prior to surgery. MRI and myelography (Images 4 and 5 ) are two techniques that allow the localization of a spinal cord lesion. Cerebrospinal fluid analysis may be performed as well to help rule out any other diseases of the nervous system.


MRI of a herniated disc at C4-5
Image 4





Myelogram C3-4 herniated disc
Image 5

The damage done to the cord is not necessarily irreparable. Many herniated discs, just as in human medicine can be medically managed. Careful management by a veterinarian, rest, anti-inflammatory medicine (often steroids) and physical therapy all play a role in the successful recovery of these patients. 

More severely affected patients either due to loss of motor function, loss of sensation to the affected limbs, or persistent pain will require surgical intervention. Again, these patients are more severely affected due to the dynamics of disc herniation, the extent of disc compression (the amount of material in the canal) and the location of the disc herniation.

Post surgical recovery can be as short as 2-4 weeks or as long as 4-8 months. Typically, recovery times are directly proportional to the degree of damage prior to surgery. Therefore, a patient with no voluntary movement to the affected limbs and loss of sensation will have a longer recovery time than a patient that has surgery due to chronic discomfort. 

Early in our understanding of spinal cord trauma subsequent to herniated discs, veterinarians counseled owners that a patient that had lost deep pain response to the affected limbs would have a 10% or less chance of recovery. Currently, we appreciate that many of these patients will regain their ability to walk, but the recovery will be long and the owner must have a very strong commitment to providing the nursing care and physical therapy necessary for a successful recovery. 

Clients, rightly so, are always concerned with the prognosis for their pet. At our hospital our experience is that patients that have a recent onset of signs such as spinal pain, with present or decreased motor function will often be successfully treated medically. It must be recognized that medical treatment is done initially in the hospital and under a clinicians supervision. Should the patient not respond, surgery must be considered.

Patients that have lost motor function, but maintain deep pain are recommended surgery. Success with surgical decompression ranges from 85-90%. Patients that have lost deep pain sensation to the affected limbs have suffered substantial injury and the exact extent is very difficult to appreciate even with the benefit of MRI. These patients are given a 50% chance of significant improvement with a long recovery time expected. 

The most common surgeries performed for herniated disc are a hemi or dorsal lamenectomy, usually performed on the thoracic and lumbar spine and ventral slot performed on the cervical spine. The choices of surgical approach depend on the location of the herniated disc within the spinal canal as well as individual preferences of the surgeon. 

Care for a patient post-surgery again is dependent on the extent of spinal injury. Patients that are ambulatory need to be restricted in their activity and slowly brought back to ‘normal’ daily activity over a 4-6 week period. Patients that are not ambulatory require confinement as well, passive range of motion exercises, assistance outside to urinate and defecate, possible assistance in urinating and careful observation. 

Herniated intervertebral discs can be a frightening event for a pet owner. Prompt intervention, application of appropriate care and diligent home care will typically lead to the pets recovery. Any animal that has experiences a herniated disc, despite the completeness of the care provided, may be left with some deficits, a weak leg or some coordination issues, for example. It is key that the owner receive a thorough over view of their pets condition and an appreciation of the  clinicians expectations for their pet so that all expectations are realistic and the owner is prepared for the recovery process ahead.


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Suggestions for some Purr-fect Holiday Gifts

>> Sunday, November 4, 2012






When I was young and the holidays were approaching, I made sure that all the animals in our household had a stocking and some treats, even my horse. That was a long time ago and gifting your pets was not as popular as it is today. In 2010, the Associated Press reported that 56% of all pet owners gave holiday gifts to their pets. Currently, according to the American Veterinary Medical Association, 36% of all US households have dogs and 30% own cats. This translates into a huge amount of gift giving. Both to the pets and to the myriad of pet lovers.

Since I have such a long history of being a pet-gift-giver, I thought I might provide my top ten gift suggestions.

  1. Give the gift of safety. Be sure that your household is pet safe and make sure that the gifts you give and the items you take to other households are pet safe. Remember that ribbons and tinsel, potpourri, Poinsettias, chocolates, alcohol, Lilies and many other hostess gifts can prove fatal to pets. Also, pets love to get into purses and bags left on the floor. Be sure all medications, sugarless gums and cigarettes are sealed and kept away from pets. Also, raw dough and antifreeze are common potential toxins. Visit www.aspca.org for more information.
  2. Give a gift in the name of your favorite pet or animal lover. Donate to a charity or rescue in your area that benefits animals.  Community Sharing’s Pet Pantry, Meals on Wheels Pet Feeding Program, and local animal rescue organizations (I prefer no-kill shelters) are always in need of your help. Remember, there are horse and exotic pet rescues too!
  3. Water. Give a pet water fountain. Pets, particularly cats, enjoy fresh, moving water. Cats are attracted to the flowing water and staying well hydrated is essential to feline health. 
  4. Make sure any pet that is lost can be found. Microchip’s allow pets  to be identified and reunited with their owners. They are inexpensive, safe and easy. We recently microchipped a clients tortoise!
  5. A Fur-ever Friend. Pets should never be given as surprise gifts. The addition of a new pet should be well researched. Always remember to visit pet adoption groups and rescue leagues to find a new pet.
  6. Pretty as a picture. Consider giving your favorite animal lover and their pets the gift  of  a  professional photo session. 
  7. Michigan Made products. As they say, Keep It In The Mitt! There are some great Michigan companies that make pet products. I am a big fan of Troys Treats ( ph 248.688.4530), they are locally made with Michigan products and Darwin (my dog) says they are Great!. Visit www.michigan-made/pets/  or http://www.mi-made.com/category/Pets to be inspired by other Michigan Made products.
  8. Toys !!! We can’t forget that we all need to have a little fun! Laser pointers for cats and mechanical mice encourage exercise and these toys keep their minds nimble. Be sure dog toys are sturdy and not easily destroyed. Remember, rawhide toys and other ‘food related’ toys, are not appropriate for pets with food allergies.
  9. Buckle Up! Using dog seat belts will help prevent injuries that might land you and your dog in the emergency room. Also,  be sure cats are secured in a crate to limit injuries in a car accident. 
  10. Finally, give the gift of wellness. Every pet owner would appreciate a gift certificate for pet care at their preferred veterinary hospital. Preventative medical care will help keep everyone happy and healthy.

Have a peaceful and happy New Year!


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What is BAER (Brainstem Auditory Evoked Response) testing all about?

>> Sunday, October 28, 2012





What Is BAER (Brainstem Auditory Evoked Response) Testing All about ?

The process of hearing is extremely intricate. Whether the sound is loud or soft, high or low an incredible number of very intricate biological processes have to occur in a strictly choreographed manner. 

When you think about it, it is amazing that so many of us DO hear. There are such a multitude of places along the biological path of hearing where malfunctions can occur, it’s amazing that there are relatively few individuals that are deaf. 

Sound begins its journey into our senses, our consciousness, as waves transmitted through the air. These air waves then cause vibrations in the tympanum or ear drum. These sound waves move the ear drum and then move three tiny bones (the smallest bones in the body) that sit within the middle ear. This moves liquid within the cochlea, a spiral, sea shell shaped organ, of the inner ear. Another series of membranes are moved by the liquid which causes small, pigmented hair cells to move. These are receptors for the 8th cranial nerve (CN VIII). At this point the movement triggered by the sound waves is now conducted through the nerve and the brainstem as electrical activity within the skull. 



Dogs and cats, just like people, can be born deaf. This is typically due to sensorineural deafness or a dysfunction of the sensors that allow sound to enter the nervous system as electrical impulses (the hair cells). 

BAER testing is a hearing test. In veterinary medicine we cannot rely on the pets response to sound to check their ability to hear.  Dogs and cats with hearing deficiencies can depend heavily on vibration and visual input to compensate for their hearing loss. It can be very difficult to tell if a pet is completely deaf or even deaf in one ear. They are very capable in adapting and compensating for their disabilities.  Rather than depending on our observations (subjective analysis) we use BAER tests (objective analysis) to follow the sound as it is conducted from the inner ear to the brainstem. 

Few dogs are trained to raise their paw (or finger as a person would) when they hear a to a certain tone. BAER testing helps us analyze their ability to hear without relying on their conscious responses. BAER testing is easily performed on either an awake or anesthetized pet.  We recommend that the pet be at least 6 weeks old and preferably 12 weeks old for this test. When they are less than 12 weeks old there is a slight risk of false negative tests (this means that a hearing ear might tests as deaf). 

Each ear is tested separately and 3 small needles are placed under the pets skin, one at the top of the head, the next at the base of the ear being tested and the last, a ground lead, is somewhere out on the pets body. The needles at the base of the ear and the top of the head will record the electrical activity as it is conducted from those little hair cells into the brain stem.  Then an ear phone or ‘clicker ‘ is placed in the pets ear and it will emit a clicking tone at a volumes of 80-100 decibels. We use an 87 decibel sound. The machine then records each click as it is conducted along the 8th cranial nerve and on through the brain stem. 

A pet that has a hearing response on the BAER test will demonstrate a series of peaks that occur at certain time intervals on a graph. This is a normal BAER test.



If the pet has an inherited deafness or deafness as a result of damage to the inner ear and the hair cells within the inner ear , the test would have no peaks and would be flat(see below).


BAER testing can be used to check for other interruptions in the hearing process such as tumors of the 8th cranial nerve and damage of areas within the brainstem. 

At our office, BAER testing is performed on awake patients, we seldom find that we need to sedate or anesthetize puppies and kittens that are tested. Sometimes when more detailed tests are indicated or a pet is particularly uncooperative anesthesia can be used. 

BAER testing should be performed on any pet suspected of being deaf or one of the breeds listed below, prior to their being adopted into a new home. Deaf animals can make great pets and companions, but owners must be aware of their special needs so they can  learn to communicate with their new pet and train that animal adequately. This will allow the pet to avoid injury and learn to function well within the household. 

Dog and Cat breeds associated with reported congenital
 (inherited deafness)

Akita
French Bulldog
Springer Spaniel
American-Canadian Shep
German Shepherd
Sussex Spaniel
American Eskimo
Great Dane
Tibetan Spaniel
Am. Staffordshire Terrier
Great Pyrenese
Tibetan Terrier
Australian Blue Heeler
Ibizan Hound
Toy Poodle
Australian Cattle Dog
Italian Greyhound
Walker American Foxhound
Australian Shepherd
Jack Russel Terrier
West Highland White Terrier
Beagle
Kuvasz
Whippet
Bichon Frise
Labrador Retriever
Yorkshire Terrier
Border Collie
Maltese
Felines
Borzoi
Miniature Pinscher
European White
Boston Terrier
Miniature Poodle
White Cornish Rex
Boxer
Mixed Breed Dog
White Devon Rex
Bull Terrier
Norwegian  Dunkerhound
White Manx
Cardigan Welsh Corgi
Nova Scotia Duck Tolling Retriever
White Persian
Catahoula Leopard Dog
Old English Sheepdog
White Scottish Fold
Cavilier King Charles Span.
Papillon
White Turkish Angora
Chihuahua
Pit Bull Terrier
White American Shorthair
Chow chow
Pointer
White British Shorthair
Cocker Spaniel
Puli
White Exotic Shorthair
Collie
Rhodesian Ridgeback
White Oriental Shorthair
Dalmatian
Rottweiler

Dappled Dachshund
Saint Bernard

Doberman Pinscher
Schnauzer

Dogo Argentino
Scottish Terrier

English Bulldog
Sealyham Terrier

English Cocker Spaniel
Shetland Sheepdog

English Setter
Shropshire Terrier

Fox Hound
Siberian Husky

Fox Terrier
Soft Coated Wheaten Terrier


From: Dewey CW. A practical guide to canine and feline neurology 2003;Ames: Iowa State Press: 232.

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Mittens The Laundress

>> Monday, October 8, 2012






One of the really great things about my job is everyone that visits me has a funny or entertaining story about their pet that they share during their visit. Sometimes they tell me what they went through to get the cat in her carrier, or about their pets entertaining activities at home, regardless of the exact details, inevitably there is some kind of a story. These stories illustrate to me how much we value the companionship of our pets, how important they are to our families and how boring things would be without them.

Sometimes there are stories like the one about Mittens and her owner Julie. Julie and her husband, Tim, visited with me at a recent community event. Julie enjoyed talking about their dog, Mittens. Mittens was adopted as a puppy by her two sons and at the time they already had two dogs. Her sons were responsible for caring for Mittens and they developed an interest in training her. Mittens quickly learned the basics and then she learned how to skate board, pick up objects on command and retrieve. She seemed to have a real aptitude for learning and the whole family enjoyed her antics.  A few years ago Julie had extensive spinal surgery that left her with limited mobility. Bending and picking up even the lightest objects was a challenge. Julie quickly realized that Mittens was ready and willing to help pick things up. Mittens was not a service dog, nor were Julie and her family professional trainers, but together they were the perfect team. 

Mittens can remove laundry from the dryer (the video is attached above). Tim was so excited to show me the video, he went home to get his camera so we could see Mittens in action! Julie explained that Mittens enjoys tidying up so much that she picked up the parts her son had laying out in the garage while he was repairing a car and brought them to her! 

Mittens and Julie’s story reminded me of another patient. A few years ago, I treated an Australian Cattle dog named, Mason. Tom, his owner, explained that he had been a very busy executive, traveling around the world. However, he developed a severe seizure disorder and became housebound. He had always wanted a dog, but had never had the time for a pet. Tom said he thought, with everything else going so badly for him, he could at least adopt the canine companion he always wanted. So he went to the local shelter and adopted Mason. Mason had been surrendered because he had a few problems, but Tom felt they were a perfect match. Unfortunately, Mason was not the easiest to live with at first. But they became closely bonded in a very short time. Slowly, Tom began to realize that Mason could tell when he was going to have a seizure. This gave Tom the ability to intervene and avoid a seizure and gradually his seizures subsided. Tom and Mason began leaving the house. They walked more and more, getting further and further from their home, something Tom never thought he could do again. Soon, Tom and Mason were able to begin leaving their home for trips. Tom began driving and working, always with his friend at his side. He explained that he has been seizure free for years and he attributed his cure to Mason. Now Mason is a first class world traveler and Tom’s constant companion.

These stories make me wonder what forces conspire to bring these people and their companions together at just the right time. Maybe sometimes the helping hand we are looking for is actually a paw.

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