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Case Study 1 - Problems caused by pain?

Scenario:


Anouska is a ten-year-old pure-bred Doberman. The owners took great care when choosing a breeder.

They report she has slowed down a little over the last two months and will occasionally bare her teeth for no apparent reason. The main reason for their call to you is that she actually tried to bite her male owner when he stroked her. There were no puncture wounds, but he did have extensive bruising.

They say her behaviour is very unpredictable.

Anouska is fed a raw diet but has recently lost interest in her food.

The couple have no children but occasionally visit friends who have dogs. Anouska plays well with them and appears to have no issues towards other dogs.

They also report Anouska has had a couple of “accidents” in the house. These have occurred while the owners were in and the wet patches were discovered by chance.


Client: Mr & Mrs Smith

Breed: Doberman

Sex: Female

Age: 10 years old

Diet: Raw diet

Presenting problems

· “Slowing down”

· Baring teeth for no apparent reason.

· Tried to bite male owner when he tried to stroke her.

· Unpredictable behaviour.

· Lost interest in food.

· Suspected incontinence.


Possible causes

· Slowing down may simply be due to old age.

· Baring teeth and biting may be due to pain. Possibly from arthritis or Canine hip

dysplasia (CHD).

· “Accidents” in the house may be senior dog incontinence, possibly from a urinary tract infection.


Genetics

Living on average between 10-13 years - various health issues affect this breed. About 60 % of Dobermans suffer from dilated cardiomyopathy during their lifetime. (Beauchat, 2017) Other common health problems include: CHD, Demodicosis, Gastric torsion, Osteosarcoma, Von Willibrand’s disease & wobbler syndrome. (Alt, 2019)


Physiology


Dobermans historically have had their tails/ears docked however that is not the case with this particular dog. The ideal weight for a female should be between 32-35 KG (Bailey C & Sporre-Willes R, 2015) in this instance Anouska is only 29KG so slightly underweight.


Environmental Factors


Anouska seems to show aggression upon being stroked in the home by her owner. This would indicate that the dog is in pain which is the reason for the bite. The pain would activate the sympathetic nervous system activating the fight or flight response which explains the bite. (O’Heare, 2014).


Diet


Anouska is fed a raw diet. This significantly increases the risk of salmonella or e.coli (Shmidt et al, 2016). Salmonella causes the following symptoms (Clark, n.d.):


  • Diarrhoea, sometimes with mucus in the stool

  • Fever

  • Vomiting

  • Loss of appetite or anorexia

  • Dehydration

  • Increased heart rate

  • Lethargy

  • Depression

  • Skin disease

  • Swollen lymph nodes

  • Shock

  • Miscarriage in pregnant dogs

This list of symptoms is worrying as the dog is presenting with some of these problems. Therefore I would definitely seek a vet consult. (Please see letter below) This could also explain the accidents in the house (may be very watery diarrhoea)


Diagnosis


Most likely the dog is suffering pain. A vet can rule out any stomach inflammation which can be treated with medication. Should arthritis be diagnosed then pain management should be implemented.


Rationale


The loss of appetite and lethargy led at first to consider gastro-intestinal upset. Although I want to get this ruled out I’m not convinced this is the case. The owners would definitely notice fever and diarrhoea, and although wet accidents have been found they do not smell of faeces.

Owing to the fact the dog is now an old lady she is more susceptible to arthritis and I believe it is this pain that has caused the problems.


Risk assessment


Urgent veterinary treatment is essential for pain management. If this goes untreated her symptoms will get worse. Her appetite will get worse and she could die. In the meantime she could become more aggressive to her owners and the bites could get worse.


Clients goals/expectations


The clients want to go on long walks with their dog and play fetch. I have followed this up with a consultation phone call to explain that they must manage their expectations. Fetch has been shown to exacerbate arthritis (Capon et al. N.d) this is due to the dog running full gallop and skidding to a stop. This puts a lot of force on unstable socket joints.


Treatment programme


The family should block access to the stairs to prevent excessive strain on joints. Any wooden flooring should be carpeted to prevent slips. A ramp should be utilised for the car and a special orthopaedic bed should be used for her.


Veterinary treatment


NSAID’s (Metacam) should be prescribed from the vet to relieve the pain from the arthritis.


Diet


Vet will provide a more suitable diet. Dog food is to include glucosamine and chondroitin to lessen arthritic inflammation.


Exercise


It is important that the dog’s exercise is restricted. Mind games and other calm stimulating activities must be employed. Any weight gain at this stage is welcome as she is underweight and not eating.


Follow up


Follow up appointments arranged for two weeks and four weeks.


Outcome


Anouska’s owners immediately took her to the vet. No Salmonella or E.coli was found but it was still recommended to change her diet due to the dangers of a raw diet. The owners declined to change the diet however.

The dog was found to have advanced arthritis and inflammation around her back legs socket joint with her pelvis. She was prescribed a course of Metacam to relieve this.

The family have stopped playing fetch and walks now involve a slower pace with lots of sniffing. The owners have given her an orthopaedic bed and have put down carpeting on their wooden floors. A baby gate has been installed on the stairs and a ramp has been bought for the car. After two weeks there were no more instances of incontinence. After 4 weeks she is now eating better on her raw food diet and the family are giving her glucosamine and chondroitin supplements. They report that she is now more receptive to cuddles and strokes and the pain seems to be managed. No more biting incidences have occurred.


Behaviour modification plan:


Anouska is in pain because she is getting older now and has arthritis in her joints. As well as taking her medication I would recommend the following:


Diet:


Her diet should be changed to one more suitable to a senior dog. These diets have additional supplements to help her as she ages. Specifically I’d like her to have glucosamine and chondroitin as these will help with the inflammation in her joints.


Managing her environment:


· Stairs are a no go! It will put a lot of pressure on her joints to run up and down the stairs.

· I notice you have a hardwood floor in your hall. If a carpet can be put down it will prevent her slipping and aggravating any inflammation.

· I’d recommend an orthopaedic dog bed as this will help to ease her joints, promote healing and give her less pain.


Walks/exercise:


If you are driving her anywhere I would recommend a ramp for the car. This is because jumping up will cause her pain and lifting her might cause even more! (It may result in another bite if you hurt her too much).


Fetch is really, really bad for her! If she likes the ball then drop it next to her so she can hold it in her mouth but please don’t make her run for it or it will make her arthritis pain worse. Walks should be calm, at her pace and allow her to sniff everything! This will engage her brain and make her more tired and settled than running around and pumping adrenaline around her body!


References


Alt, K (2019) “Doberman Pinscher Health Issues: Know what to look for”. Canine Journal.


Bailey C & Sporre-Willes R, (2015) “Doberman”. FEDERATION CYNOLOGIQUE INTERNATIONALE (AISBL) no 143 pp 1-9


Beauchat, C (2017) “An Update On The Genetic Status Of The Doberman”. The Institute Of Canine Biology.


Capon H, Pountain, D, Tindall, L, Barr, R, Bruder, M (n.d.) From the Canine Arthritis Management Team: On Throwing Balls [WWW] Canine Arthritis Management. Available from: https://caninearthritis.org/article/on-throwing-balls/ [Accessed 27/08/2021]


Clarke, M (N.d.) Salmonella Infection In Dogs: Symptoms, Causes, & Treatments [WWW] Dogtime.com. Available from: https://dogtime.com/dog-health/53925-salmonella-infection-dogs-symptoms-causes-treatments (Accessed 27/08/2021)


O’Heare, J (2014) “Aggressive Behaviour In Dogs” 2nd edition.


Schmidt, M & Williams, J (2016) Do raw meat diets pose health risk for our pets and us? Institute of infection and global health.



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