Diskospondylitis is a bacterial or fungal infection of the disks between the vertebrae (intervertebral disks). This infection can occur in any area of the spinal column, and it can occur at multiple sites. Diskospondylitis is also known as spondylitis, intervertebral disk infection, and vertebral osteomyelitis.

Diskospondylitis occurs much more often in dogs than in cats.

The bacterial/fungal infection can reach the intervertebral disks several ways.

• Through the bloodstream, which is the most common method. (Chronic infections of the skin, urinary tract, prostate, etc. can result in bacteria entering the bloodstream and travelling to the disk area.)
  
• Via direct contamination from punctures or bite wounds near the spine, or from procedures or surgery near the spine.
  
• From the migration of foreign bodies through the area near the spine.

Signs

Neurological signs have a gradual onset and are progressive. At the beginning, spinal pain, stiffness, unsteady walking, and other nervous system problems may occur. Spinal pain is the most consistent clinical sign. Impaired movement (paresis) is usually mild, unless the infection gets into the spinal canal. However, if the pet doesn’t get appropriate treatment, signs can progress to paralysis, often caused by fractures of the vertebrae. The muscles alongside the spine may atrophy (waste away); this is most likely due to local nerve damage or associated myositis (muscle inflammation).

Spinal cord compression can be caused by granulation tissue, bony changes, or fractures or dislocations (luxations) due to the infection. The vertebral fractures or dislocations may require surgery to stabilize them.

Occasionally, the infection may result in meningitis, meningomyelitis, or an abscess in the spinal canal.

Diagnosis

Diagnosis may require radiography, advanced imaging modalities (CT scan, MRI, bone scintigraphy), urinalysis, bacterial cultures, serology, and cerebrospinal fluid analysis.

Radiography

Radiographs (X-rays) of the spine will typically show damage to the vertebrae on either side of the affected disks.  In chronic cases, bone changes and deformities of the spine may be seen. Changes may not show up on the radiographs for 3-6 weeks after clinical signs start, so if the first radiographs are normal but the clinical signs are progressing, your veterinarian will likely repeat the radiographs.

If a typical lesion is detected, radiographs of the entire spine are recommended because some pets have multiple lesions. Infection causes disk degeneration, and destroys the ends of the adjacent vertebrae. These degenerative changes may weaken the vertebral column and make it susceptible to pathologic fractures, which stem from infection rather than trauma. The body may try to bridge the damaged area with bone, which can encroach on the spinal cord and nerve roots, causing more problems.

Advanced Imaging

Bone scintigraphy, computed tomography (CT), and magnetic resonance imaging (MRI) are more sensitive than plain radiography, particularly for early lesions. Myelography and/or MRI/CT are helpful for pets that have neurological problems, and these imaging methods are considered important if spinal surgery is going to be done.

Urinalysis

Pets may have pus and/or bacteria in their urine.

Bacterial Cultures

Culturing the urine, blood, spinal fluid, or other infected tissues may help identify the organism(s) that caused the infection. However, culture of the infected disk space will yield the most accurate results. Fluoroscopic-guided fine needle aspiration may be necessary to get the best sample. If spinal surgery is necessary, samples of the infected areas should be obtained and cultured.

Serology

Brucellosis serology (checking the blood for current and previous infections) should be performed. Brucellosis is a possible cause of diskospondylitis, and can be transmitted to people.

Cerebrospinal Fluid (CSF) Analysis

CSF analysis is called for in animals with neurologic signs. In addition to culturing the CSF, routine cytology, cell count, and protein determination are done.

Causes

Bacteria

Bacteria such as Staphylococcus, Streptococcus, Escherichia coli, and Brucella spp. are commonly isolated organisms. Pseudomonas, Proteus, Pasteurella, Corynebacterium, and Actinomyces spp. are sometimes found. Reproductive problems may occur with Brucella infections. There are reports of pets infected with Bordetella spp., Erysipelothrix rhusiopathiae, and Salmonella spp.

Fungi

Fungal organisms that can cause diskospondylitis include Aspergillus, Blastomyces, Histoplasma, Coccidioides spp., and occasionally Paceilomyces. In Europe, infection with Rasamsonia argillacea has been reported. A single case of infection with Westerdykella spp. has also been reported in a German shepherd dog. Fungal infections can be more difficult to diagnose than bacterial infections, so your veterinarian will also look for enlarged lymph nodes, lung or eye lesions, and fungal organisms in the urine.

Other Agents

Protothecosis, a disease caused by a type of green alga, has been associated with diskospondylitis.

Treatment/Management/Prevention

Antibiotic Therapy

Treatment involves a long course of antibiotics that are specific for the infective organism. Ideally, the antibiotic selection will be based on culture and sensitivity results from the infected disk. If disk culture is not possible, then antibiotic selection will be based upon the culture results of urine, blood, or other infected areas.

Antibiotic treatment may be needed for many months. Recurrence of the disease or persistence of signs can be a problem if antibiotic therapy is stopped too soon, if the antibiotic being used is ineffective, or if corticosteroids or other immunosuppressive drugs are used. If clinical signs do not improve while the pet is taking antibiotics, your veterinarian may decide to repeat the disk culture.

As for Brucella infections, treatment is only undertaken with the understanding that a cure cannot be expected, long-term antimicrobials will be required, and the return of the infection is common. Infected dogs should be neutered to reduce the risk of transmission to other dogs and people, to remove potential reservoirs of infection, and to resolve other clinical problems (infection of the testicles, for example). For all practical purposes, Brucella diskospondylitis should be considered incurable.

Antifungal Therapy

Antifungal drugs, particularly itraconazole, may be effective for treating some cases of fungal diskospondylitis.

Decompression

Your veterinarian may advise surgical exploration of a lesion that does not respond to treatment or that has persistent draining tracts that suggest foreign body migration is occurring. Decompressive surgery and/or stabilization may be considered if evidence of spinal cord compression is found on myelography or MRI, or if severe, progressive neurologic problems occur. Surgical stabilization of affected sites may be useful in cases in which spinal instability is a significant complication.

Supportive Therapy

If antibiotics are effective, pain medications may be needed for only a few days.

Monitoring and Prognosis

After your pet has had at least six weeks of therapy, your veterinarian may take more radiographs to see if the lesions have improved. Improvement of clinical signs often occurs before improvement can be seen on the radiographs. Prognosis for recovery is guarded and depends, to some degree, on the cause of the diskospondylitis.

Being carnivores, domestic, feral, and wild cats that hunt for food get adequate amounts of taurine from their diet.  However, some commercial cat foods at that time contained insufficient amounts of taurine causing dilated cardiomyopathy and other health issues.  This discovery resulted in pet food companies adding more taurine to their manufactured foods. Subsequently, taurine-associated dilated cardiomyopathy in cats has all but disappeared.  It is occasionally diagnosed when cat owners feed unbalanced diets (e.g., boiled poultry or vegetarian diets).

A few years later, certain breeds of dogs were found to also have dilated cardiomyopathy in association with taurine deficiency.  This was unexpected because dogs, unlike cats, can synthesize taurine from other sulfur-containing amino acids in their food.  Investigators suspected that these breeds were unable to synthesize taurine in amounts needed to replace losses. Taurine is typically efficiently recycled in the small intestine, but various dietary factors can affect this process. When supplemented with high doses of taurine, these dogs resolved their cardiomyopathy in many cases.

Since that time, specific categories of diets have been sporadically linked to heart disease.  One group of Newfoundlands that were fed a commercial lamb-and-rice diet developed taurine deficiency and reversible cardiomyopathy.  Other dogs have also been found to have a taurine deficiency when fed similar lamb-and-rice diets.  Occasionally, dogs fed vegan or vegetarian diets have been taurine deficient and suffer heart disease.

Most recently, Golden Retrievers have been identified as having a taurine-deficiency associated cardiomyopathy. 

Is diet-associated cardiomyopathy caused by taurine deficiency?

The evidence suggests that the recent “outbreak” of cardiomyopathy in dogs is likely not primarily related to taurine deficiency.  Blood assays of taurine in many affected dogs show normal taurine concentrations.  The observations suggesting this condition is related to taurine deficiency originate from populations where several of the affected dogs were Golden Retrievers (who are a special case, as described above).  It is hypothesized by some that being taurine deficient makes these dogs more susceptible to whatever is causing the diet-associated cardiomyopathy. Because of concerns from some veterinary researchers about the methods used to assess taurine status in the studied populations with few or no Golden Retrievers, we cannot completely rule out the role of taurine deficiency at this time in all breeds. Time will tell.

If it’s not taurine, what is the cause?

We don’t know.  The only common link that investigators have observed is “grain-free” diets that use lentils and other legumes (peas) as the “base ingredient.” There are many theories, but no definitive answers explaining how these diets cause cardiomyopathy. There is also a lack of reporting and consistent data collection on diet-related heart issues in pets. Cardiomyopathy is most likely caused by a combination of genetics, other medical conditions, and diet.

Are all “limited ingredient” or “grain free” diets at fault?

Some dogs are prescribed diets to diagnose and treat allergies (skin or gastrointestinal diseases).  Such diets might include a limited number of uncommon ingredients, such as salmon, kangaroo, potatoes, peas, etc.  At this point, no therapeutic diets, manufactured by the major pet food manufacturers (Hills, Purina, Royal Canin), have been associated with cases of diet-associated cardiomyopathy.

There is no medical or nutritional indication for “grain free” although some veterinary therapeutic diets recommended to diagnose and treat allergies are also grain free. They are chosen because the ingredients happen to be novel for the specific patient, but they are not used because they lack grains per se. Grain free is simply a marketing category and there is no specific benefit. 

In recent years, canine diets containing pulses, which are the dried seeds of foods like chickpeas, lentils, beans, and dry peas, have been linked to diet-associated cardiomyopathy versus just the presence or absence of grains (corn, rice, and wheat).

What should I do if my dog eats a grain-free legume-based or other implicated diet?

First, check the ingredient label.  If peas or lentils are the main ingredient (or main carbohydrate source), consider changing to a diet that contains grains.

Second, if you are reluctant to change the diet, consult your veterinarian about having a cardiac ultrasound (echocardiogram) to see if your dog has evidence of cardiomyopathy.  If your dog is found to be affected, even if it’s showing no clinical signs, change the diet to a grain-based commercial diet. Most nutritionists recommend using the WSAVA guidelines for the selection of commercial diets.  

Third, if you have a dog that is “at risk” for taurine deficiency (American Cocker Spaniel, Golden Retriever, Newfoundland, Dalmatian) and eating an implicated diet, have the blood taurine levels checked. Measure both whole blood and plasma collected at the same time to enable the most accurate interpretation of your dog’s taurine status. If those are low, determine if the dog has cardiomyopathy with a cardiac ultrasound, change the diet, and supplement taurine as directed by your veterinarian.

The more data collected, the more likely researchers will be able to resolve whether taurine deficiency plays a primary or secondary role in causing this diet-associated cardiomyopathy.

Your veterinarian or veterinary cardiologist is the one best able to advise you about the most appropriate course of action for your dog.

What about cats?

A few cat cases have been reported to the FDA, but the numbers are too small to say anything definitive. This appears to be primarily a dog problem. 

The diaphragm is a thin muscle that separates the organs in the chest (heart, lungs) from the organs in the abdomen. It is also involved in breathing: when the diaphragm contracts, it helps pull air into the lungs.

A hernia develops when an organ pushes through a weak spot in the muscle around it, creating a hole.

Diaphragmatic hernias result from abdominal organs (e.g. liver, stomach, intestines) being pushed through a hole in the diaphragm. That hole is the hernia. The hole can be caused by trauma, such as being hit by a car, or it can be congenital, meaning that the pet was born with it.

Peritoneopericardial Diaphragmatic Hernia

A certain type of defect that has a big name – peritoneopericardial diaphragmatic hernia – is not nearly as complicated as it sounds. As we know, the diaphragm is a muscle that runs between the chest and abdomen. It helps us breathe by affecting the communication between the double-walled sac that contains the heart and the membrane that lines the belly. The heart sac is called the pericardium and the membrane is called the peritoneum. What happens with this type of hernia is that abdominal organs can move through the hole in the diaphragm directly into the heart sac. Obviously, abdominal organs are not supposed to be in the heart sac. Usually cats and dogs are born with this type of hernia, but trauma can also cause it.

Diaphragmatic Hernia Symptoms

When the abdominal organs have moved through the hole in the diaphragm, they become trapped and lose their blood supply. Misplaced organs in the chest can also crowd the lungs, or in the case of peritoneopericardial diaphragmatic hernias they can crowd the heart, preventing pets from breathing normally or letting the heartbeat correctly. Symptoms can include coughing, poor appetite, laying around more, trouble breathing or taking rapid and short breaths, fever, and collapse. In some cases, pets can live for many years without any symptoms, especially if the abdominal organs are able to move easily in and out of the chest or the hole is too small to allow movement through it. Such hernias may be found unexpectedly while addressing another problem.

Diagnosing a Hernia

For diagnosis, the veterinarian will perform a thorough physical examination. Sometimes a veterinarian will become suspicious when they hear tummy grumbles in the chest instead of in the belly. X-rays of hernias often show abdominal contents in the chest, or unusual gas patterns or shadows. If the X-rays don’t show an obvious answer, the veterinarian may give an ultrasound or they may choose a barium series, in which they feed the pet a type of medicine called barium to highlight the stomach and intestines on additional X-rays.

Treatment

Treatment requires surgery to fix the hole in the diaphragm (and heart for peritoneopericardial diaphragmatic hernias) and move the abdominal organs back into the belly. If the organs are severely damaged from being trapped in the chest, surgery to fix the damage or remove the entire organ may also be necessary. 

Unfortunately, diaphragmatic hernia repair carries some risk because the diaphragm helps us breathe. Because of this risk, some veterinarians will avoid surgery in pets that do not show symptoms. The issue with waiting until symptoms occur to perform a risky surgery means that organ damage may be irreparable by the time surgery is performed, so it is important to fully discuss the pros and cons of a wait-and-see approach with your veterinarian. 

For pets that do undergo surgical repair, once the pet has fully recovered and healed from surgery, they are unlikely to experience future issues.

• oral behaviors: self-licking, self-chewing, air or nose licking, flank sucking, wool sucking, fly snapping, polyphagia (eating more), polydipsia (drinking more), psychogenic alopecia (pulling out hair), pica (eating non-nutritional   items) chewing and licking objects;
•  vocalization: repetitive barking, whining, howling;
•  hallucinatory: shadow or light chasing, startling, avoidance, fly snapping, air licking;
•  aggressive: self-directed aggression (growling, biting at tail), aggressive behavior directed towards an object.

Dogs and cats of any age, breed, or sex can develop a compulsive or repetitive behavior disorder. The average age of onset is 12-36 months in dogs and 24-48 months in cats. Approximately 50% of animals with compulsive and repetitive behaviors start to show signs before one year of age.

Some breeds are more likely to show these behaviors.

•  Bull Terriers: spinning, tail chasing, freezing
•  German Shepherds: spinning and tail chasing
•  Great Danes and German Short-Haired Pointers: self-mutilation, stereotypical motor behaviors such as fence running, hallucinations
•  Dalmatians, Rottweilers, and German Shepherds: hallucinations
•  Doberman Pinschers: flank sucking
•  Border Collies: staring at shadows
•  Australian Cattle Dogs: tail chasing
•  Miniature Schnauzers: checking the hind end

There are other risk factors for compulsive behaviors. Living in stressful environments may cause anxiety, conflict, or frustration, predisposing the animal to compulsive behaviors. A previous injury or irritation may trigger the behaviors. In some situations, the behavior might have been accidentally reinforced, resulting in attention-seeking behaviors.

As with all behavior concerns, the first step is to rule out underlying medical conditions.

Some common medical diseases that may result in compulsive behaviors include:

•  seizures;
•  neurological diseases; 
•  infectious diseases such as Lyme disease or distemper;
•  gastrointestinal disorders;
•  ophthalmological disease;
•  metabolic diseases;
•  exposure to a toxic substance;
•  skin diseases;
•  injuries.

When diagnosing compulsive and repetitive conditions, the first step is a complete physical and neurological examination. Routine blood work and urinalysis can help to determine your pet’s overall health and function of internal organs along with any other diagnostics that your veterinarian may feel is necessary. Video recordings of your pet when you are not there to observe their behavior can help differentiate attention-seeking from compulsive behaviors.

Treating compulsive behaviors is a multi-step process.

1. Manage specific triggers: Treatment starts by avoiding specific triggers for the behavior whenever possible. Turn off the lights or close the blinds to reduce the creation of shadows. Avoid punishment or physically stopping your pet from performing the behavior. Both cause conflict and may result in an increase in anxiety or aggression directed at you.  
2. Manage anxiety: Anxiety often contributes to compulsive behaviors, so it is important to treat the anxiety in addition to the compulsive behavior.
3. Avoid reinforcing the behavior and provide distractions instead. Food dispensing and puzzle toys can be great ways to distract your pet to reduce the compulsive behavior.
4. Use positive reinforcement to teach and reinforce alternate behaviors such as coming when called, going to a mat, nose targeting, eye contact, and a chin rest. 
5. Make sure your dog’s basic needs are being met with physical activity and mental enrichment to reduce the opportunity for compulsive behaviors to occur. 
6. Medications may be needed for the treatment of compulsive behaviors.

Compulsive and repetitive behaviors may require lifelong treatment for your dog. Relapses can occur if they become stressed or experience conflict or frustration. If you have not seen improvement in two to three months or the behavior worsens, your dog should be reevaluated by your veterinarian. Compulsive behaviors are often managed for life, not cured.

Cerenia®, an FDA approved medication, is effective at preventing motion sickness in dogs. If the anxious behavior does not persist, then motion sickness was likely the cause.

Step 2: Pheromones and Aromatherapy

Adaptil®, a pheromone, is an odorless message specific to dogs that can help dogs feel calm and relaxed during times of stress. Feliway®, is the cat version. Pheromones are sprayed on the floorboards, in your pet’s carrier, and where your pet rides.

Wait 10 minutes before letting your pet back in their carrier or car and never spray directly on your pet.

Lavender, chamomile, and sandalwood scents are thought to reduce anxiety and have a positive effect on behavior and mood. A study was published showing dogs spent significantly more time resting and sitting and less time moving and vocalizing during car rides when lavender was introduced for car rides.

Step 3: Window Shades and Thundercaps

Blocking the view outside can be dangerous to the driver. Tools such as small window shades or a Thundercap are helpful in reducing both motion sickness and car ride anxiety.

Step 5: Long-Term Treatment

There are many approaches to decreasing your pet’s anxiety in the car. All techniques start with a calm and relaxed animal. Conditioning relaxation on a mat or the use of a Treat&Train® are helpful when modifying this behavior.

Step 6: Medication

Medications can be helpful when reducing anxiety in the car. Talk with your veterinarian about options for your pet.

It turns out each type has a different potential for toxicity. In order to understand which types of chocolates are more toxic, we will need to review how chocolate is made.

Cocao trees, which require a tropical climate, are farmed in orchards like any other fruit-bearing tree. The fruit of the cacao tree, called a cacao pod, is sweet and attracts monkeys or other wildlife who eat the fruit but not the bitter seeds. The seeds are discarded in the natural setting, allowing new trees to grow. Outside of the farm situation, the seeds cannot be released from the fruit unless some type of animal breaks the fruit open. Ironically, it is the bitter seeds, packed with theobromine and caffeine, which are used to make chocolate.

The pods grow directly off the trunk of the cacao tree and must be harvested by hand so as not to damage the tree. The pods are split, and the seeds are scooped out and left to ferment under banana leaves for about a week. This process turns the cocoa seeds into the rich brown color with which we are familiar and creates the chocolate flavor we crave.

The seeds are then dried out for another week, packed in sacks, and shipped to chocolate manufacturers. The seeds must be roasted, ground, pressed to remove the seed oil (this oil is called cocoa butter, which is used in sunscreens, white chocolate, and cosmetics, among other things), and finally tempered to create the exact consistency.

• Chocolate liquor is the liquid that results from grinding the hulled cacao beans.
• Cocoa butter is the fat that is extracted from chocolate liquor. It is combined with sugar and flavoring to create white chocolate. White chocolate is not directly toxic as it has no chocolate liquor, but its rich fat content can be a problem, as discussed below.
• Cocoa powder is the solid that remains after the cocoa butter is removed from the chocolate liquor. The powder can be treated with alkali in a process called Dutching, or it can be left alone. Note the low-fat nature of cocoa powder, hence its use in low-fat baking.
• Unsweetened (baking) chocolate is basically straight chocolate liquor containing 50% to 60% cocoa butter.
• Dark chocolate (also known as semisweet chocolate) is chocolate that is 35% chocolate liquor (the rest being sugar, vanilla, or lecithin).
• Milk chocolate is chocolate that is at least 10% chocolate liquor, the rest being milk solids, vanilla, or lecithin.
• Chocolate liquor is the one with all the problem biochemicals. The more chocolate liquor is in the end product (i.e., how dark the chocolate is), the more toxic it is.                                                                                                                                                                                                                      Pancreatitis

Sometimes we eat chocolate plain, as in candy. Sometimes we eat it baked into cakes, mixed into ice cream, etc. Sometimes we share these treats with pets, and sometimes, our pets share these treats without our permission. As far as pets are concerned, the first potential problem with these sweets is the fat. A sudden high-fat meal (such as demolishing a bag of chocolate bars left accessible at Halloween time) can create a lethal metabolic disease in dogs called pancreatitis.  Vomiting, diarrhea, and abdominal pain are just the beginning of this disaster. Remember, in the case of pancreatitis, it is the fat that causes the problem more than the chocolate itself.

The fat and sugar in the chocolate can create an unpleasant but temporary upset stomach. This is what happens in most chocolate ingestion cases.

Theobromine and Caffeine

Theobromine causes:

• Vomiting 
• Diarrhea 
• Hyperactivity 
• Tremors 
• Seizures 
• Racing heart rhythm progressing to abnormal rhythms 
• Death in severe cases

Toxic doses of theobromine are 9 mg per pound of the dog’s weight for mild signs and up to 18 mg per pound for severe signs. Milk chocolate contains 44 mg per ounce of theobromine, semisweet chocolate contains 150 mg per ounce, and baking chocolate contains 390 mg per ounce. White chocolate has virtually no theobromine and is only a problem because of its fat content. These calculations seem complex, and they certainly can be. What it boils down to is that your veterinarian will need to know the type of chocolate and how many ounces were most likely consumed. If it is not clear how much chocolate was actually consumed, the largest possible amount should be determined based on how much candy, cake, etc., is missing.

It takes nearly four days for the effects of chocolate to work its way out of a dog’s system. If the chocolate was only just eaten, it is possible to induce vomiting; otherwise, hospitalization and support are needed. It is common for clinics to receive phone calls about pets who were found to have consumed a chocolate product, and the owner wishes to know if the amount was toxic. In order to answer such questions, it is necessary to know the pet’s weight, the type of chocolate, and the amount of chocolate. Chocolate calculators are available at most veterinary practices, and it can be determined relatively quickly if the pet should be made to vomit immediately. 

Treatment

As mentioned, the first step is to remove as much chocolate from the body as possible by inducing vomiting or using adsorbents such as activated charcoal to bind the chocolate and keep it from being absorbed by the GI tract.  For many patients, removing undigested chocolate converts the toxicity from neurologic poisoning to just an upset stomach that is easily managed. If too much caffeine/theobromine has been absorbed, the treatment is support: sedation for the tremors and intravenous medications for any cardiac arrhythmias. Support is needed until the toxins have been processed and removed from the body so expect severe cases to need intravenous fluid support and hospitalization for a few days.

An ounce of prevention is worth a pound of cure. Keep chocolate treats where your pet cannot reach them.

Hemp plants are legal to grow so long as they contain less than 0.3% THC, the chief recreational cannabinoid of Cannabis.

Cannabinoids are the active Cannabis-derived substances that have pharmaceutical activity. Over 480 relevant substances have been isolated. The amount of each contained in a sample of Cannabis will depend on the subspecies of plant, how it has been dried, the time of year it was harvested, the age of the plant, and other factors.

The body has natural cannabinoid receptors in neurologic cells as well as in immune cells. Effects of cannabinoids are only partly through these receptors. Our bodies make natural cannabinoids as well. Cannabinoids can have assorted pharmaceutical effects: reduction in nausea, induction of euphoria, interference with short term memory and ability to filter insignificant information, increased appetite, antioxidant effects, anti-inflammatory effects, antibacterial effects, and more.

The psychoactive chemical that makes a recreational drug is delta 9-tetrahydrocannabinol, more commonly called THC. It is typically 1-8% THC while hashish, made from the flowering tops of the plant and their resins, can contain up to 10% THC.

Another cannabinoid chemical is cannabidiol, commonly referred to “CBD”, which is not considered recreational and is of a more medicinal nature. Cannabidiol has been used in human medicine to mitigate anxiety, improve appetite, relieve nausea, control seizures of certain types, and assist in sleep disorders. Assorted CBD products are available for human use both online and through dispensaries. Some products are marketed for pet use though is, with rare exception, not legal (see section below).

Cannabis plants have been used medicinally for thousands of years. Cannabis was made illegal in the U.S. first in 1911 and was ultimately listed in the Controlled Substance Act of 1970 as a schedule I substance, meaning that it has no accepted medical use. In recent years, attitudes have changed and medical use first became legal in 1996. As medical uses for cannabinoids are being explored and more states legalize medical and recreational Cannabis, exposure of pets to THC has increased dramatically, particularly in dogs.

Cannabis Intoxication in Dogs

The usual pet toxicity case involves a dog that has inadvertently eaten it. In dogs, clinical signs typically begin 30 to 90 minutes after it has been eaten. Because THC is stored in the body’s fat deposits, the effects of ingestion can last for several days.

Symptoms

Signs include: incoordination and listlessness along with dilated pupils, slow heart rate and sometimes urinary incontinence. A characteristic startle reaction has been described where the pet appears drowsy and even may begin to fall over but catches balance. Cannabis toxicity can look similar to intoxication with numerous other sedatives, but the most serious consideration is anti-freeze poisoning, which looks similar in its early stages and is usually fatal if not diagnosed early.

The dog in this video stole a Cannabis-containing baked good from the owner. Note the characteristic startle response and balance issues.

It is important for all the relevant exposure information to be given to the veterinarian if the pet is to be helped; veterinarians are not obligated to report anything to local police. If you know Cannabis was involved in an intoxication, you must tell the attending doctor. Obviously this goes for other recreational drugs as well.

Urine testing similar to that done with humans can be done in dogs to make the diagnosis of Cannabis intoxication. Test kits are available at most drug stores and can include assays for a number of recreational drugs. A relatively large volume is needed to run these tests, so if the pet is small this may be difficult to obtain, particularly in a female. Also, false negatives are common when the THC urine test is performed on pet urine; a positive is confirmatory but there are many false negatives as the metabolites relevant to the test are different between dogs and humans. In most cases, the diagnosis is made based on the clinical presentation of the dog plus history of Cannabis exposure.

Treatment

If less than 30 minutes have passed since the Cannabis has been eaten, it may be possible to induce vomiting, but after symptoms have started the nausea control properties of the cannabidiol make it difficult to induce vomiting. Furthermore, if the patient is extremely sedated, vomiting can be dangerous as vomit can be inhaled and cause a serious and deadly aspiration pneumonia.

Activated charcoal is a liquid material used in treating poisoning. Activated charcoal is given orally and as it passes from one end to the other, toxins are trapped in the charcoal so that when the charcoal passes from the patient, the toxins pass too. This technique of detoxification may be used to treat Cannabis toxicity if ingestion has occurred recently.

Fluid support and keeping the patient warm may also be needed. If the patient has lost consciousness, then more intense observation and support is needed. The chance of fatality is statistically small but possible. In most cases, the patient can simply be confined to prevent injury until the THC wears off.

Medical Cannabis Products for Pet Use

As medicinal Cannabis becomes legal and commonplace in the U.S., many people wish to try products on their pets. Some cannabinoid companies even make products packaged for pet use. There are several reasons to be cautious about using these products. Here are some to consider:

• The FDA, being a federal agency, does not recognize any of these products as legal and thus their manufacturers are not required to show them to be effective. Similarly, they are not required to actually contain the amount of active ingredient they claim to have. (In several studies, numerous CBD oils were found to contain no CBD whatsoever. See this link for details.
  
• An effective cannabinoid dose quickly becomes ineffective as the body becomes tolerant to the medication and more is needed to generate the desired effect. A cannabinoid that seems to create a good effect at first, is not going to be useful later on. How long does it take for a dose to become ineffective? No one knows but there was a study showing that with regular use, a toxic dose is no longer a toxic dose after one week.
  
• According to the American Veterinary Medical Association, “under current federal and state law, veterinarians may not administer, dispense, prescribe or recommend cannabis or its products for animals.” None of the laws allowing for legalization of Cannabis use extend to pet use. Pet use of cannabinoid is not legal with only a few exceptions.
  
• Research involving cannabinoid use in pets in sparse. Until research gets underway and more is published, proper regimes for pets are not available.
  
• While these products are most likely safe and readily available, none of them have been formally investigated for pet use in the same way that FDA-approved medications have been. If there is a product that actually has been proven effective and is available through your veterinarian, you may get better results from a more mainstream treatment plan.

Cannaboids will interact with other medications so if you plan to use any of these products, be sure your veterinarian is aware that you are doing so. Keep any medicinal or recreational products out of the reach of pets and children.

The ASPCA’s Animal Poison Control lists these products as the most common ones that can poison pets. These are not the only ones, just the most common ones.

Household Products

• Bleach
• Carpet fresheners
• Carpet Shampoo
• Essential oils
• Fabric softener sheets
• Grout
• Toilet cleaning tablets
• Vinegar and water

Medications and Cosmetics

• Adderall
• Petroleum jelly
• Aspirin, baby aspirin
• Bar soap and face wash
• Breath fresheners (Xylitol)
• Cigarettes and nicotine patches
• Ibuprofen and naproxen
• Kaopectate and Pepto Bismol
• Mosquito repellent with DEET
• Pseudoephedrine (and other nasal decongestants)
• Sorbitol
• Topical creams/ointments (read labels for ingredients)

Most pet owners know that chocolate is bad for dogs and can cause significant problems for a dog; cats are usually too finicky to eat it. But what signs of chocolate toxicity should you look for when you know your dog ate chocolate, and what should you do?

Just ingesting chocolate, which most dogs don’t typically eat every day, can cause an upset stomach.  In these cases, you can see:

• Vomiting
• Diarrhea
• Abdominal pain
• Lack of appetite

If you notice any symptoms after your dog eats chocolate, it’s best to have them evaluated by a veterinarian or emergency clinic quickly. The theobromine can also cause a dangerously rapid heart rate and high blood pressure, both of which may require treatment.

What to Do

A small amount of milk chocolate, like the amount found in a chocolate chip cookie, is not a problem.

For larger, recent exposures, just getting your dog to vomit the chocolate is enough. Your veterinarian or local emergency clinic can help you with this, so call them if your dog has ingested chocolate. They can help you decide when, how, and where to induce vomiting and if further therapy is needed. In cases where a dog is showing signs of chocolate toxicity, they can also start treatment and contact an animal poison control center for guidance. 

The ASPCA National Animal Poison Control is available 24 hours a day at 888-426-4435. Expect an initial consultation fee of around $100.00 and additional follow-up is at no charge. You will be assigned a case number your veterinarian can use to communicate with a toxicology specialist before beginning treatment. 

Pets Can Participate in Their Own Care Routines

Teaching pets to take part in care routines should be prioritized over modifying the pet’s behavior for other reasons, such as obedience training.

Modern zoos care for animals, which are often massive, without resorting to physical restraint. Imagine a giraffe voluntarily stepping onto a giant platform to get weighed. Picture a tiger presenting his tail through a small window of an enclosure to have a blood sample taken. For so many reasons, it is not effective to repeatedly dart and fully anesthetize these cherished animals every time healthcare is needed. Veterinary teams can implement these sophisticated but user–friendly techniques by prioritizing Low Stress Handling®.

This is an exciting time in veterinary medicine. Practitioners certified in Low Stress Handling® are joining forces with clients, board-certified veterinary behaviorists, and trainers who use positive reinforcement methods. The collaborative goal is to strengthen the human-animal bond by implementing these powerful cooperative care techniques for the benefit of clients and patients.

When Pets Say “No” To Care Routines

Cats and dogs sometimes growl or hiss when the veterinarian walks into the room, cower during examinations, or try to flee at the site of a nail trimmer. Fear can escalate to a point where the pet refuses to allow veterinary personnel to touch them. Pets can become so fearful, resistant, and defensively aggressive when visiting the veterinarian that the staff runs out of options to provide care to these patients. These pets may then need to be referred to board-certified veterinary behaviorists.

It is also common for pets to become frightened during home care routines. One painful or scary experience, such as exposure to a loud set of clippers, a cleaning of a painful, infected ear, or an accidental clip of a toenail to the quick can result in a pet developing lasting memories of that event. Each animal experiences handling, restraint, and care in different ways. Sensitivity levels vary among pets, with some being more prone to stress and anxiety than others. These pets that show avoidance or resistance during care routines at home, in grooming salons, or at animal hospitals are exhibiting signs of anxiety, fear, or both.

Low Stress Handling® veterinary practitioners will do everything they can to provide a pleasurable experience during veterinary care. Your pet’s veterinarian may prescribe short-term, anti-anxiety medications before scheduled appointments. They may also make environmental modifications, such as bringing your pet into the exam room by skipping the busy lobby. The veterinary team will treat pets in the exam room (rather than “the back”) whenever possible. Low Stress Handling® practitioners will make sure clients are included in the decisions being made about the pet’s care. When caregivers understand their pet’s emotional state, it helps everyone make better decisions together. It is imperative to slow down and realize that continuing a procedure with a fearful pet makes the patient less treatable in the future. Realizing when pets are anxious or frightened is half the battle.

Cooperative Care Teaches Pets to Say “Yes” to Care Routines

Core Concepts in Cooperative Care:

Emotional health status and medication use. Before teaching cooperative care routines, a veterinarian should evaluate a pet’s physical and emotional health. Some patients are simply too anxious to learn. Medications can be helpful in creating a comfortable starting point by relieving the pet’s anxiety enough to allow them to participate and receive food for counterconditioning.

Veterinarians may prescribe medications to reduce overall anxiety or situational medications intended for use before stressful events, and sometimes both. Using multiple medications can help to avoid the sedating effects that may come with a larger dose of a single medication. Additionally, many pets may require short-term anesthesia for veterinary care or grooming until they can be successfully retrained through cooperative care routines.

Body Language. Each species of animal communicates with their own unique body language. Interpreting what pets are communicating with their body language does not come naturally to most people. Your Low Stress Handling® Certified veterinary practitioner can guide you to the appropriate professional who can help you interpret your pet’s body language. These professionals include board-certified veterinary behaviorists (DACVB), board-certified veterinary technician specialists in behavior (VTS), and progressive positive reinforcement trainers who have a close association with the veterinary behavior community. Trainers who use any form of punishment or recommend prong or shock collars, choke chains, etc., should be avoided. These techniques break down the human-animal bond and potentially intensify fear and fear aggression.

Prevention. Resilience conditioning is defined as supporting an individual’s ability to recover from stress. If young pets display sensitivity to being touched, during routine handling, it is time for intervention and changing the approach to improve their ability to recuperate from stress. Support and agency are core concepts in both resilience conditioning and cooperative care.

Low Stress Handling® veterinary practitioners have a crucial responsibility to support each patient’s resilience for future care events. This is achieved by providing predictability, social support, and agency during veterinary care. For example, kittens might lick baby food off a lick mat during procedures, puppies can be trained to stand on a platform for treats while undergoing a gentle examination, and any non-essential treatments should be postponed if a patient shows signs of being overwhelmed. Each time cooperative care routines are practiced with puppies and kittens, they start to remember that veterinary visits are safe and predictable.

Veterinarians and veterinary technicians are integral in preserving the human-animal bond (HAB). This bond can deteriorate when clients struggle to care for pets at home or when veterinary professionals cannot effectively treat patients who have become fearful or dangerous. A simple yet effective preventive measure is to continuously feed a puppy or kitten throughout their veterinary experience. This approach helps these young pets develop resilience and reduces fear in care contexts.

By gradually introducing pets of all ages to home and veterinary care routines and by pairing those routines with high-value food and other pleasant experiences, pets find pleasure in care procedures. When pets remember these experiences as enjoyable, they want to do those activities again.

Important Tip: The frequency of treats during cooperative care is continuous at first, 10 to 15 per minute. The treats should be pea-sized and delicious.

Targeting and Stationing. Targeting and stationing are valuable techniques for training animals to participate willingly in their care. Targeting involves training an animal to direct a specific body part, or their entire body, toward a designated point or object. This method can be applied to various animals and for different purposes. For instance, a parrot may be trained to target their wing into a person’s palm for feather inspection or a dog can be taught to touch their nose against a wall and stand still for a short veterinary examination.

The practice of targeting behaviors paired with positive reinforcement (e.g., food) for each repetition helps to make targeting and the target object safe and predictable for the animal. For example, if a dog is taught to target the inside of a basket muzzle with their nose, the muzzle becomes a familiar and non-threatening object. This principle can be extended to a variety of grooming and veterinary tools.

Stationing is a technique closely related to targeting and is particularly useful in teaching animals to stay at a specific location for an extended period. This concept is highly effective in various settings and for different species. For instance, a horse can learn to station themselves in a particular spot for voluntary grooming and veterinary care, eliminating the need for restraints like cross ties. Similarly, a dog can be taught to stand on a yoga mat for home care routines, and this mat can then be brought to the veterinary clinic to provide a familiar and comforting environment. Cats can be trained to jump onto a pedestal to receive oral medication, making the process smoother and less stressful for the cat and the caregiver.

Choice, control, and consent. In traditional pet care or treatment methods, animals often have no say in the process, which can be confusing and frightening for them as they do not understand the intentions behind these actions. However, modern techniques in animal care are changing this dynamic. These techniques involve communicating intentions to the animals and teaching them to express “yes” or “no” to their care.

This approach of allowing pets, zoo animals, wildlife, and livestock to consent to or deny their own care has shown surprising results. Contrary to the assumption that when given a choice, pets would say “no” all the time, the opposite is often true. The more we acknowledge their “no” the more they begin to say “yes”. They begin to engage in their care routine.

Start Buttons. Start buttons are an innovative concept in animal husbandry and a key element in cooperative care routines, emphasizing the importance of animal consent and autonomy. By observing and reinforcing animals with food as they display natural and comfortable behaviors, these behaviors can be encouraged and, therefore, more frequently offered. The concept is to teach the animal to present these behaviors as a signal to initiate a care routine, effectively giving them a “start button” communicating that they are ready to start their care routine.

This method is being applied across various species. For instance, horses can be taught to nod their heads to communicate you can start brushing them. Dogs can be trained to rest their chin on a towel to indicate readiness for home care and to lift their chin as a signal of discomfort or the need to stop.

When a pet stops offering their start button behavior, they are withdrawing their active participation in the care routine, communicating a “no” or “I need a break.” The more a caregiver acknowledges when a pet says “no”, the more comfortable and less fearful or defensively aggressive the animal becomes in future care situations.

By empowering pets with the control to start and stop their own care routines at will, caregivers are providing their pets with autonomy. This practice not only improves the animal’s experience during care routines but also strengthens the trust and communication between the pet and their caregiver, enhancing the overall quality of care and the human-animal bond.