Threshold: Bowdu’s July checkup

Tags

aging dogs, canine hypothyroidism, finances, glucosamine, ichon, senior dogs, vet

I dreaded the accounting on this one, but delaying it doesn’t make the expense go away. Bowdu’s last vet checkup was a heavy one, financial and psychological.

For Bowdu’s annual exam, I had an additional concern. Bowdu’s back legs — his back right leg, in particular — had been shaky for quite some time now. Last year, the vet said it indicative of muscle weakness, a symptom that often accompanies hypothyroidism. Bowdu’s energy levels remain consistent, so we maintained observational hover pattern.

Unfortunately, in the last couple months, his hind leg seems to have been giving him more trouble. The shaking, which was fairly sporadic in the past, is fairly constant now. One day a couple months ago, he started walking with a limp and keeping that back right foot raised. This wasn’t set off by any memorable trauma, and our routine has been fairly steady and low-impact, all around. He wasn’t expressing any audible pain, so I kept watch and waited it out. He returned to normal stride after a few days.

A few weeks ago, the same thing happened again. This time, however, he wasn’t so quick to bounce back. He is clearly not jumping as high as he used to. Getting up on the bed is a two-step process now, using his dog bed (placed on a cushion at the foot of the bed) to trampoline himself up to the human bed. He even allows me to lift him into the car — something that he usually makes an undignified stink about. On our off leash walks, he boycotts certain regular routes that we’ve hiked for years, and won’t follow closely. This is unusual, even for his Shibaness.

(Apologies for the vertical videography)

The second video, in particular, is Bowdu at his creakiest and slowest. [**Significant ETA: I just realized the second video is from the same day of his vet exam, which means his slow motion is actually a residual effect of the Acepromazine. The pace helps to show his funny gait though.] He is not a young dog anymore, but at nine years old, this is not what I would expect either. So we went off to the vet for as full a workup as we could manage without sedation (other than his acepromazine) …

• Office Call: senior semi-annual exam, $56 $50.40
• Total Body Function, $179 $161.10
• Urinalysis add-on, $61 $54.90
• Comfortis, 12 doses (20.1 ~ 40 pounds), $201.06
• Referral credit, ($56.00)
• TOTAL: $411.46*

* Prices reflect my 10% student discount, where applicable

The bloodwork came back just fine, and his thyroids continue to be well managed at his current dosage of 0.2mg of Soloxine, twice a day. The physical exam, however, was a shrieking, fur-flying, anal gland-releasing mess.

So much for his winning streak as a “good” patient. Bowdu was not having it this time. Suffice to say, I’m now looking forward to another estimated $500 examination, which will include sedation and X-rays, to get Bowdu’s back end issues properly diagnosed.

Based on Bowdu’s history and what I know of other Shibas with similar health profiles, I strongly suspect it’s an ACL injury. I don’t want to say much more without an official diagnosis. In the meantime, he’s been getting loaded up on liquid glucosamine supplements (which I’d stopped for a while, and more on that some other day) and he continues to get daily fish oil capsules. His weight is good, so there’s no change to his diet. We continue our regular walks, including our off leash hikes along less strenuous trails, which I think gives him the freedom to move at his own pace and comfort.

I have to trust that he knows his own body as intimately as nature allows. He won’t tax or purposely hurt himself. It’s only been a couple weeks since his visit and about 10 days since I started loading him with glucosamine, but he’s been noticeably improved. His situation is far from dire, but it will need to be addressed.

And this, too, is when I feel the pressure of maintaining an aging dog on a student’s budget. Even if his situation is “just” remedied with steady glucosamine supplements, I think I’m looking at about an additional $200 a year on nutraceutical expenses — which I’m ready and able to do. What I do now will have an impact on Bowdu long beyond my current budget situation.

The vet also mentioned an injectible solution called Ichon which is more expensive, but reportedly, more effective. Absorption is one of the biggest variables across tablet, liquid, and now injectible forms of glucosamine, so I’m going to have to do some research to figure out a solution that works best for us.

Getting ahead of ourselves though, especially since there hasn’t been an official diagnosis. Apparently, the supplements — and time, of course — are making a difference, so this is what’s in our future. Clearly, we’ve passed a life stage threshold of some sort. While Bowdu may not be as active as he was even a mere year ago, there’s a lot of life in him yet. Learning how to make the most of it is an ongoing, mutual process.

Better

The Bows are doing better.

Bowdu’s looking extremely scraggly now that he’s lost nearly all his underfur. A few tufts remain to be plucked. At least his skin is not raw and red anymore, and he’s not frantically itching his chest.

This round of shedding produced a lot of dandruff along his back. I didn’t actually shampoo his back when I gave him the medicated bath that threw his skin oils out of whack, and I haven’t bathed him again since. Just letting him shed it all out, with some manual assistance, and supplementing with fish oil, vitamin E, and Honest Kitchen Sparkle.

It’s been a couple weeks, but Bowpi’s harness hasn’t arrived yet. I’ll have to report later. Her more extreme hacking cleared right up with meds and the return of clear skies. Yesterday brought another round of rain, and it seemed to me that she was chuffing a bit more with the wet weather. Perhaps that’s the connection after all.

For now, she still wears her limited slip collar, which is not an issue during our daytime off-leash walks. At night, I’m being extra careful to maintain a loose leash, though it can be a challenge when she insists on her own targets for the sniffing that MUST! happen at THAT! particular spot.

Like everything else in my life, I’m figuring this out as I go. Luckily, the dogs don’t judge too harshly for my missteps. They do get impatient when I move too slow and haven’t taken them out yet, according to schedule.

Deadlines and pushy hounds riding my tail…

Health update on the cusp of spring

Tags

flea dermatitis, hair loss, honest kitchen, kennel cough, skin and coat supplements, skin rash, tracheal collapse, vet

A health update is called for, as we’ve had a titch of trouble recently.

Last Wednesday, I brought Bowpi in to the vet. She’d been cough-wheezing for a while. It’d reportedly started in November, when I was still in Taiwan. I certainly noticed it when I came back — a sporadic, whuffing sound that came on when she was balled up, either getting into or just emerging from sleep. RJ figured it was due to the unusually dry winter we’ve been having in California, and as it seemed to come and go, we just kept monitoring her.

The cough suddenly got louder and more frequent over one rainy weekend, so I had her in ASAP. Basically, she was whuffing and chuffing in several, continuous, uncontrolled rounds, and doing a lot of this in addition:

… yet, she wasn’t coughing frequently enough that I could count on her to demonstrate her symptoms to the vet. So I took video. Even on the day that I brought her in, the rain had cleared up, and she hadn’t coughed for over 12 hours. And Bowdu, as you can see, has been his usual, doofy self, so it didn’t seem to be a highly contagious condition.

Based on the video, manual palpation, my description of the symptoms, and Bowpi’s overall age and stature, the vet’s diagnosis was partial tracheal collapse, aggravated by a secondary infection of kennel cough. She spared me the X-rays for a more precise diagnosis, since she was pretty sure that was what was going on, and her condition wasn’t severe. She was able to recreate the coughing sound in the examination room by pressing on Bowpi’s trachea, and noted that the condition was not in the esophagus, so there was some process of elimination going into the diagnosis too.

So we were sent off with a round of Doxycycline for the cough, and a harness for Bowpi is already on the way. I definitely feel some guilt, wondering if this all could have been prevented if I had just been walking Bowpi on a harness to begin with. Like pretty much every Basenji I’ve ever walked, she’s always been a puller, jerking with great determination (for such a small dog!) towards the object of her scrutiny. This is much less of a problem when she’s off leash, as the vast majority of our daytime walks tend to be.

Obviously, I can’t always walk her off leash, so I’m doing what I can to minimize the harm that’s already been done. Like the doc predicted, her cough cleared right up after a week of medication, and her chuffing has subsided to very occasional, and minor disruptions. Neither her energy levels nor appetite has been affected, and otherwise she remains in great shape, so we carry on, and will follow up by phone in a couple months.

I am transparent about pet finances on this blog, and since veterinary fees can be one of the most inscrutable costs, I present the itemized bill:

• Office call, $56 $50.40 (minus 10% student discount
• Doxycycline (strength: 25 mg/mL), 28 mL, $30
• TOTAL: $80.40

Meanwhile, Bowdu was off his flea medication schedule for over two weeks, as I’d forgotten about it in February’s flurry. This is atypical of me, and poor Bowdu is the one that had to suffer for it.

Due to what I think were some flea or bug bites, Bowdu got really itchy in a couple spots on his chest, resulting in the loss of large swathes of fur. I didn’t actually see any bugs, though I saw the bite areas, and I didn’t find anything on Bowpi, whose short fur is usually quick to reveal any such problems. However, knowing that Bowdu does react pretty intensely to bug bites, and given the intensity of the fur loss (most of it came right out within about a two day window), my first response was to get both dogs back on Comfortis, ASAP.

This does coincide with a seasonal fur blow, which is already pretty intense in its own right. Since a few years ago (with the diagnosis of canine hypothyroidism), I’ve noted that Bowdu does tend to lose his fur in big, bald patches when he’s shedding. Pictures from February 2011 for comparison:

Pretty much always the same areas around the neck, chest, and belly, but never his back.

This is clearly the worst Bowdu has had it in years, with raw red skin and hyperpigmentation and everything.

I gave him a bath with some medicated shampoo to try and ease the itch and speed along the shedding process. I think it was actually a little too intense and offset his skin oils, because he’s felt greasier since the bath. I’ll give him another week or so, and try again again with a gentle shampoo.

Meanwhile, he’s been getting generic diphenhydramine (Benadryl) about twice a day, with breakfast and before bedtime. He’s got his skin and coat supplements: the usual fish oil and vitamin E, and additional Honest Kitchen Sparkle (which is being discontinued due to “regulatory challenges combined with low sales” — time to formulate our own herbal blend!). His itching seems to be under control, he just looks and feels rough, and is a bit cranky about being touched in certain ways.

At least he’s not too self-conscious about showing off his precious, slightly bald tummy.

The Cost of things: February 2014

Tags

budgeting, canine dental, comfortis, dog clothing, dog treats, flea allergies, flea preventatives, hurtta, pet finances, petmeds, soloxine, virbac

This is my fourth year of tracking pet finances at the House of Two Bows. This is an ongoing effort to get a practical sense of what it costs to keep two 20 ~ 30 pound adult dogs in an area of the US with relatively high costs of living. Previous posts in this series can be found under the category of finances.

The Cost of (Pet) Things for February 2014:

• Food: $10 [previous month, $67]
• Treats: $12 [previous, $50]
• Grooming: $8 [previous, $0]
• Vet & Medical: $121 [previous, $0]
• Accessories and misc: $44 [previous, $23]
• TOTAL: $195 [running average for 2014: ~$167.50/month]

Yeah for an awesomely low FOOD total! Well, that’s about as low as it ever gets, anyway. Rocking the power of 50% discounted chicken, cheap organs, and working through the food we already stockpiled.

For treats, the Bows got a bag of C.E.T. HEXtra Chews in the “petite/small” size, which I have found to work pretty well even though they’re marked for dogs under 11 pounds. The other sizes are made from chlorhexidine coated rawhide, while the petite size is about a five-inch long stick of what I can only describe as a “hide-like compound.” Well, I mean, they are made of actual beefhide, and other ingredients, but it doesn’t look like it. They seem less of a choking hazard and less apt to cause intestinal blockage for the Bows, anyway.

These days, I’m hard pressed to find anything I need to bump up my PetMeds orders to reach their minimum threshold for free shipping. I tacked on one grooming/hygiene item, another tube of dog toothpaste, because an order was necessary in the next category.

For Vet and Medical needs, Bowdu got another 250 days of Soloxine refills at 8 cents a pill for 0.4 mg (or 0.2 mg per dose, twice a day) from PetMeds. That’s a good deal.

What was not a good deal and kind of pissed me off was that Comfortis prices have yet again been jacked up, at $100.53 for a box of 6 ordered directly from my vet. No free dose this time. This is up about $10 from last year, purchased at $92.12. Yet, it’s still cheaper to get it directly from the vet, since this is the only way you qualify for the ongoing Elanco rebate (minus $10 on a pack of 6, or $25 on a pack of 12). PetMeds charges $98.99 for the same amount, and the rebate does not qualify.

Not that the rebate is much to praise. My WTF, Elanco? post, in which I ranted about the company’s repeated difficulties with processing my simple rebate, has become one of this blog’s most visited and commented posts, even a year after I wrote it.

I swear, I only stick to Comfortis because we have no better alternative, specifically for Bowdu and his flea allergy dermatitis that is made worse with his thyroid condition (more on that in another post). Anyway, if I’m ever at the vet at the same time that the Elanco rep is dropping in, boy do I have a lot I want to say…

[Edit 7 March 2014: Elanco now has an online electronic rebate submission form. Interesting. Let’s see if that streamlines the process at all…]

Finally, in accessories, I picked up a Hurtta outdoor jacket for Bowpi, because rain! (we need it badly, here in California). And I got it on sale at an excellent price! And her three-year-old Outward Hound jacket (pictured below) is getting ratty and in need of replacement!

And… and… Dammit, I really don’t have any good excuse to have spent $40+ (with shipping) on a freaking dog jacket. Sigh. I admit, I did it in a moment of weakness. The item hasn’t arrived yet, and I’m skeptical about feeling like my purchase was justified once I receive it. At least, given the good things I’ve heard about Hurtta, it better not suck.

The cost of things: July 2013

Tags

acepromazine, blood tests, budgeting, pet finances, vet

Another month, another barrage of expenses…

This is my third year of tracking our pet finances here at the House of Two Bows. This is an ongoing effort to get a practical sense of what it costs to keep two 20 ~ 30 pound adult dogs in an area of the US with relatively high costs of living. Previous posts in this series can be found under the category of finances.

The Cost of (Pet) Things for July 2013:

• Food: $76 [previous month, $14]
• Treats: $5 [previous, $28]
• Grooming: $0 [previous, $0]
• Accessories and misc: $0 [previous, $0]
• Vet & Medical: $289 [previous, $0]
• TOTAL: $370 (running average for 2013 ~$172/month)

WARNING (a reminder to myself, to cushion the blow): For July and into August, I am in stockpile mode. Expenses for the Bows are expected to plummet after that, because I am not going to be here to buy them things, and I am the primary purchaser of supplies at the House of Two Bows. I’ll explain shortly; details are hard to divulge at the moment.

Food expenses weren’t nearly as bad as anticipated, given all that I purchased: approximately 20 pounds of raw chicken portions, several pounds of organs, and ten pounds of whole sardines. I’ve portioned things out and really can’t stuff anymore into the freezer unless I eject all the human food. This should be enough raw meat to last several months (since they’re not on a fully raw diet), supplemented by occasional purchases of turkey parts when they roll back into season, and other freshly butchered meats.

Rounding out the food expenses for the month were the usual tubs of plain yogurt, a small stack of Weruva canned food that will serve as emergency rations, and joint supplements purchased from Prime Pet Supply.

Treat expenses were simply 2 pounds of chicken hearts, which are sitting in the dehydrator as I type. We also got a boost from the folks at Chewy.com in exchange for another review coming up shortly…

Veterinary and medical expenses were the biggies this month. Bowdu’s last veterinary checkup was October 2012, and Bowpi’s was just this last March 2013. Knowing what a pain he can be to examine, the vet seems to be doing us a favor by letting us prolong Bowdu’s blood draws (to check thyroid function) to once every 8 to 10 months, instead of every 6 months as is typically required. However, they still want us to come in for physical exams before signing off on his Soloxine prescription.

So Bowdu got dosed up with Acepromazine (he takes just one 25mg pill beforehand, but we keep a couple extra on hand for future occasions), and I brought them both in for an exam. Might as well, since I’m going to be away for a while, right? I’m a little miffed though, because I had scheduled an appointment with a new receptionist and asked explicitly if bringing both Bows together would count as one visitation fee — and she said yes. I should have known better, as the final bill accounted for each of them separately.

VET BILL
• Acepromazine (25 mg @ 3 tablets), $16.09
• Office call: annual exam, 2 @ $56 $50.40 = $100.80
• Total body function (includes thyroid), $169 $152.10
• Canine rabies, 3 year booster, $21.75 $19.58
• TOTAL BILL: $288.57 (after 10% student discount)

I expressed that it wasn’t what I was expecting, but I didn’t argue. Each Bow did occupy a separate appointment slot, after all. But I knew there was nothing wrong with Bowpi, and really didn’t need to shell out $50 for the vet to tell me that she needs to lose about a pound, because I know, I know… I blame summer communication issues between meals, as RJ has been handling breakfast and I’ve been doing their dinners, and it’s hard to balance portions day by day when each side isn’t monitoring what the other’s doing. Grr…

Anyway, Bowdu’s bloodwork and three-year rabies booster comprised most of the hefty bill. On the upshot, he didn’t utter a single shriek this time, and we were told that he does seem to be getting better with each visit. That doesn’t mean he’s learning to enjoy the vet. He’s just resigning himself to the experience — sedative, Thundershirt, basket muzzle and all…

For those of you with multiple dogs, I’m curious about your vet experiences. I understand the logic behind individual consultation fees, but I am wondering — does your vet offer multi-pet discounts?

I’m griping out of surprise because this is the first time since getting Bowpi that we have been charged for two separate consultations. We’ve had first-time intake appointments accounting for both dogs with two different vets (including this one), and were only charged a single visitation fee each time. Perhaps intake appointments are automatically blocked across two time slots, so the single fee was an introductory courtesy. At any rate, I now know that this is my vet’s policy so I won’t be surprised next time. I preferred bringing them in one at a time, anyway.

The cost of things: May 2013

Tags

allergies, budgeting, goat's milk, heartworm, honest kitchen, iverhart, joint supplements, pet finances, petmeds, soloxine, sparkle, wapiti labs

This is my third year of tracking our pet finances here at the House of Two Bows. This is an ongoing effort to get a practical sense of what it costs to keep two 20 ~ 30 pound adult dogs in an area of the US with relatively high costs of living. Previous posts in this series can be found under the category of finances.

The Cost of (Pet) Things for May 2013:

• Food: $67 [previous month, $66]
• Treats: $16 [previous, $11]
• Grooming: $0 [previous, $7]
• Accessories and misc: $0 [previous, $0]
• Vet & Medical: $54 [previous, $0]
• TOTAL: $137 (running average for 2013 ~$158/month)

For food and the Bows’ daily diet, aside from the usual yogurt and fresh meat here and there, this month was mostly about supplements. A free shipping offer from The Honest Kitchen allowed me to stock up on a couple canisters of Sparkle at a reasonable price. I added this skin, coat, and digestive supplement to their daily meals around this time last year — right at the cusp of Bowdu’s spring coat blow, and into the summer allergy season. Though he’s got some patches of black skin on his legs now (as has been typical for the past few years), he got through last summer quite nicely, so I’m implementing the same regimen again.

The Honest Kitchen also sent us a complimentary grab bag of supplements to try out, including a couple packs of their brand new goat’s milk supplement, Pro Bloom. I’m trying to dig up info on goat milk for dogs, which they are selling as a formula rich with digestive enzymes and probiotics. Will report back in due time…

One last biggie purchase also came at a significant discount from the Pawalla shop — a 30 gram bottle of elk velvet antler extract from Wapiti Labs, which I’ll be alternating with liquid glucosamine supplements for a while. I prefer joint supplements in additive forms, as opposed to tablets or chewable treats, because it seems easier to add the amount I want directly to their meals.

Treats included a round of Honest Kitchen Beams and a couple pounds of chicken hearts and gizzards for the dehydrator. This is one of RJ’s favorite thing to do for the Bows… and by this point, I believe the dehydrator has finally paid for itself!

Finally, for medications, I stocked up on another 250 days worth of Soloxine (0.4mg pills broken into two halves, twice a day) for $20 via PetMeds. They’re usually slightly more expensive than that, but PetMeds does have a price-matching guarantee that they’ve always been good to honor, when I point out that Drs. Foster and Smith sell the same pills for less.

I also seriously considered stopping heartworm medication for the Bows, given the very, very low incidences of heartworm in our local microclimate. Basically, as my vet explained when I was discussing this option with her, the nightly fog that creeps over the area drops temperatures below a level that allows mosquitoes to propagate. However, we had a couple heat waves, and the buzz of a single mosquito one night made me paranoid… So I figured that if I were to take the Bows off heartworm medication, summer is not the time to do so.

I got Iverhart. It was cheap. Cost is a concern at the moment… which is why budgets are necessary.

Next up: Reporting on the Novato Shiba Picnic 2013!

Comfortis: monthly flea protection in an oral dose

Tags

ADE reports, advantix, adverse drug experiences, allergies, bad reactions, Center for Veterinary Medicine, comfortis, drug reactions, drugs, elanco, FDA, flea allergies, flea dermatitis, flea preventatives, fleas, frontline, milbemycin oxime, spinosad, trifexis, veterinary medicine

When Bowdu was battling his summer of extreme allergies, I became adamant about the need for continuous flea control. In the past, we’d used monthly topicals with apparent success. It was difficult to see any bugs camping out in Bowdu’s thick fur forest anyway. But in the process of trying to deal with his allergies and improve his skin condition after his hypothyroidism diagnosis, our vet — a new one to us, at the time — recommended that we bathe Bowdu a little more frequently during allergic months, and give him an oral flea preventative to complement that measure. She recommended Comfortis (spinosad), which we’d never tried or heard of before from any of our previous vets. We started using it in October 2010 and have been satisfied with its effectiveness.

There are several disadvantages to spot-on topical flea treatments like Advantix and Frontline. The application process itself isn’t an issue, but I never liked the smell — and if I dislike it, I can only imagine how the lingering scent assaulted Bowdu’s sensitive nose. They leave an unnatural residue, I couldn’t bathe let alone touch the dogs for days after application, and even when instructions were followed to the letter, fleas seemed to return well before a whole month had lapsed… as we found out when we got Bowpi, whose short fur made them easier to detect.

The Bows are active, outdoorsy, and relatively social. If we do nothing, they will pick up fleas, and the last thing we need is an infestation in the house. So it’s critical for me to keep them on some kind of flea preventative — Bowdu in particular, as I fear that a single bite could trigger an itch that would cascade into another summer of dermatitis hell.

So Bowdu gets his flea meds pretty much every month here in the California Bay Area, the land of eternal spring. Fleas never seem to go dormant here, and I’d rather Bowdu be on prevention than deal with the aftereffects. I am more conservative dosing Bowpi for a number of reasons.

For one thing, she really hates the taste. Comfortis claims their product is a “chewable, flavored tablet” that is “readily consumed by dogs.” If it tastes like it smells, it must be rich with the flavor of… medicine. Blechk. We learned just how adept Bowpi can be at spitting out pills because of this drug, which she will NOT ingest unless it’s split up and well hidden in a flavorful, sticky meal. Since you’re supposed to administer this with food, luckily this is not a huge issue.

Secondly, Bowpi’s short fur makes it not only makes it easier to find, but also to eliminate fleas by hand. I’ll often let her go without the drug until I do happen to see a bug. Then I snatch it off her white belly or wherever, she gets medded at next meal, and the problem is quickly resolved. It is startlingly fast and effective; one time, I just happened to find a dead flea on her two hours after dosing her. The package claims that one dose will start killing fleas in 30 minutes, and it remains effective for an entire month. I do not exactly understand the internal mechanism by which the drug spinosad works, but it’s obviously potent!

The main reason I take it easy with Bowpi is because of her weight. She ideally hovers around 20 pounds, give or take half a pound. But the first time my vet sold us the drug, she automatically prescribed the same dosage for Bowpi as 30-pound Bowdu. This makes it easier for us to just buy one box specified for dogs 20.1 ~ 40 pounds that we can give to either dog as necessary, instead of having to purchase two separate boxes.

HOWEVER, I do not give either dogs a full pill. I generally break each tablet into four quarters as evenly as possible, and give Bowpi the equivalent of half a pill while Bowdu gets three-quarters.

I do this for a couple reasons. Elanco’s product label for Comfortis states that the 10.1 ~ 20 pound dosage contains 270 mg of Spinosad per tablet. The 20.1 ~ 40 pound contains 560 mg of Spinosad per tablet, or just a little more than double the amount of drug in the previous weight range.

Recommended minimum dosage for the drug to be effective is 13.5 mg/pound — so each dose actually contains just a little more than this baseline amount for the top end of the weight range to ensure the drug’s effectiveness. Bowpi for example, if at a full 21 pounds, would need at least 283.5 mg (50.6% of a pill) and Bowdu at 30 pounds needs at least 405 mg (72.3%). The drugmakers expect the dogs to be able to tolerate some overage, and indeed, my dogs never seemed to have any problems the two times I gave them the full pill.

Unfortunately, many others do. I first noticed an alarming number of online reports of negative reactions to Comfortis collected in the comments section of an entry by Dr. Patty Khuly dated March 29, 2008 on Fully Vetted, Comfortis, the flea-killing wonder drug, and the general state of flea drug resistance. It was introduced to veterinary use that year, and Dr. Khuly was singing its praises. The comments piling up under that post, however, seemed overwhelmingly negative — now at 139 comments at the time of this post and still accumulating, including the top voted comment about a Shiba Inu’s bad reaction. I have seen no followup on Fully Vetted or on Dr. Khuly’s new blog at VetStreet.

And then I started noticing handfuls of Shiba and Basenji people on my breed-specific forums reporting and asking about bad reactions to Comfortis and its sister drug, Trifexis (which contains both spinosad and milbemycin oxime for heartworm prevention). I got curious and asked about specific weights and dosages, and noticed that everyone who reported issues had pets that weighed in the lower 20-something pounds, but were giving full pills for 20.1 ~ 40 pound dogs. In one case, a Shiba owner followed up with a call to the company hotline, and was told that her specific cluster of symptoms (laying in “contorted positions,” being unresponsive, trembling, having difficulty maintaining balance) had not been reported before.

Unfortunately, the company representative was flat-out wrong. The FDA has actually collected pages and pages of documented Adverse Drug Experiences for both Comfortis and Trifexis — cumulative reports available in .pdf form here (search by drug name, not product name). So make no mistake — it is a controlled substance, and no drug is “perfectly” safe, as the full document made apparent to me.

That said, my own dogs have not had any problems with it, especially not after I began minimizing and fine-tuning the dosage on my own. My own conclusion was not that the drug itself was inherently evil, but that it remains important to monitor my pets for their own, individual sensitivities. Because the Bows have not reacted badly, and for us, the benefits outweigh the [unseen, to us] risks, I do plan to continue using Comfortis. Nevertheless, knowing that my specific breeds (and of course, others) commonly fall in that lower 20-pound danger zone, where they seem most susceptible to the possibility of overdosing, I will continue to suggest splitting up the pills as a precaution. No, the drug is not “guaranteed” to be blended evenly throughout the pill, and it’s not scored for ease of division. But this works for me until Elanco decides to fine tune this particular dosage jump.

Note: a similar problem applies in the difference from 40.1 ~ 60 pounds (810 mg) and 60.1 ~ 120 pounds (1620 mg), but the change is most pronounced in the size upgrade I’ve been discussing.

In summary…

Comfortis PROS:

• Highly effective, fast-acting, consistent
• Leaves no smell or residue
• Lasts a whole month
• Allows pets to be bathed as necessary
• Relatively easy to administer with food, though picky pillers may need some tricks

Comfortis CONS:

• Noxious smell and taste may make it unpalatable to some dogs
• Must be prescribed by your vet
• More expensive than topical treatments (approx. $60/box for spot-ons vs. $90/box for a 6-pack of Comfortis)
• Does not take care of ticks
• Poor customer support from company (based on my own experiences in addition to anecdotal information above)
• Potential for adverse drug effects not fully acknowledged

Finally, if you do find that your pet has experienced an adverse reaction to this or any drug, please ask your vet to help you fill out an Adverse Drug Experience form to send to the FDA. Internet anecdotes and the advice of well-intentioned non-professionals such as myself should always be taken with caution. Ultimately, the relevant regulatory agencies also need to be notified through the appropriate channels.

Adverse Drug Experience form: http://www.fda.gov/AnimalVeterinary/SafetyHealth/ReportaProblem/ucm055305.htm
Comfortis website: https://www.comfortis.com/
Trifexis website: https://www.trifexis.com
Elanco Pet Health (makers of Comfortis and Trifexis): https://www.elanco.com/products-services/pet-health.aspx

Edited to add more relevant links to anecdotal information as I stumble across new info:
Trifexis Toxicity in Dogs: Charlie had a Scare!

Bowpi sees the vet

Tags

blood tests, canine dental, comfortis, dog back injuries, pet finances, vet

In anticipation of Bowpi’s third year adoption anniversary, I scheduled her a general veterinary checkup, including full bloodwork and a required rabies booster. Aside from the vaccination clinic (DHPP) and the emergency visit, her last official checkup was nearly a year ago for her lick granuloma back in April 2012. Unfortunately, even after a round of Betagen, it’s still there as a toughened and unsightly bump. As it remained unchanged in size and didn’t seem to bother her, we moved on. In nearly all other aspects, she has been alert, healthy, living and dreaming to the fullest, so I figured now was as good a time as any to run a full blood exam on her as a baseline from here on out.

“Since she’s technically a ‘senior’ now, we would recommend it,” commented the vet when I asked her to order the tests. My vet considers any larger breed dog that’s five years and older, and smaller breed dogs seven years and older to be fading just out of “middle age” by default. I know she means no offense, but I can’t help but cringe when I hear that word… Senior? Hardly! Not if she’s going to live to be 16 or 17 years old, like so many Basenjis I’ve heard about, right?

I confessed that just last week, Bowpi seemed to have suffered an unexpected injury as she was heard yelping when jumping up onto the bed. And onto the couch. And peeping just slightly when jumping into the car. We examined her all over and found nothing caught in her toes, no tenderness or sensitivity in her legs, and not a scratch on her. Figuring it could be a muscle or a joint thing, as happened to Bowdu about a year ago, I started slipping her some glucosamine as well, and lifting her up and down higher levels for a few days. Her gait was not noticeably affected, and she was still quite willing to run and dart about with other dogs as well, so we figured she was all better and let her jump up and down at will. But then a day later, her peeps returned.

The doctor figures it’s likely a minor back injury, a “very common complaint” with older dogs. Thank goodness she didn’t drop that s-word again. She recommended helping Bowpi up and down higher levels for as long as a month so as not to create additional discomfort.

Meanwhile, I was glad not to be chided for the state of her teeth and rancid breath. We really are trying, I swear! The vet assured me that her teeth were “not that bad,” and encouraged me to keep brushing — which I do, as best as I can. She suggested that Bowpi’s gnarly breath probably has more to do with her unique stomach flora than tooth decay, which makes sense to me. We’ve learned how to navigate and avoid Bowpi’s vomiting patterns since the very first day she joined our home, since she does seem to have a sensitive stomach, but she still has quite a capacity for launching unexpected oral stinkbombs. She’s particularly dangerous when stuff has been sitting in her stomach for a while. Anyway, this is just another thing to keep an eye — or nostril — out for.

The blood tests came back normal for almost everything. There were a few categories (specifically cholesterol, reticulocytes, and HGB/HCT) which were slightly off, but not alarmingly so. I’m more apt to pin the blood aberrations on temporary physiological issues, and I’ll take the slightly high cholesterol as an indication that I should continue to be careful and keep up with diet research, adapting as necessary.

The damage:

• Office Call: Annual Exam, $56 $50.40 (after student discount)
• Canine Rabies 3-year booster, $21.75 $19.58 (student discount)
• Total Body Function, $169
• Comfortis for 20 ~ 40 pound dogs (6 pack), $92.12*
• Referral credit, -$56 (because I sent a friend to this vet)

TOTAL: $275.10

* Elanco (the makers of Comfortis and Trifexis) is still offering a mail-in rebate for 6 or 12-pack purchases, but my vet’s price on this has gone up by a few more dollars again, as seems to happen every time we refill. Gargh.

Finances in review for 2012

Tags

budgeting, pet finances

For two years now, I have tracked our pet expenditures at The House of Two Bows in order to get a concrete sense of what it costs to keep two 20 ~ 30 pound adult dogs at my personal standards in one of the most expensive regions of the country. I had a lot more to say last year when I broke down and analyzed my expense categories in detail. I’m paring it down to just two charts this year.

2012 pet expenses

• Food: $806
• Treats: $175
• Grooming: $56
• Accessories and miscellany: $215
• Vet & medical expenses: $648
• ANNUAL TOTAL: $1900

2011 vs. 2012 monthly average by expense category

The numbers, put side by side (2011 / 2012):

• Food: $84 / 67
• Treats: $26 / 15
• Accessories & miscellaneous: $15 / 18
• Grooming: N/A / $5
• Vet and medical expenses: $122 / 53
• Average per month: $247 / 158

Food and treats:

The Bows are typically fed a high quality, grain-free, fish-based kibble in the morning, and then either dehydrated raw, fresh or thawed raw meats, bones, and organs, or a home-cooked meal in the evening. They get various supplements with their meals, including fish oil, vitamin E, PlaqueOff, liquid glucosamine, and other seasonal bits.

Overall, we spent more wisely on edibles this year, and the payoff is evident in the numbers. My strategies:

• Limited purchases of pre-made frozen commercial raw food, one of the most expensive types of food I purchased last year. Instead, I put more effort into putting together our own home-prepared raw recipes.
• Limited purchases of edible dental chews (e.g. Terrabones, Zuke’s Z-Bones). Instead, we fed more raw bones and skin chews, which are more economical and hold a superior claim on being “natural.”
• Took advantage of grocery store bargains, stalking the 50% off sell-by-today corner. I still can’t buy much in bulk without a separate freezer though.
• Waited for sales, coupons and rebates, then milked them for all they were worth. We got several free bags of high quality kibble, Groupons and vouchers to online pet supply retailers, and alerts to significant sales on some of our favorite brands by subscribing to mailing lists.

RJ also became more proactive about dehydrating homemade treats towards the end of the year, a practice which I expect will carry into the next.

Finally, I have to give credit to Chewy.com, Patrick at Salmon Ears, Pawalla, Pets Love Toys, and The Honest Kitchen for knocking about $150 ~ $200 from this year’s food and treat expenses. I neither expected nor desired to make any revenue when I started this blog, so occasional freebies are nice. We don’t plug products for the sake of money, though these opportunities help us save some!

Grooming, accessories, and miscellaneous:

I love that I don’t have to spend much on grooming for either a Basenji or a Shiba Inu. I purposely stay away from primp-necessary breeds; it’s enough to contend with the constant shedding at home from Bowdu. So our “grooming” category overlaps with basic hygiene, and consisted of a Dremel purchased at the beginning of the year (and used with much success!), baby wipes for allergy season, and dental supplies.

Not much to add about the other accessories that I haven’t already discussed in previous monthly roundups. Unlike last year, I didn’t bother counting a cent towards gas or tolls. The enjoyment derived from traveling together really is shared; it’s not that I’m taking them places, it’s that they’re taking me places I’d otherwise not make the effort to explore.

Veterinary and medical expenses:

Regular meds include heartworm (Interceptor), flea medication (Comfortis), and thyroid medication (Soloxine).

So this is the biggest discrepancy between the past two years because we didn’t have to do a full dental, and we got through the year without unexpected medical emergencies! Well, Bowpi had a minor incident at the dog park that was fully paid by the other party. Though I’ve only been keeping track of our budget for two years, I’ll consider this an atypical year for veterinary expenses. I’d love to keep it this low every year, but realistically, I realize it only takes one nasty spell to knock those figures skyward.

Meanwhile, Bowpi’s dental health continues to aggravate me. I’d much rather spend an extra $5 a month maintaining her teeth than spending $500 all at once every other year on a full dental. Pet health is more than just a commitment of finances, but also time. Heading into 2013, the condition of Bowpi’s teeth and Bowdu’s chronic issues will continue to be major concerns. I just hope we can keep it all under control, even as we anticipate changes on the horizon at the House of Two Bows.

Jottings from Dr. Dodds’ Webinar on Canine Hypothyroidism

Tags

canine health, canine hypothyroidism, dr. dodds, hemopet, thyroids, vet, veterinary endocrinology

On Sunday evening, I attended a webinar on “[Canine] Thyroid Disease and Autoimmune Thyroiditis” presented by Dr. W. Jean Dodds, DVM and sponsored by the Danish-Swedish Farmdogs USA.

As a pet person who has already read Dr. Dodds’ book and slogged through other peer-reviewed publications on canine hypothyroidism as best as I could, the vast majority of this was repeat information. I paid attention and took notes anyway as if it was all new to me. Perhaps I would’ve gotten more mileage out of the talk and Q&A opportunity if I was a dog breeder, because she had a lot of really thorough information directed towards breeders on how to screen and select for thyroid disorders. Her open liaison with breeders, in my opinion, is quite invaluable and one thing that sets her apart as a public spokesperson for canine health issues.

I also appreciated some of the detailed observations she presented with pictorial examples, which went beyond the level of description in her book (most of her pictures were already in there). Some of her comments about barrel-chested and front-loaded hypothyroid dogs made a lot of sense to me, based on what I’ve come to understand about Bowdu’s form and the range of movement he’s capable of.

She also talked a little about natural thyroid options. It’s hard to find good information about natural thyroid therapy for canines, so I would have liked to hear more about that. I wouldn’t say she embraces the idea, but she does mention it as an option, and she was willing to name-drop a few brands with a couple caveats: 1) it’s much more critical to get the dosage right and monitor reactions, since natural thyroid supplies BOTH T3 and T4 (whereas synthetic pet meds on the shelf right now just supply T4), and 2) it’s more expensive, and would probably be prohibitively so for dogs that weigh more than 60 pounds. This was covered in her book as well.

She mentioned a new double-blind clinical trial that she just wrapped up with Drs. Linda Aronson and Nicholas Dodman at Tufts (they’ve collaborated before). Results should be forthcoming in a veterinary behavioral journal. Thyroid function and aggressive/aberrant behavior were under investigation. I await the publication of that study to see what new information is presented.

In response to a good question from a trainer, who asked how she can talk to pet owners about Hemopet/Hemolife without disparaging the work of her clients’ regular vets as inadequate, Dr. Dodds clarified her organization’s position as a clinical research laboratory that needs to collect its own samples for publication purposes, using its own procedures. Hemopet is not meant to replace the work of conventional vets or compete with the handful of commercial labs that handle the majority of diagnostic tests for North American vets. Dr. Dodds’ lab is open to discussing their interpretations with conventional vets, and this would be an ideal professional relationship for the pet owner. If any part of this process is blocked, however, it’s really up to the client to decide if it’s in their best interest to work with what they have, or to seek another vet.

In all this, she hinted at some of her criticisms of the current state of the veterinary establishment. The talk was interlaced with other non-specific commentary that made it clear she understood her marginalized position, but I thought she was quite discreet. She’s been a lot more diplomatic than some vets have been to or about her, in my experience! She professed her love for the veterinary field and believes strongly in her line of work and research, though she found several things lacking in veterinary education. True to her word, that’s been one area in which she’s been campaigning for a long time. At times this does involve a bit of self-promotion that borders on oversell. But I think once you acknowledge how many questions remain in the vast, open and interconnected fields of canine health, genetics, behavior, breeding practices, pet culture, etc., then a lot of that kind of laboratory territorialism falls by the wayside as petty turf wars — particularly disadvantageous to pet people who have no stakes in that establishment, like myself.

Should the opportunity arise again, I’d recommend participating in one of Dr. Dodds’ presentations or webinars if:

• You want a quick overview of how hypothyroidism affects canine health, and you’re not inclined to spend the same amount of money on her book.
• Your own vet is unhelpful, dismissive, talks down to you, or oversimplifies explanations about thyroid issues.
• You’re a dog breeder and want to understand the dynamics of thyroid health and testing for your own breeding goals.
• You are a holistically-minded trainer who appreciates how genetics, overall health, diet, and living environment can affect a dog’s behavior, and you have some specific questions you’d like to ask.