Q) My 2 Year Old Boxer Has Spinal Arthritis. How much exercise should she be having?


On today's episode of Twin Trees Vet Talk, we welcome our special guest and dear friend Dr. Katie Buss. Dr. Buss is a small animal veterinarian and winner of the "My Vet’s the Best,"  a nationwide contest that honours veterinarians for their outstanding service.  

Dr. Buss helps answer a question from Charlee, a dog mom who is VIP at Twin Trees Vet. We ultimately discuss the consequences of unregulated pet breading, including high rates of genetic diseases within certain breeds and dangerous practices we are seeing such as improper antimicrobial use leading to antimicrobial resistant infections.

Charlee asks: "My 2 year old boxer has just been diagnosed with severe spinal arthritis. Managing the pain but how much exercise should she be having? She’s still a crazy girl at heart with lots of energy." 

The Backstory: How Charlee Earned VIP status

We met Charlee in the Twin Trees Vet ER when her puppy, Cali, was brought in for a life-threatening emergency. When Cali first arrived she was struggling to breathe, distressed and her tongue and gums were blueish because of her low oxygen levels. Unfortunately, we don't have the video footage showing those first terrifying moments because we were so focused on stabilizing her as quickly as possible.

 Once things had settled down a bit we started recording.  In the first clip of the video above, you can see Cali is still struggling to breathe even after receiving supplemental oxygen and sedation.  When patients are really struggling to breathe, they become very afraid and they panic. This causes their heart to race, which increases the oxygen demands of the body. Panicked patients will often take short choppy breaths which are not efficient, making matters worse very quickly (they need more oxygen because their heart is racing, but they are getting less because their breathing is inefficient). The sedation allows them to relax and take longer, slower, deeper breaths deep breaths. 

In the first clip you can see that she is receiving supplemental oxygen through her nose. The pulse oximeter (the little grey machine on the left with the red flashing numbers -it is hooked up to her lip to measure the oxygen saturation of the blood or SPO2), is reading "91" percent. A healthy patient breathing room air should always have an SPO2 of greater than 95%. Patients with an SPO2 of less than 92% while breathing room air require supplemental oxygen. An SPO2 of less than 92% while receiving supplemental oxygen is a criteria for mechanical ventilation, so you can see this was a very scary moment indeed. 

In the second part of the clip (birds eye), you can see Cali is doing a bit better. Her SPO2 is 97-98%. If you listen, you can hear me passing along the 3 most important take-home lessons for pet owners that could save your pets life. I tell everyone these 3 tips, because they are so very important:

1) Don't wait too long to get help. Cali's owners acted swiftly. Perhaps if they had they waited a few more hours (like so many owners wait until the very last minute...), we may not have been able to saver her. She probably would have died.
2) Prevent the preventable. Learn about the common dangers (ie. toxins like grapes, raisins, xylitol in sugar-free gum). Buying a puppy from an irresponsible breeder is also a danger that can be avoided. Both Cali's spinal problem and her respiratory emergency could have been avoided if her breeder were more responsible.
3) Be prepared for the worst case scenario- Know pet first aid, have an emergency plan, but most importantly, be financially prepared. I cannot stress enough the importance of having good medical insurance for pets- in the event of catastrophic emergency, it is lifesaving. If Cali's owners hadn't been financially prepared for a catastrophic emergency, we may have had to kill sweet little Cali instead of save her, like we have to kill so many of our patients when they do not have good medical insurance.

Had Cali needed to be placed on a ventilator, her hospital bills would have likely exceeded $10,000. When pet owners are not financially prepared for the cost of a catastrophic emergency, like one requiring mechanical ventilation, they can find themselves quickly backed into a corner, having to make life-or death decisions for cost reasons. In these situations, many owners choose to end their pet's life when they are unwilling or unable to pay for ongoing treatment. For me, this is the most difficult part of being a veterinarian. Luckily for us, Cali's owners did have medical insurance and were 100% committed to doing everything possible for her. After Cali was stabilized, she was transferred to the critical care unit at a nearby veterinary specialty hospital, where she was under the 24 hour care. Thankfully, she improved and did not need mechanical ventilation. Her owners followed all of our recommendations and worked with an amazing team of specialists for approximately 1 year until the respiratory infection was finally cleared.

As an emergency veterinarian, I always make my recommendations from the standpoint of "what is best for the patient," but it is very common for pet owners to dismiss my recommendations because they a) don't want to pay for medical care b) don't really believe in medical care for pets or c) can't afford medical care. This is a major source of burnout and stress for veterinarians, because we have to see our sweet patients suffering or even being killed when we know that we may have been able to save them- if only the owners would give us the green light to do what we need to do.

ANTIMICROBIAL RESISTANCE: Why did this happen to Cali? It could have been avoided altogether.

It turned out that Cali had acquired a multi-drug resistant respiratory infection at her breeding kennel, where her breeder was "tinkering" with antibiotics. "Antimicrobial resistance," where bacteria become resistant to antibiotics, is a HUGE problem we are facing, and is a result of antibiotics not being used properly (incorrect dose, skipping doses, not given for the correct time frame, etc.). Only a licensed practitioner should ever be dispensing or prescribing antibiotics, and they should be given EXACTLY as prescribed on the label. 

Antibiotics were discovered less than 100 years ago and have completely transformed medicine. Even the bubonic plague (the "Black Death"), which killed an estimated 50 million people in the 14th century, is a basic bacterial infection (Yersinia pestis) that would be easily treated with modern day antibiotics.

Antimicrobial resistance has gotten so bad in the last few years that we now regularly see pets with infections where the bacteria are resistant to ALL of the antibiotics we have in our hospital. Antimicrobial resistance is such a crisis that the authorities are now talking about controlling antibiotics in the same way that narcotics are controlled.

Are you wondering- what is a ventilator for?

Back to Cali's back pain: what is spondylosis Deformans?

"Spondylosis deformans is a noninflammatory, degenerative condition of the spinal column characterized by the production of bone spurs along the bottom, sides, and upper aspects of the vertebrae." (Spondylosis Deformans in Dogs and Cats Veterinary Partner). 

bridging spondylosis in a young boxer genetic disease

There is an alarming prevalence of spondylosis in certain strains of Boxers:

"In Norwegian Boxers, a prevalence of 26% (104/402) of spondylosis was found. In Italian Boxers, an even higher prevalence (50%) of grade 3 spondylosis was reported. The prevalence and the degree, or grade, of spondylosis were described to increase with age." -(Spondylosis and Spinal Abnormalities: When Are They Relevant? from VIN: Veterinary Information Network).

So it looks like Cali's breeder may have two strikes. Strike 1: tinkering with antibiotics leading to a near-fatal antimicrobial resistant pneumonia. Strike 2: uninformed/irresponsible breeding leading to genetic disease in a dog that is just a baby (only 2 years old!). Are the more strikes? Only time will tell, but if this is happening, there is a good chance that we may see other genetic problems down the line, such as hip dysplasia, heart problems, neurologic disease and thyroid disease (see below for a list of diseases that boxers should be screened for BEFORE breeding them).

The take home lesson on breeding:

Unfortunately, the breeding of pets is not regulated. There is little oversight. Anybody can breed a pet for hobby or for profit. Unlike the automobile industry, where car manufacturers must meet certain standards, nobody is checking under the hood of your puppy to ensure that it was manufactured responsibly and safely. This has led to unacceptable rates of genetic diseases in pets. Many of these genetic diseases are very serious, even life-threatening. Most pet owners don't know about this- they don't know what questions to ask of breeders, what diseases the breeding stock should be screened for BEFORE breeding. And if they don't know about any of these diseases, then they usually haven't been informed about the cost of medical care to manage these problems- many are life-long problems, many need surgery, many will cut your pet's life very, very short. Buyer beware, buyer be informed. 

It is evident that the pet breeding industry needs to be regulated the way the automobile manufacturing industry is regulated.

Helpful Hint: If the breeder does not educate you about all of the common genetic diseases in that breed, and then show you the documentation of all of the testing they did (working closely with a licensed veterinarian) to ensure that they took every possible step to reduce the chance of your pet ending up with those genetic diseases....that is not a good sign.  

Only the consumer can hold irresponsible breeders accountable, by reporting substandard breeding practices to your local veterinary boards and legislative bodies. 

Breeders- if you don't know about this please enrol in as many breeding classes as possible before you consider breeding another pet. Breeders have two main responsibilities: 1) to breed pets that are healthy and of a good temperament and 2) to ensure those pets are adopted into good, long-term forever homes where they will be properly cared for.  It is unethical to breed pets with preventable genetic diseases and to then sell those pets to unsuspecting families who are left to deal with the aftermath. We need to change this.

OTHER GENETIC DISEASES IN BOXERS THAT YOU SHOULD DEFINITELY KNOW ABOUT. ASK YOUR BREEDER IF THEY TESTED FOR ALL OF THESE!!

OFA-CHIC Health Testing Requirements For Boxers 

"The OFA, working with the breed's parent club, recommends the following basic health screening tests for all breeding stock. Dogs meeting these basic health screening requirements will be issued Canine Health Information Center (CHIC) numbers. For CHIC certification, all results do not need to be normal, but they must all be in the public domain so that responsible breeders can make more informed breeding decisions. For potential puppy buyers, CHIC certification is a good indicator the breeder responsibly factors good health into their selection criteria. The breed specific list below represents the basic health screening recommendations. It is not all encompassing. There may be other health screening tests appropriate for this breed. And, there may be other health concerns for which there is no commonly accepted screening protocol available."

  • Hip Dysplasia (One of the following)
    OFA Evaluation 
    PennHIP Evaluation registered with OFA
  • Autoimmune thyroiditis
    OFA evaluation from an approved laboratory 
  • Cardiac Evaluation
    Advanced Cardiac Exam - must also include Holter 
  • Degeneratative Mylopathy (DM)
    DNA based DM test from an approved lab - results registered with OFA 
  • ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY (ARVC) DNA Test
    DNA based ARVC test from an approved lab - results registered with OFA

ABOUT THE OFA (Orthopedic Foundation for Animals)

"Our mission is to promote the health and welfare of companion animals through a reduction in the incidence of genetic disease." A main objective of the OFA is to advise, encourage and establish control programs to lower the incidence of orthopedic and genetic diseases. 

Wondering about a different breed? Explore the OFA database by breed: 

What Genetic diseases and/or conditions should my breed be screened for? 

 ADDITIONAL RESOURCES:

-Orthopedic Foundation for Animals: https://www.ofa.org/

-AKC Guide to Responsible Pet Breeding: https://www.akc.org/breeder-programs/breeder-education/akcs-guide-responsible-dog-breeding/

-AKC Breeder Education Courses: https://www.akc.org/breeder-programs/breeder-education/breeder-education-courses/

-Guidelines for Responsible Pet Ownership https://www.avma.org/policies/guidelines-responsible-pet-ownership

-Responsibilities of Pet Ownership https://www.canadianveterinarians.net/responsibilities-of-ownership

-CVMA Position Statement on Responsible Pet Breeding: https://www.canadianveterinarians.net/documents/dog-breeding 

RELATED VIDEOS:

Q) A Young Puppy Paralyzed By A Spinal Infection -Discospondylitis (Most Inspiring Neuro Case?)

Q) A Young Puppy Paralyzed By A Spinal Infection -Discospondylitis (Most Inspiring Neuro Case?)

WELCOME TO TWIN TREES VET TALK! Join us LIVE every Sunday 5:30-6pm PST. An informal chat with Dr. Lopez (Emergency Veterinarian) and friends to share our perspective on pet predicaments, being a veterinarian, our shared love for animals and more! Have a quick question? Want to run something by us? Or just need our two cents? This is your chance! Each week we select a handful of questions to answer. 

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3 BEST PIECES OF ADVICE FROM THE EMERGENCY VET THAT COULD SAVE YOUR PET'S LIFE

1) DON'T WAIT TOO LONG TO GET HELP! If you wait too long, it could be too late. This is especially true for concerns such as laboured breathing, pale gums and weakness. You know your pet best, so if you are worried or concerned, "when in doubt, check it out!"

2) PREVENT THE PREVENTABLE. Learn as much as possible about dangers that face your pet, such as household poisons, seemingly harmless objects (like toys, clothing, garbage and rocks), other animals, and vehicles. Pets are like toddlers and they need a responsible adult/babysitter to protect them from danger. Puppies and kittens need to start their vaccines at ~8 WEEKS (and they need boosters too!) to protect them from deadly diseases.

3) BE PREPARED FOR THE WORST CASE SCENARIO. Have a plan in place, know your nearest emergency clinic, have the ASPCA phone number on speed dial. Know basic first aid training and CPR. But MOST IMPORTANTLY, BE FINANCIALLY PREPARED. The cost of medical treatment in an emergency, and the owners' ability to pay for it, is probably the most important factor that determines whether a pet will receive the medical care it needs. The best way to protect yourself is to have good medical insurance for your pet. Do your research.

**REMEMBER**: WE ARE ALL ON THE SAME TEAM, with the best interest of the patient as everyone's first priority. Let your vet do what he/she does best, and don't try to grab the steering wheel and obstruct your vet from doing his/her job. We are all in the same car, we are all headed to the same place, but only one of us has the driver's license (meaning, only the vet has the medical training and background to "drive the car"). 

DISCLAIMER

The medical information on this site is provided as an educational resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information does not create any veterinarian-client-patient relationship, and should not be used as a substitute for professional diagnosis and treatment.

Please consult your pet's health care provider before making any health care decisions or for guidance about a specific medical condition. Twin Trees Vet expressly disclaims responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this site.