You Make The Diagnosis: Dog With Damaged Teeth

Last Saturday, I met a wonderful terrier mix.  He greeted me with warmth and affection until he realized who I was . . . THE VET.  He promptly crawled under the chair occupied by his owner.  What a smart boy! 

When I opened his mouth I noticed damage to his teeth.  Review the photo and note the worn incisors (front smaller teeth), upper and lower canines (often called the fangs) and the premolars (teeth with two or more roots behind the canines).  What caused this damage?   


Diagnosis:  Worn teeth from chewing objects

This dog loves to chew, in fact I would call him a chewing fanatic.  He chews up bones and hooves in a matter of minutes. If he had been chewing on his own body because of severe allergies, the wear pattern would be different.  (See prior case at–dog-with-worn-teeth.aspx.)  Unfortunately, this habit is wearing out his teeth. 

For dogs who love to chew, I recommend Kongs and CET Chews which are more tooth friendly instead of bones, hooves, rawhide chews and pig’s ears.  I would also limit the use of tennis balls to special occasions.  The outer surface feels soft but is actually quite abrasive.  Add a little dirt or other debris and it becomes rough as sandpaper.   Note:  I am headed to Asia until August 7th so there will be a short break in the blog while I am away. 

Celebrating The Americans With Disabilities Act

Today our nation rightfully celebrates the passage twenty years ago of the Americans With Disabilities Act.  When signing it into law, President H.W. Bush ushered in a new perspective on how we treat people.  This anniversary led me to reflect on the magnificent animals who touch and have touched, my life.  Some had disabilities . . . but each gave me more love back than I could offer them.  So today I honor Radar, the cat pictured below, who was born without eyes.  He was an extraordinary cat and you will learn his story in upcoming books.  I also celebrate Geneveive.  She had but three legs, yet also had more spunk and personality than most cats.  She is celebrated in Coated With Fur: A Vet’s Life and will reappear in books to come.  In short, I thank all the disabled animals who enrich my life.

Collectively, let us also thank the animals who assist people who have disabilities.  These amazing service animals do so much to enable so many people.  They also make me smile when I see them at the airport, store and around town.  Happy Anniversary Americans With Disabilities Act!

Dr. Nelson Quoted In Ladies’ Home Journal

Losing a pet is never easy.  That’s why I commend Ladies’ Home Journal and their sponsors for tackling this difficult, but important subject.  Below are some images from the magazine followed by a few more comments.     

Several months ago, Jenna McCarthy interviewed me for this article.  She asked great questions designed to help people with five specific topics :  when is it appropriate to consider euthanasia, unexpected deaths, dealing with death as a family, why it’s good to grieve and the importance of celebrating your pet’s life.  The result is a wonderfully written article that will help you cope and say good-bye to your pet.  I am honored to be quoted on these vital issues.       

Dogs – Short Noses And Heat Stroke

Dogs rely on panting to cool off their bodies during periods of high temperatures.  Unfortunately, the brachycephalic breeds are disadvantaged because of the shape of their skulls.  Their  compressed faces are adorable but result in abnormalities of the upper airways restricting air flow.  Specifically, these breeds often have small nostrils, very long soft palates, everted laryngeal saccules and an under-developed trachea. 

If you live with a brachycephalic dog; Boston terrier, Shih tzu, Boxer, Pug, English bulldog, Shar Pei or Pekingese, keep them out of the heat.  I have seen heat stroke develop in as little as five minutes in these breeds.  Watch for rapid respirations, a depressed attitude and dark red gums.  They may also experience vomiting and diarrhea.  If the dog is not cooled off quickly, their condition rapidly deteriorates into bloody vomiting, collapse, bloody diarrhea, seizures and problems breathing.  When the gum color changes into a sick, pale gray I know death is coming.  

To prevent heat stroke, keep your pet at a healthy weight.  Take walks and play ball early in the morning when temperatures are mild.  Limit their time outdoors during the heat of the day to a quick trip to urinate and/or defecate in the shade.  Then, return to air conditioning.  Last, watch their tongues closely for a change in color.  If their normal pink color deepens to purple or lilac, it is time to get indoors.  I know members of these breeds are social and like to accompany their families to soccer and baseball games, but sometimes the safest and most loving thing to do is leave them home.  They can help you celebrate after the event.   

Burned Paws – Protect Your Dog’s Paws From Hot Summer Asphalt

Summer is here and with the high temperatures comes hot pavement.  Since most of us wear shoes, we don’t think about how hot the concrete and pavement become during the day.  A few seconds of contact will burn a child’s feet and a dog’s paws.  One of the technicians I work with tried to measure the surface temperature of the asphalt in front of the clinic yesterday.  It was too high for the thermometer to give a number, it simply read ‘high’.  Today in Phoenix we hit 113 degrees so imagine how hot the asphalt is!   

To protect your dog, walk and complete errands early in the morning before the pavement heats up.  If you must take them out during the heat of the day, stay in the shade or carry them.  For dogs too large to carry, purchase a pair of booties to protect their paws.  Booties come in several sizes and styles to accommodate your dog’s needs.  I have a pair of Tuff Paws for my dog.  Although he doesn’t like to wear them, they are great for protecting his feet during short walks.  Dog booties are available at outdoor stores, especially those that stock supplies for hunting dogs.  Try them on your dog before purchasing to make sure the fit is correct.      

Remember that dogs sweat through their pads and noses.  In warm weather, remove the booties as soon as possible to allow this cooling process to occur.  Just as we need to stay hydrated, so do the dogs.  Please have ample water available in these summer months. 

Bedlington Terriers – Name The Liver Disease Often Found In This Breed

This beauty is Tama, a Bedlington Terrier.  She is a friendly girl who enjoys the company of dogs, humans and her family’s cat.  She is even nice to her veterinarian!  When not making friends, this little socialite loves to play with her ball.  She is a wonderful ambassador for her breed.

Unfortunately, some Bedlington Terriers will develop severe liver disease.  The disease is more common in females and clinical signs develop between 2 and 4 years of age.  What is the name of this disease?  How is it diagnosed?  What may be done to prevent it?


Diagnosis:  Copper Storage Hepatopathy

Copper storage hepatopathy is caused by excessive copper accumulation in the liver because of abnormal binding. It has many similar names including copper toxicosis, Bedlington Terrier hepatitis, copper storage disease and copper-associated hepatopathy.   I personally don’t like the name Bedlington terrier hepatitis because this disease also occurs in Dalmatian, Doberman pincshers, Labrador retrievers, Anatolian shepherds, West Highland white terriers and Skye terriers. 

As the copper accumulates, it damages the liver causing anorexia, jaundice, increased thirst, elevated urination, diarrhea and weight loss.  The results of blood tests and a urinalysis will suggest liver disease but the final diagnosis requires a liver biopsy.     

Treatment involves using copper chelators to reduce the amount of copper in the liver and then maintaining lower levels with compounds such as zinc acetate to decrease accumulation.  Some veterinarians will also use anti-oxidants in their treatment plans.

If you own a Bedlington terrier or one of the other breeds prone to this disease, I recommend genetic testing your pet to see if they are at risk.  With early detection, the effects of this disease may be lessened with diets low in copper combined with supplements to improve liver function and health.  More information about genetic testing is available at

Oleander – The Entire Plant Is Poisonous

As a child, I remember my dad trimming the oleander bushes at my grandparent’s house.  The sap dripped on to his arms and caused painful rashes.  I did not understand how truly poisonous these plants were until years later when I entered veterinary school.  We were lucky that none of our pets consumed this pretty but deadly plant. 

Oleander contains a cardiac glycoside that is extremely toxic.  Just a few leaves will kill a dog.  After ingestion, the victim experiences vomiting or it will cause colic in species that do not vomit.  It also leads to diarrhea.  A short time later, the patient’s heart rate drops and arrhythmias begin.  All parts of the plant contain the toxin so extreme care must be taken to insure clippings are not mixed into fodder for ruminants or horses.  Since it is toxic to so many species (rabbits, camels, horses, chickens, cattle, llamas, alpacas, dogs, cats, humans), I would assume it is toxic to all creatures until proven otherwise.

If your pet or child is exposed to oleander or any of the other plants that also contain cardiac glycosides (lily-of-the-valley, foxglove, squill and some milkweeds) seek medical attention immediately.  Do not wait until clinical signs develop.  With proper care, most patients will make a complete recovery without any long term affects to their hearts or gastrointestinal systems.


Oleander comes in a variety of colors including red, pink and white.  Please use caution when working around these deadly beauties.

Coated With Fur: A Vet’s Life is a Staff Pick at Changing Hands Bookstore

It is a wonderful experience to write a book and have it well received.  Particularly since this is my debut book.  I am honored and thrilled to share the news that Coated With Fur: A Vet’s Life is now recognized as a Staff Pick at Changing Hands Bookstore in Tempe, Arizona.  This independent bookseller has received numerous awards including Bookstore of the Year.  So their recognition that this is a book worth reading is gratifying beyond words.  I would particularly like to thank Mabre who wrote the summary you see in the second picture below.  Thanks too for all of you who have written me with your comments and kind words.  If you live here or are visiting the Phoenix metro area, please stop by Changing Hands Bookstore.  They have a knowledgeable and friendly staff and you will find it a vibrant place.  If you have not seen the book trailer, it is at  Thanks Changing Hands!

Lantana, A Beautiful But Poisonous Plant

Here in Arizona, many people use Lantana as a decorative plant in their yards.  The groundcover thrives in the high temperatures found in the Valley of the Sun.  They also grow in tropical regions.  In my neighborhood, I see them in gold, yellow, red and gold, purple, pink and yellow, and white. 

Unfortunately, the plant contains triterpenoid toxins that harm the liver.  The most common signs in dogs is vomiting and diarrhea.  If enough of the plant is consumed, some will die quickly.  This differs from grazing animals which usually die several weeks later due to a damaged liver.  Ruminants, rabbits, guinea pigs and female rats are all susceptible to this plant.  The red and yellow plants are the most toxic while the white is the least dangerous.  

If you have these plants in your yard, I may have to suggest removing them, fencing them off or using a basket muzzle on your dog to prevent exposure.    

Sharma, Om P., et al “A review of the hepatotoxic plant Lantanta Camara” Crit Rev Toxicol, may 2007;37(4):313-52.