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Obesity is a disease which is defined by an excess of body fat. Dogs that are over nourished, lack the ability to exercise, or that have a tendency to retain weight are the most at risk for becoming obese. Obesity can result in serious adverse health effects, such as reducing the lifespan, even if your dog is only moderately obese. Multiple areas of the body are affected by excess body fat, including the bones and joints, the digestive organs, and the organs responsible for breathing capacity.
Obesity is common in dogs of all ages, but it usually occurs in middle-aged dogs, and generally in those that are between the ages of 5 and 10. Neutered and indoor dogs also tend to have a higher risk of becoming obese.
Treatment for obesity is focused on weight loss and maintaining a decreased body weight for the long term. This is accomplished by reducing caloric intake and increasing your dog's time spent exercising. Your veterinarian will most likely have a prepared diet plan that you can use to refigure your dog's eating schedule, or will help you to create a long-term diet plan for your dog.
Diets that are rich in dietary protein and fiber, but low in fat, are typically recommended, since dietary protein stimulates metabolism and energy expenditure, along with giving the feeling of fullness, so that your dog will not feel hungry again shortly after eating. Dietary fiber, on the other hand, contains little energy but stimulates intestinal metabolism and energy use at the same time.
Increasing your dog's physical activity level is vital for successful treatment. The most common suggestions for dogs are leash walking for at least 15 minutes, twice a day, and playing games such as fetch.
Living and Management
The follow-up treatment for obesity includes communicating regularly with your veterinarian about the weight reduction program, monthly monitoring of your dog's weight, and establishing a life-time weight maintenance program once your dog's ideal body condition score has been achieved. With a firm commitment to your dog's health and weight, you will feel confident that your dog is eating healthy and feeling its best.
Now let's take a look at the other 4 causes of obesity.
If your dog should collapse and a blood sample indicates low glucose, insulinoma will be highly suspected and your veterinarian will need to follow through with further tests to confirm it. However, multiple blood samples may need to be taken over a period of time to determine if there is a persistent low glucose concentration. Your doctor will need to determine the insulin concentration at the lowest glucose concentration. Withhold food from your dog before tests are performed is essential for determining true glucose levels - your veterinarian will advise you on the appropriate way to conduct these short term fasts for your dog.
An amended insulin:glucose ratio (AIGR) may be useful when your dog's insulin level is low, yet still in the normal range. Insulinoma is still suspected in these type of cases. If the insulin level is inappropriately high for the decreased glucose level, insulinoma may still be present.
Ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) can be helpful in determining the extent of the pancreatic tumor and how much it is metastasizing. Typically insulinomas do not metastasize to the lungs; however, chest x-rays may indicate other neoplasias as a cause of persistently decreased glucose. Scintigraphy, a form of imaging using radioactive isotopes to identify abnormal tissue, can also be used to identify the location of primary insulinomas and metastasis.
If your dog has collapsed or is suffering from seizures because of an insulinoma, medical emergency treatment usually will consist of immediate administration of glucose. For home treatment of sudden collapses or seizures, corn syrup can be given as a temporary solution to increase glucose levels. But medical attention will still be needed, so consulting with a veterinarian is critical. The veterinarian may also give your dog glucose containing fluids and/or steroids to counteract the insulin effects.
If your dog's health status, along with imaging of the tumor, indicates potential value from surgery, removal of the tumor will usually be recommended. Hypoglycemia may be resolved by removing the part of the pancreas with the tumor on it. However, if there is significant metastases or functional tumor cells in the remainder of the pancreas, additional treatment will still be necessary. Likewise, if the tumors are generalized, or if there are other health concerns, medical management may be advised as the primary mode of treatment.
Prednisolone is a steroid that stimulates formation of glucose and is often a cornerstone of medical treatment. Other medications that might be used to treat insulinoma include:
Dietary management is frequently used in conjunction with other treatments. In fact, you may be able to minimize the amount of medication, or the need for additional treatments, by feeding your dog small, frequent amounts of moderate protein, low sugar foods, and complex carbohydrate rich foods. Clinically, the most important dietary technique is the frequency of the meals. Essentially, this technique is used to limit the fluctuations in insulin that instigate the hypoglycemic episodes. Controlling symptoms of hypoglycemia is ultimately the goal. Your veterinarian will assist you in developing a workable diet plan for your dog.
Living and Management
Surgery, along with dietary precautions, can dramatically lessen hypoglycemia and insulinoma symptoms for your dog. However, in many cases continued medical treatment and dietary management will be necessary. Frequent check-ups will be necessary to monitor this condition, and to determine if progress is being made in a positive direction. The success of the treatments will be evaluated and the type of treatment fine-tuned based on your dogs symptoms and whether any of the conditions have recurred.
Living and Management
Conscientious compliance with the prescribed drugs and diet is required for successful therapy. Your veterinarian will adjust the dosage of the synthetic hormones as necessary for your dog, and will also monitor the usefulness of any medications that have been prescribed. To avoid complicating the condition, do not change the type or dosage of the drug yourself, and never give anything new to your dog without first consulting with your veterinarian. This caution includes the use of herbal remedies. Diet modifications, including a reduction in fat, are recommended during the initial phase of therapy. Most dogs respond well to therapy, with activity levels and mental alertness increasing significantly after only a relatively short time.
Your veterinarian will perform a complete physical exam, including a blood chemical profile, complete blood count and a urinalysis. You will need to provide a thorough history of your pet's health leading up to the onset of symptoms.
Your veterinarian will also run tests to measure cortisone levels in your dog’s bloodstream. There are three tests for measuring cortisone which will help your veterinarian to diagnose hyperadrenocorticism: a urine cortisol creatinine ratio test, and two types of blood tests: a low-dose dexamethasone suppression test, and an adrenocorticotropin hormone (ACTH) stimulation test. Excess levels of the adrenocorticotropin hormone will be indicative of Cushing’s disease as the stimulus behind the increase in cortisone.
After your veterinarian has settled on a diagnosis of hyperadrenocorticism, there will need to be further tests to see if it is being caused by PDH related tumors, or overgrowth of the pituitary gland. The high-dose dexamethasone suppression test is a blood test that may conclusively point to PDH caused hyperadrenocorticism by measuring cortisone levels in response to administration of the anti-inflammatory agent dexamethasone. A lowered, or unchanged cortisol level in response to the test will indicate Cushing’s disease.
Another blood test, the endogenous ACTH concentration test can confirm an adrenal tumor (AT) as the cause of your pet’s hyperadrenocorticism.
X-ray and ultrasound imaging can show 50 percent of adrenal tumors, and can be quite helpful in differentiating PDH from AT. If a patient has an AT, chest radiographs and ultrasound images should be taken to visually examine the body for any possible metastasizing.
Dogs with non-spreading adrenal tumors and small carcinomas will be surgically treated in most cases. Medical treatment to stabilize your pet before surgery may be necessary.
Many dogs can be treated with drugs; the type will be dependent on the location and type of tumor. These drugs can have serious side effects, so dogs taking them should be closely monitored.
LIVING AND MANAGEMENT
If your dog is being treated with medications for this condition, you will need to be prepared to continue treatment for the life of your pet. You will need to be observant of any adverse reactions to medications. Signs of an adverse reaction are lack of energy, weakness, lack of appetite, vomiting, diarrhea, and possible difficulty walking. If any of these side effects do occur, you should discontinue the medication, contact your veterinarian, and administer prednisone, which your veterinarian will have prescribed for you. If your dog does not respond to the prednisone, it should be taken immediately to the veterinarian for an emergency visit.
Your veterinarian will schedule a follow-up visit around eight days after initial treatment if your dog is receiving the oral medication mitotane for pituitary-dependent hyperadrenocorticism. If it is being treated for an adrenal tumor, you will need to take your dog for a follow-up visit around 10-14 days after initial treatment. Once your dog has stabilized, you will need to return to the veterinarian for follow-up appointments at one, three, and six months, and then every three to six months after the first six months of treatment.
Like any medical procedure, the need to spay or neuter should be addressed on a case by case basis. Most dog owners feel the benefits of spay/neuter (preventing unwanted litters and heat cycles; reduced aggression, roaming, and/or marking; eliminating or reducing the risk of certain diseases) outweigh the potential downsides (risk/expense of surgery and an increased chance of other diseases).
Once the decision to spay/neuter is made, the question of when to perform the surgery then arises. Again, the pros and cons of spay/neuter before versus after puberty need to be considered. When spayed prior to the onset of the first heat cycle, a female risk of mammary (breast) cancer falls to almost zero. Waiting just two heat cycles virtually negates the benefit of surgery, in this regard at least. Also, the effect of neutering on aggression in male dogs is much better when the surgery is performed before aggression begins (in other words, before puberty) versus after the behavior has developed.
One of the biggest downsides of spay/neuter is an increase in the incidence of weight gain. This can be prevented and controlled with relative ease by reducing the number of calories a dog takes in and providing ample opportunities to exercise. If so, this might be reason to consider delaying the surgery, at least in those cases where obesity was of particular concern.
A paper published in the July 15, 2013, issue of the Journal of the American Veterinary Medical Association (JAVMA) put those fears to rest. The study looked at the medical records of 1,930 dogs that were spayed or neutered at ≤ 6 months of age (782), > 6 months to ≤ 1 year of age (861), or > 1 to ≤ 5 years of age (287) and compared them to the medical records of 1669 hormonally intact dogs. The dogs’ records were followed for at least ten years or until they were diagnosed as being either overweight or obese.
This study confirmed the link between spay/neuter and an increased risk for weight gain, but this relationship was only statistically significant during the first two years after the surgery was performed. Also, the age at which a dog was spayed or neutered had no effect on whether or not he or she was subsequently diagnosed as being overweight or obese.
Overall, this paper is good news for people who elect to spay and neuter their dogs. Yes, the tendency to gain weight needs to be addressed, but the timing of the surgery doesn’t affect the outcome.
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