Some of our Irish will get cancer during their lives. We don't have a genetic test nor do we know the mode of inheritance for cancer.

This is a cause of grief for many owners and causes the early deaths of far too many of our beloved animals. If your Irish is limping, has a growth, a wound that won't heal or any unusual sign, the sooner you get to your vet's surgery to be examined the better.

Some owners choose to pursue aggressive chemotherapy; others pursue herbal treatments and in some cases there is little that can be done to halt or even slow down the progress of the disease. Early detection will, of course, help the odds and you and your veterinarian decide which course to choose.

Many Veterinary teaching hospitals have cancer treatment programs and outcomes are often more positive than they were in the past.

Gastric Dilation Volvulus (GDV) - More commonly known as "Bloat"

BLOAT IS AN EMERGENCY - The technical name for bloat is "Gastric Dilatation-Volvulus" ("GDV"). Bloating of the stomach is often related to swallowed air (although food and fluid can also be present). It usually happens when there's an abnormal accumulation of air, fluid, and/or foam in the stomach ("gastric dilatation"). Stress can be a significant contributing factor also. Bloat can occur with or without "volvulus" (twisting). As the stomach swells, it may rotate 90° to 360°, twisting between its fixed attachments at the oesophagus (food tube) and at the duodenum (the upper intestine). The twisting stomach traps air, food, and water in the stomach. The bloated stomach obstructs veins in the abdomen, leading to low blood pressure, shock, and damage to internal organs. The combined effect can quickly kill a dog. It is frequently reported that deep-chested dogs are particularly at risk.

Symptoms of Bloat:
The dog may have an obviously distended stomach especially near the ribs but this is not always evident depending on the dog's body configuration.

The biggest clue is the vomiting: the pet appears highly nauseated and is retching but little is coming up. If this is seen, rush your dog to the veterinarian IMMEDIATELY for stomach decompression and shock management.

Bloated dogs, once stable, should have surgery. Without surgery, the damage done inside cannot be assessed or repaired plus bloat may recur at any point, even within the next few hours. Surgery, called gastropexy, allows the stomach to be tacked into the normal position so that it may never again twist. Without gastropexy, the recurrence rate of bloat may be as high as 75%!

Health Matters...Hypertrophic Osteodystrophy

S. Gary Brown, D.V.M., D. A.C.V.S.

Irish Setter Club of America Health Committee Member

Hypertrophic Osteodystrophy causes lameness and extreme pain in young growing dogs. It is often misdiagnosed. The Irish Setter Club of America is currently conducting extensive research into this disease. The following article by orthopaedic surgeon Dr. S. Gary Brown is reproduced with the author’s permission.

Hypertrophic Osteodystrophy (HOD) is a developmental disease in larger breed dogs (commonly the Great Dane, Alaskan Malamute, and Irish Setter). This disease usually begins between the ages of 3 months to 5 months of age. HOD is often sporadic and can vary in intensity. Although at times several dogs from one litter may be affected. There are questions about the heritable nature of the disease but no answers from an organized study have been documented.

Most of the affected animals are first presented because of lameness or reluctance to walk. There are often fevers of 104 - 104.2degrees F (over 40 decrees C) and anorexia (refusal to eat). These signs usually get progressively worse. Over days the metaphyseal regions of the long bones (the area next to the growth plate, but towards the mid bone, not the joint) will be tender to digital pressure, slightly swollen and warm to the touch (using the inside of the wrist). More adversely affected animals will be systemically ill. The fevers and anorexia will continue, and weight loss comes quickly if the affected animal is not treated. This disease is bilateral (both sides) and often will effect the metaphyses of front legs as well as rear legs.

Symptoms can be episodic and are often relentless. Reports of responses to various treatments can be traced to dogs with episodic disease and varying degrees of severity. This information is anecdotal at best. Early on the metaphyseal area becomes swollen and very painful. It is in this metaphyseal area that HOD exerts its major pain and produces radiographic changes. The distal radial/ulnar metaphysis (above the wrist joints) are the most commonly affected sites, although the metaphyses of all long bones are certainly susceptible. Therefore it is not uncommon to see clinical disease and radiographic changes in the metaphyses of many long bones in the body. There are severe inflammatory changes going on in the metaphysis and resultant changes in the local blood flow. This change can disturb normal cartilage growth and development of the adjacent growth plate (physis). The resulting interference in the cartilage transformation into bone (endochondral ossification) can be seen as finger-like at times, extending up into the metaphyseal marrow cavity. The result can be premature slow-down or early growth plate disruption, resulting in shorter bone length or even curvature.

This is more common in the Great Dane than the Irish Setter (in my experience). The usual microscopic changes, which are seen in the metaphysis, are Inflammation, haemorrhage, necrosis (cellular death), microfractures and remodelling of the bone. Periosteal new bone (a thin sleeve of bone around the outside of the cortex can occur as the result of inflammation).

The cause of HOD remains unknown; however, there are many speculations. The autoimmune nature of this is currently under investigation at one university. Viral causes (even Canine Distemper) have been implicated, although they just might be one more kind of stress precipitating HOD. Vitamin C deficiency has been thought to be a cause; however, there is neither documentation nor scientific reason for this in the dog. Vitamin C therapy has not met with much success.

Excessive amounts of dietary protein and high caloric intake have been implicated; scientific support for this is also lacking. However, over nutrition does play an important role in Osteochondrosis. An infectious origin has been proposed, and there are reports where hematogenous (blood borne) bacteria have been noted to produce florid radiographic changed in the metaphyses which perhaps could be confused with HOD.

Therefore, if not careful, hematogenous or osteomyelitis (bone infection) could possibly be confused with HOD. A good radiologist should be able to differentiate this. Documentation of the use of possible blood cultures, to isolate bacteria, in HOD cases has not been reported. Therefore documentable cases of actual infections have been few. For most cases, the cause is still unexplained.

Diagnosis is usually clinical, and later confirmed by radiographic examination. In the very early stages there is point tenderness in the metaphysis. One week later we see radiographic changes. This is represented by a radiolucent line, parallel and immediately adjacent to the growth plate. This line represents bone necrosis and reabsorption of some of the microspicules of bone. This metaphyseal region may remain mildly affected throughout the course of the disease if well treated, or may show early irregular widening if there is some alteration in the growth plate and its endochonral ossification. The periosteal new bone formation may form a collar around the bone, localized to the inflamed metaphysis, or it can be rather extensive and extend several centimetres toward the mid bone. On occasion, severe involvement can affect the growth plate, often the distal ulna, resulting in lateral bowing deformities of the front legs.

In all cases of true HOD, treatment is begun by anti-inflammatory doses of Prednisone. We have not used immunosuppresive doses in the cases we have treated so far. The initial doses of Prednisone (2mg/Kg/per day) will start for 7-10 days, and gradually be weaned down for approximately 4 weeks. In all cases we add Multi-source Glucosamine, 3V Caps (or Derm Caps’) and supportive care. The mild cases are not difficult to treat, whereas the more severely affected animals require more aggressive care. Those animals that are not treated early on require IV fluids and electrolytes, nutritional support, and tremendous nursing care to arrive at a successful result. On occasion, parenteral nutrition is needed for a severely affected animal. Pharyngostomy tubes have been used for liquid food administration.

Nursing care is paramount in the successful management of the much more severe cases. We have always added oral antibiotics: usually Chloromycetin or alternately Clindamycin for 3 to 4 weeks. In two cases of Great Dane HOD, mild puppy strangles (juvenile cellulitis) were apparent. The use of Prednisone has been critically important.

The use of non-steroidal anti-inflammatory Multi-source Glucosamine may take 7-l0 days to take effect, which coordinates with the reduction of the Prednisone doses. If well treated with anti-inflammatories, the need for pain medications can be greatly reduced to the use of other oral medications such as Torbutrol, being careful to not suppress the dog¹s appetite.

The dogs which have been treated solely with Rimadyl have mostly not done well at all. The prognosis for the mild cases can have a good prognosis. Severe cases are more difficult. Lately we have seen more effective treatment for the severely affected cases with the above regimen.

Early recognition and appropriate treatment of HOD will hopefully not allow your dog to reach a critical metabolic state. I would hope that some of this information will assist in making the early diagnosis of Hypertrophic Osteodystrophy.