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Seizures; Perianal Fistula

Seizures; Perianal Fistula

Also, hereditary deafness.

Question
I have a six-year-old chocolate Lab male who came from a local breeder and has nothing special about his pedigree. He is an outside dog during the day and a house dog at night. I would like to breed him with my female "high end" yellow Lab this fall and am considering getting him OFA tested and an eye certification.

Dogs with predominantly white coats may be at higher risk for hereditary deafness, especially if they also have blue eyes. The majority of pointers are free from this affliction, however.

The problem is that I have witnessed him experience two seizures. From what I have read, the seizures I witnessed were mild, with stiff muscles, mild to moderate trembling, and one scared dog. They lasted less than three minutes and were mild enough that he could have one beside my bed during the night and I might not even wake up.


I have talked to my vet and she recommended caution and monitoring the number and severity of seizures. If anything changes, I am to bring him in for testing and treatment. I have not witnessed an occurrence in 13 months.

The only reason I am considering him for breeding is because of his abilities in the field, blind, and home.


With the availability of outstanding stud dogs in the Lab market should I eliminate him from contention because of his condition? Save my money on the OFA and eye cert testing? Possibly neuter him?

If he is bred do I, as an ethical breeder, release the seizure information to potential puppy buyers?
--JB

Answer
I would eliminate him from breeding consideration. One thing the Lab breed has going for it is a lot of dogs to choose from and a lot of progeny history. It is difficult to get a diagnosis of the cause of a seizure problem in dogs but most are idiopathic epilepsy, and in the Lab and several other breeds this should be considered as hereditary.

Other causes are head trauma, viral diseases, hypoglycemia, other metabolic diseases and brain tumors. I feel there is no need to take a chance of passing on a seizure problem when there are many other studs to choose from.

Do keep as accurate a record of your dog's seizures as you can. This will help your veterinarian establish a diagnosis and develop a treatment plan if seizures become more frequent or more severe.

Question
About two weeks ago, I noticed my nine-year-old Brittany, Cleo, was having trouble defecating at times. She would arch her back and strain and trot off with her back arched, having produced little if any feces. Shortly thereafter, she started to excessively lick her anal area. I took a look at it and saw that the area was quite inflamed, so I took her to the vet.

By then the anal area was bright red, and there was some bleeding. The diagnosis was perianal fistula and I was sent home with the following prescriptions: prednisone 20mg/twice daily and cephalexin 500mg/twice daily. The prednisone was to taper off after 7 days, with a follow-up appointment in 10 days.

What I wasn't told at the time is that this is a very serious condition. Over the next few days her condition has deteriorated (although the pus seems to be gone) to the extent that she is nearly fecally incontinent. (I have kept her in an Elizabethan collar continuously).

On walks she will attempt defecation without success. At home she'll just be lying there and the feces will ooze out. So now she's collared and diapered.

Despite all this she doesn't appear depressed (put out a little, maybe) and still exhibits energy and enthusiasm on her runs and swims. Also, she has dropped 2 to 3 pounds since last weighed in April and now weighs 40 pounds. This dog has never been sick in her life until now.

Today I took her back to the vet and had a consultation with the vet (and clinic owner), a woman of long experience and considerable empathy. Here's what she prescribed: 30 days of cyclosporine (generic) @50mg/twice daily with weekly follow-ups with the possibility of adding a topical in the future.

I also bathe Cleo two or three times a day, have prevented her from licking herself and she is taking the above medicine. Am I doing all I should be doing?
--RF

Answer
This is the only question about perianal fistula that I can remember since day one of this magazine. This disease is most commonly seen in German shepherds. It is also reported in the Irish setter but my experience with it in the hunting breeds has been limited to a few cases in Brittanys and springers. I have seen a number of cases in shepherds and they are no fun to treat.

Many things have been tried as treatment regimens and nursing aids for this disease. This tells us that nothing really works very well. I think a combination of things is the best approach and you must expect that healing will be a long process with many hours spent in home care and rechecks at the veterinarian's office.

Years ago I began by starting the dog on a long course of antibiotics, along with flushing of the tracts under anesthesia and then keeping the dog on stool softeners to prevent constipation. Current therapy has evolved to surgery to remove all diseased tissue around the anus. This is accomplished with sharp dissection, cryosurgery, or laser surgery.

Each has its own advantages but all can leave the dog with fecal incontinence problems and post surgical healing problems. Antibiotic therapy is usually combined with the surgical procedure and administered for three to four weeks. The latest addition to this therapy is some course of immunosuppressive drugs to address the immune mediated issues that have recently been incriminated as part of the pathogenesis of perianal fistulas.

One option for this phase is prednisone. This drug is cheap but does have some side effects. The newer drug is cyclosporine. It is effective when given on a long-term basis but is very expensive, especially for large dogs. Along with this some dogs benefit from eating hypoallergenic diets.

Then there is the daily nursing care. This should consist of cleaning fecal soiling from the hair coat, enemas if constipation occurs, irrigating the healing surgical area and pain medication. There are reports of dogs benefiting from tail amputation. The theory is that the tail covers the anus when it hangs down, which cuts off air circulation to the area.

This moist atmosphere is very susceptible to infection. I've not tri

ed this and feel it is rather drastic.

Prognosis is not good for perianal fistula. Many will eventually heal, but be prepared for long periods of treatment and much nursing care.

Question
My three-year-old English pointer had puppies 15 weeks ago, three males and four females. Two of the female pups developed sensory neuropathy, and one of the two has been put down.

Could all of the pups have this problem? Is it hereditary? Does it come from the male or female, or is it caused by a combination of the two? Is there a test to check for this? Is there a cure?
--J

Answer
Deafness occurs in all breeds and can be due to either congenital causes or acquired causes. In the group of congenital causes are the hereditary defects that cause pups to be born deaf. The Dalmatian is the breed most noted for its high incidence of hereditary deafness in puppies.

Other breeds certainly can have deaf puppies from genetic causes but little research has been conducted to delineate modes of inheritance and genetic markers for the condition.

Some things we do know. In pointers and other breeds it is probably passed as a recessive disease and requires both parents to have the gene to produce puppies with deafness.

Another finding is that pups with mostly white coat color and/or blue eyes have congenital deafness. I was interested to find that in a colony of pointers kept for their nervousness, and used as a model for the study of nervousness and anxiety issues in humans, there was a high incidence of hereditary deafness.

It was postulated that their nervousness was precipitated by the fact that the dogs could not hear and were frequently startled by sudden intrusions into their space. Also, in an attempt to maintain this colony with this nervous trait, the dogs were highly inbred.

Bottom line is that in our average population of pointers, with the frequent crossing of bloodlines that occur we very rarely see a puppy born with hereditary deafness.

You might want to check the pedigrees of the sire and dam of your liter and see if anyone else has had congenital deafness show up in their breeding. Also consider the coat color factor and look at that, as well.

Tom Holcomb remains at htholcombdvm@qwestoffice.net.

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