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Recognizing the Important Work of Service Dogs

Service dogs are special companions. They help people with disabilities, they provide comfort in times of crisis, they support our country’s police force and military, and they do so much more. At Atlantic Veterinary Internal Medicine & Oncology, we understand just how important these dogs are, especially to the people they serve. We’re proud to be able to provide internal medicine and oncology services to keep them in the best of health so they can go on to do great things.

So, what are some of those great things service dogs do? Not all service dogs wear a vest, meaning many of them are doing extraordinary work in plain sight. Let’s take a look today at the essential roles service dogs play in our communities, and how they help their human companions.

What Kinds of Service Dogs Are There?

To understand what service dogs do, it’s first important to understand what they are. The Americans with Disabilities Act (ADA) defines service dogs as dogs that are individually trained to perform specific tasks and to work with people with disabilities. The ADA defines disabilities as “physical, sensory, psychiatric, intellectual, or other mental disability.” It’s important that the work of the service dog be directly related to the handler’s disability, which grants them status as an official service dog. Service dogs have legal rights that other trained dogs don’t have including full public access rights with their handler and acceptance on flights and other forms of public transport.

 

Types of service dogs include:
Guide Dogs – Guide dogs, or “seeing eye” dogs are one of the most well-known type of service dog. These dogs help people with blindness or visual impairment navigate the world safely and independently.

Hearing Dogs – Hearing dogs alert people who are deaf to sounds such as an alarm, a knock on the door, or someone entering a room.

Psychiatric services dogs – Psychiatric dogs assist people living with a mental disorder such as post-traumatic stress disorder, anxiety, or depression. These dogs can help lessen the frequency of psychiatric episodes and can help their humans feel safer in the world. Those with PTSD can often be hyper vigilant about their safety, but their dogs can help them feel safer by entering a room before them and turning on the light, accompanying them to public places, and more.

Mobility assistance dogs – These dogs help people with mobility limitations, such as needing to use a wheelchair, prosthetic, or other assistive device. Mobility assistance dogs perform tasks for their people such as fetching things their handlers can’t reach, opening doors or cabinets, and carrying items.

Seizure alert/response dogs – While somewhat controversial, seizure alert dogs are trained to predict the onset of a seizure in their handlers, although there is no clear scientific evidence that they can do this reliably every time. Seizure response dogs, on the other hand, are trained to stand guard over their handler when they are experiencing a seizure, bring them medication or a phone after an episode, or even go for help.

Autism assistance dogs – These dogs help those on the autism spectrum more easily navigate their surroundings. They can help distinguish important sensory input (like a smoke alarm) from other sensory input, act as icebreakers in social situations, and can even alert their handlers to repetitious behaviors or overstimulation.

What’s the Difference Between Service Dogs & Working Dogs?

Working dogs are those that are trained for a specific purpose such as detection, herding, hunting, search and rescue, police work, or military service. These dogs do not have the same legal rights as service dogs because they are not assisting someone with a disability—therefore they are not covered under the ADA. However, whenever and wherever they are performing their job, they are not often subject to legal ramification.

Types of working dogs include, but are not limited to:
Search and rescue – these dogs are trained to find missing persons, whether from a kidnapping, a natural disaster, drowning situations, avalanches, or other dire situations. They often either use a scent in the air or the scent of a specific object to find what or whom they’re looking for.
Police K9 units – These dogs have a variety of roles in the police department from sniffing out drugs, criminals in hiding, or contraband to patrolling, or actively attacking a suspect.
Military dogs – Military dogs serve with our armed forces in many different roles similar to police dogs, but the ante is upped significantly. These dogs are trained to endure harrowing combat experiences while still performing their duties, which might include explosive detection, patrol, search and rescue, and attack.

Are Therapy Dogs Considered Service Dogs?

Therapy dogs are not considered service dogs. While therapy dogs do go through training to become certified, they are not trained in a specific role to help someone with a disability, and so are not covered by the ADA. Therapy dogs often work with their owner to provide comfort to people in nursing homes, hospitals, hospices, schools, and mental institutions. These dogs need to be comfortable in new environments and unfazed by unfamiliar sounds and movements. They also need to be happy with being handled and loving people is a huge plus!

We Support Working & Service Dogs

At Atlantic Veterinary Internal Medicine & Oncology, we are proud to provide services to our community’s working and service dogs that help them do their best jobs yet. These dogs must be at the peak of physical fitness to be able to fully perform their duties and serve their handlers. We also recognize the deep bond these dogs share with their handlers, and we’re dedicated to strengthening it with our specialized medical care. If you or a loved one works with a service or working dog who needs internal medicine or oncology care, please reach out to us at (410) 224-0121 and we’ll be happy to help.

Understanding Osteosarcoma in Dogs in Annapolis, Columbia & Towson

Osteosarcoma is a form of bone cancer in dogs that accounts for 85% of primary bone tumors diagnosed, making it the most common bone tumor. It is a highly aggressive tumor, characterized by local invasion and destruction of the bone as well as early metastasis (spread to other organs, the most common site of metastasis being the lungs). Osteosarcoma most commonly affects the limbs (or the appendicular skeleton) of large to giant breed dogs.  It can also occur in other bones such as the skull, ribs, vertebrae, and pelvis (the axial skeleton) which are more common sites in smaller dogs.

Clinical Signs of Osteosarcoma

The signs associated with bone cancer in dogs may be nonspecific and depend on the location. Tumors involving the limbs often cause various degrees of lameness, pain, and muscle wasting, and a firm swelling may become evident as the tumor grows. The pain can cause other problems such as irritability, aggression, loss of appetite, weight loss, whimpering, restlessness or reluctance to exercise.

Diagnosis and Work-up (Staging)

The initial evaluation for any dog suspected of having a bone tumor will include a complete physical exam, blood work (complete blood count, serum chemistry profile), urinalysis, radiographs of the primary site as well as the lungs, and an aspirate or biopsy of the lesion. In some cases a CT scan is recommended to evaluate for metastasis and/or surgical planning.  Unfortunately, 80-90% of dogs diagnosed with osteosarcoma already have microscopic spread to the lungs but we are not able to detect these microscopic lesions with X-rays or a CT scan. The work-up and staging are important for two reasons. First, it is necessary to determine the tumor type and extent of the cancer to determine the appropriate treatment and prognosis. Secondly, it also provides the clinician with information regarding your dog’s general health and may identify concurrent medical or musculoskeletal problems all of which may influence the treatment recommendations. 

Treatment Options for Osteosarcoma in Dogs

Treatment recommendations for bone tumors depend on multiple factors and the ultimate goal is to help improve your pet’s quality of life. Treatment can be divided into two parts:

  • Pain management/treatment of the primary tumor
  • Treatment to address the risk for metastatic disease

Pain Management

The initial focus of treatment is pain management. Osteosarcoma causes pain due to the invasion and destruction of normal bone by the tumor. There are several options for pain management depending on the location of the tumor. These include surgery (amputation for osteosarcoma of the limb), oral analgesics (pain relievers), radiation therapy and/or intravenous bisphosphonate therapy. 

For osteosarcoma involving a limb, amputation is the best method for pain control. It is much easier to control post-operative pain than it is to control chronic bone pain. An amputation also eliminates the risk of a fracture at the tumor site. Fractures occur because the tumor weakens the bone to the point that it can break. Fortunately, the risk of a fracture is low (~20%).  Most dogs will do very well with an amputation and often resume many of their normal activities such as running, playing, swimming, etc. It is important to understand that if an amputation is performed for osteosarcoma without chemotherapy, most patients develop metastatic disease and succumb to the cancer within 4-6 months, which is why we don’t always recommend amputation as a sole therapy.

For dogs that are not candidates for an amputation or situations in which a caretaker isn’t interested in amputation, we have several options for pain management that can be used singly or in combination. There is no “one size fits all” when it comes to pain management and we may need to try several combinations until we find what works best for a particular dog. 

Oral Analgesics include non-steroidal anti-inflammatory drugs (NSAIDS) (or aspirin-like drugs), steroids and narcotics. It is common to combine a NSAID with a pain medication like gabapentin, amantadine, codeine and fentanyl.

Palliative Radiation Therapy (PRT) involves the use of several large doses of radiation administered once a week, for 3-4 doses. PRT appears to be the best option for pain management if surgery (amputation) is not pursued. The goal of this form of radiation is to improve/maintain the patient’s quality of life with minimal negative impact (minimal side effects). Approximately 70% of dogs experience pain relief with PRT which lasts for an average of 4 months. It may be possible to repeat a course of PRT, depending on the dog, though the duration of the response is usually shorter than the original response. PRT for bone tumors (appendicular) is for pain management and is not a treatment for the primary tumor. In most patients the tumor continues to progress even though the patient is more comfortable and fracture is still a risk.

Bisphosphonates: Bisphosphonatesare is a class of drugs that are meant to slow or prevent bone breakdown as well as increase bone production. This class of drugs is used frequently in women to prevent osteoporosis (ie. Boniva or Fosamax). Several of the drugs have also been used to help control pain from bone destruction. The most commonly used drug is zoledronate. This medication is administered intravenously once every 4 weeks as a 15 minute infusion. Initially we plan 2-3 treatments and then determine if there has been an improvement. If there has been an improvement, this drug can be repeated for as long as there is response and the patient tolerates the drug. Side effects are rare, but we do monitor kidney function prior to each treatment due to a low risk for kidney damage.

Chemotherapy

The most common cause of death in dogs with appendicular osteosarcoma, especially those undergoing an amputation, is metastasis to the lungs. Because of this, systemic chemotherapy is recommended as a follow-up to surgery for dogs with appendicular osteosarcoma. Chemotherapy is not likely to cure most dogs with osteosarcoma but can significantly prolong their quality of life to 10-12 months on average with 20% of patients alive at 2 years. Survival time for dogs treated with an amputation alone is about four months. We currently recommend the chemotherapy drug Carboplatin. This chemotherapy agent is administered intravenously once every three weeks for 6 doses. Most dogs tolerate chemotherapy well with less than 10% experiencing side effects significant enough to warrant an outpatient visit and less than 1% will require hospitalization or experience any life-threatening side effects secondary to chemotherapy.  

The goal of any treatment is to maintain your pet’s quality of life. Your veterinarian will work with you to determine the best course of treatment for you and your dog.

Hemangiosarcoma in Dogs in Annapolis, Columbia & Towson, MD

Hemangiosarcoma of the spleen, or spleen cancer in dogs, is a cancer that is diagnosed in many canines every year. It is a cancer made up of the cells that line blood vessels, and therefore can be found in any part of the body. However, the most common sites include the spleen, liver and right auricle of the heart. Approximately 2/3rds of masses in the spleen are malignant and of those, 2/3rds are diagnosed as hemangiosarcomas. Splenic hemangiosarcoma is most often diagnosed in older dogs, with German Shepherds, Labrador Retrievers and Golden Retrievers being the most commonly affected breeds.

Splenic hemangiosarcoma in dogs is very dangerous because there are very few signs of the cancer until the spleen either ruptures or the cancer happens to be spotted on a routine abdominal radiograph or ultrasound. This is largely due to the fact that the spleen is deeply seated in the body. In fact, many dogs that are diagnosed with splenic hemangiosarcoma present to their veterinarian on an emergent basis with a history of lethargy, decreased appetite, weight loss, acute collapse, pale to white mucous membranes and/or swelling in their abdomen. Vomiting and diarrhea can also be seen in a small percentage of patients.

Splenic masses can sometimes be seen with abdominal radiographs but are most often diagnosed with an abdominal ultrasound. In either case, once a splenic mass has been detected, it is in the patient’s best interest to undergo further diagnostics (i.e. staging tests) to evaluate for any evidence of metastasis (spread of the cancer to other areas of the body). These tests include an abdominal ultrasound (if not already performed) to evaluate for possible disease in any of the other abdominal organs, chest radiographs determine if there is any evidence of disease in the lungs, blood work that includes a CBC (which checks the red and white blood cells and platelets), a chemistry panel, clotting times and a urinalysis. An echocardiogram of the heart may also be warranted. Studies have shown that a small percentage of patients with splenic hemangiosarcoma can have a mass in the right auricle of the heart at the time of diagnosis.

Surgery is the primary treatment for a splenic mass and we need to keep in mind that not all splenic masses are malignant. The only way to obtain a definitive diagnosis is with removal of the spleen and submitting the sample for biopsy.  The hope is to pursue surgery before the mass or masses rupture, but most patients present in a crisis secondary to rupture of the mass leading to emergency surgery. With surgery alone, the median survival time is approximately 1-2 months with patients succumbing to metastatic disease.

Hemangiosarcoma has a high metastatic potential even if the spleen has been removed. Due to the aggressive nature of hemangiosarcomas, chemotherapy may be recommended to try and slow the progression of the cancer.  The primary chemotherapy drug used to treat hemangiosarcoma is doxorubicin (also known as adriamycin). Fortunately, most patients tolerate chemotherapy well with minimal side effects. These side effects can include stomach upset (decrease in appetite, nausea, vomiting, diarrhea and lethargy), decrease in white blood cell count and thinning of the fur coat. In addition, doxorubicin has also been shown to have a cumulative toxicity on the heart and because of this, doxorubicin has a lifetime dose in dogs that we do not exceed. In some cases, an echocardiogram may be recommended prior to the first treatment to obtain a baseline of their heart function and then again prior to the 5th or 6th treatment. Doxorubicin is administered intravenously once every 3 weeks for 4-6 treatments. Patients treated with surgery and chemotherapy experience a median survival time of 4-6 months.

In addition to traditional therapy, there are a couple of other treatment options that have shown some promise, but there is limited information regarding their true efficacy. These include I’m Yunity and Yunnan Baiyao. I’m Yunity is an extract of polysaccharopeptide from Coriolus versicolor mushroom (commonly known as the Yunzhi mushroom) that showed some promise in a small study out of the University of Pennsylvania. This study was very small, so it is unknown whether the information gathered in this study is representative of the larger population.

Many oncologists are prescribing the Chinese supplement Yunnan Baiyao. This supplement is thought to help slow down or stop bleeding from some of the cancerous lesions. There is also some data that shows it may also promote healing and possibly has some anti-tumor benefit against hemangiosarcoma. To better understand the benefit of this supplement, clinical studies are needed.

There may be some ongoing clinical trials available to your pet. Clinical trials are most often trying to find a new and possibly better treatment to improve the outcome for dogs with hemangiosarcomas.

Splenic hemangiosarcoma is a very aggressive cancer and, unfortunately, long-term control/survival is difficult to achieve.  Our main goal when treating your pet is to provide good quality time for all of you.