LARYNGEAL PARALYSIS IN THE MINIATURE BULL TERRIER
the test is finally available !!!
Larynx paralysis is a disease in the Miniature Bull Terrier, which is scientifically not well understood. Larynx paralysis leads to difficulties in breathing, especially during physical activity, and may cause death by suffocation in severe cases. Larynx paralysis may require surgery to relieve the difficulties in breathing. fortunately it has been identified a genetic risk factor for larynx paralysis in Miniature Bull Terriers. Genetic testing has become available.
In the course of a major research effort we successfully identified a genetic risk factor for one form of larynx paralysis (LP) in Miniature Bull Terriers. Our research was supported by many
highly motivated owners who donated samples and data of their dogs. The identified risk factor for LP has an autosomal recessive mode of inheritance with variable penetrance. Therefore, not every dog with a high risk genotype will actually develop LP. On the other hand, it is also possible that dogs with one of the favourable genotypes nonetheless will become affected by LP. The identified risk factor does not explain all forms of LP. We
assume that additional, clinically similar forms of LP exist. These other forms of LP are controlled by so far unknown factors.
the study enables genetic testing and thus may help to avoid the accidental breeding of puppies with an elevated risk for LP. Genetic testing is currently offered by Laboklin.
Laryngeal paralysis is a common condition of middle to older aged dogs that involves
loss of normal function of the larynx. The larynx is a collection of cartilage flaps, or
laryngeal folds that sit in the back of the throat over the entrance to the trachea (wind
pipe). Muscles attach to the larynx allowing it to open when breathing and close when the
dog is eating and drinking to protect the airway. When the larynx becomes paralyzed, the
folds remain in the closed position even when the dog is trying to breathe. Breathing
becomes labored and difficult.
There are many potential causes of laryngeal paralysis, but the most common cause is
idiopathic. This means there is not an identifiable underlying cause. The most common
presentation occurs in older dogs, Most of
the time laryngeal paralysis does not progress to involve other parts of the body.
However, some dogs have been noted to develop neurologic signs in other parts of the
body within a year of diagnosis suggesting that laryngeal paralysis is part of a more
generalized problem (degenerative polyneuropathy affecting multiple nerves).
Signs & Symptoms
Clinical signs of laryngeal paralysis are primarily a result of progressive failure of the
laryngeal muscles. Dogs with laryngeal paralysis are noisy when breathing in,
particularly when panting. In early stages of the disease, owners may easily miss the
abnormal sounds. As the disease progresses, the dog may fatigue easily, develop a bark
change, and cough/gag when eating and drinking. Signs may progress for months to years
before becoming a clinical problem for the dog. Severe upper airway obstruction can
occur during strenuous exercise or in heat and humidity, which results in respiratory
distress and collapse. The symptoms can snowball as increased breathing rates and
panting cause the laryngeal folds to become swollen and inflamed and worsen airway
obstruction. Dogs that have more generalized signs (degenerative polyneuropathy) may
present with difficulty swallowing, regurgitation, and hind end weakness
Treatment & Aftercare Treatment options can vary widely depending on the severity of signs and quality of life. Dogs that are not severely affected may be managed conservatively. Conservative management involves moderation in exercise, weight loss and possibly anti-inflammatory medications to reduce laryngeal swelling. Dogs that have severe difficulty breathing may be candidates for surgery. Multiple surgical techniques have been described, however “laryngeal tie back” surgery is the most commonly performed. This procedure, also known as arytenoid lateralization involves suturing one or both sides of the larynx into a permanently open position to relieve upper airway obstruction. Tie back surgical procedures carry the risk of leaving the airway unprotected and increase the risk for aspiration pneumonia. As a last resort, a tracheostomy can be performed. Prognosis Prognosis for improvement of clinical signs and quality of life is generally good to excellent for idiopathic laryngeal paralysis. Unilateral (one sided) laryngeal tie back surgery usually results in less respiratory distress, less respiratory noise, and improved exercise tolerance, but leaves dogs at risk for developing aspiration pneumonia. Dogs with more generalized signs (degenerative polyneuropathy) progress to develop additional neurologic signs around one year following diagnosis. Unfortunately, it can be difficult to predict which dogs will progress to develop more generalized signs. However, dogs that do not develop more generalized signs can continue to live a good quality of life following successful treatment of laryngeal paralysis
Treatment options can vary widely depending on the severity of signs and quality of life. Dogs that are not severely affected may be managed conservatively. Conservative management involves moderation in exercise, weight loss and possibly anti-inflammatory medications to reduce laryngeal swelling. Dogs that have severe difficulty breathing may be candidates for surgery. Multiple surgical techniques have been described, however “laryngeal tie back” surgery is the most commonly performed. This procedure, also known as arytenoid lateralization involves suturing one or both sides of the larynx into a permanently open position to relieve upper airway obstruction. Tie back surgical procedures carry the risk of leaving the airway unprotected and increase the risk for aspiration pneumonia. As a last resort, a tracheostomy can be performed.
Prognosis for improvement of clinical signs and quality of life is generally good to excellent for idiopathic laryngeal paralysis. Unilateral (one sided) laryngeal tie back surgery usually results in less respiratory distress, less respiratory noise, and improved exercise tolerance, but leaves dogs at risk for developing aspiration pneumonia. Dogs with more generalized signs (degenerative polyneuropathy) progress to develop additional neurologic signs around one year following diagnosis. Unfortunately, it can be difficult to predict which dogs will progress to develop more generalized signs. However, dogs that do not develop more generalized signs can continue to live a good quality of life following successful treatment of laryngeal paralysis.
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PRIMARY LENS LUXATION (PLL)
What is dislocation of the lens?
The lens is in the eye, behind the pupil, and is suspended from thin wires. This suspension apparatus, called "zonulae" or "ciliary threads", serves on the one hand to the positioning of the lens behind the pupil (or Blende, to use a term optical) and the other to the tensioning or to the release of the lens, which thins or thickens.
These wires must be resistant. The genre changed, however, causes a weakening of the materials. With increasing age the seal becomes so weak that the fine wires tear. Often enough already slight mechanical stresses, such as with the barking force. When the wires are torn, the lens is pushed by the pressure of the liquid of large cavity ocular rear through the pupil until the anterior ocular cavity. There, it gives rise to irritation. Furthermore, the outflow of the liquid eye no longer takes place correctly. Through the "ciliary threads" and the pupil it penetrates into the cavity anterior ocular from where it escapes through the pores located at the corners of the cavity itself. This leads to a high pressure in the eye, for glaucoma, which can in turn cause significant eye damage and severe pain for the dog. In rare cases, the lens falls back into the eye socket, which is less dangerous. In the absence of glaucoma can groped to remove the lens with a surgical intervention. Sometimes must be removed the entire eye. The drama lies in the fact that often immediately after the first eye becomes ill also the second. For the dog that is the end of a period in which hunting was joy and passion.
The identification of the gene.
The dislocation of the lens also affects humans. This gave me the assurance that in the world of research you do everything to find the gene for the disease. I've always said that you had to wait for the science did light on the problem. For this reason I also considered the probability of genotype a kind of transition to molecular genetic analysis. "The Success comes to him who knows how to wait." In fact that's what happened. Despite the general assembly of 2009 has resolved to proceed in search of the gene, there was no need. In September 2009, even before the Club received the Deutscher Jagdterrier Veterinary Institute Hannover research plan, two groups of American and British researchers have found almost simultaneously the gene and suggested a genetic test. We are now able to supplement or replace the estimated probability of genotype with safe identification of the genotype.
It must first be said that the breeding plan, so far valid, is no longer adapted to the new situation. Once the carriers of disease susceptibility were always considered to be a risk, because no one knew if they were being played coupled with other carriers of disease susceptibility, are not recognized as such. Today these animals are not scared anymore. If you are matched with animals tested genotype N / N, 50% of the puppies will be healthy (N / N) and the remaining 50% will consist of carriers of disease susceptibility. None of the young animals, however, will be sick! Therefore, there is no reason to exclude the activity reproduction. If a breeder wants to choose a puppy from this litter to be used later as a player, can play it safe and recognized by genetic testing a dog of the type N / N. The fact that whole dynasties have been the victim of anti-dislocation of the lens, a thing of the past. If the old the breeder was still valid, after testing the genetic breeding of the dogs would be unnecessarily removed from the reproductive process. One of our goals was to avoid this faulty behavior within herds. The new breeding plan for the elimination of the mutation in breeds includes the terms from which they can be used only when playing more than dogs absolutely healthy.
First of all, a few definitions that might help with the understanding of cardiac disease.
A HEREDITARY cardiac disease is one that is passed on genetically from the parents to the pups. It may not always be expressed as disease that can be detected in the dog, but may lie hiding in the genes, waiting to be passed on and possibly expressed in future generations.
A CONGENITAL heart disease is one that an individual pup is born with.
In most cases this is technically apparent on examination in the young pup, although young pups can be very difficult to examine, so that a murmur may only be detected in larger and older pups.
There are a few congenital cardiac diseases that do not have murmur associated with them. In some instances the disease becomes more obvious as the heart grows and matures.
For example, sub aortic stenosis (SAS), can increase in severity as a pup grows, which is one of the reasons heart testing is performed after 12 months old (18 months old in giant breeds).
A congenital disease is not always inherited from the parents. A pup may develop abnormally in some way as a foetus because of an individual problem.
ACQUIRED heart disease is not present in any way at birth and develops later in life. The dog can have hereditary predisposition to developing an acquired disease, as can be seen with certain breeds being more prone to developing dilated cardiomyopathy (DCM).
A MURMUR is the sound of turbulence when listening to the heart. The heart sounds normally heard with a stethoscope (lub-dup, lub-dup etc) are created by the sound of blood hitting closed valves.
The blood usually flows around the heart smoothly but anything leading to turbulence in the flow may be heard as a murmur (a whooshing sound around the normal heart sounds).
Sometimes minor turbulence is created in the heart when no disease is thought to be present and might be heard as a murmur.
Congenital Heart Disease in Bull Terriers
There are 2 areas of the heart more commonly affected by congenital abnormalities in English Bull Terriers.
Firstly, the aorta, which is the large vessel leaving the heart on the left side with oxygenated blood to transport to all the arteries in the body. This can show stenosis obstruction which makes it more difficult for the left ventricle to pump the blood out through this vessel.
The second area is the mitral valve which is between the left atrium (this chamber receives oxygenated blood from the lungs) and the left ventricle. This valve can also show stenosis and not open properly, thus restricting the passage of blood into the ventricle. It can also leak when closed so that when the ventricle pumps blood out of the aorta, blood leaks back the wrong way into the atrium. These can be seen separately or together.
Because these congenital abnormalities of the aorta and mitral valve are seen more commonly in Bull Terriers it is assumed that there is a hereditary reason for this. I am not aware of detailed genetic research into these conditions in the breed, but stand to be corrected, as it may not have come to my attention, particularly if in another country.
Other congenital conditions can of course exist in Bull Terriers but are only seen at a 'normal' rate of incidence
Absence of a murmur
Bull Terriers who have no murmur or other obvious signs of cardiac disease when a
cardiologist is able to have a good listen, are considered as passing the heart test and this is a great step towards insuring that healthy dogs are used for breeding. It is a test that is to be encouraged and whilst not infallible, it is not costly, and far better than no heart test at all before breeding.
Whilst it is certainly very good news if no murmur can be heard, unfortunately it does not mean that there is definitely no congenital heart disease present and also does not mean that acquired cardiac disease will not develop in the future. For example, the mitral stenosis mentioned, may not give rise to an audible murmur if it occurs alone and SAS may not produce a murmur that can be heard until the dog is older. In an ideal world, given that Bull Terriers are hard to listen to, all dogs to be used for breeding would be scanned, including those without murmurs. However it is understandable that for many owners the cost of the scan is prohibitive and passing the stethoscope heart test is a very good first step towards finding out if your dog has a healthy heart.
Murmurs in Bull Terriers
Bull Terriers are not the easiest dogs to listen to with a stethoscope! The shape of their chest and their muscular build put the heart a long way from the chest wall and, if the dog is excited the breathing and movement sounds produced can make it almost impossible to hear the heart sounds in a few dogs. Any dog in which a murmur can be heard and dogs who are impossible to listen to with a stethoscope should have echocardiography (heart ultrasound scan) performed by a cardiologist if there is a desire to breed from that dog. In the interests of general health
it is better to perform this investigation anyway if a Bull Terrier has a murmur. In some cases the scan might show that the murmur is not associated with cardiac disease and is 'innocent' or physiological and then that dog could be used for breeding. If cardiac disease was confirmed by a scan it would allow the owner to make an informed decision not to use that dog for breeding and also would help determine any need for treatment, monitoring and prognosis.
If a murmur is heard but no scan performed, it would be safer not to breed from that dog, as there is a reasonable chance, that cardiac disease is present and it may be passed on to the pups.
Subaortic stenosis is a narrowing (stenosis) of the area underneath, the aortic valve, that causes some degree of obstruction or blockage of the blood flow through the heart. The narrowing can be mild, moderate, or severe; if moderate or severe, it can force the heart to work harder and potentially be harmful to the heart's health.
Subaortic stenosis is a problem that affects dogs and is rare in cats. It most commonly occurs in large-breed dogs. Subaortic stenosis appears to be genetic in origin; the first signs of it may be present at birth (moderate or severe cases) or may appear in the first year of life (usually milder cases).
In mild sub-aortic stenosis no signs are observed. In moderate (sometimes) and severe (almost always) cases, symptoms such as weakness, breathing difficulty (dyspnea), fainting (syncope), and, in extreme cases, sudden death are all possible as a result of subaortic stenosis. Realize that dogs with subaortic stenosis, even severe subaortic stenosis, may look perfectly healthy and active. These dogs generally do not realize that their hearts are compromised.
A Certified Cardiac Veterinarian will perform a thorough physical examination (including listening carefully with a stethoscope for a heart murmur or irregular heartbeat) and ask you whether you have seen any of the symptoms described above.
An echocardiogram (cardiac ultrasound) is the test of choice for subaortic stenosis. An image of the inside of the heart is displayed on a monitor in real time. This test allows the veterinarian to assess the valves (including any narrowing), blood flow patterns and velocity, degree of stenosis (i.e., extent of blockage), and other aspects of cardiac structure and function. The degree of severity is assessed using several components of the ultrasound exam, especially Doppler ultrasound, which measures the direction and flow of blood as it courses through the heart.
Mild subaortic stenosis can be of no consequence to an individual dog.
Moderate or severe subaortic stenosis may cause symptoms and may increase the risk of sudden death. Depending on the exact degree of severity, treatment may be required, and other measures (such as limiting activity) may be recommended to minimize the amount of work done by the heart. There is no cure for subaortic stenosis. Since it is thought to be of genetic origin it is often recommended that dogs with subaortic stenosis not be bred to avoid passing the disease along to future generations.
If the disease is mild, treatment is not required. However, subaortic stenosis can get worse as a growing dog reaches its adult age and body size. Therefore, dogs with moderate or severe subaortic stenosis, may require medication. One form of treatment is a medication given orally called βeta blockers, which reduce the intensity of the heart's work, help to prevent the heart from beating too fast and can control arrhythmias. If your dog has been found to have moderate or severe subaortic stenosis, it is important to reduce the workload on the heart (and therefore to decrease the risk of sudden, collapse, fainting, or even sudden death) by controlling or avoiding bursts of sudden activity or any intense exertion.
Several surgical procedures and minimally invasive (balloon catheterization) procedures have been performed to reduce the obstruction of subaortic stenosis with little success. However, recently a new technique has become available utilizing a special "cutting" balloon, which appears to have favorable results. Generally in this country, currently surgery is not an option.
FOLLOW UP EXAMINATIONS
Follow-up appointments are important to monitor progress, to determine if treatment should be adjusted, and to keep your pet as comfortable as possible. If placed on medication, periodic echocardiograms may be performed to help tailor the therapy to your pet. If your dog has difficulty breathing or collapses, go to your veterinarian or the local veterinary emergency clinic immediately, even if the collapse is brief and your dog is back on his or her feet shortly.
Mitral Valve Disease
Mitral Valve Disease is not just a disease of the heart. It’s the disease of the heart for dogs, responsible for a full three-fourths of all canine heart diseases. A low-grade heart murmur may be the only early warning sign. Later on, coughing, exercise intolerance, rapid breathing, or fainting may develop. Treatment generally involves medication to ease the burden on the heart and promote better functioning, as well as medications to help control blood pressure and fluid retention. Other modalities include a low-sodium diet and exercise restriction.
Degenerative disease of the heart’s mitral valve (the left atrioventricular valve) which is the most common acquired cardiac condition in dogs.
This disease goes by the names endocardiosis, chronic valvular disease, and chronic valvular fibrosis.
Mitral Valve disease can be congenital (the dog is born with a defective valve) or acquired.
Whether the leak is caused by congenital disease or degenerative the results are similar.
The heart muscle is a pump that moves blood through the four chambers using involuntary contractions that promote the one-directional flow of the blood. The valves between the chambers form a tight seal that prevents the backflow of blood into the preceding chamber, thus keeping the blood flowing in the forward direction.
When the valves degenerate over time, they become thickened and deformed, thereby losing the tight seal and causing some blood to move backward in the heart. When the valve between the two left chambers of the heart (the mitral valve, between the left atrium and left ventricle) fails to form a tight seal, blood moves in a backward direction (into the left atrium) when the left ventricle contracts. This means the heart has to work harder to pump the volume of blood the body needs for normal functions.
Congenital mitral valve disease (mitral valve diplaysia) is where the dog is born with a mitral valve abnormality that leads to a leak or restricted flow (stenosis). Bull Terriers are prone to this form of congenital disease and can pass on the disease to their offspring. In young dogs this is the type of mitral valve disease that is being screened for.
Symptoms and Identification
Dogs with early or mild mitral valve disease may be identified by a heart murmur of low-grade severity heard loudest (using a stethoscope) over the left side of the chest. In these cases, no other clinical signs are typically observed. As this progressive disease advances, coughing, exercise intolerance, and increased respiratory rate and/or effort may develop. Fainting or collapsing may also occur, as well as sudden death (in rare cases).
Dogs with advanced or severe mitral valve disease may also experience symptoms consistent with heart failure. Heart failure occurs when the heart can no longer pump the requisite amount of blood for normal body functions. When this happens, fluid accumulates in the lungs, a condition veterinarians call pulmonary edema.
To identify this disease among dogs who suffer characteristic murmurs or other telltale symptoms, diagnosis is best achieved through chest X-rays, electrocardiograms (EKG), and echocardiography (ultrasound of the heart) with Doppler technology (demonstrating the flow of blood) to elucidate the abnormal change in the dimensions of the heart and the blood flow through the region of the mitral valve.
A consultation with a veterinary cardiologist may be recommended for some affected dogs.
Treatment for mitral valve disease relies heavily on drugs. These include specific medications to ease the burden on the heart, diuretics for removal of excess fluid, medication to help regulate blood pressure, and other medications to help relieve the symptoms of heart failure. Additional therapies include a low-sodium diet and exercise restriction.
Luckily, a great many mitral valve disease patients don’t require any treatment at all until they show symptoms. And most who do tend to live well with drug therapy alone. Only the severely diseased tend to succumb, in spite of treatment.
Preventing congenital mitral valve disease requires removing affected dogs from the breeding pool.
The main Kidney Disease affecting the breed is FAMILIAL NETHROPATHY which is screened for using the Urine Protein: Creatinine (UPC) test. The recommended or ‘standard’ result, at which a dog is NOT considered at risk, is a ratio of 0.5, however, on advice from the KC/AHT, Miniature Bull Terriers specify the lower, ‘safer’ ratio of 0.3. Any ratio above 0.5 should be investigated with further tests. It is recommended that the UPC Ratio test is carried out at the age of 12 months and then annually thereafter with all breeding dogs/bitches having a current, valid certificate prior to mating.
WHAT IS A URINE PROTEIN:CREATININE RATIO?
The urine protein: creatinine ratio is a simple test that measures how much protein is being lost through the kidneys, and determines if the loss poses a health risk for the pet. The test involves measuring the amount of protein and creatinine in a urine sample, and mathematically dividing the protein value by the creatinine value.
Ideally, the urine for the test should be collected, mid stream and first thing in the morning, prior to eating.
LETHAL ACRODERMATITIS (LAD)
his is yet another nasty disease for Miniature Bull Terriers
Lethal Acrodermatitis is a serious inherited skin condition in Bull Terriers which causes early death. This disease causes severe retardation of growth, thick skin and painful blisters on the muzzle, eyes, nose, ears, feet, and mucous membranes which eventually leads to pneumonia and death. The most commonly affected areas are the muzzle, ears, feet, legs, and groin. Most breeders can recognize the disease in the puppy by the time it is six to eight weeks old because it is less than half the size of the other puppies in the litter and has flat, splayed feet with dermatitis.
Symptoms of Lethal Acrodermatitis in Dogs
If your dog has lethal acrodermatitis, the signs will most likely be evident by the time he is about three to six months old. Some of the most often seen complaints are:
Thickened skin on legs and feet
Painful eruptions on toes
Pustules and lesions on face
Blisters on mucous membranes (lips, nostrils, mouth, genitals, throat)
Slow growth Standing with legs splayed apart
Deformed and broken nails
Numerous bacterial infections
Frequent nasal discharge
Pneumonia (high body temperature, coughing, breathing difficulty)
Up to now some relief from the condition could be gained from following a diet with foods high in zinc and omega-3 and omega-6 fatty acids as well as fish, flaxseed oil, soybean oils, sunflower oils, liver, chicken, salmon, beef, and veal. Your vet may have also offered injections of supplements but these should only be administered by a vet.
This disease is almost always fatal and whilst some dogs may live for several years, but if your dog is in constant pain then its quality of life must be paramount.
The University of Bern, Switzerland, headed by Prof. Dr. Tosso Leeb, conducted a research programme into this disease, as a result of this the Animal Health Trust announced that with effect from Monday 15th January 2018 their DNA testing service have launched a new DNA test for Lethal Acrodermatitis in Bull terriers and Miniatures.
A dog’s patella, or knee-cap can luxate (slip out of place) there are varying degrees but, at its most severe it can be a painful condition for the dog.
A competent vet can manipulate the dog's legs to check for signs of a slipping patella and will assess whether the dog’s patella are normal. In cases where the patella is luxating the vet should be able to ‘grade’ the problem, eg from mild to severe.
Dogs should be checked for this condition on maturity, ie after 12 months of age, and again should any symptoms arise, eg if a dog regularly ‘hops’ on one of its rear legs.
In severe cases an operation to fix the joint may be required.