Merry Christmas!

Winter weather and short days always make me want to hibernate-hole up by the fire with a good book or a knitting or crochet project. Exercise is definitely NOT in the picture. I was a California girl-sunshine and beaches are what get me up and moving. And then there are all those holidays with all the yummy comfort food. Of course, it is no surprise that my weight goes up at this time of the year-just like it does for many of my patients.

Little Bear is a darling, happy dog that has battled numerous health problems in her 7 years-and most of these can be related to her obesity. Her owners had trouble realizing she was overweight at all She is a Pomeranian and has a thick, fluffy hair coat-kind of like me wearing a big, heavy sweater, her coat hides a lot! When she was quite young, Bear had surgery on both knees to correct a condition she was born with, medial luxating patellas, where both knee caps moved towards the inside of her legs. Her recovery from the surgery was fine, but over the years, all her extra weight has put a lot of wear and tear on those vulnerable joints. She has also had two surgeries to remove cystic calculi or bladder stones. These tend to form in animals fed lots of table scraps, altering the urine pH, thus allowing the urine to crystallize. Earlier this year, Little Bear started limping on a front leg, and we found she had significant DJD or degenerative joint disease (arthritis) in her carpus (wrist.) Normal dogs bear about 70 percent of their body weight on their front legs. Dogs like Bear who have orthopedic conditions in their hind limbs, such as her knee problems, or labs with hip dysplasia will put even more weight on the front in an effort to get stress off the hurting hind legs. This is likely what happened to Little Bear's front leg. Bear's owners also told us they noticed she was having trouble breathing lately; I suspected this, too, was related to her excessive weight. Our blood work to assess her overall health showed that Little Bear was hypothyroid, or had an underproducing thyroid gland. This was undoubtedly contributing to her weight issues as all of metabolism is slowed down in hypothyroid dogs.

Now, we aren't talking about a lot of weight here. Little Bear is a Pomeranian after all. A healthy weight for her would be around 6 or 7 pounds; she has been weighing in over 9 pounds. 3 pounds doesn't sound like much, but it would be similar to me weighing in at 280 pounds! This is a significant percentage, and her quality of life was obviously affected. We showed her owners how to assess her body fat, feeling over ribcage for her now non-existent ribs-currently padded by a layer of fat. Ideally we would be able to feel the ribs under the skin. It would be hard to see her body silhouette with all that fluff, but in short haired dogs, you would want to see a tucked up flank and a "waist" when looking down at their backs. Her owners were of course concerned about all of her health issues and her quality of life.

Little Bear was in a viscious cycle many humans understand-exercise is difficult because of the pain/discomfort on the joints, but it is essential for weight loss. And boy, does she love her snacks! We put her on a thyroid supplement and a low calorie food and had her weigh in with us every month. But with her relative inactivity, her weight just didn't budge. When Bear's weight actually increased one month, we talked to her owners about the next step-adding a fairly new medication for weight loss in dogs.

I am not one to use medications when they aren't necessary. Diet and exercise are, of course, essential tools for weight loss and should absolutely be adhered to by the overweight dog's owner. But obesity is a severe health issue, as you can see from all of Little Bear's problems. Slentrol (dirlotipide) is a weight loss medication approved for use in dogs only (nope, we can't use this in fat cats or fat humans) to help when all other attempts have failed. It works to suppress their appetites-which sometimes concerns owners who are used to having overweight dogs that scarf down food eagerly. They become concerned when their dogs actually walk away from partially emptied food bowls-something must be wrong! Maybe they aren't feeling well! I'll have owners actually add some gravy or broth to the food to entice the dogs to eat more! You can see that prescribing this medication is often all about training the humans what is an appropriate amount to feed their dogs in the long run and implementing new diet and exercise habits. Once the new habits are learned and a goal weight is achieved we can stop the Slentrol and just feed the appropriate amount of food-the amount the dog told us they needed.

Like any medication, Slentrol is not without its side effects. We carefully monitor dogs while they are on the drug, including weighing them in every 2 weeks or so to ensure they aren't losing weight too rapidly and have no vomiting, diarrhea or lethargy. We will check blood work to be sure no organs are being affected by the drug. We haven't used much Slentrol yet, but since obesity can be a life-threatening issue, I expect this will change. We started Little Bear on a low dose of the medication, saw an initial small weight loss, but then a plateau. We discussed her case with the veterinarians at the pharmaceutical company who developed the drug, mentioning her bladder stones, thyroid issues and obesity. We have slowly increased her dose of Slentrol and she finally started to lose again. She is handling the medication just fine-Bear is as happy as ever and her owners are noticing her limping less and being much more playful as the weight is coming off. That is exactly our goal-improved quality of life, for as much quantity as we can get. Little Bear is fortunate to have such dedicated owners who are committed to her care and now understand how weight is an important part of that.

We are closing up the hospital early this afternoon and sending everyone home to spend time with family and friends. We have a few critters boarding with us, including our "sweet" diabetic cat, Cooper, who is a bit of a challenge. It seems he gets a bit stressed here and doesn't eat well. (who can blame him? It can be a scary place with the barking dogs, weird sights and smells.) That really affects his blood sugar level and thus his need for insulin. My entire staff is helping during the holidays by keeping him eating, learning to monitor his glucose levels and administer insulin only if it is needed. His owners have entrusted us with his care and we sure want to do our best for him and them. The rest of the critters will get fed and walked and played with while their owners are away. Merry Christmas everyone.

Peace,
DrReneigh