Dear Doctor

Letters to Tufts Veterinarians-November 2013

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Yes, but are they really warts?

Q I have an 8-year-old bichon frise who has been developing warts for the last two years. Can you tell me what causes them and also whether I can do anything to stop them? She bites the ones she can get to, and then they bleed. I’m worried that they itch or hurt her.

Wilma L. Baker

New Martinsville, West Virginia

Dear Ms. Baker,

A”This is a tough one,” explains Tufts veterinary dermatologist Andrea Lam, DVM, “because a lot of people will look at lumps and bumps and call them warts, but they’re not true warts.” Indeed, we have our suspicions that the lesions you’re seeing on your dog’s skin are not in fact warts.

“Virtually all warts are based in or around the oral cavity,” Dr. Lam says, on the lips or inside the mouth, and they are almost always seen in puppies, who are not quite yet immune competent. “That leaves them susceptible to getting warts from the papilloma virus — sometimes one or two, sometimes a mouthful.” They’re contagious, Dr. Lam notes. “Puppies hang around together, share toys, and kind of play bite one another,” and in that way pass the virus along. If there are a lot of them, it can make it hard for the dog to eat. “I’ve seen some cases so severe a dental surgeon will get involved to remove some of them,” Dr. Lam says. “But that’s really uncommon.” In most cases, the warts simply resolve on their own once the immune system develops and matures. No treatment is usually required.

It’s rare for adult dogs to have warts, on the other hand, which is why Dr. Lam says that “the bumps on your pet should probably be biopsied so you can make certain what they are. There are a lot of little benign growths that dogs get as they age, and they are sometimes bothersome and sometimes not.” If any are bothersome, a vet may be able to remove them or provide a topical ointment to make them less sensitive.

“Of course,” Dr. Lam adds, “there is always the possibility that it’s a cancer,” which is why you do not want to delay bringing the bumps to your veterinarian’s attention.

The dog whose jumping is causing bruises

Q I have a 1-year-old shih tzu who will not stop jumping when I come home after being away for a while. Even though I have her nails cut and filed every month, they are bruising my arms to the point that I look like I have been in a boxing match. I am 76 and thin skinned.

She also jumps on other people who come into the house. I have older friends and am afraid they will trip on her. I have ignored her. I have held her down. I don’t know what to try next. Any help would be appreciated. On the whole, she is a good dog and in other instances very obedient.

Patricia Lovit

Columbia, South Carolina

Dear Ms. Lovit,

AWe are sorry for what you are going through. The good news is that the answer is in your question, as well as the reason it has not been working. You say you have tried ignoring her, which is the right response to her jumping. The problem is in the inconsistency — you have also held her down.

Your switching tactics is certainly understandable. When you try something and it doesn’t appear to be working, it’s only logical to want to try something else. But what dog owners need to be aware of is that if a dog has been doing something and getting a reaction — even a negative reaction — the first thing that’s going to happen when you switch tracks is that the behavior is going to get even worse at first because the dog is going to try that much harder to get you to react to whatever she has been doing.

People are the same way. If your key has always opened a certain door lock, for instance, and you go to use it one day and the door won’t open, you’re going to jiggle the key harder and harder and ever more frantically before realizing that either someone has changed the lock or that perhaps humidity has made the door stick too hard to open. You’ll only give up once you’ve thoroughly worn yourself out in the fruitless effort.

The good news is that if you go back to ignoring your dog when she jumps, she will cut out the behavior. The news that might be harder to hear is that it will take about three weeks. For the first several days, she’ll jump even more, then gradually cut it out.

So here’s the deal. Each time the dog jumps, say “Off.” Say it only once, then turn to stone. If you keep repeating it while the dog is jumping, she will know the word has no power. Fold your arms, hands turned to the side, and avert your eyes. When the dog finally stops jumping — and it could take up to three minutes — turn to her and say, “Good girl!” Perhaps pet her as well.

You might also want to employ a head halter such as a Gentle Leader, or perhaps a Snoot Loop, as shih tzus tend to have short snouts. This will work for when you come in from outside, and for visitors. When the dog jumps, simply put the apparatus on your pet and apply gentle, sustained pressure to the lead with a soft tug while saying “Off” (once). That will send a message to pressure points on your dog’s nose and neck that you’re in charge. No yanking. Just gentle exertion.

As for your arms when you return home from somewhere, consider using Soft Paws. These are vinyl nail caps that glue on to your dog’s nails to keep them blunt and harmless. Invented by a veterinarian, they can be a help to elderly people with fragile skin, those with diabetes who bruise easily, and people taking blood thinners. You fill each nail cap with the adhesive provided and slide it over the nail. It’s safe and non-toxic, even if your dog swallows one, and each application lasts a month to a month and a half. For more information, go to www.softpaws.net.

Treatment of one disease causes another

QI found your article on Addison’s disease in the October issue very interesting. You said there’s sometimes a genetic component, but my neighbor had a dog who ended up with Addison’s disease when he was being treated for Cushing’s disease. Is there a connection?

Miranda Reiter

Baltimore, Maryland

Dear Ms. Reiter,

AIt does happen that sometimes treatment for Cushing’s disease causes Addison’s. Cushing’s disease is the secretion of too much of the body’s natural steroid, cortisol. The medications used to slow cortisol secretion, Lysodren and Vetoryl, sometimes overshoot the mark, so to speak, and cause the release of too little cortisol. That’s Addison’s.

This effect is more likely at higher doses of the drugs, but it’s not a matter of the veterinarian prescribing too high a dose of the medication or not watching for a reaction. “It’s unpredictable,” explains Tufts internal medicine veterinarian Orla Mahony, DVM. “You can’t know which dogs are going to over-respond to the drug.

“It doesn’t happen often,” Dr. Mahony adds, “but it’s a side effect we warn every owner of. And there are varying degrees. Some dogs become Addisonian temporarily — you stop the medicine and then re-start it — and for other dogs the Addison’s is permanent. Fortunately, Addison’s disease is generally easier to treat than Cushing’s, so it’s not the worst thing in the world if it happens. The veterinarian just changes her focus,” giving different drugs to make sure the cortisol that’s missing is replaced.

Addison’s disease brought on by treatment of Cushing’s is an iatrogenic form of the illness, “iatrogenic” meaning a condition that is inadvertently brought on by treatment of another condition.

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