Embrace Pet Insurance Blog

Q&A: issues with an amputated toe in a dog

One of my more popular posts is on the topic of toe amputations in dogs and cats.

Recently, one of my readers, Heather Z, posted a question about her lab's post-surgical toe issues that I thought was worth separating out as its own post.

Hi. We have a 111 lb black lab and just had his third (III) toe removed on the front right paw in the middle of October. He still walks with a limp and holds it up when he stands. We keep it wrapped in a sock with a cone on his head all day every day because he wants to lick it. When he goes out, we wrap it to keep it dry.

He has been on antibiotics and about the 2nd week it started to pus and the swelling of his fourth (IV) toe was still huge and didn't go away. Brough him in and they upped his antibiotic. Nothing was said if it was infected but that's what I think. We also put a drying solution mixed with water on it twice a day and blow dry it as recommended.

I'm just worried that something else could be wrong with swelling not going down still going on a month. It is a pain. I think we did the right thing but its just hard seeing him like this and there's no improvement with the swelling! Anybody know of this?

I passed the question on to Dr. Heather Carleton, one of Embrace's veterinary advisors and this is what she had to say in response:

My question would be why was it initailly amputated? Was is broken, arthritic, had a tumor, etc? If it was amputated because of a tumor, I would be concerned that there is recurrence. If not, I would have the foot x-rayed and make sure there is no bony involvement with the infection (i.e. with the bone above the ampuatation site). If there is, the area may need to be debrided. If it is just soft tissue that is infected, antibiotics should take care of it.

Heather Z's got back to me with an answer for Dr. Carleton:

We had it amputated because it had a hard tumor growing connected to the bone. We had it sent into the lab and it is benign. He has been on cephalaxin and ciprofloxacin, which did not work, and now we went to clindamycin. I took him in last Thursday and had the desolvable stitches they left in taken out. I started to cut them out and they took the rest out. Our vet says it should clear up and to call and talk to him Monday. Well, that is tomorrow and it is still swollen. He said the next thing will do is move up to a more expensive antibiotic that costs $100 bucks or so.

This is still really frustrating because it is not getting that much better and he still limps. I hope this next option he has in mind works or else the next move will be going somewhere else and getting a second opinion and probably an x-ray and possible debridement as you suggested.

Here's an update from Heather Z.

When I brought him in last Wednesday, the vet thought he was doing much better now that the desolveable stitches had been romoved and the swelling around the scar tissue started to heal better. I just don't get why they left them in there. I heard from other people that desolveable stitches can cause inflammation. I also think when they wrapped his foot postoperately with the sticky wrap they did it too tight and was supposed to remain that way for 7 days. I also talked to other people and they said that they rewrap and change around the 3rd day.

The vet said he looked like he was healing well and the inflammation of his big toe should not be a concern because it is part of his healing process. He is moving around better and the outside toe looks almost back to normal size but the middle toe is still very swollen but may have improved a tad since suture removal. I am supposed to check back with him in two weeks and keep giving him his clindomycin 4 pills twice/day.

So, somewhat better but he still has to have a cone on his head when we are gone and something on his foot so he doesn't lick it like mad. I left the house for an hour and he somehow pulled it off and yanked his booty off and was licking it till it bled. Uh. But that is how it is going so far. It is now one month and 1 day. Buddy is a crazy licker anyway and is always grooming. I just hope things start getting better faster!

Have you found yourself in this situation? Let us know what happened in the comments...

Related Posts:
Toe Amputations for Cats and Dogs
Ask Laura: the impact of toe amputation surgery
Ask Laura: dog weight bearing toe amputation appropriate or not?  
Ask Laura: infected ingrown toe nail on cat  
Ask Laura: to amputate or not to amputate the cat's toe, that is the question
Corns on a greyhound's toe: Dr Riggs discusses

Patellar Luxation Surgery: Destino, A Chihuahua Mix with Bilateral Luxating Patellas

You might not have imagined that jumping off the couch for a little dog could be the start of big knee issues but poor Destino was destined for 2 major knee surgeries before he reached the age of 4.

Patellar luxation is a slipping knee (the patella) that can move out of position too easily. It's measured in grades (grade 1 being the least problem, grad 4 being the worst) and is treated with pain medication in less severe cases and corrected with surgery for the higher grades. 

After Destino jumped off the couch one day, he started to limp a little and after a veterinary exam, his owners discovered he had a 3.5 grade out of 4 patellar luxation in his left knee as well as a grade 2 of 4 patellar luxation in the right knee. His pet parents had no idea.

Destino had two surgeries over 2 years and is now back to his old self.

Here's an example of the costs associated with the most recent surgery on the right knee performed in Parkland, Florida in January 2009.

ITEM	BILLED AMOUNT
Baytril 68mg Qty 7	$ 21.70
Clavamox 125mg Qty 14	$ 16.80
Tramadol 50mg  Qty 21	$ 21.00
Metacam 10ml	$ 26.50
CBC	$ 43.00
General Health Profile IH	$ 84.00
Electrocardiogram Pre-Anesthetic	$ 60.00
IV Catheter	$ 45.00
Fluid Intravenous per Day	$ 38.00
Infusion Pump daily	$    5.00
Anesthesia General	$   105.00
Anesthesia 1/2 hr	$ 50.00
Anesthesia Electronic Monitoring	$ 28.00
Buprinex Inj x4	$   108.00
Baytril Inj	$ 37.00
Hospitalization per night	$ 40.70
Daily Dr. Exam	$ 21.40
Metacam Inj	$ 36.00
Infectious Control Fee	$    5.00
E-Collar	$ 19.50
Surgery	$    1,100.00
	$    1,911.60

Destino's refund check was $1,463.04 after a $200 deductible and 10% copay (the Prescription Drugs & Dental Illness add-on was not chosen for Destino's policy) for a monthly premium of $24.76.

Related posts:
Guest post: A General Discussion of Orthopedic Issues in Dogs
Guest Post: Four Most Common Orthopedic Problems in Dogs
Top 10 ways to prevent orthopedic issues in dogs
How much did you say patella luxation cost to treat in my dog?

Top 10 ways to prevent orthopedic issues in dogs

I've done a lot of talking about orthopedic issues after the fact. Today I turn my attention to preventing orthopedic issues in dogs (cats seem to have far fewer issues with their bones than dogs):

1. Keep your dog nice and trim:
   Starting with the most obvious approach, slim dogs have fewer orthopedic issues. Excess weight can wear on cartilage, causing limping, pain, and worn joints. Find out from your veterinarian what your dog's ideal weight is, how many calories your dog should eat to keep to that weight, how often you should feed your dog, and in what form (not too many treats now!)
2. Exercise your dog in water:
   Another way to keep a dog's weight down is to exercise. Running and walking are all good but one excellent way to reduce exercise's burden on your dog's joints is exercising in water. The water's buoyancy supports and lessens stress on the joints, encourages freer movement and provides a safe environment for exercise. If you have access to an ocean, lake or river, make sure your dog feels safe in the water and is a comfortable swimmer first. You might want to start off in a kiddie paddling pool so your dog is nicely comfortable in water before larger and deeper bodies of water.
3. Feed your dog daily supplements:
   Some supplements such as methylsulfonylmethane, glucosamine hydrochloride, glucosamine sulfate, and glucosamine hydroiodide are thought to help joint health and perhaps prevent arthritis, which often occurs alongside other orthopedic issues. They come in pill form or are now being added to some dog foods.
4. Use elevated dog bowls for your dog's food and water:
   Dog bowls that are raised off the ground keep the spine aligned in a more natural manner, putting less stress on the vertebrae, leading to less wear and tear
5. Preventative acupuncture:
   An veterinary acupuncturist can find the weakest spot in your dog's ‘system’ and treat that before it gives clinical symptoms.
6. Good behavioral training:
   A well behaved dog that listens to commands and behaves well in public and among other dogs is much less likely to be in the position to have an accident, whether it be overly aggressive play leading to a cruciate ligament rupture or a car accident with multiple broken bones. I don't know how many times we've seen a dog park accident cause a tramatic hip dysplasia incident leading to surgery.
7. Preventative tests and examinations:
   Get your veterinarian to perform PennHip or OFA tests, as well as a thorough orthopedic examination to spot hip dysplasia, cruciate ligament tears, luxating patellas before they becomes a serious problem. Knowledge is the best weapon against serious disease and once you know if your dog is likely to have problems in the future, you can really focus on weight reduction, arthritis prevention through supplements, and appropriate exercise regimes
8. Surgery:
   Correcting conditions such as patella luxation can help reduce the likelihood of related conditions such as a cruciate ligament tear
9. No breeding:
   Do not breed a dog with hereditary orthopedic conditions such as patella luxation, hip dysplasia or osteochondritis dissecans. These conditions can be passed down through genes to their progeny perpetuating these serious canine health conditions,
   ...and finally...
10. Neuter at 6-months old and onwards:
    Some studies have shown a higher incidence of hip dyslasia and cruciate ligament tears with early-age neutering. As your veterinarian about the right time to neuter or spay your dog

Related Posts:
November is Orthopedic Month At Embrace Pet Insurance
Guest post: A General Discussion of Orthopedic Issues in Dogs
Guest Post: Four Most Common Orthopedic Problems in Dogs   

See this video of Rottweiler Lula working on her hips and back in a hydrotherapy tank...

Embrace pet: Tahlula, a seven year old rescued Rottweiler

For some blogging fun, we're going to highlight some of our staff pets. Today, we’re here with Tahlula, a seven year old Rottweiler, to talk about her life as an Embrace pet.

Q: Hello, Tahlula. Tell us a bit about yourself.
A: Hi, My name is Tahlula, but everyone calls me “Wu”.

Q: So, Wu, what do you like to do for fun?
A: I like naps in my little bed near the space heater, but when it’s warm outside, I prefer lounging outside in the sun, watching the birds in the garden.

Q: So you’re pretty laid back then?
A: Yes, sometimes my body is sore, so I like to nap more than most. I had to have surgery in both of my knees a few years ago when I tore my cruciate ligaments, whatever those are! Mom said that her $50 shelter dog ended up getting $4,000 bionic knees, but I feel much better with them. They still have some arthritis and I also have hip dysplasia, but I take pain relievers for that now, and it doesn’t bother me much. I guess it’s just part of being a senior Rottie.

Q: So you think that these issues are because you’re a Rottweiler?
A: Well, probably. My back pain is also part of being a big dog.

Q: Ow, a back problem?
A: My mom says it’s called IVDD. It means one of my discs slip and put pressure on my spinal cord, which is not only painful, but scary. The first time it happened, I couldn’t walk so well. I would fall over like a baby deer, but I didn’t even realize my legs weren’t working.

Q: What do you do when that happens?
A: My people give steroids, and they drove me to a vet’s office that gave me physical therapy in the underwater treadmill to help me walk again. I got to go every week for a long time! Everyone said that was much better than another surgery, and I agree. It’s on youtube if you want to see.

Q: So you liked therapy?
A: Yes-it helped me pump up my big muscles. Rottweilers look funny with little scrawny legs. Plus, I liked it when they used the blow dryer on me afterwards.

Q: How did the back injury happen?
It flares up if I get too excited and put strain on my neck. Like, a couple of weeks ago I saw a cute puppy on our walk, and we played, but then I was paying for it the next day. Mom says I can’t wear collars anymore-only harnesses, so I don’t strain.

Q: But otherwise you’re life is pretty normal?
A: Yep, it’s good. I can do most everything I want, including visit my friends at the Embrace office. They’re nice, and some of them share their lunches with me. But, that’s off the record, because I’m not supposed to tell my mom.

Q: You like to eat? What is your favorite food?
A: Oh yes! I love fruits and vegetables. My favorites are bananas and apples but most of all green tomatoes! Speaking of which, I should be going. I think I need to remind my mom that it’s almost time for dinner...

Thank you Wu for joining us today. I've got some noms at my desk when you come to visit - we won't tell mom :)

Guest Post: Four Most Common Orthopedic Problems in Dogs

Today, we have a guest post from Dr. Rex Riggs, owner of Best Friends Veterinary Hospital in Powell, Ohio. He is a veterinarian, and an Advisory Board member of Embrace Pet Insurance. Dr. Riggs writes about orthopedic issues from a small animal practioner's perspective.
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Orthopedic problems in dogs are commonly seen in a busy small animal veterinary practice. We are becoming a more active society and often include our dog friends in our athletic pursuits. Running, chasing a ball or catching a Frisbee are all great exercise for dogs but can also result in injuries. We are also seeing more purebred dogs with all their great attributes but we also see the less desirable traits that come with that breeding. Many breeds are genetically predisposed to muscular skeletal problems.

The four most common orthopedic problems seen in dogs are hip dysplasia, torn cruciate ligaments, patellar luxations, and disc problems.

1. Hip dysplasia:
   A genetic disease, hip dysplasia is influenced by a number of factors. It is a much more common in large breed dogs such as German Shepherd Dogs, Labrador and Golden Retrievers. Treatment often involves lifetime anti-inflammatory medications which can run $2 to $3 dollars a day. If the hips develop extensive arthritis, often titanium joint replacements need to be used costing between $2,000 to $3,000 per hip. Preventative measures are the key and weight plays a huge role in the expression of hip dysplasia. It has been shown keeping your dog lean can decrease dysplasia by up to 30%. Weight reduction is the number one pain reliever in dogs and people.
2. Cruciate Ligament Tears:
   How many times do you read in the paper about your favorite football player out for the season with an ACL tear? ACL stands for anterior cranial cruciate and it is the ligament that keeps the knee in working order. Well, instead of a big linebacker taking out your dog’s knee it is more likely a squirrel or rabbit that your dog took chase (which he never catches!). The squirrel zigs, the dog zags and there goes the knee! Torn cruciate ligaments, just like in people need to be surgically repaired to prevent crippling arthritis. There are many different types of surgical procedures and the type used depends on the size of the dog, and can range from $1,500 to $2,500.
3. Luxating Patellas:
   Knee cap problems are also commonly seen in many breeds of dogs. The kneecap, or patella, rests in a groove. Smaller dog’s patella’s tend to slip out of the groove to the inside or medially, and is known as medial patellar luxation. Medial patellar luxation in small dogs can often be repaired for $1,000 to $1,200. Larger dogs patellas, generally slips to the outside or laterally. These dogs often have other more involved problems with the bones of the leg as well and thus repair can be more complicated, costing as much as $3,500.
4. Disc Disease:
   Just as with many of us, our dogs also can have disc problems in their neck and backs. Cocker Spaniels, Poodles, Dachshunds and Lhasa Apsos are all breeds that can suffer from neck disc issues, whereas large breed dogs often have chronic lower back issues. Most of these cases can be treated conservatively with the same medications used to treat hip dysplasia. When discs become ruptured, they become surgical emergencies. The disc material can slip into the spinal canal or nerves causing intense pain or even paralysis. These surgeries need to be done often within hours in order to get good results. These emergency back surgeries can reach $3,000 to $5,000.

Related Posts: other posts by Dr Riggs

____________________________________

Dr. Rex Riggs grew up in Wadsworth, Ohio, near Akron. Dr Riggs is co-owner of Best Friends Veterinary Hospital in Powell, Ohio. He is also on the board of the North Central Region of Canine Companions of Independence, a board member of The Ohio State College of Veterinary Medicine Alumni Society and Small Animal Practitioner Advancement Board at The Ohio State College of Veterinary Medicine. Dr. Riggs lives in Lewis Center with his wife Nancy, their two dogs Boo and Maggie, and two cats Franklin and Speeder. Outside of work, Dr. Riggs is an avid golfer and enjoys travel and photography.

Guest post: A General Discussion of Orthopedic Issues in Dogs

In the Embrace Pet Insurance policy terms and conditions, and orthopedic condition is defined as: 
"related to the musculosketal system, which is made up of the body’s bones (the skeleton), muscles, cartilage, tendons, ligaments, joints, and other connective tissue (the tissue that supports and binds tissues and organs together)."

So, with that rather unwieldy definition at the top of our mind, let's talk turkey about ortho conditions.

Today we have a guest post from Dr Susan Wright, Electric Dog Fence DIY's staff veterinarian, on the different types of orthopedic conditions.
 _____________________

Orthopedic issues are a very common reason for dogs to visit their veterinarian. They relate to problems with the bones, muscles, joints and ligaments of his body. These problems can be as simple as a strained ligament, or as complicated as a fracture of the pelvis.

There are several causes of orthopedic problems in our dogs. Firstly, they may be congenital, where your dog is actually born with the condition. One example is patellar luxation, where his kneecap freely moves out of its groove in his thigh bone. If not treated appropriately, it leads to lameness and arthritis in your dog's knee joint.

Orthopedic conditions can also be developmental, where the condition develops more slowly, and is influenced by other factors as your dog matures. The best example is hip dysplasia. Whether or not your dog becomes affected by hip dysplasia depends not only on genetics, but also on his nutrition as he grows, and how much exercise he gets when he's young.

Lastly, they can be acquired, when your dog injures his musculoskeletal system while playing, or in an accident. Fractures associated with motor vehicle accidents, or cruciate ligament ruptures while playing ball are both examples of acquired orthopedic conditions.

When you take your dog to your vet with an orthopedic problem, there are times when it's easy to obtain a diagnosis. She will usually be able to feel a fractured bone in his leg, or recognize the abnormal movement of his knee joint when a ligament is torn. In every case of an orthopedic condition, x rays will be taken to firstly confirm the diagnosis, and secondly to assess if there is any further damage to surrounding tissues. In the case of a bone fracture, an x ray will also help your vet decide on the best technique for repairing the break.

When it comes to treatment, there are several options for your dog. There are many conditions that your regular vet is very qualified to manage, such as straightforward limb fractures; however, she may recommend that you take your dog to a board certified orthopedist for further treatment. These specialists have undergone specific training in orthopedics, and can perform difficult procedures such as total hip replacements.

In some cases, surgery is the best way of managing your dog's orthopedic problem; however other modes of treatment may also offer some relief. Anti-inflammatory pain relieving medication can be used in acute injuries, as well as for more chronic conditions such as arthritis. Those who are interested in alternative therapies are often very interested in trying acupuncture to treat their dogs. Many vets are recommending physical therapy and hydrotherapy in conjunction with more conventional treatments. Many times, our dogs must endure a period of restricted exercise while they recover.

We are very fortunate in that most orthopedic conditions in our dogs can be treated, bringing them pain relief and allowing them to return to normal mobility and function.
__________________________

This guest post is brought to you by Electric Dog Fence DIY's staff veterinarian Dr. Susan Wright. Dog Fence DIY takes you through all the steps of using an electric fence for dogs including installation, training, and how to find the best system for you and your pet. Electric Dog Fence offers a wide variety of different pet containment systems at the best available price to you.

Cruciate Ligament Surgery: Barron the Pit Bull Mix

Continuing Orthopedic Month at Embrace, I wanted to give you an example of how a persistent limp can turn into $7,000 of veterinary bills.

Here's the story of 5 year old pitbull mix Barron, who had not one, but TWO cruciate ligament injuries, requiring two major surgeries.

Barron's symptoms were not immediate, nor persistently bad, but his lameness flared up and down, particularly when he played hard. After a month or two of these symptoms, his owner took him to the vet and the cruciate ligaments were diagnosed by X-ray.

Here's an example of the costs associated with one of those surgeries performed in April 2009 in Newburgh, NY:

 

ITEM	BILLED AMOUNT
NYS Mandated Biological	$ 4.50
Operating Theater	$ 17.30
Surgical Pack And Disposables	$ 32.00
Surgical Pack	$ 39.50
IV Cath /SQ Fluids	$ 50.00
Injections - Multiple	$ 50.50
OR/Orthopedic	$ 94.50
Anesthesia-Isofluorane	$ 152.60
Cruciate Ligament Repair	$ 2,250.00
Fentanyl Patch 5 day Pain 50ug/hr	$ 71.00
Fentanyl Patch 5 day Pain 25ug/hr	$ 39.00
Technician Assistant	$ 41.00
Nursing	$ 14.80
Morphine Inject	$ 0.00
Telazol	$ 0.00
Convenia Cefovecin 2 wk injection	$ 105.00
Hospitalization	$ 74.50
NYS Mandated Biological	$ 4.50
Medicated 2x daily	$ 29.00
Nursing	$ 14.80
Tramadol HCL #10 Qty 20	$ 25.15
Rimadyl 100mg Qty 14	$ 47.37
	$ 3,157.02

Remember, this is just one of two surgeries that Barron had to have for a total cost of treatment of $6,989.99.

Tom, Barron's owner says "After hearing horror stories from a friend about their dog and the costs involved with treatments he received, my wife and I looked into pet insurance and decided that Embrace was the way to go. Barron had to have not 1 but 2 major surgeries on his rear legs, after injuring one while playing, and the other by chasing after animals in our back yard. He also suffers from hip dysplasia."

Read more about Barron's cruciate ligament rupture claim over at the Embrace website.

Related posts:
November is Orthopedic Month at Embrace Pet Insurance
How much did you say a ruptured cruciate ligament cost to treat in my dog?
Ski - a dog who recovered from a cruciate ligament injury without surgery
What happens when my dog's cruciate ligament tears?
Tibial tuberosity advancement (TTA) versus a Tibial Plateau Leveling Osteotomy (TPLO) in dogs
$3,449 claim: Rottweiler with hip dysplasia has ACL repair

November is Orthopedic Month at Embrace Pet Insurance

Back before Embrace Pet Insurance was but a twinkle in my eye, I knew something about pet health (it's hard not to learn with a dog and at least 4 cats in the house at any one time as a kid) but nothing like I know now.

One area I was particularly weak on was canine orthopedic conditions. For some reason, our dogs never had issues with their hips, knees, or elbows, which we're very grateful for so I never had to learn from experience.

But at Embrace, I've learnt quickly. I'd say that orthopedic conditions are our number one category of claim by amount. For example, in the first half of 2009, as a percentage of total claimed amounts at Embrace:

• cruciate ligament ruptures accounted for over 9%
• hip dysplasia - 5%
• patellar luxation - 4%

Wow - nearly 20% of our claims were from just 3 orthopedic conditions!

These are interesting stats, particularly if you are considering different pet insurance policies for your dog. All of these conditions, cruciate ligaments included, are considered genetic in origin, meaning that they are inherited conditions (also known as breed-specific conditions as some breeds are more prone than others for getting certain conditions.)

So, if you want pet health insurance coverage for conditions your mixed or purebred dog is likely to get, you better get a policy that covers hereditary conditions, such as one from Embrace.

Since this type of claim is so important in the grand scheme of things, November is Orthopedic Month at the Embrace blog. I'll explore orthopedic issues in a series of articles from a number of different perspectives. I hope you enjoy them as much as I do.

Oh, and be sure to let me know if you have any particular orthopedic topics you'd like to cover and I'll make sure to address as many as I can throughout the month.

Related Posts:
How much did you say a ruptured cruciate ligament cost to treat in my dog?
$3,449 claim: Rottweiler with hip dysplasia has ACL repair
Hip dysplasia in dogs (and cats)
What happens when my dog's cruciate ligament tears?
Ski - a dog who recovered from a cruciate ligament injury without surgery

September is National Pet Health Insurance Month

September 2009 is National Pet Health Insurance Month and the North American Pet Health Insurance Association (NAPHIA) is celebrating by wanting to put money in your pocket or that of your favorite veterinarian.

We like money in our pockets, don't we?

What do you need to do?

Either:

for a $500 prize to you: 
submit a story of how pet health insurance has helped you in a situation when your pet was in need of medical care.

...and/or

for an educational grant and a plaque of excellence for your favorite veterinarian:
nominate your favorite veterinarian by telling NAPHIA why their vet deserves this honor.

Check out NAPHIA's webpage on National Pet Health Insurance month for more details but just so you know, all submissions must be received by September 30, 2009 at 11:59 PM EST so get them in now!

FYI... As I'm on NAPHIA's Board, I'll be reading your stories and nominations - I can't wait to see them!

Guest Post: Should Your Dog Get the New Canine Flu Vaccine?

Tis the season of hurricanes, tornadoes and the flu and I'm delighted to welcome Dr. Susan Wright to guest blog on the topic of canine flu. No need to panic; she's got all the facts in hand. Read on...

____________________________________________________________________________________

The media has been full of information and advice about influenza lately. First equine flu, then swine flu, and now canine flu. It's not hard to understand why people become alarmed about diseases such as influenza, when they spread so rapidly and may be fatal. In the last few days, Canine Flu cases have been confirmed in Virginia, New York, Colorado, New Jersey and Pennsylvania. So what should you do?

In June 2009, The United States Food and Drug Administration approved a vaccine against canine influenza; however, if you spend some time researching the disease, you'll discover that canine flu may not be as big an issue as you may think.

Vets first identified canine flu in 2004 in Florida, but it is thought that it was prevalent in racing greyhounds from 1999. The virus seems to have evolved from the similar equine influenza virus.

Canine flu is quite a new disease, so most dogs won't have any immunity to the virus. Approximately 80% of dogs exposed to the virus will fall ill. The remaining 20% of dogs, although showing no symptoms, are infected and may still spread disease.

Dogs pick up the virus from the sneezes or saliva of dogs who are carrying the infection. It may take 5 to 7 days after infection before a dog shows any sign of being ill. Having said that, the period before the symptoms show is when an infected dog is most likely to spread the virus. A dog that looks to be perfectly healthy may well be spreading lots of virus in his environment.

There are two types of canine flu - one is a fairly mild form, and the other is a severe, possibly fatal form. The majority of infected dogs develop the mild form of canine flu.

In the mild cases, dogs may cough and have a runny nose. These symptoms can last a month or more. They don't eat, they have a high temperature, and are depressed and lethargic. It's not uncommon for people to think their dog just has the familiar kennel cough instead of canine influenza; the symptoms are very similar.

If a dogs condition worsens, they can develop pneumonia, and have difficulty breathing. Up to ten percent of dogs affected with the severe type of the disease will die. Dogs are much more likely to succumb to the more severe type of canine flu if they are already ill, such as those with cancer, or chronic disease.

To confirm a diagnosis of canine flu, an unwell dog will need to have a blood test, which will detect the presence of antibodies to the virus. A dog that recovers from canine flu infection seems to be immune to repeat infection for several years.

Whether you should vaccinate your dog depends on your circumstances, your dog's general health, and whether or not he will be at increased risk of severe canine flu.

The disease is likely to spread in environments where dogs are allowed to get close to each other. If your dog often stays in a boarding kennel, or you go to shows or training classes, you may want to consider vaccinating your dog. Similarly, if you take your dog to dog parks, or if he accompanies you as you help out in a shelter, your vet may recommend a vaccine for him.

You may also want to consider vaccination if your dog does have an underlying medical condition. These dogs are more at risk of developing severe canine flu. If your dog prefers to be a homebody, and doesn't venture out much apart from an occasional stroll in the neighborhood, many vets would suggest vaccination isn't really necessary.

The virus itself only lasts a week or so in the environment, and it is easily killed by regular household bleach. So, hygiene is very important in preventing the spread of the disease. Make sure you wipe down any show benches you use, and don't let your dog drink from public drinking bowls. The other thing to keep in mind is that the vaccine doesn't prevent infection, it just lessens the severity of any symptoms and reduces the spread of the virus.

If you need more information, speak to your vet about whether or not he or she recommends vaccination for your dog. And finally, there is no evidence that canine flu spreads to humans.

Dr. Susan Wright is veteran veterinarian who blogs for DogFenceDIY.com, a site that shows dog lovers how to safely contain their dog with an underground fence.