Thursday, March 22, 2012

The Last Biggest Loser Contestant

Last week I saw three fat dogs on my appointments. The last dog of Tuesdays appointment was Squishy.



Squishy is a four year old spayed Pug. She is like many of the Pugs we see; short, fat, happy, and eternally (sounds) congested. She is a sputtering, spitting, tongue lashing tan rounded mass with a curled and kinked tail that lobs around in no definable motion and a tongue that doesn't quite fit the confines of its' mouth home.
She was originally purchased by the daughter of my clients. But soon after Squishy came to the "grandparents" for a very short over night stay it seems they got to attached to her and she never went back to her mom.

Not only was she not originally their dog, but she was also not originally called Squishy. She was a more respectably named "Layla." Although to know her I have to agree that she is more fittingly a Squishy than a Lyla to me.



Squishy is what her mom always called her and that's how I will always think of her. Both of them face to face making kissing gestures at each other and elated by how adorable Squishy is. It was mutual adoration and the Mrs never went anywhere without her Squishy by her side.

I have been Squishy's Vet since she was first a Squishy. She has since the very beginning, always had a weight problem. We see it so commonly in Pugs that I almost think that society thinks this is what they are supposed to look like. I have to remind my clients that Pugs are supposed to have a round head, but that only their head is supposed to be globoid. Pugs are actually supposed to have a stocky wide shoulder and heavy upper body but a small waist and hind quarters. It's sort of like a miniature Bulldog stance.

I spent most of every single appointment with Squishy reviewing the Pug anatomy, drawing pictures, trying any way I could possibly think of to convince Mrs Squishy how vitally important it was to keep her thin and healthy. Every trip in our door was the same. She never lost a pound (rather she usually had gained one or two). It got to the point that the Mrs. just didn't want to hear my concerns, and didn't care what Squishy's waistline looked like. She just wanted Squishy to have everything she wanted and wanted her to be happy.



The problem with most of the Pugs that I see is that they are so attached to their owners that they have forgotten the needed limitations and discipline that their little 15 pound bodies need to follow. They are master beggars and manipulators. Most of the Pugs that I see have no diet that resembles a high quality commercial dog food.

In Squishy's defense she is actually on a very good dog food. But it has taken us three years to get her there. She eats DeliFresh. It is a refrigerated meat based dog food that resembles bologna loaf available for you and me at the grocers deli counter. She LOVES her food! And because it is the only food we have found that she and her owners both love, we have stuck to it. The problem now lies in the snacks. She gets a reward snack for every move she makes. They love her so much that they can't help but reward her for her attention. So she gets treats galore and she rewards them with attention galore! And everyone is happy except me and her waistline.

The absolutely disastrous aspect of having a fat Pug is that their already abnormal head and anatomy gets pushed even harder into maintaining an open airway than it was due to breed conformation.

I have gone over the "brachycephalic syndrome" already, but for those of you who missed it here it is again.

Brachycephalic dogs are those dogs with the short noses. Actually many of them have a black spot of a nose but no extension of the bone between the nose and the eyes. We have essentially genetically bred them over centuries to have no nose. We pushed their nose into their face and in the process some of the anatomy that was supposed to be in that space got lost or jammed into another space. These Pugs always sound like they are snorting because their nose, which should be a three dimensional cube like structure, is now a flattened broadened structure. This is much better described by a picture.




The second anatomical abnormality we imposed on the Pug is the elongated soft palate. We pushed this back into the throat so now the soft palate infringes on the turf of the larynx/pharynx area and we get a dog that has a very difficult time breathing.





The above pictures are from this great vet text.

To make matters even worse the small nose can't pull air in well because the alar wings are shutting off the nose (they ALL need a Breathe-Right strip), and the elongated soft palate closes off the back of the throat. The saccules in the larynx get beaten to a swollen fleshy mess and can't fit in their pouches anymore so they evert and take up more space in an already crammed area. The final blow to the ability to breathe is a weakened trachea that is not a stiff cartilaginous tube with nice heavy duty cartilage rings to keep your tracheal tube open, but instead a weak tube that actually collapses with stressful breathing.

http://www.youtube.com/watch?v=-bOwDBowtds A great video on Brachycephalic Syndrome, and surgical treatment options and general recommendations.


It's a snowball disaster for some brachycephalic dogs. THE WORST thing that you can do to an already breathing challenged Pug is let them get fat! It is another burden that some of them have no room to bear.

This was always my point with Squishy and her mom. My voice began to fall on deaf, dreading the sound of my voice, ears. So I laid off of all of them.

I have learned that there really isn't anything as important as how much an owner loves their pet. Nothing trumps that love. And if I ever feel as if I am venturing into a territory that will lessen that bond I back off. I can only try to offer advice and then help out if needed later.

So a year ago I decided to not brooch the subject anymore and just try to offer advice with the Mrs. if she asked for it.

About 5 months ago we got a call saying that Mrs. Squishy had had a fatal heart attack.

We sent cards and sympathies and I felt terrible for ever opening my mouth and being the bad guy that I thought she recognized me as. I worried about her family and I worried about Squishy.

Last Tuesday the Mr. came in with Squishy. She was every bit as happy and fat as she had ever been. Mr. on the other hand was sullen, quiet, and sad.



"Dr. Magnifico, would you help me with Squishy's weight? I couldn't bear to lose her too." He said with a barely audible voice.

I could feel the sorrow in his soul. I almost broke down in the room with him. This little fat exuberant pup was all the most important loved one in his life and he wanted to keep her and his wife's memory alive as long as he could.

We started Squishy's weight loss plan with the following.

We were going to measure how much food she was given and he was going to promise to not feed her any treats for a week. I suspected the excessive calories were from the treats and I wanted a week to test my theory.

On day 1, Tuesday March 13, 2012 Squishy weighed 20 pounds.



We also decided that Mr and Squishy would come in every Tuesday night for a chat, a weight check, and because I think he needed a schedule and a visit from friends.

Last night, Tuesday March 20, 2012 Squishy's weight was 20.9 pounds.

So much for my great plan.

We discussed what the last week composed of and it turns out Mr. just had shoulder surgery, so the walking got cut way back. (He normally walks three times a day. We might need to quantify a distance).

But the with hold treats suggestion was forgotten.

So this week Squishy went home with one bag of treats that were 3 1/2 calories each and instructions to only feed 5 per day. (I also suggested he break 1 treat into 4 smaller treats).





We will see what next Tuesday's numbers look like.

Best of Luck Squishy and dad!



http://www.youtube.com/watch?v=-bOwDBowtds A great video on Brachycephalic Syndrome, and surgical treatment options and general recommendations.


For more information please see;
http://www.petmd.com/dog/conditions/respiratory/c_multi_brachycephalic_airway_syndrome

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