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Medical Care Considerations

A trained, healthy working dog is an extremely valuable asset to an organization or individual and can save lives when appropriately deployed in a wide variety of situations. Keeping the canine team healthy and injury-free is paramount in maintaining the effectiveness and well-being of the dog, the handler, and those dependent upon the outcomes of the team’s actions. Extensive resources are involved in training these specialized dogs, so there also is incentive to maximize the time in which they are at peak performance. A comprehensive preventive medical care plan is the cornerstone of health for any working or service dog. Protection dogs are no exception.

Job requirements, environmental exposures, and travel requirements are important factors to consider when building an individualized care plan for a working dog. The 2017 AAHA Canine Vaccination Guidelines provide an excellent resource for information regarding vaccine recommendations that translate directly to optimal working dog care.40 Veterinary teams that are involved with canine breeding and puppy raising programs that support the supply and demand for adult working dogs have special considerations for planning preventive care programs that may deviate frompet puppy programs. All working dogs should receive recommended core vaccinations, along with strong consideration for noncore vaccines based on risk factors and locale. Most working dogs are additionally vaccinated for infectious upper respiratory diseases and leptospirosis from the noncore group, and remaining noncore vaccine options should be evaluated on an individual basis.

The veterinary team can refer to the 2011 AAHA-AVMA Canine Preventive Care Guidelines as another valuable tool for planning preventive healthcare programs for working dogs.41 In addition to vaccination, programs should include parasite prevention, dental evaluation and treatment, weight and diet evaluation, fitness evaluation, and behavioral and performance evaluation. Establishing routine health exams is important in early detection of issues that may affect sustained performance, and the AAHA-AVMA Canine Preventive Healthcare Guidelines recommend a minimum of once-yearly health exams. Although there is a paucity of data that defines an ideal interval for health exams in working dogs, it is the advisory panel’s opinion that exams should be considered twice yearly for this population. As a component of these exams, it is important to obtain a thorough history about the dog’s performance from the handler. Video or photo documentation of work-related concerns or responsibilities (provided by the client) may be facilitative for the care team’s screening of the patient’s needs. Although handlers may not have the knowledge to medically assess their canine partner, they are often so closely bonded with their dogs that they detect very subtle abnormalities in the dog’s movements or behavior, well ahead of what the veterinary team can detect symptomatically.

As a component of preventive care, dental health is critical in sustaining the protection dog’s ability to perform bite work duties. Because protection dogs routinely train by performing bite exercises on aids such as bite sleeves or suits (which often contain an inner core of metal mesh to protect the human decoy), coupled with the fact that they can create an extraordinary amount of occlusal force during maximal bite pressure, the potential for traumatic damage to the teeth is increased. A detailed review of the mechanics of the bite can be found in J. Bradshaw’s article in the 2017 July/August issue of Working Dog Magazine.42 The teeth that are most involved with creating functional grip and power in the bite, namely, the canine and carnassial teeth, should be preserved whenever possible following dental injury. The practitioner involved in working dog care should maintain a close working relationship with dental specialists who can provide advanced care such as root canal therapy when teeth are damaged.

It is important to discuss the policy of neutering with the working dog or breeding program manager, as many (particularly male) working dogs are left intact for an extended period of their working careers. There has been much debate about health outcomes of early neutering in dogs. Recent meta-analyses point to an increase in overall risk of hemangiosarcoma, lymphoma, mast cell tumors, and osteosarcoma in both sexes. This must be balanced with the known prevention of reproductive cancers such as mammary, uterine-ovarian, and testicular cancers when the dog is neutered. Additionally, gonadal hormones play an important role in normal musculoskeletal development, and removal of the hormone source during the developmental period is generally thought to worsen the risk of heritable orthopedic disease.43

Overall fitness is of critical importance in preparing the protection dog to perform efficiently and safely in the line of duty. Weight management is one of the first steps in promoting high functionality in working dogs. The veterinary team must develop a practiced eye for evaluating lean yet well-muscled working body conditions. Caloric requirements should be specifically calculated for the working dog and adjusted as necessary to maintain a lean, ideal body condition, and often on a recurring basis. A useful formula to start the process is the National Research Council’s (NRC) calculation for metabolic energy requirement for the active dog: 132 kcal/day X 3 MBW, where MBW is the metabolic body weight calculated as (kg0.75). Routine activities for the protection dog tend to be rigorous and involve running, jumping, abrupt direction changes,moving on unstable surfaces, and high impact. Given these requirements, an overweight protection dog may be at particular risk for impact-related injuries through both ballistic movement and high-velocity bite work, as excessive weight increases forces within the involved joints.

There are no studies in working dogs correlating fitness training to injury prevention. However, based on human studies, it is reasonable to expect that proper physical conditioning would serve a role in decreasing sports- or performance-related injuries.44–49

Additionally, proper physical conditioning is important in the management of heat stress and may lessen the occurrence of work-related heat injuries. Working dogs are sometimes surprisingly ill-prepared for the physical demands of their jobs. In such cases, the veterinary team should have a detailed discussion of any fitness training that is conducted by the handler. Exercises for protection dogs should include a balance of sprint and moderate endurance training, strength exercises targeted at the core muscles of stability (primarily back, abdominal, and hip) and the cervical region (supporting safe and effective bite work), and functional neuromuscular exercises that promote balance and proprioception. Additionally, the importance of warming up before job performance and cooling down at the conclusion of duty needs to be communicated. Recent work by Farr et al. describes a fitness assessment and conditioning plan for working dogs that can aid the practitioner in developing a program of exercise for the canine team.10 Specialists in canine sports medicine and rehabilitation can also serve as valuable consultants for creating programs to promote working dog fitness. The American College of Veterinary Sports Medicine and Rehabilitation (https://vsmr.org/) is a useful resource for veterinary care focusing on conditioning and rehabilitation.

Veterinary teams providing care to working dogs should be prepared to deliver urgent care for common injuries and toxicities. Although dermatologic disease, gastrointestinal disturbances, soft tissue and musculoskeletal injuries, and heat injuries are commonplace in the realm of working dog medicine, the protection dog is especially vulnerable to traumatic injuries such as gunshot wounds and penetrating injuries from knives. The veterinary team must be prepared to triage and stabilize such wounds if the dog is presented for emergency care. Swift and coordinated emergency care has saved the lives of many working dogs, so that the canine team can reunite as a functional unit. It is important to also address any behavioral issues that arise as a result of traumatic events. Dogs can develop their own form of post-traumatic stress that can endanger their careers if the condition goes untreated.50 Traumatic injury can also result in the death of the working dog, an event that is particularly difficult for the handler and other team members. The veterinary team must be prepared to navigate the death of a working dog with an understanding and profound empathy for the rituals that are observed in honoring the loss of a four-footed partner.

TABLE 3

Healthcare Recommendations for Protection Dogs
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Healthcare Category Protection Dog
Preventive care
  • Dental care
  • Core vaccines to include leptospirosis, Bordetella, CIV (in atrisk populations)
  • Annual heartworm testing; vectorborne disease in at-risk populations
  • Fitness and conditioning; adequate warm-up before work
  • Annual wellness screening tests (e.g., biochemistries, fecal analysis)
  • Flea and tick preventives
  • Prophylactic gastropexy
  • Leave functional dewclaws and tails intact
  • Awareness of susceptibility (exertional and nonexertional) to heat stroke
Behavior
  • Be aware of and prepared to address
    • Noise sensitivity
    • Anxiety
    • Environmental aversions
    • Acclimation to husbandry practices
  • Recognition and early treatment of post-traumatic stress
  • Implications of training methods on welfare
Nutrition
  • Body Condition Scores (ideal is 3.5–4.5 out of 9)
  • Use of supplements as appropriate to the individual (joint, probiotics, skin)
  • Caloric requirements and dietary assessments
  • Need for special diets (prescription, performance)
Reproduction
  • Delay desexing in both males and females until past closure of growth plates to decrease the risk of orthopedic issues later
  • Consider leaving males intact through working life
  • Neutering does not measurably change motivation to work
  • Consider minimally invasive ovariectomy or OHE and combining with gastropexy
Common injuries
  • Feet, pads, nails
  • Musculoskeletal (muscle strains, DLSS , overuse/repetitive injuries)
  • Ballistic wounds (gunshot, handgun); penetrating injuries (knife, impalement); blunt trauma from falls
  • Dental trauma (fracture of teeth, particularly canines)
  • Tail tip trauma (“happy tail”)
  • Airway obstructions (e.g., inhaling ball)
  • Heat injury
Common diseases
  • Infectious diseases (vector-borne, region-specific disease; leptospirosis)
  • Gastrointestinal: diarrhea, GDV
  • Ear/skin disease (atopy, environmental, food allergy)
  • Upper respiratory (in at-risk kenneled populations)
  • Urinary: UTIs; prostatitis
  • Ocular: corneal disease (pannus), foreign bodies
Handling
  • Low-stress techniques
  • Premedication as appropriate
  • Keep handlers with dogs
  • Have handler apply cage-style muzzles
  • Staying below threshold; avoid triggers
  • Practice calm behaviors from veterinary team and dog-handler team
  • Consider performing exams outside (do not trap dog in small area)
  • Understand and identify special commands
Screening for heritable diseases
  • Hip dysplasia
  • LS disease
  • Elbow dysplasia
  • Degenerative myelopathy
  • Progressive retinal atrophy (PRA)
Mental/emotional considerations
  • End-of-life or end-of-career decisions require additional considerations/ accommodations
  • Euthanasia: it will involve a network of support from teammates and honoring their process and culture
  • Traumatic events (apprehension, getting shot) create an incredibly strong bond with dog
  • Financial limitations and responsibilities
  • Dog may be a proxy for handler stress (emotions roll down the leash)
First aid
  • Trauma/hemorrhage
  • Airway obstruction
  • Toxicity, field decontamination (both oral and dermal decontamination)
  • Hydration
  • Heat injury
  • Transport
  • Triage GDV
  • Assessment of vital signs and knowledge of normal values
Triggers for retirement
  • Loss of mobility, pain
  • Loss of interest in job
  • Terminal disease
  • Inability to certify/recertify
  • Contraindications for high-stress performance: Addison’s disease, epilepsy, laryngeal paralysis, cardiac disease
Needs of handlers
  • Communication
  • Respect for bond
  • Access to medical education and medical information regarding their dog (resources 24/7)
Needs of owners
  • Financial planning
  • Communication; timely written reports
  • Utilizing “HMO” contract or insurance
  • Investment in dog, assurances; value of treatment
Needs of organizations
  • Education
  • Needs dogs that can provide the services expected of them
  • PR: media loves a good working dog story
Possible exposure risk
  • Illicit drugs

These guidelines are supported by generous educational grants from the AAHA Foundation,
Boehringer Ingelheim Animal Health USA Inc., CareCredit, Merck Animal Health, and Zoetis.

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