Veterinary Care 
Maintaining your dog’s health benefits both you and your dog; you continue to enjoy the enhanced mobility you’ve become accustomed to and your dog’s well being remains intact.  This informational packet covers the basics of choosing the right vet, nutritional recommendations, body condition scoring, preventative healthcare, common health problems, and emergencies.  

Choosing a Veterinarian
Your dog’s veterinarian should be chosen with the same care, time and consideration that you spend on selecting your own personal physician.  Choosing a local veterinarian for your dog should be completed before arrival to class or as soon as possible upon arrival home with your dog.  
How do you go about selecting a veterinarian?  One of the best ways is a referral from family or friends.  Another option is consulting other service dog users in your area.  By choosing a veterinarian this way, it is more likely they will already have insight into the unique bond that develops between dog and handler, as well as understanding some of your dog’s responsibilities.  This knowledge assists him/her in choosing appropriate therapy recommendations for your dog.   All states have professional veterinary medical associations that can be found in the yellow pages or online.  These state associations can be a resource for finding a veterinarian.  In addition, there are two national associations in the United States, the American Veterinary Medical Association and the American Animal Hospital Association that can also be a resource for locating a veterinarian.  Choose a veterinarian that you are comfortable with and can trust.  
Recommended Diets for your Dog
From puppyhood to formal training, your dog should have been fed the highest quality diets available.  It is recommended that you feed a comparable diet during your dog’s entire working life.  There are many diets available at most major pet food stores that meet our recommendations.  These include (but are not limited to) premium brands such as Nutrisource Element, Steve’s Real Food, Inukshuk, and Outback Trails. We recommend grain in foods. If you have any questions about a specific diet, we recommend you contact your veterinarian. 
Once you choose a diet, stay with it.  Consistency is important.  Switching diets often is not recommended, and may cause vomiting, diarrhea or relieving issues in harness.  Your best bet is to pick a high quality diet that is easy to find and stick with it. 
Keeping your dog at an optimal weight by feeding an appropriate amount of food will prolong his/her working life. You may do this while also hand-feeding.  Also, it has been proven that maintaining a healthy weight is linked to fewer and later onset of health issues.  It is extremely important to monitor your dog’s weight with regular body checks and weigh-ins. In most cases, once settled into your home and lifestyle, your dog will be more relaxed and working less than he or she was in training and class.  After returning home with your dog from an intensive, you will likely reduce the amount of food that you fed in class.  If you don’t, your dog may become overweight. If your dog becomes overweight, there are over the counter weight reduction foods specifically designed for this condition.  There are also prescription diets that your vet may recommend for safe and effective weight loss. However, maintaining your dog’s weight is easier than taking pounds off.

Body Condition Scoring
Body Condition Scoring (BCS) is a tool you and your veterinarian can use to help assess if your dog is at an appropriate weight.  It does not require a scale, is easy to learn and can be done anytime.  Many grads check their dog on a monthly basis.
How do you check your dog?  The next time your dog is standing up, put your hands on either side of your dog just behind the shoulders and rub gently back and forth.  Get familiar with how the ribs feel under the skin.  Gently slide both hands back along the sides of your dog until you come to the last rib.  At this point, your hands should feel a slight depression, about 1 to 1.5 hand spans long.  This is your dog’s waistline.  Continuing farther back you will feel the beginning of the pelvis (point of the hip). 
Now place one hand on top of your dog between the shoulders and slide your hand along the spine toward base of the tail.  You are feeling for the tops of the vertebrae.  Next put one hand underneath your dog on the rib cage and slide it back toward the rear legs until you reach the thighs.  The stomach area should feel tucked up. 
With all of this information it is easy to determine the BCS score for your dog.  We use the 9 point scale published by Purina® with a few modifications.  They are as follows:
A BCS of ___ is characterized by the following:
1.	Ribs, tops of vertebrae, pelvic bones and all bony prominences are easily felt.  There is a definite loss of muscle mass.
2.	Ribs, tops of vertebrae and pelvic bones are easily felt.  No palpable fat.  Minimal loss of muscle mass.
3.	Ribs are easily felt, no fat over them. Tops of vertebrae and pelvic bones can be felt with more pressure, and there is no loss of muscle mass.
4.	Ribs easily felt along with a thin covering of fat.  Waist is easily felt.  The stomach area is tucked up.
5.	Ribs are felt without excess fat covering. Waist is still felt. The stomach area is tucked up.
6.	Ribs are palpable but with more pressure due to slight excess of fat.  Waist can barely be felt. Stomach area is still tucked.
7.	Ribs are covered with a heavy layer of fat requiring increased pressure to palpate. Waist is absent or barely felt.  Abdominal tuck beginning to disappear.
8.	Ribs almost not palpable due to fat layer. Waist is absent, may begin to bulge out. Abdominal tuck is lost.
9.	Massive fat deposits over chest, spine, base of tail. Waist and abdominal tuck are absent. Fat deposits on neck and legs. Obvious abdominal distention.

What is the Body Condition Score of your Dog? 
We expect Service dogs to maintain a 4 or a 5.  We rarely see service dogs in the field that are too thin.  Most dogs that are out of the ideal range are too heavy (6-9 range).  By checking monthly and following the BCS system, we anticipate all service dogs to maintain within the ideal range.

Vaccinations and Recommended NLWD Protocols
Vaccinations are an integral part of your dog’s preventative care.  Vaccines keep your dog protected from serious infectious diseases.   Advances in medicine have resulted in better vaccines that are more specific, provide longer protection, and allow your veterinarian to make recommendations appropriate for your dog.  The length of this immunity is variable for different diseases and that is why vaccinations need to be “boostered” or repeated at regular intervals.
There are two general groupings of vaccinations: those that target “core” diseases and those that target “non-core” diseases.  Core vaccinations prevent diseases that are widespread and easily transmitted.  Core vaccines are recommended for all dogs and need to be kept current at all times regardless of where you live and your lifestyle.  The two most common core vaccines are Rabies and the Distemper/Parvo vaccine which covers four different types of infections.  Adult dogs should be vaccinated for these viruses every three years. 
Non-core vaccines are ones that are considered optional and recommendations are based on evaluation of risk of exposure, likelihood of infection, and severity of disease.  Non-core vaccines include Leptospirosis and Bordetella (also referred to as Kennel Cough).  Your dog should have received both core and non-core vaccinations.  NLWD recommends that you contact your local veterinarian to discuss the non-core vaccines that are recommended for your home area and to set up boosters.     
Fleas and Ticks
Dogs and cats share the same fleas, and fleas can travel from one pet to another.  Ticks are everywhere, and the diseases they carry can pose serious risks to your dog.  Thus, it is critical to protect all of your pets from fleas and ticks with high quality prevention products.  
Fleas feed on your dog’s blood and flea infestation can lead to anemia (blood loss), severe allergies, skin infections, and intestinal parasites such as tapeworms. 
Ticks are another blood-sucking skin parasite, but instead of biting a hole in the skin like the flea, the tick attaches itself to the skin to feed. There are hundreds of species of ticks. Ticks carry and transmit many life threatening diseases; the most familiar is Lyme disease.
Limiting exposure to tick areas reduces the chance of infestation.  The areas of highest tick population are in forests, rangelands, tall weeds and grasses along hiking trails.  If working your dog in these areas, always groom immediately after your walks to remove ticks before they have a chance to attach.  Even with conscientious care and prompt grooming, some ticks may be missed.
Service Dog’s should be taking Heartworm and Flea/Tick preventatives.  In conjunction with application of a safe, topical monthly preventative on all pets, such as Frontline Plus, it is also very important to keep your home clean by frequent vacuuming and washing of all bedding.    

Heartworm Disease
Heartworm disease is a serious and potentially fatal disease in pets all over the world.  It is caused by foot-long worms (heartworms) that live in the heart, lungs and associated blood vessels of affected dogs, causing severe lung disease, heart failure and damage to other organs in the body.  
The mosquito plays an essential role in the heartworm life cycle.  When the mosquito bites and takes a blood meal from an infected animal, it picks up baby worms.  Then, when the infected mosquito bites another dog the heartworms invade that new animal.  It takes approximately 6 months for the worms to mature into an adult heartworm.  Once mature, heartworms can live for 7 years in the dog.  
Clinical signs of infection may come on slowly over months or years. Signs include mild persistent cough, reluctance to exercise, fatigue after moderate activity, decreased appetite, and weight loss.
Heartworm disease is preventable.  Your dog was started on a monthly heartworm preventative medication as a puppy, and has continued on this preventative uninterrupted ever since.  Also, your dog should be blood tested to ensure he/she is heartworm negative prior to being issued.  While you may be fortunate to live in a heartworm free area, it is strongly recommended that you continue to administer the monthly preventive medication, especially if you plan on traveling to areas that may have heartworm-infecting mosquitoes. 
Even with year-round use of a heartworm preventative, routine heartworm blood testing is recommended.  Depending on your veterinarian, routine blood screenings are done either yearly, every other year, or every third year and can be done at the same time as your annual exam. 
What happens if you forget to give the preventative by a few days or even up to a couple of weeks?  Give a dose immediately, and then go back to the same scheduled day your dog was on.  The medication works by clearing the bloodstream of any baby heartworms that may have been deposited by a mosquito.  If the medication lapse is longer than 1 month, check with your local veterinarian on how to proceed.
If you remember to give the preventative monthly, and perform the recommended heartworm checks by your veterinarian, your dog should remain heartworm-free for its entire life.

Ear Infections 
Ear infections are most commonly caused by bacteria or yeast.  Ear mites, moisture or wax, foreign bodies, and allergies can all be contributing factors in the development of an ear infection.  Because the ear canal in the dog is mostly vertical (unlike a human ear canal that is horizontal), it is easy for debris and moisture to be retained in the ear canal.  
If ear infections become recurrent they can cause inflammation and narrowing of the ear canal which can make the ears even more susceptible to further infection. Regularly and effectively cleaning your dog’s ears will help to prevent this downward spiral.
To maintain healthy ears and prevent infections, we recommend cleaning your dog’s ears once a week.  You will learn how to do this in class.  Even with conscientious cleanings, dogs can develop ear infections. Signs of an ear infection include excessive odor, increased discharge or apparent discomfort when cleaning.  If any of these signs are noticed, please contact your local veterinarian for an appointment. 

Vomiting and Diarrhea 
Vomiting, diarrhea and a decreased appetite are the most common signs of gastrointestinal upset.  There are many possible causes for these conditions, including viruses and parasites, something very simple like having eaten something bad, or something more complicated like cancer or organ problems.  Treatment is aimed at the underlying problem, and can be as simple as withholding food or as complex as surgery.  The most common cause is gastroenteritis secondary to dietary indiscretion, or eating something the dog shouldn’t have.  This includes the obvious behaviors like getting into the garbage or grabbing something off the floor.  Even a seemingly harmless treat like a piece of your dinner can cause an upset stomach in your dog.  To help prevent any GI upset, you should give only kibble as a food reward.  
Cases of mild vomiting and/or diarrhea typically respond well to TLC and basic home care.  Withholding food for at least 12 hours to allow the gastrointestinal tract to rest may be recommended.  If the signs resolve, your dog can then be started on small amounts of bland, highly digestible food, such as boiled chicken and white rice, or a prescription intestinal diet.  If your dog continues to respond to the bland diet for the next 24 hours, slowly mix back in their regular diet over the next several days.  If the vomiting or diarrhea continues or becomes more severe, seek veterinary care that same day.

Emergencies
Emergencies will happen.  With good planning, the impact of the event can be mitigated.  During your first veterinary visit, find out if they offer after-hour emergency care and find the location of the closest recommended emergency clinic.  Practice locating the emergency clinic both during the day and at night.  This is important as emotions run high during an emergency and locating a new place during the night, in the rain or snow can cost valuable time.  Be aware that many emergency clinics require a deposit in advance of treatment and payment in full when your dog is discharged. 
To be prepared, save the phone numbers of both your local vet and the local veterinary emergency clinic.  Always have this information on you.  

What is an Emergency? 
The following is a partial list of potential emergency situations: 
- Repeated vomiting or diarrhea with blood or violent episodes
- Bloated, swollen, distended or painful abdomen, with or without vomiting
- Difficulty breathing, e.g. noisy respiration, blue tongue, gasping for breath.
- Loss of balance or consciousness or seizure – tremors, staggering, convulsions, tilting of the head, sudden blindness
- Major trauma from a fall or vehicle accident
- Laceration, open wound, broken bone, or puncture wound
- Ingested poison, including chocolate, grapes, raisins, uncooked bread dough, macadamia nuts, human medications, slug bait, and rodent poison
- Heatstroke – heavy panting, weakness, rectal temperature of 104 °F or higher 
- Eye injury or suspected eye injury

Bottom line: If you are concerned about your dog’s health, call your vet for further advice.  Sometimes a health situation can be handled over the phone, but be prepared to transport your dog for veterinary attention if needed. 
Follow the VFA procedures mentioned earlier for emergency care financial assistance.  It is important to first stabilize a life-threatening health issue then contact the VFA coordinator for additional authorization. 

Conclusion
Even with the best of care and oversight, health issues still arise in our dogs. That said, we can often avoid or prevent many common ailments by following our vet’s suggestions and using good common sense. Your dog depends on you to help him or her remain healthy and viable as your partner. We wish you and your dog many years of good health!