Mastiff Index

How To Choose A Veterinarian For Your Mastiff

(OR How To Choose A Doctor For Your Kid)
by Robin M. Smith, DVM
For more information go to: Doc Rob's Library of Mastiff Medicine

As a veterinarian and a mastiff lover, the most frequent question I get asked is "How do I know my veterinarian is the right one for my mastiff?" You don't. If the world were perfect, we might have "Mastiff Veterinarians" that just take care of mastiffs and are at your beck and call....BUT, as you know, the world ain't perfect (sorry to disillusion some of you...). I thought I would try to get you to understand how I got involved with mastiffs and how I learned mastiff medicine and the criteria to look at to evaluate your veterinarian. Some of you have wonderful veterinarians already, this is not to create any dissension with your doctor at all ... it is primarily for those that do not have a veterinarian and are still looking.

A little background on me and how I learned all that I am from a mastiff. First, I didn't graduate knowing any particular breed. We all kind of knew a little about a lot of different breeds. I started off practicing large and small animal medicine since I was new and needed to develop a clientele. After 5 years, I went exclusively into small animal medicine and as of the last 2 1/2 years, I have even gotten more specialized and just practice emergency medicine in small animals. I had my first mastiff client 8 years ago, the dog was not a very good specimen, but I learned then about the severity of hip dysplasia in the breed as he was very dysplastic. Then, about 6 years ago, I met a mastiff breeder and that is when my love of mastiffs really began. I didn't know a whole lot about the breed, but the breeder worked with me and we learned alot together and over the years of persistent bugging of my colleague specialists and learning from trial and error, I can truly say that I believe I am a specialist in mastiff medicine. No, I do not know everything there is to know and fortunately am learning something new each and every day ... that is why I love veterinary medicine. I have even been involved as a "mastiff veterinarian" in a courtroom because of my knowledge of the breed. So with that background, I will present the questions I get the most and try to give the answers.

How do I know my veterinarian knows about mastiffs?
Ask them. Mastiffs are not really that different than a Pomeranian ... in the fact they have all the same parts and work about the same way. So, I first tell a person to talk to their veterinarian and talk to other clients that have known that veterinarian and decide if that veterinarian is a qualified veterinarian to begin with.
How do I know my veterinarian is a good veterinarian?
First, talk with them. Ask them what their policy is on a variety of subjects:
Ask how they handle emergencies. Do they see them themselves or do they refer to an emergency clinic?
  • If they see the emergencies themselves, ask if they have seen any GDV's (bloats) and ask how they treated these cases. In my opinion, I believe EVERY dog that presents with GDV should be surgically explored. I have seen cases where a dog was tubed and the stomach went back to normal size, as if nothing was wrong, and a few days later the dog died. Upon necropsy, it was found that the stomach and part of the intestines were dead. This dog may have had a chance had it been explored when presented. Not all veterinarians can treat these cases. Since this is one of the most life threatening emergencies we see in mastiffs, I think it warrants asking about. The veterinarian should have access to help with these cases. He should have an EKG monitor to evaluate. He should have 24 hour care at the hospital to monitor the dogs. He should have gas anesthesia for the surgery. He should be able to do blood work and get immediate results. The reason a lot of these dogs die is because of a process called "reperfusion injury". After the stomach and spleen are untwisted, the circulation that has been cut off begins again and the body has produced some nasty molecules that are now in the bloodstream. The molecules can reek havoc on the body and cause a lot of imbalances.
  • If your veterinarian does not see his own emergencies, then I would visit the emergency clinic that does see them. Check out the staff. Some emergency clinics are staffed, unfortunately, with new graduates to keep the cost down. I think an occasional new graduate may be able to treat most emergencies, but I would rather have someone who is experienced. Find out what they use to monitor, etc.
Ask about their protocols for surgical procedures and what type of anesthesia is used?
Some veterinarians will become annoyed when you start questioning their practices. If they do, find yourself another veterinarian. When asked this particular question, I love showing the client exactly what I can do and how we do it. I am proud of our facility and the quality of care I can provide. I think mastiffs are not to be dealt with as "just big dogs". They have a lot of sensitivities. I think that because the mastiff is so large, and their chest cavity is huge, the heart in general is more sensitive to certain drugs. Also, because of their huge body mass, drugs are distributed a little slower and therefore you get a slower onset of action. This should be taken into account and the anesthesia should not be increased to quicken the anesthesia because you can over sedate the animal.

I do pre-surgical blood work on ALL mastiffs regardless of age. On mastiffs that appear healthy on exam and are under 3 years of age, I do a BUN (blood urea nitrogen), a creatinine, an ALT, and a PCV and TP. These few tests evaluate kidney, liver and hemodynamic functions. If the mastiff is 3 years of age or older, or has some detectable abnormality on exam, I do the following tests: BUN, creatinine, ALT, ALKP, TP, ALB, PHOS, GLU, GLOB, T. BILI, AMYL, and electrolytes (Na, K, and Cl) and a full CBC with differential and a urinalysis. The dog must be heartworm negative also. In mastiffs 5 years of age or older, or if they have any problems, I also do an EKG. Our practice now does full ultrasound and I am still learning, but in the future, I think I will require all giant breed dogs to have a cardiac ultrasound prior to anesthesia. You all may think this is a lot of testing, and it is. But, I find that I would rather know how the dog is going to react to anesthesia and if there are any problems. And the best part is if all the tests come back normal. Then, I have a baseline from which to compare future tests if the dog has problems.

I believe using injectable anesthetics in mastiffs as the only anesthetic is wrong. I think anytime a giant breed dog is anesthetized, that the dog should be put on gas anesthesia. Some veterinarians still use Halothane, which is okay, but the use of Isoforane is the best. Halothane sensitizes the heart to epinephrine so has the chance of producing the greatest arrhythmias or abnormal heartbeats. Personally, I use a combination of Valium and Ketamine injectable and then intubate (put in an airway) and put the dogs on Isoforane. My dosage of Valium and Ketamine is a lot lower in mastiffs that other breeds because of their size. I use .3 mg./kg Valium and 10 mg./kg. Ketamine IV. If a larger dose is used, the dogs are sedated too deeply. I do not use the pre-anesthetic, Acepromazine, since this drug is known to lower blood pressure by dilating the blood vessels. Also, the onset of action is very slow which causes some veterinarians to overdose and then they have greater problems because it is picked up by the fat in the body and released slowly thereby causing prolonged recovery times. Giant breeds and greyhounds are known to be very sensitive to this drug. Avoid it if possible.

Another drug to avoid in mastiff anesthesia is Rompum (Xylazine). This drug also sensitizes the heart thereby causing arrhythmias. Just think if you used Acepromazine as a pre-anesthetic, Rompum to anesthetize the dog and put the dog on Halothane ... boy, you are cruising for a bruising ... all these drugs can cause severe heart arrhythmias and used together ... well, I probably do not have to tell you ... YET, many veterinarians still use this combination. I would change veterinarians if he wants to use this combination. Period.

Rompum is used in cats as an emetic (to cause vomiting). So, the dog has to have been off food for quite awhile to not cause vomiting and the threat of aspiration. In emergency situations, we all know that sometimes the dog has to be anesthetized and has previously eaten. Rompum is the wrong drug to use in these cases. I do not use Rompum anymore.

I have used Telazol as an injectable anesthetic in the mastiff and it works pretty well. I have given it at .1 ml/10 lbs. but do not exceed 1 ml.

Another good anesthetic is Oxymorphone alone and in combination with other drugs. This drug can be reversed with Naloxone and the dog can actually get up and walk out. It is expensive but sometimes expense is worth it. This drug is fairly safe to use.

Ask how the dogs are monitored during and after anesthesia.
We have the dogs on a pulse oximeter during surgery which lets us know how much oxygen the dog is getting and whether it is breathing adequately, it lets us know the heart rate and the respiratory rate and the temperature of the dog. I think the temperature is very important since there is a process called "malignant hyperthermia" where the dogs react to anesthesia by raising their core body temperature to a very high number, sometimes 108 degrees. This can be monitored. Or vice versa, the animal may get too cold. Not all veterinarians have these devices, in fact, a lot do not. I would be very comfortable just having a technician monitoring the heart rate, respiratory rate and color of the gums of the animal every 5 minutes while in surgery. Some veterinarians do not have technicians or are short handed and once in the surgery room, do not have anyone monitoring the animal. I think this borders on malpractice and you need to ask this question. After surgery and on recovery, we have a ward technician who monitors the vital signs every 15 minutes until the dog is sitting up ... again, this is necessary. The time when the dog is most likely to die is right after anesthesia ... from vomiting and aspirating the contents into the lungs or from abnormal heartbeats or from stopping breathing. Monitoring the animal during and after surgery is a MUST.
What should I ask my veterinarian to find out if he knows about mastiffs and if he has not treated mastiffs, should I find another veterinarian?
First of all and most important, is not whether your veterinarian has treated mastiffs before, but is how willing is he to learn about them and how comfortable are you talking with him. We all have to start somewhere. I think the most frustrating thing I hear from people is "I took my mastiff to the veterinarian and he said it probably has hip dysplasia." Most of you know that mastiff puppies go through an ugly stage and walk really weird and it is at this time when a veterinarian seeing your dog will make this comment. Perhaps it does have hip dysplasia...but I think that the best educating we can do with veterinarians is allowing them to see just how these guys develop and how gawky they are until sometimes 3 years of age. I see alot of limping mastiff puppies. There are alot of causes of limping in mastiff puppies. I am very aggressive in my treatment of limping mastiff puppies ... BUT, do not just assume since it is a mastiff, that it is dysplasia. Be willing to help your veterinarian learn. But, on the other hand, your veterinarian must want to learn and must enjoy finding out about things they do not understand.
What are the biggest health concerns for a mastiff?
  • GDV (bloat) - see above for information.
  • Orthopedic conditions/developing conditions - your veterinarian should be familiar with hip dysplasia, OCD, panosteitis, elbow dysplasias, doing OFA radiographs, growth problems and how to treat them or have a good referral doctor to refer to.
  • Skin condition - you veterinarian should be familiar with allergies, staph infections of the skin and how to treat.
  • Thyroid condition - your veterinarian should know and understand the different thyroid tests and how to interpret the results.
  • Reproductive problems - your veterinarian needs to understand the cycling of a mastiff bitch and the most common problems. They must understand culturing prior to breeding and all the testing necessary prior to breeding. They must also understand the problems mastiffs have with labor/dystocia. Must have facilities or be able to refer to facilities to do C-sections. Should be able to do a work-up on a bitch that has not been able to be bred.
  • Heart problems - your veterinarian must be aware of the most common heart problems in mastiffs, cardiomyopathy, and know how to diagnose and treat this disorder.

Bottom line: Be comfortable with your veterinarian. There are good veterinarians and there are bad veterinarians as in every profession. There is a state association in your state to call and to check up on your veterinarian but all it can provide is if any disciplinary actions have been taken against that particular veterinarian. We, as a profession, unfortunately are not really monitored. There are more legislative rules coming out every day and the one I am enjoying is the policy of the name "hospital" vs. "clinic". Basically, if you are operating a veterinary hospital, you must have patient supervision 24 hours a day. If you have a clinic, you must post a sign in the waiting room stating that you do not have 24 hour care and the animals are not monitored overnight. So, many hospitals are having to change their names to "clinic". I think this is a good legislative move although it will probably be difficult to enforce.

I think the one most important quality of a veterinarian is "will they call and ask for help or advice when they do not know the answer" or do they just try to make it through. You know which one you want for a veterinarian.

Please feel free to call me if you have any particular question about anything pertaining to veterinary medicine. I will try to help and if I cannot, I will try to find someone who can.

Robin M. Smith DVM
410-848-3363 (w)
410-489-9235 (h)

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