How to Choose a Veterinarian for Your Mastiff
By Robin M. Smith, DVM

As a veterinarian and a Mastiff lover, the most frequent question I get is, "How do I know my veterinarian is the right one for my Mastiff?" You don't. If the world was perfect, we might have "Mastiff Veterinarians" who 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 when evaluating 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 who do not have a veterinarian, who are still looking, or who perhaps are now wondering if they made the right choice.

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, since I was new and needed to develop a clientele. After five years, I went exclusively into small animal medicine, and as of the last two and 1/2 years, I have become even more specialized, and just practice emergency medicine in small animals. I had my first Mastiff client 12 years ago and 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 10 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 a lot together. And over the years of persistent bugging of my colleague specialists and learning from trial and error, 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 if my veterinarian knows about Mastiffs?

Ask. Mastiffs are not really that different than Pomeranians... in the fact that they have all the same parts and work about the same way. So, I first tell people to talk to their veterinarian and talk to other clients that have known that veterinarian, and decide for themselves if that veterinarian is qualified.

How do I know if my veterinarian is a good veterinarian?

Ask what the vet's policy is on a variety of subjects:

(a) How emergencies are handled -- Does the vet handle emergencies himself, or is your dog re-ferred to an emergency clinic? If emergencies are handled by the vet, ask if the vet has seen any GDVs (bloats) and ask how these cases were treated. In my opinion, I believe EVERY dog that presents with GDV should be surgically explored. I have seen cases where that 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's something to discuss with your vet. The veterinarian should have access to help with these cases. He (or she) should have an EKG monitor for evaluation. He should have 24-hour care at the hospital to monitor the dog. He should have gas anesthesia for the surgery. He should be able to do bloodwork 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 circu-lation that has been cut off begins again, and the body has produced some nasty molecules that are now in the bloodstream. The molecules can wreak 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 emergen-cies, but I would rather have someone who is experienced. Find out what they use to monitor dogs, etc.

(b) The protocols for surgical procedures and the type of anesthesia used -- Some veterinarians will become annoyed when you start questioning their practices. If they do, find yourself another veteri-narian. When asked this particular question, I love showing the client exactly what I can do and how we do it. 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 its chest cavity is huge, the heart in general is more sensitive to certain drugs. Also, because of the Mastiff's huge body mass, drugs are distributed a little more slowly, 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 effect because you can also oversedate the animal.

I do pre-surgical bloodwork 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 also be heartworm negative. In Mastiffs five years of age or older, or if there are 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 epi-nephrine, so it has the chance of producing arrythmias. 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 than in other breeds because of their size. I use .3 mg./kg valium and 10 mg./kg. ketamine IV. If the 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 ves-sels. Also, the onset of action is very slow, which causes some veterinarians to overdose. Then there are greater problems because the drug 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 arrythmias. Just think... if you used acepromazine as a pre-anesthetic, rompum to anesthetize the dog, and then put the dog on halothane... boy, you are cruising for a bruising. All these drugs can cause severe heart arrythmias, 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 some time 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 some-times expense is worth it. This drug is fairly safe to use.

(c) 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 the dog is breathing adequately. The oximeter also lets us know the heartrate, respiratory rate and temperature of the dog. I think the temperature is very important, since there is a process called "malignant hyperther-mia" in which the dogs react to anesthesia by raising their core body temperature to a very high number -- sometimes 108 degrees, or vice versa, the animal may get too cold. This can be monitored. Not all vet-erinarians have these devices -- in fact, a lot do not. I would be very comfortable just having a technician monitoring the heartrate, respiratory rate and color of the gums of the animal every five minutes while in surgery. Some veterinarians do not have technicians or are short-handed, and once they are in the surgery room, do not have anyone monitoring the animal. I think this borders on malpractice and you need to ask about this. After surgery and during recovery, we have a ward technician who monitors the vital signs every fifteen 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 because the dog just stops breathing. Monitoring the animal 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 how willing he is to learning about them, and how comfortable you are talking with the vet. 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 the dog 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 three years of age. I see a lot of limping Mastiff puppies. There are a lot of causes of limping Mastiff puppies. I am very aggressive in my treatment of limping Mastiff puppies... but do not just assume that since it is a Mastiff, it is dysplastic.

Be willing to help your veterinarian learn. 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?

(a) GDV (bloat) --see above for information.

(b) Orthopedic conditions/developing conditions -- your veterinarian should be familiar with hip and elbow dysplasia, OCD, panostenitis, growth problems (and how to treat them) and OFA radiographic procedure -- or know of a good doctor for referral.

(c) Skin conditions --your veterinarian should be familiar with allergies and staph infections of the skin and how to treat them.

(d) Thyroid conditions -- your veterinarian should know and understand the different thyroid tests and how to interpret the results.

(e) Reproductive problems -- your veterinarian needs to understand the cycling of a Mastiff bitch and the most common problems. The vet must understand culturing prior to breeding and all the testing necessary prior to breeding. The veterinarian must also understand the problems Mastiffs have with labor/dystocia. The vet must have facilities -- or be able to refer to facilities -- to do C-sections and should be able to do a work-up on a bitch that has not been able to be bred.

(f) Heart problems --your veterinarian must be aware of the most common heart problems in our Mastiffs. Cardiomyopathy is the most important of these; the vet must 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 there are good and bad people in every profession. All that state associations can provide is information regarding any disciplinary actions against a particular veterinarian. We, as a pro-fession, are not really monitored, unfortunately. But there are more legislative rules coming out every day.

I think the single most important quality of a veterinarian is whether the vet will either call and ask for help and advice when needed... or just try to make it through alone. You know which one you want for a veterinarian.

If you have any questions, feel free to contact me.

Robin M. Smith, DVM
Westminster Veterinary Emergency/Trauma Center
269 W. Main St., Westminster, MD 21557
Work 410-848-3363
(Fax) 410-848-4959
E-mail: RocknRob56@aol.com

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