Doberman Diseases
von Willebrand's Disease:

Unfortunately, there is no such thing as a perfect dog of ANY breed. Canine geneticists estimate that the average purebred dog is carrying at least 4-5 defective genes?. even grand champions. Today?s breeders make the best breeding decisions they can based upon testing results, conformation, temperament, working ability, pedigree, etc. A good breeder is open and honest about the health status of all their dogs and is always willing to help and guide the new puppy owner.

Over 350 inherited diseases have been recognized in dogs. The threat of a health problem is not a reason to avoid a breed. All breeds have their genetic traits and these traits should only inspire you to be more careful in selecting the breeder to insure that bloodlines are as defect-free as possible.

Many inherited diseases are restricted to particular breeds but others, such as hip dysphasia, occur in a wide range of breeds. The more common diseases which affect Dobermans are cervical spondylitis (Wobbler Syndrome), von Willebrand's Disease and thyroid disease. Cancer, hip dysplasia, heart problems, eye defects, skin diseases and chronic active hepatitis (CAH) are also problems which are found in Dobermans.

von Willebrand's Disease is one of the least destructive diseases inherited by Dobermans but it should not be ignored. It is a genetically inherited autosomal recessive bleeding disorder much like hemophilia and is the most common bleeding disorder in canines and in humans. It affects some 60 different breeds of dogs including the Doberman Pinscher and, because it is genetic in nature, there is no cure only eradication by deliberate breeding strategies. It is passed on directly from one generation to the next and will affect offspring to varying degrees. The likelihood is that the offspring will be affected more severely than the parents.

Although Dobermans are one of the breeds most commonly affected by von Willebrand's, they usually have only the milder form (Type I). Other breeds suffer from type II (moderate to severe form and extremely rare being found only in German Shorthaired Pointers and German Wirehaired Pointers) and still others are well known to suffer from type III (severe but rare).

According to information I received from VetGen, since Dobermans inherit the type I form of the disease, homozygous affected puppies (those which inherit a defective gene from both parents) are not likely to die in utero or soon after death as may occur with the more severe type II and type III forms. Both heterozygous Doberman puppies (those inheriting a defective gene from only one parent) and homozygous puppies usually survive quite well. Further, since von Willebrand?s Disease is recessive, penetrance does not play a role in inheritance.

Under normal circumstances, type I means that bleeding will clot normally. However, in times of stress or with major blood loss during surgery or as a result of trauma, the defect may become ?clinically? apparent with the inability to clot. Bleeding tendencies can be exacerbated by medications or by stress such as illness, particularly viral disease since viral infections can prolong clotting times by impairing platelet cohesiveness and/or endothelial cell production in the blood vessel walls (the endothelial cells produce the protein called von Willebrand's factor which is necessary for normal clotting). Because Parvovirus attacks the gastrointestinal tract where it causes bleeding, it is especially dangerous to Dobermans. Live virus vaccines can have the same effect.

There are 3 classifications of type I vWD dogs: Clear, Carrier and Affected. As of January 2004, VetGen states that of the Dobermans it has tested, 25% of Dobermans were classified as clear, 49% were carriers and 26% were classified as affected.

Clears:

A clear Doberman completely lacks the vWD gene and, if bred with another clear Doberman, will produce offspring which will be completely free of the gene. However, since such a small group of Dobermans are designated as clear, exclusive inter-breeding of clears may only rob the Doberman of many of it?s highly desirable characteristics and will probably cause other genetic problems to become more prevalent because other genetic disorders affect this and most other pure bred dogs. Therefore, most breeders recommend that clear to carrier breeding be continued. Affected dogs should be spayed, neutered or bred only to clears. Breeding a carrier to a clear will result in 100% carriers which are considered by most breeders to be acceptable. Affected dogs should not be ?put down? because many, if not most, will live long, healthy lives with the proper attention to care.

Dobermans which are found to be ?Clear? of von Willebrand?s genes can be quite hard to find. The disease CAN be bred out of a kennel?s bloodline if the breeder is diligent but it is very time consuming and expensive to do so since obtaining a clear female is very expensive and the stud fees for breeding services for a clear male can cost several thousand dollars. Accordingly, such puppies are much more expensive to purchase. The following table illustrates a breeder?s strategy for autosomal recessive diseases such as von Willebrand's Disease:

Breeding Pair
Combinations / Clear Male / Carrier Male / Affected Male
Clear Female / 100%
Clear / 50/50
Carrier / Clear / 100%
Carrier
Carrier Female / 50/50
Carrier / Clear / 25/50/25
Clear/Carrier/Affected / 50/50
Carrier / Affected
Affected Female / 100%
Carrier / 50/50
Carrier / Affected / 100%
Affected

Carriers:
Carriers possess only the gene and are unlikely to ever be affected by symptoms. Carriers of the vWD gene are at little or no risk of bleeding from the disease but will transmit the gene to 50% of its offspring. Clear to clear and clear to carrier breeding tends to reduce the appearance of the gene since even carriers will produce 50% clear puppies if bred to a clear or 50% carriers and 25% clears if bred to another carrier. It's simple genetics!
Affecteds:
Affected dogs blood severely or entirely lacks von Willebrand factor (vWF) which is a protein which helps to promote blood clotting by increasing platelet cohesion. von Willebrand's disease doesn?t lower the number of platelets available, it simply makes them less ?sticky? so they are unable to accomplish normal clotting.

An affected pup my bleed from its gums when teething, may have spontaneous nosebleeds, blood in its stool or urine, have excessive bleeding during estrus or after whelping, experience prolonged estrus, have blood in its gastrointestinal tract or it may display prolonged bleeding from small or superficial wounds which can lead to anemia, shock, or, if left untreated, even death. Accordingly, you might request that your vet keep desomepressin, and, at times of scheduled surgery, fresh frozen plasma or cryoprecipitate (a clotting enhancer) on hand. In an emergency, a transfusion of blood or fresh frozen plasma may stabilize the injured dog. The dog donating the blood may be treated with a drug called DDAVP prior to donation which will raise the amount of von Willebrand's factor in the donor?s blood to make the blood more likely to help the recipient clot more readily.
Affected dogs can have injuries and surgeries without ANY complications and never have a bleeding problem. Why some dogs classified as affected display clinical signs of bleeding while others do not is not yet well understood. Many Doberman owners report that their dog underwent routine spaying, neutering, ear cropping and tail docking as a puppy with an uncomplicated recovery from such procedures but this does not eliminate the possibility that a dog may be affected since some dogs do not become obvious ?bleeders? until later in life. If not tested during puppyhood, genetic affectation usually becomes apparent at about 4 years of age.

Not all dogs will actually bleed, or they may do so only sometimes. von Willebrand's factor status can alter during an animal?s life so that an older dog may show a higher or lower reading than might have been the case earlier in life. A previous non-bleeder can become a bleeder or the percentage of the von Willebrand's factor in the blood can be raised by such events as estrus and pregnancies. Since the disorder often diminishes with age and can therefore result in false-negative results, testing should be done at an early age.
Acquired von Willebrand?s:
In addition to the congenital (inherited) variety of vWD, an acquired (not born with it) version has also been reported and is associated with hypothyroidism. Auto-immune diseases (in which the body's antibodies attack the body itself) like hypothyroidism inhibit the production and function of von Willebrand's factor in the blood. Some researches claim that both inherited and acquired vWD is a secondary result of auto-imumune thyroid disease and that finding low or low-normal levels of vWD and/or platelet numbers may be an early indication of thyroid disease. If a dog has congenital vWD, their bleeding tendencies can become clinically severe when hypothyroidism is present.

Those dogs with acquired von Willebrand's disease caused by hypothyroidism are best treated with thyroid hormone supplementation (thyroxin) daily for the rest of their lives. Thyroid supplementation is also frequently prescribed for inherited vWD but such treatment is not always successful. Hyperthyroid dogs can also exhibit low platelet count.

ELISA Testing for von Willebrand's Disease:
In the past, the buccal mucosal bleeding time test and the ELISA (enzyme-linked immunoabsorbent assay) test were about the only diagnostic tools available to differentiate between clear carrier and affected Dobermans. Both measure the levels of von Willebrand's factor in the blood. The mucosal test is not reliable because it is not specific for vWD since bleeding times are also prolonged in dogs with thrombocytopenia (low platelet count) or with platelet functional defects.

ELISA testing can be done as early as 7-8 weeks and runs about $60. Blood levels of vWD vary daily in normal, healthy dogs and is exaggerated in dogs which are in estrus or pregnant and in dogs with a systemic illness (especially liver disease) or in those with inflammatory disorders. The von Willebrand's factor protein is also easily damaged during testing. The more protein which is damaged, the less reliable will be the test.
The ELISA blood test has been reported to have a misclassification rate of less than 5% but breeders know that the results can vary widely from day to day and do not rely heavily upon it. If using the ELISA test breeders know that they must test more than once in a lifetime.

In Dobermans a vWF ELISA test result of 36% or above is usually adequate to prevent excessive bleeding. Levels of 10-20% may adequate to prevent excessive bleeding for mild events such as neutering. Major events such as trauma followed by major surgery may exhaust the vWF in animals which have higher assays including some carriers.

Factors which will help improve the reliability of ELISA testing:
The dog should be healthy, unstressed and should not have been on medication (including steroids or antibiotics) for 60 days. Females should be tested in mid-cycle (90 days after estrus ends) and not while pregnant, lactating or in estrus. Males should not be tested while breeding since hormones and adrenaline can affect the test?s results. Also vaccinations should not be given 2 weeks prior to testing and it is advisable to wait 2 weeks to test after any blood transfusions or surgeries.
Factors which will not affect ELISA test results:

Age (tests results may vary slightly over time but usually not enough to change the status of the dog), gender, worming medications, heartworm medications, flea/tick medications or diet (type of feed being used).

VetGen Testing for von Willebrand?s Disease:
The newer and completely accurate VetGen DNA test can be performed at any age since DNA is present at birth and does not change throughout the dog?s life. It costs about $150 and is necessary only once.

Medicating an Affected Dog:

Certain medications can precipitate a bleeding crisis in affected dogs and it is critical that they be avoided. The list includes: Nsaids (such as Aspirin, Phenylbutazone, Ibuprofen and Indomethacin), Estrogen, the cillins (Penicillin, Ampicillin/Amoxicillin), Sulfa-based antibiotics, Phenothiazine tranquilizers, Theophylline, Antihistamines, and Chloramphenical. Drugs which can induce hemorrhagic disease include at least 10 antibiotics, 8 anti-microbials, 5 anti-convulsants, 7 anti-inflammatory agents, 12 anti-cancer drugs, 7 cardiovascular medications, 1 diuretic, 1 hormone (estrogen), and 12 in the miscellaneous category. There are undoubtedly more and who knows about drugs used in combination with the seemingly endless array of alternative medical therapies? One combination we do know about and which should ALWAYS be avoided is aspirin-related products (such as Rimadyl, Ascriptin, etc.) and steroids (such as Prednisone, Dexamethasone, etc.). No over the counter drugs should EVER be used in combination with prescription drugs without the approval of your vet. Low platelet counts can result from diseases of the spleen and liver or from any of several types of cancer as well as occurring secondary to protein-losing processes, inflammation of blood vessels, (allergic and auto-immune, and the frequently fatal disseminated intravascular coagulation (DIC).

Hip Dysplasia:

Hip dysphasia (improper growth of the hip) is both polygenetic (some researchers speculate that there may be as many as 13 genes involved) and multifactorial (influenced by many non-genetic factors) so it is understandably very difficult to reliably breed away from. Efforts to control this condition date back to the 1960?s.