Maltese Health Issues – Keeping Your Maltese Dog Healthy

You are your Maltese’s primary health care provider.

You will know what is “normal” for your dog.

Yours will be the best sense that something is “wrong” even when there is no obvious injury or illness.

The more you understand preventive health care, the better you will care for your dog throughout his life.

This section details the many health issues that could occur so you are prepared. For other aspects, see our main Maltese breed guide.

Your Veterinarian is Your Partner

Working with a qualified veterinarian is critical to long-term and comprehensive healthcare. If you do not already have a vet, ask the owner of the kennel from which you purchased your Maltese for a recommendation. If you purchased your pet outside your area, contact your local dog club and ask for referrals.

Make an appointment to tour the clinic and meet the vet. Be clear about the purpose of your visit and about your intent to pay the regular office fee. Don’t expect to get a freebie interview and don’t waste anyone’s time! Go in with a set of prepared questions.

Be sure to cover the following points:

How long has this practice been in operation?

• How many vets are on staff?
• Are any of your doctors specialists?
• If not, to which doctors do you refer patients?
• What are your regular business hours?
• Do you recommend a specific emergency clinic?
• Do you have emergency hours?
• What specific medical services do you offer?
• Do you offer grooming services?
• May I have an estimated schedule of fees?
• Do you currently treat any Maltese patients?

Pay attention to all aspects of your visit, including how the facilities appear, and the demeanor of the staff. Things to look for include:

• how the staff interacts with clients
• the degree of organization or lack thereof
• indications of engagement with the clientele (office bulletin board, cards and photos displayed, etc.)
• quality of all visible equipment
• cleanliness and orderliness of the waiting area and back rooms
• prominent display of doctors’ credentials

These are only some suggestions. Go with your “gut.” If the clinic and staff seems to “feel” right to you, trust your instincts. If not, no matter how well appointed the practice may appear to be, visit more clinics before making a decision.

First Visit to the Vet

When you are comfortable with a vet practice, schedule a second visit to include your Maltese. Bring all the dog’s medical records. Be ready to discuss completing vaccinations and having the animal spayed or neutered.

Routine exam procedures include temperature and a check of heart and lung function with a stethoscope. The vet will weigh and measure the puppy. These baseline numbers will help chart growth and physical progress. If you have specific questions, prepare them in advance.

Vaccinations

A puppy’s recommended vaccinations begin at 6-7 weeks of age. The first injection covers distemper, hepatitis, parvovirus, parainfluenza and coronavirus.

Recommended boosters occur at 9, 12, and 16 weeks. In some geographical regions a vaccine for Lyme disease starts at 16 weeks with a booster at 18 weeks.

The rabies vaccination is administered at 12-16 weeks and yearly for life thereafter.

Evaluating for Worms

Puppies purchased from a breeder are almost always parasite free. Worms are more common in rescue dogs and strays. Roundworms appear as small white granules around the anus. Other types of worms can only be seen through a microscope.

These tests are important since some parasites, like tapeworms, may be life threatening. Before a puppy’s first visit, the vet will ask for a fecal sample for this purpose. If the puppy tests positive, the standard treatment is a deworming agent with a follow-up dose in 10 days.

Spaying and Neutering

Purebred adoption agreements stipulate spaying and neutering before six months of age, but the procedures also carry health and behavioral benefits.

Neutering reduces the risk of prostatic disease or perianal tumors in male dogs. The surgery lessens aggressive behaviors, territorial instincts, urine marking, and inappropriate mounting.

Spayed females have a diminished risk for breast cancer and no prospect of uterine or ovarian cancer. There are no mood swings related to hormones or issues around the dog coming into season.

“Normal” Health Issues

Although the Maltese is a healthy dog when obtained from a good kennel, the breed does have a number of associated medical conditions. I will discuss those genetic health issues shortly. The following problems are “normal” health-related matters that can appear with any breed.

Pets that are inattentive or lethargic and that are not eating or drinking should be examined. None of these behaviors are normal for a Maltese.

Diarrhea

All puppies subject to digestive upsets when they get into things they shouldn’t, like human food or even the kitchen garbage. Given the sensitivity of the Maltese digestive system and the small size of their stomachs, do everything possible to minimize the risk of these types of incidents.

If your dog does have a case of diarrhea from eating something it shouldn’t, expect the loose stools to resolve within 24 hours. During that time, the puppy should have only small portions of dry food and no treats.

Give the dog lots of fresh, clean water to guard against dehydration. If the loose, watery stools are still present after 24 hours, take your Maltese to the vet.

The same period of watchful waiting applies for adult dogs. If episodic diarrhea becomes chronic, take a careful look at your pet’s diet.

Chances are good the dog is getting too much rich, fatty food and needs less fat and protein. Some Maltese owners believe their dogs do better eating a smaller meal twice a day than the recommended single serving.

Allergy testing can identify the causes of some cases of diarrhea. Many dogs are allergic to chicken and turkey. A change in diet resolves their gastrointestinal upset immediately. Diets based on rabbit or duck are often used for dogs with such intolerances.

Either a bacteria or a virus can cause diarrhea, which accompanies fever and vomiting. Parasites, in particular tapeworms and roundworms, may also be to blame.

Vomiting

Dietary changes or the puppy “getting into something” can also cause vomiting. Again, this should resolve within 24 hours. If the dog tries to vomit but can’t bring anything up, vomits blood, or can’t keep water down, take your pet to the vet immediately.

Dehydration from vomiting occurs faster than in a case of diarrhea, and can be fatal. It is possible that your dog may need intravenous fluids.

When your dog is vomiting, always have a good look around to identify what, if anything, the dog may have chewed and swallowed. This can be a huge benefit in targeting appropriate treatment.

Other potential culprits include: hookworm, roundworm, pancreatitis, diabetes, thyroid disease, kidney disease, liver disease, or a physical blockage.

Bloat

Any dog can suffer from bloat. The condition is the second most common cause of death in dogs behind accidental trauma (like being struck by a car) in young dogs and cancer in elderly canines.

Some breeds are at higher risk than others. Also known as gastric dilation / volvulus or GDV, bloat cannot be treated with an antibiotic or prevented with a vaccine. In roughly 50% of cases, bloat is fatal.

In severe cases, the stomach twists partially or completely. This causes circulation problems throughout the digestive system. Dogs that do not receive treatment go into cardiac arrest. Even if surgical intervention is attempted, there is no guarantee of success.

Signs of bloat are often mistaken for indications of excess gas. The dog may salivate and attempt to vomit, pace, and whine. Gas reduction products at this stage can be helpful. As the stomach swells, it places pressure on surrounding vital organs, and may burst. All cases of bloat are a serious medical emergency.

Risk Factors

Larger dogs with deep chests and small waists face a greater risk of developing bloat. These include the Chow, Great Dane, Weimaraner, Saint Bernard, Irish Setter, and the Standard Poodle. This does not mean, however that a dog with a sensitive system like the Maltese is immune from a case of bloat.

Eating habits factor into the equation. Dogs that eat one large meal per day consisting of dry food are also at risk. If your Maltese has a tendency to gulp or gobble its food, your pet can still ingest large amounts of air and face a higher than usual chance of developing bloat in relation to its size.

Experts recommend dry food for dogs, but don’t let your Maltese drink lots of water after eating. Doing so causes the dry food in the stomach to expand, leading to discomfort, and a dilution of the digestive juices.

Limit the amount of play and exercise after meals. A slow walk promotes digestion, but a vigorous romp can be dangerous.

Stress also contributes to bloat, especially in anxious or nervous dogs. Changes in routine, confrontations with other dogs, and moving to a new home can all trigger an attack.

Dogs between the ages of 4 and 7 are at an increased risk. Bloat occurs most often between 2 a.m. and 6 a.m., roughly 10 hours after the animal has had his dinner.

Prevention

Feed your pet small meals 2-3 times a day, limiting both water intake and exercise after eating. Take up your pet’s water at mealtime and do not offer it to the dog for at least 30 minutes after your pet finishes his meal. Do not allow strenuous activity for at least an hour.

Test your dog’s dry food by putting a serving in a bowl with water. Leave the material to expand overnight. If the degree of added bulk seems excessive, consider switching to a premium or organic food.

Keep an anti-gas medicine with simethicone on hand. (Consult with your veterinarian on correct dosage.) Consider adding a probiotic to your dog’s food to reduce gas in the stomach and to improve digestive health.

If a dog experiences bloat once, his risk of a future episode is greater. Keep copies of his medical records at home, and know the location of the nearest emergency vet clinic.

Allergies

The Maltese breed is susceptible to allergies from a number of sources, not just pollen, often exhibiting sensitivity to grass and other materials that touch and irritate their skin. This may mean that your pet can only spend a limited amount of time outdoors and may need to be bathed with a medicated shampoo.

Owners tend to notice a potential allergy when something changes in the dog’s behavior to suggest discomfort like itching. Common allergy symptoms include chewing or biting of the tail, stomach, or hind legs or licking of the paws. In the Maltese, this is often accompanied with hair loss and bald patches.

In reaction to inhaled substances, the dog will sneeze, cough, or experience watering eyes. Ingested substances may lead to vomiting or diarrhea. Dogs can also suffer from rashes or a case of hives.

If the reaction occurs in the spring or fall, the likely culprit is seasonal pollen, or, in the case of hot weather, fleas. Food additives like beef, corn, wheat, soybeans and dairy products can all cause gastrointestinal upset.

As with any allergy, take away suspect items or try a special diet. Allergy testing offers a definitive diagnosis and pinpoints necessary environmental and dietary changes. The tests are expensive, costing $200+ / £120+.

The vet may recommend medication, or bathing the dog in cool, soothing water. Special diets are also extremely helpful.

For acne-like chin rashes, switch to stainless steel, glass, or ceramic food dishes. Plastic feeding dishes cause this rash, which looks like blackheads surrounded by inflamed skin. Wash the dog’s face in clear, cool water and ask the vet for an antibiotic cream to speed the healing process.

Skin Conditions

As a breed the Maltese is also subject to skin conditions like pyoderma, a bacterial infection that can be secondary to a wound or that can develop on the superficial layers of the skin. It presents with inflamed lesions full of pus and is generally accompanied by partial hair loss.

The area itches and, if the dog can reach it, there may be additional trauma to the skin from scratching and/or biting. Outpatient treatment for pyoderma with topical medications and antibiotics is generally successful with the only possible complication being a spreading of the bacteria into your pet’s bloodstream.

General Signs of Illness

Any of the following symptoms can point to a serious medical problem. Have your pet evaluated for any of these behaviors. Don’t wait out of fear that you are just being an alarmist. Vets can resolve most medical problems in dogs if treatment starts at the first sign of illness.

Coughing and/or Wheezing

Occasional coughing is not a cause for concern, but if it goes on for more than a week, a vet visit is in order. A cough may indicate:

• kennel cough
• heartworm
• cardiac disease
• bacterial infections
• parasites
• tumors
• or allergies

The upper respiratory condition called “kennel cough” presents with dry, hacking. It is a form of canine bronchitis caused by warm, overcrowded conditions with poor ventilation. In most cases kennel cough resolves on its own.

Consult with your veterinarian. The doctor may prescribe a cough suppressant or suggest the use of a humidifier to soothe your pet’s irritated airways. When the cause of a cough is unclear, the vet will take a full medical history and order tests, including blood work and x-rays. Fluid may also be drawn from the lungs for analysis. Among other conditions, the doctor will be attempting to rule out heartworms.

A Note on Heartworms

Mosquitos spread heartworms (Dirofilaria Immitis) through their bites. They are thin, long parasites that infest the muscles of the heart, where they block blood vessels and cause bleeding. Their presence can lead to heart failure and death. Coughing and fainting, as well as an intolerance to exercise are all symptoms of heartworm. Discuss heartworm prevention with your vet and decide on the best course of action to keep your pet safe.

Additional warning signs include:

• Excessive and unexplained drooling.
• Excessive consumption of water and increased urination.
• Changes in appetite leading to weight gain or loss.
• Marked change in levels of activity.
• Disinterest in favorite activities.
• Stiffness and difficulty standing or climbing stairs.
• Sleeping more than normal.
• Shaking of the head.
• Any sores, lumps, or growths.
• Dry, red, or cloudy eyes.

Often the signs of serious illness are subtle. Trust your instincts. If you think something is wrong, do not hesitate to consult with your vet.

Diabetes

Small dogs like the Maltese can suffer from one of three types of diabetes: insipidus, diabetes mellitus, and gestational diabetes. All point to malfunctioning endocrine glands and are often linked to poor diet. Larger dogs are in a higher risk category.

In cases of diabetes insipidus, low levels of the hormone vasopressin create problems with the regulation of blood glucose, salt, and water.

• Diabetes mellitus is more common and dangerous. It is divided into Types I and II. The first develops in young dogs and may be referred to as “juvenile.” Type II is more prevalent in adult and older dogs. All cases are treated with insulin.
• Gestational diabetes occurs in pregnant female dogs and requires the same treatment as diabetes mellitus. Obese dogs are at greater risk.
• Abnormal insulin levels interfere with blood sugar levels. Any dog that is obese is at a higher risk for developing diabetes.

Symptoms of Canine Diabetes

All of the following behaviors are signs that a dog is suffering from canine diabetes:

• excessive water consumption
• excessive and frequent urination
• lethargy / uncharacteristic laziness
• weight gain or loss for no reason

It is possible your pet may display no symptoms whatsoever. Diabetes can be slow to develop so the effects may not be immediately noticeable. Regular check-ups help to catch this disease, which can be fatal even when you do not realize that anything is wrong.

Managing Diabetes

As part of a diabetes management program, the vet will recommend diet changes, including special food. Your dog may need insulin injections. Although this may sound daunting, your vet will train you to administer the shots. A dog with diabetes can live a full and normal life. Expect regular visits to the vet to check for heart and circulatory problems.

Hemorrhagic Gastroenteritis

Any dog can develop hemorrhagic gastroenteritis (HGE). The condition has a high mortality rate. Unfortunately, most dog owners have never heard of HGE. If a dog does not receive immediate treatment, the animal may well die.

Symptoms include:

• profuse vomiting
• depression
• bloody diarrhea with a foul odor
• severe low blood volume resulting in fatal shock within 24 hours

The exact cause of HGE is unknown and it often occurs in otherwise healthy dogs. The average age of onset is 2-4 years. Approximately 15% of dogs that survive an attack will suffer a relapse. There is no definitive list of high-risk breeds.

The instant your dog vomits or passes blood, get your dog to the vet. Tests will rule out viral or bacterial infections, ulcers, parasites, cancer, and poisoning. X-rays and an electrocardiogram are also primary diagnostic tools for HGE.

Hospitalization and aggressive treatment are necessary. The dog will likely need IV fluids and even a blood transfusion. Both steroids and antibiotics prevent infection. If the dog survives, the animal should eat a bland diet for a week or more with only a gradual reintroduction of normal foods. In almost all cases the dog will eat a special diet for life with the use of a probiotic.

The acute phases of HGE lasts 2-3 days. With quick and aggressive treatment, many dogs recover well. Delayed intervention for any reason means the outlook is not good.

Dental Care

Chewing is a dog’s only means of maintaining his teeth. Many of our canine friends develop dental problems early in life because they don’t get enough of this activity. Not all dogs are prone to cavities. Most do suffer from accumulations of plaque and associated gum diseases. Often severe halitosis (bad breath) is the first sign that something is wrong.

With dental problems, gingivitis develops first and, if unaddressed, progresses to periodontitis. Warning signs of gum disease include:

• a reluctance to finish meals
• extreme bad breath
• swollen and bleeding gums
• irregular gum line
• plaque build-up
• drooling, and/or loose teeth

The bacterial gum infection periodontitis causes inflammation, gum recession, and possible tooth loss. It requires treatment with antibiotics to prevent a spread of the infection to other parts of the body. Symptoms include:

• pus at the gum line
• loss of appetite
• depression
• irritability
• pawing at the mouth
• trouble chewing
• loose or missing teeth
• gastrointestinal upset

Treatment begins with a professional cleaning. This procedure may also involve root work, descaling, and even extractions.

With Proliferating Gum Disease, the gums overgrow the teeth causing inflammation and infection. Other symptoms include:

• thickening and lengthening of the gums
• bleeding
• bad breath
• drooling
• loss of appetite

The vet will prescribe antibiotics and surgery is usually required.

Home Dental Care

There are many products available to help with home dental care for your Maltese. Some owners opt for water additives that break up tarter and plaque, but such products may cause stomach upset. Dental sprays and wipes are also an option, but so is gentle gum massage to help break up plaque and tarter.

Most owners incorporate some type of dental chew in their standard care practices. Greenies Dental Chews for Dogs are popular and well tolerated in a digestive sense. An added plus is that dogs usually love them.

The treats come in different sizes and are priced in a range of $7 / £4.21 for 22 “Teeny Greenies” and $25 / £15 for 17 Large Greenies.

Brushing your pet’s teeth is the ultimate defense for oral health. This involves the use of both a canine-specific toothbrush and toothpaste. Never use human toothpaste, which contains fluoride toxic to your dog. Some dog toothbrushes resemble smaller versions of our own, but I like the models that just fit over your fingertip. I think they offer greater control and stability.

The real trick to brushing your pet’s teeth is getting the dog comfortable with having your hands in his mouth. Start by just massaging the dog’s face, and then progressing to the gums before using the toothbrush. In the beginning, you can even just smear the toothpaste on the teeth with your fingertip.

Try to schedule these brushing sessions for when the dog is a little tired, perhaps after a long walk. Don’t apply pressure, which can stress the dog. Just move in small circular motions and stop when the Maltese has had enough of the whole business. If you don’t feel you’ve done enough, stop. A second session is better than forcing your dog to do something he doesn’t like and creating a negative association in his mind.

Even if you do practice a full home dental care routine, don’t scrimp on annual oral exams in the vet’s office. Exams not only help to keep the teeth and gums healthy, but also to check for the presence of possible cancerous growths.

Canine Eye Care

Check your dog’s eyes on a regular schedule to avoid problems like clogged tear ducts. The Maltese often suffers from excessive tearing, which can stain the fur around the eyes and down the muzzle.

As a part of good grooming, keep the corners of your pet’s eyes and the muzzle free of mucus to prevent bacterial growth. If your dog is prone to mucus accumulation ask your vet for sterile eyewash or gauze pads. Also consider having the dog tested for environmental allergies.

With longhaired animals, take the precaution of keeping the hair well-trimmed around your pet’s eyes or tie the hair up in the trademark Maltese top knot.

Dogs love to hang their heads out of car windows, but this can result in eye injuries and serious infection from blowing debris. If you don’t want to deprive your dog of this simple pleasure, I recommend a product called Doggles.

These protective goggles for dogs come in a range of colors and sizes for less than $20 / £12 per pair. The investment in protecting your dog’s eyes is well worth it. All my pets have worn the Doggles without complaint.

Conjunctivitis

Conjunctivitis is the most common eye infection seen in dogs. It presents with redness around the eyes and a green or yellow discharge. Antibiotics will treat the infection. The dreaded “cone of shame” collar then prevents more injury from scratching during healing.

Cataracts

Aging dogs often develop cataracts, which is a clouding of the lens of the eye leading to blurred vision. The lesions vary in size and are visible as a blue gray area on the eye.

In most cases, the vet will watch, but not treat cataracts. The condition does not affect your pet’s life in a severe way. Dogs adapt well to the senses they do have, so diminished vision is not as problematic as it would be for us.

Glaucoma

Glaucoma is characterized by a buildup of fluid with a resulting increase in pressure inside the eye. Glaucoma may develop on its own, or as a complication of a shifted cataract. Dogs with glaucoma experience partial or total loss of vision within one year of diagnosis.

Symptoms include swelling, excessive tearing, redness, and evident visual limitations. Suspected glaucoma requires immediate medical attention.

Cherry Eye

The condition called “cherry eye” is an irritation of the third eyelid appearing as a bright pink protrusion in the corner of the eye. Either injury or a bacterial infection causes cherry eye. It may occur in one or both eyes and requires surgery to effect a permanent cure.

Progressive Retinal Atrophy (PRA)

Progressive Retinal Atrophy is an inherited disease that ultimately leads to complete loss of vision. The condition can affect any breed, but the age of onset and progression of the disease vary with each type of dog. The general pattern is:

• initial night blindness
• slowly deteriorating vision
• total blindness

PRA is not painful. The Maltese generally suffers from one of two types of PRA, early onset with signs evident between 2-5 years of age, and late onset with full blindness occurring by 10 years of age or later.

Diagnosis is made via an examination of the retinas by a veterinary ophthalmologist. Typically dogs with PRA adapt very well so long as they remain in familiar surroundings with no changes in the arrangement of furniture. Care should be taken not to startle the animal, and toys should include some kind of noise making device like a bell to aid in location.

Hip and Elbow Dysplasia

Any breed can be susceptible to hip dysplasia. A dysplastic defect prevents the affected bones from fitting properly into the associated joint. It is a painful condition that causes limping in the fore or hind quarters. The condition may be inherited, or the consequence of injury and aging.

The standard treatment is anti-inflammatory medication. Some cases need surgery and even a full joint replacement. Surgical intervention for both defects carries a high success rate, allowing your dog to live a full and happy life, but the procedures are expensive.

Canine Arthritis

Dogs, like humans, can suffer from arthritis, which may develop in the presence of hip or elbow dysplasia as a secondary complication. Arthritis is a debilitating degeneration of the joints and is common in larger breeds.

As the cartilage in the joints breaks down, the action of bone rubbing on bone creates considerable pain. In turn, the animal’s range of motion becomes restricted.

Standard treatments do not differ from those used for humans. Aspirin addresses pain and inflammation, while supplements like glucosamine work on improving joint health. Environmental aids, like steps and ramps, ease the strain on the affected joints and help pets stay active.

Arthritis also occurs as a natural consequence of aging. Management focuses on making your pet comfortable and facilitating ease of motion. Some dogs become so crippled that their humans buy mobility carts for them.

Genetic Abnormalities and Inherited Conditions

Although responsible kennels work hard to eliminate potential genetic illnesses from their blood lines, there are some conditions for which there are no screening tests available.

The Maltese and Maltese mixes that come from backyard breeders or other sources do not benefit from the same genetic cultivation and are even more susceptible to health issues. Before you adopt a Maltese, you should be aware of the possibility of the following conditions, all of which are associated with the breed.

Reverse Sneezing

First-time Maltese owners are often alarmed by the wide range of sounds their pet makes that seem to indicate the animal cannot breathe.  These vocalizations range from snorting to honking and hacking. All are likely a sign of reverse sneezing.

Essentially the dog’s pharynx spasms, a problem usually alleviated when the dog swallows a few times. You can also help out by gently rubbing your pet’s throat. Sometimes taking the dog into the fresh air also lessens the duration of the episode.

This problem is extremely common with the Maltese, but is a harmless condition and does not require the intervention of a veterinarian.

Tracheal Collapse

All toy breeds can suffer from tracheal collapse, with the highest incidence in Yorkshire Terriers. Other breeds with an elevated risk for the condition include the Chihuahua, Maltese, Pomeranian, Toy Poodle, Shi Tzu, Pug, and Lhasa Apso.

The trachea or windpipe connects the throat to the lungs, directing air into the respiratory tract. This tubular structure is comprised of a series of cartilaginous rings that do not actually form a full circle. Imagine the face of a clock and trace an arc from 2 o’clock to 10 o’clock and you will understand the essential shape of these “rings.”

The remaining region is a flexible membrane. A rapid inhalation of air can cause the trachea to flatten out, making it difficult for air to pass into the lungs. The most common sign of tracheal collapse is a dry and harsh cough that can become chronic. The sound is sometimes described as a “goose honk.”

The coughing is worse during the day, but better at night and may be triggered by excitement or by pressure on a dog’s neck from a collar and leash. Eating and drinking can also set off episodes. Other symptoms include:

• intolerance to exercise
• labored breathing
• bluish gums

Dogs that are overweight or those that are exposed to smoke and dust are often affected. Hot, humid weather makes the condition worse.

Any dog with a cough should be evaluated by a veterinarian since either reverse sneezing or tracheal collapse may be indicated. A cough can also be a sign of heart disease, heart worms, or even something as simple as kennel cough.

The vet will likely order x-rays and other tests to conclusively determine the cause of the cough. Treatments include the use of cough suppressants, antibiotics, bronchodilators, and corticosteroids to control inflammation. In severe cases, corrective surgery may be required.

Luxating Patella

The Maltese is also at a higher risk level for a luxating patella resulting in frequent dislocations of the kneecap. The condition can affect one or both kneecaps.

Surgery may be required to rectify the problem. Often owners have no idea anything is wrong with their dog’s knee joint. Then the pet jumps off a bed or leaps to catch a toy, lands badly, and begins to limp and favor the leg.

The condition may be genetic in origin, so it is important to ask a kennel owner if the problem has surfaced in the line of dogs he cultivates. A luxating patella can also be the consequence of a physical injury, especially as a dog ages.

Any time you see your dog limping or seeming more fatigued than usual after exercise, have the dog checked out. Conditions like a luxating patella only get worse with time and wear, and need immediate treatment.

Hypoglycemia

Hypoglycemia or low blood sugar is a problem in toy breed puppies including the Maltese. In puppies, the most common form is Transient Juvenile Hypoglycemia presenting around four months of age just after the dogs have been weaned.

Eating reverses the episode, but the condition may be misdiagnosed as viral hepatitis or encephalitis by vets who are not familiar with this issue in smaller breeds.

If caught early, hypoglycemia is easily treatable, but if allowed to progress, the condition may be fatal. Symptoms include:

• listlessness
• weakness
• pale to white gums
• vomitingon an empty stomach
• foaming at the mouth
• shaky, unsteady gait
• falling over

In extreme cases, the dog will lie on its side and show no response to stimuli. This constitutes a life-threatening emergency. Try to get the dog to take some waffle or pancake syrup by mouth and immediately call your veterinarian. If the puppy lapses into a hypoglycemic coma, death will result quickly.

It is always easier to prevent low blood sugar than to treat it. Make sure your dog is eating every 3-4 hours until it reaches 5 months of age and begins to put on good body weight.

Epilepsy

The Maltese faces a somewhat higher risk of seizure disorders and epilepsy than comparable breeds. If the pattern of seizures is recurring, the dog may be suffering from epilepsy, which is hereditary. Other seizure activity may be caused by low blood sugar levels.

Although hypoglycemia is a bigger risk in Maltese puppies, a dog of any age can suffer from the problem. The Maltese has low muscle mass, which reduces the breed’s ability to process and regulate glucose.

If your dog has a seizure, no matter how mild, immediately take the Maltese to your vet for evaluation. You may need to feed your pet more frequently, reduce stress levels in the dog’s environment, or remove potentially toxic substances like household chemicals or even houseplants to which your pet is exposed.

The vet may prescribe anti-seizure medication to control such episodes, which must be administered regularly.

Portosystemic Shunt

A portosystemic shunt is an abnormal connection between the blood vessel that connects the liver and the gastrointestinal tract. This causes blood in the tract to be diverted past the liver, exposing the body to the toxic by-products of digestion. In about 75% of cases, the shunts are congenital (present at birth.)

Clinical signs of the condition mimic liver failure and include:

• poor weight gain
• depressionand lethargy
• apathy
• weakness
• seizures
• drooling and salivation
• problems with balance
• vomiting
• bladder stones
• blindness

The condition is diagnosed with routine lab work, x-rays, and ultrasound. The only treatment is surgical intervention.

Shaker Dog Syndrome

Shaker Dog Syndrome presents suddenly in young adult dogs (age 6 months to 3 years) and is associated not just with the Maltese, but other small, white breeds including the West Highland terrier.

The cause is unknown. After the first episode the symptoms get progressively worse over a period of 1-3 days and then stabilize. The tremor, which affects the entire body, can be mild or so severe the animal cannot walk.

The condition is not painful and most dogs recover completely when treated with corticosteroids and/or benzodiazepines. Dogs with Shaker Dog Syndrome should never be used in a breeding program.

It is common for dogs to require medication for life to control this condition.

Hyperthyroidism

Malteses have the ninth highest rate of hypothyroidism among 140 breeds included in the Michigan State University Thyroid Database. Hyperthyroidism occurs when the thyroid gland fails to produce adequately. The deficiency of the hormone causes:

• obesity
• lack of energy
• dulled mental abilities
• infertility

The dog’s hair may change, becoming brittle, dull, and falling out altogether while the skin gets dark and tough.

The condition can be managed with daily medication that must be continued for life.

Breeding Malteses

The decision to breed Maltese dogs should only be undertaken for one reason — a desire to improve existing bloodlines mixed with a healthy love for these exceptional animals.

Breeding pedigreed dogs is not a get-rich quick scheme, nor is it an inexpensive hobby. Before you even contemplate making such a commitment to living creatures, you must be an expert not only in living with and training Maltese dogs, but also in reliably pairing animals for the best genetic results.

The purpose of this book is not to educate potential breeders, but to introduce the Maltese to potential owners. You have a great deal to learn before you can even consider becoming a breeder, but if that is your ultimate goal, start making friends in the Maltese world now. Cultivating a mentor is an essential step toward owning and operating a successful, well-run breeding operation.

Euthanasia

The hardest decision any pet owner makes is helping a suffering animal to pass easily and humanely. I have been in this position. Even though I know my beloved companions died peacefully and with no pain, my own anguish was considerable. Thankfully, I was in the care of and accepting the advice and counsel of exceptional veterinary professionals.

This is the crucial component in the decision to euthanize an animal. For your own peace of mind, you must know that you have the best medical advice possible. My vet was not only knowledgeable and patient, but she was kind and forthright. I valued those qualities and hope you are as blessed as I was in the same situation.

I am fortunate that I have never been forced to make this decision based on economic necessity. I once witnessed the joy of a biker who sold his beloved motorcycle to pay for cancer treatments for his German Shepherd. The dog meant more to him than the bike, and he burst into tears when the vet said, “We got it all.”

But the bottom line is this. No one is in a position to judge you. No one. You must make the best decision that you can for your pet, and for yourself. So long as you are acting from a position of love, respect, and responsibility, whatever you do is “right.”

Managing Healthcare Costs

Thanks to advances in veterinary science our pets now receive viable and effective treatments. The estimated annual cost for a medium-sized dog, including health care, is $650 / £387. (This does not include emergency care, advanced procedures, or consultations with specialists.)

The growing interest in pet insurance to help defray these costs is understandable. You can buy a policy covering accidents, illness, and hereditary and chronic conditions for $25 / £16.25 per month. Benefit caps and deductibles vary by company.