When purchasing a Boxer it is important to know what kind of health conditions affect the breed. There are a few health conditions that the Boxer is prone to that should be checked for by performing the recommended health test for each particular condition. All health testing should be done prior to breeding not after. If buying a puppy from fully health tested parents is important to you then you should become familiar with what those conditions are so you can ask the breeder what health tests were done on both the sire and the dam prior to the breeding. Health testing does not guarantee that the resulting puppies will not get any of the conditions tested for as dominant or recessive genetic traits can come through at any time and you will end up with a puppy who may have a health condition even though it's parents are free of the condition themselves. Why bother testing if it doesn't guarantee the offspring will be clear one might ask? If breeders were to not test for these health conditions then they could be permanently "imprinting" any particular health condition into the bloodline and there would be little to no chance of eliminating the condition or manipulating the condition to the point where the dog does not develop symptoms. If breeders continually test each generation and use the results to make their best breeding decision the breed will become healthier and will live longer as a result.

Below is the list of health conditions that affect the Boxer and what health screening method is used to check for that particular health condition.

1. Arrythmogenic Right Ventricular Cardiomyopathy (ARVC):

Arrythmogenic Right Ventricular Cardiomyopathy (ARVC) was formerly known as Boxer Cardiomyopathy. ARVC is a genetic disease that runs in families and causes substantial illness and/or death in Boxers. It has been reported in humans and recently in cats too. The genetic defect is transmitted as an autosomal dominate trait. For this reason it is strongly recommended that dogs with this congenital defect not be bred. ARVC is a disease of the heart that causes arrhythmias (abnormal heart beats) beginning in the right ventricle of the heart. The arrhythmia present is a ventricular tachycardia with premature ventricular complexes. This means the ventricles are contracting too rapidly and out of sync with the rest of the heart. This causes a decrease in blood flow to the body and can lead to episodes of collapse, unconsciousness, and even death. In some cases the incidence of the premature heart beats was over 28,000 in a 24 hour period.

ARVC is checked for using a holter monitor that is left on the dog for 24 hours and testing for this condition should be done yearly. The most common type of holter used is an analog cassette holter recorder (monitor) which uses a cassette tape to record data from the monitor's electrodes that are attached to the dog. Once the monitoring is complete, the cassette tape is then sent off by mail to be read at a holter monitoring specialist company that is equipped to read the tape. The other type of holter used is a digital holter where a CF card is used to record data from the monitor's electrodes that are attached to the dog. With digital you send the data electronically by email to be read at a holter monitoring specialist company that is equipped to read digital data. It is recommended that breeders do not make a breeding decision base on one holter result. In other words, more than one holter should be done before making a breeding decision.

The following are two excellent places to have your cassette and/or digital data read:

A. Alba Medical - this company can read both types of holter recorders (monitors). You can read about the two types of service plans and their cost here.

B. VCGL Canine Holter Monitoring Service - This is a service offered by board-certified cardiologist, Dr. Kathryn Meurs, at Washington State University. Dr. Meurs is the leading researcher on ARVC. You can read about her service plans and their cost here.

More links on Arrythmogenic Right Ventricular Cardiomyopathy (ARVC):

Arrythmogenic Right Ventricular Cardiomyopathy
Dr. Kate Meurs 2005 Report
Familial Ventrical Arrythmias In The Boxer

Exciting New Discovery In The Fight Against Arrythmogenic Right Ventricular Cardiomyopathy (ARVC):

Vet Cardiologist Discovers Gene For Heart Disease
Boxer ARVC DNA Test

2. Aortic/Sub-Aortic Stenosis (AS/SAS):

In aortic stenosis, there is a partial obstruction to the flow of blood as it leaves the left side of the heart (the left ventricle) through the main blood vessel (the aorta) that carries blood to the rest of the body. The obstruction ranges from small nodules to a fibrous band, most commonly just below the aortic valve ("subvalvular aortic stenosis"). Due to the obstruction, the heart must work harder to pump out an adequate blood volume. Clinical signs and long-term outcome depend on the degree of narrowing, or stenosis.

AS/SAS is checked for by echocardiogram with color flow doppler and it should be performed by a board-certified cardiologist. For screening prior to breeding, it is recommended that Boxers should be at least 24 months or 2 years of age at the time of testing. The reason for this is that current information now reveals that Aortic/Subaortic Stenosis (AS/SAS) may develop upon sexual maturity in dogs that were previously tested clear. The cardiologist will "listen" to the dog's heart (auscultation) using a stethoscope which checks for any murmur present prior to the ultrasound. A Boxer that has no murmur is usually considered to not have AS/SAS, however, echocardiography is the only way to obtain flow rates and it also allows the cardiologist to check for other abnormalities with the heart that cannot be found by auscultation alone. Recently the maximum flow rate values have been reevaluated and raised to 2.4 IF there is no evidence of structural causes. At the time of echocardiogram examination, the cardiologist should determine if the flow value for an individual Boxer is of concern or not.

More links on Aortic/Subaortic Stenosis:

Aortic/Subaortic Stenosis
Louisiana State University - Aortic Stenosis
Mar Vista Medical - Subaortic Stenosis (SAS)
Merck Vet Manual - Aortic Stenosis
SAS - What it is & why breeders should be concerned

3. Canine Thyroid Disease:

The most common cause of canine thyroid disease is autoimmune thyroiditis (estimated 90% of cases). Thyroiditis is an immune-mediated process that develops in genetically susceptible individuals and is characterized by the presence of antithyroid antibodies in the blood or tissues. Thyroiditis is believed to start in most cases around puberty, and gradually progress through mid-life and old age to become clinically expressed hypothyroidism once thyroid glandular reserve has been depleted. During this process the animal becomes more susceptible to immune-mediated or other diseases affecting various target tissues and organs. The prerequisite genetic basis for susceptibility to this disorder has been in established in humans, dogs and several other species.

Canine thyroid disease is checked for by a blood sample taken at one's veterinary clinic by an Animal Health Technician (AHT) or by your veterinarian. The blood sample is then sent off to an accredited laboratory to test for thyroid disease. It is important to know that a full panel must be done to get accurate thyroid results. An "in-house" check of the dog's T4 and TSH does not properly tell you if the dog has canine thyroid disease or not. The Orthopedic Foundation For Animals (OFA) requires the blood sample to be sent to an OFA approved laboratory as listed on their website if you want to register your dog's result in their registry. If you do not wish to register your dog's thyroid results in the OFA database, the OFA approved laboratories would be highly recommended to have your vet send your dog's blood sample to for a full panel to be run. A full panel thyroid test checks for Total T4, Canine Thyroid Stimulating Hormone (cTSH), Free T3, Free T4, T3 Autoantibodies (T3AA), T4 Autoantibodies (T4AA), and Thyroglobulin Autoantibodies (TgAA).

Thyroid testing for genetic screening purposes should be intitiated once healthy dogs and bitches have reached sexual maturity. For males this can occur between 10 and 14 months of age. For females it should be done during the first anestrous period (the time between each heat cycle) following their first heat cycle. Once the initial thyroid profile has been done, dogs and bitches should be rechecked annually.

More links on Canine Thyroid Disease:

OFA - Hypothyroidism
Mar Vista Medical - Hypothyroidism
Thyroid Articles by Dr. Jean Dodds
Thyroid & Seizures

4. Canine Hip Dysplasia:

Dysplasia comes from the Greek words dys, meaning "disordered" or "abnormal", and plassein meaning "to form". The expression hip dysplasia can be interpreted as the abnormal or faulty development of the hip. Abnormal development of the hip causes excessive wear of the joint cartilage during weight bearing, eventually leading to the development of arthritis, often called osteoarthritis (OA) or degenerative joint disease (DJD). The terms osteoarthritis and degenerative joint disease are used interchangeably.

Canine hip dysplasia and elbow dysplasia is checked for by positioning the dog's hips and elbows in a certain way and then a radiograph (x-ray) is taken while the dog is held in that position. There are two types of methods to check for Canine Hip Dysplasia. One is using the method recommended by the Orthopedic Foundation For Animals (OFA) which can be done with or without sedation at one's veterinary clinic and the other is performed by a certified veterinarian using the PennHIP method that requires the dog to be under sedation. Each method has it's own grading system.

More links on Canine Hip Dysplasia:

Canine Hip Dysplasia (CHD) & Degenerative Joint Disease (DJD)
Hip Dysplasia In Dogs
Hip Dysplasia In Dogs: Diagnosis, Treatment & Prevention
Mar Vista Medical - Hip Dysplasia
Merck Vet Manual - Hip Dysplasia

5. Degenerative Myelopathy (DM):

Degenerative Myelopathy is a progressive disease of the spinal cord in older dogs. The disease has a gradual onset typically between 8 and 14 years of age. It begins with a loss of coordination (ataxia) in the hind limbs. The affected dog will wobble when walking, knuckle over or drag the feet. This can first occur in one hind limb and then affect the other. As the disease progresses, the limbs become weak and the dog begins to buckle and has difficulty standing. The weakness gets progressively worse until the dog is unable to walk. The clinical course can range from 6 months to 1 year before dogs become paraplegic. If signs progress for a longer period of time, loss of urinary and fecal continence may occur and eventually weakness will develop in the front limbs. Another key feature of DM is that it is not a painful disease.

Degenerative Myelopathy has typically been diagnosed through a process of elimination. Other causes of the weakness have been looked for using diagnostic test such as myelography and MRI. Once other causes have been ruled out, a presumptive diagnosis of DM is usually made. The only way to confirm the diagnosis of DM is by examination of the spinal cord under microscope when a necropsy (autopsy) has been performed as there are degenerative changes in the spinal cord characteristics for DM that are not typical for some other spinal cord disease. Keep in mind that other types of diseases that affect the spinal cord can have similar signs of loss of coordination and weakness as DM so it is important to check for other spinal diseases as they may be more effectively treated. There are no treatments that have been clearly shown to stop or slow progression of DM.

In July 2008, researchers at the Broad Institute and the University Of Missouri announced that they had identified a gene that is a major risk factor for the development of Degenerative Myelopathy (DM) in dogs. As a result of this research breeders, pet owners and veterinarians now have a DNA test available to purchase through the Orthopedic Foundation For Animals (OFA) website. There are two possible forms of the gene, the normal form ("N") and the abnormal form ("n" or "A" as used by the researchers). Every Boxer has two copies of the gene, one copy comes from each parent which results in one of the three combinations; two copies of the normal gene (homozygous normal) which is also referred to as "Clear" or "NN", two copies of the mutated gene (homozygous mutated) which is also referred to as "At Risk" or "nn" or one copy of each gene (heterozygous) which is also referred to as "Carrier" or "Nn". It is important to note that having two copies of the mutated gene does not necessarily result in disease and the researchers recommend that dog breeders take into consideration the DM test results as they plan their breeding programs, however, they should not over-emphasize this test result. Instead, the test result is one factor among many in a balanced breeding program.

More links on Degenerative Myleopathy (DM):

Degenerative Myelopathy (DM)
Degenerative Myleopathy (DM)
Degenerative Myelopathy DNA Test: Breeding Expections For Various Combinations
Degenerative Myelopathy DNA Test
Degenerative Myleopathy (DM) Test Results Statistics

6. Eye Disease:

While some may believe that eye disorders in the Boxer aren't common, it should be noted that some of the eye disorders listed below can be found in the Boxer and some of these eye disorders are considered to be inherited. It should also be noted that while the Boxer may not be listed as a breed predisposed to some of the eye diseases listed, it does not mean the breed should not have regular eye exams. The easiest way to get your Boxer's eyes examined by a board-certified ophthalmologist is at Canine Eye Registration Foundation (CERF) eye clinics which are frequently hosted by All Breed Kennel Clubs or Breed Clubs throughout the year. These clinics are usually held at the same venue as the host club's dog show but not always. Some clinics are not held on the same weekend as a dog show and some specialist veterinary clinics also have a board-certified ophthalmologist on staff for eye exams throughout the year.

A. Cataracts - A cataract is any opacity or loss of transparency of the lens of the eye. The opacity may be confined to a small area of the lens or capsule, or it may affect the whole structure. A complete cataract affecting both eyes will result in blindness, whereas small non-progressive cataracts will not interfere with vision. Primary cataracts occur in some breeds; in other breeds the cataract may develop secondarily to another inherited disorder such as progressive retinal atrophy or glaucoma

B. Cherry Eye - The third eyelid is a triangular shaped structure in the inner corners of your dog's eyes that you may notice sometimes partly covers the eye. It consists of a t-shaped cartilage to provide support, and a tear gland. The third eyelid is important in protection of the surface of the eye, and in tear production. It is also called the nictitating membrane (or membrana nictitans) and haw. In Boxers, a prolapse of the gland or "cherry eye" occurs when the base of the gland (embedded in the cartilage) flips up and is seen above and behind the border of the third eyelid. The prolapsed gland becomes swollen and inflamed. The condition frequently occurs in both eyes and is most common in young dogs.

C. Corneal Dystrophy (Epithelial Erosion) - Corneal dystrophy is an inherited abnormality that affects one or more layers of the cornea. Both eyes are usually affected, although not necessarily symmetrically. Chronic or recurring shallow ulcers may result, depending on the corneal layers affected. The type of Corneal Dystrophy that affects Boxers 7 to 8 years and older is called Epithelial Dystrophy which causes shallow painful erosions/ulcerations in the cornea.

D. Distichiasis - Distichiasis is when extra eyelashes grow from abnormal follicles located on the inside edge of the eyelid. They may be singular or multiple.

E. Ectropion - Ectropion is a defect of conformation in which there is a sagging or rolling-out (eversion) of the eyelids. This results in abnormal exposure of the eye, which often leads to irritation. Ectropion is most commonly seen in dogs with exaggerated facial features where it is often a breed characteristic.

F. Entropion - Entropion is the inward rolling of the eyelid, most commonly the lower lid. This irritates the surface of the eye (the cornea) and may ultimately cause visual impairment.

G. Glaucoma - Glaucoma is a leading cause of blindness in dogs. It is the result of increased fluid pressure within the eye (elevated intraocular pressure or IOP). If the pressure can not be reduced, there will be permanent damage to the retina and optic nerve resulting in visual impairment. Complete blindness can occur within 24 hours if the IOP is extremely elevated or can occur slowly over weeks or months if the the elevation is mild. Glaucoma is usually very painful. Glaucoma may be primary (inherited) or secondary to a number of eye disorders including luxation of the lens, tumours of the eye, and uveitis (inflammation of the eye).

H. Progressive Retinal Atrophy (PRA) - The cells of the retina receive light stimuli from the external environment and transmit the information to the brain where it is interpreted to become vision. In progressive retinal atrophy (PRA), deterioration of the retinal cells causes blindness. The term progressive retinal atrophy covers several types of inherited degeneration (deterioration) of the retina. Sub-classifications of PRA are based on the age at which dogs show signs of the disease and the type of retinal cell which is affected.

More links on Eye Disease:

Cataracts: A Common Ocular Disease In Dogs
Inherited Disorders Of The Eye
Mar Vista Medical - Corneal Ulcers & Erosions
Merck Veterinary Manual - Ophthalmology

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