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Problems in Boxers

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Most people talk about breeders needing to understand the genetics and how to breed or vets understanding the diseases and knowing how to diagnose and treat. These first two points are extremely important and will always be important but of equal importance is the need for the pet owner YOU to understand and be aware of what signs to look for and what problems the Boxer inherits. This way you the beloved guardian will be better armed to Know How to help your beloved best friend when something is going wrong. Hopefully this material prepares and helps:

BOXER (Working dog)


Origin: Germany

Height: Male 23-25 inches (58-63.5cm.) Female 21.5-23.5 inches (55-60 cm.)

Weight: Male 60-70 lbs. (27-32 kg.) Female 55-65 lbs. (25-30 kg.)

Color: Fawn and brindle.

Coat: Short and shiny.

Care: Needs good home dental care. Note Boxers tend to drool and snore a lot.

Use: Bred to hunt originally. Today act as a good watch dog and guide dog for the blind, but above all as a great companion.

General Appearance: Medium sized sturdy square muscular build with graceful speed and power.

Average life: 10-12 years.


Temperament: Good natured, highly intelligent, affectionate, and playful all describe the Boxer.

Obedience: Extremely intelligent and obedient. Dominant males can be difficult to train. Easy to house train.

Behavior: Extremely sociable with children and family members, though can be timid or dominant around strangers. Boxers make good watch dogs and can be trained to be good guard dogs. (Note puppy mill varieties or improperly bred Boxers are being recognized with more behavioral problems)

Activity: High indoor and outdoor activity.

ASSESSMENT: Great family dog though can be quite energetic and playful so prepare because they are no couch potato. Perfect for family with grown children that can play in the backyard with their new loving protector. If drooling or messy eating is a concern stay away!!


Many canine medical problems tend to be breed-specific. During breeding, to achieve uniformity in physical and behavioral traits, each breed of dog also becomes susceptible to inherited disease traits. Following is a list of the most common medical issues seen in the Boxer breed. To give your dog the best possible health care, your Boxer puppy should be screened for each of these medical problems (see “Visit Your Veterinarian” section for recommended screening visits). Treatment options can be discussed with your Veterinarian as required.


Factor II deficiency (hypoprothrombinemia)

This is an extremely rare clotting disorder. Animals are usually presented with a nose bleed.

Diagnosis: The diagnosis is confirmed with factor II activity.

Treatment: The treatment involves fresh-frozen plasma.

Factor VIII deficiency (hemophilia A)

Severe inherited clotting disorder, inherited as a sex linked recessive trait - carried and therefore transmitted by females but seen in males. Although dogs can be carriers of the disease without displaying any signs, in affected dogs they show signs of lameness from bleeding into their joints. In affected young male dogs this disease should be suspected if the dog displays any pronounced bleeding, swelling, lameness or even neurological signs.

Diagnosis: Difficult to detect carriers. Clotting profile tests including levels of Factor VIII are helpful to find out those dogs with the disease ( males ).

Treatment: Treatment involves transfusion with fresh frozen plasma or something called cryoprecipitate.


This is an inflammation of the blood vessel caused by an immune mediated disease usually presented as an ulcerative skin lesion.

Diagnosis: Diagnosis is usually confirmed with biopsy and histopathology.

Treatment: Treatment involves anti-inflammatories or immunosuppressive drugs.

Von Willebrand’s disease

This is a bleeding disorder caused by a deficiency of a coagulation protein known as factor VIII deficiency. The condition normally does not cause a problem unless the patient sustains some form of trauma or undergoes surgery (most commonly detected at the time of spay or neuter).

Diagnosis: Blood testing for the factor in the blood or a DNA test.

Treatment: Blood products or DDAVP depending on need.



The Boxer has a high susceptibility to developing tumors. Some of these tumors are mastocytoma, histiocytoma, lymphosarcoma, osteosarcoma, fibrosarcoma, melanoma, glioma, thyroid carcinoma, lung, squamous cell carcinoma and testicular carcinomas. Therefore it is important to have all lumps checked immediately with your veterinarian.


Abnormal dentition

This is the presence of extra incisors.

Diagnosis: Usually diagnosed on inspection of mouth.

Treatment: Treatment involves removal to avoid overcrowding.

Gingival hyperplasia

This is the proliferation of gum tissue which grows over the teeth.

Diagnosis: Visual and biopsy followed by histopathology.

Treatment: Surgical removal of excess tissue along the gum line.



This is a condition whereby the stomach fills up with gas dilates and rotates. The patient is usually admitted trying unsuccessfully to vomit in severe distress and pain. This is a true emergency that must be addressed immediately.

Diagnosis: Diagnosis is through radiographs and clinical signs.

Treatment: Immediate medical intervention involving iv fluids and gastric lavage. This is followed by surgical tack down of the stomach.

Colitis (granulomatous/histiocytic)

This condition is usually seen between 2 months and 2 years of age. The presenting signs vary from bloody to chronic mucousy diarrhea.

Diagnosis: Diagnosis is confirmed with endoscopy and biopsy.

Treatment: Treatment use to involve using anti-inflammatories and immunosuppressive drugs though recent studies have isolated an E-coli as a pathogen thereby making it routine to treat long term with antibiotics (enrofloxacins).

Esophageal dilation

This is a condition whereby the esophagus is abnormally large and flaccid. This is part of the esophageal motility disorders seen in puppies. Puppies are usually seen for regurgitation.

Diagnosis: Diagnosis is confirmed with a barium swallow.

Treatment: Treatment involves feeding animals from an elevated platform.

Hepatic portosystemic shunt or arteriovenous fistula (hepatic microvascular dysplasia)

This is a malformation of blood vessels in the liver permitting blood to bypass the liver (where it would be detoxified ). Patients normally exhibit profound weakness/lethargy, stumbling and virtual collapse especially after eating. This is due to the toxins effect on the brain (known as hepatic encephalopathy).

Diagnosis: Blood testing, radiographs, ultrasound with liver biopsy and potentially surgical exploration.

Treatment: Medical therapy to reduce effects of toxins on brain from the liver and surgical correction to tie off large shunting vessels if found.

Pyloric stenosis

This is a condition whereby the pylorus, which empties the stomach into the small bowel , is thickened creating an obstruction.

Diagnosis: Diagnosis is confirmed with gastroscopy.

Treatment: Treatment involves surgery.



A cataract is an opacity (cloudiness) in the lens. The patient with a cataract is not able to see through the opacity. If the entire lens is involved, the eye will be blind. This can start at a very early age.

Diagnosis: Easily recognized with a physical examination by your veterinarian.

Treatment: Removal of the cataracts via phaecoemulcification as is done in people. Return to vision is normally very good to excellent if caught early.

Central progressive retinal atrophy (CPRA)

This condition is recognized by mottling and increased reflectivity of the area centralis resulting in loss of central vision. Usually seen in animals between the ages of 1 ½ and 4 years old this condition will begin with day vision problems and can progress to total blindness.

All animals susceptible to CPRA should be screened by an ophthalmologist.

Diagnosis: Diagnosis is usually confirmed by examination by an ophthalmologist.

Treatment: None.

Corneal dystrophy

Normally affects both eyes and is usually the result of lipid (fat) accumulation in the cornea ( front) of the eye and appears like crystal or hazy opacities.

Diagnosis: Made on ophthalmologic examination after checking for causes of elevated cholesterol levels including hypothyroidism (low thyroid levels).

Treatment: None but most of these don’t affect vision

Corneal ulcer (ulcerative keratitis)

This is a defect in the superficial layer of the eyeball resulting in pain and if left unattended loss of sight. More than 80% are seen in spayed females over 5 years of age.. Patients are usually presented with unilateral ocular pain and blephorospasm.

Diagnosis: Diagnosis is confirmed by fluorescein staining the eye. Many of these patients should be screened for KCS.

Treatment: Treatment resolves around topical ocular antibiotics and oral NSAIDS. If the corneal ulcer is deep surgical intervention will be necessary.


Extra very fine eyelashes growing out of upper or lower eyelids irritating the cornea (eyeball).

Diagnosis: Careful examination

Treatment: This condition is treated with the surgical removal of the extra eyelashes. This can be done most carefully using electrocautery


This is a condition of the eyelid whereby it turns inward and irritates the eye.

Diagnosis: Careful examination

Treatment: Repaired surgically if needed

Eversion of cartilage of the third eyelid

This is a rolling out of the cartilage at the edge of the third eyelid.

Diagnosis: Diagnosis is made by clinical picture.

Treatment: Treatment involves surgery.


This condition is presented as a red painful eye. Glaucoma is caused by an increase in fluid pressure in the eye.

Diagnosis: Diagnosis is confirmed with tonometry.

Treatment: Treatment can involve both medical and surgical procedures depending on the type and severity of the glaucoma.

Haws (prolapsed gland of the nicitans known as cherry eye)

This refers to an enlarged gland that is displaced from its normal position. It is a red mass which protrudes above the third eyelid.

Diagnosis: This diagnosis is made on visually recognizes the protruded gland.

Treatment: The treatment of choice is a gland tack down performed surgically.

PRA (progressive retinal atrophy)

This disease is characterized by night blindness and dilated pupils. The loss of retinal vessels will progress and eventually result in total blindness.

Diagnosis: Ophthalmologic examination. All breeders should have breeding stalk and puppies screened by an ophthalmologist.

Treatment: None available



A disease characterized by an increase in the production of corticosteroids from the adrenal glands. Animals are presented eating a lot drinking a lot and possibly a pot bellied appearance.

Diagnosis: Diagnosis is confirmed with blood tests, and in some cases, advanced imaging techniques.

Treatment: Treatment for PDH (pituitary dependant hyperadrenocorticism) and ADH (adrenal-dependant hyperadrenocorticism) involves using lysodren, trilostane or ketoconazole. Adrenal carcinoma will need surgery and a pituitary macroadenoma will need radiation.


This is a disease recognized by decreased activity, weight gain, heat or cold seeking, and possibly loss of fur over the back end as well as susceptibility to infection .

Diagnosis: Made by history, clinical signs and thyroid blood screening (many tests are available and no one is perfect)

Treatment: Supplementation with a synthetic form of the thyroid hormone the patient lacks (much like insulin for diabetics however this is a pill).


Atrial septal defects

This is a cardiac anomaly resulting in communication through the interatrial septum. Usually detected as a murmur at the puppy’s first physical.

Diagnosis: Diagnosis is confirmed with the aid of an ultrasound and the prognosis depends on the size of the defect.

Treatment: The only treatment would be open heart surgery.

Boxer Cardiomyopathy (Arrythmogenic right ventricular cardiomyopathy)

This is an electrical disease of the heart causing an irregular beat or arrhythmia. This arrhythmia can cause weakness, collapse or sudden death.

Diagnosis: Diagnosis is usually confirmed with a holter monitor which is 24 hour EKG that tests for the presence of PVCs.

Treatment: Treatment involves the use of anti-arrhythmic medication (solatol), diuretics and ACE inhibitors.

Endocardial fibroelastosis

This is a condition whereby there is scarring of the cardiac muscles interfering with cardiac function.

Diagnosis: Tentative diagnosis can be made with ultrasound, though a definitive diagnosis will only be attained with a cardiac biopsy.

Treatment: No specific curative treatment – will need to treat for cardiac failure.


These are usually diagnosed by the veterinarian in the puppy. The murmurs are caused by a defect in the heart ( subaortic stenosis, pulmonic stenosis, and atrial septal defect) and are evaluated for severity with an ultrasound.

Sinus arrhythmia

This is a condition whereby there are irregular discharges from the sinoatrial node which can be normal or a result of pathology in the heart.

Diagnosis: The diagnosis is confirmed with ECG.

Treatment: Treatment depends on the cause for the arrhythmia.

Subaortic stenosis

Is a disease of the heart whereby the main branch coming out of the left ventricle of the heart called the aorta has a scar-like narrowing or “stenosis” (which is another word for narrowing.) just below the aortic valve . This means that less blood gets out to the system with each pump of the heart and it therefore must work harder.

Diagnosis: Use a stethoscope to auscultate for a murmur and ultrasound for a definitive diagnosis.

Treatment: Although surgery can be attempted by ballooning the hole open – a subsequent stricture is likely within a few months. Normally treatment is not an option but depending on the severity potentially no treatment is necessary.

Tricuspid valve dysplasia

This is a condition whereby the valve did not form correctly in utero and leaks creating a murmur.

Diagnosis: Diagnosis is confirmed with the use of echocardiogram.

Treatment: Treatment and prognosis depends on the severity of disease.


Hip dysplasia

This is a deformed hip joint (coxofemoral joint) resulting in mild to severe lameness depending on the severity of the hip dysplasia.

Diagnosis: The diagnosis is made by palpation of a positive Ortolani, and radiographs ( PennHip vs routine v/d pelvis).

Treatment: Obviously treatment is dependant on the degree of hip dysplasia and amount of clinical signs – treatment can go from cartrophen to NSAIDS to TPO to FHO to total hips.

Osteochondritis dissecans (OCD)

This is a disease whereby the cartilage within the joint spaces have defects (divides in the cartilage at then ends of the bones) resulting in pain when there is flexing of the specific joint.

Diagnosis: xrays

Treatment: Medication (NSAIDS and cartrophen/adequan) and rest help but usually this condition requires surgery

Patellar luxation

Patellar luxation is a condition whereby the kneecap slides out of place causing pain. The bone often slides back into place however the degree of displacement may increase over time as tissues stretch and bones become deformed. Arthritis can further complicate the condition.

Diagnosis: Diagnosis is confirmed on physical exam and xrays.

Treatment: Treatment is surgical.


This is a condition whereby there are bridges of bone formed from one vertebral body to another.

Diagnosis: Diagnosis is confirmed with x-rays.

Treatment: Treatment involves the use of anti-inflammatories.


Cervical vertebral malformation/instability (Wobbler’s syndrome)

This condition is also known as wobblers syndrome describing the in-coordination that progresses with the disease. The in-coordination will progress to paralysis if not treated in time.

Diagnosis: Diagnosis is confirmed with a myelogram.

Treatment: Treatment consists of surgery to try to stabilize the neck bones (vertebrae) and take compression off the spinal cord.


White Boxers (about 25%of all boxers) have an increased chance of being deaf. The cause of deafness associated with the white color is the absence of pigment cells in the inner ear.

Diagnosis: Diagnosis can usually be made through a good physical exam. The definitive test is known as BAER (Brainstem Auditory-Evoked Response) testing.

Treatment: None.


This disease is characterized with having seizures. Seizures usually begin between 6 months and 5 years of age. Seizures normally include paddling of the limbs, vocalizing, salivating, falling over, urination, defecation or other odd behavior like signs.

Diagnosis: Normally made based on history, breed and age, although blood testing is done to rule out other less common diseases.

Treatment: Condition is usually controlled with anticonvulsant (anti seizure ) medication.

Intervertebral disc disease

Intervertebral disk disease is characterized by either a swollen or herniated disk. The pressure on the spinal cord can cause anything from intense pain to paralysis.

Diagnosis: Diagnosis is based on clinical signs, x-rays and +/- myelogram and MRI.

Treatment: Treatment involves either medical or surgical intervention. If there is any loss of deep pain surgery should be immediate.

Progressive degenerative myelopathy

This is a disease whereby the animal becomes stumbly (ataxic) in the hind legs. It is progressive beginning as a mild incoordination and over time possibly years progressing to complete paralysis.

Diagnosis: Diagnosis is suspected with clinical signs and history.

Treatment: The only treatment available is antioxidants, diet and amicar.

Progressive axonopathy

This is a peripheral neuropathy which begins as lack of coordination in the hind legs and progresses to all limbs in the first year.

Diagnosis: A muscle biopsy and electronic testing of nerve conduction will aid in the diagnosis.

Treatment: None.

Spina bifida

Spina bifida is the presence of a midline cleft in the vertebral arch due to failure of formation during development. This may result in mild neurological deficits to herniation of meninges.

Diagnosis: Diagnosis is achieved with x-rays.

Treatment: Treatment is rarely attempted in veterinary medicine.



Cryptorchidism refers to one or both testicles that have not descended into the scrotum. Usually confirmed by 4 months of age.

Diagnosis: Diagnosis is made by a physical exam.

Treatment: Treatment involves an abdominal castration.

Vaginal hyperplasia

This is an overgrowth of tissue in the vagina during heat or estus

Diagnosis: Diagnosis is based on clinical exam.

Treatment: Treatment depends on the severity of hyperplasia.


Elongated soft palate

This is one of the disorders associated with dogs with brachycephalic syndrome. The most common clinical sign is noisy breathing with or without breathing problems.

Diagnosis: Diagnosis is confirmed by viewing the palate with light anesthesia.

Treatment: Treatment involves surgical resection of the elongated part of the soft palate.

Hypoplasia of the trachea

This is the malformation of the trachea resulting in narrowing of the tracheal lumen.

Diagnosis: Diagnosis is confirmed with radiographs.

Treatment: No specific treatment.



This condition is better known as chin acne. Dogs are presented with small pustules to abscesses on the chin. Drooling makes the condition worse.

Diagnosis: Diagnosis is confirmed with biopsy and skin cultures.

Treatment: Treatment involves keeping the chin dry plus topical antibiotics/anti-inflammatories and +/- oral antibiotics.

Atopic dermatitis

This is an allergic skin condition created by an allergy to airborne pollens, dust mites, or molds. The patient is usually admitted extremely itchy with/without secondary hot spots.

Diagnosis: Diagnosis is confirmed with skin scraping, biopsies and IDAT (intradermal allergy testing.

Treatment: Treatment can encompass everything from immunotherapy to long term meds.

Calcinosis circumscripta

This is a condition characterized by dystrophic mineralization of tissue. The calcium deposits are usually over pressure points such as elbows, ankles, neck or on the tongue.

Diagnosis: Diagnosis is confirmed with a biopsy.

Treatment: Treatment involves surgical removal.

Cutaneous asthenia

This is a condition whereby the skin lacks normal strength and sensation resulting in large tears.

Diagnosis: Diagnosis is confirmed with biopsy and histopathology and biochemical analysis of the dermal collagen.

Treatment: No specific treatment so the only recommendation is around lifestyle so to present injury.


This is a disease caused by a small parasite which sits in the fair follicle and eventually causes loss of hair. Typically seen in the young or immunocompromised animal. There are 2 forms of demodicosis localized and generalized disease. This will affect both prognosis and treatment.

Diagnosis: Diagnosis is easily confirmed with skin scrapings. In generalized form should also do thyroids full bloods and measure immunoglobulin levels.

Treatment: Will vary from no treatment at all to long term antibiotics and miticidal therapy.

Dermoid cyst

This is a cyst composed of skin like structures seen in young animals.

Diagnosis: Diagnosis is confirmed with biopsy and histopathology.

Treatment: Treatment involves surgical removal.

Lupoid onychopathy

This is a disease affecting the nail bed resulting in licking and possible lameness.

Diagnosis: Diagnosis is confirmed with biopsy and histopathology.

Treatment: Treatment involves marine oils, tetracycline, niacinamide or pentoxifylline.

Nodular dermatofibrosis

This is a condition whereby there are nodules (lumps) on the skin and can lead to cancer of the kidneys.

Diagnosis: Diagnosis is confirmed with biopsy and histopathology.

Treatment: None.


This is a condition presented as an irritation to the webbing of the feet causing terrible itchiness.

Diagnosis: Diagnosis is confirmed on physical and supported with cytology and possible biopsy and culture.

Treatment: Treatment usually involves topical anti-inflammatories and antifungals.

Seasonal flank alopecia

This is a seasonal follicular dysplasia resulting in loss of hair on one or both flanks.

Diagnosis: Diagnosis is made on clinical signs, blood tests and skin biopsies.

Treatment: Treatment is usually not necessary because hair will regrow. In some cases melatonin can be used to prevent recurrence and/or hasten hair regrowth.

Sterile pyogranuloma syndrome

Sterile pyogranulomas are firm lumps in the skin usually on the feet and face.

Diagnosis: Diagnosis is confirmed with biopsy and histopathology.

Treatment: Treatment involves surgical removal and immunosuppressives or tetracycline and niacin.


Cystinuria/cystine uroliths

Cystine crystals develop in the urine due to a kidney disorder. Cystine stones develop most commonly in males. Animals are usually admitted with blood in urine and straining to urinate.

Diagnosis: Diagnosis is made with urinalysis and abdominal ultrasound.

Treatment: Treatment involves feeding vegetarian diets and supplementing to increase ph in urine. D-penicillamine will specifically reduce the concentration of cystine in urine.

Renal dysplasia

This disease is defined by the formation of abnormal nephrons. Prognosis usually depends on the extent of disease in the kidneys.

Diagnosis: Diagnosis is achieved by ultrasonography and biopsy.

Treatment: In severe cases the only treatment is renal transplant.



Proper questioning to the breeder can help with your choice of breeder. A knowledgeable breeder with good selection principles will openly discuss breed problems.

Questions to the breeder:

1. Discuss temperament of parents.

2. Ask about screening for Von Willebrand’s, hips, PRA, hypothyroidism and cardiomyopathy.

3. Ask whether they have had many tumors in their dogs and if so which ones.

4. Discuss diets and feeding in respect to colitis and bloat.

5. Ask about allergies and skin problems in their lines.

6. Discuss bladder stones in their lines.

7. Ask about epilepsy in lines.


The following screenings and assessments are recommended as your puppy grows. These specific screening tests/procedures will be done along with a routine physical exam.


1. Assess eyes for distichiasis, entropion, cataracts, and PRA.

2. Auscultate heart well for murmurs.

3. Discuss importance of good diet due to susceptibility to bloat and colitis.

4. Discuss importance of teeth brushing due to likelihood of more dental issues.

5. Check whether cryptorchid.

6. Discuss cleaning chin well to avoid chin acne.

7. Discuss with clients the breeders screening process for hereditary diseases.

8. Palpate knees for luxating patellas.


1. Clotting profile (ACT or buccal bleeding time ) with presurgical bloods pre neutering.

2. Assess eyes for any distichiasis or entropion.

3. X-ray spine and hips while under for neutering.


1. Run urinalysis and thyroid panel with yearly wellness profile.

2. Evaluate eyes yearly for distichiasis, glaucoma (IOP), PRA, and corneal dystrophy.

3. Auscultate heart well for irregularities yearly. Possibly refer to cardiologist for ECG or Halter monitor.

4. Assess feet for pododermatitis and skin for early signs of allergies yearly.

5. Evaluate yearly for any lumps or bumps on skin.

6. Examine mouth well for gingival hyperplasia yearly.