# West Highland White Terrier Health Problems: Inherited Conditions and Preventive Screenings ## Key Takeaways - West Highland White Terriers are predisposed to several inherited conditions, including atopic dermatitis (environmental allergies) which presents with pruritus, erythema, and recurrent skin/ear infections, managed via elimination diet trials, intradermal/serum IgE testing, and immunotherapy. - Skeletal issues like Craniomandibular Osteopathy (CMO) and Legg-Calvé-Perthes Disease affect young Westies (3-8 months and 4-11 months respectively), diagnosed via skull/hip radiographs and managed with pain relief, supportive care, or surgical intervention (Femoral Head and Neck Excision for Perthes). - Pulmonary Fibrosis (IPF), a progressive and often fatal lung disease, affects middle-aged to older Westies (8+ years) with clinical signs of exercise intolerance and dry cough, diagnosed via thoracic radiographs and CT scans, with management focusing on symptomatic relief. - Neurological conditions include Globoid Cell Leukodystrophy (Krabbe Disease), a fatal lysosomal storage disorder diagnosed by genetic testing, and White Shaker Dog Syndrome, characterized by generalized tremors, responsive to corticosteroid therapy. - Ocular (hereditary cataracts) and renal (polycystic kidney disease) conditions also occur, diagnosed via ophthalmic examination and abdominal ultrasound respectively, with management focused on vision preservation and slowing kidney failure progression. - Preventive screenings are critical, including annual physical and orthopedic exams, ophthalmic evaluations, and for senior dogs, baseline bloodwork, urinalysis, thoracic radiographs, and abdominal ultrasound to facilitate early detection of these breed-specific health concerns. --- The West Highland White Terrier, known affectionately as the Westie, is a small, sturdy, and spirited companion with a distinctive white coat. While they are generally a robust breed with a lifespan of 12 to 16 years, their genetic background predisposes them to a specific set of inherited health conditions. For any owner, understanding these breed-specific health problems is not about expecting the worst, but about proactive management. Early detection through preventive screenings can significantly improve both the quality and length of your [dog](/knowledge/veterinary-medicine/clinical-methods/dog)'s life. This article provides a definitive, source-grounded overview of the most significant inherited conditions in Westies, the recommended screening protocols, and practical steps for managing their health. ## At a Glance: Key Health Concerns in the West Highland White Terrier This table summarizes the most common inherited conditions discussed in this article. It is a clinical guide, not a diagnosis. Always consult your veterinarian for advice tailored to your individual dog. | Condition | System Affected | Typical Age of Onset | Key Clinical Signs | Primary Screening Method | | :--- | :--- | :--- | :--- | :--- | | **Atopic Dermatitis** | Skin / Immune | 6 months to 3 years | Pruritus (itching), erythema (redness), recurrent ear infections, licking [paws](/knowledge/veterinary-medicine/clinical-methods/paws), face rubbing | Intradermal allergy testing, serum IgE testing, elimination diet trial | | **Craniomandibular Osteopathy (CMO)** | Skeletal | 3 to 8 months | Pain on opening mouth, difficulty eating, drooling, swollen jaw, fever | Skull radiographs (X-rays) | | **Legg-Calvé-Perthes Disease** | Skeletal (Hip Joint) | 4 to 11 months | Hind limb lameness, muscle atrophy, pain on hip extension | Hip radiographs | | **Pulmonary Fibrosis** | Respiratory | Middle-aged to older (8+ years) | Exercise intolerance, persistent dry cough, increased respiratory effort, crackles on lung auscultation | Thoracic radiographs, CT scan, arterial blood gas analysis | | **Globoid Cell Leukodystrophy (Krabbe Disease)** | Neurological | 3 to 6 months | Tremors, ataxia (incoordination), muscle weakness, vision loss, behavioral changes | Genetic testing (DNA test) | | **Hereditary Cataracts** | Ocular | Variable, often young adults | Cloudy appearance to the eye, vision impairment | Complete ophthalmic examination (slit-lamp biomicroscopy) | | **Polycystic Kidney Disease (PKD)** | Renal | Middle-aged to older | Increased thirst (polydipsia), increased urination (polyuria), weight loss, vomiting | Abdominal ultrasound, genetic testing (DNA test) | | **Patellar Luxation** | Musculoskeletal | Variable, often young | Intermittent hopping or skipping lameness, sudden lameness | Orthopedic examination, palpation, radiographs | | **White Shaker Dog Syndrome** | Neurological | 6 months to 3 years | Generalized tremors, nystagmus (rapid eye movements), head tilt | Clinical diagnosis, ruling out other causes | ## Understanding the Breed's Predisposition The West Highland White Terrier originated in Scotland, bred for hunting vermin. Their genetic isolation, combined with the selection for specific traits like the white coat and terrier temperament, has led to a higher prevalence of certain inherited diseases. These conditions are often autosomal recessive, meaning a dog must inherit two copies of the mutated gene (one from each parent) to be affected. This is why responsible breeding practices, including genetic screening of parent dogs, are critical in reducing the incidence of these diseases. As a pet owner, being informed about these predispositions allows you to partner effectively with your veterinarian in a preventive healthcare plan. ## Skin and Allergic Conditions: Atopic Dermatitis One of the most common health problems in West Highland White Terriers is atopic dermatitis (AD), a chronic, inflammatory, and pruritic (itchy) skin disease triggered by an allergic reaction to environmental allergens like pollen, mold, dust mites, and dander. The condition is often inherited and is a lifelong issue that requires consistent management. ### Pathophysiology and Clinical Signs In a dog with AD, the skin's barrier function is defective, allowing allergens to penetrate more easily. This triggers an exaggerated immune response, leading to inflammation and intense itching. The classic signs of AD in a Westie include: - **Pruritus:** The most prominent sign. Dogs will scratch, rub, lick, and chew at their skin, especially on the face, paws, ears, and ventral abdomen. - **Erythema:** Reddened, inflamed skin. - **Recurrent Skin Infections:** Secondary bacterial (pyoderma) and yeast (Malassezia) infections are common due to the damaged skin barrier and self-trauma. - **Otitis Externa:** Chronic ear inflammation is a frequent comorbidity. The inflamed, itchy ear canals are a perfect environment for secondary infections. - **Hyperpigmentation and Lichenification:** Chronic inflammation can cause the skin to thicken and darken over time. ### Diagnosis and Management Diagnosis of AD is a process of elimination. Your veterinarian will first rule out other causes of itching, such as flea allergy dermatitis, food allergies, and sarcoptic mange. This typically involves: - **Food Elimination Trial:** A strict 8 to 12 week trial with a novel or hydrolyzed protein diet to rule out food allergies. - **Allergy Testing:** Intradermal skin testing or serum IgE blood tests can identify specific environmental allergens. These results are used to formulate allergen-specific immunotherapy (ASIT), commonly known as "allergy shots" or drops, which is the most effective long-term treatment for AD. - **Symptomatic Management:** This may include: - **Antipruritic Medications:** Drugs like oclacitinib (Apoquel) or lokivetmab (Cytopoint) are highly effective at controlling itch. - **Topical Therapy:** Medicated shampoos, conditioners, and sprays to soothe the skin and control secondary infections. - **Essential Fatty Acid Supplements:** Omega-3 and Omega-6 fatty acids can help improve the skin barrier. - **Strict Parasite Control:** Year-round flea and tick prevention is essential, as flea bites can exacerbate allergy symptoms. **Veterinary Guidance:** The AVMA and AAHA wellness guidelines emphasize a multimodal approach to managing chronic conditions like AD, combining medical therapy with environmental management and client education. ## Skeletal and Orthopedic Conditions West Highland White Terriers are predisposed to several orthopedic problems, many of which manifest during the puppy and young adult stages. ### Craniomandibular Osteopathy (CMO) Also known as "lion jaw" or "Westie jaw," CMO is a painful, non-cancerous proliferative bone disease affecting the skull, particularly the jawbones (mandible and tympanic bullae). It typically appears in puppies between 3 and 8 months of age. - **Clinical Signs:** Puppies may exhibit pain when opening their mouths, leading to difficulty eating, drooling, weight loss, and a fever. The jaw may appear swollen. - **Diagnosis:** Skull radiographs reveal characteristic bony proliferation (new bone growth) along the mandible and skull base. - **Prognosis:** The condition is often self-limiting. The abnormal bone growth may regress spontaneously once the puppy reaches skeletal maturity (around 12 months of age). Management focuses on supportive care, including pain relief, anti-inflammatory medications, and a soft, easily consumed diet. In severe cases, a feeding tube may be necessary temporarily. ### Legg-Calvé-Perthes Disease This condition involves the spontaneous degeneration and death of the femoral head (the "ball" of the hip joint) due to a disruption of its blood supply. It is a common cause of hind limb lameness in small breed dogs, including Westies, typically appearing between 4 and 11 months of age. - **Clinical Signs:** The first sign is usually a progressive hind limb lameness that may come and go. The dog may yelp in pain, and you may notice muscle atrophy (wasting) in the affected leg. - **Diagnosis:** Hip radiographs will show characteristic changes, including flattening and fragmentation of the femoral head. - **Treatment:** The standard treatment is surgical removal of the affected femoral head and neck, a procedure called Femoral Head and Neck Excision (FHNE) or "femoral head ostectomy." This surgery eliminates the bone-on-bone contact, allowing a false joint to form with scar tissue, which is typically pain-free. Most dogs regain excellent function in the leg after surgery and physical rehabilitation. ### Patellar Luxation Patellar luxation, or a "trick knee," is a common condition in small breeds where the kneecap (patella) slips out of its normal groove (trochlear groove) in the femur. It can be medial (toward the inside of the leg) or lateral (toward the outside). - **Clinical Signs:** Dogs may have an intermittent "skipping" or "hopping" gait, where they hold the leg up for a few steps before putting it back down. This is often painless at first. Over time, it can progress to a persistent lameness and lead to arthritis. - **Diagnosis:** Diagnosis is made through physical palpation by a veterinarian. Radiographs are helpful to assess the severity of the luxation and the degree of secondary arthritis. - **Treatment:** Mild cases (Grade I and II) may be managed conservatively with weight management, joint supplements, and anti-inflammatory medications. More severe cases (Grade III and IV) or those causing persistent lameness often require surgical correction to deepen the groove and realign the tendons and ligaments. ## Respiratory Conditions: Pulmonary Fibrosis Idiopathic pulmonary fibrosis (IPF) is a devastating, progressive lung disease that is significantly overrepresented in West Highland White Terriers. It is characterized by the progressive scarring (fibrosis) of the lung tissue, which makes it increasingly difficult for the dog to oxygenate its blood. It is often compared to a similar disease in humans. ### Clinical Signs and Diagnosis IPF typically affects middle-aged to older Westies (average age of diagnosis is around 8 to 12 years). The hallmark clinical signs are: - **Exercise Intolerance:** The dog tires easily on walks and may lag behind. - **Persistent Dry Cough:** A chronic, non-productive cough that may worsen with excitement or exercise. - **Increased Respiratory Effort:** You may notice rapid, shallow breathing (tachypnea) or labored breathing (dyspnea). - **Crackles on Auscultation:** When listening to the lungs with a stethoscope, a veterinarian may hear distinctive "crackling" sounds, especially at the end of inspiration. Diagnosis is based on clinical signs, thoracic radiographs (which may show a characteristic interstitial lung pattern), and more advanced imaging like CT scans. An arterial blood gas analysis can demonstrate low oxygen levels in the blood. Unfortunately, a definitive diagnosis often requires a lung biopsy, which is invasive. ### Management and Prognosis There is no cure for IPF. The disease is progressive and ultimately fatal. Management focuses on improving quality of life and slowing the progression: - **Corticosteroids:** These are often used to reduce inflammation, though their efficacy in IPF is debated and they are not a cure. - **Bronchodilators:** These may help open the airways and ease breathing. - **Oxygen Therapy:** In advanced cases, supplemental oxygen may be needed. - **Weight Management:** Maintaining a lean body condition is crucial to reduce the workload on the lungs. - **Avoiding Stress:** Minimizing excitement and exposure to respiratory irritants like smoke and dust is important. The prognosis for a dog diagnosed with IPF is poor, with a median survival time of around 1 to 2 years after diagnosis. This condition highlights the critical importance of recognizing early respiratory signs in a Westie and seeking prompt veterinary evaluation. ## Neurological Conditions Two significant inherited neurological conditions affect West Highland White Terriers: Globoid Cell Leukodystrophy and White Shaker Dog Syndrome. ### Globoid Cell Leukodystrophy (Krabbe Disease) This is a severe, fatal, lysosomal storage disease caused by a deficiency of the enzyme galactocerebrosidase. This enzyme is essential for the production and maintenance of myelin, the protective sheath that surrounds nerve fibers. Without it, the nervous system degenerates. - **Clinical Signs:** The disease is progressive and typically appears in puppies between 3 and 6 months of age. Early signs include tremors, ataxia (wobbliness), and muscle weakness. As the disease progresses, the puppy may develop vision loss, seizures, and severe cognitive dysfunction. - **Diagnosis:** A definitive diagnosis is made through a DNA test that identifies the specific gene mutation. This test is crucial for breeding decisions. - **Prognosis:** The disease is relentlessly progressive and fatal, usually by 1 year of age. There is no treatment, and euthanasia is often the humane choice once the puppy's quality of life deteriorates. ### White Shaker Dog Syndrome Also known as generalized tremor syndrome, this condition is characterized by sudden, generalized, rhythmic tremors. It is most common in small, white breeds like the Westie, though the reason for this predisposition is not fully understood. It is believed to be an immune-mediated inflammatory condition affecting the central nervous system. - **Clinical Signs:** The primary sign is a fine tremor that affects the whole body, which may worsen with excitement or stress and decrease when the dog is resting. Other signs can include nystagmus (rapid, involuntary eye movements), head tilt, and ataxia. - **Diagnosis:** Diagnosis is typically based on the characteristic clinical signs and the breed. The veterinarian will rule out other causes of tremors, such as toxins, metabolic diseases, or other neurological disorders. - **Treatment:** The condition is highly responsive to treatment with corticosteroids (e.g., prednisone). Most dogs show significant improvement within 1 to 2 weeks. Treatment is usually continued for several months, and some dogs may require lifelong low-dose therapy to prevent relapse. The prognosis is generally excellent, and most affected dogs go on to live normal, happy lives. ## Ocular Conditions: Hereditary Cataracts Cataracts, or opacities in the lens of the eye, are a common inherited condition in many breeds, including the West Highland White Terrier. These can appear at any age, from juvenile to adult. - **Clinical Signs:** The most obvious sign is a cloudy or bluish-white appearance to the pupil. As the cataract matures, it can cause vision impairment and, if complete, blindness. - **Diagnosis:** A thorough ophthalmic examination by a veterinarian, ideally a board-certified veterinary ophthalmologist, is required. They will use a slit-lamp biomicroscope to visualize the lens and determine the type and stage of the cataract. - **Treatment:** The only effective treatment for a cataract that is causing significant vision loss is surgical removal (phacoemulsification). This procedure has a high success rate in dogs. For dogs that are not surgical candidates, the focus is on managing secondary inflammation (uveitis) and helping them adapt to their vision loss. ## Renal Conditions: Polycystic Kidney Disease Polycystic kidney disease (PKD) is an inherited condition in which multiple fluid-filled cysts develop in the kidneys. These cysts gradually replace normal kidney tissue, leading to progressive kidney failure. While more commonly associated with Persian cats, it is a recognized inherited disease in West Highland White Terriers, though the genetic basis in this breed is less well-defined than in cats. - **Clinical Signs:** Signs of chronic kidney disease (CKD) typically appear in middle-aged to older dogs and include increased thirst (polydipsia) and urination (polyuria), decreased appetite, weight loss, vomiting, and lethargy. - **Diagnosis:** Abdominal ultrasound is the best way to visualize the cysts in the kidneys. Genetic testing for the specific mutation in the *PKD1* gene may be available, but its reliability in Westies should be discussed with your veterinarian. - **Management:** There is no cure for PKD. Management focuses on slowing the progression of kidney failure, which includes a therapeutic renal diet, managing blood pressure, and providing supportive care such as fluids and medications to control nausea and vomiting. ## The Role of Preventive Screenings Preventive screenings are the cornerstone of managing breed-specific health risks. Early detection of many of these conditions can dramatically alter the course of the disease and improve the outcome for your pet. According to the AAHA Canine Life Stage Guidelines, regular wellness examinations are essential at every life stage, from puppyhood to the senior years. ### Recommended Screening Protocol for West Highland White Terriers | Life Stage | Recommended Screenings | Rationale | | :--- | :--- | :--- | | **Puppy (0-12 months)** | **Physical Exam:** Full orthopedic and neurological exam at every vet visit. | Early detection of CMO, Legg-Calvé-Perthes, and patellar luxation. | | | **Genetic Testing:** DNA testing for Globoid Cell Leukodystrophy. | To confirm the dog is not a carrier or affected. | | | **Ophthalmic Exam:** Baseline eye exam. | To rule out juvenile cataracts. | | **Adult (1-7 years)** | **Annual Physical Exam:** Including a thorough skin and ear exam. | Early diagnosis and management of atopic dermatitis and otitis. | | | **Ophthalmic Exam:** Annual screening by a veterinary ophthalmologist. | Early detection of hereditary cataracts. | | | **Orthopedic Exam:** Annual palpation of joints, especially the knees and hips. | Early detection of patellar luxation or early arthritis. | | **Senior (7+ years)** | **All of the above, plus:** | | | | **Bloodwork (CBC/Chemistry) and Urinalysis:** Annual or semi-annual. | Baseline health, early detection of kidney disease (PKD) and other metabolic issues. | | | **Thoracic Radiographs (X-rays):** Consider baseline chest X-rays. | To screen for early signs of pulmonary fibrosis. | | | **Abdominal Ultrasound:** Consider a baseline scan. | To screen for PKD and other abdominal organ changes. | ### The Importance of Genetic Testing For a breed with as many inherited conditions as the Westie, genetic testing is a powerful tool. The Orthopedic Foundation for Animals (OFA) and other registries maintain databases for genetic testing. Testing breeding dogs for mutations like the one for Globoid Cell Leukodystrophy is essential to avoid producing affected puppies. While genetic tests exist for some conditions, they do not exist for all. For example, there is no simple genetic test for atopic dermatitis or pulmonary fibrosis, so screening relies on clinical evaluation and diagnostic imaging. ## Limitations and When to Contact a Veterinarian This article provides a comprehensive overview of the health problems common to the West Highland White Terrier breed. However, breed-level information cannot predict the specific health of any individual dog. A dog may have none, one, or several of these conditions. The age of onset, severity, and response to treatment vary greatly between individuals. This information is for educational purposes and is not a substitute for professional veterinary diagnosis or treatment. **You should contact your veterinarian immediately if your Westie exhibits any of the following emergency red flags:** - **Difficulty breathing:** Labored, rapid, or noisy breathing, or a persistent, worsening cough. - **Acute lameness or inability to bear weight on a limb.** - **Signs of severe pain:** Whining, panting, restlessness, aggression when touched, or a swollen, painful jaw. - **Seizures or sudden collapse.** - **Repeated vomiting or diarrhea (especially with blood), or a sudden loss of appetite.** - **Sudden onset of tremors or incoordination.** - **Straining to urinate or an inability to urinate.** Early intervention is always the best course of action. If you have any concerns about your dog's health, do not hesitate to schedule an appointment with your veterinarian. ## Frequently Asked Questions **1. Are West Highland White Terriers prone to many health problems?** Yes, the breed is genetically predisposed to a range of inherited conditions, including skin allergies (atopic dermatitis), orthopedic issues (Legg-Calvé-Perthes disease, patellar luxation), and a severe lung disease called pulmonary fibrosis. **2. What is the most common health issue in West Highland White Terriers?** Atopic dermatitis, or environmental allergies, is arguably the most common health problem seen in the breed, often manifesting as chronic itching, scratching, and recurrent ear infections. **3. What is the life expectancy of a West Highland White Terrier?** The typical lifespan for a Westie is 12 to 16 years. Many live long, healthy lives, but inherited conditions like pulmonary fibrosis can shorten this. **4. What is craniomandibular osteopathy in Westies?** Craniomandibular osteopathy (CMO) is a painful bone disease affecting the jaw of young puppies. It causes swelling and pain, but in many cases, it resolves on its own as the puppy matures. **5. How is pulmonary fibrosis in Westies diagnosed?** Diagnosis is based on clinical signs like a dry cough and exercise intolerance, and is supported by thoracic radiographs and more advanced imaging like a CT scan. Your veterinarian may also recommend blood gas analysis. **6. Is there a genetic test for West Highland White Terrier health problems?** Yes, a DNA test is available for Globoid Cell Leukodystrophy (Krabbe disease), which is a severe neurological condition. Testing for other conditions may be available through specific laboratories and should be discussed with your vet. **7. What should I feed a West Highland White Terrier with skin allergies?** A food elimination trial with a novel or hydrolyzed protein diet is the gold standard for diagnosing a food allergy. Your veterinarian will recommend the best diet for your dog's specific needs, which may include a veterinary therapeutic diet. **8. At what age should I start screening my Westie for hereditary health conditions?** Screening should start in puppyhood with a thorough physical exam and genetic testing. Annual wellness exams, including orthopedic and ophthalmic checks, should continue throughout adulthood, with more comprehensive screenings like bloodwork and imaging recommended for senior dogs. ## Veterinary Disclaimer This article is educational and is not a substitute for veterinary diagnosis or treatment. 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