The Vet gave Mack a clean bill of health. Mack did well at the clinic other than his typical growls towards the vet staff and other patients. Due to Maryland law I will have to invest in a muzzle for him until the behavior is corrected. I hate the idea immensely but I don't want to lose my dog or receive a thousand dollar fine for his attitude. I have come up with an idea that has a high chance of working.
The muzzle is loose enough to allow him to open his mouth and there is enough room for him to receive a treat and eat it without discomfort. This also allows him room to bark or growl. I'm going to take him into familiar surroundings where we won't run into many strangers at first and click treat when he remains quiet. When he is able to see strange people and dogs at a distance without becoming upset we'll start having people approach and ignore him while talking to me. I figure it's a good start. I hope it works for his sake as well as mine. I'm dreaming of the day when I can walk him in public without worrying about someone getting bit.
On a positive note, we are currently working on learning the command "Enough". I wait for him to bark twice and then say enough. When he stops barking he gets the click/treat. It seems to be working very well. His growling when people come into the yard is still pervasive though. I really don't mind him protecting the house, but I'm thinking that for now I need to teach him not to do these things anywhere.