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Recurrent Corneal Ulcers (Indolent Ulcers)

by Hannah Wright on July 9th, 2018

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What is the cornea?
The cornea is the clear window of the eye. It is a delicate structure which is less than a millimetre thick. In order to be transparent, the cornea has no blood vessels. It consists of three layers which are arranged like those of a sandwich. The three layers comprise: 1) the epithelium – this is the thin outer ‘skin’ of the cornea;  2) the stroma which is the much thicker middle layer of the ‘sandwich’;  3) the endothelium – this is the inner layer of the cornea and is very thin indeed (only one cell thick).

What is a corneal ulcer?
Any injury involving the cornea can be described as an ulcer. Generally, corneal ulcers are described as superficial or deep, depending on whether they just involve the outer skin (the epithelium), in which case they are called superficial ulcers or erosions – or whether they extend into the middle layer (the stroma), in which case they are called deep ulcers. The attached image shows the use of a dye called fluorescein which will stain ulcers and show up the defect. Most superficial ulcers heal rapidly as the cells of the surrounding outer ‘skin’ (the epithelium) slide and grow into the defect. The new skin that grows then sticks to the tissue underneath. Most superficial ulcers will have healed within a week.

How do I notice that my dog has an ulcer?
The cornea is sensitive because it has a lot of nerve endings, and ulceration is usually associated with quite marked discomfort because the nerves are exposed. Signs of eye discomfort include weeping, blinking, squinting, pawing at the eye and general depression.

What makes an ulcer indolent?
An indolent ulcer is an ulcer which fails to heal in the expected time. It then tends to cause ongoing discomfort and irritation. Eyes affected with indolent ulcers try to grow a new surface skin over the defect, but the incoming cells fail to stick down onto the layer underneath (the stroma). As a result, a thin layer of loose tissue can often be seen surrounding the ulcerated area. The reason why the cells fail to stick is not fully understood but is believed to be mainly because the epithelial cells fail to form tiny ‘feet’ that normally hold on to the tissue underneath.

Are certain breeds predisposed to develop indolent ulcers?
Certain breeds are predisposed to develop indolent ulcers – Boxers, Corgis, Staffordshire Bull Terriers and West Highland White Terriers are often affected. However, any dog can develop an indolent ulcer, and older patients are more commonly affected. Once a dog has suffered an indolent ulcer in one eye, it may develop one in the other eye, or recurrence of ulceration in the first eye. This can happen at any time after the first ulcer (sometimes years later).

What treatment options are available if my dog has an indolent ulcer?
It is not possible to achieve healing of indolent ulcers with the use of antibiotic or false tear ointments alone. In order for healing to occur, it is important that all loose tissue is removed and that the exposed stroma is treated and ‘freshened up’ to allow adhesion of new epithelial (‘skin’) cells. The process of removal of loose epithelium is called ‘debridement’ and in most patients it can be carried out with the use of local anaesthetic drops in the eye. Diamond Burr Debridement is the gold standard although other methods may be employed. Following the debridement, the exposed stroma is sometimes abraided with small dot-like scratches using a fine needle to allow the ‘feet’ of the new cells to take hold. The latter procedure is called a ‘punctate’ or ‘grid’ ‘keratotomy’.

In very fractious patients, it may be necessary to give a sedative to perform these procedures. More severe and longstanding cases require more radical treatment under a general anaesthetic. In this instance all diseased epithelium and some of the underlying stroma is removed. This procedure is carried out under the operating microscope with a sharp knife. The operation has a high success rate but is not suitable for every case.

What care will be required following debridement and cautery?
Usually, a broad spectrum antibiotic will be dispensed to be applied three times daily to help to prevent infection. In some cases, it may be necessary to give a drug (atropine) which widens the pupil and reduces pain associated with the ulcer. Often patients with an indolent ulcer will receive a painkiller which is given with food. In some patients, the pain associated with the ulcer appears more severe than in others.

How does the eye appear during healing of the ulcer?
In some patients, healing of the ulcer occurs fast and the cornea will only be slightly cloudy during treatment. However, in patients where healing of the ulcer is slow, it is common to find that blood vessels grow into the cornea and that pink granulation tissue forms to cover the defect. During this time, the eye may appear very red and odd looking. However, once the defect is fully covered, the granulation tissue will gradually clear over a period of months, leaving only minor corneal scarring in the majority of cases. Vision in most patients will return to normal or near normal after an episode of indolent ulceration.

How long does an indolent ulcer take to heal on average?
With a single treatment of debridement and cautery, approximately 80% of indolent ulcers heal within one to two weeks. The remaining 20% may require more than one treatment and, on occasions, it can take several weeks until full healing of an indolent ulcer is achieved.

The option of surgery for an indolent ulcer may have to be reconsidered if it fails to heal after several attempts at debridement  and/or keratotomy.

What complications can occur if my pet has an indolent ulcer?
The biggest concern is certainly the possibility of infection. This can occur even if a suitable broad spectrum antibiotic is used on a preventative basis. If infection occurs, indolent ulcers may become deep and may require urgent surgical intervention.

Until healing of the indolent ulcer is achieved, it is advisable that the patient returns to the surgery to ensure satisfactory progress. Once the ulcer has fully healed, patients should not require frequent veterinary attention and a return will only be necessary in selected cases or if the problem recurs in either eye.

 

Corneal ulcer

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Pet of the month – July – Elsa

by Hannah Wright on July 9th, 2018

Category: Pet of the Month, Tags:

We are so pleased to report that delightful Elsa is making good progress after a very severe bout of Haemorrhagic Gastroenteritis (HGE).

Elsa’s symptoms were initially intractable vomiting. As she did not respond to therapy and has a habit of eating wood which can be very hard to detect on imaging, she underwent an exploratory operation to check that she had not swallowed any. This might in turn have splintered, perforated the bowels and caused peritonitis. Thankfully this did not prove to be the case, however did develop haemorrhagic diarrhoea. Appropriate and swift therapy has put her on the road to recovery!

Elsa

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Special Offer – July 2018

by Hannah Wright on July 9th, 2018

Category: Special Offers, Tags:

Offer July 2018

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Special Offer – June – Microchip Offer

by admin on June 1st, 2018

Category: Special Offers, Tags:

Microchip Offer (1)

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Pet of the month – June – Bertie

by admin on June 1st, 2018

Category: Pet of the Month, Tags:

Pet of the month for June 2018 is a handsome Bichon Frise called Bertie.

What possessed Bertie, at 19 years of age, to change the habits of a lifetime and consume some glass nobody will ever know, but luckily his owner was at hand and observed this.

She quickly rushed him in to the surgery, where radiographs confirmed the presence of 3 pieces of glass in his stomach. Despite worries over his age Bertie underwent an exploratory laparotomy under general anaesthesia to locate and remove the glass.

We are delighted to report that Bertie is doing really well and has bounced back to health!

 

BERTIE

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Healthcare advice for pets travelling abroad

by admin on June 1st, 2018

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When taking your pet abroad it is important to realise that there are potential disease risks which need to be considered. Animals from the UK will have no natural immunity to several diseases which are common in Europe and elsewhere.

The four main disease risks are Leishmaniasis, Babesiosis, Ehrlichiosis and Heartworm. All are potentially life-threatening and so must be carefully considered before travel. These diseases are all transmitted to pets when they are bitten by an infected insect (an insect which spreads a disease in this way is known as a vector). Different insects, or vectors, spread different diseases. With the exception of Heartworm, the only way to protect your pet from catching the disease is to prevent it being bitten by the vectors. Therefore, it is useful to know the feeding habits of the vectors and where they are likely to be found. The tables below give information about these diseases and their insect vectors.

The lists of geographical areas mentioned in the tables are not exhaustive. Also, high-risk times of day or year may be noted in the tables, but vectors will also feed outside these peak times. These diseases principally affect dogs, but cats may also be affected.

Whenever you are travelling abroad with your pet it is sensible to seek the advice of a local veterinary surgeon with regard to preventative health, as he or she will best know the local disease risks. If your pet falls ill while you are abroad you should seek veterinary assistance as soon as possible. It is worth finding out about local vets in the area before travelling, especially if the language is going to be a problem.

Should your pet fall ill after you have returned to the UK, do remember to mention to your veterinary surgeon that your dog or cat has travelled or lived abroad, even if it was years previously, as some of these diseases can take many years to emerge.

Leishmaniasis:

Cause of Leishmaniasis

  • Protozoal Parasite

Vector

  • Phlebotomine Sandfly

Where do Sandflies live?

  • Woods and gardens (not beaches!)
  • Mediterranean countries and islands

Feeding activity of Sandflies

  • Potentially any time of day
  • Peak activity May to October

Prevention of bites

  • Do not allow dogs to sleep outside. Sandflies enjoy similar cool resting places to dogs!
  • Allowing animals to sleep upstairs may reduce bites, as Sandflies have limited flight
  • Environmental insect repellents – e.g. coils and plug-ins
  • Scalibor repellent collar for dogs or Advantix

The speed of onset of illness

  • It may take up to 6 years for signs to develop after an animal has been bitten

Clinical signs of illness

  • Chronic or recurrent weight loss, skin and eye lesions, lameness and enlarged lymph nodes

Treatment

  • Variable success of treatment

Special considerations

  • Zoonosis (i.e. it can potentially be passed to humans)

Babesiosis:

Cause of Babesiosis

  • Protozoal parasite of the red blood cell

Vector

  • Tick

Where do Ticks live?

  • Forest and rough grazing including campsites!
  • France, Southern Europe but as far north as Belgium, Germany and the Netherlands

Feeding activity of Tick

  • Especially Spring and Autumn

Prevention of Tick bites

  • Prevent tick attachment – repellent collars (Scalibor for dogs)
  • Treatments to kill attached ticks – Frontline (cats) or Advantix (dogs)
  • Daily checking and removal of ticks using Tick Hook (see note below)

Speed of onset of illness

  • Rapid onset disease is possible

Clinical signs of illness

  • Due to haemolyticanaemia (destruction of the red blood cells). Pale mucus membranes, jaundice, weakness, fast breathing, red urine, collapse, death

Treatment

  • May not be curative

Ehrlichiosis:

Cause of Ehrlichiosis

  • A rickettsial parasite in the white blood cells

Vector

  • Tick

Where is this Tick found?

  • France, Corsica, Spain, Italy and Portugal, and further north to Germany, Belgium and Holland

Feeding activity

  • As for Babesiosis

Prevention

  • As for Babesiosis

Speed of onset of illness

  • Rapid onset disease, sub-clinical infection (i.e. the parasite is in the body but does not cause signs of illness) or chronic infection (i.e. causing a slower, long term illness) are all possible

Clinical signs

  • Fever, anorexia and enlarged lymph nodes

Treatment

  • Vets most commonly prescribe the antibiotic doxycycline to treat ehrlichiosis in dogs. It is typically given once a day for three to four weeks. Other medications can also be used when the situation warrants.

If a dog receives treatment in a timely manner, his condition will usually begin to improve rapidly, often within just a day or two, and the prognosis for complete recovery is good. In more severe cases, additional treatments (e.g., intravenous fluids, blood transfusions, immunosuppressive medications, and/or pain relievers) may also be necessary.

Heartworm (Dirofilariasis):

Cause of Heartworm

  • Nematode worm found in pulmonary arteries (those in the lungs) and heart

Vector

  • Mosquitoes

Where do the Mosquitoes live?

  • From northern France south to the Mediterranean. Much of the USA and Canada
  • Hyper-endemic in the Po Valley in Italy

Feeding activity of Mosquitoes

  • Mainly at night but some species feed during the day
  • Especially from May to September

Prevention of Mosquito bites

  • Small mesh nets or window covers
  • Environmental insect repellents – coils and plug-ins
  • Scalibor repellent collar for dogs and Advantix

Prevention of disease

  • Drug prophylaxis (preventative treatment) using Milbemax tablets – start a month before exposure, then give monthly until one month after return to the UK. Where dogs may have been previously exposed, testing is required prior to treatment. Testing comprises blood tests and chest X-rays (radiographs)

Clinical signs

  • Associated with respiratory disease and heart failure

Treatment

  • Dogs with heartworm disease will initially receive treatment needed to stabilise their condition. They will then be given medication to kill circulating microfilariae, and most will undergo a series of three injections over a month’s time to kill adult worms in the heart and lungs. Hospitalisation when these injections are given, and possibly at other times, is necessary so that your vet can watch closely for side effects. Prednisolone and doxycycline are also typically prescribed to reduce the chances that the dog will react badly to the death of the worms. Other treatments may be needed based on an individual dog’s condition.

If a dog has caval syndrome, a surgical procedure will be necessary to remove adult worms from the right heart and pulmonary artery by way of the jugular vein. Most dogs with caval syndrome die regardless of treatment.

Summary General Recommendations:

Ticks
Prevent tick attachment

  • Scalibor collars (dogs)
  • Advantix spot-on (dogs)

Kill Ticks

  • Frontline (cats)
  • Advantix spot-on (dogs)

Daily check for ticks and remove any found using a Tick Hook

Sandflies and Mosquitoes:

  • Keep your pet inside at times of peak activity
  • Use meshes/netting over windows
  • Use environmental repellents
  • Scalibor collar (dogs) or Advantix (dogs)

Heartworm prevention:

  • Monthly Milbemax tablets or fortnightly Advocate
  • Start one month before exposure and continue until one month after return

Please note:
It is important to take great care when removing ticks to ensure that the mouth parts are fully removed. Failure to do so may cause an abscess or granuloma (inflamed lump) to develop. To ensure safe removal we recommend using a specially designed Tick Hook. These come with instructions for safe tick removal.

All of the above products can be supplied by our clinic. Please note that for licensed veterinary products to be dispensed, your pet needs to be under our care which may require a clinical examination if we have not seen your pet for some time.

 

Dog & Pet travel

 

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Special Offer – May – Feline Hypertension Month

by admin on May 1st, 2018

Category: Special Offers, Tags:

Feline Hypertension month (1)

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Pet of the month – May – Pepper

by admin on May 1st, 2018

Category: Pet of the Month, Tags:

Pepper is Pet of the Month for May. She is a rescue dog with a chequered past who has recently found a good home. Her new owner is making good progress dealing with her separation anxiety.

Separation anxiety and behavioural problems can occur in dogs when they are left home alone.

Dogs are social creatures that have evolved to live with humans. It  isn’t surprising therefore that unwanted behaviour sometimes occurs when a dog or puppy is left ‘home alone’. However, whilst it is often assumed that the problem behaviour is triggered by ‘separation anxiety’, this is not always the case. It is therefore very important that the reason for the unwanted behaviour is clearly identified for each individual.

What sort of problem behaviour is typically seen?
The most commonly reported separation problems in dogs are excessive barking or howling, eliminating indoors and damage to the house or its contents. Dogs may also show physical symptoms such as excessive salivation, or compulsive behaviours such as pacing or excessively licking themselves. Most start to show the problem behaviour as soon as the owner has left, but others may not do so for some time or may start to feel distressed as soon as they realise the owner is about to go out. They may then try to stop them leaving, perhaps by blocking their access to the door or – rarely – by becoming aggressive.

What causes separation anxiety or other problem behaviour when a dog is left alone?
Dogs may show unwanted behaviour when alone for a wide variety of reasons. For example elimination may be an involuntary reflex reaction due to separation anxiety. However, it may also occur because the dog isn’t properly house trained and so eliminates if he is caught short whilst the owner is out. It may be due to a urinary tract infection or another medical problem that makes the dog need to eliminate more often. In geriatric dogs it may be due to declining mental faculties resulting in confusion about when or where to eliminate.

Separation anxiety and other problem behaviour when a dog is home alone may occur for a wide variety of reasons
Destructive behaviour when left alone, such as when the dog scrabbles at a door or window, may be caused by the dog trying to follow the owner due to separation anxiety. Alternatively, the dog may chew out of boredom or may cause damage whilst trying to get to something he wants. It also isn’t uncommon for a dog to spend a happy afternoon raiding the cupboards and fridge when left alone in the kitchen, but to settle perfectly happily if left in a room where there is no access to food. This is more a case of ‘whilst the cat’s away….’ than emotional distress.

Vocalisation may also have multiple causes. Dogs vocalise to communicate and may howl or bark for prolonged periods due to separation anxiety. However, they are also likely to bark if someone approaches the property and they are trying to guard it. It therefore can’t always be assumed any barking or howling is triggered by emotional distress at being alone.

Even where the unwanted behaviour is triggered by emotional distress, this may arise for different reasons in different dogs. Some dogs appear to become overly attached to or dependant on their owner. These dogs seem genuinely distressed at being separated from them. In other cases the distress may be because the dog didn’t learn to feel comfortable being alone as a puppy. He may then become distressed the first time this happens, such as when a family member returns to work or a doggy (or feline) companion dies. Some may bark and scrabble at doors out of frustration because they want to accompany the owner on their adventure into the wide world outside. In a few cases the unwanted behaviour is triggered by something happening when the owner is out that makes the dog scared. This can then lead to the dog becoming fearful whenever they are alone in case it happens again.

How do we know what is causing the separation anxiety or other problem behaviour?
Finding the causes for separation anxiety (or other problem behaviour) requires a careful assessment of what is happening when the dog is both with people and alone. Video recordings of the dog’s behaviour when no-one is there can also be very revealing.

For example if a dog causes damage to doorways as soon as and every time the owner leaves, this is likely to be due to some kind of emotional distress. Observation of the behaviour will show if it is due to anxiety or frustration, and the dog’s history will reveal if it’s due to lack of familiarisation as a puppy or over attachment. If the behaviour doesn’t occur until much later, is directed to household contents and occurs in a young or under exercised dog, it is more likely to be boredom. If the behaviour is intermittent, video recordings may reveal certain triggers for the behaviour, such as when bins are collected in a dog with a phobia of lorries.

How can we prevent separation anxiety and other separation problems in dogs?
Most puppies can be familiarised to being home alone if they are taught to gradually accept this when they are very young. Other problem behaviours can be prevented by teaching your dog to prefer being outside when he wants to eliminate and making sure he has plenty of exercise, stimulation and companionship.

Top tips to help familiarise puppies to being home alone

  • Start by leaving when your puppy is tired, well fed and has just been out into the garden
  • Place your puppy in a safe area such as his crate or a puppy proofed area of the house
  • Give your puppy something engaging e.g. a new toy, or a food item such as a Kong with a small amount of food inside
  • Leave calmly but don’t sneak away – it is important that your puppy knows you have gone
  • Initially leave for just five minutes. Make sure you are somewhere your puppy cannot hear, see or smell you
  • Come back after the allotted time regardless of what is happening e.g. barking or whining
  • If your puppy is quiet he can be greeted immediately
  • If he is making noise ask him to ‘sit’, then give attention when he obeys. If he doesn’t yet know this command just wait for him to be quiet then greet him. Don’t ignore him for long periods as this is punishing
  • Repeat 3-4 times a day. He should quickly stop being concerned by you leaving and settle to his toy or food item
  • You can then start to increase how long he is left for. Start by increasing this by five minutes at a time, up to 30 minutes, then by 10 minutes at a time up to an hour. Each increment should be repeated 3 or 4 times. As the duration he is left for goes up the frequency can reduce
  • Even puppies that live with another dog must learn to be alone

How can we stop this behaviour?
If prevention hasn’t worked then the method of correction will depend on the cause. For example, if indoor elimination is due to a lack of house training this can be rectified by teaching the dog to prefer to be outside to eliminate using similar methods to those used with puppies. If the dog is being destructive due to boredom this may be helped with toys, improvements in overall exercise and stimulation or reducing the period of time the dog is left alone. However more complex problems may require a tailored treatment package developed specifically for your dog’s needs by a specialist in this area. If your pet is showing problem behaviour when left alone then discuss this with your vet. They will be able to rule out any underlying medical problems and, if necessary, refer you to a suitably qualified behaviour expert.

Pepper

 

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FELINE HYPERTENSION

by admin on May 1st, 2018

Category: News, Tags:

To encourage awareness of Feline Hypertension this month we are offering the owners of all cats over 8 years of age with no previous history of hypertension a FREE Screening test with one of our nurses.

Hypertension, or high blood pressure, usually occurs in cats secondary to other diseases. The most common diseases to cause high blood pressure in cats are chronic renal failure (kidney disease), hyperthyroidism and anemia. Cushing’s disease and certain forms of cancer can also cause high blood pressure.
Hypertension is a serious problem in the cat, as it can cause blindness and strokes, just as in people. The first symptom seen is usually sudden blindness from retinal detachment – the high blood pressure literally blows out the back of the eye. If retinal detachment is caught early, with prompt and aggressive drug treatment the retina will sometimes reattach itself at least partially, and some vision will be restored. Many cats, however, will be permanently blind as a result. Owners will sometimes notice the cat’s pupils are fixed and fully dilated, or only respond very slowly and sluggishly to light. This is an emergency situation which should be treated as soon as possible.

The other common symptom of untreated high blood pressure is bleeding into the brain. Cats may suddenly show signs of disorientation, circling around and around in one spot, or otherwise acting strange. Some cats will wander the house crying as if distressed.

Ideally, high blood pressure should be diagnosed and treated before the cat becomes blind or suffers brain damage. If your cat has been diagnosed with chronic renal failure, hyperthyroidism or anemia, a blood pressure check will probably be recommended as well.

Some cats with high blood pressure will have heart murmurs or abnormal heart rhythms. If your veterinarian picks up a heart murmur or arrhythmia in a cat, especially an older cat prone to kidney or thyroid disease, a blood pressure check will be recommended. We may also pick up on high blood pressure when we draw a blood sample – if the blood gushes into the syringe without our having to pull back on the
plunger, the cat’s blood pressure is probably very high.

About 65% of cats with chronic renal failure have some degree of hypertension. This is a serious problem because hypertension in turn worsens the kidney disease. It becomes a vicious cycle in which the high blood pressure worsens the kidney disease, which increases the blood pressure even more, which then worsens the kidney disease, etc. Any cat diagnosed with chronic renal disease should have a blood pressure check on a regular basis.

In cats with hyperthyroidism the hypertension is usually temporary. Once the thyroid disease is controlled with medication or radiation treatment, the blood pressure goes back down. Treatment for high blood pressure in this disease is usually only needed for a few weeks to months. Treatment is still important, however, to prevent blindness and brain damage.

Although blood pressure measuring is important to monitor, it can also be difficult to do accurately in cats. Most cats are stressed and nervous at the veterinary clinic, and some are hostile. Blood pressure readings will probably be higher than they would be if measured when the cat was at home in its own environment. If a cat is aggressive or terrified, readings may not be possible at all. We will advise you as to whether an accurate blood pressure reading is possible in your cat.

We try to make the experience as stress free as possible, in a quiet room. The measurement itself is painless, just as it is in humans, but the cat may be frightened by the procedure. The cat needs to be held still, and a Doppler monitor is used to get the measurement. The monitor makes a noise which may frighten to some cats. The feeling of the cuff on the leg also makes some cats nervous, as does being held.

The goal of treatment is to decrease the blood pressure gradually to avoid a sudden decrease in blood flow to the kidneys, which will make kidney disease worse. In cats with chronic renal failure and high blood pressure, the pressure should be rechecked every 3-7 days, depending on how good the first reading was. Once two good readings on two successive visits are obtained, the cat is considered stable on the medication. The blood pressure is then rechecked along with kidney blood testing about every three months. Drug treatment will be necessary for the rest of the cat’s life.

There are two medications commonly used to treat hypertension. Amlodipine is usually tried first. If the response is not adequate, we may switch to benazapril. Occasionally, a cat will need both amlodipine and benazapril to control the high blood pressure.

For cats with chronic renal failure but a normal first blood pressure check, rechecks are recommended every 6-12 months. Hypertension may show up later in the course of the disease, as kidney function gradually worsens with time. In cats recently diagnosed with hyperthyroidism, the blood pressure may be high. If affirmative we will prescribe a two to three week course of blood pressure medication for the cat while the thyroid level is coming down in response to treatment. Once the thyroid level is back in the normal range, the medication can usually be stopped.

Cats that have already suffered blindness or visual impairment from hypertension usually get around well in their own home with some modifications to the environment. Your cat may not be able to find its way to the basement litter tray any more but blind cats rarely stop using the tray as long as it is accessible to them. Be sure the food and water bowls are also accessible without climbing or jumping. Dabbing some perfume or cologne on table legs and doorways once a week at first with help your pet to smell where it’s going and makes navigation easier.

Be sure to call us if you have trouble administering your cat’s medication or you notice any change. We are always glad to help!

See website: http://www.amodeus.vet for further information

Blood pressure

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HOME MONITORING OF HEART FAILURE

by admin on April 3rd, 2018

Category: News, Tags:

This article provides key aspects of monitoring your pet with heart failure at home and explains the parameters to record. These need to be monitored frequently (daily) in the few weeks after initial diagnosis and commencement of medications, or at any time when things are unstable, such as a relapse or progression in symptoms. The frequency of recording can be less (weekly) when everything is stable and your pet is happy. You can record all of these using a diary or computer database. Remember to always bring your record back with you to every visit.

Sleeping Respiratory Rate (SRR)
This should be recorded when your pet has had a period of rest and is asleep. This might be by your feet or in bed. It is best to record this when your pet falls asleep when you are in the room, as opposed to going into the room where your pet is already asleep – as they usually wake up when you enter.
Breathing is often best seen when your pet is lying on the side and the chest and flank can be seen to rise and fall. A breath in and then out is recorded as one breath. The rate is given as the number of breaths in 1 minute.

Heart rate (HR) at rest:
This is more difficult to record, but it is possible to do and it provides very useful information. The heart rate when ‘in the vets’ is always somewhat elevated because of excitement or nervousness, so does not represent the real heart rate at home.
The heartbeat can be felt by placing your hand on the chest over the heart, just inside the ‘armpits’ on the left side, but can be either side of the chest. You could purchase a cheap stethoscope and learn to listen to the heart rate. Feeling the pulse in the leg does not always represent the heart rate, as some abnormal or weak heartbeats might not produce a palpable pulse, so we prefer that you do not use this method.
You could purchase a heart rate monitor, and whilst these are a little more expensive, over the course of your pet’s life, often represent good value for money. The rate is given as the number of heartbeats in 1 minute.

Weight
One of the effects of heart failure is the accumulation of excess fluid in the lungs (oedema), chest cavity (pleural fluid) or abdomen (ascites). One litre of fluid is equivalent to 1 kg in weight. Thus monitoring your pet’s body weight is a useful means to track the loss or gain in fluid accumulation.
We recommend weighing your pet weekly. It is often best to use the scales at your own vets for consistency and accuracy.

Appetite
Your pet’s appetite may reflect his/her well-being. It is a simple scoring system, comparing appetite to when your pet was well prior to this illness and is as follows:

Appetite Scores:

1 Ate hardly anything
2 Ate much less than normal
3 Ate a little less than normal
4 Normal
5 Ate very well

Exercise
Once any congestion has resolved with treatment, a return to some exercise is good for the well-being of your pet and for the circulation. The ability to exercise also reflects the ability of the heart to function and circulate blood, so it can be a useful indication of how well your pet is doing. Again this is a simple scoring system, comparing the ability to exercise to when your pet was well prior to this illness and is as follows:

Exercise Scores:

1 Can hardly exercise at all
2 Is exercising much less than normal
3 Is exercising a little less than normal
4 Normal
5 Exercises very well

Cough
Coughing is a common symptom in dogs (it is rare in cats). This can occur for a few reasons. One is that an enlarged heart presses on the windpipe, compressing it and this triggers a cough; it probably feels like something is stuck in the throat. Another is the accumulation of fluid in the lungs (oedema), this needs to be moderately severe to trig, of course,h. Then of course a dog (or cat) can be coughing secondary to various lung conditions such as bronchitis (or asthma in cats). Monitoring the frequency and severity of a cough can therefore be useful.

Cough Scores:

1 Very often, daily
2 Often, daily
3 Often, weekly
4 Occasionally, weekly
5 None

The Happiness Factor
This is a surprisingly useful overall score of how well your pet is. It is a simple scoring system, comparing how happy your pet is compared to when your pet was well, prior to this illness and is as follows:

Happiness Scores:

1 Very unhappy
2 Much less happy than normal
3 A little less happy than normal
4 Happy, back to normal
5 Really happy

AUSCULTATE DOG HEART

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