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Chronic Kidney Disease in Cats

by admin on May 1st, 2015

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Chronic Kidney Disease in Cats‘Chronic kidney disease’ (Part 1) is a term used to refer to cats with kidney insufficiency or failure. ‘Chronic’ simply means long term. ‘Insufficiency’ or ‘failure’ means that the kidneys are no longer able to adequately perform their normal tasks. ‘Chronic kidney failure’ refers to the situation where the kidneys have not been able to perform one or more of their normal tasks adequately for a period of time (months to even years). Because the word ‘failure’ evokes such a sense of doom, we often opt for the term ‘chronic renal insufficiency’ or ‘chronic kidney disease’ instead, as many cases can be treated successfully and can look forward to months or often years of quality life.

 

What do the kidneys do?

The kidneys perform many functions in the body, including:

  • helping to maintain fluid balance in the body
  • producing certain hormones which stimulate red blood cell production and activate Vitamin D
  • regulating blood pressure
  • regulating electrolyte balance
  • excreting waste products in the urine. Blood is constantly filtered through the kidneys to remove the toxic waste products of the body’s metabolism. Urine is produced in this process.
  • concentrating the urine by returning water to the body, preventing dehydration

Fortunately, there is considerable ‘reserve capacity’ in the kidneys. It is well recognised that in healthy animals and humans, it is possible to remove one kidney completely without any adverse consequences due to the capacity of the other kidney to take over normal function. In fact, two thirds to three quarters of the total functioning kidney tissue (of both kidneys) has to be lost before clinical signs of chronic kidney disease develop.

How common is chronic kidney disease in cats?

Chronic kidney disease can affect any cat, of any age, any sex, and any breed. It is most commonly seen in middle to old-aged cats (those over 7 years of age), and it becomes increasingly more common with advancing age. It has been estimated that around 20-50% of cats over 15 years of age will have some degree of chronic kidney disease and it is seen more frequently in cats than in dogs.

What causes chronic kidney disease?

Most cases of chronic kidney disease are considered ‘idiopathic’ (i.e. they have an unknown underlying cause). However, some causes are well known and recognised, including:

  •  Polycystic Kidney Disease (an inherited disease in Persians/Persian lines where cysts replace normal kidney tissue)
  • infections (also called ‘pyelonephritis’, from infection from the bladder or bacteria from blood stream, or the disease Feline Infectious Peritonitis)
  • toxins (e.g. antifreeze, certain drugs)
  • tumours (e.g. kidney lymphoma)

Other conditions can also gradually affect the kidneys from birth (‘congenital’ defects). Trauma, hypokalaemia (low blood potassium), and hypercalcaemia (high blood calcium) can also be contributory causes of chronic kidney disease in cats.

Intensive research is still on-going in attempt to uncover the underlying cause(s) of most cases of this disease.

If an underlying cause can be identified, this is often treated in an attempt to slow the progression of ongoing and irreversible damage to the kidneys. In most cases however, treatment is usually directed at management of the disease and the complications which arise from it.

What are the clinical signs of chronic kidney disease in cats?

‘Azotemia’ is a condition where toxins have built up in the bloodstream and can be detected on blood tests. The term ‘uraemia’ means that the patient is experiencing symptoms of poisoning from the build-up of these products in the blood stream.

Many other signs of chronic kidney disease are considered vague and non-specific—some arise from the accumulation of toxins in the blood system whilst others arise as complications from the body trying to ‘stabilise’ the disease.

Clinical signs include:

  • weight loss
  • poor, unkempt hair coat
  • excessive drinking
  • excessive urination
  • nausea
  • loss of appetite
  • anaemia
  • lethargy
  • bad smelling breath (halitosis)
  • high blood pressure
  • (sometimes) calcification of soft tissue

How will my vet diagnose chronic kidney disease?

A diagnosis of chronic kidney disease is usually made by collecting both a blood and urine sample at the same time. There are two substances in the blood – urea and creatinine – which are commonly measured, as these are by-products of metabolism that are normally excreted by the kidneys. In chronic kidney disease, the blood concentration of these two products will increase to varying levels. There are other conditions which can also cause elevation of these substances (e.g. dehydration) and hence why a urine sample is usually assessed at the same time to assess the concentrating ability of the kidneys. Typically with chronic kidney disease, there will be increased urea and creatinine concentrations as well as poorly concentrated urine. The urine ‘specific gravity’ is a measurement of urine concentration.

Furthermore, screening blood tests may also highlight important complications which may have developed as a result of chronic kidney disease such as hypokalaemia (low blood potassium), anaemia, and hyperphosphataemia (high blood phosphate). High blood pressure is a common complication of chronic kidney disease in cats and if uncontrolled, can worsen the kidney disease. Therefore, your vet will usually want to measure your cat’s blood pressure if there are any concerns about kidney disease. Depending on the case, your vet may want to perform additional tests such as total thyroid, urine culture (to rule out kidney infection), urine protein creatinine ratio to assess if there is significant protein loss in the urine which can contribute to the progression of kidney disease, and ultrasonography to rule out kidney or ureteral stones/cysts/masses.

If there are signs of kidney disease, your vet will attempt to ‘stage’ the disease on a scale of 1-4 (‘IRIS Staging’) depending on creatinine values, urine protein to creatinine value, and blood pressure measurements, in order to facilitate treatment and monitoring of the patient and progression of disease.

Early diagnosis of chronic kidney disease in cats

Because chronic kidney disease is such a common disease in cats, routine screening of all mature and older cats (over 7 years old) can assist with early diagnosis and intervention, which in turn, may slow down the progression of disease and prolong a good quality of life. Yearly or twice yearly routine veterinary examinations are extremely important in older cats. During these examinations, your vet will check a urine sample and record your cat’s body weight. A declining urine concentration or body weight may be early signs that chronic kidney disease is developing and that further investigations should be explored.

How do you treat chronic kidney disease in cats?

It has been estimated that around 20-50% of cats over 15 years of age will have some degree of chronic kidney disease. As we spoke about above, ‘uraemia’ means that the patient is experiencing symptoms of poisoning from the build-up of toxins in the bloodstream due to the kidney disease. Our goal in treatment is to slow the progression of irreversible disease and prevent uraemic episodes which can make a cat feel unwell. Although chronic kidney disease is not a curable or reversible disease, appropriate support and treatment can both increase the quality of life, and prolong life by slowing down the progression of the disease.

The goal in early stage kidney disease patients is to postpone or even fully prevent the development of uraemia. The goal in patients in the later stages of chronic kidney disease is to resolve the uraemia and bring the patient back to an earlier stage of disease.

If a specific cause for the chronic kidney disease is identified (eg, bacterial infection of the kidneys), treatment is prescribed (e.g. antibiotics) to arrest the progression of the disease. In most cases, however, treatment is aimed at reducing the symptoms of the disease. Many cats will need to initially be put on a drip (this is known as ‘intravenous fluid therapy’) to correct dehydration and eliminate the excessive build up of toxins in the blood (similar to dialysis in humans). Once stable, treatment goals are aimed at supporting kidney function and minimising the complications of chronic kidney disease, such as the development of uraemic episodes. Despite therapy, chronic kidney disease is considered irreversible and will eventually progress over time.

Optimal management of chronic kidney disease usually requires regular monitoring by your vet, including weight checks, blood and urine tests, and blood pressure assessment, to identify any treatable complications as they arise (eg, anaemia, low potassium, high phosphate levels, urinary tract infections, and high blood pressure).

Dietary management of chronic kidney disease in cats

Cats with chronic kidney disease are more likely to become dehydrated (due to the reduced ability of the kidneys to conserve water). Maintaining a good fluid intake is therefore very important, and may help to slow progression of the disease. As cats obtain much of their water intake from their food, whenever possible, cats with chronic kidney disease should be fed tinned (or sachet) foods rather than dry foods.

An ideal diet for a cat with renal failure is a diet low in phosphate and lower in protein compared to maintenance cat diets. Saying that, protein restriction must be performed with care as too much protein restriction can be extremely detrimental to the general health of the cat. This will result in the body breaking down its own muscle to satisfy requirements, resulting in significant weight loss/poor condition and can worsen kidney disease.

Low phosphate content

Restricting the phosphate content of the diet appears very beneficial in protecting the kidneys from further damage in cats with chronic kidney disease. While restricting protein in the diet helps maintain quality of life, restricting phosphate thus appears to prolong the life of cats with chronic kidney disease. If blood phosphate concentrations remain high despite being on a low phosphate diet, further treatment with drugs known as ‘phosphate binders’, which reduce the amount of phosphate absorbed from the intestine, may also be indicated.

Other dietary measures

Other aspects of the diet may also have an important role to play in helping manage cats with chronic kidney disease. These include:

  •  the addition of anti-oxidants to try to protect the kidneys against further damage
  • essential fatty acids to help maintain blood flow through the kidneys and reduce inflammation
  • added potassium to prevent hypokalaemia (low blood potassium)

Managing the change to a new diet

Cats will often develop a strong preference for particular diets. Lower protein diets can be less palatable and therefore changing a cat’s diet with the appropriate therapeutic diet can be challenging. These tips may help:

  1. Always make gradual changes over a period of 1-2 weeks, especially if your cat is considered ‘fussy’
  2. Only increase the amount of the new food once your cat is happy to eat the old mixture
  3. Warming the food to body temperature may help increase the palatability and stimulate appetite with the released aroma

In most cases, with sufficient care and time, cats can be very successfully transitioned to a new diet, and as this is such an important part of managing chronic kidney disease it is worth taking the time to do this properly.

If cats absolutely refuse to eat any of a new diet, it is important that they eat something, so keep offering their old diet in this situation and contact your vet for further advice.

Managing dehydration

Using a wet rather than a dry diet is important to increase water intake in cats with chronic kidney disease. However, they sometimes still do not consume enough water to compensate for what is being lost in the urine. In these cases, make sure a good supply of fresh water is always available, and cats should be encouraged to drink by offering several watering stations around the house (pint glasses filled with water are always useful!). Using flavoured waters (chicken, tuna spring water – not brine!) or water fountains can encourage drinking. Using intermittent intravenous fluid therapy at your vet clinic may be required every few months. Your vet can also teach you how to administer intermittent subcutaneous fluid therapy in the home environment.

Phosphate binders

If, despite using a low phosphate diet, blood phosphate levels remain high, using a phosphate binder added to the diet may be required. This is important, as controlling blood phosphate levels appears to have a good protective effect on the kidneys in cats with chronic kidney disease.

Potassium supplementation

Some cats with chronic kidney disease will also develop low blood potassium levels. This can cause muscle weakness, can contribute to poor appetite and itself can worsen chronic kidney disease. Where this is identified, potassium supplementation (usually in the form of tablets, gel or powder added to the diet) would be required.

Controlling blood pressure

Cats with chronic kidney disease are at risk of developing high blood pressure and this can have a number of damaging effects including acute blindness/blood accumulation in eyes, strain on heart muscle, and worsening of the kidney disease. Blood pressure should ideally be monitored in all cats with chronic kidney disease and can be treated with medication if diagnosed.

Treatment of anaemia

In advanced chronic kidney disease, anaemia can be quite common and is due to the lack of production of a hormone by the kidneys called erythropoeitin. This hormone stimulates the bone marrow to make red blood cells. Anaemia can also result from blood loss from the intestines due to the effects of toxins on the stomach lining. Severe anaemia may lead to lethargy and weakness and result in poor quality of life. Depending on the underlying cause, and severity, a variety of options may be available to alleviate the effects of anemia including iron supplementation, management of stomach ulceration, and the administration of erythropoietin to stimulate the bone marrow.

Treatment of nausea and vomiting

Nausea and vomiting are more common in advanced chronic kidney disease and can cause poor appetite and significantly affect a cat’s quality of life. Various drugs can be used to control these signs.

Use of ‘ACE inhibitors’ and ARBs (Angiotensin Receptor Blockers)

Blocking the activation of a hormone known as ‘angiotensin’ may be of benefit in chronic kidney disease in cats. This can be achieved by using so called ‘ACE-inhibitors’ (angiotensin converting enzyme inhibitors), or using angiotensin receptor blockers (ARBs).

Drugs such as ACE-inhibitors and angiotensin receptor blockers can benefit cats with chronic kidney disease by dilating blood vessels and supporting blood flow through the kidneys, lowering blood pressure, and also significantly reducing protein loss through the kidneys which can lead to the progression of disease, and so potentially improve survival in these patients.

What is the prognosis for cats with chronic kidney disease?

Because chronic kidney disease is usually progressive over time, it will eventually lead to the need for euthanasia once it has reached ‘end stage’ with recurrent uraemic episodes. However, the rate of progression of kidney disease will vary considerably between individual cats. With appropriate support and treatment, quality of life can be improved and progression of the disease slowed down. Therefore the long term prognosis will greatly depend on the stage/severity of the disease and the underlying cause in each individual patient and your vet will be able to discuss this with you.

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Disc Disease in Dogs

by on April 2nd, 2015

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DachshundDachshunds and similar breeds such Pekingese, Lhasa Apsos and Shih Tzus, have short legs and a relatively long back. These breeds suffer from a condition called ‘chondrodystropic dwarfism’. As a result they can be prone to back problems, more specifically disc disease.

 

What are intervertebral discs?
The intervertebral disc is a structure that sits between the bones in the back (the vertebra) and acts as a shock absorber. The structure of a disc is a little like a jam doughnut with a tough fibrous outer layer (annulus fibrosus) like the dough, and a liquid/jelly inner layer (nucleus pulposus) like the jam.

 

In chondrodystrophoid breeds like dachshunds, the discs undergo change where the nucleus pulposus changes from a jelly-like substance into cartilage. Sometimes the cartilage can mineralise and become more like bone and show up on an x-ray. In these breeds, this change occurs in all discs from approximately one year of age and is considered part of usual development for these dogs. This change in the discs is a degenerative process and predisposes the disc to disease.

 

The most common type of disc disease in dachshunds and other chondrodystrophoid breeds is ‘extrusion’. This is where the annulus fibrosus ruptures and allows the leakage of the nucleus pulposus into the spinal canal. An analogy we often use is the jam leaking from a jam doughnut when it is squeezed.

 

What are the signs of disc disease in dachshunds and other breeds?
The first evidence that there might be a problem is that your dog may be in pain. This may consist of yelping and/or a hunched back and more subtle signs such as quietness and inappetence (lack of appetite). Back pain is commonly mistaken for abdominal pain.

 

After pain there may be mobility problems. The first thing to occur is wobbliness of the hind limbs – termed ‘ataxia’. After this, weakness can develop with the wobbliness, which is termed paresis. Subsequently, the patient may lose control of the back legs altogether and not be able to walk. If there is no movement in the hind limbs this is ‘paralysis’.

 

Will my dog need to be referred to a specialist?
Spinal disease can sometimes be difficult to manage and your dog may be referred to a specialist. At the referral clinic, your dog will be assessed by the specialist neurologist or neurosurgeon. They will test various reflexes to decide where they think the issue may be. They will perform a clinical examination which will assess for other disease processes and look for any areas of pain. One thing that is important to assess is the presence of pain sensation. We call this ‘deep pain sensation’. To assess this, the specialist will pinch your dog’s toes, usually with fingers initially but it may need to be with forceps. This is not a pleasant test to perform but it is necessary as the presence of deep pain comes with a more favourable prognosis. The loss of deep pain sensation means the prognosis is worse and without surgery is considered very poor.

 

What investigations will be performed?
After the clinical examination, we will generally have a good idea where the problem is and the next step is to confirm the diagnosis. The best way of diagnosing disc disease is with MRI (magnetic resonance imaging) or CT (computed tomography). With MRI we get detailed information about the soft tissue such as the disc itself and the spinal cord. Computed tomography uses the same technology as x-ray and provides good information about the bone and mineral structures and can tell us where the lesion is and whether or not surgery is indicated.

 

How is disc extrusion treated?
If a disc extrusion – the ‘jam out of the doughnut’ scenario – is diagnosed then we can opt for conservative care or surgical management.

 

Conservative care is a non-surgical management and can be considered in dogs where the signs are mild or intermittent and when there is only mild compression of the spinal cord. It can also be considered if there are concerns regarding the cost of surgery.
Surgical treatment involves making a window through the bone structures of the vertebra, into the spinal canal, a procedure called a ‘hemilaminectomy’. Once into the spinal canal, the disc material (nucleus pulposus) is removed and the spinal cord is decompressed. Surgical treatment tends to give a speedier and more predictable recovery and is often considered the treatment of choice, where indicated.

 

What is the prognosis for a dog with disc disease?
When dealing with spinal injury, particularly from disc disease, we aim for patients to achieve a functional recovery. This means the patient is pain free, is able to get around on their own (although they may still be wobbly) and able to toilet themselves unaided. Whether a patient will return to normal or whether there will be residual deficits is down to the individual.

 

The prognosis for patients who have intact deep pain sensation is favourable, with most patients (80-90%) achieving a functional recovery. In patients without deep pain sensation, the prognosis is guarded, with only 50% of cases achieving a functional recovery but without surgery the prognosis for a functional recovery is approximately 5%.

 

Surgery tends to speed recovery and aid early pain control. We expect most patients to recover within the first 2 weeks after surgery, with a smaller number of patients taking longer (2-6 weeks). If there is no improvement after 6 weeks the prognosis becomes more uncertain and long term disability may be present. This occurs in approximately 1 in 10 patients.

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Inappropriate Urination in Cats

by on March 5th, 2015

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Cat faceUrination in cats – when does it become a problem?

Urination is a very natural and necessary behaviour for cats as it is for humans, but, according to the Association of Pet Behaviour Counsellors analysis of feline behaviour problems, 55% of cases in 2012 were due to urination on vertical and horizontal surfaces. So why does a natural and necessary behaviour in cats become such a problem for humans and when does it become a problem for the cats themselves?
 
My cat has started urinating in inappropriate places. What can I do?

A cat will relieve itself by squatting and urinating usually onto loose earth or into litter trays and it generally causes little concern. However, it may become a concern to you if your cat begins to empty its bladder in the soil surrounding the Yucca plant, on a newly washed duvet or into that handy hole in the bath or sink. For your cat this is natural behaviour, as the earth around the Yucca is no different to the earth in the garden and it is a bit chilly out there at this time of year! The fluffy duvet feels squishy beneath the paws and your cat might simply associate that squishy feeling with the relief of going to the toilet and can’t help itself. The sink and bath have a very handy hole for the urine to drain away into, thus keeping the paws dry and it does have that familiar smell of urine about the place.
In these scenarios it is more of an issue for you. However, if you started to stalk your cat every time they began to look for a place to urinate and were armed with a water pistol, then this is likely to cause an increase in stress for your cat and may result in an increase in urination. One way to address this would be to simply encourage your cat to urinate in more appropriate places, such as offering extra litter trays and a specific dug over area in the garden.

If on the other hand, your cat’s normal behaviour changes and they suddenly begin to urinate inside the house, or are no longer using their litter tray, then you need to understand why. The first stop is a trip to your vets to check for underlying medical reasons such as Feline Lower Urinary Tract Disease; a term used to describe the many conditions that affect the lower urinary tract of cats, so that this is ruled out or treated.

If your cat has been given the all clear, or has been successfully treated but still continues to urinate in areas you feel are unusual, then you may be referred to a clinical companion animal behaviourist.

There are many reasons that cause changes in urination behaviour such as…

  • The perceived threat of a neighbouring cat
  • The appearance and stress of a newly introduced kitten or human baby
  • Negative associations with the litter tray
  • The pain of urination
  • A change in litter type
Even when these stressors have been addressed, your cat may continue to use these areas due to habit and the lure of the lingering smell of urine. The behaviourist will work with you and your vet to establish the underlying reasons for the change and discuss ways to help modify your cat’s behaviour and reduce any related stress.

My cat has started spraying in the house. Why is this and what can I do?

The same goes for urinating onto vertical surfaces (spraying). Spraying is a normal behaviour used in scent signalling by both entire and neutered male and female cats. Your cat will back up to a chosen vertical surface, raise their hindquarters and squirt a small amount of urine, usually accompanied by a quiver of the tail. As with bladder urination, this is generally a normal behaviour for a cat but may become an issue for you, especially if you are a fastidious gardener, if your cat begins to spray against the box hedge topiary causing it to turn brown or the paint begins to peel off the picket fence! But when does it become an issue for your cat?

If your cat suddenly and out of character begins to spray closer to or within the home area, it may be an indication that your cat is feeling anxious. Has a new cat moved into the area? Are the neighbours building a new extension? Have you just brought home a new puppy, kitten or baby? A visit to your vets is vital so that he/she can consider all the potential causes and eliminate serious medical conditions that may appear similiar but require urgent and quite different therapy. A referral to a clinical companion animal behaviourist may be advised and they will work with you and your vet to understand why your cat may be feeling anxious and suggest ways to help them cope better.

Thus, a sudden change in the frequency and placement of normal cat urination and spraying is a likely indication that something may have changed emotionally for your cat.

Any use of aversive techniques such as spraying your cat with water or getting cross and stalking it around the house is only going to make things worse and may cause further problems, so seek help from your vet as soon as possible.

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Head Tilt in Dogs

by on January 30th, 2015

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Dog Head TiltWhat Does it Mean if My Dog has a Head Tilt?

A persistent head tilt is a sign of a balance (vestibular) centre problem in dogs. It is very similar to ‘vertigo’ in people and is often accompanied by a ‘drunken’ walk and involuntary eye movements, either side to side or up and down.
The feeling that the room is spinning due to the eye movements is what causes a feeling of nausea in both people and dogs. The signs may not be as severe as mentioned here and can just consist of a mild head tilt. Signs often seen associated with a head tilt but unassociated with balance abnormalities include a facial ‘droop’ and deafness.
Causes of a head tilt
A head tilt represents a disorder of the balance centre. However, the balance centre resides in the inner bony portion of the ear as well as the brain. So a head tilt could represent a simple ear problem or a very serious brain disease.
Ear problems which are responsible for head tilts include:
  • Infections
  • Polyps
  • Reactions to topical drops or solutions if the ear drum is damaged
  • Hits to the head
  • (Occasionally) ear tumours
  • (Rarely) a genetic abnormality affecting puppies, especially those of the Doberman breed
  • Idiopathic vestibular disease

 

The most common cause, is what is called idiopathic vestibular disease. There is no known cause of this disease, a variant of which is also seen in people. The signs can start very suddenly and be accompanied by vomiting in severe cases. This condition, however, will resolve given time without any specific treatment.
Brain diseases responsible for balance centre dysfunction can include:
  • Tumours
  • Trauma
  • Inflammation
  • Stroke
  • Rarely, similar signs can be seen in dogs that are receiving a specific antibiotic called metronidazole. Recovery will often take place within days of stopping this medication.

 

Clinical signs of vestibular disease – is it the ear or is it the brain?
In addition to a head tilt, signs of vestibular disease (balance centre dysfunction) include ataxia (a drunken, falling gait) and nystagmus (involuntary eye movements). There are several signs to look for which help separate out whether the origin of the disease is inner ear or brainstem (central nervous system – CNS).

Central nervous system localisation will often be associated with weakness on one side of the body that can manifest as ‘scuffing’ or even dragging of the legs, in addition to lethargy, and sometimes problems eating and swallowing, or loss of muscle over the head.

A balance problem associated with an inner ear disease is not likely to be associated with any of these signs. However, some dogs will exhibit a droopy face and a small pupil on the same side as the head tilt.

Tests recommended for a dog with a head tilt
Evaluation of an animal with a head tilt includes physical and neurologic examinations, routine laboratory tests, and sometimes x-rays. Your veterinary surgeon may carry out a thorough inspection of the ear canal, which may require sedation of your dog – this can be useful to rule out obvious growths or infections. Additional tests may be recommended based on the results of these tests or if a metabolic or toxic cause is suspected. Identification of specific brain disorders requires imaging of the brain, such as magnetic resonance imaging (MRI). Collection and examination of cerebrospinal fluid, which surrounds the brain, is often helpful in the diagnosis of certain inflammations or infections of the brain.

How do we treat head tilt in dogs
Treatment for vestibular dysfunction will focus on the underlying cause once a specific diagnosis has been made. Supportive care consists of administering drugs to reduce associated nausea and or vomiting. Travel sickness drugs can be very effective. These must only be given following advice from your veterinary surgeon. Protected activity rather than restricted activity should be encouraged as this will potentially speed the improvement of the balance issues.

Outlook (prognosis) for head tilt in dogs
The prognosis depends on the underlying cause. The prognosis is good if the underlying disease can be resolved and guarded if it cannot be treated. The prognosis for animals with idiopathic vestibular disease is usually good, because the clinical signs can improve within a couple of months.

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Winter Coughs – Be prepared

by on January 5th, 2015

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Coughing Dog

We have seen a surprising number of coughing dogs over the last few weeks all caused by a contagious form of  infectious tracheobronchitis otherwise know as Kennel Cough – an unfortunate name as you do not need to be in kennels to catch it!

These infectious coughs, very similar to what we can catch, are caused by a strain of doggy flu (parainfluenza) and a bacteria called Bordetella bronchiseptica working together.

This infection can be vaccinated against with a few droplets up a nostril. This vaccination needs boosting annually to keep protection as high as possible.

Kennel cough usually presents as a harsh honking cough, often with the poor dog retching at the end.  This is due to coughing with such force that the windpipe collapses trigging the gag reflex.  Understandably many people worry that their dog initially is choking with something stuck in their throats.

These germs are extremely contagious, every time a dog coughs it releases thousands of infectious droplets which can survive in the environment and even on our clothes!  Infected dogs should be rested and isolated until the cough has gone. This can mean your dog is not allowed to go for a walk for some weeks!

Just like our human flu vaccinations, kennel cough vaccines can never give 100% protection but will often manage to reduce the severity of signs and duration of signs if any new strains emerge.

If  your dog is walked in busy parks or is likely to be mixing with other dogs, either in kennels or with a dog walker, we would definitely recommend vaccinating against Kennel Cough. As always if you are at all worried about your dog or not sure of his/her vaccination status then please contact the surgery for advice.

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Dry Eye

by on December 3rd, 2014

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DRY EYE
What is Dry Eye?

Keratoconjunctivitis sicca (KCS), commonly referred to as “Dry Eye”, is one of the most common dog eye problems. Dry Eye affects 1 in every 22 dogs.

Dry Eye is caused by destruction of the tear glands by the dog’s immune system. This means that too few natural tears are produced. Damage to the tear glands is irreversible. If left untreated, eventually the tear glands are completely destroyed and the dog loses the ability to produce tears. Dry Eye is a painful condition, and ultimately leads to permanent blindness.

Natural tears have many important functions which are lost in Dry Eye: they carry vital nutrients and oxygen, lubricate and cleanse the eye, and help protect against infection. Without tears, the eye becomes very dry and uncomfortable. Conjunctivitis, eye infections and ulcers become more common and discharge may be seen from the eyes. New blood vessels start to grow on the surface of the eye and dark pigmentation may develop. Eventually these changes lead to permanent blindness. It is very important to diagnose Dry Eye early, before these undesirable changes become severe and much of the tear tissue is destroyed.

It is important to recognize that in the vast majority of cases, Dry Eye is a lifelong condition and requires lifelong treatment. If not treated correctly, the dog will experience discomfort and the disease will affect its sight and welfare long term.

Dry Eye has a very variable appearance, so it is not possible to diagnose the condition just by looking at it. Fortunately there is a quick and simple test to diagnose Dry Eye, and with correct treatment the condition can be managed successfully long term.

Dry eye can affect all breeds at any age, so it is important to be aware of the signs to look out for.

Signs of Dry Eye

The appearance of Dry Eye can be quite varied and subtle, especially early in the disease. It is better for the health of the dog’s eyes to pick up the problem early, so that more tear tissue remains and fewer abnormal changes to the eyes develop. The earlier the problem is diagnosed and treated, the better the long term outlook for the dog’s eyes.

We recommend testing virtually all sore eyes for Dry Eye, to make sure the condition is diagnosed as early as possible.

If your dog has any of the following signs, you should make an appointment with your veterinarian. Remember to tell your veterinarian if your dog has experienced any previous eye problems.

Signs to look out for

  • Uncomfortable eyes – your dog may blink excessively, rub its eyes or try to keep its eyes closed
  • Eyes red and inflamed
  • Discharge from the eyes
  • Dry looking eyes
  • Frequent conjunctivitis, eye infections or corneal ulcers
  • Dark pigment on the surface of the eyes
  • Prominent blood vessels on the surface of the eyes

As dogs with Dry Eye are prone to getting eye infections and conjunctivitis, we recommend testing for Dry Eye in all dogs that have had more than one eye infection in any 12-month period. Otherwise, Dry Eye could be missed and the dog only treated for the infection, and not the ongoing underlying problem.

Diagnosing Dry Eye

Diagnosis of Dry Eye is quick and simple – the test only takes 60 seconds. Your veterinarian probably already tests most dogs with eye problems as well as predisposed breeds routinely.

Your veterinarian measures tear production in dogs using a Schirmer tear test (STT). The STT involves placing a special strip of paper in the eye to assess tear production. Usually the tear production in both eyes is tested as the results are often quite different. The test will not cause your dog any discomfort and does not require sedation or anesthesia. The results of this test are available are immediately. The results of the test are interpreted along with other findings, such as clinical signs, to determine whether KCS is present. If your dog has Dry Eye, it is not producing sufficient tears and should be started on treatment immediately.

Breeds affected by Dry Eye

Dry Eye is very common – 1 in every 22 dogs are affected by this disease. However, in certain breeds, this figure is almost doubled. It is important to be aware that the eyes of some dogs affected by Dry Eye look quite normal, despite severely reduced tear production and destruction of the tear glands. The sooner Dry Eye is diagnosed and the correct treatment started, the better the long term outlook for the dog’s eyes. Dry Eye is also painful (a bit like having grit in your eyes) so prompt treatment will also improve the welfare of the dog.

Predisposed Breeds

All breeds of dogs can develop Dry Eye at any age, but some are more prone to the condition. Breeds of dog particularly susceptible to Dry Eye include:

English Cocker spaniel
West Highland White terrier
Cavalier King Charles spaniel
Shih-Tzu

Other breeds include the Yorkshire terrier, Bulldog, Pekingese, Pug and Lhasa Apso.

We recommend testing susceptible breeds regularly and many owners elect to have their dog tested during a routine appointment, such as for vaccination. This ensures that Dry Eye is picked up early and treatment started before too much tear gland tissue is destroyed.

Diagnosis of Dry Eye is quick and simple – the test only takes 60 seconds and involves placing a special strip of paper in the eye to assess tear production.

Call us today to make an appointment.

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Canine Prostate Awareness Month

by on October 31st, 2014

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Canine Prostate Awareness Month

Canine Prostate Awareness Month

 

Canine Prostate Awareness Month (CPAM) is an initiative to highlight the prevalence of Benign Prostatic Hyperplasia (BPH) in male dogs, and to encourage owners to check for and seek treatment for it. CPAM takes place during November – or ‘Movember’ as it has been called by those fundraising for human male prostate disease and testicular cancer.

 

More than 80% of entire male dogs over the age of five suffer from BPH, a painful condition which is often hidden.

 

CPAM aims to remind us that men are not the only ones to suffer from prostate disorders. It’s a well-supported initiative and, running it at a time when the media spotlight is already on the dangers of prostate cancer in men, means we can spread the message that owners should also be monitoring dogs for signs of prostate disease. The problem with BPH is that the majority of dogs suffer in silence. It is a painful condition that too often goes unnoticed until it reaches an advanced stage, where the owner notices blood in the urine or painful urination.

 

Clinical signs of Prostate disease include:

- Straining to pass faeces (due to size of prostate)

- Straining to pass urine/ no passage of urine

- Blood present in urine

- Stiff hind limb movement.

If you are concerned at all about your dog showing any of the above signs please contact the surgery to make an appointment.

 

Diagnosis and monitoring of BPH is carried out via blood tests and rectal palpation. Simple medical treatment can be administered, the effects of which can be seen within a week and last for six months.

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Fireworks – How can you help?

by on September 30th, 2014

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Firework stress affects almost 50% of dogs and many cats too.

 

Dog nose peeping outWith November fast approaching now is the time to take appropriate steps to alleviate a potentially distressing time for your pet.

Stress can manifest itself in many ways – some dogs will run around and vocalise; others even become destructive and may harm themselves. However, sometimes the signs of stress can be much more subtle. This is especially true for cats and they will often withdraw and hide, meaning that their stress is not easily recognised

 

The most important change that must be made is for you to change your behaviour. It is completely natural to want to reassure your pet when it is stressed however all this does is reinforce the unwanted behaviour and unfortunately makes matters worse.
If stress associated with fireworks is not dealt with, it often progresses to fear of other sounds like thunder and gunshots and eventually even every day noises such as car doors slamming. As a result we must address this problem promptly and effectively to improve the welfare of our pets.
Managing firework stress needs an approach to both the short and long-term issue. In the short term we must manage our pets on the night. Long term we need to change the feelings our pets associate with fireworks in order that they do not become stressed.

 

 

Short Term Management

 

Here are some useful tips to help your pet cope during the firework season:
* Provide a den or hiding place and ideally where your pet would normally seek refuge
* Muffle the sound of the fireworks and radio, television, close the curtains
* Keep your pet inside and close the cat flap and ensure you dog is not able to access the garden
* Do not fuss them, or tell them off, if they are stressed
* Reward quiet, calm behaviour
* Consider anxiety relieving products such as Adaptil, Feliway, Zylkene and KalmAid.  There are no known side effects with these products such as sedation or memory loss.  They can be used for both short and long-term management.

 

 

Long Term Management

 

Sound desensitisation is proven to address the underlying problem by altering your pet’s reaction to the stress-inducing noises. It works by exposing your pet to the scary sounds under controlled conditions whilst it is doing something enjoyable such as chewing a favourite toy or treat. This then breaks the negative association that your pet has learned with respect to fireworks and makes the association more positive.  The most common method uses CD’s which are played initially for a very short amount of time at low volume. The length of time and volume is gradually increased as your pet progresses through the programme.
Sound Desensitisation takes time (usually weeks to months) and you must be guided by your pet as to how quickly you can progress.

 

 

How do anxiety-relieving products help?

 

Zylkene is a novel natural product derived from milk protein, which has relaxing properties, and is proven to help manage stress in cats and dogs.
KalmAid contains L-Tryptophan which is an essential amino acid that affects production of serotonin. Serotonin has a calming and relaxing effect. L-theanine, another amino acid also has a calming effect.  Vitamin B1 is added as deficiency has been associated with nervous disorders.
Feliway is a synthetic copy of the natural feline facial pheromone, and creates a state of familiarity and security in the cat’s local environment.
Adaptil is a copy of a naturally released dog ‘appeasing pheromone’ that has a comforting and reassuring influence.
Please make an appointment to discuss your pet’s specific needs with us.

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Streptococcal Pneumonia in Dogs

by on September 1st, 2014

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An Emerging Respiratory Disease That Can KillPUPPY 22

 

The Canine Infectious Respiratory Disease (CIRD) Group at the Royal Veterinary College (RVC) are currently researching a bacterial disease that has been increasingly implicated in fatal cases of infectious pneumonia in dogs over the past five years. They are calling for dog owners and vets to recognise the signs of the potentially fatal disease Streptococcal pneumonia to ensure rapid treatment and contribute to research to reduce further spread.

The bacterial infection Streptococcus zooepidemicus causes a severe, bloody pneumonia in dogs, producing signs similar to those associated with toxic-shock syndrome in humans.

 

How is Streptococcus zooepidemicus transmitted?

 

The bacterium can be ‘carried’ by dogs in their upper respiratory tract (most likely their tonsils) without showing any symptoms of disease and it is likely that, as yet unknown, bacterial, host or environmental factors, possibly including an over-exuberant immune response to the bacteria, are responsible for the severe pneumonia observed in the worst cases. These ‘carrier’ dogs may be an important source of infection if introduced to new populations, especially in rehoming kennels where dog come and go all the time.

 

What are the signs of Streptococcal pneumonia in dogs?

 

Infected dogs develop the following signs:

Sudden-onset fever
Sneezing
Rapid, shallow breathing
Bloody discharges from the nose or mouth
Lethargy (tiredness)
Reluctance to eat

Some dogs may collapse, which indicates a developing septicaemia. In most cases this occurs within 12-24 hours of the onset of the first symptoms (which may be mistaken for classical ‘kennel cough’ caused by viruses). In a small proportion of cases, the disease has been known to be fatal to dogs within 24 hours of contracting the infection.

 

How likely is the disease to occur in pet dogs?

 

In most cases there seems to be a trigger-factor such as a significant stressful event, for example rehoming, strenuous activity such as a race, or preceding illness. Outbreaks are isolated and tend to occur where dogs mix in large groups. Although it is rarer in family pets, it is still important for owners to be aware of the symptoms, especially if they regularly visit kennels or go to events where animals gather. In the initial stages, signs are similar to those of the more common ‘kennel cough’, which occurs in similar environments. However, in Streptococcus zooepidemicus outbreaks, dogs quickly become seriously ill and show very severe signs. In contrast, most dogs with kennel cough will usually have a relatively mild illness and deaths are rare.

 

Can pneumonia caused by Streptococcus zooepidemicus be treated?

 

Treatment of Streptococcal pneumonia is often ineffective unless started rapidly following onset of the first symptoms and is currently based on a suspected diagnosis. If owners notice the sudden onset of a fever in their dog, accompanied by sneezing, nasal discharge which is often bloody, and their animal becoming lethargic, they are advised to seek veterinary help immediately. With prompt identification, medical treatment and supportive care, dogs can make a full recovery.

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Ten Unexpected Dangers

by on August 4th, 2014

Category: News, Tags:

pet safe toxinsThe most unexpected things around the home and garden can present a hazard to your pets. This week we look at ten unexpected dangers you might not have been aware of. Prevention is better than cure – if you can, always ensure that potential hazards are kept securely away from your animals, and take what steps you can to prevent exposure. If you suspect your pet may have eaten or encountered any of the hazards discussed in this newsletter, contact your vets straight away for advice and appropriate treatment; do this even if your pet seems completely well, as with many of these dangers, there can be a delay of hours to days before signs of illness become apparent. Starting treatment before the pet starts to appear unwell can significantly improve the odds of them making a full recovery.

 
 
Raisins
 
Raisins contain an as-yet unidentified substance which can in some cases cause acute renal (kidney) failure in dogs. And it’s not just raisins, but currants, sultanas, and even fresh grapes, too.
 
Raisins and grapes are a rather unusual poison, as some dogs seem to be able to eat them quite safely – whereas other dogs can develop life-threatening acute kidney failure; as few as four or five grapes are believed to have resulted in one dog’s death. The mechanism of the toxic effect is still unknown, and since there’s no way of really knowing whether your dog is going to be one of the unlucky ones, it’s best to make sure they never eat any kind of grapes, raisins, or other dried vine fruits – whether they’re raw, or prepared in cakes, puddings or other cooking. Christmas, with its proliferation of mince pies, Christmas pudding and other seasonal treats, is a particularly high risk time of year!
 
 
Painkillers
 
Just about all of us have a pack of Paracetamol, Ibuprofen, or Asprin somewhere around the house (and often in our handbags, too!). While they are freely available without prescription, and very widely used by people, all of these medicines (from a family known as the non-steroidal anti-inflammatory drugs) have the potential to cause illness in our pets, sometimes even after only a very tiny dose.
The toxic effects can vary quite widely depending on the drug taken, and the species of animal, and include the potential development of stomach ulcers, liver and kidney damage, and also abnormalities affecting the blood. Confusingly, these medicines are sometimes used intentionally in dogs and cats by veterinary surgeons – they can be very useful, powerful drugs, if used carefully and in appropriate patients. If you ever find a chewed up pill packet (whether it contained over the counter painkillers, or any other medication) contact your veterinary surgery ASAP for advice.
 
 
Cut flowers
 
All the parts of lily plants (including the pollen which is present on the stamens of lilies in cut flower arrangements) are highly poisonous to cats, with the potential to cause life threatening kidney failure. Cats can be harmed even as a result of swallowing pollen which has transferred to their fur while walking past flowering lilies, or from chewing leaves or flowers, either from flower arrangements, or from plants growing outdoors in gardens
Fortunately general awareness of this problem is now growing, and cut flower arrangements containing lilies – particularly those from larger retailers – are starting to carry warning labels. Plants and cut flowers from the Lilium and Hemerocallis species are most hazardous, though other lily-type flowers (including lily-of-the-valley) also present a variety of different toxic hazards.
 
 
Bread dough
 
Bread dough is an occasional cause of serious illness and can affect all species, though dogs, due to their tendencies to eat all kinds of things, are most often affected. Dough containing live yeasts will continue to ‘rise’ (that’s to say increase in volume) inside the dog’s stomach, which is at more or less a perfect temperature! Because of the elastic, springy nature of rising bread dough, it tends to stay in a large ball and is extremely difficult for the dog to vomit up or to pass further down the digestive tract.
As the ball of dough swells, it stretches the stomach wall, causing pain, and serious damage to the tissue as a result of the blood supply being compromised – very much as happens during the life-threatening condition GDV (gastric dilatation and volvulus, or ‘bloat’). As if this wasn’t bad enough, the yeasts also produce alcohol (ethanol) as a by-product of their fermentation, and this can be enough to cause symptoms of alcohol toxicosis. So, keen bakers among you, keep your rising dough and proving loaves safely out of reach of your pets!
 
 
Certain over-the-counter flea products
 
A number of over-the-counter flea spot-on products marketed for dogs in the UK and elsewhere in the world contain an active ingredient from the pyrethrin or pyrethroid family (most commonly ‘permethrin’). While these are generally well tolerated by dogs, the concentration of active ingredient in these products can potentially make for a lethal dose for a cat, whether the product itself is accidentally applied to the cat in error, or even due to cats snuggling up to recently treated dogs in the household and the product rubbing onto them.
Cats exposed to permethrin develop twitches and muscle tremors which can progress to epileptic-type fits if the drug passes into their brain and central nervous system in a high enough concentration. These seizures can sometimes be fatal. To be on the safe side, contact your veterinary surgery for advice on appropriate safe flea products for your whole household.
 
 
Needles & threads
 
Most cats just can’t resist string or thread, which is a habit that can get them into trouble! Playing can sometimes lead to biting and swallowing, and swallowing string (or sewing thread, knitting yarn, ribbon, tinsel…) can cause a very serious form of foreign body obstruction in the gastrointestinal tract, which can require extensive surgery to resolve, and can sadly sometimes lead to the death of the patient. Unfortunately, sometimes the threads that cats find have sewing needles on the end of them, which can complicate matters further, increasing the risk of gut perforation and problems associated with needle migration. Kittens, who are particularly inquisitive and playful, are especially at risk, so keep your needles and threads safely locked away!
 
 
Corn on the cob
 
Dogs seem to love to chew on these, and if they swallow a piece, corn cobs seem to be almost the perfect size to cause an obstruction in the intestines. Unlike some of the other unfortunate non-food items our dogs like to chew on and sometimes swallow, corn cobs are essentially invisible on x-ray, which can make the process of identifying and diagnosing the foreign body obstruction even more challenging than usual for veterinary staff.
Classic opportunities for dogs eating corn cobs are at summer family BBQs – other BBQ party hazards include cooked bones, and kebab sticks – and scavenging in bins. Yet another reason to ask visitors to your home not to feed your dogs tit-bits, and keep your kitchen waste secure until bin day!
 
 
Cement powder
 
Powdered cement and concrete, both before use, and the dust produced from cutting or grinding solid materials, can pose a serious hazard to fish and waterways. Cement powder is a strong alkali, and when added to water can raise the pH very substantially, exposing any animals in that water to the risk of what are, essentially, chemical burns. In addition, the fine powder easily clogs the gills of fish, and can suffocate them rapidly.
If you’re having building work (or there is some going on nearby) it’s really important to cover and protect both outdoor ponds and indoor fish tanks if there is any risk of cement or concrete debris contaminating them. And, since many surface water drains flush into waterways with minimal water treatment, anyone working with cement or concrete should avoid washing any wastes ‘away’ into surface drainage, as dilution does very little to reduce the hazard, and serious damage can be caused to river and lake ecosystems as a result of cement and concrete run-off.
 
 
Antifreeze
 
Vehicle antifreeze (ethylene glycol) can cause poisoning in all animals, but most commonly affects dogs and cats. Ethylene glycol tastes sweet, which is attractive to pets, and unfortunately vehicle antifreeze is often stored very insecurely in sheds and garages, and not cleared up carefully after accidental spills or leaks from car radiators. The lethal dose of undiluted antifreeze solution in a cat could be as little as a teaspoon.
Symptoms initially resemble drunkenness, with balance and movement abnormalities, and often vomiting. As the ethylene glycol is metabolised in the body, substances are created which cause serious and irreversible damage to the tissues of the kidneys, resulting in rapid kidney failure. Pets who have consumed antifreeze unfortunately often do not survive, but time is of the essence and the sooner treatment is started the better the odds. So check around your home, and any sheds, garages and outbuildings for antifreeze and make sure it is stored correctly, and if you ever suspect antifreeze poisoning in your pets, act fast.
 
 
Curtains
 
It is common, particularly in more expensive hand-made curtains, to use small weights, either in the corners of the bottom hem, or all along the bottom hem, to help the curtains hang nicely. These weights are still very often made of lead.
These little nuggets can look like an object of interest to small mammals – including rabbits – and pet birds, especially parrots with their inquisitive natures, to whom they resemble nuts or seeds. If swallowed, they can cause lead poisoning. The other common cause of accidental lead poisoning in small pets and birds is the use of previously painted wood to make hutches, runs, and similar structures – if this wood is old enough to have been treated with lead paint in the past, very little may be required to cause serious health problems.

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