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Pet of the Month – January 2017 – Sophia

by admin on January 3rd, 2017

Category: Pet of the Month, Tags:

Sophia Pug Pet of the month for January is Sophia, an 11-year-old Pug. She is seen here in post-op recovery having just had an ovariohysterectomy to treat a condition called pyometra.

Pyometra is an infection of the uterus (womb).  It is a common condition in older female dogs that have not been spayed but can occur in un-spayed dogs of any age.  Occasionally we see cases occurring in cats.

What causes pyometra?

Each time a female dog has a season (usually about twice a year) she undergoes all the hormonal changes associated with pregnancy – whether she becomes pregnant or not. The changes in the uterus that occur during each season making infection more likely with age.  A very common organism called E. coli, found in your dog’s faeces, usually causes the infection.  We most commonly see cases of pyometra in the 4-6week period after a heat.  Injections with some hormones to stop seasons or for the treatment of other conditions can also increase the risk of pyometra developing.

 

What are the signs of pyometra?

Pyometra is of course, only seen in females (since males do not have a uterus). It is more common in older females (above 6 years of age) but can be seen at any age. The signs usually develop around 6 weeks after the female has finished bleeding from her last season, but in some cases, the bitch appears to have a prolonged season.

 

Early signs that you may notice are that your dog is:

  • Licking her back end more than normal
  • Off colour
  • Off her food
  • Drinking more than normal  (and will probably urinate more)

 

These signs will progress and you may see:

  • Pus (yellow/red/brown discharge) from her vulva
  • She may have a swollen abdomen
  • Vomiting
  • Collapse

If left untreated signs will worsen to the point of dehydration, collapse and death from septic shock.

 

Diagnosis

Your vet will probably suspect your dog has a pyometra based on your description of the signs and from their examination of your pet.  They may suggest procedures such as ultrasound and blood tests confirm the diagnosis, rule out other possible causes and to check that your pet is well enough to undergo treatment.

 

Treatment

The treatment of choice for pyometra is surgery to remove the uterus as soon as possible.  The operation is essentially the same as a routine spay, however, there is more risk involved and a higher chance of complications when the operation is being carried out on a sick pet. Your dog will also be given intravenous fluids (a drip), antibiotics and pain relief.

Most dogs will make a full recovery after treatment for a pyometra if the condition is caught early.  Spaying your dog before she develops a pyometra will prevent this condition occurring.

We are delighted to report that Sophia has made a full recovery after surgery.

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Special Offer – January 2017 – Dental Offer

by admin on January 3rd, 2017

Category: Special Offers, Tags:

Dental Offer Jan 2017

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Special Offer – December 2016 – Arthritis Awareness Month

by admin on December 1st, 2016

Category: Special Offers, Tags:

Dec-16 Arthritis Awareness Month

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Pet of the Month – December 2016 – Smudgey

by admin on December 1st, 2016

Category: Pet of the Month, Tags:

Smudgey is giving us a reproving look from the depths of a buster collar that should prevent him removing his indwelling urinary catheter.

SMUDGEYThe catheter had to be placed under anaesthesia in an emergency procedure to relieve a potentially life-threatening condition called urethral obstruction.

Urethral obstruction is a problem that occurs almost exclusively in male cats. This is because the urethra of a male cat is much longer and much narrower than that of a female cat, and so is more susceptible to becoming blocked.

Urethral blockage is not a common condition, but when it occurs it is painful, the cat will be unable to urinate despite repeated efforts, and it is a life-threatening emergency as it can cause acute kidney failure and death within 2-3 days if not managed appropriately
 

What are the signs of urethral obstruction?

A cat with urethral obstruction will usually show:

  • Repeated attempts to urinate that are unproductive
  • Crying or discomfort when straining to urinate
  • Increased agitation, and there may be some vomiting

Depending on the underlying cause, you may also have noticed some other changes in your cat’s urinating behaviour over the preceding few days such as increased frequency of urination, straining, discomfort or even some blood in the urine.

Contact your vet immediately if you think your cat may have an obstructed urethra, as this is an emergency situation.
 

What causes urethral obstruction?

Several underlying conditions can cause obstruction of the narrow urethra of a male cat, including:

  • A ‘plug’ in the urethra – this is usually an accumulation of proteins, cells, crystals and debris in the bladder that accumulates and lodges in the urethra
  • A small stone (urolith) or an accumulation of very small stones – these form in the bladder but may become lodged in the urethra
  • Swelling and spasm of the urethra – during inflammation of the bladder and urethra, whatever the cause, the inflammation may cause swelling of the wall of the urethra which may contribute to blockage, and in a number of cases the inflammation and irritation causes the muscle around the urethra (the urethral sphincter muscle) to go into spasm – this too can cause obstruction if the cat is not able to relax the muscle.

 

How is urethral blockage managed?

If your cat’s urethra is blocked, the vet will need to relieve the obstruction quickly.

Blood tests may be important to see if there are any significant complications. In particular, cats with a blocked urethra may develop acute kidney failure and may develop very high blood potassium concentrations; these are life-threatening complications that should be checked when possible.

X-rays or ultrasound may be needed to help determine the underlying cause of the obstruction and to help determine the best treatment method.

Under anaesthesia a catheter is passed into the urethra (via the penis) so that fluids can be infused to help flush out the obstruction (or sometimes to push it back into the bladder). These procedures have to be done very carefully to avoid damaging the delicate lining of the urethra.

If the obstruction is caused by spasm of the urethral muscle, simply sedating or anaesthetising the cat may be sufficient to allow easy passage of a catheter into the bladder.
 

What happens after the obstruction is relieved?

Once the obstruction has been relieved, the vet will want to infuse a sterile saline solution into the bladder via the catheter so that all the blood and debris (that will inevitably be present in the bladder) can be washed out. This is usually repeated several times to remove as much debris as possible to reduce the chance of re-obstruction.

Once this has been done, the vet will decide whether the urinary catheter can be removed. If there has been a severe blockage, your vet may want to leave a catheter in for a few days (usually no more than 2-3 days) to ensure urine can be produced while treatment is commenced for the underlying disease and inflammation.
 

What other treatments are given?

Further treatment depends on the underlying cause of the obstruction, the severity of the obstruction, and what (if any) complications have arisen. Any damage to the kidneys may be completely reversible, but cats will often have to receive intravenous fluids for several days if the kidneys have been affected. In addition to intravenous fluids, other drugs commonly used to help manage cats include:

  • Other pain-killing (analgesic) drugs
  • Drugs to help relieve spasm of the urethra (spasmolytics)
  • Anti-inflammatory drugs to relieve the swelling in the urethra

 

Long-term management of the cat with urethral obstruction

In the short-term, while the initial swelling in the urethra settles down, cats may need to be on anti-inflammatory drugs, spasmolytics, and perhaps analgesics for several days and even up to a week or two.

Longer term, management is aimed at the underlying cause of the urethral obstruction. Cases associated with uroliths (stones in the urethra and bladder) will need to be managed with special diets to reduce the risk of their recurrence. Most cats with urethral spasm or urethral plugs are thought to have underlying feline idiopathic cystitis. These cats should be managed with painkillers and the aim of reducing stress.

If repeated episodes of obstruction occur despite appropriate management, in some cases a surgical operation can be performed (called perineal urethrostomy) to help open and widen the narrow end to the urethra. This should not be regarded as a first-line therapy though as it does not deal with the underlying cause, and the surgery can sometimes be associated with complications such as the risk of stricture formation and an increased risk of bacterial urinary tract infections.

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POISONS PUT LITTLEHAMPTON PETS IN PERIL

by admin on December 1st, 2016

Category: News, Tags:

Poisons put Littlehampton pets in peril, as 95% of vets report cases.

Fitzalan House Vets warn local pet owners to guard against poisonous perils after the British Veterinary Association’s (BVA) Voice of the Veterinary Profession survey showed 95%of South-East region companion animal vets had seen cases of toxic ingestion or other toxic incidents over the last year.

Across the UK, vets saw on average one cases of poisoning every month, with chocolate (89%), rat poison (78%) and grapes (60%) the most common poisons that vets had treated. Other poisons involved in the cases vets had seen included:

• Human non-steroidal anti-inflammatory drugs, such as high-dose aspirin (57%)
• Antifreeze (47%)
• Lilies (43%)
• Slug pellets (41%)
• Accidental overdose of prescribed veterinary medicines (34%)
• Inappropriate application of permethrin (flea treatment) (30%)
• Paracetamol (26%)
• Adder bites (21%)
• Mouldy food (10%)
• Detergent (10%)
• Blue green algae (8%)
• Other medicines, such as antidepressants or nicotine products (9%)
• Recreational drugs (4%)

Other less common cases involved xylitol poisoning from chewing gum, poisoning from wild mushrooms and fungi, as well as horse worming products ingested by dogs.

Vets know that sometimes owners can take every precaution and accidents still happen. If an owner suspects their pet may have ingested or come into contact with any harmful substance they should contact us immediately on 01903-713806 for advice.

BVA President Gudrun Ravetz said:
“These findings from BVA’s Voice of the Veterinary Profession survey show how common incidents of pet poisoning are and underline that owners must be vigilant especially with prying pets. The top five poisoning cases seen by vets include foods that are not toxic to humans but which pose a significant risk to pets such as dogs, like chocolate and grapes, alongside other toxic substances such as rat poison and antifreeze. Owners can take steps to avoid both perils – keep human food away from and out of reach of pets and make sure other toxic substances and medicines are kept securely locked away in pet-proof containers and cupboards.”

 

 'PET POISONS'

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Special Offer – November 2016 – Diabetes Awareness Month

by admin on November 3rd, 2016

Category: Special Offers, Tags:

Diabetes Awareness Month

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Pet of the Month – November 2016 – Bruce

by admin on November 3rd, 2016

Category: Pet of the Month, Tags:

Poor Bruce! This is not the first time our practice cat has featured in this newsletter. At present Bruce is suffering from pancreatitis and is in our hospital.

Pancreatitis in cats has two forms, acute and chronic, which are usually diagnosed by symptoms and by ruling out other diseases. There are diagnostic tests for pancreatitis, but they are not always accurate, they can be costly, and can be quite invasive for a definitive diagnosis. Pancreatitis can also predispose your cat to other disease processes.

The pancreas is an organ that makes two primary products – digestive enzymes and insulin. Normally the digestive enzymes are released in an inactive form and are not activated until they reach the intestinal tract. This is to prevent the enzymes that are designed to break down food from coming into contact with the delicate pancreatic tissue.

In pancreatitis, for reasons yet unknown to us, these digestive enzymes will become activated while they are still in the pancreas. This results in significant inflammation and irritation to the pancreatic tissue, which can also cascade to other surrounding tissues such as the liver and intestinal tract. This can lead to secondary bacterial infections in the pancreas.

If the activation of the digestive enzymes is significant enough, then your cat can develop acute pancreatitis which can range from mild to severe and life threatening. If the activation of the digestive enzymes remains mild and continues long term, then your cat may develop chronic pancreatitis, which can result in the development of scar tissue in the pancreas, and eventually pancreatic insufficiency and predisposition to diabetes. It has been estimated that 30% or more of cats have chronic pancreatitis, but many may never show symptoms.

 

Acute pancreatitis:

Symptoms - Every cat will have different symptoms, some may have several, and some may have only one.

  • Intense vomiting: Your cat may vomit multiple times over a period of hours or days, and may not be able to keep food down. This needs to be addressed quickly to prevent dehydration.
  • Pain: Your cat may be sitting in a hunched position with their head tucked, or not want to be picked up or touched. Acute pancreatitis is very painful in all mammals.
  • Anorexia:Your cat may be feeling intensely nauseous and painful, so it is unlikely that they will want to eat.
  • Lethargy: Your cat may be extremely tired and lethargic.
  • Diarrhoea: If your cat’s pancreas is so inflamed that it is not secreting digestive enzymes into the small intestine, then any food that your cat does eat may come out as diarrhoea with a very foul odour.

Diagnosis - With acute pancreatitis, we will need to begin treatment immediately. How we treat at this point will be based on the severity of the symptoms and blood sample results.

  • Blood tests: As well as general haematology and biochemistry tests there are pancreas specific tests such as fPLI – this stands for feline pancreatic lipase immunoreactivity which can be elevated in pancreatitis in cats. However, while a positive test can confirm a diagnosis of pancreatitis, a negative test does NOT rule it out. It is possible to have a false positive with this test. The accuracy of this test has been estimated to be between 50-80%. So, while we may use this test to try and confirm a diagnosis of pancreatitis, we will not use it to make an initial diagnosis.
  • Ultrasound: For an experienced ultrasonographer, this can be a good way to diagnose pancreatitis, by finding an enlarged, thickened pancreas on ultrasound. However, this requires a more advanced skill level of ultrasonagraphy than most general practitioners have.
  • Biopsy: This is considered the gold standard for a 99.9% accurate diagnosis. However, this requires exploratory abdominal surgery which is invasive to your already sick cat, and it can take 2-3 days to get the histopathology results, so we do not do this routinely.

Treatment - The goal of treatment for acute pancreatitis is to reduce your cat’s pain and nausea, stabilize any electrolyte abnormalities, treat any secondary infections, and reduce the inflammation until your cat is able to heal.

  • Pain management: This is one of the most important aspects of treating acute pancreatitis. Commonly used drugs are: Buprenorphine. This is a narcotic that has show to have excellent pain control in cats. This is our most common first line pain management for acute pancreatitis.
  • Nausea: We have several anti-nausea medications that we will use in cats with acute pancreatitis. Most commonly used is Cerenia (maropitant). This is a fairly new drug that has quickly become our first line of defense for nausea in cats. This drug not only reduces nausea and vomiting, but it also has anti-inflammatory and anti-pain properties.
  • Reducing gastric acid secretion in the stomach can help an already nauseated cat. We often use omeprazole.
  • Antibiotics: We may use antibiotics to treat any secondary infections.
  • Intravenous fluids: If your cat is having a hard time staying hydrated due to vomiting or not drinking, or if your cat has abnormal electrolytes, then we will start intravenous fluid therapy.
  • Syringe feeding: If is very important that you cat eats. If they are too nauseous to eat, we may syringe feed them a very bland diet or a prescription diet.

Possible long term effects: Acute pancreatitis can lead to destruction of a fair amount of pancreatic tissue. How much tissue is affected can determine what happens next. Some of the more common sequelae are:

  • Scar tissue: After the inflammation subsides, there is a chance of scar tissue developing in the healing process. As long as there is enough healthy tissue remaining, then your cat may never have any additional problems.
  • Chronic pancreatitis: This is what happens when your cat’s pancreas continues to have low grade chronic inflammation. This can result in regular vomiting and anorexia episodes.
  • Pancreatic insufficiency: When too much of your cat’s pancreas that makes digestive enzymes is destroyed, either by severe acute pancreatitis, or by chronic pancreatitis, eventually the pancreas will not be able to make enough enzymes to digest food. Your cat may then have large fluffy diarrhea and an increase in vomiting. This can be treated by giving your cat synthetic digestive enzymes.
  • Type I diabetes: When enough of your cat’s pancreas that makes insulin is destroyed, it will not be able to make enough insulin to counteract the glucose in the body. Your cat may then develop diabetes and will need to be started on insulin injections.

 

Chronic pancreatitis:

The symptoms of chronic pancreatitis are very similar to acute pancreatitis, but on a milder scale. A common pattern we will hear is that your cat will vomit several times a day for a few days, not want to eat, and may act uncomfortable and lethargic, and then a few days later, will be fine until the next episode. These symptoms can also be similar to inflammatory bowel disease, so we may ask you lots of questions about exactly what goes on with each episode, and frequency to try and distinguish between the two.

Diagnosis again is similar to acute pancreatitis, but it can be harder as the blood work will be more likely to look normal, fPLI will only be positive if there is significant inflammation, and ultrasound will be even harder to detect. There is a blood test available that will test for two pancreatic enzymes and two intestinal enzymes to try and differentiate between pancreatitis and inflammatory bowel disease, but if it is negative, it still doesn’t rule either one out for sure.

Treatment most commonly is symptomatic, with pain medications, antibiotics, and anti-nausea medications. For cats who do have routine flare ups of chronic pancreatitis, we may want to treat long term with Cerenia as a preventative. We have a few other preventative treatment options as well if Cerenia is not an option.

While pancreatitis is one of the more painful and potentially nauseating diseases we can see in cats, as you have just read above there are things we can do to decrease its effects and help your cat to feel better.

Bruce Pet of The Month

 

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Corneal Ulcers in Dogs and Cats

by admin on November 3rd, 2016

Category: News, Tags:

Corneal ulcers are defects of the ‘cornea’, the clear ‘window’ of the eye.

 

What is the cornea?

The cornea is a very special tissue that is completely transparent. In contrast to the skin, it lacks pigment and even blood vessels to maintain its transparency. The cornea is very rich with nerves, making it a very sensitive tissue. This is the reason why even small particles such as dust on the surface of the eye can be so uncomfortable.

The cornea is made of three layers:

  • a very thin outer layer (epithelium)
  • the thick middle layer (stroma)
  • a very thin inner layer (endothelium)

All three layers are important for the cornea to work. The outer layer or ‘epithelium’ can be thought of as a layer of cling film that forms the surface of the cornea and protects it from infections. It works as a shield to the eye. The thick middle layer or ‘stroma’ is what gives the cornea its strength and stability.

 

What are corneal ulcers?

Corneal ulcers are classified by the depth, depending on the layers they affect. Corneal Ulcer

If only the epithelium is missing this is classified as a ‘superficial ulcer’ or surface defect only. If the ulcer reaches into the stroma it is classified as a ‘deep ulcer’.
corneal ulcer

While superficial or surface ulcers are uncomfortable and present a risk of infection to the eye; the eye is not at risk of bursting unless additional problems occur. However when the ulcer gets deep the eye becomes weak and can even perforate. Deep ulcers lead to visible indentations on the surface of the eye and can be accompanied by inflammation inside the eye.

Signs of corneal ulcers usually include eye pain (squinting, tearing, depressed behaviour) and ocular discharge, which can be watery or purulent. Sometimes a lesion may already be visible on the surface of the eye. In this case it is particularly important to seek help from your veterinary surgeon as soon as possible.

 

How is a corneal ulcer diagnosed?

To diagnose a corneal ulcer your vet may use a special dye that highlights any defects of the surface layer by staining the underlying tissue green (see the image at the start of this article). This test is called the fluorescein test.

 

Why do corneal ulcers occur?

When the presence of an ulcer has been confirmed, it is important to try and find a reason for it. Most ulcers occur due to an initial trauma. This is more likely to happen in dogs and cats with very prominent eyes (also called ‘brachycephalic’ animals), for example in Pugs and Pekingese dogs or Persian cats. In cats the flare up of a Feline Herpes Virus infection is also a common cause for the development of a corneal ulcer. Many conditions can increase the risk of corneal ulcers. Reduced tear production is a common contributing factor, but other conditions such as an incomplete blink, in-rolling of the eyelid (also called ‘entropion’) or eye lid tumours may contribute to the occurrence, but even more so may interfere with the healing process.

 

How are corneal ulcers treated?

To treat an ulcer it is essential that the underlying cause is identified and if possible corrected. This will stop the ulcer from getting worse and allow the eye to heal as quickly as possible. The treatment plan will usually include eye drops to treat or prevent infection but may include other medication depending on the cause and severity of the ulcer. Painkillers and/or antibiotics by mouth may also be necessary.

 

Do any corneal ulcers require an operation?

If an ulcer is deep or the cornea is even ruptured, surgery is required to save the eye. Different techniques are available, but all of them place healthy tissue into the defect to stabilise the cornea. Very small suture material, as thin as a human hair, is used to repair the cornea and an operating microscope should be used to handle the small and very fine structures of the eye.

In most patients the healthy tissue is taken from the same eye from an area adjacent to the corneal ulcer.

The pink tissue next to the cornea (the conjunctiva) can be used for that to place a ‘conjunctival pedicle graft’ into the defect. More commonly, healthy corneal tissue attached to conjunctiva is used as it provides more strength to the wall of the eye. This is called a ‘corneoconjunctival transposition’ (Figure 5).

Corneal grafts are also possible but rely on the often limited availability of donor corneal tissue. Grafting surgeries are very successful in saving eyes, but can lead to scaring of the cornea leaving it less transparent in areas.

 

How can corneal ulcers be prevented?

Particularly in patients with prominent eyes, regular eye examinations should be performed to detect weaknesses in the corneal health. Indications of that may include white or brown marks on the surface of an otherwise comfortable eye or sticky discharge that continues to recur. Any painful eye should be presented to a veterinary surgeon as soon as possible.

Eyes may be cleaned with tap water that ideally should be boiled and cooled down again, using a lint-free towel. This should however not replace or delay the visit to a veterinary surgeon, as many ulcers require medication to achieve fast healing and prevent ill effects to the transparency of the cornea and therefore the sight of the dog or cat. Particularly; if a deep indentation or bulging tissue is noted on the surface, the eye should not be manipulated to prevent any additional damage.

Corneal ulcers are best prevented but if they are present they should be treated as soon as possible to stop them from getting bigger and deeper.

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Special offer – October 2016 FIREWORKS

by admin on October 7th, 2016

Category: Special Offers, Tags:

Special Offer October 2016 Fireworks beware

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Pet of the Month – October 2016 – Margot

by admin on October 7th, 2016

Category: Pet of the Month, Tags:

Margot is currently doing really well, recovering from an operation to correct “cherry eye’.

Cherry eye, or prolapse of the gland of the third eyelid, is quite common in small dogs and refers to a pink mass protruding from the animal’s eyelid;. The prolapsed gland itself rarely causes discomfort or damage to the eye, so the repair is mostly cosmetic. Most people choose to repair it, because it can have a very unpleasant appearance.

The gland contributes about 40% of the total tear-production of the eye and it is therefore imperative to aim to preserve the gland if possible as removal can cause a dry eye which can lead to damaged vision. If this does happen, it is controllable with medications, but it is preferable to prevent it. The most common surgical approach is a technique in which the gland is re-positioned using a mucosal pocket, creating a new envelope for the gland to sit within, but taking care to leave a few millimetres on either side to allow tears to drain freely. The unaffected side is often operated on pre-emptively.

Pet of the Month - October 2016 - Margot

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