News


COVID-19 Update & article on Feline Lower Urinary Tract Disease

by admin on May 5th, 2020

Category: News, Tags:

A massive thank you to all our customers for being so understanding and patient at this difficult time!!

Our main Littlehampton hospital REMAINS OPEN and in line with government guidelines small teams are working 24-hour shifts to provide emergency care and urgent treatment where animal welfare would be compromised by delay, as well as providing repeat medicines.

Concerned about your pet’s health but don’t think it’s an emergency?

If you are worried about your pet, please phone us and explain your situation. We’ll arrange a suitable way of conducting your appointment that is in everyone’s best interests.

There are a variety of options available to everyone – the important thing is to let us know and we’ll work together!

To respect social distancing rules, we are replacing our standard consultation service with video and telephone consultations. Please contact the practice to arrange an appointment and discuss suitable communication platforms (eg Skype, Facetime, WhatsApp). Payment can be made over the phone.

What constitutes an emergency that needs immediate care?

If any of the below apply to your pet, contact us IMMEDIATELY:

  • Breathing difficulties
  • Open wound injuries
  • Trauma (e.g. car accidents)
  • Male cats struggling in the litter tray to pass urine
  • Rabbits neglecting food
  • Swallowing hazards ie.toys/clothes
  • Ingestion of poisonous/harmful substances
  • Eye problems
  • Vomiting or diarrhoea especially if your pet appears quiet or depressed or if it is going on for a long time (more than 24 hours)
  • Swollen abdomen or retching (especially large dogs)
  • Loss of thirst & appetite
  • Struggling to give birth
  • Seizuring/fitting
  • Collapse

 

If the recommendation is to come into the practice, please note the following advice to keep you and our staff safe:

  • We will ask that you telephone us when you arrive in the car park.
  • A member of staff will come out and take your pet into the clinic.
  • After making an assessment we will ring you on your mobile to discuss the necessary treatment and way forward.

Can I bring my pet in for an INITIAL VACCINATION COURSE?

Unvaccinated puppies, kittens and rabbits are at risk from picking up the diseases we commonly vaccinate against.

Whilst the risk can be lessened by keeping pets inside and avoiding contact with unvaccinated animals, please contact us to discuss your pet’s current situation with you, and risk assess whether vaccination at this point is recommended.

Can I bring my pet in for their ANNUAL VACCINATION BOOSTER?

We can postpone this vaccine for up to 3 months after the due date without requiring a restart. During these exceptional times, we ask that you delay the booster, but for no more than a maximum of 3 months after the due date.

Can I bring in my pet for a HEALTH CHECK?

Not at this moment in time because this is not deemed critical. However, if your pet is ill we will be able to conduct a consultation via a video or telephone consultation. Please ask the practice for further information.

Can I bring my pet in for NAIL CLIPS? Or to have their ANAL GLANDS expressed?

This should be postponed, provided your pet is not suffering pain or discomfort.

How can I get my REPEAT FOOD or MEDICATIONS?

It is important that you continue to give your pet the appropriate food and medication. We are looking at ways of getting these to clients who are due them and postal / delivery services may be an option. Please contact us to make suitable arrangements.

How can I get my FLEA, WORM, TICK and FLYSTRIKE treatments?

It is important that you continue to give your pet the appropriate treatments. We are looking at ways of getting these to clients who are due them and postal / delivery services may be an option. Please contact us to make suitable arrangements.

Can my pet still have ELECTIVE OPERATIONS such as Neutering and Lumps removals?

These operations are not deemed to be critical during these extraordinary times and we therefore ask that unless your pet’s health is being endangered, you postpone these procedures until government guidelines on social distancing change. If you have specific concerns please contact us to discuss your pet’s current situation, and risk assess whether surgery at this point is recommended.

What about ULTRASOUNDS and BLOOD TESTS?

It depends whether these are deemed critical or not – please contact us to discuss.

Please continue taking care of yourselves and all your lovely pets!! 

                                                                                                                       

WHAT IS FLUTD?

FLUTD stands for feline lower urinary tract disease. This is a term used to describe a collection of conditions which can affect the bladder and/or urethra (tube from the bladder to the outside).

The most common conditions causing FLUTD are:

  • Urolithiasis (stones in the bladder and/or urethra)- there are various different stones which can form in the urinary tract resulting in FLUTD due to irritation of the bladder/urethral lining.
  • Structural defects- rarely some cats can be born with anatomical defects which can lead to signs of FLUTD. Alternatively a defect such as a stricture (narrowing of the urethra secondary to scar formation) can develop in older animals.
  • Bacterial infection- this is a relatively uncommon cause of FLUTD. In some cases an infection can be present alongside another condition.
  • Cancer- tumours of the bladder and/or urethra are thankfully rare in cats.
  • Urethral plugs and urethral spasm- urethral plugs are accumulations of cells, cyrstals and other debris which, if formed in the urethra, can block urine output from the bladder in male cats. In addition spasm (muscular contraction and narrowing) of the urethra can occur which can also result in blockage of the urethra.
  • Feline Idiopathic Cystitis (termed F.I.C.)- this is the most common cause of FLUTD (around 60-70% of cases). The exact cause of F.I.C. is unknown although there are studies which suggest that this condition results from an abnormal response to stress. This condition is diagnosed after excluding all other causes however many cats with other conditions (for example urethral plugs/spasm) will also have F.I.C.

What are the signs of FLUTD?

The most common clinical signs of FLUTD relate to abnormalities of urination. In some cats which only urinate outdoors signs may not be apparent at home. If observed signs would include:

  • Straining to urinate
  • Crying when urinating
  • Urinating in inappropriate places
  • Urinating more often than normal
  • Smaller volumes of urine produced when urinating
  • Inability to urinate (this can be life threatening, requiring immediate veterinary attention).
  • Blood visible in the urine
  • Over-grooming the perineum
  • Signs of pain/inappropriate aggression particularly around the hind end.

How is FLUTD investigated?

Initially a thorough history including identification of any potential factors that could lead to stress (i.e. house move, new pet in the environment or building work at home) is taken. A physical examination will then be performed. In male cats the bladder size and texture will carefully be assessed to identify whether urethral blockage (obstruction) is present. Next a combination of some or all of the following tests may be performed:

  • Urinalysis: This may be collected at home (free-catch) or by taking a sample directly from the bladder using a needle. The urine concentration is assessed alongside checking for bacteria, blood, protein or crystals.
  • Blood tests: A blood sample may be taken, especially in cats with suspected urethral blockage. This is to assess kidney function and blood salt (electrolyte) concentration. In addition some cats can have alterations in blood calcium levels which could predispose to stone formation.
  • Abdominal ultrasound: This can be used to check for any signs of a tumour or stones in the bladder. The bladder wall thickness can also be assessed.
  • X-rays: Some bladder or urethral stones (uroliths) can be visible on an X-ray of the abdomen.

How is FLUTD treated?

The treatment of FLUTD will vary depending on the underlying cause. In general FLUTD is a painful condition and therefore in all cases pain relief is normally administered. A short summary of possible treatments for each cause is given below.

Urolithiasis

If bladder stones are causing clinical signs they may need to be removed. Some types of stones (e.g. struvite) can be dissolved by changing to a specifically manufactured prescription diet. Others are normally removed surgically. If a urethral stone is present and causing blockage then additional, emergency treatment is required. This is discussed in more detail in the “Urethral plugs and urethral spasm” section.

Structural defects

Often surgery is required to correct structural defects. In cats with urethral strictures, dependent on the location, a procedure called perineal urethrostomy can be performed to open the urethra above the narrowing, creating a permanent new location for urine to exit.

Bacterial infection

Bacterial infections are treated with antibiotics. Due to the increasing prevalence of resistance, antibiotics should only be used in cats where there is either a very strong suspicion of infection or confirmed infection (particularly as this is less common).

Cancer

The most common type of cancer found in the bladder is called transitional cell carcinoma. This is generally treated with a combination of chemotherapy and non-steroidal anti-inflammatories. Other benign tumours may be treated by surgical removal.

Urethral plugs and urethral spasm

Urethral plugs or spasm resulting in blockage of the urethra (normally in male cats due to the diameter, shape and length of the urethra) can be life threatening. This is because if it is left untreated the kidneys can become damaged and blood salts can become deranged leading to heart problems and even death.

Cats with urethral blockage are rapidly assessed. Normally pain relief and muscle relaxants are administered alongside fluid therapy into the vein. The patient is then either anaesthetised or heavily sedated and removal of the blockage is performed (normally by flushing and placement of a catheter through the urethra into the bladder). After the catheter is passed into the bladder it is often secured in place for a few days. This is prevent immediate re-blockage and to allow time for the spasm and associated inflammation/swelling of the urethra to improve. The catheter is then removed and the patients are observed to ensure that they are able to urinate.

In cats with kidney problems due to the blockage fluid therapy into the vein will need to be continued until the kidneys improve. Sadly in some cases permanent damage to the kidneys can occur resulting in chronic kidney failure. Thankfully this is uncommon.

Rarely it is not possible to unblock the urethra with a catheter. In addition some cats have recurrent episodes of urethral blockage despite preventative therapy. In this specific but small group of patients a perineal urethrostomy can be performed (as discussed in structural defects). It is important to understand that there can be serious complications associated with the surgery and it does cure the condition.

Feline Idiopathic Cystitis (F.I.C.)

The management of F.I.C. is complex as the cause is multifactorial. Factors thought to contribute to the condition include a defective bladder lining, stress (specifically an individual’s inappropriate reaction to stress) and inflammation caused by the central nervous system. In humans a similar condition exists called ‘interstitial cystitis’. Changes in the bladder lining and brain of cats with F.I.C. are similar to those found in humans with this disease.

There are various different treatments available, with evidence behind each recommendation varying in quality and quantity. A short summary of each therapy area is given below:

  • Dietary medication: Simply changing from dry to wet (sachet or tinned) food can help to increase the amount of water consumed. This can result in the production of more dilute urine. There are various prescription urinary diets available which may be recommended in specific circumstances (particularly if struvite stones are present or high blood calcium).
  • Increasing water intake: In addition to changing to wet food, cats with F.I.C. should be encouraged to drink more water to enhance the production of dilute urine. This can be achieved by providing a water fountain, ensuring fresh water is always available in multiple locations or adding water to food.
  • Litter tray number and location: There should be at least one litter tray for each cat in the household. These should be placed in different locations, preferably in less busy areas of the home. The type of litter can also have an impact and therefore providing a few different types to evaluate which is preferred can help. Cats that normally urinate outside should not be forced to use a litter tray.
  • Identification and modification of stressful stimuli: This is a very important part of management but is often the most difficult to practically achieve. If an event that would be anticipated to cause stress is to occur (i.e. house move or new pet) then measures to minimise the impact should be considered. It is thought that conflict with another cat in the same household is the most common cause of stress in cats with F.I.C. Signs of this may not be immediately obvious and resolving or improving this can be difficult. Encouraging play and the addition of new toys to the environment can help. In cats that are indoors only, allowing some outdoor access can help (if safely possible). Consultation with a behaviourist can also be required to identify and improve causes of stress.
  • Painkillers: Chronic or intermittent pain relief can be prescribed. There are various types available including non-steroidal anti-inflammatories and opiods.
  • GAG replacers: GAG replacers theoretically help cats with F.I.C. by improving the abnormal bladder lining. There are multiple different formulations available and some are present in prescription diets targeted for urinary tract disease.
  • Synthetic pheromone therapy: Feliway® is a feline synthetic pheromone which may help to reduce stress and anxiety. There are various ways this can be used (either a spray or a plug-in diffuser). Further advice is available from the website and there are different products available to use in different scenarios (i.e. in multi-cat homes or during times of anticipated stress).
  • Anti-depressants: In extreme cases human anti-depressants can be used. These are normally reserved for severely affected cats that are refractory to all other forms of therapy.
Cat in litter tray

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Pet of the month – May 2020

by admin on May 5th, 2020

Category: Pet of the Month, Tags:

Pet of the Month for May is handsome Hadley, who has featured in this slot before.

He rejoins us this month as a reminder of how short a time it takes for a pet to rifle through an owner’s bag when their back is turned – in this case eating a packet of ibuprofen!

Ibuprofen is highly toxic and will cause gastrointestinal upset, including ulceration and acute kidney injury.

Luckily Hadley’s predilection for items that cannot be in the least bit tasty was noticed immediately. Vomiting was induced and he promptly brought up the tablets and remains of the packet. Activated charcoal was also administered.

We are delighted to report that he is back to his normal self and suffered no ill-effects.

Feb - Hadley

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Special Offer – May 2020

by admin on May 5th, 2020

Category: Special Offers, Tags:

Rabbit Offer May

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Special Offer – April 2020

by admin on April 6th, 2020

Category: Special Offers, Tags:

Tackling Ticks

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Pet of the month – April 2020

by admin on April 6th, 2020

Category: Pet of the Month, Tags:

This delightful 4 year old Bulldog first came to see us having been very sick. Buzz was also straining to urinate.

An ultrasound scan showed he had numerous stones in his bladder, necessitating urgent surgery.

Surgery proved more extensive than expected as Buzz not only had 50 stones in his bladder but he also had 18 stones wedged tightly in his urethra, the tube connecting the bladder to the outside world. His bladder had to be opened and evacuated and his urethra had to be incised on the underside of his penis to release the obstacles.

Buzz is recovering really well and we are extremely pleased with his progress to date!

 Buzz

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COVID-19 UPDATE & FAQ’s

by admin on April 6th, 2020

Category: News, Tags:

Firstly may we say a massive thank you to all our customers for being so understanding and accommodating at this difficult time.

And a huge thank you to all our amazing vets, nurses and receptionists for pulling together to find the best possible means by which to provide local pets with the care they need.

Small teams are working 24/7 on a roster to provide emergency care and urgent treatment where animal welfare would be compromised by delay.

In line with government guidelines we are now only open for emergencies and for patients that need essential care to avoid unnecessary suffering or maintain animal welfare.

Our main Littlehampton hospital REMAINS OPEN however as you would expect we have put in place all the necessary steps to ensure that we reduce the risk of virus transmission, and are keeping the main door closed. We need to keep everyone safe.

Concerned about your pet’s health but don’t think it’s an emergency?

If you are worried about your pet, phone us and explain your situation. We’ll arrange a suitable way of conducting your appointment that is in everyone’s best interests.

There are a variety of options available to everyone – the important thing is to let us know and we’ll work together!

To respect social distancing rules, we are replacing our standard consultation service with video and telephone consultations. Please contact the practice to arrange an appointment and discuss suitable communication platforms (eg Skype, Facetime, WhatsApp). Payment can be made over the phone.

What constitutes an emergency that needs immediate care?

If any of the below apply to your pet, contact us IMMEDIATELY:

  • Breathing difficulties
  • Open wound injuries
  • Trauma (e.g. car accidents)
  • Male cats struggling in the litter tray to pass urine
  • Rabbits neglecting food
  • Swallowing hazards ie.toys/clothes
  • Ingestion of poisonous/harmful substances
  • Eye problems
  • Vomiting or diarrhoea especially if your pet appears quiet or depressed or if it is going on for a long time (more than 24 hours)
  • Swollen abdomen or retching (especially large dogs)
  • Loss of thirst & appetite
  • Struggling to give birth
  • Seizuring/fitting
  • Collapse

If the recommendation is to come into the practice, please follow the advice given by our staff. 

  • We will ask that you telephone us when you arrive in the car park. 
  • A member of staff will come out and take your pet into the clinic. 
  • After making an assessment we will ring you on your mobile to discuss the necessary treatment and way forward.
Our governing body, RCVS, and BVA advise us that current restrictions will remain in place for 3 weeks from Monday 23 March and will be reviewed in light of any further government instructions or relevant information, after that period.
 

COVID-19 FAQ’s

Can I bring my pet in for an INITIAL VACCINATION COURSE?

A vaccination is not deemed an emergency and we will not be offering an initial vaccination course. If you have a puppy, we recommend that they are kept inside and not exposed to other dogs. You should book a vaccination course as soon as possible after normal service resumes.

We will review this and provide a further update if the government extends the initial three weeks of enhanced measures to slow the spread of the virus.

Can I bring my pet in for their ANNUAL VACCINATION BOOSTER?

We can postpone this vaccine for up to 3 months after the due date without requiring a restart. During these exceptional times, we ask that you delay the booster until up to a maximum of 3 months after the due date.

Can I bring in my pet for a HEALTH CHECK?

Not at this moment in time because this is not deemed critical. However, if your pet is ill we will be able to conduct a consultation via a video or telephone consultation. Please ask the practice for further information.

Can I bring my pet in for NAIL CLIPS? Or to have their ANAL GLANDS expressed?

This should be postponed if your pet is not in any danger of feeling discomfort. If you are uncertain whether this is the case, please arrange a video or telephone consultation with the vet.

How can I get my REPEAT FOOD or MEDICATIONS?

It is important that you continue to give your pet the appropriate food and medication. We are looking at ways of getting these to clients who are due them and postal / delivery services may be an option. Please contact us to make suitable arrangements.

How can I get my FLEA, WORM, TICK and FLYSTRIKE treatments?

It is important that you continue to give your pet the appropriate treatments. We are looking at ways of getting these to clients who are due them and postal / delivery services may be an option. Please contact us to make suitable arrangements.

Can my pet still have ELECTIVE OPERATIONS such as Neutering and Lumps removals?

These operations are not deemed to be critical during these extraordinary times and we therefore ask that you postpone these procedures, until government guidelines on social distancing change.

What about ULTRASOUNDS and BLOOD TESTS?

It depends whether these are deemed critical or not – please contact us to discuss.

Cat

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Hip dysplasia

by admin on March 3rd, 2020

Category: News, Tags:

What is hip dysplasia?

Hip dysplasia means abnormal development of the hip joint. It inevitably leads to the development of arthritis (osteoarthritis). Either the hip dysplasia or the secondary arthritis may cause hip pain.

Hip dysplasia is a genetic disorder caused by the combination of genes from the parents (dam and sire). During the first few months of life, as the hips are developing, they become unstable. As a result the ball (femoral head) and socket (acetabulum) move apart during weight bearing. This causes abnormal forces on the soft bones which leads to the ball becoming flattened and the socket becoming shallow.  The process is self-perpetuating and causes damage to the covering of the bones (the articular cartilage). Cartilage damage is a key feature of the secondary osteoarthritis.

What are the signs of hip dysplasia?
Hip dysplasia is a common condition, especially in large breed dogs. The key signs are hind limb lameness and stiffness. The latter is generally most evident after rest following exercise. Difficulty rising and reluctance to jump or exercise are also common features. A rolling hind limb action may be seen in young dogs. More subtle signs include restlessness, moaning and licking the skin over the hip.

Signs tend to develop when the dog is immature and growing (five to 10 months of age) or when adult (perhaps a few years of age). When immature, it is the instability of the hip that causes the pain whereas in adult dogs it is the osteoarthritis which results in discomfort.

How is hip dysplasia diagnosed?
Examination may reveal muscle wastage (atrophy), especially over the hips. Manipulation of the joints may cause increased pain and instability may be palpable.

X-rays (radiographs) are necessary to diagnose hip dysplasia. They enable the severity of the abnormal joint development and presence of secondary osteoarthritis to be assessed.

How can hip dysplasia be treated?
The majority of dogs with hip dysplasia can be managed satisfactorily without the need for surgery. Exercise often needs to be controlled to some degree. Each dog will have its own threshold of duration and type of activity beyond which hip pain may increase. Hydrotherapy is often beneficial. Dogs that are overweight benefit from being placed on a diet. Tit-bits may need to be withdrawn and food portions reduced in size. Regular monitoring of weight may be necessary. Painkillers (anti-inflammatory drugs) may be indicated to make the dog more comfortable. Long-term drug therapy should be avoided if at all possible in view of potential side effects.

Some dogs with hip dysplasia fail to respond satisfactorily to conservative treatment and in these cases surgery may be indicated. The two key types of surgery are (1) reconstructive and (2) salvage.

Reconstructive surgery
In some young dogs (usually less than a year of age) the abnormal hip joint may be reconstructed to make it more stable. This involves cutting the pelvis and rotating the cup (acetabulum) over the ball (femoral head). The rotated section is secured in the new position with a specially designed plate. Either a triple pelvic osteotomy (TPO) or a double pelvic osteotomy (DPO) can be performed. Reconstructive surgery has the advantage of maintaining the dog’s own joint tissues and hopefully reducing the development of osteoarthritis. Unfortunately many young dogs with hip dysplasia are not good candidates for reconstructive surgery.

The aftercare following DPO or TPO surgery is very important. Exercise has to be restricted for eight weeks until the cut bones heal. Long-term hip function is generally good. Further surgery or long-term medication is generally not necessary.

Salvage surgery
Adult dogs with hip dysplasia and secondary osteoarthritis that fail to respond to medical management may require salvage hip surgery. The principle options are to replace the hip with an artificial one (total hip replacement) or to remove the ball (femoral head removal or excisional arthroplasty).

Total hip replacement generally results in significantly better limb function compared to femoral head removal and the recovery is much quicker. However, although uncommon, there are potential complications with total hip replacement surgery that need to be carefully considered prior to making a decision. With modern systems total hip replacement can be performed successfully in all sizes of patients.

Femoral head removal provides a ‘false joint’ where the limb is supported on the pelvis by scar tissue and the surrounding muscles. Recovery following surgery is slow and the limb ends up slightly shorter. Aftercare, especially physiotherapy and hydrotherapy, is very important.

Total hip replacement
Total hip replacement surgery involves replacing the painful joint with a plastic cup and a metal ball (acetabular and femoral prostheses). Care following surgery is critical to reduce the possibility of complications, such as dislocation of the prostheses. A rapid reduction in joint pain and improvement in limb function are to be expected.

What is the outlook with hip dysplasia?
The outlook or prognosis with hip dysplasia and the associated osteoarthritis is generally good. As mentioned above many dogs can be managed successfully with conservative treatment involving modification of exercise and weight, with or without the need for anti-inflammatory painkiller drugs. Those that fail to respond satisfactorily may necessitate reconstructive procedures (DPO or TPO) or salvage surgery such as total hip replacement. The outcome of these procedures is generally very good, albeit that there are potential complications.

 

HIPS NORMAL

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Pet of the month – March 2020

by admin on March 3rd, 2020

Category: Pet of the Month, Tags:

Pet of the month for March is Boots, a delightful one year old Whippet who was recently hit by a car.

Boots presented with severe difficulty breathing and respiratory distress. Radiography showed he had a pneumothorax, which is an accumulation of air outside the lungs, but inside the chest wall. The air outside the lung prevents the lungs from inflating normally, and as happened with Boots can lead to lung collapse.

Treatment involved draining the air from inside the chest cavity to allow the lungs to expand, and oxygen therapy was provided until Boots was stable. Additonally strong pain relief was provided.

Boots required intensive care and repeated chest drainage until the damage repaired.

We are delighted to report that Boots is now back to good health!

 

BOOTS

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Special Offer – March 2020

by admin on March 3rd, 2020

Category: Special Offers, Tags:

March Wellness Offer

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Special Offer – February 2020

by admin on February 3rd, 2020

Category: Special Offers, Tags:

Feb Neutering Offer

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