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Special Offer – August 2019

by admin on August 1st, 2019

Category: Special Offers, Tags:

Check a Lump

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Spinal Fractures

by admin on August 1st, 2019

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Spinal Fractures
Fractures (breaks) of the spine occur when dogs and cats are involved in road traffic accidents or suffer other major trauma such as a fall or running into a patio door. Spinal fractures are often associated with varying degrees of injury to the spinal cord (the bundle of nerves inside the vertebrae) and, therefore, nerve damage. Although many animals may be paralysed as a result of the fracture, they will often recover, provided that they retain the ability to feel pain and that they are managed appropriately. Some cases can be treated medically, but it is often necessary to consider surgery to stabilise a fractured spine.

What is involved in a spinal fracture?
In a spinal fracture, the bones (vertebrae) of the spine break (fracture) or come apart from each other (dislocate or luxate). Fracture of the spine usually occurs as a result of a significant injury, such as being hit by a car, although occasionally the bones in the spine may fracture with minimal, if any, trauma because they are already weakened by a condition such as a tumour (referred to as a ‘pathological fracture’).

When the vertebrae of the spine fracture or dislocate (luxate) the associated vertebral displacement often injures the nerves of the spinal cord. The concussion and compression of the spinal nerves affects nerve function, and the signs that develop may vary from only mild weakness through to paralysis (inability to voluntarily move the limbs). Severely affected patients may become incontinent and lose the ability to feel pain in their limbs and tail.

How are spinal fractures diagnosed?
Physical examination of the patient by the specialist may enable detection of instability of the spine or abnormal alignment of the spine. Importantly, examination also enables assessment of the severity of any associated spinal cord injury – in particular, whether or not the patient can still feel pain.

X-rays (radiographs) are often obtained to look for evidence of fracture (or luxation) of the vertebrae and are generally sufficient to make a diagnosis in the majority of cases. Occasionally a more advanced imaging technique is preferred, to provide additional detail of the spine. CT scanning is particularly good at looking at the bony detail of fractures which may not be apparent on normal X-rays. MRI scanning is not so good at detecting damage to bones of the spine, but it is excellent for assessing any damage to the spinal cord.

How are spinal fractures managed?
Spinal fractures (and luxations) are often emergencies because of the associated spinal cord injury and risk of further damage. As a result, they need to be treated with the minimum of delay. Affected dogs and cats are often in significant pain, and care should be taken to avoid the handler being bitten or scratched. Patients should be moved with great caution in case the spine (vertebral column) is unstable, as further movement may aggravate the injury and any nerve damage. Strapping the patient to a rigid board may be helpful in some cases.

Some fractures of the spine may be treated conservatively without the need for surgery. This is particularly appropriate in patients with relatively stable vertebrae and minimal spinal cord injury. Conversely, dogs and cats with unstable fractured spines, those with significant spinal cord injuries and those in severe pain are often best treated surgically. Surgery aims to re-align and stabilise the affected vertebrae. The procedure most often involves placing screws or pins in the bones on either side of the fracture (or luxation) and securing them with either a plate or cement.

What is the outlook (prognosis) in patients with spinal fractures?
The outlook in dogs and cats with spinal fracture is primarily dependent on the severity of the spinal cord injury and how the patient is treated. Provided the ability to feel pain in the limbs and tail is maintained and the patient is managed appropriately, the outlook is generally good. Recovery may take a number of weeks (or even months in severely affected cases) and supportive care, including physiotherapy/hydrotherapy exercises, may be necessary. In contrast, patients with spinal fractures that can no longer feel pain are very unlikely to recover, no matter how they are treated, since the spinal cord injury is generally severe and irreversible.

 SPINE LUXATION

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Pet of the month – August 2019

by admin on August 1st, 2019

Category: Pet of the Month, Tags:

Our Pet of the Month is the delightful Rascal, seen here recovering from removal of his anal sacs. Rascal had the misfortune to suffer months of anal sac issues ranging from impaction to infection with associated pain and discomfort, making anal sac removal the only viable way forward.

What are the anal sacs?
The anal sacs are two small pouches located on either side of the anus at approximately the four o’clock and eight o’clock positions. The walls of the sac are lined with a large number of sebaceous (sweat) glands that produce a foul smelling fluid. The fluid is stored in the anal sacs and is released through a small duct or canal that opens just inside the anus. The anal sacs are commonly called ‘anal glands’. The sacs are present in both male and female dogs.

What is their function?
The anal sac secretion contains chemicals that act as territorial markers or ‘dog calling cards’. The secretions are similar to those produced by a skunk, which are used to repel enemies and alert other animals to their presence. Anal sac fluid is usually squeezed out by muscular contractions whenever the dog passes a bowel movement, providing a distinctive odor (or individual ‘scent signature’) to the feces. This is why dogs are so interested in smelling one another’s feces.

Why are the anal sacs causing a problem in my dog?
Anal sac disease is very common in dogs. The sacs frequently become impacted (plugged) usually due to inflammation of the ducts. The secretion within the impacted sacs will thicken and the sacs will become swollen and distended. It is then painful for your dog to pass feces. The secreted material within the anal sacs is an ideal medium for bacterial growth, allowing abscesses to form. Bacteria that are normally present in the feces can readily travel up the ducts and enter the sacs. In normal situations, the bacteria are flushed out when the secretions are expelled during a bowel movement. However, if the sacs are impacted, the fluid does not empty normally and they become infected. The fluid then becomes bloody and eventually the sacs become filled with pus, forming an anal sac abscess.

The abscess will appear as a painful, red, hot swelling on one or both sides of the anus. If the abscess bursts, it will release a quantity of greenish yellow or bloody pus. If left untreated, the infection can quickly spread and cause severe damage to the anus and rectum.

Another cause of recurrent anal sac disease is change in stool consistency. This can occur in dogs with gastrointestinal diseases such as food allergies and inflammatory bowel disease.

How will I know if my dog has anal sac problems?
The first sign is often scooting or dragging the rear along the ground. There may be excessive licking or biting, often at the base of the tail rather than the anal area. Anal sac disease is very painful. Even normally gentle dogs may snap or growl if you touch the tail or anus when they have anal sac disease. If the anal sac ruptures, you may see blood or pus draining from the rectum.

How is anal sac disease treated?
Treatment for impaction involves expressing or emptying the sacs. If the impaction is severe or if there is an infection, it may be necessary to flush out the affected sac to remove the solidified material. Since these conditions are painful, some pets require a sedative or an anesthetic for this treatment. Antibiotics are often prescribed and sometimes may need to be instilled into the sacs. Most dogs will require pain relief medications for several days until the swelling and inflammation have subsided. In advanced or severe cases, surgery may be necessary.

Problems with the anal sacs are common in all dogs, regardless of size or breed. If you are concerned that your pet may have an anal sac problem, call your veterinarian.

Is the condition likely to recur?
Some dogs will have recurrent anal sac impactions or abscesses. Overweight dogs tend to have chronic anal sac problems because their anal sacs do not empty well. Each impaction may cause further scarring and narrowing of the ducts, leading to recurrences that are even more frequent. If this condition recurs frequently, surgical removal of the sacs is indicated. If the cause of anal sac disease is change in stool consistency, prevention involves treating the underlying cause and may require changing the dog to a higher fibre diet.

Are anal sacs necessary for my dog? Will removal have any adverse effects?
Anal sacs produce the pungent smelling secretion that allows the dog to mark his or her territory. For our domesticated dogs, this is an unnecessary behavior and removal will not adversely affect your pet.

Are there any risks associated with surgical removal of the anal sacs?
Removal of the anal sacs is a delicate and specialized surgery. Some dogs will experience loose stools or lack of bowel control for one to three weeks following surgery. This occurs because the nerves controlling the anal sphincters (muscles that close the rectum) run through the soft tissues near the anal sacs. If the infection is deep and extensive it can be impossible to avoid damaging the nerves during the surgery. This damage resolves without further treatment in the majority of pets. In rare cases, the nerve damage is permanent and can result in fecal incontinence or the inability to control bowel movements, with constant leakage of feces from your dog’s anus.

As with any surgery, general anesthesia is required which always carries some degree of risk. Advances in anesthesia drugs and monitoring continue to decrease these risks. For dogs suffering from chronic or recurrent anal sac infection or impaction, surgical removal is the best option to relieve the pet’s pain.

What other problems can develop with the anal sacs?
Older dogs can develop cancer of the glands within the anal sacs called adenocarinoma. Therefore, it is very important to have your dog examined by a veterinary as soon as any of the above clinical signs are seen.

Rascal

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Pancreatitis in Dogs

by admin on July 3rd, 2019

Category: News, Tags:

What is pancreatitis?
The pancreas is an organ in the abdomen (tummy) which is responsible for releasing enzymes (types of proteins) to digest food. The pancreas also releases important hormones (such as insulin) into the bloodstream. Pancreatitis occurs when the pancreas becomes inflamed (tender and swollen). In most cases pancreatitis occurs for no apparent underlying reason, although sometimes it can have a particular cause (such as scavenging food). Pancreatitis most commonly affects middle aged to older dogs, but in addition, dogs of certain breeds (e.g. Cocker Spaniels and Terrier breeds) are more prone to developing the condition.

What are the signs of pancreatitis?
Pancreatitis can cause a variety of symptoms, ranging from relatively mild signs (e.g. a reduced appetite) to very severe illness (e.g. multiple organ failure). The most common symptoms of pancreatitis include lethargy, loss of appetite, vomiting, abdominal pain (highlighted by restlessness and discomfort) and diarrhoea.

How is pancreatitis diagnosed?
The possibility that a dog may be suffering from pancreatitis is generally suspected on the basis of the history (i.e. loss of appetite, vomiting, etc) and the finding of abdominal pain on examination by the veterinary surgeon. Because many other diseases can cause these symptoms, both blood tests and an ultrasound scan of the abdomen are necessary to rule out other conditions and to reach a diagnosis of pancreatitis. Although routine blood tests can lead to a suspicion of pancreatitis, a specific blood test (called ‘canine pancreatic lipase’) needs to be performed to more fully support the diagnosis. An ultrasound scan is very important in making a diagnosis of pancreatitis. In addition, an ultrasound scan can also reveal some potential complications associated with pancreatitis (e.g. blockage of the bile duct from the liver as it runs through the pancreas).

How is pancreatitis treated?
There is no specific cure for pancreatitis, but fortunately most dogs recover with appropriate supportive treatment. Supportive measures include giving an intravenous drip (to provide the body with necessary fluid and salts) and the use of medications which combat nausea and pain. Most dogs with pancreatitis need to be hospitalised to provide treatment and to undertake necessary monitoring, but patients can sometimes be managed with medication at home if the signs are not particularly severe. At the other extreme, dogs that are very severely affected by pancreatitis need to be given intensive care.

One of the most important aspects of treating pancreatitis is to ensure that the patient receives sufficient appropriate nutrition while the condition is brought under control. This can be very difficult, because pancreatitis causes a loss of appetite. In this situation it may be necessary to place a feeding tube which is passed into the stomach, and through which nutrition can be provided. If a dog with pancreatitis is not eating and will not tolerate a feeding tube (e.g. due to vomiting), intravenous feeding (using a drip to supply specially formulated nutrients straight into the bloodstream) may be necessary.

What is the outcome in pancreatitis?
It may be necessary for dogs with pancreatitis to be hospitalised for several days, but fortunately most patients with the condition go on to make a complete recovery, provided that appropriate veterinary and nursing care is provided. In some instances, dogs can suffer repeated bouts of the condition (called ‘chronic pancreatitis’) and this may require long term management with dietary manipulation and other approaches which the specialist will discuss with you in detail, as required.

 

Pancreatitis

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Pet of the month – July 2019

by admin on July 3rd, 2019

Category: Pet of the Month, Tags:

Meet Dylan…

He came to us today because he was licking his front foot. On examination one of our vets found a small sore lesion between his toes. An anaesthetic was required to examine his foot and open up the lesion in which a grass seed was found!

This is not the first time Dylan has been so unfortunate. Last time a total of 16 grass seeds were found amongst all 4 of his feet!

Sensible precautions at this time of year are:

  •  Avoid long grass in the summer months
  • Maintain your own lawn
  •  Throughly check your pet after walks, particularly feet, ears, eyes and mouth.
  •  Ensure your pet is regularly groomed, especially if they have a long or thick coat.

Dylan

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Special Offer – July 2019

by admin on July 3rd, 2019

Category: Special Offers, Tags:

July DRY EYE

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Inflammatory Bowel Disease (IBD)

by admin on June 6th, 2019

Category: News, Tags:

What is IBD?
IBD is a disease that causes inflammation in any part of the digestive tract (stomach and/or intestines and/or colon i.e. large bowel). Some breeds of dog, such as Soft Coated Wheaten Terriers have a genetic predisposition to this disease. In other breeds of dogs and cats it can be triggered by a parasite or food intolerance. More commonly no specific underlying cause is found and the disease is thought to be caused by an over-activity of the body’s immune system (which normally fights off infections) to ‘foreign’ proteins (such as food) that are eaten, resulting in inflammation.

What are the signs of IBD?

  • Weight loss
  • Vomiting
  • Diarrhoea
  • Increased or decreased appetite
  • Blood or mucus in the faeces

How is IBD diagnosed?
IBD is diagnosed by a combination of tests, as several other diseases can cause similar signs. Blood tests are often performed to rule out other underlying diseases such as liver or kidney disease, and faecal examination is performed to look for any parasites. Cats with IBD can have low vitamin B12 levels therefore vitamin B12 is measured in all cats.

As foreign body obstructions, or sometimes tumours, can cause weight loss and vomiting, X-rays or ultrasound scans are usually performed to rule out these problems.

Finally, the ultimate diagnosis of IBD is made by taking biopsies from the stomach, intestine or colon. Usually this is performed under a general anaesthetic using a flexible endoscope camera, of which we have several different sizes to suit different sizes of patient. This is not an invasive procedure and most pets recover very quickly and will go home within 24 hours.

How is IBD treated?
Many dogs and cats will improve following a dietary trial. Often this involves prescribing a new diet that is hypoallergenic (i.e. unlikely to cause a reaction) or contains a protein source that your pet has not eaten before (such as venison or salmon). This is fed for 1 to 2 months and it is very important that no other food, treats or tit-bits are given. Some pets won’t respond to one diet but will respond to an alternative diet.

Pets that don’t respond to diet alone may be prescribed certain antibiotics.

Dogs and cats that are severely affected or that don’t respond to the treatments mentioned above will be prescribed steroids. A high dose is prescribed initially and this is decreased every few weeks for several months. Sometimes in pets that don’t tolerate steroids or don’t respond to steroids alone, other drugs which suppress the immune system are prescribed.

What is the long term outlook? (prognosis)?
IBD has a broad spectrum of severity, ranging from mild vomiting and diarrhoea to severe weight loss and fluid build up in the abdomen. It is not generally a life-threatening disease but can be in severely affected patients. It is not a curable disease, therefore the aim of treatment is to minimise the frequency of vomiting and diarrhoea: it is rare to be able to stop the clinical signs altogether. Keeping a diary of how often the signs are happening can be helpful to us in establishing the success of treatment. Most dogs and cats are able to live a good quality of life following a diagnosis of IBD.

Dog Boxer

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Special Offer – June 2019

by admin on June 6th, 2019

Category: Special Offers, Tags:

Rabbit Vaccination Offer

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Pet of the month – June 2019

by admin on June 6th, 2019

Category: Pet of the Month, Tags:

Bob is one of many cats we are caring for who suffers from IBD (Inflammatory Bowel Disease).

IBD is not a single disease but a group of chronic gastrointestinal disorders caused by an infiltration of inflammatory cells into the walls of a cat’s gastrointestinal tract. The infiltration of cells thickens the wall of the gastrointestinal tract and disrupts the intestine’s ability to function properly.
IBD occurs most often in middle-aged and older cats.

How is IBD diagnosed?

Symptoms of feline IBD are not specific.  They may include vomiting, weight loss, diarrhea, lethargy and variable appetite.
The symptoms of IBD can vary depending on the area of the digestive tract affected.
A definitive diagnosis of feline IBD can only be made based on microscopical evaluation of tissue collected by means of an intestinal (or gastric) biopsy.

How is IBD treated?

The treatment of IBD usually involves a combination of change in diet and the use of various medications.  There is no single best treatment for IBD in cats. Your veterinarian may need to try several different combinations to determine the best therapy for your cat.
Hypoallergenic diets are usually tried first. Corticosteroids like prednisolone may be used to reduce inflammation of the gut, and antiobiotics such as metronidazole are commonly used.

What does the future hold for a cat with IBD?

IBD is a chronic disease.  Few cats are actually cured. Symptoms of IBD may wax and wane over time. IBD can often be controlled such that affected cats are healthy and comfortable. Vigilant monitoring by the veterinarian and owner is critical.

We are very pleased to report that Bob has responded well to dietary management and is currently not requiring additional medication. Luckily he is not adept at hunting and so we have no fear that he might upset the illness through illicit snacks!

 

BOB

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Arthrodesis

by admin on April 30th, 2019

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What is arthrodesis?
Arthrodesis means the surgical fusion of a joint. In other words, the bones forming the joint are permanently joined together so that there is no movement in this part of the limb. Arthrodesis is a salvage procedure that is generally only performed when there are no other options to save the function of the joint.

What joints can be arthrodesed (fused)?
The shoulder, elbow, carpal (wrist), stifle (knee), hock (ankle) and digit (toe) joints can be arthrodesed. The main joint that cannot be fused is the hip joint. This is generally not a problem since the hip joint can be replaced with an artificial one. Elbow and knee replacements are also possible alternatives to arthrodesis of these joints.

Reasons for performing an arthrodesis
The principle indications for arthrodesis are:

  • osteoarthritis that is causing chronic pain and cannot be managed medically
  • joint instability that cannot be treated by other means
  • fractures involving the joint surface that cannot be repaired
  • infection involving the joint that fails to respond to antibiotics
  • tumours in or around joints
  • muscle/tendon rupture that cannot be managed directly

What does arthrodesis involve?
There are a number of important steps when fusing a joint:

  • the surface of the joint (known as the articular cartilage) must be removed to enable bony fusion.
  • a bone graft should be placed into the spaces between the bones to promote fusion. This may be an autograft (from the patient), an allograft (from a donor) or a combination of both.
  • the bones forming the joint to be arthrodesed must be rigidly stabilised to maximise the possibility of bony fusion. This is most commonly achieved with one or two plates that are secured to the bones under the skin. Occasionally an external skeletal fixator (a metal framework) is employed, where the bones are stabilised with pins that penetrate the skin and are attached to bars on the outside of the limb.
  • exercise must be restricted until there is radiographic (X-ray) evidence that the bones have fused. This often takes eight to 12 weeks.

Risks and complications
The majority of arthrodesis operations are uneventful and are not associated with complications, however, these are major procedures and thus the following complications are possible:

  • loosening or breakage of implants (plates, screws, pins) may occur if the joint fails to fuse in sufficient time. Implant failure can result in joint instability and necessitate further surgery.
  • wound problems, such as breakdown and infection, are primarily associated with arthrodesis of the carpal (wrist) and hock (ankle) joints. Wound management within the first few weeks of surgery is of vital importance to minimise this risk. Dressings are often applied to the limb to minimise swelling and prevent the patient interfering with the wound.
  • fracture of bones adjacent to the fused joint may occur due to the abnormal forces that result following arthrodesis surgery.

How good is limb function following arthrodesis surgery?
Limb function after arthrodesis surgery is primarily dependent on which joint is fused. It is good following carpal (wrist) and hock (ankle) arthrodesis and fair following shoulder arthrodesis. Fusion of the elbow or stifle (knee) joint significantly compromises limb function. Dogs and cats generally have to swing the limb outwardly (circumduct) when walking in order to prevent the toes dragging on the ground.

Conclusion
In those patients where arthrodesis is indicated, the vast majority benefit from surgery. Fusion of a joint is undoubtedly a major undertaking, and these procedures are commonly performed by specialist orthopedic surgeons. We will be pleased to give as much help and support as possible if you decide to give your pet the opportunity of arthrodesis surgery.

Carpal arthrodesis

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