Musings of a Vet

Keep the Cat Indoors at Night

2011-05-09T15:27:00.000-07:00

I wrote a previous post (September 2006) putting out a plea to keep your cats indoors at night to avoid having them hit by cars. Today I plead with you to also keep them indoors to avoid predator attacks and territory disputes with other cats in the neighborhood.

Cats are more active at night. They do like to go outside and roam, mate, hunt and socialize at nighttime. This can make keeping them inside at night challenging. So many times, however, these nighttime roamings result in injuries or deaths.

When cats fight, they use both their teeth and their nails. If you have ever been scratched or bitten by a cat, you can attest to the damage they can do! The teeth in particular act like hypodermic needles - creating a small hole in the skin and depositing bacteria from the cat's mouth under the skin. Cat skin heals quickly - sealing that bacteria under the skin. There it festers in the anaerobic conditions often causing an abcess - a pocket of pus under the skin. This appears as a lump that can be hard or soft, and which may or may not be painful.

The abcess can only be eliminated by bursting open by itself when the pressure becomes too great, or by being lanced -- surgically opened to allow the pus out. The wound is then flushed with saline or an antiseptic solution. The next challenge is keeping that wound open so all the bacteria can clear and not set up another infection. Sometimes we use artifical drains, and sometimes we just have the owner pick the scab off each morning! One way or the other the wounds need to be cleaned daily until no more pus is being produced -- sometimes as long as 5-7 days. Often we will prescribe antibiotics to help clear the infection and prevent it going into the blood and causing a systemic infection.

Fortunately abcesses are rarely deadly - I cannot say the same for encounters with coyotes or other predators. If a dog or coyote catches a cat, often they will grab them over their back. If the cat is lucky or quick, they'll just get ahold of loose skin and fat - at which point the cat can whip around, scratch the predator in the face and escape. If not, the jaws of the canid are strong enough to crush the spine of a cat and kill it. I have also seen a case where a dog picked a cat up and shook it like a toy. The cat escaped, but had its abdominal muscles torn even though there were no wounds in the skin. She was brought to the vet 3 days later when she stopped eating. It turned out that her intestines had started to herniate through the openings in the muscles and were starting to be blocked. One patient that had a narrow escape a couple years ago was a rabbit that had been caught by the back leg by a fox. The skin had torn at the top of her leg and she managed to wriggle out - flaying her leg and leaving the fox with just a mouth-ful of skin!

A lot of rescue organizations now are requiring potential adoptive families to promise to keep their adopted cats indoors 100% of the time. I am a bit more moderate in my opinion since I think there is a lot of benefit that comes of going outside -- for humans and animals! I will let my cat outside when I am outside too and call him in when I come in. At the very least, I encourage my clients and friends to not let their cats out in the morning until the sun is up, and bring them in before dusk. THIS IS NOT A GUARANTEE - a hungry, sick or brazen coyote may be out in the middle of the day.

If I have managed to convince you to start keeping your cats indoors, be prepared for some interrupted sleep over the next couple nights while your cats settle in to their new routine. Offer them some food when they come in and perhaps a treat before bed. You could set up a whole bedtime routine for them (treat, grooming session, tooth brushing) so they get some good attention from you and then will hopefully learn not to disturb you while you're asleep.

Your cats will thank you for it in the long run!

A Good Read

2009-03-23T22:23:00.003-07:00

I just finished a fantastic little book - I laughed, I cried, I recommend it! It is entitled Walking Ollie - or, Winning the Love of a Difficult Dog. It is written by a UK novelist, Stephen Foster, who was a novice dog-owner a couple years ago and who has now been "broken in" by Ollie, a lurcher with a shady past. I wouldn't say it is written for the dog-snob, but for anyone who has experience with rescue dogs and their neuroses, you will enjoy this book.

I read the preface just after spending some time at the Off-Leash Area at Marymoor park. This paragraph reminded me of some of the dogs we saw there. He is describing Ollie and a young whippet playing in a field: "Let loose, the pair of them perform loops around an imaginary greyhound track, using each other as the hare; finally they pause to catch breath, and while they rest they chew each other's ears and play-fight until they appear to be beat; and then they do it all again, over and over, until they have run themselves into the ground and can barely stand. I find all this a thing of beauty, an aesthetic delight, a visceral therapy. I can watch it for a long time." (p5)

Later in the book he discusses the delicate matter of poo:
"As time went on, I became obsessed with the quality of his turds, and in this I am not alone. Watch dog-walkers: the animal stoops, craps, clears the area. Depending on where, when and type of owner, this may be followed by the picking-up. But say we're in a thicket (all owners leave it behind in a thicket) -- observe the pause and the slight lean forward as an inspection is made for consistency, shape, color, quality, and quantity. Excrement, for the dog owner, is as the tea leaf to the clairvoyant -- a sacred window onto health, fortune, and well-being." (p 106)
...
(reporting a conversation with his friend Peter Kadic - an experienced dog-owner:) "As we were talking dog crap on one occasion, Kadic came up with the perfect definition for the ideal in stools, 'Foster,' he said, 'you want to be able to trip over 'em, not slide in 'em.'" (p 107)

[I apologize for the coarseness of the language.]

Dog Poetry - the Meaning of Life

2009-03-17T16:43:00.004-07:00

I love listening to the Writer's Almanac on Public Radio each day. The other day Garrison Keillor read a poem that made me giggle as I was trying to drive. I'm posting it here - hopefully no one will mind:

The Meaning of Life
by Nancy Fitzgerald

There is a moment just before
a dog vomits when its stomach
heaves dry, pumping what's deep
inside the belly to the mouth.
If you are fast you can grab
her by the collar and shove her
out the door, avoid the slimy bile,
hunks of half chewed food
from landing on the floor.
You must be quick, decisive,
controlled, and if you miss
the cue and the dog erupts
en route, you must forgive
her quickly and give yourself
to scrubbing up the mess.

Most of what I have learned
in life leads back to this.

"The Meaning of Life" by Nancy Fitzgerald from Poems I Never Wrote. © Poetry Harbor, 2001.

If you'd like to listen to Mr. Keillor read it in his perfect style, the link is here.

Go Jump in a Lake!

2009-01-14T22:06:00.003-08:00

HYDROTHERAPY - a long word meaning using water to improve health.

Many of my clients look at me like I've suddenly started speaking German when I mention the word or ask them if their dog likes to swim. Hydrotherapy is an important weapon in the arsenal we use to fight obesity, arthritis, and limb injuries.

I have yet to visit an actual hydrotherapy pool, but we had one near to our practice in Leigh-on-Sea, Essex, and there are several here on the Eastside in the Puget Sound area. Clients I have referred to them in the past have been pleased and surprised by the results of their weight loss and/or the improvement in their dogs' ability to walk.

Why do I recommend hydrotherapy? As you may have heard from human medicine/fitness gurus, swimming is excellent exercise - it increases the heart rate and aids in the burning of calories -- as important in an obese dog as it is in an obese human. The water supports the body and reduces the strain on joints, bones or muscles that are injured or arthritic. It therefore allows a dog who otherwise cannot walk far enough to sufficiently exercise to rehabilitate an injured leg, or drop a few pounds, to do so in an environment in which he is not likely to cause further injury and often with MUCH less pain than he experiences on land.

Now these dedicated hydrotherapy pools are fantastic for a couple reasons. First, they are WARM - if you've ever tried to swim in the Pacific ocean or the Thames river in winter you'll appreciate why this is important. Secondly, they often have trained therapists who can help guide you and your dog to the exercises that will be most beneficial. Third, they will often have a harness, or some other floatation device that will help dogs who are unable to keep themselves above water. Forth, some are able to use jets to produce a current to increase resistance and therefore increase the speed of calorie burning/ muscle building.

Can you get the same benefit from your own swimming pool/jacuzzi at home or a lake or the ocean? The answer is possibly - depending on what your dog needs and is willing to do in those environments. If you're simply trying to get your dog to lose some weight, certainly try the free options first. If, however, your dog has had an injury or is debilitated in any way, I would recommend going to a hydrotherapy pool first for a couple sessions. You'll learn a lot, get a lot of support from the people there, and hopefully find it worth the time and money.

I'm listing the local pools here for your convenience. They have photos so you can get an idea of how it works. I have not been to these places personally, so please do not take this as a professional recommendation -- it's up to you to talk to them and get recommendations from previous clients.
K9 Aquatics: www.k9aquatics.com
Heavenly Spa: www.heavenlyspa.info
Cottage Spa: www.cottagespa.com
USA Association of Canine Water Therapy: www.caninewatertherapy.com
UK Canine Hydrotherapy Association: www.canine-hydrotherapy.org

Finally - if you do decide to try your pet in the pool or lake, use a floatation device or keep them on a leash in the shallow water first so they can build their confidence and you can be sure they can actually swim! Don't let them out of your sight and be prepared to go in and rescue them if needed. I haven't heard of any dogs drowning, but I don't want to!

p.s. The Heavenly Spa advertises a "Canine/Feline Warm Water Pool". In all honesty - I have yet to meet a cat who would subject itself to the indignity of getting wet - even in the name of hydrotherapy. If your cat has benefited from a "dip" I'd love to hear about it!

Fleas? in January??

2009-01-07T22:29:00.004-08:00

I was doing some research on Google the other day and noticed that searches for information about flea control has its peak in June in the United States. This is logical since flea problems do peak in the warm summer months. I, however, also have noticed a small rise in animals with flea allergies or flea infestations in December and January. Owners are always surprised when I comb through their pet's coat and pull out a few live fleas or some dirts. I remind them that when the central heating comes on in these cold months, it seems to stimulate an emergence of juvenile fleas that have been pupated in the carpet or upholstery of the house.

I always recommend that ANY pet that is allergic to flea saliva should be on effective flea control every month throughout the entire year. It is also useful to use a product that incorporates an insect growth regulator whenever possible to reduce or eliminate the flea burden in the environment. (See also previous post on flea control.)

The purpose of dogs' legs

2008-10-31T23:30:00.003-07:00

I love children's literature because it can say things in a simple and direct way that adult literature often cannot.

This week my daughter and I checked a book out of the local library entitled We Honestly CAN Look After Your Dog. It is a book in the Charlie and Lola series by Lauren Child. Lola and her friend Lotta are attempting to demonstrate their vast knowledge of the needs of canine friends in an effort to convince Charlie's friend Marv that they can safely look after his dog while he goes to play football (soccer).

"Lola says, 'Dogs must go outside and must walk.'
"Lotta says, 'Otherwise what is the point of their legs?'"

So that is the message for today - take your dogs out for a walk -- otherwise what is the point of their legs?

New Vet TV

2008-09-03T09:54:00.003-07:00

The American Veterinary Medical Association (the AVMA) has started a new web TV service entitled AVMAtv. So far it just has short little blurbs about various issues in veterinary medicine, but promises updated content as time goes on. Subjects include vets in the military, how to become a vet, exotic species in Hawaii, and disaster preparedness.

There is a section on "Pet Wellness" which hopefully will ultimately support what I am trying to do here which is raise awareness of early signs that your pet is ill. Currently there is just a blurb on Cat Wellness sponsored by Cornell University and Fort Dodge which is encouraging a cat "wellness check" with your vet every 6 months.

Check out the site and enjoy!

An Itchy Situation

2008-06-09T08:44:00.004-07:00

The Flea Season is upon us (probably more in other parts of the world - Seattle is still chilly and rainy). I've spent some time over the last couple days catching up on the BEWILDERING array of products available to control these pesky pests.

Fortunately there is a fantastic summary of the products at Veterinary Partner.com. The author has only reviewed the products that are available over the counter or by prescription from vets. She hasn't gone into the pet shop or feed store products.

Most vets have to choose a few select brands/products to carry because there are so many and they all come in various sizes for various sized pets! For example, my current employer offers Frontline, Revolution, Capstar and Sentinel. My last employer only carried Advocate (aka Advantage Multi), Stronghold (aka Revolution) and Program.

The goal of flea control is four-fold: Kill any existing adult fleas, prevent transmission of other parasites (i.e. tapeworms), prevent the hypersensitivity reaction associated with a flea-saliva allergy and prevent development of eggs, larvae and pupae in the environment (i.e. your rugs and bedding!). For this reason, I always recommend products that kill fleas before they have a chance to bite - this takes care of the first, second and third problems on that list. Products that act as insect growth regulators, contraceptions or that have residual activity in hair/skin that the larvae feed on then takes care of the last.

Many products today also provide some degree of protection against other parasites - ticks, lice, roundworms, heartworms and mosquitoes. Your vet can help you decide which parasites your pet is most likely to be exposed to and therefore which product, or combination of products will be most effective. For example: We do not have heartworm in our area, but many of our clients travel with their dogs to heartworm endemic areas, so for these pets we recommend Sentinel which has an insect growth regulator, an internal wormer and a very good heartworm preventative. The trouble is that it does not kill adult fleas AND the fleas actually have to bite the animal to get the medication. If I have a patient who is also allergic to flea saliva, I also recommend a product like Frontline that rapidly kills fleas and keeps them from even biting.

I have always been disappointed with products from the pet shops. Reading their literature, they claim to be as good as the prescription products, but in reality I have rarely found this to be the case. Collars, for example, provide a heavy dose of insecticide in the front half of the animal, but the concentration "tails off" toward the back half and often this is where I find fleas in animals wearing flea collars. The pet shop spot-on products have older and less safe ingredients and I'm not convinced that the "carrier" -- or the solution the active ingredient is mixed with -- is as effective as the veterinary products. They are probably adequate for the non-allergic dog with low exposure to fleas from outside sources. Unfortunately I have seen many disappointed owners unable to understand why their dog is scratching even though it was treated with a pet shop product for fleas just the week before.

Flea treatment is important for your dogs and cats - please use a monthly treatment or at least comb through your animals' coats weekly to check for fleas or "dirts" (the black crumbly droppings from the fleas that dissolve red when wet). Other animals can also get fleas - I have seen rabbits and ferrets with fleas. Rabbits can have Advantage - it is licensed for use in rabbits in the UK and has been used successfully for years. (Frontline is not safe - please do not use it on rabbits). Revolution/Stronghold is safe for ferrets.

If you know that your dog or cat has allergies, even if they are not specifically allergic to flea saliva, it is important to keep them on good flea control. A single bite from a single flea and often push an allergic pet over the edge into uncontrollable scratching leading to skin damage, secondary infections and the potential for a hefty vet bill - certainly more than the flea control would have cost!

Rabbit Emergencies

2008-04-20T22:37:00.003-07:00

I was reminded again this week how important it is to have your rabbit examined at the first sign of it being unwell.

Rabbits are a prey species, and as such WILL NOT show signs of illness until they can't cope any more and often are about to die. If a prey species shows signs of weakness in the wild, they are more likely to be picked up by a predator, so those who can be stoic in the face of pain have a greater chance of survival.

The rabbit patient of note this week had been fine the previous morning. The previous afternoon it was "resting" in it's cubby and didn't eat its dinner. That was the point at which it needed to be examined. Unfortunately it didn't come in until the next morning by which time it was going into shock and died before lunch despite treatment for the shock.

Before he died, we had gotten as far as taking some radiographs and had identified a problem in the region of the liver/stomach. Fortunately the owners gave us permission to perform a necropsy (post-mortem examination) to find out what was going on. It turned out that this very-well cared for and well-loved pet had a torsed liver lobe: one of the lobes of the liver had twisted, cutting off its blood supply, and then ruptured, sending blood pouring into the abdomen and causing the shock.

I had never run into this condition before in rabbits, but an online literature search revealed it is "not uncommon" and often is identified in well-cared-for rabbit pets, often house rabbits. Those who survived had been given fluids and supportive care early and the condition had been diagnosed with blood tests (raised liver enzymes indicating damage to the liver) and ultrasound as well as radiographs. One even got as far as surgery in which the offending lobe was removed. Unfortunately our patient didn't live long enough for us to get to that point.

So the lesson for the week is to get your rabbit down to the vet's the minute it refuses food or behaves oddly, and be prepared financially if they ask you to allow some diagnostics - radiographs, ultrasound, blood tests - along with hospitalisation and fluid support. It may be a matter of life or death.

Healthy,well pets and preventative screening, oh my!

2008-02-06T20:57:00.001-08:00

I was reminded a couple days ago of the importance of regular check-ups for pets who otherwise seem healthy. A rabbit came in with "diarrhea" and with feces clagged around her back end. As I reviewed her records, I noted that 6 months previously I had had extensive discussions with the owner about diet and how to prevent loose feces such as this (the official diagnosis is cecal dysbiosis, but that's a different story!). I wondered what had happened such that the rabbit had gotten into such a state. It turned out the family had just slipped a little in their feeding regime - feeding more pellets than the rabbit needed, not enough hay or grass and a few too many of the wrong type of vegetables. This left their beloved pet with a sore and gassy tummy and unable to recycle her cecotrophs causing them to stick to her back end! By simply having a physical exam and discussing the daily feeding we were able to overcome a problem which, if left, could have escalated into a problem requiring costly hospitalization and danger to the pet's life.

As vets we like to see our young healthy pets once a year and older pets every 6 months (or more often for animals with certain conditions). This helps us do our job of looking after the health of the pet and allows us to build a relationship with the pet and the owners. In many countries, annual vaccinations give us a good excuse to do this. The 6-monthly myxomatosis vaccine for rabbits in England was very useful for regular discussions of diets and teeth checks. In the US, though, the distemper/parvo vaccine and the rabies vaccine for dogs are now able to be given every 3 years. If these are the only vaccines your pet has, should they only see the vet every 3 years? Certainly not!

Annual check-ups go by many names: wellness exams, preventative medicine screens, healthy pet exams, etc. They enable your vet to check teeth, listen to the heart and lungs, feel the abdomen, and weigh your pet. Many owners can't do this for themselves, or don't know what they're looking for. You can discuss diet and subtle changes in your pet's behavior. Many vets are starting to incorporate blood screening into these annual exams. This gives them one more tool to diagnose conditions early while they can be easily treated and before they become a real problem for your pet.

In our practice, for dogs and cats, we recommend a pre-operative blood test prior to spaying or neutering a pet -- even those that are only a couple months old. This allows us to check that the kidneys and liver are able to handle the anesthetic, to check that there aren't any clotting problems in the pet, and to be sure they aren't anemic or harboring an infection that should be treated before "stressing" the body any further. After this we recommend a similar blood test (without the clotting profile) annually along with an annual fecal exam until the pet is 7 years old (5 for giant dog breeds). After age 7 we like to do a more comprehensive blood test that includes thyroid levels and a urine screening in addition to the regular fecal test.

Why do we want so much blood year after year? Pets are very good at hiding when they are a bit under the weather (or we humans aren't as good at noticing!). It is easy to see that your 10 year old cat is a bit sluggish and just attribute it to getting older. In reality she may be a bit sore with arthritis or feeling a bit nauseated from kidney disease. By the time a cat shows the typical signs associated with kidney disease of drinking too much and losing weight (similar to signs of thyroid disease and diabetes) 75% of their kidney function has been lost and cannot be recovered. If, however, at age 9 that cat had had a screening and the vet had seen that her kidney values were up from the previous year's test and the urine was more dilute, he could have put her on a special diet that would slow down the progression of the disease and help her feel better for longer.

This all becomes much more important with flock and prey species. With birds we rely heavily on our annual blood and fecal screenings - once a bird starts showing clinical signs it's nearly too late! We can pick up things like subclinical respiratory infections or early liver disease from an inappropriate diet. Rabbits also often harbor subclinical infections that can only be detected with a CBC (complete blood count - a count of the red and white blood cells in the blood).

So work an annual exam into your calendar - ask your vet to send you a reminder if you aren't sure how long ago you were last there. Be prepared with a list of questions/topics to discuss and be ready to have that blood sample taken - it may improve your pet's life and give you more time together to enjoy each other's company!

New Country, New Challenges

2007-01-11T17:15:00.000-08:00

Soon after posting the last message I learned our family would have the opportuntiy to move to the Seattle area of Washington State, USA. The last couple months have been full of packing, selling belongings, moving and getting settled. I'm now in the process of becoming licenced to practice veterinary medicine in the State of Washington. I hope to start re-posting useful information and commentary soon.
I already miss my clients and colleagues in Leigh-on-Sea, but am excited for the new challenges that I'm sure are just around the corner.

A Plea...

2006-09-09T15:35:00.000-07:00

I had a very distressing night on call last night.
I received a phone call from some clients saying their cat had just been hit by a car and was not in a good way; could they bring her down? Fortunately I was able to see her immediately, but that didn't change the outcome. Soon after arriving at the surgery she became unable to breathe and the owners had to watch helplessly as I attempted to CPR their sweet pet back into the land of the living.
I lost the battle. The owners were devastated, understandably.
As I made my way home, I discovered a fox on the road in front of my house freshly dead from having been hit by a car. I scooped him up to take to the morgue at the surgery so he could be cremated with some dignity.
My colleague who had been on call the night before had attended 3 cats who had been hit by cars. Each of these cats required emergency treatment, and then further investigations and treatments in the form of xrays and surgery to repair broken bones or wounds.
My plea is two fold: to everyone who operates a motor vehicle, please be careful! It is so easy to get complacent on roads that we drive down each day. These animals nip out into the road with no warning and may be dazzled by your headlamps or confused by noise or running from a predator. Please decrease your speed and increase your awareness of what is in front of you on the road. Just think how you would feel if it were your own animal... or a child.
Secondly, to everyone who owns a cat, please make every effort to enclose them indoors at night. Most of these accidents happen in the dark when visibility is reduced and the humans are tired! If they insist on going out, please make every effort to have them wear a reflective collar. Many of these accidents are preventable, and they are devastating for all involved.

Not to Be a Stick in the Mud, But…

2006-07-31T13:36:00.000-07:00

I was at the park the other day and a lady arrived with a bouncy Cocker Spaniel. My heart sank as she picked up a stick and threw it for her beloved pooch to retrieve. You may think this is the best way to spend an afternoon – throwing a stick for your dog – but I can only see it as a potential road to disaster.

Stick injuries to the mouths and throats of dogs are a nightmare for the dog, for the vet and for the owner. The most basic and common injury is getting the stick caught on the roof of the mouth, between the upper teeth. This happens if the stick isn’t longer than the dog’s mouth or, more often, if the dog bites down too hard and breaks the stick, lodging the broken piece at the top of the mouth. A more serious injury occurs when the stick goes into the back of the mouth and the sharp end penetrates the lining of the pharynx. Often, even once the stick is removed, bits of bark or other foreign material can be left behind. It is extremely difficult to clean these wounds, even with the animal under anaesthetic and if any material is left behind it can cause inflammation (aka a foreign body reaction) or abscessation.

I treated one patient while at university whose oesophagus had been penetrated by the stick. It had to be referred to us at the university hospital for specialist surgery and ICU care during his recovery.

Another dog we treated at the local surgery had to have multiple anaesthetics to remove all of the bark that had become imbedded in his pharynx.

May I suggest rather than a stick, that a Frisbee, a bit of thick rope, or a sturdy rubber toy be employed to exercise your dog and that you leave the sticks for some one else.

The Cost of Animal Health

2006-07-26T15:17:00.000-07:00

In the UK, we are blessed (or cursed depending on how you look at it) with a National Health Service. As a result, the humans rarely have any idea what it costs for them to see the doctor or spend a night in hospital. It comes as a bit of a shock when they come to the vet's and are asked to pay sometimes hundreds of pounds for treatment. There are three aspects of the price of veterinary medicine that I'd like to discuss:
(1) Getting an Estimate
(2) Insurance
(3) Prevention is Cheaper than Cure

(1) Before you even make your appointment you can get an idea of what it is going to cost you. Receptionists are used to people phoning up to find out the cost of a consultation (remember to ask how long the time-slot is -- a vet who does 20 minute consults may not be twice as expensive as one who does 10 minute ones so you may get more for your money). They will also give you an idea of costs for routine procedures like neutering and dental work. Once you have seen the vet and s/he has told you what is wrong and what needs to happen to fix it, it is a good idea to ask for an estimate. This gives you an idea of what kind of money you will be expected to hand over at the end of treatment and may help you make decisions as to which procedures to accept or decline. The estimate may be verbal or written. I prefer to give written estimates (I print out a copy for my clients to take home with them) so if there is a discrepancy at the end we can explain why it is different. If I do give a verbal estimate, I always make a note in the record. This reminds me to let the client know if the treatment is going to exceed what I initially thought. If your vet gives you a verbal estimate, I suggest you write it down yourself and make sure you have heard him correctly (50 rather than 15 for example). Please also realise that an estimate is only that. Once the vet is able to see the results of tests or the way your animal responds to treatment, the course of further treatment may change.

(2) I am always relieved when a client tells me they have insured their animal. I don't view this as a green light to spend lots of money on unnecessary tests, but rather as an equaliser. It allows me and the owners to do what is right for the individual patient rather than what the owner can afford (which may not be appropriate for the pet). Many people are sceptical of insurance companies, having found them unwilling to pay out for problems with their home or car. We have found them very accommodating so far and have had very few problems. For people who don't want their money to go to some large corporation, perhaps never to be seen again, I suggest opening a savings account just for the pet. I suggest finding out what the insurance premiums for your area are and saving that as a minimum amount. I do often suggest to clients who bring me new puppies/kittens for vaccination that they start a savings account, but take out insurance for the first couple years since this is when animals tend to be the most accident-prone and when the savings account will still be too small to cover the cost of a broken leg or retrieval of a swallowed toy.

(3) Please, please, please vaccinate your pets. If you decide you don't want them vaccinated, for whatever reason, at least bring them for an annual check up -- especially once they enter their geriatric years (over 8 years old for dogs and cats, over 5 for rabbits). Your vet can pick up subtle changes in your pet and can help curb problems before they become expensive. A toothbrush and tube of doggy toothpaste along with a demonstration of teeth brushing by the nurse is a lot cheaper than an anaesthetic for dental cleaning and extractions of rotten teeth. Kidney disease can be managed just with diet in the early stages, but may require multiple blood tests, blood pressure tests, fluids, tablets and hospital stays if not diagnosed until it is advanced.

Finally, when you are thinking of bringing a new pet into your home, please remember there is more than just the purchase price to factor in. A £2.00 hamster can ultimately cost £200-300 with the cage, food, toys and veterinary care.

My Claim to Fame... or Not!

2006-07-22T15:25:00.000-07:00

A different kind of post today: one of a more personal nature...

A new series started tonight on ITV (Channel 3 in the UK). It is called Prehistoric Park and is on Saturdays at 6:50pm. I imagine in a couple months it will air in the US on the Discovery Channel or Animal Planet or some similar channel.
(See the ITV website for more details)

My claim to fame, however, is that I auditioned for it, believe it or not. They had advertised in one of the vet mags for a female vet with acting experience. That's me, so I sent in an audition DVD. Unfortunately I wasn't chosen, so you can imagaine the eagerness with which I watched tonight's opening episode. The vet they've chosen is a woman named Suzanne and I don't know anything else about her. She only had a few short scenes in tonight's episode, so we'll see if she plays more of a role in the future ones.

Maggoty Bottoms -- No Thanks!

2006-07-18T16:32:00.000-07:00

It has been hot in the UK for the last couple of days and the flies have been going wild. I noticed a maggot crawling out of one of my rubbish bags this morning as I put it out for collection. I even thought I saw one on my head of lettuce this morning while I was getting the sandwiches ready. If it was real, then the flies really are getting desperate.

These glimpses of the larval stage of the common housefly brought back vivid memories of previous summers full of maggoty bottoms. My heart sinks at this time of year if I’m consulting and a rabbit appears on my list as an extra “fit-in”. It usually happens about 4:30 in the afternoon when the owner has gone out to check on the rabbit and take it its evening meal. She’s either had to catch the rabbit up out of the run and notices them then, or the rabbit has already gone into shock and is flat out in the hutch.

Fly strike – the term applied to the process of a fly laying her eggs on an animal and the subsequent hatching of those eggs and the damage they cause – strikes fear into the heart of all rabbit owners (or it should!). The eggs look innocuous, just micro cream-coloured grains of rice arranged like a raft – it could be sawdust to the untrained or uninitiated. They hatch into tiny wriggling worm-like parasites whose goal is to eat as much as possible and grow as large as possible. If the rabbit (or other animal… see below) is wet or has faeces stuck to the underside of its tail, the maggots start there, but often keep going and can enter the rectum, vagina or urethra, or can burrow in through the skin and enter the abdomen.

It is often this faeces under the tail that attracts the flies in the first place, but any animal that is debilitated can be a target. If the animal is lying still long enough for the fly to land and lay the eggs, or if it is not grooming the eggs off after they are laid, it will be a target.

My rabbit clients probably get bored when I harp on about the importance of fibre in the diet and the importance of making sure you only ever see the hard round balls of faeces, not the soft smelly faeces (aka caecotrophs). I and my nurses have spent too much time picking maggots off the back ends of rabbits though! I want to put a stop to it!!

To prevent fly strike you MUST:
(1) Feed your rabbit properly. Make sure they have a high fibre diet (see previous post) with LOTS of grass and hay.
(2) Monitor the droppings daily. If you are seeing caecotrophs in the hutch more than once in a blue moon, get to your vet and get it sorted.
(3) Check your rabbit 2-3 times daily. Not just glancing in to see if he’s breathing, but physically picking him up and turning him over. Comb through the fur at the back if possible.
(4) Don’t allow your rabbit to become overweight. This makes it very difficult for them to groom properly and remove bits of faeces and fly eggs (they just can’t reach!).
(5) Remove faeces and urine along with any soiled bedding from the hutch daily. Flies have more sensitive “noses” than humans, so if it smells to you it will be heaven for a fly.
(6) Use mosquito-type netting over the hutch and run and keep them in the shade on hot days to prevent access by the flies and to prevent the rabbit from overheating and becoming debilitated.
(7) If you’re concerned about fly strike and have followed the previous 6 recommendations, there is a product that can help. “Rear Guard” is licensed for the prevention and treatment of fly-strike. It is a bit fiddly to use and to apply properly, but it does kill the maggots and prevent the eggs from hatching. It does not repel the flies, however, so it is not a replacement for good hygiene, diet, etc as listed above.

If you discover that your rabbit (or other animal) has maggots it IS an emergency and they need to be seen by a vet immediately – even if it’s midnight. The maggots release substances as they feed that can send the animals into shock and kill them. Often the maggots are secondary and there is something else that is going to kill the animal first, so no matter what, if you see maggots, call the vet and then get down there ASAP. If you can’t be seen straight away, you can help your pet by starting to pick the maggots off yourself with a pair of tweezers. If your pet already shows signs of going into shock, try to minimise stress, wrap him up in a towel and put him near a warm radiator or under a warm lamp.

Also, rabbits are not the only animals that are affected at this time of year. Guinea pigs, dogs and cats are also susceptible. The saddest case I have seen was a dog who had had chronic diarrhoea but the owner had not been cleaning it away from the fur at the back end. The flies were having a field day. It was not a pretty sight.

Please don’t make me or my nurses clean up any more maggoty bottoms this year!

Thanks.

Further reading:
Glen Cousquer Case Report of an obese Lop-eared rabbit with fly strike. This is more for vets, but will give you an idea of the kind of work that can be necessary to repair the damage caused by the maggots.

A Word about UV

2006-07-17T15:33:00.000-07:00

Everyone is uptight these days about avoiding Ultraviolet (UV) radiation exposure: stay out of the sun; put sun cream on; make sure you're protected against UVA AND UVB; UV causes skin cancer! All of these things are important to remember if you are a human, particularly one of Scottish descent (complete with reddish hair and freckles) like me.

If, however, you are a reptile, UV takes on a completely different significance. UV radiation allows a complex organism like an iguana, tortoise, snake, or, yes, a human, to make vitamin D which helps with calcium absorption and metabolism. When we avoid UV radiation we are preventing our bodies from making this useful molecule. This isn't a problem if you are a human drinking vitamin-D fortified milk and eating fish or eggs. If you are a vegetarian iguana or Spur-thighed tortoise, then to be deprived of sunlight or other source of UV light is to be deprived of normal bone growth and strength. This leads to deformed bones and can result in multiple broken bones.

Reptiles in captivity need to have regular access to unfiltered sunlight (sometimes a challenge in Great Britain, but make the most of it when you've got it!). When sun exposure isn't a possibility, then a good UV lamp is the next best thing. Unfortunately not all reptile owners realise a few key aspects of UV supplementation:

(1) There can be no glass or plastic between the animal and the light. If you are concerned about your pet breaking or burning himself on the light, then put a sturdy wire mesh in front of it, but no other barrier.
(2) The UV portion of the light only lasts 6-9 months. This is long before the actual light burns out, so be sure to mark on your calendar when to change the light - twice a year (it's easy if you remember to do it when the clocks change, for example). You don't have to throw the light away, you can use it elsewhere in your house as just a regular light.
(3) The UV portion of the light doesn't extend very far. Only 12-18 inches. It therefore needs to be positioned near where your pet likes to bask. For a tortoise or a snake this will be near the floor of the enclosure, for an iguana or chameleon this will be near the top of the enclosure.
(4) Be sure to buy a lamp for reptiles, not one simply marked "broad spectrum" or labelled for fish. These other lights won't necessarily have the wavelengths your pet needs.

Finally, the need for UV has been best documented in reptiles, but birds and small mammals do also benefit from a trip (in safe accommodation) into the back garden on a sunny day. It's best not to do this when the family is over for a barbeque, or the neighbourhood dog is barking his head off. Choose a quiet time when there isn't much of a breeze and gradually introduce your pet to the big wide world. Don't be surprised if they are a bit scared at first. There are a lot of predator smells/sounds that we won't necessarily pick up on. As they spend 10-30 minutes outside a couple times a week, you will hopefully notice an improvement in their health and well-being.

Bring on the summer sun!

Keep the Sandpaper Out of the Bird's Cage

2006-07-15T13:14:00.000-07:00

If ever there was a bit of pet shop paraphernalia that was useless and potentially dangerous it would be the sandpaper perch covers and cage bottom sheets. They are touted as useful for wearing down the nails of budgies, canaries and other small caged birds. In truth, all they do is irritate the birds' feet and empty the owner's wallet!

As part of his normal preening activity, you should notice your bird nibbling his nails occasionally. This, along with the normal perching and climbing activity your bird should also be exhibiting, is enough for a normal, healthy bird to keep the nails at an appropriate length. Occasionally I will trim the sharp points off my birds' nails if they seem to be catching in nesting material or soft furnishings around the house.

A sandpaper perch cover only serves to give a rough place for the bird to perch. At best this is unnecessary, and at worst may predispose the bird to bumble foot (a sore area on the weight-bearing surface of the underside of the foot and subsequent infection). The sandpaper floor covers are the same. I also worry if your bird is like my lovebirds and shreds the paper at the bottom of the cage -- it can't be nice to accidentally ingest!

If your bird's nails appear to be overgrowing, there are a couple reasons this could be happening. A parasitic infestation or painful condition could be altering the bird's preening routine. Malnutrition - either due to not being offered the right food, competition for food, or selective feeding - can also cause nails to overgrow.

The best types of perches for your bird are natural branches. These can either be collected from your own fruit trees (i.e. apple, cherry, pear trees), or they are commercially available at good pet stores with bolts and washers to connect them to the sides of the cage (see photos – these are the perches from my budgie’s cage). The benefit of these more natural perches is the variation in diameter which allows the bird to choose where he is most comfortable; they also allow him to exercise his feet and vary the pressure points throughout the day. They also look nicer than plain wooden dowels or plastic perches! A branch that isn't attached at both ends will also swing/sway a bit when the bird lands on it mimicking tree branch movement in the wild and helping with balance and muscle coordination.

The floor substrate you should use will depend a bit on the activity of your bird. If he spends time shredding the paper, then paper kitchen towel or plain, unprinted paper will be best. If he never goes down to the floor, you can use newspaper or similar. I encourage my clients to change the paper regularly (as often as daily sometimes) to monitor the droppings – their number and consistency – and maintain good hygiene.

Let’s only use sandpaper to tidy the ends of our natural branch perches; it has no other use in a bird’s cage!

Walk Through the Grass at your Peril

2006-07-12T15:49:00.000-07:00

You wouldn't think something as simple as taking a walk would be painful or life-threatening. And it rarely is immediately. There is, however, a hidden danger in the long, uncut grass on the verge, or in the field, or in the park, or even in your own garden. The Brits call them "grass seeds"; the Americans call them "foxtails".

The San Francisco Dog Owner's Group has produced a document which includes some good pictures of the species of plants involved.
http://www.sfdog.org/do/foxtails.pdf

I always dread seeing canine patients from July through September since this is what we call "grass seed season". This is the time when the warm sunshine of late summer induces the grasses to put up their seed heads. As the seed heads dry out the seeds (or "awns") are dispersed. A dog brushing against the seed head as he runs through the field will later find multiple awns caught in his fur. Because of the arrow-like shape of the awns they can only migrate in one direction and if that direction is "into the dog" it then becomes a fight to get them out again.

The dog breeds that have the most trouble with grass seeds are the spaniels and other hunting breeds. These dogs have longish hair and dangly ears -- perfect for collecting grass seeds. The seeds can penetrate the skin and most often do so between the toes. They can also get caught in the eyes (especially behind the 3rd eyelid), in the ears, and inhaled or swallowed. They are initially simply irritating -- the eye becomes red and weepy, the ear is itchy and produces copious amounts of wax, the skin develops a red raised area that can become infected -- often the owner is alerted to a problem when the dog starts limping or licking the foot or shaking his head.

The seeds become life-threatening if they are not removed. Infection is just the tip of the iceberg. They can migrate up a leg slowly month after month and eventually end up in the chest -- one was reportedly removed from a lung.

They are notoriously difficult to find. They are not visible on xray, so at times it is like searching for a needle in a haystack. We use long thin forceps (alligator/crocodile forceps) to probe the sore area of the foot in an effort to blindly retrieve the foreign object. In the ear, an otoscope makes the procedure a bit easier as you can sometimes visualise the seed, but then retrieving it without puncturing the ear drum or pushing the seed further in can be nerve-wracking!

An ounce of prevention in the case of grass seeds is worth pounds and pounds of cure! Firstly, in your own garden, mow the lawn frequently enough to prevent the seed heads from maturing (they are not dangerous when the are green). Petition your local authorities to maintain public parks and other areas for the same reason. Obviously in fields and wooded areas, areas that are allowed to go a bit wild for the wildlife, the frequent mowing isn't going to be an option. If you take your dog to these areas, check him CAREFULLY when you get home. Brush his coat thoroughly and examine his paws. When you look between the toes, part the hair so you can see the skin at the top-most part. Check the ears with a torch/flashlight and pull down the eyelids (if you dog will let you) to be sure no seeds have gone in. I often recommend to owners who have dogs with fluffy feet to have a groomer shave the feet to just below the carpal pad -- a "poodle cut" – during this part of the year. Trimming hair around the eyes and shaving/plucking the hair from around the entrance to the ear canal also makes a big difference.

If, as so often happens, you come home from work after the vet's has closed for the night and find your dog has been licking his foot all day, it is not a life-or-death emergency; you do not have to call the vet out that night (unless your dog is in extreme pain). Examine the foot to see if you can see the end of the seed poking out from the skin. Pull it out if you can see it. If not, and you are comfortable doing so, trim the hair way from the sore part of the foot. Soak the foot for 10 or 15 minutes in a chlorhexidine solution (if you have it) or a saline solution (1 teaspoon table salt in 1 pint of warm water). If your dog is keeping you awake licking it you can put an Elizabethan/Buster collar on or put a sock over the foot.

When you see the vet the next day, be prepared for the possibility of your dog needing an anaesthetic. Retrieving grass seeds is a painful process and unless your vet is very lucky to find it on the first probe or your dog is very laid back, they often need a bit of "chemical restraint".

Feeding Guidelines for Pet Rabbits

2006-07-11T08:05:00.000-07:00

(This information was originally published as part of a "New Bunny Pack" I put together for clients of Downes and Partners Veterinary Surgery in 2004. I have modified some of the wording for this forum.)

There have been many recommendations over the years as to the best diet for rabbits. Much of this has been based on what has been fed to laboratory rabbits kept in small cages with little to no exercise and a very short life span.

Today, pet rabbits can live up to 12 years so we are trying to feed them a more natural diet. Wild rabbits spend most of their day grazing on fibrous meadow grass and then select a few tastier morsels as they are available such as roots, bark, branches, flowers and leaves. This diet is very high in fibre, low in protein and fat, and requires a lot of chewing!

Diets that are deficient in fibre cause a number of problems. Dental disease is the most common result of a grass-deficient diet. Diarrhoea, soft stools and flystrike are also problems resulting from low-fibre diets. Diets too high in sugar and fat can cause obesity, which also contributes to dirty bottoms and flystrike!

I recommend, whether your rabbit resides indoors or outdoors, that hay and fresh grass should make up the main part of his/her diet. The grass is best picked by the rabbit himself while grazing in a protected run. The hay should be good-quality, bagged, meadow or timothy hay. Alfalfa hay is also available. This can be fed ad lib to growing animals and pregnant or lactating does, but should be fed only in small quantities to fully-grown rabbits.

Once daily you may supplement this diet with a very small amount of a concentrated pelleted or extruded food. In the UK, I recommend Oxbow Bunny Basics, Burgess Super Excel Lite, or Supreme Science Selective. I do not, under any circumstances, recommend a mixed or muesli-type food of any make or brand. A concentrated food, if fed, should be fed at a maximum rate of 10-20g food per kg rabbit per day. Pregnant and lactating does, ill animals, and animals recovering from surgery may have extra requirements and your rabbit vet can advise you if your pet falls into this category.

Weeds, such as dandelion, chickweed, and nettles are often enjoyed by rabbits along with branches from fruit trees such as apple and pear. Fresh green leafy vegetables, such as cabbage, spring greens, kale and broccoli are also delicious treats. Many rabbits also enjoy herbs such as mint and parsley. If you have a question about any food or plant item, please feel free to ask your vet.

Please remember, that ANY change to your rabbit’s diet must be made slowly over a week or so to allow his/her gut to adjust to the new foods. Any sudden change, even swapping to a new bag of his regular food, can cause an imbalance in the gut flora and subsequent bloating, release of bacterial toxins and possibly death. Even if you are just feeding a new bag of your regular food, mix some of the old and new bags together to allow a gradual change-over.

The final word: Rabbits eat GRASS!!

The Cat is Getting Old

2006-07-10T14:33:00.000-07:00

It has happened so many times. A client brings in a thin, scraggly 14 or 15 year old cat. She has been with the family for years and they love her dearly. They say the cat has been losing weight over the last couple months, but has been eating well, so they didn't think anything of it. They just thought she was getting old. She is now skin and bones so they think she may need to be put down, but look hopefully at me to see if there is anything that can be done.

I ask my usual questions as I examine her. The answers are familiar: yes she is always hungry, yes she seems to have a lot of energy for her age, yes she occasionally throws up but we thought it was hair balls, yes she is restless at night. The exam reveals bad teeth, bright eyes, a racing heart rate, a heart murmur, severe muscle wastage and no body fat... and a large lump in the neck to one side of the trachea.

I inform the client that I will need to do some tests to confirm, but that I suspect the cat is getting old and is suffering from one of the most common "old-cat diseases": hyperthyroidism. Fortunately it is completely treatable and often carries an excellent prognosis.

I find the three most common "old-cat diseases" are kidney disease (failure/insufficiency), hyperthyroidism and cancer (various types). Each of these diseases can be treated if they are caught early enough and managed to maintain the quality of life of your beloved moggy for many years after diagnosis.

Hyperthyroidism is caused by an over-active thyroid gland. The gland is shaped like a butterfly and is located on either side of the trachea (windpipe) on the front of the neck. Often one side overacts first and the second side follows a year or two later. Because thyroid hormone regulates the metabolic rate of the cat, too much thyroid hormone makes them burn calories much faster than they can take them in. They become very hungry and very active/restless. Because they can't take in enough calories, they start to burn all their fat reserves, and when those are gone, they start to burn muscle.

Thyroid hormone also increases the heart rate. A normal cat who is nervous in my exam room will have a heart rate of between 160-200 beats per minute. I have counted heart rates of 240-260 in some hyperthyroid cats. The heart starts to wear out from all the hard work it is doing. Initially you just hear a murmur, but eventually the cat can go into heart failure and this is usually what kills the cat if the thyroid is left untreated.

I diagnose hyperthyroidism with a simple blood test. I always test the kidney and liver enzymes as well and monitor these throughout treatment. The high blood pressure associated with a rapid heart rate can mask an underlying kidney disease. This then becomes apparent once the heart rate and blood pressure are brought down to within the normal limits.

I start treatment with tablets given once, twice or three times per day depending on how high the thyroid levels are. I always check the patient 2 weeks after starting treatment to make sure they are not suffering any adverse side-effects (dramatic loss of appetite, lethargy, vomiting or itchy skin for example) and to adjust the dose accordingly. After a further 2 weeks, I check the thyroid hormone level and kidney values. Once the patient is stabilised we discuss further options. Cats, if they tolerate the tablets, can stay on them indefinitely. I prefer to surgically remove the overactive thyroid since most cats do not reliably take their tablets! There is also the option to use radioactive iodine to irradiate the thyroid tissue, but I have yet to have any clients take me up on this option. (It requires the cat to be hospitalised for a month since her urine and faeces are radioactive for this length of time after the treatment. It also costs over £1200, while the surgery is more like £250 per side and only requires an overnight stay in hospital).

I have only ever had to start 1 patient on thyroid supplementation after removing the thyroid and I have only ever had one patient experience the most serious side effect of surgery which is damage to the parathyroid and subsequent hypocalcaemia (resulting in fits/seizures which resolved with calcium supplementation). If you do opt to have your cat’s thyroids removed, please be aware that they can still be hyperthyroid. Some cats seem to make thyroid tissue elsewhere in the body. These cats can only be treated with tablets or radioactive iodine. Sometimes the thyroid is also located in the chest rather than the neck. These cats cannot have the operation.

So the long-and-the-short of this post is... if the cat seems to be getting a bit old and thin, get her checked sooner rather than later -- she'll thank you for it!

Please note: prices vary widely in different parts of the country and world. The prices mentioned here were examples from two veterinary surgeries in the Southeast of England.

Introduction

2006-07-10T14:16:00.000-07:00

As I go through my day consulting with my clients and treating my patients, I often wish I could shout to the pet-owning public bits of information that would help them look after their beloved pets better. The birth of the blog is a great opportunity to do just this.

I am a small animal veterinarian, but I do have some knowledge of farm animals and equids. I will be publishing basic information about husbandry and healthcare of certain species and tips for recognising when your pet needs to see a vet. I will not be able to comment about specific cases or diagnose a problem via email. If you have questions about a specific disease or condition, I can do my best to address it in a general sense. My experience is limited to diseases and medicines available in the USA and the UK, but much of this is transferable to the rest of the world.

If you think the information I have published is inaccurate, I am not so proud as to not accept correction, so please correct me -- preferably including a source for your information (such as a journal article or personal experience).

Thanks!