DOGS
CONDITIONS
Addison's Disease
Addison’s disease, also known as hypoadrenocorticism, is a very serious hormone imbalance. Affected dogs often have only very subtle, intermittent signs, until the disease progresses to a life-threatening Addisonian Crisis.
Lack of natural steroid hormones, made in the dog’s adrenal glands. Normally, dogs make two types of steroids: glucocorticoids (like cortisol, which help them cope with stress) and mineralocorticoids (which control their salt and water balance). In Addison’s, the adrenal glands do not produce enough of these hormones; this may be because of damage to the adrenal glands (Primary Addison’s) or, more rarely, injury or disease of other glands in the body that regulate the action of the adrenals, such as the pituitary (or “Master”) gland. Occasionally, Addison’s can also be the result of excessive steroid medications (we call this “Iatrogenic Addison’s”, and it occurs because the adrenal glands stop making steroids because we are giving the dog so many; if we reduce the dose too fast, the glands cannot adapt in time).
Addison’s disease can affect any dog. However, it is most common in young to middle-aged bitches, and is slightly less common in male dogs of all ages.
Much of the time, a dog with Addison’s may appear almost normal. However, observant owners will often notice subtle signs such as intermittent vomiting, shaking, muscle weakness or weight loss. These symptoms come and go, and in between episodes may disappear completely. Eventually, however, an affected dog will undergo an Addisonian Crisis, where the symptoms suddenly and dramatically worsen. This is a life-threatening condition, and is usually characterised by acute, severe vomiting and diarrhoea, dehydration, collapse and the rapid onset of shock. Without treatment, it is often fatal. Sadly, in as many as 30% of dogs, the first symptom is an Addisonian Crisis.
There are characteristic changes in the blood salts that are very suggestive of Addison’s (especially the ratio between the sodium and potassium). A conclusive diagnosis, however, requires a specialist blood test called and ACTH stimulation test, where a sample of blood is taken, and then your dog is injected with a hormone that should increase the production of cortisol. A second blood sample is then drawn some time later, and if the dog’s cortisol level hasn’t risen, they are confirmed to have Addison’s disease.
Fortunately, once diagnosed, it is perfectly possible to treat Addison’s very effectively. In a Crisis, we would put the dog on a drip to correct the salt and fluid imbalances, and give them a steroid injection to help tide them over. Then we would aim to replace the “missing” hormones with specialist steroid medication – either as tablets or a long-acting injection. Regular monitoring is important to ensure that we’re giving them the right amount of artificial steroids, but this can normally be done with a simple one-off blood test.
Unfortunately, neither Primary nor Secondary Addison’s can be prevented as yet. However, Iatrogenic Addison’s can be avoided by only very, very gradually reducing the dose of steroids if your dog has to be on these medications for any reason.
Allergies
An allergy is an abnormal immune reaction to an otherwise harmless substance (an “allergen”). Allergies are one of the most common causes of skin disease seen in dogs.
Your dog’s immune system is a very powerful, very effective defence mechanism – anything that gets into them that it doesn’t recognise is attacked and destroyed. However, sometimes the immune system can make a mistake, and respond to a harmless substance in the environment (such as pollen, or a particular type of food, for example). Of course, this cannot be destroyed but the immune system tries really hard to do so! The most common allergen in dogs is thought to be flea saliva (nasty, but not actually harmful!), but they can respond to a wide range of other substances, such as pollen, certain types of protein found in food, storage mites, cleaning products, fabric softener and many more.
Any dog may develop an allergy; however, it is most common for dogs to become allergic early in adult life. It’s important to remember, too, that a dog cannot become allergic to a substance until they have been exposed to it on at least two occasions.
The exact symptoms will depend on what part of the immune system has been stimulated; in general, however, most allergies in dogs present with skin symptoms (yes, even food allergies). These include itching, reddening of the skin, hair loss, self-trauma (from the scratching) and secondary infections. In many cases, the skin first affected is that lining the outer ear canals, so dogs with allergic skin disease may initially appear to have an ear infection; the softer skin between the pads on their feet is also commonly affected (when this is involved, we call it “pododermatitis”). In other cases, the allergy may cause a runny, itchy nose (“allergic rhinitis”, very like hayfever in humans!), itchy, sore eyes (allergic conjunctivitis) and, rarely, stomach upsets (especially diarrhoea).
There are three approaches to diagnosis. The first is to look at the history – when do the symptoms appear, are they associated with any type of food, or bedding, or environment? Do they only appear after walking under certain trees in the park, or if you’ve used a particular fabric conditioner? This will often allow us to determine what types of things are causing the allergy, but not always. If not, we can use special tests such as the IgE Blood Test (to look for raised levels of antibody in the bloodstream) or the Intradermal Allergen Test (where we inject certain substances into the skin and then measure the response). These both have strengths and weaknesses, but using a combination of the two we can usually determine the cause of your dog’s allergic reactions. The exception is food allergies, as there are no lab tests that can diagnose the condition. In the case of a food allergy, the only way to demonstrate it is to put the dog on an Exclusion Diet, where they eat only either novel foods (that their immune systems have never been exposed to before) or, better, a hydrolysed diet (which is specially formulated so the immune system cannot respond to it). If the symptoms resolve, then we reintroduce one foodstuff at a time until we discover which one is the problem!
The ideal treatment for any allergy is simple – avoid the allergen! In some conditions (like Flea Allergic Dermatitis) this is very doable – it isn’t easy but it is possible to eradicate fleas in your house. However, this isn’t always practical, so there are other options. The first is medication – there are a range of different medications available to reduce itching and damp-down the immune system’s abnormal response. Some are rarely successful (such as antihistamines), some have many side effects (like steroids) and some are very expensive (like ciclosporin), but careful and judicious use of medication can make all the difference to a dog’s quality of life. Other possibilities include desensitisation, where we “teach” the immune system to ignore harmless allergens.
No – predisposition to developing allergies is partly genetic, but it also depends on the environment. Unfortunately, at this time they cannot be prevented.
Anaemia
Anaemia is actually a symptom, not a specific disease. It refers to a situation where there aren’t enough red blood cells in the dogs bloodstream to effectively transport oxygen around the body.
There are a wide range of different conditions that can cause anaemia. Broadly speaking, these can be divided up into three areas. Firstly, those conditions characterised by loss of red blood cells. This essentially means blood loss – after a serious injury or wound, the dog will become anaemic because they have lost so many red blood cells. Secondly, diseases that result in the destruction of red blood cells, such as Immune-Mediated Haemolytic Anaemia (IMHA, where the immune system malfunctions and starts destroying red blood cells) and Babesia infection (where a parasite attacked and destroyed the cells). Finally, anaemia can also result if the body isn’t making enough – for example, in iron deficiency and malnutrition, chronic, long-term disease, kidney failure, or certain diseases of the bone marrow.
It depends on the type of anaemia, and the specific underlying disease – for example, tumours are more common in older dogs, whereas immune mediated anaemias are more common in young adults.
It will of course depend on how severe it is, but generally, the symptoms include pale or white gums, poor exercise tolerance, breathlessness and panting (even after little exercise, or at rest), rapid heart rate and, in some cases, collapse.
Firstly, we’ll have to look at your dog’s blood. We’ll use machines in our lab to count the numbers of red blood cells, but then we’ll have to look at the cells under our microscope to try and work out what’s going on. It may be necessary to use other, specialist tests (such as the Coomb’s Test for immune mediated anaemia), and the blood sample may need to be sent away to an external laboratory. Essentially, we will try and work out what the cause is, so that we can correct it. In a few cases, this can be really complicated, requiring lots of different techniques such as X-rays, ultrasound, additional blood tests, and even bone-marrow biopsies to determine what’s going on.
In most cases, once we can determine the underlying cause and stop that, the anaemia will resolve on its own. For example, surgery to close a bleeding wound; medication to kill Babesia parasites, suppression of the immune system in IMHA, iron supplementation if the diet is deficient, etc). However, if the anaemia is very severe, it may be necessary to carry out a blood transfusion from a donor dog to supply extra red blood cells, and buy us time to work. Sometimes, the cause isn’t something we can fix, sadly, but in the majority of cases, it can be either fixed or managed with medication.
It depends on the cause. Babesia infection, for example, can be prevented by using good tick repellents; immune mediated anaemia, however, cannot be predicted or prevented.
Anal Gland Problems
Dogs have a pair of anal sacs (often called “anal glands”) situated just inside their anus. In a healthy dog, these glands empty every time they go to the toilet – modifying the smell of the dog’s faeces so that they can be used to communicate with other dogs (although they all smell equally vile to us!). If these glands become impacted, the secretions inside cannot be squeezed out. As a result, the glands become increasingly full, swollen and uncomfortable.
Any source of a “malfunction” in these glands can lead to problems. Most commonly, the glands fail to empty properly, and so become progressively fuller. The usual causes are an episode of diarrhoea (runny faeces don’t squeeze out the glands as effectively as nice solid ones); poor conformation of the glands (which is probably genetic); or an increase in the “thickness” of the fluid (for example, a primary infection, but this is quite rare). Once the gland is impacted and unable to empty itself, secondary infections (which are very common!) occur. This causes the tissue to swell, making the impaction even worse. Eventually, if not expressed, a large and painful abscess will form next to the dog’s bottom. When it ruptures, it may ooze pus all over the dog’s back end, or burst internally causing severe internal infection.
Any dog may suffer from anal gland problems; however, toy and miniature breeds seem to be at higher risk of abnormally shaped or positioned anal glands. A dog who has suffered from a recent episode of diarrhoea is also at much higher risk.
The first sign is usually “scooting” – rubbing their bottom along the floor, trying to squeeze out the glands. If this is not successful, they may start licking, scratching or biting at their back end. As the glands become more swollen and painful, they may become constipated – they don’t want to go to the toilet because it hurts so much!
Very simply – one of our vets will put a finger in your dog’s bottom and feel the glands. They’ll easily be able to tell if they’re swollen, blocked – and if they’re painful, your dog will make it very clear…!
The vast majority of anal gland issues are simple impactions, and our vets can easily “squeeze” them out and empty the overfull gland, solving the problem. Occasionally, if the gland is really swollen and inflamed, we may need to give them a short course of antibiotics and anti-inflammatory medication before we can empty them. If this isn’t sufficient, the next option is to admit the dog for surgery and surgically drain the glands.
Some dogs are particularly prone to anal gland disease; for these, we’d recommend a small change in the diet (typically, a slight increase in the fibre content) which will allow the passing faeces to squeeze out the contents more effectively. If that isn’t enough, we can always surgically remove the glands – this is a pretty complicated operation, and there are possible side effects, but it definitely removed the problem!
Atopic Dermatitis
Also known as “Atopy”, Atopic Dermatitis is the second most common allergic disease in dogs, with as many as 15% of dogs affected. It may best be described as a condition where the dog’s immune system is hyperactive, giving them a predisposition to developing allergies to multiple different harmless chemicals (or “allergens”) in the environment.
Atopic Dermatitis is a genetic condition, although the exact mechanism isn’t well understood. It causes a predisposition to developing allergies, and may also make the skin more susceptible to bacterial infections as well. Affected dogs may become allergic to pretty much anything – typically we’d expect to see allergies to grass, tree and other plant pollens, harmless mites (like dust mites or storage mites), as well as foodstuffs (typically protein sources such as beef or soy) and other ubiquitous substances. Occasionally, however, dogs develop much more unusual allergic reactions, for instance to perfume or even rice.
Although Atopy is seen in many breeds, the most heavily predisposed is the West Highland White Terriers. Other breeds with a higher than average chance of developing the condition include Staffordshire Bull Terriers, Boxers, Labradors, Golden Retrievers and German Shepherd. The symptoms always appear first in young dogs – although they may be so mild at first that they aren’t noticed or diagnosed until the dog is older.
Atopy results in what we often call “allergic skin disease”; however, it is often more severe and harder to manage than other skin-based allergies. The most characteristic symptom is violent itchiness – often dogs will rub themselves raw trying to scratch – which is usually worst on the face, in the armpits and on the feet. Other symptoms often include repeated “ear-infections” (because the ear canal is lined with skin!), and skin infections (“pyoderma”). The end result is hair loss, reddened, sore or scratched skin, and then infection with pustules forming.
Unfortunately, it is very hard to diagnose atopy conclusively – we generally work by “ruling out” other options! That said, the most powerful diagnostic technique in our armoury is the 2009 Favrot Criteria, which comprise a list of “check-points” we score the dog against. If 5 are met, there’s an 80% chance the dog is atopic; if we can match 6, that goes up to 90%. There are different versions of the test, but the criteria usually include: (1) symptoms appearing before three years old; (2) the dog mainly lives indoors but is still affected; (3) the itching improves if steroid medication is given; (4) the itching occurs before the hair loss or rash; (5) the front feet are affected; (6) the centres of the ears are affected, but (7) the edges are not; and (8) the dog’s belly is more severely affected than their back.
Sadly, there is no cure for Atopic Dermatitis. However, it can be managed, and there are a wide range of different management options available. The key (if possible!) is allergen avoidance – if your dog isn’t exposed to any of the allergens they overreact to, they won’t develop symptoms. Allergy Tests (which may use a blood sample or a skin-prick test) can tell you what your dog is reacting to, so you can take steps to minimise their exposure. Skin treatments can be very useful, such as fatty acid sprays and soothing shampoos; but medications are usually essential. The mainstay of management is generally a drug called ciclosporin, which “tunes down” the immune response, but other options include steroids (effective but often with severe side effects if used for too long) and oclacitinib (an anti-itching drug). There’s also the possibility in many cases to use immunotherapy with a vaccine that helps to “teach” the immune system that a particular allergen is harmless. In most cases, no one approach will be successful on its own, and managing a dog with Atopy requires experimentation and committment to find the combination of techniques that works for them.
There is no preventative medication or screening test at the moment, unfortunately, for this genetic disease.
Aural haematoma
An aural haematoma (sometimes called a “cauliflower ear”!) is like a bruise inside the ear. However, because of the location, the blood doesn’t dissipate, but forms a large swelling between the layers of skin and cartilage inside the ear flap. In this sense, it’s more like a blood blister, causing massive swelling and deformity of the affected ear or ears.
The most common cause is the dog shaking their head excessively – so it’s worth thinking of the haematoma itself as a symptom rather than a disease in its own right. The most common causes are ear infections; ear mites; and foreign objects (like grass seeds) in the dog’s ears. This makes them scratch at their ears and/or shake their heads, resulting in rupture of the fine blood vessels inside the ear flap.
Any dog may get an aural haematoma, but it is most common (and usually most severe) in dogs with long, floppy ears like Setters or Spaniels. These dogs are more likely to injure their ears when shaking, and are also slightly more likely to suffer from ear problems in the first place.
It depends how severe it is. A mild case may just have a swelling (often reddish or blue-purple) on one part of the ear flap (pinna); whereas a more severe one might result in the whole ear flap blowing up like a balloon. The swelling may be soft or hard to the touch, depending on how recent the bleed is and how much the blood has clotted. Usually, they are uncomfortable initially but soon become painless.
The symptoms are pretty characteristic, but if in doubt, we can put a needle into the swelling and draw out some of the fluid – if it’s blood, then the diagnosis is confirmed.
Haematomas will usually subside on their own in a few days, but this often results in permanent scarring and deformity of the ear, so we usually recommend prompt treatment by one of our vets. There are several ways to approach this condition, depending on how severe it is, and how tolerant the dog is! The simplest is simply to drain out the blood with a needle and syringe (we can usually do this in the consult with the dog awake). However, it will usually refill, needing two, three or even four drainages before it stays down. Injecting a little bit of steroid medication into the ear after draining it does seem to reduce the chance of recurrence. In many cases, however, it is better to to treat the condition surgically. The dog is given an anaesthetic and when asleep, we open up their ear, remove all the fluid and clotted blood,and sew all the layers back together again. The ear is then bandaged up to the the head to keep it safe while it heals! Whichever course of treatment we use though, it’s vital to investigate the underlying problem – which is why we’ll always have a look down their ears (on BOTH sides!) before we let you leave.
Rapid and effective treatment of ear infections and other diseases will in most cases prevent an aural haematoma from forming in the first place. If you have a dog with itchy ears, regular cleaning with a suitable ear-cleaner will often help too.
Babesia
Babesiosis is a disease caused by infection with Babesia canis. It is spread by ticks and causes anaemia.
The Babesia organism is a microscopic parasite a bit like an amoeba. It can only survive and breed inside red blood cells – unfortunately, by living inside them it damages the cells. These organisms are spread by tick bites, and until recently, wasn’t found in the UK. Unfortunately, in 2016 the first UK-based transmission of the disease occurred, and it is now thought to be present in our native tick population. The good news is that it can only be transmitted by the Meadow Tick (Dermacentor reticulatus) which is relatively uncommon; the common Sheep Tick (Ixodes ricinus) doesn’t carry the disease.
Any dog may be exposed to tick bites if they go outside. The East of England is currently the highest risk area for Babesia, but as the disease will be carried by foxes, it won’t remain isolated to this region indefinitely.
The destruction of red blood cells results in anaemia, meaning the dog is unable to transport oxygen around their body successfully. The symptoms do vary a little from dog to dog, but usually involve shortness of breath, lethargy, pale gums, discoloured urine and jaundice.
The parasites are usually visible if we look at a blood sample using a microscope. However, confirmation of the diagnosis requires special stains and so we’ll often send a sample away to an external lab for an expert pathologist to confirm.
There are no licensed medications for dogs in the UK to kill the parasites, but we can order them in from other sources if needed. In addition, infected dogs are often very, very sick (some will sadly die even with treatment) so intensive care nursing in the practice is essential if they are going to survive. This may also require a blood transfusion, to replace the infected and damaged red blood cells.
There is no vaccine against Babesia, but the need for a tick is the organism’s weak link! Ticks can only transmit the disease after they’re firmly secured to your dog (usually 24-48 hours after the initial bite), so an effective tick control product will minimise the risk of infection. If you find a tick on your dog, use a tick hook to remove it (or ask one of our nurses to do it!).
Bladder stones
Bladder crystals form in urine all the time – there are loads of unwanted salts and waste materials in urine which can react together to produce them. Normally, however, they are so small that they don’t cause any problems. Sometimes, however, the stones may get large enough to irritate the bladder lining, or even cause a blocked bladder – which is a medical emergency.
There are a number of different types of stones, each with their own set of causes. The more common ones are: (1) Struvite (also called “Triple Phosphate” or “Magnesium Ammonium Phosphate”), which are usually caused by infections, alkaline urine, or sometimes minor dietary imbalances. (2) Cystine, caused by acidic urine, usually only a problem in dogs with a particular genetic disorder. (3) Calcium Oxalate, which may be caused by a genetic disorder, abnormal calcium levels (typically in dogs with a tumour or a parathyroid disease), or antifreeze poisoning. (4) Urate, usually caused by liver disease but is normal in some breeds of dog!
Any dog may develop a bladder stone – most commonly struvite, triggered either by a urinary tract infection or a slight dietary imbalance. Cystine crystals are most commonly seen in breeds such as Newfoundlands, Bassets and Chihuahuas; whereas the gene causing Calcium Oxalate production is more common in the Yorkshire Terrier and Lhasa Apso (among others). Urate crystals almost always mean liver disease – except in Dalmatians, where they are a normal finding! If stones do start to form, they are unlikely to cause a blockage in bitches (whose short, wide urethra or “urine tube”, is normally able to expel them). They’re much more dangerous in male dogs, where they may block the urethra or become lodged in the penis bone, preventing the dog from urinating.
The most common symptom is cystitis (although this may also be the cause, especially with Struvite!). This typically causes blood in the urine, pain and discomfort on urination, and unusually frequent production of small amounts of urine. If the bladder becomes blocked (a “Urinary Obstruction”), however, the dog will be straining to urinate without passing anything except perhaps a small amount of blood-tinged fluid. Once their bladder is full this will result in uraemic poisoning, causing depression, dehydration, vomiting, collapse and, ultimately, death if not rapidly treated.
We can see the crystals in urine samples when we look at it down the microscope – each type looks different so we can tell which we’re dealing with (for example, Urate crystals look like spindles or spiky balls, whereas Struvite forms rectangular crystals sometimes described as being like “coffin lids”). An obstruction, however, we would usually diagnose based on the presenting signs, an overfull bladder, and evidence on blood tests of dangerously high levels of urea in the blood. Sometimes, we can see the stones in the bladder too, with ultrasound or X-rays.
Many stones (Struvite, Cystine and Urate) can be dissolved with a proper diet – we recommend a commercially prepared diet that is formulated not just to prevent them from forming, but to dissolve any stones already present. However, if they are too large, or are causing an obstruction, they usually have to be removed surgically. Many stones lodged in the urethra can be flushed back into the bladder, and then we can remove them easily from there in surgery, but if not, we will have to cut into the urethra to remove them.
If you have a dog who is prone to bladder crystals or stones, an appropriate diet is the best way to prevent them.
Cancer
Cancer, or more properly neoplasia, is an abnormal growth of body cells. It occurs due to damage to the DNA (the “blueprints” or “instructions” that tell the cell how to behave), and especially to those genes which tell a cell when to stop multiplying itself. However, it’s important to realise that cancer isn’t a single disease – there are thousands of different types. Some are benign (grow but don’t spread); some are malignant (invade tissues and spread around the body); and some are intermediate, being invasive but not prone to spreading.
Ultimately, all cancers are due to a mistake when copying the DNA, and is usually due to a random mistake. However, most mutations do not cause cancer – the damaged cell may repair itself (there are enzymes called dismutases whose only job is to fix errors in DNA!); if not, it will usually self-destruct, and if it doesn’t, the immune system is very, very good at finding and destroying any mutated cells. However, with so many billions of cells in the body, every now and again, one slips through the net, and grows into a cancer, or tumour. That said, although there is a constant background level of random mutations occurring, some environmental factors can increase the risk – such as radiation, certain chemicals (carcinogens), or because they’ve inherited defective genes that mean the body doesn’t shut down a cancerous growth so efficiently.
In general, cancer is a disease of older dogs – because they’ve had many more cell divisions, and therefore more chance of a mutation occurring somewhere along the way. There are a few tumours that are predominantly seen in younger animals, but they are relatively uncommon. In addition, there are a few breeds that are at increased risk of cancer (such as Flat Coat Retrievers) because of their genetics. Finally, some animals are immune to some types of cancer – for example, a castrated dog cannot develop testicular cancer because he doesn’t have testicles to become cancerous!
Ultimately, it depends on what the cancer is, where it is, and how big it is. For example, a brain tumour may cause seizures or wobbliness, whereas a bone tumour in the leg might cause lameness. In general though, in most cancers you would expect to find a lump or swelling somewhere in the body; weight loss; lethargy and perhaps depression; swelling of the dog’s lymph nodes (as the immune system tries to fight it); and occasionally vomiting or diarrhoea.
As usual, it depends on the type of tumour! There are, however, a range of different techniques we can use. In general, blood tests or the symptoms will make us suspicious of a tumour somewhere, and then we go on a “tumour hunt”, using our eyes and hands, plus X-rays and ultrasound scans (and sometimes CT or MRI scans) to look for it. Once we’ve found the lump, we’ll often take part of it out and send it to a pathologist to find out exactly what it is (you can’t always tell just by looking!) and how best to treat it.
There are four major approaches. (1) a benign, slow growing tumour (such as a lipoma), may simply be left and monitored, especially if the dog is very old and sick and treatment might be more dangerous than it’s worth. If it changes behaviour or starts causing a problem, we would, however, reassess it. (2) Surgical removal of the tumour tissue – this is usually the mainstay of treatment, and we’d aim, to remove every single tumour cell. Sadly however, this isn’t always possible. (3) Chemotherapy is increasingly available, to prevent regrowth, mop up any stray cells, or slow down the growth of inoperable tumours. Unlike in humans, we use lower doses because keeping the dog comfortable and happy is more important than killing every last tumour cell. (4) Radiation therapy is available at some specialist hospitals to kill the tumour tissue.
No, full stop. Cancers will occur – probably the vast majority of dogs will develop one in their lifetime if they live long enough (although in most cases, it’ll be so small no-one will ever know).
Corneal ulcers
A corneal ulcer is a “scratch” on the front of the eye (the cornea being the transparent window in the front). Although the eye is quite capable of healing itself, damage to the cornea can easily become infected, resulting in scarring and, if not rapidly treated, vision impairment.
The most common cause is running through long grass! As the dog runs, the grass whips back in their face and, while the blink reflex is really fast, it isn’t always quite quick enough to avoid a grass cut to the cornea. Other common causes include cat scratches (cats always go for the eyes or the nose) and grass seeds and other debris blown on the wind – when running in grass or if dogs stick their head out of a moving car window (which, by the way, it’s a really bad idea to let them do!). However, an ulcer doesn’t only happen because of trauma – excessive dryness can cause part of the cornea to die and peel away, giving a similar effect. This is seen in dogs with Dry Eye, and those whose eyelids don’t meet in the middle properly.
Absolutely any dog may get a corneal ulcer due to trauma. However, dogs with protuberant eyeballs (like pugs) are at highest risk of getting an ulcer because their eyelids don’t close properly to protect and moisten the corneal surface. In addition, some breeds (such as Boxers) are at an increased risk of developing an indolent, or non-healing, ulcer if they do get an eye injury.
A corneal ulcer, whatever the cause, usually presents with what we sometimes call the “PLB Triad” – Pain (the eye is obviously sore and often they’ll rub at it); Lachrymation (running eyes); and Blepharospasm (the eye is held closed). If it’s been there a while, it may become less painful and they’ll open it again; you may then see a milky scar on the eye, and blood vessels growing in from the edges to help repair the damage.
We look into their eye with an instrument called an ophthalmoscope, and then put some dye into the front of the eye (usually fluorescein, but occasionally others). These dyes stick only to damaged corneal tissue, and glow when exposed to blue light, so we can see where, and how large, the damaged area is.
The majority of corneal ulcers will heal rapidly with conservative treatment – antibiotic eyedrops to prevent and treat infection, and painkillers to reduce the discomfort and swelling. However, if an ulcer doesn’t want to heal (these are called “indolent ulcers”), or starts to get bigger (e.g. a “melting ulcer”), there are a wide range of different treatment options we can use. These include plasma drops (where your dog’s own blood is collected, processed, and then applied to the eye to prevent melting or widening of the ulcer) and EDTA drops (same reason). At the same time, a temporary soft contact lens may be fitted to protect the area while it heals. Surgical treatment may also be needed; the most common techniques are a Grid Keratectomy (where the eye is scored under anaesthetic to encourage healing) and Pedicle Flaps (where part of the lining of the eyelid is temporarily attached to the eyeball to help it heal).
In most dogs no; however “doggles” (goggles for dogs) may be useful to protect the eyes of pets with especially bulging eyes.
Coughing
A cough is a really common symptom; however, it’s a symptom not a disease! Coughing is a protective reflex – if anything irritates the airway, the dog will cough to try and clear mucus or debris from their lungs and windpipe. However, many different disease conditions can trigger a cough, so it’s always worth getting it checked out.
Any source of irritation to the airway or throat can potentially cause coughing. The most common causes in dogs include: (1) Kennel Cough – a very common infection of the trachea (windpipe) and larynx (voice box); any dog can be infected (although vaccinated dogs are less likely to be ill) and the condition is very contagious. (2) Chest infections and pneumonia are uncommon but do occur in dogs; typically, the dog will be ill in themselves. (3) Heart failure is the commonest cause of coughing in older dogs – caused by an enlarged heart pressing on the trachea, and also an accumulation of fluid in the lungs (pulmonary oedema). (4) Lung tumours can also cause a cough; in dogs (who rarely smoke tobacco!), lung cancer is usually secondary to another tumour elsewhere. (5) Tracheal Collapse Disorder (commonest in toy breed dogs) also causes a characteristic cough, as the windpipe collapses and the dog coughs to try and inflate it. (6) Lungworm (both Dog and Fox Lungworm) can cause coughing, and are being increasingly diagnosed in the UK – although the distribution is rather patchy. (7) Inhalation of food – most common in dogs with laryngeal paralysis, but it can happen in dogs who are just excessively greedy and gobble their food!
Any dog can get a cough! However, heart disease and lung tumours are more common in older dogs, whereas kennel cough seems to be a bit more common in young adults. In addition, a dog who is vaccinated against kennel cough is less likely to develop the disease than one who isn’t.
The type of cough can sometimes help to diagnose the cause (although beware of relying on this on its own!). Tracheal collapse usually causes a “honking” type cough, as does Kennel Cough (which may also be described as a barking cough). The cough in Kennel Cough can often be induced by gently feeling the larynx and windpipe in the neck. On the other hand, a cough caused by heart failure tends to be soft and almost apologetic. Other symptoms may also be relevant – for example, a dog with pneumonia will be systemically ill in themselves with a fever, lethargy and depression; whereas dogs with heart failure are more likely to have exercise intolerance.
Physical examination and listening to the chest with a stethoscope will give us a lot of information; however, additional tests are often needed – typically X-rays of the chest and ultrasound scans of the heart. Blood tests for infection, lungworm and heart function are also available.
It depends on the exact cause – for example, a chest infection would need antibiotics, whereas heart failure requires heart medications. We rarely look to suppress the cough itself (because in many cases it is doing its job in removing mucus and infectious material from the chest), but if needed, there are drugs we can use. NEVER use human cough syrups in your dog unless your vet has recommended it!
The risk of Kennel Cough can be minimised with vaccination and isolation of infected dogs; and lungworm can be prevented with certain spot-on medications, but otherwise no.
Cruciate injury
The cruciate ligaments are a pair of structures in the stifle (like our knee) joint of the dog. These (especially the cranial cruciate ligament or CCL) may rupture or break, causing severe lameness and instability in the joint.
In the majority of cases, the rupture is due to degeneration of the ligament that occurs over some weeks or months before they fail completely. However, an otherwise healthy ligament can rupture if overloaded (typically if the dog slips when running and changing direction fast). The exact cause of the degeneration isn’t clear, but is probably due to very mild overloading over months or years, and to some extent to the dog’s genetics.
The biggest risk factor is obesity – a heavier dog means more load on the ligament and more risk that it will start to degenerate. In addition, certain breeds (such as Labradors) are reported to be at higher risk, and there is a (very slight) increase in risk in neutered dogs compared to entire ones.
Cruciate ligament injuries almost always present with moderate to severe lameness. This may appear suddenly (“acute lameness”) or more gradually (“chronic lameness”), depending on the exact type of damage. In addition, you may notice a swelling on the inside of the leg, over the joint (this is sometimes called a “medial buttress”).
If the ligament has ruptured, it is possible to move the tibia (shinbone) forward relative to the femur (thigh bone) – this is called cranial draw. When we examine your dog, we may find this sign, but more often we will book your dog in for X-rays; when they’re sedated for the X-ray, this cranial draw is much more obvious and will confirm the diagnosis.
In dogs under 8kg, the ligament my heal on its own, given strict rest and a very gradual reintroduction to exercise, possibly involving hydrotherapy. However, in heavier and larger dogs, this is very unlikely, and surgery is usually required. There are several different surgical procedures available, and which we’ll use depends on the dog in question and the configuration of their stifle joint. The most common surgical procedures are ligament replacement (like a fabellar suture, where an artificial fibre is used to replace the damaged ligament); tibial tuberosity advancement (TTA and MMP operations, where the front of the tibia is cut and moved, so the cruciate ligament isn’t needed any more); and tibial plateau levelling osteotomy (TPLO, where the bone is cut and rotated to stabilise the joint without needing a cruciate ligament). The great advantage of bone surgeries (TTA/MMP and TPLO) are that the dog will be up and able to walk within 24 hours, whereas the ligament replacement surgeries require longer. In all cases, however, the dog will need a very gradual return to exercise, and often physiotherapy or hydrotherapy. Too early return to exercise will result in the repair breaking down, and may result in breaking of the affected leg.
To some extent yes – don’t let your dog get overweight or obese! That’s the best way to minimise the risk – dogs of a healthy weight are at significantly lower risk.
Cryptorchidism
Cryptorchidism, or retained testicles, is one of the most common developmental disorders in male puppies. It is important because once puberty has started, testicles are supposed to be outside the body where they can be kept cool. An overheated testicle inside the body will be infertile (sperm cannot be made at body temperature) and is nearly ten times more likely to become cancerous with a nasty disease called a Sertoli Cell Tumour.
When the puppy is in his mother’s womb, his testicles develop next to the kidneys (just like in all mammals, including humans). Once his body decides it is male, a ligament called the gubernaculum pulls the testicles down through the body, through the inguinal canal and into the scrotum – they are supposed to have arrived by a couple of weeks after birth. If this system fails for any reason (usually due to a failure of the gubernaculum to contract fully), the dog will be cryptorchid. It is not uncommon for testicles to be “hidden away” in the inguinal canal before puberty; however, when they grow to adult size at about 6-9 months old, they should drop to and stay in the scrotum – if they’re inside the abdomen at this point, they will be too big to fit through the canal.
This is a genetic condition, so a dog whose father had the condition will probably be cryptorchid, too.
Simple – affected dogs will usually only have one testicle visible! Occasionally, both testicles are retained, but this is uncommon. If your dog does seem to have only one testicle, it is very unlikely that they genuinely don’t have a second one (monorchidism), it’s far more probable that the second is hidden away internally.
Physical examination makes it very clear that the scrotum isn’t fully occupied! If the second one cannot be located during surgery, it is possible to remove the present testicle and then do hormone tests to see if there is another one hidden away somewhere.
Because of the cancer risk, the retained testicle MUST be removed, and because the condition is genetic, so must the “normal” one. In humans, a procedure called an orchiopexy is used to fix a retained testicle into the proper place in the scrotum; however, because of the heritability of the condition, it is considered unethical to do this in dogs.
Only by not breeding from existing cryptorchid dogs, and preventing them from breeding by castration.
Cushing's Disease
Cushing’s Disease, or Hyperadrenocorticism, is a disorder of the endocrine system, where the adrenal glands release too much cortisol (a natural steroid).
Cortisol is sometimes called “the stress hormone”, because it is released in the body in times of stress (physical or mental/emotional). It is produced in the adrenal glands, but these are themselves controlled by the pituitary gland, which releases a hormone called ACTH (adrenocorticotropic hormone) telling the adrenals to make more cortisol. If an adrenal gland malfunctions and starts making excessive amounts of cortisol, or if the pituitary malfunctions and releases excessive amounts of ACTH, the result is the same. In most cases, these are due to secreting tumours (about 85% are in the pituitary, so-called Pituitary Cushing’s). There is another form of the disease too, called Iatrogenic Cushing’s, which is due to excessively high doses of artificial steroids.
The diseases usually affects adult to elderly dogs.
The symptoms of any kind of Cushing’s are the same; as steroids affect a wide range of different systems, Cushing’s can have a wide range of different effects. Common symptoms, however, include: (1) Increased thirst and increased urination. (2) Increased hunger. (3) Hair loss, usually causing bald patches on both flanks. (4) Muscle loss and fat redistribution, resulting in a “pot-bellied” appearance. (5) Increased susceptibility to infection (especially urinary tract and skin). (6) Increased susceptibility to diabetes mellitus. (7) Lethargy. (8) Dislike of heat or hot weather. (9) Increased breathing rate, and often increased panting.
Although the symptoms are quite characteristic, unfortunately there is no test that is 100% accurate in diagnosing Cushing’s Disease. The most commonly used tests are: (1) The Urine Cortisol to Creatinine Ratio (UCCR) Test. This is very good as a screening test, but gives lots of false positive results (in other words, you may get a positive result even if the dog doesn’t have Cushing’s, but it’s very unlikely you’ll get a negative test if it does). (2) The ACTH Stimulation Test, which works by measuring the response of the adrenal glands to the ACTH hormone. (3) The Dexamethasone Suppression Test (in High and Low Dose forms), which looks to see whether adrenal function is reduced when additional steroids are introduced to the body, which it should be but isn’t in Cushing’s. The High Dose test can also distinguish between Pituitary and Adrenal Cushing’s.
The standard treatment is with medications that temporarily suppress the adrenal gland’s ability to make cortisol; with the proper dose, cortisol levels can be managed and kept within the proper range. The active ingredient in these tablets is trilostane, and they are licensed for use in dogs. There is another, related, drug, that permanently destroys the adrenal tissue (mitotane), but this is not licensed and is rarely used, because even a very slight overdose could lead to Addison’s Disease.
No, there is no preventative treatment known.
Cystitis
Cystitis just means “inflammation of the bladder”. In dogs, we usually mean a urinary tract infection (bacteria growing in the bladder), but cystitis can also be caused by bladder stones (urolithiasis) or, rarely, a bladder tumour.
By far the most common cause of cystitis in dogs is ascending infection – bacteria that crawl their way up the urethra (the “urine tube”) from the outside world. This is much more likely in dogs where the bladder is a less hostile place – for example, diabetic dogs (where the urine contains lots of sugar for the bugs to feed on), those with Cushing’s disease (where the immune system is impaired), and those with unusually dilute urine (e.g. Cushing’s, Psychogenic Polydipsia, or Diabetes Insipidus). The bacterial infection damages the bladder wall, resulting in symptoms. It is now thought that in some cases, the bacteria may in fact penetrate further, causing a kidney infection. If bladder stones form, there are a number of different types; the most common, struvite, forms because of an infection, whereas other types may reflect an imbalanced diet, or a metabolic defect (e.g. liver disorders leading to urate stones). These stones then rub against the wall of the bladder, causing irritation (just like an infection would). Occasionally, in older dogs, a tumour (or cancer) of the bladder wall may form, also causing the clinical signs.
Female dogs are at a much higher risk of infection, because their urethra is shorter and wider, so bacteria can more easily enter along it. Bladder stones are most often secondary to an infection, but some dogs (such as Dalmatians) are at an increased risk due to certain metabolic differences, and any dog with liver disease is also at increased risk. Bladder tumours, meanwhile, are most common in older dogs.
The symptoms may be subtle or very obvious, depending on the severity and the specific dog! However, they most commonly include: (1) Blood in the urine. (2) Urinating often, but only producing a small amount each time. (3) Pain on urination. (4) Sometimes, incontinence may seem to occur. It is unusual for cystitis to cause a fever or other signs of systemic infection (such as lethargy or loss of appetite); if this occurs, its suggests a more serious condition such as a kidney infection. If your dog is trying to pass urine and isn’t able to, they may have a stone blocking their bladder – this is an emergency and needs IMMEDIATE veterinary attention.
Most commonly, cystitis will be diagnosed with a urine sample. The presence of blood suggests significant irritation to the bladder wall, and often we can see (or grow) bacteria from in the urine. A urine sample mustn’t be collected from the floor or ground, because we won’t be able to check for infection – instead, it should be collected in mid flow (the use of a shallow dish or saucepan may help!). Other tests on the urine may demonstrate crystals (suggestive of stones forming) or abnormal cells (suggestive of a bladder tumour). If stones or a tumour are suspected, X-rays or ultrasound scans may be required to find and localise them.
The vast majority of dogs with cystitis will respond really well to simple treatment with a course of antibiotics. The use of a urine sample to grow the specific bacteria (culture and sensitivity testing) will allow us to choose the most appropriate and effective antibiotic. If there are bladder stones, it may be possible to dissolve them with a special diet; however, some stones are too large, the wrong type, or in the wrong place (for example, blocking the bladder) for this to work, and in these cases they must be surgically removed. Bladder tumours are, sadly, usually inoperable, but there are some medical treatments that can reduce the severity of the symptoms, making the dog more comfortable.
If a dog has a tendency to develop crystals or stones, the use of a special Urinary diet will reduce the chance of any forming. In any dog, making sure that they have free and unrestricted access to water will reduce the risk of cystitis developing, but cannot entirely prevent it.
DCM
DCM stands for Dilated Cardiomyopathy, a form of heart disease characterised by an enlarged but weakened heart muscle. It is most commonly seen in certain breeds, but may also be due to dietary deficiencies. In many cases, DCM leads to abnormal heart rhythms (arrhythmias).
In most cases, it is due to genetic disease, but a taurine-deficient diet can also be a cause. In either case, the heart muscle becomes weaker, resulting in decreased pumping effectiveness. As the muscle becomes weaker, the heart swells up like a balloon, resulting in an enlarged heart with very thin walls (which of course reduces the pumping power even further). The enlargement of the chambers of the heart and thinning of the muscular walls increases the risk of arrhythmias as the “communications system” inside the heart becomes less effective. Eventually, it will inevitably lead to heart failure.
Any dog with a taurine-poor diet (nowadays, this is usually confined to dogs fed a poorly designed home-cooked diet). The more common genetic form is seen primarily in Dobermans, Boxers, Deerhounds, Irish Wolfhounds, Great Danes and other giant breeds, although it is also recognised occasionally in Cocker Spaniels and Portuguese Water Dogs.
Most dogs in the early stages of the disease (the “preclinical phase”) show no symptoms. However, this will progress over time to include reduced exercise tolerance, weakness, depression, weak pulses and sometimes a highly irregular or chaotic heart rhythm (atrial fibrillation). Eventually, congestive heart failure will develop with breathlessness, coughing, blue gums, swelling of the abdomen and (sometimes) extremities, collapse and ultimately death. In some dogs (especially Boxers), sudden death may occur without warning. Unfortunately, the disease is always progressive and always fatal – without treatment, death usually occurs in 6-24 months after diagnosis.
Initially, signs of heart disease in a dog of a susceptible breed are highly suspicious; X-rays can identify an enlarged heart but not the exact cause. A confirmed diagnosis therefore relies on echocardiography – an heart scan using ultrasound. With this technique, the swollen, weak heart is clearly visible. In some cases, an ECG may also be useful to categorise the arrhythmia, allowing our vets to determine the best treatment.
The mainstay of treatment is to increase the pumping strength of the heart; and to manage the abnormal heartbeat. The most commonly used drug is pimobendan, which makes the heart muscle work harder, increasing the heart’s efficiency. If atrial fibrillation is occurring, the drug digoxin may be used instead, or beta-blockers to slow down the abnormal heart rate. If the dog has gone into congestive heart failure, diuretics (“water tablets”) such as frusemide, and ACE inhibitors such as benazepril will help to mitigate the symptoms. Dietary management may also be useful – particularly a low-sodium high taurine and high carnitine diet (as in most commercial cardiac foods). Good medical management will not stop the progression of the disease, but it will slow it down, and make the dog more comfortable.
The dietary form can (by feeding a proper, healthy diet with added taurine), but the genetic form cannot, sadly, be prevented.
Dental disease
Dental disease is a catch-all term relating to disease of the teeth and gums. It is very common in dogs, and ranges from mild scale on the teeth to severe periodontal disease that may contribute to kidney or heart disease.
Unlike us, dogs and cats do not brush their teeth every morning and evening. As a result, plaque builds up – this is a mixture of food material, dead cells from the gums, and bacteria. Over time, this becomes thicker and then mineralises (turns into a hard, stone-like matrix which we call tartar). When this bacteria-ridden growth reaches the gum line, it causes infection of the gums – gingivitis. If untreated, this will spread down into the tooth socket, and at this stage we refer to it as periodontitis. This weakens the ligaments holding the teeth in the socket, causing them to become loose and eventually fall out. In addition, infection can spread through the bloodstream to other organs, especially the heart and kidneys. It doesn’t matter what food a dog is eating, or whether they regularly chew bones or chew toys – some dogs will still develop tartar and then dental disease (although some foods are worse than others).
All dogs are at risk from dental disease, but it is often most dramatic in older dogs where the plaque has had years to build up. In addition, miniature and toy breeds are slightly more likely to develop early onset dental disease because they often have abnormalities of the mouth, meaning the teeth are at odd angles and therefore are more likely to build up plaque and tartar.
Initially, the main symptom is halitosis (bad breath!). Over time, this may progress to red, swollen and inflamed gums, loose teeth and pain when eating. In severe cases, dogs may stop eating entirely. In addition, heart disease and kidney failure have both been linked to untreated dental disease.
Simple physical examination is often sufficient, however, dental X-rays are also invaluable. In most dogs, a full examination of the mouth and teeth requires a general anaesthetic so that the gum-lines can be probed (something that isn’t possible in very many conscious ones!).
Once dental disease (even severe plaque) has developed, it requires surgical treatment – we call this “a dental”, and it’s exactly the same treatment as you get when you go to the dentist. The only difference is that we have to use a general anaesthetic. We will carefully examine every tooth, and remove any that are too diseased to survive. Then we’ll clean the remaining teeth with an ultrasonic scaler and then polish them to make them smooth. Afterwards, preventative care is all that is usually needed!
Yes, very easily. Although there are a range of “dental chews” available, these are of limited use in most dogs (although they’re often better than nothing). The same goes for specialist dental diets; chewing on bones is not reliable and may introduce health problems of its own, so isn’t something we’d usually recommend. The most important and effective preventative treatment is tooth brushing – something you should be doing every day. Use a normal tooth brush, and special dog-toothpaste (don’t use human toothpaste – the mint burns their gums), and gently brush the teeth at least daily. Mouthwash additives in their water or food will also help slow down the growth of plaque. Regular brushing sounds difficult, but it is the only way to prevent the formation of plaque and subsequent dental disease.
Diabetes mellitus
Like humans, dogs can get diabetes mellitus (sugar diabetes). And like us, it is more likely to occur in the obese than in those of a healthy weight. While the early symptoms may be subtle, it is a potentially fatal condition and can result in severe and life-threatening complications.
Insulin is needed in the body to tell cells to take glucose (sugar) out of the bloodstream and into the cells, where it can be used as fuel. In diabetic dogs, there is insufficient production (often coupled with peripheral insulin resistance), so the blood glucose levels rise uncontrolled. However, the body is unable to use this sugar, and instead turns to burning fats and proteins for fuel. In the short term, this is fine, but if it goes on too long, the dog is at risk of diabetic ketoacidosis, where the blood become acidic and organ systems start to shut down. This is rapidly fatal without immediate emergency treatment.
Any dog may develop diabetes, but it is most common in mid-adult life. Specific risk factors include pancreatitis (because of damage to the pancreas, where insulin is made), pregnancy, some infectious viral diseases, the use of high doses of steroids, Cushing’s Disease, and (most importantly) obesity. Certain breeds may be at higher risk, even when all these factors have been accounted for – there is evidence that the Miniature Pinscher, Cairn Terrier and possibly Dachshund and Poodle are at slightly increased risk.
In the early stages, the most common symptoms are increased thirst and increased drinking (this may lead to mild urinary incontinence, especially overnight); increased hunger and weight loss (because they cannot use the sugars in their blood). Affected dogs are also prone to repeated urinary tract infections. Later, if diabetic ketoacidosis occurs, loss of appetite, lethargy, depression, dehydration, vomiting, collapse and ultimately coma and death. All dogs with diabetes, even if it is well controlled, are likely to develop cataracts as well, so it’s always worth monitoring their eyesight, or getting the vet to check it over when you come in.
An increased blood glucose level is highly suspicious, as is a high sugar reading in the urine. However, there are other possible causes of these signs (including stress and certain kidney diseases), so the most usual way to confirm the diagnosis of simple or early diabetes is to send away blood for a fructosamine test – this measures the AVERAGE blood glucose level over the previous 2-3 weeks. Another method is to do repeated blood sugar levels over several hours to a day – this is called a blood glucose curve, and will clearly demonstrate persistent high blood glucose levels. In Diabetic Ketoacidosis, the presence of ketones in the blood over a certain level is diagnostic – we often measure this by ketones in the urine (which is equally useful).
Most diabetic dogs can be managed and stabilised effectively, but it is very unusual for it to be possible to manage them without the use of regular daily (or twice daily) injections of insulin. By giving extra insulin at exactly the correct dose, we can “top up” what they’re making, and keep their levels in the “normal” range. However, as insulin levels vary over the course of the day, and high levels can be dangerous (leading to a “hypoglycaemic episode” where the dog behaves abnormally, and may become unconscious, have fits, or even die) it is important to match the insulin dose to their feeding times. As a result, a regular, stable routine is VITAL, as is regular monitoring – with a blood glucose meter at home or blood glucose curves. Special diabetic diets also help, by smoothing out the peaks and troughs in blood sugar levels.
The risk can be reduced by keeping your dog a healthy weight, but even healthy dogs develop diabetes, and there is no certain way to prevent it.
Distemper
Distemper is an infectious disease of dogs, also known as “hardpad”. It is a very serious condition, and has a mortality rate of approximately 50%; in addition, even dogs who survive and appear to recover may develop symptoms later in life due to the original infection.
Distemper is caused by Canine Distemper Virus – a viral infection closely related to measles. Dogs can contract it by accidentally inhaling or swallowing fluid droplets from an infected dog (produced by the infected dog sneezing them out, but also in the vomit, diarrhoea and urine). Foxes and other wildlife may act as a reservoir for the virus, accounting for sporadic outbreaks in unprotected dogs.
Any unvaccinated dog is at risk from Distemper; however, if the percentage of dogs in the area that are vaccinated is high enough, the risk is relatively low as the virus will not be able to become established in the population. The more people who choose not to vaccinate however, the higher the risk is for everyone’s pets.
Initially, there is a fever, which peaks within a week and may not be noticed. However, a few days later it returns, also causing a runny nose and runny eyes; this is rapidly followed by vomiting and diarrhoea, and a thickening of the skin on the footpads (hence “hardpad”). Some dogs will develop infection of the brain and spinal cord, causing wobbliness, paralysis, seizures or a coma, About half of all infected dogs will die or need to be put to sleep, but this may take weeks or even months. In recovered dogs, some will have damage to their eyesight or persistent neurological problems and a certain percentage seem to be fine but will go on to develop “Old Dog Encephalitis”, a degenerative brain disease in later life. This usually causes seizures or a “dementia-like” syndrome.
Clinical disease is relatively rare nowadays; however, compatible symptoms in an unvaccinated dog are highly suggestive. Confirmation of the diagnosis usually requires virus isolation in a specialist lab from blood, fluid or tissue samples.
There is no specific treatment available; the standard treatment is supportive (with fluids and symptomatic relief – e.g. antiemetic drugs for vomiting, or anticonvulsants for seizures). Antibiotics are often used to help prevent secondary infections which may in themselves prove fatal. At all times, however, the infected dog must be kept in quarantine, away from other dogs, to minimise the risk of transmission of the infection.
Yes – the modern Distemper vaccine is very effective, and once the primary course (2 injections 2-4 weeks apart, then a booster at 12 months) is completed, only needs topping-up every 3 years.
Fractures
Although in popular use a “fracture” means an incompletely broken bone, technically it means ANY break in a bone. These may be complete or incomplete (like a Greenstick fracture), compound (penetrating the skin), comminuted (multiple overlapping fractures, also known as “splintering”), multiple (several non-overlapping fractures) or simple (one clean break that doesn’t interfere with any other structures).
90+% of fractures are caused by trauma – being hit by a car, falling from a height, or tripping while running fast are all common causes. More rarely, a fracture may result from an underlying disease process, such as a dietary deficiency (like rickets) or bone cancer.
Any dog can break a bone! Dogs that exercise a lot, or throw themselves around are probably at slightly higher risk, as are very unfit dogs whose musculoskeletal structure is less robust, but the most broken bones are RTAs – road traffic accidents.
The key signs of a fracture are focal pain, swelling, loss of function, and abnormal movement. The majority of fractures are in the legs, where this is often obvious as non-weight bearing lameness (the dog cannot use the limb or put any weight on it). Fractures to other areas may be harder to diagnose, but usually at least three signs will be present. The exception is in incomplete or partial fractures, especially of bones that are naturally splinted (e.g. the toes). These are still very painful, but the dog may be able to use the affected limb to some extent.
The presence of a fracture may be easily obvious (especially if the bone is bending in the wrong place, or a paw is facing the wrong way round!) but to determine exactly what is broken, how and where, we need to X-ray the dog.
It depends what, and where, the fracture is. Some fractures (like incomplete toe fractures, for example) will heal with just a support dressing. Others require surgical fixation, with pins, screws, or even an External Skeletal Fixator (a kind of scaffolding surgically attached to the bone(s) to hold them in place while they heal). It is unusual to be able to effectively cast a fractured limb in a dog, but it is sometimes appropriate, especially in puppies. If a cast is used, it is VITAL to keep it clean and dry, and have it checked regularly for rubbing or sores.
The best way to prevent a fracture from occurring is to keep your dog under control so they can’t run out into roads!
GDV
Better known as “bloat” or a “torsion”, a Gastric Dilation and Volvulus (GDV) is a rapidly progressing condition that is almost invariably fatal without treatment.
A GDV occurs when the dog’s stomach fills with gas (the “dilation” or “bloat”) and then twists (the “volvulus” or “torsion”). This cuts off the blood supply to the stomach and spleen, so these organs start to die; however, it also prevents bloodflow back to the heart, so affected dogs rapidly go into shock. To make matters worse, multi-organ failure then develops, which releases toxic amounts of potassium into the blood, causing the heart to fail. No-one knows exactly why a GDV occurs, but there are certain risk factors we are aware of.
Certain breeds are particularly prone to developing a GDV, usually large and giant breed dogs with a deep-chested conformation (such as Great Danes, German Shepherds, Setters). However, it can occur in any breed. There does appear to be a genetic component, as close relatives of dogs that have had a GDV are at higher risk themselves. Finally, feeding strategies – exercising vigorously immediately after eating or drinking is a known trigger factor.
Typically, the dog first appears restless or uncomfortable; then they start retching. This is usually unproductive, with nothing coming up, but sometimes white froth is seen. They are obviously painful, and the left side of their abdomen (or, later, both sides) may be visibly distended. They will then start showing signs of shock, with pale gums, fast heart rate and panting or laboured breathing. This is followed by collapse and ultimately death.
In many cases, the diagnosis is clear from a simple examination of the dog; however, if there is a question mark over the cause of the symptoms, an X-ray will show the gas-filled, distended stomach occupying the majority of the front half of the abdomen.
THIS IS AN EMERGENCY THAT REQUIRES IMMEDIATE VETERINARY ATTENTION. For first aid, it is sometimes possible for the vet to pass a stomach tube to deflate the stomach; if not, they will often use a wide-gauge needle to let the gas out and buy time. These dogs are highly unstable and require intensive care fluid and electrolyte therapy before they are fit for surgery. Sometimes, heart medications are needed to stabilise the heartbeat as well. Definitive repair requires a surgical procedure called a “gastropexy”, where the stomach is returned to its normal position and then fixed to the abdominal wall so it cannot twist again.
Careful management of feeding and exercise will reduce the risk; however, in high-risk breeds that have a close relative who has suffered a GDV, it is possible to carry out a “prophylactic gastropexy”, where we go in and fix the stomach in place to prevent a GDV from ever occurring.
Hip dysplasia
Hip dysplasia is a condition characterised by malformation of the hip joints, which leads to rapid degenerative changes (typically early-onset arthritis). It is a genetic condition that used to be present in many breeds; due to the BVA/KC Hip Scoring Scheme it is gradually becoming less common, but it is still one of the commonest causes of hindlimb lameness in dogs.
It is a genetic disorder caused by the interaction of many different genes. In addition, the severity of symptoms will often depend on the environment the dog lives in, and even how they grew up. In most cases, it causes the “socket” (acetabulum) of the hip joint to be too shallow, so the “ball” (the femoral head) keeps popping out. This causes stress on the joint, resulting in further deformity and, ultimately, early onset osteoarthritis in the hips.
It is typically seen in large-breed dogs, but other breeds may also be affected. The highest risk breeds include St Bernards, German Shepherds, Labradors and other Retrievers. The incidence in Setters used to be very high, but a strict breeding programme appears to have reduced it substantially.
Although the condition begins in the immature dog, in many cases symptoms will not be apparent until later (although very severe cases may show as early as 4 months). Classical symptoms include decreased willingness to run, climb stairs and slopes, or jump; difficulty getting up after lying down; and intermittent hindlimb lameness. The condition usually affects both hips (although one may be worse), so it is not uncommon for the dog to be lame on different sides on different occasions, depending on which one hurts more that day. In addition, dogs often adopt a “Marilyn Monroe” type gait, with a narrow-based stance as they try to keep their legs tightly together to reduce the chance of their hip popping out of joint. Other dogs may adopt a “bunny-hopping” or swaying way to get around, because this puts less pressure on the painful joints.
Clinical examination is highly suspicious, but X-rays of the hips are diagnostic.
Unfortunately, there is no way to restore normal hip structure in these dogs. However, most dogs can live relatively normal lives if the arthritis can be controlled (for example, with anti-inflammatory drugs and painkillers). In more severe cases, surgical reconstruction (e.g. triple-pelvic osteotomy) or removal of the hip joint (e.g. excision arthroplasty) can render the affected joints pain free. However, the “gold-standard” treatment for a dog who cannot be kept comfortable with medical treatment is a hip replacement, where the affected joints are replaced with artificial ones. This is estimated to be successful in over 90% of cases.
Only by attempting to breed the relevant genetic traits out of breeds – the Hip Scoring scheme is designed to identify those dogs with “bad genes” which should not be bred from, and those with “good genes” that should be prioritised.
Kennel cough
Kennel Cough is a highly contagious condition that easily spreads from dog to dog. As the name suggests, it causes a cough, but in severe cases may also lead to pneumonia.
There are a number of different viruses and bacteria that can cause kennel cough. These include Parainfluenza Virus, Canine Adenovirus 2 and the bacterium Bordetella bronchiseptica (first cousin to the human disease, Whooping Cough, which it closely resembles). Whatever the cause, however, the condition is very similar, with inflammation of the larynx (voicebox) and trachea (windpipe) and sometimes the lung tissue (bronchi) as well – as a result it is also sometimes called Infectious Tracheobronchitis.
All dogs are at risk from this highly infectious disease, although vaccinated dogs are less likely to contract it. The infectious agents are carried by dogs, foxes, and even cats and may be transmitted indirectly (e.g. on grass or even clothing that has been exposed).
The classic symptom is a “honking” cough, that is triggered or worsened when the throat is rubbed or stroked. There may also be a mild fever, loss of appetite and lethargy, specially in the early stages; and occasionally a runny or snotty nose. Untreated, the condition will usually self-resolve in 2-3 weeks, but occasionally it can cause more serious effects, such as pneumonia. In this case, the fever will rise, and the dog will become increasingly lethargic. The cough will become moister, and they may struggle to breathe.
Clinical examination is usually sufficient – a cough that can be induced by gently feeling the larynx is pretty much diagnostic! There are also ways to test for the individual agents, typically by taking a swab from the back of the throat and sending it off to a specialist laboratory.
As it is usually self limiting, treatment usually involves rest, quarantine from other dogs (to minimise the risk of spreading it!) and anti-inflammatory medicines to reduce the fever and make them more comfortable. If there is a risk of more severe infection, or an unusually high risk of spreading the infection, antibiotics may be used to kill bacteria and especially the Bordetella. Dogs with pneumonia, however, require intensive care nursing and antibiotics; and may need to be hospitalised and put on a drip of intravenous fluids and medication.
Canine Adenovirus is quite rare, because the “routine” vaccination most dogs gets protects against it (the reason is that the closely related CAV-1 causes Infectious Canine Hepatitis, and vaccinating against one protects against both). There are vaccines against Parainfluenza – the injectable is less effective, however, than the combined Parainfluenza and Bordetella vaccine which is given up the nose. This vaccine reduces the chance that a dog will become infected, but, if they do contract Kennel Cough, it will be less severe and they will spread it less than an unvaccinated dog.
Lungworm
Lungworm is a really nasty parasite, that can prove fatal to infected dogs. It is now being increasingly diagnosed, due to the roll-out of a new blood test for the parasites.
The Dog Lungworm, Angiostrongylus vasorum, is a type of roundworm that (as and adult) lives in the blood vessels around your dog’s heart. From here, they lay eggs which travel to the lungs, where they hatch. The baby larvae are then coughed up by the dog, swallowed, and pass out in their faeces. Once out of the dog, they infect passing slugs and snails. These molluscs then spread the infective (L3) larvae in their slime trails wherever they go. When a dog licks a slime trail – or eats a snail or slug – the larvae burrow through their gut wall and travel back to the lungs, ready to start the cycle again.
Lungworm is present throughout the UK; however, its distribution is quite patchy. Some areas see a lot of cases, while others just a mile or two over may see them only very rarely. However, in principle, any dog, anywhere in the UK who ever has access to the outdoors (and therefore to slugs and snails) is potentially at risk.
The most common early sign is a soft, moist cough (as the dog is coughing up the larvae). However, this may progress to heart failure (pale gums, reduced exercise tolerance, even collapse) as the worms build up in the blood vessels. In addition, more worms means more lung damage, so difficulty breathing may also occur. To be able to live in the bloodstream, the worms produce blood-thinners, so abnormal bleeding may also be seen, typically bruising, a rash (on the skin or gums), or bleeding from nose, mouth or bowels. If this stage is reached, affected dogs will usually die if untreated.
The “Gold Standard” test has always been considered finding the worm larvae in the dogs faeces; however, there is now a simple blood test that can be carried out in the practice lab to see if a dog is carrying the worms and therefore may need treatment – whether or not they are showing symptoms yet.
The worms can easily be killed with certain prescription spot-on medications. If there is a severe infection, it may be necessary to give anti-inflammatory drugs as well, to prevent pneumonia happening as the worms die in the lungs. Dogs with heart failure will usually make a complete, or nearly so, recovery once the worms are dead, although they may require oxygen and supportive care in the meantime. Dogs with clotting disorders may require a blood transfusion as well, to replace the clotting factors and the blood that they are losing.
Yes – regular treatment with an appropriate spot-on medication will kill the larvae before they are absorbed. In addition, making sure that your dog doesn’t play with slugs or snails; or have any toys or bowls that they might crawl over, will minimise the risk.
Fox Mange
Mange is a serious skin condition, caused by a burrowing mite. It is one of the itchiest skin diseases known, and dogs will often injure themselves trying to scratch it; in addition, the mites are very contagious!
A variety of burrowing mite called Sarcoptes scabiei. This digs into the skin and munches its way through the top layers, causing severe itching. It can easily be transmitted between dogs, cats, foxes and many other animals – and can also infect humans (we call it Scabies if it infects us!). It’s called Fox Mange because most cases are associated with dogs rolling in places foxes have been – the fox having left a few mites behind it.
Any dog who comes into contact (directly or indirectly) with an infected animal.
Severe itching, followed by a “bumpy” rash. It usually affects the margins of the ears first, but can be anywhere on the dog’s body. The itching is so severe, dogs will often injure themselves trying to scratch, and lose their hair, so it isn’t uncommon to see a dog who is largely bald in patches, with an inflamed rash and cuts or scrapes from itching.
Skin scrapes let us collect part of the upper layers of the skin and look at them through the microscope; hopefully, we’ll see some mites there! However, because it’s so itchy, sometimes there are very few mites to find, so we will often treat a suspicious case even if we can’t confirm the diagnosis.
There are a range of prescription spot-on medications and medicated washes (again, prescription only) that rapidly kill the mites. They do not, however, kill the eggs, so usually have to be repeated in 3-4 weeks to break the life-cycle.
Not entirely – however, regular treatment with a suitable anti-mite product (which will also do fleas and often worms too!) will prevent an infection becoming severe.
Heart Valve Disease
Valve Disease, also known as Endocardiosis or Valve Incompetence, is the most common heart disease in dogs – over 30% of dogs will develop some degree of valve disease by 12 years of age. As a result, it is the most likely diagnosis (although not the only one) in an older dog with a heart murmur.
Inside the heart there are four valves, which work to make sure that blood only flows one-way through the chambers. These are the left atrioventricular (the Mitral or Bicuspid Valve); the right atrioventricular (the Tricuspid Valve); the Aortic Valve and the Pulmonic Valve. Over time, in some dogs, these will start to degenerate, with nodules or bits of scar tissue forming on the edges. This prevents the valve from closing properly, leading to “regurgitation”, or leakage of blood. Over time, this reduces the heart’s efficiency, leading to heart failure. Although any valve can be affected, the Mitral Valve is the most commonly involved, in roughly 95% of cases.
Any older dog may develop valve disease; however, some breeds of dog are at increased risk. The highest risk is seen in Cavalier King Charles Spaniels, closely followed by Chihuahuas, Cocker Spaniels and a number of other small and toy breeds. Male dogs are at slightly higher risk than females; and the commonest age of onset of heart failure is 10-12 years (although the heart murmur is often detected 2-3 years before that). Cavalier King Charles Spaniels are unusual in that not only is the condition very common, but it develops rapidly, with most affected dogs developing signs of heart failure by 8 years old.
Initially, the only symptom is a heart murmur – an abnormal noise caused by the blood rushing in an unusual direction which the vet will hear when they listen to the dog’s chest. As the disease progresses, signs of heart failure will, sooner or later, develop, with reduced exercise tolerance, coughing, panting or difficulty catching breath. Eventually, the heart will fail, leading to profound weakness, pale gums, difficulty breathing, swelling of the abdomen, collapse and (eventually) internal drowning from fluid in the lungs.
In a high risk breed, hearing a murmur is highly suspicious, and may be sufficient to start treatment. However, to confirm the diagnosis, chest X-rays (to demonstrate an enlarged heart) and ultrasound (echocardiography) are required.
The condition cannot yet be cured (although there is experimental heart surgery being tested at the RVC in London). However, there are a wide range of medications available to manage the condition. The most commonly used are diuretics (“water tablets” like frusemide or spironolactone, which prevent fluid build up), ACE Inhibitors (such as benazepril, which improve the dog’s quality of life and how well they feel), and drugs to increase the strength of each heartbeat (Pimobendan, which increases lifespan).
No – however, recent research (the EPIC trial) suggests that starting a dog on Pimobendan before they develop symptoms significantly delays the onset of heart failure.
Osteoarthritis
Osteoarthritis, also called “Degenerative Joint Disease”, is the type of arthritis that older dogs (and people!) get from a lifetime of wear-and-tear. It’s probably the commonest single disorder of the older dog, and the commonest threat to their welfare and wellbeing.
As a rule of thumb, there are three causes of osteoarthritis – normal weight bearing on an abnormal joint (e.g. in Hip Dysplasia); abnormal weight bearing on a normal joint (e.g. obese or overweight dogs); and normal weight bearing on a normal joint for an abnormal length of time (e.g. old dogs). Whatever the cause, however, the process is the same – the joint cartilage becomes damaged, leading to inflammation, pain and further damage. At the same time, extra bone forms around the joints to try and stabilise them, but this restricts the range of motion.
Any older dog, especially if they are overweight, have orthopaedic problems (e.g. hip dysplasia, elbow dysplasia, or a poorly healed injury), or are “high mileage”, e.g. working or highly active dogs.
The most common early symptom is “stiffness” and a reduced desire for exercise or activity. This may initially be misdiagnosed as simply “getting older” or “slowing down”, but it is in fact due to joint pain. It typically progresses to difficulty rising or ascending stairs or slopes, and then definite and obvious lameness (although this is usually present in more than one leg). A characteristic feature is that the lameness or stiffness is usually worst immediately after getting up, and it then decreases or “works off”. It is also often worse the day after strenuous exercise.
In many cases, osteoarthritis can be diagnosed simply from the history and a good description of the symptoms. The most useful additional test is often a “Range of movement examination” where the vet will see how far in each direction a joint can be moved without pain – this is usually reduced in patients with advanced arthritis. To fully assess the joint(s), it is necessary to carry out X-rays and look at the bone ends and joint spaces; however, this isn’t always appropriate in an old or ill dog.
Strictly speaking, there is no cure for osteoarthritis; however, it is possible to replace some joints – hip and elbow replacements are now fairly common. That said, arthritis is rarely so severe that this is required, at least initially, and it can usually be managed with a combination of techniques. At home, the owners can make the dog’s life a lot easier with some simple modification – ramps instead of steps, a comfortable bed to lie on, and keeping their sleeping areas warm. In addition, weight loss can be a very powerful tool in the overweight dog – it is estimated that a reduction of one body condition score point is as effective as a dose of a painkiller! Physiotherapy and hydrotherapy can also be very helpful; however, the mainstay of managing arthritis patients is with medication – usually anti-inflammatory and painkilling drugs. Remember, there are no over-the-counter painkillers for dogs, and human products are often lethally poisonous to dogs. Nutritional supplements (such as glucosamine or chondroitin) are also widely used – the evidence for their effectiveness is weak, but they do seem to help some dogs, especially if given with a large meal (to reduce their breakdown by the stomach acids).
Osteoarthritis will probably develop eventually in most dogs; however, it can be delayed and slowed down with proper care throughout life. This would include weight control, regular exercise, and getting and lameness or other orthopaedic disorders diagnosed and treated as early as possible.
Parvo
Parvo (or, more properly, Canine Parvovirus) is a severe, often fatal viral infection. Although nowadays it is most commonly seen in puppies, Parvo can affect adults as well if they are unvaccinated.
The Canine Parvovirus is transmitted in the faeces of infected dogs. The incubation period of the virus is 7-14 days; once the virus infects a new dog, it attacks both their immune system and their intestines, causing massive breakdown of the gut wall. This allows bacteria from the gut to invade the body, leading to septicaemia (“blood poisoning”). In rare cases, there may also be damage to the heart.
Any unvaccinated dog is potentially at risk. Disease is most commonly seen in puppies between 6 weeks and 6 months of age; up until 6 weeks, they are protected by their mother’s immunity (“Maternally Derived Antibodies”). However, in some breeds (such as Rottweilers, Dobermans and possibly German shepherds) this maternal immunity lasts longer – this (counterintuitively) means that the puppies are at HIGHER risk of Parvo, as the maternal immunity may prevent them from responding properly to their puppy vaccines.
The initial symptoms are lethargy and loss of appetite; this is followed by severe vomiting and diarrhoea. The diarrhoea is initially watery but rapidly becomes bloody and develops a foul smell, caused essentially by dead, decaying gut lining. In some cases, chunks of gut lining are passed in the diarrhoea. The dog will now become severely ill, collapse, and will rapidly go into septic shock and die without treatment.
There are rapid diagnostic tests available which we can carry out in minutes using a sample of faeces, or even a swab from the rectum, which will diagnose the presence of the Parvovirus.
These dogs are incredibly ill and need full intensive care nursing – as well as isolation from all other dogs. High dose intravenous fluids via a drip will help combat the septic shock, and antibiotics will help prevent bacterial septicaemia. Anti-vomiting medications are also invaluable. Immune stimulating drugs (such as interferon), although expensive, can also be very useful in rallying the immune system; however, we would expect at least one in three affected puppies to die despite all treatment efforts.
Yes – there is a highly effective vaccine available (although in certain breeds it may need to be given later than in most dogs). Once the dog has had their puppy course and an annual booster, the vaccine lasts for approximately three years before needing a booster.
Pyometra
Pyometra, or “a Pyo”, is an infection of a dog’s uterus (womb). It is a severe and potentially fatal condition, and preventing it is one of the main reasons for spaying bitches.
In a normal, healthy bitch, after every season her uterus prepares to receive puppies (this is driven by the hormone progesterone), and whether or not she becomes pregnant, the uterine wall will thicken and secrete fluid. As she gets older, this becomes more and more pronounced – we call this Cystic Endometrial Hyperplasia. Once she’s decided she isn’t actually pregnant (about 2 months after her season), the lining thins down and the fluid is reabsorbed. However, if during this time bacteria can enter the uterus, this fluid is a perfect foodstuff for them, and they rapidly grow and multiply, causing disease. There are two types of Pyo – an Open Pyo (where the cervix remains open, so the pus can drain out of her vagina and vulva), and a Closed Pyo (where the cervix is closed so all the bacteria, pus and toxins are trapped inside). Although both are dangerous, a Closed Pyo is more likely to be fatal, and is harder to diagnose.
Any unspayed bitch – although it may be slightly more common in those who haven’t had a litter (although it can happen to any bitch). It usually develops within 3 months of a season, and is more likely in older dogs. Overall, 23% of unspayed bitches can be expected to develop a Pyo by 10 years of age.
A dog with an Open Pyo may just appear a little off colour, with a thick cream, yellow or greenish vaginal discharge. However, more often she will be displaying signs of systemic illness, typically increased thirst and urination, lethargy, and loss of appetite. A Closed Pyo is more dangerous, as there is no discharge to warn you of a problem. She will start out with these non-specific signs, but then rapidly deteriorate and start vomiting, her gums may change colour (to red or possibly pale grey), and her abdomen may seem to swell. Ultimately, she will collapse, go into shock and die.
Usually with an ultrasound scan to look at the uterus – a pus-filled, inflamed uterus is very obvious on ultrasound. Other possible tests include blood tests and a vaginal exam.
The treatment of choice is ALWAYS surgical removal of the infected uterus, and this is the only effective treatment for Closed Pyos. In an Open Pyo, it may be possible to use hormones (to make the uterus shrink down and expel the infection) and antibiotics (to treat the bacteria) – however, although many dogs will apparently respond to this treatment, the Pyo will recur after the next season in over 80% of cases.
Yes – by spaying. In most cases, a neutered bitch cannot develop a pyo.
Vomiting
Vomiting may best be described as the active expulsion of the dog’s stomach contents. It’s actually a normal function – dogs often eat nasty things, and by vomiting them up they can minimise the risk of serious poisoning. However, it is a very non-specific sign, and can be caused by a huge range of different conditions.
In dogs, the most common cause is “Dietary Indiscretion”, also known as “Garbage Gut” – essentially, they ate something rotten and nasty! However, there are a huge range of other causes, depending on whether it is Acute Vomiting (sudden onset) or Chronic Vomiting (it’s been going on for a while). The common causes of Acute Vomiting include infections (e.g. gut infections, such as Salmonella or Parvovirus; a response to a high fever; or Pyometra); high worm burdens; reactions to certain drugs (such as NSAID painkillers); poisons (e.g. chocolate); intestinal obstructions; metabolic disorders (e.g. liver disease); pancreatitis; or neurological problems (such as Vestibular Syndrome or travel sickness). Chronic Vomiting, on the other hand, is more likely to be due to more ongoing disease processes, such as kidney failure; SIBO (Small Intestinal Bacterial Overgrowth); IBD (inflammatory Bowel Disease); or tumours in the abdomen or intestinal wall.
Any dog can begin vomiting – it depends what the cause is! In general, in a young dog or one with a habit of eating stupid things (typically but definitely not exclusively Labradors), we’d be leaning towards Garbage Gut or a blockage; whereas in an older dog, kidney disease or tumours are a little more likely.
True vomiting can be difficult to distinguish from regurgitation (where the contents of the oesophagus or gullet simply “flop” out) or even from coughing up a big lump of phlegm. However, vomit when produced has a characteristic acidic smell, and is usually stained yellow or greenish.
Determining the exact cause is really important – while Garbage Gut, for example, can be treated symptomatically, an intestinal obstruction needs urgent surgery. To determine the likely cause, the vets will carefully examine the dog’s abdomen, and check their heart and circulatory function. Blood tests can be used to determine how dehydrated (and therefore in danger of complications such as shock) the dogs is, and whether their kidneys or liver are working properly; whereas X-rays and ultrasound scans are used to examine the intestines and internal organs for signs of blockage or malfunction. In some cases, an “exploratory laparotomy” or Ex-Lap is needed – surgery to open the abdomen and actually look to see what’s going on.
It depends, of course, on the cause. Simple “Dietary Indiscretion” can usually be managed by starving the dog for 24 hours, providing water little and often, and then reintroducing a bland diet (e.g. boiled chicken and rice, or a commercial intestinal diet). Sometimes, antivomiting drugs may also be appropriate. In other cases (such as Pyometra or kidney failure), the underlying disease must be treated; and in some conditions (like an intestinal obstruction), urgent surgery to remove the blockage is required.
The simplest way to prevent vomiting is to prevent your dog from eating nasty rotten things they find in the garden, the dustbin, or out on a walk!
MANAGEMENT
Anaesthesia
Anaesthesia is essentially rendering the dog unaware of the surgery we’re performing, in a safe and reversible way. Without it, we wouldn’t be able to perform any surgical procedures in a safe and ethical manner – from elective operations like spays and castrations up to major procedures like spinal and orthopaedic reconstruction surgery, we wouldn’t be able to perform any of them. We appreciate that an anaesthetic on your dog is a stressful idea at the best of times, so in this factsheet we’re going to go through the procedure for you and explain what will happen, and why we do it.
There are other types of anaesthetic (sedation, or local anaesthetic for example), but for most procedures, when we say “anaesthetic” we are talking about a general anaesthetic, where the dog is completely unconscious and unaware of what we’re doing. This is in many ways the most useful type of anaesthesia, but there are definite risks associated with it – an anaesthetised dog is so deeply asleep that they cannot always maintain their own breathing rate, heart rate and blood pressure. We have skilled nurses who will be monitoring these parameters, and more, throughout the procedure under the supervision of a vet, so any deviation will be rapidly detected and dealt with. Because of the way the drugs work, any anaesthetic is a balancing act between the dog going too “deep” (and potentially coming to harm), or coming too “shallow” (and potentially running away!). We work to keep them at a level of sleep called “surgical anaesthesia” where they are comfortably asleep but still safe.
Anaesthetics in animals are very, very safe – severe complications in healthy dogs only occur in roughly 0.12% of anaesthetics (so less than 1 in 800), but if there are other disease processes, the dog is very sick, or is elderly, this risk is higher. As a result, we’ll usually offer you a blood test, to rule out any underlying conditions such as liver disease, kidney disease, or anaemia, that could adversely affect them under anaesthesia. If we find a problem, it doesn’t necessarily mean we can’t do the anaesthetic – just that we might need to take some extra precautions.
First of all, they’ll be seen either by one of our nurses or one of the vets, who will give them a careful check over for any signs of something that might affect the anaesthetic – for example, a heart murmur or a fever.
Assuming all is well, we’ll then give them a premed – a combination sedative and painkiller to help them relax, and minimise any discomfort after their surgery (whatever it is). Using a premed also means that we can use a lower dose of anaesthetic, which reduces the risks.
We’ll move them into a quiet kennel to settle down and relax until we’re ready.
Once we’re all set up for them, one of the nurses will bring them down to the prep area for induction, where we will send them off to sleep. This is usually done with an injection of propofol, but sometimes we may use an anaesthetic gas by face mask.
Once the procedure is over, we’ll turn off the gas and allow them to start waking up, now that they’re breathing just pure oxygen.
Once they start to swallow, we’ll take out the breathing tube, and then move them to the recovery area where the nurses can keep a close eye on them until they’re awake and ready to go home. It’s quite normal for a dog to be sleepy or a bit off colour after they get home – it may take them a while to clear all the anaesthetic from their system, especially if they’re a bit older – but if you’re at all concerned, feel free to call us at any time.
Anaesthesia seems really scary, and people get very worried about the risks. However, except in life-or-death emergencies, we will have carefully prepared, and we wouldn’t recommend an anaesthetic unless the risk of not performing the operation was much higher than the risk of carrying it out. All our vets and nurses are fully trained in anaesthesia – because as we’re all taught at vet school, there’s no such thing as a safe anaesthetic, only a safe anaesthetist!
Breeding
Deciding to breed from your dog is a major decision – there are a lot of things that can go wrong, as well as a lot of important decisions that you’ll have to make! It can be difficult, and heart-breaking, and expensive, and rewarding (often all at the same time!), so we’ve put together this brief guide to help you through the process
Before you decide to breed, it’s really important that you’re fully prepared. Although actually getting the puppies is the highlight, to get to that stage, there are a lot of preparatory steps. So, before you commit, are you really ready? Is the bitch really suitable to breed from – does she have a good temperament, is she fit and healthy, is she old enough, and can you get all the proper health checks done (such as Hip- and Elbow scoring, and perhaps DNA tests)? Can you find a reputable stud dog, who’s had all of his health checks too? Can you assist the bitch when whelping, and help her raise a litter (which could contain 12, or 14, or even more puppies!)? Can you care for the pups (worming, vaccinations, microchipping) and then find them all good, loving homes? Remember, not everything goes according to plan, either – so are you prepared to pay for a caesarean section, if it becomes necessary, bottle rear some or all of the pups, arrange for treatment of any that become ill, and take back any that the new owner decides they don’t want?
Then definitely consider breeding. If, however, you’re in any doubt, remember how many dogs there are in pounds up and down the country waiting for a new home. So, if you do decide to breed, you’ll need to make sure you’re legally covered: if you are producing five or more litters per year, or if your Local Authority think you may be breeding for commercial gain, you will need a breeders license, so check with them before you proceed! In addition, you may want to check what your pet insurance covers – it often excludes any conditions relating to breeding.
Your next step is to get your bitch well and truly checked over by one of our vets – they’ll be able to recommend any additional tests you may need. Then you will need to find a stud dog – it’s important to check that he’s fully tested and healthy as well, and that he isn’t too closely related to your bitch (inbreeding is a Bad Thing and we really want to avoid it). If he’s not bred before, you might want to consider checking his fertility, especially if you’re buying him for stud purposes, or paying a large fee! It’s also worth thinking about legal contracts with the dog’s owner, to avoid any misunderstandings.
Once she’s been mated, we can check for pregnancy from about three and a half weeks with ultrasound, but it isn’t really totally reliable until about four weeks – and bear in mind is it NOT possible to count how many puppies there are in an ultrasound scan.
Remember, if anything should go wrong, make sure that you call us! The commonest problems that dogs suffer during pregnancy are:
Also known as “milk fever” or hypocalcaemia, this usually occurs at the end of pregnancy or within a couple of weeks of birth. It usually causes shivering and muscle tremors, but can progress to muscle rigidity, seizures and collapse.
This is where the uterus just doesn’t push. This is most common in smaller litters, especially of small and toy breed dogs, but can occur to any bitch. It can sometimes be treated with injections, but usually a caesarean section is required.
Also known as Dystocia. This occurs when a puppy gets stuck in the birth canal, and is potentially fatal to the puppy and to the bitch. If the bitch is straining without result, or there’s a prolonged gap between puppies, contact us for advice straight away.
There are a wide range of different causes for weak and puny puppies, but it’s always worth getting the litter checked out if you have any concerns. Sometimes, even the smallest runts can be saved with appropriate care, so don’t give up until we’ve had a chance to check them!
Breeding requires a great deal of effort, not to mention expertise – but that should be the least of your worries, because you can always talk to us for any advice you need.
Castration
In the wild, all male dogs remain entire and fertile throughout their lives. However, the price of that is an increased vulnerability to some diseases and injuries, and some behaviours that we, as owners, don’t find attractive. Neutering is the most common surgical procedure carried out on dogs, and it is now commonplace. If you’re trying to decide whether to get your dog “done”, it’s worth looking at the arguments for it, against it, and then looking at the procedure itself, so that you can make an educated and informed choice.
There are both advantages and disadvantages to castrating dogs. Whether it’s the most appropriate thing to do will depend on a wide range of factors.
(1) more or less by definition, a castrated dog’s fertility is removed, so you can’t change your mind. (HOWEVER, remember that he may still have some sperm “left over” for several weeks after the operation, should he get the chance to “use” them!)
(2) There is a very slight increase in the risk of some rare tumours (about 0.4% extra cases of prostate cancer, and 6 extra cases of bone cancer per 100,000 dogs).
(3) There is an increased risk of orthopaedic injuries (double the risk of cruciate ligament injuries, possibly an increased risk of hip dysplasia, and because the growth plates in the bones are closed by puberty, they stay open longer meaning an increased risk of certain types of fractures).
(4) Weight gain – castrated dogs need less calories than entire ones, so you need to feed them less or they’ll put on weight!
(5) There is some research suggesting that neutering may in fact make certain problem behaviours worse, especially those related to fear or anxiety.
(6) Risk of surgery – perhaps 0.1% chance of a serious complication.
There are, however, major advantages:
(1) No unwanted pregnancies.
(2) Reduction in behaviour owners often dislike, such as running off to look for bitches in heat (which increases their risk of road accidents), less sexual behaviour such as masturbation and humping (although it won’t be entirely eliminated), and some types of aggression may be reduced in some dogs.
(3) No risk of testicular cancer (no testicles = no cancer!) – this affects between 1.5% and 16% of entire dogs.
(4) Massively reduced risk of most other prostate diseases, hernias and certain cancers of the bottom.
(5) Lifespan – a castrated dog will, on average, live 14% longer than an entire one.
Ultimately, you have to make the decision, but we can support you with the facts!
So, when you’ve made up your mind to have your dog neutered, you just have to book him in for the operation. If you want to know more, read on (those of a squeamish disposition may wish to look away now…).
Castrating a dog is a very simple surgery (unlike spaying a bitch), because his reproductive organs are conveniently located outside his body. In the procedure, his testicles are removed (so it is NOT the same as a vasectomy, where the testicles remain in situ but the tubes carrying sperm from them are cut) preventing him from making either sperm or testosterone – essentially returning his hormone balance to that of a prepubescent puppy. There is no evidence that dogs miss their testicles once they’re gone, nor does castration per se have any effect on their personality or psychological development.
The night before the procedure, it’s important he be starved – talk to our nurses who will advise you on how long, but in general, no food after 6pm and no water after 10pm. When you bring him in the next morning, we’ll carefully check him over for any problems that might affect his surgery, and then we’ll give him a premed injection (a combination of mild sedative to help him relax and a painkiller for afterwards). Then, when we’re ready, we will give him a general anaesthetic so he is completely asleep, and pass a breathing tube down his throat to help him breathe. The nurse will scrub the area around his scrotum (ball sack) while the vet scrubs up, and then they’ll begin.
It takes perhaps 15 minutes (a very quick procedure!) as a small incision is made in front of the scrotum, and one at a time the testicles are pulled out of this, clamped and cut off. The arteries and spermatic cords are then tied off with dissolvable stitches, and the skin sutured closed. Remember, the scrotum is NOT removed – it is normal for your dog to go home with an empty pouch of skin between their back legs.
Then we’ll wake him up, and as soon as he’s awake he can go home with a collar on to stop him licking at the wounds until they’ve healed.
Most dogs are completely back to normal in a day or so, but it is important to restrict their exercise until the skin stitches come out, roughly 10 days later!
Neutering of male dogs does prevent some unpleasant diseases, and increases lifespan by about 14%. However, there are arguments both ways, and you have to make up your mind about your own dog and what would be best for him.
Diet
It’s a common misconception that dogs in the wild live off meat – but of course that isn’t true! They also eat vegetables and, more importantly, whole animals – meat, bone and internal organs. Putting together a properly balanced diet for a dog isn’t actually as easy as you might think, so we’ve prepared this brief guide to help you!
Although, like us, dogs are omnivores (meaning that they can eat both meat and vegetables), there are some important differences in what they require for a healthy diet. All animals need a number of components in their food, and the correct balance is essential for health.
Dogs can get energy from fat, protein or carbohydrate. The amount a dog needs will vary depending on their level of activity, their life stage (for example, puppies and pregnant bitches need more than an older dog).
An adult dog needs at least 18% protein in their diet, and a growing puppy or a pregnant bitch needs a minimum of 22% (much higher than we do!). However, not all protein sources are equal – animal protein is termed “higher biological value” than plant protein, because it has a healthier mix of essential amino acids for dogs (yes, really – this is why it’s really, really hard to formulate a healthy vegan diet for a dog). In addition, dogs need unusually high amounts of the amino acid taurine (unlike humans, who can manufacture their own) in their diet. Without it, they will develop heart disease (cardiomyopathy).
Fat provides calories, taste, essential fatty acids and vitamins (A, D, E and K) that are required for healthy skin, coat, hormone production, blood clotting, immunity and many other functions. Insufficient fat in a diet means that firstly, the dog won’t want to eat it, and secondly, they will get progressively more ill as their reserves of these vital compounds are depleted.
Carbohydrate is a useful source of energy, but not essential for dogs! The only exception is in a bitch who is producing milk, where she should be getting at least 23% carbohydrate in her diet to produce milk sugar to feed her puppies.
Unlike humans, dogs do not need much fibre in their diet – about 5% is probably about right, more can (surprisingly) lead to constipation and other gut problems.
These are generally similar to human requirements, although a bitch needs proportionately more calcium when she is lactating (she’s likely to have a lot more than one baby to feed!).
There are one or two other differences too – for example, dogs can make their own Vitamin C.
It’s also important to remember that a dog’s nutritional requirements will vary if they are ill or have a chronic health condition – particularly diabetes, urinary crystals, liver disease, kidney disease, heart disease or skin diseases.
In practice, the best approach is usually to feed a reputable, balanced, commercial diet. For example, taurine-deficiency cardiomyopathy is nowadays only seen in those who follow an inappropriate home-cooked diet; whereas calcium imbalances are most common in those who follow a “raw-meaty bones” type diet. That said, it is perfectly possible to formulate a healthy home-cooked diet; however, before you do, make sure you talk to a properly qualified canine nutritionist – don’t try to make it up as you go along, or follow a fad internet diet! Our vets will be able to put you in touch with someone if you wish.
Euthanasia
We look after our dogs, let them into our home and our hearts, and love them dearly. In the end, though, all too often it’s us who have to decide when to call it a day and let them go. In this short guide, we’ll talk about how and when to make that decision, preparing yourself and your family for it, and then the procedure itself.
Sadly, it is quite rare for dogs to die peacefully in their sleep at home; more commonly, they will struggle on, suffering more and more each day. We can (and should) prevent this, and one of the worst mistakes you can make is to leave it too late – a decision you are likely to regret. Making the decision that it’s time to put your dog to sleep is never easy – and it shouldn’t be.
Definitely – there are ways that you can prepare, to make it a little less difficult when the time comes.
When your dog is healthy and well, make a list of all the things they most love doing – those things that, for them as an individual, life wouldn’t be worth living if they couldn’t do.
Make a list of all the things your dog hates most, too.
When they become old, or ill, take out those lists and compare them to their current life. Are they still getting to do things they love? Are they having more good days than bad? Or are they uncomfortable or in pain most of the time; having to constantly do something they hate just to keep going?
When you have made the decision, it is important that everyone in the household is on board with it – if there is significant disagreement, come in and have one of the vets check your dog over and talk to you about the options. If there are children involved, it is all the more important to make sure that they are kept informed – don’t try to spare their feelings by making up a story, as it may be harmful in the longer term. You can check out some excellent information on dealing with the issue here: https://www.bluecross.org.uk/pet-loss-support-children-missing-my-friend.
When the time comes, it is best to book an appointment in advance – it means we can make sure that there are both the time and the staff to have everything go smoothly. We may give your dog a sedative, if they seem distressed, and then we will clip a small patch of fur, usually on the foreleg. A veterinary nurse will hug your dog and raise the vein, and the vet will give an injection of an anaesthetic (it’s not a poison or anything nasty, just an overdose so they go quietly to sleep and don’t wake up). If you would like to stay with them, that’s absolutely fine; if not, that’s fine too.
Finally, the vet will perform some checks to make sure they’ve gone. Don’t be alarmed if they seem to move, or even gasp after death – this is due to reflexes, it’s quite normal, and isn’t a sign that anything’s gone wrong. There are usually a number of options for dealing with their remains – talk to one of our staff for details.
Afterwards, it’s quite normal to feel grief, anger, or depression – don’t let anyone say “it was only a dog”, because they were your dog, and part of your family!
Although it can be the hardest decision in the world to make, it’s even harder to live with the fact that you left it too long, and allowed a beloved pet to suffer unnecessarily. If you need to talk to anyone, please feel free to give us a ring.
Obesity
Obesity is a real threat to dogs (and people!) in the UK, and how better to manage it that with a fitness programme! But do you know how much exercise your dog needs? How should you modify it if they’re old, or ill, or very young? In this guide, we’ll talk you through the details of best to exercise your best friend.
Dogs need exercise to build and maintain muscle mass, cardiovascular fitness, and to reduce (or at least control) the amount of fat they’re carrying around. In addition, exercise will strengthen bone, ligaments and other parts of the musculoskeletal system. A fitter dog is a healthier dog, and is likely to cost you less in vets bills (!), and they will also be a happier dog if they’re getting out and about rather than being cooped up indoors all day long.
Well, excessive exercise (especially in an unfit dog) can be harmful – although it is unlikely to lead to a heart attack, it can result in musculoskeletal damage. In particular, we see muscle tears, strains and sprains much more commonly in unfit, overexercised dogs. Usually these are relatively minor, but torn ligaments and tendons can also occur which take much, much longer to heal.
You’ll have to carefully calibrate how much exercise you give your dog, and how hard you work them. To work this out, there are several factors you need to take into account:
Some dogs need more exercise than others – Setters, collies and Spaniels, for instance, need much more activity (to keep them sane if nothing else!) than Greyhounds (for whom a “mad half hour” once a day is usually sufficient). Some dogs, like Labradors, are mentally happy with very little exercise, but need to be encouraged to do more; and others (like Jack Russell Terriers and Chihuahuas) tend to be underexercised (just because they have short legs doesn’t mean they don’t need as much exercise time as other dogs- it just means they won’t cover as much distance in that time!).
An unfit animal should have a gradually increasing exercise programme, rather than starting cold and doing too much. Likewise, a very fit dog will need more exercise to maintain that fitness.
In general, a young dog needs more exercise than an older one, although there are of course exceptions.
Some dogs love exercise, some not so much! Ironically, the dogs with a tendency to laziness probably need to be given more organised exercise, as they won’t do it themselves…
Any disease conditions they may have might affect their ability to exercise. For example, a dog with heart or lung disease may require controlled exercise; and a dog with arthritis needs little-and-often to keep their joints supple.
How hard you exercise your dog is also a bit of a debate – madly running around and chasing toys burns more calories than a gently bimble in the park, but also puts more strain on joints, ligaments and muscles. Overall, a mixture of fast and slow work is probably best for most dogs.
As a bare minimum, almost every dog needs 30 minutes of exercise per day – and some need a LOT more!
First Aid
It’s really scary when you find your dog suddenly injured or hurt – but if you know how to respond immediately (in the minutes before you can get them to us), that can make all the difference to whether they survive or not. So, here’s our guide to emergency first aid!
There are a series of basic steps you can take that will allow you to work through most types of injury and give your dog the best chance, If at any stage, however, you’re unsure what to do or you’re worried about your dog – CALL US!
If you become a casualty yourself, you aren’t helping your dog! Key things to watch out for are traffic (stop the traffic or at least make sure the road is clear before running to your injured pet); deep water (don’t go in out of your depth); electricity (make sure the power is off); and sharp drops or cliffs (don’t fall over yourself!). In addition, frightened or painful dogs are much more likely to bite or snap, even without meaning to. So, make sure you can hold your dog’s muzzle, and consider using a tie, a belt or a strip of bandage as a temporary muzzle.
This is the good old ABC – Airway (can they breathe? If not, extend their head and neck and try to clear any obstruction), Breathing (watch for the movement of the chest and feel for airflow from the nose or mouth), and Circulation (feel their heartbeat behind the left elbow, and their pulse in the groin). If they’re not breathing or have no pulse, CALL FOR HELP, then start CPR until it arrives. To breathe for your dog, hold their mouth shut and breathe into their nose until you see their chest rise – usually about 10 breaths per minute. If they have no pulse, you must perform chest compressions – just like in humans, 100 compressions per minute.
Assuming they aren’t actually dying, check your dog over and try to work out what other injuries they have. At this point, concentrate on things that might be fatal – severe bleeding, chest or head injuries, or crushing injuries.
If so, try to stop it. If a major artery is cut, a dog can bleed to death in 2-3 minutes. So, if there is significant bleeding from anywhere, stop it. As a general rule of thumb, if it oozes, it’s unlikely to be dangerous; if it trickles, try and stop it, if it gushes or spurts, it needs to be stopped NOW! The best way to stop bleeding is by applying firm pressure to the injury, ideally through a clean cloth or pad to spread the pressure. DO NOT remove your hand or the pressure until 5 minutes after you’re certain the bleeding has stopped, or you may pull the clot away and make it start again.
Open wounds that aren’t bleeding dangerously should be covered with a sterile dressing if possible, and a clean cloth if not; and then left until we can assess them. If there’s a foreign object embedded in the wound, DO NOT pull it out unless we tell you to – it may be controlling the bleeding. Burns need to be managed differently – cool the burn with lots of water, and then wrap it in cling film to protect the area.
Any fractures present may need stabilising – although most of the time, if your dog has an obviously broken bone, leave it well alone! However, if a limb is wobbling dramatically, you may need to put a splint on it. Don’t do this until you’ve spoken to us, and we’ll talk you through the process if needed.
Get them to us so we can work on them! There’s a limit to what you can do “in the field” as it were. The best place for any injured dog is at the surgery, where we have the staff and the equipment to treat them properly. The best thing you can do, therefore, is bring them to us. If they aren’t able to walk on their own, try and lift them on a rigid board or plank rather than a bendy blanket (which can worsen spinal injuries) – we’ll be able to advise you if necessary.
If your dog survives to reach us at the surgery, there is a good chance we can save them – but what you do in the first few minutes after an accident or injury can make all the difference.
Flea control
Fleas are the biggest cause of skin disease for UK pets – even now, with so many great products on the market, they’re still present living on dogs across the country! There are two reasons they’re hard to get rid of – firstly, they can jump from dog to cat to rabbit to human to dog and so evade us; and second, 95% of the fleas aren’t living on the animal, but hiding away in your home, waiting for their chance.
There are a number of phases to getting your home “Flea Free”, but they sit easily into two categories. Firstly, kill the adults, then break the life-cycle!
Herbal flea remedies are notoriously unreliable – what works in one dog fails completely in another. This is particularly true of that old favourite, garlic, which typically results in a flea-ridden dog becoming a smelly, flea-ridden dog! Unfortunately, we cannot recommend homeopathic remedies, as there is no evidence that they are effective against fleas.
There are a wide range available, at very cheap prices. However, remember that, with medicines as with everything else, you get what you pay for. Over-the-counter products from pet shops or supermarkets are unlikely to be as effective as prescription-only or vet/pharmacist only products – not least because these often do not need to prove their effectiveness.
There are a lot of different spot-on medications, containing different ingredients, but they all work by killing the fleas. The most common contain fipronil, selamectin or imidacloprid, but there are others as well. These medications have to prove their effectiveness before being given a license; however, remember that many aren’t waterproof and will wash out if you give your dog a bath or they regularly swim. On the other hand, these are often effective against other parasites, such as ticks or mange mites. Of course, you can only get these from, or with a prescription from, your vet.
There are a number of different brands, and different active ingredients available now; these have the advantage that they cannot be washed off, and some will also treat for ticks as well. They do still need to be repeated periodically though – like all medications, they won’t last for ever! Some over-the-counter tablets only last for 24 hours, whereas some of the prescription-only products may last 3 months.
Available in prescription-only and over-the-counter forms, once again, the prescription-only or vet/pharmacist only forms are the most effective. These ones kill adult fleas, and may also treat or repel ticks, mosquitoes or even sand-flies.
Some flea products contain ingredients called Insect Growth Regulators, that effectively put the fleas on the pill so they only lay non-viable eggs. Others contain ingredients that directly act to kill flea larvae in the environment. These are invaluable for preventing a household infestation, but may not completely control one that is already established (or at least, not quickly).
These can be sprayed onto soft furnishings throughout the home to kill larvae and eggs. Bear in mind that, although generally effective, you need to follow the label instructions, as some can be toxic if you overdose! In addition, flea pupae are immune to any form of chemical warfare we can practically employ!
Yes, the humble vacuumed cleaner is your secret weapon in the war on fleas! It will suck up eggs, and the flea-droppings that the larvae feed on, but more importantly, it will stimulate the pupae to hatch, releasing new hungry adults. In this state, they an easily be killed with an insecticide spray!
No one medication or intervention will control a severe infestation – instead, you’ll need to attack them on several fronts, usually with an adult-killing medication, and environmental control spray or medication, and spotless hygiene in the home. If you need advice, feel free to call us!
Giving medications
It’s all very well for us vets to say “give these tablets twice a day, next patient please!” – but how easy do you actually find it to give medication to your dog? In this brief guide, we’ll look at some common medications, and easy tricks to help you get them into or onto your pet!
Different routes of medication are used for different conditions in dogs; however, there are a few common ones we’ll look at here. Remember, whatever the medication is, always follow the directions that came with it. If you can’t read something, or can’t understand them, or if they seem wrong – don’t make it up, call and ask us!
Tablets or capsules are the most common forms of medication, and can be among the trickiest to administer. In many cases, they can be hidden in food (typically inside a chunk of wet food or hidden in their bowl) – however, make sure that giving it with food won’t alter how well it works. If they won’t eat it in their dinner, try giving it in a little bit of chicken, ham or cheese as a special treat. If they still won’t fall for it, or if it is a medication that cannot be given with food, you’ll have to give it by hand. The simplest way is to sit your dog down, and then point their nose towards the ceiling. Open their mouth, and put the tablet as far towards the back of their mouth as you can (without getting nipped!). The close their mouth and hold it closed, gently rubbing their neck until they’ve swallowed. After swallowing, they’ll try to lick their lips, at which point they’ve almost certainly swallowed the tablet – but remember to check, a few dogs are quite cunning at hiding tablets in their cheeks!
These are usually given with or on food, and can just be measured out onto or into the food. Usually, it’s easier to administer them in a strong-smelling or particularly tasty type of food, but most are designed to taste quite nice by themselves. If you have to give an oral liquid in the absence of food, or the dog won’t eat the food with it on, the trick is to use a syringe (obviously without a needle on) and gently inject it between their teeth. The best technique is to sit them down, close their lips with one hand and then insert the syringe through the gap between their cheek teeth, then GENTLY syringe it into them (not too fast or they might choke on it). Once it’s in their mouth, hold their mouth closed and rub their throat until they swallow.
Most commonly used for flea, tick and other parasite treatments, spot-on medications are increasingly popular. They should be applied to the back of the dog’s neck (i.e. where they can’t reach it to lick!). Part the hairs carefully, and then deposit the liquid on the skin directly. If the volume of liquid is too great, split the dose between 2 or more sites. Make sure it’s completely dries before you pet the dog or allow any other pets to lick them!
Used to clean the ears, so don’t confuse these with ear drops (containing medication for treating ear diseases). To apply an ear cleaner, have the dog sitting or standing upright, and lift the dog’s ear up (which will straighten the ear canal). Then apply a suitable amount of cleaner directly into the canal but DO NOT force the nozzle into the ear, or you may damage the sensitive structures inside. Instead, insert the tip of the nozzle just into the canal before squeezing. After filling the canal with the cleaner, find the firm “trumpet” of cartilage below the ear, and give it a good massage – you’ll usually get a lovely squishing sound as you move the cleaner around inside the ear, and most dogs love this bit (because it scratches the itchy bits inside!). Then use a cloth or cotton wool to wipe away the liquid and dirt that comes back out of the ear (again, DON’T stick anything down inside). Beware afterwards – most dogs will shake their heads violently, spraying the room with cleaner and liquid ear wax, so probably better do this away from any soft furnishings!
These should be applied in exactly the same way as a wash, but not wiped away afterwards – the quantity is usually too small to need it.
There are all sorts of different shampoos and washes, for many different conditions. Each needs to be made up in a different concentration and left on for a different amount of time. Basically, READ THE LABEL before you start! In general, however, you need to wet the dog all over (this might be easiest in the bath using a shower attachment, or outside in a tub with the hosepipe!). Then apply the shampoo (remember, you may need to wear gloves for some) and lather it up. Allow the dog to stand for the required amount of time before rinsing thoroughly with lots and lots of fresh water, and then allow them to dry off naturally (towelling and using hair dryers are usually a bad idea, for various reasons).
Medicating a sore eye can be really difficult – dogs don’t like you poking at their eyes (understandably), and the muscle that closes the eyelids (orbicularis oculi, if you’re interested is, for its size, the strongest in the whole body. The tick with eye drops is not to try to apply them directly to the surface of the eye (the dog’s blink reflex is often too fast for that!) but into the lower eyelid. So, allow the dog to stand or sit upright, and then with one hand gently CLOSE the affected eye. Use your thumb to carefully open just the lower eyelid, so it sticks out, and apply the required quantity of drops onto the INSIDE of the lower eyelid. Then, allow the eye to close, and the drops will be transported onto the surface of the eye. Easy!
Giving medications can be tough, but it’s usually straightforward once you know how! If your dog really resents it or you’re finding it really hard, don’t struggle on and risk getting hurt, or hurting your pet. Instead, give us a call and we’ll be able to show you how (or suggest a different option if even we can’t get them to cooperate!).
Operations
It’s always worrying when your dog has to come in for an operation – but it’s really useful to know what will happen and how to prepare for it! In this guide, we’ll explain what will happen, what the options are, how best to prepare your dog, and how to help them recover afterwards.
If your dog is coming in for an emergency operation, then the preparation bit isn’t so important (if it’s an emergency, we’ll work with whatever state they’re in!). However, most operations are either elective (in other words, you choose to have it done, like neutering) or at least pre-booked (like orthopaedic surgery).
If their stomach is full of food, there’s a high risk they’ll vomit under anaesthesia, which is not only messy but potentially dangerous. We would usually recommend that dogs have no food after 8pm the night before, and no fluids after midnight (if this doesn’t apply to your dog we’ll tell you!). For unweaned puppies, however, it is very risky to starve them for this long, so we recommend checking with one of our vets or nurses.
There’s nothing worse than having to remove matted hair, mud and brambles from a dog before we can perform an operation – and it makes it REALLY hard to keep the site sterile too! Even if it’s just running the hosepipe over them if they’re really muddy, it’s better than nothing… For some operations, we may recommend bathing in an antiseptic skin disinfectant – talk to the vet or the nurse when booking in if you think this might be necessary.
Remember to tell us any medical history the dog has when you come in, especially if it’s something we might not know (like episodes of vomiting recently, something that happened at a previous vets, or any odd reactions to medicines). Although we’ll probably have it on our records anyway, it’s much safer to double check…
(4) Think about blood tests. We offer pre-operative blood tests to all dogs undergoing surgery. If your dog is more than 7 years old, we strongly recommend it, as it can pick up problems that we don’t know about, such as kidney or liver issues that might affect the surgery.
(5) Remember to ask us BEFORE we admit your dog!
After the operation is completed, we’ll usually keep your dog in with us for a few hours, or possibly overnight, until they’re ready to go home. This does NOT, however, mean that they have fully recovered!
(1) Look after them once they get home. Most dogs will want to go to their bed and sleep, but some may still be a little wobbly and struggle to get around normally. It is not uncommon for dogs to develop diarrhoea in the 24 hours after an operation, so be prepared… As a result, we recommend offering a light meal of boiled chicken or fish and rice, or a commercial intestinal diet, on the night after the operation and possibly the next morning. Then they can go back onto their normal diet.
(2) Your dog will have been sent home with medications and instructions – follow them! The medications we prescribe are usually painkillers and, sometimes, antibiotics, both of which can be potentially dangerous if you don’t follow the instructions. In addition, make a note of any recheck times – we’ll usually want to see them again in 3 or 4 days to check all is well, and then in 10-14 days to take any stitches out. Don’t forget!
We will walk you through every step of the way, but if there’s something you don’t understand, or you’re at all worried about your dog – call us and ask!
Spaying
Entire bitches are at an increased risk of a number of disease condition, some of which are potentially life-threatening. These diseases can be prevented, or at the very least, the risk reduced, by spaying (neutering). However, this is a surgical procedure, and obviously it does involve some risks in and of itself, as well as having other consequences (never having any more puppies being the most obvious!). There are a lot of people and websites who will tell you that you MUST have your bitch spayed, or that you MUSTN’T. In this guide, however, we’ll look at all the pros and cons, so that you can make your own mind up.
Spaying a bitch is a surgical procedure where the ovaries (and, usually, the uterus or womb) are surgically removed. It’s a fairly big op (although dogs seem to cope and recover really well), but it’s still an optional surgical procedure with a one in 1000 risk of significant complications. So, what are the advantages – why do people do it?
Most bitches will come into season roughly every six months (although it may be longer for large and giant breeds). When they’re in season, or “in heat”, they pass a bloody discharge from their back end, which can be really messy. In addition, every male dog in the vicinity is likely to be queuing up at your back door trying to get to her! Some bitches also undergo quite dramatic personality changes; and they may suffer from “False Pregnancies” in the couple of months following the season. If they get “caught” by a dog, it’s likely to be a real pregnancy, and then you have to look after and find homes for all the puppies! Spaying completely removes her cycle (it cannot occur), and she cannot get pregnant. This means you’re not going to be part of the overpopulation problem, with dogs stacked up waiting for rehoming in shelters and rescue centres.
Neutering reduced the risk of reproductive tumours. About 7% of unspayed bitches will develop a mammary tumour (breast cancer) in their lifetime; if spayed before the second season, the risk drops by 92%; if spayed before her first, it’s down by 99.5%. Spaying an older bitch has progressively less effect. This protective effect extends to other reproductive tumours – a dog without a uterus or ovaries cannot, for example, develop uterine or ovarian cancer!
This is a serious and, if untreated, usually fatal infection of the uterus (womb). An astonishing 23% of unspayed bitches will develop a pyometra by 10 years old. The risk is essentially zero in spayed bitches.
That said, there are some disadvantages too. Hormone changes can result in weight gain, coat alterations. After neutering, most dogs will be more prone to put on weight – but that doesn’t mean they become fat because of neutering. They become fat because their owners overfeed them! A few dogs also show a change to the quality of the coat – this is actually pretty rare, and usually really minor.
(2) Orthopaedic disease. There’s been a lot of research done into the effects of spaying on certain bone and joint disorders. There is good evidence to suggest that there is a slightly higher risk of bone cancer (osteosarcoma) in spayed bitches (unspayed bitches have a risk of 0.006%, spayed bitches 0.012%). In addition, spayed bitches have a higher risk of growth plate injuries, and seem to be at slightly higher risk of cruciate ligament injuries.
(3) Some studies suggest an increase in the rate of certain tumours (particularly some types of bone cancer, and blood vessel cancer)> It’s worth remembering though that the risks of these are much lower than the risks of, for example, pyometra.
Unlike neutering a dog, which is a very simple operation (his reproductive organs are easily accessible!), spaying a bitch requires entering the abdomen. In most cases, this is done as an “open” surgery, where she will have a general anaesthetic, then the surgeon will open her abdomen and remove her ovaries and uterus. A more modern alternative is the laparoscopic bitch spay, where we use keyhole surgery just to remove her ovaries – this has a much faster recovery time, and seems to provide all the advantages of the traditional surgery. Both are done under general anaesthetic, but we’d expect her to go home the same day in most cases.
Once you factor all of these risks and benefits in together, you can expect a spayed bitch to live 26% longer than an entire one.
Spaying your dog is an important decision – there are hundreds of thousands of unwanted dogs in the UK, so reproductive control is really important. It also genuinely does save lives; however, there are disadvantages too, so it’s important that you make up your own mind.
Vaccines
Your dog is constantly at risk of contracting a potentially deadly disease. Distemper, Parvovirus, Infectious Canine Hepatitis – they haven’t gone away, they’re still out there. The reason we don’t see them as commonly as we used to is that most dogs are vaccinated to protect them; without vaccination, any dog is at risk. There are also some rarer or less severe diseases we can vaccinate against – such as Kennel Cough and Leishmania. Vaccination is a very low risk way to protect your dog – and the other dogs around you – and we strongly recommend it!
We offer a wide range of vaccines against different diseases, and we’ll look at each of the more important ones in turn. Vaccines work by “teaching” the immune system how to fight a particular infection. They do not “weaken” or “strengthen” it, but they do make it better able to fight particular diseases. Some vaccines (like the Parvo Vaccine) contain a weakened but still live form of the disease agent – these often give longer lasting immunity (3 years) compared with those containing inactivated or dead organisms (like Leptospirosis, which only lasts a year or so). It’s also important to remember that, unlike in humans, vaccines for dogs do NOT last for life – the manufacturer’s recommended repeat dose dates are based on the time interval that will protect 99% of dogs vaccinated. It is true that some dogs’ immunity does last longer, and for some disease, you can do antibody tests to see if the levels of antibody are still high. However, for most disease (especially Lepto, for example), this test is unreliable because the vaccine does not produce protection using antibodies but other components of the immune system. Fortunately, there is very little evidence of any significant risk to healthy dogs from vaccines – “over-vaccination” is a theoretical rather than a real risk.
This is a very serious disease that, although closely related to measles, is much more dangerous. It is estimated that 50% of unvaccinated dogs who are infected will die, even with treatment. Typically, it causes a runny nose and eyes, vomiting and diarrhoea, pneumonia, seizures or fits, hardening of the footpads and ultimately death. Even in dogs who recover, encephalitis (causing dementia or fits) may occur as a result months or even years later. The vaccine requires 2 doses 2-4 weeks apart, then a booster a year later. It is repeated every three years.
ICH is caused by a canine adenovirus that attacks the liver. Infected dogs become severely jaundiced, have a high fever and lose their appetite; in severe cases, bleeding, fits and death may occur within hours. Even after recovery, infected dogs will often excrete the virus in their urine for many months. The vaccine requires 2 doses 2-4 weeks apart, then a booster a year later. It is repeated every three years.
Also known as “Parvo”, this virus is probably the most commonly seen fatal infection in dogs. Although vaccination is very effective, puppies face a short gap of vulnerability after their mother’s immunity wears off and before their vaccines kick in – this is why it is vital to keep as many dogs as possible vaccinated to minimise the risk of transmission! Older dogs can also develop Parvo too, though – it’s not just a disease of puppies. They virus attacks the intestines causing vomiting, diarrhoea and then severe, bloody diarrhoea, dehydration, septicaemia, shock and death. Even with intensive care nursing and treatment, at least 30% (and often more) will usually die. The vaccine requires 2 doses 2-4 weeks apart, then a booster a year later. It is repeated every three years.
Also known as Weil’s Disease, this is caused by a group of bacteria that are transmitted in urine (from rats, dogs and cattle). It can also infect people, and it is able to invade the body even through intact skin. It damages the kidneys and the liver, and in severe cases may be fatal. There are a wide range of different “serovars” or strains of the bacterium; traditional vaccines are available against 2 of these strains, but some newer vaccines will protect against 4. The older vaccine needs only 2 doses, 2-4 weeks apart, and then an annual booster. The newer (L4) vaccine requires 3 doses, 2 weeks apart in a puppy, and then annual boosters. The vaccines DOES NOT last more than a year, and CANNOT be tested with “titre tests”.
The two most important causes of Kennel Cough are Parainfluenza and the bacterium Bordetella bronchiseptica. The symptoms are a honking cough, which may persist for months, and often a low fever, lethargy and loss of appetite; however, in severe cases, pneumonia may occur which can even be fatal, especially in very young or very old dogs. There is an injectable vaccine against Parainfluenza (which can be given along with the Lepto vaccines), but it’s effectiveness is limited. The full Kennel Cough vaccine is given up the nose and gives protection against both types. Vaccinated dogs do sometimes develop kennel cough (it isn’t a perfect protection), but it is milder and much, much less infectious than if they had been infected without the benefit of vaccination. For maximal protection, the dog requires one dose annually.
Although not (yet) present in the UK, rabies is a highly dangerous disease which can infect any mammal, including humans. Once symptoms occur, the disease is almost 100% fatal. Any dog wanting to visit mainland Europe (or most other non-UK countries) MUST be fully vaccinated before they leave. Infected dogs usually become hyperaggresive and will run around biting people and frothing at the mouth (the virus is transmitted in the saliva) before having seizures and dying. There is no treatment, and infected dogs must be put down to prevent their suffering and to protect the public. The vaccine requires a single injection (no requirement for blood tests any more) and must be repeated every 3 years.
This is a fairly exotic disease, not yet native to the UK. We do, however, see it in dogs that have returned to the UK from southern Europe, where it is fairly common. It is spread primarily by sand-fly bites, although direct dog-dog transmission can also occur. Leishmania usually causes a scaly, scabby skin lesion, which gradually spreads; however, it can also cause severe internal damage as the parasites attack the gut (causing vomiting and diarrhoea), the muscles (causing muscle pain and lethargy) and the kidneys (causing increased drinking and urination). Most dogs will also suffer weight loss, and although the disease can be managed, it cannot be 100% cured. The vaccine requires 3 injections, 3 weeks apart under the skin and boosted annually for at-risk dogs.
Vaccination will reduce the chance that your dog contracts the disease, the severity if they do contract it, and the risk of them spreading it. Not all dogs can be vaccinated effectively (for example, dogs on certain medications won’t respond properly to vaccines), so you are protecting these dogs as well as your own by vaccinating. If you want to know more about a particular disease or vaccine, give us a call!
Worming
Dogs are naturally host to a range of unpleasant internal parasites. The most important of these are roundworms and tapeworms, but hookworms and pinworms are also a problem for many dogs. Some roundworms pose a very real threat to human health as well – their larvae (present in and around dog droppings) can invade the gut if poor hygiene is followed, and may even crawl in to the liver, brain or eyes (we call this visceral larval migrans, and it’s most significantly a problem in children). The best way to control these parasites is with an effective worming programme for your dog.
It is important to make sure that whatever wormer you’re using covers all the major groups of worms – tapeworms, for example, aren’t sensitive to most conventional wormers, so modern products usually contain an ingredient such as praziquantel which will put an end to them. However, with so many options out there, it’s important that you understand what is available:
The use of garlic and wormwood to control intestinal worms is an ancient practice; however, it is not ideal in dogs. These products may have some effect on roundworms, but they are also both toxic to dogs, so only very low doses can safely be used (this is probably why the effect on the worms seems fairly limited). Homeopathic remedies, meanwhile, have been extensively studied but sadly, there is no evidence that they are effective against worms of any type.
There are a wide range of different active ingredients available in these products, but the vast majority contain piperazine or nitroscanate. These products are effective against some kind of worms, but nitroscanate in particular is notoriously toxic in high doses, so you have to make sure the dose is very accurate! In addition, these products are usually only effective against a narrow range of worm species.
These liquids often contain fenbendazole, a very safe, gentle wormer that is effective against roundworms and some protozoal parasites (suitable for nursing mothers and young puppies). Other formulations may cover different species of roundworm.
These are combination tablets, with several different active ingredients. By combining them (typically, pyrantel, oxantel and praziquantel), the tablets are able to combat all the common worm species.
Again, these are combination drugs, but containing more potent active ingredients (such as milbemycin), meaning they are often effective against an even wider range of parasites, often including roundworms, tapeworms and even lungworm. However, they can only legally be purchased from your vet, or with a veterinary prescription.
There are an increasing number of spot-on products that kill fleas and also some worms (often based on selamectin or moxidectin). In general, these are effective against roundworms, sometimes hookworms or whipworms, but not tapeworms. Again, these can only legally be purchased from your vet, or with a veterinary prescription. There is also an increased risk of harm (at overdose) in Collies and other herding-type dogs. Normal doses are safe, but these drugs should NEVER be given at more than the recommended dose; or in combination with other treatments such as milbemycin, as they can cause fits, or even death, in susceptible dogs.
It is important that most dogs are wormed regularly, to prevent the parasites “building up” in their system, and to stop them from completing their life-cycles. In particular, it is vital to worm bitches when they’re in pup (some worms can invade the puppy even before birth, and also in the bitch’s milk). Similarly, young puppies should be frequently wormed, even before they get their vaccinations – talk to one of our vets for details.
This is a slightly more complex issue. Worms may be transmitted by eating live prey or fresh meat; by sniffing around in the park; or even by fleas. As a result, all dogs are at some risk of worm infestation. In general, we’d recommend worming every 3 months; but if your dog has a habit of eating roadkill, or catching rabbits, for example, more frequent worming (every 6 or even every 4 weeks) would be advisable.
Our dogs will always be at risk from worm infestations, but with a regular worming programme, they can be controlled. Talk to us for more details.