Ebola seems to be dwindling, but look out: Avian Flu is back!

Just as the news headlines about Ebola have dampened down from boiling to a quiet simmer, Avian Flu has leapt back into the news. The Telegraph headline today sums up the media reporting: “Bird flu strain which can be passed to humans detected in Holland”. Meanwhile, even closer to home, the BBC reports that a case of bird flu has been confirmed at a duck breeding farm in East Yorkshire. The ducks are being slaughtered and a 10km (6 mile) exclusion zone is in place. It all sounds as if an apocalypse along the lines of the “Contagious” movie has landed in Europe, but the truth is far less exciting. Avian Flu is a viral disease that is highly infectious between birds. This is the single fact that needs to be stressed more than anything else. It is a bird disease, and the risk to humans is minimal.

The strain of avian flu that is in the news is similar as the one which was first seen in Hong Kong in 1997, and has been appearing spasmodically ever since. That one was known as H5N1(H-five-N-one), a name that describes the type of proteins on the virus particles. The Netherlands strain is the H5N8. The strain in Yorkshire has been identified as an H5 strain but further details are not yet available. It is true that humans can be infected by such strains of the virus, but the risk of this is so small as to be almost negligible.
Hundreds of millions of birds have died because the disease spreads rapidly from bird to bird, and because authorities react to viral outbreaks by carrying out mass slaughtering of poultry flocks in an attempt to eliminate the virus. When humans have been infected, the virus has not spread from person to person. It has remained as a bird virus only, with humans only occasionally getting in the way, usually when they are working in close proximity to infected birds when they inhale viral particles. If Avian Flu reached the UK, everyone working with poultry would know to be ultra-careful about hygiene, so the risk of humans dying of bird flu would be minimal. There is no such thing as a human pandemic of bird flu.
Readers may then wonder why there seems to be a type of hysteria around Avian Flu. The reason for this is the potential for a change in the virus which could indeed lead to a human pandemic. The avian virus could mutate into a new strain of virus that is highly infectious to humans. If this happened, the new Human Flu virus would spread across the world rapidly. This is what happened in 1918, when 50 million people worldwide died in a flu pandemic and the authorities are justifiably concerned about the risk of a repeat of this.

Ask a vet online – ‘my dog has been weeing blood could it be infection or something more’

Question from Sharon Harris:

My dog aged 10 has on a couple of times been weeing blood he does one long one which is ok then just walks round weeing bits but that’s when the blood starts he is wanting to go out more often than he usually does ,drinking more still eating and his usual self but have noticed a lump that is inside lower stomach but has lumps all over his body but many wiems have these lumps could it be infection or something more

Answer from Shanika Winters:

Hi Sharon, thank you for your question regarding your 10 year old dog who is passing blood in his urine (wee) this symptom is called Haematuria. It sounds like your dog is still bright and happy in himself, it is possible that his haematuria is due to an infection but can also be related to bladder disease, kidney disease or prostate disease.  It is really important to get your dog examined by your vet as soon as possible.

What will happen when I take my dog to the vet?

Your vet will ask a lot of questions to form a history of what is going on with your dog, including drinking and urinating habits which you have already listed in your question.  It is very helpful to bring in a urine sample in a clean container when the condition relates to the urine.  It can be tricky to catch a urine sample from your dog, especially if they prefer to wee when off the lead but a clean bowl and some perseverance should eventually mean you can get a sample.  Your vet can collect a sample by passing a urinary catheter (long thin soft plastic tube placed into the bladder) but this can be uncomfortable and may require sedation/hospitalisation for your dog….

“Me and My Dog” – working together to eradicate rabies

Most dog owners adore their pets, and “pet selfies” are a popular way of expressing the joy of the bond between human and animal. A new campaign by a charity is using pet selfies to drive forwards an important goal: the global eradication of rabies.

The concept is simple. Take a selfie of yourself with your pet, then upload it to the charity website. When you reach the uploading page, you’ll be asked if you want to make a donation: even a couple of pounds will do. The idea is to make this a viral campaign: if enough people do this, the charity will raise a game-changing sum of money, and the goal of rabies eradication will be a step closer.
There’s an irony to the idea of “dog and owner” pictures being used to counter rabies: 99% of human cases of rabies are caused by dog bites. If it wasn’t for the close relationship between humans and dogs, rabies wouldn’t be an issue….

Ask a vet online- ‘my Bichon friese keeps goin for his side and making bald patchers’

Question from Shell Cottam:

My Bichon friese keeps goin for his side and making bald patchers, we are have in to keep his cone on to stop it, is there anything you can recommend to stop him doin this please

Answer from Shanika Winters:

Hi Shell and thank you for your question regarding your dog going for his side. I will discuss some possible reasons for your dog’s behaviour and then possible ways to tackle these.

From what you are describing it sounds as though your dog is biting and or scratching at himself to the extent that he is losing his hair. I am sure that both you and your dog would be a lot happier if he did not have to keep a cone on his head long term to prevent his hair loss. The first think we need to do is find out the history of how your dog is in general and how long the condition has been going on. Your vet will ask you some of the following questions:

Is your dog generally well?

By this we mean is he eating, drinking, toileting, happy to exercise and generally acting as normal other than the condition you have brought him in for. We ask this as underlying illnesses can sometime show up in unexpected ways, so something you may not at first think is linked to the hair loss could be. An example of this would be if your dog was generally listless and not as keen to exercise along with hair loss this may suggest an underactive thyroid gland.

How long has the condition been present and has it changed?

Your vet will want to know when the condition first started and if there were any particular changes at this time e.g. getting a new pet, change of food, starting a new job all things that can help us to work out why your dog is losing hair and if the situation is stable, improving or getting worse. It is really important to tell your vet if you have already tried any treatments….

Ask a vet online- ‘my cat is now 18 yrs old, bit loathe to help him on his way’

Question from Susan Banfield:

My cat is 18 yrs old, has lost most of his front teeth, bad breath, dribbles all the time, extremely skinny and has trouble keeping himself clean. Bit loathe to help him on his way over the bridge as his coat still shines, bright eyes, eats well and still goes outside to toilet and explore. Am I being fair?

Thank you

Answer from Shanika Winters:

Hi Susan and thank you for asking one of the most delicate questions that a pet owner and vet will face ‘when is the right time to have my pet put to sleep?’

As our pets ages we are very aware that we do not want them to go on for too long and that our vet can put our pet to sleep so as to prevent unnecessary suffering. This is however never a simple or easy decision to make and is very much specific to each individual pet, its condition and its owner. I will go through the way in which we try to help an owner work out if that time has arrived. Please remember that as your veterinary team we are here to help and support you any your pet through all situations even after you lose a pet we are here to talk to…..

The unnecessary death of the Ebola dog

Ebola virus hysteria is taking hold of the northern hemisphere. The latest victim was a cross-bred dog called Excalibur, who was euthanased by the Spanish authorities even though he showed no signs of being infected with the virus, and despite the fact that there is no evidence that dogs can transmit Ebola to humans.

The twelve year old rescued dog had the misfortune to belong to a Spanish nurse who became the first person to become infected with Ebola in Europe after nursing a Spanish missionary priest who had been repatriated from Sierra Leone to Madrid for intensive treatment. The priest died of the virus on September 25th,, and the nurse is thought to have picked up the virus after touching her face with a contaminated glove as she removed her protective suit after finishing her shift.

Excalibur was a much loved pet in perfect health, and after Madrid’s regional government obtained a court order to euthanase him, the nurse’s husband put out a call for his life to be saved. An online  petition rapidly gathered over 400000 signatures, and crowds of angry animal-loving protestors had to be restrained by police outside the apartment where the dog lived. Despite the protests, Excalibur was euthanased. The deed has been done. But was it really necessary? Did the animal present a risk, or was he just a scapegoat sacrificed to give the authorities a sense that they were doing something?

There is scanty evidence to support killing a dog in a situation like this. Bats are thought to be the natural reservoir for the Ebola virus in central Africa, carrying the virus without showing signs of illness. Monkeys and apes become infected and fall seriously ill, like humans. But despite extensive research, there’s been almost no evidence of other animals becoming infected or carrying the virus.

There is one study that casts a cloud over the innocence of dogs: researchers investigating the 2001-2002 outbreak of Ebola in Gabon found low levels of antibodies in blood samples from dogs in areas where there had been cases of Ebola in humans and apes. This confirmed that the dogs had been infected with the virus, but it was impossible to know the source of their contact: from bats, apes, or from humans? It was also not possible to determine whether the dogs could have been infectious to humans at some point. In theory, the fact that they had been infected with the virus implies that at some point they may have shed the virus in their secretions, in the same way as infected humans pass on the infection.

Some researchers believe that it would have been wiser to have kept Excalibur alive, not for sentimental reasons, but to learn more about the spread of the disease. If he had been kept in quarantine, serial blood samples could have been taken, monitoring his immune status. The question of whether or not dogs need to be included in Ebola virus control schemes could have been definitively answered in a safe environment. And if he had been clear of any sign of the virus after several months, he could have been released from quarantine to resume a normal happy doggy life.

Sorry, Excalibur: the precautionary principle and the political need for action seized the initiative: we still don’t know much about Ebola in dogs, and you’ll never enjoy another happy walk with your owners.…

Are vets more interested in the health of their patients or the money in their pockets?

I recently wrote a blog here titled “Debunking myths about “rip off” veterinary fees”, and since then, the subject of money has continued to be one of the banes of my life as a vet in practice.

My aim in life is to do a job that I enjoy, and to be paid a reasonable salary: for most people, that just means that you go to work, do your stuff, and come home at the end of each day. For vets, it’s different: every day, as part of our job, we need to ask people to give us money. Most of us would be delighted if this discomfitting task was taken away from us, but unfortunately, it’s an unavoidable part of our job description.

One recent case provided a good example of the type of daily dilemma that faces vets. An elderly terrier, Sam, had a small benign tumour on his flank. He was fourteen years of age, and his owner had been hoping that we might be able to leave the tumour alone: it’d be better to avoid a general anaesthetic unless it was absolutely necessary. When the tumour began to ooze blood, and Sam began to lick it a lot, we couldn’t leave it any longer so he was booked in for surgery. When booking the operation, I mentioned to his owner that it would be wise to take the opportunity to clean up his teeth, which were caked in tartar. And I gave a detailed estimate of the expected costs.

We took all the usual precautions to ensure Sam’s safety. He had a detailed clinical examination and pre-anaesthetic blood tests to ensure that he had no underlying illnesses that could make an anaesthetic risky. An intravenous line was set up to give him continual fluids during the procedure and to give us instant access to a vein if any emergency treatment became necessary. And a vet nurse was designated to hold his paw and to monitor him for every second of his time under anaesthesia, from induction until he was sitting up at the end.

Everything went well: the tumour shelled out quickly and easily, and a line of sutures closed the wound. I carried out a thorough descale and polish of his teeth, as planned. But it was then that the dilemma arose: beneath the tartar covering his teeth, it turned out that two of his molar teeth had large diseased areas. The gum margins had recessed, exposing large parts of the tooth roots. One of the teeth had serious infection, causing the tooth to be loose: it was easily removed. The other molar tooth was more complicated: one root was seriously diseased, but the other two roots were healthy. The tooth needed to be extracted, but it would be a tedious, time consuming surgical extraction, taking over half an hour, and requiring follow up x-rays to ensure that it had been done properly. This would involve an extra cost to the owner of well over £100. I had already given an estimate, and I didn’t feel that I could go ahead with this without permission.

While Sam was still anaesthetised, I asked a nurse to phone his owner to explain the situation. There was no answer on the home line, and the mobile number wasn’t working. What should I do now?

If I went ahead, I’d be carrying out unauthorised work on someone’s pet. If there were any unexpected complications, the owner could hold me liable. And as for the extra cost? Could the owner justifiably refuse to pay?

The safest legal approach would be to make a note of what needed to be done, and then to inform Sam’s owner that he needed a follow up anaesthetic in a few weeks, during which we’d tackle his dental issues. But I knew that it would be far safer for Sam to have the entire procedure completed during this first anaesthetic, and I knew that his owner would be unlikely to agree to pay for a second anaesthetic on top of this first one. So Sam’s dental issues would probably not be treated, and he would suffer as a consequence.

I made an “on the hoof” decision to go ahead with the dental procedure. It took even longer than I had anticipated, and I had to take a series of x-rays rather than just one. By the end, I was happy that Sam had been given the best treatment, but I was nervous about the owner’s response. Would she think that I had done this just as a way of extracting more money from her? What if she genuinely couldn’t afford more than the estimate that I had given her?

I felt so uncomfortable about the situation that I gave a significant discount on the extra work that I had done. Effectively, I ended up working my lunch hour for nothing because I felt so awkward about it.

But what else could I have done? In the interest of the dog, I could not have left painful, diseased teeth untreated.

What would pet owners feel if the vet presented them with a situation like this? Should you pay the full amount of justifiable extra work if it is unauthorised?  Do you trust your vet? Or do you feel that we are working more for our own interests than for the benefit of your pet?

 …

Is your doggy going doddery? – Cognitive Dysfunction in dogs

Cognitive Dysfunction, a condition similar to Alzheimer’s, is very common in older dogs. 50% over the age of 10 year will show some sort of symptoms and this only increases with age. In the early stages these changes can be subtle and often the condition is only noticed when the pet’s behaviour becomes more severe. However, recognising and treating the condition early is vital to have the best chance of halting or even reversing the changes in the brain.

The symptoms of cognitive dysfunction will vary between individuals but can include;

Confusion or vacancy – these are often the first signs to manifest but are also the most difficult to pick up on. Affected dogs will have periods (which can initially last just a few seconds) of seeming confused or lost in familiar surroundings. In the early stages a call or command can bring them out of it but later on it can be more challenging.
Pacing or circling – again this can begin as quite a subtle problem but gradually becomes more apparent. Dogs will often move from room to room in the house, resisting all attempts to stop them or move in small circles. They can appear quite distressed during the activity, panting and wide eyed, but they won’t stop….

Ask a vet online-‘ My chinese crested wanted to stay outside, saw today his penis is hanging and the end skin colour pink’

Question from Samantha Mihlo Grobler:

Hi. Hope you are well? My chinese crested wanted to stay outside for a week now which are very uncommen for him as he lies inside the whole day. Think somewhere in the block were a female in heat. Saw today his penis are hanging and the end skin colour pink. Could he have broken it or something??? Will send photo on request. Thank you

Answer by Shanika Winters:

Hi Samantha and thank you for your question regarding your male Chinese crested dog. What you are describing sounds like a condition called Paraphimosis, this is where the penis cannot be retracted back into the prepuce (the skin in which it is normally found). This condition is an emergency and your dog should be taken to your vet straight away.

There is a bone in the penis of the dog called the os penis, this can break but is very unusual. However the resulting pain and swelling if the os penis was to break could cause paraphimosis.

Normally the penis is able to move in and out of the opening of the prepuce freely, this can however go wrong and the penis can be prevented from coming out Phimosis or from going back in paraphimosis.

If the penis becomes stuck outside of the prepuce then the tissue can become damaged, infected, cause trouble with urination and be very painful to your dog.

Why has my dog got paraphimosis?….

Hack, hack, hack – Hairballs! – Invaluable advice for cat owners

There’s nothing quite like being woken up at 2am to the oh-so-unpleasant sound of your cat producing a large hairball at the foot of your bed. Or perhaps quite so unsettling as stepping in it the following morning. Hairballs, also known by the fancy and somewhat horrifying name of ‘trichobezoar’, are something that most cat owners will have to deal with at some point. But how do they form and how can we help prevent them?

What is a hairball anyway?

A hairball is pretty much what it says on the tin – a ball of hair. Except it isn’t often in the shape of a ball, more cigar-shaped due to its passage through the oesophagus on the way out. They’re usually quite small, a few cm in length, but can be quite impressive at times. Cats have tiny barbs on their tongue that are perfect for picking up dead hairs in the coat. When the cat grooms itself, it swallows a significant amount of hair which usually passes without issue in the stools but sometimes accumulates in the stomach instead. Hairballs are, as one might expect, more common in long-haired cats and older, more experienced groomers who have more time to spend cleaning themselves each day. They also tend to occur seasonally, at times of increased shedding. Sounds like a pretty normal process, and in fact, it’s not uncommon for most cats to have a hairball once or twice a year (a spring clear-out of the stomach if you will…). But are they really ‘normal’?….

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