Ask a vet online-‘I have an 8 year old Maltipoo who has had teeth and gum problems for the last 4 years.’

Question from Mary Collins O’Hara:

I have an 8year old Maltipoo who has had teeth and gum problem for the last 4years. He had 8teeth pulled, including some teeth on the bottom front, so now he drools all the time and he has the worst breath. I have done several rounds of antibiotics, I brush his teeth but his gums are so tender, he cries. I don’t know what else to do. Please help.

Answer by Shanika Winters

Hi Mary and thank you for your question regarding your dog’s ongoing mouth problem. An adult dog usually has 42 teeth which are made up of four different types:

12 Incisors which are for nibbling

4 Canines which are for grabbing and puncturing

16 Premolars which are for cutting and shearing

10 Molars which in theory are for grinding up food

Most dogs over the age of 3 years have some form of dental disease, this may be as mild as inflamed gums (gingivitis) and plaque through to infected tooth roots with gum recession. Along with the functions listed above the teeth help hold the dogs tongue inside its mouth and keep the shape of its mouth by holding the cheek flaps out. Many dogs cope extremely well after major extractions where they are only left with a few healthy teeth.

E-cigarettes – Safe for smokers but not for our pets!

No-one could have missed the phenomenon of e-cigarettes. On every street, in shops, pubs and restaurants there are people sucking on the pen-like objects. The jury is still out on whether they are better for the smoker’s health than traditional cigarettes but they are undoubtedly very dangerous for our pets.

Electronic cigarettes are battery powdered devices that vapourise a liquid, which is then inhaled. The fluid is held in a small chamber in the middle of the device and is a mixture of glycerin (a colourless liquid), flavouring and nicotine in varying concentrations.

Nicotine is the substance which makes cigarettes so addictive but in the tiny quantities smokers inhale, it is not especially dangerous. It is the tar and other elements which are carcinogenic and this is why many people are opting for e-cigarettes. However, in large doses nicotine it is extremely toxic and can even be deadly.

Sensationalist reporting of TB in cats is not helpful: does the media want a cat cull?

Let’s start with the facts about the cats with TB, as reported in the Vet Record: perhaps surprisingly, these have not been published in full in any of the mass media outlets in the past two days:
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BETWEEN December 2012 and March 2013, a veterinary practice in Newbury (west Berkshire) diagnosed nine cases of Mycobacterium bovis infection in domestic cats. In seven of those cases the diagnosis was confirmed by bacteriological culture. The nine affected cats belonged to different households and six of them resided within a 250 metre radius. The animals presented with mycobacterial disease of variable severity including anorexia, non-healing or discharging infected wounds, evidence of pneumonia and different degrees of lymphadenopathy. The latest information is that six of the cats have been euthanased or have died. The three surviving animals are undergoing treatment and are reported to be responding. At the time of writing, no new cases had been detected in local cats since March 2013.
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The newspapers have missed this aspect of the story, and focussed entirely on the fact that the disease, for the first time, seems to have been passed on to two humans who had been in contact with one of the cats. The humans have responded well to treatment……..

Ask a vet online – ‘Can you suggest a home remedy for mites in dogs please?’

Question from Sharon Barett:

Hi can you suggest a home remedy for mites in dogs please? I used the spot on treatment off the vet for 3 months but it did not make any difference she still scratches it a King Charles Spaniel 5months old thank you .x

Answer from Shanika Winters MRCVS, online vet

Hi Sharon and thank you for your question regarding your itchy Cavalier King Charles Spaniel. In order to answer your question I will discuss the possible causes of the itch, how we work out a diagnosis and then some treatment options.

Why is my pet scratching/itchy?

If your pet is scratching itself then something will be causing an irritation, most commonly this is due to the presence of external parasites such as fleas ( Ctenocephalides canis or felis) or mites ( e.g. cheyletiella, sarcoptes scabeii). Itchiness can also be due to the presence of an allergy to things you pets eats (food allergy), contacts (contact allergy) or inhales (atopic allergy).

How to diagnose the itch

It is really important to work with your vet to find out the cause of your pet’s itch. The first thing your vet will do is ask for a detailed history of your pets condition including how long it has been going on, any changes to your pets routine, any changes to your household, what treatments have already been tried and if they have had any effect.

The next step is for your vet to perform a full physical examination of your pet paying extra attention to the skin and coat, underlying diseases can have symptoms that affect the skin which include Hypothyroidism( under active thyroid gland), Cushing’s disease ( over production of steroid) and diseases of the immune system….

Is Paul O’Grady mad to spend so much money on his terminally ill dog?

Paul O’Grady, the comedian-turned-dog-advocate, hit the news this week when he talked about spending over £8000 in vets’ fees to treat his nine year old Cairn Terrier Olga for cancer of the kidney. The Daily Mail reports that Paul has ignored advice to have her put down, and instead he’s paying for intensive chemotherapy and surgery to keep her alive. The story has ignited a debate about veterinary fees and pet insurance: Judith Woods, a feature writer for the Daily Telegraph, has added her own tale of spending £3600 when her Manchester Terrier, Daisy, developed a rare form of kidney disease. She had her pet insured, so her feature extols the benefits of pet insurance for these unexpected occasions.
Paul and Judith are clear in their opinions, with no doubt that they have made the right decision for their own pets. It’s the online comments on the stories that are interesting, with members of the public sounding off with their own thoughts on expensive treatments for pets, and the pros and cons of pet insurance.

The Daily Mail readers’ comments to Paul’s story are mostly short and positive: “It’s lovely that he’s done this for his beloved dog”, “Good on you, Paul, you are a true dog lover” and “If I was as rich as him, I’d do the same”.
Telegraph readers have responded in a predictably more loquacious way to Judith’s feature.
First, of course, there are many “dog lovers” who are supportive of giving pets all reasonable treatment that can be afforded, accepting that high quality veterinary care can be costly, and agreeing that pet insurance can be a sensible way of budgeting for unexpected health crises. When completing a survey of attitudes to dogs on a recent trip to a slum in Delhi, I found that around 60% of the local population “liked dogs”, with 40% disliking them: I now find myself wondering if a similar proportion of attitudes exists in the UK population. For the 60% who care for their pet dogs, it’s hard to consider withholding treatment.

There are plenty of comments from the opposite side of the spectrum – perhaps the 40% who aren’t so fond of dogs. Some of these “anti-treatment” comments are worth discussing in more detail:
“All pet insurance does is persuade owners to consent to prolonged and possibly invasive treatment of their pet. Unless they own a valuable breeding animal they would be kinder and more sensible if they had a really sick pet put to sleep.”

Caring for older cats – Part 2 – helping your feline through old age

Did you know that cats age the equivalent of 24 human years in their first 2 years of life? After that, each cat year is about equal to 4 human years. So my 18 year old Maddy cat is the same age as my 88 year old grandmother. Doing that calculation helps put her age in perspective, and makes you wonder, am I taking care of her as I would care for my grandmother? In my last blog I talked about some of the signs that your cat may start to show as they get older. Observations such as changes in behaviour, toileting issues or changes in sleep patterns are all relatively common in older cats, but could actually indicate an underlying medical condition. Any changes in your ageing cat should be discussed with your vet so that if there is any concern, the appropriate diagnostic tests can be run and treatment can be started if necessary. But if you and your vet decide that your older cat is physically well, there are still lots of things that you can do to help them age a bit more gracefully.

Give them a nail trim

Most cats, especially those that go outside regularly, don’t need (and don’t want) their nails trimmed. Older cats, however, don’t tend to need them much for hunting, tree climbing or fighting with their neighbours. Although feline claws naturally shed with daily activity, the nails of older, less active cats tend to get overgrown and can even grow all the way around and into the pad of the foot, a very painful condition. Even if they’re not overgrown, they still frequently get stuck on the sofa or their bedding, particularly if the cat suffers from arthritis and has limited movement. Trimming the claws is relatively straightforward and most of the time you can do it at home. Ask your vet or vet nurse for a demonstration if you are unsure.

Give them a toilet

Would you want your 88 year old grandmother to have to go downstairs, out the back door and down the garden to use an outside loo in the middle of the night?….

A vet in Delhi day 7: summary and conclusion

I’ve spent my final day in the slum and it’s time to draw it all together and reach some conclusions. What’s it all been about, what have I achieved, and what’s going to happen next?

First, to explain: the rationale behind my work has primarily been human health. It’s shocking that rabies is still a major killer in India, despite the fact that it’s completely preventable. If 70% of the street dogs in an area are vaccinated, the disease dwindles and disappears to insignificant levels. Surely this is a goal that is achievable?

The current estimated incidence in India of around 3 deaths per 100000 people per year means that over 20000 people, mostly children, die unnecessarily every year. In a slum like Mayapuri, with a population of 12000, there’s probably around one death every three years. Feedback from my questionnaire suggested that this may be close to the truth. Rabies is common enough to be a constant threat, but rare enough that it’s easy for people to forget about it. Yet it is such an horrific, unnecessary death that everything possible must be done to prevent even one fatality.

ASHA deals effectively with many health and welfare issues in the slums, vaccinating children with BCG, MMR, Hepatitis, Tetanus and Polio: before ASHA arrived 15 years ago, no babies were being vaccinated – the uptake is now 100%.  ASHA also treats adults for TB under the DOTS programme, and offers a range of birth control methods.

There’s no doubt that the charity’s work has transformed the lives of the slum dwellers. But what about rabies? When I asked this question last year, it seemed that it was a bit of a grey area: ASHA is so busy with other priorities that it’s easy for rabies to slip under the radar. When I discovered this, I felt that there was an opportunity for me to use my background as a vet to look into the issue when visiting the slum with a group of volunteers from my local church.

Mission Rabies – who are already in the process of vaccinating millions of dogs around India – do not have an immediate plan to focus on the Delhi area, but they were exceptionally helpful in assisting me with this project. They drafted a questionnaire for me to use while here, and they advised me on important aspects such as informed consent and male/female interpreters.

So what did I discover? Well, I found out how difficult it is to do social research. I had thought I might gather several hundred questionnaires over 3 days, but the process took longer than I had expected: up to 15 minutes for each interview via an interpreter, then time spent seeking out the next candidate. I ended up with just 40 completed questionnaires: not as many as I’d have liked, not enough to be significant in a formal sense, but still perhaps enough to gather valuable feedback about the subject.

What did I learn?

First, I discovered some interesting socioeconomic facts.

  • 75% of households live in just one room, shared between an average of four people: no kitchen, no bathroom, no hot water
  • 95% of slum dwellers own a mobile phone
  • 90% own a television
  • 65% own a bicycle.

Second, I discovered that street dogs are a significant part of the slum community, with an average estimate of one dog per 17 humans (the range was one per 5 to one per 20 people). The only way to get a more accurate figure would be to do a detailed dog census, which would be a major logistical challenge in itself, but the estimates are enough to make the point that there is a substantial population of dogs..

While only 15% of people said that they “owned” a dog, 57.5% said that they feed local dogs at least once a week. This ties in with the reported attitudes to dogs: 40||% said that they “liked” dogs, 15% were indifferent t while 45% of interviewees said that they “did not like dogs” (presumably the latter never feed them).

Third, I investigated the local people’s knowledge about rabies. I found a low level of awareness of the disease. 80% of respondents had not heard of rabies, and only half of the 20% who said that they had heard of rabies were able to explain the disease to someone else. Some people thought that rabies would make them “bark like a dog”. Furthermore, only 45% of people thought a dog bite could be fatal, with 55% of people disbelieving this. There’s clearly a need for community education about rabies in order to prevent future cases.

More positively, despite the lack of knowledge about rabies, 90% of people would go to hospital if bitten by a dog (where they would be given the post-exposure rabies vaccination). As well as doing this, some people would take other action, including putting red chilli powder on the wound, and resorting to “witchcraft”. The 10% who “did not know what to do” if they were bitten by a dog are worrying: they would be very vulnerable to developing clinical rabies if bitten.

What’s going to happen next?

If nothing is done, nothing will happen. The situation will remain the same, and people will continue to die of rabies at a rate of around one person every three years.

Clearly this cannot be allowed to happen.

ASHA already have an effective network of community health volunteers on the ground, keeping an eye on the health of inhabitants in their local area, and passing on information to them about health and disease using handouts and flash cards. On my last day in the slum, ASHA kindly arranged for me to give a presentation to a dozen community health volunteers from Mayapuri and another nearby slum. I was able to pass on the initial results of my survey, and to discuss the challenge of rabies awareness with them. I …

A vet in Delhi – day 6: a selection of photos

I’ve been busy this evening working through my survey results so that I can give a presentation to ASHA about them tomorrow, so I have not had time to write a blog. But to give a sense of the past day here, I’ve put together a selection of photos. The captions should be enough to tell their stories….

A vet visits a Delhi slum day 5 – asking about dogs in the world’s biggest motor workshop

When I return to the slum each morning, I’m repeatedly reminded of a type of hell: there is mud, grime, and two other aspects that are difficult to convey via a blog – a strong “workshop” smell (oil, fumes, solvents etc), and most of all, NOISE. Maypuri is known as the biggest motor workshop in the world, and wherever you go, there are deafening sounds of metal beating against metal, metal drilling through metal and engines roaring. Unemployment here is not the highest in the world, at 20%: there is work, but it’s tough, noisy, dirty work. Beat-up vehicles litter the streets, where they are picked at by people with spanners, screwdrivers and sledge hammers. I saw a dumper truck being reduced from a slightly bashed but otherwise perfect vehicle to absolutely nothing at all after being picked at all day by a small army of hard working labourers.

Nothing is wasted. People collect 5cm lengths of wire, random nuts and bolts, springs and anything at all. Children as young as five are sent by their parents to search for bits of metal, using wooden sticks with big magnets on the end. The oily grime on their skin is permanent: hot showers or baths don’t exist here.

I have found myself questioning my priorities as I walk through them holding a questionnaire to ask about the stray dogs. Many of them seem bemused: nobody has ever asked them about dogs before. Why dogs, when people are clearly suffering?…

A vet visits a Delhi slum day 4: getting down and dirty with the questionnaire

We are staying in the YWCA close to Delhi city centre, so every morning we are collected by a minibus and dropped at the slum. I was faced with the first shock of the day as soon as I stepped out of the minibus. Most street dogs lift their heads to look at you as you walk past: this young one didn’t, so I stopped to get a better look. I called to him, then I gently touched him but he didn’t move. I picked up his hind foot, aware that I could be bitten if he was frightened, but he remained motionless. He was still breathing, but he was unconscious: he was dying.

I couldn’t do anything to help him. I called back an hour later, and as I ‘d expected, he was dead. At the end of the day, I looked again, and his body was gone. This type of incident must be a daily occurrence out here, but for a newcomer like myself, it’s hard to get used to….

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