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Getting ready for an anaesthetic at the vets

At one time or another we all have to face our beloved pets having an anaesthetic which can be a scary process if it’s not properly explained. Fortunately most veterinary practices have a fantastic team of nurses that can help you understand the procedure. (NB. I have used “he” in the article for continuity but this goes for all dogs a Labrador crop and cats regardless of gender). To give you a head start, here are some top tips: 1. The number one golden rule for preparing for an anaesthetic is no food after midnight (this does not apply to rabbits or guinea pigs). Also, some practices may give you an earlier time say nine or ten o’clock but the principle is still the same, basically no midnight feasts and no breakfast. The reason for this is two fold. The main reason is to stop your pet vomiting and potentially inhaling it. This can also prevent nausea on recovery. Another reason is to try and prevent any ‘accidents’ on the operating table which increases the risk of contaminating the surgical environment although to safe guard against this, some practices routinely give enemas and express bladders before surgery. So, while it breaks your heart to tuck in to steak and chips with Fido giving you the big brown eyes treatment console yourself with the knowledge that you are actually acting in his best interests to help minimise the risk of anaesthetic. 2. Give your pet the opportunity to relieve himself before coming into the surgery. Obviously this is easier with dogs but while we advise taking dogs for a walk before coming in we don’t mean a five mile hike on the beach with a swim in the sea, we mean a nice gentle walk around the block to encourage toileting. If you bring your dog in covered in dirt and sea water, you’re increasing the anaesthetic risk as we have to keep him asleep longer while we prep him. (See my previous article about how we prepare your pet for a surgical procedure). 3. Tell the nurse when she is admitting him whether you have noticed any unusual behaviour. Vomiting, diarrhoea, coughing or sneezing can all be indicators of problems and may need to be investigated prior to anaesthesia. Also tell the nurse if your pet is on any medication, when he last had it and bring it with you if you can. This way, if your pet needs to stay in after his operation, they will have everything he needs without adding extra to your bill. Harvey blanket1. Some pets get a little worried when in a new place so it may be helpful to bring in a jumper of yours or a blanket that smells like home. Be prepared for this to come home dirty! Some animals have accidents on recovery and with some of the larger practices getting through over fifteen loads of washing a day (with different people doing the laundry) it may not be possible to locate your blanket once it has disappeared into the washing room abyss. It does help tremendously if the blanket is labelled with your name. That way, if it does enter the washing room, it can be found again. Eventually. Obviously with smaller practices it’s much easier to keep track of individual items. 1. Give the practice a phone number that you can be contacted on. This is something that has surgeons and nurses tearing their hair out on a regular basis. All too often we’re given a phone number only to call it and hear a message saying that the mobile phone has been switched off or to hang on the end of a ringing phone. The reason behind this is sometimes we need to contact you during surgery because we have found something unusual or that we weren’t expecting and need to gain your consent to a change of procedure. It’s your pet and your decision and we want you to be involved every step of the way but we need to be able to speak to you to do that. I’m not saying you need to be sat by your phone from the minute you drop your pet off but please give a phone number that you or someone who can get hold of you will answer. Or at the very least, a answering machine that you check regularly. 1. Have faith in your veterinary team! If they suggest extra procedures such as intravenous fluids or blood sampling it’s because they think it would benefit your pet. I had one incident where a long haired cat was coming in to be sedated and lion clipped (shaved basically as his hair was matted). As he was over eight years old and hadn’t had a blood test I suggested a basic profile just to check what the liver and kidneys were doing. The blood tests revealed elevated kidney values which meant that there was some degree of kidney disease present. Finding this early meant that we were able to recommend a special diet to help slow the degeneration down (it’s never reversible) and the cat is now more likely to be monitored before he gets too ill. 70% of the kidney needs to be affected before clinical signs appear, wouldn’t you want to know before it gets to that point? Also, if we can see there’s an irregularity before we do the surgery, we can provide additional care to further minimise the risk. 1. Ask questions. We would much rather sit with you and explain away your concerns than have you sit at home or at work worrying. Also, if you are going to search the internet for information about the procedure your pet is having, please use reputable sources such as this one or ones written by the veterinary profession. The last thing you need to be reading is a blog by Joe Smith (fictional) about his one off experience about x, y or z and scaring yourself silly. The whole process is stressful enough, don’t torture yourself! Indie1. Bring your pet in suitably restrained. A cat needs to be in a cat carrier and a dog needs to be on a lead. A cat wrapped in a towel can easily become dinner for nervous, hungry German Shepherd. Don’t laugh, I’ve seen it happen! Yes this is a minority case but why put your pet at risk? We can’t predict how our pets will react in stressful situations (and coming to the vets certainly counts) so keep everybody safe by having control over your animal. Putting a cat in a carrier usually minimises their stress anyway as they feel safer and more secure and having your dog on a lead means that you can prevent him from bolting out of the door and on to the road. 9. That’s it! You are now fully prepared! Give your pet to the nurse to settle in and walk out the door. That’s actually easier said than done but in order to make this a smooth transition for your pet you need to be calm about it. Animals are very good at picking up stress and will become more worried about the situation the more worried you are. Obviously if your pet is aggressive the nurses may ask you to pop him in his kennel for them but the majority of veterinary professionals are more than capable of handling any type of animal and if you hand them the lead and walk out the door, nine times out of ten the dog will stare out of the door after you for a second or two then follow the nice sounding nurse who is being very enthusiastic and telling him what a good doggie he is through the door to the surgery. Don’t forget that we nurses are masters of cajoling and soothing. We have to work with vets as well after all! If you are worried about a problem with your pet, please talk to your vet or try our Interactive Symptom Guide to check how urgent the problem may be.
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When to spay – When is the best time to spay or neuter?

In recent years, "desexing" - spaying and neutering - has become the obvious and natural choice for most pet owners. Apart from population control, it's often been said that there early neutering is better for the health of the individual animal. The latest recommendations are that spaying and  neutering should be carried out at an earlier age than has previously been suggested. Some animal rescue groups are spaying animals that are clearly "puppies" and "kittens" for practical and cost reasons. At the recent WSAVA/.BSAVA/FECAVA congress, the subject of early neutering of pets was the focus of a "debates and controversies" session. The question was asked: "how early is too early?", but the debate widened to include the question: "should neutering be recommended at all?" The answer to this question turned out to be complicated: it depends on the individual animal. It just isn't possible to have a blanket recommendation that is correct for every situation.  Spaying and neutering is not without risk, as with any surgical procedure. Surgery should be only entered into after an informed discussion of the risks and benefits in each individual case. The benefits are well known:  many now believe that it's best to spay a bitch before her first season. This eliminates the risk of unwanted pregnancy and the physiological and behavioural changes associated with the reproductive cycle. It also significantly reduces the risk of mammary cancer. For male dogs, castration eliminates the risk of testicular cancer, the second most prevalent cancer among male dogs. It also reduces the incidence of other non-cancerous conditions of the mature prostate (e.g. benign prostatic hyperplasia, prostatitis/prostatic abscesses, prostatic cysts and paraprostatic cysts). Prostatic hyperplasia starts at 1-2 years of age with 95% of dogs affected by 9 years of age.  Finally, castration dramatically reduces the risk of tumours of the perineum. In female cats, there are also well known benefits from spaying: feline mammary cancer is the third most common form of neoplasm, though with a lower risk than in female dogs, and 80% of feline mammary tumours are malignant. Entire queens are seven times more likely to develop mammary cancer than those spayed at puberty. And for tom cats, neutering reduces fighting behaviour by over 80%, significantly reducing cat bite abscesses, as well as reducing the risk of FIV infection. Neutering also significantly reduces male urine marking behaviour. So what about the risks of neutering? The first adverse effect is well known: spayed and neutered animals are more likely to become obese. In theory, this can be easily prevented by following careful nutritional advice, but we all know that in practice, it isn't always so easy. For female dogs, urinary incontinence is the next best known complication. This is more likely to occur in bitches that are spayed at any age compared to bitches that are not spayed. Much research has been carried out on the effect of the timing of spaying on urinary incontinence and there is still debate over whether spaying before the first season marginally increases or marginally decreases the risk of this problem. In male dogs,  castration is associated with an increased risk of bladder and prostate cancer, but the incidence of these cancers remains very low compared to testicular cancer and other prostatic disease in entire dogs. More significantly, the WSAVA forum discussed recent evidence that suggests that spaying and neutering before skeletal maturity increases the risk of bone tumours in large and giant breeds of dog. One study in the USA found that the general risk of Rottweilers developing osteosarcoma was one in eight. For neutered Rottweilers, the risk is one in four.  This doubling of risk is something which cannot be ignored, yet it's still not widely known. So what advice should vets give to their pet-owning clients? For vets working in overcrowded animal shelters or in areas where owners are less compliant with the needs of responsible ownership, early neutering is the first choice for nearly every case. Cats are often spayed at less than four months of age, and dogs before six months, and in many animal rescue centres, it's done even earlier. The surgery seems to be simpler, with animals recovering more rapidly, and subsequent complications from unwanted pregnancies are removed. For vets working in private practice with well-informed, dedicated pet owners, there's room for a more detailed debate about the specific needs of the individual animal. Is it possible to make any overall generalisations? There is a large overpopulation problem for pets in this country, arguably caused by accidental or irresponsible breeding . If vets can generate a belief that neutering is "normal" then we stand a greater chance of reaching those that we do not currently find it easy to reach. If, on the other hand, vets take a "maybe" stance that openly invites choice, then people are more likely to choose to take the least action and spend the least money. As a result many bitches and dogs will remain entire and many unwanted puppies and kittens will be born. My conclusion? There are clearly issues about spaying and neutering that deserve discussion with responsible owners who wish to understand the risks of neutering and to weigh them against the benefits. "Desexing" surgery may not be the most appropriate decision in all cases. But in general, the following rules are most likely to be correct, for most of the time: Male and female cats should be neutered/spayed  at 4-5 months of age Male and female dogs should be neutered/spayed at 5-6 months of age
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Equine ER – Dealing with traumatic injuries

I recently had to stop on the side of the road to help out a family whose trailer had rolled over, trapping their horse inside. By the time I'd got past the queue of stationary holiday traffic, they'd already done the first aid basics, and it was great to see how well they'd coped. However, it made me think about what owners can do in emergency situations for shock, trauma and blood loss in horses. [caption id="attachment_2528" align="alignright" width="275" caption="Not an emergency! I like to use ketchup and a good natured pony for Pony Club First Aid Training. If you want to know more, contact your vet - many practices run great first aid training courses for clients"]Not an emergency! I like to use ketchup and a good natured pony for Pony Club First Aid Training. If you want to know more, contact your vet - many practices run great first aid training courses for clients.[/caption] In serious accidents, the most common injuries are probably bruises and lacerations - jagged cuts, caused by broken metal and debris cutting through the skin. However, puncture wounds and broken bones are also not uncommon, and it can be really difficult to determine what's a mild graze, and what's a deep, dangerous puncture wound in the field, let alone by the side of a busy road! If you're faced with a real emergency like this, remember three things - first, make sure you and anyone else around are not at risk. Second, get someone to call a vet and any other emergency services (e.g. the police to close the road, the fire brigade to cut horses and people out of the wreckage, and of course ambulances for any human casualties). Finally, assess the horse(s) and do what first aid you can at the scene. When assessing the injured horse, I find it really useful to look at it in two stages - the Primary and Secondary surveys. The Primary Survey is designed to find injuries that are immediately life-threatening, and need addressing NOW. This would include serious fractures, significant bleeding, breathing difficulties and any neurological disorders (half a tonne of fitting horse is a danger to itself and everything within ten to twenty feet). I like to start at the nose and work rapidly to the tail, running my hands over the horse, looking for wounds or areas that don't feel right, and assessing how the horse responds. If you find a wound that's gushing blood, it needs to be stopped; a "grating" feeling under your hands when you feel along a canon bone often indicates a fracture, which must be stabilised. In an emergency situation, the key is to stabilise the horse until it can be moved to a safer location for further workup, and it is vital to be quick, but also smart. Don't get so bogged down with relatively minor injuries that you miss somethng life-threatening! A wound that that oozes can be left until you've finished the primary survey; one that's running with dark blood needs seeing to, one that's spurting may kill the horse before you've finished unless you address it immediately. To stop bleeding, apply pressure - even a major arterial bleed can be slowed, if not stopped, by a padded up numnah pushed into the wound by one or two people (ideally two, so you can swap over when you start to get tired). One of my horses was staked on a hack many years ago, when a piece of wood flicked up into his groin and tore the femoral artery. His life was saved by two of the people out riding with him, who pulled off their jackets and forced it into the wound, slowing the bleeding until a vet could arrive to pack it closed. The major risk areas for bleeding are the groin and neck, where major blood vessels run close to the surface and can easily be damaged. It is really important when doing a primary survey to check for signs of shock - horses are incredibly tough, but they can still suffer internal bleeding and blood loss, even if nothing's obvious, so roll up the horse's lip and check the colour of his gums. Then press on them so they go white, and time how long it takes for the colour to return. A normal, healthy horse will have nice, pink gums and a capilliary refill time of less than 2 seconds. White or very pale gums indicate shock, probably from blood loss, as can a prolonged refill time, while blue gums may indicate heart problems. A horse that is behaving abnormally need to be treated with extreme caution - concussion is uncommon, but it does happen, and is often more dangerous to the people around than it is to the horse! There's nothing you as an owner can do about it, so make sure you're ready to jump clear if needed. A suspected fracture is a nightmare for any horse owner; however, it's worth remembering that some fractures in some horses can be repaired surgically. The most effective form of first aid is to immobilise the limb with a thick bandage and/or splints - however, unless you know exactly what to do, don't try to apply splints without a vet's instructions. Some fractures, sadly, are irreparable - I once got called to a horse that had fallen over trotting across its field, the person who called said it had a "small cut". When I arrived, his hock was pointing the wrong way round, and sadly I had to tell the owner that there was nothing that I could do, except put him down to remove the suffering. Once the primary survey is completed, and everything addressed as best you can, you need to consider moving the horse to safety. If possible, wait for the vet to arrive first, but this may not be possible if you are in an unsafe or inaccessible location. Remember, a horse with anything significant on the Primary Survey isn't fit to be moved anywhere until it has received veterinary treatment! In the case of my roadside horse, we were able to borrow a box to move him off the road to a nearby restaurant car park (I know, not perfect, but we had to improvise at the time!). As soon as you've got him to a safe place, it's time to carry out a Secondary Survey. When they arrive, the vet will probably repeat what you're doing - but if you've already carried out a survey, you can bring anything important to their attention, speeding up treatment. The Secondary Survey is a full examination of the horse, checking every lump or bump, scrape or cut for further significance. If a vet is doing it, we'll often clean up wounds and probe them for depth as we go along; however, please don't do this yourself! We need to see everything as far as possible as it is if we're to properly assess it. We'll always be grateful, though, if you can tell us what there is and where - e.g. "three grazes and a cut on the left flank, swelling over the right eye and a deeper wound on the right hock" allows us to prioritise the swollen eye and the deep wound, before we check over the grazes. Now is the time to apply pressure to any oozing or dribbling wounds, to check the feet (I've seen otherwise apparently normal horses prove to have deep cuts in their soles from climbing over broken metal to escape - and immediately after the incident, appear completely sound under the influence of adrenaline). Periodically, recheck the gums to make sure that the horse isn't becoming "shocky". Remember, horses are almost unbelievably tough - it is amazing what they can survive. My horse who got staked lost about half his total blood volume, but he made a complete recovery and lived for another ten years in excellent health; and the horse in the road accident, despite being thrown across the road, appears to have got away with cuts and bruises. So, even if it looks a disaster, it's always worth trying first aid until a vet tells you otherwise, because it really can save a horse's life. Check with your vet to find out if they run first aid courses so you can be prepared.
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How Do You Know If A Cat Is In Pain?

DenbyIt sounds like such a simple question, but the answer is actually far more complicated than we think. And it’s not just cat owners who struggle with this question, those of us who have studied these creatures for years still frequently miss signs of feline pain. Because when it comes to showing signs of pain (or any illness for that matter), cats are masters of disguise. In the feline world, complaining gets you nowhere, and showing signs of weakness can get you killed. Sure, some cats in pain will cry out, but if you see a cat crying out in pain, the problem is likely very severe indeed. Besides, cats cry out for many reasons, so even if you do see this, how can you tell if it is due to pain or some other form of stress? Next time you think your cat may be in pain, try to remember some of the following signs of feline discomfort: • Lameness: Ok, we’ll start with an easy one. But you’d be surprised how many people come to me with a limping cat who insist that they are not in pain. If your cat is limping, he’s doing it for a reason. And that reason is usually pain. Even if your cat doesn’t have a limp, check for other signs like difficulty jumping up or down from the bed or finding that it’s not worth their effort to climb the stairs anymore. Arthritis is hugely underdiagnosed in cats because many owners either don’t observe or don’t think to mention these changes. If you do notice something unusual with your cat’s behaviour, please speak up as sometimes vets don’t think to ask these kinds of questions. • Vocalisation Yes, as previously mentioned, some cats in pain (particularly severe, sudden pain) will cry out or howl. If you see this, take them to the vet immediately to have them checked out, even if you can’t see anything else wrong with them. But it’s not always a howl that they make; sometimes it’s just a more insistent meow, or even a lack of sounds such as normal greetings or cries for food. • Decreased appetite Speaking of food, it’s true that some cats in pain will either stop eating, or not eat as much as normal. But not every cat will respond this way because in the wild, a cat that doesn’t eat will die so if they are able to eat despite even very significant pain, they often will. • Hiding A cat in pain will often hide from you. You may notice them spending more and more time under the bed or in the back of the cupboard. Or, you may notice that they are quite restless and have a hard time settling in any one place. To you, it may just seem like odd behaviour but to them, it can be a cry for help. Hiding isn’t the only behaviour that can indicate pain, any change in their normal routine may be a clue no matter how subtle, so try to take notice and figure out why the change occurred. • Eye position and expression This one is much more subtle, and unless you are very observant you may not pick up on it at all. A painful cat may sometimes have slanted eyes that are squinting or partially closed. They may also have dilated pupils (the blacks of their eyes look very large or ‘wide eyed’), and a generally strange expression on their face. Or they may seem to ‘zone out’ and just stare blankly ahead. Now there are lots of reasons why a cat will show one or more of these things, so don’t be too quick to diagnose your cat as painful if you don’t notice any other signs. But if you do notice a strange look in their eyes, it’s probably best to have them checked out by a vet. Amber-on-grass• Posture If you picture a happy cat in your mind, you may think of one who is relaxed and playfully rolling around in response to a good petting session. Now consider the opposite - a painful cat will often sit in a hunched, guarded position. Their muscles may be quite tense, and they will flinch or pull away when touched. Some cats just don’t like being touched, but if yours normally does and then suddenly doesn’t, consider pain as a possible cause. • Aggression As previously mentioned, a painful cat won’t want to be touched and this often leads to aggression. If you stroke your cat and he turns around to bite or scratch you, or if he hisses at you when touched, or even if he just starts to twitch his tail in an agitated manner when there doesn’t seem to be any reason for it, get him checked out by the vet. • Licking, chewing, or fur loss Cats will sometimes make a fuss over the particular part of their body that is in pain, but this is not always the case. Some cats with cystitis (bladder disease) will lick their tummies and cause fur loss in that area. Likewise, some cats with arthritis in a particular joint may lick or chew at that area more frequently than normal. Rarely, this licking is enough to cause damage to the overlying skin. • Other medical changes There are some signs of pain that only your vet is likely to pick up on (although you may notice that something just doesn’t seem right), including increased heart rate, breathing rate, temperature or blood pressure. Because these things require the help of a professional to properly measure, it is very important that you take your cat in to the vet whenever you suspect something out of the ordinary. As you can see, pain in cats is no simple subject. There are some obvious signs of course, but many more that may go unnoticed for some time. Therefore, if you do happen to notice any of the above signs, it’s always best to take your cat to the vet to have them checked out as soon as possible. Even then, it can be very difficult to tell if they are in pain, so sometimes the best test is to treat for any possible pain and then re-evaluate to see if it made any difference. Whatever you do, try not to ignore it because unlike humans, who are very good at expressing discomfort, cats will most often suffer in silence and it’s our job to make sure they don’t have to. If you are worried that your cat may be showing signs of pain described above, talk to your vet or try our Interactive Cat Symptom Guide to check any other symptoms you notice.
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