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Toxoplasmosis gondii, Pregnancy and Cats – Fact vs. Fiction

Well over halfway through my second pregnancy, I am currently inundated with comments from clients, mostly positive, and it has added a bit of humour and lively conversation to my otherwise increasingly tiring days. ‘Do you know if it’s a boy or a girl?’ ‘How do you think your toddler is going to react to the new baby?’ ‘Are you going to come back to work after two children?’ But one question I wasn’t expecting came from a woman with a lovely ginger tom – ‘Are you sure you’re OK to examine my cat if you’re pregnant?’ I laughed and assured her that despite my expanding waistline I could still reach the table and her cat would be fine. But after a slightly confused and very embarrassed smile, she explained that she had recently been told by a friend that she would have to give up her beloved cat once she became pregnant because it wasn’t safe for pregnant women to be around cats. It had been a while since I had heard that myth and was saddened to hear it again, but I wasn’t terribly surprised. We spent most of the rest of the consultation discussing the real facts about toxoplasmosis, the disease in question, and she left very much relieved that her feline friend was not going to have to be evicted should she ever decide to have a baby, and determined to speak to her GP if she had any further concerns. What causes toxoplasmosis? Amber-on-grassToxoplasma gondii, the protozoal parasite responsible for causing the disease known as toxoplasmosis, is a tiny single-celled organism that can infect many different species from mice to sheep to humans. Cats, however, are the only hosts in which the parasite can reproduce, so in addition to being infected themselves, they can also release oocysts (which are essentially the eggs from which new organisms are created) in their faeces. These eggs are very resistant and can survive in some environments for months, allowing other animals to ingest them with their food. When other animals such as mice become infected with the parasite, it develops to form tiny cysts in their muscles and waits there until the animal is eaten by another cat so it can begin the cycle all over again. Most animals, therefore, are capable of spreading the infection through the consumption of their flesh, but only cats are able to spread it via their faeces. What happens to cats that are infected with toxoplasmosis? The short answer to this question is, well, usually not much. In fact, unless the cat is otherwise ill or immunocompromised (young kittens, or those with FIV or FeLV), most owners don’t even notice if their cat becomes infected. If cats do show symptoms, these usually include fever, decreased appetite and lethargy. Rarely, more serious cases may develop pneumonia, blindness or inflammation of the eyes, or more commonly, neurological symptoms such as personality changes, loss of balance, walking in circles, difficulty swallowing, or seizures. How are people infected and why is it so dangerous? People can become infected by handling the faeces of infected cats (but only during the few weeks after they become infected for the first time, after that they stop shedding the eggs), gardening in soil that has been defecated in by recently infected cats, or more commonly, eating undercooked meat of any kind as animals such as lambs and pigs can also be infected (the cooking process kills the organism). But as you’ll see below, all of these things are easily prevented with simple and common sense measures. There are three main health concerns when it comes to humans. The first and most well-known risk group is pregnant women. Expectant mothers that pick up the disease for the first time during pregnancy (ie, NOT those that have already been exposed to it earlier in life) do not usually show symptoms themselves but are capable of passing the infection on to their unborn child. In these cases, vision and hearing loss, mental disabilities and occasionally even death of the child are possible. So there is certainly cause for concern. The second group of people that are particularly at risk are those that already have immune systems that are deficient, such as those with HIV or AIDS or who are on chemotherapy. Finally, although the vast majority of people who become infected with the toxoplasma organism (and that includes a staggering one third to one half of the world’s human population!) show only mild flu-like symptoms if any at all, it has recently been linked to some pretty serious conditions such as brain tumours, attention deficit disorder, obsessive compulsive disorder, schizophrenia and possibly even an increase in suicide risk. But because most people don’t know they have it, it isn’t something that is routinely screened for so a lot more studies need to be done before we know the true effects of the illness in all species, not just humans. If toxoplasmosis can do all that, why would anybody own a cat?? Domino-sleepingBecause even though cats spread the disease, we are very unlikely to catch it directly from them. Cats are only capable of spreading the disease for the first 2-3 weeks after they are first infected. After that, they are immune to new infections and although they may later show symptoms, they are not later contagious. And then even if your cat was shedding eggs, there has to be direct ingestion of the contaminated faecal material by humans. Not many of us (perhaps toddlers aside...) will intentionally consume cat faeces, but we will sometimes come inside after gardening and grab a quick sandwich without remembering to wash our hands. This is not a problem with the cat itself, rather our own personal hygiene. It is extremely unlikely that you would pick up toxoplasmosis by petting your cat or being scratched or bitten by your cat, because the organism is not spread by the fur or saliva. You CAN, however, pick up toxoplasmosis by eating undercooked infected meat, particularly lamb and pork. Again, this is not your cat’s fault, rather our own lack of taste or culinary skills, and is by far the most common way of picking up the disease in developed countries. What’s the best way to avoid becoming infected? Use common sense, and if you are pregnant, take a few extra precautions and chances are you’ll be just fine. Unless you already have it, which is probably more likely than you care to acknowledge, but chances are you’ll never know it so you might as well do these things anyway! • Don’t eat raw or undercooked meat or drink unpasteurised milk. And once you’re finished preparing raw meat, wash your hands and all surfaces that it may have touched. • Wash fruits and vegetables before eating them, even if they came from your own organic garden. • Wash your hands well after gardening and before eating, especially for children, goodness knows where those hands have been... • Pregnant women, and people with suppressed immune systems, should not clean the litter tray (I don’t know many pregnant women who wouldn’t jump at the chance to make their partner clean the litter tray). Or if you must clean the litter tray yourself, wear gloves, wash your hands well and try to remove the stools daily as faeces that have been sitting around for a few days are more infectious. Toxoplasmosis is a serious illness and can cause serious harm to both cats and humans. But contrary to what many people believe, living with a cat only slightly increases your chance of catching the disease and with the help of simple common sense measures like those mentioned above, this risk can be minimised. So yes, I’m perfectly happy to keep working and living with cats, and hopefully you will be too. But if you do have any questions regarding either your own health or that of your family, make an appointment to speak with your GP and make sure everybody is aware of the facts rather than the myths about toxoplasmosis. If you are worried about your cat talk to your vet or use our Interactive Cat Symptom Guide to check any symptoms they may be showing and see how soon you should visit your vet.
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Fat pets: silently suffering due to their owners’ “kindness”

Here's a paradox: the biggest cause of suffering in pet dogs may be  people who believe that they love their pets the most. What am I talking about? Overfeeding and its consequence: obesity.

Over a third of dogs in the UK (2.9million) are overweight or obese while 25 per cent of cats (3 million) suffer the same problem. These animals have a serious risk of developing diabetes, heart disease and arthritis, and have a lower life expectancy than pets with a healthy weight.

Arthritis is probably the most common issue that causes physical suffering. As a vet, whenever I treat an older dog for sore joints, I write out a check list of the treatment plan. And the top of the list, in nearly every case, is "weight loss". For many animals, this is more effective than any medication.

The people at Battersea Dogs and Cats Home will be discussing this problem in tonight's episode of Paul O’Grady: For The Love of Dogs on ITV1 at 8pm. Prevention of obesity seems simple in theory, but for some reason, many pet owners find it difficult. Again, part of the problem may be that we see pets like little humans, and we feed them accordingly.

The Battersea team have put together some simple tips that may help owners understand how to keep their pets slim and trim.

The first aspect is to work out the amount that a pet needs to eat: this depends on its breed, age and size, but as a rough indication, a small dog only needs about 350 calories a day while for a cat, it's around 280 calories. So a slice of toast is equal to a third of the dog’s daily calories, equivalent to a human eating half a loaf of white bread. Other useful comparisons include a 3cm cube of cheese (equal to a whole cup of molten fondue cheese), one custard cream (half a pack of custard creams), and half a tin of tuna (a large cod n’ chips from the local chippie).

The second tip is to stick to a standard diet, without extras. It’s a common misconception that dogs and cats get bored with their food. When pets turn their noses up at their dinner, it's often because they aren't hungry rather than because they don't like it: they will often still eat interesting nibbles if offered. It's similar to the way that we humans will often manage dessert at the end of a meal, even if we're feeling comfortably full. This is a common cause of weight gain in pets, just as it is in humans.

Third, if you're worried about your pet's weight, consult your vet. There are medical reasons for weight gain that may need to be ruled out, and a regular (free) weigh in on your vet's electronic scales is the best way to monitor your pet's body condition. It's difficult to assess this by just looking, especially when you see your pet every day, because weight gain happens so gradually.

Pets don't get fat because they choose to eat too much: it's because their owners choose to feed them so much.

If you have an obese pet, there's no dodging it: it's your fault. The situation can be remedied, so don't despair. Take an action to do something about it today. Go on: pick up the phone, call your vet and arrange that all-important weigh-in.

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Competition Vetting

[caption id="attachment_2858" align="alignright" width="167" caption="Horse Jumping, photo by EDWARD McCABE"]Horse Jumping, photo by EDWARD McCABE[/caption] Like everyone I know, I was glued to the Olympics - great job Team GB, especially our first Dressage and Show Jumping medals for a long time! However, I wonder how many people think about the infrastructure and planning that go into keeping the horses fit, safe and healthy when they compete? I've been a treating vet at a lot of competitions over the years, including Endurance events, local, regional and National Championship Pony Club events (where the standard is often as high as at many BE competitions!) and the International Show Jumping at Sheffield Hallam Arena. I was also on the vet team as a student at Badminton back when they still had roads and tracks before the cross country. The vets that people most often seen are those on the Ground Jury at competitions - the notorious "Trot Up" before the competition starts, and again (in eventing) before the horses go forwards to the show jumping phase. At Badminton and most other big events, there are two vets - one on the Ground Jury, along with two or three other worthies - and one in the Hold Box. If there is a question over a horse's fitness to compete, they get sent to the hold box, where the second vet examines them to see if there is a medical problem rendering the horse unfit. This is a very contentious area - I've never yet been at an event where the Ground Jury and the vets didn't come in for a barrage of criticism over their decisions. However, it's important to realise that they have to balance several factors: Firstly, if a horse is unlevel on the trot up, it may be truly lame, or it may have a "mechanical lameness" - in other words, an abnormal gait that is non painful, and does not render it unfit (on welfare grounds) or unsafe to compete. To help them decide, they trot the horse up before the competition, and then note down any anomalies of gait or stride. Secondly, there are some horses with minor injuries who can appear far more badly injured than they actually are. This is the reason for the Hold Box - a horse with a mild lameness due to a stone in it's hoof (yes, it does happen, I've seen it!) will probably trot up sound once the offending pebble has been removed; likewise, I once saw a hopping lame (7/10 at trot, for anyone interested) horse go 100% sound after a misfitting stud was removed. Thirdly, of course, the Ground Jury and the vets have to watch the riders or grooms who are trotting up the horse. It's an old joke in the profession that the shorter the skirt and tighter the top of a woman competitor, the more carefully you have to check the horse, because she's trying to distract your attention from something! The role of the vet as a judge of fitness is of course expanded in Endurance competitions, where every horse has to be checked at various points along the track to ensure it is fit to continue, and that its heart rate drops enough to be permitted to go on. Different events have different requirements for judging, but as a general rule, the horse has to trot up sound and well hydrated, and have a heart rate below a certain value (e.g. 80 beats per minute). I was at one big competition once where there was a dispute over whether the (leading, international competitor's) horse was sound or not. The decision was passed to a panel of 3 vets, none of us having seen the horse before that day, and its soundness or otherwise put to a secret ballot. This used to be standard practice at two- and three day events, when there was a roads and tracks phase before the cross country. In these competitions (and there are still a few ongoing, regional Two Day Events in various corners of the country), the vet is present simply to determine whether the horse is fit and safe to continue. I once had to pull a horse because it was obviously "not right" - not an easy decision for a vet student at a CCI 3*! The rider appealed the decision - and while we were waiting, it tied up completely, and had to be recovered by the horse ambulance. I still shudder to think how badly it might have been injured if we had allowed it to run cross country. At these events, riders, trainers etc can be very keen for the vet to pass a suspect horse as sound (although strangely, it doesn't seem to be such a problem at Pony Club) - however, we're really not trying to ruin your day (honest, and no, we don't get paid to "fail" some competitors horses either), we're just trying to make sure that an injury doesn't ruin your horse's week, month or season! Of course, that brings me on to the treating vets at an event. Any equestrian competition will have a vet either on call or - especially at big events - on site. Some events (like the Pony Club Championships, Badminton or the International Show Jumping) will have the horses stabled on site. At these, there will usually be some vets assigned to the stables area, and others out on the course or at the arena. Nowadays, we also have access to Equine Ambulances and their fantastic staff. They may look like normal horse trailers, but inside they have slings, winches, padded walls and often lowering floors - everything you need, in fact, to quickly and safely evacuate an injured horse. The job of the course/arena vets is to be first on the scene and assess the state of the injured horse. They will give first aid, stabilise any strained tendons or suspicious fractures, and then decide where to send the horse. The big decision to make is whether it's best to send the horse back to the stables (and if so, on foot or in the ambulance?), or refer them directly to a hospital facility. Fortunately, injuries that need immediate referral are rare; and most cases will be sent back to the stables. While assessing the horse, I like to have screens available - it doesn't mean I'm preparing to put the horse down, but it does mean I can examine them in a calmer, more private environment. If we do need to put a horse down, we'll usually try and move it off the track or away from the arena in the ambulance, to get some privacy. While the course vets have to perform in the blaze of publicity, the stables vets are equally important. During the competition, the stables vets will keep in touch with their colleagues on the course, either by phone or (usually) radio. Quite often we'll listen in on official channels as well so we can be leaning the right way if there is an incident! It's the stables vets who will deal with most injuries and accidents during the competition, and it can get pretty hectic, stitching up rows of horses in succession... At many competitions, there will only be a couple of us, looking after several hundred horses, 24 hours a day. I remember one memorable competition several years back where the night after the cross country phase, I got about an hour's sleep - the rest of the night I was up treating the colicing, the sprained and strained, and the just “not quite right". Most of my patients that week were mildly dehydrated – it’s amazing how much more horses need to drink after competing in hot weather! That’s the only time I can remember when I had to ring up a local practice to borrow more electrolyte salts, because I'd used up everything I took with me... (And the next year, when I took boxes and boxes of the stuff, they competed in gales and torrential rain, and I actually had cases of rain scald to treat... Well, that's the English summer for you!). If you are concerned about your horse, talk to your vet or try our Interactive Horse Symptom Guide to see how urgent it might be.
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