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Ask a vet online –‘after the vet said she had gone she gave out a cry and her body jolted’

Question from Diane Stirk: I had to have my little blind girl put to sleep Friday, she was 13 and had all symptoms off dementia, but after the vet said she had gone she gave out a cry and her body jolted, y did she do this does it mean she wasn't gone, I'm heatbrocken over this, Answer from Shanika Winters: Hi Diane firstly I am very sorry that you recently lost your pet, having a much loved pet put to sleep is always a very difficult decision.  I will try and explain what happens when a pet is put to sleep and to explain what can happen afterwards.  I hope that this can help to ease your upset over what happened with your pet. The reason we call euthanasia of a pet putting them to sleep is because your pet is actually given a very high dose of anaesthetic (drugs which are normally used to bring us to sleep for an operation).  The dose of anaesthetic given will cause your pet’s heart to stop beating; they will also stop breathing which results in them passing away. The anaesthetic drug is usually given by an injection directly into your pet’s blood stream.  With cat and dogs the injection is usually given into a vein on one of the front legs.  A small area of fur is first clipped away, the skin is then cleaned, and your pet’s leg will be supported by an assistant to enable your vet to put the injection into your pet’s vein.   You are still able to hold or hug your pet while the injection is being given if you want to.  In the case of rabbits the injection is often given into a vein on the ear, some smaller pets are given anaesthetic gas first followed by an injection. In some cases if the blood stream cannot be accessed, as your pet may have a collapsed circulation then the injection may be given into the kidney or liver.  The anaesthetic will then be absorbed into the blood stream a little slower than when injected directly into a vein. If your pet is distressed or generally frightened at the vets then they can be given a sedative before the anaesthetic injection.  The sedative is to calm your pet and reduce anxiety, which should hopefully make the process of losing your pet less stressful for both pet and owner.  Use of a sedative does however mean that the process will take a bit longer as the sedative will take time to work.  The sedative can be given as a tablet or injection into the skin or muscle. Once the anaesthetic reaches the correct concentration in your pet’s blood stream, this will cause your pets heart to stop beating and them to stop breathing.  Your pet will no longer react to sounds or touch; your vet will listen to your pet’s heart, feel for its pulse and may check its reflex by gently touching the eye.  This is all to confirm that your pet has passed away. After a pet has passed away as the muscles relax the bladder and bowels may empty, some pets also give a gasp as the air leaves the lungs.  In some animals there are jerky movements after death, called agonal movements.  These movements do not mean that your pet is alive or suffering.  The agonal movements happen as chemicals leak out of the body cells and allow muscle to contract.  Normally when alive these chemicals are kept in place until the body needs to use its muscles. Understandably it can be very distressing for a pet owner to see or hear sounds coming from their pet after he/she has been put to sleep.  If you have any concerns either before or after losing a pet then make sure you contact your vet or veterinary nurse.  We will make time to discuss things with you and do our best to help put you at ease with this very difficult situation. I hope that this answer has helped a little to explain what happened after you lost your pet and that your worries have been eased. Shanika Winters MRCVS (Online vet)

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. Your vet will also take into consideration whether or not your pet has been neutered(castrated) as in older male dogs the influence of sex hormones(produced by the testicles) can affect the prostate gland which can lead to haematuria.  The prostate gland is found in male dogs around the neck of the bladder and it produces various secretions which go into semen (the liquid sperm is in).  The prostate gland is usually small and inactive in neutered male dogs, but in entire male dogs the prostate can become enlarged, infected and or cancerous.  Many of the diseases of the prostate gland can lead to haematuria.  Your vet can often feel the shape and size of your dog’s prostate gland by examining your dog internally and externally. The kidneys are the organ which actually produces urine, your dog has two and they filter his blood to remove toxins and waste products which are then lost in the urine.  So haematuria could be blood coming from the kidneys either due to infection, kidney stones or cancerous changes in the kidneys or the tubing from the kidneys to the bladder (the ureters). The bladder is a stretchy bag made of muscle and lined with a delicate membrane (layer) which stores the urine produced by the kidneys and empties out through a tube called the urethra.  Haematuria could be blood from the bladder or urethra due to infection, stones, polyps, trauma (accidents) or cancerous changes. Your vet will thoroughly examine your dog paying extra attention to the back end of the abdomen, will also check your dog’s penis and likely examine your dog internally (via his bottom).  This helps to give information about the kidneys, bladder and prostate gland. What will happen to the urine sample? The first thing your vet will do is look at the colour of the urine sample, this may or may not show visible blood, sometime only tiny traces of blood are present in the urine sample and can be picked up on a dip stick. A urine dip stick is a card strip that has lots of little coloured patches on it; they each detect different chemicals and substances in the urine and give a quick result.  Most veterinary practices can also examine urine samples under the microscope to look for unusual cells and or crystals. If the result and rest of your dog’s examination suggests infection then your vet may suggest trying a course of antibiotics.  If however your vet thinks there may be more going on a carefully collected urine sample may be sent for laboratory analysis which involves culture and sensitivity, this looks at what bacteria are present and which antibiotics are likely to work on them. What further test might my dog need? Your vet may suggest blood tests to check that your pet has not lost too much blood, how its general health is and how well its body organs are functioning.  Blood tests do not always show up a lot of changes but this still gives us information as to how your dog is. X-rays may be taken conscious or under sedation or general anaesthesia, this gives a picture of what is happening inside of your dog, in the case of the bladder and prostate gland we sometimes add a contrast (chemical or air) to help show up details of the tubing and bladder lining. Ultra sound scans are another way of looking more closely at what is happening inside your dog, in order for these to be performed an area of fur will be clipped away, the skin cleaned and then a gel placed onto it to help p the ultrasound probe to make good contact and pick up details.  Ultrasound scans can be particularly useful for looking at the kidneys and bladder. What possible treatments might my dog need? The exact treatment your dog has will depend on what disease process is found in in what part of your dog it is. Urine tract infection: This is usually treated with a course of antibiotics and repeat urine samples tested to see when the infection has cleared. Bladder stones/urine crystals: This can be treated using special diets to reduce stone/crystal formation, surgery to remove stones, medications to help dissolve stones/crystals along with antibiotics and pain relief as required. Bladder growths/polyps: These can be surgically removed and analysed to give an idea of they are likely to return or cause further problems. Kidney infection:  This is usually treated by intensive antibiotics along with intra venous fluid therapy (drip line into your dog) to help keep the kidneys flushed through and functioning. Kidney growth/abnormalities: If the growth is cancerous and might spread then the kidney might be surgically removed. If the kidney is diseased e.g. polycystic then it will be left in place and your dog given medications and diets to help preserve what is left of its kidney function. Prostate enlargement/growths: If your dog is entire then surgical or chemical castration might be advised along with surgery to de bulk the growth if appropriate. I hope that my answer has helped you to understand how complex something as simple as blood in the urine can be.  Hopefully with your vets help, your dog will be on his road to recovery soon. Shanika Winters MRCVS (Online vet) If you have any worries about your pet, please make an appointment with your vet, or try our Symptom Guide.

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. From what you are describing it sounds like your cat has done very well to get to 18 years of age and still be going out, toileting correctly and eating.  Loss of teeth is to be expected as pets get older, often as vets we may have extracted teeth due to infection or damage.  You mentioned that your cat was struggling to keep clean, by this I assume that we are talking about grooming of his coat.  Cats and dogs use their front teeth to almost comb through and nibble at their coats, as you mentioned most of these are missing then it would necessary to groom your cat using a comb, brush or mitt.  If an elderly cat is skinny yet eating well this tends to make us wander if the cat may have an overactive thyroid gland, which can be diagnosed by blood test and then  can be treated using tablets or by surgery/radioactive iodine. Does my cat still have a good quality of life? There is not a simple answer as to whether a pet still has a good quality of life, we need to discuss how your pet was at its prime and take into consideration that even though it may not be able to do all those things now he can still be leading a happy, pain free life. The most basic functions are eating, drinking and being able to go to the toilet.  As cats age we may need to offer them softer foods/smaller meals more often in order for them to get enough food.  Some cats need encouragement to drink, making sure we refresh the water in their bowls regularly, have the bowl near where they rest and some cats prefer running water so a water fountain may help.  Toilet function for a cat involves getting into the correct posture which is not always easy if there is any arthritis/pain in the legs/spine and also accessing the litter box( use of lower sided litter boxes can make it easier to get in/out of them).  Minimising pain can be achieved by treating any underlying arthritis and or use of joint supplements. So even if your pet needs a few small changes to be able to perform its basic functions then it can still be having a good quality of life just with a little bit of extra help. As owners we ask ourselves whether our pets are still happy.  How happy and responsive your cat is also needs to be considered relative to how it was when younger taking into account normal changes expected with age.  Not all animals are very responsive so cannot all be measured on the same scale, also there are natural changes at different life stages e.g. juvenile cats are very playful and this will reduce as they become adult cats.  Also obesity can affect how interactive a cat is, so helping your cat to reach its optimum weight will reduce risk of diseases such as arthritis and diabetes as well as help him to be more interactive with you. Grooming is an activity which cats spend a lot of time doing, as they become older and potentially less flexible then this becomes harder for them, but as owners we can help.  If we did not brush our hair for days on end think how uncomfortable, itchy and sore we would feel. So this is a really simple area in which we can help our older cats to feel happier and more comfortable. But they may not appreciate that we are trying to help them at first so little, often and gently is the way forward. I hope that my answer has helped you to work out how you can help your cat and that the final decision is always yours as the pet owner but that your veterinary team are here to help you make such a hard decision.  We are more than happy to give you the time you need to discuss matters with us to make sure we all do the right thing for your much loved pet. Shanika Winters MRCVS (online vet) If you have any worries about your pet, please make an appointment with your vet, or try our Symptom Guide.
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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’? Are hairballs a cause for concern? If they happen infrequently and the cat seems to pass them without issue, then there isn’t much to worry about.  However, there are some medical conditions which can cause more frequent furball production:
  • Pain or stress can cause cats to overgroom, leading to increased hair ingestion
  • Flea infestation can lead to increased grooming as the cat tries to get rid of the little critters and the itch they leave behind
  • Allergic skin disease also causes itchy skin that cats are more likely to lick excessively
  • Gastrointestinal disease can alter the speed at which material moves through the intestinal tract, resulting in less hair making it out in the stool and more getting trapped in the stomach.
But even with the above conditions, the increased hairball production can usually be managed and treated accordingly.  Of much greater concern are the hairballs that DON’T get coughed up and instead stay in the stomach, getting larger and larger until they’re too large to come back out.  In this case, it will either stay in the stomach until it is so big that it causes significant other symptoms, or try to pass into the intestines and cause a life-threatening obstruction.  The only treatment is surgery to remove the blockage, and reports of hairballs the size of a grapefruit are not unheard of! Is there anything we can do to prevent them? Cats will always swallow their own fur, but there are some things you can do to minimise the impact:
  • Groom your cat regularly.  By brushing them you remove a lot of the dead hair that they would otherwise be ingesting.
  • Long-haired cats with significant hairball problems can have their coat clipped a few times a year to minimise the fur load.
  • Feed small meals frequently, instead of one or two large meals a day, to help move things through the intestines more quickly
  • You could consider changing the diet, as any diet change can affect gastrointestinal function.  There are special hairball diets out there but in most cases there is little scientific evidence to say that they work.  Speak with your vet before changing your cat’s diet.
  • Your vet may prescribe various medications, which can include oils such as liquid paraffin or other hairball remedies which can help lubricate the hairballs, enabling them to pass through the intestines more easily.
One final word of caution – sometimes people mistake a coughing cat for one that is trying to bring up a hairball as the noise is very similar.  If your cat ‘hacks’ like it’s about to produce a hairball but nothing ever appears, speak with your vet as coughing in a cat can actually be a sign of a serious illness such as asthma or occasionally heart disease.  And like any other medical problem, if your cat does get frequent hairballs, don’t wait for it to get worse, ask your vet for advice and get it sorted before it becomes an even bigger problem. Amy Bergs DVM MRCVS  - Visit The Cat Doctor website by clicking HERE If you are worried about any aspect of your cat's health, please book an appointment with your vet or use our symptom guide.
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Ask a vet online-‘How often should an 8 week old kitten be using the litter tray’

Question from Janine Anne-Ruby Law: How often should an 8 week old kitten be using the litter tray, I got my kitten on Saturday afternoon and she has only pooped twice is this normal? She seems to have settled in really well but I am a bit concerned about this help please? Answer from Shanika Winters: Hi Janine and thank you for your question regarding your kitten and toilet training.  From what you are describing about how well your kitten is settling in to her new home and the fact that she is using her litter tray you probably have very little to worry about. Cats and kittens will pass faeces (poo) when they receive a signal from their bowel (large intestines) that faeces are present and ready to be passed. The exact frequency with which faeces are passed will depend on each individual, their diet, and if they are stressed or have any underlying problems such as bacterial, viral or parasitic infection. It is normal for kittens to pass faeces as often as they are fed a meal, so at eight weeks old your kitten is probably being fed 3-4 times a day and could therefore be expected to pass faeces up to four time a day, however as your kittens digestive system becomes more efficient and dealing with food and waste products this may well decrease down to once or twice a day.  An adult cat would usually pass faeces once or twice a day. More important than how many times a day your kitten is passing faeces is whether the faeces looks normal, are passed easily and without any pain or distress. What might cause my kitten problem passing faeces? If your pet has a change of diet her digestive system might take some time to adjust to this change, the result may be an increase or decrease in the amount of times they pass faeces and changes to the consistency( harder or softer). If your kitten is not drinking enough water or getting enough moisture from its diet then the faeces may become dry and more difficult to pass, leading to less frequent passing of faeces, straining and discomfort passing faeces and possibly the passing of some blood with the faeces. Infection of bacterial and viral causes can lead to soft faeces with or without blood/mucous being passed more often than normal. Parasites such as round worms are a common finding in the digestive tract of kittens; this can cause constipation, diarrhoea with or without vomiting.  Most kittens are wormed( treated for worms) before you collect them and further worm treatment will be advised by your vet either in the form of paste, liquid, granules, tablets or spot on treatments. Lack of an opening at the anus, is a very rare condition which can prevent a kitten form being able to pass faeces or a lack of the development of part of the intestine which means the faeces cannot get to the anus.  This is usually detected in very young kittens prior to weaning and can sometimes be treated surgically by your vet. Blockages of the digestive system such as a foreign body, hair balls and even tubes of gut stuck into it (intussusception) can all lead to abnormalities in faeces production. In conclusion it sounds as though you have a healthy kitten that is using her litter tray well and regularly, so long as this continues then you should not need to worry.  I hope that what I have discussed in my answer gives you an idea of how many different factors can affect how often your kitten will pass faeces.  The most important thing is to look at how your kitten is in themselves, if they appear bright, are eating, drinking, and toileting normally then do not worry. If there are any changes which worry you, then ask your vet for advice. Shanika Winters MRCVS Online vet