Browsing tag: bones

Osteoarthritis in dogs.

Stiffness in older dogs may be due to osteoarthritis which could be treated.

Stiffness in older dogs may be due to osteoarthritis which could be treated.

This week I met a lovely 12 year old Labrador called Amber, who has been suffering for some time now with osteoarthritis. She is on a combination of two treatments, which keep her quality of life good although her condition is getting worse.

This is a very common complaint in dogs, especially middle-aged and elderly ones, but the good news is that the treatments available are improving all the time.

One of the most common findings in a routine examination of an older dog is stiffness of one or more joints. On questioning the owner, we often find that there is occasional lameness or difficulty getting into the car, or stiffness for the first few minutes of exercise before the dog “gets going”. One of the most likely causes of such symptoms, although not the only one, is osteoarthritis or degenerative joint disease. Most people just call it arthritis, although there are other kinds of arthritis as well.

Medium to large breeds are most commonly affected by arthritis, but it can happen in any size of dog. Usually the onset is quite slow and may not be noticed at first by owners, or just put down to the inevitable process of ageing. Unfortunately this can mean that owners are not aware that their pet is in pain, or underestimate how much pain they have. Owners are often surprised when it is suggested that their dog has arthritis that would benefit from treatment, and equally surprised by the improvement they see when treatment starts. A very common reaction is that he/she is “like a new dog”. This is mainly because their joint pain has been removed or reduced.

Arthritis is a degenerative condition of the joints, where the cartilage overlying the bone becomes rough instead of smooth and movement of the joint becomes difficult and painful. The fibrous capsule surrounding the joint becomes thickened and restricts the amount of movement the joint can make. New pieces of bone called osteophytes can grow on the damaged surface, further restricting movement. The joints may make clicking or crunching noises when the dog walks, and the joints may also be swollen.

Diagnosis of arthritis is by a mixture of examination of the dog, history taking (asking the owner about the dog’s exercise tolerance etc) and further examinations such as x-rays. It may not always be necessary to take x-rays, but it can be very helpful to rule out other conditions which might also be treatable, but would require a completely different type of treatment. As well as helping to make the right diagnosis, the changes seen can help decide on the best treatment. While the dog is anaesthetised, the joints can be manipulated much more thoroughly than when the dog is awake, so a more thorough examination can be made.

Regular short walks are advised for affected dogs.

Regular short walks are advised for affected dogs.

Once the diagnosis of arthritis has been made, treatment can begin. Before even thinking about drugs, the vet will want to consider whether changes need to be made to the dog’s weight and exercise regime. Being overweight puts increased strain on all the leg joints, so slimming down if necessary should be considered as part of the treatment. Rest can also be very important. Regular, frequent, short walks will be tolerated much more easily than an occasional long run.

Often the first line of treatment involves “chondroprotective agents” like glucosamine and chondroitin. These can be given in tablet form or can be included in the diet. They help to repair the cartilage and maintain the lubricating fluid of the joint, the synovial fluid. Two points worth remembering about these are, firstly, that the full effects may not be seen until six weeks after starting, and secondly, the formulations on sale for human use may not be as effective in dogs as those formulated for dogs.

Another very common group of drugs used to treat arthritis are called non-steroidal anti-inflammatories, or NSAIDs for short. These reduce pain and inflammation and can be given as tablets, liquids or injections. These drugs are generally very safe, but if used for a long time it is sensible to monitor the dog’s liver function as a healthy liver is needed to metabolise these drugs. A routine blood test is carried out every 6 months or as recommended by your own vet. Like all drugs there can be side effects, including the possibility of diarrhoea and vomiting in some dogs. If your dog develops any new symptoms while taking any drugs, it is advisable to seek advice from your veterinary surgery.

In some more serious cases other drugs may need to be used, such as steroids or strong painkillers.

Surgical treatments can also be used in the treatment of arthritis. Operations which have been common in human medicine for many years, like hip replacements, are now more widely available to dogs too. In severe cases of hip arthritis, this can allow enormous improvements in quality of life. In younger dogs where arthritis may be the result of a developmental problem in a joint, surgery may be recommended. Not all veterinary practices carry out these sorts of procedures so your dog might need to be referred to a local specialist in orthopaedics.

Amber is a lucky dog in that her symptoms are well controlled even though her exercise is restricted. She has an examination and a weight check every 3 months and a blood test every 6 months. She spent a lot of our consultation lying on her back having her tummy tickled, and I had no doubts that she is still leading an enjoyable life.

If you are concerned about arthritis, stiffness or lameness in your dog, or any other health issues, contact your vet or use our Interactive Dog Symptom Guide to help you decide what to do next.

The dilemma of Gizmo’s leg tumour

Gizmo and his vet, Reg.

Gizmo and his vet, Reg.

Gizmo was a lovable cat who had been known to the practice for many years. She was one of those vocal Orientals who sounded like a baby crying. In fact she had reached the tremendous age of 21 years with no major health problems until his teeth started to loosen and she had difficulty eating.

We are always extremely cautious with giving anaesthetics to aged cats so we took some blood tests for organ function which came back completely normal. She came through his dental with flying colours.

A couple of months later she came back with a very painful leg, swollen around the left knee (stifle). When we X-rayed the leg our worst fears were confirmed: Gizmo had bone cancer. We took further X-rays and there was no sign of spread to any other part of her body.

Bone cancer in dogs is highly malignant and has often already spread by the time the diagnosis is made. Although chemotherapy and amputation are options, survival time can be very poor.

Cats are a slightly different proposition and their form of bone cancer (osteosarcoma) tends to stay more confined and is slower to spread.

My instinct with Gizmo being 21 was to recommend her being put to sleep but her owner was determined that we should do everything possible for her providing that he did not suffer. Prior to the surgery we were having great trouble keeping Gizmo free of pain and at home she was on strong oral pain relief every couple of hours. I agonised over the decision to operate but was eventually persuaded to go ahead by his owner’s dedication to him and the fact that Gizmo behaved like a cat half her age.

Gizmo after amputation of a hind leg.

Gizmo after amputation of a hind leg.

The surgery went well and Gizmo recovered very quickly and was much more comfortable with the leg removed and surprisingly mobile. She lived on for another seven months when unfortunately the cancer returned in his pelvis and reluctantly at this point we had to admit defeat.

Looking back, my colleagues thought I had lost my reason undertaking this surgery on such an old cat but I think the extra quality of life which Gizmo went on to have justified going ahead. Anaesthetics and pain relief are so much better these days than they were twenty years ago. She was certainly one of those cats who seemed to inspire the old folklore about a cat having nine lives and she will never be forgotten by all of us who knew her.

If you are concerned about pain, swelling, lumps or any other problems in your cat, please contact your vet or use our interactive Cat Symptom Guide to help you decide what to do next. For more information about insurance which could ensure the cost of operations like this one are covered, please see our pet insurance pages.

Cat Pelvis Operation – Vet Orthopaedics

Pelvis_surgery

Joe the TV vet performs difficult pelvis surgery on a cat.

Cats lead dangerous lives, dodging traffic, fighting over territory and being chased by dogs, so it is not surprising that we vets spend a reasonable proportion of our working lives patching up the results of their adventures. Whether it’s repairing serious damage caused by road traffic accidents, or patching up less severe injuries from bite wounds, cats that have been in the wars certainly keep us vets busy everyday of the week.

Most of the time these injuries are not too severe – cat bites, and bruises and strains from over-energetic leaping and climbing usually heal well and require nothing much more than antibiotics and painkillers to help the cat recover. Sometimes, however, cats are less fortunate and that is when things get much more serious and the outcomes can be less positive. Road traffic accidents are by far and away the main cause of these more serious injuries, and repairing the damage that a tonne of car can do to 5 kilos of fragile cat can be a very involved and difficult process.

Thankfully there are now many highly specialised vets who can offer amazingly hi-tech operations and treatments that can quite literally put broken cats back together. A friend of mine from university, Toby Gemmill, is now an eminent orthopaedic surgeon in Birmingham and I truly believe that provided the pet’s head and chest are in one piece, there’s not much he couldn’t put back together successfully. Using all manner of techniques, including external fixators (metal frames that hold shattered legs back together from the outside rather than the inside), bone grafts and much more, vets like Toby can work wonders on even the most severely injured animals.

There is a problem though, and that’s the age-old issue of money. The state-of-the-art treatments that Toby and other orthopaedic vets carry out are understandably expensive with costs often reaching many thousands of pounds. This puts them out of the reach of many pet owners, unless of course they have pet insurance, leaving them faced with some very difficult decisions – should they try to beg, borrow or steal the money required for a potentially life-saving operation? Or should they simply call it a day and opt to have their pet put to sleep? These are terrible decisions to have to make, and it is one of the reasons why vets like myself, who are general practitioners rather than specialists, end up tackling complex operations that are well outside our comfort zone.

Take Portia the cat underneath the drapes in this picture for example. She was hit by a car and suffered severe injuries to her pelvis and back legs, and required a major orthopaedic operation if she was going to have any chance of surviving. However, her owner had no pet insurance and could not afford to consider visiting a specialist – but she was desperate to try and save her beloved cat, so I offered to try my best and have a go myself.

The operation Portia required was something I have attempted before, but it really is not something I’m that comfortable with, so it was a very long and stressful operation. The end result was pretty good – definitely not as good as if Toby had done the procedure, but a whole lot better than nothing and I think there’s every chance that she will pull through as a result. In fact it’s me that I’m more worried about – I need a stiff drink and a lie down to recover from the stress!

Joe Inglis BVSc MRCVS is the vet for the One Show, This Morning and BBC Breakfast. He runs his own line of natural pet food called Pet’s Kitchen

The nightmare before Christmas…

Christmas is one of my favourite times of year, all those presents and decorations, not to mention the yummy food!  However, there are problems we see commonly with pets around the holiday season that are directly connected with the festivities and this blog is about recognising and helping to prevent them.

Chocolate

chocolateChocolate is poisonous to dogs and there is often a lot more of it around at this time of year!  The basic rule is the posher the chocolate, the worse it is, as the more expensive brands contain higher percentages of cocoa solids.  The cocoa solids are ingredient which is dangerous and they can cause agitation, palpitations and damage both the heart and the kidneys.  If your dog has eaten chocolate and you are concerned, call your vet and keep the packaging, so you can tell them the cocoa solid percentage.  Chocolate poisoning is treated by making the dog sick, putting them on a drip and giving them sedatives.  Ensure during the festive period that all treats are kept well out of reach of dogs (don’t forget the ones on the tree!) and that the only chocolate they are given is especially for dogs.

christmas dinner
Christmas dinner

It is tempting, when we are tucking into a fabulous spread for Christmas lunch, to share this with our pets.  However, their bodies are less able to cope with unusually rich food than us and nobody wants to be clearing up vomit and diarrhoea on Christmas day.  If you do give your pet a treat, stick to small amounts of lean meat and vegetables, avoid rich gravy or dressings.   Also, NEVER feed cats or dogs turkey bones.  These can cause huge damage to the guts and sometimes require expensive surgery to remove them. Another thing to avoid is giving Christmas pudding or cake to your dog, as raisins are very toxic to dogs.

baubles
Tinsel and decorations

Cats find tinsel fascinating and will often play with it if they get the chance.  However, this can cause problems.  The way cat’s heads are put together means they are prone to getting things stuck around the back of their throat.  The small fronds of tinsel are just the right size to get caught here, especially if the cat has been chewing at them and they usually require an anaesthetic to remove them.  You should also take care to keep any delicate or glass decorations or baubles out of reach, as they could cause a pet significant damage if they are broken or eaten.  Sometimes, especially if your animals are young or lively, it can be best to dispense with the posh Christmas decs until they are older or calm down and stick to the ordinary plastic ones instead!

dog_sleeping

Visitors

Christmas is a time for socialising, which often means a regular supply of visitors to the house.  Most animals will cope with this fine and enjoy all the extra attention, but some will find this very stressful.  If you know your cat or dog dislikes having people in the house, ensure they have the means to escape from them and don’t force them to be sociable.  Also, stick as close to their normal routine as possible, which help them feel more settled.


fireworkFireworks

A great many pets find fireworks with their bangs and flashes very frightening and  they are commonly set off at this time of year.  It is important you deal with this fear correctly to ensure that you do not inadvertently make it worse.  Firstly, prepare a ‘den’ for your pet somewhere in your home where they feel safe.  It should be warm and cosy with a covered top as pets will feel most secure being completely surrounded.  Try using the DAP or Feliway diffusers to calm pets, these release comforting pheromones which can help your pet feel much more secure.  When the fireworks are happening, keep the curtains closed, play the TV or radio to drown out the noise and, hard though it is, try not to comfort them when they are scared as this will only praise the behaviour and can make them worse.  Finally, consider starting a desensitising programme to help your pet cope with the fireworks once the season is over, your vet will be able to advise you on this and provide CDs of firework noises to play.

If you have questions about this, or any other pet related subject, you should contact your vet.

Cat is the vet for petstreet.co.uk an on-line social networking site for pet lovers.

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