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The story of Dan, a coughing Springer Spaniel

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Dan was a nine year old Springer Spaniel who loved strenuous physical exercise. His owner, Dr Mullen, was a medical doctor who was an enthusiastic hill walker, so they made a good team. They would spend days off in the Dublin mountains together on six-hour hikes through the countryside. Dan was brought to see me because he had developed an irritating cough, and Dr Mullen was worried.

The cough did not affect Dan during exercise. He was still able to run for hours without any problem, but the following morning, immediately after getting up, he would cough repeatedly as he walked around the room. It seemed to be a productive cough: sometimes he swallowed after the cough, and other times Dr Mullen found patches of white phlegm on the floor. When Dan had been up and about for half an hour, the cough seemed to clear, and he’d be fine for the rest of the day.

I started by physically examining Dan. I listened carefully to his chest with my stethoscope. He had the perfect heartbeat of a fit dog, with slow steady sounds and no murmurs or irregularities. His lungs, however, sounded noisier than normal, with some wheezes and crackles. He definitely had some type of lung disease, and further tests were needed.

The following day, Dan was anaesthetised, X-rays were taken, an endoscope was used to directly view the lining of his airways, and finally tiny biopsies were taken of the many red sore areas that we could see. Dr Mullen called in three days later to discuss the full results of our investigations.

“I can say for certain that Dan is suffering from Chronic Bronchitis”, I began. “The initial X-rays suggested that that there was thickening of his lower airways, and using the endoscope, we could see that the thickening was because of inflammation of the lining of the small tubes of the lungs, known as ‘bronchi’. The biopsy of the red, swollen areas confirms that the disease process is simple inflammation, with nothing sinister going on. Finally, he has a mild bacterial infection in his lungs.”

Dr Mullen asked me if an antibiotic would completely cure his dog.

“Although antibiotics will help him, for a complete cure, he needs to go onto long term medication using other drugs. The chronic bronchitis probably started out with a simple infection, but there is now also an irritant and allergic aspect to the disease. The tiny particles of dust, smoke and pollens that are always in the air are perpetuating the bronchitis. We’ll use two drugs to help him. Firstly, a ‘broncho-dilator’, which will widen his airways and lessen the tight narrowing of the bronchi that is making them irritated. Secondly, a low dose of steroids will directly lessen the irritation. We’ll modify his dose of each drug so that he should be able to live a normal, symptom free life without side effects from medication.” There are other options for treatment, including an inhaler mask, but this treatment was my standard first stage.

Dan was sent home with three containers of tablets, and twice-daily medication ritual became part of his routine. I saw him again two weeks later, and the cough had almost completely stopped. He was suffering some side effects from the steroids, with increased thirst and appetite, but we were then able to reduce the dosage, so that he was given tablets only on every second day. When he came back a full month later, Dr Mullen was delighted.

“His cough has vanished completely”, he told me. “And he is enjoying his walks more than ever. The only problem is that he’s wearing me out! Do you know any tonic pills for a fifty-five year old human?”

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Beware of Slugs and Snails and Angiostrongylus (lungworm)

snailTo a gardener, slugs and snails can be a nuisance because they eat your plants, but to dogs they can pose a serious health risk because they act as an intermediate host for one of the most serious types of internal worms. The worm called Angiostrongylus Vasorum is sometimes referred to as lungworm or heartworm (although other types of lungworm and heartworm also exist). It affects dogs and foxes, and in the last few years it seems to have spread across most of Northern Europe including the U.K. I have seen two cases in the south-west of England in the last year. I am pleased to say that both dogs survived but they were both very ill for a time. The life cycle of this parasite takes place partly inside the dog (the host) and partly inside the snail or slug (the intermediate host). An infected dog or fox will have adult worms in the lungs and blood vessels, which produce eggs. These worm eggs are coughed up and swallowed by the dog, and then passed out in the faeces. They are then eaten by the slug or snail, which completes the cycle of infestation when eaten by another dog. dog_drinking_puddleIt can be easy to see, or hear, if your dog eats a snail because of the crunching sounds, but it is much harder to know if they eat slugs. Unfortunately some of the slugs are quite small and any dog which grazes on grass or drinks from puddles could be swallowing tiny slugs. The symptoms of infection with this parasite can be quite varied. The effects on the lungs may cause coughing or breathlessness on exercise. Various bleeding disorders can be caused by the blood failing to clot, which may show as nosebleeds or bleeding in the mouth or eyes, or unexpected bleeding after surgery. Less commonly the brain, kidneys or central nervous system can be affected. All of these are serious and can be fatal. Diagnosing the cause of the problem is by a combination of a physical examination, blood tests and faecal tests (to identify worm larvae). Other tests such as x-rays or ultrasound imaging may be necessary in cases where the symptoms are less clear cut, to distinguish this from other conditions. The good news is that treatment is available with a number of drugs available from your vet. Some commonly prescribed worm tablets and some commonly prescribed flea treatments will kill this parasite (when used as directed by your vet, which may be more frequently than for other parasites), and this is just one reason why all dogs should follow a suitable parasite treatment regime. Dogs with more serious symptoms will require intensive care and possibly blood transfusions and other drugs. The best advice to dog owners to avoid this problem is:
  1. Ask your vet which is the most suitable product to use for routine worm and flea treatment, and use it regularly, even if you don’t suspect that your dog has any parasites.

  2. Try to stop your dog eating slugs and snails if you can.

  3. Pick up your dog’s faeces and dispose of properly.

  4. Don’t be tempted to use slug bait, as this can be very poisonous.
Please ask at your veterinary surgery if you would like more information or advice on this very unpleasant parasite. Jenny Sheriff BVM&S MRCVS 3/12/09 If you are concerned that your dog is coughing or having nosebleeds use the interactive dog symptom guide to find out what you should do.

What is Kennel Cough?

[caption id="attachment_101" align="alignright" width="284" caption="Dogs can pick up kennel cough playing in the park  as well as in kennels."]dogs_playing[/caption] As a boarding kennel owner and a vet, I am often asked about this illness. From my point of view it has an unfortunate name, which implies that it only occurs in kennels. In fact an outbreak can occur in any area, and because it spreads rapidly, sooner or later an infected dog is bound to enter the kennels. Outbreaks are more common in the summer months, but there have been several cases in my area recently. Perhaps the mild autumn we have had has provided the right conditions for spread. Kennel Cough is a contagious illness of dogs, the main symptom of which is coughing. It should correctly be called Infectious Canine Bronchitis, or Infectious Canine Tracheobronchitis, but it is often known as Kennel Cough because of the fact that it spreads most readily when dogs are in close contact with each other. As well as in kennels, this would also occur at dog shows, training classes, veterinary surgeries, grooming parlours and many popular exercise places eg parks, beaches etc. The infection is spread by air-borne droplets, like colds and flu in humans. Another similarity with flu in humans is that there are many different strains of infection, making it difficult to prevent entirely by vaccination. One of the most common forms of kennel cough is caused by Bordatella Bronchiseptica, but a mixture of both bacteria and viruses may cause it. These agents cause irritation to the lining of the dog’s trachea (windpipe) and upper bronchi. The period between exposure to infection and developing symptoms (the incubation period) is often fairly long, sometimes up to 2 weeks. The first symptom is usually a dry, harsh cough which may end in retching and will probably sound as if something is lodged in the dog’s throat. Some dogs will be very well apart from a cough, but others may develop a temperature, a runny nose, appear lethargic or go off their food. Rarely there are other symptoms such as diarrhoea or vomiting. Usually the infection is not life-threatening but it can be a nuisance, and it may take several weeks to clear up completely. As with most illnesses, it is more likely to be a problem in older dogs, especially if they have pre-existing heart or lung problems. If the infection is very mild, treatment may not be necessary. More usually, affected dogs will need to see their vet to distinguish the condition from other types of cough (such as heart conditions, foreign bodies, bronchitis, or more rarely, lung tumours). Treatment for kennel cough might include antibiotics and anti-inflammatories. There is no specific treatment for the viruses involved, but any secondary bacterial infection would be helped by antibiotics. Responsible owners will then take steps to keep their dogs away from others to prevent spread, although there is nothing you can do to stop spread during the incubation period before you know that your dog has the infection. It would be unfair to blame the kennels if your dog does pick this up during a stay as a boarder, as there is little the kennels can do to prevent infection spread in the air. An infected dog will have brought the infection in before its owner or the kennel owner was aware that it was infected. The risk is similar to that of catching a cold or flu from another guest while on holiday: unfortunate but not the fault of the hotel! However, it is always a good idea to inform a kennels, grooming parlour etc if your dog develops this condition after a visit. [caption id="attachment_96" align="alignleft" width="210" caption="Kennel Cough Vaccine with applicator"]Kennel Cough Vaccine with applicator[/caption] There is a kennel cough vaccination which can be given to dogs, and although it cannot prevent all cases, it will reduce the likelihood and possibly the severity of cases in an outbreak. The vaccine is a small volume of liquid administered by the vet into the dog’s nostril using a syringe with a special applicator on the end. Most dogs accept this fairly easily although some do dislike having it administered. Firm but kind restraint by a veterinary nurse will usually allow the vaccination to be given without too much fuss. The first vaccines were given every six months, but more recent ones have been shown to work for twelve months so only need to be given annually. It may not be advised to give it at the same time as the routine annual injections, but your own surgery can advise you about this. Boarding kennels will usually insist on vaccination to protect all their boarders, and it would also be advisable to have your dog vaccinated against kennel cough if you are intending to go to dog shows or if they have medical problems as mentioned above. Always check with your own veterinary surgeon, who knows your dog’s medical history, if you are not sure. Jenny Sheriff BVM&S MRCVS If you are worried that your dog may have kennel cough use the interactive symptom guide to find out what you should do.