Browsing tag: dog

Ask A Vet Online – Help, I’ve got a stuffy-nosed Pug!

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Natalie Kent asked:

My 8 year old pug has just been diagnosed with Pseudomonas in his nose. He’s been having problems with his nose for about a year,   discharge, blocked up etc. Vet did a nose swab and found this bacteria. He’s been on marbocyl antibiotics for 2 weeks and it’s not       completely gone away, still a bit of discharge and a bit stuffy but vet refuses to give any more tablets, what else would you suggest?

Reply:

Hi Natalie, thanks for your question. Because of the conformation of their skull and nasal passages, Pugs are prone to a range of different breathing problems, and may suffer from recurrent nasal infections, so I’ll start by discussing the anatomy of the nasal passages and the defects Pugs typically suffer from. Pseudomonas is a particularly nasty bacterium that can be very difficult to treat effectively, so I’ll also talk about appropriate antibiotic therapy and the reasons why the symptoms may not have resolved. Finally, I’ll look at different ways forward for your dog.

What is the “normal” anatomy of a dog’s nose and airway?

When a dog breathes in, the air flows through the nostrils (also known as the “nares”) into the nasal chambers. The left and right sides are separated by a dividing wall (the “nasal septum”) so what affects one side doesn’t always reach the other; and they are separated from the mouth by the bone of the hard palate (the ridged roof of the mouth). These chambers aren’t open – they are almost filled with scrolls or swirls of bone called the conchae (because they look a bit like sea shells), leaving only a narrow space in between for air to flow. This is important because even a small amount of fluid or swelling of the tissues here can make a dog very congested and uncomfortable.

Behind these 2 chambers is a common space where left and right nasal chambers meet called the nasopharynx; the floor of this is made up of a strong muscular band called the soft palate. When breathing, the soft palate prevents food from entering the nasal passages. The air then flows through the larynx (voicebox), down the trachea (windpipe) and into the lungs.

Opening out of the airways in the skull are the sinuses; these are hollow spaces inside the bone that make the head lighter and easier for the dog to carry around. There are 2 sets – on each side of the skull is a frontal sinus (in the forehead) and maxillary sinus (in the upper jaw, just above the tooth roots).

So what’s different about pugs?

Dogs can be divided into 3 different groups of breeds, based on their skull shape:

  • Dolichocephalic – dogs with long noses, e.g. Greyhounds
  • Mesocephalic (also known as mesaticephalic) – dogs with medium noses (most dogs, e.g. Labradors)
  • Brachycephalic – dogs with short noses (e.g. Pugs).

As one of the most extreme brachycephalic breeds, Pugs almost always suffer from some degree of Brachycephalic Airway Obstruction Syndrome. This is a condition caused by selective breeding over many generations for an abnormally short skull, and includes a range of conditions such as:

  • Nostril Stenosis – narrowing of the nostrils.
  • Elongated Soft Palate – over-long soft palate that blocks the airway.
  • Everted Laryngeal Saccules – folds of flesh that stick out into the voicebox, blocking airflow.
  • Hypoplastic Trachea – where the windpipe is a little too narrow.

These are all caused by excessive amounts of soft tissue – in the course of breeding for the modern Pug, we’ve been very successful in shrinking their bones, but not so much the soft tissues around them. As a result, Pugs have loads of extra folds of tissue in their nasal chambers and airways, making breathing a little more difficult.

That’s all very interesting, but why did my dog get the infection in the first place?

There are a number of possible reasons, but let’s start with the most obvious – with lots of extra soft tissue in their noses, all those little crevices, nooks and crannies are perfect for bacteria to find a home and start to grow!

Other possible underlying causes include:

  • Foreign bodies – dogs are particularly prone to getting things stuck up their noses, like grass seeds or even bits of food.
  • Tooth infection – because the roots of some of the upper teeth are right next to the maxillary sinuses, an infection of the tooth can cause sinusitis and nasal infection.
  • Fungal infections – fairly rare in the UK, but they do occur.
  • Polyps – benign growths in the nasal chambers or pharynx.
  • Tumours – malignant growths of the airways.

These conditions aren’t uncommon in dogs, and often result in secondary bacterial infection. Once the infection is resolved, however, the symptoms may persist or recur because the underlying problem has not been addressed.

What is Pseudomonas?

Pseudomonas is a Gram Negative bacterium (meaning it has a double cell membrane as well as a cell wall) that commonly causes skin, ear and sometimes nasal infections. It is a very tough organism, and is prone to rapidly developing resistance to antibiotics. This means that in most cases, a prolonged (usually 2-6 weeks) course is required to ensure that it is completely eliminated. Exactly what antibiotic to use will depend on the results of the culture and sensitivity swab which your vet did – judging by what you’ve said, it would seem that this particular infection was susceptible to marbofloxacin (Marbocyl), a fluoroquinolone antibiotic commonly used against these bacteria.

So why hasn’t the treatment worked?

There are a number of possible reasons.

Firstly, it may simply be that the course wasn’t long enough – however, your vet is right to be cautious about just handing out more antibiotics; overuse of antibiotics in animals or people is one of the main drivers of antibiotic resistance.

A second possibility is that the course was long enough, but the Pseudomonas is now resistant to marbofloxacin; I’ve seen this happen before when treating these infections. You give an antibiotic that the bacterium is proven to be sensitive to, and within a week or two, the test results show that they have gained resistance to it.

Alternatively, there may have been other bacteria on that nasal swab that didn’t show up because there were so many Pseudomonas. In that case, if they weren’t susceptible to marbofloxacin, they’ll still be there causing problems even once the Pseudomonas are all dead.

Finally, and given the duration of the problems you’ve been having I’d say this is the most likely, there may be another underlying problem (such as a nasal polyp, a foreign body, dental disease, or even his nasal conformation and anatomy) that is causing the symptoms.

OK, what should I do next?

I think the most important thing is to find out what’s going on inside your dog’s nose right now. You know that some weeks ago there was a Pseudomonas infection; however, you’ve got no idea if that’s still the case and that treatment has failed (and if so, why); or if the symptoms are ongoing despite the successful treatment because the Pseudomonas were themselves only secondary to something else.

The first step would be for your vet to repeat the nasal swab (if possible, using the same laboratory) and see how the results are different – what bacteria are growing there now, and what antibiotics they are susceptible to.

The next thing to consider would be direct visualisation of the nasal chambers under anaesthetic; this usually involves rhinoscopy (putting a camera or endoscope up the nose) and/or retrograde visualisation (looking at the back of the nose with an endoscope or mirror) to see if there’s anything stuck there, or any masses or polyps growing. This isn’t always easy in pugs and may require referral to a specialist; however, your vet will be able to perform X-rays of the skull and nasal chambers, as often polyps and tumours are often clearly visible on an X-ray of this region.

I think it’s very important for you to discuss your concerns with your vet, and talk about further diagnostics – you really need to sort out what’s going on in that nose to make him comfortable again and to hopefully avert any more serious consequences! All the best, I hope you can get this sorted out quickly.

David Harris BVSc MRCVS

Do I need to worry about “Alabama Rot”?

You may have read in the news recently of another cluster of dogs affected with the exotically named “Alabama Rot”. Also known as “Cutaneous and Renal Glomerular Vasculopathy” (CRGV), this condition is still poorly understood. As a result, there’s a lot of worry and speculation, and vets are receiving increasing numbers of panic-stricken phone-calls from dog owners! So, what do we actually know about CRGV?

What is it?

Firstly, let’s specify what it isn’t – for example, despite excitable media reports, it isn’t a “flesh eating bug”. Nor is it a “superbug” or a variant of the Ebola (or any other) virus.

Technically speaking, it is a form of thrombotic microangiopathy, a condition where blood clots form in the small blood vessels in the body, blocking off blood supply. For some reason, the skin and the kidneys are most sensitive; without a blood supply, the tissue dies, causing ulcers on the skin, and failure of the kidneys.

Is it a new disease?                                     

Not exactly – it was first diagnosed in the United States in the 1980s. However, the first cases in the UK were detected in November 2012; since then, cases have been seen from across the country (there’s a map of confirmed and suspected cases here). It is most common in the winter and spring – most cases are detected between November and May.

What causes it?

No-one knows. It is probable that a bacterial toxin (i.e. a poison made by bacteria, that causes disease even in the absence of the bacteria themselves) is involved, perhaps from E. coli; however, this has not yet been confirmed, and tests for E. coli shigatoxin (one possible culprit) have proved negative. There is, however, no evidence that it is caused by a toxic plant, heavy metal poisoning, or genetics (although it was once thought that only Greyhounds and other sighthounds were predisposed, this is not now thought to be the case). It has been suggested that contaminated pet food may be involved, but this seems improbable – there just aren’t enough affected dogs for that to be likely.

So what are the symptoms?

Initially, the first sign is an ulcer or wound, usually on the legs. They typically look like small, round sores and usually occur on the legs, but may also be found on the body, face or tongue. The lesions range from 5 to 50mm (1/5” – 2”) in diameter.

1-9 days later (usually about 3), affected dogs will usually suffer acute kidney failure. The symptoms are of increased thirst, changes in urination (increased amounts of dilute urine, or in more severe cases, reduction or absence of urine production). This is accompanied by lethargy, anorexia, vomiting, depression and often bad breath (which may smell metallic). Once clinical signs of renal failure occur, the prognosis for recovery is poor.

Dogs that, for whatever reason, do not progress beyond the skin lesion stage have a better prognosis, assuming no further complications develop. Overall, half of the dogs affected will suffer abnormal bleeding (thrombocytopaenia); about a third may show some degree of jaundice (yellow gums and eyes); and one in five are anaemic (with pale gums and difficulty catching their breath).

How do dogs get it?

Firstly, it doesn’t seem to be contagious from dog to dog, or to or from humans. The current thinking is that there is an environmental link – most cases are associated with walking in muddy woodlands, and it may be that there is a toxin in the mud that is absorbed by the dogs.

How can it be avoided?

As we don’t know the exact cause, avoidance is difficult. However, thorough washing of your dog’s coat after walking in woodland (especially if muddy… like everywhere this year!) is a sensible precaution that should reduce the risk. In addition, it is likely that certain places pose a higher risk than others; if there has been a case in your area, it is probably wise to avoid areas where the affected dog(s) were walked in the days before they were diagnosed. It’s also really important to check your dogs over regularly – not just for sores or ulcers, but also for cuts, ticks, mats of hair or other injuries.

How do I know if my dog is affected?

Fortunately, most dogs with skin lesions don’t have CRGV! However, if your dog does have any strange or unexplained sores or wounds, it’s important to get them checked out by your vet – in the vast majority of cases, they’ll be able to demonstrate a far less worrying condition. They can also do blood tests to check for kidney problems – although as it is often several days before these show up, repeating the blood tests in 48 hours may be necessary.

How can CRGV be treated?

Unfortunately, there is no specific treatment. However, treatment of the skin ulcers will minimise the risk of secondary infection; and if kidney failure occurs or appears imminent, hospitalisation and intensive care will maximise the affected dog’s chance of survival. In some cases, referral to a specialist hospital may be suggested, to give your dog the best available care and therefore chance of recovery.

How dangerous is it?

As a rough estimate, the condition is fatal in 80-90% of cases. However, early diagnosis and treatment is thought to maximise the chances of survival.

Fortunately, it is still a very rare disease – in the last three months, there have only been 4 cases (in Staffordshire, Hampshire, Greater London and Lancashire). If you are concerned your dog may be affected, contact your vet for advice – however, the majority of skin lesions and sores will be due to cuts, insect bites or grazes, and are nothing to worry about. It’s also important to remember that, even if your dog is affected, prompt diagnosis and rapid treatment gives them a much better chance of survival.

For more information please visit Anderson Moores Veterinary Specialists who are taking the lead in treatment and advice on the condition.

Ask A Vet Online – Help! The fleas are revolting…

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Anne Stafferton asked:

This one is a bit boring really I’ve spent hundreds of pounds on flea stuff only for it not to work I breed cats so it’s a nightmare I’m now combing them all every day to get fleas out any suggestions on what really really works

Answer:

Hi Anne, thanks for your question about fleas in cats. I know exactly what you mean – they can be a real nightmare to get under control! I’m going to answer your question by (briefly!) discussing the flea life-cycle and how it can be broken, and then talking about the specific treatments that are available. As a warning, on a blog like this I am legally obliged to use the generic names for all the drugs and medicines (otherwise I would get nasty letters from the Veterinary Medicines Directorate, the government department who regulate advertising of veterinary medicines). You can, however, look up any of the generic names for the active substances and “translate” them into brand names on the VMD’s Product Information Database.

What are fleas?

Fleas are a group of obligate ectoparasites – this means that they live on the outside of other animals, and cannot survive in any other way but by sucking the blood of their hosts. Once an adult flea lays her eggs, they fall onto the floor, the carpet, and into the cat’s bedding. Here they hatch into larvae, which live, hidden deep in the fabric, in the dust, and in cracks in floorboards etc.

The larvae survive primarily by eating the faeces of adult fleas, which fall off the cat as the “black sand” we all know and hate! This material is semi-digested blood, and is very nutritious for the larvae. After their final moult, they turn into pupae (like the chrysalis of a butterfly but less pleasant) and there they stay, waiting for a chance to hatch.

Pupae can remain dormant for months or years, and in this state they are more or less impervious to virtually any treatment we can use against them (although apparently repeated steam cleaning can kill them). When they detect air movement, heat, or increased carbon dioxide levels (all indicators that a cat, dog or human is close), they hatch and leap on board, to feed, breed and repeat the cycle.

Traditionally, we think of fleas as being a spring and summer problem; however, with modern insulation and central heating, nowadays we see them all year round. The flea life cycle can only complete in a relatively warm environment, but we kindly provide them with a nice warm, comfy house to grow up in.

So how do you break the cycle?

There are a number of points at which the cycle is vulnerable – however, it’s important to remember that if the cats go outside (even briefly) they can pick up new fleas (deposited by other cats, dogs, foxes and even small mammals such as rodents). It only takes one amorous flea couple to reinfest a whole household…

The adult fleas are actually pretty easy to kill – even old-fashioned drugs like fipronil will kill most of the adults present, and many of the newer medications are much more potent.

The larvae need to cut their way out of their eggs (using a special “egg tooth” made of chitin); if their synthesis of chitin is impaired (e.g. by lufenuron) they cannot hatch.

The larvae cannot develop into adults in the presence of juvenile hormone – if this is chemically supplied (as an Insect Growth Regulator, e.g. S-Methoprene), they cannot make the change into adults.

The number of eggs, larvae and pupae in the house can also be reduced, by washing of fabrics (especially bedding) in hot (60C) soapy water. Although it won’t kill all of them, it will reduce the numbers and wash a lot away down the drain where they can’t hurt anyone!

The pupae themselves are pretty much impervious to any treatment, but they can be “tricked” into coming out as adults, which are then much easier to kill. The common method is regular vacuuming – the air movement and heat trick the pupae into hatching; you won’t catch many in the cleaner, but once out, they are vulnerable to environmental insecticides.

In fact, if you keep a “closed household”, with all the cats (and dogs if you have any) living indoors 24/7, it is theoretically possible to break the life cycle without treating the adults at all… but it will take a long time (the adults may live for 4-6 months) and you’re always at risk of a new introduction (in your clothes, for example).

So how do I kill them?

As you’ve found, there are a huge range of different flea control products on the market! Broadly speaking, these can be divided into 5 categories:

Environmental insecticides:

These are products used to spray the infested house, killing adults, sometimes eggs, and larvae. They will not kill pupae, but if applied rapidly after vacuuming, they can be very effective.

Most products contain permethrin, which is toxic to cats – this means that you have to be careful using them, by treating rooms one at a time and shutting the cats out until they have ventilated. The cans will explain how long to leave it for on the label, or talk to your vet, before reintroducing the cats.

On-cat environmental treatments:

These are applied to, or administered to, the cat, to treat the environment, and rely on the fact that the larvae are eating the flea’s droppings. There are 3 particularly important ones:

  • Lufenuron – a chitin inhibitor, available as an oral liquid, a tablet, or an injection. Does not kill adults, but prevents larvae and pupae from hatching properly.
  • Pyriproxifen – an Insect Growth Regulator, available in some prescription-only fipronil products.
  • S-methoprene – another IGR, available in some prescription-only fipronil products.
  • Imidacloprid – an insecticide available as a spot-on that kills adults and larvae in the vicinity of the treated cat.

Over-the-counter adulticides (products that kill adult fleas only):

These are of various effectiveness; most contain piperonyl butoxide or dimpylate (not very potent but pretty harmless) but there are still some on the market containing permethrin, which although effective is potentially lethal to cats. In general, if it is available over-the-counter without any regulation, it’s probably not that powerful.

The most popular products in this group are the spot-ons containing fipronil, which is an older drug but still fairly effective. Some of these products are over the counter, and others are classified “NFA-VPS” (which means there are certain restrictions on their supply, but they still do not require a prescription) Contrary to popular opinion, there is no conclusive evidence that resistance of fleas to fipronil is widespread – however, fipronil containing products are water soluble (so may wash off if the cat gets wet) and are much less effective than the modern prescription-only products.

The other commonly used active ingredient is imidacloprid, which is a different class of insecticide that is active against adult and against the larvae. Again, it doesn’t suit every cat but may be useful.

There is also an interesting product available as a tablet containing nitenpyam, which is very effective at killing adults – but only lasts 24 hours after being given. It is best used to kill off the bulk of the adults when starting a flea control program.

Prescription-only products:

Fipronil-combos – spot-on products containing fipronil plus an Insect Growth Regulator, to treat the adults and the environment simultaneously. Last between 4 and 8 weeks, but the adulticide (killing of adults) effect tends to wear off after about 4-5 weeks.

Flumethrin/Imidacloprid combo collar – this is a collar containing flumethrin (a form of permethrin that is safe for cats) and imidacloprid. It lasts about 6-8 months, and is very effective – if the cat will keep it on!

Imidacloprid/Moxidectin combo – another spot-on, that treats a wide range of different parasites. Lasts about 4 weeks.

Selamectin – a spot-on product, but one that is absorbed into the cats system so it cannot be washed off – very useful for outdoor cats! It also treats roundworms and both mange- and ear-mites, but does require the flea to bite before it works. Lasts about 4 weeks.

Indoxacarb – Another spot-on, but one that is utterly inactive in the cat’s body, until it is “turned on” by a unique metabolic action inside the flea, and the larvae if repeated every 4 weeks.

Spinosad – a tablet, given once a month, that is really effective against fleas, but does cause some cats to vomit; if given with food, however, it normally stays down – it does require the flea to bite, but kills very, very fast (in a few hours).

Herbal and homeopathic remedies:

Available, but no proven effectiveness. I have heard garlic recommended, but, sadly, in my experience it just doesn’t work and is potentially toxic to cats.

There’s so much choice! What do I do?

Bottom line – you’ll never control fleas if you only attack one stage of the life cycle. You need to kill the adults (and I’d recommend you talk to your vet about the more potent, modern, prescription products rather than rely on older and less powerful medications); however, you also need to decontaminate the environment, with regular vacuuming, insecticidal sprays, and good old fashioned washing and cleaning! If you’re still struggling to get on top of the situation, talk to your vet – not every product suits every cat, and it’s sometimes necessary to try several alternatives until you find the product, and the control methods, that suit your cats and their lifestyle.

All the best – I hope you can rid your cats of their unwelcome visitors!

David Harris BVSc MRCVS

Ask a vet online – How often should my dogs get boosters?

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Karen Taylor asked:

How often should our dogs be re-vaccinated (boosters)?

Answer:

Hi Karen, thanks for your question about booster vaccinations. This is an area that’s become quite controversial in the last few years, and there’s a lot of confusion about the subject. In addition, there’s a lot of very poor-quality information out there, so I’ll try to make this quite clear and obvious!

To put it as simply as possible – see your vet every year for a health check, and discuss your vaccination strategy with them.

For more detail… now read on!

What are vaccinations?

Put simply, a vaccination is a way of teaching your dog’s immune system how to recognise and defeat the micro-organism that causes an infectious disease, without the risks (of illness, potential long term health problems or death) inherent in a “natural” infection.

This is achieved in one of three ways:

1)      A weakened form of the disease-causing organism.

These are called “modified live” or “attenuated” vaccines, e.g. for Distemper and Parvovirus; the organism included is unable to multiply and/or cause clinical disease, but it is active enough to stimulate a strong immune response. Most modified live vaccines give a stronger and more long-lasting immune response than an inactivated vaccine; however, they aren’t suitable for every disease (because some organisms cannot be weakened enough to make them safe).

2)      An inactivated (“killed” or “dead”) form of the organism.

These cannot ever cause disease, but allow the immune system to recognise the protein coat of the organism and therefore attack it next time. They may be used for particularly dangerous or unpredictable diseases such as Rabies or Leptospirosis, but don’t always give such long-lasting protection.

3)      Subunit vaccines, introducing part of the organism to teach the immune system what it “looks like”.

For these, part of the protein coat of the target organism is replicated in a lab, and included in the vaccine; this means the immune response is really tightly targeted at one particular, vital, part of the organism. These are used, for example, in the Leishmania vaccine.

There are 2 groups of vaccines – core and non-core. Core vaccines are those that should be given to every dog – they protect your dog and everyone else’s against dangerous, highly contagious and potentially fatal diseases. Non-core vaccines are those that are given to protect dogs that are particularly at risk of a specific condition because of their location, lifestyle, etc.

The core vaccines that every dog should have are against:

  • Distemper.
  • Parvovirus.
  • Canine Infectious Hepatitis.

The vaccine against Leptospirosis is technically non-core; however, it is generally agreed that every dog in the UK is at risk of Lepto (which is spread by rat urine), and so it is treated as a core vaccine by most vets.

The non-core (optional) vaccines available are:

  • Rabies (only necessary for pets travelling abroad).
  • Parainfluenza (one of the causes of kennel cough).
  • Kennel Cough (the bacterial sort, Bordetella bronchiseptica).
  • Lyme Disease (only necessary for dogs at high risk, e.g. gundogs, in high risk areas, e.g. the South West peninsula).
  • Leishmania (only necessary for dogs travelling to southern Europe).
  • Canine Coronavirus (only usually needed in breeding kennels).

If vaccines are so good, why do they need boosting?

Because nothing lasts forever! Eventually, the immune system starts to “forget” how to handle a particular disease organism. Booster vaccines effectively remind the system and refresh the immunity.

However, immunity to different diseases (and different types of vaccine, for that matter) lasts a variable amount of time, and that’s the problem. Some dogs will retain immunity for longer than others – unfortunately, there’s no easy way to tell which dogs are immune to what for how long.

Is there any way to tell whether my dog actually needs a booster?

Not really! The trouble is that although some vaccines operate by producing protective antibodies (e.g. Rabies), others rely on inducing a Cell Mediated Immune Response (immunity that doesn’t rely on antibodies in the blood, but circulating immune cells, e.g. T-lymphocytes and Natural Killer (NK) cells) – such as the Leishmania vaccine, which may not produce any antibodies at all. And most of them probably rely to some extent on both systems.

It’s easy to test the dog’s blood for antibodies (and there are some commercial companies that will do this and say “yes, high levels of antibody, so the dog is protected” or “no, not enough antibody, the dog needs to be vaccinated again”. However, this is not generally considered reliable, because:

  • The serological titre (level of antibodies in the blood) can only tell you how much antibody there is in the bloodstream at the specific time the test is done – it cannot tell you whether the levels will remain high for the following 12 months.
  • The link between antibody levels and protection isn’t consistent – some dogs utilise other parts of the immune system (cell mediated immunity) – for example, dogs can be protected against Leptospirosis in the presence or absence of significant circulating antibody levels.

So how long does immunity actually last?

How long the vaccine lasts depends on the exact formulation of the vaccine; at the time of writing, the three Core vaccines generally need boosting 1 year after the initial course, then every 3 years. Most Rabies vaccines needs boosting only every 3 years; and the others usually require annual boosters.

To get a license for a vaccine, the manufacturer has to demonstrate that the product has a protective effect, however that is defined. For Core vaccines, they have to demonstrate onset and duration of immunity such as to fulfil the license claim to:

  • “Prevent mortality and clinical signs caused by canine distemper virus infection”.
  • “Reduce clinical signs of infectious hepatitis and viral excretion due to canine adenovirus type 1 infection”.
  • “Prevent mortality, clinical signs and viral excretion following canine parvovirus infection”.

If this cannot be demonstrated to the regulator (in the UK, the Veterinary Medicines Directorate – VMD), they won’t get a license for the product. This means that manufacturer’s recommendations for duration of immunity are those that will protect the vast majority of dogs for the quoted time (3 years or 12 months, depending on the vaccine).

To make life a little more complex, any vet who uses a different vaccination interval, unless they can document a good clinical justification, is technically acting illegally by using the vaccine off-license (i.e. not as licensed by the manufacturer). This sort of behaviour tends to lead to unpleasant interviews with the VMD and has led to vets being struck off (although not, to my knowledge, for vaccine infringements as yet).

Can over-vaccination harm my dog?

There’s no reliable evidence that it can. In cats, every subcutaneous injection (of anything, even saline!) slightly increases the risk of an Injection Site Sarcoma, but despite a lot of scientists, vets and owners trying to find a link, there’s no evidence that it causes any problems in dogs.

That said, absence of evidence is not necessarily evidence of absence, so a responsible approach would be to vaccinate as infrequently as the current evidence suggests is sufficient to provide protection – in other words:

1)      Get a health check for your dog at the vets every year.

2)      Follow the manufacturer’s recommendations (unless your vet has a particular clinical reason not to):

  1. Distemper, Parvo and Infectious Hepatitis – boosters every 3 years.
  2. Lepto – annual booster.
  3. Rabies – boost every 3 years.
  4. Other Non-core vaccines – usually every year.

 

I hope that helps; this is a really controversial area in some quarters, but the evidence base for the current vaccination protocols is pretty secure, and it is what I’d advise you to follow.

David Harris BVSc MRCVS

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?”

Training dogs: can old dogs learn tricks? And what about residential “boot camps” for dogs?

Does your dog ‘sit and stay’?

The early autumn is a bit like a mini-New Year. The summer has ended, schools have gone back, and the term-time routines start again. It can be a great time to start new projects, and for many dog owners, that can include tackling the complicated issue of training their pet. Many dog owners have pets with bad habits that they want to change.

Dogs behave in response to the way that their owners treat them. A dog will only beg from the table at mealtime if her owner has taught her to do this by feeding titbits in the past. A dog will only jump up onto the settee if she has been allowed to do this by her owner. It then follows that it is possible to re-train dogs by changing the way we behave towards them. A dog can be re-trained at any age, by using modern dog training methods.

Anybody can set themselves up to be a dog trainer, and so there’s a wide variety of styles and standards in the dog training world. Some have had formal instruction in dog training. Some have even passed exams. Others are self-taught. It’s best to choose trainers who have been taught the latest techniques, and who continue to make an effort to keep themselves up to date.

As in other areas of life, dog training is an evolving science. Techniques used thirty years ago would now be thought to be completely inappropriate by the experts. The modern belief is that dogs should be trained by reward rather than by punishment. Choke chains should never be used. Dogs should never be hit or hurt during training.

It is very important to choose the right dog trainer, and owners should spend some time doing research rather than just choosing the first name they find in the phone book. It could be useful to go along to a training class as an observer. Do you like the style of the trainer? Talk to a few of the dog owners at the class. Have they found the classes useful and effective?

Once you have chosen a dog trainer, make sure that you attend classes regularly, and make sure that everyone in the household knows the rules. Dogs need consistent, continual monitoring. If one person in the house persists in feeding the dog from the table, she will never learn to stop begging.

It’s one thing to train a puppy or a young dog, but what about retraining an adult dog? How do you break old habits? This is much more challenging, but it’s still possible.

One controversial answer can sometimes be to send your pet off to a ‘training camp’. Dogs stay at the training centre for a two or three week period. They are taken out of their own environment, and they are taught a new routine. When you collect your dog, you are first shown a twenty-minute video of your dog behaving in a calm, obedient way. You are then given a two-hour lesson in the techniques that you need to use to ensure that your dog continues to behave calmly and obediently. Finally, the training centre remains in contact with you, so that you can telephone them if you have problems, or even book your dog in for another training session if needed.

This type of “boot camp” is controversial, with many trainers believing that it is a short cut that should not be taken, and that an owner needs to be involved from the start, all the way through the process. My own view is that, like many aspects of pet care, it is impossible to make a “one size fits all” pronouncement. Residential training works well for some dogs, but not all.

Regardless of what sort of dog training you choose, the formal instruction is only the first stage. The second stage is up to you. You need to spend fifteen minutes a day working with your pet. For long-term success, you need to stick to a simple but challenging statement – ‘I promise to continue to give my dog regular daily training sessions’!

Ask a vet online – My dog has black dandruff!

Sheila Elcott asked:

I have an 11 year old red fox lab boy who keeps getting a build up of black coloured dandruff type patches under his chin & his manly areas. Up to date with spot on. Is it his age & lack of my grooming care? After bathing & removing said patches the skin clears. He has hip & elbow dysplacia to boot. Tnx

Answer:

Hi Sheila, thanks for your question. Skin problems in dogs can be really frustrating to deal with, so I’ll go through some of the possibilities, then talk about how they can be investigated and managed.

So, what can cause patches of black dandruff material to appear?

There are a number of possibilities that spring immediately to mind:

  • Flea dirt. Flea droppings are black flecks, sometimes comma-shaped.
    • I know you’re up to date with spot-on, but there are a wide range of different products out there, some of which are more effective and longer-lasting than others. In addition, most spot-ons are water soluble, so regular bathing or swimming will reduce their effectiveness.
    • You’ll very rarely see a live flea unless there’s a really severe infestation. To check it out, try the wet paper test:
      • Scrape some of the black material onto a sheet of wet white paper.
      • If it goes red, it is probably a flea dropping – they’re basically just dried digested blood.
  • Scabs. As blood dries, it turns black and crumbly. It can be caused by:
    • Lice. Heavy louse infestation can cause scabbing where the parasites suck.
    • Skin infections. In these areas, this would typically be a skin fold infection, where saliva or moisture is trapped against the skin, damaging it and allowing infection to become established.
    • Allergic reactions (e.g. contact dermatitis). Reactions to products such as surface cleaners, pesticides, some plants, etc etc; typically affect the high-contact surfaces – chin, elbows, hocks and belly.
  • Sebaceous matter. Sometimes, excessive secretion of sebum may give the symptoms you’re discuss. This may be due to sebaceous adenitis (an inflammatory disorder), or simply from aging changes.

Unfortunately, without seeing the dog, it’s difficult to know which of these is the most likely for your boy!

So where do we go from here?

Ideally, you want to rule out parasites – do a wet paper test; and ask your vet to do skin scrapes and tape strips to examine the black material and the skin underneath it. Also, try and see if there’s anything that seems to trigger an episode – for example, if it always flares up after using a particular floor cleaner, I’d be really suspicious it was an allergic reaction.

So what can be done?

If a specific cause can be identified, obviously it should be treated (for example, a louse infestation should be treated; and you should avoid using any products that your dog is allergic to).

Even if not, there are certain techniques that may be useful in controlling the symptoms. As the problem resolves with cleaning, I’m quite suspicious that it might be a skin-fold infection – these are often more common in older dogs. In general, these can be controlled with grooming, good hygiene, and the use of medicated antiseptic wipes (e.g. CLX wipes) to control the growth of bacteria in the area. Sometimes, bathing with an antiseptic shampoo can help as well – you should talk to your vet about the options.

I hope that helps and you can get him sorted out!

David Harris BVSc MRCVS

Ask a vet online – My pets breath is bad, but teeth are fine – help!

Question from Sarah Knight:

My Scottie has horrendous breath, teeth are fine, have changed her diet, she also has charcoal on her meals, any other ideas truly welcomed!

Answer: Bad Breath

Hi Sarah, thanks for your question about your dog’s bad breath. To answer it, I’m going to run through the possible causes of halitosis, along with any other symptoms they might show. I’ll then talk about the most likely reasons, and where to go next with diagnosis and treatment options.

Causes of Halitosis

Halitosis, or “bad breath”, is defined as an “offensive odour emanating from the oral cavity”. There are a number of possible causes, some of which are more common than others.

1) Diet

You say you’ve modified her diet, but a lot of dogs (especially terriers!) eat unpleasant things given half a chance – particularly faeces (those of other dogs, horses, livestock etc), or dead and rotting things (often mice or birds found lying in the undergrowth when out on walks). Inevitably, eating anything like this will lead to bad breath.

2) Metabolic disease

We’re particularly talking about diabetes or kidney failure here – both of which can lead to halitosis. In diabetes, the body produces ketones as a fuel supply for the brain, which have a strong smell (with overtones of pear drops – however, not all humans have the gene required to be able to detect this); in kidney disease, the build up of nitrogen waste products in the blood may result in oral lesions and/or smelly breath. In both cases, you’d expect to see increased thirst and possibly weight loss, but the signs can be pretty subtle in the early stages.

3) Respiratory disease

Infections of the nose and sinuses often lead to foul smelling breath, as can tumours of the nasal cavity. Sometimes, in fact, there are no other symptoms, although I’d usually expect some nasal discharge (a single snotty nostril that doesn’t clear up is the classic sign). Have you noticed any wheezing or sneezing? These can be signs that there’s something amiss as well. Sometimes dogs can get foreign bodies such as grass blades stuck up their noses – these result in inflammation and infection, and the tell-tale smell.

4) Oesophageal disease

Some conditions of the oesophagus (the gullet or “food pipe”) can result in halitosis – particularly some tumours or a condition called megaoesophagus, where the gullet is stretched and doesn’t function properly. However, these are usually associated with regurgitation of food or difficulty swallowing.

5) Skin disease

Although I wouldn’t say it was especially common in scotties, infections of skin around the lips (lip fold pyoderma)  can occur in any breed, and can smell quite unpleasant – if the skin around her mouth looks sore or is painful, this is a distinct possibility that will need intervention. Pyoderma like this can also be a result of an allergic condition.

6) Dental disease

This is by far the most common cause of halitosis! Most dogs develop some tartar and plaque as they get older; in some its much worse than others. You say her teeth appear fine, and I’m sure they do, at least at the front; however, plaque is much more common towards the back of the mouth where it’s much harder to see. In addition, dogs can get what’s called a biofilm, where the teeth are covered in a thin membrane of bacteria, but may look normal. In addition, tooth disease doesn’t have to be above the gums – a healthy-looking tooth may have severe gingevitis (gum infection), or periodonitis (infection and inflammation of the roots) which is a common cause of bad breath.

I have to say that, without seeing her, I think some degree of dental disease is the most likely explanation.

Where do we go from here?

Firstly, it’s always worth checking to see if she is picking up faeces from something, and if so, preventing her from having free range in that area. If she’s eating her own, there are products available (e.g. Copro-Nil) that make a dog’s own faeces much less appetising.

Assuming that isn’t the (nice, simple!) cause, check to see if she is showing any other symptoms – snotty nose, sneezing, regurgitating, drinking more, losing weight etc. Measuring water intake over a 24 hour period is really useful; as a rough rule of thumb, more than 90ml per kg per day is an abnormally high amount. If she is showing any of these signs, or you are at all concerned, you should see your vet for further investigation. Blood and urine tests can be used to diagnose kidney disease and diabetes, and X-rays are commonly used for nasal and oesophageal disorders.

The next step is to check for dental problems. It is virtually impossible to do a full dental examination on a conscious patient, but your vet will probably have several tricks up their sleeve that let them get a good look around to pick up the obvious. For a full dental examination, however, an anaesthetic is needed (and I have to say, it’s pretty rare not to find any issues at all in an adult dog). A “dental” (so-called) is a very routine procedure, and would be my favoured way forward, unless you and your vet can be pretty confident that there aren’t any underlying dental issues.

What happens in a “Dental”?

Essentially, the dog is anaesthetised, then their mouth and teeth can be carefully examined (without risk to fingers). Any loose or diseased teeth are removed, and the remainder are scaled and polished to remove any plaque or tartar (just like a visit to the hygienist for us). Normally, the dog will go home the same day.

Is there anything else I can try first?

Yes – if there aren’t any other symptoms, and you can’t see any signs of gum disease or plaque, you can (and really should!) start brushing her teeth. In fact, even if your dog has just had a dental, if at all possible start to brush afterwards – bacteria attach to the freshly cleaned tooth within 6-8 hours, and mineralise (forming dental calculus or “plaque”) within days.

Get a soft tooth-brush suitable for her size (a children’s brush, or a specialist dog one), and some dog tooth-paste (DON’T use human paste – the mint flavour is really nasty for most dogs). Just as you would brush your teeth, gently brush hers, a little at a time until she gets used to it. I would strongly advise every dog owner to brush their pet’s teeth – it would avoid a lot of problems later on.

I hope that helps and that you can get her smelly breath under control!

David Harris BVSc MRCVS

Ask a vet online – is there a test for Leptospirosis?

Berry Wilkinson asked:

I was wondering if you can titre test for leptospirosis? Or is it only useful when you are testing sick dogs? Thanks.

Answer:

Hi Berry, thanks for your question about testing for Leptospirosis. To answer it, I’ll briefly discuss Leptospirosis as a disease, then talk about the different diagnostic techniques available. Finally, I’ll discuss vaccination and the implications for diagnosis.

What is Leptospirosis?

Leptospirosis (“Lepto”) is a disease caused by bacteria of the genus Leptospira. There are more than 300 strains (technically called serovars) of the bacteria. In the UK, Leptospira icterohaemorrhagiae and L. canicola used to be the most common, but since widespread vaccination against these has started, it is now thought that L. interrogans and L. kirschneri may be more important.

The disease is transmitted by body fluids of infected animals, including rats. The symptoms of Leptospirosis in dogs include:

  • Fever and sore muscles.
  • Loss of appetite, vomiting, diarrhoea and dehydration.
  • It may cause kidney or liver failure
  • Sometimes the only symptom is sudden death.
  • Infected dogs may shed the bacteria in their urine for months or years without showing any clinical signs.
  • Leptospirosis is highly zoonotic – i.e. it is a high risk pathogen for infecting humans.

How is Leptospirosis diagnosed?

There are four methods to test for Leptospira in clinical samples, of which two are clinically useful. They are:

  • Darkfield microscopy – looking for the bacteria themselves. This is very siple, but is notoriously unreliable, unfortunately!
  • Bacterial culture – attempting to grow the bacteria; however, in many cases the bacteria are very hard to culture, so even in confirmed infections, this test may come back negative.
  • Serology – looking for antibodies produced by the immune system in response to the presence of the bacteria. However, vaccination will often lead to a positive response, and low-positive titres (levels of antibody) may persist for a prolonged period. In addition, the levels of antibodies often won’t be significant in the first week of infection.
  • PCR – testing blood (early infection) or urine (later stages of infection or carrier status) for genetic material from the Leptospira bacteria; this is a very sensitive and specific test. However, a negative PCR result doesn’t rule out carrier status because the bacteria are only shed intermittently in the urine, and will not be present in the bloodstream; and it can also appear negative in some milder infections.

So how is serology interpreted?

  • The normal screening test for Lepto is an antibody test (“ELISA testing“) that gives a simple positive or negative result.
    • If this is negative, then in general either:
      • The dog doesn’t have Lepto, or
      • The dog has only been infected in the last week or so.
    • If the result is positive, then:
      • The dog has Lepto, or
      • The dog has had Lepto in the past, or
      • The dog has been vaccinated and still has high levels of circulating antibody.
  • If the ELISA-test is positive; or if the symptoms are suspicious but PCR (genetic) testing is negative, the next phase is to use a different type of antibody testing (“MAT serology“) to determine the level of antibodies in the blood (the titre).
    • On a single test:
      • Low titres are most likely to represent vaccination or past infection.
      • Moderate titres may indicate vaccination or infection.
      • High titres usually represent acute infection.
    • However, it is far more useful to carry out paired serology – 2 tests 7-10 days apart:
      • In a genuine infection, the titre would normally be expected to rise by at least four-fold.
      • In chronic infection, or asymptomatic shedding, diagnosis can be really difficult, but a persistent moderate titre that doesn’t decay over time is highly suggestive of chronic infection; however, demonstration of the organism’s genetic material by PCR in repeated urine samples is often more practical.

What about vaccination?              

There are a number of different Leptospirosis vaccines available; most of them cover 2 strains (“bivalent vaccines”), although some now cover 4 (“quadrivalent vaccines”). They are aimed at covering the most common types that cause disease, and there is relatively little cross-protection between strains (so immunity to one strain or serovar won’t usually protect against another).

The vaccine doesn’t necessarily prevent infection, but it should reduce the risk of infection, and it does reduce the severity of clinical disease and shedding (for whichever strains or serovars are covered by that vaccine).

There are some commercial tests that claim to determine whether a dog requires vaccination against Leptospira by testing circulating antibodies. This may work in some cases, but it is very limited. There are a number of problems with this approach:

  • The serological titre (level of antibodies in the blood) can only tell you how much antibody there is in the bloodstream at the specific time the test is done – it cannot tell you whether the levels will remain high for the following 12 months.
  • The link between antibody levels and protection isn’t consistent – some dogs appear to utilise other parts of the immune system (cell mediated immunity) and are protected against Lepto even in the absence of significant circulating antibody titres.
  • After vaccination, titres normally drop off over 4-5 months, but protection lasts for 12 months.

As a result, it is wisest to maintain annual vaccination against Leptospirosis, to reduce the risk of infection to your dog and to you.

I hope that helps!

David Harris BVSc MRCVS

Ask a vet online – my dog has skin allergies, how do I help?

Question from Leona Poppleton:

my dog has skin allergies and so gets very dry skin and sometimes scabs that look quite painful is there anything that I can get or do to help this?

Answer: Scabby Skin

Hi Leona, thanks for your question about your dog’s skin. Allergies with skin symptoms are pretty common in dogs, so I’ll briefly discuss allergic disease, then go on to some of the many different treatment options.

What are skin allergies?

The phrase “skin allergies” refers to the itching, scratching and sore skin that allergic dogs get. However, it doesn’t have to be caused by something on the skin – e.g. food allergies (although quite rare in dogs) can lead to skin symptoms – so “allergic skin disease” is a better term.

Essentially what is happening is that the dog’s immune system misidentifies a harmless substance as a dangerous threat, and tries to attack it, causing soreness and itching. Allergic reactions may be triggered by a wide range of substances such as pollen, certain foods, fleas, mites, plants or even some washing powders. In a large number of cases, there’s no specific “allergy” involved, but the dog has a disease called Atopy (or Atopic Dermatitis), where the immune system reacts abnormally to a wide range of different stimuli. Atopy is partially genetic, and is more common in some breeds (e.g. West Highland White Terriers).

How is it diagnosed?

It is important to get allergic skin disease properly diagnosed by your vet because there are many contributing factors and different underlying problems. As a result, diagnosis can be long and exasperating! In addition, diagnosing Atopy requires ruling out all other possible causes.

1) Initially, its vital to make sure that there aren’t any parasites (especially fleas!) on the dog – this is a LOT harder than most people think, and usually requires treatment of the affected dog, all other pets in the house, and the house itself. (A side note here – there are a lot of over-the-counter products available for treating fleas: some work, some don’t work, and some are very dangerous if not used correctly. I would strongly advise talking to your vet for advice, particularly as the most effective treatments are prescription-only medicines, some of which will also act over time to treat the environment as well as killing adult fleas).

2) The next step is to make sure there aren’t any skin infections that could be contributing to the symptoms, or mites burrowing into the skin. This may require skin scrapes to remove a layer of skin (it really doesn’t hurt!) and tape-strip tests to check for yeasts or bacteria.

3) There are a number of allergy tests available – these mostly use blood samples; intradermal tests (injection of test substances into the skin) may be more reliable, but they are expensive and difficult to perform.

4) To rule in or out food allergies, a controlled food trial is essential. This can be done with truly novel food sources, but in general it is more effective and practical to use a hypoallergenic diet from your vet. These diets are formulated so that the proteins are broken down so small that the immune system can’t recognise it. In a food trial, the dog is fed ONLY the controlled diet (no treats or snacks!) for a number of weeks. If the symptoms resolve, you reintroduce the original diet one item at a time, to determine what’s causing the allergy.

But why does it make my dog itch so much?

Itching is what’s called a “summative, threshold” experience. This means that there is a threshold level, below which itching won’t be felt. Anything that stimulates an itch (“pruritic”) response such as a flea bite, an allergy, or a skin infection, raises the level of “itch” until it breaks this threshold and the dog feels itchy. In most allergic dogs, several different factors combine to make the itching overpowering. Unfortunately, actually scratching makes things worse – this is called the “itch/scratch cycle”.

What are the scabs I can sometimes see?

Scabs generally mean one of three things:

1) Flea bites

2) Skin infection

3) MOST COMMONLY – self-inflicted skin damage caused by scratching. The skin is sore because it’s been scratched, and it’s been scratched because its sore etc etc… Scratching also damages the skin and allows infection to become established, which makes the itching worse.

What can I do about it?

The bad news is that most allergies cannot be cured, only managed. However, with good management, most cases of allergic skin disease can be fully controlled the vast majority of the time. There are a number of classes of treatment, which I’ll deal with in turn; however, many cases will require multiple overlapping treatments, so it is essential that you work with your vet to put together a management programme.

1) Disease modifying treatments

These attempt to reduce the underlying allergic response. The most effective are licensed immune-modifying drugs such as ciclosporin*, which when used long term reduces the allergic response. There is great hope for immunotherapy, where the immune system is gradually taught to tolerate certain allergic substances; this must be made up by a lab specifically for your dog’s allergies. Sometimes an allergy can be “cured” by this route, but it is more usually used to reduce the dog’s sensitivity.

2) Relieving symptoms

These act specifically to reduce the sensation of “itch”. There are three main drugs used for this. Firstly, antihistamines; these are not licensed for use in dogs and may have noticeable side effects, but a vet can legally prescribe them under the cascade if necessary. My experience is that they aren’t very reliable in dogs, but may be useful in some cases. There is also a new drug called oclacitinib which works purely to suppress a dog’s itch sensation. Finally, there are steroids. These reduce inflammation, mildly suppress the immune system and are very, very effective at reducing itching. They’re also inexpensive; however, if used long term, they have a wide range of side effects. They’re often best used as a “rescue” treatment, although steroid creams and sprays that can be applied directly to the sore spots on the skin have fewer side effects.

3) Reducing other sources of itching

This category would include products such as antibiotics for skin infections and antifungals for yeast infections (many of which are available as medicated shampoos), and parasite treatments for fleas and mites.

4) Reinforcing the skin barrier

This is a relatively new area, but seems to be a really useful in some cases or in addition to other treatments. There are soothing and hydrating shampoos which work to remove allergic substances from the coat and soothe the skin; as well as oatmeal shampoos which seem to have an anti-itching effect. Finally, there are the ω-3 fatty acids which appear to help many itchy patients; they may be in the diet (particularly in “skin” or “dermatology” diets), added to food as a supplement, or used as a topical spray or spot-on.

Overall, you and your vet need to find the combination of treatments that suit your dog. Managing the allergic pet is a big task, but I hope this has helped, and that you can keep your dog comfortable!

David Harris BVSc MRCVS

* PS – you may notice I’m using generic drug names not brand names in this article. This is because, for legal reasons, I’m not permitted to name specific brands in a blog like this. If you want to know more, check out the government’s Veterinary Medicines Directorate website.

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