Browsing tag: ideal weight

Fat pets: silently suffering due to their owners’ “kindness”

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

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

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

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

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

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

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

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

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

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

What NOT to feed your cat.

Gizmo eatingClients often ask me what they should feed their cats. It sounds like a simple question, but the answer is far from straight forward. The biggest debate amongst veterinarians at the moment is whether or not a cat should be fed dry food or wet food, or both. Personally, I tend to lean towards wet food as it seems to be the more natural option for a lot of different reasons that I won’t go into in this article. But I don’t necessarily recommend that to all of my clients. My own cat, for example, loves almost any dry diet but seems to hate wet food, so this is clearly not a good option for her. Being fussy creatures by nature, in most cases, the best food for your cat is the one that they will eat. But this isn’t always the case. Read on to see some examples of what NOT to feed your cat…

“I feed my cat only the finest fillet steak! Costs me a fortune, so it must be good for her, right?”

Short and long answer to that one – absolutely not. It’s true that in the world of well-balanced, scientifically formulated complete pet foods, you generally get what you pay for. More expensive foods, on the whole, tend to be of better quality than cheaper ones. But that only applies to complete, well-balanced pet foods. Just because a human food is expensive (ie, humans really like it and therefore are willing to pay a high price for it), doesn’t mean it’s going to do your cat any good at all. Sure, a bit of steak here and there isn’t going to hurt them, but by feeding your cat exclusively the muscle meat of any animal, they will quickly become deficient in a wide range of vitamins and minerals. There is, for example, very little calcium in muscle meat, to name just one. Other expensive human foods can even be dangerous for cats, even in small volumes. So if you ever feel like splashing out on your cat’s diet, put back the caviar and foie gras and ask your vet for their recommendation instead.

“But sometimes all she’ll eat are her treats, so I just give her those!”

The problem with this one is that unless your cat is extremely ill and you’re happy to get them to eat anything at all, this simply isn’t true. Cats are absolute masters when it comes to training their owners at mealtimes. And they’re not stupid. A normal, healthy cat will not starve itself. But they’ll certainly have you believe that they will. A normal cat (again, we’re not talking about sick cats here) who only eats treats, or some rubbish, unbalanced cat food, does so because their owner keeps providing it. Take it away and offer a balanced cat food, and eventually they will eat it. They may make you feel like you are the most horrible human on the planet for denying them their favourite food, but they will eat it. OK, you may have to try a few different flavours before you find one that they won’t argue about with you, but there is a good cat food out there that they will eat. And they will thank you with their good health, though not necessarily in any other way… Look at it another way, if somebody offered you a salad and a chocolate bar, you’d probably choose the chocolate bar. But that doesn’t mean you wouldn’t eat the salad tomorrow if that’s all there was! A word of caution though, if you try to change your cat’s diet, always do so gradually by mixing it in for a few days to avoid stomach upset. And if they really do go for more than 24-48 hours without eating their new food, speak with your vet for advice because it can be dangerous for a cat to not eat for too long and there may be an underlying medical problem that you didn’t know about.

“My cats deserve a special treat, so I give them tuna for dinner every night”

And I’m not talking about a complete and balanced tuna-flavoured cat food here, but tinned tuna for humans. In this case, it’s not the tuna itself that’s the problem (unless of course your cat is unfortunate enough to be allergic to tuna), rather the fact that it is fed as a meal every night. Too much fish can have inappropriate levels of calcium and phosphorus, and could lead to other problems like thiamine deficiency if raw fish is fed too often. There can also be low levels of toxins like mercury in some fish that won’t harm you if eaten occasionally but can build up if eaten in large quantities. It’s also worth noting that it is particularly important not to feed more than just the very occasional small treat of liver, as eating too much liver can cause serious vitamin toxicities. Like most things, moderation is key. Again, you might enjoy eating pizza for dinner every night, but it probably wouldn’t do your body any good. If you’d like to give your cats a treat, try giving them a different treat each time, provided each one is safe and not too high in fat, and give just a small amount of it, not a whole meal’s worth.

“I’m sorry, did you say crisps?”

Of course, there are some human foods that shouldn’t even be fed in moderation. You’d be amazed what some people will admit to feeding their cats as treats ‘because they really seem to like it’. Sure, your cat may love crisps, but they have absolutely no nutritional value for them (or us, really…), and are simply high in salt, fat, and carbohydrates. They may not necessarily hurt them, but they certainly don’t need them, and it’s not difficult to find them a more appropriate snack. Common human foods that probably shouldn’t be fed to cats in any quantity, no matter how much they seem to like them, include sweet or savoury biscuits, processed sandwich meat, and chips among many other things. You could also add milk and cheese to this list, although I haven’t had much luck convincing clients to give these treats up as they are used so commonly. Cats would not and probably should not naturally drink milk, and can in fact be allergic to it, it is only our domestication of them that has created this ‘need’. And then there are things like onions, chocolate, alcohol, tea, coffee, grapes and raisins that can be toxic in even small quantities so these should never be given to cats.

Daisy pinching foodWhether the problem is finding a food that your cat seems to like, your cat constantly crying out for food, or your own overwhelming desire to treat them to something you think is nice, it’s important to remember that as the carer of this domestic animal you are generally in control of your cat’s diet. If your cat is overweight, chances are you’re feeding it too much, no matter how much they tell you they’re starving. If your otherwise normal, healthy cat will only eat the most expensive smoked salmon, it’s because you offered it to them and they decided it was good enough to hold out for. And if you’re unlucky enough to have a cat that hunts you down and cries for a tasty treat even though you know they shouldn’t have it, be strong and walk away, or better yet, try some kind of distraction such as a toy or a good stroke. It’s not always food they’re crying out for, sometimes it’s the attention of being fed. But if it persists, be sure to take them to the vet for a checkup because constantly crying out for food can actually be a sign of hyperthyroidism or other serious illness.

Whatever the cause, if you find yourself with a feline feeding issue, speak with your vet because many times the solution is easier than you think. And remember, just because your cat wants it, doesn’t mean it’s in their best interest to have it!

If you are worried about any specific symptoms your cat may be showing, talk to your Vet or try our Interactive Cat Symptom Guide to help assess how urgent it may be.

Sammy’s Story – Feline Diabetes Isn’t As Scary As It Sounds!

Sammy catSammy is a lovely, and much loved, 13 year old moggie who has always been the picture of health. Healthy appetite, healthy weight and body condition – and he seemed pretty happy too. But a few months ago his owner noticed him at the water bowl more than she used to. At first she didn’t think anything of it, but with the extra drinking came extra urination, and it also seemed to be associated with an increase in appetite. But still she assumed that this was normal as the weather was getting colder and he was spending more time inside. However, at his next annual check-up with me, we found out that he had actually lost almost a pound in the past year. I recommended a blood and urine test and his owner agreed, and when the results came back the answer was clear – Sammy was diabetic.

His owner was in tears. How could she possibly cope with a diabetic cat? She works full time and has two small children, and besides, she has no medical training so how on earth would she be able to give an insulin injection twice a day? She even thought about having him put to sleep because she simply wasn’t going to be able to handle his condition. But we had a nice long chat about what it means to be diabetic and what the treatment would and wouldn’t entail, and by the end of the conversation she was willing to give it a try.

What is diabetes?

This gets a bit complicated, but I’ll do my best to explain it. Sugar in the blood (also called glucose) is a very important source of energy for the body and without it the body’s organs (particularly the brain) run out of fuel and start to shut down resulting in lethargy, confusion, fits, coma and even death. Too much of it however can also be harmful and diabetes is a condition that results in the cat’s blood sugar being too high. Most of the time this is because the body doesn’t produce enough insulin, the hormone responsible for lowering and stabilising blood sugar. High blood sugar in turn results in lots of very sugary urine which leads to more frequent urination, and the increased urination causes increased thirst and drinking. A lack of insulin also means that the body’s cells can’t use the glucose, even if there’s lots of it in the blood, so the body starts to break down other tissues such as fat and protein for energy. This then causes weight loss, but also an increase in appetite as the body tries to compensate. Therefore, the four most common symptoms of diabetes are:
Amber drinking

1. Drinking more than normal
2. Urinating more than normal
3. Eating more than normal
4. Weight loss

Diabetes is not the only disease that causes these symptoms, but if all four come together, it puts diabetes at the top of the list.

How is diabetes diagnosed?

Diagnosing diabetes sounds like it should be pretty easy – if a cat has high blood sugar, it has diabetes, right? Not quite. Cats can have high blood sugar for a couple of different reasons, the most common being stress. And what cat isn’t stressed by the time it gets to the vet, let alone has its blood taken for testing? It is therefore important for your vet to make sure that it isn’t just stress causing the high blood sugar. One of the easiest ways to do this is to test the urine for sugar as well – if there is sugar in the urine, chances are the cat is truly diabetic but this still isn’t a perfect test. If your vet suspects that your cat may have diabetes, a second blood test will typically be run. This could either be, depending on your vet’s personal preference, a single test called fructosamine, or a series of glucose measurements over several hours called a glucose curve. Fructosamine measures the average amount of glucose in the blood over the past 2 weeks (thus making it a more accurate test than a single glucose measurement) whilst a glucose curve measures both the highest and the lowest blood sugar levels on a curve over the course of a day. Both tests are used commonly and both can help the vet diagnose and treat diabetes.

And now the scary bit – how is diabetes treated?

Because diabetes usually means the body doesn’t make enough insulin, the best way to treat diabetes is to give the body more insulin. This may sound easy, but unfortunately insulin can only be given by injection with a needle under the skin. And it has to be given every day, usually twice a day, at about the same time each day so a regular routine is essential. The good news is that the needles are very very small, and so is the volume that needs to be injected. Therefore most of the time the cat doesn’t even seem to notice, especially once they get used to the process. The bigger concern for the cat is having to go into the vet periodically for check-ups and blood tests to see how their body is coping with the treatment, but even that isn’t too bad and once their condition is stabilised these checks can often be done less often.

Another thing that may help is a change of diet to something that is high in protein and low in carbohydrates (the nutrient that gets broken down into glucose after digestion). It is important to monitor your cat’s diet when they are on insulin, as if they do not eat regularly, the insulin could actually hurt them. Similarly, weight loss can help the body better regulate its glucose metabolism so losing excess weight in a controlled manner could make a big difference to their treatment and in some cases may even result in the disease resolving completely.

If your cat is diagnosed with diabetes treatment is essential. It is not generally acceptable to allow the disease to go untreated as it can cause significant discomfort and severe problems for the cat. With insulin therapy, a well-managed diabetic cat can go on to live many healthy, happy years. Insulin, however, is not without risks itself, as giving too much of it can result in a condition called hypoglycaemia, or blood sugar that is too low. As mentioned above, this is a life threatening condition that can result in lethargy, confusion, fits, coma and even death. You should speak with your vet about what symptoms to look out for and how best to manage them should they arise and it’s very important that you let your vet know immediately if you think your cat may be hypoglycaemic.

I am happy to say that both Sammy and his owner are doing very well today. His owner gives him two injections a day, which she has fit into the family routine and no longer sees it as a bother, just something else that has to be done. She has even offered to speak with other owners of newly-diagnosed diabetic cats to give them the confidence they need to get through the initial diagnosis and first few weeks of treatment. So if you find yourself with a diabetic cat, don’t be discouraged, it’s not actually that scary and yes, you can do it!

If you are worried that your cat is showing the symptoms described above, please talk to your vet or try our Interactive Cat Symptom Guide to help decide what to do next.

How can you tell if your pet is in pain?

Domino-sleeping
It seems a simple enough task, to be able to tell when your pet is in pain but actually it can be a lot harder than you think. Animals have been programmed over millions of years of evolution to hide when they are sore or in discomfort, otherwise predators and competitors would pick up on the signs and target them. So, as owners, we need to be vigilant to quite subtle changes in our pet’s behaviour that could indicate they are in pain, and ensure they don’t suffer in silence.

Depression

Most of us assume that if an animal is in pain they will cry out or whine but actually the opposite is true. Chronic (low grade and continual) pain is very depressing and often animals learn to cope with it and show few outward signs of a problem, other than maybe being quieter than normal or sleeping more. The problem with is that this sort of pain is common in older pets, for example with arthritis, and this is what we expect them to do anyway. However, even in excruciating pain our pets can be very quiet and withdrawn. I once saw a cat with a very badly broken leg who had managed to drag himself home, curl up in his basket and was so calm his owner didn’t think he was in any discomfort, until she saw the x-rays! Often with this type of pain, it is not until you give your pet some pain killers, and see the difference in their behaviour, that you realise how sore they were in the first place.

Lameness

A very common sign of leg pain, from pulled muscles to arthritis, is limping. Other than this the pet can seem quite well and cheerful, and often won’t respond to the leg being moved about or felt, which can lead to their owners thinking they aren’t in any pain, when nothing could be further from the truth! Lameness is a very common problem and if it lasts more than 24 hours (even if it is intermittent) the pet should always be checked over by a vet.

Smelly Breath

All pets have smelly breath to some degree (!) but halitosis can often be the only sign, without looking in their mouths, which some pets are reluctant to let their owners do, of painful teeth problems. Often people assume if their pet is eating then they aren’t in any dental pain but this isn’t the case, as an animal’s drive to eat will always overcome any soreness. In fact, if a pet does stop eating because of mouth pain, it is likely to be excruciating and will have been there for some time. Other signs of mouth pain include tartar build up on the teeth and swollen gums. If you are concerned, most vets run free dental clinics, so give them a ring and pop along.

Weight Loss
Bunnies

Our smaller pets, like rabbits and guinea pigs, are even better than cats and dogs at hiding when they are sore because, as prey animals, if they show any signs of being ill, they will be quickly singled out by predators. So their owners have to be even more vigilant to spot problems. In fact, it is not uncommon for these pets to be brought into our clinics close to death, their owners distraught that they have missed signs of a problem or thinking they have fallen ill very quickly, when it is more likely they have been poorly for a while but have managed to hide their symptoms. However, one thing which always happens if these animals are in pain or poorly is that they will lose weight, even if they appear to be eating normally. So, weighing your small pets regularly is a great way of monitoring them and any changes in a downward direction should always be taken seriously.

Our pets can’t speak for themselves and in many cases are too brave for their own good; trying to pretend that everything is fine when in fact they are in pain and suffering. So, all good owners should be alert to the small changes that could indicate a big problem and make sure they get them treatment they need and deserve.

If you are worried that your pet may be in pain, please contact your vet. If any other symptoms are present why not check the urgency of the problem by using our Interactive Symptom Guide?

New Years Petolutions!

It is the time of year for New Year’s Resolutions but if our pets were to make them, what would they be…..?

Dog

Grey-Collie-dogOh! A New Year’s resolution? That sounds fun! I can I do one? Can I, can I, please?! Right, OK, what should I try? How about slobbering less?! Could do but that would be VERY difficult and I think Mum would miss it, she always shouts with delight when I give her a big kiss, especially first thing in the morning when she hasn’t seen me for AGES! I love walks, what about going on more?! With Dad obviously, that time I tried it on my own wasn’t so successful. A lady caught me and I ended up at the VETS, yuk! But Dad soon came to collected me and said it was a good thing I was chips (I think!). I like chips, they let me eat the crunchy ones they don’t like. Anyway, yes, walks, I love them but wish I could go off the lead more (that’s why it was SO much fun when I went on my own!). Dad doesn’t let me much but I love to run. I know he gets a bit cross when I don’t come back straight away but it is so BRILLIANT to run, it’s what we dogs are made for! I suppose I would go back if he made things more interesting, like playing games or having some treats. Also, I am not very good at commands but then again we don’t practice them much and my doggy brain needs to be reminded otherwise I forget stuff. So, more walks where I can run, yes, that would be it! Now, where’s Mum, I feel a good slobber coming on!

Cat

Amber

A New Year’s resolution? That sounds like hard work, can’t I just lie here and sleep? I like sleeping, I am very good at it, maybe I should resolve to do it more, I think I could just about manage another hour or so a day, it is a very busy life you know. I used to run around when I was younger but it is much easier now to lie still now, the staff say that is because I am slightly larger than I used to be but I know that I am perfect. There is always a full bowl of biscuits down, but what is a cat to do, ignore them? I don’t think so! Obviously I don’t always eat everything I am given, sometimes I just lick the gravy or jelly from the meat course but that is mainly to keep the staff on their toes and the menu varied. I did hear mention if I stay this cuddly I could get problems like arthritis or diabetes, which don’t sound very nice, so maybe I should try to slim down a bit. Hmm, I shall sleep on it, zzzz.

Rabbit

Bunny

Well, yes, a New Year’s resolution, I think I could manage that. Let me just clean my paws while I think. It would be nice to nose twitch to a friend about it but I don’t have one. nibble nibble I do get lonely on my own, the people come to see me every day, especially the little one, but it isn’t the same as having somebun here all the time. nibble nibble We bunnies naturally get on together well, think how many friends I would have if I lived in a burrow! One thing I know I should do is eat more hay, it is good for my teeth and tummy, nibble sniff nibble, but when there is a full bowl of yummy pellets around all the time, it is very difficult to resist them and then I don’t have any room for hay! nibble, clean ears, sniff, nibble So, I will try to eat more hay, but what I would really love is a friend! nibble, nibble, nose twitch, big sigh!

Our pets have simple needs and wants and it would be so easy in most cases to help them! Maybe that could be your New Year’s Resolution and then everyone’s a winner!

Why not take a look at our Pet Care Advice pages? Or if you are worried about your pet, check the problem with our Interactive Symptom Guide.

What Your Rabbit Really Needs

Bunnies crop

Rabbits are really popular pets in the UK, second only to cats and dogs, and they can make great companions. However, despite peoples best efforts their needs are often misunderstood and rather than being treated as the intelligent, social animal they are, many are condemned to a life of loneliness and boredom in a cage at the bottom of the garden. It is not difficult to look after rabbits in a way that will keep them both healthy and happy, so what do they really need?

The most important thing you can do to keep a rabbit healthy is feed them a balanced diet. The most common problems that vets see in rabbits are over-grown teeth, tummy upsets and obesity related disease, all of which are directly related to them being fed incorrectly. The vast majority of a rabbit’s diet, at least 80%, should be good quality hay. As a rough guide, every day a rabbit should eat a pile of hay as big as it is. Rabbit’s teeth grow continually and without hay to grind them down, they can develop painful spikes, which rip into the tissues of the mouth, and nasty abscesses in the roots. Hay is also required for good digestion (rabbits can easily die from upset tummies) and helps prevent them getting fat. In addition to hay rabbits should have a small amount of fresh vegetables every day, half a handful is enough and a small amount of pelleted rabbit food, no more than a tablespoon twice a day. This is often where people go wrong, leaving the rabbit with an over-flowing bowl of rabbit food, which, because it is high in calories and very tasty, it is all they eat, giving them a very unbalanced diet.

Rabbits are extremely social creatures, in the wild they live in large family groups, and they should never be kept on their own. The best thing to do is to buy sibling rabbits when they are young. You can introduce rabbits when they are adults but it has to be done with care as many will fight at first. However, it is important to persevere and get the right advice as rabbits are miserable when alone. They are also very intelligent, so make sure they have a variety of toys in their cages and runs to keep them entertained. These don’t have to be expensive, there are plenty of commercially available rabbit toys or just a couple of logs they can play on and nibble are fine.

All rabbits should be neutered, even if they are kept with others of the same sex, and this can be done from the age of 4 months for boys and 6 months for girls. Neutered rabbits make much calmer pets and are far easier to handle. They are also much less likely to fight with each other; 2 entire males kept together, even if they are siblings, can become very aggressive once their hormones kick in. Neutering also has huge health benefits, particularly for the females, of whom 80% will get uterine cancer if they are not spayed.

For most people the whole point of owning a rabbit is because they are cute and cuddly creatures but anyone who has tried to pick up a startled or poorly handled rabbit will know that they can do a lot of damage with their strong nails and back legs! So, it is important that they are played with and handled everyday so they are used to human interaction. Rabbits are prey animals in the wild and their only defence mechanism when frightened is to struggle and try to run away. This is why they don’t always make great pets for children, who can be, unintentionally, quite rough or unpredictable in their handling and it is a big reason why rabbits bought as pets for children end up forgotten and neglected at the bottom of the garden; because no child will play with a pet which has hurt it. However, with regular, careful handling from an early age rabbits can become great companions and members of the family.

Rabbits can make great pets but they need just as much care and attention as other animals and shouldn’t be seen as an ‘easy’ option. Although they are often bought for children they are not always the most suitable pet for young people and they should always be kept with at least one other rabbit. However, they can be real characters once you get to know them and really give back what you put in, provided, of course, you give them what they really need!

For details on examining a rabbit, neutering and vaccinations, take a look at our Pet Care Advice pages. If you are worried about any symptoms your rabbit may be showing, talk to your vet or use our Rabbit Symptom Checker to help decide what to do.

Urinary Incontinence in Bitches

Holly, a Golden Retriever, age 13

Holly, a Golden Retriever, age 13

Holly, a 13 year old Golden Retriever bitch, is a regular boarder at my kennels. Recently she developed urinary incontinence, and her owner feared she might have to be put down. The problem can be difficult to live with because of the smell, increased washing, damage to carpets etc. Just as importantly, it is distressing for the bitch herself who would like to keep herself clean but is unable to stop the leakage of urine.

Fortunately Holly’s owners discussed the problem with their vet who prescribed some treatment which now has the problem under control.

We all dread our pets growing old, and one of the problems we tend to associate with ageing is urinary incontinence, or leakage. Although this happens mainly in older bitches, it is not a problem that has to be just lived with. In many cases there are treatments which can help control this, and can greatly improve quality of life.

Urinary incontinence can happen in both dogs and bitches, but is much more common in bitches. It can also be related to being overweight, and being spayed. In younger animals it can be due to a congenital abnormality (present since birth).

Although incontinence is more common in spayed bitches, this does not mean that spaying is a bad thing. There are many benefits which together outweigh the disadvantages (Please see our Pet Care Advice section, Neutering, for further information about this)

Urine is produced continuously by the kidneys, and is stored in the urinary bladder. When the dog or bitch urinates, the urine is expelled along a tube called the urethra. The rest of the time, urine is prevented from leaking out by the urethral sphincter muscle. Usually, control of this sphincter muscle is under the voluntary control of the dog, so once they have been trained when and where to urinate, they go in the right place and at the right time.

The most common cause of incontinence, especially in older bitches, is urethral sphincter incompetence. If the sphincter muscle loses tone, it can allow urine to leak out. The bitch will still be able to urinate voluntarily when she wants to, but there will also be leakage, often without her even realising it. She will of course clean herself up if there is leakage, but she will be unable to stop it from happening.

The signs of incontinence are wet patches where the bitch has been lying down, wet legs, infections of the skin and excessive licking at the vulva. There is not necessarily an increase in the amount that is being drunk or being urinated, but if these are increased as well then that also needs investigation.

As always, your vet will first need a full medical history and will need to make a full examination of your dog, probably including blood tests and urine tests. It can also be helpful to examine the urinary tract by ultrasound scan, or by x-rays using special contrast medium to help show up the size, shape and position of the bladder and the urethra. It is important to check for problems other than incontinence, and for other causes of incontinence, such as urinary infection, bladder stones, liver and kidney disease and diabetes. Any of these would require quite different treatment. Once these have been either ruled out or treated, if incontinence is still a problem then it can be treated.

A number of drugs are available which help by acting on the muscle of the urethral sphincter. The drugs may be given either in the form of a syrup which is given on food, or as tablets. As with all drugs, there can occasionally be side effects which your vet will ask you to watch out for. Very often the problem is greatly improved and the treatment can be successfully continued long term at a maintenance level.

In a few cases there is no improvement, and then other causes need to be investigated further. In a small number of dogs there is a physical abnormality which could benefit from surgery (such as repositioning of the bladder neck). These cases involve quite specialised treatment and might need a referral to a specialist veterinary centre.

Incontinence is a distressing problem for both dog and owner, but it is well worth seeking advice from your vet on the treatments available.

If you are worried about urinary incontinence or any other problem with your pet, please talk to your vet or use our Interactive Symptom Guide to help decide what to do next.

Pain Part 2: Getting rid of pain

Pain and pain relief are massive topics which can – and do – fill several textbooks. It’s way beyond the scope of a blog to go into all of the detail surrounding the use of painkillers, and so all I really want to do is to outline some of the different types of pain control that we can use, both in the surgery and as day-to-day treatments.

Pain relief is one of the great success stories in medicine, and it’s no coincidence that some of my favourite drugs of all time are painkillers. Our advances mean that pain in our patients shouldn’t be accepted, and although sometimes we fail to control it, we should never stop trying.

We use a number of different types of painkiller:

  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Steroids
  • Opioids and opioid-like drugs
  • Others

NSAIDs

These are the most widely-used type of painkiller and include (for humans) aspirin, ibuprofen and paracetamol. They act by stopping inflammation.

They’re commonly prescribed for post-op pain and for joint problems and may be given for long periods of time. When you’re given painkillers to take home from the vets, they’re usually NSAIDs.

Three things to really take on board with these drugs:

  1. Human drugs are not always safe for pets, so never give anything to your pet without talking to your vet first: half a paracetamol can kill a cat, a big dose of ibuprofen can do the same to dogs and even a solitary aspirin can be a lethal overdose for a toy breed, designed as it is for a much bigger animal (us). This is why we have veterinary-licensed drugs for our patients.
  2. Increasing doses won’t give more pain relief, and may cause side effects. If they’re not working for your pet, talk to your vet about alternatives.
  3. NSAIDs are most effective when given before the inflammation starts. It might seem odd to suggest giving painkillers before the pain even begins, but this is important in treating chronic, repeated and predictable pain like arthritis.

Two of the most common drugs we use are meloxicam and carprofen. Meloxicam usually comes as a syrup, which can be dosed very accurately, and carprofen is generally in tablet form. Both drugs may be used long term as a daily dose and both have been responsible for giving patients their lives back, sometimes for years. We’re also rediscovering paracetamol as an excellent addition to treatments in dogs.

Recently, newer NSAIDs have been introduced which are labelled either as cox-2 inhibitors (e.g. firocoxib), or else dual inhibitors (tepoxalin). Essentially, these are just descriptions of which bit of the inflammatory cascade they act upon, and they’re designed to reduce some risks of side effects that we see with other NSAIDs. It’s arguable, though, as to whether they’re better at relieving pain than some of the older drugs.

More recent still is Trocoxil, an NSAID for dogs which is only given once a month. The theory is that because it acts as a persistent block to inflammation, there’s no point where the vicious cycle of pain can really take a hold. The exact ins and outs of the drug are a bit too much to go into here, but as always, speak to your vet about this medication if you’re interested in finding out more. Do understand, though, that it’s not for every patient and your vet may have good reasons not to use it on your dog.

Steroids

Steroids are very powerful anti-inflammatories, which gives them painkilling properties. However, they also affect the immune system – many patients take them for allergies and auto-immune problems – and can have major side-effects when used long-term at high doses; they also can’t be given with NSAIDs and so for practical reasons their use as painkillers is limited. You may have experience of PLT (Predno-LeucoTropin), a medicine with a steroid component which can be great for chronic pain when other drugs seem to be failing. It’s been around for a long time, and many an experienced vet will recognise its usefulness.

Opioids

Opioids are a group of drugs which act to block the passage and brain detection of pain signals. The classic drug in this group is morphine, which still forms the basis for relief of severe pain in humans. These are very powerful painkillers indeed, although the degree of pain relief depends on whether they’re what we call a full-agonist or a partial-agonist.

Drugs like morphine, pethidine and fentanyl are full-agonists, and tend to be used only within the surgery. They are subject to close control and are never dispensed. Generally they’re given by injection, although fentanyl is available as a long-acting skin patch, which has been very successful for use in trauma patients like RTA cats.

Buprenorphine and butorphanol are partial-agonists and are often used as part of a pre-med before surgery. Buprenorphine is a great painkiller which is usually injected within the practice, but may occasionally be dispensed for oral, very short-term use. It is certainly useful in breaking pain cycles and allowing us to get onto more stable pain relief regimes. For in-patients where NSAIDs either don’t quite cut it, or else a combination therapy is needed, buprenorphine is an excellent drug.

A drug that we’ll often use long-term in out-patients is tramadol. This is a human drug which acts in a similar manner to opioids, and has a number of significant advantages:

  1. It’s usually pretty safe, although it can temporarily knock some patients a little flat. Your vet should tell you about this when prescribing.
  2. It’s a GOOD painkiller
  3. As it has a different way of working to NSAIDs or steroids, it can be used in conjunction with many other drugs to create a better painkilling effect

Others

Other drugs that we use act in novel ways, or else are designed for other purposes but just happen to help with pain control. These are important drugs, and whilst they’re described last they’re definitely not least in importance. In brief:

  • Local anaesthetics may be used in and around surgery, to numb the pain nerves. These tend to be injectable, although some creams are available which can be useful to pre-treat patients with needle phobias and the like.
  • Ketamine – yes, the horse tranquiliser – has been used for years in emergency medicine as a painkiller; it’s often included in battle packs for soldiers. Its use in our patients is quite specialised and confined to hospital environments.
  • Gabapentin. This is a very interesting drug indeed. It’s normally used as an anti-epileptic, but seems to have a great effect on pain of nervous origin (aka neuropathic pain), so can be useful for spinal and neurological conditions.
  • Cartrophen is an anti-arthritic drug (also sometimes used in bladder problems in cats) which has a number of effects on joints. It’s usually given as four weekly injections, followed by a variable period of remission. It can be very beneficial for some arthritis patients, but may need a little forward planning in its use, as its administration isn’t recommended at the same time as NSAIDs. It’s certainly a drug worthy of close inspection in long term arthritis cases.

Integrated methods of pain control

Whilst it’s obvious that we have some great drugs for relieving pain, reliance on drugs alone in any condition is generally a limiting approach, as adding in other treatment types – or modalities – may offer greatly increased success rates.

For example, in heart disease drugs may help to keep the cardiovascular system going, but are much less effective when used by themselves than in an overall strategy including lifestyle change, weight loss, exercise programmes, regular monitoring and support networks.

Similarly, drugs may form the heart of a pain relief strategy, but shouldn’t be used as an excuse to avoid other measures that can help – and there are even times when non-drug pain control is good enough that painkillers are not needed. Whatever the non-drug modality used, the decision on when not to use painkillers is a simple one:

  1. The pain is being completely controlled by non-drug methods.
  2. That’s it.

Remember that phrase – pain is not acceptable in our patients. If nothing else, these blogs should have explained both why pain is a bad thing in the long run, and the sheer number of drugs that fight pain. Treating pain completely without drugs is a brilliant solution, but simply taking the edge off the pain is not enough. Equally, though, finding a number of ways to help with the pain will almost certainly mean that your pet gets more relief and is happier.

Treatment modalities which can help in chronically painful conditions include:

  • Acupuncture – there’s a reasonable body of evidence for the physical effects of acupuncture and theories of how it may ‘close the gate’ on pain. It’s now widely available around the country, but must be performed by or under the direction of a vet.
  • Supplements – for joint problems, there are a number of supplements containing combinations of glucosamine, chondroitin and green-lipped mussel extract, which protect the cartilage and may even get rid of the need for painkillers in early arthritis. Additionally, essential fatty acid supplements and vitamin E are both mooted as aids to tissue repair and free-radical scavenging.
  • Herbal remedies containing Devil’s Claw are widely available, but be warned that the supplement can cause side effects and that clinical trials have produced highly variable results.
  • Weight loss – whilst it’s obvious that in arthritis, every excess ounce is another ounce of pain, recent work has suggested that body fat has a chemical pro-inflammatory effect which may exacerbate pain generally. Reducing body fat may reduce the body’s pain responses, particularly in chronic conditions.
  • Surgery – for many painful conditions, surgery is the obvious treatment to permanently remove the pain at source.
  • Physiotherapy – hydrotherapy, mobilisation, massage and PROM are all very useful in promoting recovery and dealing with chronically painful conditions. Access to these services is usually by referral from your vet, and animal physios are highly qualified professionals.
  • Mood enhancement – pain is depressing, so elevating mood helps patients to cope, and also makes new pain easier to deal with. A number of products are available, from pills (including zylkene, a natural extract, and amitryptilline) to pheromone sprays and diffusers (feliway, DAP), but equally, promotion of routine and enjoyable activities can be very successful.
  • Prevention –as the best pain relief is prevention, a word should be said about how we avoid seeing dogs with arthritis or cats with pancreas issues in the first place. Also perhaps timely, as the Animal Health Trust, in conjunction with Edinburgh Vet School, have just announced a project into genetic testing for hip and elbow dysplasias in Labradors. Being able to breed the conditions out of our patients will have a major impact on the wellbeing of future generations (so, if your Lab is KC registered and hip scored, the AHT might just want to hear from you).
  • Magnet therapy – to this day, I still don’t know if this really works, but plenty of my clients are convinced – including a large proportion of horse owners, who are about the most hard-bitten, unpersuadable people out there.

There are, of course, countless other integrated therapies, like Reiki or Homeopathy, and each will have their champions and detractors. The important factors with any of these are choice and inclusivity – it’s fine to explore all of the possibilities, but not to the detriment of the patient. As a general rule, the vet who prescribes you meloxicam won’t demand that you stay off the Reiki during treatment, and this should work both ways.

The mainstay of pain relief will always be drug therapy, but its effectiveness can be massively enhanced by looking at integrated treatments. Pain is such a debilitating problem that anything which can help to remove it has got to be worth exploring. If you feel that your pet may be in pain, especially if you’re already giving treatment, then speak to your vet about what you can do – there are so many ways to target pain that there’s bound to be something to help.

And do remember that phrase: pain is not acceptable in our patients.

If you are worried about your pet’s health, talk to your vet or use our Interactive Symptom Guide to help assess how urgent the problem may be.

Neutering dogs – Bitch spay operation: a step by step guide

Deciding whether to spay

Spaying or neutering a female dog is not a small operation, so owners should think carefully about all the pros and cons before deciding.

The main advantages of spaying are preventing pregnancy, preventing infection of the uterus (pyometra), preventing ovarian or uterine cancer and reducing the likelihood of mammary (breast) cancer, all of which can be life-threatening. It also prevents the inconvenience of having a bitch in season with unwanted attention from male dogs.

The main disadvantages are major surgery with associated risks, an anaesthetic with associated risks and the increased likelihood of urinary incontinence in later life. Fortunately, the risks involved in anaesthesia and surgery are very small indeed compared with the risks of the other conditions which are prevented by spaying. Urinary incontinence in later life is a nuisance but not very common, and can usually be controlled by drugs.

There is no medical reason to let a bitch have one litter before spay, in fact some of the benefits like protection against mammary tumours, are lost if the operation is delayed. Unless an owner is committed to having a litter, with all the work and expense that can be involved, and the bitch is also suitable in temperament and free of any hereditary problems, then breeding should not be considered.

Tilly GrinSome people expect that their bitch will get fat after spay, but in fact this is entirely preventable with a healthy diet and proper exercise.

My own opinion is that most bitches should be spayed because of the health benefits. My boxer bitch Tilly was recently spayed.

Deciding when to spay

It is not a good idea to spay when a bitch is in season or about to come into season, because the blood vessels supplying the uterus and ovaries are all larger and this will increase the risks of surgery. The other time we try to avoid is the 8 weeks after a season, when a bitch may suffer from a hormonal imbalance called a false pregnancy. If this happens, she may be acting as if she is nursing pups and the operation at this time would cause such sudden changes in hormone levels that it would be unfair to her. Also if she was producing milk, the enlargement of the milk glands would make it more difficult for the spay wound to heal.

For all of these reasons, the time chosen to spay is usually either before the first season occurs, or 3-4 months after a season. A physical examination by the vet will determine whether a 5-6 month old bitch puppy is mature enough to spay before her first season.

Before the operation

As well as timing the operation carefully to reduce any risks, it is also important that the bitch is not overweight. Because this increases the difficulty of the operation, it may well be advised that an overweight bitch should lose weight before the operation.

Another important way of spotting avoidable risks is by taking a blood test before the anaesthetic. This could be done on the day of the operation or a few days earlier. This is used to check the liver and kidney function (both vital when dealing with anaesthetic drugs) and to rule out any unsuspected illnesses.

Before going to the surgery

Before any anaesthetic the patient should be starved for a number of hours, according to the instructions of the surgery. This prevents any problems with vomiting which could be dangerous. It is also a good idea to allow the dog enough exercise to empty the bladder and bowels. Apart from that, it is best to stick as closely as possible to the normal routines of the day so that the dog does not feel anxious.

Being admitted for surgery

On arrival at the surgery, you can expect to be seen by a vet or a veterinary nurse who will check that you understand the nature of the operation and will answer any questions you may have. They will ask you to read and to sign a consent form for the procedure and ask you to supply contact phone numbers. This is very important in case anything needs to be discussed with the owner before or during the operation.

Before the anaesthetic

Your bitch will be weighed to help calculate the dosages of drugs and given a physical examination including checking her heart. If a pre-anaesthetic blood test has not already been done, it will be done now and the results checked before proceeding. If any abnormalities are found, these will be discussed with the owner before deciding whether the operation goes ahead or not. One possible outcome is that extra precautions such as intravenous fluids may be given.

A pre-med, which is usually a combination of several drugs, will be given by injection. This begins to make the dog feel a bit sleepy and ensures that pain relief will be as effective as possible.

The anaesthetic

There are several ways in which this can be given, but the most common is by an injection into the vein of the front leg. The effects of the most commonly used drugs are very fast, but don’t last for very long, so a tube is placed into the windpipe to allow anaesthetic gas and oxygen to be given. The anaesthetic gas allows the right level of anaesthesia to be maintained safely for as long as necessary.

Various pieces of equipment will then be connected up to monitor the anaesthetic. This is a skilled job which would usually be carried out by a qualified veterinary nurse. Apart from the operating table, the instruments and the anaesthetic machine, a lot of specialised equipment will be on “stand by” in case it is needed.

The area where the surgical incision is to be made will be prepared by clipping and thorough cleaning to make it as close to sterile as possible. The site is usually in the middle of the tummy, but some vets prefer to use an incision through the side of the tummy.

The operation

While the bitch is being prepared for surgery as mentioned above, the surgeon will be “scrubbing up” and putting on sterile clothing (gown, gloves, hat & mask) just as in all television surgical drama programmes. The surgical instruments will have been sterilised in advance and are opened and laid out at the start of the operation.

The operation involves removal of the ovaries and uterus (ovario-hysterectomy). The surgeon carefully opens the abdomen by cutting through the various layers. The first ovary is located and its blood vessels are tied off before it can be cut free at one end, then this is repeated with the second ovary. It is a delicate and fiddly job, needing great care and attention. The main body of the womb or uterus is then tied off as well before the whole thing can be cut free and removed. After checking for any bleeding, the layers of the tummy can then be sewn closed again. A dressing might be applied to the wound. Further drugs may be given now as needed.

When the operation is finished, the gas anaesthetic is reduced and the bitch begins to wake up. She will be constantly monitored and the tube removed from her windpipe when she reaches the right level of wakefulness.

Recovery

Like humans, dogs are often a bit woozy as they come round, so she will be placed in a cage with soft warm bedding and kept under observation. Usually they will wake up uneventfully and then sleep it off for the rest of the day.

After-care

The bitch will not be allowed home until she is able to walk and is comfortable. Full instructions should be given by the surgery concerning after-care. The most important things would be to check the appearance of the wound, to prevent the bitch from licking it (with a plastic bucket-collar if necessary) and to limit her exercise by keeping her on the lead. Any concerns of any kind should be raised with the surgery.

Any medication supplied should be given according to the instructions. Pain relief can be given by tablets or liquid on the food. Antibiotics are not always needed, but may be supplied if there is a need for them.

Usually there will be stitches in the skin which need to be removed after about 10 days, but sometimes these are concealed under the surface and will dissolve by themselves.

tilly's wound with text

After a couple of weeks, if all goes according to plan, the bitch can be allowed to gradually increase her exercise levels. This is the stage that Tilly has now reached and she is thoroughly enjoying a good run again now that she is feeling back to normal.

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.

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