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Babesiosis – a new arrival to the UK

On 16th March this year, newspapers and news feeds across the UK broke the news that a new "deadly tick-borne disease" had been diagnosed in dogs in Kent. The disease turned out to be babesiosis - a parasite of the red blood cells, similar in many ways to malaria, transmitted by tick bites. The condition has now, apparently, reached the UK for the first time. So, how seriously should we take the stories, and are they accurate?

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Ask a vet online – “My dog has trouble peeing”

Question from Jaamal Dupas: I have a 7 month old female dog. When she squats to pee the first time it's normal. Then she tries again and only a few drops. And i noticed a drop of blood the last time she went. Could this be a UTI or her going into her first heat. I have a vet apt in a few days but was just curious. Answer: Pee Problems-dribbling and blood Hi Jaamal, thanks for your question about your dog’s urinating. To answer your question, I’m going to discuss the “symptoms” she’s showing, the possible causes, and then talk about how your vet will go about deciding which one of these conditions is the cause, and the treatment options. What are the symptoms? Technically, in animals they’re called clinical signs, not symptoms, but it means the same thing. In the case of your dog, she’s able to urinate, but it’s taking her two or more goes to empty her bladder. This is technically called “pollakiuria.” The other problem you’ve noticed is that there was a drop of blood in the urine last time she went-this is called “haematuria.” What are the possible causes? Before your vet can determine what the exact cause is, they’ll need to make what’s called a “differential list”-this is a list of the possible conditions that could cause the clinical signs observed. In your dog’s case, we can factor in her age and sex to narrow it down a little bit. So, what are the likely possibilities? 1) A urinary tract infection This is probably the most likely cause! Urinary tract infections in bitches are quite common (more so than in male dogs, because the urethra, the tube that leads from the bladder to the outside world, is shorter and wider). The typical symptoms are an increased frequency and urgency of urination, with some blood in the urine. Your vet may want to do some more tests to confirm it (see below), but it is the most likely explanation. 2) Bladder stones or crystals Sometimes, due to diet, infection or genetics, the crystals that can form in the bladder enlarge and become stones blocking the urethra. These can be very painful, and often mean it’s difficult for the dog to urinate. I don’t think it’s that likely in your dog’s case because it sounds like she passes urine quite easily, but it is a possibility. In dogs, many crystals and stones are actually due to untreated infections! 3) Her season (oestrus) As you’re aware, some blood from the vulva is quite normal in bitches during their season (usually every 6–8 months or so)-see here for more info on them: http://www.vethelpdirect.com/vetblog/2014/12/16/ask-a-vet-online-what-age-do-seasons-stop/. It isn’t usually associated with passing drops or dribbles of urine though, so although I can’t rule it out, I don’t think it’s the most likely cause. 4) Trauma or injury Obviously, anything that makes it uncomfortable to urinate may make her stop and start when she’s going. Cuts or bruises around the vulva would account for the signs, but I think there would be more obvious issues, such as obvious pain or swelling or visible wounds. 5) A womb infection A womb infection can leak brown or red pus that looks very like blood; however, if it occurs it’s usually a few weeks after a season, and you obviously don’t think she’s had her first yet. Although it’s unlikely, I’d always keep it on the list until it can be ruled out, because dogs can become very sick very fast. 6) A bladder or urethra tumour This is a theoretical possibility, but in a 7 month old I would have to have ruled EVERYTHING else out before I considered it! Where next? You’ve already made an appointment with your vet, which is very sensible. As we suspect a urinary infection, I’d advise you to catch a sample of urine before you go in (as fresh as possible, caught in a CLEAN pot), as your vet may well want to do some tests. Once you get to the vets, they’ll ask you some questions to determine if there are any other symptoms or signs (for example changes in drinking), then they’ll examine her. They may want to take a swab from her vulva to see if she is in fact in season or not; they’ll also have a good feel of her abdomen and bladder to see if they can feel any abnormalities; and look at her vulva for signs of infection or injury. My experience is that in simple urinary infections, there’s often nothing abnormal on the physical exam-quite often there won’t even be a temperature! That’s why the urine sample is so important. The vet (or their nurse or tech) will usually do a dipstick to look for blood, protein, acidity and so on, which can be suggestive of infection. If there are any abnormalities, they’ll often look at the urine down the microscope, looking for bacteria and white cells, which will confirm the presence of an infection; and for crystals which may indicate a problem with crystals or stones. If their findings suggest an infection, and there are a lot of antibiotic resistant bacteria in your area, the vet may choose to send away the sample to check which antibiotic is most effective. However, if it is a simple urinary tract infection, in most cases it will resolve quickly with a course of antibiotics and possibly some painkillers. I hope my answer has helped you understand the possibilities, and that with your vet’s help, she’s soon getting better! David Harris MRCVS If you have any worries about your pet, please make an appointment with your vet, or try our Symptom Guide.
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Do you know when your pets are poorly?

It may seem like a silly question, of course you would know when your pets are sick wouldn't you? They share your life, your home and you know them really well, just as you do other members of your family. However, what many people don’t realise is that our animals are extremely adept at masking signs of illness and often by the time we realise there is a problem, they have been struggling for a while. This blog was inspired by a cat I saw last week. She was owned by some lovely clients; regulars with their other pets and they definitely have their best interests at heart. I didn't blame them for not noticing sooner this one was poorly because a) felines are notoriously good at hiding illness and b), you know, I'm a vet, so really I should be quite good at spotting when animals are sick but I don’t expect others to be. However, I think they may have realised they had left it a little long to bring her; several times during the consultation the husband mentioned that they had waited because she didn't seem in ‘distress’ and here in lies the nub of the matter for this cat, and for many of the pets I see. Animals are very, very good at hiding when they aren't feeling well or are in pain. You could say they are made of much sterner stuff than us humans, and they probably are, but in the main this characteristic comes from millennia of evolution; in the wild sick creatures are soon picked off by predators. This means that even when they feel dreadful animals will do their level best to behave as normally as possible or they may simply go off and sit quietly in a corner or curl up and sleep much more than usual. What they won’t do it moan or groan (or winge and demand tea and sympathy!), the most we might get is a reduced appetite or a limp. This is especially true of problems like arthritis, cancer or kidney failure, all of which are common in older pets. Sadly this little cat had the latter of these and I will tell you how this tale ends now; blood tests showed her renal function was so damaged the kindest thing was to put her to sleep. Many people would think it almost impossible to not notice a pet was so sick they were near death but this is not the first time I have dealt with a case like this and it won’t be the last. Obviously you don’t want to be dashing down to the surgery every 5 minutes when a pet isn't quite themselves but neither do you want to leave things too long. So what is best to do? My advice would be to always be aware of how your pets are and if they have seemed ‘off’ for more than a day, ring your practice for a chat. A good clinic should take the time to speak to you and help you decide whether there is really a problem or not or use the symptom checker on this website! Cat Henstridge BVSc MRCVS - Read more of her blogs at catthevet.com
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Ask a vet online – Why is my staffy rubbing his bum on carpet after his glands were done? – Anal gland problems in dogs.

Question from Jo Padfield Why is my staffy rubbing his bum on carpet after his glands were done. Pls Answer from Shanika Winters (online vet) Hi Jo and thank you for your question about your dog’s anal glands. I will explain a little about what anal glands are, where they are and why dogs have them followed by a discussion of what can go wrong with them and how these conditions are treated. What are anal glands? The anal sacs (commonly called the anal glands) are a pair of sacs found either side of the anus (bottom); they are around 1cm across and open via a duct (tube) in the anus. As with your dog the anal sacs often become blocked and or infected and this is called anal sacculitis. The substance inside the anal sacs is produced by glands that line the inside of the sacs, this smelly substance should be passed each time your dog does a poo, and leaves a scent marker to other dogs. What goes wrong with the anal sacs? Diseases of the anal sacs include anal sacculitis as mentioned and less often tumours. Other conditions around the bottom include anal adenoma (small non-cancerous lumps around the anus), anal furunculosis (cracked infected skin around the anus usually found in German Shepherd Dogs) and perianal hernia (where muscles weaken and separate either side of the anus allowing pelvic and abdominal contents to push through, seen in older uncastrated male dogs). It is really important to have your dog thoroughly examined by your vet to make sure that the condition has been diagnosed correctly so that the correct treatment can be given. How are blocked anal sacs treated? We usually treat blocked anal sacs by manually emptying them out, this can be done by inserting a gloved finger into the anus and gently squeezing on the sac to empty the contents into a piece of tissue paper. The anal sacs can be emptied from the outside but this does not allow the anatomy of the sacs to be examined as thoroughly. Some owners feel confident that they can learn to empty their dog’s anal sacs, this is something to discuss with your vet who can show you how to do this. If there is infection in the anal sacs then your vet might give your dog antibiotics, this can be given orally or put directly into the anal sacs after they have been flushed out. If the anal sacs are going to be flushed out, most dogs will need sedation or general anaesthesia to allow this to be performed, a small cannula (plastic tube) is passed into the anal sac via the opening of the duct on the anus and saline is then flushed in and the glands then emptied, the process is repeated until the glands appear clean. Antibiotic and anti-inflammatory preparations can then be put into the anal sac. Sometimes steroids may also be given to ease the irritation caused by anal sacculitis. Anal sacs sometimes are not properly emptied if your dog has soft poo or diarrhoea; this usually improves once your dog’s poo is firm again and can be helped by a change in diet. When is surgical removal of the anal sacs an option? If there are severe repeated anal gland infections and the dog does not tolerate medical treatment and manual emptying of the anal sacs then surgical removal is considered. The procedure is performed under general anaesthesia and does carry a small risk of disturbance to the dog’s ability to control passing poo. In most cases the lack of control when pooing is temporary but due the closeness of the nerves controlling continence to the anal sacs themselves there is this risk of them being damaged. Remember that your vet will discuss the pros and cons of a procedure with you so that a joint and informed decision can be made by you with the help of your vet. I hope that this answer has been helpful for you and that your dog starts to feel more comfortable soon. Shanika Winter MRCVS (Online Vet) If your dog has a problem with its anal glands please book an appointment to see your vet, or use our online symptom checker
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Ask a vet online – ‘My dog keeps shaking his head and scratching his ears’

Question from Amanda Shaw My dog keeps shaking his head and scratching his ears, they feel a little bit swollen but they are cleaned often so no mites he is lively and not off his food I'm at a loss. Answer from Shanika Winters MRCVS, online vet Hi Amanda and thank you for your question about your dog’s ears. It is great that you are cleaning your dog’s ears regularly. I will discuss a list of possible causes for your dog to be shaking his head, scratching his ears and for the swelling followed by some treatment options. Why is my dog shaking his head and scratching at his ears? The symptoms you have described could be due to a foreign body e.g. a grass seed down the ear canal, bacterial or yeast infection, skin allergy, parasites e.g. ear mites, polyps or an aural haematoma (blood blister) all of which can be painful. Grass seeds are a common finding down the ear canal of dogs that go for walks in the countryside. The shape of a dog’s ear canal has an upright tube (vertical canal) and then a 90 degree bend and a sideways tube (horizontal canal) at the end of this is the ear drum (tympanic membrane), this lends itself to getting things lodged inside. A foreign body like a grass seed can usually be seen by your vet with the help of an otoscope (hand held torch with a magnifying lens and a funnel). Grass seeds can usually be removed using a special pair of long grabbing forceps; some dogs will however need sedation or a general anaesthetic to allow the removal and examination to be carried out safely. We often send dogs home with antibiotic and pain relief after foreign body removal to combat any infection and pain. Bacterial and yeast infections of the ear are conditions that affect the skin that lines the inside of the ear canals. The shape of the ear canal along with the ear flap (pinna) tends to funnel in moisture and trap germs. Dogs with a large floppy pinna such as Spaniels have the added feature of a closed lid over the ear canal all leading to a great environment for germs to breed. Infection may be present on other parts of the body and the whole animal may need treatment not just the ears. If the condition is only affecting the ears then ear cleaning solution and antibiotic drops can be a very effective treatment. If you are new to applying ear cleaner and ear drops then ask your vet or veterinary nurse to show you the best way to use them. If the condition is affecting other areas of skin then injectable or tablet medications may be given so that the drugs can travel in the blood stream to reach more areas of the body. When infections are not clearing up your vet might suggest taking swabs from the area. The swabs are sent to the laboratory for bacteriology and sensitivity. This tells us which bacteria and yeasts are present, and which drugs should be effective against them. Skin allergy can affect the ears as the ear canals are lined by skin, diagnosis and treatment of skin allergy can involve swabs, biopsy samples and skin scrapes analysed at your vets or sent to a laboratory. Treatment of skin allergy can involve use of low allergy diets, shampoos, desensitisation vaccines, antibiotics, antihistamines and various immunosuppressant drugs. Parasites including ear mites (Otodectes cynotis) and ticks (Ixodes varieties) can lead to irritation and then bacterial infection of the ears. Ticks are usually visible to the naked eye but ear mites are more easily seen under a microscope. Use of an appropriate antiparasitic treatment and removal of the parasites are the best method of treatment. Aural haematoma, this is a blood blister usually found on the outer skin of the ear pinna, seen as a swollen area which often causes the ear to droop. The swelling is soft and fluid filled, it is often the result of a trauma such as a dog fight or vigorous ear shaking. The haematoma develops as small blood vessels in the ear burst and the blood leaks under the skin, this separates into a pink tinged fluid and a thicker dark red clot. Some dogs are prone to recurrence of aural haematomas and repeat treatments may be needed. There are two main methods of treatment, draining via a needle or surgical drainage under a general anaesthetic. Antibiotics, steroids or anti-inflammatory drugs may also be given in the form of tablets, injections or directly into the ear. Ear polyps are growths of different size that occur inside the ear canal, they are usually diagnosed on examination using an otoscope. Polyps are usually not cancerous but if there is any doubt then the polyp can be sent to a laboratory for analysis after removal. Small sized and numbers of polyps may not cause a problem to your dog but if there is irritation they can be removed surgically, in more serious cases removal of part or all of the ear canal may be an option. In conclusion it is really important to have your dog’s ears examined by your vet so that a correct diagnosis and appropriate treatment can be started. I hope that my answer has been helpful and that your dog has much more comfortable ears as soon as possible. Shanika Winters VetMB MRCVS (online vet) If your dog has a problem with its ears please book an appointment to see your vet, or use our online symptom checker
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