Vet Help Direct Blog » infection

Baldness in Dogs (Alopecia)

David — Wed, 01 Feb 2012 22:03:43 +0000

I’ve been seeing a number of bald dogs in the consulting room recently, and it made me wonder how common a problem it is – and how many conditions there are that can lead to a dog losing his hair!

Baldness (or alopecia, to give it its technical name) isn’t generally a disease in its own right – it is almost invariably a symptom of an underlying disease condition. So, when I’m faced with a poor, balding dog in the consult room, my first task is to try and define what the underlying cause is. With a symptom with so many possible causes, what we do to narrow down the possibilities is to work out a differential list – a list of all the possible conditions that can cause baldness – and then eliminate them until we come to the actual cause in this specific case.

So, in no particular order, here are the more common causes of hair loss in dogs, along with their other major signs or symptoms:

Firstly, those disorders that give a symmetrical pattern of hair loss (i.e. the same pattern of hair loss on both sides of the body):

Hypothyroidism

Hair loss is symmetrical along the trunk and may also involve the tail, armpits and the belly. The skin isn’t inflammed or itchy, but there may be a darkening of colour and dandruff or greasy skin. Caused by production of too little thyroid hormone, other common symptoms include lethargy, weight gain, and sometimes muscular weakness. To diagnose hypothyroidism, your vet will take a blood sample; treatment is simple, with daily tablets containing replacement thyroid hormone.

Cushing’s Disease

Once again, hair loss is symmetrical, and there may be hard lumps in or under the skin (calcinosis cutis). Cushing’s is caused by too much cortisol (an important natural steroid hormone) being produced by the body. Other symptoms include increased hunger, thirst and urination, development of a pot-belly, muscle weakness, skin thinning and “spots” or “blackheads” developing. To diagnose it, your vet may have to do a series of blood tests to see how your dog’s body responds to injections of steroids or other hormones. Tablets to treat Cushing’s usually act to reduce production of steroids, although some destroy the adrenal glands that make the excess hormones.

Iatrogenic Cushing’s Disease

This is a form of Cushing’s disease caused by long term use of steroid medications (e.g. Prednisolone for severe allergies). The only treatment is to VERY GRADUALLY reduce the steroid dose – but this needs to be done carefully, following advice from your vet, because if you reduce it too far, too fast, it can result in severe withdrawal effects, or even death, due to a lack of cortisol in the body.

Sex hormone disorders

Excess production of sex hormones (e.g. due to a testicular tumour) or insufficient sex hormones (usually after neutering) can, in rare cases, cause symmetrical hair loss.

And now, those diseases where there are patches of hair loss in various sites across the body:

Flea Allergic Dermatitis

This is probably the commonest cause of all! Dogs with a flea allergy scratch and scratch, and wear the hair away. FAD is usually straightforward to diagnose (very itchy dog plus fleas is something of a giveaway), although in extreme cases, a single flea bite can set it off, which is harder to detect. Prevention is simple – avoid and kill fleas – although it can be hard in severe cases to keep the flea population low enough, and anti- allergy medication may be required.

Sarcoptic Mange

Mange mites burrow into the skin, creating a very itchy patch covered in little bumps. The dog scratches away at it, wearing the hair away, creatng a bald patch. The most common site is on the ear; fortunately, there are some spot-on treatments available from your vet that will kill the mites and stop the itching.

Demodectic Mange

This is a different variety of mite, and unlike the sarcoptic mite, it doesn’t itch at all. Most dogs have a few, and they don’t cause any problems, living harmlessly deep inside the hair follicles. However, sometimes they can start to multiply, and the sheer numbers start to result in hair loss. Typically, it is a patchy disease, with hair loss in distinct regions that get bigger over time. Sometimes there is a bit of scale forming, but the mites themselves do not cause itching, although secondary bacterial infection may occur, which can. To diagnose Demodex mites, your vet will have to take a deep skin scrape, usually with a scalpel blade, and then look at it under the microscope. If Demodex mites are found, treatment may involve spot-ons like Promeris Duo, or bathing with Aludex for several months – sadly, it can take a lot of work to get it under control.

Primary Pyoderma

Bacterial skin infections are common in dogs, and can result in hair loss. The skin is usually reddened and inflamed, and there may be pussy “spots”. Often the area is itchy and sore, but occasionally there are cases where the skin looks almost normal, but hairless. The vet can diagnose it by taking scrapes and smears from the skin, then looking at them under the microscope. Treatment nay involve antibiotic creams, washes, and sometimes tablets to kill the bacteria.
Sometimes a yeast infection can cause the same symptoms; treatment then is usually with anti-fungal washes.

Ringworm

(Or dermatophytosis) is often diagnosed in practice, generally by using a Woods Lamp, which makes the fungus glow. Its appearance can vary widely, but most looking involves patches of hair loss, sometimes with scales, sometimes itchy (but not always). It’s particularly a problem in dogs that are ill with something else, and have reduced immunity. To get a definite diagnosis, hair plucks have to be sent to a lab and cultures, but that can take weeks so vets will often start treatment while waiting for confirmation to come back. Treatment usually involves washes, shampoos and occasionally tablets to kill the fungus, but it can take a long time to completely clear a bad infection.

Allergic Reactions

(e.g. to a spot-on medicine, or a new floor cleaner, sometimes even to food!). Usually, there is reddening and inflammation of the skin, and itching, before the hair comes out, but occasionally hair loss is noticed first.

There are other causes (e.g. genetic disorders, immune diseases like pemphigus) but they are generally far less common. It’s important to remember the old adage that “common things are common” before jumping to cocclusions.

Baldness and hair loss in dogs can be a marker for a serious underlying condition – it’s almost never due to simple old age! – but most of these conditions are either curable, or at least manageable.

And the dogs I saw this week? Well, one was a nice simple skin infection (although it didn’t look like it to begin with, the tests were clear and she responded really well to antibiotics). The other one had been on steroids for several years, and the effect over that time had given him Iatrogenic Cushing’s. His owners are working to reduce the dose (very, very gradually, as his body has become dependant on the tablets now), and to keep him warm, they’ve bought him a coat to wear when he goes out in the cold for a walk!

If you are worried about bald patches on your dog, talk to your vet or check any other symptoms using our interactive Dog Symptom Guide to help decide how urgent the problem may be.

It may be getting cold outside, but it’s always flea season at home…

Amy — Tue, 22 Nov 2011 19:29:26 +0000

I see it almost every day, and constantly warn my clients about it, yet somehow even I wasn’t expecting it – yes, last week my very own cat came home with fleas. ‘How could this happen to me?’ I said, ‘I’m the vet!’ Well, the answer is very simple. I, like many of us, forgot to apply my cat’s flea preventative for the past few months. The weather was getting colder and she wasn’t going out as much, and with everything else going on the monthly treatment just slipped my mind. It sure was a wakeup call, however, to find the
tell-tale rusty brown dirt on my cat’s favourite bed.

And let’s face it, fleas are downright creepy. They eat blood and leave their faeces all over your pet, not to mention the fact that they can live in your carpets and even jump up and bite you. But at the same time, they’re pretty amazing little creatures, and successful ones at that.

Did you know…

… there are more than 2000 species of fleas around the world? 63 of these are found in the UK, and 10 of these can be found in our own homes. The most common species seen however, is called Ctenocephalides felis, which although it is commonly called the cat flea can also be found on dogs.

… fleas are responsible for spreading the Bubonic Plague in people, and myxomatosis in rabbits?

… fleas can jump up to 150 times their own length, and consume 15 times their own body weight in blood daily?

… a female flea can lay about 50 eggs a day, and once these new fleas mature, they can each bite up to 400 times a day. Add all that up and you’ve got one miserable cat.

How do I know if my cat has fleas?

This sounds like a simple question but it can be a lot harder than you think to diagnose fleas in cats. Sure, sometimes you can see them scurrying around your cat’s fur but it isn’t always that easy. In fact, I have seen four patients with significant flea infestations in just the past week, and none of their owners were aware of the problem. Animals with fleas don’t always itch, and there are lots of other reasons why cats can be itchy. Also, cats can sometimes eat any fleas that they come across whilst grooming themselves, so you don’t always see them. The most reliable way to tell if your cat has fleas is to comb your cat well with a very fine-toothed comb (they make flea combs just for that purpose) over a piece of white paper or onto some cotton wool. This will result in the flea ‘dirt’ (which is actually their faeces) falling onto the white surface where you can see it. Then cover the specks with a bit of water and rub gently – if the dirt turns reddish-brown, it is flea dirt. If your cat has a lot of fleas, you may be able to see the dirt in their bedding or other favourite areas without even needing a comb.

Of course, if you have any doubts, your vet would be happy to examine your cat for fleas and advise you as to the best course of action.

Why is it important to prevent and treat fleas?

• Adult fleas feed on blood, which in young kittens can result in weakness, anaemia, and even death.

• Some animals are very allergic to flea bites, which makes them more likely to develop a bad skin infection as a result. Even one bite can set off a reaction, so you may not ever see the offending flea itself. So if your cat has an itchy skin infection but you can’t find any fleas, it’s probably worth treating them for fleas anyway.

• Fleas carry tapeworms, which are spread to the cat when they eat the fleas during grooming. Therefore, if your cat has fleas, they should also be treated for tapeworms.

• If all of that wasn’t bad enough, they can bite you too. Cat fleas won’t live on a human, but they won’t be able to resist a free meal…

How do you treat a cat with fleas?

Before going into battle against your cat’s fleas, it’s a good idea to understand a bit about their life cycle so you can plan the best attack. Adult fleas mostly live on the cat, but they can live up to two years and survive in the environment for up to six months. Once they find a host, they start eating and laying eggs. Both the eggs and the flea faeces fall off the animal, where the larvae hatch and feed on the flea dirt. The satisfied larvae then dig deep into carpeting or furniture, trying to escape the light and making themselves incredibly hard to kill. They then develop into pupae and build themselves a cocoon. The flea develops to adulthood inside the cocoon then waits until just the right moment to burst out and jump onto your unsuspecting cat by detecting changes in pressure, heat, noise or vibrations. The whole process takes about 15 days from egg to adulthood, but they can lie waiting in their cocoons for up to 2 years so modern conveniences like central heating can cause a resurgence in flea populations that you thought you had under control. As you can see, treating fleas doesn’t just involve putting a flea preventative on your pet (although that’s a very good place to start), you must treat the environment as well.

1. Ask your vet which flea medication is best for your pet and use this as directed. This will be either a long-acting insecticide to kill adult fleas or an insect development inhibitor to prevent eggs from maturing into adult fleas, or possibly both. These can come in the form of a spot-on liquid, spray, tablet, or injection. Collars and powders are not recommended for use in cats now that more effective and safer treatments are available. Flea treatments from the pet shop or internet may be just fine, but they also may not work as well and if used incorrectly, could seriously harm your cat. Be particularly careful never to give a flea product intended for dogs to your cat! If in doubt, ask your vet.

2. Treat ALL animals in the house, provided there is a licensed flea treatment for that particular species. If you treat just one pet and not the others, the fleas will just go live on them instead.

3. Wash everything that you can. This particularly includes their bedding (and your bedding, if they have access to that too, eek!).

4. Hoover everything else. Frequently. This includes carpets, floorboards, skirting boards, sofas or other soft furnishings and any other little nooks and crannies where the young fleas may hide.

5. Once you’ve done your best to mechanically remove as many fleas as possible from the house, and if you still have a problem, go after the remaining residents chemically. There are several products on the market that can be used to safely treat fleas in your house, ask your vet for their recommendation.

6. Finally, be prepared to repeat these treatments if necessary, as flea eggs can hatch in waves that will need to be treated at different times. Be patient, be thorough, and be sure to follow all instructions carefully.

As with most things, an ounce of prevention is worth a pound of cure. If even the thought of fleas makes you shiver or perhaps you don’t fancy the extra housework mentioned above, I’d suggest you take steps to prevent your cat from getting fleas in the first place. Use flea preventatives on a regular basis as directed by your vet, which often means once a month. Don’t be tempted to stop the preventative in the winter months, which may be OK in colder climates but doesn’t apply to most of the UK, especially thanks to central heating. Remembering to apply the preventatives regularly can be difficult, so many come with stickers that you can put on your calendars, don’t be ashamed to use them! And remember, even vets’ cats are at risk – fleas can strike any pet, at any time. Be ready!

If you are concerned that your cat is itching or has fleas, check their symptoms using our Interactive Cat Symptom Guide to find out if you need to see your vet.

Fluffy Can Give Blood Too! Blood Transfusions in Cats

Amy — Tue, 21 Jun 2011 20:52:59 +0000

For the past month our local radio station has been bombarding us with adverts asking us to give blood due to increased need over the holidays. My husband and I ignored them at first but then eventually gave in. On the way home after giving blood, we started talking about cats donating blood and I realised it had been ages since I’d seen a feline transfusion. They are relatively uncommon, especially in general practice, but it’s an interesting subject so I thought I might look into it a bit further. Hopefully your cat will never need one, but if they do (or if you’re just curious about the whole process!), here’s a little bit about what goes on behind the scenes.

Why would a cat need a blood transfusion?

The main reason why cats get blood transfusions is because they are severely anaemic, which means they don’t have enough red blood cells in their blood. Red blood cells are responsible for carrying the body’s oxygen, so not having enough of them leads to serious problems. Anaemia can occur for three main reasons – not enough red blood cells are produced (problems with the bone marrow or chronic diseases such as cancer), too many are lost (major bleeding after an injury or surgery), or too many are destroyed (autoimmune disease or poisoning). Mild anaemia is not a problem and the cat’s body will usually recover on its own, but severe red blood cell loss either needs to be treated or else it can end in euthanasia. Sometimes medication is enough to fix the anaemia, but occasionally the lost blood cells need to be replaced. The way we measure red blood cells is called PCV (packed cell volume), also sometimes referred to as HCT (haematocrit), and transfusions are only really indicated when that number gets below 12-14% along with clinical signs. If a cat has a disease that can be treated such as infection, autoimmune disease or severe bleeding, then a transfusion may be performed but if their condition cannot be fixed, such as most cancers or end-stage chronic kidney disease, then it probably won’t.

Do cats have different blood types?

Yes. Just like people, cats have different blood types and giving the wrong one can have disastrous consequences. Feline blood types are called A, B, or AB, similarly named to those in people but entirely different chemically, and the difference between them is the type of chemical called an antigen that the cells have on their surfaces. The cat’s body knows to leave cells with its own antigens alone but to kill off cells that have the other type of antigen, so giving the wrong type of blood will not only result in severe inflammatory disease in the cat but also the immediate destruction of the new cells that have just been given. Therefore, it is essential that all cats be blood typed prior to donating or receiving blood (unlike dogs, who are not as picky for their first transfusion). Most cats worldwide are type A, fewer are type B, and very few are type AB. Interestingly, certain breeds are more likely to have certain blood types, with most Siamese having type A and most Devon Rex having type B. Most standard domestic shorthair cats are type A. There are other variations in feline blood, such as Mik positive or negative, which can cause reactions but these are less well studied and it is not yet possible to test for them. If any sort of mismatch is suspected, then a drop of the donor’s blood is mixed with a drop of the recipient’s blood on a card and the cells are monitored for a reaction.

Where does the blood for transfusions come from?

Although there are some feline blood banks in the US, most feline blood transfusions in the UK come directly from donor cats at the time it is needed. Donor cats, who are often staff pets but if your cat is big and healthy there’s no reason why they couldn’t donate, should be at least 4 kg but preferably over 5 kg in weight and must not have donated blood in the past 2 months. They should also be fully vaccinated, screened for infectious diseases and not on any medications. Potential donors are given a full physical exam and blood test to ensure they are healthy enough to give blood, and a blood type is done. Once they have passed all of these tests, they are usually sedated and approximately 50-60 ml of blood is collected from the jugular vein in the neck over about 10-15 minutes, followed by the administration of IV fluids to help replace some of the lost blood volume. The blood can then be stored in the refrigerator for up to 24 hours because it is mixed with an anti-coagulant to keep it from clotting.

How is a blood transfusion given?

The blood from the donor cat is then attached to an IV fluid line and filter and given very slowly into the patient’s vein. The recipient cat needs to be watched very carefully for any sign of reaction such as fever, changes in heart rate or changes in blood pressure. The whole process usually takes several hours and the cat is checked regularly throughout. The prognosis for any cat given a blood transfusion depends much more on the underlying condition than the transfusion itself, but it can significantly improve survival for cats with certain kinds of conditions.
Feline blood transfusions are most commonly done in large referral centres, but as there is no special equipment needed they can be done in general practice as well. Because of the time and cost associated with screening both donor and recipient cats, as well as the collection and transfusion process itself, blood transfusions are very expensive and therefore not often chosen by the owner even if they are on offer. But as veterinary medicine progresses and we become more comfortable with the process, it will hopefully become a more practical option in the future.

If you are worried about any problems with your cat, speak to your vet or try our Interactive Cat Symptom Guide to help decide what to do next.

Urinary Incontinence in Bitches

Jenny — Mon, 06 Jun 2011 12:20:43 +0000

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.

“Please don’t tell me I have to brush my cat’s teeth, because I’d rather keep my fingers…”

Amy — Tue, 10 May 2011 21:03:11 +0000

My last article talked about a few of the dental problems most commonly seen in cats, and how easily they can be missed by both owners and vets. Remember, a cat with dental disease will probably act just like a healthy cat, but that doesn’t mean they’re not in pain! I’ll continue now by mentioning some of the preventative measures and treatments that can help keep your cat’s mouth healthy and pain-free.

What can I do to help prevent dental disease in cats?

Of the diseases mentioned previously, periodontal disease (gum disease) is by far the most common but fortunately the easiest to help prevent. Although genetics plays some role in whether or not a particular cat is going to have bad teeth, there are several things you can do to help keep the pain and inflammation to a minimum:

Brush the teeth – OK, this is admittedly not going to work for everybody. Or even most people. Or really even more than just a few people. But it’s worth giving it a try because if you are lucky enough to have one of the most chilled out cats on the planet, tooth brushing is the gold standard in preventative dental health care. By removing the bacteria before they are able to cause disease, the whole disease process is stopped in its tracks. Just use common sense and don’t get bit – if your cat doesn’t even like to be picked up or stroked, he probably won’t take too kindly to you shoving a toothbrush in his mouth.

Dental rinses or gels – These products work by killing off some of the bacteria in the mouth before they have a chance to cause disease. For cats (who let’s face it, probably won’t let you get anywhere near their mouths), one of the most sensible options is an antiseptic liquid (often containing chlorhexidine) that you put in their drinking water which can have the added benefit of freshening your cat’s breath. In most cases, if it sounds too good to be true, it probably is so although products like this can have some beneficial effect, they are not likely to solve all of your problems.

Special dental food – Some vets still say that plain old dry kibble helps keep your cat’s teeth clean. And many food manufacturers make similar claims to that effect. Although there is likely to be some truth to this, it is probably not as effective as we like to think. Most dry food is small and easy to swallow whole, so only a small percentage of it actually gets chewed. And I’ve seen plenty of cats who have seen nothing but dry food their whole lives with horrible teeth. If you want to help prevent dental disease with your choice of food, do your research and choose one that has been scientifically proven to decrease plaque formation. These foods tend to be more expensive, larger in size so they have to be chewed thoroughly before swallowing, and made in a special way such that they achieve maximum contact with the tooth surface. Ask your vet for their preferred dental health diet, which is often only available by prescription.

Regular dental cleanings at the vet – Unfortunately, even if you could train your cat to open her mouth and sit still on command, this would probably still require general anaesthesia. Vets use the same kinds of dental instruments on cats that dentists use on people (ultrasonic scalers, polishers, and drills) and the procedure itself varies from mild discomfort (with a simple scale and polish) to severe pain (with a surgical tooth extraction) and the use of local anaesthetics is not as reliable in cats because they can’t tell us what they feel. Also, dental cleanings require a lot of water and it is essential that an endotracheal tube (soft rubber tube inserted into the trachea or windpipe after they are asleep to aid breathing) is placed to prevent water from being breathed into the lungs. Although a general anaesthetic may sound like a risk that is greater than the benefit of clean teeth, most people both overestimate the risk and underestimate the benefit. When you consider that severe periodontal disease can have potentially fatal consequences, a dental cleaning can actually help save your cat’s life. Many people are (understandably) also concerned with the cost of having their cat’s teeth cleaned. I can assure you that if vets had figured out an easier, faster or less expensive way of cleaning animals’ teeth, we would all be doing it. And by having routine dental cleanings throughout an animal’s life, you can help prevent major vets’ bills down the road from complicated surgical tooth extractions or related systemic illness. As they say, an ounce of prevention is worth a pound of cure!

How can I tell if my cat has dental disease?

Signs of severe dental disease or pain in cats include bad breath, wobbly teeth, excessive salivation or drooling, teeth chattering or strange gnawing motions. Other symptoms can include lethargy, decreased appetite, depression or hiding/not wanting to be touched, although these can be seen with almost any illness! Another important yet subtle sign is whether or not your cat actually chews their food before swallowing it. Even some cats with no teeth at all will happily eat dry food by swallowing it whole, so instead of just assuming that everything is ok, try to notice how much crunching they do with each bite. If you’re particularly observant, you may even notice your cat chewing more on one side of the mouth (the healthier side) to avoid touching a painful tooth.

You may not ever notice them in pain, but more often than not owners remark after the painful teeth are removed that their cat is acting like a kitten again. This is further proof that they show such subtle signs of pain that they are often missed by owners and even vets, and although it is nice to be able to help them feel better, how much nicer would it be to prevent these problems from occurring in the first place! If you have noticed any of the symptoms listed above or are otherwise worried about your cat’s teeth, please speak to your vet. Because until your cat learns how to phone us herself, she’s relying on you to make sure that she doesn’t have to suffer with painful dental disease in silence.

Chronic Diarrhoea in Cats – Could it be Tritrichomonas foetus?

Amy — Fri, 11 Feb 2011 10:32:28 +0000

Marla is an older cat who has recently had the displeasure of becoming a frequent visitor to our practice. She was adopted not long ago from an animal shelter and now lives with a lovely woman who thankfully has a lot of patience!

Marla first came to see us because she had developed diarrhoea and a red, irritated rear end. She had a type of diarrhoea called ‘colitis’ (which simply means inflammation of the large intestine or colon), that caused her to strain frequently to produce small amounts of sometimes bloody stool. She was treated with antibiotics and her diet was changed to something that was bland and easy to digest, and although sometimes her symptoms seemed to improve a little they continued. A standard stool sample was run but this was negative for all worms and harmful bacteria. After nearly a month of problems and after trying every routine treatment out there, we decided to try one last and wouldn’t you know, it came back positive!

Marla had developed an infection of Tritrichomonas foetus (which I’ll call T. foetus from now on), a previously rare but becoming increasingly common infection in cats. Recent studies have shown that the infection is even more common than we think, so if you think your cat may be affected it might be worth looking into!

What is T. foetus?

T. foetus is a single-celled protozoal parasite (bigger than a bacteria but smaller than a mite, with a very clever membrane and a few tails that help it move around). The infection was originally found in cattle, but it’s cats that have been more of a concern recently.

Most affected cats are less than 1 year old, but as in Marla’s case, it can affect cats of any age.

Purebred kittens from breeding colonies or cats in shelters or multi-cat households are more likely to get the disease.

Up to 30% of cats in the UK and US may test positive for the organism, but not all those that carry the disease will show symptoms.

What are the symptoms?

Symptoms include (some of which you may only see if your cat uses a litter tray):

Semi-formed to liquid faeces (diarrhoea)

Blood or mucus in the faeces

Straining or painful defecation (may lead to howling in the litter tray)

Increased frequency of defecation (more frequent trips out the cat flap)

Inflamed and painful anus (may lead to or be caused by excessive licking)

Despite the above symptoms, however, most affected cats are otherwise well in themselves and do not usually lose weight.

How is it treated?

If your vet suspects that your cat may have T. foetus, they will recommend you bring in a fresh stool sample from your cat. They will then look at the sample under the microscope to see if they can find any of the tiny organisms or send it to a special veterinary lab where they can run a test called PCR to detect the organism.

Most cases will resolve on their own but it’s a slow process, sometimes taking many months, and many owners (and cats!) may want to treat the disease to get rid of it faster.

None of the drugs currently licensed in the UK for use in cats can kill T. foetus. However, there is an antibiotic called ronidazole that is used to treat the disease in the United States and this drug can be used in the UK if the cat’s owner provides their informed, written consent. Not all cats will respond to the drug and a few may develop side effects (neurological problems that go away once the drug is stopped), although the vast majority of cats won’t have any problems.

If your cat has had T. foetus and is now back to normal, it is possible that they may still be carrying the disease in their body and could therefore pass it on to another cat. The disease is unlikely to infect people, but those who have a weakened immune system should not handle any cat with diarrhoea. Basic hygiene measures should be taken as a precaution and to stop it from spreading to other cats in the household (or shelter, cattery, breeding colony, etc.). Always wash your hands thoroughly after handling cat faeces and after cleaning litter trays and wash all cat bites and scratches immediately with soap and water (always seek medical attention immediately if the wound develops signs of infection such as redness or swelling).

Until recently, most vets probably hadn’t heard of this organism and were therefore not likely to look for it. But as we become more aware of the disease, we will hopefully be able to diagnose and treat it faster so cats like Marla can be back on their feet in no time. So if you think your cat may have T. foetus, please speak up!

If you are worried about diarrhoea or any other problems with your pet, speak to your vet or use our Interactive Symptom Guide to help decide what to do next.

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

Jenny — Tue, 04 Jan 2011 12:04:00 +0000

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.

Some 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.

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.

What is Pyometra?

Jenny — Thu, 23 Sep 2010 10:46:46 +0000

Pyometra is a condition affecting unspayed bitches (and less commonly cats) where the womb, or uterus, becomes infected. In mild cases it can come on fairly slowly with only slight changes in the uterus, but the worst cases happen very quickly and the womb becomes swollen like a balloon, but filled with pus. These are urgent and life-threatening.

Pyometra happens when the lining of the uterus (the endometrium) changes under the influence of the bitch’s hormonal cycle. It nearly always happens a few weeks after she has been in season and is more common in older bitches. The use of certain hormonal drugs to postpone seasons has been linked with an increased risk of pyometra. Rarely, a spayed bitch can develop a similar infection in the remaining part of the uterus, called a “stump pyometra”, but this is uncommon.

The first symptoms are not very specific, with the bitch appearing a little unwell and off her food. Usually the thirst will increase and there may be some vomiting, but not all symptoms happen in all cases. If the cervix (the junction between the uterus and the vagina) remains open, there is often an unpleasant vaginal discharge. If the cervix is closed, the discharge cannot escape and these cases are more serious. The temperature may be raised, and when toxins enter the bloodstream the bitch will become seriously ill. In a small number of cases, kidney failure and death will result.

It is usually easy to diagnose a pyometra from a combination of the history and the physical examination. If there is any doubt, x-rays or ultrasound scans can help in the diagnosis. Blood tests can also help by confirming high levels of infection-fighting white blood cells.

The treatment for pyometra is the surgical removal of the uterus and ovaries, also called ovaro-hysterectomy or spay. It is a more difficult operation in a bitch with pyometra than the regular spay operation in a young healthy bitch. The uterus is often enlarged and fragile. If it should leak or burst, there is a high risk of peritonitis. Having said that, the operation is nearly always successful. It is usually carried out immediately after diagnosis, unless the bitch needs to be stabilised first to allow her a better chance of coming through the operation.

After-care would include antibiotics and possibly fluids by drip if the bitch was very poorly. Exercise will be restricted for a minimum of 10 days while the wound heals, and pain relief will be given.

There have been attempts to treat pyometra with drugs rather than surgery, but it is unlikely that severe cases would respond to anything but surgery. In mild cases which improve for a time there is every chance that the condition will come back after the next season.

It is often said by owners after the bitch has recovered from a pyometra operation that they are healthier than they have been for years. In these cases the condition had probably been grumbling for a long time but not enough to worry anyone until recently. The changes in the bitch’s behaviour which had been put down to advancing years are reversed, often giving a whole new lease of life.

The best way to prevent pyometra is to spay whilst the bitch is young and healthy. Unless you really want puppies, with all the responsibility and expense that goes with them, it is best to spay either before the first season or about three months after it. Your own vet can advise on the best time for your particular bitch. The added advantages of spaying young are the reduced risk of mammary tumours and the avoidance of further seasons and unwanted pregnancies. There could be a slightly increased risk after spay of developing urinary incontinence, and some bitches develop a fluffy coat instead of a sleek shiny one. These drawbacks are greatly outweighed by the benefits.

It is always a good idea to take note of changes in your dog’s behaviour or general wellbeing. Noticing small changes in appetite or thirst could be crucial in diagnosing this type of condition early. If you are worried about any of these symptoms, always ring your veterinary surgery for advice.

Our Interactive Symptom Guide can help you check out any unusual symptoms and advise on how soon you should visit your vet. Earlier diagnosis usually means more successsful treatment.

The Importance of Dental Care

Jenny — Thu, 16 Sep 2010 15:55:54 +0000

There are two types of dental care for pets: that given by the owner at home, and that given by the vet in the surgery. Both are very important to the wellbeing of our pets.

It is thought that two thirds of dogs and cats over 3 years old suffer from dental disease. This is not a cosmetic problem, although the appearance and smell from an affected mouth can be very unpleasant! More importantly, it is a cause of pain and ill health.

The most important type of home dental care is brushing the teeth. This is best started when the dog or cat is very young, even though we hope there will be no tooth problems at that age. This means that brushing will not hurt. Special veterinary toothpaste and a soft brush are needed, and it is important to brush every day. It might take time to get your pet used to the idea of tooth brushing, but at this age you can start gradually with paste on a finger and work up to introducing the toothbrush. Human toothpaste is not suitable for animals as they contain additives like fluoride which are meant to be spat out and not swallowed, but animals will lick their teeth and swallow the paste.

Some diets are specially formulated to help reduce dental plaque. The hardness and shape of the kibble help reduce formation of plaque and tartar.

Other products that can be used at home include mouth rinses and gels to rub into gums. Carefully designed chews and toys can also help to provide some mechanical cleaning of the teeth, but daily brushing is the most effective preventative.

Bacteria are present in all mouths, but only some of them cause a problem. They cause most problems when there is plaque on the teeth or in little crevices between the teeth and the gums. Plaque builds up over time in all mouths and is made up of substances contained in the food and the saliva. Over time, plaque hardens and mineralises to form hard calculus (or tartar).

In some breeds there is a higher likelihood of dental disease because of the shape of the head or overcrowding of the teeth. Another factor is the way the animal’s own immune system responds to the problem in the early stages, so you could have two animals with the same lifestyle and diet but with different amounts of dental disease. This immune response is particularly important in gum disease in cats (gingivitis).

Broken or cracked teeth provide a focal surface for plaque and bacteria, and so do retained temporary teeth. The so-called “baby teeth” usually fall out by about 6 months of age, to be replaced by the adult set. If a first tooth does not fall out and an adult tooth erupts alongside it, there is a crevice which traps food debris and allows bacteria to multiply.

Gum changes occur alongside dental disease, starting with redness and inflammation and mild discomfort, which can progress to the formation of pockets between the gum and tooth which will eventually destroy the attachment of the tooth.

When your vet examines your pet’s mouth, he or she will be assessing a number of things. After checking the general shape and health of the whole mouth, they will look for any lost, loose, broken or retained teeth. They will assess the teeth and gums for inflammation and calculus, and may need to use a probe at the gum edge. In cats in particular, they will also be checking for resorptive lesions, which occur when the surface enamel is lost, followed by the deeper structures of the tooth, eventually exposing the sensitive nerves.

If dental treatment is recommended, it will be carried out under general anaesthetic. Even in the most co-operative of patients, it is not possible to reach every surface of every tooth with the animal awake. It is also difficult to predict whether any extractions or x-rays will be needed until the teeth have been thoroughly cleaned. This also makes it notoriously difficult to estimate the cost in advance, but your vet should be able to give you a rough estimate or a range of possible costs if you ask.

As with any anaesthetic it is usually advised to have a blood test to check the pet’s general health, and in particular how well the liver and kidneys are working. This is because they are required to metabolise, or break down, the anaesthetic drugs. However, it does not mean that anaesthetics cannot be given if there is a problem with liver or kidney function; it usually means extra precautions will be taken, the choice of drugs may be different and intravenous fluids may be given. Most patients needing dental work tend to be middle-aged or older, but this does not make it too risky to give an anaesthetic. As long as the animal has been fully examined and blood-tested, the risks of the anaesthetic are often smaller than the risks from the dental disease itself.

Sometimes owners want to delay this type of treatment for as long as possible, especially if the dog or cat still has a healthy appetite, but this can make matters worse. If the animal is off its food because of dental disease, it is already quite advanced and will need much more treatment, and the animal’s general health may have deteriorated during the delay.

Antibiotics are often needed before and after a dental procedure. If bacteria from the infected mouth enter the bloodstream, there is a risk that they may settle in places like the heart valves.

The equipment used in a vet’s surgery for dental work is very specialised. An ultrasound descaler is used to remove calculus from teeth and another attachment is used to polish the teeth. Several hand held instruments are needed to do simple extractions. More complex extractions, where teeth have several roots, may need a full surgical kit. An x-ray machine and developer is needed for many dental cases so that hidden structures can be visualised. All of this equipment has to be sharpened or maintained and sterilised between each procedure.

Although the most common dental procedures carried out by vets are descaling, polishing and extracting teeth, dentistry for animals is becoming more sophisticated all the time and there are specialists available to deal with the most complex cases.

Regular examination of your pet’s mouth, both at home and in the surgery, is important in spotting problems early and planning the right treatment. As well as dental disease this can also help with early detection of mouth and throat tumours, which are not uncommon. Ideally the mouth should be examined at least once every 6 months.

A week or two after a dental procedure, when everything is healed, is a great time to start brushing teeth again, or for the first time if it wasn’t started as a puppy/kitten. If unsure about the brushing technique, ask your vet or nurse for advice or a demonstration.

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Why does it matter if my pet is thirsty?

Jenny — Fri, 03 Sep 2010 13:49:21 +0000

Most pet owners will have been asked by their vet, probably more than once, whether there has been any change in the amount their dog or cat is drinking. It is an important question because the answer can give us valuable information. Of course thirst increases naturally in hot weather, after exercise and when being fed a dry diet, but it can be much more significant than that. The dog or cat will probably spend more time at the drinking bowl, or the owner will notice that they have to refill it more often than expected. The amount of urine passed will increase as well, and this may be the first sign noticed by the owner.

An increase in thirst can be a side effect of certain drugs, but can also be caused by a number of quite serious problems. It is always important to mention it to your vet. Some of the most common causes of increased thirst (polydipsia) are:

1. Fever, which can have many causes including infections or bite wounds

2. Kidney disease, where the kidneys lose their ability to filter waste products from the blood and control its salt content

3. Liver disease, which can take a number of different forms when the various functions of the liver are not being carried out as efficiently as normal

4. Diabetes mellitus, when there is a lack of insulin, a hormone produced by the pancreas which controls blood sugar levels

5. Diabetes insipidus, when the animal lacks anti-diuretic hormones so is unable to concentrate the urine

6. Cushing’s disease, when an excess of natural steroid hormones is produced by the adrenal gland

7. Pyometra (in unspayed females) is an infection of the womb (uterus) which can be sudden or gradual in onset

8. Urinary infection or bladder stones

9. Hyperthyroidism, more common in older cats, where increased thirst is only one of many symptoms caused by an excess of thyroid hormone.

Other causes also occur, and sometimes there is more than one cause present at a time.

To find out the reason for an increase in thirst, your dog or cat will need to have a full clinical examination. Small clues can be gathered from examination of every part of the body. For example, the colour of the “whites of the eyes” may change in liver disease. Weight loss or gain could be important. Feeling the abdomen may reveal enlargement of individual organs such as liver or kidneys. A discharge from the vagina could indicate a womb infection (pyometra) in an unspayed female. A heart murmur is often present in hyperthyroidism, and changes in skin and body shape occur in Cushing’s disease.

These clues mean more when considered with the full history of the animal. The age, gender, whether neutered, breed, type of diet, previous illnesses and vaccination status are all relevant. Then the vet will need to ask about the increase in thirst. How long ago did it start? Was it sudden or gradual? Have any changes been noticed in the appetite? You may be asked to measure your dog or cat’s water intake over 24hrs to check whether it is abnormally high or not.

Usually some lab tests will need to be carried out to diagnose the problem. A urine sample is useful to look for signs of infection, crystals or substances which should normally be removed by the kidneys, and to measure the kidney’s ability to concentrate the urine.

A blood test is nearly always needed to distinguish between the various possible causes. The first test is usually a general screening test to narrow it down, followed by more specific tests to reach a diagnosis. To get to the correct diagnosis can take time.

X-rays or ultrasound imaging can be used to visualise the internal organs and might be advised if the results of blood tests suggest they would be useful.

Many of the causes of increased thirst are very serious if left untreated, but many are also very treatable. They require very different treatments, so it is well worth diagnosing the problem so that the right treatment can be given.

If you are worried that your cat or dog may be drinking more, or about any other problems, talk to your vet or try using our Interactive Symptom Guide to help decide what to do next.