Author: vetstream

Examining a patient from the outside can be really useful – we can pick up a lot of information. Even more useful is what we call “obtaining a history” – finding out what they’re doing or not doing!) when they’re at home, what their symptoms are, when they started, and if there are any obvious triggers. However, the body of a dog, cat, rabbit or indeed any mammal is incredibly complicated.

For example, a simple symptom like vomiting has the following major (and fairly probable) causes: adverse food reactions, food allergies, eating a foreign object, eating something rotten (“dietary indiscretion”), sudden diet change, dehydration, drug reactions, drug side effects (especially painkillers), viral gut infections, bacterial gut infections, stomach ulcers, gut intussusception (where a loop of intestines turns inside out and gets stuck in itself), twisted gut, intestinal tumours, gut stasis, constipation, kidney failure, liver failure, septicaemia, systemic infections (e.g. with a fever), acidosis (where the blood is too acidic), low blood potassium, high- or low blood calcium, high- or low blood sodium, pancreatitis (inflammation of the pancreas), peritonitis (inflammation or infection of the abdomen), pyometra (a wound infection), Addison’s disease, diabetes, vestibular syndrome, meningitis, head trauma and concussion, worms, Giardiasis (another intestinal parasite), lead poisoning, antifreeze poisoning, mould poisoning, anaphylactic shock, heat stroke, motion sickness and pain.

And that’s only the common causes of acute, or sudden onset vomiting – the list of possible causes for chronic (ongoing) vomiting is even longer!

As a result, often the only way to find out exactly what’s going on inside the body is to look at the blood. Blood is a fascinating organ – it fights infection, maintains hydration, and has a host of other functions, but most importantly, it carries things around the body (nutrients, oxygen, wastes). As a result, it contains traces of chemicals released by every other organ – which means we can look for those traces, to tell us how well those organ systems are working.

Of course, there are so many thousands of different chemicals in a 1ml sample of blood that there’s no way we can test them all, so we concentrate on certain key “markers” – chemicals or other blood components that have been proven to demonstrate how well particular systems are working. In practice, what we’re usually running is a “screening” test – looking for common problems that might let us narrow down our search for a cause to your pet’s illness.

We can generally divide our blood test into two components:

Haematology

This is the study of the different blood cells; and nowadays we usually use a machine to count them, then use a good old-fashioned microscope to examine individual cells for signs of damage or disease.

By far the most common cell type is the red blood cell, or erythrocyte. Counting these will tell us if the patient is anaemic (low) or dehydrated or possibly polycythaemic (high). Looking at them and measuring them will also tell us a lot – different changes in blood cell shape may suggest immune anaemia(immune mediated haemolytic anaemia), certain blood-parasites such as Feline Infectious Anaemia or Babesia canis, some types of poisoning (e.g. onion poisoning), or iron deficiency. It can also tell us if any anaemia is regenerative (i.e. the body is able to make new red blood cells) or non-regenerative (if it can’t for some reason).

We can also count the platelets (usually by eye with a microscope – the machines aren’t very good at it!). These are the clotting cells – too few mean the body cannot clot properly.

That said, we’re often more interested in the white blood cells. Different ratios of the various types can tell us a lot –  very high neutrophil counts suggest an acute infection; low numbers of neutrophils suggests either that the patient is immunocompromised or that they are fighting a severe infection. Levels of lymphocytes may indicate infection, or sometimes leukaemia, while eosinophils suggest either an allergy or a parasitic infestation.

Biochemistry…

…is the study of the chemical traces in the blood – often, these are salts, nutrients or waste products, but some are proteins released from damaged cells, or parts of the immune system that give us an inkling as to what is going on at the cellular level in our patients. Our standard screening test is a “Chem-12”, which looks at 12 key substances:

• Albumin (ALB) – This is the main transport protein in the bloodstream; high albumin suggests dehydration, whereas this is only low following severe blood or plasma loss, occasionally really severe gut or kidney disease (protein losing enteropathy or protein losing nephropathy), or liver failure. Usually, this is pretty stable – anything dramatic enough that it changes the levels of albumin in the blood is likely to be fairly severe.
• Globulin (GLOB) – This is essentially all the other proteins in the body. A low globulin is really rare; a high globulin count is suggestive of inflammation, infection, immune disease, or a tumour.
• Total Protein (TP) – This is just the levels of the albumin plus the globulin added together.
• Blood Glucose (BG or GLUC) – Animals need glucose in their blood for fuel – low glucose suggests insulin overdose or, rarely, septicaemia; high glucose may mean stress, Cushing’s disease or (most likely) diabetes.
• Blood Urea Nitrogen (BUN) – Urea is the main waste product from protein metabolism. A low urea almost always means liver disease, whereas a high level generally indicates kidney failure, a blocked bladder or dehydration.
• Creatinine (CREA) – Another marker for kidney function, creatinine is most commonly raised only in kidney failure.
• Alkaline Phosphatase (ALKP) – this is an enzyme that is released from damaged cells – mostly liver cells and a raised level often means cholestasis(where the bile stops flowing). However, it can also indicate liver disease, treatment with some drugs (e.g. phenobarbitone), Cushing’s disease and even some bone disorders.
• Alanine Aminotransferase (ALT) – This is another liver enzyme, but is only released from damaged liver cells. High levels indicate liver damage.
• Total Bilirubin (TBIL) – Bilirubin is released from the breakdown of red blood cells; high levels cause jaundice. This may be prehepatic (caused by haemolysis, abnormal red cell breakdown), intrahepatic (caused by liver disease) or posthepatic (due to a bile duct blockage).
• Calcium (CA) – if blood calcium levels change much, the muscles, brain and heart stop working – so it’s really important to monitor it closely! Alterations may indicate cancer, excessive milk production, kidney disease or bone disease, among other possibilities.
• Sodium (NA or SOD) – Sodium is a key salt in the blood – it is very tightly regulated by the body. In general, it will only change in severe dehydrationor salt poisoning.
• Potassium (K or POT) – Potassium is a salt usually removed by the kidneys; however, if the levels get too low, muscles stop working; if they get too high, it can stop the heart. Possible causes for altered potassium include kidney disease, severe vomiting, and tissue death (e.g. in a torsion).
• Cholesterol (CHOL) – In humans, doctors really worry about cholesterol counts. In animals, it isn’t such a big deal – we tend to use it primarily as a marker of how recently the animal ate, although in cats especially it can also be a sign of fatty liver disease.

Other specific tests do, of course, exist, for hormones (e.g. thyroid levels), signs of pancreatitis, EPI, certain infections (e.g. FIV, FeLV, Parvovirus), and many other possible diseases.

However, there’s nothing else out there that gives us as much information in a hurry as a simple Haematology and Biochem – a test which we can do in house in about 20 minutes!

This is a question that often comes up, because the WSAVA Vaccine Guidelines (issued by the World Small Animal Veterinary Association) are periodically updated, recommending longer vaccination intervals. This gets a lot of press coverage, and as a result, people often think that the standard vaccine protocols are in some way harmful; or that they can delay vaccination and it won’t matter. Unfortunately, the truth is much more complicated than that.

The confusion comes about because the WSAVA publishes general guidelines on vaccination protocols designed for vets across the world to use – they’re not definitive rules, set in stone! They are really useful, but (and it’s a big but) they need to be interpreted in light of local conditions in the UK, because what vaccines are needed here aren’t necessarily the same as those needed in California, or Siberia, or Uganda. That’s why you need to discuss any concerns you have about vaccination with one of our vets – whose experience and training will enable them to help you choose what’s right for you and your dog here in the UK.

Ultimately, there are three issues that we need to look at – what diseases you want to protect your dog from; how long the vaccine lasts for; and what the risks are.

What diseases do we vaccinate for?

The WSAVA regards three vaccines as “Core”, meaning that every dog should be vaccinated against them – and we agree entirely with them on this! These diseases are those which are likely to be fatal, are easily spread between dogs, and/or have a severe impact on quality of life –  Distemper, Parvovirusand Infectious Canine Hepatitis. However, we would add an extra disease to that list – Leptospirosis. This disease is very common in the UK, and although rarely life-threatening, it is easily spread, severe, and zoonotic (which means that humans can catch it).

Other optional vaccines available are for Parainfluenza and Bordetella (the major causes of kennel cough), Rabies (legally required if you want to take your dog abroad and then come back to the UK), Lyme Disease (mainly a risk in the south and west of Britain) and Leishmaniasis (an exotic infection only found in southern Europe). Which of these we’ll recommend depends on your dog’s lifestyle and their individual risk of infection – so, for example, if you never take your dog abroad, we wouldn’t recommend that you waste your money on Rabies or Leishmania vaccines.

How long do the vaccines last?

It depends on the vaccine and on the vaccine’s license. However, vaccines don’t last forever – eventually their effectiveness and therefore the protection they offer declines. As a rule of thumb:

• Distemper, Parvovirus, Hepatitis and Rabies vaccines last 3 years.
• Leptospirosis, Parainfluenza, Bordetella, Lyme Disease and Leishmania vaccines last only one year.

So, you can see where the confusion has come from – because the WSAVA regards Lepto as “non-Core”, they have said that dogs only need vaccinating every 3 years. However, in the UK, Lepto is so important that it needs to be kept up to date – meaning our dogs need annual vaccination.

The other complication is the legal situation – vets are, generally, legally obliged to use medications (including vaccines) in accordance with the manufacturer’s guidelines. If the manufacturer cannot prove that the vaccine lasts the full 3 years, it doesn’t matter what the WSAVA say – it’s irresponsible for us to recommend you only vaccinate every 3 years, as we could be leaving your dog unprotected.

At the moment, the major vaccine manufacturers are all happy with the durations of activity listed above, but vaccine protocols won’t – and shouldn’t – change until the manufacturers can prove their effectiveness over longer periods.

What are the risks of overvaccination?

Here’s where things get sticky. Theoretically, overvaccination could increase the risk of autoimmune disease (where the immune system goes haywire and attacks the body’s own tissues); and could lead to a range of other inflammatory conditions. However, there’s no actual evidence that this is an issue in dogs – no study has demonstrated a clear, unambiguous link between vaccine frequency and other diseases. That said, it is sensible to limit the number of vaccines given to the minimum required for protection (apart from anything else, it’ll save you money!).

On the other hand, undervaccination has a well established and proven link with developing severe and potentially fatal diseases!

So where do we go from here?

Our standard vaccination protocols are designed to protect our patients as safely and completely as possible. If you’re concerned about your dog, or think they may be at increased risk, give us a ring and talk to one of our vets so we can advise you on how best to protect them as an individual.

When we’re looking at urine samples down the microscope, we often see pretty little patterns forming, like snowflakes or tiny jewels. Unfortunately, these bladder crystals can cause serious disease in dogs and cats – but the good news is that by looking at their shapes under the microscope, we can often determine how best to treat them.

What problems can bladder crystals cause?

The biggest issue is that crystals don’t often stay microscopic! Eventually they grow, forming stones in the bladder (uroliths). These irritate the bladder lining, causing cystitis. However, the biggest risk is that the crystals find their way down into the urethra (urine tube leading from the bladder to the outside world) and get stuck there, preventing the dog or cat from urinating.

This is uncommon in females, because their urethra is relatively short and wide, so anything that fits into it tends to be passed (possibly after some straining). In males, however, the urethra is long and narrow, so obstructions are much more likely. A blockage is particularly likely to occur where the urethra bends around the pelvis, or in the penis where the penis bone causes a dramatic narrowing. The highest risk of all is in tomcats which were neutered early – towards the end of puberty in cats the penis dramatically grows, with the urethra becoming much wider. If the cat was neutered before this growth phase occurs, the penis and urethra stay small for life.

What types are there?

There are a number of different types of crystal, so let’s look at them in turn…

Struvite

Also known as magnesium ammonium phosphate and triple phosphatcrystals.

Look like “coffin lids” – rectangular crystals.

Caused by:

• Alkaline urine
• Infection (in dogs only)
• Struvite crystals will often form in stale urine even in normal animals.
• The stones can be dissolved with a proper diet

Cystine

Look flat, thin and hexagonal, a bit like a snowflake.

Caused by:

• Acidic urine
• A genetic disorder resulting in kidney disease (seen in breeds such as Newfoundlands, Bassets, Chihuahuas).
• Can be dissolved with a suitable diet

Calcium Oxalate

Form small square crystals with an X in the centre.

Can form in alkaline or neutral urine.

Caused by:

• Genetic predisposition (e.g. Yorkshire Terrier and Lhasa Apso dogs; Burmese and Persian cats)
• Antifreeze poisoning
• Excessively high blood calcium levels (in conditions such as hyperparathyroidism, some tumours)
• Cannot be dissolved, must be surgically removed.

Urate

Also known as Ammonium Urate

Look like spikes or spindles, or occasionally spiky balls (“thorn-apples”).

Found in acidic and neutral urine.

Caused by:

• Normal in Dalmatians!
• Liver disease, such as a portosystemic shunt.
• Can be dissolved with a proper diet.

Uric Acid

Usually diamond shaped.

Pretty rare, occasionally occur in acidic urine.

Calcium Phosphate

Long, thin rectangular crystals

Quite rare, occur in alkaline urine.

Calcium Carbonate

Cause the urine to appear cloudy – normal in rabbits and horses!

What are the symptoms of bladder stones?

Cystitis

Blood in the urine

Pain on urination

Passing urine little and often

Bladder obstruction

Straining to urinate

Passing very little or no urine

Uraemia

Depression

Dehydration

Vomiting

Collapse

Death

How can they be treated?

Many stones can be dissolved in a suitable diet; if, however, they are causing an obstruction they must be removed surgically. This is usually done by opening the bladder and removing the stones. For stones lodged in the urethra, the preferred technique is retrograde urohydropropulsion, whereby we flush the stones backwards into the bladder.

If you think your dog or cat may have bladder stones, make an appointment for one of our vets to see them as soon as possible. If they have an obstruction and are unable to urinate normally, we need to see them straight away, day or night!

Summer time… Blue sky, bright sun, lush green foliage, grass waving in the wind like a green-gold sea… Well, perhaps not the first two in Britain! But there is one constant threat to our dogs in the summer months and that’s those pesky grass seeds.

The waving heavy heads of ryegrass, timothy, fescues and cocksfoot look lovely, and are an important feature of our countryside, but to dogs they are not just fun to run through, but potentially dangerous.

What’s wrong with grass seeds? Surely they’re just pretty?

Pretty, maybe. The trouble with them, however, is their shape. Because they taper towards one end, and have all those little barbs pointing the other way, once they get into something they don’t come out easily. In fact, they have a tendency to work their way further in. Some vets even refer to them (only partially as a joke) as “self forging”, like those bullets that dig their way through armour plate.

So what problems do they cause?

Well, it depends of course on where they end up. To explain why this is so bad, we need to look at how the dog’s body responds to a foreign body (the technical term for anything that gets in where it shouldn’t be).

All mammals, including dogs, have a really efficient immune system – the most ruthlessly xenophobic killing machine ever discovered or built. If it finds something that doesn’t match it’s built-in map of what proper dog cells should look like, it will attack it without mercy until the invading bacterium, virus, amoeba or worm is killed. And this is all very well and good, and why our dogs aren’t constantly dropping dead of colds. However, in the process, this inflammatory reaction (triggered to help kill the invader) damages the tissues nearby, causing pain, swelling, redness, heat and loss of function. If there’s a real invading disease or parasite, that’s a price the dog is willing to pay. However, a grass seed isn’t strictly speaking an invading organism – yes, it will carry some bacteria with it, but it cannot be killed or destroyed by the immune system. As a result, the inflammatory reaction goes on and on and on until either the seed is expelled, or the dog suffers severe symptoms, pain and distress.

So, where can grass seeds get stuck?

Pretty much anywhere! However, there are some sites where we tend to see them more often; dogs pick them up running about in the long grass.

• Eyes – in the eye, grass seeds cause intense irritation, pain, usually with closed,  swollen, watering eyes, and dogs will often rub at them with their paws. Once in, the grass seed has three options.
  • Most commonly, it scratches or wounds the front of the eye, causing a corneal ulcer. It then falls out.
  • Sometimes, it can get trapped behind the eyeball.
  • Occasionally, it works its way into the soft tissues around the eye.
• Ears – grass seeds are always falling down ears! The symptoms are of a really sudden onset ear infection with itching, rubbing, head tilting and often severe distress.
• Nose – a grass seed up the nose is one of the most common reasons for a one-sided runny nose! Affected dogs sneeze and paw at their nose to try and dislodge it – but of course, the more they try, the deeper it goes.
• Lungs – of course, if they inhale it and manage to dislodge it from the nasal passages, there’s a chance it will make its way down the windpipe. This can cause severe difficulty breathing and coughing as pneumonia develops.
• Salivary glands – if the seed makes its way into the mouth instead of the nose, it can get stuck in the salivary ducts – the tubes carrying saliva from the glands to the mouth. This can make the blocked gland swell, becoming obviously enlarged and painful.

Paws – if a grass seed finds its way between the toes, it can penetrate the soft skin and dig its way deep into the foot, causing severe lameness.

How are they treated?

Sadly, there’s only one option – the seed must be found and surgically removed.

If you think your dog may have a grass seed stuck somewhere, make an appointment to see one of our vets!

You may recently have read the scary headlines in the newspapers about “deadly new ticks” and “fatal dog diseases” new to the UK – especially if you live in the South East, where local media have picked it up and run with it. But what’s really going on? Is there really anything to worry about, or is it another case of a media scare story that’s going to blow over in a few weeks? Let’s have a look at the evidence, and at what’s really going on here…

What’s all the fuss about?

A disease called babesiosis, that has been diagnosed in 4 dogs in Essex. One of them has since died of the infection.

What’s that?

Think of it as a bit like malaria for dogs. It’s caused by a single-celled parasite called Babesia canis that gets inside the dog’s red blood cells, damaging them. Unfortunately, the dog’s immune system then gets in on the act, and in trying to kill the Babesia parasites, starts destroying red blood cells willy nilly.

Is that like anaemia?

Yes, exactly – the dog doesn’t have enough red blood cells left to carry oxygen.

So what are the symptoms?

They vary a bit from dog to dog, but usually include shortness of breath, tiredness, pale gums, discoloured urine (often sort of coffee-coloured) and sometimes jaundice.

Jaundice? Does it attack the liver too then?

It can, but the jaundice is is usually due to the breakdown of the red blood cells. Other possible symptoms include fever, enlarged glands, kidney failure and in severe cases or if left untreated it is often fatal.

OK, it’s bad, but surely now the infected dogs are treated the problem has been fixed?

No – babesiosis is transmitted by ticks. The unusual thing about this outbreak is that the dogs all became infected in the UK – all previous cases have contracted it abroad. This means that there’s a population of ticks living in the UK that are carrying the infection, and spreading it to every animal they bite.

So it’s going to spread?

Exactly – foxes will carry the infection to other areas, and be bitten by ticks there, infecting them. It’s probable that eventually ticks across the UK will be infected.

What, every tick?

No, that’s one bit of good news – Babesia can only be carried by the (pretty uncommon) Meadow Tick, Dermacentor reticulatus. The common Sheep Tick (Ixodes ricinus) doesn’t carry them. Meadow Ticks are most common in the south-west of England, west Wales and (you guessed it) Essex and Kent.

Can the disease be treated?

Yes, it can – special anti-babesia medications are available to kill the parasites, and with intensive care and sometimes blood transfusions, most infected dogs will survive.

So how do I protect my dog? Is there a vaccine?

Sadly, no there isn’t a vaccine in the UK – however, ticks can only transmit the disease after they’ve securely attached themselves to the dog – a process that takes about 24-48 hours. So, any treatment that repels them or kills them before this process if complete will make it really unlikely they can infect your dog. Give us a ring, and one of our vets will be able to recommend a suitable spot-on, collar, or tablet for your dog. If you do see any ticks – use a tick hook to remove it! One of our nurses can show you how, if you like.

What about me? Am I in danger?

Probably not – Babesia canis, as the name suggests, usually infects only dogs; cases in humans are very rare and usually involve people with a weakened immune system.

What should I do if I think my dog’s infected?

CALL US – straight away! The sooner a case is diagnosed and treatment started, the better the chances that they’ll make a full recovery.

Most pet owners anticipate spending at least part of the night of 5^th November attempting to coax their dog or cat out from under the bed. It is an evitable response to the loud bangs, whistles and crashes of fireworks. However, many pets react equally as badly to more year-round sounds such as thunder or car alarms. It is actually quite a common occurrence and can be quite distressing to witness depending on the severity of the reaction.

It can sometimes be difficult to establish what triggers the fear response in animals, particularly dogs, who often hear sounds outside of our human hearing range. Sounds that may seem perfectly normal to us can be painfully loud for a dog. Age can be a factor too. Some puppies can show a marked fear response while other dogs can develop the problem as they get older. There is even some evidence of a breed disposition with typical herding breeds such as collies being more likely to suffer from fear of loud noises.

Signs to watch out for

• Shaking or trembling
• Being more clingy than usual and getting under your feet
• Hiding under beds or behind sofas
• Panting or ‘smiling’, the drawing back of lips over the front teeth
• Whining
• Urinating or pooing in the house
• Panicked running or digging at the carpet or rug

It is important not to try to console your pet during this time. As odd as it sounds it can be counter-productive and your nervousness can make them think they are right to be scared. If you behave normally, they will take cues from your behaviour and begin to respond better themselves. Puppy training from an early age exposes a young dog to a wide variety of environments and novel stimuli, making them less likely to develop fear of new things in the future.

Some of these signs can be misinterpreted as ‘naughty’ behaviour and owners may not be aware that they are associated with fear. Do not to punish them as they will be unable to understand why they are being told off. Equally, forcing them to face their fears is not the right thing to do, it is ineffective and very unfair.

What can I do about it?

Luckily, there are some tricks you can try to help reduce your pet’s anxiety. Create a safe haven for them. If they regularly sleep in a crate, then cover it with blankets to make it cosy and dark. The blankets will also help muffle sound and bright flashes. It is a good idea to let them decide where their safe place will be, even if it’s under your bed. Forcing them into somewhere they are unfamiliar with will only increase their anxiety. Be sure to keep their favourite toys handy as well, the more familiar items they have near them, the more comforting the haven will become.

Play music or have the tv volume up a little higher that normal. Sometimes simply drowning out the frightening noise is enough to calm them down. This often works with older dogs as their hearing starts to wane with age.

If you know of any potential hazard in advance, for example, bonfire night, then taking them out for a good long walk before dark can help. Just being physically tired can reduce their response level. Distraction is a good idea too; play is a good way of diverting their attention away from what is going on outside the house.

These ideas are good starting points for helping your pet cope. The next step could be desensitisation training, exposing them to low-level noise in a controlled environment and slowly increase the volume over time. This can be effective but great care must be taken not to traumatise your pet and cause more suffering.  Due to this risk, it is usually only recommended on the advice of an animal behaviourist. There are also medications, anxiolytics, that a vet can prescribe in extreme cases of noise aversion but they are often ineffective on their own and many owners prefer not to drug their animals if it can be avoided.

What if I have a cat?

Cats show similar fear response behaviours to dogs in many ways. They can be skittish and often choose to hide in dark places or get high on top of cupboards and bookcases. Again, let the cat choose its own safe spot or provide a few boxes covered in blankets in an out the way place. Laundry rooms or boiler rooms are often a favourite as they are dark, warm and away from the bustle of the house. Like a dog, familiar smells are very comforting to a stressed cat.

Trust can be a significant issue with our feline friends and, unlike dogs, they do not always want to be near us for comfort. Give them opportunities to be near you if they wish but do not force them. Keep your movements gentle and give them space to escape should they need it. Drawing the curtains, blocking the cat flap and keeping the radio on low will help distract them from what is going on outside.

Cushing’s Disease, or Hyperadrenocorticism, is a condition caused by excessive production of natural steroid hormones (mainly cortisol) in the adrenal glands. It is most common in dogs, but does also occur (rarely) in cats (it’s also fairly common in horses and ferrets, but those are separate blog articles!).

What causes it?

There are three forms of the disease:

• Pituitary Dependent Cushing’s – 85% of true canine Cushing’s cases are due to a malfunction in the pituitary gland. This is usually a benign tumour (adenoma) that sends the signal (a chemical messenger called ACTH) to the adrenal glands instructing them to keep producing cortisol, even if there is plenty already in circulation.
• Adrenal Dependent Cushing’s is due to a tumour in the adrenal gland that constantly produces more and more cortisol. It is less common than the pituitary form.
• Iatrogenic Cushing’s (sometimes called “False Cushing’s”) occurs when excessive amounts of artificial steroids (e.g. prednisolone) is given to a dog or cat, causing steroid overdose and the symptoms of Cushing’s. It is probably the most common, but is very easily cured by lowering the dose of medication!

In both dogs and cats, true Cushing’s is more common in middle-aged to elderly animals.

What are the symptoms?

Steroids have a wide range of different effects, and therefore Cushing’s has a lot of potential symptoms. The more common ones include:

• Increased urination and thirst (steroids lead to more dilute urine being produced, so the animal must drink more to compensate, meaning they urinate more – a vicious cycle).
• Increased hunger.
• Panting and dislike of hot weather.
• Lethargy.
• Obesity and/or muscle wasting and a pot-bellied appearance.
• Muscle weakness
• Recurring urinary tract infections.
• Secondary respiratory infections, especially in cats.
• Increased risk of diabetes.
• low healing of minor wounds.
• Skin changes:
  • Hair loss, typically along the flanks.
  • Thinning of the skin.
  • Blackheads (comedones) in the skin.
  • Abnormal whitish calcium deposits in the skin (calcinosis cutis).
  • Skin infections.
  • Increased risk of Demodex mite infestation.
  • Increased skin frailty, resulting in easily bruised or cut skin.

• Other possible symptoms (although they are rarer) include:
  • Increased blood pressure.
  • Abnormal clotting.
  • Heart failure.
  • Seizures or blindness.
  • Increased risk of cruciate ligament injury (especially in small dogs).
  • Shrinkage of the testicles.
  • Overgrowth of genitalia in the bitch.
  • Prostate overgrowth in neutered dogs.

How is it diagnosed?

The clinical signs are often very suggestive, but unfortunately there is no one test that is perfect for diagnosing Cushing’s – this is because there is a lot of overlap between normal dogs with naturally high cortisol levels, and dogs with Cushing’s with relatively low cortisol levels.

The three tests that are most commonly used are:

• Urine Cortisol:Creatinine Ratio is a good screening test and can be performed on a urine sample collected at home, but although it will pick up most dogs with Cushing’s, it also has a high false-positive rate (so the test comes back positive in a non-Cushingoid dog).
• ACTH Stimulation Test – a blood sample is taken to measure the blood cortisol, then synthetic ACTH is injected and another sample taken a little while later. The degree of response to the drug can be used to distinguish most Cushing’s patients from those with other illnesses (although there are quite a lot of false negative results as it doesn’t pick out all the Cushing’s patients).
• Dexamethasone Suppression Test – the same basic protocol as the ACTH test, but an artificial steroid (dexamethasone) is injected instead. In a normal animal, the artificial steroid suppresses natural steroid production, but not in Cushingoid animals. Although this test also has a lot of false positives, it has the great advantage that some varieties can be used to distinguish between Pituitary and Adrenal Dependent Cushing’s.

Most of the time, we’ll use a combination of clinical signs and one or more of these tests to make a firm diagnosis of Cushing’s.

Can it be treated?

Yes, there are a number of different treatment options. In Adrenal Cushing’s where there is a single adrenal tumour, it can sometimes be surgically removed. There is also a drug called trilostane that permanently destroys adrenal gland tissue – however, there is a severe risk of causing Addison’s Disease (where the dog cannot make enough steroids), so this drug is rarely used nowadays.

However, by far the most common treatment option is a drug called mitotane, which suppresses cortisol production in the adrenal glands. This is given as a capsule by mouth once or twice daily and is very effective in the vast majority of affected dogs.

If you think your pet may have Cushing’s, make an appointment to see one of our vets.

Kidney disease is one of the most common degenerative conditions in cats, especially in the elderly. However, it can also occur in younger animals exposed to certain toxins or infections. In this blog, we’re going to have a brief look at the more common causes of kidney failure in cats, and the symptoms that they cause.

What are the functions of the kidneys?

The main function of the kidneys is to filter the blood, removing waste materials (like potassium, urea, creatinine, certain drugs, and excess water and salts) but keeping what the cat needs (like proteins, glucose, sodium and enough water to maintain their hydration).

They also produce certain hormones, especially renin (which helps to regulate blood pressure) and erythropoietin (which controls the production of red blood cells).

What are the symptoms of kidney disease?

There are two different types of kidney disease, with subtly different symptoms. In either case, however, there will be no symptoms until more than 75% of the kidney tissue (i.e. one and a half kidneys!) have been lost – this is the “functional reserve capacity” of the renal system.

Acute Kidney Injury

This occurs when the kidneys are suddenly injured, e.g. by a toxin, or a sudden dangerous drop in blood pressure. Typical symptoms are sudden in onset, and include:

• Loss of appetite.
• Lethargy or even collapse.
• Vomiting and (sometimes) diarrhoea, possibly with blood.
• Altered urination – increased in mild cases, reduced or even absent in the most severe ones.
• A metallic smell on the breath.
• Seizures, coma and death.

Chronic Kidney Disease

This happens when the damage is more gradual, and the symptoms tend also to appear more gradually and may be subtle and non-specific:

• Loss of weight
• Weak, but not usually absent, appetite
• Tiredness and lethargy
• Occasionally vomiting.
• Increased thirst
• Increased urination
• Poor coat quality (often a “staring” coat)
• Anaemia, as the damaged kidneys do not produce enough erythropoietin.
• Metallic breath, but not usually as dramatic as in acute conditions.
• Muscle weakness, due to the loss of potassium salts.
• High blood pressure, caused by overproduction of renin, that may cause strokes or blindness.

What can cause kidney failure?

There are a wide range of possible causes; in some cases, two or more will interact to cause more severe kidney damage than would normally be expected. Common causes include:

• Infection of the kidney (pyelonephritis). This may occur with bacteria that spread up from the urinary tract, or through infections carried in the blood (e.g. from dental disease).
• Oxygen starvation, usually caused either by shock (e.g. after a road traffic accident) or low blood pressure (e.g. in an anaesthetic – this is why we like to monitor blood pressure so carefully during surgery!). The kidney cells are metabolically very active and need a constant supply of oxygen – if this is interrupted, then cells start to die.
• Certain systemic viral infections (especially feline leukemia virus (FeLV), feline immunodeficiency virus (FIV), and feline infectious peritonitis (FIP)).
• Polycystic Kidney Disease (PKD) – this is a genetic disease, most commonly seen in Persian cats, where fluid-filled cysts form in the kidneys and crush out the normal, healthy tissue, resulting in early onset chronic kidney failure.
• Poisonings – especially with antifreeze, or as a side effect of certain painkillers, although this is rare. These usually cause acute kidney injury, although they may contribute to chronic disease later in life.
• Kidney tumours, especially a cancer called lymphoma which can form within the kidney tissues.
• Blocked bladder – where a stone prevents the cat from urinating. The bladder fills with urine, and the back-pressure then damages the kidneys. If not treated, however, the bladder will rupture and the cat will soon die of internal poisoning.
• “Wear and tear” – unfortunately, simple old age takes its toll on how efficient the kidneys are! Because cats are obligate carnivores (i.e. they have to eat meat to survive), they need a high protein diet. The more protein there is in the diet, the harder the kidneys have to work to filter the blood – and so the earlier signs of kidney problems are likely to turn up. This is probably why cats have a higher risk of kidney disease than dogs, who are omnivores with a lower protein requirement.

How can kidney disease be treated?

Some very mild acute kidney injuries which, if treated immediately, may be partially reversible. However, in general, kidney disease cannot be cured. It can, however, be managed, with medication, a suitable renal diet, and careful monitoring (of kidney function and blood pressure, among other parameters).

If you think your cat may have kidney disease, contact one of our vets for advice.

The hairy members of our family (yes I am talking about the pets) rely on us to keep them nice and slender, with a balanced diet giving them all their nutritional needs. Now, being a bit of a foodie myself (especially when it comes to cake, chocolate, crisps, cheese…. maybe I should stop before I fill the page) I tend to have passed on this love of food to my dog Daisy. As well as looking like me, she also likes to eat as much as me, and with a cute irresistible face like this how can you resist! (Unfortunately for me we look alike- but I am not this cute).

But here is where the tricky part comes. Daisy likes to go through cycles of getting a bit soft around the edges. A good weight for Daisy, being a working Cocker Spaniel, should be around 12-12.5kg, but she has been known to creep right up to 13.5kg.

Now, for someone who works in a vets, I’m probably not setting a very good example, but it’s easy for any of us, no matter who we are, to be a bit over zealous when feeding our pets. I thought the best way to explain how easy it can be sometimes for Daisy to get a few too many tit bits, would be to ask her to do a diary in the life of Daisy. Here’s what she had to say:

A day in the life of a “Working” (more like sleeping) Cocker Spaniel

When I wake up in the morning everyone is asleep, and I have to nudge them with my face to make sure they wake up to give me my breakfast. Sometimes I get everyone up as early as half past 5, because all I want is my breakfast. I wake up, go outside for a quick wee, and run straight back in for food. After taking about 1 minute to eat it, I go back out to the toilet again, and come back in still hungry!

If I’m lucky mum does me a treasure hunt and hides biscuits around the house for me to find, but it doesn’t take me very long. Then when mum and other members of the family have their breakfast I wait and see if they have anything for me. Sometimes if I’m lucky, I get my own taste of some milk in my bowl, yummy! Then I go back and lay on mums bed and have a few hours’ kip, its tough work being me so I need lots of sleep.

By about lunch time I get to go on a walk over the woods, where I don’t stop, not even when I need the toilet, this helps me to burn all my energy off. When I get back and have my legs washed (much to my disgust, what’s the point in getting dirty if I then get cleaned again), I often get given a chew bone to help keep my teeth pearly white.

When the humans start eating their lunch, I often might get a few bits of meat when they finish because I put on my best soppy look. Later in the afternoon I’ll go out for another walk, and when I come back I get my dinner- yummy! I start asking and pestering for this at about 2 o’clock, even though I don’t have my dinner till 4 – just to make sure they don’t forget.

When the humans have their dinner again later on, I pretend like I haven’t had mine, and then I often may get a few more bits of scrap meat or vegetables- delicious! Once when the humans went out at Christmas I was so hungry that I opened one of their bags and helped myself to my doggy stocking. I got so full I couldn’t finish it all. 

In the evening the humans tend to snack lots on lots of yummy things like popcorn and biscuits, they are so greedy so I don’t think it’s fair when they tell me I’m being a porkie pie. I usually sit there expectantly, give them my best fluttering eyelashes, and get some bits of popcorn or biscuits or crisps. I’ve managed to get my way so much that the humans buy some digestives just for me- they even have a special name – Daisy Digestive. I know they’re in there, so anytime I hear movements of the biscuit tin, no matter where I am, I run to it as fast as I can.

After all this exhausting work of eating, sleeping, and going out for walks, I’m ready for bed. Although, if I hear a rustling downstairs, I’m still quick to get up and see what food may be on offer.

Now, as you can see Daisy can get to eat a lot in the day! If we looked at that in terms of numbers, Daisy (for her size, based on her level of exercise) should only consume about 860 calories a day to maintain her weight. Her chappie, which is her main food for the day comes to around 680kcals, that leaves only 180 left for her to have. GULP. So her handful of biscuits that she has in the morning will be another 58kcals, for a dental stick from pedigree they are 53kcals, 73kcals for a digestive biscuit, and for ¼ of a chicken breast it is approximately another 75 kcals. Now, if I add all this up, and that’s excluding the milk, it comes to around an extra 250 calories, which means in a day she could be having 930calories- that’s over 10% a day more than she should be, and that’s just in one day!

I thought by using myself as an example, it would show how easy it is to overfeed your pet, and how quickly this can start leading to weight gain and subsequent health issues. That’s why we, at Mayne vets, are doing a month dedicated to helping all our clients and their furry friends.

Any pets that may have weight issues can come in to see us, to see where they could be going wrong, and how we can put them back on track again- and this is all free of charge! So if you think, like me, you could be overfeeding your pet, and perhaps they could do with losing a few of those pounds, then please ring in and book with the nursing team today. 

(I try not to be naughty anymore to set a good example, but Daisy still gets her ‘Daisy Digestives’- please don’t tell the vets!).

People will be petting their pet and find a lump or a bump, something that has popped up overnight, they then assume the worse – Its CANCER, sometimes we then avoid finding out more. Either though fear or worry or cost.

During the first week of February (weekdays only) as part of our involvement with WORLD CANCER DAY we are offering a free consultation with Louise or Gemma to get the worrying lumps and bumps checked.

We have all been in your situation and its scary so we hope that we can help put your mind at rest or we can get in early and remove the small swelling which is a sign of a more dangerous disease process – remember larger masses are harder to remove.

Causes:
Most superficial lumps and bumps are caused by one of the following

1. Puncture Wounds – Often these have resulted from a bite, they fester beneath the skin surface and then eventually break open.

2. Benign Masses – Warts, skin tags, fluid-filled cysts, fatty tumours (lipomas) and histiocytomas are all examples of benign (non-cancerous) masses that may or may not need to be removed depending on size, site and how much the animal is bothered by the mass.

3. Cancerous tumours – These are the scariest of the masses. Sometimes they can be cured with surgical removal but sometimes they have spread to other parts of the body locally or to distant parts of the body.

What you can do at home:
There are some simple suggestions to help at home

1. Assess your pet – if your pet appears unwell or there is a smell or discharge from the lump then we need to see him ASAP as it may be a more urgent situation, than if he is well the lump is not red or hot with no odour.

2. Mark the mass – So many people steal themselves to come to the vet for the bad news but then cannot find the mass when they get into the consult room. Clip some hair from around the area or mark it with tipex or a small amount of nail varnish.

What we will do:
We need to find out the origin or cause of the mass to this this several things may take place.

1. History – We will ask several questions – how long have you noticed the lump? Has it grown quickly? Is the dog/cat bothered by it? How has your pet been otherwise?

2. Perform a physical exam – Sometimes the look and feel of a mass can give us plenty of clues. Examining from head to tail will also give us clues as to any further complications.

3. Fine needle aspirate – We will insert a needle into the mass to try to extract some tell-tale cells that can be looked at under the microscope. These will be looked at in house by our staff and sometimes for a more expert opinion send to the pathologists. Unfortunately this test only tells you what cells are in the area the needle hits so it’s not 100% representative of all the cells in mass.

4. Incisional biopsy –In order to get more cells or a fuller picture of the mass sometimes we will cut a piece away. We do this a number of ways but your pet will need to be sedated or anaesthetised for it. We would do this if the FNA has been non diagnostic and we wanted to remove the mass surgically but were concerned about removing the correct margins.

5. Excisional biopsy – This increases our chances of making a definitive diagnosis, but it means removing the entire lump and then submitting the tissue to the laboratory for full assessment.

Once a diagnosis has been made we can give you the most accurate prognosis and treatment for the type of mass it is.

We are really keen to put your minds at rest so please ring to book an appointment quoting the term – lumps and bumps check.