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Feature

Why keyhole bitch spay?

By admin On June 18, 2013 - 0 Comments

Why keyhole bitch spay?

As in human surgery the benefits of carrying out keyhole procedures in the dog are becoming established.  This is particularly true when it comes to carrying out neutering in our pets; these benefits include less postoperative pain, lower incidence of postoperative illness, a far better view of the surgical area and a rapid return to normal activity.

Do we need to remove the uterus (womb) and ovaries ?

In the UK (and the USA) the predominant teaching in veterinary schools has been that when carrying out a spay, it is essential to remove the uterus along with the ovaries to prevent any uterine disease developing. In mainland Europe ovariectomy (OVE) alone has long been advocated as a safe alternative ovariohysterectomy (OVH). With the advent of  laparoscopic spay procedures it is now accepted in the both the UK and the USA that OVE is a safe procedure.

The two questions I get asked regularly are, will they develop pyometra (womb infection) or will they get uterine (womb) tumours as they get older?

The answer to the first question is a straightforward no. It is currently understood that progesterone ‘priming’ of the uterus leads to development of a pyometra.  The only natural source of progesterone in the bitch are the ovaries. If the ovaries have been removed pyometra cannot occur.  There is no evidence that bitches have ectopic ovarian tissue and in all reported cases of ‘stump’ pyometra, there was either ovarian tissue left behind post spay or they had been treated with oral progestagens.

Will my bitch develop uterine cancer?

The overall reported risk of uterine neoplasia in intact bitches is 3 in 10,000 (0.003%) and almost all the reported tumours have been benign leiomyomas. These are slow growing, non invasive masses which can be cured by hysterectomy, and there are no reports of tumours developing in bitches spayed under 2 years of age, which suggests a strong hormonal influence to their development. The answer to this question is that it is highly, highly unlikely.

When should I spay my bitch?

Two concerns which relate to timing  of a spay procedure are the possibility of increased risk of urinary incontinence after a spay but also minimising the risk from development of mammary tumours. Many of the actual numbers often quoted on this subject are not very scientific as they were based on reports written before veterinary surgeons appreciated the necessity for robust statistical analysis.

It is likely that the risk of development of mammary tumours significantly increases after the first season and then continues to rise slightly with each subsequent season thereafter for at least the first few years. Therefore, in order to minimise the risk from development of mammary tumours, bitches should be spayed before the first season, but there is some benefit from spaying after later seasons.

The risk of urinary incontinence is present following any neutering procedure (around 5% of cases), and unfortunately some bitches will become incontinent whether they are spayed or not. Recent reports suggest that there is no greater  risk of young bitches developing incontinence. It is clear that urinary incontinence is the result of a complex interaction of many factors and therefore it cannot be simply attributed to an effect of sexual maturity or spaying alone.

What should you expect?

Though the incisions made for keyhole spay are very small (5 or 10mm), we do need to clip a large enough area to ensure that the skin around the wound is clean before surgery is carried out.  The technique that we carry out involves making 3 small incisions so that the instruments and camera can be inserted into the abdomen. In larger bitches we make use of 2 ports that are 5mm and one that is 10mm; in small bitches we will use 3.5mm ports.  Some surgeons prefer to use a 2 port technique but when this is done the flanks have to be clipped as well. It is our experience that most owners prefer the less obtrusive clipping associated with a 3 port approach.

When you collect your pet the wounds will be covered with light Primapore dressings, to help keep the wounds clean. These can be removed in 2 days time. We recommend that skin sutures are removed after 10 days. Your pet will also be given 5 days of anti-inflammatory drugs to make her comfortable.

The biggest issue we have is that most owners find it very difficult to keep their pet calm and quiet after the first 24 hours!  We do however recommend lead exercise only for the first week after surgery, to allow the internal wounds to heal.

Do you own a large or giant breed dog?

Gastropexy reduces the risk of occurrence of GDV and as such it is logical to offer prophylactic gastropexy in those breeds that are most at risk from bloat (gastric dilatation volvulus; GDV). In bitches, such a procedure could be readily carried out at the same time as a routine laparoscopic spay. A gastropexy is the suturing of the right side of the stomach to the body wall so that it is fixed and cannot twist. Some concerns have been expressed that gastropexy may significantly alter gastric motility due to the repositioning of the stomach.  Recent research showed that there was minimal disruption to gastric motility and emptying 10 weeks post surgery. Prophylactic gastropexy is an underused technique and many large and giant breed dogs run the risk of GDV.

Laparoscopic-assisted gastropexy is a procedure which is readily carried out at the same time as keyhole spay and involves making a small (3 – 5 cm) incision on the right flank; the stomach is sutured to this and the skin then closed.  This minimally invasive technique has been shown to have minimal effect on pain scoring and recovery is as rapid as for a normal spay.  The only difference is that lead exercise is recommended for 4 weeks after surgery to ensure that the stomach fuses to the body wall. Of course this is not limited to female dogs! Northwest Surgeons also performs prophylactic gastropexy on male dogs!

Ok. I want my dog to have a keyhole spay.

Northwest Surgeons is one of a few centres performing these procedures and the only practice in the area backed by a team of specialists. The surgery is performed by Professor John Williams, a European Specialist in Small Animal Surgery and the anaesthesia for these cases is handled by our dedicated veterinary anaesthetists, who are either European & RCVS  Specialists or residency-trained. To arrange for your dog to have this procedure, you will need to ask your vet to refer you to us. It’s that simple. Once they give us authority to treat your pet, we will call you and arrange everything. Your pet will be admitted on the morning of surgery and will be ready to go later that day. If you have several dogs, we can help. Just ask. The cost of a laparoscopic spay is only £500, with or without gastropexy.

What do other clients say?

Our specialist in cardiology Simon Swift, who had his only dog Millie spayed using the keyhole technique, has written his account of her procedure here for you to read.

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lungworm larvae
General

Lungworm, slugs and slug-bait – considering the risks

By admin On April 26, 2013 - Comments

What is lungworm?

‘Lungworm’  – a life-threatening parasite in dogs – has been attracting a great deal of attention in the veterinary press over the last decade, but has been previously regarded as a problem limited to the southern part of the UK. Since its recognition in the UK more than 30 years ago, lungworm has been spreading throughout the UK and northern Europe. This change in distribution is, at least in part, due to a changing climate and we do indeed see this at Northwest Surgeons.

Lungworm may go undiagnosed until severe life-threatening signs develop – dogs may be infected for months before developing clinical signs and may then die within hours of showing signs of illness.

The scientific name for dog lungworm is Angiostrongylus vasorum – but other lungworms exist in other species. Looks pretty nasty, doesn’t it?

Angiostrongylus is contracted by the dog eating a slug or snail harbouring lungworm larvae.

The larvae then migrate through the body to reach the major blood vessel between the heart and the lungs (pulmonary artery). Here the larvae mature to adults and lay eggs. The eggs hatch to immature larvae which migrate into the lung tissue and are coughed up and swallowed. The larvae end up in the dog’s faeces, to be ingested by other slugs and snails. Click here to view the lifecycle. 

What problems can lungworm cause?

Cough, coughing blood, breathing problems

Lethargy

Heart failure

Collapse

Sudden death

Which dogs are at risk?

The majority of dogs affected are young dogs, but we have diagnosed cases in mature and elderly dogs. As slugs and snails are fairly ubiquitous, most dogs are potentially at risk. Studies show that very few infective larvae are found in the slugs’ or snails’ slime trails, but a puddle contaminated with a dead slug may contain huge numbers of larvae.

Dogs may inadvertently or intentionally ingest slugs or snails. Many of the dogs that we have diagnosed have not been seen by their owner to eat slugs or snails.

How is lungworm diagnosed?

The initial suspicion is based upon the clinical signs, but x-rays, heart scan, blood tests, blood clotting tests and faecal examination for parasites (Baermann examination) will form part of the diagnostic work-up.

Can lungworm be treated?

With early diagnosis, lungworm can be cured with no lasting permanent damage. Unfortunately, significant damage may already have occurred by the time of diagnosis.

Can lungworm be prevented?

Preventing exposure to slugs and snails is difficult, but a monthly spot-on treatment is available to prevent lungworm. The treatment should be used year-round but is particularly important during periods of high snail and slug activity.

What about eliminating slugs and snails?

The most common slug bait – metaldehyde – is extremely toxic to pets and we would not recommend using this.

Use some safer alternatives:

-       Encourage natural slug and snail predators such as hedgehogs or birds.

-       Buy ‘Nemaslug’ – a live nematode worm that kills slugs

-       Place non-toxic slug traps – either homemade or proprietary

-       Adhesive copper tape around pots to protect the plants.

What should I do now to protect my dog?

Discuss lungworm prevention – along with other parasite control measures – with your veterinary surgeon. The licensed preventative spot-on is a prescription medication – it cannot be bought in supermarkets or pet stores.

You will still need to use a regular dewormer in tablet form.

 

 

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GDV
Feature

New thoughts on GDV

By admin On April 9, 2013 - Comments

This week, Prof John Williams specialist in small animal surgery provides vets with an update on one of the genuine emergencies we see in dogs.

Having been busy co-editing and writing for  the new edition of the BSAVA Manual of Canine and Feline Abdominal Surgery, I was researching for the updated chapter on Gastric Dilatation & Volvulus (GDV) and thought it would be a good time to bring the findings of a paper on 306 cases of this life threatening condition to people’s attention (Mackenzie G, Barnhart M, Kennedy S, DeHoff W, Schertel E. A Retrospective Study of Factors Influencing Survival Following Surgery for Gastric Dilatation-Volvulus Syndrome in 306 Dogs. J Am Anim Hosp Assoc. 2010 Mar;46(2):97–102.)

The most striking feature of this study is that survival rates are improving, with a reported overall mortality of 10%,  and those cases which simply underwent derotation and gastropexy the mortality was only 3%.  The mortality rate did increase to 20% when gastrectomy and splenectomy were performed, this again is lower than previous reports where it is over 30%.  Previously, overall mortality rates of around 15 – 50 %  have been commonly reported for this acutely life threatening disorder.

The take home messages for me, from this paper were

-All the cases were referred to a surgical referral centre.

-There is some leeway in time from the onset of clinical signs before surgery needs to be performed.

-Total fluid resuscitation appears to be the  key step in successful survival of these patients. 

             *Though patient stabilisation and surgery still needs to be carried out in a timely fashion.

-Anaesthetic times were less than half those previously reported -though not statistically significant- the mean surgical time was 48 minutes (median time was 30 minutes).

There are clear and well identified statistically significant factors which increased the mortality rate in this study.

-Pre-operative cardiac arrhythmias

*4 out of 12 dogs with intermittent ventricular arrhythmia died

*No dogs with ventricular tachycardia died

-Carrying out splenectomy alone (15% mortality)

-Performing gastrectomy alone  (9% mortality)

-Splenectomy combined with partial gastrectomy (20 % mortality)

-Postoperative cardiac arrhythmias

*4 out of 28 dogs that developed ventricular tachycardia died

*Intermittent ventricular arrhythmia postoperatively did not significantly affect mortality

Interestingly in this report there was a lower mortality rate for those dogs that had an ‘increased time from presentation to surgery’.  This clearly goes against the logic that surgery should be carried out as soon as possible to minimise the risk of tissue ischaemia and its sequelae.  The authors argue that their goal was complete fluid resuscitation prior to anaesthesia and surgery and that they aimed to achieve this in a timely manner.  In their study the median time from presentation to surgery was one hour, the shortest time interval was 15 minutes and the longest 5 hours. Another factor which was of great interest was that the duration of clinical signs had no effect on the mortality rate, the median duration was  6 hours with a range of 2- 12 hours.

So, plenty to consider that may change your view on management of GDV. In the initial stages your main goal has to be fluid resuscitation in these patients. Secondly gastric decompression is important to prevent impairment of venous return. But once the dog is stabilised the option is there to refer to a specialist surgeon to complete the surgery. GDV needn’t strike fear into the front-line vet and at Northwest Surgeons the team of specialist surgeons and anaesthetists are poised to help you at any stage.

 

 

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Feature

Chocolate off the menu for dogs

By admin On March 28, 2013 - Comments

Easter is here and there will be chocolate in nearly every home! Children and busy households may drop some chocolate onto the floor and right away your dog has picked it up. Some hungry dogs will stop at nothing to open your Easter eggs! Although it may seem harmless at first, it is important that you recognize the signs of chocolate poisoning and that you call your vet as soon as possible, as the condition could be fatal.

What makes chocolate toxic to my dog?

Chocolate contains 2 toxic components – theobromine and caffeine. Theobromine is present in greater amounts and is responsible for most of the clinical signs in a case of chocolate toxicity. Dogs can´t break down and excrete theobromine as efficiently as humans. As a result, the half-life of this toxin is very long in the dog and clinical signs will arise depending on the amount and type of chocolate ingested and also the weight of the dog.

What signs should I look out for?

Initially, the dog may develop abdominal (stomach) pain, vomiting and hyperactivity. The vomit may contain substantial amounts of chocolate, giving it a very characteristic smell. The dog may be restless, drooling saliva and increased thirst is also common.

As the time passes and there is increased absorption of the toxic substance, they may show an increased rate of breathing, muscle tremors, or rigidity. The colour of the gums may become bluish (this is known as “cyanosis”). Some dogs may develop seizures and in some cases the poisoning is fatal.

In the majority of cases, the symptoms occur within a few hours, but it has been known to be delayed for as long as 24 hours.

How much chocolate is too much?

The different types of chocolate contain different amounts of theobromine. In decreasing order of content of theobromine, we have:

Cocoa beans
Cocoa powder
Dark chocolate
Milk chocolate
Chocolate powder
White chocolate

Therefore, cocoa beans, cocoa powder and baking chocolate present the highest risk of toxicity, while poisoning will be unlikely with white chocolate. As little as two small one-ounce squares of baking chocolate can be toxic to a 10kg dog

What is the treatment for chocolate toxicity?

Theobromine has no specific antidote. Every case is different and your vet will adjust the protocol according to the clinical signs. Do not wait for your dog to develop clinical signs. You must call your vet immediately and he will likely try to make him vomit. If the dog has eaten the chocolate several hours before (vomiting won’t be beneficial in these cases) or if the dog is fitting, you should expect a more guarded prognosis.

Is chocolate also toxic for cats?

Yes, it is. Cats don’t tend to pick up things from the floor as frequently as dogs, but cats are even less tolerant to theobromine than dogs are.

So what may seem totally harmless, could actually be fatal to your beloved pet. For advice on other household hazards to pets, click here for our latest blog.

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fat-dog
Feature, Our Pets

The pet obesity epidemic

By admin On March 19, 2013 - Comments

Obesity can have a severe impact on people’s health, increasing the risk of type 2 diabetes, some cancers, and heart and liver disease. There is also a significant burden on the NHS – direct costs caused by obesity are now estimated to be £5.1 billion per year. As a nation we struggle to take obesity seriously and this spills over onto our pets as well. Research by the PDSA, the UK charity which provides pet care to those in need shows that 13.5 million overweight pets regularly receiving fatty and sugary treats such as takeaways, crisps and cakes. The PDSA Animal Wellbeing (PAW) Report shows that;

  • Overweight pets are at risk of serious health conditions such as diabetes, heart disease and arthritis, and have a lower life expectancy than healthy pets
  • 61% of pet owners think severely overweight pets should be removed from an owner who persistently ignores veterinary advice
  • 51% of pet owners think that overweight owners are more likely to have overweight pets
  • 48% of owners admit to giving their pet a treat because they think it makes their pet feel happy, while 29% of owners say it’s because it makes them happy

Do any of these statements ring true? One of the comments we always hear is that people feel sorry for their pets and cannot ignore those wanting eyes! You must resist! The second comment is ‘so am I killing him with kindness?’ The answer is clearly yes, but that is not the answer people want to hear.

A previous report from 2010, involving almost 30,000 dogs across the UK over the past four years  found a staggering 35% of pets were carrying too many kilos. In 2006 the figure was 21%, and PDSA warned that if the trend continues, almost half of all dogs could be overweight by the end of 2013. So 2013 is here, we have a pet health epidemic and the time for action is now.

The recent government call to action on obesity sets  ambitions for a downward trend in excess weight in both children and adults by 2020 and sets out how, by working together, a wide range of partners will be able to make these ambitions a reality. From this, it is clear that as pet owners you need help.

Firstly, ask yourself whether you think your pet is overwight. Not sure how to tell? Click here to view the PDSA’s page with charts that you can download to assess your dog, cat or rabbit. You can also download the full PAW report from this page too.

Secondly, don’t be afraid to phone your vet practice and request an appointment. Most practices run weight clinics with knowledgable staff with workable solutions for you.

How can Northwest Surgeons help?

 At Northwest Surgeons one of our nurses Caroline Boothroyd holds an advanced qualification in nutrition and is able to tailor-make diet regimes to suit the individual cat or dog. As well as producing a weight-reduction plan, Caroline is there to support you through the process.

With our orthopaedic clinic many of the cases our orthopaedic specialists see suffer from arthritis. In people we know that weight reduction is one of the key factors reducing pain in arthritis – and should be considered before medication. Our team of specialist-led anaesthetists run a pain management clinic for these patients so we  are perfectly equipped to offer everything you need to help your pet lose weight and improve their comfort levels.

Shocked by what you have read? Yes, this is a real welfare issue. We as owners are to blame and need to wake up to what we are really doing to our poor pets.

Put the biscuit back!

 

 

 

 

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Feature

Anaesthetic risk – need to know information

By admin On February 21, 2013 - Comments

In this age of information overload you need to be sure you are looking in the right place – especially if you are researching information on your pet.

There are many preconceptions about anaesthesia, but what’s the latest information that you need to know?

Every procedure we perform in veterinary medicine and surgery carries risk. As far as anaesthesia is concerned, as specialists we are not only aware of the risks, we are at the forefront of ensuring we do everything we can to minimize risk and make the anaesthetic as safe as possible for your pet.

You make think that sedation is safer than anaesthesia. When we appraise the evidence this is unlikely to be true. So what are some of the factors to take into account?

Drugs

If any one drug were proven to be unsafe it would be removed from the market. There is a pre-conception that certain drugs should not be used in certain breeds. Current evidence tells us that it is difficult to make breed-specific recommendations and we do not find that one breed is more difficult than another with anaesthesia.

‘There are no safe drugs only safe anaesthetists’

Familiarity of the drugs we use and the techniques required for anaesthesia is of paramount importance. This is only acquired through experience – gained through our busy caseload as well as our past experience.

Health status

It is clear from the latest study into anaesthesia mortality that health status is one of the main predictors of complications under anaesthesia. Approximately 1:1900 healthy dogs and 1:900 healthy cats die under anaesthesia. If we take sick cases into account the chance of dying drops dramatically to 1:70 for both dogs and cats. The good news is that these figures have improved compared to earlier studies.

Pre-GA blood tests

The latest research would suggest that in a fit and healthy animal, a pre anaesthetic blood test does not improve safety. We know that in dogs over 8 years old there is a benefit and this has shaped our clinical approach. Where we have any suspicion from examining an animal that further information is necessary we will take a blood sample. This decision should always be made by a veterinary surgeon and you should never have the decision placed upon you, the owner. Being a specialist referral centre many of the animals presenting us are sick and so we do have the facilities to run these tests in-house prior to anaesthesia.

Monitoring

As a specialist referral centre every anaesthetised case is monitored by a Registered Veterinary Nurse under the supervision of a specialist anaesthetist. The specialist plans the anaesthetic for every individual patient, taking into account the patient’s history, presenting condition and procedure to be conducted. We have full monitoring at every anaesthetic station to alert us immediately if any parameter changes. Should a problem occur under anaesthesia we are best equipped to react to any change. A nurse dedicated to that pet records parameters every 5 minutes.

We know that monitoring does not stop at the end of the anaesthetic. The recovery period actually carries the greatest risk and during this period we continue a high level of monitoring. If necessary, we have the knowledge and experience to provide intensive care to those pets in the greatest need.

Pain

A definitive link between pain and anaesthesia safety is yet to be documented but we certainly find very painful cases are more difficult to manage under anaesthesia. In this regard our anaesthetists constantly strive to prevent pain before, during and after surgery so you can rest assured this is one of our utmost concerns with every surgical procedure.

For more information on what happens during anaesthesia, you can read a separate article written by our anaesthesia specialist Matt Gurney. In you are interested in one of our case studies, this one follows Lily, a young Cavalier King Charles Spaniel through a hip replacement at Northwest Surgeons.

We regularly update our blog with useful veterinary specialist articles for owners, vets and nurses. Check back from time to time!

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Our Pets

Moving home with your cat

By admin On February 5, 2013 - Comments

Moving home can be just as stressful for your feline friends as it is for you. Here are some tips to help you with this:

  • Provide the house you currently live in with two Feliway pheromone diffusers – one upstairs and one down. This should be done the month before you move. When you move to your new house continue with the Feliway adapters for at least the first 1-2 months.
  • You can obtain an oral tablet named Zylkene to help with cat behaviour in stressful situations. For more information on stress and behaviour modification techniques click here. Zylkene can be obtained from your local veterinary practice.
  • If your cats are microchipped ensure you call the database administrator to change the registered address. If you do not have your cat microchipped, this is highly recommended and is a very quick and simple procedure.
  • It is advised to keep your cats indoors for 2-4 weeks. Provide one litter tray per cat and one additional one. You may need to use soil for litter if your cats are used to going outside.
  • Ideally provide separate feeding stations to help relieve stressful situations. Cats are solitary animals and will be happier eating on their own.
  • Provide your cats with lots of comfortable beds and hideaway areas. You can purchase enclosed beds which some cats really like and feel secure in, alternatively once you unpack this will be a use for those packing boxes! Familiarise your cats with the any new bedding before you move so they have their own scents. This will help to make them feel more secure and comfortable.
  • If you do not already have scratching posts, I would provide a couple whilst they are kept indoors to save your sofas!

If you follow these simple instructions you and your cats should hopefully be very happy in your new home.

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New Year 2013 Party
Feature, General

New Year, New Blog!

By admin On January 8, 2013 - Comments

With the New Year well underway you may be left pondering your resolutions. Right across the scope of what life throws at us there are things we wish to do better, things we’d like to learn. Where specialist veterinary advice is concerned, let our blog ‘On the pulse’ help you.

The Northwest Surgeons blog is designed to help you, the pet owner and aims to be a reliable source of veterinary advice. Have a look yourself and you will see the wide range of topics we tackle from infection control and MRSA right through to the ins and outs of veterinary specialisation. We all love a behind the scenes tour. That’s why our blog and our website are both full of photos and case studies. We want you to see the work that goes on behind the scenes in achieving our goal of providing the very best to your pet.

At Northwest Surgeons we are much like the consultants of the veterinary world. If your dog or cat needs specialist care, your vet can refer you and your pet to us, much as your GP would refer you to a consultant at your local hospital. So yes, we deal with complicated cases day in day out – but some seemingly complicated cases could have been avoided with simple veterinary care.

You should never overlook the importance of routine worming and vaccination. Five years ago, lungworm (Angiostrongylus) was rare in the north west of England. Nowadays this disease, which can prove fatal, is becoming a more frequent diagnosis. Dogs and cats should both be wormed at least every 3 months with a good quality wormer purchased from your vet. Don’t be tempted to accept a cheaper supermarket brand – it is cheap for a reason. Parasites are incredibly good at evolving ways to become resistance to wormers so an inferior product may leave your pet vulnerable to disease. The first noticeable sign of lungworm in your dog could be as obvious as a cough but this horrible disease is not always caught in the early stages and our internal medicine specialists have all dealt with fatal cases.

One of the worms which infects dogs, Toxocara canis, can be dangerous to infants. If eggs of this worm are ingested by children, the eggs become larvae and migrate through the body. If these larvae reach the eyes, the result can be blindness. This is one major reason why dogs are kept out of children’s play areas in parks and away from beaches where children play. If you are a dog owner with young children it is imperative that you worm your dog. In dogs it is rare to see external evidence of worms (I wish I had £1 for every time I heard an owner tell me there’s no way their dog has worms! We’ve all seen the way dogs lick one another!)

Thanks to widespread vaccination many diseases, which previously affected dogs are rarely seen. This is truer for dogs, Distemper for example. In cats, the diseases that we vaccinate against are still prevalent (cat flu and feline leukaemia) due to the fact that there are more wild cats than dogs and people are less likely to vaccinate their cats.  In dogs, parvovirus and leptospirosis (Weil’s disease) are two diseases that are still seen daily by vets in certain areas of the UK and we should no way become complacent. Dogs and cats should be vaccinated every 12 months – ask your vet for more details.

Parvovirus is a major cause of dysentery-type diarrhoea in puppies – there is no specific treatment and this highly contagious disease can prove fatal. (If you are on Twitter you can sign up for parvo alerts in your area).

Leptospirosis is a challenging disease because there are many types (serovars) of this disease and it can even affect dogs that are vaccinated – this is because it is impossible to vaccinate against every different variation. It causes liver and kidney failure and is also transmissible to people.

Are you reading this looking at your pet, thinking they need to join you in the New Year dieting? Like in man, obesity in dogs and cats is getting worse. Fat pets suffer from similar problems to obese people such as diabetes and arthritis. It’s official – quality of life improves when obese pets lose weight! Your local vet nurse will happily advise you on the best way to trim those pounds from your pet – first thing to do: zero tolerance on treats!

If all of this is leaving you a little concerned about the cost of maintaining your pet, have you thought about insurance? It may surprise you that many vets and nurses insure their own pets. That’s because when something goes wrong, we all want the very best. And there is no NHS for pets. Yes, veterinary specialist care is not cheap, but neither is private medical care.

Our advice is to insure your pet. But, like everything in life, you get what you pay for. Look for a policy that covers a condition for life – if your dog suffers with diabetes, a lifelong condition, what’s the use in a policy that stops paying after one year? So how much cover do you need? If your dog or cat gets hit by a car and needs specialist treatment the bill is likely to be several thousands of pounds. There are many £2000 policies on the market, but these may leave you short, so aim for at least £4000 per condition, per year. For more detail see our blog on pet insurance. Warning – if it’s cheap there’s a reason why. Every month we deal with clients who thought they were adequately covered with a good policy. Ask your vet who they insure their pets with!

Maybe your aim for 2013 is a little training for your best friend? For great advice on dog training see our link to the Blue Cross

Whatever you decide for 2013, make a resolution to check back on our blogs and see what we’ve been up to! Happy New Year!

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Feature

Pets, vets and Christmas – your need to know guide!

By admin On December 18, 2012 - Comments

Christmas is great fun for all the family, and that includes our four-legged friends! If you’ve seen all the fuss about the recent advert for a certain major supermarket though, you’ll know that the festive season is also potentially dangerous…here are a few of the hazards to watch out for:

Food

We all enjoy a few treats at Christmas time – but be careful about sharing these goodies and make sure to hide them away if you have a pet who’s partial to pinching the odd bit of food.

Raisins, sultanas, currants and grapes are common ingredients in festive cakes, Christmas pud and mince pie and have attracted lots of attention after that supermarket advert! Even a few raisins or grapes can be toxic so if your pet manages to get hold of any of these then get him or her to the vet straight away. Possible signs of toxicity include sickness, diarrhoea, poor appetite and lethargy. If caught early then your pet stands a good chance of recovering, but left untreated the toxins can cause kidney failure and death.

Many of us already know that chocolate is poisonous to our pets. It contains both caffeine and another related stimulant called theobromine. Its effects can range from vomiting and diarrhoea, dehydration and fever to neurological signs such as seizures and even potentially abnormal heart rhythms which can be fatal. Baking or dark chocolate contain the highest proportions of cocoa solids and are most toxic, but in sufficient quantities milk chocolate can be harmful too so make sure those selection boxes are well hidden away!

Other foods to watch out for include onions and other foods from the onion family (commonly found in that Christmas stuffing!) , which contain a chemical which causes rupture of the red blood cells leading to anaemia.  Of course turkey bones, which are brittle and splinter when cooked – it’s easy for cats or dogs to choke on the fragments or for sharp pieces to damage the intestine, leading to severe infection (‘septic peritonitis’) which  is fatal in a high proportion of cases.

We all want to spoil our pets so that they can enjoy Christmas too, but remember that lots of the rich and delicious foods we enjoy over the festive season are too rich for them. Eating unusually fatty foods is potentially linked to a serious condition called pancreatitis; it can cause severe stomach pain, sickness, diarrhoea, lethargy and in some cases even death. Of all the medicine cases we see here at Northwest Surgeons, the pancreatitis cases are some of the most painful. 

Many of us like to get into the festive spirit with a drink or two but alcoholic beverages are poisonous to pets so keep them well out of their reach. If your pet has had a few too many Christmas goodies then don’t hesitate to get them to the vet for treatment!

Christmas decorations

Festive food isn’t the only potential danger at this time of year! With all the decorations around, there are many other potential problems if you have a curious cat or a daredevil dog.  Cats in particular find ribbons and tinsel irresistible toys, but beware…they can easily be ingested, and can require surgical removal so again if this happens take your pet to the vet straight away. Watch out for wrapping paper and toys too!

Lights and tree decorations can be similarly fascinating, especially for young puppies or kittens who have never seen them before. These can cause cuts or scratches in the mouth if chewed, or again can require surgical removal if swallowed. If you choose more natural decorations such as mistletoe or holly then watch out for the berries, as these too can be toxic if consumed in large amounts. Signs to watch out for include drooling, sickness, and diarrhoea. Even the Christmas tree is not completely harmless, with the oils from the fir tree irritating the mouth and stomach causing drooling and sickness. The tree needles needles too can be sharp and can get caught in the paws or in the back of the throat if swallowed –ouch!

Last but not least….

Antifreeze might not be particularly festive but it’s certainly more common at this time of year when it’s cold. It contains ethylene glycol and is severely toxic. Unfortunately for our pets it also has a sweet taste which encourages many of them to consume it. In the acute or early stages your pet might appear drunk but the real target organ is the kidney; crystals form within the kidneys resulting in acute kidney failure and once this happens the prognosis is extremely poor so the sooner you can get your pet seen and treated the better. The chances of survival are linked both to the amount of antifreeze consumed and how quickly treatment is started.

Remember too that nervous or elderly pets might find the festivities all a bit too much – what with lots of visitors in the house, music, and the noise from crackers, party poppers or champagne corks it can be a stressful time. Make sure you provide a quiet spot for them to retreat to, and you could ask your vet about treatments such as the Feliway or DAP diffusers to help keep them calm too. Click here for our blog on keeping cats happy during fireworks.

While all of this sounds scary, most of these festive hazards are easily avoidable if you are aware of them. Of course we would like to wish you and all your pets a happy and a healthy Christmas but if you do encounter any of these problems then the team at Northwest Surgeons are here to help, even on Christmas Day!

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Maiz n George (2)
Feature

What happens if my dog doesn’t recover after a spinal injury?

By admin On November 29, 2012 - Comments

At Northwest Surgeons we see an estimated 150-200 cases of spinal disease per year.  Most of the cases we see have a form of intervertebral disc disease (similar, but not entirely the same as a slipped disc in a person).  When we see these cases we need to assess the severity of the injury and we use a 1-5 grading scale, 1 being the least severe and 5 being the most severe. 

Many spinal cases are amenable to surgery and we would consider the prognosis for grade 1, 2, 3 and 4 patients to be approx 90% chance of making a functional outcome i.e. free from pain, able to walk, although they may still be wobbly, and able to toilet themselves.  For grade 5 patients the prognosis is approximately a 50% chance of making a functional outcome with surgery but only 5% without; in some circumstances the prognosis is even poorer than this.  We would generally have cautious optimism when faced with a dog with a grade 1, 2, 3 or 4 spinal problems and although the prognosis is less favourable for a patient with a grade 5 problem, surgery offers the best hope.

But what happens if your dog is one of the unfortunate patients that doesn’t recover after a spinal injury?  Well, if your dog cannot walk and is doubly incontinent (cannot urinate or defecate on its own) many owners will make the incredibly tough decision to have their dog put to sleep and we have to warn them of this risk before we start treating any spinal patient, especially with patients that may have a less than 50% chance of recovery.

But what if you feel that your dog would cope as a paralysed dog and what if you wanted to do everything that you could to save your pet’s life?  Maisie was one such patient and her owner, Stuart, felt that he wanted to do everything he could for Maisie.  At the time of writing, Maisie is 6 months after spinal injury for which she had spinal surgery but unfortunately did not recover. 

Stuart has kindly written a frank and honest account of management of a paraplegic dog and given us permission to reproduce his report on our website in the hope that his story with Maisie might be of help to others unfortunate enough to be in a similar position.  Stuart writes:

 “As promised please find below a few videos of Maisie on her wheels and having a hydrotherapy session, I have also attached a couple of picture for you too:

Maisie wheels video 1 -  http://www.youtube.com/watch?v=cHtFo8r5DJc

Maisie wheels video 2 - http://www.youtube.com/watch?v=FnJXXeh7F5M

As I said, she is doing really well! Even though there isn’t much change in her rear legs she has adapted great! When she’s in the house she just drags herself around, she is pretty much as quick as she was before when she gets going and as all our floors are dog friendly she hasn’t picked up any friction injuries at all.

Outdoors we put her on her wheels which again she has adapted great. At first she was a little wary of them, just because they were something new but it literally took her 5 minutes to be running round on them! Now she keeps up with my other dog when we are out although she does get tired a little quicker than she used to so I just never take her too far and give her plenty of rests out of the wheels. This is where I got the wheels from http://wheels4dogs.co.uk  and they were on a next day service. I think the company is actually American and these are the UK distributor. This is the US site which has much more info on it http://walkinwheels.com/

Toilet wise, when she is in the house we use a newborn baby nappy with a hole cut in for the tail as sometimes she will wee lightly herself or if she is playing she will dribble so the nappy just keeps things hygienic. I express her 4 times a day, once at 7am, once at 12 noon, once around 5pm and again before we go to bed about 10.30pm. Every time I express her urine I also try to make her poo. To do this I literally just rub her bum with a wet wipe, I’ve got used to how things feel now so can tell when she needs to do one, she poo’s probably twice a day. Once I rub her bum slightly, she does the rest herself. I’ve found the best way to wee and poo her is onto puppy training mats either on the decking if its dry or in the kitchen, that way I can see how much she has done. At first I found it hard and because I wasn’t emptying her bladder completely she got a couple of little water infections but I guess it just takes practice and now I’m a master at it! Haha. To be honest now we are in a routine things are really easy, if anyone goes down this route tell them not to be disheartened by the first few weeks, it gets so much easier. I’d say Maisie is easier to look after than my other dog George!

I’ve also started taking her to a local hydrotherapy pool once a week which she really likes. Even if it doesn’t help her regain her legs in any way, its good exercise for her heart and front end and also gives her a good bath once a week. Maisie Hydrotherapy Session - http://www.youtube.com/watch?v=viREz66Nh9Q

The first couple of weeks were tough, especially trying to keep her still but we got through it. When we are out of the house the dogs sleep in a soft enclosed bed so they can’t run around too much. They are well happy in there and usually even when we are in and they need a rest they would rather go in there than sit on the couch with us.

I don’t think keeping a disabled dog would work for every situation, it would depend on the amount of time people could give up, the environment and the dog and there is also an associated cost with nappies, pads, wipes etc but I’m glad we kept Maisie. She is the same old dog, she hasn’t changed one bit she has just adapted! If I thought for one minute she was miserable or in pain then I would do the right thing by her but I can honestly say she is just as happy as she always was!”

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