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Surely it isn’t really dangerous to throw sticks for dogs?

This is a topic that comes up again and again - but sadly, it is true! Over the last year or so, there has been a growing chorus from vets to warn people of the (very real) dangers of throwing sticks for dogs - sadly hindered by celebrities who should know better. Yes, it’s true that many dogs catch sticks every day of their lives and never have a problem, but how would you feel if it was your dog that became impaled, abscessed, or bled to death from a lacerated artery?
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What the new Public Space Protection Orders mean for dog owners.

Public Space Protection Orders were first introduced by the UK government in the Anti-social Behaviour, Crime and Policing Act 2014. They were intended to prevent anti-social behaviour in public places (a bit like the old fashioned “ASBOs”, Anti-Social Behaviour Orders, but for a place not a person).
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Grapes and raisins can kill dogs. Read this to find out how to keep your pet safe this Christmas.

Does your dog enjoy mince pies and Christmas cake? Beware: you could accidentally poison them.

For many people, it seems unbelievable that grapes and raisins can poison dogs. They're harmless to humans. We've all seen dogs occasionally eating foods containing raisins with no apparent ill effects. How can they suddenly be poisonous?

Why are grapes and raisins not always poisonous to dogs, and never poisonous to humans? First, like all poisons, the poisonous effect depends on the dose taken per kilogram of animal body weight. Large dogs can safely eat some raisins without problems. Secondly, the toxic ingredient in raisins seems only to be present intermittently, so a dog may eat raisins without problems on several occasions, then fall seriously ill the next time. What is the toxic ingredient in grapes and raisins? The actual toxic ingredient is still a mystery. The fact that grapes and raisins can be poisonous has only been deduced by circumstantial evidence, with many dogs developing acute renal failure for no obvious reason, with the only common factor being the previous ingestion of grapes or raisins. Samples of the fruit in such cases has been analysed, but a toxic agent has not yet been isolated. The best guess so far is that it is a water-soluble substance, and that it's in the flesh of the grape/raisin, but not the seed. One theory is that it is a mycotoxin (i.e. a poison produced by moulds or fungi on the grapes). The problem in dogs was first highlighted after a year with high levels of rainfall. This had led to damp grapes which were more likely to develop fungal growth. But why should humans be safe from this toxin? It's well known that cultured dog kidney cells in the laboratory are exquisitely sensitive to other types of mycotoxins. It makes logical sense that dog kidneys might also be more sensitive to damage by another mycotoxin, even its identity has yet to be established. So how much do owners need to worry about grape/raisin toxicity? If a terrier steals a mince pie, is a visit to the vet needed? If a Labrador has a slice of Christmas cake, do they need to be taken to the emergency vet? This is always a judgment that is not black and white. It seems sensible to look at the lowest recorded doses of grapes or raisins linked to acute renal failure in previous cases of poisoned dogs. This allows an estimate of the probable toxic dose depending on the animal's body weight. Grapes The lowest toxic dose is around 20g grapes per one kilogram of body weight. A typical grape weighs 2 – 5g, making a toxic dose is around 4 grapes per kg. So if a 5kg terrier eats 20 grapes, or a 30kg Labrador eats 120 grapes, there's a high chance of a serious problem, and veterinary intervention is definitely indicated. Raisins The lowest poisonous dose in confirmed cases has been around 3g/kg. An average raisin weighs around 0.5g, making a toxic dose approximately 6 raisins per kg. So if a 5kg terrier eats 30 raisins, or a 30kg Labrador eats 120 raisinsthey need to see the vet. Some studies have suggested that the toxic agent is neutralised by cooking, so cooked raisins (e.g. in pies and cakes) may not present such a high risk.

Important note

Please remember that the above doses mention quantities that have definitely caused serious kidney failure in the past. The decision on whether or not to take a pet to the vet is a personal decision, taken after balancing the possible risks. Many people prefer to take a conservative approach, to be as safe as possible. For example, if a dog has eaten even half of the above quantities, it may be safer to take them to the vet for “just in case” treatment.

What do vets do for dog that have eaten grapes/ raisins? 1) If ingestion has happened in the previous hour. This is the ideal situation: the vet can give an injection to cause the pet to vomit, emptying the stomach and removing the grapes/raisins before any toxic ingredients have had a chance to be absorbed into the bloodstream. 2) If ingestion has happened in the previous two days but the pet is still well Depending on the situation, vomiting may still be induced, activated charcoal may be given to limit absorption of the toxin, and intravenous fluids may be given to flush fluids through the kidneys in an attempt to minimise any damage. Blood and urine tests may be recommended to monitor kidney function. If the dog is well after three days, then the high risk period is over. 3) If ingestion has happened and the dog is unwell (e.g. vomiting, dull, inappetant) In such cases, the kidneys may have already been damaged by the toxin. Urine and blood tests will be carried out to assess the severity of the damage to the kidneys, and intensive care will be needed to save the pet's life, including high levels of intravenous fluids. The prognosis is guarded: unfortunately, some affected dogs die, despite the vet's best efforts.  Conclusion.
  • Keep grapes and raisins away from dogs.
  • If any dog eats them accidentally, phone your local vet (even if it's after-hours)
  • Tell your vet how many grapes/raisins were eaten along with the body weight of your pet.
  • Your vet will then advise you on the safest course of action.
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Fear of fireworks can affect cats as well as dogs: how do we know, and what can we do to help them?

fireworks-80210_1920 In the veterinary blogging world, there are key seasonal topics that come up every year: hazards around the home at Christmas, chocolate poisoning at Easter, heat stroke in summer and, of course, the fear of fireworks at Halloween/ Guy Fawkes Day. It can be a challenge to come up with a new angle every year: it could be tempting to find an old article, re-jig it and re-phrase it, and the job is done. After all if you plagiarise yourself, is there anything wrong with that? A better answer, however, is to seek out a completely new angle. So with the help of the Wikivet archives, instead of writing a repeat blog of what to do with dogs that are terrified of fireworks, here's an alternative: how to help cats cope with fear of fireworks. In general, fireworks phobia is not nearly as big an issue for cat owners as for dog owners. But it's very likely that it may be just as big an issue for the animals themselves. Cats, being independent creatures, are far more likely to run away in terror and hide, leaving their owners entirely unaware of their distress. Cats don't pace around, whining and barking. If they are terrified, they're far less likely than dogs to bother their owners in any way. So at this time of year, it makes sense for cat owners to be proactive about this subject: take a careful look at your cats, and make sure that they are definitely not distressed by the sounds of bangers and other fireworks outside. The signs of distress can be subtle enough: they may indulge in intensive bouts of over-grooming (which can be likened to an anxious human chewing their nails). Or they may dart around the house, rushing upstairs and hiding under beds. Perhaps the best way of assessing this is to ask yourself if your cat is behaving in a normal relaxed manner. If not, then they may be suffering from fear of fireworks noises, and you may be able to make them feel more comfortable with some simple steps. So what can you do? As with dogs, prevention is the best answer. Ideally, avoid taking kittens that come from aggressive or fearful parents, or that have been reared in an isolated, unsocial environment. Make sure that kittens have proper habituation to a wide range of events and stimuli during the sensitive period before 7 weeks of age. Deliberate exposure to sound stimuli using recordings is helpful, but kittens should not be habituated to traffic sounds: cats need to be frightened of oncoming cars. After kittens have grown older, new noises should be introduced gradually and slowly, again using recordings, so that they are less likely to terrify the cat. Pheromone diffusers may help to enable adult cats to adjust to episodes of loud noise, such as parties or firework displays. And it helps to have a “cat friendly home”, with snug beds hidden in low-down places, and high-up perching posts for cats to survey the world below them. For cats with an established severe fear reaction, consulting with a feline behavioural expert can be helpful: a simple phone consultation may be enough to allow you to cover some specific aspects of your own cat's behaviour. A general process of “desensitisation and counter-conditioning” is the general aim: this means exposing the cat to a low level of the noise which causes a bad reaction, while rewarding the cat for staying calm and playful. As long as the cat remains contented, the noise can gradually be increased in volume: hopefully the cat will become “desensitised” to it. Feline pheromones help this process, and in some cases, your vet or behavioural expert may suggest psychoactive medication. If your cat has a fear of fireworks, don't let them suffer in silence. Observe them carefully, and with some simple, thoughtful steps, you should be able to help them enjoy this time of year. By the way, keep all cats inside during the hours of darkness around Guy Fawkes night: it isn't a safe time for cats to be out on their own.
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The BBC is wrong to allow an unqualified person to recommend unproven treatments to animals

The Hay Festival is not a place where you might expect to learn about the treatment of animals: it's an annual literature festival held in Hay-on-Wye, Powys, Wales, for ten days at the end of May every year. Caroline Ingraham has written an interesting book - "How animals heal themselves" -  which is presumably the reason she was given the opportunity to give an account of her subject at the Hay Festival last week. The BBC have created a podcast from her talk,  but I believe that the editors were wrong to give her this uncritical forum to propagate her views. Caroline has a controversial belief in the ability of animals to choose their own medicine. There's nothing wrong with her having these beliefs, but there is a problem when her views are broadcast without any "public health warning". There is a serious risk that animals could suffer unnecessarily if members of the public follow her advice to the letter. In her talk, Caroline recounts entertaining anecdotes of animals (including elephants, horses, dogs and cats) that have recovered following her approach of allowing them to choose their own treatment from vegetation and other substances in their natural environment, or from herbal products offered to them by Caroline. In her words, the animals "guide her to help them make a full recovery". Caroline stresses the importance of "letting animals lead the way" for behavioural and physical problems. As a vet in practice, I know that 70% of the animals brought to see me will recover by themselves, with no intervention or medication. Animals have evolved with strong internal natural healing capacity (it's called homoeostasis) Our aim as vets is to assist the healing process using scientific methods. There are many reasons why animals may fail to heal themselves, and science can often help. Serious bacterial infections are cured by giving antibiotics that kill the bacteria. Coughing caused by a failing heart is stopped by giving diuretics that remove the fluid gathering in the lungs. Cancer can be cured by surgical excision, followed sometimes by drugs to slow the regrowth of cancer cells. These are all treatments that are scientifically proven: in trials, it has been shown that if some animals are given the treatment, and some are not, a significantly greater number of animals improve. Caroline offers no such evidence: her treatments are all anecdotal. My concern is that she may be witnessing the "regression towards the mean"  i.e. the ability of animals to heal themselves without human intervention. Since around 70% of animals may recover naturally, if you believe that any recovery that you witness was caused by your intervention, you will believe that your treatment "works" 70% of the time. While this may sound impressive, the truth is that your intervention is having zero effect. If Caroline wants to clearly demonstrate the efficacy of her methods, she needs to do what pharmaceutical companies are obliged to do: carry out trials that compare animals receiving her treatment with animals that receive no treatment (a so-called control group). If she does this, she will be able to say without question that any extra improvement in the treated group is due to her treatment. Without doing this, her claims have no scientific validation, and it's hard for objective observers to take them seriously. At the end of the talk, the presenter did ask Caroline if she was a scientist, and if her work was "evidence based research". She replied "I am not a scientist but the subject of zoopharmacognacy is an academic science". Caroline says that in trying to develop her work, "resistance came in from a variety of different establishments that tried to make it really very difficult for me to continue this work." There is a simple reason for this resistance: there is strong legislation in the UK to protect animals. Only vets are allowed to diagnose and treat animals. The law is there to stop (often well-meaning) unqualified people who may not be aware of their own ignorance  from accidentally harming animals because of their lack of knowledge. There may be some truth in Caroline's claims: animals may be able to choose certain forms of self treatment for some physical and behavioural issues. But this has not been proven, and it is wrong to state it as fact. It just does not seem right when an unqualified person suggests that pets should be allowed to choose their own "pain relieving herbal remedies" rather than the safe proven methods of pharmaceutical pain relief recommended by the vet attending the animal. And it does not seem right that the BBC should give such a person an uncritical platform to disseminate her viewpoint. Update 25th November - Caroline has forwarded this response to the original blog: I believe that your post undervalued the importance of case reports (referred to as anecdotes) that can provide important, detailed information about individual cases that can be very valuable, and it is much better to gather this information than do nothing at all, especially as cases typically come to us after other options have been tried. In fact some successful clinical trials have been started principally because of the promising findings of a collection of related interesting case reports; a topical example is in the human medicine world where the recent FDA approval of a new viral therapy against melanoma, which was inspired by case reports of some patients with cancer going into remission after a viral infection: http://www.nature.com/news/cancer-fighting-viruses-win-approval-1.18651 (of course in this case viral therapy would have to be under the control of a qualified specialist with an appropriately modified virus!). Other observational, non-experimental approaches have also been fruitful, such as with the work by Jane Goodall, among others.  As for Applied Zoopharmacognosy itself, after my lecture to veterinary students at Bristol University yesterday, many came up to me inspired by these case reports and want to explore setting up research projects, and possibly even small scale clinical trials, investigating self-medicative behaviours. I take your point about regression to the mean, but I understand this likely applies more to certain, short term conditions such acute pain, acute infections, slight anxiety etc. that in many cases would be expected to resolve spontaneously. Many of the individuals that I have worked with have long term conditions, most commonly with long standing behavioural issues but also other symptoms as well. The responses can be dramatic and remarkably fast, and so regression to the mean is a less plausible explanation in these cases. It is it important to note that we do not make medical diagnoses, and I advocate self-medicative approaches as complimentary to veterinary treatment not as a replacement; veterinarians are highly trained and highly skilled individuals and their input is typically invaluable. It would be fantastic if veterinarians were to add Applied Zoopharmacognosy as part of their skill set. Finally, I read with great concern in several veterinary blogs (though not this one) and tweets that I have been suggesting to pet owners to offer onions to dogs as a wormer. I would like to clarify that I have never offered, nor recommended giving an onion to a dog. It was merely an observation of an event that I found fascinating since it paralleled other documented occurrences of sick animals selecting typically poisonous plants including: Michael Huffman when he witnessed chimpanzees selecting Vernonia amydalina (locally known as 'Goat killer'), to rid themselves of nematodes (Huffman and Feifu, 1989; Jisaka, et al 1993), and in a study by Singer, et al. 2009, when caterpillars with parasitoid wasp larvae infestations changed their foraging on (normally) poisonous alkaloids such to rid themselves of parasites. The relationship between self-medicative behaviour and plant poisons is a complicated topic, which would take a lot of words to cover adequately. In brief, the most common plant poisons are due to certain chemicals called alkaloids and the reasons for why animals may poison themselves on these are not incompatible with self-medication (possible reasons include evolutionary separation of poisonous plants and companion animals, degradation of bitter warning compounds during drying such as with ragwort, reduced alternative foraging options etc.). Applied zoopharmacognosists typically work with extracts high in other compounds such as terpenoids, not alkaloids. My observations have been presented at a scientific conference in South Korea last year following an invitation by my colleague Michael Huffman, Associate Professor, Kyoto University as well as at Bristol university. I would be more than happy to open dialogue on the subject with any interested parties. Challenges to consider with self-medictaion and clinical trials: I would fully support clinical trials that look into the efficacy of self-medicative approaches. However, clinical trials are often prohibitively expensive and time intensive. The difficulty would also be that it is not immediately obvious how a trial that focuses on two different approaches to animal health could be set up without having to split it up into multiple, equally expensive trials that each focus on particular conditions. It is also important to remember that clinical trials are not completely fail-safe either.  
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