All the latest info on caring for your pet

Looking for something in particular? Check our categories!

Babesiosis – a new arrival to the UK

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

4 Comments

Crufts – the best and worst of the dog world?

Crufts starts today – the World's Largest Dog Show - an annual dog-fest that used to be seen as a "best of British" institution, but which has become controversial in recent years. This year, three different viewpoints have been loudly expressed.
No Comments

Sometimes it’s not teeth – other causes of bad breath in pets.

Bad breath, or halitosis, is very common in dogs and cats; however, there are a wide range of possible causes. Some are simple to treat; others less  so – but bad breath is almost always symptoms of an underlying problem.
No Comments

Ask A Vet Online – Help, I’ve got a stuffy-nosed Pug!

pug-981207_640

Natalie Kent asked:

My 8 year old pug has just been diagnosed with Pseudomonas in his nose. He's been having problems with his nose for about a year,   discharge, blocked up etc. Vet did a nose swab and found this bacteria. He's been on marbocyl antibiotics for 2 weeks and it's not       completely gone away, still a bit of discharge and a bit stuffy but vet refuses to give any more tablets, what else would you suggest?

Reply:

Hi Natalie, thanks for your question. Because of the conformation of their skull and nasal passages, Pugs are prone to a range of different breathing problems, and may suffer from recurrent nasal infections, so I’ll start by discussing the anatomy of the nasal passages and the defects Pugs typically suffer from. Pseudomonas is a particularly nasty bacterium that can be very difficult to treat effectively, so I’ll also talk about appropriate antibiotic therapy and the reasons why the symptoms may not have resolved. Finally, I’ll look at different ways forward for your dog.

What is the “normal” anatomy of a dog’s nose and airway? When a dog breathes in, the air flows through the nostrils (also known as the “nares”) into the nasal chambers. The left and right sides are separated by a dividing wall (the “nasal septum”) so what affects one side doesn’t always reach the other; and they are separated from the mouth by the bone of the hard palate (the ridged roof of the mouth). These chambers aren’t open – they are almost filled with scrolls or swirls of bone called the conchae (because they look a bit like sea shells), leaving only a narrow space in between for air to flow. This is important because even a small amount of fluid or swelling of the tissues here can make a dog very congested and uncomfortable. Behind these 2 chambers is a common space where left and right nasal chambers meet called the nasopharynx; the floor of this is made up of a strong muscular band called the soft palate. When breathing, the soft palate prevents food from entering the nasal passages. The air then flows through the larynx (voicebox), down the trachea (windpipe) and into the lungs. Opening out of the airways in the skull are the sinuses; these are hollow spaces inside the bone that make the head lighter and easier for the dog to carry around. There are 2 sets – on each side of the skull is a frontal sinus (in the forehead) and maxillary sinus (in the upper jaw, just above the tooth roots). So what’s different about pugs? Dogs can be divided into 3 different groups of breeds, based on their skull shape:
  • Dolichocephalic – dogs with long noses, e.g. Greyhounds
  • Mesocephalic (also known as mesaticephalic) – dogs with medium noses (most dogs, e.g. Labradors)
  • Brachycephalic – dogs with short noses (e.g. Pugs).
As one of the most extreme brachycephalic breeds, Pugs almost always suffer from some degree of Brachycephalic Airway Obstruction Syndrome. This is a condition caused by selective breeding over many generations for an abnormally short skull, and includes a range of conditions such as:
  • Nostril Stenosis – narrowing of the nostrils.
  • Elongated Soft Palate – over-long soft palate that blocks the airway.
  • Everted Laryngeal Saccules – folds of flesh that stick out into the voicebox, blocking airflow.
  • Hypoplastic Trachea – where the windpipe is a little too narrow.
These are all caused by excessive amounts of soft tissue – in the course of breeding for the modern Pug, we’ve been very successful in shrinking their bones, but not so much the soft tissues around them. As a result, Pugs have loads of extra folds of tissue in their nasal chambers and airways, making breathing a little more difficult. That’s all very interesting, but why did my dog get the infection in the first place? There are a number of possible reasons, but let’s start with the most obvious – with lots of extra soft tissue in their noses, all those little crevices, nooks and crannies are perfect for bacteria to find a home and start to grow! Other possible underlying causes include:
  • Foreign bodies – dogs are particularly prone to getting things stuck up their noses, like grass seeds or even bits of food.
  • Tooth infection – because the roots of some of the upper teeth are right next to the maxillary sinuses, an infection of the tooth can cause sinusitis and nasal infection.
  • Fungal infections – fairly rare in the UK, but they do occur.
  • Polyps – benign growths in the nasal chambers or pharynx.
  • Tumours – malignant growths of the airways.
These conditions aren’t uncommon in dogs, and often result in secondary bacterial infection. Once the infection is resolved, however, the symptoms may persist or recur because the underlying problem has not been addressed. What is Pseudomonas? Pseudomonas is a Gram Negative bacterium (meaning it has a double cell membrane as well as a cell wall) that commonly causes skin, ear and sometimes nasal infections. It is a very tough organism, and is prone to rapidly developing resistance to antibiotics. This means that in most cases, a prolonged (usually 2-6 weeks) course is required to ensure that it is completely eliminated. Exactly what antibiotic to use will depend on the results of the culture and sensitivity swab which your vet did – judging by what you’ve said, it would seem that this particular infection was susceptible to marbofloxacin (Marbocyl), a fluoroquinolone antibiotic commonly used against these bacteria. So why hasn’t the treatment worked? There are a number of possible reasons. Firstly, it may simply be that the course wasn’t long enough – however, your vet is right to be cautious about just handing out more antibiotics; overuse of antibiotics in animals or people is one of the main drivers of antibiotic resistance. A second possibility is that the course was long enough, but the Pseudomonas is now resistant to marbofloxacin; I’ve seen this happen before when treating these infections. You give an antibiotic that the bacterium is proven to be sensitive to, and within a week or two, the test results show that they have gained resistance to it. Alternatively, there may have been other bacteria on that nasal swab that didn’t show up because there were so many Pseudomonas. In that case, if they weren’t susceptible to marbofloxacin, they’ll still be there causing problems even once the Pseudomonas are all dead. Finally, and given the duration of the problems you’ve been having I’d say this is the most likely, there may be another underlying problem (such as a nasal polyp, a foreign body, dental disease, or even his nasal conformation and anatomy) that is causing the symptoms. OK, what should I do next? I think the most important thing is to find out what’s going on inside your dog’s nose right now. You know that some weeks ago there was a Pseudomonas infection; however, you’ve got no idea if that’s still the case and that treatment has failed (and if so, why); or if the symptoms are ongoing despite the successful treatment because the Pseudomonas were themselves only secondary to something else. The first step would be for your vet to repeat the nasal swab (if possible, using the same laboratory) and see how the results are different – what bacteria are growing there now, and what antibiotics they are susceptible to. The next thing to consider would be direct visualisation of the nasal chambers under anaesthetic; this usually involves rhinoscopy (putting a camera or endoscope up the nose) and/or retrograde visualisation (looking at the back of the nose with an endoscope or mirror) to see if there’s anything stuck there, or any masses or polyps growing. This isn’t always easy in pugs and may require referral to a specialist; however, your vet will be able to perform X-rays of the skull and nasal chambers, as often polyps and tumours are often clearly visible on an X-ray of this region. I think it’s very important for you to discuss your concerns with your vet, and talk about further diagnostics – you really need to sort out what’s going on in that nose to make him comfortable again and to hopefully avert any more serious consequences! All the best, I hope you can get this sorted out quickly. David Harris BVSc MRCVS
No Comments

Do I need to worry about “Alabama Rot”?

You may have read in the news recently of another cluster of dogs affected with the exotically named “Alabama Rot”. Also known as “Cutaneous and Renal Glomerular Vasculopathy” (CRGV), this condition is still poorly understood. As a result, there’s a lot of worry and speculation, and vets are receiving increasing numbers of panic-stricken phone-calls from dog owners! So, what do we actually know about CRGV? What is it? Firstly, let’s specify what it isn't – for example, despite excitable media reports, it isn't a “flesh eating bug”. Nor is it a “superbug” or a variant of the Ebola (or any other) virus. Technically speaking, it is a form of thrombotic microangiopathy, a condition where blood clots form in the small blood vessels in the body, blocking off blood supply. For some reason, the skin and the kidneys are most sensitive; without a blood supply, the tissue dies, causing ulcers on the skin, and failure of the kidneys. Is it a new disease?                                      Not exactly – it was first diagnosed in the United States in the 1980s. However, the first cases in the UK were detected in November 2012; since then, cases have been seen from across the country (there’s a map of confirmed and suspected cases here). It is most common in the winter and spring – most cases are detected between November and May. What causes it? No-one knows. It is probable that a bacterial toxin (i.e. a poison made by bacteria, that causes disease even in the absence of the bacteria themselves) is involved, perhaps from E. coli; however, this has not yet been confirmed, and tests for E. coli shigatoxin (one possible culprit) have proved negative. There is, however, no evidence that it is caused by a toxic plant, heavy metal poisoning, or genetics (although it was once thought that only Greyhounds and other sighthounds were predisposed, this is not now thought to be the case). It has been suggested that contaminated pet food may be involved, but this seems improbable – there just aren't enough affected dogs for that to be likely. So what are the symptoms? Initially, the first sign is an ulcer or wound, usually on the legs. They typically look like small, round sores and usually occur on the legs, but may also be found on the body, face or tongue. The lesions range from 5 to 50mm (1/5” – 2”) in diameter. 1-9 days later (usually about 3), affected dogs will usually suffer acute kidney failure. The symptoms are of increased thirst, changes in urination (increased amounts of dilute urine, or in more severe cases, reduction or absence of urine production). This is accompanied by lethargy, anorexia, vomiting, depression and often bad breath (which may smell metallic). Once clinical signs of renal failure occur, the prognosis for recovery is poor. Dogs that, for whatever reason, do not progress beyond the skin lesion stage have a better prognosis, assuming no further complications develop. Overall, half of the dogs affected will suffer abnormal bleeding (thrombocytopaenia); about a third may show some degree of jaundice (yellow gums and eyes); and one in five are anaemic (with pale gums and difficulty catching their breath). How do dogs get it? Firstly, it doesn't seem to be contagious from dog to dog, or to or from humans. The current thinking is that there is an environmental link – most cases are associated with walking in muddy woodlands, and it may be that there is a toxin in the mud that is absorbed by the dogs. How can it be avoided? As we don’t know the exact cause, avoidance is difficult. However, thorough washing of your dog’s coat after walking in woodland (especially if muddy… like everywhere this year!) is a sensible precaution that should reduce the risk. In addition, it is likely that certain places pose a higher risk than others; if there has been a case in your area, it is probably wise to avoid areas where the affected dog(s) were walked in the days before they were diagnosed. It’s also really important to check your dogs over regularly – not just for sores or ulcers, but also for cuts, ticks, mats of hair or other injuries. How do I know if my dog is affected? Fortunately, most dogs with skin lesions don't have CRGV! However, if your dog does have any strange or unexplained sores or wounds, it’s important to get them checked out by your vet – in the vast majority of cases, they’ll be able to demonstrate a far less worrying condition. They can also do blood tests to check for kidney problems – although as it is often several days before these show up, repeating the blood tests in 48 hours may be necessary. How can CRGV be treated? Unfortunately, there is no specific treatment. However, treatment of the skin ulcers will minimise the risk of secondary infection; and if kidney failure occurs or appears imminent, hospitalisation and intensive care will maximise the affected dog’s chance of survival. In some cases, referral to a specialist hospital may be suggested, to give your dog the best available care and therefore chance of recovery. How dangerous is it? As a rough estimate, the condition is fatal in 80-90% of cases. However, early diagnosis and treatment is thought to maximise the chances of survival. Fortunately, it is still a very rare disease – in the last three months, there have only been 4 cases (in Staffordshire, Hampshire, Greater London and Lancashire). If you are concerned your dog may be affected, contact your vet for advice – however, the majority of skin lesions and sores will be due to cuts, insect bites or grazes, and are nothing to worry about. It’s also important to remember that, even if your dog is affected, prompt diagnosis and rapid treatment gives them a much better chance of survival. For more information please visit Anderson Moores Veterinary Specialists who are taking the lead in treatment and advice on the condition.
6 Comments