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Wikivet blog: oral hygiene – the key to a healthy mouth in pets

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It's well known that regular home care of pets' teeth is the only way to ensure optimal dental health, but it's also well known that most owners find this challenging. Dental experts have identified that there are two methods of home care, depending on an owner's ability to get involved: active and passive.

Brushing your pet's teeth a) Active home care is “hands-on” where the pet owner is physically involved with removing plaque and maintaining oral hygiene. Tooth brushing and applying anti-plaque agents directly into the mouth fit into this category. Active home care is the ideal answer, but it isn't always easy. It's known as the "gold standard" of preventive dental care. Clara, a Cavalier King Charles Spaniel, is a ten year old dog who is an ambassador for active home dental care. Her owner started to brush Clara's teeth when she was a pup, and has built tooth-brushing into her daily routine. Clara knows that before she can tuck into her dinner, she has to sit still for a 30 seconds while her owner whizzes around her mouth with a toothbrush and some chicken-flavoured toothpaste. The results of this daily routine are astonishing. Most ten year old dogs have advanced dental disease, with gingivitis, accumulations of tartar and missing teeth. Clara, in contrast, has teeth that are as healthy as a two year old's. Clara provides a good example of the power of active owner dental care. "Letting your pet clean their own teeth" b) Passive homecare refers to aspects of an oral hygiene program that help to reduce plaque in the mouth, but do not require the owner to get involved with the hands-on tooth-brushing or mouth-handling. Examples of passive home care include giving a special type of diet that helps to keep the teeth clean, or offering a dental chew to help reduce plaque accumulation. Jake is a ten year old terrier who has been given a daily dental chew for the past five years. His owner originally tried to brush his teeth, but he wouldn't let her. Many owners have this experience, and this has created a niche in the market that has been occupied by a wide range of commercial products. Jake's owner discovered that he loved the taste and texture of a dental chew, designed to be given once daily. Jake gets this every evening, as a treat before bed. His owner has reduced his daily food ration to take account of the calories in the dental chew, and he's stayed at his ideal weight. Jake did originally need a dental clean up and polish, to remove the build up of tartar that had occurred before he started his dental chews. But the daily chew regime has worked wonders for his back teeth (the molars), and they're as clean as Clara's. The front teeth (canines) have accumulated some tartar (Jake doesn't use these when chewing), but the problem is a minor one that doesn't need any intervention at this stage. Home dental care is an important part of a pet's daily routine, whether you choose an active or passive approach. To find out more, read the Wikivet section on dental hygiene, by clicking here.
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Training dogs: can old dogs learn tricks? And what about residential “boot camps” for dogs?

[caption id="attachment_4418" align="aligncenter" width="442"] Does your dog 'sit and stay'?[/caption]

The early autumn is a bit like a mini-New Year. The summer has ended, schools have gone back, and the term-time routines start again. It can be a great time to start new projects, and for many dog owners, that can include tackling the complicated issue of training their pet. Many dog owners have pets with bad habits that they want to change.

Dogs behave in response to the way that their owners treat them. A dog will only beg from the table at mealtime if her owner has taught her to do this by feeding titbits in the past. A dog will only jump up onto the settee if she has been allowed to do this by her owner. It then follows that it is possible to re-train dogs by changing the way we behave towards them. A dog can be re-trained at any age, by using modern dog training methods.

Anybody can set themselves up to be a dog trainer, and so there’s a wide variety of styles and standards in the dog training world. Some have had formal instruction in dog training. Some have even passed exams. Others are self-taught. It’s best to choose trainers who have been taught the latest techniques, and who continue to make an effort to keep themselves up to date.

As in other areas of life, dog training is an evolving science. Techniques used thirty years ago would now be thought to be completely inappropriate by the experts. The modern belief is that dogs should be trained by reward rather than by punishment. Choke chains should never be used. Dogs should never be hit or hurt during training.

It is very important to choose the right dog trainer, and owners should spend some time doing research rather than just choosing the first name they find in the phone book. It could be useful to go along to a training class as an observer. Do you like the style of the trainer? Talk to a few of the dog owners at the class. Have they found the classes useful and effective?

Once you have chosen a dog trainer, make sure that you attend classes regularly, and make sure that everyone in the household knows the rules. Dogs need consistent, continual monitoring. If one person in the house persists in feeding the dog from the table, she will never learn to stop begging.

It's one thing to train a puppy or a young dog, but what about retraining an adult dog? How do you break old habits? This is much more challenging, but it’s still possible.

One controversial answer can sometimes be to send your pet off to a ‘training camp’. Dogs stay at the training centre for a two or three week period. They are taken out of their own environment, and they are taught a new routine. When you collect your dog, you are first shown a twenty-minute video of your dog behaving in a calm, obedient way. You are then given a two-hour lesson in the techniques that you need to use to ensure that your dog continues to behave calmly and obediently. Finally, the training centre remains in contact with you, so that you can telephone them if you have problems, or even book your dog in for another training session if needed.

This type of "boot camp" is controversial, with many trainers believing that it is a short cut that should not be taken, and that an owner needs to be involved from the start, all the way through the process. My own view is that, like many aspects of pet care, it is impossible to make a "one size fits all" pronouncement. Residential training works well for some dogs, but not all.

Regardless of what sort of dog training you choose, the formal instruction is only the first stage. The second stage is up to you. You need to spend fifteen minutes a day working with your pet. For long-term success, you need to stick to a simple but challenging statement – ‘I promise to continue to give my dog regular daily training sessions’!

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Ask a vet online – My dog has black dandruff!

Sheila Elcott asked: I have an 11 year old red fox lab boy who keeps getting a build up of black coloured dandruff type patches under his chin & his manly areas. Up to date with spot on. Is it his age & lack of my grooming care? After bathing & removing said patches the skin clears. He has hip & elbow dysplacia to boot. Tnx Answer: Hi Sheila, thanks for your question. Skin problems in dogs can be really frustrating to deal with, so I'll go through some of the possibilities, then talk about how they can be investigated and managed. So, what can cause patches of black dandruff material to appear? There are a number of possibilities that spring immediately to mind:
  • Flea dirt. Flea droppings are black flecks, sometimes comma-shaped.
    • I know you're up to date with spot-on, but there are a wide range of different products out there, some of which are more effective and longer-lasting than others. In addition, most spot-ons are water soluble, so regular bathing or swimming will reduce their effectiveness.
    • You'll very rarely see a live flea unless there's a really severe infestation. To check it out, try the wet paper test:
      • Scrape some of the black material onto a sheet of wet white paper.
      • If it goes red, it is probably a flea dropping - they're basically just dried digested blood.
  • Scabs. As blood dries, it turns black and crumbly. It can be caused by:
    • Lice. Heavy louse infestation can cause scabbing where the parasites suck.
    • Skin infections. In these areas, this would typically be a skin fold infection, where saliva or moisture is trapped against the skin, damaging it and allowing infection to become established.
    • Allergic reactions (e.g. contact dermatitis). Reactions to products such as surface cleaners, pesticides, some plants, etc etc; typically affect the high-contact surfaces - chin, elbows, hocks and belly.
  • Sebaceous matter. Sometimes, excessive secretion of sebum may give the symptoms you're discuss. This may be due to sebaceous adenitis (an inflammatory disorder), or simply from aging changes.
Unfortunately, without seeing the dog, it's difficult to know which of these is the most likely for your boy! So where do we go from here? Ideally, you want to rule out parasites - do a wet paper test; and ask your vet to do skin scrapes and tape strips to examine the black material and the skin underneath it. Also, try and see if there's anything that seems to trigger an episode - for example, if it always flares up after using a particular floor cleaner, I'd be really suspicious it was an allergic reaction. So what can be done? If a specific cause can be identified, obviously it should be treated (for example, a louse infestation should be treated; and you should avoid using any products that your dog is allergic to). Even if not, there are certain techniques that may be useful in controlling the symptoms. As the problem resolves with cleaning, I'm quite suspicious that it might be a skin-fold infection - these are often more common in older dogs. In general, these can be controlled with grooming, good hygiene, and the use of medicated antiseptic wipes (e.g. CLX wipes) to control the growth of bacteria in the area. Sometimes, bathing with an antiseptic shampoo can help as well - you should talk to your vet about the options. I hope that helps and you can get him sorted out! David Harris BVSc MRCVS
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Ask a vet online – is there a test for Leptospirosis?

Berry Wilkinson asked: I was wondering if you can titre test for leptospirosis? Or is it only useful when you are testing sick dogs? Thanks. Answer: Hi Berry, thanks for your question about testing for Leptospirosis. To answer it, I'll briefly discuss Leptospirosis as a disease, then talk about the different diagnostic techniques available. Finally, I'll discuss vaccination and the implications for diagnosis. What is Leptospirosis? Leptospirosis ("Lepto") is a disease caused by bacteria of the genus Leptospira. There are more than 300 strains (technically called serovars) of the bacteria. In the UK, Leptospira icterohaemorrhagiae and L. canicola used to be the most common, but since widespread vaccination against these has started, it is now thought that L. interrogans and L. kirschneri may be more important. The disease is transmitted by body fluids of infected animals, including rats. The symptoms of Leptospirosis in dogs include:
  • Fever and sore muscles.
  • Loss of appetite, vomiting, diarrhoea and dehydration.
  • It may cause kidney or liver failure
  • Sometimes the only symptom is sudden death.
  • Infected dogs may shed the bacteria in their urine for months or years without showing any clinical signs.
  • Leptospirosis is highly zoonotic - i.e. it is a high risk pathogen for infecting humans.
How is Leptospirosis diagnosed? There are four methods to test for Leptospira in clinical samples, of which two are clinically useful. They are:
  • Darkfield microscopy - looking for the bacteria themselves. This is very siple, but is notoriously unreliable, unfortunately!
  • Bacterial culture - attempting to grow the bacteria; however, in many cases the bacteria are very hard to culture, so even in confirmed infections, this test may come back negative.
  • Serology - looking for antibodies produced by the immune system in response to the presence of the bacteria. However, vaccination will often lead to a positive response, and low-positive titres (levels of antibody) may persist for a prolonged period. In addition, the levels of antibodies often won't be significant in the first week of infection.
  • PCR - testing blood (early infection) or urine (later stages of infection or carrier status) for genetic material from the Leptospira bacteria; this is a very sensitive and specific test. However, a negative PCR result doesn't rule out carrier status because the bacteria are only shed intermittently in the urine, and will not be present in the bloodstream; and it can also appear negative in some milder infections.
So how is serology interpreted?
  • The normal screening test for Lepto is an antibody test ("ELISA testing") that gives a simple positive or negative result.
    • If this is negative, then in general either:
      • The dog doesn't have Lepto, or
      • The dog has only been infected in the last week or so.
    • If the result is positive, then:
      • The dog has Lepto, or
      • The dog has had Lepto in the past, or
      • The dog has been vaccinated and still has high levels of circulating antibody.
  • If the ELISA-test is positive; or if the symptoms are suspicious but PCR (genetic) testing is negative, the next phase is to use a different type of antibody testing ("MAT serology") to determine the level of antibodies in the blood (the titre).
    • On a single test:
      • Low titres are most likely to represent vaccination or past infection.
      • Moderate titres may indicate vaccination or infection.
      • High titres usually represent acute infection.
    • However, it is far more useful to carry out paired serology - 2 tests 7-10 days apart:
      • In a genuine infection, the titre would normally be expected to rise by at least four-fold.
      • In chronic infection, or asymptomatic shedding, diagnosis can be really difficult, but a persistent moderate titre that doesn't decay over time is highly suggestive of chronic infection; however, demonstration of the organism's genetic material by PCR in repeated urine samples is often more practical.
What about vaccination?               There are a number of different Leptospirosis vaccines available; most of them cover 2 strains ("bivalent vaccines"), although some now cover 4 ("quadrivalent vaccines"). They are aimed at covering the most common types that cause disease, and there is relatively little cross-protection between strains (so immunity to one strain or serovar won't usually protect against another). The vaccine doesn't necessarily prevent infection, but it should reduce the risk of infection, and it does reduce the severity of clinical disease and shedding (for whichever strains or serovars are covered by that vaccine). There are some commercial tests that claim to determine whether a dog requires vaccination against Leptospira by testing circulating antibodies. This may work in some cases, but it is very limited. There are a number of problems with this approach:
  • The serological titre (level of antibodies in the blood) can only tell you how much antibody there is in the bloodstream at the specific time the test is done - it cannot tell you whether the levels will remain high for the following 12 months.
  • The link between antibody levels and protection isn't consistent - some dogs appear to utilise other parts of the immune system (cell mediated immunity) and are protected against Lepto even in the absence of significant circulating antibody titres.
  • After vaccination, titres normally drop off over 4-5 months, but protection lasts for 12 months.
As a result, it is wisest to maintain annual vaccination against Leptospirosis, to reduce the risk of infection to your dog and to you. I hope that helps! David Harris BVSc MRCVS
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Ask a vet online – my dog has skin allergies, how do I help?

Question from Leona Poppleton: my dog has skin allergies and so gets very dry skin and sometimes scabs that look quite painful is there anything that I can get or do to help this? Answer: Scabby Skin Hi Leona, thanks for your question about your dog's skin. Allergies with skin symptoms are pretty common in dogs, so I'll briefly discuss allergic disease, then go on to some of the many different treatment options. What are skin allergies? The phrase "skin allergies" refers to the itching, scratching and sore skin that allergic dogs get. However, it doesn't have to be caused by something on the skin - e.g. food allergies (although quite rare in dogs) can lead to skin symptoms - so "allergic skin disease" is a better term. Essentially what is happening is that the dog's immune system misidentifies a harmless substance as a dangerous threat, and tries to attack it, causing soreness and itching. Allergic reactions may be triggered by a wide range of substances such as pollen, certain foods, fleas, mites, plants or even some washing powders. In a large number of cases, there's no specific "allergy" involved, but the dog has a disease called Atopy (or Atopic Dermatitis), where the immune system reacts abnormally to a wide range of different stimuli. Atopy is partially genetic, and is more common in some breeds (e.g. West Highland White Terriers). How is it diagnosed? It is important to get allergic skin disease properly diagnosed by your vet because there are many contributing factors and different underlying problems. As a result, diagnosis can be long and exasperating! In addition, diagnosing Atopy requires ruling out all other possible causes. 1) Initially, its vital to make sure that there aren't any parasites (especially fleas!) on the dog - this is a LOT harder than most people think, and usually requires treatment of the affected dog, all other pets in the house, and the house itself. (A side note here - there are a lot of over-the-counter products available for treating fleas: some work, some don't work, and some are very dangerous if not used correctly. I would strongly advise talking to your vet for advice, particularly as the most effective treatments are prescription-only medicines, some of which will also act over time to treat the environment as well as killing adult fleas). 2) The next step is to make sure there aren't any skin infections that could be contributing to the symptoms, or mites burrowing into the skin. This may require skin scrapes to remove a layer of skin (it really doesn't hurt!) and tape-strip tests to check for yeasts or bacteria. 3) There are a number of allergy tests available - these mostly use blood samples; intradermal tests (injection of test substances into the skin) may be more reliable, but they are expensive and difficult to perform. 4) To rule in or out food allergies, a controlled food trial is essential. This can be done with truly novel food sources, but in general it is more effective and practical to use a hypoallergenic diet from your vet. These diets are formulated so that the proteins are broken down so small that the immune system can't recognise it. In a food trial, the dog is fed ONLY the controlled diet (no treats or snacks!) for a number of weeks. If the symptoms resolve, you reintroduce the original diet one item at a time, to determine what's causing the allergy. But why does it make my dog itch so much? Itching is what's called a "summative, threshold" experience. This means that there is a threshold level, below which itching won't be felt. Anything that stimulates an itch ("pruritic") response such as a flea bite, an allergy, or a skin infection, raises the level of "itch" until it breaks this threshold and the dog feels itchy. In most allergic dogs, several different factors combine to make the itching overpowering. Unfortunately, actually scratching makes things worse - this is called the "itch/scratch cycle". What are the scabs I can sometimes see? Scabs generally mean one of three things: 1) Flea bites 2) Skin infection 3) MOST COMMONLY - self-inflicted skin damage caused by scratching. The skin is sore because it's been scratched, and it's been scratched because its sore etc etc... Scratching also damages the skin and allows infection to become established, which makes the itching worse. What can I do about it? The bad news is that most allergies cannot be cured, only managed. However, with good management, most cases of allergic skin disease can be fully controlled the vast majority of the time. There are a number of classes of treatment, which I'll deal with in turn; however, many cases will require multiple overlapping treatments, so it is essential that you work with your vet to put together a management programme. 1) Disease modifying treatments These attempt to reduce the underlying allergic response. The most effective are licensed immune-modifying drugs such as ciclosporin*, which when used long term reduces the allergic response. There is great hope for immunotherapy, where the immune system is gradually taught to tolerate certain allergic substances; this must be made up by a lab specifically for your dog's allergies. Sometimes an allergy can be "cured" by this route, but it is more usually used to reduce the dog's sensitivity. 2) Relieving symptoms These act specifically to reduce the sensation of "itch". There are three main drugs used for this. Firstly, antihistamines; these are not licensed for use in dogs and may have noticeable side effects, but a vet can legally prescribe them under the cascade if necessary. My experience is that they aren't very reliable in dogs, but may be useful in some cases. There is also a new drug called oclacitinib which works purely to suppress a dog's itch sensation. Finally, there are steroids. These reduce inflammation, mildly suppress the immune system and are very, very effective at reducing itching. They're also inexpensive; however, if used long term, they have a wide range of side effects. They're often best used as a "rescue" treatment, although steroid creams and sprays that can be applied directly to the sore spots on the skin have fewer side effects. 3) Reducing other sources of itching This category would include products such as antibiotics for skin infections and antifungals for yeast infections (many of which are available as medicated shampoos), and parasite treatments for fleas and mites. 4) Reinforcing the skin barrier This is a relatively new area, but seems to be a really useful in some cases or in addition to other treatments. There are soothing and hydrating shampoos which work to remove allergic substances from the coat and soothe the skin; as well as oatmeal shampoos which seem to have an anti-itching effect. Finally, there are the ω-3 fatty acids which appear to help many itchy patients; they may be in the diet (particularly in "skin" or "dermatology" diets), added to food as a supplement, or used as a topical spray or spot-on. Overall, you and your vet need to find the combination of treatments that suit your dog. Managing the allergic pet is a big task, but I hope this has helped, and that you can keep your dog comfortable! David Harris BVSc MRCVS * PS - you may notice I'm using generic drug names not brand names in this article. This is because, for legal reasons, I'm not permitted to name specific brands in a blog like this. If you want to know more, check out the government's Veterinary Medicines Directorate website.
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