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Just stiff, or sore?

One of the most common conditions encountered in practice is arthritis, otherwise known as osteoarthritis, or degenerative joint disease (DJD). It may be underdiagnosed because many owners may see their older dogs ‘slowing down’ or ‘becoming stiff’ and consider it part of getting old. It’s often only picked up at routine examinations, such as during vaccinations. While common (thought to affect 20% of adult dogs) it is not normal and can significantly impair our ageing pets’ quality of life.
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What makes dogs lame, and how can they be helped?

Why is a lame dog lame? The obvious, but incorrect, answer to the question is 'because it has a sore leg'. The correct answer is more complicated, but also quite obvious when you think about it. Firstly, what is a lameness? Everybody knows what a lame animal looks like - they 'walk wrongly'. But what is happening to make them walk wrongly? There are three main reasons why lameness may occur. Pain is the most common and most important cause of lameness. If an animal damages a limb, any further pressure causes more pain, and so the instinctive response is to rest the limb, by carrying it, or at least by not putting full weight on it. The type of damage can vary widely from a bruise to a laceration. The damage can be anywhere in the limb, from the toe to the shoulder or hip, and the result is the same - a lame animal. Long term diseases such as arthritis can also involve considerable pain. The second cause of lameness is instability. It is common for dogs to rupture the ligaments of the knee, and when this happens, the knee becomes unstable. If the dog tried to put weight on the leg, the knee would collapse. So the dog refuses to put weight on the leg. Any other joint can be affected in the same way by damage to the supporting ligaments. The third cause of lameness is stiffness. When a dog develops arthritis, the affected joint becomes swollen and gnarled - like many older people's arthritic finger joints. The swelling of the joint is due partly to new bone which grows around the arthritic joint as part of the disease process. This new bone acts like rust seizing up a metal hinge - it stops full normal movement of the joint. An elbow joint may only be able to move through half of its normal range of movement. The result of this new bone is that the joint is stiffer and less mobile than it should be - and this means that the animal is unable to use the limb in the normal way. Hips, shoulders and knees are also commonly affected in this way. So lameness can be caused by pain, instability and stiffness. What can be done to help lame animals? Weight control, controlled exercise and physical therapy are all important aspects: this always has to be individualised, and the best answer is to ask your vet what your pet needs in these areas. The new generation of painkillers provide excellent relief from pain. Immediately after an injury, dogs can be given drugs which prevent short term suffering until the injury is treated. In addition, if a disease involves long term pain (such as arthritis), this can be dealt with very effectively by continual daily medication, as advised by a vet. Instability of joints can often be well treated using new surgical techniques which may involve inserting artificial ligaments, using metal implants or by other methods. The stiffness of arthritis can be helped by using regular anti-inflammatory medication, similar to that used for arthritis in humans. There is also an animal-only anti-arthritic drug, given by injection, which can help considerably in some cases. Other therapies including hydrotherapy and acupuncture can also play a role, as can daily food supplements such as glucosamine chondroitin sulphate, and even special high fish-oil diets designed for pets with joint disease. Owners should be warned that it can be very dangerous to give human drugs to their pets, unless their vet has given them permission to do so. Toxic reactions are common, especially when some of the more modern human painkillers and anti-arthritic drugs are given to dogs. If you have a lame dog, you should ask your vet for advice on the best way to relieve the problem.
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The Drugs Don’t Work – Or Do They?

Today I put to sleep a lovely old Collie owned by a lovely man. It was definitely the right decision, the dog was really struggling on his legs and had become very depressed and withdrawn. This is a common scenario and very often the way that arthritic pets come to their end. In fact, a very similar thing happened to our beloved family Labrador, Molly, a few years ago and although she was still trying to get about and clearly happy to be with us, she was obviously in a lot of pain which could no longer be controlled. Euthanasia in these situations is a true kindness and although still desperately upsetting, is by far the best thing for the pet. However, just as I was discussing the euthanasia of this dog with his owner, he said something that stopped me in my tracks. ‘Well, we did try him on some of your arthritis medication a few months ago but to be honest it didn’t seem to be doing anything more than the Asprin I was giving him, so we stopped it’ Now, at this stage in the process there was no point in me making any comment on this statement (or my thoughts on giving pets human medications!) and you may think it sounds like quite a reasonable thing to say but to be honest, I really had to bite my tongue. Arthritis is a very common problem in older pets but it is also very under-diagnosed because the signs can be difficult to spot, mainly because our animals are so stoical in the face of chronic pain. Even just a bit of stiffness after rest can indicate a significant problem. The medications we have to treat it are extremely effective but often, and especially in the older pets with more advanced arthritis, just one drug on it’s own doesn’t completely combat the problem and they need a combination of medicines to really keep them comfortable. (Anyone with an older relative will probably be familiar with this concept; my granny seems to be on hundreds of tablets!) Our darling Molly was practically rattling in her last few months I had her on so many medications and supplements These kept her comfortable but eventually, they could no longer control her pain and give her the strength to get around, so the kindest thing was to let her go. My message is, if you have an older pet, firstly, don’t assume that them slowing down and stiffening up is a ‘normal’ part of aging (well, in a way it is but that doesn’t mean we can’t do something about it!) and if the medicines your vet gives you don’t make much difference at first, don’t assume that that is because there isn’t a problem or that nothing else can be done, it may just be they need different tablets or combination therapy to give them their bounce back! This is far preferable to leaving them to struggle in silence and although, in the end, their arthritis may mean they need to be put to sleep, it will certainly give them more time and mean their final months with you are pain free and comfortable. And finally, please don’t give your pets ANY human medications without talking to your vet about it first. Drugs often work very differently in animals than they do in people and some can be actually harmful.
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Ask a vet online – “My dog is drinking a lot, and seems to be starving to the point of raiding my Shopping bag. She has Arthrities and her back end seems to be wobbly.”

Question from Gurnos Tenants Residents My dog is 14 and is drinking a lot, and seems to be starving to the point of raiding my Shopping bag, something she has never done before. She has Arthrities and sometimes her back end seems to be wobbly. Answer from Shanika Winters MRCVS online vet Thank you for your interesting question which has four parts, I will discuss one at a time. Your dog is drinking a lot. The first thing to do when you have noticed that your pet is drinking more is to work out the actual amount of water being drunk. This is most easily done by measuring out how much water you put into the water bowl, also how much is left each time you change the water. It is best to work out how much your pet is drinking over a few days as this will give an average amount per day taking into account differences on each day. We usually consider a dog to be drinking too much if water intake is more than 100ml/kg/day that would work out as around 2L for a 20kg dog (a medium sized dog). So when you discuss your pet’s water intake with your vet they will want to know the amount your pet drinks a day, its weight and if there have been any changes to your pet’s diet. Dry food diets tend to lead to pets drinking more water than wet food (tins or pouches). Your vet will also want to know if your pet is passing urine as normal or if this has changed in amount or frequency, often it is helpful to collect a sample of urine in a clean container and take this to your vet for analysis. Increased drinking is called polydipsia (PD) and can be an indication many conditions including kidney disease, infection, hormone imbalances and diabetes. It is really important to discuss any other symptoms your pet is showing with your vet so that the most appropriate urine and blood tests can be performed to find out the cause of your pets PD. Your dog is raiding your shopping bags. When a pet has an increased hunger we call this polyphagia (PP). It is normal for dogs to eat more food when their energy needs go up e.g. when the weather is cold, if they are more active than usual or during the later stages of pregnancy or lactation (milk production). So provided there is no obvious reason for your pet to be eating more this is definitely something worth discussing with your vet. Ideally if your pet is weighed regularly and records have been kept of this any changes will help to make a diagnosis as to what is causing your pets PP. Some of the conditions mentioned for PD can also lead to PP. Arthritis and a wobbly back end. Arthritis is a degenerative condition of the joints which is very common in pets as they get older. There is increasing damage to the joints which can lead to difficulty standing and walking as well as pain. Your vet will diagnose arthritis based on the signs your pet is showing such as difficulty getting up and walking, wasting away of muscles, physical examination plus or minus x-rays. Often the joints feel stiff and your pet will object to their joints being moved through a normal range of movements. The hips, elbows and back are common sites for arthritis and may well lead to the wobbly back end that you describe your dog as having. There are other causes for a wobbly back end such as spinal disease other than arthritis, general weakness and poor circulation. After discussing the points you have raised as regards your dog I think it would be advisable for you to take your dog for a full examination by your vet, please take as much of the extra information you can to help a diagnosis to be made so that your pet can receive the best treatment possible. A few simple blood tests and or x-rays will help your vet to work out how best to treat your pet, we do not like to just assume that changes are due to a pet ageing. Where possible we want to provide the best quality of life for all animals. I hope that this answer has been helpful to you and that your dog soon returns to a good quality of life. Shanika Winters MRCVS (online vet)
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How Do You Know If A Cat Is In Pain?

DenbyIt sounds like such a simple question, but the answer is actually far more complicated than we think. And it’s not just cat owners who struggle with this question, those of us who have studied these creatures for years still frequently miss signs of feline pain. Because when it comes to showing signs of pain (or any illness for that matter), cats are masters of disguise. In the feline world, complaining gets you nowhere, and showing signs of weakness can get you killed. Sure, some cats in pain will cry out, but if you see a cat crying out in pain, the problem is likely very severe indeed. Besides, cats cry out for many reasons, so even if you do see this, how can you tell if it is due to pain or some other form of stress? Next time you think your cat may be in pain, try to remember some of the following signs of feline discomfort: • Lameness: Ok, we’ll start with an easy one. But you’d be surprised how many people come to me with a limping cat who insist that they are not in pain. If your cat is limping, he’s doing it for a reason. And that reason is usually pain. Even if your cat doesn’t have a limp, check for other signs like difficulty jumping up or down from the bed or finding that it’s not worth their effort to climb the stairs anymore. Arthritis is hugely underdiagnosed in cats because many owners either don’t observe or don’t think to mention these changes. If you do notice something unusual with your cat’s behaviour, please speak up as sometimes vets don’t think to ask these kinds of questions. • Vocalisation Yes, as previously mentioned, some cats in pain (particularly severe, sudden pain) will cry out or howl. If you see this, take them to the vet immediately to have them checked out, even if you can’t see anything else wrong with them. But it’s not always a howl that they make; sometimes it’s just a more insistent meow, or even a lack of sounds such as normal greetings or cries for food. • Decreased appetite Speaking of food, it’s true that some cats in pain will either stop eating, or not eat as much as normal. But not every cat will respond this way because in the wild, a cat that doesn’t eat will die so if they are able to eat despite even very significant pain, they often will. • Hiding A cat in pain will often hide from you. You may notice them spending more and more time under the bed or in the back of the cupboard. Or, you may notice that they are quite restless and have a hard time settling in any one place. To you, it may just seem like odd behaviour but to them, it can be a cry for help. Hiding isn’t the only behaviour that can indicate pain, any change in their normal routine may be a clue no matter how subtle, so try to take notice and figure out why the change occurred. • Eye position and expression This one is much more subtle, and unless you are very observant you may not pick up on it at all. A painful cat may sometimes have slanted eyes that are squinting or partially closed. They may also have dilated pupils (the blacks of their eyes look very large or ‘wide eyed’), and a generally strange expression on their face. Or they may seem to ‘zone out’ and just stare blankly ahead. Now there are lots of reasons why a cat will show one or more of these things, so don’t be too quick to diagnose your cat as painful if you don’t notice any other signs. But if you do notice a strange look in their eyes, it’s probably best to have them checked out by a vet. Amber-on-grass• Posture If you picture a happy cat in your mind, you may think of one who is relaxed and playfully rolling around in response to a good petting session. Now consider the opposite - a painful cat will often sit in a hunched, guarded position. Their muscles may be quite tense, and they will flinch or pull away when touched. Some cats just don’t like being touched, but if yours normally does and then suddenly doesn’t, consider pain as a possible cause. • Aggression As previously mentioned, a painful cat won’t want to be touched and this often leads to aggression. If you stroke your cat and he turns around to bite or scratch you, or if he hisses at you when touched, or even if he just starts to twitch his tail in an agitated manner when there doesn’t seem to be any reason for it, get him checked out by the vet. • Licking, chewing, or fur loss Cats will sometimes make a fuss over the particular part of their body that is in pain, but this is not always the case. Some cats with cystitis (bladder disease) will lick their tummies and cause fur loss in that area. Likewise, some cats with arthritis in a particular joint may lick or chew at that area more frequently than normal. Rarely, this licking is enough to cause damage to the overlying skin. • Other medical changes There are some signs of pain that only your vet is likely to pick up on (although you may notice that something just doesn’t seem right), including increased heart rate, breathing rate, temperature or blood pressure. Because these things require the help of a professional to properly measure, it is very important that you take your cat in to the vet whenever you suspect something out of the ordinary. As you can see, pain in cats is no simple subject. There are some obvious signs of course, but many more that may go unnoticed for some time. Therefore, if you do happen to notice any of the above signs, it’s always best to take your cat to the vet to have them checked out as soon as possible. Even then, it can be very difficult to tell if they are in pain, so sometimes the best test is to treat for any possible pain and then re-evaluate to see if it made any difference. Whatever you do, try not to ignore it because unlike humans, who are very good at expressing discomfort, cats will most often suffer in silence and it’s our job to make sure they don’t have to. If you are worried that your cat may be showing signs of pain described above, talk to your vet or try our Interactive Cat Symptom Guide to check any other symptoms you notice.
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