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    Life and Death – Blocked bladders in cats and dogs

    A blocked bladder - or urethral obstruction - is a potentially life-threatening condition. The term means partial or complete blockage of the urethra, which is the tube that runs from the bladder to the external genitalia. In male dogs and cats, the urethra is longer and narrower than in females, making males more prone to this condition. A blockage can have various causes. 

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    How do we know when is it time to put our pet to sleep?

    I have always hated this question, although most clients ask it sooner or later. I have heard it so many times, over the heads of much-loved but declining pets. It's a horrible subject. Horrible and very emotive, but that's not why I have hated it so much. No, the reason I've always hated it, is because I never have the right answer - and that's not because I'm not a good vet. Rather, there is simply never a 'right' time to sign a bit of paper authorising the euthanasia of someone you love.

    Should 'You Just Know?' 

    I have heard people say they 'just know.' And I'm sure that some people do: they wake up one morning and suddenly understand that their companion has quite simply had enough. My Mum used to be a huge advocate of this, but when I thought back, her elderly dogs both suffered sudden declines. For example, one of the pets of my childhood (Bruce) was already badly arthritic when he had a bad fit which left him suddenly blind. As horrible as it was in that case, the decision itself must have been relatively cut-and-dried. 

    But if that isn't your experience, don't worry; it has never been mine either. My last dog never had neurological deficits; the arthritis just got worse and worse, bit by bit, and there never was a day that was significantly more terrible than the previous one; yet suddenly, he was a shadow of what he had been. In this case, I think it is human not to be sure. But it is also human to think that somehow, you ought to be. This expectation brings feelings of helplessness, mental paralysis and pain. 

    'When the pain / illness / sickness is too much.'

    So how much is 'too much'? What do we measure? 

    Some say they'll know when their dog no longer gets up to greet them when they get home from the shop. For others, a dog that doesn't try to greet them is fine, as long as she can still enjoy a nice fuss. Perhaps she will rise slowly, and poddle over to her owner when she's ready. After all, there are paraplegic dogs out there who haven't 'got up' on their own in that way for years, but are still demonstratively happy. There are other creatures whose pain relief, if required, is still working, but they might be in different kinds of pain: confused, or permanently dizzy. The pain doesn't have to be physical for it to be 'time.' 

    To help to quantify how much pain or illness is too much, some vets encourage owners to fill in questionnaires; to objectify the problem using a score. 

    Some people find it easier to gauge in numbers of a quality-of-life scale; it gives them something palpable to discuss. If gauging things with numbers is your thing, then ask your vet about this. There are several versions available.

    'When there are (or are definitely going to be) more bad days than good days.

    Again, two different owners might judge this differently; the definition of 'a good day' is probably different for every owner and dog and will certainly change over time. But I think that's okay: it's right that different pets are different because animal-human bonds are so individual. But then there's the question of what ratio of 'no' days to 'yes' days is okay. Is one good day in two okay? How about one good day in three? Two good days in three? Four in five? How about two fantastic hours a day and then mostly sleeping? Again, what works for one family pet here isn't going to work for another.

    But wait - we've talked a lot about the limitations of different ways of deciding. So what do we do?

    Next time it's me, I will decide using all of these ways; by measuring pain scores when applicable; by subjectively labelling days 'bad' or 'good' days in a diary, or even recording important incidents, or a rough number of 'good' or 'bad' hours. I will decide by talking to all the people who know the pet well (but be aware - good listeners will often say what they think you want to hear). I will decide by collecting as much medical understanding as I can about what was happening. 

    Armed with all of this, I'll decide using instinct, and by talking in advance with everybody at home, so that I understand what everyone else believes. I think it's worth having difficult conversations about 'how things are,' 'good and bad days or weeks' and how much 'bad' is okay. For sure, not all family members will agree, but if this is the case, we can agree in advance about how the decision should be made. Whose decision should it be? Do we put it to a vote? Will the children get a say? What will we do about the ashes? Will we have a private cremation? What arrangements can be made? 

    In my experience, if you talk about it a lot, if you have all these conversations, then..... 

    .....it will still be really, really tough when the time arrives. You still might not walk away feeling that you got everything right. And that is a very normal feeling because death, like life, isn't perfect. The death of a pet is difficult and actually, that is okay.

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    Why did the vet prescribe an “NSAID”?

    If your pet has been prescribed an NSAID you might be wondering what it is, and what it does. NSAIDs are one of the most commonly prescribed classes of drugs in animal medicine, with millions of doses given daily. They’re used for everything from routine surgery to part of a care plan for complex conditions such as arthritis. 

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    The importance of routine preventative treatment, even now!

    Ensuring your pet lives a long, healthy, and happy life with you and your family is a key goal for vets. While we are always there to help when your pet is sick, prevention of disease is better than trying to find a cure. Being aware of the risks to your pet and ensuring to seek veterinary assistance when needed helps to reduce stress and harm to you and your animal and help to lower costs. As every pet is different and unique, an individual preventative health plan can be tailored for you based on your location, your pet and what risks they may be exposed to. There are various aspects of your pets’ health that you should consider in routine preventative treatment, which are covered below.

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    What is pancreatitis in cats?

    Pancreatitis is a common gastrointestinal disorder in cats, and, quite literally, means inflammation of the pancreas. The pancreas is a small organ located close to the stomach. It is responsible for producing enzymes that are involved in digesting food. If the pancreas becomes inflamed or damaged, it can’t function normally causing the digestive enzymes to be released inside the pancreas itself, rather than into the stomach resulting in self-digestion. The amount of digestive enzyme released will impact how severe the symptoms are.

    What causes pancreatitis?

    Pancreatitis can be caused by a number of things, although in some cats no reason is found. It can be associated with inflammatory bowel disease and inflammatory liver disease - a combined problem termed ‘triaditis’ which occurs due to the close proximity of the liver, guts and pancreas. Pancreatitis can be seen secondary to trauma, infection, parasite burden or due to a reaction to certain drugs. A slightly higher incidence of pancreatitis has been reported in Siamese cats.

    What are the symptoms of pancreatitis?

    The symptoms can be quite vague and can include lethargy, reluctance to eat, abdominal pain, weight loss, vomiting, and diarrhoea. Sometimes, if the liver is affected too then your cat may also be jaundiced. You may see a yellowish tinge to the whites of your cat’s eyes, skin and gums. Symptoms can be acute, occurring within 24-48 hours, but some cats suffer from chronic relapses. Unfortunately if cats don’t eat for a period of time, usually 3-5 days, then they can go on to develop something called Hepatic Lipidosis. This is quite serious, and occurs when excessive fat is deposited in the liver and can lead to liver failure.

    How is pancreatitis diagnosed?

    After taking a thorough review of your cat’s recent history, your vet will perform a full physical examination. Checking for signs of abdominal pain, nausea, dehydration and fever. As the clinical symptoms of pancreatitis can be quite vague and often can be seen with lots of other illnesses, your vet will want to run some tests. An ultrasound of the abdomen can be performed to see if the pancreas looks inflame. As well as reviewing other nearby organs like the liver and intestines. A blood test is recommended to check the levels of feline pancreatic lipase enzyme, as well as assessing their general organ function. They will pay particular attention to liver and kidney parameters as well as electrolytes.

    How is pancreatitis treated?

    Mild cases may recover with supportive treatment including bland food, pain relief and medication for nausea. Nausea can be hard to detect in cats, so anti-emetics are often considered in all patients with a suspicion of pancreatitis. In more severe cases, cats may need to be admitted to hospital and placed on intravenous fluids to correct dehydration, any electrolyte imbalances and support them while they’re not eating. To reduce the risk of hepatic lipidosis, if they are still not eating then a feeding tube may be considered, so we can safely ensure their nutritional requirements are met. Pain relief forms a big part of the treatment plan, and often involves opioid painkillers.

    What is the prognosis like?

    Most cats improve within a few days. Depending on what or if a cause was found, your vet will be able to discuss any long term management that they may require with you. This may involve a diet change on to a prescription low fat gastrointestinal diet. Cats’ that have had pancreatitis, are likely to have repeated episodes in the future and may require monitoring.

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    Managing Stress in Cats during the Pandemic

    The current coronavirus pandemic has changed our everyday lives as we know it. Even though we seem to be past the worst of it, many of us are feeling stressed, anxious and overwhelmed. You are definitely not alone and someone else who might have similar emotions right now is your pet! Cats are very perceptive animals and can sense and reflect our stress or anxiety. While they might not understand the coronavirus itself, just like humans, animals can become stressed and overwhelmed when changes in their daily routine occur. 

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