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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 It was definitely the right decision, the dog was really struggling on his legs and had become very depressed and withdrawn.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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Animal experiments: numbers rising while studies show low levels of production of beneficial results

Vivisection is a controversial subject - I've written about this several times before in my Daily Telegraph blog. There are two news stories this week on the subject. First, figures released by the UK government show that animal  testing in the UK has increased by almost ten per cent,  with more than four million experiments taking place a year, the highest figure since 1982. These figures have been "spun" by both sides of the debate, with the British Union for the Abolition of Vivisection understandably describing them as "shocking", while supporters of animal experimentation maintain that the overall trend of  "experimentation" is downwards, with the apparent increase in numbers due to the recent development of genetically modified mice that have been bred to carry specific genes or to develop signs of human disease to assist progress towards cures. Whatever the truth, it's clear that the figures deserve careful analysis before reaching sweeping conclusions: but who has time to wade through the reams of Home Office statistics? The second news story has come in from the USA, with a "study of studies" demonstrating the poor level of return from animal experiments: only two out of 1411 animal studies on treatments for human neurological diseases came up with results that went on to produce 'convincing' data in randomised controlled trials in humans. The researchers have called for stricter guidelines for study design and analysis to improve these statistics in the future. Vivisection is an emotive subject - who could not be against it when faced with images of distressed laboratory animals, as shown in the Daily Mail article? (Mind you, the images are out of context with the article's content - rabbits have not been in racks for testing like that for many years in the UK, and research on great apes is already banned in the UK). Is animal experimentation ever justified? In a meat-eating society, how is it worse than chickens, pigs, cattle or sheep being killed for consumption? Andrew Knight has written an excellent book on the subject, well worth reading: you can buy it here. The good news is that the trend is moving away from vivisection (see the recent banning in the EU of all cosmetic products that have been tested on animals, anywhere in the world). But there's a long way to go.
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Caring for Constipated Kitties

I thought I might write a few words about this sticky subject after seeing a particularly unfortunate case the other day.  Minty is a slightly grumpy, independent and strong-willed 15 year old cat who until a week ago, had been ageing gracefully.  She had lost a bit of weight and done a bit of vomiting, and had the occasional faecal ‘accident’ inside the house. But she was eating well and seemed well in herself, though she usually kept herself to herself.  The owner went away for the weekend and left Minty some dry food and water down as she had done many times before to no ill effect, but when she returned home on Sunday evening she noticed that something was wrong - Minty was crying in the litter tray.  When she looked inside, she realised that Minty hadn’t actually defecated at all in the past few days.  When I saw her the following day, Minty was dehydrated and I could feel a large, hard mass of stool in her colon. X-rays showed that her condition was quite severe, so we anaesthetised her and performed an enema, manually removing some of the stuck faeces and softening what remained.  We also gave her some IV fluids to rehydrate her, and lots of pain medicine as both the procedure and the condition can be very painful.  Fortunately for Minty, she recovered well from her anaesthetic and within a few days started to pass stools on her own again with the help of some other medications.  But if it hadn’t been caught and treated when it was, it could have been a very different outcome.

What causes constipation in cats?

In Minty’s case, the cause ended up being dehydration, as a result of kidney disease that hadn’t previously been diagnosed.  A blood test done at the time of her anaesthetic picked up on the condition (which hadn’t been noticed at home due to the cat’s independent lifestyle).  Dehydration causes the stool to become firm and more likely to get stuck on the way out.  But other causes include neurological or muscular disorders or pain (such as arthritis) which prevent the cat from being able to defecate normally.  Tumours or other masses can obstruct the intestine and cause constipation, as can pelvic fractures which cause the space between the pelvic bones to narrow.  Behavioural issues can affect defecation as well, as a cat that is uncomfortable with their environment may put off defecating longer than is healthy.  Rarely, other diseases like hypothyroidism or even some drugs themselves can result in constipation. How do you know if your cat is constipated? This can actually be trickier than it sounds!  Many cats will defecate exclusively outside so you may never see their faeces or watch them defecate.  Even those that will use a litter tray tend to do so when nobody is around.  So it’s an easy condition to miss until the situation becomes quite desperate as in Minty’s case.  Signs to look out for include:
  • Hard, dry stools
  • Smaller stools
  • Less frequent stools
  • Difficulty defecating
  • Pain (sometimes displayed as a loud howl but not always) whilst defecating
  • Vomiting and loss of appetite in severe cases
  • They may also make repeated trips to the litter tray without actually producing anything, but it’s often hard to tell whether they’re unable to urinate or defecate (and it’s important to make the distinction as being unable to urinate for a male cat is a medical emergency!).  And if they’re severely constipated, they can actually produce liquid stools that look like diarrhoea, just in case it wasn’t complicated enough... What should you do if you think your cat is constipated? If you think your cat’s stools are looking different or you think they’re having problems urinating or defecating, ring your vet for an appointment.  They’ll take a feel of the abdomen and may be able to feel a large mass of faeces stuck in the colon.  If they suspect constipation, they may run a series of tests such as x-rays to see the extent of the problem, along with blood and urine tests to try to find out why it happened in the first place.  If the problem is severe, your cat may need to be anaesthetised for an enema to remove the impacted stools (one of the highlights of our day, I assure you!), or they may use a smaller type that doesn’t require anaesthesia.  The vet will then discuss with you some of the things that you can do to help prevent a relapse of the condition.  Some cases, however, are so severe that they’re actually classified as ‘megacolon’ which is just as it sounds – the colon stretches so large that it isn’t able to work as a muscle anymore to push the faeces out.  In this case, surgery and/or lifelong medication may be required, or even euthanasia if treatment fails to give them any relief. How can you prevent it? If your cat is prone to constipation, or if you have noticed any of the above symptoms, your vet may recommend one of several different treatments that can be used to prevent the problem from recurring.  One is also a hairball remedy – a flavoured paste that contains soft paraffin to help things move along - that cats generally don’t mind taking.  Another is a liquid that makes the stools softer, but cats don’t tend to like the taste very much.  Other remedies are available, but may be harder to get a hold of so aren’t as common, your vet may look into this further if necessary.  However, one of the very best and easiest things you can do to prevent constipation is to stop feeding dry food and switch to a wet cat food.  This will increase the amount of water in their diet significantly and help prevent dehydration.  There are other ways to encourage your cat to drink more, such as flavouring their water or adding even more water to their food along with making sure there is always lots of fresh, clean water available throughout the house.  It’s also important that the litter tray is kept as clean as possible to encourage them to use it frequently.  And of course, you’ll also want to address any underlying medical condition that may have contributed to the constipation. In most cases, constipation is a mild, temporary condition that responds to simple changes in diet or gentle medications, especially if caught early, so if you think your cat might be affected, be sure to speak with your vet right away. If your cat is constipated please contact your vet for advice. If you are worried about your cat but not sure it needs to see a vet please click here.
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    New study shows that spayed & neutered dogs live for longer and die of different diseases compared to entire dogs

    It was just last month that I wrote a blog here about the pros and cons of the decision on whether or not to spay/castrate your dog. This seems to be an area which is coming under increasing scrutiny by researchers, perhaps because it is relatively easy to analyse stored data to discover differences between spayed/neutered and entire populations. After all, the contrast between two study groups doesn't get much more black and white than that: spayed/neutered or entire. In one of the most recent studies (published online in April 2013), the historical records of over 80,000 sterilized and reproductively intact dogs were examined from a database of dogs presented to North American veterinary teaching hospitals over a period between 1984 and 2004. The cause of death and the lifespan of each animal was noted. To make the data as "clean" and unbiased as possible, the researchers removed around half of the records. First, they took out all young dogs, and all those where the spay/neuter status had not been recorded. Then they took out all those dogs that had died from congenital disease (i.e. disease which the animal had been born with, which obviously could not be influenced by neutering). Finally, they removed all of those dogs where no specific cause of death could be categorised. This left them with 40,139 dogs for analysis of the relationship between the effect of spay/neuter on age and cause of death. The findings of the study are fascinating, and if you have an interest in reading scientific papers, you should read the report in full yourself. For those who don't wish to, there were two main findings. First, spaying/neutering caused dogs to live significantly longer lives. Females lived for 26.3% longer if they were spayed, and the life expectancy of males was increased by 13.8% after castration. Second, there was a striking effect of spaying/neutering on the cause of death. Spayed/neutered dogs were dramatically less likely to die of infectious disease, trauma, vascular disease and degenerative disease. In contrast, sterilized dogs died more commonly from neoplasia and immune-mediated disease. This difference was similar for both males and females. So what does this mean for pet owners? The study results could be taken to be broadly supportive of spaying and neutering both males and females, if length of life is taken as the most important outcome. It also suggests that owners of spayed/neutered dogs should be aware of the fact that their pets will be more likely to suffer from neoplasia or immune-mediated disease, and it would make sense to discuss with their vet what sort of signs they should look out for, so that if these diseases do develop, they will be well briefed in advance. I still stand by my recommendations in the previous blog: all pet owners should discuss spaying and neutering with their vet. It may not be the right decision for every pet, but on average, this study demonstrates that it's the most likely choice to lead to a longer life for your much loved pet.
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