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Ask a vet online ‘symptoms to know if your dog has kidney failure’

Question from Susanne Hayward: how come no symtems to know if your dog has kidney failier Answer from Shanika Winters: Hi Susanne and thank you for your question about how to know if your dog has kidney failure.  I will answer your question by discussing what kidney failure is, how we diagnose it and what signs you can look out for in your dog. So what is kidney failure? The kidneys are two bean shaped organs present mid way along the back of your dog’s abdomen (tummy); they have a large blood vessel going in and another large blood vessel coming out of them.  The job of the kidneys is to filter your dog's blood and remove toxic/waste products but make sure that the important useful chemicals e.g. proteins, nutrients (sugars and fats) and blood cells remain in the blood.  The kidneys are also involved in breaking down some chemicals such as medications.  The Kidneys are also important when it comes to keeping the correct amount of water in your dog's blood, this ensures that all the body cells are adequately hydrated and can function at their best. Kidney failure is a term used to describe a stage of kidney disease once more than two thirds of your dog's kidney function has been lost.  That means that out of the function of your dogs two kidneys there is a third or less now working.  Kidney disease is a broader term used to describe any problem with the kidneys this could be infection, neoplasia (tumour), polycystic (disease where kidneys are taken up by lots of cysts or cavities) or loss of function with age. So how does my vet look for kidney disease? Whenever you take your dog to see your vet they will ask you questions regarding how your dog is doing in general including how they are eating, drinking, urinating (weeing) and defecating (pooing).  These along with other questions will give your vet an idea as to your dog's general state of health and is called a history. The answers to the questions your vet asks along with anything they find on physically examining your dog along with the reasons as to why you brought your dog to see the vet will help your vet to try and work out what is going on with your dog. Some specific findings in kidney disease: Whether your pet is young, middle aged or elderly the following may be found: Anorexia Some dogs either completely stop eating or have a reduced appetite due to the build-up of toxins in their blood which makes them feels under the weather. Weight Loss Most dogs will start to lose weight as they are eating less but also as they are losing important substances such as proteins from their blood as these are not reabsorbed by he kidneys and end up being lost into the urine (wee). Polydypsia/Polyuria This means increased drinking and urination, and happens as the kidneys try to remove more waste products and toxins by flushing them out by producing more watery urine. Change in kidney size The kidneys can become small and hard or even large.  With some tumours or polycystic kidney disease the kidneys can become larger.  In cases where the kidney function has decreased and the working part of the kidneys has become replaced by fibrous tissue then the kidneys can become smaller and harder.  Usually the size of the kidneys is something your vet will try and feel or look at on a scan or x-ray. Halitosis Some dogs may show a strange unpleasant smell on their breath, this can happen when waste products such as urea build up in the blood and can give off a smell. Blood changes Your vet may suggest doing blood tests of your dog, this is to identify changes to chemicals in your dogs blood such as increased levels of urea, creatinine, potassium and phospahate but also decreased levels of proteins and blood cells.  The blood results can be used to monitor how your dog's kidney disease is going. Urine changes Dogs with kidney failure tend to produce large quantities of very dilute urine which can contain protein.  As kidney disease progresses the actual amounts of urine produced can sometimes decrease as the kidneys are no longer able to filter out and flush out the waste products from the blood.  Testing your dog's urine is a non-invasive way for your vet to monitor your dog's kidney disease. How can my dog's kidney disease be treated? Depending on the stage of your dog's kidney disease the following treatment options are available: Diet There are specially formulated diets for dogs with kidney disease which have the correct balance of protein, fat, carbohydrate and minerals to ensure your dogs body can function with minimal extra work for its kidneys. Medications There are a wide range of medications available for dogs with kidney disease starting with drugs to improve the blood flow to the kidneys, some to decrease blood pressure (high blood pressure can be damaging to the kidneys), some to bind harmful chemicals and also some to decrease fibrosis (a change where functional kidney tissue is replace by scar tissue). I hope that my answer has helped you to recognise some of the signs of kidney failure/disease in dogs and that along with the help of your vet we can now give dogs with kidney disease the best chance possible when disease is detected early. Shanika Winters MRCVS (Online Vet) If you have any worries about your pet, please make an appointment with your vet, or try our Symptom Guide.
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And the Winner of Best UK Vet 2015 is… Blacks Vets in Dudley, West Midlands

We are delighted to announce that the Best UK Vet Awards have been judged and the winner is Blacks Vets - Dudley Hospital Veterinary Practice in the West Midlands. With over 262 4 and 5 star reviews on its website, Blacks Vets, Dudley Hospital topped the review charts of all 3500 vets on VetHelpDirect.com and Any-UK-Vet directories. Chosen by pet owners themselves, the Best UK Vets Award is a genuine reflection of the excellent client and patient care provided by Blacks Veterinary Practice over the last year. In second place were Blacks Veterinary Practice Oldbury and in third place were Streatham Hill Veterinary Surgery in Streatham Hill. Good honest reviews are an excellent way to help pet owners find the best local vet. They also show your vet what you value about their practice! Here is what the team at Blacks Vets had to say about winning the 2015 award...

"We are absolutely thrilled to have been voted Best UK Vet by the pet owning public.  The team here work incredibly hard in our Accredited Veterinary Hospital, staffed by our own nurses and vets 24/7, 365 days a year, to meet the needs of our clients, constantly striving to improve pet care in our local area.  To be recognised by our clients for the veterinary care, surgical and referral work we do, as well as the day to day preventative care in our Healthy Pet Club means everything to us.  We are so very privileged to have fantastic clients and pets who have take the time to nominate us, thank you so so much, we are truly overwhelmed"

If you’d like to help your vet win next year, then don’t forget to leave a review after your next visit! For more information please visit www.vethelpdirect.com
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Ask a vet online: ‘ anything I can do to help hip dysplasia?’

Question from Erin Taylor: Anything i can do to help my bm's hip dysplasia? She's only 1 Answer from Shanika Winters: Hi Erin and thank you for your question regarding your dogs hip dysplasia, to answer your question I will discuss what hip dysplasia is, how it is diagnosed and then treatment options. So what is hip dysplasia? The hip joint is made up of the head of the femur (the top part of the upper leg bone) and the acetabulum (the socket in the pelvis).  The hip joint also includes cartilage (smooth strong and cushioning substance), ligaments (strong fibrous tissue connections) and joint fluid (liquid which lubricates the joint). Dysplasia means that this part of the body has not formed properly, in the case of hip dysplasia it can involve some or all parts of the hip joint not being the correct shape, size or working correctly.  Hip dysplasia is more common in certain breeds of dog such as the Labrador and the German shepherd dog but can be found in any breed or cross breed of dog. Hip dysplasia is a congenital disease, which means it is present from birth; it can also be hereditary which means it can be passed on from parent dogs to their puppies.  The kennel club has a scheme for measuring and recording the extent of hip dysplasia in certain breeds of dog, this is to help people decide which dogs to use for breeding so as to try and reduce the risk of producing puppies with severe hip dysplasia. In general when your vet talks about hip dysplasia they mean that the femoral head is either abnormal in shape and or not adequately covered by its socket, this results in extra wear and tear on the hip joints which in the long term can lead to arthritic changes plus or minus lameness/pain. How can I find out if my dog has hip dysplasia? Usually a pet owner would bring their dog in due to lameness or an unusual gait (way in which the dog moves).  Your vet will then ask you questions to help form a history of what has been going on with your dog.  The questions will include e.g.  when did you first notice the problem, how long has it been going on, how quickly has is progressed, has the condition improved with rest and or medication as well as general health questions regarding eating, drinking and toileting. Your vet will want to observe your dog moving; usually this can be done on the lead in the vet practice building or carpark area.  It is always important to remember that when at the vets your pet may not show its lameness the same as at home or straight after rest.  It can sometimes be helpful to bring in a video clip of your dog's movement. The next step will be for your vet to perform a full clinical examination of your dog, all major body systems will be checked with extra attention being paid to the joints in this case specifically the hip joints.  Your vet will gently feel along your dog's legs and move all the joints through a normal range of movements.  While doing this examination your vet will watch for any reactions suggesting that your dog is uncomfortable, decreases or increases in how much a joint moves and also any clicks or grating sensations. All the above information will help your vet to decide what is the next step, which might include rest, further monitoring, use of pain relief or x-rays. It is important to be aware that x-ray findings do not always match the signs that a dog is showing.  Some dog's hips will appear almost normal in appearance on an x-ray yet they can be very lame and vice versa.  X-rays can be useful to make a diagnosis of hip dysplasia and also to monitor how the disease is progressing.  In the case of the kennel club scheme, very specifically positioned x-rays need t be taken, these are then sent off to be analysed and a number or hip score will be given for your pet. What can be done to help/treat dogs with hip dysplasia? Diet Your vet may suggest putting your dog onto a specific diet; this may be a weight control diet or one that is designed to support joints.  The reason for weight control is to reduce the amount of strain put on your dog's joints so as to allow the best function possible for the longest time possible.  Joint support diets are designed to contain specific ingredients which help keep your dog's joints in good working condition (will go into more detail under joint supplements). Exercise plan This is to make sure that your dog is having enough exercise and of an appropriate type to keep their joints working at their best for as long as possible.  In cases of hip dysplasia where your pet has started to show arthritic signs it is important to do little and often exercise rather than sudden long bursts.  Exercise is important to keep your dog's weight down, to maintain muscle strength and unsure your dog can move. Some pets may be referred for physiotherapy, this is where a specially trained therapist will show you how to move your pets joints, in some cases his may be in water ( hydrotherapy) as this reduces the weight and strain on the joints.  Some physiotherapy exercises are ones that you will be asked to do with your dog at home. Weight control As already mentioned it is important that your dog does not become overweight, as this added weight will put more strain on your dog's joints and lead to faster progression of any arthritic changes.  Diets and exercise as the main way to regulate your dog's weight.  Many vet practices run weight clinics where your dog’s weight can be monitored and help given to choose the best diet and how much of this your dog should be fed. Medications There are a range of anti-inflammatory and pain relieving medications available for dogs which need them.  Your vet will advise you on which product or combination is best suited to your pet.  In generally we try to get you pet onto the lowest effective dose of any given medication.  At times a combination of medications may be necessary and the doses or specific medications used might be changed to meet your dog’s needs. Anti inflammatories These are available as injections, tablets and liquids and include carprofen, meloxicam and firocoxib.  These are usually administered with or after food, any your vet may advise monitoring your dog's kidney function as this can be affected by some of these medications. Opioids These are strong pain relieving medications available in tablet, injectable and patch form.  They include morphine, buprenorphine and tramadol.  This type of drug is not usually sent home and strict licensing rules exist around their use. Joint supplements These tend to contain combinations of chondroitin, glucosamine (can be from green lipped mussel) and various minerals.  These chemicals are thought to help maintain a healthy joint.  Some of these chemicals are also used for human joint disease.  It is important to use products designed for dogs and at the correct dose. Surgical interventions There are a few surgical procedures which might be suggested for dogs with hip dysplasia.  Removal of damaged cartilage and or loose fragments can be performed.  Excision of the femoral head if it is very severely abnormal can sometimes be performed; this is more common in smaller dogs and cats.  Total hip replacement, this is something we are more used to hearing as a procedure to be carried out on elderly people.  Hip replacement s a specialist procedure, it can only be performed on certain dogs after careful consideration by a specialist vet. I hope that my answer has helped to explain how complex a disease hip dysplasia is, how it is detected and that there are a wide variety of ways to help your dog.  It is definitely best to tackle the problem of hip dysplasia with the help of your veterinary team who can advise you on the best treatment plan specifically designed for your dog.  Your dog will need careful monitoring which may include regular checkups with your vet, veterinary nurse and or physiotherapist.  I hope that your dog has a comfortable good quality life. Shanika Winter MRCVS (online vet) If you have any worries about your pet, please make an appointment with your vet, or try our Symptom Guide.
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