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Preparing for Fireworks – with Sound?

Firework fears are one of the commonest behavioural issues we see in practice – unsurprisingly, a lot of dogs spend the week on either side of Bonfire Night terrified. In almost every case, this is because of the noise – a sudden, sharp and loud sound, with no obvious warning (from the dog’s point of view). Although a few dogs are afraid of the light show, it’s pretty rare – it’s usually about the sound. The dog’s natural dislike of loud noises is worsened because we get really excited about fireworks, and tend to jump around, shout and exclaim loudly. We know that’s because we’re enjoying the display – but dogs often get the wrong end of the stick and think we’re alarmed, or scared ourselves. Therefore, in their mind, it must be something truly terrifying if humans are afraid of it too. There are a number of different options to manage firework fear in dogs (behavioural techniques, Adaptil pheromones, various calming products, and if necessary, anti-anxiety medication from your vet). However, there’s one really effective option that is rarely used to its maximum extent. This is Sound Desensitisation. The principle is to help your dog to learn that the scary bangs and crashes aren’t anything to worry about. Part of the problem is that fireworks are a rare and special event – a couple of weeks in the autumn, and again over the New Year, and that’s about it for most people (OK, if you’re in the US, or have American neighbours, maybe in the early summer too – but that’s still only three times a year). As a result, firstly the dogs never get used to it, and secondly, we’re perhaps a little bit too inclined just to manage our pets’ anxiety, rather than try to treat it at the source. Sound desensitisation is a essentially a process of habituation – the noise becomes a normal part of the background to daily life, and the dog learns to ignore it. This is how it works: 1)      As early as possible, start exposing your dog to very, very quiet firework sounds – ideally, a mixture of rockets, bangs and multiple explosions. There are a number of excellent commercial CDs and mp3 downloads – but you could use any suitable soundtrack, such as the video link here: Fireworks in action. 2)      To begin with, play it at the minimum volume your computer, tablet, or phone can manage. 3)      Act completely normally while it’s playing through – get on with your normal day, and leave it playing as background (the embedded video is about 13 minutes long, and you’ll want to run it through completely once if not two or three times each session). This may be difficult, especially if your dog is suspicious, but if you start it on the very lowest volume settings, they may jump, but they’re not likely to have a meltdown. Even if they do, however, as far as possible act normally. Don’t lavish them with extra fuss, or give them special treats – it is very important that they see this as just a normal part of the day. Of course, they should have a safe den to hide in, if necessary, but hopefully it won’t be needed. 4)      Every day or two, increase the volume by one or two clicks – but continue to behave normally yourself. The aim is to build it up to a noise level similar to the actual display before Bonfire Night – but very, very gradually. 5)      If you reach a volume where your dog is showing signs of genuine fear, reduce the volume a little, and keep it there for a few more days. Then start to increase it again. 6)      Eventually, the vast majority of dogs will learn that firework noises are a normal part of life, and nothing to get too upset about. A few dogs have such deep-rooted phobias that desensitisation on its own isn’t enough – in these cases, have a chat with your vet, as some anti-anxiety medication may be useful as an adjunct; or speak to a good canine behaviourist – your vet will be able to recommend one. However, for the vast majority of dogs, this is an effective way to treat and prevent noise phobias – but you need to start as early as possible – ideally several months before Bonfire Night. Good luck to everyone with dogs suffering from sound phobias! David Harris BVSc MRCVS
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Oscar, the grumpy cat who needed twice daily injections to treat his diabetes

[caption id="attachment_4489" align="aligncenter" width="585"]Oscar does not tolerate humans who annoy him Oscar does not tolerate humans who annoy him[/caption]

Oscar, a ten year old cat, had started to lose weight, despite the fact that he was eating well. His coat had begun to look bedraggled, as if he was not grooming himself as much as usual. His owner had noticed him visiting his water bowl more frequently, and she had needed to fill up the bowl every day, rather than every three days.

When I examined him it was clear that Oscar had lost a significant amount of weight. His ribs were prominent, and I could feel the sharp tips of the bones of his back. When I weighed him, I discovered that he had lost a kilogram since his previous visit.

Physically, I could find no obvious cause of a problem, so I decided that a blood profile was needed. Fifteen minutes later, the printout from the biochemistry analyser gave me the clear-cut diagnosis of his illness.

Oscar’s blood glucose was around four times higher than normal. The only possible reason for this was the condition known as diabetes mellitus. Oscar’s pancreas had stopped producing the hormone called insulin, and as a result, his blood glucose was not being controlled. Weight loss, ravenous appetite and copious thirst are classical signs of diabetes, in cats just as in humans and dogs.

As I explained the diagnosis to his owner, I could see a worried furrow developing across her brow. I explained that Oscar’s condition was treatable, but that he would need to have a daily injection of insulin for the rest of his life. Her shoulders slumped, and she looked at me sadly. “Nobody would dare to give Oscar an injection”, she told me. “He’d just get so annoyed with us if we tried something like that!”

I reassured her that the injection was given with an ultra-fine needle, and that only a tiny amount of liquid would be needed. For a cat of Oscar’s size, the volume of insulin would probably be around one hundredth of a teaspoonful, which is literally a single drop. It was very likely that he would barely notice the injection.

I demonstrated the injection technique, using a piece of fruit – an orange – as a practice target. It took a few attempts until she had learned to hold the syringe correctly, but soon she was able to insert the needle steadily and firmly into the orange. She was still very anxious about injecting her cat, so we decided that it would be best for her to bring him in to see me for his injection every morning for the first week.

The technique was simple. I gave Oscar a bowl of his favourite food, and as he lowered his head to eat, I quickly slipped the injection into the scruff of his neck. He stopped eating for a moment, and looked suspiciously at me before recommencing his meal. On day three, his owner gave the injection herself, and by day five, she was able to do this quickly and confidently.

After several dose adjustments over a few weeks, Oscar’s blood glucose had returned to normal. At the same time, his owner reported that his excessive thirst had disappeared. It seemed that his diabetes had been controlled.

The success of his treatment was confirmed at his final visit six weeks later. As the cage door was opened, Oscar stepped out in a confident and dignified fashion, with his head held high. He had put on weight, he was grooming himself again, and even his whiskers looked alert and bristling. He was definitely a healthy cat again.

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What should be done about vets collaborating with puppy farmers?

The BBC Watchdog exposé about a puppy farm in Bradford was shown last night: it provided a shocking reminder of  this horrific industry. Puppy farming  is one of those hidden issues in our society. We all know that it goes on, but it happens behind closed doors, and it's generally only with hind sight that people realise that they have bought a puppy-farmed dog. Typically, somebody sets their mind on a certain breed. They try the “quality breeder” route, but discover that they'll have to wait four months, and there's a hefty price tag. So when they find a pup on the internet that's immediately available, costing 30% less, it can be tempting. They meet the seller in a car park, because “it's much easier than giving directions to our place in the countryside”. It's only later, when the initial excitement of welcoming the pup has worn off that they notice the fleas, the worms, the poor body condition and the nervousness, all indications of a classic puppy farm upbringing. It's one thing for an unscrupulous breeder to be producing puppies in sub-standard conditions, but what about the vets who may be involved in helping them? I came across one purchaser of a puppy-farmed dog recently who was incensed that her puppy came with a vaccine certificate signed by the local vet. She was furious, and she wrote to the vet, demanding answers to her questions. “Do you do any checks in people bringing litters to your practice? Do you ask to see the parent dogs? Do you do background checks on breeders? Do you not wonder why there are so many puppies? How many litters of pups have you vaccinated for this man?” These are all good questions: how much responsibility should vets take in such situations? The British Veterinary Association, the representative body for vets, has certainly been proactive on the puppy farm issue, campaigning for a review of existing breeding licensing legislation to ensure it is fit for purpose. The BVA supported the conclusion of Professor Bateson’s report on dog breeding which argued that current legislation should be reviewed and re-presented as regulations under the new Animal Welfare Acts. Current legislation insists that anyone breeding dogs as a business and/or breeding more than four litters a year, in England, Wales and Scotland, is bound by the Breeding of Dogs Acts 1973 and 1991 and the Breeding and Sale of Dogs (Welfare) Act 1999. Local authorities must ensure that regular inspections are carried out by people with veterinary and welfare expertise to ensure that the regulations are complied with. Clearly, this does not always happen, which is why there are so many calls for more action to be taken. But while the BVA and anti-puppy farm activists may be trying to move puppy farm regulations along at a political level, what about vets on the ground? Should vets refuse to vaccinate pups from suspected puppy farm backgrounds? Should they even go further, acting as whistle blowers to report establishments that they may feel are problematic? Most vets tend to approach the subject from the side of the puppy buyer, promoting responsible pet ownership and giving advice to prospective dog owners on what to look for when buying a puppy. When it comes to tackling suspected puppy farmers, vets don't like to see themselves as “policemen” or “law enforcers”. There's a fear that if vets act as nosey informers, puppy farmers will start to avoid vets altogether, driving the puppy farm industry even further underground. These vets would argue that at least if there is some veterinary contact, the worst of the excesses may be limited. There's no doubt that if any vet encountered blatant cruelty, they would take the necessary action to deal with it, informing the authorities as needed. It can be a harder call when there's a grey area, with issues suspected but perhaps not proven. Sceptical critics, of course, will accuse vets of taking the money for vaccines and turning a blind eye for the sake of continued business. What is the truth? It probably lies somewhere between the views of the vets vaccinating the pups (who believe that they are keeping half an eye on what's going on), and the views of their critics (who believe that the vets are entirely money driven). As Sophocles wisely pointed out 2500 years ago, “What people believe prevails over the truth”. The BBC Watchdog exposé can be viewed by clicking here.        
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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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Do I really need to worm my horse?

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Endoparasites;  the gut-wrenching villains that terrorise our horses from their tums to their bums, but how big an issue are they for the average horse? Which worms do we need to be aware of? Is wormer resistance really that big an issue? So many questions, so many drug names.

What is a worm?

A worm, or an endoparasite, is an organism that lives inside of your horse, to your horse's detriment. We have all seen the adverts for ‘good bacteria'; this is known as a synergistic relationship, where both host and occupier benefit. With parasites, only the parasite gains.

  1. Cyathostomes. Why did the cyathostome always get what he wanted? Because he was so encystant… Excuse my awful jokes; it’s been a long day. Cyathostomes are a type of nematode, or round worm, known as small encysted redworm.  The adults, when in the large intestine, produce eggs that the horse will excrete onto their pastures; the eggs then hatch, and the larvae are eaten by the horse. It is also the larvae that are capable of encysting (hiding) in the walls of the large intestine. So the saying really is true, don't eat where you… These nasty critters can encyst in the mucosal lining of the large intestine of horses; the larvae are capable of ‘hypobiosis’; they stay in a state of arrested development (a bit like hibernation).  It is when they emerge that they can cause potentially fatal damage and diarrhoea, known as larval cyathostomosis.
  2. Strongyles (large redworms). These nematodes are detrimental to your horse in a different way than their smaller namesakes. Eggs in the pasture have a moult phase, referred to as Larval stage 1, L1, and moult to form, logically, L2. The L3 are consumed by an unwitting grazer; it is the L4 stage that migrate from the gut to the arterial supply of the intestine (the cranial mesenteric artery if you are curious). This can cause a compromised blood supply to the large intestine with inflammation of the arteries known as verminous arteritis, and can cause the dreaded colic.
  3. Parascaris Equorum (ascarids); another nematode. Are you the owner of a young horse? This one is for you (sorry!).  Thankfully, our equid amigos develop a resistance to these worms; however, young-stock in the 6 month – 2-year old bracket are highly susceptible. The eggs are passed out in excrement, and moult to L1 and then L2; unlike large redworms, it is the second larval stage that is ingested. They, too, have a damaging migratory pathway; from the intestines, they migrate through the liver and moult to L3, before progressing to the lungs.  From here, they can be coughed up, swallowed, and moult to L4 and then adulthood in the small intestine before starting the whole cycle again. Liver and lungs may be damaged, but impacted colic from a heavy worm burden, along with ill-thrift and a pot-belly, are common signs.
  4. Dictyocaulus arnfieldi (lungworm) is another nematode. To my horror, it is donkeys that are particularly affected by lungworm, and carry it, as the life cycle is not actually completed in the horse.  These larvae are ingested, and burrow out of the intestinal wall into the bloodstream, where they penetrate the lungs. They will cause reactive changes in the respiratory system, such as coughing, increased mucus production and irritation of the bronchi. Chronic pneumonia, secondary infections and pulmonary oedema (fluid on the lungs) may be other features in heavy burdens.
  5. Anoplocephala (tapeworms); a cestode, not a nematode. It requires an intermediate host to develop to a larva from an egg, and it finds a host in the oribatid (harvest) mite. When the horse eats the mite with the parasite, the adult tapeworms can then settle in the caecum (the huge fermentation chamber of the horse gut) and small intestine. Tapeworms pose a real threat to your horse by associations with spasmodic colic; it can cause food impaction and intussusception, when the colon ‘telescopes’, folding in on itself. Inception may be about a dream within a dream, so think of intussusception as a colon within a colon.
Other parasites include Oxyurius equi (pinworms, causing itching and irritation around the anus) and Gasterophilus (bots; actually a fly larva, and not known to cause many problems despite settling in the stomach).

What can we do about worms?

I have been on many yards with rigid worming routines as a means of prevention as much as treatment: this is called interval dosing. Is it necessary? If I had to fall in a strict ‘yes’ or ‘no’ camp, I would be in the latter. Wormers, known as "anthelmintics", are becoming less efficacious; that is to say, anthelminthic resistance is becoming a real problem. The more that worms are exposed to wormers, the more the wormer becomes a selection pressure; some worms will have innate features which allow them to survive despite these chemicals specifically designed to kill them – pesky mutants. The more that we use wormers when we may not need to, the stronger this selection pressure is; we kill the worms which are susceptible to the wormers, allowing the few worms which can survive to reproduce in an environment with less competition. Thus, new wormers need to be developed all the time; a laborious and long task. How can we slow or stop this resistance developing? By being responsible owners and avoiding ‘over-worming’ - saving our horses and wallets in the process! Moving away from wormers, we need to look to management. As we can see in the life-cycles, it is the output of eggs in faeces that are responsible for providing a suitable environment for parasites. Poo-picking fields is one of our biggest weapons in the battle of the bugs; deploy it often! Quarantining new horses prior to turn-out can help to minimise worms on a busy yard; moxidectin and praziquantel can be used 24 hours prior to turn-out. What wormers are available? There are macrocyclic lactones (ivermectin and moxidectin), tetrahydropyrimidines (pyrantel) and benzimidazoles (fenbendazoles) and pyrazinoisoquinolines (praziquantel). We must treat with what is most efficacious for the type of worm, and also only when it is needed. Faecal egg counts (FECs) give a picture of what worm eggs are being put out in your horse’s faeces; when the FEC exceeds 200 eggs per gram, it may be justification for worming. If that sounds a lot, we need to get our heads around the fact that horses will always have worms; whilst this is not a pleasant idea, unfortunately our horses will never have a totally worm-free body, and we shouldn’t strive for that in our worming regimes. Further to this, we want to keep a certain worm population ‘in refugia’; this means we want to keep some worms unexposed to wormers, because then we are not selecting for worms resistant to the wormers. It is only when worm burdens get too high and will damage our horses’ well-beings that we should use wormers. FECs can reduce the selection pressure that help those resistant worms to thrive, as well as being a cost-effective means of targeting the individual horses who need it most.

Is there an ideal worming regime?

Perhaps not. FECs will not give an accurate representation of encysted populations, and are not deemed specific enough for tapeworm counts. Fecal egg flotation or ELISA (enzyme-linked immunosorbent assay) blood tests can be used for tapeworms, but are more expensive. Furthermore, an ELISA detects the antigen (the immune response to a parasite) level, thus the burden may appear high as antibodies are still circulating against the old burden, even if the worms are now dead. However, there are means of interval dosing that do not require administration of a wormer, regardless of whether the horse needs it. We must focus on what burdens are of concern and when… SPRING: Performing a faecal egg count (FEC) for strongyles; ivermectin or single dose pyrantel can be utilised if there are over 200 eggs per gram. Stronglyes were previously a huge concern for causing colic, but thanks to ivermectin, they have become less of a menace, hence the need to protect the efficacy of this wormer by responsible use. Additionally, treatment for tapeworms in the form of praziquantel or double dose pyrantel may be used in spring. SUMMER: FEC for Strongyles and treatment when the FEC indicates, again with ivermectin or pyrantel. AUTUMN: we must treat for any encysted cyathostomes. Remember the larval cyathostomosis? Commonly these larvae will encyst, and emergence can occur in late winter/early spring. Treatment of a heavy burden is advisable; a five day course of fenbendazole, or a single dose of moxidectin are licensed for encysted cyathostomes. However, a large amount of dead worms and a huge inflammatory reaction can spell out a disaster in the form of colic, so if there's a heavy burden your vet may recommend using the older (and less potent) but "gentler" course of fenbendazole first, and then following up with moxidectin 4-6 weeks later to "mop up" any survivors. Tapeworms can be treated with praziquantel or double dose pyrantel again at this time of year. WINTER: The same treatment (or not!) for strongyles when indicated; if bot flies were a problem over the summer, ivermectin or moxidectin will kill the larvae in the stomach. From all of us here from VetHelpDirect, we hope your horses have a wonderfully worm-free year ahead! There is nothing so good for the inside of a man as the outside of a horse. ~John Lubbock
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