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.
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.
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.
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