Public Space Protection Orders were first introduced by the UK government in the Anti-social Behaviour, Crime and Policing Act 2014. They were intended to prevent anti-social behaviour in public places (a bit like the old fashioned “ASBOs”, Anti-Social Behaviour Orders, but for a place not a person).
Dr Pete Wedderburn BVM&S CertVR MRCVSDr
- December 18, 2015
For many people, it seems unbelievable that grapes and raisins can poison dogs. They're harmless to humans. We've all seen dogs occasionally eating foods containing raisins with no apparent ill effects. How can they suddenly be poisonous?
Why are grapes and raisins not always poisonous to dogs, and never poisonous to humans?
First, like all poisons, the poisonous effect depends on the dose taken per kilogram of animal body weight. Large dogs can safely eat some raisins without problems.
Secondly, the toxic ingredient in raisins seems only to be present intermittently, so a dog may eat raisins without problems on several occasions, then fall seriously ill the next time.
What is the toxic ingredient in grapes and raisins?
The actual toxic ingredient is still a mystery. The fact that grapes and raisins can be poisonous has only been deduced by circumstantial evidence, with many dogs developing acute renal failure for no obvious reason, with the only common factor being the previous ingestion of grapes or raisins. Samples of the fruit in such cases has been analysed, but a toxic agent has not yet been isolated.
The best guess so far is that it is a water-soluble substance, and that it's in the flesh of the grape/raisin, but not the seed. One theory is that it is a mycotoxin (i.e. a poison produced by moulds or fungi on the grapes). The problem in dogs was first highlighted after a year with high levels of rainfall. This had led to damp grapes which were more likely to develop fungal growth.
But why should humans be safe from this toxin? It's well known that cultured dog kidney cells in the laboratory are exquisitely sensitive to other types of mycotoxins. It makes logical sense that dog kidneys might also be more sensitive to damage by another mycotoxin, even its identity has yet to be established.
So how much do owners need to worry about grape/raisin toxicity?
If a terrier steals a mince pie, is a visit to the vet needed? If a Labrador has a slice of Christmas cake, do they need to be taken to the emergency vet?
This is always a judgment that is not black and white. It seems sensible to look at the lowest recorded doses of grapes or raisins linked to acute renal failure in previous cases of poisoned dogs. This allows an estimate of the probable toxic dose depending on the animal's body weight.
The lowest toxic dose is around 20g grapes per one kilogram of body weight. A typical grape weighs 2 – 5g, making a toxic dose is around 4 grapes per kg.
So if a 5kg terrier eats 20 grapes, or a 30kg Labrador eats 120 grapes, there's a high chance of a serious problem, and veterinary intervention is definitely indicated.
The lowest poisonous dose in confirmed cases has been around 3g/kg. An average raisin weighs around 0.5g, making a toxic dose approximately 6 raisins per kg.
So if a 5kg terrier eats 30 raisins, or a 30kg Labrador eats 120 raisins, they need to see the vet. Some studies have suggested that the toxic agent is neutralised by cooking, so cooked raisins (e.g. in pies and cakes) may not present such a high risk.
Important notePlease remember that the above doses mention quantities that have definitely caused serious kidney failure in the past. The decision on whether or not to take a pet to the vet is a personal decision, taken after balancing the possible risks. Many people prefer to take a conservative approach, to be as safe as possible. For example, if a dog has eaten even half of the above quantities, it may be safer to take them to the vet for “just in case” treatment.
What do vets do for dog that have eaten grapes/ raisins?
1) If ingestion has happened in the previous hour.
This is the ideal situation: the vet can give an injection to cause the pet to vomit, emptying the stomach and removing the grapes/raisins before any toxic ingredients have had a chance to be absorbed into the bloodstream.
2) If ingestion has happened in the previous two days but the pet is still well
Depending on the situation, vomiting may still be induced, activated charcoal may be given to limit absorption of the toxin, and intravenous fluids may be given to flush fluids through the kidneys in an attempt to minimise any damage. Blood and urine tests may be recommended to monitor kidney function. If the dog is well after three days, then the high risk period is over.
3) If ingestion has happened and the dog is unwell (e.g. vomiting, dull, inappetant)
In such cases, the kidneys may have already been damaged by the toxin. Urine and blood tests will be carried out to assess the severity of the damage to the kidneys, and intensive care will be needed to save the pet's life, including high levels of intravenous fluids. The prognosis is guarded: unfortunately, some affected dogs die, despite the vet's best efforts.
Keep grapes and raisins away from dogs.
If any dog eats them accidentally, phone your local vet (even if it's after-hours)
Tell your vet how many grapes/raisins were eaten along with the body weight of your pet.
Your vet will then advise you on the safest course of action.
In the veterinary blogging world, there are key seasonal topics that come up every year: hazards around the home at Christmas, chocolate poisoning at Easter, heat stroke in summer and, of course, the fear of fireworks at Halloween/ Guy Fawkes Day. It can be a challenge to come up with a new angle every year: it could be tempting to find an old article, re-jig it and re-phrase it, and the job is done. After all if you plagiarise yourself, is there anything wrong with that?
A better answer, however, is to seek out a completely new angle. So with the help of the Wikivet archives, instead of writing a repeat blog of what to do with dogs that are terrified of fireworks, here's an alternative: how to help cats cope with fear of fireworks.
In general, fireworks phobia is not nearly as big an issue for cat owners as for dog owners. But it's very likely that it may be just as big an issue for the animals themselves. Cats, being independent creatures, are far more likely to run away in terror and hide, leaving their owners entirely unaware of their distress. Cats don't pace around, whining and barking. If they are terrified, they're far less likely than dogs to bother their owners in any way.
So at this time of year, it makes sense for cat owners to be proactive about this subject: take a careful look at your cats, and make sure that they are definitely not distressed by the sounds of bangers and other fireworks outside. The signs of distress can be subtle enough: they may indulge in intensive bouts of over-grooming (which can be likened to an anxious human chewing their nails). Or they may dart around the house, rushing upstairs and hiding under beds. Perhaps the best way of assessing this is to ask yourself if your cat is behaving in a normal relaxed manner. If not, then they may be suffering from fear of fireworks noises, and you may be able to make them feel more comfortable with some simple steps.
So what can you do?
As with dogs, prevention is the best answer. Ideally, avoid taking kittens that come from aggressive or fearful parents, or that have been reared in an isolated, unsocial environment. Make sure that kittens have proper habituation to a wide range of events and stimuli during the sensitive period before 7 weeks of age. Deliberate exposure to sound stimuli using recordings is helpful, but kittens should not be habituated to traffic sounds: cats need to be frightened of oncoming cars. After kittens have grown older, new noises should be introduced gradually and slowly, again using recordings, so that they are less likely to terrify the cat. Pheromone diffusers may help to enable adult cats to adjust to episodes of loud noise, such as parties or firework displays. And it helps to have a “cat friendly home”, with snug beds hidden in low-down places, and high-up perching posts for cats to survey the world below them.
For cats with an established severe fear reaction, consulting with a feline behavioural expert can be helpful: a simple phone consultation may be enough to allow you to cover some specific aspects of your own cat's behaviour. A general process of “desensitisation and counter-conditioning” is the general aim: this means exposing the cat to a low level of the noise which causes a bad reaction, while rewarding the cat for staying calm and playful. As long as the cat remains contented, the noise can gradually be increased in volume: hopefully the cat will become “desensitised” to it. Feline pheromones help this process, and in some cases, your vet or behavioural expert may suggest psychoactive medication.
If your cat has a fear of fireworks, don't let them suffer in silence. Observe them carefully, and with some simple, thoughtful steps, you should be able to help them enjoy this time of year.
By the way, keep all cats inside during the hours of darkness around Guy Fawkes night: it isn't a safe time for cats to be out on their own.
Dr Pete Wedderburn BVM&S CertVR MRCVSDr
- June 11, 2015
The Hay Festival is not a place where you might expect to learn about the treatment of animals: it's an annual literature festival held in Hay-on-Wye, Powys, Wales, for ten days at the end of May every year.
Caroline Ingraham has written an interesting book - "How animals heal themselves" - which is presumably the reason she was given the opportunity to give an account of her subject at the Hay Festival last week. The BBC have created a podcast from her talk, but I believe that the editors were wrong to give her this uncritical forum to propagate her views. Caroline has a controversial belief in the ability of animals to choose their own medicine. There's nothing wrong with her having these beliefs, but there is a problem when her views are broadcast without any "public health warning". There is a serious risk that animals could suffer unnecessarily if members of the public follow her advice to the letter.
In her talk, Caroline recounts entertaining anecdotes of animals (including elephants, horses, dogs and cats) that have recovered following her approach of allowing them to choose their own treatment from vegetation and other substances in their natural environment, or from herbal products offered to them by Caroline. In her words, the animals "guide her to help them make a full recovery". Caroline stresses the importance of "letting animals lead the way" for behavioural and physical problems.
As a vet in practice, I know that 70% of the animals brought to see me will recover by themselves, with no intervention or medication. Animals have evolved with strong internal natural healing capacity (it's called homoeostasis) Our aim as vets is to assist the healing process using scientific methods. There are many reasons why animals may fail to heal themselves, and science can often help. Serious bacterial infections are cured by giving antibiotics that kill the bacteria. Coughing caused by a failing heart is stopped by giving diuretics that remove the fluid gathering in the lungs. Cancer can be cured by surgical excision, followed sometimes by drugs to slow the regrowth of cancer cells. These are all treatments that are scientifically proven: in trials, it has been shown that if some animals are given the treatment, and some are not, a significantly greater number of animals improve.
Caroline offers no such evidence: her treatments are all anecdotal. My concern is that she may be witnessing the "regression towards the mean" i.e. the ability of animals to heal themselves without human intervention. Since around 70% of animals may recover naturally, if you believe that any recovery that you witness was caused by your intervention, you will believe that your treatment "works" 70% of the time. While this may sound impressive, the truth is that your intervention is having zero effect. If Caroline wants to clearly demonstrate the efficacy of her methods, she needs to do what pharmaceutical companies are obliged to do: carry out trials that compare animals receiving her treatment with animals that receive no treatment (a so-called control group). If she does this, she will be able to say without question that any extra improvement in the treated group is due to her treatment. Without doing this, her claims have no scientific validation, and it's hard for objective observers to take them seriously.
At the end of the talk, the presenter did ask Caroline if she was a scientist, and if her work was "evidence based research". She replied "I am not a scientist but the subject of zoopharmacognacy is an academic science".
Caroline says that in trying to develop her work, "resistance came in from a variety of different establishments that tried to make it really very difficult for me to continue this work." There is a simple reason for this resistance: there is strong legislation in the UK to protect animals. Only vets are allowed to diagnose and treat animals. The law is there to stop (often well-meaning) unqualified people who may not be aware of their own ignorance from accidentally harming animals because of their lack of knowledge.
There may be some truth in Caroline's claims: animals may be able to choose certain forms of self treatment for some physical and behavioural issues. But this has not been proven, and it is wrong to state it as fact. It just does not seem right when an unqualified person suggests that pets should be allowed to choose their own "pain relieving herbal remedies" rather than the safe proven methods of pharmaceutical pain relief recommended by the vet attending the animal. And it does not seem right that the BBC should give such a person an uncritical platform to disseminate her viewpoint.
Update 25th November - Caroline has forwarded this response to the original blog:
I believe that your post undervalued the importance of case reports (referred to as anecdotes) that can provide important, detailed information about individual cases that can be very valuable, and it is much better to gather this information than do nothing at all, especially as cases typically come to us after other options have been tried. In fact some successful clinical trials have been started principally because of the promising findings of a collection of related interesting case reports; a topical example is in the human medicine world where the recent FDA approval of a new viral therapy against melanoma, which was inspired by case reports of some patients with cancer going into remission after a viral infection: http://www.nature.com/news/cancer-fighting-viruses-win-approval-1.18651 (of course in this case viral therapy would have to be under the control of a qualified specialist with an appropriately modified virus!).
Other observational, non-experimental approaches have also been fruitful, such as with the work by Jane Goodall, among others. As for Applied Zoopharmacognosy itself, after my lecture to veterinary students at Bristol University yesterday, many came up to me inspired by these case reports and want to explore setting up research projects, and possibly even small scale clinical trials, investigating self-medicative behaviours.
I take your point about regression to the mean, but I understand this likely applies more to certain, short term conditions such acute pain, acute infections, slight anxiety etc. that in many cases would be expected to resolve spontaneously. Many of the individuals that I have worked with have long term conditions, most commonly with long standing behavioural issues but also other symptoms as well. The responses can be dramatic and remarkably fast, and so regression to the mean is a less plausible explanation in these cases. It is it important to note that we do not make medical diagnoses, and I advocate self-medicative approaches as complimentary to veterinary treatment not as a replacement; veterinarians are highly trained and highly skilled individuals and their input is typically invaluable. It would be fantastic if veterinarians were to add Applied Zoopharmacognosy as part of their skill set.
Finally, I read with great concern in several veterinary blogs (though not this one) and tweets that I have been suggesting to pet owners to offer onions to dogs as a wormer. I would like to clarify that I have never offered, nor recommended giving an onion to a dog. It was merely an observation of an event that I found fascinating since it paralleled other documented occurrences of sick animals selecting typically poisonous plants including:
Michael Huffman when he witnessed chimpanzees selecting Vernonia amydalina (locally known as 'Goat killer'), to rid themselves of nematodes (Huffman and Feifu, 1989; Jisaka, et al 1993), and in a study by Singer, et al. 2009, when caterpillars with parasitoid wasp larvae infestations changed their foraging on (normally) poisonous alkaloids such to rid themselves of parasites. The relationship between self-medicative behaviour and plant poisons is a complicated topic, which would take a lot of words to cover adequately. In brief, the most common plant poisons are due to certain chemicals called alkaloids and the reasons for why animals may poison themselves on these are not incompatible with self-medication (possible reasons include evolutionary separation of poisonous plants and companion animals, degradation of bitter warning compounds during drying such as with ragwort, reduced alternative foraging options etc.). Applied zoopharmacognosists typically work with extracts high in other compounds such as terpenoids, not alkaloids.
My observations have been presented at a scientific conference in South Korea last year following an invitation by my colleague Michael Huffman, Associate Professor, Kyoto University as well as at Bristol university. I would be more than happy to open dialogue on the subject with any interested parties.
Challenges to consider with self-medictaion and clinical trials: I would fully support clinical trials that look into the efficacy of self-medicative approaches. However, clinical trials are often prohibitively expensive and time intensive. The difficulty would also be that it is not immediately obvious how a trial that focuses on two different approaches to animal health could be set up without having to split it up into multiple, equally expensive trials that each focus on particular conditions. It is also important to remember that clinical trials are not completely fail-safe either.
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).
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.
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.
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.
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.
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.
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.
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.
Dr Pete Wedderburn BVM&S CertVR MRCVSDr
- October 9, 2014
Ebola virus hysteria is taking hold of the northern hemisphere. The latest victim was a cross-bred dog called Excalibur, who was euthanased by the Spanish authorities even though he showed no signs of being infected with the virus, and despite the fact that there is no evidence that dogs can transmit Ebola to humans.
The twelve year old rescued dog had the misfortune to belong to a Spanish nurse who became the first person to become infected with Ebola in Europe after nursing a Spanish missionary priest who had been repatriated from Sierra Leone to Madrid for intensive treatment. The priest died of the virus on September 25th,, and the nurse is thought to have picked up the virus after touching her face with a contaminated glove as she removed her protective suit after finishing her shift.
Excalibur was a much loved pet in perfect health, and after Madrid's regional government obtained a court order to euthanase him, the nurse's husband put out a call for his life to be saved. An online petition rapidly gathered over 400000 signatures, and crowds of angry animal-loving protestors had to be restrained by police outside the apartment where the dog lived. Despite the protests, Excalibur was euthanased. The deed has been done. But was it really necessary? Did the animal present a risk, or was he just a scapegoat sacrificed to give the authorities a sense that they were doing something?
There is scanty evidence to support killing a dog in a situation like this. Bats are thought to be the natural reservoir for the Ebola virus in central Africa, carrying the virus without showing signs of illness. Monkeys and apes become infected and fall seriously ill, like humans. But despite extensive research, there's been almost no evidence of other animals becoming infected or carrying the virus.
There is one study that casts a cloud over the innocence of dogs: researchers investigating the 2001-2002 outbreak of Ebola in Gabon found low levels of antibodies in blood samples from dogs in areas where there had been cases of Ebola in humans and apes. This confirmed that the dogs had been infected with the virus, but it was impossible to know the source of their contact: from bats, apes, or from humans? It was also not possible to determine whether the dogs could have been infectious to humans at some point. In theory, the fact that they had been infected with the virus implies that at some point they may have shed the virus in their secretions, in the same way as infected humans pass on the infection.
Some researchers believe that it would have been wiser to have kept Excalibur alive, not for sentimental reasons, but to learn more about the spread of the disease. If he had been kept in quarantine, serial blood samples could have been taken, monitoring his immune status. The question of whether or not dogs need to be included in Ebola virus control schemes could have been definitively answered in a safe environment. And if he had been clear of any sign of the virus after several months, he could have been released from quarantine to resume a normal happy doggy life.
Sorry, Excalibur: the precautionary principle and the political need for action seized the initiative: we still don't know much about Ebola in dogs, and you'll never enjoy another happy walk with your owners.