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Urinary Incontinence in Bitches

[caption id="attachment_1699" align="alignright" width="300"]Holly, a Golden Retriever, age 13 Holly, a Golden Retriever, age 13[/caption] Holly, a 13 year old Golden Retriever bitch, is a regular boarder at my kennels. Recently she developed urinary incontinence, and her owner feared she might have to be put down. The problem can be difficult to live with because of the smell, increased washing, damage to carpets etc. Just as importantly, it is distressing for the bitch herself who would like to keep herself clean but is unable to stop the leakage of urine. Fortunately Holly’s owners discussed the problem with their vet who prescribed some treatment which now has the problem under control. We all dread our pets growing old, and one of the problems we tend to associate with ageing is urinary incontinence, or leakage. Although this happens mainly in older bitches, it is not a problem that has to be just lived with. In many cases there are treatments which can help control this, and can greatly improve quality of life. Urinary incontinence can happen in both dogs and bitches, but is much more common in bitches. It can also be related to being overweight, and being spayed. In younger animals it can be due to a congenital abnormality (present since birth). Although incontinence is more common in spayed bitches, this does not mean that spaying is a bad thing. There are many benefits which together outweigh the disadvantages (Please see our Pet Care Advice section, Neutering, for further information about this) Urine is produced continuously by the kidneys, and is stored in the urinary bladder. When the dog or bitch urinates, the urine is expelled along a tube called the urethra. The rest of the time, urine is prevented from leaking out by the urethral sphincter muscle. Usually, control of this sphincter muscle is under the voluntary control of the dog, so once they have been trained when and where to urinate, they go in the right place and at the right time. The most common cause of incontinence, especially in older bitches, is urethral sphincter incompetence. If the sphincter muscle loses tone, it can allow urine to leak out. The bitch will still be able to urinate voluntarily when she wants to, but there will also be leakage, often without her even realising it. She will, of course, clean herself up if there is leakage, but she will be unable to stop it from happening. The signs of incontinence are wet patches where the bitch has been lying down, wet legs, infections of the skin and excessive licking at the vulva. There is not necessarily an increase in the amount that is being drunk or being urinated, but if these are increased as well then that also needs investigation. As always, your vet will first need a full medical history and will need to make a full examination of your dog, probably including blood tests and urine tests. It can also be helpful to examine the urinary tract by ultrasound scan, or by x-rays using special contrast medium to help show up the size, shape and position of the bladder and the urethra. It is important to check for problems other than incontinence, and for other causes of incontinence, such as urinary infection, bladder stones, liver and kidney disease and diabetes. Any of these would require quite different treatment. Once these have been either ruled out or treated, if incontinence is still a problem then it can be treated. A number of drugs are available which help by acting on the muscle of the urethral sphincter. The drugs may be given either in the form of a syrup which is given on food, or as tablets. As with all drugs, there can occasionally be side effects which your vet will ask you to watch out for. Very often the problem is greatly improved and the treatment can be successfully continued long term at a maintenance level. In a few cases there is no improvement, and then other causes need to be investigated further. In a small number of dogs there is a physical abnormality which could benefit from surgery (such as repositioning of the bladder neck). These cases involve quite specialised treatment and might need a referral to a specialist veterinary centre. Incontinence is a distressing problem for both dog and owner, but it is well worth seeking advice from your vet on the treatments available. If you are worried about urinary incontinence or any other problem with your pet, please talk to your vet or use our Interactive Symptom Guide to help decide what to do next.
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Pain Part 2: Getting rid of pain

Pain and pain relief are massive topics which can – and do – fill several textbooks. It’s way beyond the scope of a blog to go into all of the detail surrounding the use of painkillers, and so all I really want to do is to outline some of the different types of pain control that we can use, both in the surgery and as day-to-day treatments. Pain relief is one of the great success stories in medicine, and it’s no coincidence that some of my favourite drugs of all time are painkillers. Our advances mean that pain in our patients shouldn’t be accepted, and although sometimes we fail to control it, we should never stop trying. We use a number of different types of painkiller:
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Steroids
  • Opioids and opioid-like drugs
  • Others
NSAIDs These are the most widely-used type of painkiller and include (for humans) aspirin, ibuprofen and paracetamol. They act by stopping inflammation. They’re commonly prescribed for post-op pain and for joint problems and may be given for long periods of time. When you’re given painkillers to take home from the vets, they’re usually NSAIDs. Three things to really take on board with these drugs:
  1. Human drugs are not always safe for pets, so never give anything to your pet without talking to your vet first: half a paracetamol can kill a cat, a big dose of ibuprofen can do the same to dogs and even a solitary aspirin can be a lethal overdose for a toy breed, designed as it is for a much bigger animal (us). This is why we have veterinary-licensed drugs for our patients.
  2. Increasing doses won’t give more pain relief, and may cause side effects. If they’re not working for your pet, talk to your vet about alternatives.
  3. NSAIDs are most effective when given before the inflammation starts. It might seem odd to suggest giving painkillers before the pain even begins, but this is important in treating chronic, repeated and predictable pain like arthritis.
Two of the most common drugs we use are meloxicam and carprofen. Meloxicam usually comes as a syrup, which can be dosed very accurately, and carprofen is generally in tablet form. Both drugs may be used long term as a daily dose and both have been responsible for giving patients their lives back, sometimes for years. We’re also rediscovering paracetamol as an excellent addition to treatments in dogs. Recently, newer NSAIDs have been introduced which are labelled either as cox-2 inhibitors (e.g. firocoxib), or else dual inhibitors (tepoxalin). Essentially, these are just descriptions of which bit of the inflammatory cascade they act upon, and they’re designed to reduce some risks of side effects that we see with other NSAIDs. It’s arguable, though, as to whether they’re better at relieving pain than some of the older drugs. More recent still is Trocoxil, an NSAID for dogs which is only given once a month. The theory is that because it acts as a persistent block to inflammation, there’s no point where the vicious cycle of pain can really take a hold. The exact ins and outs of the drug are a bit too much to go into here, but as always, speak to your vet about this medication if you’re interested in finding out more. Do understand, though, that it’s not for every patient and your vet may have good reasons not to use it on your dog. Steroids Steroids are very powerful anti-inflammatories, which gives them painkilling properties. However, they also affect the immune system – many patients take them for allergies and auto-immune problems - and can have major side-effects when used long-term at high doses; they also can’t be given with NSAIDs and so for practical reasons their use as painkillers is limited. You may have experience of PLT (Predno-LeucoTropin), a medicine with a steroid component which can be great for chronic pain when other drugs seem to be failing. It’s been around for a long time, and many an experienced vet will recognise its usefulness. Opioids Opioids are a group of drugs which act to block the passage and brain detection of pain signals. The classic drug in this group is morphine, which still forms the basis for relief of severe pain in humans. These are very powerful painkillers indeed, although the degree of pain relief depends on whether they’re what we call a full-agonist or a partial-agonist. Drugs like morphine, pethidine and fentanyl are full-agonists, and tend to be used only within the surgery. They are subject to close control and are never dispensed. Generally they’re given by injection, although fentanyl is available as a long-acting skin patch, which has been very successful for use in trauma patients like RTA cats. Buprenorphine and butorphanol are partial-agonists and are often used as part of a pre-med before surgery. Buprenorphine is a great painkiller which is usually injected within the practice, but may occasionally be dispensed for oral, very short-term use. It is certainly useful in breaking pain cycles and allowing us to get onto more stable pain relief regimes. For in-patients where NSAIDs either don’t quite cut it, or else a combination therapy is needed, buprenorphine is an excellent drug. A drug that we’ll often use long-term in out-patients is tramadol. This is a human drug which acts in a similar manner to opioids, and has a number of significant advantages:
  1. It’s usually pretty safe, although it can temporarily knock some patients a little flat. Your vet should tell you about this when prescribing.
  2. It’s a GOOD painkiller
  3. As it has a different way of working to NSAIDs or steroids, it can be used in conjunction with many other drugs to create a better painkilling effect
Others Other drugs that we use act in novel ways, or else are designed for other purposes but just happen to help with pain control. These are important drugs, and whilst they’re described last they’re definitely not least in importance. In brief:
  • Local anaesthetics may be used in and around surgery, to numb the pain nerves. These tend to be injectable, although some creams are available which can be useful to pre-treat patients with needle phobias and the like.
  • Ketamine – yes, the horse tranquiliser – has been used for years in emergency medicine as a painkiller; it’s often included in battle packs for soldiers. Its use in our patients is quite specialised and confined to hospital environments.
  • Gabapentin. This is a very interesting drug indeed. It’s normally used as an anti-epileptic, but seems to have a great effect on pain of nervous origin (aka neuropathic pain), so can be useful for spinal and neurological conditions.
  • Cartrophen is an anti-arthritic drug (also sometimes used in bladder problems in cats) which has a number of effects on joints. It’s usually given as four weekly injections, followed by a variable period of remission. It can be very beneficial for some arthritis patients, but may need a little forward planning in its use, as its administration isn’t recommended at the same time as NSAIDs. It’s certainly a drug worthy of close inspection in long term arthritis cases.
Integrated methods of pain control Whilst it’s obvious that we have some great drugs for relieving pain, reliance on drugs alone in any condition is generally a limiting approach, as adding in other treatment types – or modalities - may offer greatly increased success rates. For example, in heart disease drugs may help to keep the cardiovascular system going, but are much less effective when used by themselves than in an overall strategy including lifestyle change, weight loss, exercise programmes, regular monitoring and support networks. Similarly, drugs may form the heart of a pain relief strategy, but shouldn’t be used as an excuse to avoid other measures that can help – and there are even times when non-drug pain control is good enough that painkillers are not needed. Whatever the non-drug modality used, the decision on when not to use painkillers is a simple one:
  1. The pain is being completely controlled by non-drug methods.
  2. That’s it.
Remember that phrase – pain is not acceptable in our patients. If nothing else, these blogs should have explained both why pain is a bad thing in the long run, and the sheer number of drugs that fight pain. Treating pain completely without drugs is a brilliant solution, but simply taking the edge off the pain is not enough. Equally, though, finding a number of ways to help with the pain will almost certainly mean that your pet gets more relief and is happier. Treatment modalities which can help in chronically painful conditions include:
  • Acupuncture – there’s a reasonable body of evidence for the physical effects of acupuncture and theories of how it may ‘close the gate’ on pain. It’s now widely available around the country, but must be performed by or under the direction of a vet.
  • Supplements – for joint problems, there are a number of supplements containing combinations of glucosamine, chondroitin and green-lipped mussel extract, which protect the cartilage and may even get rid of the need for painkillers in early arthritis. Additionally, essential fatty acid supplements and vitamin E are both mooted as aids to tissue repair and free-radical scavenging.
  • Herbal remedies containing Devil’s Claw are widely available, but be warned that the supplement can cause side effects and that clinical trials have produced highly variable results.
  • Weight loss – whilst it’s obvious that in arthritis, every excess ounce is another ounce of pain, recent work has suggested that body fat has a chemical pro-inflammatory effect which may exacerbate pain generally. Reducing body fat may reduce the body’s pain responses, particularly in chronic conditions.
  • Surgery – for many painful conditions, surgery is the obvious treatment to permanently remove the pain at source.
  • Physiotherapy – hydrotherapy, mobilisation, massage and PROM are all very useful in promoting recovery and dealing with chronically painful conditions. Access to these services is usually by referral from your vet, and animal physios are highly qualified professionals.
  • Mood enhancement – pain is depressing, so elevating mood helps patients to cope, and also makes new pain easier to deal with. A number of products are available, from pills (including zylkene, a natural extract, and amitryptilline) to pheromone sprays and diffusers (feliway, DAP), but equally, promotion of routine and enjoyable activities can be very successful.
  • Prevention –as the best pain relief is prevention, a word should be said about how we avoid seeing dogs with arthritis or cats with pancreas issues in the first place. Also perhaps timely, as the Animal Health Trust, in conjunction with Edinburgh Vet School, have just announced a project into genetic testing for hip and elbow dysplasias in Labradors. Being able to breed the conditions out of our patients will have a major impact on the wellbeing of future generations (so, if your Lab is KC registered and hip scored, the AHT might just want to hear from you).
  • Magnet therapy – to this day, I still don’t know if this really works, but plenty of my clients are convinced – including a large proportion of horse owners, who are about the most hard-bitten, unpersuadable people out there.
There are, of course, countless other integrated therapies, like Reiki or Homeopathy, and each will have their champions and detractors. The important factors with any of these are choice and inclusivity – it’s fine to explore all of the possibilities, but not to the detriment of the patient. As a general rule, the vet who prescribes you meloxicam won’t demand that you stay off the Reiki during treatment, and this should work both ways. The mainstay of pain relief will always be drug therapy, but its effectiveness can be massively enhanced by looking at integrated treatments. Pain is such a debilitating problem that anything which can help to remove it has got to be worth exploring. If you feel that your pet may be in pain, especially if you’re already giving treatment, then speak to your vet about what you can do - there are so many ways to target pain that there’s bound to be something to help. And do remember that phrase: pain is not acceptable in our patients. If you are worried about your pet's health, talk to your vet or use our Interactive Symptom Guide to help assess how urgent the problem may be.
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Neutering dogs – Bitch spay operation: a step by step guide

Deciding whether to spay

Spaying or neutering a female dog is not a small operation, so owners should think carefully about all the pros and cons before deciding. The main advantages of spaying are preventing pregnancy, preventing infection of the uterus (pyometra), preventing ovarian or uterine cancer and reducing the likelihood of mammary (breast) cancer, all of which can be life-threatening. It also prevents the inconvenience of having a bitch in season with unwanted attention from male dogs. The main disadvantages are major surgery with associated risks, an anaesthetic with associated risks and the increased likelihood of urinary incontinence in later life. Fortunately, the risks involved in anaesthesia and surgery are very small indeed compared with the risks of the other conditions which are prevented by spaying. Urinary incontinence in later life is a nuisance but not very common, and can usually be controlled by drugs. There is no medical reason to let a bitch have one litter before spay, in fact some of the benefits like protection against mammary tumours, are lost if the operation is delayed. Unless an owner is committed to having a litter, with all the work and expense that can be involved, and the bitch is also suitable in temperament and free of any hereditary problems, then breeding should not be considered. Tilly GrinSome people expect that their bitch will get fat after spay, but in fact this is entirely preventable with a healthy diet and proper exercise. My own opinion is that most bitches should be spayed because of the health benefits. My boxer bitch Tilly was recently spayed.

Deciding when to spay

It is not a good idea to spay when a bitch is in season or about to come into season, because the blood vessels supplying the uterus and ovaries are all larger and this will increase the risks of surgery. The other time we try to avoid is the 8 weeks after a season, when a bitch may suffer from a hormonal imbalance called a false pregnancy. If this happens, she may be acting as if she is nursing pups and the operation at this time would cause such sudden changes in hormone levels that it would be unfair to her. Also if she was producing milk, the enlargement of the milk glands would make it more difficult for the spay wound to heal. For all of these reasons, the time chosen to spay is usually either before the first season occurs, or 3-4 months after a season. A physical examination by the vet will determine whether a 5-6 month old bitch puppy is mature enough to spay before her first season.

Before the operation

As well as timing the operation carefully to reduce any risks, it is also important that the bitch is not overweight. Because this increases the difficulty of the operation, it may well be advised that an overweight bitch should lose weight before the operation. Another important way of spotting avoidable risks is by taking a blood test before the anaesthetic. This could be done on the day of the operation or a few days earlier. This is used to check the liver and kidney function (both vital when dealing with anaesthetic drugs) and to rule out any unsuspected illnesses.

Before going to the surgery

Before any anaesthetic, the patient should be starved for a number of hours, according to the instructions of the surgery. This prevents any problems with vomiting which could be dangerous. It is also a good idea to allow the dog enough exercise to empty the bladder and bowels. Apart from that, it is best to stick as closely as possible to the normal routines of the day so that the dog does not feel anxious.

Being admitted for surgery

On arrival at the surgery, you can expect to be seen by a vet or a veterinary nurse who will check that you understand the nature of the operation and will answer any questions you may have. They will ask you to read and to sign a consent form for the procedure and ask you to supply contact phone numbers. This is very important in case anything needs to be discussed with the owner before or during the operation.

Before the anaesthetic

Your bitch will be weighed to help calculate the dosages of drugs and given a physical examination including checking her heart. If a pre-anaesthetic blood test has not already been done, it will be done now and the results checked before proceeding. If any abnormalities are found, these will be discussed with the owner before deciding whether the operation goes ahead or not. One possible outcome is that extra precautions such as intravenous fluids may be given. A pre-med, which is usually a combination of several drugs, will be given by injection. This begins to make the dog feel a bit sleepy and ensures that pain relief will be as effective as possible.

The anaesthetic

There are several ways in which this can be given, but the most common is by an injection into the vein of the front leg. The effects of the most commonly used drugs are very fast, but don’t last for very long, so a tube is placed into the windpipe to allow anaesthetic gas and oxygen to be given. The anaesthetic gas allows the right level of anaesthesia to be maintained safely for as long as necessary. Various pieces of equipment will then be connected up to monitor the anaesthetic. This is a skilled job which would usually be carried out by a qualified veterinary nurse. Apart from the operating table, the instruments and the anaesthetic machine, a lot of specialised equipment will be on “stand by” in case it is needed. The area where the surgical incision is to be made will be prepared by clipping and thorough cleaning to make it as close to sterile as possible. The site is usually in the middle of the tummy, but some vets prefer to use an incision through the side of the tummy.

The operation

While the bitch is being prepared for surgery as mentioned above, the surgeon will be “scrubbing up” and putting on sterile clothing (gown, gloves, hat & mask) just as in all television surgical drama programmes. The surgical instruments will have been sterilised in advance and are opened and laid out at the start of the operation. The operation involves removal of the ovaries and uterus (ovario-hysterectomy). The surgeon carefully opens the abdomen by cutting through the various layers. The first ovary is located and its blood vessels are tied off before it can be cut free at one end, then this is repeated with the second ovary. It is a delicate and fiddly job, needing great care and attention. The main body of the womb or uterus is then tied off as well before the whole thing can be cut free and removed. After checking for any bleeding, the layers of the tummy can then be sewn closed again. A dressing might be applied to the wound. Further drugs may be given now as needed. When the operation is finished, the gas anaesthetic is reduced and the bitch begins to wake up. She will be constantly monitored and the tube removed from her windpipe when she reaches the right level of wakefulness.

Recovery

Like humans, dogs are often a bit woozy as they come round, so she will be placed in a cage with soft warm bedding and kept under observation. Usually they will wake up uneventfully and then sleep it off for the rest of the day.

After-care

The bitch will not be allowed home until she is able to walk and is comfortable. Full instructions should be given by the surgery concerning after-care. The most important things would be to check the appearance of the wound, to prevent the bitch from licking it (with a plastic bucket-collar if necessary) and to limit her exercise by keeping her on the lead. Any concerns of any kind should be raised with the surgery. Any medication supplied should be given according to the instructions. Pain relief can be given by tablets or liquid on the food. Antibiotics are not always needed, but may be supplied if there is a need for them. Usually there will be stitches in the skin which need to be removed after about 10 days, but sometimes these are concealed under the surface and will dissolve by themselves.

tilly's wound with text

After a couple of weeks, if all goes according to plan, the bitch can be allowed to gradually increase her exercise levels. This is the stage that Tilly has now reached and she is thoroughly enjoying a good run again now that she is feeling back to normal.
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Osteoarthritis in dogs.

[caption id="attachment_826" align="alignleft" width="237"]Stiffness in older dogs may be due to osteoarthritis which could be treated. Stiffness in older dogs may be due to osteoarthritis which could be treated.[/caption] This week I met a lovely 12 year old Labrador called Amber, who has been suffering for some time now with osteoarthritis. She is on a combination of two treatments, which keep her quality of life good although her condition is getting worse. This is a very common complaint in dogs, especially middle-aged and elderly ones, but the good news is that the treatments available are improving all the time. One of the most common findings in a routine examination of an older dog is stiffness of one or more joints. On questioning the owner, we often find that there is occasional lameness or difficulty getting into the car, or stiffness for the first few minutes of exercise before the dog “gets going”. One of the most likely causes of such symptoms, although not the only one, is osteoarthritis or degenerative joint disease. Most people just call it arthritis, although there are other kinds of arthritis as well. Medium to large breeds are most commonly affected by arthritis, but it can happen in any size of dog. Usually the onset is quite slow and may not be noticed at first by owners, or just put down to the inevitable process of ageing. Unfortunately this can mean that owners are not aware that their pet is in pain, or underestimate how much pain they have. Owners are often surprised when it is suggested that their dog has arthritis that would benefit from treatment, and equally surprised by the improvement they see when treatment starts. A very common reaction is that he/she is “like a new dog”. This is mainly because their joint pain has been removed or reduced. Arthritis is a degenerative condition of the joints, where the cartilage overlying the bone becomes rough instead of smooth and movement of the joint becomes difficult and painful. The fibrous capsule surrounding the joint becomes thickened and restricts the amount of movement the joint can make. New pieces of bone called osteophytes can grow on the damaged surface, further restricting movement. The joints may make clicking or crunching noises when the dog walks, and the joints may also be swollen. Diagnosis of arthritis is by a mixture of examination of the dog, history taking (asking the owner about the dog’s exercise tolerance etc) and further examinations such as x-rays. It may not always be necessary to take x-rays, but it can be very helpful to rule out other conditions which might also be treatable, but would require a completely different type of treatment. As well as helping to make the right diagnosis, the changes seen can help decide on the best treatment. While the dog is anaesthetised, the joints can be manipulated much more thoroughly than when the dog is awake, so a more thorough examination can be made. [caption id="attachment_802" align="alignright" width="300"]Regular short walks are advised for affected dogs. Regular short walks are advised for affected dogs.[/caption] Once the diagnosis of arthritis has been made, treatment can begin. Before even thinking about drugs, the vet will want to consider whether changes need to be made to the dog’s weight and exercise regime. Being overweight puts increased strain on all the leg joints, so slimming down if necessary should be considered as part of the treatment. Rest can also be very important. Regular, frequent, short walks will be tolerated much more easily than an occasional long run. Often the first line of treatment involves “chondroprotective agents” like glucosamine and chondroitin. These can be given in tablet form or can be included in the diet. They help to repair the cartilage and maintain the lubricating fluid of the joint, the synovial fluid. Two points worth remembering about these are, firstly, that the full effects may not be seen until six weeks after starting, and secondly, the formulations on sale for human use may not be as effective in dogs as those formulated for dogs. Another very common group of drugs used to treat arthritis are called non-steroidal anti-inflammatories, or NSAIDs for short. These reduce pain and inflammation and can be given as tablets, liquids or injections. These drugs are generally very safe, but if used for a long time it is sensible to monitor the dog’s liver function as a healthy liver is needed to metabolise these drugs. A routine blood test is carried out every 6 months or as recommended by your own vet. Like all drugs there can be side effects, including the possibility of diarrhoea and vomiting in some dogs. If your dog develops any new symptoms while taking any drugs, it is advisable to seek advice from your veterinary surgery. In some more serious cases other drugs may need to be used, such as steroids or strong painkillers. Surgical treatments can also be used in the treatment of arthritis. Operations which have been common in human medicine for many years, like hip replacements, are now more widely available to dogs too. In severe cases of hip arthritis, this can allow enormous improvements in quality of life. In younger dogs where arthritis may be the result of a developmental problem in a joint, surgery may be recommended. Not all veterinary practices carry out these sorts of procedures so your dog might need to be referred to a local specialist in orthopaedics. Amber is a lucky dog in that her symptoms are well controlled even though her exercise is restricted. She has an examination and a weight check every 3 months and a blood test every 6 months. She spent a lot of our consultation lying on her back having her tummy tickled, and I had no doubts that she is still leading an enjoyable life. If you are concerned about arthritis, stiffness or lameness in your dog, or any other health issues, contact your vet or use our Interactive Dog Symptom Guide to help you decide what to do next.
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But rabbits are meant to be cuddly, aren’t they?!

Cat is the vet for petstreet.co.uk; an on-line social networking site for pet lovers. Obesity is a huge (if you will excuse the pun!) issue in our pets and can lead to significant health problems. It is usually easy to tell if Rover or Kitty are getting porky, their large bellies are generally the giveaway, but it can be more difficult in pet rabbits, who often appear quite round anyway, especially if they are fluffy! However, it is an extremely common problem in the species and can lead to some very nasty illnesses if it isn't tackled. [caption id="attachment_610" align="alignleft" width="300" caption="Rabbits come in all shapes and sizes, so it's not easy to see if they are overweight just by looking."]Rabbits come in all shapes and sizes, so it's not easy to see if they are overweight just by looking.[/caption] How do you tell if a rabbit is fat? It is difficult just by looking to tell if a rabbit is over-weight and while putting them on the scales is helpful, the healthy weight for each individual will vary. Getting your hands on them and feeling is the most reliable method. Firstly, you should be able to feel your rabbit's ribs when you place your hands on their chest, if you can't, or can only manage it by pressing very hard, then there may be a problem. Equally you should also be able to fairly easily make out their spine and hips. They should have an obvious waist and only females should have a dewlap and even then it should be fairly small. How did my rabbit get fat? Because it eats too much! Unfortunately it is easy to get the proportions of different foods in your rabbits diet wrong and this can lead to them putting on weight. Most rabbits are fed on some form of commercially prepared rabbit food but many owners don't realise that it is very calorie dense and must be fed sparingly; an average sized rabbit should eat no more than two tablespoons of hard food a day. Fruit is also a big culprit in making rabbits gain weight as the sugars it contains are very calorific, so keep fruit treats to a minimum and stick to vegetables for the regular fresh food in their diet. Also, rabbits are naturally active creatures but many are kept confined to small hutches or runs. This is also often a factor in any weight gain because they simply cannot exercise as much as they should and have nothing to do but eat. What are the problems obesity can cause? The most distressing problem seen in rabbits made much worse by them being fat is Fly Strike. If rabbits are over-weight, they are prone to becoming dirty and matted around their backends, mainly because they cannot physically reach round to clean themselves. The flies lay their eggs in the impacted faeces which quickly hatch into maggots. These will feed on the dirt but quickly start to attack the rabbit itself and, literally, eat it alive. It is a horrendous problem, very painful and often fatal. Obese rabbits are also vulnerable to pressure sores on their hocks due to their weight and bad skin because they cannot groom adequately. Arthritis is also a big issue in fat rabbits, their joints are under excess strain and their weight makes the disease even more painful. How do I diet my rabbit? Firstly, ensure their diet is not too rich. The ideal diet for a rabbit consists of 80% hay (everyday a rabbit should eat a pile of hay as big as it is) with a small amount of fresh vegetables and minimal rabbit food. The rabbit food is the biggest culprit in weight gain, so if they are fat and you want to diet them, cut it out altogether. It isn't a necessary part of the diet anyway so long as they have unlimited good quality hay and regular amounts of fresh food. Obviously they should have no human food at all. The second law of weight loss is exercise more and this can be done in rabbits fairly easily. They should all be allowed out in a run, the house or garden for at least 30 minutes twice a day. Rabbits are most active in the early morning and dusk, so if they can only have limited exercise then these are the best times to allow it. You can also encourage them to hop about by hiding tasty (but healthy!) treats around the garden or run, which also helps their inquisitive natures and keeps them mentally stimulated. Good choices for this are sprigs of herbs, edible flowers such as roses or carnations or weeds like dandelions or clover. You can even get special harnesses for rabbits and so can take them out for walks (as long as you don't mind the curious stares!) Obesity is a problem for all kinds of pets and owners should always be vigilant that their animals are not carrying extra weight. For rabbits this is especially important as they are very good at hiding any signs of illness and so keeping them in the best of health in the first place is vital. If you are concerned about your rabbit, why not pop them down to your vet? They would be happy to check them over and answer any questions you may have. If you are concerned about your rabbits health, please contact your vet or use our interactive Rabbit Symptom Guide to help you decide what to do next.
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A New Year’s Resolution for Pet Owners

It is traditional at this time of year to make resolutions for ourselves. These often concern a healthier lifestyle, like exercising more, losing weight or giving up smoking. I know I make two out of those three every January, and if I was a smoker I would make all three. But we should also remember our pets’ wellbeing at this time. It is estimated that 25-35% of dogs and slightly fewer cats in this country are overweight. A very small number of those will have a medical problem as the cause, such as hypothyroidism (which would be tested for by your vet if your dog is unable to lose weight or has other symptoms) but the vast majority are caused by us, the owners. Overfeeding and under-exercising are the main culprits, in other words, calorie intake is greater than energy used up. fatcatonscalesIt can be very difficult to notice that your own pet is putting on too much weight because when you see them every day, you do not notice a gradual change. It is important to have your pet weighed regularly and take advice from your vet or vet nurse about their weight. Many surgeries offer free clinics to help owners to manage their pet’s weight correctly. They will weigh him/her, discuss the best diet and the right amount, discuss exercise, set realistic targets etc. They may also assess your pet’s bodily condition by a system called body scoring. Some take photos so you can see progress, some offer prizes for slimmer of the month! We all love to indulge our pets and it gives both pets and owners pleasure to give their animal a treat. But when a dog or cat becomes overweight it can lead to serious medical problems involving the heart, the joints, complications in diabetes, higher risks in surgical procedures and others. An obese animal, however well-loved, is not a well-cared for animal. In extreme cases obesity is a form of animal cruelty and animals have been removed from owners for their own welfare. Prevention is much better than cure, as in all things, so feeding the right amount of an appropriate diet from a young age is important. If the dog or cat then gradually puts on weight over the years, it is up to the owner to modify their own behaviour. Dogs are scavengers by nature and will eat when the opportunity presents itself. If it presents itself frequently, most dogs will not say no thank you. Cats are often better than dogs at regulating their own intake, but there are exceptions and of course many cats are confined indoors which greatly reduces their exercise. As we are in control of the food supply, we need to make sure it is the right amount. Unfortunately it can be difficult to accept that the obesity is the owner’s fault, not the pet’s fault. Seeking help with a good diet and exercise regime is the first step. Learning not to use tit-bits or treats as the main reward system or the main way of showing your pet affection is also crucial. Treats can be given but could be halved, or given half as frequently, or taken from the dog’s daily ration of food, or substituted with a healthier snack like a piece of carrot or something similar. Training yourself to offer praise and affection in place of tit-bits can be harder than training your dog. If we were offered a new miracle treatment for our pets which would make them live longer and cost no money, we would probably be sceptical. But for a quarter of UK pet owners there really is such a thing, and it’s not only free but will actually save you money. Supervised weight loss and regular exercise for overweight pets will make them happier, healthier and help them to live longer. For dog owners, the exercise may also play a part in helping us to keep our own fitness resolutions. Happy New Year!
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