Richard has been writing for the Sidmouth Herald as part of their Pets Practice page for a few months now, we thought we would start adding them all here too just in case you miss an edition!R and Dylan 2

Richard writes from the heart and from the head as he uses his vast knowledge and experience from over 22 years as a small animal vet to guide us through some tough topics as well as re educating us on some age old ones too!

If you have a suggestion as a topic for Richard to cover in one of the Heralds editions please comment below and you may see your idea covered in print.

Friday 13/3/15

Large Vet companies…..

Like it or not, corporate veterinary practices are here to stay. Just as with dentistry, individual  veterinary practices are becoming part of large groups, often involving up to 100 practices.
These groups either evolve from companies opening up new practices or by buying existing practices or sometimes both.
It was only in 1999 that the first corporate vets started and already some estimates suggest 15% of practices are corporate and this will only increase.
This model mirrors companies like the large supermarket groups with the economies of scale allowing them to purchase drugs cheaply and centralise other costs and thus tempt clients with lower prices.
Hopefully all vets recognise the public are entitled to value for money and that people can shop around for prices but I think corporatisation of an industry can come with some risks.
With  any large business, especially one with share holders ,profit can be the sole reason for its existence. consequently there will be pressure on employees to meet specific targets and many employees will be on commission.
This can then lead to a public suspicion of the industry as a whole and sadly this is filtering into the veterinary sector. When I graduated 23 years ago, I can’t remember people talking about vets overcharging , whereas now it seems much more prevalent. Whether this is actually true or is just a perception is irrelevant , the damage is being done. The vet is no longer seen as a caring individual who has chosen the profession as a vocation, but simply an employee in a large company.
This is where the small private practitioner has a huge role to play in reversing this perception. To go back to the supermarket analogy, smaller shopkeepers are making a resurgence as the public recognise that they can offer so much more than just cheaper prices.
Private vets will probably stay in the same community for long periods of time so that long term relationships can be built that will benefit the owner and the pet.
Commission based work is very rare in private practice so again the public suspicion will be lower and also the simple fact that you are actually seeing the owner of the practice with your pet should mean the amount of care and attention you receive will be greater .That is a simple fact of human nature . The vet can be judged on their clinical acumen and caring attitude rather than how big the practice is, how big their advertising budget or how many Facebook likes they have.
I suppose I risk sounding like a Luddite but I worry the profession is veering away from the vocation that it used to be.

Historic blogs -

Euthanasia…….

Euthanasia is a very vexing and contentious topic but one which is one of the cornerstones of Veterinary medicine.

As a new graduate I have to swear an oath to alleviate suffering to any animals presented to me and if all other avenues have been exhausted then euthanasia can be performed.

With the progression of modern medicine we are able to perform procedures we didn’t dream of twenty years ago and animals are living longer and longer but at some point there is nothing more we can do. At this point sadly I have to discuss our final option . The actual timing varies from person to person and I think this is where the Vet’s experience comes into play about trying to advise the client because hopefully the vet can give a more objective view of the situation.It is inevitable that this decision will be considered very late in the game as  the last thing a client wants to do is pick up the phone and request that their beloved pet be put to sleep just as much as it is the last thing that the vet wants to perform…Too many times clients have reported huge regret about” hanging on too long” and again I think it is our job to try and ensure this doesn’t happen. If the vet has all the relevant information then hopefully the right decision can be made at the right time.

I think we are very lucky as vets to have this option that our human counterparts don’t. Many clients have watched loved ones die slowly and often in a great deal of discomfort and say they wish these people had the same options as their pets, and most clients will report to me a sense of grief but at the same time a feeling of relief as they realise they have put a stop to any suffering their pet was undergoing.

Obviously at this hugely distressing time, it is essential to try to make the whole process as stress- free as possible.

Often I will perform the procedure at the client’s house as a home environment will cause less distress to the animal.

I also prefer to lightly sedate to pet beforehand because the actual injection to euthanase the animal has to be given intra venously which in itself can be stressful so sedation alleviates this.

The injection itself is like an overdose of anaesthtic agent and should only take a matter of seconds so hopefully again the animal is completely unaware of what is going on and simply falls asleep next to the owner.

Euthanasia is one of the worst aspects of our job but if performed properly and with sensitivity it should be considered a great boon.

Feeding the birds……

A client has recently brought in a dying bird from her garden for treatment and mentioned that this is not the only one she has seen that appears to be ill. She wondered what the cause could be and what could be done to prevent these occurrences.
Obviously naturally occurring diseases and injuries can be responsible but there are many things we are doing that can cause the demise of our winter garden visitors.
Slug pellets are generally composed of a chemical called metaldehyde which is extremely toxic to wildlife as well as slugs.The blue cololur is supposed to make them unattractive to birds and if spread very thinly is less of a risk as only small amounts can be ingested at once .But some gardeners will put them in piles which means more can be eaten at once making them fatal.
Rodent poisons can also be fatal predominantly to birds of prey.Once a rat has eaten the poison it will die, but it then becomes carrion to birds of prey and so they are secondarily poisoned. Therefore the advice for rodents is to trap them first before they are euthanased so that poisons can’t get into the ecosystems.
Even our good intentions are sometimes misguided and can harm the birds.
Peanuts are often put out for birds but if the are left too long they can become mouldy and these moulds can contain poisons called aflatoxins .These chemicals are extremely poisonous causing liver failure and death. Furthermore birds cannot metabolise salt so slated peanuts can themselves be very harmful if put out for birds.
Putting bird feeders by windows can also be dangerous as the birds are more likely to fly into the window either causing serious inury or death.
In conclusion ,if we are to enjoy the sight of beautiful birds in our gardens there are many things we can actively do to secure their future.

Vaccinations……

Vaccination is one of the most important pillars of preventative medicine, whether in humans or in animals, and yet it is something that is overlooked in the pet population.
The main diseases that are vaccinated in the dog are Parvo Virus , Distemper , Canine Infectious Hepatitis, Canine Parainfluenza virus and Leptospirosis.All of these diseases are potentially fatal.
In the cat we vaccinate against cat Flu, Feline Leukaemia and Feline Panleucopaenia, again all of the diseases are potentially fatal even with the best treatment.
It is often argued that vaccinations are unnecessary and can actually harm your pet. The Internet is filled with stories of pets dying after vaccination, but I can honestly say that in 25 years of practice I have never seen a dog die post vaccine and only two cats that had a fatal reaction to a vaccine.
You will always get a small proportion of reactions to any drug , just as you do in human medicine and obviously these cashes are tragic ,but you have to weigh up the pros and cons of vaccination.
As a student I worked at the PDSA in Liverpool and watched puppy after puppy die of Parvo Virus simply because they weren’t vaccinated, so surely the benefits of fatal disease avoidance outweighs the risk of  less than one reaction in 25 years.
Another argument against vaccination that is often put forward is that our dogs don’t need all the vaccines every year.
This is correct and certainly up until 10 years ago vets did vaccinate every year against all the diseases.
However this has been addressed and the vaccine that I use only incorporates all the diseases every 3rd year, but proper studies have shown that the Leptospirosis portion of the vaccine only gives immunity for 1 year .so it is essential to vaccinate against this illness annually.
Equally with the cats, the vaccine immunity is only present for a year, although there is some argument against vaccinating for Feline Leukaemia as the cat seems to build up its own immunity as it gets older, but this isn’t a hard and fast rule so prevention must be better than contracting this fatal disease.
I have heard people say that they have never seen a case of any of these diseases locally and  so why should they bother with the vaccine.
This is surely evidence of the success of the vaccine programs as I certainly saw far more cases of these diseases twenty years ago.
The dangers of this argument is echoed tragically again in human medicine.Due to completely erroneous information surrounding the MMR vaccine in babies and a link to autism, people have stopped vaccinating their children .Consequently Measles which 15 years ago was almost eradicated has started to occur again in children,sometimes with tragic results.
Your vet can advise you on the best vaccine regime for your individual pet but I hope the arguments above have put some of the myths about vaccines to bed for good.
Chronic Kidney Disease in the Cat………..
Kidney disease is probably the most common complaint in older cats and it is estimated that between 20-50% of 15 year cats being affected to some degree. For reasons unknown to us, it is quite an uncommon disease in the dog.
The main role of the kidney is to remove waste products from the body and consequently as the kidney fails these products build up in the body causing illness and in themselves actually accelerate the rate at which the kidney deteriorates.
The cause of the disease is unknown but chronic infections such as dental disease can contribute to the failure of the kidneys.
The main symptoms are familiar to most pet owners and include an increased thirst, increased urination , poor appetite ,vomiting and weight loss,
Diagnosis is fairly straightforward ,with early signs being detected by testing the cats urine and also blood tests will reveal the disease as it progresses.Ultrasound can also be used to determine the structure of the kidney to detect a possible kidney tumour or cyst ,but the vast majority of cases occur simply because there isn’t enough kidney tissue left to perform its job properly
Early diagnosis and treatment is an absolute must with kidney disease as I mentioned before the rate of deterioration accelerates as the disease progresses .so early treatment will slow the detrerioration which is always inevitable with the disease.
The mainstay of management is access to water all the time to allow flushing of the waste products.
A low protein diet also helps as it is mainly the breakdown products of protein that cause the problems ,so the less protein being taken in then there is less work for kidneys to do .
The diet should also be low in phosphorus and this type of diet is commonly available from your vet.
There also evidence that drugs called ACE inhibitors which are generally used in heart disease are beneficial for feline kidney disease.
Anaemia is also common with kidney disease and can be treated with hormone injections.
Unfortunately with all these treatments the disease will progress but if caught early this progression will be slow and cats can live very happily for many years with ongoing kidney disease.

Puppy Socialisation and it’s importance……..

The last thing you want as a new pet owner is an antisocial dog. Like children, dogs are not born with the social skills to live in our homes and know how to interact with people and all other animals and objects.

Socialisation is the process that all new puppies should undergo as early as possible to prepare them for their lifelong journey ahead, ensuring that they become happy, confident and relaxed in all aspects of their environment and understand how to communicate and interact with other dogs in a social group as well as the other pets within the family home.

Socialisation, simply means “learning process”. Early and ongoing socialisation is the key factor to a happy and well rounded family pet.
As soon as your puppy has settled into it’s new home, it is vitally important to introduce them to as many new stimuli as possible but ensuring that all interaction is done in a measured and pleasureable way and kept as fun as possible so that these memories instill a happy and relaxed approach to all things future encountered.
This involves meeting and spending play time with adults, children, the veterinary surgeon, groomer, all types of people including those with beards, wearing hats, crash helmets or carrying umbrellas. Meeting all other animals including walking past fields that have farm animals and horses so that the puppy becomes familiar with the sight of these bigger animals from the start. Careful and gentle exposure to everyday situations, such as, hoovering, travelling in the car, traffic noises, cyclists, television, children shouting loudly and all other sights and sounds that you are aware your puppy will be exposed to throughout their life.

Ensure that they are encouraged to play and become involved with other dogs and people from the very start. When meeting new dogs and puppies, encourage them to say hello to big dogs, small dogs, dogs with flatter shaped faces, with long coats, short coats and of all different colours. At every stage of positive interaction, always reward your puppy with praise and/or a treat. Up until approxiamately 16 weeks of age, puppies will take on board all new experiences with gusto and although shy, should not be fearful, after 16 weeks of age, they can become more weary as the learning and development stage has passed, which is why early socialisation is key. If your puppy looks shy when exposed to new stimuli and wants to be picked up, resist the urge to do this or mollycoddle them as this gives your puppy the wrong signals and instills in them a fear of that new stimulus because you have effectively removed them from it telling them that it was something to be afraid of as they learn from you and your actions. Allow the puppy to stay by your feet or on your lap but ensure that they can still be exposed to the new object, person or sound without you cuddling or holding the leash too tight, they will want to check out the new object but in their own time and they then understand there is nothing to be fearful of.

After your puppies first vaccinations, normally around 8 weeks of age, it is best to get your puppy registered with a local puppy class, we run our own here at the practice for example, free of charge, which exposes them to new sights and sounds in a controlled and measured environment where all the puppies are of a similar age and experience. In this environment they can learn together and a trained behaviourist can help answer questions and queries you may have and help you to understand some of the behaviours your puppy may be exhibiting, as well as discussing toilet training, basic obedience and general aspects of new puppy care, including all areas of socialisation and when to start setting boundaries. Puppy classes are so important and helpful as each week your puppy will be introduced to new sights, sounds and objects as well as learning how to socialise and interact with other dogs of various breeds, and people in an appropriate and controlled way.

They will also learn the importance of quiet time too and how this is all too easy to miss in the excitement of a new puppy, but by missing this key aspect out, the dog thinks everything is always a game and will not settle when you are around, they must learn to be calm around you too. Part of the socialisation process is also about touch, getting your puppy used to being held and handled around the feet, ears, face, mouth and tail, areas we tend to forget about until their first veterinary trip and then it is all very strange and the instinct of fear sets in. Getting them used to this from the start keeps the process relaxed for the puppy as well as for you. Having puppy classes held at the veterinary practice also ensures that the puppy sees the practice as a fun place to visit and will love coming back.

If your puppy is exposed to all new things early and in a controlled manner, and this is continued throughout your young dogs life, you will be rewarded with a well rounded, well behaved best friend to share your home and life with.

Dentals……..

How often have you heard the phrase uttered by the vet that your cat or dog “needs a dental”?
Often it is said almost as an aside or a trivial matter ,but it is a fact that periodontal disease is the most common disease in our dog and cat population .
If your animal had a large infected wound on its leg you would probably take it to a vet for antibiotic therapy but because the problem is hidden in the mouth then it is overlooked
Periodontal disease involves inflammation and infection of the teeth ,gums and associated structures and  cause great pain to the animal, ,however
cats especially are very good at hiding the pain and the disease is often well advanced before it is noticed.
It is mainly caused by poor dental hygiene as is the case with people not brushing their teeth ,although in the cat there are various viruses which can cause very painful gingivitis.
As well as causing pain in the mouth the infection also damages vital organs such as the kidneys ,liver .heart and lungs as the bacteria in the gums is carried in the blood stream to these organs where it causes more damage.
This affect is paralleled in humans where dental disease causes damage to patients with pre existing heart disease.
Prevention is the best course of action and good oral hygiene can be maintained by brushing ,the feeding of hard biscuit based diets and offering your animal one of a multitude of products which will scratch the plaque off the teeth as they chew.
There are also additives for food which help breakdown the build up of plaque but mechanical removal by chewing is by far the most effective treatment.
If, however your animal does have to undergo dental surgery,,recovery is usually very swift and could well prolong his or her life  and alleviate a lot of unnoticed suffering

Pet Myths…….

Should I let my bitch have season before it is spayed?

There is no scientific evidence to support this theory . Reasons for delaying spaying usually incorporate the words “balancing hormones”. Hormones don’t need and can’t be balanced, and there are good reasons to actually spay your bitch at a young age. The primary reason in my view is that it greatly reduces the risks of developing mammary cancer, as the number of seasons a bitch has is directly proportionate to mammary cancer incidence. In addition the operation is much easier , less likely to carry perioperative complications and recovery is quicker.

I have to restrict the amount of exercise my puppy can do.

Many owners worry that any type of moderate exercise will damage their puppy’s joints. This theory has been existent for as long as I can remember and again there is no evidence to support this. Almost all joint problems suffered by juvenile dogs are inherited such as hip dyspasia and another condition called osteochondrosis. By restricting your puppy ,you can often end up with a bored and frustrated dog that develops behavioural as a result. There is even some evidence now that by restricting exercise muscle development over the hips becomes poor and that in itself can become a problem. So I recommend allowing your puppy to exercise as much as it likes as long as you don’t have to carry it home!

Cats regulate their food intake.

Even 25 years ago I was taught this at University, but it is clearly not true. I see many overweight cats which leads to many health problems ,among them diabetes.This may be due to the advent of dry foods but it is well worth weighing out your cats food before you hand it out.

I need to feed my new puppy and kitten milky meals and cereals.

This is again unnecessary as if your new pet is on a good quality pet food it will have the necessary nutritional elements already in it. Your pet will probably like it but lactose intolerance is quite common in dogs and cats and cows milk can often cause diarrhoea so I would stick to pet food and water from the outset.

Castration will change my dog to the detriment.

Most often asked by male members of the family , it is again not true. It is the undesirable characteristics such as roaming ,dominance and aggression that will be changed in your dog. He will still be just as ebullient and lively and in addition will be less likely to be afflicted by prostate, testicular  and anal cancers ,so it is well worth taking the plunge.

Lungworm…….

My puppy always eats snails-where’s the harm in that?
Unfortunately over the last year or so research has shown there can be great deal of harm in this perfectly normal behaviour for an inquisitive dog.
Slugs and snails and the slime they leave behind can be a source of Lungworm and if this parasite is ingested the consequences can prove fatal.
Slugs and snails prefer warm wet conditions Devon provides both these at this time of year and the map shown defines this area as a place where lungworm cases are being reported.
The difficulty with the disease is that the symptoms are very vague .varying from mild vomiting ,diarrhoea, coughing,and unexplained bleeding, right up to very acute death due to interference with normal blood clotting.
Diagnosis is simple with a blood test performed by your veterinary surgeon and treatment is possible but early detection is necessary.
Prevention is the best course of action and removal of toys from the garden and cleaning of dog bowls where slugs might be found are useful.There also products from your vet which can also prevent the disease.
If you are concerned about any of these issues consult you vet sooner rather than later as the consequences can be catastrophic.

Old age in pets…….

It is a well publicised fact that the human population is living longer and the same is true for our pets.
I think in the twenty years that I have been a vet the average life span of both dogs and cats and certainly rabbits has increased by probably two to three years.
The obvious joy of having your pet longer brings along with it certain medical conditions that previously were much less of an issue.
Hyperthyroidism in the cat was unknown in the 1970s, but with 20 year old cats very common now, I diagnose this disease almost weekly. The thyroid runs your metabolic rate and in cats with this disease the rate is greatly increased that means they will vast quantities of food and yet still rapidly lose weight. They have a very rapid heart rate and some will have diarrhoea.If your older cat is displaying these symptoms it well worth a visit to your vet as it is very treatable with surgery or medication.
Kidney disease is very common now in cats they are living longer and is essentially the kidneys wearing out with age. An marked increase in thirst is the main symptom of the disease along with weight loss,poor appetite and vomiting as the disease progresses. Early intervention is the key with kidney disease as your vet can prescribe many medications which will slow the progression of the disease, but these are less effective if the disease is further on in progression.so talk to your vet early if you see your cat drinking more.
Dogs in old age suffer different diseases, the main ones being osteoarthritis and heart disease.
Owners will often describe their dogs as “slowing down” and think it is just old age when often there are very treatable diseases occurring.
Large breed dogs will very often suffer from arthritis and the don’t want to walk any more because it is painful for them to do so. They will look stiff and will sometimes be lame. X rays can be used to diagnose the disease and use of weight and exercise management and possibly the use of pain killers can hugely improve  their quality of life for long periods.
Underlying heart disease is often seen as just general ageing and is again very treatable. It is seen mainly in smaller breeds and is a slowly progressive disease(; dogs don’t get generally get heart attacks as such)  so you have plenty of time to treat the disease. Heart disease in small dogs is due to a leaky valve in the heart resulting in a heart murmur which your vet will detect and this accompanied by a decrease in ability to exercise and often a cough.
Again early detection makes a great deal of difference as recent human evidence has proposed the use of a drug called spironolactone which prolong the life of your dog markedly if used early and hugely increase their quality of life.
In conclusion, don’t think your animal is just getting old as there are a huge number of conditions that can now be very easily treated to further prolong your time with your beloved pet.

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