Archive for the ‘Dogs’ Category

What is HCM?

HCM is the most common heart disease in cats and stands for Hypertrophic Cardiomyopathy. Although it has occasionally been reported in dogs, this is very rare.

So what actually is it?

HCM describes a condition where the muscle wall of the heart becomes diseased. The walls grow additional layers of muscle, becoming stronger and stronger (which sounds like a good thing). However, this causes two problems – firstly, the space inside the heart (the lumen) is narrowed, meaning that the volume of blood that can be pumped out with each heartbeat is reduced. The second problem is that the thicker heart wall cannot relax properly – so the heart cannot fill effectively between beats. This means that the cat’s heart rate increases, to maintain their blood pressure – but of course, the harder the heart works, the stronger and thicker the muscle becomes.

What causes HCM?

There are three main causes:

  • Primary HCM occurs in an otherwise healthy cat. It is the most common form and is thought to be a genetic disease. In some high-risk breeds (Maine Coons and Ragdolls) the exact mutations have been discovered and there are DNA tests that can be carried out, but these aren’t available for most cats.
  • Secondary HCM is a response of the heart to another disease process. This may be:
    • Hyperthyroidism (an overactive thyroid), the most common secondary cause.
    • Hypertension (high blood pressure), usually in turn due to kidney failure.

What are the symptoms?

Most affected cats show no symptoms at all in the early stages of the disease. This is because even though the heart is becoming less efficient, the cat’s body can compensate for the disease, masking the symptoms. In this phase, one of our vets may hear a heart murmur when checking your cat over at vaccination, but there usually aren’t any other signs. However, the condition is progressive, and eventually, they won’t be able to mask it any longer. Some cats progressively develop subtle signs that gradually worsen, but many appear absolutely fine until they suddenly collapse, or even drop dead – this is known as an acute decompensation crisis.

There are two different clinical syndromes associated with HCM:

  • Congestive Heart Failure – where the heart can’t pump blood effectively enough, leading to pooling of fluid in the lungs and other organs. Typical symptoms usually appear in more-or-less the following order:
    • Heart murmur
    • Abnormal heart rate or rhythm
    • Increased time spent sleeping
    • Less time being active or playing
    • Increased breathing rate
    • Increased breathing effort
    • Pale or blue gums and cold extremities
    • Collapse or fainting
    • Open-mouth breathing
    • Sudden death
  • Thromboembolism – the failing heart isn’t pumping blood smoothly through its chambers, and as a result, blood clots start to form within the heart. At any stage, bits of these clots can break off and travel round the body. If they come to rest, they will grow and block an artery, and the symptoms will depend on where this occurs:
    • Stroke – where the blood clot blocks blood flow in the brain. Symptoms include fits, collapse, blindness and coma.
    • Pulmonary embolism – occurs in the lungs, resulting in very sudden onset difficulty breathing.
    • Aortic thromboembolism, also known as a saddle thrombus, is the most common form – it is one of the most common presenting symptoms of a cat with HCM. This occurs because a blood clot has cut off ALL circulation to one or both hind legs, causing extreme pain and paralysis, and is often fatal.

How is HCM diagnosed?
There are two ways the condition can be diagnosed; however, the DNA test is not one of them. This is because some cats who have the mutation don’t develop HCM, while many cats without it do.

A better “screening test” is the proBNP blood test – any cat with a raised proBNP level is likely to have some form of heart disease and needs further investigation.

The “gold standard” for diagnosis, however, is echocardiography, where a vet uses ultrasound to look inside your cat’s heart and measure how thick the wall is and how well their heart is working.

It’s important to remember, though, that just because a cat doesn’t have HCM, it doesn’t mean they’ll never develop the disease – it’s a condition that can develop at any age, and so cats in high-risk breeds should be regularly tested.

Is there any treatment?

Sadly, there is no cure for the genetic form of the disease. Affected cats should never be bred from, and if possible, all Maine Coon and Ragdoll cats should undergo DNA testing before they breed, in case they are carriers of the defective gene. Cats with Secondary HCM, however, can sometimes be returned to almost normal heart function if the underlying disease is detected and treated early enough.

In most cases, medical treatment is required. The mainstays of treatment are:

  • Slow down the heart rate – our vets may use drugs such as beta-blockers for this.
  • Help the heart relax between beats – a drug called diltiazem is licensed for this purpose in the UK.
  • Prevent clots from forming – using human drugs such as aspirin or clopidogrel at specific feline doses on prescription.
  • Reduce fluid buildup – ACE-inhbuilduprugs like benazepril and diuretics like frusemide are commonly used to reduce fluid pooling, helping the cat to breathe.

How long can a cat live with HCM?

The prognosis for cats with HCM is very variable – some cats may never develop clinical signs and will live normally for many years. Once symptoms appear, most cats survive less than two years; if the first symptom is a blood clot, the average survival time is only six months. As a result, the best prognosis is thought to be for cats diagnosed early, before symptoms appear!

If your cat is in an at-risk breed, or you are concerned about heart disease, make an appointment to get them checked out by one of our vets. If necessary, they can arrange blood testing or heart scans to see what’s actually going on!

I think my dog’s scratched his eye – what should I do?

First things first – get him down to us to check it out! Dogs’ eyes are delicate, and it’s really important that we’re able to treat any injuries quickly… 

Why do dogs get scratched eyes?

Any object that is either hard or sharp will scratch the cornea (the front layer of the eye) – grass blades, thorns or brambles, a cat’s claws, etc. As a result, this type of injury is known as a corneal ulcer or corneal laceration. The most common cause is running through thick undergrowth or grass and not blinking quite fast enough! It’s also fairly common for a grass seed, a blade of grass, or even a clump of hair to become trapped underneath the eyelid, causing scratches every time the eyeball moves.

If a dog encounters an aggressive or particularly scared cat, they will often make a swipe with their claws – and may catch the dog’s eyes.

The other big problem is with dogs with protuberant eyes (like Pugs) who cannot extend their eyelids to cover the whole surface of the eye. Inevitably, these dogs are at higher risk of eye injuries!

What are the symptoms of a scratched eye?

The most common signs are:

  • Runny eyes
  • Redness of the membranes around the eye
  • Swollen tissue around the eye
  • Milkiness or blueness of the surface of the eye
  • Pain and rubbing
  • Holding one eye closed

Is there any other condition that can be mixed up with it?

Yes – most commonly dry eye (keratoconjunctivitis sicca), where the eye doesn’t produce enough tears; as a result, the centre of the cornea dries out and cracks or ulcerates.

What will the vet do?

Firstly, we’ll try and find out how severe the injury is. To do that, we may have to sedate the dog, but usually, we can use local anaesthetic to stop it hurting and allow us to examine the eye. Once we’ve had a really good look at the injury and the rest of the eyeball, we’ll use a special dye called fluorescein – this sticks to damaged corneal cells, showing us how wide and how deep the injury is. We can then decide on the best course of treatment.

What can be done about it?

The vast majority of corneal injuries are fairly minor and respond really well to simple treatment. This usually involves a short course of antibiotic eye drops and some painkillers for a week or so. If by the end of this time the injury is healing but not quite gone, we can usually just extend the treatment for another week or so. The reason we use antibiotics is that it’s usually just the infection in the wound that stops it from healing on its own!

Is there anything else you might do?

Additional drugs and treatments are available to encourage healing, most commonly plasma drops. This is a liquid that is extracted from the dog’s own blood (we’ll take some if we need to!) that is full of pro-healing, anti-infection and anti-wound breakdown chemicals; and is applied as an eyedrop. Other options include EDTA drops (which do a similar job) and bandage lenses (soft contact lenses that will protect the eye while it heals).

A really serious laceration of the cornea may require surgery – often a pedicle flap to use part of the lining of the eye as a tissue graft to protect and nourish the injury and allow it to heal.

What if it doesn’t heal in that time?

If the eye doesn’t heal normally, the injury may become an indolent ulcer. In this case, we may perform surgery to encourage healing (such as a grid keratotomy); or use a pedicle flap or graft as above.

It’s very, very unusual to come across a scratched cornea that won’t respond to one or more of the advanced treatments we have available now!

If you think that your dog may have an injured eye, get them to us for a checkup as soon as possible.

Does Distemper still exist?

Sadly yes, distemper is still present – and potentially deadly – in the UK. In other countries, where a much smaller percentage of dogs are vaccinated, it is much more common (for example in Finland distemper is still a significant cause of death for dogs). 

So what is distemper?

Distemper is a viral disease of dogs. It is closely related to several other diseases including Seal Distemper (in seals, unsurprisingly), Rinderpest (in cattle) and  Measles.

How is it spread?

By droplets in the air containing body fluids – faeces or diarrhoea, vomit, urine or even air breathed out by an infected dog or fox. Once inhaled or ingested by another dog, the virus invades the dog’s lymphatic system and spreads throughout the body.

Fortunately, the virus does not survive well in the environment and is killed by most disinfectants and cleaning agents.

What dogs are at risk?

Any unvaccinated dog is at risk of Distemper. The incubation period is about one week, and once infected, most dogs will develop disease to some extent. However, how severely they will be affected will depend on how rapidly, and how effectively, their immune system responds. If it responds fast and well, they may only suffer subclinical disease (mild, non-specific signs), whereas if it doesn’t respond properly, or is very slow, then the full-blown disease will result. Of course, many dogs’ immune systems will fall somewhere between these extremes, giving a range of severities.

So what are the symptoms?

The typical progression of symptoms is:

  • Fever
  • Lethargy, loss of appetite (in subacute disease, symptoms may stop here)
  • A runny nose and eyes
  • Intermittent fever
  • Vomiting and diarrhoea
  • A cough and difficulty breathing
  • Changes in behaviour (e.g. stupor or hysteria)
  • Wobbliness and/or seizures
  • Paralysis
  • Inflammation of the eyes, sometimes proceeding to blindness
  • Thickening and hardening of the foot pads and nose (hence the old name, “Hardpad”).

Other complications are common, typically secondary bacterial infections, such as pneumonia. Some dogs will apparently make a recovery, but then months or years later will develop brain problems (“Old Dog Encephalitis”).

It sounds nasty, but how serious is it?

Estimates for mortality suggest that between 20 and 50% of infected dogs will die. It really is that bad. The only good news is that dogs who are infected and recover usually have a very good immunity to the disease for some years afterwards, and possibly for life.

What about people – can we get it?

There is evidence that people can contract it, especially if they are very old, very young, or have a weakened immune system (e.g. due to disease, chemotherapy, or pregnancy). Fortunately, however, the disease is usually less serious in humans, and in any case the measles vaccine gives good protection.

Can it be treated?

Basically, no – there is no specific treatment for Distemper virus. Infected dogs will get full supportive therapy (intensive care nursing, anti-inflammatories to control the fever, antibiotics to control secondary infection, intravenous fluids), and medications to control the symptoms (e.g. antiemetics to stop the vomiting, anticonvulsants to stop seizures), but whether they live or not will depend to a great degree on how well their own immune system meets the challenge.

How can it be prevented?

Very easily – vaccinate your dog. And, just as importantly, make sure he gets his boosters on time! The Distemper component of modern vaccines lasts for quite a long time, so this vaccine doesn’t need to be repeated annually. However, don’t just do the primary puppy course and forget about it – it does need to be boosted at one year old, and then every three years, or the protection will drop and your dog will be at risk.

If you are concerned about Distemper, contact one of our vets for advice.

What is a hip and elbow score in dogs?

As a result of domestication and inbreeding, many dogs sadly suffer from defective joints. The most common conditions are hip dysplasia and elbow dysplasia. 

These are developmental conditions, where the hip and/or elbow joints do not form normally, resulting in early onset arthritis and joint pain. The conditions are also genetic, meaning that they can be passed down from a sire and a dam to their offspring – but many less severely affected dogs show no symptoms until later in life, potentially after they have had many puppies.

To help breed out these problems, the Kennel Club and the British Veterinary Association set up the Hip and Elbow Scoring Schemes, and breeders are strongly advised only to breed from dogs with good scores.

So, what is hip dysplasia?

The hip joint has evolved to be a perfect ball and socket joint, allowing the femur (the upper bone of the leg) to rotate easily in the socket provided by the pelvis (hip bones), without popping out of joint. Nowadays, however, this “perfect joint” is only commonly seen in wolves and racing greyhounds – where the ability to run and keep on running is essential!

In hip dysplasia, the “socket” is too shallow for the “ball”, usually with abnormally sloping sides and a very small rim. This results in abnormal movement of the ball, leading to pain, arthritis and sometimes even dislocation of the joint. Unfortunately, except in the most severe cases, dogs can appear absolutely fine until early middle age, when progressive arthritis becomes obvious.

So how does the Hip Scoring Scheme work?

The BVA/KC Hip Scoring Scheme requires a very specific and carefully positioned X-ray of the hips under a general anaesthetic (so the dog doesn’t wriggle!). This image is then sent off to a panel of experts who will grade each of the hips on nine different criteria. These include the angle the hip makes (the Norberg Angle), how well the ball sits within the socket (“subluxation”), the shape of the socket, and the shapes of the head and neck of the femur. For each of these points, each hip is scored from 0 to 6, with 0 being perfect, and 6 being such severe damage that the joint is non-functional. At the end, they add up all the scores and send them in as a Left and a Right Hip score for the dog.

How is that useful?

The score for each hip gives an indication of how severe the dysplasia is (so, for example, a hip scoring 0-3 is usually considered normal and healthy). The specific dog can then be compared with their breed average, and only dogs with a Hip Score of less than the breed average should be bred from, to improve the breed overall and minimise the risk of Hip Dysplasia.

In the first ten years of the scheme, the average hip score of UK Labradors went down from 16.5 (1996) to 12.8 (2007)!

OK, that’s hips, what about elbow dysplasia?

Elbow dysplasia is a much more complex condition, comprising a number of different problems – but once again, it is a genetic developmental condition that seems to be becoming more common, possibly as a result of inbreeding. The most common primary disorders include osteochondrosis (OCD), fragmentation of the coronoid process (a bony spur which breaks up when loaded, FCP) and ununited anconeal process (another bony spur that fails to fuse properly to the rest of the ulnar or elbow bone, UAP).

These primary lesions appear relatively early in life – usually well before the puppy is fully grown – resulting in early onset arthritis and lameness. However, like in Hip Dysplasia, some dogs do not show clinical symptoms until much later in life.

And how are those scored?

Again, a series of carefully positioned X-rays are needed (at least two different views, and sometimes three, to highlight different parts of the joint). Each elbow is then scored 0 (normal) to 3 (significant primary lesion and/or very severe arthritis). Once again, the experts read the X-rays and send back a score for each elbow.

So, again, you only breed from dogs with better than average elbows, right?

Actually, to control Elbow Dysplasia you must be much stricter – it is recommended only to breed from dogs with a grade of 0 for both elbows.

Can anything be done to treat dysplasia once it develops?

Sadly, this is a degenerative condition that cannot be cured. However, certain primary lesions can be managed (such as using bone screws to reattach ununited bones, and removing bone chips from inside joints). The mainstay of treatment is medical, with reduction in body weight, exercise control, joint supplementation and pain relief being the main treatment options.

In severe cases, hip or elbow replacement surgery is possible and is very effective – but also very expensive!

If you’re thinking about breeding from a dog or a bitch, make sure you talk to one of our vets about Hip and Elbow scoring first!

How can veterinary nurses help with preventative health?

Veterinary nurses play a large role in helping and advising pet owners with the care and well-being of their animals. We are proud of our veterinary nursing team at Goddard Veterinary Group, and the passion they have for the health of your pets. Part of that role includes advising on preventative healthcare – keeping your pets in the best health before problems arise.

Diet

There are so many diets on the market for pets it is really difficult to know where to begin! Our nurses can advise you on the best diets for your pet’s specific breed, age and the recommended feeding amount.

If your pet is overweight and should ideally be fed a smaller amount or given a calorie reduced diet, our nurses will be happy to advise and weigh them. They can further advise on maintaining their weight, when they reach their target.

Preventing obesity in pets can help lengthen their lives and dramatically reduce the risk of heart disease, diabetes and joint pain, among other conditions.

Fleas and worms

Almost every pet will end up with these critters at some point in their lives. Preventing them is much better than having your pet playing host to them. If you suspect your pet has fleas for example, our nurses can take a look at their coats and search for tell-tale signs.

Worms, of course, are a lot more difficult. However, there are symptoms that can point to a worm problem. Goddard’s veterinary nurses can explain the life-cycle of these parasites, and the best ways to avoid having both your pet and your home infested with them.

When it comes to fleas and worms it really is worth preventing them – the cost of treating a skin condition caused by fleas for example, far outweighs the price of flea treatment!

Vaccinations

Although it is our vets that vaccinate your animals, our nurses can give you advice and guidance on the types of diseases that pets can be vaccinated against. No one wants to have a pet with a potentially life-threatening disease, and vaccination can prevent that from happening.

Nails

It is our senior pets that we find can have a problem with their toenails, simply because they won’t tend to wear them down as easily as younger pets. Senior pets are normally less active, often choosing softer ground to walk on, whereas a puppy that tears about on all types of ground will have a pedicure naturally! This is why preventing nails from overgrowing and making your pet uncomfortable is important. Our nurses can check your pet’s toenails and trim them if necessary.

It’s not just dogs either, cats too can have this problem especially if they have gone off using the scratch post. Our nurses will also make sure the dew claws are a comfortable length, in extreme cases these can curl around and dig into the pad, even leading to infection.

Microchipping

As of April 2016 all dogs over age of eight weeks in the UK, are required by law to have a microchip.  These tiny devices, about the size of a grain of rice, can help you and your pet to be reunited if they happen to get lost. A microchip is also a requirement for a pet passport.

No responsible owner would want to lose their pet and our nurses can help advise about microchipping, preventing this from happening. At present there is no law about cats being microchipped, but we strongly advise this is well – in fact almost any animal species could be microchipped!

One thing you may hear our nurses and vets reiterate, is keeping your contact details up to date for the microchip, especially if you move home!

Teeth

Our nurses can give all sorts of advice about preventative health when it comes to your pet’s teeth. From brushing techniques to dental products, they can help advise on keeping your pet’s teeth pearly white. Dental health is very important as poor teeth can affect other parts of the body, including major organs, through infection and toxins in the bloodstream.

Pets even at the age of 4-5 years can start to suffer with dental disease, so it’s very important to get the advice as early as possible on helping to keep their teeth sparkling!

With advice from our team of nurses (and vets) on preventative health, your pets can really benefit. Be sure to ask us if any health aspect of your pet worries you — we’ll be happy to help.

Don’t forget Goddard Veterinary Group’s healthcare plan, ProActive Pets. The scheme provides discounts on your pet’s preventative healthcare, allowing you to spread the cost throughout the year.