Posts Tagged ‘healthcare’

Pet Diabetes Awareness Month: Diabetes in Dogs

What is it?

Like humans, any dog can get diabetes mellitus (sugar diabetes). And like us, it is more likely to occur in the obese than in those of a healthy weight. While the early symptoms may be subtle, it is a potentially fatal condition and can result in severe and life-threatening complications.

What causes it?

Insulin is needed in the body to tell cells to take glucose (sugar) out of the bloodstream and into the cells, where it can be used as fuel. In diabetic dogs, there is insufficient production (often coupled with peripheral insulin resistance), so the blood glucose levels rise uncontrolled. However, the body is unable to use this sugar, and instead turns to burning fats and proteins for fuel. In the short term, this is fine, but if it goes on too long, the dog is at risk of diabetic ketoacidosis, where the blood become acidic and organ systems start to shut down. This is rapidly fatal without immediate emergency treatment.

What dogs are at risk?

Any dog may develop diabetes, but it is most common in mid-adult life. Specific risk factors include pancreatitis (because of damage to the pancreas, where insulin is made), pregnancy, some infectious viral diseases, the use of high doses of steroids, Cushing’s Disease, and (most importantly) obesity. Certain breeds may be at higher risk, even when all these factors have been accounted for – there is evidence that the Miniature Pinscher, Cairn Terrier and possibly Dachshund and Poodle are at slightly increased risk.

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What are the symptoms?

In the early stages, the most common symptoms are increased thirst and increased drinking (this may lead to mild urinary incontinence, especially overnight); increased hunger and weight loss (because they cannot use the sugars in their blood). Affected dogs are also prone to repeated urinary tract infections. Later, if diabetic ketoacidosis occurs, loss of appetite, lethargy, depression, dehydration, vomiting, collapse and ultimately coma and death. All dogs with diabetes, even if it is well controlled, are likely to develop cataracts as well, so it’s always worth monitoring their eyesight, or getting the vet to check it over when you come in.

How is it diagnosed?

An increased blood glucose level is highly suspicious, as is a high sugar reading in the urine. However, there are other possible causes of these signs (including stress and certain kidney diseases), so the most usual way to confirm the diagnosis of simple or early diabetes is to send away blood for a fructosamine test – this measures the AVERAGE blood glucose level over the previous 2-3 weeks. Another method is to do repeated blood sugar levels over several hours to a day – this is called a blood glucose curve, and will clearly demonstrate persistent high blood glucose levels. In Diabetic Ketoacidosis, the presence of ketones in the blood over a certain level is diagnostic – we often measure this by ketones in the urine (which is equally useful).

How can it be treated or managed?

Most diabetic dogs can be managed and stabilised effectively, but it is very unusual for it to be possible to manage them without the use of regular daily (or twice daily) injections of insulin. By giving extra insulin at exactly the correct dose, we can “top up” what they’re making, and keep their levels in the “normal” range. However, as insulin levels vary over the course of the day, and high levels can be dangerous (leading to a “hypoglycaemic episode” where the dog behaves abnormally, and may become unconscious, have fits, or even die) it is important to match the insulin dose to their feeding times. As a result, a regular, stable routine is VITAL, as is regular monitoring – with a blood glucose meter at home or blood glucose curves. Special diabetic diets also help, by smoothing out the peaks and troughs in blood sugar levels.

Can it be prevented?

The risk can be reduced by keeping your dog a healthy weight, but even healthy dogs develop diabetes, and there is no certain way to prevent it.

If you have more questions, contact your local Goddard practice!

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Pet Diabetes Awareness Month: Diabetes in Cats

What is it?

Diabetes mellitus is a common disease where sugar (glucose) in the blood is unable to enter the cells of the body due to problems with insulin. This means the cells have no energy and feel like they’re starving even though there is plenty of sugar available. Cats usually get insulin resistant diabetes (equivalent to Type 2 diabetes in humans). This occurs when, although the pancreas is making insulin, the cat’s body cells are not responding normally to it. The result is that the blood sugar levels climb and climb, but the cells cannot use it.

Why is it important?

Untreated diabetes will eventually result in coma and death, either due to brain damage from cerebral dehydration (hyperosmotic coma), or metabolic collapse (diabetic ketoacidosis or DKA). Cats that are treated and stabilised have a good prognosis. If the underlying cause of insulin-resistance can be resolved cats can go into remission, meaning they no longer need treatment.

What’s the risk?

Diabetes is more common in middle-aged to older, male, indoor/inactive and Burmese cats. It has also been linked to long-term steroid medication use, chronic pancreatitis, acromegaly, and Cushing’s disease. However, obesity is probably the most important single risk factor.

What happens to the cat?

Classic symptoms for diabetes include weight loss despite an initially good appetite, increased drinking/urination, walking flat footed (like humans) and smelly breath. In later stages, untreated cats can enter diabetic ketoacidosis (DKA) which causes anorexia, vomiting, lethargy and eventually a coma which can lead to death.

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How do you know what’s going on?

Your vet will be suspicious of diabetes based on the history and clinical signs you tell them as well as their examination. One single test alone, however, cannot usually be used to diagnose diabetes and sometimes repeated testing over several days is required. This is because there are many other factors, including severe stress, that can lead to a temporarily high blood glucose level.

To check for diabetes, your vet will perform a blood test to assess the blood glucose level. If this is high, they will often then check for sugar in the urine (glucosuria) which should be negative in a healthy and non-diabetic cat. A further blood test called fructosamine can be used to check the average blood glucose level for the last couple of weeks to make sure your cat has consistently had high sugar levels indicating diabetes. The urine will also be assessed for signs of ketones which are found in DKA and some vets can also test for ketones in the blood.

Urine may need to be cultured to check for a secondary infection which is common due to the high sugar content. Other diseases can cause and be associated with diabetes and these may also be checked for, particularly if your cat is not responding well to treatment. These include pancreatitis (inflammation of the pancreas), acromegaly (a growth hormone tumour) and Cushing’s disease (steroid producing tumour, although this is rare in cats).

What can be done?

Diabetic cats that present with ketones in their blood/urine usually require hospitalisation for intravenous fluid therapy (a drip) and treatment with short-acting insulin to stabilise them. Once stable, diabetic patients can be treated at home provided the patient is compliant and the owner is willing.

Diabetes can be treated with long-acting insulin injections given under the skin 1-2 times a day. There are different types of insulin and methods of injecting insulin available and your vet will go through the options with you. Many owners find the idea of injecting their cat daunting, however, your vets and vet nurses will go through the process and practise with you until you feel confident. It is important that you follow a strict routine, giving the insulin and feeding your cat at the same time every day.

Food is typically given at the time of injection and not in between as this can result in poor control. In many cases, weight loss and a low carbohydrate diet are beneficial and can improve the chances of your cat going into remission. Response to insulin is monitored using blood glucose tests/curves and fructosamine (see above) and your cat’s dose will be adjusted accordingly.

Cats with poor control of their diabetes will show symptoms as described above. Cats that are too well controlled because of too much insulin or going into remission can show signs of low blood sugar (hypoglycaemia). This includes lethargy, trembling/twitching, wobbling when walking, and depression. In severe cases, hypoglycaemia can result in seizures and a coma. If you are worried your cat is hypoglycaemic then give them something to eat if they are able to swallow, if not then rub some honey on their gums and seek veterinary attention immediately.

Achieving good control of diabetes within the first six months markedly increases the chance of remission. However, cats that have gone into remission can still become diabetic again in the future.

How can I protect my pet?

You can help decrease the chance of your cat getting diabetes by minimising the risk factors where possible. Try to keep your cat slim and active, as overweight cats are over 4.5 times more likely to get diabetes. Feeding a diet which is lower in carbohydrates can help prevent obesity and often results in lower blood glucose levels after eating, compared to many commercial diets.

If you have any questions please get in touch with your local Goddard practice!

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Tick Bites: When to worry, and how to prevent them

Ticks are widespread in the UK. They are actually arachnids rather than insects and, like spiders, adult ticks have 8 legs and vary tenfold in size from 1 millimetre to 1 centimetre. Ticks hatch from eggs and develop into larvae, then nymphs, and finally into adults. At each stage ticks have to attach onto and feed from an animal (their host), to develop into the next stage. The younger stages of ticks, like larvae, prefer to feed on small animals like birds and rodents. However, the older stages can attach onto and feed on larger mammals, such as dogs and cats, and also humans. For this reason, these unwelcome hitchhikers are something you should be aware of.

How do animals get ticks?

Whilst they could be found in some gardens, particularly in more rural areas, ticks are most commonly found in vegetation in areas such as woodland, meadows and moors.  When they are looking for a new host to attach to, they are described as ‘questing’ and will wait on low branches and leaves to attach to any animal brushing past.

Is there a particular time of year that my pet is likely to be affected?

Ticks are most active in spring and early summer, and then again in early autumn. They are generally dormant in cold weather. However, with global temperatures on the rise, they are likely to be active for a greater proportion of the year.

Why should I worry about ticks biting my pet?

The majority of the time, tick bites will not harm your pet. Rarely, bacterial infections or abscesses will develop at the site of a bite. This is more likely to occur if a tick has been improperly removed, with part of the tick being left in the skin. However, the main reason for wanting to prevent tick bites in dogs is that they have the potential to act as vectors (spreaders) of infectious disease.

What diseases can be spread by ticks?

In the UK the most common disease that ticks transmit is Lyme disease, caused by the bacterium Borrelia burgdorferi. Dogs that are bitten by an infected tick do not always become ill. We know this because many dogs in the UK have antibodies in their blood to the bacterium, suggesting they have been exposed, without ever showing signs of being unwell. However, some dogs do become ill, and this can occur weeks to months after being bitten. Signs of Lyme disease in dogs can include painful swollen joints, a fever and lethargy. It can also go on to cause glomerulonephritis, a condition affecting the kidneys.

Lyme disease can also affect humans, often showing as a characteristic ‘bulls-eye’ rash in the area of the bite. This rash is not generally seen in dogs.  Humans can initially suffer from a flu-like illness, but can also be affected by heart rhythm abnormalities, neurological problems and arthritis. In some people, this can become a long-term illness.  Whilst there is no evidence humans can be directly infected by dogs carrying Lyme disease, dogs could bring infected ticks into your home and garden.

Babesia is another parasite that can be transmitted by ticks to your dog. It can cause damage and destruction of red blood cells in the bloodstream, sometimes causing severe anaemia (low red blood cell count), as well as bleeding disorders and organ failure, and can be fatal. Until fairly recently, Babesiosis was a disease only seen in the UK in dogs that had travelled from continental Europe. However, in recent years, several cases of Babesiosis have been seen in dogs in the South East of England that have never travelled abroad, sparking concern that this infection is now beginning to establish in ticks in this country.

Dogs and humans can also contract a disease called Ehrlichiosis from ticks, though this is also rare in the UK.

How can I prevent my pet from getting ticks?

It is important to check your dog daily for ticks and remove any that are found, particularly at times of the year when ticks are most active and when your dog has been walked in areas that are high risk. Be sure to check them all over, including their feet, groin and armpits. Cats can also be affected by ticks but are quite good at grooming them off. If your cat gets ticks, they are most likely to be found on areas of the body they cannot clean so easily, such as on the head.

There are a variety of preventative tick treatments available that will repel ticks, kill them once they have attached, or both. Infected ticks do not spread infections such as Lyme disease until they have been attached to the host for around 48 hours. Effective tick treatments will kill ticks much quicker than this, meaning they are killed before they can transmit disease to your pet. Many of these treatments also prevent flea and other parasite infestations. Our practice staff would be happy to discuss with you what treatment would be best suited to use for your pet as part of their routine parasite prevention, so please do get in touch!

What should I do if I find a tick on my pet?

The easiest way to remove a tick is by twisting it off using a special tick remover. Properly removing a tick in this way reduces the risk of leaving the tick’s mouthparts still attached.  Ticks should never be removed by squeezing or pulling, nor by being burnt.

If you are unsure or worried that your pet has a tick, book an appointment with your local Goddard vet.

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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.