Time for a controversial one, I feel… I have three dogs, and other than those they manage to scavenge in the park, I won’t let them have bones!
For those of you preparing to type away and tell me how wrong I am to advocate such a thing, this tip is based on one of the hardest cases I’ve dealt with in my 25 years as a vet, which involved a lamb bone lodged in the distal oesophagus.
This incident was several years ago and, thankfully, our friend is now doing fine, but it was incredibly traumatic for all concerned at the time.
As I type this I am waiting to see a dog that is straining to pass fragments of bone and is in a lot of discomfort.
So, go on – tell me how wrong I am, and give me all the evidence-based medicine that you should…
The respiratory rate calculator from Boehringer Ingelheim is available for both Apple and Android devices.
I’ve just discovered the “respiratory rate calculator” by Boehringer Ingelheim, which acts as a useful tool in aiding clients to keep an eye on their dogs’ respiratory rate.
I find this invaluable for dogs with congestive heart failure, and because it allows owners to keep a record of results over time it can be a great aid in monitoring the response to various therapies.
Further information and download links for both Apple and Android devices can be found at www.yourdogsheart.com.
Not a flea or food allergy… what else could it be?
Allergen-specific immunotherapy (ASIT) can be a useful tool in cats.
I see a number of cats that, following parasite elimination and control – plus no response to dietary trial – remain pruritic. We use serological testing via our commercial laboratory and then order in the ASIT vial(s) according to the results.
Although the efficacy of ASIT is by no means guaranteed, I find it generally works well in cats. In fact, I find the majority are controlled well, although it has to be said we see fewer cases than in dogs.
While not exactly a major sign of food allergies, the number of times a day a patient passes stools can raise suspicion of the condition.
Between 60% and 65% of dogs with adverse food reactions (AFR) have concurrent gastrointestinal disturbance (Paterson, 1995) and (Loeffler, 2004).
Another study confirmed my impression dogs with AFR produce on average 3 stools a day, compared with an average of 2.1 stools/day in atopic dogs and 1.6/day in normal dogs (Loeffler, 2004). This decreases to normal in dogs with confirmed AFR once managed.
So, it’s definitely worth asking the question, and given encouraging clients to undertake food trials can be challenging, this can be very helpful in discussions as to the possible causes of pruritus.
REFERENCES
Paterson S (1995). Food hypersensitivity in 20 dogs with skin and gastrointestinal signs, Journal of Small Animal Practice36(12): 529-534.
Loeffler A et al (2004). Dietary trials with a commercial chicken hydrolysate diet in 63 pruritic dogs, Vet Rec154(17): 519-522.
As spring warms up, my own nose and sinuses have detected increasing pollen levels, and there’s been a corresponding increase in pruritic patients coming across the threshold.
I think the role of pyoderma in allergic skin disease is well established and accepted. However, it is not uncommon to see dogs with no obvious skin lesions that are markedly pruritic, and cytology often reveals large numbers of cocci without the correspondingly high levels of inflammatory cells.
In patients with reduced barrier function, this overgrowth can contribute significantly to the levels of pruritus. I find a significant number of dogs’ pruritus reduces by at least 50%, if not more, with appropriate antibiotic and shampoo therapy when overgrowth is identified by cytology.
I usually repeat the cytology in around 2 to 3 weeks to check for resolution, although, of course, given the relapsing nature of the condition periodic treatment is required.
Reference
Rosenkrantz W (2010). Proceedings of the NAVC Conference 2010.
Owners will often ask me to view the quality of life of pet companions nearing the end of their days. This is something I’ve often struggled with, as the primary caregivers are often better placed than I am within the confines of a 10 to 15-minute consultation.
I had the pleasure/honour of becoming the first person to buy Alice Villalobos’ book on canine and feline oncology at a veterinary conference a number of years ago. I know I was the first person because the author, on the stand, told me so – and we have been friends ever since.
Alice introduced me to the HHHHHMM Quality of Life Scale, which equates to: Hurt”, “Hunger”, “Hydration”, “Hygiene”, “Happiness”, “Mobility” and “More Good Days than Bad”. I have found the scale invaluable when discussing with owners at a difficult time.
While a subjective element remains with any such scale, I find it invaluable in guiding a discussion. Full details are available in Alice’s book (Villalobos, 2007)
“Why diagnose early? Obtaining a definitive diagnosis with cytology or biopsy early and before excision will lead to improved patient outcomes for superficial masses. Surgery is likely curative for the majority of superficial tumours when detected early, when they are small – especially benign lesions and locally invasive tumours with a low probability of metastasis. If tumours are removed with complete surgical margins, the prognosis is often good with no additional treatments needed.
“Pet owners need to be aware of the ‘pea’ size requirement to have masses evaluated, and veterinarians must measure and document the size of the mass to compare growth.
“If more than 1cm (or the size of large pea) and present for a month, the mass should be aspirated or biopsied.
“Knowing the tumour type prior to the first surgery will increase success of a curative-intent surgery.”
In all honesty, I rarely do this for masses booked in for surgery and I suspect as lipomatosus, and for masses that visually appear consistent for histiocytoma – but there are tips here I will follow in the future.
Reference Ettinger S (2015). Top Ten Oncology Mistakes and How to Avoid Them, North American Veterinary Conference: Small Animal & Exotics Proceedings, Gainsville, Florida.
A tie-over dressing. Image source: VNT:CPD, Sept 2008 – “Wound care and management” by Alison Young DipAVN(Surgery), RVN.
One of my colleagues showed me a technique we found to be a really useful aid to wound management.
We all know open wounds can take ages to heal by second intention, depending on wound size, infection, blood supply and a patient’s health. My colleague recommends tie-over bandages are used until the wound is no longer infected and can then be closed without tension.
Tie-over bandages provide a method for stretching and lengthening the local skin to facilitate wound closure. The amount of skin relaxation obtained depends on the location of the wound and the local skin character. Maximal stretch is usually noted within 2 to 3 days after placement of tension on the skin.
Tie-over bandages are also useful for securing bandages in areas that are difficult to incorporate into a regular bandage, or to reduce tension on primarily closed wounds (mast cell tumours, for example).
I also came across an article (Tobias, 2015) on just this subject that stated: “The laces are tightened 2 to 3 times a day to gradually increase tension on the skin. Most animals require sedation and analgesics during bandage changes for the first 3 to 5 days. If wounds are effusive or the laces are tight, the lacing material usually must be cut to change the bandage.”
I have limited experience of this technique, but it is definitely one worth considering in cases with difficult areas to bandage.
I have found acupuncture really helps some of my chronically painful canine patients, usually due to arthritis, but also in some cases of back pain too.
I have to say I usually use this as an adjunctive, rather than sole therapy, but often with good effect.
Evidence certainly exists in human medicine to suggest this helps (Witt et al, 2005). However, for some reason I have a mental blank and sometimes forget this as a possible therapy where dogs are not fully, or completely, responding to more traditional medications – and I would suggest this is well worth a go.
We are lucky enough to have a veterinary surgeon in our area who practices acupuncture and we are very grateful for his efforts.
References Witt C, Brinkhaus B, Jena S et al (2005). Acupuncture in patients with osteoarthritis of the knee: a randomised trial, Lancet 366:136–143.
