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…
Wildlife veterinary medicine is more than being a good shot with a dart gun and knowing what anaesthetics to fill the darts with.
I know this because I was part of a group from Glasgow vet school that visited the Shamwari Game Reserve in South Africa to find out exactly what wildlife medicine entails.
Minimal intervention
Generally, as the animals on the reserve are considered wild, the main aim is to keep veterinary intervention to a minimum.
The majority of the veterinary work is translocation (involving mainly sedation and/or anaesthesia) but there are a few exceptions, which are often dealt with in the reserve’s rehabilitation centre – particularly if the animal in question is rare or highly valuable.
Although we learned a lot about anaesthetics (which was surprisingly easy to relate to practice at home), there’s far more to it than meets the eye.
In-depth knowledge
During our two-week stay we learned that an in-depth knowledge of animal behaviour, among other aspects of conservation, is the vital foundation of the veterinary work.
For example, the length of time an animal will spend in transit and whether the animal will be woken up in the field will have an impact on drug choices – a prey animal needs a complete and rapid recovery in the field to avoid showing weakness to the herd or any predators in the vicinity, whereas an animal travelling halfway across South Africa would require longer lasting sedation.
Species differences are also important to consider; drugs that are highly dangerous in some animals may be the sedative of choice in others.
Additionally, the reaction to being darted needs to be carefully evaluated in terms of both the animals’ and the staff’s safety. We were particularly aware of this when working with buffalo and having to judge the right amount of sedation reversal to allow them to wake up completely, while giving ourselves enough time to dash into the truck and put a safe distance between us before they did so.
A different perspective
The team at Shamwari were eager to give us a practical, hands-on experience – which was great.
Image courtesy Shamwari Conservation Experience.
Not only was it an awe-inspiring couple of weeks, but it was also incredibly useful in terms of consolidating knowledge and practical application of pharmacology – particular anaesthesia.
Experiencing all aspects of conservation in addition to the veterinary work also gave a different perspective to veterinary medicine.
It was exhilarating to be working with such beautiful and potentially dangerous animals – I could certainly feel my heart going through the roof when taking blood from a lion whose snores sounded suspiciously like growls.
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.
We do get taught about pigs at uni, but they are seen so irregularly in practice that the “P” word sends a shiver of fear down any vet’s neck.
Having a pig farm in the family gives me a bit of a distorted view on the world. For example, I’m a complete pork snob and would rather go without then eat crap sausages.
However, I find it bizarre vets start panicking and fervently flicking through dusty textbooks on the practice shelf before going out on the incredibly infrequent pig call.
When I think about it, though, it isn’t so bizarre. I can’t remember the last time we had a vet out to the pigs. My step-grandad has been looking after them and developing his own bloodline for 50 years – if there’s anything he doesn’t know about pigs, it’s not worth knowing.
The UK pig farming industry has been declining over the years to the point where there are very few pig farms around, and those that still exist rarely need a vet because the farmers know what they’re doing.
We do get taught about pigs at uni, but they are seen so irregularly in practice that the “P” word sends a shiver of fear down any vet’s neck.
But what about the pet pig? I went on one pig call while on placement at a mixed practice, and finding out we were going to see a Gloucester old spot (one of the breeds we have at home), I was intrigued. As it turned out, the pigs were “rescued” from going to slaughter and the pig we had been called out to was lame, but still weight bearing.
Pigs: nothing to be afraid of…
Suspecting a mild break or soft tissue damage after a compromised examination (a quick manipulation before the sow decided she was walking off), the vet gave an anti-inflammatory and advised re-examination a few days later.
On discussing the case with my step-grandad, he disagreed, and muttered something about mycotic lameness or remnant erysipelas. His advice was to “bang in some penicillin” (farmer’s favourite) or lincomycin.
However, on the re-examination, the pig had improved and the owner was given oral anti-inflammatories to continue with.
After relaying this advancement, the pig expert then retracted to: “Well, it could have caught its leg”.
Either way, the pig has improved.
Even though pigs are rare in practice, I think it’s important not to be scared of something you don’t know much about (the same also applies to exotic pets) and to always know the books are there for back up. Failing that, in my case, my step-grandad is a phone call away – even if the second opinion is to be taken with a pinch of salt.
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.
I spent a couple of weeks at a mixed practice on extramural studies. It was a placement of firsts – first experience at a very “young” practice (lots of newish graduates), first clinical farm experience and first surgery experience.
It gave me an insight into the difference between older, more experienced vets and new grads – from the way they approach consultations and cases to the time/skill difference in surgical procedures. Obviously, a lot of this comes with experience, but it was reassuring to know I’m not quite as lost as I thought I was (and it also helped me recognise areas to work on).
I did work experience at farm practices before uni, but hadn’t been to one as a proper student. It entailed the bread and butter of farm practice – being shoulder deep in a cow’s rectum.
My younger brother found it particularly fascinating, always asking me when I got home each night how many cows I’d seen. Appealing as it sounds, I found reproductive physiology and pharmacology began making a lot more sense.
One day we were called out to castrate 34 calves, which turned out to be a day of avoiding hailstones while the vet cut, twisted, pulled and I injected. Nearing the end of the never-ending stream of beef calves, the vet invited me to have a go. A few minutes later, covered in blood, cow poo and sweat (it required a surprising amount of elbow grease), I had performed my first surgical procedure.
The following day I found myself being told to scrub up, then was guided through a cat castrate. It was a bit surreal, because the vet started off with “cats are a bit like calves…” I couldn’t help wondering how many students castrated a calf before a cat…
A few days later, the same vet supervised my second unassisted castrate. I had a real sense of achievement, having been able to perform the procedure without being told what to do. I know it’s a simple surgery and may seem like peanuts to a qualified vet, but it was quite a step for me – and everyone has to start somewhere.
I also scrubbed in on an exploratory laparotomy on a ferret, which was unusual to say the least, especially when the huge mass we were investigating in the abdomen turned out to be fluid filled and exploded slightly after a needle was stuck in. Since it was attached to the uterus, the vet decided to spay the ferret, which sparked the conversation of why ferrets aren’t often spayed and the resulting hormonal changes involving the adrenals.
Overall, I had a tiring couple of weeks, but felt the vets were eager to get me involved and my clinical skills certainly progressed further than I expected.
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)
