End of life…

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As I walked out of clinic at 1am on Monday morning a family were arriving to say goodbye to their pet having been summoned by phone just 15 minutes before when he started to deteriorate so rapidly that it was obvious he only had minutes to live. They made it in time to say bye thanks to the Vets Now ECC nurse recognising what was happening early and allowing them to be summoned.

Through the weekend we’d helped countless animals who left the clinic to go home with their parents, yet there was a high proportion that was never going be leaving, whether or not their pet parents realised it when they arrived. Unfortunately our pets can never tell us how sick they are, how much pain they are in, and that they want to go on over the rainbow bridge.

This is worse as often it is not just that they are seriously ill (and sometimes even dying painfully), but is also so sudden that their parents may not have had time to come to terms with this and accept it. It is not human nature to give up and sometimes when it comes to the decision to end life it can feel this way even though it is really not.

The weekend was a mix of those that came to ask us to help them send their loved pets on over Rainbow Bridge – the request of one parent that nearly made me cry was that someone would cuddle them as they moved on. Then there were those that hadn’t realised how bad the condition was and how much pain their pet was in that let them go on pain free when realising. There were also those that just refused to give up even though it could be considered to be  the kindest thing for their pets.

Vets are legally entitled to euthanise an animal on welfare grounds if they believe the welfare is compromised and the animal is suffering. However , we realise the importance of the bond parents make with their pet and that doing so will not be easy on the parents – in fact it would be very traumatic for the parents which is something we never want.

Instead we rely on our ability to communicate with pet parents. Sometimes it is very obvious to us how bad an animal is because of our experience and training whilst it may not be to their parents. We release that the animal is never going to be able to leave alive, and whilst we may attempt to make the animal comfortable with very strong pain medications, it is the owner that we need to treat.

Euthanasia is one of the most powerful tools that a vet has – read about how it really works here.

It’s not all about money… how Vets Now try to save you money!

the-emergency-patient

The emergency vet is always going be more expensive than your normal day vet. It costs money just to open the door and have the team there ready whilst it is not possible for them to guarantee that they will have patients.

Because of this fee just to be seen by a vet there is a big effort to make sure that only pet parents that really need to be seen arrive at the clinic. This starts with the national contact centre where a call handler, supported by a qualified veterinary nurse  will talk to you about your pet on the phone and tell you whether you can wait for your day vet or you need to be seen by an emergency vet.

If, on arriving at the clinic, the client’s pet has improved dramatically, then or course they can change their mind with no charge. If a vet is not available to see an owner and sick or injured pet within a short time of arriving, then as soon as possible a registered veterinary nurse will triage the animal and get any immediate first aid needs started. Veterinary nurses are unable to diagnose or prescribe medication so this may be in conjunction with the veterinary surgeon ‘behind the scenes’ but with the owner’s informed consent.

There are a limited number of consultations that registered veterinary nurses are legally allowed to undertake on their own. These include things such as replacing a slipped or damaged dressing and are charged at a lower fee.

Then something that really surprised me when I arrived was that a manual blood test was used (I’ll write more about this later) instead of using automated machines that were used by the day vet in the same building. This was weird at the start – however in discussion it costs less than half the price of the automatic machines, is faster, and most importantly takes much less blood to do. It took less than 0.2ml for nearly every patient over the weekend which for an emergency patient keeping as much blood as possible in the body is important. Plus it means that certain parts of the blood test (such as amount of Red Blood Cells) can be repeated as needed without being forced to test everything again.

Sometimes a pet may need to come into the hospital for monitoring or to be given IV fluids to help them with dehydration for example. When this happens instead of being charged for the entire night or weekend the hospitalisation is split into 7 hour slots so you only actually get charged for the time your pet is in the hospital.

Off course the treatment varies between patients, however the vet does consider the different options to keep the cost of treatment as low as possible whilst keeping your pet alive. Emergency medicine is about trying to rule out possible life-threatening conditions and it can be necessary to be proactive to achieve this. While this can cost money it could potentially be life-saving and cost less in the long run, both financially and emotionally. Anything Vets Now do will be discussed with you and as I have said options will be discussed wherever possible and at the earliest opportunity. Many of the emergency tests Vets Now use regularly need to be repeated to get the most value from them. Sometimes repeats are built into the hospitalisation and nursing fees so there are no additional charges but allow your pet to have a high standard of monitoring and care.

I personally would recommend getting insurance such as Pet Plan to help you cover the cost of emergencies. Responsible pet ownership is something that Vets Now are very keen to promote, as they understand just how quickly veterinary bills can rise . Costs can quickly rise in the initial part of any emergency, even if the outcome is not good. Being able to find out more information to help the vet get an idea of prognosis, while not having to worry about the fine detail of the financial situation can be a great benefit of pet insurance. Lots of policies exist however and it is important to find one that meets your needs so always read the small print.

The emergency patient…

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Arriving to Vets Now with a quick tour of the practice and introduction to the team I changed and it was time to see my first consult with head vet Rebecca. It was not the bleeding dying dog or cat that I expected but a rabbit with early gastrointestinal stasis that had stopped eating – giving medication against pain and to encourage gut movement we hope that we had caught it early and that the rabbit would be fine.

One of the attractions of emergency and critical care is that you never really know what is going to come through the door. Most patients will go through telephone triage so we may get a little notice to prepare if necessary; however there is always the chance that someone will run a dying pet straight in. If you have time to telephone (or can get someone else to telephone) before you come then it is better because it allows preparation of anything necessary before you arrive. This can be even more important if there are already critical patients as it may be necessary to triage the least critical to a secondary area so we have a table to work on or a connector for oxygen.

The uncertainty of what is next is also one of the challenges of  emergency medicine; you need to be very confident in your ability to deal with whatever comes in. And you have to be able to cope well under pressure  – especially when multiple emergency patients arrive at the same time.

Whilst able to send some patients home, there were unfortunately a few where euthanasia was the best option – either because they were not treatable or because they lacked any quality of life. I’ve written an entire post on euthanasia that will follow in the next couple of days.

The day quickly became one of maggots with what felt like an endless supply of the wriggly white flesh eaters being found on a cat, pigeon and a rabbit. It is amazing how quickly with the summer heat that flies will take advantage of any moist fur to lay their eggs. The eggs tend to hatch rather quickly so within 24 hours there can be a serious problem if not treated so these were emergencies. Fortunately shaving half the cat managed to remove all the maggots and only the top layer of skin was damaged, however the pigeon and rabbit had much more extensive wounds and had to be euthanised on welfare grounds.

For my first day however it was a rather relaxed introduction to emergency practice – I had time to learn how things worked – and to pick the brains of the vets and vet nurses I was working with to get a better understanding of how it worked with Vets Now. It also gave me some time to practice some of the clinical skills such as manual PCV (blood cell counts) that I’d not done for several years.

The Dachshund: A Tiny Dog With A Big Personality

There are few more smile inducing sights than seeing a miniature dachshund confidently standing up to a larger, more docile dog. This tiny creature with short stubby legs and a long body is stubborn, often foolishly so, and will fearlessly frolic with other dogs, cats and any other pet you may have in your home. A lively little mutt, a dachshund is an ideal choice for the first time dog owner due to their relaxed temperament and ability to fit in pretty much anywhere. Your dachshund will be your faithful companion and relish any opportunity he has to sit with you and succumb to your chin rubs.

Although he is a healthy breed, the dachshund has a few medical ailments that need to be watched out for as he grows older. Be aware and get him to the vet if you spot any of the warning signs of the following conditions.

Epilepsy

As with the human condition, dachshunds can develop seizures at any age. Watching your dog have a seizure can be terrifying, but the best thing you can do is stay with him and soothe him until it passes. It is thought that this neurological condition is genetic and incurable. However, there are plenty of medications that can be utilized to get your little hound’s epilepsy under control should he develop it at some point in his life.

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Parasites

In a similar way to other hounds that love their walks, dachshunds are susceptible to anything parasitic ranging from fleas to ticks. The best way to combat this is to ensure your little guy starts a regular flea prevention routine from puppydom. Spot on treatments are the simplest and least intrusive way of giving your dog medication. You place a tiny pipette of medicated liquid onto the back of his neck once a month to keep him protected against the nasty parasitic blighters.

There are many parasites carried by other tiny critters that you need to be aware of. If you have a read of a post about a heartworm dog named Bobby Sue, you’ll see just how deadly parasites can be. Mosquitos can carry heartworms and release the parasitic larvae into a dachshund’s bloodstream after biting his skin. If your little pal starts coughing, seems wheezy or is losing weight, get him to the vet for a check up.

Intervertebral Disc Disease (IVDD)

Because dachshunds weren’t blessed with the strongest of vertebra, their elongated shape means that they can find themselves with a whole host of back issues. They may need to have anti-inflammatory medication or have an operation to have discs removed if the pain becomes too great. It’s vital when you lift up your dachshund to give him a cuddle that you support his rear end and back. Because this is such a prevalent problem in the dachshund breed, owners have tried to fend off back problems with visits to a doggy acupuncturist or chiropodist with great success.

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If you find yourself the proud companion of a dachshund, you’ll be welcoming a fiery, entertaining and delightful little creature into your home. He or she will be at the center of many a comical memory and will be a welcome addition to any family.

How Not To Make A Dog’s Dinner Out Of Your Pooch’s Diet

Every pet owner wants to take good care of their pet. Whether it is a cold or fleas, it is essential to fix the problem so that your dog isn’t in pain. However, there is one area where dog owners are not up to scratch: their pooch’s diet. Pets are like humans and need a balanced and tailored diet. With that in mind, the following tips are here to help. This is how not to make a dog’s dinner out of their diet.

Take Them To The Vet If There Are Problems Like Itchy Skin

Yes, going to the vet is expensive and a lot of hassle, but it is the only way you will find out about allergies and deficiencies. Like people, dogs are allergic to certain foods, or their stomachs can’t digest them as well as others. Obviously, you need to avoid these foods, but it isn’t possible if you don’t know what they are in the first place. By visiting the vet and asking for a food trial, intradermal skin test or a blood test, they will be able to tell which items in foods are good and which are bad.

Go Au Naturel

If in doubt, opting for organic food is always a good option. Natural dog food doesn’t contain any chemicals or unnecessary additives. Therefore, it shouldn’t be hard to digest or cause them to be sick. Plus, the natural ingredients will boost everything from their mood to their stamina. The key is to find truly natural food because there are suppliers who fudge the facts. A good tip is to take the label test. This means forget about the packaging, reputation, and PR and focus on the ingredients. What you are looking for is a high percentage of meat as well as soy protein and corn.

Introduce Human Meats

If your dog has ever been sick bets are a vet has recommended chicken and rice. This bland diet is good to help “reset” the digestive tract when they are ill. To get the most nutrients out of their diet, a dog needs a balanced diet which can be commercially made however treats can be given. With this in mind, don’t be afraid to introduce meat you would eat, such as beef. Of course, the protein in meat is an essential nutrient. But always do your research first and avoid chocolate as it is poisonous to most dogs.

But Don’t Cook It

Every time you have a piece of red meat it will go in the frying pan or the oven. Humans have evolved to need cooked meat as a part of their diet, yet dogs aren’t the same. Pretty much every other animal species on the planet requires meat, and they should have it raw. When you cook it, the meat loses its nutritional value and your dog won’t get the same benefits. Also, chewing raw meat is good for their teeth. However, stick to beef because poultry and pork can cause salmonella.

Ultimately, your dog’s diet is down to you, so please take the responsibility seriously.

Cold Facts: Common Health Concerns Among Siberian Huskies

Siberian Huskie

It is no wonder why the popularity of Siberian Huskies has grown exponentially over recent years; they are just so hard to resist. There aren’t many other breeds that are quite as strikingly gorgeous as the Siberian husky, what with those piercing blue eyes, that thick coat of fur and those disarming wolf-like looks. But it isn’t just their appearance that makes them such amazing pets. It is their joyful demeanour, their buoyant energy, their loyalty and friendliness. But the fact they make the best furry friends imaginable is also what makes it so hard to cope with when they get sick. There is an emotional bond that can crush your soul like nothing else.

Yes, Siberian Huskies tend to be incredibly healthy compared to a lot of other breeds, but that doesn’t mean they are free of all health concerns. Quite the contrary, in fact. Of course, the best medicine in your arsenal is knowledge and prevention, which is why we are going to highlight the main health problems of this very special breed:

Huskie in the snow

Corneal Dystrophy
Unfortunately, Siberian Huskies are known for suffering autoimmune disorders that affect the eyes and one, in particular, is to do with the cornea. Unfortunately, this tends to be a hereditary disease and one that your local veterinarian will probably tell you has no known cure, whether medicinal or therapeutic. What it looks like is tiny white spots in the cornea, with the condition affecting your pups vision. It’s not nice, but the good news is it isn’t painful.

Zinc Deficiency
Another autoimmune disorder your husky is susceptible to is a low level of zinc in their body, which tends to cause hair loss. The most common areas of hair loss are on the face – lips, chin and eyelids – but it can also occur at their elbows, hocks and feet. The obvious thing to do is add a zinc supplement to their diet. However, before you do this we would strongly recommend you speak to your vet first.

Progressive Retinal Atrophy
Yeah, Huskies tend to get it pretty rough with their eyes, and this is another hereditary example of this. This is a condition whereby your dog’s retina slowly disintegrates over time. The best way to ensure that this condition doesn’t affect your puppy is to have your Husky screened at an early age and let it undergo the necessary examination. While this won’t cure them, it will allow you to make lifestyle adjustments to ensure any progression is put off for as long as possible.

Hip Dysplasia
Ask any vet and they will tell you that a lot of big dogs are prone to hip dysplasia and Siberian Huskies fall into the category. To give you a little more information on it, hip dysplasia is where the joint doesn’t quite fit together properly, making later life a lot harder for them. There are certain things you can do to help your dog if they suffer from this. However, we would also recommend you ask the breeder whether the pups parents have been screened for hip dysplasia. It is hereditary, so those parents who were fine on this front tend to produce a litter that is unaffected too.

The Emergency Vet…

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Accidents can and will happen, most often when you are not expecting them, and medicine is not cheap. This is especially so when it happens when your normal vet is not open, as then you are often sent to a specialist emergency vet, which is almost like an A&E department for pets. The vets here are trained to save your pets life; in addition to specialist training they have access to the important equipment and drugs necessary to do this.

Over the next 4 days I have been invited to join Vets Now one of the UK’s leading providers of Emergency Centres for Pets that have been in accidents or are seriously ill. I’m excited to learn a lot of things to help with emergencies, yet I am apprehensive about how intense it will be and how little I know.

I’ve been invited into two different centres in two different cities so I can see a range of different patients and learn from several different vets.

The first centre I am at just for the weekend, expecting to be there from 12 lunchtime until 7pm Saturday evening. Then again all day on Sunday from 8:30am until evening again with night staff taking over to continue to provide the care needed.

The second centre I am on overnights on Monday and Tuesday from around 6pm until the next morning as the normal overnight shift is 15 hours long. This centre also takes patients from the PDSA charity so is expected to be a lot busier.

During this time I’ve been allowed to tweet – so keep an eye on my twitter feed @vetschooldiary for live updates from behind the scenes as it happens.

And off course I will be blogging my experience as well (potentially once I’ve managed to catch up on sleep!).

The Cat Owner’s Guide: Drawing The Line With Your Wild Feline

Keeping your cat happy

Cats are beautiful and fascinating creatures. They have minds of their own, and, whilst this is one of the many exciting and intriguing things about them, it does mean that cats have a tendency to wander off into the outdoor world without warning. Of course, this wild attitude is fine outdoors, but there have to be rules at home. You can’t let their untamed behavior go unnoticed indoors. Dragging in dead animals, scratching, and generally making a mess are all things which you can’t let slide. Here’s the cat owner’s guide to drawing the line with your wild feline at home.

House-train your cat.
It is possible to house-train your cat, no matter what the myths may say about cats being independent and free spirits who bow to no owner. First of all, cats can go to the toilet. You don’t have to just accept that they’re going to urinate everywhere; train them to understand the rules of the house. Think of a place that suits you; a litter box or perhaps the outside the world. Then, the next time your cat needs the toilet, take them to that place to go.

Make sure you praise your cat for doing a good job, as they’ll associate this affection with going to the toilet in the right place. Obviously, reinforcing good behavior goes for all forms of house training, such as getting them come home every time you call them from your garden or front porch. It’s all about your cat making mental associations to reinforce their good habits and diminish their bad ones.

Regular visits to the vet.
Your feline friend likely has mixed thoughts about the vet, but it’s important that you put your foot down and manage to get your cat to the vet regularly for check-ups on their health; they may like to venture off into the outdoor world to freely explore and do their own thing, but that’s all the more reason to get them checked out for infections, illnesses, and injuries. You’ll want to look out for cat worming because this is a pretty nasty intestinal parasite. Of course, even the small cuts and scratches, which are wounds your cat will pick up a lot in its outdoor excursions, are things you should check out; you don’t want a small cut to become infected and make your furry buddy sick.

Simple toys for cats

Keep them entertained.
Cats are wonderful pets when it comes to entertainment. A simple ball of string or a toy mouse can keep them happy for hours, but it is important that you give them toys. Animals are like humans; they become restless when they’re bored. A restless cat is sure to make you restless and cause a fuss around the house, so giving them forms of entertainment is a great way to ensure that they’re not going out of their mind and they’re not making you go out of your mind either. A happy household leads to a happy cat.

Over the rainbow bridge…

Euthanasia - Crossing the rainbow bridge

As the vet reaches for the cats leg to give the final injection the cat lies alone on the table. She has had trauma and is not in good way, and her parents cannot stand to see her in this way. I reach out to do nothing more than stroke her as she starts her onward journey over the rainbow bridge.

As the injection goes in I see her laboured breathing stop, she looks calm and relaxed as I stroke her and wish her a safe onward journey. The injection is in and the vet removes the needle before reaching out and stroking her as well briefly before they listen for a heartbeat. I’m sure she’s gone but it is important to check, sometimes it can be difficult to tell with all the noises that occur after death so sometimes can feel like you are listening a long time.

I’m sad this cat I knew only for a short while at what is probably the worst point in her life couldn’t be saved, yet I take comfort in the fact she now gets to run free. We gently remove her IV cannula to go to the clinical waste, clean her, and then wrap her in her blanket to go home with her parents for burial.

She is not the first, and will not be the last; however she did not go alone. Even for those few minutes she took a piece of my heart with her, and she went on her final journey across the rainbow bridge loved and cared for. This is something her parents never saw and something maybe one day they will wonder about, however they should not worry. They have the memories of her running around the house not struggling to breathe unable to lift her head.

I will never judge a parent that cannot be there at the end, it’s one of those choices that is so difficult to make. There is rarely a right answer, and sometimes there is not even any time to even think about it properly. Yet these parents may say their goodbyes when it is time to bury her, I will never know. It is a choice that can only be made by you. Sometimes after trauma we will explain to parents what to expect to see as sometimes injuries look much worse after being shaved and cleaned so that the parent can make a choice.

Personally I believe saying goodbye is important, some vet practices even have rooms just for this so we can give as much time as parents need. Sometimes in a busy practice we do not have enough of these rooms so we make do with what we have. We will explain what will happen to you, and tell you what we are doing. We’ll never try to rush you, we’ll try to keep noise outside to the minimum, and we will all feel your pain.

EDIT
If you have lost a pet and are struggling with the loss then please do call the Blue Cross Pet Bereavement Helpline – 0800 096 6606 (UK Only) – or visit their website for more information at  https://www.bluecross.org.uk/pet-loss. It is a traumatic experience, and there are people that have experienced it themselves who want to listen to you.

Sorry Chow Chow Owners, Your Pooch Just Isn’t The Best For Training

Are some dogs harder to train than others? Unsurprisingly, the answer is “yes.” Despite the fact that all dogs are descended from the same species, the breeding process has made some of them a nightmare to live with. While poodles might be relatively easy to train, chow chows and pugs certainly aren’t.

Here are some of the breeds of dog that are hard to train.

Beagles

Do you own a beagle? They can be loving dogs. Too loving perhaps. The problem with beagles is that their strong sense of affection can sometimes get the better of them. Often all their training goes out of the window, once their emotions start racing.

Source: Wikimedia Commons
Source: Wikimedia Commons

Beagles need authoritative owners. They need people who are willing to be consistent in their instruction, even if their dog might seem adorable sometimes. That mean no feeding at the table, relatively few snacks and treat, and a strict doggie timetable.

Mastiffs

Mastiffs are impressive dogs. Perhaps that’s why they always seem to feature in films. But these giants hounds are certainly a handful to keep under control around the home. There’s no doubt that Mastiffs are gentle giants. But their gentleness doesn’t mean that they’re particularly interested in training: far from it.

To really communicate with a mastiff, you need to have a firm hand. Mastiffs will respond to their owners, but their owners must put themselves in the dominant position. Submissive owners or owners who break the rules around feeding time will soon have an unruly mutt on their hands.

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If you can get mastiff training right, they can make great companions. But they need to respect you first.

Pugs

Pugs are among the strangest dog breeds out there. Owners of pugs are often approached by people who’ve never seen a pug before asking “what is it?” Even pug owners have to admit their dogs look strange.

Pugs, however, can be a problem dog, according to training specialists Royvon. It’s no so much that pugs are unruly or aggressive, it’s just that they’ve got more important things to do, it seems than obey their owners. Pugs just want to be left to their own devices to do their own thing, it seems, and that can make them particularly different to train. Unlike most dogs, they’re independent spirits.

It’s not impossible to train a pug. It just takes a combination of consistent training and confident instruction. Pugs can become bored quickly, so great discipline from the start is essential.

Afghan Hound

Afghan hounds are a beautiful breed, thanks to their fur and ears. They’re also surprisingly intelligent: almost in sheepdog territory. But unlike sheepdogs, Afghan hounds are not particularly easy to train. They have almost cat-like personalities according to some experts, meaning that they’re more interested in what they can get out of you, rather than actually doing anything you tell them to do.

Source: Wikimedia Commons
Source: Wikimedia Commons

Even if you do manage to train an Afghan hound, getting that training to stick is a big challenge. Afghan hounds have a tendency to forget the lessons they learn, which is why they need to be regularly refreshed. There’s nothing worse than an unruly dog!

Dalmatian

Dalmatians are incredibly cute: everybody agrees with that. But their cuteness has also made them cheeky and unruly. In fact, Dalmatians are extremely highly strung compared to more laid-back breeds like spaniels. Because of this, they’re almost impossible to control without vigorous, active training.

To keep a Dalmatian successfully, owners need to be constantly vigilant and engaged with their dogs. Dalmatians need regular walks in the park, perhaps twice a day. And they need a daily training ritual to let them know who the boss is. Without these, things can quickly get out of hand and Dalmatians can become disruptive in the home. Over time, a lack of owner interaction can cause them to disobey your instructions, even if they are trained.

Chow Chow

The Chow Chow likes to be the master of its own destiny. As a result, many owners find it difficult to control, especially around feeding times. To get the upper hand in your relationship with your chow chow, you need to establish a clear pecking order early on. It should be entirely clear who is the leader of the pack.

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In practice, this means being consistent. Just a small thing, like feeding your Chow Chow from the dinner table rather than out of its bowl can lead to disruptive behaviours, especially around meal time. Sometimes, Chow Chows can display aggressive behaviours. If this is the case, then you may want to consult with a specialist.