Vomit

Last week I received an early morning distress call from Pippa’s owner. Pippa had vomited four times during the night and had not slept at all - even keeping the family up in the process. The last bout of vomiting had also contained some blood. Vomiting is a very common symptom in dogs and may have many different causes. 

Pippa is a five-year-old female Pekingese, and very much a family dog that has hardly ever suffered from ailments, so everyone at home was alarmed and distressed to witness such violent vomiting.
The Pekingese is a small, long-haired, flat-faced dog and a very popular breed in Malta. This dog is an ancient Chinese toy breed, also known as the Lion Dog due to its resemblance to the lion statues found at the entrance of many Chinese imperial buildings. I have always found the Pekingese to be among the most docile of the smaller breeds, and Pippa was no exception – a really sweet-natured dog.

Vomiting is a very common symptom in dogs and may have many different causes. The fact is that dogs vomit very easily when compared to, say, cats, horses or humans. This is possibly due to their ancestral ‘pack’ origins and instinctive competition to eat – a sort of philosophy of ‘eat now, think later’. So vomiting in dogs should be considered as a form of defence of the stomach against anything that it considers undesirable.

The rule of thumb on a normal healthy dog is that any vomiting which is less frequent than once a week could be ignored. Any vomiting that occurs more frequently than that should tell you that something is not quite right with your dog.  In addition, when a dog vomits, even on an empty stomach, precious nutrients are being lost together with liquids and electrolytes, and a relatively healthy dog can quickly deteriorate. Pippa had, in fact, vomited four times in one night, so her owners had good reason to be worried.

In cases of repeated vomiting, first of all it is important to make sure that there is no general illness which may be causing this. In particular, the most important of these are possible kidney and/or liver conditions. Irritations of the stomach lining due to dogs’ instinctive propensity to ‘eat now, think later’ is a common problem. So dogs are capable of eating anything and everything they might regard as food – including bones.

Dogs also occasionally ingest foreign bodies, such as pieces of toys or small stones. While stones can be very easy to diagnose because they are very visible on X-ray, other foreign objects can be difficult – as in the case of peach stones, which are hardly visible on X-ray owing to their organic woody composition.

If objects such as peach stones are ingested and are small enough to travel down the intestine, this results in intermittent bouts of vomiting, which is generally beneficial for the dog, but terrible for rapid diagnosis.

Perhaps the one that tops my list with regard to difficult diagnoses was an internal hernia which was only resolved during exploratory surgery when we found that the dog’s intestines had become entangled through a tear in an adjacent intestine.

A simple symptom such as vomiting could have a straightforward cause, but it could also have a complicated source. In such cases, if unresolved, it very often becomes a race against time to save the dog.

There are a number of other conditions which could cause repeated vomiting. Megaesophagus is a congenital defect where the pipe taking food down from the mouth to the stomach is wider than it should be. This means that the food ingested by the dog never makes it to the stomach and in most cases is regurgitated soon after being swallowed. There are also a number of abdominal tumours that can cause vomiting and an ultrasound examination will reveal such tumours.

Perhaps it’s worth mentioning that you should always be vigilant about items that your dog could possibly ingest – be it edible or not. Apart from upholding good feeding principles, you should also avoid allowing small-sized toys, particularly if you know your dog has a habit of carrying things in its mouth.

What is important if and when vomiting does occur, is to gather and observe as much information as possible for your vet, who will ask you for all related information: how many times? How long has it been going on? What came up? Was it related to drinking or eating or both? How soon after ingesting does it happen? Are stools being passed in the meantime? What are they like and when was the last incident?

All this information will help your vet assess how serious the condition may be and will avoid losing valuable time if a serious situation does exist. Pippa’s blood tests turned out just fine. She had been given a doggy treat she enjoyed tremendously just a couple of days before, so diagnosis was quite straightforward. Pippa’s owner called the next day to let me know that all vomiting had stopped and that Pippa was getting back to normal and showing the first signs of a return to interest in food.

Dr. Martin Debattista
Veterinary Surgeon

thisweekwiththevet@gmail.com

Grass seeds

Grass seeds

This week Hank came back to the clinic for a follow-up.  I had seen Hank four days previously with a very inflamed red eye which was causing him no small discomfort.

Hank is a two-year old neutered red and white male Brittany Spaniel with a typical medium-length coat.  The Brittany has been bred as a gun dog, primarily to hunt birds, but has also become popular in the last couple of years as a family pet.

I had only managed to examine the eye after having sedated Hank due to all the pain and discomfort.  Only after having cleaned the eye could I see the tail end of a grass seed which had perforated the inner mucosa of the lower eyelid which was gently removed.

I was glad that I decided to sedate Hank to get a closer look. Hank’s owner glad that he decided to finally visit the vet after a whole two days of Hank not getting better, and most of all Hank was allot happier when he woke up.

Walking out in the Maltese countryside in spring and summer when the grass has already dried out can give dogs plenty of enjoyment, but it can also cause problems that you should be aware of.  At this time of year, grasses and weeds are dropping their seeds and the most problematic of these seeds are the spike-like arrows and round burrs.  These seeds have been designed to attach themselves to passing traffic in an attempt to disperse and reseed.

The spiky arrows have fibers that resemble Velco and cling to clothes and dog coats.  They tenaciously migrate in only one direction and will therefore even burrow into skin.  The outcome can be nasty and sometimes difficult to treat.  The round burrs are huge problem for owners of dogs with long floppy ears and spaniels top the list in this respect.  Apart from matting fur, these burrs can get lodged in the ears and cause severe swelling and pain.  So, at this time of year, you need to keep an eye out for changes in canine behaviour relating to the ears, nose, eyes, mouth, and paws. 

If your dog is:

·       shaking it head, favoring one side of its head, or scratching its ear, it is possible that a grass seed has become lodged in the ear canal.  The ear is a very delicate instrument and your dog will suffer if it not treated quickly.

·       sneezing violently, possibly with blood, or pawing at its nose, then a grass seed could have got caught up in the nasal canal. 

·       exhibiting signs of weeping or discharge from the eye and the eye is red and inflamed.  A grass seed could be embedded in the soft tissue beneath the upper or lower eyelid.  If not attended to, your dog could go blind.

·        limping, then the first thing to check for is a grass seed.  Seeds that get caught in between dogs’ toes can penetrate the skin .

·       showing a skin swelling in any part of the body could also be caused by penetrating grass seeds. These need to be treated accordingly depending on  location and duration

 

You should make every effort to check your dog at this time of year, but you should attempt to gently remove grass seeds only if you can still see it protruding from its entry point – you might still need to see your Vet to make sure that the full seed has been extracted.   Additional preventive measures that you can take after walking your dog include brushing and combing your dog’s coat after every walk, avoiding areas with long drying grass, and keeping your dog’s coat trimmed if they are medium to long-haired.

Hank’s problem was identified and treated.  His owners tell me that he still enjoys running through the grass, but this time they are careful to check him over after each walk.

Dr Martin Debattista

Veterinary Surgeon

thisweekwiththevet@gmail.com

 

Grieving the loss of your pet

 

This week I realised that I will never get used to the idea. I have had to euthanise many pets over the years and it never gets easy. True enough, even this time round I found myself saying: “Let’s do this fast because it’s difficult even for me.”  

Mindy was first brought to the clinic 12 years ago as a tiny puppy in a wicker basket. She very quickly outgrew her basket and matured into a gentle, champagne-coloured, female labrador.
Mindy was loved from the day she was welcomed into her family. I could see this from the way she sought her owners’ approval whenever she was being treated and that this love and respect was reciprocated.

The love Mindy’s owners had for her was amply demonstrated in later years when Mindy developed a persistent and terrible skin condition caused by a complicated and uncommon hormonal imbalance.  Until her condition was completely diagnosed, Mindy benefitted from her owners’ unswerving faith in finding a cure and their complete dedication in continuing with her lifelong treatment.  Despite these difficulties, Mindy was able to live a normal life until very recently, when insurmountable complications developed and the only option left was to humanely put her down.

It is perfectly natural to feel devastated when a pet dies. Dogs and cats usually become such a part of the family that their loss is equal to that of losing a member of your own family. People who have never had pets are likely to find it difficult to understand the grief you feel for the loss of your dog or cat, but this is a perfectly normal sentiment and you should allow yourself time to grieve your loss, just as you would for a member of your own family.

We all cope with grief in different ways and we all need our own time to recover. However, if you have other pets, it is important that you give them plenty of attention since they will similarly be feeling the loss of your pet. Keep up with their usual feeding and exercise routines. Playing with them will help both them and yourself to cope with the loss.

In most cases, you should not rush to get a replacement dog or cat; you will instinctively know when the time is right, and only then will you be emotionally ready to fill the void left by your recent loss.
However, retired seniors who have lost a companion pet are likely to benefit from getting another pet sooner rather than later.  But do not try to replicate the dog or cat you have just lost.  Just as we all have our own personalities, so do dogs and cats. You can obtain advice from your veterinarian as to the typical characteristics to expect from different breeds.

Dr. Martin Debattista
Veterinary Surgeon

thisweekwiththevet@gmail.com

Cats: ringworm

Last week Scabby’s owner came in. I usually remember pets’ owners depending on how difficult or severe the case was.  Scabby had the most severe case of ringworm I had seen in a tiny kitten, and an owner with a heart of gold, wishing to do all that was necessary. And she did. 

It was wonderful to see Scabby’s owner coming in last week to neuter some strays which she also feeds.  She told me that Scabby had turned into the most loving of house cats and she was really grateful.

Ringworm is not a worm; it is a fungal disease of the skin.  The name ringworm is derived from the fact that quite often it spreads in a circular fashion, and as it spreads the centre heals and leaves the shape of a ring.  Ringworm is very common in stray kittens, possibly due to the fact that they live in damp conditions and would not have developed any immunity when they are young.

Ringworm is contracted by direct contact, even by humans, so it is very important to avoid touching strays unnecessarily and to always wash hands afterwards.  But Scabby was bad. Not only was most of her body affected, her case was complicated by having a superimposed skin infection and most of her nails were deeply involved. Poor Scabby, I recalled, was just about the size of my palm when I first met her.

Good deeds never get the amount of publicity as bad deeds.  So often, especially during Sunday emergency clinic, we see people coming in to save a stray kitten they have found, not to mention the many people who take care of the countless colonies of cats around the island, and the volunteers working in dog sanctuaries.

There is really far more kindness towards animals in Malta than we give credit for.

Dr Martin Debattista
thisweekwiththevet@gmail.com

 Bathing your Dog

This week Sherry couldn’t sit still.  Where Sherry normally sat quietly on the examination table, here she was, frantically scratching, licking and nipping whatever she could get at. Her owner wearily told me she was even keeping them awake at night.

Sherry is a 12-year-old, amber-coloured Golden Retriever. This breed was originally developed as a gundog, but Sherry is now in her twilight years and prefers to take it easy in the garden, sunbathing in the winter sun on a warm patch of soil.  Skin allergies are common with Golden Retrievers, but Sherry had long been placed on a diet designed to minimise such problems.  Nevertheless, Sherry’s skin was dry and flaky, and patches of exposed skin had become raw with scratching.

 

A sandfly test was taken, and a skin scraping was examined under the microscope for mites. Both these tests proved negative. Something else was bothering Sherry. Having also discounted a possible flea allergy, I asked Sherry’s owner about her dry skin condition. How long had it been since she was bathed?

 

In over 30 years of veterinary practice, I have dispensed a considerable amount of advice. Yet I find myself repeatedly returning to a fundamental topic that is rife with myth. Sherry had not been bathed for over six months because her owner was told by well-meaning people that washing dogs too often is harmful to the wellbeing of their skin and coat.  With such a myth perpetuated, countless dog owners choose to live with smelly dogs. And when dogs’ skin condition dries out too much, they inevitably exhibit considerable discomfort, just like Sherry.

I often liken the skin of a dog to that of a tree which needs to be watered frequently in the summer months and less often in winter – about once or twice a week in July and August and down to once every three weeks during the coldest of winter months.

As with humans, a quick shower has a drying effect on a dog’s skin, while a long bath has a hydrating effect, so baths are preferable.  But do not use your own shampoo. The PH of your dog’s skin is different to yours and your shampoo will only dry out and irritate its skin. The formulations of dog shampoos nowadays has become as sophisticated as ours and conditioning agents have been added to the basic detergent to make sure that both dogs’ skin and coat are cleaned and conditioned without stripping them of their natural oils.

Please do not use flea and tick shampoos unless your veterinarian has actually prescribed it for your dog. This is another misconception. A flea and tick shampoo will only remove fleas or ticks that are actually on your dog at the time of bathing. But it will not provide long-lasting protection.  There are a number of good shampoo products available. Ask your vet for advice on which best to use, since this choice could actually depend on the size of dog, type of coat and the place where your dog lives or sleeps.

Leave the option of using medicated or treatment shampoos in the hands of your veterinarian as and when needed.  Throughout, you need to be observant. Just as not all shampoos agree with us, so it is with your dog.  Bathing should never make your dog’s skin condition worse. If you notice any reaction – redness, flakiness or increased itching after bathing, don’t give up on bathing your dog – just seek the advice of your vet.

Sherry’s days of sunning herself in the sun while lying on soil in the garden had a cumulative effect on drying out her skin. And as with humans, her age also meant that her skin produced less naturally hydrating oils. A good long soak, and plenty of them, will see Sherry continuing to enjoy her retirement.

Dr. Martin Debattista
Veterinary Surgeon

thisweekwiththevet@gmail.com

Timely action against Sandfly

This week, it was great to see Thor again.  Thor is a Springer Spaniel, full of fun and mischief. The word 'Spaniel' comes from Spain or Hispania, due to the fact that this breed originated in this country.

There are now about 20 different breeds of spaniels, with the most well-known in Malta being the Cocker Spaniel, American Cocker, King Charles Cavalier, Brittany Spaniel, Papillion, and the Springer Spaniel which is very popular in Malta. They make good hunters, family pets and are often used by police and customs officers as sniffer dogs.

True to nature, Thor was an energetic dog. And yet, I only recently got to know the real Thor, since he was a pitiable sight when he first came in three months ago since Thor was one of the worst-affected cases of sandfly I saw last autumn.

I have already written about sandfly but this is the right time of year to remind dog owners about its importance and insidiousness. Sadly, too many dog owners already know quite a bit about this disease – either due to experience or, hopefully, because they are now well-informed and take precautions to prevent it attacking their dogs.

The sandfly disease, or as it is medically referred to 'Leishmaniasis', is contracted in the warmer months from infected sandflies. Leishmaniasis is a one-celled blood parasite which mainly infects the blood, bone marrow and other organs.

Symptoms of Leishmaniasis may vary from dog to dog, depending mostly on the type of resistance (or immunity) stimulated by this parasite. Early signs to look out for and which are usually common in all cases are loss of weight and energy.  Besides these primary symptoms, Thor was also suffering from one of the more common signs, which includes a very dry, scaly skin with swelling of the paws and bleeding ear tips. 

Since Leishmaniasis is contracted during summer and takes a few months for the disease to develop, veterinarians typically see clinical cases in the autumn and winter. January and February are the months during which it would be ideal to have your dog checked for Leishmaniasis.  Apart from clinical examinations, your veterinarian will carry out a test which gives results within a few minutes. This test has now been available for a number of years.

January and February are also when you should discuss with your vet the need to protect your dog from Leishmaniasis for the coming summer months.  This is best done as part of the flea, tick and sandfly protection programme. If you are not aware of this programme, ask your veterinarian about preventive treatment for your dog.

We are living in exciting times. Treatment for Leishmaniasis has seen some developments in recent years. There was a time when there was very little choice for this disease. Now, there are products that are far safer to administer when inner organs have been compromised by the disease.  The original preventive methods are still important, since these address the measures you need to take to reduce and prevent sandfly bites by not letting dogs sleep outdoors from dusk until dawn during the warmer months, and by using veterinary-registered products containing pyrethroids, or derivatives in the form of collars or drops, as well as citronella-based products and UV lights in dogs’ sleeping quarters.

In addition to these preventive methods, last year a new vaccine became available which gives your pet a high percentage of protection. Interestingly, the vaccine is essentially a purified protein derived from the culprit parasite. Again, now would be the time to discuss this with your veterinarian to give it enough time to kick in, well before the infective months.

In the fastest turnaround we’ve seen in the battle against Leishmaniasis, this year another product has become available, which increases the natural resistance of the dog in the most beneficial form.  Leishmaniasis is still a very important disease every dog owner should be aware of. With the help of your vet, this would be a good time to discuss a specific protection programme according to the dog’s breed, location and lifestyle.

There was a time when Leishmaniasis was truly a dreaded disease, largely because it was so widespread and also because there were limited protective measures. So it was great to see Thor again, full of boundless energy.

Dr. Martin Debattista
Veterinary Surgeon

thisweekwiththevet@gmail.com

Elderly and their pets

This week Lucy came in for her check-up. She was brought in by an elderly couple I have known for many years through what seems like a lifetime of pets. Because they are elderly and lived alone, Lucy has become the centre of their world.

Whenever elderly clients bring in their pets, the biggest concern for me is knowing how extremely important and beneficial pets can be to the health of elderly people.  In Canada, dogs were at one time banned from residential homes. This ruling had to be overturned due to the negative effect this was found to have on the well-being of the residents.

A similar case happened in Australia, where it was found that allowing cats in residential homes had a huge beneficial effect on elderly people. In the UK, I have actually met dog owners who voluntarily visit residential care homes, accompanied by their dogs that have been vetted and approved for voluntary work. And here I was once again facing a situation where elderly clients had come to the clinic worried sick about their beloved pet.

Lucy is an 11-year-old slightly overweight white female poodle. She had been limping on her left hind leg ever since she fell off the sofa the week before. My initial suspicion as to the probable cause was confirmed upon examination: Lucy had a rupture of the anterior cruciate ligament in the left knee joint.

The knee joint is one of the largest joints in the body and greatly de­pends on its ligaments for stability. There is no ball-and-socket con­figuration, as you get in the pelvis or the shoulder. Instead, all you have are two flattish bone surfaces of the femour and tibia which are largely held together by two ligaments in the centre of this interface.

These ligaments cross over each other just like the letter X. Hence, the description 'cruciate' which means ‘cross-shaped’ and comes from the Latin term cruciatus.  Overweight dogs have a ten­dency to rupture the anterior of the cruciate ligaments. This destabi­lises the joint due to the fact that the dogs’ weight is too much for their knees to cope with, especially when making certain movements, as happened with Lucy.

The same injury can, however, happen in fitter dogs during exu­berant activities such as chasing rabbits. This actually happen­ed to another patient of mine.  There are many other ailments that may cause a dog to limp on its hind legs, and X-rays may be necessary to exclude other possible ailments and to ascer­tain the development of arthritis in the knee joint.

Diagnosis of anterior cruciate ligament rupture is based on the evidence of what is known as the ‘drawer movement’ of the joint while the dog is heavily sedated. When the stability of the joint has been compromised due to the rupture of the cruciate, the two bones – namely the femur above and the tibia below – can be manually made to slip across each other in a drawer movement.

This movement and lack of stability is the reason why the dog limps and also why, if left untreated, it can give rise to secondary permanent arthritis in the joint. Lucy was lucky because her owners chose to bring her in very soon after the injury, thus preventing secondary arthritis.  Because of the elevated degree of ‘drawer movement’ and the lack of secondary arthritis, surgery was the treatment of choice. My clients were willing to have Lucy operated and within a few days the operation was carried out.

There are many different tech­niques for cruciate ligament re­pair, which may vary according to surgeons’ discretion as well as the size of the dog, but all are aimed at restructuring and rein­forcing the ligaments to re-establish the stability of the knee joint. Any orthopaedic surgery carries its own risk of compli­cations, so I was glad to see Lucy’s owners walk in one month after her operation with a big smile on their faces.

Lucy was certainly walking much better and I hope this improvement continues over the coming months.

Dr. Martin Debattista
Veterinary Surgeon

thisweekwiththevet@gmail.com