A–Z Common Conditions in Cats and Dogs – Easy Reference with Treatment Options
In the previous chapters, Elizabeth and I explained how we can all provide holistic care to our pets. It would be wonderful if both we and our pets could be healthy always – by eating the right food and following a holistic, stress-free lifestyle. Unfortunately, though, because of a number of reasons and predisposing factors, illness does occur.
Conventional medicine teaches us that disease is primarily caused by pathogens such as bacteria, fungi, viruses and other microorganisms. We all know that these can only cause disease if the conditions for them to thrive are conducive. Over the years, we have identified many new diseases – some are caused by our genes, others by lifestyle, or the wrong diet or eating too much; some are caused by germs, by environmental pollutants and toxins, or by genetically modified foods and additives. And there are still many diseases for which the cause remains a mystery.
As a holistic integrative veterinarian I also believe that emotions (both our own and those of our pets) are an important cause of ill health. My job is difficult because many a time I have had to treat animals, or at least alleviate their symptoms, even if the actual cause is unknown. In my experience complete cures can be achieved, but only if the root cause of the disease is identified and eliminated. Correct diagnosis is therefore very important, and a systematic approach to disease is key to successful outcomes.
Obtaining a thorough history from the pet guardian is priceless for enabling a correct diagnosis. My humble request to pet guardians worldwide is that they should be honest with their vet and mindful of their pet. It is vital to look out for any abnormal behaviour in your pet and contact your vet quickly if you are in doubt. An incorrect history can waste valuable time, as we will all end up barking up the wrong tree. Just your honest version of events can help immensely in ensuring a correct diagnosis and the right treatment.
HOW TO USE THE A–Z
In this chapter, I have listed the most common conditions or diseases that I see in cats and dogs. Each condition is described briefly and followed by a summary of the probable cause, the key clinical signs, the conventional methods of diagnosis and then both the conventional and holistic treatment options available, including special home-made diets, healing, herbs and acupressure where applicable.
As a vet I regard your support in treatment as crucial, which is why under each condition there is information under the heading ‘you’ which describes your role. I sincerely hope you will find this helpful and follow it when the need arises. Remember: only a qualified vet can make a diagnosis, but you can help them arrive at it quickly by recognizing an emergency, taking your pet to the clinic in time, providing the right information, complying with the medication regime, keeping follow-up or revisit appointments and feeding the right diet.
The list of conditions is lengthy, but you need not read it in one sitting. It is designed as a quick, user-friendly reference section that you can consult when your pet shows any of the symptoms listed. Please note that the same symptoms may be present in different conditions, so always check with your vet if you are confused. The aim here is to educate you so you can make an informed decision and be there for your pets when they need you most. Remember: your pet depends on you. So let us get started.
An abscess is a localized collection of pus that has built up within the tissue of the body and is usually contained within a cavity.
In both dogs and cats the single most common cause of an abscess is a bite from another animal. Dogs are often seen fighting with each other and if the skin is punctured and heals quickly an abscess may follow in 2–3 days. Cats are seldom observed fighting – the awful noises that accompany most cat fights may be the only clue.
The teeth of cats and dogs resemble sharp little needles and can inflict deep punctures in the skin and underlying muscles. These small wounds heal quickly but damage may have been done because the teeth carry infection (bacteria), which is injected into the tissue at the time of the bite and forms an abscess 2–3 days later. Other organs that can develop abscesses are the tooth roots, the prostate gland in male dogs, the anal glands, the eye, the pancreas and the liver, but these are less obvious and can only be diagnosed by a veterinarian.
In dogs, a swelling or lump, at the place where he or she was bitten, is the classic symptom that an abscess may be forming. In cats it is not that obvious. Cat bites are commonly seen on the tail, the top of the head or on any of the limbs, or sometimes on the side or the back. So any sudden onset of lameness, swelling on the head, hissing when stroked, tail held low or just not eating after being out the night before may be symptoms that warrant a trip to your veterinarian.
Pus oozing from a swelling on the skin is a clear indication of an abscess and can be easily diagnosed by a watchful pet owner. However, as mentioned above, in cats especially, a thorough physical examination by the vet or the owner is needed to identify an abscess on the skin, because the abscess is well hidden in the fur or long hair.
Pain and vocalizing when the pet is touched or stroked can also reveal the site of an abscess. Abscesses inside the body are trickier. Fever, if the abscess has not ruptured, and sepsis if the abscess ruptures internally will alert your vet to the possibility. They may then perform appropriate blood tests and/or an ultrasound examination, depending on the organ involved.
Most vets tend to prescribe a 7–14 day course of antibiotics for a bite wound, along with a course of painkillers or anti-inflammatory drugs. If the abscess is very large, extensive, or your pet is too fractious or aggressive, then the vet will have to anaesthetize/sedate them and surgically lance and drain the abscess, flush out the pus and then place drains for continuous drainage. Some medium-to-large bite wounds may need to be sutured or stitched up.
Your vet will also advise you to clean the abscess at home with an antiseptic, usually dilute chlorhexidine. Further infection can be prevented by keeping the wound clean, and preferably keeping the pet indoors till the wound has closed over. You can complement this with healing and herbs, as detailed below.
Unfortunately, the most common accident seen nowadays in small animal veterinary practice, in both dogs and cats, is the RTA (road traffic accident). RTAs are emergencies and it is extremely important that your pet is rushed to the vet as quickly as possible.
Cats seem to be involved in RTAs more than dogs, especially at night. The headlight glare from fast-moving vehicles seems to make them freeze on the spot and they tend to get hit mainly while crossing the road. Most cats tend to have poor road sense. Puppies and young, excitable dogs tend to get hit when they run out of their homes and straight across the road in front of oncoming traffic. Male dogs that have not been neutered are also more likely to be hit when they chase after bitches in heat.
If your cat has been out all night, do check that it has returned for breakfast. A cat walking slowly, limping or dragging itself into the house, or breathing rapidly after a night out, should be taken straight to the vet. RTAs involving dogs are usually witnessed by their owners, or the driver who hits the animal.
It is very important that an accurate history of the cat’s whereabouts is provided to the vet, as this is crucial for an accurate diagnosis. In cats scuffed nails will alert the vet to the possibility that the animal may have been involved in a RTA.
A complete and thorough clinical examination will be carried out by the vet, in order to identify which organs or body systems have been affected by the accident. Pelvic fractures, mandibular fractures, bladder rupture, fractured limbs, diaphragmatic hernias, kidney damage and head injuries are common post-RTA. Based on the injuries it might be necessary to take radiographs, MRIs and blood tests to check their extent.
Emergency treatment to stabilize the shocked animal is the first priority. Treatment will involve immediate pain relief, starting an intravenous drip to combat fluid loss, blood transfusions, and antibiotic treatment if there are open wounds. In some cases immediate surgery may be necessary if there is a ruptured bladder or a complicated diaphragmatic hernia.
If there are fractures, these will be confirmed by X-rays and then, depending on the urgency, type of fracture and the vet’s expertise, they will be repaired immediately or at a later date. Treatment of RTAs can be expensive and prolonged. Some animals involved in serious RTAs who suffer multiple severe injures will carry a poor prognosis and the vet may advise euthanasia.
Take your pet to your vet as soon as possible following an RTA, because almost every accident could be an emergency. I understand that this can be an incredibly stressful time for you and your pet, but you need to be calm and collected. I recommend using the relaxation technique outlined by Elizabeth in How to Give Healing to Your Pet. You can practise this on your way to your vet and you will find that it prevents both you and your pet from panicking. After the visit, and once your pet has been stabilized, you can carry on using complementary care to hasten the healing process as advised below.
The joy of owning a pet is replaced by fear and worry when the pet in question, be it a cat or a dog, is aggressive. While cat aggression is usually a problem to the guardian or to the veterinary fraternity, dog aggression has huge social implications, especially in the current climate. Needless to say, 70 per cent of dogs that present to veterinary behaviourists have a diagnosis of aggression.
Aggression is also one of the top reasons for the euthanasia of healthy dogs. The societal effects of aggression are also quite significant. There are implications for both the human–animal bond and also on public safety. The majority of the dogs, and frequently cats, given up to rescue centres and shelters are reported to have some type of aggression-related problem.
I have decided to address this topic in as much detail as the scope of this book will permit, because I believe that this is one area where you, the guardian, can really make a huge difference to the outcome.
Common causes of aggression in dogs
It is not always possible to wholly understand the reason for aggressive behaviour in a dog. Knowledge of when the behaviour started can help in identifying the motivation for it, but this is not always possible, especially if you got the dog when it was already an adult. It is therefore important to ascertain not only when the problem behaviour first became a concern, but also when the dog first displayed this behaviour – be it fear or aggression. This is not only important to plan the treatment but also to give a prognosis.
Owners and other humans can play a very key role in an aggressive dog’s behaviour, for better or worse. Harsh training techniques, abuse, miscommunication between human handler and dog, and inconsistent reward and punishment can all confuse a dog big-time. It is difficult for a dog to differentiate between a thief, a window cleaner or a postman, so if you want your dog to guard your property, then it is more likely that he or she will become aggressive.
An important biological relationship seems to exist between aggressive behaviour and serotonin levels in the brain. A study looking at the serum levels of this neurotransmitter found that aggressive dogs had lower serotonin levels compared to non-aggressive ones (Cakiroglu et al, 2007). See Chapter 1: Food Is Medicine, for advice.
Kennel-raised pups tend to show aggressive behaviour towards unfamiliar people, especially vets!
Risk factors for aggression
There are several identified and well-documented risk factors for canine aggression, both dog-related and human-related.
Certain dog breeds, among them Rottweiler, Chow Chow and German Shepherd Dog, rank higher for territorial aggression as they were historically bred for this behaviour. However, caution should be exercised, as there are large variations between individuals within breeds – your pet need not be aggressive just because of its breed.
Male dogs tend to be over-represented, compared to bitches. This is where castration is usually recommended. It may not get rid of the aggression entirely but it will decrease it. Also, research has shown that there is no correlation between age at castration and the outcome of decreased aggression post-castration.
The dog’s housing, training and management have a definite effect on its behaviour towards unfamiliar people. It has been proven that poor socialization of puppies between 3–14 weeks of age can make them more aggressive or fearful. Similarly, fatal attacks on humans have been documented as those in which dogs were left unrestrained on the owner’s property. Pit Bull Terriers, Rottweilers and German Shepherd Dogs, in that order, have been most commonly involved in such attacks, which suggests a breed predisposition.
Common signs of canine aggression
Most people can easily identify aggressive behaviour in dogs. The following are classic signs, although not all dogs will show all of them.
Growling at you or a stranger.
Standing in the doorway like an obstruction and daring you to get past.
Rough play with you and other members of the family that gets out of hand easily and turns into an angry battle.
Territorial aggression – which is displayed by chasing people or other animals out of the garden or house, barking incessantly when strangers or other animals approach your home and, worst-case scenario, attacking and/or biting people or other animals.
Your vet should be the first port of call. It is important that a veterinarian examines your dog and rules out obvious and not so obvious medical conditions that may cause him or her to be aggressive. Painful orthopaedic conditions, gastrointestinal disorders, sensory deficits and neurological abnormalities can all predispose a dog to display aggression. Sometimes, blood tests may also be required to eliminate metabolic causes.
The vet will then usually refer your pet to either a vet colleague who specializes in behaviour, a behaviourist, or a trainer, who can then start the process of diagnosis. It is important to have an accurate diagnosis so that an appropriate prognosis and treatment plan can be formulated. If a primary diagnosis cannot be made then you should at least have a list of differential diagnoses to work with.
NB: Be very careful when deciding on a dog trainer, as some of them can make matters worse. Not all behaviourists are the same and not all their techniques will be suitable for your pet. So please shop around!
The vet or the behaviourist who is dealing with a case of aggression needs to make a risk assessment. Not only does this evaluation deal with the dog in question, but it also has to determine what risks are present when considering other dogs and people who might be affected by this dog’s behaviour. Physical injury to this dog and others (dogs and people), emotional injury and potential liability must all be evaluated. Once this is done, treatment can be initiated.
No assurance can be given that aggression will be ‘cured’, since this is a normal part of the behavioural repertoire of a dog. Treatment only focuses on managing the dog and changing the underlying motivation sufficiently. Hopefully there will be a significant reduction in the frequency and intensity of the aggressive behaviour, and the associated risk will be substantially minimized to an acceptable level.
Your vet and you
One or a combination of the following strategies may be advised by your vet, behaviourist or dog trainer, but only your compliance and strict adherence to their advice can bring about a reasonable change in your dog’s behaviour. It is vital that you remain centred, stable, calm, present and relaxed. This is the foundation for the preparation work that will enable your dog to understand what you wish to change.
Avoidance – simply avoiding the situation that triggers the aggression is one of the most commonly used methods. Confining your dog is part of this, but it may not always work for you and your pet. Blocking your dog’s view can be useful too, especially in dogs that watch out for animals trespassing on what they deem to be their territory. Use your own body to block the line of vision between your dog and the other animal.
Reinforcement and reassurance – this involves keeping the dog on a proper lead when outside. You may also have to be trained to change the way you interact with your dog.
Use of control and restraint aids – head collars, muzzles that allow your dog to pant, drink and safely vomit may need to be used. Halties also fall in this category and can be extremely effective.
Desensitizing and counter-conditioning – these strategies are the main techniques used to change your dog’s response to strangers. The main goal here is to replace unwanted behaviour with positive behaviour – for example, from being aggressive to being calm and focused. I have found them very successful.
Pheromone therapy – Dog Appeasing Pheromone (DAP) is supposed to be beneficial in decreasing anxiety, and consequently aggression. It is available as a slow-release collar, a plug-in electric diffuser for use within the house, and as a spray to use on bandanas, furniture, etc. Pheromone therapy is potentially safe, but its efficacy in reducing aggression is yet to be proven and I have not had great feedback about it from pet owners.
Medication – I strongly believe that this should never be the first line of treatment. In my experience, most guardians tend to rely on medication rather heavily and do not take the behaviour-modification training programmes advised seriously enough. Also there is the problem of disinhibition – as the drugs alleviate anxiety, your dog may actually show more aggression as he or she starts feeling less fear.
Then there is the usual problem of drug side effects. These can range from anorexia to anxiety, hallucinations and many others, depending on the drug used. The most commonly used medications for aggression are SSRIs like Prozac, tricyclic antidepressants like amitriptyline and clomipramine, and finally benzodiazepines like alprozolam and diazepam, which may reduce anxiety. It usually takes at least four to six weeks before their full effects are seen.
Surgery – castration of male dogs is the main procedure recommended. There is evidence that a 50 per cent reduction is seen in dogs exhibiting territorial aggression. It is not a cure-all, but it may help to show that the owner is proactive. Some behaviourists now advise that dogs who exhibit nervous aggression, as compared to those that are dominant aggressive, should not be castrated, as they need their testosterone confidence to deal with stressful situations.
Acupressure – energy imbalances can contribute to aggression, so alongside training and behaviour modification, I recommend stimulating acupressure points L 14 and LIV 2. L 14 is an acupoint that is located on the front paw, where the thumb and the index finger meet. LIV 2 is located in a dip on the rear leg, toe 2 on the inside at the 2nd joint.
Just stroking these points for half a minute once a day can be beneficial. Warning: some pets hate their feet being touched so please start off by just touching the feet before proceeding to acupressure. See Chapter 6: Fingers and Thumbs for instructions.
Exercise – tiring your dog out by increasing the amount of exercise it has can be effective. Play therapy is also good for distracting a dog from showing negative aggressive behaviour, as the mood changes straight away.
Diet – feeding an aggressive dog natural, chemical-free foods can really help. I recommend that you read Chapter 1: Food Is Medicine, and cook Elizabeth’s wholesome recipes (see Chapter 2). It has been documented that commercial pet foods may contain chemical preservatives such as ethoxyquin, which can make dogs irritable and cranky.
Healing & herbs
Animal healing is a fantastic complement to veterinary care and can be safely given by you to your pet. Read Chapter 5: How to Give Healing to Your Pet, for instructions. Hands-on healing can be given by you to your own dog or by an experienced animal healer after the dog has accepted him or her. Elizabeth strongly advises that distant healing is best for dangerous dogs that are people-aggressive; see Chapter 5.
Canine aggression is a very common problem but one that can be prevented in most cases. Prevention is always much better than cure. Proper selection of the right dog for the particular family or person is therefore very important. Vets should discuss prevention and identify early signs of aggression to stop it escalating into a major public health risk.
I believe that with an integrated approach that combines humane behaviour-modification techniques, Elizabeth’s relaxation techniques to help you build trust, and feeding the right diet, it should be possible in most cases to improve the dog’s behaviour and reduce the aggression significantly.
Aggression in cats
Top behaviourists consider feline aggression to be an outward manifestation of the internal emotional state of the cat. They believe that cats may direct aggression towards people due to fear, anxiety, frustration (seen in rescued cats who may have been outdoor cats but are now stuck indoors) or even misdirection of their predatory instincts. Lactating and nursing queens may be more aggressive in order to defend their kittens.
Similarly, fearful cats learn that their aggression helps keep people away, so they may start becoming more pre-emptively aggressive. Kittens that were not handled properly between the ages of two and seven weeks may become reclusive and show defensive aggression. Some feline aggression can be a result of inappropriate play behaviour, but inter-cat aggression is usually due to competition for food/water/mating, or even just space.
Cats tend to hiss, hide, make low-throated growls or high-pitched vocalizations when they are angry. Your cat may try to attack your feet suddenly when you are walking past. Some cats will suddenly grab the owner’s hand and bite or scratch aggressively without letting go. Inter-cat aggression is characterized by fighting and chasing, or just staring from a distance for hours. If cornered, cats may actually launch themselves at the perceived threat and bite. Aggressive cats tend to be reclusive and may not like petting or stroking.
If your cat is aggressive he or she will be confirmed as being aggressive towards people and/or aggressive towards other cats and animals by your vet, or by a behaviourist if your pet is referred to one. They will then carry out a risk assessment and formulate a treatment plan.
Your vet and you
Cat attacks and bites can cause serious injury, so no matter how much you love your cat you must try and avoid situations that may cause your pet to turn on you. As a behavioural first aid, your vet may advise you to separate an aggressive cat from you or other cats, depending on who is the usual target for its attacks. If your cat attacks neighbouring cats, you will have to keep your cat indoors, at least temporarily.
It is absolutely crucial to provide an aggressive cat with coping strategies in the form of high or low hiding places, cat flaps to escape, playing stations, scratching posts, etc. I tend to focus on behaviour-modification techniques initially, but in extreme cases, especially if it has become obvious that the aggression stems from anxiety, I have prescribed certain calming medications.
Pheromone therapy with Feline Facial Pheromone (FFP) has been found to be effective in relaxing and relieving anxiety caused by social tension among cats. These come in the form of plug-ins or sprays. You can also try herb-infused toys, as described below, in order to encourage natural play and predatory behaviour, as this can also be beneficial. I strongly recommend that you read the section on mental and emotional wellbeing for cats in Chapter 1: Food Is Medicine.
An allergy is a damaging immune response by the body to a substance, especially a particular food, pollen, fur or dust, to which it has become hypersensitive.
Flea allergic dermatitis is one of the most common allergies seen in veterinary practice. In most pets, grass, food, cleaning products, washing powder used to clean bedding, dust mites, pollen, mould and insect bites/stings can trigger an allergic reaction. Over-vaccinating has also been known to trigger allergies so it is worth discussing this if your pet’s symptoms appear to be related to their boosters.
Pyotraumatic dermatitis, commonly known as wet eczema or hot spot, may be caused by self-trauma, licking and scratching that is a response to an allergy or even clipper rash from a dog groomer’s clipper. It is more frequent in hot and humid weather.
These will depend on the allergen and can range from itchy skin, biting or licking the feet or skin, rubbing the face on the floor or against furniture excessively, restlessness, rashes, runny nose or eyes, sudden swellings like hives, and even recurrent ear infections. Hot spots – a well-demarcated, moist, red, sore, hairless patch on the skin – may be seen.
Most of the time, a diagnosis can be made from the history and presenting clinical signs. In some severe cases where the cause is unknown, Intradermal Allergy testing or blood tests for specific sources of allergens may be recommended. In my experience these are quite useful.
As a responsible pet guardian it is your duty to notice symptoms quickly and then look for a possible cause before you take your animal to your vet. This will help the vet make an accurate and prompt diagnosis. Once your vet has examined your pet he or she may prescribe flea treatment if a flea allergy is found, advise a steroid injection to reduce hives and alleviate itching, prescribe creams or eye drops and recommend dietary changes, depending on your pet’s diagnosis.
If the allergy is recurrent and it has not been possible to identify the cause, then the vet may advise blood testing to identify the allergen, after which immunotherapy vaccines may be needed.
Food elimination trials can be useful where food allergy is suspected (see Chapter 1: Food Is Medicine). Topical antibiotic and steroid gels may be prescribed for patches of acute moist dermatitis and the area will need to be clipped and cleansed with dilute chlorhexidine. Systemic antibiotics may be needed in certain breeds and when there is secondary bacterial infection.
Your pet may be prescribed special shampoos for itchy skin, antihistamines, and in chronic cases long-term steroids may also be necessary (although this is not ideal, and should be avoided where possible). Please read carefully Chapter 8: Which Drugs and Why, which describes the side effects of steroids.
I try my best to avoid treating pets with long-term steroids but in some cases I have to relent to pressure from the pet owners, either because they are not willing to be patient or they do not have the funds to investigate the skin condition. In cases where the pet concerned is itching so badly that it is literally ripping itself apart, steroids may have to be used.
Please insist on a proper diagnosis, rather than choosing temporary fixes like steroids. Consult your vet and spend time, money and energy on ascertaining the cause of the problem.
These two glands are situated each side of the anus at the 4 o’clock position on the right side and the seven o’clock position on the left. The duct that empties each gland opens into the rectum just inside the anal ring. Anal glands can be very troublesome in some dogs. The gland secretes a pungent-smelling, brownish discharge that is very distinctive and often smells of dead, decaying fish.
The anal sacs normally empty and refill every day. They empty when the dog or cat has a bowel movement and the smell of this fluid is unique to the pet. When the stools are not firm enough, the act of defecation fails to exert enough pressure to squeeze the glands, and as a result the fluid accumulates in the sacs over time, causing discomfort, itchiness and sometimes anal gland abscesses. This problem is extremely rare in cats.
Most people who observe their dog rubbing its bottom on the floor assume that he or she has worms. I have heard this particular symptom described variously as skating, scooting, dragging bottom on the floor, etc., all of which suggest possible anal gland involvement as the poor dog is trying to apply pressure on these sacs to empty them.
Some dogs will lick at their rear end excessively and make it sore. It is very important to examine your pet’s rear end at least once a week, to check if there is any abnormal redness or swelling. Anal gland abscesses are very painful and need veterinary intervention.
If you think your dog is showing the above symptom you can try and massage the region around the anus with a warm flannel. This may cause the glands to empty. Small dogs can be placed in a warm bath and gently dragged across on their bottoms to empty the glands. If neither of these work then make an appointment with your vet to have your pet’s glands emptied.
If the pet has an anal gland abscess then the vet will prescribe a course of antibiotics and some anti-inflammatory drugs. In severe cases your pet may need to be sedated and the gland lanced, drained and flushed with antibiotics. If your pet suffers anal gland problems recurrently, despite treatment, the vet may advise their surgical removal as a last resort. In my experience, it is not a good idea to manually empty the glands frequently as this is unnatural – it can increase inflammation and impaction and even stop them from emptying naturally at defecation.
An anal gland problem is best treated by you, as it can be prevented with the right diet. Elizabeth and I recommend feeding your dog a high-fibre diet with added vegetables like broccoli and carrots, as this can help the stools become harder and firmer, and as a consequence, the glands should hopefully empty naturally; see Chapter 1: Food Is Medicine.
Separation anxiety encompasses a range of separation-related behaviour problems that take place when the pet guardian is partially or completely absent. This condition may exist on its own, or pets that exhibit this condition may simultaneously display fears and phobias of new/novel situations, fear of strangers, heightened sensitivity and fear of loud noises, cars, fireworks, etc.
As domestic dogs consider their human family as their pack, they can bond excessively to certain family members and this over-attachment can be a cause of separation anxiety in some dogs. It may make you feel special that your dog loves you more than other family members, but for your pet’s sake ensure it is not excessive. Not much has been documented about this condition in cats, but I have had many feline patients who have exhibited what appeared to be separation distress behaviour.
Fear of fireworks and thunderstorms is common, and may be down to the fact that your pet was not habituated, or exposed, to noises within the first three to six months of its life. Your dog may have had a traumatic experience or may have learned it from another pet or even from you – if you are scared of loud noises, your pet is more likely to be the same. There is some evidence that suggests that neutering animals before six months of age or earlier can make them more fearful of noise.
Dogs may bark constantly, destroy furniture or objects, urinate or defecate inappropriately and lick or groom themselves excessively. Cats may show stress over grooming and lick themselves raw; some may scratch furniture and show marking behaviour by house soiling. They may also hide a lot or turn aggressive or reclusive.
A behaviourist or your veterinarian will arrive at a diagnosis of separation anxiety or phobias based on key findings in your pet’s behavioural history. This can be quite a long consultation or may need several consultations. As these problems can have multiple and varied underlying motivations – including fear, over- or under-stimulation, territorial behaviour and hyper-attachment – a definitive diagnosis and a single treatment option may not always be possible.
During my TV talk shows, most of the calls I received were from worried pet guardians about their pet’s abnormal behaviour. Unfortunately, this is one area where there are no quick fixes and no guarantees. Animal behaviour is complex and even the most experienced behaviourist can completely cure only some cases.
As a veterinarian, I deal with each pet on an individual basis and then try a combination of medication, management and coping strategies. As phobias and fears can potentially severely impact the health and welfare of a pet, the focus should be on treatment rather than just management.
Only after performing a complete physical exam and carrying out any routine blood tests to ensure vital organ function, will I start an animal on medication. Benzodiazepines are very effective, especially in acute episodes of noise phobia such as fireworks, and there are individual variations in response. In my experience they seem to work really well in some animals but not in others.
I start the animal off on the medication and when the management protocols are in place, I wean them off the drugs or ask that they be used sporadically. I have found that complementing drugs with appropriate behaviour and environmental modifications seems to have the best results in the long term.
In contrast, while dealing with separation anxiety problems, the focus should be on acute management protocols and behaviour training. Medications such as clomipramine hydrochloride or fluoxetine can be an add-on, but are unlikely to provide any long-term benefit on their own. In some cases Selegiline can also be tried as it does seem to benefit emotional disorders. Dog Appeasing Pheromones (DAP) are a useful adjunct to therapy as most medication can take several weeks to actually make a difference.
As a pet guardian your role is key when dealing with emotional disorders and phobias. Following the vet or behaviourist’s advice with regards to management protocols is vital for ensuring a quicker and more long-term solution to your pet’s problem without making them drug-dependent. As your state of mind plays a crucial role, I advise that you follow the grounding techniques described in Chapter 5: How to Give Healing to Your Pet, and become less anxious and worried, as this will be picked up by your pet.
Treating separation anxiety
Once your pet is diagnosed by a vet as having separation anxiety, you will be provided with tailor-made instructions on how to interact with your pet differently so he or she can stay ‘home alone’ eventually. You may be asked to play more with your pet, or exercise them more, as increased exercise tends to make pets calmer and decrease anxiety. In the short-term, you may be required to avoid leaving your pet alone and may have to take your pet to work, arrange a pet sitter or use a doggy day care service.
Dealing with a pet who has separation anxiety is not too different from leaving a toddler behind. You might have to eliminate your departure cues if this is a trigger – for example, you could pack your bag without your pet noticing or dress in casual clothes and change at work, or distract your pet with a chew, etc. Over time you may have to pretend you are leaving the house but actually not go anywhere. The aim here is to disassociate the cues from the actual departure.
Planned, graduated training departures are advocated by many behaviourists, and you will need specialist training with your dog to achieve this. Increasing your pet’s independence and decreasing hyper-attachment is very important. You will have to ignore your pet’s attention-seeking behaviour – such as pawing, leaning, nudging and barking – but attend to him when he is calm and quiet. Please note: do not ignore your pet – just ignore his attention-seeking behaviour.
Take your pet on more walks, play with him more, and go training together. I have recommended combined healing sessions for you and your pet using the Animal Whispers Sound Therapy music CD and have had great feedback from pet guardians. See Resources section for details. You can leave this music playing for your pet while you are out and he or she will find it very calming and therapeutic.
Sometimes, avoiding close contact with your pet may be necessary to reduce dependence and clingy behavior on demand. So do not encourage your pet to come and sit on you when he or she wishes to. It does not mean you should ignore your pet completely. Instead, you should be the one to initiate contact, once in a while.
You could spread a towel on your lap, which is a cue for your pet to sit there, or pat or call them to sit by you. Eating often decreases anxiety in a dog so giving them something tasty to chew while you are leaving the house can really help.
Your pets are not being stupid when they become scared. They have no control over their fears or phobias so realizing this is a first step to helping them get over them. It is very difficult to ascertain how noise sensitivities or fears have developed in each case, but there are two main types of theory, based on human research:
Associative processes like social learning, as seen in monkeys.
Non-associative processes, like poor habituation (exposure) to noises or fears in early life, sensitization to thunderstorms and chronic stress due to inadequate environment or lifestyle.
Desensitization and counter-conditioning (DSCC) using a noise recording is the standard treatment. By gradually increasing the exposure to a certain noise (fireworks or thunder, say) by using a CD with a recording of it, it is possible to habituate your dog to the sound. The hope is that your pet will basically get used to the noise and not show problem behaviour unless it is too loud. These recordings are readily available from your vet or behaviourist, or online.
Apart from this, for reducing the effects of thunderstorms, lightning or fireworks on dogs that are afraid of them, environmental modifications are recommended. Using blackout blinds and curtains can be effective. There is an antistatic cape called a Storm Defender that seems to be effective in some dogs. White noise machines like fans, and providing dogs and cats with safe places to hide during fireworks and storms, along with medicating them, can help.
Pheromone therapy using Dog Appeasing Pheromone (DAP) diffusers, T-touch and acupressure-based massage therapy, and also using aids like the Thundershirt or Anxiety Wrap, have been known to help. While the Storm Defender has a thin metallic lining that claims to repel ionic charges, the Anxiety Wrap uses acupressure points all over and the Thundershirt mainly covers the girth.
Research conducted at Tufts University in the USA did not prove convincingly that the antistatic mechanism used in the Storm Defender was beneficial. More research is necessary so I cannot recommend any particular product. Unlike the Storm Defender, which is specifically designed for thunder-related fear, the other two products claim to help with other anxieties as well. I have had mixed reports about all of them so the best way is to try each one out.
You should try and ignore your pet’s fearful behaviour and avoid cuddling or reassuring them, as this can reinforce the anxiety. Just distract them by starting a game, dancing to loud music or doing obedience training – all of which can be very useful. Punishing or shouting at your pet is definitely a big no, and can make matters worse.
Calming sound therapy, lavender and chamomile preparations (as described above under Anxiety) and giving healing can be beneficial. Increased serotonin levels, caused by feeding more carbohydrates, can also help, as they alter the mood. Feeding pasta or rice half an hour after a main, protein-rich meal is advisable.
Prevention is always better than cure so it is highly recommended that you expose your pet to various kinds of noise from when they are 12 weeks old, and do it gradually. Fears and phobias can be inherited so do enquire about the demeanour and responses towards noise, etc., of your prospective pet’s parents. Finally, unless it is for medical reasons, do not get your pet neutered at an early age.
Any animal in good health will usually be ready for food – just like us. In the case of animals, though, it is the pattern of eating that is important. We all know a fussy pet that only picks at its food and may not eat even once a day, but after a couple of days suddenly eats a good meal. The old adage ‘a healthy pet is a hungry pet’ is for the most part very true.
Stress, changes in the family, depression, pain, fever, poor-quality or boring food, weather changes, parasites, oral lesions, infections, constipation and cancer can all cause loss of appetite. If the cause is simple then just changing the pet’s food or giving them more attention may solve the issue. Severe gingivitis or dental disease can also cause an animal to go off its food. See the case study of Boris the Labradoodle of Chapter 1: Food Is Medicine.
Appetite loss (or inappetance) is usually a symptom of some underlying disease. If appetite loss is accompanied by other signs of ill health, these should be taken into account and the appropriate remedy given; if in any doubt seek veterinary help. Most pets will just stop eating completely or pick at their food.
Cats with respiratory infections cannot smell their food so they may come close to their bowl and then walk away without eating. Dogs and cats with painful lesions in their mouth may try to eat and then yelp or howl and back off from their food. These behaviours must be observed carefully and reported to your vet. If your pet is refusing all food, including favourite treats, then there is definitely some underlying cause that needs veterinary help.
After obtaining a full history and performing a thorough clinical examination your vet will arrive at a diagnosis. Blood tests and X-rays may be needed if the vet suspects infectious diseases, pancreatitis, constipation, obstructions (foreign bodies inside your pet) or cancer. Cats with ulcerative stomatitis will have ulcers in the mouth that prevent them from eating. Most cancers will also cause pets to lose weight and appetite. Dogs and cats that have eaten foreign objects may have a blockage that will make them stop eating. Appetite loss may also be due to liver and/or kidney failure.
This will vary, based on the diagnosis. Simple cases of inappetance triggered by mild infections and fever will respond to antibiotics and painkillers. Animals who have swallowed foreign objects will need emergency surgery to remove the foreign body and clear the obstruction. Severely constipated animals may need enemas.
Dental extractions may be necessary if bad teeth are causing inappetance. If your pet has pancreatitis it may need to be admitted and placed on a drip until its appetite returns (see Pancreatitis). Cancer cases will need to have special treatment and appetite stimulants. Kidney and liver failure cases will need to go on special diets, appetite stimulants and vitamin injections.
If your pet refuses food but seems to be itself in every other way – alert, active and interested – there is nothing to worry about. It is okay for a cat not to eat for 24 hours and for a dog, 48 hours, but a sudden change in eating habits is certainly noteworthy. If at all possible you should examine your pet’s mouth to check if there is any soreness in the gums/tongue or teeth. This is much easier with dogs than with cats but if your pet turns aggressive then stop at once and take him or her to your vet as soon as possible.
You can try swapping your pet’s usual food to some tasty human food or another make of pet food. If your pet gulps it down there is nothing to worry about. Serving him or her warm food (body temperature) can stimulate the appetite, too, and feeding in a quiet place may help if the household is noisy.
‘Degenerative joint disease’ is a more appropriate name for osteoarthritis (OA) in veterinary medicine and it is probably the most common skeletal disease seen in dogs. The term osteoarthritis was derived from three Greek words meaning bone, joint and inflammation and is defined as a progressive degeneration of joint cartilage and the underlying bone, resulting in the formation of bony spurs at the margins of the joints. These spurs are the main source of pain and it is this progressive remodelling of bone that makes arthritis a degenerative and chronic disease.
Wear and tear is probably the most common cause of arthritis. When an animal walks or plays or runs, quite a lot of stress is inflicted on the joints and when this happens repeatedly over the years, the joint cartilage breaks down and arthritis can develop. This is usually the case in older animals, but it can also happen in young ones who are overworked or those that already have conditions such as osteochondrosis (OCD) or developmental disorders like patellar luxation, elbow or hip dysplasia (see hip dysplasia).
If your pet has had some sort of joint trauma (fracture, ligament injury, dislocation) that joint can consequently develop arthritis. In my experience, those joints that have been operated on, like the knee joint in cruciate surgery or to correct patellar luxations, tend to develop arthritis eventually.
Overweight and obese pets have a much higher chance of acquiring osteoarthritis. Certain dog breeds, like German Shepherd Dog, Labrador or other large breeds, tend to suffer from it more, mainly because they are genetically more likely to have developmental disorders like hip dysplasia.
Most pets will exhibit some form of lameness or stiffened gait. Dogs will show reluctance to jump into cars and cats will stop jumping onto higher surfaces. Because the actual articular cartilage lacks nerves, your pets will not feel pain initially, so they will continue to be active. This can actually make matters worse, because the disease then progresses to the next stage.
Once a lot of cartilage has been destroyed, the cushioning effect in the joints is lost and therefore the surrounding joint tissues, the joint capsule, the ligaments and the bones become swollen and painful. This is when lameness is observed in arthritis. The lameness can be intermittent, it can affect more than one joint and it can be made worse by prolonged rest or by exercise. Cold weather can also make the symptoms worse. The affected joint may be swollen, hot and painful.
Most of the time arthritis is diagnosed by observant pet guardians, who see the symptoms described above. Vets confirm the diagnosis based on the symptoms and by manipulating the affected joint to feel the swelling and/crepitus (popping/cracking sounds) or reduced range of movement. A history of pre-existing conditions like osteochondrosis or hip dysplasia will point towards a diagnosis of osteoarthritis. If your pet has had a previous episode of trauma that caused joint instability, this will also alert the vet.
Sometimes, the vet may need to X-ray the affected joint to rule out cancer and to ascertain the extent of disease. It may also be necessary to perform a joint tap and send it off for culture and sensitivity, if there is a suspicion of septic/immune-mediated infectious arthritis. Blood tests may be necessary in sick or elderly pets to ensure their vital organs, especially the kidney, are in good condition to metabolize the medication that may be prescribed.
Modern-day management of OA involves a three-pronged approach – adequate pain relief, maintaining the correct weight, and regular, moderate exercise at the same time and for the same length of time each day. NSAIDs (see Chapter 8: Which Drugs and Why) are the most popular medications used today for the management of OA as they bring down the inflammation of the joint rapidly and quite effectively in the short term. However, they can cause side effects when used long-term.
Other types of painkillers – like tramadol, gabapentin, codeine, etc.– may also be prescribed. Steroids are very rarely used these days to treat OA, but some vets may use an occasional depomedrone shot in cats that refuse to take oral NSAIDs.
In dogs, Pentosan polysulphate, given as a sub-cutaneous (into the skin) injection once weekly for four consecutive weeks, can be very useful as it actually helps the regeneration of cartilage. Joint supplements containing glucosamine hydrochloride and chondroitin sulphate with Dexahan, krill oil, antioxidants and omega-3 fatty acids are very effective. The vet may also refer your pet to a veterinary hydro- or physiotherapist.
If your pet is overweight, then strict weight loss measures should be put in place, as the already struggling joints cannot carry excess weight. You must always feed your pet the right amount and feed them for the weight you want them to be, rather than the weight that they are. Most vets have free weight clinics and will help you achieve this.
Acupuncture and acupressure can help with chronic pain (see Chapter 6: Fingers and Thumbs). Hydrotherapy with a professional, or taking your dog swimming on a regular basis, can be very helpful as the water takes the strain off the joints, encouraging your pet to move without pain. You can take your dog on regular lead walks, starting with a gentle five minutes and building up to half an hour maximum, twice a day. You must listen to your dog and not overdo it.
Problems pertaining to the urinary bladder are quite commonly seen in veterinary practice. Infections of the bladder, inflammation of the bladder (cystitis), urolithiasis (bladder stones) and urinary incontinence are observed in both dogs and cats. Feline Lower Urinary Tract disease, or FLUTD, is a broad term used only in cats and covers all the above conditions and plugged-penis syndrome.
1. URINARY INCONTINENCE
Urinary incontinence is defined as the involuntary or unintentional leakage or passage of urine and therefore indicates the loss of voluntary control of urination.
Mixed or multiple causes of incontinence have been documented in humans and this is very likely the case in dogs and cats too. In most instances it may not be possible to ascertain all the causes. It is much more common in middle-aged to elderly pets, neutered female dogs and juvenile female dogs and seems to affect medium to larger breed dogs more than the toy or small breeds.
Acquired urethral incompetence caused by low estrogen levels in neutered female dogs is common and is an example of hormone-responsive urinary incontinence. Developmental disorders of the urinary tract, lesions in the cerebellum, spinal cord lesions, lumbosacral disc disease, UTIs (urinary tract infections) and bladder cancer are some of the causes of urinary incontinence. Overflow incontinence due to an over-distended bladder is seen in traumatic fractures of the spine or pelvis. Obesity can also be a contributing factor.
Excited puppies may urinate in excitement inside the house or when they are still training. A neutered female dog may have little accidents in the house or her bedding, and legs may be damp from urine leakage. Most owners find that their dog’s bed is wet and smelly, as she has leaked involuntarily overnight. Elderly dogs or those with spinal injuries will dribble or leak while just standing.
Only a veterinarian can make a diagnosis, by differentiating between similar signs. By examining your pet and taking a full history, your vet will decide whether your pet is exhibiting voluntary but inappropriate urination, has polyuria or is just urine spraying (cats). Palpating your pet’s urinary bladder to check its size and ability to express urine, and checking your dog’s prostate (males only) and genitals will enable your vet to arrive at the correct cause.
Blood tests may be needed if your pet is urinating a lot and drinking too much (polyuria and polydipsia), in order to check whether they have underlying diabetes, kidney or liver disease. Testing your pet’s urine sample will provide clues to infections, stones, cancer, diabetes and kidney disease so it is a good idea to get a urine sample before you visit your vet. Radiographs/ultrasound scans may be necessary to rule out stones, congenital problems, cancer and kidney pathology. It may also be necessary to perform a neurological examination or catheterize your pet as required.
It is not easy to treat incontinence. There is also quite a bit of variation in the response of each animal to the same treatment. Moreover, in many cases there are multiple causes, so it may not be possible to stop involuntary urination completely, although it is possible to reduce it. After ruling out temporary incontinence due to infections, estrus (bitch in season), or behaviour, your vet will commence treatment.
Incontinence in neutered female dogs is responsive to estrogen. I have had good success with estriol, which is a synthetic, short-acting estrogen, as it increases the muscle tone in the lower urogenital tract and improves urodynamic function. Phenypropanolamine is also very successful in treating incontinence secondary to urethral sphincter incompetence. Surgery may be required if anatomical disorders are diagnosed and your vet will then refer your pet to a specialist. Prosthetic sphincter implantation is now available.
Cystitis simply means ‘inflammation of the bladder’ and it seems to occur more commonly in females than males (except in cats).
The urinary bladder is a sterile organ. Ascending bladder infections usually occur as a consequence of bacteria travelling up into the bladder via the urethra. As female dogs tend to crouch quite low while urinating, they can pick up infections from the ground or grass, etc. Cystitis in male cats has been attributed to eating various dried cat foods. Feline Idiopathic cystitis (FIC) is very common in cats and is believed to be stress and diet induced, but there is evidence that these cats may also have spinal cord changes and altered bladder wall function. Persian cats seem to be more prone to FIC.
Dogs seem to present with frequent urination and/or blood in their urine (hematuria). Cat owners find that their cat is urinating in strange places, like the sink or bathtub or on kitchen tops, or just going in and out of the litter tray frequently. Some cats may vocalize more. Both cats and dogs may be observed to lick their genitals excessively.
Your vet will usually request a urine sample from your pet so it will save time and money if you can take one with you. It is not too difficult to collect a urine sample: when your dog starts to urinate just hold a clean, wide-mouthed container in the stream and collect it; it need not be sterile. A sterile sample is only needed if your vet wants to culture your pet’s urine sample, in which case, he or she will obtain one by performing a cystocentesis with or without an ultrasound.
It is challenging to get a urine sample from your cat; however, it can be done if you can keep your cat in and provide a litter tray with special cat litter called Katkor. This litter will not absorb any urine and will therefore enable you to get a clean sample. Most vets will give you this litter if they want a urine sample.
Your vet will send the urine sample off to a lab, where it will be tested for bacterial growth, and recommendations will then be made with regards to the correct antibiotic that will work against them. This is very useful as it ensures your pet gets the right treatment. Urine microscopy, X-rays and ultrasound, with or without catheterization, may be necessary to rule out bladder stones and blockage of the urethra or ureters.
Most vets will start your pet on a preliminary course of broad-spectrum antibiotics. In recurrent cases, after sending your pet’s urine for culture and ascertaining the organisms involved in the infection, a different or longer course of antibiotics may be needed. Pain relief may also be necessary.
A nutritional supplement called Cystaid is also prescribed by many veterinarians. This contains N Acetyl D Glucosamine, which helps to protect the bladder lining and is usually necessary in recurrent chronic cystitis. Pets with recurrent bladder infections are more prone to developing bladder stones. Your vet may advise a prescription diet that will help maintain the correct urine pH and/or prescribe urinary acidifiers in order to prevent bladder-stone formation. See Bladder stones for more information.
Your pet’s diet can make a huge difference. Wet food is preferable to dry. In my opinion it is better not to feed dry food as the sole diet, especially to male cats, but to use it in small amounts, giving a teaspoonful at a time once or twice daily, in addition to fresh, home-cooked food or canned food.
I recommend adding the home-cooked chicken broth to dry cat food, to increase the water intake. As some cats seem to love dry food and may not eat wet food at all, it may be necessary to feed both. You need to increase your pet’s water intake if it is mainly on dry food (see tips below for doing this).
Urine infections are more common in alkaline urine (pH>7) so diets that help acidify the urine will help. In general, vegetarian and cereal-based diets tend to increase the likelihood of alkaline urine, whereas animal-based protein sources tend to acidify.
3. BLADDER STONES
Uroliths (commonly known as bladder stones) can be of different types, based on their composition. They form in the bladder as microscopic crystals, which then precipitate into larger macroscopic stones. While the majority of uroliths form in alkaline urine, some do form in acidic urine. Struvite urolithiasis is more common than other types, in both cats and dogs. Cats with FLUTD suffer with urethral plugs, which may be struvite crystals or just composed of sloughed tissue and blood. These plugs occlude the penile urethra and cause plugged-penis syndrome.
Certain dog breeds are more predisposed genetically to certain types of stones. There is a high incidence of struvite uroliths in Miniature Schnauzers, whereas Dalmatians are highly likely to suffer with urate urolithiasis. Any breed can suffer with bladder stones, although the above-named breeds, plus Shih Tzu, Lhasa Apso, Cocker Spaniel, Miniature Poodle and Bichon Frise, have a breed predilection.
Recurrent urinary tract infections by urease-producing microbes, a diet that makes the urine alkaline, and some other metabolic factors can contribute to struvite stones. Cats that are primarily on dry commercial foods high in cereals and vegetable materials tend to suffer more with urinary caliculi.
The symptoms of bladder stones are the same as those of cystitis, except when a stone or stones tries to pass the urethra (then it can be very painful). If the stone is large enough or there are many of them, they can block the urethra, in which case the dog or cat cannot urinate. This is an emergency and you must rush your dog/cat to the vet to have them unblocked.
Blocked male cats are very common in practice because they usually have underlying FLUTD and therefore the urethral plug occludes the penis, making it impossible or very difficult for them to urinate. I have palpated (felt with my hands) a large, grapefruit-sized, rock-solid bladder in some cats while examining their belly area, which indicates blockage.
I have also palpated stones in the bladders of cats and dogs in the consulting room many times. Obviously the ease with which a vet can do this with your pet will depend on the size of the stones and the size of your pet. Examining a urine sample under the microscope will enable the lab or the vet to identify the type of stone, based on the crystals seen.
An ultrasound scan and/or X-rays may be necessary to confirm the position of the uroliths if more than one is suspected. It will also enable the vet to rule out kidney stones and hydronephrosis (engorgement of the kidney due to obstruction). If left for too long, renal failure is a possibility so blood tests may be required to check if kidney function has been affected.
A blocked cat has to be admitted and dealt with as an emergency. It will need to be sedated and a urinary catheter placed and sewn externally, to enable it to pass urine. Any stones are flushed back into the bladder. If the stones look tiny on the X-ray, the cat may be discharged after a couple of days on a special prescription diet that will dissolve the stones. But if they are too large, and are repeatedly blocking the catheter, then it may be wise to perform a cystotomy (open the bladder) surgically and remove the stones.
The diet prescribed will depend on the type of uroliths identified, so it is very important that the stones are analyzed before a diet is changed. Your vet will also prescribe antibiotics if the diagnosis is infection-induced struvite urolithiasis. Anti-inflammatory medication for pain relief and to suppress the inflammation of the bladder wall and/or urethra may be prescribed.
If you are the owner of a male cat who is predominantly on dry food, you have to be extra vigilant and observe him urinating if possible. If your cat looks quiet or lethargic and seems to be licking his penis excessively, please get him checked out immediately. Wherever and however possible, increase your pet’s water consumption. Wet food and fresh, home-cooked diets contain plenty of water, so it is worth trying them. See Chapter 1: Food Is Medicine, and Chapter 2: A–Z Food Recipes, for ideas.
Tips for making your pet drink more
Buy a pet water fountain.
Add tuna or chicken flavour to water.
Add water or a low-salt broth to food.
Cats love to drink from a tap, so let your tap trickle on and off.
Burns cause cell death and as a consequence they cause breakdown of the cell integrity. Burns and scalds are common in humans but relatively rare in animals, maybe because their instinct is so good that they escape or avoid getting hurt. Any burn or scald should be taken seriously. A burn may not immediately be apparent because of the animal’s fur or hair, and the extent of the injury may not be easy to assess. If there is any doubt at all, it is best to consult your veterinary surgeon without delay. Burns are an emergency.
Burns may be caused by radiation therapy, microwave radiation, thermal or chemical sources. Fires, heating lamps/pads, hair dryers and faulty electrosurgical units can cause thermal burns in practice. Scalds are caused by boiling water or oil and are more common at home, when pets are in the kitchen.
Allowing cats to walk on kitchen worktops can lead to burns if the animal touches the hot surface of an electric hob. Chemical burns can occur from caustic or acid materials. I have seen burns on the tongues of cats and dogs that have tried to drink hot tea or coffee from their guardians’ cups. Burns are classified as superficial, deep or full-thickness burns, depending on how much of the skin structure is damaged.
Some burns are obvious immediately, but most can take 2–5 days to be seen. Singeing of hair or fur is usually easily visible and can be the only symptom in some pets. Burns caused by hot metals and fires can be seen immediately, but it may take 24–48 hours for the full extent of the burn to become visible. Chemical burns tend to be erosive and necrotic in nature. Your pet licking itself at a particular spot/not eating/sore feet, etc., may all point to burns; if in doubt check with your vet.
If you have actually witnessed the burn, then diagnosis is clear, but if not a superficial burn may be difficult to diagnose. Your vet will perform a full physical examination, including eyes, ears, mouth, respiratory tract, urogenital tract, anus and footpads, before arriving at a diagnosis. If there are extensive burns and concurrent shock, and/or breathing difficulties, this will be assessed by your vet. For a concrete diagnosis, a biopsy of the lesions, including their margins, may be necessary.
After a full exam, as detailed under diagnosis, your vet will decide on the course of treatment. Sedation may be necessary if your pet is fractious, and to evaluate and treat the burn accordingly. Hair will need to be clipped very carefully from the burned surface and if it epilates easily that may be indicative of a deep burn.
If the burn has just happened, your vet will aim to cool the burned area by lavaging with saline or water (at 3–17°C/37–63°F) for a minimum of 30 minutes in order to relieve pain and stop the burn from progressing deeper. If extensive burns are present, or your pet was in a fire and inhaled smoke, then treatment will be on a higher footing and will be expensive and extensive. Treatment for shock with fluid therapy, bandaging and surgical debridement, with or without reconstruction, may be needed.
Topical antibiotic therapy to prevent wound infection and silver sulfadiazine in dressings will be used. Superficial partial-thickness wounds may be left to heal as an open wound. Each burn is dealt with on a case-by-case basis, taking into consideration costs, the extent of the burn and, most importantly, your pet’s welfare and long-term prognosis.
Note: your vet may refer your pet to a surgical specialist if he or she requires extensive reconstructive (plastic) surgery following a burn.
If you witnessed the burn and are sure it was caused by hot water or a chemical substance, the first thing to do is to rinse the area with cold tap water for 10 minutes. If your pet is agitated or tries to bite you or escape and will not allow you to do this, then it is best to take them to the vet immediately as he or she can sedate your pet safely to treat the wound.
Healing & herbs
Elizabeth recommends distant healing in the case of burns and scalds, as your own body heat radiating from your hands or close contact can be uncomfortable to your pet.
Make your own
For superficial burns, aloe vera basic gel can be applied quickly, as it has antiseptic and soothing properties. If you are unsure about the type of burn, please contact your vet. Use calendula ointment when the skin is healing post-burn.
If your vet has diagnosed your pet’s burn as superficial then you can try homeopathic burn ointments that contain hypericum. According to Francis Hunter, an expert in veterinary homeopathy, Cantharis (Remedy 6) is a very effective treatment for minor burns and scalds. Give one tablet every hour, up to four doses, then one tablet every two to four hours during the day for a few days, until your pet is obviously no longer distressed, is able to rest comfortably and, most important, not trying to lick the affected area continuously.
Cancer is very common in small animal practice and is seen in both dogs and cats. It is the most feared and dreaded disease among both humans and pets. Cancer is responsible for the deaths of almost 50 per cent of older pets, especially those more than 10 years of age. However, it should also be noted that not all cancers result in death. If diagnosed early, some of them, like solid tumours, can be surgically fully removed and this is curative.
The word ‘cancer’ does not actually refer to a single disease but to a large group of them. Their two main features are uncontrolled cell division or growth in the body and the ability of these cells to travel from their original site to other parts of the body. Death occurs if this spread cannot be controlled. Cancers are given names based on the type of cell from which they originate or the body part affected. The table below provides a list of some common dog and cat cancers and the main organs they affect:
Abdominal – pancreatic cancer, liver and kidney cancer
Every time I report a confirmative diagnosis of cancer to an anxious pet guardian, I am always asked, ‘What has caused my pet’s cancer?’ The answer is – I do not know. This is because it is impossible to pinpoint a single cause for cancer.
There is a huge list of possible causes though, and I am mentioning the most commonly implicated ones here. Bad genes or breeding, neutering too early or too late, carcinogens in the environment, using plastic feeding bowls, drugs or chemicals in the water, carcinogens in commercial pet foods, viruses, chronic inflammation, vaccines, stress due to owner stress and even an excess of sunlight can cause cancer.
Most of these causes are also true for us. As our pets share our environment, they are also exposed to everything that we face. There is also some evidence to suggest that dogs, and especially cats, can develop lung cancer due to passive smoking – inhaling because owners smoke around them.
Recent research suggests that our negative emotions also impact on our pets, as they look up to us and share deep bonds with us. In my experience, most stressed owners also have stressed pets and sick owners also have pets that fall sick more often. More research into this would be invaluable.
These tend to vary, depending on the location and the type of cancer, and in most cases they are very general. Most pets show at least one of the following signs – lethargy and exhaustion, vomiting, weight loss in spite of eating, appetite loss, struggling to swallow, lumps and bumps, non-healing sores or even bleeding. It is important that you consult your vet if any of these symptoms develop, especially if your pet is middle-aged or elderly.
If your pet develops a growth, get it checked by your vet. You will be asked about how quickly the lump is growing and also how long it has actually been on your pet. Taking a series of photographs of the lump will be very useful. Your vet will usually be able to tell you if it is a tumour. Tumours can be benign or malignant: the benign ones have a low or zero potential to spread and are therefore not deemed dangerous, while the malignant ones are cancerous and very likely to spread.
To be sure if the tumour is benign or cancerous, your vet may perform a FNA (fine needle aspirate) of the tumour or insist on a biopsy of the tumour or a bone marrow biopsy in certain cases. FNAs can usually be performed without anaesthetizing your pet, whereas biopsies can only be obtained by sedating or giving a full general anaesthetic. These biopsies or FNAs are then sent to a histopathologist, who will report if it is cancerous, where it will spread to and how quickly, and also provide the grade and prognosis.
X-rays are necessary for bone tumours and ultrasound examination for abdominal tumours. MRI and CT scans help diagnose brain or spinal tumours. Blood tests are required to identify certain types of cancer, such as those caused by feline leukaemia virus (FeLV) or feline immunodeficiency virus (FIV) in cats. It is best to get advice from a veterinary oncologist before carrying out too many tests or surgical tumour removal. They can perform a proper diagnostic evaluation and advise on the best options after considering the type of tumour your pet has and the extent of disease.
Depending on the type of cancer, your vet or oncologist will advise chemotherapy, surgical excision or radiotherapy. In some cases your pet might need a combination of these treatment methods. In most cases, grading and staging the tumour will provide a guide to the appropriate treatment method.
For example, solid tumours will require surgical removal and then perhaps radiotherapy afterwards, especially if it has not been possible to get a clean margin (tissue around the tumour that is free of tumour cells) for various reasons.
An experienced oncologist and a radiation specialist will make this decision, as radiotherapy will not be effective against all cancers. Similarly, chemotherapy will work best in some cancers, especially in dogs, and can actually cure them. It is not really used in cats, as it can be more dangerous to them. Most people are scared of chemotherapy and its side effects, but in reality most dogs do very well on it compared to humans and have very mild side effects such as nausea, vomiting or diarrhoea.
Going into detail about each of these options is beyond the scope of this book, and I strongly advise enlisting the help of an oncologist. Although oncologists are expensive because they are specialists, their experience and knowledge is invaluable and if you find the right one, they can actually save you money by avoiding unnecessary tests.
I strongly recommend that you read Dr Demian Dressler’s book, The Dog Cancer Survival Guide. In it he describes a full-spectrum treatment schedule in which you can play an active role to ensure your dog with cancer has both a good-quality and a long life. Dr Dressler advises using a combination of conventional vet treatment, nutraceuticals like Apocaps, immune-system boosters, the correct diet and finally brain chemistry modification as the backbone of cancer care, which I fully endorse.
Traditional Chinese medicine, Ayurvedic medicine and homeopathy can also be considered, but must only be performed by a veterinarian who has trained in these modalities. This may be the only choice left if your pet has advanced cancer with a poor prognosis with conventional therapies. An experienced complementary therapist and healer like Elizabeth or a holistic vet like myself can advise you on the use of herbs (especially if you cannot afford nutraceuticals), healing techniques and also natural diets that help support your pet through cancer.
Finally, please do not be scared of the statistics that provide the median survival time – how long your pet will live once diagnosed with cancer. Each pet is unique and the numbers may not necessarily apply to your pet. Be proactive, speak openly to your vet or oncologist and then decide on the right treatment plan – one that will suit you and your pet. The decision is yours, but try to educate yourself well so you can make the correct choice for your pet and provide the right support.
Colitis refers to inflammation of the colon that results in the reduced ability of the colon to absorb water and store faeces. It is a very common cause of diarrhoea in small animal practice and usually a recurring problem in the same animal.
Colitis can be caused by bacterial or protozoan infections or it can be dietary. If your pets are allergic to the protein in their food or have eaten abrasive material including bones or some foreign body, colitis can occur. Histiocytic ulcerative colitis is observed in Boxers and can usually start by the time the dog is two years old. Colitis can also occur in cats or dogs secondary to chronic pancreatitis.
Both cats and dogs present with semi-solid to liquid faeces. There is an increase in the frequency of bowel movements, but only a small amount of faeces is voided each time. Your pet may strain for a long time before or after defecating. Dogs may have chronic diarrhoea with mucus and blood, but cats tend to have solid but bloodstained faeces. Some dogs may also vomit.
The symptoms above, combined with a history of dietary indiscretion (your pet eating something they are not supposed to eat, or scavenging), is usually enough for your vet to arrive at a diagnosis of colitis. Your vet will have to differentiate between colitis and the possibility of cancers like lymphoma and adenocarcinoma, which have similar symptoms. By performing a rectal examination, your vet will rule out recto-colonic polyps and by feeling your pet’s abdomen they will check for intussusceptions.
If your pet strains frequently or vomits a lot, then one section of the intestine can telescope into another, which is known as intussusception. Blood tests may be necessary if there is a lot of bleeding. Faecal smear examinations are necessary if protozoan infection is suspected and abdominal ultrasound may be performed if cancer or foreign bodies are possible.
In recurrent colitis, or in Boxer dogs, colonoscopy with biopsy or an exploratory laparotomy followed by biopsies of the intestine may be indicated. X-rays are only needed if intussusceptions or bony foreign bodies are suspected.
If your pet has mild colitis, then fasting him or her for 24–48 hours may be enough. You can also try a hypoallergenic prescription diet containing a protein that your pet has not been exposed to. Or if there is no likelihood of an allergy just feed home-cooked chicken and rice. Supplementing the fibre intake with bran or adding psyllium can help bulk the faeces up to bind faecal water and ensure formed faeces. See Chapter 1: Food Is Medicine.
Mild colitis cases will be treated as outpatients, but if your pet has bled a lot from his rectum or has become dehydrated then he may be admitted for blood tests and fluid therapy. Antimicrobial therapy may be initiated if faecal cultures reveal giardia, salmonella, histoplasma or campylobacter.
Anti-inflammatory drugs or steroids may be prescribed if your vet thinks the colitis is of inflammatory origin or immune-mediated. Motility modifiers may be added in to stop the diarrhoea and help the formation of normal faeces. Surgery is only needed if cancer, foreign body or intussusception is diagnosed on radiographs or ultrasound.
Constipation can be defined as difficult, incomplete or infrequent defecation accompanied by the passage of hard or dry faecal matter. This condition is not as common as diarrhoea in pet animals, but it does occur in older cats and occasionally in dogs. Although it appears to be a simple issue, it can be a symptom of serious health problems and therefore worth understanding.
In dogs the dietary causes of constipation are mainly eating cooked bones; in cats it is eating hair or fur balls or other foreign materials. If your pet does not exercise because it cannot move for some reason, or is just lazy, constipation is a possibility. Dirty litter boxes can make cats constipated and dogs that are hospitalized tend to become constipated because of the lack of familiar surroundings.
In dogs, constipation can be secondary to prostatic disease, pelvic fractures, spinal paralysis, megacolon, cancer and foreign bodies. If your pet has a painful condition near its anus, like anorectal disease (anal sac issues, anal gland abscess, rectal prolapse, perianal fistula or perineal hernias), he or she can become or appear constipated. Defecation becomes painful and is therefore avoided.
Bite wounds around the perianal area can also cause your pet to defecate less frequently or not at all. Debility or general muscle weakness, dehydration and conditions that impair the smooth muscle function can also cause constipation. Obesity can predispose your pet to constipation.
The symptoms are usually obvious to dog owners as their pets usually defecate while out on a walk, but they can be missed in cats, who tend to be secretive or do not use the litter tray. Straining to pass faeces, passing tiny, pebble-like or hard and dry faeces, or not passing faeces at all is usually observed in constipated pets. Passing blood or mucus may also be a symptom. Some pets may vomit or stop eating if the constipation is prolonged and has gone unnoticed.
A rectal and perianal examination by your vet is necessary for a diagnosis. Hard faeces are usually found sitting in the colon and can also be palpated in the abdomen of thin dogs/cats. Sometimes a radiograph/ultrasound exam may be needed if there is a worry that it could be cancer-related, or down to prostate issues, accidents, megacolon or foreign bodies like bones.
Barium enemas may be necessary to identify a mass in the lumen of the intestines that could be causing an obstruction and thereby constipation. Painful urination in cystitis can be mistaken for constipation, as the pet is just observed straining, so that will need to be ruled out. Blood tests may be required if your vet suspects dehydration, kidney disease or hypothyroidism.
Treatment depends on the diagnosis of the cause of constipation. In mild and recent cases, a laxative like lactulose or liquid paraffin may be sufficient, but if your pet is dehydrated he or she will need to be an inpatient. After aggressive fluid therapy, your pet will need to be sedated and given an enema, with your vet manually removing the faeces. If investigations have revealed other causes of the constipation your vet may need to perform surgery or treat the primary cause of constipation.
A cough is actually a clinical symptom of many conditions and not a condition per se. It is therefore not prudent to treat a cough without actually diagnosing the cause of the cough or the condition causing it. The cough reflex is one of the most powerful reflexes in the body and is actually a warning that something is not quite right with the pharynx or the respiratory system. Suppressing a cough without a diagnosis can be dangerous.
Diseases affecting the sinuses, tonsils, trachea, lungs and heart can all cause an animal to cough. The pattern of the cough, its frequency and characteristics can suggest the probable cause for the cough. For example, coughs caused by congestive heart failure and tracheal collapse tend to be more nocturnal whereas coughs that are exacerbated by exercise or excitement are usually due to irritation in the larynx or trachea or bronchi.
Your vet will enquire about the duration, the timing and the type of cough before performing a full clinical exam. Pinching the throat of your pet to elicit a cough is helpful too. In my experience, most pets do not cough in the consulting room and start again at home so it is a good idea to video your pet’s cough to enable a more accurate diagnosis. Blood tests may be required to rule out lungworm, heartworm or eosinophilia.
If your pet’s cough is accompanied by bleeding from either the nose or mouth, then it may be necessary to perform a coagulation profile to rule out bleeding disorders. X-rays, thoracic ultrasound, bronchoscopy or laryngoscopy are other diagnostic tools that may be necessary, especially if foreign bodies or tumours are suspected. Feline asthma is quite a common condition and radiographs of the lung can help confirm it. CT scans are the best way to evaluate the sinuses.
A differential diagnosis of coughs is given below, so you can appreciate why diagnosis is crucial before treatment.
Coughs appear very disconcerting to the owner and the noise can be upsetting. Unfortunately, investigating a cough does require time and money. Most vets will try to treat a cough symptomatically with antibiotics, bronchodilators, cough suppressants, mucolytics, expectorants and sometimes steroids. Cardiac coughs will need diuretics and treatment for the heart condition. If the cough is non-responsive or persistent, then further diagnostic work is needed before an appropriate treatment can be chosen.
Dental care and surgery are becoming much more common in modern-day veterinary practice, thanks to the advancement of veterinary dentistry and dental techniques. It is also important to mention here that the popularity of veterinary dental procedures is increasing because more domestic pets need them nowadays, compared to their wild ancestors, who had good teeth. Today, our dear pets are plagued by rotting teeth, abscesses and gingivitis, but it is up to us to change this.
Predisposing factors for dental disease
We have been breeding all kinds of dogs over generations for all sorts of reasons. Some have been bred to hunt, some to show better and others merely to look cute. By doing this we have distorted the natural shape of a dog’s jaws.
Today, most of the toy breeds have such tiny jaws that it is impossible for all the required teeth to be accommodated in the space. Overcrowding of teeth therefore results in impactions and misalignments, and predisposes the dog to gum disease. In practice, vets can vouch for the fact that Yorkshire Terriers are over-represented when it comes to dental disease – most of them have lost half their teeth by the time they are four years old, or even younger.
This is probably the most important reason for bad teeth in our domesticated pets today. Animals are meant to chew raw food that is chelated, rich in vitamins, minerals and enzymes. Contrary to what most pet food manufacturers would like us to believe, dry food and crunchy biscuits do not clean a carnivore’s teeth.
In the wild, chewing through tough skin and bones scrubbed a dog’s teeth like a toothbrush and thereby prevented the build up of tartar. Unfortunately, commercial pet foods do not require much teeth action at all. In fact, they form a kind of glue that adheres to the teeth, contributing to dental decay. Poor food also leads to halitosis (foul breath), as it festers in the gut and the offensive odour then backs up.
The presence of certain infectious diseases – like feline immunodeficiency virus (FIV), feline leukemia virus (FeLV), and feline calici virus in cats and metabolic disease such as diabetes mellitus in cats and dogs – increases the risk of acquiring periodontal disease.
In dogs, actual tooth decay only causes 10 per cent of dental problems. Periodontal or gum disease, which is the inflammation of the soft tissues surrounding the teeth, is actually much more common. Statistics show that more than two-thirds of dogs over three years of age suffer from some form of periodontal disease. The formation of plaque and tartar irritates the gums, resulting in gingivitis.
If left untreated, gingivitis results in periodontal disease, which is unfortunately irreversible. As I explained above, old age, genetics or bad breeding, tooth alignment, diet and chewing, general health, grooming habits, dental home care and finally the mouth environment all contribute to the development of dental problems in dogs.
In cats, dental disease is also very common and there are several contributing factors to its development. Tooth alignment, which is poor in breeds like Persian, Siamese, chinchillas and some other British breeds, is one factor. Diet, oral chemistry and poor dental care and grooming habits are also responsible.
Infectious diseases such as feline leukemia virus and feline calici virus cause severe gingivitis and periodontal disease. The most commonly observed dental diseases in cats are gingivitis, periodontitis, feline ulcerative stomatitis, feline odontoclastic resorptive lesions (FORL) and fractures of teeth due to trauma or jaw abnormalities.
Dogs with dental disease exhibit halitosis (bad breath), bleeding gums, pawing at the mouth, drooling, stained teeth, tartar and plaque on teeth, purulent exudates (pus) around teeth, general malaise, irritability, depression, loose teeth, sensitive teeth and difficulty in chewing or eating.
In cats, symptoms range from persistent bad breath or halitosis to bleeding gums, reluctance to eat and groom, approaching food then running away after tasting it, vocalizing, pawing at the mouth, drooling, swelling on face under the eye, teeth discolouration and tartar formation.
Veterinarians should be the first port of call when dental problems are suspected. Most vets will check the teeth of domestic pets when they go in for their annual booster vaccination or health check. This is the time when subclinical or asymptomatic early dental disease is picked up. Obviously if a pet shows any of the symptoms listed above, the vet will suspect dental problems.
Clinical examination of the teeth is the first step. X-rays may be required if teeth root damage is suspected. Blood tests may be required if the pets are geriatric or there is suspicion of underlying infectious diseases causing the dental problem. A general anaesthetic may be required if the animal is fractious or if there is significant evidence that extractions are imminent.
Your vet (conventional veterinary dentistry)
In dogs, treatment of periodontal disease is multi-faceted and depends on the stage of the disease. Prophylactic dental treatment is carried out by a veterinarian. The plaque and tartar are removed under a general anaesthetic using a professional ultrasonic scaler and the teeth are polished to remove microscopic scratches that predispose to tartar build-up. After descaling and polishing, the teeth are assessed visually, by probing and by radiography if necessary, and a decision is then made on the treatment options.
Depending on the condition of the teeth any one or a combination of procedures may be required. If your finances do not permit and there is advanced periodontal disease the veterinarian will have no choice but to perform tooth extractions, both by manual and drilling techniques. If you can afford a veterinary dentist they may be able to save the teeth by using advanced procedures. Specially selected antibiotics may also be prescribed.
In cats, early gingivitis and mild periodontal disease may be treated with just a simple descale and polish, as described in the dogs section above, under a general anaesthetic. Endodontic disease with pulpitis may need X-rays and then either root canal treatment or extraction.
Feline odontoclastic resorptive lesions (FORLs) are difficult to treat and the cost-effective option is to extract the affected teeth. Tooth root abscesses usually require tooth extraction and then flushing, followed by antibiotic cover. Lymphocytic plasmacytic stomatitis and feline ulcerative stomatitis are very resistant to treatment, and sometime drastic measures like extracting all teeth besides the canine teeth may be advised as a last resort.
There is no doubt that with dental disease, ‘an ounce of prevention is worth a pound of cure.’ Unlike many health conditions, it can be stopped almost entirely with natural home care. Please see the following important steps in preventative dental care.
Diet – feeding species-appropriate raw food is a very sensible option. If this is not possible then prescription dry kibble dental diets, which are tartar-control foods, can be tried. They are made with increased amounts of vegetable fibres that wrap around the teeth and prevent the food particles from adhering, or pull the tartar away when animals bite into them.
Raw or steamed vegetables can also be given to pets to fight tartar. See Chapter 1: Food Is Medicine. Elizabeth recommends adding one teaspoon a day of 100 per cent ground seaweed to the food of both cats and dogs that have gingivitis (see Resources section for stockists) and also feeding the Bladderwrack K9/Feline sea biscuits.
Chews – tartar-control chews are a good choice and so are soft, gentle dental bones of good quality. Raw, meaty bones from the butcher that do not splinter can be given to dogs and cats regularly to stop tartar build-up. Knuckle bones for dogs and chicken necks for cats are also recommended. Pets must be supervised while they eat bones, to stop splintering and accidental swallowing. Use real deer antler treats.
Brushing – for cats and dogs, a regular regime of twice-weekly teeth cleaning and brushing can go a long way in preventing dental disease. Lots of different, easy-to-use brushes are available. Special enzyme-based toothpastes and gels can be used. Natural toothpastes that have no known side effects are quite effective in cleaning out the tartar. Vets also recommend sprays and gels that prevent tartar formation – these can be rubbed onto the teeth.
Mouth inspections – owners who regularly inspect their pet’s mouth can usually tell if the smell or teeth appearance is abnormal. This is vital as gum disease and tumours can be identified early on.
Veterinary visits – it is very important to arrange for regular oral exams by a vet who can then nip the problem in the bud by alerting the owner when there is a problem. A good home dental care regime can also be formulated, together with the owner’s input, in the best interests of the pet concerned.
Dental problems pose a painful, chronic threat to the health of most of our domestic pets. They also tend to suppress the animal’s immune system and render them more vulnerable to other degenerative diseases. More worrisome is the fact that bacteria from the infected teeth can enter the bloodstream, damaging the kidneys and/or the heart.
It is therefore very important to strengthen the whole constitution of our pets so they can fight dental disease from the inside out. By feeding a healthy, wholesome diet, and including regular home-based dental care and routine veterinary examinations, it is definitely possible to prevent dental problems.
Depression is defined as a condition of mental disturbance, typically with a lack of energy and difficulty in maintaining concentration or interest in life. It is characterized by a range of symptoms, such as persistent low mood, absence of positive effect (loss of interest and enjoyment in ordinary things and experiences), and a range of associated emotional, cognitive, physical and behavioural symptoms.
Because animals cannot communicate with us even if they have these kinds of experiences, the general opinion is that ‘we cannot really say if an animal is depressed’. But this does not mean that animals do not suffer from depression. Most pet guardians have absolutely no doubt that their animals can be unhappy, angry, happy or fearful or even feel guilty.
According to psychiatrists, the core symptom of depression is anhedonia, which simply means an inability to feel pleasure and is defined as a psychological condition characterized by the inability to experience pleasure in acts that normally produce it. This also happens to be the only measurable symptom of depression in animals. Research shows that animals do suffer from depression, although not everyone is convinced. However, most people who work with animals have come across depressed ones.
Different animals exhibit different reactions to depression. A good guide to identifying the condition is to recognize out-of-the-ordinary behaviour. The most common signs are lethargy, lack of appetite or overeating, sleeping excessively, loss of initiative, moping, pacing, anxiety, aggression and even destructive behaviour. Some dogs may also stop playing, walking and participating in usually joyful activities.
Vets have noted that becoming withdrawn and excessive vocalization, barking or meowing can also be signs of depression. Cats tend to show some additional signs apart from the ones listed above, such as excessive grooming, not greeting their guardian and hiding in strange places. Regressive behaviour, such as when the animal was a puppy/kitten, and inappropriate urination and defecation may also be seen.
Grief – this is the most common cause of depression in animals. The death of a favourite family member, losing an animal playmate, divorce in the family and family members moving out can all cause an animal to feel lonely and sad.
Changes in environment – a new partner or a new baby, a new pet, moving into a new home, change of furniture, being kennelled. Any one of these changes can cause the pet to become disorientated and feel lost and depressed.
Changes in schedule – dogs that are used to the owner being at home with them can become depressed when they take up a job. Separation anxiety can therefore be described as a big trigger to depression.
Mental state of the owner – dogs definitely pick up on the emotions of their owners; depressed owners seem to have depressed pets. The animals respond to the grief of the owners.
Abuse – most ill-treated pets are depressed.
Weather and seasonal changes – seasonal affective disorder (SAD) has been observed in dogs, just as in humans, when winter begins. Similarly, prolonged bad weather, and hurricanes that change atmospheric pressure, seem to impact on the moods of pets.
Chemical imbalances – as in humans, low levels of serotonin may be a predisposing factor to depression in animals.
Medical conditions – most animals exhibit signs of depression when there is something physically wrong with them.
As sick pets tend to show many of the same symptoms as depression, it is important to consult a vet and rule out physical ailments and life-threatening medical conditions before assuming that a pet is suffering from depression. Depression therefore tends to be diagnosed by vets through the process of elimination – after ruling out the possible medical causes for the symptoms exhibited.
A complete physical examination, blood tests, etc., may be necessary to rule out medical reasons for the depression. Obtaining a very thorough history goes a long way in the diagnosis of depression in animals. This usually reveals a trigger in the form of a coinciding event that may have started the cycle of depression. It is therefore vital to identify the cause. Once this has been established, it is a lot easier to confirm the diagnosis of depression.
Your vet and you
In mild cases of depression I usually suggest some simple changes or common-sense interventions in the pet’s lifestyle that can make a huge difference:
Increased attention – giving you pet more attention, playing more games with him or her and cuddling more can help. Going on walking trips and holidays with dogs – as a way of re-bonding – is also a good idea.
Mental stimulation – grief-stricken pets can be cheered up by hiding away things that remind them of the person who is not around, and just spending more time with them and distracting them with mental-stimulation activities like Kongs and games. Fishing pole-style toys or just an aquarium with fish can lift the spirits of our feline companions. Acquiring a new puppy or kitten can also help if the pet has lost its playmate or long-term animal companion.
Light treatment – light and the functioning of the pituitary and endocrine glands are intimately linked. There is enough evidence that light stimulates the body to release hormones that can uplift the moods of animals, just as in people. So allowing the animal to sunbathe on a sunny porch or in a garden can make a big difference.
Drugs – most responsible vets avoid using psychoactive drugs to treat pet depression. This is mainly because very few of these drugs are actually licensed for animal treatment – there is very little research and therefore a lack of data on animals. Vets are also aware that psychopharmacology can only be a valuable adjunct to more traditional environmental management and behaviour-modification programmes. Moreover, all of these drugs have side effects and if used in the wrong combination can cause central nervous system toxicity sometimes leading to death.
Pheromone therapy – pheromones are a natural form of therapy based on the chemical signals used by animals for communication – for example, Feline Facial Pheromone (FFP) for cats and DAP (Dog Appeasing Pheromone) for dogs. There is evidence-based data to document their efficacy in many anxiety-based disorders, so they may help in depression. They can be sprayed or diffused into the air in the pet’s environment and have hardly any side effects, but they may confuse the pet by giving them mixed messages.
Dietary supplements – L-tryptophan is being added to diets such as Royal Canin Calm as it is a precursor of serotonin (mood enhancer).
I have found music to be very effective in healing pet emotions. Although not every pet responds to music, some do respond to their favourite melodies. Music recorded at special healing frequencies is used to relax animals – as in, for example, the Animal Whispers Sound Therapy CD by Elizabeth Whiter and Tim Wheater.
Healing & herbs
Animal healing is a fantastic complement to veterinary care and can be safely given by you to your pet. See Chapter 5: How to Give Healing to Your Pet for instructions. Elizabeth documents several cases of grief-stricken pets that recovered as a result of healing in her first book, The Animal Healer.
Make your own
Elizabeth recommends offering calendula, catnip, chickweed, mint, nettle and rosehip infused in sunflower oil on a self-selection basis to your depressed pets. Catnip-infused sunflower oil can cause feline euphoria and alleviate depression. For cats she also suggests rose petal water, the valerian and catnip toys, and fresh and dried catnip. Ginger-infused honey can also lift the mood. The plant St John’s Wort has also been used in animals and so have skullcap and valerian, but their effectiveness in actual veterinary therapy is anecdotal.
There is a tremendous gap between a common-sense viewpoint and that of official science on the subject of animal feelings and emotions. So it is not surprising that very few scientists believe that animals can actually suffer from depression. As a vet, from personal experience with clients I can say with conviction that almost every single pet owner who brings his animal to me firmly believes that his pet has feelings. They not only believe it, but see evidence of it every single day.
Research on Zoochosis (abnormal behaviour patterns associated with animals kept in zoos or other artificial environments) in captive animals and evidence of clinical depression in the livestock population from a study by the US Food and Drug Administration confirms that animals do suffer from depression. Depression is a natural emotion but when it persists for a long time it can make a pet physically ill, so it is important to determine whether the depression has caused an illness or is a consequence of it.
Once the cause of the depression is established, it is possible to treat the depression quite easily in the majority of cases. In my view common-sense interventions, behaviour-modification techniques and complementary therapies should be attempted before treating animals with psychoactive drugs that have questionable efficacy and dangerous side effects. Only in the most serious cases, where there is concurrent aggression/self-trauma, is psychopharmacology justified.
Diabetes mellitus (DM) is a common condition that affects both cats and dogs. It is an endocrine disorder of carbohydrate, fat and protein metabolism that is caused by a deficiency of the pancreatic hormone called insulin. As in humans, diabetes is classified as type I (insulin-dependent) and type II (non-insulin dependent). Almost all of the dogs with diabetes and 50–70 per cent of the cats have type I. There is no complete recovery from diabetes, but it can be successfully controlled so that your pet can have a good quality of life.
Diabetes mellitus is caused by an absolute or relative lack of the hormone insulin, which controls the blood glucose level. Insulin deficiency prevents your pet from converting sugar (glucose) in its diet into energy. As a consequence, there is more glucose circulating in the blood and more sugar excreted in the urine of your pet. DM is more common in female dogs and male cats.
Genetic susceptibility, certain infections, pancreatitis, pre-existing Cushing’s disease, immune-mediated destruction of the beta cells in the pancreas of dogs, amyloidosis in cats and the use of certain drugs are the main causes of DM. Obesity is a common cause of type II DM in bitches and cats, and entire female dogs are more at risk than spayed ones.
In the early stages of the disease, your pet will appear to be drinking much more than normal and urinating a lot more. It will also lose weight, despite eating a lot – it may be ravenous and constantly harass you for food. Recurrent cystitis, sweet-smelling ketotic breath and cataracts may be seen in later stages.
Ketoacidotic DM is a real emergency and your pet should be rushed to the vet. When this happens, apart from the above symptoms, your pet will also be very lethargic, weak and tired, and will stop eating. Poor haircoat, dandruff, an unkempt or shabby appearance and muscle wasting may also be seen in some pets.
If your pet is drinking or urinating more than usual then it is always best to get him or her checked by the vet. DM needs to be differentiated from other diseases that may cause your pet to show these same symptoms. Your vet may request a urine sample and test for glucose in it with a dipstick or he or she may perform a blood test to check glucose levels. Blood tests may also be needed to rule out kidney and liver disease at the same time. If your pet has a persistent fasting blood glucose greater than 10mmol/l, it confirms DM.
Injecting your pet with insulin 1–2 times daily and regularly is necessary to treat DM. If your pet has ketoacidotic diabetes, it may be necessary to admit them and treat them as an inpatient first as this is a serious problem. If your pet is well in itself, and the vet is sure that the diagnosis is uncomplicated diabetes, they will start giving subcutaneous insulin injections and teach you how to administer them yourself using special insulin syringes with needles.
You may be required to visit your vet once or twice a day for injections, depending on the protocol selected, until your pet is stabilized and the vet is happy with your injection technique. Most vets will provide you with a DVD and leaflets explaining the procedure. It is important that you strictly follow the vet’s advice and try your best to inject insulin at the same time every day.
Regulating your pet’s diet is a very important part of the treatment. A diet based on high-quality complex carbohydrates (lentils, whole grains, broccoli, spinach, etc) with no simple sugars, restricted fat and moderate protein levels is necessary to prevent wide fluctuations of blood glucose. See Chapter 1: Food Is Medicine to learn about the hidden sugars in commercial pet foods.
Regular moderate exercise is beneficial, but you must not overly exert your dog. Diabetic coma, hypoglycaemic shock and ketosis are possible complications of DM so you will need to monitor your pet carefully and may be required to obtain a urine sample and check it every morning. Sometimes you may even be advised to check your pet’s blood glucose regularly with a glucometer. Insulin must always be stored in the refrigerator and it is important to check the expiry date on it.
Using the right disposable syringes is vital as this can vary with the type of insulin. Always contact your vet immediately if your pet’s symptoms are worse or it is losing weight. It is necessary to keep some source of concentrated glucose or sugar, like honey or sugar lumps, in case your pet goes wobbly or too quiet, as this may be due to low blood sugar – a result of too much insulin. In order for your pet to be a stable and happy diabetic, it is important to avoid making drastic changes to his or her environment, food or exercise regime.
When faeces are passed from the bowels frequently and in liquid form, the condition is known as diarrhoea. It is a very common condition in both dogs and cats. If the diarrhoea started abruptly it is known as acute diarrhoea. If a change in faecal frequency and consistency, and the volume of faeces, has persisted for three weeks, or it seems to be happening intermittently, it is known as chronic diarrhoea.
The intestines are responsible for secretion, motility and absorption, so an imbalance of any of these functions can result in diarrhoea. Acute diarrhoea is common in puppies and kittens although potentially any animal can suffer with it. This is because young animals tend to eat anything, whether food or foreign bodies, and are also more prone to worms and infectious diseases.
Dietary indiscretion is the most common cause of acute diarrhoea. Excess food, spoiled food, garbage, dietary intolerance or even sudden food change can all cause sudden diarrhoea. See the table below for common causes of acute and chronic diarrhoea.
Inflammatory bowel disease; malabsorption and maldigestion.
Intestinal obstruction and foreign bodies, intussusceptions, haemorrhagic gastroenteritis.
In cats: FeLV, FIV and FIP viruses. In dogs: clostridium, giardiasis, salmonella, campylobacter, etc.
Infectious – viruses such as parvovirus in dogs and feline pan leukopaenia in cats; canine distemper. Bacteria, worms, etc.
Foreign bodies causing partial obstructions.
Drugs – antibiotics, NSAIDs, steroids, anticancer and de-worming drugs.
Exocrine pancreatic insufficiency and hepatobiliary disease.
Poisons and toxins – lawn and garden feed, insecticides, weedicides, etc.
Hyperthyroidism in cats.
These vary, based on the underlying cause. In acute, mild diarrhoea, apart from frequent liquid stools, the pet is healthy and well. If the diarrhoea persists for days, especially in young animals, they can quickly become dehydrated and listless. The symptoms therefore vary with the severity of the disease. Fever, low blood pressure, vomiting, abdominal pain or discomfort and weakness may also be present.
A complete physical examination by the veterinarian, a faecal sample examination and an assessment of the hydration status is necessary. If there is any suspicion of a foreign body or an obstruction, X-rays of the abdomen and/or ultrasound exam may become essential. Endoscopy and biopsies may be required in cases of chronic diarrhoea.
The majority of dogs and cats with mild diarrhoea only (without vomiting) need minimal treatment and can get better with fasting them for 12–24 hours, and then feeding them a bland diet like chicken and boiled rice or some prescription diets for gastrointestinal health.
In some others, where the diarrhoea is causing discomfort or is messy, anti-diarrhoeal drugs that modify motility, probiotics and intestinal protectants may be prescribed. Antibiotics are not usually necessary in mild cases. Intravenous fluid therapy is warranted if your pet is dehydrated and also vomiting. In cases of parvovirus, where there is bloody diarrhoea, isolation and intensive care will be necessary.
Anti-emetics to control vomiting and supportive treatment will be given on an inpatient basis. If the cause is worms, anthelminthics or de-wormers are indicated. Bacterial infections will need an appropriate antibiotic course. Special diets will be necessary for malabsorption, exocrine pancreatic insufficiency (EPI) and pancreatitis. If your pet has eaten a foreign body then surgery will need to be performed to remove it, or any other obstruction. Chemotherapy may be advised if there is evidence of cancer.
Monitoring your puppy or kitten carefully and preventing them from scavenging or eating foreign bodies is the responsibility of every pet guardian. Similarly, feeding them good-quality food in the right amounts and identifying intolerances is also key to preventing gastrointestinal upsets.
Elizabeth avoids offering any infused oils to pets that have diarrhoea. Once the diarrhoea has abated offer separately either mint- or rosehip-infused sunflower oil for dogs, and for cats try calendula- or catnip-infused sunflower oil on a self-selection basis.
Otitis externa is the inflammation of the external ear canal above the ear drum, or tympanic membrane, and is very commonly seen in practice. Otitis media (inflammation of the middle ear) and otitis interna (inflammation of the inner ear) are also seen but not as frequently. It is important to remember that most of the time, otitis is actually a secondary symptom of some other underlying disease.
Ear problems are more common in dog breeds that have hairy ear canals, pendulous ears or stenotic (narrow) ear canals. Bacteria, yeasts and ear mites can all cause ear infections. Food allergy, atopy (an inherited tendency to be hyperallergic or more prone to allergies) and hypothyroidism may also cause otitis. Frequent swimming can also increase the frequency of ear infections. Grass seeds, other plant materials or foreign bodies can be an important cause of otitis. Finally, polyps, cancerous growths and other obstructions in the ear canal contribute to otitis.
Head shaking and smelly or malodorous ears are common symptoms of ear disease. Cats and dogs can scratch their ears excessively and sometimes howl in pain after doing so. In severe cases, bloody discharge, redness and aural haematomas may be present. Head tilt (holding the head tilted to one side) is seen if there is vestibular syndrome (a balance mechanism disturbance) and middle ear involvement. Severe cases may also be lethargic and vomit.
It is very important to have your pet’s ear examined by a vet before randomly squirting ear drops, in case there is a foreign body or a cancerous growth inside it. Using an otoscope or an otoendoscope, your vet will make a diagnosis. Taking an ear swab for culture and conducting a microscopic examination of the discharge for mites and yeast may also be needed. If otitis media is suspected X-rays may be warranted.
After arriving at a diagnosis your vet will prescribe ear drops, which are usually a combination of different antibiotics and steroids. If your pet has very hairy ear canals, it may be necessary for him to be sedated to pluck the hair and also flush the debris from the ear canals. This is also important from a diagnostic point of view as it can be impossible to visualize the eardrum if the ear canal is occluded by hair and wax.
If a head tilt and vestibular syndrome is present, oral steroids and antibiotics are necessary. Treating the underlying cause, whether it is an allergy or hypothyroidism, for example, is crucial to prevent recurrent otitis. If the opening to the ear canal or the canal itself is obstructed, or stenosed (narrowed) then surgery to open up the ear canal or to remove the obstruction will be advised.
Aural haematoma is a blood-filled swelling which forms in the flap of the ear. If your pet has been scratching or shaking its head too vigorously, it can end up damaging small blood vessels in the ear flap, which bleed into the flap. The swelling can occupy some or the whole of the ear flap and may need surgery to correct it. Your vet may attempt to drain the swelling while your dog is conscious (if you have a very compliant, cooperative pet), but this is not always a success and the haematoma tends to recur.
It is important to inspect and clean out your pets’ ears regularly – at least weekly. Using a good-quality ear cleanser from a vet or a herbal preparation is ideal.
For a small aural haematoma, to try to prevent further haemorrhage, and for the elderly dog that may not be a good candidate for surgical correction of a haematoma, Elizabeth recommends gently massaging the outside of the ear with the aloe vera basic gel with a clove of garlic crushed into it (see Aloe vera basic gel) every day for a week. It relieves the tenderness. She also recommends the garlic oil remedy for prevention.
The term ‘epilepsy’ means recurrent seizures or fits. In general, if there is no identifiable cause for a seizural disorder then it is called epilepsy. Dogs, especially males, are more likely to suffer with classic or idiopathic epilepsy than cats.
Primary idiopathic epilepsy is a result of functional disturbances in a brain that is structurally normal, and therefore has no obvious cause, except maybe a hereditary predisposition. The exact mechanism of this dysfunction is still very much unknown, but is thought to be biochemical. True epilepsy is most common in dogs when they are aged between six months and five years. It is rare and very poorly documented in the cat.
Seizures or convulsions most commonly occur while the dog is asleep or resting, and therefore is reported often at night or in the early morning hours. Your pet may become stiff, salivate or drool profusely, chomp its jaw or clamp it shut. Some dogs urinate, defecate, howl and may paddle with all four limbs. After the seizure, the vast majority of animals may become confused and disorientated, drink lots of water and wander or pace aimlessly.
Most pets are presented at the practice after the seizure has stopped, unless the seizure is very prolonged. Epilepsy is diagnosed after ruling out other causes of seizures, like poisoning, tumours, infection, fever and brain damage. The age at which the seizures start and their type and frequency provide important clues to a diagnosis of primary epilepsy. Pets suddenly developing seizures in old age may have metabolic disease or some brain lesion.
MRI and CT scans are necessary to confirm a suspicion of actual brain disease, like tumours or infections. Blood tests are necessary to ensure that liver function is good, so that medication can be safely commenced.
No treatment is required if the seizure is less than two minutes in duration and is not recurring. Dogs that have a cluster of seizures (two or more in 24 hours) and those that have seizures at regular intervals of one to four weeks have to be medicated. The drug of choice is usually Phenobarbital, but sometimes diazepam may be used by your vet in combination. There are newer drugs too, and your vet may decide on them after conferring with you.
If your dog has recurrent seizures and does not become fully conscious between them, or has seizures lasting more than five minutes, this is an emergency called status epilepticus. It can be life-threatening and needs immediate veterinary medical treatment. Your pet will have to be admitted and given intravenous medication and IV fluids, and be monitored carefully until stabilized.
It would be useful to video your pet while it is having a seizure, but that may not always be possible as a seizure can be a very distressing experience to your pet and to most pet guardians. It is also important to maintain a record of the number of seizures and their duration, as this can help with the diagnosis. Remember that your epileptic pet is unlikely to die of a seizure, but if it develops status epilepticus, it is a life-threatening emergency.
Also make sure your pet cannot injure himself on furniture or objects while he is having a fit. Most pets on anti-epileptic drugs tend to become overweight so this must be monitored. You should be aware of the side effects of the medications your pet is on and inform your vet if they are present. Regular blood testing to ensure there is no drug toxicity and no liver damage is necessary as your pet will most likely be on medication for life. Acupressure and homeopathy may help. Ask your holistic vet.
Healing & herbs
Animal healing is a fantastic complement to veterinary care and can be safely given by you to your pet. Do not attempt contact healing while your pet is having a seizure. Concentrate on keeping calm and offering distant healing until the seizure has stopped. See Chapter 5: How to Give Healing to Your Pet for instructions.
Any eye condition can be potentially serious and should therefore be checked by your veterinary surgeon. Immediate treatment is essential to prevent permanent damage to the eye, and blindness in many cases. This is mainly because more or less all eye conditions, from simple to serious, have the same signs and can look alike. There are more than 50 conditions that can affect the eye and the eyelids, but the most commonly seen eye conditions are conjunctivitis, corneal ulcers in certain breeds, foreign bodies in the eyes and cataracts. Blindness is rare but can be sudden.
Conjuctivitis is inflammation of the conjunctiva, which is the membrane lining the inner side of the eyelids and the external surface of the eyeball or globe. The third eyelid is also included. Allergy, infections and dry eye can all cause conjunctivitis. Dry eye, known as keratoconjunctivitis sicca (KCS), is a deficiency of tear film resulting in drying of the cornea and the conjunctiva. This is more common in certain dog breeds, such as the Cocker Spaniel, West Highland White Terrier, Shih Tzu and Lhasa Apso.
Corneal ulcers are basically craters on the surface of the cornea and can be a result of trauma from a foreign object or self-trauma by scratching at the eye, or even from grass seeds. In certain breeds like Boxers, and other breeds that have a bulbous or protruding eyeball, these ulcers are more common. Cataracts can be secondary to diabetes but are most often a sign of the ageing lens and occur in older dogs.
The most commonly seen symptom in most of the above eye conditions (except cataract) is a weepy eye with clear or greenish or yellowish discharge. Your pet may rub its eye, keep it partially or completely shut and avoid bright lights. Redness of the eye or bloody eye may also be seen. Sometimes the eye looks hazy or swollen. A tendency to bump into things is seen if your pet is partially or fully blind or has cataracts.
After taking a thorough history from you and performing a general clinical examination, your vet will then perform a complete ophthalmic examination using a opthalmoscope. A fluorescein stain test to rule out ulcers and a schirmer tear test to rule out dry eye may also be performed.
If your vet suspects an increase in intraocular pressure, he or she will check this with a tono pen. Lash abnormalities such as ingrowing eyelashes will be ruled out and your vet will also check for any foreign bodies in the corners of your pet’s eye and under the third eyelid. If the situation is more complicated, your pet may be referred to an eye vet for further investigation.
In simple, straightforward bacterial or allergic conjunctivitis, your vet will usually just dispense some antibiotic or steroid eye ointments or drops. If your pet has an ulcer that is large or non-responsive to topical treatment, then surgical procedures may be required. If your vet suspects a blocked nasolachrimal duct, then sedation and flushing of the ducts may be necessary. I have had to enucleate, or remove, a dog’s eye on many occasions because of eyeball rupture and proptosis (eye pops out in front of the eyelids).
Cataracts are irreversible, and to improve your pet’s quality of life, surgery may be necessary – especially if he or she is young. It must be remembered though that cataract surgery in dogs is undertaken by veterinary eye specialists only and can be expensive. Once diagnosed, they are better performed sooner rather than later. The procedure in dogs is more complicated than in humans as there is usually a lens-induced uveitis (an inflammatory response to rupture or injury to the lens) that decreases the success rate of cataract surgery.
Corneal ulcers will not heal if steroid eye drops are used, so it is dangerous to use any random leftover eye drops in your pet’s eye without getting a diagnosis from your vet. Bathing your pet’s eye gently with clean water can help remove the sticky discharge.
Some dogs I see in practice have hair covering their eyes. This can cause eye infections, tear staining and ulcers. Cleaning your pet’s eyes regularly, and keeping the hair from falling into them, could be the single most useful thing you could do to help your pet. Please get your groomer to trim hair on the head, or if your pet will allow it, tie it up with a little bobble. Hair on the face can even make some dogs fearful and photophobic. The cornea is very slow to heal so it is best to prevent corneal damage. It can take weeks and even months for corneal ulcers to heal.
In certain brachycephalic breeds where the eye is quite protruding – Pug, Shih Tzu, Bulldog, etc.– trauma can easily dislodge the eye as the eye sockets are quite shallow. This is an emergency and your pet’s eye can be saved only if you get them to the vet quickly. Delay will reduce the chances of saving the eye and your pet’s vision.
There are certain infectious diseases that can spread between cats but do not infect dogs. Feline immunodeficiency virus (FIV), feline leukemia virus (FeLV), feline infectious anemia (FIA) and feline infectious peritonitis (FIP) are still seen in practice whereas, due to regular vaccinations, feline infectious enteritis and feline influenza, or cat flu, are rare now, especially in the UK. A brief knowledge of these diseases is important for any cat owner and the table below will be useful for this purpose.
* FIV belongs to the same group as the human AIDS virus and is usually referred to as Cat AIDS. However, there is no evidence that people can be infected by cats with FIV. Because FIV and FeLV are spread by cat bites, your vet may advise you to keep your cat indoors to prevent spread.
Elizabeth recommends offering catnip- and nettle-infused sunflower oil on a self-selection basis (see Herb-infused sunflower oil).
Fleas are common ectoparasites and can be very annoying to you and your pets. They are dark brown in colour and have droppings resembling charcoal dust that can be seen when you part your pet’s fur. The life cycle of a flea is complex and there are four life stages – egg, larva, pupa and adult. If the environmental temperature and humidity levels are optimal the life cycle may last for weeks, but if not it can be less than a week.
Ctenocephalides canis (dog flea) and Ctenocephalides felis (cat flea) are the common fleas, although hedgehog and human fleas may also be the cause. Fleas are responsible for the transmission of tapeworm (Dipylidium caninum) and some other infectious diseases. Seasonally warm climates or places where the weather is warm and humid all year round are ideal for fleas. Because of modern central heating, fleas are able to survive all year round, but they tend to peak in both spring and autumn.
Understanding the flea life cycle is crucial to the prevention of recurrent infestations. The life cycle begins when the adult flea sucks blood from a host like your pet and lays eggs. Each single female adult flea can lay up to 50 eggs a day. The eggs remain in your home and hatch when the temperature is warm and humid, so modern central heating is ideal for them. In cold and dry temperatures, they take longer to hatch.
Blind larvae emerge next and make up to 60 per cent of the flea population in the environment. They eat flea dirt (pre-digested blood) and when conditions become conducive, will spin a cocoon and form pupae. These pupae have a sticky outer coating so they can hide deep in bedding and carpets and cannot be cleaned out by vacuuming or sweeping. Only when a pupa or cocoon senses a host nearby will it hatch into a flea. The triggers are the vibrations of your pet walking, people moving about, a rise in CO2 levels and body heat. The adult flea then starts the cycle again, as the following diagram shows:
Your pet may bite or scratch itself compulsively on various parts of its body, especially on its rump or back area. Some tend to demonstrate corncob nibbling or chewing. Excessive licking and skin infections may also suggest fleas. If your pet is allergic to flea saliva, then just one fleabite is needed to cause severe flea allergic dermatitis.
Flea saliva contains a histamine-like compound that irritates skin. No flea needs to be present alive on your pet to cause flea allergic dermatitis (FAD). Young puppies and kittens may become pale, ill and debilitated if the flea infestation is severe because, if a large number of fleas suck blood, the animal can become anaemic.
Flea dirt on the back and neck, hair loss from chewing and actual fleas when the fur is combed are all diagnostic of a flea infestation. As fleas are the intermediate hosts for both the dog and cat tapeworm, if your pet’s faeces has tapeworms it suggests a flea infestation.
You can also try the wet paper test: take a wet piece of filter paper and gently rub it along the flea dirt on the back of your pet. If it is flea dirt, the black flecks will turn red – confirming fleas. Blood tests may be required to check the red blood cell count and haemoglobin levels if your pet becomes anaemic due to a severe flea infestation. If your dog suffers from allergic dermatitis/atopy, intradermal or antibody testing may be warranted to confirm flea allergy.
Your vet will treat flea allergic dermatitis with steroids or antihistamines and washes and may even have to prescribe antibiotics if there is a secondary bacterial infection on top of the FAD. You will then be advised to put proper flea control in place. There are a wide variety of flea treatments on the market, but the safest and least toxic ones are those supplied by your veterinarian.
The flea treatment must be fast-acting so the existing fleas on your pet are killed quickly. It should also have a long-lasting effect, to prevent re-infestation. Adult fleas need to be killed off before they lay eggs. Some flea treatments can also worm and kill mites but may not work on ticks. It is important to discuss your pet’s lifestyle with your vet so that the right product can be used. Spot-on preparations are very popular as most pets do not like tablet preparations. However, it is still a matter of choice because some pets can have a localized reaction to the spot-on or lick it off.
Preventing a flea problem will save your pet the discomfort and you the hassle of spraying your whole house with chemicals. Both fleas on your pet and fleas in the environment have to be controlled in order to effectively treat a flea infestation. Environmental treatment is as important as treating your pet and is compulsory, especially if the fleas are biting you and your family. You will need to identify potential areas in your house that could be infested.
The eggs could have fallen in the rest areas of your house, like your living room or bedroom, or on garden furniture. As fleas survive in centrally heated houses, it is important to keep the flea treatment going all year round. There are some very good chemical preparations that you can use yourself, but if the infestation is bad then professional exterminators may need to be called in. Dips, shampoos and powders are now outdated, cause dry skin, and may contain organophospates, which should be avoided, especially in cats.
Elizabeth recommends feeding the Garlic K9 biscuits for dogs and the Feline Chive treats for cats once or twice a week, to ward off fleas. Feeding a tiny amount of yeast extract at the end of a teaspoon is recommended during peak flea season as it seems to deter some insects.
Overall, approximately 10 per cent of dogs suffer with some form of heart disease. It can be present at birth (congenital) or can be acquired as an adult. Acquired heart disease is much more common than congenital. Congestive heart failure (CHF) is the most common manifestation of heart disease in dogs and cats and can be left or right sided.
Left-sided CHF affects the left side of the heart, and the most common cause for it is mitral valve disease (MVD). This is more common in older and smaller breeds – the Cavalier King Charles Spaniel is predisposed to MVD. The mitral valve of the heart becomes degenerate and nodular, preventing the valve from shutting fully so blood squirts backwards through the gap with every heartbeat, producing a ‘heart murmur’.
Dilated cardiomyopathy (DCM) is the second-most common heart disease and tends to occur in larger dog breeds, especially males. Several large breeds, including Great Dane, Dobermann, Boxer, Golden Retriever and Newfoundland, are predisposed to DCM. In DCM, the major pumping muscle of the heart (the left ventricle) becomes weak and struggles to pump blood. As a result the left ventricle cannot empty fully and becomes dilated and stretched.
In cats, hypertrophic cardiomyopathy (HCM) is the most common acquired heart disease and can cause sudden death. Any cat can suffer from it, but it is more common in middle-aged to older castrated male cats. A blood clot or emboli – arterial thromboembolism – is a complication seen in 50 per cent of cats that have HCM. Taurine deficiency can cause heart disease in cats so if your cat is on a home-cooked diet, do supplement it with taurine (see Chapter 1: Food Is Medicine).
Right-sided CHF affects the right side of the heart and may be caused by tricuspid valve disease, DCM and pericardial effusion (fluid around the heart), which may be due to a pericardial bleed. Pericardial bleeds can occur due to a cancerous growth of the heart or pericarditis (inflammation of the pericardium – the membrane surrounding the heart).
Congenital heart disease can be hereditary and there are certain breeds that are more prone to certain heart defects. There is also a hereditary element to some adult heart diseases like DCM. Heartworm disease is caused by a parasite called Dirofilaria immitis, which is spread by mosquito bites. This is uncommon in the UK, but prevalent in other countries.
Most dogs with heart disease present with some common signs. Coughing, laboured breathing or panting excessively, reluctance to exercise and sometimes abdominal enlargement. Some dogs may also go off their food and lose weight if the loss of appetite goes undetected. They might become lethargic and tire easily.
Cats with HCM have similar signs. Although they tend not to cough, their breathing is worse. Both dogs and cats with cardiac disease may have sudden spasms and collapse, and then recover completely within minutes. These episodes are known as syncope. Cats with thromboembolism may collapse and be unable to use or drag their back legs. They are paralyzed in their back end and have cold feet. These cats will also be in a lot of pain and tend to vocalize. This is an emergency and you must take your cat to a vet immediately.
Your vet will take into account several factors, like your pet’s species, age, sex and breed. After obtaining a thorough history of the symptoms, he or she will check your pet’s heart with a stethoscope to listen to murmurs, heart sounds, heart rate, etc. Your pet’s respiratory rate is an important clue, and the colour of their tongue and gums will also provide valuable information.
After a full clinical examination, your pet may need blood tests, X-rays, ECG and/or echocardiography in order to get a concrete diagnosis. Other causes of cough, like bronchitis, kennel cough and lung problems will also need to be ruled out. This will usually be done step by step, to get a full picture.
The table below shows the parameters for normal heart and respiratory rates for dogs and cats. By counting the number of times your pet’s chest or abdomen rises up and down in one minute, you can count their respiratory rate. By sliding your hand along the chest between the front legs, towards centre-left, you can feel your pet’s heart and can count their heart rate.
Normal heart rate and respiratory rate
140–240 beats per minute
65–150 beats per minute
Treatment of cardiac disease will depend on how critical or stable your pet is when diagnosed. If your pet is critical, he or she will have to be admitted for cage rest and oxygenation. They may need to be sedated for X-rays if they are distressed, and intravenous medication may also be given.
If your pet is stable and a proper diagnosis of the heart condition has been made, he or she will be started on two to three types of medication, such as diuretics (water tablets), ACE inhibitors to reduce water and sodium retention, and other drugs. In DCM cases, special drugs to enhance the ability of the heart to contract better will be prescribed.
Antiarrythmic drugs like digoxin, and blood pressure-lowering drugs may also be necessary. In cats with HCM, calcium channel blockers are the first choice of treatment. The main aim of veterinary treatment with drugs is to improve the quality of your pet’s life by alleviating the clinical symptoms of heart disease, and to prolong their life. Heartworm disease can be treated with some monthly injections but sometimes if there are too many adult worms, surgical removal may be necessary, which is risky.
Rest and regulated exercise are key to helping your pet’s heart cope with heart disease. Excessive exercise is dangerous and must be avoided. Obesity is a well-known cause of increased cardiac workload, especially if your pet is running or playing, etc., so feeding your animal the right food and in the right amount to enable weight loss is vital. It is very important that you feed your pet a low-sodium diet. High-salt diets exacerbate fluid retention and that is a problem in heart failure. Salty treats should also be stopped.
Elizabeth recommends home-prepared natural diets with plenty of vegetables, so please refer to the superfoods shopping checklist. Many processed pet foods have a high salt and fat content so they are best avoided. Cats need taurine for a healthy heart, and that is naturally available in fresh meat. Avoid commercial cat foods, which have synthetic taurine instead.
Animal healing is a fantastic complement to veterinary care and can be safely given by you to your pet. See Chapter 5: How to Give Healing to Your Pet for instructions. Holistically speaking, heart problems, especially acquired disease, may be a result of energy imbalances in the body so stimulating acupoints HT 7, located just above the wrist on the outside of the forelimbs, and points BL13–15, on either side of the spine between the shoulder blades, can be beneficial. See Chapter 6: Fingers and Thumbs.
Hip dysplasia is predominantly a common inherited orthopaedic disorder of large and giant dog breeds, but it can also affect a wide range of other mammals. The hallmark of this condition is the abnormal formation of the hip socket and the abnormal development of the structures that make up the hip joint, leading to subsequent joint deformity.
In its severe form hip dysplasia causes crippling lameness and painful osteoarthritis of the hip joints. It is therefore one of the most studied veterinary conditions in dogs and probably the single most common cause of canine osteoarthritis affecting the hip joint. See Arthritis above.
Genetic factor – hip dysplasia is primarily a hereditary condition so puppies of parents who had the disorder are more likely to inherit it. However, because it is a polygenic trait, it can skip generations; also, some puppies in the same litter may not inherit it.
Environmental factors – over-nutrition, leading to rapid growth and obesity; too much exercise too young, like jogging with a pup under one year of age; and over-exertion of the hip joint and injury or ligament tear at a young age can all contribute to the development of hip dysplasia. The debate continues as to what degree the problem is inherited and to what extent environmental, man-made influences contribute to this condition.
Breed predilection – large and giant breeds, such as Newfoundland, Mastiff, German Shepherd Dog, Labrador and Golden Retriever, Rottweiler and large hounds are over-represented. Some small breeds, like Pug, Bassett Hound and Bulldog, can also suffer from this condition.
Normal hip vs dysplasic hip anatomy
In a normal hip joint, the ball-shaped femoral head is supposed to fit snugly into the socket of the pelvic acetabulum or socket. In dogs with hip dysplasia, the normally tight-fitting hip joint is much looser, allowing the femoral head to ‘rattle around’ in the acetabular fossa.
The reason for the laxity, or ‘loose fit’, could be a shallow hip socket (acetabulum) or a misshapen femoral head (caput) or a combination of both. In either case, there is abnormal wear and tear of the joint that results in the pathology observed in hip dysplasia. The constant rubbing leads to degenerative changes and ultimately, to osteoarthritis.
Puppies and young dogs – if there is major hip dysplasia, pups can show signs from as early as five to 10 months of age. They bunny hop like a rabbit, rest quickly after exercise, and after play they hesitate to get up quickly and instead sit on their haunches with one or both legs splayed outwards like a frog. They also avoid negotiating stairs or slopes. Some of them avoid jumping and carry their back legs slightly forward so as to rely more on their front legs.
Adult dogs – dogs with very mild dysplasia may not show any symptoms, except slight lameness after over-exertion or stiffness first thing in the morning. Even this limping may not start till they are four to five years old. Only dogs that have severe hip dysplasia will show pain or limited mobility prior to maturity.
Severely dysplastic dogs exhibit symptoms ranging from stiffness or soreness after rising from rest, reluctance to exercise, bunny-hopping gait (legs move together at run, rather than swinging alternately), swaying or wobbly gait, lameness, pain, reluctance to climb stairs or jump up into cars, refusal to stand on hind legs, and sudden dislocation of the hip joint. Some dogs cry or wince when the hips are touched. In advanced cases, there is atrophy of the muscles adjoining the hip and thigh areas.
As different dogs have different body weights, pain thresholds, lifestyles and exercise routines, there is a lot of variation in symptoms. Some dogs with the same extent of hip dysplasia start showing signs early while others may be asymptomatic. Each dog is therefore unique in its capacity to adapt and live with hip dysplasia.
When a puppy or an adult dog is presented to a veterinarian with the above symptoms, based on the history, signalment, physical examination and palpation, he or she will suspect a hip problem. A confirmed diagnosis of hip dysplasia would require X-rays of the hip taken in a certain position, with the dog lying on his/her back and the hips positioned in a specific way. Sedation is compulsory to obtain a good X-ray. Hip scoring may be carried out to evaluate the extent of hip dysplasia and to provide guidance regarding use for breeding – this is mainly owing to hip dysplasia being an inherited disorder.
There is no complete cure for hip dysplasia but it is possible to alleviate the symptoms and in most cases provide a good quality of life for your dog by using a combination of the following:
Enforced rest or exercise control – rest is crucial, especially when there are acute episodes like dislocations, and also when there is significant arthritis. By resting, there will be a reduction in the wear and tear of the hips.
Mild analgesics or painkillers – hip dysplasia can go from being non-painful to being very painful depending on the extent of arthritis in the joint, so most dogs will need some painkillers, such as tramadol, codeine, etc.
Anti-inflammatory drugs – as in osteoarthritis of any joint, your vet will most probably prescribe NSAIDs (non-steroidal anti-inflammatory drugs), which double up as painkillers as well as reducing inflammation. Meloxicam, carprofen and robenacoxib are a few popular ones. See Chapter 8: Which Drugs and Why for side effects and uses of NSAIDs.
Surgery is usually the last choice and is opted for only when medications fail to provide an adequate quality of life. There are two main types of surgery – those that aim to modify or repair the abnormal hip joint and those that replace the hip completely:
Triple pelvic osteotomy is exclusively performed in young animals aged between five months and one year. It can only be performed by a specialist veterinary orthopaedic surgeon and it is vital that there should be no evidence of any arthritis at the time of surgery. The procedure involves rotating the pelvic acetabulum (socket) in such a way that it is better aligned with the femoral head and enables the head to sit snugly in the socket.
Femoral head excision is considered a salvage procedure and is performed in dogs with significant pain and irreversible arthritis. The surgery involves the removal of the femoral head. As a consequence scar tissue fills the defect between the femur and the acetabulum, which forms a false joint and gives back 70 per cent hip function without any pain.
It is a relatively inexpensive procedure and can be performed by an experienced vet. It works best in dogs that weigh less than 20kg (45lb). I have performed several of these operations and found it quite beneficial; most dogs do quite well on it.
Total hip replacement involves removing both the ball and the socket and replacing them with implants. It is very similar to the operation in humans. The success rate is 95 per cent and optimal joint function is reinstated. It is currently the best surgical procedure recommended to correct hip dyplasia in large-breed dogs and needs to be performed by a specialist orthopaedic veterinary surgeon.
More research is being conducted, and other surgical procedures – like DARthroplasty, pubic symphysiodesis and capsular neurectomy – are also being explored. BioScaffold implant procedures are also being tried out. Surgery for hip dyplasia should not be taken lightly and various other options should be discussed with your vet before deciding.
Weight control is definitely the single most important thing you can do to help your dysplastic dog. Reducing weight can really make a phenomenal difference to the progression of hip dyplasia to the severely arthritic form. Low-calorie prescription diets are usually recommended by vets.
Overweight dogs may be advised to go onto obesity management and other weight-loss diets. If you are committed to cooking for your dog, you can make balanced recipes or use raw food, low-carb and low-fat diets and add joint supplements (see Chapter 1: Food Is Medicine).
Both conventional and holistic vets recommend nutritional supplements that help rebuild cartilage and/or promote joint surface lubrication. Supplements containing chondroitin sulphate, glucosamine, glycoflex and collagen are all very effective, in both early and advanced cases.
Dog hip braces, special harnesses, orthoses and other mobility aids are being marketed. These can be very useful where hip dysplasia has caused severe muscle wastage. Pressure-reducing ortho beds, foam bedding, ramps, stairs and car hoists can really help these dogs move from place to place and alleviate their pain.
Regular moderate exercise is the key to keeping your dog mobile, but at the same time ensuring they are not over exercised. Large-breed pups under 18 months of age must not be pushed to walk too far or exercised for too long.
Healing & herbs
Animal healing is a fantastic complement to veterinary care and can be safely given by you to your pet. Read Chapter 5: How to Give Healing to Your Pet for instructions. Healing per se can therefore be an excellent tool in pain management when used with other appropriate healing modalities. See Musculoskeletal section below for herbs, and for the home-cooked food recipes that can really help.
Acupressure – make a three-finger tripod with the thumb, index and middle finger, and position them over the hip bone on three acupressure points – BL 54, GB 29 and GB 30 – pressing for 30 seconds at a time. This has been found to be immensely beneficial. I have used acupressure on my own dog, who has hip dysplasia, and others have found it quite helpful. See Chapter 6: Fingers and Thumbs, for image and further details.
Giving dysplastic dogs a daily massage relaxes the tight muscles and relieves pain by increasing circulation. The aim is to massage the muscles, not the bones. A heat massage using a hot water bottle/heating pad wrapped in a thick towel applied to achy hips for 10 minutes once or twice a day helps.
Hydro- and physiotherapy can also be very beneficial. Hip hammocks have been found to be affective in aiding dogs suffering from hip dyplasia to regain their mobility. Several companies are now designing orthotic and prosthetic solutions to help stiff dogs get moving. Ask your vet for details.
Hip dysplasia is a complex orthopaedic problem affecting the hips of primarily large to giant-breed dogs. It is caused by a combination of both genetic and environmental influences. The abnormal development of the hip joint leads to hip laxity and gradually results in osteoarthritis of the coxo-femoral joint.
The condition has a major welfare impact on the lives of the dogs who suffer from it. By following a good dietary and therapeutic plan, it is possible to provide a good quality of life for dogs with hip dysplasia. Careful, selective, sensible breeding is the only way to prevent hip dysplasia in the future.
The kidneys are responsible for the removal of waste products and excess water from the bloodstream in the form of urine. Kidney disease can be acute (sudden) or chronic (over time). In the acute form, referred to as acute kidney injury (AKI), there is an abrupt drop in kidney function but there is a chance of recovery. In chronic renal failure (CRF), there is a progressive loss of kidney function in stages, and if left undiagnosed and untreated, it is not possible to repair the kidney.
AKI can be caused by accidents in which there may be trauma to the kidneys; by poisoning with poisons such as lilies, grapes or antifreeze; by infections such as leptospirosis; by acute pancreatitis; by the use of non-steroidal anti-inflammatory drugs; and by renal lymphoma.
Chronic kidney failure may be idiopathic (unknown or spontaneous), or due to ageing, high blood pressure, diabetes mellitus, urinary tract infections, polycystic kidney disease, kidney stones or cancer. There can be many other less common causes too. CRF is more prevalent in cats over nine years of age and dogs who are more than seven years old, but may affect an animal of any age.
Acute kidney injury (AKI) – your pet may suddenly start drinking more, go off its food, develop diarrhoea and vomit. Sometimes the vomit may have pieces of lily if the cause is lily poisoning. Neurological signs like seizures and tremors may be seen in antifreeze (ethylene glycol) poisoning. Halitosis and difficulty urinating may also be present. Dehydration can occur.
Chronic renal failure (CRF) – poor appetite, weight loss, increased urination and thirst, vomiting, uraemic breath or bad breath and blood in the faeces due to gastrointestinal ulceration are some of the symptoms seen. Most of these signs are not seen in the early stages of CRF.
It is not easy to distinguish between acute and chronic renal disease and veterinary attention is a must to get a diagnosis and initiate treatment. Acute renal failure is not as common as the chronic form but is rapidly progressive. In AKI, your pet is most likely to have been fine one day and then really sick the next. This is usually the case if there is exposure to a toxin or a poison.
After taking a full history and examining your pet clinically, the vet will palpate the kidneys to check their size. In general the kidneys are painful and enlarged in AKI but small and shrunken in CRF. Blood tests to check the levels of urea, creatinine and phosphorus are very important.
The vet will examine your pet’s urine under the microscope for crystals and casts, check if his or her urine is dilute or normal and look for the amount of protein being voided. Ultrasound examination, X-rays, both plain and contrast radiography, may be necessary to rule out kidney stones, obstruction, cysts and tumours.
Early recognition is crucial to the successful treatment of AKI so it is important to seek veterinary help sooner rather than later. Specific treatment can be given as antidotes if the poison is known. However, in most cases the cause is unknown, making treatment difficult. Sometimes it is also too late to make the pet vomit or to treat. Antidotes need to be given within three hours. Supportive treatment with intravenous drip, anti-emetics to stop the vomiting, supplying the correct nutrition and providing pain relief in AKI is the mainstay of treatment.
Your pet will have to remain an inpatient until he stops vomiting and is eating. CRF can only be managed but cannot be cured. In CRF, after initial hospitalization your pet can go home on a proper prescription diet. In cats with CRF drugs to treat high blood pressure and ACE inhibitors may also be prescribed and are very effective. ACE inhibitors have been proven to delay the progression of chronic renal insufficiency in cats, provided they are also on a renal diet.
Omega-3 fatty acids and vitamin B are useful nutrients to supplement. Phosphate binders may need to be added to the diet to reduce phosphate intake, which comes from protein; restricting the protein intake is therefore crucial. Also, drugs may be prescribed to reduce the protein lost in your cat’s urine, as this is associated with a shorter life span. It is important to remember that the biggest challenge in pets with CRF is getting them to eat. See feeding tips above, under Appetite Loss.
So a prescription diet designed for kidney disease management, or a home-made one with the following features, is necessary. See also Chapter 1: Food Is Medicine.
Key features of a renal diet:
Must be tasty.
Must be low in phosphorus.
Must contain a low amount of high-quality protein, like eggs, chicken, sardines.
Must be high in omega-3 fatty acids, vitamin B and antioxidants.
Must have moderate salt content.
Must be high energy – with calories from non-protein sources such as brown rice, basmati rice and millet.
The liver is the largest organ in the body, both in animals and humans. It is very important and has many critical functions. Liver disease is a diagnostic challenge to any veterinarian because of the organ’s ability to regenerate, and because 70 per cent of the liver needs to be damaged before signs of liver disease are observed. The good news is that even if severely damaged, the liver can regenerate if given the right nutrition.
Liver disease may be caused by infections such as leptospirosis and infectious canine hepatitis. Both of these are relatively less common nowadays because of regular vaccinations. Liver shunts and fibrosis can be the cause of liver problems in very young animals. Liver cancer is more common in older animals.
Copper-associated liver disease is seen in West Highland White Terriers and Bedlington Terriers. Cocker Spaniels are more predisposed to cirrhosis. Cats are different to dogs with respect to liver functions and suffer more with fatty liver and cholangiohepatitis. Sometimes liver disease is secondary to other diseases like diabetes mellitus, Cushing’s disease and cancer spread from other parts of the body.
Many of the symptoms seen in liver disease are also found in other diseases, making it difficult to diagnose. Most animals stop eating or get picky with their food. They appear tired and may drink and urinate a lot. Vomiting and diarrhoea are quite common in liver disease. Yellow gums and yellow conjunctiva indicate jaundice, which is a symptom of liver disease with or without gall bladder involvement. Ascites or fluid accumulation in the abdomen is a common feature of liver disease.
Not all of these signs will be seen in the same animal. Poor tolerance to drugs and weight loss are seen in advanced liver disease. Seizures, fly catching and even aggression may be seen in animals that have developed hepatoencephalopathy.
After taking a full history and performing a clinical examination of your pet, your vet may want to confirm liver disease by performing some blood tests. Checking liver enzyme levels, to see how much of the liver may be damaged, and performing liver function tests will be necessary. Routine haematology to check the blood count may also be needed.
Ultrasound examination of the liver will enable the vet to rule out tumours and check for liver enlargement, gall bladder problems, etc. Liver biopsy is the only way to get a definitive diagnosis in most patients. X-rays are also part of the investigation, as they can help rule out any obstruction. Faecal and urine samples may also need testing. As the liver is responsible for manufacturing clotting factors, the clotting time of blood may be increased.
Liver disease is very difficult to treat with drugs but it can be managed by diet. If your pet’s liver disease is caused by another disease like diabetes, then treating that should help. Similarly, leptospirosis and other causes should be treated and removed. The aim of treatment is to stimulate regeneration and prevent hepatoencephalopathy from developing. Your pet may need to be admitted and cage rested to improve hepatic circulation, reduce pain and stimulate their appetite.
Steroids may be necessary in certain types of liver disease. A nutritional supplement called S-adenosyl-L-methionine has proven to be very effective due to its anti-inflammatory and cytoprotective properties. Antibiotic therapy may be commenced in hepatitis and cholangiohepatitis. Liver cancer is difficult to treat.
Starvation is the worst thing to do in liver disease, in both cats and dogs, so every attempt must be made by you to get your pet eating. Good-quality protein in the right amount is very important. Soya and egg protein is preferable to meat. A commercial prescription diet for liver disease, supplemented with cottage cheese, is probably the safest option, provided your pet will eat it. See the information on a home-made diet in Chapter 1: Food Is Medicine. Vitamins B and E should be increased in the diet but not A, C or D.
Key features of a liver diet:
Moderate levels of high-quality protein, such as chicken, fish and turkey.
Easily digestible carbohydrates, such as basmati rice.
Increased fibre and zinc levels and B-complex vitamins.
Low in copper.
Moderate salt content.
Elizabeth strongly advocates a home-prepared, natural diet with plenty of vegetables, so please refer to the superfoods shopping checklist. Processed pet foods contain high levels of salt, fat and additives etc., which are highly detrimental to the liver. As the liver is an important organ for detoxification, when it is damaged it is very important to keep the diet simple.
You can also feed soya milk and oat porridge with added milk thistle from time to time. If your pet is having chemo- or radiotherapy, the Charcoal K9/Feline D-Tox biscuits can help with detoxification.
Mange is a common skin problem caused by microscopic parasites called mites. Sarcoptic mange and demodectic mange are seen regularly in practice, but lately, due to modern flea-control products that also control mites, it is probably on the decrease. Most modern spot-on flea-control products can also prevent mite infestation so make sure you buy the right ones.
1. SARCOPTIC MANGE
This is a contagious dermatosis that affects dogs primarily and is seen very rarely in cats. It is caused by the mite Sarcoptes scabiei. When this mite tunnels under the skin and leaves secretions, it triggers an allergic or hypersensitivity reaction that can be intensely itchy.
Tiny papules and greyish-yellow crusting on the ear pinnae, elbows, hocks and on the skin adjacent to them are usually seen in this type of mange. By scratching, your pet may make them worse and also end up losing the hair or fur in these areas.
A diagnosis is made by identifying the mites or their eggs under a microscope. Multiple skin scrapings from the affected areas have to be examined and some other flotation/concentration techniques may be necessary.
Your vet and you
Organophosphates and amitraz treatments will be prescribed to kill the mites. Ivermectin injections may also be given, unless your pet is a Border Collie or Collie cross, or a breed in which this drug is contraindicated. You may also need to treat your home and consult your doctor if you develop lesions – as scabies can be contagious to humans, this is very important. Not just the pet that is affected but those that are in contact with him or her should also be treated.
2. DEMODECTIC MANGE
This is also known as red mange and is quite different from sarcoptic mange because it is not a contagious disease – i.e. it does not spread to others. The mite Demodex canis is present in small numbers on the skin of healthy dogs without causing any symptoms at all, but if an animal is immunosuppressed or is genetically predisposed, these mites increase in numbers and cause clinical disease.
Localized demodicosis is seen in young dogs (three to 11 months). The face and forelimbs are usually affected and you may see focal areas of hair thinning, scaling, alopecia and even some redness. Most of these cases do not need treatment and usually self-cure.
The generalized form is seen in adult dogs and can look quite horrendous, with severe skin lesions. As the mites burrow, the hair follicles rupture and a foreign body reaction to these mites results, causing widespread redness, itching, crusting and even furunculosis, which is a chronic skin disease.
Dogs affected may also look quite miserable, stop eating and even develop a fever. Microscopic examination of deep skin scrapes obtained from affected areas will usually reveal a large number of cigar-shaped mites. If the lesions have become too thickened, then a skin biopsy may be needed.
Once diagnosed treatment involves clipping or shaving the areas, bathing every two weeks with amitraz solution or benzoyl peroxide shampoos. Your pet may be prescribed oral milbemycin or ivermectin injections. Skin scrapes must be performed every two weeks, to check if the mites are decreasing in number, and treatment must be carried on for a good four weeks after a negative skin scrape.
Steroids must not be used, even if your pet is very itchy, because they will cause further immunosuppression and exacerbate the infestation. This is one of the more serious skin conditions – second only to skin cancer.
There are a large number of muscle, bone and joint problems that can affect dogs and cats. A few of the most common disorders are outlined in this chapter. In general, dogs and cats have a hardy musculoskeletal system but disorders can occur for several reasons. Please see table below for a brief list, with causes, symptoms, diagnosis and treatment options. As arthritis and hip dysplasia are common and involve a lot of guardian input, I have written in detail about them in separate entries above.
* Fractures are best treated early rather than late. They may not be life-threatening most of the time but the outcome is much better if fixed early on. See symptoms above.
Good nutrition is key to joint and bone health. As the guardian, you can play a key role in preventing musculoskeletal disorders. Just like us, animals cannot manufacture omega fatty acids 3, 6 and 9 and so it is paramount that their diet contains them. A natural diet containing oily fish and ground, natural nuts is good.
Pancreatitis is a very painful, life-threatening and commonly under-diagnosed condition affecting both cats and dogs. It is defined as inflammation of the pancreas. This inflammation causes leakage of the digestive enzymes from the pancreas and as a result the pancreas literally starts digesting itself. Pancreatitis can be acute (sudden) or it can be chronic (slowly occurring over a period of time). While both forms are life-threatening, the acute form is more serious and painful.
In the majority of cases the cause is unknown and dogs seems to suffer more than cats. The acute form is more common in dogs and is very painful, while cats seem to suffer from the chronic form, exhibiting milder symptoms. The incidence of pancreatitis is more common among obese, middle-aged or elderly dogs and more common in bitches than males.
The trouble in dogs usually starts when they eat something too rich and too high in fat (like a whole birthday cake), or something too foreign (a dead bird) that is too challenging for their digestive system. The pancreas is then overburdened and becomes inflamed. Instead of sending the digestive enzymes described above to the duodenum, it starts to leach them into the abdomen and raises the enzyme levels in the blood, causing severe pain.
The chronic form of pancreatitis in dogs maybe due to hyperlipidaemia, high-fat diets, viral or bacterial infections, contaminated food and water, concurrent diabetes mellitus and also the use of certain drugs like organophosphate parasiticides, antibiotics and diuretics. In cats there is an increased prevalence in those animals that already have cholangiohepatitis, hepatic lipidosis and concurrent inflammatory bowel disease. This is often referred to as triaditis.
The main problem with pancreatitis is that the symptoms are very vague, making it extremely difficult to diagnose, especially in cats. In acute cases, the abdomen becomes painful and distended, vomiting and nausea follow, the animal stops eating and becomes depressed and lethargic.
The signs can range from the aforementioned classic signs of a gastrointestinal upset to that of collapse and death. Some dogs adopt a ‘praying mantis’ posture – stretching because of the pain. Cats may present with inappetance and even jaundice. It is this lack of specific symptoms that makes the diagnosis of pancreatitis challenging.
Veterinary attention should always be sought because potentially a pet can die from pancreatitis. The vet will obtain a full history (dietary indiscretions like scavenging, eating garbage, cakes, fatty food, etc. must be mentioned) and then perform a thorough clinical examination. By a process of elimination and differential diagnoses he or she may arrive at a provisional diagnosis of acute/chronic pancreatitis.
Following this, a diagnostic blood test called CPLI (canine pancreatic lipase immunoreactivity) in dogs and FPLI (feline pancreatic lipase immunoreactivity) in cats may be indicated. Ultrasound of the abdomen and X-rays may also be necessary. A general health profile may also be requested.
The treatment of pancreatitis is primarily supportive, meaning that there is not usually a direct cause and cure. The animal needs to be sustained while allowing natural healing to occur and to help the pancreas recover. The veterinary team will take care of the animal’s fluid needs via IV or drip, and will address any other disease processes (infection, diabetes, etc.) while letting the pancreas heal on its own. In cats the treatment varies, depending on whether there is concurrent jaundice, cholangiohepatitis, etc.
Nil by mouth or NPO(non per os) used to be the rule of thumb in pancreatitis. Basically it means NO FOOD. By doing this we were essentially ‘switching off’ the pancreatic enzymes to prevent autodigestion. Resting the pancreas and gastrointestinal system is key to recovery.
It can mean no food or water by mouth for one to five or more days while on IV fluids. This is dependent on the severity of each case, and the animal must be on fluids and other support to survive and heal the pancreas while off oral food and water. Nowadays, pets can be fed special low-fat food via a naso-gastric tube (straight into the stomach), thereby by-passing the pancreas.
Pain relief is always provided. Antibiotics, antacids, anti-emetics, etc., may also be prescribed, depending on the case.
A low-fat diet. After recovery, a low-fat prescription diet like Hill’s ID or Royal Canin low-fat gastrointestinal diet is recommended. Acute cases are always admitted and treated as inpatients to provide supportive treatment until the pet can eat and keep down substantial amounts of food for sustenance.
It is possible that years and years of feeding commercial pet food lacking in natural digestive enzymes can overload a pet’s digestive system and this additional stress can cause the pancreas to malfunction. So feeding dogs and cats high-quality, all-natural foods after recovery is very useful.
During the initial illness, apart from the IV drip, the pet could be put on a liquid fast and fed a chicken or vegetable broth as multiple small feeds with ad lib distilled water. Home-made diets, low in fat and oils with chicken or turkey and grains like brown rice or millet, may serve the same purpose and work out healthier and cheaper. Try recipes such as the chicken broth or the K9/Feline Nature’s Own Hotpot. It is very important to keep the diet simple and not overload the body. See Chapter 1: Food Is Medicine.
Healing & herbs
Animal healing is a fantastic complement to veterinary care and can be safely given by you to your pet. Read Chapter 5: How to Give Healing to Your Pet for instructions. Giving distant healing to a pet while he or she is an inpatient at the vet’s could go a long way in helping a quick recovery – the animal will also be less distressed in the hospital. Acupressure is beneficial.
Hands-on healing can then be done when the pet returns home, especially focusing on the solar plexus, which rules the pancreas. Healing can help with the quick return of homeostasis because it promotes calm, peace and deep relaxation, which hasten recovery in any disease process.
Pancreatitis causes a lot of suffering to the animal concerned – it is not only painful but can cost the life of a valued pet. Viewed holistically, the pancreatitis is less often a distinct condition but more a part of a larger disease complex. Rather than pumping drugs into an animal on diagnosis, it is better to focus on the larger disease complex and ease it with holistic measures. Natural, low-fat diets and good supplements can prevent flare-ups.
Accumulation of pus in the uterine cavity or uterus is referred to as pyometra and is therefore a condition that only occurs in females, both in queens and bitches. The uterus becomes infected in unneutered females, especially in older dogs, and is regarded as an emergency. It occurs in the luteal phase of the oestrus cycle, between 5 and 80 days after the end of a season or oestrus.
It is not uncommon to get bacterial infection in the uterus from time to time but this infection can be persistent and become pyometra if there is underlying cystic endometrial hyperplasia – build-up of the uterine lining without a pregnancy. Use of hormones like estrogen to control season or to cause abortions can also increase the risk of pyometra.
These bacteria find their way into the uterus by the anogenital route and can persist there if the endometrial lining is abnormal. If your pet has been spayed, it is possible for her to develop pyometra of the uterine stump at any time. Elderly bitches that have never had pups are predisposed to pyometra.
Lethargy, inappetance, drinking more (polydipsia) and urinating more (polyuria), with or without vomiting, are the common clinical signs. There may be an obvious swelling of the abdomen as the uterus becomes distended with pus. In later stages, there may be a smelly vulva discharge that can be a light chocolate-brown colour, or sometimes blood tinged and yellowish cream in colour.
Some animals also have a high temperature. If left undiagnosed, animals can die within 14–21 days from the beginning of clinical signs as described above. The uterus may rupture due to the large amount of pus inside and cause septic shock.
This condition can be diagnosed by a vet on the basis of the symptoms alone, but whenever possible an ultrasound scan or an X-ray is necessary to confirm it and to detect an enlarged, pus-filled uterus. Leukocytosis is seen frequently in closed-cervix pyometra so performing a blood test to check leukocyte numbers is important but not always necessary.
Pyometra should be differentiated from metritis, which is also a uterine infection but occurs in bitches that have just had pups. A general health profile is helpful to rule out other common causes of polyuria and polydipsia like diabetes, liver and kidney disease.
Ovariohysterectomy or neutering is the treatment of choice if your pet has pyometra. The success rate is quite high if she is diagnosed quickly after the symptoms develop. I have successfully performed a large number of these operations and have had no problems, even in very elderly pets that are otherwise healthy. In most animals the distended uterus is at least four to five times the size of a normal uterus.
Intravenous fluid therapy prior to surgery is very beneficial, especially if there is renal dysfunction due to the increased thirst. A course of antibiotics is usually prescribed to combat the infection. Prostaglandins and antibiotics have been tried in combination in bitches where surgery is not possible due to some other serious health condition, or because the bitch is used for breeding. These are not always successful and most pets have required spaying at some point. More recently a drug called Aglepristone has been tried in pyometra, with limited success.
If you do not intend to breed from your pet then it is a good idea to get her neutered in order to prevent pyometra, a life-threatening condition that is best prevented. The cost of performing a routine ovariohysterectomy (OVH) is much lower than surgery for pyometra. Observing your pet and monitoring her seasons is also very important, to enable early diagnosis and treatment.
Dermatophytosis, commonly known as ringworm, is an infection of the skin, hair or nail caused by fungi such as Microsporum, Trichophyton or Epidermophyton. Ringworm can easily spread to humans, especially children, who tend to be in very close contact with the infected pets. It also spreads from pet to pet, but it should be noted that most of the cases of ringworm seen in people are not from pets.
The fungus Microsporum canis is responsible for approximately 50 per cent of the cases seen in both dogs and cats. Young animals less than 12 months of age seem to be more susceptible, maybe because their immune response is still quite poorly developed. Persian cats seem to suffer more too. Old and immunocompromised pets may also be more predisposed. Cats in colonies are at high risk as the fungal spores are shed in the cattery and can remain alive for 18 months.
Circular, rather damp, areas of skin appear as the hair becomes damaged and falls out. These focal areas are primarily seen on the face, head and feet. Lesions also tend to be strikingly symmetrical and not itchy. In cats just a dull hair coat and some patchy hair loss may be the only symptoms.
Your vet will need to differentiate ringworm from other skin diseases causing similar symptoms like pyoderma, FAD, eczema and other mite infestations. A wood’s lamp is used for diagnosis as the lesions fluoresce under this UV light, but it is not definitive, as only Microsporum canis infections tend to be positive. Hair plucks from the suspected area are cultured in a special dermatophyte test medium (DTM) to obtain a definitive diagnosis.
Your vet is not allowed to dispense treatment without a definitive diagnosis, so these tests are compulsory. All long-haired cats with lesions have to be clipped and the clippings burned so as to reduce environmental contamination. Systemic treatment with drugs like griseofulvin or ketoconazole may be necessary in cats and can be very prolonged and expensive.
Griseofulvin is contraindicated in pregnant queens and has several side effects. Washing with antifungal shampoos and applying topical antifungal agents like clotrimazole and micanozole may be useful alongside lime sulphur or enilconazole dips.
Catteries will need to put in strict protocols and management changes as ringworm is a difficult disease to contain. Areas used by your pets at home should be vacuumed daily, to get rid of contaminated hair and spores. 1:10 diluted household bleach solution should be used to clean all cages and surfaces where your cat has been. Enilconazole sprays are available and can be used as an environmental agent. See your doctor if you find circular lesions on your own skin.
Elizabeth has had fantastic results in dogs with aloe vera topical gel with two drops of tea tree oil added to it (Aloe vera basic gel). Avoid tea tree with cats.
Pets live a lot longer these days due to the advances in veterinary medicine. Ageing itself is inevitable but certain disease conditions become more common as your pets age. The following table lists these conditions, along with their incidence.
Most of the conditions above are chronic and get progressively worse as your pet gets older. They may be incurable. Nowadays, veterinary practices have geriatric clinics for the ageing pet that are worth attending. Your vet will check your pet’s urine, perform blood tests and check blood pressure after performing a thorough clinical exam to rule out the conditions listed.
In general small breeds have a longer life expectancy than large breeds. Overweight pets tend to have a shorter life span because their systems are overloaded. These animals also tend to be exercised less, and develop arthritis, heart disease and diabetes. The drugs used to treat them can give them a reasonable quality of life but may compromise their life span.
Indoor pets tend to live longer than their counterparts who go outdoors, because they are less likely to be involved in road traffic accidents, pick up infections or get bitten, etc. On average, it can be said that castrated male cats live five years longer than entire Toms, while spayed female cats live four years longer than entire females. It is surmised that this could be because they expend less energy in reproductive and birth-related activities.
Senility occurs to an extent in dogs and cats, just like in people. Your dog may appear confused and wander aimlessly around the house, stand with his head in the corner for a while or void faeces and urine inappropriately. It is almost as if he has forgotten where to urinate or defecate.
Cats may forget to use the cat flap or go out through the cat flap only to appear on the window sill a few minutes later, asking to be let in, and then repeat the process almost immediately. Your pet may otherwise appear normal, eat, drink and have a decent quality of life.
A gradual reduction in nerve cells and neurotransmitters is thought to be the cause of senile behaviour.
Your pet may act as described above, and may also have deafness, blindness and a disturbed sleep pattern. They may lose their sense of time and wake you up at unearthly hours, and even vocalize or bark or howl. House soiling is common. Some may stop grooming themselves and become distant.
You can usually tell by the symptoms but it is important to get your vet to give a full clinical exam to rule out any other conditions that may be amenable to treatment.
Elizabeth recommends offering on a self-selection basis either bladderwrack, calendula, catnip, chickweed, mint, nettle or rosehip infused in sunflower oil, depending on the condition.
Stomach or gastric disorders are quite common in dogs and less common in cats. Cats seem to suffer with fur balls mainly, whereas dogs can have many conditions. Gastric disorders can be acute or chronic.
The following table lists the common disorders and their probable causes.
Gastritis – very common and may be due to eating decayed materials, toxins, bones, grass, drug treatment, infections like parvovirus, leptospirosis, worms and even food allergies.
Gastritis – due to kidney failure or liver failure.
Gastric dilation and volvulus (GDV)/torsion. Bloating due to aerophagia; eating cereal-based foods too quickly; overeating and pyloric obstruction. Gastric torsion – a condition common in deep-chested dogs who eat a large amount in one meal and then exercise.
Tumours – benign polyps or gastric adenocarcinoma. Gastric ulceration – due to chronic drug use such as NSAIDs; renal and kidney failure.
Pyloric obstruction – due to a foreign body/polyp.
Pyloric stenosis in young Boxers.
HGE – haemorrhagic gastroenteritis, as in parvovirus.
Foreign bodies – like bony pieces or gravel or balls, etc., that have not been passed.
Overeating in puppies.
Fur balls in long-haired cats.
Pyloric stenosis in Boxers, Bull Terriers and Oriental cats.
Vomiting is a very common symptom in both acute and chronic stomach disorders. Bloating and abdominal swelling are seen in gastric dilation and volvulus (GDV) with torsion. Inappetance, increased thirst but bringing water back up. Hematemesis or vomiting blood may also be seen. In chronic disease, the vomiting may be intermittent and there may be waxing and waning appetite, depression, melaena (black faeces) and abdominal pain.
If your pet cannot keep anything down, you need to seek veterinary attention to stop dehydration. Radiographs or X-rays, barium meal studies, gastroscopy, exploratory laparotomy and a gastric biopsy may be necessary depending on the cause.
Surgery is necessary to remove gastric foreign bodies and tumours and for obtaining biopsies. Gastric dilation and volvulus (GDV) is an emergency and a stomach tube may be passed to deflate the stomach. This will not be possible in torsion, where the stomach twists on itself and closes the esophageal sphincter. Then, after stabilizing your dog on fluids, etc., surgical correction will be necessary, which can be quite complicated. If gastric ulceration is diagnosed, antacids, gastroprotectants and anti-emetics may be prescribed. Feeding your pet little and often is advisable.
Simple gastritis can get better on its own, so simple steps like starving your pet for 24 hours and then offering a bland diet such as boiled fish or chicken and rice may be enough. Water should be offered in small quantities, otherwise your pet will vomit it all back up. GDV is an emergency and needs urgent veterinary attention.
In simple cases of gastritis, when your pet is on the mend and where the veterinarian has ruled out GDV, FB, etc., you can offer calendula-, mint-, or catnip-infused sunflower oil on a self-selection basis.
The thyroid gland releases the thyroid hormone under the control of the pituitary and hypothalamus. This hormone controls metabolism, activates hair growth and is necessary for growth and development. Hypothyroidism is a condition seen primarily in dogs, whereas hyperthyroidism is common in cats and is also the most common endocrine disorder seen in cats.
Hypothyroidism is a clinical condition, affecting dogs mainly, where there is inadequate production of the thyroxine hormone because of thyroiditis, thyroid atrophy or (rarely) cancer. Hyperthyroidism on the other hand is a pathological condition seen primarily in cats where there are increased levels of circulating thyroid hormones.
This could be because nodules in the thyroid gland are hypersecreting or, rarely, due to a thyroid carcinoma or cancer. Hyperthyroidism is very rare in dogs but extremely common in late middle-aged and elderly cats.
Hypothyroid dogs present with dullness, lethargy, inactivity, excessive moulting and hair loss, as well as weight gain (they cannot lose weight even when put on a diet). They may also suffer with recurrent skin infections and ear problems and intolerance to cold may also be observed.
Hyperthyroid cats are very hungry, drink a lot, show weight loss, may vomit and have diarrhoea. Some may become aggressive and hyperactive and appear to be breathing with difficulty. They also appear shabby, unkempt and have thickened nails.
Hypothyroidism has to be differentiated from other conditions, such as skin or endocrine conditions. Your vet will take a full history, perform a full clinical exam and then perform a blood test to check your dog’s thyroxine levels and that of the thyroid-stimulating hormone. Low T4 levels are consistent with hypothyroidism.
In most cats with hyperthyroidism, your vet will be able to feel the enlarged thyroid gland, at least on one side of the neck. A heart murmur is usually present and there may be some other abnormalities on auscultation. The age of your cat and its appearance will give your vet important clues. A full blood test to rule out other diseases with similar symptoms and a test to check thyroxine levels will be carried out. If there is suspicion of underlying renal and myocardial disease, an ultrasound exam of the kidney and X-rays of the heart may be needed.
Hypothyroid dogs will need to be given Levothyroxine twice a day, to deal with the low thyroxine levels. Dosage will be adjusted by response to therapy so regular blood testing to check thyroxine levels will be advised. In cats with confirmed hyperthyroidism, drugs like methimazole or carbimazole, which interfere with the synthesis of the thyroid hormones, are prescribed and must be taken life long. These are to be taken by mouth, and in practice, I have found this difficult for the majority of cat owners as their cats are not easy to medicate by mouth.
In such cases, thyroidectomy (surgically removing the enlarged thyroid) may be the only choice. I have performed several of these operations with a very good success rate. Surgical treatment of thyroid carcinomas is mainly palliative and usually not curative.
While drug treatments have side effects, surgery can have complications too, like hypoparathyroidism. As the parathyroid is attached to the thyroid it may not always be preserved during a thyroidectomy. Radioiodine therapy for hyperthyroidism is very effective but expensive.
Vomiting is the forceful reflex expulsion of the contents of the stomach through the mouth. It is a symptom of many conditions in the dog and the cat. Vomiting may be acute (less than one day’s duration), chronic (intermittent vomiting on and off) or persistent (vomiting for weeks or months).
The following is a list of possible causes for acute and chronic vomiting in dogs and cats.
Food indiscretion (eating rapidly and scavenging), food allergies, including sudden diet change.
Diseases of the oesophagus, such as hiatal hernia, reflux or inflammation.
Drugs like NSAIDs, steroids, chemotherapy.
Infections – like helicobacter.
Inflammation of the stomach or intestines due to viruses like parvo, canine distemper, bacterial disease, campylobacter, etc.
Metabolic disease like kidney, liver, gall bladder, diabetes, chronic pancreatitis and electrolyte abnormalities. Cats – cholangiohepatitis and hyperthyroidism.
Worms – puppies and kittens may vomit worms.
Inflammatory bowel disease.
Gastrointestinal obstruction, foreign bodies in the stomach or intestine, GDV, cancer, intussusception and constipation.
Partially obstructing gastrointestinal disease – gravel, foreign bodies, or bony pieces and intussusception
Infections in the abdomen – pyometra, pancreatitis, peritonitis, hepatitis.
Neoplasia – cancer, polyps, etc.
Poisons or toxins, including household plants, antifreeze, etc.
Neurological problems such as brain tumours or vestibular syndrome.
Liver or kidney failure.
Post-surgical motility disorders.
Endocrine disorders like diabetic ketoacidosis, Addison’s disease.
Food allergies and intolerances.
Heat stroke, motion sickness, fear, etc.
Toxicity and constipation.
As vomiting can be caused by a whole host of conditions, unless it is just temporary and one-off, you must get your pet checked out. After taking a full history and performing a clinical exam your vet may advise blood tests to rule out metabolic and infectious causes. X-rays and/or ultrasound may be required if there is suspicion of a foreign body or obstruction.
Endoscopy is very useful to rule out foreign bodies in the oesophagus, stomach or duodenum. It can also diagnose ulcers. If Addison’s disease is suspected then an ACTH stimulation test may be necessary – this is a blood test to check cortisol levels. Other tests may also be required, depending on the suspected cause.
As the most common cause of vomiting is dietary indiscretion, fasting your pet for 12–24 hours, followed by small amounts of water, ice cubes and bland food, is usually sufficient. Elizabeth recommends chickweed ice cubes, ginger-infused honey and Ginger K9 biscuits. In cats that vomit fur balls, offering catnip-infused sunflower oil can be very beneficial. Please read the tips under appropriate conditions if the cause of vomiting has been ascertained by your vet.
If vomiting persists then your pet will need veterinary treatment and hospitalization. Fluid therapy with anti-emetics, antacids and H2 antagonists like Ranitidine may be necessary until your pet can keep food and water down. Proton-pump inhibitors like omeprazole are prescribed in chronic cases.
Anti-emetics like metaclopramide are contraindicated if there is an obstruction so will not be given until X-rays have confirmed its absence. Inflammatory Bowel Disease (IBD) cases may need steroids and antibiotics, and also worming if there is concurrent worm infection. Symptomatic therapy, supportive therapy and if necessary surgery to remove foreign bodies is the approach to vomiting cases.
Healing & herbs
Animal healing is a fantastic complement to veterinary care and can be safely given by you to your pet (see Chapter 5). Stimulating acupoint ST 36 can also help (see Chapter 6 for location and technique).
Worms infect most dogs and cats at some point in their lives and are quite a common problem in pets. Most puppies are born with worms and will need regular worming depending on the risk of re-infection. Worms can infect people and their larvae pose a health risk, especially to children. There are two main types of worms that commonly infect cats and dogs – the roundworms (or Nematodes) and tapeworms (or Cestodes).
The roundworm Toxocara canis can actually cause blindness if transmitted to humans. In general roundworms are more common in puppies and kittens whereas tapeworms are common in adults. Cats that hunt are more likely to get worm burden. There are also other less common worms like lungworms, heartworms, whipworms and hookworms.
The dog roundworm (Toxocara canis) lives in the small intestine of dogs and can be picked up by the puppy in the womb of the bitch by the transplacental route. They can also be infected through the milk, or by eating eggs that all parasites lay. The cat roundworm (Toxocara cati) is not picked up by the kitten in the womb but by intramammary transfer – suckling the mother’s milk. It can also be infected by eating the eggs of the worms or by the cat eating small rodents. Roundworms look like pieces of string or vermicelli.
Tapeworms have very complicated life cycles involving passage through an intermediate host or second animal (the flea or a small rodent or rabbit, depending on the particular tapeworm concerned) before they can again infect their main host animals such as the dog or cat.
Tapeworms are flat and can be 50cm (19in) long, but the tapeworm segments that become detached from the end of the worm and fall out in the faeces resemble grains of rice. Dipylidium caninum is the most widely diagnosed tapeworm in both cats and dogs and is transmitted by fleas.
Dogs become infected from contaminated soil, which may contain faeces from an infected animal. The worm eggs or larvae can survive in the faeces for a whole year and fox droppings are an important source of tapeworm larvae. Swallowing fleas infected with Dipylidium caninum while grooming is another potential cause.
Cats and dogs can be infected by tapeworm when they eat infected small mammals like rabbits or mice. As tapeworms infect grazing animals like sheep, feeding on a sheep carcass can also be a source of infection.
The lungworm (Angiostrongylus vasorum), which is spreading at an alarming rate in the UK, is actually a type of nematode. An increase in the number of slugs and snails, increased pet movement and urbanization of foxes have all been declared as significant factors, resulting in increased risk all year round rather than a seasonal problem.
The lungworm larvae are carried by slugs and snails and the problem occurs when dogs accidentally eat them from dirty puddles, grass, outdoor water pools or bowls, or deliberately eat them if they are sat on their toys or bones, etc. Frogs carry larvae and foxes can also get infected and spread the disease.
The lungworm larvae migrate via the digestive tract, and via the bloodstream they actually enter the lungs and the heart. The disease was first discovered in France and is found in other countries all over Europe, America and Africa. Younger dogs less than two years of age are more susceptible.
Symptoms differ, depending on the age of your pet and the worm. Kittens and puppies may actually pass roundworms that look like strings in their stools. They may be pot-bellied, lethargic and have vomiting and diarrhoea. Some pets vomit whole worms. Adult pets scoot their bottom across the floor or lick or groom excessively around their bottom.
Worms should not be taken lightly as excess worm burden can actually kill a kitten or puppy. In lungworm disease, your pet may show no symptoms at all. However they might tire easily, cough, bleed excessively when injured, have nose bleeds, become anaemic, lose weight and appetite, vomit and have diarrhoea. Occasionally seizures and depression may also be symptoms. Sudden death is also possible with lungworm disease.
In most cases, the worms may go unnoticed and are only spotted because the animal vomits whole roundworms or passes them when it has diarrhoea. Tiredness and poor growth in spite of eating well may suggest worms. Tapeworms for example, may be seen as rice grains around your pet’s bottom but most of the time they are invisible and stay in the intestines – sucking away valuable nutrients and blood, which eventually causes weakness and tiredness.
As the same symptoms can be caused by various other health conditions, it is important to take your pet to the vet so he or she can rule out the other causes. Most vets will enquire about worming during your pet’s annual check or during any visit. If there is a suspicion of worms, you will be asked to collect a three-day pooled faecal sample, which will then be tested for worm segments, larvae, etc. Lungworms are diagnosed by a Baermann test, faecal examination and X-rays. A blood clotting test may also need to be performed.
Depending on the worm that is the cause of the infection, your vet will provide the correct product; this is why it is important to seek veterinary attention. Many modern flea treatments also contain worming products so do check what the product does. The dosage is different if your pet has an active infection than if they are fine and just need prevention. Similarly, the dosage for worming treatments is calculated based on the weight of your pet, so it is important to get your pet weighed.
Puppies and kittens need to be wormed every two weeks from two weeks of age until they are 12 weeks old.
They should be wormed monthly till the age of six months and then wormed every three to six months, based on the product used and their lifestyle. Some products may only last for one month so do check the pack.
As roundworm larvae can be transferred to the pups from day 42 of pregnancy, Fenbendazole treatment should be given every day from day 40 of the bitch’s pregnancy until two days after she has whelped.
Lungworm treatment should be given by your vet and then prevented by using products regularly. Advocate is a very popular product used for prevention in the UK.
There are many safe and effective treatments for roundworms available in the shops but be sure you understand them and are sure of the diagnosis. Discuss your pet’s lifestyle, your lifestyle, kids involved, your pet’s hunting habits, etc., with your vet so they can advise the correct product. If your pet does not take tablets then you may be given a syrup or a spot-on wormer. Most vets will be happy to give the wormer to your pet manually if you find it difficult.
How to reduce the risk of worms
Pick up your pet’s faeces regularly and dispose of them safely.
Regularly pick up your dog’s toys at the end of each day and store them in a snail-tight box.
Check and clean your pet’s water bowl, in case snails target it.
Worm all new pups and kittens.
Stop your pet from scavenging carcasses and hunting.