Alabama Rot
CRGV (Cutaneous and Renal Glomerular Vasculitis) or Alabama Rot is a newly recognised disease in the UK. We do not yet know what is causing this disease, but there have been cases recognised in the Stoke-on-Trent area recently. The disease is often fatal. However, the transmission of the disease is currently unknown, but it does not seem to be passed between dogs or to affect people. The symptoms of the disease begin with a lesion, which looks like a cut or scratch on the feet or face, followed by kidney failure over a few days.
Kidney failure usually presents a severe illness with dehydration, vomiting, and lethargy. This often becomes refractory to treatment and can become fatal. No cure or effective treatment is yet known, and there is no known guaranteed preventative.
The best advice we can give currently is to wash off your pets thoroughly after taking them for walks, especially in muddy areas.
We saw a suspected case of Alabama Rot at the practice, and the dog was fortunate to survive the disease. This was following a week of severe illness and vigorous intensive care, but not all dogs are as fortunate.
We don’t wish to cause any panic, as the number of cases diagnosed is still very low, but we want to bring this information to our clients. If anyone needs further information, please feel free to ask us. Otherwise, Anderson Moores Veterinary Specialists have been doing a lot of work in this field and have good information on their website.
Anal Sacculectomy
The anal sacs are pockets situated either side of the anus which vary in size, depending on the size of the dog. They have small openings towards the opening of the anus. Their purpose is to hold secretions from glands and are occasionally known as “scent glands”, as the liquid they hold is a very potent and offensive smell.
These sacs tend to empty their contents when a dog passes faeces. On occasion, they can spontaneously empty when a dog barks or jumps. Or can even do so without any sudden activity.
Problems with Anal Sacs
The anal sacs can become problematic for several reasons:
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Impaction: This is Where the Sacs Fail to Empty Naturally, so the Liquid Secretions Inside Build-Up, Causing the Dog to Feel Discomfort. The Dog May Lick at its Rear End or Drag their Bottom Across the Floor to Release the Pressure
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Anal Sac Infection
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Anal Sac Rupture: If Not Emptied, the Gland May Eventually Rupture, Causing the Foul Liquid to Run into the Tissues Around the Bottom, Causing a Painful Infection and Abscessation. The Rear End Will Be Extremely Hot, Swollen, and Painful. The Abscess May Eventually Burst, causing a Hole to Appear in the Skin Near the Bottom. Before the Abscess Bursts, the Infection Can Make the Patient Extremely Unwell.
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Anal Sac Adenocarcinoma: Cancer of the Anal Sac
Anal Sac Impaction
Many dogs experience anal sac impaction, they may go on to express the impacted material spontaneously or after rubbing the area. If the pressure does not relieve; manual expression may be required, whereby the liquid inside the sac is squeezed out. If the material is not easily expressed, the vet may recommend flushing of the gland. Sometimes a diet change may be recommended to help the problem.
For cases that suffer from frequent impactions or multiple infections or rupture, the vet may recommend that the glands are flushed and filled with a mixture of anti-inflammatory and antibiotic. In more severe cases or cases which involve cancer of the sac, a surgical cure is to perform an Anal Sacculectomy. The surgery involves complete removal of the anal sacs.
Pre-Operative Considerations:
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Patients Must Be of Good General Health and Able to Undergo a General Anaesthetic
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Scar Tissue is Likely to Make the Surgery More Challenging and Can Increase the Likelihood of Short-Term Problems After the Operation
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We Ask That All Patients Are Starved for 24 Hours Before the Operation and Taken Out for Toilet Purposes Before Attending the Practice on the Day of the Operation
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If There Has Been Anal Sac Rupture or Abscessation, the Surgery Cannot Go Ahead Until the Area is Fully Healed
The Surgical Procedure
The patient undergoes a pre-operative examination, then a combination of sedative/painkiller is administered. The patient is then anaesthetised, and the rear end is clipped short and cleaned. The anal sacs are flushed with antiseptic. The vet prepares a resin which is instilled into the sacs, making them easier to surgically dissect. A short incision is made into the skin over the gland, and the surgeon gently dissects the sacs out from between the muscle layers around the rectum. Once the sac is removed, sutures are placed to close the space, these may either be dissolving sutures underneath the skin, or skin sutures which sit on top of the skin. The patient is cleaned and recovered from anaesthesia by the nursing team.
What to Expect Immediately After Surgery
Any surgery around the rectum and the rear end is very uncomfortable. We supply pain relief by injection, while the dog is in the surgery, and often an Elizabethan Collar is required. Preventing the dog from licking at the area and worsening the discomfort and soreness. Pain relief will be provided for use at home, however, in some cases, antibiotics may be required.
The recovery phase differs, tremendously, for this procedure. Some dogs act as if nothing has happened and return to normal within 24 hours of the procedure, whereas some refuse to pass faeces for several days post-operation. Other patients exhibit diarrhoea after the surgery, often when scarring is present, and the tissues have had to be manipulated extensively. If this is the case, then you may be required to keep the dog restricted to a small area and clean the rear end regularly. This will resolve in a matter of days, and medication can be provided to help reduce the volume of diarrhoea. Some dogs lose some ability to hold faeces and may need to poo more regularly. We recommend frequent opportunities for toileting in the week post-operation, or for the dog to be kept restricted to an area, where the furnishings can be more easily cleaned. For a few weeks post-surgery, your dog may have accidents, where faeces are passed unexpectedly, this usually occurs when they bark or jump up and is caused by the swelling and tissue disruption during the surgery. In majority cases, this resolves over a few weeks. Very occasionally, we see infections in the surgical sites, this is made more likely if the patient can lick and interfere with the site and should be treated with bathing and antibiotics.
Long Term Expectations
We expect a full recovery within a month of the procedure and return to normal toileting patterns. With any surgery in this area, there is a risk of long-term incontinence. This is a rare long-term side effect, and usually where a very large dissection has been required to remove a cancer of the anal sac. If the anal sac has ruptured before surgery, there may be small pieces of the sac tissue within the surgical site that aren’t removed, and these may then cause an abscess or irritation after the surgical site has healed, this would mean a second surgery was needed. This only happens very rarely.
Dog Castration
Surgical castration is currently the most reliable permanent means of preventing unwanted breeding in male dogs. Given the large numbers of unwanted dogs in the UK, male dogs should be castrated unless there is a good reason not to do so.
However, recent research suggests that castration might increase the risk of some health problems in male dogs, while it reduces the risk of others. There is not currently enough evidence to know how reliable these findings are and whether they apply to all dogs or just certain populations of dogs. Until more research becomes available, decisions regarding castration should be made according to its effects on population control and behaviour rather than health.
Castration involves removal of both testes, the main source of testosterone in males. Testosterone acts as a behaviour modulator. It does not directly cause behaviours but increases the likelihood that certain behaviours will occur, including:
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Escaping/Roaming to Find In-Season Bitches
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Urine Marking
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Confident Aggression to Other Male Dogs
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Excessive Mounting of Bedding, People, and Other Dogs
Testosterone Influences
Testosterone can also influence other behavioural traits, including:
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Risk-Taking Behaviours: Entire Animals May Be More Likely to Engage in a Risky Situation Rather Than Withdrawing
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Arousal and Intensity of Aggression Shown During a Conflict: Entire Males Tend to Become Aroused More Quickly, Show Higher Arousal Levels, and Remain Aroused for Longer Than Castrated Males
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Self-Confidence: Research in Other Species Suggests That Testosterone is Associated with Confidence and Castration with an Increase in Fearfulness and Anxiety.
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Interest in Other Dogs, Especially Bitches, Making It Harder to Get Their Focus When Working/Training
The longer-term effects of castration before puberty compared to afterwards in male dogs has not been fully evaluated. More research is needed before we can assess this more accurately.
Whether or not castration will affect the likelihood of a dog showing a behaviour, depends on several things, including:
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Whether or not that behaviour is influenced by testosterone. Many problem behaviours are not influenced by testosterone at all, and some of those that are can occur for other reasons.
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How long the dog has been showing the problem behaviour. Learning increases the likelihood of a dog continuing to show a behaviour after castration.
Benefits of Castration
Castration is most likely to be beneficial in dogs showing behaviours that are likely to be influenced by testosterone, including:
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Escaping, Roaming, or Distractibility Due to Nearby In-Season Bitches
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Indoor Urine Marking
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Confident Aggression to Other Male Dogs (Particularly Entire Males)
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Excessive Mounting of Bedding, People, and Other Dogs
Castration can reduce the severity of these behaviours but may not eliminate them; behaviour modification may also be needed. Castrating sooner rather than later can reduce the effect learning has in maintaining behaviours longer term, and castration before puberty should reduce the likelihood of these problems occurring. However, it does not always prevent them altogether.
Castration may be beneficial in:
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Aggression Between Two Entire Male Dogs That Live Together: Castration of One or Possibly Both of the Dogs Can Potentially Help to Reduce Tension Between Them, But Only If Done Alongside Behaviour Modification, and Only After the Dogs Have Been Assessed Carefully by a Qualified Behaviourist Before Castration is Considered
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Dogs Showing Aggression That Does Not Seem to Be Motivated by Fear, But Only if Done Alongside Behaviour Modification to Address the Reason Why the Dog Is Showing Aggression (Advise a Behaviour Consultant Before Castration)
When to Avoid Castration
Castration is unlikely to be beneficial or can be detrimental in dogs showing:
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Unruly, over-excitable, and adolescent behaviours. These will respond better to reward-based training and appropriate mental and physical stimulation.
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Inappropriate predatory, hunting, or herding behaviours
Fearful Dogs
Castration could potentially be detrimental in dogs that are generally fearful, unconfident, or specifically fearful of unfamiliar people, places, and being handled. There are many anecdotal reports of fearful dogs becoming even more fearful after castration. This could be related to the effect of losing testosterone on their self-confidence, although more research is needed to verify this. This could also occur as a result of aversive experiences associated with castration itself.
These dogs might benefit from being left entire, if showing no testosterone-related behaviour problems, and if unwanted mating can be reliably prevented. If castration is necessary for behavioural reasons or to prevent unwanted mating, behaviour modification to reduce fearfulness should ideally be implemented first.
Care should be taken to make the experience of being castrated as minimally aversive as possible for a fearful dog. This should include:
Fearful Dogs
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Muzzle Training Beforehand to Ensure a Dog Is Comfortable Wearing a Basket Muzzle (e.g. Baskerville Ultra) and Ensure They Are Wearing This When They Arrive at the Surgery
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Premedicate On Arrival at the Surgery, and Allow the Owner to Stay with the Dog Until They Start to Become Drowsy
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Ensure Premedication Contains Agents That Reduce Anxiety and Awareness.
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Ensure the Dog Is Kennelled in An Area That Is Quiet and Not Brightly Lit, Both Before and After Surgery
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Ensure All Handling Is Calm and Gentle, Both Before and After Surgery
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Put a Familiar Piece of Clothing or Blanket in the Kennel During the Recovery, Exposing the Dog to their Owners’ Scent as They Come Around
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Ensure Effective Pain Relief Both During and After Surgery Until Animal No Longer Painful
Should You Castrate?
What to do if you are not sure whether to castrate or not?Deslorelin (Suprelorin, Virbac) is currently the best reversible indicator of the effect of castration. It can be used to assess the potential behavioural effects of surgical castration from 4-6 weeks post-implantation. Testosterone initially increases for 2 weeks after implantation, and then falls to post-castration levels after 4-6 weeks.
Information on NSAIDs
If your pet has been prescribed an NSAID as an anti-inflammatory painkiller, please take the time to read the following information. If anything is unclear, or if you have any concerns, then please ask a member of staff for further details.
NSAIDs are used as a painkiller, as an anti-inflammatory, to reduce swelling and redness in inflamed areas, to reduce high temperatures, and in certain cancers. They may be prescribed as a short course (following a surgery or injury) or for long-term use (e.g. for arthritis). Commonly used NSAIDs are Metacam, Previcox, Rimadyl, Onsior, and Loxicom.
Possible Side Effects
NSAIDs are a very effective group of drugs and are widely used. Most patients tolerate NSAIDs extremely well, however, side effects can occur in any patient. The most common side effect we see with NSAIDs is mild to moderate vomiting or diarrhoea. These symptoms usually go away once the medication is stopped, although some cases may require additional treatment for the stomach or intestinal upset.
It is vitally important that any NSAID is stopped if your pet suffers from sickness, diarrhoea, or any unexpected illness, during treatment. Continued use of the NSAID once sickness or diarrhoea has started can lead to a much more severe stomach or bowel condition.
Long term use of NSAIDs can cause stomach ulcers, however, this is treatable once recognised. In some cases, patients may be able to continue to receive NSAIDs, alongside some form of stomach protectant medication. If your pet is poorly or vomiting whilst taking NSAIDs, you must seek veterinary advice, and stop the NSAID until instructed otherwise.
NSAIDs should be used with caution in patients with any kidney problems, and this will be taken into consideration for your pet. NSAIDs have also been known to cause kidney problems. This can be far worse in patients who are ill and continue to receive NSAID medication. It is important to stop giving NSAIDs to animals who seem unwell or ill unless specifically directed by the veterinary surgeon.
For any further information, please speak to a vet or nurse at the practice.
Pet Passports
An Animal Health Certificate is a document that allows for your pet to travel in between the UK, EU and some non-EU countries without requiring quarantine. It is a document that records the medical information specific to the animal so that authorities are aware that they have had all relevant vaccinations and treatments. Please refer to the government’s overview here.
The basic requirement for pet travel within the EU is a microchip, a single rabies vaccination, and a passport. You must wait 21 days from the date of vaccination, before returning to the UK with your pet from an EU country.
We recommend 2 rabies vaccinations, 2 weeks apart, as not all pets have enough immunity from a single injection. However, you can still travel back to the UK 21 days after the first injection. The rabies vaccination must be repeated every 3 years. Pets must be at least 12 weeks old at the time of rabies vaccination.
Before returning to the UK, your pet must be given a tapeworm treatment by a vet and the relevant section signed in the passport. This must take place between 24 and 120 hours (1-5 days) before returning to the UK. For short trips of less than 5 days, this means that it is often more practical to have the tapeworm treatment before you travel.
Rabbit Health
Cancer in Un-Spayed Female Rabbits
Did you know that a non-neutered, female rabbit, aged over 3, is at 60% risk of developing uterine cancer? This climbs as high as 80% once she reaches 6 years of age. This type of cancer is extremely aggressive and can rapidly spread to other areas of the body.
Symptoms
Unfortunately, there often aren’t any symptoms, until the cancer is quite far progressed. By this time, it has often spread to other areas of the patient's body.
Symptoms that may develop as cancer progresses include:
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Weight Loss
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Blood in the Urine
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Bleeding or Discharge from Her Vulva
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Coughing, Wheezing and/or Breathlessness
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Aggression
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Mammary Masses
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Lethargy
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Abdominal Masses
Treatment
Surgery is required as soon as possible to remove the uterus and ovaries. If cancer has spread to other organs, no other treatment is possible.
Prevention
Uterine cancer can be prevented by getting your rabbit spayed, and this can usually be done around 5-6 months of age. Should you wish to discuss neutering your rabbit, please contact your veterinary clinic, and speak to one of the vets or nurses.
Ticks
Until recently, we rarely saw ticks on pets which hadn’t left Stoke-on-Trent. Towards the end of last summer, we started to see more and more ticks on local pets, which hadn’t travelled, and the same is true of this year. It appears that the local tick numbers must be on the increase.
Ticks are small arthropods, which attach onto mammals to take a blood meal. They start as small as a grain of rice, as they ingest blood their body swells, up to the size of a pea. When they have finished taking blood, usually after a few weeks, they fall off and crawl away to complete the next stage of their life cycle.
As well as causing an intense local reaction, which makes dogs and cats itch at the site that the tick is attached to, ticks can transfer diseases during the time that they are attached to the animal. These include Babesia, Lyme’s disease, and Ehrlichiosis, all of which, can cause severe illness.
Ticks are best prevented by a tablet or spot-on formulation, during the summer period. However, if your dog picks up an uninvited visitor, they must be removed promptly to avoid disease transmission. It is important that the entire tick is removed, as if the tick’s mouthparts are left under the skin this can cause an inflamed or infected lump at the site of the tick bite. Special tick removers can be used, which twist the tick out easily, and the tick can then be killed.
Ear Canal Ablation
Sometimes an ear infection is so severe that surgery is the only option. The organism growing may resist treatment, the ear canal might have mineralized due to chronic irritation, or the ear canal might be so scarred and narrowed that external cleaning is impossible. No matter the issue, this degree of an irreversible disease requires surgical treatment. In such cases, all the diseased tissue, the entire ear canal, bones of the middle ear, etc. are removed. The middle ear is drained, and the healthy tissue around the ear is closed. This ends what has generally been a long ordeal of pain, odour, ear cleaning, and expensive veterinary medications, and re-checks.
It is important to understand the surgical procedure and its associated risks. This surgery requires advanced skill and is a procedure that not all veterinarians are comfortable performing. The surgery essentially removes the ear structures but leaves the ear flap unchanged. The round bone behind the ear called the tympanic bulla is opened and flushed. A normal bulla is hollow and air-filled. After years of otitis, the bulla is usually packed with pus, slime, or infectious material that must be scooped or rinsed out. Many important nerves travel through this area of the ear, and these are exposed to potential damage during surgery.
Preparing for the TECA
Radiographs or a CT scan to assess the tympanic bullae are helpful. It is useful to know before surgery how bad the bullae look, how narrowed the ear canals are and if they are mineralized, and if there is an obvious tumour growing. These images help confirm that the surgery is appropriate for the patient.
The ear may be cultured, and this helps get the patient on an effective antibiotic right from the beginning. Further cultures may still be required once the bullae are opened. It is important to assess the patient's cranial nerve function before surgery. If these nerves are diseased before surgery, it is unlikely that they will regain function after surgery. Nerve disease that results from surgery is usually temporary, so it is important to know if the nerve problems exist before surgery.
The facial nerve runs just near the base of the ear, and this nerve controls facial expression. Facial paralysis is not uncommon after long-standing ear disease. This means that the patient is slack-jawed, usually on one side of the face, and may not be able to blink. After a time, the eye usually retracts into the eye socket to facilitate tear lubrication, so that the loss of blinking does not lead to eye damage. Initially, lubricating gels are helpful.
Hearing is usually diminished after long-term ear infections. Further hearing loss after ear ablation may not represent a dramatic change for the patient. Most owners have a good sense of whether their pet can hear, so it is rarely necessary to formally test hearing. After the ear canals are ablated, in many patients, some hearing remains as sound waves can still be transmitted through the tissues.
What Happens in Surgery
Before surgery, the ears and head are shaved, and the ear canal is flushed one last time to remove as much infected material as possible. This is done to minimize bacterial contamination of the normal tissue.
Both the vertical and horizontal portions of the ear canal are removed as one long intact curved cylinder. The bones of the middle ear and the eardrum are removed as well, with the bone of the tympanic bulla exposed and opened. Any material is flushed out, and the cellular lining of the bone is scraped away. Any material left inside after closure will lead to chronic drainage of liquid from the incision. Sometimes an external drain is left in place during the healing period.
Oral antibiotics and pain medication can be expected after surgery, as can an Elizabethan collar to protect the delicate incisions from scratching.
Pre Operation Starvation Protocols
Before an anaesthetic/sedation we will often request that you starve your pet. This is to reduce the risk of regurgitation of stomach contents. Research into starvation protocols has come a long way in the last 10 years and we now try to tailor our starvation protocols to best suit the patient. Below is a standard guide of what we would recommend in most situations, however our vets can change this for specific cases so if at any point you are unsure of what to do please contact the practice.
Dogs*
* Diabetic patients, colon/rectum/anal gland surgery and brachy breeds see exceptions below
Puppies - under 12 weeks should not be starved or have access to water withdrawn.
Dogs - over 12 weeks/adults should have food removed 4-6 hours prior to surgery. We generally start operations after 10am so food should not be given after 6am. Its important to make sure your pet has eaten before starvation begins, ideally a small meal between 5am and 6am. Wet food or cooked meat is best as its easily digested but we would not recommend feeding something your pet is not used to eating as this can cause stomach upsets. If your dog will only eat dry food or you’re not an early bird follow the below instructions.
If you’re not an early bird or only feed dry food we recommend giving your dog their normal evening meal the evening before a surgery, then a small meal last thing at night around midnight, then remove access to all other food. We do not recommend withholding water at any point for any starvation protocol.
*Exceptions dogs
Diabetic dogs – Please contact the practice and we will advise an appropriate plan depending on normal meal and insulin dose. This helps to ensures we can keep glucose levels as stable as possible throughout the day.
Colon/rectal/Anal gland removal surgeries– Due to the nature of these surgeries we require a longer 12-24 hr starvation protocol. Breakfast the day prior should be given in the morning then ideally a small meal around lunchtime 12-1pm the day before. Its important that dogs do not have an evening meal or breakfast before surgery. We make sure we have some nice food ready for them as soon as they wake up. For cats under going these types of surgery please contact the practice for feeding regime.
Brachy breeds (or dogs with the possibility of restricted airways) – The risk of regurgitation is increased in breads with smaller or restricted airways such as French bulldogs and Pugs. For this reason we normally provide medication to be given leading up to surgery and 5 days post surgery. The evening before surgery we recommend giving their normal evening meal and then a small meal of their normal food last thing at night midnight. After this remove access to all other food. We do not recommend withholding water at any point for any starvation protocol.
Cats*
* If your cat is diabetic please see exceptions below
Kittens - under 12 weeks should not be starved or have access to water withdrawn.
Cats over 12 weeks/ Adults - Should have food lifted at 6am or midnight if you are unable to remove it at 6am. It’s important to make sure you cat has eaten before starvation begins, ideally a small meal of their normal food. Wet food at midnight is ideal but if your cat is only used to eating dry food do not change their diet as this can cause stomach upsets. We do not recommend withholding water at any point.
*Exceptions cats
Diabetic cats – Please contact the practice and we will advise an appropriate plan depending on normal meal and insulin dose. This helps to ensures we can keep glucose levels as stable as possible throughout the day.
Ferrets - Should be starved but for no longer than 1-2 hours before surgery so we will usually be able to do this after admission to the practice.
Rabbits, Guinea pigs and other exotics
Its important that rabbits and guinea pigs have constant access to food and water we do not recommend starving prior to surgery. Generally no exotic breeds should not be starved prior to surgery unless specifically advised to do so by one of our vets.