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Gastric Dilation Volvulus – A True Veterinary Emergency

This can also be known as Gastric Torsion, stomach twist or GDV. This is a condition that requires EMERGENCY treatment and the sooner it can be treated, the more likely it is that your dog will survive. It can occur in any breed but it is more common in large and giant breed dogs that have a deep chest, for example, Red setters, Boxer, Doberman’s and Great Dane’s. It is a condition that causes severe shock to the dog’s body and can be fatal if not treated immediately.

Symptoms that your dog may have a GDV:
  • Restlessness
  • Drooling
  • Increased effort/rate of breathing
  • Vomiting white froth or unsuccessfully trying to vomit
  • A later sign is the abdomen becoming enlarged, very pale gums and an increased heart rate and eventually collapse!

If a dog is presented with a GDV then it is likely he/she will be rushed straight through for the vets and nurses to get to work immediately! They will be put onto fluid therapy, and straight away in most cases, X-rays will be taken and action to decompress the stomach as soon as possible. Once the patient is stable they are taken in to surgery to explore the abdomen and reposition the stomach and spleen if displaced and to fix the stomach to the abdominal wall to prevent further twisting.

Once surgery has been successfully performed the patient is still critical for around 24/48hrs post-surgery and food and water is very slowly introduced. Returning to a normal diet is between 3-5days as long as there are no complications! You will be taking you dog home with either a buster collar (lamp shade/cone of shame) or with a Medical Pet Shirt, which people prefer as they are less invasive for the patient.

What can you do to reduce the risk of a GDV occurring in your dog:
  • Avoid feeding large meals
  • Always leave at least an hour, before and after exercise, before you feed your dog
  • Not allowing your dog to take in massive amounts of water in one go

Contrary to common belief, feeding a dog from a raised food stand actually increases the risk of bloat, so avoid doing this and feed from the floor as usual.

One of our Nurses, Jess, went through this with her Doberman only a few weeks ago. It highlights that no matter how careful you are it can always still happen to your pet and if you pick up on the signs early enough it can save your dog’s life. Thank you Jess and Westwood for letting us share your story!

Westwood’s emergency

Westwood had had his usual dinner, fed an hour and half to two hours after his walk on Friday evening. Westwood was quite settled after eating and was sitting on the sofa. He did get up and drink quite a bit of water, which I did take away temporarily so he didn’t take too much water in after his meal. Westwood got back on the sofa and did not show any symptoms till a good three hours post eating.

Firstly, Westwood just seemed a bit restless. He kept getting up and down from the sofa, as though he couldn’t get comfortable. He then spread out on the floor. He was still reasonably bright other than being a bit restless but instinct and being aware of the condition (GDV) made me know that he was probably starting to bloat. Being a nurse I knew that this could lead to the stomach twisting which is an emergency. Westwood didn’t appear bloated at this point but he started to seem a bit uncomfortable in his abdomen. He then stood up in a hunched position and was drooling. He then started to deteriorate quite quickly. I rang Vets Now at our Walnut Tree Hospital, to make them aware of the situation. As I was on the phone giving our details, Westwood started extending his neck right out and started retching but nothing came up. We immediately left the house and drove to the surgery. It was less than a ten minute drive but Westwood continued to retch unproductively, and once at the surgery he lay on the floor, he was obviously very unwell. Westwood still did not look bloated visually, although all the other signs were there, so I would urge owners not to wait until the abdomen appears distended. The Vets Now team were brilliant and immediately took an x ray of Westwood’s abdomen which did show lots of gas. Blood tests were taken and Westwood was placed on two drips and given pain relief.

Luckily, Westwood’s blood levels were normal apart from being dehydrated. Dogs that are not bought to the surgery soon enough go into shock and their vital organs are compromised. Once Westwood’s pain relief had started to take effect, a stomach tube was passed consciously. Some food and liquid came through the tube but it could not be fully passed which indicated that his stomach was twisted. He was anaesthetised and quickly prepared for surgery. Westwood continued to receive intravenous fluids and intravenous antibiotics while he had his operation. His stomach had twisted at the top (the pylorus) and his spleen had flipped onto the wrong side. Some dogs require the spleen to be removed if the blood supply has been cut off, but Westwood was very lucky. The Vets Now surgeon passed the stomach tube again to empty the stomach fully and then repositioned it. She then performed a gastropexy, a procedure which involves suturing the stomach to the abdominal wall so it cannot twist again. Westwood continued to have fluids overnight and strong pain relief and over the weekend. Vets Now kept us updated with how he was progressing and we brought Westwood home late Sunday afternoon once he had started eating was more comfortable. Westwood has now made a full recovery. We are so grateful to Vets Now, but also to Milton Keynes Veterinary Group, who also looked after Westwood on Saturday morning to the afternoon before Vets Now took over his care again.

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Cat clinics at Stoke Road

In September 2013, we introduced a new Cat Clinic at Stoke Road in Bletchley. Held on Tuesday afternoons, this allows us to cater specifically for your cats needs and minimise the stress they may experience when visiting us.During the clinic times, we have a strict ‘no dogs’ policy, giving your cat a peaceful wait for their appointment. We will also use plug in ‘Feliway’ diffusers in our reception area, further promoting a calm atmosphere for your cat. All of our staff are trained to handle cats in a quiet and confident manner, and if you would prefer a nurse to help you hold your pet in the consulting room, they are always eager to assist. In the waiting room, there is a cat carrier tree. This is so that they can be up off the floor, so in turn they feel more secure and can survey their surroundings.

On Saturday 14th June 2014, we will be hosting a “Cat Clinic Client” Event. We are inviting guest speakers to talk about most things feline! Your invitation will follow in due course – save the date!

Cat clinics are open to all our feline friends, for vaccinations, repeat prescription check-ups and general health checks, and everything in between. Our computer system is linked across all of our surgeries, so even if Stoke Road is not your normal branch, we are able to access your cat’s previous notes and treatment details, and reception staff can make appointments from any site.

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Choosing the right cattery

It’s the time of year that everyone starts to dream of sunnier climates. The weather is cold, generally gloomy, mostly wet, and we all end up day dreaming of the most elusive thing in the UK – Sunshine. So you book your holidays, daydream about what you’ll pack and gladly think about the most difficult choice being to sunbathe by the sea or by the pool. But while you’re dreaming of your perfect escape, who’s going to look after the family member who won’t be coming with you? Choosing the right cattery can be a daunting decision, leaving behind a family member in the care of a relative stranger is no easy task. So how do you know which to pick? We’ve put together a small guide for you on what to look out for to make sure that your cat’s holiday is just as amazing as yours.

1) General considerations
  • Know your price range – Catteries will range in price depending on their location, and services available. As with all things, generally the more you pay, the better the service provided will be. In the MK area prices will range from £8.50 to £15 per day, with some discounts for multiple cats!
  • Inspections – If the cattery you’re interested in doesn’t allow any prior inspections, then seek somewhere else. Meeting the people who will be looking after your family member while you’re away is really important and shouldn’t be underestimated.
  • Websites – If they have a website then it’s worth looking into all that they offer, and if there are any specific terms and conditions you must abide by before lodging your cat there.
  • Testimonials – On their website is great, but those on a hosting website e.g. yell.com are better as they’re not controlled by the cattery owners and so not subject to bias. This means you can get a real idea of what other cat owners before you have really thought about the cattery.
2) Accommodation
  • Housing – Your cat shouldn’t be housed with cats from other households, so individual housing should be available. That being said, if you have multiple cats, it would be better for them to be housed together and so “family accommodation” or cat flaps opening up several individual pens to one another should be available. The housing should also be heated, even in the summer the British nights can get chilly, its important that your loved one stays comfy and cosy so they can enjoy their holiday.
  • Environmental Enrichment – At home your cat will have access to a range of different environments to play around in, a cattery should ideally provide facilities for play and scratching around to ensure that your cat doesn’t get bored during their stay.
  • Outdoor Access – It is important for cats to have the access to the outdoors that they are used to but in a safe environment. Ideally the cattery should have an outdoor run providing a safe area for cat’s to have the outdoor exploration they are used to. Also some catteries may offer outdoor access ad lib, so your cat may come and go as he/she pleases.
  • Safety Passage – Should your cat prove to be a bit of a Houdini, a safety passage should be in place so that if an escape attempt is made, they can be caught and returned to the safety of their pen, quickly and without any problems.
  • The Surrounding Area – If your cat isn’t used to dogs, then ideally the cattery shouldn’t be in range of a doggery, or any noisy neighbours!
3) Cattery requirements
  • Vaccinations – A good cattery will require that your cat is fully up to date with their vaccinations before entering the cattery to ensure that there is no spread of disease at all.
  • Flea and Worming treatment – Most good catteries will also ask that your cat is treated for fleas before their stay, and some may also ask for up to date worming treatment.
4) Additional considerations
  • Prescription/special diets – Catteries should either offer most diets themselves or be happy to deal with feeding special prescription diets.
  • Medications – Some catteries will be happy to administer medications, its worth checking if they will do this and if there is any extra cost incurred.
  • Grooming – Long haired cats will need grooming on a regular basis, you will need to check if the cattery will provide this service and if there is any additional cost involved.
  • Veterinary arrangements – These should always be sorted BEFORE you leave for your holidays, you will need to give the cattery your consent for veterinary treatment if it is necessary. Checks should also be made as to which veterinary surgery will be used in the event that your cat does require attention.
  • TLC – Your cat is used to having a loving, caring owner at home and so should be spoilt with love and affection whilst on holiday too! Ensure that there are provisions made for time to be spent fussing your cat.

Happy Cattery hunting, and Happy Holidays from all of us at Milton Keynes Veterinary Group.

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TB in Cats and the risk to people

With the news this week that two people have been infected with tuberculosis, almost certainly from their cats it is a worrying time for cat owners. Evidence at present suggests that the risk of transmission to people from their cat is considered very low and in the Milton Keynes area this risk is luckily probably even lower. Tuberculosis is caused by a group of organisms called Mycobacteria. These organisms are generally quite slow-growing and also quite resistant to antibiotics.

There are three main species of mycobacterium that we need to concern ourselves with regards to cats and they are Mycobacterium tuberculi, Mycobacterium bovis, and Mycobacterium microti. 90% of human TB is caused by M.tuberculi and some by M.bovis. Infection in people with M.microti is extremely rare. Cats on the other hand are quite resistant to M.tuberculi with M.microti and M.bovis causing most of their infections. TB in cats invariably presents with non-healing, discharging skin sores, rather than respiratory complaints. In the days before pasteurisation it was commonly caught from drinking infected cow’s milk but now it is invariably caught by being bitten on the front legs and head by small rodents which themselves have TB, so cats that hunt are at much higher risk.

We had an unusual case of TB in a cat Milton Keynes a few years ago. She initially presented with a discharging lump below her eye which on analysis was confirmed as TB but was unable to be classified. She had 6 months of triple antibiotic therapy and seemed cured. A year or so later she appeared with inflammation in the left eye which resolved with treatment. A few months later she came back with this lesion in her eye, a similar one in the back of her right eye and a gritty lesion in the lymph node in her back leg from which we were able to culture the T.microti. She also had extensive lung involvement on x-rays. After several more months of treatment the lesions resolved although she remains blind. A year or so later she relapsed with lesions on her spine but she is now on continuous treatment with antibiotics but remains a very sweet happy cat.

The problem with TB is that the organisms are extremely difficult to grow and over 50%, in most studies are unable to be cultured. For those of us in Milton Keynes however the good news is that in those cats where we do culture there TB the typing has a strong relation to geography. In a study done between 2004-8 nearly all the cases of M.bovis in cats came from the West of England and Wales, while nearly all the cases from the South East of England were M.microti. TB is difficult to treat in both people and animals and there is also the ethical dilemma of using what are the most effective treatments in people in animals which may lead to greater resistance. TB in cats is uncommon, but also easy to miss therefore if owners have a pet that is unwell they should consult a vet. However the one ray of sunshine is that cats in our area that do catch TB are likely to be carrying M.microti making the risk to their families very low.

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Alabama Rot!

As you probably already know a local veterinary practice has had a confirmed case of ‘Alabama Rot’, the disease thought to be responsible for the illness in some dogs in the New Forest since December 2012. More recently it has been identified in other counties in the UK, the dog treated locally was primarily exercised in Salcey Forest. The Forestry Commission have been contacted and made aware of the case and are putting signs up warning dog owners immediately.

Idiopathic cutaneous and renal glomerular vasculopathy, otherwise known as CRGV or Alabama Rot is a disease that has been known about since the late 1980’s. Dogs presenting with the disease have kidney failure and/or skin lesions. The cause of the disease remains unknown. Most commonly, the skin lesions are seen below the knee or elbow, and are a symptom of the disease rather than being a wound from injury. There may be a patch of red skin or an ulcerated area, and there may be swelling around the lesion. In the following two to seven days, the affected dogs have developed sign of kidney failure, which includes vomiting, lethargy and reduced appetite. This disease will not be the only cause of skin lesions or kidney failure, often there will be another cause. However, prompt diagnosis and treatment is imperative for any dog with ‘Alabama Rot’, but without knowing what causes the disease, it is also difficult for us to be able to give you specific advise on prevention or where to walk your dog. We would like to stress that there has been only one case in Northants, but as the disease is fatal in most cases, it is better to be safe then sorry.

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