Making health care decisions for your pet
It is common for a veterinary surgeon to recommend a particular test, operation or treatment for their patient. As pet owners, we have to decide whether to go ahead with the suggested procedure. But how do we know that we are making the right decision?
In human health care, there is currently a campaign to raise awareness of the BRAN system to help patients make these decisions. BRAN stands for Benefits, Risks, Alternatives and what happens if we do Nothing. The system can be just as useful for pet owners.
The first question to ask your vet when they suggest an operation, blood test, Xray or course of medication is “what are the likely benefits?” For example, having an operation to remove a cancerous lump from a pet’s skin would hopefully cure the cancer.
The second question to ask is “what are the risks?” In the example above, going ahead with the operation would carry a risk of complications under the anaesthetic and bleeding or infection at the operation site.
The third question is “what are the alternatives?” Sticking with our original example, alternative treatments such as chemotherapy or radiotherapy may be possible.
It is always a good idea to ask about what would happen if we did nothing. For example, some cancerous lumps grow very slowly, and in a very elderly pet it may be that leaving the lump alone will probably not lead to any further problems within the pet’s natural lifespan.
At Acorn House Veterinary Hospital we understand that our patients are well loved family members and it can be worrying when a test or treatment is recommended for your pet. All of the veterinary surgeons at Acorn House will be very happy to guide you through these decisions, and the BRAN system can be a very helpful way to do this.
What is Brachycephalic Obstructive Airway Syndrome?
Brachycephalic Obstructive Airway Syndrome (BOAS for short) is the name given to a set of breathing problems that can occur in breeds of dog that have very short, “squashed” faces. Examples of these breeds are English and French Bulldogs and Pugs.
Why does BOAS occur?
Many dogs of these short-faced breeds have difficulty breathing because the shape of their skull means that they have:
- Narrow nostrils
- Overlong soft palate (at the back of the throat)
- Narrow windpipe
- Swollen larynx (voicebox)
These features narrow the airway (as if the dog is trying to breathe through a narrow straw).
What are the symptoms of BOAS?
Affected dogs will have noisy breathing (worse when excited or exercising) and often snore when they are asleep. Some dogs have to make such an effort to suck air through the narrow passageways when they breathe, that they suck stomach acid up into the food passage, causing gulping, burping, retching and vomiting. More severely affected dogs may be reluctant to exercise, or will collapse during exercise. Hot weather makes everything worse.
What can we do about BOAS?
Dogs with BOAS should avoid strenuous exercise, particularly in hot weather. Using a harness instead of a collar and keeping dogs at a lean body weight are also helpful.
However, surgery is the treatment of choice when dogs cannot breathe properly. Excess tissue can be surgically removed from the nostrils and soft palate, improving air flow.
In general, the earlier the surgery is performed (ideally before 2 years of age), the better the outcome as this condition worsens over time. Affected dogs should not be used for breeding so that we can reduce the number of dogs being born with these problems in the future. Sometimes surgery can be carried out at the same time as neutering.
BOAS surgery should be carried out by experienced surgeons with good facilities for supporting patients through the surgery and recovery period.
What is “dry eye” in dogs?
“Dry eye” occurs when the body does not produce enough tears to keep the surface of the eye healthy. Dry eye can affect any dog but it is most often seen in Cavalier and Cocker Spaniels, Bulldogs, Pugs, West Highland White Terriers, and Yorkshire Terriers.
Why does dry eye occur?
In most cases dry eye occurs because the dog’s immune system attacks the tear-producing gland in the eye. As the tear gland is damaged, it is able to produce fewer and fewer tears.
What are the symptoms of dry eye?
As tear production is reduced, the eye will feel gritty and sore. Some dogs will rub at their eyes. The shiny, reflective surface of the eye may look dull. The eye will often produce sticky mucus or excessive crusty “sleep” in response to the irritation.
Dogs with dry eye are at increased risk of developing eye infections and ulcers.
Eventually, the damaged surface of the eye may develop abnormal blood vessels or patches of dark pigmentation, and blindness will occur.
How is dry eye diagnosed?
It is important to diagnose dry eye early, so that damage to the tear gland can be halted. Vets use a paper strip test called the “Schirmer Tear Test” to measure tear production. This test only takes sixty seconds and does not require sedation.
What is the treatment for dry eye?
An eye ointment is available which can “switch off” the faulty immune system in the eye, preventing further damage to the tear glands.
In some cases, artificial tear drops must also be applied regularly.
Very rarely, an operation is suggested, to divert saliva from the mouth into the eye.
When dry eye is recognised and treated early, the prognosis is excellent. If you are concerned about your pet’s eyes, please contact Acorn House Veterinary Hospital. The veterinary team at Acorn includes a post-graduate certificate holder in ophthalmology (the study of eyes).
Many dogs love to chase, chew and carry sticks but did you know that sticks can be dangerous for your dog?
Pepper came to see us last month after picking up a stick whilst out on a walk. Pepper now seemed uncomfortable around her neck area.
Pepper was given a general anaesthetic so that our vets could examine her mouth and throat further. A tiny fragment of stick was visible wedged in the soft tissues underneath Pepper’s tongue. Amazingly, this turned out to be only the tip of a 4cm piece of stick! Do watch this video of the stick being removed from Pepper’s tongue:
Pepper went on to make a full recovery and continues to be on the lookout for sticks when she is out and about! Her story reminds us that sticks can cause serious injuries to dogs. Injuries are most likely if the sticks are thrown for dogs to chase. Playing, chasing and chewing are fun, healthy activities for dogs, but rubber sticks, balls or Frisbees are much safer alternatives to sticks.
Update on rabbit vaccination Click here to read the latest information
Baby birds- what should we do?
Little Tweet is a baby sparrow that was brought into the surgery. At this time of year it is common to find young birds apparently alone on the ground. Click here to read more........
New tick-borne disease in the UK – what do we need to know?
What are ticks?
Ticks have always been a problem in the UK. They are spider-like creatures that feed on the blood of animals including dogs and cats (and sometimes humans). Ticks can be found across the UK – particularly in woodland, moorland, and grazing pasture but also in parks and gardens.
What damage do ticks cause?
The ticks attach to animals and feed on their blood for 5 - 7 days before dropping off again. Attached ticks can cause discomfort and blood loss, but in many cases pets appear unaware of their presence. The big concern is that ticks can carry infectious diseases and pass these on to the animals when they feed.
Belle’s Photo Diary
Meet Belle! We were delighted to have her to stay earlier this week when she came to be spayed at Acorn House Vets. Her owner kindly agreed for us to make a photo record of her day to give all of our clients a behind the scenes look at what we do. Click here to view Belle's photo diary.
Gold standard cat care at Acorn House
“Acorn House Veterinary Surgery is a gold standard cat-friendly practice”.
That was the assessment made last week by the International Society of Feline Medicine (ISFM). The ISFM assesses the facilities and services that veterinary practices offer to their feline patients – a little bit like an Ofsted inspection. We are delighted to have received the top level award!
Acorn House is the only gold standard cat-friendly practice in Bedfordshire.
So what have we been doing to make our practice so special? Over the course of 2015 we extended our building to include a completely separate cat ward. This means that cats can recover from surgery and illness in peace and quiet, away from the sounds and smells of the dogs in the practice and the hustle and bustle of our busy team. We can even watch the cats on our CCTV system, monitoring their every move without them realising it! Our cat ward boasts very large kennels with igloo-style beds for cats to relax in.
We also have the luxury of a completely separate isolation ward so that stray or infectious cats can be cared for without putting other patients at risk.
This picture shows our Senior Nurse, Paul caring for a cat with a viral infection in our dedicated cat isolation ward.
In the waiting room we have provided a separate cat waiting area. This area has elevated resting places for cat baskets as we know that cats feel safer when they are higher up.
We also have cat basket covers available to provide additional privacy. Special thanks to vet Romina and her mum for making these!
The entire practice team has undertaken additional training in cat-friendly handling. For example, Heidrun and Emily are examining Phoebe in the bottom half of her travel box as this helps her feel safer than perching on the bare consultation table.
Nervous cats may feel more secure in a snug towel wrap (as demonstrated by Sheldon and Hayley below) and others will respond to a ready supply of cat treats!
Of course, our feline patients continue to benefit from all of the other practice facilities such as two operating theatres, digital X-ray, dental suite with dental X-ray, endoscopy, ultrasound, piped oxygen and anaesthetic gases and our own vets and nurses available for emergency care at the practice or in your own home 24 hours a day, 365 days a year.
Next week’s blog will follow one of our feline patients through a typical day at Acorn House, bringing you all of the action behind the scenes!
Katharine Nelson MA Vet MB GP Cert (SAM) PG Cert (Behaviour) MRCVS
Benji bites off more than he can chew!
“My dog has a bone stuck on his jaw!” came the emergency call last Friday night. Small fragments of fragile bones and sticks quite commonly get stuck inside the mouth but Benji had got himself into a much more unusual situation. His owners had given him a hollow bone stuffed with treats to keep him occupied for an hour or so. But such was Benji’s determination to get every last scrap out of the bone, he had managed to force his entire lower jaw, teeth and tongue into the bone cavity. The bone was now completely stuck! Despite Benji (and his owners) being admirably calm, the bone proved impossible to remove with Benji awake.
Fortunately, with some lubrication and gentle manipulation with Benji under a general anaesthetic, we were able to release Benji from his treat. Incredibly the bone had caused no injuries to Benji’s teeth or jaw and he was up and about an hour later as if nothing had happened.
We definitely encourage the use of chews and food toys to keep dogs entertained and calm when they are left alone for short periods. Many dogs feel anxious or unsettled when their owners depart and providing a food toy can turn this experience into a positive one. I have never encountered a problem with this particular bone type before and think that Benji and his owners were just very unlucky. Nevertheless, I will now advise owners to double check that the cavity inside these bones or inside Kongs and other puzzle toys is either much larger or much smaller than the lower jaw.
But dogs will be dogs, and if there is trouble to be found we can be sure that they will find it! That's why Acorn House has one of its own vets on call 24 hours a day, 365 days a year.
Katharine Nelson MA VetMB GP Cert(SAM) PG Cert (Behaviour) MRCVS
It was during a particularly eventful family holiday to the Isle of Mann that I decided that I would help animals for ever and become a vet. My Dad and I conducted a dramatic rescue of a seagull with fishing line wrapped around its wing as waves crashed around us onto the rocks and a crowd of onlookers cheered us on. Six months previously we had risked life and limb to scoop a lamb out of a fast flowing river in the Yorkshire Dales (although I secretly suspected that the presence of our dog might have been the reason the lamb jumped into the river in the first place - just as well there was no crowd of onlookers that time). A literary and television diet of James Herriot and the BBC drama "Two by Two" (following the professional and romantic exploits of a zoo vet) confirmed to me that a veterinary surgeon did indeed have the ultimate "dream job".
My first dog was a collie-cross named Sadie. She spent her early life as part of a pack of dogs living rough on the streets of Hull and at the age of six months she was involved in a road accident that left her requiring surgery for a broken leg. Fortunately this led to my family rehoming her after her surgery and she lived with us to the grand age of 16 years. As a child I clearly had great faith in the vet that repaired her broken leg as we lived a very active life - looking back at this picture of myself and Sadie completing a home made agility course I find it hard to believe that either of us could jump so high!
I was fortunate enough to join the Cambridge University Veterinary School in 1997. Competition for places at vet school was and is high, and I am very grateful to my parents and teachers who advised me early on that if I wanted to be successful I would need to gain a lot of practical experience with animals before applying. Much time was spent on farms, at stables and in boarding kennels/catteries merrily milking, lambing, exercising and inevitably undertaking plenty of mucking out and picking up poo! I also arranged to "see practice" at our local vets and witness first-hand what the job entailed.
At Acorn we are well placed to provide information and offer work experience placements to students considering a veterinary or veterinary nursing career. Being a busy mixed practice with a vast array of diagnostic and surgical equipment and 24 hour care for our patients there is always plenty to see!
We have collected some photographs of our vets with their childhood pets – see if you can guess who they are!
A B C
D E F
Scroll down for answers
A: Katharine Nelson B: Adele Fryers C: Rosie Theakston
D: Sheldon Middleton E: Cathy Fryers F: Gill Monsell
- Practice Newsletter
- Read the latest information, offers and advice by reading our practice newsletter.
Acorn House Veterinary Surgery
Linnet Way, Brickhill, Bedford, MK41 7HN