Pet Health Advice

What are allergies?

An allergy is an abnormal immune reaction to an otherwise harmless substance. Allergies are one of the most common causes of skin disease seen in dogs.

What causes allergies?

Your dog’s immune system is a very powerful and effective defense mechanism – anything that gets into your dog that the immune system doesn’t recognise is attacked and destroyed. However, sometimes the immune system can make a mistake, and respond to a harmless substance in the environment (such as pollen, or a particular type of food, for example). This cannot be destroyed but the immune system tries really hard to do so. The most common allergen in dogs is thought to be flea saliva but they can respond to a wide range of other substances such as pollen, certain types of protein found in food, mites, cleaning products and many more.

What dogs are at risk?

Any dog may develop an allergy; however, it is most common for dogs to become allergic early in adult life. It’s important to remember that a dog cannot become allergic to a substance until they have been exposed to it on at least two occasions.

What are the symptoms?

The exact symptoms observed will depend on what part of the immune system has been stimulated; in general, however, most allergies in dogs present with skin symptoms (even food allergies).

These include itching, reddening of the skin, hair loss, self-trauma (from scratching) and secondary infections. In many cases, the skin first affected is that lining the outer ear canals, so dogs with allergic skin disease may initially appear to have an ear infection; the softer skin between the pads on their feet is also commonly affected. In other cases, the allergy may cause a runny, itchy nose or itchy, sore eyes. Rarely an allergy can cause an upset stomach (especially diarrhoea).

How are allergies diagnosed?

There are three approaches to diagnosis of allergies.

The first is to look at the history – when do the symptoms appear, are they associated with any type of food, bedding or environment? Do they only appear after walking under certain trees in the park, or if you used a certain fabric conditioner? This will often allow us to determine what types of things are causing the allergy, but not always.

If not, we can use special tests such as an IgE blood test (to look for raised levels of antibodies in the bloodstream) or an Intradermal Allergen Test (where we inject certain substances into the skin and then measure the response). These both have strengths and weaknesses, but using a combination of both we can usually determine the cause of your dog’s allergic reactions.

In the case of food allergies, the only way to definitively demonstrate it is to put the dog on an exclusion diet, where the dog eats only novel foods (that their immune systems have never been exposed to before) or, better, a hydrolysed diet (which is specially formulated so that the immune system cannot respond to it). If the symptoms resolve, then we introduce one foodstuff at a time until we discover which one is the problem.

How can they be treated or managed?

The ideal treatment for any allergy is simple – avoid the allergen! In some conditions (like Flea Allergic Dermatitis) this is very doable – it isn’t easy but it is possible to eradicate fleas in your house. However, this isn’t always practical, so there are other options.

The first is medication – there are a range of different medications available to reduce itching and damp-down the immune system’s abnormal response. Some are rarely successful (such as antihistamines), some have many side effects (like steroids) and some are very expensive (like oclacitinib), but careful and judicious use of medication can make all the difference to a dog’s quality of life.

Other possibilities include desensitisation, where we “teach” the immune system to ignore harmless allergens.

Can allergies be prevented?

Unfortunately, at this time they cannot be prevented. Predisposition to developing allergies is partly genetic, but it also depends on the environment.

What is arthritis?

When we talk about “arthritis”, we usually mean “osteoarthritis”, also called “Degenerative Joint Disease”. This is the type of arthritis that older dogs get from a lifetime of wear-and-tear. It’s probably the commonest single disorder of the older dog, and the commonest threat to their welfare and wellbeing.

What causes arthritis?

As a rule of thumb, there are three causes of osteoarthritis – normal weight bearing on an abnormal joint (e.g. in Hip Dysplasia); abnormal weight bearing on a normal joint (e.g. obese or overweight dogs); and normal weight bearing on a normal joint for an abnormal length of time (e.g. old dogs). Whatever the cause, however, the process is the same – the joint cartilage becomes damaged, leading to inflammation, pain and further damage. At the same time, extra bone forms around the joints to try and stabilise them, but this restricts the range of motion.

What dogs are at risk?

Any older dog, especially if they are overweight, have orthopaedic problems (e.g. hip dysplasia, elbow dysplasia, or a poorly healed injury), or are “high mileage” e.g. working or highly active dogs are at increased risk. However, arthritis may occur in any dog under some circumstances.

What are the symptoms of arthritis?

The most common early symptom is “stiffness” and a reduced desire for exercise or activity. This may initially be misdiagnosed as simply “getting older” or “slowing down”, but it is in fact due to joint pain. It typically progresses to difficulty rising or ascending stairs or slopes, and then definite and obvious lameness (although this is usually present in more than one leg). A characteristic feature is that the lameness or stiffness is usually worst immediately after getting up, and it then decreases or “works off”. It is also often worse the day after strenuous exercise.

How is arthritis diagnosed?

In many cases, arthritis can be diagnosed simply from the history and a good description of the symptoms. The most useful additional test is often a “Range of movement examination” where the vet will see how far in each direction a joint can be moved without pain – this is usually reduced in patients with advanced arthritis. To fully assess the joint(s), it is necessary to carry out an X-ray examination and look at the bone ends and joint spaces; however, this isn’t always appropriate in an old or ill dog.

How can arthritis be treated or managed?

Strictly speaking, there is no cure for arthritis; however, it is possible to replace some joints – hip and elbow replacements are now fairly common. That said, arthritis is rarely so severe that this

Is required, at least initially, and it can usually be manged with a combination of techniques.

At home, the owners can make the dog’s life a lot easier with some simple modification – ramps instead of steps, a comfortable bed to lie on, and keeping their sleeping areas warm. In addition, weight loss can be a very powerful tool in the overweight dog – it is estimated that a reduction of one body condition score point is as effective as a dose of a painkiller! Physiotherapy and hydrotherapy can also be very helpful.

However, the mainstay of managing arthritis patients is with medication – usually anti-inflammatory and painkilling drugs. Remember, there are no over-the-counter painkillers for dogs for long-term use, and human products are often lethally poisonous to dogs. Nutritional supplements (such as glucosamine or chondroitin) are also widely used – the evidence for their effectiveness is weak, but they do seem to help some dogs, especially if given with a large meal (to reduce their breakdown by stomach acids).

Can arthritis be prevented?

Arthritis will probably develop eventually in most dogs; however, it can be delayed and slowed down with proper care throughout life. This would include weight control, regular exercise, and getting and lameness or other orthopaedic disorders diagnosed and treated as early as possible.

What is dental disease?

Dental disease is a catch-all term relating to disease of the teeth and gums. It is very common in dogs, and ranges from mild scale on the teeth to severe periodontal disease that may contribute to kidney or heart disease.

What causes dental disease?

Unlike us, dogs and cats do not brush their teeth every morning and evening. As a result, plaque builds up – this is a mixture of food material, dead cells from the gums, and bacteria. Over time, this becomes thicker and then mineralises (turns into a hard, stone-like matrix which we call tartar). When this bacteria-ridden growth reaches the gum line, it causes infection of the gums – gingivitis. If untreated, this will spread down into the tooth socket, and at this stage we refer to it as periodontitis. This weakens the ligaments holding the teeth in the socket, causing them to become loose and eventually fall out.

In addition, infection can spread through the bloodstream to other organs, especially the heart and kidneys. It doesn’t matter what food a dog is eating, or whether they regularly chew bones or chew toys – some dogs will still develop tartar and then dental disease (although some foods are worse than others).

What dogs are at risk?

All dogs are at risk from dental disease, but it is often most dramatic in older dogs where the plaque has had years to build up. In addition, miniature and toy breeds are slightly more likely to develop early onset dental disease because they often have abnormalities of the mouth, meaning the teeth are at odd angles and therefore are more likely to build up plaque and tartar.

What are the symptoms of dental disease?

Initially, the main symptom is bad breath. Over time, this may progress to red, swollen and inflamed gums, loose teeth and pain when eating. In severe cases, dogs may stop eating entirely. In addition, heart disease and kidney failure have both been linked to untreated dental disease.

How is dental disease diagnosed?

Simple physical examination is often sufficient; however, dental X-rays are also invaluable. In most dogs, a full examination of the mouth and teeth requires a general anaesthetic so that the gum-lines can be probed (something that isn’t possible in very many conscious ones).

How can dental disease be treated or managed?

Once dental disease (even severe plaque) has developed, it requires surgical treatment – we call this “a dental”, and it’s exactly the same treatment as you get when you go to the dentist. The only difference is that we have to use a general anaesthetic. We will carefully examine every tooth, and remove any that are too diseased to survive. Then we’ll clean the remaining teeth with an ultrasonic scaler and then polish them to make them smooth. Afterwards, preventative care is all that is usually needed.

Can dental disease be prevented?

Yes, very easily. Although there are a range of “dental chews” available, these are of limited use in most dogs (although they’re often better than nothing). The same goes for specialist dental diets; chewing on bones is not reliable and may introduce health problems of its own, so isn’t something we’d usually recommend. The most important and effective preventative treatment is tooth brushing – something you should be doing every day. Use a normal tooth brush, and special dog-toothpaste (don’t use human toothpaste – the mint burns their gums), and gently brush the teeth at least daily. Mouthwash additives in their water or food will also help slow down the growth of plaque. Regular brushing sounds difficult, but it is the only way to prevent the formation of plaque and subsequent dental disease.

What is it?

Diarrhoea is defined as the passage of a greater than normal volume of faeces; usually, the faeces are much wetter than usual, and they frequently have a more offensive smell than normal. Diarrhoea can be caused by disease of the small intestine or the large intestine (sometimes known as small bowel vs large bowel diarrhoea); and may also be due to an increase in gut movement or (counterintuitively) a reduction in movement.

What causes diarrhoea?

Diarrhoea is one of the most common symptoms reported in dogs, and there are a huge number of possible causes. The commonest reason for a dog to develop acute (sudden onset) diarrhoea is diet – either too sudden a change in what they’re being fed, or they’ve eaten something nasty (this is known as dietary indiscretion, and may also be accompanied by vomiting).

However, other possible causes include infection (e.g. Parvovirus or Campylobacter), a heavy worm burden, or infection with parasites such as Giardia. There is also a condition called Small Intestinal Bacterial Overgrowth (SIBO) where an excess of bacteria in the small bowel leads to problems.

Non-infectious causes include pancreatic disorders (such as Exocrine Pancreatic Insufficiency, EPI), or toxins (such as chocolate peanuts or heavy metals). Sometimes, the dog’s own body is the problem, with conditions such as immune system diseases (e.g. Inflammatory Bowel Disease, IBD), food allergies (although this is rare, they usually cause itchy skin), or tumours of the intestine (especially Alimentary Lymphoma).

What dogs are at risk of diarrhoea?

Almost all dogs will develop diarrhoea at some time in their lives. Puppies are at the highest risk of Parvovirus; young adult dogs are at higher risk of dietary indiscretion, while older dogs are more likely to have tumours. Sometimes genetics are also a factor – German Shepherds often have poor intestinal immunity, making them more prone to infections, whereas some lines of Basenji are predisposed to IBD.

What are the symptoms of diarrhoea?

Although all dogs with diarrhoea are producing more faeces than usual, the exact symptoms will depend on where the diarrhoea originates. Small Bowel diarrhoea typically causes a larger increase in faecal volume, but only a mild increase in frequency. It is often associated with vomiting, loud intestinal noises, and if it goes on for too long, weight loss. Large bowel diarrhoea, on the other hand, tends to result in massively increased frequency of defecation, often with straining. In many cases, the faeces passed will be jelly-like and may contain blood. Of course, as diarrhoea is a symptom, the underlying illness may cause other symptoms as well – such as weight loss in tumours, or fever in infections.

How is it diagnosed?

Well, the presence of diarrhoea is pretty unmissable. However, working out exactly what the cause is can be quite challenging. Fortunately, most cases of acute diarrhoea can be managed symptomatically and will resolve on their own in a short time.

Diagnostic tests to determine the cause include blood tests (especially for Cobalamin and Folate for SIBO, plus TLI for EPI); and faecal analysis (to look for worms and other parasites, plus certain bacteria (such as Salmonella and Campylobacter). If a food allergy is suspected, a hypoallergenic exclusion diet may be needed; and if IBD might be responsible, endoscopy and gut biopsies are invaluable.

How can diarrhoea be treated or managed?

For simple acute diarrhoea, home management is usually appropriate for the first 2-3 days, assuming the dog is otherwise healthy and bright in themselves. Do NOT starve a dog with diarrhoea, but do offer them plenty of water (ideally with dog-suitable electrolytes to help prevent dehydration), and feed a very bland diet (boiled chicken and rice, or a specialist intestinal food). Anti-diarrhoeal pastes such as ProMax will also help, but NEVER give human medicines unless told to by the vet. If the diarrhoea doesn’t resolve on its own; or if your dog seems dull, listless, ill in themselves, or has any other symptoms, take them in to the practice so your vet can check them over. In most cases, once the cause is identified, we’ll treat that, but occasionally specialist anti-diarrhoeal drugs may be prescribed.

Can diarrhoea be prevented?

The best way to minimise the risk is to make sure your dog only eats a good-quality diet, you don’t change food rapidly, and you don’t let them rummage in dustbins or eat dead rotting things they find out and about!

What is pyometra?

Pyometra, or “a Pyo”, is an infection of a dog’s uterus (womb). It is a severe and potentially fatal condition, and preventing it is one of the main reasons for spaying bitches.

What causes pyometra?

In a normal, healthy bitch, after every season her uterus prepares to receive puppies (this is driven by the hormone progesterone), and whether or not she becomes pregnant, the uterine wall will thicken and secrete fluid. As she gets older, this becomes more and more pronounced – we call this Cystic Endometrial Hyperplasia. Once she’s decided she isn’t actually pregnant (about 2 months after her season), the lining thins down and the fluid is reabsorbed. However, if during this time bacteria can enter the uterus, this fluid is a perfect foodstuff for them, and they rapidly grow and multiply, causing disease.

There are two types of pyometra – an open pyometra (where the cervix remains open, so the pus can drain out of her vagina and vulva), and a closed pyometra (where the cervix is closed so all the bacteria, pus and toxins are trapped inside). Although both are dangerous, a closed pyometra is more likely to be fatal, and is harder to diagnose.

What dogs are at risk of pyometra?

Any un-spayed bitch – although it may be slightly more common in those who haven’t had a litter (although it can happen to any bitch). It usually develops within 3 months of a season, and is more likely in older dogs. Overall, 23% of un-spayed bitches can be expected to develop a Pyo by 10 years of age.

What are the symptoms of pyometra?

A dog with an open pyometra may just appear a little off colour, with a thick cream, yellow or greenish vaginal discharge. However, more often she will be displaying signs of systemic illness, typically increased thirst and urination, lethargy, and loss of appetite.

A closed pyometra is more dangerous, as there is no discharge to warn you of a problem. She will start out with these non-specific signs, but then rapidly deteriorate and start vomiting, her gums may change colour (to red or possibly pale grey), and her abdomen may seem to swell. Ultimately, she will collapse, go into shock and die.

How is pyometra diagnosed?

Usually with an ultrasound scan to look at the uterus – a pus-filled, inflamed uterus is very obvious on ultrasound. Other possible tests include blood tests and a vaginal exam.

How can pyometra be treated or managed?

The treatment of choice is usually surgical removal of the infected uterus. In some cases that are caught early, it may be possible to use hormones (to make the uterus shrink down and expel the infection) and antibiotics (to treat the bacteria) – however, although most dogs will respond to this treatment, the pyometra will recur after the next season in many cases.

Can pyometra be prevented?

Yes – by spaying. A neutered bitch cannot develop a true pyometra.