Sickness Care

Most dogs and cats over the age of seven years have significant problems with oral health. This is often unrecognised by their owners, and they suffer in silence. The main reason for this is a diet which does not need much chewing, and therefore allows the build-up of plaque and tartar.

Plaque and tartar then cause gum disease, which is the commonest reason for tooth loss in dogs. Feeding of appropriate foods, chews etc will help reduce the build-up, but many dogs and cats need to have regular dental scaling to keep their mouths healthy.

Cats also develop a painful condition called “feline odontoclastic resorbtive lesions” (FORLs for short). Here small areas of tooth enamel are dissolved away by cells in the cats own gum tissue. The holes that result are very painful, and they grow larger until the tooth breaks off at the gum. Unfortunately, nothing can be done to save affected teeth, and usually by the time an affected tooth is found, the best treatment is removal.

Rabbits have a different range of dental problems, mostly involving overgrowth of thier continuouisly erupting teeth. These may need to be filed down regularly. Sometimes rabbits also develop tooth absesses.

We have long recognised the importance of thorough and careful dental scaling and surgery, so we have:

• All our dental patients are treated by a qualified veterinary surgeon
• An ultrasonic scaler for tartar removal without damaging teeth or gums
• A mechanical polisher to leave the surface of the teeth as smooth as possible, slowing the recurrence of tartar
• A high-speed air drill to help remove teeth with minimal trauma to the surrounding gums
• As well as a wide range of hand instruments

If a general anaesthetic is to be given, you will also be asked if you would like a blood test done beforehand. Of course, all animals undergoing an anaesthetic will have a full examination beforehand, but sometimes there are hidden problems which an examination does not reveal.

This blood test looks at various organ systems which are particularly relevant to anaesthesia, such as the state of the kidneys and liver, and cell counts. It is not a full blood panel, and a clear result is not a guarantee either that there are no internal problems, nor that the anaesthetic will be completely safe, but it sometimes gives us useful guidance, particularly in older pets. In younger, apparently healthy animals, the results are usually normal, but even in these patients we occasionally find unexpected problems.

Home visits can be arranged if necessary, if you live within Cardiff itself. In exceptional circumstances, we may be able to visit you farther afield.

Please phone the main surgery on 02920 621 511 before 10:00am, if possible. Visits are usually made during the late morning.

However, pets are often more difficult to examine on their own territory, and all the necessary facilities, instruments, drugs and help may not be available. So it is almost always better to bring the patient to the surgery if you possibly can. In addition, Home Visits are time consuming, and so are considerably more expensive than consultations at the surgery.

If your pet has been injured and you are unsure how to move him/her safely, or if you think he/she may have a contagious disease, please call the surgery for advice.

Hip dysplasia is a disorder of the hip joint which begins during the growing stage in puppies and which is strongly influenced by inherited and environmental factors. It can cause spontaneous lameness of the back legs in a proportion of affected dogs.

The condition often affects both hips, although lameness may be seen in only one leg. Giant, large and medium sized breeds are most commonly affected although the problem may be seen in small breeds.

In the normal canine hip joint, the head of the thigh bone (femur) fits tightly into the deep socket in the pelvis (acetabulum). The femur head should sit within the acetabulum so that more than 50% of its surface is snugly contained. Hip dysplasia describes malformed joints which are loose fitting (lax). This laxity results in an unstable gait, and the head of femur rubs unevenly against the rim of the pelvic socket. The joint cartilage is then subject to excessive “wear and tear”and the joint capsule lining becomes inflamed and painful. These processes result in deformity of the bones and arthritis develops.

Detecting the signs

One of the main problems in detecting hip dysplasia is that some dogs with abnormal joints do not show any lameness and apparently walk with a normal gait. Lameness is only apparent if the joint is sufficiently unstable or painful to enforce a change in gait and may relate to the age of the dog as well as the severity of the condition. Potentially dysplastic hips are probably normal at birth but deteriorate as the animal grows. Signs of lameness appear as the puppy becomes more active. It will not move as freely as normal dogs and often “bunny hops” when trotting -as this allows it to shift weight off the painful back leg on to the front legs. Affected puppies prefer to sit rather than stand and have difficulty with stairs. When walking they may have a marked sway with the pelvis appearing to rise and fall with each step. Puppies suffering from severe dysplasia may not be able to move faster than a painful walking pace. Hip dysplasia progresses significantly between 6-18 months of age with most of the changes developing before the animal is 2 years old. In adult dogs the changes that began in early life may result in hip arthritis in middle or old age. The dog will then become lame even though no signs were noticed when it was a puppy.

Genetic and environmental factors influence the development of hip dysplasia and affect the final degree of lameness and disability.

The environmental factors of most importance are:

• Feeding a diet that results in excessively heavy puppies at a young age. This leads to overloading of the soft cartilage of the developing joint and a resulting deformation of the predisposed dysplastic joint.
• Overexercise of dogs with unstable joints will exacerbate any wear and tear of the hip.

Treatment

Various methods of treatment are available for hip dysplasia.

Rest and anti-inflammatory drugs will often help dogs showing pain after exercise. Lead walks which are short but frequent -10 minutes 4 times a day - will allow the growing skeleton to adapt and the joint to become more stable and painfree by the time the dog becomes mature at about 15 months of age. This is greatly helped by keeping the dog slim and not allowing it to grow too fast. This conservative treatment is successful in about 60-70% of cases and the dog can then be allowed to become more active. Dogs with severe signs that do not respond may need corrective surgery which may take many forms. In young dogs, realignment of the hip joint components can be performed by cutting the bones and adjusting them with steel plates and screws. For older dogs, a total hip joint replacement in which the femur head and acetabulum are replaced by a stainless steel prosthesis which fits into a plastic socket can be performed. These operations are costly and have to be carried out at veterinary referral centres.

Prevention

The main way of preventing a puppy from having hip dysplasia is to breed only with unaffected dogs. Any animal of a suseptable breed should be x-rayed before being mated. The xrays are examined by a panel of experts and allocated a score - the lower the better. At the Heath Veterinary Group we are well equipped to take Hip Dysplasia xrays of even the largest dogs.

Making sure the diet is right is very important. Large breeds should be fed a diet specifically for them. This will control the puppies rate of growth, reducing the stress on the immature joints.

It is spread by blood-sucking insects. In the wild rabbit population, the rabbit flea is usually the carrier. In pet rabbits, the rabbit flea may be the source (perhaps carried home to your garden by dogs or cats), but other biting insects (for example midges) are also important carriers.

Because of this, late summer and autumn are the disease is seen mostly in late summer and autumn. All pet and wild rabbits in UK are susceptible; occasionally our native wild brown hare is also affected. There is no evidence that some breeds are more susceptible than others.

Symptoms

Symptoms of myxomatosis include puffy swellings around the head, face, ears and anogenital areas. The eyelids swell so much as to cause blindness within a few days. Feeding and drinking become difficult, and many patients develop a secondary lung infection after about 8 days. Over 90% of infected wild rabbits die, but with careful nursing and veterinary treatment, the recovery rate for pet rabbits is a bit better than this. However, the illness can be very protracted, and some patients may take several weeks or months to recover, sometimes leaving problematic skin scarring.

Prevention

Because of the importance of insects (mosquitos and fleas) in transmission of myxomatosis, steps to control these are important in avoiding the disease. Keep the hutch and bedding dry and clean so as not to attract mosquitoes. Consider using insect repellant strips and flea sprays etc. We have a very good and safe insecticide for use in the hutch available at the surgery. It is also important to treat your dogs and cats with a good flea treatment, as they can pick up fleas from wild rabbits and bring them home.

It is most important to vaccinate pet rabbits every year against myxomatosis. A single injection is given on each occasion. The optimum time for this is in the mid-late summer so that protection is maximum when the disease is most common. The patient will not be made poorly, but some rabbits will develop a small nodule where the injection was given.

VHD was first seen in the UK in 1992, and has spread throughout the country. It is common in wild rabbits. The virus is easily spread between rabbits or via contaminated hutches, bedding and food. It can also be carried on other animals’ feet – for example pet dogs could pick up the virus during a country walk and bring it back to an urban garden.

VHD only affects rabbits, and usually only those over 6 weeks old. 90% of infected rabbits develop symptoms which can include loss of appetite, bleeding from the nose and general malaise. Most infected rabbits die, and death is often sudden, without warning. Only vaccination can control the spread of the disease in domestic rabbits. VHD is so deadly it has been released in Australia to kill wild rabbits with great success. The problem is, it kills pet rabbits too.

Prevention

There are several measures you can take to reduce the risk of infection.

Good hygiene is very important. Keep the hutch very clean. Don’t pick green food from areas where wild rabbits live. Make sure there is nothing to attract wild mice and rats to your rabbits: sweep up any spilt food and bedding.

Rabbits kept outside (especially in garden runs) seem to be at increased risk of catching VHD, so bringing them inside improves their safety (but at the risk of reducing their exercise and fresh air), and make sure wild birds can’t get inside outdoor hutches. Most importantly, your rabbits must be vaccinated against VHD, including houserabbits kept indoors.

Vaccination

Vaccinations against VHD can be given from 10 weeks of age. The immunity produced lasts only a year, and an annual booster vaccination is essential. It is safe to use in pregnant animals. Occasionally, there may be a mild reaction at the injection site, but rabbits very rarely feel poorly afterwards. The vaccine is of the ‘killed’ type and cannot possibly cause disease. Unfortunately, VHD vaccination cannot be done at the same time as myxomatosis vaccination – we usually allow 2 weeks between the doses.

RHVD 2

For background, whilst the “classic” RVHD has been present in the UK for decades, variant RHVD (also known as RHVD2 or RHDV variant) was first noted in 2010 in France, and has subsequently been identified in the UK .

This virus has some differences from the classic RVHD. In particularly it may affect rabbits of any age, as opposed to RVHD1, which is rarely if ever seen in rabbits under 8-10 weeks of age. It has also been reported that the variant gives rise to lower mortalities than classical RVHD, this is not necessarily borne out by reports, and this may be thought to be due to be the case due to its phylogenetic placement alongside non-pathogenic strains. Mortality may vary from collection to collection, and possibly from breed to breed.

The only vaccine for rabbits currently available with a UK License is Nobivac Myxo-RHD , which was made available in 2012. Not long after that, the other 3 vaccines against RHVD on the UK market ceased to be available.

This vaccine does not appear to offer protection against RVHD2, and neither do the previous vaccine brands available in the UK. However, RHVD1 and Myxo remain the most significant health threats which can be vaccinated against, and so coverage with this product remains a priority.

Work from Italy and France, however, suggests that, with our reservoir of wild rabbits, we can expect to see RHD2 starting to predominate over RHD1 in the next 5 years or so.

However, there are now 4 vaccines available in the EU which have been licensed or are undergoing licensing for efficacy against RHVD2.

Three of these vaccines (Filavac VHD K C+V, Cunivak RHD and Cunipravac RHD-2 Variant) now have a Special Import or Special Treatment Certificate from the Veterinary Medicines Directorate, on the basis of a clear need to do so given the current disease status.

In particular, Filavac VHD K C+V is available through a UK wholesaler, precluding the need to order it directly from France, but note that the veterinary practice ordering it still needs to obtain an SIC from the VMD. At present, stocks are available through three wholesalers, NVS, Henry Schein, and Centaur, but availability is very variable, and practices are advised to contact wholesalers directly for information on stock availability. There is no reason why other wholesalers cannot stock this product, and practices tied to a specific wholesaler may want to consider encouraging them to stock it.