Esme’s Story

Our Big Bear Award for bravery goes to Esme, a 12 year old labrador and ex guide dog. At the end of 2012 Esme had split a nail on her front right paw. Initially the split did not seem to bother Esme, however over time the appearance of the affected toe slowly changed and the nail failed to heal.

For several months Esme’s toe had been treated with extended courses of antibiotics with no improvement. In April 2013 she came to see the team at Vet4life for a second opinion. Over time Esme’s toe had transformed from having a small, seemingly innocuous crack in the nail to a swollen and deformed digit. Esme’s family were understandably very concerned for their beloved lab.

Alex the Vet trimmed the broken nail back, revealing a severely swollen nail bed and toe.  She examined a swab in the clinic, finding a bacterial infection. A second swab was submitted for bacterial culture and sensitivity. Had the split nail become infected, with infection slowly spreading into the bone (osteomyelitis)? Or had the nail split because of existing pathology, such as a tumour, and then become secondarily infected? An answer would be revealed with histopathology- the toe was severely deformed and unfortunately the only option for treatment at this point would be amputation.

X-rays of Esme’s toe revealed significant lysis (bone loss) had occurred, with the nail and lower phalanges (bones of the toe) had been slowly eaten away. To ensure there was no evidence of metastes (cancer spread), chest x-rays were also taken, which were normal.

The culture results were very concerning. Three different types of bacteria had been cultured, all showing multiple resistance to all common antibiotics. In fact, Esme’s infection was sensitive to only one remaining antibiotic! This particular antibiotic has potential for adverse effects on kidney function, so  prior to any treatment Esme’s general health was thoroughly screened with blood tests . She was then hospitalised on a drip while multiple doses of the antibiotic were given intravenously. Esme’s health and kidneys were monitored closely.

Following several days of treatment the infection had been brought under control and surgery could go ahead. The toe was successfully amputated in an hour long surgery. Esme remained in hospital overnight to continue antibiotic therapy and ensure adequate post-operative pain relief. She was discharged the following day to recover at home with orders of strict rest and plenty TLC from her family!

The whole amputated toe and surrounding tissue were submitted for examination.  A diagnosis of digital melanoma was made on histopathology. Surgical margins were clear, so the surgery was successful in removing all cancerous tissue. Unfortunately, digital melanoma does carry a guarded prognosis with an average survival time of approximately one year. However, advancements are currently being made in the treatment of canine melanoma patients.

Esme is now doing well and has adapted to life with one toe less. At this point in time there are no signs of spread of the cancer, but will require regular check ups in the future. She is enjoying getting back to her walks in the park with her family and doggie friends. After facing a serious infection and major surgery with much courage we believe that lovely Esme is a worthy recipient of a Vet4life Big Bear Award.

Did you spot our clinic on ITV Daybreak yesterday morning? Yep, some of the team were up very early for live filming which took place inside the surgery!

If you missed it, you can catch the replay here.

Local vet Zara Boland talked about pet obesity and showed us a couple of ways to tell if our pets are overweight. Unfortunately fat pets are on the rise but the Pet Food Manufacturing Association (PFMA) has launched a national campaign to promote good nutrition and a healthy lifestyle for UK pets, called Friends for Life.

Part of this campaign involves a “Weigh in Wednesday” each week in May, promoting pets to be a healthy bodyweight, which can extend their lifespan by up to 2 years. The campaign launched yesterday and Vet4life were delighted to be of help!

What is Laser Therapy?

It’s never a good thing when an animal is ill but when it does happen our aim is to make them as comfortable as possible and back to health as quickly as possible. We’re really pleased to now offer laser therapy as an advanced pain relief option at the clinic. Laser therapy uses specific wavelengths of light to help reduce pain, improve circulation and decrease swelling.

Laser therapy is a drug free, surgery free, pain free treatment for many conditions, including:

• Arthritis
• Tendon and ligament problems
• Fluid swellings
• Muscle strains
• Post-traumatic injury
• Post surgery wound healing and pain control
• Neck and back pain
• Hip dysplasia
• Burns

What to Expect

A quick and simple procedure, your pet won’t need to be sedated or restrained and the experience is usually pleasant and comforting to them. Often, improvement is seen after the first visit, but most of our patients find greatest benefit after several treatments. Each treatment lasts between 2 to 8 minutes. Results are quick and the majority of our patients are more comfortable and more mobile in just a few days.

Returning to Activity

Laser therapy can relieve pain, reduce swelling and increase your pet’s range of motion. Often he or she will show new energy and freedom, a new lease of life, so to speak!

Therapeutic Effects

During treatment, the laser energy increases your pet’s circulation to the area being treated. This promotes the flow of water, oxygen and nutrients to the damaged area – a bit like massage on a person. This helps reduce inflammation, swelling, muscle spasms, stiffness and pain. As the injured area gets back to normal, function is restored and pain is relieved.

If you think laser therapy may be right for your pet, please get in touch or read more here. Call us to have a chat about this non-surgical, drug free choice of treatment. We’d love to hear from you.

Are you just about to qualify and looking for a great place to start your nursing career?

Vet4life in Teddington are looking for a qualified and registered veterinary nurse to join our small, friendly team. We are looking for someone with great communication and organisational skills. In return we can offer a job within a modern and progressive practice with facilities that include laparoscopy, ultrasound, digital x-ray, endoscopy and a new class IV laser! Salary is negotiable dependent on experience and other benefits include a generous CPD allowance and payment of RCVS and VMD fees.

Please browse the website for more information or if you wish to apply for the position please email jointheteam@vet4life.co.uk for an application form.

Rocky’s Story

Rocky, a 16 week old black and white Schnoodle (Schnauzer/Poodle cross), had only been with his new family since Christmas when disaster struck in early February. He was a clever puppy and was settling into his new home well. Although his family were constantly trying to stop him chewing tempting items like toys and clothing, he was always up to mischief!

Very early one morning Rocky woke up his owners to go outside to the toilet. After a small treat to reward his excellent toilet training he looked suddenly ill and began to vomit. Again at breakfast time he vomited several times and he also seemed quite flat.

Rocky was brought straight to the Vet4life clinic for assessment of his vomiting. 

On arrival, Alex the vet was delighted to see such a gorgeous Schnoodle puppy (Rocky looks similar to her Australian Labradoodle Max!). She was, however, very concerned about Rocky’s health.

On examination Alex found that Rocky had tacky gums – an indication of dehydration. He was also very quiet for a normally bouncy puppy. When palpating his abdomen he reacted painfully, shying away. Concerningly, Alex could feel a firm 2 cm object present in Rocky’s intestines.

Rocky was admitted to hospital and placed on intravenous fluids to support his circulation and correct the dehydration. Pain relief was also given to make him more comfortable. X-rays were taken under a mild sedation to further investigate. The abdominal X-rays confirmed the presence of, not one, but two foreign objects visible in his intestines:

An investigative abdominal surgery, called an exploratory laparotomy, was urgently required to inspect Rocky’s intestines with an aim to remove the foreign objects.

Rocky was fully anaesthetised for the surgery. A large incision was made into Rocky’s abdominal wall to inspect his internal organs. Two foreign objects were found to be located in separate sites along the small intestine. Despite being very inflamed, the intestinal tissue looked good and healthy. The foreign objects were beginning to cause an obstruction of the small intestine. If the objects were not removed immediately from Rocky’s intestines they would potentially lead to severe injury of the small intestinal wall and consequently infection and obstruction of the intestines – all life threatening complications.

The objects were carefully removed by performing an enterotomy, which is a small incision into the intestinal wall. Two separate enterotomies were required as the two objects were located far apart inside the small intestine. The rest of Rocky’s abdominal contents were also inspected and found to be healthy. Rocky’s incision was then closed and he was recovered from his anaesthetic.

Rocky woke up excellently from his anaesthetic. He had to remain in hospital for another 24 hours to continue intravenous fluids, antibiotics and pain relief.

The next day he was bright, comfortable and ready to go home. Rocky had done amazingly well for a young puppy who had undergone such a major surgery!

When it was time to go home the two objects were presented as evidence to his owners. His owners recognised the offending objects – they were 2 foam toys missing from their children’s room! Unbeknown to his owners Rocky had snuck into the children’s room the evening before he became unwell to secretly play with their toys! It was fortunate that Rocky has such attentive and caring owners, who noticed quickly that Rocky was unwell, meaning that the obstruction was diagnosed early, avoiding any major injury or illness.

Rocky is now back to being 100% and his family are very vigilant to prevent access to the kids’ rooms and foreign bodies so that history won’t be repeated!

Nina’s Story

Late one night, Nina, a 3 year old female black Domestic Short Hair cat, was crossing Teddington High Street when she was hit by a passing bus. Tristan, Vet4life’s out of hours vet, received a call from her worried owners and rushed to the clinic to assess Nina’s injuries. The accident scene was just down the road from the Vet4life clinic and so emergency treatment was started almost immediately following the accident.

Straight after being hit by the bus Nina was unable to use her right hind leg. There was also a large wound over her right hock with severe deformity of the lower leg. She had a small bleed into her eye, but luckily it was minor so would not cause any long term damage to her vision.

Emergency treatment was started immediately. Nina was placed on a drip of intravenous fluids to support her circulation. Intravenous antibiotics were given to prevent infection of her open wounds and strong pain relief was given to alleviate Nina’s discomfort.

A fracture of the hock was strongly suspected due to the deformity of Nina’s right back leg. She was sedated for radiography and further assessment. Multiple radiographs were taken to determine the extent of Nina’s injuries. In all road traffic accidents, major and potentially life threatening concerns include rupture of the diaphragm, which can lead to herniation of abdominal organs into the chest, bone fractures, rupture of the bladder and other internal injuries. Fortunately, despite the grand scale of Nina’s accident with the bus, no injury to her internal organs was detected.

The radiographs of her injured right hind leg confirmed a dislocation of two of the metatarsals, the bones connecting the toes to the hock. Orthopaedic surgery would be required due to the severity of her injury and instability of the joint in right hind hock. While surgery was arranged, a protective bandage was placed on her right hock to stabilise the fracture site and protect the open wounds on her leg.

A specialist opinion of Nina’s injuries was sought prior to an hour long operation to repair the fracture. Ian the Vet placed pins and a wire in the right hock to stabilise the joint and allow the fracture to heal correctly.

The image below shows the two post-operative X-rays of Nina’s dislocated metatarsals her right hock. They show the wire placed to stabilise the joint and dislocation site:

Nina is a beautifully affectionate cat at home, but very nervous in new environments and people. Due to her anxious disposition she required light sedation for her bandage changes and treatment. Despite her anxiety, she was very brave throughout her ordeal and coped with her hospitalisation well. Following her surgery Nina recovered excellently and she was ready to return home the following day.

To allow Nina’s dislocated hock to heal correctly she initially required several weeks of confinement in a small cage at home. She is recovering well from her accident. She still requires a prolonged period of rest and TLC, alongside some light physical activity to prevent muscle wastage in her injured leg. We wish her a speedy recovery and commend her for her bravery in the face of a very serious and life threatening accident!

We were lucky enough to be entertained and informed by local vet Zara Boland last week, who delivered a great presentation on “Emergency First Aid for Pets”.

First and foremost, the best thing you can do in an emergency is not panic! Of course this is a lot easier said than done, but it’s incredibly important to remain calm and act cautiously. Assess the situation and ask yourself whether there’s anything you can do straight away or is it crucial to get to the vet immediately?

Remember, if in doubt, a vet is only ever a phone call away (our number is 0208 977 3955).

What exactly is considered a pet emergency?

Some owners are more worrisome than others, so an emergency can vary depending on the owner. Typically, an emergency tends to occur when the vet practice is closed and when the problem cannot wait until the next morning.

Examples of veterinary emergencies include shock, collapse, choking or breathing difficulties, profuse bleeding, bloat (GDV), open fractures, penetrating injuries, prolonged seizures or even an allergic reaction of bites or stings.

As a veterinary practice, some emergencies we normally come across are:

• Road Traffic Accidents (RTAs), bleeding, open wounds and broken bones
• Seizures
• Heatstroke
• Bloat (GDV)
• Poisoning, vomiting and diarrhoea
• Fights and bites
• Stick injuries
• Eye injuries
• Allergic reactions

Vital signs

There are some simple tests you can do to check whether your pet is in pain or severely unwell:

Temperature

An animal’s temperature is a quick way to check how they are. For dogs and cats, normal is about 38 C.

Pulse

A good pulse is strong and regular and felt on the left side of the chest (behind elbow) and just inside their thigh. Depending on size of dog, normal resting is between 60-130 beats per minute and for cats, normal is between 140-200.

Breathing

Observe their chest movement and the amount of effort involved – are they struggling?

Gum colour and hydration

Normal gums are pink and moist. Hydrated skin “pings” back when pulled rather than staying up and tenting.

Purchase a pet first aid kit

Would you like to buy a pet first aid kit? The kit contains saline for flushing wounds and eyes, alcohol wipe, thermometer, bandages and an information card with emergency numbers on.

Pop in to the clinic or call us on 020 8977 3955. We are selling them for £14.99 each.

Moving an injured pet

If the dog can walk, gently coax him or her into the car and help them in. If they can’t walk, lift them into the car. You should lift small dogs by supporting their chest and hindquarters and large dogs should be rolled onto a blanket or firm board and carried on.

Cats should be wrapped securely in a towel and lift in the same manner as a small dog, holding close to your body. It’s a good idea to use a cat carrier or similar.

Some of the most common scenarios we are asked about are Road Traffic Accidents and Bloat (GDV):

Road Traffic Accidents

These are every owner’s worst nightmare. You should stay calm and call the vet in the first instance. Approach the animal from the front, avoiding sudden movements. Speak gently, using their name if possible. Check for shock and manage bleeding and broken bones, but always take them to the vet even if they appear uninjured – internal organ damage may not be obvious.

Bleeding and open wounds

• Apply direct and continuous pressure with clean material
• Bandage if possible
• If blood soaks through, apply extra layers
• Remember that bleeding often looks worse than it actually is.

Broken bones

If you can see bone ends or severe swelling or limb deformity, it’s likely a bone is broken. It will be extremely painful so muzzle the animal before touching. Manage bleeding as above, DO NOT apply a splint, move with extreme care and use a firm board if there’s a spinal injury. Keep cats and small dogs confined when in transport.

The best way to avoid RTAs is to always keep your dog on a lead when walking anywhere except in enclosed parks or other areas with no traffic.

Bloat (Gastric Dilation Volvulus)

This is a true emergency and is most common in large, deep chested dogs such as Irish Wolfhounds, Great Danes and St Bernards (although if you regularly read our postings it can happen in any breed, last week we successfully saved a Border Collie). You will observe a sudden bloated tummy (but not always), dribbling and drooling, gulping, retching, restlessness or pacing and collapse.

If untreated, bloat can be fatal so call the vet immediately if you have any doubt. The best advice to prevent bloat is to feed your dog small amounts frequently (not large meals) and never exercise them immediately after eating.

Be a Responsible Pet Owner

Even though having a pet is a lot of fun, it’s an enormous responsibility. Domestic pets are completely dependent on their owners and having a pet means so much more than just providing water, food and shelter.

Be sure to…

• Have a pet collar with your number and your vet’s number
• Always microchip and vaccinate
• Get pet insurance – emergency intensive care can be very expensive, increasing stress for everyone
• Carry a First Aid Kit if you can (we are selling these for £14.99 – ring us or pop in to the clinic to purchase one)

Remember – prevention is always better than cure.

If you suspect your animal is experiencing a veterinary emergency, please call Vet4life immediately on 020 8977 3955.

Sweepy’s Story

Sweepy, a 10 year old black and white cocker spaniel, was brought to see Ian Stroud at Vet4life in November 2012. In just a few days Sweepy had gone from being a bright and happy dog to becoming very quiet and sleeping a lot. He was also refusing all food. When Ian examined him he found that Sweepy was lethargic. His gums were also pale and jaundiced.

Ian knew Sweepy was critically ill and so he admitted him straight into hospital for emergency treatment and investigation. Blood tests were immediately run in the clinic. Haematology results revealed a very low red blood cell count. Sweepy was severely anaemic.

Anaemia can be due to several causes including blood loss or red blood cell destruction (haemolysis). To test for haemolysis Ian mixed a drop of Sweepy’s blood with a drop of saline on a microscope slide. Rather than evenly dispersing when diluted, Sweepy’s blood cells immediately formed irregular clumps; a sign of haemolytic anaemia. Sweepy was suffering from a severe case of Immune Mediated Haemolytic Anaemia (IMHA).

IMHA occurs when the immmune system attacks and destroys the body’s own red blood cells. IMHA may occur secondary to a range of underlying diseases such as infections, toxins or cancers. In dogs the large majority of cases are idiopathic, meaning that no underlying cause can be identified. The disease is usually seen in middle aged female dogs and certain breeds, including Cocker Spaniels like Sweepy, are more commonly affected.

In IMHA the patient’s red blood cells are either destroyed within the circulation or removed by the spleen. As red blood cell numbers fall, the oxygen carrying capacity of the blood is reduced, often to critical levels. Patients may develop lethargy, weakness and collapse. The gums may appears pale or, as in Sweepy’s case, yellow with jaundice. Jaundice occurs due to build up of the red blood cell break down product bilirubin in the tissues. As the disease progresses internal organs are adversely affected by poor oxygen supply (hypoxia). The kidneys can also be damaged by the products of red blood cell breakdown. IMHA can rapidly lead to very severe life threatening illness and potentially fatal complications such as blood clots.

Sweepy had a severe anaemia and therefore required urgent and intensive treatment in order to save his life. Fluids were given intravenously to support his circulation and to dilute the potentially toxic products of haemolysis. He was also started on therapy to suppress his immune system and halt the destruction of his remaining red blood cells. Supportive therapy was started with pain relief, gut protectants and special nursing care.

Sweepy rapidly responded to treatment. His owner visited him regularly in hospital to give him a little extra TLC and try to tempt him to eat. Although some severe cases of IMHA may require a blood transfusion Sweepy’s positive response to treatment meant that this was avoided. After two nights in hospital he was a lot brighter and much to our delight he finally began to eat again. On his fourth day in hospital he was much improved, his red blood cell count had increased significantly and he was deemed well enough to go home.

Sweepy will require several months of immunosuppressive therapy for IMHA. His red blood cell count needs to be checked regularly and he requires daily medications. He remains bright despite his condition and has responded excellently to his treatment so far.

Well done Sweepy for remaining brave through what has been such a traumatic time.

Happy Christmas!

Often, attempts to liven up their food with treats, gravy, chicken and a different flavour or type at every meal-time leads to overweight pets. In the same way, when presented with a delicious cheese board after a big meal I find it very hard to resist indulging myself even though I have eaten more than enough!

One of the most common questions I hear when discussing diet is “Won’t she get bored just eating one type or flavour of food?”

The answer is usually “No, just feed a really good quality diet, ensure that she is eating the correct amount and give a modest amount of treats during the day as a reward for good behavior.”

Our pets do not seem to require the stimulation of different tastes and textures as humans. However, if we can change how we feed our pets we can ensure we care for both their nutritional requirements and their mental stimulation.

Activity feeders, or food puzzles, are devices that make meal times fun. They are available for cats and dogs and can be used for feeding both wet and dry diets.

Simple ones are balls or tubes that are rolled along the ground dropping kibble on the ground when the hole is vertically down. These are particularly good for puppies. Other basic feeders include Kongs and other gnawable (but durable) toys that can have wet food put in them. A top tip is to put them in the freezer. This both prolongs the enjoyment of the activity and can be a nice cool treat on a summer’s day.

Other feeders can have sliding doors or levers and spinning parts that have to be negotiated before the food is revealed. They are often durable, safe and can be put in the dishwasher to be cleaned. We have a very extensive range of activity feeders at the clinic because we are so passionate about their advantages. In many cases we suggest that all your dog’s (or cat’s) meals can be fed using one of several these.

One of the reasons why the activity feeders are so great for your pets is that they slow down eating, especially important in deep-chested dogs that are prone to bloating or dogs that are prone to obesity. They also stimulate natural activities such as scavenging and hunting. This will make the meal more satisfying and relieve the boredom that many pets experience. Many of the minor behavioural issues that we encounter at the clinic can be addressed with simple environmental enrichment and increasing the mental stimulation our pets receive. Activity feeders deliver these changes in spades.

Like any new skill, the activity feeders can take time to master and may require a little patience starting with the simple puzzles first. However, the rewards are huge as you are helping to keep your pet healthy, happy and mentally stimulated.

Have a look in our online shop for some great activity feeders.