Sunday, June 30, 2013

The Musings of Dr Liz - Follow up, Follow up, Follow up!

Follow up! Follow up! Follow up! (to the sounds of the carnivals "Roll up Roll up Roll up"

Take your pet in for their "Follow up" vet visit, for the best treatment plan for your pet.

Vets have medications, we have advice (great advice if you ask me).  We have your back (to coin a phrase).

Your vet wants you to "follow up" with them, so we can make sure that everything is going as well for your pet as we like to think it is.  And if there is anything not quite right, we can nip it in the bud early!

There is no point telling your best friends cousin that your vet didn't fix your pet's problem - go back to the vet.  We need the follow up to know that what we are doing works, and definitely, if what we are doing doesn't work, so we don't repeat that mistake again.

A quick email, or txt message to your vet may be enough, but usually a physical, hands on, face to face recheck is often the best.

Remember, it is cowardly to tell other people that vets didn't fix a problem, but not let the vet know at all.   I don't know if that has happened to me, as hopefully people can tell me to my face, but I do read posts of dog forums where that seems to be the case.

A follow up may not be free, but if you really care about your pet, and the pet's of other people, then your vet needs to know if what they are doing is working or not.

Thanks for reading, and I look forward to knowing what you think about rechecks at the vet - are they really necessary?

Tuesday, June 25, 2013

Dr Liz's Dental Discussion - Dental Xrays

Thanks for being here. I write about Astonishing Secrets, my muses, and now doing a Dental Discussion... what is next? Follow, and you will see.

Dr Dean and Dr Doc Discuss
Dental Xrays! 
Dental xrays are something that if we went to a dentist ourselves complaining of a sore tooth, we would take it for granted our dentist would take the opportunity to take radiographs.

But it is not the case in many veterinary hospitals who see pets with sore teeth.

Now, I am not saying that those veterinarians who do not do dental xrays and extract infected teeth are doing the wrong thing.  Removing obvious pain and pus is never wrong.

But what I am saying is that it is possible (and more likely than not) that they are missing alot of disease simply because they do not have all of the information - how could they when 2/3rds of the tooth is under the gum, and that is the part that they cannot see without xrays. And before 2005, I was one of them.  I thought I was doing the right thing too. Until I reviewed what was Best Practice in Veterinary Dentistry, and realised that diagnostic dental radiographs was part of it.

At Russell Vale Animal Clinic, we started taking dental xrays in 2005... using normal film, and developing using chemical developer and fixer.   We upgraded to digital in 2009.  Even though we were the smallest vet hospital in Wollongong, we were one of the first to adopt digital radiographs  in the 'Gong, and the only to adopt digital dental radiographs (and one of four at the time in NSW - to my surprise, when I found out several years later).

In the US, dental xrays is a standard... in Australia, it is just a recommendation.  But stupid  me... Dr Liz, who believes in a high standard, skipped over the recommendation part, assumed it to be best practice, therefore, we had to find a way to afford it, and provide it.  Our animals deserved no less.

Sadly, it is my determination to practice to a high standard, that works against us.  How?  Well, you, as a loving pet owner, perhaps visiting another veterinary hospital, to be told your pet needs a dental - you ring around for a price, but we can't compete.  We don't provide the same dental service as they do, nor for the same price, for obvious reasons.  It isn't about the  money, but ensuring that all disease is identified and treated as soon as possible.

But let me go on to the exciting things I have found (and have been able to fix and prevent ongoing pain ) in my pets.   And the end of the day, it is all about removing pain from my pets, so they can go on in their lives and be happy.  Diseases do not excite me.... getting rid of them, and making sure they never come back to hurt the animals they affect, does.

All of these radiographs are from my own case files, and I have deliberately removed the pet and owner details.

All pet owners receive copies of their pet's dental radiographs as we believe strongly that pet owners are the best advocates for their pet's welfare.  And they can only do this with information.

Missing teeth: ( I will write a full blog just on this interesting topic alone)

Unerupted teeth: If you looked at the gum, you would not see the first premolar which is sitting underneath the gum.  In a large number of dogs, this unerupted tooth can progress to form into a dentigerous cyst (see photo below)

Disease around the tooth root and/or furcation or other bone loss consistent with periodontal disease:

Broken teeth:

Teeth with evil hooks:

Visually normal teeth, but which are resorbing (and causing pain):

Assessing depth of enamel defects: (no picture)

Dentigerous cysts: a bone eating cyst that forms as a result of an unerupted tooth.

Seeing a three rooted tooth which should normally be a two rooted tooth, such as this one in a cat.

Retained baby tooth roots:
Retained baby tooth root tips

Tooth roots under neath the gum, the ongoing presence is causing pain, although the gum looked normal :

I could go on and on and on, but I am sure by now you get the gist of how important it is that you choose a vet that is able to take dental radiographs if they need to, to be able to identify all areas of disease in your pets mouth, and then deal with it.

Russell Vale Animal Clinic has had dental radiograph capabilities since 2005, and digital intra-oral radiographs since 2009.  If we need to, we can email our radiographs quickly to dental specialists for an extra opinion.

Any questions, sing out.... let me know, either here or via email.

Friday, June 21, 2013

Dr Liz's Dental Discussion: The Beginning

pet dental scale and polish animal dental
Dr Dean and Dr Doc 
It's Dr Liz again, and after my Astonishing Secrets, and Muses, I am starting a new series about one of my favourite topics.

You think it is just about teeth , and dental stuff, but really, it is going to be about how to keep our pets as healthy and happy as we can, and how to turn older pets back into puppies and kittens again.  And that involves keeping their mouths as healthy as we can.

Dr Dean and Dr Doc are going to be the faces of Dr Liz's Dental Discussion.  They are two gorgeous little ones, with the most important thing you need to keep your pet's mouth healthy - the handy toothbrush.

I just love getting the phone call the day after a pet has had their sore mouth fixed up, to be told that they are back to being like a young'un again.

Dr Liz says " And this tooth looked clinically normal
on inspection, but see the bone loss cause by the infection
at the base of this tooth" 
But this series isn't just about sore teeth, or the hard stuff sitting on the tooth, or even about how to keep teeth healthy... it is also going to challenge some much loved belief on how to keep mouths healthy.

Please remember as your read the series - whilst I may talk about fascinating diseases and exotic xrays,
I never ever forget that they belong to a much loved family pet and patient of mine.  All that I do is directed towards keeping my animalclinic family as happy, and healthy as I can... always.

Also remember as you read, that every pet's mouth I have ever examined is unique - and what might be OK for one pet, might not be OK for another... this is why a vet's judgement is needed to assess each case on a case by case basis. Even the vet dental specialists will tell you that.

Finally, as you read all of this... I am not an animal dentist, but I have a particular interest in practicing a high standard of care for many things, and this includes dentistry.

And, it is a discussion.  I am not good at one way conversations, I prefer to work with people to do what is possible to keep their pet healthy.

Thanks for reading, and being part of the bellambivets blog.

Saturday, June 15, 2013

Pets, Parasites and Protecting the Family

Today, I am writing about pets, pests, parasites…. And how to protect your family –
your entire family. Are you ready for a (true) story?

Just Imagine the following scenario. You are sitting on the lounge, with a drink in your hand. On one side lies your beloved cat, Leonard… all curled up. On the other side lies your dog Sheldon. And then, in walks your wife.

In her hand is a pencil like thing, and when you get up to have a look at it, it has two bars on it… one purple, one blue. Whilst your head starts to comprehend what it means, you notice the open box of pregnancy tests on the table.

You look at your wife, you look at your pets, and then you look at the door.  But you aren’t looking at the door because you want to run through it, but to wish the pets outside. The need to protect your pregnant wife and your unborn family has just kicked in.

Images go through your brain of how pets can make your unborn child sick, from going blind, to deaf to other congenital abnormalities.
Think of your family group... then do all  you can
to protect them all.

All vets are dedicated to the health of all animals, as we know by keeping our pets healthy, we keep us all healthy too. 

It is not uncommon for parents- to - be to ring up their vet to ask questions about their pets, especially after they have been given (mis) information by their own doctor. 

  • Did you know that you could get worms from lying on the grass?
  • Did you know that 30% of kids eat soil, sand and grass, a behavior known as pica?
  • Did you know that these are the ways our kids, as well as us, can get infected by the worms that our pets may carry?
  • Did you know that a puppy infected with only 20 roundworms (which is not a lot of worms) can layover 500 000 eggs in the environment in one week. 

All very sobering thoughts.

What do you need to do to protect your family?

The first thing is….

  1. 1.       Go to your pet’s health record, and to where you store all of your pet’s medications.
  2. 2.       Put it all on one spot on the table
  3. 3.       Get a sheet of paper and write down everything that you have and what it does. For example – Advantage for cats – does fleas and lice.
Use the following information to make sure your pet’s preventative program is all sorted. If in any doubt, your local vet will always help you. 

Preventative care for your pet is the best way of protecting your human family, so Leonard and Sheldon (or whatever your pet’s name’s are,  can still stay sleeping on the lounge whilst you watch TV).

For dogs:

  •   Your worming medication should cover Roundworm, Hookworm, Whipworm, Flea Tapeworm and Hydatid Tapeworm.
  •    Your vet can provide the best Heartworm prevention through a once a year injection, so take advantage of that.
  • Your flea control should cover fleas and lice, (animals can be short term carriers of head lice, so I like to treat them too).

Cats (and kittens) are great family pets if all of the right
things are done to keep them (and your family) healthy.

For cats:

  •     Your worming medication should cover roundworm, hookworm and tapeworm.
  •  Your flea control should cover fleas, lice and mites.
Your vet can provide the best advice on how often and what you should use to keep your pet worm and flea free, as we have seen what products do and don’t work.  It is our daily work.

Now onto Ringworm.  Unfortunately, Ringworm is not a worm, but a fungal infection and Toxoplasmosis is a protozoan disease, both of which we can’t worm against.  These two types of infections are the most common reason why new mums are often scared of their cats.

Cat’s can be carriers of Ringworm, and Fungal cultures are needed to check, but most kids are infected from the class mates or from playing in the dirt.

Toxoplasmosis is the scary one, but as a mother of four, who has worked with cats, I am still Toxoplasmosis negative, so it really isn’t an easy infection to get.

But to protect yourself and your family against Toxoplasmosis and intestinal worms, especially if you are pregnant, follow these guidelines.

  • ·         Make sure you have one litter tray per cat plus one extra
  • ·         Wear gloves when cleaning the litter tray
  • ·         Practice good hygiene – wash your hands frequently
  • ·         Rinse all fruit and vegetables prior to eating.
  • ·         Avoid uncooked or partially cooked meat
  • ·         Cover your kid’s sandbox when not in use
  • ·         Clean up your pet’s poop daily
Leonard and Sheldon... we are happy to be part of a family.
Your pet loves to be part of your family.
Go give your family a hug!
Families are fun, and they are more fun if you have pets.

 Don't think about preventative care of your pet as "alot of money", but think of it is an investment in the long life and health of yourself, your children, your family as well as your family pet.

I am Dr Liz, and I am a vet at Russell Vale Animal Clinic.  We love animals, and we are here to help.

Wednesday, June 5, 2013

The Musings of Dr Liz - Is owning a pet a privilege or a right?

Welcome to another of the musings of Dr Liz. What do you think about pet ownership?  Is it a privilege or a right?

I hear a few of you saying that we have the right to have a pet.

So lets look at "a right" and "a privilege" in the way that I look at them.

I often find that people who feel they have a "right" to something, often take these things for granted.  In Australia, we take "democracy" and "freedom of speech" as a right, not respecting the fragility of these concepts.  

In my view, those who believe in the "right" of pet ownership, may show a lack of true care and respect of their pet.

If the object is a "privilege", it is something that we will treasure.  It is something earned through hard work, either by ourselves or by our forefathers (if it is something such as democracy).  It is something that has value, and it needs to be protected.

In my view, a pet is a privilege - we are the lucky ones in that our pets have opened up their hearts to accept us, flaws and all.

A pet is a privilege, and one which we should always treasure.  We should protect all animals.... as they protect us.

Sunday, June 2, 2013

Astonishing Secrets - Emergency Pain Relief for your dog or cat

Welcome to another Astonishing Secrets post - where it is all about helping you (the loving pet owner) help your pet (the most important thing) until you can get them to see your vet.

"I hear you hurt somewhere. My advice to you is to see Dr Liz"
As I have said before (and will continue saying)... this is not to replace a vet visit, as really, if your pet needs a vet visit, then it needs a vet visit.  Reading lots of stuff on the internet is not going to change the fact that your pet is unwell, and needs to see a vet.

Now, back to what this post is all about - Emergency pain relief for your pet.  Now, this is just for dogs and cats, as every other animal are not little dogs or cats  And the same applies for dogs and cats too... dogs are not little people, and cats are not little dogs.   Remember this fact!

I have to thank Potter and Maggie, two patients that came to visit me recently ...  both pets had suffered pain, and it was either on a weekend or out of hours.  Not severe enough to be life threatening, but certainly enough to interfere with their weekend activities.  And, as loving pet owners they still didn't want to disturb me to ask.

Feeling miserable?
The advice I am going to give you, is just general advice only, and you have to use common sense on whether it is appropriate for your pet, given what you know about your pet's medical history.

Disclaimer: I will accept no responsibility for any adverse reaction or effect this advice may have on your pet, as only you know your pets medical history and what medications they are on. Please let me know, however, if you have any problems, as I genuinely want to help you and your pet. As I am in NSW, Australia, I am going to talk about medications easily available in my area.

Now, as dogs are not small people.... you have to not do what some people do - if I take 2 capsules, then 1 capsule should be OK for my dog.  This is soooo wrong!  Do not do that!

What we are going to talk about are the over the counter human medications, as this is really to help you in a time when you can't get to a vet immediately.

What you need:

1. Your pet's weight
2. A great vet - that you know you can speak to about this information comfortably

The medication I am suggesting you can use are over the counter, no prescription necessary in New
South Wales Australia.  You also have to remember, and this VERY important,  the medication is "off label use", which means that whilst it is regularly used in animals for emergency pain relief, and what I will write is well published (for dose rates), it is not registered for use in pets.

What you need for dogs:

1. A knowledge of your pet's other medications - if they are on any supplements, treats, medications from the vet or from your best friend - stop reading now, and check with your vet.

2. If your pet is on no other medications, then you can think about following my advice.

You can use either Panadol (paracetamol) or Aspirin (Salicylic Acid), AND you need to know your pet's weight.

There is a fine line between what is beneficial, and what is toxic for dogs.... so an accurate weight is important.  At Russell Vale Animal Clinic, we ALWAYS give you a weight chart, so this should be fairly easy.

For Panadol (paracetamol)- the dose FOR DOGS is 10 mg/kg given once daily each TWO days  for no more than TWO doses.  After that, you REALLY need your vet.

Check the medication strength on your tablet.  If it is 300 mg, then this should be safe for a 30 kg dog. If it is 500 mg, then this is safe for a 50 kg dog.

Panadol pediatric liquid is usually 120 mg/5 mls, so that makes it a 24 mg/ml solution.  A 10 kg dog needs 100 mg, so they would need 4 mls. (DO NOT GIVE TO CATS)

Panadol for 5 -12 yrs is 240 mg/5 mls.  Are you starting to get my point about knowing your pets weight and the strength of the medication you are on?

For Aspirin...the dose for dogs is 10 mg/kg given daily for 4 days then stop for 4 days. This is Aspro.  This could be 100 mg, 300 mg or 320 mg (or anything else depending on the brand you have).

A 10 kg dog should get the 100 mg tablet. A 30 kg dog should get 300 mg tablet. 
Always give it with food. Never give it for more than 2 days.

What you need for our cats:

Cats are not small dogs, and it is important that you NEVER give them any pain medication, as even panadol or paracetamol can kill cats.

Even our prescription pain medications can cause harm, so unfortunately, I am not going to give any
advice here for cats, other than, speak to your vet.  Aspirin can be used, but the dose is much much lower than dogs, and you need your vet to give you that advice.

Never underestimate the benefit of somewhere quiet, with minimal disruption, somewhere warm and soft, and gentle pats, to help relieve pain.

I am Dr Liz, and I am a vet that wishes all pets stay happy and healthy.  And when they aren't, I am here to help them get better.  Thank you all for allowing me to continue doing what I do... helping as many pets as I can.