Monday, September 23, 2013

Astonishing Secrets - Hot Spots and your dog

Welcome to another Astonishing Secret, where we try to help you help your pet until you can
"Do you have a "Hots" spot  for me?"
organise a vet visit for your pet's Hot Spot!  This is not to replace a vet visit, as most pets need prescription medications to help things settle down fast - after all, you want your pet to be happy and back to normal sooner rather than later.

 Hot Spots can come up very quickly ( a matter of hours), but it can take days (or even weeks) to clear up.   They also have a good reputation for coming back too.

Hot Spots will always recur when the underlying cause is not identified, and the perpetuating agents (bacteria) are not controlled.

Hot spots are often given the name of Acute pyotraumatic dermatitis or Acute Moist Pyoderma - but Hot spot describes it best - it is a red round sore with yellow ooze (pus), which mats the fur together - and it is painful to touch, but the dog can't stop themselves from scratching, licking or biting it.   Cats can get hot spots too - the treatment is similar, but the causes are different.

A worried Giro!
Meet Giro, the inspiration for today's post.  I saw him this morning, and his loving owner researched the net and found a lot of information - some of it useful, some of it not.  So here is the local rundown on this common, painful skin condition. 

First of all - how to recognise a "Hot Spot" 

  • it is acute - it comes up very quickly
  • it is red, round or oval shaped sore with matted fur, sometimes with a yellow ooze (which is pus)
  • hairloss is common, and a feature is an intense itchiness
A vet visit is always necessary, as the challenge comes in not actually diagnosing or treating the Hot Spot, but to determine why it occurred - that is, looking at it like a sign of disease, other than a diagnosis in its own right.  Virtually all pets need more aggressive therapies than what is available in most households.

How can you treat "Hot Spots" at home?

The principles of treatment are fairly straightforward -
- the lesion is wet - the moisture traps infection  - so you need to dry it out
- the lesion is itchy - we need to stop the pet accessing the sore
- the lesion is being perpetuated - stimulated to continue either through the weather (humidity is a factor) or bacterial overgrowth of the skin alone.

An ugly red sore on top of Giro's head - after treatment.

If at any time you think your pet may hurt you in trying to treat this at home, do not persist - never underestimate how painful these sores are. We don't.  We often need to sedate or anaesthetise patients to get them cleaned up properly.

The first thing is -  Clip up the area, using clippers or scissors. Clip to the area beyond the redness - you need to be able to see normal skin

Next - using an antibacterial wash (we suggest 3% chlorhexidine - brand name Dermcare Pyohex available through most veterinary hospitals) - gently wash/soak the sore. Leave it on for 10 minutes. Rinse very very well. (a note on this shampoo - it is very concentrated, and will not lather easily. Dilute a small amount in water, and then gently sponge it on, and do not forget to rinse it off well.) There are some human chlorhexidine solutions (3% is the concentration you need).  As an alternative, you can use Betadine, but only for a maximum of two days - whilst it had antibacterial effects, it can also delay healing, which we do not want.

Next - Pat dry with a towel or gauze swabs. (this deals with the wet part and the bacterial overgrowth part of the problem).

The next part depends on what you have at home, or what you are able to get your hands on without a veterinary prescription.   We now need to settle down the itching, and stop the itch-scratch cycle, knowing full well that in the majority of cases, it is due to an underlying allergic skin disease

(whether it be biting flies, mosquitoes, fleas, food or grasses/pollens).

It also depends on where the hot spot is - if it is on the head or butt - an Elizabethan collar may help.  If it is somewhere else, and a foot can get to it, then a sock on the foot may help.

As for ointments and creams - your pet really needs a topical anti-anflammatory and anti-bacterial cream - the ones we use are by prescription only.  But in an emergency,  out of normal hours - what can you use?  Until you can get into a vet, we suggest a 0.5% hydrocortisone cream that should be available over the counter at the chemist, but you cannot use this any more than twice on the sore, as you really need the combination ointment. You need to find one that you can use on open skin (check with the pharmacist).

What can we do at Russell Vale Animal Clinic -

As your pet is in pain, we  use medications to sedate them to allow us to clip and clean the sore properly.  Some pets are so stoic and brave, that we may use lots of huggles and liver treats instead to allow us to clip up the sore. Some pets benefit from systemic medications of antibiotics and anti-inflammatories, as well as the topical treatments.

What we always do is discuss with you the "why" it happened,
to determine on how to prevent recurrence

 Hot Spots will always recur when the underlying cause is not identified, and the perpetuating agents (bacteria) are not controlled. 

What not to use

  • Do not use Dettol or Savlon creams or lotions (animal bacteria can multiple in these ointments - you are just feeding the bacteria rather than killing them)
  • Do not use Tea tree oil or any equivalents (they don't work - scientific tests show that sores get better inspite of, rather than because of these types of things) and definitely do not use Wool wash - Dogs and cats have fur not wool!
  • Do not use alcohol (it stings) or Mercurochrome (it doesn't really dry out the sore, it just turns your pet into one with pink splotches, and makes it harder to see how the hot spot is healing.
  • Do not use salty water if the hair has not been trimmed off
  • Hair dryers or water that is too hot or cold (makes things worse)
  • Do not use oatmeal based shampoos or conditioners (they have no antibacterial function at all).
  • Do not use human shampoos or conditioners without veterinary advice.

I am Dr Liz, and my team and I are always there to help you. Do not be frightened to give us a call on  42 845988 to discuss your pet's Hot Spot, or any other medical condition.

If you have any suggestions on what you would like the next "Astonishing Secret" to be about, email me or post a comment below. 

Finally, A big Thank You to Giro and his loving pet owner, for allowing me to treat him today, and to share his beautiful (albeit worried) face.

Wednesday, September 18, 2013

How to deal with fleas which won't die

My father was an absolutely interesting man, and whilst not perfect, there was one thing which was truly special about him - and that was his love of animals, and even more special, on how they seem to gravitate towards him.

After he died, we eventually rented out our family home, to a family with pets.


Asleep - on the bed - and I wonder what else they are sharing..
fleas, maybe?

And recently, they moved out, but their pet's fleas did not.  

So, I have now had to deal with an all too common scenario faced by many loving pet owners - how to deal with fleas which won't die... or as the true situation is - how to eliminate the flea plague living in your house.

It has been over  month since the tenants have moved out, and during that time, the house has had three seperate environmental flea treatments.

The first one was a professional pest control treatment (and I was warned a second one would be necessary).  

We still were getting emergent fleas (the little ones).  The professional flea treatment did work, as we
Ugly Fleas !
had no adult fleas, but  like any other human being, I got impatient, and bought the flea bombs from the supermarket about a week later.  It promises to sterilise the flea eggs, and stops them from hatching for up to 9 months.

I visited the house almost daily, and found no fleas - and thought! wow!  that has worked.  And then, I couldn't visit for a week and a half.

I was there one afternoon, and after 2 hours, had to leave. Those little blighters were at it again!

So I set off another set of flea bombs,  as a knee jerk reaction.  But I had to ponder why did I, or why should I, need to repeat the treatment?

The answer is because of the flea life cycle - they hatch in "waves", and they must go through the egg to larvae to pupa stage - and whilst the flea treatments work on the adults, and the flea bombs on the eggs, they do not do much for the larval or pupae stages!

Patience is a virtue, but being attacked by these fleas is really challenging mine.  On many levels. As  one who loves animals, as a veterinarian, and, now, as a landlord.

As an aside,   I often get the comment from clients about "grass fleas" - I now have a new "brand" of fleas - I have  have "carpet fleas", "tile fleas", "timber floor fleas" and "laminate fleas", as what is jumping me on me when I am in my old house are definitely fleas, but seem to come out of nowhere. The fact is that these are all the same type of flea, which is the "cat flea".

The real flea problem in any environment are the eggs that a pregnant adult  flea lays, which she does on the pet, which fall into the environment...wherever the pet may be.

So, this is all about how to deal with fleas which won't die.  This is what I did to clear up my flea problem (which is still ongoing, but at least I can work for several hours in the house without being molested)

  • Patience - essential - the flea eggs can live in the environment for up to a year. To expect to be flea free after a single treatment is not a realistic expectation.
  • 95% of the flea problem is in the environment, with 35 % in the pupae (not able to be killed readily) stage.
  • Vaccumming regularly is essential - this stimulates eggs to hatch and continue on the life cycle - the adult fleas are then killed by any flea bombs or treatments, or sucked up into the vacuum cleaner bag - to die a slow death via flea collar). How regularly?  I would recommend each 2-3 days, and emptying the vaccum cleaner bag each time.
  • Quality flea control on your pets - we would suggest using Frontera flea spray (Ilium) - even though as a spray it is an initial nuisance, it will provide the best flea protection your pet can get.  (Of course, if your flea problem is not as bad as mine, then you can use the spot -on type treatments). In my situation, there are no pets in the house, so the fleas are choosing me (as the closest living creature) by  default. 

Tuesday, September 17, 2013

The musings of Dr Liz....A satisfied Pet Owner

Welcome to another of my musings... and this one is inspired by a statement made by a speaker at
the Australian Veterinary Association Practice Management conference in Sydney in July 2013.

The speaker was a dietician, who spoke about Work/Life Balance.  And in amongst all of what Work/Life balance was all about (which isn't about working less, and life-ing (living)  more), she talked about her own business, and how she assessed and measured and therefore, ensured client satisfaction.

The comment that pricked my ears, was the one where she made that the customer satisfaction was increased if they liked the dietician, and it was unrelated to the information or knowledge of the dietician.

And I thought "Wow".  Sounds very much like one of my earliest blogs that I wrote a year ago... Life is a popularity contest, was/is the title

There was another blog written by someone else that I read a few months ago -  this blog  equated
A photo of Paige entertaining one of
my patients at home - a "hospitalised"
patient at Russell Vale Animal Clinic.
trust to likeability in the workplace.  The problem I had with that blog is that it implied that it was your fault that you were not trusted, as you must've done something dishonest to have deserve that.  And I do have a problem with that comment.

Con men or scam artists cannot be trusted, but aren't they likeable?  Isn't this how they get away with what they do? Aren't we more likely to trust the likeable, even if they don't deserve our trust (or our like?).

This is me at home, with Leo,
an injured stray in 2011... I look awful,
but how about the care he is getting?
If care was based on my looks, it would
be a bad score.
What about how someone looks?  There was  another webinar on customer service, and it make a point that  attractive sells.  We are more likely to buy if the person is attractive, well dressed, well groomed.

Does the care I take of your pet change or differ if I wear daggy trackpants and a comfy Tshirt, or if I am not wearing any makeup or if my hair is due for a trim?  It doesn't, but your perception of my care does.  And thus,  your satisfaction of what I do.   And I get that, which is why I don't even own a pair of daggy track pants (and I don't wear a Tshirt to work). I can't make myself look like Elle McPherson, nor can Dirk look like Brad Pitt. And it is no help that make up causes a bad reaction - my eyes go all puffy, they go red and I feel ill.  So my basic makeup is, well, minimal.

Sad, as I do like to be comfortable when I am on the floor playing with the puppies and dogs, or doing the cat whispering with the cats on the Feliway sprayed bench... and having legs up to heaven would  be nice, considering I am short.

There are so many nuances to happy, satisfied pet owners, and I don't believe it is all about how we look where loving pet owners are concerned.  I think it is a complex mix of things, and I, and all of us at Russell Vale Animal Clinic work towards making your pet as happy and healthy as they can be, and as a result, make you as satisfied as  you can be with what we have done, and how we have done it. After all, isn't this what you want from your vet?

I am Dr Liz, and all of us at Russell Vale Animal Clinic get absolutely excited every day that we turn up at the vets. Call us on 42 845988 or book online (via our website or email us directly).

Thursday, September 12, 2013

Astonishing Secrets - Wollongong pets need solutions to the itchiness

Welcome to another Astonishing Secret - this is about what you can do at home to help your itching
"Do ya wanna know a secret?"
pet cope with the high pollen count until you can get them to the vet hospital.  A reminder that this is not to replace a vet visit, but to make sure your pet is as comfortable as you can make them until we can see them.

As a vet, I have access to alot of information and knowledge about itching pets, but experience tells me that what may work great in one pet, may not in another.  At the vet check, we can assess what is a good first thing to do.  Reality is, I tend to find I get a better outcome (that is a pet with controlled skin, long term) if I have an owner committed to ongoing rechecks, so we can tweak the management plan. Of course, I am talking about those pets who suffer from allergies or infections as a cause of their itchies!

Have you noticed that during spring and summer, our weather reports also include a pollen count?  That is because people suffer from pollen allergies.  Whilst dogs and cats are not little people, their immune systems can have similar reactions. So, this is all about what you can do to help reduce the "pollen" impact on your pet.

What signs might you see if grasses and pollens are causing the itching problem in our Wollongong pets?

In dogs, we might see
- itchy feet
- swollen, itchy ears
- red muzzle
- rashes that come and go on the abdomen
- patchy hair loss
- excessive general scratching (but you don't see fleas).
- increased scooting (rubbing their bottoms along the ground)

"Ooh, just there, that's the spot" 
In cats - we might see
- excessive grooming (and fur balls as a result)
- scratching around the head and neck
- small bumps along the body or lower legs

In rabbits - we see
- scurfy skin (looks like someone has dusted them with coconut flakes)
- hair loss
- excessive scratching around the neck.

What can you do at home to help your pet until you can get them into seeing us?

One bit can get your pet itching for hours!
Like when you get bitten by a mosquito!
1. Flea control is essential -

Even though they may not be the cause of your pet's itchiness, we do know that they can make things worse.  What if you don't see any fleas?  Well, treat for them anyway. Just because you don't see them, doesn't mean that one is not floating around causing a bit of grief here and there. 

Avoid flea rinses or flea shampoos as they can make things worse.

 I recommend Frontera Spray or Frontline Spray for dogs and cats.  I prefer these sprays as they will cover fleas (up to 3 months), lice and sarcoptes mites, as well as provide protection against ticks for 3 weeks.  For rabbits, you can use Bayer's Advocate, Advantage or Zoetis' product, Revolution each 2 weeks.

These are perfect for itchy pets with
skin infections, but they are not
for every pet! Ask your vet first!
2. Have a good look at the shampoos you are using.

Could they be making things worse? Are you using a conditioner?  If you aren't, you should be.  Visit our website for more detailed information on choosing the right shampoo for your pet.

We are big fans of PAW Nutriderm conditioner, but some of the human rinses can also help.  Why not look at Alpha Keri Oil, Dermaveen or QV ointments. They may help some pets (not all).

 A note to remember - avoid lotions (they can make things worse).   It might be some trial and error on finding the right shampoo and conditioner for your pet, but don't give up.  I have had a case where the only treatment that helped was a $5 bar of lanolin shampoo from the local Sunday markets. 

3. Nutrition plays an important part in the overall health of your pet.

But don't expect a change in food to stop your pet from itching immediately. Food allergies are difficult to diagnose and even more difficult to treat. When I talk about nutrition and skin problems, it is to ensure that the pet has all the ingredients it needs for its immune system to help cope with irritated skin, with extra stuff to minimise its reactivity to irritants.  Look for the sensitive skin range at your vet hospital, or local pet shop.  The only favourite thing I suggest the food has - free from preservatives, high in antioxidants and essential fatty acids.  Many times, I usually lean towards the fish based foods for this reason.

4. Careful use of antihistamines -

Antihistamines are widely used, including us, but every time we suggest their use, we always tell loving pet owners that they will only help 1 in 3 pets.  Whilst they are overall safe, they are not risk free either. You need to know your pet's weight and their medical history, to ensure that there are no contraindications in using these medications. 

Keen to know more? Visit our website for a antihistamine dose chart guide.

I am Dr Liz, and whilst I love spring and summer, for the glorious long days, I don't like it as I get to see many itchy pets.  Fortunately, I have solutions for the short term and long term management for itchy pets, but I don't have "instant forever" solutions. For your pet to benefit from these solutions, make sure you call us to make an appointment, and let Dirk know it is for an itchy pet - that way we can ensure we allot sufficient time to cover everything properly.

Our website does have a "Skin Management" page, which we try to keep current. Why not check it out?

Call us on 02 42 845988 or you can book online at

Sunday, September 8, 2013

Losing Fitzgerald Darcy

In Loving Memory of Fitzgerald Darcy  2013
Losing Fitzgerald Darcy.... one very special (often annoying), but none the less, seriously missed cat.

Today, as National Pet Memorial Day, I can publicize the feelings and emotions, and yes, memorialise pets whom have touched my soul, and I think of daily.  Today, we can write about our pets whom we have lost, but not forgotten.

As a vet, I, with my colleagues all over the world, deal with death. That does not make us experts in it, or how to deal with it.  Through observation and listening/reading the comments of colleagues, I often notice that there is always a particular death that tips them over the edge, and catches them unawares. And this is what can slip vets into career change, suicide or severe depression.  I hope I never get to this state, but there have been times where I have felt an understanding of this black hole of unending sadness.

Each loss takes its toll on me.... whether it be a family member, a family pet, or wild animal (we often seen injured wildlife, and have to make the decision to end their life), or any pet that I come into contact with.  I take deep breaths, and allow myself to feel sad.   And this may mean that I can't put a smile on my face five minutes later. I am envious of those vets who can.

I am so thankful that whenever I explain to clients why I can't be all jolly, they understand.  So, Thank you. Some don't understand, and that is OK.  I hope they do find a vet who do not show the sadness they feel (I only hope it is that they don't show, rather than they don't care).

Our Fitz, at more happier times! Fast Asleep, doing what
he does best!
But this is all about Fitzgerald Darcy... known to us as Fitzy or Fitz. We lost him earlier this year, in an accident - and we live in a quiet street, and we never knew him to go onto the road.  It was... a shock!

He came into Russell Vale vets as a stray cat.  He was a small grey kitten, and he had severe diarrhoea, was in a poor state, and really, not in a good way.  The Good Sams who brought him in already had three cats, and were unable to take in another.  He was not microchipped, and had no other identifying tags.

Our intention was to keep him until his diarrhoea settled, and then to rehome him.  We knew it was a death sentence to send him to the local pound, due to his medical condition. They were already overwhelmed with healthy kittens and cats looking for a home.  We couldn't, in all conscience, rehome an unwell animal ourselves.  That was 8 years ago.

Yes, he was a young cat.  Now that he is gone, the guilt we feel at his loss is still there...this is where the self- doubt, the self recriminations come in... if we could keep him indoors, if we kept him confined, if we installed a cat-backyard, with four walls and ceiling... he would still be alive today.

And he would be, but he wouldn't have experienced the life he did, if we had done all of that.  I am not saying you shouldn't take those precautions, but where we live, in a normally quiet street with a low speed limit of 50 km/hour, we back onto grassland, and we have neighbours (very lovely ones) on either side.... and we are on half an acre of backyard.  So, it is not your average street!  We did not think him at risk or at danger at all.

And the reality is, seeing, and knowing his injuries, whoever hit him, knew they had hit something... and they kept on moving.

Wow... this is reading like something I had not intended.  I hope that when you read this, you know it was written with grief in the heart, as losing a pet hurts. It just does.

Fitzy was a cat like we had never had before.  His diarrhoea meant that I could not rehome him until he was better... and by the time he was better we couldn't rehome him.  He got on so well with our cat Dash, that it wasn't a problem keeping him.  He wasn't in a cage recuperating, but part of our family at home, in our house.

Fitzy had a real walk on him - it was unlike any other cat I had seen.  It was like the "cat walk " of the models... he would walk along, and then, he would be down on the ground, lying like he is stretching out on a chaise lounge, with that "come hither" look in his eyes.  We called it the "Fitzy slump".   It is hard to describe.... except he would do it just in front of you, in the kitchen, just about as you are to walk through, so you have to step over him.

He had a charm about him...

But at 4 in the morning, when he is trying to wake you up...not charming ... he would claw on the wardrobe doors, or meowing in a "me - e- ow" which was his way of asking you to get out of bed, look at the food bowl, confirm that it is still full of food, rustle it with your fingers to make it fuller, so he could feel more comfortable eating it.

Teddy, our hero... who we lost in 2011
from Canine Lymphoma 
As I miss Teddy's wagging tail when I come home from work, even though he used to bark at 4 in the morning, so will I miss Fitz's re-arrangement of my TV cabinet or work desk in my bedroom, to ensure he got the attention he deserved.

I always talk to my kids about being kind to others, as you never know if that will be the last time you will see them. Sometimes, you just don't get to say good bye.

Fitzy... we can't imagine our life without you.   We are sorry that your last moments were in some pain, and we were not there to help you.   We re-traced your steps and can see that  love you had for us... you went down our front stairs through the gate, to the back door... as that was closed you went to the garage, and laid in your favourite warm spot... to enjoy the last of the sun's rays on your body.

Tegan found  you resting, as peacefully as you could possibly be, which meant that you died soon after your injuries. We wish we could've been holding you in our arms, telling you how much we love you, and how special you are.. I know that an Angel would've have been doing that, and it is with that thought, that lightens our heart.

Losing Fitzgerald Darcy... it is months since you have now left us, and the pain is as acute now as it was then.   Being a vet does not make the pain any easier to go through.  Any loving pet owner will understand

It hurts. Plain and simple. Not withstanding the psychobabble of the stages of grief, the funeral parlour speak of "celebration of life"... lets just face it... it hurts.

We may smile when we remember the little quirks, we may cry when we realise that when we talk to them, we are talking to air.

It hurts, and we hurt when others go through the loss also. " In Sympathy"  or "Our Condolences" is then real, not just a few token words on a card.

On this day, 8th of September 2013, we light a candle in memory of our pets who are on greener pastures.

I am Dr Liz, and today, my family and I pray for all pets and for you...  In Loving Memory.

Tuesday, September 3, 2013

Musings of Dr Liz - It's just a virus, says the doctor.

Welcome to another one of  my musings... but this one is a bit different - I am writing this while I am suffering from a head cold, and feeling all stuffy in the head, and sniffly. Not sick enough to go to the doctor, as I am
"It's just a virus?"
just feeling off, lethargic, not wanting to move much, and with the typical cold signs.

I know what the doctor will say - its just a virus, go to bed, drink lots of fluids. Sleep. You'll be fine.

Now, that last line made me think about what I say to a loving pet owner, who brings their pet in with similar signs - a bit off, not themselves, didn't eat well that morning (or night before). I wouldn't say " You have a virus, go to bed, drink lots of fluids, you'll be fine!"

Leo taking Dr's advice and going to bed!
I admit to being a bit disgruntled when I am told that by my GP, as really, I don't go to see him often, and so, in my view, when I do go, it is because I do feel really unwell, and I want him to help me feel better.  I can only imagine that a loving pet owner would feel the same way too - after all, we hate the thought of our pet being in pain, or being lethargic and unwell.

As a vet, I work on a theory that if our pets are unwell enough for us to notice that they are unwell, then they are seriously and truly unwell.  Now I do know some pets do pretend to be unwell - for example - they pretend to limp when you are watching, but walk perfectly fine when they think you aren't, but this not as common as you may think.

Do our pets get "viruses" like us?  You bet they do.  Can they feel lethargic as a result?  Sure, of course they can.  Do they need to see the vet every time you think they are unwell?  Not always, but how do you as the loving pet owner know when it is OK to wait and see? Even vets get that wrong sometimes (as do doctors - we all know stories of people being sent home from hospital only to get worse shortly after).

Would you prefer that I say "your pet is ok" without a check up or any tests?  -  Most times I would be right, but what if I was wrong, which is possible some of the time.    Or would you prefer that I say that "Our check up of your pet, (plus the test results), tells us that your pet will be fine" and we would be right 100% of the time. And in those pets where the check up shows up something abnormal, we can act on it straight away and get things fixed.

I know which score I would like  as a vet - which is 100%. Rather than take the chance of being right a huge chunk of the time, as an intelligent guestimate.  At the end of the day, the ball is in the hands of the loving pet owner, as I can't drag your pet into the vet - only you can do that.

As I sneeze myself into another box of tissues, I'll have to content myself with the doctors advice, and head off to bed with lots of fluids and a big box of tissues. And hope that this time, my own GP is right!

I am Dr Liz, and I wish you all good health. Bring Spring On!