Rappie

I would suspect that Kelly Louise's specialist will let her know when treatment is indicated, there are many approaches. I would suspect that most of the specialists follow the IRIS guidelines for staging and sub-staging renal disease which many vets in general practice may not (although plenty do). Under these guidelines, early stages of chronic kidney disease do not require ACEI unless there is evidence of persistent hypertension, or end organ damage (the guidelines are slightly different for cats). Edit to add: My comments are not a criticism of vets in general practice (I am one!) but there are several different approaches and many contradictory articles and theories - even just related to the one type of drug. There have been reports of protective effects, positive effects on glomerular filtration, evidence that ACEI should only be used in cases with high levels of protein in the urine, that ACEI are not indicated in dogs etc etc. The more important thing is that good reasoning stands behind the decision to use any drug and regular monitoring is undertaken so that any changes in clinical condition are detected early.

I'd organise a vet visit. They have have a good feel of the lump and see if there are any others - then depending on what it is, either organise removal, a fine needle biopsy (which is a good place to start) or recommend very close monitoring.

The medications are used in chronic kidney failure to prevent damage to other organs, but do not change the 'failure' status of the kidneys. The main problems are related to what we refer to as 'end organ damage' due mainly to high blood pressure - which can cause problems with eyes, the vascular system and other parts of the body. The kidney diets are the mainstay treatment - they have a moderate protein restriction (smaller amounts of high quality, bioavailable protein) and are low in sodium and phosphate. Sometimes a phosphate binder will be added if the phosphate levels in the blood are increased. Regular monitoring is important - both of the creatinine level (we usually measure the serum urea level too but it is not a very sensitive indicator of worsening kidney disease), other blood levels like calcium and phosphate, blood pressure, urine protein levels and urine concentration. It's only once we find that there are changes in either of these that other medications are really indicated. Once a diagnosis has been established, they would generally be checked every 3 months or so. Dog (and cats) with dilute urine are also prone to developing urinary tract infections, so I would generally do a urine culture if there was any question over whether a UTI might be or could be present. It's also important to be aware of the hydration status of animals with kidney failure as they have no way of retaining water when they start to get dehydrated and may need to go on IV fluids even if they have non-kidney related problems like diarrhoea or vomiting.

The only contraindication of relevance that I'm aware of is that pentosan polysulfate can affect coagulation times in some animals, so it is not recommended that they are used at the time of surgery. Aside from this they are considered to be very safe. Prudent use (lower than recommended doses, lowest frequency of administration) of NSAIDs like Previcox is acceptable if the benefit they give outweighs the potential negative effects. With progression of renal failure, other drugs like gabapentin and tramadol can be useful for managing pain without having significant effects on the kidneys.

Thanks Jigsaw!

If you go to the Library section, the to Rounds and search for 'low stress handling' it should be the first result. I had completely forgotten about it. The behaviour boards are quite interesting too - not sure if you go there, but a lot of 'big names' of veterinary behaviour post there.

Going slightly off topic, but do you have access to VIN? There are some good rounds transcripts on there from a vet called Sophia Yin on low stress handling and restraint in veterinary hospitals. She has published a handbook style reference that comes with a DVD. I haven't actually seen the book in the flesh, but I have found the transcripts quite interesting.

I haven't seen any specific studies but if you come across any good info then I'd love to see the links. I'd really like to get our nurses involved in activities like this but it's hard to find extra time. We've had a couple of parvo pups in recently, it's difficult with them being in isolation, but I'm trying hard to get people to spend even a minute or so at a time doing something 'nice' each time they are in there. Otherwise it becomes a twice daily routine of injections and poking and prodding - I'm trying to get the nurses to work for tail wags instead of the dogs working for food I think I'm the biggest user/giver of liver treats in our clinic

No problem

The chance of seizures being due to a problem in the brain increase with the age of the patient. If they are occurring at a frequency of 4-6 weeks, then this is the point that I would either consider starting medication to prevent seizures or continue with further investigation in an attempt to find a specific cause for the seizures. The most common result from running blood tests in seizuring patients is that all the values are normal, which gives us more of an indication that the problem is not related to the function of the rest of the body. Sometimes we certainly do find a cause on the blood works, and it is the simplest starting point for investigation. Imaging of the brain is the best way to find a tumour or lesion, either through MRI or CT. Beyond this, there may be specific further testing for other problems like metal toxicity, or parasitic disease indicated but unfortunately there is no general screening test for the weird causes. In Sydney we have a wonderful neurologist who is always happy to take referral consults for second opinions - it's a good way to get reassurance even if nothing further is done. If no further investigation is to be done, and the seizures are increasing in frequency or severity then it is reasonable consider medication anyway so long as you are aware of the possibilities that you might NOT be treating. Sometimes we're not able to do everything and the options of treating vs not treating become a balance of risk. I'd suggest a good chat with your vet to develop a plan.

We regularly anaesthetise geriatric dogs and cat for procedures, including those with pre-existing medical problems like heart and kidney disease. With due attention to the medical issues and a balanced anaesthesia using up to date drugs and protocols, it shouldn't be too much of an issue to anaesthetise a healthy dog (or cat) over 10 years of age.

Age alone isn't a limitation to anaesthesia and surgery, but it is taken into consideration along with any concurrent disease. In an otherwise healthy dog, it's (almost) never too late to desex.

This is an observation, not a criticism (and I guess reflects part of the problem with defining anything related to behaviour).... Among veterinary behaviourists, a distinction is made between problem behaviours and behaviour problems. The things you have described as training issues, would be considered problem behaviours. They are a nuisance and undesirable, but are variations of 'normal' behaviours but expressed in a way that an owner might consider to be 'inappropriate'. Behaviour problems are those where a response is inappropriate (in the context in which it is expressed), harmful or detrimental or dangerous to the dog itself, or other dogs or humans that might be exposed to it. (PS. I'm not a veterinary behaviourist by any stretch, but I have done a post grad course in Behavioural Medicine and these discussions are of great interest to me).

Helen Nicholson is fantastic. Her website is here - she consults at the Animal Referral Hospital in Homebush, and at Parramatta Veterinary Surgical Specialists. ETA: I have seen some good results with acupuncture, but I would recommend a veterinary acupuncturist with IVAS certifcation. Swimming is good exercise but can be quite tiring. As a general rule any exercise should be 'moderate' and not result in fatigue. I'd also make sure that other factors like pain relief, maintaning a lean body weight and supporting the joint (through oral supplements and zydax / cartrophen / pentosan injections etc) are taken care of.

It is a serious situation. If the penis remains exposed and engorged it will eventually lose it's blood supply as the continued swelling combined with constriction from the preputial opening will cause strangulation of the tissue. If it's not corrected while the tissue is still viable then amputation can be the only option. There are some surgical procedures that can help. If it's happening on a regular basis and cannot be managed by modifying behaviour and / or assisted reduction, then I would consider a second opinion with a specialist surgeon.

I know it might be too late for you to take her to the vet, but I would definitely suggest that your OH does. Arm him with enough information to let the vet know what is going on - time of her last season, that she's drinking more water, change in urination habits. Taking a urine sample to the consult is also very helpful, otherwise the vet can try to get one during the consult. With the list of possibilities, it definitely something I would get checked.

It seems that between Kirty's vet and a derm nurse, a nice in house work up has been done, a course of treatment laid out and a plan put in place if things do not improve? Saying that you will test for thyroid dysfunction if the conditions do not respond to treatment is not discounting it as being a possibility. If there are limitations to funds, then conservative treatment of the existing and identifiable problems is a perfectly reasonable thing to do.

Of that $1400 bill, more than half of it would be the cost of the antivenom - the price went up last year and it's very expensive. It will require at least one vial to treat a dog that has been bitten, possibly two or more depending on the response to treatment. Every clinic I have worked in has required either full payment or at least $1000 before starting treatment. Every time a vial is used but not paid for, it's another $800-900 that is needed to buy more. In a region with a lot of snakes, that becomes very expensive for the vet, very quickly.

It's not always easy to dislodge the obstruction. I distinctly remember a case I treated last year, a GSD with a rubber ball stuck in it's throat. It was a smooth rubber ball with a hole through the middle but the hole was blocked by the soft tissue of the throat. The ONLY good thing about the size of this ball meant that a little bit of air could still pass behind the ball from the nasal passages - the back of the oral cavity was completely blocked. Due to the length of time the ball had been stuck, possibly an hour or so there was so much swelling that the ball wasn't budging. It took an emergency anaesthesia, tracheotomy and the coordinated efforts of all the vets on duty (4 of us) to finally dislodge the ball. The recovered and is doing absolutely fine now. It might be possible to dislodge things that have just got lodged, but I'd never recommend small hard rubber balls to any dog, let alone a large one. On a more amusing note, I treated a Doberman last year that looked for all the world like it had an intestinal foreign body and was very very sad. It was late on a Sunday and he was very dehydrated so I started him on fluids with a plan to consider surgery the next day if he wasn't improved. After a few hours of fluids, he pooped out a small rubber "super ball" and looked 100% better after that!

Whether or not to give an injection can be a matter of personal preference. Unless there is some reason not to use oral medication such as vomiting or diarrhoea or weakness significant enough to mean that a patient cannot eat, I don't normally give an injection. If given with food the time for absorption is not significantly different between injectable and oral forms, and there is a very slim risk of reaction to an injection. There is nothing wrong with giving an injection, but there is no need to worry about it if the dogs are otherwise healthy.

Saline for flushing wounds and betadine for topical application are probably all you need. Add Manuka honey if you wish and a fly repellant if required. Ointments like Prednoderm and Neotopic / Neocort are useful for things like small abrasions or superficial pyoderma (hot spots) and other types of dermatitis but have no place in treating fresh or traumatic wounds. If a wound needs more than flushing and Betadine, it needs to see a vet.

How much dog do you need to be in the photo? Full body? Front or side on?

Incontinence occurs in up to 20% of speyed bitches. Pyometra may affect up to 25% of bitches. The incidence of mammary tumours in entire bitches or those speyed after 2 seasons is up to 25%.

The published statistics for the risk of mammary tumours are 0.05% if speyed before the first season, 8% after the first season but before the second and about 25% after the second. After this point there is no difference in risk between dogs that are desexed after having had 2 seasons and those that are not desexed. There is some evidence to suggest that speying at any point reduces the risk of benign mammary tumours but the risk of malignant ones is unchanged.

Sentinel contains lufenuron which is an insect growth regulator, it has no killing action against fleas. Comfortis is spinosad, which is an adulticide - kind of like month long capstar. Neither have any action against ticks. For ticks you're mainly looking at fortnightly application of Frontline or Advantix although there are other options like Permoxin spray, tick collars and Proban tablets. I would suggest calling a local vet in the area you're moving too and seeing what they recommend.