Rappie

Kersti is a registered specialist in veterinary behavioural medicine, qualified as such on 3 continents with an excellent international reputation. Her consultations generally last for 3 hours and include written discharge instructions and follow up with you and your veterinarian. It's not cheap, but she is fantastic.

If you move to a new practice, you may request that the previous practice forward the medical record and radiographs to your new vet. The transfer is normally done between the practices however in some cases (international or interstate transfer) you may have the radiographs released to you. Other medical records are usually posted, faxed or email directly to the new practice.

As stated from the NSW-VPB and AVA the radiographs remain the property of the veterinary hospital and must be retained. It might not seem fair but that the way it works, we must retain evidence of the results of any diagnostic tests performed, which includes taking radiographs. The other thing that makes it complicated is that you are not the patient - and veterinary patients are not responsible for their own health. What you pay for is not the film, so much as the procedure of taking diagnostic images and then the interpretation of those images by your veterinarian. You're free to request copies - this is easy with digital radiography, but a digital camera can be used to take clear photos of them, or if advised before hand double film can be used.

Although aspirin can be used in some veterinary patients it's generally my last choice of pain relief. In a true emergency requiring pain relief, the oral route is least likely to be effective and there may be medical conditions that preclude that route of administration. In any condition involving shock, toxins, dehydration, gastrointestinal disease and bleeding then I would not choose a NSAID such as aspirin. I would include things to assist safe transport of a dog to a veterinarian, such as towels or muzzles or leads. If it is a situation that requires pain relief, the rest of the dog would need to be assessed too.

Products containing any of the 'mectins' - Revolution, Advocate, Heartgard (even Proheart according to their info) are safe to to give to untested dogs as the active drug will not kill adult heartworm. Sentinel and Interceptor require testing. I would still strongly recommend heartgard testing prior to commencing any of them as it is important to know whether the dog is infected with heartworm for their long term management.

The price you have been quoted would be for a physical examination, consultation and the vaccination itself. Any modified live vaccination must be given by a veterinarian. A physical examination is a neccessity as the veterinarian that administers the vaccination should have personal knowledge that the dog appears healthy and has a normal temperature. As a matter of interest, over the last few months I have changed the way I greet clients at a consultation. When confirming the reason for a visit, I have been saying something along the lines of "So, Fluffy is here for a check up and vaccination today?". I have been quite suprised by the number of people who respond with "No, just a needle today"...

As Stormie mentioned, if the metronidazole (Metrogyl) is for vomiting or diarrhoea then I would usually withold a NSAID such as Metacam. Definitely one to speak to your vet about.

You're welcome westiemum It's not uncommon to end up with a Pseudomonas infection secondary to a number of other "normal" infections. Pseudomonas likes to have a party in the first line treatments like Dermotic / Surolan and Canaural etc. After a few infections the micro-environment of the ear changes and become even more hospitable to nasties

I will second / third / fourth a skin scrape, sticky tape test and at least an examination with a Woods Lamp (will only pick up 50% of cases of ringworm - but it's a start). Edit to add: The antibiotics and Malaseb washes may well cover most common bases, but having a diagnosis is always preferable, particularly in cases where there are implications for general management - such as zoonosis or environmental contamination.

Having a culture and sensitivity result is probably the most helpful piece of information. With any ear infection, I always do an in-house swab to determine what is actually growing down problem ears. Anytime I find rods, I warn clients from the outset that these infections can be frustrating to treat and Pseudomonas in particular is prone to being antibiotic resistant. I recommend a culture at that first visit if I find rods. TrizEDTA cleaner helps to weaken the cell wall of the bacteria so that it is more susceptible to the topical antibiotic treatment. Sounds like you're on track with this treatment. Close monitoring is really important, I like to recheck weekly and do regular in house swab to keep tabs on what is growing. It will take week, if not months to clear and infection and some dogs will have recurrent problems. I tend to use low dose steroids (one of the few situations I do) to reduce the inflammation in the ear canal, which opens them up and lets the treatment get to all of the ear canal. The Rimadyl is just a different drug doing the same thing. It is really important to treat until the infection clears, and then some. Unfortunately I come across a few cases where the owner has stopped treatment because the ear looked better, but the infection was never resolved - becomes very hard to treat those ones.

Pale gums indicate either lack of red blood cells, or poor perfusion of blood to the tissues. Pain can cause that latter but if they are "quite pale" then it would generally be pain with an obvious cause (surgery, injury or trauma etc). If you are concerned and the gums really are pale pink then I would consider a check up and triple check whether there is any possible access to rat bait or other toxins. If the gums are not a shade of pink at all then it's vet straight away.

There's no need to feel embarrassed about it. You know what limitations you have and work with them. I just meet a lot of people for whom teaching their dog anything isn't important, but they will still expect myself and my staff to just 'deal' with whatever the problem is. As I get older, and grumpier, I'm much less inclined to put myself or my staff in harms way. Patience, liberal use of liver treats, experienced staff and calm handling go a long way but the safety of everyone is paramount. If it's any consolation, I own one little dog who detests having her nails cut. It's taken a lot of work but she will accept nail clipping now, she doesn't like it, she pulls faces but she will sit quietly with restraint (lying on her side with leg extended) and *tolerates* it. We follow up with something super-exciting like a biscuit and everything is forgiven I don't expect her to like it, but I do expect her to let me do it - but it's taken a long time. My proudest moment was Little Miss Wriggle Pants sitting still while my OH held her for me to take blood from her jugular (he's quite a good nurse). She's never had that done before, but all the poking and prodding they endure amounted to something... she shot me accusing look but didn't flinch, lol.

Teaching it at puppy class, and having owner recognise it as both being important and something that requires ongoing effort is not always the same. I ran into this today. A dog with a torn dew claw, I wanted to examine it's foot. "Oh, he doesn't like his nails clipped" Have you tried teaching him to accept having his feet touched? "Oh yes, they taught us that at puppy preschool but he didn't like it, so we never do it".

Getting dogs used to being handled, particularly being gently restrained is very important. It's not just for the vets benefit, but for owners as well because they will need to administer medications, or clean wound and so on. I work with positive reinforcement - I don't think that in itself is the problem, but it's often not used well by owners. I don't think pets should be expected to LIKE what we do to them, but they should learn to tolerate it, and in teaching them to do that we should make it worth their while (reward good behaviour). It's also very useful for dogs to be taught to wear a muzzle even if they should never need one. I don't see many dogs that have actually be taught to accept things, mainly dogs who you can do thing to. Generally speaking, owners have very little concept of how to safely restrain their animals for various types of examination (ie. keeping wayward teeth away from my hands). It is unfortunately common for owners to present me with their bouncy Labrador and then take a few steps back and hold the end of the lead while it cavorts around the consult room, then get frustrated with me when I ask them to hold their pet so I may look at it. I think again its one of those situations where the average DOL member is probably miles ahead of the average member of the dog owning public...

Antihistamines are given prior to vaccination in dogs that have previously had a reaction involving facial swelling or urticaria etc. For post-vaccination reactions, an antihistamine injection may be given for an allergic-type reaction but sometimes we see dogs (and cats) that are generally painful or have a fever and these dogs might be given an anti-inflammatory injection instead. It is not uncommon for pets to be lethargic for 24 hours or so, or to be tender around the injection sites - these effects are not uncommon in people either.

The NSAID medications are very effective at what they do. In most cases they are very well tolerated and a lot of the time when they are prescribed for long term use it is, as others have mentioned, a quality of life issue as to whether they receive the medication. I see a great many more patients benefit from this treatment than suffer from it, side effects get a great deal of noise made but occur infrequently. Where possible and particularly in an older patient on long term treatment, I try to get a blood sample prior to starting the treatment to get a baseline for liver and kidney function. I recommend repeating this every 6-12 months (depending on the patient) to monitor any changes. I generally always try incorporate joint modification agents (cartrophen / zydex / pentosan injections), weight loss, moderate exercise and joint supplements in either a commerical form like Glyde or JointGuard, or fish oil and glucosamine. Sometimes in dogs that do not tolerate NSAIDs or those that need extra help I will add in a different type of pain relief like Tramal. I sometimes suggest physio, massage and acupuncture. I know that a lot of people use a chiro but I recommend ruling out major medical issues prior to treatment. In general the NSAIDs should be given with or just after food, and not given if the animal is not eating or drinking well, is vomiting or has diarrhoea. If you have any concerns you should speak to your vet about the medication.

If the area that you are seeing is within the eye itself, it's unlikely to be pigmentary keratitis as this affects the cornea. From your description its difficult to say what it could be, but possibly a melanotic lesion or any other process that affects the iris, such as iris atrophy or synechiae. It is very hard to tell without seeing it and it is worth a check up if it concerns you. Does it move around the as the pupil constricts and dilates?

It is not necessary to rotate through brands of heart worm preventative, nor intestinal worming treatment. For the latter I would recommend a vet brand over supermarket as they have a higher % efficacy after dosing and cover tapeworm as well.

Right now, the no bones recommendation is because this dog has a pancreas that is not functioning properly. It's not regulating the release of digestive enzymes, nor is it producing sufficient amount of insulin. It needs a low fat diet with a moderate fibre content, fed in consistent, measurable quantities while it is stabilising. Once the BG levels are stable, then yes, you can speak to your vet about modifying the diet but "stable" may take several weeks or months to eventuate.

Canine cognitive dysfunction isn't uncommon unfortunately. I think some blood tests are a great idea in order to determine whether theres a medical cause for the behaviour changes. It's not something you just have to deal with, there are some medical treatments available and Hills b/d is also something that is worth trying as I've seen it help several dogs.

There's lots of different opinions and it really depends on whether the ear is a 'problem' ear that needs cleaning or its just for maintenance, and whether its a hairy ear or not. For maintenance cleaning, wiping out with ear cleaning solution is fine. If one notices more debris than usual it is worth investigation. It is possible to over clean ears as I said, it depends on the ear. I don't recommend cleaning normal ears for the sake of it. For a problem ear, I think 'flushing' is much more effective. In clinic I will use saline for very sore, ulcerated ears or the Bayer Clean Ear solution. Rather than squirt in the ear, I soak a cotton ball in solution, then squeeze this against the bottom of the ear flap so that the fluid dribbles down the ear canal and you can use it to block the ear canal off. Then massage the ear canal for a good 30 seconds or so then wipe debris out with a dry cotton ball. If it's mucky, repeat till it starts to clear. If not, stand back and let the dog have a good shake (outside is a good place to clean ears). The PAW ear cleaner is very good, but the recommendation from the manufacturers is to no use it more frequently than once weekly, so it is often not suitable for really gooey ears that need medicating and cleaning twice daily. Edit to add: Before putting any liquid down an ear canal it's important to know what state the ear drum is in. Although some cleaners are safe even in the absence of a tympanic membrane, I wouldn't recommend any of the alcohol based cleaners for any abnormal ear (hence using sterile saline for the initial clean of any dodgy looking ear).

The heart rate of any dog can vary fairly significantly regardless of size but as a general rule, smaller dogs have higher heart rates. I would expect a Chihuahua to be between 120-140 but this is not a set rule. In your case what would be of more concern to me would be whether the heart rate is like this all the time, whether it can increase in response to stress (including exercise) and whether the dog shows any clinical signs related to it (reluctance to exercise, fainting etc). I'd suggest that you check the heart rate at home several times and check. If it's persistently low then I would think it worth doing some kind of investigation, even if only starting with an ECG. In a small dog you should be able to feel the heart beat by cupping their chest with your hand, count the beats over 15 seconds then x4 to get beats per minute.

You're most welcome

Glad to hear it

For maintaining a normal ear - I'm in the no plucking camp. As Clyde mentioned, plucking the hair can aggravate the hair follicles and cause problems of it's own. Occasionally, in a dog with an ear infection I will recommend that we pluck the ears but it really depends on the ears. Sometimes it will be after a few days of treatment if the ears are really inflamed. Off the top of my head, in all of the ear infections I've seen in the last 5 months, I have only needed to pluck ears in two dogs. That said, I think clipping daggy bits of hair covered in ear gunge away from the base of the ear is a good idea.