Rappie

The recommendation to test every two years while only using intermittent heartworm prevention is not in line with the general heartworm guidelines. No amount of heartworm is desirable so it doesn't really make a lot of difference how big they are, if anything the number of worms is more significant because even one could cause an embolus once it dies. A comment regarding heartworm prevention generally is that for most of the oral products at least, the doses are given at intervals rather than lasting for a full month ie. A dog receives 12 doses at 1 month intervals rather than 365 days of treatment. Same goes for oral intestinal workers, the ingredients in the tablets are not well absorbed systemically and kill intestinal parasites 'on the way past'. The dosing schedule is based on the life cycle, hence an increased frequency for example if you are trying to prevent hydatid tapeworm vs other intestinal parasites.

I would wait for the vet to contact you. It will depends on the amount that was supposed to be dispensed and the fee structure including a dispensing fee which are things that are specific to your situation and the vet clinic.

Glad to hear there's some improvement Lorello :) Between the steroids, bleeding and having a massive immune response it is not usual for dogs with ITP (or any of a range of conditions) to seem lethargic. If the platelet numbers continue to go up then that is positive. Most of the risk of relapse occurs when we try to reduce the dose of steroids. That wont be for some time though, usually several weeks at the initial dose then a slow dose reduction every 2-4 weeks after rechecking the platelet numbers. There is a percentage of dogs that need to remain on steroids long term, or even for life but unfortunately this cant be predicted at the beginning. Kirislin - thankyou I'm a strong believer in open communication between vets and owners and know that particularly in cases like this once you get home its very easy to forget information you've been told, or think of new questions or need some clarification of information. I'm glad that posters find it of benefit :)

Yes, just give it now and continue regular dosing.

It was only expected to bphase the registration approved a couple of weeks ago. It's been coming for a while but stock isn't expected until the new year.

Sometimes with difficulty, however there are usually some markers that help to distinguish between various causes. Both IMT and rodenticide poisoning can cause bleeding. IMT is due to a lack (or in cases of a level of 1 - essentially none) of platelets, where rodenticide poisoning is due to an inability of platelets to initiate blood clotting. Often a simple distinction is are the platelets on a blood film or not. If there are no platelets, a normal red cell level and evidence of bleeding then a problem with platelet numbers is the problem. If there are lots of platelets, a normal to low red cell level and evidence of bleeding it looks more like a clotting problem. Although it can vary, IMT tends to have bleeding occur as petechiae (tiny bleeds seen on the gums or skin), small areas of livid bruising, bleeding from light pressue etc. Often with rat bait there can either be no external bleeding (but there is internal bleeding into the chest, joints or abdominal cavity) or abnormal visible bleeding with no history of trauma - a dog I saw recently had a large swelling around its eye, a huge haematoma and a very swollen purple leg. Between a thorough history, physical exam and some blood tests its usually possible to narrow it down. The platelet counts in IMT tend to be dramatically low (<50, normal is around 200-500) whereas even if they are reduced due to other causes of bleeding they are still adequate for clotting to occur (>50). Clotting times and some other tests can be used to get more information.

IMT is immune mediated thrombocytopenia. The anaemia can be due to immune mediated haemolytic anaemia (referred to as Evans Syndrome whenit occurs with IMTP) or secondary to internal bleeding due to a lack of platelets to initiate clotting. I'm sure there are several DOLers that can share their personal experiences but if you have any general questions feel free to ask :)

Yes to Bordatella but it usually requires significant immune compromise. Cats can also become infected with it.

Yes. It is a flavoured chew I think so dosing is in whole tablets and not split tablets.

Yes, surgical options are definitely considerations for dogs with chronic changes to the ear canal and absolutely speak to a specialist surgeon about it.

The usual volume for a large dog ear is 1ml which is expensive and often impractical with a medication like Mometamax. I am based in Sydney so unfortunately I dont have any recommendations for dermatologists. Without actually seeing the dog it is very difficult to interpret recommendations from other vets. I have certainly seen some dogs with chronic ear infections where there were very limited options (whether they be practical or financial) and euthanasia should be considered but it is not common. Age alone is not a barrier to having a general anaesthesia either so I assume there are either underlying medical issues or underlying vet issues at play. Similarly, being old and having arthritis is usually an indication to be more proactive about pain relief and management of this condition not an indication for euthanasia however a combination of other issues including medical problems, cost of medication, long or short term benefit to the dog etc must all be considered. Edit to add a comment about chronic ear infections: with chronic otitis there are a number of changes that occur within the ear canal that means the whole environ,wnt is no longer 'normal' and never will be, such as thickening of the skin, scarring, narrowing and calcification of the cartilage of the ear canal itself. This makes effective cleaning and medicating quite difficult, means that the normal self cleaning mechanism of the ear is often non-existent and regardless of the actual trigger (ie atopic dermatitis or food allergy etc) predisposes the ears to repeat infection. It is important to try to determine whether the dog has a recurrent or resistant ear infection as the management of them can be different. It really also depends on what is causing the infection as a yeast infection is different to a bacterial infection with cocci, which is different again to a bacterial infection with rods (like pseudomonas which are known for their propensity to become resistant to antibiotics).... And a mixed infection of more than one of these is different again.

She may need some more diagnostics and a treatment re-jig, or the opinion of a dermatologist. If it is not done regularly the she at least needs regular ear cytology, and although I don't do them routinely she may benefit from an ear culture if the pattern is changing. IMHO (and that of many dermatologists) Mometamax or not, 8 drops is not a useful volume of anything to put in a GSD ear and the volume of medication is important to the efficacy of treatment (at least 1ml for a large dog) as is the duration (at least 3 weeks if not an acute case). There are other medications which may be more helpful and economical if this dog has ended up with a chronic pseudomonas ear. It also really important that the cleaning done as maintenance is effective (ie filling of the ear canal with a good massage). It is also important to try to control underlying allergies if they have been identified and treat any other secondary skin infections if they exist.

Would a vet be able to identify the cause of a wound by lifting a scab to actually see a wound? Somehow I have my doubts. There was no festering under the scab of my Rottie's supposed WTS bite, just a clean wound that healed rapidly but bugger about the lack of hair growth to the area. I know my GP can't identify the cause of a wound because she asks me what happened to cause it. Not to ascertain the cause as such but sometimes the type of wound - is the scab covering intact skin, necrotic skin, an abscess, a puncture wound etc.

Did she have the testing done while she was having an episode? The combination of phenobarbitone and potassium bromide can lead to pancreatitis in some animals. Phenobarbitone alone can also sometimes cause lipemia or increase in fat in hr blood which can predispose some animals to developing a pancreatitis. The most reliable means of trying to identify pancreatitis is with abominal ultrasound and an experienced operator, a normal CPLi (the pancreatitis blood test) doesn't rule it out, particularly chronic or low grade cases. This of course doesn't mean that this is the cause but it would still be a consideration for me and would support at least a trial of a low fat diet.

I'm sorry this response is going to be short but I'm in the midst of toddler wrangling... The answer to all your questions is likely to be yes, possibly. Certainly the live intranasal vaccine can induce mild upper respiratory tract signs due to the local immune response but it does not typically also result in lower respiratory signs. 3 months in the life span of a dog that already has a grade 5 heart murmur is a long time and thing can change rapidly, or they may progress very slowly. The often confounding thing about dogs with mitral valve disease, especially CKCS is that they will often have concurrent dynamic airway disease / chronic bronchitis which can contribute to the clinical signs and require additional management. There was a recent paper published headed by a cardiologist here in Sydney that was investigating the theory of left atrial enlargement causing compression of the mainstem bronchi and resulting in a cough, and after bronchoscope was performed found that in many of the dogs there was no compression but there was evidence of bronchitis. In your case, management of the heart failure may require a medication review, some chest radiographs, and consideration of medication options for chronic bronchitis (of which there are many but usually commencing with a course of doxycycline prior to other respiratory medications) If you're not happy with your current vet then ask around for another well respected vet for a second opinion, or consider getting a referral to see a medical specialist or cardiologist (depending on your location). You're welcome to PM me or post here if your have other questions.

The Pentax lenses would probably sell even to owners of DSLRs but I'm not sure about the body.

Obstructive diseases of the biliary system are mostly medical or surgical problems, while diet is used as one of the supportive treatments. Has your dog had an ultrasound to identify the cause of the obstruction (intrahepatic such as from inflammation or extra hepatic such as pancreatitis like Jules mentioned, or a mass), or have blood tests shown evidence of cholestasis (slowed bile flow)?

That sounds expensive to me, my BSD just had a lipoma behind her elbow removed together with a dental plus one molar extraction for $533. I think you got yourself a good deal. The cost of dentistry, like many other procedures, is relative and the only way to compare prices is to know exactly what is included in the estimated cost - blood tests, IV fluids, dental radiographs, local anaesthetic blocks, gingival flaps, sutured wounds etc or what is a 'standard' kind of dental in many practices of scale and polish and remove teeth that are wiggly or very diseased.

This. The other suggestions of 'social' visits and treats are good too. Perhaps see if there is a vet at your current practice ( or another one) who is willing to help you. I see a lot of anxious dogs or have dogs with previous bad experiences booked in for second opinions. Learning to wear a muzzle at home is very beneficial because it is then one less stressors when you get to the vet. Sometimes having a stranger ( ie a nurse) restrain can help, and this doesn't always mean that your pet has to leave the room. I do plenty of consults on the floor of the consulting room, and for some dogs that hate being in the clinic we sit outside in the backyard of the clinic instead, and book them in during quiet times of the day. There are some dogs where the best 'quick fix' for a problem is to do a quick GA to deal with the immediate problem then work on a long term strategy from there.

from what you've said it it's very early on and it is possible that the values will hang around the upper end of normal and sneak just out of normal range for a while yet. If you are interested in how the treatments in the review article apply to clinical management (again getting ahead of ourselves) then I can send you the link for the site that does that too. Edit to add: I'm not trying to foist information on you but given your science background I thought you might appreciate guidelines and algorithms and evidence that decision making more than being told 'this is just what we do'

He was just being super efficient and was really keen for you to get it :laugh: A lot of the information won't be relevant to you at this point in time (and hopefully not for a while) but I hope you find it interesting and.somewhat useful at least. If you want or need any other info then let me know.

I've sent you the reference details by PM Jaybeece. If you get the PM three times that was just my toddler helping......

I have it in one of my readers from my masters so I'll dig the reference up for you.

The prescription diets are the only treatment that has been shown to actually have an effect on the progression of kidney disease. I can get you a 'standard' home cooked diet recipe but constructing it may not be that much cheaper. The basic principles of feeding a dog with kidney disease are a reduced protein diet, not the traditionally recommended restricted protein diet. The protein needs to be be of high biological value but not in excess. It also ends to have reduced sodium and phosphorous which can make it a little more difficult I are diets since muscle meat is high in phosphorous so that is where other protein sources come into it. Omega oils supplements may be useful but more so where there is an inflammatory component such as in glomerulonephritis. Fish oil will bie more useful than something like megaderm same the EHA + DHA content in the latter is no high enough. There is an excellent evidence based review article in the Journal of Small Animal Practice (I think). I can get the reference for you if you are interested. Feel free to PM me if you like.

How worrying for you! Unless there is an underlying condition like severe hip dysplasia it is generally indicated to always attempt closed reduction of hip luxations. Unfortunately, particularly in the case of traumatic luxations there is often a significant amount of damage to the joint capsule and the surrounding muscles and it may only be successful in around 50% of cases. In the cases where it is not successful, there are two general options - either a surgical procedure to provide stabilisation of the joint through placement of a toggle pin or similar, or a surgery called a femoral head and neck excision. Surgical stabilisation is a better option for young, large active dogs because it maintains the hip joint, however unless the vets are very experienced at orthopaedic surgery it is likely to require referral to a specialist surgeon. The femoral head and neck excision can be performed in general practice and can have good results however it important to be aware that it is considered a salvage procedure- which means that the head of the femur is removed completely and between the muscle and scar tissue a functional 'joint' forms in the space. It is certainly done in larger dogs and with success ( there have been a few cases on this forum) but is not normally the primary recommendation unless there are other compounding factors. Your vet should discuss the pros, cons and likely costs with you for both options.