However, our inferiority tends to mask the fact that there are a few special areas in which we do better. And because we don’t recognise them, we tend to make bad assumptions and harm our dogs. So here they are…

Heat Regulation

There’s good evidence that humans evolved as a hot weather specialist. Our unique power seems to be the ability to run for long periods in warm or hot conditions. Some traditional societies still hunt this way today.

The theory goes that we aren’t faster or stronger, we’re more persistent. As long as we have access to enough water, we can keep up a steady pace and control our body temperature by sweating. Our prey species aren’t so lucky, and eventually they slow down from heat exhaustion.

Sweating is rare in the animal kingdom for two important reasons:

1. It’s incredibly wasteful of body water
2. It’s not compatible with hair

It’s probably no coincidence we’re nearly naked, or that we think ponds and lakes are nice to be around. It may even explain why a bottle is a lot nicer to own than a plate or bowl.

Of course, the problem appears when we exercise with dogs. Most heat stroke in dogs happens because we just don’t feel the same way as they do in warm weather. We’re frequently comfortable when they’re not, and it only gets worse the more we move.

Appetite Regulation

I call it a ‘beginner’s mistake’. That’s the idea that a dog’s appetite has any practical meaning and should be listened to.

The human appetite, while not perfect, is probably what trips us up here. If we avoid processed foods, and follow our appetite, we tend to eat around the right amount of food.

Not so with dogs. Our appetite seems adapted to a food supply that needs regulation, such as a winter store. A dog’s appetite is adapted for feast and famine.

If wolves don’t gorge themselves on food when it’s around, and store it as fat, they might die when it runs out. That’s why a dog seems to be capable of eating a week’s food in one sitting. It’s also why they will act hungry long after they’ve had enough.

People who attempt to feed a dog by following their appetite do it because they worry that their dog feels hungry. It’s a natural, caring feeling, but it’s wrong. Even if it’s true that they feel hungry, feeding a dog this way results in a short and unhealthy life.

Dietary Flexibility

Have you heard the saying, ‘don’t change a dog’s food suddenly’ and wondered if it’s a myth? It’s not.

Humans are one of the most indiscriminate feeders on the planet. It’s another of our special adaptations: we eat nearly everything and thrive on variety. Dogs want to as well, but they often can’t.

Rapid food change in dogs is a common cause of gastrointestinal upsets like vomiting and diarrhoea. The sort of change I’m talking about isn’t just swapping supermarket brand A for brand B. It’s when the nutrient mix is altered substantially.

The best example is when the dog that normally eats dog food is given human leftovers. I also see it after feeding a meal unusually high in meat, even when it’s bought especially for them.

The gut enzymes that process food are highly specific, and need several days to be regenerated. A dog’s gut only keeps what it needs, based on what’s been coming through. Therefore, a sudden influx of unusual nutrient will result in a large amount of undigested material suddenly available for gut bacteria, and… boom!

These three mistakes probably go under our radar because we’re always told how weak humans are. And in fact, humans adopted dogs to take advantage of all their special skills: speed, strength, stamina and even ferocity, plus all the different ways they find prey that we can’t.

So it’s still something like Humans 3 : Dogs 1000. But they’re an important three.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

First a description, then a logical treatment plan.

Types of Cat Diarrhoea

Vets separate cat diarrhoea using two key differences: location and timeframe.

• Small bowel diarrhoea or enteritis is the more common location. Signs are soft, runny or watery poop, often associated with weight loss and a poor appetite.
• Large bowel diarrhoea or colitis is not associated with weight loss or a loose stool. Signs are pain when toileting, needing to go more often, and the presence of mucus or blood.

Many cases show a bit of each. Both can be either:

• Acute, meaning rapid in onset and only lasting a few days, or
• Chronic, meaning lasting for two weeks or more

It’s this latter distinction that’s most important, as the two have very different origins. I’ll discuss each in turn.

Causes of Acute Feline Diarrhoea

Reasons why a cat might suddenly get diarrhoea include:

• Diet change, especially if carried out too quickly
• Feeding inappropriate foods like milk
• Cats eating prey like birds, mice or even insects
• Bacterial infections e.g. Salmonella
• Viral infections e.g. parvovirus (not the dog one!), coronavirus (not the human one!)

Treatment in an otherwise healthy cat can be supportive, such as a bland diet of boiled chicken and access to their preferred type of water.

Many times we never need to know the cause because it gets better quickly. Other times, you will need to see the vet, especially if there are other signs of illness or the diarrhoea persists for more than 24 hours.

In a kitten with loose stools who is otherwise healthy, the first thing I will try is changing them from cheaper supermarket foods onto premium diets. It’s surprising how often this works.

Causes of Chronic Feline Diarrhoea

Once cat diarrhoea persists, there is a whole different set of causes. These include:

• Protozoal infections e.g. Giardia, Coccidia, Tritrichomonas
• Parasitic infection e.g. intestinal worms
• Thyroid disease
• Pancreatitis
• Liver or kidney disease
• Tumours
• Inflammatory Bowel Disease (IBD)
• Foods

Diagnosis is a process of elimination. Therefore we recommend running these tests in the following order:

1. Blood testing to detect problems of the liver, kidney, pancreas and thyroid
2. Faecal testing to detect the infectious causes, especially in young or rescue cats
3. Ultrasound to detect many tumours

One thing that all cat owners need to know is that most of the time these tests will be negative. Occasionally that might tempt us to skip to the next step but we need to keep in mind what we’ve missed if we do.

Once we have eliminated the above conditions, we are left with a condition we call chronic enteropathy or CE.

Investigation of Chronic Enteropathy

Now finally we are down to only three common conditions. These are:

• Food Responsive Enteropathy (FRE)
• Steroid Responsive Disease (SRD)
• Small Cell Lymphoma

The observant among you might notice that I haven’t mentioned IBD. That’s because IBD overlaps with both FRE and SRD, which are more practical and workable descriptions.

Now the plan will be the following three tests:

• Dietary trials
• Immunosuppressive trials
• Intestinal biopsies

The order in which we do these will depend on the health of your cat. For example, a severely unwell cat is probably best stabilised and having biopsies done before things get worse. A mildly affected cat can probably go through the tests in the order above, stopping when improvement occurs.

Food Trials

Around 60% of cats with chronic enteropathy will respond to nutritional management. These odds are so good that even if the first diet trial fails, it’s worth trying a different one before moving on. In fact, if there’s time I will try to do three:

• A novel protein or hydrolysed diet (read about these here).
• A home made diet (found at the same link)
• A low carbohydrate diet (learn how to do this here)

A response to the new food is often seen within two weeks.

Food allergy or intolerance usually develops over a long period. A common mistake is to assume that it can’t be a food problem because the diet hasn’t changed.

Medication Trials

A failure to respond to a food trial will lead us to either a medication trial or biopsy, depending on the urgency of the case and owner preference. The use of prednisolone has lower rates of success than food but is the logical next step for most. It has significant side-effects, that you can read about at the link.

Cats that respond to prednisolone are probably the ones that have IBD (often also called lymphocytic‐plasmacytic enteropathy). Sometimes we get the best results by continuing a hydrolysed diet during the medication trial.

Intestinal Biopsy

Small cell lymphoma in cats is just as common as IBD, but the only way to diagnose it is via tissue samples. These can be collected endoscopically but are more accurate if done via abdominal surgery. The invasive nature of the procedure explains why we often delay biopsies, but we can make the mistake of waiting too long.

If a cat gets too unwell, they may not recover from the surgery. Also, small cell lymphoma has a good treatment but it takes time to work.

Additional Therapies

All cats wth CE should also either have their serum vitamin B12 checked or receive regular B12 injections. Vitamin B12 levels are affected by intestinal disease, and the deficiency then worsens the problem.

More than once I have seen cats for whom everything was done right, but who only got better when B12 was given. The response is usually rapid.

There is no evidence for the use of probiotics or prebiotics. However, I have had good responses to their use in some cases, and they are well worth trying.

Lastly, there is much talk of the use of fibre. I have stopped recommending this due to poor results, but you are welcome to try.

In summary, the best attitude to feline diarrhoea is to be logical and follow the steps above without excessive delay. I hope that you, after reading this, find a simpler and earlier solution. However, I also hope you can see that there’s a lot of reason for optimism whatever the diagnosis.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here. The information provided here is not intended to be used as a substitute for going to the vet. If your pet is unwell, please seek veterinary attention.

What do you do now?

The answer is to consider the possibility that your dog has chronic enteropathy, or CE. This is a poorly understood group of related disorders that often respond to dietary, antibiotic or immunosuppressive treatment. Sometimes the solution is more than one of these approaches.

In the past, we have called these overlapping diseases by names you will recognise better:

• Inflammatory Bowel Disease or IBD
• Food Intolerance
• Food Allergy
• Small intestinal Bacterial Overgrowth

Here I will use the more practical and workable definitions of:

• Food Responsive Enteropathy (FRE)
• Antibiotic Responsive Diarrhoea (ARD)
• Steroid Responsive Disease (SRD)

Diagnosis of Chronic Diarrhoea

So how do we work out which one it is? In the absence of any definitive test, a treatment trial is the most common strategy chosen by vets. The only other alternative is intestinal biopsy, but its invasiveness and expense make it worth avoiding if possible. Sometimes however, there’s no alternative, such as with rarer diseases like lymphoma.

Most often, a treatment trial will be done in the following order:

1. Specially formulated diets
2. Antibiotics
3. Immunosuppressives

The final choice of what to do first will depend on factors like the age, breed, severity of signs and laboratory test results.

Food Trials

Around 64% of dogs with CE will respond to a diet trial. These dogs are usually younger, and healthier than the rest. With such good odds and a healthy population, it’s no surprise that a diet trial mostly comes first.

Often it is worth trying several diets. I recently saw a dog who was initially treated with a hydrolysed diet and rice but failed to respond. I put her onto another hydrolysed diet, stopped the rice and her diarrhoea almost instantly resolved.

Responses can be expected to be seen within 2 weeks. You can choose from either commercial diets or one you make yourself. I have written about these diets in depth at this link. A favourable response means you may wish to just keep using the diet for life, or experiment with ingredients until you work out which ones are implicated.

The exception to using regular FRE diets occurs when dogs have very low blood albumin levels such that we suspect (or even better, have proven) lymphangiectasia. This is an intestinal wall disease that responds best to ultra-low fat diets instead.

Antibiotic Trials

A poor or absent response to dietary manipulation might point us towards an antibiotic trial. The drugs used are mostly either metronidazole or tylosin.

Dogs with ARD are generally older large breed dogs, and especially German Shepherd dogs. A favourable response usually means you will need to keep giving the antibiotics for life, although the dose can often be substantially reduced.

Boxers and French Bulldogs are prone to Granulomatous Colitis, a specific condition that responds best to fluoroquinolone antibiotics. These dogs can usually be taken off the drug some time after a cure is achieved.

Immunosuppressive Medications

Dogs that fail to respond to either diet or antibiotics alone can be tried on immunosuppressives. However, some vets will consider the use of such drugs without biopsy as inappropriate. I personally think the decision needs to be made on a case by case basis.

The drug most commonly employed is prednisolone. You can read about its uses and side effects at the link. A second drug, if used, is most commonly cyclosporin.

Other Treatments

All dogs wth CE should either have their serum vitamin B12 checked or receive regular B12 injections. Vitamin B12 levels are affected by intestinal disease, and the deficiency then worsens the problem.

More than once I have seen dogs for whom everything was done right, but who only got better when B12 was given. The response is usually rapid.

There is only low grade evidence for the use of probiotics and none for prebiotics. However, I have had good responses to their use in some cases, and they are well worth trying.

There is much talk of the use of fibre such as psyllium or pumpkin. Apart from dogs on raw diets, I have stopped recommending this due to poor results, but you are welcome to try.

Finally, you should never give up. A 2021 study of 10 dogs who had already failed to respond to both dietary therapy and immunosuppression found that 8 of them responded to further dietary attempts. These diets were mainly focused on ultra-low fat levels, together with novel proteins in most cases. Half were commercially available and half were formulated by a veterinary nutritionist.

My experience with chronic diarrhoea in dogs is that it can always be managed if owners are willing to persist. It can be very frustrating and expensive at its worst. However, for many dog owners, these experiences become just distant memories once the solution is found.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

Or do you wonder if it’s OK to buy a puppy from a pet shop.

Or does your pet store puppy have the any of following symptoms?

• Droppings that aren’t 100% solid
• Difficult or slow toilet training
• A fussy or picky appetite
• Poor weight and slow growth

Then you need to read this.

The Problem With Pet Stores

Modern pet stores look upmarket, have stylish branding and do everything they can to give the impression of a responsible place to buy puppies. Some even possibly are. The public can only judge them at their words, and I’ll never blame anyone who does.

However, the reality is often different.

Here an edit of the third message I sent to a local shop called Boutique Paws. I’ve added headings and images to make it easier to read. It’s important to stress that the shop is not the only one of its type and buyers should beware of all similar stores, no matter how well polished the exterior.

Dear <pet shop owner>

It is with disappointment that I have to report the latest case of a sick puppy sold via Boutique Paws. I am hoping this time it will be received with a commitment to investigate the illnesses I have seen in puppies from your store. 

Giardia In Puppies

As you can probably guess by now, the problem concerns multiple giardia infections. Giardia is a single-celled protozoan parasite that causes gastrointestinal signs such as vomiting, diarrhoea, weight loss and even death in puppies. If that it not enough, it is also a serious human health risk, especially to children in contact with these puppies.

The latest incident concerns a just-purchased puppy who was taken to an emergency vet after passing blood. I subsequently examined the pup and found him to be significantly underweight, and infected with giardia. He has been started on treatment, and I expect him to make a full recovery. However, it never should have happened.

More than this single case, the scale of the situation is frankly alarming. I am just one of hundreds of vets in Adelaide, yet I have seen three puppies from your store recently with giardia. Most of the time, these infected puppies show only mild persistent diarrhoea and poor growth. Unless a vet already suspects giardia, it is likely that this will be put down to ‘change of diet’ (as did the emergency vet) and the subsequent slow toilet training as just ‘one of those things’.

My history dealing with puppy farms is the reason I can see the problem clearly, but I fear not all vets share my bitter experiences. If puppies with giardia are not identified via specific testing, they will carry and pass on the parasite for life. Who knows how many are affected.

Where Giardia Comes From

I hear you have been telling customers who complain that the puppies are getting giardia from their water or environment. If that is so you need to be able to explain two things:

1. Why I almost never see giardia in puppies from any other source except yours
2. How all three puppies could have picked it up in those few days despite having loose stools from day one

There is strong circumstantial evidence that you are unwittingly selling puppies with giardia. You are welcome to prove me wrong, but to do so you need to stop being in denial. The only way forward is to get veterinary advice.

Giardia is a parasite of dogs that is easily eliminated and controlled with good hygiene, husbandry and veterinary care. Persistent infection in pet shop puppies can only mean one of two things:

1. Breeders sending out puppies infected with giardia
2. Puppies being infected wth giardia in the shop

Either way, this is unacceptable. If on one hand you are purchasing puppies from such disreputable sources, you need to re-examine why you are in the business in the first place. Your responsibility is to refuse to deal with them until they get their house in order. The presence of giardia indicates deficient or absent veterinary care.

If on the other hand, puppies are being infected in your shop, it is a failure of basic hygiene, and you need to get local veterinary advice. My personal opinion is that the answer is likely to be a combination of both factors.

Giardia has to come from somewhere initially, but the fact that all types of puppies appear to be infected suggests further spread is occurring.

How To Prevent Giardia In Dogs

Fixing the problem is certainly not just about dispensing antibiotics. It will involve all of the following steps:

1. Testing puppies on arrival to determine the source of the problem
2. Refusing to deal with the breeder(s) who return positive test results
3. Using pens for puppies that can be easily disinfected
4. Never mixing puppies from different sources or with differing ages
5. Testing existing pets and breeding animals owned by the shop
6. Periodic ongoing monitoring

Of this list, only hygienic pens are difficult, but that’s the price we all pay for housing animals properly. You are very welcome to come and learn how we did it in our new clinic. However, I suspect your main problem will be point 2.

Where Pet Shops Get Their Puppies

From previous discussions, I know that you (like most pet shops) struggle to find enough locally-bred puppies to sell. Therefore you are forced to use commercial large scale breeders mostly based in Victoria.

I can’t say that these breeders are the source, but this will be easy to check with a cheap test. If they are, you must stop using them until they commit to a solution. Selling fewer puppies may be the price you have to pay for selling puppies with fewer problems. 

It will shock you to learn that puppies from Boutique Paws are indistinguishable to me from the puppy farm puppies I used to see. I am sure this was not your intention in setting up the shop, and I hope this fact spurs you into action. You are putting the health of puppies and their families at risk, but you are also only a step away from the RSPCA becoming involved. 

Kind Regards, Dr Andrew Spanner, Walkerville Vet

Addendum: I published this due to the lack of an adequate response to my previous attempts to help and offered the owner a right of reply. Since then, an outpouring of stories of problems posted on our email (which I sadly felt were too risky for me to leave there without verification) has made me withdraw the offer.

The situation appears a lot more serious and widespread than even I feared. Puppies are being diagnosed with giardia across Adelaide. The day after I posted this I saw a fourth, and I expect more to come.

Update 15 July, 2019. This post was published 7 days ago, and the shop was temporarily closed shortly afterwards. Boutique Paws announced today that they are working with the support of Pet Doctor Woodville. With attention to the points outlined above, there is every reason to believe that puppies can be sold free of infection. I wish them the best.

However, the two puppies from BP that we have tested since that date have both been carrying giardia infections, one with no obvious symptoms. Therefore, it’s a good idea to ask for a test just to be sure.

Please note that it is never normal for puppies to pass blood in their poo, and the routine use of antibiotics in puppies may only be masking illness or encouraging the development of antibiotic resistance.

What To Do Next

To those reading this, I hope what I’ve written helps you to either choose a puppy or help the one you’ve got. If you know someone who’s purchased a puppy from a pet store recently, not just Boutique Paws, send them this link. The rates of infection are so high that there’s a good chance their puppy is infected too.

If you have a puppy with some of the symptoms I mentioned, please talk to your vet for a non-judgemental and thorough consultation. Nobody wants to live with giardia. My dogs have never had a loose stool in their life and neither should yours.

Lastly, it’s not your fault to trust what you’ve been told. It even took me a while to see the problem. I would only ask that in tackling it we don’t expose the shop staff to any stress or criticism.

So where can you get a good puppy? Follow this link.

Note: comments from owners of affected puppies are very welcome. They will be published anonymously but in the interests of complete accuracy I will contact you privately to get consent to talk to your vets. They will be happy to assist.

Related Reading

McMillan, F. D. (2017). Behavioral and psychological outcomes for dogs sold as puppies through pet stores and/or born in commercial breeding establishments: Current knowledge and putative causes. Journal of veterinary behavior, 19, 14-26. Read Paper Here.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

Lymphoma is caused by the abnormal multiplication and growth of lymphocytes. These are a white blood cell found throughout the body, including the bloodstream, gut and lymph nodes.

Signs Of Lymphoma

The main signs of lymphoma in cats are vague illness, weight loss and reduced appetite. Other signs depend on the organ affected by the tumour, and can include:

• Diarrhoea (see other causes at the link)
• Abnormal swellings
• Drinking more
• Intermittent vomiting
• A runny or blood nose

Diagnosis of Lymphoma

The diagnosis of lymphoma in cats is rarely straightforward. It often starts with seeing the vet for a vague general sign like weight loss. A physical exam might suggest blood testing, leading to further tests like an ultrasound exam.

Only a surgical biopsy will give an accurate diagnosis. A needle biopsy alone, while useful, can only tell you that it’s lymphoma. It’s essential to know what type of lymphoma it is before you make a decision on whether to treat or not.

Two other causes of abdominal lumps easily confused without investigation are FIP and hairballs.

High grade alimentary lymphoma and renal lymphoma have a very poor prognosis. Reported median survival times even with treatment are only around 3 to 4 months. That’s in contrast to nasal lymphoma and small cell alimentary lymphoma which have reported survival times of several years with treatment. There is even a solitary form which can be surgically cured, but this is rare.

Beware of older information giving a blanket statement like “cats live on average for a year after diagnosis of lymphoma.” This figure derives from studies where the types of lymphoma were not separated, and is virtually meaningless today.

Treatment Of Feline Lymphoma

Treatment depends on the type and location of the tumour.

High grade alimentary lymphoma, renal lymphoma and other systemic large-cell forms are treated with traditional chemotherapy protocols. These involve visits to the vet for injections, tablets and blood tests. The number and duration of visits will depend on the protocol chosen.

Nasal lymphoma is treated with similar drugs plus the use of radiation. Unfortunately, licensed radiation therapy is only available in a few capital cities. For cats in Adelaide, that means a long trip for treatment, if at all.

Small cell alimentary lymphoma is treated with alternating doses of prednisolone and chlorambucil given at home on a daily basis.

To Treat Or Not?

There is no right or wrong answer on whether to treat lymphoma in cats. However, here are my opinions based on 25 years of experience:

1. If there’s any chance you’ll treat, don’t delay. Excessive weight loss will worsen the chance of responding to treatment.
2. Small cell alimentary lymphoma and nasal lymphoma offer compelling cases for choosing treatment, based on their long average survival times.
3. Other lymphomas have lower response rates: only 30% of cats achieve full remission with alimentary forms versus 52% in all other locations (remission is the disappearance of signs and symptoms).
4. Despite this, lymphoma treatment is worth trialling to see if remission can be achieved. That’s because the survival time for a cat that can achieve remission is much better at around one year. If there is no response, or illness occurs, it’s easy to stop.
5. Euthanasia is a reasonable and compassionate choice which cannot be criticised. Read more about taking this difficult choice here.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here. The information provided here is not intended to be used as a substitute for going to the vet. If your pet is unwell, please seek veterinary attention.

It’s not a case of people trying to pull a fast one; they just believe in what they use. Who doesn’t? If all you have is a hammer, everything looks like a nail.

The trouble is, though, most owners of dogs with skin problems aren’t getting the advice they need. Or they’re getting it far too late.

So join me while I explore the five myths that prevent itchy dogs from getting the right treatment, food or otherwise.

Myth 1: Most itchy skin is caused by food allergy

No one is saying food allergy doesn’t exist. However, it’s only one of many causes of itching in dogs.

The most common cause of itching is still flea or mite infestation. This is true whether you can see fleas or not. Before good flea controls, even vets got this wrong.

Almost as common in a temperate climate is allergy to pollens, dust mites, or grasses. Sometimes it feels like we vets spend more time treating skin allergies in dogs than doing anything else. This will vary a little based on where you live.

When Claire and I studied, we were taught that food allergy is only 1 to 2% of itchy dogs. Recent studies come up with 15 to 20%. Whichever way it is, there are other things you should think of first.

Myth 2: Skin foods are just for food allergies

Just because food allergy isn’t common doesn’t mean foods don’t help itchy skin. Most dog owners don’t realise that there are two sorts of skin diet. The other sort for nutritional support of skin is criminally under-used.

Two Australian products are Royal Canin Skin Support® and Hills Sensitive Skin®.

Some dogs respond well to these specially made skin health diets, while others improve on raw diets. The idea is to increase diet quality and add factors known to help the skin. With a bit of trial and error, nearly every itchy dog will get some benefit.

Myth 3: Most dog allergies are to grains

There’s no doubt that grain allergies exist, it’s just that they’re nowhere as common as you are told. Proteins such as beef and dairy actually cause the highest number of adverse food reactions in dogs. You can read the full list of dog food allergies here.

In practice, the dogs that improve on grain-free diets are probably just responding to a better diet in general. So while you are very welcome to feed a grain-free diet, it’s not a priority to most vets, and there are better ways to help your dog stop scratching.

Update (2019): This article discusses a possible link between certain grain-free diets and heart disease

Myth 4: I can test my dog for food allergy

Do a Google search and you’ll be bombarded by ads for food allergy tests. Please stay away from these.

There is currently no reliable test for any adverse food reaction in dogs other than the good old elimination diet. Other tests will just give you a load of misleading information. In other words, the only way is the hard way. Sorry.

Myth 5: I changed the diet so it can’t be food allergy

Many food intolerances will improve by diet change, but we’re talking allergy. That’s when the immune system starts reacting to a harmless protein as if it’s a threat.

As anyone with a nut, gluten or shellfish allergy knows, any amount, no matter how tiny, will provoke a response. Even if a food says “beef” or “salmon” on the label there are usually other ingredients. Plus, the food is likely to be made on equipment used for other foods.

Then there’s the issue with inaccurate or missing ingredient lists on Australian pet foods.

So How DO I Find Out If My Dog Has A Food Allergy?

Food allergies are clearly still important. I’ve told you what doesn’t work so let’s finish with what does.

As part of a thorough workup, every dog with skin disease should be investigated for food allergy. The only way to do this is a properly designed and executed food trial. Please visit our page on homemade and commercial elimination diets if you want to learn more.

But in the meantime, don’t stress. Your dog most likely isn’t scratching because of the food you chose. And even if they are, there is a clear path to fixing it. Just not the one most people are told.

Now Have Your Say For Aussie Pets!

The fact that you’ve made it to the end tells me you care about pet food, and that you’re a stayer. Now use these rare powers for something incredibly easy and important!

The recent media scandal caused by deaths of dogs eating Advance Dermocare has triggered a Senate inquiry. Everyone is welcome to make a submission. The more that are received the better the chance of real change.

Visit our page on the Senate Inquiry into Pet Food Safety. You’ll find links and instructions for sending a submission. You can say as little or as much as you like, and address only one of the points or all of them. Personally, I’ve used it to call for pet foods to be regulated like human foods.

The voice of ordinary pet owners needs to be heard, not just the special interests. Submissions close on the 20th of July, 2018.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

Diagnosis of Food Allergies

The bad news is that there is no simple test. Popular blood test kits are not reliable enough.

The good news is that you can do it at home. It’s called an elimination diet. You have two choices:

1. Buy one off-the-shelf
2. Make it yourself (this is preferred if possible, see below)

Note: if you give any other food item, even tiny scraps or flavourings, you could ruin the test. You should place your pet where they can’t hoover up table scraps, crumbs or kitchen waste especially around mealtimes. Keep the dishwasher closed and supervise animals when outside. Other pets in the house are best fed on the same diet if there’s any chance of cross-contamination.

Commercial Elimination Diets

In Australia, both Hills Pet Nutrition, Royal Canin and Prime100 sell elimination diets. Purina options are also available in other countries.

Which ever you choose, it’s best to only use one. This is especially true for Anallergenic, which is currently our preference.

Food Allergy Diets for Dogs

• Hill’s Prescription Diet d/d Potato & Venison Formula – canned & dry
• Hill’s Prescription Diet z/d – dry
• Royal Canin Hypoallergenic – canned & dry
• Royal Canin Anallergenic – dry
• Prime100 SPD kangaroo & pumpkin or crocodile & tapioca – loaf

Food Allergy Diets for Cats

Whether you make or buy it, it is essential that every cat in the house on the same elimination diet. It is impossible to prevent exposure to a degree that will stop the symptoms completely. For example, water shared between cats is likely to become contaminated with microscopic food particles.

• Hill’s Prescription Diet d/d Venison & Green Pea Formula – dry
• Hill’s Prescription Diet z/d – canned & dry
• Royal Canin Hypoallergenic – dry
• Royal Canin Anallergenic – dry
• Royal Canin Gastrointestinal (pouches- this isn’t truly an elimination diet but I’ve included it as it works well for many cases of IBD)

Bold = in stock at Walkerville Vet (the rest can be ordered)

Home-Made Elimination Diets

The home-prepared diet is considered the gold standard elimination diet. Although commercial alternatives from your vet are easier, we always recommend at least starting by trying to do it yourself. Here’s how you do it…

Step 1: Understand the theory

This is a giant test to see if your dog or cat is allergic to part of their existing diet. Therefore, if we design a diet with NO previously used ingredients there should be no reaction. You can’t be allergic to something your body has never encountered.

You have to make a simple diet entirely out of ingredients your dog or cat has never eaten. Your diet won’t be balanced but if your pet is adult, in good health and not pregnant, no harm should occur over the trial period.

Step 2: Make the diet

For dogs, choose one meat and one carbohydrate source at a proportion of 1:2 or 1:3. Ingredients might include one of: [goat, rabbit, kangaroo, fish species] plus one of: [pumpkin, sweet potato, potato, tapioca] etc. By all means, cook it in batches to save time. Turkey and duck may be best avoided due to possible cross-reaction with chicken allergy.

For cats, just choose one meat source from the above list and there’s no need to cook. It’s a lot easier. However, only use meats fit for human consumption. The meat needs to be 100% pure, with nothing else packed on the same equipment without cleaning.

Step 3: Never, never compromise

This is the critical thing: the immune system is the most sensitive detector we know. It can’t be fooled. There’s no point in doing an elimination diet until every member of the household is on the same team and agrees to avoid treats or accidental food access.

Step 4: Run the test for long enough

For skin problems, it takes 8 weeks before 90% of food-allergic dogs and cats will have improved. By this time, if your pet is still itchy or unwell, the cause is unlikely to be a food.

For gastrointestinal problems, the response is typically more rapid. I expect to see some results within 2 weeks.

If they are getting better, you still have more to do…

Step 5: Rechallenge the original diet

The real test is this: do the skin or gastrointestinal problems return when they go back to the old food? Otherwise the improvement might have been due to something else. If you get a worsening after rechallenge, your pet most likely has a food allergy. The next step is to find out to what…

Step 6: Identify the allergen(s)

Put them back on the elimination diet until they are better again. Now, a week at a time, add back one individual ingredient (such as beef, chicken, wheat, dairy) until your pet starts reacting to one of them. There could be more than one.

Step 7: Design a lifelong diet

Once you know the offending ingredient, the problem is usually that it will be found in all pet foods at some level. Choices are:

• Find a mainstream limited ingredient diet
• Make your pet’s food yourself
• Use the veterinary diets listed above (e.g. when you go on holidays)

Remember, home made elimination diets aren’t balanced enough to use beyond 8 weeks. You need to either find a commercial alternative that is tolerated or get nutritional advice on how to construct a balanced diet.

If you got this far, well done; you’re on the home stretch now.
If your diet trial failed, don’t despair. It’s probably not the food but there’s so much more your vet can do.

You might also like: The myths about food allergy in dogs.

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

The use of non-veterinary drugs is a common question from pet owners. When is it a good idea to give your dog human medications? Sometimes, surprisingly, it is. Just not that often.*

Here are the top over the counter (OTC) drugs you can give, and a few you definitely can’t! Plus some guidelines for safe and appropriate use. See full disclaimer below.

Dog Antihistamine Dose Chart

Antihistamines can be used in dogs to reduce the signs of allergy. The following antihistamines appear safe in dogs (note that Benadryl is no longer sold in Australia as diphenhydramine tablets).

These doses have essentially been worked out by trial and error and often scaled down from human doses.

Bad stuff: We don’t know why, but dog allergies respond very poorly to antihistamines. Even the best (cetirizine) only helps 20% of dogs. The response may improve if combined with EFAs (see below) and it’s worth trying a few before giving up.

Aspirin, ibuprofen, Naproxen for Dogs

Non-steroidal anti-inflammatory drugs like these work well in humans with minimal side-effects. This means we get a lot of questions about using them in dogs.

Bad Stuff: Please don’t use these drugs at all. Human anti-inflammatory medications are almost universally toxic to dogs. A single dose of Nurofen or Voltaren can be fatal, and survivors are left with permanent organ damage. Even aspirin, although used in the past as a blood thinner, is not recommended.

The veterinary pain medications are the only safe option. Read about effective treatments for arthritis in dogs here. If your dog has taken any human anti-inflammatory, contact a vet immediately. See also paracetamol below.

Carsickness Treatments

Mild motion sickness in dogs can be treated with Phenergan or Benadryl antihistamine tablets (see doses above) which may also cause mild drowsiness. Ginger products used for people also appear safe.

Bad Stuff: Most dog owners don’t see much success. Nowadays the only good drugs for car sickness are prescribed at the vet. Dramamine was great but was taken off the market due to problems with human abuse.

Read a lot more about stopping car sickness in dogs here.

Cough Suppressants

Dextromethorphan is an ingredient found in many human dry cough treatments. We often use it to comfort dogs with kennel cough at a dose of 5, 10 or 20mg depending on the dog’s size (usual dose 0.5-1 mg/kg twice daily). Just make sure that the product you use contains no other drugs.

Bad Stuff: You need to be 100% sure that the cough can be safely suppressed. Click here for the common causes of coughs in dogs. If it is caused by lower airway infection, heart disease or a foreign body then suppressing it is very dangerous. Even when the diagnosis is confirmed to be kennel cough, antibiotics usually work faster so please see your vet first.

Diarrhoea Meds

PAW Digesticare is an OTC veterinary probiotic and prebiotic food supplement. Combined with a bland diet, it helps restore the normal gut bacterial flora and can assist with some diarrhoeas. We supply either sachets or you can purchase a whole tub.

Vets use binding products to help reduce the unpleasant symptoms of diarrhoea. These include bismuth sub-salicylate, kaolin or montmorillonite. All are fairly harmless but you might have trouble finding them as they aren’t used much in people.

Bad Stuff: Home treatment is only appropriate for bright and happy, fully vaccinated adult dogs with mild diarrhoea of no more than a few days duration. They need to also have a good appetite and no blood in the stool. Although I understand why frustrated owners may resort to it, there is no place for Imodium in canine medicine. If symptomatic treatment doesn’t work, it’s off to the vet.

Ear Drops for Dogs

Epi-otic and similar veterinary ear cleaners are an essential part of good preventive management of problem ears. Aqua ear can be used to dry the ears of frequent swimmers and prevent infection. Except for these, there isn’t much.

Bad Stuff: OTC ear drops are over-used and frequently abused.  They are only appropriate for prevention, not treatment. None will fix even the mildest problem so don’t be fooled by your dog’s ‘improvement’. They are just learning to live with the pain. Most ear drops permanently damage hearing if the eardrum is ruptured, and are always painful in diseased ears.

Read a review of over-the-counter ear cleaning solutions here.

Eye Drops for Dogs

Human artificial tears and OTC antibiotic eye ointment can be used in dogs.

Bad Stuff: The use of these products without a diagnosis masks serious disease and could lead to loss of the eye or loss of sight. Glaucoma, dry eye or corneal ulcers look the same as conjunctivitis without testing.

Glucosamine for Dogs

Glucosamine and chondroitin supplements for arthritis can be given to dogs with a very low risk of side effects. Doses are assumed to be similar to that of a human of the same size.

Bad Stuff: There is next to no evidence that glucosamine works in pets. Read here about the caregiver placebo effect and more effective arthritis treatments for dogs.

Laxatives for Dogs

Lactulose is a safe and effective laxative suitable for prolonged use in most dogs. It is sold as a liquid in pharmacies and given at approximately one teaspoon per 5kg body weight. The dose is then adjusted to give a faecal consistency neither firm or sloppy.

Paraffin oil can also be used at similar doses but must be mixed with food, and is much less suitable for long-term use.

Bad Stuff: For every five dogs that owners think are constipated, only one really is. Unless you’re certain (e.g. your dog always gets bound up after chewing a bone) it’s best to confirm the diagnosis first and rule out more serious problems. Severely bound up animals will need a proper enema, and I don’t mean Microlax.

Melatonin for Dogs

Melatonin is commonly advocated as a mild and safe sedative for dogs.

Bad Stuff: Evidence is sorely lacking for its efficacy, and the only ‘melatonin’ sold without prescription in Australia is homeopathic. How they can even claim it’s really melatonin is beyond me.

Omega 3 Essential Fatty Acids

There’s very solid evidence for the benefit of omega 3s in dogs. They are proven to reduce signs of dermatitis and may play a role in reducing cardiac arrhythmias. They are safe and often well-tolerated by dogs at a dose of 1 g fish oil per 4-5 kg bodyweight.

Bad Stuff: Although they are useful, omega 3 fatty acids do not exert a strong effect in most dogs. Don’t give up too soon though; they can take 3 weeks to show an effect. They should be avoided in dogs prone to pancreatitis.

Pain Relief for Dogs

So what can you give a dog for pain? The best of a bad lot is paracetamol, sold as Panadol, Calpol or Tylenol (called acetaminophen in the US). It is sometimes used by vets at a dose of 10 mg/kg twice daily.

Bad Stuff: My strong advice is to avoid paracetamol unless it’s impossible to get to a vet. Paracetamol is nowhere near as safe or effective as pain meds made for dogs. It is extremely toxic to cats.

Skin Creams

Hydrocortisone 0.5% cream (e.g. Dermaid) is available without prescription. It can be used for areas of minor irritation or allergy.

Many antifungals (e.g. Canesten) can be used in pets.

Bad Stuff: Do not use creams on broken skin, and always be aware of how much is being swallowed by pets. You could easily reach a toxic dose by reapplying creams that are licked off. It’s best to fit an elizabethan collar if using and see your vet if there isn’t rapid improvement. Prolonged use can cause skin damage.

Fungal infections in dogs are very unlikely. If it looks like ringworm, it’s usually bacterial. The best thing for this is our magic pink chlorhexidine disinfectant scrub (available OTC).

Vomiting Suppression in Dogs

Bad Stuff: Antiemetics & antacids should never be used in dogs without veterinary advice. If your dog is vomiting, there is usually a good reason, and suppressing the vomiting is probably not the best answer. Antacids are used commonly in people but have almost no place in canine medicine.

Disclaimer

None of these drugs has been properly tested for safety in animals so pet owners need to accept that there may be unknown and possibly serious adverse effects. Always check first with your vet if these medications are suitable for your dog and be very careful if your pet has any other health problem or is on other drugs. Doses in mg/kg are estimates only; a 20kg dog X 2 mg/kg diphenhydramine would receive 40mg.

*Why Are Vet Drugs Different?

There are four reasons why most animal drugs don’t get used in people and vice versa.

1. Different diseases: many of the common problems of dogs or cats are rare in humans
2. Different drugs: even when the disease is the same, another medicine may work better in animals
3. Different metabolism: many drugs successfully used in people have a ridiculously impractical half-life or dose, or actually are toxic
4. Different legislation: for reasons lost to me, but possibly related to points 1, 2 & 3, companies often release separate drugs onto the veterinary market than the human one

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

OK, let’s try that again. Imagine a universe where cats actually look after humans. I can just hear the sorts of things they would say:

• You really must get one, they’re so cute.
• Have you seen how they carry things around with their cute little hands?
• They beg so adorably for ice cream or chocolate.
• I train mine using those horrible smelly sweets.

Then there would be the responsible cats who say that you should never give your human any chocolate, ice cream or sweets. It’s just not good for them and shame on you other cats for spoiling your human so.

Now back to reality. Hopefully, you can see what I’m doing. A Google search will tell you that cats are lactose intolerant and that milk causes gastrointestinal upsets. All this is true, in theory. In practice, it’s all about the individual cat and the amount you give.

Why Give Cats Treats

Cats aren’t dogs. I don’t feel any need to give my dogs treats because everything they get is a treat to them. Crumbs? Awesome! You dropped a piece of banana? Double awesome! An unguarded cat litter box? I’ve died and gone to heaven!

Cats don’t work that way. Cats aren’t going to give away their appreciation for just any old thing. You’ve got to earn it.

Getting a cat to do a trick or even just to come when called feels like a major life achievement. That’s why most cat owners when asked will admit to feeding treats to their cat. Things like meat offcuts, fish, or odd personal tastes like Grendel and his seaweed rice crackers. So what about milk?

Can Cats Drink Milk?

In practice, cats love milk and I have never known a problem with an owner feeding it. Yes, I’m sure it’s possible to give them an upset tummy but we aren’t exactly running milking sheds here. It’s usually only a small amount on offer.

Of course, some cats will suffer food allergies to any ingredient. If you look at this data on cat food allergies you’ll see why I stop dairy and fish in any cat with skin or gastrointestinal problems. Then there are kittens, who should never be given milk containing lactose. However, these are the exceptions to a generally harmless treat.

Is It OK To Give Cats Milk?

As long as you only feed a treat-sized amount and your cat is healthy, you are doing no harm. Like most things, it’s better to give the same amount regularly than causing big changes in the diet each day. This allows the gut to adapt.

As for lactose, small amounts are tolerated by most cats. If you’re worried about the lactose you can buy special lactose-free pet milk, or use yoghurt which has a naturally lower lactose level.

How do I give Grendel a milky treat? Every morning I froth milk for our coffees and ‘somehow’ there’s always too much froth left over. The warm frothy kitty-cino is probably only a splash of milk but it’s one of the many highlights of his day.

What Treats Are Bad For Cats?

The good news is that cats generally are clever enough to avoid problems. This list of dangerous foods for dogs is also true for cats if they actually ever ate them. As for foods that might just be too rich or unbalanced, the solution is in the very word we use: ‘treat’. If you keep them to under 5% of a lean diet the only risk you take is that your cat may become more demanding, not any less healthy.

Related: How to keep cats from getting overweight

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

When To See The Vet For Diarrhoea

It’s especially important to see a vet straight away for:

• Puppies, old dogs or those without up-to-date vaccination
• Vomiting, not eating or other signs of illness
• Blood in the stool, excessive diarrhoea or possible poisoning
• Dry, tacky gums or any other sign of dehydration

Now dive deeper…

90% of the diarrhoea we see in dogs has only one cause: eating the wrong thing.  Sometimes it’s after eating something that’s off, other times it’s just too much of something new. That’s the subject of this article.

For this to be true, your dog needs to appear completely normal in every other way: no lethargy, no loss of appetite. Please see a vet straight away if there are any other signs of illness.

If you’re not sure of the cause, visit this page for all the common causes of diarrhoea in dogs.

What To Give A Dog For Simple Diarrhoea

For uncomplicated dietary diarrhoea, it’s reasonable to attempt home treatment for the first 24 hours.

The best diet for a healthy dog with mild diarrhoea is a bland meal such as minced chicken breast boiled with an equal weight of white rice. Skim off any fat that rises to the top and allow to cool.

Feed smaller than normal meal sizes and see your vet if diarrhoea persists beyond 24 hours. Please do not give any medications such as Imodium® or bismuth (e.g. Pepto Bismol®) without veterinary advice. These drugs only mask the illness, and may actually cause harm.

Sometimes the worst thing about simple diarrhoea in healthy dogs isn’t the effect on the dog. It’s the tremendous, disgusting mess it causes. You are always welcome to let us take your dog for a few days until it passes. We don’t charge too much for hospitalisation and it’s something we’re only too happy to deal with. Just another day at the office!

Vet Treatment Of Diarrhoea

If there has been no improvement in 24 hours, or there are any other signs of illness, it’s time to visit the vet. Of course, you can go straight away without waiting if you prefer.

Here at Walkerville Vet, we no longer use antibiotics for routine, uncomplicated diarrhoea. Here’s what our new protocol looks like:

Dog Diarrhoea Treatment Plan

1. Full physical to check for dehydration or signs of systemic illness. These dogs will be admitted to hospital.
2. Testing for serious causes of diarrhoea such as parvovirus, coronavirus, Giardia & other parasites, with treatment as necessary.
3. Dogs with a fever, or blood in the stool or puppies or seniors are often prescribed antibiotics.
4. Happy dogs with ‘normal’ diarrhoea, loose stool or mucus will be given a chance to get better with other treatments first. These include prebiotics, probiotics, binders, bland diet and antiemetics.
5. If there’s no improvement, antibiotics may be given as a last resort.

Despite the fact that most dog diarrhoea can be effectively treated without antibiotics, many dogs still get given a course. Back in 2017, we committed to reducing our use of them, and the results have been just as good as before.

So why do so many dogs still get metronidazole for acute diarrhoea?

Why Dogs Get Antibiotics For Diarrhoea

• It’s effective. It’s quite clear to vets that metronidazole is rapidly effective at stopping the most common sort of diarrhoea.
• We know what it’s like. Anyone who’s had a dog with diarrhoea knows what a mess it causes, and we don’t want you to have one more minute of it than you have to.
• People expect it. We’ve been doing this for quite a while and many dog owners have become quite used to receiving antibiotics.
• We can’t be sure. Sometimes, antibiotics are indeed necessary.

Have we been doing the wrong thing by giving your dog metronidazole? The answer may be yes.

What’s Wrong With Using Antibiotics?

• The dose we use to fix simple diarrhoea could make more troublesome bugs resistant. That means worse diarrhoea like that caused by Giardia may become harder to treat, and even become a problem for humans.
• The normal bacterial population, called the microbiome, is profoundly affected by antibiotics and may take several months to recover. This could cause problems such as susceptibility to future infections.
• We could cause adverse effects from using unnecessary drugs.

We thank you for putting your trust in us. We can promise you that we have only your dog’s best interests at heart. Just sometimes, that doesn’t mean doing the easiest thing.

Related: Causes of Diarrhoea in Dogs | Are We Over-Using Antibiotics In Cats?

Have something to add? Comments (if open) will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here. The information provided here is not intended to be used as a substitute for going to the vet. If your pet is unwell, please seek veterinary attention.