They are a great help, and I’m not going to tell you not to use them. But I want you to be careful.

What Is A Lick Mat?

A lick mat is a textured flat surface made out of rubber, usually with suction cups to attach it to the floor. The pattern on the top is designed to trap food and make it hard to eat quickly. The aim is to get dogs and cats to spend their time in licking instead of other unwanted behaviours, or to alleviate boredom and anxiety. Unlike other slow feeders, licky mats promote licking behaviour, instead of food seeking or foraging.

Uses For A LickiMat 

The uses being promoted for the LickiMat® on their website include:

• Entertainment & distraction
• Reduction of anxiety & stress 
• Boredom buster 
• Slow feeding
• Raw feeding
• Environmental enrichment
• Improving oral health

Some of these uses make a lot of sense. A lick mat is a great way to get a dog to tolerate unpleasant situations like bathing, grooming, nail clipping and vet visits. That’s only so long as your dog is highly food-motivated.

You could also use it as an aid to crate training and getting your dog accustomed to car trips. It’s also a great way to alleviate stress in temporary situations, like fireworks and thunderstorms, or owners leaving the house.

So what’s the problem? Firstly, some of the claims make little or no sense.

Do Lick Mats Improve Oral Health?

LickiMat’s manufacturers claim that by stimulating saliva production it can clean the tongue, teeth and gums. Well, as someone who is well-acquainted with the literature on what actually keeps pets’ mouths clean, this statement lacks any basis in fact.

In fact, the sorts of treats being used on these mats should logically make periodontal disease worse, not better. Always remember that periodontal disease in dogs and cats follows the same course as it does in humans: you wouldn’t expect your teeth to be better by licking peanut butter off a rubber tray either.

What about the claim that scraping the tongue freshens your pet’s breath? Ludicrous. I’ve been a vet for close to 30 years, and I’ve never yet seen bad breath caused by tongues!

Are Lick Mats Calming?

One of my major concerns not just with lick mats but more generally is the contrast between being busy and being happy. While I think these products are great for preventing anxiety in stressful situations, it’s a big claim to say that such products improve anxiety that’s already present. As with my complaints about Adaptil and Feliway, such claims might stop dog and cat owners choosing remedies that actually help them.

Beware the manufacturer claim that “the extended licking action promoted by LickiMat releases a calming hormone”. So far there’s no evidence for anxiety reduction with lick mats or any ‘hormone’ being released. Yes, a mat might keep them busy and less prone to expressing anxious behaviours, but that’s not the same thing.

These two complaints are minor quibbles compared with my concerns about safety. Here are two ways.

Intestinal Obstruction & Hygiene

In the past month we have seen two animals need veterinary attention as a result of lick mats.

The first is a dog called Murphy. He was left alone with a lick mat for just a moment, and promptly chewed it up and swallowed it. Thankfully his owners immediately saw what happened and brought him down. That’s his vomit in the picture at the start.

The second is Tex the cat. He ate a piece of his lick mat without anyone noticing. When he started vomiting, his owner realised what was wrong. That’s his x-ray below; the white rectangle in his belly is the piece, now blocking his intestines.

There’s also a picture above of that piece matched with the rest of the mat, after we took it out. Without major surgery, he would have been in a lot of trouble. The same could have been true for Murphy of course.

This should come as no surprise. Vets have always said that anything flavoured like food, but not digestible is extremely dangerous. So here’s the newly updated list:

• corn cobs
• satay sticks
• icecream sticks
• meat wrapping
• cooked bones
• lick mats

How To Use Lick Mats More Safely

“You must fully train your dog before leaving her/him alone with a LickiMat.” So say LickiMat.

These products are being promoted for pets left home alone, which in my view is madness. In the general enthusiasm for anything new, we’ve forgotten some basic rules.

It is my strong view that no dog should be left alone with a lick mat. Even after ‘training’, whatever that is. There’s no telling when a dog will get frustrated and just chew it up. Cats might be at a lower risk, but Tex shows us it can still happen, especially with the softer silicone products.

Another thing: watch out that these mats are properly cleaned after each use. This is particularly important if you’re using them with raw food. It would be smart to buy ones that are dishwasher safe.

What Can I Use Instead Of A Lick Mat?

I’m not opposed to using food as a distraction when they need to be left. If you do, I recommend slow feeder bowls, Kong Wobblers, Bobalots and Nina Ottoson products with long track records of proven safety. Or you can hide food around the house or garden.

To be fair, LickiMat make a ‘Tuff’ version, and even a keeper tray to make chewing harder. But I have seen both the red and black rubber Kongs destroyed and know only too well how destructive a determined dog can be.

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.

Prednisolone is a problematic drug, and I understand why vets avoid it, but sometimes it’s just what’s needed. Amber, who’s pictured above is a perfect example.

Amber’s Story

Like many Labradors, Amber suffers from the common skin allergy of dogs we call atopic dermatitis. You can read about it here but her symptoms were a classic example:

• Repeated ear infections
• Dermatitis and licking in the paws
• Scratching at the body and face

When I first met her, she was a distressing case. At no time during her first exam did she stop either scratching her muzzle and ears, or biting her feet. It was incredibly difficult to concentrate and come up with any plan.

Fortunately I had already read her previous history. It was a litany of frequent visits to the vet. For example, at one point it said “owner has a constant battle with the ears”. To the owner’s credit, she kept it up when many others would have given up or run out of money.

Once you stop fighting, the ears suffer permanent damage and you’re heading for ’end stage’ ears, constant pain and total ear canal ablation.

Amber’s Treatment

Amber’s problem was continuous, and she needed a continuous solution. At the first visit, I treated her secondary ear and skin infections, with a promise of a longer term approach once they were fixed.

Apart from a vomiting episode that we put down to the antibiotics, everything went like a dream.

At the second visit, she was improving well. We discussed the treatment options, and the owner elected to use prednisolone. At the third visit, she was back to playing at home, and only scratching two or three times a day.

I saw her the other day for a routine check. It’s now 12 months and she’s never needed to see a vet for her skin since.

When To Use Prednisolone

Prednisolone is certainly not a wonder drug. I’ve deliberately chosen a perfect example to show you what it can do, but Amber’s not typical.

Prednisolone has significant side effects that you can read about here. For probably two thirds of dogs that we try it on, we can never get the dose low enough to make these acceptably mild.

For other dogs, the prednisolone never works well enough. It’s important to point out that Amber’s owner also started five important dose-sparing strategies at the same time:

• Medicated shampoo
• Skin support diet
• Top shelf parasite control
• Ear flushing
• Topical cortisone such as spray, cream or lotion on flare ups

Without these the required dose would have been too high. But even with them it stays too high for most dogs.

Importantly, even at an effective prednisolone dose most dogs will still have mild signs of their skin problem. Unlike the other drugs below, using a dose sufficient to completely remove symptoms almost always causes unacceptable adverse effects.

Dog Skin Allergy Drug Choices

Prednisolone is one of at least four long-term, systemic medications for atopic dermatitis. How do you choose? Have a look at my dodgy diagram.

For Amber, prednisolone nicely ticks all three requirements off. However, most other drugs can be placed somewhere in the triangle. Where they go depends on the drug, the patient and the vet.

There is usually a trade-off between price, safety and efficacy. I’ll make some general comments about each of the four. You can read more by following the links.

Cytopoint is clearly the safest option, and probably the most effective. However, as a monthly injection, it’s also the most expensive.

Apoquel is usually cheaper but also expensive. We see side effects in a few dogs, and it doesn’t always work quite as well. However it’s still an excellent drug.

Atopica is not a common choice any more as it’s about the same cost, but seems to have more side effects. However, it still has a place on occasions.

Prednisolone is very cheap, but has lower efficacy and very low safety.

How Long Can A Dog Stay On Prednisone?

Whether a dog can stay on prednisolone depends on the response over time. All dogs need close monitoring, and six-monthly blood testing is ideal.

Reasons for stopping prednisolone include worsening side effects, worsening skin disease (especially in young adults) or failure of the owner to attend follow up appointments.

For the lucky few like Amber, there’s no reason to think that she won’t be on it for life. Prednisolone is badly flawed, but dogs like her show why it should always be among our options.

In the end it’s all about quality of life.

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.

Inevitably, over a long career, mistakes have happened. Times when the benefit of hindsight showed me I took the wrong path and made the wrong choices. I never forget them, and in fact, although they are painful to remember, it’s remembering them that counts.

Those who cannot remember the past are condemned to repeat it.

I’ve talked before about how the twin evils of isolation and limited resources conspire against vets. I’d like to share three painful stories from my career that contain important messages for pet owners.

Costs

Patient X had a bladder infection. Like many of these cases, she came to us after being seen passing blood in her urine.

Most cases of cystitis are easy: a short antibiotic course and everything’s OK. This was one of the exceptions. She got better on antibiotics but then immediately relapsed. To a vet, this is a red flag for a bladder stone, which we subsequently diagnosed on x-ray.

She was scheduled for routine surgery, which usually costs around $1000. The problem was, no one remembered to tell the owner before she was booked in. To make matters worse, a previous and lower cost estimate was accidentally put on her admission form.

She was dropped off for surgery and the form was signed. Only a few minutes later we saw the mistake and called her owner straight back. However, the damage had been done. In one brief moment, we destroyed the relationship of trust that had developed between us over many years.

What You Can Learn

You have every right to ask about the cost whenever your vet discusses any surgery, test, medicine or anything else. As our normal service, we should have given this to X’s owners without being asked. But do not feel shy about asking; there may be other options or ways to reduce the fee, and vets may just forget sometimes in our enthusiasm to get on with the job.

Vets all vary in what they charge and clients should feel OK to talk about this. Read more here about what to do if you feel your vet is too expensive.

Overconfidence

In a small village in rural England, Border terrier Y was having seizures. They weren’t like normal epileptic fits, didn’t respond to treatment and were getting worse. It was clear that something needed to be done. The problem was that I was a long way from any help.

That was OK. I knew what needed to be done and I’d done it before; in fact, the video shows me doing the same thing many years later. He needed a cerebrospinal fluid (CSF) sample taken and analysed.

I anaesthetised him and performed the procedure just like in the video, but with one important exception: the fluid just would not flow no matter how I positioned the needle. Eventually, instead of CSF, blood started dripping from the hub. He never woke up from the anaesthetic.

To this day I do not know if the difficulty I experienced, and the bleeding were a result of his illness, or if I was just having an off day. Either way, the results were devastating.

What we can learn

I was a young vet in working an isolated environment with too high expectations. Now when I hear of other vets being placed in similar circumstances I can only worry for them. If you are a vet being asked to work in such a way, make sure you’ve got good support from the vets around you. Be prepared to say no if you haven’t, or even change jobs like I later did. If you are the pet owner in this situation, make sure you let the vet know they can say no. I also think it’s OK to ask about risks and experience before proceeding.

Just a few weeks ago I thought of the Border Terrier again. After 20 years and hundreds of CSF taps I once again failed to collect a CSF sample. This time I remembered the Border terrier, and after two good attempts called it quits and woke the dog up. Frustrating, yes, but better to learn from history and do no harm.

Communication

Patient Z was in trouble and his owner was desperate. Over the several years since his diagnosis of diabetes, he had been through a roller coaster of tests and hospital stays with first, one, then another veterinary group. He was needing to spend at least one day in hospital for testing at least once a month. His owner reported that there was no end in sight and that the spiralling costs had become such that all other projects had been cancelled.

His owner had asked the previous vets if it was possible to manage his diabetes at home, to which the answer was no. When the same question was asked of me I said I would support it. After all, despite the best intentions of the vets he wasn’t any closer to good control of his disease and the stress of handling may have been part of the problem.

Things went well at first and everyone was happy. Even the test results relayed from home appeared to show things were on the right track. However, one year after first seeing Z, he came to me with a sudden behaviour change, which had coincided with being stepped on. His owner suspected that he had been injured but despite our investigations, there were no clues.

Two weeks later he still wasn’t any better, and I suggested he get a referral opinion with a specialist. This his owner did, and the answer was found. He, in fact, was suffering from vision loss due to a rare retinal degeneration associated with poorly controlled diabetes. The owner subsequently complained that if I had referred him much sooner this would not have happened.

What You Can Learn

You can ask for a referral at any time. We don’t mind; I assumed based on the owner’s comments and the cat’s history that referral was not an option. In doing so I broke a rule I’ve tried hard to live by all my career: Offer every owner the best regardless of what you think they will accept. If you’re interested, this page gives a guide to the veterinary specialist services available in Adelaide.

Of course, I should have been strong enough to say no to a request to treat the disease at home. In doing so I broke the second rule: the patient always comes first. The client wasn’t at fault to ask; as a vet, I should have provided a clear opinion not influenced by the owner’s wishes.

What If Your Vet Makes A Mistake?

I have a strong belief in the power of mistakes to do good. People who know me know how often I say that when everything goes well, we’re all much the same. It’s when a business or individual makes a mistake that you can really judge them.

If you feel that a trusted professional has made a mistake, go to them with your concerns. You may not be right but you can expect a reasonable and open attitude. If they deny, bluster, argue or in any other way avoid facing the issue, it’s a warning sign. They are not listening to the feedback they need the most to improve their services. I find this especially true when I call breeders about a fault in their puppies or kittens.

If on the other hand, they are open to criticism, answer reasonably, are prepared to learn from mistakes, and show humility, you probably should give them a chance. In my opinion, it’s that willingness to consider all points of view or confront errors that make them the vets less likely to make mistakes in the future.

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.

I’ll also show you what happened to a patient of ours last week, but that’s the more predictable outcome of kids walking dogs. This particular consequence catches nearly everyone by surprise.

Firstly, though, why are bad things more likely when kids walk dogs than when adults do the same?

What Kids Do Differently

1. Children are proven to be poor at reading dog body language, in my experience including teenagers. That means they often don’t read the early warning signs from either their own dog or other dogs they encounter.
2. Younger dog walkers lack experience dealing with dogs and people. They are more likely to take at face value the “don’t worry, he’s friendly” that we hear regularly, and aren’t as good as anticipating dangerous situations.
3. Smaller kids lack the physical strength necessary to avoid being pulled over or having the leash pulled from them by an excited or aggressive dog.

What Goes Wrong?

Although there are also three obvious bad things, I’m here to tell you about the one most people miss. It’s the psychological damage done to children and it’s a direct consequence of the other bad things. These are:

• Dog attack
• Car injuries
• Lost dogs

I don’t want to pretend that psychological or physical injury to children is worse than the same thing happening to dogs, but that’s certainly how society sees it.

How It Happens

Think it through with me. The kids take the dog for a walk, and a bad thing happens. The dogs slips a lead and gets run over, or the dog is attacked by another dog. Either way, the injuries are serious and possibly fatal, and it all happened in a frenzy of chaos.

The kids are possibly at least partly at fault, but even if they aren’t they will feel to blame for what happened. They experienced the whole distressing event, and were powerless to stop it. They have no adult able to help them make sense of what happened.

The Consequences

This is an event that may mark them psychologically for life. If they tried to intervene, they also may end up with physical injuries. Either way, what started out as a nice thing to do has ended up a tragedy. They have a toxic combination of traumatic experience, guilt and possibly grief.

Now run this test: Google “kids walking dogs” and have a look at the search results. It’s all about how good it is for kids to get a job walking dogs and the positives of responsibility, with almost no discussion of the true risks except with difficult dogs. There’s no understanding that it’s the other dog, or the car we’re worried about, and that the effects of a moment can last a lifetime.

Bella’s Story

Bella here represents the more familiar face of the problems we see. She was at the park when a group of kids came with their Dalmatian. By all accounts, the Dalmatian was leash reactive and pulled the leash out of the kids’ hands. Bella was bitten around the head but luckily escaped serious injury. It could have been a lot worse.

My Story

The only thing that saved me was a little voice in my head that made me turn the bike around. I was in a hurry and asked my kids to walk the dogs, but instead I ended up shadowing the kids just to see what they would do.

I watched them happily heading to the local park and there on the other side was a big dog off leash. I watched the owner begin to panic as she realised there was another dog coming, and saw enough of the dog’s behaviour to see why she was worried. She must have thought that at that time of day she would have the park to herself. Haven’t we all?

No problem. I cruised over and said, “kids, lets walk this way,” and the crisis was averted. Lesson learnt, even though I shouldn’t have needed reminding.

How Kids Can Walk Dogs

I think the only way is with a responsible adult. I make the best use of the time by teaching them how to walk dogs properly, showing them what dangerous situations look like, and explaining when to avoid other dogs. I also find it’s a great opportunity to talk to kids about their lives in general.

I may be over-reacting but I don’t think so. I love my kids, and I love my dogs, and that’s two good reasons to keep them both away from danger. However, if you can suggest ways that kids can exercise dogs safely, please let me know in the comments section below.

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 A Dog Has Sudden Back Problems

1. Sudden loss of control of the hind legs is a life threatening emergency
2. Keep affected dogs as still as possible until a vet can examine them
3. Home care or surgical options exist, & dogs can go on to live normal lives

Now dive deeper…

Have a look at the video below and pay close attention to how Rickey is walking. That’s not a limp caused by a sore leg. To a vet, that’s an emergency. If your dog ever starts walking like this, especially after a jump or fall, keep them very still and see a vet immediately. Their life may depend on it.

What Is Ataxia?

Rickey is ataxic. That means he’s lost some control over how his legs are moving, and it’s a hallmark of neurological disease. Something is interfering with his nervous system’s ability to move his legs.

There are many possible reasons for hind leg problems that you can read here, but for Ricky, one cause stands head and shoulders above the rest…

Intervertebral Disk Disease

Intervertebral disks are the flexible pads that sit between the spinal vertebral bones in the back. They act both as joints and cushions, and are yet another marvel of nature. IVDD is when the disk fails, and although it’s often called a ‘slipped disk’, that’s not really what happens in dogs.

Rickey’s disk didn’t slip, it burst after he jumped off a chair. In Type I IVDD, the disk itself degenerates and the ring of fibres that holds it together weakens. Eventually it gets weak enough that a sudden compressive force, usually from jumping off furniture, causes the outer fibres to split and the inner disk content to be violently expelled.

The bad news is that when it ruptures, contents of the disk often travel towards the spinal cord. That’s Rickey’s xrays showing which disk is the likely culprit. You can see that the spinal canal containing the cord runs just above the disk. What we can’t see on the xray is that some of that disk material is now pressing on the spinal cord hard enough to stop the flow of nerve signals.

Which Dogs Are At Risk

IVDD is mostly associated with certain dog breeds. These include:

• American Cocker Spaniel
• Basset Hound
• Beagle
• Bichon Frise
• Cavalier King Charles Spaniel
• Chihuahua
• Corgi
• Dachshund
• Dandie Dinmont Terrier
• English Springer Spaniel
• French Bulldog
• Jack Russell Terrier
• Pekingese
• Poodle (Miniature and Toy
• Scottish Terrier
• Shih Tzu

What all these breeds have in common is a genetic defect called chondrodystrophy. The same thing that causes their cute body shape also causes premature degeneration of intervertebral discs. IVDD is always more common in overweight dogs of these breeds.

In our clinic, IVDD also occurs in very excitable and energetic dogs of any breed. This may explain an increased prevalence observed in male dogs. There is a higher risk in desexed (neutered) females that could be explained by increased weight.

Why Is IVDD Serious?

Rickey was lucky; his cord injury was only partial, his owner brought him straight down and he responded well to treatment. All three of these factors can easily go the other way.

• Disks can rupture with enough volume or force to totally and permanently disable the spinal cord
• Movement of the spine can cause more and more disk material to press on the cord until paralysis ensues
• Some dogs don’t respond and need advanced referral surgery

If a dog has lost all voluntary movement and pain sensation to the hind legs, there’s still a chance that rapid surgical decompression can save them. However, if paralysis can’t be reversed there’s not much hope for quality of life. I know from bitter experience that no matter what people say about how good their dog is on a cart, the reality of their life is very different.

Dogs with IVDD often have back pain at the time of the spinal injury, shown by arching of the back, shivering and lethargy. It’s especially important to be aware of signs of the disease in susceptible breeds such as the Dachshund, Beagle, Shih Tzu, Lhasa Apso or Pekingese. Sometimes the main problem is pain from nerve root compression, not neurological dysfunction.

Confirmation of the diagnosis is only possible with advanced imaging such as CT scans or MRI. However, in most cases the combination of the history and examination plus plain x-rays are enough for vets to be confident. X-rays such as Rickey’s often show a narrow disk space and/or calcified disk material visible in the spinal canal.

There are two options for treatment:

1. Conservative Treatment

For dogs with mild to moderate signs, and no further worsening, conservative treatment is often very successful. However, I have personally seen too many dogs get worse with poorly managed conservative treatment.

The theory behind cage rest is that if the dog is kept extremely still, the disk material will stop moving and the body is able to wall off and repair the damage. Dogs must be confined in a cage that is only just big enough to fit their bed plus food and water.

The only times a dog should be allowed out of the cage for at least the first two weeks is while being held to go to the toilet. Yes, it sounds cruel, but if the dog is near the owner, they are usually happy enough. The consequences of failure are just too serious to take chances.

A vital part of conservative treatment is close monitoring by the owner and vet, with the readiness to change course quickly if necessary.

2. Surgical Treatment

Surgical referral is best if a dog is severely affected, has repeated episodes, or fails to respond to conservative treatment. The option of referral is always available even in milder cases even if only for a second opinion and advanced imaging.

Long-Term Management

Rickey responded well and will eventually be able to return to a normal life. However, he’s always at risk of a recurrence so we’ve made a few changes:

• Weight loss: he wasn’t fat but we want him as thin as is comfortable
• No high impact activity: walking is good, running and jumping are bad
• No access to furniture: an example would be settling in a crate at night to stop a dog jumping on the bed

Rickey’s case was successful for more than one reason. When his owner rang for a Saturday appointment, we were already booked to 5:30pm and the nurse, to her credit, didn’t hesitate to slot him in, even though it was ‘only a leg problem’. Who could have guessed over the phone how much danger Rickey was in?

Now Read: The Link Between Neutering & IVDD In Dachshunds

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.

On one hand:

• You don’t want to waste your vet’s time.
• It’s a going to be a big hassle to get to the vet.
• It could be expensive, especially late at night.

But:

• Your pet might be suffering.
• You know they can’t tell you what’s wrong.
• Animals often hide their illnesses.
• You’ll never forgive yourself if you miss something important.

You need to know if you’re either over-reacting or instead not reacting fast enough.

How do you recognise the right time to take pets to the vet?

What are the signs of illness in dogs, cats, rabbits, ferrets, rodents and birds?

Here are five common scenarios that should help. Can you see the common link?

Ella

A normally playful dog that was a little off colour and was shaking her head.

Evie

A rabbit with a white spot in her eye.

Seth

A dog that wasn’t playing or active like he usually is.

Tom

A cat that was sleeping a lot and off his food.

Jackie

A female dog weeing more often than usual.

None of these pets was obviously unwell but their owners were concerned. We see cases like this every day. Here’s what happened next:

Ella had an ear infection.

Evie had a serious infection called encephalitozoon that can also cause progressive paralysis but is easily treated.

Seth had hurt his back. Read here about how serious back problems can be in dogs.

If Tom didn’t get antibiotics he was going to end up with a nasty cat bite abscess.

Jackie had a urinary tract infection.

They were all in pain, possibly except Evie. They all needed treatment. All except Seth were going to get a lot worse if nothing was done.

So am I saying you should always go to the vet all of the time? No. Here is the common thread:

In each case their owners knew their pets were not ‘themselves’.

As a guardian of a very special animal, you know that animal better than anyone else ever can. You know their personality, normal behaviour, usual activity level etc. So…

How Do I Know When To Go To The Vet?

• Trust your gut instincts.
• Changes in behaviour are always meaningful. Pets don’t suddenly behave differently for no reason. Sometimes the cause isn’t a physical ailment, but usually it is.
• If you are worried, don’t let yourself be talked out of it. Your first impression is usually the best guide.
• If you aren’t the regular owner, or are running a boarding or kennel facility, you need to be especially careful. In this case you don’t know what normal behaviour is so you have to keep a higher index of suspicion for illness.

If an owner is concerned by something but the vet can’t see the cause, it’s more likely that the vet hasn’t seen it yet than the owner is wrong. It might take a second visit or extra tests to find.

Do I Need To Go To The Emergency Vet?

Most of the time you’ll already know when it can’t wait. If in doubt, call your closest after hours emergency vet. They’re busy and won’t advise you to come unless they can see a good reason.

If you feel bad for asking, remember that vets won’t ever complain that you’re wasting their time. If pet owners always wait until they are 100% sure something is wrong, sometimes they will leave it too long.

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.

How To Get A Cat To Eat

1. Try a familiar food first: moist, smelly foods are usually tastier.
2. Warm the food up to body temperature.
3. Try flavourings like fish, kangaroo or gravy.
4. Only happy cats eat, so give them plenty of pats.
5. Get a vet to check that your cat isn’t sick or stressed.

Now dive deeper.

Getting a sick cat to start eating, or convincing a cat to try a new food is a problem most of us will face. Like Cleo’s owners did.

Cleo’s Story

A few weeks ago, Cleo had a sudden turn and ended up at the emergency centre. She was falling over, wobbly, her pupils were the wrong size. Like most unwell cats, she’d also stopped eating and drinking.

The emergency care was good, but it wasn’t easy to see what was wrong. She came to us the next day, and we equally weren’t able to see the cause, but we took blood tests and tried some simple treatments that often help

In her case, she didn’t improve and by the next day she was in our hospital on a drip receiving supportive care. We had by this time decided that her signs most closely resembled a stroke, or cerebrovascular accident.

After 24 hours, Cleo’s signs had improved, but she was hating her time in hospital and becoming very stressed. We felt that her best interests now lay in being sent home for intensive TLC.

By now, she was drinking by herself; the only problem was, she still wasn’t eating. We wondered if she’d be better off by now at home where she was less stressed. She was sent home on trial, by no means out of danger. Read more about her later.

Unlike dogs, cats aren’t adapted to periods of starvation, and can get even sicker if they don’t eat. They also aren’t as motivated by food.

What if a cat needs to change foods?

• Be patient unless your vet tells you it’s urgent.
• Mix the new and old food over at least seven days, starting with mostly the old food, and increasing the percentage of new food each day.

So let’s talk about sick cats in more detail.

How To Get A Cat To Eat

See The Vet First

If a cat isn’t eating, there’s always something wrong. If Cleo hadn’t had veterinary care, she would certainly not have survived.

I’m amazed how often I’m asked about getting a cat to eat that I haven’t seen. I always say the same thing:
Attend to the problem that’s making your cat not want to eat first.

Mostly, they are sick with a serious illness. Sometimes it’s psychological, such as anxiety, but that doesn’t make it any less urgent.

What Causes A Cat To Stop Eating?

As soon as a cat gets sick, they usually go off their food. Common causes include:

• Chest infections
• Abscesses
• Tooth and gum disease
• Cholangiohepatitis
• Kidney failure
• Pancreatitis- read about feline pancreatitis here
• Heart disease
• Chronic pain
• Anxiety or stress

Start with a vet check and treat whatever is causing the poor appetite. Then follow these special tricks to get cats eating.

Use The Right Food

Have you noticed how cats generally prefer to eat exactly the same food every day? It isn’t that it’s the tastiest food, it’s that it’s the food they are most familiar with.

Most cats don’t like novelty, and it only gets worse when a cat is feeling sick. The best food to feed your sick cat is almost always the same food you are already using.

Of course, there are tricks:

• Moist food is usually more palatable, and also reduces the risk of dehydration.
• Cats can develop food aversions (see later).
• Food warmed to body temperature is always more attractive.
• Smelly foods improve the appetite.
• You can try sprinkling fish flakes, whitebait or tuna juice on the food.
• Certain foods are inherently more popular. You’ll already know some of your cat’s favourites, but we often recommend minced raw kangaroo meat, whitebait in gravy, or in fact, any foods in gravy. Once your cat is better, read why we don’t recommend feeding kangaroo meat to cats every day.

Reduce Stress

Just like Cleo, stress in cats will switch off the appetite. That’s why we moved her to our isolation ward, but she was still too stressed to eat. We often send cats home quite early if we can see this happening.

The same thing applies at home though. Make sure that your cat is in his or her favourite place and that there are no obvious stressors. For example, although some like the company, many sick cats prefer not to be bothered by other cats, dogs or children.

Tender Loving Care

I can’t state this strongly enough. TLC can be the difference between life and death for a sick cat.

Most cat owners already know the best trick to get a sick cat to eat. We pat them. In our hospital, a nurse or even a work experience student sits with them and pats them just how they like it. It’s amazing how often they will then get up and go to their food.

If they don’t, hand-feeding small tidbits often works or getting them to lick moist food from your fingers.

You’ll find that you need to do this very frequently at first. By all means leave out a few of their favourite biscuits if they want to nibble but keep trying a variety of types and textures of food. It’s best to remove these after each offering and use a fresh batch next time.

Understand Food Aversion

Food aversion is when a cat develops a particular dislike to a certain food.

By all means offer food frequently, but the key word is ‘offer’. No matter how frustrated you get, don’t try to put the food in your cats mouth. This is likely to lead to food aversions which only make matters worse. Fundamentally, your cat has to feel in control.

You may also find your cat develops a food aversion by associating their usual food with the sickness of nausea they feel. We are familiar with this in humans; I can’t enjoy lemonade simply because it was given to me when I was sick as a child, even though it wasn’t the cause.

Measure Your Success

How can you be sure your cat is eating enough?

• Offer measured quantities that are refreshed at least twice a day.
• Keep a record of how much is being eaten
• Prevent other cats or dogs from accessing the food
• Use a set of kitchen scales to monitor your cat’s weight (these scales cost me $12.95 at IKEA and weigh up to 5kg)

We never recommend you leave food out in large amounts for cats: the food gets stale and you usually can’t tell for a few days if your cat stops eating. Read our guide to feeding cats for more information.

Appetite Stimulants

There is a reasonably effective appetite stimulant for cats, but it’s not something we want to use very often. These are a last resort, and without an integrated approach are no more than a sticking plaster over the problem. Before using an appetite stimulant, the cat needs to be:

• On a veterinary treatment plan
• Drinking by his or herself
• Comfortable and pain-free

For these reasons, I’m sorry that I won’t say the name or dose of the appetite stimulant we use. The drug is not registered for use in cats, and without veterinary supervision, appetite stimulants can be dangerous.

We’ll certainly tell you when it’s time to try pharmaceutically enhancing your cat’s appetite.

Cleo’s Conclusion

Her owners worked hard to provide her with her favourite foods, tried some new tasty options as well, and kept tempting her with small, frequent meals. They certainly made her as comfortable as they could and gave her lots of her favourite attention. To begin with it was very frustrating but slowly she started showing interest in the food.

We also had her on a new medication and prescribed her an appetite stimulant, which seemed to help.

We checked on her daily, and after three days she was looking for her food by herself and starting to gain weight. She’s doing well now.

Cleo’s case also shows how animals are sometimes treated without reaching a firm diagnosis. A referral opinion was offered, as in any uncertain cases, but it was also quite logical to treat her on the basis of general support given her likely illness.

She’s not out of danger yet, but we’re all glad we gave her a chance.

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 To Do When A Rabbit Is Sick

1. When rabbits get sick they tend to hide serious illnesses until very late so if something is suspected to be wrong it’s best to get it checked by a vet
2. Common causes of illness in rabbits are gastrointestinal stasis, kidney stones and traumatic injuries

Now dive deeper.

Caring for rabbits is an increasingly large part of our daily workload. Here are three of our recent cases which show the complexity and variety of rabbit diseases, and the need to treat them with special care. One story does not end well; the owner has requested we included this as a warning to other rabbit owners.

Mr Poppy

Mr Poppy is over ten years old, and still healthy and happy even if he sleeps a lot these days. Like most rabbits of his age, he needs daily treatment for arthritis, but he’s still an active bunny. As you can tell by what happened.

He came in from playing outside with his mate holding up a hind leg. When he came to us, it was clear he had multiple fractures of his metatarsal bones. Without surgery, he would be in serious trouble as a rabbit’s hind leg must be fully functional, and it wouldn’t ever heal by itself.

We scheduled surgery for the next day. Rabbits can’t and don’t vomit, so we don’t starve them before surgery. This is also to help prevent gastrointestinal stasis (see Hunny Bunny later).

We placed a drip for intravenous fluids in a marginal ear vein, and gave him a normal gas anaesthetic via endotracheal intubation, just like dogs or cats (or people!). His X-rays showed three fractures; the two central bones needed pins but the third (arrow) would heal once we aligned the other two. It may look logical from the xray but trust me: there is nothing more fiddly and needing more patience than pinning such tiny bones.

His whole anaesthetic took two hours but we are very happy with the result. At suture removal yesterday he’s looking great, moving well and even starting to ‘thump’ again. In the meantime his owners found the cause of the injury; his mate had knocked a loose brick off a pile and he was probably in the wrong place.

Hip Hop

Hip Hop was a well-loved bunny who we not only saw for regular check ups, but would even go to board with Rachael’s bunny at times. All seemed well until Hip Hop started losing weight and going off her food.

Just like in any species, we took blood which showed tragically advanced kidney failure. Hip Hop’s x-rays showed large nephroliths (kidney stones) which were considered to be the cause of the problem. Our opinion was that he was unlikely to survive the disease, very likely to get worse, and so we recommended euthanasia to prevent suffering. Her owner was devastated.

On investigation, it was discovered that her diet contained a high percentage of lucerne hay. Her owner knew the importance of hay in a rabbit’s diet (see Feeding Rabbits. However, when selecting hay, it is a common and easy trap to select lucerne hay; it’s nicer looking, as you can imagine from the second picture, and rabbits prefer it.

The most important message here is that lucerne hay (identified by its oval leaves; it’s not a grass) contains an excessive amount of calcium. Kidney and bladder stones are a great risk, though until I saw HipHop’s problem I didn’t know just how high that risk was. When selecting hay for your rabbit, make sure to only feed grass hay or meadow hay.

Hunny Bunny

Hunny Bunny came to me one recent Saturday lethargic, not eating and limping on a hind leg. He was clearly in pain. It was also clear that the pain had caused a secondary ‘gastrointestinal stasis’ where his gut had stopped moving. Crucially, he was no longer producing the steady supply of droppings that indicate a healthy rabbit.

To give an idea of how we think, our concern was mainly the fact that his gut had stopped. This is often fatal to rabbits even more than colic can be to horses. Rabbits are herbivores with a complex fermentation process easily disturbed by outside forces. Read more about GI stasis and rabbit digestion here.

Seeing he was not too bad, and hoping it would be a short-lived problem, I prescribed pain relief. He did improve over the weekend but deteriorated again so that several days later it was clear he needed to be hospitalised. We placed a drip and started medications to control pain and stimulate his gut, combined with syringe feeding a critical care mix. It was touch and go for several days and his full recovery was only possible when we could send him home to the continued care of his owners.

He’s back to normal now, and his owners have since found what is likely to have been the cause. A goshawk is hanging around their yard, and although they do not usually attack such large prey it does seem to have attempted to take him and caused the injuries in the process. Goshawks are one one of the rarer native species in Adelaide. I always get a thrill when I see one so I hope the two can live in peace and harmony.

Have something to add? Comments are welcome and will appear within 24 hours of lodging.

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.

We’re so excited that one of our patients has a pacemaker that we can’t stop talking about it.

Jack came to us a few months ago with a history of falling over at home. From the moment of his first examination it was clear there was something very wrong with his cardiac rhythm. A good heart creates a rhythm you can dance to but this beat would empty the dance floor.

We scheduled blood tests, X-rays and an electrocardiogram (ECG) which is the best way to sort out the various types of rhythm disturbances. Read more about diagnosing heart diseases here.

He was a great patient, but his heart would beat along happily and then just stop. Eventually after the long pause there was what we call an ‘escape complex’, which is the heart’s way of rescuing itself.

It was easy to see that he had what we call sino-atrial arrest (heart block), and that his heart’s natural pacemaker (the sinoatrial node) was not working properly.

The rest of his tests showed that his heart was otherwise OK so we advised a referral to a specialist veterinary cardiologist for assessment.

Dr Richard Woolley, a cardiac specialist, advised that Jack would do well with a pacemaker, and his owner gave the consent. Dr Woolley is consulting in Adelaide these days but at the time Jack had to travel to Melbourne. The actual pacemaker is shown.

Here he is after surgery. By all accounts he’s doing very well, and after a few calibrations of the pacemaker, it’s working well and he’s now able to lead a normal life again.

He now has some very specific instructions:

• no collars (the electrical leads are in his neck)
• no blood sampling from the right jugular
• pacemaker removal prior to cremation (it is explosive)

Though I think the time when the last item will be necessary is now far into the future.

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.

This is Micki. He’s so happy and active that this is the best photo we could take. But he wasn’t always so perky. Last year he started having seizures and his very concerned owner brought him to us. There was nothing remarkable found on his physical exam, so we took blood for haematology and biochemistry, as we always do when dogs are having seizures.

In this case, Micki’s blood test results showed elevations in his liver enzymes, suggesting a liver problem. To investigate the findings we scheduled an ultrasound examination of his abdomen.

An image from the scan of his liver is shown. In it, you can see from the scale markings that his liver, although unremarkable in echotexture, is only 2cm thick (the dark oval is his gall bladder) It was clearly reduced in size, and inaccessible to a biopsy needle.

Micki’s Diagnosis

We discussed the results with his owner. It was clear to us that such an abnormal liver was the source of Micki’s problems, but we cannot diagnose the exact liver condition without a biopsy. There are lots of liver problems found in dogs.

However, the problem was likely to be a degenerative hepatitis common to older dogs. You can read about the same disease in one of our vets’ dogs here.

The gradual destruction and shrinking of the liver mean it no longer has the ability to detoxify the products arriving from the gut. Therefore, these nasty compounds like ammonia and urea are shunted past the liver and manage to reach the brain. This is called hepatic encephalopathy.

Micki’s Treatment

An understandable choice was made to not proceed with an invasive liver biopsy via exploratory surgery. The treatment decision was then very clear; to provide a diet which minimised the work required to be done by the liver while at the same time supporting its ongoing survival. This food is called Hills Prescription Diet l/d.

Many owners are reluctant to make the big decision to completely change their pet’s diet in the face of illness. They probably do not think something as simple as a food can do that much to help, and worry that their pet will find the new food bland and uninteresting. However, Micki’s owner took the decision with full enthusiasm and made the difficult swap.

The results were better than even we expected. When we examined Micki recently, his owner reported that there were no more seizures in the 35 weeks since the diagnosis. Micki was brighter, more active and most surprisingly liked the food more than his old food.

Treatment of Hepatic Encephalopathy in Dogs

Treatment options include:

• liver support diets to reduce toxin production (always)
• lactulose to encourage toxin elimination (often)
• antacids to combat gastrointestinal ulcers (often)
• antibiotics to reduce toxin production (rarely)

I suspect that the liver diet is not tastier than his old food, even though it looks that way by Micki’s attitude to it. The more likely explanation is that the new food improves his brain function and sense of wellbeing so he is naturally healthier and hungrier. It’s another example of an answer we often give when an owner asks how they can stimulate their sick pet’s appetite- make them feel better!

Follow up: one year later, Micki is still going strong and is just as full of vigour and life. There is now a second liver diet called Royal Canin Hepatic Support.

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.