What can be done for these poor suffering creatures? I’ve talked about noise phobias before, but now we have a new tool in our fight against this major welfare issue.

Sileo: The New Noise Sensitivity Drug

Sileo (pronounced “SEE-layo” not “si-LAY-o”) is a syringe loaded with a gel containing dexmedetomidine, an alpha-2 agonist sedative. It’s the first time that a drug of this strength has been registered for dog owners to use.

Therefore, we have to be very careful, as you’ll see later. That’s also why dog owners can only get it prescribed after a checkup and a discussion with their vet.

Sileo is indicated for the alleviation of acute anxiety and fear associated with noise in dogs. Ironically, (but perhaps understandably given the difficulty) Sileo has not been evaluated during thunderstorms even though they are likely to be its main use. It has been trialled against fireworks, with the results you see above.

Sileo’s Safety In Dogs & People

The first thing you’ll notice once you get it is the extremely child resistant packaging. This should serve as a warning to keep it well away from children at all times and wear gloves when using. The good news it that is took me to actually read the instructions before I could open the box.

Vets already know too well that dexmedetomidine can cause low blood pressures, body temperatures and heart rates. We also see it being a little unpredictable from dog to dog. The same dose that ‘barely touches the sides’ in one dog can be dangerous to another.

For safety’s sake, please avoid using Sileo in any dog with significant sickness or pre-existing illness. This could include even temporary problems like the severe stress caused by the noise phobia itself if they become heat stressed or dehydrated. If it is used in very hot or cold conditions, you will also need to be careful that your dog’s body temperature stays in the correct range.

I would also be very careful combining it with other anxiety medications that cause sedation like trazodone or clonidine. Dogs with noise phobias often have a whole drugs cabinet and it would be very tempting to use more than one in times of stress.

Lastly, I would never use it in young puppies or in breeding females.

Having given all these dire warnings, the fact remains: there is a tremendous need for an effective drug for noise phobia in dogs. That’s why it’s often worth taking the risk.

When To Give Sileo 

Like all anxiety medications, Sileo will work best if it is given before exposure to whatever causes the fear. Therefore, try to predict the stressful event (such as by watching the weather radar for approaching thunderstorms), and give it 30 to 60 minutes before. This is how long it takes to work.

If you aren’t able to predict, it’s still worth giving the drug as soon as you hear the noise or your dog starts showing signs of anxiety. It just may not work as well under these conditions.

After giving the correct dose, do not give any more, even if the results are insufficient. After 2 hours, you can give a second dose, and then every 2 hours up to a maximum of 5 doses, as long as your dog remains free of side-effects.

Sileo is not supposed to be swallowed, and will probably not work if it is. Instead, it is applied to the inside of the mouth between the upper teeth and the cheek. Therefore, absorption could be a problem in dogs with severe gum or dental disease. It could also be a problem if you feed your dog shortly afterwards. I would wait 30 minutes.

How To Give Sileo

Sileo comes in a metered dose syringe with a rotating ring to set the correct dose. The earlier model had a locking mechanism but it caused many overdosages in the USA due to the ring lock not engaging. Having used this update, it seems hard to accidentally overdose.

Please read the enclosed leaflet very closely as it contains detailed descriptions and pictures of how to use it properly. 

In brief, you rotate the ring right down to the syringe barrel then back until the correct number of dots is exposed between the syringe barrel and the ring. It will then cause the plunger to stop at the correct place when you squeeze it into your dog’s mouth.

Sileo Dosage Chart

If the dose is more than 6 dots, divide the dose between both sides of the mouth.

Sileo Side Effects 

Alpha-2 agonists are known to cause vomiting in some dogs. Therefore, don’t be too concerned is there is a brief vomit as it starts to take effect. Any more than this and you will need to seek help. 

Other side effects will generally be related to excessive drowsiness and sedation, including a low heart and breathing rate, and low temperature. Adverse effects should not last more than two hours but there will be some variation between dogs.

If your dog appears excessively sedated, or breathing too slowly, please seek immediate veterinary care. There is an antidote available which should almost immediately reverse the effects.

How Well Does Sileo Work?

The graph at the start shows the results of a European placebo-controlled double-blinded field study. 71 dogs with a history of fireworks phobia were treated at New Year’s Eve with a maximum of five doses at two hour intervals. For comparison, 73 dogs were treated with a placebo containing no drug.

You can see that 75% of the treated dogs had a good or excellent response, compared with 33% of placebo-treated dogs. There was a statistically significant difference (p<0.0001) between dexmedetomidine and control in favour of dexmedetomidine.

At the same time note that there were still plenty of dogs who responded very poorly. And it’s also worth noting that in this study, the treatment was able to be started in most cases before the onset of the noise.

So:

• Sileo won’t help every dog enough on its own
• Sileo may cause excessive side effects in some dogs
• Sileo will be expensive for larger dogs if it’s needed very often

For all these reasons, we need to not forget the other options.

Medications For Noise Sensitivity

Dogs with anxiety to noise are treated with both drugs and environmental manipulations. A quick list includes:

• being a calming and reassuring presence
• creating a ‘safe zone’ where your dog likes to hide
• getting a dog behaviourist consultation
• benzodiazepines like alprazolam and diazepam
• clonidine
• trazodone
• gabapentin
• dexmedetomidine

Visit this page for a longer discussion of these options. One thing I will take the time to specifically warn you about here, though, is Adaptil. You can read why on this page, but a simple summary is that it just doesn’t do enough. The placebo effect shown above should be sufficient warning to always be guided by science when you can.

And one last grumble. As an ancient-language fan, the name ‘Sileo” grates on me a bit. It’s Latin for “I am silent”, which speaks all too loudly to how we sometimes approach mental health in animals. That is, as problems for us, not them.

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.

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.

So it was with great hope that here in Australia we awaited the arrival of Purina’s new food designed to reduce human allergies to cats and kittens. Imagine the possible benefits if it works:

• More people being able to enjoy the company of cats
• More cat rescue and less rehoming
• Better relationships for allergic partners of cat owners

But could it also be too good to be true? If it encourages people who can’t keep cats to get them, surely this will be a backwards step instead. I found my first Devon Rex in an animal shelter where she’d been dumped for just this reason.

I’m going to take you through the science behind Purina LiveClear® as impartially as I can. By the end, you’ll have a good idea of what to expect if you try it.

How Purina LiveClear Works

It starts with the major cat allergen of humans: Fel d 1. This complex protein is found in the saliva, sebaceous glands, skin and fur of cats. It’s very stable, and can easily become airborne, from where it causes all the usual signs of allergy in people: sneezing, runny eyes, asthma etc

Cats probably spread most of the Fel d 1 around by licking their coat. So the people at Purina thought: what if we developed a food that blocks the Fel d 1 from the saliva?

It’s actually very clever.

They expose chickens to cat allergens and collect their eggs. These then contain high levels of anti-Fel d 1 antibody. The egg proteins are sprayed onto cat biscuits so that cats end up having antibodies to their own allergen in their saliva. Theoretically then, when they groom themselves, the Fel d 1 is taken out and inactivated.

As an aside, it’s worth noting that in the trials the food was fed continuously, which makes sense when you see how it works. However, as any vet knows, it can be hard to do this without having a fat cat.

Does Purina LiveClear Reduce Allergens?

According to Purina’s own research, cats who eat LiveClear have a 47% reduction in allergen on their coat. And this is true, if a little oversimplified.

The reality is the graph here. It shows the same cats divided into four groups based on how much allergen they had in their coat. You can see that the top 25% have a lot more than the rest. You can also see that the actual levels vary for all of them week by week.

In fact, a look at the original paper shows that even these data points are averages of substantial individual variation.

Of course what matters most is how this translates to its effect on people. Is an average 47% reduction enough, and does the weekly variation make a difference?

Does LiveClear Reduce Human Allergy?

To give Purina some credit, they could have stopped here, but they went on do do human trials. They exposed people affected by cat allergy to blankets from cats fed either a control food or LiveClear. The study was double-blind, meaning that neither the researchers or test subjects knew which was which.

In other words, a high-quality piece of work. Sadly for Purina and cat allergy sufferers everywhere, the results were disappointing.

The following table shows the P-values for each symptom. Values less than 0.05 are generally regarded as significant. As you can see, there were no significant differences between reaction levels to blankets from treated or untreated cats.

Difference Between LiveClear & Control Food In Allergy Symptoms

Hang On- Purina Said It Worked!

Actually, there were differences found when the results were compared with earlier known exposure (i.e. no longer blinded). This should be yet another demonstration of the enduring power of the placebo effect. And yet that’s not what was said.

While I honestly think that LiveClear will help some people, using an unblinded allergen exposure as a comparison is not the way to find the proof.

Well, you might say, if the subjects felt better, does it matter whether it was a placebo effect or not?* That’s an ethical discussion for another day. What we really need is a good blinded study using cats in their own homes to get closest to the real world scenario.

So Is Purina LiveClear Worth It?

The evidence so far suggests that Purina LiveClear is an unreliable way to reduce cat allergy symptoms in the home. I certainly would not recommend that allergic people plan on having cats based on this intervention alone.

Despite this, I applaud the company for such an innovative approach, and I’m not writing the food off completely either. For just as some cats will produce unacceptably high Fel 1 d levels, others are likely to respond well, especially combined with other approaches. You won’t know unless you try.

If you already live with a cat, but are allergic, or have an allergic partner, then there’s not a whole lot to lose. LiveClear is clearly as safe as any other cat or kitten food. If it doesn’t help, all you’ve done is bought a more expensive version!

Related: The Shaky Evidence For Feliway In Cats | Other Ways To Reduce Household Feline Allergens

* Strictly speaking, this is a nocebo effect, where the known allergen exposure is likely to have increased the subjects’ perception of symptoms. Then compared to the lower tested levels later, a significant difference appears. Clear? No, I didn’t think so!

Sources

Bonnet, B., Messaoudi, K., Jacomet, F., Michaud, E., Fauquert, J. L., Caillaud, D., & Evrard, B. (2018). An update on molecular cat allergens: Fel d 1 and what else? Chapter 1: Fel d 1, the major cat allergen. Allergy, Asthma & Clinical Immunology, 14(1), 1-9

Pezzali, J. G., Smith, S. C., & Aldrich, C. G. (2018). An overview of the effect of diet on the allergenicity of cats to susceptible humans. SOJ Vet Sci, 4, 1-9

Ramadour, M., Birnbaum, J., Magalon, C., Lanteaume, A., Charpin, D., & Vervloet, D. (1998). Cat sex differences in major allergen production (Fel d 1). Journal of allergy and clinical immunology, 101(2), 282-284

Satyaraj, E., Gardner, C., Filipi, I., Cramer, K., & Sherrill, S. (2019). Reduction of active Fel d1 from cats using an antiFel d1 egg IgY antibody. Immunity, inflammation and disease, 7(2), 68-73

Wedner, J. H., Mantia, T., Satyaraj, E., Gardner, C., Al-Hammadi, N., & Sherrill, S. (2021). Feeding cats egg product with polyclonal-anti-Fel d1 antibodies decreases environmental Fel d1 and allergic response: A proof of concept study. J Allergy Infect Dis, 2(1), 1-8

One disease in particular, myxomatous mitral valve disease (MMVD) is said to account for 75% of heart disease and affects 85% of small dogs over 13 years old. Not all of these will need treatment, but many will. Later I’ll show you how to tell.

There is no question that recent advances have made MMVD much less of a death sentence than it once was. So it’s good to get to know pimobendan, the newest, and most commonly used of these treatments.

How Pimobendan Works

Pimobendan is a drug that unusually has two separate positive effects. First, it increases the strength of contraction of the heart, increasing the amount of blood delivered. Second, it dilates blood vessels in the general circulation, reducing the heart’s workload.

Pimobendan needs to be given at a dose of 0.2–0.3 mg/kg twice a day on an empty stomach, leading to the following inescapable logic. If it needs to be given one hour before any food and 12 hours apart, then even starting with a 7am dose will result in an 8pm dinner time. Now of course, we don’t recommend feeding dogs after dark…

You can picture the disappointment in peoples’ faces when they think this through. It’s definitely a drug for the early risers in the house. The only other alternative is to make their main meal in the morning.

Lifespan Of Dogs On Pimobendan

Early work demonstrated that pimobendan could help dogs with MMVD, but by how much was uncertain, and so vets like me were slow to change treatments that were already working. Then two large international studies appeared. With them came a sea-change in how we viewed this drug.

Each of them has something important to say about both effects and side effects. Both are referenced below.

2008: The QUEST Study

252 dogs with naturally occurring MMVD and congestive heart failure were divided into two groups: one taking pimobendan and another taking benazepril, the leading heart treatment at the time. Both were allowed other treatments as needed. They were then studied over the following years until one of the following three things happened:

1. sudden death
2. euthanasia for cardiac reasons
3. treatment failure

For pimobendan, the median time to this endpoint was 188 days. For benazepril it was 140. So a good result, but far from impressive. However, it’s worth pointing out here that these survival times are artificially short; many dogs in the study had already been affected for some time before beginning.

Real life is better. The point is more that in matched groups, pimobendan outperformed its rival.

2016: The EPIC Study

To my knowledge, the EPIC study was the first in veterinary medicine to be stopped early because of what was found. 354 dogs were chosen who had MMVD but were not yet in heart failure. At this earlier stage they had enlarged hearts as determined by xray and ultrasound.

Up to the time of the study, treatment was not believed to help at this stage, and so they were divided into dogs given pimobendan and dogs given a harmless placebo instead. This time the endpoint was chosen to be one of:

1. development of left-sided heart failure
2. euthanasia for a cardiac reason
3. death presumed to be cardiac in origin

The median time to this endpoint was 1228 days in the pimobendan group and 766 days in the placebo group. In other words, dogs with enlarged hearts but without heart failure had an extra 60% or 462 days of disease-free life if they took pimobendan.

This of course was a stunning result. Once it became obvious, all of the dogs were put on pimobendan.

Pimobendan Side Effects

Similar rates of adverse effects were reported for pimobendan and benazepril. This suggests that the drug is at least as safe as other heart treatments,

Pimobendan also recorded similar side effects to the placebo. Deaths in the pimobendan group were 46.4% versus 57.2% in the placebo group. This suggests that pimobendan is safe compared with any drug.

If you want to take a closer look, I’ve included the reported side effects from both studies in two tables after the references.

Help! Pimobendan Killed My Dog!

What then do we make of online reports of terrible events after dogs took pimobendan? The high rates of death and side effects in the placebo group provide the best clue. These are old dogs with a high risk of illness from any cause.

We humans are notoriously bad at separating causation from correlation. In fact, with any one dog, it’s virtually impossible to decide if a sudden death is caused by a drug or not. It’s only by looking at large groups that we can see the trend. Sometimes it’s real, other times it’s not.

Pimobendan may in fact cause deaths in some dogs. Even if so, the evidence tells us that they are heavily outweighed by the dogs that survive for longer.

When Should My Dog Take Pimobendan?

Pimobendan is a much better drug at stopping dogs going into heart failure than it is in treating them once they do. So here’s a quick summary of how to use pimobendan in 2022 and beyond:

1. Get regular checkups (at least annually) to look for early signs of heart disease. This is mainly the appearance of a heart murmur.
2. Once a murmur appears, watch fitness, coughing and resting respiratory rate closely and get a checkup at least every 6 months.
3. Follow your vet’s advice on further testing. Sooner rather than later they will want to do chest xrays and possibly cardiac ultrasound to look for the signs of heart enlargement.
4. Even if things are normal, expect things to change and so repeat the tests every 6 to 12 months based on your vet’s advice. Eventually you’re likely to spot the right time to start pimobendan.
5. Once started, most heart disease will stabilise but dose adjustments and extra medications will still be necessary as the disease slowly worsens (hopefully over years, not months). Therefore, keep attending scheduled checkups and get advice straight away if anything changes.

Most importantly, trust the science. It’s very hard to judge the efficacy of any treatment used to prevent a disease instead of treat it, but we actually have a lot to go on here.

Related: A Dog With Dilated Cardiomyopathy (also treated with pimobendan) caused by a grain-free diet

Update: Mitral Valve Repair

I hesitate to add this as I fear giving dog owners false hope, but several comments below have spurred me to also discuss the surgical option. As of 2023, there are now several centres around the world that offer open heart surgery to improve mitral valve function. It is not replacement of the valve, but instead modifying its shape or adding support so that the leak is less significant.

Costs are extreme (I would guess $40-50K) and availability currently limited to the UK, France, Japan and the USA. If you Google ‘dog mitral valve repair’ you should find useful information from these sites. There is no doubt that this procedure will become more commonplace with time, and hopefully more realistic.

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.

References

Boswood, A., Häggström, J., Gordon, S. G., Wess, G., Stepien, R. L., Oyama, M. A., … & Watson, P. (2016). Effect of pimobendan in dogs with preclinical myxomatous mitral valve disease and cardiomegaly: the EPIC study—a randomized clinical trial. Journal of Veterinary Internal Medicine 30,(6), 1765-1779. Full Article.

Häggström, J., Boswood, A., O’grady, M., Jöns, O., Smith, S., Swift, S., … & DiFruscia, R. (2008). Effect of pimobendan or benazepril hydrochloride on survival times in dogs with congestive heart failure caused by naturally occurring myxomatous mitral valve disease: the QUEST study. Journal of Veterinary Internal Medicine, 22(5), 1124-1135. Full Article.

Keene, B. W., Atkins, C. E., Bonagura, J. D., Fox, P. R., Häggström, J., Fuentes, V. L., … & Uechi, M. (2019). ACVIM consensus guidelines for the diagnosis and treatment of myxomatous mitral valve disease in dogs. Journal of veterinary internal medicine, 33(3), 1127-1140. Full Article.

Here I’m going to lead you through the evidence and end with advice on how to use fish oil most effectively.

Skip the next section unless you’re really interested!

Fish Oil Essential Facts

First, what exactly is fish oil, and how might it work?

Almost all the fatty acids available to land animals like dogs (and us) are omega-6. The body uses these to make arachidonic acid and from this to make various inflammatory molecules.

When the body uses an omega-3 instead of omega-6, the end result can be anti-inflammatory instead. It’s not that omega-3 is the more natural; in fact, the body in arthritis is promoting inflammation, not suppressing it. What we are doing by supplying omega-3 at high doses is ‘tricking’ the body into using it instead.

In dogs, the effective omega-3 fatty acids are eicosapentaenoic and docosahexaenoic acid (EPA & DHA). Linseed and flaxseed oils contain ALA, which is almost unavailable to dogs. EPA and DHA mostly come from certain fish, but certainly not all of them. Feeding fish without dietary analysis is very unlikely to give the same benefit.

Fish Oil & Omega 3 Dog Studies

Now to the evidence. I’ve read all the studies using fish oil in arthritic dogs that included a control group. The control group is fed a dummy diet or supplement so that the owner placebo effect can also be measured and removed.

In fact in nearly all of these studies the placebo group improved as well. It’s the difference we’re interested in. I have one concern though: fish oil is very hard to hide due to its smell!

Fish Oil As A Supplement

The first study comes from Finland³. They gave dogs with arthritis 110 mg of DHA/EPA per kilogram body weight. This gave a final dietary ratio of omega 6 : omega 3 as 11 : 1 and would equate to roughly 7 regular strength 1g capsules for a 20kg dog.

No differences in measured performance were found. The only differences were that owners were more likely to see improvement, and more likely to guess correctly when their dog had the treatment diet rather than the control.

The results of this study suggest that, if done this way, the benefit of feeding an omega 3 fish oil supplement to dogs with osteoarthritis is small. 

Purina Fish Oil Therapeutic Diet

The second paper⁴ evaluates a veterinary therapeutic diet marketed to alleviate the signs of arthritis. This diet contained 1.08% DHA/EPA with a ratio of omega 6 to omega 3 as 1.3 : 1.

In this study, there were no differences between the treatment and control groups either in measured performance or owner assessment. As the authors stated, “the present study cannot convincingly claim that VTD [= veterinary treatment diet] improved the limb function to a greater extent than a regular diet”

Interestingly, both groups improved substantially. This is almost certainly due to the study design: owners were asked to avoid any intense activities (jumping, running, throwing ball or Frisbee, etc.) during the study duration. Which just goes to show how important it is to stop high-impact activity in these dogs.

Hills Fish Oil Therapeutic Diet

Finally we have the Hills product called JD or j/d. My clients will know I recommend this, and now I hope you will see why. However, I also want you to see that the effect is still not very dramatic.

Hills Prescription Diet j/d has 3.5% DHA/EPA, with a ratio of omega 6 to omega 3 as 0.73 for the kibble and 0.68 for the canned form. Note this is the first time you have seen a diet with more 3 than 6.

There are four studies, and I’ll quickly summarise them:

• Dogs on j/d were able to have greater reductions in anti-inflammatory doses than dogs on control foods. Average final doses of carprofen were 3.5mg/kg vs 3.85mg/kg respectively¹.
• During initial investigations, a difference for lameness and weight bearing were noted between dogs on food A (0.8% omega 3) and those on food C (similar to the final product)². 
• Using floor pressure plates to measure leg use, dogs on j/d increased their peak vertical force by 5.6% at 90 days⁵.
• In a home feeding trial, owners of dogs fed j/d reported improvement in their dogs’ ability to rise from rest and play at week 6 and the ability to walk at weeks 12 and 24 after the feeding trial began⁶.

In all cases, improvements were found, but not huge ones. Each study also included many factors that did not show any change.

How Fish Oil Can Be Toxic To Dogs

Here are some of the ways fish oil could be harmful to certain dogs:

• Dogs prone to pancreatitis should not be fed diets with normal to elevated levels of fats and oils. Therefore, fish oil could cause severe illness or even death in these dogs.
• Dogs with fish-based food allergies could also react severely to fish oil.
• Even normal dogs can have unexpected gastrointestinal upsets when fed fish oil. These are usually mild vomiting or diarrhoea, and will stop if you cease giving fish oil.

What about the fact that the therapeutic diets are grain-based? As you’ll see here, vets advise against grain-free diets.

Can You Use Human Fish Oil Capsules?

A common question is whether you can use pharmacy fish oil to treat dogs. This is true for skin disease, but false for arthritis. The reason for this is that the food manufacturers, through mysterious means, reduce the levels of omega 6 before adding omega 3. It’s also just that fish oil incorporated in the diet is a lot easier to give!

As you can see from the doses above, it would be nearly impossible to achieve either a sufficient dose or an acceptable 6:3 ratio by adding fish oil to an existing diet. Such a dose would probably also be toxic.

Fish Oil Dosage Calculator

The main drawback of j/d is its price. If you find it too costly, then here is a quick formula for the maximum fish oil dose you can give. Using a scientific calculator (also my smartphone calculator if I turn it sideways), raise your dog’s body weight to the power of 0.75 and multiply by 370. As a rough idea, for a 20kg dog the answer would be 3500mg.

Now look at the fish oil jar to see how many milligrams (mg) of combined DHA and EPA each gram contains. For fish oil containing 300mg per gram, the final fish oil dose equals 3500 divided by 300, or eleven grams. Bear in mind that this will still fall short of ideal doses but it should do something.

As I hope you’ve gathered by now, whichever way you use it fish oil can be helpful, but it’s very unlikely to do enough on its own. The treatment of canine osteoarthritis is multimodal, meaning we come at it from multiple angles. So click here to see the other recommended treatments for arthritis.

And a final disclaimer: I sell Hills j/d so I can easily be accused of bias. To this I say: if I didn’t think it worked, I wouldn’t sell it or choose it for my own dogs! And in fact, you can now see why, when I can’t get j/d, I won’t sell you anything else to replace it.

Sources

1. Fritsch, D. A., Allen, T. A., Dodd, C. E., Jewell, D. E., Sixby, K. A., Leventhal, P. S., … & Hahn, K. A. (2010). A multicenter study of the effect of dietary supplementation with fish oil omega-3 fatty acids on carprofen dosage in dogs with osteoarthritis. Journal of the American Veterinary Medical Association, 236(5), 535-539
2. Fritsch, D., Allen, T. A., Dodd, C. E., Jewell, D. E., Sixby, K. A., Leventhal, P. S., & Hahn, K. A. (2010). Dose‐titration effects of fish oil in osteoarthritic dogs. Journal of veterinary internal medicine, 24(5), 1020-1026
3. Hielm-Björkman, A., Roine, J., Elo, K., Lappalainen, A., Junnila, J., & Laitinen-Vapaavuori, O. (2012). An un-commissioned randomized, placebo-controlled double-blind study to test the effect of deep sea fish oil as a pain reliever for dogs suffering from canine OA. BMC veterinary research, 8(1), 1-14
4. Moreau, M., Troncy, E., Del Castillo, J. R. E., Bedard, C., Gauvin, D., & Lussier, B. (2013). Effects of feeding a high omega‐3 fatty acids diet in dogs with naturally occurring osteoarthritis. Journal of animal physiology and animal nutrition, 97(5), 830-837
5. Roush, J. K., Cross, A. R., Renberg, W. C., Dodd, C. E., Sixby, K. A., Fritsch, D. A., … & Hahn, K. A. (2010). Evaluation of the effects of dietary supplementation with fish oil omega-3 fatty acids on weight bearing in dogs with osteoarthritis. Journal of the American Veterinary Medical Association, 236(1), 67-73
6. Roush, J. K., Dodd, C. E., Fritsch, D. A., Allen, T. A., Jewell, D. E., Schoenherr, W. D., … & Hahn, K. A. (2010). Multicenter veterinary practice assessment of the effects of omega-3 fatty acids on osteoarthritis in dogs. Journal of the American Veterinary Medical Association, 236(1), 59-66

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By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

1. Made a police report against a former client
2. Complained to the Pharmacy Council of New South Wales

It was pure luck that we found out about the fraud, and it’s taught us all a valuable lesson: that the online pet pharmacy system is not fit for purpose. It must change.

As the friendly policeman said later, he could understand her actions because the temptation was put in her path. The real problem is that it was so easy.

Here’s what happened.

The Chronic Skin Issue & Its Cure

I saw a dog back in 2020 for a second opinion on a long-term skin problem. We get a lot of these at Walkerville, and they’re always hard work. With this one I got lucky.

It turned out that the dog responded beautifully to Apoquel®, which hadn’t been tried before because of the cost. But once the owner saw the response, she knew it was worth it.

After the second visit, she asked for a script, which was fair enough. We charge $292.50 for 100 x 16mg tablets and you can get it online for $253.90 plus our script fee of $19.70.

Online vs In-House Scripts

What’s going on here is that vets normally prescribe medications from their own in-house pharmacies. Sometimes however, the owner will request a written prescription they can take away to be filled elsewhere. These days this is typically done online.

For convenience reasons, this owner actually kept getting the drug from us despite having a script. After all, the cost wasn’t that much different. The script seemed to start being used when we said we needed to see her dog again before we could supply more.

Pet Meds & The Law

You see, vets legally and morally must have animals ‘under their care’ in order to prescribe safely. The commonly accepted timeframe between checks is 6 months on stable medications. At this time we will ask for a recheck appointment costing around $60.

It sounds logical but you would not believe how often this is a source of conflict. In the current case, it seems that by the time the dog’s owner wanted to use the script, it was past 6 months. So she simply wrote over the date with a new date!

I’ve seen the fake and let’s just say that it was a pretty weak forgery. Passing a doctored prescription is completely against the law of course. But the temptation to do so is combined with a system more holey than Swiss cheese.

It’s Too Easy To Fake It

Once I found out the pharmacy had been supplying drugs without a valid prescription I assumed that they were also breaking the law. How wrong I was. It turns out that (in NSW at least) what they did was totally fine.

Before COVID, the pharmacy was supposed to get the original signed hard copy that the client had been supplied. Since that time, they are totally within their rights to supply the drug based solely on an electronic copy. Which can be changed by anyone with any smartphone.

The way it is, it’s too easy for Schedule 4 prescription drugs to be supplied without any regard for the consequences. In the internet age of self-diagnosis, this is extremely worrying.

It gets worse if a client tries to buy the drug from overseas. We saw one of our patients go blind after the owner bought counterfeit cyclosporin from Singapore. Of course, she was told it was the real thing, only cheaper.

How Often Does It Happen?

I would dearly love to go through the records of one of these pharmacies and see just what percentage of their prescriptions have physical proof of validity. This is a crazy system. Imagine going to your local pharmacy with just an email and getting a prescription filled.

If you can, it’s wrong.

What Must Change In Pet Scripts

I remain happy to support online scripts, just not ones that lead to:

• my signature being shopped around on forged documents
• pets being medicated without any veterinary oversight

From now on, we will only handle the electronic and hard copies ourselves. To do this, we will need to nominate just one pharmacy and send all scripts there. There will be a modest increase in costs but the result is peace of mind.

Another alternative would be for the industry to get together and make a secure online system not open to fraud. And I’m keen to hear the industry view in the comments below. But I’m not going through this again.

Related: Why 6 Monthly Prescription Checks Matter

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.

Most of the techniques and products mentioned can also be used in cats.

How To Clean Dog Ears At Home

I stand by my methods although they aren’t exactly the same as you’ll read elsewhere. Clean ears in a place where you don’t mind the cleaner and wax being flicked all over, including the ceiling!

Step 1: Look For Signs Of Infection

Ear cleaning is likely to do more harm than good if your dog is showing any of the following signs:

• Head shaking or ear scratching
• A head tilt or holding the ear down
• An ear odour that’s different from elsewhere on their body
• Redness or swelling around the ear opening

If one or more of these is present, please get a checkup before putting anything in the ear.

Step 2: Choose The Right Product

There is a wide variety of ear cleaning products available. Choosing the right one should be based on your dog’s needs and your vet’s advice.

In my experience:

• Acidic cleaners are best suited for the prevention of recurrent yeast infections
• Otoflush works best for recurrent bacterial infection
• PAW and Sonotix work best for excessive wax buildup.
• as for Ear Canker Drops, I still haven’t found a use where there isn’t a much better product

Click here for an evidence-based review of international ear cleaners.

Step 3: Apply A Trial Amount

Ear canals are long, narrow and crooked, so you can never be sure you haven’t missed a deep infection. Therefore start by inserting a trial amount.

Place only five drops of ear cleaner in each ear, give a treat, and step back to observe. Your dog or cat will shake it out in a few seconds and then go about their regular business.

If they keep scratching at the ear or show any signs of discomfort, do not proceed further. See your vet immediately.

Step 4: Apply The Full Amount

Now pour the cleaner into one ear canal until it begins to overflow. You’ll probably use 3-5mL to do so. The whole time, use a second person if available to give treats and prevent head shaking.

Ear cleaner is better tolerated if it is at body temperature, so a pro tip is to carry it in your pocket for 30 minutes before use.

Step 5: Massage The Ear Canal

To massage the cleaner in effectively, you need to know dog ear anatomy. The ear canal goes almost vertically down for half its length, before turning in towards the midline.

Therefore, feel for the tubular shape of the canal running down the side of the head below the opening. It feels like silicon rubber and you can gently grasp it between finger and thumb.

Squeeze and ‘milk’ the canal in a downwards motion. You should hear a satisfying squelching sound, and your dog should like it, not hate it. Again, if it causes discomfort, stop and see a vet.

Step 6: Rinse And Repeat

Holding the head to prevent shaking, slide your hands around to the other side of the head. You’re trying to let the first ear soak for as long as possible. Therefore, it’s good to reverse the order the next time you do it.

Now repeat steps 4 and 5 in the second ear. Afterwards, I like to continue holding and patting a dog’s head for a few minutes, all the while telling them how good they are. Once again, this is to allow it to soak in a little.

Step 7: Shake!

The only reasons you may not allow shaking is if you’re somewhere you don’t want mess, or if the dog has ear flap injuries. Otherwise, step back and let your dog rip.

They should have a good shake, take a break and then shake again. This expels more debris than trying to drain the ears using cotton wool.

Step 8: Dry Off The Excess

To finish, pat (never rub) the ear canal and ear flap with dry clean cloth or tissues. Do not put cotton buds (Q tips) in the ear canal, ever. A small amount of cleaner left behind should be OK.

You can very gently wipe extra wax from the outer folds. Use a make-up remover soaked in the ear cleaner, but please be careful; ear skin is very fragile.

In dogs with very hairy ears, you may need to apply a drying agent, but please only do this with your vet’s advice.

How Often To Clean Dog Ears

Many dogs do not need their ears cleaned. For those that do, once a week seems best. The frequency can then be adjusted in conversation with your vet.

Many vets recommend the use of ear cleaners before ointment during the treatment of otitis externa (ear infections). This would therefore be once or twice a day. I do not find this often to be necessary, but there are certainly times that I also recommend this.

It’s also important to bear in mind that excessive wax buildup may have an underlying cause that needs its own treatment. The best example is atopic dermatitis, but ear mites are a very common cause as well, especially in young dogs.

Lastly, keep an eye on the expiration date and quality of your cleaner. Even within the date, once they are opened they may degrade. This is especially true if you apply the drops by touching the nozzle to the ear or you leave it in a warm place.

I always unscrew the cap and look inside before use. If I see cloudiness or floaters, I throw it out and get a new one.

That’s it! These seven steps will altogether take you about five minutes once you get into the swing of it. Ear cleaning can be a regular weekly task without any inconvenience or discomfort if you do it right.

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.

Unfortunately, it’s mostly based on products found in the UK and USA, but we can still use it to make some general rules for Australian dogs.

I can find three recent papers, two of which compare a number of products. Their results are summarised in the table below.

Paper 1 used the cleaner in dogs themselves, so is potentially more valid than paper 2 where they looked at activity in the lab at different dilutions. For paper 2, a cleaner that still works at a 1/32 dilution is better than one that stops at 1/16 or 1/2.

Only the first two are available in Australia, but we have other products not found on this list.

The Best Ear Cleaners In Australia

A further paper³ compares Epi-Otic Advanced with the cleaner found in Australia (Epi-Otic). Note that both were equally uncomfortable in 38% of dogs, which is why I don’t use acidic cleaners when infection is present. Pleasingly, however, it found that there is very little difference in efficacy.

This is gratifying as I feel that Epi-Otic is very good for the prevention of yeast infections.

I use PAW Gentle Cleaner primarily for wax accumulation without infection.

Note that Epi-Otic’s main weakness is its activity against Staph. And in fact, you can see a good demonstration of this here. For these infections in Australia, I have used Otoflush.

Until doing this comparison I did not realise I could also buy CleanAural in Australia. I found it being sold at a local supplier, then used it for 1 month only to find it was discontinued and I could no longer get it! Back to Otoflush for me.

The four ear cleaners in bold are pictured above.

How To Clean Ears At Home Naturally

What about these commonly recommended ear cleaners?

• alcohol
• olive oil
• hibiscrub (chlorhexidine)
• vinegar
• hydrogen peroxide

None of these are likely to work well, especially in the presence of infection. All are also likely to cause damage to hearing if the ear drum is ruptured. Some could be very painful.

I have included a recipe for an apple cider vinegar ear flush here, but I honestly would not use it unless no other options are possible. As you can see from the table above, pH is not the only factor in the efficacy of ear cleaners.

Now you’ve chosen your cleaner, all you need now is to know how to use it! So next, read my seven quick and easy steps to clean your dog’s ears.

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.

Sources

1. Mason, C. L., Steen, S. I., Paterson, S., & Cripps, P. J. (2013). Study to assess in vitro antimicrobial activity of nine ear cleaners against 50 Malassezia pachydermatis isolates. Veterinary dermatology, 24(3), 362-e81.
2. Swinney, A., Fazakerley, J., McEwan, N., & Nuttall, T. (2008). Comparative in vitro antimicrobial efficacy of commercial ear cleaners. Veterinary dermatology, 19(6), 373-379.
3. Rème, C. A., Pin, D., Collinot, C., Cadiergues, M. C., Joyce, J. A., & Fontaine, J. (2006). The efficacy of an antiseptic and microbial anti-adhesive ear cleanser in dogs with otitis externa. Veterinary Therapeutics, 7(1), 15.

Fast asleep he may appear, but as soon as a door or window opens, up comes his periscope head. If you aren’t quick enough, or the lock doesn’t click, he’s gone. Next thing, the whole family is out with torches (not the flaming kind but it feels that way) until he’s found and returned.

We do this because outdoor cats run a high risk of road trauma, fight abscesses and FIV infection. But sometimes he’s impossible to find. So I’ve always been interested in smart tech to help me, and recently I invested in an AirTag.

However, it may not be the best option.

Cat Tracking Options

Here’s a summary of the cat trackers available in Australia and their pros and cons. Please note that microchips do not have any tracking ability and must be actively scanned by a hand-held reader.

GPS Cat Trackers

These are devices that use satellites to fix your cat’s position to within metres. The signal is then usually sent back to your phone via a sim card and mobile phone connection. Therefore you need to make sure that anything you buy will work in the country where you live.

Pros are:

• Work anywhere there’s mobile reception
• The only reliable way to get real time information

Cons are:

• Require an ongoing subscription to pay for mobile telephony
• Relatively expensive (from $100)
• The heaviest option (from 30g)
• Require frequent recharging (every 5 days or so)

Bluetooth Trackers e.g Tile & BlaqWolf

These trackers use a downloadable app and the bluetooth signal on your smartphone to locate your pet. The tracker is located in one of two ways:

1. If it’s within bluetooth range, by using the app on your phone
2. When someone else with the app comes within range

Pros are:

• Lightweight and can be attached to collars in most cases
• Less expensive
• Good battery life (around a year)

Cons are:

• Limited range but probably more than AirTag
• Once the cat is out of your bluetooth range, you are relying on other users of the same system to be near it

Apple AirTag

Apple’s tracker also uses bluetooth. It shares the same pros and cons as Tile and other bluetooth trackers, with one important exception: there are many more users. When marked as ‘lost’ it is picked up by iPhones within range using the Find My feature and a signal is sent back to your phone.

AirTag can be used with non-Apple phones as well. An iPhone user who finds it can also tap it to reveal contact information.

Here are my personal experiences:

• Its bluetooth range seems very short; inside the house I only get around 10 metres before it is unfindable, or 20 metres outside.
• It weighs 18g including holder which is probably heavier than Tile but seems well tolerated (more on this later)
• I left it on a park walking track and received a message about every 10 minutes with its location but this will depend on the number of passers by
• In real life many notifications will be out of date by the time you receive them as your cat will have moved
• It does not work when in motion; your cat needs to have stopped to be located
• It only pairs to one Apple ID (this is a key difference with app-based Bluetooth trackers); other devices can use the FindMy feature as long as they are logged in as you
• It uses a CR2032 button battery, which are extremely toxic if swallowed (this hazard would mainly apply to dogs)
• The shiny side gets very dirty (or do I just have a dirty cat?)

Update 2 Months Later…

My cat has escaped once. The AirTag pinged off a neighbour’s phone. However, until I marked him as ‘lost’ the notifications were only if I opened and checked the FindMy app.

He didn’t ping again and waltzed back home an hour later. The AirTag didn’t help find him but did confirm that he had escaped. So a partial success.

An Apple update since release means that AirTags now beep at a random time between eight and 24 hours when separated from an iPhone. This is to prevent them being used for stalking, but it has the unintended consequence of your cat beeping unexpectedly.

How much this bothers them I cannot say but I would definitely warn anyone who looks after your cat while you are away, especially cattery owners.

Apple are also releasing an Android app later in 2021 so that the tags can be detected by non-iPhone users.

AirTag Cat Collar Attachment

I bought the ‘Belkin Secure Holder with Keyring for AirTag’ for $20. The supplied keyring is too big so I replaced it with a small one and it hangs well at my cat’s neck without too much swinging.

The holder can be written on but writing tends to rub off. I plan to lightly engrave the plastic with my phone number and address instead. I’m avoiding engraving the AirTag itself until it’s out of warranty (Apple offer free engraving but only four characters or emojis).

I have seen special cat collars with inserts for AirTag available online but have no idea how secure or comfortable they are.

Is The AirTag Worth Buying For Cats?

Although the AirTag is not designed for tracking cats and has many serious flaws, it is inexpensive and well-tolerated. As long as people understand what it cannot do, its great advantage is being detectable by the large number of iPhone users in your suburb.

If your cat goes outside regularly, and you want to know where they go, a GPS tracker would be a much better option. As a backup system for an indoor cat, my view is that it’s a worthwhile investment.

But my golly, how grateful will I be for your views (in the comments below) if you use any trackers!

Disclaimer: I’m no tech-head and could have made some basic errors so please don’t rely solely on this information! Perhaps I should stick to my day job instead…

Now read: Why Slamming The Door On Cats Is A Bad Idea

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By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. Meet his team here.

Ear cleaning can be a great way to improve the health of your dog’s ears but it can also cause a lot of harm. Therefore, it’s important to know if it’s the right treatment for your dog.

Here I’m going to help you recognise when ear cleaning is beneficial & when it’s harmful. Everything I say here also applies to cats.

In two weeks I’ll talk about how to do it and what to use.

When To Clean A Dog’s Ears

Probably less than 10% of dogs need their ears cleaned regularly. Therefore, it is not advisable to start cleaning a dog’s ears unless your vet recommends it.

Just like with toenails, new dog owners are often told that ears need regular maintenance. This is untrue. Both areas just need to be kept an eye on in the majority of dogs.

What Is The Brown Stuff In My Dog’s Ears Anyway?

The brown material seen around the ear opening is called cerumen, or just wax. In the normal ear it is transported up the canal until it reaches the outside. Therefore, a small amount just in the folds is perfectly fine if the ear is odourless and not inflamed.

A dog who may benefit from ear cleaning is one who suffers from frequent buildup of waxy material deeper in the ear canal. Certain breeds like Dachshunds are known for this, and removing it regularly via gentle cleaning at home can prevent ear infections.

To see it, shine a head torch or bright penlight straight down the vertical part of the ear canal. Brown material seen down here is abnormal. However, here’s why you shouldn’t clean it out without getting advice first…

3 Reasons Cleaning Can Make An Ear Worse

The picture at the start shows a view down my microscope after the wrong dog’s ears were cleaned. The little purple dots are bacteria, almost certainly Staphylococcus. This dog had a mild ear problem before the wash, and a severe one shortly afterwards.

I don’t blame the owner at all. In fact, if you look at the bottle she used, it actually says to use it for ‘otitis externa’ and smelly ears. This is an incredibly bad idea.

So the first reason cleaning can be bad is if the infection is bacterial, not fungal. Most ear cleaners only treat yeast (pictured here) and seem to make bacterial ones worse by adding excess moisture.

The second reason ear cleaning is harmful is when the ear is sore. Nearly all antifungal ear cleaners on the market are very painful when applied to raw tissues. It’s a lot like putting vinegar on a wound or rash.

We see a lot of head shyness in dogs who have had infections treated using cleaners. These dogs have been hurt with ear treatments and are losing their trust in people. It makes future treatment very much harder to the extent that some can only be successfully treated under sedation.

The third reason ear cleaning is harmful is when the ear drum is ruptured. Most cleaning solutions will cause nerve damage and balance problems if they enter the middle ear. I have seen this done several times. It usually occurs after a prolonged ear infection, but it can happen quickly in unlucky dogs.

When Not To Clean Ears At Home

If your dog is showing any of the following signs, please get a checkup before putting anything in the ear:

• Head shaking or ear scratching
• A head tilt or holding the ear down
• An ear odour that’s different from elsewhere on their body
• Redness or swelling around the ear opening

Almost certainly, your dog will have an ear infection or grass seed needing veterinary attention first. Afterwards, cleaning may be helpful to help prevent future infections but it’s almost certainly too late for this one.

Even for non-smelly ears with a bit of cerumen only, I would get a checkup just to be sure. Dogs are masters at hiding pain so you never know what’s lurking in the horizontal canal.

A single checkup first could save a lot of bother later.

You Might Also like: Why Dogs Get Ear Infections | How To Treat Ear Infections

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.