Kingsnorth Vets – 20th November 2013

In the kennels today was a hedgehog which had been found by an owner when their dog attacked it. Luckily, it was not injured and was eating well. Apart from removing a couple of ticks and giving it a quick check over, nothing else had needed to be done so the case was going to be handed over to the RSPCA.

Today was the day of kidney failure; also in the kennels was a very skinny, old cat with weepy eyes being given pain relief on a drip because it had kidney failure, a dog was put down because of a number of issues including appalling teeth and kidney failure, a dog with kidney disease (they hadn’t failed yet) was on a drip, constantly whining and in discomfort. It had instructions to be fed only white fish or its own food, this is because, in order to stabilise kidney disease, one of the most important measure to take is diet management to relieve the kidneys of as much work as possible, reducing the build up of waste material.

Furthermore, during one of the consults I observed, a 12 year old collie was brought it by the kennels it was staying at as its owners were on holiday. It was receiving its normal medication for bladder incontinence but had begun having severe diarrhoea whilst at the kennels. It was not eating and smelt awful. After being taken out to the back, bloods were taken and analysed in the onsite lab. The results showed ion imbalance in the dog’s blood. The low iron levels indicated that it was currently anaemic whilst the overview suggested probable kidney failure. It was put on a drip and given pain relief and anti inflammatory drugs for there was very little else that could be done.

Kidney disease can be caused by a number of problems including infection, diabetes, long-term high blood pressure or kidney stones. Kidney disease often does very little harm, but sometimes it can escalate into kidney failure. This is defined as occurring when the kidneys function at less than 30% of their normal level. When the kidneys are functioning so poorly, the concentration of urea in the body and the levels of water and ions become imbalanced. The build up of toxins in the blood can cause coma or heart attack and will almost always be fatal. In humans, kidney failure can be treated using haemodialysis where the ion concentrations are restored outside of the body in a dialyser. However, when appropriate to do so for a better long-term treatment, the patient will undergo a kidney transplant. At the moment, neither of these methods are available for veterinary use in the UK.

A rabbit was brought in to have its claws clipped. I was staggered at the length of them, especially because the owner said that she frequently let the rabbit run on her patio. However, this made no difference to their length as would be expected because the claws were growing in the wrong direction. This meant that the owner would need to ensure that they were clipped as often as necessary to prevent them becoming uncomfortable.

A cat was brought in for its vaccination. Its brother has a heart murmur so the vet also took this opportunity to listen very carefully to this cat’s heart for any signs of heart problems. A heart murmur occurs when a valve in the heart is damaged so when the muscles contract, there is some backflow of blood. The place in which the murmur occurs is dependent on the valve which is damaged. This can become a problem if there is not a great enough volume of blood being pumped under high enough pressure out of the body for cells will not receive sufficient oxygen to aerobically respire. Luckily, this cat only had slight signs of heart murmur so it was rated grade one. The vet explained to me afterwards how murmurs are placed in categories and graded based on their intensity. This ranges from grade 1 – ‘A quiet murmur that can be heard only after careful auscultation over a localised area’ – to grade 6 – ‘A murmur sufficiently loud that it can be heard with the stethoscope raised just off the chest surface.’

An overweight dog was brought in needing nutritional advice for, despite the vet suggesting dietary plans, the dog had lost no weight. The vet suggested a number of options including specially designed ‘obese’ diets, however, the only fool proof way to improve the dog’s weight loss would be to reduce the amount of food that it was being given and encourage more exercise. Portions of food can be reduced slowly so that the dog doesn’t notice and when done gradually, the dog should not become hungry quickly.

A dog was brought in with diarrhoea. The vet asked very carefully about the appearance of the faeces. The owner reported that there was blood and mucus, however the blood was only in streaks. This suggested that it was not a big problem and probably just an upset stomach from something that had been eaten. The vet prescribed anti inflammatories to help settle the swollen stomach and bowels and instructed that the dog should only be fed bland food such as white fish and rice. The vet explained to me that if there had been lots of blood in the diarrhoea, this would present a different, much more serious problem, probably caused by infection. Therefore, antibiotics would be given. There was a chance that this case was the beginning of an infection and could escalate but the vet hoped that it was not. If the diarrhoea did not cease and the blood became more severe, the owner would have to visit again for the situation to be reassessed.

The final appointment of today was a border terrier with an ulcer on its eye. Previously, the ulcer had covered almost the whole eye but after applying fluorescein,  the green dye highlighted a much smaller area, showing that the eye was healing quickly as expected. When the dog had been brought in initially, the eye had to be locally anaesthetised because of the extremely sensitive cornea and very strong muscles in the eyelid which could not be opened. However, after being prescribed eye drops, the dog looked much happier and in very little pain with no anaesthetic required. The vet explained that the dog would have to continue to be brought in to be checked until the eye had fully healed. This is because the ulcer could develop rough edges. This would be a problem because healing happens from the outside inwards, with cells building up and over the wound, burying the damaged cells. Therefore, rough edges on the ulcer would halt the progress of the cells for they would be unable to climb across the ulcer. If this was shown by the fluorescein the vet would smooth the edges of the ulcer with a cotton bud. After the consult, the vet told me more about fluorescein and how if there was a darker patch in the centre of the green highlighted ulcer, this would suggest that the damage penetrated deeper into the eye. This would be a serious problem and would be referred to a specialist.

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