Heathfield Vets aim to provide a highly professional, caring, supportive, understanding and friendly environment for you and all your animals. All our staff are highly trained and we are committed to constantly attain the highest standards of care. 
 
Newsflash... 
Emergencies outside surgery hours 24/7  
Please Call:  
01435 864422 
Client Events - see below for upcoming FREE events 
 
Our Free Arthritis Evening was held on Monday the 14th of November 2011 and was a great success. Please see below for information from the evening. 
ARTHRITIS ADVICE 
 
Obviously arthritis is a topic which many pet owners find of interest as there was a good turn out for our recent practice meeting. This is hardly surprising, given that most of us, as well as our pets, are likely to experience this problem in later life but it was made clear that younger age groups can also be affected, either as a result of family tendencies, birth defects such as hip dysplasia or due to injury. 
 
A series of speakers gave an excellent overview of arthritis - predisposing causes, underlying pathology, diagnosis, and, most importantly, prevention and treatment. 
 
The evening began with a power point presentation about the basic structure of synovial joints - for example, those in the limbs. This was followed by an explanation of how joints become arthritic, starting with compromised or damaged cartilage causing loss of shock absorbency, which leads to grating of bone against bone (crepitus). This worsens as reduced production of synovial fluid decreases lubrication. These two factors cause inflammation and discomfort followed by stiffness and decreased range of movement as the body attempts to control the pain by producing new bone and fusing the joint. As the surrounding muscles begin to atrophy, there is less support to the affected joint, so it becomes more vulnerable to further damage. Overall, a cumulative process leading to a permanently damaged joint, but via many stages which might be circumvented or ameliorated. 
 
This naturally led on to ways we can help including: 
 
Recognizing signs of arthritis 
Reduced appetite 
Aggression or depression due to chronic pain 
Frequent yelping or whimpering 
Becoming less sociable/hiding 
Lying on the floor rather than jumping onto chair/sofa 
Reluctance to walk or play 
Difficulty standing up or climbing stairs 
Sensitive to touch on the back or legs 
Stiffness, limping or lagging behind 
Limitation of movement 
Constant licking of painful joints 
 
Nutrition 
It is important to maintain optimum weight to reduce excess stress on damaged joints. As exercise may need to be modified, reduced calorie diets are the best way of decreasing weight if needed. 
As the basic cause of arthritis is defective/damaged cartilage then it is helpful to include elements which decrease breakdown and/or encourage production of healthy cartilage. This can be in the form of modified food or as a supplement. 
 
 
Exercise 
Each animal needs an individualised plan to encourage healthy activity and maintain suppleness and muscle strength whilst minimising further damage. Consider several shorter walks spread over the day rather than one intense bout of exercise which might lead to stiffness. 
Hydrotherapy helps with these aims; the warm water supports the body and encourages increased joint movement, whilst avoiding the concussion caused by any ground based exercise yet provides good resistance to help increase muscle strength. 
 
Management changes 
Think carefully about ways of helping your pet deal with the challenges of daily life eg. preventing access to stairs or providing steps, ramps. 
 
Reducing pain/inflammation 
Cartilage supplements (see nutrition) also help relieve inflammation and pain in joints 
Acupuncture not only stimulates the release of endorphins (the body’s natural feel good hormones) but also blocks the ability of the central nervous system to feel pain 
Non-steroidal anti-inflammatory drugs (NSAIDs) are potent pain killers as well as reducing inflammation. However, they need to be used with care and require regular monitoring 
 
 
Cats 
Cats are a special case - it is estimated that at least 90% of cats over the age of 12 years are adversely affected by arthritis due to their athletic lifestyle, but often this is not recognised - partly because the are naturally stoical but also because the changes they show are more subtle than in dogs. They rarely limp as often multiple joints are affected and so the lameness is disguised 
Look for reduced activity - hunting, playing, jumping - especially down as the elbows are frequently affected 
Overgrown claws due to reduced activity 
Problems using the cat flap 
Increased resting time - not necessarily asleep but spending more time in one place 
Missing the litter tray - inability to negotiate the high sides or get into the appropriate position 
Unkempt coat - difficulty reaching round to groom 
Constant licking of affected, painful joints 
Signs of pain - ears back, tense expression; resentment of petting or grooming; hissing at other cats. Depression due to chronic pain 
 
Management changes 
Provide soft beds for sore joints in easily accessible, quiet places 
Place beds in quiet, draft free areas of the house 
Igloo beds or cardboard boxes can make an older cat feel warm and secure 
Provide 'steps' up to higher sites, eg, the sofa, the cat flap 
Tie the cat flap open so the cat doesn’t need to push through 
Always have a litter tray inside and use a low sided version or cut out the sides to make it easy for arthritic cats to climb in 
Use different types of litter that are softer for sore feet 
Make sure food and water are easily accessible, at floor level or with steps up to higher levels 
Put food, water and litter trays on one level to avoid the cat having to go up and down stairs 
Radiator beds are popular but again arthritic cats will need help to get into them, other warming devices such as wheat bags can help but electrical devices should be used only when the cat is monitored 
Arthritic cats may need extra grooming and help cleaning eyes and perineal region 
Overgrown claws need regular cutting 
 
If you suspect your pet may be suffering from the effects of arthritis, please ask for advice – a lot can be done to improve quality of life 
An example of good hips 
An example of a dog with hip dysplasia of its right hip (on left as you view the xray). Notice how the hip 'ball' is not sitting in the socket.  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Our Free Firework Evening was held on Thursday the 21st of July and was a great success. Please see below for information from the evening.  
 
FIREWORKS ADVICE 
 
Ways we can help 
We are always happy to see you and your pet and discuss which course of action might be of most benefit. 
 
Fear is a perfectly normal emotion which helps individuals deal with dangerous situations – either by attacking or by running and hiding (fight or flight). However, when placed in a situation where neither of these reactions is possible, or where the response is inappropriate, the ensuing panic attack may lead to injury to your pet as well as damage to your property. 
 
Many cats and dogs are afraid of loud and sudden noises and in some individuals the fear becomes extreme leading to: 
 
•Shaking 
•Salivation 
•Howling, barking or hissing 
•Loss of bowel and bladder control 
•Destructiveness 
•Hiding or running away 
 
These reactions may become more marked the longer the noise continues and often continue long after the noise has stopped. If you ignore this problem, it is likely to worsen with repeated exposure (unless your pet becomes deaf with increasing age). This is because the fear itself is an unpleasant experience. Animals can also lear to associate the scary noise with other things and the fear can generalise e.g. to cars/ rain, so older animals left untreated can develop ‘life’ phobia! 
Anti-anxiety remedies 
Pheromones 
 
Dog Appeasing Pheromone (DAP or recently renamed Adaptyl) mimics the scent given off by a bitch when she is feeding puppies, providing a sense of reassurance and well being. It can be used to provide comfort in a stressful situation, helping to reduce vocalisation, house soiling and destructiveness. Clinical trials have shown an 80% decrease in panting, trembling, cowering and crying when used to help fear of fireworks. It is available as a plug in diffuser, a spray or as a collar. 
 
Feliway is the equivalent product for cats, based on the scent given off when a cat claims its territory by chinning or cheek rubbing against familiar objects (or you!). It is available as a plug in diffuser or spray. 
 
Neither of these products have any sedative effects, so can safely be used for allaying fear in any circumstances. Not only can they be used alone or in combination with other remedies for fear of fireworks but they can also be used for added support during desensitisation and counter conditioning.  
 
 
 
Herbal remedies 
Scullcap and Valerian tablets/Valerian compound liquid: 
 
Scullcap is a gentle herbal remedy useful for treating anxiety, nervousness, excitability and noise phobias. It does not cause drowsiness or impair normal behaviour, so in addition to being used for allaying firework fears, it can help reduce stress and improve concentration during a desensitisation programme. 
 
Dose: Dogs and cats 1-2 tablets\5kg twice daily with the second dose being given 2 hours before dusk 
Valerian compound acts within 30 minutes and is useful as a rapid top up for previous doses of Skullcap and Valerian tablets or on its own when it is difficult to administer tablets. It can be added to food or given directly by mouth and in fractious cats can be dripped onto a paw (and licked off) or onto bedding (for inhalation). 
 
Dose: 
Cats: 0.25 teaspoonful orally and/or a few drops on bedding. Give less to very thin cats 
 
Dogs: Small breeds 0.25 teaspoonful by mouth 
Medium breeds 0.5 teaspoonful by mouth 
Large breeds 1 teaspoonful by mouth 
Giant breeds 1.5 teaspoonful by mouth 
 
If you know that your pet has suffered with severe firework stress in the past, then begin treatment up to 3 weeks prior to the firework season. In milder cases start 1 week beforehand. When the fireworks are at their worst, it is quite safe to give a double dose. Treatment can be continued for as long as necessary, until all risk of sudden bangs has passed. 
 
Note: Although safe in most animals, herbal treatments should not be used during pregnancy or lactation. 
 
• Zylkene 
 
Zylkene helps to manage stress in many common situations in cats and dogs. It can also help your pet to adapt to change. It is a palatable product and is easy to give with food. 
 
Zylkene can be used for both short-term stress e.g. kennel or cattery stay, fireworks or long term e.g. for multi cat households. 
 
Zylkene short term should be started 1-2 days before the fireworks are anticipated. It can be continued throughout the firework period and then stopped. 
 
Zylkene long term can be used in pets undergoing sound desensitisation as feeling more relaxed can help learning. 
 
Dose: 
Cats 75mg up to 5kg 1 capsule a day 
Small dogs 75mg Between 5 and 10kg 2 capsules a day 
Medium dogs 225mg Between 10 and 20kg 1 capsule a day 
Large dogs 450mg Between 20 and 40kg 1 capsule a day 
450mg Over 40kg 2 capsules a day 
 
Homeopathy 
 
There are several homeopathic remedies which can have remarkable effects on noise phobias. Please speak to Janet Nuttall if you are interested. 
• Bach rescue remedy/flower remedies 
Although not available from the surgery, you might like to investigate this option at your local health food store 
 
Avoid sedatives – this may seem an obvious solution but will often exacerbate the problem next time. Not only do sedatives increase sensitivity to noise, but also by leading to drowsiness and incoordination, your pet has no control of the situation so leading to increased fear. 
 
Sedatives also decrease the learning ability and will have a negative impact on any remedial training you are trying. 
The best treatment is a combination of behavioural training and anti-anxiety products. 
 
Desensitisation\counter conditioning 
The best approach to this problem is to change the dog’s perception of the noises using the behavioural modification techniques of desensitisation and counter-conditioning. The details of how to do this should be provided with the sound recording CDs that are commercially available, but the quality of the instructions varies considerably between products. It is therefore important to look for a CD that has comprehensive and easy to follow instructions. Research has shown that those products with clear instructions are associated with better results. Even when you purchase a quality CD you may need professional help structuring your programme for your individual dog and you should not be afraid to ask for further assistance. Training will normally take a few weeks so you do need to be patient. 
 
There is no doubt that these methods are the most effective and long lasting at easing the symptoms associated with noise phobias. However, it is not a quick fix – depending on the individual patient it may take weeks to months of dedicated work on the part of the owner, with periodic refresher sessions to maintain the good effect. 
 
Try not to play the CD at the same time of day or in exactly the same position at each session. Place the speakers near windows or doors or, if practical, have the pet indoors and the sound coming from outdoors – try to mimic reality as far as possible. 
 
Once you have completed desensitisation it is important to proceed onto counter conditioning. This involves playing the CD at low volume but giving a treat or starting play when the formerly frightening noise is heard. As soon as the treat is eaten or you stop the game, the CD is turned off. Repeat over several sessions until your pet starts to look excited as soon as the sound is heard. Further work at slowly increasing volumes will reinforce the association between the noise and a treat. The aim is to replicate the reaction you see when your pet hears the fridge door being opened or the biscuit bag rustling. 
 
When is the best time to start treatment? 
Treatment is likely to be more successful if your dog is not exposed to the real sound stimulus during the behavioural modification programme. It is therefore best to start treatment at a time of year when the problem noises, such as fireworks or thunderstorms, are unlikely to be encountered. 
 
How do I carry out a desensitisation and counter-conditioning programme? 
• First you need to identify an area in which your dog can relax. Use somewhere that is otherwise quiet in the house and away from large windows etc. It should not be the place that your dog currently runs to when it is scared, as this will have unpleasant associations. It may be useful to use a Dog Appeasing Pheromone (DAP or recently renamed to Adaptyl) diffuser to help your dog to relax. This should be plugged in for a few days before you start the treatment programme within the area that you have identified as your dog’s den. It should remain on for the whole duration of the training programme and possibly during the first stressful season. Refills for the diffusers are available and last 4-6 weeks. 
• During the first stage of treatment it is important for your dog to be relaxed and it may therefore help to take him for a good walk or play and exercise session before you plan to start the treatment. 
• It can also help to train your dog to sit and relax on command as you can then get your dog to relax when you are ready to start the treatment. 
• Once your dog is obviously relaxed either spontaneously, or through command, you are ready to begin the treatment process. 
 
How do I organise desensitisation? 
It is important to start off with a noise recording at a volume that does not elicit any distress. The starting sound is likely to be below audible levels for humans since dog hearing is considerably more sensitive than our own. It is therefore important to start with the CD player at zero volume and use the movement of your dog’s ear flap as the sign that the sound has become detectable by your dog. Ideally you want the ear flap to just move when your dog hears the sound and if he goes on to lift his head then you have increased the volume too far. 
 
When your dog’s ear flap begins to move you should leave the volume of the CD at that level until the ear is stationary again. You can then increase the volume until ear flap movement begins again and repeat this process over and over again. 
 
How long should a training session be? 
It is important that you do not persist with the exposure for too long as you run the risk that something will distract your dog and cause him to come out of the relaxed state. It is important you always end a session on a positive note with a clear association between the sound and the state of relaxation. It is therefore better to train little and often rather than try to achieve too much in one session. 
 
When do I restart training? 
This depends very much on the individual dog and your own circumstances. It can be as short a time as an hour or as long as the next day. It is important, however, not to leave too long a gap between training sessions. 
 
What happens in the new session? 
The new session is started with the level of noise that was reached at the end of the previous session but this is then increased slightly. You need to bear in mind that it is important not to go beyond the point when your dog may notice the sound and react with anything more significant than movement of the ear flap. If your dog exhibits any behaviour, such as lifting the head or attempting to leave the room, it is important to go back several steps and start with the noise at a much lower volume. 
 
Keep repeating the process, increasing the volume only slightly at a rate your dog can cope with. The aim is to reach the stage where your dog continues to lie in a relaxed state with his ears stationary even when the CD is playing at a reasonable volume. There is no need to increase the volume to excessive levels since the aim of desensitisation is simply to associate a relaxed and neutral emotional state with the presence of the previously feared sound stimulus. 
 
What does counter conditioning involve? 
The second phase of the treatment process involves forming a positive emotional association with the sounds. 
 
In order to achieve this the CD is played during activities that your dog finds pleasurable, such as eating and playing. You should wait until your dog is engaged in a pleasurable activity and then start the CD at zero volume. Gradually increase the volume until your dog shows the slightest sign that it has heard the noise. Keep the noise at this volume until your dog is no longer responding in any way and then gradually increase the volume again. You do not want your dog to stop its activity or to show any signs of a negative response to the sound and if this happens you have increased the volume too quickly and will need to go back a stage. The aim is for the noise to play in the background while your dog engages in a pleasurable activity so that the emotional state induced by the game or the eating is paired with the presence of the sound. 
 
How long will this training programme take? 
The programme will typically take a few weeks but it can take longer than that to reach full volume. Do not be tempted to rush things, especially during the first phase of desensitisation, as it is very important to have a good foundation of relaxation association before starting on the counter conditioning. Eventually your dog should remain relaxed in the presence of normal intensity noises and then he is ready to form positive associations with the sounds. Once you have reached this point it is important to reinforce the positive response to the sounds on an occasional basis. 
 
How often do I have to do this revision programme? 
Initially, it is worth repeating the programme at least once a week until you reach the first firework or thunder season. Assuming your dog copes well during this period you should just repeat the latter part of the exercise (the counter conditioning) every 4-6 months. Do not expect your dog to remember everything until the next big party! 
 
What happens if I haven’t managed to get my dog trained in time? 
This is not an uncommon problem and we have an additional fact sheet that gives advice as to how to manage your dog’s fear or phobia during an unavoidable period of exposure to the problem noises. 
 
 
What to do on the night of expected fireworks 
You may find the following hints useful: 
• Never show any reaction to fireworks yourself. If you get cross, your pet becomes even more frightened. If you soothe your pet and give special attention, you not only reinforce the feeling that there is something nasty happening, but also inadvertently reward the fearful behaviour. Instead, give the impression of being jolly and unconcerned and only give rewards (food treats or a game) once he/she has begun to relax. 
 
• If there is another (unaffected) pet in the household, start a game – the frightened one may be tempted to join in. Use toys and chews as distractions. 
 
• Dogs and cats have very sensitive hearing, sight and sense of smell. You can help mask the noises by playing reasonably loud music with a rhythmic beat, minimize the flashes by drawing thick curtains and leaving the indoor lights on and disguise the gunpowder smell by using a room spray or burning joss sticks. 
 
• Prepare a safe haven where your pet can hide – somewhere relatively soundproof with few windows. For a dog prepare a den in a corner– either a nest of old blankets with an old unwashed jumper to provide reassurance or an upturned box with a carpet flap for entry and suitable bedding. Cats often feel safer when up high – prepare a box or little nest on a high shelf. Make sure that the door to the room is propped open so that your pet can access the area whenever scared but does not feel trapped. A couple of weeks beforehand start encouraging your pet to use the area by feeding treats there several times daily. At the same time install a pheromone diffuser as close to the area as possible and leave it switched on – this will provide a calming influence. Further details on DAP for dogs and Feliway for cats can be found below. 
 
• Ensure that your pet is secure at all times to prevent escape and bolting, whether indoors or outdoors. For dogs this means using a safe collar/harness and lead and exercising well before and after the peak firework time. Cats should have access to a litter tray and the catflap locked before it gets dark. Everyone in the household should be aware of the need to keep doors, windows and gates securely closed. Each November the animal shelters report a huge increase in the number of lost, unidentified and unclaimed pets. Consider having yours microchipped now so that if he\she panics and escapes, you can be reunited as soon as possible. 
 
• Use a high carbohydrate diet to decrease anxiety – feed a meal including cooked wholemeal pasta, mashed potato or stodgy rice, preferably in the late afternoon. Add Brewers yeast to increase the vitamin B6 level. 
 
What should I do if I don’t appear to be making any progress? 
If you seem to be having any problems, consult your veterinary practice for further advice or help. It is not uncommon for owners to need professional help to resolve this problem. Sometimes sound sensitivity may be associated with both medical and more general psychological problems which will need to be assessed. If your dog also suffers from problems when he is left alone, it is best to seek professional advice from the outset. Also if you are concerned at the intensity of your dog’s problem, seek professional advice as drug therapy to help during the behavioural therapy may be required. However, drugs will not cure your dog, they are merely an aid to the treatment that can safeguard his welfare. 
 
 
Contacts 
If you have any further questions or problems, please contact the surgery on 01435 864422 or Natalie Lagstrom from Naturally Pets on 0800 328 3256. 
 
Heathfield Vets would like to thank Naturally Pets for sponsoring and attending this evening. 
This client education handout is based on material written by Daniel Mills BVSc PhD ILTM CBiol MIBiol CCAB 
DipECVBM-CA MRCVS RCVS Recognised Specialist in Veterinary Behavioural Medicine, Sarah Heath BVSc DipECVBM-CA CCAB MRCVS European Veterinary Specialist in Behavioural Medicine (Companion Animals) and Helen Zulch BVSc MRCVS 
Used with permission under licence. ©Lifelearn, The Penguin House, Castle Riggs, Dunfermline FY11 8SG. 
Registered Address: Chimneys, Hailsham Road, Heathfield, East Sussex, TN21 8AD,UK 
Tel: 01435 864422  
Registered in England. Registered Number 5204826. VAT Registered number 192374644