Month: August 2018

Pyometra (‘pyo’ or womb infection)

Pyometra is a common disease in un-neutered female dogs that requires major surgery to cure. Though potentially very serious, many animals respond well to the treatment and can expect to make a full recovery. The best way to protect your female pet against pyometra is to have her neutered.

Pyo = pus, infection; metra = womb or uterus. Pyometra is a serious infection of the womb resulting in the accumulation of infective fluid (pus) within the cavity of this organ. It is usually seen in older, female dogs who have not been neutered.

Pyometra may be classified as open or closed. In open pyometra, a common sign is a discharge from the vagina. This discharge may be bloody or yellow or cream coloured. In closed pyometra, no discharge to the exterior occurs.

If the pus does not drain out though the vagina, your dog may become very sick and develop toxaemia (blood poisoning). The presence of this poison in the body has serious effects on other body organs and systems and can lead to life-threatening conditions such as kidney failure. Untreated, pyometra can cause death from dehydration, toxaemia and kidney failure.

A less common problem, stump pyometra, occurs in females who have been spayed (neutered), but in which a small remnant of womb remains within the body and becomes infected. Because only a small amount of womb is present, signs tend to be less severe, but this condition also needs treated to prevent complications.

Each time a female has a season (usually about twice a year) she undergoes all the hormonal changes associated with pregnancy – whether she is pregnant or not. The changes in the womb that occur with each cycle make infection more likely with age. Infection is usually caused by a very common organism called E. coli. The disease often occurs in the weeks or months following a heat or season period. Injections with some hormones to stop seasons or for treatment of other conditions can also increase the risk of pyometra developing.

Pyometra is obviously only seen in females (since males do not have a womb). It is more common in older females (above 6 years of age). The signs usually develop around 6 weeks after the female has finished bleeding from her last season.

Early signs of pyometra may not be very obvious. You might notice that your pet is just licking her back end more than usual. She may be off colour and off her food. Often she will be very thirsty and because she is drinking so much may start to wet in the house. Sometimes the pus escapes from the womb and a reddish-brown or yellow discharge may be seen at the vulva. As she gets more ill she may start to vomit, become very depressed and unwilling to get out of her bed.

Symptoms are likely to worsen over a period of days to several weeks. If untreated signs progress to dehydration, collapse and death from toxic shock.

Your vet will probably suspect what is wrong with your pet from your description of the symptoms although they may want to do some other tests to confirm the diagnosis and also to make sure that your pet is well enough to withstand an operation.

Blood tests may be taken to see if the toxins from the infection have entered the blood and could be affecting organs elsewhere. X-ray and ultrasound examinations may be undertaken to confirm that the uterus is enlarged.

Once the diagnosis has been confirmed your pet should have an operation to remove her womb as soon as possible. This is the same operation as carried out to routinely spay a female dog, however in a sick animal suffering from pyometra it carries much more risk. The risk of not operating is even higher; most animals will die if surgery is not performed. If the womb is not removed, toxins are released from the infection which get into her blood and make her more and more ill. Eventually these toxins can cause kidney failure.

Before performing the operation your vet may want to give your pet some fluids (into her vein) and antibiotic treatment. Surgery might be delayed for 12-24 hours to give your vet time to get your pet into a better condition to tolerate the surgery. She may need to stay in hospital after surgery for continued treatment.

Very occasionally dogs have been treated with special hormone injections to empty the womb without having to perform an operation. However, this treatment is only considered in valuable breeding bitches and is often not successful.

In very old animals with pyometra and clear evidence of organ failure, e.g. kidney and liver failure, or where other major problems such as serious heart disease exist, euthanasia may be the kindest option.

Pyometra is a serious disease and unfortunately a proportion of patients will not pull through despite treatment, owing to organ failure and complications. Overall, many dogs do recover remarkably well and it is certainly well worth pursuing treatment.

If your pet recovers from the operation then there is a good chance she will return to her former health. In fact many owners report that after the operation their dog is better than she had been for a long time before. It may be that the infection had been building up for a long time before the animal became really ill.

The only way to be sure your pet won’t develop this condition is to have her neutered. If you are not intending to have puppies from her then she should be neutered at as young an age as possible. Not only does this remove all the complications associated with the reproductive cycle but, if a female is neutered before her first season, she is also protected against mammary (breast) cancer developing in later life. Ask your vet for details about the best time to have your pet neutered.

Although pyometra may be more common in bitches that are not neutered and have never had puppies, it is not exclusively a disease of these animals. Breeding does not guarantee protection and indiscriminate breeding of pet dogs is not to be encouraged.

Hand-rearing puppies

Fortunately it is very unusual for a mother to be unable to rear her puppies herself. Taking on the task of bringing up a litter of puppies is rightly daunting and it requires considerable dedication for the first 4 weeks. If you are placed in the situation of having to rear puppies by hand you should contact your veterinary practice for advice.

It is uncommon for puppies to need to be totally hand-reared. It is very rare for bitches to be unable to produce sufficient milk, but sadly if the mother has died, is ill, or has abandoned the litter it may be necessary to step in. If a foster mum can be found then this is ideal as the puppies will be brought up naturally. A foster mum could be a bitch having a false pregnancy or one that has lost her own litter or only has a few puppies. If you have a very large litter the mother may be unable to feed all the puppies and supplementary feeding should be carried out although the puppies can be left with their mother at other times.

A note of caution – if a mother is rejecting a particular puppy from a litter there is a good chance that she knows that it’s unhealthy and this is the reason for rejection. Although you can find nothing wrong with it and hand-rearing this puppy may be successful there is a high chance that you will not succeed.

New puppies should be introduced very carefully to a potential foster mother. The foster mum is more likely to accept them if they smell of her. This can be achieved by letting the puppies cuddle up on a piece of bedding that the foster mum has been sleeping on. Do not wash the bedding first as you want the scent to rub onto the puppies. After a short time the foster mum can be introduced. The introduction must be closely supervised to ensure the foster mum accepts the puppies and doesn’t harm them.

There are a number of milk products available which have been correctly formulated to replicate bitch’s milk. Cow’s milk and human milk substitutes are not recommended as the quantity of protein, fat and carbohydrate differ from that in bitch’s milk.

Recommended milk substitutes:

  • Welpi – designed especially for puppies.
  • Pedigree Instant Milk Substitute – designed especially for puppies.
  • Lactol – suitable for puppies but not species specific so the above formulas are preferred.

These formulas are available from your veterinary practice and you should seek advice on their use. It is essential to make up and use formula milk according to the manufacturer’s instructions. Signs of under nutrition include failing to gain weight, crying and inactivity, however over feeding can be just as dangerous. It is important to increase the volume given as the puppies get bigger.

Puppies should increase in bodyweight by 5-10% per day for the first two weeks of life (after the first day – it is normal for them to lose weight in the first day of life). Failure to grow at this rate may indicate underfeeding or ill health. It is helpful to weigh each puppy every day and to keep a growth chart so you can see that all the puppies are growing well. They should be weighed at the same time of day, e.g. just before a certain feed and you certainly need to take into account whether the puppy’s stomach and bladder are full or empty at the time of weighing. Carefully clipping a little fur from a part of the body and carefully recording this may be helpful.

Milk substitute should be made up fresh for each feed and warmed to 38°C / 100.4°F (body temperature) before feeding.

It is very important that you feed puppies very slowly, keeping their heads up to allow them to swallow. If you give milk too fast it might go down the wrong way (into the air passages) which could lead to pneumonia.

If you are trying to save a weak puppy it is safer to feed it using a stomach tube rather than giving milk via the mouth. This should not be attempted by an untrained person and involves passing a suitably sized tube through the mouth, down the throat and into the stomach. Milk is then placed into a syringe and injected down the tube into the stomach. A veterinary nurse will be pleased to show you how to feed the puppies initially.

For the first week of life feed normal puppies using a syringe with a teat attached. Nursing bottles can be purchased in pet shops and through your vets but these are not recommended until the puppy has a good sucking reflex.

Supplying colostrum

Colostrum is a special kind of milk that contains antibodies to protect the puppy during the first few weeks of life. Puppies that have inadequate colostrum are less likely to survive. Colostrum only works if ingested in the first 12 hours after birth. After this time the puppy’s stomach and intestine change so that they digest the antibodies rather than allowing them to be absorbed intact as is necessary. Also, after the first 12 hours, the mother begins to stop producing colostrums and switches over to producing normal milk.

So, if at all posible, try to obtain colostrum and get this into each puppy in its first 12 hours after birth. If this is impossible it can be substituted, to some extent, by a veterinary surgeon injecting the puppy with serum.

New born puppies need to be fed every 2 hours from birth up to 7 days of age. From 8-21 days this can be decreased to every 3 hours. The amount fed should be increased to compensate for this at each feed. At 4 weeks of age feeding every 4 hours is recommended along with the introduction of solid puppy food. Between 5-6 weeks you can slowly decrease the amount of milk provided and increase the amount of solid food as long as all the puppies are feeding well and gaining weight. By 6 weeks the puppies should be fully weaned, being fed entirely on puppy food.

The following equipment is recommended:

  • Syringes –  2ml for puppies.
  • Teats – assorted sizes available depending on the size of neonate.
  • Cotton wool.
  • A room thermometer – those sold for horticulture are suitable.
  • Another thermometer to measure the temperature of the milk prior to feeding is also needed.
  • Scales – it is vital to weigh the puppies accurately each day. The scales will need to weigh accurately to the nearest 5g and ideally to the nearest gram.
  • Sterilising Fluid – e.g. Milton, to keep equipment sterile. Equipment should be sterilised and stored without rinsing, then rinsed thoroughly just prior to use. As well as not being good for the puppy if ingested it may put them off feeding if they can taste it.

New born puppies need to be kept clean and dry. After feeding you should clean their mouths with warm boiled water and cotton wool, drying afterwards. More importantly you need to encourage urination and defaecation. This would normally occur when the dam licks and stimulates their genital areas. You can copy this by rubbing the area with warm, damp cotton wool. This should be carried out every 2-4 hours until 3 weeks of age when they should be able to urinate/defaecate voluntarily.

New born puppies are unable to regulate their own body temperature. They need to be kept in an enclosed controlled environment of approximately 25-30°C / 77-86°F, free from draughts. This can be achieved by thermostatic controls on a radiator, hot water bottles wrapped in towels, heat pads or infra-red lamps.

Heat pads should be designed for animals and be wrapped in towels or paced under vet beds. If used incorrectly they could burn the puppies as they generally reach temperatures of 52°C / 125.6°F. Infra-red lamps should not be placed directly over the neonates and must be at least 5cm away. Place a room thermometer in among the puppies.

Bedding should be soft and warm, eg towels, and needs to be easily washable. Newspaper is suitable to start teaching the puppy house training – again from 3 weeks of age. Soft, warm bedding should still be provided.

Puppies are able to crawl at birth so should be quite mobile although they will be sleeping for a while from the anaesthetic if born by caesarian. Standing occurs from 10 days. By 3 weeks of age puppies should be able to walk around. Puppies are born with their eyes closed. They generally open them between 10 -14 days.

Do puppies need socialising?

Socialisation is very important in all dogs. This period should start from 4 weeks of age in puppies. It is essential that puppies become used to being carefully handled and are acclimatised to everyday noises and situations, e.g. the vacuum cleaner, hairdryer, car and washing machine etc. This enables them to learn that these experiences are nothing to be afraid of.

It is also a good idea for puppies to meet other animals. Ensure that all animals introduced are fully vaccinated and that they will not harm the puppies. Puppies that are hand-reared generally do not have much resistance to disease until they are vaccinated so it is vital that all animals introduced to them are completely fit and well. Puppy socialising classes should be encouraged once fully vaccinated.

Puppies can be vaccinated from around 6 weeks. Early vaccination may be beneficial in hand reared puppies who will not have received appropriate protection from their mother’s milk (inadequate colostrum).

If’ you are at all worried or just require advice then please contact your veterinary practice. New born animals are very fragile and can deteriorate rapidly if their needs are not fully met. After the first day, each puppy should maintain or gain weight each day – contact your veterinary practice if this does not occur.

False pregnancy

Some unneutered female dogs develop changes several months after a season. This is often referred to a ‘false pregnancy’ or ‘pseudopregnancy’. In most animals this is not a serious condition but it can be inconvenient for the owner and disturbing for the animal. Usually the condition resolves without any treatment but if you are not thinking of breeding from your pet then it is worth considering neutering to prevent this condition.

After oestrus (heat or season) in the female dog or cat the same hormonal changes occur whether or not she is pregnant. The phase of the heat cycle after oestrus is called dioestrus. During dioestrus levels of the hormone progesterone rise. In normal females dioestrus ends spontaneously if they are not pregnant. In pregnant females dioestrus ends as the female goes into labour.

All entire females undergo the same hormonal changes whether or not they are pregnant. This means that after oestrus changes occur in the body to support a pregnancy. For 2-3 months hormonal levels are similar to those in pregnant females. It is this part of the heat cycle that can result in a ‘false pregnancy’. ‘False pregnancy’ could be said to occur ‘naturally’ during dioestrus in all females (since they undergo the same hormonal changes whether or not they are pregnant).

At the end of this period (when a pregnant female would be giving birth) progesterone hormone levels drop and this can fool some female into thinking that they have given birth and need to care for their puppies. Sometimes behavioural changes develop and females may ‘adopt’ a cuddly toy and protect it like their young, in others physical changes may also occur including milk production.

Signs of false pregnancy usually develop around 2-3 months after the previous season. It can be very difficult to know whether a female is actually pregnant or is having a false pregnancy. If you are not absolutely sure that your pet could not be pregnant then you should visit your vet and ask them to check her over.

Each affected female will show different signs including:

  • Poor appetite, lethargy and depression
  • Nest building behaviour and ‘adopting’ toys
  • Behavioural changes, including aggression
  • Mammary development and milk production

In some animals the signs are very subtle, in others they can be dramatic. Signs of false pregnancy may develop after the first season and usually get more obvious with each heat cycle.

In the vast majority of cases false pregnancy is not a serious condition and you should not worry too much. Most females remain well throughout. Try to treat your pet the same as normal and don’t encourage her abnormal behaviour. If she shows a preference for a particular toy and tries to guard it, take this away from her for a few weeks. Encourage her to undertake her normal activities and try to distract her from any ‘strange’ behaviour with more interesting activities like play.

If your pet’s mammary glands develop and she starts to produce milk you should probably get her checked over by your vet. In most cases milk production dries up without any treatment but some females lick at themselves and stimulate more milk production. This can be uncomfortable for her and there is the risk of an infection (mastitis) developing.

You should also see your vet if your pet is off her food for more than 24 hours, if she has abnormal discharges from her nipples or vulva or she seems unwell in other ways. These may be the signs of more serious problems developing.

In females who have mild signs treatment may not be needed. In most cases the signs will resolve without any treatment as the hormone levels alter as the cycle continues. However in some cases (particularly where behavioural changes are very marked or a lot of milk is being produced) you may want to try to settle the signs more quickly.

There are a number of drugs that may help to reduce the duration of the signs but these will rarely stop the problems immediately. Many of the drugs used are hormones which may be given to stop milk production or affect hormone levels (cabergoline, bromocriptine, megestrol acetate or testosterone). These drugs can sometimes have significant side-effects and so are only used if signs are causing significant problems, or as a last resort.

The best way to control false pregnancy is to neuter the female. Preventing further seasons will prevent the problem happening again. However, if your pet has suffered from false pregnancy, it is important to let the signs abate before neutering. The operation should not be carried while she is still producing milk as it can then be very difficult to stop this.

Once a female has had a false pregnancy they tend to have recurring false pregnancies at every oestrus and signs may last for many weeks. Drug treatment can help during the false pregnancy, but the best solution is spaying, after the false pregnancy has ended. If your pet has suffered a false pregnancy discuss the options for treatment with your vet.

Eclampsia (puerperal tetany)

Canine eclampsia, also sometimes wrongly called  “milk fever”, is a dangerous condition brought on by low levels of calcium in the blood stream. It is also called hypocalcaemia and puerperal tetany and needs emergency veterinary attention.

Eclampsia is most commonly seen in small or medium-sized bitches a few weeks after whelping. If your dog is in this category you should watch out closely for this condition. It has been shown to be more likely to occur with large litters as the demands on bitches to feed these pups are greatest.

Signs most commonly develop during the first 3 weeks of nursing although it can be seen in the last few weeks of pregnancy and as long as 6 weeks after birth.

The very early signs of eclampsia are easily missed by the owner. These include tiredness and reduced appetite. At a later stage bitches with eclampsia show marked changes such as shivering, restlessness, panting, and incoordination. Some bitches show signs of pain and may rub their face and bite at their feet. They often do not respond to the owner in the usual way. If the disease progresses without treatment bitches may have seizures and very high temperatures of up to 41°C / 106°F. The condition can worsen rapidely (1-2 hours) and immediate help is necessary.

Eclampsia is caused by low blood calcium (hypocalcaemia ). Some bitches are predisposed to develop the condition and their risks can be increased by inappropriate nutrition – “Home made” diets are usually at fault. A common mistake is for owners to add extra meat to the bitch’s diet. This causes a mineral imbalance and can upset the levels of calcium in the blood.

Bitches with large litters are particularly at risk because they are producing more milk – milk contains quite high levels of calcium and when puppies start to take large amounts of milk (10 to 30 days after whelping) the bitch may find it hard to maintain sufficient calcium in her blood. Milk production has priority over the blood stream for calcium!

Eclampsia is a life-threatening condition and your vet will need to start treatment straight away. Intravenous fluids are given to replace calcium and energy levels. It is vital that the bitch is monitored closely during this time and your vet may want to admit her to the hospital for this treatment. In addition to correcting the calcium levels other emergency treatment may include lowering of body temperature with cool baths.

When given intravenous calcium patients generally stabilise within 10-15 minutes and the temperature is reduced to normal via the cool bath.

You need to be aware that bitches that have had one episode of eclampsia are more likely to have recurrent bouts and great care should be taken later in the same whelping and at subsequent pregnancies.

After initial emergency treatment calcium supplementation should be continued (your vet will supply tablets). Supplement the puppies’ intake with a milk replacer as soon as possible to decrease the milk demands on the bitch. Puppies should be weaned as soon as possible.

In future pregnancies you should provide your bitch with a high quality commercial food but don’t over supplement with calcium or unbalanced meat products. Diets should not be supplemented with calcium as this can negatively influence the bitch’s ability to activate calcium when needed.

Cryptorchidism (retained testicles)

When a male puppy is in the womb its testicles are drawn up inside the body. After birth the testicles begin a journey from inside the tummy (abdomen) to the scrotum. Both testicles should have descended to the scrotum by six month of age and be easy to palpate. If testicles do not end up in the scrotum by this age they are said to be ‘retained’. Retained testicles are a relatively common occurrence in male puppies, particularly in certain breeds. If your puppy has retained testicles we will probably recommend an operation to remove them (castration).

If one or both testicles cannot be found in the scrotum by the age of 6 months the dog is considered to be a cryptorchid. Your vet should check for the presence of testicles in the scrotum at the examination at time of first vaccination. If they are not present there by 3 months it is very unlikely they will ever be.

Usually one testicle can be felt in the scrotum but the other has not completed its journey from the abdomen. It may have become stuck anywhere along the way and in many cases your vet will be able to feel the testicle somewhere under the skin. Often the missing testicle is still inside the abdomen and therefore cannot be felt at all.

In most cases cryptorchidism is caused by a defective gene. In order to cause this condition the gene is usually present in both the mother and the father. Since the defective gene may be passed on to future generations animals that are cryptorchid should not be allowed to breed. Breeding should also be avoided from the mother and father of affected animals.

After birth testicles descend into the scrotum because this is colder than the normal body temperature of the animal. If a testicle remains inside the body for many years it is more likely to develop cancer. The cancer of retained testicles is serious and causes significant changes such as hairloss and anaemia (due to excessive hormone production) as well as spreading to other parts of the body.

Another possible serious complication is that of ‘testicular torsion’. If the testicle remains in the abdomen it may become tangled in the ligament that attaches it to the body wall. This can cut off the blood supply to the testicle causing severe abdominal pain. As the testicle is not visible it can be quite difficult to work out what the problem is.

Dogs with both testicles retained are usually sterile (unable to father puppies). Those with one normal testicle can still be fertile, although the quality of their sperm is reduced.

Animals with retained testicles are also more likely to have other genetic defects like umbilical hernias and an abnormal penis.

To avoid future complications dogs with retained testicles should be castrated. Removing retained testicles can be a difficult operation as they may be located anywhere in the abdominal cavity. Sometimes the internal testicle can be detected – usually by ultrasound but often it is too small to be seen clearly. In any case your vet will need to open up your dog’s belly to remove the missing testicles. This should be done before the dog reaches middle-age to reduce the risk of the retained testicle becoming cancerous.

Since the animal is not suitable for breeding (due to the high risk of passing on the condition) both testicles should be removed – even if one is in the scrotum. This is important to prevent possible future confusion. If the puppy is rehomed and only one testicle is found in the scrotum further surgery might be carried out to try to locate the (already removed) other testicle.

Breeding from your dog

A bitch (female dog) can produce 1-2 litters of puppies each year. If you are not intending to let your bitch have puppies then you might consider having her neutered. However, if you do decide to breed from your bitch there are many things to consider to ensure that both mother and puppies are strong and healthy.

A bitch in season will often attract an army of potential suitors from the local dog population and around the time she is most fertile she may become desperate to escape to meet up with them! You will probably want to have some say in her choice and it is essential to keep her securely indoors and walk her on a lead or away from other dogs during this time. There are already many unwanted dogs and puppies, the majority arising from the consequences of such chance matings.

If you have a pedigree dog you will want to find a partner of the same breed so that the puppies are purebred and you should speak to an experienced breeder of your breed well in advance of planning the mating. Information on local breeders can be obtained from the breed club secretary or the Kennel Club web site –

Certain breeds have particular problems when giving birth so it is advisable to speak to an experienced breeder of these breeds before going ahead with a mating. There is a high incidence of some genetic problems in certain breeds and many breeds operate screening schemes to prevent breeding from affected animals. Your dog may have to undergo X-rays, eye examination or other tests at your vets before being mated.

Bitches should not be allowed to have puppies until they are fully grown and are mature themselves. This age will vary from breed to breed and between individuals. The first season may occur between 6 months and 18 months of age but few recommend allowing a bitch to become pregnant at her first season. Most breed societies recommend breeding from bitches that are older than 2 years at the time of birth.

Most bitches develop a pattern of seasons which usually occur with a regular interval between 5 months and 1 year. Seasons usually last around 3 weeks and bitches are most receptive around 10-14 days into the cycle

Bitches are usually mated twice during the receptive period. You can start counting the days of her cycle from when you first see signs of bloody discharge at the vulva. However some bitches have very light discharge and you may easily miss the first few days.

The best way to find the right time of mating is to do some blood tests starting around day 7-9. Bitches produce a hormone called progesterone at the time that they release the eggs (ovulate) to be fertilised and this can be used to time the mating. The tests have to be repeated every 2-3 days to find the right time for mating. If the bitch ovulates between day 12-15, as most of them do, two or three tests should give you the expected result. ‘Late’ bitches can require more testing, but it is worth doing these tests as these bitches would not conceive at the normal time.

There are other signs to look out for like the bitch standing and turning her tail and her discharge changing from bloody to a lighter colour.

The hormonal changes following a bitch’s season follow a very similar pattern whether or not she is pregnant. Therefore many bitches develop a so-called ‘false pregnancy‘ and often show changes in behaviour and may even show mammary development and milk production.

It can be very difficult to be sure your bitch is pregnant merely by feeling her tummy. In the early stages the developing foetuses are very small and easy to miss. If only 1 pup is present it might be difficult to locate even at full term. The best way to confirm that your bitch is pregnant is to ask your vet to perform an ultrasound scan around 2-3 weeks after mating. At this time the scan should also give an indication of roughly how many puppies are present. Of course some of these foetuses may not make it to full term but it provides a good guide to litter size.

There is also a blood test for a hormone called ‘Relaxin’, the pregnancy specific hormone in dogs. This test can be useful if ultrasound is not available.

In the last third of the pregnancy you may want to increase the amount you feed your bitch. However, if she has a large number of puppies (or they are large) the distended womb may fill her belly and make it difficult for her to eat larger meals. It is a good idea to split feeding into 3 smaller meals throughout the day.

Many breeders will switch to feeding the bitch on puppy food in the last trimester, as this has higher energy and protein level as well as more calcium and phosphorus (minerals which are important for the development of healthy bones and teeth).

When your bitch has given birth she will need a secure bed in which to raise the puppies. Prepare this a few weeks before the puppies are due so that the mother can get used to sleeping there and is settled for the birth.

Normal pregnancy in the bitch is 63 days from conception, although smaller dog breeds often have shorter pregnancies. The time from mating to conception can be very variable in the dog and it is possible for conception to occur up to 7 days after mating.

Calculation of the delivery date is best based on results of examination of smears taken from the vagina or hormone tests made before conception. Alternatively ultrasound in the first few weeks of pregnancy may allow ageing of the foetuses.

Lungworms in dogs (Angiostrongylus)

Referring to Angiostrongylus vasorum as a lungworm is quite misleading. Although the early stages of the parasite do affect the lungs and severely infected dogs may show signs of coughing, other signs are far more common. These lungworms (Angiostrongylus vasorum) are also known as the French heartworm.

This is a parasite where the adult worm infects dogs but the young stages are carried by slugs and snails. The parasite itself may not cause the dog any problems unless present in very large numbers. However, in order to survive in the blood vessels the parasite releases substances which affect the clotting of the host’s blood. Thus infected dogs are more prone to bleeding than normal dogs. This bleeding can pose a life-threatening risk to an affected pet. Thus this parasite is can be more dangerous to a dog than the more common worms that live in the intestine and it is very important to take precautions to prevent infection.

This disease used to be confined to dogs living in the South of the country (especially the South East, South West and South Wales). However, in the last ten years the disease has become much more common and has been seen in dogs as far North as Scotland. All dogs in the UK should now be considered potentially at risk.

The adult worms spend most of their lives in the blood vessels close to the heart. However, when the eggs laid by the adults hatch, the immature worms (larvae) force their way through the walls of the blood vessels and into the lungs. The dog then coughs up the larvae and swallows them. The larvae pass into the faeces which is in turn eaten by slugs and snails (which love dog poo!).

The larvae develop in their new host until this is eaten by a dog. Slugs and snails often crawl into dog’s food bowls or onto toys if these are left outside. Dogs also eat these garden pests when drinking from outdoor water sources and eating grass. Once back in the dog the young worms make their way back through the dog’s body to the blood vessels.

Many infected dogs show no signs of illness. Dogs that are unwell show a wide range of symptoms: breathing problems, coughing, bleeding excessively from cuts or bleeding internally with no signs of trauma, anaemia and loss of condition. Other animals may show neurological changes including seizures. If your dog is unwell in any way make an appointment to see your vet.

Not all dogs with lungworm show breathing-associated signs. The adult worms in the blood vessels and heart can cause heart failure but also produce a substance to stop the blood clotting. This can cause your dog to bleed, with or without an injury. The bleeding can take place inside the body and may affect the brain or eyes resulting in seizures or blindness.

It is unlikely that your vet will know straight away what is wrong with your dog and they will need to do a number of tests in most cases to make the diagnosis. If you live in an area where lungworm is common your vet may be more familiar with the disease and may be suspicious of the signs at an earlier stage. If there is a suspicion that your dog is infected your vet can do a test for lungworms.

The infection can’t pass direct from to dog without first passing through a slug or snail. However, if you have several dogs living in the same household and one is found to be infected it is likely that the others will also be at high risk of infection. The common lungworm of dogs (Angiostrongylus vasorum) does not affect cats or people.

The aims of treatment are to eliminate the lungworm infection and also to manage the clinical signs. There are a number of drugs that can be used to eliminate the worms but infected dogs should be monitored carefully when receiving treatment as the sudden killing of the worms could result in a severe allergic reaction.

If your dog has severe signs (particularly affecting the brain or signs of heart failure) your vet will want to keep your pet in the hospital for specialised care.

Most dogs go on to make a full recovery with appropriate treatment. However, infection can prove fatal for some dogs despite intensive treatment.

Most dogs are infected by contact with slugs or snails (and usually from eating these) – so if you can reduce your dog’s exposure to these that will reduce the risk.

Regular treatment of your dog with a product that can kill the worms can help to protect them against infection. The standard worming treatment that you give your pet every 3 months or so may not protect them from lungworm infections. You will need to get additional treatment from your vet and this may be given in the form of a monthly spot-on (at the back of the neck) which will protect against lungworms and treats your dog for other common parasites such as fleasworms, and mites. Contact your own vet for further advice on the risks to your dog and how to manage them.

Laryngeal paralysis

Laryngeal paralysis causes respiratory (breathing) noise and exercise intolerance in medium and large breeds of dogs. The disease is very slowly progressive and may start very subtly, so by the time you notice significant breathing noise or inability to exercise it might be quite far progressed. If you notice these changes in your dog you should seek veterinary advice and have a vet check your dog for possible associated problems or diseases.

The larynx is the voicebox, but it has many other functions than producing sound. All of the functions of the larynx require the vocal cords to open and close. Tensing of the vocal cords during air movement produces sounds. When your dog breathes in, the vocal cords open to allow more air in, the harder the breathing, the more open the larynx is to maximize air flow.

The larynx also stops food and liquids from entering the windpipe (trachea).  During swallowing or vomiting, the vocal cords move together to completely close the opening of the larynx. If any food, water, or irritant reaches the larynx, trachea, or lungs, coughing occurs to force foreign materials out of the larynx or airways.

Just before coughing, a deep breath is taken to completely fill the lungs, and the larynx opens wide to let that large amount of air in. During the cough, the larynx closes partially, making the air move rapidly at a high pressure, pushing out the abnormal material.

Laryngeal paralysis is lack of function of the larynx due to damage or degeneration of the nerve supply to the laryngeal muscles. Loss of the nerve function leads to loss of muscle contraction. The end result is a larynx that cannot open and close normally.

If the vocal cords cannot move out of the larynx, the larynx does not open wide enough to allow maximum airflow. If this happens your dog will not be able to exercise normally and can even progress to episodes of collapse, or passing out.

Laryngeal paralysis is typically a disease of larger breed dogs (such as setters and Labrador retrievers) and some medium breeds (Brittany spaniel). In most cases the nerves degenerate over time as part of a general disease of the nerves. Because the nerves degenerate slowly the signs of disease are not seen until dogs are quite old, usually more than 9 years old.

However some dogs have other diseases that cause laryngeal paralysis and may be affected at less than 1 year of age. In most affected dogs the signs really only affect the larynx but some dogs may have diseases affecting other nerves in the body and these may show signs of regurgitation (inability to swallow food properly) or difficulty in walking.

The first sign of laryngeal paralysis may be a subtle change in bark. Slowly progressing, the condition then results in noisy breathing, especially during panting. The noise is usually much worse during activity, when maximal air flow is required. Since the vocal cords cannot move, they sit in the airway and vibrate as the air flows by, resulting in the noise that we call “stridor.”

If the condition progresses, your dog may not be able to move sufficient air through the larynx panting (in hot weather) or during exercise, resulting in a blue tinge to the tongue and lips. In hot weather your dog may be at risk of developing heat stroke as efficient panting is the dog’s main cooling mechanism. The worst clinical signs are those of collapse, passing out, and potentially death.

Your vet will listen to your dog’s breathing and can recognise the stridor, or noise, as being more prominent during inhalation, or when you dog breathes in. They will also carefully listen to the lungs in an attempt to diagnose aspiration pneumonia. Other conditions can also cause coughing and exercise intolerance, such as heart disease, so listening to the chest with a stethoscope is very important.

An ultrasound machine can be used to look at the vocal cords during breathing but the best way to diagnose laryngeal paralysis is to look directly at the larynx. In order for your vet to do this your dog will need to have a very mild general anaesthetic so that your dog will allow the vet to look into your dog’s throat.

Although it is uncommon to find an underlying cause for laryngeal paralysis your dog should be tested for the conditions that can cause laryngeal paralysis. If one is missed, the condition could lead to more signs in the rest of the body, such as the regurgitation or difficulty walking. Since the larynx cannot close to protect against aspiration pneumonia, chest X rays are important. They also allow the heart size and shape to be evaluated for potential heart disease that could cause coughing and exercise intolerance.

Your dog’s general health should be assessed prior to general anaesthesia required for laryngeal examination, so blood and urine samples are usually tested. If your vet has any concerns about other specific diseases they may want to perform other tests.

Once nerve and muscle function are lost they cannot be recovered. If the laryngeal paralysis results in a decreased quality of life, a surgery can be done to permanently tack one side of the larynx in an open position and allow better airflow past the vocal cords. A vet with experience with this type of procedure should be able to perform the surgery with minimal difficulty. Your vet may want to refer your dog to a specialist surgeon for the operation.

Laryngeal paralysis is a slow, progressive disease. You may not notice early changes, as you are with your dog every day and mild changes are hard to recognise. Changing your dog’s activity level and keeping them in a cool environment may help and your dog may be more comfortable wearing a harness rather than a collar.

If the condition is affecting your dog’s quality of life, you can consider surgery. Surgery may never be done or can be done early in the course of the disease. The most important thing is to know what you and your dog like to do for a happy quality of life and to know the potential outcomes after surgery.

The strict answer to this question is no because laryngeal function cannot be restored. The surgery restores the ability of air to move past the larynx, relieving the problem of obstruction of air flow. Thus, most dogs have less noisy breathing, can be more active, and are at a reduced risk of overheating. You should notice an immediate improvement in your dog’s ability to exercise, but do not let them overdo it early on!

For an experienced vet the surgery is rapid and relatively straightforward. After surgery you must keep your dog quiet for a couple of weeks to ensure that healing has occurred. If the stitches break during this period then the vocal cords will flop back into the larynx.

After surgery one vocal cord is always in an open position, so the ability to protect the airways and lungs is permanently lost. Your dog may cough or clear its throat more frequently, especially when eating, drinking, or exercising because material may contact the larynx and first part of the trachea.

Your dog will always be at risk of developing aspiration pneumonia after surgery. Some dogs never get it, some get it once and respond to treatment, some get it repeatedly, and rarely a dog dies of aspiration pneumonia. Early detection and treatment are key to minimising the affect of aspiration pneumonia.

Coupage for dogs

If you think your pet has a respiratory condition that might benefit from coupage, seek advice as soon as possible from your veterinary surgeon or veterinary physiotherapist.

Coupage is a form of chest physiotherapy that when performed correctly can be beneficial in loosening and removing excess secretions from the lungs. Many respiratory conditions result in an accumulation of secretions (also called mucous, phlegm, sputum) within the lungs that the patient cannot easily clear. This can result in difficulty breathing, poor gas exchange, collapse of lung segments and infection.

The lungs naturally produce mucous as part of their natural defence mechanism. When there is a chest infection, and occasionally with other conditions, the mucous increases and becomes thick and sticky. In the normal situation, these secretions are removed by coughing, but if the animal has lung disease or weakness, this is not always possible. The use of antibiotics can control any infection but they do not remove the secretions. Some will be absorbed naturally into the body but some will remain within the lungs.

Excess secretions provide a good environment for infection to develop as well as causing breathing difficulties. They block the airways and prevent the passage of oxygen from the inspired air to the blood stream, so having a detrimental effect on gas exchange. It is important therefore to remove the secretions to allow more effective and efficient breathing and increase the amount of oxygen getting into the body.

It is certainly possible for you to perform coupage on your pet as long as you have received training from an appropriately qualified veterinary professional. Coupage is a specialised technique. However, veterinary professionals will be adequately trained to perform it. In particular, chartered physiotherapists will have undergone extensive training in all chest physiotherapy techniques.

In many cases, coupage is more effective when used in combination with other techniques such as postural drainage and vibrations, and if appropriate you will also be advised about these.

  • Hands should be formed into a ‘cup’ shape (with your fingers and thumb held closely together).
  • Keeping your wrists loose you should flex and extend them whilst you gently pat your pet’s chest wall in a rhythmical manner. Your hands should pat the chest alternately, moving around the area being treated. Do not use too much force when performing this technique as the momentum developed in your wrists is sufficient, and too much force can be uncomfortable and may be detrimental to your pet.
  • The coupage technique sends shock waves to the lungs which loosen the secretions and allow their transfer from the small airways to the larger airways where they can be cleared by coughing.
  • Coupage can be performed using a one-handed or two handed technique and at a slow or fast speed, but you should be taught the correct technique for your pet by your veterinary professional.
  • The technique should be performed through a sheet or thin towel to prevent too much stimulation to the skin. If your pet is small you can perform the same technique with 2 or 3 fingers from one hand.
  • In most cases, coupage should be continued for 30 seconds to one minute. You should perform the technique continually during the advised time period.
  • The hands are positioned on the chest wall over the affected part of the lung, and the chest is vibrated. During each vibration the hands gradually move towards the head end.
  • Vibrations are only carried out whilst your pet is breathing out (during the expiration phase), so each vibration lasts for approximately 3-6 seconds.
  • Generally 4-6 repetitions are carried out before allowing the animal a short rest period and then resuming coupage.

Postural drainage involves getting your pet into the best position to allow secretions to drain from the affected part of the lung. There are positions appropriate to all parts of the lung, and if appropriate you will be taught the postions that should be adopted for your pet.

When the techniques of coupage, vibrations and postural drainage are used in combination, the optimal chest physiotherapy regime is as follows:

Your pet should be positioned in its postural drainage position for 10-20 minutes, during which time the following should be carried out as in the example below:

  • Coupage for 30 seconds to 1 minute
  • Vibrations for 4-6 expirations
  • Rest period of 1-2 minutes to allow drainage of the now loosened secretions
  • Repeat several times over the 10-20 minute period*

*The number of repetitions, times, etc. will be determined by your veterinary professional (treatment is individual for the patient).

Coupage dislodges the secretions, vibrations move them towards the large airways, and the postural drainage position then allows the secretions to drain during the rest periods. Your pet may cough during its treatment, thereby clearing some of the mucous from its airways. It is common however for animals not to cough during treatment, but to cough 15-20 minutes later once they are walking around. Sometimes the secretions are swallowed rather than being coughed up, but at least they are out of the lungs.

Chest physiotherapy should never be done straight after a meal or drink, and you should wait at least one hour before starting the treatment.

Chest physiotherapy treatment involving coupage, vibrations and postural drainage should only be carried out when excessive secretions are known to be present. This may be once a day or it may be 4-5 times a day, but you will be advised on this. It is often more beneficial to do it after periods of rest (e.g. first thing in the morning) when the animal has been relaxing and the secretions have been draining naturally.

Performing these techniques on animals that have no secretions can be detrimental to that animal’s overall condition. Your pet should therefore be reassessed regularly during the treatment period, so you can receive updated guidance from your veterinary professional as to the appropriateness of continuing this therapy.

Coughing in dogs

It is not uncommon for dogs to cough occasionally. However, if your pet is coughing frequently or has persistent episodes of coughing then you should seek veterinary advice. There are many causes of coughing and many of these can be treated successfully. Some dogs occasionally cough when they get excited or pull on their lead. Many causes of coughing if left untreated, can progress over time causing severe consequences for your pet. If your dog develops a constant cough, an intermittent cough that does not get better after 2 weeks or becomes at all unwell then you should make an appointment to see your vet.

The trachea (also known as the wind pipe) is a tube that runs from the throat down into the chest where it branches to form the major airways in the lungs. The normal trachea is a soft tube that is held open by numerous rigid rings of cartilage. Coughing is the result of irritation or inflammation of the sensitive lining of any part or the airways or the lungs, and is an important protective mechanism allowing the removal of foreign material and mucus from the airway.

In young animals coughing is more likely to be caused by an infection, as a result of the dog inhaling a foreign body (such as a grass awn) or irritation due to smoke or other irritants. Some dogs have a congenital problem with their trachea which can allow the trachea to collapse and obstruct their airway so that they cough every time they get excited or pull on their lead. Brachycephalic dogs (those with short noses like pugs) may have long term respiratory problems that cause persistent or intermittent coughing.

In older animals other causes of coughing, such as heart disease and tumours, become more common. However, chronic bronchitis and other long term diseases reflecting damage to the respiratory tract over a lifetime can also develop in later life. A cough associated with chronic airway disease may be persistent but not get worse and your pet may remain bright and well otherwise.

Older dogs may also develop damage to the nerve controlling the vocal cords and these can obstruct their airway causing coughing particularly after eating, drinking or swimming if food and liquids pass into the airways instead of the oesophagus (the food pipe or gullet).

If your dog is coughing it is really important to get your vet to check them over to identify any possible causes that require treatment or to reassure you that nothing more serious is going on.

Some dogs with a cough may be completely normal in other respects, but this depends entirely on the underlying cause of the cough. In a young, otherwise healthy dog, kennel cough (infectious tracheobronchitis) is the most likely cause of cough. This usually gets better without treatment in 1 to 2 weeks but if coughing is persisting beyond this time or your pet is unwell you should seek veterinary advice. If you are taking your dog to the vet and think there is any possibility your dog may have kennel cough then it is advisable to leave you dog in the car until the vet has examined your dog, rather than risking potentially passing it to other dogs in the waiting room.

Dogs with pneumonia may have a fever, be off their food and feel pretty miserable. Nasal discharge may be present and this can be clear or snotty. Dogs with heart disease or lung problems may also have breathing problems and be unable to exercise normally. If laryngeal paralysis is present the changes to the vocal cords can cause changes in the tone of a dog’s bark (generally sounding hoarse), and exercise intolerance with some dogs developing blueness of the membranes (cyanosis) in their mouth or even collapse after exercise.

When presented with a coughing dog your vet will first want to establish some information which may help then localise which part of the respiratory tract is affected. Questioning you about the nature of the cough (whether it is dry or moist, intermittent or always present) will provide valuable information so it is important you think about the circumstances in which your dog coughs before you attend the veterinary visit. If you are able to take a video clip of your dog coughing on your mobile phone this may help your vet further. Your vet will want to examine your pet and look for any other signs of illness such as fever which may give a clue as to the cause of the cough. By listening to your dog’s chest with a stethoscope your vet will be able to assess heart and lung health. There are many diseases that can cause chronic coughing and your vet will want to rule out the more serious causes of coughing before a final diagnosis is made.

Investigation of coughing involves X-rays of the trachea and the chest and your vet may want to pass an endoscope (a small tube with a camera on the end) through the trachea and down into the lungs to take some samples; these are usually washes to look for inflammatory or cancerous cells, and to provide material for culture.

The treatment of coughing varies greatly depending on the cause. In some cases, if the cough is not too severe, no treatment may be necessary. Medical treatment may be available for coughing related to heart disease and infectious causes of cough. Rarely, if more sinister disease such as cancer is present, other treatment options willbe considered. It is important not to administer human cough medicine to your dog without veterinary advice.