Coming soon: dates with your dog

I'll take the driver's seat: Coco loves a road trip.

I began a discussion with the first year vet students about the way humans bond with animals, and I mentioned Tom Chatfield's argument that time spent twiddling with smartphones, tablets, computers and other technologies is replacing time we might have spent with pets.

That lead to an informal exercise involving students logging how much time they spent with their companion animals vs technology (many used technology while spending time with their animals - eg, had their cat sit on their laptop while they struggled to use it). The results were a little scary. Some of us spend ten or twelve hours on a computer [ie on a weekend], leaving little time to walk the dog. So could technology represent something of a companion animal welfare issue? And if so, how do we reclaim the time to spend with animals?

As a start, SAT is putting together a series of posts on dates with your dog. If you do anything fun with your dog I'm very keen to hear about it.

In the meantime I wanted to introduce Coco, a beautiful rescue dog adopted as a senior at the age of twelve. She loves road trips (even the super-long ones), hanging out with big dogs, and chicken. Coco, or Cokes as she is known to those in her inner circle, wins hearts wherever she travels.

Coco strolls along the beach as the clouds roll in.

Behind the scenes at a pet portrait shoot

Jenny Parker points her lens in Phil's direction. Note he is pointing his nose in my direction. But she studied his moves and they fell into a rhythm. That, folks, is what makes a pet photographer as opposed to a happy snapper.

Those who know the SAT team (ie me) well know that I am pretty keen with a camera. Those who know the team really well know that I might have several thousand photos of a certain white fluffy someone. But sometimes a fresh pair of eyes can produce a photo that is a bit different.

Anyway, in the interests of quality time we decided we'd book a session with Shoot-Ya-Pooch photographer Jenny Parker. Pet-portraits are the modern family portrait. 

Taking photos of cute animals might seem like the ideal job, but watching Jenny in action made me realise how patient you have to be. Phil really put her through her paces - forcing her to get down on a yoga mat to shoot him from the right angle, walking out of shot just as she pressed the shutter button, and pretending not to hear her say his name. Beyonce wouldn't be a bigger diva.

I was the typically stage mum, saying "ummm, he won't do that because..." or "he can't stand in that position because..."

That was the first twenty minutes. Then he started to really relax...(that may have coincided just slightly with the introduction of some chicken cubes) and made a total liar of me. When I said "oh, there's no way he will sit still there..." he sat still, looked down the barrel of the lens and tilted his head like Taylor Swift.

Malibu watches Jenny work.

During the shoot we met Jenny's dog Malibu, who made off with some of the props and undertook some earnest quality control on the chicken cubes. If you want to see some of the shots, there's a preview on Jenny's Facebook page (click here).

Malibu: "I think this plush pink giraffe is safer over here where I can mouth him protectively."

Three things I learned: facts about fleas

Phil interrupts a photo session to scratch a flea-induced itch. He's tiny, he's white, he's just the right flea-jump height, so he's a walking version of the so called "white-sock test". [You can try it at home but prepare for a shock. Put on some white socks and walk through your house slowly. Count the number of fleas - they are positively phototactic, meaning they love light and white!].

It wasn't my intention to institute a flea theme this week, but the Australian Small Animal Veterinary Association hosted an excellent webinar with Dr Geoff Gibbons on fleas last night. I meet fleas daily in practice, I see the irritation and misery they create and I've even sprung them sinking their teeth into my furry family.

In animals they cause pruritis, flea bite hypersensitivity, tapeworm (Dipylidium caninum) and, in severe infestations in puppies and kittens, clinically significant anaemia (I've transfused a kitten for severe flea-induced anaemia). Alongside mosquitoes, the rabbit flea transmits myxomatosis. 

I took this photo of a cat flea (Ctenocephalides felis) under a microscope using a smartphone. Ectoparasites are impossibly beautiful up close. You can see the blood inside the flea...as well as some flea faeces building up the abdomen. The larvae feed on flea faeces.

In humans they spread rickettsial diseases, bartonella and the plague (which Dr Gibbons reminded us killed more people than all wars combined). Oh yes, and also worms (Hymenolepis nana and Dipylidium caninum).

They're filthy, but they're fascinating and they are hardcore. For example, they can jump a distance of 33cm and a height of 18cm (I am not mathematically gifted enough but proportionally speaking I know I can't jump that high).

So what did I learn? Well, it was the review of the life cycle and features of the life stage that I found most useful.

1. Adult fleas constitute only 5% of the infection. The eggs make up 50%, larvae 35% and pupae 10 per cent. I've never really broken it down numbers-wise before, but this reinforces the point: an adult flea on an animal is a SIGNIFICANT finding. That is the tip of the flea iceberg. Take home message: if you see a single flea, you need to treat an infestation.
2. The reproductive break point (RBP) is the time after the application of a flea product when the drug's concentration has declined to a level at which fleas are not killed prior to egg laying (egg laying occurs around 24-48 of the flea's first feed). Because the speed of the kill is proportional to the concentration of product administered, the RBP is reduced in very big dogs at the upper end of the dose range. Interestingly, most chemicals have an RBP of around three weeks. Take home message: regular flea control is vital.
3. The main reasons for poor control of fleas, or outbreaks of fleas, are irregular treatment, not treating all in-contact animals (including strays/wildlife), applying most of the product to fur (versus applying to skin), some product being sucked back into tube [I'd not heard of this but apparently when you squeeze the tube you should not release it while it still has contact with the animal as some product can be sucked back in], underdosing, poor environmental control and failing to attack all stages that CAN be attacked (adults, larvae, eggs - the pupae are almost indestructible). So far there is no evidence of resistance to the chemicals available on the Australian market (though some delegates disagreed based on their experience), so the main cause of fleas continuing to stick around despite treatment was inappropriate treatment. Take home message: there are a gazillion ways to misuse flea control. Use it the right way. 

I must confess that fleas tend to take advantage of my frequent spells from vacuuming. They know their enemie's weaknesses well. 

Dr Gibbons reminded us that, aside from good flea prevention, the vacuum cleaner should be used daily in flea affected areas. Sigh.

Why dog flea products should not be used on cats

Spot-on flea products must be used carefully. ALWAYS read the label.

“The only thing necessary for the triumph of evil is for good men to do nothing.” – Edmund Bourke.

Permethrin toxicity is common in cats but strikingly underreported in the published literature. It is unlikely that pet owners or veterinarians fully comprehend the enormity of the problem. My training certainly didn’t prepare me.

During my first year as a new graduate I was on call when a nine-year-old male neutered domestic shorthair was presented by two young boys – 15 and 18 years old respectively. The boys, concerned the cat was bothered by fleas, asked their parents for money to purchase some treatment. When they got to the supermarket they had just enough money for a spot-on product intended for small to medium dogs – not the slightly dearer product intended for cats.

The product contained permethrin, a synthetic pyrethroid that is metabolised very differently in dogs than cats. 

Not seeing the warning (which was in fine print, buried in the extensive information on the packet), they applied the spot-on product to Cuddles. Several hours later they noted Cuddles was acting strangely – frightened, scared, and twitchy. Their regular vet wasn’t answering, and they didn’t have a car to drive to the 24-hour-referral centre. Their parents didn’t volunteer. So they arrived on our doorstep, having finally read the packet label and bathed the cat twice in an effort to decontaminate the fur.

On examination the cat was wet (consistent with bathing), drooling a little, and had dilated pupils. Otherwise it seemed fine. The boys reported no exposure to other toxins, no seizures or loss of consciousness, no history of loss of bowel or bladder function and no vomiting. The only issue was that the cat had been treated with permethrin. I knew this was toxic to cats, but didn’t appreciate how toxic. I sought advice in the most comprehensive textbook I could find: it suggested that “the overall prognosis is very favourable”, and treatment consisted of diazepam for seizures.

Well, this cat wasn’t seizuring. It had been rapidly decontaminated, and I didn’t want to risk inducing excitement by giving another bath. Since the cat was not seizuring and the prognosis was reportedly good in seizuring cats, I figured the prognosis for Cuddles was fair to good. I was very wrong.

I remember being touched by these boys’ concern for their cat. Thinking I was being overzealous, I admitted the cat, administered activated charcoal (to bind any toxin groomed from the fur) and gave a dose of diazepam to reduce the risk of seizure activity. I ran this by a colleague who agreed it was a good plan (she graduated in the same year I did, with the same instructors and same textbooks).

I left the clinic at 10pm that night. The cat was a little scared looking otherwise fine. I returned at 6am the following morning to find the cat in status epilepticus – intractable seizuring. Despite administration of numerous doses of medication the cat died later that morning.

My employer, a vet with some 20 years experience, said that those cats ALWAYS have a poor prognosis. I contacted the manufacturer of the product to report an adverse event. The receptionist took my call and said “oh, another one.”

So how could I reconcile the favourable prognosis given by the textbook? Because permethrin intoxication is massively under-reported. If a veterinarian in practice doesn’t take the time to report an adverse event, only the client and the vet know about it. Because many cats, as I learned from speaking with colleagues, don’t make it to the vet. Because a lot of owners cannot afford vet treatment – after all, many applied the dog product because it was cheaper than the cat product.

Every veterinarian I spoke to had treated cats for permethrin toxicity and the majority had treated or known of cats that did not make it.

An email I wrote to a colleague at the time expresses my frustration:

“…I feel upset that an otherwise healthy cat died a particularly nasty death. Colleagues have since told me the cat would have been out of it but he was cooking his little brain in there and although I didn’t cause the suffering if I had known how bad it could have been I would have taken some further measures to prevent it.”

In an effort to make me feel better, a fellow vet friend said: “the clients killed the cat, you didn’t”.

Whilst the boys applied the toxin, I don’t believe it was their fault. How could they appreciate that cats are not small dogs – that they have a different way of metabolizing drugs that makes them exquisitely sensitive to this toxicity? They had a limited budget and bought a product that was within their means.

Aside from causing irritation and flea bite hypersensitivity, fleas are a health risk to cats and humans as they carry diseases like bartonella. These fleas were combed off a single (very anaemic) kitten.

Those kids were treating their healthy cat for fleas – they had no idea of the potential consequences. Even the warning, which stated plainly that the product should not be used on cats, did not explain that it could be harmful or fatal.

The more I read the more I learned. Diazepam, as it happened, was not the drug of choice – many permethrin-caused muscle fasiculations and seizures are refractory. It would have been prudent to refer the cat for 24 hour monitoring. And there was a HUGE discrepancy between the incidence of toxicity reported by my colleagues and that reported in the literature (ie there was not a single case reported to the Australian Veterinary Medicines and Pesticides Authority between January 1995 to May 2003.

I collaborated with colleagues and we surveyed Australian veterinarians about the incidence of permethrin related toxicities in cats. Most (81 per cent) of respondents had seen permethrin intoxication in a feline patient within the previous 2 years. In total there were 750 individual cases reported – with 166 deaths. Far from a favourable prognosis.

So: owners don’t always read labels, and veterinarians don’t always report adverse drug events (so the literature doesn’t always reflect reality).

But a product you buy from the supermarket shelf should be safe. It is my belief that permethrin spot-on products should not be available without point-of-sale advice. Detailed warnings need to be provided and they need to be understood. This is a preventable event, we have the potential to save lives, and permethrin intoxication is a veterinary health crisis for which we are all responsible. We owe it to Cuddles and all cats affected by this toxin to ensure that it is used responsibly.

References

Anon(2003) APVMA Report of Adverse Experiencs, January 1995 to May 2003 AS CITED IN Woo & Lunn 2004 – nb has since changed from http://www.apvma.gov.au/qa/aerp1995_2003.pdf

Dormon DC and Dye JA (2005) Chemical Toxicities. In Ettinger SJ and Feldman EC (eds) Textbook of Veterinary Internal Medicine, 6^th edition. Elsevier Saunders, St Louis, p259.

Malik R, Ward MP, Seavers A, Fawcett A, Bell E, Govendir M and Page S (2010) Permethrin spot-on intoxication of cats – literature review and survey of veterinary practitioners in Australia. Journal of Feline Medicine and Surgery 12(1):5-14.

Woo A & Lunn P (2004) Permethrin toxicity in cats. Australian Veterinary Practitioner 34(4):148-151.

Guest Post - Adele Lloyd from Sentient on her trip in Uganda

Dr Adele Lloyd Dr Alex examining a patient at Uganda SPCA.

Today's post is by Adele Lloyd, Vice President of Sentient and I think it is safe to say someone who has put her veterinary skills to use in some of the most interesting contexts.

Adele visited Uganda where her sister is a primatologist who has connections with the Ugandan Society for the Prevention of Cruelty to Animals (USPCA) and is active within the local rural communities. Adele went to help in a behavioural capacity with some locally rescued dogs as well as to volunteer at the USPCA.

Adele writes:

The USPCA is a non-profit animal welfare organization. It is the only organization in the country with the goal of promoting animal welfare through encouraging society to live up to its responsibilities by assisting to achieve an improved level of animal care and husbandry.

Dogs at the Uganda SPCA.

Adele and her husband last visited Uganda in 2008 where they helped in a veterinary and husbandry capacity at the USPCA. 

“It was fantastic seeing one of the animal carers, Remi, again who remembered us being there 5 years ago. He especially remembered the work we did helping a young, terrified Doberman who was rescued from a pit latrine (a ‘hole in the ground’ long drop toilet) where he had been for many days. He was incredibly underweight and terribly frightened of people. After an intensive week of feeding up and gentle socialization, he was almost a different dog and was adopted a week later, which was a great outcome and reward for us and the staff at the USPCA.”

Dr Adele Lloyd and Remi anaesthetise a patient at the Uganda SPCA.

Since Adele’s last visit, the shelter has employed a new manager Alex who helps the new vet Dr Alex with consults and surgery. It was great to see that the staff had further developed their skills and focus towards the needs of the animals in their care. Remi was keen to learn from Adele with regard to some tips on making the ‘catching’ part of their “Catch-Neuter-Return” street dog program more humane.

Sharing skills can improve animal welfare.

Adele took part in the spey and neuter program at the USPCA as well as hosting a short workshop on dog behaviour with the staff - 

“I was just so pleased that the staff actually wanted to know how to treat the dogs there better by understanding their behavioural needs better.”

A patient at the Uganda SPCA.

 The USPCA is run on a shoestring so any donations and help from vets as well as other volunteers are always very welcome. If you need a good excuse to visit Africa then why not combine a working holiday with seeing the amazing wildlife and scenery of Uganda. Having been there three times now and also having a sister who has lived there for 16 years, Adele is happy to give volunteer information as well as details on where the best places are to visit and stay: adele.lloyd@sentient.org.au.