Ticks and Fleas spread diseases…

Ticks like this carry disease

I spent years learning about diseases, medicine and surgery to become a vet so I could help make animals better. Yet sadly there have been many times where I’ve either seen a dog die or be euthanised because of diseases that are preventable. For me it is heart-breaking to see a dog die like this, yet even worse are the owners crying because they did not know any better. I hope by writing this I can help prevent suffering to another dog and their owners.

Most people with a dog will probably have seen a tick or flea at some time or other. Whilst it is common to believe they may just be an annoyance to your pet, in some cases they can carry diseases which may be spread to your pet or in some cases even you.

Actually calling fleas an annoyance may not even be accurate as the itchiness that they cause can be extremely painful and lead to a dog destroying its own skin trying to get it to stop. However today I want to rather focus on ticks. In April this year I saw 23 dead dogs due to a disease carried by ticks. It is one that is relatively new to the UK; however it is very common where I studied as a vet in Slovakia.

This disease is caused by another parasite called Babesia which exists inside blood cells and is transmitted by ticks when they feed. When it enters a new animal the parasite spreads in the blood entering the red blood cells and then replicating inside it causes the cell to rupture and die. This process repeats until there are very few red blood cells left, it is treated, or the dog dies.

The symptoms vary, when the dogs I have seen suffering from this have arrived they have often been lethargic, the worse ones have been yellow with icterus and collapsed. The common symptoms are blood in the urine, lack of appetite, weight loss, pale gums and tongue, lack of energy and collapse. In fact the symptoms can be so non-specific that one of my teachers here actually once told me that if I cannot explain the symptoms by any other means then I should check for Babesia.

Checking for Babesia is generally easy with a blood test where a smear is examined under the microscope – if it is positive for Babesia then they will be seen within the red blood cells as in the dog below…

Babesia parasite inside a red blood cell
The dark puple “butterfly” in the middle circle is typically what Babesia looks like under a microscope © Chris Allen 2017

So we have the diagnosis, now for the treatment. Unfortunately this is where it gets complicated as although there is medication to kill the Babesia parasite, it can often be a battle to keep the dog alive long enough for the medication to work. Without enough red blood cells to deliver oxygen throughout the body the organs cannot work, the heart starts working faster to try and move the few good cells it has around faster, and the waste is filtered into the urine. The regeneration of red blood cells takes a few days to really start, so one potential lifesaving treatment is a blood transfusion – however this often just buys more time as these red blood cells may then also be infected and destroyed by the Babesia parasite.

The next problem then comes with the cost of treatment as well; often these dogs need hospitalisation and intensive therapy which for some is unaffordable. It really can be a gamble as to whether or not they survive at all, even if treatment is attempted, potentially leaving a big bill and a dead dog vs the happy pet parent taking their dog home.

The main question though is why it is even necessary.  Although tick products are generally not licensed against tick borne diseases, to help prevent Babesia you should help protect your dog against ticks with a vet recommended treatment, remove any ticks you find as soon as possible, and especially make sure you do this if you travel into mainland Europe.

I fully support the Pet Parasite Action campaign – such a little thing as regular prevention could help save your dog’s life even though you may not know it. You don’t go out and leave your front door unlocked to avoid theft, why would you leave your pet unprotected against diseases such as this?

Click Below to Check You Are Protecting Your Pet…

Pet Parasite Action Protect your pet

Death, the good, bad and ugly…

An exhausted vet student

Death is one of those bad words, that we try to avoid talking about, that we ignore and hope we never have to face.

Yesterday I read a blog post called “The dirty secret about CPR in this Hospital (That Doctors Desperately Want You To Know)”. For me it was nothing new, however it made it easy to understand and got the point across in a way I never could so I would highly recommend checking it out.

Since reading this it has remained stuck in my mind throughout the day, I think being in the veterinary profession gives me the other side of the picture. Unfortunately I have been in the position of watching someone I loved die slowly in a hospital bed – it was never what I expected – I expected to turn up one day and find them in their garden or home after a heart attack. It took several days for the die under the Liverpool Pathway (since then I am much more clued up as to why this may not always be the right thing) however the alternative was open heart surgery with very very very small odds of a meaningful recoveryEven at that point in time, without realising I was thinking about the quality of life and not the quantity – the chance of them doing what they loved and leaving the hospital after this surgery was near zero. The quality of life would be zero, even though the quantity would be increased (if you can consider it as life).

Whenever this person had spoken about death to me I had tried to change the subject as I was scared to think about it. I was scared of losing them. I didn’t want to think about it.

So moving forward 5 years with a lot more education and experience I am writing this. Over the past two years I’ve been seeing practice I have been around death, caused death, and prevented death. Some days it seems to be all I deal with, last Tuesday by the last patient I’d seen so many patients die or euthanized that I was no longer surprised when I confirmed another death.

Let’s talk about some death – from the perspective of a vet student… These have all happened to me…

It is 1am, my phone goes, one word – “torsion” – and I am out of bed and running for the door, 10 minutes after this phone call I am scrubbing into surgery. A torsion (GDV or bloat where the stomach swells up with gas) is a surgical emergency. The dog will die without a vet and surgery. An hour or so later the dog is in recovery, and a few days later it goes home.

Last Tuesday at 6:45pm when I was walking out the door to go to lunch a call came in… “torsion”… the owners were on their way about 20 minutes out. That’s 20 minutes for me to prepare. Operating Theatre set up, preparation for stabilisation, emergency fluids, decompression. Car drives up to the door, owner says I think he’s dead… I’m in the back of the car listening to nothing, feeling no pulse, no breathing. This dog didn’t even make it in the doors.

Is a torsion painful? Yes. Can it be fixed with surgery? Sometimes. Will the dog have quality of life after surgery? Yes. Is it a painful way to die? I would not like to die like this.

I am in surgery, normally opening the abdomen is pretty routine, however this time we are struggling. If I hadn’t opened the scalpel blade myself I would have thought it was blunt and old. Opening the abdomen finally it is like all the organs have melted together… There is nothing there, and nothing that is possible, I am wondering how the dog was still alive. We were not sure what we were going find, however I would have never expected this… The owners chose never to allow this dog to wake up.

We’ve got what is expected to be a pyometra – however there is a large mass in the abdomen along with lots of fluid. The owners know that it may be bad – and are waiting by the phone. I am running anaesthesia, the patient is having some problems to breathe so I have placed them onto a ventilator to help them. The abdomen is opened and the right liver lobe the size of the dogs head is removed from the abdomen – the breathing becomes easier. There are changes to other organs as well – it is not a pyometra however there are tumours on the uterus. We call the owners, and they give permission to euthanise on the table. I administer the drugs that will end this life – and relieve the suffering.

In human medicine – these patients would be closed and taken to recovery – they would be given drugs for pain and potentially kept sedated until they die. There is no guarantee of when this would be, they’d be trapped there in a hospital bed hooked up to machines.

A horse – unable to stand, with fluid on its lungs, anemia. The condition is getting worse… There is no quality of life, and the chance of recovery is very slim. We make the decision to euthanise and administer the drugs to do so. The horse is peaceful, out of pain, and no longer drowning inside out.

In human medicine this patient would be treated – humans are lighter than horses, the anatomy is different, and the lungs are like bags of crisps instead of sacks of potatoes. Its treatable – and there is a chance of recovery to a quality of life.

I will end on a puppy, this puppy had a deformity in its leg that was surgically correctable – however it was not showable and not breeding material. I cuddled this puppy on my lap when it was sedated, and held it when it was given the final injection. Not to relieve its suffering, simply because it was unwanted. We tried to encourage the owners to sign it over to be rehomed, tried to talk about the surgical options. That is the danger of euthanasia – that it can be used for ends other than relieving suffering.

We may not be able to pick when, however you can choose how you want to die. Where you want to die. It’s a conversation that should be had, and you can even find online guides like the Five Wishes (https://agingwithdignity.org/docs/default-source/default-document-library/product-samples/fwsample.pdf?sfvrsn=2 ) to help you.

Holding that little life in my hand…

Cow for emergency slaughter

Something that they don’t tell you when you start on the road to become a vet is the amount of death that you will see. This week I have seen everything from the euthanasia of a 1 hour old puppy, through to the emergency slaughter of a cow that could not stand.

This morning started with an owner and a fellow student carrying in the limp body of their dog, this is where you go from 0 to 60 in seconds. I was sat with 3 doctors talking about eyes, yet within seconds eyes were forgotten. One was taking care of getting an airway into place with intubation, another worked to get a IV cannula into the dog, another started chest compressions and I prepped emergency drugs. Unfortunately today we had an unsuccessful outcome.

Here in clinic we do not have a defibrillator, and sometimes I wonder if we did would we see better outcomes in resuscitation attempts… There are not really any real statistics in veterinary medicine on the survival with defibrillation. However in human heart attacks where CPR is given using a defibrillator within the first minute gives a 90% chance of survival with this decreasing by 10% every minute after. If defibrillation is not performed within 10 minutes of the cardiac arrest then the survival becomes just a measly 2%.

With this knowledge from the human field you can understand why I wonder about our veterinary patients. Is it the same?