Although not undertaken lightly, general anaesthesia may be applied in other situations:

1. Where the dog’s temperament makes it extremely difficult to handle – for example, with some animals it may be necessary in order to be able to examine wounds or remove skin parasites.

2. Where a long, painful procedure has to be performed which may unduly distress the dog, such as examining the bowel of a dog with colitis using an endoscope.

3. Where it is necessary for the dog to remain absolutely still – for example for radiographs to be taken. This is particularly necessary if such radiographs involve complex techniques, e.g. the injection of contrast media to show up certain tissues more clearly.

As with any type of ‘photograph’, movement produces blurring of the image so that it can be difficult to distinguish important details. For certain radiographic procedures it may be sufficient to keep the animal still by holding it, but this is usually unsatisfactory for complex procedures, as well as exposing the handlers to non-essential radiation. (Incidentally, radiography has no curative properties – it is used merely for diagnosis.)

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In the vast majority of cases, yes. Modern anaesthetic drugs are less toxic and have a greater margin of safety than previously, and in the hands of trained, experienced veterinary staff death from anaesthesia seldom occurs. However, it should be appreciated that, just as in human medicine, there are individuals who, quite unpredictably, may react unfavorably to a particular drug. Fortunately, such idiosyncratic reactions are few and far between.

Certain groups of animals are more at risk from the undesirable effects of anaesthetics – principally the very old, the very young, and severely ill, debilitated or weak animals, especially those suffering from shock. Whenever possible, it is better to delay anaesthesia and surgery until the animal is in a stronger condition to withstand it. But clearly in an emergency this is not possible.

Two general rules emerge therefore:
1. Postpone non-essential anaesthesia and operations (e.g. spaying) on sick animals until they have improved.
2. Perform any really essential anaesthesia and surgery immediately, before the dog’s condition deteriorates further.

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Almost all surgical operations on dogs are performed under general anaesthesia (a generalized loss of sensation accompanied by unconsciousness). The use of a general anaesthetic is most important for humane reasons; it prevents fear and pain during the operation, and, by avoiding pain, greatly minimizes surgical shock which would otherwise frequently prove fatal. In addition, general anaesthesia relaxes the muscles and avoids the possibility of movement, which is an important prerequisite for successful surgery, particularly on delicate or complex structures.

Because of the use of general anaesthesia, the normal reflex movements (automatic responses) are temporarily abolished, including the coughing reflex. Normally any material which attempts to enter the larynx at the back of the throat provokes a violent bout of coughing to prevent its passing down any further, i.e. down the windpipe.

Under general anaesthesia vomiting can occur it there is food or water in the stomach, and this material will pass up to the back of the throat (pharynx), where the digestive and respiratory tracts cross each other. Because of the lack of an effective coughing reflex, there is then a grave risk that some of the material may pass through the larynx and down the windpipe to the lungs. Such vomited material, containing acid from the stomach, is very irritant and would provoke a severe pneumonia (inhalation pneumonia), which is invariably fatal.

Furthermore the pressure of a stomach distended with food on the abdominal side of the diaphragm can interfere with normal breathing while the dog is anaesthetized.

It is to avoid these potentially serious consequences that food and water must be restricted prior to general anaesthesia. Because food can be retained in the stomach for several hours, an overnight fast is usually advised, which means that an animal is not fed after its normal evening meal on the day before it is to be anaesthetized.

Water is removed from the stomach much more rapidly and it is therefore usually sufficient to prevent drinking on the actual day of anaesthesia. In all cases follow your veterinary surgeon’s advice. Longer periods of deprivation are undesirable because they weaken the dog and reduce his chances of successfully withstanding the stress of surgery.

There are two other important points:
1. Do not feel sorry for the dog and give it a drink against your veterinary surgeon’s instructions, because you may literally kill it with kindness.

2. Tell the vet, or his nurse or receptionist, when food and drink was last consumed. If you know, or suspect, that the animal has in fact eaten or drunk after it was supposed to, say so, do not conceal the fact. It is usually better to postpone the operation than to expose the animal to an unnecessary risk.

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Yes, fractures of the limbs below the elbow joint in the front limb and the stifle joint in the hind limb can be effectively treated with casts and splints. However, if plaster casts are applied too tightly they can cause pressure sores where they press on bony prominences and in extreme cases may lead to gangrene; if too loose they will not hold the bones together for healing to take place and may even slip off. They can also become soggy if allowed to get wet and the dog may chew at them. In recent years a number of materials which are lighter, easier to apply and more hard-wearing than Plaster of Paris have been introduced. These include fibreglass tape, plastic – as sheets or tape (Hexcelite) – and polyurethane (Neofrakt), which is also used to give durability to men’s shirts. Despite their advantages, the newer materials have the major disadvantage of being two or three times more expensive.

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Cryosurgery, or cryotherapy, is a technique in which intense cold is applied in a controlled manner to kill diseased cells while producing the minimum of damage to healthy tissue. A rapid freeze followed by a slow thaw is required for greatest efficiency, so the use of liquid nitrogen is preferred, either sprayed over the lesion or to cool a probe placed in contact with it. To obtain the maximum destruction of abnormal cells two, or even three, freeze-thaw cycles are advisable.

The technique has been used in dogs primarily to remove superficial tumors (e.g. from the skin, nose, mouth and rectum) and grossly infected tissue around the anus (perianal fistula). As with other forms of surgery it is performed under general anaesthesia. Lesions heal with scarring, and on the skin hairs often grow back a different color. An unpleasant smelling exudates may appear from the larger treated areas for up to two weeks afterwards.

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Some veterinary surgeons, especially in Britain, are unhappy about performing operations which will not benefit the animal but are carried out simply to gratify the whim of the owners or to enhance their social status. It is quite proper to describe such procedures as mutilations. The most commonly performed of these is tail docking which is generally carried out to conform to accepted ‘breed standards’. In many European countries and in North America ear cropping is practiced on certain breeds (e.g. on the Dobermann, Great Dane, Rottweiler and Boxer) to produce an alert appearance, but the practice is banned in Britain. The de-barking of dogs (ventriculocordectomy) is also practiced in some countries, along with a variety of cosmetic operations, including the removal of areas of skin pigmentation that to the owner appear unsightly or interfere with the animal’s suitability for showing. Other mutilating operations include inserting false testicles where they have not descended, capping discolored teeth and, to be in fashion, inserting small gemstones in the canine teeth.

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The basic methods for controlling the spread of zoonoses to man are the same as for controlling the spread of disease between dogs, though, with the exception of vaccination against rabies, immunization is not available.

Dogs which are discovered to be infected should be treated as soon as possible, and/or isolated depending upon the dangers inherent in the transfer of the disease. With rabies, isolation on suspicion of infection and euthanasia if signs appear are advisable and in many countries mandatory. Where treatments are relatively innocuous, these may be carried out routinely as discussed previously.

Hygienic precautions are also of great importance to break the chain of transference at as many points as possible. The hands should be thoroughly washed after handling dogs and before putting the hands to the face or in the mouth, for example before eating. This applies particularly to young children. The kissing of pets should also be discouraged. Dogs should not be allowed to lick the face, or sleep with humans or on their beds. Also dogs should not be allowed to lick plates and utensils used for human use, and their own feeding bowls should be washed separately from crockery and cutlery used by humans.

The dog’s excreta should be collected and disposed of (preferably by burning) as soon as possible. Regular grooming and bathing of your dog, especially if long-haired, will reduce the risk of infection being spread by a contaminated coat. Although it is difficult to destroy the sticky roundworm eggs of dogs, they can be removed from the environment by thorough scrubbing of affected surfaces with hot detergent solution followed by a thorough rinsing down.

All food for animals should be stored well away from that for human consumption and prepared using different utensils and work surfaces. To reduce the risk of the dog acquiring an infection (e.g. with salmonellae) which could in turn be passed to man it is advisable to feed dogs only on dried, canned or cooked meat.

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Diseases that can be transmitted from animals to man are known as zoonoses. Comparatively few of these are spread by the dog, although they do include some that can be extremely important, especially in children.

External parasites transmissible to man include fleas, the ‘itch mite’ (Sarcoptes), the fur mite (Cheyletiella) and ringworm fungi. Cat fleas (the species most commonly found on dogs) often attack man and in some urban situations have even replaced the common human flea (Pulex irritans). They generally come from the environment rather than from the dog itself, so that the first bites are usually on the ankles. In adult humans an itchy red rash is found, and in children irregularly inflamed weals which subside within forty-eight hours to leave small, red, raised papules which are intensely irritant. Later these lesions can occur anywhere on the body. Occasionally fleas may transmit the tapeworm Dipylidium to children.

Like Sarcoptes, mentioned earlier, the fur mite is easily able to penetrate clothing and most frequently affects the forearms, trunk and buttocks of humans causing small red spots which itch furiously and develop into yellow, crusted lesions.

Ringworm fungi can also cause a marked inflammatory reaction in humans, with loss of hair if the head is involved. Human infestation with the ear mite is very rare, but has been reported to cause lesions on the trunk and legs.

Of the internal parasites Toxocara canis and Echinococcus granulosus are of greatest importance. Toxocara infection, primarily of children, results in passage of the larvae through tlie body (visceral larva migrans) and there may be damage to a vital organ. However in Britain the widely publicized ocular damage appear to affect only about one person in a million each year. Echinococcus granulosus is of greater significance, especially in sheep-rearing areas, and the infection of humans with the eggs of this minute tapeworm results in the unpleasant human disease of hydatidosis which at present can only be treated surgically and may prove fatal. Very rarely humans may be infected by the intermediate stages of other tapeworms (Taenia species, Diphyllobothrium and Spiro­ metra) or with the canine whipworm or tongue worm.

If human skin comes into direct contact with soil containing the larval stage of those hookworms that infect dogs, the larvae may penetrate the skin, resulting in a dermatitis called cutaneous larva migrans or creeping eruption. This disorder is rare in temperate climates but in warmer regions, such as Florida, the migrating larvae are a considerable nuisance and may even progress to the lungs, causing a wheezing cough. In mosquito-infected regions the microscopic larvae of the heartworm (Dirofilaria immitis) may be transferred by a mosquito bite from the blood of the dog to that of man and become trapped in the lung, producing the usually symptomless condition of pulmonary dirofilariasis.

The transmission of rabies virus to the human population by the bites of dogs is of course of major concern, as is the role of dogs in spreading leptospirosis. Canicola fever caused by Leptospira canicola (whose main reservoir host is the dog) is a rare disorder in man, but Weil’s disease due to L. icterohaemorrhagiae is much more common. The main reservoir for this organism is the rat, so that the disease, characterized by fever, headache, vomiting and jaundice, is most often associated with those working in rat-infested surroundings, e.g. canal and sewer workers, miners, and refuse operatives.

Bacteria may also be implanted in bite wounds, causing them to go septic and form abscesses. Salmonellosis (characterized by fever and diarrhoea containing blood), Campylobacter infection (causing abdominal pain and profuse diarrhoea) and tuberculosis are other bacterial diseases which the dog may, occasionally, communicate to man. Campylobacter infection has only recently been recognized and may be revealed to be a very significant zoonosis. Rarely the dog may act as a source of human infection with the virus of lymphocytic choriomeningitis, resulting in flu-like signs; but far more common sources of infection are house mice or hamsters. The suggestion has also been made, at present unsubstantiated, that human contact with canine distemper virus can lead to the development of the human disease multiple sclerosis.

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The most frequent complication in the management of a diabetic dog is the inadvertent injection of an overdose of insulin, which causes the dog to show weakness, confused behavior and staggering, followed eventually by convulsions and coma. Fortunately, the situation is rapidly reversed by dosing the dog immediately signs appear with one or more dessertspoonsful of honey or syrup, or a specially prepared glucose solution stored in the refrigerator against just such an eventuality.

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Diabetes mellitus (sugar diabetes) is a condition that affects about six dogs in every thousand, three-quarters of them bitches. It is most common after middle age and Dachshunds are particularly likely to be affected.

The condition arises from the deficient production of the hormone insulin by the beta cells of the pancreas. As a result, glucose derived from the diet and from metabolism within the body cannot be stored for future use as an energy source and much of it is simply excreted in the urine. Diabetic dogs show the classic signs of an increasing loss of weight and weakness, despite a markedly increased appetite, together With an increased thirst and the passage of large volumes of urine. Approximately one quarter of them develop cataracts (opacity of the lens in the eye). Later, if no treatment is given, body fat is broken down to provide energy and at this stage the dog loses its appetite, becomes dehydrated, vomits and eventually goes into a coma (keto-acidotic coma), which if untreated would lead to death.

In humans the condition in elderly patients (maturity-onset diabetes) may be controlled simply by changing the diet to reduce the calorie intake, or in addition giving a hypoglycaemic drug to boost the output of insulin by the beta cells. Most of these patients, however, are either routinely diagnosed or feel unwell and visit their doctor before obvious signs develop. In contrast diabetes in a dog is closer to the type known in man as juvenile diabetes, and in general it needs to be very pronounced before the owner seeks veterinary advice. In this situation only insulin administration will provide adequate control. Insulin is not effective unless injected and long-term control requires daily subcutaneous injections of a long-acting preparation, plus daily urine testing and regular check-ups for the rest of the animal’s life. If, as is usual, a fine, sharp needle is used for the injection (ideally a new disposable one each day) the discomfort for the dog will be very slight. But if you feel unwilling, or unable to embark on such a disciplined course you would be better advised to have the animal put to sleep rather than to subject it to half-hearted attempts at treatment, however well intentioned.

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