Welcome to Pet Chat on 2NURFM. Greg Richard here. We're joined by Dr David Tabrett and Cheryl Shaw. Great to see you both once again. Can I agree? It's nice to jump in the hot seat for a Wednesday afternoon. It's great to be here. What have you got lined up for us today, guys? I'm going to be talking about cats today. Cats? Oh, right. Yes. Okay. And that's the brooch? Yeah. Look, it's a sad cat, this one. It's so stiff. It needs to see a vet, I'm sure. We can help with that. And if we get time, I want to talk about some new innovations in veterinary practice, and that's the use of telemedicine. Right. So calling up your vet. Well, not just calling. Let's do video chat. Oh, right. There's so many options. Oh, I know. Almost too many options. Welcome to the 21st century, Greg.
And a shill. We're talking about cats, but with arthritis. I've been told not to massage them as well, though. Oh, you could get bitten there, a little bit sore, a bit touchy. Might get scratched as well. Absolutely, yes. And cats can actually give a nasty bite, which causes an abscess on people. So you do need to be very careful when you've got a cat that could potentially be in pain and bite you. But about 80% of cats, by the time they're 10 years of age, have some arthritis, either in one joint or multiple joints. So it's really a time in winter to take a look at your cat, because often we don't realise that our cat is starting to get symptoms of arthritis. And in wintertime, just like with dogs and us, we tend to be a little bit stiffer in the morning and when it's cold. So this is a time that you can take a good look at your cat.
Just watch what it's doing. Often a cat that has been used to jumping up in a window and sitting in the sunlight might not be wanting to do that anymore. And so you can say, oh, yeah, the cat's no longer doing that. Or it might be something simple like you've got some stairs and the cat's no longer going up or going down or having difficulty in doing that. So that's, again, another indication that the cat could have some problems. Often we think, oh, it's just when they're stiff. But there can be more going on because arthritis can affect their elbows, their hips. It can affect their lower and upper body, their back. And it can also affect their jawbone. So often you'll get cats that are vocalising. So you've just got to understand that some of these symptoms that the cat is showing you.
So worth taking your cat to the vet just to see if there is something that can be done. Now, there's lots of different management that the vet can talk to you about. And, David, it's quite a simple thing once we diagnose treatment, isn't it? But as you said, quite underdiagnosed, I think. Yes. Because we don't really look at our cats in the same way because they may tend to be sedentary most of the time, whereas dogs seem a lot more active. So yeah, I think that once we start looking at cats and looking for a problem like arthritis, it is probably there a lot more than we think. Yeah. And sometimes it can be vocalising. Some cats really vocalise because they are in pain and owners don't realise that that's what they're doing. They'll often think that it could be some dementia or something like that, but it can often be pain related. So also the change in toileting, inappropriate toileting can be another indicator that the cat's having some difficulty. So it's just about checking what the cat...
is actually doing. Because often if they're just laying around and they're not interested in play anymore, whereas once they might have chased that feather on the end of the little pole, they're not wanting to do that, they're just wanting to lay around, there could be something going on. So I think it's worth in wintertime really checking out your cat and just seeing what it's doing. Has it changed its behaviour? Does it appear in pain? Is it stiff like my cat broached, this poor cat? Its legs are stiff, its back's stiff. So checking out if it is happening to your cat and seeking some help from your vet so you can get some management and some pain so this insidious disease doesn't really get a hold of them in that way. Yeah, talking about the diagnosis is oftentimes
it's about a really good clinical examination. And so the veterinarian being able to make sure they can palpate those joints, check the range of motion. The other thing we do is also assess muscle mass. Oftentimes with a very mild arthritis or some degree of injury, it might be difficult to see the difference with the cat, but when I actually palpate them, I can see, okay, look, that leg is this size and this leg is half the size. The muscle is not there because what happens is that muscle goes through a process called disuse atrophy, which is where if they're just not using the leg quite as much, the muscle fibres will start to shrink down. And so that could be a clue as well. And even if we get to the point of doing x-rays, that may be a late change. If we see something on x-ray, I think that tends to be fairly late in the process. So it's really about paying attention to their behaviour and then making sure that the...
vets able to have a good look and palpate all those areas, as we mentioned. Yeah, because when they're kittens, I mean, they're jumping around and they're playing. They even defy gravity in a way, some of the things they do. So they're really wearing down that joint area and causing a lot of trouble there. But, I mean, older cats will slow down.
for sure, for different reasons. I don't think we're saying that it's always going to be arthritis. No. But it is actually the underdiagnosed thing. And the one that you mentioned that I've said here on the show before is the inappropriate urination. And that could just mean that the cat has trouble climbing in and out of the litter tray. Yes. And so they might just go beside the litter tray. And maybe that's the reason is arthritis. Yeah. But I think we see arthritis a lot in our dogs and we go, oh, we better take the dog. But the cat just seems to just miss out on that, where I think in this time in winter, it's a really good time to have a look at your cat and just see whether your cat can jump or not. Yeah.
So what's the test for that, if they can jump or not? Well, actually, one of the things that I do in a consult room is make sure the doors are locked and then let the cat out of the cage. And I'll just watch it walk around. And the owners will sit on the chair. And if the cat jumps up onto their lap or something like that, that gives me an indication. I'll put the cat up on the table. And oftentimes, the cat might then jump off the table. But that's a different height. And so then I can observe. Maybe the cat won't do that. OK. Or if it does a little stumble or something.
Yeah, yeah, yeah. Or just dust won't go and jump off. That's right. And, you know, the owners are often going to say, oh, they always jump up on the table. And that's the thing they notice at home. Yes. You know, they've stopped jumping onto the table. They're jumping onto the chairs. And that's really a fairly straightforward test. Okay. Fair enough. Easy. Then we've got to massage them, right? A gentle massage after this as well. It's Pet Chat on 2NU RFM 103.7. And Noel from Arcadia Vale. He's got a five-year-old cocker spaniel which has infected lips and they're not responding to treatment. Doesn't sound good, Noel? No, we thought he had bad tooth or something.
It was just foul. We took him to our local vet and he gave me an injection and a course of antibiotics. And he was the copper spangles are the only ones who get this infection in their bottom. Yep. And anyway, we've done the course of antibiotics. But, mate, it's just foul. It's still there. And I think it's worse than what we first took him.
Yeah, I think I have seen it in a couple of other breeds, but they're pretty much all the same shape where they've got, you know, these folds on their lips. And so we do see a number of different breeds that this kind of applies to where they'll have things like nasal folds and lip folds. And also around the back end, actually, if there's excess skin and there's folds, they can get development of infections. Often it's a yeast that starts off with these areas. once other bacteria get involved, you get that really foul smell. And it's difficult to treat, for sure. Part of the problem is that with the treatment, the infection is really on the outside. It's starting on the skin, on the surface of the skin, and then it actually gets embedded in the deeper tissue. The problem is that when you give oral antibiotics, they're going through the bloodstream, and then the antibiotic has to kind of attack the bacteria, which are way out on the edge of the skin where there's no blood supply, right? So unless it's a really deep infection, and some of these do, then certainly...
oral antibiotics are warranted. But a lot of the time we will treat this with topical therapy, so an antibacterial, antifungal shampoo. And it does take quite a lot of time because ultimately if there's this lip fold that's there, you know, that's an anatomical problem. It's not going away. No, no. And that's where in some of these dogs actually we'll do surgery to remove the fold.
That's pretty invasive though, isn't it, that surgery? Well, I mean, it's not too bad. It's like if they have a lump somewhere, we'll take a lump off. And then in this case, what we're doing is we're removing the actual lip fold and bringing the edges of the lip back together so that we've reduced the area that infection can develop. Having said that, so that's something that oftentimes we'll trial a course of antibiotics, we'll trial some antifungal, antibacterial shampoo, those sort of things. And then probably if we keep finding it coming back, and particularly, yeah, Cocker Spangles are renowned for this, then they often do require surgery. And not all Cockers are going to have this problem, but certainly I've seen.
Lots and Cheryl, you see this a bit. Yeah, we see this a lot. And with the cocker spaniels, when those folds are really deep, it's really important that you try to keep them as dry as possible because if you can get as much moisture out, it stops that yeast from really and the bacteria from breeding so much in the fold. So using your maliceb to wash that area, but then getting it as dry as you possibly can and treating it really three days a week with your maliceb will really have a good impact on it. That's what a lot of cocker spaniel breeders say to their clients when they buy these cockers. If they are prone to having those lip infections, to use the maliceb three times a week and really make sure that you're getting it as dry as you possibly can.
Just to get on top of it. Yeah, and drying often means, in some cases, we'll use an alcohol wipe. Oh, right. You know, you can get those alcohol swab wipes and you can just use that to swab it out because that'll actually dry it out. But you have to do that after you do the topical therapy. Yeah, and if you've got a dog that's really drooly, trying to keep that area dry as well because some of your cockers are very highly strung and they often are quite wet around the mouth. So trying to keep that dry. If it's a deep fold, you can use a Q-tip into that fold to try and pull out some of the moisture. But just trying to keep it as dry as possible so that you can get on top of that infection. Yeah. And when you have the drink, dry.
Yes, absolutely. I mean, it's a lot of extra work for you, but you need to get on top of it just so that you can see if you can avoid surgery. But, you know, it may be the way you're going to need to go. Yeah, I wouldn't be... Don't be kissing the way it is. But, yeah, but, you know, having some face washers around, some, you know, some cotton pads, and you're just trying to just keep that area dry. Oh, okay. Thank you very much for your help. No worries. Thanks, Noel. Good luck with that. Okay. Bye-bye. See you. Cheers. Thanks, Noel. And, David, you mentioned it all about.
Going to the vet isn't just in person anymore. You can do it all sorts of different ways, not just phone leaver. Look, the last two years, can I say it, we've pivoted. It's been unprecedented, and I'll try and throw in a few more cliches. But it's really interesting because there has been, obviously, developments in technology that have allowed us to interact with clients, interact with patients in different ways. And one of the things that we've developed is an increase in capacity to provide telemedicine.
A lot of the time, I think it started off, we certainly have seen this in terms of tele-triage, you know, where we can speak to clients or look at a FaceTime video or something that actually we can observe the patient and go, yeah, that patient needs to come in or, you know, they're not too bad or whatever. But it's actually now getting to the point where we're providing telemedicine. And there are some challenges in that for sure. And certainly there's going to be a lot of conditions. I mean, I work in emergency. So, you know, a lot of our patients actually do need to come in. But at the same time, there are people who, look, are remote, who now have access to immediate veterinary care.
in terms of advice and so on that they can do, which they did not have before. So that's a really important thing. Or it would have taken them like hours to get to see someone. Yeah. I mean, I've had patients that have driven to Newcastle from five hours away in the middle of the night. Yeah.
So, you know, those guys, that's great. Maybe we do need to see them, but at the same time, can we actually provide some degree of advice before they leave the house, for instance? We've actually done the same thing, by the way, with other veterinarians as well, where they've kind of taken us through, say, x-rays now can be sent, or we can access their server and look at the x-rays, look at the blood tests, and we can actually consult. And look, this has even gone to another level, which is our x-rays... get read by specialists through a company that's based in the UK, but they also have offices in Australia. The interesting thing is that we can send them x-rays or ultrasound or whatever, anytime, day or night, and there's someone awake who's going to look at them. They've been so successful, but actually now there's a bit of a wait time. But the other thing is they've now got specialist services available. So we send them a whole history and we can actually get a specialist to give us a report.
back within hours. And interestingly, we had a case of this the other day on the weekend, and I was working with one of our vets, and I said, let's get this case reviewed. And so we sent it, and of course we're thinking, it's Sunday, where's it going to go? And it goes around the world, and it ended up that the specialist who consulted for us is based in Sydney. So it went around the world and came back. But we were also doing, as I mentioned, tele-triage, tele-medicine, and I mentioned about remote.
access or early access. The other thing that a lot of people would be aware of is that there is a huge pressure on veterinary hospitals through increased work, but also a shortage of staff. That's been seen in a lot of different industries, but certainly in the veterinary world, this has been coming for quite a while. And so what this means is that telemedicine provides another avenue. So if I can't see you in person, but maybe there's someone sitting in their home, a veterinarian in their home down in Victoria, and they can actually consult. So we're expanding the possibility for people to access veterinary care 24-7. That's amazing. How long do you think it'll be before you'd be doing telesurgery?
There is, you know, in the human world, that actually happens. Really? Yeah. So they have, you know, robotic surgical instruments, and they're controlled remotely. There's always a surgeon on site, but maybe they have someone who's more specialised who can actually sit in Sydney and do that surgery, and then that could be our Dubbo or something, and then they're doing surgery in a different place through robotics. I'm not quite sure how comfortable I'd be with... Yeah, I mean, it does throw up a couple of challenges, both in our confidence, but, you know, they're probably more reliable than... I'm going to get in trouble for saying that.
More reliable than people. We'll move on anyway. We've got Paul for a while, and he's got a 17-year-old Jack Russell. He wants to know when he's thinking about euthanising his dog. Yeah. Hey, Paul, how are you going? Yeah, good. Okay, so we've got a 17-year-old female, Jack Russell. She's obviously now deaf and blind. We've got some arthritic problems, particularly the hind legs and on her back, and so she's getting medicated for that. That's fine. Nighttime is pretty hard to settle, so we have a sleeping pill for that. The issue is, you know, quality of life is not great, but all our vitals are very strong.
Very strong. Brilliant heart, liver kidneys, you name it. So we've got this heart-wrenching question of when is the time? Is there some sort of like a checklist that people can sort of work their way through and say, yeah, well, just now you've come to the end. This is the time to do it.
Yeah, look, and it's a very common question that gets raised. And I think just to recognise that, you know, you've done a wonderful job, particularly with a couple of those other health problems that are there. And I think that's one of the things a lot of people find is, you know, we go along over the years and a problem crops up and we'll get that treated and so on. So then we end up with 17-year-old, 20-year-old dogs and 25-year-old cats. And that's not a bad thing. I'm not saying that's bad. It just brings up these...
challenging questions that you're asking. And I think in the circumstances where, for instance, we see dogs that maybe are 17, but they've got heart disease. And oftentimes as that deteriorates, you can witness the deterioration in the quality of life very clearly. And so maybe those decisions are a bit easier. But in the circumstances you're discussing, there is actually some checklists that are used for quality of life assessment. And it's not actually a case of, you know, a threshold that you reach that says, hey, now's the time, because that is very much a personal decision. And I've always said to...
people you know some when i have this question in a consult room it's really look some people wouldn't have gone this far and some people are going to go further and so it's it does become that personal decision i guess the one thing i always say is like are they enjoying their day you know if a dog if someone says their dog sleeps 22 hours a day i'm like well is that because it's in pain or is it because it has you know serious dementia and it won't eat um but if it just wants to lie in the sun and sleep well i'm happy you know i'm happy with that it's up to you so yeah she's eating well drinking well obviously can't walk very far so all that's hard um But, yeah, as I said, all the buttons are really strong.
Yeah, look, there's no age, there's no kind of threshold, as I said, but it is worth having a look at the quality of life assessments. In part, it may not provide that decision point, but what it could do is actually give you a more objective determination. And maybe that's something that you do. Look, let's do an assessment now using that score. And then, you know, three months time, we do it again and see what we think. Because if you're watching your dog day to day, it's pretty hard to sometimes pick up on when they're deteriorating. And then, you know, the neighbour or a family member who hasn't been there for a while says, oh my gosh, what are you doing?
Yeah, well, that's why I ran, because, you know, you guys will be objective from a distance, and I'm just giving you the facts, and I'm really interested in what you've got to say. Yeah, one of those things that you've just mentioned, David, is really good. Viewing the pet again in three months' time, and one of the ways you can do that, because we do, when we're living with them, we forget what's going on. If you record, you know, a few hours every day, you know, for a week, and then view that in a month's time, and then again in two months, and just see where you're sitting at, where the things have deteriorated, because the phone is really a good tool to just remind you of what was happening. So just a little video? Yeah, a little video. Yeah. The other thing, Paul, is...
And speaking with specialists on veterinary oncologists, one of the things they kind of help people with this decision making is, you know, are they eating? Are they in pain? And are they vomiting? And those are often some of those key quality of life points to ask. So, you know, if your dog is passing those things, then that doesn't mean that they don't or that they have a good quality of life. It's just they're some of the things that actually are key in that determination. Sure. And sometimes a lot of shivering going on. So I'm not sure that's pain or cold weather or adrenaline. I'm not sure.
Yeah, certainly pain is something to be aware of, and chronic pain, particularly with arthritis and so on, we were discussing earlier, making sure that we have some medication if that's needed. But a lot of, for instance, Jack Russell's little dog, short hair, they'll get cold. They don't control their body temperature that well. So just making sure they're warm, they have a jacket maybe, that sort of thing. Yeah, doing all that. I knew it was a $50 million question, but I thought I'd have to ask. Yeah, no, it's a really good discussion, and I think it's an important one.
A lot of people are obviously, as their pets live longer and longer, they are having these thoughts as well. So we really appreciate you ringing in. Okay. Thanks very much for all your advice. No worries. Thanks, Paul. Thanks a lot. Bye-bye. It's a tough question to ask though, isn't it? I mean, regardless of, I mean, no one wants to put their pet down. Yeah, I think it's, you know, I had a dog, and I've mentioned this story before, when I was going through university and he had cancer. And again, we had a family friend visit and kind of went, oh, look, you know, he's really gone downhill since I saw him last time. But I'd just been looking at the dog every day and just going, oh, well, yes, he's got that.
He looks all right. And ultimately, it just became, are there more bad days than good days? But that's not quite the situation Paul's talking about where you've got an active disease process like cancer or, as I mentioned, heart disease. That's another one. I think when it's these just gradual wear and tear age things, then you still need to make that assessment. Is today a bad day or a good day? Are we eating, pain, and making sure they're not vomiting or problems like that? That's where you've got to also try and think of the fatty animal as well.
You're not doing it just to live around and say you've got someone company. Yeah, that's right. That's right. And that's why we use those objective assessments, or as Cheryl was saying, just a video to remind yourself. That's another easy way to do it. Well, before we run out, I've got about a minute to go. Dog of the Week. End of a cheery note. And it's Bonnie. It's a seven-year-old cattle dog. That's not too bad.
Well, looks like Bonnie likes the lounge. We can tell. Most photos are on the lounge. All the photos are Bonnie just sitting or lying on something. So how active is Bonnie? I mean, she's a cattle dog. She's going to want to run around a bit. She's going to want a fair-sized yard, I would imagine. That's a good point. Lots of walks. That's a good point. One of the things a lot of people, when they're thinking about taking dogs, particularly thinking about these different breeds that have a really active lifestyle and they're bred for that sort of activity. So making sure you've got, obviously, a secure yard, but the ability to exercise the dog as well.
So that's really important. Catalogs can get bored quite easily. Yeah, some of them are more balanced than others, I think. And particularly, you know, if there's nothing identified that she's had problems with, then, you know, as long as you can provide that activity. And mental stimulation, that's the other thing, isn't it, Cheryl? They're really intelligent. Yeah, they need to be active. And I noticed that the website is saying, you know, Bonnie's good with kids who are respectful of dogs. So you better train your kids. Train your kids first. I think it's a really good message, though, for people is to understand how do we approach a dog?
How do we respond to dogs? And understanding what the messages the dogs are giving us. We have to learn how to speak dog because they're not going to learn how to speak English. Okay. I think. One day soon. One day soon we'll learn how to speak dog. We'll develop the technology. Well, guys, we're out of time for another week. Thank you very much for coming in. Thank you. No worries. Thanks, Greg. And we'll be back again next Wednesday from 12 o'clock on 2NURFM. Thanks for listening to this podcast from 2NURFM at the University of Newcastle. You'll find them all at 2NURFM.com.