Explore every episode of the podcast Call the Vet - an insider's guide to dog and cat health
Dive into the complete episode list for Call the Vet - an insider's guide to dog and cat health. Each episode is cataloged with detailed descriptions, making it easy to find and explore specific topics. Keep track of all episodes from your favorite podcast and never miss a moment of insightful content.
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Pet Cancer: What Most Owners Don’t Know About Diagnosis, Treatment, and Quality of Life
25 Nov 2025
00:45:19
What happens when your beloved pet gets diagnosed with cancer? In this episode of the Call the Vet podcast, Dr. Alex sits down with board-certified veterinary oncologist Dr. Nicole Leibman for a candid, myth-busting conversation about cancer in our furry family members.
From the most common warning signs and why early detection matters, to breakthroughs in treatment (including cutting-edge immunotherapies!), Dr. Nicole shares insider expertise and heartwarming stories from her work in New York City.
Whether you’re worried about a lump on your pet, curious about chemotherapy side effects in animals (hint: it’s not like in humans!), or just want to understand how specialists and general vets work together, this episode is packed with practical insights and empathy.
Plus, you'll hear about a revolutionary in-home nursing service that's changing the way pet care is delivered.
If you love your pets and want the best for them—don’t miss this heartfelt and eye-opening chat!
Navigating Tough Decisions: Molly’s Story and How to Choose the Best Care
19 Oct 2025
00:26:48
😮 Just because we can do more tests or treatments for our pets, doesn’t mean we should—sometimes doing everything isn’t the best choice for their quality of life!
🐾 Recently, my own cat Molly faced a life-threatening illness, forcing me to ask the same tough questions I ask clients every day:
• Diagnose first! Without accurate diagnosis, you risk the wrong treatment and a poor prognosis.
• Ask if additional tests will really change your treatment plan—or simply add expense and stress. • Weigh every treatment option from “gold standard” to practical compromises, considering outcomes, costs, and the impact on daily life.
• Always balance the risks and benefits, including the stress of medications, procedures, and hospital visits.
• Remember: what’s right for one family or pet may not be right for another—your gut feeling matters, too!
💡 The real takeaway? Making decisions for your sick pet isn’t just about medicine—it’s about honestly weighing options, understanding what will improve (or hinder) their quality of life, and recognizing when doing less might actually be the kinder choice.
Unpacking the Crisis: navigating the challenges of modern veterinary care
15 May 2024
00:27:03
😲 Are you concerned about the rising costs of vet care? You're not alone and this episode dives deep into the issues plaguing the pet health care space, affecting your pets, you, and those within the veterinary industry.
It's easy to vilify veterinary professionals as money grabbing (and many do) but the truth is very different - Did you know that in the last 12 months, 25% of veterinary staff in the UK received absolutely NO pay raise? The preconception that vets are "only in it for the money" couldn't be more misplaced!
📉 Yet this is on the back of record vet bill rises. We're facing serious global challenges in pet healthcare:
- Inflation is skyrocketing, yet vet pay isn't keeping up, making it tougher for veterinary professionals worldwide.
- Costs are on the rise, not just for pet owners but for the clinics too, due to increased prices for drugs and necessary medical equipment.
- There's a trend of corporatization where shareholder returns are driving business decisions and the staff in your clinic may have zero say in pricing and service provisions.
🧐 Importantly, we need to consider the advanced level of care provided today compared to decades ago. Practices now are equipped with state-of-the-art technology to offer the best care, which significantly drives up the costs.
But is this also part of the problem?
This episode covers so much more, and while I don't claim to have all the answers these topics are vital for you to be aware of so we can work towards a future that works for everyone.
Should You Test or Just Treat a Cat with Potential Heart Failure?
03 Sep 2020
00:13:02
If your pet's unwell, then making the decision to run a certain diagnostic test, or have a procedure carried out can be really difficult. Especially if there is a chance that that could actually cause your pet harm.
That's the challenge faced in today's question because the last thing we want to do when we're trying to make a diagnosis is to actually kill our patient!
Does your pet show signs of fear, anxiety, or stress when they visit their veterinarian?
If so, they are not alone!
The “Fear Free” movement seeks to put a stop to this and make your pet’s trip to the vet an experience to be enjoyed rather than feared! How then is a fear free certified veterinarian different, and should you consider changing vets?
Having recently become fear-free certified, I shared a live training in The Academy about the ways that a veterinary visit can be made as low stress as possible (members can watch the full training replay here).
Highlighting the difference between a fear-free veterinarian and a “normal” vet is an important question to answer, especially if your dog or cat hates their visits to the hospital.
How To Choose a Puppy with the Best Genetics | #71
20 Aug 2020
00:14:51
When you bring a new puppy into your life, the last thing you want is for them to suffer from a horrible genetic condition that could have been predicted if you had known a test was available.
This is just one consideration when it comes to making sure your new puppy is as healthy as possible.
Sinister or Safe...the post-vaccination lump?! | #70
13 Aug 2020
00:11:35
We all know how important vaccinations are in keeping our pets safe from preventable, deadly diseases. The last thing we want though is for our interventions to have the opposite effect and hurt our dogs and cats. The risk of side-effects is a reality, but if your dog develops a lump after vaccination is it something to be concerned about?
Don't Let Separation Anxiety Stress Your Dog (with Sara Ondrako) | #69
06 Aug 2020
00:30:33
Are you scared that whenever you leave your dog alone you are going to return to a scene of total destruction?
Have you been spending a lot of time with your new puppy during lockdown and started to worry about how they are going to cope when restrictions lift?
Separation anxiety is no laughing matter or minor inconvenience. In fact, if changes aren’t made then a dog can quickly go from feeling a bit anxious to destroying your house and doing themselves a serious injury trying to escape.
Fear not!
Help is at hand as Sara Ondrako, a canine behavioral consultant, talks with me about how to put a stop to separation anxiety, as well as how to prevent your pup from ever developing a separation-related problem in the first place.
Having a blood test is a frequent next-step when a problem is being investigated. It is also a common recommendation to run bloods as a "routine" health screen in older dogs and cats. The results, however, can sometimes leave you with more questions than answers...
Download Pet Health Essentials - my free guide that will help optimize your pet's health so they are living as healthy, happy, and full a life as possible
In this episode I discuss that:
"Normal" blood test parameters are based on a mathematical formula which means that a certain number of results are expected to fall slightly outside the normal reference range.
Blood results can not be taken in isolation. It is important that they are interpreted based on an individual patients history, symptoms, and physical examination
For mild abnormalities in an otherwise healthy pet, the options to consider include further testing or monitoring with repeat testing after a period of time to see if a problem is indeed developing.
Physiotherapy and other physical therapies like hydrotherapy form an important part of any rehabilitation and recovery process after surgery or injury. It is though vital that any treatment is carried out properly - otherwise, there could be more harm done than good
When carried out by a trained practitioner, physiotherapy can improve chance of successful recovery + reduce the risk of side-effects, speed up recovery, reduce pain, and maintain muscle. Incorrect technique can lead to the exact opposite!
Vaccines are a fundamental step in having the healthiest dog (and cat) possible. It is though important to only vaccinate against diseases that actually pose a threat. Otherwise, the risk of side effects outweigh the potential benefits.
Vaccinations is just one of the 5 topics I discuss in my free guide Pet Health Essentials
Although vaccines are very safe, you do need to be aware of potential side effects, and deciding on the type of vaccine and frequency of administration is very much based on a risk:benefit assessment performed in conversation with your veterinarian.
Dodgy Bones in Bigger Dogs: the threat of HOD | #65
11 Jun 2020
00:18:14
Large and giant breed dogs are at risk of a number of fairly unique conditions that affect their bones and joints. Understanding the implications of this can save you a lot of heartache and ensure you know exactly how to manage them for optimal health.
Hypertophic osteodystrophy in dogs is a bone disease that occurs in young, fast-growing large and giant breed dogs like Great Danes, boxers, Labrador retrievers - particularly severe in the Weimaraner and Irish Setter.
It causes lameness, increased temperature, anorexia, and dogs suffering from HOD can be truly painful and miserable.
All is not lost though, as the prognosis is likely better than you might expect...
Beat the Itch: everything you need to know about itchy skin in dogs and cats | #64
04 Jun 2020
01:05:37
Having an itchy dog or cat can be incredibly frustrating!
Finding out why they are itching is not always easy and then finding a management or treatment plan that stops your dog or cat scratching all the time can take forever.
Join me as I work through the causes of itching in dogs and cats, how you can diagnose the problem in your pet, and then what you need to know about treating their skin condition to stop them from itching and scratching for good!
At the very least, you need to know itchy pet causes which include parasites, infections, anal gland problems, other skin disease, and allergies. It's also important to know that your pet might not be itchy! Boredom, stress, and pain can make them appear to be scratching but the problem is something else.
Optimizing Care for Dogs with Elbow Dysplasia (and arthritis): Practical Advice
08 May 2024
00:14:06
🐾 "Elbow dysplasia in young dogs can start affecting them not just when they're old, but potentially very early in their life!" 🐶
🩺 Today on Call the Vet, we dive deep into managing chronic conditions like elbow dysplasia and arthritis:
1️⃣ Multimodal approach is key—combining dietary changes, weight management, and environmental modifications to tackle the issue comprehensively.
2️⃣ Therapeutic diets and supplements (especially omega-3 fatty acids) can significantly enhance comfort.
3️⃣ Regular, gentle exercise and use of ramps can prevent worsening of the condition.
4️⃣ Complementary therapies like hydrotherapy and physiotherapy are crucial for maintaining joint mobility and muscle mass.
💡 Early intervention plays a pivotal role in managing conditions like elbow dysplasia effectively. Starting treatment when symptoms are mild can drastically improve quality of life. This proactive approach can decrease the need for continuous medication and help manage pain more effectively.
For some dogs, surgery may be an option, and this episode also covers what you need to know if you think this may be the path for you and your dog.
Helping Your Picky Dog: are they healthy or is there more to it? | #63
28 May 2020
00:15:59
Getting your picky dog to eat can be hard enough, but it’s even more worrying if you think they are too skinny…
I understand how frustrating having a picky dog can be, especially if you are worried that they are underweight.
There are 2 steps you need to take:
Find out if your dog is actually a healthy weight or not. Hopefully your vet should have given you some indication as to whether or not he is a healthy weight. If not then answering a few questions will help you to find out, which you can read about in my article all about how to condition score your dog.
Next, you should study my top tips for how to make a picky dog eat, and once you have settled on a strategy stick to your guns!
A lot of owners feel like their pet’s health is out of their hands, and simply put their trust in luck. The reality is that this approach compromises their pet’s health and ends up costing a lot more money.
The fact is that since I graduated from vet school in 2006, it’s become increasingly clear to me that the most common diseases and injuries I see in my patients are almost completely preventable...
The biggest causes of poor health and a reduction in quality of life in both dogs and cats are obesity, dental disease, and arthritis. As well as the impact these have on your pet, being overweight alone is said to cost a dog owner $2,026 per year, and a cat owner $1,178.
These are the diseases that you have the power to prevent, or at least significantly reduce their impact on your pet’s life, by taking a proactive approach. Even better, taking the right action doesn’t take a lot of resources or cost a lot of money.
I know by being part of this community that you are willing to take action
Today I’m excited to share with you how the Our Pet’s Health Academy could add years to your pet’s life, reduce their chance of developing the most common threats to their health, and ensure they are living their best life possible.
This transformation from your pet being a walking veterinary bill into a picture of health will take place through:
a range of targeted courses (and the list is rapidly growing!)
a comprehensive resource library
live monthly training sessions on key topics with Q&A for all your queries
an exclusive forum to share your experiences with other dedicated dog and cat lovers.
Taking the time to invest in your pet's health really does make a world of difference when it comes to them living a healthy, happy, and full life.
Stop Your Cat Shredding Your Furniture (+ use a scratching post instead!) | #61
14 May 2020
00:13:49
If your cat is shredding the arm of your favorite sofa or scratching your curtains all the time, one of the best solutions is to get your cat to use a scratching post instead.
Getting your cat to use their new scratching post is more complicated than simply adding it to the corner of your room. But using these proven steps will help them quickly make the transition!
Steps to Getting Your Cat to Use a Scratching Post
Making sure the scratching post is at the angle your cat prefers (some like horizontal, others like vertical surfaces).
Trying different materials - carpet vs cardboard - some cats can be put off if their nails keep getting caught in loops of carpet.
Putting the post in the area that your cat prefers (start off near the furniture they currently scratch).
Attract your cat to the area using catnip or Feliway spray.
Give your cat a tasty reward as soon as your cat uses the post.
Stopping Your Cat Scratching the Furniture
Put a heavy blanket over the arm of the couch or temporarily tie up the curtains to help break the habit
Don’t punish your cat - stress causes more scratching or urine spraying
While most cats will successfully transition to using a scratching post, for those who don’t you could consider trying claw covers that you can glue on.
The last thing I want is to see as a veterinarian is my patients come to see me at the vet clinic because they are unwell or injured. Especially if it is something that could have been prevented in the first place (or at least the risk massively reduced).
The fact is, it is well within your reach to take the right steps to optimize your dog and cat’s health and ensure that your pet is living their best life and improve their happiness.
While you might think that your pet’s health is mostly a matter of luck, the reality is that the most common diseases and causes of poor quality of life are almost completely preventable. A few surprisingly simple steps can make all the difference!
Whether you are a new puppy or kitten owner or have a senior dog and cat, concentrating on my 5 top tips for a healthier, happier pet is all it takes to take your pet's health to the next level!
There is no good evidence to suggest that feeding garlic has any flea repellant activity
Garlic, onion and chives (all in the allium family) cuse red blood cell destruction which can result in severe anaemia - head here to read more about onion and garlic poisoning in dogs (LINK TO POST
How Do Flea Treatments Work?
Modern flea and tick preventive treatments work in different ways depending on the active ingredient. They are generally much more targeted towards insect biology rather than mammalian biology.
Older drugs, such as organophosphates, were much more dangerous, as well as being less effective
There are still potential side-effects with modern flea treatments (something that's true with any drug), and these might make certain products a good choice for some individuals while not suitable for others.
Epilepsy is NOT the Problem - Old Dog Seizures | #58
23 Apr 2020
00:13:09
It can be a very worrying time if your older dog has started to have seizures. While it is tempting to pass them off as normal “idiopathic” epilepsy, the reality is that, unless your dog has had seizures when they were younger, it is highly unlikely that this diagnosis is correct.
There is likely to be another underlying seizure cause.
While a thorough history and simple blood test might be all that is needed to diagnose the seizure cause in the case of poisoning, kidney failure, or liver disease for example, in other cases reaching a diagnosis can be very challenging and referral to a neurologist may be required in these more complex cases if funds allow and a diagnosis is not otherwise forthcoming.
Disease Progression vs Drug Side Effects
While it is easy to blame a drug if your dog develops new symptoms relatively soon after starting treatment, side effects are not always to blame. In fact, they are often a result of progression of the underlying disease process - especially in the case of old dog seizures.
Unfortunately, seizures in older dogs can be more challenging to treat. If there is underlying organ disease then very often seizures only develop late in the course of the disease, making successful management harder.
Being able to go toilet is fundamental to life. There are a number of reasons why an older cat might not be able to pee or poop. All need treatment but some are more serious than others.
Grab my FREE guide to keeping your cat as happy and healthy as possible
The reasons why a cat is unable to empty their bladder:
an obstruction within the bladder which can be the result of inflammation, infection, stones or a tumor
nerve damage that can result from trauma, injury (such as a "tail pull" event), or cancer
bladder muscle weakness which can happen if the bladder becomes very full and then is unable to contract even when the original problem is corrected.
pain (due to arthritis for example) can result in a cat being unable or unwilling to go to the toilet and hold on for extended periods of time. While a cat will eventually urinate, this can result in severe constipation
If your cat is having problems pooping as well then I'd be especially worried about the second group of issues. Either way, I'd recommend that your cat is assessed straight away by your vet as a bladder obstruction is fatal if not cleared, and the other causes will result in pain which needs to be addressed.
Grapes can be incredibly poisonous but they can also be completely harmless…so when should you worry?
A single grape will be absolutely fine for a dog of this size
I have a raisin and grape toxicity calculator to help you know when there could be a problem in the future
There is a lot of uncertainty about grape poisoning because the actual toxin is unknown and there is a lot of variation in individual dog sensitivity
If you have a question where emergency treatment might be needed, it is always best to contact your veterinarian or emergency service straight away so that, if treatment is needed, it won't be too late.
Head over to the full show notes, and download your free guide to keeping your pet as happy and healthy as possible
Hormone Hiccups in Dogs - phantom pregnancy + too old to spay? | #55
02 Apr 2020
00:13:20
Phantom pregnancy is a common problem in entire female dogs where the body is essentially tricked into thinking it is pregnant. Spaying is the best way to get rid of the problem for good. But if you have an older female dog, is the surgery too risky?
A dog who has had a phantom pregnancy after a previous heat, typically experiences one every subsequent season. They also often become more pronounced each time.
Treating Phantom Pregnancy
Usually, there is no need to give any pharmaceutical treatment. The phantom pregnancy will sort itself out without any intervention in a couple of weeks or less.
If you want to help this resolution take place faster, you can:
Increase their exercise levels
Reduce their food intake
Medication can be given, especially if there is a lot of milk and a risk of mastitis
Spaying an Older Dog
3 big benefits of spaying a dog: prevent pregnancy, prevent pyometra, reduce breast cancer risk.
Risks of spaying an older dog:
GA + surgery risk are very low, but do depend on the overall health of the individual dog
There are some potential some side effects to being spayed before twelve months of age, especially in larger breed dogs. These risks don’t appear to be present in female dogs that are spayed in older age.
All the details and links can be found in the full show notes
A Mountain of Dog Poop - the green way to dispose of it! | #54
25 Mar 2020
00:12:04
I bet you haven’t thought about the environmental impact of your dog’s poop (and if you have you’re amazing!).
The fact is that leaving their waste where they toilet in a health hazard, and the plastic waste and methane production from simply throwing it in the trash is huge.
Here are some solutions…
The Dog Poop Mountain!
over 96 million dogs in US, UK + Australia alone, producing about 12 million tonnes of dog poop every year!
If we assume that every dog goes once a day and 1 plastic bag is used to dispose of each motion, then 2900,000,000 plastic bags are used every month just to dispose of dog waste.
Dog Waste Disposal Options
Regular trash + landfill
Flush down toilet
Doggy septic tank
Bury
Compost
Wormery
Biogas system
Full details, along with the pros and cons of each option can be found in the blog
Old Dog Health: exploring the link between heart failure and seizures
01 May 2024
00:15:40
Increasing age can bring increasing health complexity and in this episode, we unpack a complex listener-submitted scenario about a 14-year-old Chihuahua battling congestive heart failure and mysterious seizures.
This episode is packed with invaluable insights, from understanding heart murmurs to dissecting the causes behind seizures in older dogs, with insights for all pet parents with older animals.
🚨 Did you know? A heart murmur isn’t always an indicator of overt heart failure in dogs! 🐶
1️⃣ Dr. Alex explains that a heart murmur simply indicates turbulent blood flow, which could be due to a leaky valve but doesn't necessarily mean that heart failure is present.
2️⃣ Seizures in older dogs are rarely due to epilepsy; the causes are often much more complex, ranging from organ disease to brain lesions.
3️⃣ Monitoring a pet’s sleeping respiratory rate at home can be a simple yet effective way to gauge heart health over time.
4️⃣ Diagnostic steps include full blood testing, urine testing, X-rays, and possibly an echocardiogram or MRI to pinpoint the exact health issues.
The COVID-19 coronavirus is rapidly spreading across the globe, and there are reports of pets being abandoned en-mass with people fearing their dog or cat could spread the infection to their family.
In this special episode, I discuss the risk that your pet poses to your health, as well as how you can better prepare your pet for the events that are to come.
Be aware too that this is a rapidly changing situation. Head over to this post that I will keep updated with the latest COVID-19 information as it relates to your pet and their care.
Can dog’s spread coronavirus:
1 dog in Hong Kong is felt to have developed a very low level of infection having caught the disease from their coronavirus-infected owner
Swabs have only ever come back with a weak positive result, and antibody testing has so far come back as negative. This suggests that the risk of a person becoming infected from their pet is very, very low.
Pet owners should not be overly concerned (wash hands, don’t let your pet lick your face, practice good hygiene) and under no circumstances should they abandon their pets.
Preparing your pet for COVID-19:
Make sure you have an appropriate level of supplies including food, litter and any medication your pet might need. Don’t hoard, just ensure that you are not waiting until you have run out before buying more
Ensure you have a backup carer in place. Do you have a plan if you are taken to the hospital at short notice? Do they have a key, and are they aware of your pet’s medical requirements? Have you confirmed they will be happy to do this given the current situation?
Seeking veterinary care during the pandemic:
Call ahead on the day to check your appointment is running as planned and to check for any new instructions
Consider delaying any non-essential visits, and if you do need to visit the vet clinic then only have 1 family member take your pet.
If you are unwell with and symptoms of coronavirus than ask someone else to take your pet in.
How to Stop a Cat spraying (when you've tried everything imaginable) | #52
12 Mar 2020
00:12:21
A cat who urinates outside the litter box, literally spraying their urine on everything, is one of the most stressful conditions around - both for your cat and you as their owner. Even more so if you’ve tried absolutely everything to help them stop. Here are the next steps to take…
One thing I always find helpful with cases that are not going as I would hope or expect is to go back to basics and check that nothing has been skipped over or overlooked because it was originally felt to be unlikely or insignificant.
The first thing is to determine: is it peeing while assuming a normal position but outside the litterbox, or is it spraying on vertical surfaces?
Next would come working through common medical problems. If these checks show nothing of concern then you can truly focus on the problem as a behavioral one.
There are several different anti-anxiety medications out there, it can take a bit of trial and error to find the best single drug or combination.
Given everything you have already tried, my final suggestion would be to see if there is a behavioral specialist that you could contact, be referred to, or the best would be visiting you at home
Head over to the show notes for more information and further resources
Choosing the best diet to feed your dog can be a minefield, especially if they are fussy. In this episode I discuss the main risks and benefits of feeding raw and cooked diets, along with some strategies for getting your fussy dog to eat!
"I believe there are both benefits in raw diets and processed diets. However, my dog has a hard time being interested in his food enough to eat it and he struggles with keeping weight. I have tried all different mixes of foods so I was wondering if I could mix both cooked chicken and other cooked items of a raw diet into his daily ration of processed food?” - Justyce
As far as raw vs cooked diets go, there is a lot to consider and certain risks and potential benefits everyone needs to be aware of:
Raw diet risks include - Parasites, Infection (a risk to pet AND owner!), a lack of balance
Benefits - Specific diets proven to be valuable treatment option in certain conditions
Mixing cooked chicken and other cooked ingredients into a raw diet or cooked commercial diet is absolutely fine in my mind, and in fact, cooked chicken (or other meat) has fewer risks than raw meat.
One thing to consider is that adding a significant amount of "extras" to a commercial diet may have the effect of making it unbalanced. If fed as a topper though, to improve the palatability of a diet, this is really unlikely to be a problem.
Head of to the full show notes for more information and further resources
Spaying Your Dog: Ovaries Only or Uterus as Well?! | #50
26 Feb 2020
00:13:52
If your dog is due to be spayed, which option is best for their long-term health? Removing just the ovaries is becoming more common, but how does this compare against a traditional ovariohysterectomy?
I don't believe there is any significant difference in risks or benefits of removing just the ovaries compared to a traditional ovariohysterectomy.
In theory there will be a chance of uterine tumors but these are incredible uncommon (uterine cancer in dogs makes up only 0.4% of all cancers in dogs) so this is a theoretical rather than "real-life" risk.
If I was spaying an older dog and there was some form of uterine problem present then I would always take the whole uterus along with the ovaries. For young dogs, this will not be an issue.
Removing just the ovaries can make the surgery faster and the incision smaller - although this will depend on the surgeon performing the procedure. Also laparoscopic spays only ever remove the ovaries.
Removing just the ovaries likely comes with a slight reduction in surgery risk (although this is already small) as exposure may be better and so the risk of bleeding is reduced.
Your dog has had a routine senior blood test or pre-anesthetic screen and the liver enzymes are high. Your dog has no symptoms of liver disease though. They appear completely healthy.
This is a very common situation to find yourself in. But what should your next step be?
What are liver enzymes?
Changes in different liver enzymes mean different things
ALT and AST are used as a marker of liver damage, although AST is also found in muscle and so can also increase if the muscles are damaged.
ALKP/ALP and GGT are markers of o problem with the normal flow of bile, a liver waste product. These are also sensitive to diseases outside the liver + non-harmful causes of elevation, as well as also being released from other tissues or in the presence of steroids.
What Causes raised liver enzymes in Dogs
There are lots of potential causes of raised liver enzymes and screening blood tests are seldom definitive for the exact cause.
Sometimes increased serum liver enzyme activities occur because the patient does have primary liver disease, but very often they are secondary to disease outside of the liver. And to confound results even more, tissues other than the liver also produce these enzymes.
The liver plays a major role in the metabolism and excretion of drugs, toxins, and waste products. As a result it is susceptible to injury as a direct result of these or due to diseases in other parts of the body. Common examples include dental disease, hormone abnormalities (such as Cushings disease), intestinal disease, and pancreatic disease.
Increased liver enzyme activities can occur from benign processes (e.g. hepatic nodular hyperplasia) which is not uncommon in older dogs.
Diseases of the liver itself are also numerous and can include infections, cancers, immune problems, and inflammatory conditions.
What to do if your dog’s liver tests are high?
The answer really depends on your dog!
A mild elevation in liver enzymes can be a sign of many things like dental disease, intestinal disease, general inflammation, as well as liver disease of course. Mild elevation can also be completely normal in an older dog, and this is pretty common. The other blood results may prove a clue, as will your dog's history and physical exam.
Options include:
Rechecking the blood levels a few weeks later to see if there is any change.
Treating any other diseases that are known to be present (such as dental disease)
More testing, such as a blood test called a bile acid stimulation, or imaging with ultrasound (or xrays).
The liver is a very hard organ to know exactly what is going on and in some cases, when everything points to a problem within the liver itself, a biopsy is needed.
Vaccinating Your Cat: how often is too much? | #48
13 Feb 2020
00:16:03
Cat vaccination frequency varies depending on the lifestyle of a cat, and the vaccinations that they need:
No need to vaccinate cats every year with the core vaccine (flu and panleukopenia), although the WSAVA recommendations are that high-risk cats benefit from an annual flu booster. Rabies may also be required depending on where you live.
All cats should have a full booster vaccination every 3 years.
For indoor cats, the non-core vaccines (like leukemia) won't be needed unless the diseases are present in the household already. For those cats that will benefit from these non-core vaccines, an annual booster is needed.
The same vaccine is used for the initial vaccine course and the booster vaccines, the only difference is that the initial course requires 2 or 3 vaccines (depending on the age of the kitten/cat) to ensure initial immunity is achieved.
Shark Mouth! When Retained Teeth Cause Problems | #47
06 Feb 2020
00:11:19
Does your puppy or kitten have more teeth than they should? Have you noticed their baby teeth sticking around? If so they can end up causing serious problems. This is what you need to know!
For most dogs and cats, the deciduous baby teeth are all present by 2 months of age, and then become replaced by the adult teeth by 6 months. In some breeds it is more likely that some baby teeth fail to fall out.
Retained teeth can push the adult teeth out of normal alignment, causing problems. they can also result in food becoming trapped, something that can quickly lead to advanced dental disease.
At the standard spay/neuter age of 5-6 months, one of the pre-op checks should be for retained teeth. These can then be removed at the same time without the need for a second anesthetic.
Head over to the full show notes and download my free guide to keeping your pet as healthy as possible
Let Your Cat Out at Night or Keep Them Grounded? | #46
19 Dec 2019
00:09:59
Do let your cat explore outside? What about at night? It could just be safer for your cat to keep them indoors!
"Will my cat be okay if I let her sleep in a close room at night?" - Maricar
Your cat will be absolutely fine in a closed room at night so long as it's not too hot or cold.
She should have access to fresh water and I'd recommend having a litter tray for her to use as well as a comfortable bed!
I fact, your cat will most likely be better off inside than being allowed outside at night. It is typically during the night that cats get into fights (that can also spread diseases like FIV), or get hit on the road.
Head over to the full show notes and download my FREE guide to keeping your pet happy, healthy, and out of the vet clinic!
Killing Ticks Without Harming Your Dog - Bravecto Facts | #45
12 Dec 2019
00:12:25
Bravecto is one of the newest kids on the block when it comes to the control of fleas and ticks. While it works very well, some people question this drug’s safety and others struggle with the tablet’s price. So can you split Bravecto tablets, and when should you be worried about an overdose or Bravecto side effects?
Bravecto is isoxazaline parasite control product that is a tablet which: Kills fleas for 12 weeks, kills most ticks for 12 weeks (Ixodes ricinus, Dermacentor reticulatus and D. variabilis), but only kills the lone star tick for 8 weeks
The Bravecto data sheet clearly states: "The chewable tablets should not be broken or divided". This is because the active ingredient can not be guaranteed to be evenly mixed throughout tablet and so half a tablet may contain less or more than half the total tablet dose.
It is uncertain how significant the difference could be but it could mean that a dog is either under-dosed or overdosed. This will depend on the size of your dog compared to the supposed dose given
That being said, the dose rate for dogs within 1 dosing band corresponds to a dose of 25 – 56 mg fluralaner/kg body weight which is clearly quite a large dose rate to work with. You may be happy with this and so choose to split the tablet, but it is not something that I can specifically recommend.
Overdose testing has been carried out for Bravecto and: "No adverse reactions were observed following oral administration to puppies aged 8 – 9 weeks and weighing 2.0 – 3.6 kg treated with overdoses of up to 5 times the maximum recommended dose"
As with any drug there are potential side-effects which include: diarrhea, vomiting, drooling and inappetence, and in rare cases muscle tremors, wobbliness and even seizures in dogs taking these drugs. It might be that your dog is at a higher risk of side-effects - for example, I would be cautious about recommending its use in epileptic animals or those suffering from other types of seizures
The Not-So-Simple Case of Cystitis: Molly's Mucometra | #44
05 Dec 2019
00:16:39
If your dog or cat isn’t responding to treatment as well as you’d like, or their problem comes back, it’s tempting to either just sit on it or go to a different vet for a second opinion.
Today I want you to meet Molly and her owner Bex, whose story is a great example of checking in with your vet when treatment wasn't going to plan, and how seemingly simple common problems can actually be the result of something much more unusual!
Lessons for Everyone - Bex had a great approach to Molly’s illness, with lessons that we can all learn:
Looking for information online but knowing that a vet visit was needed. No information online (even on this site!) can replace a consultation with your veterinarian so that a thorough history and physical examination can be performed.
Not ignoring the fact that treatment hadn’t worked as well as expected. Seeking additional help early rather than wait until Molly was really sick, and not going to a different vet because things hadn’t gone to plan first time. Working through a health problem is a process, and you shouldn’t expect your veterinarian to be able to cure every problem in a single consultation.
Common things occur commonly. If you hear hoofs sometimes it’s zebras rather than horses (but normally it’s horses)! For animals that are really sick it may well be best to run a whole barrage of tests immediately. For most though, when time is not so critical, there is a process of testing for or treating the most likely diagnosis. If there isn’t the response expected then the more unusual causes will begin to be investigated.
A big thank you to Bex and Molly for letting me share their story! Find the full show notes with pictures here
Anesthetic risk and surgical safety (what you need to know to keep your pet safe)
15 Apr 2024
00:19:12
😱 Don't gamble with your pet's life. When it comes to your furry friend's surgery, knowing the risks is crucial for their safety!
🩺 Surgery may not be just routine - from a tiny risk of 0.01% for neutering procedures (that's 1 death for every 10,000 surgeries) through to a 16% death rate for the sickest of patients, the risk really does vary hugely by individual.
🏥 Several measures can increase safety: from pre-surgery blood tests, weight management, to advanced monitoring equipment - these are vital!
💡 The takeaway? Proactive health management & choosing a vet with the right skills & equipment is a game-changer. It not only reduces risk but ensures peace of mind.
💬 Have you ever delayed a surgery for your pet due to fear of anesthesia risks? What could have eased your worries? Share your thoughts!
Pet Insurance: a waste of money or life-saver? | #43
28 Nov 2019
00:17:09
What do you think? Is pet insurance a needless expense? Or is it, in fact, a vital life-saver? In Australia, the pet insurance industry has just been given a Shonky Award for being one of the dodgiest products in the country! On the other hand, pet insurance could allow your pet to receive life-saving treatment you would not otherwise be able to afford. So is insurance for your dog or cat something you should be thinking about?
Choice, on reviewing 86 different pet insurance policies, claimed it couldn't recommend a single one. Some key reasons were that pet insurance is "Riddled with exclusions and technicalities, pet insurance is one of this country’s worst value insurance products," and "It relies on emotionally manipulating your love of your pet to sell you worthless insurance".
Insurance doesn’t cover: routine care - vaccinations/parasite control, often excludes dentistry, and there are serious exclusions based on breed as well as your pet’s medical history.
I often tell people that an insurance companies job is to NOT pay out so that they can make money for their stakeholders. The fact is that, on average, a pet owner will pay more in insurance than they will ever claim back
BUT - insurance can be the difference between life and death! Serious illness, expensive diagnostics, and complex surgeries will often be unaffordable without insurance. The alternative is less than ideal care, not making a diagnosis and trying to cut corners, euthanasia, or death
One pet insurance alternative is to have an emergency savings fund for your pet dog or cat.
Talk to your vet about how much this should be for your pet. A rough guide might be $5000 - $10,000 depending on the size and breed, as well as where you live.
One draw-back to this is that if you are only just starting a savings fund, what are the options if the fund is not enough to cover your vet’s bills. Credit cards, finance and other loan options are very expensive ways to access money. Borrowing from family may be an option. You need to have a plan.
Insurance can be a worthwhile product that can give you peace-of-mind and may also save your pet’s life. It is though not the only option
For more information about pet insurance and all the links discussed, head over to the full show notes.
Insurance is my bonus tip in the 5 steps to keeping your pet happy, healthy, and out of the vet clinic! You can download your free guide here.
Avoiding Superbug Creation + Long Term Antibiotic Risk | #42
21 Nov 2019
00:13:17
Antibiotics are an incredibly valuable treatment for all manner of infections and diseases in pet dogs and cats (as well as us humans of course!). But if your pet needs long-term antibiotic treatment you might be worried about the potential for side effects. Here are some questions you need to answer…
Different antibiotics have different potential side effects. Neurotoxicity could be seen with metronidazole treatment for example, but not with amoxicillin.
Side effects are most often (but not always) either individual or dose-dependent rather than time-dependent. Antibiotics kill bacteria throughout the body, not targeted to a single area, can result in chronic diarrhea and may lead to the development of resistant infections.
Are antibiotics really needed long-term?
There are conditions that require the long term use of antibiotics such as: antibiotic responsive diarrhea, inflammatory bowel disease and metronidazole, and chronic snuffles treated with azithromycin
In other conditions, antibiotics are just treating the infection that is happening because of another disease. Addressing the primary disease may eliminate the need for antibiotics
Is the right antibiotic being used?
If repeat of long term antibiotics are needed then always worth asking
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Anal sac abscesses are not particularly common in cats. They are though painful and there are some causes that mean a vet check is always a good idea.
Tracey asks: “My 4 year old male cat seems to have a burst abscess anal gland on the right side his anus. He seems okay. He has been licking it and hasn’t been sick in any way. He is very active and it seems to be healing now and closing up.”
Not a common cat problem - anal gland abscesses normally develop after the anal sacs fail to empty as normal, become impacted, infected and then burst out into the surrounding tissue
Causes of anal glands failing to empty properly include: Soft stools, Inflammation of the surrounding tissue, Anatomical issues, Masses in or beside the anal glands
Anal gland abscesses are typically very painful and require treatment: Antibiotics, Pain killers, Expression/flushing which may need sedation
An urgent visit isn't needed but, given anal gland problems are not a common issue in cats, it will be worth getting them checked and emptied to make sure there is no sign of a mass or other problem.
Straight after an AG abscess, I often find that the anal glands fill up quicker than normal and will often recommend a re-examination 2-4 weeks later to make sure there is no recurrence
If your dog or cat's treatment is not going to plan then what should you do? It might be tempting to take them to a different vet for a second opinion. While this is certainly an option, it may not actually be the best idea
Important that if a problem isn’t resolving, or if there are unexpected changes, to revisit with your veterinarian. Record what problems you are seeing at home by writing down list and take video as often pets won’t “perform” during a consultation
If signs are non-specific and no particular issues are found on exam then we often start with a symptomatic treatment trial. Lack of response, or progression, will then trigger further investigations such as blood, xray, or urine testing
If you don’t feel that your pet is getting the care you expect then can consider getting 2nd opinion. It is important you have realistic expectations of your veterinarian. 2nd opinions definitely have their place but in my experience it is very seldom that I end up recommending anything particularly different compared to the first vet
The importance of having a relationship with your vet based on trust can not be overstated
For complex cases, especially where tests have been inconclusive and response to any treatment has been poor, being referred to a specialist may be best.
Panting Cat? They're living life on the edge...| #039
30 Oct 2019
00:11:09
If your cat is breathing fast, even if it’s only for a short period of time, then you need to know that they could be incredibly sick. Cats are great at hiding signs of being unwell, and while they may be completely healthy, in my mind, a cat who is breathing quickly of heavily should be seen as a potential emergency.
Heavy and fast breathing is always a bit of a worry in cats. Cats are great at hiding signs of being unwell and so it might only be noticed that they are struggling when they are almost on deaths door - this is not an exaggeration!
Breathing heavily can be a sign of a number of different things including: Normal (physical exertion, fright), pain, lung disease (e.g. asthma, cancer), fluid in the chest (e.g. due to heart failure, liver disease, and trauma), infection (a cat bite to the chest is a common cause), air in chest (caused by e.g. lung pathology, trauma), chest mass (cancer, diaphragmatic hernia), anemia (caused by bleeding or red blood cell destruction).
About 30% of Maine coon cats have a genetic mutation that makes it likely that they will develop hypertrophic cardiomyopathy. This makes heavy breathing even more significant in this breed
Any cat that is breathing heavily should be checked over as a matter of urgency, if they are “panting” then this is a potential emergency. Keep your cat quiet and handle/move/stress as little as possible. Stress can result in respiratory arrest and death. These cats can really be on the very edge of survival
For more information head over to the full show notes
Spaying Your Female Dog (is it the right thing to do?) | #038
24 Oct 2019
00:17:35
Spaying your female dog is one of the biggest surgeries she will have in her life. You need to know that you are doing the right thing. So should you spay your dog, and if so what is the best age?
Known benefit of spaying a female dog include: eliminate pyometra risk, massively reduce mammary cancer risk, spayed dogs live longer lives, reduced roaming and trauma risk, and eliminate pregnancy risks (such as c-section, eclampsia)
Potential risks of spaying: risk of anesthetic and surgery, increased risk of developing urinary incontinence, increased obesity risk, increased potential of joint problems in larger breed dogs, and there may be an increased risk of certain cancers (especially in Rottweilers)
From all of the available evidence, it is impossible to make any sweeping generalizations.
Simple, one-size-fits-all rules are much more appealing and far easier to apply than a subtle, complicated decision based on various risks and benefits that are not fully understood.
What is right for one individual may be wrong for another, because of the breed of your dog, or because of the different risks that people are comfortable living with.
For small breed dogs, I would still recommend spaying when they are around 6 months old before their first season.
For larger breed dogs, however, where there is no risk of them becoming pregnant and where they can be successfully managed while on heat, I recommend delaying this operation until they reach 1 year of age or a little older.
Full show notes and links to several related articles can be found here
An Old Dog with Kidney Failure and Seizures - facing up to reality | #037
17 Oct 2019
00:13:04
Watching your dog having a seizure is an incredibly distressing event to witness. But what can you do to help stop their seizures if they're not having a fit caused by epilepsy? Sometimes treatment is tough and the prognosis poor.
Recognizing these situations is so important if you want to be sure that you are making the decisions that are in your dog’s best interest.Seizure causes are numerous. They fall into the five main categories of: Toxins, infection, organ dz, brain lesions, and epilepsy.
Controlling seizures involves making a diagnosis and then being able to treat, manage, or cure it effectively. When there is a disease causing the seizures, other than epilepsy, then anti-seizure medication alone will often fail to control the seizures adequately - especially in the long term.
Anti-seizure medication can though form part of symptomatic treatment plan while investigating and starting treatment targeted at the specific underlying cause.
The kidneys help to regulate hydration, body salt levels and filter out numerous toxins from the blood
In advanced kidney failure, seizures can result from the build up of toxins within the blood. This is typically only seen right at the end of long term failure, or if there has been a sudden failure - acute kidney injury - e.g. antifreeze toxicity. Seizures are a sign of severe and advanced kidney damage and unfortunately the prognosis is likely going to be really poor.
Whenever our pet has a really serious disease, we need to be realistic about the likelihood of recovery and whether ongoing treatment is resulting in an improvement, whether the condition itself is curable, as well as the condition of your pet (e.g. are they comfortable or in pain)
Vital that you work in conjunction with your veterinarian. It is important that you know what to expect, the likely outcome based on the treatment and investigation decisions made, as well as the potential costs involved.
Decisions need to be re-evaluated on a weekly, daily or even hourly basis. We always need to be thinking what the best decision is for out pet, not for us
Make no mistake, if your dog or cat has a problem with their eye then it can go from being a minor inconvenience or irritation to something really serious within a day or two. It could even result in permanent blindness or loss of the eye.
You definitely want to make sure that they are being given the right treatment for keratitis or any other form of eye disease!
Keratitis is an inflammation of the surface of the eye - the cornea. There are 2 main categories: ulcerative and non-ulcerative
Keratitis in cats is most often caused by infection with herpesvirus, but can also be due to other causes including trauma, irritation, immune system dysfunction, increased intraocular pressure (glaucoma), and dry eye
The surface of the eye becomes pink/white/chalky with raised lesions, you may also notice new blood vessels growing over the eye
So long as no ulceration of cornea then steroid drops are the most common treatment of keratitis in cats, although this will depend on your cat’s history and the suspected underlying keratitis cause.
If a corneal ulcer is present - something your vet will check using fluorescein stain - then antibiotics will be given first to allow the eye ulcer to heal
Additional treatment may be needed alongside the steroid eye drop. These can include oral or injectible steroids and antiviral medication
Treatment may be needed lifelong. Once a cat has herpesvirus then it is often with them for life and may cause a permanent or intermittent keratitis (as well as other problems)
If your cat is receiving steroid eye drops and any discharge is geting worse or their eye becoming painful then stop the medication and get your cat’s eye checked over straight away. If an ulcer is present and steroid eye drops are continues then it is possible for a deep ulcer to form that can then burst
How to Groom Your Sassy Long-Haired Cat (and keep them calm)! | #035
02 Oct 2019
00:14:35
Grooming a long-haired cat can be a full-time job. If they don't like it then it can also be a nightmare where you end up being covered in scratches and blood!
This cat in question is getting poop stuck to her back end and the first step is to find out why this is happening and if there is an underlying condition that needs treating. If not, there are several steps that any owner can take to make grooming easier at home or to reduce the stress of any visit to your groomer or veterinarian.
Talking to Children about the Death of a Pet (and helping them grieve) | #034
26 Sep 2019
00:17:05
If we have a pet in our lives, then unfortunately at some point there will come a time when we will need to make a really difficult decision to say goodbye.
Today's question is all about how to speak to your children about the death of a pet. How to talk to them and involve them in the buildup to euthanasia. And once your dog or cat has died, how to help your child grieve.
Unraveling a multi-dog mystery (with lessons for every pet parent)
27 Mar 2024
00:15:03
🐾 Get ready to tackle this itchy pet mystery with Dr. Alex answering a question sent in by listener Trish that addresses some really key pet-care pearls. From narrowing down the potential causes of any problem, the importance of making a proper diagnosis, through to when to seek the input from your veterinarian. This episode has something for every pet parent!
Is a Prescription Diet Really the Best Food for Your Dog? | #033
23 Sep 2019
00:16:51
Are prescription diets really the best option for your dog or cat if they are unwell? Is raw feeding or switching to a home-cooked diet as good (or even better)? And are vets are paid to sell diets by the big food companies?
Feeding your dog or cat the best diet can be tricky and the choice is even more important if they are unwell!
What's Up Doc? Rabbit teeth and the importance of diet | #032
18 Sep 2019
00:16:41
Dental disease in rabbits is one of the most common problems they develop. It is also a big reason that a rabbit may need to be euthanized while they are still relatively young. Understanding why tooth problems develop and how to prevent then can ensure your rabbit lives a long and happy life! Check out the full show notes at callthevet.org
I'm tackling two completely separate topics this week
Why a cat could be leaking urine after suffering from a blocked bladder (01:45)
How to prevent cystitis in cats (09:52)
The causes of a hard, bloated abdomen in a Chihuahua (25:32)
For full show notes, mentioned resources, and to get your dog and cat health questions answered by veterinarian Dr. Alex, simply head to callthevet.org