Applying Eye Drops with Low Stress Handling™

October 14, 2020 (published)
M. Leanne Lilly, DVM,DACVB

Photo by M. Leanne Lilly

 

At some point in many dogs’ lives, they will require eye drops. This might be a one-time event to examine the eye or it may be multiple times per day to treat chronic disease. Regardless of the cause, applying eyedrops need not be a struggle for you or the pet, whether at home or in a clinic setting. The same approach works in both places.

Gather everything you need:

A comfortable place for you and the pet. For small pets this might be on a table, on a chair, or even on your lap if the pet is comfortable there. For large dogs, leave them on the floor.

Items for positive reinforcement and distraction: typically food, but a toy will work well for some pets. You may want or need something the pet can lick the food off (for example, a spoon with a dab of peanut butter).

The eye drops/medication to be given.

Photo by Corey Bodine

Get set up comfortably:

Avoid bending over or toward your pet, it is best to crouch to the side or behind the pet.

Keep your posture as upright as possible so there is no sense of urgency due to impending back/neck pain. If you are prepared to take your time, your pet won’t pick up on your anxiety cues.

Have the dog seated or standing, looking at you or at a right angle. Large dogs can rest their chin on your leg, or the edge of the couch or a chair to decrease downward motion. These are behaviors that can be taught; in a pinch, you can lure a dog to do them with some food.

Giving the eye drops or ointment

Uncap the eye drop bottle or ointment tube.

Photo by M. Leanne Lilly

Get the bottle in position near your pet’s eye. (The photo to the left shows how you want to be positioned.)

Hold the bottle or tube horizontally or tilted up so it is not dribbling on the pet.

Positioning your hand is typically least stressful when coming from underneath and behind the ear as if you are petting the dog.

Rest the outside/pinky edge of your hand on the dog’s head, behind their eyebrow. This should preferably be just outside of their peripheral vision. (See example to the left.)

If your dog is concerned about this positioning, do a few rounds of counter conditioning by moving your hand closer and closer to this position and feeding food just after hand placement so that your hand touching their head means food is coming.

You are most stable with your hand and wrist on the dog’s head, which requires placing the target eye away from you.

Photo by M. Leanne Lilly

Since you are slightly above the dog, make a kissy or smoochy noise, or say their name in a high-pitched happy tone to get them to look up. This opens their eyes wider for you.

Quickly drop in the drop/ ointment without touching the lid or the eye – gravity does most of the work for you.

Follow with food from your other hand or use it for the entire duration of the process if needed. There will be more head motion if the dog is eating while you attempt to drop in the drop/ointment, but your hand will move with their head.

If you need to put drops in both eyes, some dogs will allow you to shift immediately to the other eye. Some dogs need a short break, and you’ll need to repeat the process.

 

Photo by Corey Bodine

Applying a Muzzle to an Aggressive Dog

Colleen S. Koch, DVM, DACVB
Date Published: 12/15/2020

 

Disclaimer: If a dog needs to be muzzled, it should be sedated. Just because we can do something does not mean we should; it is important to consider the long-term impact of the interaction on the pet. The owner should be encouraged to desensitize their dog to wearing a basket-type muzzle.

Applying a muzzle can be necessary for some patients’ procedures to keep the handlers safe. The ability to apply a muzzle quickly and securely without increasing the stress and anxiety of the patient is critical.

Most veterinary clinics use cloth sleeve type muzzles. They are not recommended or intended for prolonged procedures. The snug fit prevents the patient from panting, which can increase the patient’s fear and anxiety. Basket-type muzzles should always be the first choice. They allow the patient to pant (which helps reduce their anxiety), eat, drink, and vomit.

If your clinic has not converted to the use of basket muzzle or is not fluent in applying basket muzzles quickly in fearful dogs, consider using these tips to reduce your patient’s anxiety when applying a cloth muzzle. Please note, if a patient requires muzzling, the owner should be sent home with a basket-type muzzle and instructions for desensitization and counter-conditioning to facilitate future veterinary visits.

Use a Styrofoam or paper cup* with a treat so the dog must stick its nose into the cup.

Photo courtesy of Colleen S. Koch

The cup should be short enough the dog is able to eat the treats at the bottom.  If the dog has a short snout, you can cut the top edge of the cup so the dog’s tongue can reach the treats.

Feed the dog treats in the cup; repeat several times.

Once the dog is readily putting their nose in the cup, it is time to add the muzzle.

Photo courtesy Dr. Colleen S. Koch

The muzzle will be slipped inside the cup with the edges of the muzzle hanging over the edge of the cup (see pictures below). The muzzle is not applied to the dog yet.

Photo courtesy Dr. Colleen S. Koch

The next step is to present the cup with treats in the bottom and the muzzle nested inside the cup.

Photo courtesy Dr. Colleen S. Koch

The current treat, and previous offers of treats in the cup, should encourage the dog to readily stick their nose in the cup with the muzzle nested inside. Repeat this step 2-3 times to encourage the dog to quickly put their nose in the cup with the muzzle.

Photo courtesy Dr. Colleen S. Koch

Next, slowly raise the strap on the muzzle as the dog continues to eat the treats.

Photo courtesy Dr. Colleen S. Koch

As long as the dog is distracted by the treats, continue to attach the strap. If the dog finishes the treats before the muzzle is applied, try to anticipate and remove the muzzle and cup before the dog is finished with the treats.

Repeat this process until the strap is applied. A longer-lasting treat may be required.

Photo courtesy Dr. Colleen S. Koch

If at any time the dog struggles or backs away, stop and go back to the previous step.

Once the muzzle straps are attached, remove the cup and continue to feed treats while the dog is wearing the muzzle. The use of a tongue depressor, mixing spoon, or metal bowl may be used to keep hands away from the mouth if the patient is grabbing treats hard with their teeth.

Photo courtesy Dr. Colleen S. Koch

To remove the muzzle, offer the treat-filled cup for the dog to stick their nose in.

Photo courtesy Dr. Colleen S. Koch

While the dog is distracted eating the treats, unfasten the muzzle.

 

*Helpful hints:

Have several cups ready with the dog’s favorite treats, enabling you to move through the process quickly and easily.

Styrofoam and paper cups can have diluted chicken broth frozen in them to facilitate muzzle application prior to an injection and or surgery.

Deep stainless-steel bowls can be used instead of cups for more aggressive dogs and or those with larger snouts.

Aggression Between Familiar Dogs

Christine Calder, DVM, DACVB
Date Published: 12/21/2020

 

Aggression between familiar dogs in the same household is a common occurrence and is one of the most common reasons that dogs are surrendered, rehomed, or euthanized. This aggression can be secondary to high arousal or excitement levels. When a fight occurs, damage to the relationship between the dogs can be difficult to repair.

There are a variety of factors that need to be considered when determining the future relationship between these dogs. For instance, aggression between female dogs is reported to be the most common and is the most difficult to treat due to the severity of injuries and intensity of aggression that occurs between the dogs. Fights between male dogs are often due to resource guarding and are the easiest to treat. Other indicators for poor outcome include:

Photo Courtesy of CattleDog Publishing

  • fights escalating in intensity.
  • fights occurring between two female dogs of similar size and age.
  • no noticeable early warning signs or triggers.
  • level three bite or above.

 

As with any behavioral concern, the first step is looking for underlying medical causes contributing to the behavior.

Treatment Plan

When aggression occurs between familiar dogs, the initial goal of the treatment plan should focus on improving the welfare for both dogs. Although it can be difficult, there should be complete separation of the dogs with no visual contact. Leashes, gates, and tethers can be useful.

Monitor body language of each dog. Since dogs are often very subtle with body language monitor closely for hard stares or stiff posture that is signaling to another dog that they are uncomfortable. It is important that both dogs be completely relaxed in close proximity to each other. Direct stares (longer than three seconds) need to be quickly redirected to reduce escalating tensions.
Basket muzzle training is very important for safety. All dogs should be conditioned to wear a muzzle. This is not a punishment but rather a predictor of good things. Go slow and always wait for each dog to put their own nose into the muzzle. We never force it on, and the dog must willingly place their nose in the muzzle. We never advance it on them.

The dogs should never be together until they are 100% comfortable wearing their muzzles. A muzzle with a buckle is ideal as plastic clasps can break easily. A Baskerville Ultra or Jafco Muzzle with the end square for treat dispensing would be best.

Once comfortable in muzzles you can start walking them next to each other, one adult per dog. This is a great way to rebuild their relationship.

Teaching alternative behaviors such as “touch” is a great behavior to teach your dogs. It can be used to redirect a dog when needed. It can also be used to teach new behaviors and even as an emergency recall.

Teach your dogs to relax on a mat. This can be used later if the dogs are to be reintroduced.

Establish a safe haven such as a crate or room for all dogs. Make sure good things happen in this area. Food dispensing, puzzle toys, classical music and pheromones, can be helpful. A tether or gate may be necessary. If using a crate, be sure to cover and place them out of sight from each other.

Practice Cue-Response-Reward interactions with each dog. A Cue-Response-Reward interaction system encourages predictability and consistency therefore reducing overall anxiety and instability in the relationship between the dogs.

Photo courtesy of CattleDog Publishing

Phase II

Once both dogs are comfortable wearing muzzles and relaxing on their mat.

  • Initially, bring them out for short periods together.
  • One adult per dog and sit on opposite sides of the room. A tether may be necessary.
  • Give them something to do, like a long-lasting treat or toy giving the dogs an opportunity to be together, stay calm and relearn to like each other.

Always separate when they cannot be directly supervised with your entire attention.

Medications

In many cases medications for one or both dogs may be needed to lower anxiety.

Adopting a Shelter Dog

Miranda Spindel, DVM, MS
Date Published: 06/12/2018

 

Deciding to add a new animal to your family is an exciting time! It can be very rewarding to choose to adopt a dog or puppy from an animal shelter or rescue program. Not only will you be adding a wonderful companion to your family, you will also be saving a life. There are still millions of shelter animals being euthanized annually in the United States that would have made wonderful family pets. Here are a few things to consider before, during, and after the adoption that can help ensure success.

Before Adopting

Photo Courtesy Dr. Teri Ann Oursler

Make sure you are ready

Adopting an animal means that you are agreeing to be responsible for the animal’s care for many years to come. It is always smart to think ahead and try to consider what might change in your life and how you will be able to ensure that you meet your new dog’s needs as a beloved family member. Veterinary care, nutritional needs, exercise requirements, and how well the dog will blend with children and other family members are all important considerations.

Research what type of dog is right for you and your family
There are many factors that may play into the type of dog you seek to adopt. Breed, energy level, sociability, haircoat, age, and your own personality and lifestyle are just a few. Many shelters are experienced at helping to make lasting matches and may even have standardized, research-backed questionnaires for you to fill out to help with this process.

Learn about your local shelters and rescues
Most areas have more than one animal welfare organization and each may have different missions and philosophies. You may wish to give your adoption support to the agency your philosophies align best with. Consider asking your regular veterinarian about the local shelters. Chances are, they’ve examined animals from most of the nearby facilities. They will have opinions about the health and well-being of newly adopted animals and about shelter operations. It can also be useful to ask friends what their experiences have been.  Ultimately, you should not only feel great about the dog or puppy you are bringing home, but also about the organization you choose to support through your adoption. There are many things to learn about and consider!

During the Adoption

What to expect
Rescues and shelters take variable approaches to the adoption process. Some require you to fill out involved questionnaires and will call landlords and perform reference checks. Others take a more open, trusting, and conversational approach. Some shelters will send animals home the first day you visit and others take a slower approach. It can be helpful to familiarize yourself with how the shelter you visit works right away, so you won’t be disappointed after you’ve matched with a dog. Almost all shelters will require their animals be spayed/neutered prior to adoption. Many shelters will have already performed the surgery before animals are made available for adoption, while others wait until adoption papers have been signed. This is also something you may want to find out about early on. Less commonly, shelters will send animals home with a voucher or other system and require spay/neuter at some point after adoption. It can be helpful to try to keep an open and compassionate mind during the adoption process. Remember that shelters are busy and chaotic places not only for the animals they house, but also for the humans that work there.

What to ask
Once you have found a dog that you are interested in, ask the shelter for as much information as can be provided! Get a complete history, but recognize that sometimes there is not much information known. Find out when and where the shelter obtained the dog; was it brought in as a stray, surrendered by an owner, transferred from another shelter, or some other situation? Ask what is known about the previous living situation and how the dog has behaved since being at the shelter. You should also be shown the medical records the shelter has kept since intake (and any previous records that might exist). You will want to ask about any ongoing medical issues, whether the dog is on any medication, and if there are known medical issues what anticipated care will be required. Inquire about what sort of follow-up services the shelter offers such as health insurance, microchipping, obedience training, or consulting for behavior issues or medical issues. Finally, be sure to ask about return policies as it is important to know what options exist if the adoption does not work out.

After the Adoption

Veterinary visit
Although many sheltering organizations have staff veterinarians, many do not. The level of veterinary care can be advanced to non-existent. No matter which exists in the shelter your dog comes home from, it is always wise to schedule an appointment to see your regular veterinarian soon after adoption. Illnesses such as upper respiratory infection and diarrhea are quite common in the early period after adoption due to the stress of shelter stays, and your veterinarian can help provide appropriate care so that your new friend recovers optimally. Vaccination boosters, parasite examinations, microchip implantation, and other important preventive care may also be needed during the early time after arriving home.

Be patient
It can take weeks for a new dog to adjust to a new home, yard, family, and environment. Keeping things quiet for a week or so, learning about and employing crate-training, and establishing a solid routine can help. Especially for an older dog, patience during the initial adjustment period often pays off in spades once the dog settles in!

Use your Community Resources

Finally, don’t be afraid to ask for help if things aren’t perfect initially or if you have questions. The shelter you adopted from will ideally be your first source of information and happy to hear from you and to provide support!

Alcohol Poisoning

Becky Lundgren, DVM
Date Published: 07/04/2005
Date Reviewed/Revised: 02/18/2020

Photo courtesy of Shutterstock

 

Dogs and cats can get more than just drunk when they drink ethanol, isopropanol, or methanol — they can get a trip to the emergency room. Pets can die from ingesting alcohol.

What are ethanol, isopropanol, and methanol?

Ethanol (ethyl alcohol) is most commonly formed from the fermentation of sugars. Ethanol is found in alcoholic beverages, some liquid medications and mouthwash bases, rotting/fermenting fruits, and rising (raw) yeast-containing bread dough. The “proof” of ethanol is twice the percentage of alcohol concentration (i.e. 80 proof = 40% ethanol). Although ethanol is also in some household inks, cleaners, and solvents, the levels are low enough to generally be of no clinical significance if these products are ingested by pets.

Isopropanol (isopropyl alcohol) is in rubbing alcohol (70%), some anti-freezes, some detergents, glass/window cleaners, perfumes/colognes, and alcohol-based topical sprays, including some pet flea-control and grooming products. Isopropyl alcohol is more than twice as potent as ethanol or methanol.

Methanol (methyl alcohol, wood alcohol) is most commonly found in automotive windshield washer fluids (20-80%), but is also in some gasoline additives, “canned heat” fuels (e.g. Sterno®), and some household solvents (e.g., paint removers).

Although the strength of these three alcohols vary, the clinical signs associated with their ingestion by dogs and cats are quite similar.

All poisoning problems boil down to the amount of alcohol ingested compared to weight, just like a dosage of medicine. Thus, when pets drink an alcoholic beverage that was left within reach, or that was given to them intentionally by someone, it can cause a significant toxicity problem. In addition, significant absorption can occur through the skin or by inhalation.

Dogs are highly susceptible to the effects of alcohols. Signs of mild inebriation may occur with even minor exposure. Within 15 to 30 minutes after the pet has drunk the alcohol on an empty stomach (or within 1 to 2 hours on a full stomach), central nervous system (CNS) signs, such as staggering, excitement, or decreased reflexes, can begin. Behavioral changes can be seen, as can an increased need to urinate. As the problem gets worse, the pet may become depressed, have a slow respiratory rate, or go into cardiac arrest. Puppies and kittens are at particular risk because of their small size and immature organ systems.

Alcohols are depressants, so many of the clinical signs associated with them are due to their effect on the CNS. Alcohols irritate the gastrointestinal tract. They also act as diuretics, and the alcohol and its metabolites are eliminated by the kidneys. Liver damage may occur after exposure, although it is much more common in animals that have repeated or chronic exposure.

Clinical Signs

Clinical signs of intoxication can occur within 15-30 minutes of ingestion of alcohol. Signs include nausea, vomiting, thirst, urination, dehydration, lethargy, incoordination, disorientation, becoming cold (hypothermia), low blood pressure, and alcoholic bad breath. In severe cases, blindness, tremors, tetraplegia, respiratory depression, coma, or seizures may develop. Death is uncommon but may occur, especially if the pet has severe respiratory and cardiovascular depression, low blood pressure, and/or hypoglycemia.

Diagnosis

Diagnosis is based on a history of exposure, combined with appropriate clinical signs and laboratory tests.

Treatment/Management/Prevention

The treatments your veterinarian may use can include assisted ventilation, intravenous fluids (to improve elimination of the alcohol/metabolites, to provide cardiovascular support, and to correct electrolyte abnormalities), seizure control, and other supportive therapies. In addition, if the alcohol toxicosis is due to the ingestion of bread dough, your veterinarian may need to wash out your pet’s stomach with cold water to inhibit further alcohol production and to break up the dough mass for removal. In addition, your pet will be confined to prevent accidental self-injury.

Prognosis

Most dogs with alcohol intoxication can recover with adequate symptomatic and supportive care. Recovery may take 8-12 hours, and tends to take longer if it was a severe intoxication or if isopropanol was involved.

Preventing Alcohol Toxicosis

All alcoholic beverages and alcohol-containing fluids should be kept out of reach of your dogs and cats. Consult your veterinarian before giving any ethanol-containing liquid medications.

Do not feed raw bread dough to your pets or leave bread dough out to rise in areas that can be reached by them. Always dispose of discarded bread dough carefully.

Aural Hematoma in Dogs and Cats

Wendy Brooks, DVM, DABVP
Date Published: 01/01/2001
Date Reviewed/Revised: 05/28/2021

An aural hematoma in a dog. This is called a cauliflower ear. Photo by MarVistaVet

Why is an Aural Hematoma a Problem?

A hematoma is swelling created by a broken blood vessel after bleeding has occurred inside a tissue. Hematomas in the earflaps (aural hematomas) occur when head shaking breaks a blood vessel within the earflap. The earflap may partially or completely swell with blood. The swelling may be so large that the opening of the ear canal is occluded. The extra weight of the earflap may be uncomfortable and may lead to a permanent change in the carriage of the ears. This condition is more common in dogs but can occur in cats as well. The earflap will feel fluctuant and fluid-filled, like a water balloon.

A small hematoma may not actually be a problem and may not require repair. There are several situations where the hematoma should be repaired.

  • The hematoma is so big that the ear canal is occluded (blocked). If this is the case, the ear cannot be evaluated for infection nor can any infection be treated. In this situation, the hematoma must be relieved before the ear canal can be accessed.
  • The hematoma is in a location where natural healing will create scarring in such a way that the ear canal will be permanently narrowed. A permanently narrow ear canal can predispose the patient to a lifetime of ear infections. This is particularly a problem in cats.
  • The hematoma should be repaired if the owner feels the heavy ear flap is unacceptably uncomfortable for the pet.
  • To maximize the ability of the ear flap to stand up straight after hematoma resolution or to prevent excessive scarring in the ear flap for cosmetic reasons.

What do we do to Relieve it? 

There are probably as many ways of correcting ear hematomas as there are veterinarians. Some veterinarians have good results using medical therapy, treating with a corticosteroid. You and your veterinarian need to discuss the best way to treat your pet. The following are some commonly performed procedures. Some veterinarians will use low-level laser therapy in the treatment regimen for aural hematomas.

Aspiration

This procedure involves simply using a syringe to remove the fluid contents from the hematoma. The problem is that a space is left behind when the fluid is removed and this space readily refills with more fluid leading to only temporary results. The benefits of the aspiration method are that it is inexpensive and relatively easy to perform but the disadvantages are that it may introduce infection and may require multiple attempts. If the clot in the hematoma is already well organized and on its way to scarring, there may not be much fluid left to aspirate and the technique may not work at all. Usually other methods are utilized.

Ear flap after pie-crusting sutures. Tubing is used to help flatten the ear. Photo by MarVistaVet

 

Pie-Crusting Sutures

Here, an incision is made in the earflap surgically. The hematoma is drained of fluid and blood clots. To prevent the hematoma from refilling with fluid, multiple sutures are placed in the hematoma area either vertically or horizontally, either partly or completely through the earflap, with or without ear cartilage removal. Sometimes bandages are applied post-operatively, sometimes not. Sutures are generally left in place for three weeks to allow good scarring to take place so that refilling will not occur. The earflap is essentially quilted to close any space where fluid might refill.

 

 

Teat Cannula Placement

Teat cannula. Photo by MarVistaVet

A teat cannula is a small device used in the treatment of udder inflammation in cattle. It can be placed in the opening of the teat to allow drainage of milk or infected discharges. Teat cannulas can also be surgically placed in a dog’s aural hematoma if the earflap is large enough to accommodate the device. The hematoma is drained of fluids and allowed to heal over the next several weeks. This method is generally successful but does involve the dog tolerating a gadget inserted in its earflap for several weeks as well as accompanying fluid drainage.

 

 

What if There is a Concurrent Ear Infection?

Usually there is a reason why a dog has been shaking his head: an ear infection. This means that the ear infection must be treated along with the hematoma. The ear will need cleaning, microscopic examination of the discharge, and medication. Sometimes ear shaking just happens and there is no underlying infection, but be prepared for the expense and trouble of treating an ear infection along with that of the hematoma.

What if We Leave it Alone?

If left alone, an ear hematoma will resolve by itself. The fluid will be re-absorbed back into the body and the earflap will no longer bulge. The problem is that a lot of scarring is associated with this process and the ear is often not cosmetically appealing afterwards (i.e. it becomes a “cauliflower” ear). Resolution of a large hematoma can take several months during which it may be uncomfortable for the pet. If the patient is a poor anesthetic risk, it is certainly reasonable to forgo surgery.

Aural Hematoma in Cats

Ear hematoma before surgery. Note ear canal is totally blocked by the swelling. If allowed to resolve on its own, the canal could easily scar closed, sealing in infection. Photo by MarVistaVet.

The situation in cats is somewhat more complicated than in dogs largely because the cartilage in the feline ear is more sensitive to inflammation and scarring is more severe. This makes the untreated hematoma more likely to form a permanently narrowed ear canal and long-term ear infection potential. Cats’ ear cartilage tends to experience more healing deformity than dogs’ ear cartilage and more curling and softening of the thinner pinnal areas is seen.

Post-operatively, this cat’s ear canal is open to prevent infection but there is an issue. Photo by MarVistaVet.

What this comes down to is that there is less leeway in letting the ear heal on its own in cats than dogs. Surgical repair is especially important as there is a greater tendency for the a cat’s canal to narrow. That said, a more natural cosmetic appearance of the actual ear flap is harder to achieve in cat than dogs. It is more important to focus on the function.

As with dogs, a cat’s hematoma is generally brought about by ear infections and subsequent head-shaking. (In cats, most ear infections stem from ear mites but there are plenty of exceptions.) Bandaging is often used post-operatively as is the Elizabethan collar to protect the ear from being scratched. The cat will need confinement during a healing period of approximately 3 weeks.

The ear carriage of the post-operative ear does not match the normal ear. Photo by MarVistaVet.