Stop chopping dogs’ ears off

Attribution: American Bully Europa / CC BY-SA (https://creativecommons.org/licenses/by-sa/4.0)

Ever seen a dog like this? Selective breeding has created enormous variation in appearance between dog breeds, in terms of size, shape, coat colour and muzzle length. But humans haven’t (yet) managed to breed a dog breed without pinnae (ear flaps). This dog wasn’t born without ear flaps – somebody cut them off.

The RSCPA has reported a massive 236% increase in reports of dogs with cropped ears in the past 5 years, and I certainly have seen a larger number of these dogs in practice. Actually, I had never a seen a dog with cropped ears until the past couple of years.

Why do humans crop dogs’ ears? Historically, it was considered by some to have preventative health benefits for working dogs, as smaller, less exposed pinnae were not so susceptible to injury. There is no reputable evidence to support this, and it is a practice that has been largely confined to particular breeds, such as the Dobermann, and not widely performed in all working dogs. However, the huge increase in the practice seen recently is not in working dogs; it is in pets, particularly the ‘American Bully’ type and Cane Corso, and is performed for purely cosmetic reasons.

Ear cropping is considered to be a mutilation and is illegal to perform in the UK. Anybody performing the procedure can be prosecuted under Section 5 of the Animal Welfare Act 2006.

It’s a welfare issue for a number of reasons. Have you ever had an ear piercing? Now imagine having your ear flap cut off – painful right? Given the ‘backstreet’ nature of ear cropping, the puppy is very unlikely to be anaesthetised for the procedure or given adequate (or perhaps any) pain relief. A dog has the same nervous system that will sense this pain as you or I would experience it. And aside from the acute pain caused by the procedure itself, the wound created has to heal, with risks of infection. Animals have evolved to have ear flaps for a reason, and for dogs, as well as having some protective function for the ear canal, are a vital means of expression; a way that dogs communicate their emotions and intentions to other dogs. A dog without ear flaps is very difficult for other dogs to read.

Why has ear cropping become more popular? Ultimately, it is because people like the striking, and intimidating image it gives the dog. Celebrity ownership of these dogs and glamorisation on social media perpetuates the problem. The more people are exposed to these images, it begins to seem normal. Try searching ‘exotic bully’ on Instagram – you’ll be confronted with a plethora of pages all with hundreds of horrifying images of very peculiar looking dogs, all with their ears cropped, that look like they have been given a handful of anabolic steroids with their kibble. One of the captions I stumbled across for a photos was ‘freak of nature’.

These pages have tens of thousands of followers. What really concerns me is that the ear cropping seems to be just another manifestation of the growing popularity of dogs that have extreme conformations. Many of the most popular breeds right now are the ones that we have moulded into a shape that is almost unrecognisable from the canids we humans bred them from. People seem to want dogs that have a striking and unique appearance, and we have arrived at a point where, frustrated by the boundaries of genetics, we have resorted to cosmetic surgery to make our pets look the way we want them to. They are both companion to us, and fashion accessory. But our society has become increasingly blind to the suffering these extremes cause to the animal.

The vast majority of dog’s with cropped ears are imported. Usually they are bred abroad in countries with a more lax approach to animal welfare, have the mutilation performed at a young age and are imported with pre-cropped ears. Or, they are dogs bred in the UK, but sent abroad as puppies to have the procedure carried out.

The RSPCA have got behind a petition, calling on the government to ban the importation of dog’s with cropped ears, which you can sign here. Please do.

Ultimately the issue is not going to go away whilst these dogs are considered desirable, and the demand for them remains. Though they are in fashion now, hopefully very soon, tiny ear flaps will be SO last season.

What kind of book would Herriot write in 2020?

Earlier this month, the iconic All Creatures Great and Small made a triumphant return to our television screens. Over 3.3 million viewers tuned in to watch the debut episode of the remake which follows the colourful working life of Yorkshire vet James Herriot, making it Channel Five’s most popular show in terms of viewing figures for over 5 years. In the midst of the unease and widespread anxiety the COVID pandemic has fomented, the programme is a soothing hot water bottle antidote of a show; a welcome opportunity for escapism.

Magic potions in the Veterinary Pharmacy of the 1940s in the James Herriot Museum

Last week, the Daily Mail published an interview with the adult children of the real life James Herriot, Alf Wight, who penned the classic series of books the television series is based on. Aside from discussion of the family’s involvement in the production process of the remake, they spoke quite candidly about their father’s struggles with his mental health – something I personally was not aware of. While for the most part their childhood was as idyllic as one might imagine, there were darker times for the family and periods where the author contemplated suicide. What’s more, the real life Siegried Farnon, Donald Sinclair, sadly actually took his own life not long after Wight passed away. Alf Wight’s daughter Rosie felt very much that for her father, it was ‘cathartic getting his feelings out on paper’. Writing seemed to function as an outlet for the real James Herriot; a means to recentre himself and cope with the challenges of life.

For me this was profoundly upsetting to read. James Herriot is a national treasure; an emblem of the veterinary profession. His escapades are what many, particularly those of the older generation, think of when they imagine the work of a vet. James Herriot is a sort of sacred figure and to find out that he and another of the vets depicted were afflicted in this way was quite shocking

We vets are a pretty rare species: just one in every 3300 people in the UK, is a veterinary surgeon. To put that into context, one in every 482 people is a solicitor, and one in 233 is a medical doctor.  So although the vast majority of people may not personally know a vet, the profession is very much in the public consciousness. This is in part because of our national obsession with pets and the plethora of veterinary programmes on television that All Creatures Great and Small is just one of; the Supervet, the Yorkshire Vet and the Vet on The Hill being three of the most popular currently. These shows allow viewers to vicariously experience the day to day work of a vet and therefore most feel they have a good idea of what a vet’s work involves.

Whenever I tell a stranger I have just met what I do for a living, people are eager to here about my job; just this morning in the barbers, as soon as I mentioned that I was a vet, the conversation becomes much more animated. ‘You must love your job?’ I am usually asked. And my reply usually starts ‘yes, there are times I really enjoy it, but…’

Because in some ways, the profession is not in a great place at the moment. Veterinary courses remain heavily oversubscribed, so there is no shortage of intake, but the profession’s workforce is haemorrhaging ; vets are leaving the workforce at a greater rate than they can be replaced. But watching all these vet programs with cute animals and charming owners, it must be hard for those outside of the profession to fathom why this is the case.

Encouraging advances have been made in terms of awareness of mental health problems in wider society in recent times, and it is becoming clear that those who work within our care-giving profession are especially afflicted by such problems, with the suicide rate for vets being 3-4 times the national average. I don’t know many vets who haven’t cried at work at some point. I would consider myself a calm and relatively resilient person, but there are many times I have felt truly overwhelmed. Compassion fatigue and burnout are endemic in the profession.

The reasons for this are complex. Client expectations continue to grow. Nowadays, unlike in Herriot’s time, many pet owners anticipate a human standard of care, and vets need to have command of a huge range of knowledge and techniques. We are GPs, but GPs who over the course of one day might also need to be surgeons, radiographers, radiologists, obstetricians, dermatologists and cardiologists. And while junior doctors have many years more of structured learning and examinations after their five or six year undergraduate course, some unlucky new vets will receive little to no support on qualifying; they are more or less expected to hit the ground running immediately. Perhaps terrifyingly, they are never examined again.

Vets are high-achieving and driven people, and undergo lengthy training to qualify, but having to deal with any problem that might walk through the door is highly challenging especially as our patients are mute and we have to rely on the often unreliable but well-meaning narration of their owner’s (the dog rushed in as an emergency with its guts hanging out that turned out to have an erection springs to mind).

A thorough examination of the reasons vets decide they no longer want to do their job is beyond the scope of this blog. Overall I think that the work of the vet creates a perfect storm for mental health issues to be whipped up. And easy access to euthanasia drugs does not help.

On the whole, I personally can’t bear to watch vet programmes. They are the last thing I want to sit down with a cup of tea and watch after a long tiring day. But I can see why these shows appeal to the animal loving public, particularly when it comes to charming depictions of the work of James Herriot in a simpler time, long ago.

I certainly do not begrudge anyone sharing in the joys of our job, but I do think it would be helpful to shine a bit more light on the more sobering aspects of being a vet. To share in our lows as well as giddy highs. I think that’s why the Herriot family interview really struck a chord with me as it did just that.

Link to the Daily Mail piece: https://www.dailymail.co.uk/femail/article-8765955/James-Herriots-children-reveal-truth-Creatures-Great-Small-series-lifts-spirits.html

The customer knows best, right?

This gem popped up on my YouTube homepage today https://youtu.be/urZLTobAfJc.

In the clip, Dr House from the eponymous US TV series is seen in a consultation with a worried mother and her young baby who is mildly unwell. The mother becomes disgruntled when asked whether the reason she has missed her child’s vaccination dates is that she thinks vaccines don’t work. ‘I think some multinational pharmaceutical company wants me to think they work. Pad their bottom line’. In classic blunt House fashion, he confronts the mother with the fact that even a business selling coffins for small children is a money making enterprise, and perhaps she might want to spend her money on something that has the potential to save her child’s life.

Though my patients are furry, as someone in the medical realm who deals with the general public all day every day, I could empathise with House’s sentiment watching the clip. I’ve felt the same sense of frustration welling up inside of me at times. I’m pretty sure most vets would agree with me saying that it seems increasingly commonplace for pet owners to rebut evidence-based veterinary advice, or at least question it, in favour of something they have either read on the internet, or advice from Jan from pilates. The fervent anti-vaxxers do not only exist the the realm of human medicine. At times I find myself having to make a conscious effort to force my eyeballs not to roll.

It’s very easy in these situations to be driven down a path towards misanthropy.

I can empathise with the reasons why pet owners might want to do their own research: they just want to do the best for their pet and be reassured that what the vet has told them is indeed correct. Seemingly infinite information is available everywhere at any time via the internet in our pocket. Anybody who wants to can tap away and do their own studies on any topic they please. Veterinary medicine is no different, but unlike doing research on what car insurance to get, the best way to rid your garden of snails or finding DIY instructional videos, pet owners are seeking information about the best way to look after a living being who they usually love dearly. So things can understandably get a whole lot more emotional, particularly when a pet is very sick.

As veterinarians, we are trained to practice evidence based medicine – to base our advice where possible on research and information which is gained empirically, and this approach is the cornerstone of modern medical practice. As students, as well as laying down the bedrock of knowledge in veterinary medicine, all vets are taught how to critically evaluate information in a scientific manner. I certainly don’t always know everything, but like all vets have been given the tools to keep developing and expanding my knowledge.

The internet can be a real minefield. The internet affords us all with freedom of expression. But whilst this is considered indispensable in Western democratic society, when it comes to incorrect medical advice it can be really harmful. Accountability is practically non-existent online. The issue is that on the internet, absolutely anybody with any level of expertise can erect their own soapbox and present themselves as an expert in an area that they have absolutely no formal training in. The internet is also a place where emotional individual stories capture attention and go viral in a way that more reliable sources of facts and figures just can’t compete with, even if presented in an interesting way.

The ‘Lepto 4 vaccine’ debate is a classic example of this. It is a vaccination that is widely used to protect dogs against 4 different serovars or types of leptospirosis, a bacterial infection which is transmitted primarily via the urine of rodents. It is an infection that in dogs is challenging to diagnose, difficult to treat and has an extremely high mortality rate in dogs that become ill with it (shown to be 40-60% in various studies).

As a general rule when talking about both humans and animals, vaccinations are given most widely for infections that are either very common in a population, even if infection causes mild, but still significant disease, or if the disease caused by the infection has a high mortality rate. This infection falls into the high mortality rate category. Additional to this, the infection is zoonotic meaning it is one that human owners can pick up from their dogs, making it even more important to vaccinate against.

Here is some useful and reliable information of leptospirosis and vaccination against it in dogs:

https://onlinelibrary.wiley.com/doi/full/10.1111/jsap.12328

My dog’s had the L2 but not the L4 – should I upgrade?

The first is a review paper with a lot of technical jargon. The second is a well referenced information page directed at pet owners so is more accessible.

Whenever a vaccination is given, there is always a small risk of a ‘vaccine reaction’. For the Lepto 4 vaccine, the incidence of suspected adverse reactions is 7 in 10,000, or 1 in 1429. As this is ‘suspected’ cases this will include some cases that are reported but not proven to be linked to the vaccination, and will include many minor reactions that are easily treated, such as swelling at the site of injection. Speaking from my own personal experience, in 5 years of being a vet and using the Lepto 4 vaccine for the majority of that period many times every single day, I have never seen an animal become seriously unwell following vaccination. That’s not to say it doesn’t happen, and that it isn’t awfully sad when it does. However, it is extremely rare and the benefits brought around by vaccination outweigh this risk.

Despite this, in a movement initially gaslit by several inaccurate and sensationalist stories in the press, a really high proportion of new puppy owners come to me for their new family member’s first health check and immediately tell me that they do not want their dog to be given the Lepto 4 vaccination, because it is dangerous. They have often been told by their breeder or have read online that it kills dogs. There are angry communities of outraged people that have sprung up on social media, echo chambers where pet owners go to be share their experiences of the awful Lepto 4 vaccination and declare war on the corrupt companies that manufacture them and the disgusting money-grabbing vets that administer them.

We live in an era where the line between fact and fake news is increasingly greyed and even everything that Donald Trump, the ‘leader of the free world’ says, has to be fact checked. The relationship between the vet and pet owner sadly nowadays can often begin on a delicate footing where trust is not assumed.

A growing contempt for and distrust of modern medicine by some is not the only factor. When it comes to the relationship between the vet and the pet owner, money is a definite influence when it comes to trust issues.

While I know from speaking to friends who are NHS doctors that it is commonplace for people to question medical advice, cost doesn’t really play a role because it is largely taken out of the equation in human healthcare in the UK (thankfully). As a vet, every treatment or piece of advice I give generally has an associated cost, and this can frequently act as a barrier to the best treatment. It costs £40 to take my advice and give the Lepto 4 vaccine – the hurdle that I have to jump is proving I don’t have a vested interest. That I am giving the vaccine because I believe it is the right thing to do for the dog, and backed up by the science. I wonder how if pet owner attitudes would change if the same treatment was free?

It can be exhausting to fight against this lack of trust all the time. On occasions it is frankly quite upsetting. Like most other vets, I’ve had to make a lot of sacrifices in my life to get to this point in my career. And the main reason why I continue to do my job is a love for animals; the same little fire that burned inside me as a child and set me on the arduous path to become a vet.

So while adopting House’s rude manner is likely to be counterproductive, vets like me should be unapologetic about taking a firm stance against pseudo-science, misinformation and quackery. Because it is so important for our animal patients that we remain champions of rational evidence-based medicine and firm advocates that we should be the primary port of call for health advice for pets, not Dr Google.