Animal Care

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GROWING PAINS Mark Newton-Clarke, MA VetMB PhD MRCVS Newton Clarke Veterinary Surgeons

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September was one of my favourite months when I was young but then later on in life, the spring months seem more cheerful. Maybe not this year but let’s dwell on other things. Since restrictions were eased and we were able to start on the backlog of vaccines, dentals and routine operations, the clinics in Sherborne and Yeovil have never been busier. Into the mix goes a surge of puppies and their problems, and a spike in emergency work. With our clients still waiting outside for the essential verbal part of the consultation and pets being taken by us into the buildings for examination and treatment, time management is important. This is a thank you for all the patience shown by owners as the whole process takes longer than normal. The bullet- and virus-proof screens should be up in reception by the time this is read so no waiting

outside in the rain this autumn and winter.

Last month, I chatted about puppies and this month I thought I’d tell you about some classic puppy problems that lead to a visit to the vet - all seen in the last few weeks. So, what do puppies do that lands them up at Swan House? Eat stuff, fall from a height and be unlucky enough to have a congenital problem, for starters. Add to that fleas, ear mites, worms, upset tummies, runny eyes and a rashy or scurfy skin. That shortlist covers just about everything; most of which is worrying for owners and unpleasant for puppy, but easily treated. However, nothing is trivial and really young animals can go downhill rapidly due to their sparse reserves of energy. Testing blood glucose is therefore one of the essential parts of any investigation into a sick puppy.

Let’s go back to my shortlist. ‘Eating stuff ’ is deliberately vague as obviously it depends on whether puppy has gorged on the contents of the recycle bin, slug-bait, a piece of elastic/plastic or drugs - prescription or otherwise - we see it all! The Veterinary Poisons Information Service (VPIS) is excellent for advice to owners (for a fee) if you suspect a toxin has been gobbled down the puppy gullet. The VPIS database on animal poisoning means they can give detailed information to owners and vets, often reassuring that treatment is not needed or guiding best practice if it is. They can be found online but the telephone number is 01202 509000 (last time I checked, 1 minute ago). Let’s hope you don’t need it, for puppy or geriatric alike.

Poisons are one thing, physical obstructions of the gut quite another. Sudden, dramatic and lifethreatening signs of intestinal blockage are seen early in the symptomology (persistent vomiting, abdominal pain, collapse) though I have seen a handful of the tricky-to-diagnose, slow-moving partial obstructions. I have waited 5 days for a champagne cork to exit a Golden Retriever and 10 days for a bit of plastic to go through a Cockerpoo. Both dogs displayed normal vital signs and remained stable (although closely monitored by blood tests, ultrasound and x-rays) throughout their illness so avoided surgery to remove the offending item.

Less fortunate are those that suffer an intestinal perforation caused by the sharp edge or physical bulk of an intestinal foreign body as it makes its way down the gastrointestinal system. The bacteria in the gut are harmless if they stay there but given access to the peritoneal cavity or blood stream, they can wreak havoc. Trauma caused by an intestinal foreign body allows this to happen, so we see localised or generalised peritonitis (infection and inflammation of the body cavity) and sepsis as a result. One such case, involving a young Spaniel, came in recently, after two-weeks of going off her food and losing weight, with only a single episode of sickness - nothing dramatic.

I was the first to attend this case and after some careful fingertip searching of the tense abdomen, I could feel something I knew was not normal. But that’s about as far as your fingers can take you, along with a list of likely possibilities in your head. Luckily, my co-worker Kate was on hand to run her ultrasound probe over the troubled abdomen. An hour later, Kate was removing a foot-long section of gut that had been compromised by a sharp piece of plastic, working its way slowly down the intestine. By compromised, I mean perforated and infected, leaking bacteria into peritoneum and blood vessels; a life-threatening situation. Now, chopping out a piece of gut and joining the two ends together is not easy. Imagine trying to create a waterproof seal between two bits of floppy hosepipe using only a piece of cotton. An inadequate metaphor but illustrative. Anyway, Kate performed her usual miracle and this plastic-hungry puppy was eating again only a few hours after surgery and has made a full recovery.

Pups at height. Not good. Of course not, but 6 inches is big if you’re the same size. Immature bones are not strong, and a short drop can cause fractures. So, for wriggly puppies in arms, hold carefully and firmly; puppies on the ground need to be protected as they are easily stepped on. Two examples this last month, both successfully treated but in very different ways using a mixture of the past and the present. By that I mean an old-fashioned plaster cast for one and some internal Meccano for the other. The method we choose depends on a number of factors. For example, type of fracture, its location - especially how close to a joint, the age of the puppy and unfortunately, financial considerations. Specialist orthopaedic surgery always runs into the thousands of pounds, so insurance is really important for young puppies, giving everyone peace of mind and the opportunity to get the best treatment available. We offer a free month of insurance, through PetPlan, for puppies coming in for vaccination - very worthwhile if you need it.

Stay safe and well, puppies and owners...

THE SANCTUARY BEAUTY ROOMS

AND FANCY THREE? HAVE A TRIO OF TREATMENTS FOR £65 THIS SEPTEMBER

| HALF LEG WAX (USUAL PRICE £28) | EYELASH & EYEBROW TINT (£24.25) | | LEGS & FEET MASSAGE (£29) | CHEST OR B ACK WAX (£25.30/£30.75) | EXPRESS MANI OR PEDI (£22.50) | EYEBROW & LIP WAX (£26.50) | 20 MIN BACK, NECK AND SHOULDER MASSAGE (£36/45MINS) | | EXPRESS/MINI CACI EYELIFT (£47.30/1 HR) | CACI MICRODERMABRASION (£31.90) |

LOCKDOWN SKIN Sarah Hitch, The Sanctuary Beauty Rooms and The Margaret Balfour Beauty Centre

Avesun/Shutterstock

Lockdown skin; it’s a thing. It has its own hashtag, Instagram pages and will probably end up in the dictionary.

For many, the initial problems of skin dehydration and dullness concerns came from a rapid change of lifestyle and the loss of normal routines. The ‘every day’s a holiday’ syndrome which, no doubt, involved eating and drinking the wrong things, excessive screen time and probably enjoying too much of the very hot weather we had.

Others had these skin concerns due to the extreme stress that materialised as a response to the altered lifestyle factors, where sometimes having several too many glasses of wine a day was a coping mechanism. Extreme stress causes us to produce the ‘stress hormone’ cortisol, which in turn can lead to weight held around our stomach and adult acne flare ups. Throw lack of sleep, lack of fresh air and enjoying craved sugar fixes

into the mixing pot and our skin is now showing the effects of those months and needs some replenishment to reboot it. Happily, professional skincare therapists are now on hand and able to touch your faces, intensively treat and advise you on how to continue to protect and care for your skin. I personally cannot wait to get on a couch and drift away while my face has a party at the hands of a professional!

The next trial for our faces is the wearing of face coverings or masks. They should always be regularly changed or laundered of course, otherwise they are ineffective in protecting you and others. However, despite wearing a clean face covering, the heat, sweat, make-up and the effect of the compression on the skin creates its own challenges.

At the salons, we are already seeing an increase in blocked pores in our own skins: bumpy complexions and actual, real spots! For me, this was the catalyst for taking the mask-wearing factors seriously. Obviously, because we work in close contact services, we are wearing masks all day, every working day, and so these issues have been sped up and heightened compared to what you may have noticed at this point.

Deep cleansing and exfoliation are key here, particularly in the regularly covered area but also on the rest of our face and bodies, as we also tend to get hotter when wearing masks and so perspire all over. Use gentle cleansers or soap-free face washes and up your cleaning to twice a day, if you usually only have a night routine. Change to clay-based cleansers, exfoliants or masks particularly if you start to suffer from skin breakouts. Treat these individual breakouts with an ‘on the spot’ topical treatment to minimise bacteria and speed up healing. Try not to pick as you will do more damage and an open spot will not like being covered by a mask.

Exfoliating can be upped to twice or three times a week in the jaw line area to smooth the bumps and help the pores to keep clear of blockages and bacteria build up.

As life gets back into some sort of routine, aim for your skin to do the same.

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Body & Mind THE LONG AND GRINDING ROAD LAND’S END TO BRISTOL Mike Riley, Riley’s Cycles

Since I was encouraging folk last month to take A third bottle cage was added to carry tools, leaving 2 their bikes on adventures, it seemed opportune water bottles cages. when my son Matt suggested we ride Land’s End I selected Schwalbe G One Speed tubeless tyres to Bristol. This is the toughest part of the Land’s End because punctures would delay us, and the timetable was John O’Groats (LEJOG) route. He had 4 days available tight. These would also suit Matt for commuting duties. and Grandma would help with childcare at our home, Every possible route has been documented by giving respite for our daughter-in-law. folk travelling this cycling pilgrimage. I opted for a

Customer’s work took priority, so, as usual, setting up route which claimed to select the least bad climbs. Matt’s bike and my own were at the bottom of the list. I chopped the route into daily sections and created Matt’s wheels were swapped for a lighter set of Hunt GPX files for each day. If you have not experienced 4 seasons on his Genesis Croix de Fer. I had the same cycle GPS computers, your life has been all the richer. set and fitted them to my Reilly Spectre titanium bike. Compatibility and ease of operation are alien concepts;

I guess developers think cyclists like to suffer, so they make it as hard as possible to use these navigation ‘aids’.

Well-known GPS supplier Garmin, have recently fallen victim to a crippling ransomware attack so their servers were down. After hours, I found a convoluted ‘work around’ to load the routes onto the cycle computer including the elevation profiles.

We split my Lotus bike packing set, so Matt carried the handlebar bag and I had the saddle bag. Hotels were booked for two nights, so minimal kit fitted the two bags. This added a few kilos, especially when water bottles were full.

A spare folding tyre and inner tube each were talismans against punctures with CO2 canisters to inflate tyres. All we took was a spare jersey, minimal après-ride clothing (flipflops, shorts and t-shirt), toiletries, ‘Bum Butter’ chamois cream, chain lube, first aid kit and a few tools and spares.

Penzance, Land’s End, Camborne 59km, 680m, 4:10 hours

After driving the hire van down, we set off at 13.52 along Longrock seafront. It was apparent this was not a cycle-friendly route, as we were confronted with vehicle drivers fighting for parking spaces then a very rough surface. Abandoning the scenic route, we took to the road. After Penzance, at the pretty village of Mousehole, we rode up what felt like a cliff; our first taste of lung-busting climbs. On arrival at Land’s End, after a slight detour via Sennen Cove, it was shrouded in sea mist. After a quick selfie, we rode back to Penzance. Time was getting on, so we put our heads down and pressed on, passing through Hayle, the sea mist again cooled us, and we cracked on until arriving at Tyzacks hotel. The reception was unmanned, so we took the bikes up to our room for security. After showering, we went for a meal figuring all that exercise allowed us to eat the dirtiest options on the menu!

Camborne, Bodmin, Launceston 119km, 1645m, 9:40 hours

A late breakfast service and an ambitious choice of ‘a large Cornish’ meant departure after 09.00. Early navigation issues took us in a circle at Redruth, then a Google shortcut lead round a farm field, followed by walking along an overgrown woodland path to tarmac.

After a pasty pitstop, we were on route for Bodmin moor, an insect hit above my glasses and stung me. Remembering my GP was stung in a similar place and fell unconscious, I halted. Matt checked it was not a bee sting and we continued.

The familiar Camel trail was a treat, with a pause at the Blisland Inn to replace fluids before hitting the moor. The climb to the moor was long, and the plateau covered in low cloud. Matt was anxious to reach the hotel before dinner service stopped; pressing on, our average speed crept up and I shouted a regular countdown of miles remaining for encouragement. The hotel was called Eagles House and guess where eagles nest… on a high point. The room was great and although I was out of place in very casual clothes, we enjoyed a good meal with superb views across countryside we had traversed.

Launceston, Wellington 115.82km, 1248m, 9:38 hours

On a couple of occasions, we met another cyclist called Sammy riding the whole LEJOG route, raising money for the Firefighter’s charity; we chatted while a large dairy herd ambled to milking. The granite way was a highlight and we appreciated crossing railway bridges instead of plunging into valleys, however, there was still a testing climb out of Oakhampton.

This day’s destination was Wellington, where a lift back to Sherborne was planned. The last 10 miles seemed to be routed the most tortuous way possible, adding to the pressure to reach the rendezvous.

Wellington, Bristol 91km, 510m, 7:45 hours

We were weary and sore by now and I would not have objected to stopping, as I had a painful nerve in my buttock. We elected to continue, but with the best will in the world, departing with a baby and toddler around is never quick. Our start at Wellington was later than ideal, but we were very grateful for the lift.

After crossing Somerset levels then Bridgewater canal and River Parrot trails, we decided to call it at Redhill village on the outskirts of Bristol. Again, the clue was in the name and the end point turned out to be atop a killer hill. Just as Matt said, ‘You can carry on, but I am phoning Nathan.’ I saw the sign behind a bush for the recreation hall - what a relief! We loaded up the dusty bikes on my son Nathan’s car and headed to Pensford, the rendezvous point for collection to return to Sherborne. The Riverside Inn had delightful views from the back garden, including a weir and a viaduct, but no food, so our reward was deferred but a cider refreshed me.

Last month, I wrote about the importance of mental strength. This month, I want to discuss the importance of physical strength; strength training is an important type of activity that should be undertaken at nearly every stage of our lifespan.

With inactivity comes muscle deterioration and weakening. This same process also occurs as we get older, a process referred to as sarcopenia which is an age-related decline of muscle tissue (see previous articles!) When we are 100, we won’t be as strong as when we were 90; at 90, we won’t be as strong as when we were 80 and so on… Once we reach approximately 35 years of age, muscle tissue and bone mineral density begin to deteriorate, which can lead to an increased risk of injury, joint pain and falls.

Although our bodies will weaken, the speed of this is determined by us, what we do and how often we do it. Fighting the negatives of the ageing process is key to a healthy, happy and independent way of life. Strength or resistance training can assist with slowing this process. We need to use resistance that will transfer through our bones, muscles and joints. This resistance is what will make us ‘stronger for longer’ and help slow down the natural weakening of the body due to our muscles’ ability to adapt when a stimulus, or stress, is placed on our body. In order to better tolerate this ‘pressure,’ the muscles respond by increasing in size with supporting ligaments, tendons and connective tissue also mounting in strength. Resistance can come in a number of forms. STRENGTHEN THE BODY Craig Hardaker, BSc (Hons), Communifit

Image: Stuart Brill

Here at Communifit, we use body weight, elastic, dumbbells, kettlebells, ankle weights and barbells to name a few.

Structured, targeted and specific strengthening exercise, using resistance, must be completed regularly each week. It is recommended that older adults complete two or more sessions per week of muscle strengthening exercise, focusing on all the major muscle groups. Completing strength training is something that many can do in the comfort of their own home. You don’t have to buy fancy equipment or a gym membership. It can be activities as simple as: • Slowly sitting and standing from a chair • Pushing up against a wall or kitchen worktop • Rising up onto the balls of your feet • Biceps curls, overhead press, lateral and frontal raises with makeshift dumbbells using jars or milk bottles • Slowly stepping up and down from the back step

Not all exercises suit everyone; what may work for one person may not for another. This is where structure and safety are important, and how we can help. During lockdown, we have created exercise sheets, videos and online 1-1 personal training sessions. These have been hugely popular as we seek to invest in our health. If we can help you, please do contact us. Stay safe, stay healthy, stay strong.

GETTING BACK TO WEIGHTLIFTING SAFELY AND EFFECTIVELY Simon Partridge, BSc (Sports Science) Personal Trainer and Dan Ogden, Strength and Conditioning Coach, SPFit • Lift your chest up, squeeze your shoulder blades

We’ve been delighted to welcome our members back since reopening in July. Most people had not been able to do any weightlifting for 4 months so it was imperative that we started back safely and effectively. One of our favourite coaching phrases, and one particularly applicable to weightlifting, is ‘please leave your ego outside the building’.

Remember, unless you have had access to a full home gym, you will not be able to lift what you did before lockdown. Think long term; it does not matter what you can lift this week, but how much you have progressed by say, Christmas. So, here are some tips to ease you back into your training. These are for the first few months not just a few days.

• Take more time to warm up • Work on your flexibility and mobility, even more than before • Start with a lower volume – use fewer sets then build these up progressively • Start with a lower intensity – slow things down, take your time • Try and rebuild your technique so it is even better than before • Respect all the other gym users patient and doing everything safely and effectively

• Most importantly – enjoy being back in the gym whatever training you do

We love to use the five big lifts: deadlift, squats, bench press, overhead press and pull ups in our weekly strength programmes. Here we’ll focus on the deadlift.

exercise to increase overall body strength, improve posture and it burns a lot of calories. It is a weight training exercise where a loaded bar is lifted off the ground to the level of the hips, torso perpendicular to the floor, before being placed back on the ground. It is a compound exercise, so it works multiple muscle groups at the same time (quads, glutes, hamstrings, adductors, calf muscles, abdominals and all your muscles in the lower and middle back, as well as the trapezius).

Here are Dan’s coaching cues when performing the deadlift: • Stand with your mid-foot under the barbell, feet approximately shoulder-width apart • Reach down and grip the bar with a shoulder-width grip • Bend your knees until your shins touch the bar together, straightening your back • Take a breath in to create tension in your abdomen, hold the breath and drive your feet through the floor standing yourself up • Return the bar to the floor by hinging at your hips, pushing your glutes backwards, whilst keeping a slight knee bend • Once the bar has passed your knees, bend your legs lowering the bar back to the starting position

Our own fitness is always about playing the long game. The pandemic and all its ramifications make being We’ve chosen the deadlift because it is a great

even more important. Remember the old saying, work smarter not harder. Please make sure you have fun and just enjoy being back in the gym. Good luck everyone.

FATIGUE FOLLOWING COVID-19 AND VIRAL INFECTION

Dr Tim Robinson MB BS MSc MRCGP DRCOG MFHom GP & Complementary Practitioner

One of the commonest symptoms that patients are complaining of following Covid-19 infection is fatigue. This is often the case following other viral infections such as flu and glandular fever. The fatigue is not relieved by rest, not present before the infection and is now having a significant impact on quality of life. The other common symptoms are difficulties with concentration, memory ‘brain fog’, unrefreshing sleep, flu-like symptoms, along with recurrent sore throats, gland swelling and balance problems.

The reason for the lethargy and the other symptoms is the effect of the viral infection on the immune system. It has been either damaged or malfunctioning in a way that is not understood. The components of the blood that normally fight viral infections are reduced, particularly the Natural Killer (NK) white blood cells. Inflammatory markers in the blood are also elevated which suggests ongoing inflammation and sub-optimal restoration of the immune system.

The impact of this post-viral fatigue on a previously fit person can be devastating; there is a prolonged and significant effect on occupation, personal relationships, education, social and personal activities.

As the exhaustion and associated symptoms follow a viral infection such as Covid-19 there is no doubt in the diagnosis. However, if there had been some symptoms prior to this, other treatable causes of fatigue or the other presenting symptoms must be excluded and referred to the patient’s general medical practitioner. Red flag symptoms such as unexplained weight loss and other symptoms suggestive of cancerous conditions must be reported to the GP.

Post-viral fatigue has a variable and fluctuating outcome. It is still early days in our full understanding of recovery from Covid-19 but many patients take a considerable time to recover. Eventually, the fatigue passes but there is often a fluctuating pattern of good and bad periods of health in the process. Until then, it can be very frustrating because of the effect it is having on quality of life.

As explained earlier the widespread cause of the post-viral fatigue and other symptoms is an overactive immune response leading to damaged tissues and imbalanced body systems. Therefore, the strategies for recovery must be aimed at repair and rebalance.

In order for the body to repair itself, it must be provided with the supportive healing components of a healthy balanced diet, reinforced with Vitamin D, Omega 3 fish oils, Zinc, Vitamin B Complex and a probiotic for the immune system.

A clear understanding of energy management is essential for the recovery from post-viral fatigue and Covid-19. It is important to be aware of energy saving strategies, by learning pacing techniques and avoidance of ‘over doing it’. Equally important are strategies to gain energy; these are chiefly by attending to sleep hygiene with a strict bedtime routine, muscle conditioning and stress reduction. Techniques such as meditative mindfulness, yoga and gentle limited exercise will all be needed to aid recovery.

doctorTWRobinson.com glencairnHouse.co.uk