01x04: Trude Mostue | First Aid

Do you know what to do if your dog gets a paw cut, suffers from diarrhea and vomiting, or eats a plate of chocolate? Veterinarian Trude Mostue shares her best first aid tips.

JEANETTE: I remember rushing home from riding lessons every Wednesday to catch the latest episodes of Vet School and Vets in Practice, where today’s guest was one of the stars. The student from Bristol School of Veterinary Science became well-known in England as well as other countries. Later, she started her own veterinary clinic in Norway, and now she’s leading the vets in FirstVet. Trude Mostue, welcome.

TRUDE: Thank you very much. That was very impressive, actually. All the things you mentioned, I’d almost forgotten all of it because it’s a long time ago. But I have very nice memories from that time. I spent so much of my career on camera. It was very unusual, but at least I can say that I’ve been working as a veterinarian all these years. Now it’s actually 20 years.

JEANETTE: Now you are the boss of I think 15 vets in FirstVet. What is FirstVet?

TRUDE: This is really exciting, actually, because for so many years I’ve been working in the ordinary veterinary practices – which is very exciting and very nice. You meet people and you see the patients and you do diagnostics and you operate. And I still do that one day a week, but times are changing. I’ve been so lucky to take part in the newest of developments when it comes to what we call telemedicine, which is actually that you can have your veterinarian on your mobile.

So if you have a question or if you’re worried about your pet, let’s say, you’re out in the woods or if you’re in the mountains, on a boat or wherever – I actually did have a patient that called me from a sailboat the other day, and they were worried about their dog. It was vomiting. Maybe it was seasick. They were far away from the vet and they called me on video cam.

This service is actually based on consultations via video cam on your mobile, so I consult my patients by talking to them through a camera. Of course, I can’t check the pet physically, but I can tell a lot by just watching a pet and asking the owners to check different things. Also, they have a lot of questions, and I answer all the questions. Instead of googling, they will very often call us and they will feel reassured afterwards whether they should go to the vet or not.

JEANETTE: What are the most common questions you get and the most common injuries you see?

TRUDE: It’s a lot of first aid situations. For instance, one of the most common things people call me about – and the rest of the team, of course – is injuries to paws, like cuts. They’ve been cutting their paws on glass or different things when they’ve been for a walk. Then I have to talk to them and help guide them through how to clean the wound, how to make sure there’s no glass in the wound, and how to bandage the foot. Then I assess the wounds, whether they need to be stitched or not.

This is a quite cool thing to do because when you’re out there, maybe in the middle of the woods – or maybe you’re just home from a walk – it’s great to have someone to talk to and someone to guide you. So I think that’s the most common thing I see.

JEANETTE: Do you have any general guidelines? I know every injury is different, but what should I do if my dog gets a wound in the paw when I’m out hiking, for instance?

TRUDE: I think on a general basis, I always advise my clients maybe after they talk to me, because they always are missing a lot of equipment, I always think you should carry, wherever you are, a little first aid kit, which could include some bandaging, some antibacterial wash, maybe some scissors and some cotton and so on. I think the most important thing to do if you have a clean cut in the paw, and particularly under the paws, is to flush the wound, maybe just with some sterile saline water to make sure there’s no glass or dirt in the wound.

Once you’ve flushed and cleaned it, I think you need to dry it and then you bandage with cotton between the toes. People very often say they know how to bandage their hand, but the difference between a human hand and a dog paw is of course that they sweat a lot on their paws. So you have to make sure you put a lot of cotton in between the toes, for instance, before you put on the bandage.

So I think the most important thing when it comes to these kind of injuries is for people to think ahead, make sure they have what they need if it should happen. Saline, for instance, or chlorhexidine is excellent. A little bottle of chlorhexidine.

JEANETTE: But if you don’t have this, is it okay to use water?

TRUDE: Of course you can use water and whatever you have. I think the most important thing is to flush it so you don’t get the dirt staying in the wound. Then if you don’t have any bandaging material – which maybe that’s the realistic situation – if you are out in the woods, then maybe just put a sock on. Take your sock off and put the sock on.

What very often happens if you get cuts in those types of areas, you get a lot of bleeding. Some people panic when they see all this blood, but always remember that very little blood looks very, very dramatic, particularly when you have a white dog. [laughs] I have a lot of clients that call and they’re in full panic, full of blood, and saying “oh, there’s blood everywhere!” But actually, it just looks dramatic.

But it’s important to know how to stop the bleeding as well, because they can bleed an awful lot, and then you need to put a pressure bandage on. This is actually quite a simple thing to do, even if you don’t have bandaging material. You can be creative. You put something firm on the top of the wound and put pressure on it, and then you just put a long strip of something. It could still be your poor sock. [laughs] I think everyone should have some spare socks in their rucksack when they’re out for a walk.

And then just tie it really hard, and of course then it will stop bleeding after a little while. So I think that’s the most important thing when it comes to stopping bleeding in the wounds.

JEANETTE: When do you know if the dog is bleeding too much or if this is just normal bleeding, so to speak?

TRUDE: It’s really hard to know whether it’s a normal bleed or not because it really depends where the cut is. Sometimes if you’re unlucky, it’s been cut in a place where you have big blood vessels, and then you will have very dramatic blood loss. But you will know that because the blood is really pumping out.

Regardless of how much or how little, you should try to put a pressure bandage on. A normal dog that doesn’t have any blood diseases that stops the blood from clotting, it should stop bleeding very quickly, within minutes.

JEANETTE: We started talking about legs. When you are active with your dog, accidents can happen, and sometimes dramatic accidents like breaking a leg.

TRUDE: Oh my gosh, yes. That’s a very dramatic accident, and yes, that is a very acute emergency. You obviously have to go and see a veterinary clinic as soon as possible. But the things you can do, and the most important thing to do, is to stabilize the fracture. You probably will have to carry your dog, so I hope you have a Chihuahua and not a Rottweiler. But to stabilize the fracture is really important.

JEANETTE: What do you mean by stabilizing the fracture?

TRUDE: Again, if you’re out and about, you have to take whatever you have – and maybe you have to take two sticks on each side of the leg, and then you wrap a sock again, maybe. [laughs] Again we have to use socks. Maybe you should always wear two pairs of socks in case something happens. And long socks. So use something that you find to tie the sticks around the leg.

But of course, if it’s an open fracture, which is very dramatic, you have to make sure you rinse with some water or whatever you have accessible first, and then try to – I’m saying bandaging, but if you don’t have any bandage, then use whatever you have. A t-shirt, rip the t-shirt apart, and okay, you have to walk home in your bra, but never mind. [laughs]

JEANETTE: Most important is the dog.

TRUDE: Most important is the dog. So the most important point is to stabilize the fracture so it’s not getting worse by the time you reach the veterinarian.

JEANETTE: Other dramatic accidents could be choking, if your dog gets something in their throat.

TRUDE: Choking is actually not such a common acute emergency as you would think it is, but I have come across it a couple of times in my career. Personally, it was a quite dramatic experience because I was quite new in the profession. It was a dog that swallowed a little rubber ball. Those kind of things are quite dangerous when you’re playing with your dog and you let it play with small rubber balls because they get stuck in the back of the throat.

At this particular incident, the dog showed the typical symptoms of going a little bit blue. The tongue went blue. The dog was really stressed. It was not able to breathe, and it was just standing there looking really desperate.

The way you should handle a situation like this – and remember, differentiate between if it’s coughing and the airways are open – but you have to aim for open airways. You can actually practice the Heimlich maneuver on dogs.

JEANETTE: How do you do that on a dog?

TRUDE: The challenge we have in the veterinary world and in the dog world is obviously that we have very small dogs and we have very big dogs, like the Great Dane and the Chihuahua. They’re two quite different approaches.

With the very small dogs, you just have to lift them up, put them halfway upside down, and push their chest from the side.

JEANETTE: How rough can you be when you do this? Because I know with myself, I would be a bit scared to injure the dog.

TRUDE: It’s really hard to say because, again, it really depends. On a Chihuahua, of course you have to be a little bit more careful than you have to be with a German shepherd. You need to see some form of effect. You have to see that their chest is actually moving. The chest actually can take quite a lot of pressure. I can show you, but it’s difficult to explain in this type of format.

JEANETTE: I’m not quite done with the paws yet, because something that happens quite often is also that the dog may lose a claw or injure a claw.

TRUDE: Very common problem, you’re absolutely right. Of course, dogs walk around everywhere and they run around and they twist around, and one of the other most common problems we have is ruptured claws, fractured claws, or they actually manage to pull off the cover of the claw, so the nerve and the blood vessels are bare, which is quite dramatic. It doesn’t bleed so much, but it’s actually very, very painful.

What you always should do if you have an acute lame dog is to go through the claws. If he has just a partial fracture of the claw, it’s very painful. Sometimes you can see the claw is in a different angle. It’s not like a massive emergency, but it’s really painful, and the dog will be lame.

What I would say to that is that if the claw has broken, if it has a really big fracture in it, or if the capsule is off, then you have to come and see us. But you can put a bandage on so it doesn’t hurt so much in the meantime. To learn how to put a proper bandage on your dog’s leg is very important.

JEANETTE: It’s not always easy to see that something is wrong with your dog, but one thing that’s quite easy to see is if it’s vomiting or having diarrhea. What can you do if that happens?

TRUDE: Two of my favorite symptoms. [laughs] It’s the most common symptoms you will see in your dog in all of its life, really, because dogs do vomit and they do have diarrhea because of their feeding habits. They will eat anything. Well, my dog does, anyway, and it does induce vomit.

The most important thing is really to understand when your dog is vomiting and when it has diarrhea because it has eaten or stolen a piece of pizza – because that does happen – or when it is caused by something you should worry about.

I would say two things. The most important thing to look for is how is your dog in itself? Is there blood in the vomit and the diarrhea, and particularly the diarrhea? If we just talk about the diarrhea in itself, I have a lot of people sending me photographs of diarrhea, which is very nice.

JEANETTE: Lovely. [laughs]

TRUDE: It’s lovely, particularly if I’ve just had my dinner. [laughs] So I’m very used to assessing photographs of diarrhea. We can laugh, but there’s actually quite a lot of information to read from a photograph of diarrhea, or just to ask questions around the diarrhea, because that tells me quite a lot.

Let’s say you have a dog that is well in itself, it’s jumping around, it vomits a couple of times, and then he runs out again, and then he goes out to have liquid diarrhea. Then he comes running back in again and he wants to play. Then I would probably say it’s okay. He’s probably eaten something that doesn’t agree with his gastrointestinal tract. If it continues to be well in itself and it doesn’t seem affected and he still has diarrhea, I would still say that’s probably just something he has eaten.

But if he should start to be a little more sleepy, more fatigued, not interested in food, and maybe the diarrhea goes from just being soft to watery and maybe bloody diarrhea, and then he starts to vomit more and more, and maybe there’s blood in the vomit as well, then there’s reason to be worried.

Let’s go back to what you can actually do yourself. The situation you don’t need to be worried about, when the dog is bright and happy in itself, playing around, and he vomits and he has a little bit of diarrhea, but it’s still very happy and eating and everything – the way to handle that is actually to starve it for 24 hours and then swap the normal food with something easily digestible, like white fish and rice or chicken and rice. Dogs love that, normally. This is just to restart their stomach lining and the intestines. It’s to give it a break from whatever the dog has eaten.

JEANETTE: Should the chicken or the fish be raw or cooked?

TRUDE: Definitely cooked chicken, and not, of course, tandoori chicken. [laughs] Plain chicken, plain fish. The idea is easily digestible food with no spices. Yeah, that’s a good point, actually. Sometimes I’ve had people that fed their dog who had diarrhea with tandoori chicken because it was chicken, and that didn’t go well. You never know what people think. You have to be clear, so thank you for that.

So in the normal situation with the diarrhea and the bright dog, it’s easy to handle yourself. Starve it for 24 hours, then easily digestible food the day after, and then you give it that type of food until the diarrhea has stopped. Give the food in small portions and often if it’s vomiting. Once you feel that the symptoms have stopped, then you can start to reintroduce their normal food.

JEANETTE: And if it doesn’t stop, then you call the vet?

TRUDE: Yes. I would say if it relapses into watery diarrhea, then maybe you should go and see the veterinarian and have a clinical checkup.

But the bloody diarrhea and the vomit is really spooky and it can be quite dangerous. Very often I see this with poisonings. Poisonings are actually quite common, but we’re not able to diagnose it. We don’t know really why the dogs have been poisoned, or if it has been poisoned. All we see is hemorrhagic gastroenteritis, which means bloody diarrhea and vomit, which is one of the most common symptoms of poisoning.

JEANETTE: Is there any kind of poisoning that could actually kill the dog?

TRUDE: There’s plenty of poisonings that can kill your dog. Of course, rat poison can. The modern rat poison now is a little bit different than it used to be in the old days. It’s more slow-acting, so the dogs actually bleed to death slowly, so you don’t actually see it straightaway and you don’t see the classic gastrointestinal symptoms as I just described straightaway, but you actually see a dog that bleeds to death from the inside, which is very dramatic.

We do see poisonings from mushrooms, for instance. Chocolate poisoning. We need to talk about chocolate poisoning.

JEANETTE: Yeah, because you should not give your dog chocolate. Not even dark chocolate?

TRUDE: Do you know what they’ve actually done to the dog chocolate?

JEANETTE: No.

TRUDE: What they do is take theobromine, which is the chemical that is poisonous to the dogs. They’ve taken it out. Yes, you’re right, you shouldn’t give your dog chocolate. I agree.

But at the same time, I handle so many panicky people that panic when their dog has eaten a little piece of chocolate, but don’t worry. It’s actually okay most of the time. But I have to be careful about saying that because the problem with chocolate and dogs is that each individual dog can react a little bit different. Every single dog has different tolerance levels to this chemical, theobromine.

There are actually formulas you can use that will tell you how to calculate how much theobromine your dog might have eaten. If you know how many grams of chocolate your dog has eaten, in theory you should be able to calculate. We do know that there’s a certain level that is poisonous and it will give a delayed effect, and there’s a certain level that is not poisonous.

So we do have some good ways of handling this, but I would always recommend dog chocolate as a general rule. If your dog should eat dark chocolate, that’s no good because that contains the most theobromine. White chocolate is okay, chill. It doesn’t contain any theobromine, actually. Milk chocolate is something in between.

So again, it depends on the size of the dog and how much it has eaten. But there are ways of calculating if it is poisonous or not.

JEANETTE: Are there other things that dogs should absolutely not eat?

TRUDE: Well, dogs are dogs, and they will always try to eat everything that we eat. I would say in general, if you eat normal types of food at home, if the dog should get hold of that type of food, it’s no panic. There’s nothing in particular that is very poisonous unless they eat a lot of it. I think that is a good general rule. If they eat a little of it, it’s okay, but too much of everything is really bad.

You should remember that always make sure that you put your tablets, like paracetamol, all the NSAIDs, away, because dogs eat everything, and that can actually be quite poisonous if they eat a bunch of paracetamol or too much of NSAIDs, painkillers. The scary thing about that is they can have delayed effects, so you don’t know straightaway that there’ve been poisoned.

JEANETTE: You also have some dogs that like to eat strange objects, like for example socks. If that happens, what symptoms do the dogs get and what can you do?

TRUDE: One of the most popular hobbies amongst us veterinarians that do surgeries is to collect foreign bodies that we’ve taken out of dogs’ intestines or stomachs. I’ve taken out keys, knickers, pens, batteries – I have a list of things. They are quite impressive when it comes to appetite.

But the symptoms you should look for, it’s a classic symptom. At first you won’t notice very much, but then it will take a little time – and it depends, of course, what it has eaten – but let’s say it’s tights. That can actually go quite far down in the intestines, so it might be fine for a long time. Then the tights start to clog up in the intestines, and it won’t let anything go through. Then you will see a dog that has chronic vomiting, very lethargic.

Very often when I saw these dogs coming through to the surgery and on my list it said “vomiting dog” and I saw it coming through the door, I knew straightaway just looking at it, because it looked so sad. It looked really lethargic and it didn’t greet me. That’s a typical thing with that type of dog. They feel really terrible.

But that usually has been going on for a little while, so the chronic vomiting dog that’s not quite right itself and with a history of wanting to eat a lot of different things, you should be aware of. Also, particularly if it doesn’t pass feces in a normal way. Maybe smaller than normal, maybe in thin stripes, for instance, because it’s only got – depends how far down the foreign body has managed to move.

JEANETTE: There’s also other things that can happen to this part of the dog’s body. Gastric dilatation? Very complicated.

TRUDE: Gastric dilatation. It’s a complicated word, and it can be a complicated condition. This is the big bad acute emergency for all of us vets and for, of course, the owner.

JEANETTE: What is it and why does it happen?

TRUDE: Gastric dilatation, when we use the word “dilatation,” means that the stomach has increased in size because of gas or too much food. Sometimes when that happens, for some reason – we don’t really know always why it happens, but we just know that certain breeds are more predisposed than others – what can happen is the very heavy stomach can start to twist on its own axis, and it becomes blocked.

Then the gas continues to expand the stomach, and then you get into a situation where it’s a real emergency, and we’re talking about hours before the dog might die because it goes into acute shock because blood vessels and everything are being strangulated. So you actually have a stomach that’s twisted. It might sometimes have food in it, or it has just gas. Usually it develops gas if it stays like that for a little while.

What you see, the symptoms you should look for – and particularly if you have a Great Dane or any sort of dog with a deep chest – you see a dog that is trying to vomit, it’s retching, and it will usually stand – not always, but it will have this particular stance with its front legs kind of spread and it’s retching, but it doesn’t manage to vomit anything. Then it becomes acute very poorly, and then you see swelling on the left hand side.

JEANETTE: Why on the left hand side?

TRUDE: That’s where the stomach lies. That’s the position of the stomach. If you should have a dog with those type of symptoms, you have to act very fast and just get to the car and move to see the closest veterinary surgery as soon as possible.

JEANETTE: So there’s nothing you can do yourself, other than rush?

TRUDE: There are things you can do, but they’re very dramatic. It’s not something I recommend people to do. But let’s say if you’re in the middle of the mountains and you have nowhere to go and you have hours and hours before you can see a veterinary surgery, then the most important thing you have to do is to get the air out of the stomach, to release the pressure. When you release the pressure, the stomach might twist back into its position, and that might increase the blood flow and you’re not in such an acute situation.

But the way to do it is very dramatic. You actually have to cut a hole in the side of your dog through the skin, straight into the stomach. But you’re talking about a life and death situation. This is the kind of thing you can do when you’re talking to a vet on the phone.

JEANETTE: Because then the vet will tell you exactly where to do it and how to do it?

TRUDE: Yes. This is the kind of acute emergency I’m dreading when I’m doing the video consultations, but in a way I know that will be helpful because I can actually see the dog, and I can guide the owner, and what I would then do is say, “Listen, there’s been acute vomiting, there’s been retching. It’s a Great Dane. You’re in the middle of the mountains. You can’t get to the vet. Do the following. Dog is on its side. Try to push the stomach. Does it feel like it’s air-filled?” I will watch the owners do it and I will also see the dog from the side. If I see there’s swelling on the left side, I might prepare the owner to actually puncture the stomach.

This is very dramatic, so I’m really hoping this won’t happen and no one ends up in this situation. But if you have to, you have to. You have to use a knife or you have to use maybe something that you have in your first aid kit. This is why I’m so keen to tell people, please be prepared when you are in a place where there’s no help to get. Make sure you have the right equipment, because if you have something to help you in that type of situation, then you might be able to save the dog’s life. Maybe something else than just a knife, for instance. There are certain things I recommend in a first aid kit for that particular situation.

JEANETTE: Many of our listeners love going on long hikes in the mountains with their dogs, being away for days, so for those people, what would you recommend to have in their kit?

TRUDE: First of all, have a good think through what you will bring. I would definitely, of course, bring things to bandage feet and bandage legs. So any type of bandaging material. Anything to clean wounds, like chlorhexidine. It’s excellent because it’s antibacterial, antifungal, it’s anti-everything. [laughs]

Sterile saline is also excellent, particularly in drop form. If you go to the pharmacy and you just buy these little drop things that you use for eyes if you’re wearing contact lenses, it’s a sterile saline solution for eyes, and that is excellent to use for any acute eye emergencies. I would also recommend that you bring scissors, of course, a fine knife, and also a stomach tube.

JEANETTE: What is a stomach tube?

TRUDE: This is when you are in a dramatic emergency. You can actually pass a stomach tube if you suspect a gastric dilatation. But it can’t be twisted because then you won’t be able to pass the stomach tube. It’s a plastic tube that you pass through the mouth into the stomach. If you can do that and manage to get the dog to vomit or to actually get some gas out of the stomach that way, then you usually prefer that when you are out of reach from a surgery.

Then I would of course recommend things like hydrogen peroxide, actually, is a good thing to have. I don’t know if you know, but I usually think about that as bleaching hair. But you can buy that in the pharmacy, 3%, to induce vomiting. That’s not what it’s for in the pharmacy, but you can use that to induce vomiting in dogs that have eaten something they shouldn’t – particularly if you own a Labrador. Of course, you have to use that under supervision of a veterinarian.

JEANETTE: Another thing that I always have in my car or at home is this twister for ticks, because insects could also be a problem for some dogs. And even snakes.

TRUDE: Yeah, all those nice creepy-crawlies. First of all, yes, ticks. I’ve had some panicky calls around ticks, and usually they start off like “My dog’s got a little tumor, what should I do? Oh my goodness!” It’s dramatic. “It’s got cancer! It’s going to die!”

When I see the little legs on that little blue-grey blob on the skin, then I always feel very relieved. I try not to be patronizing and I say, “Well, it’s actually a tick.” Most people are like, “Oh, that’s what they look like?” I think they’ve only seen them without the body on. So many people are using the preventative drops – which I always think you should use when it’s the season for it anyway.

But you can use the tick remover. It’s very smart. The good thing about that is when you use the tick remover, you don’t squeeze the tick. Sometimes if the tick has got blood in it and it’s been on the skin for a little while and if you twist and pull – like I normally actually used to do – then sometimes if you twist and pull and you push the body a little bit too much, you can inject some of that stuff in the tick into the dog. And if you’re unlucky, that tick might have borreliosis.

But in general, ticks are nothing to worry about. As long as you remove it within 24 hours, they don’t really transmit disease. Always check your dog anyway. I think it’s such a good habit to have, not only to cuddle it. I think for those of you that have hunting dogs and working dogs, it’s like a maintenance process. Check your dog every night for cuts and bruises, for ticks, anything, to keep it fit and healthy. I think in that process – if you go through the coat, all the different body parts, then you should discover ticks.

JEANETTE: What about snakes?

TRUDE: Snakes, yes. I’m glad we don’t live in Australia. [laughs] Both Norway and England, we can have adder bite. This can be quite a tricky condition to treat because you don’t always know that the dog has been bitten by an adder. It can also vary in how dramatic it is and how serious it is depending on where it’s been bitten.

We have different ways of assessing your dog when it comes into the surgery. If we suspect adder bite, then we have a classification system from not so serious to very serious. Then usually the dog is in shock. The symptoms can vary, everything from the dog walking into the surgery wagging its tail, a little bit swollen on the nose but still very happy – those type of bites, you don’t really treat with anything in particular apart from just observing to see if it develops into anaphylactic shock.

Then we have had dogs that are really poorly, and then we have to put them on intravenous fluids and anti-venom as well. I’ve had several dogs on anti-venom intravenously for the more serious cases.

JEANETTE: Most dogs seem to be bitten in the nose. Is this the worst place?

TRUDE: I think the worst place to be bitten is in the head region, and particularly of course close to the neck. Anywhere with a lot of blood vessels. But it can actually be quite serious if the bite is on the paw because there’s quite a few blood vessels there as well. The seriousness is dependent on how good the adder was to bite. Did he manage to get a lot of poison in? If that happens on the paw or the leg or the face, it doesn’t really matter. There’s blood vessels everywhere. But actually the nose and the lips are not so vasculated, so it’s actually not such a bad place to be bitten.

JEANETTE: The classic thing that you might hear that you should do if my dog is bitten in the leg, for instance, is tie something around and carry it. Is that correct?

TRUDE: Again, it depends how deep the bite is and how much venom. I think by the time you discover that the dog has been bitten, the venom is around in the body anyway. So yes, you can do it. It doesn’t do any harm. But I don’t think, unfortunately, it will help an awful lot.

Carry it, we usually recommend to stop the dog using the muscles so we stop the venom going around the body too fast. We’re trying to stop the absorption. But again, it’s questionable how useful that is. I think the most important thing is just to know about the seasons when the black adder is about and just know when the days are typical for black adders. And know your dog so you pick up the symptoms as fast as possible and then observe, and then go to the vet as soon as possible, really, because they can actually become quite ill.

JEANETTE: It’s not only insects and snakes that could bite a dog. Also other dogs.

TRUDE: Yeah. We have a lot of dog bite injuries, and usually the bigger dogs are bitten by the smaller ones. I am allowed to say that, owning a bigger dog myself. To be honest with you, it’s puncture wounds most of the time, and in my experience there needs to be a massive dog fight for it to be very serious for them to have to be stitched.

But I do assess quite a few bite wounds when I’m working, and very often, as I said, it’s mostly puncture wounds. The danger of puncture wounds – they don’t necessarily have to be stitched up; it’s just that they have to be cleaned properly, because literally dogs – not so much as cats. Cat bites are terrible, but dogs also have bacteria on their teeth, and of course, if they bite through the skin, they inject bacteria.

So keep those types of wounds clean. I think that’s the most important thing. Back to the good old chlorhexidine. It’s such a wonderful product. I should be sponsored by them. [laughs] I tend to recommend a few products so often. Actually, they’re not really products; they’re just generics. I think it’s amazing to have some chlorhexidine in the house because you can use it for so much. Cleaning wounds, your dog gets a rash, you can clean the rash with chlorhexidine. You can do anything with chlorhexidine.

JEANETTE: When dogs are fighting, something could also happen with their eyes. What should you do if your dog gets a scratch or maybe gets something in their eye?

TRUDE: Eye injuries are very common. I see it mostly when the dogs have been arguing with cats. But I’m actually quite surprised that it doesn’t happen more often when they argue with cats. I have a dog myself, and he is in constant argument with the big cat I have here, and I just let them get on with it, but he still hasn’t had an injury. [laughs] I think they’re both very fast.

But anyway, it does happen. They can get scratches on their eyes. I think it’s more common to happen when they’re out for walks and they run through bushes and they get a twig in their eye. Or they can get foreign bodies getting stuck under their eyelids.

The symptoms are quite similar. If they get foreign bodies like grass seeds, for instance, that’s a quite typical thing. In the eyelids you see a very swollen eye, and they keep their eyes closed. Dogs that have had injuries to their eyes, particularly if they have twigs or a cat scratch or even foreign bodies, tend to squint with their eyes, keep it closed. Their eyes water.

As an emergency action, what you can do is use sterile saline water drops for eyes that I talked about that you can buy from the pharmacy. Eye drops are excellent when you’re in that type of situation, because what you need to do is flush the eye. You need to try to flush whatever is in there out before you get to the vet.

There are, of course, many acute emergencies, but when your dog doesn’t want to open its eye and it’s really watery, that is an acute emergency. Try to flush it with sterile saline. That’s all you can do until you get to the vet.

JEANETTE: So you should not try to get anything out with your fingers.

TRUDE: You can try to flush whatever is in there out with sterile water eye drops. But it’s so hard to actually see anything, and when they’re that swollen, we need to sedate.

JEANETTE: In summer there is a lot of insects, like mosquitoes, wasps.

TRUDE: If your dog is stung by just one wasp, there’s not very many things – you don’t have to do very much. One wasp is okay. But if you have a swarm of them, then you might get into trouble. It’s a little bit individual from dog to dog how badly they respond to wasp bites. It’s a little bit like us people. Some people are more allergic to insect bites and react more like allergic shock.

I’ve seen some dogs that can go into quite a bad reaction, and they need to be treated very quickly, particularly with dogs that have been stung by a swarm. If the insects managed to bite them around the neck region and head region, and if their airways are restricted, then you know you’re in trouble.

So what do you do? In an emergency, and if you are nowhere near a vet, you can give dogs antihistamines. You can, but it needs to be calculated by a veterinarian, and you need to talk to a veterinarian before you do it. But if you have antihistamines with you, let’s say if you’re in your summer house or somewhere where there is no veterinarian, then you should talk to a veterinarian on the phone and they will guide you on the dosage. That can take the swelling down.

But usually if you have a bad anaphylactic shock, you need to see a veterinarian and the dog needs to be treated thereafter.

The most common reaction and the most common complaint is usually you’ve been out for a walk, you were coming back, and the dog is showing signs of licking or itching, particularly in the stomach area where their fur is quite sparse. They show me photographs or they show me the rash on the dog’s stomach, and I can see small red dots everywhere.

What can you do? What do you think I will suggest? The good old chlorhexidine. It’s actually so useful to use that because it will actually soothe the skin a little bit. Most of all, if you have had a really bad reaction and the skin is very irritated, put some cold, damp cloth on the skin. That will help a lot. And maybe around the whole dog, but usually insects tend to go for the places with very little fur, so it’s usually underneath the dog in the stomach area, by the legs, on the legs and the face.

So just try to cool the dog down. Maybe give a cool bath. That can take the swelling down. And then try some chlorhexidine just to keep it clean, because what will happen? The dog will itch and it will induce secondary skin infections. That’s actually the second stage. I see a lot of secondary skin infections from itchy dogs. Try to avoid that. Try to stop the itch as fast as possible; otherwise you’ll end up with double trouble.

JEANETTE: If my dog gets a skin infection, can I treat it myself, or should I go to the vet?

TRUDE: Most of the time the chlorhexidine will fix it. What you also should have in your first aid kit is a good antibacterial ointment to put on the skin. You can also buy something like aloe vera – that’s a little bit untraditional – and also medical honey. That is very good for soothing skin, for healing wounds. I do use that a lot, actually.

JEANETTE: Great. Now we have learned a lot, but I have one question left, and that’s a question we ask everybody on this podcast. If you were going to do a dog sport, what would it be?

TRUDE: Oh my goodness, a dog sport. I think that’s quite hard because in a way, I always wanted – I must confess if I wasn’t a veterinarian, I would love to be a dog handler in the police, work with dogs in the police force, particularly working with narcotics. [laughs] I just love the thought of working with dogs and their smell, to teach them how to find things, people and everything, just to utilize their senses. That’s my interest. But that’s probably not a sport, is it?

JEANETTE: Could be. At least it’s a hobby, and there is something called smeller in Norway.

TRUDE: That’s true, actually. I’m considering maybe my dog Cash and me should do that. At the moment we are trying to stabilize his head because he’s 1 year old, German shepherd. So I have enough work to do with him just getting him stable and happy.

JEANETTE: Thank you so much for taking the time to join us on this podcast.

TRUDE: Thank you for inviting me. It’s been a pleasure.