Dr Liesel van der Merwe is a small animal medicine specialist. Send her your questions: This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Dr Liesel van der Merwe

In the medical field there needs to be a clear distinction made between sicknesses, or conditions which can be cured, and those which we aim to control.

An abscess, or intestinal foreign body or broken bone can be treated and the patient will generally be cured. Many other diseases are actually only symptoms of underlying disorders and symptomatic treatment will only result in a transient response. Identifying the underlying cause may result in a cure or improved management of the presenting complaint.

It is very important for an owner to understand when a disease can only be controlled as it will prevent you from becoming frustrated and also jumping from vet to vet in the vain hope of a cure.

There are, however, acceptable and unacceptable levels of disease control and this may depend on the treatment your pet is receiving or the severity of the underlying condition. If you still feel that more could be done, a second opinion is always an option, but don’t just jump ship because you are expecting a cure when this is not possible.

I am going to name a few examples. Urinary tract infections: Normally urine in the bladder is sterile. There are natural barriers to bladder infections (cystitis) and these include a healthy lining, a functional sphincter/valve and a nice long urethra in male dogs.

Additionally, urine is quite concentrated, which is not a good environment for bacteria. If your dog has a bladder infection, one or more of the defence mechanisms are not working. This can be a bladder stone causing damage to the lining, a bladder tumour also damaging the lining, sphincter weakness causing urinary incontinence in bitches, which in any case have a short urethra predisposing to infection.

In adult, uncastrated male dogs infection of the prostate can result in bladder infection. Hormonal diseases such as Cushing’s and diabetes also increase a patient’s susceptibility to cystitis. So, in actual fact, the presence of cystitis is actually just a symptom.

Ear infections are common in dogs. A bacterial or fungal infection in the ears is always a secondary problem. The primary problem is either conformation of the ear, swimming or water in the ear or a generalised allergic skin condition. Until the underlying cause is managed the ear infections will keep on re-occurring.

What is important to note is that the underlying causes cannot always be cured. Skin allergies are very difficult to cure and we generally manage them by diet, improving the condition of the skin and trying to eliminate whatever is causing the reaction (seldom possible). These patients will still be prone to intermittent flare-ups of skin and ear infections, but with a lower frequency than a patient which is just being treated symptomatically. 

Urinary incontinence can sometimes be managed by medication and hormones and if that is ineffective, surgery can be performed to “tighten” the bladder outflow tract. As long as a dog is incontinent, he or she will be prone to bladder infections.

Skin and bladder infections, increased water intake and urination and weight-loss are all signs of diabetes. Once the diabetes is under control with daily insulin injections, these symptoms should be controlled and only flare up when there is a problem with the glucose levels.

A dog suffering from epilepsy will not be cured with the medication. The general aim is to decrease seizure events by at least 50%. Medications can be combined and changed but, depending on the number of seizures the dog was originally experiencing, this may or may not be an acceptable result.

The body is a complicated organ and our knowledge just touches the surface of how all the different organs and cells interact with each other. It is important to understand when a condition can just be controlled or managed.