A dog with more than a million followers on social media is back online thanks to specialist vets at one of the UK’s top referral centres.  

Internet sensation Puggy Smalls, who has more than 205,000 followers on Instagram alone, was referred to Linnaeus-owned Southfields Veterinary Specialists in Essex, suffering from a persistent head tilt and an increasing lack of coordination.

An MRI scan revealed significant signs of inflammation and infection throughout both of seven-year-old Puggy’s ears, including the external ear canal and the middle and inner ear.

Southfields’ clinical director Dr Henry L’Eplattenier, a European and RCVS specialist in small animal surgery, said it was a challenging case that needed long-term care and treatment to rectify.

Dr L’Eplattenier explained: “Puggy was initially treated medically and referred to our specialist in dermatology Filippo De Bellis, who carried out an ear flush and myringotomy, which creates a hole in the ear drum to allow any trapped fluid in the middle ear to drain out. 

“Analysis of the fluid removed from the middle ear via the myringotomy revealed that the infection of the ear had now become multi-resistant, meaning all routinely available antibiotics would be unlikely to be effective to fight the infection.

“So, even though Puggy was doing okay on his medication, we discussed surgical treatment with his owners because of the high risk of the recurrence of the clinical signs.

“Puggy was subsequently booked in for surgery but suddenly his condition deteriorated dramatically. He became very unsteady on his feet, often falling over, and his head tilt had worsened further.

“He had also developed nystagmus, which clearly indicated his vestibular system, which controls balance, was now affected.”

Puggy’s surgery was brought forward and his right ear operated on first. Dr L’Eplattenier continued: “In cases such as this, we are reluctant to operate on both ears at the same time as this is quite a painful procedure and we feel it is kinder to stage the operations and perform them about four to six weeks apart.

“Both operations required the total removal of the entire ear canal, including the ear drum and gaining access to the middle ear by removing some bone to widen the opening.

“This allows the middle ear to be completely emptied of any infectious discharge or pus and flushed with saline to ensure all residue is removed.”

Puggy recovered well from the first operation and a month later underwent the same operation on his left ear, again recovering positively and is now back to his best.

Owner Charlie Osman, from Kent, said her pet’s successful treatment was a relief after a worrying time: “Puggy couldn’t stand or walk and regular antibiotics weren’t working. He had a permanent head tilt and was very confused and upset.

“We were pleased it wasn’t a neurological issue but very sad to learn Puggy would lose his hearing. However, the vets assured us he would get the best possible care and he is now doing very well.

“The care and time Southfields provided from start to finish was incredible. The communication was non-stop and they really looked after our precious boy.”

Puggy’s Instagram page can be found on the social media platform via the handle @thepuggysmalls.

Southfields, which is moving to a state-of-the-art new £16 million site in Basildon, Essex, next year, offers a range of specialist-led services including anaesthesia and analgesia, cardiology, dermatology, exotics, internal medicine, neurology, oncology, radiotherapy, ophthalmology, orthopaedics and soft tissue surgery.

For more information, visit www.southfields.co.uk or search for Southfields Veterinary Specialists on social media.

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