Wednesday, November 26, 2008

Happy Thanksgiving!

Are you going to travel with your pet for the holidays? Traveling together can be a good way to strengthen your relationship because you are spending more time together, but remember-not all pets actually LIKE traveling. By making the right preparations in advance, training and providing diligent, loving supervision throughout the holiday, you and your pet can have a great time.

Dogs trained reliably for the following behaviors have advantages for travel, whether going with you or staying home at a boarding facility.

1) Come when called-dogs who run the other way when called can be at risk for injury or worse.
2) Ride calmly in cars-if they get carsick or anxious it just isn't any fun for the pet or you.
3) Rest calmly in a crate-dogs who can't spend time confined to a small kennel can injure themselves by chewing or clawing at bars or just get messy if they stress out and defecate/urinate on themselves
4) Walk loosely on a leash-dogs who pull on a leash risk injury to their throats and can hurt those holding the leash.
5) Wait at doors for permission to exit-dogs or cats dashing out opened doors can wind up in tragic situations. New people won't know to squeeze out a slightly opened door to hold in an eager pet.

Cats should of course be litter box-trained (I thought this was so basic but had a client the other day who never provided a box for her cat as he always went outside.)
All pets should have a microchip implanted for permanent identification should they get lost (collars often come off.)

Make sure your pet is healthy before traveling-most airlines require a health certificate if you are flying with your pet. Get this done within the time limits they set-each airline is different.
Have a good idea of rules and regulations of hotels and even preferences of family members where you and your pet will be staying- not all are "pet friendly."

If traveling makes your pet very stressed or anxious, tranquilizers aren't really a good idea. They can alter personalities in unpredictable ways, can drop body temperatures and some airlines won't accept pets who are overly sedated. It might be better just to leave your pet home if they hate traveling that much.

Above all, be be safe and have a good time. Lots of preparation ahead of time can make all the difference.

I'm off to California tomorrow for a nice long weekend. No, Verbal and the others aren't going along this time. My hospital attendant, Kristina, has graciously agreed to stay with my menagerie. I'm so fortunate to have some one I totally trust with my beloved kids. I get to spend some time with my wonderful in-laws in the central California coast area. (We haven't been home in ages so this will be a real treat.) I hope everyone has a safe and healthy holiday; I'll get back to writing when I get back.


Tuesday, November 25, 2008

To Be Sad or Mad?

There's no easy way to break this news. Do you remember Lucy, the parvo dog the staff saved with help from the Flake's Fund? Well, she is dead, and I'm really, really angry about it. My staff is just devastated, and I can't blame them. It seems her adopted owner, the one we thought we were doing such a nice, generous thing for by donating over $600 of medical care when she claimed poverty on a newly adopted shelter dog, got frustrated by Lucy's "ongoing medical issues." We saw Lucy for a recheck and booster vaccines a couple of weeks after her hospital stay and found she had some warty growths on her lips and tongue. These were most likely due to a papilloma virus of dogs, probably contagious to other dogs but not transmittable to humans. I "treated" this problem by crushing a few of the largest growths, making them bleed a little, thus exposing the warts to Lucy's bloodstream. This would theoretically allow antibodies to develop against the virus and is often all that is needed to "cure" the problem; no costly diagnostics or treatment regimens are necessary. In a phone call a few days later to check up on that situation, the owner told us she gave Lucy to her brother and his family, who were a better match for her personality. That was a little hard to stomach, but OK, whatever was best for the dog. In reality, she took her to the local humane society and Lucy was euthanized for whatever reason. We do not know what the owner's situation was, if she was embarrassed or inconvenienced or why she didn't contact us when she decided she didn't want or couldn't keep Lucy any longer. We very likely would have gone the distance again and tried to find her a good home, especially with her history with us. She was a very sweet dog, a little shy, but who could blame her? My staff is in shock about the news, not understanding how their good deeds could be so unappreciated or taken so lightly. It will probably make them a little gun shy about extending those gifts in the future, and that is a shame. My hospital manager wrote a pretty heated letter to Lucy's owner; I asked her to sit on it for a few days and rewrite it when she wasn't necessarily in the height of emotions. I do agree she should send something to inform this woman what our perceptions are and how much the entire staff was hurt by her actions. Maybe we aren't the right veterinary team for this family; trust and teamwork have to go both ways. Rest in peace, Lucy.

Monday, November 24, 2008

Help For That Itchy Dog

We saw Tinkerbell this morning, a sweet little Cocker Spaniel cross dog, who was shivering and trembling in her owner's arms. Some pets can be pretty scared at the vet's office, but I don't think nerves were Tinkerbell's problem. It seems Tinkerbell had been scratching and biting at her skin and had pulled patches of hair off all over her body. On this frosty November morning, being without her nice warm fur coat, poor Tinkerbell was cold!

I combed through what was left of her hair and checked for evidence of a flea infestation. I didn't really expect to see one; if you were a flea, you would probably pick a much better place to live, one where there actually was hair, and where the skin wasn't hot, inflamed, infected and under attack from chewing teeth and scratching claws all the time. But flea control is essential for any itchy dog and I didn't want to miss something so obvious. Tinkerbell had been in earlier this summer for virtually the same problem. The prime targets on her body are her feet and her ears, although her entire body was now affected. Since this wasn't a seasonal issue, and sure enough, no fleas or flea"dirt" (dried feces) was seen, I suspect she has a food allergy. It isn't one of my favorite diagnoses to make since it requires a huge commitment in time and energy for owners and is a life-long management issue-there is no "cure" for allergies.

Few people realize that dogs rarely get eye or respiratory issues when they have allergy problems like people do; they get itchy! Sometimes their itchiness shows up as the dog licking or chewing the feet or shaking their head. Chronic ear infections often have allergies as the underlying cause. The immune system is "over-reacting" to some stimulus, and if it is a particular food, can do so for 6 WEEKS after ingesting that food. That is how good (or bad) the immune system is. Then because of the self-trauma of licking and chewing, secondary infections will develop, often with bacterial or yeast organisms taking hold. It is important to treat ALL of the problems as well as the underlying cause or the pet will never get better.

Now, it isn't a specific brand of food that is the problem; it is usually one or more ingredients in that food that causes the immune reaction. It seems that in humans, I hear most often about wheat or gluten or corn-type allergies or sensitivities. In dogs and cats, it tends to be animal protein sources, especially chicken, beef and dairy. And it is important to note that you can't be allergic to something you haven't been exposed to before, so that old food you have always fed your dog with no problem is exactly what is most likely to be the culprit. It had to take time for the immune system to build up antibodies against the particular antigens or allergens.
There are two ways we might go about diagnosing and treating a food allergy in pets. The first is to feed a "novel" or new protein source, one the dog has never been exposed to and has therefore not had the opportunity to build antibodies against. Foods such as venison or rabbit or even kangaroo are now formulated for just this purpose. The second way is to feed a hydrolyzed protein source, one where the protein has been broken down to the smaller amino acid components so is not recognizable by the immune system as a problem. We have to feed either of these ways EXCLUSIVELY for a minimum of 8 to 10 weeks in order to get all the old antigens or allergens out of the system. Everyone in the family has to be on board, no treats or snacks at all. By that time, the pet may be feeling so good that the owner may not want to change foods ever again, and that might be just fine. Some pets could eventually develop allergies to the novel protein, so we discuss what to look for down the line. But if the owner wants to chance it, we can then do a challenge-feed one type of protein for a week or so and see if the pet's skin or ears react.

Tinkerbell went home with some information about food allergies in dogs, as well as antibiotics for the secondary bacterial infection we found. Her owners will treat her ear infection with some drops to put in the ears every day. They will use an oral antihistamine to help alleviate her itchiness, as this has helped her in the past. (We had to increase her dose a bit as Tinkerbell's weight really snuck up on us this year. We will really have to work on that, too!) She has an antibacterial shampoo, as topical therapy is often beneficial for these dogs, and, of course, her new food. See what I mean about a big commitment for her owners? It will be a challenge, for sure, but I am optimistic that her owners want the best for their friend and will call if any problems come up. We set them up for a recheck for the infections in a couple of weeks and will touch bases on the allergy issue at that time. She is a lucky dog to have such devoted humans caring for her.


Friday, November 21, 2008

Grieving a loss

Well, last night we said good bye to my best friend's dog, Vardaman. Oh, how it hurts to talk about. As a veterinarian, I know that we did the very best thing for him; he was tired, and even though he would have continued to fight for her if she asked it of him, she knew it wasn't fair to do so. He lived 15 1/2 years, a long time for a Border Collie, but even that wasn't long enough for her to have him in her life. I sure understand, and my heart aches for her in her loss. I believe I did all I could as her veterinarian these past few days (well, years, really.) Now I have the challenge of knowing how to be there for her as a friend.

There are some excellent online resources for people grieving the loss of a beloved animal family member, and I thought I'd share them with you. Be warned; don't visit these sights without a bucket load of kleenex at hand!

I have always liked a simple site: , a gentle, compassionate website for pet lovers who are grieving over the death or an illness of a pet. There you will find personal support, thoughtful advice, The Monday Pet Loss Candle Ceremony, Tribute Pages, healing poetry like The Rainbow Bridge and much more.

For those who may need the help of a trained counselor in pet loss and bereavement, is a very good site to visit. Here's some info about them:

The Association for Pet Loss and Bereavement is a nonprofit association of concerned volunteers who are experienced and knowledgeable in the tender subject of pet death. Our chatrooms are free and available to anyone bereaving for a beloved pet. The APLB is a compassionate nonprofit organization of trained volunteers, dedicated to helping people during this very special kind of bereavement. We are constantly improving all our services, and making them freely available on the Internet. The APLB is unique, and the only organization in the world doing all this. Here you will find 10 tips for coping with the intense emotions and the difficult decisions one faces upon the loss of a pet

Pet Loss Grief Counselor HotLines This is a link of numerous, usually veterinary student-staffed "hot-lines" anyone can call for a compassionate, understanding ear. Days and times these lines are available are listed, and there are no charges for these services.

Don't be embarrassed by your emotions or think your grief is "over-the -top" or not normal. If your pet was lucky enough to really be a member of the family, you are, unfortunately, going to feel that loss as you would any other family member, and sometimes even more. I think that might be because we have the added responsibility of taking complete care of these pets throughout their lifetime, and this can often make us feel like we have failed in some way when the inevitable happens.

You will find many other websites, good and bad, if you search "pet loss" online. Beware during this vulnerable time of scams and unethical practices. And remember that grieving includes celebrating the blessings of a good life. Smile and remember those good times.



Thursday, November 20, 2008

Teamwork for Shaumbe

This morning we had a challenging anesthesia procedure I thought would be interesting to tell you about. I am very proud of my team that worked well together and resulted in an excellent outcome for our patient.

Shaumbe is an 18 (yes, 18!) year old Abyssinian cat that came to us last week for the first time. He has had excellent care during his long life. His very astute owner noticed a slight swelling of his lower lip and that he was having some difficulty eating. During our exam we noted that Shaumbe was missing many teeth due to extractions from prior dental procedures, as well as gingivitis(inflammed gums) and apparent broken teeth. The external swelling on his lip was really just the surface of a more concerning problem. When I opened his mouth to get a better look, I could see there was a large mass or growth involving most of that side of his mouth, possibly down into his throat. It was difficult to evaluate completely with him awake (and likely in pain,) so we discussed the need for anesthesia to get a better look, get samples of the mass for histopathology (microscopic examination of the tissue for identification) as well as treatment of the dental disease we knew to be present.

You can bet that Shaumbe's owner was concerned for his safety due to his very advanced age. I certainly couldn't blame him! But he had experienced how dental disease took its toll on his friend in the past and how treating it made Shaumbe feel so much better. He also recognized the need to identify that mass so we could make a plan for treating it if possible. He asked me what we could do to make this anesthetic procedure as safe as possible for his beloved 18 year old cat.
I explained that anesthesia has risks for any patient, young or old. Look what happened to my own Verbal during the short procedure to remove the pin in her jaw. Our hospital takes numerous precautions to help minimize those risks. We treat each patient as an individual, so each anesthetic procedure is tailored to that one patient and his or her specific needs.

Shaumbe was admitted to the hospital this morning by Kayla and Kaylena, doing their best to reassure his owner that we would do our best to care for his buddy. Amber, Shaumbe's veterinary technician, started by running a pre-anesthetic blood profile where we got an idea what his metabolic state was, how the organs were functioning (the liver and kidneys are especially important because they are the organs that will get the anesthesia back out of the blood stream,) whether there was any anemia, diabetes, infection or other underlying issue. Shaumbe's blood work told us he had some kidney insufficiency, so we knew to use good IV fluid therapy during his procedure to help take some of the work load off the kidneys. We also now knew that certain medications like the NSAID's we commonly use for pain relief would not be appropriate because of his poor kidney function. Amber placed an IV catheter in his cephalic (arm) vein and started a balanced fluid solution.

We used multi-modal anesthesia as we have talked about on this blog before. Small amounts of several drugs rather than larger doses of one can often be safer and have lower incidence of side effects. Since we knew Shaumbe was going to have a painful procedure done, he got some pre-op pain relief medication as well as some antibiotics due to the necrotic (infected) appearance of the mass in his mouth. He also received inhalent or gas anesthesia, which is much safer than injectable drugs as we were able to control levels of the drug throughout the procedure as well as have direct access to his airway in case of emergency. Shaumbe also was connected to several monitoring devices for blood pressure, heart rate, percent oxygen, respiration rate and body temperature and Cori, one of his nurses, was there to alert me to any abnormalaties during his procedure.

Body temperature is especially important during long anesthetic procedures because it can drop quite low in some patients and thus compromise bodily functions and recovery. I read just that morning on VIN, the VeterinaryInformation Network, an online resource for veterinarians, about a neat trick of using the bubble wrap used for packaging as insulation for anesthetized patients, so Shaumbe got a layer of bubbles on him. Our hospital attendant, Kristina, placed warmed fluid bags against him (not too hot as to cause damage to his skin or be uncomfortable if he was awake) and also tumbled some blankets in the clothes dryer for awhile, getting them nice and toasty and wrapped him up in those, too.

Amber got his teeth (what were left of them!) cleaned up for him, then took over his anesthesia monitoring while I did the biopsy on the mass and sutured him up.

His recovery was pretty uneventful....we like that! He did have some nasty greenish-yellow material on his endotracheal tube(the tube placed in his airway to deliver his anesthetic gas and oxygen) when we removed it from his trachea, likely from the infection brewing in his mouth from his teeth, the masses or both. It was a good thing he was already on antibiotics if that stuff was in his airway. His post-operative temperature was 98.8, a degree or two below ideal, so his nurses placed him in a heated recovery kennel, covered him with some newly warmed blankets and cuddled him up with those heated fluid bags. The bubble wrap worked nicely so we'll probably try that again on other patients. We will allow Shaumbe to sleep and have his IV fluids run through him most of the day, monitoring his vital signs and pain level, then send him home towards the end of the day when we feel he is good and stable.

I just gave his owner a call to let him know he could stop holding his breath, that Shaumbe came through his procedure like a champ. I could hear the relief in his voice and was so glad I could give him that good news. I hope that will be the case when we get the results of his biopsy back, but we'll do our best for his friend no matter what the results might be.

I wanted you to see how it took our entire team to get Shaumbe through his procedure today, no one person more "important" than another. We all work well together, wanting more than anything a good outcome for our patients and the humans who love them.


Wednesday, November 19, 2008

Verbal Dog

My office is lonely today; the blankets under my desk are empty because "Daddy" stayed home and is working from home today. This means he got to keep our dog, Verbal, with him. I am so very fortunate to have been able to bring her to work with me every day since we opened the hospital 6 years ago. Not everyone is that lucky, for sure. There are a lot of pets who spend most days alone, waiting for their humans to come home, some for long hours at a time. Verbal occasionally stays home when my husband Michael stays home. Getting to play in the yard HAS to be more fun than sleeping under my desk. But after the past two days of over the top emotions, I really don't like those empty blankets.

How about I tell you a bit about my wonderful Verbal dog? Can you guess where her name comes from? While it is true that she is very talkative and has an opinion about everything, that isn't the reason for the name. When I brought her home as a 4-week old puppy, I thought it best to let Michael have a go at naming her. We had just bought our first home, and I had already brought home chickens and ducks and we were working on fencing to move our horse home. Our favorite movie at the time was "The Usual Suspects" with Kevin Spacey. He actually had two character names in that movie, and Keyser Soze just didn't fit a cute little girl puppy. His other name was "Verbal" Kint.

Yes, 4 weeks is way too young for a puppy to be leaving its mom and litter mates. She was actually brought into the clinic where I was working that year to be euthanized after her daddy dog mauled her for getting too close to his food bowl. She had a fractured jaw and her tongue was torn to the point that only a 1/4 inch strip of delicate tissue held it in place. Well, I could understand putting down an aggressive dog that would do such a thing to a helpless puppy, (would he hesitate if it was a young child, after all?) but certainly not the pup. The "breeder" (I use the term loosely as this was a cross-bred puppy, Labrador and Golden Retriever, where no health testing of the parent dogs had been done prior to breeding-more on that later) refused to spend any money on fixing the pup as they had 9 or 10 others at home and the costs seemed too much to them. Michael and I really had started talking about adding our first dog to our family, so I asked for these people to surrender the puppy to me so I could assume her care.

The owners of the clinic were great, big-hearted people and allowed the surgery to place a pin in her tiny jaw and attempt the re-attachment of that hanging tongue. I was really concerned about the nerve and blood supply, and because the tissue was so swollen, didn't think the sutures would hold very well. But young animals have special angels looking after them and my new puppy healed very quickly. Yes, to this day her tongue is a bit goofy, curling up to her ear when she yawns, and most of her water goes anywhere but in her mouth when she drinks (is that any different from most floppy-lipped dogs?) But it adds a bit of character to her big goofy smile, and boy does she have a great smile!

She was growing quickly and healing well, so about 10 days later we anesthetized her to remove the pin from her jaw. Her heart actually stopped during the procedure and required aggressive CPR and an injection of epinephrine or adrenaline right into the heart itself to get things started again. Obviously we were successful in getting her back, but the lack of oxygen to her brain resulted in her being blind for a full day and she was ataxic or wobbly for about a week after! It was awful; I was so in love with that little girl already and hated seeing her like that. Thank goodness it was a transitory thing, likely brought on by low blood sugar. We usually fast animals (withhold food) before surgery and in very young patients like her, probably should have shortened this time. I threatened her that she would never get anesthesia again, having to stand very still and suck it up when she was spayed (just kidding!)

So, as I mentioned, with no health testing of the parents, it was inevitable that the puppies of that litter were affected by serious issues such as hip and elbow dysplasia, orthopedic conditions where the joints don't form normally and result in painful motion. Verbal was actually "rabbit-hopping" to prevent that pain at 6 weeks of age-that's how bad her hips were! She had a femoral head and neck ostectomy (FHO) surgery to completely remove the ball from the ball and socket joint of her worse hip joint. It was a terrific "salvage" procedure for a bouncy, busy young puppy where confinement would really be an issue if we chose other types of surgery with lengthy "keep them quiet and off the leg" recoveries. Her strong muscles of the thigh are holding the joint together.

Verbal has been what I lovingly call my "genetic disaster" dog. Other than her routine spay at around 5 months of age and the FHO and jaw and tongue surgeries, she has had multiple surgeries on her legs, been treated for allergies in the form of skin and ear issues, and has had several dental procedures. A few of her permanent teeth were affected by the pin placed in the jaw and subsequently "died." I have always been a bit cautious about her temperament, especially around little dogs, since she has that genetic trait passed on from that "wonderful" daddy dog of hers. She has had numerous lumps and bumps, but two very serious cancerous masses where she had radiation therapy for one and radical surgical excision for the other.
She has been a trooper, going through all those anesthetic procedures and now managing her multi-modal analgesia (pain management) for pretty bad arthritis. Her remaining teeth are worn down from always chewing on tennis balls when she was younger. I learned all about that from a veterinary dentist when I noticed her teeth were gradually wearing down to the gum line. He told me tennis balls have silica in them, a very abrasive substance. So be warned about letting your tennis ball-obsessed dogs chew on those balls. It is fine to play fetch, just take them away after the game so they aren't worrying them and abrading their teeth away like Verbal did.

Verbal is 10 years old this year and is slowing down like older dogs do. Since I really thought each time she faced cancer that I would lose her, every extra day with her is a wonderful gift.
She puts up with the various cats and other critters I have brought into our lives at different times in her life. She doesn't have time for me to be sad, often coming to me and pushing my arm up with her big nose, telling me things will be fine. She loves to chase the chickens and rabbits in our big yard, never wanting to catch them, often just bouncing in place to try to get them to go so she can chase them again. She is such a happy dog, always having a stick or stuffed toy in her mouth when one is to be had. Can you tell how very much I love that goofy yellow dog? Aren't we all lucky to have these great friends in our lives?


Tuesday, November 18, 2008

Every Bird Should Get to Fly

OK, I do not support the lottery, but this commercial makes me smile every time. I think we all need a lift after my dismal latest postings. Maybe I love the commercial so much because I have chickens and even an emu (Bill.) Who knows, maybe a penguin in my future? Enjoy....



I have a heavy heart today and just can't shake it. Yesterday's post surely contributes to it, as you can imagine. Star's owners have been terrific. Didn't you just love that picture of her smiling in ecstasy for the camera, so content to be with her humans?

Another issue I've been debating about writing about (I don't want to hurt anyone by sharing MY feelings) came up yesterday and is looming large. We have a slow morning with only a few appointments so I am "dwelling." Not good. My best friend, Kristen, has an older dog, too. Vardaman has been her best friend for 15 1/2 years, a true tribute to her love and care. I met them as patient and client many years ago when a relief veterinarian accidentally gave him a vaccine that was meant to be given intranasally (drops in the nose itself) subcutaneously (under the skin) where the majority of vaccines are given. When I found out about the mistake, I researched and found that this could actually cause serious illness in some dogs, so got right on diagnostic and preventive care for her friend. It took some time and numerous follow up appointments where we actually learned we had much in common besides our obvious love of animals. Sometimes through adversity friendships can grow strong, as ours obviously did. Vardaman pulled through that episode with flying colors, thank goodness! Over the years, Vardaman had more than his share of ailments as he aged and, being the beloved pet of my best friend, I felt a great responsibility to keep him doing the best that he could. She was a devoted and knowledgeable pet owner, often making suggestions and researching supplements and medications and diets for him. I did the same, often consulting specialists and as a team, we kept Vardy pretty comfortable and happy.

Time has taken its toll as it will on all of us and yesterday he came in very sick from vomiting all weekend. We thought it could be a reaction to his numerous medications or suspected something worse due to his age. Unfortunately, we confirmed the worst with blood work and radiographs (x-rays) of his abdomen. Kristen loves him with all of her heart and above all does not want him to suffer. I love HER with all of my heart and don't want HER to hurt, but I know I can't stop that. Words like "don't worry" are pointless; of course she will worry about her buddy. He is currently at a referral hospital on IV fluids (my hospital is not staffed 24 hours) and being managed for his vomiting and pain and being given excellent care, but he isn't home with her, and that hurts. Due to his age and frailty, she doesn't want to put him through any extensive procedures, and even if she did, there would be no guarantees that would extend his life significantly. The choices are so hard to make, but since she knows him the best, it really is up to her to make them for him. I (and her referring doctors) can only give the medical information and advice at hand to help with those decisions. I believe we are going to try to get him "healthy" or at least strong enough to go home for a few days of normalcy, then make the decision to say goodbye in a peaceful setting at his home on the weekend.

There is something that has been bothering me, and I am hoping someone reading this (if I haven't totally bummed you all out over the past few days!) might be able to help me with. I know this is going to change my friend's and my relationship forever. I don't want her to remember me as "the one who killed her dog." You know by now after reading my blog for this long how important I believe this "gift" to be for our devoted pets. Ending suffering with dignity is something I do believe in and consider it my duty if not privilege to provide. But there is certainly a finality to it, and not everyone sees it as I do. I once drove over an hour to a friend's house to euthanize his 16 year old hound dog in the comfort of his house, it went as peacefully as you could wish, and he really never talked to me again. I would be devastated if that happened again. Then there is that tiny part of me that imagines the day when it will be my turn to say goodbye to my best friend, Verbal. Selfish, I know, but I am only human, and I love her more than is probably sane.

I could get a colleague to handle this particular situation for me, but that wouldn't be fair to my friend or the dog she loves so much. He has been MY patient and I take that very seriously. I'll pray about it and love on the new puppies and kittens scheduled to be seen this week. They are good therapy....they sure don't have time to be sad! I do love being a veterinarian, but some days are certainly harder than others. Thanks for "listening."


Monday, November 17, 2008

Our Perfect Companions Age Too Darned Fast!

I have a quote on the wall in my office...."Our perfect companions never have fewer than four feet." -Colette, 1873-1954. (Guess we have to make an exception for Ricardo, the 3-legged cat, right?) My sister, Kristine, sent me the card with that thought on it. Thanks, K.

I'm writing this afternoon through tears, so forgive a typo or two. We had to say good bye to a true "perfect companion," Star, a lovely, dignified older greyhound with the best humans a pet could ever ask for. I have had the privilege of working with this great family for a while now, so this final visit when we all said good bye to our friend was especially hard, as any one who loves their pets like family members must imagine.

Star didn't have the dreaded cancer or kidney or liver failure or any other awful disease. She really was just old, and her poor weakened body couldn't keep up with her still alert mind. She wanted to go on those beloved walks with her humans, but those once graceful greyhound legs couldn't support her weight anymore, and she tired out after only a few steps. She had been stumbling and dragging her toes for quite some time now, and with the help of that multi-modal analgesia we talked about recently, she managed pain and weakness fairly well--up until this weekend, that is. Her owners knew it was time to let her give up the fight, and fight she did for quite a long time.

She did everything we asked, even when some of the medications we tried didn't quite suit her, she took the side-effects like a trooper, and recovered well when we quit those and tried something else. Her caring humans knew it wasn't fair to go to heroic measures for her; Star was tired. She passed peacefully this morning in the arms of her beloved humans. We can all wish to go that way. Good bye, Star. We will miss you.

My friend, Stacy, who is a veterinarian, too, sent me a little missive about living with dogs. I don't know who wrote it. Thought I'd share that with you now. What the heck, I'm already crying....


When you bring a dog into your life, you begin a journey - a journey that will bring you more love and devotion than you have ever known, yet also test your strength and courage.

If you allow, the journey will teach you many things, about life, about yourself, and most of all, about love. You will come away changed forever, for one soul cannot touch another without leaving its mark.

Along the way, you will learn much about savoring life's simple pleasures - jumping in leaves, snoozing in the sun, the joy of puddles, and even the satisfaction of a good scratch behind the ears.

If you spend much time outside, you will be taught how to truly experience every element, for no rock, leaf or log will go unexamined, and no rustling bush will be overlooked. Your pace may be slower - except when heading home to the food dish - but you will become a better naturalist, having been taught by an expert in the field.

Too many times we hike on automatic pilot, our goal being to complete the trail rather than enjoy the journey. We miss the details - the colorful mushrooms on the rotting log, the honeycomb in the old maple snag, the hawk feather caught on a twig. Once we walk as a dog does, we discover a whole new world. We stop; we browse the landscape; we kick over leaves, peek in tree holes, look up, down, all around. And we learn what any dog knows: that nature has created a marvelously complex world that is full of surprises, that each cycle of the seasons brings ever-changing wonders, each day an essence all its own.

Even from indoors you will find yourself more attuned to the world around you. You will stop to observe the swirling dance of windblown leaves, or sniff the air after a rain. It does not matter that there is no objective in this; the point is in the doing, in not letting life's most important details slip by.

You will find yourself doing silly things that your pet-less friends might not understand: spending thirty minutes in the grocery aisle looking for the perfect doggie birthday treats, or driving around the block an extra time because your dog enjoys the ride. You will roll in the snow, wrestle with chewie toys, and bounce rubber balls till your eyes cross - all in the name of love.

Your house will become muddier and hairier. You will buy more lint rollers. You may find dog biscuits in your pocket or purse and find the need to explain. You will learn the true measure of love - the steadfast, undying kind that says, 'It doesn't matter where we are or what we do, or how life treats us as long as we are together.' Respect this always. It is the most precious gift any living soul can give another. You will not find it often among the human race.

And you will learn humility. If you pay attention and learn well, when the journey is done, you will not be just a better person, but the person your pet always knew you to be - the one they were proud to call beloved friend.

I must caution you that this journey is not without pain. Like all paths of true love, the pain is part of loving. For as surely as the sun sets, one day your dear companion will follow a path you cannot yet go down. And you will have to find the strength and love to let them go. A pet's time on earth is far too short - especially for those that love them. We borrow them, really, just for awhile, and during those brief years they are generous enough to give us all of their love - every inch of their spirit and heart, until one day there is nothing left.

The dog that only yesterday was a pup is all too soon old and frail. The youth with boundless energy wakes up stiff and lame, the muzzle now gray. Deep down we somehow always knew this journey would end. We knew that if we gave our hearts they would be broken. But give them we must for it is all they ask in return. When the time comes, and the road curves ahead to a place we cannot see, we give one final gift and let them run on ahead - young and whole once more.

'Godspeed, good friend,' we say, until our journey comes full circle and our paths cross.


Friday, November 14, 2008

Not for the Sqeamish

Every veterinarian has little stories of their strangest patient, (or client!) most memorable, or both. One that certainly falls in that category for me happened when I was a fairly new doctor, getting much needed and welcomed experience at a very busy emergency clinic. It wasn't unusual to be faced with crying family members, and Rufus had a very emotional, tearful young owner, not more than 8 or 9 years old. She had a little shoe box, closed with some apparent breathing holes cut into the top. We often saw "pocket pets" at that ER service, rats and hamsters and even hedgehogs and chinchillas. It was how I got my beloved Edgar, a wonderful little chinchilla who was missing most of his hair. Now, chinchillas are known for their thick, lustrous coats, and a naked chinchilla is really pathetic. His owner didn't want the hassle of working up his alopecia, (hair loss) so surrendered him to me. I suspected he was pulling his hair out from a stressful living situation, and for some reason he settled into his new life with Michael, me and all our menagerie just fine. Edgar didn't think cats hanging onto his cage were anything to stress about, apparently; they were fascinated with this giant "rodent." Anyway, Edgar was a way cool pet, grew all his hair back and lived with us for another 10 years! He passed away earlier this year and I still miss handing him his daily raisin treat and watching him munch them eagerly.

Back to Rufus and his distraught little owner. She told me through her tears how very sorry she was that she had dropped him when cleaning his cage and he had "broken open." Unsure what she could mean by that, I opened the lid of the shoebox and got quite a shock. There was a GIANT, fuzzy brown tarantula! Ummm, I know veterinarians are supposed to treat "all creatures great and small", but spiders???? Rufus had, indeed, broken open---his abdomen was split wide open and what looked like intestines were out on the toilet paper lining the box. I figured the owners would simply like Rufus to be humanely euthanized; this was a very serious injury (duh!) and one I had no experience in handling. Nope. His owner pleaded with me to save his life. In those days and at that time of night there wasn't anyone to call for advice. There weren't any "spider medicine" textbooks on the shelves or online resources to consult. I was it.

I used some very long wooden cotton tipped applicators to manipulate Rufus in the box and do a cursory exam. The area of his body that was split open was not like a mammal's skin; it was like a hard "crust" or "shell." The intestines themselves looked in pretty good shape. I got some saline solution and lavaged them, (rinsed them off) then proceeded to reduce the herniation of the intestines (push them back into the abdomen where they belonged.) I used the moistened cotton-tipped applicators for this, and they reduced pretty easily. So, now what? How were we going to keep them in place? I didn't even know for sure if the hard shell would heal eventually. It made sense that it would, but I sure didn't look forward to suturing this crunchy material, possibly breaking it apart even more. Besides, that would likely require anesthesia of some kind, and I REALLY didn't want to attempt that in a likely debilitated patient that I had no way of monitoring (and had no idea of normal parameters like heart rate, respirations, blood pressure-ha! Could you see putting a blood pressure cuff on one of those little hairy legs?!) We often use a type of tissue glue for closing skin wounds or the last layer of multiple layer suture closures. I thought that might be a good option, so still holding the abdominal contents in with the applicator, drew a line down the crack with the tissue glue. I was so relieved when it held fast. I really couldn't think of any "post-operative" instructions other than to make sure to keep Rufus quiet and warm, get him eating right away, and to get him to his regular veterinarian if he had any problems with that or with eliminating waste. (Do spiders even poop?) I couldn't know what his prognosis would be, but his little owner was delighted to have him all back in one piece. I called to check on him a few days later and all was well....amazing. You can bet that is one patient I will never forget.


Thursday, November 13, 2008

Holiday Dangers

It is hard to believe the holiday season is almost here. My sister, Teresa, thought it would be a good idea to warn pet owners of some of the dangers pets may face at this festive time of the year.

Gastro-intestinal issues seem to be the primary reason we see pets on emergency after big holiday get-togethers. Our pets certainly know something special is being cooked, just like we do! What could it hurt to slip your dog a yummy piece of turkey skin or playfully dangle a shiny strand of tinsel in front of your kitten to chase after? While a bit of meat probably wouldn't hurt most animals (and would really be appreciated-just look at those begging eyes!) anything that pet isn't used to, especially fatty foods like turkey skins or really spicy ones, has the potential to cause serious GI upset such as pancreatitis or gastroenteritis.

A good rule of thumb is if it isn't that great for our diet, it probably isn't for them, either. (People love to pour gravy over their dog's is so yummy and of course the dog loves it, but if he or she isn't used to that kind of fat content, it can be a real problem.) Turkey and chicken bones, even really large ones, splinter quite easily so are very bad for our pets to chew on. They can cause impactions in the intestines as well as perforations, (punctures) resulting in peritonitis, a possibly deadly infection in the abdomen. Speaking of chewing, make sure those extra extension cords and packages of batteries aren't accessible to curious puppies.

Some foods like chocolate, coffee, onions, grapes and raisins, can actually be toxic to animals. A relatively new source of food toxicity (and isn't necessarily a "holiday" danger) is food artificially sweetened with xylitol. Sugar-free gums are a common culprit and have actually caused the death of numerous pets. There are some plants like mistletoe, holly and amaryllis which are toxic so keep them well away from your pets. The poinsetta has long been considered toxic to pets but really would only cause a bit of an upset stomach (if anything) so don't worry about that plant.

Your animal may become poisoned in spite of your best efforts to prevent it. You should keep telephone numbers for your veterinarian, a local emergency veterinary service, and the ASPCA Animal Poison Control Center (1-888-4 ANI-HELP) in a convenient location. If you suspect that your pet has ingested something poisonous, seek medical attention immediately.

Now how about playing with that tinsel and your kitten? Cats LOVE to chase strings, ribbons, yarn (as I know from trying to knit or crochet with the "help" of my cats Spartacus and Stella!) and all things dangle-y, and many like to chew on them as well. This can be very dangerous as linear foreign bodies (ingested string-like objects) can cause intestinal blockages or bunching and may require surgery to remove. The whole Christmas tree can be a hazard for pets, so make sure it is mounted in a very secure stand to avoid being knocked over by climbing cats or curious dogs. Broken glass ornaments can cut delicate foot pads. The water in the base of the tree sometimes has chemicals for tree preservation or sap which is toxic or irritating to the gi system. Don't be too surprised if a pet becomes "unhousebroken" and urine marks the tree; why else would humans bring trees into the house????

It is never too early to get your house "critter-proofed" for the holidays. I hope we all have a safe and very happy season.


Wednesday, November 12, 2008

Multi-modal Analgesia

It is hard to believe, but there was a time (not long ago, really) when veterinarians did not prescribe pain relief medications to animals. Either because they don't cry like humans do or simply can't say "Ouch! That Hurts," it was believed that they didn't feel pain as we did. Others might have thought pain was present, but that it was a good thing, especially post-operatively, because it would keep a patient quiet and thus less likely to injure itself. That is just ridiculous, of course. I am so glad those times are behind us! Animals certainly do feel pain; they just express it in different, possibly more subtle ways. My veterinary technicians or nurses are trained to recognize these signs, particularly in post surgical patients. Vocalizing or crying is a pretty obvious sign. Rapid heart rate or dilated pupils may indicate pain or fear. The pet may have an abnormal posture or gait/lameness, or may be trembling or shaking. They might be licking or chewing at the sight of pain, be restless or depressed. A once totally sweet critter might now be grumpy or aggressive or might be distancing themselves from their humans. The only sign of pain might be anorexia (not eating.)
Treating for pain can be complicated by the patient's personality (cats are notorious for being difficult to medicate) or their reactions or sensitivities to some medications (non-steroidal anti-inflammatory medications, NSAIDs, for instance, commonly affect the gastrointestinal tract, causing vomiting or diarrhea or may affect the kidneys or liver when used long term.) We do know that it is usually better to use lower doses when possible to avoid side effects, but those low doses might not be as effective at managing the pain. That is why veterinarians are commonly using what we call "multi-modal"analgesia or pain management. It can start with combinations of drugs before, during and after surgeries, as well as medications for chronic pain.
My dog, Verbal, is a typical patient who gets several medications or therapies, often at lower doses than using just one of them alone, and getting far better benefits. She has very bad DJD or degenerative joint disease from hip and elbow dysplasia as well as an improperly healed cruciate ligament rupture in one knee. She is on a special diet for joint health, (some dog's are given additional supplements like glucosamine and chondroitin.) Verbal gets an NSAID called Derramax for the antiinflammatory benefits, and also gets tramadol, a weak opiod-type drug when she "over does it." There are many NSAIDs and opiods to choose from if dogs or cats have reactions to particular ones. I have also used medications such as gabapentin for neurogenic pain, and have just started using one called amantadine. It is also important not to forget the alternative therapies such as acupuncture, massage, or herbal remedies.
It can be a bit confusing for owners, juggling all the different pills and powders and foods, but if it is better for their pet's health, most are willing to give it a try. I hope to continue to learn and apply that knowledge to make my patients as comfortable as possible for as long as possible. They certainly deserve it!

Tuesday, November 11, 2008

Be Sure to Thank a Veteran Today

Just a little deviation from "vet stuff" for a bit to tell you about an extra-curricular activity I really enjoy through the little Methodist church where I'm a member. (And it relates to the Veterans Day holiday today.) Every year I write up some short Christmas letters and send them off to the soldiers through a program called "Troop Fan Mail." Here's their website:

They have some guidelines about the sizes of the "cards;" they actually prefer 81/2" by 11" sheets folded over. It is best not to dwell on how sad it must be for the soldiers not to be at home during the holidays, that they must be missing their families and friends. Instead I try to write a bit about myself, my job, my church, and my critters and how very, very much I appreciate those soldiers and their incredible dedication and sacrifices. I definitely keep my "politics" out of it! I may not support the war itself, but you better believe I support those young men and women who give so much of themselves and are put in harm's way every day. I try to get a couple hundred cards done and also send some money for postage, too. Most years I get a few responses and even develop pen-pal type relationships with one or two of these soldiers. My staff and clients often get into it with me, stocking and sending along care packages every few months or so when we can. It is such a little thing that makes us feel good. Now, wouldn't it be nice if this program wasn't needed in the future? We can only hope!

I did want to tell you an amazing story I heard today on VIN, the Veterinary Information Network where I often go for researching cases, looking up doses of new medications, consulting with specialists...and often just chatting with other veterinarians. The subject of the story was "Cruelty Case", so I was prepared for something pretty awful. Here's how it went:
The dog was brought in by the neighbor of the owner, a young woman who had a live-in boyfriend. The woman had to work all day so the boyfriend came home between work and classes at a university to let the dog out that afternoon. The woman received a phone call from the boyfriend saying "you need to decide--it's either me or the dog." She got home later that evening to find the dog's head swollen and the dog acting scared and painful. She called the neighbor for help, saying she was afraid BF had done something to the dog. The neighbor tried to get her to take the dog to the vet, but she said she'd wait to see how the dog was in the morning. The following morning she went to work, so the neighbor brought the dog in to see me. This dog's head was very, very swollen. She had extensive bruising, including scleral (whites of the eyes) bruising, bruising in the ears, and even some retinal hemorrhage in one eye. The neighbor was livid and told me he was going to "kick some a**." I told him to calm down, that I was going to give him some advice. I told him to leave the clinic and take the dog directly to Animal Control and file a complaint. I told him kicking a**, while it might feel good, would simply get HIM in trouble. It would be far better to deal with the matter legally. I also told him he needed to be prepared to come to court to testify. He said he would. I told him I would testify as well.

Long story short--court was today. I flew in for the case (I live in another state). I testified about the dog's injuries, emphasizing how painful the dog was. The neighbor testified to his involvement and to everything the owner had said the night it happened. Not surprisingly, the owner had taken the BF back, forgiven him, and now claimed she was sure it was an accident. The BF claimed he had thrown a toy at the dog because he was frustrated that she had urinated in the house, but had not intended to hit the dog and that the injuries were "accidental."

Judge: Don't, sir, stand there and tell me it was accidental. You were angry and you intentionally threw the toy at the dog.

BF: Yes, ma'am, but I didn't mean to hurt her. She's my best friend.

Judge: You mean it's OK to hit your best friend when you are frustrated?

BF: No, Your Honor, you don't understand. I was just frustrated--it had been a long day. I'm in school and working and it was just frustrating that she peed in the house. I didn't mean to hurt her. She's like a daughter to me.

Judge: Now that's a scary thought. That you think of her as your daughter and still thought it was OK to throw something at her simply because you were frustrated. If you think a dog peeing on the floor is frustrating, wait until you have a two year old child. You don't know the meaning of the word frustrating. And your reaction to frustration is scary. And the thought of you some day having a child that you think it's OK to do the same thing to is scary. You say you're taking classes?

BF: Yes, I'm a student at Regent University.

Judge: You're enrolled in classes this semester?

BF: Yes, Your Honor.

Judge: Well, you're about to miss some classes.

She then turned to the owner.
Judge: Ma'am, he gave you a choice when this happened of him or the dog. I can see that you are back with him. That was a mistake. Since you are having trouble deciding between him and the dog, I'm going to help you with that decision.

Back to the BF:
Judge: Sir, you will pay a $250 fine. I'm sentencing you to 6 months in jail, but am suspending five months. You will serve 30 days in jail. And you will not own or be in the same household with any companion animals for the next four years.

Back to the owner:
Judge: Ma'am, he's going to be in jail for 30 days. You have that time to decide between him and the dog because you can't have both. If he comes back to live with you, the dog becomes a ward of the court. If you keep the dog, he has to find somewhere else to live and cannot visit with you while the dog is there. Is that understood?

I want to send this judge the biggest bouquet of flowers ever, and a nice thank you card, and I don't even know what state, city, even country she is in! If I find out, I'll be sure to share it with you. What a GREAT human, and a true advocate for our animal friends.


Monday, November 10, 2008

What Did You Do Friday Night?

Did you go out to dinner? See a blockbuster movie? (I am envious if you did; if you read my bio, you know I LOVE movies!) Maybe go out to a club for music and dancing? Well, I think I have you all beat.

Just as we were closing up shop, one of our long time clients called and said one of their beautiful, sweet Pitbull's, Butterfly, had been in hard labor all day and hadn't yet produced any puppies. She was panting and circling, couldn't get comfortable, and seemed exhausted to her owner, so of course we were concerned about dystocia, or difficulty giving birth. We told her to bring Butterfly right in. Ordinarily an end of the day emergency elicits groans and grumbles from the staff, especially on a Friday night, the end of an emotionally draining week. The possibility of brand new puppies causes exactly the opposite effect-jostling for who gets to stay for the overtime and help with delivery or a possible C-section (surgery to remove the puppies from the pregnant bitch's abdomen) and revival of the newborns.

Butterfly presented in pretty good condition overall, leaking milk from engorged (full and tight) mammary glands, restless, but no signs of abdominal contractions. Her gums were slightly pale pink and a bit tacky, probably from the panting. I assumed she had uterine inertia, a condition where the smooth muscle tissue is simply "worn out" from contracting over and over and using up vital nutrients like calcium and glucose. I put on gloves and lubed up my fingers and did a digital exam of her birth canal. There was a fetus in its membranes just within the birth canal with no indication of blockage, but I couldn't be sure. I also did not get the blackish green discharge on my gloves that comes from disruption of placenta from fetus, so I assumed the fetus still had nutritional and oxygen support from Butterfly. I thought it would be worth trying medical management of her dystocia rather than jumping right into surgery, although I let her owner know that might be a possibility later on.

Oxytocin or pitocin is a hormone produced in the hypothalamus of the brain and is used as an injection for inducing or enhancing uterine contractions at partuition (birthing), or post-partum (after birth) for retained placentas or aglactia (non-production of milk.) It can also help to involute or shrink up the uterus if it doesn't do so naturally after birth or after a prolapse (protrusion out of the vulva.) It is important to know that oxytocin will not work if the muscles are depleted of calcium and glucose, as I mentioned above, so correcting for these defecits are essential before giving oxytocin. We placed an IV catheter in her cephalic vein (front arm) and gave Butterfly a medication called calcium gluconate, which has both calcium and glucose. This was given very slowly to have the least effect on her heart muscles as possible. We then gave the oxytocin subcutaneously (under the skin.)

About 15 minutes later a slimy, wiggly (thank God!) light brown puppy made her presence known. Butterfly showed herself to be an excellent momma, licking vigorously to help clear the fetal membranes from the puppy's head and stimulate respiration efforts. We clamped off the umbilical cord, suctioned out her airways, gave her a very brief exam, weighed her and examined the placenta for any abnormalities (of which there were none.) Butterfly would have eaten the placenta if given the chance but she didn't NEED to do so as some breeders believe. Butterfly's owner took over the job of showing the pup where the milk was. Newborn puppies usually start to nurse on their own with the first 2 - 3 hours, but MUST do so by 8 hours or so. Colostrum, or the first milk, is rich with maternal antibodies and without these, puppies or kittens will have virtually no chance of fighting off infections from bacterial and viral invaders they face everyday. It wasn't long before a second puppy was delivered. She was screaming loudly, so we knew breathing wasn't a problem!

Things were progressing just fine. Butterfly was acting very maternal, delivery was going normally, the pups were of a good size for their breed and the owner knew just how to handle their care and what to watch for in case of trouble. Butterfly would be much less stressed at home, so I gave her owner my cell phone number "just in case", lined up a crew of my staff who wouldn't mind being called on the spur of the moment if there was an issue, and sent the happy family home to finish the job.

I got a nice email over the weekend with pictures of 5 healthy puppies (so far?) and will see them and Butterfly later today for a brief post- partum exam.

Something must be in the air; we just got a call that another of our patients, Mia, a lovely Bassett Hound with awesome owners, had 8 puppies yesterday! We get to see that happy family tomorrow...oh boy! I do love my job most days :)


Friday, November 7, 2008

How About a Charcoal Milkshake?

Mmmmmm. We have a glamorous job sometimes. What with the poop and pee and all sorts of other excretions from hospitalized and nervous critters, I thank God I have such a dedicated nursing and hospital attendant staff willing to step in and clean, change bedding and litter boxes and hose out runs if there is even a whiff of a need. I have a very sensitive sense of smell, and know how important it is to clients that a hospital is clean without smelling like super strong disinfectants. We are lucky to be located adjacent to a Subway Sandwich store....the dogs often come in drooling and licking their lips wondering where their tasty morsels are!

This morning we had another "fun" excretion experience thanks to a new patient, Cinnamon. It seems Cinnamon ate 10 - 15 of her owners prescription strength 800mg Ibuprofen tablets. Now, we don't use this medication in dogs or cats at all since there are so many safer ones available, but if we had to come up with one, a suggested dose would be around 180mg TOTAL for a dog of Cinnamon's size. Certainly not 8000 to 12,000mg! The immediate concerns for ibuprofen overdose is for gastric ulceration. Her owners were pretty sure she ate those pills within 45 minutes of her arrival at the veterinary hospital. Good for them for getting her in so quickly.
We always call poison control when we have a suspected toxicity case coming in. They can be very helpful, give us a case number and follow up with us later. I think they like breaking up the monotony of working on "boring old humans" all day by getting an interesting animal case in once in awhile. (I also have a link to the ASPCA's Poison Control service on my website. They are available 24 hours a day and all pet owners should know about their wonderful service.)
OK, now for the "fun" excretion experience. We administered Cinnamon a drug called apomorphine intravenously to induce emesis (vomiting) and then stood back and let her rip. I feel so bad having to do that to critters, but in a supervised setting with the proper medications, it is an important part of the treatment plan for some toxicities. It used to be very common to tell owners to give hydrogen peroxide automatically if their pet had eaten something bad. We are finding more and more problems with pets who get peroxide, including stomach bleeding, so we really do recommend getting your pet to a vet if at all possible. Somethings that are ingested should NOT be vomited back up due to dangers of aspiration (inhaling the material into the lungs) which can be worse than the original toxicity or can be caustic to the esophagus. Always check with your veterinarian or poison control before inducing emesis in your pet.

Cinnamon vomited (sorry about the graphic descriptions here!) chunks of food, lots of brown fluid and some green plastic looking things, but no obvious white tablet material that the owner said the pills looked like. So the lucky girl got to experience the next fun step in treating over-doses...activated charcoal. We made a slurry out of the powdered charcoal we keep for this purpose and placed a tube into Cinnamon's stomach (made easier because she was a bit quiet from the sedation effects of the apomorphine.) We were only able to give her half of her calculated dose before she acted a bit uncomfortable, so pulled the tube and will give her the rest in about an hour. The charcoal will hopefully absorb any toxins (the ibuprofen) remaining in her system.

We placed an IV in Cinnamon so we could diurese her (flush fluids through her system) in hopes of warding off the secondary effects of ibuprofen overdose, damage to the kidneys and possibly other organs. She's getting medications to protect her stomach lining and antacids and we are watching her very carefully. We'll check her blood values later to see if she has any long term damage or if she lucked out by having owners who got her in right away for treatment. Cinnamon has only been with these humans for 2 weeks-they just adopted her from the shelter! They didn't know her very well yet, but I guess now they know one thing about her, she likes to get into things she shouldn't. Time to "Cinnamon-proof" the house!


Thursday, November 6, 2008

Do you have room to love just one more????

Our Flake's Fund has been very busy lately. Maybe the story of one of these recipients will hit your heart just the right way, or maybe you'll know someone who would be willing to take on a special new friend. A veterinary hospital just isn't the best place to grow up, especially for our first case.

"Dagwood" is a pedigreed Standard Poodle puppy who is 12 weeks old. He is the prettiest apricot color with crazy curly puppy fur. He came to us at 3 weeks of age when his breeder noticed he wasn't nursing, was very listless, had a high fever, and had respiratory (breathing) difficulty. I suspected he had pneumonia, maybe from aspirating (breathing in) milk into his lungs. This owner just didn't have the time or money to put into caring for one special needs puppy , what with a big litter of healthy pups at home. We did some blood work and chest x-rays, and started him on some liquid antibiotics. We also started tube-feeding him to get nutrition into him right away. He needed his strength built back up if he was to survive. My nursing staff went above and beyond the call of duty, taking this tiny, runt of the litter puppy and giving him the intensive nursing care he needed around the clock for several weeks. They truly saved his life. His temperature normalized, his breathing became more normal and he began to take a bottle instead of having to be fed by a stomach tube. He had a few set backs and needed tube feeding during these set backs, but over all they never let him lose weight again. He has since been dewormed and started on his vaccines, eats regular puppy food all on his own, is well on his way to being house trained, and today he is getting neutered! He is a happy, goofy little guy who really needs a good home. Standard Poodles are way cool dogs, easy to train, and love to swim and retrieve. No, you don't have to trim him up with pom-poms all over him (unless you want to!)

"Twitchi" is a beautiful calico kitten, brought in by a good Samaritan who found her by the side of the road literally twitching or seizuring. She had such a high fever we were sure she would have brain damage, but so far, so good. She will need a special human who can take time with her because, not surprisingly, she is pretty shy. I think she would love to fine someone with a welcoming lap to cuddle on all day long! She does fine with all the dogs and cats she sees here on a daily basis, and boy, does she love her food. She is quite vocal when dinner time comes around and Kristina, our hospital attendant, hasn't dared to fill her bowl yet. She is FeLV and FIV negative, has all her vaccines current and was spayed, so she is ready to go to her new home.
Flake's Fund does good work, as you can see from these 2 examples. If you know anyone who might be interested in adding them to their families, have them give us a call for more information. We will really miss them, so would enjoy a visit or updates once in awhile :)


Wednesday, November 5, 2008

Congratulations, President-elect Obama

We had a strange season for fleas this year. All summer seemed to be pretty manageable, then when October came, so did the fleas. My staff were trimming Verbal's nails and found some on her. I was mortified! The vet's dog certainly shouldn't have fleas. Granted, her monthly flea control was due that very day, but wasn't over due, so she sure shouldn't have been infested. Yuck. Parasitology was one of my worst subjects in school. I hate those little creatures. We saw two darling little 7 or 8 week old kittens last week absolutely covered in fleas. We gave them a great medication called Capstar, a one-time pill that kills fleas in 30 MINUTES. During those kittens' exams, we just kept picking off the dying carcasses of those nasty bugs, stopping our count after a hundred or so. They were lucky little kittens. Some can be so infested that they become anemic-the fleas actually eat so much of their blood that they can no longer carry oxygen through their blood stream and they can literally suffocate. We had an ADULT cat die from flea anemia last year. How tragic is that, something so preventable?
There are some pretty great flea prevention products available for our cats and dogs. We carry Frontline Plus and Vectra because they not only kill the adult stage of the fleas but also prevent eggs and larva from hatching. No flea product has any efficacy against the pupae (cocoon) stage or keeps the flea from biting at all. Whatever you do, keep the harsh chemicals like pyrethrins away from cats (these are found in some dog products like Vectra and Advantix) and are actually sold as safe for cats in products like Hartz and Seargents drops, collars, and shampoos. They are NOT SAFE. They can cause tremors, seizures, and death in some cats and even some dogs. We lost a 160 pound Mastiff from a flea powder-he started seizuring and never stopped. What's more, these products don't even work. We often see fleas crawling right over flea collars on patients that come in the hospital. There is even an "antidote" page on their manufacturer's website. Wonderful, huh?

Flea allergy dermatitis (FAD) is a condition of the immune system where the bite from a single flea can cause pruritis (itching) and alopecia (hair loss) for up to 6 WEEKS on an affected pet. The hair loss pattern is usually found around the hind end and tail of the dog, and sometimes around the neck and head of cats. Other than moving your pet to Alaska to avoid fleas all together, the only thing you can do to help a pet with FAD is to practice diligent flea control on the pets year round and in the environment (house and yard,) as well as treat allergy symptoms before the pet scratches him or herself raw and makes secondary infections in the skin. Antihistamines can help a small percentage of animals, so can soothing oatmeal/antihistamine baths and topical sprays.
Oh, and did you know that fleas are an important part of the tapeworm life cycle? That's right. Tapeworm eggs are found inside the flea, so when a pet is chewing or grooming themselves and ingests a flea, it eats the tapeworm egg. Most often only segments of tapeworms are passed from the affected animals body. These segments will look like little wiggling grains of white rice stuck to the hairs under your pet's tail or on the fresh feces. They may look like little sesame seeds on the bedding when the segments dry out. I sure don't know why we insist on describing these things with food analogies! Gross.

Call your vet if the symptoms of FAD are becoming evident. Sometimes stronger anti-inflammatory medications are needed to break the cycle of the immune reaction.


Oh, I want to express my sincere sympathies to my head technician, Amber and her husband, Rob, who had to say good bye to their cat, Lucky last night. Remember the blog I wrote called Cancer Sucks? Well, it really does. Lucky was just diagnosed with a fairly rare condition called lung-digit syndrome where he had cancer that occurred in his lung and in his toes. Weird, but then cancer can do any darned thing it wants. Lucky had a strong personality and could be a bit of a butt-head at times. I know that is why he will always have a special place in their hearts. He was much too young to have this happen to. I am so sorry that my dear colleague has to hurt so very much.

Tuesday, November 4, 2008

Be Sure to Vote Today!

Yesterday was all over the place emotionally. We met an old dog named Beamer for the first time, and boy, was he sick. Evidently he had broken a pyrex type serving dish a week earlier and actually ate some of the glass. Beamer came to us so sick, dehydrated, hanging his head, depressed, not eating, ropey drool coming from his lips, his heart was racing from fear and pain....his wonderful owner was just overcome with worry. And yes, he had serious money issues. I tried to let him know that it wasn't likley going to be an easy fix, even with all the money in the world. His owner hated seeing his friend hurting so much. He was a beloved family member for over 12 years. At least I knew I could help with that.

"Grieve not, nor speak of me with tears, but laugh and talk of me as if I were beside you.... I loved you so-- 'twas Heaven here with you." (Isla Paschal Richardson).

Not an hour later we met Peanut, a bouncy, silly little 7 week old Cocker Spaniel puppy. She was full of life, licking everyone who got close to her, wiggling all over the place. What a ball of joy! She has a great family who really loves her...what a lucky puppy. How in the world can you go from such gut-wrenching agony to such happy, happy joy in such a short amount of time and not think you have a split personality or something?

We are going to have a staff meeting soon to try to help our team deal with some of these issues that are becoming more frequent in this economy. "Compassion fatigue" is a real phenomenon in the health care industry, and I want to try and protect my big-hearted staff from experiencing it. I have to let them know that they can't care more for a pet than the owner does, as hard as that sounds. We also can't judge people who don't do all the recommended diagnostics and treatments for their pets at the time they bring them in. We don't know what their reasons are for declining the recommendations. If the staff want to take on the costs of treating a specific animal once in awhile, I will support their efforts, as we did for Lucy, the parvo dog. But it just can't happen every day, unfortunately. We have a business to run, and their salaries to pay. People usually get into the veterinary field because they genuinely love animals, but it just isn't enough.

Yuck, I don't want this blog to be a big downer, but it seems I picked a crummy time in the lives of many of our clients to start writing about the day to day happenings in a veterinary hospital. Hopefully there will be lots more entries about critters like little Peanut in the future.


Monday, November 3, 2008

Vaccine Protocols

Ever wonder what all those initials stand for when your dog or cat gets their yearly (or hopefully now every three-year) "shots?" Dogs or puppies usually get vaccines with letters like DHLPP. D stands for distemper, a virus which can affect many organs of the body, especially the nervous system. H is for hepatitis, an infectious disease of the liver, spread by contact with urine, feces and other secretions of infected animals. L is for leptospirosis, a bacterial disease of which there are many strains. The liver and kidney are most commonly affected, and are often transmitted by wildlife in the area. P is for Parvovirus, a highly contagious, often fatal disease of the digestive system. The other P is for parainfluenza, a nasty respiratory infection. Cats and kittens are usually given a vaccine with letters like FvRCP. FvR is for feline viral rhinotracheitis, an upper respiratory disease. C is for calicivirus, another mostly respiratory disease, though we also see mouth ulcers with calici. P is for panleukopenia, or feline distemper. It can affect many organs of the body, including the nervous and gi systems.

We don't have a one-size-fits-all for our vaccine protocols at our hospital. That makes it hard to give estimates when people call wanting to know what it will cost to get their pet up-to-date on "shots." The truth is there are numerous answers to that question based on the individual pets' needs, their exposure risks, lifestyles, etc. It doesn't make sense to give a pet a vaccine for a disease where they just don't have the risk of contracting the disease. There is some good information on recommended vaccines for dogs and cats at the vaccine protocol link on my hospital website

We just recently changed the manufacturer of all of the cat vaccines, as well, to avoid the adjuvents or "carriers" in the vaccines that have been attributed to the vaccine-site sarcomas or cancers in some cats. It has been shown that some of these cancers can show up 9 years after an injection! While this is, thankfully, a very rare occurrence, to have it happen at all to a patient we were trying to give a preventative vaccine to would be a terrible tragedy. Get more information on vaccine-associated sarcomas at Not vaccinating at all just isn't the right response, for your cat or for human health (rabies virus.)

One of the cat vaccines, the feline leukemia vaccine, is now delivered by a transdermal route-a needleless system that looks like a space-age instrument. (See the above picture.) It is pretty cool, but took some getting used to. The staff has been very supportive of the changes, knowing we are doing them for the benefits of the patient's health. It would be a lot easier to keep things the way they have always been done, but medicine, particularly immunology, is always changing, and I will do my best to keep up with those changes.