Sunday, October 28, 2012

Giggling while using the gigli wire

After we closed on Saturday, I was sitting at my desk going through my stack of files. One of my clients called to say that his dog had got the bone she was chewing stuck in her mouth. I told him to come right over. I was picturing that the bone was caught in the hard palate. I hadn't pictured this. There was no way that the bone was coming off while she was awake.

So, under a general anesthetic she went. This way, I was able to use my gigli wire to get it off. The gigli wire is a surgical wire used to cut through bone smoothly. I was able to slide it through and start sawing. Her Dad, provided counter balance. It only took 10 seconds to saw through. I popped it off and woke her up. Another successful day at the office!

Tuesday, October 23, 2012

Years of Searching

Today was the day I found my paper!

COX, M.G., ANDERSON, D.M. and RYON, J. 1997. Comparative digestibility by wolves (Canis Iupus) and Coyotes (Canis Iatrans) fed feedstuffs of animal origin. Can. J. Anim. Sci. 77:560.

Doesn't it look official?!!? My first(long story) maiden name was Cox and I was thrilled when I got to work with the wolves and coyotes at the Canadian Wolf Research Centre in 1996-1997. This was during my final year at the Nova Scotia Agricultural College (now known as the Dalhousie Agricultural Campus) and everyone in their last year had to do a research project. I was told later that the project I worked on could have qualified for a Masters program!!! What I also didn't know was that this project was going to take me out of class so much. When my professors wanted to let me know that I needed to study for a test, they would come find me in the lab where I basically lived for about 4 months.

Over the years I have looked for this paper as I have many fond memories of working with the animals. It was bitterly cold that winter and yet I had fun getting to know the animals. This is also the only time in my life that I was actually interested in picking up the scat (poop). Mom always had to nag me to clean up after the dogs and my mutterings about how I felt about it were not exactly positive!

Here is one of my test subjects. He looked forward to me coming with the food everyday. One day, he actually nipped at my butt to get me to move faster towards the area where I would place his food. I don't think he got the reaction he was looking for cause I started laughing so hard. Here I was, alone in the 1 acre pen with a wolf trying to herd me.

If you are bored, go to this link and find page 20. There you will find the abstract. Woohoooooo!!! I am published.

Sunday, October 21, 2012

Panda hugs

Another item on the bucket list checked off! I got to go to China. We had been told by our fantastic travel agents, Dave and Arlene, of Pace Setter Travel, that we would be able to see the Pandas. I never dreamed that I would ever get to hold a Panda. Absolutely thrilling to put it mildly.

You can imagine the surprise when the Panda was brought in. I had been under the impression that we would be holding a baby. The baby basically dwarfed me.

I was exposed to the most extraordinary example of positive reinforecment while I was there. Panda bears are not the friendliest animals on earth. However, the way they are handled at this facility, they are completely comfortable with humans. Who wouldn't be when you have the association of sitting on an excited person's lap while eating your favorite bamboo shoots, honey and apples?

Monday, September 3, 2012

Not more anal glands!

Anyone who thinks that being a veterinarian is a glamorous, fun job where you get to play with puppies and kittens all day is delusional! Fun, yes but after your first run in with an anal gland, no glamor! I seem to be having a run of patients needing help regarding their anal glands. With this in mind, I took a picture of one of my most recent sacculectomy cases to show off.

Let's go back to basics. Anal glands are the scent secreting glands located just inside the internal and external sphincter muscles of the rectum. There is one on either side of the anus between 3-4 o'clock and 8-9 o'clock. Normally, when the dog (or cat) defecates, the anal glands are self expressed. Problems occur for a number of reasons. Some of these include when the material becomes too thick to easily be expressed, the ducts leading from the glands to the anus become blocked, the area becomes inflammed leading to blockage of the ducts, the glands become infected or rupture of the gland. The list goes on.

When deciding to go forward with surgery, you have to weigh the pros and cons seriously. Pros: no more smelly glands that can become infected or ruptured (takes 7 - 9 weeks to heal and are much more likely to rupture again). Cons: fecal incontinence, infection, inflammation, dehiscence of the incisions. This is not a surgery to be taken lightly.

So when we have a case where we need to remove them, I want to avoid a particular complication at all costs. Fecal incontinence is no fun. The dog is just walking along, feces falls out and s/he has no idea it happened. I have only had one case where it occured and it resolved in two weeks.

One of my tools is coloured wax. Who knew that Crayola crayons would have so many uses! It can be a bloody surgery and having a contrasting colour really helps. During the surgery prep I infuse both the glands with the colored wax. This allows me to make my incision just that much further away from the anus; thereby decreasing the chance I will tick the nerves to the sphincters off.

Back to the picture. I made an incision over the gland so you could see how thick it was from the chronic infections. At the bottom of the picture you can see the duct. Since I didn't place a ruler by the gland, it is difficult to have perspective on the actual size. Small, but large enough to be a pain in the......well, you get the idea!

Tuesday, August 21, 2012

Dental surprise!

One of my patients, Tazo, was having a hard time chewing her food so she was brought in for an exam. Her 108 (really big upper molar had some gum recession and purulent (abcess material) along the gum line. We scheduled her for surgery.

Well, today was the day. We took a radiograph to see what was going on with the bone around the tooth and to see if there were any tooth root abcesses. I was not expecting to see this picture. The entire back root was gone, as was the bone from infection. It also usually takes anywhere from 20-40 minutes to remove this tooth but it only took half the time. The biggest problem was getting enough gum tissue to cover the sockets once I got all the "debris" out of them.

Here is the after picture with the area sutured close. No more wiggly, painful tooth! Plus, her breath doesn't clear a room out now.

Saturday, August 18, 2012

I saw red!

This week, we got a call that an emergency was coming in and they were just a few minutes out. Dog versus horse. That is about as heart warming as reading a Dean Koontz book.

In came Soda with blood coming from the right nostril and the right eye trying to leave its socket. The picture kind of tells the story for me.
Everything was bloody. The anterior chamber (area of eye in front of pupil was full of blood, the sclera (white of the eye) was bulging and the entire eye was being pushed out by the hematoma that was likely bleeding behind the eye itself. The swollen eyelids were basically holding the eye in place.

I was so proud of my staff. We got things happening pretty quickly. Stephanie drove to Troy's clinic to get non-absorbable suture (I only had absorbable), Kelly, PJ, Claire and Caitie got her pre-meded and under a general anesthetic while Jac and Belle rearranged my schedule so we could do the procedure.

The procedure is pretty neat when you don't think about what would happen if you accidently poked the eye with the needle............You basically use the eyelids as the bandage. The eyes stay lubricated and by suturing the eyelids closed, it stops the bleeding. To make sure the eyelids don't rip (well, if you don't like gross stuff, you should have stopped reading sooner!) I used small pieces of IV tubing as anchors. We will remove the sutures in 2 weeks and see what is happening. There is a chance she may be blind in that eye but as long as she is comfortable, that is the most important thing!

Sunday, July 29, 2012

Adrenaline rush

There are a number of emergencies that can cause an adrenaline rush in a veterinarian. A hit by car, cat straining to urinate, seizures and a GDV (gastric dilation and volvulus) aka bloat.

A young Golden Retriever, named Harry, wasn't acting like himself. He was fine when he'd been fed around 6am but at 9am he just wasn't himself. He was retching, vomiting and eating grass hastily (98% of dogs eat grass just because they like the taste of it, just ask all four of my dogs).

I was relieved when I felt Harry's abdomen. His stomach was quite large but it wasn't hard like a basketball. His intestines were also pretty gassy feeling. I was also happy the history included vomiting up grass. Classically, GDV dogs try to vomit but nothing can come up. Off we went to take a radiograph.

What I did not want to see was a twisted stomach. If you look closely at this picture you will see the typical look of GDV. It looks like Popeye, the sailor, is flexing his biceps. When this is what you see, you either fly into surgery or perform humane euthanasia. Once the blood supply has been cut off from the twist of the stomach on itself, you have a very limited period of time before the stomach starts to die.

You can imagine how happy I was to see that the stomach was just significantly enlarged. There is another radiograph showing the gas extended right back to the rectum. We put a stomach tube down his throat to remove some of the gas and then admitted him for observation. We needed to make sure that if his stomach started to torse that we deal with it immediately.

He was taken on regular walks (helped to air out the treatment room as his gas was a nasty smell of success)! His folks also came to walk him a few times as well. By the end of the day, he was starting to act like his goofy normal self! The radiograph taken prior to him going home made us all so happy. The stomach was normal in size and only the large colon was gas filled. Yay Harry!!!!

Wednesday, July 11, 2012

Belly Ache Time

I had a rather long feeling day today and looking forward to yoga made it a bit easier. Did my first handstand ever and was on a bit of a high as I walked back in the door at home.

The problem was that I was only greeted by three out of four dogs. I followed some interesting sounds into the kitchen to find the fourth. Yes, that is my special needs boy, Kodak, sitting on the counter. What you can't really tell is how large his belly is from all the food he'd eaten.

I rethought my dinner plans (spaghetti) as I tried to figure out how he got up there. It wasn't until I went around to the other side of the counter that I discovered the key. Yes, I have now separated the boxes from the stool so his "steps" are dismantled.

Currently, he is laying around like a beached whale that has a cute little wagging tail.

Tuesday, July 10, 2012

Slab fractures

I was informed by one of my volunteers this morning that I have been rather negligent in my blogging lately. Luckily she told me this as I was about to start my dental surgery so I took pictures as I went along.

Recently, I had a dog come in for its yearly physical exam and vaccinations. I found that it had a slab fracture on its carnaissal tooth (if I'm going to use fancy dental charting - the 108 was fractured). It had occured long enough ago that the pulp was black. The thought of walking around with a tooth like this makes me want to cringe but our animals don't often tell us when they are having tooth problems.

Today was the day to take it out. I am holding the "slab" part of the tooth up. One thing you should never see is tissue between pieces of the same tooth. Yup, there is the infected tissue. Would you like to know what it smelled like? Nasty! There is a positive about a fracture like this, it exposes so much that it makes it incredibly easy to figure out where to do the drilling to isolate each of the three roots.

This is one of the three roots and all of them had granulomas on the root tip. Basically there were small abcesses on the tips. If you are having a hard time orienting yourself, the nasty tip is pointing to the left. The other thing that is missing from this root is length. The infection has eaten away at the tooth so it is now shorter. I won't bore you with how long I cleaned each of the sockets so I could feel comfortable about closing it properly. At least I know she will enjoy the pork liver flavored antibiotics!!!

Tuesday, June 26, 2012

Puppy and kitten brain mush

I have a confession. I absolutely loose all ability to be professional walking into the appointment room when there is a kitten or puppy. I can't tell you the amount of times the staff have reminded me that I am supposed to walk into the room, greet the owners and introduce myself while looking them in the eye and then greet the puppy or kitten.

Here's what goes on in my brain. Ok, this time, I'm going to be professional. I can do this.............I open my mouth and out comes cooing baby sounds. I pick up (possibly grab puppy or kitten out of the owner's arms) the little one and tell them they are going to have a good time with their auntie Bourque. I am sure that many owners would have no idea who I am except for the fact that I wear a white smock and wear a name tag.

I have been doing this for as long as I can remember. I would fall asleep with the litters of puppies piled on top of me (honest Mom, I was doing my homework, I just couldn't move and disturb the puppies). I think that when the day comes that I can't completely enjoy these little miracles, I'd better hang up my smock.

I only vaguely remember this picture being taken one Sunday morning after we'd completed the assessments for the new dogs coming into the PALs program. One of the volunteers brought in their puppy for a little socialization and this is what happened.......

Friday, June 8, 2012

Quirky night

My evening last night was rather interesting. Not only did I get very lost on the University of Calgary campus after being stuck in the wonderful traffic jam on Crowfoot, I got to meet Bob from Quirks and Quarks. I had been asked to come answer a question for the Quirks Question Roadshow. Dogs peeing isn't the sexiest topic to talk about but it was so much fun to be there. I wish that when I'd been asked about the fire hydrant, I'd said something along the line the dogs were urinating as "reply all".

Here's the link if you want to hear about this and other interesting topics:

Wednesday, May 30, 2012

NAVC Institute

I just have to write about last week when I was at the NAVC Institute doing a behaviour course with my idol, Dr. Karen Overall, a board certified veterinary behaviourist. I had taken this course five years ago and thought it was time to take it again. It was even better than the last time. We did behaviour cases, got introduced to new behaviour modification protocols and new medication protocols. It was all I could do to stay seated, I was so excited.

I’ve included a link so you can see what I was doing. What the schedule doesn’t tell you is how much extra time was put in. When the other courses were finished after dinner, we would head back into the room at 7pm for another few hours of work. I did get to bed at a normal time on Wednesday night since we were off “early” for the banquet.

I had been emailing Dr. Overall about a rather complex case and that evening she told me that I was going to present it to our course and the instructor of the neurology course as well as his students. Let’s just say that I didn’t get to bed cause I needed to make a proper case presentation. I haven’t done one of those since vet school. Luckily I was able to jazz it up a bit because I was able to email the owner for some photos. I will be forever grateful for her taking the time to send the pictures. I am also very glad my Mom made me do public speaking in 4-H. I was able to “turn it on” and get the answers we needed.

The next night another attendee presented how he’s changed the way he practiced general medicine so his hospital was more behaviourally aware. I am so glad not to be the only vet who sits on the floor if it makes the dog or cat feel more comfortable.

We were also lucky to have two attendees from Norway. They did a lot of search and rescue work and all the animals are trained with only positive methods. When Dr Overall as you to do a presentation, you do it, so she presented how they trained and were tested. Just amazing!!! I also loved the fact that both of her English Cocker spaniels had their beautiful tails.
In addition to being in class and madly taking notes, we also got to work on “bratty” dogs that were referred by local trainers and vets. While everyone else was adjusting equipment, I found a puppy that had been brought in for socialization. The focus on this 12 week old German Shepherd puppy was breathtaking. I grabbed a clicker and some treats and away we went. Willow would have jumped through a flaming hoop if I’d asked.

I also had a blast with the true behaviour cases. One dog had noise phobias and the other had fear aggression. I loved watching their body language and how the specialists work with them and their suggestions to the owners.

Check out the course at this link

Friday, May 18, 2012

First of the year

The girls had booked off most of the morning so I could catch up on my files before heading off to my behaviour conference in Florida. Before you get too envious, we have been asked to bring fleecy jackets and blankets as the conference rooms are kept quite chilly. Plus, we start at 8 in the morning and end at 9 or 10 at night.

I wasn't exactly looking forward to my worklist but I trudged through the files until one of the girls walked in and asked if I would be willing to take a look at a dog that had played with a porcupine. I was so happy!!! When animals wake up after having quills removed, they look so much more comfortable. The other great thing about this case was that the owners had not trimmed the quills. It is an old wives tail that trimming allows the quills to deflate. They cannot deflate as they are too stiff; however, the more you touch them, the more they work their way into the skin.

Monday, May 14, 2012

Not without my heels!

Last year, we sponsored the hayrides at the Millarville Market. This year, we are helping to sponsor the “Run to the Millarville Farmers’ Market” half marathon. Race day is Saturday, June 16. All proceeds will benefit the non-profit Millarville Racing and Agricultural Society.

There is an incredible amount of information on the website. One tidbit of information stood out for me. “The race course will close at 10:30am, allowing for a maximum race pace of just under 10 minutes per kilometer.” Are you kidding me? I would need at least an hour per kilometer so I didn’t die of heart failure!

Good luck to all the participants!!!

Tuesday, May 1, 2012

Sunday Fun

So people have been telling me that I need to get out more. For some reason, me having so much fun playing with sebaceous cysts and abcessing kind of freaks people out.

Well, I got out of Okotoks and went to a seminar in Calgary this past Sunday. I bet you're thinking its not much of an improvement BUT it was about behaviour. Dr. Horwitz came up from St. Louis to talk to the Calgary Academy of Veterinary Medicine. It was a great review and she had some great videos of inappropriate behaviour. The one that had me watching with one eye open was the one of the child sitting in the corner with the dog while it was trying to eat. It was a very patient dog but you could see it getting more and more stressed as time progressed. The dog did escalate to lifting its lip and the video stopped.

If somebody bugs me while I'm eating, I am not exactly the most polite person in the world. (Most people have learned never to do it more than once!). Think of it from the dog's perspective. For whatever reason, us humans have decided its okay for us to bug our dogs while they are eating. Why? I bet there would be a lot less bites occuring at meal time if they were only allowed to eat in another room or in their crate by themselves.

Dr. Horwitz talk gave me a lot of ideas so when I have time....... : )

Sunday, April 22, 2012

Like an Onion

A little while ago I saw another really cool oral papilloma. I have written about them before but I guess this particular papilloma didn't get the memo. Not only was it on an older dog, it was in the inner pinna (ear). Of course, the owner was quite concerned as it had grown at an incredible rate.

Was it ever fun to remove though! I used a hemostat and basically removed it one section at a time. The base was only 3mm in diameter. It did bleed a fair amount but Bobby looked very cute in his stockinette headband as he walked out the door.

Saturday, April 14, 2012

Rant time

I have included a cute picture so that if you aren't interested in reading my rant, you can at least see my Cardinal the day I brought him home.

So, this morning, my receptionist, Stephanie, answered a call. It turned out to be a very upset client. A few months ago, she had brought in her dog who was bleeding from the nose. Now, yes, this is an emergency and needs to be seen. Unfortunately at that time, I was in surgery. One of my AHTs went to evaluate the dog and felt that rather than waiting an undetermined time for me to finish my surgery, they needed to immediately go to the emergency clinic. Off they went and it turned out that the dog required humane euthanasia as there were no other options.

Now, we didn't know the client was upset and a vaccine reminder was recently sent out for her other pet. Not quite sure how we were to know that she never wanted to use our services again if we aren't told.

I have two points I would like to make. One, if you want to be mad and take it out on somebody, take it out on me. I was the one performing surgery. Two, I cannot leave surgery!!!! It is non-negotiable!!! If this client were to take a deep breath and put herself in the shoes of the owner who's dog I was performing surgery on, I am very sure she would never want me the surgery room.

If you have made it this far, thank you for putting up with my rant!

Sunday, April 8, 2012

Amazing skin

Just over a week ago, Katie was brought in for an issue with her left forelimb. A month ago, she had been playing with one of her friends when a tooth accidently caught her skin. It seemed to be healing well so she wasn't brought in to see me until she started chewing and licking the area.

We had a couple of treatment options. One was to do nothing (gross!), place a local anesthetic and debride the infected tissue or surgically remove. The problem with the last choice is the fact that once all the tissue was removed, it would be a tad difficult to close the defect.

Option two it was. The picture on the left shows what the leg looked like when she first came to see me. The middle picture shows what it looked like once the dead and infected tissue was removed (same day). I showed Katie's owner how to bandage it and they would need to be changed on a daily basis. The picture on the right is the incredible healing after just one week. I can't wait to see how much she's healed in two weeks!!!

Friday, April 6, 2012

Socks again!

When I got to work Wednesday, I was disappointed the surgery that was scheduled had cancelled. It really isn't a good idea to feed your pet the morning of surgery. I thought it would be a long morning of paperwork until we got the call. One of my client's dogs had a habit of eating socks and they saw Sebastian eat one the night before. When they woke up, he was vomiting and refused to eat breakfast. For Sebastian, it was a huge flag.

When they carried him in (usually he bounced in) my heart sunk a little bit. We took a radiograph and there was the bloody sock. Plus, the gas pattern confirmed it was stuck. As I went to tell the owners, my staff prepped him for surgery.

My AHT, Kelly, scrubbed in to help me. Those are her hands on the right waiting to hold the jejunum for me. I've labeled the picture. The very thick section of the intestine contains the sock. Through the incision, I also pulled out a bunch of grass coming out in advance of the sock. Once the sock was out, the peristalsis began (this is a huge relief as it indicates the intestines are working). The contractions were hitting Kelly's hand as she held off the intestines. It was the most beautiful wave of contraction once we had finally closed the incision and tested it with saline. I will neither deny nor confirm that a cheer may have resounded throughout the hospital at that time.

Sebastian's recovery was pretty routine. I kept him for the night so I could monitor him for any problems. The only problems I discovered were trying to get him to walk across the parking lot to the grass instead of running and he found ANOTHER sock on the way back to the building. How do you loose a sock???? Luckily, I saw it a fraction of a second before he could sniff at it. I'm glad I have good reflexes!!!

Tuesday, April 3, 2012

Classic cruciates

I had a patient with such a classic case of a torn cruciate ligament that I just had to blog about it. A couple days ago this goofy Lab was running around when she came up lame. Her owners didn't see what happened and she didn't make a sound. All they knew was that she couldn't put weight on her right hind limb. They gave her some time to see if she would improve but when she didn't they brought her in for an exam.

So during her initial exam yesterday, she was her usual happy self until I tried to extend and flex her stifle (knee) joint. It was obvious she was painful, especially when she wouldn't put weight on it. We scheduled her for sedation and radiographs this morning.

The sedation allowed me to be able to check her for a positive cranial drawer sign. When you watch the video, just pretend I figured out how to get rid of the sound! We always check both knees to make sure we don't miss any problems.

Unfortunately, when a dog (and sometimes a cat) has an injury such as this, surgery is required. If left untreated, approximately 80% of patients will rupture the other knee.

Sunday, April 1, 2012

I likely need to get out more.....

There is a mass that I really like to play with on our dogs (don't often see them on cats). It is called a sebaceous cyst. They are absolutely benign and don't usually cause issues. I have seen them as small as a pin head to the size of a kiwi.

All dogs have sebaceous glands that excrete sebum (oil). This oil keeps their skin from being dry and full of dander. If the gland becomes blocked, a cyst forms. The cyst can go away on its own but sometimes I get to help out.

Any lump or mass found on your pet should be aspirated (place a needle in the mass and draw out cells). Sebaceous cysts often have a feel to them that I have learned to appreciate and instead of using a 22G needle, I go with a bigger 18G one. This will give me a big enough opening to express the contents. Sometimes the lining of the cyst starts to come with it and I try to get that out too. No lining equals no more cystic material.

The thing about doing a good job and getting everything, including the lining, is that they won't come back!

Sunday, March 25, 2012

Not for the faint of heart

I was going through my photos today and saw this picture. It is a case that did not end so well.

An owner brought in her cat, roughly five years old, that was having trouble breathing. His gums were a pale pink and he was using his abdominal muscles to help him breathe. When I tried to listen to the heart, I could barely hear it. We took a radiograph of him laying on his side (he became a bit panicky when my AHTs, PJ and Kelly, tried to take a picture of him on his back). The radiograph showed so much fluid in the chest that I couldn't see the heart. As his prognosis was so guarded, his owners chose to humanely euthanize him.

In odd cases like this, that just don't seem to add up, I asked the owners to let me do a necropsy (autoposy on an animal). Fortunately, they also wanted to know why they had to loose him at such a young age.

I always start by looking in the abdomen and in this case, it was clean. The chest, on the other hand was surprising and amazing (more proof that I don't get out much). The fluid I could see on the radiograph was bloody. The reason he was having problems breathing was because the blood was basically squishing the lung lobes. There was no evidence of trauma, so I knew there was something pretty weird going on. Once I was able to remove the blood, I found the heart. It was huge because there was also blood in the pericardial sac (sac around the heart).

Blow the picture up (sure, it is a bit gross, but you have to admit it is cool too!!). Alright, the blue dashed lines outline the very thin layer that should be muscle. The arrow points to my thumbnail that you can actually see through the fibrous layer. The yellow line indicates how thick the muscle should be throughout the heart.

My hypothesis is this heart defect was something he was born with. Over time, the area became thinner and blood began to ooze into the pericardial sac. Since he was starting to have difficulty breathing, it cause increased stress on the lungs leading them to ooze bloody fluid. There is no way he could have survived.

Friday, March 23, 2012

Alien brain

My staff knows that I get really excited when there is a mass that I will be able to poke (oh yeah, should be professional – “take an aspirate of”). The other day I had one to check and on first look, it seemed like a straight forward cyst full of liquid. I cleaned the area with my antibacterial soap and in went my needle. Once all the fluid was out, I could feel there was more tissue moving around. I used both hands to feel around it, when……out it birthed. Everyone in the room, including the dog, just looked at me as I sat on the floor in complete disbelief. It looked like I had a little alien brain in my hand.

I will keep you posted on the alien as it is being sent away for histopathology.

Sunday, March 18, 2012

Lance teeth

I promised a couple of blogs ago to tell you about a neuter that was a little different. As per usual, a full physical exam is done prior to surgery. PJ, one of my AHTs, called me over to see the Sheltie’s mouth. He had what is commonly known as lance teeth. This is a hereditary problem whereby the adult upper canines grow straight forward. The green lines show where the tooth should be positioned.

The main issue is periodontal infection. Remember that the tooth has enamel. Enamel does not attach to the gum so this creates a huge pocket that becomes a great place for plaque and bacteria to take over. Periodontitis (infection and inflammation of the periodontal ligament) affects the local area as well of being a source of bacteria for the rest of the body.

So, how to fix the problem? There are two options. One is to refer to the dental specialist who can basically apply braces so he can have a normal mouth. The other is to remove the lance teeth. Due to financial and time constraints (Robby would need to see the specialist every two weeks until the problem was resolved), the owners and I elected to go forward with tooth extraction.

After taking radiographs (too make sure there were no other surprises), I elevated the gingival flap. I will admit I was surprised to see how much of the tooth was exposed without any bone over it. (The blue line shows where the gum line was.) I really took my time elevating the teeth cause I didn’t want to send the roots into the nasal canal. I was so glad I did. I could actually see the nasal turbinates through the bone. You can be assured the gingival flap was closed very carefully.

Friday, March 16, 2012

Always learning

So, today a lady stopped in to ask about her young cat. Snowflake had chewed on a plant earlier in the week and didn't want to eat much. Luckily she knew the scientific name of the plant - Dieffenbachia. I tried to go onto VIN (Veterinary Information Network) but it was temporarily down. So I hit Google and then asked my receptionist, Belle, to tell the owner to go home to get Snowflake.

It turns out that this beautiful houseplant is completely toxic to cats, dogs and young children. When chewed on, the plant cells release calium oxalate crystal that cause pain in the mouth and skin. There are also toxins that cause swelling and burning in the mouth and throat. The other fun symptoms include hypersalivation and difficulties eating and drinking. In some cases, the throat can close causing suffocation.

Well, our little Snowflake had eaten a very tiny amount and had vomited the little piece of plant. He continued to vomit periodically and had a poor appetite. Lucky though, no issues in the mouth and only a little dehydrated. Even though he wasn't thrilled with the fluids given subcutaneously, he should do very well on the tasty food his Mom can syringe in for him.

The other name of this plant is Dumb Cane because it can render a person speechless (from pain) for a short period of time. Hmmmmm.........

Monday, March 12, 2012

She's how old?

Amongst the Monday surprises I saw today, this one had me speachless for a period of time. I had three cat spays and one dog neuter scheduled. Started with the spays cause I had an added procedure with the neuter (next blog). Two of the girls were almost 6 months old (sisters) and the other was 18 weeks old.

I was so surprised when I found the uterus in the youngest. She was in heat!!! I have only seen one other kitten this young go into heat (of course she was mine). I came home one day from college and my kitten, Carob, was making some interesting noises. After a sleepless night, I headed downstairs with her and left her to get spayed. There were a number of perks about living in the apartment over the veterinary hospital when I was a student.

To get a better perspective of the size difference, double click on the picture. The one on the left is of the in-heat uterus. So, while the older cats were double the size of the kitten, her uterus was double the size of theirs.

Thursday, March 8, 2012

Incredible surgery!

So today was the day to remove THE stone. It was like birthing out a calf from that poor little bladder. The wall of the bladder so thickened that closing my incision was rather interesting. The sutures kept trying to rip through the muscle - I have had more fun in my time with bladders. I did have a hugh sigh of relief when we filled the bladder with saline to make sure my two layers would hold.

Wish I could save the stone but we are going to do the responsible thing and send it away for analysis.

Tuesday, March 6, 2012

One more nail in the raw diet coffin!

I walked into an appointment for a sore ear last week. While I was getting a history, the owner happened to mention the dog had just urinated on the floor and thought there was blood in it. Well against all of Murphy’s laws, little Molley squatted again and out came some bloody urine.

I always start at the head and work my way back when doing a physical exam. By doing the same pattern over and over again, you know you will get everything covered. I got a sample of the ear debris and gave it to one of the techs for cytology analysis. I continued on and when I got to the caudal abdomen (back half of the abdomen), I had to maintain a poker face. I felt a kiwi sized moveable yet firm mass. What was running through my mind – this is where the bladder should be but what in the world is this. Is this a mass benign or malignant? I told the owner that I had found an abnormality and could I take Molley back to the treatment room so I could do a cystotomy (get urine directly from the bladder).

I wish I could have seen my face when I inserted the needle. It hit something hard. I pulled the plunger back and got bloody urine. That’s when I started to get an idea of exactly what I was up against. I stuck my head back in the room to ask her owner if I could do a radiograph of her abdomen. Well, I think the picture speaks for itself. The red outline is of the irritated bladder wall. The stone itself is 4.4cm by 3.5cm.

Now for the part that makes me see red. A number of our small breed dogs are predisposed to developing crystals in their urine as well as bladder stones. The two most common stones are struvite and calcium oxalate. Look at the size of the stomach and try to figure out what is in it. Look again where the green arrow is. Can you see the outline of the chicken necks that are made up of…..bones? Let’s think this through folks. I know we all want to feed the best quality food we can to our pets. But feeding raw diets is not the way. (If you are currently feeding a raw diet, I dare you to send a portion away for laboratory analysis. I will bet that the diet will not come back as balanced. The mineral/vitamin levels will not be appropriate for long term feeding.) So, guess what can happen when a dog is fed high levels of calcium? Some will develop bladder stones.

We are doing the surgery later this week. We elected not to do it immediately as I wanted to give the antibiotics time to heal the bladder wall so it will be a little less delicate to work on during surgery. Don’t worry, I’ll be taking more pictures and will update the case on Thursday or Friday.

Sunday, February 26, 2012

Alpha Rollovers Do NOT Work!!!

If I go through another week where people are calling in wondering why their dog tried and/or did bite them when trying to do an alpha rollover, I may lose it. For those of you who have no idea what an alpha rollover is, I will explain. It is a behaviour performed by an inhumane human whereby this human forces a dog onto its back, stares it in the eyes and then places the other hand into the groin area. It is based on wolf interactions observed during the 70s. Unfortunately, it was an artificial pack of young wolves who had the need to fight a lot.

Since then, a lot has been learned, especially since the scientists started to study real (natural) wolf packs. They were determined to be composed of a Mom and Dad with their offspring and some other family members such as aunts and uncles. If you are using terms such as pack theory, alpha, omega etc. then you have some reading to do! Please start with Dog Sense by John Bradshaw.

What I’m leading up to is that adult wolves do not roll each other. They use more subtle (and elegant) pieces of body language to get their points across. In the WILD, it is RARE to see an adult wolf offer to expose their own abdomen to another wolf. It is much more commonly shown by the babies to the adults.

HOWEVER!!!!! In CAPTIVE wolves, the belly up behaviour is shown by the outcasts of the group. In the wild, these would have been the ones who would leave and join up with a wolf of the opposite sex to create their own pack. In captivity, they have had to learn to show exaggerated puppy behaviour so they don’t get beat up. We humans have created this behaviour artificially.

It just doesn’t work – so don’t do it. Your dogs likely think you are acting like a freak – so don’t do it. You may be scaring the bejesus out of your dog – so don’t do it. You could get bit (especially if your dog is anxious) – so don’t do it. The Monks of New Skete who recommended pet owners do it 30+ years ago are now asking people to not do it – so don’t do it. If on TV, it comes with a caution of ‘please don’t do this at home’ – do not do it!

If we are going to be respectful and humane to our dogs, we need to stop doing these bloody alpha rollovers! Instead of thinking about packs, think about families. Dogs are part of our families.

Monday, February 20, 2012

Why do dogs jump up on us?

Why do dogs jump up on us? Why do they do behaviours that we find annoying? Well, the simple answer is that if it has worked in the past to get our attention, they will do it again. Think of the way people normally handle a dog jumping up on them. They tell them to get down, shout, push them down or other more punitive (not recommended) measures. Regardless, they get attention even if it is negative.

Now think of what happens when the rules get changed. One of the best ways to get rid of the behaviour is to simply ignore it. For a dog jumping up, fold your arms, turn your back and walk away. When they stop the behaviour, quietly ask for an appropriate behaviour such as a sit and when they give it, treat, praise and/or play with a toy.

One of the side effects of changing the rules is our dogs will often go through what is called an extinction burst. They will do the behaviour with more vigor in hopes of getting the desired attention. (I once had a Lab X jump into my lap during a consultation when the paw on the lap just didn't work with me.)

A great way to illustrate a point is to get a human example. Yesterday morning, I went to yoga class. Their scanner can be a little touchy with the cards. You just have to get the angle right. Sometimes I would need to scan it a couple of times (kind of like a dog jumping up to get attention). So I walked in with my card ready and swipped it under the scanner. I thought nothing of it as I changed the position of the card, how close or far away it was and kept swipping (extinction burst). Now, I won't embarrass myself by saying exactly how many times I trying. The truly embarrassing part was that the machine was off..........

If you have read my blogs before, you know that Kodak is my special needs dog. Since I diagnosed him so early with his anxiety based aggressive issues, I instituted protocol for deference. He has to sit for all attention, then he gets what he wants. I grabbed a picture of him asking for attention to get up on my lap as I was doing a draft of this blog.

Friday, February 10, 2012

MacGyver time

About three weeks ago, a little male dog named Coreo came in for a regular neuter. Normally I don’t get called over to try to intubate by my techs, but this morning I did. For a moment, I thought they were playing a trick on me! He had a severe overbite so I could grab his tongue but the mouth wouldn’t open far enough to place the endotracheal tube in. An inch and a half just doesn’t cut it. We took some radiographs and woke him up. I wasn’t comfortable going forward with surgery if I couldn’t have airway access. If something had gone wrong, I wouldn’t have been able to control the situation.

Once he was awake, I went to take a look at the radiographs. Not only was he born with a congenital overbite, he also had a congenital malformation of the temporomandibular joint (jaw joint) on both sides. The only reason that he was doing was well as he was eating and drinking was because of the overbite allowing the tongue to grab the food. Dogs just never know they are disabled!

As the CT scan and surgery were not in the playing cards and Coreo was finding more things to hump, we agreed to go forward with the castration. I had one major concern; I still needed control of the airway. Since there could be more congenital problems, I needed to bypass the area. So, we did a temporary tracheostomy. I modified an endotracheal tube so it would fit into the trachea. It was cool being able to take the time to place one rather than doing it under the duress of an emergency.

I haven’t been so happy during surgery in quite a while. Every time I looked at Coreo’s oxygenation ranging between 97-98%, I just grinned. The recovery was pretty neat too. Once he woke up, we simply removed the tube. His muscles just covered the trachea sealing the hole and the skin will close shortly. Love my job!!!

Sunday, February 5, 2012

If Dr. Seuss were a vet

I was recently sent this poem. I have tried to find who the author is but to no avail; however, it is practically perfect.

I won't dispense it, Sam I am....
I won't dispense without exam.

I won't dispense it to your dog,
Although you'll bash me in a blog.

I won't dispense it to your friend,
Who yells at me without an end.

I won't dispense it for the ear,
For the eyes, or for the rear.

I won't dispense it though you yell,
How mean I am - the world you'll tell.

I won't dispense it to your cat,
To your bird, or to your rat.

I won't give in - I'm standing tell,
Although you'll whine and cry and call.

I won't dispense it, Sam I am,
You can't have meds without exams!

Sunday, January 29, 2012

A bowlful

So, how do our pets get these tumors called lipomas? Just like any other tissue in thce body, fat cells can become masses. Fatty tissue in a particular area grows more quickly forming a tumor. I generally see them in dogs in their senior years. Our slim dogs and cats don't seem to develop them as easily.

No matter what anyone tells you, you cannot tell if a mass is a lipoma or not without aspirating the contents with a needle. This is a very easy procedure for all involved. I simply use a needle and syringe to remove cells from the mass and look for fat drops on a slide. It is always a relief to see that glossy, clear droplet.

Usually a lipoma is just a cosmetic problem. Only the ones causing issues are generally removed. This one is from a small dog of roughly 22lbs (now 21lbs!). It was growing behind the left shoulder blade and she was starting to have issues walking. Knowing that it was a lipoma before surgery made it much easier to perform. I didn't have to worry about margins, I could just cut over it and scoop it out. It's not a sexy surgery but it sure is fun!

Sunday, January 15, 2012

Oh yes, I took the picture!

These pictures were taken in the name of science.

Many people don't know that intact male cats have barbs on their penises. They are supposed to have two purposes. One is to induce ovulation in the female cat and the other is supposedly to scrape sperm from other male cats out of the female's vagina.

For veterinarians, there is another purpose. If there are no barbs on the penis, the cat has been castrated. I know it is generally very easy to tell if a cat has been castrated (just lift the tail). I have run into a couple cats that had been adopted as neutered males but it turned out they were bilaterally cryptorchid (the testicles were still in the abdomen).

Sunday, January 8, 2012

A dog named Zipper

Well, this past week, they came by two again. This is a little story about a dog that I shall call Zipper. Over the years he has made a habit of eating things that aren't exactly what you would describe as edible. Last year I had to do an emergency exploratory to remove material that had become stuck. One incision was made into his stomach and two into his intestines.

His owners knew something was up when he started to vomit and wouldn't eat. He is a really great dog to work with but there are times when you just shake your head when you see his name on the appointment book. We were pretty busy with multiple surgeries so the girls had him dropped off with automatic radiographs.

When I got out of surgery the radiograph was ready for me. There it was, the classic pattern for a foreign body. All the gas built up in the intestines as well as an incredible amount of gas in the stomach. You can see the arrow where the foreign body was stuck. It was in the large colon so we proceeded with a few enemas. When that didn't produce the foreign body, we sedated him and were able to pull out a small grey sock with pink trim.

We were elated until we did a follow up radiograph just to make sure there wasn't anything else left lurking in his intestines. Now that the gas was moving, it showed up. Another one!!!! He got to stay the night for more enemas. We were so happy when the other one was produced. The daughter did not want the pair back.

Oh yeah, why I call him Zipper. It would be nice to just be able to open his stomach with a zipper to see what he's eaten this time.

Monday, January 2, 2012

They came by two

I have slowly learned that the moment that I think I've seen it all, something new will be right around the corner. So it was when I went to examine a young puppy for the first time. I always start at the head and make my way back. I kind of got stuck on the mouth. As you can see from the picture, this puppy had two baby canine teeth (or 604s using the proper terminology) on her left upper jaw. I told her owners that we would need to remove both teeth when she was under general anesthetic for her spay. This is necessary to make room for the adult tooth to come in properly. Having two teeth blocking the adult tooth is bad news.

We scheduled her spay for 16 weeks of age. Once we were done with that procedure, we did dental radiographs to make sure the adult tooth was there (which it was). Then came the delicate work. In order to remove the two baby teeth, I needed to make a flap which you can see in the bottom picture. I always find it interesting that people think it is so easy to remove baby teeth. The root makes up two-thirds of the whole tooth. Break the root off and you have doubled your work load. In this case you also have to take into account that no harm can come to the adult tooth. It is very delicate at this stage.

Wonder what I'm going to see next!