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!