Snow Leopard

Snow Leopard
Snow Leopard cub (7 mos old) - Cape May County Zoo

Monday, October 31, 2011

Kiwi Gives Vet Team A Scare

A rare white kiwi (type of bird, not a fruit!), gave her veterinary team a scare as they went in to remove a stone from her gizzard.






The  article out of New Zealand has a video clip of this adorable bird!


Tomorrow I'm going to post a case but didn't have time to get pictures of the radiograph I took late in the day.  Another case of how animals hide serious, long term illness from us!







Sunday, October 30, 2011

Pet Insurance


Top 10 pet medical conditions

Dogs
Cats
Exotics
1.   Ear Infection
1.    Lower Urinary Tract Disease
1.    Bowel obstruction
2.   Skin Allergy
2.    Gastritis/Vomiting
2.    Gastritis/Vomiting
3.   Skin Infection/Hot Spots
3.    Chronic Renal Failure
3.    Bladder Infection
4.   Gastritis/Vomiting
4.    Hyperthyroidism
4.    Upper Respiratory Infection
5.   Enteritis/Diarrhea
5.    Diabetes
5.    Eye Infection
6.   Arthritis
6.    Enteritis/Diarrhea
6.    Cancerous Tumor Requiring Surgery
7.   Bladder Infection
7.    Skin Allergy
7.    Arthritis
8.   Soft Tissue Trauma
8.    Periodontitis/Dental Disease
8.    Skin Inflammation
9.   Non-cancerous Tumor
9.    Ear Infection
9.    Skin Abscess or Pressure Ulcer
10.  Hypothyroidism
10.   Upper Respiratory Infection
10.    Inflammation of Hair Follicles
Source: Veterinary Pet Insurance Co., 2010 data



One thing more pet owners are savvy about is the availability of insurance for their pet's health care.  As in the human market, there are people who work on determining the risks and costs associated with your pet, depending on your locale and other factors. This is discussed in a recent article I read called Pet Illnesses Can Be Predicted.


Some veterinary hospitals, including the one I am currently employed at, make it part of the education of every new puppy and kitten owner. The best time to purchase a policy is when they are young and healthy.  However, most companies will still insure pets that are young adults to a bit older (cut off can be 8-10yrs on average). Many also will not cover pre-existing conditions (diabetes, hip dysplasia). 


In general, these policies are not very expensive.  According to this article on the Basics of Pet Insurance most policies range from $10-100 a month but the majority are well below $50. 


There are a number of well known veterinary insurance companies out there. Some have been around a while ( VPI)  while others are fairly new (Embrace). There are also plans available through the ASPCA and others. I always encourage my clients to do the research. I do not know the ins/outs and costs of each company or plan. I can say this much though:


1. Be prepared to pay no matter who your insurance company is or what plan you have. These companies will reimburse you. You need to pay the veterinarian at the time of service. 


2. There are plans to cover just serious/unexpected things like traumas and cancer or plans to cover wellness visits/vaccines/heartworm prevention as well as plans that cover it all! 


3. Some companies (and I won't name names) have become increasingly difficult to get reimbursements from due to "us" not using the "correct terminology" that they want.  Yeah, they are getting just like some of the human insurance companies.


Example: We had a dog come in to have a growth evaluated. The growth was suspicious for a type of malignant tumor. However, the only way to know for sure is to have it removed and sent to the pathologist. The insurance company didn't want to reimburse her for surgery because we said "suspect x type growth." Well, yeah! SUSPECT. We had to wait for it come back to know too! We even had to change what we call some of our lab tests to make sure this insurance company would pay it. 


4. They will NOT tell us how to practice medicine however - what medicine to use, to do or not do surgery, etc. If they go down that path, rest assured, us fiercely independent animal docs will not let it happen. 


5. There are some really great, more people oriented companies out there. Ask your vet about what their experiences are. I am mentioning this because I had no idea either until I started to hear from clients about issues they were having and also going to a few meetings where I got to talk to other companies as well. Some of these companies have a much better rate of reimbursement too.


6. Pet insurance is still no substitute for just using common sense and preventative veterinary care, including regular wellness visits and age appropriate diagnostics. Those things alone can save you money and prolong your best friend's life. 





Saturday, October 29, 2011

Hope for Bats?

Yes, bats. Bats are very beneficial to the environment. They are a tremendous help to agriculture and public health (they consume TONS of bugs, including mosquitoes!) despite the fact, that yes, some bats are a source of rabies. But that's not THEIR "fault." They are not out there seeking to harm you ok?


The bat population has take a big hit from this white nose syndrome that's been in the news. Now there is a definite known cause and hopefully, with that, a cure or prevention strategy.


It has been estimated that the decimation of the bat population could cause US farmers millions, if not more.


Let's hope we can help these oft mis-understood and certainly underappreciated creatures soon!


Read about it here: Cause of Bat Deaths Definitively Found

Friday, October 28, 2011

Unexpected

That word defines a lot of what happens in daily practice.


Outcomes for patients are unexpected - this can be good or bad. The diagnosis can be unexpected. This is especially often true for the pet owner. What walks in the door - be it client or pet - can be unexpected for us, the veterinary team.


I guess that's what makes no two days alike. It's what makes it fun and interesting and stressful.  


Today I had a few things that were "unexpected." 


Bad:


One was an older sheltie that had been on phenobarbital to control her seizures.  She was also on an NSAID for severe spinal spondylosis. I saw her about a month ago and she had been doing ok. She had complete blood work which was excellent!


She came in this morning, laterally recumbent and minimally responsive. She was also icteric (yellow dog = NOT a good prognosis). My recommendation was - given her condition no amount of money would've saved her - to euthanize her. The big picture is what matters and the center of that canvas should be the dog's quality of life and/or her likelihood of having any if we follow through on diagnostics and treatment. Other factors, of course, come into play - the age/breed of the pet (which can point toward what it possibly could be, the lifespan for that type of dog/cat, etc), the level of owner commitment for care of the pet, previous history and other known medical problems and finances.  


---
Good:


There was a kitten that was rescued and adopted out last weekend. This past Monday the poor little thing came in in a severely neurologically impaired state. There was no history of trauma or intoxication. He looked pretty bad off to be honest.  We had to treat him symptomatically. It appears, after running some tests, he had an infection. I still don't know what caused it. All I know is that our treatment is working and he is 90% better. I never count cats out because they are amazing healers. He went back to his very grateful new owner today!


The owner had this cute little helmet..he's a snowboarder and felt his little still wobbly kitten could use it!




---
Funny:


A client brought a young, UNspayed female cat in for a vaccine and check up. We discussed with them the importance of getting her spayed soon before any health issues arose. They wanted to know the cost. No problem. Then the wife said to me, "But if you spay her, won't she lose her meow?" No, I am NOT kidding. She thought she would become silent if we spayed her. *looking at my cats now* - if ONLY!! 











Wednesday, October 26, 2011

Unfounded Fears

One of MY personal "pet peeves" is that many times, human physicians will tell their patients untrue things regarding the risk pets pose to their family's health. This is because (and I love human physicians) veterinarians are the best trained health professionals when it comes to zoonotic diseases. 


The top one has to do with pregnant women and cats regarding the parasite Toxoplasmosis. Yes, this CAN be a serious issue if a pregnant woman contracts this parasite during fetal development. However, it is more likely to be contracted from gardening or handling raw meat.  


This small and very non scientific article highlights these facts.


For real info on Toxoplasmosis, go to the Companion Animal Parasite Council Website.



Tuesday, October 25, 2011

Drug Shortages

This brief article touches on a topic that I freely admit I don't fully understand: drug shortages.


I don't get them in the human world or the animal world. Of course, in veterinary medicine, we use a lot of human drugs too.


I understand that at times there may be issues with the supply of  a component or chemical involved in a specific drug's manufacturing. In some cases, the issue is a regulatory one - the plant where the drug is made may have not met some requirement (not even necessarily that the drug is UNsafe) and have to close/requalify etc. We have enormous regulatory burdens in this country (that are both costly in dollar amounts and in productivity.) They drive business away and costs up. YOU can do something about that - contact your legislators, vote for pro-business candidates (NO ONE is against common sense safety so don't even go THERE), encourage research and development, etc. In rare cases, it's a true safety or purity issue. 


The problem is that animals (and humans) suffer when we are in short supply or drugs are "back ordered" for months on end.


Thankfully we in the veterinary world, have compounding pharmacies that can often make these drugs for us - and often in a liquid form (flavored to boot!)  


Still I often find myself limited in what I can use for MY patients because of this and have to go to a 2nd choice drug. 





Monday, October 24, 2011

Random Thoughts

I freely admit I don't have any inspired topic today. I don't have a cool news story or a case with interesting pictures. I don't even have a crazy client story.


So I'll give you what I've gotten out of the past several days at work.


1. I think every single day for the past few weeks I've seen several "skin issue" cases - rashes, itching, hair loss - and almost every single one was Flea Allergy Dermititis. Fleas are BAD this year! People that never had flea problems are having them. Including folks with indoor only kitties and no dogs!


2. I still am amazed that people simply don't show up for appointments and better yet, surgeries. In this day and age, come on - everyone has a cell phone or knows someone that does!  Just call!


3. Even after 13+ years, I still have things that baffle me. I had a kitten come in today with neurologic signs (rolling to one side) with no obvious cause. We adopted this cute thing out from a nurse that was fostering him a few days. He was fine. He was in the new owners home with no trauma, no toxins. Yet he has a pretty high white blood cell count. I hope we can help him but he's not looking too good, despite force feeding, IV fluids, steroids and antibiotics. Still, I NEVER count a cat out until he/she is dead! They are amazing.  


4. I still wonder why some people come in when they clearly don't want to treat the pet because it's too old to spend money on. Then don't! Don't waste my time or your money. Oh and this case, the dog had a problem that was likely short term even though he was older (age is NOT a disease). 

Sunday, October 23, 2011

Siberian Tiger Gets Root Canal


ANCHORAGE, Alaska (AP) — An Anchorage endodontist performed a root canal on a big tooth in a very big patient — a full-grown Siberian tiger.

Dr. Doug Luiten worked on 300-pound Kunali — measuring nearly 7 feet from backside to nose — Thursday at the Alaska Zoo.

"It's the longest tooth I've ever worked on," Luiten said of more than three-inch (8 centimeter) canine.
The zoo had to order some special instruments to accommodate the longer tooth, and even had to modify those during the root canal.

Kunali was not restrained, and didn't wake up during the hour-long procedure thanks to anesthesia administered by Dr. David Brunson, a visiting veterinarian from Madison, Wis.

"He was a good boy, he handled things well," Brunson said.

Hours after the procedure, Alaska Zoo Executive Director Pat Lampi said 7-year-old Kunali was doing fine.

"It couldn't have gone any better today, it was perfect," said Dr. Riley Wilson, the zoo's veterinarian.
The root canal was necessary after Kunali fractured the tooth 4 or 5 years ago, likely when he hit a metal post.


Read more: http://www.seattlepi.com/news/article/Alaska-dentist-performs-root-canal-on-tiger-2229314.php#ixzz1bdoZXJ1Z




Saturday, October 22, 2011

Breed of the Week: American Pit Bull Terriers

When I was thinking of what breed to do this week (yes, I realize I've skipped this as my Saturday topic for a bit but I don't want you to get bored), I thought about what breeds I see walk in my door on a daily basis. I've already covered just a few that I see regularly and a few less common ones.




This breed is one of the most misunderstood breeds out there.
Ask anyone who works at a veterinary hospital what breeds they fear as far as biting/aggression/possible being injured by, etc. and I can tell you that "Pit Bulls" do not make the top 10. You know what breeds they'll say: Chow Chows, Cocker Spaniels, Chihuahuas, Miniature Pinschers, American Eskimos, and  Rotties (yes there are many nice ones of these too but I've face more "hairy eyeballs" from this breed than Pits)  and Cane Corsos, to name some. Vets and techs out there feel free to add YOUR "biters" to the comment section.


The biggest "danger" from most pits is whether or not they are dog and/or cat friendly. Many are and  live in homes with all sorts of critters. There are some that are dog aggressive or see cats as prey but guess what? Many greyhounds see cats as prey too. I know many breeds and mixed breed dogs that do not like other dogs. So what? 


99% of these dogs (uh oh..should we have them occupy Pet Smart??) are sweet and loveable mushes! I am telling you I can do nearly anything I have to without any trouble. They are so stoic it can be hard to determine if and where they are painful.


The biggest health issues I see are skin related. For dogs that are abused and used to fight, they actually have sensitive skin. Many have recurrent skin infections and allergies.   They can also have hip issues.


The biggest problem I see with them are that FAR FAR too many people who have them want to breed them. This is beyond aggravating for us in the business as we KNOW how many shelters are overflowing with Pit Bulls -many of whom are sweet and would make wonderful pets but:


1. There are just far too many period for the number of homes available
2. Many places won't allow Pits due to homeowners insurance or other such bans (ridiculous breed discrimination)
3. Sadly many of these people are only adding to the stereotypes about what Pits represent - even though they are NOT fighting their pits
4. Breeding, if done right, does not produce wads of dough
5. Many people are "afraid" of pits because of unfair media sensationalism and will choose instead (after seeing that the shelter has mainly these) a high priced pet store puppy, like a cute adorable Cocker, who will grow up to be a biter. Yeah, I've seen this scenario a few times..trust me.

Friday, October 21, 2011

Why You Should Have Her Spayed!

Warning up front: there may be some pictures that disgust some people.


Today an older rescue Yorkie came in and saw my boss for what we term "ADR" - ain't doing right. Yeah, it IS a valid veterinary term. Sometimes the owners really can pinpoint it, but know when something is off about their pet.


This dog had a fever and an elevated white blood cell count. A radiograph revealed what, at first, appeared to be her urinary bladder but it was in a bit of an odd position.  So we did an abdominal ultrasound and it looked like she had pockets of fluid and the lining was more indicative of uterus than bladder.


Now this dog was a rescue who everyone thought was spayed. 


So she had surgery and this is what it looks like when a uterus fills with pus:





And when I cut into it (as anyone that knows me, KNOWS, I like to do!):




This was literally a pudding consistency and color.


This dog had a "closed" pyometra - so she was very sick (no draining of all that pus.)


Now her case is not typical - she was rescued later in life with a sketchy history. If you get a puppy though or a young dog that you know never had surgery, you can prevent this problem and the other one I encountered today by spaying your dog. My personal recommendation is to do so before the first heat. Why?


(No pics on this one)


I took nearly the entire mammary chains off on both sides of a 10yr old plus dog because she was not spayed until a week or so ago (by a rescue group). These masses were invasive and likely malignant. THIS could've been avoided if the person that got her as a pup had done the responsible thing.


All in all, you have a healthier, longer lived dog.


And here's the other plus: it's cheaper to do a regular spay than a pyometra. And hey, if you don't have to remove mammary tumors later in life, you save that money too! 







Thursday, October 20, 2011

Updates

Ok, so the other day I posted about a dog with an abnormal chest radiograph:


 As it turns out, according to the specialists, this is a fat pad. Hmm. Interesting. I can't say, in 13 yrs of practice, I've ever seen a fat pad that pushed the heart up that far off the sternal border. Ok. They also can't find the root cause of this dog's issues either. That may involve another follow up blog.


Then there's this one:




I amputated the entire digit on this older Rottie mix. I could palpably feel that this mass involved the first two digits. As it turns out, this is a malignant melanoma that DID involve those digits.  It's been on the dog a while, so there is a good chance it has already spread through the blood vessels or lymphatic system. The pathology report confirms this as well. The dog is doing well and has healed great post-op!


 Then there's my blog on Monday, Oct 3rd where this was on one of my intra-op pictures:




Though this most assuredly seemed like some type of tumor, it turns out that it simply cystic endometrial hyperplasia and chronic endometritis. In other words, the tissue was excessively overgrowing and inflammed due to hormonal influences. So this lucky kitty is fixed with a spay! 

Tuesday, October 18, 2011

Something Is Just Not Right

About a month ago, an 8 yr old very sweet Husky came in after getting into the garbage. He was acting a bit off but not too ill. The only thing I found on his exam was that he had some mild pain when I palpated his abdomen. We ran some basic diagnostics on him: an abdominal radiograph and some blood work. It was all normal. So we treated him for gastroenteritis and sent him home. He soon recovered and was back to normal. 


I saw him last week for his semi-annual senior wellness exam and a few vaccines. He was doing and looking great.


Then on Monday, he came in and was again, "not right" - but this time, there was no history of garbage ingestion or other dietary indiscretion. He was pretty normal on physical exam. He was acting very much like his he was during his bout the prior month but given that it had recurred, we set him up for an ultrasound later in the week.  In the meantime, we put him back on the medications that had helped him before.  


However, this time, by the next day, he seemed worse. He was restless and panting. He has a wonderful and astute owner so I knew if she was concerned, we should be concerned. I had her bring him in and our plan was to repeat an abdominal radiograph and my boss would come in and ultrasound him later in the day.  Well, the radiograph was non remarkable but I figured we should take a chest rad too. Why not? 


So we did and got this:




The problem here is that the heart (the white "object" in the center of the black areas - lung fields) is not contacting the sternum. There should not be a space there. There are only a few reasons this happens: trauma which can cause bleeding and/or pneumothorax (not the case with this dog), fluid, infection or a mass of some type.  You can actually see the edges of the lung lobes on either side of this gap. 


Other than an elevated heart rate, this dog's chest sounded just fine!


I don't know what it is. The dog is going to a specialist tomorrow for a continued workup. Ultrasounding this area is difficult at best unless you are very experienced in it. He may require an MRI or CT scan, etc. In any case, I will let you know when I find out. 


I am also planning on updating a few other cases I had posted about in earlier blogs - some surgical cases that I finally have pathology back on! So keep reading!


Thanks!!

Monday, October 17, 2011

Rare White Tiger Facing a Big Surgical Procedure

I hope this is a successful procedure for this gorgeous kitty.
By success, I don't just mean that he lives through it but that he has good quality of life AFTERWARDS.



Sanctuary's rare white tiger needs life-saving surgery

He’s a rare stripeless white tiger.
And he is facing a medical procedure uncommon for his species.
Ten-year-old Snow Magic is scheduled to soon have a life-saving amputation of his paralyzed rear left leg, but it will be expensive and somewhat complicated. A special operating table must be built to fit him, and he’ll need a sterile enclosure to keep him tightly confined while he recuperates. Then, he’ll need a handicap accessible enclosure to live in.
A fundraising effort is under way to cover the costs.
The 500-pound tiger was retired from magic shows in Las Vegas about three years ago and has since lived at Serenity Springs Wildlife Center near Calhan with about 120 other big cats and other exotics.
Snow is adored by the staff and visitors. He loves swimming in a water tank and makes soft, friendly “chuffing” noises at visitors. He particularly enjoys his meals and anxiously awaits dinner time, so, spoiled cat that he is, he gets his raw meat before any of the other cats.
On Friday, Snow Magic peered from his den, then made a cameo appearance, walking around his enclosure with his useless left leg dragging in the dirt. He chomped down a huge hunk of meat, and emitted some definitely non-gimpy roars.
There are two types of white tigers — those that are white with greyish and black stripes and those that are stripeless. Although firm numbers are hard to come by, exotic animal experts say there could be 300 or more of the striped ones in the United States. Stripeless ones like Snow Magic are more rare. Nick Sculac, owner of Serendipity Springs, says he’s seen estimates for the cats as low as around 20 in the United States.
White  tigers are created when the recessive gene for the color is inherited from both parents. Starting in the 1960s,  several  zoos had breeding programs. But in recent years, the American Zoological and Aquariaum Association has asked zoos not to breed them because defects are common. The Captive Wildlife Safety Act bans commerce in dangerous exotics for pets.
Serenity Springs is often called on by the U.S. Department of Agriculture to take animals that are confiscated. It is the largest federal and state licensed big cat placement center in Colorado, and the only one with a state zoological license.
Sculac says Snow Magic’s medical problems began two years ago when he suffered a spinal aneurism that paralyzed his back legs. Veterinarians used steroids, acupuncture and massages to heal his right leg, but the treatment did not help the left. He had been able to walk stiffly without use of the left leg. But the muscle has deteriorated so much the hip is dislocated.
The medical choices for Snow Magic were to try surgery or euthanize him. “Since he is a healthy cat otherwise, we believe he deserves the opportunity,” said Julie Walker, who helps run the sanctuary. Such animals can live 25 years or more.
Veterinarian Melanie Marsden of Pikes Peak Veterinary Clinic, who provided care when Snow Magic recovered from the aneurism, will do the surgery. She is consulting with big cat specialists.
“We’ve done 150-pound dogs and they do well,” she said. “They take about an hour. For Snow, we anticipate two hours best case scenario. Recovery should be pretty straightforward.”
The medical team will do the surgery in the veterinary clinic on the sanctuary grounds. 
Sculac is soldering a new top for a surgery table to fit the big cat because his leg must be stretched out.
Caring for him afterward will be a bit tricky.
“A wild animal doesn’t necessary like nursing care,” Marsden said.
They are building a sterile enclosure attached to the clinic for better access to give medications and take care of the incision. Snow will have around the clock care for several weeks.
Dogs and cats that have surgery usually hate wearing those plastic collars to keep them away from their wounds. It probably won’t be any different for Snow Magic. Marsden calls the devices, the “cone of shame.” They will have to fashion an inner tube size contraption so he can’t turn his head and pull off the bandages.
The sanctuary staff will build a special accessible enclosure for Snow. Instead of a water tank swimming pool, he will have a ground-level pool he can step into without jumping. The den will be ground level, too. They will sod the area and add shredded rubber for soft cushioning.
They estimate the cost of everything will be around $25,000, including the surgery. The cost of 12-foot high chain fencing alone is about $4,000.
So far, donors have chipped in $5,650 for Snow Magic.  


Read more: http://www.gazette.com/articles/sanctuary-126799-saving-surgery.html#ixzz1b62eguUx