tag:blogger.com,1999:blog-57530806684224275572024-03-05T04:07:45.746-08:00Purr-ViewsThoughts, opinions and experiences on (mostly) animal related topics.purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.comBlogger445125tag:blogger.com,1999:blog-5753080668422427557.post-5060070904573511592014-11-26T13:51:00.000-08:002014-11-27T06:45:54.254-08:00What You Don't Know ........<span style="color: #b4a7d6; font-family: Arial, Helvetica, sans-serif;">can hurt you. Yesterday was a prime example. Well, today too...as this case bled into two days. No, not literally but the case came to me yesterday and my wonderful friend and boss had to deal with it today. </span><br />
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<span style="color: #b4a7d6; font-family: Arial, Helvetica, sans-serif;">So this particular case illustrates that often times as good as WE think we are as pet owners, we aren't. We think we know what our pets do and don't do. But I can tell you all - and I am guilty here too - no, we don't. I, personally, had a cat that was obsessed with string like objects that found them no matter what I did! He even destroyed a few pieces of clothing with appropriately sized string (one a robe, the other a sweater) and CONSUMED these things! Yes. Fortunately for him and me, we didn't have to take him to surgery. Here is a prime example of unknowns happening....</span><br />
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<span style="color: #b4a7d6; font-family: Arial, Helvetica, sans-serif;">So this dog ate some foreign bodies and developed what we call an intussception ( telescoping of intestines) as well as having some intestine that was dying, and the owner truly had no idea. None. Never saw it happen, etc. This was a puppy...which is often the worst offender. Puppies - cute but good at subterfuge! Until....they get sick. Sadly, this dog, despite the best medicine, did not make it and makes us realize, we are often clueless to reality. </span><br />
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<span style="color: #b4a7d6; font-family: Arial, Helvetica, sans-serif;">We - meaning those in veterinary medicine and those that are pet owners - learn the most from the things that hurt us all the most. Sweet girl pictured here had more than enough love to save her but sometimes it's beyond even that. </span><br />
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<span style="color: #b4a7d6; font-family: Arial, Helvetica, sans-serif;"><br /></span>purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com0tag:blogger.com,1999:blog-5753080668422427557.post-81318449555953201482014-03-27T07:20:00.003-07:002014-03-27T16:16:01.503-07:00When Positive Is NOT A Good Thing<div class="separator" style="clear: both; text-align: center;">
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<span style="color: #6fa8dc; font-family: Arial, Helvetica, sans-serif; font-size: large;">The photo above shows a feline combo or feline leukemia </span><br />
<span style="color: #6fa8dc; font-family: Arial, Helvetica, sans-serif; font-size: large;">(FeLV) / feline immunodeficiency virus test (FIV). The center blue dot at the top - the 12 o'clock if you will - is the control dot. That dot should appear every single time the test is run as it means it ran correctly. </span><br />
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<span style="color: #6fa8dc; font-family: Arial, Helvetica, sans-serif; font-size: large;">The dots you see that are at the 3 and 6 o'clock positions are positives for feline leukemia and FIV, respectively. </span><br />
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<span style="color: #6fa8dc; font-family: Arial, Helvetica, sans-serif; font-size: large;">This test is from a stray cat that was brought in the other day by a good Samaritan who has been seeing this cat outside of her home most days for the past year. He was friendly enough to touch and the other day, after going missing for over a day, came back clearly in distress and not moving well.</span><br />
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<span style="color: #6fa8dc; font-family: Arial, Helvetica, sans-serif; font-size: large;">He was unable to stand and crying and his exam revealed severe infections in three of his four feet, a suspected joint infection in his left elbow (very swollen and painful) and/or trauma to that leg and overall depressed mentation. </span><br />
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<span style="color: #6fa8dc; font-family: Arial, Helvetica, sans-serif; font-size: large;">Though the "owner" was willing to take responsibility for further diagnostics, the first thing we always do is this test. This sad case is a perfect example of why we insist upon it. </span><br />
<span style="color: #6fa8dc; font-family: Arial, Helvetica, sans-serif; font-size: large;">With radiographs and other tests and medications potentially adding up to hundreds of dollars, not to mention the likelihood this cat would not recover as expected, this test saves everyone a lot of further heart ache. The cat included.</span><br />
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<span style="color: #6fa8dc; font-family: Arial, Helvetica, sans-serif; font-size: large;">This cat has been infected, and is now clearly clinical, with two immunosuppressive feline viruses. He is the poster child for FIV - an un-neutered male cat who has been seen fighting with at least another cat in the area. FIV is spread via fights and bites as well as sexually. Feline leukemia is spread via close intimate contact (grooming, sharing food/water bowls, etc) and transplacentally, meaning it can be passed on to the kittens. </span><br />
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<span style="color: #6fa8dc; font-family: Arial, Helvetica, sans-serif; font-size: large;">The kindest thing to do for this cat was to euthanize him. Even if he was not sick and merely positive, he could not live with any other cats AND he certainly should not be put back outside spreading these viruses to other cats, reproducing and potentially creating positive kittens. A cat with one or both of these viruses is also more prone to infections and they are more likely to be serious, therefore they need to be kept inside for that reason as well. </span><br />
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<span style="color: #6fa8dc; font-family: Arial, Helvetica, sans-serif; font-size: large;">We know cats can survive a long time with FIV alone. They should be kept indoors. They can live with other cats if there is no intense fighting (enough to cause punctures) among the cats in the household. </span><br />
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<span style="color: #6fa8dc; font-family: Arial, Helvetica, sans-serif; font-size: large;">It's the FeLV that's the kicker here. Cats that are infected rarely live past 2-3 years. </span><br />
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<span style="color: #6fa8dc; font-family: Arial, Helvetica, sans-serif; font-size: large;">AND this cat has both viruses - truly a no win situation for him.</span><br />
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<span style="color: #6fa8dc; font-family: Arial, Helvetica, sans-serif; font-size: large;">As we assured the kind lady, it is nice that he didn't have to suffer outside in the cold, unable to get food and water and starving to death outside. Sometimes that's just part of being an animal lover. </span><br />
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<span style="color: #6fa8dc; font-family: Arial, Helvetica, sans-serif; font-size: large;">I'll discuss prevention and other aspects of these diseases in my next blog post.</span><br />
<span style="color: #6fa8dc; font-family: Arial, Helvetica, sans-serif; font-size: large;"><br /></span>purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com2tag:blogger.com,1999:blog-5753080668422427557.post-60189361514492136782014-03-21T18:56:00.002-07:002014-03-21T19:12:11.183-07:00It's Almost Time for Lyme<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">I'm going to be very honest with you. I truly DO take for granted sometimes what people know, get and understand. No, these are not deep medical secrets, things only students of anatomy, physiology or pharmacology would know. These are things I know are "out there" in the media and that pet owners talk about. Things that pet owners often worry about getting themselves and see their own doctors about. The thing is, often what they know isn't accurate. It certainly is not tailored to their pet or where they live. </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">Lyme disease is one of the most common things I diagnose, year in, year out here in the Poconos. Northeast PA has the highest incidence in human and dog cases per the CDC. FYI - cats for whatever reason, are immune to it (see, I told you cats were amazing!). Anyhow, what upsets me the most is that this disease, while endemic to this region, is preventable. </span><br />
<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">However, if patients are not properly protected, they can die from it. </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">Lyme nephritis is kidney failure cause by the Lyme bacteria. The bacteria cause an immune response whereby immune complexes clog up the tiny little glomeruli (or filters) in the kidneys. There is NO treatment once we reach this point. Lyme nephritis, in my personal experience of 15 years, does not seem to hit those dogs that are routinely vaccinated. Dogs with Lyme nephritis can live a few days to weeks (rarely months) with medications, fluids, etc. However, they are doomed. Even if they are 2, 3, 5 years old, etc. Trust me, I've had to be the bearer of the news I dread to deliver. I've had to euthanize otherwise healthy young dogs with years left because they didn't have a $25 vaccine on board. Yes. It sucks. </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">Even a vaccinated dog can and often, in our area, does test positive for Lyme on the 4Dx Snap test. The test does NOT get a false positive from vaccine and is only positive from active infection. Therefore, that tells me that the vaccine offers a HUGE protection in clinical disease to our dogs. There is NO reason not to vaccinate a dog, unless he or she has cancer or some other massive immune system issue where vaccines are a problem. This is a very RARE circumstance. Even indoor little "foo foo's" that supposedly never go out have tested positive in my practice settings. </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">Dogs usually test positive months after exposure to an infected tick. They will not test positive from a tick you pulled off the day or week of your visit with us. </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">If your dog tests positive, I WILL treat him or her with a month of antibiotics. In a year, we will want to check an antibody level. However, you should continue to (or start) vaccinating your dog for Lyme (it's always a series of 2 vaccines initially, then yearly) and using an effective product like Vectra (any topical needs to be applied more frequently if you bathe or swim your dog a lot.) Lyme re infections can occur at any time. This is not chicken pox in humans.</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">So when we ask or recommend that your pet get tested, it's not because we want to make more money. It really is not! I can assure you. There is nothing more upsetting and maddening to me to have to tell someone their pet is going to die (from something that could have been prevented with proper care and listening to or even going to a veterinarian). Please understand and follow our recommendations. If you don't trust your vet, please find one you do. There are a lot of things we cannot prevent or change or predict. However we work very hard at the things we can! </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;"><br /></span>purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com0tag:blogger.com,1999:blog-5753080668422427557.post-19892619921535299072014-03-06T08:39:00.003-08:002014-03-06T08:42:00.275-08:00This is Normal<span style="color: #ffd966; font-family: Arial, Helvetica, sans-serif; font-size: large;">During a vaccine clinic this past weekend, a volunteer for <a href="http://www.nokilllv.org/">No Kill Lehigh Valley</a> asked me to send her the pictures of the cat pyometra and a normal uterus. </span><br />
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<span style="color: #ffd966; font-family: Arial, Helvetica, sans-serif; font-size: large;">I wanted to share those pictures with you so you could also see the massive difference between normal and infected uteri. The surgical instruments in both pictures are the same. They are from a small spay pack. That should help give you perspective too! </span><br />
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<span style="color: #ffd966; font-family: Arial, Helvetica, sans-serif;">A reminder of what the infected uterus looks like:</span></div>
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<span style="color: #ffd966; font-family: Arial, Helvetica, sans-serif; font-size: large;">Please have your cat (or dog) spayed when your vet recommends it. Generally for cats 6 months is fine. If you adopt an older cat and she's not spayed, it's not "too late." Age is not a disease but a pyometra is and a potentially fatal one at that. </span></div>
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<span style="color: #ffd966; font-family: Arial, Helvetica, sans-serif;"><br /></span>purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com1tag:blogger.com,1999:blog-5753080668422427557.post-29289131134405112972014-03-01T07:09:00.003-08:002014-03-01T07:09:51.220-08:00A Hard Lesson<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">I'm sometimes surprised about what surprises me in this profession. A case last from last week is a good example.</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">A new client came in with an 8 yr old overall "healthy" cat because she saw some discharge from the "back end." Of course, there are a few possibilities with that description. The cat was indoor only and lived with her two other female litter mates. All of the cats were unspayed. </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">Her reason for not spaying was them was she thought that the (one) reason for spaying - to prevent pregnancies - was eliminated because she kept them strictly indoors. This was NOT a wrong thought.</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">What she didn't know were that:</span><br />
<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">1. Having a uterus makes them possible candidates for developing a serious infection called a pyometra</span><br />
<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">2. Have a uterus/ovaries makes both dogs and cats have a HIGH incidence of mammary tumors later in life with cats having an 80% chance of them being malignant (dogs it's 50%). </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">As I examined this sweet little kitty (she was only about 8 lbs), I felt her abdomen was rounded/distended and felt a bit abnormal (I could not palpated distinct organs) but the owner hadn't noted any changes in her "shape or size." Her appetite had been good so maybe she was a little bigger because she was older and not as active. </span><span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">Also this whitish discharge (pus) was coming from her vulva. </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">My years of experience screamed - pyometra. We ran some blood work to make sure her organ function was ok and that she was also feline leukemia/feline immunodeficiency virus negative. I also put the ultrasound probe on her belly and found large pockets of fluid, consistent with a pyo. Her blood work was all good except for a moderate anemia, which often goes along with chronic infections, and a high white blood cell count, consistent with our pyometra.</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">The only way we could save her was to do emergency surgery on her. </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">So we got her admitted and over lunch break, did her surgery. In my 15 years of experience she was the weirdest and worst case (especially for a cat) I have ever seen. I will share some pictures below. At first I was baffled as to why I couldn't get the rest of her uterus out - the cranial portion of the horns on either side where we find the ovaries as well. I thought she had some massive adhesions at first (she had a few minor ones as it turned out but that was not the cause of the difficulty) , which was definitely possible given the inflammation going on inside her. However, as I enlarged the incision it became clear to me the uneven pocketing of pus that was going was creating a much larger portion of the horn than we typically see. It's usually just a very enlarged "Y" but evenly enlarged. Not in this case as you can see from the pictures. Remember, this little girl is 8 lbs.</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">The large portions were very firm too so once we had them out I wanted to cut into them to make sure they weren't some type of mass. As it turned out, it was simply pus. </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">The sweet girl made it through surgery just fine. She was carefully monitored by our wonderful surgical nurses. She had her antibiotics on board and her IV fluids running. She woke up and was extubated just fine, however, she never really came around. She continued to be very listless despite warmth and tender care and then her body temperature started to plummet and we lost her a mere hours post op.</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">Why you may ask? Well, she was very little and clearly this had been going on for longer than the owner could've have known. There is a very good chance she was septic (bacteria in the bloodstream from this very severe infection) and that will often cause organ shut down in spite of what we do. We weighed her after surgery and she lost over 1 lb! That's how big her uterus was. That too could have been a bit of shock to her system. However, the flip side is if we did nothing, that uterus would've ruptured and she would've died a painful death. It was a lose/lose. </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">This was a hard lesson for both the owner and me. The owner wasn't aware of the (other) dangers of not spaying and I thought for sure I could save her (call it a bit of pride in what I do and how I do it.) </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">The one positive outcome is that she is now going to have her other two cats spayed and she has become a wonderful client. And we both learned something. </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif;">Normally the enlarged uterus is symmetrically enlarged and in a cat, typically only as large as the lower portions - closest to the end of the "Y" that you see here - (not the BIG pockets)</span></div>
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif;">I was happy to find only pus in these large pockets. </span></div>
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif;">One of our nurses, Kara, holding her in a warmed towel as she wakes up from surgery.</span></div>
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;"><br /></span>purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com2tag:blogger.com,1999:blog-5753080668422427557.post-43875585514455108672014-02-09T15:25:00.000-08:002014-02-09T15:25:23.313-08:00After the Respite<span style="color: #e69138; font-family: Arial, Helvetica, sans-serif; font-size: large;">It has been a while since I've come in here and shared anything with you. I hope that I still have your interest and attention but if not, it's certainly incumbent on me to regain it.</span><br />
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<span style="color: #e69138; font-family: Arial, Helvetica, sans-serif; font-size: large;">At times I feel like the same things are said over and over, yet no two days in veterinary medicine are truly the same. So my perfectionism has, perhaps, gotten the best of me and caused me to pause in my writings. </span><br />
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<span style="color: #e69138; font-family: Arial, Helvetica, sans-serif; font-size: large;">There are many things that come up each day in practice that surprise me or show themselves as educational points. I now run the practice Facebook page, so I've been using my time and focus on that. If you are interested click on this link: <a href="https://www.facebook.com/PoconoPeak?ref=hl">Pocono Peak Veterinary Center</a></span><br />
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<span style="color: #e69138; font-family: Arial, Helvetica, sans-serif; font-size: large;">But here's an article of interest that I've known about for a while. By the way it's not the only article about it. There are others from other sources. Everything has unforeseen (or maybe even seen but not cared about) consequences. Things that may not seem at first to impact on our businesses and lives, at further glance, do. In this case, legislation that affects such a huge portion of our budget and lives, most certainly has an impact on small businesses like veterinary offices. While healthcare laws do not impact us like our human physician colleagues, anything that impacts the economy will hit us too. Our business is dependent upon disposable income. We operate under free market principles. It's a beautiful thing. Competition leads to lower costs for clients, increasing skill allows us to (rightfully) earn more, and transparency makes everyone responsible for what they spend. There's no overuse on something you feel the cost of AND there's no one telling me how to practice. Thank God!</span><br />
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<span style="color: #e69138; font-family: Arial, Helvetica, sans-serif; font-size: large;"> <a href="http://www.dcclothesline.com/2014/02/09/obamacare-causes-3-problems-pet-owners-veterinarians/">ACA Impacts Veterinarians</a> shows just a few things that will happen as this rolls on. Of course I don't have to tell you when there are less jobs and lower incomes, we can certainly expect people to budget differently and spend less on their pets. We are already seeing these effects which are likely to only get worse. Pets don't come in until much later in a disease process or worse, we are seeing pets abandoned when people lose their jobs or homes. </span><br />
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<span style="color: #e69138; font-family: Arial, Helvetica, sans-serif; font-size: large;">Don't worry though, we are a very stubborn hard working group of people. We didn't get into this for the money (we knew we'd be in debt and could've done a lot of other things) but we do need to pay our bills too. We are creative and innovative and won't let anyone stand in our way of doing what we love. I, for one, will continue the good fight! </span><br />
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<br />purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com0tag:blogger.com,1999:blog-5753080668422427557.post-53477898280000608652013-09-25T19:29:00.003-07:002013-09-25T19:29:47.665-07:00Yes, I See Chickens Too!<span style="color: #e69138; font-family: Arial, Helvetica, sans-serif; font-size: large;">For those of you who have been following this blog, you already know that I do, indeed, see chickens. You may even know that it stems from my time as an undergraduate at the University of Delaware.</span><br />
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<span style="color: #e69138; font-family: Arial, Helvetica, sans-serif; font-size: large;">I found this article and it is in line with what I have heard and seen - that there are more people with pet chickens or hobby chicken farms (usually for eggs).</span><br />
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<span style="font-size: large;"><a href="http://online.wsj.com/article/SB10001424127887323527004579081812563033586.html?mod=dist_smartbrief">Owners of Pet Chickens Scramble When Their Pets Feel Afowl</a></span><br />
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<span style="color: #ffd966; font-family: Arial, Helvetica, sans-serif; font-size: large;">On another cool chicken related note, I recently found out that my veterinary alma mater, <a href="http://www.vet.purdue.edu/">Purdue University</a> started a veterinary residency program for poultry medicine!</span><br />
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<br />purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com0tag:blogger.com,1999:blog-5753080668422427557.post-59472590676763288082013-07-05T18:31:00.000-07:002013-07-05T18:31:13.548-07:00Top Dogs<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">Once again, the American Kennel Club has released the list of America's favorite dogs. </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">A few comments I'd like to make. This is simply a compilation of which breeds are most commonly owned, in numerical order. However, many dogs are not AKC registered and don't even get "counted." Even purebred dogs, depending on where they come from, can be unknown to the AKC. Then of course, there are the mutts and the overpriced mixes (also called designer dogs.) </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">As a small animal veterinarian, who has been in practice 15 years, I can say the list is fairly on target. We DO see a lot of Labs, Goldens, Rotties, and the smaller dogs on the list. I also see a LOT Of Pit Bulls (they are a tremendous unreported population - 99.9% of the time amazing sweet dogs - but over represented in our shelters and often needed to be labelled as "lab mixes" due to homeowner's and other insurances. THAT is sad, considering that it's not Pit Bulls that I fear or have gotten bitten or nearly bitten by most. Not by a VERY long shot.</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">Anyhow, before you get any dog, research it - especially if you are fixed on a specific breed. I urge to you seriously consider a shelter dog. They are great pets and often they are there for reasons that have nothing to do with them but with the humans that had them. Every breed has it's own rescue too so you can still save an animal without contributing to the over population problem. If those don't meet your needs, be very careful and stick with a reputable breeder - and yes, you will pay more because they do it the right way and spend $ on their breeding animals. </span><br />
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<span style="color: #e69138; font-family: Arial, Helvetica, sans-serif; font-size: large;">Here is </span><a href="http://www.wfmz.com/-/121798/18344006/-/n4k52ez/-/index.html" style="font-family: Arial, Helvetica, sans-serif; font-size: x-large;">The List</a>purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com0tag:blogger.com,1999:blog-5753080668422427557.post-46858334652829777192013-06-16T14:27:00.002-07:002013-06-16T14:27:23.049-07:00The Role of a Veterinarian<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">When most people hear the word "veterinarian" they think of one or two things, such as their dog or cat's doctor or James Herriot (showing my age here huh?) If they live on a farm, they may also be familiar with the large animal vet who makes farm calls, no matter the time or weather. We got the US Postal Service beat on this one, I can assure you! </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">However, as I've said before - probably on here as well as at educational venues I've spoken to - there are SO many more things we do. Things you don't see. Things you don't think about.</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">Veterinarians, above ALL medical professionals, are the best trained and most knowledgeable about zoonotic diseases - those that can be transmitted between humans and animals. In vet school, we are given numerous examples of cases where animals were either incorrectly blamed or the wrong info was given by well meaning physicians. They just don't know sometimes. Then "Fluffy" ends up at the shelter. For no good reason.</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">In any case, we have a HUGE role to play. Even those of us in small animal practice. There are a list of diseases that are "reportable" as well as those that are "foreign." These are SERIOUS in their impact - be it economic or health related or BOTH. It was a vet who helped find West Nile Virus. Veterinarians work with and for the CDC, the USDA, the NIH, state health departments and a host of other agencies and private companies to help protect YOU and your family, not just the family pet or the income your farm animals provide. </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">They call this concept "one health" because we all get affected by many diseases, toxins and pollutants. Physicians AND veterinarians are on the look out for these diseases or changes in a disease pattern or species. We can learn from each other how to combat and prevent these diseases too. </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">If you are interested in this please go to this website at <a href="http://www.aardvarks2zebras.org/?utm_source=smartbrief&utm_medium=email">the AVMA</a> to learn more.</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;"><br /></span>purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com0tag:blogger.com,1999:blog-5753080668422427557.post-27633894568756816142013-06-13T18:12:00.001-07:002013-06-13T18:17:11.735-07:00Leptospirosis: What is it?<span style="color: #ffd966; font-family: Arial, Helvetica, sans-serif; font-size: large;">Leptospirosis is a bacterial infection. However, it's not quite THAT simple. There are a number of different subtypes or "serovars." The vaccines we use get some, but not all that are out there. This is a zoonotic disease, meaning we can acquire it from animals, notably our dogs. Humans can and do acquire this infection apart from dogs too however.</span><br />
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<span style="color: #ffd966; font-family: Arial, Helvetica, sans-serif; font-size: large;">It is, despite not getting the "media hype", the most common zoonotic disease in the world. It is most often carried by rodents and disseminated through their urine into water sources or puddles of water. Humans and other animals contract it via contact with these - licking paws, consuming the water or just splashing and contact with wounds or mucous membranes. </span><br />
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<span style="color: #ffd966; font-family: Arial, Helvetica, sans-serif; font-size: large;">The "risk" groups as listed by the CDC are as follows:</span><br />
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<span style="color: #674ea7; font-family: Arial, Helvetica, sans-serif;">Leptospirosis occurs worldwide, but is most common in temperate or tropical climates. It is an occupational hazard for many people who work outdoors or with animals, such as:</span></div>
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<li style="margin: 0.7em 0px 0.7em 1.5em; padding: 0px;"><span style="color: #674ea7; font-family: Arial, Helvetica, sans-serif;">farmers</span></li>
<li style="margin: 0.7em 0px 0.7em 1.5em; padding: 0px;"><span style="color: #674ea7; font-family: Arial, Helvetica, sans-serif;">mine workers</span></li>
<li style="margin: 0.7em 0px 0.7em 1.5em; padding: 0px;"><span style="color: #674ea7; font-family: Arial, Helvetica, sans-serif;">sewer workers</span></li>
<li style="margin: 0.7em 0px 0.7em 1.5em; padding: 0px;"><span style="color: #674ea7; font-family: Arial, Helvetica, sans-serif;">slaughterhouse workers</span></li>
<li style="margin: 0.7em 0px 0.7em 1.5em; padding: 0px;"><span style="color: #674ea7; font-family: Arial, Helvetica, sans-serif;">veterinarians and animal caretakers</span></li>
<li style="margin: 0.7em 0px 0.7em 1.5em; padding: 0px;"><span style="color: #674ea7; font-family: Arial, Helvetica, sans-serif;">fish workers</span></li>
<li style="margin: 0.7em 0px 0.7em 1.5em; padding: 0px;"><span style="color: #674ea7; font-family: Arial, Helvetica, sans-serif;">dairy farmers</span></li>
<li style="margin: 0.7em 0px 0.7em 1.5em; padding: 0px;"><span style="color: #674ea7; font-family: Arial, Helvetica, sans-serif;">military personnel</span></li>
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<span style="color: #674ea7; font-family: Arial, Helvetica, sans-serif;">The disease has also been associated with swimming, wading, kayaking, and rafting in contaminated lakes and rivers. As such, it is a recreational hazard for campers or those who participate in outdoor sports. The risk is likely greater for those who participate in these activities in tropical or temperate climates.</span></div>
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<span style="color: #674ea7; font-family: Arial, Helvetica, sans-serif;">In addition, incidence of Leptospirosis infection among urban children appears to be increasing.</span></div>
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<span style="color: #ffd966; font-family: Arial, Helvetica, sans-serif; font-size: large;">Also to note:</span></div>
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<span style="color: #674ea7; font-family: Arial, Helvetica, sans-serif;">It is estimated that 100-200 Leptospirosis cases are identified annually in the United States. About 50% of cases occur in Hawaii.</span></div>
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<span style="color: #674ea7; font-family: Arial, Helvetica, sans-serif;">The largest recorded U.S. outbreak occurred in 1998, when 775 people were exposed to the disease. Of these, 110 became infected.</span></div>
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<span style="color: #674ea7; font-family: Arial, Helvetica, sans-serif;">Although incidence in the United States is relatively low, leptospirosis is considered to be the most widespread zoonotic disease in the world.</span></div>
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<span style="color: #674ea7; font-family: Arial, Helvetica, sans-serif;">Significant increases in incidence have been reported from Peru and Ecuador following heavy rainfall and flooding in the spring of 1998. Thailand has also reported a rapid increase in incidence between 1995 and 2000.</span></div>
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<span style="color: #e69138; font-family: Arial, Helvetica, sans-serif; font-size: large;">The following article discusses leptospirosis in our dog population</span><span style="color: #ffd966; font-family: Arial, Helvetica, sans-serif; font-size: large;">. <a href="http://vetmedicine.about.com/od/diseasesandconditions/a/CW-Leptospirosis.htm">Lepto in dogs</a></span></div>
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<span style="color: #e69138; font-family: Arial, Helvetica, sans-serif; font-size: large;">Why do I bring this disease up? Is it something I see often?</span></div>
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<span style="color: #e69138; font-family: Arial, Helvetica, sans-serif; font-size: large;">Well, no. It is a core part of my vaccination protocols for most dogs. Most. It is definitely out there though. </span></div>
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<span style="background-color: white; color: #e69138; font-family: Arial, Helvetica, sans-serif; font-size: large; line-height: 1.33em;">This IS something I have seen. It can be fatal. I actually believe it's underdiagnosed. It can cause a wide variety of signs which can be present in OTHER disease processes. It's not that "simple" to diagnose and the antibiotics we often use to treat those "other" things often get this too. </span></div>
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<span style="background-color: white; color: #e69138; font-family: Arial, Helvetica, sans-serif; font-size: large; line-height: 1.33em;">The biggest issue is vaccine reactions. This vaccine or vaccine component (it can be found combined with other vaccines) causes the most vaccine reactions of all the ones we have and give to our dogs. </span></div>
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<span style="background-color: white; color: #e69138; font-family: Arial, Helvetica, sans-serif; font-size: large; line-height: 1.33em;">However, it is still important for all dogs UNLESS they have a vaccine reaction that is so severe, to get this vaccine. They can be pre treated with diphenhydramine. </span></div>
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<span style="color: #e69138; font-family: Arial, Helvetica, sans-serif; font-size: large;">I can tell you I vaccinate MY own dogs, including my smaller 17lb dog. </span></div>
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<span style="background-color: white; color: #e69138; font-family: Arial, Helvetica, sans-serif; font-size: large; line-height: 1.33em;">There are some breeds more prone to vaccine reaction and in small breeds, I do recommend splitting vaccines up and not giving 3 or 4 at once. </span></div>
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<span style="background-color: white; color: #e69138; font-family: Arial, Helvetica, sans-serif; font-size: large; line-height: 1.33em;">Combination vaccines have been found to be less likely to cause reactions than single vaccines. This is why we choose combination vaccines where we can. </span></div>
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: large;"><span style="color: #e69138; line-height: 31px;">Talk to your veterinarian about this. Not the breeder. Not the groomer. Not someone who also owns a "x" dog. </span></span></div>
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purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com0tag:blogger.com,1999:blog-5753080668422427557.post-56624391581473945552013-05-25T08:24:00.003-07:002013-05-27T19:08:17.917-07:00Hairballs: It's not just YOUR cat with this problem<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">Hairballs or trichobezoars (the technical name for them) are common in our domestic feline friends. I have also seen them in rabbits. In fact, they can occur in any animal that grooms themselves. Most animals pass these or bring them back up, and if you are a cat owner, you know it's usually on your light colored carpets. </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">Thankfully, they very rarely cause an obstruction but at times we do need to remove them surgically. </span><br />
<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">This is a surgery I would've loved to have been in on....</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;"><a href="http://www.cbsnews.com/8301-204_162-57585933/surgeons-remove-4-pound-hairball-from-400-pound-tiger/">4 lb Hairball Removed from Lion</a></span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;"><br /></span>purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com0tag:blogger.com,1999:blog-5753080668422427557.post-25446452894882981592013-05-13T06:14:00.002-07:002013-05-13T06:14:19.783-07:00It's Probably NOT Ear Mites<span style="color: #8e7cc3; font-family: Arial, Helvetica, sans-serif; font-size: large;">Other than in kittens and occasionally puppies, we don't see ear mites as the most common cause of ear problems in pets, especially adult dogs.</span><br />
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<span style="color: #8e7cc3; font-family: Arial, Helvetica, sans-serif; font-size: large;">Pet owners, however, seem to assume this IS the likely problem, run out and get an over the counter "ear mite" treatment, to find, that it doesn't work. That's when I see them.</span><br />
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<span style="color: #8e7cc3; font-family: Arial, Helvetica, sans-serif; font-size: large;">Ear problems are one of the top 10 reasons we see dogs. While every breed can be affected, it is those "floppy eared" breeds like Goldens, Labs, Cockers, hounds, etc that are more likely to have a problem. This is because there is much less air flow and more humidity in these ears versus a straight up ear breed like a German Shepherd. </span><br />
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<span style="color: #8e7cc3; font-family: Arial, Helvetica, sans-serif; font-size: large;">While what we see <u>is</u> often an infection, there is usually also an underlying allergy component. This can be an allergy to a food component/s and/or inhalant agents. It's not always easy to get to the bottom of this. Diet trials must be done with 8-12 weeks of an EXCLUSIVE diet that involves a novel protein and carb source (one your dog's body has not seen). This means no treats, no table food, etc. NONE. Not even a "small piece." Many dog foods have common components and your dog may be reacting to one of those. Also, grain is not evil and not the cause of all allergies. This is the current "fad" that people think is the miracle cure. When I was in vet school, it was "lamb and rice." The thing is, when all the foods started having lamb and rice, guess what? It was not something "new" to our dogs immune systems. There is no ONE cure for all dogs. Each dog is different. I've seen dogs allergic to egg, chicken, beef, soy and other components. Speak to your veterinarian about what is the best way to start trying to find out what your dog is reacting to. </span><br />
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<span style="color: #8e7cc3; font-family: Arial, Helvetica, sans-serif; font-size: large;">Inhalant allergies can often been found via a blood test or referral to a veterinary dermatologist for the "gold standard" - a skin test. </span><br />
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<span style="color: #8e7cc3; font-family: Arial, Helvetica, sans-serif; font-size: large;">In the meantime, you will need to clean and treat those ears. You also need to be prepared for the fact that this is not something we often "cure" but more often manage.</span><br />
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<span style="color: #8e7cc3; font-family: Arial, Helvetica, sans-serif; font-size: large;">It is for this reason that it is important that you get your puppy used to having his or her ears touched. You should play with them, massage them and wipe them out. I recommend unscented baby wipes. Then when they are 70 lbs they won't be fighting with you for the treatment needed to help them. Oral meds are NOT better than direct topical treatment and often are very expensive because of the type of antibiotics needed to treat these types of infections. </span><br />
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<span style="color: #8e7cc3; font-family: Arial, Helvetica, sans-serif; font-size: large;"><br /></span>purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com0tag:blogger.com,1999:blog-5753080668422427557.post-56162390224740752672013-05-03T03:40:00.001-07:002013-05-03T03:41:18.560-07:00Top Ailments<span style="color: #e06666; font-family: Arial, Helvetica, sans-serif; font-size: large;">Every year, one or more of the pet insurance companies releases a list of the top ten reasons pets were taken to the vet, based on their claim data.</span><br />
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<span style="color: #e06666; font-family: Arial, Helvetica, sans-serif; font-size: large;">They are pretty accurate when I think of what I see year in/year out and the problems don't generally change from year to year. </span><br />
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<span style="color: #e06666; font-family: Arial, Helvetica, sans-serif; font-size: large;">Here's a link with the information along with some links to other cool pet related lists: <a href="http://shine.yahoo.com/pets/most-common-dog-38-cat-aches-pains-top-131800154.html">Common Dog and Cat Issues</a></span><br />
<br />purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com0tag:blogger.com,1999:blog-5753080668422427557.post-10880449988719985272013-04-20T09:25:00.001-07:002013-04-20T09:25:46.962-07:00A Few Things<span style="color: #f9cb9c; font-family: Arial, Helvetica, sans-serif; font-size: large;">As we get into spring and thunderstorms start to pop up, you may notice your dog getting anxious, pacing, panting, hiding, etc. This is a very common issue that we see and there are remedies that your veterinarian can offer so your dog doesn't have to suffer during this time. There are things like thunder shirts, which offer non pharmaceutical ways to address anxieties and there are good sedatives as well. </span><br />
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<span style="color: #f9cb9c; font-family: Arial, Helvetica, sans-serif; font-size: large;">I can tell you that I personally use 5mg of acepromazine on my Shih Tzu because, starting at age 6 (he's 8 1/2 yrs old now), he developed severe anxiety during storms. I have no idea why. Nothing bad or traumatic happened to him during one of these. He tremors and shakes throughout the entire thing if NOT given medication. However, with the ace on board, he's able to relax and sleep. </span><br />
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<span style="color: #f9cb9c; font-family: Arial, Helvetica, sans-serif; font-size: large;">Please call your veterinarian if your pet is experiencing these signs. </span><br />
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<span style="color: #f9cb9c; font-family: Arial, Helvetica, sans-serif; font-size: large;">The other thing I wanted to share today is a great article on what a proper dental is again. I know I discussed this topic once before but it's important enough to go over again. </span><br />
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<span style="color: #f9cb9c; font-family: Arial, Helvetica, sans-serif; font-size: large;">You cannot and should not do a dental cleaning on an awake animal. A few reasons: </span><br />
<span style="color: #f9cb9c; font-family: Arial, Helvetica, sans-serif; font-size: large;">-you cannot get below the gum line</span><br />
<span style="color: #f9cb9c; font-family: Arial, Helvetica, sans-serif; font-size: large;">-scraping teeth without polishing creates MORE grooves for</span><br />
<span style="color: #f9cb9c; font-family: Arial, Helvetica, sans-serif; font-size: large;"> tartar and bacteria</span><br />
<span style="color: #f9cb9c; font-family: Arial, Helvetica, sans-serif; font-size: large;">-your groomer or "friend" does not have the proper dental equipment to do a proper assessment and cleaning (this includes checking for pockets that may call for removal of teeth)</span><br />
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<span style="color: #f9cb9c; font-family: Arial, Helvetica, sans-serif; font-size: large;">A few things I'll add to this: </span><br />
<span style="color: #f9cb9c; font-family: Arial, Helvetica, sans-serif; font-size: large;">*not ALL vet practices have a dental x-ray machine but you can still do an excellent job - I've seen many cases long term post dental and they were fine - it's the person doing IT that matters the most - what is their training, experience, etc?</span><br />
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<span style="color: #f9cb9c; font-family: Arial, Helvetica, sans-serif; font-size: large;">*I do not recommend brushing teeth. Why? Well, we brush our teeth 2-3x a day and STILL have dental disease. I do not think anyone can even do that with their pets. I have seen that giving your dog something good to chew on (a bully stick or knuckle bone) will DEFINITELY improve dental health. I have seen it scrape the tartar off the teeth. If you dog will NOT chew, there is nothing you can do to change that. </span><br />
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<span style="color: #f9cb9c; font-family: Arial, Helvetica, sans-serif; font-size: large;"><a href="http://www.veterinarypracticenews.com/vet-practice-news-columns/dental-pearls/the-professional-pet-dental-cleaning.aspx?cm_mmc=17311855">The 9 Steps to a Professional Dental Cleaning</a></span>purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com0tag:blogger.com,1999:blog-5753080668422427557.post-23775714911206054652013-04-05T03:52:00.001-07:002013-04-05T03:57:36.780-07:00Vaccine Components: Distemper<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">Most pet owners get yearly reminders about the vaccines their cat or dog is due for without even understanding what diseases the vaccines are preventing. The reason is that, for the most part, we just don't see too many of these diseases any more, especially in most parts of the United States.</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">I thought it would be a good idea to break down what is in each vaccine and explain to you what that "letter" stands for exactly!</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">So we'll start with dogs and the DHPP or the DHLPP or the DA2PP. Different vaccine manufacturers and different combinations of components are the reason for some of these letter differences. </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">Today we are focusing on the "D" which stands for distemper.</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">This is directly from the <a href="http://www.merckmanuals.com/vet/generalized_conditions/canine_distemper_hardpad_disease/overview_of_canine_distemper.html">Merck Veterinary Manual</a>. It may surprise you to know it's not just dogs that can succumb to this disease. Raccoons, red pandas and large cats can also get this disease. </span><br />
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</span><span style="letter-spacing: 0px;"><span style="color: #6fa8dc;">Canine distemper is a highly contagious, systemic, viral disease of dogs seen worldwide. Clinically, it is characterized by a diphasic fever, leukopenia, GI and respiratory catarrh, and frequently pneumonic and neurologic complications. The disease is seen in Canidae (dogs, foxes, wolves), Mustelidae (eg, ferret, mink, skunk, wolverine, marten, badger), most Procyonidae (eg, raccoon, coatimundi), some Viveridae (binturong), red pandas (Ailuridae), Elephantidae (Asian elephant), primates (Japanese monkey), and large Felidae.</span></span></div>
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</span><span style="color: #f6b26b; letter-spacing: 0px;">I have seen this disease in young puppies that most likely came from Midwest "puppy" mills to be sold at pet stores. They did not survive. It is rarely seen here in the US in our pets, but is still prevalent in 3rd world countries. It is by no means "elminated" and since wild animals can get it and carry it, your pet should be protected as recommended by your vet.</span></div>
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The "distemper" name comes from the neurologic signs shown by the animal. Over the years, many people have genuinely asked if it was going to "calm" their animal down. No. It has no effect on your dog's behavior. </span></div>
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We have excellent vaccines that have a high rate of protection. It's important for puppies to get a series started at 6-8 weeks and continuing every 3-4 weeks until 16 weeks of age. The next vaccine would be a year from that last pup shot and after that, it may be a 3 yr or a 1 yr vaccine. Currently there is only ONE licensed 3 year vaccine (in other words, this company has done the studies that back up it's claim that IF exposed to the disease, your dog will not get it in that time period.) Wishing or "thinking" it might be so is another thing and a vaccine company will only stand by what it's studies have shown.</span></div>
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;"><span style="line-height: 17px;"><br /></span></span>purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com0tag:blogger.com,1999:blog-5753080668422427557.post-39325177408871728872013-03-31T04:34:00.000-07:002013-03-31T04:34:23.561-07:00Bunnies are Cute....<span style="color: #b6d7a8; font-family: Arial, Helvetica, sans-serif; font-size: large;">..but they do require a lot of care! </span><br />
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<span style="color: #b6d7a8; font-family: Arial, Helvetica, sans-serif; font-size: large;">This is the time of year when people think it might be cute to get their child a bunny. It is worth considering the "cost" before you make a decision based on emotion.</span><br />
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<span style="color: #b6d7a8; font-family: Arial, Helvetica, sans-serif; font-size: large;">While rabbits are cute and can make excellent pets, there are some caveats and things to consider.</span><br />
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<span style="color: #b6d7a8; font-family: Arial, Helvetica, sans-serif; font-size: large;">1. Is this rabbit going to be inside or outside (in a hutch)?</span><br />
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<span style="color: #b6d7a8; font-family: Arial, Helvetica, sans-serif; font-size: large;">2. Are you aware of the proper feeding requirements of a rabbit?</span><br />
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<span style="color: #b6d7a8; font-family: Arial, Helvetica, sans-serif; font-size: large;">3. Are you aware of the proper habitat (be it in or out) for a rabbit?</span><br />
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<span style="color: #b6d7a8; font-family: Arial, Helvetica, sans-serif; font-size: large;">4. Are you prepared for veterinary expenses? </span><br />
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<span style="color: #b6d7a8; font-family: Arial, Helvetica, sans-serif; font-size: large;">5. Is there a veterinarian in your area that sees rabbits (not all vets do!)?</span><br />
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<span style="color: #b6d7a8; font-family: Arial, Helvetica, sans-serif; font-size: large;">A great resource for rabbit owners and those interested in rabbits is <a href="http://rabbit.org/">The House Rabbit Society</a>. </span><br />
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<span style="color: #b6d7a8; font-family: Arial, Helvetica, sans-serif; font-size: large;">Some caveats from my personal experience:</span><br />
<span style="color: #b6d7a8; font-family: Arial, Helvetica, sans-serif; font-size: large;">-they don't live that long overall - 6 to 7 years, with a rare 10-12 year old</span><br />
<span style="color: #b6d7a8; font-family: Arial, Helvetica, sans-serif; font-size: large;">-once they get sick - or rather, show YOU that they are, they decline rapidly and fairly often, die even with treatment</span><br />
<span style="color: #b6d7a8; font-family: Arial, Helvetica, sans-serif; font-size: large;">-they can be aggressive (see my comment below)</span><br />
<span style="color: #b6d7a8; font-family: Arial, Helvetica, sans-serif; font-size: large;">-if not handled properly, they can literally break their back, leading to the need for euthanasia</span><br />
<span style="color: #b6d7a8; font-family: Arial, Helvetica, sans-serif; font-size: large;">-some need to have their teeth trimmed every 4-6 weeks by a vet</span><br />
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<span style="color: #b6d7a8; font-family: Arial, Helvetica, sans-serif; font-size: large;">FYI..*I* do see rabbits for medical and surgical conditions. Spaying and neutering of rabbits is also often recommended for behavioral and medical reasons. </span><br />
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<span style="color: #b6d7a8; font-family: Arial, Helvetica, sans-serif; font-size: large;"><br /></span>purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com0tag:blogger.com,1999:blog-5753080668422427557.post-48295671655883862762013-03-28T14:42:00.003-07:002013-03-28T14:42:58.569-07:00Tiger Gets New Surgery <span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">A novel way of eliminating pain is to remove the "signal" pathway. In the case of <a href="http://www.sacbee.com/2013/03/19/5275086/op-should-reduce-texas-tigers.html">Tacoma, the 13 year old Siberian tiger</a> this means cutting the nerves that "tell" his brain his aging hips hurt. </span><br />
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<span style="color: #a2c4c9; font-family: Arial, Helvetica, sans-serif; font-size: large;">Check out this story about a cat and a Japanese train that, well, saved each other.</span><br />
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<span style="color: #a2c4c9; font-family: Arial, Helvetica, sans-serif; font-size: large;"><a href="http://transportationnation.org/2013/03/06/meet-the-feline-station-master-of-the-wakayama-electric-railroad/">Feline Station Master Tama</a></span><br />
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<span style="color: #a2c4c9; font-family: Arial, Helvetica, sans-serif; font-size: large;">PS. I love the ailurophilia going on in that nation!</span><br />
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<span style="color: #a2c4c9; font-family: Arial, Helvetica, sans-serif; font-size: large;"><br /></span>purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com0tag:blogger.com,1999:blog-5753080668422427557.post-85797779857228961792013-02-26T06:31:00.002-08:002013-02-26T06:31:57.120-08:00Use it ALL or CALL! <span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">It has come to my attention recently that people have been doing all sorts of things with medications and their pets.</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">Here are a few examples:</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">1. Using meds from another pet in the household</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">2. Having "leftover" antibiotics for the same patient for the same problem</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">3. Using medications from a friend's pet</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">4. Using medication here and there, a few days at a time or whenever "x" happens (red ear, diarrhea, etc you name it!)</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">Ok, there are NUMBER of problems with these situations.</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">First of all, you should NEVER have "left over" antibiotics unless one of two things has occurred</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;"> A. Your pet had a problem with them and you called your vet for a NEW or different medication to treat the problem</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;"> B. Your vet gave you a second round of them because he/she knows it's a recurrent problem and understands you KNOW how that when it recurs you are to give the entire second course as directed</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">B is not usually a problem - because those cases/clients are familiar to us and "get it." A however, is a HUGE problem. People stop giving medications for all sorts of reasons, never call us to discuss it and then return 2 weeks to 6 months later to tell us that "Gee, doc the problem never got better." AND sometimes they are upset about it!! Yes, really! We do answer phone calls and we don't even charge for that! </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">No antibiotic or anti fungal - be it topical or oral - should be used here and there. It's for a certain course or length of time to kill the bacteria or yeast in that location. Even if your pet seems to be doing better, by stopping early you are in essence breeding more resistant forms of bugs for the next go round. </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">All I can say is PLEASE follow the instructions and if there are any issues or concerns, PICK up the phone and call your veterinarian. YOUR vet. Your VETERINARIAN. Not your groomer, Aunt Susie, your neighbor, etc.</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">We do know a thing or two after 8 years of school and many years of in the field practice and most of us are more than happy to help and if we don't know, can find out for you! </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;"><br /></span>purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com0tag:blogger.com,1999:blog-5753080668422427557.post-61940984783414726922013-02-15T15:38:00.000-08:002013-02-15T15:38:18.889-08:00Turtle Medicine<span style="color: #6aa84f; font-family: Trebuchet MS, sans-serif; font-size: large;">Ok, I freely admit this is NOT from my personal case files. It is from a colleague that I work with a few days a week.</span><br />
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<span style="color: #6aa84f; font-family: Trebuchet MS, sans-serif; font-size: large;">So this turtle had an abscess. The pictures below best show it:</span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgL2gTkTQbRq_cJhtdbDRxUxOYaCsjfUzJNcrVwJijKtOExKtIyADjPj-cQ3p8atN6MJiJxHLTWzKEXNU-x6hbL_X3z1jK-fmjsNEyjrn6nUxsqWptT41Z55SCOF3XRbJvxRL7u63-uHhQ/s1600/Image+2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgL2gTkTQbRq_cJhtdbDRxUxOYaCsjfUzJNcrVwJijKtOExKtIyADjPj-cQ3p8atN6MJiJxHLTWzKEXNU-x6hbL_X3z1jK-fmjsNEyjrn6nUxsqWptT41Z55SCOF3XRbJvxRL7u63-uHhQ/s320/Image+2.jpg" width="320" /></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhQtUEV6mFX0AVGM8ZODTJEDZWkeBAoHhhLkoyclqFrdD7zOcWj5g0NELwhCyilK33wZsQiSlgIL9XC1y1Y8u9ZBxwX_AFYyzemPzPmbs2aedBWppqwkFpWUaEMzqF-IgbsvYpfgykypzE/s1600/Image+1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhQtUEV6mFX0AVGM8ZODTJEDZWkeBAoHhhLkoyclqFrdD7zOcWj5g0NELwhCyilK33wZsQiSlgIL9XC1y1Y8u9ZBxwX_AFYyzemPzPmbs2aedBWppqwkFpWUaEMzqF-IgbsvYpfgykypzE/s320/Image+1.jpg" width="320" /></a></div>
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<span style="color: #6aa84f; font-family: Trebuchet MS, sans-serif; font-size: large;">Here is a good link for turtle owners: <a href="http://www.boxturtlefacts.org/Ear_Infections_in_Chelonians.pdf">http://www.boxturtlefacts.org/Ear_Infections_in_Chelonians.pdf</a></span><br />
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<span style="color: #6aa84f; font-family: Trebuchet MS, sans-serif; font-size: large;">What was very cool was seeing the doc give propofol INTO the sinus and slowly watching the turtle go to sleep. FYI, reptiles do everything slowly including heal.</span><br />
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<span style="color: #6aa84f; font-family: Trebuchet MS, sans-serif; font-size: large;">But what was needed was to open this up and flush it out. So once the sedation had taken effect, this is what the outcome was:</span><br />
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<br />purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com0tag:blogger.com,1999:blog-5753080668422427557.post-49499371929287324282013-01-26T09:33:00.000-08:002013-01-26T09:33:40.881-08:00I See Chickens Too<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">Yes, I see chickens as patients too. I don't generally do birds, but by "birds" I really mean what are classified as Psittacines - parrots and the like. I never saw enough of them to feel very comfortable doing the best for them or their owners. I would of course, on an emergency basis but most people who have these birds - if they seek veterinary care - want and deserve someone who does a LOT of bird work.</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">I love raptors too but I rarely get the chance to work on them either. I did a little at a few jobs and in my time at the Cape May Zoo.</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">I am very familiar with chickens, however. This is because of my time at the Univ of Delaware - and not just because we ARE the Fighting Blue Hens. Delaware is a huge poultry producing state - both eggs and meat. There is a lot of research at the University regarding poultry health and nutrition, as well as related topics like agricultural methods, environmental impacts, etc. </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">I did research as an undergrad in poultry nutrition and I loved it. I also helped a few grad students with other topics like poultry immunology, etc. It was here that I learned what I now use to treat the occasional chicken that comes in to my office.</span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">The chickens I see are often pets. They may be used for eggs but overall they are truly dearly loved and very sweet to work with. </span><br />
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">This is a sweet girl named Buffy who was attacked by a beagle one morning that had gotten out of his owner's property. She came in with multiple lacerations to the left hind end - thigh and very close to the vent (which is the shared GI, urinary and reproduction - egg laying - outlet). </span></div>
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">She was in stable condition but needed some wound cleaning and closing. Due to the discomfort she was experiencing we used gas anesthesia to sedate her and cleaned up the wounds. One involved muscle so I sutured that up as well as closed most of the skin. Fortunately there was not a lot of tension on it. And also fortunately, the vent was untouched and in tact. Her tail feathers were torn off and the the tail head itself was shredded pretty bad but we got it back to a pretty normal anatomy. </span></div>
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">Here are some immediate post op pics:</span></div>
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">We sent her home on some injectable antibiotics that we showed her owner, a knowledgeable pet parent, how to give. </span></div>
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<span style="color: #f6b26b; font-family: Arial, Helvetica, sans-serif; font-size: large;">This is her one week later and all the sutures are still there and the tissue appears to be healing very nicely. She is enjoying a pampered life at home in a very protected area and is apparently the envy of the other chickens in the flock!</span></div>
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<br />purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com0tag:blogger.com,1999:blog-5753080668422427557.post-88311337550792415042013-01-25T14:08:00.001-08:002013-01-25T14:08:33.691-08:00Important Info!<span style="color: #f1c232; font-family: Arial, Helvetica, sans-serif; font-size: large;">I'm sharing a list put out by the AVMA on some of the top poisonous HUMAN drugs that our pets may ingest and the harm they can cause.</span><br />
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<span style="color: #f1c232; font-family: Arial, Helvetica, sans-serif; font-size: large;">Please, keep your medications out of the reach of your pets. You may not understand it (frankly, I don't) but they sometimes will eat them, no matter what they taste or look like! </span><br />
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<span style="color: #f1c232; font-family: Arial, Helvetica, sans-serif; font-size: large;">Check this out: <a href="https://www.avma.org/public/PetCare/Pages/Poison-pills-for-pets.aspx?utm_source=facebook&utm_medium=socmed">10 Poison Pills for Pets</a></span><br />
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<span style="color: #f1c232; font-family: Arial, Helvetica, sans-serif; font-size: large;">And if your pet does eat these or any other human medications, please call YOUR veterinarian (not your neighbor, the breeder, your uncle, your hairdresser, etc). If it's after hours, call an emergency veterinary center in your area.</span><br />
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<span style="color: #f1c232; font-family: Arial, Helvetica, sans-serif; font-size: large;">AND please - PLEASE - call us BEFORE you give any medications we didn't prescribe. We will talk to you about things over the phone if you are a client. Please don't give something for 3 weeks and then call to see if it's ok! Dogs are different than humans and cats, well, they are a whole different animal! </span><br />
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<span style="color: #f1c232; font-family: Arial, Helvetica, sans-serif; font-size: large;"><br /></span>purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com0tag:blogger.com,1999:blog-5753080668422427557.post-90079554557059983162013-01-21T16:16:00.002-08:002013-01-21T16:16:44.269-08:00A Long Awaited Answer<span style="color: #ffe599; font-family: Arial, Helvetica, sans-serif; font-size: large;">Now that the holidays are behind us, we can get back to learning and experiencing life in the world of veterinary medicine.</span><br />
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<span style="color: #ffe599; font-family: Arial, Helvetica, sans-serif; font-size: large;">I posted a picture of a dog's skin toward the end of last month, asking readers to take a guess as to what was going on. I didn't get any responses but I won't take that personally - I know it was a busy time of year AND I've been away from the blog for a bit.</span><br />
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<span style="color: #ffe599; font-family: Arial, Helvetica, sans-serif; font-size: large;">Well, here's what's going on with that dog. That dog happens to be MY dog, a 4 yr old Golden Retriever named Theo. </span><br />
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<span style="color: #ffe599; font-family: Arial, Helvetica, sans-serif; font-size: large;">Theo has <a href="http://www.petmd.com/dog/conditions/neurological/c_dg_hydrocephalus#.UP3XuKVBnZc">hydrocephalus</a> which is explained at the link. We don't know whether it was congenital or not, but we do know he was normal at 9-10 months of age. </span><br />
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<span style="color: #ffe599; font-family: Arial, Helvetica, sans-serif; font-size: large;">He began exhibiting restlessness at about 2 1/2 - 3 yrs of age. Sedatives did not help his condition. The MRI was the definitive diagnosis and the reason he was put on the medications he was on and they have helped tremendously. He is not a 100% "normal" Golden and probably never will be, but he has come a long way.</span><br />
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<span style="color: #ffe599; font-family: Arial, Helvetica, sans-serif; font-size: large;">He was on a low dose of steroids, which are used to treat a wide variety of neurologic conditions in animals. Dogs and people tend to have more issues with long term steroids than our feline friends, who do quite well with them. </span><br />
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<span style="color: #ffe599; font-family: Arial, Helvetica, sans-serif; font-size: large;">Theo developed a rare condition called <a href="http://www.leospetcare.com/calcinosis-cutis/">calcinosis cutis</a>, which IS what it sounds like - calcium deposits in the skin. It can be quite irritating. </span><br />
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<span style="color: #ffe599; font-family: Arial, Helvetica, sans-serif; font-size: large;">The photos were pretty classic or as we say in veterinary medicine - pathognomonic for this disease. I sent photos of Theo to my favorite local dermatology vet - <a href="http://www.lehighvetderm.com/site/view/174809_OurDermatologist.pml">Dr. Brian Palmeiro, VMD</a> </span><span style="color: #ffe599; font-family: Arial, Helvetica, sans-serif; font-size: large;">and he agreed it was likely that. We needed a few skin biopsies to determine 100%, so I performed those in my office and yes, it was indeed that. </span><br />
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<span style="color: #ffe599; font-family: Arial, Helvetica, sans-serif; font-size: large;">Now we are weaning him off the pred slowly - SLOWLY - that's the key. Why? Well, when we give dogs or cats (or people) steroids, we shut down the pituitary adrenal axis pathways for these being produced naturally in our bodies. If we simply stopped cold turkey, our bodies would go into shock! We need steroids, so to let the adrenal glands get back up to production mode, we slowly wean off the prednisone. Fortunately, it's the phenobarb that's helping with most of the neurologic signs AND I have to have him possible evaluated for surgical drain placement, which might mean no meds are needed down the road.</span><br />
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<span style="color: #ffe599; font-family: Arial, Helvetica, sans-serif; font-size: large;"><br /></span>purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com0tag:blogger.com,1999:blog-5753080668422427557.post-23372691014661606702012-12-22T10:06:00.001-08:002012-12-22T10:15:48.305-08:00What is this? <span style="color: #ffd966; font-family: Arial, Helvetica, sans-serif; font-size: large;">Ok, I have a few pictures to show you. I will tell you this about it. The pictures are of the skin of a 4 year old Golden Retriever. He has a brain condition which required him to be put on long term phenobarbital and prednisone. The neurologic issues resolved with medication. Approximately 6 months after the medication was started, this happened:</span><br />
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<span style="color: #ffd966; font-family: Arial, Helvetica, sans-serif; font-size: large;">The lesions are hard and crusted. The hair that is attached easily pulls off. There is some itching/discomfort associated with it but overall the dog is doing well - happy, eating, etc.</span><br />
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<span style="color: #ffd966; font-family: Arial, Helvetica, sans-serif; font-size: large;">This WAS biopsied and so we do have a definite diagnoses.</span><br />
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<span style="color: #ffd966; font-family: Arial, Helvetica, sans-serif; font-size: large;">Any thoughts or further questions?</span><br />
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<span style="color: #ffd966; font-family: Arial, Helvetica, sans-serif; font-size: large;"><br /></span>purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com6tag:blogger.com,1999:blog-5753080668422427557.post-67544900776847984352012-12-16T10:16:00.001-08:002012-12-16T10:16:27.444-08:00A Few Lessons in This One<span style="color: #ea9999; font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: large;">I realize what *I* commonly see, may be "weird" or "rare" or frankly, SHOCKING, to most of you.</span><br />
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<span style="color: #ea9999; font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: large;">One of the most common things I see is dogs or cats with late stage cancer that were showing no signs until the day or two before they came into my office. Sometimes, thankfully rarely, people ignore signs like weight loss, lethargy, vomiting and inappetence and let it go for months. Though THAT does happen. It saddens me because there are times we can help those pets. </span><br />
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<span style="color: #ea9999; font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: large;">We have to remember our pets often deal with pain and disease better than we do. It's truly part of their "predator" nature to hide illness. Or else they could become "prey." It's truly amazing what processes animals are going through and yet they continue to eat and greet us as happily as ever.</span><br />
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<span style="color: #ea9999; font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: large;">But remember, we too can have things going on that no doctor in the world could see and often we have tests that are negative or normal while severe disease rages on inside. </span><br />
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<span style="color: #ea9999; font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: large;">The other day an older German Shepherd came in (7 years) for being lethargic and a distended abdomen. The owner noticed this. Now, because I know what I know and do what I do, one of the top things that came to MY mind - breed, age, signs - bleeding splenic tumor. This is very common in our GS, Goldens and Rotties as they get older. I've seen dogs come in fine and they went out for a run and collapsed because the bleed was fast. I've seen dogs I've examined and palpated come back in 3 months later with a mass that was NOT there before. </span><br />
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<span style="color: #ea9999; font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: large;">This is how cancer works - in us and them.</span><br />
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<span style="color: #ea9999; font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: large;">So this dog needed some tests to confirm this and also to see how good of a surgical candidate we were - always possible for other diseases to be going on AT the same time. Dogs, cats and people can live just fine without a spleen.</span><br />
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<span style="color: #ea9999; font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: large;">Other questions:</span><br />
<span style="color: #ea9999; font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: large;">1. Was there any evidence of spread (namely to the chest)?</span><br />
<span style="color: #ea9999; font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: large;">2. How anemic was this dog (do we need a blood transfusion)?</span><br />
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<span style="color: #ea9999; font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: large;">Dogs can have benign or malignant splenic tumors. The only way to know is to remove the spleen and send tissue to the pathologist. The most common cancer is hemangiosarcoma.</span><br />
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<span style="color: #ea9999; font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: large;">The dog was moderately anemic (not in need of a transfusion) and the x-ray confirmed a bleeding mass with loss of detail on the image in the area of the spleen. An ultrasound was done to check for any spread to the liver (other types of cancer would do that - mast cell, lymphoma). </span><br />
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<span style="color: #ea9999; font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: large;">We do these things to see what kind of surgical candidate the dog is AND to help the owner make the most educated decision possible. This is a serious surgery and they can die from secondary cardiac arrhythmias, blood clots, etc. </span><br />
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<span style="color: #ea9999; font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: large;">So, we take the dog to surgery and this is what we see:</span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjMmoZgq6w2LEK1p4oaWKYa2SdZVqPH6NFt5cvyFJ0zeUOBYDSUyyFQi5wL3xpccjkn7x7EwJVslM07yzyrYriA1AL0vm2mfRoGlBP2IFPhvs1gmSnstgo7o1mksQX1VlajRNIGnI3sWS8/s1600/Image.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjMmoZgq6w2LEK1p4oaWKYa2SdZVqPH6NFt5cvyFJ0zeUOBYDSUyyFQi5wL3xpccjkn7x7EwJVslM07yzyrYriA1AL0vm2mfRoGlBP2IFPhvs1gmSnstgo7o1mksQX1VlajRNIGnI3sWS8/s320/Image.jpg" width="320" /></a></div>
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<span style="color: #ea9999; font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: large;">What you see is a big mass on top of the spleen, a smaller one off the front edge and then hundreds of little red/brown masses all over the <a href="http://ovariancancer.about.com/od/ovariancancerglossary/g/ovca_omentum.htm">omentum</a>, and I mean, ALL over. There are more than what is even in this picture. </span><br />
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<span style="color: #ea9999; font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: large;">This was not going to be visible on any other test other than..bingo: an exploratory surgery. Sometimes the best test is using your eyeballs! </span><br />
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<span style="color: #ea9999; font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: large;">There was evidence that some of these "little" spleens had started to grow and bleed out. There was NO way this was resectable. The owner was notified and chose to humanely let the dog go while she was sleeping. No other choice really. The kindest but hardest one. </span><br />
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<span style="color: #ea9999; font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: large;">We thought we could fix this one. We couldn't. We didn't know until we got in there. This is what happens sometimes. </span><br />
<span style="color: #ea9999; font-family: Helvetica Neue, Arial, Helvetica, sans-serif; font-size: large;"><br /></span>purrduedvmhttp://www.blogger.com/profile/14957386677877301391noreply@blogger.com1