There’s always a first

Vet school already feels like years and years ago but in reality this year will only be 5 years since I graduated from the University of Pennsylvania School of Veterinary Medicine.  I was just thinking about this recently and remembered Claire, my first dog spay in veterinary school.  She’s pictured below with me the morning before her surgery. 

We spent only one week with these dogs. They came from a shelter in Philadelphia and we spayed or neutered them and tried our hardest to find homes for them. Many students adopted them for their own. I remember praying I didn’t fall in love with my spay-dog because I couldn’t take her home to my apartment with my allergic roommate. And then it was Claire. She was initially wary of us vet students who were poking and probing her but as you can see, she became comfortable with us. I would spend my extra time with her that whole week. I asked my boyfriend if he could adopt her. I asked my classmates. I think I even asked my parents too. Just someone please adopt this adorable little girl! 

Her surgery went spectacularly. She recovered uneventfully and the following morning we spent an hour together with her on my lap as I wrote up her post-op medical record.  I started called her Claire-bear. I also started trying to figure out if I kept her on the lower floor of my apartment if my allergic roommate would be able to handle that. Maybe just maybe it would work. And then, on her last day before having to head back to the shelter, we received word that she had an approved adopter. Her savior was a veterinarian who lived on a small farmette. I was ecstatic…and oddly sad at the same time. She was destined for a life of fun and adventure; but, selfishly, I would miss my little Claire-bear. I think of her frequently, wondering how she’s doing. To this day, this picture is still saved on my phone. I picture her in my head romping around her farm by day and curled up on a super soft bed at night like the queen she deserves to be. 

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Here’s a fun one…

My mother texted this picture to me today. Don’t mind the glare from the glass.  She told me to find Cooper. Cooper is my parents 3 year old mischievous Chocolate Labrador. So, there are obviously cows and also a black cat in this picture, but where is the lab? When you see him you’ll know…πŸ€”πŸ˜‹πŸ˜ƒ

Ignorance is bliss

As a veterinarian we have all kinds of diagnostic tools at our disposal. When a sick pet is in front of us we use a thorough history and physical examination to best determine the likely causes of illness. Sometimes we need further diagnostics to help us out or give us more detail. At many primary care veterinarians this is blood work or X-rays. We have those at AHCC but we also have begun to increasingly use our ultrasound machine. 

Ultrasound is a fantastic diagnostic tool but it comes with a steep learning curve. I have received extra hours of ultrasound training and quite frankly really enjoy the challenge of that learning curve. However, I’ve learned the ultrasound usually draws cases which tend to have some sad news. Sure, I get a few who are normal or which show healthy puppies in the womb, but more often than not, I find some form of disease that carries with it a  guarded prognosis. I guess this is where the statement “ignorance is bliss” makes sense. 

Last week I used the ultrasound to diagnose a gall bladder mucocele in an old dog.  Surgery is almost always needed for these but even with surgery it is a very dangerous and risky process. The owners decided not to pursue the risky surgical treatments. We kept him comfortable for a few more days  before saying goodbye. The owner said something to me as we were reminiscing about her beloved…she said she was so thankful to know exactly what was ailing him so we weren’t completely in the dark as to why he was so sick. She was happy she didn’t have to take him to a specialist and that she was able to receive the answers right here at our clinic instead of another less familiar hospital.  I can’t thank her enough for sharing that with me. I’ll forever remember this as it helps me further understand the value of what I am able to offer our clients, even if it is a bit of a burden to be the bearer of bad news.

The flip side of the blissful ignorance coin is the fact that “knowledge is power”.  I too must remember the times ultrasound has saved the life of a pet by giving us the knowledge of what was occurring and time to fix it.  My most fond memory of this was when a dog had an intussuception of the intestines which was identified through ultrasound. He was on and off the surgery table within two hours of his ultrasonographic diagnosis. So yes, I love ultrasound. I’m happy to continue to provide this service and hope to save more lives with it, or at the very least, to make sense of an ailing pet and allow us to keep him comfortable with the power of knowledge. 

Dog Days of Summer

  

I love summer, I really do.  What I don’t like about summer is having to leave Drago at home sometimes because it is too hot outside for him.  Drago lives for the outdoors.  He loves car rides too, and appears to enjoy people-watching from the car while I grocery shop.  Today, in Pennsylvania it was over 90 degrees farenheit.  Drago wanted so badly to be outside but I only let him outside for about 15 minutes at a time.  He seemed disappointed when I ran an errand  and didn’t take him with me.

However, maybe he doesn’t mind not being outside too much.  As I type this post, he’s laying upside down on the love-seat in front of the airconditioner.  Every now and then his toes and tail twitch as if he’s dreaming about chasing a squirrel.  Maybe he’s outside in his dreams. πŸ™‚  We’ll have to take a nice walk in the wee hours of the morning tomorrow before it gets hot again.  There are always lots of squirrels out at that time too…

Mystery Dinner

Dogs, and cats for that matter, eat all kinds of weird things.   Some eat foods, some eat toys, some eat poop (ew!)…the list goes on and on.  Being a veterinarian, we get to see some really intresting cases of weird things eaten.  In my post  Pet Poison Hotline I mentioned what happens when pets eat toxins but what about when a dog eats inanimate objects? Toys? Strings? Bones?  This condition is known as dietary indescretion.

When your pet eats an inanimate object only three things can happen:

  1. Nothing – it passes.  You may or may not see it pass as a present in the yard.  If you don’t find it eventually you begin to wonder if he ever actually ate it.  OR, you consider the possibility that it may still be inside.
  2. She makes a mess – by vomiting it back up, along with the rest of the contents of the stomach.  Then, to make matters worse, diarrhea develops too.
  3. Bad news bears – it gets stuck.  This also can cause vomiting or diarrhea or worse if not dealt with in a timely manner. 

Our physical examination and diagnostics like blood work and x-rays can help us determine if something is stuck.   Sometimes on x-ray you can see a stuck object.  Other times, you see large dilated airfilled intestines and stomach as gas backs up from the obstruction.

Check out the following x-ray for a dog presenting for vomiting and diarrhea with straining.  He has a history of getting into the trash can and did so a few days ago before all this started.  Do you see anything?

     Do you known what his diagnosis is? It’s a foreign body…in the stomach.  If you don’t see it, the following reproduction of the image with overlays points out the foreign body/bodies (green circle) in the stomach and a small amount of gas (blue arrow) in the intestine.  In this case, the gas amount is normal, it’s just the foreign body that showed up on x-rays that is abnormal.

  
 Okay, hopefully you see it now.  Now the fun part comes…what is it?  This pup had surgery and we pulled the foreign body out of his stomach.  When we went in, we were thinking we would be retrieving some rib-bones that had been in the trash can and were still stuck together.  However, this was not the case, and I should have known seeing as these two things look so identical in shape and length.   Do you know what it is yet?

  
Pacifiers!  Crazy right? Surgery went well and he recovered uneventfully.  The owners, when shown what was collected from his stomach were astounded.  Apparently, these pacifiers were missing for a full week!

It can sometimes be fun to try to guess what may be the culprit of an obstruction.  However, it is much more fun to see you smiling and not worrying over your pet as they undergo surgery to relieve an obstruction.  Be mindful of what your pet’s habits are.  Some pets will eat these things, others could care less.  Learn to know your pet and what objects or foods need to be kept away…this way, I won’t have to open up their gi tract to find out just what mystery dinner Fido had a few days ago.

Frankie

Last week I posted about the TNR group I work with. I mentioned how it’s nifty when I get to see cats they pulled off the streets and adopted out to clients who eventually come to my primary care practice, Animal Health Care Center of Hershey. Sometimes, we see them for illnesses before they are adopted out. Meet Frankie. Frankie must have been abandoned because what Flame-point Siamese is a bonafide stray? Frankie was taken in by PAWS. He was thin, under-conditioned and un-neutered. He was given lots of groceries and love. Last week, he developed vomiting and diarrhea. So much so that the pound he gained since being taken in had vanished. PAWs brought him into AHCC. One of our doctors attended to his care while he was hospitalized for a few days. He was diagnosed with inflammatory bowel disease. Medications to help reset his system were given and a dietary change was made. He went “home” to PAWS on Thursday.  I had another TNR clinic on Saturday at PAWS’ headquarters and got to see Frankie running around the great room. It is so good to see your patients feeling better and back to health. Assuming he continues to do well and gains his weight back, I’ll be neutering Frankie and cleaning up his teeth later this month. Clearly he doesn’t know these plans or I doubt he would have taken the following selfie of the both of us… πŸ˜‰
 

Smile!