Sunday, November 27, 2011

Guest Blogger, My Best friend, and her dog Banjo

Linda, in her store with her two guard dogs. Well, if wagging and barking "hello, come pet me!" is an alarm call

   Ever since Krista started writing her blog, I have threatened to write a guest appearance, mainly about Banjo, the rescue she changed our lives with, but also (like it or not, Krista) about Krista herself.

     There are some days that change your own history and the day I met Krista was just one of those days, although of course I didn't know it at the time.  My husband, Carroll, and I have an antiques store is an obscure and ridiculously remote part of southern York County, Pennsylvania called Gatchellville. About six years ago, I was in the house, which is located right across the driveway from the store, and my husband came in and said there was a customer at the front door of the store.  I reminded him that we were closed and that he should tell the gal to come back another day.  Carroll told me that he told her that to go away and come back another day but that she refused to leave!  Well, now I know that that is classic Krista.  If there is something she wants, she goes after it, and she doesn't leave until she has it.

     It turned out to be a lucky day for all of us.  Carroll and I had just moved to southern Pennsylvania.  Krista and her husband, Joe, had just done the same.  We all loved antiques, good food, old houses, and animals, and along with another couple, Barbara and Richard, we formed a band of brothers, so to speak. 

     We have spent the past six years pondering the universe, fighting over politics, drinking more champagne than I want to admit to, lavishing each other with gifts, and becoming a family. 

     Without knowing what was happening, these people have become the people who, without question, I would lend money, donate a kidney, flip hundreds of pancakes for, and in Krista's case, trust with my animal's medical care.

     Inevitably at the end of a workday, when Krista and Joe show up at our house for dinner (why do I do all of the cooking, by the way?), the topic is first and foremost people and their animals what happened at the clinic how people can be cruel, lazy, and downright stupid with their pets, and how it is a never ending uphill battle to make the world safe for the animals in our possession. We have to get this conversation out of the way before we can go on to other things like how our families drive us crazy, what antiques we saw at a show we went to, and who wants what gift for Christmas.

     I will tell you that Krista-Joe, too-do not suffer fools easily and pity the poor folks who come into her clinic who have neglected their pets.  In her case, the customer is not always right and she does not mind telling them.  Well, that's as it should be. 

     For me, I know she has gotten my own pets miniature poodles named Mason (who has since passed away), Noodle, and Banjo through any number of scrapes and I rest easier just knowing that she is at the other end of the phone in an emergency. 

Banjo, (foreground) and Noodle, (background) slumbering on their porch.

Two years ago, my little dog, Noodle, was attacked by a vicious Rottweiler in the back yard of our house.  We were minding our business, out for our evening walk, and this dog came out of nowhere and somehow mistook Noodle for a nice dinner sandwich.  It was one of the scariest days of my life. I thought that, not only would Noodle be gone, but that I would be attacked as well, and the two of us would be left to die alone in the field.

     By a miracle I was able to get away, but I thought that Noodle was dead.  There was blood everywhere.  However, I sensed a faint heartbeat when I got him into the house.  One phone call and five minutes later, I was at Krista's old stone house.  Joe was carrying Noodle in and she had turned the upstairs bathroom into a sterile emergency room.  

Thank-Goodness Noodle is still with us! Amazingly not too much worse for wear.  We were lucky that day.

     Another lucky day occurred last February when we got a call from Krista someone had dropped off a small white poodle and she thought we might want to adopt it. It turns out that the people had even offered to pay for euthanasia if it could not find a good home.  

     I wasn't looking for another dog.  The way we care for Noodle is the way some families might care for n entire squadron of five year olds-just dressing him in his daily sweater sets is a job-so I wasn't looking for another dog.

     But as is Krista's way, she was pretty insistent that we wanted this dog.  I agreed to come in and meet him the next day.  I wasn't excited. I figured there had to be a lot wrong with him if his previous family would just drop him off, unwanted.

Me and Banjo at JVC.
Banjo, in his first few days at JVC, Looking scruffy and scared.

When I met him, I knew I was right.  There was a lot wrong with him.  He had ear infections, urinary tract infections, matted fur, runny eyes, chronic diarrhea, and was positive for heartworm.  He was the scrawniest, most pathetic poodle I have ever seen; with a face that just cried out with is misery.  Please, please, please, won't somebody love me!?

     I knew if I just picked him up for one second I would be a goner. So I resisted for a full five minutes. Just staring at him from across the room. Could I commit to this pathetic little bundle of matted fur? To make him even more pathetic, he has a strange albino-ish coloring with pink circles around his eyes and a pink nose. He looks as if he is perpetually crying.

     I knew I had a little bit of an out by telling the folks at the clinic that we would leave the decision to keep this dog up to Noodle, the spoiled (and healthy and beautiful) poodle at home. 

Well, the two bonded like twin brothers who had been separated at birth and were reunited on the Oprah show.  From the second they laid eyes on each other, they have been inseparable, two peas in a pod, always shoulder to shoulder in their perch in the window.

Carroll, Linda's Husband, with their two peas, Noodle (left) and Banjo (right).

     This dog, who came with the cumbersome name of Jean Luc has been renamed Banjo and has learned to live with a family who loves him and spoils him, something that all dogs should hope to have. He still has some health problems, most recently a series of very worrisome seizures.  He has allergies, oddball rashes, ear infections, and I think he will always be pretty high maintenance.  But to me-and to my husband, Carroll, he is one of the most beautiful dogs in the world.   We are so glad that we were able to rescue him from the clinic in Jarrettsville. 
     Thanks, Krista.

Banjo, on the couch, (where he usually is), in plaid, (like he usually is), with his bone.

Saturday, November 26, 2011

November 26, 2011

For almost all of us Thanksgiving is just behind us and Christmas has begun its ominous countdown descent.

And also for most of us the month between these two holidays is FULL of things to do and lists to accomplish because there are deadlines dictated by calender dates. For me there are the following items on my list;

Today; Today I head off to celebrate with many of our JVC staff the wedding of one of our technicians. It is the second wedding of the year for JVC and we are all looking forward to sharing the big day. We are all excited to finally see all of the things she has been talking about, planning for, and anxious about. Her dress, her hair, make-up, flowers, cake, decor have all been many a topic, sneak peek and debate over the last few months. There have been diets, advice, and of course, a little drama. But all of these things are normal conversations when you have a clinic full of women between the ages of 20 and 50. We love to talk "girl stuff" and wedding is one of our favorite topics. (Followed closely to the birth of a baby, and the discovery of a medical challenge to one of us, or our pets.) With that many women there is always chatter, (although after spending 20 years around nothing but men I will say that they are just as bad).
Our second wedding, Nov 26, 2011

Our first wedding of 2011

Jarrettsville Vet is for most of us our second family. Many of us have been there for 5 years or longer. (Actually I believe that of the 20 plus employees ALL of us have been there for 4 years plus, except for 1, my dad, as hospital administrator). In many ways the current chapter of our lives is something we all share and have gone through together. JVC is our work, stress, drama, outlet from our "other half of our life: home" and the place we are able to confide in each other the trials and tribulations that we all have in common, be they spouses, pets, kids, parents, holidays, illnesses, clients, cases, and local gossip. We are our own family, with all of the idiosyncracies, ups-downs, and drama that a family brings. We are our own soap opera. And for today we are a family coming together to celebrate one of our most treasured moments, a wedding. I will spend hours getting ready, take the gifts that are already wrapped, and be proud, happy, emotional and excited to see her months of planning all come together. It is another badge of honor I display proudly for being the owner of a place that is the platform for such richness in my life. Congrats lil princess! see you soon!

Next weekend, Sunday from 1 to 3, is our annual, (let's see 5th maybe?) Pets With Santa event. We decorate the entire clinic, invite anyone and everyone for a free meet-greet, eat, drink, and get your picture taken with Santa day. My whole family comes to help set-up, organize, and participate in making this fund-raiser a success. My brother is a professional photographer, so he carts up his equipment, and sets up a beautiful back drop. My sister and her husband help the behind the scenes organization of making sure the photos get to Wal-Mart, and my husband keeps the staff smiling, sets up a video monitor to play the pictures from past years, and keep me sane. And my dad greets everyone and helps with the logistics of the paperwork. My groomer and receptionist take over the Santa and elf duties, and the rest of the staff help with traffic control, barking dog next to scared cat dilemma, and meet and greet our clients. The entire event is free for everyone and anyone (even if you don't have a pet), but we ask for a donation of any amount if you can do it to assist with our pet rescue, treatment, and adoption program. We try very hard to help every client who needs help with their pets needs, and also try to help the local Humane Society when they call and tell us that they have a dog they are at the end of being to shelter, but it takes funds to continue. I am happy to donate my time for our pets, and I have an amazing group of vets who do the same, but we still have to pay for housing, food, medications and the staffs time.

I try to blog about each of our rescued pets and their plights, but I know I have neglected many. (Off the top of my head there is; Lola, at least 6 kittens, Banjo, the chihauas my tech took, pit bulls, Lilly, gosh, there are many others). I think we rescue about 2 dozen or more a year. Sometimes I look at those guys as they are in our care sometimes for months and ask myself "what the heck am I doing?" I have internal and external emotional pleas with my spouse, my staff and my friends about where to draw my "I can't live with myself if I do this" line. I grapple daily with the advice of "you can't love a pet more than their owner does," and "you can't save them all," and "it's just a cat." I try very hard to not my a decision that I will regret later because of money (don't go into Vet medicine if you care about money and ethics, is my advice), or doing what is quickest and easiest. I try to remind myself that "if you ever have to chose between being right and being kind, chose kind," (my favorite quote written by the spiritual guru Dwayne Dyer. But back to the point, the Pets with Santa fundraiser helps us to continue providing care to pets who don't have any other options.

Pudgie, One of our rescues

Lilly, a 2011 rescue, who now has a great home

A 2010 rescue, Sage

2011 rescue, Bella, from BARCS

2009 rescue, Lemon, still looking for a home

Banjo, a 2010 rescue, with his brother on the left, Noodle, and my best friend, Linda, their mom.

Kiki, from Animal rescue, and Buddy. Both are looking for a home.
So if any of you are in the Northern maryland area next Sunday, Dec 4th between noon and 3 or 4 o'clock please come in to say "hello" eat, drink, and be merry with us. It is my favorite day of the year in the clinic and I spend all year looking at the incredible photos we take.

Then we have to start getting ready for the Pet Expo in Timonium on Jan 27 thru 29. It will be the place where everyone can meet our staff, ask the Vets and techs any questions you might have about pet care. And we will be giving away lots of goodies. If you have never gone to this it is an incredible conglomeration of everything pet. Every breed, every species, every-everything pet pandamonium. But please! don't bring a tiny toy breed, or puppy, it is too dangerous with soo many people, and Please make sure your pet is vaccinated before you bring them. that Fair grounds is a petri dish of disease for pets. My advice is to not bring them, there are thousands of people and the majority of the pets are petrified by the crowds, and I have witnessed dog fights, pets being stepped on, etc. So not worth it. Link to their website;

Ok, here are some of my favorite Pets with Santa photos;

Diedra, (my sister), Daisy, and John (Diedra's husband)

Our 2010 family photo. Me, with Savannah, Jekyl on Santa, and Joe with Charleston

Friday, November 25, 2011

Ears, Everyone has 'em, no one treats 'em right

My Jekyl. His morning ritual. Jumping on the bed to say "Good Morning!"
The famous saying in vet school is that "90% of the problems we see as Vets is skin and gut." Problem is that every vet student  bitches about Derm (dermatology) and GI (gastroenterology) class because they are so hard. It's the bread and butter of vet business, the demise of a few vet students, and the frustration of many an owner and their pet.

At the average skin/derm appointment I have to tell my owners to be patient, talk to me alot, and try not to get frustrated. Sometimes the road we get on has many a twist, turn, pit stop, pit fall, and sometimes you just want to drive off a cliff. It can be a life long problem for many dogs and cost their parents a small fortune in the process.

I love Derm and I like GI (well I love GI surgery, does that count?), and I agree it is the bread and butter.

So I thought I would talk about a dermatology topic that I see and live everyday; Ears. You see my adorable floppy eared beagle pup Jekyl has weekly cleaning sessions because those big adorable floppy ears keep the dirt and wax in and the sunshine and air out. Versus my pit bull pup Charlie who has more erect ears.

Anatomically the bigger and floppier your ears are the more likely you are to have ear problems. The Cockers, Bassetts, and Hounds tend to have yeasty ears. The darkness, moisture, and wax (food) make the perfect environment for the yeast (aka bugs) to thrive. The Labs and Shepherds have a predisposition for bad skin, so their ear ailments arise from their skin problem. Then there are the Shar Pei's and Bulldogs who because of their smooshy faces end up having stenotic (narrow) and tortuous ear canals. Ontop of that  many of these guys have ear flaps that are jammed to their head and you get narrow, moist, dark, "I already have bad skin" and being unable to get to their closed ear canals and you have big ear problems!

Here is my ear problem kid, and his brother with out ear problems. See what I mean, genetics dictate!

I want to start with the most basic advice on ears. Keep them clean! Sounds so simple. We all wash our ears, swab them, and maintain our own personal ear hygiene, so why do we wait until our pets are fire red and stink so bad I can diagnose them from the other end of the vet hospital. Or let those ears go to the point of hematoma (the ear flap swells like a pillow). Or progress to deafness? I think it is because many people are scared to clean ears. So for every ear appointment I get I give a demo on how to clean ears.

I gave this demo the other day. I asked what they do? And got the answer that I usually get. "I squirt in some cleaner and then swab out with Q-tips." "OK," I say, "I know that most of us have been taught this way and you see us do it, but I think that there is an easier and more effective way." Then I go onto to explain, "Doctors have their own opinions on how to do everything. I mean they are entitled to them, but they are wrong with ear cleaning." I always say it jokingly, (OK, half-jokingly). I then go get a big bottle of cleaner, (I only sell the big bottles), because if you are here for an ear problem you will very likely have an ear problem again soon, so I want you to be ready before you call me.

My hope is that you won't ever have to call me again. My hope is that when your dogs ears start to bother him, (when he is at the initial inflammation stage), that you at home can clean your way out of the inflammation stage and avoid the (next) infection stage all together. My job is to educate you enough that you can keep your pet healthy and avoid seeing me.

Ok, here is the "primer" on ear cleaning. If all else fails, read the label! The label on our ear cleaner reads. "Fill ear canal until overflowing and then gently massage into ear. Let pet shake out excess." See? very simple. No poking, no swabbing, no fighting, no biting, and no hurting. Now, many pets have ears that hurt, so anytime you touch a painful ear you are hurting your pet. I don't want the ear cleaning to be a torture process that your pet hates because then it won't ever get done. So be gentle, be patient, and don't scare or upset your pet.

For the first few times it is a 2 person job. The first person holds the right hand on the pets collar and left hand firmly on the nose. Keep the nose up and don't let your pet fight out of the position hold. Be firm, be kind, be patient and be gentle, and don't let your pet fight. The second person then takes the ear flap (aka pinna) firmly and gently pulls it straight out away from the face. (Perpendicular to the eye so that you open the "L" shaped ear canal into moee of a straight line). Then fill the ear with the cleaner until it overflows. (No one ever uses enough). You want to "FLOOD" the ear canal, and that's another reason I sell the big bottles only. Remember your pet's ear canal is about 3 inches long. You need to get the cleaner to fill the whole canal. Then fold the ear flap like a burrito (always a reference to food ;-)), and massage into the head. You should be massaging against the skull and you should hear a squishy sound. It is the same concept as the agitator in your washing machine. This should not hurt. Actually, most pets love the ear massage. If it hurts then it means one of two things; 1. The ear is infected and you need a vet appointment, or 2. The ear drum is ruptured and you DEFINATELY need a vet appointment.

I don't want owners to swab the ears because if the ears are red then the swab feels like sandpaper. And a dog with a hurt ear won't want to let you clean them ever again. And the other reason we don't swab is  that we are trying to get rid of the junk in those ears, not shove it back down the ear canal. Let your pet shake out the excess ear cleaner and the junk that is causing the problem.

I also tell people that you cannot over clean, but you absolutely can over medicate. I don't care if you clean the ears daily. Some pets need daily cleaning, some weekly, some yearly. 

Everyday I see a dog in the clinic for "itchy ears." Most often these guys are here for their umpteenth time. There is a huge subset of clients who only come in because their dogs ears are to the point that their dog keeps them up all night, has blood coming out of their ears because they have been itched raw, smell like infection started brewing in them last month, or the ears are so infected and painful that the owner is in fear for their life when they try to put the medication "in that small tube I got last time," in their pets ears.

Oh, the frustration of the phone call that starts as "Hey Doc, I know we haven't been in in awhile, but Sam's ears are bothering him again, and I was hoping I could get more of that medicine he got last time?" Argh, it's a hard call to answer somedays. Firstly, because I would like to see your dog outside of the disasters so that maybe we can find an answer to the problem before it hits catastrophe stage. Secondly, because that little tube you have been using on and off over the last year is a whopper of a steroid with a big gun antibiotic/anti-fungal and I am afraid you are acting like Dr. Frankenstein and inadvertently growing a batch of superbugs in those ears. You see when you have a legitimate infection (most of the time you don't, because most of the time you simply have inflammation.) We are supposed to treat twice a day until the clinical signs (redness, itchy, smell, etc) are gone for at least three days. That way you have killed all of the bugs and not just the weak ones. If you only treat intermittently you are killing the weak bugs and allowing the most powerful bugs to reproduce. Eventually you get what we call "antibiotic resistence." The only treatment after you hit this stage is surgical removal of the entire ear canal. This is called a "salvage procedure."

I have done many ear canal resections to relieve pets of the constant pain of ear infections. It is the only way to stop the pain, and these guys are long deaf by then already.

I met one little Yorkie a few months ago with terrible chronically infected ears. She had just been rescued from a hoarder. Her ears had been so infected (a combination of ear mites and infection) for so long that one of her ear canals had closed already. She had a persistent head tilt and difficulty walking because her balance was off from her ear being so damaged for so long.

The next week I removed her unsavable ear canal. She was 4 pounds and had a tough time with her surgery and recovery. It took a few weeks before she could stand up, walk, and blink normally. Thankfully we were able to save the other ear with very aggressive steroids and antibiotics. She is a very gentle shy girl and her new family gave her the complete opposite life from where she had come from. She receives endless amounts of care, love, time, and she is finally healthy. She will probably never come out of her quiet reserved shell, because was raised being outnumbered and overlooked but she is happy and finally living the life she always deserved.
Post-op, Left TECA, aka Total Ear Canal Ablation

For more information on ears I really like the book "Small Animal Ear Diseases" by Gotthelf.

Here are some of my favorite Big-eared pictures and patients. Oh, I can't resist the ears!

Baby Jekyl, the first week we got him. Note the Sutured butt..

Jekyl, OMG do I love this beagle!

Thursday, November 24, 2011

Bulldogs, The Good, The Bad, and the Skin

I saw a Bulldog yesterday that prompted me on the importance of "an educated consumer is our best customer." (I borrowed that tag line from the long run advertisements, and now I think defunct? chain of stores in the Philadelphia-Maryland area called Syms). Before you fall prey to the incredibly charming and sweet  captivating persona of a Bulldog you have to know what you are getting yourself into.

They are the cutest puppies on the planet, (I know I already said this about Bassett Hounds, but I do think Bulldogs are just as cute, OK maybe a little cuter). Those smooshy round faces, that rolly-polly body, and the adorable-ness is impossible not to make even the most rigid person melt to their knees. At 0 to 12 months old there is nothing but cute bounding abundant love, smiles, laughing, joy, an internal self affirmation that this was the best decision you ever made in your life, and you KNOW that you will never love anything more than this puppy!

Here I am as a fourth year vet student on medicine block (rotation) with my two very sick bulldog puppy patients. Those guys were in the ICU for weeks, but thankfully made a full recovery.

After 14 months things start to go very slowly downhill.. It starts with a very gradual almost undetectable scratch every so often. Or maybe a "little pinker than normal" ear. After a few weeks the itch becomes an incessant "thump-thump-thump" of the foot hitting the floor all night and this really starts to annoy you. So, you naturally make an appointment at your Vet's for "itchy skin." At this first visit I will listen quietly and write down everything that you are saying and doing to try to get the itch to stop. I will ask "what you are feeding? how much? how often? and what you use for flea and tick prevention?" I also will ask if "You have ever had a Bulldog before?"

My best friends baby. On his first Christmas.

After a thorough physical exam I will sit down and start to discuss everything that is about to follow in this story. I will admit to you that "Bulldogs are one of my favorite breeds of dogs." "They are gentle, friendly, affectionate, great with children, and usually have few to no behavioral issues. BUT, they are probably the most expensive breed of dog to own." I will explain my bold statement with, "they are expensive because there is no other dog breed that requires more time and attention and has more long standing issues than the average Bulldog." Your heart will sink a little, and you will hope that "your dog will prove me wrong." I won't blame you and I will keep my fingers crossed for you that you are right and I am wrong.

Here is a list of the common Bulldog problems I see:

1. Skin. 
This is the most common Bulldog problem that I see. Many Bulldogs that I treat need chronic medications to just "control" their itch. The skin gets thicker, and bacteria and yeast overpopulate, they get itchier, and scratch more, and traumatize their skin, and then develop wounds, etc. The cycle gets more severe and the interval between the outbreaks becomes shorter. If you have a "quick" first visit at your vet's office I would be willing to bet that they just put you on a steroid (most likely prednisone) for a few weeks. the itch will quickly go away and you will feel as if it is behind you. I really hope that at that first visit your Vet warns you about the likelihood that this problem will be chronic, and that long term steroids are dangerous. when I say "skin" here I am talking, feet, face, ears, butt, belly, and everywhere!.

2. Entropion. 
This is a condition where the excessive heavy haired skin around the eyes rolls inward. The constant rubbing of hair on the cornea causes excessive tearing and trauma to the cornes. It is like ALWAYS having hair or an eyelash in your eye, annoying and painful as your cornea is worn away. It is usually corrected surgically by giving the Bulldog a face life. We actually remove some of the excess skin so the skin roll doesn't rub the cornea of the eye. I have done a lot of face lifts (eyelid tacking) on 3 to 8 week old puppies. If the entopion is not corrected the dog can go blind from the cornea getting damaged beyond the point of being able to see through the eye anymore. (See Levi's story.)

This is Corky. His entropion surgery story.

3. Joint problems. 
When you mutate any animal as much as we have selectively bred the Bulldog you get genetic problems. The elbows and shoulders carry a very heavy load because these guys are so front heavy. Most dogs carry about 60% of their weight on their front legs but Bulldogs can carry up to 70%. Those broad thick shoulders cause an immense amount of joint stress on the elbows which are already bowed out. And just for fun try to look at a hip x-ray of a Bulldog. Most of them don't even look like they have a hip socket.

4. Brachycephalic Syndrome. 
(Aka short skull) Our term for what happens when you shove the nose up into the brain. Dogs were supposed to have a nose. When you breed for no nose the anatomical architecture has to go somewhere so the following things happen to the Bulldog.
  • The soft palate, (the fleshy part of the back of the roof of your mouth gets pushed down your throat which makes it harder to breathe or pant.
  • The trachea gets weaker. So what should be a hard cartilagenous tracheal tube is instead a soft collapsible straw. If you breathe in to hard it is like trying to suck an very thick milkshake up a straw. The straw collapses instead of the milkshake going into your mouth.
  • The laryngeal saccules become everted. These live in the back of your mouth on both sides. They are supposed to live in little pockets sort of in the cheek area. But if there is enough stress in your mouth to breathe they become everted. They look like a grape on the walls of your mouth.
  • The wings of the nose are excessive and narrow the noses ability to bring air into the nose. Try to hold your nose about 90% closed and then take a deep breath, impossible right? 
We usually recommend surgery to correct any and all of these so that the dog can breath better.

I will go on to say that in most cases these guys have chronic "atopy". This means that these dogs are genetically  predisposed to inhaled or absorbed environmental allergens. To make it simple anything in your environment can set these guys off. Because we can't live in a plastic bubble we try to "minimize" how many things these guys react to. 

So, our basic advice is to;

1. Keep them on a GOOD flea & tick preventative monthly year around. This is a REQUIREMENT! There can't be any missed doses. We know that the one thing most dogs are allergic to, or can trigger their itchiness is flea. And 1 flea bite can start the whole cascade of itchiness. We all also know that once you start scratching you get itchier.

2. Keep the skin as calm and quiet at home as possible in the hopes that it will reduce the severity and duration of your "bad flare-ups." I ALWAYS go over the things that an owner with a dog with atopy should have at home. These include ear cleaners, Benadryl, medicated wipes, Fatty acid supplements, sprays and shampoos. I do a lot of training of my clients to try to minimize the flare-ups.

3. We always talk about food. I want people to understand that about 12% of the dogs with allergies have a food component to their allergies. I get soo much resistance from owners to try a hypo-allergenic diet. The first thing that they always reply is, "he has been on the same food his whole life." To which I reply, "you develop allergies over time. So although he may have been fine eating beef, chicken, or dairy for the last few years he may now be allergic to them. And, if we can just keep that food out of his body then maybe we won't have the allergy anymore?' "If someone told you that you were allergic to bees then you would stay away from bees right?" I also tell my clients that we want to find something that is curable. Not eating a food that causes your skin to itch is a cure for itchy skin. "You should hope for food allergy, because the rest of the list probably isn't curable."


As a last few pieces of advice I will say; it is very important to know your dog, pay attention to them, watch for any signs of things being abnormal and don't dismiss them. If you see hives give Benadryl. If you have very itchy skin give a bath. If you see your dog is lethargic, having trouble breathing, swelling up like a cartoon character get in your car and go to the Vet NOW!

An allergic reaction can kill.

And lastly, know what you are getting into. Those sweet adorable round snuffly faces and genetic disasters that can cost a fortune. But lord knows I love them!

Remember Pudgie? the bulldog. She came to us with terrible skin.

Wednesday, November 23, 2011

Rabies. Why You Should Worry About It.

While I was at the TNR today I was over hearing one of the Animal Control Officers from Harford County talk about one of the most recent rabies outbreaks. There was a connection between the family who owned the farm where the rabies outbreak occurred and one of our Veterinarians. It seems one of my Vets knows and lives very close to the family where the outbreak occurred. (Talk about hitting close to home, it really did for her). Even if the family isn't a neighbor of mine, they live about 10 miles from our clinic, and about 7 miles from my house. So hit close to home for all of us.

The story goes like this;

One day during the early summer the father was outside working around the house when one of their "barn cats" (barn cats around here means you are not an inside "attended to" kitty, but rather, you are a "you are on your own to fend for yourself" kind of kitty). These kitties are usually allowed to sleep under the roof of a building that you own, but they are not named, petted, or given medical care. The Animal Control Officer told us that the father was attacked by one of his barn cats. The attack was reported as being unprovoked and the left injuries to his leg that were severe enough to require immediate medical care. She was called out to their farm because when you go to the emergency room or hospital and report that your wounds are the result of a bite, the local authorities are called in to investigate.

When the Animal Control Officers arrived it was discovered that this particular cat had never been vaccinated for Rabies. Because the cat had "neurologic signs," hadn't been vaccinated, and it had bitten someone, it was decided the cat should be euthanized. The cat was then sent to the State Lab for its brain tissue to be examined for evidence of rabies infection. Three days later the lab called to report that the cat was in fact positive for rabies. This piece of news set two things in motion; First, the father went to the health department and his physician to start post-exposure rabies treatment. Second, the Animal Control Officers came back to his farm to investigate how many other animals were potentially exposed.

The Animal Control Officers learned that none of their pets were up to date and/or vaccinated for rabies. To insure the safety of the entire family the Harford County Animal Control Officers trapped and euthanized all of their pets. It final tally was over 40 cats. Some were even "indoor only" cats.

To this day the family can't bear the idea of getting another pet.

But thankfully everyone is doing fine.

I tell this story many times a day when I have an owner who wants to decline vaccinating for rabies. I always reply; "First, You, and I  are required by law to vaccinate your pet. It is not an elective procedure. Second, rabies will kill you, why would you want to risk that? And third, it is cheap! $5.00 at the fire hall, or $12.00 at JVC. To cheap to risk this story happening to you."

To read about other rabies cases in Harford county, MD. see the link

You can also read more about my personal rabies scare at my earlier blog. Learning My Lesson The Hard Way.

And the annual rabies report from JAVMA in the Sept 15, 2011 edition.

Monday, November 21, 2011

Sadies, 3 pelvic fractures and still loves everyone

8 pm, 11/21/11
Sadie went to VOSM today for her pelvic fracture surgery repair. So she can walk again normally.

She is the sweetest most gentle girl, and we have all really fallen in love with her. I will send word about her once I have an update.

For now please keep your fingers crossed for her and send a big Thanks to VOSM and Chris for saving her. They are an incredibly generous talented bunch of people. We are all so grateful for her second chance.

I will add pictures and updates as I get them.

Sadie, 1 week ago, the night she was hit by the truck

Her radiograph from the day she arrived with us. the left side of her pelvis has the breaks, the right side is intact.

 Ok, it is 9:30 pm and Chris just texted me to say that he just finished with Sadie's surgery. What a long day for him. I feel terrible that he was working so long and late and hard for our charity case. It seems we always give him the hard, long difficulty surgeries.

He repaired Sage's fractures. See her story, (gosh that was a longtime ago). I remember me, Chris, and my very amazing tech, working on her from 7 pm to 1 am..That was a long night. I can't believe Chris still talks to me. I am a shitty friend. I would dump me.

I'll update you all as I get news. (Although I know Chris will call soon, but I will be in bed sooner) Goodnight world.


Sadie was brought back to us last night late. Because of very rainy weather and lots of traffic. She is a little wobbly on the three good legs and has a bandage over her right hip joint and a plastic e-collar to dissuade her from licking at her incision. But she remains optomistic and as energetic as ever to be loved. She is being cared for by one of my fabulous technicians, who told me when she got back to the clinic that she is getting attached to her already. (She has been her chauffeur for the transit back and forth to the surgeon). So my tech took her home last night to watch her, and so she wouldn't feel alone after her surgery. She wrote the following back to me this morning after I texted her to ask how she did overnight. "She's a perfect little angel. ;-) and doing well. I just keeping telling myself that she's really ugly." It is impossible to resist her big doe eyes and sweet affectionate demeanor. I think my poor tech has fallen hard. It is impossible not to with that face. I replied with the typical "lol." Because I know I can't resist her either.

The bandage over the incision of her right hip, (aka coxo-femoral joint)

Sadie and her chauffuer, (Who is beautiful but camera shy)

You can't resist that face! (My good friend sent me a facebook a message that said,,,"o, I have to squeeze her!" I know the feeling.
 Sadie will have a great Thanksgiving, and I hope you all do too! I will post her post-op radiograph when I get it, so you can see her plate. Very exciting stuff!

Timber, How could the 2nd dog be more tragic than Ruger?

I introduced you all to Ruger a few days ago. I told you about the long difficult road it was to finally get him a diagnosis, and then the incredible struggle it was to keep him happy and functional once we got it.

In the end, after his struggles with finding his disease and watching him through his ups and downs, he died of malignant lymphoma 2 months after his first sign of illness. His story was agonizing to watch and heart breaking for his parents. Through it we became friends and allies in a war against the disease in Rugers body. He was an "incredibly sweet loveable dog, and he can't ever be replaced."

So were the last words I heard from Rugers parents. They said that Ruger was "one of a kind" and that they "could never replace him," and I knew the pain of losing him would take a long time to heal.

I wished them well, told them to call me anytime, and that they were great parents who had a dog that loved them.

A few weeks later I was elated to see Ruger's dad in the waiting room with a rambunctious bouncing curly locked Golden Retriever puppy. I was so happy to meet that little boy they named Timber. Timber's dad was all smiles as we smothered that puppy in kisses and compliments. I asked how his wife was doing? He said he had surprised her with the puppy and she was feeling better now that he was in the house. They were healing and moving on. But they did have lots of questions about whether Timber was a "normal" puppy. They just didn't remember Ruger being so energetic when he was Timber's age. I told them that "all puppies are diferent, and that he did seem a bit more energetic than the average Golden." Secretly, I thought that he was just what they needed. The busier that Timber kept them, the less time they would have to mourn. But it was apparent to everyone that they loved this pup to pieces.

At Timber's first visit he was 8 weeks old. We started him on his first set of puppy vaccines, flea & tick preventative, ran a fecal to check for intestinal worms, and started him on heartworm prevention. We also spent a great deal of time going over our puppy instructions. These help owners understand what we do, what we recommend you do at home, feeding guidelines, and lots of helpful hints.

I saw Timber every three weeks from 8 weeks to 17 weeks old. He grew into a beautiful bouncy adolescent. He was one of the few puppies who was always happy to come in and visit us. Which is quite a big compliment when you are getting multiple vaccines at each visit.

For his last puppy visit, at 17 weeks, I spoke to Timber's dad about what the recommendations for Timber's next few months would be. I gave Timber his last puppy examination and then vaccinated him for his last puppy distemper combination shot, and his last Lyme disease vaccination. I then asked the technician to bring Timber back to the treatment area so he could have his blood taken for his pre-op neuter check. Timber was in the back with the technician for about 5 minutes. While they were in the back I stayed in the exam room because I wanted to ask him for his permission to write about Ruger in this blog. He said that it would be fine. Timber was brought back into the exam room as we were talking about the magnificent dog Ruger was. Out of the corner of my eye I saw Timber squat and urinate on the floor..I thought that this was odd, he never seemed scared or nervous around any of us before. Then within 10 seconds his back end went limp and he sort of fell/fainted. Timber's dad said, "Oh, he must be tired?" But my gut knew better. I lept to the floor, put my hand around his heart, and looked at his gums. His gums were pink, but I'll be damned I couldn't feel a heartbeat. Without any word to his dad I picked up his lifeless 30 pound body and ran through a packed reception/waiting area. I looked like a t.v. show, and I was wishing that this was one. I placed Timber on the surgery table, and got my stethoscope on his heart immediately. Nothing. His gums were now purple. I started CPR and swearing. How could I possibly face these owners? God, the devastation of losing Timber would be too much for them. I was thinking all of this and barking orders at my petrified staff. Within 1 minute we had 2 i.v. catheters in. I had him intubated, and I was shoving massive amounts of life saving heart starting drugs in his veins. Yes, a flashback of Pulp Fiction ran thRough my head. I never stopped the chest compressions and his color very quickly became pink again. Within 3 minutes he had fluids, a drug to increase his heart rate (atropine, see Pulp Fiction) and oxygen. Within 1 minute I felt his heart flutter under my fingers gripping his chest. I was determined and desperately pleading to coax him back to consciousness. I was continuing his CPR and then his heart stopped again. I gave a HUGE dose of atropine in his i.v. catheter. It was my last hope and I was losing all hope. Within 30 seconds his heart regained life and started beating fast and furious. Ok, I did get really nervous here. His heart went from zero to 200 beats per minute. But he was alive! Oh! I could breathe again. Within a minute or two he was conscious.

I took a deep breath and walked back to the exam room. I tried as calmly as I could to explain what had just happened. I brought Timber's dad in the back to sit with Timber so I could keep monitoring him. I begged them to stay another hour, until we closed because I was so afraid I would lose him. Within 30 minutes that puppy was up and jumping around like nothing had ever happened.

I went home that night feeling as if I had just lived through one of the most scary, nail biting, near death experiences of my career.

Timber is doing great. Although it has been too long since I ran that pre-op blood work. I bet they are afraid to come back and tempt fate again. I better call them tomorrow.

Sunday, November 20, 2011

TNR, Tired & No Relief

OK, that's not what TNR really stands for. It is "Trap Neuter and Release." It is the acronym for one method of trying to address the feral cat over population problem. I whole-heartedly stand by it's intended premise. It is designed so that we, (the kind-hearted compassionate group of us who think that cats are the responsibility of mankind who domesticated them in the first place), have a safe responsible alternative to catching and killing because there aren't enough homes for all of the cats in this world.

About three times a year JVC (Jarrettsville Vet, my clinic) hosts the local TNR. The TNR is set up and run by the most kind generous bunch of people. They organize, co-ordinate, set-up, sedate, vaccinate, treat, care for, assist with surgery and dote over some of the saddest felines imaginable. They donate a huge number of hours in making sure that these cats needs are addressed and provided for. Some of these cats have never known human kindness before, and some are down right vicious with fear. But these volunteers never get frustrated or quarrelsome. I quite frankly don't know how they do it. I do however understand why they do it. They all share a desire to help a species that is often overlooked, under appreciated, and often viewed as 'unworthy.' These volunteers all share a love for cats and that in itself drives them to help save these cats from certain death from either euthanasia injection, gunshot, falling prey to other animals, or poisoning.

Dr Morgan (goofily -happily) spays a feral cat.

I understand this affection for felines. After all, I have 6 of my own and I love my kitties dearly. They are the thing I most look forward to at the end of my day. Nothing compares to snuggling up with Wren or Jitterbug purring next to me as I drift off to sleep. They are a big part of the reason I think my life feels so blessed.

Ready to start surgery.
Today at JVC there were 3 Veterinarians, 3 JVC technicians, and about 14 volunteers who made this TNR possible. We all donated about 6 hours of our time to provide very low cost spays and neuters to 43 cats.

So, here is where I take a deep breath. We all volunteered to help make those cats lives better. But for the county we live and work in, Harford County Maryland, I will say it is very upsetting that NO ONE else helps out. NO ONE else volunteers their veterinary facility, their time, or their staff.

Is this frustrating? HELL YES!

Do I understand why? HELL YES, and, HELL NO! There were cat owners driving (multiple) cats to the clinic in their brand new Mercedes. Now this was not the majority of the owners, but please? When was the last time anyone of you, or they, were asked to work for free? I understand why vets are so bitter about this. We went to school forever, (most of us had 4 years of college AND THEN 4 years of vet school), at an average cost of $120,000. Since then everyday of our working professional lives someone asks us to do something for free. I mean how is that fair?

Dr Hubbard and Dr Morgan share a surgical assembly line.

So after every TNR I come home feeling proud of myself for still giving a hoot, and frustrated that I donated my time and weakened the impression of value of these surgeries.

So I understand both sides. I guess I just lack conviction to pick one and stand by it.

To those volunteers today at the TNR at JVC you did an amazing job! and I applaud your generosity, compassion and devotion!

Oh, and whoever made the vegan chili it was fantastic and I loved it! Thanks. I ate three whole bowls.

and a link to discuss the subject further

I was just doing some "web-surfing" and found the following discussion about our county, Harford County, Maryland, where the discussion of TNR came up, and the horrific adoption rates of our shelter. 31% of cats leave the shelter, and 71% of dogs. Very sad. Please read the blog and discussion and chime in!

Saturday, November 19, 2011

Ruger's Ominous Mystery Illness

Ruger’s story began in April 2010 when he came into JVC (Jarrettsville Veterinary Center) because he had a decreased appetite and was vomiting. Ruger, a 7 year old Golden Retriever, is owned by two of the nicest people and they adore him. He is a 70 pound gentle, docile, affectionate boy. He is charming and irresistible.
On his first visit we treated him like we do many acute gastro-intestinal disease dogs. We took a full history, gave him a thorough physical examination, offered to run some basic diagnostics, (but didn’t force because he was “acute”) and treated conservatively with anti-nausea drugs, subq fluids, and gastro-protectants. Three days later his owners called back to say he had begun to vomit again and now his stool was loose. This time his owners elected to run the recommended basic diagnostics. 
We ran bloodwork, took x-rays, and went over the history again to make sure nothing had changed or been overlooked. This time we learned that his food had recently been changed, and he wasn’t on heartworm preventative. So we ran a heartworm test, it was negative, thank-goodness, and put him on a bland commercial diet. We also learned that Ruger had had seizures in the past. His bloodwork came back inconclusive (a nice way to say, thanks for paying for this but saddly it didn’t really help us get an answer). But a day later Ruger was feeling better.
10 days later and Ruger was back. OK detectives here where the years of sleuthing pay off! So let’s go back over his history so far. Because we now have all of the clues we need to help steer us in the right direction.
·         7 year old Golden Retriever; unfortunately for Goldens this is the time we start looking for cancer. These guys are cancer factories. They all die of cancer!
·         Waxing and waning disease. Big red flag. There is something going on. The dog knows it, so you better start digging, it is there lurking somewhere.
·         Vomiting and loose stool/diarrhea means you have something going on in the gut. These cases frequently wax and wane so take serial weights. The scale doesn’t lie. He was 70 pounds his first visit, 68 the second, and 64 the last.
He now needs to be watched very closely. Any small note of concern is reason for discussion with the Vet.
He returned 4 days later, now it was 2nd of May, with the complaint “still not eating or drinking.” His stools were getting even looser. His owners were offering anything and everything to peak his interest in food, but very little of the offerings were being contemplated or taken. We recommended they repeat the blood work and radiographs but they declined. (I think that initially this was acceptable to decline but now it should have been repeated. Just because the blood doesn’t indicate something on the first try doesn’t mean that it won’t later. I say this a lot; “Your body knows there is something wrong before the lab does.” Trust the dogs word over the labs!) We also recommended an ultrasound.
Ultrasounds are a much more sensitive way of looking inside the abdomen. Radiographs (slang = x-ray) are great for bone, but an ultrasound allows you to see the internal soft tissue architecture that is the contents of your belly. That’s why we use ultrasound for fetuses, and x-ray for broken bones.
The May 2nd examination also revealed a depressed and dehydrated Ruger. I think most people significantly underestimate how important good hydration is. A day of not eating or drinking normally or a few episodes of vomiting can cause significant dehydration. Once the dehydration snowball starts every hour makes it exponentially and significantly worse. This is why we Vets tell owners to bring your pet in when you call and tell us your pet has been vomiting and/or having diarrhea. The Vet who saw Ruger on this visit had only two rule outs for his possible diagnosis; gastrointestinal disease and cancer.
By May 5th  Ruger still wasn't eating or drinking. At this point everyone at the clinic was worried enough to start talking about referring Ruger to a specialist. This and repeating the bloodwork was declined. We also scheduled them for an ultrasound in 2 days, (the soonest we could get it) and we added medications for diarrhea. We offered to run the diagnostics as soon as the owners wanted. We received a few phone calls updating us on Ruger. He was doing better, eating better, and his owners believed he was back to normal: disaster averted, and ultrasound cancelled.
On May 20th Reuger vomited bile. His parents scheduled an ultrasound for ASAP, which was 5/25. The ultrasound finally hit pay dirt! Thank goodness, after all of this it was time to start finding a villain to point the finger at. The ultrasound found “the mid to distal (away from) small intestine revealed a significant infiltrative pattern with loss of detail, (something is there that is mucking up the normal architecture).. strongly suggestive of lymphoma or carcinoma (bad and worse cancer). Intraoperative ultrasound would be warranted." Another word’s the Internal Medicine Specialist reading the ultrasound thinks that the abnormal tissue won’t be seen grossly during an exploratory surgery. He recommends the surgeon be ultrasounding their way through the abdomen so we don’t miss the abnormal spot. Problem with that is it is waay expensive! I discussed the ultrasound findings and suggestions with Ruger’s parents and they decided to have me just go in and do the old fashioned exploratory surgery. (Ok time for my personal admission, I LOVE EXPLORATORIES! I love the whole treasure hunting, never know what your-gonna-find mystery, so fun I can’t even stand it!)
One big deep breathe and all doubts of ability cast aside the ext day Ruger was in surgery. I made my midline ventral abdominal incision and entered Ruger’s belly. Lucky for all of us I found a big abnormal mass in the area of the stomach. It was easily removed and Ruger’s worrysome surgery ended quickly and without fanfare. His intestinal culprit was put in a bottle and sent off to be fixed in formaline, shaved into little slivers, and scrutinized under a microscope. 5 days later we had a diagnosis for Ruger. It was lymphoma. His biopsy report read “intestinal mass: malignant lymphoma..the long term prognosis is poor.” With these words Ruger was taken to an oncologist for a treatment plan and a miracle.
Getting the already not eating Ruger to eat after having been opened and explored was not happening. He protested for days, and refused every morsel offered. We were also struggling with keeping his total protein, (specifically albumin, the tiny very important vital to life protein so that your blood actually stays in your vessels) in the normal range. He became so weak and lifeless that we were forced to give him a plasma transfusion. As happy as I was to have a diagnosis I was concerned I might lose my patient before we got to the treatment part. Even with the transfusion he wouldn’t resume eating. So we turned to drugs, and within a day those drugs had him eating. Ruger took his second wind and ran. He did great for a month. During this time he started his chemotherapy and we all regained our hope for his recovery and conquest of cancer. Because he was doing so well and because there are detrimental adverse effects to long term drug use we started to taper his drugs. But unfortunately as we started to taper him off of these drugs he started to turn his nose up to his food. Within a few days we ended up right back at transfusions and those same steroids and appetite stimulant drugs.

Ruger spent his last three days at the emergency hospital. They were suggesting he continue with the transfusions. His parents called me in deep despair seeking advice for what they should do. I knew by their voices that they wanted Ruger to be cured, but understood he wasn’t going to be. They wanted someone to give them advice based on what was right for Ruger and not what was right for the cancer. I told them that Ruger had given up a long time ago, and that keeping him alive in a hospital wasn’t what he wanted. He was weak, and tired and ready. They were so grateful for the permission to let him go. They just couldn’t say it and they didn’t want to admit it.
There were many conversations exchanged between us after Ruger passed. There were words of sorrow, acceptance, and grief, and many, many tears. I was sad to say goodbye to Ruger, but I was more saddened by the thought of not seeing his parents, or worse yet, not seeing them and knowing that they didn’t want to love another dog, or love anything again, because it hurts too much to lose a pet.
A few weeks later Ruger’s dad came in with an eight week old Golden that they named Timber.
Oh, Timber, you are another story! Cutest puppy ever, but his story, that’s another tale of drama and…oh, its too good to leak..stay tuned!