The Common Goal

There is no argument that the focus of everyone's immense efforts here is the animals. 

Me, and the compound kitty, Mitsi.. I do LOVE her!

To have such a strong common goal is the only way this many craggy, crazy people, all deprived of sleep, food, warm comfortable beds and all of the amenities associated with running water, AND, being from all corners of the UK, (and me the single American), could coexist together for weeks on end. Life here is complicated, and full of tragedies. People are trying to live normal lives, but, it is obvious that isn't possible here. Because of the poor living conditions, the overarching fear of air raids, bombs, and all of the insecurities war can present it is difficult to lose your way if you don't have a common goal and purpose. It is the glue that keeps us cohesive. If we didn't have this I am sure all of the ragged edges of all of the hardships would crack us. I am also sure that I am the person who fits in the least here. (I think I am proud of that.)

The depth and width of the pet dilemma that is here is oceanic. Mind boggling. This is a country that has very few frivolities. Dogs roam. Cats roam. People trudge in ratty clothes, and everyone sweeps bent over, scoliosis, kyphosis, nose to the dirt, sweep, sweep, sweep. An old country, old people, old stories of war, a country of tales of having been claimed by others, broken away from them, the castaway step-child and the weight of the world with whom you never know who you will saluting to lives here. These people have so much to manage already that the pets, the kind animals, are stepped over and passed by. To be honest there is probably no way to even begin to suggest an end to this mess. As the war drags on the problems deepen, intensify and coalesce. The lesion this began as has become a metastatic cancer of a wound that never received adequate treatment to begin with. How do we try to end the plight of these animals when we started at accepted indifference?

The animals here, at the compound I stay at, were all extracted (the term they all use) from the streets and abandoned shelters after they lost their residencies to the bombs that their homes became Russian targets of. They are all scarred. Some with obvious wounds, others with anxiety based fear so deeply embedded you don't want to know the source, or, excise the reason. You just assess, be kind, exude confident optimism and take small steps one heartbeat at a time. I am a fixer. I am wired to examine, dissect, treat, cure, and claim victory. here, each of these must be set aside. Reduced, and simplified to simply what I can do in the right here, presently, now. I will go mad, abandon the cause if I try to practice medicine like I do in my well controlled, everything accessible home. There are almost no spayed or neutered animals here. I assume with every tragic life threatening ailment that they come to me with they are also passing it forward to the half dozen offspring within them. Great, the problem multiples as I gaze upon it. There is no end. No finishing point.

The dogs here at the compound came from a shelter in Alexandria Ukraine. The shelter before the war used to run with a capacity of about 40 dogs and cats. When the war hit the numbers surged to 400. When the staff could no longer manage the animals and the war they reduced the care to feeding alone. No cleaning and no exercising. When the threat of further invasions and insecurities presented the shelter staff had to make an even more perilous decision. They opened the cage doors so the pets would not be left to starve. The group when in weeks ago to find many of the animals set free from their cages. The scene they came upon was about 150 animals alive the rest in some form of eaten. It is what we would all be faced with if 5 weeks went by without food or water. The weak, gentle and submissive were not who were left to rescue. Most of these dogs are German Shepherds. All are thin, matted, and apprehensive of humans. this is what war looks like. The war of abandoning human kindness and compassion. It is the face of people we should never be reduced to become. It is also why I am here.

I wonder if as the days pass that I won’t grow more indifferent to this place then desiring to stay and help? It is the same dilemma I face at home as a veterinarian. Do I give up as others have to save my fragile soul, or provide it with barricades shrouded in tattered clothes and fight on?

Cryptorchid Neuter Canine. What Happens When Your Dog Doesn't Have His Testicles In The Scrotum?

This is Cash. He is an 11 month old German Shepherd.

He was purchased from a private breeder at 8 weeks old. At his first examination I, his veterinarian, found that only one of his testicles was in the scrotal sac where it belonged. He also has a small umbilical hernia.

Umbilical hernia in the center, shaving the scrotal area for the neuter.

An umbilical hernia can be a very dangerous finding in puppies. If the hernia (a hole the communicates with another adjacent body cavity, in this case the abdomen), doesn't close like it is supposed to then the contents of one space can possibly move between them. In Cash's case his intestines could slip out the open umbilical (belly button) hole. If a piece of intestine slips out we worry that it can twist and strangulate, therefore, inhibiting gut function. This can be fatal. All hernias should be checked by a veterinarian frequently to decide if, or when, surgical intervention is needed. Not all need to be closed, or require surgery, but all need to be monitored very closely and if the hole is big enough to let abdominal contents slip through surgery should be planned as quickly as possible.

Correcting the umbilical hernia

My bigger concern for Cash was his undescended, unpalpable testicle.

The testicle in the abdomen.

Abnormally small (the retained, intra-abdmoninal testicle) on the left,
and, the normal testicle (one in the scrotum) on the right.

Cash was seen by me every 3 weeks for his puppy examinations and vaccines. His missing testicle never made an appearance. At his 6 month exam we discussed giving him another few months to let gravity and maturity see if it could coax anatomy into its correct position. At 10 months old he still didn't have two palpable testes so his family elected to neuter him, correct his umbilical hernia, and perform an exploratory surgery to look for the missing goods.

Pre-op bloodwork ($60 for a partial chemistry and CBC) was done and returned normal.

Surgery included; umbilical hernia repair.
pre-scrotal neuter of the left teste.
abdominal exploratory surgery to find and excise the retained left testicle.

Cash did very well under anesthesia and his testicle was quickly and easily found in the caudal part of his abdomen by his urinary bladder.

cost for surgical care was;
anesthesia, $215, approx 90 minutes
medical pet shirt; $28
suture material; $150
NSAID, for analgesia; $20
antibiotic $$30
hernia repair $75
e-collar $15
castration cryptorchid $300
total about $930

Related Blogs;

Retained Testicle In A Dog.

If you are interested in help for your pet and don't know where to go please find us here at Pawbly.com. It is a free online community dedicated to educating and inspiring pet people everywhere. It is free to use and open to everyone.

I can also be found at Jarrettsville Vet in Harford County Maryland. Visit our Facebook page here, or see our online Price Guide at our website jarrettsvillevet.com

Scrotal Ablation, Diesels Nip and Tuck

This is Diesel. He is a 16 month old Newfoundland who was at the clinic for his neuter. He, as a giant breed dog, was neutered a little later than the usual 6 months old that we typically recommend to allow his body to grow. There has been some debate about when it is most beneficial time to spay and neuter the larger breed dogs. Diesel's family had also decided to neuter him and remove the excess skin of the scrotum. The older a dog gets the more the scrotum stretches. Some dogs have excessive scrotal skin and their parents elect to remove it at the time of the neuter. We call this a scrotal ablation.

Typically we neuter a dog by making an incision in the area above the scrotum and remove the testes through it. Testicles are attached to the body with two large vessels that are tied off and removed. It is not typically a difficult nor involved surgery,  but it does leave behind the sac of tissue that the testes used to live in.

For those male dogs that are neutered before a year old, and especially those that are smaller breeds, the scrotal skin will shrink and adhere to the pelvic area in the following months after the testes are removed. 

For those male dogs that we neuter later in life the scrotal sac can become stretched and a pendulous skin sac remains. This is in almost all cases merely a cosmetically unpleasing remnant that long haired dogs can hide easily. 

I have had some older shorter legged dogs whose scrotal sac became so long and pendulous that it became ulcerated and abraded to the point of needing to be surgically removed.

For Diesel's neuter the entire scrotum was removed along with the testicles.

The skin in the inguinal area is closed with ample skin sutures to hold the tension of an active dog. 

Diesel, the finished product.

If your dog has excessive scrotal skin talk to your vet about whether an ablation is also indicated for your dogs neuter.

At our clinic a dog neuter is $225 and the scrotal ablation is an additional $150. Diesel was also prescribed an NSAID for pain and inflammation and in  some cases an e-collar. The boys under 6 months old rarely investigate their incision sites, but those over 6 months might and we prefer for you to be ready to put an e-collar on and not wake up the next morning with an open incision.

I am happy to answer any pet questions, and they are always free, if you meet me atPawbly.com. Pawbly is a free open pet community dedicated  to helping pet people by educating and inspiring those of us devoted to our pets.

 I can also be found at the clinic, Jarrettsville Vet, in Northern Maryland. Or find me on Twitter @FreePetAdvice.

Henry's Big Day. Neutering a Small Breed Dog

Henry and I on Sunday December 1, 2013.
He was at the clinic for our annual Pets With Santa event.
Coincidentally this was the day before his neuter.

Henry is a 7 month old Yorki-Poo. How is quite possibly the cutest scruffy pup you will ever see.

He has been to the clinic almost weekly since his parents adopted him at 8 weeks old.

There are a few important things that a small breed puppy needs.

First, every new puppy (or pet for that matter), should be to visit the vet within their first three days with you.
Bring your puppy and a fresh fecal sample.

Also, bring a list of questions. Your first visit (and every one thereafter), is the time to get your feet solidly in the ground.

For small puppies, (or sensitive dogs), I recommend splitting up vaccines. You are more likely to see a vaccine reaction if you give multiple vaccines. Smaller dogs seem to be more sore after vaccination also. The advantage to splitting them up is that we can reduce the likelihood of soreness and if you do get a reaction you know what vaccine caused it. The disadvantage, well, you have to make more trips to the vet. At my clinic, however, you will not pay for a separate office visit if we decide to split up the vaccines. But this is something to ask at your first visit. The cost of a vaccine is somewhere between $10-$30, but an office visit might be $30-$50, or more.

Another note on vaccines: All vaccines have the potential to cause a reaction. It doesn't really matter how many times a pet has been vaccinated, had the same vaccine, or whether they have never had a problem before. It can happen at anytime and with any vaccine. For this reason, I always recommend that you vaccinate your pet on a day that you can be with them after the vaccines have been given. You should also have the vaccines given as early in the day as is possible. Nothing worries me more than vaccinating a pet with known prior reactions 15 minutes before closing time. The worst reaction (anaphylactic shock, respiratory or cardiac arrest, or even death) is most likely to occur within the first few minutes to hours of the vaccine. Pets with known previous reactions should be watched very closely for a few hours after their visit. Some of my patients stay in the clinic for about 30 minutes after in the reception area so we are steps away from help if needed. Assume a reaction might happen and be prepared for it. But, remember vaccines save countless lives so please keep your pet vaccinated, and if you do have a problem talk to your vet about it. There are lots and lots of options!

At the puppy visits we discuss basic training, housebreaking, leash walking, socializing, behavioral concerns, any special breed health concerns, how to successfully get your pet used to having their teeth brushed and nails trimmed, etc.. We also set up the vaccine schedule for the first four months (or longer if you started late) of age. Spaying and neutering age is usually about 6 months old.

Henry dressed up in our ravens room.
Looking so dapper!

For Henry, like most small breed dogs, we waited and watched for his deciduous (baby) cuspid (canine) teeth to shed. This is never normally a problem in the larger breed dogs, but many smaller  breed puppies do not shed. These can cause significant and severe dental disease, tooth decay and affect overall health and longevity. If the teeth have not fallen out by 9 months old, they probably never will, so they should be removed under general anesthesia either with the spay/neuter or as a separate anesthetic event.

In Henry's case we waited until he was 7 months old in the hopes that they would depart on their own accord.

When they did not we scheduled his neuter and removed them.

Lucky for Henry, our resident dental expert was on hand. She removed his baby teeth as I removed his testicles.

Dr. Hubbard, our resident dental expert works on the front end, while I neuter the back end. Only the luckiest of dogs has two vets to work with them at the same time!

A prefect extraction!
The entire tooth was removed and the adult tooth was not damaged
or jeopardized in the process.

Henry also has vestigial rear dewclaws. Puppies should have these removed between days 2-5 after being born. Henry was not adopted from a breeder who followed this. So we removed them at his neuter.

Many clients ask me about dewclaw removal, (I have been asked to remove them from 10 plus year old dogs). The discussion about removal is multi-factorial and needs to be a discussion with your vet. Don't just ask them to remove them without your vet examining the feet and discussing the surgery.

For Henry the rear dewclaws were not articulated with the foot. They were what I refer to as "just hanging in the breeze." They had nail, but they were small. These nails will grow and bleed if you cut them too close, but becuase they are not held close to the leg they often catch on things and can tear easily. Because they are not articulated (joint and bone attached to the foot) they are easily surgically removed. Removing them at the time of neuter saves having to risk anesthesia and pay for a another surgery.

For those pets with dewclaws that are articulated (tightly adhered to the leg/foot), then we talk about why the client wants them removed. Most clients want them removed because they are cosmetically not pleasing. The client had expected they would have been removed before they adopted their puppy, or they are not comfortable trimming nails. Because these nails are not in contact with the floor they are not worn down naturally so they need to be trimmed. Nails should not be surgically removed because a parent can't (or won't or is afraid to) trim nails. Also those dewclaw that are held tight to the foot (articulated) must be surgically amputated at the joint that is at the very base of the toe. This can often cause a long (anywhere from an inch to multiple inch long) scar. The hair may, or may not grow back over this scar. The cosmetic after may not be as "pleasing" as the owner expects.

Henry's caudal half, post-op. He has some abnormal scrotal erythema (redness) and needed an ice pack post op. He also has two one inch incisions to remove his dangling dewclaws.

Waking up.

I don't bandage the feet unless I am worried about bleeding and want to keep pressure on the incision.

Bandages, in my opinion, are just a cover to hide potential disaster. They get wet, they hold in infection and they provide the perfect hiding place and environment for badness, warmth, humidity, and secrecy! Bandages in my hands are only used for very limited periods of time and under very close supervision. Bandages need to stay dry, be removed as soon as possible if they get wet (water or blood) and never be on longer then a few days.

Now he is awake!

Going home with momma! And an e-collar!
The more incisions you put in a puppy the more they want to investigate them!

Post-operatively for the tooth extractions, Henry should be offered softened food (either add water to dry food and let it sit until softened) or wet food for the first 3-7 days. A healthy mouth will heal very quickly after a tooth extraction, if it is done with minimal trauma, clean techniques, and surgical closure after. 

For the neutering Henry had a cold pack applied to the scrotum to reduce redness and aid in the discomfort of the incision.

For the dewclaws we keep them clean, dry, monitor for infection. Use booties if he goes outside and it is muddy, snowy, etc. 

For more information on puppies;

The Puppy Primer, The First Instructions

Crate training Your Puppy

Housebreaking Your Puppy

Puppy Diets

Baby Teeth Blog

If you have any pet questions you can find me at Pawbly, or on Twitter @FreePetAdvice.

Surgery Monday, Aug 28, 2013

I'm too tired to fill in the blanks tonight..

But here's what my day looked like:

Three sphinx kittens to neuter..and their mom standing by as the recovery ward.

And for our local rescue we did three kitten neuters, and two kitten spays..

And lastly, a laceration repair on a lower eyelid.

And at the end of every day I get to head back home to be with my own bunch.

My Savannah, at 17 1/2 and still happy to see me at every single occasion and happy for a thick lawn of grass to stick her nose in to breathe in a life she remembers not too long ago.

My husband and our Jekyll,,,two peas in a pod

For many people the idea of working with animals everyday is a dream.

For me it is my real-life, and my purpose..

Happy end of Monday everyone!

Problematic Peeing Puppy, Is It Behavioral Or Medical?

Today's Pawbly question..

I have an unneutered 7 month old aussie-poo mix who wont quit peeing and spraying every where. The last week he has hiked his leg on people's faces, legs, my tv, and all over my walls. We take him outside every hour, but nothing works. He just does it even worse outside. I have run out of ideas for what to do that might actually work. Any advice?

Barks and Blooms replied;

http://www.barksandblooms.com/

Hi Christie--An Aussie-Poo! What's his name?
My first thought is neutering help with this issue.
It sounds like it may be more of a territorial behavior rather than a potty training issue.
Here is a great article with information on why this is happening and what to do about it. It suggests neutering an intact male to reduce the spraying, but also offers solutions if you choose not to neuter. Please let us know how he progresses!

http://pets.webmd.com/dogs/urine-marking-in-dogs

Barks and Blooms gave great advice! Many Thanks to them for helping Christie,

I added a few thoughts just from the DVM point of view, 

Hello!! Everyone!!

Certainly in a 7 mo old puppy I would ask your vet about neutering. Lots of boys like to "mark their territory" with urine, BUT, the other concern is a urinary tract infection. It is not as common in younger puppies but it is a possibility, and the longer you wait to treat a urinary infection the more difficult it can be. Also, an untreated urinary tract infection can lead to a kidney infection which is VERY VERY bad.

The ASPCA has a wonderful blog on spaying and neutering, it is included below. It can help you talk about and think about neutering. If your puppy is marking then neutering ASAP is the best way to curb the unwanted behavior.

http://www.aspca.org/pet-care/spayneuter/spay-neuter-top-ten.aspx

There are some pee pad diapers available commercially, but if your goal is to stop the peeing then you need to identify and treat the underlying cause. Pee collection diapers just help collect all of the pee, and that means changing a lot of diapers.

If you need any help discussing any of these I would be happy to help.

We are all so excited to be able to provide a platform for so many viewpoints and we hope to be able to provide lots of resources for people and their pets world wide!

http://www.pawbly.com/

Here is why I recommend spaying and neutering;

Many new pet parents wonder about spaying and neutering. It is one of the most common questions I am asked at a new puppy and kitten examination.

At every new puppy/kitten exam I discuss the timeline for care of their new addition.

In general puppies and kittens visit the veterinarian every three weeks between 8 and 16 weeks. At six months old we recommend spaying and neutering.

Here are some of the reasons why we recommend spaying and neutering.

In case you aren’t familiar with the terms, spay a female, neuter a male.

Spaying is removal of the female reproductive organs. This is usually the removal of the uterus and ovaries via an abdominal incision.

Spaying a female before their first heat cycle will significantly reduce their chances of ever having mammary (breast) cancer. (It is reduced to almost zero). Mammary tumors affect both dogs and cats but is often aggressive and life-threatening in cats. If you ever feel bumps or abnormal tissue around your pets nipples please see a veterinarian.

Spaying will help your pet live longer.

Spaying will help your cat be a better pet. An unspayed cat will go into heat, usually for 4-5 days about every three weeks, during breeding season. When they do they often call loudly, usually at all hours of the day and night, and act erratically. Some will even spray urine to attract a male. This is very annoying and drives some pet parents a little crazy.

Spaying your pet will help prevent pet over population. There are millions of unwanted pets who cannot find a home. By spaying your pet you will be helping prevent another unwanted pet from being the victim of a society that euthanizes unwanted or un-owned pets.

Your pet does not benefit from having a litter, neither does allowing your pet to have a litter help your family understand responsibility or biology. A pet that is allowed to have a litter is allowing a nation of over populated pets to be burdened further. Teaching responsibility starts with teaching to be kind and compassionate. Do you know where those babies will go? Can you afford to care for all of them in case you cannot find a forever loving home for them?

Not spaying your pet can lead to the additional expenses. This includes veterinary care, vaccinations, de-worming and spaying and neutering if you cannot find them a home.

Neutering is the removal of the testes from the scrotum.

Neutering removes the chance of testicular cancer and significantly reduces the chance of prostate problems in dogs.

Neutering also reduces the roaming of your dog. They will not be driven to stray to find a mate and it will help keep your pet safely in your yard or home. Unfortunately, many dogs are involved in traffic accidents or hit by a car because they are driven to roam to find a female in heat.

Behavior issues may be curbed or avoided by neutering. Aggressiveness and marking with urine are more common in intact males. If you wanted a pet to be your companion then it is in both your and their best interest to spay and neuter.

An unneutered cat will often mark or spray your home and your belongings. The urine is very strong smelling and can be difficult to remove. Neutering your cat before 7 months old will help prevent this behavior from being displayed. If your cat starts to spray see your veterinarian and have him neutered as soon as possible to try to stop this.

Spaying and neutering requires veterinary assistance. There are affordable, low cost spay and neuter clinics available in almost all cities in the U.S. The anesthetics and procedure are routine and very safe. Anesthesia has inherent risk but there are many ways to diminish the risks to your pet. Ask your veterinarian for information and recommendations about these surgeries.

If you decided a pet was something you wanted to share your life with then you decided to have a pet for the love and happiness they bring. By spaying and neutering you are helping to prevent disease, provide a safer home, save other pets from pet overpopulation and provide for a happier longer life with your pet.