Wordless Wednesday, September 11, 2013

Jekyll waking up in the morning.
Every night he sneaks into bed and sleeps like an inanimate sand bag at (or on) your feet.
Waking up is a very elaborate exaggerated process. 
It is good to be Jekyll beagle.

Cooper. At four months. Here for an acute case of diarrhea.
Cause? Re-crate training because occasionally his mom has to go to work.
Read about his stress induced colitis soon.

Buried in between his parents for his exam.
Only visible by a darting tongue "hello."

Our weekend adventure; The York Fair, York, Pennsylvania. The oldest fair in America.

Joe and I have a few items on our checklist every time we go.
First stop ALWAYS the fowl barn.
I am predicting the next designer pet fad is going to be fancy chickens.
These guys are flamboyant and fabulous!
And they fit in a purse!

Magnificent, but hard to accessorize.
But he makes a very impressive lawn ornament. 

A pile of pretty pigeons.

As impressive as the chickens were, I am partial to the bunnies.

This is a Lion Head rabbit.
Oh, goodness did I want to smother this baby in kisses!
Have you ever seen anything as adorable as this powder puff?

Back to work on Monday!

Anyone remember Lilly?
She was at the clinic this week because she ate a piece of carpet.
Berber carpet is like a fishing line in the gut. It is a nightmare in most cases to pass.
Very, very lucky for her it appears between the vomiting episodes and the tid bits found as her parents sifted through every bowel movement it looks as if it is all out of her..

Beau, who recovered so beautifully from puppy strangles. He will be neutered soon. He was scheduled for Monday, but he still has his upper baby canine teeth in, so we postponed. None of us want to have to put him under general anesthesia twice.

Also on the Monday surgery schedule was Elliott and Kit's pin removals. Both four months old now, they each had broken legs that were fixed by placing stainless steel pins in them.

Elliott getting ready for surgery. 

Elliott's two pins.
They stick out of the end of his femur.
But have kept it stable and allowed it to heal very well over the last month.
Thankfully they were very easily removed.
Elliott was also neutered.

Kits pins were not as easy to remove. They were buried in his knee.

Kit's x-ray.

Both Kit and Elliott waking up (or sleeping) after surgery.

We met a fully Raven adorned Ranger puppy. Who is about the most charming love. Even Brady got caught up in his adorableness!

Meet little Sheldon.

And Sally.

Back on the Monday surgery schedule. Lilly with a cruciate repair. She was one of the happiest patients we have ever had. I am pretty sure she thought that she was just here for summer camp. She loved all of the attention, and she got a lot of it!

Shaving and prepping the knee for surgery.

And six more kittens to be spayed and neutered for No Kill Harford. I think (hope) that we are getting to the end of the 2013 kittens. There were three all black ones and 3 tabby's.

Three boys sleepy post op.

And they are awake! And hungry!

And little Samoa was spayed too.
Remember her?

More patients to meet.

If I ever needed a spokesperson I would nominate her.
That face!

Two peas in a pod.

And on a happy note. Little max, who came in last Thursday evening not feeling well and with a terrible fever, went to the Harford Emergency & Referral Veterinary Services for two days of fluids and hospitalization came back to visit feeling much better.

He felt so good he gave us a little paddling hello.

Stella.
A hunting dog who made a trip to the ER because she was peeing blood as she was retrieving doves.
She is a great case to discuss.
Stay tuned.

Lilly, the day after her cruciate surgery and wearing her e-collar so she can't pull out her sutures.

What a smile!
This is Jasper the Border Collie.

And Jasper.
A two year old who had to go through three other homes before he found one where he was understood and loved in spite of being a bit if a rambunctious puppy.

Jekyll.
Waking up again.

And lastly my Savannah, with Oriole. 

One last note. On this day twelve years after the tragedy and terrorist attack on the twin towers I hope that we all remember how lucky we are to live in the greatest nation in the world and understand how delicate freedom is. We are a nation of so many different people who came together in a moment of unimaginable loss. My heart and thoughts are with all of those who lost loved ones.

God Bless America.

When the Price Tag is the Show Stopper

There are not too many Pawbly questions that I carry over into my blog. But every once in a while I get hit by a question that reminds me that my primary duty is to help pet parents. Whether they be near, far, wide, rich, or unfortunately, in many cases, those people trying to take care of their pets and live within  budget.

Here is the question that Damion asked us today on Pawbly:

We adopted a kitten about 3 months ago. She is now about 5 1/2 months old. Normally she is VERY playful cat, jumping and running all over the place. Yesterday when I got home she was laying down and instead of her usual come up and greet me, she continued to lay there so I knew something was wrong. When she attempted to get up she was not putting any pressure on her back leg. She did this about a month ago as well but was fine after a couple of days so I figured it was a simple injury. As bad as it seemed this time, I knew it was more serious. We took her to the animal hospital last night to find out she has severe hip displasia and bad knees. Her one hip is now disclocated and would not stay back in after sedating her and attempting to relocate it. At his point we are told the socket joints are too shallow to hold the femur bone in. The surgeon said the one side is dislocated and the other MAY dislocate in the future as well. He suggested we do a femorial head resection surgery (or FHO) on the disclocated hip and we can do the patella luxation surgery on the knees, but the total cost is around $4,000. This doesn't even include surgery on the other hip. We don't have the money for the surgery and we don't want to take her to a shelter where they will put her down. The shelter where we took her from said they can do an evaluation to see if she could be surrendered but that would only place us on a waiting list and more than likely she would need too much attention and care to be able to take her back. We want to keep her and nurse her back to health but we don't know what to do. She is on pain meds now and doesn't seem to be in pain but is walking very little. She is eating and drinking but is not really using the litter as she really can't climb in. Please let us know if there is anything we can do, some financial assistance possibly? Thank you.

Here is my answer;

Hello Damion,

I am so sorry to hear of your kittens mis-fortune. What a terrible set of diagnoses.

It sounds as if your kitten may have some congenital rear leg deformities which left her susceptible to luxation of the hip(s). If the surgeon said that both hip sockets were shallow then she certainly may be at risk for dislocation of the contralateral (other) hip.

Without having the x-rays, and performing a physical examination (and because this is the internet, and I couldn't diagnose without seeing your kitten and discussing all of the concerns with you), I would strongly suggest that you ask for and seek out a second opinion. Maybe from a general practitioner who is comfortable and proficient in orthopedic surgeries in kittens? (A good hint here is to call ALL of your local rescues and ask them who they go to, or recommend, AND ask ALL of your local veterinarians too).

Many general practitioners are able to do this surgery and often they are significantly less expensive than a surgeon.

I have also seen some success in people starting a Facebook page, or local petition to ask for funds to help subsidize their own veterinary expenses.

For example I know of a client who had 2 kittens with fractured rear legs. After some networking and searching he was able to get both of them fixed for $500, (after receiving estimates for over $4,000) so it is possible.

As a last mention. There are many kittens and cats with limited mobility who live happy lives by their parents making adjustments to their home environment. Think about significantly reducing the size of your kittens living area so that she does not have to walk a great distance for any of her routine needs, i.e., litter box, bed, food, water, scratching mat, etc. If her rear legs get too weak there are carts available to help support their weight and assist in mobility. (See (http://www.handicappedpets.com/).

If you are anywhere around my neck of the woods I would be happy to help your kitten with an examination and discussion, or maybe even surgery?

I wish you the very best of luck and hope that you can find some help for your kitten. I also hope that she can stay with you, and that you can help her regardless of her current, or future handicaps.

Sincerely,
Krista

For those of you who don't know which kittens I am referring to see; Elliotts story. Or Kits story.

Cats. The most popular pet and yet the most neglected.

Goodness Gracious! Can it be?

Yet another article on how Americans pay so little attention to their cats? The dilemma du jour, du decade..for the last forever..is..how to resolve the mindset that cats, although the most popular pet, are also the most neglected when it comes to veterinary care.

Another four pages of an article of why's:

• Why do cat parents not get routine care?
• Why do they think that they don't need to?
• Why are cat parents afraid to bring their cats to the vets?
• Why can't vets figure out how to overcome the cat parents obstacles to not seeking routine care?

A few studies and programs the article references that have been designed and implemented over the last few years to help understand the whys? and help address them. They are;

• Partners for Healthy Pets.
• Bayer DVM.
• Cat Friendly Practice 

The statistics the article shares speak volumes as to the magnitude of this problem.

• 83% of people bring their cat to the vet within the first year of ownership.
• After that the number drops to 48% per year. Almost half of people stop bringing their cat to the vet after their first year!! Shocking! 
• Worse yet, about 20% of the veterinarians surveyed had not brought their own cats in for an examination during the past year. 

The points this article presents are;

• How do veterinarians help encourage more visits? 
• How do we educate people about how important routine care is? 

Well, apparently we better do all of that at the first visit. We now have to discuss all of the kittens first year needs, litter box issues, diet, behavior, spay/neuter, indoor and outdoor concerns, de-worming, hairballs, exercise, AND NOW, everything else for the rest of that cats life, JIC you never come back? OR, be optimistic and hope you are part of the 48% and open a dialogue about why it is so important to return in a year.

The numbers behind this article from the studies that have been conducted help fill in the sad statistical gaps.

• 70% of people acquire their cat for "free." (How much does it cost you to adopt vs "free").
• Nearly 40% of cat owners surveyed don't think their cat needs yearly vet visits.
• Nearly 40% of cat owners surveyed who become stressed when thinking about bringing their cat s to the vet. 

There are so many reasons.

• Cats are perceived as being self-sufficient and reliant. That their survival instincts give their guardians a false feeling of not needing much more than food, water, and shelter.
• It is thought that because many of those "free" cats don't get veterinary care and therefore their guardians are never educated on how important routine care is and how it benefits their pet.
• Cat parents also are very sensitive to the stress that taking their cat anywhere causes. The wrangling to corral them into a cage. The blood bath they are exposed to. The endless crying pleas on that previously short, but now never-ending, trip to the vet. STRESSFUL!
• Many people don't believe that their cat is at risk for any diseases if they are kept inside.
• Many people don't realize that in almost all states rabies vaccinations are required (mandated by law) to be kept current.

Did you know that the veterinary industry has spent over $5.5 million on trying to figure out why so few people seek care for their cats, AND, how to encourage them to keep their cats current on veterinary care and disease prevention?

Suggestions;

• Opening a dialogue with clients about why routine care benefits them and their pet.
• Opening a dialogue about why they aren't visiting?
• Discussing possible ways to lessen the stress of traveling, capturing, and examining.
• Cat exclusive times in the clinic.
• A whole clinic approach to caring for cats as the uniquely sensitive beings they are.
• Follow through. Call and check-in after the cat goes home. Discuss examination findings, follow up advice, short and long term plans, and what worked at this visit and what to work on to make the next easier.

The above information comes from the September 1, 2013 article Herding Cat Owners, Groups to encourage veterinary clinic visits. 

Please share your thoughts, and please help us take care of your feline pets. 

If you have any pet related questions I can be reached anytime at Pawbly.com. I can also be found on Twitter at FreePetAdvice or at Pawbly.

Wordless Wednesday (Another Failed Attempt).

Driving to work on Sunday.

Jekyll riding booster seat shotgun.

Thankfully, we never get on a major road and we are never traveling more than 40 mph. 

Like it, or not, I am holding him the whole time. 

Nothing beats a happy patient.

I was a bit concerned about how red his ears were (allergies, infection?).

"Nope," his mom said "excitement."

This little one needs a home.
He is renting a small pad in the lobby.
He purrs on sight, rolls over immediately, and will charm you faster than Casanova on his best night.
And that little mustache!! Oooh, so cute!

My Magie.

Looking coy and a bi devilish!

She was actually attacking my toes.

"Ouch!"

Wren and Magpie, making it almost impossible for me to work.

Until they decided that work was boring.

So they napped, of course.

Little baby Bo. 

Just rescued by a couple who cuddled him, cooed over him, and 

said that they were "going to try to find him a home."

Personally there was waay to much oogling over him for me to believe they can part with him.

"Good Luck letting him go. He's too adorable. I'm a softy too."

A happy to be at the vet pup.

Porter, the IVDD dog. Who motors around with his own little twist, but never stops to feel sorry for himself or wonder why life threw him a wrench.

He is a true testament to,

"Get up, work hard, be grateful, and live in the moment."

Little Dottie.

Here for her kitten vaccine.

Feeling very safe with her mom.

If there was anyway I could do it I would gift myself a kitten every year.

Buddy at his post.

He is the king of musical chairs.

If you get off of yours he will be in it before you can shoo him off.

Elliott and his x-ray. He is four weeks post-op.
He has no limp and he, in true kitten fashion, has healed quickly and completely!
He will be in on Monday to have his pins pulled.

This is Kits x-ray. His brother, who also had a broken leg.
Fixed two weeks ago.
Pin removal (if possible, I am very worried because they are in the knee joint.
I have to try to dig them out on Monday.
Stay tuned for this one too).
Why do I do this to myself?
I will be stressed until they are out.

Happy Hump Day!

If you have a pet related question you can get an answer (and also find me) at Pawbly.com on Twitter @FreePetAdvice or @pawbly.

When Fear Decides What To Do.

This is Dallas. He is a twelve year old lab mix who has lived at Animal Rescue since the day they found him. That day was about eleven years ago. He is a lifer. He will very likely die in the one place he has ever known as home. Now, I do not say this to ask you to feel sorry for him. Although many of us believe that a real home with parents and your own yard and the full flight of affection being doled only to you is the ultimate guardianship experience, Dallas is happy, loved, and at home he shares with about a thousand other four legged friends.

Dallas developed a slight swelling of his left upper eyelid a few months ago. Over that time the swelling has progressed and the eye was being irritated significantly each time he blinked. The consequence of irritation on your eye? profuse yellow-green discharge.

He was brought to a veterinarian who recommended a biopsy to determine the identity of the mass.

So Dallas was placed under general anesthesia and a small sliver of the fleshy soft conjunctival mass was shaved off and submitted to a lab.

Here's where my goat gets a little ruffled. You ask any vet what they think this is and they will ALL say, "cancer."

AND, here is where I need to add a BIG GIANT disclaimer. Medicine is always a delicate dance of "should do's," and "can-do's." What is optimal is not always feasible, for more reasons than I have the strength to list.

You ask any vet who works for a rescue what they would do about it and they will ALL say, "in a twelve year old lab that has never left the rescue I would take that mass off and keep him happy and comfortable for the remainder of the days he has left."

To not take as much, or all, of that mass off at the first surgery, is infuriating for me to think about.

Dallas, came to me because he still had a huge, annoying, ugly mass on his eyelid. Only difference this week, it had a name 'adenocarcinoma.' AKA, cancer, AND, he had just been through general anesthesia a week ago.

(Note; in all pets, especially older pets; minimize the number of anesthetic events to as few as possible. Anesthesia has its own inherent risks, it is an immuno-suppressive, it lowers/weakens your immune systems ability to fight off disease and illness, and it can 'turn-on' cancer cells).

The rescue came to us because we have a laser. The laser allows us to cut tissue quickly and with minimal bleeding, hugely important when you are trying to remove a soft, friable, fleshy, fragile skinless grape from under an eyelid.

The other huge advantage; it cuts like butter, and about as fast as a hot knife through it.

And in less than five minutes Dallas got a new eyelid.

For those of us who try to live and practice by the gold standard there are problems with our quick fix:

• Clean margins. These are how we know that we removed the whole tumor in its entirety. This is done by submitting the mass to a pathologist for microscopic evaluation. Without clean margins there is a much higher chance that the tumor will come back.
• Additional surgeries would have been required to try to get clean margins because Dallas would have needed his entire upper eyelid removed. A flap would have had to have been advanced from the skin on his head, or side of his face, to reconstruct the top eyelid. The problem with this is the eyelid margins. This is the area of skin without hair that allows you to blink without sweeping a row of lashes/hair across your delicate and sensitive cornea.

Dallas did wonderfully through his surgery. His eye looks great and he has no further discharge or swelling.

He is still looking for his own home, but blinking and seeing comfortably in the home he has spent his whole long healthy life in.

Here is my take away advice from Dallas' story. Talk about every aspect of your pets treatment plan. Discuss long term and short term risks and benefits. Surgery has inherent risks, and often it is hard to try to guess prognosis without a diagnosis, but each case has its own set of circumstances to guide all parties through the twists and turns of their particular case. Make decisions based on thinking, discussing, and deciding on what is best for all parties. Try to not make them based on fear. I know this is hard to do, but don't avoid potentially life saving or quality of life decisions because YOU are too afraid to try. I see this too often in private practice. Pet parents not making a decision because they are crippled by the fears of what-if.

If you have any questions about anything pet related please find me on Pawbly.