This is not really a veterinary post, but Smokehole Canyon is one of the best family canoe trips I've done. My children and I and a couple other families run this river near Petersburg, WV every Memorial Day Weekend. From beautiful scenery to a great canoe-only campsite, challenging hikes, a wonderful swimming hole, a cave, fresh spring and many class 2 rapids, this river has it all and is one of my kids' favorite family trips. Here is yours truly running "Landslide Rapid", the last major rapid before camp (where you don't want to flip and spill all your gear). Fortunately, the canoes have always made it through unscathed.
Sunday, July 8, 2012
Batter Up!
The other day I was inspecting our house for wasps, ants, and other pets in anticipation of doing some exterior painting. I was particularly interested in the wood trim that we had wrapped with aluminum years ago. As I rounded one corner and looked up, there was a bat snugly nestled between the concrete foundation wall and the base of the trim wrap in a space that could scarcely hold another of its kind. As I got closer it bared its teeth. I backed off, but the veterinarian in me was impressed with the lack of tartar and periodontal disease!
Thursday, May 31, 2012
Proverbial Wisdom
A client recently returned a survey card on the appearance of the clinic, courtesy, professionalism, and empathy of the staff, and value of services. We were pleased to see all outstanding scores, but her note "I appreciated the kindness of the staff and doctors. Proverbs 16:24" made me curious. Here is the reference:
Proverbs16:24 Gracious words are a honeycomb, sweet to the soul and healing to the bones.
Although this quote referred to the words of our staff, her kind sentiments were sweet to my soul and a reminder that graciousness, aside from being good manners, reflects an appreciation and respect for others and the level of composure of one's own soul.
This is a timely message as we are experiencing frustrating local phone service problems. In talking to tech support, it is easy to vent about inefficiencies and unresolved issues, but at the other end of the line is someone who is generally trying their best to work within what is an imperfect sytem. Even someone who comes across as rude deserves a basic level of respect. Who knows what frustrations they are experiencing? Perhaps ones that make call forwarding problems seem pretty insignificant.
Proverbs16:24 Gracious words are a honeycomb, sweet to the soul and healing to the bones.
Although this quote referred to the words of our staff, her kind sentiments were sweet to my soul and a reminder that graciousness, aside from being good manners, reflects an appreciation and respect for others and the level of composure of one's own soul.
This is a timely message as we are experiencing frustrating local phone service problems. In talking to tech support, it is easy to vent about inefficiencies and unresolved issues, but at the other end of the line is someone who is generally trying their best to work within what is an imperfect sytem. Even someone who comes across as rude deserves a basic level of respect. Who knows what frustrations they are experiencing? Perhaps ones that make call forwarding problems seem pretty insignificant.
Wednesday, March 14, 2012
Second Chance
Remember "Chance" from my February 6, 2012 post? She has been making up for lost time (and food!). Here is Chance on presentation:
Then after 6 days of supportive care at Towne:
And now after a month of family life and good cooking:
Then after 6 days of supportive care at Towne:
And now after a month of family life and good cooking:
Tuesday, February 7, 2012
Senior Blood Work
Often the most successful visits are the least exciting--the surgery that heals well, the diabetic who is easily managed, the limping that turns out to be just a broken nail. Unfortunately the opposite is true as well. It usually doesn't bode well when I have a "very interesting case", although there certainly are exceptions. Many of those exceptions appear in this blog, but today I have a sadder tale.
A 12 year old cat came in for a routine visit several weeks ago to have some lumps checked. These turned out to be mast cell tumors. Although these can be treated more conservatively in cats than in dogs, these tumors were in locations (mouth, eyelid) where they would be difficult to remove if they got larger. Before surgery we ran some senior blood work. This showed a mild elevation in the kidney values and a high red blood cell count. I was suspicious that the high red cells might just be a lab error or some dehydration, but the kidney elevation seemed a little out of place as well.
As most cat families know, chronic kidney insufficiency is common in older cats, but something just didn't seem to fit. The first step in working up this problem is to recheck the values to see if they are consistent. Well, today she came in for a recheck and possible surgery. Unfortunately, her kidney values were even higher and her RBCs remained elevated. I decided the best course was to look at her kidneys with ultrasound to see if there were just age related changes or a more significant problem. Both kidneys looked very abnormal and there was a large (half the diameter of the kidney) tumor in the left one.
Now the pieces fell into place--a kidney tumor that was not only contributing to the kidney dysfunction, but was probably stimulating the high RBCs. You see, the kidneys produce erythropoetin, a hormone that stimulates the bone marrow to produce erythrocytes (RBCs). In fact, some cats with chronic kidney disease are put on epogen (replacement hormone) because their kidneys don't produce enough! For this kitty, the tumor was probably overproducing this hormone.
Needless to say, we cancelled surgery and started supportive care (home fluid therapy) to keep the kidney values in line. Fortunately this condition is not causing any significant discomfort right now, but we suspect that we might see some more complications within the next 3-4 months.
This case is a reminder that some level of preanesthetic screening is a good idea in pets. It saved this kitty from undergoing a procedure that would not have provided the long term benefit that we intended. It also allowed us to intervene earlier in treating the kidney disease. This will certainly lead to a better quality of life, no matter how quickly her condition progresses.
A 12 year old cat came in for a routine visit several weeks ago to have some lumps checked. These turned out to be mast cell tumors. Although these can be treated more conservatively in cats than in dogs, these tumors were in locations (mouth, eyelid) where they would be difficult to remove if they got larger. Before surgery we ran some senior blood work. This showed a mild elevation in the kidney values and a high red blood cell count. I was suspicious that the high red cells might just be a lab error or some dehydration, but the kidney elevation seemed a little out of place as well.
As most cat families know, chronic kidney insufficiency is common in older cats, but something just didn't seem to fit. The first step in working up this problem is to recheck the values to see if they are consistent. Well, today she came in for a recheck and possible surgery. Unfortunately, her kidney values were even higher and her RBCs remained elevated. I decided the best course was to look at her kidneys with ultrasound to see if there were just age related changes or a more significant problem. Both kidneys looked very abnormal and there was a large (half the diameter of the kidney) tumor in the left one.
Now the pieces fell into place--a kidney tumor that was not only contributing to the kidney dysfunction, but was probably stimulating the high RBCs. You see, the kidneys produce erythropoetin, a hormone that stimulates the bone marrow to produce erythrocytes (RBCs). In fact, some cats with chronic kidney disease are put on epogen (replacement hormone) because their kidneys don't produce enough! For this kitty, the tumor was probably overproducing this hormone.
Needless to say, we cancelled surgery and started supportive care (home fluid therapy) to keep the kidney values in line. Fortunately this condition is not causing any significant discomfort right now, but we suspect that we might see some more complications within the next 3-4 months.
This case is a reminder that some level of preanesthetic screening is a good idea in pets. It saved this kitty from undergoing a procedure that would not have provided the long term benefit that we intended. It also allowed us to intervene earlier in treating the kidney disease. This will certainly lead to a better quality of life, no matter how quickly her condition progresses.
Monday, February 6, 2012
Take a Chance on Me
This is one of those stories that every animal lover hopes for:
A 3.6 pound hypothermic cat with chiggers, neurologic signs, crusty eyes, skin sores, and jaundice was rescued by one of our very compassionate clients from certain death in the outdoors. Finally ill enough to catch, this young stray cat was brought to us with a temperature that didn't even register on our digital thermometer. We were certain that tests would show some sort of major health problem, but blood work and x-rays only showed mild anemia and mild jaundice.
We set to work warming, hydrating and syringe feeding her. At first she seemed to respond well, but her weakness just wouldn't improve. We rechecked her blood work, concerned that the hydration had diluted her blood and found that her potassium was very low. This was treatable, but unfortunately her red cells and protein level were lower. Worse, a recheck 2 days later showed a critically low protein level.
She was eating better with some assistance however, and a vocal personality was starting to emerge, so we sent her home for continued TLC . She started eating without assistance and regained her strength. Still, I was afraid I'd have bad news when we rechecked her blood work today. To my surprise, her red cells and protein were improved and she was noticably stronger and more alert. She still has a long way to go, but seeing her sit contentedly in her new mom's lap was so sweet! And now she has a name: Chance.
I hope to follow up with more pictures documenting her recovery, but 6 days out, here she is:
A 3.6 pound hypothermic cat with chiggers, neurologic signs, crusty eyes, skin sores, and jaundice was rescued by one of our very compassionate clients from certain death in the outdoors. Finally ill enough to catch, this young stray cat was brought to us with a temperature that didn't even register on our digital thermometer. We were certain that tests would show some sort of major health problem, but blood work and x-rays only showed mild anemia and mild jaundice.
We set to work warming, hydrating and syringe feeding her. At first she seemed to respond well, but her weakness just wouldn't improve. We rechecked her blood work, concerned that the hydration had diluted her blood and found that her potassium was very low. This was treatable, but unfortunately her red cells and protein level were lower. Worse, a recheck 2 days later showed a critically low protein level.
She was eating better with some assistance however, and a vocal personality was starting to emerge, so we sent her home for continued TLC . She started eating without assistance and regained her strength. Still, I was afraid I'd have bad news when we rechecked her blood work today. To my surprise, her red cells and protein were improved and she was noticably stronger and more alert. She still has a long way to go, but seeing her sit contentedly in her new mom's lap was so sweet! And now she has a name: Chance.
I hope to follow up with more pictures documenting her recovery, but 6 days out, here she is:
Saturday, January 28, 2012
Plant Awns
Today a Golden Retriever presented with a rapidly growing mass under her jaw. It was not painful or inflamed, but when I took some fluid out of it with a needle, I saw very large numbers of bacteria and white blood cells. I suspected that this abscess could be due to a foreign body or infected salivary gland, so I sedated her and made an incision over the mass. After blotting away the fluid that came out of it, I was relieved to see this plant awn inside.
This 1 cm seed pod can penetrate tissue, and due to its shape, can't back out. Although plant awns are more common out west, we see our fair share of them here. In fact, I once saw 2 dogs, 2 days in a row, with plant awns lodged in the mucus membranes of their left eyes. And they were from the same family!
I believe this awn migrated from the mouth rather than through the skin for three reasons: First, the mucus membranes of the mouth are much thinner. Second, I could actually feel a thin tubular structure leading to the abscess. This was the tract that the awn followed before it was walled off by the body and led to the abscess. Finally, the type of bacteria in the abscess were typical of oral bacteria, and not the skin.
This 1 cm seed pod can penetrate tissue, and due to its shape, can't back out. Although plant awns are more common out west, we see our fair share of them here. In fact, I once saw 2 dogs, 2 days in a row, with plant awns lodged in the mucus membranes of their left eyes. And they were from the same family!
I believe this awn migrated from the mouth rather than through the skin for three reasons: First, the mucus membranes of the mouth are much thinner. Second, I could actually feel a thin tubular structure leading to the abscess. This was the tract that the awn followed before it was walled off by the body and led to the abscess. Finally, the type of bacteria in the abscess were typical of oral bacteria, and not the skin.
Subscribe to:
Posts (Atom)