Warfarin rodenticide

I am not against rodenticides. I fact, these, can help control rodent overpopulation which can serve as vectors for communicable diseases and destroy household and work stuff. However, I am against irresposible usage of these products. These products are poisons and should be strategically placed to bait target species and not our beloved pets, especially dogs and cats.

FYI: Warfarin is also used as a medication, however, it may cause toxicity in large amounts.
Warfarin and warfarin-based rodenticides are not the only rat poisons available commercially but also zinc phosphide and bromethalin.

There are different ways employed to treat and decontaminate a patient that ingested warfarin-based rodenticide, so if your pet ingests one, immediately seek veterinary service and don't forget to bring with you the package of the poison.

Again, be a responsible pet owner. Dog proof your household.

Princess

One early morning, Princess, a female shih-tzu was taken to me. Apparently she was vomiting with decreased appetite on the day of presentation, feverish and unable to defecate about 4 days after surgery. She was subjected to a cesarian section from another clinic 4 days prior. The owner also noticed dehiscence of the wound area and decided to put a bandage around to prevent Princess from licking the area or further dehiscence. The area upon my inspection is wet and the sutures are slowly eating through the skin.
I took a radiograph to check for continuity of the abdominal muscle area. It seemed dehisced though i was doubtful since she was just subjected to surgery which means the area would still be cloudy, hazy and probably in diasrray due to healing and inflammatory reaction.

In the meantime, we stabilized her through fluids and medications and blood profiling was done revealing elevated wbc, slightly decreased rbc, normal kidney and liver functions. Cleaning of the area and changing the dressing was done to avoid contamination and further infection.

Further assesment and repair of the area should be done deemed necessary and a night after, we have a go signal.

Since the sutures were already cutting through the skin, I decided to first remove it and here's how it looks... (by the way she also has an umbilical hernia)

With the owner's consent, we prepared Princess for her surgical repair.
When we parted the skin and subcutis, we noticed a suture from which I am still unable too see where it came from. Aside from that, a fleshy material or organ is staring directly at me. At first i thought it was the subcutaneous fat but it wasn't.
It was the intestine! Thus this also means that the abdominal muscle sutures were also dehisced. Abdominal fluids were also seeping out. I am worried that infection can or could have entered the dehiscence.

Thankfully, the intestinal loop is still normal and vital. Careful examination of other organs was done and were replaced with care.

I decided to close the muscle only on that night leaving the subcutaneous area and skin open but with a wet-antibiotic treated bandage to keep the wound from infection.

After 24 hours, I was sure that there are no signs of infection on the outside, closure of the subcutis and skin was done.

Ten days later, Princess is back but for sutre removal only. See it on the next two pictures. one still with the suture and the next after removal.

You may also noticed that her left eye (she has no right eye due to trauma years ago) is cloudy. Antibiotic treatment plus cyclosporine was prescribed and positive change is noticed. Could be keratoconjunctivitis sicca (KCS) but that's another story.

Roundworms!

THESE ARE NOT NOODLES!

These are roundworms.

Three cute little puppies defecated worms one Sunday morning at the clinic. Gross! Right! Though I am used these parasites all the way from parasitology class, I almost puked that morning- concerning that I already had a headache that same day.

Going back, wow! these puppies also have pets of their own. Well, actually they have parasites!!! Roundworms are one of the many parasites that can affect dogs and cats and also humans. Yup, you read it correctly: FYI roundworms can also affect us.

Basics: These roundworms can be trasmitted from dog to dog in different modes.
1. Feco-oral route: ingestion of feces with eggs.
2. Transplacental route: larvae migrate from the mother to the fetus while during pregnancy.
3. Transmammary/transcolostral: larvae migrate from the mother to the young through the milk.
4. Ingestion of transport hosts such as rodents.

Thus, regular deworming or pets is recommended at 3-6 months interval or actually depending on your pet's lifestyle and your veterinarian's recommendations. Pups can be dewormed starting at 3 weeks of age.

So, see to it you that if you have dogs, bring them to your vets.

Scabies

Sacrcoptes scabiei var. canis

PANIC AND SCRATCH ALL YOU WANT YOU INFECTED HUMANS! most likely, you got it from cuddling your previously fluffy now alopecic (balding), pruritic and crusty pets.

Generally known as scabies or mite infestation or by its scientific name, this organism is NOT a normal resident of the skin, both pets and humans but a PARASITE, which causes severe itching that you'll be scratching until you bleed. These mites burrow under the skin and reside on the stratum corneum - a layer of the skin. The irritation is due to body's reaction against these invaders and just imagine a mite eating you up!

Basically, this is detected by you veterinary staff during skin check ups. If your pet has it, you are also at risk of contracting it. Your veterinarian treats your pet while you should go to a dermatologist...

yeast!!!

DON'T PANIC!(unless you have to)

I don't think this is the cause of human yeast infections ( You unhygienic people! LOL).

Meet Malassezia pachydermatis, one of the common residents of your doggie's or kitty's skin. In normal pets, they can be seen in small numbers though may greatly increase in number if your dog contracts skin infections. This may also be found in ear infections of your pets. Usually this organism likes the warm, wet and unexposed areas of the skin; talk about axilla, ingunals, chin, skin folds and the ears.

And do humans have to panic?

If you are immunocompromised then maybe you should. Recent studies revealed that neonates and those with poor immune status may be affected with M. pachydermatis. Though humans also have a normal skin commensal of the Malassezia genus, the M. furfur, M. pachydermatis was also implicated especially in humans exposed to pets like me. (waaaah!!! panic! panic! LOLz)

I guess, it's just about health. Once you are immunocompromised, then you should atleast takeprecautions. If you are constantly exposed to pets, then hygiene comes. Consciousness helps.

Got to go now. I still have to to a self check!!! LOL

ALI

Ali was actually a colleague's case. He was admitted due to a non-healing and infected wound. Prior to admittance, he underwent umbilical hernial repair from another establishment. Yet, days after the surgery, the owners noted that the surgical incision was swollen with pus and fluid oozing and is actually not healing. Upon assessment and repair, it appears that the whole wound is actually infected and there's more pus and necrotic tissues underneath. We cleaned the area and resutured the dehisced internal layers. We left the wound open covered with wet sterile bandages with antibacterial dressing to help keep the wound clean and for new granulation tissues to form prior to closure. A few days after presentation, we also noticed something: Ali is unable to stand up. Though actually responsive and with appetite, her limbs are stiff and extended. Is this tetanus? Concerning that he had a prior history of an infected wound, we assumed that this could be the T thing. Medications against tetanus were given and Ali was monitored for a few more days - three weeks total more or less.

The picture above was taken a few days prior to Ali's release. Slowly, she was able to gain back control of her limbs and was able to stand up on her own.

Clostridium tetani, the bacteria responsible for the production of the toxin causing tetanus is actually found in the soil. It can gain entry and cause infection in pets through wounds especially deep puncture wounds or those that have been in contact with the soil or area with the bacteria. Dogs and cats are actually pretty resistant to tetanus, however, predisposing factors may make them susceptible to the disease.

It has been quite a while since I posted something in my blog.
Though I always have an interesting case to share, I often forget to take a picture prior during and after the procedures and/or treatments done...
I was also a bit busy these past few days...

lucy

Lucy, a six-month old basset hound, is very unlucky. Her humans found her barely conscious, drowning in the pool one Sunday morning. At presentation, she was almost blue, dyspneic, weak and recumbent. At the same time, her stomach appears bloated. We took a radiograph and saw a very dilated stomach filled with gas and most likely also fluids. The lung area is also very hazy as the pool water may have accumulated with the respiratory lining most likely compromised.

Oxygen was provided yet since Lucy was conscious she was constantly shying away from the oxygen hood. Since bloating is also an emergency condition then it also has to be corrected thus, blood profile and baseline blood tests were done which were actually normal.

the radiograph on the left was taken before gastric intubation. notice the dilated stomach filled with gas and fluid. also notice the hazy lungfield (on both radiographs). the radiograph on the right was taken after the stomach was relieved of the gases and fluids.

During intubation for gas anesthesia, blood came out of lucy’s trachea, an indication that severe bleeding from the lungs has taken place. Blood accumulation will further compromise gas exchange. However, endotracheal intubation will also be beneficial to provide almost 100% oxygen. Then we did gastric intubation to release gases from the stomach. Aside from air, mixture of gastric fluid, pool water and blood was also recovered. Another x-ray was also taken check and there we saw that the stomach is already relieved of gases and fluids. Now we are back to the lungs… the blood+fluid filled lungs.

me and my assistant during gastric intubation. Lucy is on gas.

When Lucy was taken off the endotracheal tube, hood oxygenation was provided, she was actually pink as compared to the bluish color she was earlier. She also received all medications however, she still left us that same day…

Max’s new owner rescued him from the streets. He was apparently in(?) a plastic bag by the street of an actually rich village when he was found.

Max was presented due to limping and at presentation, the left forelimb was swollen, painful to touch and has a wound with pus oozing. Radiograph revealed no fractures and/or dislocations but is suspicious for periosteitis.

Max during one of our would cleaning nights

Medications, wound management and removal of pus was the main goal. Increasing the appetite is also included. 4 days later, Max was ready to go home.

he's having his ears cleaned - earmites...

wound has actually improved from a swollen one with oozing pus to this one with granulation tissue forming.

The funny thing was Max was only given his name on the day of his discharge, about 4 days after presentation. During his stay at the clinic he doesn’t have a name and is identified only as Siamese kitten.

A few days later, Max’s owner called up that Max is actually a lot better. He’s walking, though still limping, and is more playful than ever. Aside from that he is also more demanding now… hehehe. Siamese.

As of posting of this blog, max has not visited the clinic yet but I got spoke with the owner just the other night. Apparently, Max is very very active now, the wound healed though with slight limping and he has a very good appetite. He'll be visiting this coming week.

I asked the owner if she's still willing to give up max for adoption, she said "not anymore", she loves max and intends to keep him.

Pregnancy termination and Metritis

Bubbles is a 6-year-old female shih tzu at presentation (now she's 7) with fishy-smelling brown vaginal discharge. She is 6 weeks pregnant: positive for fetal forms and activity at ultrasound earlier (from a sister clinic). Is she terminating her pregnancy? Is she aborting? Why?

Rechecking her status: Active at presentation, pale mucous membranes, shivering, normal body temperature, tick infested!!! 1st time to breed.

Things to consider: Age, presence of ticks, Ultrasound: about 2 fetal balls in vesicles still with activity and heartbeat. Another 2 vesicles containing non-moving fetal balls.

Bloodworks were also taken into consideration: Increasing white counts, and lymphocyte counts with decreasing hemoglobin concentration...
Ehrlichia testing resulted positive, Brucella testing however was not done.

For several days, Bubbles was monitored at the clinic for further discharges and daily ultrasound from day 1

Day 5 of confinement revealed no fetal activity is all the vesicles. The vesicles were also in disarray and the boundaries were not as defined as it was days ago. Blood count revealed increasing white counts, lymphocytes, monocytes ang granulocytes... But we have a happy dog but without vaginal discharge and contractions...

Now, if she terminated her pregnancy, will it still be reabsorbed? at 6 weeks not really. It should be expelled. We waited for her to expel the fetuses while giving medications with caution.

Two days later, there was nothing. We opted for ovariohysterectomy. Here's what we saw.

Enlarged uterus with a closed cervix!

I decided to open up the uterus to see what it contains...

Brown mucoid material surrounding the fetuses which are not viable and are already decomposing.

I asked several colleagues prior to surgery including the referring doctor. Some were actually gave a GO signal for the surgery, others a NO.

But the important thing for me is Bubbles leaving the clinic alive, happy and healthy.