REMINDER

Sales of firecrackers will increase in the days to come.
These firecrackers are readily available and anyone can get access to them.
Thus, firecracker poisoning may be a concern.
It is advised to check whatever you pet ingests especially when walked.
Please also educate your children or young siblings not to offer them to your pets.
Firecrackers can cause poisoning.
It's better to be cautious and avoid accidental ingestion.

If you are not comfortable with me as your veterinarian and do not trust my judgement, I think it's better to look for another veterinarian.

As a veterinarian, aside from the skills learned during college days and day to day training in the small animal practice, it is also important to develop people skills. You may see us talking to dogs and cats in order to calm them down during check ups but mostly, we are speaking with their owners and caretakers, explaining to them the different options for treatment, health management, vaccinations and other things necessary. That is called the client-veterinarian-pet relationship. this can further be simplified to the veterinarian-clent realtionship, client-pet relationship and the veterinarian-pet realtionship.

In order for these relationships to work properly, each individual should be able to communicate well, understand each other and respect one another. One must know their limitations and boundaries. In most cases, these relationships are going well. But if it becomes a roller-coaster ride, and the relationship gets bumpy, then you know there's something wrong.

Just like any other service, a client can choose their veterinarian and a veterinarian can choose whom to serve. Though as vetetinarians we have a noble duty to these dogs and cats (and other pets), their owners will still decide for them. Lucky are the pets with responsible owners. Thus, if a client is not satisfied with one veterinarian's service, he can go to another and another until he finds the one (and hopefully the pet is still alive by then). And us vets can decline to treat a patient if we think that the owners doesn't trust us, does not believe us and disrespects us.

Remembering Doodie (aka Phoozie)

She was known as Phoozie when she was presented at the clinic. Not eating, inactive and basically not herself.

She was diagnosed with chronic renal failure.

Checking Phoozie's real gender, it turns out that she is a castrated male, (a HE)!!! Yes, for the longest time that Phoozie was with his real owners, they didn't know that since they only got Phoozie from the streets and adopted his as thier own. Upon knowing this, they changed his name to Doodie.

For several weeks, Doodie was hospitalized and blood counts, chemistries and electrolytes were monitored. He got well eventually and this video is the first time he started eating again.

She went home a few days later.

Yet after a few months, since kidney disease continually progresses, she was back at the clinic.

After a few days, it was time to say goodbye.

Goodbye Doodie. We will always remember you as one of the good tempered and sweet siamese we cared for in the clinic with such loving and caring owners.

Remembering Yoji...

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.

MUGU

What’s with these needles? Do dogs love them because they are shiny? (I thought only mermaids love to collect shiny objects?) Well, Mugu is another exciting needle storage machine… needles with threads actually.

Mugu was presented way back, during the 1st month of my graveyard duty. The owner noticed a string coming out if her anus. She may have ingested those strings the day earlier when the owner’s sister was repairing her uniform. We took a radiograph and tadaaan!!!



Two needles were visible on the radiograph at the colorectal area. We waited for the foreign materials to pass out from the anus with a little assistance. Mugu was lucky enough to pass out the neddles without further damage aside from one needle piercing the anal sphincter. After that Mugu came home a very happy dog.

Peanuts

Be responsible enough for your pets. As owners, you should be responsible enough to know your pets and keep them protected and safe. In some instances though, accidents happen yet, it will still be the owner’s responsibility for their pet to receive veterinary care and treatment.

This case was presented a few weeks ago. This Dachshund, Peanuts was brought in the clinic at about 12 midnight due to hacking. The owners only observed it the same night of presentation. Her appetite was normal and without problems in defecation and in urination. She was active and responsive at presentation. The caretaker told us that she did not succeed in trying to prevent the Peanuts from eating something earlier. She said she was unable to identify the object.

I requested for radiograph to check for the trachea and chest, and here’s what we saw…

Notice the Radio-opaque material at the area of the hyoid apparatus of Peanuts.

We tried to open up Peanut’s mouth to see if we will be able to see the object and retrieve it without the need for sedation, but we were out of luck. Next Stop: Sedation. But I do not sedate a pet without a bloodtest. You can never be too sure if they have a concurrent kidney or liver disease and with such problem may cause further complications such as death.

Peanuts’ blood profile was normal though and we proceeded to sedate her.

With the aid of a laryngoscope and my trusty technician, we performed the examination in the surgery room and tried to locate the foreign object. I hoped that Peanuts did not accidentally swallowed the object while waiting for the blood test results and during induction or else, it will be a major disaster… Luckily after a few minute of probing, I finally saw a silver material embedded at the ventral area of the larynx. It was a sewing needle!

The needle after retrieving it from Peanuts.

Peanuts during the recovery period

Whoah! Was Peanuts trying to stitch something up?

The caretaker was apparently sewing earlier and lost the needle after using it, and here comes Peanuts…

Everything went well until the owners declined to pay the total amount of the check up! Wow! Talk about responsibility…

This is nicole… after boob repair!

I didn’t took a before shot - I forgot. Sorry!
Well, what happened was she jumped off a fence, and giving birth about two weeks ago, unaware that her mammary glands enlarged maximally, got caught on the wire leaving a 5 inch laceration. Luckily, it wasn’t too deep. But is was bloody and during repair, I noticed blood and milk mixing… I know she was just fine, she stayed about two more days after her admittance. The owner apparently forgot she was in, I think. But she terribly missed her puppies while at the clinic.

NOOPY

Asbcesses are sometimes really are pain in the ass. What is more annoying is the development of abscesses at the IV site. This actually, can be prevented by aseptic technique, monitoring and changing of the IV site every now and then.

This is noopy and she has an abscessed arm. Abscessation are actually tricky to manage and may or may not require a few days of confinement and monitoring. As for the owners it was ok for them for noopy to stay awhile during the treatment.

Day 1: severe abscessation. The area was flushed with NSS, PenG, Povidone lodine with table sugar and nitrofufazone was added prior to bandaging…

Daily, the wound was cleaned, unfortunately, was not documented…But, there was improvement. We noticed that the area became clearer with granulation tissue formation. There was no noticed foul odor versus the first day and the wound became smaller

Day 7: the wound is clean, smaller and appeared to have healthy granulation tissue. With formation of granulation tissue, flushing of the wound is important. Rubbing the area even with a sterile gauze that can remove the newly formed tissues should be avoided.

Day 8: the wound was left open to dry and fortunately, noopy went home today without the need for bandage.

Noopy visited the clinic for vaccination update (which was again overdue!!! What’s the use of appointment slips and recommendations?!) and the arms that was affected was already clear, with hairs regrown and no evidence of previous abscess formation.

Going back to the case, why did I use sugar in the wound dressing?

Actually, I learned the technique when my father’s bed sores were being treated by his surgeon prior to grafting. He explained that the bacteria present will ferment the sugars first before it will digest the protein of the skin, and with the presence of antibiotics and povidone iodine, the microbes will die. Further research also revealed that sugars tend to promote better granulation tissue formation, decrease edema formation, attraction of macrophages, source of cellular energy and for necrotic slough . What’s more encouraging is that it is readily available and inexpensive. Aside from table sugar, dextrose powder and honey may also be used.

GOOPS

Goops was presented at the clinic due to swelling observed at the right side of the face (at about the area of the submandibular-parotid areas) just ventral to the ear to the ears. Previous history revealed bullying by other dogs.


Initial check-up revealed several scratches at the face but without deep wounds, with dark-brown, grainy otic discharge of minimal amount and an attached, firm swelling of the submandibular/parotid areas about 2 inches in diameter.
Ear swab revealed earmites.
Aspiration of the swelling revealed blood. Thus the swelling must be hematoma. The area was aspirated and the swelling subsided. Medications and compress were recommended.


A few days later, goops was again brought to the clinic due to the same problem, this time, bigger. Upon inquiry, the owner was not able to follow recommendations.

This time, drainage thru penrose drain, was placed and the area was bandaged, with Elizabethan collar placed to avoid scratching and removal of the bandages. Medications, wound cleaning and warm compress was again recommended for strict compliance.


A few days later, the owner reported back that the swelling already subsided without any complications and medications were given diligently.


By the way, this case earned us a family pizza from domino’s and a roasted chicken from andok’s… thanks to the client.

Fortune!

Meet Fortune! The cute, sweet and friendly Pomeranian. Cute, Yeah! Sweet and Friendly?! Nah! I strongly disagree, and I think most us think so too. Hehehe. Well, actually if you're gonna pet him and take him outside the cage especially if you're new, he will like you, and act friends with you. But when he sees someone he likes more especially if you've already put him down on the floor or on the table, he'll growl or worse bite you if ever you'd want to hold him. Maybe that's why he stayed here boarding longer than he could have stayed at home with his master. Poor Fortune... if you could just lose the biting.

Tree Kangaroo

I didn't actually know tree kangaroos exist. I haven't seen one until I saw one in the clinic, here in the Metropolis! Well actually, the owners imported her (I did not ask from where) and designed a room in their house similar to its habitat. But it is still important to leave them alone in their natural habitat and to protect the natural place where they dwell is the most valuable and effective form of keeping them alive and safe.

Apparently I touched its coat (just like a stuffed toy) only a little coarse. And it had a pouch too on its abdomen! With its long claws, it may have scratched me if it was feeling better already, told the owner. Huah!!!