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!!!