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FCEM – a disease that often has a good ending, unless you’re a squirrel

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Skye had been completely normal when her family left for work and school that morning. But, when her big brother arrived home early in the afternoon, he found her sprawled out at the front door, her eyes two big saucers. She toppled over with each flailing attempt to stand. It was like her legs had abandoned her. Panic set in.
When she arrived at our hospital around 4 pm, she no longer had the use of her limbs. Her heart was pounding – she was a very scared dog. Skye was given sedative medication to help her relax and to allow us to perform some tests. X-rays showed that she had some narrowed intervertebral disc spaces and considerable arthritis along her spine. She would need to be referred to a neurologist for a definitive diagnosis, but we suspected fibrocartilaginous embolic myelopathy (FCEM) was the culprit.

FCEM is an acute infarction of the spinal cord caused by a vascular embolus of fibrocartilage. The condition can be thought of like a spinal stroke. There is usually a history of sudden collapse with or without vigorous exercise. The symptoms may worsen within the first few hours but often do not progress beyond the time a patient is examined by a veterinarian. A single limb, or all four limbs may be affected with varying degrees of weakness or paralysis. Many patients will regain near normal function of their limb(s) within 2 to 6 weeks.

With the love of her family, lots of nursing care, and her own unwavering determination, Skye is now walking short distances with assistance. Hopefully before long, she’ll be chasing squirrels out of her backyard again!

How To Thank A Tick

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I’ve been thinking a lot about ticks and Lyme disease this spring. Tick numbers in Durham Region are on the rise. Every day, I talk with dog owners about the realities of Lyme disease. Dogs are more resistant (than humans) to developing Lyme disease and knowing the risks, symptoms and strategies for avoidance can help manage our fears about exposure to ticks. This week one of my clients asked, “What are ticks good for? I mean, why do they even exist?”
“I’ve often wondered the same thing about wasps.” I answered. That conversation got me wondering if there is a way to thank ticks for their existence. I decided it would be easiest to start by thanking my dog.

Thank you Gryphon for reminding me that it’s important to check you over every night. I need to feel for any bumps that could be a tick that’s hitched a ride on your handsome furry face! Without you, I may have seen one news story about Lyme disease, felt a pang of anxiety, told myself to wear long pants while camping this summer and then … within a week, forgotten all about the threat of ticks. As usual Gryphon – you’re da bomb dawg!

Ok, that was easy. Now, on to thanking ticks. This is tougher but here we go.

Dear Deer Tick,
I heard Mom talking about how you like to hang out in long grass. She said you like rabbits too. We have a lot in common! I like to sniff stuff, how about you? I like pretty much everyone I meet. Sometimes I eat bugs though, even the ones that sting, so I’m sorry if I ever eat you or someone in your family. Anyway, I need to thank you. I’ve been getting checked over every night for ticks. It’s like a full body massage – I feel myself getting sleepy just thinking about it! Well, time for me to get back to work. I’m on backyard bunny patrol today – I just bark real loud and scare them off so they don’t eat Mom’s flowers. She doesn’t like that.
Everyone’s furry friend,
Gryphon D’Or

A Whoosh in my Box of Chocolates

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This morning as I worked away in Rusty’s mouth, cleaning his teeth and wrestling with his tongue that is honestly about two sizes too big, I thought to myself – Dental cleanings really are like Forest Gump’s box of chocolates. You never know what you’re gonna get.

Here’s what was in my dental box of chocolates today.
1. Thick tartar crammed between crooked teeth
2. Gums that bled with the most gentle probing
3. Gingival hyperplasia – this is when gums overgrow as a response to infection and inflammation
4. Furcation exposure – this is a tunnel that forms due to bone loss between the roots of a multi-rooted tooth
5. Gum recession
6. Loose teeth
7. Bad breath
8. Plaque

But before I even opened this little furry fellow’s mouth, I had my first surprise. I discovered a very quiet heart murmur immediately after induction of anesthesia. Rusty has had his heart auscultated many times at Brock Street Animal Hospital and no one has ever heard a murmur. In fact, I listened to his heart before sedating him this morning and heard nothing but a nice regular distinct lub dub, lub dub. It’s possible that the murmur is related to anesthetic medications or it may indicate early disease of the heart valves. Many older, small breed dogs have degeneration of one or more of the heart valves. This results in some backward flow of blood with each beat of the heart. The backward flow causes turbulence within the chambers of the heart and creates the fuzzy, whoosh whoosh sound of a murmur.

All the people that love Rusty (and there are lots!), now know to watch for coughing, exercise intolerance and an increase in his sleeping respiratory rate; these are symptoms that could indicate congestive heart disease.
So, today I had a little extra ‘whoosh’ in my box of chocolates but despite the challenges, Rusty went home with a nice clean mouth and as much zest for life as when he arrived this morning!

Insolent Eyeballs

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A bit like having a piece of sand in your eye, scratches or ulcers on the cornea hurt. In dogs and cats, corneal ulcers will generally heal with 7 to 10 days of treatment with antibiotic and tear replacement drops. There are however cases where the wound persists despite prolonged treatment; we call these, indolent ulcers. The term indolent means lazy or slow to heal. In these cases, new cells at the edges of the ulcer are unable to adhere to the ulcerated surface. Much like a wet bandaid, they just don’t stick so healing cannot occur.

Last week I saw Kobe, a handsome spirited Collie mix. Kobe had a corneal ulcer that refused to heal with drops alone, and I found myself thinking that a better term for this condition would be, insolent ulcer. Maybe it was because I’d been dealing with a bit of an unruly teenager for a few days, but really when you think about it, the term ‘insolent’ is actually very appropriate. I mean these corneas have no respect for the body’s attempt to heal itself!

So, how do we get these bad tempered corneas back to optimal health?

We perform a procedure called a striate keratotomy. Loose flaps of healing tissue at the edges of the ulcer are gently removed with a dry cotton swab. Then a small gauge needle is used to scratch a grid pattern over the surface of the ulcer. This stimulates healing and creates openings through the unhealthy corneal tissue which allows new cells to stick and ultimately fill in the defect. Striate keratotomies are effective in 60-70% of cases. If this procedure is not successful, referral to a veterinary ophthalmologist is required for a superficial keratectomy. In this procedure, a thin layer of cornea is completely removed (including the ulcerated area) leaving behind only healthy tissue. No matter the treatment used, patients always have to wear an Elizabethan collar (aka e collar or lampshade) which prevents them from rubbing the eye and causing further damage.

Managing insolent eyeballs requires patience and persistence, and in Kobe’s case, he seems to be well on his way to feeling better!

Chocolate Chow Down

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Fin did not bother to chew the chocolate. To be fair, if I thought someone was going to try to steal my chocolate, I’d probably snarf it down as quick as possible too. And while it was upsetting that the Easter goodies were gone in seconds, it was more worrisome that Fin is a dog – and a mere 25 lbs at that! He arrived at the hospital within half an hour of enjoying his ‘treat’, wagging his tail with a fierce enthusiasm. Fin seemingly unaware of his mom’s considerable concern, wiggled his bum and sniffed with excitement as I checked him over.
The chocolate he’d eaten was prepared at a bakery, then covered in clear plastic wrap. The sticker label had the name of the company but nothing more – no ingredients, no weight in grams or ounces. We had no way of knowing how much chocolate little Fin had eaten.

Chocolate contains theobromine, a chemical that in high enough doses, is toxic to dogs. Baking chocolate has the greatest concentration of theobromine (making it the most likely to cause symptoms) followed by semisweet, dark, and then milk chocolate. Milder signs of toxicity include vomiting, diarrhea and hyperactivity. Severe signs of toxicity include tremors, seizures and abnormal heart rhythms which can lead to death. Anytime we suspect a dog has ingested a toxic amount of chocolate, induction of vomiting is recommended. The sooner this is done the better. Some patients also require gastric lavage, aka ‘getting your stomach pumped’. If it’s beyond 4 hours since ingestion, induction of vomiting will be of limited benefit. Patients that are showing symptoms of toxicity need supportive care (hospitalization, intravenous fluids etc.) until the chocolate has been metabolized and cleared from the body.

Within about 20 minutes of arriving at the hospital, poor Fin was busy heaving up chunks of chocolate along with bits of his breakfast. As unpleasant as it all was, it was much better than the alternative had he digested and absorbed that amount of chocolate. And, I’m happy to say that Fin bears no hard feelings – he left the hospital looking bright, wagging his entire back end.

Even More Than What I Hoped For

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Years ago I had an interview with two veterinarians that owned a clinic north of Toronto. I don’t remember their names but I recall thinking they seemed like kind and gentle men. While waiting to meet with them, I noticed a photo album in their reception area. It was filled with pictures of dogs and cats and thank you cards from clients. During my interview, they asked what I most hoped for in my career as a vet.

“Someday, I hope to have an album like the one out in your waiting room.” I answered.
They laughed and said, “Well, unfortunately most of those pictures and cards were received after a pet died, so not necessarily the most uplifting.”

Perhaps they thought I was silly but twenty-two years later, my feelings haven’t changed. Every card of thanks and picture that we receive is a reminder to me that what we do matters – that we make a difference in the lives of our clients and their pets.

A couple of weeks ago, I had a moment that surpassed my wide eyed musings of so many years ago. One of our patients, Madison had an appointment for a laser treatment. She’s a beautiful chocolate lab with a mask of white around her eyes and nose. Kristin carried out her treatment and when they were finished, Madison headed out to the front desk with her mom.

I was sitting in my office when I heard a chorus of voices, “Where are you going?”
I stood and headed out to see what was happening. Madison had wandered by the reception desk to the pharmacy and turned the corner to the treatment room. When she saw me coming towards her, she stopped.

“Oh Madison – hello beautiful girl!” I said as I placed my hand on top of her warm head. She swished her tail back and forth, like wind shield wipers during a gentle spring rain. Then she turned and walked back to her mom’s side at the front desk. Turns out, she wanted to come and say hello – to me. And afterwards, I just could not stop smiling.

Chameleon Lumps

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It was a sunny December morning. Charlie flopped down in front of the fire after a good romp at the park. As her owner stroked the right side of Charlie’s belly, she felt a bump. The bump hadn’t been there earlier in the day, and while Charlie paid it no mind, a phone call was promptly placed to our hospital to book an appointment. During that visit, a growth was found underneath the skin on Charlie’s flank – it was small and well defined.

“What do you think it is Doctor?” Charlie’s dad asked.

“I can’t say for sure without a biopsy. Could be a benign fatty lump. It is right next to a nipple, so it could be a mammary tumor – these are usually benign in a dog that was spayed before the first heat. A mast cell tumor is always a consideration with any lump. Mast cell tumors are cancerous, although those that are low grade can be cured with surgery.” I said.

To put it plainly, mast cell tumors are nasty buggers. Their red and itchy appearance when growing from the surface of the skin, is fairly characteristic and prompts us to take quick action. But when growing underneath the skin, they can feel very much like a fatty lump (aka lipoma). Mast cell tumors tend to send cancer cells to “stake out” the neighbourhood tissue. This means that they often spread locally, and are larger than they appear to the naked eye.

It turned out that Charlie did have a mast cell tumor. But, thanks to her owner’s careful observations and quick decision making, surgery to remove the mass was successful.

Whenever I’m asked what a growth is, be it on or under the skin, I wish I could be 100% certain in my answer. But I can’t. No one can. Only a biopsy, either needle or surgical, can provide a more definitive answer. So while many lumps and bumps are harmless, it’s important to talk with your veterinarian any time one is found on your pet.


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Every time my dog Gryphon poops, he tweets #GryphonWasHere. Now, don’t misunderstand. Gryphon does not carry around a phone and update his status with every bowel movement. He lets the world know the old fashioned way – he expresses his anal sacs.

The anal sacs are two nifty little structures that are located just beyond the anal opening in dogs and cats. If we imagine the anus as the face of a clock, the anal sacs are positioned at 4 and 8 o’clock. They contain fluid that gets released every time feces mosey on down the rectum to the anus, and then out into the great big world beyond. The purpose of this fluid? Simply to mark territory. To tell other dogs and cats, “Listen up, this is my neighbourhood!” (or in Gryphon’s case “Hey everybody, come play with me!”).

Occasionally the anal sacs can become impacted, infected or abscessed. Early signs of trouble can include scooting and/or excessive licking at the hind end. Common causes of anal sac problems include food allergies, seasonal allergies and diarrhea. Some dogs need to have the anal sacs manually expressed on a regular basis to prevent impaction.
Thankfully, most dogs and cats never experience any trouble with their anal sacs, nature’s original form of social media!

Five Women and a Cat

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It was the last appointment of 2015. There we were – five women and a cat named Valentino. The name Valentino, comes from the latin word “valens” which means, he who has value. It was a most appropriate name for this loving, sweet natured orange tabby cat. Years ago, he’d had a mass surgically removed. The procedure was subsidized by The Farley Foundation, a charity that helps reduce the cost of non-elective veterinary care for disabled people, seniors on social assistance, and abused women entering registered women’s shelters. Like many folks who could really use the financial help, Valentino’s mom was reluctant to accept it; she did not want to deprive someone else that may need the funds more than herself. Her concern for others, was exactly the reason that she so deserved to benefit from this wonderful charity.

The driver paced the waiting room, brought his arm down on the front counter, “Can you hurry up?” he said.
“We’re doing our best.” was the honest reply, although I suppose it would have been most honest to say, No, we can’t hurry up. There is no room for impatience in death.

In the exam room, our ritual played out as we spoke of Valentino’s life – the recent insidious weight loss, the puddles of bloody fluid found around the house that morning, what a great companion he’d been, how many girlfriends he’d had … how many broken hearts he would leave behind. When it was over, Valentino’s mom left the room, the whisper of her wheelchair motor the only sound as she glided through the doorway like a gentle breeze.

The front door of the clinic closed on the end of another year. Two grieving women headed home, while the other three finished their day’s work. Our lives moving on in different directions, but forever bound together by a cat named Valentino.

Raccoon Rumble

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It was an unseasonably warm December day for Southwestern Ontario. A beautiful afternoon to be outside, and that’s exactly where Charlie and Abby wanted to be. They were in the kitchen, toenails clicking as they circled and shifted, their whining breath fogging the glass of the back door. Jane finished putting away the last of the clean dishes and folded the tea towel over the oven handle.
“Hang on you two. I’m coming,” she said.
She looked out the door, and saw what it was that had the dogs so worked up. Len, the neighbourhood bunny stalker, was on the roof of the shed. He was stretched out in all his orange tabby cat glory, his eyes closed against the warm sun. Jane opened the sliding back door and the dogs took off as if someone had shot a starter’s gun. Len jerked his head in their direction, leaped to the fence and disappeared into the neighbouring yard. Charlie and Abby skid just short of the fence, barking like mad fools.
“They look quite pleased with themselves,” Jane thought as she closed the door and turned back to her dinner preparations.
Minutes later, a fierce noise erupted in the yard.
“Ugh – what are those two up to now?” she wondered.
She quickly realized it was not their usual sound of alarm, like when someone walked by the side gate. This barking was much more intense. Then, a third voice was thrown into the mix; it was high pitched and hissing.
“Oh no – Len!” Jane ran to the back door.
But it wasn’t Len.
It was a raccoon, and there was a lot of blood.

This story is fictional, but based on an incident that played out in Hamilton earlier this month. On December 2, two dogs had a significant altercation with a raccoon that was later confirmed positive for rabies. Five days after this, three more rabies positive raccoons were confirmed in the area. The Ministry of Natural Resources and Forestry (MNRF), distributes wildlife rabies vaccine baits in specific areas, to help protect our wildlife against rabid raccoons that cross the border into Canada. MNRF initiated hand and aerial baiting in the Hamilton area on December 7.
What steps can you take to avoid exposure where you live?
1. avoid contact with potentially rabid wildlife such as skunks, fox, raccoons and bats
2. keep your pets up to date on their rabies vaccinations
Rabies is a fatal disease – please protect yourself and your pets!