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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!

Mental Health Week.

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Mental Health week.

Being its Mental Health week, I thought I would do a blog on the benefits of owning a pet and how it can help your mental health.

I know for sure that my pets make me happy, they make me laugh, smile and comfort me when I am feeling down.

Pets never judge, they never look at you and think you look bad without your makeup, or your still in your jammies at 2 pm on a Sunday.

They love you with their whole being, they love you regardless of what you look like, what you drive.

I love my walks with my dogs, and feel so much better after I get home, they are happy and relaxed which makes me feel happy too.

When I get home, they are so happy to see me, in fact I can go to the washroom and come out and they are just as happy to see me….Daisy thinks I have a trap door in the washroom that I will disappear out of if she doesn’t come into the washroom with

Having pets for some, gives them a purpose to get up in the morning, a purpose to get out and take a walk.  Pets rely on us to take care of them, in return they give us so much more.

I know that without my pets, my heart would be so empty, my house too quiet.

Go give your pet a hug , I know I will when I get home!

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!

Family vacation.

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Family vacation

I just recently returned from Jamaica, a once in a lifetime vacation with my husband, sons and their significant others.

I was told by many that had visited Jamaica, that the drive from the airport to the resort would be hair raising and that animals are hit and killed daily.  So with my anticipated excitement for the vacation, I was also dreading the drive as I didn’t want to witness anything horrible.  I actually had a headache and my heart was pounding when we landed.

The moment we landed the lushness and beauty of the greenery was stunning. Beautiful flowers on trees, exotic, just how I imagined, we were newbies to the Caribbean. All of our eyes were wide open with awe at the beauty.

As we boarded the bus I had decided not to look out the window and would just close my eyes.  It would be a 45 minute drive and I could do that with my eyes closed.  The drive started and we were told by the driver that we would be travelling along the coast line for a bit, then we would be going up through the mountains too.  The bus was packed with excited travelers, all looking forward to a week of sun and R and R.

I tried so hard not look, and when I did, I saw green lush landscape. Half-finished houses, small shacks and lots of goats.  The goats were either tied to a pole or loose, all away from the busy road, thank god.  I saw donkeys, some tied, some loose, all away from the road, thank god again.  There were horses too, the same thing, it’s like they knew to stay away from the road.

I did not see one dog, or any bodies, which was a huge relieve for me. I am sure it happens, but it didn’t on the days I was travelling to and from the resort.

Once at the resort, I thought I would see strays, but no, only 3 cats, I was able to befriend one of them.  There were also little geckos which I was told the cats hunt and eat.  The cats were thin and flea ridden.  I felt sorry for them and wished I had brought some Revolution, but then I realized that one dose wouldn’t really do any good.

I had to turn off the part of me that wanted to help and save them, I was on vacation and this was a once in a lifetime family vacation.  The thing that I really noticed was how the staff looked at me oddly when I was giving food, or petting the cat.  They don’t see animals as we do, as house pets.  This is not saying that there are no pets in Jamaica, as I am sure there are, but the staff I chatted with didn’t have pets.

Most of them grew their own food and killed their own chickens and goats.  Once I realized that I was on vacation and not there to save the animals of Jamaica, I was able to enjoy my vacation.  The people and country are beautiful, and I accepted that they have a different culture and view on animals.

We will be returning next year, and I hope the cat I befriended is still there.

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.

My Pet Peeve

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This has been my pet peeve for as long as I can remember working in the Veterinary field.  The clients who think we are just in it for the money.  The client who feels we are just scamming them, charging too much.

Now saying this, we at Brock Street Animal Hospital have amazing clients and patients that do value what we have to offer, and for that I am grateful.   I can count on one hand clients that have voiced their opinion on the cost being too much.   I also work part-time at our local Emergency Clinic, I hear the comments there on a daily basis.  I understand that people are emotional when it comes to their pets, and finances can play a role in heightening the emotions.  But again, we all have to make a living and pay overheads.

I try to explain that we are not government funded, we are private businesses, run by Doctors and staff that have to make a living like everyone else.   We have equipment that the clinic has to buy, the same equipment that they use in human hospitals.  We have fully trained staff that got into the field due to their love of animals.   This does not mean that we should give our services free, or discounted, we still have families to support, mortgages to pay, and children to send off to University.

If we were to compare the care and pricing of our human counterparts, we are so much less, and there is not a wait list like there is if you’re a human.

We take such pride and care for our patients, that price does not enter into our minds when we are presenting a treatment plan.   Vet clinics are just like any other small business, it costs money to run a clinic, pay staff and maintain equipment.

We value what we do and that is why I know I get upset when someone says that we are just in it for the money, it offends me.

Our goal at the end of the day is to help your pet feel better, extend their life and make them happy.