He was diagnosed with early renal failure and this is being managed well with diet change and subcutaneous fluids. He has issues with chronic constipation and this is being managed when need with enemas and laxatives.
The next one is the doozy. Tucker had been peeing blood and standard urinalysis was unrewarding to the exact cause. During one of his recent exams palpation of his abdomen revealed a lot of feces which made evaluating the bladder difficult. When standard therapy for suspected urinary tract infection failed, more diagnostics were underwent to try and figure out what was happening.
Tucker had a specialist abdominal ultrasound which revealed a mass in his bladder. After further discussion Tucker was referred to a referral hospital for a specialist surgical consult; it was decided to go ahead with surgery to try and remove the mass. Tucker had about ⅓ of his bladder removed in an attempt to get wide margins for the invasive mass. The pathology report came back as a Transitional Cell Carcinoma, which is the most common cancer of the bladder. It can respond well to chemotherapy and so Tucker was then referred to a specialist Oncologist.
Tucker is currently undergoing a regiment of chemotherapy with an Oncologist and he is doing pretty good. This case demonstrates the importance of specialists in veterinary medicine. Much like human medicine there is often a need to see multiple doctors in order to get an accurate diagnosis and proper treatment.
At last update Tucker is doing well. He still has energy, eating well and gets love of love and hugs from his family at home, and here at Smith’s. We all wish Tucker the best as he proceeds with his treatments.
Tai ❤ is a 6 years old Australian Shepherd. He presented to Smith’s for check-up after he was noticed to be drinking from everything [including the bird bath, kiddie pool]. His appetite was a little bit off and he seemed to be slightly lethargic. His examination was fairly normal, but blood work was initially run to screen for any obvious disease [Tai has a habit of eating things he shouldn’t]. The results showed a mild elevation in his kidney enzymes, but otherwise things were fairly normal. Next we had an ultrasound performed to assess the kidneys and other abdominal organs. The ultrasound showed that a lot of Tai’s intra-abdominal lymph nodes were enlarged, and closer physical exam revealed a mild enlargement of some of his peripheral lymph nodes. A sample was taken from a number of nodes around his jaw and shoulder for further investigation.
Lymph nodes are found throughout the entire body and are one of the body’s first line defenses against infectious agents. Any kind of stimulation to the body can lead to enlargement [e.g. teething, skin rashes, allergies. Samples of the lymph node do not always reveal the underlying disease, but help to differentiate a ‘reactive’ lymph node [ie. reaction to an antigen] from a cancerous one [e.g. Lymphoma].
Unfortunately Tai’s aspirates came back consistent with lymphoma. After a long discussion Tai was referred to an oncologist for further assessment. At this appointment it was decided to start chemotherapy and Tai has had two rounds so far. His lymph nodes are decreasing in size and he is starting to feel more himself. We send our thoughts of good health and positivity to Tai and his family as they battle through this rough patch.
Emerald (Emma) Vegnaduzzo
Emma ❤ is a young Schnauzer who presented for difficulties urinating. She was dribbling urine and had obvious soreness while urinating. A urinalysis revealed a urinary tract infection. Despite being on antibiotics and pain relief, the symptoms continued. An x-ray revealed a large number of stones in the bladder. A cystotomy [bladder surgery] was performed to remove the stones, and they were sent off for analysis. Emma recovered well from the procedure.
Stones of the urinary tract can be found in the kidney [renoliths], ureters [ureteroliths], bladder [uroliths] or urethra [urethroliths]. Most humans have heard of kidney stones and It is often very surprising to people when they are found in the bladder.
There are multiple types of stones and they each have a variety of factors that lead to their formulation. For example some breeds of dogs are prone to developing stones [e.g. Schnauzers, Dalmatians], some lifestyles predispose to it [e.g. Neutered, indoor male cats] and some stones develop secondary to urinary tract infections.
Diet has also been linked to stone formations, and so some pet food companies have researched and developed specific diets to help try and prevent the formation of stones in our furry friends.
Emma has been doing very well since the procedure, and her family could not be happier. Her stones we determined to be composed of Calcium Oxalate, which is very common for the breed. We wish her family the best for the future!
Ted ❤Ted is an adorable Airedale who presented to the clinic for poor appetite and pain after a weekend with friends and family. On physical exam Ted was very depressed [very unusual for Ted] and had pain in his abdomen. Worried that Ted had ingested something inappropriate, x-rays were taken to rule out a foreign body and blood work was performed to investigate liver / pancreas involvement. The x-rays revealed a mass in one of Ted’s organs. Blood work revealed elevated lipase indicating pancreatic inflammation. The worry was that Ted’s mass was pancreatic related. Ted had an ultrasound done which revealed that he had both pancreatitis and a mass in the spleen. The spleen itself is important in the regulation of white and red blood cells. It contains a large volume of blood and most masses of the spleen are related to the blood vessels that maze around within. If a mass in the spleen ruptures this can leading to bleeding into the abdomen, and it some cases, sudden death. Removing the spleen is the best course of action to prevent any kind or rupture. Pancreatitis is a fairly common inflammatory condition of the dog, often occurs secondary to inappropriate ingestion of foods containing high levels of fat or protein. Ted was taken to surgery and his spleen was removed before the mass had ruptured. He recovered quite well from the procedure and had been doing great since. The mass was sent for evaluation and there was no obvious sign of malignancy detected. We wish Ted the best in his recovery and a happy, healthy life for the future.
Bella ❤ Bella is an adorable, young Keeshond. She has been making regular visits to Smith’s since she was a wee puppy. The last year Bella had been limping intermittently on her forelegs, and they would improve with a bit of rest and pain relief. X-rays were taken of the elbows and it revealed a fairly serious elbow dysplasia, that is likely congenital in nature. Despite the severity of the condition, Bella continued to be an active, energetic and alert dog. Running around and barking at other dogs in the park, playing with her family and being incredibly adorable. Then Bella developed intermittent diarrhea. It would respond symptomatically to certain antibiotics but then would always come back. At one point she was at an after hours clinic for bloody diarrhea where they found she had low albumin [blood protein]. Low protein levels are either losses in the urine, feces or decreased production by the liver. Diagnostics [urine samples and ultrasound] isolated the problem to the small intestines that suggested an inflammatory bowel disease. Medications and special diets are being employed to try and control her clinical signs. Bella is still very bright and alert and gives kisses every time she is in clinic. We hope that we are able to garner control of her condition to ensure a happy, comfortable dog. Good Luck Bella!
Chewy ❤ Chewbaka is a lovable, 13 year old Collie Mix. Over her many years she has dealt with a few health concerns including knee surgeries and urinary incontinence. Recently she had an episode of illness characterized by weakness, inappetence and diarrhea. Primary diagnostics revealed severe elevations of her kidney enzymes and a urinary tract infection. An abdominal ultrasound was performed and it was discovered that Chewbaka had large stones in both her kidneys and one of her ureters [the tube that leads from the kidney to the bladder]. The most likely cause of stone development was a severe kidney infection. Things were looking grim for poor Chewbaka. Kidney stones, while less common than bladder stones, are secondary to similar factors [e.g. infection, diet, metabolic disorders]. If left untreated kidney stones can obstruct urine flow through to the bladder causing progressive kidney failure. Treatment depends on the underlying cause and some stones that are tiny, often can be left alone. Diet to dissolve stones [depending on stone type], surgery and lithotripsy are the typical modalities for therapy. Lithotripsy involves breaking the stones into smaller pieces use shock waves. Chewbaka was treated in hospital with supportive care of intravenous fluids and anti microbials. Due to her current instability surgery was not a safe option at the time. Once stable enough for at home care Chewbaka was discharged for continued support at home. Chewbaka’s parents worked hard to support her during this time; she didn’t eat very well, she became difficult to give medication to and needed to be assisted with walks. With a strong and unwavering support team at home Chewbaka made great strides in her recovery. Getting her in for regular rechecks her condition continued to improve as did her kidney values on blood tests. At her last check she was walking unassisted, eating well and not peeing around the house. We want to commend Chewbaka’s family for their hard work – physically and emotionally – for giving Chewbaka the care she needed to get better. We hope that Chewbaka continues to improve and will soon be clear of her kidney infection and once stable can discuss further stone management.
Fred (AKA Fred Fred) Toben
FRED ❤ (AKA Fred Fred) Amidst the holiday season and new year we would like to nominate one of the nearest and dearest visitors to our hospital. Fred, and his dad Jerry, have been coming to SVH for a long, long, long time. Last month Fred celebrated his 23rd birthday and it is our honour to celebrate him. At 23 years old Fred is one of the oldest cats on record at SVH. He didn’t make it to 23 without some health scares along the way. Fred was hyperthyroid – for a while he was on medication to control it but then it was decided to go with a more permanent form of control — Radioiodine therapy. This kept Fred’s thyroid levels in check. Fred has had recurrent bouts of pancreatitis, which he has been successfully treated for on multiple occasions. Most recently Fred’s kidneys have been giving him a hard time. 23 years old kidneys do not work as well as they used to, this leads to dehydration which can impact all of Fred’s other organs. To combat this chronic dehydration, Fred gets subcutaneous rehydration three times per week. Fred has also developed anemia [a lower than normal amount of red blood cells], which can occur as kidney function wanes. Fred has recently start hormonal injections to try and boost his Red Blood Cell levels to give him some more energy. So we at SVH would like to celebrate Fred for making it to [and passed] 23, and we hope to be there with him for the remainder of his!!!!
December 2016 Zbo Can Zbo ❤ is an English Bulldog with a bit of a corker of a problem. He presented for not having defecated for 4 days. He had been trying profusely but couldn’t produce any feces. There was no history of trauma but he had been constipated before. His current diet was raw food with bones. A feel of his belly revealed a large amount of firm feces. X-rays confirmed that the feces was present and there was no obvious fracture in the pelvis or obvious intestinal abnormality. Rectal exam was unrewarding as the feces was just out of reach. Therapy for constipation varies based on the underlying cause – for example bone impaction, megacolon, foreign material, cancer, hairballs and fractured pelvis. Most constipated animals are dehydrated at time of presentation and need to have this corrected. Once the hydration is achieved you work to remove the fecal load from the colon. You can work from the front end giving laxatives, or work from the back end and try enemas. Once the animal is relieved then addressing the underlying cause to prevent it from happening again is imperative – this can be as simple as a diet change or may require chronic medication. Severe constipation is called obstipation and these patient require the most intervention. Attempts to remove Zbo’s blockage using laxatives and enemas were unsuccessful. He was transferred to the emergency hospital and after 4 days they were able to relieve the obstipation. We wish Zbo the best for the future, and will them find a diet that helps keep him regular.
Zoe ❤ Cooper is older dog with a heart murmur. She has had one for a long period of time but recently it intensified. Zoe’s parents brought her for trouble breathing and coughing, and on exam her respiratory rate was over 100 breaths per minute. In consult she coughed up some clear foamy fluid. An x-ray confirmed that Zoe’s lungs were filled with fluid. Emergency care was started and once stable Zoe was transferred to an overnight hospital for further treatment. Congestive heart failure is a common sequelae to heart disease. Often dogs, or cats, will have a mild heart murmur for years. This does not indicate that the heart is failing, only that blood flowing through the heart is creating extra noise – this can be more many different reasons. To investigate those reasons a cardiac ultrasound can be performed to determine the exact nature of the murmur – for example a faulty heart valve or a thicker heart wall. Therapy is targeted and controlling the clinical signs secondary to the specific heart disease – diuretics to reduce fluid in the lungs, beta blockers to reduce rapid heart rates and even medication to make the heart beat stronger. Zoe spent the night in the emergency hospital where she was monitored and given further diuretics to eliminate the fluid in her lungs. She was discharged the next day and start on at home medications, to which she has responded favourably, and we hope that this continues for a long time. Update: Zoe’s mom is happy to report that her baby is doing remarkably well and has made an amazing recovery since being on her medications! All the best Zoe!
Newt ❤ is a 13 y/o Papillon who has chronic issues with his knee cap. He was born with a condition called luxating patellas; which in essence is a dislocating knee cap. This condition is common among tiny breed dogs. The groove that is meant to hold the knee cap is too shallow and the knee cap escapes. Patella luxations are graded out of 4, with 1 being minor and 4 being severe. Low grade luxations often needs minimal intervention and the animals have good function of the limb. High grade luxations more often require surgical correction, as typically the animal cannot bear weight on the limb. Newt had low grade luxations his whole life, but one day Newt’s family came home and he was limping on his right hind limb. It was apparent that his luxation had worsened. His knee cap would not stay in place and he couldn’t walk on it. X-rays were negative for a fracture, but there was mild swelling within the knee joint itself. The thought was Newt hurt himself while nobody was home and worsened his luxation. Newt was scheduled for surgery with a specialist surgeon. The specialist found that Newt had actually torn his cruciate ligament! It is common for a ruptured cruciate to exacerbate a luxating patella. Newts cruciate rupture and luxating patella were dealt with in one surgery. It is 2 weeks out and Newt is doing great. His family is performing his daily physiotherapy and giving his pain medication.Newt is already bearing weight and wants to run around the backyard. We wish him a speedy recovery.
Jake ❤ is a 16 month old male, neutered Domestic Long Haired cat. He lives happily with his best friend Gavin. Jake spent the weekend at Gavin’s parent’s house, while he was there he spent most of his time hiding under the bed, likely because he was unfamiliar with the environment. When Jake got home he seemed grumpy and not himself. He wasn’t eating his favourite foods. He was excessively grooming his groin and crying a bit. When Jake came to visit his physical exam revealed that he had a very large, painful bladder and he was unable to relieve himself. Jake was experiencing an urethral obstruction. A urethral obstructions is when something blocks the outflow of urine from the bladder. These are most commonly physical [e.g. Crystals, Mucus, Stones] but can be anatomical [e.g. mass] or physiological [e.g. increased sphincter tone] as well. Overweight, indoor, neutered male cats have been shown to have higher incidence of urethral obstruction. If the obstruction continues for too long there is real risk for bladder rupture as well as kidney damage. Jake was admitted to hospital for further testing and to clear the obstruction. Jake was given heavy sedation and pain relief. A urethral catheter was passed until an obstruction was felt. Gentle flushing with saline was able to dislodge the obstruction which ended up being a ‘plug’ of crystals. Jake was given intravenous fluids and monitored in hospital until he was able to urinate on his own. Feline Lower Urinary Tract Disease [or FLUTD] is a complicated condition that involves both a behavioural and urinary tract component. Stressful situations can induce a sterile cystitis which leads to the development of crystals. These mix with mucous and plug the urethra. Inappropriate diet is another cause of crystal production. Alterations in the pH of urine create an environment that encourages crystal production. Jake was started on a special diet to help reduce crystal production. Jake will also be kept out of as many stressful situations as possible. At last check up Jake and Gavin are doing great, both are happy and healthy! We wish them both the best!
Henry De Santis
Henry ❤ is an adorable American Bulldog. Great temperment – super friendly, loves to have his belly rubbed and loves kisses. Unfortunately, he also loves scratching! Excessive scratching is common in dogs that have allergies or external parasites. Henry has been on flea and mite prevention to reduce the risk of parasites. Henry has had allergies since he was a young pup [and he is only 2!]. It started out with only some mild bumps on the head but progressed to full blown itchiness across his entire body and ears. Allergy is a very broad diagnosis and it can be very difficult to identify an exact cause. Allergies are differentiated into different categories classified on their suspected origin —
>Atopy – similar to what we consider seasonal allergies.
Allergies in dogs and cats can lead to some pretty intense scratching, and because of their sharp nails they can do a lot of self-trauma. This can lead the way to superficial skin infections [dermatitis], which also makes them itchy. Now they are itchy because of allergy and infection and both problems need to be addressed to ensure a happy and healthy pet. Once a doctor has a suspicion about a type of allergy they will aim to control that allergy and treat any concurrent infections [e.g. changing the diet, using antihistamines to stop itch, antibiotics, special topical therapies]. Skin cultures can be used to identify troublesome bacteria that is not clearing with standard therapies. Testing can be done to try and identify specific problem allergens – skin prick tests and serum allergy testing can be performed. If an allergen is identified then immunotherapy can implemented to desensitize the patient, or avoidance of the allergent. Henry is suspected to have atopy with some food allergy as well. He is currently being managed well with shampoo therapy and a new anti-itch medication called Apoquel! We hope he continues to do well on this therapy and remains happy and itch free!
Jack ❤ is a large, large Borzoi who lives with his sister Sasha. They have a storied history, being generous gifts of thanks from a team of Russian hockey players. They have lived harmoniously together, both being un-fixed, for years without any pregnancy. Jack presented for excessive ‘cleaning’ of his genitals and some blood dripping from the area. A urinalysis was consistent with infection and Jack cleared up on a standard course of antibiotics. Then the problem came back, again and again. Jack had an ultrasound of the urinary tract performed to figure out why he kept getting these infections. The ultrasound revealed that Jack has a severely enlarged prostate, which is likely secondary to infection or a condition called benign prostatic hyperplasia [BPH]. Prostatis, BPH and prostatic cancer are all inflictions that are more common in un-neutered male dogs, as the prostate is strongly influenced by testosterone. Many therapies to treat prostatic disease involve blocking the effects of testosterone, or removing the source of testosterone production. Common clinical signs of prostatic enlargement are blood in the urine, pain when urinating and even constipation! Currently Jack is doing well on his medications and has had his neuter surgery. He is happy and bounding around like a majestic elk. We wish him a speedy recovery.
Chili ❤ is one tough Miniature Pinscher. He lives with his 2 ‘brothers’ and they all get along well. Late last year, Chili’s family noticed he was having some difficulty peeing and there was blood present. A urinalyisis and culture was performed, and there was no bacterial infection present, but a large amount of red blood cells. Blood in the urine [hematuria] is a common finding with urinary tract pathology. The most common organs affected are the bladder and kidneys. In dogs hematuria can be encountered with urinary tract infections, bladder stones, polyps and tumours. After further discussion a specialist ultrasound was performed to evaluate the urinary tract. In turns out the Chili has a tiny mass growing inside his bladder. A catheter was inserted to collect a sample directly from the mass itself. The lab results came back with the diagnosis of transitional cell carcinoma. A transitional cell carcinoma is tumour of the bladder lining. The tumour commonly spreads to other areas of the body, and can be found in the lungs, liver and kidneys. The good news is there are a number of treatment modalities available – surgery and chemotherapy are available and provide a good long-term prognosis. Currently Chili is doing well on current treatment plan, and we wish him the best in his fight with cancer.
Biggie ❤ is one of the most adorable pugs in the world. He brings smiles to the faces of everyone at the clinic when ever he comes in. He has always been a healthy pup until one day he started feeling sick. Biggie began having daily vomits. There had not been a diet change and there was no suspicion he had eaten something inappropriate. He was still eating well but would throw up a few times a day. Blood work was run to rule out certain conditions [e.g. liver / kidney disease, Addison’s, pancreatitis]. X-rays were suspicious of a foreign body and an ultrasound was performed to confirm its presence. The ultrasound, performed by a specialist, was clear of an obvious foreign body or other obvious anatomic abnormalities [e.g. pyloric stenosis], the suspicion being inflammation as the cause of his signs. He was sent home with symptomatic therapy – a low fat diet, an anti-emetic and antibiotics. The next day Biggie was still vomiting even on the special diet and symptomatic care. The ultrasonographer returned to double check and again no foreign body was discovered. A portion of the intestines had reduced motility which may have been causing reduced outflow of food. Biggie was started on intravenous fluids for rehydration of the intestines and continued on symptomatic care. Food was withheld for 48 hours to allow the GI tract to rest as well. After 48 hours of therapy Biggie was restarted on small amounts of food. His parents home-cooked for him and things were great, until he was placed on Gastro dry food again. Then the vomiting started again. We withdrew that food and started a different specialized diet, and since then Biggie has been perfect. Vomiting is a frequent presentation for patients at Smith’s. Many times a thorough history will get to the bottom of things, but sometimes a work up is needed to rule out more serious conditions. Working with specialists is also an important diagnostic tool – their insight often helps provide appropriate therapy. Food sensitivity is a common concern in dogs and cats as well. Grains, proteins, preservatives — the list goes on and on. It can be difficult to determine the exact nature of the irritant and so multiple diet trials may be needed to determine an appropriate maintenance diet. Biggie is still doing well and looking great at home. We wish him and his family the very best of health in 2016.