Author: Dr. Christine McFadden

The Lost Turkey

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Thanksgiving 2016

Sooner or later a turkey is bound to fall off the truck. I don’t know how it happens nor why it seems to occur only at this time of year (turkey production is no longer seasonal), but there you have it. A large white domestic turkey (not to be mistaken for its brown-feathered wild brethren) falls off the transport truck between farm house and processing plant. And a Good Samaritan sees it by the side of the road, pulls over, and struggles to fit the somewhat ungainly bird into their back seat. Never mind the stray feathers and turkey, um, effluvium.

I am ultimately presented, as my patient, with a live, knobby legged Thanksgiving turkey who may have suffered some scrapes and cuts (once, a broken leg) but is often surprisingly unscathed by its ordeal and very much looking forward to its next life in the lap of luxury as a pet.

This is where two worlds collide – not so much Magical Beasts and schools called “Hogwarts” – but the pragmatic eye of the farmer versus the starry-eyed vision of the Good Samaritan.

Our farmers work hard. They put in long hours and worry over everything that can affect their crops or the livestock they raise, from rainfall to heat exhaustion. Will they get a water allotment this year to grow enough hay and feed for their animals? Once the hay is baled and the feed stored they wonder how many mice or squirrels will try to make off with it? Or what sort of unseen bacteria might introduce a disease to threaten their herd – and the farmer’s livelihood? It can be a dicey business and YOUR dinner’s success depends upon it.

Ah, therein lies the rub. The farmer is trying to feed you. The Good Samaritan is rescuing an animal in distress – worse, one that was on its way to certain death. And now they’re in front of me, asking to heal their injured turkey. More, often the G.S. is railing against a system where they abruptly come face-to-face with where dinner comes from.

I do my best. I come from farming stock, though I was raised in the city. My training has been thorough and I accept the farm-to-table process. I am personally unable to name an animal and eat it (we’re talking chickens and turkeys here, stay on track) but am capable of a guilty, wicked sense of humor when confronted with a situation like this, where I want to whip out my recipe cards and start murmuring, “wait, I have the perfect orange sauce right here.” May I hasten to add, No! I have never said this. I remain professional.

I have helped these turkeys. I patch up their scrapes, administer medicine, pinned that broken leg. And although never has one become a returning client, it always puts a smile on my face when my annual Thanksgiving bird arrives in our office as secretly I, too, root for the one that got away!

Post Script : For those who may have read a recent column : All three large-breed dogs who came in on harnesses this week tried to bite me. One wore a red harness, another brown with a pink leash! It’s true!

 

Christine B. McFadden, DVM

drmc@mcmenagerie.com

Mac the Mountain Lion

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You would think that making a hotel reservation in San Francisco 10 months in advance might guarantee you would show up on the appointed day. You would think that by talking about this proposed trip to your fellow staff members, every day, all day, starting a week in advance would promote your cause and that you would, indeed (for once), be on time. San Francisco isn’t that far away.

 

My choice of careers sometimes leaves me sweating. We work by appointment but I rarely bother to check my schedule. Planning ahead is great but means nothing because truly, illness is not planned, nor are emergency hit-by-cars or BBBD’s (Bit by Big Dogs) or other accidents. So I show up on time and pack my lunch. From there I proceed as directed. Helping animals is interesting and fulfilling for me and it is rare for me to begrudge an intrusion into my “personal” time.

 

I felt a little frisson of apprehension when Donna, the Zookeeper of Merced City’s Applegate Park Zoo, mentioned that Mac wasn’t eating. It was the day before I was supposed to leave. Mac is our Mountain Lion. He and I go way back – so far back that he is actually my namesake! Mac was sent to the Zoo as an orphaned cub weighing only 5 pounds. Mountain Lions (felis concolor) are also known as cougars or pumas. They range in the foothills and mountainous areas of our region. Our Zoo cares for a population of native wildlife that has been orphaned or injured, deemed non-releasable to the wild and would otherwise be humanely euthanized. We provide these animals a safe home and in turn provide an educational resource for our community to learn about the birds and animals indigenous to our area, from the waterfowl that migrate through our great Valley to our unique variety of Birds of Prey. We are enriched by the mountain lion, bobcats, black bears, foxes, coyote, and deer found within our zoo and native from Merced up to Yosemite National Park.

 

Mac was spotted and spunky, with a baby “roar” that sent shivers down your spine. He had to be bottle fed, but didn’t tolerate the Kitten Milk Replacer (KMR) he’d been started on. I called a wildlife expert at UC Davis and they advised that tigers and lions should not be fed KMR, only smaller cats. Who knew? We straightened out his formula and Donna, the Zookeeper, put hours of care into bringing him back around.  Mac was vaccinated, microchipped and neutered and grew into a gorgeous, well-muscled young lion. In the early morning hours he could be found intently creeping along the ground, stalking young visitors outside his pen. The kids never noticed. Donna he fell in love with, and will answer her and purr just at the sight of his foster Mom. For Donna’s part, she respects his wild nature. Donna knows that one playful swipe of his enormous paw could gut her. She stays outside his fence at all times.

 

Animals in the Zoo have the benefit of living much longer lives than they might in the wild, being well fed and receiving medical care. On the downside, they are not as active nor do they have the stimulus of hunting for their food. Avid zookeepers search for ways to enrich the environment of their charges and many novel sights may meet your eyes as you tour the Applegate Zoo. Mac has a log cabin and a very high “mountain perch”. He has a large “kiddie” swimming pool which he especially enjoys in the summer and has been known to nap in. Mac the Mountain Lion also loves soft cuddly towels but may not have them because he eats them.

 

The Zoo is supported in part by the Zoo Society, through fundraisers. Each year for Halloween they put on “Zoo Boo”, decorating the Zoo in spooky costumes and offering safe trick-or-treating. Mac hates Zoo Boo. Like the “Grinch Who Stole Christmas”, he hates the noise, noise, noise! So when he went off his food this year, no one was worried at first. But 2 days went by, the ghosts and goblins were gone and still he wasn’t eating. Now, a Mountain Lion who needs an exam is no easy patient. So at noon on Friday (San Francisco on hold) we had to squeeze him up close enough for me to inject an anesthetic. Once asleep, I examined his mouth for anything caught in the back of his throat but it was clean, so off we went to the vet hospital. An x-ray of his abdomen revealed that his stomach was packed full of “something” that didn’t belong there! Into surgery went Mac! We opened up his abdomen and hefted out a very heavy stomach. Once opened in a procedure called a gastrotomy we removed 2.2 pounds of firehose, wadded up in big mountain lion-sized bite sized pieces. Mac had been offered this as a play toy for “enrichment” but had chewed it up and eaten it instead. Many sutures later he was all put back together and returned to his home at the Zoo, where he is making a full recovery and already looking for more mischief to get into. And yes, I made it to San Francisco after all. Good grief!

 

Christine B. McFadden, DVM

drmc@mcmenagerie.com

 

Scientific Discovery : Koch’s Postulates

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Subtitled : Big Dogs and Harnesses

 

I have made a huge scientific discovery! Hold your breath just a moment more and I’ll share it with you. Now science, as we all know, is based on evidence. Evidence starts as a belief that must be supported by facts; a fact is something that can be proven. Facts are often supported by research. Do you remember Robert Koch from your school days? (From your science classes, of course). In 1890 he published a paper called “Koch’s Postulates” which outlined four criteria that had to be met to determine if a particular bacteria or microbe caused a disease. This was groundbreaking evidence at the time. Or possibly your school days were spent in other studies, as the Mock Turtle in Lewis Carroll’s “Alice’s Adventures in Wonderland”, who was only able to take the “regular courses”. When asked what he studied he replied : “Reeling and Writhing of course, to begin with, and the different branches of arithmetic- ambition, distraction, uglification, and derision.” Whatever courses you chose to study, I shall refresh your mind about Koch’s Postulates.

 

Dr. Koch required four criteria to be met (modified wording):

  1. The microorganism or pathogen must be present in all cases of the disease. (A pathogen is often a bacteria or virus that causes disease)
  2. The pathogen can be isolated from the diseased person or animal host and grown in pure culture.
  3. The pathogen grown in culture must cause the disease when given to a new, previously healthy patient.
  4. The pathogen must be again isolated from the newly sick host and identified as same.

 

In 1890 Dr. Koch created guidelines for the scientific community as researchers hurried to determine the underlying cause of many diseases. Badly needed at the time, Koch’s Postulates have come to be refined and modified as Science has become more sophisticated and modern technology continues to open up areas of exploration where truly, no man (or woman) has gone before.

 

I wish to invoke Koch’s Postulates as the gold standard upon which I have built my own fabulous contribution to the Body of Knowledge known as veterinary medicine or maybe Truisms of Life or maybe just What Always Happens When a Large Dog appears in a Pink Harness. Here we go.

 

McFadden’s Unvarying Inviolable Life Truth:

“Large Dogs in Pink Harnesses Will Bite You.”

 

Please, take your seat, no standing ovation necessary.

 

The pathogen here is the harness. The disease is uncontrolled behavior. And I fudged a bit – Large breed dogs in ANY harness will try to bite you. Dogs in PINK harnesses will probably try to attack you. Maybe it’s the embarrassment of being caught out in pink. Boy or girl dogs.

Number 1. The harness must be present in all cases of the not-well-controlled lunging dog.

Number 2. The harness can be removed from the dog and a proper collar replaced, one capable of delivering correction and asserting control, and dog manners will improve considerably.

Number 3. Large dog harnesses, cultured under grow lamps in a factory, will, when bequeathed to a new Shephard or Husky or what-have-you, produce equally out-of-control dogs without any sense of boundaries in their life. As they jump at you, clawing your legs or snapping at your hands their owner will assure you that they just want to play.

Number 4. Remove the harness from the poorly trained dog (yep, it’s the harness) and start over. Postulates fulfilled.

 

I’m definitely on to something here.

 

Christine B. McFadden, DVM

drmc@mcmenagerie.com

 

The Liver

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If you’re ever stranded in Alaska in survival mode and must save yourself by eating a polar bear (before it eats you – polar bears are one of the most dangerous bears around) do NOT eat their liver! Eating a polar bear liver could kill you! (they accumulate huge amounts of Vitamin A in their livers, which is toxic at high levels). Livers fascinate in other ways. Liver is considered one of the most nutrient-dense foods you can eat, packed with vitamins, minerals and protein. Packed with iron to prevent anemia. Think French pates, liver and caramelized onions, foie gras. But the liver doesn’t start out as a benefit for our tables, this important abdominal organ is best known as the body’s “workhorse” or factory. It is considered the most crucial organ in the body. (The heart is obviously very important, but it doesn’t do half the things the liver does to keep a body going). Tucked under the diaphragm that divides the abdomen from the chest, the liver’s dark maroon lobes fill the upper right side of the abdomen. The liver makes body proteins and blood clotting factors. The liver makes enzymes and antibodies and detoxifies the blood. It is the only internal organ capable of regenerating itself when damaged.

 

She was a dog as straightforward as her name. “Patty” was a blue merle Australian Shepherd. She grew up on a farm, did her chores, followed her master faithfully and if a cow kicked at her or some mud got in her coat she just accepted it and kept going. Patty had a job to do. Vaccinations and visits with the vet were also just a part of life and she accepted that and moved on. Petting and treats from strangers were accepted graciously but certainly not begged for. Patty knew her value.

 

Every good athlete eventually faces that moment of recognition when the youngster can run faster and jump higher. So it came to pass that Patty, with all her experience of years and dog smarts, was noticeably slower than the younger dogs she had helped train. Time to start her on some arthritis medication. Wonderful news, it helped. Patty could still put on a good show. She’d been on medication for about four months when her owner carried her in to the vet hospital one morning. Patty wasn’t eating, had been vomiting. And she wouldn’t even get up to check out the barn in the morning. Something was very wrong.

 

Should you ever see any creature, animal or human, suffering from jaundice you will not soon forget it. From across the room the whites of Patty’s eyes glowed neon yellow. I lifted her lip to inspect her gum color and instead of a healthy bubblegum pink color they also glowed a dull yellow. The insides of her ears were eerily yellow. Patty was jaundiced, or in medical terms “icteric”. Jaundice means to turn yellow. The yellow color comes from a pigment found in red blood cells that have broken down. The liver is supposed to help process this

by-product, then wash it into the intestine so it can pass out of the body. If liver function is compromised, this yellow pigment called bilirubin will build up in the bloodstream to toxic levels, turning mucous membranes and even skin yellow. Patty was in critical condition.

 

Bloodwork, x-rays and an abdominal ultrasound all provided answers to different pieces of the puzzle. We were able to determine that although Patty’s liver function was severely compromised, she did not have an infection or cancer. Although a working farm dog, Patty had not been exposed to pesticides or other toxins. Our differential included the possibility that she was suffering an adverse reaction to her medication. Patty was hospitalized and started on intensive IV therapy to flush the bilirubin out of her system. Medications to relieve other symptoms of nausea and provide hepato-protection were also administered intra-venously. We monitored her progress  through daily blood tests. Over 48 hours passed before we could visibly see the fading of yellow from her skin. Patty made it. To be safe, we changed her arthritis medication to one processed by the kidneys. The cows sent their thanks.

 

Christine B. McFadden, DVM

drmc@mcmenagerie.com

 

 

 

 

Emergency Work

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Dr Mc Blog

January 14, 2016
Emergency work is not as much fun as it’s cracked up to be. I imagine it’s easier when that’s ALL you do, and staying up all night takes on a kind of rhythm, you adjust to sleeping during part of the day. I am one of those unfortunates who do not do well after 24 hours of being on my feet and some adjustments have had to be made in my career because of it.

They should have recognized this back in vet school. One particularly hellish week I was assigned to the Small Animal Intensive Care rotation. I am certain they used this to weed out the weak : I was assigned evenings, over-nights, and mixed them back and forth. I had one day. In addition, we were all to present for Rounds at 11 AM, or else. By the end of the week I was so groggy from lack of proper sleep that I had to stand, then sit, then jump up again during rounds just to keep awake. My remaining memories from this time were of a dog that presented for near-fatal bleeding ulcers of the stomach, caused not by the 5 pound box of Valentine’s candy he ingested (chocolate can be very toxic to dogs) but by the helpful owner who heard you can give them hydrogen peroxide to make them throw up and instead of a tablespoon (which would have been the recommended amount for a 90 pound dog by her veterinarian) she managed to throw a good pint down his throat. The dog lived, but it was nip and tuck for a while. There was a parrot caught in a typewriter. (We ended up dismantling the typewriter. The bird suffered a small laceration on one toe, which healed beautifully). And there was a female client who was so impressed with her station in life that she addressed her husband as “Dr” and we all wondered if she wasn’t allowed to use his first name. I’ve met more of that type since and now understand that they just need to get over themselves. But these days in school only served to underscore what I already knew – some of us just can’t pull all-nighters.

And of course my first job (yes, here in Merced) involved rotation through emergency work. To be more precise, an emergency medical call can occur at any time of day – seizures, poisoning, hit-by-cars – and it can be inconvenient to drop everything, annoying your other clients, to attend to that pet. On the other hand, at least here in Merced, most clients recognize that that could be them with their pet and they graciously forgive you.

So during the daytime, I can pretty much handle whatever walks through that door. My definition of emergency work is confined to those cases that come in after normal day time business hours, during sleep, on days of presumed rest.

My very first week of being on call in Merced I had two hit-by-cars on different nights and removed two bleeding spleens around 2 AM. They both lived. The third spleen (yes, things come in three’s) came in with a little dog suffering from an immune disorder. He also survived and improved after his splenectomy. So in the first month that I worked as a veterinarian fresh out of school I removed three spleens! I found that odd, but this career has always provided many unusual and odd things to get through.

There was the night I was driving to an emergency call (yes, driving the speed limit) and a cop pulled me over. He knew me (I took care of the police dogs) and he said he thought I’d wobbled. I assured him I’d had nothing stronger than orange juice (it is extremely rare for me to drink alcohol. The effects are worse than emergency work). He replied that he believed my story about an emergency because he knew I never looked that way in the daytime………..

So it is to everyone’s benefit that I procure 8 hours of sleep every night. You might say it’s just what the doctor ordered!

Christine B. McFadden, DVM
drmc@mcmenagerie.com

Accreditation / Monkey Pox Virus

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Dr Mc Blog

 

September 14, 2016
I am going to share with you the Veterinary Accreditation Program through the United States Department of Agriculture (USDA) and the Animal and Plant Health Inspection Service (APHIS). What? The USDA-APHIS educate and certify veterinarians to inspect animals for disease prior to writing a health certificate for animal travel.

The Center for Disease Control (CDC) in Georgia is a governmental body we should all get down on our knees and give thanks for! The CDC is our nation’s health protection agency. It monitors all kinds of diseases that crop up in the United States and abroad that might affect us, from food borne illnesses (think E coli in the spinach or listeriosis in raw cheese products) to contagious measles outbreaks that start at California resorts to zoonotic infections passed from animals to people. The CDC works hand in hand with the USDA-APHIS, and the system trickles down to yours truly, the local town veterinarian. Which means I am authorized to fill out and sign a health certificate for a pet planning to travel to another state or country. Not a big deal? Think again.

Why so much interest you might well ask, in where Fido goes on vacation? Is this just another way that Big Brother is invading your privacy? The short answer is no. According to the USDA-APHIS they are recognizing new emerging infectious diseases world-wide. Of ALL the bacteria, viruses and other disease-causing pathogens that affect humans, they estimate 61% to be zoonotic or spread from animals to humans. Of the new “emerging” diseases they believe at least 75% to be zoonotic. The USDA-APHIS bodies wish to protect YOU by verifying that all animals that travel are disease-free, to safeguard humans. As a veterinarian may I add that this also helps safeguard our pets and our food sources. Our way of life.

The National Veterinary Accreditation Program web site shares some fascinating information of how the local town veterinarian can be a link in this chain of protection.

In 2003 a shipment of over 700 small mammals and rodents were imported to the US from Africa. The wildlife importer brought in dormice, various unusual rats and some rope squirrels. There is always a market for unusual animals in the pet trade, sometimes zoological parks or animal preservation parks, even research. The animals arrived safely in Texas, where they were re-distributed to Illinois. Many of the rats were housed near Prairie dogs. The Prairie dog has been adopted as a pet by many people. They are native to many areas of the United States. They have not been bred in captivity for generations, but may be relatively docile, eat timothy hay and are awake in the daytime which is a real bonus for people who enjoy interactive time with small rodents as pets. Unbeknownst to all, the rats were carrying the monkeypox virus and transmitted it to the Prairie dogs. The Prairie dogs were distributed to pet shops in six Midwestern states. These Prairie dogs went into pet homes.

Monkeypox is a virus in the same family as Smallpox. Smallpox was a deadly viral disease that the European explorers and settlers first brought to the Americas in the 1600’s. Native American tribes had never encountered this virus and had no natural immunity; many Indian tribes were decimated by Smallpox. Smallpox was eradicated in the United States before 1980, so a vaccination program against Smallpox is no longer enforced. Monkeypox was first diagnosed in Africa over 40 years ago. The disease causes a fever, enlarged lymph nodes and small raised polka-dot like spots or rash that may cover the body. Both humans and animals can develop the rash. Monkeypox is known to be zoonotic, spreading from a sick pet to a human by body fluids, soiled bedding and close contact. Signs of Monkeypox can show up as little as one day after exposure. There is no specific treatment against this virus, though vaccination against Smallpox may provide protection against Monkeypox for 85% of the people who receive it. Again, no one has routinely received Smallpox vaccination since 1972. Children born after that time will have no immunity.

Monkeypox had NEVER been seen or diagnosed outside of continental Africa until this outbreak in 2003 in the United States. Over a period of four weeks, from May to June, at least 47 people were infected from their new Prairie dog pets. One of the first family cases started May 11th 2003 when two Prairie dogs arrived in their new home. One of the Prairie dogs was ill with a skin rash and runny nose on the 15th and taken to their veterinarian. By the 20th the family was ill and the Prairie dog died. The veterinarian sent tissue samples to various labs at the same time as biopsies of the skin were being performed on the family by a dermatologist. Joint diagnosis confirmed Monkeypox. Quick action taken by the CDC, USDA and APHIS contained the outbreak. No person died. Monkeypox has not been seen in the United States since.

As a small town veterinarian I have been involved with potential cases of Rabies, Salmonella, Campylobacter, Avian tuberculosis, Chlamydiosis and West Nile disease. All veterinarians are here to serve.

Christine B. McFadden, DVM
drmc@mcmenagerie.com

 

 

Bupthalmia

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Dr Mc Blog

 

August 16, 2016
Somewhere along the way your children catch on to you and become very suspicious when you are happy about something. Mine questioned the origin of names I kept pressing upon them for new pets. They obstinately refused to name the new cat “Tenesmus”. C’mon, I begged, it sounds great, doesn’t it? What does it mean? they questioned. Surly attitude! When I confessed tenesmus meant “straining to defecate” they did not laugh. I told them no one else would know. “No, Mom”, they said.

I have another favorite : Buphthalmia. Yes, it sounds like a long burp! Is there anyone else out there who only burps after drinking root beer? I digress. So what is “buphthalmia”? Pronounce it “bup” then add “thal-mee-ah”. It was an ophthalmologist, an eye doctor, who coined this word. Spelling that ph-th thing was the first question on our opth exam back in vet school.

Buphthalmia is different than exophthalmia. Exophthalmia is when the eyeball bulges out of the orbit, pushed behind by a space-occupying lesion like a blood clot or a mass. Buphthalmia is a little different : you will see an enlarged eyeball, bigger and wider than normal, because the cornea and surrounding tissues covering the eyeball have been stretched out by fluid build-up inside the eye.

The eyeball is nestled safely inside a protective ring of bones, often collectively referred to as the eye socket or orbit. The eye is an amazing organ and provides one of the five major senses, sight. The eyes of many animals have specialized features that allow them to see underwater, see in the dark, reflect light, and see in color. Most mammals and many birds and reptiles have a third eyelid which slides over their eyeball to both protect and lubricate the eye. Humans lack a third eyelid. It slides up from inside the inner lower corner of the eye, near the nose, and may be light pink in color. The inside of the eye is constantly bathed in a gentle fluid, the aqueous humor. This fluid circulates in front of the lens and helps to keep the eyeball round. The fluid pressure provided by the aqueous humor can be measured as intra-ocular pressure or IOP. If you, a human, has ever seen an eye doctor, they have probably measured your IOP with a tonometer – a little puff of air directed straight at the center of your cornea. We also use tonometry in veterinary medicine. Why do we care? Because the fluid in the front of the eyeball can build up, creating too much pressure. Too much pressure inside the eye is diagnosed as GLAUCOMA. This often happens because the aqueous humor doesn’t drain away properly. Once clogged, through a disease process or even an inherited problem of narrow drainage, the fluid builds up, creating pressure on the outer eyeball membranes and cornea which spread and bulge. The eye may look red or bluish and the pupils may dilate. Once the eyeball has enlarged, called buphthalmia, there is no going back. The eyeball will never return to its original size.

Your pet has an emergency. Without immediate medical treatment, in as little as a couple of hours the sustained high intraocular pressure can lead to blindness. If only one eye is affected by glaucoma the other may be at risk. Buphthalmia is a classic sign of glaucoma. Once diagnosed, the remaining Healthy eye should be treated with preventative eye drops for the rest of the pet’s life.

Certain breeds are predisposed to glaucoma, though the largest category is “mixed breed”, so no dog is safe. Cocker Spaniels, Bassets and Beagles, Boston Terriers and Norwegian Elkhounds all make the list. I’ve seen it in a family of Bouviers, an Akita and in Jack Russell Terriers. One day the owner notes their dog’s eye is a little cloudy and the next day as they come in for their appointment it is bulging and blood shot and ugly. It is too late to save the eye. A blind, painful eye requires enucleation or removal, for humane reasons. Thankfully, many eyes can be saved by prompt attention and treatment.

Christine B. McFadden, DVM
drmc@mcmenagerie.com

 

 

Innocent / Tale of The Clinic Cat

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Dr Mc Blog

 

August 2, 2016
Ladies and gentlemen : the story you are about to hear is true. Only the names have been changed to protect the innocent….I take pride in offering good customer service. Which when it collapses, I have been known to say in a hushed voice “Wow. We don’t just drop the ball, we drop kick it into the closest wall.” What follows is a true story. Really.

The family was super nice, a throwback to Andy of Mayberry and Dona Reed. They presented as a mother and father with their sweet 4 year old daughter and brand new puppy. The Mom wore lipstick and a flowered dress. The daughter said cute things and blew kisses. The puppy was a miniature Dachshund and needed vaccinations. Simple enough, a service I provide daily and could do standing on my head. Or is that expression “in my sleep”? In the end, it wouldn’t matter a bit how experienced I was. I was doomed to fail from the moment they said “hello”.

The puppy was adorable and his examination went well. He was calm for his vaccination, which I appreciated because a shrieking puppy often sets off the children and then the mother joins in hysterically and suddenly everyone is snapping at each other and there aren’t enough princess stickers to calm everyone down. I have spent years developing a vaccination technique where I am rarely bitten by either the dog or the mother. These things are more important than you might think. I waved goodbye as I reminded them that the puppy was due back in a month for its next puppy shots and turned my attention to the next patient.

Within two hours they were back. The puppy was quiet, his tail dragging, running a fever, tiny body bumpy with hives. We re-name everything in medicine (not me personally, I just had to memorize it like a foreign language), so properly the allergic skin reaction was called urticaria. I expressed surprise (I was, it’s not that common to see a vaccine reaction) and concern (I was, though there was no indication of shortness of breath, difficulty breathing or vomiting, an indication of a severe allergic reaction called anaphylaxis which can lead to death). I treated the reaction with an antihistamine injection and advised them that we would modify the vaccine type for the next visit. In addition, they could start children’s Benadryl at home the day before to minimize any reactions. They toddled off and the puppy recovered beautifully overnight.

On his second visit the puppy underwent vaccinations without further surprises and we were all grateful. We also performed surgery that day, taking care of a small umbilical hernia that pouched open from his belly button area. The surgery went smoothly and his recovery was uneventful. The family picked him up that same afternoon and took him home, nestled safely in their arms. They were back the next day. He had chewed out his stitches. I re-anesthetized him and put them back in, adding an Elizabethan collar (the cone of shame) and placing him on antibiotics. I talked the Mom down off a ledge every day for the next week as the puppy fell over his cone, refused to eat with it on, threw up his medicine and in general did not cooperate with the program. We got through it.

In a parallel universe, back at work, we had a Clinic Cat. He went by the unimaginative name of “Barney”. This had nothing to do with purple dinosaurs or an Andy of Mayberry character, but originated as he did : he started life as a barn cat and eventually adopted us and moved inside. A big orange tomcat, we fixed him up, literally and figuratively. Barney knew the exact length of a dog’s leash and would calmly sit down and wash his face exactly 4 inches beyond its reach. Clients were always on their best behavior because other animal lovers were watching them and who could stand that pressure? Sometimes we had to spray water at Barney to get him to move before the dog stroked out. He was an unusually gentle cat and greeted many people and their pets. If you didn’t own a dog he could have a very calming effect.

Certainly the child with the miniature dachshund was entranced by Barney. The cat had withstood the affections of several Clinic Children many times over and we considered him the perfect clinic mascot. Until said child and her miniature dachshund puppy chased him under a bench, cornering Barney. Barney lashed out, inflicting a long scratch directly over the child’s eyebrow. All heck broke loose. The daughter’s trust in pets was broken. The child was hurt. She was a beautiful child and this could leave a scar on her face. It might become infected. These were all valid concerns and I sent the family to their pediatrician on my dime. Barney’s career ended and he went to a real home with a proper backyard and no dogs to torment. I vowed to never keep another Clinic Cat. And when the family moved away the following year I breathed a  sigh of relief that nothing could go wrong again!

Christine B. McFadden, DVM
drmc@mcmenagerie.com

 

The Spleen

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Dr Mc Blog

 

July 19, 2016
“Tank” was adorable. An enormous Golden Retriever puppy, he had moved into the long-legged gawky teenage stage most pups go through and was ripe for the adjustments necessary to bond with his foster family, who had volunteered to train and socialize this puppy for Guide Dogs for the Blind. Guide Dogs for the Blind has been around since 1942. They place service dogs each year with blind and low-vision people who benefit from renewed activities and lifestyle once accompanied by their “Seeing Eyes” dog.

In order to prepare a puppy for his or her future responsibilities and to bond with people they benefit from leaving a kennel situation and moving into a home. A youngster needs to learn basic manners, basic obedience training, be properly housebroken and above all, be loved. Many future guide dog puppies are placed in homes through 4-H programs. They may live with their foster family for over 12 months, when they are returned to the Guide Dogs for the Blind school for temperament testing and suitability as a Companion Service Dog. A puppy that passes this test will be enrolled in further training, at the end of which they are matched with their Human. The foster family is invited to attend the Graduation Ceremony and meet the new Team (Guide Dogs may remain the property of the School). Dogs that do not pass an entry test will first be offered back to their foster family before being placed in a pet home.

Thus it was that Tank came home to roost. Large and ebullient, he was deemed a little too frisky to take his job seriously and flunked out of the program. Far from hanging his head in shame, Tank was overjoyed to be reunited with his first family and never looked back. He demolished hoses, lounged in the swimming pool and ate them out of house and home. On his visits to the Clinic we put on our “calm” faces – when pleased to see you (and Tank was pleased to meet everybody!) Tank could literally knock you over with his enthusiastic greetings. Subtlety was foreign to Tank, but his doggie charms were irresistible and he was so cheerful that we all loved him.

That was 11 years ago. Today Tank is nearly 12 years old. His owner has brought him in because he is very quiet, too quiet even for a dog that has calmed down with maturity. His weight has dropped, though not because of a diet. His gum color is a little pale, suggesting the possibility of anemia. Most horribly, I can feel a large mass in his abdomen. I keep my head down for a moment, bent over the dogs’ back as I consider what I shall say. Before I have to look his owner in the eyes. That first moment when unspoken fears are acknowledged.

We discuss tests, his age. Tanks’ owners agree to pursue a diagnosis.

The blood tests deliver both good and bad news. Tests confirm that Tank is anemic. But his liver and kidney function are good, other internal organs good. X-rays demonstrate a large undefined mass in his abdomen. We continue to an ultrasound examination of his abdomen, which helps to identify the spleen as the mass. We are breathless as the machine’s probe moves up to explore Tank’s liver. One of the most horrible cancers a dog can get typically involves both liver and spleen. Tank’s liver appears to be clean; we cannot identify evidence of cancer spreading there. We must now consider the option of other disorders of the spleen.

The spleen is an interesting organ. Looking like an elongated red-purple colored tongue, it sits near the stomach. The spleen is the largest filtration system of old blood cells in the body. In addition, it produces a portion of the new red blood cells the body needs and cells for the immune system. That said, a spleen can be removed and the animal can live a perfectly normal life, no special medications or supplements needed. Because it is filled with blood, the spleen can develop large blood clots called hematomas, which can burst open. The dog will bleed to death. It can twist upon itself or develop tumors. Any disease or trauma that causes a ruptured spleen may lead to death by rapid bleeding out into the abdomen. It is splenic cancer that is the most feared; because of its close connection to the bloodstream this cancer spreads rapidly.

We discussed the options. Tank might have hematomas of the spleen. Removed surgically, his prognosis would be excellent. But we might open him up and find evidence of a spreading cancer that had gone undetected by our other tests. Worse, in the early stages, cancer might have spread at the cellular level but not be evident until long after surgery. Often the trained eye of the surgeon cannot visually differentiate between a hematoma or cancer, so we could go to surgery, remove the spleen, performing a splenectomy, only to find out days later that the results of the biopsy test at the lab were cancerous. The family needed time to confer. Ultimately they agreed upon proceeding to an exploratory abdominal surgery, where we found a gigantic spleen. It was bulbous and lumpy, an angry dark purple color that spread from one side to the other and, once removed, was found to weigh over 3 pounds (when healthy it had probably weighed less than 6 ounces). Tank came through surgery fine. In less than 24 hours he ate a healthy breakfast. He went home the day after the surgery, wagging his tail at being relieved of that tremendous weight. Within 2 weeks Tank was rapidly putting on weight (sigh) and appeared restored to his old self. We all rejoiced when the pathology report could not detect any cancer, but pronounced the cause : splenic hematomas. Tank’s future appears bright and we all look forward to his cheerful greetings to come.

Christine B. McFadden, DVM
drmc@mcmenagerie.com

Heatstroke

/ Dr. Christine McFadden / Leave a comment

Dr Mc Blog

 

May 24, 2016
Summer is coming. In Merced that can mean baking temperatures over 100 degrees. Even if the day doesn’t go over the 90’s, the black asphalt paths that line Bear Creek, Black Rascal Creek and many other favorite walking paths will heat up significantly, holding the heat well into the evening hours. People walking in rubber soled sneakers may not notice how hot the ground feels. I actually recommend that clients who take their pets out for an evening stroll bend down and place a flattened palm to the sidewalk or path – only then will they recognize what their dogs’ feet are feeling. Sometimes my hand has burned at 9 o’clock at night! If at all possible, consider early morning walks with your dog – they can be quite refreshing and you might take in an egret or hawk flying overhead.

Dogs are digitigrade (love words!), meaning they stand and bear their weight on their toes, not a sole or heel like a person. Each toe is covered by a protective pad of keratin, a horned callus that protects them from injury. Inside that is thick fatty tissue, a good shock absorber. This pad is soft in young puppies, thickening and hardening with the use they get from exercise and exposure to different terrain. A dog that has sat on the couch all summer will have tender feet if suddenly expected to go game hunting for miles in the fall. That bicycle ride you took, with your dog running gamely behind? Don’t be surprised if he or she comes up lame the next day, bare patches of pad rubbed away to expose bleeding sores. This goes way beyond blisters and will take weeks to heal, as the lost tissue can’t be sewn back on, but must slowly granulate in from the sides of the wound. Walking on soft grass is about all those dogs can bear to do for some time. Don’t take your dog’s feet or athleticism for granted – they need regular, planned exercise for peak performance and health. This is your chance to shine as a Personal Trainer! Don’t blow it!

I would like to believe everyone knows not to leave a dog in a car in a parking lot during our summers. Forget cracking the windows. A CRACKED WINDOW WILL NOT PREVENT HEAT BUILD UP IN THE CAR. It has been estimated that even on a day when the outdoors temperature is in the mid-70’s, that the interior of a car can rise to over 100 degrees or higher in less than 30 minutes. Seventy degrees? Can you imagine how quickly that temperature spikes in our area on a real summer day? One estimate I read stated that on a 90 degree day the inside of a car could reach 110 degrees in less than 10 minutes! The American Veterinary Medical Association (AVMA) posts some interesting and horrible facts from several studies on Pets in Vehicles.  The car acts like a greenhouse, with the air unable to circulate or get back out through the windows. The pet cannot breathe in the overheated air and dies from heatstroke. The dogs core (inside) body temperature may go over 104 degrees. The highest temperature I ever recorded in the stomach of a dog that had died from heatstroke was 110 degrees – our thermometer didn’t register any higher. It was too hot to keep my gloved hand inside to perform the necropsy. (The word “autopsy” is reserved for post-mortem examinations of humans or “self”. An autopsy is an examination done to determine the cause of death. In animals we most commonly use the word necropsy.). These are very sad moments, indeed. California does have laws restricting leaving pets confined inside a car under conditions that endanger the pet’s life. Please, leave your pet at home while you run errands. Here in the Valley make sure your outdoor kennels are not all concrete, baking in the sun. Shade cloth is not enough protection, either. Mature trees, watered and shaded grass, even outdoor misters should all be considered for your dog’s health and comfort during the summer days when they are outdoors. As we see each summer, it is a matter of life or death.

Christine B. McFadden, DVM
drmc@mcmenagerie.com