Veterinary Medicine

Have A Nice Day !

/ Dr. Christine McFadden / Leave a comment

George Carlin, a comedian I’m not much familiar with, found fault with the phrase “Have a nice day,” saying it was “probably unrealistic to expect someone to have a nice day all day long.”

I am as guilty as the next person at wishing people I meet to “have a nice day” upon taking their leave. It has become an ingrained auto-response. The phrase is depersonalized and meaningless more often than not. Carlin’s riposte struck home because it has only been a few weeks since that very phrase landed me in the middle of a hostile exchange between my staff and a client.

The first I knew that we had a problem was finding a chart on my desk with a note “Client upset. Please call.” We get very few complaints, surprising, perhaps, given the number of animal patients we see in a day and the variety of human clients attached to them. I suppose some people never discuss their dissatisfaction with us and simply go elsewhere with their pets. Our best clients tell us when we have let them down and I very much appreciate that – how else to improve our services? And then there are, well, those days that we just mess up. We don’t just drop the ball, we kick it over the fence. No half measures for us, no sir.

So I read the chart. It landed on my desk because I had examined a cute little Maltese dog and vaccinated her when she first arrived to board with us. That had been days earlier and I had not heard of any problems during her stay. I then requested to speak with any personnel who might be able to enlighten me. This can be a dicey tightrope – understandably your staff wants to feel that you’ve got their back and truthfully, the client is not always right.

With half the story under my belt, I felt prepared to call the client, who was pleasantly surprised that I even called. The saga was not life threatening in any way but was important. The client had requested her dog be bathed upon arriving at the clinic. This made no sense to the staff because like some people, a dog away from home may exhibit different behaviors than their owner is accustomed to. He may stay up until all hours of the night. She may bark joyfully nonstop. Both will engage in food fights, scattering food willy nilly. Someone peed on their favorite blanket then ate it. In short, your calm little house pet may have the manners of the worst frat boy party animal you’ve ever seen depicted in a movie once you step away. I know, I’ve seen ‘em. So we always suggest a bath and fluff up right before heading home. Time to put the leash back on. Momma’s coming and you don’t want to disappoint Momma.

In this case, the staff just thought someone heard it wrong, so they waited to give the bath 4 days later, when the dog was scheduled to go home. Only Momma came back a day early. We absolutely would have given the bath then but everything got bolloxed up in the explanations and finally the good woman took her dog (bathless) and went home. The final insult? As she was leaving in high dudgeon, one of my staff called out “Have A Nice Day.”

Ouch! Hit that ball right out of the park.

I was treated to a delightful lunch at a Ruth Chris Steakhouse recently and noted that at every request the staff responded “with pleasure.” I considered trying to incorporate this into my daily interactions with clientele, but somehow, when asked to express anal glands I think saying “with pleasure” could backfire on me. I am trying to rid myself of “Have a Nice Day.”.

Christine McFadden, DVM

drmc@mcmenagerie.com

Reflections Back on 2017 from the New Year

/ Dr. Christine McFadden / Leave a comment

I can’t speak for you, but let me start this by saying that I spent my first night of the new year sleeping on the floor. No, you too? So let our first resolution be to stay home next year! Nothing stronger than water had crossed my lips, we missed the ball drop in New York because we were arguing too much as we channel-surfed at the last minute and I couldn’t tell you if there were midnight fireworks because we were all asleep long before the year crossed over. Some of us on the floor. I was there mostly because the makeshift mattress set up for the kids was very narrow. If you were next to your mom you would be snuggling, but if forced to share the same space with your sister it would have been a war zone all night. I chose “some sleep” over “none”. The great thing to come out of this? Everything settled to the down side and I’m convinced my silhouette, as seen from the left, is much slimmer.

I had lots of time to think while performing this balancing act. I remembered the faces of some I’d said goodbye to in the previous year. “Nella” was a gallant Golden Retriever. He was named as a young dog by a child too young to know a girl name from a boys and owned by a war veteran too kind to correct the child. Nella was the color of a vanilla wafer cookie. He was a big-hearted dog, always gently greeting me with a wave of his plumed tail, no matter the exams, the blood tests or x-rays that were needed. At 16 years of age, he suffered from severe arthritis. His owner always had a kind smile and a silly joke when he came in. He thanked us for our efforts to keep the big dog comfortable. He cooked for Nella when needed. On the bad days we hugged. And finally there was no denying that the most loving thing he could do for his dog was to let him go.

I started 2017 with a C-section delivery on Jan. 1. Ring in the new!

I ended 2017 with an 18 pound cat, Shrek, that had his bladder obstructed by tiny bladder stones they call “sand.” He couldn’t urinate. His bladder filled up tight as an over-filled balloon and the plumbing backed up until the pressure shut down his kidneys. It is hard to walk when your bladder feels like a large boulder in your stomach. When your kidneys shut down you feel tremendous nausea. It’s called uremic poisoning, because the body waste that the kidneys should filter out are reabsorbed into the bloodstream, poisoning you. It is impossible to eat when your kidneys shut down. A true emergency, his bladder at risk of rupture, we rushed Shrek into surgery. Under anesthesia we spent long minutes trying to break down the plug of small grit blocking his urethra until we could place a bladder catheter and empty his bladder. Then we pumped him full of intravenous fluids to encourage his kidneys to go back to work. Shrek looked a little odd, with one tube dripping fluids in at the front end and another dripping out more fluids (urine) at the back end. Key to prevent recurrent formation of this “sand” in Shrek will be his conversion to a diet of food developed specifically to prevent urinary sand of Feline Lower Urinary Tract Disease (FLUTD) syndrome.

My final thoughts before drifting off to sleep were of the first stanza of a poem I memorized years ago. The poem is by Alfred, Lord Tennyson.

Ring out, wild bells, to the wild sky,

The flying cloud, the frosty light:

The year is dying in the night;

Ring out, wild bells, and let him die.

 

May the new year be kind to you and your pets.

Christine B. McFadden, DVM

drmc@mcmenagerie.com

Accreditation / Monkey Pox Virus

/ Dr. Christine McFadden / Leave a comment

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

 

 

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

Calcium

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May 3, 2016
It was a very odd week. Monday started out with an African Grey parrot that was rushed in because of odd seizures observed by the owner. Popeye made the trip in a cat carrier since he couldn’t perch, and when I opened the grated door I had to laugh : a sizeable grey parrot with a dark maroon tail was fluttering convulsively but at the same time reaching out greedily to gobble down some peanuts just out of reach. He had figured out how to roll just right with each shake of his wings and was inching ever closer. Popeye wasn’t at all perturbed by his mild convulsions but was very upset that the peanuts kept evading him. After a brief discussion where I learned that he was fed almost exclusively on sunflower seeds I drew some blood tests and treated him for a calcium deficiency. Seeds may be high in protein and fat but are notoriously deficient in calcium and trace minerals. No single food item will ever provide complete nutrition to any animal. Popeye’s recovery was dramatic.

On Tuesday an owner presented his middle-aged Dachshund “Dracula” for a second opinion. The little dog just seemed to have muscle twitches all the time. He’d had some blood tests run, but nothing conclusive had turned up and regular anti-seizure medication had been of no help. Dracula lived a quiet life, mostly indoors and had never had any other medical issues. He trotted around the exam room, with a fine tremor marring his step. He wasn’t shaking from anxiety, nor did he act oddly in any other way. Looking over the chart shared by my colleague I noted that his blood calcium test was quite low. Since any single test may occasionally be off due to lab error I recommended we repeat these tests as a starting place. Again, his calcium levels came back very low. Diagnosis : A disorder of his parathyroid gland, which regulates calcium in the body. Treatment with calcium and Vitamin D supplements provided immediate relief while his case was fully worked up.

When the Green Iguana showed up on Wednesday I had a sneaking suspicion that I was having a “run” on calcium related issues. The lizards’ lower jaw was puffed out, looking mismatched to her upper face. She had an odd crook in her front leg from a “folding fracture”, indicating soft bones. Once again I investigated her diet and light exposure – never outdoors in natural sunlight (no creature was bred to live totally indoors!) and fed iceberg lettuce, no dark leafy greens, no vitamin supplements. Diagnosis : Metabolic Bone Disease or “Iguana Rickets”. Real sunshine and an improved diet did wonders for her.

By Thursday the staff had started to joke about it. Our 10 o’clock appointment was a young man with a muscular Pit Bull puppy, only 12 weeks old. The puppy had broken both his front legs. As I observed the heavy bodied male, named “Oscar”, I noted that he was unusually cheerful as he ran around the room, clumsily trying to chew on my assistant’s pants leg. He looked bow legged in front and indeed, both of his wrists (carpi) bulged and kind of knuckled over. He was walking on these legs, which a dog with a fracture usually cannot do, as it’s too painful and the bone actually can’t support weight as it slides apart. Questioning brought out the history of a puppy fed an exclusive diet of steak and hamburger. Oscar’s owner was proud of his beautiful dog and wanted to provide only the best for him. He had spared no expense by feeding an all-meat diet. What I was looking at was a very old-fashioned case of rickets or osteomalacia (soft bones). Without a balanced diet – and without bones meat alone is deficient in calcium – Oscar’s rapidly growing bones had softened and he couldn’t support the weight of his own body. The bones had started to fold down. Caught early, a corrected diet of simple commercial puppy food could reverse the process and over time the bones will straighten, though not always 100%. Happily, within two weeks Oscar was moving more normally.

The body is a marvel. Calcium is rich in many foods: dairy products like cheese, yogurt and milk, dark leafy greens, fish canned with their bones, bone meal by-products. Calcium is added to all pet foods formulated commercially, just as it is added to products like orange juice for people. But eating calcium rich food is not enough. The body requires Vitamin D3 to absorb and use the calcium taken in. Dogs, cats, birds and reptiles can all make their own Vitamin D when exposed to natural sunlight, through a complex interaction with UV light on their skin. Vitamin D is found naturally in egg yolk, fish oils and fatty fish like salmon or tuna, and cheese. Many animals, especially birds and reptiles, don’t naturally eat these foods and if kept deprived of sunlight (indoors/caged) will develop rickets, broken bones, and even seizures or death because they cannot make the Vitamin D they need. Even if their diet includes a calcium supplement they will suffer. For this reason special UV lights are recommended for indoor pets and at least weekly outings into real sunshine. All diets should include both fresh foods and commercial foods fortified with Vitamin D and Calcium, from turtle pellets to bird feed and other pet foods. Leave the balancing up to the professionals!

Christine B. McFadden, DVM
drmc@mcmenagerie.com

 

 

The Bladder

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April 6, 2016
I thought we could talk about bladders today. Before you grit your teeth, let me say that it’s bound to be a lighter subject than body issues that lead to discussions of Milk of Magnesia or Preparation H. A far better organ system for public discussion. Bladders hold a deep fascination for my office staff. Instead of guessing how many jelly beans are in a jar, they often wait spell-bound to see how much urine that little dog can release on a waiting room plant. One client who frequents our hospital has a particularly clever little Yorkie who always manages to spray out a puddle despite our diligence and speed. Unfailingly, the good woman will say “My, he’s never done that before.”

Each day the kidneys filter the blood that flows through your veins, removing waste and impurities. Most of the blood continues to recycle to the rest of the body, but a small percentage of fluid and the filtered waste must be eliminated for continued good health. This fluid is called urine. In most mammals urine looks like a clear watery fluid, usually a shade of yellow, and is composed of excess body water, salts, and other waste. The yellow color is caused by the pigment urochrome, a breakdown product from hemoglobin. When dehydrated, the urine color may be darker yellow or orange as this pigment concentrates, indicating the need to drink more water. Each beat of the heart sends 20-25% of that blood flowing straight to the kidneys. Once urine is manufactured in the kidneys it travels from the kidneys via little tubes called ureters to the bladder, the holding tank in the body’s plumbing system. It is stored there until the pet voluntarily decides to empty their bladder, through another single tube called the urethra, to the outside. The act of emptying the bladder is called micturition or urination or voiding or peeing. Of course, all of these body parts can develop problems of their own, but the most common diseases revolve around the kidneys or the bladder. Kidney infections are not nearly as common as bladder infections, though often people confuse the two. Bladder infections may be caused by bacteria ascending up the urethra, because the bladder is the first stop from the “outside”. Today we will limit the discussion to dogs as the bladder problems seen in cats are often quite different in cause and treatment.

Prada’s Mom suspected a bladder infection when she observed blood in the urine. Female dogs are affected more often than males. Some affected pets may strain to urinate or may urinate very frequently or in unusual places. Although some dogs are depressed, Prada, a tiny snow-white Maltese, appeared bouncey and pain free. An examination was performed to determine if the bladder wall felt normal or was thickened. The bladder may have unusual “lumps” which could be cancerous growths or actual bladder “stones”, real rock-like growths that can fill the inside of the bladder. A urine sample was taken to analyze for bacteria, crystals, blood and other signs of disease. Sometimes the urine must be cultured to determine what kind of bacteria is affecting the dog and which antibiotic will best treat the infection. Because this was Prada’s second bladder infection in one year, a culture test was performed after obtaining her urine sample by cystocentesis, a sterile needle tap directly into the bladder. This method is preferred for a bacterial culture over a “catch” of urine because there will be no contamination from the pet’s hair or the environment as the sample is obtained. Chronic or repeat bladder infections may lead to the formation of bladder stones due to the chronic irritation of the bladder lining. These will require surgical removal in most cases. Bladder infections should never be minimalized as they can in turn ascend further up to the kidneys, which is potentially life threatening. Prada’s culture highlighted the best antibiotic choice for her and she responded quickly to her medication.

There is a small but significant obstacle to the pursuit and study of diseases of the bladder : obtaining the sample. Home catch, free catch, cystocentesis…. Apparently this has confounded veterinarians long before me! One very old veterinary text book neatly summed it up thusly : “Take about a dessert-spoonful of the dog’s urine (which you must use your own judgement how to obtain: place, for instance, a clean damp sponge at a spot where you think the animal will stale)…..”. Good to know I’m not alone!

Christine B. McFadden, DVM
drmc@mcmenagerie.com

 

Skin Care plus MRSA

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Dr Mc Blog

 

March 1, 2016
Have you heard? There are new scrubs, mousses, lotions, creams, and wipes to improve your PETS’ appearance! For some reason these are not appearing in “Vogue” magazine or even “Dog Fancy”. Since I can’t skim a popular magazine in line at the grocery store without encountering pressure to rejuvenate my own skin, I don’t understand why all these products for pet appeal aren’t making big news. Perhaps skin care for animals just hasn’t caught on yet. Although I’m not entirely sure – I’ve heard there’s a blueberry facial mask out there, plus things like milk baths and rose water nail soaks for the (overly?) pampered pooch. Who knows? I heard of a doggie salon that gave the owners coupes of champagne while they waited. Perhaps that’s the force behind the trend.

For those of us in the less glitzy trenches, we refer to skin care as “dermatology” and the new mousses, wipes, etc have been formulated to address common health problems addressed daily in veterinary medicine.

Skin sores that bubble and break open on your pet may be the result of a bacterial staphylococcus infection. “Staph” is considered a normal inhabitant on the surface of the skin, until it goes rogue and breaks out as whiteheads or bubbling pus-filled lesions. In humans there is an increasing fear of an antibiotic resistant form of staph called “MRSA” (pronounce it “mersa”), which in simple terms means a staph bacteria that is resistant to the antibiotic methicillin, by extension the family of antibiotics headed up by penicillin. This bacteria takes advantage by invading the body through a wound, at a surgery site, or even a scraped elbow and is feared because it cannot be readily treated by the old tried-and-true antibiotics. The bacteria has simply found a way to survive, to overcome the tools fighting to destroy it. Because people in hospitals are at higher risk, due to their lowered immune resistance, stress, or fresh surgery sites, MRSA infections are feared. Pets can also develop a methicillin resistant staph infection, though it’s a slightly different bacterial strain called staph psuedointermedius, or MRSP (I say “mersip”. No one has corrected me yet). The veterinary community continues to monitor the prevalence of this infection and at this time it is not considered a risk to humans or other pets. When we find a skin infection not healing as expected we often recommend a culture swab be taken to diagnose both the type of bacteria and identify the best antibiotics to treat the problem. This is how we diagnose MRSP infections. One of the treatments is a mousse that cleans bacteria off the skin. It can also be used to bathe the pet, prior to an orthopedic or other major surgery, decreasing the risk of post-operative complications. There are anti-bacterial skin wipes, also.

Another new product is an eye wipe to assist dogs with epiphora, a condition where the pets’ tears spill down his or her face. A compound, porphyrin, in the tears causes a brown stain to form which is both unsightly and, staying wet, allows bacteria to breed which can lead to infection around the eye. The constantly wet skin may scald and create open sores under the eyes which is very painful. Dog and cat breeds with flat “pushed-in faces” like Pugs and Persians may be anatomically predisposed to problems of tears spilling out onto their faces. Once your veterinarian has determined that the tear ducts are open and draining properly and ruled out other medical causes, you may be directed to these wipes to keep the condition from escalating into painful sores.

Pets that are completely white haired, with no other color or pigment, are at higher risk of sun-related skin cancers as they sun bathe in our backyards here in the Central Valley. In cats red, scabby crusts may form on their ear tips or around the nose. In dogs it often begins on the thin skin of the nose or as deep purple blotches on the tummy near the back legs. Human sun screens may not be safe for your pets because they will eat it, literally, as they lick themselves! Zinc oxide (the white glob on the lifeguards’ nose) is toxic to dogs. Some dogs will tolerate hats or wear protective T-shirts, but the best idea in our hot summers is to simply keep these at-risk pets indoors during the day as much as possible.

In medicine there is always a new discovery around the corner. None of the skin care products I get to review will remove the laugh lines from Fido or Kitty but they do come with the promise of remedying a skin affliction. Please celebrate by raising your own glass of champagne.

Christine B. McFadden, DVM
drmc@mcmenagerie.com

 

 

 

Variety Is The Spice Of Life

/ Dr. Christine McFadden / Leave a comment

Dr Mc Blog

 

February 17, 2016
They say variety is the spice of life. I am fortunate to have an extremely interesting career! In the past eight days I have seen one rabbit with an ear ache and spayed another. A lizard presented with scoliosis, curvature of the spine, caused by underlying malnutrition. I saw a cat with a very odd skin mite that may not have been diagnosed in Merced before! By the simple act of pressing scotch tape over the cat’s dander and looking at this under the microscope I found a mite I’d never seen before. My colleague, Dr. Klingborg, identified it from a derm (skin) meeting he’d attended in November and now we’ve held several discussions on the presence of this mite in Merced (it is considered to be contagious between cats). And always, the “usual” mix of cats, dogs, and birds. Today while performing spay surgeries (an ovariohysterectomy surgery) on cats I opened up one female cat only to find parts of a mummified fetus in her abdomen, causing no known distress to her before today. I completed the surgery and explained the situation to her owner, using digital photos taken during the surgery. Another veterinarian in the practice, Dr. Lauppe, was doing an orthopedic surgery on an injured knee while Dr. K removed a cancerous mass and attended to a dog that had been attacked by another dog (BBBD – Bit By Big Dog). A guinea pig with an eye ulcer came in and the Zoo needs a review on the Mountain Lion’s diet. A delightful Labrador had five enormous rotting teeth extracted and went home on antibiotics and painkillers. In two weeks he’ll be soooo much better! A lady called about a duck she thought might have eaten a tiny battery (the battery could corrode the stomach and cause heavy metal poisoning. All waterfowl are at risk of ingesting odd metal objects – they just like shiny objects). A woman (I never got her name) brought in a hummingbird that “fell from the sky”. We mixed up sugar water, revived the uninjured bird and sent it off with her to be released where she found it. An abuse case was brought in by Animal Control and a pregnant dog with three puppies stuck inside presented for a Caesarean section, performed beautifully by one of the other vets. I saw a Sulcata African tortoise with a mild upper respiratory disease and discussed the special dietary needs the new owner would want to address. Obtained from a Tortoise rescue group, the Sulcata’s shell mounded up on top, called pyramiding of the carapace. Much like the lizard with the deformed spine, it indicated an improper calcium and vitamin D ratio, the tip of the iceberg for signs indicating malnutrition.

February is National Dental Month for Dogs and Cats and most veterinarians who care for companion animals focus special attention on dental care this month. In veterinary medicine we are not focused on the whitest smile to impress someone! You are most fortunate if you have never experienced a tooth ache. Some dogs present with teeth so brown with mineralized plaque and calculus that it looks like moss has grown on them. That bad breath smell is from the bacteria growing along and under the gum line. The same bacteria that can dislodge and spread to the heart or kidneys. Cats demonstrate “jaw chatter” if you touch a tooth with a neck lesion cavity near the gum line – you can observe this incredibly painful response after you peel your cat off the ceiling. Most dogs and cats continue to eat despite foul teeth – please do not judge your pet’s dental pain by whether they haven’t starved to death! Over the years I have heard countless times of pets that “acted years younger” once their abscessed teeth were removed, their mouths healthy again. Call your vet today – there are some great deals out there this month!

Christine B. McFadden, DVM
drmc@mcmenagerie.com

Feline Urinary Syndrome or FUS, FIC, FLUTD

/ Dr. Christine McFadden / Leave a comment

Dr Mc Blog

 

December 21, 2015
I think he was already 90 when we first met. The blue eyes, the felt hat reminded me of my own grandfather. A little shorter than me, he was a kind man who had moved to the States when his family emigrated from the Azores. It had been a long time since he worked on a dairy, and his companion now was a black and white cat, Jimmy, vividly marked like a Holstein cow. On that first meeting, Jimmy was just in for a check-up and vaccinations. We talked more about Mr. B’s wife, who had passed away after eating watermelon. He blamed himself for letting her eat the seeds – she loved watermelon so much that she’d inhale chunks heedless of any seed that went with it. He knew the seeds had killed her. I suspected cardiac arrest was the underlying cause from the rest of our discussion. That afternoon we forged a bond that grew over the years. Jimmy’s owner lived independently in a small house in the country. When he could no longer drive a car he rode a three wheeled bicycle, humming along the back roads for miles at a time.

Jimmy came and went as he pleased, growing a little plump under the tender loving care of home, plied with a variety of foods on a near daily basis. One morning Mr.B brought him in, both quite agitated. Jimmy was having trouble walking, crying out, and Mr. B said he kept trying to pee at home. He didn’t think anything was coming out.

When I placed my hand over the cat’s abdomen I immediately felt a hard ball inside, about the size of a baseball. Just that gentle touch yielded a scream of anguish from Jimmy that made us all jump. That ball was the cat’s bladder, swollen near to bursting because the outlet was obstructed. The tube that carries urine from the bladder to the outside is called the urethra. Tiny bladder crystals or struvite, sometimes called “sand” had formed in Jimmy’s bladder. The crystals precipitated from a combination of minerals found in his food, often magnesium, ammonium, phospate. Thirty years ago we called this the Feline Urinary Syndrome. We blamed the diet – no one knew why, or which cats – and knew it could occur in both male or female cats. The crystals irritated the lining of the bladder and urethra, causing swelling, thickening, and pain when urinating. In male cats, the urethra is longer and narrows at the tip, so they can obstruct. If a big clump of “sand” passes at one time it acts like a cork, stopping up the bladder so no urine can pass. Of course, the kidneys are the last to know, so they stay on the job making urine, which fills up the bladder until it can’t get any bigger (or it ruptures). Everything comes to a screeching halt and the kidneys start to shut down (post-renal kidney failure). At this point the cat has a relatively short time to get help – under 24 hours – before it dies.

Treatment at the veterinary hospital is immediate; this is not a procedure that can be safely put off until lunch. Risks are high. The cat must be anesthetized and a urinary catheter threaded carefully backwards up the urethra (retrograde) using a sterile flush if necessary to break down the obstruction. The catheter is placed directly into the bladder and sewn in place, often for 1 or more days. An intravenous catheter is also placed to immediately flush the system and get the kidneys up and running. Blood tests tell the picture of the degree of kidney disease. The cat will have more blood tests before coming off IV’s to be certain that kidney function has been regained. Oddly, most of these cases are not infected with bacteria, though we use antibiotics to prevent a secondary infection once an indwelling bladder catheter is in place. Other names for this syndrome now include Feline Interstitial Cystitis and Feline Lower Urinary Tract Disease.

A change in diet may prevent recurrence of crystal formation. This requires a Prescription diet from your veterinarian. The food maintains the urine PH in a very narrow range that prevents formation of more crystals. In dire circumstances when a cat obstructs a second time, a surgery called a perineal urethrostomy (big words!) is life-saving. The surgery widens the urethra 3-4x more than before. The cat may still form crystals, but it shouldn’t be able to obstruct again.

Jimmy responded well to treatment and readily accepted his new diet. He died from other causes about 2 years later. His owner grieved. It was springtime, and Mr. B had his door open to let in the fresh breeze. He dozed off in his recliner and was startled upon awakening to find a black and white cat, boldly patterned, winding herself through his legs and around the coffee table. He knew it wasn’t Jimmy, but? He named her Susie. She had come to stay. Every time I saw them together we would marvel at how Jimmy must have sent her.

FUS=feline urinary syndrome;FIC=feline interstitial cystitis;FLUTD=feline lower urinary tract disorder. If you like words.

Christine B. McFadden, DVM
drmc@mcmenagerie.com