Organs

A Border Collie called ‘Dunkin’

/ Dr. Christine McFadden / Leave a comment

The afternoon was humming along as I made my way from one exam room to the next. Behind Door No. 1 was a kitten with a snotty nose. Behind Door No. 2 was a tiny parrot with a broken leg. And behind Door No. 3 there was Dunkin.

Dunkin (not, his owner assured me, named after the doughnut store) was a gorgeous Border Collie, marked with crisp whites blending beautifully into black highlights. Not quite yet a year old, both he and his owner appraised me as I entered. I greeted them and settled in to hear the story behind their unexpected visit.

Dunkin and his owner had been playing a game of fetch. Lithe, athletic, I could see the dog in my mind making a fantastic leap into the air to grab the flying stick. Nothing is more beautiful to me than a good athlete at the top of their game. Only when Dunkin caught the stick he’d made an odd sound, and blood had trickled out of his mouth. They had come straight away to the vet clinic.

I first performed a full physical exam, then gently asked Dunkin if I could look into the back of his mouth. Say what you will, politeness counts with dogs who have been taught manners. Sure enough, way back, I could see a bruised area, though not terribly well. I asked his owner for permission to anesthetize Dunkin for a full exam of the back of his throat.

On the surgery table, Dunkin lay in a deep, non-painful sleep. He was intubated and his heart rate and blood-oxygenation levels were excellent. We examined teeth, gums and around his tongue. All fine. Farther back, I could see the source of blood coming from his right tonsil area. It looked odd. Stretching out his neck, I could see the tonsillar crypt, a pouch-like indentation in the back of the throat, behind the base of the tongue. Something that looked like a fuzzy caterpillar was suspended below the purple, bruised and bloody hole. Momentarily puzzled, I examined his left side, where both tonsillar crypt and tonsil were intact and a normal glossy pink. Wow! The stick that Dunkin caught had sheared off his right tonsil in a near perfect excision. It hung on by a tattered shred. There was no question of reattaching it, so I completed the tonsillectomy and sutured the battered crypt back together. Some antibiotics, some anti-inflammatory and pain medications and Dunkin was set to go.

And go he did. I followed up with Dunkin about two weeks later and he sat perfectly still as I examined the back of his throat. He had healed beautifully. His owner reported that she had stopped tossing sticks for him but it seemed hopeless – if she wouldn’t play, Dunkin would happily toss a stick as high into the air as he could and then leap joyfully after it! You just can’t keep a good dog down!

Christine McFadden holds a license to practice veterinary medicine and surgery. She has cared for the family pets of Merced at Valley Animal Hospital for more than 30 years. Send questions or comments to drmc@mcmenagerie.com

The Pancreas

/ Dr. Christine McFadden / Leave a comment

Dr Mc Blog

July 28, 2015
Don’t you wonder how some things ever came to be named? Now the word “pancreas” comes from an anatomist named Ruphos of Ephesus, around 1 or 2 AD. In Greek pancreas means “all flesh”. And it IS a pale pink scrawny L-shaped ribbon of an organ sitting in a crook of small intestine near the right side of the stomach wall. Nothing you can really get your hands on during surgery. In fact, you don’t WANT to get your hands on it during surgery. The pancreas is notoriously sensitive to rough handling and maybe handling of any kind and as a young surgeon I worried that if I had to gently nudge it to one side to access some intestine or heaven forbid hooked it when trying to locate a recalcitrant uterine horn (uterus) during a spay surgery that my patient would have a belly ache for days afterwards or maybe die. That part turned out to be not so true but even after 30 some years of exploring abdomens I am still skittish about handling the pancreas and try to avoid any surgical contact.

So what does a pancreas do? The pancreas serves two very important yet distinctly separate functions in the body. One is an endocrine (hormonal) function, as the pancreas produces the hormone insulin. When this system runs amok, pets suffer from diabetes mellitus, often called “sugar diabetes”. The other cells of the pancreas exert exocrine (enzymatic) control and produce amylase and lipase, two enzymes that help digest food in the small intestine. When these exocrine cells malfunction, the digestive enzymes are released willy nilly into the pancreas, not the intestine, where they start to digest the wrong thing. This is the disease Pancreatitis. Inflammation of the pancreas and surrounding abdominal tissue as these enzymes eat away at it is so marked that it may be seen on an x-ray. Tremendous pain over the anterior abdomen is often present. The pancreas is most stimulated to produce its digestive enzymes by high fat foods and protein.

Kahlua was a doggie princess. A little pudgy in middle age, she was lovingly treated to her fair share of dog food and table goodies, often high in fat. One day she started to vomit her dinner. She was sluggish and screamed in pain when her owner gently picked her up around her tummy. In our office she was running a low grade fever and cried when her anterior abdomen was palpated. Among her blood tests a special test for pancreatitis, the Spec Cpl (specific Canine pancreatic lipase test) was positive. Both amylase and lipase scores were in the thousands. When we told her owner the news he was ghastly quiet. Finally he raised his eyes and told me quietly that he had just lost his wife to pancreatic cancer. Kahlua was all he had left of her. He didn’t need to say more. I couldn’t rule out cancer that early because there is no blood test to rule out cancer of the pancreas. If cancer is present, it may be the size of a small pimple and won’t always show up on an ultrasound scan. We would have to proceed with standard treatment for pancreatitis and if Kahlua did not improve as expected would review our other choices. After several days on intravenous fluids to flush out her body and absolutely no food (do NOT want to stimulate the pancreas during this time!) Kahlua brightened up considerably and was no longer painful over her tummy. Her signs of infection responded well to antibiotics and when we gave the all clear and offered a tiny meatball of a bland low fat food she gobbled it down and never looked back. Despite this brush with serious disease Kahlua never had another problem with her pancreas, though she did maintain a low fat diet for the rest of her long life. She was another lesson in proceeding cautiously when discussing any particular ailment of a pet that humans might share, as all too often I find that my diabetic patient has a diabetic owner, or that heart disease or cancer “runs in the family”. Kahlua was 7 years old when she developed pancreatitis and lived another 10 years beyond that, a princess to the end.

Christine B. McFadden, DVM
drmc@mcmenagerie.com