Friday, November 30, 2012

How's 'at? Veterinary Terms & Abbreviations I



Like other professions, veterinary medicine has its share of abbreviations and slang. Most are legitimate short hand for disease conditions, however many disguise a dire prognosis or allow veterinary team members to humorously communicate a less than flattering assessment.

Feed Me...or Not

Agroceryosis - Lack of groceries, i.e. owner hasn't been feeding the animal. Sadly this is too common in outdoor dogs in the winter.
Garbageitis-Dietary indiscretion, almost always applied to a dog eating something he shouldn't have, e.g. old socks, spoiled food, rocks, disposable razor blades, (all true.)   Cats know better.
(Courtesy of www.freeclipart.com)
CFT - Chronic food toxicity i.e. obese

Cat and a half-Similar to cft but, like under-tall, often used to gently suggest to the owner that perhaps they've been feeding more than a little too much.


History Matters

Veterinary patients can't actually tell us what's wrong or where it hurts and when a problem isn't obvious a good history from their owners is often crucial to making an accurate diagnosis. It makes our jobs so much easier when owners have been paying attention and know what's normal for their pet...

BDLDLDL- Big dog, little dog, little dog lost. Picture an 80 pound dog in a 15-20 pound body, that's a Jack Russell Terrorist. Now imagine the terrier charging into the air space of an actual 80 pound dog, say a disgruntled Rottenweiler. No contest. And yet, those little dogs that fling themselves into the jaws of destruction once seem to keep at it so it's not unusual to see this collection of letters multiple times in a chart.

ADR-Ain't Doin' Right. Sometimes an owner just can't quite articulate what the problem is and the appointment book says, "adr."  Or, conversely, the receptionist surrendered in self defense because the person making the appointment has presented a plethora of unrelated information,

"Well, he's coughing but only after eating grass and vomiting but I think that's because he has a rash from the new food but he hasn't really been eating all week since we sprayed the yard but my brother-in-law's dog was fine and they both had the same hair cut after they were boarded at a new kennel do you think he can get his vaccines today?"

This could be anything from a simple case of a picky eater with kennel cough, to a serious case of skin and gastrointestinal chemical poisoning. What I know for sure is that I would not want my flu or tetanus vaccine if I had a cold or had been poisoned and hadn't eaten all week...

Friday, November 16, 2012

Out Of A Limb


Unfortunately for one small tabby cat, that's not a typo in the title.

On a blustery morning the week before a Thanksgiving past we were still gathered at the front desk warming after the 20 foot walk from the parking lot. It was one of those deceptively sunny days with a finger-numbing wind chill. The first surgical appointment of the day was still checking in when a young woman rushed in the door holding her hands to her chest.
Reaching into her coat she produced a kitten while saying,
"I found him on the side of the road."
Holding up her other hand she finished,
"And here's his leg."

I already had the little dark grey tiger in my hands by the time I realized that everyone else in the room had sensibly taken a step back and now stood wide-eyed and motionless, especially the scheduled surgery's mom who was several shades paler than when she entered!

Tossing a quick, "We'll take care of him," over my shoulder I headed to the treatment area.

An inventory of the little stray's injuries revealed it was the distal 1/3 of his left rear leg that was severed with additonal leg and hip fractures, his right hip was dislocated, his tail was limp and fractured and he had multiple other laceratons. No more than 12 weeks old, cold and shocky from hypothermia and the pain of his injuries, he started to purr. I knew I had to give that kind of character a chance, even if his prognosis was guarded.

(As an aside, I should note that we disposed of the "leg" so optimistically supplied by our Good Samaritan. I'm pretty good in the operating room, but not that good. The nature and extent of his injuries suggested he'd been napping under the hood of a car and had gotten caught in the fan and/or belts when the engine was started.)


(Courtesy of Rulingcatsanddogs)
 On frosty mornings it never hurts to give the hood a few raps to rouse and remove any snoozing neighborhood critters.

(Courtesy of catsguru)


    










Intravenous fluids, antibiotics, pain medication and a warm meal did wonders. By morning I deemed him stable enough for anesthetic and surgery but not for too long. In order to keep the surgical time to a minimum I opted for a non-standard amputation of his left hind leg at the stifle or knee joint, amputated the tail beyond the injury, reduced the hip dislocation, sutured numerous lacerations and called it a day. The little guy's recovery was smooth but it was several days before he managed to balance himself and a few weeks before he learned to walk.

We initially toyed with calling him "Tripod" but Pirates of the Carribean was popular and his lop-sided gait and one swollen eye, not to mention abundance of personality, earned him the moniker "Captain Jack." CJ was adopted by a retired couple who supply regular updates on his progress. To their delight, and occasional consternation, he learned to fly through the house and navigate furniture like a pro. Now 6 years old, Captain Jack has become an especially handsome boy cat.

Thursday, November 8, 2012

Bladder Stones, The Case of Princess and the Pee




Bladder stones, (also called urocystoliths), are an all too common affliction of our canine and feline companions. The how and why of their development varies by species and breed and even by individual.

(X-ray of bladder stones. Courtesy of enpevet.de)
Almost 50% of bladder stones in dogs involve a urinary tract infection. The microscopic bacteria in the urine do two things that promote urolith formation. First, they alter the pH of the urine, making it more alkaline and causing minerals to precipitate or solidify out of solution. Second, the bacteria themselves provide a nidus or starting point for crystal formation. The remainder of bladder stones form due to a combination of an individual's genetics, metabolism, and diet.



(Courtesy of caninehealthanswers.com)

Urinary crystals can grow into visible and sometimes huge stones causing trauma to the bladder, frequent and/or bloody urination, and occasionally life-threatening urethral blockage. For many years, treatment of bladder stones involved a combination of antibiotics, dietary management and surgery. However, thanks to voiding urohydropropulsion, a technique developed by Dr. Jody Lulich of the University of Minnesota Urolith Cnter, there's a non-surgical option to resolve small bladder stones. And that's where Princess comes in.

 


Princess is a 9 year old Rat Terrier owned by Mrs. Maria Wethington and our Case of the Month.


To say that Princess and her housemates Prince and Baby are doted upon or that Ms. Wethington is merely a concerned pet owner would be serious understatements. They travel on pillows, lots and lots of pillows. Originally from Germany, Mrs. Wethington has lived in the United States for 45 years. She retains a charming accent and, despite some serious health concerns of her own, the indomitable courage and sense of humor of a woman who's seen too much difficulty not to appreciate every sunrise.

Careful as she is with her canine babies, it's no surprise that when Princess began to act a little oddly Mrs. Wethington was quick to seek veterinary care. It was that early intervention that made voiding urohydropropulsion an option. Briefly, the technique involves placing a urinary catheter and instilling sterile saline into the bladder to gently distend it. A finger is placed over the urethra to prevent leakage while the dog is held upright, tipping the bladder stones down. The bladder is gently squeezed, the finger pressure is released and the stones are flushed to the outside. This technique works if the stones are relatively small, (which usually means of short duration), in relation to the dog.



And that's exactly how it worked in Princess's case. The initial flush produced almost two dozen tiny stones, and a subsequent flush 2 more. Following a post-procedure x-ray she was still a little sleepy but sitting up and back in her mom's arms in less than an hour.




As you can see Princess is relatively large for a Rat Terrier, but nonetheless loved by her mom. An analysis of her bladder stones is pending. With those results and careful monitoring for recurrence we hope to keep Princess healthy and out of surgery in the future.

Saturday, November 3, 2012

Veterinary Requirements--The Ick Factor

A pair of scrubs, $30.00.
A stethoscope, $199.00.
Four years of veterinary tuition, $120,000.
That warm, wet feeling you get from a puppy...peeing directly into your shoe, priceless!

Well, not exactly priceless in a good way. But the above incident really happened to a co-worker, last month in fact, and it does illustrate an important truth about clinical veterinary medicine. Namely, you're going to get wet. And smelly. And quite possibly sick or injured at some point.

Professional Attire?
(Courtesy of funnyvet.com)
There are many options for someone with a veterinary degree: fundamental research, education, food safety and regulation, journalism, politics and organization, public health, bio-terrorism and epidemiology, sales and pharmaceuticals among them. The most common public perception of a veterinarian, clinical practice, is not for the faint of heart or the weak of stomach.

Basic, routine, every day appointments include the blood and guts of abdominal surgery and rectal temperature taking. That's before you get to the putrid stench of a pyometra, (uterine infection), cat bite abscess, anal gland expression, foot rot, chronic ear infection, rotten tooth, parvovirus diarrhea puppy or absolutely anything, (including driving through without actually stopping), to do with a swine operation. Sadly, I know whereof I speak.


Lunch Time!
(Courtesy of www.funyvet.com)
Not that I'd necessarily do something else at this point. It is, after all, something of a point of pride among veterinarians that we hold dinner meetings and lunch and learn seminars with titles like, "Vomiting and Diarrhea, a case review" or "How I treat Foul-Smelling Ears." It's quite possible for us to enjoy meals which include bean dip and melted cheese or pools of gravy while gazing at power point presentations about aberrant bodily fluids.



Need someone to help with something disgusting on short notice? A veterinarian is probably up to the job.


Career Day
(Courtesy of funnyvet.com)


I had a pathology instructor who claimed he pranked senior veterinary students by surreptitiously placing a dollop of yogurt in the floating abdominal contents of a cow opened for necropsy and asking them what they thought it could be. When they inevitably professed bafflement he would stick his finger in for a big taste, swallow, and to their stupefied horror pronounce his diagnosis, "Vanilla!"

His field of research included hematology and platelet function. Platelets are the blood components partially responsible for our ability to form a clot and thus not bleed to death on a daily basis. They have a tendency to rapidly clump, it's their job actually, but that also hindered his research. To get around the inevitable delay involved in requisitioning blood from the resident Basset Hound colony he drew his own...i.e from his own arm. We loved him.

Veterinary students are funny that way.

Special thanks to Dr. Dean Scott of funnyvet.com, for so accurately capturing the realities of veterinary school and practice and especially for making me smile out loud.