All posts by tmorgan

Interesting Cases – The Vomiting Dog Who Wouldn’t Eat (CAUTION – contains surgery photo’s)

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Suzie is an adorable 6 year old mixed breed dog.

Her concerned owner brought her to us for evaluation of non-specific signs of reduced appetite and vomiting. Her physical exam revealed a swelling in her left groin area, which was suspected to be an inguinal hernia. An inguinal hernia is an opening of the abdominal cavity where fat and/or other abdominal organs can push out of the abdomen to the area under the skin in the groin. An abdominal ultrasound was performed the same night and it ruled out other causes of her signs and confirmed that she did have a hernia.

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X-ray showing gas in her intestines prior to the trapped area of intestine.

The next morning Suzie was admitted for surgery. When the hernia was opened up, there were intestines trapped in the hernia causing an obstruction and the vomiting.  To make things worse, the piece of trapped intestine was not receiving blood supply, causing it to die. An abdominal incision was made and the trapped intestine was released and the dead segment of intestine was removed and the healthy intestine was sutured together.

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 Dying segment of intestine that was trapped in hernia

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Removal of the dying segment of the intestine.

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Re-attachment of the healthy pieces of intestine.

 

 

 

The opening of the abdomen in Suzie’s groin was also sutured closed to repair the hernia.  Thanks to the careful monitoring of our experienced veterinary technicians, Suzie did very well throughout the lengthy surgical procedure. Suzie remained hospitalized for a few days and was sent home with many medications to help her get better.

 

Due to the dedication of her loving owner, Suzie received the post surgical care and medications that she needed for a complete recovery.  Suzie started eating well, she stopped vomiting and her energy level was similar to that of a puppy again. Suzie quickly gained weight and her incisions healed well.  She is expected to have a normal life without any future complications from her repaired hernia.

 

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Bloat (GDV) & Preventative Surgery

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Bloat or Gastric Dilatation and Volvulus (GDV) is a horrible disease that affects primarily large breed dogs.  Larger breed dogs tend to have a deep chest which allows the stomach to become more mobile and potentially twist due to this increased mobility. The typical history involves a dog who has eaten a large meal or has drunken a lot of water and was too energetic prior or after this causing the stomach to twist.  However, most large breed owners are aware of this condition and are very careful in preventing their dogs from exercising immediately after eating.  Unfortunately, this condition also commonly occurs when all the precautions have been taken.

The incidence of GDV varies between breeds with the Great Dane having the highest risk with 37% of dogs affected.  When a GDV does occur, it is an emergency condition that usually requires emergency surgery and a great deal of expense.  Even when an emergency surgery is performed to correct the twisted stomach,  approximately 1/3 of dogs will die despite the veterinarians best efforts.

Bloat/GDV Summary

Normal Abdominal Radiograph

   Normal lateral abdomen X-ray showing the normal positioning of the organs.

 

GDV lateral abdomen radiograph

 X-ray showing a dog with Bloat (GDV) with the large distended stomach that has twisted and required emergency surgery

Prevention is key with this condition.  In the past, a preventative surgery was far more invasive and required a large 12-15 cm incision.  With the advent of Laparoscopy (or Key Hole Surgery, Minimally Invasive Surgery), the procedure is now far less invasive by using a small medical camera to find the stomach and surgically “tack” the stomach to the inside wall of the abdomen.  This procedure can be performed along with a laparoscopic spay in female dogs through the same incision.  It can also be performed the same time as a castration in male dogs, however separate incisions are needed.  The procedure is highly effective in preventing this life threatening condition and dogs are typically kept over for one night in hospital and sent home the following day.  The  first 10 days require minimal exercise while the area heals and then they are allowed to resume their normal activity.

Laparoscopic gastropexy - grasping stomach

  Appearance of the stomach being grasped by forceps to be sutured to the abdominal wall

 

Laparoscopic gastropexy site

  Final appearance of the stomach sutured to the body wall to prevent twisting just prior to the gas being removed from the abdomen (to remove the tension)

Laparoscopic Gastropexy Incisions

Appearance of incisions after surgery. The dog had a laparoscopic spay at the same time.

Do not hesitate to call our office for an estimate, if you have any questions, or if you are wondering if this procedure would be ideal for your large breed dog at 905-354-5645.

Dental Health

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Dental disease is very common in our pets and can cause a variety of problems beyond bad breath.  This video featuring Dr. Gagnon and Lacey highlights a dental procedure and how to give your pet a healthy mouth to improve their overall health.

Dr. Todd Morgan performing a Laparoscopic Spay

Laparoscopic Spay

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We are excited to offer this minimally invasive alternative to traditional spays.  A laparoscopic spay provides up to 65% less pain to your pet compared to a traditional spay.  A laparoscopic spay (medially termed a laparoscopic ovariectomy) is also less traumatic and provides a faster recovery time.

 

Click on our YouTube link below to find out more this procedure and how well Ziggy did undergoing a laparoscopic spay:

 

Why Choose a Laparoscopic Spay?

Laparoscopy is a minimally invasive procedure performed by passing a narrow medical camera (laparoscope) through a tiny incision into the abdomen. The laparoscope provides a magnified view of the organs allowing for greater precision.

A Laparoscopic Spay (medically termed a laparoscopic ovariectomy) requires a second tiny incision (typically <1cm) for the placement of medical instruments to perform the spay.

The ovaries are identified and isolated with endoscopic forceps. A special vessel sealing device carefully cauterizes, seals and cuts the ovarian blood vessels and ligament, thereby freeing the ovary from the rest of her uterus. The ovaries are then retrieved and removed through the tiny instrument incision. The uterus is left intact and in its natural state.

Research has found that there is no benefit to removing the uterus**. Retaining the uterus will not increase the risk of breast cancer or uterine infections, nor will your dog go through any heat cycles.

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Lap OVE2

Endoscopy - Laparoscopy - website

HOSPITAL TOUR VIDEO

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Clients are always curious with what goes on “behind the scenes” and some of the procedures we perform.

Click on our You Tube link below to get a hospital tour of our facility and check out some of the procedures we perform on a daily basis.

 

Radiograph of Lena with 2 mummified fetuses

Interesting Cases – 2 Mummified Fetuses in a Spayed Cat – Dr. Tina Gagnon

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Lena is approximately a 3 year old female, spayed, calico cat. Her new owner had brought her in within three days of adopting her, because she felt a mass in her abdomen. The mass was confirmed as abnormal on general physical exam and we decided to take an x-ray to find out more. Surprisingly, we saw two fetuses in her abdomen. I confirmed with the veterinarian that performed the spay procedure, at another veterinary clinic, that Lena had both of her ovaries and her uterus removed. The abdominal radiograph (x-ray) shown above does identify 2 kittens in the abdomen (white arrows pointing to each one) and we could see the kitten’s vertebrae and skulls on the radiograph.

We performed an abdominal ultrasound to see if she had any reproductive structures and to find out if the fetuses were alive. If they were not alive, we needed to know if they were attached to any abdominal organs that would complicate the removal of the dead fetuses. The abdominal ultrasound revealed two mummified fetuses in Lena’s abdomen. One was located near the stomach and the other was located between the left kidney and the spleen. These may have resulted from an ectopic pregnancy or, her uterus could have ruptured during a pregnancy, expelling the fetuses into the abdomen, then healed back up.

We then performed surgery to remove the mummified fetuses. One was covered in a membrane and was attached by scar tissue to the side of her abdomen. The other was walled off by abdominal fat and also attached to the back of her abdomen. Both were successfully removed. Lena stayed in the hospital over night on intravenous fluids, pain medications and antibiotics. She was sent home the next day and made a fabulous recovery.

Lena in surgery showing a mummified fetus.

Lena in surgery showing a mummified fetus at the tip of the arrow

 

 

Miche

Interesting Cases – Feline Liver Disease

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Miche, is a 3 year old Seal Point Himalayan. Shortly after adoption from a humane society,  Miche started to sneeze and sound congested.  She became less active and stopped eating.  When she arrived at our clinic she continued to show these signs and she had a fever.  It is common for cats to develop upper respiratory tract infections, especially if they have been in contact with other cats. This usually involves different viruses that affect the upper airways and can involve bacteria as well. These cats usually do not eat because they don’t feel well, they cannot smell their food and they have a fever.

Miche was kept in the hospital on intravenous fluids to hydrate her and was on intravenous antibiotics for the infection and fever. She was being fed by mouth but would not eat on her own and Miche’s fever remained high so a second antibiotic was added. After a few days, Miche stopped sneezing, her temperature normalized, she was brighter and was less congested. She still didn’t eat well, but some cats won’t eat in the hospital due to the stress of being in a different environment. Since Miche made a good recovery we decided to try her at home.

Miche was acting normally at home except she was not eating. This prompted bloodwork to see if there was something else going on causing her not to eat. The bloodwork showed that there was a problem with her liver. Cats that stop eating for as little as 3 days can mobilize their fat to their liver, causing liver disease. Considering Miche’s history of not eating, this was very possible. This is reversible and treatment involves insertion of a feeding tube to make sure the cat is getting enough nutrients.  A liver biopsy would also tell us what is happening in the liver and how to treat it.

This is what Miche's liver looked like during her laparoscopy (a special camera that looks inside her abdomen). The mottled tan liver is seen and her gallbladder is the round grey/blue structure.

Taking a biopsy of Miche's liver. The view is magnified 10 times and the sample is actually only 4 mm diameter. The liver typically is a reddish/purple colour but appears quite pale and mottled here.

Miche’s owner decided to proceed with a liver biopsy and insertion of a tube that would allow her to feed Miche through this tube directly into her stomach.  Although it was difficult at first, her owner was very dedicated and learned how to feed Miche through her feeding tube. The liver biopsies came back as lymphocytic pericholangitis which is a type of inflammation of the tissues surrounding bile ducts in the liver. Miche was put on 2 medications: one to reduce the inflammation and one to help decongest the liver.  Miche’s owner was able to give these medications through the feeding tube.

The stomach tube is placed with the help of an endoscope in Miche's stomach. A catheter is inserted into the stomach through the skin in the ideal location after the endoscope fills it with air and the graspers grab the suture material that is tied to the feeding tube and brought back into the stomach.

This is how the feeding tube appears in the stomach. Food is placed through the tube with a syringe and exits through the holes in the 'mushroom tipped" end. The tube can remain in place for months and once Miche began eating normally on her own, the tube was removed.

 

Miche continued to improve and now she is a loving, active and healthy companion for her human mother.  Three weeks later, a blood test was done to assess her liver function and came back all normal. Miche is now eating well on her own.  Her stomach tube was removed and she will continue to be monitored.  Miche is a fabulous cat and we all care for her very much.