Category

Interesting Cases

Interesting Cases – Enormous Tumour on a Spleen (caution photo’s are not for the faint of heart)

By Interesting Cases

Moses is a 8 year old Labrador Retriever who was slowly gaining weight for almost a year.  Moses actually started appearing like a pregant dog before seeing us which is hard to do for male dog.  He also started to become quite lethargic and he stopped eating.  During our physical examination a large abdominal mass was palpated and Moses was weak from the mass slowly killing him and due to an anemia from the mass bleeding into his abdomen.

It was elected to take him directly to surgery where Dr. Morgan found the mass to be an enormus tumour on Moses’s spleen as noted in the photo.  The tumour was attached to the spleen making it necessary to remove the entire spleen and mass together.

Dr. Morgan in surgery with Moses. His spleen with the tumour attached is exteriorized.

 

The time during surgery and immediately after was a critical time for Moses due to the amount of blood loss and the extent of surgery needed to remove the mass.  However, Moses was eating the very next day and he never looked back.  The photo of Moses at the top of the page was taken a few days after surgery looking like a slender Black Lab once again.  A photo of the mass below shows the impressive size of the mass which ended up weighing almost 21 lbs.  Histology confirmed that the mass was likely benign especially due to its slow growth over a year.  He continues to do fantastic after surgery and is far more energetic and playful again.  He feels great now after losing 21 lbs overnight.

This photo shows the huge size of the 21 lb spleen with tumour attached which was approximately 15 inches in diameter

 

 

 

 

Interesting Cases – Electrical Burn

By Interesting Cases

Isis is a 2yr old female boxer.  Recently due to some sudden anxiety, Isis began chewing objects at home.  Unfortunately, one of these objects was an electrical socket.  Isis’s owner heard a fair amount of noise and ran downstairs to find her still attached to the plug.  She quickly released her,  assessed and cleaned the area and then called us.

The left side of her mouth showing the electrical burn. The whitish areas are the areas of dead tissue (necrosis) on the lip and gums that is getting ready to slough off.

Burns are classified as an injury to any tissue from heat, flame, chemicals, or electricity.  FIRST DEGREE burns are red and usually there is minor pain at the site of injury. These burns only involve the top layer of skin and heal quickly.  SECOND DEGREE burns have blisters and can involve deeper layers of the skin.  THIRD DEGREE burns occur when the top layer of skin is lost and there is damage to deeper layers.  This is the category that Isis’s wound was classified as.

We decided to give Isis an anesthetic to surgically remove the tissue we were concerned about and started her on antibiotics. Here is the picture after surgery.

Isis's lip after reconstructive surgery removing the dead necrotic tissue. The sutures were removed in 10 days.

Burns, especially electrical burns, can be very severe and have secondary effects on the electrical activity of the heart as well as cause fluid in the lungs.  The best course of action, even if your pet seems fine, is to apply a cool compress, and seek veterinary attention as soon as possible.

Interesting Cases – Physiotherapy

By Interesting Cases

Duke is a high energy 3 year old labrador retriever who had surgery at the Veterinary Emergency Clinic referral center in Toronto for an instability in his right hind tarsus (hock). After surgery in January 2012, he wore a splint for 6 weeks and then a supportive bandage for an additional 4 weeks. After removal of the bandage, there was significant muscle wasting on that leg and subsequent weakness. Although he was still using the leg, there was a mild to moderate lameness still present. At this point it was decided that Duke would benefit from physiotherapy to regain strength and muscle in that leg.
Duke’s physiotherapy consisted of massage therapy, side steps off and on curbs, sit/stand exercises, cold therapy laser treatments, and slow controlled leash walks on uneven ground. Within 3 weeks, he was able to stand on the right hind leg for 30 seconds when the left hind leg was lifted up, and his strength and coordination was improving.
He continues to improve and is expected to be returning to normal function in the future.

SEE DUKE’S PHYSIOTHERAPY WITH US, CLICK ON THE YOU TUBE LINK BELOW:

http://www.youtube.com/watch?v=G3NIzVN-2vg&feature=youtu.be

Interesting Cases – Very Sick Kitten

By Interesting Cases

Jack was found as a stray kitten at about 6 weeks of age. He was brought to our hospital by good Samaritans who agreed to give him the care that he needed. He had pus caked to his nostrils indicating an upper respiratory tract infection and pus covering his eyes. One of his eyes was actually crusted closed.  This is a picture of Jack shortly after his visit and after being cleaned up.  Jack also had diarrhea that adhered to his skin and fur and created an environment for maggots to live. In addition to everything Jack was suffering from, he also had fleas that were feeding on his blood, causing his gums to look white due to an anemia. Jack’s blood was so watery since he didn’t have enough red blood cells, and this led to turbulence of blood flow in his heart causing a murmur to be heard on auscultation.

Jack needed an oral antibiotic for his upper respiratory tract infection, 2 different eye ointments to clear up his eye infection, he was cleaned and treated for the maggots and fleas, and his diarrhea was treated with probiotics and special food. It is very common for kittens to be infected with intestinal parasites.  Some kittens get parasites through the placenta before they are born or they can get parasites from the mother’s milk during nursing and they can also get parasites from the environment shortly after birth. Some of these intestinal parasites can also rarely cause problems in people. We regularly deworm puppies and kittens twice. The first dose kills adult worms and if any eggs develop then the second dose in 2 weeks will kill those parasites. Since there is no drug that will control all types of intestinal parasites, we also sent a stool sample away to see if there were any other parasites that were not treated for.

Three days later Jack was having difficulty urinating and had blood in his urine.  He was dehydrated at this point and was given fluids under his skin that helped to hydrate him over time.  A second oral antibiotic was added for his bladder infection. About 7 days later Jack was suffering from constipation and was given an enema and fluids under his skin. After approximately 10 days, Jack started to rally from his ailments and has never looked back.  Thanks to the care, time and commitment of his owners, Jack made a full recovery and is now part of a loving family with “brother” and “sister” cats.

This is Jack Now!!!

 

Interesting Cases – Niagara Regional Police Service dog “Scout”

By Interesting Cases

Scout has had a long productive career as a Niagara Regional Police Service Dog since he became a part of the department in 2001 as a young adolescent 1 year old German Shepherd.  Officer Pam Carter and Scout flew through training and the two have caught numerous “Bad Guy’s” over the past decade and were instrumental in keeping Niagara safe.

The handlers become very intuitive to their dogs and develop a symbiotic relationship as the dogs and handlers learn to read each other’s body language with clear precision. Unfortunately on July 22, 2010, Pam noticed something dramatically wrong with Scout.  He suddenly became very lethargic and was trying to vomit but nothing was coming out.  His abdomen also started to become distended and he was pacing and very restless in the vehicle.  Pam immediately realized that this could be a GDV (Gastric Dilation and Volvulus) which is fairly common in German Shepherd dogs.  She also realized he required immediate emergency surgery if this was the problem or else he would die within 24 to 48 hours.

It is because of this early recognition that we were able to see him immediately and confirm the diagnosis of a GDV on radiographs.

Scout’s stomach on X-rays revealed a very large distended stomach (outlined with red arrows) that was full of air.

A GDV can occur when the stomach over distends with food, water and/or air and then “twists” onto itself and cuts off all the blood circulation to the stomach.  This strangulation of the stomach starts to cause the stomach to die and the stomach can change from a healthy pink to a dark purple within a couple of hours and an irreparable blackish colour as it progresses.

Appearance of a NORMAL stomach

Appearance of the stomach during a GDV

German Shepherds and any large or giant breed of dog are prone to this condition due to genetically having a very deep chest which gives more room for the stomach to move around in the abdomen.  The Niagara Regional Police Canine Unit are well aware of these factors and the necessary steps to reduce this condition from occurring.  However, even with the best preventative measures, German Shepherds are more than 4 times at greater risk of developing a GDV then a mixed breed dog.  Great Danes are 41 times more likely and have the greatest risk of developing a GDV than any other breed.

Scout was immediately taken to surgery and his stomach looked very similar to the diagram above. Approximately 1/3 of all dogs with GDV die despite surgery, however the success rate dramatically increases with early recognition and intervention which was the case with Scout.  In surgery, the stomach was deflated and rotated back into the proper location.  A gastropexy was then performed which involves making an incision in the surface of stomach and overlying body wall and suturing them together.  This helps to prevent the stomach from twisting again in the future and once the sutures are absorbed by the body, the incisions will have formed scar tissue to keep the stomach in the normal location for the rest of the dog’s life.  Numerous complications can develop during and after surgery, however Scout made a full recovery and was back to work and doing what he loved best within a month.

For owners who have a large breed dog or ones that are “high risk”, there are certain recommendations that help to reduce the risk:

  • Owners should be aware of the clinical signs of a dog developing a GDV (similar to Scout’s clinical signs)
  • Feeding dogs 2 to 3 times a day dramatically reduces the risk rather than feeding once a day.
  • Water should be available at all times, but should be limited immediately after eating.
  • Vigorous exercise or excitement should be avoided for a few hours after eating
  • Studies have shown that dogs fed from elevated feeders have an increased risk of GDV and at this time pre-disposed breeds are recommended to be fed at floor level.

Scout developed his GDV at 10 years of age and he continued on as a service dog until his retirement later that year.  Unfortunately he developed bone cancer (osteosarcoma) when he was 11 years old and was eventually euthanized in April 2011. He is sorely missed by everyone in the NRPS but his legacy lives on.  We hope that Scout’s story may help people recognize or ideally prevent GDV’s from happening to other dogs in the future.

If you have any questions about this condition, do not hesitate to call us at 905-354-5645.

 

 

 

 

Interesting Cases – Intestinal Foreign Body

By Interesting Cases

Diesel is a 6 year old Chocolate Labrador Retriever who presented to us for vomiting a latex glove 4 days ago and has been vomiting and not eating since. On physical examination he was bright and alert and otherwise normal. However radiographs (X-rays) revealed a suspicious area in his intestines that was dilated with a lot of gas around it. This was highly suspicious of a foreign body and he was immediately taken to surgery.

A lateral x-ray view of Diesel’s abdomen revealing gas in his intestines (dark loops).

Diesel was sick a few months prior to this event and blood results revealed elevated liver enzymes. He had a laparoscopy procedure which is a special camera that travels into his abdomen to get a biopsy of liver which revealed a very small liver due to a liver shunt (Porto-systemic Shunt – PSS). This is a birth defect that he was born with where the blood bypasses his liver. This makes it more difficult for him to metabolize drugs or break down toxins. We therefore needed to choose his anesthetic drugs carefully to minimize any stress to his liver.

During surgery, the foreign body was found in his intestines (duodenum) and was surgically removed.

Diesel’s intestines in surgery. Note the white structure in his intestines which turned out to be a obstructed latex glove.

 

Diesel’s intestines inmmediately after removing the latex glove with sutures closing the surgical site.

Diesel was kept in the hospital on IV fluids along with pain medication, antibiotics and medications to reduce acid formation in his stomach. After 3 days he was eating well on his own and was sent home. He has since made a complete recovery. However his desire to eat bizarre objects did not change since this was his second incident of eating latex gloves. Labrador Retriever’s love getting into trouble and Diesel is no exception.

Interesting Cases – Laser Therapy

By Interesting Cases
Simba enjoying getting his “painless” laser therapy on his arthritic elbow

Simba is a 12 year old golden retriever who had a history of limping on his left front leg. Despite being on anti-inflammatory medication, Cartrophen injections to improve the cartilage in his joints, and a high quality prescription joint diet, Simba still was having pain on his left front leg. We were able to isolate the source of the pain to Simba’s elbow and decided to radiograph it to further assess the joint.

Lateral X-Ray view of a normal elbow joint

Lateral X-Ray view of Simba’s elbow. Thr RED arrows point to osteophytes which are calcified bone spurs seen with chronic arthritis

 By taking the radiograph of Simba’s elbow we were able to rule out causes of joint pain in an older dog such as cancer, and diagnose significant arthritis in his elbow joint. We decided to add treatment with a Cold Therapy Laser to see if we could get better control of Simba’s painful arthritis. The procedure is very non-invasive and involves placing a laser probe over the area of concern for approximately 7 minutes, exposing the joint to a mixture of ultraviolet and laser light. Simba’s treatment plan involves 2-3 treatments a week for 2 weeks, once a week for 2 weeks and then monthly for maintenance. He has currently received his first 2 treatments and his owner has noticed a significant improvement with his mobility and comfort beyond the other treatments he is receiving.

Therapeutic lasers are used more commonly in human medicine for sports related injuries, arthritis, and tendon injuries. More and more uses are constantly being investigated and have included the control of skin infections resistant to antibiotics, herpes virus infections, fungal infections, and even anti-aging treatments. Their use in animals is newer but is becoming more and more common. If you have any questions about the use of laser therapy, please don’t hesitate to contact our office.

Interesting Cases – Laparoscopic Castration (Cryptorchidism)

By Interesting Cases

Dusty was just like any other playful and energetic 6 month old male Cockapoo except for one difference. Usually by 6 to 8 weeks of age, the testicles of male puppies would have descended into their normal location inside the scrotum. Unfortunately for Dusty, his did not even by 6 months of age.

This condition is called “Cryptorchidism” and occurs in approximately 0.8 to 10% of dogs depending on the breed. When it occurs the undescended testicle(s) may be located in the abdomen or in the groin (inguinal) area. Dusty had 1 testicle in each location. Castration(neutering) in general is recommended for any non-breeding male to help deter some behavioural issues in male dogs as well as reducing some aggressions. Neutering also prevents tesicular infections, torsions and cancer and also significantly reduces prostate disease and cancer. For cryptorchid dogs, the undescended testicle is 13.6 times more likely to get cancerous than normal male dogs and further justifies castration.

Normal male dog with the testicle located in the scrotum

 

Performing castration on a dog with cryptorchdism is significantly more difficult due to trying to locate the testicle(s) and trying to remove them with minimal trauma. The testicles that are located in the abdomen are especially more difficult since the testicle may be located as high as the level of the kidneys to where they exit the abdomen (inguinal ring) next to the prostate and bladder (see diagram above). Using traditional surgical techniques, this uncertaintly can lead to a very large incision in the abdomen in an attempt to locate the testicle and therefore dramatically increase the amount of post-op pain and increase the chance of infections, etc.

Using endoscopy and in this case “Laparoscopy” allows us to make a very small 2-3 mm incision to allow the camera to enter the abdomen to locate the testicle. Once the testicle is found, a separate small incision can be made directly over the testicle to grasp and remove the testicle (i.e. laparoscopic assisted). The tesicle can then be ligated (tied off) as usual leaving only 2 very small incisions that need to be closed rather then a very large one.

Dr. Todd Morgan with Laura Froud VT performing laparoscopy on Dusty

 

The cryptorchid testicle was located in the abdomen resting on top of the colon and next to the bladder. The graspers are seen getting ready to grab the testicle.

 

The testicle is brought to the abdominal wall to be removed.

 

The testicle is now removed from the abdomen.

Dusty healed well from his surgery and is running around playing with his family as if nothing ever happened. If you have a cryptorchid dog or any questions about this new surgical technique, do not hesitate to call us.

Interesting Cases – Heart Disease (Sick Sinus Syndrome)

By Interesting Cases

Pico is a 12 year old, male neutered, Miniature Schnauzer. Pico began to have episodes of weakness and collapse that seemed to worsen over a period of 2 weeks. Although he would recover quickly after an episode of collapse, his owner felt Pico should be examined.

Pico was diagnosed with a condition called Sick Sinus Syndrome. In the heart is an area called the sinus node that is responsible for forming the stimulus for the heart to beat. If the sinus node is not stimulating heart contractions properly it is termed as “sick”. Miniature Schnauzers, West Highland White Terriers, Cocker Spaniels and Dachshunds are predisposed to the syndrome. In the Miniature Schnauzer and the West Highland White Terrier, Sick Sinus Syndrome may be a condition that they could inherit.

Picture of the heart showing the S-A (Sinus) Node in the upper left where the stimulus originates to beat the heart

 

Sick Sinus Syndrome is a condition that affects the heart rate. The heart rate may be very slow (bradycardia), very fast (tachycardia), or there may be a break/stoppage in the heart rhythm (sinus arrest). The diagnosis is made on history, physical examination, a holter monitor reading (ECG machine worn by the pet for 24 hours while he goes about his normal activities) and an ultrasound. Bloodwork and urinalysis is recommended to be sure that there are no other health problems present.

Pico wearing his Holter Monitor that is recording his heart beats.

 

Pico appearing quite comfortable while the Holter Monitor is working.

 

The monitor revealed that Pico had a heart rate that varied from 28 beats per minute to up to 229 beats per minute. The normal heart rate for a dog is 70-120 beats per minute. There were stoppages in the heart rhythm of up to 6.85 seconds long.

Normal ECG reading showing a regular heart beats with regular intervals

 

Sick Sinus Syndrome showing a long delay in between heart beats

 

Treatment involves medication (in Pico’s case Propantheline Bromide and Theophylline) or if necessay the placement of a pacemaker. Fortunately, Pico has been improving on his medications alone. He used to have 10-20 episodes of weakness and collapse an hour, but has improved to 10 or so much milder episodes a day (no collapse – Pico just pauses for a minute and then carries on doing what he is doing). Although quieter, Pico is enjoying his normal activities and hopefully will continue to do so for some time.

Interesting Cases – Sarcoptic Mange

By Interesting Cases

Riley and Ginger are two Springer Spaniels that presented to us in June of 2009 for extreme pruritis (itching) and hair loss that had been going on for approximately 7 months. The owners had tried food diet trials and corticosteroids but nothing had worked. Ginger was definitely more severely affected than her brother, with hair loss over 80 % of her body, scabs and crusts on her ears, body, and legs. Riley had similar signs but less of his body was affected. The owners were asked if they were showing any signs at home, and they commented that they were itchy as well, and had some white bumps on their arms.

Skin appearance at time of diagnosis

 

Skin appearance at diagnosis – looking very anxious and itchy

 

Sarcoptes Mite seen under microscope

 

Sarcoptes Lifecycle

 

Skin scrapings were performed and revealed that the dogs had a mite in their skin called Sarcoptes. Sarcoptic mange is caused by a parasitic mite that burrows just beneath the surface of the skin. The mite feeds on material in and on the skin. Sarcoptes is a zoonotic disease, meaning that it is not only very contagious between animals, but is also contagious to humans. Although the diagnosis is best made by a skin scraping examined under the microscope, it is common not to see mites when performing a skin scraping. This is due to the fact that the mites burrow deep into the skin and that it takes only a few mites to cause significant itching. At times only a presumptive diagnosis can be made on clinical signs and treatment can be initiated.

2 weeks into treatment – starting to feel bet

 

2 weeks into treatment

 

Riley and Ginger were treated with a drug called Revolution, as well as antibiotics, and antifungal medications for their secondary bacterial and yeast infections on their skin. Riley and Ginger’s owners were also treated with medication prescribed by their doctor.

1 month into treatment – feeling like new dogs

 

1 month into treatment – hair is back normal

 

One month into the treatment and Riley and Ginger are now back to their normal selves and are acting like puppies again!!!