One Small Act. One Giant Difference.

Today, I was reminded of the fragile nature of life and how one action can make a difference. A woman came into the clinic to have her dog checked, because the dog had been urinating more frequently and had blood in her urine. While the assistant was getting a history, the client’s phone rang. Although, we normally frown upon people talking on their phone during their appointment, the woman answered her phone.

Her nephew had just the left her house and was involved in a serious car accident involving a school bus. The woman was crying and shaking. I could hear every word from the other side of the clinic. She started making calls, alerting family members to the event and attempting to coordinate getting everyone where they needed to be.

As the staff members began arranging for the dog to stay for the day, I stepped into the room. The woman’s phone rang again. The nephew was being transferred to a local hospital. As she hung up yet again, I took a step towards her and wrapped her in a hug.

She clung to me.

She shook and cried harder.

Her hug back tightened.

Then she whispered, “Thank you.”

After a few moments, she let go, stating she had to call Grandma. She was shaking so hard she couldn’t hold her phone still enough to get to her contacts list. I held her phone with one arm over her shoulder until the call was made.

She struggled to get the words out to meet at the hospital, she would be there soon. I knew she was in no shape to drive right then. I apologized that I needed to get some information about her dog. I got her to focus on the dog for long enough that her breathing started to steady and she could answer some simple questions. We discussed what the plan would be for the day, and that I would call her as soon as I had any information. I had her take a few breaths and she signed the paperwork for her dog. She was calm enough to drive.

Throughout the day, I made contact with her to update her on her dog’s status, always asking about her nephew first. Although the dog was my patient, my heart broke for this woman and her family. I knew I was needed in more ways than just my role as a veterinarian. As we went through the tests, we found that her dog did not just have a urinary tract infection. She had never been spayed and was recently in heat. The blood in her urine was caused by a pyometra, a uterine infection that, if not treated, could be fatal. The pup needed an emergency surgery to remove her infected uterus.

The family did not have a lot of money, only a couple hundred dollars available, but they made some calls and found friends that would help. She called back and told us to go forward with surgery.

Surgery was a success, and I was able to call to share the good news. I was greeted with news that the nephew would also be alright.

After leaving his aunt’s house, his car went under a bus. He was pinned in the only portion of the car that was not crushed. The woman’s daughter was supposed to be with him that day as they were supposed to carpool. The bus needed to be lifted by a crane to remove the car from beneath it. The daughter would have been dead. The nephew survived with few injuries amazingly; damage to his hands, cuts and bruises to his body.

When she picked up the dog at the end of the day, she wrapped me in a giant hug, and then she showed me pictures of the car. No one should have been alive with the extent of the damage. Her hands were steady, but her voice still shook. She gave me another hug and whispered, “You were my angel today. Thank you for being there. Thank you for saving my baby’s life. You are a blessing from God.”

I fought tears that swam in my eyes. I am so thankful that I was present today; that I was willing to do more than “just my job.” I was able to be God’s hands and feet on earth. I am so thankful that I was given the opportunity to help someone. What I did wasn’t much, but it was everything to this woman and her dog.

Please, take the time to do something small (or large) to help someone. Listen when they are in pain. Be there when they need a shoulder to cry on or a hug to lean into. Please keep this family in your prayers.

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One Year Anniversary

One year ago, October 17, 2015, I officially became a business owner. After a sudden change in employment status, investigating what lay ahead, and a lot of prayer, I filed the documents that made this my new reality.

During this past year, I have worked in practices throughout eastern Wisconsin and the US Virgin Islands. I have also traveled to the desert southwest for the first time, working through Christian Veterinary Missions to perform spays and neuters for the Navajo Nation in Arizona. I have completed continuing education courses in Wisconsin, Florida, and Virginia.

Due to all of the farm animals that began showing up in the Virgin Islands and my goal for doing more mission work, I decided to do the Farm Animal Training for Missions (FARM) course in Catawba, VA in September. The Scottish Highland cows wanted to join the lessons!

Due to all of the farm animals that began showing up in the Virgin Islands and my goal for doing more mission work, I decided to do the Farm Animal Training for Missions (FARM) course in Catawba, VA in September. The Scottish Highland cows wanted to join the lessons!

Mabel was my first goat patient in the Virgin Islands.

Mabel was my first goat patient in the Virgin Islands.

 

 

 

 

 

 

I have made time to visit friends in Puerto Rico, Arizona, New Mexico, and Wisconsin. I have found some balance for myself. My goal for the business was to provide renewed strength for other veterinarians, and even when I am crazy busy and not getting a lot of sleep, I have found that I am renewed myself. I would like to share just a few of my adventures, patients, and travels!

Dulce saying goodbye and going to America

Dulce was a patient in the USVI heading to the mainland to her new family!

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Sometimes, fawns need doctors, too.

 

 

 

 

 

 

Kristy, Thurman, and I in front of the Navajo mobile veterinary unit. June 2015

Kristy, Thurman, and I in front of the Navajo mobile veterinary unit. June 2015

Churchill was injured in a dog attack. After repairing his wounds, including fixing his broken ribs and a hole through his chest wall, he was able to go to his furever home.

Churchill was injured in a dog attack. After repairing his wounds, including fixing his broken ribs and a hole through his chest wall, he was able to go to his furever home.

This is the face of a dog that enjoys eating Cane Toads (they are toxic). Thankfully, his family was quick thinking and they flushed his mouth out. After some fluids, oxygen, and more fluids, he did great!!

This is the face of a dog that enjoys eating Cane Toads (they are toxic). Thankfully, his family was quick thinking and they flushed his mouth out. After some fluids, oxygen, and more fluids, he did great!!

 

 

 

 

 

 

 

 

 

I have continued to build my skills and providing care for animals and their people. Lots of my normal dogs, cats, and rabbits, but also some goats and even a donkey! From vaccines and health certificates to skin and ear infections to major surgeries and behavioral consultations, my skills have been tested and improved. I have had cases that have pushed me passed my limits and brought me to my knees, but I not only survived, I thrived.

Juan Carlos, my first donkey patient, at about 1 month of age was found 20 feet out in the ocean after being attacked by an adult donkey. He found a new home on St. Thomas, USVI.

Juan Carlos, my first donkey patient, at about 1 month of age was found 20 feet out in the ocean after being attacked by an adult donkey. He found a new home on St. Thomas, USVI.

An arm full of puppies makes so many things better. This was a litter at I saw in St. Anna, Wisconsin.

An arm full of puppies makes so many things better. This was a litter at I saw in St. Anna, Wisconsin.

I would like to thank all of the clinics, doctors, staff, clients, and patients that let me into their lives. I would like to thank all of the family and friends that supported me with good thoughts, prayers, and places to stay.

My sister's dog, Macy, needed emergency surgery to remove a tumor on her spleen (note giant mass under my hand). Thankfully, she did well and the tumor was benign. Yeah for not having cancer!

My sister’s dog, Macy, needed emergency surgery to remove a tumor on her spleen (note giant mass under my hand). Thankfully, she did well and the tumor was benign. Yeah for not having cancer!

Merry Christmas 2014!

This past year has been an adventure. Seeing the joy of Christmas around the world has brightened my day and brings me great happiness.

For the past month, I have been working on St. John in the US Virgin Islands doing relief work. I have had many crazy experiences and have been blessed to meet many wonderful people. Although it is hard to be away from home for the holidays, I am thankful to be here. I would like to share a couple of stories from the St. John Animal Care Center, the only shelter here on the island. Since I am working at Canines, Cats, & Critters, the only veterinary clinic on the island, we see all of the animals.

The first is Churchill. Churchill is a spunky little guy that unfortunately had a run in with another dog the other day. After some immediate treatment to keep him alive and supportive care, Dr. Laura, the owner of CCC, came over from one of the offices on another island and performed surgery to close the hole in Churchill’s chest wall and repair his broken ribs. He is a fighter and is doing well now. Hoping to find a forever home!

Churchill the day after surgery.

Churchill the day after surgery.King on

The second is Dulce. Dulce is a sweet little girl that was brought into the shelter with the rest of her litter. She has been nice and healthy. Due to the generosity and love of others, she was able to leave for her forever home on Christmas Eve. Dr. Laura was delivering her to her new family in Maine. Many of the dogs from the island get adopted by people, most often living in the USA. Many of them will have a human escort to get to their new family. Others fly solo. Thankfully, Dr. Laura was able to go home to visit her family in the northeast USA for Christmas this year and take Dulce at the same time.

Dulce says goodbye and thank you!

Dulce says goodbye and thank you!

My final Christmas star, is King. King has had a rough life so far. Thankfully, his former owner brought King to the shelter when he finally realized that he could not care for him. King had stopped eating and his previous owner could not afford veterinary care. The ACC took King in and brought him to us at CCC. King weighed in at 38 pounds upon arrival and it has been a tough road getting him to eat anything. King is heartworm positive and extremely malnourished, although he has started to gain a little weight. We are doing all we can to get him strong enough for heartworm treatment. He is a very sweet boy, although not really a fan of other animals, he LOVES people! Today, King celebrated Christmas at CCC with a big squishy bed that was donated by a wonderful family for his comfort.

King on Christmas morning.

King on Christmas morning.

Please remember everyone, human and animal, that is in pain and alone this Christmas. Consider a donation of food or clothing, or even better, friendship, to someone that needs it. Consider a donation to a local shelter (human or animal) that provides for those in times of crisis.

If you want to help support the Animal Care Center and help provide for the cost of Churchill’s or King’s care, or any of the other animals, please contact the ACC here.

With the help of The Pet Apothecary, we are able to get some much needed medications for the cats with unresolved upper respiratory infections at a great discount. That being said, we still need to raise some money for the medications (about $100) and shipping to get it here.

Have a very merry Christmas (or whatever celebration you may wish to celebrate) and take time to make a difference in someone’s life today!

Veterinary Happiness

There have been a lot of things lately that have made me really sad in my life – specifically related to work. That is why I want to share a story of happiness, light, and life today.

I have been providing relief services to veterinary clinics for a little over a month now and have met a lot of great people and animals. The other day, I was eating lunch in the break room of the clinics when the door chime rang. I knew that the receptionist was on the phone, so I went up to see what I could do to help. A couple was standing there with a cat that was skin, bones, hair, and massive personality. The couple had been out at their cabin and found this cat two hours before. Another family member had seen the little guy the week before, but was unable to capture it. They brought him in to see if anything could be done to help him.

We checked him for a microchip or any other form of identification, but nothing was there. I did an exam and went over the problems that I found with them and what would need to be done to fix them. I recommended some tests to see what was going on internally. The couple really wanted him to have a chance. We discussed costs. We then agreed that we would go step by step. Collect all of the needed samples, but get some results before running the rest of the tests. The first set of tests came back clear, so they went forward with the rest. We got him on antibiotics and did some fluids to start him on the road to rehydration.

I was so happy that they gave this guy a chance. They didn’t have to bring him to a vet clinic. They didn’t have to agree to do any tests. They didn’t have to agree to do any treatments. But, they did them all. They recognized the awesomeness that was this little guy (I secretly named him Smee) and are giving him a chance to return to health. If they can’t find his owner, they plan to keep him as well.

Smee found a great home with a wonderful couple.

Thank you for making me smile and bringing back some of my faith in humanity!

Mongolia Update (August 18-23)

August 18, 2014

Today dawned with a little sadness as I recognized this was my last week in Mongolia and there was still so much to do before leaving. I have been writing teaching handouts and clarification pieces for the veterinarians so that when someone isn’t there, they have documents to refer to. I love the looks in their eyes when a new piece of information locks in and they are able to use it with their patients. It took me awhile, but I finally am comfortable enough to hold impromptu teaching sessions, well, that and there is finally a couple minutes of “free time.” The clinic has been so busy, that a time when there was a free veterinarian was difficult. Today, things finally slowed down enough that we could gather 1-5 people and have a session. As these young veterinarians move forward, I pray that they have many people to come in and mentor them. Although their knowledge is good, the implementation of the knowledge and the overall application of techniques need to be honed. It is easy to treat the immediate problem for which a person brings their pet into the clinic, but to address the entire animal by obtaining a complete history and performing a comprehensive exam is so important to the welfare of the animal and it is easy to overlook. It was a good reminder for me as well with my return to the USA.

Today was also interesting as the power was a little less trusty. It went out in the morning, but thankfully did come back on. The fallout from this is that when we went to lunch, my food (meat of course) was not completely cooked. I ended up grabbing something else at the mini market, because I didn’t want to risk getting sick again! Dinner was a lot better with my food being cooked, and then I was given the adventure of going to a hair salon in the basement of a building where my hair was greatly shortened. A bit shorter than I am used to and what was requested, but the woman did a lovely job. Another first, getting my hair cut outside of the USA.

August 19

Apparently, yesterdays teaching sessions went over well, because now the veterinarians are asking for more impromptu sessions. Of course, the first one they asked me to do, I didn’t have anything planned, but that is quite alright. “The Coughing Dog” was a great topic and not one that I would have thought to make a handout for previously. Most non-medical people do not realize how “coughing” can mean so many things – bacterial or viral infection, parasites, heart disease, asthma, bronchitis, cancer, and the list goes on. This also took us into evaluating various lung patterns on radiographs (x-rays). Hopefully, they will start using the books more frequently – especially those with pictures – to be able to recognize different patterns in the future. I know there are times, I still need a refresher and reminder of the various pattern and what they mean for the patient. We also worked on parvovirus. A disease that is preventable with vaccination, but unfortunately many people don’t realize it. I can’t tell you how many puppies would be lined up in cages, set up to their IV fluids, receiving medications, and being cared for, but just don’t make it. They are so tiny and usually at the beginning of their lives, but they aren’t able to pull through. It breaks my heart here as it does at home that lack of education of the people causes so much suffering in the animals.

I went out to Ultziit again to visit with the Spence family and two other Americans that are over for the Fast Horse Training. Tom and Johnny have been coming to Mongolia for the last 15 years or so to teach veterinarians – specifically to care for horses. I am so impressed by the work and dedication that they provide to the Mongolian people. I cannot say how many lives (both animal and human) their training has saved over the years. They spoke of veterinarians that are using a stethoscope for the first time and hearing hearts beating after 20 years in practice. It is amazing! Johnny also shared about a wonderful program that he has been involved with recently called Victory Junction, a camp for children with chronic illness and disease that allows them to have a week where their disease does not stop them, does not control them. This camp is amazing and such  a blessing to have available to children.

Despite having another wonderful time, I just wasn’t feeling good overnight, but finally got some rest. I think I had a fever and it finally broke overnight. Not sure if it was the undercooked food from the day before, but am I glad that it didn’t progress to have me end up in the hospital again!

August 20

I had a day off today to get some more shopping done, to start packing, and to go to the Ensemble – a Mongolian cultural show. It was an amazing event! The throat singing and music were interesting and I have no idea how the throat singing works (you should not only hear it, but watch it!) The craziest part of the show was the contortionist. My joints still feel sore just from watching her. Absolutely amazing!

It is really hitting me that I will be leaving soon. I miss my husband, cat, family, and church, but I really want to stay here!

August 21

I have been reminded again about the difficulties in practice here. Here, I am “the specialist.” The one with experience. The one that is supposed to have the answers. Today, I was faced with a pup that I knew what needed to be done, but I didn’t have the equipment, medications, or specialists needed to treat the pup. At home, it normally comes down to money – people can afford to treat or not, they want to treat or not. There is a specialist somewhere that can take care of the situation in many cases.

This is the story of Coco. Coco is a tiny Chihuahua (1.6 kg, about 3.5 pounds) that was given large amounts of vodka and had fallen off of a bed two days previous. Now, she has torticollis (her head and neck are tilted around making the head almost look like it is upside down), nausea, and anisocoria (her pupils were of different sizes). She also has bulging of her skull between the eyes. Normally, one would place her on oxygen, monitor her blood pressure, and a wide variety of other things (MRI, CT scan, etc), but I can’t do any of those things here. Thankfully, I have access to the Veterinary Information Network (VIN), which includes veterinarians, including specialists, from around the world that I could request help from. We were able to find some Mannitol – a medication that helps decrease brain swelling – at the corner pharmacy, so we could start that treatment. Sadly, there is no overnight care or monitoring here, so she was sent home with her owners with instructions to come back first thing in the morning. We all prayed that she would survive the night.

We also had a young kitten (maybe 3 months old) come in that had fallen off of a balcony. The family had never had a cat before and were watching her for a couple days. The family knew nothing about cats, so they left her on the balcony while they went away for a short time. They couldn’t find her upon their return on the balcony and finally found her on the ground 4 floors below. She had a broken leg (fractured femoral neck) and a pneumothorax. Thoracocentesis was performed to remove the air, and we will have to see about the leg. It is a type of fracture that can be repaired, but could also potentially be left to have the femoral head dissolve on its own. We will wait and see what happens over time.

That evening as a thank you, I purchased pizza for the entire clinic. Something that is so simple and easy that it is one of the most common things to do in America, but for them is often cost prohibitive. For about $45, I was able to blessed with their joy and fellowship.

August 22

I gave my farewell devotion this morning and was brought to tears multiple times. I, of course, stood out as emotions are not often shown in Mongolia. I on the other hand tear up at Hallmark commercials, so it wasn’t a far stretch for me to cry now. There were hugs all around and such amazing love, support, and acceptance. Thank you for allowing me to be here and to hopefully have made a difference!

The clinic itself had a slow day, but we continued to work with Coco. She even began to show her Chihuahua nature again and started to growl at me. She had some nystagmus (rotation of her eyes) today, but wasn’t rolling quite as much. She still has significant swelling of her head, but I think she may have a chance. Perhaps will never be 100%, but she has a chance to live. Enkbeyer is doing a great job. Although he is quiet and hasn’t needed a lot of help, I am happy to have become his friend.

Coco on her way to recovery

Coco on her way to recovery

I tried not to cry when the time came to say good-bye, but that didn’t happen. I was able to keep most of the tears in until I started to walk away. A part of me will remain here forever.

Dinner and then the trip to the airport went well, until I realized I had neglected to hand over my apartment keys!  Oops! The airport allowed me to call Mary, but due to the way security is set up, no one is able to come and get the keys. They will need to be mailed to the next shuttle (person traveling over to work at the clinic) when I get home. I did get to have a lovely conversation with a Pilipino woman that had just finished a trip around Mongolia. Despite living in California for the last 56 years, she still travels all over the world. I will keep her in my prayers as she was so sad that all of her traveling companions are passing away. She was very sad.

Final devotion, Final picture

Final devotion, Final picture

August 23

Despite a lot of turbulence, the flight home was good. I was able to get more sleep than on the way to Mongolia. The man next to me was a lovely gentleman from Thailand, that now lives in the USA. He travels frequently for work, and was excited to get home to his wife and high school aged twins. He recommends a trip to Thailand, I think that is a good idea!

I was then double blessed upon arrival to see my husband and Laura and Steve – friends from church that offered to pick me up. After a short chat, we walked out to the parking lot where we were also met by more church members – Gary, Ann, and Addi – I didn’t expect to see them 3 hours from home, but they were in Chicago and saw my plane landing, so they hopped into the van and found us in a parking lot at O’Hare without a telephone call or anything. If God wasn’t in that, I don’t know what else to say!

Thank you to everyone that has followed my journey. I hope that it will happen again. I will share more in the future as tidbits of my time in Mongolia come back, but the great story of this trip is over. Perhaps it is just the beginning of many more though!

May you be blessed and find a way to make life a little bit better for someone around you today.

I is for ITP and IMHA

I is for ITP and IMHA

I is for ITP or Immune-mediated Thrombocytopenia (also known as IMT), a disease that causes excessive bleeding and bruising. I is also for IMHA or Immune-mediated Hemolytic Anemia, a disease that causes destruction of red blood cells which decreases oxygenation of the body. I am going to focus on dogs for this post, although it can be found in other animals and humans. Check out Mayo Clinic for more human information!

The problem with ITP and IMHA is basically that the body attacks platelets and red blood cells and destroys them. Platelets are required for clotting, so when you don’t have them, you can’t clot, therefore, you bleed.  Red blood cells are required to carry oxygen throughout the body so that you don’t die from cellular suffocation (ok, a little dramatic, but true). In dogs, the diseases are most common in Cocker Spaniels, Old English Sheep Dogs, and Poodles, although any animal can develop these conditions. There appears to be a hereditary component, so animals that develop ITP or IMHA should not be bred. Animals that have relatives that have one or both of the conditions should be monitored closely for evidence of the diseases. The underlying cause of ITP and IMHA have not been proven, although anything that stimulates the immune system could potentially cause an ITP or IMHA crisis – illness, vaccination, or anything that stresses the immune system. (This does not mean that you should not vaccinate your pet – please discuss any concerns you may have with your veterinarian)

The story I am about to share, is from a patient of mine a number of years ago while at my last clinic of employment, Memorial Drive Veterinary Clinic, I have since begun work at Mishicot Veterinary Clinic. Chloe is a Cocker Spaniel and this is her story (shared by her humans):

Chloe

Chloe

Chloe’s story began in October 2012.  She had received her rabies vaccine and her humans, Jay and Deb, thought nothing more of it. In less than a month, she went from being an outwardly healthy and active dog to being so weak that Jay had to pick her up because she could not walk. It seemed to happen overnight. She was not eating much and stopped jumping on the love seat and the bed. She loved looking out the front window (people and dog watching), but couldn’t jump up to do it.

It was a Sunday night and she had gotten so weak over the weekend, that Jay had to actually pick her up to put her into the kennel. That was the point that they decided to call the veterinary clinic. Dr. Melanie (that’s me!) was on call and asked different questions. One of the questions was, “What color are her gums?” The answer was, “Very pale. Grey in color.” Dr. Melanie told me to bring her in. Deb just could not go because she thought this was the end and losing Chloe would be so hard. Jay came home after several hours, with no Chloe.

Chloe had a disease called ITP (and IMHA). her blood was like watered down Kool-aid, and her hematocrit was 12% (this is a measurement of red blood cells compared to fluid in the blood, anything under 37% is low – generally under 14% a blood transfusion is needed). She would bleed with little instigation. Jay had a choice to make, either put her on steroids and hope that it would help bring her numbers back up or put her down (euthanasia). It was a hard decision to make, but he decided to try the steroids.

It took several days at Memorial Drive Veterinary Clinic, and then several more days at Lakeshore Veterinary Specialists, a 24 hour emergency/specialist hospital in Port Washington, WI, before she was able to come home. She got poked and prodded (which she did not like). She was on steroids and azathioprine from November 2012 until the beginning of 2014. She started at 3/4 tablet twice a day and was weaned down to 1/2 tablet every third day. Side effects of the steroids made her want to eat constantly and she put on a lot of weight – she got up to 46 pounds. Her hair coat had gotten patchy as well. As she was weaned off of the medication, her hair started to grow in more normally, she ate less, and started to lose that weight.

Today, she is off all medications and is jumping back on the bed and watching people walk by while lying on the top of the love seat. her appetite is good and she sometimes gallops like a horse. She will be nine years old at the end of April, and we are both so glad that we had the chance to spend more time with her.

As my dad used to say, “She is the best dog you ever had.” – Jay and Deb Ney

Chloe’s situation is rare and common all at once. ITP and IMHA are common enough that we see the diseases (with and without vaccinations), but they are not something that the average clinic sees on a regular basis. It is also rare (at least in my experience), that people put in the time, money, and effort into turning around a complicated medical case. For over a year, Jay and Deb medicated and did recheck testing to monitor Chloe’s response to treatment. Chloe would get snippy, she was tired of the poking and prodding. Yet, given time and dedication to healing, she made it through amazingly well.

That being said, it is a large financial, emotional, and time commitment to treat ITP and IMHA, they can also recur, so remember that a decision to euthanize in the face of these diseases is not necessarily the wrong decision. Your veterinarian will help you determine if this is something you can do, but ultimately, it is your decision. I pray that you never need to go through this with your pet, but if you do, know that you are not alone!

 

A Miracle Named Maggie

Maggie is a wonderful basset hound that came to visit me at the vet clinic for a routine exam on August 21, 2013. She hadn’t been eating quite as much as normal and had lost some weight, but overall she seemed to be her normal self. The concern was actually more for her housemate, Toby, a beagle with a  dental abscess. During Maggie’s exam I found an abnormality and recommended a radiograph (x-ray) be taken to get some more information. Just as I suspected, Maggie had a large tumor on her spleen. There are a number of things that can cause the spleen to be enlarged, but in an older dog, they usually are not good things. After discussing options and doing some additional blood tests and radiographs, the decision was made to go forward with surgery to get some answers.

During Maggie’s exploratory surgery on August 23, 2013, I performed a splenectomy (removal of her spleen) which was very friable and falling apart in my hands. It weighed over 4 pounds! I looked around for any other signs within the abdomen that would indicated that there was metastatic cancer, but did not find anything. Samples were submitted to our reference laboratory for histopathology to find out what we were dealing with. When the results came back, there was bad news. Maggie had stage IV (out of V) T-cell lymphoblastic lymphoma – an aggressive type of cancer that effects the lymphatic system. Without chemotherapy, with the use of prednisone, survival time is usually 4-8 weeks from the time of diagnosis. With doxorubicin alone (a type of chemotherapy) they average 10-11 months. With the CHOP protocol from UW-Madison survival time is usually about 2 years.

Maggie's spleen

Maggie’s spleen right before removal

After crying and talking with Kay, Maggie’s mom, the decision was made not to do chemotherapy. I can’t say that I was happy with this as chemotherapy could make a big difference in Maggie’s survival time, but during our discussion, I understood the reasons why this wasn’t an option for Maggie’s family. I prayed. Maggie’s family and friends prayed. We all cried. We have talked about what to expect and what to watch for as the disease progresses and spreads.

Maggie two days after surgery

Maggie two days after surgery

Now, we wait. Maggie has outlived the 4-8 weeks survival time without chemotherapy. We are now 13 weeks from when she was first seen and the mass was found. She is eating, running, playing, and back to her good old self. Maggie has defied the odds. We know that she will likely have her lymphoma rear its ugly head again, but for now, we are relishing the miracle that is Maggie, one day at a time.

Maggie doesn’t let her disease stop her. She lives and loves like she always did. If only we could all experience the joy of living each moment.

Maggie and Toby - best friends living life!

Maggie and Toby – best friends living life!

Meet Spot

I would like to introduce you to Spot. Spot is a lovely dog that recently came in for her first appointment after being fostered and adopted by her new family. She is a sweet dog that just wants to sit  and rest her head on your knee. You can look into her eyes and see she is tired. Upon examination she has an ulcerated mass on her belly, some scars, and large nipples that indicate she has had at least one litter of puppies. Spot’s new family has graciously allowed us to follow Spot’s story.

Spot is such a sweetie!

Spot is such a sweetie!

What you can’t see is that Spot is very sick. She is infected with both Ehrlichiosis (a disease carried by ticks) and heartworm disease (a disease carried by mosquitoes). The saddest part is that both of these diseases can be prevented with properly administered medications. We don’t know Spot’s history, just that she came from Georgia. We have started treatment with doxycycline (an antibiotic to treat both the Ehrlichiosis and start the process of treating the heartworm) and have gotten her started on heartworm preventative as well – this is used to help kill off some of the “baby” stages of the heartworms and to prevent reinfection. Both of these treatments are just the beginning of the long road to recovery. Once mom gets enough money put together, we will remove the mass on Spot’s belly to make sure that it is not cancerous, then we will move onto the next stages of treatment for heartworm disease.

What is Ehrlichiosis?

Technically speaking, “Ehrlichiosis is the general name used to describe several bacterial diseases that affect animals and humans. Human ehrlichiosisis a disease caused by at least three different ehrlichial species in the United States: Ehrlichia chaffeensis, Ehrlichia ewingii, and a third Ehrlichia species provisionally called Ehrlichia muris-like (EML). Ehrlichiae are transmitted to humans by the bite of an infected tick. The lone star tick (Amblyomma americanum) is the primary vector of both Ehrlichia chaffeensis and Ehrlichia ewingii in the United States. Typical symptoms include: fever, headache, fatigue, and muscle aches. Usually, these symptoms occur within 1-2 weeks following a tick bite. Ehrlichios is is diagnosed based on symptoms, clinical presentation, and later confirmed with specialized laboratory tests. The first line treatment for adults and children of all ages is doxycycline.  Ehrlichiosis and other tick borne diseases can be prevented.” (http://www.cdc.gov/ehrlichiosis/)

Dogs can’t tell us in words that they have a headache, fatique, or muscle aches, but, with a simple blood test run in many veterinary offices, you can have a positive test for exposure in 8 minutes. Due to some other blood test results, Spot’s symptoms, and cost we did decide to treat for the disease without doing some more advanced testing. Ehrlichiosis, and other tick borne diseases, can be prevented using medications, checking people and pets for ticks daily and removing any ticks found, and decreasing the risk of ticks in your yard.

What is heartworm disease?

Heartworm disease (dirofilaria immitis) is carried by mosquitoes. Adult female heartworms place their young (microfilariae) into the bloodstream of animals. Mosquitoes ingest the young while feeding on animals. The microfilarae then grow into the infective larvae stage over the next 10-14 days inside of the mosquito. When the mosquito then feeds on the next animal(s), the larvae are injected into the new animal. Over the next 6-7 months, the larvae become adult heartworms. At this point, they can start creating more microfilariae, although these microfilariae have to go through another mosquito before becoming adults themselves. This is where preventative medications come into play. Most heartworm preventatives are taken by mouth and the kill the larvae so if your dog or cat is bitten and has larvae injected into it, the medication kills it before it matures. In areas of the world where heartworm is present, your veterinarian may recommend treating all year round – this is because of the life cycle of the heartworm and trying to kill off the larvae before they become adult worms. Microfilaria in a heartworm positive dog (video courtesy of Richelle Ackerman, DVM)

Infected dogs may not show any symptoms at first, but as the worm burden grows dogs can develop a cough, exercise intolerance, inappetence (not wanting to eat), and weight loss. These signs can indicate severe heart and lung disease.

Heartworm from a Pitt Bull that was left in owners back yard (Photo thanks to Maggie Highland, DVM)

Heartworm from a Pitt Bull that was left in owners back yard (Photo courtesy of Maggie Highland, DVM)

Heartworms in a Pitt Bull left in owners back yard. (Photo courtesy of Maggie Highland, DVM)

Heartworms in a Pitt Bull left in owners back yard. (Photo courtesy of Maggie Highland, DVM)

Chilay Update

Chilay came in yesterday for her recheck appointment.  She is doing great. Her mom has even shared some pictures that she took throughout Chilay’s ordeal! Congratulations, Chilay!

Here is Chilay the day after surgery when Mom came to visit.

Here is Chilay the day after surgery when Mom came to visit.

 

Chilay relaxing.

Chilay relaxing.

Relaxing at home a couple days after surgery.

Relaxing at home a couple days after surgery.

Stretching out.  Still worn out, but starting to get back on the mend!

Stretching out. Still worn out, but starting to get back on the mend!

Chilay has passed her recheck exam and is doing great.  We are so proud of her and her family!

Chilay has passed her recheck exam and is doing great. We are so proud of her and her family!

 

I'm ready for my close up! Chilay and family are thankful for all that we did.  We are thankful that Chilay's family saw the warning signs that she was sick so that would help her get better!

I’m ready for my close up! Chilay and family are thankful for all that we did. We are thankful that Chilay’s family saw the warning signs that she was sick so that would help her get better!

Sharon and family, you are the ones that made all the difference. You saw that she was sick and decided to take care of her.  Here is to a long life for Chilay with her loving family!

New Beginnings

Monday, May 6, 2013 was my first day at a new place of employment, Mishicot Veterinary Clinic in Mishicot, Wisconsin. I am blessed to have this opportunity to start fresh and have more time to spend with family and friends, while still making a difference in the lives of the people and animals around me.

As with any “first day,” I was nervous and excited to start.  The day was pretty routine with exams, vaccines, ear cytology (checking ears for infections with yeast and bacteria), and meeting new people. The unusual part came when a cat presented with hematochezia (bleeding from the butt).  When a person brings their pet to a veterinary clinic, they often call with what they think is going on, but that does not always line up with what is actually happening.  When little Chilay arrived, she was extremely dehydrated and had a discharge from her back end that was full of blood and pus. After doing some testing it was determined that Chilay needed to go to surgery. What was found surprised me! A mass in her intestines ended up being a tapeworm that was eating into her intestines and causing a partial blockage. This is what we call a parasitic foreign body – not good to have, but pretty interesting to find. Unfortunately, due to the damage to her intestines, I had to remove a portion of her intestines and suture them back together again (pictures below).

After surgery, I called Chilay’s mom to let her know what we found. Needless to say, it was a surprise for everyone.  As it turns out, Chilay was a stray that three weeks ago found her way to a bar and a new home. Was her new family prepared for the financial side of a major surgery? No.  Did they go forward anyway because they loved her and had taken on the responsibility for her health? Yes! This warms my heart. One of my goals with this blog is to share the wonderful things that happen in veterinary medicine, but also to help teach prevention of major problems.  So what do we know, or should we learn, about a new animal coming into your family?

1.  When a new animal comes into your life, it is always important to have a complete physical examination done.

2.  Check for and treat for parasitic infections – fleas and intestinal parasites are two of the most common parasites that we see. Checking stool/fecal/poop samples are the easiest way for check for many intestinal parasites, although there are different types of tests that are done on stool to find different types of infections.

3. Cats should be checked for feline leukemia (FeLV) and feline immune-deficiency virus (FIV) – this is done by blood test.  Both of these diseases are spread between cats from close contact – fighting, grooming, and so forth.

4. Dogs should be tested (depending on where you live or where the dog came from) for heartworm disease, Lyme disease, Anaplasmosis, and Ehrlichiosis – these are also a simple blood test. Heartworm is carried by mosquitoes and the others are carried by ticks.  These are the most common to check for in Wisconsin, but other areas of the country have other diseases to check for, so please speak with your veterinarian!

5. Vaccinations.  This is a very controversial topic between people when it comes to both human and veterinary medicine. I encourage appropriate vaccination for your pet. The recommended vaccines will depend on lifestyle of both you and your pet. I will save this topic for another time.

6. Microchips. When you have a new animal come into your home/family, the animal should be checked for a microchip to see if there is someone who is looking for them. Once the cat or dog is “yours,” then I do recommend having them microchipped so that if they do get away from you (slipping between your feet when you come into the house with groceries or getting lost after you have been in a car accident or some other experience) then they can be returned to you as well. Many of the microchip companies will also help you find a lost pet or provide assistance with medical emergencies – like when your dog ingests your medication.

7. The most important thing with bringing a new pet into your family is to remember that you are responsible for them now. To love them, to protect them, to provide them with medical care – both prevention and treatment.

I hope that today you snuggle those you love a little closer and remember that every day is a gift to cherish and to share love and light.

Bless you and enjoy each day as a new beginning!

Chilay's Tapeworm was 15 cm (about 6 inches) long!

Chilay’s Tapeworm was 15 cm (about 6 inches) long!

This is the section of intestine that needed to be removed with the proliferative ulceration.

This is the section of intestine that needed to be removed with the proliferative ulceration.