Leukemia

A lab came in today because he had been losing a lot of weight over a short period of time with no change to his diet or daily exercise.  Blood was taken and tests were run.  The CBC showed that the lab's white blood cell count was through the roof!  Doctors worried that he could have leukemia. 

Leukemia is a cancer of the blood that is caused by a genetic mutation that alters the structure of the bone marrow, making it able to produce these cancerous blood cells rather than healthy blood cells.

There are two types of leukemia that can affect dogs: lymphocytic (originates in the lymph nodes) and myelogenus (originates in the bone marrow).  The most common type of leukemia is lymphocytic leukemia.  It is characterized by an over abundance of white blood cells in the blood stream.  White blood cells are a part of the immune system; they are sent into the blood to fight inflammation and infection.  However mutated leukemia white blood cells are cancerous and take over the blood stream, and leaving very little room for the red blood cells and platelets to circulate.

Once the type of leukemia has been classified, it can be broken down into another subgroup based on whether it is a sudden onset (acute leukemia) or long term (chronic leukemia).   Acute leukemia can be extremely dangerous because the sudden increase in cancerous blood cells that hinders the production of healthy blood cells, which can affect a dog's life.  Chronic leukemia, although still very unhealthy, is not as malignant as acute leukemia because it is a gradual build up of cancerous cells.  Chronic leukemia is more commonly found in elderly dogs. 

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To check our preliminary diagnoses of Leukemia, the doctor ordered bone marrow aspirates and a biopsy.  Aspirates are usually done first.  The doctor sticks a needle into the bone marrow and collects liquid bone marrow and smears it onto slides to be examined under a microscope.  To get the biopsy, the doctor uses a thin biopsy needle and sticks it into the bone.  The needle has a sharp and curved edge so when it is twisted, it cuts a cylinder of bone marrow out of the bone. 

Causes for leukemia are unknown and although there is no simple cure, there are ways to treat it.  Chemotherapy is one good option because it stops the growth of these cancerous blood cells.  In patients with chronic leukemia, chemotherapy can be a smart and hopeful decision.  With patient with acute leukemia, only a small percentage of dogs can go into remission, even with very rigorous chemotherapy.  A dog's immune system is usually extremely weak from the disease and chemotherapy only weakens the immune system more and makes the patient more proned to other diseases.  Ususally transfusions will also need to occur because the disease and the chemotherapy can make them extremely anemic.

Bloated Parakeet?

A women brought her female bird into the hospital complaining that her bird had gained some weight recently.  The doctor began asking her questions to establish a history and found out that she had just gotten this parakeet, in hopes that she would keep her other parakeet company while she was at work.  Oh, and did I mention that her other bird was male?

The doctor examined and palpated the bird.  She determined that the bird was egg-bearing and sent the happy new grandmother on her way. 

Antivenim for Rattle Snake Bites

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A dog came in after being bitten by a rattle snake right on the lip.  He had severe swelling around the face, especially near the puncture.  Immediately, the dog was put on bollus fluids to keep him hydrated and the anti-venum was given. The snake bite was scrubbed with chlorhexidine scrub to ensure that the area was clean.

In general most snake bites occur on the neck and on the head.  Snakes will bite when they feel in danger, and a dog nose or head in your face can be a threatening occurrence for a snake. 

The anti-venum used to clear out the toxins released by rattle snake bites in called Antivenim.  Antivenim is most effective when given within four hours of the bite.   It is a substance containing a variety of antibodies to help the body fight off the neurotoxin.  This is given to the patient intravenously (IV).

Surprisingly enough, Antivenim is actually equine serum!  It is produced by injecting horses with several different kinds of snake venum.  Eventually, these horses will build up a resistance by producing specific antibodies for each snake toxin.  When their blood is spun in a centrifuge and the serum is extracted, it can be used as a remedy for rattle snake toxicitiy.  Because the serum has been immunized with different kinds of snakes, including Eastern Diamondback, Western Diamondback, and Central and South American Rattle Snake, the Antivenim can protect from all of these snake toxins.

When the Antivenim was given to this dog, he had to be watched extremely carefully.  Certain dogs can get a hypersensitivity reaction to the equine serum and if not supervised extremely carefully, they could die.  Hypersensitivity reactions become more common after one dose of the Antivenim has been given. 

Even after the Antivenim has done its job, there is still a little bit of swelling around the area.  Swelling tends to persist for a week after the bite but it should eventually calm down.  After two vials of the Antivenim, the dog was sent home to rest. 

Pug Emergency Splenectomy

A pug came into the hospital today in respiratory distress (she was having difficulty breathing).  It was immediately clear that there was not enough oxygen circulating through her body to saturate the hemoglobin in her blood (her gums were visibly whitened).

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We put the dog on oxygen while we placed a catheter, took blood, and ran a series of blood tests.  Her PCV was 27.  An ultrasound was performed and while we found some insignificant kidney stones, we found a large splenic mass (about the size of a baseball), which we believed to be the root of the pug's insufficient oxygen supply.  The mass was pushing on several organs, squishing them together and making it difficult to perform their responsibilities.  It was believed that if we removed the tumor, the organs could have the room to return to their duties. 

An emergency surgeon was called in.  He scrubbed up and the pug was anesthetized and sent off to surgery within an hour.  I was lucky enough to scrub in and observe the surgery.  It was fascinating! The doctor made a long incision down her abdomen.  He found the spleen and pulled it out.  He saw that the mass was beginning to detach itself from the spleen, because it had begun to clot on the side facing the spleen.  To make sure that no splenic masses would ever come up again, the doctor removed the spleen as well.  The doctor was in and out in a matter of about 40 minutes.  Lastly, he sutured her up.

Recovery for the pug was rough.  X-rays were taken of her abdomen and it was concluded that she had chronic bronchitis (a common finding in pugs and other squished-face breeds).  She remained hooked up to an IV line that was slowing dripping pain medication.  We also gave her a transfusion of about 80 mLs of plasma, which helped to replace a lot of the blood she lost during the surgery.  Her hematocrit was checked every two hours to see her progress but even after 12 hours, her PCV was idling at around 22.

Although the splenic mass did appear to be extremely problematic, something else was causing this pug to dwindle away.  She passed away the next morning due to an insufficient amount of oxygen getting circulating through her body.

Microchips

An owner brought her two American bulldogs in to be microchipped.  Although I have seen the yellow tags on dog collars before, I have never microchipped my own pets.

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A microchip is a small chip that is inserted underneath the scruff of the dgg, in between the shoulder blades.  To microchip a dog, we first scan the pet's back and shoulder region for any microchips that could have been placed there previously.  Many breeders often will microchip their puppies to ensure their return home if ever lost, so checking for any unknown chips will ensure the microchip reading will be as accurate as possible.   Next, we place the microchip gun right in the area of the skin where we want the chip to sit, and lastly, we insert it.  Most dogs do not experience any pain during the process.  Once placed, the microchip is instantly able to be detected.  

Veterinarians will then double check to make sure the microchip is working by scanning the area where the chip was inserted.  When the bar code comes up, vets know that the microchip is working well. 

Owners must fill out some paper work to ensure that the microchip number and the dog's information is entered into the database.  If your dog ever gets lost, scanning the microchip will tell anyone all of your pet's information.

Cat Box

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Some cats are very docile when in a veterinary practice; they purr and rub up against you.  When they get nervous they meow and try to crawl back into their carrier.  However every once in a while you get that extremely angry cat that wants to rip you to pieces.

A cat came in today who was so angry, he growled any time we walked by his crate.  Anyone who would have stuck their hand into the cat crate would have been shredded alive, so for the doctor to even palpate the cat, we needed to sedate or even anesthetize him.  And so, I was introduced to the "Cat Box."

The cat box is a clear plastic box used by veterinarians when it is too difficult to get near a cat.  The cat is placed into the box.  Oxygen and a gaseous sedative are attached to the box.  When the cat inhales, it is able to get oxygen into their body but also a sedative, which slowly relaxes them into a tranquil state, making it easy for us to work with the cat. 

The cat box is used only on the most vicious cats we see in the practice.  Most veterinarians can say they have used the cat box only a handful of times, but when it is needed, it is a good tool to have.  

Leptospitosis

I encountered a big pink sign on a dog's cage today that said "Lepto Positive, Wear Gloves."  I had heard of Lepto before when my dog was vaccinated for it as a puppy, but this was my first encounter with a dog who was positive for Leptospirosis.

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Leptospirosis is actually a spirochetes bacterial organism.  Although most strains of this bacteria live in nature and do no harm the majority of organisms it comes into contact with, there are two strains have been known to cause disease in dogs.  These spirochetes live on rats, wildlife and sometimes domesticated livestock.  When your pet interacts with these animals or their excrement, they become susceptible to the bacteria.

Wildlife that act as carriers for Lepto do not show symptoms, mainly because the bacteria has taken residence in their kidneys.  When they urinate, some of the bacteria will exit the body and contaminate the ground.  If the urine gets washed into a potable water source, your pets can potentially contract the bacteria.  Any bites or wounds from infected wildlife can also yield to the spread of this bacteria.  Pets can even pick up the bacteria by sniffing contaminated urine! 

Although it is something to be aware of, don't fret!  Not all animals that come into contact with the bacteria become infected.  There is a vaccine that can lower the chances of your dog contracting Lepto.  Unvaccinated puppies under six months of age are more likely to contract the most deadly strain of Lepto called L. Grippotyphosa.  The bacteria spreads quickly through the blood stream, releasing a toxin that attacks the liver and kidneys.  This strain can cause liver and kidney damage, which could be life threatening. Although puppies are more susceptible to L. Grippotyphosa, dogs if any age can contract Lepto.

Lepto is difficult to diagnose because the bacteria affects each pet differently.  The most common primary symptoms are fever, depression, stiffness in the joints, abdominal pain, excessive drooling, and vomiting.  It is very common to see a Lepto positive patient walk around with their tummy tucked underneath them because of the abdominal pain.  As the disease progresses, dogs will show symptoms of eye inflammation, red-tinged urine, dehydration, disinterest in hydrating, and nervous ticks.  If the liver is taking a beating, the dog will become jaudice (turn yellow) and sometimes show signs of uremia.  Damage to the liver can sometimes be permanent.

One of the best ways to keep your dog safe from Lepto is through vaccinations, starting when your dog is a puppy.  Most veterinarians recommend getting the first vaccination between 12 and 16 weeks of age.  Your vet will then recommend a yearly booster to make sure your pet is safe from Lepto. 

If you think your dog has Lepto take it to the vets immediately.  Also, remember to stay away from the urine and keep other dogs away from any areas where a Lepto positive dog could have urinated.