together.
This is a picture of a dog with a really, really big ear. Obviously this is not normal. What is going on here is a condition known as an aural (ear) hematoma. The ear pinna, or ear lobe, is filling with a bloody fluid and is painful and uncomfortable. These hematomas usually come about from the dog (or cat) shaking their head and/or rubbing it on the floor. In most cases an underlying cause can be identified, as is the case with this sweet guy. Skyler is his name and he battles chronic ear infections, however this was the first time his infection lead to an ear hematoma. It would seem logical the only treatment needed to alleviate the hematoma would be drainage, but in most cases it requires surgical intervention. If all we did was drain the fluid, in just a few short days the fluid would return and we would be right back where we started. In the picture I have made an "S" shaped incision into the ear, drained the bloody fluid, and removed the blood clots that form as the hematoma sits. In order to prevent the hematoma from recurring, we place sutures in the ear pinna to tack it back together. The picture to the left shows the finished product. Oftentimes, as in Skyler's case, we tack the ear to the top of the head to prevent the ear from further damage due to head shaking. In other cases we may bandage the head in an effort to reduce shaking or place an Elizabethan collar on the patient...also known as the cone of shame. Although the hematoma has been repaired, treatment does not stop there. As stated earlier, hematomas are a result of an underlying cause, and that issue must be addressed to prevent recurrence. In Skyler's case, we placed him on ear washes once a day and prescribed laser treatment. Ear infections are a condition we treat with the laser with excellent results. Skyler had a total of five laser treatment every 2-3 days. Some cases require 6-8 treatments. Fourteen days from the date of surgery, his sutures were removed. His ear infection was clear, and his Elizabethan collar was removed. Skyler is happy to be at home!
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You may not be able to see them, but trust me, they are there. Beware; snakes are everywhere! In the last two weeks I, personally, have seen two snake bites, fortunately not fatal. Both animals are at home and happy. However, it is a reminder snakes are moving and it is time to be prepared! How can one be prepared? One simple, inexpensive way to be prepared is vaccinating your dog with the Rattlesnake vaccine. Just as with any vaccine, nothing is 100%, but when it comes to a Rattlesnake bite, every little bit counts. Snake bites are complex medical emergencies and all snake bites are not created equal. Whether vaccinated with the Rattlesnake vaccine or not, the situation should be treated as a medical emergency and veterinary attention should be sought. The good news is, the vaccine helps by simulating a dog's immunity to defend itself against the toxins in the snake venom, thereby reducing the severity, delaying the effects of the bite and decreasing recovery time. This vaccine can be given to any dog over the age of four months. An initial vaccine is given and thirty days later a booster vaccine. Dogs weighing under thirty pounds should have a third vaccine thirty days after the second vaccine. The vaccine is not labeled for use in cats, but many veterinarians, including myself, have successfully used the vaccine in cats. Side effects are typical of any other vaccine and are rare. A temporary lump at the site of the vaccine is the most common complaint. These lumps usually are not painful to the animal and regress in 2-3 weeks. Less commonly, owners will complain of flu-like symptoms. Nonetheless, any side effect attributable to the vaccine will be much easier to treat than a snake bite. It must be stated again, despite being vaccinated with the Rattlesnake vaccine, a snake bite should still be treated as a medical emergency. Do not make the mistake of delaying treatment in your pet. It could be the difference between life and death. The cost of the vaccine is $25 per injection at Leesburg Animal Hospital. For further information or to make an appointment for your pet to be vaccinated please call the office at 229-759-8384. We look forward to seeing you! This Saturday will be one of my favorite Saturdays of all time. It is the 139th running of the Kentucky Derby. One day...one day...I promise I will attend the derby itself, but with this new baby of mine it is likely it will not be in the near future. I attended races at Churchill Downs during a summer internship at an equine hospital in Kentucky, but sadly, not on the first Saturday in May When I do get there, I don't want to be in the cheap seats! I want a seat with a view and I will wear a big hat. A hat so big the people behind me will fuss about it blocking their view. Every year I choose a horse, and if I were to actually wage a bet at the track, I would never pick the favorite. The reason being is I want a large return on my "investment", plus it's rare the favorite actually wins. So, this year my pick for the win is Oxbow (pictured above). Two legends, jockey Gary Stevens and trainer D. Wayne Lukas, make a pretty powerful combination, and in a race where experience counts, these two bring a lot. Lukas has two horses in the race, which will make his 46th and 47th Derby starts, and has won the Kentucky Derby four times. He being 77 years old, combined with his last Derby win being in 1999, D. Wayne Lukas is due for a win! Stevens has mounted eighteen Kentucky starts, two of which were with Lukas. Not to mention Stevens came out of retirement just to ride Oxbow! Now if you want to play it safe, be my guest. The line up is deep. The favorites, Verrazano, Orb, Goldencents and Revolutionary, all have looked good in races before the Kentucky Derby, but the truth is it's any horse's race. My pick to place is Verrazano and Revolutionary to show (for those who don't speak "horse talk," win=first place; place=second place; and show=third place). It might be a good idea to put a bet on one of trainer Todd Pletcher's horses. He only has an unprecedented five horses in the race, which makes up roughly 25% of the line up. His high numbers combined with him being way overdue for a win just might make it his year to wear the roses. Another prospect is Goldencents, trained by Doug O'neill, who trained last year's winner, Ill Have Another. It would be a neat thing if O'neill were to win again this year. Only seven trainers have won the Derby back to back. The last years back to back wins occurred was in 1997 and 1998 when Bob Baffert won with Silver Charm and Real Quiet. Sadly, Bob Baffert, as of yesterday, has pulled his two horses, Governor Charlie and Code West. Pre race coverage will be on NBC Sports Network from 11-4 with actual race coverage from 4-7 on NBC. Who will your pick be? Have you ever wanted to check your pet's vaccine status late at night? Ever wished you could receive a text message reminder? Email reminder? Well, now you can. We are proud to introduce our Pet Portal. Access to your pet's information is available at www.vetscene.com. A picture of this webpage is featured to the left. In order to access this information you will first need to set up an account. For this you will need our "clinic number," which is 6081 and your personal "client ID #," which can be found on an old statement. In addition, you will need an email and a password. Once you've set all of this up, you will have immediate access to your pet's records. In order to receive email reminders, make sure your email on file is correct. In order to receive text message reminders, a few more steps are necessary. Because of federal regulations, one must request to receive text messages. After logging in to your account this is what the page will look like. At the bottom of the page under animal information, there is an option to "enable text messaging." Click on this. It will then ask you for your cell number and provider. Next it will send you a test text message with a code. You will then have to put in that code. Once that is complete, you will receive a second test message. If it goes through, all systems are go!! You are ready to receive messages. Please keep in mind that regular text messaging rates will apply. If at anytime you wish to no longer receive text messages, simply click "disable text messaging" on this same page. A second feature of this Pet Portal allows you to upload pics of your pets which will connect to our records. The pictures can then be used for Pet ID cards. If you wish to receive a pet ID card, it will be necessary to upload a picture BEFORE checking out and completing your transaction. The reason for this is, as soon as you are invoiced out, your pet's information is electronically sent to the company who makes our ID cards and it is in line to be printed. Therefore, you can't wait until you get home to take a pic and upload it. Dr. Shannon and I, along with all the girls at LAH, are excited about this new feature. We hope it will be a feature to help make everybody's life a little easier and more organized...who couldn't use a little more organization, right? Recently we added a therapy laser to our practice (pictured to the left). Laser therapy is an advanced modality to treat pain and inflammation in dogs and cats. We have been using the laser to treat various canine and feline ailments and are excited about the results. The mechanism of action of the therapy laser is quite complicated and will take you back to your biochemisty days in college (if you were a biology/chemistry or some other science major), so if you do not want to travel down memory lane, just skip over the next few sentences. Remember the mitochondria of the cell? ATP production? Ok, well whether you do or not, those things are very important to cell life; in fact, a cell can not live without them. So, when this light, or laser, is placed on injured tissue it promotes increased blood supply to that tissue. With increased blood supply comes increased oxygen, and we all know how important oxygen is. If not, just try to live without it for 60 seconds. Oxygen is needed to make this ATP, which is produced in the mitochondria. ATP is the fuel cells need to repair and rejuvenate. Injured cells do not make this ATP at a very efficient rate, and will eventually die. So, in a nutshell all that means this. More blood...more oxygen...more ATP...healthy cell...healing/less pain. If you would like, you can do some internet research on ATP production and all that jazz or you can just take me for my word. I am like George Washington; I can not tell a lie (unless of course I am 14 and you are my parents). And the truth is, these therapy lasers really work. Recently I took a picture of some progress we made with a laser therapy and I will share them with you. The pictures are of an older dog who had a lick granuloma. Explaining a lick granuloma literally will take hours and will be almost as confusing as ATP production, so for simplicity's sake I am just going to say this dog kept licking its foot; it licked it so much it formed a wound (i.e. a granuloma). So, for treatment I prescribed laser therapy. The dog had a total of 4 treatments; no other medication was needed...no corticosteroids; no antibiotics; no NSAIDs. This is our picture before any treatment with the laser. Notice how erythemic the skin is and the thinning of the hair. The surface of the skin has a moist appearance from an impending secondary bacterial infection. This is all caused from the constant licking of the foot. Why does he lick the foot you ask? I really don't know. You would have to ask the dog. I guess it itches. Why do you scratch your fanny? Does it itch? This picture is two days after the first treatment when he returned for the second treatment. Notice how less red the skin is and you can also appreciate how the wound is drying out. We forgot to take a picture when he returned for his third treatment, but this picture is before the fourth treatment, which was his last. The wound is no longer red and the hair is beginning to peep through. Although these pictures demonstrate what a laser can do for skin problems the list for its use is long. Common ailments we have successfully treated with the laser are arthritis, post surgical pain, cuts/bite wounds, cystitis, periodontal disease, ear infections, incision sights, traumatic bruising, muscle pain, lick granulomas, burns and tendonitis. In the particular case above, the treatment plan took only four sessions. Most sessions take six but can be extended out to ten sessions. In certain cases, such as with arthritis, the treatment plan may need to be repeated, as the condition is not treated but rather managed. The cost per treatment varies greatly as to the time it takes. Many treatments only last for ten to twelve minutes while others can last thirty to forty five minutes and obviously will cost more.
Laser therapy is beneficial in so many ways but where it is especially beneficial is in the senior patient and patients with known drug sensitivities. By incorporating laser therapy into other conventional treatment plans, it can be possible to reduce the amount of toxic medications needed to treat an illness and approach the issue in more of a holistic way, which is always a plus. In keeping with our theme of addressing issues associated with mosquitoes, today we will focus on issues with mosquitos in horses. Everyone has heard of West Nile Virus, however, many may not have heard of Equine Encephalitis, especially if not a "horse person." Both West Nile Virus and Equine Encephalitis are viruses transmitted by the bite of a mosquito, which in turn became infected themselves from biting an infected bird. Once the horse is infected, the virus does not replicate to high enough levels to transmit from horse to horse; therefore, transmission is only through the bite of a mosquito. In both viruses, symptoms begin with fever and neurological signs such as, hypersensitivity to sound, excitability, aimless wondering and progress to circling, head pressing and eventually ataxia and stumbling. Other symptoms are drowsiness. lethargy, and loss of appetite. Trouble swallowing is often a symptom and can lead to severe dehydration and wasting. Both viruses, if left untreated can lead to death. Prevention is best achieved by reducing contact with mosquitos and vaccinating. Horses should begin their series of vaccines at six months of age with a second vaccine 4-6 weeks later. After the initial series of two vaccines, only one vaccine a year is necessary. It is recommended to have horses vaccinated before mosquito season so antibody levels will be increased during high mosquito season. For more in-depth information on West Nile Virus, Equine Encephalitis, and other equine vaccines visit Merial's website at www.equinewnv.com or call our office at 229-759-8384. Last week we talked about Ivermectin used as a heartworm prevention and the possibility of overdosage. At the end of the blog, I made reference to safer formulations of heartworm prevention. This week I want to talk about the different options available to safely prevent heartworms in your pet. The list of preventions is bountiful but for the sake of this blog, I will focus only on the ones available at Leesburg Animal Hospital. On our shelf we have heartworm prevention in two different formulations, pills and topicals. The first pill we will discuss is Heartgard. Heartgard is the oldest monthly heartworm prevention available. In fact it was the very first monthly tablet available ever. I can remember when this product was launched; I was in junior high school. Heartgard completely wiped out the only prevention available at the time which was a daily tablet called Filaribits. Who remembers Filaribits? Geez that was a long time ago; I mean a REALLY long time ago. I graduated high school in 1994, so that was like over 20 years ago! YIKES!! Well, never mind all that, back to Heartgard. I get distracted. Heartgard is by far the most palatable pill we have. I would say 98% of dogs will eat a Heartgard pill, so this might be the choice for a finicky eater. Heartgard has an extra ingredient in it called pyrantel pamoate which also deworms your pet for hookworms and roundworms, common intestinal parasites. The second pill available is Trifexis. Trifexis is actually a combination pill. The heartworm prevention is combined with the popular and highly effective flea pill known as Comfortis. The heartworm component of this pill is as equally effective as Heartgard, but the pill is not quite as palatable. I would say about 85% of dogs will eat this pill. One fairly common side effect of this pill is vomiting. However, if given on a full stomach, that side effect is usually eliminated. In addition to being a heartworm and flea prevention, the active ingredient in Trifexis, milbemycin oxime, will also deworm your pet for the intestinal parasites, hookworms, roundworms and whipworms. The pricetag on this product is considerably more expensive than Heartgard, but when you do the math, you actually come out cheaper than buying a heartworm and flea prevention separately. Our third Heartworm prevention is Advantage Multi. Advantage Multi is also combined with a flea prevention and is the only topical prevention we have, which makes it good for those difficult to pill pets. The heartworm prevention portion of Advantage Multi is absorbed immediately once applied while the flea prevention portion remains on the skin for a month. Because of this, it is necessary to bathe the pet in a soap free shampoo to prevent the flea prevention from washing off. Advantage Multi also deworms dogs for hookworms, roundworms and whipworms and deworms cats for hookworms and roundworms, while also preventing ear mites. Without a doubt, living in the south puts your pet, dog or cat, at risk for heartworms. Just last night I noticed mosquitos swarming around my front door. Don't be fooled into thinking your pet is not at a risk because it is an inside pet. Sure, their risk is decreased but not zero. I like to compare heartworms to pregnancy. It only takes one sperm and it only takes one mosquito bite!! Protection is the key to prevention!
For the second time in less than a year, we have been presented with a case of Ivermectin toxicity. In both of the cases, the owner purchased the Ivermectin from a feed store where they were instructed on the "proper" dose. Unbeknownst to them these owners were drastically overdosing their pets, and in a few short hours the pet began to show signs of toxicity which are vomitng, diarrhea, tremors, seizures, disorientation and blindness. If severe enough, Ivermectin toxicity can lead to death. Ivermectin is a drug labeled for use in cattle and swine. The picture to the left shows the bottle. Notice the label on the bottle. Pictured on the front is a cow and a pig. Do you see a picture of a dog or a cat? No! The reason being is because this formulation of Ivermectin is not labeled for use in the dog or the cat. So, if it is not labeled for use in the dog or the cat, maybe, just maaaaaaaybe, it might be dangerous. And the fact of the matter is that it is VERY dangerous. Call me crazy; call me irrational; call me anything you want, but just don't call me in the middle of the night when your dog is suffering from Ivermectin toxicity! Well, actually, I am kidding about not calling me. You can call me, but just realize a late night emergency Now in this picture to the left you will notice the active ingredient is in fact Ivermectin. That is because it is in a very precisely calculated dose for a particular weight. The amount of Ivermectin needed to prevent heartworms is a small amount and that tiny dose is injected into the meaty chew in a Heartgard Chewable so that it is very safe. Since Heartworm season is coming up, we will continue this discussion of Heartworm prevention with other available formulations, so stay tuned!! On March 23, it will be one year since the dentist and I said goodbye to our Skeebo. Skeebo was our 11 year old Boykin Spaniel. She was my step-dog. In the beginning of my and the dentist's relationship, Skeebo made the blending of the yours, mine and our dogs extremely difficult. She walked around with with her nose stuck up the bum of my oldest Jack Russell and could not even be in the same room with my younger Jack Russell. Skeebo was a bully. At one particular time I was in my back yard attempting to break up a fight between the two and I had Skeebo held up in the air by the collar trying to shake the Jack Russell off of her left arm. Those were some trying times for our pack. But then one day things changed. Skeebie lost her fight. Over a week or so, I noticed she was not eating well. I may have noticed it sooner but didn't think much of it because she was a finicky eater anyway. I decided to take her in to the clinic to look her over. Blood work revealed she was anemic and had a high white cell count. A treatment plan was devised and carried out and a week later her blood work was no better; actually worse. I decided to x-ray her abdomen. An x-ray revealed a large mass in the abdominal cavity of unknown origin. An ultrasound led me to believe it was her spleen. I scheduled her for an abdominal exlploratory surgery the next day. I do love surgery, primarily soft tissue surgery, but there is a reason in human medicine physicians are forbidden to work on their family members; it's emotional. I placed an intravenous catheter in Skeebo in preparation for her surgery. All the while her big brown eyes staring deep into my soul begging me to explain to her what was happening. I kissed her on the head, rubbed her silky, soft ears, told her I loved her and proceeded on with her sedation and intubation. I was a robot trying my best to disassociate it was buddy on the surgery table. After making a ventral midline incision into the abdominal cavity it did not take me long to find the problem; it literally burst out of my incision. Her stomach was no longer a stomach but rather one large tumor, roughly the size of a soccer ball. It was inoperable. I did my best to take a proper biopsy and sew her back up through my tears falling into her sterile abdominal cavity; I was no longer a robot. I knew it was not good. A week later the biopsy returned, and as expected it was a leiomyosarcoma. A leiomyosarcoma is a tumor of smooth muscle cells. Radiation was not an option due to the side effects of radiating the stomach and leiomyosarcomas are not very susceptible to chemotherapy. Skeebo lived six weeks past that surgery day. It was a wonderful six weeks for me and my Skeebie. She rode to work with me every day and followed my every move. She would lay at my feet in my surgery room or sit patiently waiting on me outside the closed exam room door. She had her good days and bad days...mostly good. Tough as nails that dog was and I could hardly tell she was sick until her last two days. She developed some diarrhea on a Tuesday night, progressively worsened Wednesday and Thursday and died Friday morning. It was a peaceful passing. I am grateful the dentist brought Skeebo into my life. It is true I did not like her in the beginning; I pretty much loathed her, and, yes, I did try to give her away to my brother-in-law, but thankfully he kindly declined. Yes, those early days were rough, but somehow in a few months our family pecking order worked itself out. That shaggy dog crept into my heart and stole it and my life was enriched the four years I knew her. We miss our Skeebie everyday but like the poet Lord Tennyson wrote, "tis better to have loved and lost than never to have loved at all." And love Skeebo we did! Way more than I would like to hear, a client will say "well, I was looking on the internet and....." or "that's not what the internet said." So, I was curious...I wanted to know exactly what happens when someone searches the world wide web for answers to their veterinary questions. I will admit, I do use the internet as well, but I am a member of forums where veterinarians come together to discuss cases, and I pay for memberships which allow me access to board certified veterinarians. I have never asked "Dr. Google" or "Dr. Wikipedia" for an answer to a medical question. I prefer to use them to find answers to questions like "How many movies has Bradley Cooper has starred in?" or exactly what is "Cinco de Mayo?" So, I tried to think like a non-veterinarian. I went to www.google.com. I typed in "bloody diarrhea in dogs," just to see what would happen. The first link, and let me say there were thousands, was a webpage called "PetMD." It sounded like a good page. I suppose it was a spin off of WebMD for humans. I clicked on the link and it took me to a page with an article called "the Power of Poop." With a title like that, I have to say I would, and did, read the article. I found it was a very informative article about how important it is to look at your pet's poop and how you can find a lot of information from it. However, it did not give much information on my search for "bloody diarrhea." So I looked at the tabs on the top of the PetMD page and clicked on the one that said "ask a vet." This brought me to a really cool page that had a large box where I could type in my quesiton. Above that box it said "a new question is answered every 9 seconds." I thought to myself "this is really cool; maybe I should offer a service like this." So I entered my question, "what could bloody stool in a dog mean?" I then clicked "get an answer." I assumed this was going to answer my question, and maybe it would have, if I had given them my credit card number! For $18 I could get unlimited answers to my veterinary questions for 1 month!! After my one-month trial, it would go up to $28/month, billed directly to my credit card. Wow! I don't know what to think of this. So, I never got my question answered. I was not willing to splurge on the $18 because, the truth is, I know what to do if my dog has bloody diarrhea. I will just call for an appointment to see my vet. Well, actually I am the vet, so I guess I don't need an appointment, do I? Here's the bottom line folks. Just call your veterinarian. That is what they are available for. Leesburg Animal Hospital has an emergency number, 229-432-3462. Write it down and post it on the refrigerator or put it in your cell phone for easy access. When you call this number you will be placed with the veterinarian on call. A simple phone call is free. We are more than willing to speak with you and will help you decide if your pet needs to be seen immediately. Hopefully we can tell you some things to do at home, ease your mind, and get you in to see us the following morning. Of course, if an after hours visit is necessary, there will be an emergency fee (and it is more than $18). I think I can speak for all the veterinarians on our emergency rotation when I say we really don't want to make that drive back up to the office, even if we are making extra money. We actually would rather be at home with our spouses and kids, so unless we honestly feel it is necessary, we will not waste our time or your money. Just call us...One call that's all!! |
Dr. Haley Hydrick Clark
Dr. Haley Hydrick Clark graduated from the University of Georgia in 1998 with a degree in Animal Science and from Tuskegee University in 2002 with a degree in Veterinary Medicine. Archives
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