We very rarely have a dull day. The challenges, the heartbreaks and the "Eureka! I know why you're sick!" moments remind us daily of the privileges of caring for our patients. The following are a few thoughtful as well as educational stories that let you in "behind the scenes" at Veterinary Services

The Unstoppable Jasmine

     Jasmine is a very special kitty to her human, 13 year old Josie Cox. Arriving home after school one day, Josie noticed that Jasmine was dragging her right hind leg. She refuses to stay indoors and is an escape artist – slipping through doors, windows, even the dryer exhaust vent to be outdoors.

     X-rays showed that Jasmine had several serious fractures in her leg. Josie and her Dad were reluctant to consider amputation so Jasmine had surgery (pins and wires with supporting bandage materials). She stayed with us for several weeks (remember, Josie is an escape artist!). However, it soon became painfully obvious that her leg was not healing well and her muscles were deteriorating. There was only one option now, amputation, which the family doubtfully and unenthusiastically agreed to. Jasmine’s second major orthopedic surgery was done and in 2 weeks she went home – completely healed, happy and slightly bald.

     According to Josie’s Dad, “After coming home from a one month absence, Jasmine jumped out of the car and hasn’t stopped running and playing yet. Her life is no different than before except she has a little skip.”

     Our pets do not recognize their limitations – many have lost a leg, an eye (or two), an ear, and it makes no difference to them. Humans would be devastated with such “problems”. We veterinarians joke that dogs and cats are 3-legged with a spare. Yes, owners have objections at first when amputation is first offered as a treatment (perhaps due to a serious fracture, the expense to repair or cancer is present), but it is sometimes the difference between life and death.

Little Chaya

     Vomiting is a very common problem in our patients. The reasons are many – some very simple (eating a piece of pepperoni pizza that has “fermented” for days in the trash can) and some very serious or complicated (a tennis ball gets stuck in the stomach or end-stage kidney failure). Whatever the cause, it isn’t normal.

     Chaya was an 8 week old puppy that acted as all puppies do – playful, happy, silly. However, her humans started to notice that every time she ate, she would vomit a small amount. Water seemed to be less of a problem than food. Being a puppy, we were first concerned about the deadly Parvo virus (a very infectious, transmittable vomiting/diarrhea virus) or a foreign body (puppies eat anything and everything). We hospitalized her and treated her for an upset stomach. She didn’t improve, but she didn’t worsen either. Perplexed, we began to broaden our diagnostics as we searched for her main problem.

     X-rays were taken of her chest and it all fell into place. Chaya had a very rare condition – a vascular ring anomaly. Her esophagus (the tube that connects her mouth to her stomach) wasn’t formed properly. One of the vessels around her forming heart grew the wrong way and entrapped the esophagus, forming a narrow stricture. Every time Chaya ate, a pouch formed in her esophagus. Some of the food and water could pass through but more of it backed up to eventually escape backward as vomit.

     Her humans were wonderful and very loving of Chaya. We referred her to the S.C. Surgical Referral Clinic in Columbia. She sailed through the complicated surgery of opening her chest and removing the “confused” vessel. She is now at home, growing like a weed and living a very normal and healthy life.

A Big Heart

     We are often amazed at how gentle and sweet animals are in the face of illness. Even when feeling badly, they will often muster up a tail wag or a soft purr. This was Jake’s way.

     Jake, a 3-4 year old Labrador mix, was adopted by a family in August, 2005. He was “free to a good home” (believe your mother when she says “there is no such thing as a free lunch”). He was very, very thin and seemed to have a swollen stomach. His humans thought he wasn’t used to good food and that he had worms. However, he had a heart murmur, was coughing and had fluid in his abdomen – all signs of Heart failure. He had heartworms.

     We considered him a poor risk for heartworm treatment and suggested blood work and chest x-rays. His x-rays showed the biggest heart that Dr. Krisita had ever seen in a dog. It took up his entire chest. How could this dog run, jump, lick your face or even breathe when his heart and lungs were already severely damaged? Could he even survive the treatment and return to normalcy? His humans decided to take the chance. Due to the severity, Jake would have a split treatment – treatment would take place in 2 stages, over 5 months.

     The first half of treatment went well. When he returned the next month for the second half, his abdomen was still enlarged and he was coughing up blood. He was starting to show signs of thromboembolism and/or clotting problems. The discussion of euthanasia was brought up. His family said, “No, not yet.” They took him home for more rest and medications of Aspirin and Lasix. Jake returned for a recheck the next month. The tincture of time hadn’t made a difference. We decided to manually remove the fluid from his abdomen. We removed 1 ½ liters of fluid. Another month passed, Jake returned for a recheck. He was his usual happy self and finally looked wonderful – 9 lbs lighter with little coughing. We completed the last part of his heartworm treatment.

     Jake boarded with us in 2006 and tested negative for heartworms. Unfortunately, that was the last time we ever saw him. His family emailed us to let us know that he had passed away in February, 2007.

     Some pets leave a lasting impression. Dr. Krisita will never forget Jake – the dog with the biggest heart she had ever seen.

Charlie the Eternal Lab Puppy

    All Labs are “puppy dogs” – meaning, they are full of silliness, good cheer and absolute adoration for their owners. Charlie exemplified all that was “Lab”. He was a big boy, always seeming to hover around 100 lbs, and whenever he visited our clinic he would bust through the double doors and head for the scale and sit down, as if to ask “have I lost any weight yet?”. 

     Unfortunately for Charlie, his genes for good bones weren’t as good as his genes for good character. Following our suggestion to x-ray his hips following his neuter procedure, dysplasia was found in both hips. Due to his young age and being clear of any arthritis, Charlie had the first of two hip reconstructions. We referred him to the S.C. Surgical Referral Clinic in Columbia and a TPO was done (Total Pelvic Osteotomy). His pelvis bone surrounding the hip joint was cut into 3 places, rotated over his femur to give a better and tighter “fit”, then pieced back together with a special curved plate and screws. Charlie came through both surgeries (a year apart) wonderfully, and the stage was set for a long life with no pain.

     It wasn’t meant to be though. In November, 2006, Charlie developed a lameness in his left hindleg. For fear that his hips had been strained or the metal was moving, we referred him back to the surgical clinic. This time he had torn his ACL (Anterior Cruciate Ligament). Just as in human athletes who twist and turn at the knees, so do dogs. Once again, Charlie had surgery and did great. Except for one thing…he developed chronic diarrhea.

     We tried everything…diagnostics, consults, medications, diet changes and yet nothing seemed to work. Over a six week period, Charlie lost 23 lbs and still his cheerful disposition remained. The timing of this problem, closely associated with his ACL surgery, baffled everyone. His owners and I had to face the fact that cancer was lurking. Despite all of our diagnostic aids and referrals to Board certified veterinarians, sometimes a diagnosis cannot be made – especially with cancer. The basic, indisputable symptom of unexplained weight loss can always point to cancer. 

     Rather than subject his wonderful, aging dog to another surgery (where questionable results can occur), Charlie was euthanized on  January 24, 2007. What a sad, sad day. I had to know though – was it truly cancer that was slowly killing Charlie? Had we made the right decision? I was given permission to do an autopsy.

     I found 5 abnormal areas in the small intestinal wall. Samples were sent to the Clemson Diagnostic Lab. Charlie had had Lymphoma, the most common cancer that affects our dogs. We all breathed a huge sign of relief. The right decision had been made for Charlie.

It took 17 Years...

Jessie was a problem child to begin with after her adoption from the SPCA. She was lucky, though, because an extraordinary lady with a heart of gold wouldn’t give up on her.

It was difficult to get “the rest of the story” on Jessie because she came from a broken home and was left behind when her second family moved from Aiken. She was, literally, a throw-away. She was hard to love because her behavior ranged from being timid to aggressive at times. Her human consulted with us and several behavior therapists. She read a lot and started her own “love treatment”. It worked – Jessie is a well adjusted, loving family member now.

That was only the beginning, though, because she started having seizures in August. Her diagnostics didn’t definitively suggest a cause so we referred her to the S.C. Surgical Referral and Internal Medicine Clinic in Columbia. She was going to have an MRI, but the Internist noticed a consistently low glucose level. More diagnostics were done, and she was diagnosed with an insulinoma. This is a very rare (my first one seen in 17 years of practicing!), difficult to find tumor located in the pancreas. Massive amounts of insulin is secreted, which, literally consumes the body’s glucose stores. Jessie’s tumor was 4 mm in size and was removed successfully. No signs of metastasis were found.

We’re still not finished with Jessie’s story, however. Her glucose stayed low, and she still had problems with her energy level and mild seizures occurring. Further testing revealed that her insulin/glucose ratio was sky high. A microscopic insulinoma is still lurking in her lymph or pancreatic tissue.

After much fact finding and soul searching, her humans decided against chemotherapy. They couldn’t bear to see her suffer the side-effects and the resultant Diabetes. For now, Jessie is happy, healthy and unawares of her shortened future. Life isn’t always fair, but I’m amazed at the serendipity that brought Jessie and her new family together. Love moves in mysterious ways.

The Insulinoma did, indeed, return with a vengeance. Jessie was lovingly put to sleep in her home on March 25, 2005.

Never, Ever Give Up

Lots of our clients know Howie, the big red Dobie that can almost look at you eyeball-to-eyeball over our front counter. He’s 110 pounds, 3 years old, and as gentle a dog as we have ever known.

In January, 2004 he began to sway and not be able to coordinate his hind legs very well. His mistress, a marathon runner, wondered if her running buddy had simply over trained with her. We knew better. Howie had Wobbler’s Syndrome. His neck vertebrae were unstable, and he was likely to continue his downward spiral into total paralysis regardless of the conservative treatments we had started. Referral to the S.C. Surgical Referral Clinic was made and serious discussions concerning surgery and the aftercare of such a big dog started. Surgery to stabilize the compressive vertebrae by grafting and plating was done within the week. Unfortunately, Howie’s luck was still bad. Nothing seemed to go right. He was totally paralyzed after the surgery and his graft broke down. The plating had moved so another surgery had to be done. His pain was constant and he HATED the neck brace he had to wear. He was unable to urinate well.

He spent approximately the next 6 months at the Animal Rehabilitation and Fitness Center under the expert hands of Dr. Maria Glinski and her staff. They used acupuncture, electrical stimulation, underwater treadmill, swimming…everything imaginable was done to change the direction of his healing. It was a race against time. Would he EVER get well? His humans were exhausted and not sure if they had made the right decision. They were not, however, about to quit.

And so, the deadline of 6 months (regardless of tears shed and money spent) neared. Could Howie, the Dobie, who loved to run and eat, continue to live prostate and dependent upon humans? The answer was clear to everyone, and Howie heard us. The light switched on, and he began to respond. He began to move his limbs on his own!

He’s home now and doing extraordinarily well (after ANOTHER surgery). Don’t ever tell us that miracles don’t happen.

Howie died unexpectedly on November 10, 2006 of reasons unknown.  He exemplified hope and will be missed by all of us.

Rosie

“Something is wrong with Rosie, Doc. I’m not sure, but she is acting as if she’s run out of gas in the last couple of days” said her owner. My exam of this sweet, 3 year old Springer showed nothing except a possible paleness to her gum color. Her owner was convinced something was terribly wrong and I had a feeling that he was right. I drew some blood for analysis and I gave her a massive dose of steroids intravenously. In retrospect, the owner’s sixth sense and the prompt steroid injection saved Rosie’s life.

Rosie had Autoimmune Hemolytic Anemia (AIHA). Her immune system had turned on her and was destroying its’ own red blood cells. Normal PCV (the percent of red blood cells) for a dog runs between 35-55%. Rosie only had 15% that first day. Her heart was unable to oxygenate her body. Soon her kidneys would begin to fail and toxins would overwhelm her body. Rosie’s condition worsened. Her PCV would drop to 6% in the next 24 hours. A product called Oxyglobin (a super charged, oxygen carrying fluid derived from cow’s blood!) was the last hope for Rosie.

Veterinarians are unsure what triggers the hemolysis or destruction of red blood cells in these healthy dogs. AIHA is in the family of the diseases that we call “Blood Dyscrasias”. Some whole red blood cells are destroyed, platelets are destroyed or clotting factors are disrupted. We rely upon steroids and chemotherapy to stop the destruction. Transfusions are usually not enough. Oxyglobin saved her life. It worked and she is indeed a miracle.

Tess - The Bionic Dog (almost) 

Tess is a young, “sorta” Catahoula Leopard dog that doesn’t have a clue as to what “bad attitude” means. She is the perfect example of kindness. When her family met her they didn’t want or need a fourth dog but who could resist her?

When she was 10 months old, her owner noticed that she didn’t walk well after exercising. She would push up her body with her front legs instead of scooting her back legs underneath her. She seemed “out of alignment”. Taking x-rays confirmed the worst. She had hip dysplasia and her femur was on the verge of popping out of the hip socket with the mere act of walking.

Hip dysplasia is a problem that affects the hip joint in primarily large breed dogs. When the ball-shaped portion of the top of the thigh bone (femur) does not fit the socket of the pelvis, the joint becomes loose. Lose hip joints are unstable and likely to deteriorate and develop degenerative joint disease (DJD) which brings on a life time of pain and limitations to the dog’s ability to jump or even walk. The best way to prevent this painful disease is for breeders to avoid breeding adults that have loose hip joints. One way to determining if the potential breeding dogs have hip dysplasia is with The Penn Hip examination. For this test x-rays requiring anesthesia are performed and then submitted to the University of Pennsylvania for a careful analysis and measurement of the hip joints. This exam can be performed as early as four months of age.

The appropriated treatment for hip dysplasia depends on the severity, age and size of the dog’s flare ups. A limited exercise program and medications like Rimadyl or Estogesic can be used to reduce inflammation and pain. Aspirin is commonly used but it can cause stomach irritation and gas. Some dogs are placed on joint supplements (Cosequin, glucosamine, chondroitin-sulfate). Dogs with extremely severe hip dysplasia can benefit from surgery. Tess needed surgery! Her condition would require a triple pelvic osteotomy (TPO). It would be a difficult surgery, but luck was actually on her side! Because she was so young and had no degenerative bone changes, I knew she would do well. During the surgery her pelvis was sectioned into pieces, put together with plates and “rolled” over her femur to tighten it up. Total hip replacements and femur Ostectomy are other options for dysplasia. I am happy to say that after 6 weeks of difficult rehabilitations, Tess is doing great! She and her owners look forward to a lifetime of painless Frisbee tossing.

The Bloodhound Who Jingled as he Walked 

The complaint from Tom was tat his two year old Bloodhound, Eli, wasn’t acting right, not wolfing down his food as he usually did and every once in a while he would vomit. During my examination I found Eli to be quite BAR (lingo for “bright, alert, responsive”), normal hydration and color normal, heart and lungs normal…wait a minute what is this funny sound I hear from his gut? No, it can’t be muscle. Let me palpate again, move his stomach and intestines around. Yep, there it is -a round object as hard as a golf ball but with a harmonious sound! I turned to Tom and in astonishment asked him if he had noticed a funny sound coming from Eli when he walked.

“Yeah, as a matter of fact I have, but I wasn’t sure it was coming from him. What do you think it is?” he asked.

“Well, there’s something in his gut that’s making music. I can’t imagine what it might be. Do you have any ideas?” I asked in amazement, trying not to laugh.

“As a matter of fact, my wife if missing one of her Chinese medicine balls. It’s a pretty little ball, painted blue with patterns on it. You hold it in your hand and move it when you’re nervous and the soft sounds calm your nerves. Eli would have liked it if he found it; he puts his nose into everything and will eat anything! Yup, that’s gotta be it!” Tom chuckled.

On the x-rays not only did we find one ball but we found two inside Eli! One was in the stomach and one in his lower intestines (see the x-ray below - the bright white areas are the medicines balls). Surgery was done that day and 2 magnificent cloisonné Chinese medicine balls were removed! Afterwards the only problem was keeping Eli still. He had no idea that he had just had major abdominal surgery. All he wanted to do was put his nose to the ground and get going again!

Tom was generous and let me keep one ball. I now have the best time telling my story of “The Bloodhound Who Jingled as he Walked” to wide-eyed school children.

When More is not Better

My client first noticed a voracious appetite in her older cat. Weight loss and soft, voluminous stools followed. “She seems fine! In fact, she’s more active than usual. I just don’t get it” she exclaimed.

Posey had a textbook case of Hyperthyroidism. Hyperactivity, weight loss in spite of a ravenous appetite, diarrhea, occasional vomiting, lack of grooming and overgrown claws are pretty common as well. Hyperthyroidism is easy to diagnose with a blood test which measures the level of one of the thyroid hormones, thyroxine (T4). It is a very common disease in our aging cat population. Thankfully, if treated, the cat has a good prognosis of growing even older. If left untreated, hyperthyroidism kills. The disease severely affects virtually every organ system in the body, with the heart and the kidneys taking the biggest hits.

There are 3 ways to treat:

Posey is doing 100 times better with the simple administration of the ointment. My client may change her mind about treatment though. We recently diagnosed another of her cats with the same disease. Two cats, using twice the medicine, wrestling with them both daily....it may make more sense to irradiate!? Who says lightening doesn’t strike twice!?

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Skin Cancer - the Great Imitator

Scabs on the ears, nose scratches, blackhead pimples, and itchy allergy bumps all have one scary thing in common. When you find them on your cat, they may not be those things at all. They may be skin cancer. Skin tumors, either on the surface or just underneath, imitate other conditions. About 90% of these tumors are treated surgically with good survival rates. When they grow into bone and tissue, the cells spread throughout the body and skin cancer then turns deadly. “Skin cancer is very common in both dogs and cats, but in cats it is more often malignant” says Kenneth Rassnick, DVM, assistant professor of Oncology at Cornell University College of Veterinary Medicine.

These are frequently seen skin tumors:

Pele was gently put to sleep on July 21, 2004.