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May 21, 2010

Porcupine Strikes Again!

This poor dog had a too-close encounter with a porcupine -- one of the more common reasons to see a dog at the clinic... (this and upset tummies). I thought we'd just share a few photos to show you what happens when you drop your dog off for quill removal.

After examination to assure us that the dog is in good enough health for anesthesia, we usually give the dog pre-anesthetic sedative and painkillers. A few minutes later, after the pre-anesthetics have taken affect, we will put your dog under general anesthesia.

As you can see in the above photo, there are often quills sticking all the way through the lip or tongue.... ouch!

Sometimes there are even quills so far back in the mouth that removal is a bit difficult.

Once your dog is fully anesthetized, here is how we remove the quills.... grab the shaft of the quill firmly with forceps, as close to the skin as possible, and PULL! Sometimes a dog will have so many quills that it will take 2-3 people working 20-30 minutes to pull all the quills. On quills that have broken off under the skin, we usually do not go in after (cut into the skin with a scalpel) because of the amount of trauma that would cause. Sometimes these quills will fester and become abscesses, sometimes they will just gradually disappear as the dog's body works to break them down.

Many quills later, and a bloody mess -- this dog is ready to wake up. We usually trim toe-nails and check the ears for foreign objects as well while the dog is still asleep. We usually send your dog home on oral antibiotics (and sometimes painkillers as well) because as you can imagine, those little quills are not the most sterile things in the world. You can expect the swelling in your dog's mouth and tongue to decrease quickly over the next couple of days.

Some questions we often get concerning porcupine quills:

  1. Is a case of porcupine quills an emergency? Yes and no. How's that for an answer? Yes, we would recommend you bring your dog in as soon as possible if your dog's mouth/face is full of quills. The sooner the quills are pulled, the better: less infection, less broken quills, and less chance the quills will end up in the dog's paws or in your hands as well. If your dog has just a few quills not located in it's mouth, then it is not such an emergency and you do not need to call in the middle of the night for quill removal (hint hint).
  2. I've always heard that porcupines throw their quills. Is this true? No, absolutely not. However, a porcupine is very good at flipping its tail around and when the tail makes contact, quills are left behind in the unsuspecting dog nose. Ouch!
  3. Do you have to cut the end off a quill to let the air out before you pull it? No. That is an old wives tale. It is not necessary to deflate the quills before removal. However, you could cut the ends off after removal if you wanted to make a quill necklace. We'll give you the quills back -- no charge.
  4. Can quills travel under the skin and through muscles? Yes. This can be especially troubling in cats as they tend to have pretty loose subcutaneous tissue. Luckily, cats and porcupines don't tend to have many interactions. We have seen the odd quill travel through tissues in the dog, especially so in quills that have lodged in the lower neck or shoulder (where the skin is loose). If there is a broken off quill in this area, we sometimes will incise over the quill and remove it just to lessen the chance of this.

I hope that answers some of your questions and provides you with a look behind the scenes of what happens when you bring your dog in for quill removal.

March 03, 2010

Sedating Feral Cats

This the time of year for feral cats to be roaming around. We have had some wander into our little farm out in the country. As the weather warms, last year's kittens (especially the males) get kicked out into the cruel world to find their own way. Also, it seems that it is also when the tom cats start prowling around, expanding their territory. We occasionally get in feral cats that have been live-trapped for spaying or neutering. Here is the way that we usually sedate these wild cats.

Example A: a young feral cat brought in by caring clients.
This young male is pretty scared to be caught in the live trap and transported to a strange smelling place.

Here the live trap is turned on end, and the cat is trying to find a way of escape.

Once on end, the top trap door is opened and bedding is firmly stuffed in on top of the cat, taking care not to smother the cat.
The goal here is to position the cat up against the side of the cage so that it cannot move around.

Here, the rump of the cat is positioned perfectly for intramuscular injection of the sedative/anesthetic combination.

Once the intramuscular injection is administered, then the bedding "restraint" is removed.

And once the cat is feeling the effects of the sedative, it can be removed for preparation of neutering or spaying -- in this case, neutering.

Once the neutering was completed, the cat was put safely back in the trap to recover. In this way, it will be easy to transport the cat back to where he came from for release -- with minimal trauma to any people or the cat. Controlling the feral cat population is a good thing.

Happy trails,

January 20, 2010

Calving and Dystocia: When to call the Vet

"They didn't say anything about this in the books, I thought, as the snow blew in through the gaping doorway and settled on my naked back.
I lay face down on the cobbled floor in a pool of nameless muck, my arm deep inside the straining cow, my feet scrabbling for a toe hold between the stones. I was stripped to the waist and the snow mingled with the dirt and the dried blood on my body. I could see nothing outside the circle of flickering light thrown by the smoky oil lamp which the farmer held over me.
No, there wasn't a word in the books about searching for your ropes and instruments in the shadows; about trying to keep clean in a half bucket of tepid water; about the cobbles digging into your chest. Nor about the slow numbing of the arms, the creeping paralysis of the muscles as the fingers tried to work against the cow's powerful expulsive efforts.
My mind went back to that picture in the obstetrics book. A cow standing in the middle of a gleaming floor while a sleek veterinary surgeon in a spotless parturition overall inserted his arm to a polite distance. He was relaxed and smiling, the farmer and his helpers were smiling, even the cow was smiling. There was no dirt or blood or sweat anywhere."
So begins James Herriot's book All Creatures Great and Small. If you have never read his books, you really should. From the first paragraph you are hooked. But this post isn't about James Herriot, rather it is about cow calving and when you should call your veterinarian for assistance. We are just starting into spring calving season here on the Palouse. I had my first middle-of-the-night calving call just a few weeks ago. It is sometimes all I can do to drag myself from my warm bed and venture into the cold blustery dark, but when a new, live calf is the result of my labors (no pun intended), it does make it all worthwhile.

Before we go into the particulars about when to call the vet, let's talk about the normal stages of parturition (labor and delivery). The first stage of labor, which is the dilation of the cervix, often goes unnoticed. You may notice the cow looking uncomfortable, getting up and down, looking around at her sides. The first stage can take up to 8 hrs or more. The second stage commences when the cervix is fully dilated and the calf can begin it's journey through the birth canal. You may see the cow behaving oddly, laying down to push a little, getting up and pacing around. Usually, the bag of fluids that surrounds the calf will rupture in a gush and "strings" from the amniotic sac will hang from the vulva. Soon afterwards, you should see the front feet appear and the nose not far behind. The second stage ends with the delivery of the calf. The second stage should not exceed 1 to 1 1/2 hours. The third stage is the delivery of the placenta and usually takes 4-8 hours.

Dystocia is what we call a difficult and/or prolonged parturition (labor and delivery). Dystocia can occur for many different reasons that fall into two generalized categories: 1) something wrong with the cow, and 2) something wrong with the calf and/or it's position. Things that can go wrong with the cow include weakness due to poor health or nutrition, uterine torsion, scar tissue adhesions, or hormonal imbalances. Problems with the calf include malpositions, deformities, multiple calves, or being too large to be pushed through the pelvis.

So, the question still is "When do I call the veterinarian to check the cow?" Well... there is no set answer, but here are some guidelines I suggest. Call your veterinarian if: 1) You think the cow should have calved and she hasn't. I regularly hear, "I thought she wanted to calve two days ago, but she hasn't shown anything yet." 2) Part of the placenta has been hanging out or you have seen fluid drainage for 1 1/2 hours. 3) Part of the calf has been out for 30 minutes and it still isn't on the ground. 4) The fluid, placenta, or calf is stained yellow. 5) The toes are pointed down instead of up. (This usually occurs with a backward calf.) I feel you will save more calves and cows (and thus more money) if you assist earlier as apposed to waiting too long.

This old diagram shows a backward calf that
will need assistance to be delivered alive.

Notice the toes pointing down with the backward calf.
If these were front feet they would be pointing up.

This is a nightmare that usually occurs at 2 AM,
with 20 degrees and 20 mph winds up my back...
and she has been this way for 2 days.

This presentation usually occurs when
the calf is dead during stage one of parturition.
It is the calf's job to get it's feet up into the vagina.

So, this has been a brief overview of calving and dystocia. Hopefully I have helped you to make decisions about when to call your veterinarian out to check your laboring cow.

PS Always go back inside the cow's uterus and check for another calf if you have had to assist her with calving. Just a tip.

November 22, 2009

Urolithiasis (bladder stones)

Meet "Miss Scarlet the Grange Dog". She came to visit us a few weeks ago with the complaint of not feeling well and having to urinate all the time. The only problem we could find on physical exam was a small amount of malodorous vaginal discharge. Since she had never been spayed, we had to consider that she might have pyometra (infection in the uterus). Surgery to remove her uterus and ovaries was scheduled, and antibiotics and pain medicines were started. When Miss Scarlet was anesthetized we were able to palpate her abdomen a little better. While she was awake, she kept her stomach muscles so tight that we could not effectively palpate. A very hard structure was felt in the caudal abdomen (towards her tail end) -- in the area of the bladder. Since there should not be any hard objects in this area, it was likely that she had, along with the infected uterus, a stone in her bladder. The medical term for this is urolithiasis.

Surgery consisted of opening the abdomen, cutting into the bladder and removing a large "rock", flushing the bladder and urethra, and then suturing the bladder closed. Next, the uterus and ovaries were removed because of her pyometra. All went well and Miss Scarlet was returned to her owner a new "lighter" dog.

This is a picture of the freshly removed stone.

This picture shows some objects for size reference. Scarlet is a 10# mixed breed terrier. As you can imagine from the size of the stone, there wasn't much room left in the bladder for urine. This reason, combined with the irritating nature of the stone, would make it so that Miss Scarlett felt like she had to urinate all the time. Add to this the irritation and discomfort from the uterus and you can understand why she didn't feel 100%.

Here are some examples of stones we have removed from other patients. Sometimes there is just one, sometimes there are hundreds -- like small gravel. These stones are very hard. Often the stones are passed out the urethra before they get large enough to cause trouble. If they are not passed they can irritate the lining of the bladder, cause bloody urine, and make the dog feel like it has to urinate often. The stone can also temporarily (or permanently) block the passage of urine, and when this happens, it is a medical emergency. Surgery must be performed immediately to remove the stone or stones so that the dog can urinate.

Crystal formation is enhanced in urine that is alkaline (has a basic pH), and is inhibited in urine that has more acidic pH. Diet is a big contributing factor to the pH of the urine. Meat based diets tend to make more acidic urine, and plant based diets make more alkaline urine. Bacteria, which like to grow in an alkaline pH, make by-products that also contribute to crystal formation. Bladder stones in dogs are sometimes found following cases of infection in the bladder (cystitis). The inflammation and bacterial by-products form debris in the bladder which provide a starting place (or nidus) for the crystals to begin forming. Once the crystals start, they can form onto each other and build and build until they make stones. So you can see that urine pH and bacterial infection go hand in hand with urolithiasis.

Not all stones are caused from inflammation, some dogs such as Dalmatians, produce bladder stones because they cannot metabolize certain substances well. In the case of some Dalmatians, they cannot metabolize uric acid and so they make uric acid stones. This type of stone formation can be possibly corrected or prevented with special diets. Other dogs, such as Schnauzers just seem predisposed to form stones for some unknown reason.

Bladder stones can look very impressive on a radiograph as shown above. This radiograph is not from Miss Scarlett, but of a dog that had the largest stone in the above stone comparison.
Can you see the more dense central portion of the stone? This could be a different type of stone within the larger stone. It is not unusual to have multiple types of stone within the bladder at the same time. It sure looks uncomfortable to me!

November 11, 2009

Welcome Kasey

We'd like to welcome Kasey to our team. Kasey was born and raised in Whitman County, where she and her husband continue to live and raise their children. Kasey has first hand experience with farm life and enjoys riding her horses and being with her dogs. She also has a pot-bellied pig living at her home, but she would tell you it belongs to her children.

Kasey is working in the mornings (and occasionally filling in for Penny in the afternoons). She replaced Jenny, as Jenny has quit to focus on to other important things in her life.

We hope you will give Kasey a warm welcome when next you visit our clinic.

October 10, 2009

Spinose Ear Tick

Blogging has been a little hit & miss lately. Sorry. It is not that we haven't been busy, or that there haven't been interesting cases, to the contrary. It seems like we've had a rash of crazy trauma cases, and those aren't the type of thing that lend themselves to blogging. It's not like you can ask an owner if you can stop and take picture of the bleeding, mangled dog before you begin treatment. And asking whether or not you can blog about their poor pet seems in bad taste. So, that's how it has been.

Anyway, last week we had a rather mundane "check dog ears" from the western part of the county. And this is what we found -- a spinose ear tick (Otobius megnini). The spinose ear tick can infest many warm blooded animals, but seems to prefer cows, horses, dogs, cats, and even humans. It can be a real problem in livestock, causing poor condition with heavily infested cattle. We have seen several of these ticks in the past few years, all from the relatively arid parts of Whitman county. In dogs, infestation of the spinose tick causes severe head shaking, pain, and digging at the ear. Severe oozing skin infections can result from the bite. Most people assume that there is just a grass seed or awn in the ear canal.

As it turns out, only the nymph and larval stages of this tick feed on blood. The adults apparently do not feed at all, and can live for up to 2 years. The feeding stages of this tick like to crawl into ears, especially deep into the horizontal canal and attach to the skin where they feed on blood and wax in the ear. The spinose ear tick can cause tick paralysis and can also spread diseases such as Q-fever, tularemia, Colorado tick fever, and Rocky Mountain spotted fever (although not necessarily in this area of the country). Treatment for infestation involves applying an acaricide solution (typically permethrin or amitraz) directly into the ear canal if the tick cannot be removed manually. In cattle, permethrin impregnated ear tags are helpful in prevention of infestation.

Kind of gives you the creeps, huh?

September 20, 2009

Palouse Empire Fair

Every September, for the past 23 years, Dr. McGraw has spent the week and weekend after Labor Day out at the Palouse Empire Fair. At first glance, this may seem like a dream job, but after you found out about the hours of service you might think otherwise. Dr. McGraw is on the fairgrounds from about 6:30 AM until the barns close at 10PM, but as you can see, Dr. McGraw takes this all in stride.

Most of the years that Dr. McGraw has served as the fair Veterinarian, he has also had children at the fair showing one animal or another: pigs, horses, bottle calves, sheep, and the occasional chicken. This year it was a black bummer lamb, and a beautiful red and white short-horn bottle calf.

Official duties for the fair Veterinarian include: checking in animals as they arrive at the fair to make sure they are healthy and free of infectious diseases, treating show animals that get sick while at the fair, and occasionally treating rodeo stock or rodeo contestant animals. Unofficial duties include: putting chicken eggs in the rabbit cages (much to the surprise of people in the rabbit barn), hiding prize ribbons where 4-H or FFA contestants cannot reach them (not very amusing to some people), and putting goose eggs in the pigeon cages (poor, poor pigeons!). Dr. McGraw can also be seen helping out in any barn that needs an extra hand, visiting people he only sees yearly at the fair, and perusing exhibits in the buildings.

The last day of the fair, Dr. McGraw organizes the "Ol' Fogies Fitting and Showing Contest." This is the 17th year he has served as the official organizer. The first year, the prize for winning the "Ol' Fogies" contest was a political campaign button with a pig's tail attached (never fear, the poor pig lost it's tail when another pig bit it off). The prize is currently an old women's bowling trophy. Needless to say, all the "ol' fogies" have a good time at the showing contest.

This year, the weather was fine and most of the animals were healthy at the fair. We like it that way. See you at the Palouse Empire Fair in 2010!