Category: Cats (page 1 of 6)

A Promise to Patients

My New Promise to Patients

I graduated from veterinary school in 2006.  Wow – that wasn’t that long ago, or was it?  It’s only been 12 years but since then veterinary medicine has changed.  Medically, we have made more advances to provide better top-notch care.  However, socially and perception-wise, veterinary medicine has been tarnished due to the evolution of the internet and social media.  It has driven a number of my colleagues out of the profession, into a depressive state, or in the worst cases – suicide.  I’m doing fine and am constantly evolving to provide the best care that I can.  As a result, this is my promise to patients: Continue reading

Cats, Strings, & Intestinal Things

cats and string

from kittenwhiskers.com

The country song goes “Mamas don’t let your babies grow up to be cowboys…” and the same thing applies to cats playing with string.  Media is chock full of images of kittens playing with balls or yarn whether it be cartoons, advertisements, or the endless supply of cute videos on YouTube.  But behind all this cuteness lies a deadly risk if a cat eats string, thread, yarn, or dental floss.  These kitties can be fixed but it’s not easy.  This is Mira’s story…

Mira cats and string

Mira

Sometimes you see your cat eat the string and sometimes you don’t.  Often times the first thing you may notice is vomiting.  This was the case with Mira.  At just 2 years old, she’s still an intensely curious cat.  All cats may vomit from time to time – hairballs, catching a mouse, chewing on plants, but never just vomiting out of spite.  When Mira started vomiting multiple times over several hours, her family knew something wasn’t right and brought her in to see us.  The diagnosis was easily found as a string was seen wrapped over and under her tongue.

When a string gets trapped at this spot, the other end of it starts moving through the stomach and intestines.  Essentially what happens is the string begins to act like a saw cutting through the intestines as it pleats them like an accordion.  Palpating a cat’s abdomen like Mira’s you can feel the intestines bunched up and thickened.  At this point, we weren’t sure how long the string had been present.  What we were all sure of was that Mira needed help in the form of surgery.

Yet, surgery isn’t just a simple snap of the fingers.  Many factors need to be considered.  Due to her vomiting, Mira was dehydrated.  With the risk of the string cutting into the intestines, blood and protein gets lost through these injuries which can complicate healing as well as leaking intestinal contents contributing to infection.  And the biggest mystery, what will you do once you’re there actually seeing the abdominal contents.  Mira’s family elected to go ahead and get her fixed up.

cats and string

Mira’s plicated intestines

Once we had her on some IV fluids and got her a bit better stabilized, I took her into surgery and investigated the damage.  In total, 7 perforations were noted and I discovered the other end of the string was in the colon.  Effectively, it was acting like a drawstring on pair of sweatpants pulling on her intestines at both ends.  Due to the number of perforations and their locations, the best option was to remove a large section of intestine and reattach the good ends.  After releasing the ends of the string through separate incisions in the stomach and end of the small intestine, I removed 32cm of the small intestine and reattached the ends before rinsing her abdomen and closing her up to recover her.

Over the next couple of days, we monitored Mira in the hospital.  Things weren’t going as we had hoped.  She wasn’t eating, kept spiking fevers, and seemed generally quieter than expected.  She only would eat tiny amounts when her family visited.  On the third day post-op, we checked some blood as she still wasn’t doing as we expected and noted several changes in the blood cell count and protein levels that concerned us and raised the suspicion that something had broken down inside.  The results were worse than before the initial surgery.  Despite all the precautions and steps we had taken to help Mira, something was leaking.

After some discussion, her family elected to have us attempt a second surgery as a means of fully discovering the extent of the problems and to fix what we could.  As soon as I got back into her abdomen, I had all the explanation we needed.  Her anastomosis site (the reattached portion) had broken down and a small leak was seen near it.  Given the amount of damage that was found and the previously removed section of intestine, I felt it best to call her family immediately and give them an update.  Assessing the extent of everything internally, I let them know her prognosis was very guarded to poor even with attempting a second repair and advised them that euthanasia was not an unreasonable option.  Her family conferred for a moment and told me to do my best to save her.  Back in surgery, I removed as little intestine as possible that was no longer viable and reattached the new ends.  After a very thorough rinsing of the abdomen and closing her back up, we all hoped for the best.

blood donor cat

Pioneer, the blood donor

Great news the next morning!  Her temperature was normal and she greeted us with alertness and purring unlike any other morning before.  A recheck of her blood now showed dangerously low levels of red blood cells and protein.  Mira needed a transfusion to give her the best chances for survival.  Luckily, one of our staff members volunteered to have her cat donate.  Mira received the much needed blood and was on the complete road to recovery.  By the next day, she was feeling spunky, her blood values had improved, and she was eating everything we gave her.  Mira was going home.

cats and string

Mira getting her transfusion

I like to think of Mira as a little “Mira-cle in May.”  Not all cats get this outcome.  It took the right combination of family commitment, veterinary team care, and a bit of luck.  The important message here is that when your pet seems sick, it’s best to not wait to see if it will pass — at a minimum, please talk with your veterinarian.  Waiting too long could make things worse.

Disclaimer: Blog posts may contain some opinions which are my own and may not reflect those of any current or former employers. Mira’s story is published with permission from her owners and some non-essential details have been omitted for brevity.

Don’t forget to follow along on Instagram @drryanllera , Facebook , or  Twitter for more pet info and interesting daily happenings!

4 More Veterinary Visit Tips

Admit it, taking your pet to the veterinarian is probably not one of your favorite things to do.  Obviously, there are those times when your fur-baby is sick and that’s understandable you’re dreading the visit especially when the outcome is unknown.  Maybe it’s the cost of things that is frustrating.  Perhaps it’s the time you spend there or the interaction with the clinic staff that have you dreading the visit.  Fear not!  You can help make those trips to your veterinary clinic be more productive, safer, and efficient so we can cooperatively get your pet treated and make the experience less exasperating.  Think of these tips as some of the secrets we think but don’t say out loud.

broken leg puppyIf the presenting complaint is pain, we have to localize the pain – I know what you may be thinking…why do you have to make my pet hurt during the exam?  Yes, it’s true that during an exam we may palpate an area and it may hurt, but we have to know what is ailing your pet.  Afterwards (and before any x-rays), we’ll be more than happy to give your pet pain medication or a sedative to help them relax.  If we can’t find the painful area, then a diagnosis may escape us and your pet might not get the proper treatment.

from Trupanion.com

from Trupanion.com

Why can’t we complete our exam? – One of the things I find to take the most time (thus extending a visit length) is not being able to adequately complete our exam.  Why is this?  Two things….chairs & leashes.  Unfortunately, many pets are still afraid of the veterinary clinic.  When this happens, they tend to climb into a small or covered space in hopes of not being noticed or to make themselves more difficult to be touched.  This often means climbing under a chair.  I don’t mind helping coax Fluffy or Spot (with bribery from treats) out from under a chair but we may feel awkward if you are still sitting on said chair….let’s call it a personal space bubble that we don’t want to pop.

This is where you can help and where the leash comes into play (for dogs at least).  Drop the leash, hold the collar or place your hands on your pet.  Leashes also create prime tripping hazards with a big, happy dog.  If your pet holds still, we can do our jobs better and give you better service.  If a staff member is able to help in an exam room (not always possible), please trust them to handle your baby as if he or she were their own.

aggressive dogNot every pet who comes to the vet clinic is happy or a sweetheart – Admittedly, I will give every patient the benefit of the doubt if they seem leary or if they snap, we will likely want to put a muzzle on them.  I’ve heard people say that veterinarians should not be afraid of animals.  The truth is, we respect them and know what some of them can do.  I’ve known too many colleagues who have been unable to continue working like their accustomed due to a nasty animal related injury.  Animals are also perceptive and if they sense they the staff is uneasy, it may send the wrong signals of being dominant.  Simply put, if your pet has a history of misbehaving, allow us to take proper safety precautions so that nobody gets hurt.  Alternatively, for routine visits, we can often prescribe something ahead of time to help take the edge off and make your pet more relaxed so that their visit may not be such a bad experience.  Many veterinarians are become FearFree certified.

from justcuteanimals.com

from justcuteanimals.com

All we all need is just a little patience – Time spent at the vet clinic can be discouraging.  Whether it is before or after your appointment may make it more so.  A veterinary visit is compromised of multiple parts and interactions, from the client services up front to the veterinary technician to veterinarian and back up to client services.  Wow!  That can be a long time depending on the reason for the visit.  If you show up early, we can make sure your contact info is up to date so that further follow up can be done once you are done with the appointment.  And if we’re able to, we’ll see you early to give you some extra time or try to get you home just a little bit earlier.  On the same token, walking into the clinic with a true emergency (hit by car, active bleeding, trouble breathing, seizuring to name a few) is understandable but we ask that you at least call us before hand so we can prepare and if needed, we can notify our scheduled appointments and give them a chance to reschedule.  If you’re walking in and it’s not an emergency, we will do our best to squeeze you in but there may also be the need to schedule you for a later appointment.

So there you have it…a few more tips to try and help ease the trip to the vet clinic.  A few more tips you say??  Yes, check out part 1 of tips for your vet clinic visit!  And please keep in mind that we are always trying our best for all of our patients so let’s all be courteous to our fellow pet lovers and the clinic staff!  If there’s another piece of advice you have, please share with us in the comments!  Thank you!

Disclaimer:  All blog posts may contain opinions which do not reflect those of my current or any former employers.

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