20th Anniversary Open House

Reminder: Our 20th Anniversary Open House is next Saturday May 2, 2009 from 10:00am to 4:00pm . We are sprucing up the clinic, stocking up on refreshments and organizing demonstrations.

11:00am and Noon: Jeannie Fisher demonstrates Canine Agility

1:00pm: Dr. Scott A. Nebergall and Chris Jess present equine digital radiography and corrective shoeing

All day: Dr. Lisa L. Eller demonstrates digital ultrasonography

All day: Dr. Linda J. Harmon-Dodge demonstrates animal chiropractic and acupuncture

All day: Elise Singer dicusses puppy and adult canine behavior

All day: Door prizes, tours and free goodies!

Rat Poison Can Be Fatal! Warning-Pictures may be digusting!

Every year in the spring and fall, we see cases at the Arthur Veterinary Clinic where pets have ingested rat poison. Rat poison can be deadly to pets! While there are several types of rat poison or rodenticides available, the most common type used are anticoagulant rodenticides. I will discuss this type.

Typical ingredients include: brodifcoum, diphacinone, warfarin and bromadoline. Most of these products include green dyes for a characteristic appearance.

How Does Rat Poison Work?

Clotting factors are proteins which are involved in forming a blood clot and preventing bleeding or hemorrhaging. Some of these factors are produced in the liver and require Vitamin K for activation. Anticoagulant rodenticides abolish Vitamin K recycling which results in Vitamin K reserves being depleted. Once the reserves are depleted, the blood cannot clot. This is why symptoms of rat poisoning can take several days to become evident.....after the body's Vitamin K reserves are depleted. By this time, even the smallest jostle or trauma can lead to life-threatening hemorrhage.

Symptoms of Rat Poisoning

Symptoms and severity of rodenticide poisoning are related to the amount of poison ingested. Most of the time, external bleeding is not obvious however bloody urine, bloody stools or nose bleeds may be seen. More commonly, pets become weak, lethargic and bruise easily. Internal bleeding may ocur. Signs of bleeding in more than one location can be an indication of blood clotting problems.

Treatment of Rat Poisoning

If you are aware your pet has ingested rat poisoning, call your veterinarian immediately. This is an emergency! Emetics are used to induce vomiting if the incident is caught quickly. Hydrogen peroxide can be administered to induce vomiting. Cathartics and adsorbents can be used to prevent the rat poison from entering the blood stream. I routinely administer Vitamin K to pets which have ingested rat poison even if vomiting is induced immediately. I also send pets home on oral vitamin K tablets for 21 days. There are different classes of anticoagulant rodenticides and some can remain in the body for several weeks. It can be difficult to know when to discontinue therapy. Blood tests to assess clotting times can be performed after Vitamin K therapy to aid in determining length of treatment. In severe cases where treatment is not instituted immediately, blood and plasma transfusions may be necessary to save a pet's life.

The Story of Moon

Okay, here's where the gross picture is seen. Moon is a 6 year old male, neutered Labrador Retriever. Moon is a great dog and well cared for. Moon is also your typical Labrador farm dog....happy go-lucky, easy going..... Moon's owners called one afternoon and said they found a bar of rat poison in his mouth. They immediately grabbed Moon and removed the bar from his mouth. Most of the bar was still present, so they did not think he had ingested much. Nevertheless, we recommended they bring him to the clinic. We induced vomiting (outside of course....and of course, it is January and cold......probably wouldn't have taken the picture had it been July!! :) Anyway, here's the picture of what Moon vomited. The point of this picture is not to be disgusting but to show how much rat poison Moon had actually ingested.....unbeknownst to his owners! The green granular substance is a large amount of poison. Moon actually vomited three large amounts like this picture!

So....if you must use rat poison, you must keep your pets far, far away from the poison. Dogs and cats can be very clever and very sneaky. To be on the safe side, no poison should be on the premise where the pet lives.

In House Diagnostic Tests: Part 2

In the previous blog, I discussed some of the diagnostic tests we run at the Arthur Veterinary Clinic. This blog continues with some of the more sophisticated diagnostic equipment.

CBC and Blood Chemistry Analyzer

Unlike most human physicians, we are able to perform a CBC (complete blood count) and chemistry panel (bloodwork) in the clinic while you wait with your animal. The CBC gives us a count of the red blood cells, white blood cells, hemoglobin and platelets. The chemistry panel is made up of 12-16 individual tests which assess internal organ function, endocrine function and electrolytes. These tests aid in our diagnosis when a pet or horse is sick or injured. We can have the results of a CBC and chemistry within 30-45 minutes of drawing blood. Below is a picture of our CBC and chemistry unit.

Incubator for Culture Samples

This piece of equipment shown below is an incubator. On the counter in front of the incubator are culture plates. This is used to perform a culture on a sample taken from an animal. The purpose of a culture is to identify the actual organism causing an infection. For the most part, a culture is taken with a sterile swab....for instance, a swab is taken of an infected ear. The swab is then plated or rubbed on the special plates which contain media to "grow" the organism causing the infection. The plates are placed in the incubator which is kept at 98 degrees. Usually, the infection is bacterial in origin but we can also identify yeast or fungal infections. The plates are then viewed at 24 and 48 hours. This photo shows a positive culture. Small white colonies of bacteria are seen growing on the blood agar (red) side and small bluish colonies are seen on the MacConkey agar (clear) side. These clusters of bacteria or fungus are then transferred to a sensitivity plate. Small discs impregnated with different antibiotics are added to the plate. This photo show the sensitivity plate with antibiotic impregnated discs. If the infection or growth fails to grow around a certain antibiotic disc, a clear halo is seen surrounding the disc and the infection is said to be "sensitive" to that particular antibiotic......meaning that antibiotic can be used to treat the infection. If the infection continues to grow despite the antibiotic disc, the infection is said to be "resistant" to that antibiotic.....meaning that antibiotic should not be used to treat the infection. Areas that we typically culture are ears, skin, urine, abscesses and mare's uteri.

Sugar Refractometer for Measuring Colostral Quality

The picture below is one of my favorite pieces of equipment. It is actually a sugar refractometer used to measure the amount of sugar in the juice of grapes when making wine. And while I do enjoy a glass of wine, we have not started a vineyard at the Arthur Veterinary Clinic. Instead, we use the refractometer to measure the quality of a mare's colostrum. Just like in other species, a mare's first milk or colostrum is full of antibodies which protect the newborn foal from infection. It is important to know the concentration of antibodies or IgG in the colostrum before the newborn foal nurses. If the colostral quality is poor or low, then the foal can be supplemented either orally, with high quality frozen colostrum or intravenously, with frozen plasma. To perform this test, a small amount of colostrum is milked from the mare before the foal nurses and placed on the refractometer. The refractometer is held up to the light and the reading is taken through the eyepiece. This percentage is then converted to the IgG concentration using the conversion chart pictured below. We like for the colostral reading to be >25% even though 20-30% is adequate. We supplement foals when the concentration is <20%.>30%. We freeze this high quality colostrum to supplement foals whose mother's have poor colostrum. This high quality frozen colostrum becomes like gold during the foaling season when frozen colostrum is in short supply. The best colostrum we have tested scored 48%!! This colostrum was chocked full of antibodies!!

Good Old Centrifuge-Our Workhorse!!!

I thought I'd include a picture of a centrifuge which is used to "spin down" samples of blood. Whether we are performing blood tests immediately, in the clinic, or sending a blood sample to an outside laboratory, most of the time the blood needs to be "spun down". What this means it the serum or plasma, depending on the the test, must be separated from the red blood cells. Most bloodwork is performed on serum or plasma. Blood samples are collected in blood tubes or vials. These tubes are placed in a centrifuge and spun at a very high rate of speed. The centrifugal force separates or pulls the red blood cells from the serum or plasma, leaving the serum or plasma setting on the top which can be easily removed with a pipette and submitted for testing. We use this centrifuge many times a day. I have actually had this centrifuge since before I started my practice in 1989!!.....I bought it in 1988 when I practiced out of my house. It has had to be repaired a couple of times but for the most part has been a real workhorse. If it ever goes kapute for good, I'll have to have a "parting ceremony" for it!!

These diagnostic tests I have described are used almost daily at the Arthur Veterinary Clinic. We perform many other diagnostic tests and procedures both for preventative veterinary medicine and for diagnosis of disease, illness and injury. And what we do not perform in house, we send to different outside laboratories across the US. Hopefully, I have educated you about diagnostic tests. Also, I hope you are beginning to realize that veterinary medicine uses highly advanced and sophisticated supplies and equipment to diagnose, treat and prevent disease and illness in animals. And we, as veterinarians, do this for the health and well-being of the animals we see and love.

In House Diagnostic Tests: Part 1

Most veterinary clinics are able to perform many diagnostic tests in house or in other words, in the clinic....many times while you wait. Because of this, I thought I'd write a couple blogs on the diagnostic tests we offer at the Arthur Veterinary Clinic. Some tests involve sophisticated equipment, while other tests do not.

Snap Tests

Snap tests are a type of test designed by Idexx Corporation. They are quick and easy to perform. They can be performed in house or stall side.....that is.... in a barn or at a farm. Here's a couple of the ones we perform at the AVC. The Snap 3D test tests for heartworm, Lyme and Ehrlichia in dogs. We use this test daily and recommend all dogs be tested annually. This particular test was negative. The blue dot at the top is the control dot. A positive test would show other blue dots below the control.

The other Snap test shown is the Foal CITE test. This test tests the IgG or antibody level in newborn foals. Foals obtain IgG in the first 12-18 hours from their mother's colostrum. This level should be over 800 mg/dl to provide passive immunity against infection in the newborn foal. We recommend this test on all newborn foals and we perform this test on all foals that are born at the clinic. With this test, the control dots are the two blue dots above the single test sample dot. As you can tell, the control dot on the left is a lighter shade of blue than the control dot on the right. The control dot on the left is the 400 mg/dl level and the control dot on the left is the 800 mg/dl level. The test sample dot should be as dark blue or darker than the right hand control dot for the sample to be over 800 mg/dl. Basically, the darker the better. Pale blue or white means the foal's IgG or antibody is low.

Another common Snap test used tests for Feline Leukemia Virus and Feline Immunodeficiency Virus in cats.
Fecal Tests

Most of you are probably familiar with the standard fecal test. You have probably had to "obtain" a stool sample from your pet to bring to your veterinarian. The principle behind a routine fecal test or fecal flotation is pretty simple. A stool sample is mixed with a special solution in a testing container. A microscope slide is placed on top to trap any parasite ova or eggs which, being lighter that the solution, will float to the top. The slide is then examined under the microscope to determine if and identify what type of ova are in the stool sample. Just remember, your pet can have a negative fecal but still be harboring parasites, depending on the shedding or release of the ova. Here's a picture of the fecal solution, container and microscope slide.

This is a picture of a microscope. First year veterinary students must purchase their own microscope to use in veterinary school. For me, this was quite an investment at the time. I paid $700 in 1983 for a brand new microscope. I splurged and bought a binocular microscope instead of a monocular. Thanks goodness for that! Fortunately, microscopes can last a lifetime if properly taken care of.

This is a chart of parasite ova or eggs as seen under a microscope slides.

Urinalysis

Another common lab test performed is the urinalysis. Much information can be obtained from a urine sample. A urine sample can be collected from a pet in three ways. A "free catch" sample can be obtained while the pet is actually urinating.....which can be challenging! The drawback to analyzing a voided sample is the urine can be contaminated with bacteria, cells or blood from the reproductive tract which can make analyzing the results difficult. A urine sample can be obtained by catheterizing a pet. However, this can also result in blood and bacteria from the procedure.....plus it is uncomfortable for the pet. The third and preferred method of obtaining a urine sample is by cystocentesis. Cystocentesis involves introducing a small needle, preferably ultrasound guided, into the bladder and removing a urine sample with a syringe. This method is actually tolerated very well by the pet and provides the most accurate sample for analysis. A urinalysis consists of three parts. The first part involves dipping a reagent stick in the urine to test for blood, protein, glucose, bilirubin, pH and ketones. The second part involves testing the specific gravity or concentration of urine using a handheld refractometer. The last part involves looking at a centrifuged portion of the urine sample under the microscope. By doing so, we can look for bacteria, red blood cells, white blood cells, abnormal cells and crystals. This picture shows the reagent strip and the handheld refractometer.

This ends the first part of "In House Diagnostic Tests". For the most part, these are common, routine tests performed on a daily basis at the Arthur Veterinary Clinic. In the second part, I will discuss some of the more sophisticated tests.

Serena

I'd like to tell the story behind this picture. This is "Serena", a golden retriever mix who was rescused by Marilyn Foulke. Marilyn, who is a friend of a friend.....and is now my friend (I'll go into more detail later), wrote this about Serena:

In 1999, after one of my dear Great Pyrenees died, I was looking for another dog to be a companion to my remaining Great Pyrenees. I definitely wanted a rescue dog, and looked in the newspaper to find a dog needing a good home.

There was a family in a very poor part of town who advertised a part Golden Retriever for sale, along with a bunch of Chow puppies. When I arrived at the house, it was obvious that it was a "puppy mill" of the worst kind. Serena was the mom- she was thin, nervous, scared, and apparently had had three litters of puppies in a short span of time, when she was still just a puppy herself.

I paid what they were asking for her, and it was all I could do to keep from getting some of the little puppies, too. From her first visit to the vet until her second visit in a few weeks, she had gained about 15 pounds, her coat had improved, and she was ready to be spayed.

I have never had a dog who so wants to be loved, and who loves so unconditionally herself.

For nine years, she was a wonderful companion to my lovely Great Pyrenees, Bella, and slept with her head on Bella's back . They kept each other warm when it was cold, and they roamed and played when it was pleasant.

A little over a year ago, Bella died at age 13, and it was very touching to see how Serena suffered the loss.

She continues to be a completely loving dog, but her visceral memory of her difficult beginnings still is apparent. She eats every meal as if it may be her last, and no amount of love and wonderful treatment from us can make her completely forget her insecure beginnings.

What a wonderful story! Now, to give credit to the photograph. This picture was taken by Cathy Lyons, a friend of Marilyn's. The picture is of Serena and Cathy's son, Ryan. Cathy is a photographer and a very dear friend of mine from high school. We had remained in contact with each other via our parents and Christmas cards. However, when we became friends on Facebook, we have reconnected......she is so very creative and I'm hoping to absorb some of her artsiness! Visit her blog http://cathylyons.blogspot.com/ and her website http://www.lyonsphotography.com/.

Thanks to Serena, Marilyn, Cathy and Ryan.....for a wonderful story about unconditional love and undying friendship.