Arthur Veterinary Clinic

Let's Cut To The Chase About EHV

2011-06-02T21:15:00.001-05:00

Equine Herpes Virus

EHV-1 stands for “Equine Herpes Virus-1.” It’s given the “1″ because there are several herpes viruses that affect horses and this one was named first. Otherwise, the “1” has no significance. Herpes viruses are very successful viruses, if you measure success in terms of how many of them there are, and how many mammalian species are affected. There are herpes viruses of horses, and people, and dogs, and cats, and pigs, and cattle, probably several other animals as well. Herpes viruses are successful for two main reasons:

1)They usually don’t hurt the host very much. That’s right, most of the time, herpes viruses are unnoticed by the host. It doesn’t do a virus much good to go killing off its host – that’s one reason why you don’t see Ebola virus spreading rapidly around the world. If the host doesn’t live, the virus can’t spread. Mostly, herpes viruses don’t cause much fuss. They are sort of like the quiet family that lives in the dark house down the street, or in the apartment down the hall. If you didn’t know that they were there, you wouldn’t know that they were there.

2)They have cleverly figured out how to evade the body’s immune system. Once a horse gets infected with a herpes virus, the virus finds a nice home, usually in and around nerves. There, they stay nice and quiet (medical folk say latent), until some stress causes the virus to activate and start causing trouble. And the fact that they can evade the body’s immune system also means that, so far, nobody has been able to develop an really effective vaccine against them.

Do you get cold sores? Something like 70% of the human population does. Most of the time, people with cold sores have perfectly normal looking lips. But add some stress – say, illness, tax returns, school (for kids) – and, BOOM, you end up with a big, painful knot on your lip. Then, the body fights it off, and the virus goes latent, waiting for another stressful opportunity.

In horses, depending on the study you read, it’s estimated that as many as 50% (or more) carry the latent EHV-1 virus in some form. Sending 700-some horses to Ogden, Utah to compete in a horse show was the equine equivalent of sending the kids to school. Panicked, excited, stressed, and packed together, it was an absolutely perfect scenario for the herpes viruses to come out and play. So, some poor horse – one of hundreds that were probably carrying the virus – stressed, and far away from home, broke with the virus, which reproduced, and then spread to other horses. Think kids in school with a cold: one of them gets sick, and before you know it, everyone gets sick.

Remember when I said that herpes viruses usually don’t hurt the host very much? Well, that’s usually true. Unfortunately, in some cases, the EHV-1 virus gets into the horse’s nervous system and causes a great deal of mischief. It can even cause horses to die. This is unfortunate, and also not uncommon with viruses. And, we do not completely understand why some horses will develop the neurologic form and other horses do not. Researchers believe that the variety or strain of virus, the horse’s own immune system and the environment all play a role in determining which horses will develop the neurologic form. The good news is most horses that get exposed to the EHV-1 virus DON’T get neurologic disease.

Of course, no one wants any horse to get sick, ever, so, understanding that, your reasonable question would be, “What can/should we do?”

And my response would be, “Go out and enjoy your horse. The EHV-1 virus is pretty much everywhere. Your horse has probably already been exposed at some point in his life.

A big question exists concerning vaccination for herpes virus. Unfortunately, there’s no really good herpes virus vaccination that completely prevents any form of the disease caused by herpes virus. This isn’t just a horse thing; there’s no really good herpes virus vaccination against any disease of any species. (And, that is another reason why herpes viruses are so successful). With that said, there are several, commercially-available vaccines that we use routinely in horses. These vaccines are labeled (approved by the FDA) to prevent infection or reduce disease of the respiratory and abortion strains. No vaccine prevents the neurologic form of herpesvirus. Vaccinating against herpes virus might help to decrease the shedding of the virus and the spreading of the virus among horses. The best advice is to consult your veterinarian concerning vaccination---not only when discussing herpesvirus but to develop an entire vaccination program that best works for you and your horse.

The best things that you can do to avoid herpes virus is to practice good hygiene measures, that is, the types of things that people should do with their horses anyway (but often don’t).

For example, new arrivals to farms should be quarantined for a few weeks before being introduced to new horses. People working around horses should wash their hands often so that they don’t carry disease. If you’re working around a sick horse, change your clothes before moving on to the next horse. Don’t crowd horses together. Feed them well. Get them fresh air and exercise. All common sense and but important, too.

Bottom line is EHV-1 can be a bad deal for individual horses. Quarantining sick horses, or horses that were exposed at the show in Utah was absolutely the right thing to do. But for most horses, EHV-1 will not cause disease. So, be prudent and be cautious. Use good hygiene measures. And discuss with your veterinarian the risks and benefits of vaccination.

A special thanks to Dr. David Ramey in Sunland, CA for letting me "steal" his information about EHV-1. Check out his website for more great equine information @ www.doctorramey.com

EHV Outbreak

2011-05-23T13:07:00.000-05:00

Equine Herpesvirus

Other common names

EHV, Equine Rhinopneumonitis, EHV-1, EHV-4

Equine herpesvirus (EHV) is a highly contagious group of viruses that causes disease in horses worldwide. EHV is one of the most costly viral diseases in the equine industry due to its ability to affect many organ systems causing both economic and animal welfare losses. EHV is responsible for causing the neurologic form or equine herpesvirus myleoencephalopathy (EHM).

Frequently Asked Questions:

1. How do we handle horses returning from events where they might have been exposed to this infection?

For horses that might have been exposed to the risk of infection, there are some steps to take to mitigate the risk at their home facility. Even if these horses are returning home from events at which no disease was reported, and even if these horses appear healthy, precautions are needed at this time as these horses could bring it home and spread it at their home farm – this is the classic way this disease spreads:

• These horses should be isolated from any other horses when they return to their home facility. Isolation requires housing them away from other horses, using different equipment to feed, clean and work with them that is used with any other horses, and rigorous hygiene procedures for horse handlers (hand hygiene, wearing separate clothes when contacting the horses, etc.).

• These horses should have their temperature taken twice a day, as temperature is typically the first and most common sign of infection–horses with elevated temperatures (101.5 degrees Fahrenheit or greater) should be tested to find out whether they are shedding EHV-1.

• If a horse develops a fever and is found to be shedding EHV-1 then the level of risk to other horses on the premises increases significantly.

• Horses that do not develop fevers should be isolated for 14-21 days.

2. What do we do if we already have a potentially exposed horse on a farm?

It still makes sense to isolate this horse from other horses. Even though it might have already been in contact with them, start isolation procedures to stop further exposure. It is important to not mix horses from different groups to accomplish this. Try to isolate the suspect horse without moving other horses from one group to another– segregation of horse groups is the key, because this will help you reduce spread if an outbreak starts. Check temperatures of all horses on the farm twice daily (fever spikes can be missed if you check once daily). If fevers are detected, then test for EHV-1.

• Any horse with signs of a contagious respiratory disease should be quarantined or isolated. Horses should neither enter nor leave the premises. In the case of EHV, quarantine should last for at least three weeks.

• Mares that abort should be isolated from other mares.

• Do not share equipment or tack among infected horses and normal horses on the facility.

• Proper hygiene should be implemented among horse handlers. Wearing gloves, thorough hand washing and disinfecting footwear can minimize the spread of the virus. Sick horses should be handled last.

3. Is there any value to using booster vaccinations against EHV-1 at this time?

Unfortunately, there is no evidence at this time that current EHV-1 vaccines can prevent EHM.

The more potent EHV-1 vaccines have been shown to reduce nasal shedding and in some cases reduce viremia and possibly lessen the severity of EHM. These products might have some theoretical value against EHM (by reducing viremia), and certainly against spread of the virus.

At this time, the Arthur Veterinary Clinic is recommending vaccinating against EHV-1 with Pneumabort K if your horse is traveling to a show, breeding farm or equine event where contact with other horses may occur.

General Information on EHV

Herpesviruses are a family of viruses which cause disease in both animals and humans. These viruses are species specific, meaning the equine herpesvirus cannot infect humans and the human herpesvirus cannot infect horses. Herpesviruses have the ability to produce a latent infection meaning the virus can remain dormant in the animal without producing any visible symptoms. This results in an inexhaustible reservoir of virus for continual transmission of infection among horses.

There are five types of herpesviruses (numbered EHV-1 through EHV-5) associated with illness in the domestic horse. Of the five types, EHV-1 and EHV-4 are the most common and detrimental.

EHV-1: Causes respiratory disease, abortion, neurologic disease and disease in the newborn foal. Young horses under the age of three which are housed in close confinement such as racetracks and show barns are most commonly affected with the respiratory form. EHV-1 also causes abortions in broodmares during the last four months of gestation. The neurologic form of EHV-1 is seen with increasing frequency and is the most devastating form. Foals born with EHV-1 rarely survive.

EHV-4: Causes an upper respiratory disease in young horses. Respiratory disease is not usually severe but loss of performance can be significant.

Most horses have been infected with EHV by two years of age. The initial exposure can occur in foals from contact with their mothers. The virus can then become latent or inactive in the foal’s body and it becomes a life-long carrier, showing no clinical signs. However, the virus can become reactivated during times of stress such as weaning, long-distance hauling or strenuous exercise and these horses can then spread the virus to other horses. Most mature horses develop some immunity through repeated natural exposure and become less susceptible to respiratory disease caused by EHV.

The incubation period of EHV is 2-10 days after infection until clinical signs appear. EHV is spread by several different routes including:

• Respiratory: A recently infected horse spreads the virus to other horses by direct contact of respiratory secretions or from infective viral particles being picked up in the air. The virus can be shed for 7-10 days from an infected horse. Infected foals are highly contagious. Mares can abort from two weeks to several months following exposure and most likely acquire the virus via the respiratory route.

• Indirect Contamination: EHV can live for days in the environment and be spread through the use of contaminated tack, handlers or equipment or from an aborted fetus and its associated tissues and fluids.

• In Utero: The virus can cross the placenta from an infected mare to her unborn foal.

Clinical signs

Respiratory-These signs can be mild to severe and include a high fever, nasal discharge, loss of appetite, lethargy, increased respirations, cough and ocular discharge. Secondary bacterial infections and pneumonia can occur.

Abortion-Mares that abort due to EHV seldom show clinical signs. The placenta is usually expelled with the aborted fetus still in the amniotic sac. One to two mares may abort in a group or abortion storms (a high number of abortions in a herd) can occur.

Neurologic-This form produces weakness of the hind limb muscles causing incoordination, gait abnormalities and inability to rise from a sitting position. These horses frequently develop urinary incontinence. Horses can become paralyzed and unable to rise. Older horses are more likely to develop the neurologic form of EHV.

Newborn Foals-Foals born with EHV are very weak and suffer from severe pneumonia. These foals usually die within 1-2 days of birth.

Hooty and Quincy

2011-03-08T07:42:00.000-06:00

Best Friends Forever

The Arthur Veterinary Clinic and its staff are committed to finding these little fella's good homes. We are not a rescue but couldn’t let these two sweet dogs be euthanized. Both dogs are what some may consider as "special needs". Please find it in your heart to help them out. These guys have had a rough start in life, but they are very sweet and deserve nothing but the best!

Hooty was found running along the road in sub-zero temperatures a few weeks ago. He is a little timid, but very sweet. We estimate that he is about 5yrs old. When he arrived he was in poor body condition and a matted mess. He does not have any teeth and is vision is not the best, but he has a heart of gold and is very loyal. We have treated him medically, given him a haircut and a good scrubbing, and he is now in tip top shape for his new home!
Quincy was relinquished by his owners. He has bilateral cataracts and is mostly blind in both eyes but manages to do VERY well getting around. A good bath and clipping some mats away and this guy is ready to go home with someone who will enjoy the company of an amazingly adaptable little doggy. Quincy is very social and loves attention. He is going to make a great addition to a very lucky home.

Check out the Hooty and Quincy album on Facebook for more pics of these cute little guys. Please call the Arthur Vet Clinic for more information. 217-543-3533

Quincy

Hooty

Foaling Season has begun!

2011-03-08T06:30:00.000-06:00

Congratulations to Iron Horse Farm and Dr. Linda Harmon-Dodge on the arrival of Jane's stud foal "Race".

Congratulations to Bella Vista Farm and Fred Helmuth on the arrival of Della's healthy filly foal.

Congratulations to Homer Miller of Arthur IL on the arrival of Shania's filly foal.

Congratulations to Harmony Hill Farm and Bill and Cathy Clark on the arrival of Kandy's filly foal "Kendra".

Congratulations to Harmony Hill Farm and Bill and Cathy Clark on the arrival of Rainey's filly foal "CaLin".

The Maternity Ward at the AVC

2011-03-03T14:57:00.001-06:00

Spring is the time for mares to foal or give birth. We use the Foalert mare monitoring system which alerts us when the mare begins to foal. This allows us to attend every foaling. When a mare arrives at the AVC to foal out, we suture (stitch) a "transmitter" to her vulva. This is a picture of a transmitter sutured in a mare. This mare is a Belgian mare named Betty who arrived to foal today!

This transmitter is triggered when the mare begins labor, transmitting a signal to a receiver which is attached to an autodialer. The autodialer then dials our pagers to alert us of labor. Here's a picture of the receiver and autodialer.

It is not uncommon for us to have 3-5 pregnant mares due to foal in the clinic at one time. Talk about an unusual maternity ward! And even though I have attended hundreds of foalings, a newborn foal still makes me smile! The other great thing about foaling out mares is we can watch these foals develop from newborns to yearlings to adults.

Here's a picture of "Emerald Mountain Lau", owned by Marylee McGee, as a newborn foal. She was born on March 5, 2008. And here's a picture of "Emerald" almost a year later as a yearling! Oh...and her mother's name is "Diamond Godiva".

Trivia Question: How long is a mare's gestation? Post your answer as a comment!

Artificial Insemination in Mares

2011-03-02T22:45:00.000-06:00

Most horse owners are familiar with artificial insemination (AI). For those of you which are not, AI is big business in the equine industry. The last 20 years has seen a huge increase in the number of breed registries which allow artificial insemination. This blog will explain AI from the mare's perspective.

Artificial insemination is performed by depositing a sample of equine semen into the mare's reproductive tract or uterus. The semen can be either fresh, cooled or frozen. Semen that is classified as fresh is collected from the stallion and then inseminated into the mare within a short period of time on the same farm. For the most part, cooled and frozen semen is transported from the collection farm to another location. This allows mare owners to breed their mares to stallions located in a different part of the country or countries. Semen that is cooled is also collected from the stallion but then processed and packaged in special containers to cool the semen at a specific rate.

Here's two pictures of shipping containers for cooled semen. The blue container is called an Equitainer and is shown with the special coolant can. These containers are meant to be reused.

This is a picture of a disposable container which utilized frozen packs to chill the semen.

This is a picture of the inside of a disposable shipper container with the semen packaged and sent in a syringe.

Cooled semen is meant to be inseminated in the mare within 24-48 hours of collection. Cooled semen is typically either sent via an overnight carrier (UPS, Fedex...etc) or placed on an airline as a cargo shipment. Transporting semen via an airline is typically called "counter to counter" shipments and this method allows mare owners to receive semen the same day and on the weekends. Semen that is frozen is collected from stallions, processed and then frozen. Theoretically, frozen semen can be stored in a frozen state indefinately. Because of this, a mare could be bred with frozen semen after the stallion has died.

Breeding a mare with cooled, transported semen (CTS)

The key to breeding a mare with CTS is the timing of the breeding. Ask any experienced reproductive veterinarian and they will tell you that the most successful veterinarians develop a keen sense or intuition. I guess what I'm saying is breeding mares is really an "art". You must use science and technology to be successful but without a good "feel" for how a mare cycles, all the science and technology in the world will not produce a pregnancy. There are several factors or signs to consider when breeding a mare with CTS. However, to avoid this blog sounding like a class in equine reproductive physiology, I will just explain the follicle development. Ideally, the semen is deposited into the mare's reproductive tract prior to ovulation. The closer the mare is bred to ovulation the better. When a mare is in estrus or heat, she develops a follicle which contains the egg. As the follicle matures or ripens, it becomes larger and softer. So, the ideal time to breed a mare is when she has a large, soft follicle....just before it ovulates and releases the egg into her oviduct. To determine the size and maturity of the follicle, the reproductive tract of the mare is "palpated" (to palpate means to touch or feel). Usually when a mare is palpted an ultrasound is used to actually view the follicle. The follicle can then be measured and recorded.

Here's a picture of one of our portable ultrasounds. This is the same ultrasound we use for pregnancy determination in mares.

This is a great picture of a large follicle. The round, black structure on the ultrasound screen is the follicle. This follicle measure ~49mm.....a good size for breeding.

Ultrasounding or sonogramming or palpating a mare

Every other day or daily palpations/sonograms begin when a mare first shows signs of heat. Typically, I will order semen when a mare has a 35mm-40mm follicle......depending on the mare, breed of mare and availability of semen. The semen is ordered and shipped either overnight or on a airplane. I will usually give the mare an injection of an ovulatory medication to ensure she ovulates when I want her to.....which is hopefully 12-24 hours after she is bred.
The picture below shows the supplies used to inseminate a mare. Sterile OB pipette, sleeve and lubricant. If the semen was not shipped in a syringe, it is transferred to a syringe for insemination.
Inseminating a mare.

After the mare is inseminated, I save a small sample of the semen to evaluate under a microscope. The two main criteria used to evaluate cooled semen are total sperm count and sperm motility. The recommended total count for breeding a mare with cooled, transported semen in 1 billion spermatozoa. Hopefully, the breeding farm collecting the stallion will send the sperm count data with the sample. Just as important or more so, though, is the sperm motility. Motility is defined as forward, progressive movement of a sperm cell. In other words, it does no good for sperm to be circling or going backwards. These sperm are not healthy and are infertile. we like to see motility of greater than 50% with cooled, transported semen. For evaluating semen, we have a video microscope which has a small screen for viewing the sperm. This type of microscope allows better determination of motility plus clients can see what we are seeing when evaluating a semen sample. We love this piece of equipment. And while you can certainly use a traditional microscope for evaluating semen, years ago we splurged and bought this "toy"!

Videomicroscope. The semen sample is placed on a slide which is placed on the microscope stage which is the blue box-like unit on the right. The sperm cells are seen on the screen as white dots or flecks. And voila'....here's a video of live, cooled, transported semen received via UPS from Texas at 24 hours old. This is a good sample of cooled, transported semen....(and one of the main reasons I wrote this blog.....I videoed this sample using my Flip video recorder while the sample was on the videomicroscope......isn't technology grand!!)

Artificial Insemination from the Stallion's Veiwpoint

2011-03-01T13:38:00.000-06:00

Earlier this spring, I wrote a blog about artificial insemination in mares. This blog will detail the steps involved in collecting semen, evaluating and processing semen from a stallion for artificial insemination. This picture shows our equine semen lab which contains all our equipment for collecting stallions and breeding mares.

Most of the stallions we collect at the Arthur Veterinary Clinic are trained to jump or mount an artificial dummy or phantom. Some stallions require a mare in heat to tease or become aroused. Other stallions need very little teasing to approach and jump the dummy. For the stallion that has never been collected, a mare in heat is placed alongside the dummy. Most stallions are very trainable and adapt quickly to jumping the dummy and being collected with an artificial vagina. Below is a picture of our equine dummy or phantom.

Equine semen if very sensitive to temperature changes. When handling equine semen, it is very important not to temperature shock the semen. Therefore, any supplies or equipment which come into contact with the semen must be at body temperature (98.6 degrees Fahrenheit or 37 degrees Celsius). We have two large incubators which keep all supplies and extender at a warm, toasty temperature of 98.6 degrees!

Collection of the Stallion

Semen is collected from a stallion with an artificial vagina (AV). There are several types of AVs used to collect stallions. Pictured below is the Colorado Model which we use at the Arthur Veterinary Clinic. Basically, an AV consists of an outer casing which houses some sort of liner. Attached to the liner is a bottle which collects the semen. We use a baby bottle liner (used for infant baby bottles) inside the collection bottle. This allows us to discard the liner after collection and reuse the bottle without washing the bottle. A filter is placed inside the liner in the bottle to separate any gel and debris from the collected semen. We place a beverage can "huggie" around the collection bottle to maintain the temperature.

The AV is then filled with warm water. The temperature of the water used to fill the AV and the amount of water used varies depending on the individual stallion. After the AV is filled, the inner liner is lubricated with non-spermacidal gel.

When the AV is assembled and lubricated, the stallion is then brought to the breeding area. The stallion's penis is washed with warm water and he led to the dummy. As he mounts the dummy, the AV is placed on his penis.

Once the stallion has ejaculated, the water is drained from the AV and the collection bottle is removed and taken into the semen lab where the filter is removed and discarded.

Evaluating the Semen

Once the semen is collected and the filter is removed, it is important to either place it in an incubator or on a warming plate to maintain the temperature. Here is a picture of semen being poured from the liner into a cylinder placed on a warming plate. The volume of semen is measured and noted at this time. The two main parameters measured when we collect equine semen are motility and concentration. Motility is an objective measurement taken by viewing the semen on a microscope. Motility is defined as forward, progressive movement......meaning the sperm should be moving in a forward direction, not spinning around in circles. Motility is vital to fertility. Without good motility, a stallion will not achieve pregnancies. In other word, a stallion can have a 100% live sperm sample with a high sperm count but if the sperm are not moving in a forward direction, he will be infertile. Motility is expressed as a percentage. Ideally, a fresh sample will have 70% or greater of forward, progressive sperm. Below is a picture of our videomicroscope used to analyze semen. A videomicroscope is a microscope attached to a video screen to allow better visualization of the semen......and it also allows clients to see the sample.

The next parament measured is the sperm concentration. We use the densimeter manufactured by Animal Reproductive Sytems.
A small sample is placed in the densimeter which then determines the concentration of sperm.

(We have a polite densimeter......"one moment please"....)

The concentration is expressed as a number per volume of sperm which is reported as X million sperm per milliliter of volume. This number is variable depending on the stallion. It can range from very low 50 million/ml (or lower) to very concentrated 350 million/ml (or higher). For the most part, the higher the concentration the better. For maximum fertility, very dilute semen must be centrifuged to increase concentration. And, believe it or not, the large draft stallions tend to have the lowest concentrations or the most dilute semen.
Once the concentration is obtained, then the total volume collected and the motility concentration is entered into the densimeter to obtain to the total number of sperm. The total number of sperm determines how many mares can be bred with a single collection sample. Here is a picture of Dr. Scott entering motility and volume data.

Packaging the Semen

When packaging equine semen, we always use extender. Basically, semen extender is full of nutrients which allows the semen to live longer and stay healthier while it awaits deposition into the mare's reproductive tract. Its kinda like a "energy bar" for sperm.....except in liquid form and they bathe in it! There are several different brands of commercially prepared extender. We prefer the INRA brand. And remember, the extender must be warmed to 98.6 degrees before being added to the semen.

Depending on whether the semen is going to be used immediately, on farm, or cooled for transport, the densimeter goes on to calculate the volume of extender and the volume of semen needed to package together for a breeding dose. 500 million sperm are used for on farm breeding while 1 billion sperm are used for cooled, transported semen.
The last step in packaging the semen is mixing the proper amount of extender with the proper amount of semen. The breeding doses are either packaged in whirlpac bags or syringes. If breeding on farm, the sample is immediately inseminated in the mare. If the semen is being cooled, it is placed in a specialized container which cools the semen at a specific rate and then maintains that temperature. Below is a picture of an Equitainer shown with the specialized coolant can. This picture is of a disposable shipping container.
These containers are then sent either overnight with FedEx or UPS or sent the same day via an airplane. If we are sending semen on an airplane, we call ahead for flight times. We have someone drive the shipping container to the airport located at the University of Illinois and purchase a cargo ticket for the shipment. Since the attacks on September 11th, only cargo shipments from "approved shippers" are allowed. The Arthur Veterinary Clinic is an "approved shipper" on American Airlines.
Reading this blog, you may think that this process takes forever. However, when collecting an experienced stallion, the whole process from start to finish takes around 20-30 minutes. While there are several steps involved, it takes much less time than it did for me to write this blog!

Equine Twins

2011-02-28T20:39:00.000-06:00

Unlike many other species, multiple births or twins are not desirable in horses. Because a mare's uterus is not designed to carry twins, when a mare becomes pregnant with twins, she will either undergo early embryonic death of both embryos before 60 days of gestation or carry them to 7-8 months and then abort the fetuses. Rarely does a mare carry and delivery full term twins. If they do give birth to twins, the foals are usually either dead or very weak and die within 3-4 days. Birthing complications and retained placentas are much more common when mares abort or give birth to twins. There are cases of healthy equine twins being born, but these cases are rare.

This is a picture of our equine reproductive ultrasound. We have two of these units at the clinic. We use these both in the clinic and on the farm to examine a mare's reproductive tract.

Before the advent of the ultrasound in equine medicine, the number of mares producing twins was unknown since they will normally loose these pregnancies early in gestation. Now, with an ultrasound, we can diagnose pregnancy in a mare as early as 14 days after ovulation. Because of this, we can diagnose twins very early in the pregnancy. If twins are picked up on an ultrasonic scan, one embryo can be manually crushed or eliminated. This allows the other embryo to grow and develop normally. This procedure must be performed early in the pregnancy.....before 18 days is ideal. And, the procedure should be performed by an experienced veterinarian. Because we deal with many draft mares and draft type crosses, we commonly pick up twins on the ultrasound. We have become very proficient at successfully reducing twin or even triplet pregnancies to a single pregnancy. We usually see 2-3 mare each season with triplets.

Below is a picture of a sonogram on a Belgian mare, performed by Dr. Scott Nebergall, of a mare who actually had quintuplets....yes, that means 5 embryos! This picture only shows three of them (black circles)....I could not get all 5 on the screen at the same time. This is a record for us at the Arthur Veterinary Clinic.

CEM

2011-02-28T12:21:00.000-06:00

On December 15, 2008, the state of Kentucky confirmed that a quarter horse stallion was positive for Contagious Equine Metritis or CEM. CEM is considered a foreign animal disease in the United States. It was first discovered in Europe in 1977. Because stallions being imported into the United States must be quarantined, tested and treated before being released into the country, CEM has only appeared twice outside the quarantine stations. In 1979, there was an outbreak. And in 2006, three Lipizzaner stallions imported from Eastern Europe tested positive after their arrival but before they had been used for breeding.

What Is Contagious Equine Metritis?
CEM is a sexually transmitted disease among horses caused by a bacteria Taylorella equigenitalis. Clinical signs may include a mucopurulent vaginal discharge, abortion and infertility. Stallions typically show no clinical signs. Stallions and mares can become chronic carriers of CEM and be sources of infection for future outbreaks. The transmission rate is high and occurs by natural mating. However, contaminated instruments and equipment used for artificial insemination can be an indirect source. The bacteria can also be spread via semen collected for artificial insemination. The disease is treatable with disinfectants and antibiotics.

The last report I read states that the USDA has identified 19 positive stallions and five positive mares. An additional 904 horses have been exposed to CEM. An exposed horse is one that was bred to a positive horse either naturally or via artificial insemination. A horse can also be deemed exposed if epidemiologically linked to a positive horse. State and Federal health officials have conducted the investigation by examining the breeding records and movement history of each infected horse to find other exposed animals. At each step, any exposed animals are quarantined, tested and treated. Owners of exposed horses are contacted by State or Federal animal health officials. There is no need to have your horse tested if you have not been contacted.

These 928 horses are located in 48 states. Exposed mares must have three negative cultures taken 3 days apart. Even if the exposed mare tests negative, she then must go through 5 consecutive days of treatment. Exposed stallions must also be cultured. After a negative culture is determined, the stallion must naturally breed two test mares and the mares must be then cultured. The exposed stallion is then treated for five consecutive days. The culturing, treating and test breeding must be done by an accreditated veterinarian and overseen by a USDA/APHIS veterinarian. While the majority of exposed horses will end up being negative, you can see why this investigation will take a long time because of the prolonged testing and treating that is required. Because of the expanse of this investigation, the source of the outbreak has not been identified. However, State and Federal animal health officials continue to pursue all information obtained from this outbreak.

I was involved in the testing of an exposed mare. While the entire procedure went smoothly and the mare was negative, it was expensive and time consuming. However, as costly and involved as the testing efforts of exposed horses are, they are crucial due to the potentially even more costly consequences to the equine industry and government if CEM becomes established throughout the US and Canada.

Digital Radiography

2010-07-28T14:45:00.000-05:00

Digital Radiography for Horses

at the

Arthur Veterinary Clinic

Digital Radiography, otherwise known as DR, is very similar to a digital camera. It gives us the ability to have "instant x-rays". Just as a digital camera no longer uses film to capture pictures, DR no longer requires x-ray film. Instead, our DR unit uses a laptop computer to capture our x-ray image. This allows us to obtain clear, superior images in a matter of moments. We no longer have to develop the x-ray, instead we are able to view the x-ray instantly. With the x-ray displayed on the laptop screen, we have the ability to magnify and adjust the image, giving us greater detail and accuracy for our diagnosis and treatment.

Another advantage of the DR system is its compactability which allows us to obtain x-rays at a farm or stable instantaneously without making the trip back to the clinic to develop the x-rays.

This is a photograph of our DR unit. The yellow piece of equipment is the x-ray generator which emits the x-ray beam. The blue plate (connected to the generator) receives the x-ray and transmits the image to the laptop on the cart. The blue plate replaces the x-ray film.

In addition to improved quality and reduced processing time, DR allows us to store images on CDs or thumb drives and to share with colleagues either electronically by email or by posting on a secure website. Each evening, all x-rays taken are stored on a hard drive at the clinic and sent electronically for off site storage, back up and archiving. This off site storage allows for secure viewing of the x-rays via the internet.

This is a photograph of a digital radiograph being taken of a horse's cannon bone or front leg.

This is a photograph of the actual digital x-ray image as seen on the laptop.

Along with the DR unit, the Arthur Veterinary Clinic also has a digital ultrasound unit for use on horses, dogs and cats. Ultrasound is a great compliment to x-rays and allows us to obtain 3-D images of dog and cat abdomens, equine tendons and soft tissue swellings. Whether we are looking a bladder for possible stones or scanning the entire abdomen, ultrasound is a diagnostic test which we use frequently at the AVC. Just like DR, digital ultrasound lets us store images on a CD, thumb drive or email electronically.

Cancer Eye in Horses

2010-01-18T09:37:00.001-06:00

Cancer Eye in Horses

In horses, tumors of the eye, skin and genital system are most common types of cancer seen. Cancer Eye is the common phrase used when a horse has a tumor or cancer in the eye, eyelid or conjunctiva. Unfortunately, these types of cancer are usually squamous cell carcinomas (SCC) which are malignant. Occasionally, this type of cancer can be a sarcoid which is not malignant.

Squamous cell carcinoma tends to occur in older horses with lightly or non-pigmented eyelids. Appaloosas and draft breeds tend to be most commonly affected with SCC. The eyelids, conjunctiva, third eyelid (nictitating membrane) and corner of the eye are the common areas. Usually, the horse develops a clear to cloudy discharge from the eye. The tumor is usually pink and fleshy in color and can be seen protruding from the eyelid or conjunctiva.

Treatment should involve surgically removing the tumor is possible. Follow up treatment includes "freezing" the tumor site or applying liquid nitrogen to the area to kill any remaining tumor cells. If the cancer cannot be excised, prescription ointments to kill the tumor can be used.

Unfortunately, SCC is malignant and can invade the tissue and bone surrounding the eye. Many times, the cancer will recur even after excision. Enucleation or removal of the entire eye is necessary in advanced cases. If you see an abnormal discharge or pink like growth from your horse's eye, you should call your veterinarian for an examination.

Below are pictures of a Belgian stallion with squamous cell carcinoma of this third eyelid. The third eyelid is an eyelid which is located in the middle corner of the eye and covers the entire eye when needed. It is used to protect the eye. The tumor is visible as the pink, raised mass in the middle corner of his eye. I excised this tumor and used cryosurgery after the excision to kill any remaining tumor cells.

Riverdance & Roxy

2010-01-02T11:02:00.005-06:00

January 1st means the beginning of foaling season.......seems too cold and too early to think about that, though!

Thought I would share a picture of a "Roxy", an Oldenburg filly, who was born at the Arthur Veterinary Clinic on May 5th, 2008. Her owner, Chrissie Moran, sent me a picture of her at 18 months! Its great to be able to see these "youngsters" as they grow up! Thanks Chrissie!

Roxy at 18 months of age

Roxy and her mother, Riverdance shortly after birth.

Roxy and Riverdance

Best Wishes for the Future!

2009-12-17T11:38:00.003-06:00

For those of you who haven't heard, Dr. Scott Nebergall is leaving the Arthur Veterinary Clinic to take a position at the Krause Veterinary Clinic in Armada, Michigan. Dr. Scott's last day is December 23rd. While we will miss him dearly at the Arthur Veterinary Clinic, we wish he and his family the best of luck.

Dr. Lisa and Dr. Linda are alive and well and are looking forward to treating and caring for all of Dr. Scott's clients and patients!

Good luck Dr. Scott!!

Paws with Claus

2009-12-17T10:30:00.009-06:00

Paws with Claus was a Great Success!

We raised $300 for Moultrie & Douglas County Animal Shelters

A special thanks to Elmer Harmon as Santa and all of Santa's Helpers:

Jeannie, Monica, Staci, Eve & Dr. Linda

Thanks also for Everyone who donated to the Shelters!

Keep Your Pet Healthy During the Winter Months

2009-11-17T10:22:00.013-06:00

As we approach the colder months and the Holiday season, it is important to remember some dangers pets face during this time of year.

Antifreeze

Most antifreeze contains ethylene glycol as an active ingredient which is toxic to animals. Antifreeze has a sweet taste. Because of this, dogs and cats will drink it. Antifreeze can be lethal, causing permanent, fatal kidney damage. Keep pets away from any spilled antifreeze or containers of antifreeze. Even antifreeze that has been diluted in the car's radiator can have enough toxic ethylene glycol to be fatal to your pet. If you suspect your pet has ingested antifreeze, call your veterinarian immediately.

Dietary Indiscretion and Pancreatitis

We all like to include our pets in Holiday meals along with the rest of the family. However, keep in mind that sudden, rich, high fat diet changes are likely to upset your pet's stomach. In general, any food your pet is not accustomed to eating has the potential to trigger intestinal upset. Foods too rich, too fatty or too spicy can all be the culprit. For some animals, the snack you sneak can trigger a serious, life-threatening illness called pancreatitis or inflammation of the pancreas.

No Bone about this One

Even the largest and heartiest of bones can splinter and irritate the intestinal lining of your favorite pet. While most of us know that poultry bones are unsafe, knuckle bones do tend to stand to vigorous gnawing. Regardless, always, always, always supervise your dog's chewing!!

And, for those pooches who prefer to eat bones rather than just chew on them.....you guessed it.....your safest bet is to avoid bones all together!

Chocolate

With leftover Halloween candy and Thanksgiving and Christmas around the corner, many of us have more chocolate around the house than at other times. The first problem with chocolate is the fat. Remember, in the case of pancreatitis, it is the fat that causes the problem. This can lead to severe vomiting, diarrhea, dehydration and abdominal pain. In the case of chocolate toxicity, theobromine is the toxic ingredient. Theobromine can cause vomiting, diarrhea, hyperactivity, tremors, seizures and cardiac arrythmias which can be fatal. Clinical signs usually occur within 6 to 12 hours of ingestion. The more chocolate liquor there is in a prodcut, the more theobromine is present. This makes baking chocolate the worst for your pet, followed by semisweet and dark chocolate, followed by milk chocolate, followed by chocolate flavored cakes and cookies. The effects of chocolate are proportional to the amount of chocolate ingested versus your pet's body weight. Remember, it takes nearly 4 days for the chocolate to work its way out of a dog's system. If the chocolate was just eaten, call your veterinarian immediately. If is possible to induce vomiting to rid the stomach of the toxic effects of chocolate.

O Christmas Tree

The Christmas tree is full of dangers for both dogs and cats. Tinsel, along with yarn, ribbon or string is certainly an appealing play toy for any pet. When ingested, it can twist and tie up the intestines. Ornaments, too, are extremely dangerous in the mouths and stomachs of pets. The water at the base of the Christmas tree can contain secretions of fertilizer and nasty bacteria that can cause serious health problems for our pets. Light strings and electrical cords are dangerous when chewed. So, use common sense when you are decorating and make sure your pet is supervised when around these items.

One of the most important parts of winter and Holiday preventative care is knowing what to do in an event of an actual emergency. Be sure and have on hand the after-hours or emergency number for your veterinarian. Also, the ASPCA (Animal Poison Control Center has a hotline: 866-426-4435 for questions and concerns about toxins or poisons your pet many ingest.

Umbilical Hernias in Puppies

2009-11-02T12:14:00.000-06:00

A hernia is defined as a protrusion of tissue or an organ through the wall that contains it. Hernias can occur at different locations on a dog's body. An umbilical hernia is a hernia at the umbilicus which is where the umbilical cord attached to the fetus or newborn puppy. To relate to people, your umbilicus is your belly button. Because of a genetic defect, the body wall fails to close at the site of attachment of the umbilical cord, resulting in an opening in the body wall and outpouching of the skin.

An umbilical hernia can vary in size to very small (2-3mm) or very large where a large defect or hole can be felt in the body wall. For the most part, the outpouching of skin contains fat from the abdomen. However, if the hernia is large, the outpouching can contain intestines.

This is a picture of a small umbilical hernia in a puppy. This hernia contains abdominal fat.

Most umbilical hernias are congenital which means present at birth. And, in dogs, umbilical hernias are thought to be hereditary.....meaning passed to the offspring from parent's genes. While most umbilical hernias are not life-threatening and do not cause symptoms, large defects which contain intestinal contents should be surgically repaired to prevent damage to the intestines. If the hernia is small and contains only abdominal fat, it can be surgically repaired when the pet is neutered.

Because umbilical hernias are hereditary and undesirable, puppies born with hernias should be spayed or castrated and not used for breeding.

Sweeney in Horses

2009-10-17T15:13:00.000-05:00

Sweeney is the common name for shoulder atrophy (shrinkage or wasting) in the horse. The muscle atrophy is caused by damage to the suprascapular nerve which innervates to the infraspinatus and supraspinatus muscles. These muscles are found on the scapula or shoulder blade of the horse, on either of the spine or bony ridge of the scapula. When these muscle atrophy, the shape of the scapula becomes noticeable by the hollowing on each side of the spine of the scapula. The pictures below illustrates the loss of muscle on the shoulder blade and the distict spine of the scapula.

The nerve damage is commonly caused by horses colliding with other horses or objects.....ie stall doors, trees...etc. Nerve damage is also caused by ill fitting work collars putting pressure on the nerve. This is seen in horses which are used to pull wagons, carts and freight.

Pain may or may not be present in the affected limb. As the muscles atrophy worsens, the horse may have difficulty extending the forelimb. Also, horses may swing their shoulder out due to instability or loosening of the shoulder joint from lack of muscle and ligament tone.

Treatment of sweeney involves anti-inflammatories and physical therapy. Nerves can heal and possibly even regenerate if the injury is not too extensive and enough time is allowed. Muscle massage and electrical stimulation has been used. For cases with extensive scarring, surgery can be performed to release the nerve and hopefully regain function. In the case of a poorly fitted collar, rest and a properly adjusted collar is indicated.

The Wonderful World of Draft Horses Part II

2009-10-03T09:32:00.018-05:00

In the last blog, I discussed some general characteristics of draft horses and the Belgian breed. This blog, I will discuss the other two major draft breeds: Percherons and Clydedales.

Percherons

The Percheron horse originated from France in the province of Le Perche, located about 50 miles southwest of Paris. Traditionally, the Percheron breed was a breed of greys. Used as a war horse, the French Knight is almost always seen on a grey or white horse. When the day of the war horse was over, Percherons were used to pull heavy stage coaches in France. These horses could trot 7-10 miles per hour with the endurance to perform day in and day out. The light colored greys and whites were easily seen at night and thus preferred. When the railroad replaced the stage coaches and horses began to replace oxen in agriculture, the need for a heavier draft horse grew. The breeders of Le Perche complied. From war horse to light draft coach to heavy draft, the Percheron breed was developed.
This picture belows show two teams in exhibition. Note the one team is a team of black Percherons and the other team is a team of greys.

Percheron gelding being driven in the Ladies cart class.

Just as other European draft horses, the Percheron breed was heavily imported into the US in the 1870s and 80s. The current Percheron Horse Association of America was formed in 1905. The number of registrations grew until the 1940s and WWII. The low point in Percheron registrations came in 1954 when just 85 head were recorded. Just like the Belgian breed, a handful of breeders persisted and Americans rediscoverd the usefulness of the draft horse. Since then, the Percheron breed has seen a resurgence in its numbers and value.

While greys and dapples are still commonly seen, the Percheron breed is noted for its coal black color. The picture below is a grey Percheron mare.

Clydesdale

The Clydesdale breed originated from Scotland in the district of Lanarkshire. As with the other European draft breeds, these horses were originally developed for use in warfare to carry knights into battle. A heavier breed was needed to carry armor-clad warriors to war. When the need for war horses declined, the Clydesdale horse was bred not only for agriculture but for heavy haulage in the coalfields of Lanarkshire. The Clydesdale breed flourished in the late 19th century leading to large numbers of exports into Australia, New Zealand, Canada and the United States. Today, the Clydesdale is virtually the only draft breed in its native Scotland. The picture above is "Samurai" owned by Dr. Linda-first place gelding and 1st place American Bred Gelding at the National Clydesdale show.

A clydesdale halter class.

The modern Clydesdale stands between 16 and 19 hands, weighing in from 1600 to 2200 pounds. The Clydesdale has a very distinctive look with its most common color being bay. A large amount of white on the face and four white stockings with the long white "feathered" legs create a vivid picture. The feather is the long silky hair on the legs that flow to the ground. Other colors in the Clydesdale breed include black and roan. The Clydesdale Breeders of the United States incorporated in 1879 to register and preserve the pedigree of the Clydesdale Breed.

So, now you know about the characteristics of the three major draft breeds: Belgians, Percherons and Clydesdales. If you are interested in seeing more of the draft breeds or perhaps even owning a draft horse, I encourage you to seek out breeders and exhibitors in your area.

More information can also be found on each of these breed registeries websites:

http://www.belgiancorp.com/

http://percheronhorse.org/

http://www.clydesusa.com/

Thanks again to Kelly Woodbury for letting me use her pictures!

And also, thanks Janine Gregg for the use of your pictures! Great job, ladies!

The Wonderful World of Draft Horses

2009-08-30T23:13:00.001-05:00

As you can tell if you've read this blog, we are draft horse enthusiasts here at the Arthur Veterinary Clinic. I was raised with Belgians on a farm near Arcadia, Indiana. Dr. Linda breeds and shows Clydesdales and Dr. Scott and his brother, Gary (my husband) have bred and shown Clydesdales, Percherons and Belgians. The Arthur Veterinary Clinic has a large client base of draft horse owners.

August and September are busy months if you show draft horses since many state fairs in the Midwest have large draft horse shows. And, the Indiana State Fair has one of the largest. On a personal note, I have just returned from spending 15 days at the Indiana State Fair helping run the draft horse show. I am the third generation of Ellers to be on the show committee. My grandfather, my father and my brother have all been involved with the show continuously since the 1950s. And, my other brother has been an announcer and I have two nephews which also help with the show.

The five major breeds which make of draft horses are Belgians, Percherons, Clydesdales, Shires and Suffolks. I will limit this discussion to Belgians, Percherons and Clydesdales which each have their individual breed registries. This blog will focus on Belgians and I will follow up with Percherons and Clydesdales on the next blog.

The draft breeds originated from Europe. They are known for their gentle disposition and drafty size which allows them to excel at farm work, pull large wagons and freight. With the advent of mechanization after World War II and the introduction of the small, rubber tired tractor, the draft breed numbers declined significantly. However, over the decades, long time breeders have persisted despite the use of tractors. Other equine lovers discovered the usefulness of the draft horse, using them on non-farm tasks. Horse shows and state fairs began to welcome the gentle giants and the draft horse industry has continued to flourish. Artificial insemination, cooled transported semen and embryo transfer are used frequently in draft horse breeding.

While the majority of draft horses are located in the Midwest and east central Canada, they are popular throughout the US. A major driving force behind the draft horse industry are the draft horse shows. A draft horse show usually consists of two parts: the halter or conformation classes for purebred draft horses and the hitch or performance classes. Most large shows have separate classes for each breed while the smaller shows and county fairs may combine all breeds in a class.

Halter classes are shown by age....for example, all the yearling mares will compete against each other. Typically, the show will crown a junior champion stallion and mare (2 years and under) and a senior champion stallion and mare (3 years and over). From these winners a Grand Champion mare and a Grand Champion stallion will be awarded. Most shows then go on to choose a Best of Breed.

Hitch classes involved horses in harness pulling either a show cart or a wagon. A show cart is usually pulled by one horse, whereas the classes pulling a wagon are teams, unicorns (three horses), four and six. Occasionally, an event will host an eight horse hitch class. Over the years, geldings have been commonly used in the hitch classes. However, the last 10-15 years has seen an increase in the number of all mare hitches which has resulted in separate classes for gelding hitches and mare hitches. If you have never been to a draft horse show, I encourage you to attend a hitch show. Watching these hitches thunder around a ring, decked out in show harness and a show wagon will give you goose bumps.....I guarantee it!!!

Belgians

The Belgian horse originated from the country of Belgium. Belgians are typically sorrel colored with a light or white mane and tail, varying amounts of white on their legs and a stripe on their forehead. They can also be blonde or chestnut. Today's Belgian is a big, powerful horse that retains the drafty middle, a deep, strong foot, a lot of bone, the heavy muscling and amiable disposition possessed by the early Belgians. His qualities as an easy keeper and a willing worker make the Belgian a favorite. The modern Belgian possesses an animated gait and hitch horses must be up headed and high stepping. At this time, Belgians outnumber all the other draft breeds combined.

The is a picture of Dr. Scott and Gary showing the first place aged yeld mare at the NABC VI. Notice that Dr. Scott is on the lead and Gary is the whipman. When the horse is lead before the judge in a halter class, the whipman trails the horse. In this picture, he is seen in front of the horse to help with the headset when standing before the judge. In halter classes, mares have their tails tied up but not their manes braided. Stallions and geldings have their tails tied up and their manes braided with rosettes. Mares manes are braided for hitch classes.

A winning eight horse hitch

A "sea" of hitch horses.

The six horse hitch class at the NABC VI

Indiana State Fairgrounds

Men's Cart Class at the NABC VI

Four Abreast Class at the NABC VI. This is a very exciting class!

Here is a video of a an eight horse hitch class

Next blog, I will discuss Percherons and Clydesdales.....plus have more great pictures! Thanks to Kelly Woodbury for letting me use some of her pictures from the shows!.

Update on Miss Millie Mae

2009-08-10T00:58:00.004-05:00

Miss Millie has found a home! She actually has been with her new owner for about 3 weeks. She is doing great and last I heard was sleeping beside the bed. Wonder how long before she's sleeping in the bed!

Mites, Mange and Creepy Crawly Things

2009-07-21T17:53:00.000-05:00

When we refer to "mange" in dogs and cats, we are usually referring a mite infestation of the skin. The two most common skin mites found in dogs are Demodex canis (canine demodicosis) and Sarcoptes scabiei (canine scabies). I am going to limit this blog to these two types of mites.

Canine Demodicosis

Demodex mites live and fed in the hair follicle and oil glands of the skin. Many dogs have small numbers of Demodex mites in their skin without causing any problems or clinical signs. Demodex mites can cause clinical signs when the host dog is immunocompromised and the mites can reproduce into large numbers. Clinically, demodicosis can present in two form: localized and generalized.

Localized demodicosis occurs in dogs less then two years of age who show signs of irregularly shaped, mildly irritated areas of hairloss. For the most part, the skin is usually not inflammed and only mildly pruritic (itchy). Many cases of localized demodicosis will resolve spontaneously without treatment. Prognosis for this form is good. In contrast, generalized demodicosis is a severe disease. Dogs with the generalized form usually have secondary bacterial infections with systemic disease including lymphadenopathy (enlarged lymph nodes), lethargy, fever and cellulitis. Generalized demodicosis is usually seen in adult dogs with an underlying immune or systemic disease. The underlying disease must be diagnosed for treatment to be effective. Unfortunately, these cases can be difficult to cure.

For the most part, Demodex mites are not considered contagious. However, if a mother has Demodex mites present on her skin, the mites can invade the newborn puppy immediately after birth. If the pup has a normal, healthy immune system, the pup should be able to eliminate the mites. Because of this, young dogs showing clinical signs of demodicosis may have a hereditary predisposition for demodicosis and should not be used for breeding.

Diagnosis

Diagnosis of canine demodicosis is made by perfoming a skin scraping on the affected areas and identifying the demodex mite under a microscrope. This is a picture of a demodex mite.

Note the elongated, cigar-shaped mite with eight legs. Demodicosis is rare in cats but can occur.

Treatment

Canine demodicosis has been successfully treated with whole body dips. Some of these dips are no longer on the market. Oral ivermectin is successful in treating demodectic mange but should be used cautiously and under the supervision of a veterinarian. Antiparasitic therapy must be continued for 2 consecutive negative skin scrapings.

Canine Scabies

In contrast to Demodex mites, Sarcoptes mites are highly contagious by direct contact between dogs. These mites burrow tunnels into the skin to lay eggs, causing intense pruritis (itching), inflammation and hairloss. The Sarcoptes mite is round, without a distinctive head and they have four pairs of short legs. Sarcoptic mites can infest people causing intense pruritis in pet owners!Dogs with Sarcoptic mites may have raised papules on their skin which develop into thick crusts. Secondary bacterial and yeast infections may result leading to chronic, generalized disease with severe skin thickening if left untreated.

Here is a picture of a dog with Sarcoptic mites. Note the reddened, scabby appearance of the skin especially on the pinna (ear flap) of the ears. Sarcoptic mites commonly inhabit the ear flaps of affected dogs.

This pup was very itchy!

Diagnosis

Unlike Demodex mites, Sarcoptic mites can be difficult to diagnose from a skin scraping. These mites can be elusive leading to misdiagnosis. Treatment for Sarcoptic mites should be instituted if the history and clinical signs are suggestive.

Treatment

As with canine demodicosis, Sarcoptic mange can be treated successfully with parasitical whole body dips. Oral ivermectin is also successful in treating Sarcoptic mites but should be used cautiously and under the supervision of a veterinarian. A topical parasitical, called Revolution, is approved for the treatment of Sarcoptic mites. Secondary bacterial and yeast infections must also be treated.

So, now you know the difference between the common skin mites that cause mange in dogs. If you are like me, just the thought of these little guys make me itch!

Millie Mae-the Pup from Turkey Neck Bend Ferry

2009-07-15T21:03:00.013-05:00

Miss Millie Mae @ the AVC

This is a great story about a stray, Beagle mix puppy named Millie Mae. Monica Miller, a veterinary technician at the Arthur Veterinary Clinic and her family were staying at a bed and breakfast cabin near Thompkinsville, Kentucky. Unfortunately, they were in Kentucky for the funeral of Monica's grandmother. To reach their destination, they had to cross the Cumberland River at McMillan's Landing using the Turkey Neck Bend Ferry which is the only state funded ferry in Kentucky and one of the last remaining free-floating ferries.

Anyway, as Monica and her family were crossing the Cumberland River, they noticed a small, Beagle type pup which obviously was a stray. Monica noticed that the pup had very little hair on her legs, face and ears. Her skin was reddened and itchy. Even though the pup was being fed table scraps and junk food by the operators of the ferry, she was scrawny and thin. Plus, the temperature was in the 90s with very high humidity. What impressed Monica the most, though, was the pup's exceptionally happy attitude. I mean, we all know how dogs can have amazing, positive personalities....but this little pup really caught Monica's attention. Weighing only 7 pounds, she would approach everyone wagging her tail and wiggling her entire body as if she had the best life in the world! As Monica said, "she was perfectly happy and accepting of her lot in life". Well.......after a couple of trips across the river, Monica decided to bring "Millie Mae" back home with her to Illinois.

Millie Mae has been staying at the AVC where we have all fallen in love with her. She has been treated for sarcoptic mites, demodex mites, hookworms and roundworms. She has gained weight, grew hair and continued to demonstrate her extraordinary personality! Now, all she needs is a home. She loves people, has never made a mess in her cage and is great with cats.....be sure and watch the video. We will make sure she goes to a great home! If you are interested in adopting Miss Millie Mae, please call the Arthur Veterinary Clinic.

Thunderstorms & Fireworks & Nervous Dogs

2009-06-25T10:03:00.009-05:00

Is your dog afraid of thunderstorms and terrified of fireworks? Does he/she become increasing anxious, pacing and panting? Or perhaps your dog panics, fleeing for a place to hide? Or maybe, he/she becomes destructive? If this is the case, you are not alone. My four year old Jack Russell terrier, Scoop, exhibits some of these behaviors even before a storm is evident to me. Below is an handout I have created on Canine Noise Fears and Phobias. At the end of the article, I have included a great website devoted to animal behavior by Dr. Rolan Tripp, a veterinarian specializing in animal behavior.

Fear is a physiologic, behavioral and emotional reaction to stimuli that an animal encounters. this reaction results in an increase in heart rate, panting, sweating, trembling, pacing and possibly urination and defecation. The animal may respond by fleeing and hiding.

A phobia is an intense response to a fear.....which is out of proportion to the stimulus. Noise phobia is an excessive, unreasonable fear response to certain loud noises. It is more common in dogs than cats. It can result in all the above signs plus destructive behavior. The most common noise phobias are to fireworks and thunderstorms.

Thunderstorms

Dogs live in a different sensory world than we do. They hear and smell things which we do not. Because of this, dogs can react to the darkening sky, the drop in barometric pressure, high winds, lightening and of course thunder. So while a noise phobia may be the main issue in a thunderstorm, these other sensory occurrences can also trigger the phobia.

Fireworks

Similar to thunderstorms, dogs react to the noise of fireworks. However, they can also react to the bright glare and smell of fireworks.

Treating Noise Fears and Phobias

Many pet owners make the common mistake of trying to calm and soothe the pet when they are acting fearful or anxious. Sure seems like the natural thing to do, right?.....just like children, we want to reassure them that everything is going to be okay. Well, this actually the wrong thing to do. When you pet and reassure your dog while they are having a panic attack, this action tells them that their panicking is okay and pleasing to you. In other words, you are reinforcing their anxiety. So, the first treatment is to stop your behavior which reinforces their behavior. And I know this is difficult....just ask my husband! He wants to pickup Scoop and put him in bed with us......under the covers! (They are both afraid of storms if the truth be told)

Behavior modification and retraining can be used to treat fear of noise. Mild signs of anxiety can be overcome by having a "fireworks" party. When the first faint fireworks start, you respond happily and reward your dog with a treat. Using a happy, cheerful voice and rewarding with small food treats during every firework boom can recondition your dog. Along these same lines, using a recording of thunderstorms and rewarding your dog for good (non-fearful) behavior can relieve some anxiety and fear. As mentioned earlier, though, it can be difficult to treat some phobias because dogs sense changes in barometric pressure, wind and light. These factors can be difficult to recreate for behavior modification.

Dogs with moderate to severe phobias and panic attacks may need medication to not only reduce their anxiety but also keep them from harm....especially dogs which flee and run or dogs which become destructive. Since most state laws require a pet examination within 12 months to receive any prescription medication, you should notify your veterinarian of your pet's fear or phobia well in advance. This will allow your veterinarian to examine your pet and prescribe the best medication.

Summertime brings both thunderstorms and fireworks which can be stressful to some pets. Using these basic tips described can help relieve your dog's anxiety. However, if your pet reacts excessively or develops harmful behaviors, do not hesitate to call your veterinarian. For excellent behavior tips and advice, I recommend the Animal Behavior Network at www.animalbehavior.net which is founded by Dr. Rolan Tripp, a veterinarian specializing in animal behavior.

Saying Good-Bye

2009-06-03T20:58:00.004-05:00

My original intent was to write a blog about euthanasia. As I was gathering my thoughts, I reflected back on my feelings and emotions when I have had to euthanize one of my own pets. Because of this, I decided to write about my beloved Welsh Corgi, Ruby and tie this into the difficult topic of euthanasia and letting go........

Ruby
August 12, 1993-September 15, 2009

This blog is both a tribute to my dog, Ruby and a lesson in aging, loving and letting go. I bought Ruby as an eight week old pup in October 1993. This was the first time I had owned a Corgi. She was a delight from the very beginning. She was easily house-broken and chewed very few belongings as a young pup. Ruby accompanied me to the clinic daily. She became our "Wal-Mart Greeter" for the equine clinic. She would come and go around the clinic, never seeming to be in the way or cause any trouble. Occassionally, her instinct to herd would erupt and she would assist us in loading a horse......now mind you, she would do this from a safe distance and just bark. In 1996, she did suffer a fractured pelvis from being kicked by a colt I was getting ready to castrate. I felt terrible.....she had to spend ~6 weeks confined to a cage.

Ruby loved the snow and winter. I remember reading in a Corgi newsletter how as a Corgi owner, one had to be careful that Corgis did not develop "intestinal chills" by laying on cold surfaces and because they were built "low to the ground". I chuckled about that article as I watched Ruby lay on ice and snow rather than be in the warmth of my office. Ruby's best friend was Dr. Linda's labrador retriever, Ben. While Ruby didn't seem to care much for other dogs, she loved Ben. They were best buddies. Ben often babysat for Ruby when I was out of town.

Ruby was a loyal companion.....she followed me willingly through a difficult period in my life when I seemed to be moving every 6 months. With each new residence, she would canvas the place, sniff and search, then make herself at home. She seemed to know.....long before I did....that this phase would end.....and all would be well. I could tell she wasn't too thrilled when Gordy joined the family and then Scoop.....but she accepted these additions with quiet stoicism.

Ruby began to slow down and start to show her age around 13 years. She would become disoriented and bark for no apparent reason. While she never would jump into my vehicle (she knew I'd pick her up), she was becoming reluctant to jump out. Radiographs showed arthritis in her hips and cervical spine. I started her on a non-steroidal anti-inflammatory, Metacam and the cognitive dysfunction medication, Anipryl. These daily medication helped her immensely and she showed her old spunk.

Then, about 6 months before her death, she developed idiopathic vestibular syndrome where she would lose her balance, listing and circling. She did recover somewhat from this episode but she just never seemed herself. Her appetite began to wan and I began hand feeding her. Towards the end of her days, she developed a cough. Thoracic radiographs revealed a mass. Caring for an elderly pet taught me alot about unconditional love, patience and duty. It also forced me to contemplate human aging and the passage of time.

When clients ask me...."when is it time?" to humanely euthanize their pet, I often tell them that they will know. The morning I euthanized Ruby, I knew it was time. She wouldn't eat, she hardly moved......and she looked at me. I could see in her eyes that she was ready. And while it broke my heart, I vowed to never let one of my pets suffer because I could not bear the pain. I euthanized Ruby surrounded by my husband, Gary and Dr. Linda. She was buried next to her boyfriend, Ben at Dr. Linda's farm.

There is much information written about grief and letting go.....and how to handle emotions and feelings after the fact. The time leading up to the decision to euthanize can be very difficult. The feelings of loss, pain and maybe guilt often deter us from letting go. My belief and philosphy is that it is a final gift that we can give our four legged friends by not allowing them to suffer. Whether it be a terminal disease, a castastrophic injury or natural aging changes, I truly believe it is our duty not to let them suffer. I am a big believer in quality of life......I read somewhere it is better to let them go one week too early, than one day too late. I believe that. God bless Ruby and all of our four legged friends.

In closing, I will reprint this anonymous letter:

A Dog's Plea

Treat me gently, my beloved friend, for no heart in the world is more grateful for kindness than mine. Speak to me often, for your voice is the world's sweetest music, as I will remind you by the fierce wagging of my tail when your footstep falls upon my waiting ear.

Do not break my spirit with a stick. Though I will forgive your every human shortcoming, your patience and understanding will more quickly teach me the things you would have me learn. In return, I will rejuvenate your heart and soul by sharing with you the simpler pleasures in life.

When it is cold and wet, take me inside, for I am domesticated and no longer accustomed to the bitter elements. Keep my pan filled with fresh food and water, for though in my youth, I may appear invincible, I depend on you for my very survival.

I ask no greater glory than the privilege of being a member of your family.
I will offer you companionship and unconditional love and make you smile in your bleakest hour. I will stand by your side, ready, willing and able to protect you with my life, should you be in danger.

But when my body or mind fails me or my injuries are too severe, please remember the things that have brought me pleasure. My sense of loyalty will drive me to go on living but I do not expect you to take heroic measures to support me or to sacrifice your own needs to care for me.

You may have to make the difficult decision to let me go before nature would take me. I understand the pain you will feel but trust you who love me most to decide what is best one last time. Please let me go while my dignity is still intact and see that my life is taken gently. Carry no guilt or remorse and be at peace with your decision. I shall leave this earth knowing with the last breath I draw that my fate was always safest in your hands.

Author Unknown

A Busy Sunday Evening

2009-05-19T16:24:00.007-05:00

Sunday evening turned out to be busy at the Arthur Veterinary Clinic! The three veterinarians (myself, Dr. Linda Harmon-Dodge and Dr. Scott Nebergall) take turns being on call and handling emergencies. But many times, we all chip in to help when a real critical case comes in or more than one emergency happens at the same time. Well....that's what occurred on Sunday. Dr. Linda was on call and she called Dr. Scott to assist with a possible canine c-section. Well, much to every one's surprise, when the client arrived at the clinic, he brought two female dogs for possible c-sections. So, not to feel left out, I arrived at the clinic to help along with our assistant/receptionist, Jeannie.

Those of you familiar with breeding dogs already know that a bitch can need a c-section for different reasons. For the most part, we recommend a c-section if it has been four hours or longer between puppies or if a bitch has been in hard labor for over an hour. We also recommend a c-section if we detect fetal distress with an ultrasound. Some breeds are more prone to needing c-sections such as bulldogs, Boston terriers, chihuahuas to name a few.

A c-section is performed much like an ovariohysterectomy (spay) except the ovaries and uterus are not removed. The female is anesthetized. We adjust our anesthetic protocol when performing a c-section. You have to remember that any anesthetic given to the mother can be absorbed by the unborn fetus. It is vital that the induction of anesthesia and the delivery of the pups is performed quickly and efficiently. This greatly improves your chances of delivering live, vigorous puppies. An incision is made on the ventral midline and the uterus is exposed. The number and location of the pups will dictate where the incision is made in the uterus. Most of the time, pups can be delivered through two uterine incisions but occasionally, a third incision is needed. The pups are delivered into the waiting hands of our "neonatal team".....which incidentally can be experienced veterinary technicians, veterinary assistants, receptionists, husbands, wives and children. Everyone involved and associated with the AVC has helped deliver c-section puppies! The pups are then rubbed, stimulated and if need be, resuscitated. Hopefully, the end result is live, healthy puppies. While the neonatal team tends to the puppies, the surgeon is suturing the uterus, body wall and skin.

Our c-section party was successful! The first mother-to-be was "Caramel Sundae", a three year old Chihuahua weighing a whopping six pounds! "Caramel Sundae" had one live pup on her own late Sunday morning. On examination and ultrasound, one of the pups showed a weak heart beat. Since it had been over 4 hours since her last pup, the decision to deliver via c-section was made. Three live pups were delivered but the one with the weak heart beat did not survive. The other two pups and mother recovered nicely, though. Here's a couple of pictures of "Caramel Sundae" and her three pups. All doing well and went home later Sunday evening.

And this is "Karen", a four year old Shih Tzu weighing in at 13 pounds. Karen had whelped two live pups on her own but had also failed to have any more pups. The ultrasound revealed two live pups in Karen's uterus and since she had not shown any signs of labor for over four hours, off to surgery she went. Two more live pups were delivered. These pups were healthy and strong. Mom and brood also went home later in the evening.

So, even though we had not planned to spend Sunday evening at the clinic, it was very satisfying to deliver four healthy, live puppies!!

Hey, have you seen my panty hose?

2009-05-09T12:04:00.001-05:00

String, Thread, Fishing Line, Dental Floss, Easter Grass……..
Bet you are wondering what in the world these things have to do with a veterinary blog! Well, these are all examples of items which can be classified as “linear foreign bodies” if ingested by a pet. Most of us know that dogs and cats will eat the darnedest things. And, many of us have experienced our pets raiding the garbage resulting in vomiting and diarrhea. For the most part, these forages of dietary indiscretion are mild and self limiting. However, when I am presented with a pet that has possibly swallowed a linear object; I tend to become much more worried.
The problem with string, thread, fishing line, Christmas tinsel, dental floss, Easter grass, panty hose (yes, I said panty hose….see the story below. Caution---not for the faint of heart) is these items can anchor in the stomach or intestinal tract causing the intestine to contract down on the object and then bunch up in an “accordion” type pattern along the linear object. This is very damaging to the intestinal tract causing the loss of blood supply, necrosis and death of the intestine. As a result, peritonitis can make the pet deathly ill.
If your pet swallows any kind of object, call your veterinarian. It is possible to administer medication and/or material to help the pet pass the object. Sometimes, the only clue that a dog or cat has swallowed a foreign object is seeing it pass in the stool. If you happen to see a foreign object or string type material protruding from your pet’s rectum DO NOT PULL ON IT! In this instance, our natural inclination may be to try to remove the object from the rectal opening, however, this can further damage the intestinal tract. Call your veterinarian immediately. Medication, enemas or possibly surgery may be necessary to remove the foreign object.
During my first year in practice, an elderly couple called with a Border Terrier which had eaten a pair of panty hose. They informed me that about 12 inches of the panty hose was protruding from the rectum and even though they tried to pull it out, it was stuck. When I examined the dog, she was quite sick and toxic. I performed surgery on the little dog and removed 24 inches of her small intestine plus the panty hose. Fortunately, the surgery went well and she recovered completely but she had to endure major surgery.
As with many issues in life, prevention is the key. If you have a pet that is prone to eating things he/she should not eat, keeping these type of items out of reach is advised. A good friend of mine once gave me his child rearing wisdom which is “Either remove the child from the temptation or remove the temptation from the child”. This also excellent advice for pets!

The 20th Anniversary Open House was a Success

2009-05-04T21:20:00.012-05:00

The weather was perfect! The clinic looked great! The demonstrations were informative! We had a great crowd! Thanks to everyone who helped make the open house a success:

My Veterinarians:

Dr. Linda J. Harmon-Dodge

Dr. Scott A. Nebergall

My Staff:

Elise Singer

Eve Adams, CVT

Jeannie Belton

Justin Berry

Mindy Hodges

Monical Miller, CVT

Taylor Stone

Staci Swisher, CVT

Significant Others:

Dave & Jan Nebergall

Gary Nebergall

Larry Belton

Bob & Sharon Groves

Chris Jess

Darrell Earnst

20th Anniversary Open House

2009-04-24T17:44:00.009-05:00

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!

2009-04-15T20:51:00.016-05:00

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

2009-04-11T18:25:00.003-05:00

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

2009-04-05T21:11:00.013-05:00

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

2009-04-05T13:04:00.008-05:00

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.

Before and after: Laceration

2009-03-29T09:44:00.010-05:00

On February 28th, a client called on emergency and had a horse with a fresh laceration. The client brought the mare, "Dallas", to the clinic for me to suture the laceration. This picture shows the laceration on the left side of her thorax, just behind her elbow. The picture was taken after I had shaved her hair and cleaned the wound. Evidently, she caught her skin on a door latch going inside her stall. This is actually a very common injury. The laceration was fairly large and a "full skin thickness" laceration, meaning all the layers of the skin were lacerated. She had even lacerated the most superficial muscle layer covering her ribs. Even though these pictures do not show it well, there is a large flap of loose skin at the right edge of the laceration.

The good news was that these type of lacerations usually heal quite nicely providing they do not become infected. I would much rather have a large laceration on a horse's side, neck or head than a small laceration on a leg. Leg cuts are slow to heal due to the lack of tissue and blood supply.

After cleaning and flushing the wound thoroughly, I administered a local anesthetic to numb the area. I then, surgically debrided (removed) any skin/tissue that appeared devitalized. It is very important to excise any unhealthy tissue because unhealthy tissue can become infected tissue. I was a bit concerned about the condition of the flap of skin...however, removing the entire flap would result in a large open wound which would have to heal by second intention, meaning without sutures. So, I placed several absorbable sutures underneath the skin to close the laceration and then sutured the skin with non-absorbable sutures.

This picture shows the repaired laceration. You will notice the bottom part of the incision is left open. There was not enough healthy skin to close this area, plus leaving it open will allow drainage of fluid. After the initial "anxiety" of the tranquilization injection, Dallas stood very calmly while I sutured the laceration. She was also given antibiotics, tetanus prophylaxis and pain medication.

And voila!.....here is the laceration after approximately 3 weeks. I removed the skin sutures and a piece of dessicated, nonvital skin which was covering the pink part of the laceration. This was part of the skin flap which I was concerned about. However, this laceration looks great! There are no signs of infection and the open part of the laceration is healthy and will continue to heal. Within 4-6 weeks, there should be only a faint scar remaining!

Jack Russell Terrier

2009-03-19T20:35:00.001-05:00

Here's a bit of history on the Jack Russell Terrier "type" of dog. I say type because they do not seem to be purebred in the sense that they have a broad genetic make-up and vary greatly in size and type. There are differing opinions and often heat discussions on what constitutes a Jack Russell Terrier or Parson Russell Terrier and which is the "true" Russell Terrier. Since I am not breeding these dogs, I'm not going to get into the discussion or argument on which is which. For my part, I could care less about their size, color or pedigree. I just love their personality.

What is agreed upon though, is this "type" was developed by the Reverend John Russell in the early 1800s. Reverend Russell was well-known for breeding fox hunting terriers in Devonshire, England. From this strain developed the Jack Russell Terrier and the Parson Russell Terrier. For the most part, it is also agreed that the Jack Russell Terrier is the smaller, longer-bodied, shorter-legged dog used to hunt vermin and rabbits. They are usually 10-12 inches in height at the withers. My dogs would fall in this category.

The Parson Russell Terrier tends to be a longer-legged, square dog used to hunt or hold fox at bay. The Parson Russell Terrier is recognized by the American Kennel Club and is 13-14 inches in height at the withers.
The Jack Russell or Parson Russel is a working terrier. They are used on numerous ground-dwelling quarry and are built for work underground. (Hence, the reason my dogs are always getting in trouble!) They are meant to locate the quarry in the earth and then either bolt or hold it in place until it is dug to. (See Mom, they were only doing what they are "supposed" to do). They are bold, friendly, intelligent, athletic, fearless and vocal dogs. Because of their high energy level, they are not recommended for apartment dwellers unless the owner can provide the terrier the necessary amount of exercise and stimulation. Otherwise, they may destroy your personal belongings! These terriers are truly a big dog in a small package which can lead to trouble and injury with larger animals.

I am lucky to have a huge, fenced back yard for my terriers to run. During the winter months, they accompany me to the clinic where they hang out in my office and the clinic barn. My husband and I are amazed at how these dogs have become such a huge part of our lives. I grew up with large, outdoor only dogs and never thought I'd end up having three dogs under 15 pounds......who sleep on my bed!! Just goes to show ya! Oh yea.....they are Colts fans!

Weekend trip to the Ellers

2009-03-18T19:36:00.003-05:00

My dogs love to go to my parents farm in Indiana. Between chasing the barn cats to riding on the gator to running in the pasture to cornering critters, they are in seventh heaven. I'm not so sure my mother enjoys their "antics" as much as I do...but everyone admits that they are entertaining. A couple of Christmas ago, we spent 4 hours looking for Gordy and Scoop. We finally found them buried in a tunnel in the hay loft. We had to move 8 layers of old hay to uncover the pair. Just as I figured, Gordy had went into one of the many tunnels between the old hay in hot pursuit of a cat with Scoop close behind. When the tunnel ended at the bottom of the stack, it was two narrow for Scoop to turn around, so they were stuck. Boy did I get a dirty look from my mother on this misadventure.....! Since then, they have been banned from the hay loft. This trip, they managed to corner something in a fallen tree trunk....which, incidently had fallen over the creek. At first I was video taping them unconcerned, watching them jump up and over the tree trunk....wondering if they were going to fall in the creek. Then, the barks and growls became more aggressive and I saw blood. I hurriedly handed my camera, blackberry and flip video recorder to my sister-in-law and crawled out on the log. I grabbed Scoop by his tail and handed him to my brother and reached inside the log for Gordy (he's always the first to the scene!). I was really going to be mad if I got bit by an irate possum! All I could see of Gordy was his tail which I grabbed and pulled him out. (That's why the tail is left ~4-5 inches long to grab and pull out of a burrow). After dunking Scoop in the creek, I was relieved to see the blood was from where he bit his own lip. Guess, they are going to be banned from logs! Here's the video before I had to rescue them!

And here's another video of Gordy and Scoop digging in the pasture for "some critter".....which they never found! Talk about "Mission Impossible"! My niece, Kallie, had a great time digging with them!

Miss Kallie, Scoop, Gordy and Lannie

Since this is the Arthur Veterinary Clinic's blog and supposed to be informational, I'll post this history of the Jack Russell breed. I don't want to bore anyone with stories about my Jacks!

Coming Soon....Antics of the Terrors...er Terriers at the Eller Farm in Indiana

2009-03-16T20:41:00.007-05:00

The terriers were at it again! My husband and I traveled to my parent's farm in Indiana. Both my brothers and their families were home for the weekend. We took all three of the Jacks....they love the farm. They usually manage to get into some kind of trouble and this weekend was no exception. Below are a couple of pictures.....I'm working on splicing the video of their "highlights". Stay tuned!....

Neutering Your Pet-Part 2: Castration

2009-03-13T08:54:00.018-05:00

The last post explained the surgical procedure of spaying. This post will explain the surgical procedure of castration. But before I explain the procedure, I'll include some information about surgery in general.

Veterinary surgery is very similiar to human surgery and quite sophisticated in terms of anesthesia, monitoring and surgical instrumentation. Many of my clients express concern when their pet needs general anesthesia for a procedure. I assure them that we use very safe anesthetic agents and that their pet is connected to a cardiovascular (CV) monitor during the entire procedure. This monitor monitors the pet's ECG, heart rate, respiratory rate, blood pressure and oxygen level. This is a picture of the CV monitor.

The type of anesthetic used is a combination of injectable and gas inhalation. In other words, the pet is given an injection of sedative intravenously which enables me to place an endotracheal tube in his/her trachea through which gas anesthesia and oxygen is administered. Gas anesthesia is very safe and we are able to control the anesthetic level more accurately. This is a picture of our gas anesthetic machine.

And just like in human medicine, all our instruments are sterilized and we adhere to sterile technique during a surgery. We use a piece of equipment called an autoclave to sterilize all instruments after they have been cleaned. This is a picture of an autoclave which uses high temperative and high pressure to sterilize (kinda like a pressure-cooker).

This picture shows an instrument pack opened and ready for surgery.

Okay, on to the castration procedure.....I'm sure you are all just dying to see these pictures! Castration or orchidectomy is the surgical removal of one or both testicles. In a routine castration, we obviously remove both testicles. Unlike neutering a female, castration is not abdominal surgery.....rather, castration involves an incision made through the skin just cranial (in front of) the scrotum. This picture illustrates the skin incision.

The testicle is exteriorized (brought to the surface) through the skin incision. The spermatic cord is then ligated (tied off) to prevent bleeding and then incised to remove. The spermatic cord consists of blood vessels, the cremaster muscle (the muscle which retracts the testicle) and the vas deferens (the "tube" which carries the sperm from the testicle through the penis). These two pictures show the testicle and spermatic cord exteriorized and then ligation. Keep in mind, these are pictures of a small (9 pounds), young dog.

Just as the spay, the castration incision is closed in two layers. However, unlike the spay, I do not place any skin sutures in the incision. Instead, I place a subcuticular (just below the skin) layer of sutures (stitches) which are absorbable or will dissolve. I do this to prevent male dogs from chewing or pulling out their skin sutures.

Just like spaying, I recommend castrating male dogs and cats around 4-5 months. One of the behavior benefits of castrating a male dog at a young age is it can prevent them from lifting or hiking a leg to urinate or mark territory with urine. Other health benefits of castration include preventing prostate enlargement, infection and cancer later in life. For the most part, castrated male dogs are better behaved and less aggressive.

Neutering Your Pet-Part 1: Spaying

2009-03-11T09:07:00.026-05:00

Neutering your pet may sound like a boring topic but it is one of the most common surgeries performed by a veterinarian. The word neuter means to make an animal sterile by either spaying a female or castrating a male. This post will explain the surgical procedure of spaying.

I like to remind clients that when a female dog is spayed, this surgery is classified as abdominal surgery. In other words, I must enter the abdomen to remove her reproductive tract. The good news is, when performing abdominal surgery on a dog or cat, we do not have to incise or cut through abdominal muscles as do human surgeons. As this picture shows, we make an incision on the midline of her abdomen through connective tissue. Because of this, abdominal surgery in dogs and cats is less painful and healing is quicker.

When a female dog or cat is spayed, the ovaries and uterus are removed. This procedure is also called an ovariohysterectomy. Ovario means ovaries. Hyster means uterus. And Ectomy means to remove. This picture below shows both ovaries and the entire uterus being removed in a small, 7 pound female dog.

When suturing (stitching) incisions from this type of surgery, I typically close the incision with two layers. The first layer of sutures is the inside body wall. This layer of sutures is very important because it is the "holding layer"......meaning this layer has the strenghth to hold the abdominal organs in the abdominal cavity. These sutures are buried beneath the skin and are absorbable, meaning they will dissolve on their own. This picture below shows the absorbable sutures in the body wall.

The second layer of sutures is the skin. These sutures are non-absorbable (they are actually a type of nylon) and will need to be removed 10 days post surgery. And while it is very important to close the skin, this layer has very little "holding" ability. These pictures below show the skin being sutured and the completed surgical site.

I typically spay female dogs around 3-4 months of age. Some shelters will spay much younger. Spaying before the first heat cycle is recommended. Spaying or neutering your female dog will prevent the headaches of having a female in estrus (heat), help prevent mammary (breast) cancer, help prevent pyometra (life-threatening uterine infections) and prevent unwanted pregnancies.

Dax and Ella Grace

2009-03-08T15:05:00.005-05:00

This picture is a great picture of "Ella Grace", the Clydesdale filly and "Dax", the Great Dane. Dax is 1 1/2 years old and owned by Gary Richards. Gary imported Dax from Finland. He is seen here muzzle to muzzle with Ella Grace after a chiropractic treatment by Dr. Linda. Ella Grace is the yearling raffle filly for the Clydesale Breeders Annual Sale being held April 23-25, 2009 at the Illlinois State Fairgrounds. The Arthur Veterinary Clinic is housing and fitting the filly for the sale. Raffle tickets are available at the clinic or by calling the Clydesdale Breeders of the USA at 815-247-8780.

Yippee, Yippee!!!!

2009-03-04T15:39:00.004-06:00

Ruth's foal, Ford E., (I'll explain the E in a minute) is nursing from his mama....after 4 1/2 long days!!!

He is doing well, even trotting & bucking around the stall. We tried to tell him he'd be much happier getting his milk directly from the nozzle! Dr. Linda wanted me to explain why the foal's name is Ford E. Ford E. was named Ford because his face looks like a Hereford cow with all the white. The E. is for Elise, Eve, Elmer & Emmett. A couple of those listed are known for their stubborness!!.....this stubborness has resulted in the little bugger nursing! For those interested, the Clydesdale breed originated from the Lanarkshire district of Scotland. It was developed in the early nineteenth century and is one of the five major draft breeds now found in the US. The other draft breeds include Belgians, Percherons, Shires and Suffolks. Clydesdales are typically bay with four white stockings with "feather" (the white hair on their lower legs) and a wide white stripe on the forehead. As you can see, Ford E. is an overachiever when it comes to the white on his face!! Many thanks for all those who helped with Ford!

Does your dog have "Doggie Breath"?

2009-03-03T23:43:00.012-06:00

Did you know that tartar buildup on your pet's teeth can not only cause bad breath but can also be detrimental to their health? Periodontal disease is the number one disease in pets. Dental disease can affect pets as early as 3 years of age. And, as a pet ages, periodontal disease can affect the heart valves, lungs, liver and kidneys. Almost every day, I see a dog or cat that has severe gum disease and resulting health issues.

Before

These are "before" and "after" pictures of "Buddy", a 13 year old mixed breed dog. Notice the "gray/brown" tartar accumulation on his teeth before dental prophylaxis or cleaning. Then compare his teeth after cleaning. This tartar is removed with manual and ultrasonic scaling. The teeth are then polished. Fortunately, Buddy did not need any extractions. Many times, I see pets with severely infected gums and loose, rotten teeth which need to be extracted. The most I have ever extracted at one time was seventeen teeth in a Chihuahua. And while dogs get along fine without all their 42 teeth, proper dental care and at home brushing can prevent tooth and gum loss. And yes, I did say at home brushing of your pet's teeth. Daily brushing is recommended but even 2-3 times weekly helps. We commonly hand out complimentary "doggie" and "kitty" toothbrushes and sample toothpaste to aid in brushing your pet's teeth.

After

So remember, that "doggie" breath you notice from Fido might just indicate he has periodontal disease!

Ruth's Foal

2009-03-02T21:48:00.004-06:00

Monday, March 2, 2009

Update on Ruth's foal, Ford. Ford continues to drink his mother's milk....from a bottle. He seems so close to nursing from his mother but just can't quite get the hang of it. He's actually funny to watch because he will nudge her udder to get the milk flowing, then lets the milk run into his mouth! We continue to take turns feeding him. Although it would be easier, we hesitate to let him drink from a bucket....however, if he doesn't starting nursing from his mother, he may become a "bucket baby"!

The Three Terrors...oops I mean Terriers!

2009-03-01T16:00:00.015-06:00

I live with three terriers who keep me and my husband very entertained! We have "Gordy" who is the tri-colored Jack Russell terrier. We "acquired" Gordy in 2001 from an Amish farm because he was not big enough for the farmer. While I don't know Gordy's exact age, I'm estimating him to be about 9 or 10 years. He is very calm for a Jack and would prefer to sleep on your lap! He is also very personal.....we call him the "Walmart Greeter" at the clinic. I have a waiting list of people who would like to adopt him.

In 2005, my husband returned from a horse show in Michigan with a surprise......"Scoop"! Scoop is also a Jack Russell terrier. He is 3 years old and is very attached to my husband. He loves going to the barn and "helping" with chores. While Gordy is independent and calm, Scoop tends to be more needy.....but he is much more loyal and obedient.

And then there's "Lannie"! Our latest addition to the herd. Lannie is a 10 month old Jack Russell. She is named after Lansing, Michigan where she we picked her up at a horse show. (Seems to be a trend here....horse show...jack russell terrier!) Of the three, she is the most "Jack" like. Very independent, energetic and fun loving. She actually jumped up on this stool on her own and proceeded to spin around! I snapped this picture of her when the stool stopped spinning.

For the most part, they all three get along.......most of the the time. Scoop isn't real thrilled that Lannie has joined the family but he's getting better. Stay tuned for more terrier "antics".

Ruth's Foal

2009-03-01T13:56:00.029-06:00

Ruth is an 8 year old clydesdale mare who foaled (gave birth) at the Arthur Veterinary Clinic on Friday February 27th at 9:45pm. Ruth is owned by Dr. Linda Harmon Dodge who is a veterinarian at the AVC. She gave birth to a very large stud (boy) foal who Dr. Linda has named "Ford". Ford weighed 200 pounds and was approximately 11 hands (44 inches) tall.

For those of you unfamiliar with horse lingo, a hand equals 4 inches. Horses are measured for height from their withers to the ground. The withers on a horse are located at the base of the neck.

Dr. Lisa passing a stomach tube.

Ruth gave birth easily and Ford was a strong foal from the start. He was standing within an hour of being born. However, he has not mastered the art of nursing from his mother or a bottle. Because of this, a stomach tube had to be passed to provide Ford with his mother's colostrum. As you can imagine, this is both frustrating and exhausting since a foal should nurse every 2-3 hours.

After 12 hours of passing the stomach tube, we discovered that Ford would drink his mother's milk from a bucket. And while this is not ideal, it is better than the stomach tube.

Dr. Linda bucket feeding Ford. Ruth is making sure she is doing it right!

So, all day yesterday and last night, we took turns bucket feeding Ford every two hours. Today, he is finally starting to get the hang of nursing from a bottle. Hopefully by this time tomorrow he will be happily nursing from his mother!

Dr. Linda bottle feeding Ford

"Hmm.......what am I supposed to do?"

Mmmmm.....supper!