This is a highly technical area of veterinary medicine. For an accurate assessment you need a person with an extensive amount of training and experience coupled with the latest equipment.
Whenever we perform an ultrasound it is done by a specialist in the field called a radiologist. This means this person is a veterinarian that only does radiology and ultrasound. After regular veterinary school a person that wants to be certified as a specialist in radiology (called Board Certified) has to spend an additional 4-5 years of study.
Our radiologist comes to our practice and performs the procedure in our office. We get the advantage of a specialist without having to drive to a university or specialty center. We get the report immediately and will go over it in detail.
This is typical of a report we get on a dog’s abdomen. This dog has liver cancer. Prior to the advent of ultrasound we had to do an expensive and painful exploratory surgery to get similar information. We have the best of both worlds with ultrasound due to less expense and it is non-invasive.
Here are the ultrasound pictures that go along with this report. It is one of the lobes of the liver. The tumor is demarcated by the yellow arrows.
Here is the report that goes with this echocardiogram
Surgical removal of the gall bladder is called cholecystectomy. Most of us have heard of gall bladder surgery in people. It is not as common a surgery in animals. This page has pictures of a surgery to remove the gall bladder in a dog. At the end of this page you can see what gall stones look like.
Our patient is an 11 year old Silky Terrier that came to us with some significant symptoms. They included anorexia for several days and lethargy. Her initial blood panel showed high elevations in Alk Phos., AST, and bilirubin.
Her blood panel is typical of a dog with this problem. You can see the significant elevations in her liver enzymes and bilirubin. Even the electrolytes are abnormal.
Her urinalysis showed significant amounts of bilirubin
We could see hepatomegaly on her radiograph. Initial treatment consisted of antibiotics, fluids, vitamin supplements, and I/D food. Heather rapidly got better on the treatment.
This is what the liver looks like on an abdominal radiograph
She had a recurrence of the problem 3 weeks later. At that time an ultrasound was performed and it was determined that she had a problem with her gall bladder.
Her gall bladder, the dark area on the top left had a problem. The line in the center is measuring the size of her common bile duct, which is large in her case.
This is her ultrasound report
She responded well to treatment with antibiotics and actigoll. When her enzyme test were almost back to the normal range we removed her gall bladder.
Before we do any surgery on the liver we make sure the clotting system of the body is working well. The liver is intimately involved with the bodies clotting mechanism, and we need to make sure we are not going to encounter a severe bleeding problem during and after surgery. This test is making sure her red blood cells are adequate (no anemia is present), along with the 4 clotting tests on the bottom, starting with Prothrombin Time.
Our patient is now ready for gall bladder removal This is a specialized surgery that is tedious and requires an experienced surgeon. In Heather’s case we called in Dr. Linda Larsen, a specialist in surgery.
Dr. Larsen is a board certified surgeon, and experienced at this surgery
Monitoring of anesthesia is critical in an older pet with liver disease. Monitoring Heather’s blood pressure is an important aspect of anesthesia.
We keep a close tab on important physiologic parameters for all of our surgeries. Monitors like this give us an early warning of an impending problem.
Once our surgeon has scrubbed up and is in sterile gown, gloves, and mask, the surgery begins
The incision into the abdomen is made at a special location called the linea alba. It is here that the tendons of the stomach muscles come together, and will hold the sutures after we close the abdomen.
The swollen liver is apparent as soon as she enters the abdomen
The first thing our surgeon does is locate the gall bladder
Now the careful dissection of the gall bladder starts so it can be removed
After careful dissection it almost full exposed at this point
As dissection of the gall bladder continued she traced it down to the common bile duct. The arrow points to the gall bladder under our surgeon’s finger. The vertical bluish structure below the gall bladder is the enlarged common bile duct.
The bile that is stored in the gall bladder is removed with a suction apparatus. This allows better visualization.
When she is satisfied with the exposure she puts several very strong sutures where the gall bladder attaches to the liver
Here is the trouble maker after it has been removed
A biopsy is taken of the liver to give us substantial information as to its health
The abdomen is flushed many times to remove any contaminants
The long incision in the linea alba is sutured. After this layer, there are several more layers of sutures placed in the subcutaneous tissue and the skin.
At this point our patient is given a local anesthetic on the suture line, an additional pain injection, and the skin incision is treated with companion laser to decrease swelling and aid in healing,. You can its use on the video below.
This is a different gall bladder removed from a different patient. This gall bladder was thickened due to stones in it.
The inside of the gall bladder after removal. The chronic thickening is apparent.
These are the gall stones that were found inside of it
The pathology report on this gall bladder
This is the analysis of these stones
Return to the Canine Diseases Page.
Rabbits make wonderful pets, that need special attention from everyone in your family regarding their health
Rabbits are prone to problems of the urinary tract. These problems range from irritating sludge in the bladder, to kidney problems, to the formation of a bladder stone that needs surgical removal. Sludge is urine thickened by calcium salts to the point of being chalky and thick in consistency, sometimes as thick as toothpaste. This causes problems in the urinary bladder usually, although it can occur in the kidneys or ureters. There are many factors why a rabbit might get this problem, so it is important to address all of them.
Rabbits need routine exams to ensure their health
As opposed to most other animals, rabbits absorb almost all the calcium in their food into their bloodstream. This causes a higher than normal blood calcium level relative to other animals. If an individual rabbit is not efficient at utilizing and eliminating any excess calcium through the urinary tract, a sludge or bladder stone problem might present itself. Some of the factors we know about that might predispose a rabbit to a urinary problem with calcium include:
Genetics- Some rabbits are not as efficient at eliminating any excess calcium
Rabbits that are not good drinkers
Sedentary lifestyle- rabbits that stay in a cage all day
A diet with excess calcium
Soiled litter pan area in a fastidious rabbit
Diseases elsewhere in the body can have an effect on a rabbit’s normal physiology, disrupting it to the point that they can stop eating and get dehydrated, leading to decreased kidney function and sludge or stones in the urinary bladder. You can learn more about them in our Rabbit Diseases section. The more common ones are:
The dark round area in the center is a greatly distended stomach due to GI stasis
The severe head tilt in this rabbit could be a sign of Encephalitozoon Cuniculi
The point on this molar tooth could cause an inability to eat well over a period of time
This conjunctivitis could be an indication of Pasteurella
This is the radiograph of a rabbit with a uterus that is greatly distended. That large whitish area in the center of this abdomen is the uterus.
This is that fluid filled and greatly enlarged uterus during the surgery to remove this uterus
This male rabbit has a very large tumor in its left testicle. The surgeon is pointing to a normal sized testicle on the other side. The cancer was removed in a neuter surgery.
Urine that contains excess calcium will have the consistency of sludge. This irritates the bladder and urethra, causing significant inflammation and pain. If the problem persists long enough, a bladder stone (urolithiasis) might form.
In order to make a diagnosis of the problem in rabbits, we follow the tenets of the Diagnostic Process. This is a methodical and detailed way to approach diseases that ensures an accurate diagnosis. It includes:
Signalment- age, breed, and gender of an animal
History- what an owner has noticed at home about a pet’s specific behavior
Physical Exam- the findings from an exam by one of our veterinarians
Diagnostic Tests- What tests are used to make a diagnosis
Response to treatment- if the diagnosis is correct the pet should get better
Urinary problems in rabbits can occur in all breeds of any age or gender. Young or old, large or small, male or female, it doesn’t matter.
Symptoms are variable, depending on the duration and degree of the problem, along with the individual rabbit’s tolerance for pain and discomfort. Some of the symptoms to watch for include the following:
Urinating more than usual (pollakiuria)
Straining to urinate (stranguria)
Unable to urinate
Blood in urine
Chalky deposits on the fur in the perineal area
Moist or damp rear quarters from urine dribbling
Licking at rear quarters
Rubbing rear quarters
Skin rash in inside of rear legs or perineal area
Grinding teeth (a sign of pain)
Odor to urine
These are also the symptoms of other diseases in rabbits, so at the first sign of any of these problem you should bring your rabbit in for an exam with one of our veterinarians.
Any sick rabbit gets a thorough physical exam by one of our veterinarians. It starts with body weight and temperature, and progresses to checking your rabbit from nose to tail for any physical abnormalities. Typical findings might include:
Low body temperature (hypothermia)
Underweight (low body condition score)
High heart rate (tachycardia)
Irritation to the perineal area
Painful abdomen upon palpation
Small kidneys upon abdominal palpation
Distended bladder upon abdominal palpation
Bladder stone palpable upon abdominal palpation
Excess amounts of chalky or bloody urine when the bladder is expressed
Over the decades our body of knowledge regarding normal and abnormal values in diagnostic tests of rabbits has increased to the point that they are crucial for a proper diagnosis.
This test should be performed on all sick rabbits irregardless of the symptoms. It should also be performed yearly as part of the Wellness Exam on rabbits. These animals age rapidly, and oftentimes hide their symptoms, so it is important to have baseline normals on an individual rabbit, and to catch problems before they become entrenched and untreatable.
The blood panel in rabbits checks for a wide array of problems. It starts with a check of the red blood cells for anemia or infection. There are tests of the kidneys and liver, important organs to assess when we suspect a urinary or kidney problem in rabbits. We also check the electrolytes, and especially the calcium level.
This rabbit has blood abnormalities that can happen with a sludge problem, and also many other problems
This will check for white blood cells, red blood cells, and crystals in the urine. We also assess the specific gravity and the protein and glucose levels, in addition to looking for signs of bacterial infection.
If we suspect a urinary tract infection (cystitis) we will take a sterile sample of urine directly from the bladder and attempt to grow out any pathogenic bacteria. If they do group out, we will check many different antibiotics to find out what antibiotic that particular bacteria is sensitive to and will kill it. This report takes 2-3 days.
This pet has a Staph. infection, that is sensitive to several different antiboitics
It is important to radiograph any sick rabbit. There are a multitude of problems that can occur on the inside that are not apparent externally during our physical exam.
This is what a radiograph of a rabbit looks like. The important abdominal structures are labeled:
B- urinary bladder
Cecum- our appendix
Did you notice the spinal fracture? Without this radiograph, we would not have known this.
This rabbit is laying on its back for a radiograph. The arrow points to the left kidney because this rabbit has significant sludge in its bladder, and we wanted to assess the kidneys. Do you notice anything else?
The two lower arrows point to the different appearance of the wings of the ileum of the pelvis, which could indicate bone cancer. We would never had known this if we had not taken a radiograph.
The sludge that occurs in the bladder, and the stones that also might occur, have a large amount of calcium carbonate in them. This means that they are radiopaque, and show up vividly on an abdominal radiograph.
The small whitish area in the center of this radiograph is some sludge in the urinary bladder of this rabbit. This small amount is of no significance in a rabbit with no symptoms of disease.
This rabbit has more sludge in its urinary bladder. This amount may or may not be of significance, depending on how this rabbit is doing, other diagnostic tests, and follow up radiographs.
This rabbit is not eating well, is lethargic, and has an odor to its urine with urine scalding on the perineum. It needs to be treated for sludge in its bladder. Can you identify other organs besides the sludge in the urinary bladder? The radiograph below labels the organs.
The cecum and sludge are obvious. In the radiograph above, did you notice the calcifications in the kidneys, circled in red?
Same rabbit as above, this time laying on its back. The large amount of sludge in the urinary bladder is even more apparent in this view.
You can see the calcification of the kidneys in this view also
This is what a distended bladder looks like at necropsy
In addition to sludge, rabbits with urinary problems can get bladder stones. Other names for bladder stones are urolithiasis and cystic calculi. These stones also occur in dogs and cats. They are handled differently in the rabbit though.
Click here to see how we take care of bladder stones in dogs and cats.
Click here to learn more about how we do surgery at the Long Beach Animal Hospital in a wide variety of animals.
These are bladder stones in the urinary bladder
Bladder stones in rabbits are removed surgically. We take special precautions in all rabbits when anesthetizing them. Our Anesthesia page has more details on anesthesia.
We have a team of people present when we anesthetize a rabbit
They are closely monitored while under anesthesia
We approach rabbit surgery like any other surgery using aseptic surgical techniques.
Everyone in the surgical suite practices aseptic surgical techniques
We use the laser to make an incision into the bladder and remove the stone. Note the lack of bleeding on this highly vascular urinary bladder when using the laser.
After any anesthetic procedure we closely monitor our patients until full recovery
This is a precise and highly accurate way to assess the kidneys and urinary bladder, and it complements radiography. We also check the other organs in the abdomen carefully with ultrasound.
This is an ultrasound of the urinary bladder with a bladder stone
In this ultrasound the kidney it is being measured
In the acute phase sludge is removed with gentle manual expression. If your pet has a chronic problem with sludge in the bladder we can teach you how to do this at home. Flushing the bladder, after manually expressing most of the sludge, helps complete the process. We might sedate your rabbit if we need to pass a urinary catheter to flush out of the sludge.
We might need to hospitalize to provide intravenous (IV) fluids in a dehydrated rabbit and to help support the internal organs like the kidneys. Pain medication is commonly used, along with assist feeding for those rabbits not eating.
If a bladder stone is present we will remove it surgically.
Once your rabbit is stabilized our goal is to help prevent recurrence of the stone. This is done by you at home in many ways:
Adding water to the food if your rabbit is not a good drinker
Giving supplemental (SQ) fluids under the scruff of the skin to increase urine output
Showing you how to express the bladder
Show you how to assist feed
Keeping the litter box clean
Decrease the weight if obese by feeding less, and increase activity
Using medications as prescribed by us if one of our doctors think it is indicated. This could include:
Vitamin C (ascorbic acid)
Using food that does not have an excess of calcium might be helpful. This means no pellets or alfalfa hay.
Feed only Timothy, Oat, or Orchard Grass hay. A small amount of fruits, and grass hay based pellets can be fed
Also feed fresh leafy green vegetables like kale, mustard greens, dandelion parsley, broccoli leaves and romaine lettuce.
If your water is hard (lots of minerals in it like calcium) you might want to get a water softener.
Any rabbit that has a sludge or bladder stone problem is susceptible to recurrence. Routine monitoring by physical exam, blood panels, and radiographs every 3-6 months is needed to catch the problem early.
Our Rabbit Diseases section has more information on rabbits, including how we surgically repaired the fractured femur in the radiograph below. This is put here as a reminder that rabbits have powerful back legs in relation to their spine and long bones. If not restrained or held properly they can easily fracture these bones. A femur can be repaired, a fractured spine cannot.
This is called a mid shaft transverse fracture of the femur
Don’t forget to give your bunny lots of TLC, like Dr. Kennedy is doing here on one of her patients
After my Botswana trip I met up with a different assistant photographer and went to Namibia. My overall observations of Namibia are very positive; great guide, friendly people, interesting desert, and great wildlife viewing. If you like landscape photography, in addition to great wildlife viewing and photography, Namibia is for you.
Namibia is a desert country, with beautiful sand dunes that go right up to the ocean. There is more to Namibia than desert, but the desert is unique, and is what I will emphasize on this page.
The people that work in the tourism industry want you to have a nice time, and make the effort to help make that happen.
Our guide’s name was Frank. He knew many people, was competent, had eagle eyes, and a warm personality. He went along with all of my antics, including how to say “how much wood could a woodchuck chuck” as he practiced his English. You will hear his efforts in videos several times in this page. Hearing his laugh after he attempts this saying was worth the price of admission!
Frank was one of the best guides I have ever had in my 10 trips to Africa
Frank worked non-stop, never taking a break, and was always ready to go at moment’s notice
His first “woodchuck” lesson
Our trip started in the city of Windhoek. Going counterclockwise from Windhoek, we hit all of these spots, which you will learn about in this page:
Sossusvlei- sand dunes and stars
Swakopmund and the Skeleton Coast- seals and shipwrecks
Twyfelfontein- rock carvings and petrified forest
Etosha National Park- wildlife (especially rhino)
Cheetah Conservation Fund- cheetah
After a five hour drive from Windhoek we saw our first sand dunes in Sossusvlei. Of course I had to climb one and leave my mark. After this first dune we spent several days in the Namib-Naukluft National Park exploring other dunes. As we drove around Frank practiced his ‘woodchuck”.
I was still suffering from jet lag when I put the rocks in the sand, so read my message from bottom to top
Even the t-shirts emphasize the sand in Namibia. In case you missed it, this is a spoof on the insignia for Land Rover cars.
Time for some housekeeping after running around in the sand
The Le Mirage is a beautiful hotel in the middle of the sand dunes. I felt like I was in Morocco after seeing this hotel.
The hotel comes alive at night
Camp fires and stargazing were one of the night activities
There was a spotlight on the waterhole to the right
We could watch the animals drink at night
Early evening star gazing
Late night star gazing
The stargazing was great, and thanks to Cindy’s expertise and late nights, we have some beautiful time lapse photos of the stars at the waterhole
I signed up for an early morning balloon ride, but it was cancelled the night before due to excess wind. I have gone on several of these in Kenya and Tanzania, and was looking forward to one over the desert. Maybe next time.
Frank still could not get the second half of “woodchuck” just yet as we drove to more dunes
The entrance to the National Park
When we arrived some people were already at the top
Time to get ready to join these people
Part way up and I was pacing myself
Fun with early morning shadows
This is the limit of my artistic ability in the sand
A little more walking and I made it to the top
The view from the top of a sand dune
We drove to another location that had some interesting topography with trees
Some of the trees grew in the middle of the dunes
Frank took us to one of his secret dunes
The dunes are almost alive, and in a short time our tracks would be gone
The wind keeps the dunes in an ever-changing state
We learned about animals tracks. These are from a lizard, the long line is from the tail
This beatle was busy digging a nest, little did I know there was something under him
The female that popped out caught us by surprise
Frank pointed out a spider trap from a dancing white lady spider
As we left the dunes it was my our first chance to see an Oryx, also known as a Gemsbok
Time to leave the “Sand Is Fun” area and work our way up the coast
The waters off the coast of Namibia are cold and rugged. Due to the ocean conditions, and the high level of shipping and fishing, many of the boats have been shipwrecked.
The entrance to the Skeleton Coast National Park
Our first shipwreck was not far from the entrance. Frank asked us if we wanted to swim to it. “I think we will pass this time Frank, maybe next time”.
The birds found this ship to be a good place to hang out
The next ship was a fishing vessel
Before we left the local artisans carved a nut with some names as souvenirs to take back home
It was interesting how they did it so easily
Cindy scored, and got seven of her souvenirs for co-workers at this spot, each with their name carved
As we continued up the coast we came across these roadside stands. Can you guess what they are selling?
People leave money when they take one
They are pieces of salt
Next stop was the Cape Cross Seal Reserve, which has Cape Fur Seals, which are a type of sea lion
The hotel is beautiful
That is the skull of a whale at the hotel
We had lunch here, which gave Frank more time to practice his “woodchuck”. We aren’t making progress as you can see from the video.
This is one section of the beach, giving you an idea of how many seals are present. There are reportedly up to 100,000 of them.
The bulls and the females were constantly interacting
It was their courtship dance
We could have kept going many more miles up the coast, seeing a multitude of shipwrecks, but it was time to turn inland and start making our way to Etosha National Park. On the way to Etosha we went past Twyfelfontein.
On the way to our hotel at Twyfelfontein we came across desert adapted elephants
Supposedly, their feet are flatter to make it easier to walk in the sand
The mother of this calf seemed bothered by our presence at first, as can be seen by her body language
She calmed down rapidly, and lazily fed with her calf right in front of us
As the herd slowly moved on the mother took one last nibble from a tree
We stayed at the Twyfelfontein Country Lodge
The beautiful hotel is carved into the rocks
This is the lobby
Where the rooms were located
There are two sites in this area to visit. The first is the petrified forest, where we saw wood (now quartz since it is petrified) that was 280 million years old.
These pieces of petrified wood are located all throughout this area
Our next stop was a guided tour of the rock carvings. They are up to 2,000 years old, and were performed by ancestors of the San people.
Can you see the giraffe, the lion with the human hand at the end of its tail, and all the plain’s animals?
This one has many carvings, including human foot prints
Our journey continued northwesterly towards Etosha, paying a visit to the Himba people, who number around 30,000 in northwest Namibia. These semi-nomadic people eke out a living with their livestock and selling crafts to tourists. Every morning the women apply a paste called otjize, which is made up of ochre stone fragments mixed with butter and fat to their skin. This gives their skin that red hue. The crown on their heads is called the erembe. So far they have been able to keep their tradition going in the face of changes brought out by the modern world in their country.
The morning milking was done, so the women showed us their crafts
If the Himba continue to resist modernization these boys will become cattle and goat herders when they grow up
After our visit to the Himba people we continued on the long road to Etosha National Park. Etosha has been on my radar for quite a while, hard to believe I will be seeing it soon.
There is a substantial amount of wildlife on the road to Etosha, as evidenced by this elephant crossing sign
And this warthog crossing sign
They should have put up a turtle crossing sign also
This is rhinoceros country. There is a serious poaching problem, fueled by the demand by the Chinese and Vietnamese for powdered rhino horns. They have this misguided, irresponsible, and archaic notion that these horns, similar to our fingernails in composition, have some special medicinal value. Their involvement with many governments in Africa, to illegally kill the rhinos and ship their horns to Asia, will cause the demise of the rhinoceros in Africa. They just don’t care.
As another example of Chinese disrespect for animals, the guides told us of Chinese tourists ignoring park rules. We observed this disrespect on our trip when we saw four young Chinese tourists get out of their car and approach some wildlife at a waterhole. Not only is this dangerous to them, it also disturbs the animals. The guides took this seriously, and emailed a photo of this to the park rangers at the exit to the park. The rangers can fine these people, and prevent them from returning to the park. After seeing this the guides told us a story of some Chinese tourists that were made to leave the country when they did something like this in the past.
I have seen rhino in East Africa at the Ngorongoro crater numerous times, along with rhino in northern Kenya and Zimbabwe. These sightings pale in comparison to what I saw at Etosha. The following photos are just a few of these sightings.
Our first rhino in Etosha carefully approached us from a distance. This is a male black rhinoceros.
He seemed to be unperturbed by our presence and got closer
They have poor eyesight, but good senses of hearing and smell, which he utilized to check us out
Watch him check us out, using mostly his ears and sense of smell, before he comes closer
He looked at us this way for a while
Apparently we passed muster, and he approached
And came close enough to get this shot
The horn is nothing more than a big fingernail in composition. I plan on going back to Africa soon to help sedate the rhino, either for transportation to a protected area in Botswana, or to help them cut off the horns to prevent poaching. You are welcome to join us. Email me at email@example.com for more inormation.
Driving around the park we encountered this old bull covered in a chalky substance
This lioness protecting her Oryx kill from the night before, kept a close watch at some people in a vehicle looking at her that were moving too much and standing up
Even though the Oryx is a vegetarian, it chews bones for the phosphorous and calcium
Lots of giraffes in Etosha
Before I go on to giraffes drinking, you need to learn some anatomy and physiology of this unique animal. To get the blood all the way to a brain this high there are several adaptations, the most important of which involve the cardiovascular system. Giraffes have a large heart in proportion to the rest of the chest compared to other animals. This is so that it can pump the blood at a pressure of 240mm of Hg (mercury), which is twice that of a human. This high pressure is needed to get blood to a brain that is high above the heart. If there is not a continuous flow of blood to the brain the giraffe will literally pass out.
This system works well when the giraffe is standing, but what about when it lowers its head. All that blood, rushing to the brain at such a high pressure, can burst the cells in the brain. A human brain experiencing a flow of blood at this pressure would experience a hematoma, and go into a coma, rapidly leading to death. How does the giraffe get away with this when it lowers its head to drink?
Giraffe have special one-way valves in the jugular veins, which keeps the blood flowing to the heart and not backwards towards the brain, where it would increase the blood pressure to dangerous levels as the head is lowered.
They also have strong and elastic valves that can expand or contract, and give local control of blood pressure at the level of the brain.
In addition, when the blood does enter the brain, they have a sponge-like structure of blood vessels (it’s called a rete mirable) that diverts the excess flow of blood around the brain, and not directly to the brain, as the head is lowered. The rete mirable does the opposite, and releases this blood back to the brain, when the head is raised. This prevents the giraffe from passing out due to a low blood pressure as it raises its head after drinking.
The action at Etosha was at the waterholes. Notice this giraffe’s front leg technique in order to lower its head to drink
This one drank with its front legs in a different position
We came across some interesting animal interaction at a waterhole. There was a very thirsty giraffe drinking in front of a male lion, with ostrich and gazelle waiting their turn.
It seemed odd to us that the giraffe got closer to the lion as it drank, when there was plenty of water at the waterhole further away from the lion. This is another one of those wildlife behaviors that is hard to understand.
After a short while a playful lioness walked past the male for a drink
He followed her, as a male lion is supposed to do, as she raised her hindquarters to him
He checked to see if she was in heat by checking her pheromones
After three great days at Etosha National Park we drove to the Cheetah Conservation Fund. Even though there were plenty of tourists, the wildlife viewing was great, and I want to go back to a different part of the park next time.
It was time to say good bye to Frank when he dropped us off at the Cheetah Conservation Fund
We said good bye to Frank, but not before he did his final “Peter Piper tongue twister”, and invited all of us in America to join him on a trip
The Cheetah Conservation Fund, founded and run by Dr. Laurie Marker, started in 1990
Namibia has more wild cheetah than any other country, and Dr. Marker is trying to save them from the goat farmers that kill them when the cheetah kill their goats. A farmer with 10-20 goats can suffer a catastrophic loss when a cheetah wantonly kills half of the farmers goats. She came up with a novel idea to help the farmers and the cheetah.
She imports and breeds Anatolian shepherds from Turkey. These are large herding dogs that are not afraid of cheetah. The program is working, and now the CCF breeds them, trying to keep up with the number of goat herders that are on a waitlist for one of these dogs.
Kangal dogs are also used in addition the the Anatolian Shepherds. These dogs are raised with the goats as pups, so they bond with the goats and want to protect them, and the goats get used to them.
In addition to the herding dog’s program, the CCF does genetic research and education of the public. Dr. Ann is in charge of the genetics program, and utilizes a sophisticated lab, with capable assistants, to do state-of-the-art genetics research on this species with poor genetic diversity. She has serum from cheetahs that goes back 25 years, and is looking for someone working on a Master’s or Doctorate in genetics to help her do a genetic analysis on this serum. There is a treasure trove of information in this saved serum.
CCF has its own creamery to help generate funds
There is a hospital that takes care of the dogs and injured cheetah, in addition to obtaining samples for genetic testing. We are going to help them upgrade their equipment.
Their young veterinarian, named Robin, has a great personality and is dedicated to helping the animals at the CFF. Dr. P plans to bring her to California for ultrasound training, and hopefully get them a new ultrasound machine to replace their dated one.
There are several captive cheetah at the CCF that cannot be released back into the wild. They have no fear of humans, and will approach the goat herds and get killed by the goat herders. They will stay at the CCF for the remainder of their lives, being well cared for, and also used to educate the public.
They are exercised daily with a special set up that pulls a red flag on a pulley. The flag is rapidly pulled around a large circumference early in the morning when it is cool.
It’s an ingenious mechanism that allows them control the speed and direction of the red flag, taking advantage of a cheetah’s natural curiosity at a moving object
You get to watch them as they are exercised every morning. The following photos show them in action chasing the red flag.
On my last night I had a chance to do a night drive with a guide from the CCF
One final sundowner with this guide, before its time to head back home the following day.
I have another Africa trip in the works for 2019, dates and locations to be determined. If you are interested in joining my group contact me at firstname.lastname@example.org
This page stresses the importance of routine yearly exams, and close owner observation, on our pets. Large breed dogs can be stoic, and have significant problems brewing without showing any outward signs. When serious symptoms like weight loss and lack of appetite finally show up, the disease process is usually well entrenched, and there is little we can do. We want to see these pets before it gets to that stage.
Pets are masters at hiding illnes, so it can be difficult if they are ill. It might be a good idea to read our short page on symptoms of disease to know what to watch for.
We also have a nice page on teaching you how to do an in-home exam. If you bring your pet to us one of our staff will go over this with you, and do a hands-on demonstration of how to palpate the peripheral lymph nodes. This early warning system is a great way to catch problems early in the course of disease.
A beautiful male labrador retriever named Colt came in for a routine Wellness Exam when he was 10 years old. During this exam Colt’s owner told Dr. Palazzolo that Colt vomited on occasion over the last month, but that otherwise he was doing fine. He is a calm dog, and just lays around a lot.
Colt’s body temperature was normal, and his weight was the same as a previous visit. A pet’s weight is a good idea of how well it is doing, and if it is maintaining its weight that is usually a good sign. In Colt’s problem, this is not the case.
During the physical Dr. P noted a very tense abdomen, so tense that he could not even palpate internal organs. After this was noted, the owner did say that Colt’s abdomen seemed to be distended. The rest of Colt’s thorough physical examination was normal.
The distended abdomen is a significant finding, and warranted a radiograph, in addition to the blood panel which is part of the Wellness Exam.
You don’t need to be a radiologist to know something is wrong with this abdomen, as evidenced by the large and round whitish structure
Here is a normal abdomen for comparison. In this normal radiograph you can see individual organs, unlike the abnormal one above, that looks like it has a beach ball inside of it.
This is a serious finding, and this mass could have many causes, and involve almost any internal organ. Due to its size, shape, location, and the relative lack of symptoms, it was probably the spleen. It could be a benign tumor of the spleen called a hemangioma, a malignant tumor of the spleen called a hemangiosarcoma, or a hematoma of the spleen. A hematoma is a blood filled cavity that is benign.
Its size said it might be a hematoma, which has the best prognosis of the three. To learn much more about spleen tumors please visit our hemangiosarcoma page.
Before we proceed any further we take a radiograph of the chest to make sure there has not been any spread of tumor to the lungs. The white object in the center is Colt’s heart, the dark areas around the heart are the lungs. This is a normal chest radiograph.
You can learn much more about how to read a radiograph if you are interested
Our radiologist, Dr. Ann Reed, performed an ultrasound of the abdomen. This ultrasound lets us know if the mass is actively bleeding, and if there has been any spread of the mass to the right atrium of the heart. If that is the case, the mass is probably a hemangiosarcoma that has already spread. This is not a good prognosis.
Colt’s ultrasound report showing it is probably benign, and consistent with a hemangioma or hematoma
In Colt’s case there was no abdominal bleeding, and the heart was OK. Colt’s blood panel came back normal, so we did a cross match of his blood, and readied a unit of blood for a transfusion in case we needed it during the surgery scheduled for the next day.
|Agglutination||Crossmatch substrate||Crossmatch blood||Transfusion kit|
Before we do a blood transfusion we do several tests to minimize a transfusion reaction
We were much better prepared for surgery the next morning with all of this information. During the night prior to surgery Colt was given intravenous fluids to stabilize him and make him a better anesthetic risk, and a pain patch was put on. Having the pain medication on board before surgery increases its effectiveness. Colt is now good to go for surgery the next morning.
We have a short page that talks all about how we do surgery at the Long Beach Animal Hospital. You might want to check it out before you see Colt’s surgery.
Colt did great overnight. We took away his popcorn after the Lassie movie ended (he likes classic movies), and he rested comfortably during the night, monitored by our night crew. He slept well, and dreamed of being a famous movie star like Lassie.
Here he is with Jennifer the next morning, keeping an eye on our surgical team as they prepare for his surgery.
Colt gets some extra petting for being a good boy, by his surgeon, Dr. Kennedy
Even though Colt has been thoroughly checked, we always perform a physical exam just prior to inducing anesthesia. An important organ to assess is the heart. If we suspect something is wrong with the heart when we listen to it we will do a pre-anesthetic EKG (electrocardiogram).
If you like heart stuff we have a very detailed page on heart disease in animals. It’s not for the “weak of heart” (pun intended), because it goes into all sorts of anatomy and physiology. If you get through it give yourself a pat on the back, and think of applying to veterinary school!
Colt’s anesthesia is initially given by injection. Once he is relaxed we put in a breathing tube and start prepping his abdomen for surgery.
This surgical monitor allows us to detect any impending problems, and make adjustments before problems become serious.
Even though we use these hi-tech machines to monitor important physiologic parameters during surgery, we also use the hands-on approach to make sure we do not miss anything. In this picture our anesthetist is listening to the heart with a stethoscope.
During the procedure Colt’s vital information is closely monitored and recorded. Our anesthesia page has more details.
While Colt is being readied for surgery Dr. K is getting her instruments ready. She will need many clamps to close off the blood supply to the spleen before it can be removed, which required more than one surgical pack.
When Colt is prepped, and under the proper plane of anesthesia, Dr. Kennedy does her draping. This draping is an important part of the surgery, and is doing carefully.
It will take more than one pair of hands to get this spleen out, so our surgical assistant, Jessica, stands by waiting for instruction. Terri our anesthetist keeps a close tab on everything.
The initial incision is only though the skin. Blood vessels just under the skin are clamped before we go any further.
You can see the two clamps that are controlling bleeding in the subcutaneous (SQ) tissue just under the skin. Colt’s spleen is humungous, so it will take a long incision to get a big enough opening to remove it
Even though the incision was made as long as possible, the opening was still not big enough to remove the spleen. Dr. K had to make a side incision in the abdomen to facilitate removal.
The spleen has an extensive supply of blood vessels that are near the stomach. A large part of this surgery is identifying and ligating these vessels, and doing this without damaging the blood supply to the stomach. These blood vessels are intertwined in tissue that is covering the spleen as the body attempts to wall of this large mass. This is the most meticulous part of the surgery, and Dr. K’s experience and skill at doing this before pays off.
These blood vessels are large and need to be handled carefully
It takes multiple clamps and special suture material to perform this important part of the surgery
Jessica is kept busy holding clamps while Dr. K identifies and continues to ligate the many blood vessels to the spleen
As more of these vessels are ligated Dr. K carefully attempts to get the spleen out of the abdomen. No luck the first time.
An adhesion from the intestines to the spleen was identified and removed. Time to try to get the spleen out again.
We need to be very careful at this point that we do not rupture the spleen by forcing it out.
With gentle coaxing and manipulating, along with Jessica’s help holding the abdomen open, we almost have it out, but not just yet
It was time for Dr. P to stop taking photos and assist in surgery. He has removed many spleens in his decades of surgery, and with the help of Dr. K and Jessica, was able to extricate the spleen. Now Dr. K could finish ligating blood vessels (and hopefully Jessica does not need to scratch an itch at her nose)!
Here she is doing a great job
The final blood vessel to the spleen is cut while Jessica holds on to the spleen
After almost 2 hours of surgery Colt is now lighter on his feet
It’s official, 14.095 pounds!
The vertical and long structure on the left is an enlarged and normal spleen, with the hematoma of this spleen on the right
Surgery is nowhere near done. After Dr. K looks for any significant bleeding on the blood vessels she ligated, she flushes the abdomen numerous times with warm saline.
The long process of putting Colt back together now begins. The most important suture layer is an area called the linea alba. This is where the muscle bellies of the abdomen meet, and is a tendinous area that is very strong. This is where the first and most important layer of sutures is placed.
After more layers of sutures are placed, and before Dr. K puts in skin staples, Colt now has a bikini scar (OK, maybe not, but once the hair grows back nobody will know his secret)
In addition to the pain patch put on the night before, and the pain injection given during surgery, a long acting local anesthetic is placed at the incision. Now Colt will be comfortable when he wakes up and through the night.
All of our abdominal surgeries receive therapy laser treatment on their incisions. This aids in both healing and pain control. Notice the staples in Colt’s skin incision.
Now comes the bandage; the first layer is gauze and telfa pads
After more pads and gauze are put over the incision, the outer layer is wrapped by Terri while Jennifer and Jessica hold up Colt. They are getting their biceps exercise for the day!
We did the surgery the day after Halloween, so we thought this was an appropriate colored bandage
Our dedicated surgical team posing with their trophy. Great job!
Colt was closely monitored for several days, and his red blood cell count was checked to make sure he did not need that blood transfusion. He went home after 2 days and was back to normal in no time. Yea Colt!
Great news on Colt’s histopathology report, confirming it is a hematoma. Colt should make a complete recovery and lead a normal, if not lighter, life.
Just in case you want to see what a spleen hematoma looks like under the microscope here is your chance
Colt with his happy mom two weeks later when he came in for his staples removal
If you go back to Colt’s initial history the owner stated Colt vomited on occasion over the last month. Looking at the size of this hematoma (a record for Long Beach Animal Hospital), the hematoma was probably brewing over several months. Its a wonder Colt could even eat, and was not vomiting more, with a hematoma of this size in his abdomen. If Colt had not been brought in for his Wellness Exam, this hematoma could have easily ruptured, causing Colt to go into shock. and most likely a rapid death.
Colt’s weight was the same as a previous visit. It was only because he had such a large mass in his abdomen, and goes to show you cannot go by just one physical parameter to determine health. It also shows you need to be thorough when investigating a medical problem.
The ability to do ultrasound with our highly skilled radiologist, telling us the hematoma was not actively bleeding, allowed us to take the time to prepare Colt for surgery. This made him a much better anesthetic risk, and and allowed him to heal faster with no complications.
The ultrasound told us it was probably a hematoma, and there was no evidence of spread to the heart which would indicate a potential malignant hemagiosarcoma of the spleen. With the blood panel and chest radiographs being normal, it was realistic to proceed with surgery based on the fact that the mass was probably not a malignant cancer.
Now that you have seen a successful hematoma surgery, now might be a good time to learn about hemangiosarcoma, a malignant cancer of the spleen. In this same page you can see another hematoma surgery of a dog with an 8 pound hematoma of the spleen.
IBD is an inflammatory condition of the stomach, small intestines, or large intestines (the gastrointestinal (GI) tract). It is sometimes called Idiopathic IDB. The Idiopathic part means that the cause of the condition is unknown.
IBD tends to be chronic in nature. It is one of the most common conditions of the gastrointestinal tract diagnosed in pets, especially in cats. Despite its prevalence, it is one of the least understood conditions, especially regarding cause. Some pets respond well to treatment, others do not.
Some cases of IBD involve the liver and pancreas. In this case there are 3 diseases occurring, and we refer to it as Triaditis. This is more difficult to treat than IBD alone.
The usual symptoms of IBD are poor appetite, vomiting, diarrhea, and weight loss. Cats tend more towards vomiting, dogs tend towards diarrhea. These symptoms appear in many other diseases, so you cannot assume your pet has IBD from symptoms alone. To learn the process of how we make a diagnosis of a disease when the symptoms are the same as so many other diseases, we have a methodical and detailed approach. It is called the Diagnostic Process.
We discuss the importance of worms (internal parasites) many times in this page in regards to IBD. With the modern medications we have, including flea products that contain medication to kill worms, it behooves you to treat your pets for worms monthly. Not only might it help prevent IBD from appearing at some time in your pet’s life, it will protect you and your children. Our Internal Parasites page has the scoop on all of this.
In spite of its prevalence, many pets are diagnosed with Idiopathic IBD when they do not have it. To standardize what IBD is, the World Small Animal Veterinary Association has listed the following criteria to help make this diagnosis:
The GI symptoms must be present for at least three weeks
Diet change, worming, and medication do not give a significant reduction in symptoms
No other explanations can be found for the symptoms
Biopsies of the intestines show significant inflammation of the interior lining
The resolution of symptoms when put on mediations that modulate the immune system (immunosuppressive).
This criteria means that a pet that responds to just a diet change technically has a Food Responsive Enteropathy. If a pet responds just to antibiotics then it technically has an Antibiotic Responsive Enteropathy.
When your pet eats, food from the stomach passes into the small intestine, which is composed of three different sections called the duodenum, jejunum, and ileum.
The majority of nutrient (proteins, carbohydrates, fats) digestion occurs within the small intestines. The inner lining of the intestines is called the mucosa, and that’s where all the action occurs when it comes to absorbing nutrients. The mucosa has a large surface area because there are microscopic folds called villa.
This is the lining of the small intestines. The villa are microscopic, so you cannot see them without a microscope.
There are many different types of specialized cells in the lining of the mucosa. Some of these cells specialize in aiding digestion, some are for absorption of these nutrients into the bloodstream, and some are part of the immunes system and defend the body from foreign invaders.
These immune system cells are important for protection due to the constant exposure the GI tract has to outside invaders in the form of oral ingestion of food and its many contaminants. It is these cells that can overreact and cause IBD symptoms.
These are the small intestines during a routine abdominal surgery. Notice the extensive blood supply, necessary to get those nutrients from the lining of the intestines into the bloodstream, and then off to every cell in the body- amazing!
This is what the ingesta looks like as it passes through the small intestines
The pancreas secretes digestive enzymes into the small intestines as the food passes through the duodenum. These enzymes are crucial for digestion of fats, carbohydrates, and proteins. As the food continues down the small intestines the enzymes from the pancreas continue their breakdown of nutrients, which are then absorbed by the mucosa of the jejunum and ileum and make it into the bloodstream.
This is the pancreas, a small but mighty organ. Our surgeon is holding the duodenum (D), with the pancreas in the center (D).
Close up view of the architecture on the outside of the pancreas
The gall bladder secretes bile into the duodenum to help in digesting fats. When the liver is a part of IBD the bile can build up in the liver and cause a problem. This is a part of the Triaditis that complicates IBD.
The large intestine is composed of the cecum (our appendix), colon, rectum, and anus. Water, electrolytes (sodium and potassium), sugars, and vitamins are the main nutrients absorbed by the large intestine. Some vitamins are produced in the large intestine also. Nutrients that were not broken down or absorbed well enough within the small intestine are further digested in the large intestine due to microbial fermentation. The large numbers of these good bacteria that are present in the intestines are crucial to normal health.
The human cecum (appendix) has atrophied to the point that it is no longer needed. Our diet does not have the fiber of our ancestors, so this organ is not needed for normal digestion, which is why it can be removed if appendicitis occurs. As a fun anatomical comparison, the cecum of a rabbit is enormous in relation to the rest of its body. That is because it is a hind-gut fermenter, and contains large numbers of bacteria to help digest food that is high in fiber. Our rabbit GI stasis page has radiographs of the cecum along with actual pictures to give you an idea of just how large it is.
Allergens cause inflammation of the mucosa, leading to the symptoms associated with IBD. The allergens that cause this inflammation can be anything, with food (especially protein) as the main culprit. Bacteria and parasites are also allergens that cause inflammation of the mucosa. It is the immune system that over reacts to these antigens that causes the symptoms of IBD. This immune system over reaction is why pets that truly have IBD need medication to suppress the immune system, in addition to dietary changes and antibiotics.
The size of the lumen thorough with the food passes and intestinal wall thickness of a normal small intestine
You can easily see the smaller lumen and thickened intestinal wall in this pet with IBD
Inflammation of the pancreas is known as pancreatitis. In pancreatitis, the digestive enzymes that would normally be secreted into the duodenum to digest food are now leaking out of the pancreas into the abdomen, causing tremendous inflammation and pain to surrounding organs. Pancreatitis is a serious disease, and usually requires hospitalization, intravenous fluids, and medication. It can be hard to diagnose in cats because they usually become quiet and sit as if content, when in reality they are in pain. A clue is the fact that are not eating well.
Inflammation of the liver in some cases may be associated with IBD, permitting an infection to creep up the bile duct and into the liver. There are many different sources to this infection, ascending from the GI tract or urinary tract.
The pancreas, liver, and intestines are closely associated, and when one has a problem it causes inflammation in one of the other ones. When all three have a problem it is called Triaditis. As you can see, it all gets quite complicated.
IBD is one of those conditions where the exact cause might never be identified. The most common causes are dietary allergies, infections, and environmental stress. Stress can happen in multiple pet households, during holidays, and in extreme weather.
Dietary allergies are involved with sensitivity to protein in the diet. Sometimes, an inability to absorb nutrients, called a malabsorption syndrome, is involved. Some pets generate an excessive amount of a specific white blood cell called an eosinophil (eosinophil gastroenteritis) in the lining of the GI tract.
Other dietary causes might include artificial coloring, preservatives, and food additives. Differentiation between the above-mentioned causes is difficult, especially since many IBD cases are associated with several concurrent factors.
It is suspected that puppies with a large amount of internal parasites (worms) are setting the stage for IBD later in life. This is another good reason to have your pet checked for internal parasites at least yearly, and wormed frequently when young.
Pancreatitis is highly associated with pets that are overweight, particularly spayed female dogs. Fatty meals are important components of the clinical history for cases involving pancreatitis. As a result, we tend to see this cause of pancreatitis around the holidays when people are celebrating with turkey (and gravy) and other similar foods that their pets’ eat also.
Inflammation of the pancreas can spread to the liver due to its proximity. This can inflame the gall bladder, causing bile to backup into the liver. This can lead to Triaditis mentioned earlier.
Inflammation of the liver and biliary system, known as cholangiohepatitis, is most commonly associated with a bacterial infection. In cases of Triaditis, it is unknown as to whether the liver is the first organ affected, resulting in secondary inflammation of the pancreas and gastrointestinal tract, or if it is the other way around. It has been hypothesized that bacterial infections may be the initiating cause of cholangiohepatitis, with IBD and pancreatitis following thereafter.
Proteins and grains in the food contribute to dietary intolerance. Intolerance occurs when there is an abrupt change in the diet, resulting in an inability for the gastrointestinal tract mucosa and associated cells to adapt accordingly. When this happens foods are often not digested or absorbed properly.
Maldigestion is a separate condition of the gastrointestinal tract that generally occurs secondary to exocrine pancreatic insufficiency. The endocrine pancreas secretes insulin to regulate the blood glucose level. The exocrine pancreas secretes the digestive enzymes needed to digest food in the intestines. If the pancreas is not secreting enzymes into the small intestines as the food passes, the nutrients will not be broken down and absorbed into the bloodstream. This leads to weight loss and diarrhea, even in a pet that is eating.
Malabsorption is secondary to numerous disease processes such as food allergies and/or intolerance, protein losing diseases of the gastrointestinal mucosal layer, intestinal parasites, antibiotic responsive disease, cancer, IBD, and immune-mediated disease. The exocrine pancreas is secreting the proper digestive enzymes in this cause. It is an inflammation of the inner lining of the intestines (the mucosa) that prevents absorption of the nutrients into the bloodstream.
Intestinal parasites (worms)
There are numerous intestinal parasites known to cause the same symptoms as IBD. They include roundworms, hookworms, whipworms (dogs only), cryptosporidia (protozoa), toxoplasma (protozoa; cats only), coccidia, and giardia.
Some intestinal parasites are known to affect humans as well (zoonotic potential). These include the larvae of roundworms causing organ involvement (visceral larval migrans), or eye involvement (ocular larval migrans), hookworms (skin involvement), giardia (gastrointestinal disorders), coccidia (gastrointestinal disorders especially in immune suppressed individuals), toxoplasma (congenital defects in babies), and cryptosporidia (gastrointestinal disorders).
A fecal examination is often one of the first steps when diagnostics are being evaluated in a pet with a gastrointestinal disease. Our intestinal parasites page has detailed information on these parasites (worms). We sometimes do a fecal Giardia test since this parasite can be hard to detect.
Cancer – Lymphosarcoma (Lymphoma)
In cats, lymphosarcoma is the most common type of cancer known to affect the gastrointestinal tract. This is not easy to diagnose, since the changes present in IBD are very similar to those in Lymphosarcoma when the pathologist analyzes them under the microscope.
Depending on the type of lymphoma (small, medium or large cell lymphoma), tissue samples must be sent in for further diagnostics in order to definitively differentiate between early cancer and IBD. Proper treatment depends upon a proper diagnosis.
These severely thickened intestines are from cancer
We have a page that shows an exploratory surgery on a cat with intestinal cancer.
Although there are no definitive infectious agents that consistently result in IBD, some organisms such as Giardia, Salmonella, Clostridium, and Campylobacter could be a cause. Some of the “good” bacteria, those that are necessary for life, can become imbalanced and cause the symptoms seen in IBD.
Any medication can disrupt the lining of the intestines. The most common one is antibiotics, since they disrupt the normal GI bacteria (referred to sometimes as flora).
Both dogs and cats are commonly affected by IBD, although it is much more of a problem in cats. IBD can occur at most any age due to the numerous causes of the condition; however, it is usually observed in pets over the age of two .
Triaditis is more commonly diagnosed in middle to older aged cats. If it is associated with a food allergy, they tend to be young adults to middle aged. Males and females get IBD in equal frequencies.
Sometimes pets are affected by IBD for many years while appearing apparently healthy in all other aspects. Typical symptoms are lethargy, poor appetite (anorexia), weight loss, diarrhea and vomiting.
Depending on the inciting cause, the clinical signs may occur intermittently over a long period of time (i.e. dietary allergy) or abruptly and progressively (immune-mediated, infectious, dietary allergy, cancer). If Triaditis is present clinical signs may range from lethargy and decreased appetite to severe vomiting, diarrhea, abdominal pain, and icterus (jaundice) due to liver compromise).
This pet has severe icterus (also known as jaundice)
Cats can have variable symptoms compared to dog. Cats that have pancreatitis might sit quietly and appear to have no problems. In reality, these cats are painful, which is why they sit like this.
In both dogs and cats, palpation of the abdomen might reveal painful and thickened bowel loops. This is not a consistent sign, and just because bowel loops are thickened, does not mean there is a problem. Pain may also be associated with palpation of the pancreas or liver in cases of Triaditis.
Lymph nodes deep within the abdomen may be enlarged and palpable as well as painful. Excessive intestinal sounds (called borborygmus ) might be heard on auscultation of the abdomen. In more chronic cases, other subtle signs may be present such as a dull hair coat, mild to moderate dehydration, fever, and overall poor body condition. None of these are consistent findings, and cannot be relied upon for a diagnosis of IBD.
These lymph nodes, call the sub lumbar, are enlarged on this dog. They are the whitish circles within the red circle. They are due to cancer, but they cannot be palpated.
Complete blood count, biochemistry panel, and urinalysis, are a starting point for diagnosis. Certain blood values might suggest IBD if in combination with clinical signs. Even “normal values” are clinically diagnostic, as they help to rule out another disease that can cause the same symptoms as IBD. A pet with a perfectly normal blood panel can still have IBD.
Some pets will have a chronic anemia (low red blood cells). Sometimes the white blood cells will be elevated, in other cases the protein will be low (hypoproteinemia). There might also be a low cobalamin level. Cholangiohepatitis (inflammation of the liver) in cats, when Triaditis is present, may be further suspected if bilirubin (hyprebilirubinemia) or liver enzymes are increased. A bile acids test helps assess the liver in these cases.
The blood panel is very thorough and checks many different organs and systems. This is a few of the many tests, the elevated liver tests are circled, and could be a sign of Triaditis in this case.
A resting cortisol test might also be used to eliminate Addison’s (hypoadrenocortocism) disease
Fecal examination is an important and inexpensive test to rule out internal parasites (worms). We sometimes give worm medication (called anthelmintics) to pets with a negative fecal if they have and GI symptoms. This is because a pet can have internal parasites that do not show up on a fecal exam. Our intestinal parasites page has much more information explaining this.
A fecal exam, checking for internal parasites (worms) is important in every pet with any signs of illness. In this exam, we are checking for eggs (ova) of the parasite. A special test for Giardia is also used.
Bacterial cultures are also utilized in some cases. The bacteria we are checking for include:
This is what we want to see when we do a urine culture- no bacterial growth in 48 hours
Abdominal radiographs are often normal in cases of IBD, but are a necessary tool to rule out other causes of similar clinical signs. Survey abdominal radiographs are also indicated prior to ultrasound as well.
This dog had chronic diarrhea. Nobody took a radiograph prior to treatment. The cause was not IBD, it was the pennies stuck in the rectum.
This cat has IBD, as evidenced in this case by the thickened small intestines at the arrow. This can also be a normal finding, and it can also be a sign of intestinal cancer. The more common intestinal cancers are lymphoma, adenocarcinoma, and mast cell tumors.
Prior to the common use of ultrasonography, barium contrast studies were performed in order to reveal disruptions of the mucosal surface along the gastrointestinal tract. We are looking for filling defects and ulcers of the mucosa and thickening. Barium has lost some of its significance since ultrasonography tends to be much more sensitive. One very nice “side effect” of giving barium to a pet that might be vomiting is its soothing affect on the lining of the intestines (mucosa) to stop the vomiting.
TLI type tests- serum fPLI (pancreatitis), fasting serum TLI (exocrine pancreatic insufficiency), fasting serum cobalamin and folate (small intestinal function and bacterial overgrowth). These are specialized tests and take several days for the results to come back.
Endoscopy is a useful tool since we can observe the lining of the esophagus, stomach, and duodenum for ulcers, lesions, and foreign bodies, that might not show up on a radiograph. Biopsy samples can be taken, although they are not full thickness, and only take the lining of the small intestines. This can lead to an inaccurate diagnosis.
This is a report from a stomach and intestinal biopsy with the endoscope
The most accurate way to diagnose IBD is to perform an exploratory surgery and take full thickness intestinal biopsy samples. If the blood protein level is low (hypoproteinemia) care must be taken because healing can be delayed.
Samples obtained during surgery are analyzed by a pathologist to help confirm a diagnosis of IBD, and also rule in or rule out the possibility of intestinal cancer. Sometimes the pathologist cannot tell the difference between IBD and cancer due to the abundance of inflammatory cells. During surgery, samples of other important organs like the liver and lymph nodes can also be obtained. These samples are very informative, and are taken in many cases.
Surgery has the major advantage of being able to see and palpate the intestines, along with taking a complete (called full thickness) sample of the intestines. This surgeon is using a scalpel blade to take the sample.
These samples are analyzed by a histopathologist. The report might come back with several different terms describing the IBD in specific medical terms, depending on the cell type:
Ultrasonography of the abdomen is an invaluable diagnostic tool. Prior to the advent of ultrasound, exploratory surgery was needed to make an accurate diagnosis, and that was only after biopsy samples were obtained. Ultrasound is dramatically less invasive and expensive compared to surgery, and the results are obtained immediately in many cases. In the case of IBD it can tell us of thickening of the intestines and gives us a suspicion that IBD is indeed present, but it cannot confirm the diagnosis.
Ultrasound is a big aid in the diagnosis of IBD in its ability to to rule out cancer and foreign bodies as a cause of vomiting. It also gives us an accurate way to biopsy internal organs like lymph nodes.
Ultrasound is rapid and painless, and the only invasive part is shaving your pet’s abdomen
This is a typical report of a pet with IBD. Note how detailed it is, and how organ size is measured.
Ultrasound can be used to measure wall thickness of various segments of the intestinal tract, which yields supportive evidence in the face of clinical signs. However, it cannot be used to differentiate between IBD and other disease processes that result in significant inflammation of the intestinal wall (i.e. lymphoma). This is where surgery has an advantage since full thickness biopsy samples can be taken for analysis
This is what the small intestines look like during ultrasound while they are being measure for size
This is what the pancreas looks like, also being measured
All of the abdominal organs are assessed during an ultrasound. This is what an enlarged abdominal lymph node looks like.
Fine needle aspirate samples may be obtained with the guidance of ultrasonography. Sometimes this test is diagnostic, sometimes it is not. Even though it is not a perfect test, we sometimes recommend it due to the simplicity in obtaining it.
A hypoallergenic diet trial may be issued for cases of highly suspected dietary allergies or intolerance. In such cases, some pets respond when the diet is altered and no further diagnostics are necessary. You must feed this food, and only this food, to see if this works. Sometimes results are immediate, other times it might take several months to know for sure.
This can be a risk if the diet trial is attempted before numerous other disease processes are not first ruled out, especially cancer and internal organ diseases like Feline Hyperthyroidism. This delay in diagnosis can affect outcome. If clinical signs do not improve or resolve within the first two weeks of the diet trial, then further diagnostic work-up is indicated.
Depending on the severity of disease at presentation, treatment must first begin with stabilizing the pet. What we do to stabilize depends on the severity and duration of symptoms.
Stabilization generally includes intravenous fluids to correct dehydration, correct electrolyte imbalance, and improve kidney function. If the protein level is low we might use a fluid called Hetastarch.
Pets that are not eating are assist fed a special diet called A/D to maintain appropriate caloric intake and to prevent further disruption of internal organ function and get the GI tract back to normal. Probiotics to help stimulate the normal bacterial flora might be beneficial.
Vomiting pets are continued on fluids to maintain normal hydration, and given a specific medication called Cerenia (maropitant) to stop the vomiting. This drug has been a tremendous help in alleviating vomiting in pets due to many different causes. We use it for IBD and also for other GI problems like parvo virus and pancreatitis without IBD. Cerenia works on the emetic (vomiting) center of the brain.
We use the injectable version in the hospital, and send home an oral version if needed
It must be understood that if one of our doctors recommends a dietary change to treat your pet’s IBD that the only food or treat that can be fed to your pet is this new diet. Nothing else can be used as a food source. Feeding other foods is a reason why this dietary change does not work in some cases. When multiple people feed a pet this needs to be communicated to everyone.
Dietary intervention is considered a mainstay for many gastrointestinal cases because a large proportion of cats and dogs with gastrointestinal disease are associated with food-sensitivity. We need to get these pets eating again for the intestines to return to normal function.
Dogs and cats with pancreatitis, which is painful and causes severe illness, do well initially with a low fat diet in the early stages to get them stronger and get the intestines used to digesting food again. I/D (Intestinal Diet) has been used by our doctors for well over 35 years, and is the gold standard for pets with GI problems. After the pet is stable we look for a long term food.
I/D comes in many variations, and our doctors will tell you which one is appropriate for your pet’s specific problem
It is the protein component of the food that causes the problem in IBD. Hill’s has solved this problem by making a food with a hydrolyzed protein that does not cause a reaction. It is unconditionally guaranteed, and is worth using in every case because it works often, and you can get your money back if it does not work. This is a complete diet and can be fed for the rest of your pet’s life. It is very rewarding when a dog or cat with the signs of IBD improves on only food and does not need medication.
The best food we have found overall for dogs and cats with food allergy is called Z/D
Novel proteins are not manipulated protein sources (as compared to hydrolyzed proteins like Z/D), but are simply new proteins that the pet has never ingested before. Many dogs and cats immune systems have not been exposed to venison, duck, or rabbit. Due to the fact that it takes long-term exposure to a protein before the immune system will react against it, then these novel protein diets are often attempted when the protein source is suspected to be the cause of IBD. The new diet will take at least 2 weeks, and up to 4 weeks, for the symptoms to diminish or resolve.
These foods might contain:
Vitamin supplementation is a critical component of treatment for some individual pets whose IBD stems from a deficiency in cobalamin (vitamin B12), specifically in cats. Pets that are sick enough to have a low cobalamin level are generally in need of more than just vitamin supplementation, requiring a combination of other medications and dietary alterations.
Steroids (corticosteroids) are used in many cases in order to decrease the inflammation. The most common ones include prednisolone or prednisone. Budesonide, is a weaker steroid, that is also used. If the root of IBD or Triaditis is due to an immune-mediated process, then more potent immune system suppressants than steroids are required, such as cyclosporine, chlorambucil, or azathioprine.
Cyclosporine is an immune modulation drug that can suppress the inflammation from IBD.
Chlorambucil (Leukeran) is a chemotherapy drug for treatment of resistant IBD or some forms of cancer
Antibiotics should be chosen based on bacterial culture and susceptibility when possible, especially in cases of Triaditis. Antibiotics such as Flagyl (metronidazole) are very commonly used for their ability to treat patients with chronic diarrhea. Some pets respond well to this medication only (they have Antibiotic Responsive Enteropathies). Flagyl suppresses the bacteria that are involved with IBD, and also mildly decreases the immune response that is an important component of IBD. Other antibiotics include Tylosin, Amoxicillin, and Fluoroquinolones. Tylosin must be compounded.
These are commonly used to help with the trillions of beneficial bacteria in the GI tract. IBD disrupts these “good” bacteria, and even the antibiotics we use to treat IBD can disrupt the normal GI flora. Make sure there is not a chicken or beef base.
Probiotics have bacteria that are considered to be beneficial to the GI tract. Probiotics have fiber that is fermented for good bacteria.
When the liver is involved (Triaditis) we might also use Actigall (ursodiol) or Denamarin (s-adenosyl methionine)
IBD can be painful, and it is important to keep the pet as comfortable as possible during an acute episode of IBD or severe case of Triaditis. Prednisone, prednisone, and Flagyl decrease inflammation, which helps minimze pain. Specific pain medications are also used.
Limited studies show promising results
A last resort that can be effective. The feces must be negative for pathogens.
The prognosis depends on many factors. This disease is usually not cured, unless there is a food allergy and we find the right diet for your pet. Most cases are controlled with diet and medication. IBD and it’s associated diseases tend to be a long-term problem that is usually managed successfully. You increase your chance of success by giving medication consistently and bringing your pet to us for exams and diagnostic tests to look for changes that require a change in treatment.
In the past, we may have accepted a declining quality of life for our aging pets as a fact of life beyond our control. Like humans, older dogs and cats are more likely to encounter health problems than younger pets. Thanks to advances in veterinary medicine, pets are living longer than ever before. A 7 year old dog or cat is equivalent to a 50 year old person.
Most humanoids are practicing preventive medicine at this age- routine physical exams, breast exams, prostate exams, blood pressure checkups, blood panels and dietary changes. Dogs and cats need similar preventive medicine at this age. Since they age approximately 7 years for every 1 year of human life, an 8 year old dog or cat is equivalent to a 56 year old person, and a 9 year old dog or cat is equivalent ot a 63 year old person. This rapid yearly increase in equivalent age emphasizes the fact that we need to pay close attention to all dogs and cats as they move beyond 7 years of life.
Just as older people experience a progressive decline in physical condition, so do senior pets. Studies indicate that 36% of senior dogs suffer from osteoarthritis, 18% show signs of Cognitive Dysfunction Syndrome, and the number one diagnosed disease of dogs in all age groups is dental disease.
Compared to humans, old age problems may progress up to 7 times faster in senior pets. Having your senior pet examined only once a year is like a senior person visiting the doctor only once every seven years. That is why, as your pet nears 7 years of age (5 years of age in Giant Breeds), preventive senior exams every 6 months can help assess your pet’s current health, provide a baseline for monitoring changes in the years ahead, and help detect health problems in the early stages, when diseases can be treated more effectively.
Senior Care is “geriatric” medicine for pets. Senior health care implies both preventive and therapeutic approaches to medicine, including nutrition, dental care, and exercise as well as therapy for diseases.
Changes in behavior or appearance may be the first indication of a problem. However, these signs may not be apparent in the exam room during your veterinary visit. It is important for you to watch for subtle changes, especially in stoic older pets.
Difficulty climbing stairs
Difficulty jumping up
Increased stiffness or limping
Loss of housetraining
Changes in activity level
Confusion or disorientation
Less interaction with family
Tremors or shaking
Skin and haircoat changes
Changes in sleeping patterns
Less enthusiastic greeting or behavior
Obesity- As their metabolism slows down it is easy to overfeed. This leads to arthritis, sugar diabetes, liver disease, and heart disease.
Dental– Inflammation of the teeth and gums may lead to pain, infection, tooth loss, bad breath, kidney and heart disease, and, as a result, decrease your pet’s life expectancy.
Hormone (endocrine)- cause a vast array of symptoms that are treatable and sometimes curable.
Cushing’s– Excess production of cortisol (cortisone) by the adrenal glands
Addison’s– The opposite of Cushing’s
Diabetes (sugar) – Excess glucose in the bloodstream due to a lack of insulin
Hyperthyroid– Excess production of thyroid hormone
Hypothyroid– Inadequate amount of thyroid production
Kidney– Failure of this organ can lead to chemical imbalances, anemia, compromised immune function, and blood clotting defects as well as altered mental capacity. Kidney disease is a leading cause of death in geriatric cats.Chronic Urinary Tract Infections can easily occur without you being aware. These are painful, and can predispose your pet to bladder stones.
Liver– Failure can lead to serious disease with chemical imbalances, anemia, compromised immune function, and blood clotting defects as well as altered mental capacity.
Heart– Pets with heart disease can experience difficulty breathing, fatigue, exercise intolerance, and lethargy.
Cancer– Can occur in many different organs. Early detection may improve the prognosis. Many treatments are available and most have few side effects.
Cognitive Dysfunction Syndrome– Similar to senility or Alzheimers in people.
Skin conditions-Hair loss, itching, and skin infections are common
Arthritis-This is painful and debilitating, and can easily sneak up on a pet without you being aware of it.
High Blood Pressure– Usually secondary to a heart problem, kidney problem, or high thyroid problem.
Inflammatory Bowe Disease (IBD)- A common problem in cats as they age.
Epilepsy– These seizures have an unknown origin, and occur in older pets.
With frequent checkups, at least twice a year, we can screen for common senior diseases. By diagnosing and treating problems earlier, we may be able to slow the disease process and prevent pain and discomfort.
In addition to a complete physical examination, diagnostic tests can help detect many diseases before your pet displays signs of a condition. Even if results are normal, the findings give you veterinarian a good baseline to identify and monitor changes in your pet’s health as the years progress.
You can do an in-home exam to help catch problems before they become entrenched.
|Physical Examination||We can check for physical signs of cancer, arthritis, heart and lung disease, dental disease, or cataracts.|
|Complete Blood Count
|This test helps identify infections, anemia, and certain types of cancer as well as problems with bleeding and the immune system.|
|Serum Chemistry Profile||This blood test can help identify diseases of the liver and kidney, and endocrine disorders such as Diabetes or Cushing’s.|
|Complete Urinalysis||A urine sample can help test for kidney disease, diabetes, urinary tract infections, and bladder stones.|
|Fecal Exam||A fecal sample can be checked for internal parasites and bacterial overgrowth.|
|Other Tests||Depending on your pet’s overall health, we may recommend additional tests such as blood pressure measurement, radiographs, electrocardiography (ECG or EKG),ultrasound, thyroid (hyperthyroid or hypothyroid) or adrenal gland (Cushing’s or addison’s) testing, as well as liver, pancreas, and small intestine function tests.|
Here are examples of blood panels and urine samples that caught problems early, and before they became so well entrenched we would have a difficult time treating them.
This pet is anemic
This one has kidney failure
Nutritional needs of pets change as they get older. Senior dogs should consume fewer calories due to decreased activity and reduced daily energy needs. This is very important because obesity increases the risk of serious diseases, arthritis, diabetes, cardiovascular disease, respiratory disease, and musculoskeletal disorders in older dogs.
Pet foods, specifically for seniors, are now available with fewer calories, limited phosphorous, more protein, balanced fatty acids, antioxidants, vitamins and minerals to meet the specific nutritional needs of senior pets. These foods have optimum amounts of nutrition, and can help in the progression of common diseases like kidney disease.
All cats that are 7 years of age and older should be on Hill’s K/D due to the significant prevalence of this problem.
Many older dogs are obese and arthritic, and the Hill’s food Metabolic and Mobility is a major help for them.
We have much more information about nutrition in animals, and why you should never take the advice of a pet store or groomer on nutrition. It is an interesting read.
1. Survey of Veterinarians, 1998. Sponsored by The Iams Company and Pfizer Animal Health.
Developed for Long Beach animal Hospital, by Glenna M Gobar DVM, MPVM, MS, courtesy of Pfizer animal Health; Sept 2001
Return to top of page
We did some laser surgery on a small shark at the Long Beach Aquarium
This 14 day old chick broke his leg. He should heal just fine and be good-to-go in a few weeks.
We recently completed the purchase of a state-of-the-art Digital Radiography unit. This computerized system will give us greater detail than ever in making a diagnosis.
Here is an example of the detail from a peregrine falcon that was presented to our wildlife program
Dr P took 25 people to the Masai Mara in October 2007 to photograph the wildebeest migration. Join us in the adventure– click on the wildebeest picture below.
Follow this link if you want to see the surgery- Sea Lion Neuter
Time for a little fun break in between clients
Lisa is now a certified veterinary technician
Daisy was rescued from Beaumont, Texas. For more information on rescuing pets in our local area contact Cathy’s K-9 rescue in Bellflower. They are up for adoption at Petco in Lakewood.
Daisy with her proud new momma!
Dr. P went to Africa in October of 2005 to help an Earthwatch team research lions. Follow me……
The first two phases are completed, the third and final phase will be completed in 2007
Dr. P went to Alaska the summer of 2005. Most of his time was spent with the bears of Katmai National Park. We have an informative page on his trip.
No doubt about it, this one is a record
One of our mentors, and one of the finest persons we know, passed away this week from cancer. He was a great human being, and taught how to give to our clients, their pets, and our community.
This is Paul doing what he did best- teaching. He is explaining to one of our rehabilitators the medical problem of a hawk with an eye problem that we sent to him from our Wildlife Program.
It was another milestone for Sandra this week, although we don’t dare ask exactly which one it is.
Wonder what she is wishing for…….probably a personal assistant or something foolish like that!
We love this picture of a Water Dragon that came in this week
Anybody got any chocolate covered flies for dinner? I like them best when they are nice and crunchy!
Chocolate covered flies? How reptilian! We prefer our chocolate over almonds.
At the beginning of March we made a diagnosis of Lyme Disease in a dog that spent time back East. Its a beautiful dog named Natasha, that was brought to us because of a limping problem on her right front leg. Her exam revealed no abnormalities to indicate a cause to her limp. Dogs of this breed and age can have numerous causes to a lameness. A complete set of radiographs were normal, eliminating many of these potential causes.
Natasha is being treated with doxycycline for one month. Natasha recovered uneventfully and is back East doing her “Natasha” thing.
How would you like to come home to this, your lovely little Jack Russell (why are we not surprised it is a Jack Russell?) on the wrong end of a bone.
The swelling on the front part of the lower jaw is obvious in this photo, and will require sedation of our little friend because we need to cut it off.
After a touch of the old “happy juice” she was relaxed enough to allow us to get to work. We had to use the dremel to make our initial cut in the bone.
Once we had one side partially cut we are able to cut through the remainder with our heavy duty cutters. You can see Dr. P’s hands supporting the jaw firmly because it took all of our strength to cut the bone, and we did not want to injure the jaw in the process.
The bone was stuck so severely, and the jaw so swollen, that we had to cut the bone again in order to get it off.
Gee, I wonder what I can get into next to drive my mom crazy!
A group of young Japanese animal technicians paid us a visit. They were on a 5 day whirlwind tour of animal related venues in Los angeles, and came by to learn about exotic animal medicine.
Their teacher was present also. In this picture they are learning proper restraint of a large bird, in this case, a Canada goose.
Lisa and Dr. Ridgeway demonstrated how to take a blood sample on a bird
Our own Chuck Henry (actually Chuck belongs to Rita Minnell) made it in the November 18th, 2004 issue of Beach Week. Way to go Chuck!
This summer Dr. Ridgeway went to africa with his family. He took some fantastic pictures….Can you guess this bird?
We have a new dental unit that gives us the opportunity to provide optimum dental care for pets. Its basically the same unit used for humanoids, and yes, it slices, it dices, and it even washes your car! Well, at least it does a great job on teeth. You can learn much more about dental care on pets.
Our nurses and doctors attended a dental seminar this week updating us on the latest information and techniques in this important health measure.
Dr. R had some family visiting from Illinois. They came to visit us at the clinic and helped us in surgery.
Dr. P and Dr. R became certified in the AED (Automatic External Defibrillator) this week. Our nice instructor, Diane, stayed after her training and assisted us in laser surgery on a poodle’s foot.
Our current extern is from the Philippines. Her name is April, and she comes from a family of doctors. Here she is helping us with our Wildlife Program by examining an acorn woodpecker.
One of the local humane groups brought a fox to our Wildlife Program that was injured in the Grand Prix fire. Its feet were mildly burned, but otherwise it was no worse for wear. Once a suitable habitat is found for release she will be on her way.
I go by various names- cutie pie, chick magnet, etc., etc. Either way, aren’t I the most adorable thing you’ve seen this side of the Mississippi? My mom says you can rent me out for $25 per hour- hey, where’s my cut in all this action!
A peregrine falcon from the South Bay Wildlife Center was brought to us this week for a wing problem.
Wendy and Sandra represented us at the Long Beach Recreational Dog Park Association’s third annual dog walk and pet fair-Thanks ladies!
Be sure to stop by and see us at the Friends of the Long Beach Animal’s Walk for the Animals 2003 on September 28th. If you come by our booth you will get some free goodies, and we can take your picture and put it on our web site for your friends to see.
Dr. P just returned from the American Veterinary Medical Association’s annual meeting in Denver. He gave several presentations to the doctors on informatics- using the internet and business practices to provide better care for clients.
One of our junior veterinarians came in recently to supervise one of our surgical procedures. He made sure everything went as planned!
Donatella, the black sea turtle Dr. Ridgeway performed surgery on a few weeks ago, (see picture later in this page) is doing fine.
If you have never worked on a 250 pound pig then count yourself one of the luckier inhabitants of this planet. They are louder than a jet aircraft engine, more uncooperative than a teenager, and eat just like, well, a pig!
This one was sedated so that we could trim its overgrown nails.
Its springtime, which means baby bird season. This little hummer is getting a tank of jet fuel in his tummy. Please remember that we only care for injured wildlife. If you find baby birds on the ground there is a good chance their mother is watching them. If you know what nest they come from, place them back in it. In general, its just best to leave nature alone. Remember to go to our Wildlife Page to learn more about our program.
Its still springtime, so now we have a baby skunk and a very hungry kitten
Dr. Ridgeway had a few students follow him for the day. They took notes on everything they saw as part of a school project. We now have some future veterinarians to hire!
We had a fish come in this week that was swimming erratically and had a growth on its side. He was easy to catch because of his illness and the fact that his buoyancy was affected.
We aspirated the growth and found it only contained air. Removing this air did help his buoyancy.
A radiograph revealed possible liver disease with secondary fluid buildup in the abdomen (called a coelomic cavity in fish), or a tumor.
The prognosis is not good. After weighing we sent the little guy home with some medication and will be rechecking him in a few days.
We recently started a new treatment modality that has been a huge benefit to many of our patients. It has allowed us to alleviate pain and suffering without having to resort to drugs all the time. We have a page on VOM that describes it in more detail.
Our staff party this year was a “Mystery Dinner” cruise in Long Beach Harbor. Some of us even figured who dunnit, while the rest of us didn’t care who dunnit, we were there to have fun.
Here we are before the fun ( and drinking) begins
Dr. P got pulled out of the audience to be part of the play. Here he is memorizing the script.
His role was to propose to one of the actors. It turns out she was hiding some important secrets…..
The CAN-CAN girl was the hit of the night (at least with all the guys)
Ian was speechless!
Jesus couldn’t get the smile off his face!
Dr. R seemed to have the most fun with her!
Claudia got a chance to show her CAN-CAN abilities
In the end, it was Corey who figured out the murderer- NOT!
Dr. R and Dr. P were just glad that nobody fell off the boat.
It is amazing how similar this fetus looks to a human baby.
If you don’t know what a Marmoset is, follow the yellow brick road…
An interesting patient brought to our wildlife program recently was a butterfly.
Its wing injury prevented it from flying
We fixed the wing with special tissue glue
After an appropriate amount of rest we filled up his tank with high octane jet fuel….
……and sent him on his way
On a recent vacation to visit family in Colorado the Ridgeway’s visited the small town of Estes Park near Boulder. Just walking down the street they saw lots of Elk and heard them bugeling. The elk in this area are protected and wear identification ear tags. They even saw one female elk with a satellite tracking collar around her neck.
Dr. P went to Alaska this summer. We have a slide show on his trip.
We added a new page recently on heart disease. It is a very detailed page, and will require a little time on your part to get through it all. Like all of our pages, if the detail is too much there is a summary page for your reading pleasure.
Our Wildlife Program took in a baby hawk with a fractured wing
After examining the chick we took a radiograph that revealed a severely fractured humerus (upper arm)
A nice whiff of our gas and off we go to surgery
Dr. Ridgeway performed the surgery during his lunch hour
He put a pin in the bone, called an IM pin, for stability
This postoperative radiograph shows the placement of the pin before its final adjustment
We had an interesting character visit us this week. We call him a “Pac Man” frog.
One of our wildlife groups needed at TB test on a Marmoset. If you look at the left eyelid you will see a reddish area that is swollen. This is how we do the test. We look at it daily over the next several days to see if there is a more extensive reaction, an indication of TB (tuberculosis)
Dr. P just came back from an advanced laser seminar at the veterinary school at Davis. He will be sharing this information with the other doctors this week.
You can learn more about laser surgery by visiting our Laser page.
Dr. P and one of his friends took Dr. Baccaro (she’s the one on the left) mountain biking in Laguna Beach. After her experience Dr. B was asked if she wants to go again. Her answer was “I’ll think about it”
On March 13th we hosted a lab seminar on reptiles and birds. We invited technicians from other animal hospitals and gave them a chance to get some hands-on experience obtaining blood. We have a short Quicktime video in this section- it will take a few minutes to download, depending on your connection. If you do not have Quicktime you can get it from www.apple.com
Terri and Dan are demonstrating the proper method to find the beating heart of a snake.
Dr. Petersen does it the easy way with our Doppler blood pressure monitor. Double click on the picture when it is finished downloading and you will hear the beating heart. You need QuickTime from www.apple.com to view it.
Dr. Ridgeway is giving instructions on how to obtain blood from a snake
Martin is supervising as we take blood from an iguana
Lisa is showing the proper way to hold a tortoise prior to obtaining the sample. Watch your fingers Lisa….
Cassandra graduates another successful student
A job well done!
Alma and Wendy decided they would rather play with the horse in back
A special thank you to Squishee for his assistance!
A travelling circus brought us a kangaroo for a routine exam this week. He was quite friendly, and loved to pose. His cataracts were not posing any significant problems.
Hard to find better look alikes than these two!
Wendy is caring for one of our wildlife patients recently. Its a Canada goose with a broken leg.
It had a fractured tibiotarsal bone (equivalent to our shinbone). This is called a midshaft transverse fracture
Dr. Petersen did his magic and put a pin in the bone called an intramedullary pin
The pin will stay in for up to 2 months. The goose just has to be a little careful when he goes through the metal dectector at the airport when he flies back to Canada
Five days after surgery he was walking around the hospital giving orders to everyone
Some of the students from our local schools came in recently to follow our doctors as they cared for sick pets. This student is learning how to read a radiograph.
Dr. Ridgeway and the staff received recognition for all their efforts in helping the wildife in our area.
Our Wildlife Program received a red tailed hawk with an injured right eye this week. It seemed to be in good shape, but we did not want to release it back to the wild until we were sure it would survive well on its own. Billie Scheaffer, by far our best wildlife volunteer, met Dr. Palazzolo at Dr. Paul Jackson’s office in Newport Beach. Dr. Jackson is an animal eye specialist, and generously donated his time to our Wildlife Program by giving the hawk a thorough ophthalmic exam using his expertise and specialized equipment. This picture shows Dr. Jackson using an instrument to check for glaucoma.
After the exam Dr. Jackson explained the problem. There was probably some penetrating foreign object (plant material, prey animal’s nail, etc) that penetrated the eye and injured the lens. Even though the lens was still present, it was only working at marginal capacity. Fortunately, this hawk has done well with minimal vision in its right eye.
This is a radiograph of a dog with a mild, chronic discharge near its toenail. Dr. R sent a sample of the discharge to the lab and found out it was a cancer called Squamous Cell Carcinoma (SCC). We took an x-ray of the foot- the arrow points to the cancerous area. You can see how the bone has been destroyed, and it is surrounded by swollen tissue.
This is a picture, through the bandage, right after we amputated the cancerous toe. This dog is doing fine–he certainly feels much better. You can learn more about Squamous Cell Carcinoma, especially in cats.
This poor little rat had such overgrown teeth that it was literally stunted from a lack of nutrition.
A quick sedative and we were able to start the process of trimming them back to normal
Ever wonder how we obtain a blood sample from a rabbit? This is the front leg of a rabbit, with the hair spayed gently with rubbing alcohol. It is much easier to see the blue vein running horizontally when the skin is wet, although, many times we cannot see the veins of the animals we obtain blood from, we can only feel them.
We use a very small needle (25-27 gauge) to gently aspirate a small amount of blood
These are the tubes we send to the lab for analysis. Each one holds 1-2 cc’s. For comparison purposes, a teaspoon holds 5 cc’s. On this small amount of blood our lab can perform an extensive number of tests
We have a nice section on Rabbit Diseases.
This ultrasound picture depicts a stone (calculi) in the gall bladder of a cat. The stone is labeled “calc” in the picture, and it is 1.1 cm in size
We have an extensive page on liver disease that will show you more pictures like these.
This picture shows the crop (not the stomach) of a very young bird. The crop is the storage organ of a bird just before the stomach. As you can see, they know how to fill it up! If these babies are not fed in the right amount, and at the right temperature, they can get diseases in this organ.
Don’t forget, we have an Avian Section to learn more about bird diseases.
This is Fred the goose getting fluid removed from his abdomen. We knew he had a problem because he was not acting normally, his abdomen was distended, and his radiograph showed fluid in his abdomen.
This closeup reveals what the fluid looked like. We removed the equivalent of 500 cc from Fred, which is an extensive amount. Unfortunately, this is probably a sign of severe disease, possibly the liver disease.
This cute little guy (he’s cute because he is sedated!) is a sugar glider from one of the wildlife organizations we donate our time to (Wildlife on Wheels- WOW). You will see their van in front of our hospital on occasion.
He came in for a neuter, so neuter we did. This picture shows Dr. Ridgeway using the laser to very gently neuter him (his boy parts were very small). He woke up as ornery as ever and went home fine that night.
One of our nurses, Lisa Welch, received an award from the Long Beach Aquarium for volunteering her expertise. Yea Lisa!
On Sunday the Friends of the Long Beach Animal Shelter had their 2nd annual dog walk
There were several dignitaries on hand – the “Frasier” dog, the “As Good as it Gets” dog, the Ice Dogs mascot, the L.B. Aquarium mascot, and the mayor!
Sandra and Cassandra set up a nice booth for our hospital. They answered lots of questions, gave out lots of Capstar, and put up with Dr. P taking pictures!
Dr. P embarassed Sandra by making her take a picture with the Ice Dogs mascot!
One of our dog patients had a chronic vomiting problem. This radiograph was taken immediately after barium was given orally. You can see how it has filled the stomach and has made its way into the small intestines. Did you notice the small microchip also?
Our staff and their friends recently spent a very relaxing Sunday (not!) at Magic Mountain. No wonder why they were so tired at work the next day!
This is a picture of a developing egg from a desert tortoise. We will let you know when it hatches!
We have a section on diseases of reptiles you might want to visit.
This week we welcomed one of our local schools on a field trip. Thank God their teachers were with them!
Our Wildlife Program was busy this week. We had several injured pelicans brought to us along with this baby hummingbird.
We also had a baby sparrow that was stuck in a glue trap
As it turns out we got the glue off without any major damage
We recently added a large section on behavior training in puppies. If you just got a puppy this is must reading for the summer.
She had to be anesthetized before we could do anything with her. She was kept in a warm water blanket to maintain normal body temperature
Several specialists were called in to help. This is a humanoid ophthalmologist, Dr. Art Giebel, examining her eye with the aid of our veterinary ophthalmologist, Dr. Paul Jackson
She has several problems with her eyes, the worst of which was a lens that had moved out of its normal position, making vision virtually impossible
While the eye specialists were working on her eyes, Dr. P was using the laser to help heal her flipper lesions. We have a detailed section on laser surgery
On May 10th Dr. R gave a tortoise a blood transfusion. We have a detailed section on tortoise diseases.
This rabbit caught his leg in his cage and thrashed so much he broke his radius and ulna.
We put a splint on it and it should heal just fine, as long as he stays quiet! We have a detailed section on rabbit diseases.
On Sunday May 6th several of our staff members participated in the Long Beach AIDS walk
The Long Beach Animal Control brought a male Peregrine falcon to us as part of our Wildlife Program. It was found on Cerritos street.
We know its history from its leg bands. This bird was hatched at Fashion Island in Newport Beach last year. Maybe his mother likes to shop at Neiman-Marcus!
The wildlife program also received a female Barn owl with 5 babies. This one is only a few days old!
Can you tell what animal this radiograph is from? We’ll give you a hint- they are great pets for kids. Send us an e-mail if you want to know if you got it right.
This little meeser was from one of our local grade schools. He was so tiny he easily fit into our hands. Its not a good idea to put an owl and a mouse on the same web page though!
We treated a dog for Heartworm recently. The drug we use is very potent and can cause side effects if not used carefully. This stresses the importance of prevention over treatment.
Heartworms are spread by mosquitoes. The heavy rains we had this past winter will bring a bumper crop of mosquitoes this summer. To prevent our local dogs from being infected we are having a special on heartworm testing and treatment in the months of April and May. Here is a copy of the letter we mailed out to all our dog owning clients:
Dear LBAH Client,
For the past decade the doctors of the Long Beach Animal Hospital have been tracking the occurrence of heartworm in Southern California. Even though this disease occurs throughout the country, the incidence of heartworm in our native dogs during this time has been minimal. The situation has changed to the point you need to be aware of this disease. Numerous local veterinarians are diagnosing heartworm in their patients, and with the advent of the rain we had in February, there will be more mosquitoes than usual. Since mosquitoes spread heartworm we expect the number of cases to increase.
Heartworm is a parasite that literally causes worms in the heart, leading to heart failure. Unfortunately, the treatment for heartworm involves the injection of a potent medication that can make a dog ill. Dead heartworms can cause an inflammatory reaction that can also make a dog very ill. Prevention is obviously better than treating. To learn more about heartworm please go to the following web site: www.heartwormsociety.org/
Prevention is easily accomplished with oral medications that are given monthly. The medication we use is called Sentinel, by Novartis. Sentinel also control fleas and internal parasites, so you are helping your pet with other common problems. Our web site at https://www.lbah.com/word/canine/worms-internal-parasites/has parasite information.
Before any dog is started on Sentinel it must test negative for heartworm. During the months of April and May our laboratory is performing this test for only $12.50, a 50% discount, courtesy of Novartis,. Novartis also offers a 100% guarantee- if you are not completely satisfied with any Novartis Animal Health Product, Novartis will solve the problem, replace the product, or refund your full purchase price. Please take advantage of this offer and call our office for an appointment to have one of our nurses perform your dogs heartworm test before May 31st.
This radiograph is from an older cat with a limping problem. Many outdoor cats with this type of problem have fractures, dislocations, or fight wounds as the cause. In this case we found a tumor, most likely caused by a tumor of the bone called osteosarcoma.
This 3 month old pup came in on an emergency this week in a comatose state. We immediately instituted IV fluidsand ran a blood glucose (sugar) test. It came back so low it did not register on the machine. We corrected the problem with IV dextrose, and within 5 minutes (picture below) he was feeling much better. It turns out he had Coccidia parasites, which could have been an initiating cause of the problem. All pups should be wormed and checked for internal parasites. Our Worms page has more details.
Its the time of year when the hibernating reptiles are waking up from their long nap. They are quite vulnerable now, especially to dog attacks. Please supervise you animals when they are left alone so we don’t encounter this type of damage.
Luther Sheaffer, the husband of one of our most ardent supporters, Billy, passed away recently. His tribute in the Press Telegram is a heartwarming story of how they met and fell in love.
This little one broke his leg. You can see his temporary splint on his rear leg.
His radiograph illustrates his fractured tibia (shinbone)
Hard to believe this cute little guy could actually swallow a needle.
Well here it is, plain as day on the radiograph just after after ingestion. In many dogs a needle of this size can pass harmlessly, especially when fed a meal of bulky type food. We can follow the progress of the needle with x-rays and intervene if there is a problem.
When we took a radiograph from a different view it was obvious just how large the needle was, and that surgery was a better option, especially since it was still in the stomach. In addition, there was the potential for string to be attached to the needle, which is an immediate reason to remove the needle. String can cause serious trauma to the intestines as it passes, so we want to remove it before it leaves the stomach.
So, off we went to surgery. After a few minutes of palpating the stomach the needle was localized. This close-up of the actual surgery shows Dr. P literally poking the needle through the stomach wall without having to make an incision.
Once the needle is sticking our far enough he can grab it and pull it all of the way out
The string behind the needle was knotted in a ball, so a tiny incision was made in the stomach to allow just enough room to remove the knot. You can see the needle at the left. The hemostat at the left is putting tension on the string so Dr. P can pull it though the stomach incision.
This is a picture of Cassandra our nurse and Bailey, a Vietnamese Pot-Bellied pig. Bailey is here to make sure he is ready for his neuter next week.
Our nurse Terry is taking a blood sample from Bailey prior to his surgery.
This is the action end of Bailey!
Dr. Ridgeway put a feeding tube in a baby desert tortoise that was ill and not eating well. We have a page on feeding tubes to help you understand their use.
The Long Beach Aquarium needed to take a radiograph of one of their sea turtles. Our nurse Terry is taking the x-ray. The turtle weighs almost 100 pounds, so this is no easy job (then why is Terri smiling so much?).
This little guy was presented to our wildlife program recently. Can you guess what it is ? (hint- its a famous cartoon character that goes “beep-beep”).
You might see our new mascot cruising (sometimes speeding) around the front office and exam rooms. His name is Tikki, and he has a magnetic personality. When you see him say hello!
Here is Tikki doing what he does best- get into mischief!
On Saturday December 3rd we walked the parade route for the Belmont Shore Christmas Parade. Of course we had to bring our 4 legged friends.
If you have never been to this parade you would be shocked at the number of people present. As you can imagine, the dogs were the hit of the parade.
One of our surgical patients recently was a Serval. It came in for a declaw. In this picture it is under anesthesia and ready for surgery. If you know anything about how feisty Servals are you understand how we enjoyed this moment of relative quiet.
We perform all of our declaws with laser due to its tremendous advantages
A good samaritan rescued this little guy from Eldorado park. In this picture our nurse Denise is holding him just prior to his treatment with intravenous (IV) fluids.
This is a picture of Michael recovering from his surgery. We removed several of his molars because the roots were elongated and causing significant pain in chewing.
This radiograph shows the extent of Michael’s problem. The white arrow on the bottom points to the elongated and rotting roots. This problem was caused by a lack of fiber in his diet. Rabbits need high fiber to prevent this- feeding only pelleted rabbit food can cause this root problem.
We have more information on rabbit teeth.
This nice little guy is name Tubby. As you can see, the right side of his face is swollen. His eye is also swollen partially shut. This is because he has a tooth abscess. Our dental page explains this abscess in more detail. He got this abscess because his teeth were never cleaned professionally. Tuffy is scheduled for surgery this week.
It turns out Tubby had a rotten canine tooth, which of course we removed. You can see the infection at the root (at the left).
This is a picture of Callie waking up from anesthesia. She is a little groggy, mostly because of her pain medication. She just had surgery for a broken femur (thigh bone) caused by falling out of a 2 story window. Callie is being comforted by Kelly (you may not recognize her because she has different colored hair every week).
The seriousness of her fracture is obvious. A splint won’t correct this, surgery is needed.
Several intramedullary pins (IM pins) were put into the femur for stability. She will need to be under strict rest for the next 2 months. We will keep you posted on her progress…
This past week somebody brought us a baby raccoon with a serious skin condition. We performed a skin scraping and found out it had mange. After we gave him an injection to cure the mange one of our nurses gave it a special bath to make him feel better. We will probably keep him for a few more weeks and treat him again until his skin has fully healed. You can learn more about how we provide care for wildlife by going to our Wildlife Program page.
Here is our little friend getting a bath from Amber.
All suds upped and no place to go!
On September 18th we successfully released the little guy. Here he is giving us a parting mug shot before he leaves.
In conjunction with our laboratory we recently put on a seminar for the technicians of other animal hospitals in the area. The seminar was a lecture and wet lab format, teaching these technicians and nurses how to obtain blood samples from birds and reptiles. Thanks to our hard working staff everyone had a very enjoyable time and the seminar attendees had plenty of hands on experience.
The presentation started out with Dr. P giving a slide presentation on proper techniques.
After we learned (and ate) we broke down into small groups and got down to the nitty gritty. Here is Terri explaining the proper way to obtain blood from an Iguana.
Amber is holding while one of the nurses successfully obtains blood from the tail vein.
Kim is making sure that this cockatiel is being held properly before any attempt is made to take blood.
This is John from our lab. He is not too keen on blood, but his curiosity got the best of him. We didn’t see him for quite a while after this…
Here are a few slides from the presentation…
Safety is always of great concern when working with reptiles. This list shows the ways in which they can harm a person. Salmonella is the bacteria that we are referring to in the list. The bottle of beer is our tongue-in-cheek way of warning everyone not to put anything in their mouths when working around reptiles because of the danger of Salmonella. If somebody does put something in their mouth the have to purchase a 6 pack for the rest of the team.
With birds most of the danger is from their beaks. The shore birds have very pointed beaks that can cause injury to face or eyes.
There is a bacteria in birds that has the potential to cause disease in people. It is called Psittacosis. If we hospitalize a bird with this disease we take special precautions.
Patient safety is also a concern. Reptiles can easily have weak bones due to metabolic bone disease, and are susceptible to fracturing during the handling process.
From this radiograph it is easy to understand their susceptibility to fracturing while trying to obtain blood.
Ill birds are highly susceptible to problems while obtaining blood. They are usually weak and having a difficult time breathing. Some of the signs of difficult breathing (called dyspnea) are obvious. Most of the time they are subtle.
This bird has subtle signs of respiratory disease as evidenced by the brown stain on the feathers from discharge around the nostrils (called nares).
Many birds have to be stabilized prior to blood sampling. They might need warmth, fluids, or even 100% oxygen like this bird.
Restraint in birds is just as important as in reptiles. This bird’s leg was fractured when someone at a pet store that was performing a nail trim did not use proper restraint.
Small birds do not contain much blood. In birds the size of parakeets (budgies) we can only obtain 0.25 cc’s in some cases. This is not enough blood for the lab to run a full panel, so we have to prioritize the tests. Sometimes we obtain such a small amount of blood that we run a PCV/TP in our hospital’s lab. This checks for anemia and gives us an idea of the protein level in the bloodstream. This protein level is a good prognostic indicator.
There are specific veins in each species that will yield blood. This slide shows some of those areas. How would you like to obtain blood from this 120 pound python?
In many reptiles we use the tail vein or jugular vein. Snakes are unique in their reptilian anatomy, and make it realistic to take a blood sample directly from the heart.
In addition to jugular veins found in reptiles we use a leg vein and a wing vein in birds. Toenails are never used because they not reliable indicators of what is going on in the bloodstream.
In the larger birds the leg vein will yield enough blood.
On Sunday September 10th at 2 PM our own doctor Petersen put on a presentation at the Long Beach Public Library at Bayshore and 2nd street in Belmont Shore. Don showed us the thought process and actual diagnosis and treatment of a cat with an intestinal problem. We have his presentation on our web site.
We will have more presentations at the library this fall, so call them for times.