LBAH Informational Articles

Vincent Palmeri- Extern Daily Diary  12/4/18

Today was another busy day at LBAH.  The first patient I was able to assist with was Milo, a 17 year old cat that came in late the previous night because he was acting depressed, recently had difficulty going to the restroom, and seems uncomfortable in his abdomen.  Dr. Kennedy did a thorough job examining Milo to find out that his presenting problems are likely related to a bad back as his x-rays showed arthritic changes (spondylosis) to his spinal vertebrae making it uncomfortable to use the restroom.  Further testing ruled out any kidney or urinary disease at this time and his overnight therapy helped Milo feel much better in the morning. We hope to see Milo back to being the normal cat he always has been.  
Another amazing case we had today was a 2 year old guinea pig named Aubrey.  She came in today to have one of her eyes removed.  Unfortunately over the weekend she seemed to have some type of traumatic episode to her eye that caused an infection and  she lost her vision in that eye, and not it is painful.  Dr. Kennedy did an amazing job removing Aubrey’s affected eye and she recovered fully after her procedure.  Abscesses in pocket pets can be serious problems and unfortunately they can linger for a long time.  It becomes very important to follow with proper postoperative care at home and continue to monitor them for any new changes such as decreased weight or inappetence. We are very hopeful that Aubrey will have a full recovery and will be back to her normal happy self.
Examining her to make sure she is ready before we proceed with the surgery
One of the monitors we used on her during this surgery to make sure there are no anesthetic problems
Ready to assist Dr. K
Terri keeping our friend warm as we leave the surgery room
Our patient is cozy warm as it is brought back to recovery
Stay tuned for tomorrow’s update as it will be a fun-filled day with many boarded specialists coming in to work together with the staff at LBAH on some of their cases.  One case in particular is a dog named Frankie, who within the past couple months had been showing episodes of vomiting and lethargy.  He was recently diagnosed by the doctors at LBAH as having Gall bladder disease.  This is a very serious condition in dogs, where an accumulation of bile sludge stays within the gall bladder and has difficulty emptying, and can become life-threatening.  Frankie is scheduled to have his gall bladder removed tomorrow with the amazing Dr. Larsen, a board certified veterinary surgeon who works together with LBAH.  Here is a link to the procedure Frankie will be undertaking tomorrow:  https://www.lbah.com/word/liver-diseases-2/ 
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Vincent Palmeri- Extern Daily Diary  12/4/18

 Today was another great experience at LBAH.  I started my day going over very important cases with Dr. P, cases that are very common on a daily basis for veterinarians.  The case we discussed was about Lil man.  Lil man is a 10.5 year old neutered male Shitzu that came in because he was not eating, and unexplained urinary accidents at home.  His examination and lab diagnostics pointed towards a infection in the urinary system.  With a great assessment by the doctors and proper medical treatment, Frankie has been doing much better at home since he was discharged.  Urinary diseases are very important in all animals, regardless of the species.  More information about urinary diseases can be found on our website at https://www.lbah.com/word/feline/feline-urinary-tract-disease/ 
Another hospital favorite that I assisted with today was Coco.  Coco is a beautiful shitzu that visited us for a recheck on persistent allergies blood work.  Coco’s mom is amazing, and she does everything she can to ensure that Coco always has the best care.  This includes routine checkups with our practice as well as local veterinary dentists, veterinary dermatologists, and veterinary ophthalmologists.   Today Coco’s visit was well received with a great bill of health and we look forward to continue on keeping her happy and healthy.    
Another great patient I was saw today was a bird named Sugar.  Sugar was brought in on emergency because he was flying around at home and accidentally flew into a window.  Trauma such as that Sugar was involved in are very serious.  Our biggest fear is not only incidences of concussion but in most cases these type of incidences can be fatal for birds.  Pets can be very stoic when injured, and not show obvious signs of pain or disease until it is too late.  It is very important for a pet that goes through a traumatic event to be assessed by a veterinarian immediately. Our website goes over important information regarding pet assessment and care along with species specific diseases in the learning center and disease section:  https://www.lbah.com/word/learning-series/
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Osprey eating fish

There is lots of activity with the hawks and ospreys at Bolsa Chica right now. If you time it right you can see them while they are dining on some local cuisine.

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Chameleon Bone Disease

We have a new page on this serious problem in reptiles. Click on our friend below to learn more.

 

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Chameleon Bone Disease

Metabolic Bone Disease (MBD), also know as Nutritional Secondary HyperParathyroidism (NSHP), occurs in many reptiles that are non-carnivorous. This page talks about MBD in chameleons, although it is most common in the green Iguana.

There are differences in why chameleons get this problem as opposed to MBD in the green iguana, but the main problem of inadequate husbandry stays consistent. You should visit our Iguana page on MBD for much more information regarding cause and treatment of this terrible disease.

Veiled chameleons are highly susceptible to stress, and usually do not do well in captivity. Therefore it is important to pay as much attention to proper husbandry as possible. Veiled chameleons do not drink from a water bowl, and need to be misted. They need a basking spot with a heat bulb that gives them a heat range of 72-80 degrees F. They should have exposure to direct sunlight, or else a full spectrum UVB (ultraviolet B) light. Adult chameleons should be fed gut-loaded crickets (feeding the crickets collard greens, mustard greens, and squash), dusted with calcium and vitamin powder.

This is what we prefer to see, a normal veiled chameleon with an attitude!

This female veiled chameleon came to us with a problem.  She was unable to eat or walk wellAny time we have an ill chameleon we handle them gently because they are fragile.

Notice anything wrong?

Maybe this picture will help in your diagnosis

Her MBD problem is so severe that her tongue just hangs out

She was dehydrated, so we rehydrated her medically with fluid injections We were worried her tongue would dry out, so we dripped water on her on tongue.

We kept her surrounded by warm blankets and soaked paper towels

She was able to pull her tongue into her mouth once she was better after our rehydration and medical treatment

We applied a temporary porous tape bandage to keep the tongue inside when we were not feeding her

MBDChameleonRad

In addition to the tongue problem, she is filled with eggs and has fractures of her bones. This chameleon is seriously ill, and if we can get the bone problem solved we would think about spaying it to remove the eggs.

The splint we put on her fractured leg

Their eyes are amazing!

This is another chameleon with MBD, although the tongue is not affected on this one.

This chameleon is weak and cannot walk

 It has a spine curvature, along with fractures in all four legs.

This is the radiograph of this chameleon, see if you can see the fractures on all 4 legs. The bones lack density, and do not show up well on this radiograph, further evidence of the severity of this chameleon’s MBD. Compare it to the normal uromastyx below.

The straight spine, and increased bone density, is apparent

Before we can correct the husbandry and nutritional problems that caused this, we need to stabilize these fractures. It will be done with custom splints that will stay on at least one month.

Talia, our ace RVT (Registered Veterinary Technician) went to work, and made custom splints

It is important to put lots of padding under the splints

The left front leg is getting its first layer of gauze wrap

Half way there, both front legs are done

Our finished product, a four banger splint

Return to Reptile Diseases Section

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There are lions on the runway!

Lets hope nobody encounters this when flying in the United States. I am not sure the pilots here are as used to this as the bush pilots in Africa. They have seen this before, and make sure the coast is clear (and they do the clearing) before unloading passengers.

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Peregrine Falcon Eating a Pigeon

This peregrine falcon is being trained for release back into the wild. After it was exercised for the day it was give its dinner of pigeon, a natural prey for it.

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Laser Neuter -Guinea Pig

We neuter (castration or orchiectomy) Guinea Pigs in a manner similar to other animals. We always use the laser for its major advantages of minimal to no bleeding during surgery, and minimal to no pain, swelling, and inflammation after surgery. Those of us that have had surgery are aware of how much pain there is after surgery, and we do anything we can minimize that pain for our patients.

Our laser is warmed up and calibrated for the specific surgery we are doing before we start the procedure

The laser is so important for our patients we use it on all of our neuters. Here is a short video of how we use it on a dog. Notice the lack of bleeding.

Sometimes people get a jaded mindset when it comes to routine surgeries like neuters, that are performed by the thousands, especially at low cost spay and neuter clinics. It is a major surgery, and we treat it as such at the Long Beach Animal Hospital, which you will learn about in this page when we neuter a cutie named Felix.

Several days prior to any surgery one of our doctors will perform a physical exam to confirm your pet is ready for anesthesia. At that time we will go over any questions you have.

On the day of surgery we need your Guinea Pig in the hospital between 7:30 AM and 8 AM. Feed your Guinea Pig the morning of surgery, and we will feed it also when it is here. We don’t fast them like we do with some other animals.

Our surgeon will call you after the surgery is complete and your Guinea Pig is awake. It can go home in the late afternoon the day of surgery unless instructed otherwise. Please call our office at 4 PM for pickup time, you will be given written post operative instructions then. We are open until midnight if you need to pick up later.

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This is a sterile surgery, and our surgeon starts the pre-surgical process by using special soap to clean his/her hands

We scrub all the way to the elbow to minimize any chance of spreading an infection during surgery

OVH-rabbit-3

While our patient is being anesthetized our surgeon is already in our surgical suite setting up instruments. Our surgeon is ready to start before our patient is at a proper plane of anesthesia. Once the anesthetist gives the green light the surgery starts immediately. We want our surgeon waiting for his patient, not the other way around.  All of this is to minimize anesthetic time.

We keep a close tab on important physiologic parameters for all of our surgeries to minimize the risk of anesthesia. Minimizing the anesthetic risk also allows our patient to recover from anesthesia faster and recover from surgery faster.

Brianna is listening to the heart rate of Felix during the surgery

Monitors give us an early warning of an impending problem. Instruments like this give us a big safety margin since we can anticipate problems before they cause any trouble.

Surgery-Monitor

This machine monitors:

Temperature

Heart Rate

Heart rhythm

Oxygen saturation

Carbon dioxide level

Respiratory rate

Important anesthetic data is recorded for this surgery 

Graphic surgical photos coming up

Most Guinea Pigs have both testes in the scrotum, making them readily accessible by a scrotal incision. On rare occasion they might be undescended and in the abdomen, although this is more of problem in dogs and cats.

Brianna, our anesthetist, is keeping Felix cozy and warm as she brings him into our surgical suite

Felix is put on a warm water blanket and Dr. Wood performs an exam on him to make sure he is ready  for anesthesia. When the OK for anesthesia is given Felix gets a pain injection. 

After the pain injection he is placed in a chamber with 100% oxygen along with an anesthetic

When Felix is relaxed his oxygen and anesthesia are administered by a special mask that fits over his face

Felix is given fluids under the skin (SQ or subcutaneous) to help support important internal organs like liver and kidney

Felix’s boy parts are cleansed carefully prior to surgery

Extra attention is paid to keep Felix warm due to his small size. Starting at the bottom, you can see three things in this photo to accomplish this:

Warm water blanket on the bottom

Fluids that have been warmed up above the blanket

Warm blankets that surround Felix on top


When our patient is ready for surgery we start the scrotal incision with the laser

The lack of bleeding on this highly vascular and sensitive organ is because of the laser, as opposed to a scalpel blade. In the above photo the scrotum has been incised with the laser and what you are seeing is a strong tissue covering the teste called the tunic. 

Notice in this video how there is no bleeding as the testicle is brought out of the incision with the tunic still covering it.  The laser will now cut through the tunic to expose the testicle.

Guinea Pig testes have substantial fat around them

The fat is ligated first. This fast has minimal blood supply so one suture suffices. 

The teste has a much greater blood supply than the fat.  It  is double ligated as an extra safety margin to prevent any bleeding after surgery


After transecting the blood supply to the teste our surgeon checks for suture integrity and any bleeding from the cut edge. We use the laser to cut the edge for control of bleeding and for comfort. 


When our surgeon is sure there is no bleeding the blood supply to the teste is placed back into the tunic

The tunic is sutured to prevent any hernia

A close up of the teste after it has been removed. On the right is the epididymis, on the left is the teste. 

The scrotum is closed with surgical tissue glue, which is much more comfortable than sutures

Our surgical patients are given cold laser (we call it Companion Laser) treatment to aid in healing and minimize post operative swelling and discomfort. You get to wear cool glasses when using this type of laser!

Dr. Wood is making sure our patient is doing OK before bringing him to recovery.

Felix recovered without any problems, and was soon munching away at his favorite food. The pain inject he was given prior to surgery is in full effect when he wakes up from surgery. If he needs more he will be given another one, although that is rare when we use the laser. He was a great patient, and will be back to doing his Guinea Pig thing in no time.  

Return to Guinea Pig Diseases Page

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Birds in Flight (BIF)- Peregrine Falcon

First things first, if you want to shoot a flying falcon you need a flying falcon. Dr. Palazzolo has a friend that is a licensed falconer. She has a wild falcon that was given to her when it was young because the parents were attacking it. She has been training it and will be releasing it soon.

This very fast flying bird is an ideal candidate to practice BIF photography. Hang on to your hats for this one, because it doesn’t get any faster than this in the natural world. A peregrine falcon on a dive can go up to 240 mph! On two separate occasions Dr. P had a chance to photograph this female falcon as it was flying around him preying upon pigeons.

Birds in flight is one of the most difficult photographic situations encountered in wildlife photography (or any photography for that matter). Birds fly very fast, faster than people realize. A bird that is flying at 40 mph, which is par for the course, is going almost 6o feet every second!

It usually takes one of the higher end DSLR cameras with regards to autofocus and frame rate to consistently get your BIF shots in focus and with the right pose. More important than that though, is to practice with whatever equipment you have.

Dr. P’s equipment are a Canon 1Dx Mark II camera with a Canon 400mm f/4 D.O. version II lens handheld. The aperture was kept at f/4 for all photos, and the ISO was at 400, giving a shutter speed that varied from 1/3000th of a second to 1/8000th of a second. The camera was set to manual mode, and all autofocus points were active in a custom setting for flying birds.

On a camera that shoots ten frames per second (10 pictures per second), a bird at 40 mph is going 6 feet in between each of those shots. Ten frames per second is just marginal for a bird at 40 mph, let alone the speed of this peregrine which can be much faster. 

The falcon is always transported hooded to keep it calm. Once we got to the beach the hood comes off, although it cannot fly away because of the jesses being held by the falconer. 

The falcon has not been fed, so its senses are keen and it is ready to hunt. You can tell by the way it moves its head, even though it is hooded, that it is primed to go.

The hood is off and its time to find something to eat

In no time it is off

While it is still close now is the time to see if your camera settings are appropriate

It needs height to assess its prey and to have enough speed to dive, so the first thing it does is go up. Now is when the fun starts!

It banked right past as I tried to keep the lens right on her

One time she flew right at me lower than usual because the pigeon she wanted was flying just above the sand

Unfortunately, the falcon was far away when it got the pigeon

It flew off to a sand dune and enjoyed its pigeon dinner

The bird has complete trust in our falconer, and she was able to walk right up even though it was eating

She was able to put the jesses back on with no problem

The bird didn’t miss a beat and kept on eating in between shaking feathers out of its mouth

Another day, another try…….

Off it went to find a new pigeon, and a pigeon it found

It always wants to go high for a good vantage point and to be able to dive

When it spotted the pigeon it banked hard to the right

And streaked down at high speed

This time the pigeon stayed low, and used a garbage can for cover

The falcon closed in…..

….. but the pigeon made a hard turn at the right time

This pigeon lived to see another day

Our falconer called the falcon back for some food she had for it

When it saw the food she had it came right in

Dinner time

 













 

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Killer Whales (Orcas) of Washington State

In September Dr. P met his cousin in the Puget sound area to enjoy the beautiful scenery and look for Orcas. We hired a private boat and guide from Maya Legacy in Friday harbor. Allen our guide did a great job, and we learned much and saw many pods. His assistants April and Zoe also helped out.

We were in a part of a large ecosystem called the Salish Sea that is filled with salmon breeding grounds, which has attracted Orcas.

The resident (there are transients here also that eat marine mammals) Orcas are in serious danger of extinction. This is due to a major decrease in their main food source, chinook salmon. It is also due to pollution in the waters around them, and excessive sounds in the water, confusing them and making communication difficult. These sounds come from all the boats (the cavitation from the spinning propellors) in the area, and also the active sonar from Navy ships.

We stayed in Friday Harbor and went whale watching 3x all around the area

Friday Harbor is in the San Juan Islands, just east of Victoria, Canada

 

The people that live in this part of the world know their Orcas. This ranged from the naturalist that talked to us about them on the ferry ride over to Friday Harbor, to the captain of our boat and his assistant. They know all of the pods, whether they are local or transients, each family member, and what they eat. 

It takes a team effort to find them in these vast waters. There are biologists and naturalists that continually do research on the Orcas. Their knowledge is critical to understanding them. They worked together well as team with the local guiding companies that take people out to see them. The companies that take tourists out to find the Orcas are professionals, and share their knowledge with each other to help everyone see them. These guides have a private radio channel and private Facebook page to help facilitate this communication. It was a job well done!

The Orca kids!

Allen our captain working hard to find the whales

Allen with his assistant Zoe scanning for the mist from the whale blowholes when they exhaled

Zoe using Allen as a tripod to keep her binoculars steady. Hey, whatever works to find them!

Nicole was part of our team of Orca scanners

It takes a lot of eyes to find them, so Hugh used his “eagle eyes” and helped out also

Hugh got his chance to use the big glass. The most important things he learned was not to drop it in the water!

Chloe got jealous when Hugh got to use the professional camera and lens, so we had to let her have a go at it

This is a large male, as evidenced by his large dorsal fin, near our boat

You never know what direction they are coming from, so you need to be observant at all times

They are not easy to photograph. You need to be ready and time your shot for the few seconds they pop to the surface to breathe. In a bobbing boat this can be a challenge!

They were quite active and breached several times

Allen did a great job of anticipating where they would go. One time several members of a pod swam just a few feet in front of our bow.

Allen put a hydrophone in the water as they swam by

Their eerie sounds as they communicate with each other are mesmerizing. They can communicate like this for vast distances

Even though we were close to them, sometimes it was nice to see them in the distance

We even came across a humpback whale (Allen called them HB’s). He positioned us just right to get some nice backlight shots of them exhaling

There is plenty of other wildlife throughout the area, including southern sea lions, bald eagles, and several different species of seals.

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