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Rixatrix posted:I only have experience with people with mitral valve insufficiency and they're always older and it's nearly always due to myxomatous degeneration of the valve. What causes this in a puppy? Is there a congenital defect of some kind? He didn't have a murmur when he went for a vet check at 7 weeks, nor when he went for stiches at 9 weeks. Is it inherited? Will it progress? Even though it doesn't hurt him in his day to day life, does it affect his maximum aerobic capacity (performance animal and all that)? Is it genetic? Will it affect his life span? Will intense exercise throughout his life affect the way the disease progresses? Dogs do get the degenerative form of mitral disease, where it develops as they age, but they can also be born with a mitral defect that results in the same leak. Murmurs in puppies are tough--if they have certain characteristics, they can be "innocent murmurs" that go away as they age and are gone by about 16 weeks. A mitral murmur should have different characteristics than that, but not all dogs follow the rules, puppies can be difficult to auscult super accurately due to their size and wiggly puppy nature, and a 1/6 murmur is so quiet that an awful lot of people won't hear it. We joke that a 1/6 means only a cardiologist can hear it. Other things can also change the loudness (or presence) of a murmur, such as anemia, dehydration/hypovolemia, heart rate. As far as performance/aerobic capacity, I have nowhere near enough experience with performance animals with subclinical or mild heart disease, or whether that sort of activity will change the progression of the disease. With myxomatous mitral degeneration the disease is generally progressive, not sure if congenital forms always are. As for genetics, there are definite breed predilections for various congenital defects, though off the top of my head I don't know who gets congenital mitral insufficiency.
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May 3, 2013 07:33
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Dr. Chaco posted:though off the top of my head I don't know who gets congenital mitral insufficiency. Anyway thanks so much for your input. If anyone else wants to chime in, please do. If you can point me to literature, please do. I don't mind making the trip to the vet school's library for this. It's easy to find information on degenerative valve disease in older dogs, but not so much in puppies.
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May 3, 2013 07:45
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Rixatrix posted:Cavalier King Charles Spaniels iirc. Or is it degenerative valvular disease? I don't remember. Cavaliers get myxomatous DMVD, yes. So the cardiologist diagnosed mitral valve insufficiency from the echo? If it's pretty mild it can be insignificant as far as hemodynamics go, but having said that, one of the first signs that it's possible to see if it worsens is exercise intolerance. I also would scrap any breeding plans if it is indeed confirmed mitral dysplasia of some sort. I can't find much in primary literature but here is a section of the Merck Manual: http://www.merckmanuals.com/vet/cir..._dysplasia.html - it's more common in cats but seen in a handful of dog breeds.
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May 3, 2013 08:28
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Topoisomerase posted:So the cardiologist diagnosed mitral valve insufficiency from the echo? If it's pretty mild it can be insignificant as far as hemodynamics go, but having said that, one of the first signs that it's possible to see if it worsens is exercise intolerance. I also would scrap any breeding plans if it is indeed confirmed mitral dysplasia of some sort. I can't find much in primary literature but here is a section of the Merck Manual: http://www.merckmanuals.com/vet/cir..._dysplasia.html - it's more common in cats but seen in a handful of dog breeds. I'm still pretty upset over this. How much bad luck can one person have with dogs and inherited issues? I did all my homework diligently before getting the puppies and all were from health checked, healthy parents and good reputable breeders. Now I have two sick dogs and one with such a deficient temperament he can't perform. This sucks 
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May 3, 2013 08:35
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I'm sorry, that really does suck. FWIW there's a pretty good chance that if it's pretty mild she will do fine, the CV system is fairly good at compensating for a small setback. I can't give you real advice you know, but if it were me, I'd still do all the performance things that will probably make her much happier. She may not ever be a star though, and I know that's kind of what you've really been seeking out. I would talk to the breeder too, though I suspect that you're on top of it. lovely things can happen to good breeders too - my neurological trainwreck deaf dog came from a stellar line and it just all showed up out of nowhere for the breeder. Part of the cost of having purebred dogs at all, I guess.
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May 3, 2013 08:59
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Topoisomerase posted:I'm sorry, that really does suck. At the moment I'm thinking we'll live like he didn't have this diagnosis at all. I know already he's not the fastest bc around, but I'll have to become a better handler to compensate for that. And if at some point his disease progresses to CHF while he's still young(ish), I will probably choose to let him go. I will treat a health issue in my dogs without regard for time or money, but only if I know it will get better. Otherwise I'd rather they live a full life with me for as long as it's good, active and fulfilling and then try to let go while it's still "too early" rather than "too late".
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May 3, 2013 11:09
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Rixatrix posted:Yeah, I think the cardiologist is thinking he'll do just fine and will compensate at least for a good long while. It was very mild (though I didn't get any figures and none of the echo data and I was too upset to ask for it) and there was no structural remodeling of the heart or big vessels. The breeder knows, or at least I posted the information on the litter's FB page where she should see it. Why not call the cardiologist back? Also, call the practice and ask for copies of the workup and interpretation to be sent to you. They've got to write a report of some kind or they're not doing their jobs.
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May 3, 2013 13:26
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Rixatrix posted:At the moment I'm thinking we'll live like he didn't have this diagnosis at all. I know already he's not the fastest bc around, but I'll have to become a better handler to compensate for that. And if at some point his disease progresses to CHF while he's still young(ish), I will probably choose to let him go. I will treat a health issue in my dogs without regard for time or money, but only if I know it will get better. Otherwise I'd rather they live a full life with me for as long as it's good, active and fulfilling and then try to let go while it's still "too early" rather than "too late". Sorry yes, HE.  This is probably the response I would have as well. Also I agree that you should totally get some written records from the cardiologist so that you can keep track of progression as well in the future if you have to change doctors.
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May 3, 2013 16:36
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Khelmar posted:My friend got a history that read "Skin biopsy" the other day. You know we can tell it's skin by looking, right? How about from where and why, the stuff the scope doesn't mention? My tech today was trying to be all proactive and helpful and on the submission form for my (really blood contaminated) splenic aspirates was about to hit "Finalize and Print" when I noticed that all they'd done was put "spleen." I figure that a portion of the horrible history winners are simply vets that couldn't give a drat, but I wonder how many are vets that don't check what their techs are doing as they rush off into the next appointment. Then, the tech simply puts "Skin Biopsy" or whatever and the vet never gets an email from the diagnostic lab saying, "The poo poo are you doing, give us history" so nothing changes. Do labs do that, or are they too worried about losing clients that no one rocks the boat?
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May 5, 2013 06:43
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I'm a diagnostic lab tech. The ones with no history aren't so bad, I can usually fix those with a phone call to the clinic. It's cases like these that are the problems: "Sudden death, no sign of illness. Treated with X,Y, and Z" (why were you treating a healthy animal? Or did you try to treat it after it died?) "Severe pneumonia, please culture" (lung piece submitted is healthy and pink) Animal died last Friday, tossed her in the bed of the pickup, brought her in on Monday (I hate you) Specimen submitted for anthrax culture, the vet called us in advance so we were expecting it, but the box arrived with ANTHRAX written in big letters on the side (No idea how that one even made it through the mail)
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May 5, 2013 20:19
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You know at there's going to be client communication difficulties when the following occurs: Alright we're taking your little one back and we'll go ahead with the leg amputation surgery we were talking about for the last half hour! Okay, but you're gonna leave the paw right? Don't take my baby's paw! But we have to take off the whole leg, there's no way we can fix it. Oh, okay.5 minutes later while they're at the front desk... Doc, can you leave their paw? I want them to still have their paw!This also happened to be the first client I've ever yelled at. They were accusing us of trying to steal their dog because we had to push surgery back due to other emergencies. They said that the only reason why we're "making up stories" is so that we can steal their dog. They started rambling on about us stealing the dog, how they KNEW that's what we're doing and that's when I lost it. "Do you want me to send (name) home in pain? No? Then (name) is staying with us until they are medically cleared to go home. I want them to stay until I am sure that they won't need intensive care and the ONLY thing I care about is their medical need. We are not trying to steal your dog. We are trying to get them better!" They mumbled about how "Well if its medical its okay I didn't know that was the reason..." "We will call you in the morning. Good night."
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May 5, 2013 20:20
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TTA/TPLO chat: My 50'ish lb pointer mix girl has done her cruciate in her back hind leg. She's 3 legging it everywhere and putting no weight on it except to toe touch when she's standing to stabilize. We saw a vet today who can only perform the extracapsular repair but has an orthopedic surgeon he works with who can perform the TPLO surgery. She runs nonstop & plays extremely hard with our Shiba so I'm hesitant on going the extracapsular repair route and potentially having her re-injure the same cruciate and be at square one. The vet recommended we go the route of rest, anti-inflammatories & pain management for 2 weeks to see if she gets any better - if not, schedule a surgery. I feel a little better that he wasn't pushing the surgery hard right off the bat. My question is more for the TPLO & TTA surgeries. I've researched both (as far internet research goes) and there seems to be no real consensus on if one would be better except that the TPLO seems to cost slightly more. The vet made no mention of the TTA surgery so I would need to discuss it with the orthopedic surgeon to see if they can even do it. I'm confused on one versus the other, I want her to have a good life but at the same time I feel it's almost a crapshoot on which surgery to pursue if it goes that route.
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May 5, 2013 22:57
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Bovril Delight posted:My question is more for the TPLO & TTA surgeries. I've researched both (as far internet research goes) and there seems to be no real consensus on if one would be better except that the TPLO seems to cost slightly more. The vet made no mention of the TTA surgery so I would need to discuss it with the orthopedic surgeon to see if they can even do it. I'm confused on one versus the other, I want her to have a good life but at the same time I feel it's almost a crapshoot on which surgery to pursue if it goes that route. The surgeons I have worked with have a specific size range of dogs for whom they will consider a TTA as well as it may be cheaper, but the procedure itself has certain specific requirements. I can't give you any advice on which surgery would be most appropriate for your animal's specific case, as a good portion may depend on the actual structure of their skeleton lending itself to one surgery versus another. Long story short is, if you have any questions as to which is most appropriate for your animal, I would talk with the surgeon. Given their clinical experience and their comfort levels with either procedure they will likely be able to tell you why one procedure may be better than another.
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May 5, 2013 23:26
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HelloSailorSign posted:Do labs do that, or are they too worried about losing clients that no one rocks the boat? My usual line in the comments is along the lines of "Interpretation of these lesions is hindered by the inadequate history received." or "Additional history would aid in the interpretation of these lesions." VanGoober: I sympathize - my favorite was the dog who died, was put into a garbage bag, then a suitcase, and left in the trunk of a car in 100˚+ heat over a weekend. When they brought the dog in for necropsy, it was dripping out of the suitcase. Their concern? The dog was itchy, and their other dog is too, they were hoping to figure out what the skin problem was. There was also the time I got an autopsy report faxed over from someone because they were sure that what had caused their animal's (very non-specific) skin problem was what killed their relative. Nothing like talking to the state EPA about a biopsy that could have been from just about anything. Khelmar fucked around with this message at 04:25 on May 6, 2013 |
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May 6, 2013 04:22
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The other day I saw a 12 year old dog with a cough, and the techs roomed it in the exam room we use for infectious/contagious things (primarily parvo pups, URI cats, and kennel cough). This involved bleach buckets, iso gowns, and bleaching or Accel-ing staff who come in the room, the entire room when they leave, the paperwork they fill out, and the money they pay with. I gave the techs a little spiel about how not every coughing dog needs to be treated like it has kennel cough, given that we hardly ever see that here, compared to the dogs with heartworm, heart failure, collapsing tracheas, cancer, foxtails in their throat (which this turned out to be), etc. Basically, if it's not a young dog newly adopted from animal control, or a dog who came back from the boarding facility with a cough, we don't need to treat them all like they have the plague. I used the example of "we don't treat every vomiting dog like it has parvo, right? Only the sick puppies, or the dogs with bloody diarrhea and no vaccines, or dogs with known parvo exposure." This weekend we had a little bit of a disaster that has me wondering if every sick dogs needs a parvo test before it comes in the drat door (sick adult dog with a little bit of vomiting, dehydration, no diarrhea, hospitalized and worked up in main treatment area for 24 hours before being diagnosed with parvo, in the middle of our monthly vaccine clinic). Jesus Christ. It was a good lesson for our staff about how epidemics spread--I think they were getting a little over-zealous in their panic, given how freaking prevalent the virus is in this county already, and that our parking lot is full of it because we can't bleach the whole parking lot every time we get a parvo patient so they walk through it daily anyway, but they were considering where they went after work the day the dog was hospitalized, whose houses they exposed, where their boyfriends went after that, whether they had foster puppies at home, who worked the vaccine clinic in between x-rays and ultrasound and bloodwork on the sick dog, etc. Then we used a lot of bleach on every surface in the clinic. I know we never get it all, because people must track it in every day, but that's why we don't let people put puppies on the ground, and why we mop the front area whenever someone walks in and says "I was told to use the side entrance because my dog has parvo, where it that?" but that doesn't keep the staff from freaking out when we miss one like this. But, we had no reason to suspect parvo--so, that leads me to wonder, should every sick dog be tested, like we recommend FeLV/FIV tests for most sick cats with vague signs?
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May 6, 2013 18:41
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Woo in 1.5 hours will be my 13th euthanasia of the last 36hours! I guess one didn't count because it went agonal as I was trying to hit the heart, so...  :
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May 7, 2013 00:55
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HelloSailorSign posted:Woo in 1.5 hours will be my 13th euthanasia of the last 36hours! What's going on over there?!
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May 7, 2013 01:03
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Shnooks posted:What's going on over there?! May is the worst month. We're about ready to lock the doors and come back in June.
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May 7, 2013 01:16
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Dr. Chaco posted:May is the worst month. We're about ready to lock the doors and come back in June. Really? We've had a rush of euths mid-April and now nothing. Lots of new patients, though. Christmas is when we're doing euthanasias like every day. February-April was all constipated cats, all the time. Every day we had at least one constipated cat.
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May 7, 2013 01:35
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Shnooks posted:Really? We've had a rush of euths mid-April and now nothing. Lots of new patients, though. Christmas is when we're doing euthanasias like every day. I don't know if May is always this bad, I think it's just the last 72 hours. Lots of emergencies, lots of parvo (parvo coming out of our freaking ears), lots of dying animals whether or not it seems like that should be the case.
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May 7, 2013 01:58
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I just gave a lecture on emerging infectious diseases, using the TB outbreak in MI, ASF in Haiti, and the 2001 UK FMD outbreak as examples. Let me tell you, if you haven't read up on the UK FMD outbreak, you should - it's sobering as hell. 10 million animals euthanized in about 3 months, the local suicide rates spiked sky-high, divorce rates went through the roof.. it's ugly. South Korea euthanized something like 10% of the agricultural animals in that country during the 2010 outbreak. It's insane. Two ways to get famous from a foreign animal disease....
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May 7, 2013 01:58
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Khelmar posted:Two ways to get famous from a foreign animal disease.... IMO, there's four... 1: discover it. 2: miss it. 3: cure it. 4: die from it. Can't go into why thinks suck so bad, too much identifying info even in broad terms with some cases
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May 7, 2013 02:07
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Khelmar posted:if you haven't read up on the UK FMD outbreak, you should - it's sobering as hell. 10 million animals euthanized in about 3 months, the local suicide rates spiked sky-high, divorce rates went through the roof.. it's ugly. The focus on population medicine and public health at my school is massive due to this.
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May 7, 2013 08:08
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Does anyone have any insight or opinions on a career as an army/armed services veterinarian?
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May 8, 2013 15:05
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Parrotstalking posted:Does anyone have any insight or opinions on a career as an army/armed services veterinarian? http://www.elliottgarber.com/
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May 8, 2013 15:58
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Hey vet folk, I've started a thread here about vet diagnostics and cases. http://forums.somethingawful.com/showthread.php?threadid=3548441 If its something you all think is fun and interesting I'll keep doing it, otherwise I'll let it fall into oblivion!
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May 9, 2013 04:53
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HelloSailorSign posted:Hey vet folk, I've started a thread here about vet diagnostics and cases. Yay I like these even though I'm terrible at them.
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May 10, 2013 06:31
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Parrotstalking posted:Does anyone have any insight or opinions on a career as an army/armed services veterinarian? I've got several friends who have done it. On one hand, they pay for school, but you don't choose where you work or what you do. They also pay for residencies if you're selected after your 4 year stint, and they pay your military salary while you're a resident ($60k+ vs. $32k). They're also fairly competitive and you don't pick your specialty, either.
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May 10, 2013 13:33
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Parrotstalking posted:Does anyone have any insight or opinions on a career as an army/armed services veterinarian? I had looked into being an Army vet and spoke to several friends, that were in the army, about doing it. But, I ended up not being eligible based on that I didn't get accepted to any vet schools within the US. This was a few years ago now, but if I remember correctly, while in school you act as a reservist: one weekend a month, two weeks a year kind of deal. Upon graduation you'd have the rank of Captain (officer), boot camp, and then they ship you off wherever the hell they want to. One person I talked to was accepted into a residency after they graduated and the army basically told them, "No, you're ours now" and sent them elsewhere. I really don't think it's that bad of a deal even still, especially with how much vet school costs. That, and when you're stationed on a base they generally give you a place to live (being an officer) that's not too bad (kind of like a hotel), everything on base is duty free, and you're still paid without having to worry about $300,000 of loans sitting over your head to pay off.
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May 12, 2013 07:03
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only 4 more weeks of sitting in a classroom (and 3 days of final exams) EVER!!!!!! then a year of mental torture and indentured servitude interspersed with sleeplessness and occasional real feelings
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May 12, 2013 08:31
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I'm so jealous of that right now. I'm studying for my "Processes in Animal Disease" (basic pathology course) prac exam in a week and a half. Then I have my 3 days of exams which are thankfully not back to back. But I still ended up with a 9am exam on a Saturday. e: by studying for, I mean procrastinating by reading various threads on the forums that may or may not be relevant to my classes.
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May 12, 2013 08:43
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Topoisomerase posted:only 4 more weeks of sitting in a classroom (and 3 days of final exams) Fixed it for you. Hope that helps.
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May 12, 2013 22:18
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HelloSailorSign posted:Fixed it for you. Hope that helps. lol yes, I suppose there are also resident lectures to go to and give, if I end up being able to go that route. And some of them will be on boring crap like urinary and GI BS instead of cool stuff like BRAINS and SPINAL CORDS. But probably not 6 hours a day of it at least! and if I specialize I might at least not be really poor in 10 years! something to look forward to! oh yeah, in the lol category, I totally turned in my 'personal business plan' with a financial goal of 'avoid homelessness and becoming a crack dealer' by accident because I was a little bit tipsy and it was super close to the deadline, so I forgot to take out some of the snark. Whoops.
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May 12, 2013 22:59
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Topoisomerase posted:lol yes, I suppose there are also resident lectures to go to and give, if I end up being able to go that route. And some of them will be on boring crap like urinary and GI BS instead of cool stuff like BRAINS and SPINAL CORDS. But probably not 6 hours a day of it at least! That is a perfectly respectable goal.
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May 12, 2013 23:22
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Another fun-filled Sunday of emergencies (4 total? I lost track), "routine" surgeries (why yes, pedicle, I do believe you are bleeding), and euthanasia (what rage-filled fucker found it necessary to shoot a cat 5 times?). Now I get to be on call, daring my phone to ring, while trying, probably in vain, to save a neonatal kitten who hasn't quite decided that she for sure wants to die, but she's really thinking about it. Fortunately I have a new baby bunny who is super cute, and the new burger joint in town is pretty good. If only I could chase that down with a couple beers....
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May 13, 2013 03:52
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Dr. Chaco posted:Another fun-filled Sunday of emergencies (4 total? I lost track), "routine" surgeries (why yes, pedicle, I do believe you are bleeding), and euthanasia (what rage-filled fucker found it necessary to shoot a cat 5 times?). Now I get to be on call, daring my phone to ring, while trying, probably in vain, to save a neonatal kitten who hasn't quite decided that she for sure wants to die, but she's really thinking about it. Fortunately I have a new baby bunny who is super cute, and the new burger joint in town is pretty good. If only I could chase that down with a couple beers.... In my several years of working in vet clinics (as a lowly kennel assistant type position), the one thing I'm glad I don't see anymore having moved to Australia are gunshot wounds in pets. I don't understand why people just shoot at people's pets. There was one case when I was working back in the US of a dog that came in with a gunshot wound. The owner had brought it in with this story: "The neighbor shot it because she was charging at him. She's (the dog) never done anything like this before to anyone!" Well, I'm no ballistics expert by any means, but I know how a bullet flies (fairly well straight), but the bullet had passed through the upper right hind limb, and had become lodged in the humeroradial/ulnar joint of the right forlimb. Pretty certain that the dog was running away from the neighbor. It wasn't a BB or air rifle bullet, but what I believe was a .22 caliber bullet. Meanwhile, we're getting blood from this dog who is obviously in pain but instead of being ferocious or angry in any way, she's licking my chin while I'm restraining her. And yes, unfortunately the dog was a breed that resembles a pit bull, but isn't really. It's been nearly 6-7 years since this happened and I don't remember much else about the case. Just that I was annoyed that the neighbors story was obviously false.
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May 13, 2013 04:26
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I had a dog walk in with a gunshot wound to the abdomen. The dog looked so OK, I even took a couple of photos of it. Turns out it hit the aorta where the right renal artery branches off, but it didn't start bleeding until I got in there. I had someone trying to hold off the aorta until I could get some sort of clamp onto it, which, not surprisingly, didn't work. Dog bled out on the table. Not sad to not do surgery anymore.
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May 13, 2013 05:22
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Liar Named Jesus posted:Meanwhile, we're getting blood from this dog who is obviously in pain but instead of being ferocious or angry in any way, she's licking my chin while I'm restraining her. This has pretty much been my experience in the exam room with every pitbull ever when I was a kennel assistant a couple years back. Whenever someone came in with a chihuahua on the other hand I'd be like "hey, laundry's done gotta go!" I'm really glad I didn't have to deal with any GSW cases. I'm not terribly squeamish but human-on-animal violence gets to me. Hell even euthanasia tears me up so I have huge respect for you vets who have to keep your composure while actually doing the deed.
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May 13, 2013 07:59
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sat. posted:This has pretty much been my experience in the exam room with every pitbull ever when I was a kennel assistant a couple years back. Whenever someone came in with a chihuahua on the other hand I'd be like "hey, laundry's done gotta go!" This. So much this. Hell, I'll even take an angry large breed over any angry ankle biter any day. Sure, they're bigger and stronger, but because they're bigger I can usually get a better hold on them and prevent myself or the vet from getting hurt. Though, I'll still take an angry ankle biter over an angry cat. I don't like loving with angry cats. It's always a less is more scenario, which is fine, but in my experience it's more difficult to predict what a cat is going to do than a dog. And when your job is basically, "You get bit before the vet does. If the vet gets bit, you'll probably be fired because you're not doing your job." At least, that was the spiel I got when I worked in a corporate run clinic as a KA. sat. posted:Hell even euthanasia tears me up so I have huge respect for you vets who have to keep your composure while actually doing the deed. My first experience on the clinical end of euthanasia was assisting in putting down a not yet symptomatic parvo puppy. It was only my 3rd day ever working in a vet clinic, 18 years old, and it was one of the worst things ever. That memory soon got replaced by having to "play tetris" with the dead freezer. It got too full because the office hadn't done what they were supposed to for 3 weeks, and I had to take everything out and put it all back together so it fit. Not that rough, really, just kinda hosed up because of the business end of things. Oh, and that I ended up getting yelled at for not finishing my work that night because I spent over an hour rearranging the freezer. Most of my bad stories of working in vet hospitals come from one in particular that was corporate run.
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May 13, 2013 09:59
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I've learned that if you get a cat angry enough they actually start to fly.
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May 13, 2013 12:13
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