Charlie is a 12 year old male, neutered Pug who had a routine dentistry procedure at a referring veterinarian, in Nantucket, Massachusetts on July 28th, 2017. During this procedure it was noted that there was a soft tissue mass on his lower left mandible at the site of the canine (#304). A biopsy of this mass revealed oral fibrosacroma with the possibility of amelanotic melanoma. Immunohistochemistry was performed on August 04, 2017 and confirmed malignant melanoma. A CatScan was completed on August 08, 2017, with biopsy of the tissue in question and mandible. These biopsies confirmed the presence of melanoma.
Cyberknife radiation was performed August 16, 2017. Charlie then received a series of Melanoma vaccines starting on August 18th and finishing on September 29th.
Another CatScan was performed on September 21st that showed expansile lysis of the right rostral mandible around the canine (304). Clindamycin and Metronidazole, antibiotics, were started.
In December 2017, Charlie had another CatScan and biopsy of his mandible. The histopathology revealed healthy granulation tissue in the absence of a tumor.
Danny is a 2 year old mixed breed who presented to the Hickory Emergency Service after ingesting dark chocolate covered raisins. While these are tasty treats, both chocolate and raisins are toxic to dogs!!! In the hospital we made Danny vomit but only a few of the treats were removed. Her heart rate was elevated and treatment was initiated.
Danny stayed in the hospital for 2 nights on supportive care. Chocolate’s toxic ingredient, theobromine, can cause an increased heart rate and abnormal heart rhythm – these were treated with medications. Raisins and grapes can cause kidney failure. This toxicity is treated with intravenous fluids and constant blood value monitoring. Severe cases of raisin ingestion may receive dialysis.
Fortunately, Danny recovered well from both toxicities and is back to being her normal playful self. During the holiday season keep your sweets and treats in a cabinet and away from your pets! If your pet ingests something toxic do not hesitate to call Hickory Veterinary Hospital or the Pet Poison Hotline.
Riggins is a 3 year old Nova Scotia Duck Tolling Retriever who presented to Hickory Veterinary Hospital’s emergency service for limping on all four of his limbs after playing in the snow. On initial examination all of the spaces between his toes were red, moist, and inflamed. He had a piece of rock salt stuck between his paw pads on his hind left limb.
His paws were scrubbed and cleaned. Riggins was sent home with some pain medication and recommendations to rest for 1 week. He recovered well but missed a few days playing in the snow! Keep in mind a few pet safety tips for the winter:
- Rock salt can get stuck between your dog’s toes leading to dried and cracked skin. Using dog boots will prevent this from happening.
- Cold weather can exacerbate arthritis. Take your older dogs on controlled walks during the winter months. Don’t overdo it!
- Dogs get cold just like people. If your dog is short haired or has a small body mass consider fitting your dog with a winter jacket or sweatshirt. They are functional and fashionable.
- Similar to humans dogs will shiver when they are cold. Use this as a cue to bring your pup indoors and warm them up.
- Once inside, dry your pup off with a towel and remember to clean their feet.
Wembly, currently a eight month old female Labrador Retriever was born via Cesarean section
with her nine other litter mates. Unfortunately, she was born with a congenital mid-line cleft palate involving both her hard and soft palates. Incomplete fusion of the maxillofacial structures during the 25th to 28th days of fetal development results in this cleft or abnormal communication between the oral and nasal cavities. Intrauterine insult/trauma, stress, corticosteroids, antimicrobial drugs, nutritional hormonal, viral, and toxic factors have been proposed etiologies. It can be heritable. In addition, brachycephalic breeds are predisposed. Aspiration pneumonia and a failure to thrive are common sequelae to cleft palates.
Intensive supportive care for Wembly focused on tube feeding every 2-4 hours, daily weights, and monitoring for signs of aspiration pneumonia. Her diagnostic work-up did not identify other abnormalities. At thirteen weeks of age, Wembly underwent her first surgical correction of her cleft palate. The goal of this surgery was to place an esophagostomy tube for long-term nutrition via a route that would bypass the surgical site and close the hard palate. To do so, an overlapping flap technique was successfully performed. This technique produces an off-set, lateralized suture line with reduced suture tension.
At sixteen and a half weeks of age, Wembly underwent a second surgery to close the soft palate. A bilateral bipedicle advancement flap was performed. This surgery healed well. The feeding tube was able to be removed and Wembly is currently doing well.
September Pet of the Month – Petey
Petey is a 1 year old Mastiff who was referred to Hickory Veterinary Hospital’s emergency service in July after the owner found him with two fish hooks in his lower lip. One had quite a large lure attached! Petey was just out of his owners’ site for a minute when they found that he had broken into a tackle box.
Petey was sedated and given systemic and local pain medication around the fish hooks in his lip. Both hooks were cut and extracted.
When he recovered from sedation, Petey was sent home with antibiotics and pain medications.
A cautionary “tail” to all fishermen, this occurs more frequently than you might expect, especially in the springtime! Fishing lures apparently attract and catch dogs and cats too!
August Pet of the Month – Luca
Luca is a 7 month old puppy who presented to the Emergency Service at Hickory Veterinary Hospital after overindulging on a bone! He was so excited to finish his treat that while chewing, it got stuck on his jaw.
Luca was brought to the treatment area and given a sedative to allow the staff to work inside his mouth. The bone was easily removed and Luca was able to go home with his family (without the bone).
July Pet of the Month – Bernie II Hallman
Bernie II Hallman, a 7-year old Bernese Mountain Dog presented to Hickory Veterinary Hospital’s emergency service in February 2017. This gentle giant was outside in the yard one afternoon and was unable to make it into the house. He was lethargic, unsteady on his feet and presented with severe skin disease.
Bernie II had a history of skin disease, which was difficult to resolve with treatment at home. The inpatient staff groomed his thick fur to obtain a better view of his skin, and lathered shampoo/conditioner in hopes to provide relief. A superficial skin scraping was then performed, and was positive for scabies mites. These small mites can cause extreme erythema (redness), and itching. This mite can also be transferred to the human species. Proper treatment with monthly prevention ex: Nexguard can aid in the resolution of these clinical signs.
Among other things, he had a paraprostatic cyst (fluid filled retained testicle) within his abdomen. Diagnostics such as an abdominal ultrasound were recommended, and Bernie II always sat steady with Dr. Reetz prior to going to surgery. Removal of the retained testicle was a success and Bernie II recovered well from anesthesia.
We are proud to announce that Bernie II made a great recovery with extensive care in hospital. We commemorate Bernie II’s dad for his dedication and perseverance in treating his best friend and old time companion!
September’s Pet of the Month – Rocky Burrows
Rocky, a 4 week old male domestic short hair feline, presented to Hickory Veterinary Hospital’s emergency department for a history of vomiting three times over the past 24 hours. Rocky was a new addition that was found outside the owners’ home.
There were no significant findings on examination. On taking radiographs there were radiodense foreign material in the small intestines and colon. Rocky was hospitalized and observed over the next three days monitoring the foreign material for passage through the intestinal tract. However, by day four two pebbles were not moving. Rocky underwent an abdominal exploratory surgery and enterotomy (one small hole in the intestines) where 2 small stones were removed from the small intestines.
Rocky recovered uneventfully from anesthesia and was home two days later.
Unfortunately, Rocky was a stray kitten whose ingestion of stones couldn’t be avoided however it is important to remember that all small objects can be played with and accidentally swallowed. Rocky is a sweet kitten with a strong will to survive and an amazing family that rescued him. Not only was he a joy to work with but a very patient kitten. He was even named after the rocks he ingested!
Is there anything in your home your cat can mistake for a snack?!
July’s Pet of the Month – Milhouse
Milhouse, a 2-year-old male neutered domestic shorthaired feline, presented to the emergency service with a history of eating a rubber kitchen mat, possibly 3 days prior. He was vomiting and produced pieces of rubber mat in the vomit. Milhouse had a history of eating foreign material in the past and had a gastrostomy (incision in the stomach) to remove ingestion plastic in April of 2016.
On physical exam Milhouse was 5% dehydrated with soft non-painful abdomen. Blood work was performed, including a complete blood count, chemistry, and electrolytes, and all the results were within normal limits. On abdominal radiographs the stomach was filled with foreign material. Milhouse was taken to surgery and a gastrostomy was performed. Al large number of rubber pieces were removed.
Milhouse recovered uneventfully and went home two nights after surgery.
It is important to keep a safe environment for cats. Al small objects that can be played with and accidentally swallowed should be removed. Cats need a large amount of environmental enrichment to stimulation. They benefit from cat furniture, climbers, scratchers, and a place to hide where they feel secure. Empty boxes can be a favorite. Cat climbers and walkways are commercially available. They need human playtime also. Other stimulation can come from interactive toys, food puzzles, other cats, fish aquariums, bird feeders in the window, or TV. There are even special DVDs and I-pad apps sold for feline entertainment. Cat grass grown inside may also be enjoyed.
Unfortunately cats that ingest foreign material are at risk of doing it again!
June’s Pet of the Month – Calliope Morris
Calliope Morris, a ten year-old female spayed Domestic Longhair cat, presented to the Emergency Service with a two day history of lethargy, inappropriate urination in the house, and hematuria. Her physical examination was normal with the exception of moderate gingivitis with calculi and a firm mass present in her cranial abdomen. Bloodwork (a complete blood count and serum chemistry) was unremarkable. Urinalysis revealed concentrated urine (specific gravity of 1.043) with a pH of 6.0 and increased white and red blood cells (>50 RBC/high power field (hpf) and 4-10 WBC/hpf). An aerobic bacterial urine culture demonstrated a coagulase positive Staphylococcus infection sensitive to Cefovecin (ConveniaR). Thoracic radiographs were grossly normal. Abdominal radiographs and ultrasound revealed a gastric mass (10 x 7 x 3 cm) within the stomach lumen, mildly enlarged mesenteric lymph nodes, an atrophied right kidney, and a small apical bladder mass.
After initial stabilization with intravenous fluids, famotidine and cefazolin, Calliope was scheduled for surgery. At surgery, a gastrotomy was performed to remove a large gastric trichobezoar (compacted hairball from months to years of grooming). In addition, multiple biopsies were taken from her stomach, lymph nodes, and bladder. Her biopsies results were encouraging with mild gastritis secondary to the trichobezoar, reactive/inflammatory lymph nodes, and chronic cystitis with a urinary tract infection. Calliope made a smooth recovery from surgery with two additional days of supportive care before returning home.
We are pleased to report that Calliope has fully recovered, her sutures have been removed, and she is enjoying time with her family.
April Pet of the Month – Chica
Chica a 12 week old female Havanese was presented as an emergency to Pennsylvania Veterinary Specialty and Emergency Associates at Hickory after a metal “baby gate” was accidentally knocked over and fell on her. Chica was just adopted the day prior to presentation.
Chica presented in respiratory distress with evidence of head trauma. Her mentation was depressed and owner reported noting a lateral strabismus (eye pointing in a different direction) of her right eye. Her physical exam revealed harsh lung sounds on auscultation concerning for pulmonary edema (fluid in the air spaces). On initial presentation Chica was treated with flow by oxygen as an intravenous catheter was placed. The oxygen helps increase her blood oxygen levels helping her respiratory distress as well as improving oxygen delivery to her brain aiding any decreased oxygen delivery to the brain due head trauma and tissue swelling. After an IV catheter was placed Chica was treated with methadone (opiod pain medication) and administered a bolus of hypertonic saline to treat her shock and head trauma. Hyertonic saline is a fluid that contains a larger amount of sodium (salt) making it greater tonicity then plasma which pulls fluid into the blood vessels helping restore blood volume in shock and reducing edema fluid in the tissue, this is the benefit in head trauma by causing a reduction in intra-cranial pressure (reduces brain swelling).
When Chica was deemed to be more stable, thoracic (chest) radiographs were obtained (please see pictures). The radiographs confirmed pulmonary edema, the pattern was most consistent with non-cardiogenic (meaning not due to heart failure) pulmonary edema secondary to head trauma. What occurs with head trauma, is there is a massive sympathetic stimulation (fight or flight response) which causes a drastic elevation in the pressure within the blood vessels of the lungs. This rise in pressure causes fluid to leak out of the vessels in the lung and into the airspaces. This is the cause of Chica’s respiratory distress.
Chica was admitted to the hospital for ongoing therapy. Her treatment regimen included oxygen supplementation, IV fluids with dextrose (intravenous sugar), and a low dose continuous infusion of the diuretic furosemide. Furosemide is a diuretic generally used to treat congestive heart failure by causing the body the expell excessive fluid accumulating in the lungs through the kidneys. It can be used to treat non-cardiogenic pulmonary at lower doses cause it stimulates the cells lining the air spaces to move sodium back into the vessels, the sodium then draws fluid out of the airspaces with it. Furosemide also causes some vasodilation of the blood vessels in the lungs reducing the excessive pressure making it easier for fluid to flow out of the airspaces back into the vessels.
Chica was hospitalized for several days, as she gradually but continually improved. Chica remained on supplemental oxygen until the edema fluid in the lungs improved enough that she could oxygenate normally without supplementing her. Chica was hospitalized for a total of four days and was on oxygen for 3 out of those 4 days. The final 24 hours she was closely monitored to insure that she was eating and drinking normally as well as breathing normally without oxygen supplementation.
Diesel Boland, a six month old, male neutered domestic shorthair presented to Hickory Veterinary Hospital with a four day history of lethargy, anorexia, and projectile vomiting. Two months prior, he had been treated for Coccidia and roundworms. His initial physical examination, bloodwork and abdominal radiographs revealed a moderately dehydrated kitten with an intestinal mass causing a complete obstruction. Abdominal ultrasound confirmed that this intestinal mass was a jejunal intussusception. Supportive care consisting of intravenous fluids, antibiotics and analgesics was instituted prior to emergency surgery. At surgery, a midjejunal intussusception was identified and manually reduced. A preventative procedure, enteroplication, was completed to stabilize adjacent bowel segments and minimize the potential for recurrence. Diesel was hospitalized for an additional forty-eight hours, during which time his clinical signs resolved, and his appetite returned. Prior to discharge from the hospital, a fecal analysis revealed roundworms; Diesel was dewormed accordingly. Two weeks after surgery, Diesel’s sutures were removed. He has returned to normal and enjoys his leisure time at home.
Intestinal intussusceptions are a telescoping of one segment of bowel, the intussusceptum, into an outer bowel segment known as the intussuscipiens. This situation quickly creates an intestinal obstruction and progressive devitalization of affected intestine. Intussusceptions can be single, multiple or double and are typically oriented in the direction of peristalsis. The most common intussusceptions, as described by their intestinal location, are ileocolic and jejunojejunal ones. They are more common in dogs and younger patients less than one year of age. The German Shepard and Siamese are at increased risk of this disease. Intussusceptions are thought to result from any pathology that creates altered intestinal motility. In young animals, intestinal parasites, parvoviral infections and foreign bodies have been precursors to intussusceptions. In older patients, intestinal tumors have been implicated. Surgical intervention is necessary to manually reduce the intussusception or resect the devitalized intestine prior to preventative enteroplication.
We are glad that Diesel’s problems are resolving, and he is doing well!
Buddy a 5yo male neutered Standard Poodle was evaluated by the emergency service at Hickory Veterinary Hospital on a Friday night with a history of vomiting and possible foreign body. Buddy had been hospitalized at a veterinary hospital in North Carolina for vomiting. There was concern of a potential foreign body causing an obstruction and evaluation for surgery was recommended. Buddy is originally from our area and his owners elected to return home with Buddy and have him evaluated at Hickory Veterinary Hospital.
On presentation Buddy was bright and alert, the only physical exam abnormality was dehydration. There was a history of vomiting which started after Buddy was playing on a beach in North Carolina. There were no medical records (diagnostics such as blood work, radiographs (X-rays), or treatments) available to the emergency doctor, as such a diagnostic work up was recommended, which included radiographs and blood work.
Radiographs of Buddy’s abdomen (stomach area) were obtained in addition to his thorax (chest). The radiographs of his abdomen were taken to try to determine the cause of his vomiting such as a foreign body. Thoracic radiographs were obtained due to concern for potential aspiration (the act of inhaling gastric contents into the lungs). The thoracic radiographs did reveal evidence of aspiration pneumonia. The abdominal radiographs revealed distension of his stomach with radiopaque (visible on radiographs) material which was very consistent with the administration of barium (a contrast substance administered to animals to help with the detection of foreign body obstructions). A definitive foreign body was not seen. A consultation with a radiologist was requested by the emergency doctor that confirmed the aspiration pneumonia as well of distension of the stomach but no obvious foreign body. Although there were no medical records available on Buddy it seemed possible that the veterinarian in North Carolina had administered barium to Buddy to confirm the presence of a foreign body. The recommendation was made to hospitalize, rehydrate (give intravenous fluids), and treat his aspiration pneumonia with the plan to re-evaluate the radiographs the following morning.
The next morning, the veterinarian in North Carolina informed us that Buddy was not given any barium (contrast material). The veterinarian also advised us that beach sand in North Carolina can be visible on radiographs. The repeat radiographs that morning revealed that the material had not moved from Buddy’s stomach. The recommendation was made to take Buddy for an exploratory surgery.
Buddy was taken to surgery that day, and what was found was a stomach full of rock hard sand that was causing an obstruction to contents flowing out of his stomach. An incision was made into Buddy’s stomach and all sand was removed. Buddy recovered well from anesthesia and improved from his aspiration pneumonia. He was discharged home to his owners about 48 hours after surgery.
Lesson learned, do not allow your dog to eat sand at the beach and sand in North Carolina can be mistaken for contrast material on an abdominal radiograph.
Dragon, a 3-year-old male shorthair guinea pig, first presented in December of 2014 for evaluation of a mass that started growing a few months prior. The mass was on the back of the neck near the spine and measured 2 cm. It was round and freely movable. An aspirate was sent for evaluation by a pathologist. Results showed a lipoma with infiltration of inflammatory cells. The client elected not treat at the time because it was benign and did not seem to be interfering with Dragon’s comfort.
His owner brought him back in January of 2016. His mass had increased to 5 cm and had begun to ulcerate a few days prior. There was serosanguinous discharge from the ulcerated mass. Removal was recommended due to risk of infection and overall decreased comfort secondary to the increased size. Dragon was started on Trimethoprim Sulfa liquid, an antibiotic, in case of infection starting in the ulcerated mass.
Dragon presented for surgery a few weeks later. He was anesthetized with isoflurane gas anesthesia. The mass was removed using cautery and blunt dissection. The incision was closed with a combination of subcutaneous and skin sutures. Dragon was prescribed and administered Buprenorphine and Meloxicam to manage pain associated with surgery. He started eating as soon as he was awake from anesthesia and went home later the same day. He was discharged with Meloxicam (oral) to help with any post-operative pain. Histopathology confirmed that the mass was a spindle cell lipoma and removal should be curative. his owner notes he is doing well at home and continues to heal. He has a lot more energy and is jumping now that he does not have the extra weight on the back of his neck!
Rico is an active, soccer playing, 13 year old Yorkie that loves to be part of his family’s activities. To his family’s horror, Rico was attacked by another dog, and suffered such severe injuries to his right front leg, that it had to be amputated.
Malibu came to us as a 9 1/2 week old, female, Brittany Spaniel. She was up-to-date on her vaccines; she was eating and drinking well, and was acting like a healthy puppy. One night, her owners notice that she was breathing just a little louder than normal. The next morning Malibu was in real trouble! She could hardly catch her breath and was turning blue!
Malibu was rushed to our hospital and brought back to the emergency treatment area for immediate evaluation by a veterinarian. Within minutes an X-Ray showed an abnormality inside Malibu’s trachea (wind pipe). In less than 30 minutes from when Malibu walked through the doors at Hickory Veterinary Hospital, our Emergency and Surgical teams had placed Malibu under anesthesia and were performing a tracheoscopy (the process of using a fiber optic camera to look inside her trachea, using the same equipment human doctors would use on you!). To everyone’s surprise, we found a big mass in the middle of her trachea!
Frankie and Lulu
Frankie and Lulu are two patient celebrities of our hospital. Yes Celebrities!
Frankie and Lulu have just authored their first book “A Canine’s Guide to the Good Life” with their silent partner Donna Cavanagh. These canine beauties have a world of knowledge and experience to share with young canine companions everywhere looking to adopt the right family.
Ninja and Eevee Baron
Ninja and Eevee, Yorkshire terrier littermates were born in December 2014. They presented for surgical extraction of retained deciduous teeth, which were found during their puppy exams. Puppies normally have 28 deciduous (baby) teeth that erupt during the first 6 months of life. The roots of the deciduous teeth resorb in order for the teeth to become loose and fall out. This allows the permanent teeth to erupt normally. Adult dogs have 42 permanent teeth.
If deciduous (baby) teeth don’t fall out to make way for the permanent teeth, they are called retained deciduous teeth and should be extracted surgically. If not removed soon after discovery they can cause dental problems – such as overcrowding in the mouth, plaque buildup, malocclusion and other problems.
It is much easier to position the permanent (adult) tooth while it is erupting, therefore if the retained deciduous tooth is extracted early enough the adult tooth usually will move to its correct position. And this is the case with Eevee and Ninja, there owners scheduled surgical extraction soon after discovery, they can look forward to healthy Yorkie mouths for years to come!!
Marley is a 6 month old female intact Chihuahua who was recently adopted by a loving family with two rescue dogs. Marley’s canine siblings are much larger in stature and love climbing on the jungle gym and going down the slides in the back yard. Unfortunately, Marley was not too keen of the idea and jumped off the jungle gym! She landed with a cry 6 feet below and could no longer bare weight on her right front leg! Her family rushed her to the emergency room at Hickory Veterinary Hospital. Where Marley received pain relief medication and subsequent radiographs diagnosed a fracture of her radius and ulna, the two parallel bones that make up the forearm. Due to the location, splinting alone would not provide sufficient stability for the fractures to heal, little Marley needed surgery.
Marley met with the Hickory surgery department the next day. She was placed under general anesthesia and a metal bone plate, just the right size for a small Chihuahua, was carefully fitted and secured with eight screws to her radius. The approach to her radius was closed and a post-operative splint bandage was placed to lend support as Marley’s bones began to heal. Marley was able to go home the very next day with strict limitations to her adventures for the next several weeks. Marley was thrilled to be back with her two canine siblings and her one very special human sister!
Our young aerodynamic patient will return in 10 days for splint removal and recheck radiographs to monitor healing, plus lots of love from the Hickory Veterinarians and staff! By the middle of Summer Marley will be back in action, with all four healthy legs on the ground!
Picasso, a 7 year old Australian Shepherd dog, presented to Hickory Veterinary Hospital for sudden left hind leg lameness. Radiographs (pictures) and palpation of his left hind leg diagnosed Picasso with a torn cranial cruciate ligament (ACL tear is athletes), which is one of the support bands in Picasso’s knee that helps to keep it stable. Picasso had Tibial Plateau Leveling Osteotomy (TPLO), which uses a special bone plate and small screws to help create a new more secure and stable knee joint for Picasso. The pup recovered great from his surgery and he even got to spend some time recovering with exercises in an underwater treadmill! He is back to running, jumping and being an active Australian Shepherd dog!
“Skippy” Loughrey-Roccia, a 12 year old male castrated Jack Russell Terrier, presented to Hickory Veterinary Hospital’s surgical service in August 2014 for the evaluation of a very large mass on the top of his head that had been presented for the last 4 years. The mass was initially small, but had greatly increased in size over time. The mass had become so large, that it began to cover his eyes, impeding his ability to see.
“Skippy” underwent surgical removal of the large mass and did well under general anesthesia. He recovered well and was discharged to his owner later that day. Over the following three weeks, “Skippy” continued to recover and his sutures were removed. He has continued to do well, and is back to begin a happy energetic dog!
Helping and healing for over 75 years.
Hickory Veterinary Hospital was founded in 1956 as a team of professionals committed to excellence in animal care. Our continued goal is to deliver the highest quality of veterinary medicine to our patients.