Friday, September 28, 2012

Lap of Love supporting cancer research


Sunday, September 23rd Dogs of every size, shape and breed packed up their owners and put on their best collars to walk for cancer. Some walk in memory of a beloved friend lost to cancer while others walk in celebration of survival. From teacup to ginormous, elderly to newborn, sleek to fluffy, well-behaved to the “something-to-be-desired”. Everyone was there!


The event was hosted by Petsafe Village and all proceeds go to Morris Animal Foundation. For those of you who aren’t familiar with MAF; the organization was founded in 1948 by Dr. Mark L. Morris Sr.

 Dr. Morris believed in a foundation set aside purely for animal health and welfare. He was also one of the first to use diet to control disease. He and his wife made special pet food themselves in his kitchen until they could no longer keep up with demand. He partnered with a company called Hill’s packing which later became Hill’s Science Diet. Royalties from the new business were used to fund animal nutrition studies. Today, MAF has funded over 2,000 animal health studies!

 Our own Lap of Love booth was one of many! There were animal-related businesses of all kinds, shelters, rescues, animal hospitals, agility groups, and even the University of Tennessee College of Veterinary Medicine was represented!

 The LOL booth was a popular spot, under a shady tree and next to a huge bowl of water. Pups stopped by for a drink and a treat while their owners grabbed LOL flyers, candy and enjoyed a little chit-chat.

Our goal for the event was $70,000. We had reached 51% of that goal prior to the event ($35,450). Final numbers are pending.


Read more or contact Dr. Cook: 
Jennifer Cook, DVM DABVP
Lap of Love Veterinary Hospice
Knoxville, Tennessee
drcook@lapoflove.com  |  www.lapoflove.com
Click here for Dr. Cook's Biography


Dr. Cook services the Greater Knoxville Area, including Farragut, Lenoir City, Oak Ridge, Clinton, Luttrell, Maryville, Sevierville, and Dandridge.

Sunday, September 23, 2012

Check Your Pet For Masses

Meet Lilu -my 9 yr old gray kitty that I was suckered into caring for when she was only 4 weeks old. I was a foster mom for the Humane Society of Broward County - Florida. I would take young kittens, foster them until they were 8 weeks old and then return them to the shelter for adoption. It was very difficult to give them back but I knew if I did, I could help more kittens!

Well - Lilu was the last kitten I was fostering before I left for vet school... and she stole our heart and we become foster  failures! :)  It wasn't hard for her to steal our hearts.... she did the 'Superman' on dad's chest her first night at home, and that clinched the deal!

Actual picture taken on her first night at home. She knew who to snuggle with!

Just the other day, Lilu was cleaning herself and made her way to the fat pad on her belly. So I had to rub on it - how can you resist the kitty fat pad - and that is when I felt a mass! AUGH!    Being a vet, I know what masses could be.... they may simply be fat (adipose tissue) - or possibly cancer.    So I immediately took a small sample with a needle and we found 'spindle cells'.  Unfortunately - it is not just fat.  Lilu will be having surgery Tuesday to have the mass fully removed and sent away for pathology.  And hopefully the results will show a benign type of cancer (at the same time we will take xrays of her chest to make sure nothing has spread to the lungs).

The moral of this story - is to examine all your pets at least monthly and if you feel any mass or see any weird discoloration, have your veterinarian check it out!

I will keep you posted on Lilu's surgery and pathology reports.  And you better believe that I will be booking my own consultation with our Oncologist so that I make the best decision for my little girl! Click here to read about Dr. Karri Miller


Dr. Mary Gardner
Lap of Love Veterinary Hospice - South Florida



Thursday, September 20, 2012

Laryngeal Paralysis

“What is it and how does it affect my pet?”  

The larynx is the guardian of the airways, keeping whatever we want to swallow out and directing air in. Laryngeal paralysis is a condition recognized mostly in larger, older dogs that can develop slowly over a year or more until it reaches a stage that causes significant breathing emergencies. The opening to the trachea (“wind pipe”) normally is pulled open on two sides when breathing in, and then these cartilages relax when breathing out. With laryngeal paralysis, the muscles that normally pull these open do not function properly. This means no expanding and opening of the larynx for a deep breath; the laryngeal folds simply flop weakly and flaccidly. When an affected dog breathes in, the cartilages do not pull open—rather, they are sucked into the opening, or in severe cases sucked shut. Early in the condition, this creates increased noise when they breathe (called “stridor”); later, it can completely obstruct their airway, and they can suffocate.

 The early signs of laryngeal paralysis can be quite subtle. They may be such things as a slight harshness in their panting. Very early there might be a simple voice change, usually a hoarse or raspy-sounding bark. Later, people report that they see their pet working harder to breathe, they have exercise intolerance and tire quickly, their facial expression is a bit anxious, and their chest is vigorously expanding. The pet may also look like he/she is “smiling” when they pant, with their lips pulled way back.

Because animals use their breathing as a means to cool themselves naturally, laryngeal paralysis patients are more prone to heatstroke under conditions that would not make a normal dog hot. This may be a simple walk outside on a sunny day or vigorous play on a cool day. When the paralysis is quite pronounced, it is very obvious that the animal is really working to breathe. The extra noise they create with each breath is harsh and easy to hear. Their tongue may be a darker red purple or blue. They are in “respiratory distress” and need medical assistance. Ironically, the airway compromise gets worse when they breathe harder, similar to asthma. Fast-moving air will suck the airway shut, while slow moving air will pass more easily. But the feeling of “air hunger” is a powerful drive, and will make an animal try to breathe harder. Additionally, some dogs will trigger their own crisis by simply barking. The vocal cords are in the larynx; when the dog tries to bark, they contract other neck muscles and narrow their airway and may incite a distress episode.

 Medical care during a breathing crisis often entails oxygen therapy, external cooling, sedation to take the anxiety away, and possibly intubation and artificial respiration for a short period. Unfortunately, most patients that have reached a crisis point will continue to suffer these breathing episodes because their airway is ineffective.

“Can we treat this problem?”

After your veterinarian confirms that your pet has laryngeal paralysis (the vocal cords are observed under light sedation to monitor if they are moving correctly, and sometimes a drug is given to stimulate breathing to see if the folds move properly during the exam) then you and your veterinarian have to decide when and if to do surgery to “fix” the problem without causing worse problems. The reason they confirm the diagnosis is to make sure the pet doesn’t have a problem that similarly interferes with breathing such as collapsing trachea or a laryngeal or tracheal tumor.

Laryngeal paralysis is a problem of anatomy. The anatomy is interfering with the airflow necessary for breathing. Ironically, the larynx is also responsible for protecting the airway and lungs from fluids and food that should only go down the esophagus into the stomach. So, the correction is simply to move or remove the interfering anatomy without causing any new problems with airway protection.

Image courtesy of the Animal Surgical Clinic of Seattle

Many different approaches have been used to surgically treat laryngeal paralysis. Most veterinarians feel that out of the list of surgical procedures with good success and few complications, the Unilateral Cricoarytenoid Lateralization or “Tieback” is the best choice for most patients. Perhaps newer techniques will come along with better success in the future. To minimize the chance of fluids or food entering the airway, the surgeon will only pull open one side enough to prevent airway compromise and future breathing crises.

While any surgery can have some post-op complications, the biggest concern with this surgery is aspiration of regurgitated stomach contents into the lungs resulting in mild to severe pneumonia. Dogs with chronic vomiting or regurgitation issues (including dogs with megaesophagus) are not good surgical candidates for this procedure. There is a medication called Doxepin that can be tried to improve laryngeal motion if your pet is not a surgical candidate or if you choose not to pursue surgery. Ask your veterinarian if this might be an option for your pet. 

While laryngeal paralysis and its post-operative complications can be quite severe, the majority of families living through this with their pets are happy with the quality of life that is restored with surgery. Restrictions following surgery are few; no neck collar/ leash indefinitely, minimize barking for 6 weeks, elevated feeding station indefinitely, and use of caution when swimming.

It is less and less common for aspiration pneumonia to be fatal, and patients can make a full recovery even in severe cases. The majority of patients do not suffer these complications and go on to live well with the ease of breathing restored. Good to excellent long term results are reported in 90-100% of patients. Complications (10-27%) include aspiration pneumonia (24- 25%) after excessive abduction; infection; and tearing of the tissues with subsequent laryngeal collapse. Voice change is common. Complications are less frequent with more experienced surgeons and with unilateral (versus bilateral) tieback procedure. Each patient must be considered individually though; talk through these potential complications with your veterinarian and choose the most appropriate plan for your pet. It is less and less common for aspiration pneumonia to be fatal, and patients can make a full recovery even in severe cases. The majority of patients do not suffer these complications and go on to live well with the ease of breathing restored. Good to excellent long term results are reported in 90-100% of patients. Complications (10-27%) include aspiration pneumonia (24- 25%) after excessive abduction; infection; and tearing of the tissues with subsequent laryngeal collapse. Voice change is common. Complications are less frequent with more experienced surgeons and with unilateral (versus bilateral) tieback procedure. Each patient must be considered individually though; talk through these potential complications with your veterinarian and choose the most appropriate plan for your pet.

BLOG WRITTEN BY:
Dr. Dana Lewis
Dr. Dana assists families with Pet Hospice and Euthanasia in the Raleigh North Carolina area (Raleigh, Durham, Chapel Hill and the greater Triangle, as well as Wake, Durham, Orange, and Chatham counties.)


Blog posted by:
Vet Mary Gardner

Sunday, September 16, 2012

Specialized Veterinary Communication Training for Vet Dr. Bacon


Dr. Bacon attends Pfizer Frank Veterinary Communication Training Program


As part of my training to serve as a student mentor for 2nd and 3rd year veterinary students at The University of Tennessee College of Veterinary Medicine Dr. Laura Bacon attended the Pfizer Frank Veterinary Communication Workshop on July 11, 2012.

The Pfizer Frank Veterinary Communication Program is an interactive course designed to help veterinarians improve their client communication skills. The program is based on over 30 years of medical communication research which has shown that shared decision making between client and veterinarian can improve patient outcome while also improving client satisfaction. The course is divided into specific modules and uses a variety of teaching methods, including small group interaction, simulation exercises, brainstorming, and open discussion.

I found the course to be extremely interesting and thought-provoking and I left the workshop excited to put my new skills into practice! While I know I am particularly empathetic and sympathetic for my clients, I have learned new ways to better understand my client's needs and wants and to encourage them to better express themselves. Some particular skills we worked on include the use of empathetic statements (reflecting the emotions displayed by my clients), allowing for reflective pauses to give my clients time to express themselves, and asking open-ended questions, which can also allow my clients the chance to tell their stories without being "led" in one direction or another.

After 12 years of practicing veterinary medicine (wow, has it really been that long?) I can honestly say that I am still passionate about caring for the wonderful animals in my care and the people who love them. If I can further improve my communication skills, I can better care for my furry patients, and continue to strengthen the human-animal bond.

In August, I will attend 2 more days of training and practice sessions for my mentor position at the University of Tennessee College of Veterinary Medicine. Stay tuned for future updates!

Laura Devlin Bacon DVM DABVP (Canine / Feline Practice)

Read more or contact Dr. Bacon:
Laura Devlin Bacon, DVM DABVP
Knoxville, Tennessee

Dr. Bacon assists families with pet hospice and in-home euthanasia in the Greater Knoxville Area, including Farragut, Lenoir City, Oak Ridge, Clinton, Luttrell, Maryville, Sevierville, and Dandridge.